Two Case Studies of Highly Insoluble Plutonium Inhalation with Implications for Bioassay

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

Carbaugh, Eugene H.; La Bone, Thomas R.

2003-01-01

Two well-characterized Pu inhalation cases show some remarkable similarities between substantially different types of Pu oxide. The circumstances of exposure, therapy, bioassay data, chemical solubility studies, and dosimetry associated with these cases suggests taht highly insoluble Pu may be more common than previously thought, and can pose significant challenges to bioassay programs.

Phenylpropanolamine and cerebral hemorrhage

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

McDowell, J.R.; LeBlanc, H.J.

1985-05-01

Computerized tomography, carotid angiograms, and arteriography were used to diagnose several cases of cerebral hemorrhage following the use of phenylpropanolamine. The angiographic picture in one of the three cases was similar to that previously described in association with amphetamine abuse and pseudoephedrine overdose, both substances being chemically and pharmacologically similar to phenylpropanolamine. The study suggests that the arterial change responsible for symptoms may be due to spasm rather than arteriopathy. 14 references, 5 figures.

26 CFR 53.4945-4 - Grants to individuals.

Code of Federal Regulations, 2010 CFR

2010-04-01

... cases of grantees whose study at an educational institution does not involve the taking of courses but... individual for travel, study, or other similar purposes by such individual unless the grant satisfies the... travel, study, or other similar purposes is not a “taxable expenditure” only if: (a) The grant is awarded...

26 CFR 53.4945-4 - Grants to individuals.

Code of Federal Regulations, 2012 CFR

2012-04-01

... cases of grantees whose study at an educational institution does not involve the taking of courses but... individual for travel, study, or other similar purposes by such individual unless the grant satisfies the... travel, study, or other similar purposes is not a “taxable expenditure” only if: (a) The grant is awarded...

26 CFR 53.4945-4 - Grants to individuals.

Code of Federal Regulations, 2013 CFR

2013-04-01

... cases of grantees whose study at an educational institution does not involve the taking of courses but... individual for travel, study, or other similar purposes by such individual unless the grant satisfies the... travel, study, or other similar purposes is not a “taxable expenditure” only if: (a) The grant is awarded...

26 CFR 53.4945-4 - Grants to individuals.

Code of Federal Regulations, 2011 CFR

2011-04-01

... cases of grantees whose study at an educational institution does not involve the taking of courses but... individual for travel, study, or other similar purposes by such individual unless the grant satisfies the... travel, study, or other similar purposes is not a “taxable expenditure” only if: (a) The grant is awarded...

26 CFR 53.4945-4 - Grants to individuals.

Code of Federal Regulations, 2014 CFR

2014-04-01

... cases of grantees whose study at an educational institution does not involve the taking of courses but... individual for travel, study, or other similar purposes by such individual unless the grant satisfies the... travel, study, or other similar purposes is not a “taxable expenditure” only if: (a) The grant is awarded...

Geothermal Case Studies

DOE Data Explorer

Young, Katherine

2014-09-30

database.) In fiscal year 2015, NREL is working with universities to populate additional case studies on OpenEI. The goal is to provide a large enough dataset to start conducting analyses of exploration programs to identify correlations between successful exploration plans for areas with similar geologic occurrence models.

Transformational change in healthcare: an examination of four case studies.

PubMed

Charlesworth, Kate; Jamieson, Maggie; Davey, Rachel; Butler, Colin D

2016-04-01

Objectives Healthcare leaders around the world are calling for radical, transformational change of our health and care systems. This will be a difficult and complex task. In this article, we examine case studies in which transformational change has been achieved, and seek to learn from these experiences. Methods We used the case study method to investigate examples of transformational change in healthcare. The case studies were identified from preliminary doctoral research into the transition towards future sustainable health and social care systems. Evidence was collected from multiple sources, key features of each case study were displayed in a matrix and thematic analysis was conducted. The results are presented in narrative form. Results Four case studies were selected: two from the US, one from Australia and one from the UK. The notable features are discussed for each case study. There were many common factors: a well communicated vision, innovative redesign, extensive consultation and engagement with staff and patients, performance management, automated information management and high-quality leadership. Conclusions Although there were some notable differences between the case studies, overall the characteristics of success were similar and collectively provide a blueprint for transformational change in healthcare. What is known about the topic? Healthcare leaders around the world are calling for radical redesign of our systems in order to meet the challenges of modern society. What does this paper add? There are some remarkable examples of transformational change in healthcare. The key factors in success are similar across the case studies. What are the implications for practitioners? Collectively, these key factors can guide future attempts at transformational change in healthcare.

[Clinical and epidemiological differences between Bordetella pertussis and respiratory syncytial virus infections in infants: a matched case control study].

PubMed

Giménez-Sánchez, Francisco; Cobos-Carrascosa, Elena; Sánchez-Forte, Miguel; López-Sánchez, María Ángeles; González-Jiménez, Yolanda; Azor-Martínez, Ernestina

2014-01-01

An increase in cases of pertussis, mainly in young infants, has been reported in the last few years. The clinical presentation of this disease is very similar to that produced by respiratory syncytial virus (RSV), which makes the diagnosis difficult. To compare the clinical and epidemiological characteristics between Bordetella pertussis and RSV infections in infants admitted to hospital. An analytical matched case-control study was conducted during the period 2008-2011. Cases were defined as infants admitted with pertussis confirmed by PCR in nasopharyngeal aspirate. Each case was matched by age, sex and date of admission to two controls defined as patients with RSV infection detected by immunochromatography in nasal aspirate. Demographic, clinical, laboratory data were compared. Seventy eight patients (26 cases of pertussis and 52 controls RSV+) were included. Sociodemographic characteristics were similar in both groups. Cases had more days of symptoms prior to admission, longer hospital stays, and increased frequency of epidemic family environment. Apnoea and cyanosis were more frequent. Cases of pertussis were more likely to have apnoea, cyanosis, and lymphocytosis while RSV infections had more frequent fever, vomiting and respiratory distress. The clinical presentations of pertussis and RSV infection are similar, but there are some characteristics that can help to distinguish between them. Copyright © 2013 Elsevier España, S.L. y Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

Are objects the same as groups? ERP correlates of spatial attentional guidance by irrelevant feature similarity.

PubMed

Kasai, Tetsuko; Moriya, Hiroki; Hirano, Shingo

2011-07-05

It has been proposed that the most fundamental units of attentional selection are "objects" that are grouped according to Gestalt factors such as similarity or connectedness. Previous studies using event-related potentials (ERPs) have shown that object-based attention is associated with modulations of the visual-evoked N1 component, which reflects an early cortical mechanism that is shared with spatial attention. However, these studies only examined the case of perceptually continuous objects. The present study examined the case of separate objects that are grouped according to feature similarity (color, shape) by indexing lateralized potentials at posterior sites in a sustained-attention task that involved bilateral stimulus arrays. A behavioral object effect was found only for task-relevant shape similarity. Electrophysiological results indicated that attention was guided to the task-irrelevant side of the visual field due to achromatic-color similarity in N1 (155-205 ms post-stimulus) and early N2 (210-260 ms) and due to shape similarity in early N2 and late N2 (280-400 ms) latency ranges. These results are discussed in terms of selection mechanisms and object/group representations. Copyright © 2011 Elsevier B.V. All rights reserved.

Assessment for Learning in Norway and Portugal: The Case of Primary School Mathematics Teaching

ERIC Educational Resources Information Center

Nortvedt, Guri A.; Santos, Leonor; Pinto, Jorge

2016-01-01

In this study, we aim to understand the forces driving assessment for learning (AfL) in primary school teaching. By applying a case study design, including the two cases of Norway and Portugal and using mathematics teaching as an example, available policy documents and research reports are analysed to identify the differences and similarities that…

Incest indices from microsatellite genotypes of mother-child pairs.

PubMed

Wenk, Robert E

2008-02-01

Suspected incestuous paternity is encountered infrequently and investigation may be complicated by absence of the suspected father. Incest indices (IIs) can be calculated from microsatellite (STR) types of only a mother and child, but could be misleading. Therefore, the method was evaluated. Combined incest indices (CIIs) of 50 randomly mated (RM) mothers and their children were compared with those of 50 simulated incestuous (SI) mothers and their children. Each CII was calculated from 18 individual locus IIs. Combined indices were categorized as "diagnostic" (<0.010 and >100 for RM and SI cases, respectively), "indicative" (CII was directionally correct but not erroneously diagnostic), and "misleading" (>1.0 in RM and <0.01 in SI). The relative importance was determined of each of the three variables contributing to the CII. In 41 cases (41%), CIIs attained diagnostic values. Fifty-two CIIs were indicative. CIIs were misleading in 3 RM cases and 4 SI cases. The number of mother-child (M-C) STR genotype similarities was the most important determinant of CIIs. Infrequent alleles in M-C similarities were important in raising CIIs in SI. The kind of M-C genotype similarity was the least important variable. Study of 18 STR loci produces diagnostic CIIs in only two of five suspected incest cases. Study of approximately 33 independent STRs would assure that greater than 97.5 percent of cases will have diagnostic CIIs if incest occurred. Study of loci that are more informative than typical STRs would be advantageous.

Multisample adjusted U-statistics that account for confounding covariates.

PubMed

Satten, Glen A; Kong, Maiying; Datta, Somnath

2018-06-19

Multisample U-statistics encompass a wide class of test statistics that allow the comparison of 2 or more distributions. U-statistics are especially powerful because they can be applied to both numeric and nonnumeric data, eg, ordinal and categorical data where a pairwise similarity or distance-like measure between categories is available. However, when comparing the distribution of a variable across 2 or more groups, observed differences may be due to confounding covariates. For example, in a case-control study, the distribution of exposure in cases may differ from that in controls entirely because of variables that are related to both exposure and case status and are distributed differently among case and control participants. We propose to use individually reweighted data (ie, using the stratification score for retrospective data or the propensity score for prospective data) to construct adjusted U-statistics that can test the equality of distributions across 2 (or more) groups in the presence of confounding covariates. Asymptotic normality of our adjusted U-statistics is established and a closed form expression of their asymptotic variance is presented. The utility of our approach is demonstrated through simulation studies, as well as in an analysis of data from a case-control study conducted among African-Americans, comparing whether the similarity in haplotypes (ie, sets of adjacent genetic loci inherited from the same parent) occurring in a case and a control participant differs from the similarity in haplotypes occurring in 2 control participants. Copyright © 2018 John Wiley & Sons, Ltd.

Capsular synovial-like hyperplasia around mammary implants similar to detritic synovitis. A morphologic and immunohistochemical study of 15 cases.

PubMed

Hameed, M R; Erlandson, R; Rosen, P P

1995-04-01

Formation of a fibrous envelope around the implant, a so-called capsule with resultant contracture of the prosthesis, is an occasional complication of augmentation mammoplasty. The capsulectomy specimen contains mature scar tissue with mononuclear cells, histiocytes, and foreign body giant cells. We studied 15 capsulectomy specimens. Seven showed a striking form of papillary villous synovial-like hyperplasia similar to detritic synovitis, a form of proliferative synovitis caused by orthopedic prosthetic devices. There was an accompanying infiltration of the subcapsular surface by mononuclear cells, giant cells, and chronic inflammatory cells. This reaction was independent of the type of prosthetic device. In one case, foreign material consistent with polyurethane was demonstrated by histology and electron microscopy. Among eight cases without capsular synovial-like hyperplasia (CSH), two showed dense fibrous tissue with foamy macrophages, and the rest showed fat necrosis, foreign body giant cell reaction, and occasional evidence of foreign material, including silicone granulomas. We stained four of the CSH, two with silicone granulomas, and one sample with dense fibrous tissue with peanut agglutinin and antibodies against vimentin and S-100 protein. Selected cases were also stained for concanavalin A and cytokeratin. CSH stained for concanavalin A, peanut agglutinin, and vimentin but was negative for cytokeratin. Our cases showed a striking similarity in the staining pattern of CSH, detritic synovitis, and normal synovium. We conclude that CSH of the mammary prosthetic capsule is pathophysiologically similar to proliferative synovitis.

TBIdoc: 3D content-based CT image retrieval system for traumatic brain injury

NASA Astrophysics Data System (ADS)

Li, Shimiao; Gong, Tianxia; Wang, Jie; Liu, Ruizhe; Tan, Chew Lim; Leong, Tze Yun; Pang, Boon Chuan; Lim, C. C. Tchoyoson; Lee, Cheng Kiang; Tian, Qi; Zhang, Zhuo

2010-03-01

Traumatic brain injury (TBI) is a major cause of death and disability. Computed Tomography (CT) scan is widely used in the diagnosis of TBI. Nowadays, large amount of TBI CT data is stacked in the hospital radiology department. Such data and the associated patient information contain valuable information for clinical diagnosis and outcome prediction. However, current hospital database system does not provide an efficient and intuitive tool for doctors to search out cases relevant to the current study case. In this paper, we present the TBIdoc system: a content-based image retrieval (CBIR) system which works on the TBI CT images. In this web-based system, user can query by uploading CT image slices from one study, retrieval result is a list of TBI cases ranked according to their 3D visual similarity to the query case. Specifically, cases of TBI CT images often present diffuse or focal lesions. In TBIdoc system, these pathological image features are represented as bin-based binary feature vectors. We use the Jaccard-Needham measure as the similarity measurement. Based on these, we propose a 3D similarity measure for computing the similarity score between two series of CT slices. nDCG is used to evaluate the system performance, which shows the system produces satisfactory retrieval results. The system is expected to improve the current hospital data management in TBI and to give better support for the clinical decision-making process. It may also contribute to the computer-aided education in TBI.

Extending 'Deep Blue' aerosol retrieval coverage to cases of absorbing aerosols above clouds: sensitivity analysis and first case studies

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

Sayer, Andrew M.; Hsu, C.; Bettenhausen, Corey

Cases of absorbing aerosols above clouds (AAC), such as smoke or mineral dust, are omitted from most routinely-processed space-based aerosol optical depth (AOD) data products, including those from the Moderate Resolution Imaging Spectroradiometer (MODIS). This study presents a sensitivity analysis and preliminary algorithm to retrieve above-cloud AOD and liquid cloud optical depth (COD) for AAC cases from MODIS or similar

Case Selection via Matching

ERIC Educational Resources Information Center

Nielsen, Richard A.

2016-01-01

This article shows how statistical matching methods can be used to select "most similar" cases for qualitative analysis. I first offer a methodological justification for research designs based on selecting most similar cases. I then discuss the applicability of existing matching methods to the task of selecting most similar cases and…

Differentiation of African components of ancestry to stratify groups in a case-control study of a Brazilian urban population.

PubMed

Silbiger, Vivian N; Hirata, Mario H; Luchessi, Andre D; Genvigir, Fabiana D V; Cerda, Alvaro; Rodrigues, Alice C; Willrich, Maria A V; Arazi, Simone S; Dorea, Egidio L; Bernik, Marcia M S; Faludi, Andre A; Bertolami, Marcelo C; Santos, Carla; Carracedo, Angel; Salas, Antonio; Freire, Ana; Lareu, Maria Victoria; Phillips, Christopher; Porras-Hurtado, Liliana; Fondevila, Manuel; Hirata, Rosario D C

2012-06-01

Balancing the subject composition of case and control groups to create homogenous ancestries between each group is essential for medical association studies. We explored the applicability of single-tube 34-plex ancestry informative markers (AIM) single nucleotide polymorphisms (SNPs) to estimate the African Component of Ancestry (ACA) to design a future case-control association study of a Brazilian urban sample. One hundred eighty individuals (107 case group; 73 control group) self-described as white, brown-intermediate or black were selected. The proportions of the relative contribution of a variable number of ancestral population components were similar between case and control groups. Moreover, the case and control groups demonstrated similar distributions for ACA <0.25 and >0.50 categories. Notably a high number of outlier values (23 samples) were observed among individuals with ACA <0.25. These individuals presented a high probability of Native American and East Asian ancestral components; however, no individuals originally giving these self-described ancestries were observed in this study. The strategy proposed for the assessment of ancestry and adjustment of case and control groups for an association study is an important step for the proper construction of the study, particularly when subjects are taken from a complex urban population. This can be achieved using a straight forward multiplexed AIM-SNPs assay of highly discriminatory ancestry markers.

Solitary Fibrous Tumor of Retromolar Pad; a Rare Challenging Case

PubMed Central

Lotfi, Ali; Mokhtari, Sepideh; Moshref, Mohammad; Shahla, Maryam; Atarbashi Moghadam, Saede

2017-01-01

Solitary fibrous tumor has a wide spectrum of histopathologic features and many tumors show similar microscopic features. This similarity poses diagnostic challenges to the pathologists and immunohistochemical analysis is required in many cases. Moreover, it is a rare entity in orofacial region which consequently would make its diagnosis more challenging in oral cavity. The knowledge of various microscopic patterns of this tumor contributes to a proper diagnosis and prevents unnecessary treatment. This study reports a case of solitary fibrous tumor in the retromolar pad area and discusses its various histological features and differential diagnoses. PMID:28620640

Risk factors for neural tube defects in Riyadh City, Saudi Arabia: Case-control study.

PubMed

Salih, Mustafa A M; Murshid, Waleed R; Mohamed, Ashry Gad; Ignacio, Lena C; de Jesus, Julie E; Baabbad, Rubana; El Bushra, Hassan M

2014-01-01

Both genetic and non-genetic environmental factors are involved in the etiology of neural tube defects (NTD) which affect 0.5-2/1000 pregnancies worldwide. This study aimed to explore the risk factors for the development of NTD in Saudi population, and highlight identifiable and preventable causes. Similar studies are scarce in similar populations ofthe Arabian Peninsula and North Africa. This is an unmatched concurrent case-control study including NTD cases born at King Khalid University Hospital, Riyadh during a 4-year period (2002-2006). The case-control study included 25 cases and 125 controls (case: control ratio of 1:5). Years of formal education, employment, household environment (including availability of air conditioning) and rate of parental consanguinity did not differ between mothers of cases and controls. Significantly higher proportion of mothers of cases had history of stillbirth compared to control mothers (16% vs 4.1%, P=0.02). Also family history of hydrocephalus and congenital anomalies were more prevalent in cases than controls (P values=0.0000 and 0.003, respectively). There was significant protective effect of periconceptional folic acid consumption both prior to conception (OR 0.02, 95% CI 0.00-0.07) and during the first 6 weeks of conception (OR 0.13, 95% CI 0.04-0.39). Further research, including a larger cohort, is required to enable ascertainment of gene-nutrient and gene environment interactions associated with NTD in Saudi Arabia.

13 CFR 134.609 - What is the difference between a fee and an expense?

Code of Federal Regulations, 2010 CFR

2010-01-01

... connection with your case. An expense is the cost to you of any study, analysis, engineering report, test, project, or similar matter prepared in connection with your case. ... ADMINISTRATION RULES OF PROCEDURE GOVERNING CASES BEFORE THE OFFICE OF HEARINGS AND APPEALS Implementation of the...

Multiple Intelligences and the Artistic Imagination: A Case Study of Einstein and Picasso.

ERIC Educational Resources Information Center

Newbold, Clair T.

1999-01-01

Argues that Albert Einstein and Pablo Picasso possessed similar artistic thought processes, maintaining that their influential discoveries (relativity theory and cubist painting), which launched 20th-century modernism, were amazingly similar in concept. (SR)

Derivation of Aerosol Profiles for MC3E Convection Studies and Use in Simulations of the 20 May Squall Line Case

NASA Technical Reports Server (NTRS)

Fridlind, Ann M.; Li, Xiaowen; Wu, Di; van Lier-Walqui, Marcus; Ackerman, Andrew S.; Tao, Wei-Kuo; McFarquhar, Greg M.; Wu, Wei; Dong, Xiquan; Wang, Jingyu;

Perspectives of rural and remote primary healthcare services on the meaning and goals of clinical governance.

PubMed

Kwedza, Ruyamuro K; Larkins, Sarah; Johnson, Julie K; Zwar, Nicholas

2017-10-01

Definitions of clinical governance are varied and there is no one agreed model. This paper explored the perspectives of rural and remote primary healthcare services, located in North Queensland, Australia, on the meaning and goals of clinical governance. The study followed an embedded multiple case study design with semi-structured interviews, document analysis and non-participant observation. Participants included clinicians, non-clinical support staff, managers and executives. Similarities and differences in the understanding of clinical governance between health centre and committee case studies were evident. Almost one-third of participants were unfamiliar with the term or were unsure of its meaning; alongside limited documentation of a definition. Although most cases linked the concept of clinical governance to key terms, many lacked a comprehensive understanding. Similarities between cases included viewing clinical governance as a management and administrative function. Differences included committee members' alignment of clinical governance with corporate governance and frontline staff associating clinical governance with staff safety. Document analysis offered further insight into these perspectives. Clinical governance is well-documented as an expected organisational requirement, including in rural and remote areas where geographic, workforce and demographic factors pose additional challenges to quality and safety. However, in reality, it is not clearly, similarly or comprehensively understood by all participants.

To Your Health: NLM update transcript - Why US diplomats in Cuba became ill

MedlinePlus

... Havana embassy. Most of the diplomats in the case study were assessed from five to seven months after ... over the course of months, and, in many cases, after receiving rehabilitative therapies' (end of quote). Similarly, the study's three authors explain most of the impacted workers ...

Site-Based Leadership: Extrapolating from Small Business to Charter Schools

ERIC Educational Resources Information Center

Arbisi Little, Joan

2012-01-01

Using a participant-observer perspective, this comparative case study sought to identify similarities between business and education to contribute to charter school training, leadership development, and school reform. This inquiry is a qualitative comparative case study using a participant observer perspective presented in a scholarly personal…

Investigation of the safety effects of knee bolster air bag deployment in similar real-world crash comparisons.

PubMed

Weaver, Ashley A; Loftis, Kathryn L; Stitzel, Joel D

2013-01-01

The lower extremity is the most frequently injured body region and knee-thigh-hip (KTH) injuries account for half of these injuries. Knee bolster air bags (KBABs) have been incorporated in some vehicles to serve as an additional restraint for the occupant's knees and reduce KTH injuries. To investigate the safety benefits of KBABs, similar frontal crashes with opposing KBAB deployment were selected from the Crash Injury Research and Engineering Network (CIREN) database. An 8-point similarity scoring algorithm was used to quantify crash and occupant similarity and select case comparisons. A total of 183 cases without a KBAB were scored for similarity to 9 KBAB cases. These similarity scores were used to select 31 final case comparisons. The effect of KBAB deployment on occupant injury patterns was investigated with a particular focus on KTH injuries. Over half of the occupants exposed to a KBAB sustained no KTH injuries and a reduction in femur fractures was observed in KBAB occupants (P = .036). However, increases in proximal tibia/fibula and foot/ankle fractures were observed in KBAB occupants (P = .022 and .002, respectively). Mildly significant decreases in pelvic fractures and Abbreviated Injury Scale (AIS) 2+ head injuries were observed in the KBAB occupants, supporting the notion that KBABs reduce forward occupant excursion (P = .094 and .055, respectively). Investigation of each case comparison yielded further insight into the reasons for injury pattern differences between cases with opposing KBAB deployment. In addition to KBAB deployment status, differences in occupant factors (age, height, and weight) and crash factors (delta V and belt use) between the cases for a particular comparison could explain variation in injury patterns. The current study presents a preliminary in-depth qualitative and quantitative assessment of KBAB safety benefits. However, further investigation is recommended to provide conclusive evidence of KBAB effectiveness.

Structural parallels between terrestrial microbialites and Martian sediments: are all cases of `Pareidolia'?

NASA Astrophysics Data System (ADS)

Rizzo, Vincenzo; Cantasano, Nicola

2017-10-01

The study analyses possible parallels of the microbialite-known structures with a set of similar settings selected by a systematic investigation from the wide record and data set of images shot by NASA rovers. Terrestrial cases involve structures both due to bio-mineralization processes and those induced by bacterial metabolism, that occur in a dimensional field longer than 0.1 mm, at micro, meso and macro scales. The study highlights occurrence on Martian sediments of widespread structures like microspherules, often organized into some higher-order settings. Such structures also occur on terrestrial stromatolites in a great variety of `Microscopic Induced Sedimentary Structures', such as voids, gas domes and layer deformations of microbial mats. We present a suite of analogies so compelling (i.e. different scales of morphological, structural and conceptual relevance), to make the case that similarities between Martian sediment structures and terrestrial microbialites are not all cases of `Pareidolia'.

Case management: a case study.

PubMed

Stanton, M P; Walizer, E M; Graham, J I; Keppel, L

2000-01-01

This article describes the implementation of a pilot case management program at Walter Reed Army Medical Center. I, it we discuss obvious pitfalls and problems implementing case management in a large multiservice center and the steps and processes implemented to expedite and move case management forward in its early stages. The insights shared may be useful for those implementing case management in a complex medical center situation. Other models used in similar situations are also reviewed.

Exploring ESL Teacher Beliefs and Classroom Practices of CLT: A Case Study

ERIC Educational Resources Information Center

Rahman, Mohammad Mosiur; Singh, Manjet Kaur Mehar; Pandian, Ambigapathy

2018-01-01

This paper presents a case study that investigated and compared the stated beliefs and observed classroom practices relating to Communicative Language Teaching (CLT) of two ESL teachers. The findings of the study revealed that both the teachers hold similar complex beliefs that mostly contradict the philosophy of CLT. The practices were not in…

Learning from Multiple Cases: A New Paradigm for Investigating the Effects of Clinical Experience on Knowledge Restructuring and Knowledge Acquisition.

ERIC Educational Resources Information Center

Boshuizen, Henny P. A.; Bongaerts, Maureen Machiels; van de Wiel, Margaretha W. J.; Schmidt, Henk G.

The effects of experience with a series of similar cases on the knowledge restructuring and learning from text were studied in a longitudinal design. Two groups of fourth-year medical students were confronted with a series of cases, part of them having the same underlying disease. The cases were interspersed with fillers, and each set of cases had…

Integrating Equity in a Public Health Funding Strategy.

PubMed

Joseph, Kristy T; Rice, Ketra; Li, Chunyu

2016-01-01

Equity can be valuable to guide decision makers about where to target funds; however, there are few studies for modeling vertical equity in public health program funding strategies. This case study modeled vertical equity in the funding strategy of the Centers for Disease Control and Prevention's Colorectal Cancer Control Program. To integrate vertical equity by using historical funding and health data, we (a) examined the need for colorectal cancer screening, (b) conducted multiple regressions to examine the relationship between factors of need and funding of states, (c) stratified states into similar need groups, (d) estimated vertical equity within groups, and (e) assessed equity in the funding distribution. Certain states with similar needs had high relative funding, whereas other states with similar needs had low relative funding. The methods used to integrate vertical equity in this case study could be applied in publicly funded programs to potentially minimize inequities and improve outcomes.

Supportive decision making at the point of care: refinement of a case-based reasoning application for use in nursing practice.

PubMed

DI Pietro, Tammie L; Doran, Diane M; McArthur, Gregory

2010-01-01

Variations in nursing care have been observed, affecting patient outcomes and quality of care. Case-based reasoners that benchmark for patient indicators can reduce variation through decision support. This study evaluated and validated a case-based reasoning application to establish benchmarks for nursing-sensitive patient outcomes of pain, fatigue, and toilet use, using patient characteristic variables for generating similar cases. Three graduate nursing students participated. Each ranked 25 patient cases using demographics of age, sex, diagnosis, and comorbidities against 10 patients from a database. Participant judgments of case similarity were compared with the case-based reasoning system. Feature weights for each indicator were adjusted to make the case-based reasoning system's similarity ranking correspond more closely to participant judgment. Small differences were noted between initial weights and weights generated from participants. For example, initial weight for comorbidities was 0.35, whereas weights generated by participants for pain, fatigue, and toilet use were 0.49, 0.42, and 0.48, respectively. For the same outcomes, the initial weight for sex was 0.15, but weights generated by the participants were 0.025, 0.002, and 0.000, respectively. Refinement of the case-based reasoning tool established valid benchmarks for patient outcomes in relation to participants and assisted in point-of-care decision making.

[Interest of upper digestive tract study preoperatively to prevent in patients carrying a gastric ban. About two cases].

PubMed

Preti, A; Dufleux, P-L; Advocat, A; Morin, J-P

2008-05-01

We report the case of a female patient with gastric band who had aspiration pneumonia after anaesthetic induction for a plastic surgery. In another similar case, we discovered preoperatively, oesogastric stasis with gastric strangulation. After deflation of the gastric band the anaesthetic procedure was uneventful.

Case Study Research Methodology in Nursing Research.

PubMed

Cope, Diane G

2015-11-01

Through data collection methods using a holistic approach that focuses on variables in a natural setting, qualitative research methods seek to understand participants' perceptions and interpretations. Common qualitative research methods include ethnography, phenomenology, grounded theory, and historic research. Another type of methodology that has a similar qualitative approach is case study research, which seeks to understand a phenomenon or case from multiple perspectives within a given real-world context.

Increasing Electronic Nose Recognition Ability by Laser Irradiation

NASA Astrophysics Data System (ADS)

Alejandra, Massacane; Juan, Vorobioff; Karina, Pierpauli; Norberto, Boggio; Silvia, Reich; Carlos, Rinaldi; Alfredo, Boselli; Alberto, Lamagna; Laura, Azcárate M.; Jorge, Codnia; Francisco, Manzano

2009-05-01

We present a method to increase the capability of an electronic nose to discriminate between a priori similar odours. We analyze the case of olive oil because it is well known that the characteristics of its aroma impair in many cases the discrimination between different kinds of olive oils especially when they are from similar geographic regions. In the present work we study how to improve the electronic nose performance for the above mentioned discrimination by the use of two IR laser wavelengths for vaporization.

Collection overlap in hospital health sciences libraries: a case study.

PubMed

Stroyan, S

1985-10-01

Given similar demographics (age, size, and user population), to what extent do community hospital libraries differ in collection content? It is sometimes assumed that hospital libraries are relatively homogeneous and therefore subject to standardized procedures and collection development guides. This study compares the holdings of two community hospital libraries in Illinois to determine similarities and differences.

Genetic Similarities between Compulsive Overeating and Addiction Phenotypes: A Case for "Food Addiction"?

PubMed

Carlier, Nina; Marshe, Victoria S; Cmorejova, Jana; Davis, Caroline; Müller, Daniel J

2015-12-01

There exists a continuous spectrum of overeating, where at the extremes there are casual overindulgences and at the other a 'pathological' drive to consume palatable foods. It has been proposed that pathological eating behaviors may be the result of addictive appetitive behavior and loss of ability to regulate the consumption of highly processed foods containing refined carbohydrates, fats, salt, and caffeine. In this review, we highlight the genetic similarities underlying substance addiction phenotypes and overeating compulsions seen in individuals with binge eating disorder. We relate these similarities to findings from neuroimaging studies on reward processing and clinical diagnostic criteria based on addiction phenotypes. The abundance of similarities between compulsive overeating and substance addictions puts forth a case for a 'food addiction' phenotype as a valid, diagnosable disorder.

A Case Study of Social and Media Influence on Religion

ERIC Educational Resources Information Center

Emery, Miranda Dawn

2011-01-01

This paper seeks to understand different religions and cultures by comparing and contrasting the similarities, differences, and opinions found within two religious/cultural groups. This case study uses the Social Learning Theory of communication to illustrate how perceptions of others are formed in a community with a growing Muslim population. It…

Transition from Clinical Manager to University Lecturer: A Self-Reflective Case Study

ERIC Educational Resources Information Center

Oldland, Elizabeth

2011-01-01

This paper is a case study exploring the author's use of reflective practice to facilitate the transition in role from a clinical manager with teaching responsibilities in a critical care unit to university lecturer. The similarities and differences in the roles with respect to learner characteristics, teaching contexts and effective teaching…

Academic Performance: A Case Study of Mathematics and Science Educators from Rural Washington High Schools

ERIC Educational Resources Information Center

Hancock, Tira K.

2009-01-01

A qualitative descriptive case study explored courses of action for educators and leaders of math and science educators to implement to help students achieve state assessment standard and postsecondary success. The problem focused on two demographically similar rural high schools in Southwest Washington that demonstrated inadequate rates of…

A comparison of results from two mycology laboratories for the diagnosis of onychomycosis: a study of 85 cases in a geriatric population.

PubMed

Scherer, William P; Scherer, Michael D

2004-01-01

An investigative study was performed to compare the results from two mycology laboratories for the diagnosis of onychomycosis in a geriatric population and to determine the possible pharmacologic treatments based on the two laboratories' results. In this study, 85 cases of suspected onychomycosis involving men and women 65 years and older from a nursing home setting in South Florida were used. Samples were taken from the hallux toenail and sent to two different mycology laboratories for fluorescent potassium hydroxide preparation and microscopic examination of a fungal culture. Of the 85 cases studied, the two mycology laboratories reported similar potassium hydroxide preparation results for 58.8% of the patients and similar fungal culture results for genus and species identification for 37.6% of the patients. When the potassium hydroxide preparation and fungal culture results were combined, the two mycology laboratories reported similar results for only 27.1% of the patients. As a result of the two mycology laboratories' findings, the possible US Food and Drug Administration-approved pharmacologic treatments may differ for 43.5% of the patients studied. The discrepancy between the two independent laboratories leaves physicians to question the reproducibility of fluorescent potassium hydroxide preparation and fungal culture analysis in a geriatric patient population for the diagnosis of onychomycosis.

Auditory and communicative abilities in the auditory neuropathy spectrum disorder and mutation in the Otoferlin gene: clinical cases study.

PubMed

Costa, Nayara Thais de Oliveira; Martinho-Carvalho, Ana Claudia; Cunha, Maria Claudia; Lewis, Doris Ruthi

2012-01-01

This study had the aim to investigate the auditory and communicative abilities of children diagnosed with Auditory Neuropathy Spectrum Disorder due to mutation in the Otoferlin gene. It is a descriptive and qualitative study in which two siblings with this diagnosis were assessed. The procedures conducted were: speech perception tests for children with profound hearing loss, and assessment of communication abilities using the Behavioral Observation Protocol. Because they were siblings, the subjects in the study shared family and communicative context. However, they developed different communication abilities, especially regarding the use of oral language. The study showed that the Auditory Neuropathy Spectrum Disorder is a heterogeneous condition in all its aspects, and it is not possible to make generalizations or assume that cases with similar clinical features will develop similar auditory and communicative abilities, even when they are siblings. It is concluded that the acquisition of communicative abilities involves subjective factors, which should be investigated based on the uniqueness of each case.

Shoulder dystocia--malpractice or acceptable risk?

PubMed

Skolbekken, J A

2000-09-01

In 1988 a new patient insurance system was introduced in Norway. It was initially described as an 'objectified' system, similar to one based on the no-fault principle. Early doubts were raised about the system's status, as it contains rules stating that compensation will not be given if the medical intervention is adequate and the involved risk is acceptable. This study was undertaken to examine the practice of these rules. An archival study was performed on the 41 shoulder dystocia cases that had been closed in the decade from 1988-1997. These cases were selected as shoulder dystocia was found to be the obstetrical event most often leading to a decision on acceptable risk. The most common injury in these cases was Erb's palsy, but fatalities and brain injuries were also observed. Compensation was given in nine cases, whereas it was denied due to an acceptable medical risk in the remaining cases. Indications of inconsistency among the reached decisions were found, and judged to be a result of differences of opinion between expert witnesses on the adequacy of the obstetrical practice. Doubts are raised as to whether similar decisions are reached in similar cases. Shoulder dystocia may be an acceptable risk in the sense that it is hard to predict and prevent. Whether the consequences of such a risk should be compensated, remains a political and economical issue. Present thinking leads to decisions that create a divide between the lucky unlucky and the plainly unlucky.

Derivation of aerosol profiles for MC3E convection studies and use in simulations of the 20 May squall line case

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

Fridlind, Ann M.; Li, Xiaowen; Wu, Di

Advancing understanding of deep convection microphysics via mesoscale modeling studies of well-observed case studies requires observation-based aerosol inputs. Here, we derive hygroscopic aerosol size distribution input profiles from ground-based and airborne measurements for six convection case studies observed during the Midlatitude Continental Convective Cloud Experiment (MC3E) over Oklahoma. We demonstrate use of an input profile in simulations of the only well-observed case study that produced extensive stratiform outflow on 20 May 2011. At well-sampled elevations between –11 and –23 °C over widespread stratiform rain, ice crystal number concentrations are consistently dominated by a single mode near ~400 µm in randomly oriented maximummore » dimension ( D max). The ice mass at –23 °C is primarily in a closely collocated mode, whereas a mass mode near D max ~1000 µm becomes dominant with decreasing elevation to the –11 °C level, consistent with possible aggregation during sedimentation. However, simulations with and without observation-based aerosol inputs systematically overpredict mass peak D max by a factor of 3–5 and underpredict ice number concentration by a factor of 4–10. Previously reported simulations with both two-moment and size-resolved microphysics have shown biases of a similar nature. Furthermore, the observed ice properties are notably similar to those reported from recent tropical measurements. Based on several lines of evidence, we speculate that updraft microphysical pathways determining outflow properties in the 20 May case are similar to a tropical regime, likely associated with warm-temperature ice multiplication that is not well understood or well represented in models.« less

Derivation of aerosol profiles for MC3E convection studies and use in simulations of the 20 May squall line case

NASA Astrophysics Data System (ADS)

Fridlind, Ann M.; Li, Xiaowen; Wu, Di; van Lier-Walqui, Marcus; Ackerman, Andrew S.; Tao, Wei-Kuo; McFarquhar, Greg M.; Wu, Wei; Dong, Xiquan; Wang, Jingyu; Ryzhkov, Alexander; Zhang, Pengfei; Poellot, Michael R.; Neumann, Andrea; Tomlinson, Jason M.

2017-05-01

Advancing understanding of deep convection microphysics via mesoscale modeling studies of well-observed case studies requires observation-based aerosol inputs. Here, we derive hygroscopic aerosol size distribution input profiles from ground-based and airborne measurements for six convection case studies observed during the Midlatitude Continental Convective Cloud Experiment (MC3E) over Oklahoma. We demonstrate use of an input profile in simulations of the only well-observed case study that produced extensive stratiform outflow on 20 May 2011. At well-sampled elevations between -11 and -23 °C over widespread stratiform rain, ice crystal number concentrations are consistently dominated by a single mode near ˜ 400 µm in randomly oriented maximum dimension (Dmax). The ice mass at -23 °C is primarily in a closely collocated mode, whereas a mass mode near Dmax ˜ 1000 µm becomes dominant with decreasing elevation to the -11 °C level, consistent with possible aggregation during sedimentation. However, simulations with and without observation-based aerosol inputs systematically overpredict mass peak Dmax by a factor of 3-5 and underpredict ice number concentration by a factor of 4-10. Previously reported simulations with both two-moment and size-resolved microphysics have shown biases of a similar nature. The observed ice properties are notably similar to those reported from recent tropical measurements. Based on several lines of evidence, we speculate that updraft microphysical pathways determining outflow properties in the 20 May case are similar to a tropical regime, likely associated with warm-temperature ice multiplication that is not well understood or well represented in models.

Derivation of aerosol profiles for MC3E convection studies and use in simulations of the 20 May squall line case

DOE PAGES

Fridlind, Ann M.; Li, Xiaowen; Wu, Di; ...

2017-05-15

Advancing understanding of deep convection microphysics via mesoscale modeling studies of well-observed case studies requires observation-based aerosol inputs. Here, we derive hygroscopic aerosol size distribution input profiles from ground-based and airborne measurements for six convection case studies observed during the Midlatitude Continental Convective Cloud Experiment (MC3E) over Oklahoma. We demonstrate use of an input profile in simulations of the only well-observed case study that produced extensive stratiform outflow on 20 May 2011. At well-sampled elevations between –11 and –23 °C over widespread stratiform rain, ice crystal number concentrations are consistently dominated by a single mode near ~400 µm in randomly oriented maximummore » dimension ( D max). The ice mass at –23 °C is primarily in a closely collocated mode, whereas a mass mode near D max ~1000 µm becomes dominant with decreasing elevation to the –11 °C level, consistent with possible aggregation during sedimentation. However, simulations with and without observation-based aerosol inputs systematically overpredict mass peak D max by a factor of 3–5 and underpredict ice number concentration by a factor of 4–10. Previously reported simulations with both two-moment and size-resolved microphysics have shown biases of a similar nature. Furthermore, the observed ice properties are notably similar to those reported from recent tropical measurements. Based on several lines of evidence, we speculate that updraft microphysical pathways determining outflow properties in the 20 May case are similar to a tropical regime, likely associated with warm-temperature ice multiplication that is not well understood or well represented in models.« less

Derivation of Aerosol Profiles for MC3E Convection Studies and Use in Simulations of the 20 May Squall Line Case

NASA Technical Reports Server (NTRS)

Fridlind, Ann M.; Xiaowen, Li; Wu, Di; Van Lier-Walqui, Marcus; Ackerman, Andrew S.; Tao, Wei-Kuo; McFarquhar, Greg M.; Wu, Wei; Dong, Xiquan; Wang, Jingyu;

Toward translational incremental similarity-based reasoning in breast cancer grading

NASA Astrophysics Data System (ADS)

Tutac, Adina E.; Racoceanu, Daniel; Leow, Wee-Keng; Müller, Henning; Putti, Thomas; Cretu, Vladimir

2009-02-01

One of the fundamental issues in bridging the gap between the proliferation of Content-Based Image Retrieval (CBIR) systems in the scientific literature and the deficiency of their usage in medical community is based on the characteristic of CBIR to access information by images or/and text only. Yet, the way physicians are reasoning about patients leads intuitively to a case representation. Hence, a proper solution to overcome this gap is to consider a CBIR approach inspired by Case-Based Reasoning (CBR), which naturally introduces medical knowledge structured by cases. Moreover, in a CBR system, the knowledge is incrementally added and learned. The purpose of this study is to initiate a translational solution from CBIR algorithms to clinical practice, using a CBIR/CBR hybrid approach. Therefore, we advance the idea of a translational incremental similarity-based reasoning (TISBR), using combined CBIR and CBR characteristics: incremental learning of medical knowledge, medical case-based structure of the knowledge (CBR), image usage to retrieve similar cases (CBIR), similarity concept (central for both paradigms). For this purpose, three major axes are explored: the indexing, the cases retrieval and the search refinement, applied to Breast Cancer Grading (BCG), a powerful breast cancer prognosis exam. The effectiveness of this strategy is currently evaluated over cases provided by the Pathology Department of Singapore National University Hospital, for the indexing. With its current accuracy, TISBR launches interesting perspectives for complex reasoning in future medical research, opening the way to a better knowledge traceability and a better acceptance rate of computer-aided diagnosis assistance among practitioners.

Pattern of occurrence of leukemia at a teaching hospital in eastern region of Nepal - a six year study.

PubMed

Kulshrestha, R; Sah, S P

2009-01-01

Pattern of leukemia is known to vary widely throughout the world. The characterization of distribution patterns of different subtypes of leukemia in Nepal needs further study. We wanted to study the leukemia pattern in our institute. A retrospective study of 196 cases of leukemia, diagnosed at BPKIHS, between January 1997 to December 2002 was done. We analyzed the pattern of leukemia at BPKIHS by morphological subtype, gender, age at diagnosis, time period of diagnosis (seasonality), and geographic distribution. Morphological sub typing showed that 121 cases were of acute leukemia and 75 of chronic leukemia. Chronic myeloid leukemia constituted the single largest group comprising 35.2 % of all cases, followed by acute myeloid leukemia (28.57 %) and acute lymphoid leukemia (19.9 %). Maximum numbers of cases were from the lowlands while least number of cases were from the mountain districts. Results were compared with literature from Nepal and other countries. This is the second series of leukemia from Nepal. The data published in this study reflects the leukemia pattern in the eastern region of Nepal. The pattern and distribution of AML, CML, ALL was similar to that in the developed western countries while the lesser frequency of CLL was similar to that in Southeast Asian region.

Collection overlap in hospital health sciences libraries: a case study.

PubMed Central

Stroyan, S

1985-01-01

Given similar demographics (age, size, and user population), to what extent do community hospital libraries differ in collection content? It is sometimes assumed that hospital libraries are relatively homogeneous and therefore subject to standardized procedures and collection development guides. This study compares the holdings of two community hospital libraries in Illinois to determine similarities and differences. PMID:4052675

Information about ADRs explored by pharmacovigilance approaches: a qualitative review of studies on antibiotics, SSRIs and NSAIDs

PubMed Central

Aagaard, Lise; Hansen, Ebba Holme

2009-01-01

Background Despite surveillance efforts, unexpected and serious adverse drug reactions (ADRs) repeatedly occur after marketing. The aim of this article is to analyse ADRs reported by available ADR signal detection approaches and to explore which information about new and unexpected ADRs these approaches have detected. Methods We selected three therapeutic cases for the review: antibiotics for systemic use, non-steroidal anti-inflammatory medicines (NSAID) and selective serotonin re-uptake inhibitors (SSRI). These groups are widely used and represent different therapeutic classes of medicines. The ADR studies were identified through literature search in Medline and Embase. The search was conducted in July 2007. For each therapeutic case, we analysed the time of publication, the strengths of the evidence of safety in the different approaches, reported ADRs and whether the studies have produced new information about ADRs compared to the information available at the time of marketing. Results 79 studies were eligible for inclusion in the analysis: 23 antibiotics studies, 35 NSAID studies, 20 SSRI studies. Studies were mainly published from the end of the 1990s and onwards. Although the drugs were launched in different decades, both analytical and observational approaches to ADR studies were similar for all three therapeutic cases: antibiotics, NSAIDs and SSRIs. The studies primarily dealt with analyses of ADRs of the type A and B and to a lesser extent C and D, cf. Rawlins' classification system. The therapeutic cases provided similar results with regard to detecting information about new ADRs despite different time periods and organs attacked. Approaches ranging higher in the evidence hierarchy provided information about risks of already known or expected ADRs, while information about new and previously unknown ADRs was only detected by case reports, the lowest ranking approach in the evidence hierarchy. Conclusion Although the medicines were launched in different decades, approaches to the ADR studies were similar for all three therapeutic cases: antibiotics, NSAIDs and SSRIs. Both descriptive and analytical designs were applied. Despite the fact that analytical studies rank higher in the evidence hierarchy, only the lower ranking descriptive case reports/spontaneous reports provided information about new and previously undetected ADRs. This review underscores the importance of systems for spontaneous reporting of ADRs. Therefore, spontaneous reporting should be encouraged further and the information in ADR databases should continuously be subjected to systematic analysis. PMID:19254390

Information about ADRs explored by pharmacovigilance approaches: a qualitative review of studies on antibiotics, SSRIs and NSAIDs.

PubMed

Aagaard, Lise; Hansen, Ebba Holme

2009-03-03

Despite surveillance efforts, unexpected and serious adverse drug reactions (ADRs) repeatedly occur after marketing. The aim of this article is to analyse ADRs reported by available ADR signal detection approaches and to explore which information about new and unexpected ADRs these approaches have detected. We selected three therapeutic cases for the review: antibiotics for systemic use, non-steroidal anti-inflammatory medicines (NSAID) and selective serotonin re-uptake inhibitors (SSRI). These groups are widely used and represent different therapeutic classes of medicines. The ADR studies were identified through literature search in Medline and Embase. The search was conducted in July 2007. For each therapeutic case, we analysed the time of publication, the strengths of the evidence of safety in the different approaches, reported ADRs and whether the studies have produced new information about ADRs compared to the information available at the time of marketing. 79 studies were eligible for inclusion in the analysis: 23 antibiotics studies, 35 NSAID studies, 20 SSRI studies. Studies were mainly published from the end of the 1990s and onwards. Although the drugs were launched in different decades, both analytical and observational approaches to ADR studies were similar for all three therapeutic cases: antibiotics, NSAIDs and SSRIs. The studies primarily dealt with analyses of ADRs of the type A and B and to a lesser extent C and D, cf. Rawlins' classification system. The therapeutic cases provided similar results with regard to detecting information about new ADRs despite different time periods and organs attacked. Approaches ranging higher in the evidence hierarchy provided information about risks of already known or expected ADRs, while information about new and previously unknown ADRs was only detected by case reports, the lowest ranking approach in the evidence hierarchy. Although the medicines were launched in different decades, approaches to the ADR studies were similar for all three therapeutic cases: antibiotics, NSAIDs and SSRIs. Both descriptive and analytical designs were applied. Despite the fact that analytical studies rank higher in the evidence hierarchy, only the lower ranking descriptive case reports/spontaneous reports provided information about new and previously undetected ADRs. This review underscores the importance of systems for spontaneous reporting of ADRs. Therefore, spontaneous reporting should be encouraged further and the information in ADR databases should continuously be subjected to systematic analysis.

Library Automation in Sub Saharan Africa: Case Study of the University of Botswana

ERIC Educational Resources Information Center

Mutula, Stephen Mudogo

2012-01-01

Purpose: This article aims to present experiences and the lessons learned from the University of Botswana (UB) library automation project. The implications of the project for similar libraries planning automation in sub Saharan Africa and beyond are adduced. Design/methodology/approach: The article is a case study of library automation at the…

Capacity Building through Integration and Transformational Leadership--A Case Study

ERIC Educational Resources Information Center

Stöcklin, Sacha

2011-01-01

This article suggests that educational managers can have an influence through leadership by establishing certain moderators that integrate and shape the faculty into a solid team working towards a high performing organisation. The study looks at a case in China and draws suggestions that could be used in other similar settings. The conclusion is…

Evaluating the Impact of Open Educational Resources: A Case Study

ERIC Educational Resources Information Center

Choi, Young Mi; Carpenter, Cathy

2017-01-01

This paper presents a case study of the replacement of a textbook with free to use materials in a class on Human Factors and Ergonomics. Data on exam grades, course grades, and student opinions over a total of five semesters are reported, before and after the implementation. The results show that class performance remained similar before and…

Paediatric case mix in a rural clinical school is relevant to future practice.

PubMed

Wright, Helen M; Maley, Moira A L; Playford, Denese E; Nicol, Pam; Evans, Sharon F

2017-11-29

Exposure to a representative case mix is essential for clinical learning, with logbooks established as a way of demonstrating patient contacts. Few studies have reported the paediatric case mix available to geographically distributed students within the same medical school. Given international interest in expanding medical teaching locations to rural contexts, equitable case exposure in rural relative to urban settings is topical. The Rural Clinical School of Western Australia locates students up to 3500 km from the urban university for an academic year. There is particular need to examine paediatric case mix as a study reported Australian graduates felt unprepared for paediatric rotations. We asked: Does a rural clinical school provide a paediatric case mix relevant to future practice? How does the paediatric case mix as logged by rural students compare with that by urban students? The 3745 logs of 76 urban and 76 rural consenting medical students were categorised by presenting symptoms and compared to the Australian Institute of Health and Welfare (AIHW) database Major Diagnostic Categories (MDCs). Rural and urban students logged core paediatric cases, in similar order, despite the striking difference in geographic locations. The pattern of overall presenting problems closely corresponded to Australian paediatric hospital admissions. Rural students logged 91% of cases in secondary healthcare settings; urban students logged 90% of cases in tertiary settings. The top four presenting problems were ENT/respiratory, gastrointestinal/urogenital, neurodevelopmental and musculoskeletal; these made up 60% of all cases. Rural and urban students logged similar proportions of infants, children and adolescents, with a variety of case morbidity. Rural clinical school students logged a mix of core paediatric cases relevant to illnesses of Australian children admitted to public hospitals, with similar order and pattern by age group to urban students, despite major differences in clinical settings. Logged cases met the curriculum learning outcomes of graduates. Minor variations were readily addressed via recommendations about logging. This paper provides evidence of the legitimacy of student logs as useful tools in affirming appropriate paediatric case mix. It validates the rural clinical school context as appropriate for medical students to prepare for future clinical paediatric practice.

Building a Community of Scholars: One University's Comparison of "Typical" vs. Open Ended Ethics Case Studies in First-Year Engineering

ERIC Educational Resources Information Center

Reid, Kenneth J.

2012-01-01

Ethics is among the professional skills embedded in the first year engineering curriculum in many institutions. The general format of the study of ethics is similar to many other institutions: student teams review case studies and develop written and oral presentations on the ethical issues encountered. This report investigates whether the use of…

What Really Matters in Synagogue Education: A Comparative Case Study of a Conventional School and an Alternative Program

ERIC Educational Resources Information Center

Litman, Lesley

2017-01-01

This article examines case studies of two part-time synagogue education programs, a conventional "Hebrew School" and an alternative program modeled after Jewish summer camp. Using the lens of teaching of Bible to children in Grades 3-5, the study provides insight into similarities and differences between the two types of programs and the…

Pivots - A Bottom-Up Approach to Enhance Resilience

DTIC Science & Technology

2015-12-01

similar to a business incubator) to provide entrepreneurs with tools and resources to withstand disaster. Case studies and best practices identify...Salve Regina University, 2013 Submitted in partial fulfillment of the requirements for the degree of MASTER OF ARTS IN SECURITY STUDIES ...business incubator) to provide entrepreneurs with tools and resources to withstand disaster. Case studies and best practices identify and inform models of

Estimating the Economic Impact of Higher Education: A Case Study of the Five Colleges in Berks County, Pennsylvania. Professional File Number 117, Summer 2010

ERIC Educational Resources Information Center

D'Allegro, Mary-Lou; Paff, Lolita A.

2010-01-01

Most economic impact studies are prepared by external consultants at significant cost to an individual college, a higher education state system, or a set of institutions with similar Carnegie Classifications. This case study provides a detailed framework that academic institutions may use to derive economic impact estimates without hiring external…

Reproducibility of data-driven dietary patterns in two groups of adult Spanish women from different studies.

PubMed

Castelló, Adela; Lope, Virginia; Vioque, Jesús; Santamariña, Carmen; Pedraz-Pingarrón, Carmen; Abad, Soledad; Ederra, Maria; Salas-Trejo, Dolores; Vidal, Carmen; Sánchez-Contador, Carmen; Aragonés, Nuria; Pérez-Gómez, Beatriz; Pollán, Marina

2016-08-01

The objective of the present study was to assess the reproducibility of data-driven dietary patterns in different samples extracted from similar populations. Dietary patterns were extracted by applying principal component analyses to the dietary information collected from a sample of 3550 women recruited from seven screening centres belonging to the Spanish breast cancer (BC) screening network (Determinants of Mammographic Density in Spain (DDM-Spain) study). The resulting patterns were compared with three dietary patterns obtained from a previous Spanish case-control study on female BC (Epidemiological study of the Spanish group for breast cancer research (GEICAM: grupo Español de investigación en cáncer de mama)) using the dietary intake data of 973 healthy participants. The level of agreement between patterns was determined using both the congruence coefficient (CC) between the pattern loadings (considering patterns with a CC≥0·85 as fairly similar) and the linear correlation between patterns scores (considering as fairly similar those patterns with a statistically significant correlation). The conclusions reached with both methods were compared. This is the first study exploring the reproducibility of data-driven patterns from two studies and the first using the CC to determine pattern similarity. We were able to reproduce the EpiGEICAM Western pattern in the DDM-Spain sample (CC=0·90). However, the reproducibility of the Prudent (CC=0·76) and Mediterranean (CC=0·77) patterns was not as good. The linear correlation between pattern scores was statistically significant in all cases, highlighting its arbitrariness for determining pattern similarity. We conclude that the reproducibility of widely prevalent dietary patterns is better than the reproducibility of more population-specific patterns. More methodological studies are needed to establish an objective measurement and threshold to determine pattern similarity.

Fungi as Endophytes in Artemisia thuscula: Juxtaposed Elements of Diversity and Phylogeny.

PubMed

Cosoveanu, Andreea; Rodriguez Sabina, Samuel; Cabrera, Raimundo

2018-01-27

Artemisia is a plant genus highly studied for its medicinal applications. The studies on the associated fungal endophytes are scarce. Ten plants specimens of Artemisia thuscula from Tenerife and La Palma were sampled to isolate the endophytic fungi. Identification of the endophytic fungi was based on morphology, Internal Transcribed Spacer (ITS) and Large Subunit (LSU) regions sequencing and indicates 37 fungal species affiliated to 25 fungal genera. Colonization rate varied among plants (CR = 25% to 92.11%). The most dominant colonizers found were Alternaria alternata (CF = 18.71%), Neofusicoccum sp. (CF = 8.39%) and Preussia sp. (CF = 3.23). Tendency for host specificity of most endophytic fungal species was observed. Sorensen-Dice index revealed that of 45 cases in the matrix, 27 of them were of zero similarity. Further, only one case was found to have 57% similarity (TF2 and TF7) and one case with 50% similarity (TF1 and TF4). The rest of the cases had values ranging between 11% and 40% similarity. Diversity indices like Brillouin, Margalef species richness, Simpson index of diversity and Fisher's alpha, revealed plants from La Palma with higher values than plants from Tenerife. Three nutrient media (i.e., potato dextrose agar-PDA, lignocellulose agar-LCA, and tomato juice agar-V8) were used in a case study and revealed no differences in terms of colonization rate when data was averaged. Colonization frequency showed several species with preference for nutrient medium (63% of the species were isolated from only one nutrient medium). For the phylogenetic reconstruction using the Bayesian method, 54 endophytic fungal ITS sequences and associated GenBank sequences were analyzed. Ten orders (Diaporthales, Dothideales, Botryosphaeriales, Hypocreales, Trichosphaeriales, Amphisphaeriales, Xylariales, Capnodiales, Pleosporales and Eurotiales) were recognized. Several arrangements of genera draw the attention, like Aureobasidium (Dothideales) and Aplosporella (Botryosphaeriales) which are clustered with a recent ancestor (BS = 0.97).

Judicial outcomes of child abuse homicide.

PubMed

Hewes, Hilary A; Keenan, Heather T; McDonnell, William M; Dudley, Nanette C; Herman, Bruce E

2011-10-01

To determine whether convictions and sentencing differ between child abuse homicide cases and adult homicide cases and to identify characteristics of the victim, suspect, or crime that influence conviction and sentencing results. Retrospective case review. Homicide data abstracted from the National Violent Death Reporting System in Utah. All deaths classified as homicide in Utah between January 1, 2002, and December 31, 2007. Judicial processing of homicide cases for conviction and sentencing results. Conviction rate, level of felony conviction, and severity of sentencing for suspects of child abuse homicide vs adult homicide. Utah had 373 homicide victims during the study period; 52 cases were child abuse homicide. Among 211 homicide cases with an identified suspect, conviction rates for child abuse homicide (88.2%) and adult homicide (83.0%) were similar (risk ratio, 1.0; 95% confidence interval [CI], 0.8-1.4). There were no significant differences in level of felony conviction (adjusted risk ratio, 0.8; 95% CI, 0.4-1.3) or severity of sentencing (adjusted risk ratio, 0.8; 95% CI, 0.5-1.5) for suspects of child abuse homicide vs adult homicide. Among child abuse homicide cases, no demographic factor was significantly associated with felony conviction results. Suspects of child abuse homicide are convicted at a rate similar to that of suspects of adult homicide and receive similar levels of felony conviction and severity of sentencing.

Evaluation of information-theoretic similarity measures for content-based retrieval and detection of masses in mammograms.

PubMed

Tourassi, Georgia D; Harrawood, Brian; Singh, Swatee; Lo, Joseph Y; Floyd, Carey E

2007-01-01

The purpose of this study was to evaluate image similarity measures employed in an information-theoretic computer-assisted detection (IT-CAD) scheme. The scheme was developed for content-based retrieval and detection of masses in screening mammograms. The study is aimed toward an interactive clinical paradigm where physicians query the proposed IT-CAD scheme on mammographic locations that are either visually suspicious or indicated as suspicious by other cuing CAD systems. The IT-CAD scheme provides an evidence-based, second opinion for query mammographic locations using a knowledge database of mass and normal cases. In this study, eight entropy-based similarity measures were compared with respect to retrieval precision and detection accuracy using a database of 1820 mammographic regions of interest. The IT-CAD scheme was then validated on a separate database for false positive reduction of progressively more challenging visual cues generated by an existing, in-house mass detection system. The study showed that the image similarity measures fall into one of two categories; one category is better suited to the retrieval of semantically similar cases while the second is more effective with knowledge-based decisions regarding the presence of a true mass in the query location. In addition, the IT-CAD scheme yielded a substantial reduction in false-positive detections while maintaining high detection rate for malignant masses.

Evaluation of information-theoretic similarity measures for content-based retrieval and detection of masses in mammograms

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

Tourassi, Georgia D.; Harrawood, Brian; Singh, Swatee

The purpose of this study was to evaluate image similarity measures employed in an information-theoretic computer-assisted detection (IT-CAD) scheme. The scheme was developed for content-based retrieval and detection of masses in screening mammograms. The study is aimed toward an interactive clinical paradigm where physicians query the proposed IT-CAD scheme on mammographic locations that are either visually suspicious or indicated as suspicious by other cuing CAD systems. The IT-CAD scheme provides an evidence-based, second opinion for query mammographic locations using a knowledge database of mass and normal cases. In this study, eight entropy-based similarity measures were compared with respect to retrievalmore » precision and detection accuracy using a database of 1820 mammographic regions of interest. The IT-CAD scheme was then validated on a separate database for false positive reduction of progressively more challenging visual cues generated by an existing, in-house mass detection system. The study showed that the image similarity measures fall into one of two categories; one category is better suited to the retrieval of semantically similar cases while the second is more effective with knowledge-based decisions regarding the presence of a true mass in the query location. In addition, the IT-CAD scheme yielded a substantial reduction in false-positive detections while maintaining high detection rate for malignant masses.« less

Lidar observation of transition of cirrus clouds over a tropical station Gadanki (13.45° N, 79.18° E): case studies

NASA Astrophysics Data System (ADS)

Srinivasan, M. A.; Rao, C. Dhananjaya; Krishnaiah, M.

2016-05-01

The present study describes Mie lidar observations of the cirrus cloud passage showing transition between double thin layers into single thick and single thick layer into double thin layers of cirrus over Gadanki region. During Case1: 17 January 2007, Case4: 12 June 2007, Case5: 14 July 2007 and Case6: 24 July 2007 the transition is found to from two thin cirrus layers into single geometrically thick layer. Case2: 14 May 2007 and Case3: 15 May 2007, the transition is found to from single geometrically thick layer into two thin cirrus layers. Linear Depolarization Ratio (LDR) and Back Scatter Ration (BSR) are found to show similar variation with strong peaks during transition; both LDR and Cloud Optical Depth (COD) is found to show similar variation except during transition with strong peaks in COD which is not clearly found from LDR for the all cases. There is a significant weakening of zonal and meridional winds during Case1 which might be due to the transition from multiple to single thick cirrus indicating potential capability of thick cirrus in modulating the wind fields. There exists strong upward wind dominance contributed to significant ascent in cloud-base altitude thereby causing transition of multiple thin layers into single thick cirrus.

Influence of protein formulation and carrier solution on asymmetrical flow field-flow fractionation: a case study of the plant-produced recombinant anthrax protective antigen pp-PA83.

PubMed

Palais, Caroline; Chichester, Jessica A; Manceva, Slobodanka; Yusibov, Vidadi; Arvinte, Tudor

2015-02-01

Asymmetrical flow field-flow fractionation (afFFF) was used to investigate the properties of a plant-produced anthrax toxin protective antigen, pp-PA83. The afFFF fractogram consisted of two main peaks with molar masses similar to the molecular mass of pp-PA83 monomer. afFFF carrier solutions strongly influenced the ratio and the intensity of the two main peaks. These differences indicate that conformation changes in the pp-PA83 molecule occurred during the afFFF analysis. Similar fractograms were obtained for different pp-PA83 formulations when the afFFF carrier solution and the protein formulation were the same (or very similar). The data show that in specific cases, afFFF could be used to study protein conformation and document the importance of studying the influence of the carrier solution on afFFF. © 2014 Wiley Periodicals, Inc. and the American Pharmacists Association.

Hypothesis testing in evolutionary developmental biology: a case study from insect wings.

PubMed

Jockusch, E L; Ober, K A

2004-01-01

Developmental data have the potential to give novel insights into morphological evolution. Because developmental data are time-consuming to obtain, support for hypotheses often rests on data from only a few distantly related species. Similarities between these distantly related species are parsimoniously inferred to represent ancestral aspects of development. However, with limited taxon sampling, ancestral similarities in developmental patterning can be difficult to distinguish from similarities that result from convergent co-option of developmental networks, which appears to be common in developmental evolution. Using a case study from insect wings, we discuss how these competing explanations for similarity can be evaluated. Two kinds of developmental data have recently been used to support the hypothesis that insect wings evolved by modification of limb branches that were present in ancestral arthropods. This support rests on the assumption that aspects of wing development in Drosophila, including similarities to crustacean epipod patterning, are ancestral for winged insects. Testing this assumption requires comparisons of wing development in Drosophila and other winged insects. Here we review data that bear on this assumption, including new data on the functions of wingless and decapentaplegic during appendage allocation in the red flour beetle Tribolium castaneum.

Null conformal Killing-Yano tensors and Birkhoff theorem

NASA Astrophysics Data System (ADS)

Ferrando, Joan Josep; Sáez, Juan Antonio

2016-04-01

We study the space-times admitting a null conformal Killing-Yano tensor whose divergence defines a Killing vector. We analyze the similarities and differences with the recently studied non null case (Ferrando and Sáez in Gen Relativ Gravit 47:1911, 2015). The results by Barnes concerning the Birkhoff theorem for the case of null orbits are analyzed and generalized.

The California Conservation Corps: A Case Study. Working Paper #5. The State Youth Initiatives Project.

ERIC Educational Resources Information Center

Bailin, Michael A.

Through site visits, a case study was made of the California Conservation Corps (CCC) in order to provide a description of its history, objectives, program features, participants, funding patterns, future plans, and key issues scheduled to be addressed by the program. Descended from similar earlier programs, the CCC was established in 1976. After…

Similarity laws of lunar and terrestrial volcanic flows

NASA Technical Reports Server (NTRS)

Pai, S. I.; Hsu, Y.; Okeefe, J. A.

1977-01-01

A mathematical model of a one dimensional, steady duct flow of a mixture of a gas and small solid particles (rock) was analyzed and applied to the lunar and the terrestrial volcanic flows under geometrically and dynamically similar conditions. Numerical results for the equilibrium two phase flows of lunar and terrestrial volcanoes under similar conditions are presented. The study indicates that: (1) the lunar crater is much larger than the corresponding terrestrial crater; (2) the exit velocity from the lunar volcanic flow may be higher than the lunar escape velocity but the exit velocity of terrestrial volcanic flow is much less than that of the lunar case; and (3) the thermal effects on the lunar volcanic flow are much larger than those of the terrestrial case.

The U.S. Armored Brigade Combat Team Versus Current Hybrid Threat: How Should the U.S. ABCT be Organized and Equipped to Address the Current Hybrid Threat

DTIC Science & Technology

2017-06-09

analysis method and focus on analyzing available documents while studying the separate but similar cases of Israel fighting Hezbollah in Lebanon and...two significant case studies will be reviewed. One deals with the conflict between Hezbollah and Israel Defense Forces (IDF) in Israel and Lebanon...Vietnam and in Operation Iraqi Freedom. Captain Houvinen in his research presented a case study from the Second Lebanon War based on the U.S. experience

Investigating potential transferability of place-based research in land system science

NASA Astrophysics Data System (ADS)

Václavík, Tomáš; Langerwisch, Fanny; Cotter, Marc; Fick, Johanna; Häuser, Inga; Hotes, Stefan; Kamp, Johannes; Settele, Josef; Spangenberg, Joachim H.; Seppelt, Ralf

2016-09-01

Much of our knowledge about land use and ecosystem services in interrelated social-ecological systems is derived from place-based research. While local and regional case studies provide valuable insights, it is often unclear how relevant this research is beyond the study areas. Drawing generalized conclusions about practical solutions to land management from local observations and formulating hypotheses applicable to other places in the world requires that we identify patterns of land systems that are similar to those represented by the case study. Here, we utilize the previously developed concept of land system archetypes to investigate potential transferability of research from twelve regional projects implemented in a large joint research framework that focus on issues of sustainable land management across four continents. For each project, we characterize its project archetype, i.e. the unique land system based on a synthesis of more than 30 datasets of land-use intensity, environmental conditions and socioeconomic indicators. We estimate the transferability potential of project research by calculating the statistical similarity of locations across the world to the project archetype, assuming higher transferability potentials in locations with similar land system characteristics. Results show that areas with high transferability potentials are typically clustered around project sites but for some case studies can be found in regions that are geographically distant, especially when values of considered variables are close to the global mean or where the project archetype is driven by large-scale environmental or socioeconomic conditions. Using specific examples from the local case studies, we highlight the merit of our approach and discuss the differences between local realities and information captured in global datasets. The proposed method provides a blueprint for large research programs to assess potential transferability of place-based studies to other geographical areas and to indicate possible gaps in research efforts.

DEB: A Diagnostic Experience Browser using similarity networks

NASA Technical Reports Server (NTRS)

Casadaban, Cyprian E.

1990-01-01

Diagnostic Experience Browser (DEB): a fusion of knowledge base and data base that allows users to examine only the data which is most useful to them is described. The system combines a data base of historical cases of diagnostic trouble-shooting experience with similarity networks. A menu-driven natural language interface receives input about the user's current problem. Similarity networks provide the user with references to past cases that are most similar or most related to those they now face. The user can then choose the case that is most pertinent and browse its full textual description which, in turn, may include references to other related cases.

Evaluation of the Diagnostic Utility of the Traditional and Revised WHO Dengue Case Definitions

PubMed Central

Gutiérrez, Gamaliel; Gresh, Lionel; Pérez, María Ángeles; Elizondo, Douglas; Avilés, William; Kuan, Guillermina; Balmaseda, Ángel; Harris, Eva

2013-01-01

Dengue, a mosquito-borne viral illness, is a major public health problem worldwide, and its incidence continues to increase. In 2009, the World Health Organization published guidelines that included a revision of the dengue case definition. Compared to the traditional definition, the revised case definition relies more on signs than on symptoms, making it more applicable to young children. We evaluated the diagnostic utility of both case definitions in two studies of pediatric dengue in Managua, Nicaragua. In a community-based cohort study, we included data from 3,407 suspected dengue cases, of which 476 were laboratory-confirmed. In the second study, we collected information from 1,160 participants recruited at the national pediatric reference hospital (723 laboratory-confirmed). In the cohort study, the traditional definition had 89.3% sensitivity and 43.1% specificity, while the revised definition yielded similar sensitivity (86.6%) and higher specificity (55.2%, p<0.001). In the hospital study, the traditional case definition yielded 96.7% sensitivity and 22.0% specificity, whereas the revised case definition had higher sensitivity (99.3%, p<0.001) but lower specificity (8.5%, p<0.001). We then evaluated the performance of two diagnostic models based on the signs/symptoms included in each definition by analyzing the effect of increasing numbers of signs/symptoms on the sensitivity and specificity of case capture. Receiver operating characteristic analysis showed a slightly better performance for the revised model in both studies. Interestingly, despite containing less symptoms that cannot be readily expressed by children aged less than 4 years, the revised definition did not perform better in this age group. Overall, our results indicate that both case definitions have similar capacity to diagnose dengue. Owing to their high sensitivity and low specificity, they should be primarily used for screening purposes. However, in a primary care setting, neither of the case definitions performed well as a screening test in younger children. PMID:23991237

Obstacles to action in arthritis: a community case-control study.

PubMed

Hutton, Ingrid; Gamble, Greg; McLean, Grant; Butcher, Hugh; Gow, Peter; Dalbeth, Nicola

2009-07-01

Despite the benefits of physical activity, people with arthritis are less active than the general population. The aim of this study was to determine the motivators and obstacles to physical activity for adults with arthritis. Participants were identified from the Obstacles to Action Study, a community based study of 8163 adults, which explored barriers and motivators to physical activity. A 1:1 case-control study was designed; cases were identified as those participants who reported arthritis (n = 1106). Each case was matched with an age, sex and ethnicity-matched non-arthritis control (n = 1106). Cases were less likely to achieve recommended physical activity targets (58.8% vs. 68.1% P = 0.00001). Furthermore, fewer people with arthritis believed that physical activity would help them lead healthy lives (86.7% vs. 91.3% P = 0.006) or viewed physical activity as a priority (53.8% vs. 59.8% P = 0.005). Cases were less confident in their abilities to try a new activity (37.1% vs. 43.7% P = 0.002) or maintain a healthy weight (65.0% vs. 74.3% P = 0.00001). Cases also reported greater negative impact scores for barriers to activity, particularly arthritis, accessibility, cost and discomfort while exercising. Motivators and environmental barriers to activity were similar for cases and controls. These findings persisted after adjusting for educational level, body mass index and comorbidities. People with arthritis are less active and demonstrate different attitudes toward physical activity. Although people with arthritis identify similar environmental barriers, they have different psychosocial barriers. In order to design effective physical activity programs for people with arthritis, these barriers must be specifically addressed.

Targeting imported malaria through social networks: a potential strategy for malaria elimination in Swaziland.

PubMed

Koita, Kadiatou; Novotny, Joseph; Kunene, Simon; Zulu, Zulizile; Ntshalintshali, Nyasatu; Gandhi, Monica; Gosling, Roland

2013-06-27

Swaziland has made great progress towards its goal of malaria elimination by 2015. However, malaria importation from neighbouring high-endemic Mozambique through Swaziland's eastern border remains a major factor that could prevent elimination from being achieved. In order to reach elimination, Swaziland must rapidly identify and treat imported malaria cases before onward transmission occurs. A nationwide formative assessment was conducted over eight weeks to determine if the imported cases of malaria identified by the Swaziland National Malaria Control Programme could be linked to broader social networks and to explore methods to access these networks. Using a structured format, interviews were carried out with malaria surveillance agents (6), health providers (10), previously identified imported malaria cases (19) and people belonging to the networks identified through these interviews (25). Most imported malaria cases were Mozambicans (63%, 12/19) making a living in Swaziland and sustaining their families in Mozambique. The majority of imported cases (73%, 14/19) were labourers and self-employed contractors who travelled frequently to Mozambique to visit their families and conduct business. Social networks of imported cases with similar travel patterns were identified through these interviews. Nearly all imported cases (89%, 17/19) were willing to share contact information to enable network members to be interviewed. Interviews of network members and key informants revealed common congregation points, such as the urban market places in Manzini and Malkerns, as well as certain bus stations, where people with similar travel patterns and malaria risk behaviours could be located and tested for malaria. This study demonstrated that imported cases of malaria belonged to networks of people with similar travel patterns. This study may provide novel methods for screening high-risk groups of travellers using both snowball sampling and time-location sampling of networks to identify and treat additional malaria cases. Implementation of a proactive screening programme of importation networks may help Swaziland halt transmission and achieve malaria elimination by 2015.

Elder Physical Abuse and Failure to Report Cases: Similarities and Differences in Case Type and the Justice System's Response

ERIC Educational Resources Information Center

Payne, Brian K.

2013-01-01

Treated initially as a social problem, elder abuse has only recently been criminalized. The criminalization of elder abuse involves penalizing offenders for actively abusing offenders as well as for violating mandatory reporting laws. Mandatory reporting laws exist to encourage professionals to report suspected cases of elder abuse. In this study,…

Assumptions of Asian American Similarity: The Case of Filipino and Chinese American Students

ERIC Educational Resources Information Center

Agbayani-Siewert, Pauline

2004-01-01

The conventional research model of clustering ethnic groups into four broad categories risks perpetuating a pedagogy of stereotypes in social work policies and practice methods. Using an elaborated research model, this study tested the assumption of cultural similarity of Filipino and Chinese American college students by examining attitudes,…

Effectiveness of seasonal trivalent influenza vaccine for preventing influenza virus illness among pregnant women: a population-based case-control study during the 2010-2011 and 2011-2012 influenza seasons.

PubMed

Thompson, Mark G; Li, De-Kun; Shifflett, Pat; Sokolow, Leslie Z; Ferber, Jeannette R; Kurosky, Samantha; Bozeman, Sam; Reynolds, Sue B; Odouli, Roxana; Henninger, Michelle L; Kauffman, Tia L; Avalos, Lyndsay A; Ball, Sarah; Williams, Jennifer L; Irving, Stephanie A; Shay, David K; Naleway, Allison L

2014-02-01

Although vaccination with trivalent inactivated influenza vaccine (TIV) is recommended for all pregnant women, no vaccine effectiveness (VE) studies of TIV in pregnant women have assessed laboratory-confirmed influenza outcomes. We conducted a case-control study over 2 influenza seasons (2010-2011 and 2011-2012) among Kaiser Permanente health plan members in 2 metropolitan areas in California and Oregon. We compared the proportion vaccinated among 100 influenza cases (confirmed by reverse transcription polymerase chain reaction) with the proportions vaccinated among 192 controls with acute respiratory illness (ARI) who tested negative for influenza and 200 controls without ARI (matched by season, site, and trimester). Among influenza cases, 42% were vaccinated during the study season compared to 58% and 63% vaccinated among influenza-negative controls and matched ARI-negative controls, respectively. The adjusted VE of the current season vaccine against influenza A and B was 44% (95% confidence interval [CI], 5%-67%) using the influenza-negative controls and 53% (95% CI, 24%-72%) using the ARI-negative controls. Receipt of the prior season's vaccine, however, had an effect similar to receipt of the current season's vaccine. As such, vaccination in either or both seasons had statistically similar adjusted VE using influenza-negative controls (VE point estimates range = 51%-76%) and ARI-negative controls (48%-76%). Influenza vaccination reduced the risk of ARI associated with laboratory-confirmed influenza among pregnant women by about one-half, similar to VE observed among all adults during these seasons.

Content-based image retrieval from a database of fracture images

NASA Astrophysics Data System (ADS)

Müller, Henning; Do Hoang, Phuong Anh; Depeursinge, Adrien; Hoffmeyer, Pierre; Stern, Richard; Lovis, Christian; Geissbuhler, Antoine

2007-03-01

This article describes the use of a medical image retrieval system on a database of 16'000 fractures, selected from surgical routine over several years. Image retrieval has been a very active domain of research for several years. It was frequently proposed for the medical domain, but only few running systems were ever tested in clinical routine. For the planning of surgical interventions after fractures, x-ray images play an important role. The fractures are classified according to exact fracture location, plus whether and to which degree the fracture is damaging articulations to see how complicated a reparation will be. Several classification systems for fractures exist and the classification plus the experience of the surgeon lead in the end to the choice of surgical technique (screw, metal plate, ...). This choice is strongly influenced by the experience and knowledge of the surgeons with respect to a certain technique. Goal of this article is to describe a prototype that supplies similar cases to an example to help treatment planning and find the most appropriate technique for a surgical intervention. Our database contains over 16'000 fracture images before and after a surgical intervention. We use an image retrieval system (GNU Image Finding Tool, GIFT) to find cases/images similar to an example case currently under observation. Problems encountered are varying illumination of images as well as strong anatomic differences between patients. Regions of interest are usually small and the retrieval system needs to focus on this region. Results show that GIFT is capable of supplying similar cases, particularly when using relevance feedback, on such a large database. Usual image retrieval is based on a single image as search target but for this application we have to select images by case as similar cases need to be found and not images. A few false positive cases often remain in the results but they can be sorted out quickly by the surgeons. Image retrieval can well be used for the planning of operations by supplying similar cases. A variety of challenges has been identified and partly solved (varying luminosity, small region of interested, case-based instead of image-based). This article mainly presents a case study to identify potential benefits and problems. Several steps for improving the system have been identified as well and will be described at the end of the paper.

Structural similarities between hematoidin crystals and asteroid bodies: evidence of lipid composition.

PubMed

Brenner, D S; Drachenberg, C B; Papadimitriou, J C

2001-02-01

Hematoidin crystals (HC) are found in tissues where extravasated erythrocytes undergo degradation. Previous studies have determined that hematoidin is composed, in part, of a bilirubin-like pigment. In a previous study (Papadimitriou and Drachenberg, Ultrastruct. Pathol. 16, 413-421, 1992), we demonstrated that giant cell asteroid bodies (AB) are formed by membrane lipid bilayers. We evaluated three cases in which HC developed within splenic infarcts. The crystals were analyzed by light microscopy (LM), electron microscopy (EM), and X-ray microanalysis. A case of sarcoidosis with multiple epithelioid granulomas containing AB was studied for comparison. By LM the HC demonstrated intense, golden-color, fine threads, both intracellularly and extracellularly, in small and large clusters, and in radiating, star-shape patterns ranging in size from 2 to 200 microm. By EM the HC were composed of a core of empty clefts, consistent with dissolved lipids, suggestive of cholesterol crystals, and were surrounded by myelinoid membrane aggregates. The AB showed by LM significant morphological similarities with the intracellular HC. By EM, the AB were composed of a core of dense phospholipid bilayer tubes surrounded by a halo of myelinoid membranes. No accumulation of specific elements was found in either HC or AB by X-ray microanalysis. HC and AB show a similar star-shape morphology by both LM and EM. We postulate that this shape is due to the physicochemical properties of the accumulated lipids which originate from superfluous cell membranes created during cell fusion in the case of AB and after cellular (predominantly red cell) breakdown in the case of HC. The golden color of the HC likely results from adsorption of hydrophobic bilirubin-like pigments left over from erythrocyte breakdown into the accumulated lipids. Thus, this study shows two different (patho)physiological processes that lead to a markedly similar morphological end-product and provides further support to our proposed mechanism for AB formation.

Dynamics of Implementation and Maintenance of Organizational Health Interventions.

PubMed

Jalali, Mohammad S; Rahmandad, Hazhir; Bullock, Sally Lawrence; Ammerman, Alice

2017-08-15

In this study, we present case studies to explore the dynamics of implementation and maintenance of health interventions. We analyze how specific interventions are built and eroded, how the building and erosion mechanisms are interconnected, and why we can see significantly different erosion rates across otherwise similar organizations. We use multiple comparative obesity prevention case studies to provide empirical information on the mechanisms of interest, and use qualitative systems modeling to integrate our evolving understanding into an internally consistent and transparent theory of the phenomenon. Our preliminary results identify reinforcing feedback mechanisms, including design of organizational processes, motivation of stakeholders, and communication among stakeholders, which influence implementation and maintenance of intervention components. Over time, these feedback mechanisms may drive a wedge between otherwise similar organizations, leading to distinct configurations of implementation and maintenance processes.

Merging Contexts and Shifting Practice within Professional Development Schools: Teachers as Teacher Educators and the Nature of Resistance--A Critical Multi-Case Study

ERIC Educational Resources Information Center

Wallace, Mary Ann

2012-01-01

This qualitative critical multi-case study examines the nature of resistance as it emerges within the work of two urban secondary teachers acting as teacher educators, each teaching a secondary teacher preparation course within their own respective school context. Both research sites are discursively and functionally similar in terms of their…

Processing Modifier-Head Agreement in L1 and L2 Finnish: An Eye-Tracking Study

ERIC Educational Resources Information Center

Vainio, Seppo; Pajunen, Anneli; Hyönä, Jukka

2016-01-01

This study investigated the effect of first language (L1) on the reading of modifier-head case agreement in second language (L2) Finnish by native Russian and Chinese speakers. Russian is similar to Finnish in that both languages use case endings to mark grammatical roles, whereas such markings are absent in Chinese. The critical nouns were…

Dermatoglyphs and chromosome mosaicism in parents of children with trisomy 18.

PubMed Central

Holmes-Siedle, M; Kerr, S; Lindenbaum, R H; Bobrow, M

1980-01-01

Parents of patients with Down's syndrome show dermatoglyphic features intermediate between the affected and the normal population. Dermatoglyphs were studied on the parents of 19 cases of trisomy 18, but no similar "intermediate" traits were discovered. The number of cases studied needs to be enlarged before it can definitely be stated that trisomies 18 and 21 differ in this respect. PMID:7381871

Psoriasiform Eruptions During Kawasaki Disease: A Distinct Phenotype

PubMed Central

Haddock, Ellen S.; Calame, Antoanella; Shimizu, Chisato; Tremoulet, Adriana H.; Burns, Jane C.; Tom, Wynnis L.

2016-01-01

Background A psoriasis-like eruption develops in a subset of patients with Kawasaki disease (KD). Objective To systematically compare KD-associated psoriasiform eruptions with classic psoriasis and the outcomes of KD in children with and without this rash. Methods This was a retrospective study of 11 KD cases with a psoriasiform eruption matched 1:2 by age, gender, and ethnicity with psoriasis-only and KD-only controls. Genotyping was performed in 10 cases for a deletion of two late cornified envelope (LCE) genes, LCE3C_LCE3B-del, associated with increased risk for pediatric-onset psoriasis. Results Similar to classic psoriasis, KD-associated eruptions were characterized clinically by well-demarcated, scaly pink plaques and histopathologically by intraepidermal neutrophils, suprabasilar keratin 16 expression, and increased Ki-67 expression. They showed less frequent diaper area involvement, more crust and serous exudate, and an enduring remission (91% vs. 23% with confirmed resolution; p < 0.001). Frequency of LCE3C_LCE3B-del and major KD outcomes were similar between cases and controls. Limitations The study was limited by the small number of cases, treatment variation, and availability of skin biopsy specimens. Conclusions Although the overall clinical and histopathologic findings were similar to conventional psoriasis, this appears to be a distinct phenotype with significantly greater propensity for remission. No adverse effect on KD outcomes was noted. PMID:26946987

Voice handicap in essential tremor: a comparison with normal controls and Parkinson's disease.

PubMed

Louis, Elan D; Gerbin, Marina

2013-01-01

Although voice tremor is one of the most commonly noted clinical features of essential tremor (ET), there are nearly no published data on the handicap associated with it. The Voice Handicap Index (VHI) was self-administered by participants enrolled in a research study at Columbia University Medical Center. The VHI quantifies patients' perceptions of handicap due to voice difficulties. Data from 98 ET cases were compared with data from 100 controls and 85 patients with another movement disorder (Parkinson's disease, PD). Voice tremor was present on examination in 25 (25.5%) ET cases; 12 had mild voice tremor (ETMild VT) and 13 had marked voice tremor (ETMarked VT). VHI scores were higher in ET cases than controls (p = 0.02). VHI scores among ETMarked VT were similar to those of PD cases; both were significantly higher than controls (p<0.001). The three VHI subscale scores (physical, functional, emotional) were highest in ETMarked VT, with values that were similar to those observed in PD. The voice handicap associated with ET had multiple (i.e., physical, functional, and emotional) dimensions. Moreover, ET cases with marked voice tremor on examination had a level of self-reported voice handicap that was similar to that observed in patients with PD.

Experiments with a novel content-based image retrieval software: can we eliminate classification systems in adolescent idiopathic scoliosis?

PubMed

Menon, K Venugopal; Kumar, Dinesh; Thomas, Tessamma

2014-02-01

Study Design Preliminary evaluation of new tool. Objective To ascertain whether the newly developed content-based image retrieval (CBIR) software can be used successfully to retrieve images of similar cases of adolescent idiopathic scoliosis (AIS) from a database to help plan treatment without adhering to a classification scheme. Methods Sixty-two operated cases of AIS were entered into the newly developed CBIR database. Five new cases of different curve patterns were used as query images. The images were fed into the CBIR database that retrieved similar images from the existing cases. These were analyzed by a senior surgeon for conformity to the query image. Results Within the limits of variability set for the query system, all the resultant images conformed to the query image. One case had no similar match in the series. The other four retrieved several images that were matching with the query. No matching case was left out in the series. The postoperative images were then analyzed to check for surgical strategies. Broad guidelines for treatment could be derived from the results. More precise query settings, inclusion of bending films, and a larger database will enhance accurate retrieval and better decision making. Conclusion The CBIR system is an effective tool for accurate documentation and retrieval of scoliosis images. Broad guidelines for surgical strategies can be made from the postoperative images of the existing cases without adhering to any classification scheme.

Short-term solar flare prediction using image-case-based reasoning

NASA Astrophysics Data System (ADS)

Liu, Jin-Fu; Li, Fei; Zhang, Huai-Peng; Yu, Da-Ren

2017-10-01

Solar flares strongly influence space weather and human activities, and their prediction is highly complex. The existing solutions such as data based approaches and model based approaches have a common shortcoming which is the lack of human engagement in the forecasting process. An image-case-based reasoning method is introduced to achieve this goal. The image case library is composed of SOHO/MDI longitudinal magnetograms, the images from which exhibit the maximum horizontal gradient, the length of the neutral line and the number of singular points that are extracted for retrieving similar image cases. Genetic optimization algorithms are employed for optimizing the weight assignment for image features and the number of similar image cases retrieved. Similar image cases and prediction results derived by majority voting for these similar image cases are output and shown to the forecaster in order to integrate his/her experience with the final prediction results. Experimental results demonstrate that the case-based reasoning approach has slightly better performance than other methods, and is more efficient with forecasts improved by humans.

Web Tools for Distributed Clinical Case Conferencing

PubMed Central

Lober, WB; Li, H; Trigg, LJ; Stewart, BK; Chou, D

2001-01-01

We have developed an information system to support distributed clinical case conferences held via video conferencing. The system has been designed by studying physicians of several specialties presenting hematology-oncology patients at Tumor Board. However, the principles of clinical case presentation are similar across many medical specialties, and we believe our approach has general applicability for presenting image and other clinical information, and organizing it for subsequent re-use in teaching files.

Child Maltreatment as a Risk Factor for Opioid Dependence: Comparison of Family Characteristics and Type and Severity of Child Maltreatment with a Matched Control Group

ERIC Educational Resources Information Center

Conroy, Elizabeth; Degenhardt, Louisa; Mattick, Richard P.; Nelson, Elliot C.

2009-01-01

Objective: To examine the prevalence, characteristics and risk factors for child maltreatment among opioid-dependent persons compared to a community sample of similar social disadvantage. Method: The study employed a case-control design. Cases had a history of opioid pharmacotherapy. Controls were frequency matched to cases with regard to age, sex…

The San Diego definition of SIDS: practical application and comparison with the GeSID classification.

PubMed

Bajanowski, T; Brinkmann, B; Vennemann, M

2006-11-01

The new definition of the term sudden infant death syndrome (SIDS) and the criteria introduced in San Diego for the subclassification of cases have been used to re-classify the first 100 consecutive cases of sudden and unexpected infant deaths that were registered with the German SIDS study (GeSID). Although there are 30 different variables that have to be considered in the general and stratified sections of the San Diego definition, it is practical, in particular, as an international standard to perform scientific studies. The comparison of the San Diego definition and the classification used for GeSID shows similarities in the methods but differences in the criteria used. Nevertheless, the numbers of cases classified as SIDS and borderline SIDS are similar (San Diego n=69, GeSID n=74). The SIDS IA criteria of the San Diego definition were not fulfilled by any case because metabolic screening and vitreous chemistry were not included in the GeSID investigation scheme. An important advantage of the San Diego definition is the introduction of the category of unclassified sudden infant death, which includes cases for which no autopsy was performed. This demonstrates that such cases cannot be classified as SIDS. In conclusion, we recommend the universal acceptance and use of the San Diego SIDS definition.

Pleomorphic leiomyosarcoma with a dedifferentiation-like appearance in the kidney: case report and literature review.

PubMed

Tajima, Shogo; Waki, Michihiko; Fukuyama, Masashi

2016-12-01

Although primary leiomyosarcoma of the kidney is extremely rare, it is the most common sarcoma of the kidney. Leiomyosarcoma with a large pleomorphic component is designated as pleomorphic leiomyosarcoma. The pleomorphic component is usually similar to undifferentiated high-grade pleomorphic sarcoma, although it variably expresses smooth muscle markers on immunohistochemistry. In the few reported cases of pleomorphic leiomyosarcoma of the kidney, cases with the pleomorphic component showing distinct nodularity similar to dedifferentiated leiomyosarcoma have not been described, to the best of our knowledge. Herein, we present a case of a 49-year-old woman with pleomorphic leiomyosarcoma in the kidney showing distinct nodularity of smooth muscle marker-expressing pleomorphic cells within a background of classic leiomyosarcoma. Along with the classification as a pleomorphic leiomyosarcoma, suggesting aggressive clinical behavior, the renal origin itself might also be a predictor of poor prognosis, as shown in a previous study. This case also involved concomitant distant metastases, already present during the initial detection of the renal tumor.

Osteochondrosis of the Superior Pole of the Patella: Two Cases with Histologic Correlation

PubMed Central

Tyler, Wakenda; McCarthy, Edward F

2002-01-01

Two cases of osteochondrosis of the superior pole of the patella are reported with histologic findings. Both patients were young girls; one had mild cerebral palsy. Sixteen cases of this disorder have been documented but without histologic study. The histologic features of these two cases showed osteonecrosis with reparative changes. These findings support that this entity is similar to other osteochondroses of the quadriceps mechanism: Osgood-Schlatter disease and Sinding-Larsen-Johansson disease. PMID:12180619

A Comparison of Mean Phase Difference and Generalized Least Squares for Analyzing Single-Case Data

ERIC Educational Resources Information Center

Manolov, Rumen; Solanas, Antonio

2013-01-01

The present study focuses on single-case data analysis specifically on two procedures for quantifying differences between baseline and treatment measurements. The first technique tested is based on generalized least square regression analysis and is compared to a proposed non-regression technique, which allows obtaining similar information. The…

Never Going Back: An Examination of Financial Health at Selected Private South Carolina Universities

ERIC Educational Resources Information Center

Armstrong, David C., Sr.

2014-01-01

This case study examined the leadership styles and overall financial health of the three South Carolina Baptist Convention universities. Each university share a similar story of financial exigency prior to the current president's arrival. Each institution has increased enrollment, endowment, and facilities over the last decade. This case study…

Similarity analysis of spectra obtained via reflectance spectrometry in legal medicine.

PubMed

Belenki, Liudmila; Sterzik, Vera; Bohnert, Michael

2014-02-01

In the present study, a series of reflectance spectra of postmortem lividity, pallor, and putrefaction-affected skin for 195 investigated cases in the course of cooling down the corpse has been collected. The reflectance spectrometric measurements were stored together with their respective metadata in a MySQL database. The latter has been managed via a scientific information repository. We propose similarity measures and a criterion of similarity that capture similar spectra recorded at corpse skin. We systematically clustered reflectance spectra from the database as well as their metadata, such as case number, age, sex, skin temperature, duration of cooling, and postmortem time, with respect to the given criterion of similarity. Altogether, more than 500 reflectance spectra have been pairwisely compared. The measures that have been used to compare a pair of reflectance curve samples include the Euclidean distance between curves and the Euclidean distance between derivatives of the functions represented by the reflectance curves at the same wavelengths in the spectral range of visible light between 380 and 750 nm. For each case, using the recorded reflectance curves and the similarity criterion, the postmortem time interval during which a characteristic change in the shape of reflectance spectrum takes place is estimated. The latter is carried out via a software package composed of Java, Python, and MatLab scripts that query the MySQL database. We show that in legal medicine, matching and clustering of reflectance curves obtained by means of reflectance spectrometry with respect to a given criterion of similarity can be used to estimate the postmortem interval.

A cholera outbreak in Alborz Province, Iran: a matched case-control study.

PubMed

Moradi, Ghobad; Rasouli, Mohammad Aziz; Mohammadi, Parvin; Elahi, Elham; Barati, Hojatollah

2016-01-01

A total of 229 confirmed cholera cases were reported in Alborz Province during an outbreak that lasted from June 2011 to August 2011. This study aimed to identify potential sources of transmission in order to determine suitable interventions in similar outbreaks. In other words, the lessons learned from this retrospective study can be utilized to manage future similar outbreaks. An age-matched and sex-matched case-control study was conducted during the outbreak. For each case, two control subjects were selected from the neighborhood. A case of cholera was defined as a bacteriologically confirmed case with signs and symptoms of cholera. This study was conducted from June 14, 2011 through August 23, 2011. The data were analyzed by calculating odds ratios (ORs) using the logistic regression method. In this outbreak, 229 confirmed cholera cases were diagnosed. The following risk factors were found to be associated with cholera: consumption of unrefrigerated leftover food (OR, 3.05; 95% confidence interval [CI], 1.72 to 5.41), consumption of vegetables and fruits in the previous three days (OR, 2.75; 95% CI, 1.95 to 3.89), and a history of traveling in the previous five days (OR, 5.31; 95% CI, 2.21 to 9.72). Consumption of vegetables and fruits has remained an unresolved risk factor in cholera outbreaks in Iran in recent years. In order to reduce the risk of cholera, sanitary standards for fruits and vegetables should be observed at all points from production to consumption, the population should be educated regarding hygienic food storage during outbreaks, and sanitary standards should be maintained when traveling during cholera outbreaks.

Combination of 2D/3D ligand-based similarity search in rapid virtual screening from multimillion compound repositories. Selection and biological evaluation of potential PDE4 and PDE5 inhibitors.

PubMed

Dobi, Krisztina; Hajdú, István; Flachner, Beáta; Fabó, Gabriella; Szaszkó, Mária; Bognár, Melinda; Magyar, Csaba; Simon, István; Szisz, Dániel; Lőrincz, Zsolt; Cseh, Sándor; Dormán, György

2014-05-28

Rapid in silico selection of target focused libraries from commercial repositories is an attractive and cost effective approach. If structures of active compounds are available rapid 2D similarity search can be performed on multimillion compound databases but the generated library requires further focusing by various 2D/3D chemoinformatics tools. We report here a combination of the 2D approach with a ligand-based 3D method (Screen3D) which applies flexible matching to align reference and target compounds in a dynamic manner and thus to assess their structural and conformational similarity. In the first case study we compared the 2D and 3D similarity scores on an existing dataset derived from the biological evaluation of a PDE5 focused library. Based on the obtained similarity metrices a fusion score was proposed. The fusion score was applied to refine the 2D similarity search in a second case study where we aimed at selecting and evaluating a PDE4B focused library. The application of this fused 2D/3D similarity measure led to an increase of the hit rate from 8.5% (1st round, 47% inhibition at 10 µM) to 28.5% (2nd round at 50% inhibition at 10 µM) and the best two hits had 53 nM inhibitory activities.

The effect of marital status on pregnancy outcome in Israel: a retrospective case-control study.

PubMed

Lurie, Samuel; Zalmanovitch, Anath; Golan, Abraham; Sadan, Oscar

2010-12-01

Previous studies have observed an association between unmarried status of the mother and adverse perinatal outcome such as increased rate of preterm deliveries, low birthweight and small-for-gestational-age infants. In Israel, attendance of prenatal care is imposed by the state and is not related to socioeconomic status; therefore, unmarried women are expected to have a similar prenatal care as married women. The objective of this study is to test the hypothesis that unmarried and married pregnant women have a similar perinatal outcome. In a retrospective case-control study, analysis of the records of women who gave birth at the delivery ward of Edith Wolfson Medical Center (a tertiary health care center) over a one-year period (2005) with respect to marital status was performed. The cases group included 304 unmarried women who were matched with 1:1 ratio for maternal age, parity, and number of fetuses in the current pregnancy. Unmarried women (n = 304) were more likely to smoke during pregnancy (35.2% vs 15.2%, P < 0.001), had a longer second stage (44.4 ± 9.8 min vs 54.4 ± 4.4 min, P < 0.05) and a shorter first stage (484.0 ± 34.8 min vs 421.0 ± 25.3 min P < 0.05) of labor. The unmarried women had similar length of gestation, preterm delivery rate, mode of delivery, low birthweight rates, low Apgar scores or meconium passage during labor as married women. In Israel, unmarried and married pregnant women may have almost similar pregnancy outcomes on length of gestation, mode of delivery and Apgar score. © 2010 The Authors. Journal of Obstetrics and Gynaecology Research © 2010 Japan Society of Obstetrics and Gynecology.

Differentiation of histoplasma and cryptococcus in cytology smears: a diagnostic dilemma in severely necrotic cases.

PubMed

Ranjan, R; Jain, D; Singh, L; Iyer, V K; Sharma, M C; Mathur, S R

2015-08-01

The correct identification of fungal organisms is important for the appropriate clinical management of patients. It becomes difficult in necrotic smears when the tissue response is not clearly discernible. It is difficult to distinguish between histoplasma and cryptococcus in severely necrotic cases, where both appear as variably sized clear refractile haloes. Four cases of adrenal necrotic histoplasma infection were studied and the morphology was compared with that of non-necrotic histoplasmosis and cases of cryptococcal infection. Eleven cases were analysed in fine needle aspiration cytology (FNAC) smears. Ziehl-Neelsen (ZN) stain was performed to exclude tuberculosis in necrotic smears. A clinical and serology correlation was performed where available. Necrotic cases of histoplasma infection revealed negative refractile clear haloes similar to those of cryptococcus. Histoplasma showed methylene blue-stained organisms in ZN stains, whereas the cryptococcus cases were negative. Similar methylene blue-stained organisms were seen in non-necrotic histoplasma infection. As a result of morphological overlap between cryptococcus and histoplasma, the distinction between the two fungi can be difficult in many cases. ZN staining appears to have a role in the differentiation of these fungi in severely necrotic cases. This observation needs to be validated on a larger number of cases with complete correlation with clinical, serology and treatment records. © 2014 John Wiley & Sons Ltd.

Shivering in Febrile Children: Frequency and Usefulness in Predicting Serious Bacterial Infections - A Prospective Case-Control Study.

PubMed

Erell, Yair; Youngster, Ilan; Abu-Kishk, Ibrahim; Kozer, Eran

2017-11-01

A prospective case-control study was conducted in a pediatric emergency department to describe the proportion of febrile children experiencing shivering and its clinical significance. Shivering was reported in 186 of 645 febrile children (28.8%). The rate of serious bacterial infection was similar in 86 children with shivering and 86 matched controls. Copyright © 2017 Elsevier Inc. All rights reserved.

CABINS: Case-based interactive scheduler

NASA Technical Reports Server (NTRS)

Miyashita, Kazuo; Sycara, Katia

1992-01-01

In this paper we discuss the need for interactive factory schedule repair and improvement, and we identify case-based reasoning (CBR) as an appropriate methodology. Case-based reasoning is the problem solving paradigm that relies on a memory for past problem solving experiences (cases) to guide current problem solving. Cases similar to the current case are retrieved from the case memory, and similarities and differences of the current case to past cases are identified. Then a best case is selected, and its repair plan is adapted to fit the current problem description. If a repair solution fails, an explanation for the failure is stored along with the case in memory, so that the user can avoid repeating similar failures in the future. So far we have identified a number of repair strategies and tactics for factory scheduling and have implemented a part of our approach in a prototype system, called CABINS. As a future work, we are going to scale up CABINS to evaluate its usefulness in a real manufacturing environment.

[Lung cancer and smoking in Asturias, Spain. A case-control study].

PubMed

Caicoya, M; Mirón, J A

2003-01-01

Lung cancer in Asturias is 1.4-fold greater than the Spanish average, while the proportion of smokers is similar. The objective of this study was to examine the relationship between lung cancer and smoking in Asturias. We performed a hospital-based, incident case control study. The cases were newly diagnosed lung cancer patients and controls were patients from the surgical wards. Information was sought on smoking, occupational exposures, and demographic variables. The analysis was performed by means of odds ratios (OR). One hundred ninety-seven cases and 196 controls were included in the analysis. The adjusted OR of cigarette smoking was 5.77 (95% CI, 2.96-11.22). The risk increased with the number of cigarettes smoked per day (chi 2 = 56.3), the number of packs/year (chi 2 = 48.4), and the age at which smoking started (chi 2 = 76.5). The OR diminished with the number of years of cessation (chi 2 = 39.9). The relationship between smoking and lung cancer in Asturias is similar to that found in other studies carried out in other parts of the western world. The magnitude of the OR may explain the frequency of lung cancer in Asturias. Greater efforts should be devoted to controlling this problem.

Dynamics of Implementation and Maintenance of Organizational Health Interventions

PubMed Central

Rahmandad, Hazhir; Bullock, Sally Lawrence; Ammerman, Alice

2017-01-01

In this study, we present case studies to explore the dynamics of implementation and maintenance of health interventions. We analyze how specific interventions are built and eroded, how the building and erosion mechanisms are interconnected, and why we can see significantly different erosion rates across otherwise similar organizations. We use multiple comparative obesity prevention case studies to provide empirical information on the mechanisms of interest, and use qualitative systems modeling to integrate our evolving understanding into an internally consistent and transparent theory of the phenomenon. Our preliminary results identify reinforcing feedback mechanisms, including design of organizational processes, motivation of stakeholders, and communication among stakeholders, which influence implementation and maintenance of intervention components. Over time, these feedback mechanisms may drive a wedge between otherwise similar organizations, leading to distinct configurations of implementation and maintenance processes. PMID:28809807

Theoretical pluralism in psychoanalytic case studies.

PubMed

Willemsen, Jochem; Cornelis, Shana; Geerardyn, Filip M; Desmet, Mattias; Meganck, Reitske; Inslegers, Ruth; Cauwe, Joachim M B D

2015-01-01

The aim of this study is to provide an overview of the scientific activity of different psychoanalytic schools of thought in terms of the content and production of case studies published on ISI Web of Knowledge. Between March 2013 and November 2013, we contacted all case study authors included in the online archive of psychoanalytic and psychodynamic case studies (www.singlecasearchive.com) to inquire about their psychoanalytic orientation during their work with the patient. The response rate for this study was 45%. It appears that the two oldest psychoanalytic schools, Object-relations psychoanalysis and Ego psychology or "Classical psychoanalysis" dominate the literature of published case studies. However, most authors stated that they feel attached to two or more psychoanalytic schools of thought. This confirms that the theoretical pluralism in psychoanalysis stretches to the field of single case studies. The single case studies of each psychoanalytic school are described separately in terms of methodology, patient, therapist, or treatment features. We conclude that published case studies features are fairly similar across different psychoanalytic schools. The results of this study are not representative of all psychoanalytic schools, as some do not publish their work in ISI ranked journals.

Theoretical pluralism in psychoanalytic case studies

PubMed Central

Willemsen, Jochem; Cornelis, Shana; Geerardyn, Filip M.; Desmet, Mattias; Meganck, Reitske; Inslegers, Ruth; Cauwe, Joachim M. B. D.

2015-01-01

The aim of this study is to provide an overview of the scientific activity of different psychoanalytic schools of thought in terms of the content and production of case studies published on ISI Web of Knowledge. Between March 2013 and November 2013, we contacted all case study authors included in the online archive of psychoanalytic and psychodynamic case studies (www.singlecasearchive.com) to inquire about their psychoanalytic orientation during their work with the patient. The response rate for this study was 45%. It appears that the two oldest psychoanalytic schools, Object-relations psychoanalysis and Ego psychology or “Classical psychoanalysis” dominate the literature of published case studies. However, most authors stated that they feel attached to two or more psychoanalytic schools of thought. This confirms that the theoretical pluralism in psychoanalysis stretches to the field of single case studies. The single case studies of each psychoanalytic school are described separately in terms of methodology, patient, therapist, or treatment features. We conclude that published case studies features are fairly similar across different psychoanalytic schools. The results of this study are not representative of all psychoanalytic schools, as some do not publish their work in ISI ranked journals. PMID:26483725

Voters and leaders in the mirror of politics: similarity in personality and voting choice in Italy and Spain.

PubMed

Vecchione, Michele; González Castro, José Luis; Caprara, Gian Vittorio

2011-08-01

Relations between voting choice and similarity in traits between voters and political candidates are examined in two studies. The first study was conducted in Spain, where the personalities of Mariano Rajoy and José Luis Rodríguez Zapatero were assessed. The second study was conducted in Italy, where the politicians assessed were Walter Veltroni and Silvio Berlusconi. Results show in both cases a similarity between voters' self-reported personality and their appraisals of the leaders of the party for which they voted. Similarity is generally higher with respect to traits that are the most distinctive for each platform and its leader. The findings show a higher similarity between voters and their leaders on the markers of agreeableness, such as "loyal" and "sincere." Findings hold across countries and political figures, demonstrating the role that personal characteristics of both voters and candidates play in orienting political preference.

GRMDA: Graph Regression for MiRNA-Disease Association Prediction

PubMed Central

Chen, Xing; Yang, Jing-Ru; Guan, Na-Na; Li, Jian-Qiang

2018-01-01

Nowadays, as more and more associations between microRNAs (miRNAs) and diseases have been discovered, miRNA has gradually become a hot topic in the biological field. Because of the high consumption of time and money on carrying out biological experiments, computational method which can help scientists choose the most likely associations between miRNAs and diseases for further experimental studies is desperately needed. In this study, we proposed a method of Graph Regression for MiRNA-Disease Association prediction (GRMDA) which combines known miRNA-disease associations, miRNA functional similarity, disease semantic similarity, and Gaussian interaction profile kernel similarity. We used Gaussian interaction profile kernel similarity to supplement the shortage of miRNA functional similarity and disease semantic similarity. Furthermore, the graph regression was synchronously performed in three latent spaces, including association space, miRNA similarity space, and disease similarity space, by using two matrix factorization approaches called Singular Value Decomposition and Partial Least-Squares to extract important related attributes and filter the noise. In the leave-one-out cross validation and five-fold cross validation, GRMDA obtained the AUCs of 0.8272 and 0.8080 ± 0.0024, respectively. Thus, its performance is better than some previous models. In the case study of Lymphoma using the recorded miRNA-disease associations in HMDD V2.0 database, 88% of top 50 predicted miRNAs were verified by experimental literatures. In order to test the performance of GRMDA on new diseases with no known related miRNAs, we took Breast Neoplasms as an example by regarding all the known related miRNAs as unknown ones. We found that 100% of top 50 predicted miRNAs were verified. Moreover, 84% of top 50 predicted miRNAs in case study for Esophageal Neoplasms based on HMDD V1.0 were verified to have known associations. In conclusion, GRMDA is an effective and practical method for miRNA-disease association prediction. PMID:29515453

GRMDA: Graph Regression for MiRNA-Disease Association Prediction.

PubMed

Chen, Xing; Yang, Jing-Ru; Guan, Na-Na; Li, Jian-Qiang

2018-01-01

Nowadays, as more and more associations between microRNAs (miRNAs) and diseases have been discovered, miRNA has gradually become a hot topic in the biological field. Because of the high consumption of time and money on carrying out biological experiments, computational method which can help scientists choose the most likely associations between miRNAs and diseases for further experimental studies is desperately needed. In this study, we proposed a method of Graph Regression for MiRNA-Disease Association prediction (GRMDA) which combines known miRNA-disease associations, miRNA functional similarity, disease semantic similarity, and Gaussian interaction profile kernel similarity. We used Gaussian interaction profile kernel similarity to supplement the shortage of miRNA functional similarity and disease semantic similarity. Furthermore, the graph regression was synchronously performed in three latent spaces, including association space, miRNA similarity space, and disease similarity space, by using two matrix factorization approaches called Singular Value Decomposition and Partial Least-Squares to extract important related attributes and filter the noise. In the leave-one-out cross validation and five-fold cross validation, GRMDA obtained the AUCs of 0.8272 and 0.8080 ± 0.0024, respectively. Thus, its performance is better than some previous models. In the case study of Lymphoma using the recorded miRNA-disease associations in HMDD V2.0 database, 88% of top 50 predicted miRNAs were verified by experimental literatures. In order to test the performance of GRMDA on new diseases with no known related miRNAs, we took Breast Neoplasms as an example by regarding all the known related miRNAs as unknown ones. We found that 100% of top 50 predicted miRNAs were verified. Moreover, 84% of top 50 predicted miRNAs in case study for Esophageal Neoplasms based on HMDD V1.0 were verified to have known associations. In conclusion, GRMDA is an effective and practical method for miRNA-disease association prediction.

Modified measles versus rubella versus atypical measles: One and same thing

PubMed Central

Gupta, Surender Nikhil; Gupta, Naveen; Gupta, Shivani

2015-01-01

Introduction: In outbreak settings, more than one virus may be infecting the given population. In twin or triple outbreak of measles, German measles (rubella), and varicella in highly immunized hilly areas, maximal number of the case patients in all the hilly villages belonged to the older age group. It suggested an obvious shift to the higher age group, warranting second dose opportunity in such case scenario. The clinical presentations of viral diseases are too similar to differentiate. The aim is to clearly categorize the case patients of modified measles, rubella, and atypical measles in outbreak settings. Results: Four outbreaks are listed. In the first one, sixty case patients were identified from 1026 people in 5 villages. Of these, 41 were diagnosed by clinically, 8 were laboratory confirmed as measles and 11 were epidemiologically linked German measles case patients. Seventy percent of the cases were vaccinated for measles. In second case, we identified 29/35 measles and 6/35 were confirmed as epidemiologically linked unvaccinated chickenpox case patients. In third one, we identified 116 cases in eight villages (112/116 clinically and 04/116 laboratory confirmed). Majority of cases were immunized against measles, but only minor cases for rubella. In fourth case, we identified 505 case patients from mixed outbreaks of varicella, measles and rubella (30/505 clinically, 467/505 epidemiologically linked and 8/505 laboratory confirmed case patients from a study population of 3280). In all the four outbreaks, prima facie, the clinical presentations of both rubella and modified measles were difficult to differentiate. Discussion: On the basis of outbreak investigation and analytical inference, it has been observed that the symtomatology of modified measles and laboratory confirmed rubella case patients/epidemiologically linked cases are so similar placed that many a time, it becomes much difficult to line list the cases in one section of modified measles or rubella or atypical cases. Conclusion: Similarities of morphological symptoms between modified measles and rubella is the point of challenge and it causes debate between pediatrician and field epidemiologist to differentiate and classify them. PMID:26985417

Modified measles versus rubella versus atypical measles: One and same thing.

PubMed

Gupta, Surender Nikhil; Gupta, Naveen; Gupta, Shivani

2015-01-01

In outbreak settings, more than one virus may be infecting the given population. In twin or triple outbreak of measles, German measles (rubella), and varicella in highly immunized hilly areas, maximal number of the case patients in all the hilly villages belonged to the older age group. It suggested an obvious shift to the higher age group, warranting second dose opportunity in such case scenario. The clinical presentations of viral diseases are too similar to differentiate. The aim is to clearly categorize the case patients of modified measles, rubella, and atypical measles in outbreak settings. Four outbreaks are listed. In the first one, sixty case patients were identified from 1026 people in 5 villages. Of these, 41 were diagnosed by clinically, 8 were laboratory confirmed as measles and 11 were epidemiologically linked German measles case patients. Seventy percent of the cases were vaccinated for measles. In second case, we identified 29/35 measles and 6/35 were confirmed as epidemiologically linked unvaccinated chickenpox case patients. In third one, we identified 116 cases in eight villages (112/116 clinically and 04/116 laboratory confirmed). Majority of cases were immunized against measles, but only minor cases for rubella. In fourth case, we identified 505 case patients from mixed outbreaks of varicella, measles and rubella (30/505 clinically, 467/505 epidemiologically linked and 8/505 laboratory confirmed case patients from a study population of 3280). In all the four outbreaks, prima facie, the clinical presentations of both rubella and modified measles were difficult to differentiate. On the basis of outbreak investigation and analytical inference, it has been observed that the symtomatology of modified measles and laboratory confirmed rubella case patients/epidemiologically linked cases are so similar placed that many a time, it becomes much difficult to line list the cases in one section of modified measles or rubella or atypical cases. Similarities of morphological symptoms between modified measles and rubella is the point of challenge and it causes debate between pediatrician and field epidemiologist to differentiate and classify them.

Anatomical study of minor alterations in neonate vocal folds.

PubMed

Silva, Adriano Rezende; Machado, Almiro José; Crespo, Agrício Nubiato

2014-01-01

Minor structural alterations of the vocal fold cover are frequent causes of voice abnormalities. They may be difficult to diagnose, and are expressed in different manners. Cases of intracordal cysts, sulcus vocalis, mucosal bridge, and laryngeal micro-diaphragm form the group of minor structural alterations of the vocal fold cover investigated in the present study. The etiopathogenesis and epidemiology of these alterations are poorly known. To evaluate the existence and anatomical characterization of minor structural alterations in the vocal folds of newborns. 56 larynxes excised from neonates of both genders were studied. They were examined fresh, or defrosted after conservation via freezing, under a microscope at magnifications of 25× and 40×. The vocal folds were inspected and palpated by two examiners, with the aim of finding minor structural alterations similar to those described classically, and other undetermined minor structural alterations. Larynges presenting abnormalities were submitted to histological examination. Six cases of abnormalities were found in different larynges: one (1.79%) compatible with a sulcus vocalis and five (8.93%) compatible with a laryngeal micro-diaphragm. No cases of cysts or mucosal bridges were found. The observed abnormalities had characteristics similar to those described in other age groups. Abnormalities similar to sulcus vocalis or micro-diaphragm may be present at birth. Copyright © 2014 Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial. Published by Elsevier Editora Ltda. All rights reserved.

Courtside: Lesson Lost?

ERIC Educational Resources Information Center

Zirkel, Perry A.

2004-01-01

In this month's Courtside, the author will stray somewhat from his usual format of describing a single case. Instead, he will be presenting the details of two separate cases, both of which involve similar circumstances, rely on similar legal arguments, and have similar outcomes. Most important, both appear to carry the same lesson. The lessons…

Standard Anatomic Terminologies: Comparison for Use in a Health Information Exchange–Based Prior Computed Tomography (CT) Alerting System

PubMed Central

Lowry, Tina; Vreeman, Daniel J; Loo, George T; Delman, Bradley N; Thum, Frederick L; Slovis, Benjamin H; Shapiro, Jason S

2017-01-01

Background A health information exchange (HIE)–based prior computed tomography (CT) alerting system may reduce avoidable CT imaging by notifying ordering clinicians of prior relevant studies when a study is ordered. For maximal effectiveness, a system would alert not only for prior same CTs (exams mapped to the same code from an exam name terminology) but also for similar CTs (exams mapped to different exam name terminology codes but in the same anatomic region) and anatomically proximate CTs (exams in adjacent anatomic regions). Notification of previous same studies across an HIE requires mapping of local site CT codes to a standard terminology for exam names (such as Logical Observation Identifiers Names and Codes [LOINC]) to show that two studies with different local codes and descriptions are equivalent. Notifying of prior similar or proximate CTs requires an additional mapping of exam codes to anatomic regions, ideally coded by an anatomic terminology. Several anatomic terminologies exist, but no prior studies have evaluated how well they would support an alerting use case. Objective The aim of this study was to evaluate the fitness of five existing standard anatomic terminologies to support similar or proximate alerts of an HIE-based prior CT alerting system. Methods We compared five standard anatomic terminologies (Foundational Model of Anatomy, Systematized Nomenclature of Medicine Clinical Terms, RadLex, LOINC, and LOINC/Radiological Society of North America [RSNA] Radiology Playbook) to an anatomic framework created specifically for our use case (Simple ANatomic Ontology for Proximity or Similarity [SANOPS]), to determine whether the existing terminologies could support our use case without modification. On the basis of an assessment of optimal terminology features for our purpose, we developed an ordinal anatomic terminology utility classification. We mapped samples of 100 random and the 100 most frequent LOINC CT codes to anatomic regions in each terminology, assigned utility classes for each mapping, and statistically compared each terminology’s utility class rankings. We also constructed seven hypothetical alerting scenarios to illustrate the terminologies’ differences. Results Both RadLex and the LOINC/RSNA Radiology Playbook anatomic terminologies ranked significantly better (P<.001) than the other standard terminologies for the 100 most frequent CTs, but no terminology ranked significantly better than any other for 100 random CTs. Hypothetical scenarios illustrated instances where no standard terminology would support appropriate proximate or similar alerts, without modification. Conclusions LOINC/RSNA Radiology Playbook and RadLex’s anatomic terminologies appear well suited to support proximate or similar alerts for commonly ordered CTs, but for less commonly ordered tests, modification of the existing terminologies with concepts and relations from SANOPS would likely be required. Our findings suggest SANOPS may serve as a framework for enhancing anatomic terminologies in support of other similar use cases. PMID:29242174

Comparing Architectural Styles for Service-Oriented Architectures - a REST vs. SOAP Case Study

NASA Astrophysics Data System (ADS)

Becker, Jörg; Matzner, Martin; Müller, Oliver

Two architectural styles are currently heavily discussed regarding the design of service-oriented architectures (SOA). Within this chapter we have compared those two alternative styles - the SOAP-style with procedural designs similar to remote procedure calls and the REST-style with loosely coupled services similar to resources of the World Wide Web. We introduce the case of a business network consisting of manufacturers and service providers of the electronics industry for deriving a set of requirements towards a specific SOA implementation. For each architectural style we present a concrete SOA design and evaluate it against the defined set of requirements.

Two Peas in a Pod?: A Case of Questionable Twins

ERIC Educational Resources Information Center

Welsh, Paul

2004-01-01

Based on an actual event, this case study focuses on problems associated with reproductive technologies. It tells the story of the "Jones" who, after in vitro fertilization, discovered that their fraternal twins were less similar in appearance than one would expect two brothers to be. Students work in teams to unravel the mystery using DNA…

Combining molecular fingerprints with multidimensional scaling analyses to identify the source of spilled oil from highly similar suspected oils.

PubMed

Zhou, Peiyu; Chen, Changshu; Ye, Jianjun; Shen, Wenjie; Xiong, Xiaofei; Hu, Ping; Fang, Hongda; Huang, Chuguang; Sun, Yongge

2015-04-15

Oil fingerprints have been a powerful tool widely used for determining the source of spilled oil. In most cases, this tool works well. However, it is usually difficult to identify the source if the oil spill accident occurs during offshore petroleum exploration due to the highly similar physiochemical characteristics of suspected oils from the same drilling platform. In this report, a case study from the waters of the South China Sea is presented, and multidimensional scaling analysis (MDS) is introduced to demonstrate how oil fingerprints can be combined with mathematical methods to identify the source of spilled oil from highly similar suspected sources. The results suggest that the MDS calculation based on oil fingerprints and subsequently integrated with specific biomarkers in spilled oils is the most effective method with a great potential for determining the source in terms of highly similar suspected oils. Copyright © 2015 Elsevier Ltd. All rights reserved.

February Hydrids (FHY-1032)

NASA Astrophysics Data System (ADS)

Roggemans, Paul; Cambell-Burns, Peter

2018-03-01

CAMS reported an outburst of an unknown minor stream on 14 February 2018, listed in the IAU working list of meteor showers as #1032 FCM (α = 124°, δ = +2°, λʘ = 324°, vg = 16.5 km/s). This analysis shows that many similar orbits can be found in the time span and region in space around the reference orbit. The term 'outburst' is rather misleading as only few orbits were detected during several nights. A search through all public available orbit catalogues resulted in a significant number of similar orbits, but the region proves to be rich in unrelated similar sporadic meteors that fulfill low and medium low D-criteria. This case study on the possible February Hydrids did not result in a convincing evidence for the existence of this minor shower. Both the distribution of the number of similar orbits and the spreading in space indicate the possible presence of a diffuse minor shower without any distinct peak activity. This is a case of a barely detectable minor stream.

Validation of Quasi-Invariant Ice Cloud Radiative Quantities with MODIS Satellite-Based Cloud Property Retrievals

NASA Technical Reports Server (NTRS)

Ding, Jiachen; Yang, Ping; Kattawar, George W.; King, Michael D.; Platnick, Steven; Meyer, Kerry G.

2017-01-01

Similarity relations applied to ice cloud radiance calculations are theoretically analyzed and numerically validated. If t(1v) and t(1vg) are conserved where t is optical thickness, v the single-scattering albedo, and g the asymmetry factor, it is possible that substantially different phase functions may give rise to similar radiances in both conservative and non-conservative scattering cases, particularly in the case of large optical thicknesses. In addition to theoretical analysis, this study uses operational ice cloud optical thickness retrievals from the Moderate Resolution Imaging Spectroradiometer (MODIS) Level 2 Collection5 (C5) and Collection 6 (C6) cloud property products to verify radiative similarity relations. It is found that, if the MODIS C5 and C6 ice cloud optical thickness values are multiplied by their respective (1wg)factors, the resultant products referred to as the effective optical thicknesses become similar with their ratio values around unity. Furthermore, the ratios of the C5 and C6 ice cloud effective optical thicknesses display an angular variation pattern similar to that of the corresponding ice cloud phase function ratios. The MODIS C5 and C6 values of ice cloud similarity parameter, defined as [(1w)(1(exp. 1/2)wg)]12, also tend to be similar.

Histological analysis on the medieval mummy in Korea.

PubMed

Shin, Dong Hoon; Youn, Minyoung; Chang, Byung Soo

2003-11-26

Recently, there have been some reports on the mummies from the medieval tombs in Korea, which were not made on purpose. Although these mummies could be an invaluable source for the studies on the physical state of medieval Koreans, there were not any reports on this subject until now. In this study, we first tried to investigate the various tissues using light- and electron-microscopic techniques. In the organs we have examined, even though the collagen fibers were profusely found within all of them, some types of cells, such as red blood cells, chondrocytes, hepatocyte and muscle cells, were also visible in various tissues. The histological characteristics of the current case seemed to be well matched with the previous study in general even though there were also somewhat different findings from the previous reports on the mummies. Although the cause of the mummification in Korea was not completely explained, we think that the cause in this case could be correlated with cultural aspects--not with natural conditions--because the mummies were only found in cases where the lime-soil barrier was maintained until their discovery, and which separated the inner space of the coffins from the outer space. As similar cases are frequently reported nowadays, invaluable data on the physical status of the medieval Koreans could be attainable if systemic investigation could be performed on similar cases which are found in the future.

Do incident and new subsequent cases of non-melanoma skin cancer registered in a Danish prospective cohort study have different 10-year mortality?

PubMed

Jensen, Annette Østergaard; Olesen, Anne Braae; Dethlefsen, Claus; Sørensen, Henrik Toft

2007-01-01

The Danish Gerda Frentz Cohort (GFC) was created for registering all incident and new subsequent cases of non-melanoma skin cancer (NMSC) among patients seen by Danish dermatologists in 1995. We have recently found, in this cohort, a lower 10-year mortality than in the general population in patients with basal cell carcinoma (BCC). Differences in mortality between incident and new subsequent cases, incomplete registration or selection bias may be responsible for this finding. We aimed to quantify differences in mortality between incident and new subsequent cases of NMSC in the GFC and to compare mortality among incident cases recorded in the GFC and those recorded in the Danish Cancer Registry (DCR). We followed 10,830 skin cancer patients and 106,696 age-, gender- and residence-matched population controls through 2006 and computed their cumulative mortality and mortality rate ratio (MRR). One-, 5-, and 10-year cumulative mortality of incident and new subsequent cases of BCC and SCC in the GFC were similar. Likewise, MRR for incident BCC (MRR=0.91; 95% CI 0.84-0.98) and incident SCC (MRR=1.29; 95% CI 1.05-1.56) among patients registered in the GFC were similar to their counterparts in the DCR (MRR=0.96; 95% CI 0.91-1.00 and MRR=1.36; 95% CI 1.22-1.52). Mortality of incident and new subsequent cases of NMSC was similar and thus did not explain the reduced mortality of BCC patients.

Three different clinical faces of the same histopathological entity: hair follicle nevus, trichofolliculoma and accessory tragus*

PubMed Central

Karabulut, Yasemin Yuyucu; Şenel, Engin; Karabulut, Hacı Halil; Dölek, Yasemin

2015-01-01

BACKGROUND Hair follicle nevus is a rare, congenital hamartoma with follicular differentiation characterized histologically by numerous, tiny, mature hair follicles. Trichofolliculoma, the histopathological features of which are quite similar to those of hair follicle nevus, is also a hamartoma that differs from hair follicle. Accessory tragus is a relatively common, benign congenital abnormality of the external ear with an incidence rate of 1 to 10 per 1,000 live births. OBJECTIVE This study seeks to assess the discriminatory value of currently available, histological criteria in the differential diagnosis of hair follicle nevus, accessory tragi and trichofolliculoma. METHODS Twenty-one patients comprising 9 cases of hair follicle nevus, 8 accessory tragi patients and 4 trichofolliculoma cases, were recruited to perform the study. RESULTS There were 10 males and 11 females in the study group. No significant difference was observed between the three study groups in terms of age, gender or histopathological parameters such as density of hair follicles, subcutaneous fat score and presence of connective tissue framework. Cartilaginous component was seen in 8 cases that were diagnosed as accessory tragi, while central cyst and radiating hair follicles were seen in 4 cases which were diagnosed as trichofolliculoma. CONCLUSION The results of our study showed that diagnostic discrimination of these diseases could be made only with the clinicopathologic correlation because of their clinical and histopathological similarities. PMID:26375221

Three different clinical faces of the same histopathological entity: hair follicle nevus, trichofolliculoma and accessory tragus.

PubMed

Karabulut, Yasemin Yuyucu; Şenel, Engin; Karabulut, Hacı Halil; Dölek, Yasemin

2015-01-01

Hair follicle nevus is a rare, congenital hamartoma with follicular differentiation characterized histologically by numerous, tiny, mature hair follicles. Trichofolliculoma, the histopathological features of which are quite similar to those of hair follicle nevus, is also a hamartoma that differs from hair follicle. Accessory tragus is a relatively common, benign congenital abnormality of the external ear with an incidence rate of 1 to 10 per 1,000 live births. This study seeks to assess the discriminatory value of currently available, histological criteria in the differential diagnosis of hair follicle nevus, accessory tragi and trichofolliculoma. Twenty-one patients comprising 9 cases of hair follicle nevus, 8 accessory tragi patients and 4 trichofolliculoma cases, were recruited to perform the study. There were 10 males and 11 females in the study group. No significant difference was observed between the three study groups in terms of age, gender or histopathological parameters such as density of hair follicles, subcutaneous fat score and presence of connective tissue framework. Cartilaginous component was seen in 8 cases that were diagnosed as accessory tragi, while central cyst and radiating hair follicles were seen in 4 cases which were diagnosed as trichofolliculoma. The results of our study showed that diagnostic discrimination of these diseases could be made only with the clinicopathologic correlation because of their clinical and histopathological similarities.

A Case-Control Study to Identify Risk Factors Associated with Avian Influenza Subtype H9N2 on Commercial Poultry Farms in Pakistan

PubMed Central

Chaudhry, Mamoona; Rashid, Hamad B.; Thrusfield, Michael; Welburn, Sue; Bronsvoort, Barend MdeC.

2015-01-01

A 1:1 matched case-control study was conducted to identify risk factors for avian influenza subtype H9N2 infection on commercial poultry farms in 16 districts of Punjab, and 1 administrative unit of Pakistan. One hundred and thirty-three laboratory confirmed positive case farms were matched on the date of sample submission with 133 negative control farms. The association between a series of farm-level characteristics and the presence or absence of H9N2 was assessed by univariable analysis. Characteristics associated with H9N2 risk that passed the initial screening were included in a multivariable conditional logistic regression model. Manual and automated approaches were used, which produced similar models. Key risk factors from all approaches included selling of eggs/birds directly to live bird retail stalls, being near case/infected farms, a previous history of infectious bursal disease (IBD) on the farm and having cover on the water storage tanks. The findings of current study are in line with results of many other studies conducted in various countries to identify similar risk factors for AI subtype H9N2 infection. Enhancing protective measures and controlling risks identified in this study could reduce spread of AI subtype H9N2 and other AI viruses between poultry farms in Pakistan. PMID:25774768

Household-level risk factors for influenza among young children in Dhaka, Bangladesh: a case-control study.

PubMed

Doshi, Saumil; Silk, Benjamin J; Dutt, Dhiman; Ahmed, Moshtaq; Cohen, Adam L; Taylor, Thomas H; Brooks, W Abdullah; Goswami, Doli; Luby, Stephen P; Fry, Alicia M; Ram, Pavani K

2015-06-01

To identify household-level factors associated with influenza among young children in a crowded community in Dhaka, Bangladesh. We conducted a case-control study using existing active surveillance for respiratory illness. Cases were children aged 12-59 months with laboratory-confirmed influenza. Controls were children frequency-matched by age group with no respiratory illness in the prior 6 months. We interviewed caregivers and observed household handwashing behaviour. Soap consumption was estimated by summing weight differences of three bars of soap sequentially left in each household. We measured concentrations of airborne particulate matter <2.5 μg in diameter (PM2.5) in a subset of households. We used logistic regression to estimate adjusted odds ratios (aOR) and 95% confidence intervals (CI). We enrolled 145 cases and 341 controls between March 2009 and April 2010. Case and control household members were observed to wash hands with similar frequency during a 5-h period (mean, 0.64 events vs. 0.63, P = 0.87), and similar daily soap consumption per capita (mean 2.92 grams vs. 2.93, P = 0.92). Case households were more likely than controls to have crowded (≥4 persons) sleeping areas (aOR = 1.67, CI: 1.06-2.63) and cross-ventilated cooking spaces (aOR = 1.75, CI: 1.16-2.63). Case and control households had similar median 24-h geometric mean PM2.5 concentrations in the cooking (69.2 vs. 69.6 μg/m(3), P = 0.45) and sleeping (65.4 vs. 67.4 μg/m(3), P = 0.19) spaces. Handwashing with soap was practiced infrequently and was not associated with paediatric influenza in this community. Interventions aimed at crowded households may reduce influenza incidence in young children. © 2015 John Wiley & Sons Ltd.

Is Mistletoe Treatment Beneficial in Invasive Breast Cancer? A New Approach to an Unresolved Problem.

PubMed

Fritz, Peter; Dippon, Jürgen; Müller, Simon; Goletz, Sven; Trautmann, Christian; Pappas, Xenophon; Ott, German; Brauch, Hiltrud; Schwab, Matthias; Winter, Stefan; Mürdter, Thomas; Brinkmann, Friedhelm; Faisst, Simone; Rössle, Susanne; Gerteis, Andreas; Friedel, Godehard

2018-03-01

In this retrospective study, we compared breast cancer patients treated with and without mistletoe lectin I (ML-I) in addition to standard breast cancer treatment in order to determine a possible effect of this complementary treatment. This study included 18,528 patients with invasive breast cancer. Data on additional ML-I treatments were reported for 164 patients. We developed a "similar case" method with a distance measure retrieved from the beta variable in Cox regression to compare these patients, after stage adjustment, with their non-ML-1 treated counterparts in order to answer three hypotheses concerning overall survival, recurrence free survival and life quality. Raw data analysis of an additional ML-I treatment yielded a worse outcome (p=0.02) for patients with ML treatment, possibly due to a bias inherent in the ML-I-treated patients. Using the "similar case" method (a case-based reasoning approach) we could not confirm this harm for patients using ML-I. Analysis of life quality data did not demonstrate reliable differences between patients treated with ML-I treatment and those without proven ML-I treatment. Based on a "similar case" model we did not observe any differences in the overall survival (OS), recurrence-free survival (RFS), and quality of life data between breast cancer patients with standard treatment and those who in addition to standard treatment received ML-I treatment. Copyright© 2018, International Institute of Anticancer Research (Dr. George J. Delinasios), All rights reserved.

Methodology Series Module 2: Case-control Studies.

PubMed

Setia, Maninder Singh

2016-01-01

Case-Control study design is a type of observational study. In this design, participants are selected for the study based on their outcome status. Thus, some participants have the outcome of interest (referred to as cases), whereas others do not have the outcome of interest (referred to as controls). The investigator then assesses the exposure in both these groups. The investigator should define the cases as specifically as possible. Sometimes, definition of a disease may be based on multiple criteria; thus, all these points should be explicitly stated in case definition. An important aspect of selecting a control is that they should be from the same 'study base' as that of the cases. We can select controls from a variety of groups. Some of them are: General population; relatives or friends; and hospital patients. Matching is often used in case-control control studies to ensure that the cases and controls are similar in certain characteristics, and it is a useful technique to increase the efficiency of the study. Case-Control studies can usually be conducted relatively faster and are inexpensive - particularly when compared with cohort studies (prospective). It is useful to study rare outcomes and outcomes with long latent periods. This design is not very useful to study rare exposures. Furthermore, they may also be prone to certain biases - selection bias and recall bias.

The Curious Case of the "Refrigerator-TV": Similarity and Hybridization

ERIC Educational Resources Information Center

Gibbert, Michael; Hampton, James A.; Estes, Zachary; Mazursky, David

2012-01-01

This article examines the role of similarity in the hybridization of concepts, focusing on hybrid products as an applied test case. Hybrid concepts found in natural language, such as "singer songwriter," typically combine similar concepts, whereas dissimilar concepts rarely form hybrids. The hybridization of dissimilar concepts in products such as…

Sacral Stress Fracture Mimicking Lumbar Radiculopathy in a Mounted Police Officer: Case Report and Literature Review.

PubMed

Bednar, Drew A; Almansoori, Khaled

2015-10-01

Study Design Case report and review of the literature. Objective To present a unique case of L5 radiculopathy caused by a sacral stress fracture without neurologic compression. Methods We present our case and its clinical evolution and review the available literature on similar pathologies. Results Relief of the unusual mechanical loading causing sacral stress fracture led to rapid resolution of radiculopathy. Conclusion L5 radiculopathy can be caused by a sacral stress fracture and can be relieved by simple mechanical treatment of the fracture.

The risk of acute liver injury associated with the use of antibiotics--evaluating robustness of results in the pharmacoepidemiological research on outcomes of therapeutics by a European consortium (PROTECT) project.

PubMed

Udo, Renate; Tcherny-Lessenot, Stéphanie; Brauer, Ruth; Dolin, Paul; Irvine, David; Wang, Yunxun; Auclert, Laurent; Juhaeri, Juhaeri; Kurz, Xavier; Abenhaim, Lucien; Grimaldi, Lamiae; De Bruin, Marie L

2016-03-01

To examine the robustness of findings of case-control studies on the association between acute liver injury (ALI) and antibiotic use in the following different situations: (i) Replication of a protocol in different databases, with different data types, as well as replication in the same database, but performed by a different research team. (ii) Varying algorithms to identify cases, with and without manual case validation. (iii) Different exposure windows for time at risk. Five case-control studies in four different databases were performed with a common study protocol as starting point to harmonize study outcome definitions, exposure definitions and statistical analyses. All five studies showed an increased risk of ALI associated with antibiotic use ranging from OR 2.6 (95% CI 1.3-5.4) to 7.7 (95% CI 2.0-29.3). Comparable trends could be observed in the five studies: (i) without manual validation the use of the narrowest definition for ALI showed higher risk estimates, (ii) narrow and broad algorithm definitions followed by manual validation of cases resulted in similar risk estimates, and (iii) the use of a larger window (30 days vs 14 days) to define time at risk led to a decrease in risk estimates. Reproduction of a study using a predefined protocol in different database settings is feasible, although assumptions had to be made and amendments in the protocol were inevitable. Despite differences, the strength of association was comparable between the studies. In addition, the impact of varying outcome definitions and time windows showed similar trends within the data sources. Copyright © 2015 John Wiley & Sons, Ltd.

Neuromuscular assessment in elderly workers with and without work related shoulder/neck trouble: the NEW-study design and physiological findings.

PubMed

Sjøgaard, G; Søgaard, K; Hermens, H J; Sandsjö, L; Läubli, T; Thorn, S; Vollenbroek-Hutten, M M R; Sell, L; Christensen, H; Klipstein, A; Kadefors, R; Merletti, R

2006-01-01

Musculoskeletal disorders in the neck and shoulder area are a major occupational concern in the European countries especially among elderly females. The aim was to assess these disorders based on quantitative EMG indicators and functional tests. 252 female computer users (45-68 years) were recruited from four European countries in two contrast groups: (1) 88 neck/shoulder (NS) cases reporting trouble in the neck and/or shoulder region for more than 30 days during the last year, and (2) 164 NS-controls reporting such trouble for no more than 7 days. Questionnaires, functional/clinical tests, and physiological recordings were performed in workplace related field studies. The results showed no differences in anthropometrics but NS-cases reported more strained head positions and more eye problems than controls. The psychosocial working factors were similar, although, NS-controls had slightly better scores on working conditions, general health, and vitality compared to cases. The NS-cases had lower maximal voluntary contraction (MVC) during shoulder elevation (mean (SD) 310 (122) N) compared to the controls (364 (122) N). During 30% MVC electromyography (EMGrms) in the trapezius muscle was lower in NS-cases (194 (105) muV) than in controls (256 (169) muV), while no differences were found regarding endurance time. Estimated conduction velocity was not different between NS-cases and -controls. Four functional computer tests were performed equally well by NS-cases and -controls, and the corresponding EMG variables also did not differ. A major finding in this large-scale epidemiological study is the significantly lower MVC in NS-cases compared with NS-controls together with lower EMGrms value at 30% MVC, while computer tasks were performed at similar relative muscle activation. The study was unable to reveal quantitative EMG indicators and functional tests that could objectively assess disorders in NS-cases.

The effect of improving task representativeness on capturing nurses’ risk assessment judgements: a comparison of written case simulations and physical simulations

PubMed Central

2013-01-01

Background The validity of studies describing clinicians’ judgements based on their responses to paper cases is questionable, because - commonly used - paper case simulations only partly reflect real clinical environments. In this study we test whether paper case simulations evoke similar risk assessment judgements to the more realistic simulated patients used in high fidelity physical simulations. Methods 97 nurses (34 experienced nurses and 63 student nurses) made dichotomous assessments of risk of acute deterioration on the same 25 simulated scenarios in both paper case and physical simulation settings. Scenarios were generated from real patient cases. Measures of judgement ‘ecology’ were derived from the same case records. The relationship between nurses’ judgements, actual patient outcomes (i.e. ecological criteria), and patient characteristics were described using the methodology of judgement analysis. Logistic regression models were constructed to calculate Lens Model Equation parameters. Parameters were then compared between the modeled paper-case and physical-simulation judgements. Results Participants had significantly less achievement (ra) judging physical simulations than when judging paper cases. They used less modelable knowledge (G) with physical simulations than with paper cases, while retaining similar cognitive control and consistency on repeated patients. Respiration rate, the most important cue for predicting patient risk in the ecological model, was weighted most heavily by participants. Conclusions To the extent that accuracy in judgement analysis studies is a function of task representativeness, improving task representativeness via high fidelity physical simulations resulted in lower judgement performance in risk assessments amongst nurses when compared to paper case simulations. Lens Model statistics could prove useful when comparing different options for the design of simulations used in clinical judgement analysis. The approach outlined may be of value to those designing and evaluating clinical simulations as part of education and training strategies aimed at improving clinical judgement and reasoning. PMID:23718556

Similarity to the Self Affects Memory for Impressions of Others

PubMed Central

Leshikar, Eric D.; Gutchess, Angela H.

2017-01-01

The present studies investigated whether similarity to the self influenced memory for impressions of others. We predicted that similarity to the self would facilitate impression memory for others, paralleling the self-reference effect found when information is processed relative to the self. We were interested in how the initial valence of the impression, whether positive or negative, affected impression memory. Across two experiments, participants formed impressions while viewing faces paired with traits and behaviors. After recognition, participants rated the self-descriptiveness of the studied traits allowing impression memory to be sorted into high-, medium-, and low-self-similarity. For positive impressions, similar others were remembered better than dissimilar others. For negative impressions, similar others were remembered more poorly than dissimilar others. These results illustrate that similarity to the self has multifaceted effects on person memory, leading to memory enhancement in the case of people given positive impressions, but reducing memory for people associated with negative impressions. PMID:28936392

Bioactive glass in cavitary bone defects: a comparative experimental study in rabbits

PubMed Central

Camargo, André Ferrari de França; Baptista, André Mathias; Natalino, Renato; de Camargo, Olavo Pires

2015-01-01

OBJECTIVES: To compare bioactive glass and autograft regarding their histomorphometric characteristics. METHODS: The authors conducted a prospective case-control experimental study on animals in order to compare the histomorphometric characteristics of bioactive glass versus autograft. Eight rabbits underwent surgery in which a cavitary defect was created in both proximal femurs. One side was filled with bioactive glass granules and the other, with autograft grafted from the contralateral side. The sides were randomized. Fourteen days after surgery, the animals were euthanized. RESULTS: Histologic analysis revealed that bone neoformation was equivalent among the two groups and the osteoblasts cell-count was higher in the femurs treated with bioactive glass. The osteocytes cell-count, however, was lower. The similarity in bone formation between both groups was consistent to literature findings. CONCLUSION: Bioactive glass is similar to autograft regarding bone neoformation in this animal model of cavitary bone defects. Level of Evidence III, Case-Control Study. PMID:26327802

Discrete Self-Similarity in Interfacial Hydrodynamics and the Formation of Iterated Structures.

PubMed

Dallaston, Michael C; Fontelos, Marco A; Tseluiko, Dmitri; Kalliadasis, Serafim

2018-01-19

The formation of iterated structures, such as satellite and subsatellite drops, filaments, and bubbles, is a common feature in interfacial hydrodynamics. Here we undertake a computational and theoretical study of their origin in the case of thin films of viscous fluids that are destabilized by long-range molecular or other forces. We demonstrate that iterated structures appear as a consequence of discrete self-similarity, where certain patterns repeat themselves, subject to rescaling, periodically in a logarithmic time scale. The result is an infinite sequence of ridges and filaments with similarity properties. The character of these discretely self-similar solutions as the result of a Hopf bifurcation from ordinarily self-similar solutions is also described.

Acoustic emission studies of large advanced composite rocket motor cases.

NASA Technical Reports Server (NTRS)

Robinson, E. Y.

1973-01-01

Acoustic emission (AE) patterns were measured during pressure testing of advanced composite rocket motor cases made of boron/epoxy and graphite/epoxy. Both accelerometers and high frequency AE transducers were used, and both frequency spectrum and amplitude distribution were studied. The AE patterns suggest that precursor emission might be used in certain cases to anticipate failure. The technique of hold-cycle AE monitoring was also evaluated and could become a valuable decision gate for test continuation/termination. Data presented show similarity of accelerometers and AE transducer responses despite the different frequency response, and suggest that structural AE phenomena are broadband.

Rational Selection, Criticality Assessment, and Tiering of Quality Attributes and Test Methods for Analytical Similarity Evaluation of Biosimilars.

PubMed

Vandekerckhove, Kristof; Seidl, Andreas; Gutka, Hiten; Kumar, Manish; Gratzl, Gyöngyi; Keire, David; Coffey, Todd; Kuehne, Henriette

2018-05-10

Leading regulatory agencies recommend biosimilar assessment to proceed in a stepwise fashion, starting with a detailed analytical comparison of the structural and functional properties of the proposed biosimilar and reference product. The degree of analytical similarity determines the degree of residual uncertainty that must be addressed through downstream in vivo studies. Substantive evidence of similarity from comprehensive analytical testing may justify a targeted clinical development plan, and thus enable a shorter path to licensing. The importance of a careful design of the analytical similarity study program therefore should not be underestimated. Designing a state-of-the-art analytical similarity study meeting current regulatory requirements in regions such as the USA and EU requires a methodical approach, consisting of specific steps that far precede the work on the actual analytical study protocol. This white paper discusses scientific and methodological considerations on the process of attribute and test method selection, criticality assessment, and subsequent assignment of analytical measures to US FDA's three tiers of analytical similarity assessment. Case examples of selection of critical quality attributes and analytical methods for similarity exercises are provided to illustrate the practical implementation of the principles discussed.

The Pediatric Home Care/Expenditure Classification Model (P/ECM): A Home Care Case-Mix Model for Children Facing Special Health Care Challenges.

PubMed

Phillips, Charles D

2015-01-01

Case-mix classification and payment systems help assure that persons with similar needs receive similar amounts of care resources, which is a major equity concern for consumers, providers, and programs. Although health service programs for adults regularly use case-mix payment systems, programs providing health services to children and youth rarely use such models. This research utilized Medicaid home care expenditures and assessment data on 2,578 children receiving home care in one large state in the USA. Using classification and regression tree analyses, a case-mix model for long-term pediatric home care was developed. The Pediatric Home Care/Expenditure Classification Model (P/ECM) grouped children and youth in the study sample into 24 groups, explaining 41% of the variance in annual home care expenditures. The P/ECM creates the possibility of a more equitable, and potentially more effective, allocation of home care resources among children and youth facing serious health care challenges.

The Pediatric Home Care/Expenditure Classification Model (P/ECM): A Home Care Case-Mix Model for Children Facing Special Health Care Challenges

PubMed Central

Phillips, Charles D.

2015-01-01

Case-mix classification and payment systems help assure that persons with similar needs receive similar amounts of care resources, which is a major equity concern for consumers, providers, and programs. Although health service programs for adults regularly use case-mix payment systems, programs providing health services to children and youth rarely use such models. This research utilized Medicaid home care expenditures and assessment data on 2,578 children receiving home care in one large state in the USA. Using classification and regression tree analyses, a case-mix model for long-term pediatric home care was developed. The Pediatric Home Care/Expenditure Classification Model (P/ECM) grouped children and youth in the study sample into 24 groups, explaining 41% of the variance in annual home care expenditures. The P/ECM creates the possibility of a more equitable, and potentially more effective, allocation of home care resources among children and youth facing serious health care challenges. PMID:26740744

Trends in Prevalence and Characteristics of Post-Neonatal Cerebral Palsy Cases: A European Registry-Based Study

ERIC Educational Resources Information Center

Germany, Laurence; Ehlinger, Virginie; Klapouszczak, Dana; Delobel, Malika; Hollody, Katalin; Sellier, Elodie; De La Cruz, Javier; Alberge, Corine; Genolini, Christophe; Arnaud, Catherine

2013-01-01

The present paper aims to analyze trends over time in prevalence of cerebral palsy of post-neonatal origin, to investigate whether changes are similar according to severity and to describe the disability profile by etiology. Post-neonatal cases, birth years 1976 to 1998, were identified from the Surveillance of Cerebral Palsy in Europe…

A mixed-methods evaluation of health-related quality of life for male veterans with and without intestinal stomas.

PubMed

Krouse, Robert S; Grant, Marcia; Wendel, Christopher S; Mohler, M Jane; Rawl, Susan M; Baldwin, Carol M; Coons, Stephen Joel; McCorkle, Ruth; Ko, Clifford Y; Schmidt, C Max

2007-12-01

Intestinal stomas have a major impact on Cases' lives. It is essential to better understand the areas in which interventions may help to minimize the negative consequences. This was a case-control survey study using validated instruments (City of Hope Quality of Life-Ostomy and Short Form 36 for Veterans). Cases were accrued from Veterans Affairs Medical Centers in Tucson, Indianapolis, and Los Angeles. Eligibility included a major intra-abdominal surgical procedure that led to an ostomy (cases), or a similar procedure that did not mandate a stoma (controls). Analysis included quantitative and qualitative responses. The response rate was 48 percent (511/1,063). Cases and controls had relatively similar demographic characteristics. Because of low numbers of female respondents (13 cases and 11 controls), only results for males are reported. Based on both the City of Hope Quality of Life-Ostomy and Short Form 36 for Veterans, cases reported significantly poorer scores on scales/domains reflecting psychologic and social functioning and well being. Additionally, cases reported poorer scores on Short Form 36 for Veterans scales reflecting physical functioning and significantly lower scores on multiple items in the social domain of the City of Hope Quality of Life-Ostomy compared with controls. Two-thirds of cases replied to an open-ended question on their "greatest challenge" related to their ostomy, which led to further clarification of major issues. Multiple health-related quality of life problems were reported by male veterans with intestinal stomas. The greatest differences between cases and controls were observed in the social and psychologic domains/scales. Findings from this study provide a greater understanding of the challenges faced by ostomates and will inform the development and evaluation of urgently needed intervention strategies.

Climate Is Not All: Evidence From Phylogeography of Rhodiola fastigiata (Crassulaceae) and Comparison to Its Closest Relatives.

PubMed

Zhang, Jian-Qiang; Zhong, Da-Lv; Song, Wei-Jie; Zhu, Ruo-Wei; Sun, Wei-Yue

2018-01-01

How geological events and climate oscillations in the Pleistocene glaciation shaped the geographic distribution of genetic variation of species on the Qinghai-Tibetan Plateau (QTP) and its adjacent areas has been extensively studied. However, little studies have investigated whether closely related species in the same genus with similar physiological and life history traits responded similarly to the glacial climatic oscillations. If this is not the case, we would expect that the population histories of studied species were not driven by extrinsic environmental changes alone. Here we conducted a phylogeographic study of a succulent alpine plant Rhodiola fastigiata , using sequences from chloroplast genome and nrITS region, as well as ecological niche modeling. The results of R. fastigiata were compared to other congeneric species that have been studied, especially to R. alsia and R. crenulata . We found that for both markers, two geographic groups could be revealed, corresponding to the QTP plateau and the Hengduan Mountains, respectively, indicating isolated refugia in those two areas. The two groups diverged 1.23 Mya during the Pleistocene. We detected no significant population expansion by mismatch distribution analysis and Bayesian Skyline Plot. We found that even these similar species with similar physiological and life history traits have had different demographic histories in the Quaternary glacial periods. Our comparative phylogeographic study sheds new lights into phylogeographic research that extrinsic environmental changes are not the only factor that can drive population demography, and other factors, such as coevolved interactions between plants and their specialized pathogens, that probably played a role need to be examined with more case studies.

Elevated Blood Lead Concentrations in Essential Tremor: A Case–Control Study in Mersin, Turkey

PubMed Central

Dogu, Okan; Louis, Elan D.; Tamer, Lulufer; Unal, Ozgur; Yilmaz, Arda; Kaleagasi, Hakan

2007-01-01

Background Essential tremor (ET) is one of the most common neurologic disorders. Aside from underlying susceptibility genes, recent studies have also begun to focus on environmental toxic factors. Yet there remains a paucity of information on such factors, making studies of environmental factors important. A recent study in New York City found blood lead concentrations to be elevated in ET cases compared with matched controls. Chronic exposure to lead produces cerebellar damage, and this could predispose individuals to develop ET. Objective The aim of this study was to determine whether the elevation in blood lead concentrations observed in a single study in New York was similarly present in ET cases sampled from a completely different geographic region. Methods Blood lead concentrations were measured in 105 ET cases and 105 controls at Mersin University, Mersin, Turkey. Results The median blood lead concentration was 2.7 μg/dL in ET cases compared with 1.5 μg/dL in controls (p < 0.001). In an unadjusted logistic regression model, blood lead concentration was associated with diagnosis: odds ratio (OR) = 4.01; 95% confidence interval (CI), 2.53–6.37; p < 0.001 (i.e., each 1-μg/dL increase in blood lead concentration was associated with a 4-fold increased odds of ET). This association was more robust when cases were compared with a subsample of controls who did not share the same home environment (OR = 8.13; 95% CI, 3.05–21.65; p < 0.001). In adjusted models, results were similar. Conclusions These data replicate those of a previous study in New York and demonstrate an association between the environmental toxicant lead and a common neurologic disorder. PMID:18007985

Beta2-adrenergic agonist use and the risk of multiple sclerosis: a total population-based case-control study.

PubMed

Tsai, Ching-Piao; Lin, Feng-Cheng; Lee, Charles Tzu-Chi

2014-10-01

The aim of this study was to investigate whether the use of fenoterol, a beta2-adrenergic agonist, was associated with multiple sclerosis (MS) risk by conducting a total population-based case-control study in Taiwan. A total of 578 patients with newly diagnosed MS who had a severely disabling disease (SDD) certificate between January 1, 2002 and December 1, 2008 comprised the case group. These cases were compared with 2890 gender-, age-, residence-, and insurance premium-matched controls. Fenoterol use was analyzed using a conditional logistic regression model that controlled for asthma, chronic obstructive pulmonary disease (COPD), salbutamol and steroid use. Compared with the group of people who did not use fenoterol, the adjusted odds ratios were 0.67 (95% confidence interval (CI) = 0.48-0.93, p = 0.016) for the group prescribed fenoterol below 2.25 cumulative defined daily dose (cDDD) and 0.49 (95% CI = 0.33-0.71, p < 0.001) for the group with a cumulative fenoterol use of more than 2.25 cDDD. The dose-response relationship was similar within the non-asthma patients. The associations were similar between males and females, but differences between age groups were observed. The results of this study suggest that fenoterol use may reduce the risk of MS. © The Author(s), 2014.

Pre-operative patient teaching in an acute care ward in Hong Kong: a case study.

PubMed

Lee, David S; Chien, W T

2002-10-01

Many nurses have acknowledged that adequate pre-operative teaching can alleviate patients' anxiety, increase patient participation in their own care, and minimize post-operative complications. However, the organization and degree to which pre-operative patient teachingfeatured in nurses' practice varies in different acute care settings. A case study design was used to explore the practice of pre-operative teaching in a surgical ward of an acute general hospital in Hong Kong. Seventeen registered nurses working on the ward were interviewed and observed in order to explore how they conduct a pre-operative teaching program and the difficulties encountered by them in carrying out pre-operative teaching on this acute care setting. Thefindings of this study indicate that pre-operative teaching workshops are organized and conducted by nursesfrom the operating theatre, in the day surgery center. Ward nurses were not actively involved in this pre-operative teaching. The results of this study present some similarities to a study with the similar design in Australia. There are also issues unique to the Hong Kong context. This case study was to review Hong Kong nurses' current practices of pre-operative teaching and to understand the cultural, conceptual and managementfactors influencing the practice in pre-operative teaching.

Bayesian approach to the assessment of the population-specific risk of inhibitors in hemophilia A patients: a case study

PubMed Central

Cheng, Ji; Iorio, Alfonso; Marcucci, Maura; Romanov, Vadim; Pullenayegum, Eleanor M; Marshall, John K; Thabane, Lehana

2016-01-01

Background Developing inhibitors is a rare event during the treatment of hemophilia A. The multifacets and uncertainty surrounding the development of inhibitors further complicate the process of estimating inhibitor rate from the limited data. Bayesian statistical modeling provides a useful tool in generating, enhancing, and exploring the evidence through incorporating all the available information. Methods We built our Bayesian analysis using three study cases to estimate the inhibitor rates of patients with hemophilia A in three different scenarios: Case 1, a single cohort of previously treated patients (PTPs) or previously untreated patients; Case 2, a meta-analysis of PTP cohorts; and Case 3, a previously unexplored patient population – patients with baseline low-titer inhibitor or history of inhibitor development. The data used in this study were extracted from three published ADVATE (antihemophilic factor [recombinant] is a product of Baxter for treating hemophilia A) post-authorization surveillance studies. Noninformative and informative priors were applied to Bayesian standard (Case 1) or random-effects (Case 2 and Case 3) logistic models. Bayesian probabilities of satisfying three meaningful thresholds of the risk of developing a clinical significant inhibitor (10/100, 5/100 [high rates], and 1/86 [the Food and Drug Administration mandated cutoff rate in PTPs]) were calculated. The effect of discounting prior information or scaling up the study data was evaluated. Results Results based on noninformative priors were similar to the classical approach. Using priors from PTPs lowered the point estimate and narrowed the 95% credible intervals (Case 1: from 1.3 [0.5, 2.7] to 0.8 [0.5, 1.1]; Case 2: from 1.9 [0.6, 6.0] to 0.8 [0.5, 1.1]; Case 3: 2.3 [0.5, 6.8] to 0.7 [0.5, 1.1]). All probabilities of satisfying a threshold of 1/86 were above 0.65. Increasing the number of patients by two and ten times substantially narrowed the credible intervals for the single cohort study (1.4 [0.7, 2.3] and 1.4 [1.1, 1.8], respectively). Increasing the number of studies by two and ten times for the multiple study scenarios (Case 2: 1.9 [0.6, 4.0] and 1.9 [1.5, 2.6]; Case 3: 2.4 [0.9, 5.0] and 2.6 [1.9, 3.5], respectively) had a similar effect. Conclusion Bayesian approach as a robust, transparent, and reproducible analytic method can be efficiently used to estimate the inhibitor rate of hemophilia A in complex clinical settings. PMID:27822129

Bayesian approach to the assessment of the population-specific risk of inhibitors in hemophilia A patients: a case study.

PubMed

Cheng, Ji; Iorio, Alfonso; Marcucci, Maura; Romanov, Vadim; Pullenayegum, Eleanor M; Marshall, John K; Thabane, Lehana

2016-01-01

Developing inhibitors is a rare event during the treatment of hemophilia A. The multifacets and uncertainty surrounding the development of inhibitors further complicate the process of estimating inhibitor rate from the limited data. Bayesian statistical modeling provides a useful tool in generating, enhancing, and exploring the evidence through incorporating all the available information. We built our Bayesian analysis using three study cases to estimate the inhibitor rates of patients with hemophilia A in three different scenarios: Case 1, a single cohort of previously treated patients (PTPs) or previously untreated patients; Case 2, a meta-analysis of PTP cohorts; and Case 3, a previously unexplored patient population - patients with baseline low-titer inhibitor or history of inhibitor development. The data used in this study were extracted from three published ADVATE (antihemophilic factor [recombinant] is a product of Baxter for treating hemophilia A) post-authorization surveillance studies. Noninformative and informative priors were applied to Bayesian standard (Case 1) or random-effects (Case 2 and Case 3) logistic models. Bayesian probabilities of satisfying three meaningful thresholds of the risk of developing a clinical significant inhibitor (10/100, 5/100 [high rates], and 1/86 [the Food and Drug Administration mandated cutoff rate in PTPs]) were calculated. The effect of discounting prior information or scaling up the study data was evaluated. Results based on noninformative priors were similar to the classical approach. Using priors from PTPs lowered the point estimate and narrowed the 95% credible intervals (Case 1: from 1.3 [0.5, 2.7] to 0.8 [0.5, 1.1]; Case 2: from 1.9 [0.6, 6.0] to 0.8 [0.5, 1.1]; Case 3: 2.3 [0.5, 6.8] to 0.7 [0.5, 1.1]). All probabilities of satisfying a threshold of 1/86 were above 0.65. Increasing the number of patients by two and ten times substantially narrowed the credible intervals for the single cohort study (1.4 [0.7, 2.3] and 1.4 [1.1, 1.8], respectively). Increasing the number of studies by two and ten times for the multiple study scenarios (Case 2: 1.9 [0.6, 4.0] and 1.9 [1.5, 2.6]; Case 3: 2.4 [0.9, 5.0] and 2.6 [1.9, 3.5], respectively) had a similar effect. Bayesian approach as a robust, transparent, and reproducible analytic method can be efficiently used to estimate the inhibitor rate of hemophilia A in complex clinical settings.

Is uniportal thoracoscopic surgery a feasible approach for advanced stages of non-small cell lung cancer?

PubMed Central

Fieira, Eva; Delgado, Maria; Mendez, Lucía; Fernandez, Ricardo; de la Torre, Mercedes

2014-01-01

Objectives Conventional video-assisted thoracoscopic (VATS) lobectomy for advanced lung cancer is a feasible and safe surgery in experienced centers. The aim of this study is to assess the feasibility of uniportal VATS approach in the treatment of advanced non-small cell lung cancer (NSCLC) and compare the perioperative outcomes and survival with those in early-stage tumors operated through the uniportal approach. Methods From June 2010 to December 2012, we performed 163 uniportal VATS major pulmonary resections. Only NSCLC cases were included in this study (130 cases). Patients were divided into two groups: (A) early stage and (B) advanced cases (>5 cm, T3 or T4, or tumors requiring neoadjuvant treatment). A descriptive and retrospective study was performed, comparing perioperative outcomes and survival obtained in both groups. A survival analysis was performed with Kaplan-Meier curves and the log-rank test was used to compare survival between patients with early and advanced stages. Results A total of 130 cases were included in the study: 87 (A) vs. 43 (B) patients (conversion rate 1.1 vs. 6.5%, P=0.119). Mean global age was 64.9 years and 73.8% were men. The patient demographic data was similar in both groups. Upper lobectomies (A, 52 vs. B, 21 patients) and anatomic segmentectomies (A, 4 vs. B, 0) were more frequent in group A while pneumonectomy was more frequent in B (A, 1 vs. B, 6 patients). Surgical time was longer (144.9±41.3 vs. 183.2±48.9, P<0.001), and median number of lymph nodes (14 vs. 16, P=0.004) were statistically higher in advanced cases. Median number of nodal stations (5 vs. 5, P=0.165), days of chest tube (2 vs. 2, P=0.098), HOS (3 vs. 3, P=0.072), and rate of complications (17.2% vs. 14%, P=0.075) were similar in both groups. One patient died on the 58th postoperative day. The 30-month survival rate was 90% for the early stage group and 74% for advanced cases Conclusions Uniportal VATS lobectomy for advanced cases of NSCLC is a safe and reliable procedure that provides perioperative outcomes similar to those obtained in early stage tumours operated through this same technique. Further long term survival analyses are ongoing on a large number of patients. PMID:24976985

Lifestyles through Expenditures: A Case-Based Approach to Saving

PubMed Central

Keister, Lisa A.; Benton, Richard; Moody, James

2016-01-01

Treating people as cases that are proximate in a behavior space—representing lifestyles—rather than as markers of single variables has a long history in sociology. Yet, because it is difficult to find analytically tractable ways to implement this idea, this approach is rarely used. We take seriously the idea that people are whole packages, and we use household spending to identify groups who occupy similar positions in social space. Using detailed data on household consumption, we identify eight positions that are clearly similar in lifestyle. We then study how the lifestyles we identify are associated with saving, an important measure of household well-being. We find that households cluster into distinct lifestyles based on similarities and differences in consumption. These lifestyles are meaningfully related in social space and save in distinct ways that have important implications for understanding inequality and stratification. PMID:27904877

Case clusters of leproid granulomas in foxhounds in New Zealand and Australia.

PubMed

Smits, Bronwyn; Willis, Richard; Malik, Richard; Studdert, Virginia; Collins, Desmond M; Kawakami, Pamela; Graham, Duncan; Fyfe, Janet A

2012-12-01

Canine leproid granuloma (CLG) characteristically presents as single to multiple circumscribed dermal to subcutaneous nodules in haired skin. An unidentified mycobacterium is considered be the aetiological agent of this entity. Several cases of canine leproid granulomas occurred in dogs in New Zealand during 2010 and 2011. Cases appeared in clusters, affecting multiple closely related foxhounds domiciled in the same kennels. All affected hounds recovered after topical and/or systemic antimicrobial therapy. Two similar outbreaks that occurred in foxhounds near Melbourne, Australia are also reported. Cases were investigated using cytological, histological, microbiological and several molecular techniques. An environmental epidemiological study was also performed. A diagnosis of CLG was established in 11 dogs. Molecular identification of the causative agent confirmed that it was a mycobacterial species with 100% sequence homology within the amplified regions of the 16S rRNA gene and internal transcribed spacer (ITS1) with that found in association with similar infections from the USA, Brazil and Australia. This report details the first occurrence of multiple cases of CLG occurring in in-contact dogs and the first proven case of CLG in dogs in New Zealand. © 2012 The Authors. Veterinary Dermatology © 2012 ESVD and ACVD.

High Speed Vessels to Market : Comparative Case Studies in the Passenger Trade

DOT National Transportation Integrated Search

2001-08-01

The Volpe Center chose to study several existing catamarans and high speed monohulls in comparison to representative SWATH family craft, including the SLICE 400 (passenger) and SLICE 600 (passenger/90 car) variants, the former similar in size and per...

RETROSPECTIVE ANALYSIS OF WOUND CHARACTERISTICS AND TETANUS DEVELOPMENT IN CAPTIVE MACAQUES

PubMed Central

Springer, Danielle A.; Phillippi-Falkenstein, Kathrine; Smith, Gary

2008-01-01

Traumatic wounds and access to outdoor enclosures containing soil contribute to development of tetanus in non-human primates. A retrospective matched case-control study was conducted at a primate center to evaluate these factors by analysis of medical records of animals sustaining traumatic injuries during a three year study period: 31 macaques with traumatic injuries and a clinical diagnosis of tetanus were selected as cases and 62 macaques with traumatic injuries and no diagnosis of tetanus were selected as controls. For an animal with injuries to the digits, the odds of developing tetanus were 9.6 times those of a similar animal without injuries to the digits (OR = 9.55, 95% CI = 1.56 – 58.59); with injuries to the tail, the odds of developing tetanus were 8.0 times those of a similar animal without injuries to the tail (OR = 7.95, 95% CI = 0.82 – 77.04); and with injuries in more than one location, the odds of developing tetanus were 8.5 times those for a similar animal with injuries in just one location (OR = 8.45, 95% CI = 1.01 – 70.46). A non-human primate with injuries to the leg was less likely to develop tetanus than a similar non-human primate without injuries to the leg (OR = 0.19, 95% CI = 0.03 – 1.2). Results indicated that wound location is associated with development of tetanus infection in rhesus macaques. Identification of high risk trauma cases will allow better allocation of wound management and tetanus prophylaxis in institutions, especially those housing non-human primates outdoors. PMID:19368246

Similarity Based Semantic Web Service Match

NASA Astrophysics Data System (ADS)

Peng, Hui; Niu, Wenjia; Huang, Ronghuai

Semantic web service discovery aims at returning the most matching advertised services to the service requester by comparing the semantic of the request service with an advertised service. The semantic of a web service are described in terms of inputs, outputs, preconditions and results in Ontology Web Language for Service (OWL-S) which formalized by W3C. In this paper we proposed an algorithm to calculate the semantic similarity of two services by weighted averaging their inputs and outputs similarities. Case study and applications show the effectiveness of our algorithm in service match.

Child maltreatment as a risk factor for opioid dependence: Comparison of family characteristics and type and severity of child maltreatment with a matched control group.

PubMed

Conroy, Elizabeth; Degenhardt, Louisa; Mattick, Richard P; Nelson, Elliot C

2009-06-01

To examine the prevalence, characteristics and risk factors for child maltreatment among opioid-dependent persons compared to a community sample of similar social disadvantage. The study employed a case-control design. Cases had a history of opioid pharmacotherapy. Controls were frequency matched to cases with regard to age, sex and unemployment and were restricted to those with a lifetime opioid use of less than five times. The interview covered child maltreatment, family environment, drug use and psychiatric history. This study found a high prevalence of child maltreatment among both cases and controls. Despite the elevated prevalence among controls, opioid-dependent males had a higher prevalence of physical and emotional abuse; female cases had a higher prevalence and greater severity of sexual abuse. The prevalence of neglect was similar for both groups. Early parental separation was more prevalent among female cases compared to female controls; otherwise the prevalence of the risk factors was comparable for both groups. The risk factors significantly associated with child maltreatment were also similar for both cases and controls. Given the documented association between child maltreatment and adult mental disorder, child maltreatment may be an important antecedent of current psychological distress in persons presenting to treatment for opioid dependence. Apart from a possible association between early parental separation and sexual abuse among female cases, the increased prevalence of child maltreatment associated with opioid dependence did not appear to be related to differences in early childhood risk factors considered in this paper. Other risk factors may be more pertinent for those with opioid dependence. The high prevalence of child maltreatment among the opioid-dependent sample has implications for the assessment and treatment of clients presenting with opioid dependence. Assessment of child maltreatment history could help inform the development of individual treatment plans to better address those factors contributing to the development and maintenance of opioid dependence. Specifically, management of co-morbid mental disorder associated with child maltreatment could be the focus of relapse prevention programmes and also have a positive influence on treatment retention.

Child maltreatment as a risk factor for opioid dependence: comparison of family characteristics and type and severity of child maltreatment with a matched control group

PubMed Central

Conroy, Elizabeth; Degenhardt, Louisa; Mattick, Richard P.; Nelson, Elliot C.

2009-01-01

Objective To examine the prevalence, characteristics and risk factors for child maltreatment among opioid-dependent persons compared to a community sample of similar social disadvantage. Method The study employed a case-control design. Cases had a history of opioid pharmacotherapy. Controls were frequency matched to cases with regard to age, sex and unemployment and were restricted to those with a lifetime opioid use of less than five times. The interview covered child maltreatment, family environment, drug use and psychiatric history. Results This study found a high prevalence of child maltreatment among both cases and controls. Despite the elevated prevalence among controls, opioid-dependent males had a higher prevalence of physical and emotional abuse; female cases had a higher prevalence and greater severity of sexual abuse. The prevalence of neglect was similar for both groups. Early parental separation was more prevalent among female cases compared to female controls; otherwise the prevalence of the risk factors was comparable for both groups. The risk factors significantly associated with child maltreatment were also similar for both cases and controls. Conclusions Given the documented association between child maltreatment and adult mental disorder, child maltreatment may be an important antecedent of current psychological distress in persons presenting to treatment for opioid dependence. Apart from a possible association between early parental separation and sexual abuse among female cases, the increased prevalence of child maltreatment associated with opioid-dependence did not appear to be related to differences in early childhood risk factors considered in this paper. Other risk factors may be more pertinent for those with opioid dependence. Practice Implications The high prevalence of child maltreatment among the opioid-dependent sample has implications for the assessment and treatment of clients presenting with opioid dependence. Assessment of child maltreatment history could help inform the development of individual treatment plans to better address those factors contributing to the development and maintenance of opiate dependence. Specifically, management of co-morbid mental disorder associated with child maltreatment could be the focus of relapse prevention programmes and also have a positive influence on treatment retention. PMID:19477004

Observational Studies: Cohort and Case-Control Studies

PubMed Central

Song, Jae W.; Chung, Kevin C.

2010-01-01

Observational studies are an important category of study designs. To address some investigative questions in plastic surgery, randomized controlled trials are not always indicated or ethical to conduct. Instead, observational studies may be the next best method to address these types of questions. Well-designed observational studies have been shown to provide results similar to randomized controlled trials, challenging the belief that observational studies are second-rate. Cohort studies and case-control studies are two primary types of observational studies that aid in evaluating associations between diseases and exposures. In this review article, we describe these study designs, methodological issues, and provide examples from the plastic surgery literature. PMID:20697313

Similarity extraction mechanism concerning historical personalities based on SQL queries in an RDBMS environment

NASA Astrophysics Data System (ADS)

Barouchou, Alexandra; Dendrinos, Markos

2015-02-01

An interesting issue in the domain of history of science and ideas is the concept of similarity of historical personalities. Similar objects of research of philosophers and scientists indicate prospective influences, caused either from one another's reading or meetings, communication or even cooperation. Key methodological role in the surfacing of the sought similarities play the keywords extracted from their works as well as their placement in a philosophical and scientific term taxonomy. The case study examined in the framework of this paper concerns scientists and philosophers, who lived in ancient Greece or Renaissance periods and dealt, in at least one work, with the subject God. All the available data (scientists, studies, recorded relations between scientists, keywords, and thematic hierarchy) have been organized in an RDBMS environment, aiming at the emergence of similarities and influences between scientists through properly created SQL queries based on date and thematic hierarchy criteria.

Home pesticide exposures and risk of childhood leukemia: Findings from the Childhood Leukemia International Consortium

PubMed Central

Bailey, Helen D; Infante-Rivard, Claire; Metayer, Catherine; Clavel, Jacqueline; Lightfoot, Tracy; Kaatsch, Peter; Roman, Eve; Magnani, Corrado; Spector, Logan G; Petridou, Eleni; Milne, Elizabeth; Dockerty, John D; Miligi, Lucia; Armstrong, Bruce K; Rudant, Jérémie; Fritschi, Lin; Simpson, Jill; Zhang, Luoping; Rondelli, Roberto; Baka, Margarita; Orsi, Laurent; Moschovi, Maria; Kang, Alice Y; Schüz, Joachim

2015-01-01

Some previous studies have suggested that home pesticide exposure before birth and during a child's early years may increase the risk of childhood leukemia. To further investigate this, we pooled individual level data from 12 case-control studies in the Childhood Leukemia International Consortium (CLIC). Exposure data were harmonized into compatible formats. Pooled analyses were undertaken using multivariable unconditional logistic regression. The odds ratio (ORs) for acute lymphoblastic leukaemia (ALL) associated with any pesticide exposure shortly before conception, during pregnancy and after birth were 1.39 (95% confidence interval (CI) 1.25, 1.55) (using (2,785 cases, 3635 controls), 1.43 (95% CI 1.32, 1.54) (5,055 cases, 7,370 controls) and 1.36 (95% CI 1.23, 1.51) (4,162 cases 5,179 controls), respectively. Corresponding ORs for risk of acute myeloid leukaemia (AML) were 1.49 (95% CI 1.02, 2.16) (173 cases, 1,789 controls), 1.55 (95% CI 1.21, 1.99) (344 cases, 4,666 controls) and 1.08 (95% CI 0.76, 1.53) (198 cases, 2,655 controls) respectively. There was little difference by type of pesticide used. The relative similarity in ORs between leukaemia types, time periods and pesticide types may be explained by similar exposure patterns and effects across the time periods in ALL and AML, participants’ exposure to multiple pesticides, or recall bias. Although some recall bias is likely, until a better study design can be found to investigate associations between home pesticide use and childhood leukaemia in an equally large sample, it would appear prudent to limit the use of home pesticides before and during pregnancy, and during childhood. PMID:26061779

Measuring the representational space of music with fMRI: a case study with Sting.

PubMed

Levitin, Daniel J; Grafton, Scott T

2016-12-01

Functional brain imaging has revealed much about the neuroanatomical substrates of higher cognition, including music, language, learning, and memory. The technique lends itself to studying of groups of individuals. In contrast, the nature of expert performance is typically studied through the examination of exceptional individuals using behavioral case studies and retrospective biography. Here, we combined fMRI and the study of an individual who is a world-class expert musician and composer in order to better understand the neural underpinnings of his music perception and cognition, in particular, his mental representations for music. We used state of the art multivoxel pattern analysis (MVPA) and representational dissimilarity analysis (RDA) in a fixed set of brain regions to test three exploratory hypotheses with the musician Sting: (1) Composing would recruit neutral structures that are both unique and distinguishable from other creative acts, such as composing prose or visual art; (2) listening and imagining music would recruit similar neural regions, indicating that musical memory shares anatomical substrates with music listening; (3) the MVPA and RDA results would help us to map the representational space for music, revealing which musical pieces and genres are perceived to be similar in the musician's mental models for music. Our hypotheses were confirmed. The act of composing, and even of imagining elements of the composed piece separately, such as melody and rhythm, activated a similar cluster of brain regions, and were distinct from prose and visual art. Listened and imagined music showed high similarity, and in addition, notable similarity/dissimilarity patterns emerged among the various pieces used as stimuli: Muzak and Top 100/Pop songs were far from all other musical styles in Mahalanobis distance (Euclidean representational space), whereas jazz, R&B, tango and rock were comparatively close. Closer inspection revealed principaled explanations for the similarity clusters found, based on key, tempo, motif, and orchestration.

Air pollution and case fatality of SARS in the People's Republic of China: an ecologic study

PubMed Central

Cui, Yan; Zhang, Zuo-Feng; Froines, John; Zhao, Jinkou; Wang, Hua; Yu, Shun-Zhang; Detels, Roger

2003-01-01

Background Severe acute respiratory syndrome (SARS) has claimed 349 lives with 5,327 probable cases reported in mainland China since November 2002. SARS case fatality has varied across geographical areas, which might be partially explained by air pollution level. Methods Publicly accessible data on SARS morbidity and mortality were utilized in the data analysis. Air pollution was evaluated by air pollution index (API) derived from the concentrations of particulate matter, sulfur dioxide, nitrogen dioxide, carbon monoxide and ground-level ozone. Ecologic analysis was conducted to explore the association and correlation between air pollution and SARS case fatality via model fitting. Partially ecologic studies were performed to assess the effects of long-term and short-term exposures on the risk of dying from SARS. Results Ecologic analysis conducted among 5 regions with 100 or more SARS cases showed that case fatality rate increased with the increment of API (case fatality = - 0.063 + 0.001 * API). Partially ecologic study based on short-term exposure demonstrated that SARS patients from regions with moderate APIs had an 84% increased risk of dying from SARS compared to those from regions with low APIs (RR = 1.84, 95% CI: 1.41–2.40). Similarly, SARS patients from regions with high APIs were twice as likely to die from SARS compared to those from regions with low APIs. (RR = 2.18, 95% CI: 1.31–3.65). Partially ecologic analysis based on long-term exposure to ambient air pollution showed the similar association. Conclusion Our studies demonstrated a positive association between air pollution and SARS case fatality in Chinese population by utilizing publicly accessible data on SARS statistics and air pollution indices. Although ecologic fallacy and uncontrolled confounding effect might have biased the results, the possibility of a detrimental effect of air pollution on the prognosis of SARS patients deserves further investigation. PMID:14629774

Using unassisted ecosystem development to restore marginal land case study of post mining areas

NASA Astrophysics Data System (ADS)

Frouz, Jan

2017-04-01

When we evaluate efficiency of individual restoration measures we typically compare individual restoration treatments or compare them with initial state or similar ecosystem in surrounding landscape. We argue that sensible way to show added value of restoration measure is to compare them with unassisted ecosystem development. Case study of ecosystem development in Sokolov post mining district (Czech Republic) show that spontaneous succession of ecosystem can be, in many parameters, comparable with various reclamation approaches. In suitable substrates the succession is driven mainly by site topography. In sites which were leveled grassy vegetation develops. In sites where original wave like topography was preserved the ecosystem develops towards forest. In forest sites the development on most of the investigated ecosystem parameters (cower, biomass soil developments, water holding capacity, carbon storage) in succession sites is little bit slower compare to reclaimed plantation during first 15-20 years. However in older sites differences disappear and succession sites show similarity with restored sites. Despite similarity in these ecosystem functions possibilities of spontaneous sites for commercial use has to be explored.

Applying CBR to machine tool product configuration design oriented to customer requirements

NASA Astrophysics Data System (ADS)

Wang, Pengjia; Gong, Yadong; Xie, Hualong; Liu, Yongxian; Nee, Andrew Yehching

2017-01-01

Product customization is a trend in the current market-oriented manufacturing environment. However, deduction from customer requirements to design results and evaluation of design alternatives are still heavily reliant on the designer's experience and knowledge. To solve the problem of fuzziness and uncertainty of customer requirements in product configuration, an analysis method based on the grey rough model is presented. The customer requirements can be converted into technical characteristics effectively. In addition, an optimization decision model for product planning is established to help the enterprises select the key technical characteristics under the constraints of cost and time to serve the customer to maximal satisfaction. A new case retrieval approach that combines the self-organizing map and fuzzy similarity priority ratio method is proposed in case-based design. The self-organizing map can reduce the retrieval range and increase the retrieval efficiency, and the fuzzy similarity priority ratio method can evaluate the similarity of cases comprehensively. To ensure that the final case has the best overall performance, an evaluation method of similar cases based on grey correlation analysis is proposed to evaluate similar cases to select the most suitable case. Furthermore, a computer-aided system is developed using MATLAB GUI to assist the product configuration design. The actual example and result on an ETC series machine tool product show that the proposed method is effective, rapid and accurate in the process of product configuration. The proposed methodology provides a detailed instruction for the product configuration design oriented to customer requirements.

Methodology Series Module 2: Case-control Studies

PubMed Central

Setia, Maninder Singh

2016-01-01

Case-Control study design is a type of observational study. In this design, participants are selected for the study based on their outcome status. Thus, some participants have the outcome of interest (referred to as cases), whereas others do not have the outcome of interest (referred to as controls). The investigator then assesses the exposure in both these groups. The investigator should define the cases as specifically as possible. Sometimes, definition of a disease may be based on multiple criteria; thus, all these points should be explicitly stated in case definition. An important aspect of selecting a control is that they should be from the same ‘study base’ as that of the cases. We can select controls from a variety of groups. Some of them are: General population; relatives or friends; and hospital patients. Matching is often used in case-control control studies to ensure that the cases and controls are similar in certain characteristics, and it is a useful technique to increase the efficiency of the study. Case-Control studies can usually be conducted relatively faster and are inexpensive – particularly when compared with cohort studies (prospective). It is useful to study rare outcomes and outcomes with long latent periods. This design is not very useful to study rare exposures. Furthermore, they may also be prone to certain biases – selection bias and recall bias. PMID:27057012

Molecular Dynamics Studies of Proton Transport in Hydrogenase and Hydrogenase Mimics.

PubMed

Ginovska, B; Raugei, S; Shaw, W J

2016-01-01

There is extensive interest in hydrogenases based on their ability to rapidly and efficiently interconvert H2 with protons and electrons, and their (typically) superior function relative to molecular mimics. Understanding the function of enzymes is one approach to implementing design features to make better catalysts and is an approach we have implemented in our work. In this review, we will discuss our efforts to develop design principles from enzymes, with specific focus on proton transport. We will also present computational studies of the mimics we have investigated with similar methodologies. We will discuss the mechanisms used by small scaffolds on molecular mimics which in many cases are surprisingly similar to those used by nature, while in other cases, computational analysis allowed us to reveal an unexpected role. Computational methods provide one of the best ways, and in some cases, the only way, to gain insight into the mechanistic details of enzymes. In this review, we illustrate the general computational strategy we used to study the proton pathway of [FeFe]-hydrogenase, and the similar strategy to investigate small molecules. We present the main results we obtained and how our computational work stimulated or worked in concert with experimental investigations. We also focus on estimation of errors and convergence of properties in the simulations. These studies demonstrate the powerful results that can be obtained by the close pairing of experimental and theoretical approaches. Copyright © 2016 Elsevier Inc. All rights reserved. Battelle, operator of PNNL, under Contract No: DE-AC05-76RL01830 with US DoE.

Comparison of two control groups for estimation of oral cholera vaccine effectiveness using a case-control study design.

PubMed

Franke, Molly F; Jerome, J Gregory; Matias, Wilfredo R; Ternier, Ralph; Hilaire, Isabelle J; Harris, Jason B; Ivers, Louise C

2017-10-13

Case-control studies to quantify oral cholera vaccine effectiveness (VE) often rely on neighbors without diarrhea as community controls. Test-negative controls can be easily recruited and may minimize bias due to differential health-seeking behavior and recall. We compared VE estimates derived from community and test-negative controls and conducted bias-indicator analyses to assess potential bias with community controls. From October 2012 through November 2016, patients with acute watery diarrhea were recruited from cholera treatment centers in rural Haiti. Cholera cases had a positive stool culture. Non-cholera diarrhea cases (test-negative controls and non-cholera diarrhea cases for bias-indicator analyses) had a negative culture and rapid test. Up to four community controls were matched to diarrhea cases by age group, time, and neighborhood. Primary analyses included 181 cholera cases, 157 non-cholera diarrhea cases, 716 VE community controls and 625 bias-indicator community controls. VE for self-reported vaccination with two doses was consistent across the two control groups, with statistically significant VE estimates ranging from 72 to 74%. Sensitivity analyses revealed similar, though somewhat attenuated estimates for self-reported two dose VE. Bias-indicator estimates were consistently less than one, with VE estimates ranging from 19 to 43%, some of which were statistically significant. OCV estimates from case-control analyses using community and test-negative controls were similar. While bias-indicator analyses suggested possible over-estimation of VE estimates using community controls, test-negative analyses suggested this bias, if present, was minimal. Test-negative controls can be a valid low-cost and time-efficient alternative to community controls for OCV effectiveness estimation and may be especially relevant in emergency situations. Copyright © 2017. Published by Elsevier Ltd.

Maternal hypertension and risk for hypospadias in offspring.

PubMed

Agopian, A J; Hoang, Thanh T; Mitchell, Laura E; Morrison, Alanna C; Tu, Duong; Nassar, Natasha; Canfield, Mark A

2016-12-01

Hypospadias is one of the most common birth defects in male infants. Maternal hypertension is a suspected risk factor; however, few previous studies have addressed the possibility of reporting bias, and several previous studies have not accounted for hypospadias severity. We analyzed data from the Texas Birth Defects Registry for 10,924 nonsyndromic cases and statewide vital records for deliveries during 1999-2009, using Poisson regression. After adjustment for potential confounders, hypospadias was associated with maternal hypertension (adjusted prevalence ratio: 1.5, 95% confidence interval: 1.4-1.7). Similar associations were observed with gestational and pregestational hypertension, including separate analyses restricted to the subset of cases with severe (second- or third-degree) hypospadias. All of these associations were also similar among the subset of cases with isolated hypospadias (without additional birth defects). To evaluate the potential for bias due to potential hypertension misclassification, we repeated our analyses using logistic regression, comparing the cases to controls with other birth defects. In these analyses, the associations with gestational hypertension were similar, but adjusted associations with pregestational hypertension were no longer observed. Our findings support an association between gestational hypertension and hypospadias in offspring, but also suggest that previously observed associations with pregestational hypertension may have been inflated due to differential misclassification of hypertension (e.g., reporting bias). As gestational hypertension is recognized after hypospadias development, more research is needed to determine if this association reflects an increase in gestational hypertension risk secondary to hypospadias or if both conditions have shared risk factors (e.g., precursors of gestational hypertension). © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

Cultural differences among health professionals: a case illustration.

PubMed

Perkins, H S; Supik, J D; Hazuda, H P

1998-01-01

This study illustrates that cultural differences arise among similarly trained health professionals. Health professionals must learn to communicate sensitively with colleagues from other cultures, to respect their values, and to recognize and resolve cultural differences that affect patient care. In this shrinking, multicultural world, health professionals cannot afford the comfortable illusion that all similarly trained practitioners share the same values about the care of patients and professional conduct.

Gender, Class and Rurality: Australian Case Studies

ERIC Educational Resources Information Center

Bryant, Lia; Pini, Barbara

2009-01-01

The interrelationship between gender and class in rural spaces has received little attention. While rural scholars have focused on the implications for class from processes of gentrification and agricultural and rural restructuring, these analyses have remained largely ungendered. Similarly, feminist rural studies have rarely explored subjectivity…

Evaluation of paradoxical TB–associated IRIS with the use of standardized case definitions for resource limited settings

PubMed Central

Eshun-Wilson, Ingrid; Havers, Fiona; Nachega, Jean B; Prozesky, Hans W; Taljaard, Jantjie J; Zeier, Michele D; Cotton, Mark; Simon, Gary; Soentjens, Patrick

2011-01-01

Objective Standardized case definitions have recently been proposed by the International Network for the Study of HIV-associated IRIS (INSHI) for use in resource-limited settings. We evaluated paradoxical TB-associated IRIS in a large cohort from a TB endemic setting with the use of these case definitions. Design A retrospective cohort analysis. Methods We reviewed records from 1250 South African patients who initiated anti-retroviral therapy (ART) over a five-year period. Results 333 (27%) of the patients in the cohort had prevalent TB at the initiation of ART. Of 54 possible paradoxical TB-associated IRIS cases, 35 fulfilled the INSHI case definitions (11% of TB cases). Conclusions INSHI standardised case definitions were used successfully in identifying paradoxical TB-associated IRIS in this cohort and resulted in a similar proportion of TB IRIS cases (11%) as that reported in previous studies from resource-limited settings (8-13%). This case definition should be evaluated prospectively. PMID:20160249

Molecular basis of quantitative structure-properties relationships (QSPR): a quantum similarity approach.

PubMed

Ponec, R; Amat, L; Carbó-Dorca, R

1999-05-01

Since the dawn of quantitative structure-properties relationships (QSPR), empirical parameters related to structural, electronic and hydrophobic molecular properties have been used as molecular descriptors to determine such relationships. Among all these parameters, Hammett sigma constants and the logarithm of the octanol-water partition coefficient, log P, have been massively employed in QSPR studies. In the present paper, a new molecular descriptor, based on quantum similarity measures (QSM), is proposed as a general substitute of these empirical parameters. This work continues previous analyses related to the use of QSM to QSPR, introducing molecular quantum self-similarity measures (MQS-SM) as a single working parameter in some cases. The use of MQS-SM as a molecular descriptor is first confirmed from the correlation with the aforementioned empirical parameters. The Hammett equation has been examined using MQS-SM for a series of substituted carboxylic acids. Then, for a series of aliphatic alcohols and acetic acid esters, log P values have been correlated with the self-similarity measure between density functions in water and octanol of a given molecule. And finally, some examples and applications of MQS-SM to determine QSAR are presented. In all studied cases MQS-SM appeared to be excellent molecular descriptors usable in general QSPR applications of chemical interest.

Molecular basis of quantitative structure-properties relationships (QSPR): A quantum similarity approach

NASA Astrophysics Data System (ADS)

Ponec, Robert; Amat, Lluís; Carbó-dorca, Ramon

1999-05-01

Since the dawn of quantitative structure-properties relationships (QSPR), empirical parameters related to structural, electronic and hydrophobic molecular properties have been used as molecular descriptors to determine such relationships. Among all these parameters, Hammett σ constants and the logarithm of the octanol- water partition coefficient, log P, have been massively employed in QSPR studies. In the present paper, a new molecular descriptor, based on quantum similarity measures (QSM), is proposed as a general substitute of these empirical parameters. This work continues previous analyses related to the use of QSM to QSPR, introducing molecular quantum self-similarity measures (MQS-SM) as a single working parameter in some cases. The use of MQS-SM as a molecular descriptor is first confirmed from the correlation with the aforementioned empirical parameters. The Hammett equation has been examined using MQS-SM for a series of substituted carboxylic acids. Then, for a series of aliphatic alcohols and acetic acid esters, log P values have been correlated with the self-similarity measure between density functions in water and octanol of a given molecule. And finally, some examples and applications of MQS-SM to determine QSAR are presented. In all studied cases MQS-SM appeared to be excellent molecular descriptors usable in general QSPR applications of chemical interest.

Warthin tumor--morphological study of the stromal compartment.

PubMed

Dăguci, Luminiţa; Simionescu, Cristiana; Stepan, A; Munteanu, Cristina; Dăguci, C; Bătăiosu, Marilena

2011-01-01

Warthin tumor is the second most common benign tumors of the parotid gland, after pleomorphic adenoma. Our study was performed on 21 cases with Warthin tumor diagnosed between 2005-2010, which were analyzed clinically, histologically and immunohistochemically, using anti-CD20 and anti-CD45RO antibodies. The analysis of age distribution within the investigated cases indicated that Warthin tumor incidence is increasing in the seventh decade of life, most patients being male (M/F 5/2). Histopathological, the analysis report of stroma÷parenchyma in 14 cases revealed a balanced distribution of the two components, in four cases, the epithelial component was predominant and in three cases, the stromal component was predominant. Immunohistochemical study for the two specific lymphocyte proliferation markers indicated positivity for both epithelial component and stroma. Cell layout of CD45RO and CD20cy at the level of lymphoid stroma had a similar pattern with normal or reactive lymph nodes.

Adrenoleukodystrophy. Electron microscopic findings.

PubMed

Powell, H; Tindall, R; Schultz, P; Paa, D; O'Brien, J; Lampert, P

1975-04-01

Ultrastructural and neurochemical studies were done on three male patients with adrenoleukodystrophy. In each case, the affected white matter contained enlarged glial cells filled with pathognomic intracytoplasmic inclusions consisting of electron-lucent spicules bounded by 25-Angstrom wide membranes. Similar inclusions were present in adrenocortical cells. These findings and a review of 47 reported cases indicate that adrenoleukodystrophy is a storage disorder caused by a sex-linked recessive error of metabolism.

How Does Innovative Continuous Professional Development (CPD) Operate in the ECEC Sector? Insights from a Cross-Analysis of Cases in Denmark, Italy and Poland

ERIC Educational Resources Information Center

Bove, Chiara; Jensen, Bente; Wyslowska, Olga; Iannone, Rosa Lisa; Mantovani, Susanna; Karwowska-Struczyk, Malgorzata

2018-01-01

This article offers insights into what characterises innovative continuous professional development (CPD) in the field of early childhood education and care (ECEC) by analysing similarities and differences from case studies of exemplary approaches to innovative CPD in Denmark, Italy and Poland. The comparative analysis focuses on four features…

Dehydration, Heat Stroke, or Hyponatremia? The Recognition, Treatment, and Prevention of Hyponatremia Caused by High Exercise Outdoor Activities.

ERIC Educational Resources Information Center

Cochran, Brent

Hyponatremia (severe sodium depletion) has symptoms similar to heat exhaustion and heat stroke and can easily be misdiagnosed. The number of wilderness users and extreme adventure activities has increased in recent years, and more cases are being diagnosed. Given that a 1993 study found that 1 in 10 cases of heat-related illnesses were…

Metal-on-Metal Hip Retrieval Analysis: A Case Report

PubMed Central

Pace, Thomas B.; Rusaw, Kara A.; Minette, Lawrence J.; Shirley, Brayton R.; Snider, Rebecca G.; DesJardins, John D.

2013-01-01

This is a case report involving a single case with severe bone and soft tissue destruction in a young male patient with a 10-year-metal on-metal total hip arthroplasty. Following complete aseptic erosion of the affected hip greater trochanter and abductor muscles, the hip was revised for recurrent instability. Histological examination of the patient's periprosthetic tissues, serological studies, and review of recent medical reports of similar cases were used to support an explanation of the destructive process and better contribute to our understanding of human reaction to metal debris in some patients following metal-on-metal hip arthroplasty. PMID:23840999

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

Rearden, Bradley T; Marshall, William BJ J

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

MYC/BCL2/BCL6 triple hit lymphoma: a study of 40 patients with a comparison to MYC/BCL2 and MYC/BCL6 double hit lymphomas.

PubMed

Huang, Wenting; Medeiros, L Jeffrey; Lin, Pei; Wang, Wei; Tang, Guilin; Khoury, Joseph; Konoplev, Sergej; Yin, C Cameron; Xu, Jie; Oki, Yasuhiro; Li, Shaoying

2018-05-21

High-grade B-cell lymphomas with MYC, BCL2, and BCL6 rearrangements (triple hit lymphoma) are uncommon. We studied the clinicopathologic features of 40 patients with triple hit lymphoma and compared them to 157 patients with MYC/BCL2 double hit lymphoma and 13 patients with MYC/BCL6 double hit lymphoma. The triple hit lymphoma group included 25 men and 15 women with a median age of 61 years (range, 34-85). Nine patients had a history of B-cell lymphoma. Histologically, 23 (58%) cases were diffuse large B-cell lymphoma and 17 cases had features of B-cell lymphoma, unclassifiable, with features intermediate between diffuse large B-cell lymphoma and Burkitt lymphoma. Most cases of triple hit lymphoma were positive for CD10 (100%), BCL2 (95%), BCL6 (82%), MYC (74%), and 71% with MYC and BCL2 coexpression. P53 was overexpressed in 29% of triple hit lymphoma cases. The clinicopathological features of triple hit lymphoma patients were similar to patients with MYC/BCL2 and MYC/BCL6 double hit lymphoma, except that triple hit lymphoma cases were more often CD10 positive compared with MYC/BCL6 double hit lymphoma (p < 0.05). Induction chemotherapy used was similar for patients with triple hit lymphoma and double hit lymphoma and overall survival in triple hit lymphoma patients was 17.6 months, similar to the overall survival of patients with double hit lymphoma (p = 0.67). Patients with triple hit lymphoma showing P53 overexpression had significantly worse overall survival compared with those without P53 overexpression (p = 0.04). On the other hand, double expressor status and prior history of B-cell lymphoma did not correlate with overall survival. In conclusion, most patients with triple hit lymphoma have an aggressive clinical course and poor prognosis and these tumors have a germinal center B-cell immunophenotype, similar to patients with double hit lymphomas. P53 expression is a poor prognostic factor in patients with triple hit lymphoma.

Rayleigh-Taylor mixing with time-dependent acceleration

NASA Astrophysics Data System (ADS)

Abarzhi, Snezhana

2016-10-01

We extend the momentum model to describe Rayleigh-Taylor (RT) mixing driven by a time-dependent acceleration. The acceleration is a power-law function of time, similarly to astrophysical and plasma fusion applications. In RT flow the dynamics of a fluid parcel is driven by a balance per unit mass of the rates of momentum gain and loss. We find analytical solutions in the cases of balanced and imbalanced gains and losses, and identify their dependence on the acceleration exponent. The existence is shown of two typical regimes of self-similar RT mixing-acceleration-driven Rayleigh-Taylor-type and dissipation-driven Richtymer-Meshkov-type with the latter being in general non-universal. Possible scenarios are proposed for transitions from the balanced dynamics to the imbalanced self-similar dynamics. Scaling and correlations properties of RT mixing are studied on the basis of dimensional analysis. Departures are outlined of RT dynamics with time-dependent acceleration from canonical cases of homogeneous turbulence as well as blast waves with first and second kind self-similarity. The work is supported by the US National Science Foundation.

Rayleigh-Taylor mixing with space-dependent acceleration

NASA Astrophysics Data System (ADS)

Abarzhi, Snezhana

2016-11-01

We extend the momentum model to describe Rayleigh-Taylor (RT) mixing driven by a space-dependent acceleration. The acceleration is a power-law function of space coordinate, similarly to astrophysical and plasma fusion applications. In RT flow the dynamics of a fluid parcel is driven by a balance per unit mass of the rates of momentum gain and loss. We find analytical solutions in the cases of balanced and imbalanced gains and losses, and identify their dependence on the acceleration exponent. The existence is shown of two typical sub-regimes of self-similar RT mixing - the acceleration-driven Rayleigh-Taylor-type mixing and dissipation-driven Richtymer-Meshkov-type mixing with the latter being in general non-universal. Possible scenarios are proposed for transitions from the balanced dynamics to the imbalanced self-similar dynamics. Scaling and correlations properties of RT mixing are studied on the basis of dimensional analysis. Departures are outlined of RT dynamics with space-dependent acceleration from canonical cases of homogeneous turbulence as well as blast waves with first and second kind self-similarity. The work is supported by the US National Science Foundation.

Zika virus outbreak in New Caledonia and Guillain-Barré syndrome: a case-control study.

PubMed

Simon, Olivier; Acket, Blandine; Forfait, Carole; Girault, Dominique; Gourinat, Ann-Claire; Millon, Pauline; Daures, Maguy; Vanhomwegen, Jessica; Billot, Segolene; Biron, Antoine; Hoinard, Damien; Descloux, Elodie; Guyon, David; Manuguerra, Jean Claude; Laumond, Sylvie; Molko, Nicolas; Dupont-Rouzeyrol, Myrielle

2018-06-01

Zika virus (ZIKV) infection has been associated with neurologic disorders including Guillain-Barré syndrome (GBS). In New Caledonia during the ZIKV outbreak (2014-2015), case-control and retrospective studies have been performed to assess the link between ZIKV and GBS. Among the 15 cases included, 33% had evidence of a recent ZIKV infection compared to only 3.3% in the 30 controls involved. All patients were Melanesian, had facial diplegia and similar neurophysiological pattern consistent with acute inflammatory demyelinating polyneuropathy, and recovered well. Furthermore, during the peak of ZIKV transmission, we observed a number of GBS cases higher than the calculated upper limit, emphasizing the fact that ZIKV is now a major trigger of GBS.

High-resolution chromosomal microarrays in prenatal diagnosis significantly increase diagnostic power.

PubMed

Oneda, Beatrice; Baldinger, Rosa; Reissmann, Regina; Reshetnikova, Irina; Krejci, Pavel; Masood, Rahim; Ochsenbein-Kölble, Nicole; Bartholdi, Deborah; Steindl, Katharina; Morotti, Denise; Faranda, Marzia; Baumer, Alessandra; Asadollahi, Reza; Joset, Pascal; Niedrist, Dunja; Breymann, Christian; Hebisch, Gundula; Hüsler, Margaret; Mueller, René; Prentl, Elke; Wisser, Josef; Zimmermann, Roland; Rauch, Anita

2014-06-01

The objective of this study was to determine for the first time the reliability and the diagnostic power of high-resolution microarray testing in routine prenatal diagnostics. We applied high-resolution chromosomal microarray testing in 464 cytogenetically normal prenatal samples with any indication for invasive testing. High-resolution testing revealed a diagnostic yield of 6.9% and 1.6% in cases of fetal ultrasound anomalies and cases of advanced maternal age (AMA), respectively, which is similar to previous studies using low-resolution microarrays. In three (0.6%) additional cases with an indication of AMA, an aberration in susceptibility risk loci was detected. Moreover, one case (0.2%) showed an X-linked aberration in a female fetus, a finding relevant for future family planning. We found the rate of cases, in which the parents had to be tested for interpretation of unreported copy number variants (3.7%), and the rate of remaining variants of unknown significance (0.4%) acceptably low. Of note, these findings did not cause termination of pregnancy after expert genetic counseling. The 0.4% rate of confined placental mosaicism was similar to that observed by conventional karyotyping and notably involved a case of placental microdeletion. High-resolution prenatal microarray testing is a reliable technique that increases diagnostic yield by at least 17.3% when compared with conventional karyotyping, without an increase in the frequency of variants of uncertain significance. © 2014 John Wiley & Sons, Ltd.

Police officers who commit suicide by cop: a clinical study with analysis.

PubMed

Arias, Elizabeth A; Schlesinger, Louis B; Pinizzotto, Anthony J; Davis, Edward F; Fava, Joanna L; Dewey, Lauren M

2008-11-01

Suicide by cop has become a familiar topic among members of law enforcement, mental health professionals, and the general public. This paper presents two cases where police officers chose to commit suicide by getting other police officers to kill them. The two police officers studied, by examination of closed case files, were found to be similar to civilians who committed suicide by cop on several demographic (gender, age, history of mental illness, and suicide attempts), and situational (stress factors, trigger) variables. The cases help us to understand possible motives and management for individuals who choose to end their life in this manner.

Abnormal folate metabolism as a risk factor for first-trimester spontaneous abortion.

PubMed

Hoffman, Michael L; Scoccia, Bert; Kurczynski, Thaddeus W; Shulman, Lee P; Gao, Weihua

2008-03-01

To assess the potential role of folic acid in early pregnancy loss by measuring homocysteine (hcy) levels in healthy, pregnant women who present with a current first-trimester miscarriage. This was a cross-sectional analysis comprising 13 patients aged 18-31 years old who had a scheduled dilatation and curettage for a first-trimester miscarriage. The controls were 15 patients of similar maternal age presenting for a first-trimester prenatal care visit. Following completion of a 21-item, structured questionnaire, patients were excluded from the study if they had any known risk factors for a first-trimester miscarriage. The remaining patients provided blood samples for measurement of homocysteine and red blood cell folate. Cases and controls were compared using a standard 2-sample t test. In order to detect a clinically relevant 2.3 micromol/L difference in homocysteine levels, 11 cases and 8 controls were needed. The mean hcy level in cases (5.8 umolmol/L) vs. controls (5.7 micromol/L) was not significantly different (p = 0.83), and all individual values fell within the normal range expected in pregnant women. Red blood cell folate levels (cases=586 ng/mL, controls=611 ng/mL) were also not significantly different (p = 0.72), and no cases of folate deficiency were detected. Maternal age (cases=26, controls=25) and gestational age (cases = 8.8 weeks, controls = 8.4 weeks) were similar between the 2 groups. In this community-based pilot study, abnormal folate metabolism was not an apparent risk factor for spontaneous first-trimester pregnancy loss.

Proof of live birth using postmortem multislice computed tomography (pmMSCT) in cases of suspected neonaticide: advantages of diagnostic imaging compared to conventional autopsy.

PubMed

Guddat, Saskia S; Gapert, René; Tsokos, Michael; Oesterhelweg, Lars

2013-03-01

Proof of live birth is of major importance in suspected neonaticide cases. Although not without controversy the lung flotation test is the main method used to asses this in different jurisdictions worldwide. The present study examines the usefulness of postmortem multislice computed tomography (pmMSCT) in the detection of live birth signs. Body scans were conducted on four infants, one was stillborn, another died a day after birth and the other two were classified as neonaticides. The appearance of the lungs, gastrointestinal tract and vascular system of the liver was compared in these cases. Clear differences were discernable between the lungs of the stillborn and the 1 day old infant. The aerated lungs and air in the stomach and duodenum were clearly visible in the latter case while the stillborn infant lacked these signs. The two neonaticide cases demonstrated similarly aerated lung tissue to the 1 day old infant. The hepatic vessels did not show any putrefactive gas changes in any of the cases. The extent of aeration of the peripheral alveoli was easily observable on the pmMSCT, thus making it a useful tool in the possible differentiation between artificially and naturally aerated lungs. During the four autopsies the classic flotation tests were performed and similar positive aeration of the lungs in the two neonaticides was shown. The stillborn's tests, on the other hand were negative for aeration. The results of this study clearly demonstrate the advantages of using pmMSCT before commencing a conventional autopsy in cases of suspected neonaticide.

A nonlinear self-similar solution to barotropic flow over rapidly varying topography

NASA Astrophysics Data System (ADS)

Ibanez, Ruy; Kuehl, Joseph

2016-11-01

Beginning from the Shallow Water Equations (SWE), a nonlinear self-similar analytic solution is derived for barotropic flow over rapidly varying topography. We study conditions relevant to the ocean slope where the flow is dominated by Earth's rotation and topography. Attention is paid to the northern Gulf of Mexico slope with application to pollutant dispersion and the Norwegian Coastal Current which sheds eddies into the Lofoten Basin that are believe to influence deep water formation. The solution is found to extend the topographic β-plume solution (Kuehl 2014, GRL) in two ways: 1) The solution is valid for intensifying jets. 2) The influence of nonlinear advection is included. The SWE are scaled to the case of a topographically controlled jet, then solved by introducing a similarity variable η = Cxy . The nonlinear solution, valid for topographies h =h0 - αxy3 , takes the form of the Lambert W Function for velocity. The linear solution, valid for topographies h =h0 - αxyγ , takes the form of the Error Function for transport. Kuehl's results considered the case - 1 <= γ < 1 which admits expanding jets, while the new result consider the case γ < - 1 which admits intensifying jets.

Applications of ground penetrating radar (GPR) in bridge deck monitoring and assessment

NASA Astrophysics Data System (ADS)

Alani, Amir M.; Aboutalebi, Morteza; Kilic, Gokhan

2013-10-01

This paper presents the essence of two case studies by the authors on two major bridges in the UK. The first case study reports on the applications of GPR and associated work carried out on the Forth Road Bridge near Edinburgh, Scotland, with the main objective of identifying possible structural defects including damaged rebar and moisture ingress at specific locations of the bridge deck. The second case study focuses on a full assessment of the Pentagon Road Bridge, in Chatham, Kent, England with particular emphasis on the identification of possible defects including structural cracks within the deck structure and establishing the layout of the upper and lower rebar positions throughout the bridge. These studies present interesting results in terms of locations of rebar and an accurate estimate of concrete cover condition as well as reporting on a remarkable similarity in the processed data concerning areas affected by ingress of moisture within the deck structures of the two bridges under investigation. It is believed that this paper will be of particular interest to bridge engineers and structural engineering practitioners with enthusiasm for adopting non-destructive testing methods such as GPR in the health monitoring and assessment of bridge structures. The observed similarities in the processed data between the two reported case studies present an interesting concept within the general context of the interpretation of GPR data, with the potential for use in many other forthcoming cases. The paper also reports on the adopted method for the GPR survey with emphasis on difficulties and challenges encountered during the actual survey. The presented results benefit from advanced processing and presentation techniques.

Critical Attributes of Public-Private Partnerships: A Case Study in Vocational Education

ERIC Educational Resources Information Center

Pillay, Hitendra; Watters, James J.; Hoff, Lutz

2013-01-01

The term "partnership" is increasingly used by governments, industry, community organisations and schools in supporting their daily businesses. Similar to the terms "ICT" and "learning," "partnerships" are now ubiquitous in policy discourse. Yet, the term remains ill-defined and ambiguous. This study reviews…

[Extra skeletal Ewing's sarcoma. Report of two cases. Ultrastructural study of one case (author's transl)].

PubMed

Krulik, M; Brechot, J M; de Saint-Maur, P; Lecomte, D; Mougeot-Martin, M; Audebert, A A; Zylberait, D; Debray, J

The authors report two cases of extra skeletal Ewing's sarcoma. The first case concerns a 26 years old woman presenting a tumor at the level of the sacrum area, locally recurrent, metastazing to the lungs and the lumbar column, despite of radiotherapy and chemotherapy and leading to death after a course of 18 months. The second one is that of a 30 years old man bearing a tumor of the shoulder area probably already metastazed to bones, rapidly recurrent and metastazing to the lungs and cause of death after 9 months in spite of intensive therapy. About these 2 observations a review of the literature of the cases of extra skeletal Ewing's sarcoma is done. Whatever nosologic discussion it seems that Ewing's sarcoma may present essentially as a tumor of soft tissues. An ultrastructural study has been performed in the second case. The findings are similar to those reported in Ewing's sarcoma.

Fragrances and work-related asthma-California surveillance data, 1993-2012.

PubMed

Weinberg, Justine Lew; Flattery, Jennifer; Harrison, Robert

2017-12-01

Fragrance chemicals are used in a large array of products. Workers may be exposed to these chemicals in the workplace directly when used as air fresheners, or indirectly in personal care products used by coworkers or others. This study characterizes work-related asthma (WRA) cases associated with fragrance exposures in California workplaces from 1993 through 2012. We used the California Work-Related Asthma Prevention Program's surveillance database to identify individuals with physician-diagnosed WRA associated with the use of air fresheners and scented personal care products (perfumes, colognes, etc.). Cases were classified using previously published, standardized surveillance methods. Perfume was the ninth most common exposure identified from 1993 through 2012. A total of 270 WRA cases associated with fragrance exposure were reported during this period, representing 3.8% of all confirmed cases. These 270 cases included 242 associated with perfume or cologne, 32 associated with air freshener, and 4 associated with both. Similar to non-fragrance cases, nearly a quarter of fragrance-associated cases were classified as new-onset asthma. Fragrance-associated cases were significantly more likely to be in office, health, and education jobs than non-fragrance-associated cases. When compared to non-fragrance cases, fragrance cases were significantly more likely to be female (94% vs 62%) and be classified as having work-aggravated asthma (38% vs 20%), yet had similar outcomes compared with cases associated with other exposures. Our surveillance data show that fragrance use in the workplace is associated with WRA. Prevention methods include employee education, enforced fragrance-free policies, well-designed ventilation systems, and good building maintenance.

The Comparability of Focus Group and Survey Results: Three Case Studies.

ERIC Educational Resources Information Center

Ward, Victoria M.; And Others

1991-01-01

Focus group findings were compared with survey findings for three studies in which both methods were used. Studies conducted on voluntary sterilization in Guatemala, Honduras, and Zaire with over 2,000 subjects confirm that focus groups yield information similar to that obtained from surveys and are useful in program planning. (SLD)

Ecological periodic tables for benthic macrofaunal usage of estuarine habitats : Insights from a case study in Tillamook bay, Oregon, USA

EPA Science Inventory

This study validates the ecological relevance of estuarine habitat types to the benthic macrofaunal community and, together with previous similar studies, suggests they can serve as elements in ecological periodic tables of benthic macrofaunal usage in the bioregion. We compared...

An Analysis of Looking Back Method in Problem-Based Learning: Case Study on Congruence and Similarity in Junior High School

NASA Astrophysics Data System (ADS)

Kosasih, U.; Wahyudin, W.; Prabawanto, S.

2017-09-01

This study aims to understand how learners do look back their idea of problem solving. This research is based on qualitative approach with case study design. Participants in this study were xx students of Junior High School, who were studying the material of congruence and similarity. The supporting instruments in this research are test and interview sheet. The data obtained were analyzed by coding and constant-comparison. The analysis find that there are three ways in which the students review the idea of problem solving, which is 1) carried out by comparing answers to the completion measures exemplified by learning resources; 2) carried out by examining the logical relationship between the solution and the problem; and 3) carried out by means of confirmation to the prior knowledge they have. This happens because most students learn in a mechanistic way. This study concludes that students validate the idea of problem solving obtained, influenced by teacher explanations, learning resources, and prior knowledge. Therefore, teacher explanations and learning resources contribute to the success or failure of students in solving problems.

Inattentive/overactive children with histories of profound institutional deprivation compared with standard ADHD cases: a brief report.

PubMed

Sonuga-Barke, E J S; Rubia, K

2008-09-01

The Inattention/Overactivity/Impulsiveness (I/OA) behavioural cluster diagnostic of ADHD is recognized as a characteristic outcome of early institutional care. We compared the symptom and neuropsychological profiles of children with a history of I/OA and early severe deprivation (D-I/OA: n=13) with standard clinical ADHD cases (S-ADHD; N=20) and children who had experienced deprivation but were not pervasively I/OA (ERA-controls; n=22). The mean age of testing was around 13 years. D-I/OA and ERA-controls were selected from the English and Romanian Adoptees (ERA) study and had spent their early lives in the extremely depriving Romanian institutions of the Ceausescu regime and were later adopted into UK families. ADHD symptoms for male D-I/OA and S-ADHD cases showed marked similarities across symptom domains. In contrast, girls with D-I/OA were more similar to ERA controls than to ADHD cases. Longitudinal data suggested that this was due to a remission of symptoms in D-I/OA girls. Neuropsychological profiles of males and females with D-I/OA, however, were similar: both were more impaired than S-ADHD and ERA controls. Children with D-I/OA were more neuropsychologically impaired than S-ADHD despite the fact that only boys showed a persistent pattern of ADHD symptoms. These results need replication in a larger sample with groups matched for gender.

Emigration for Higher Education: The Case of Palestinians Living in Israel Studying in Jordan

ERIC Educational Resources Information Center

Arar, Khalid; Haj-Yehia, Kussai

2010-01-01

This study explored reasons for the rapid increase in the number of Palestinian Arabs from Israel (PAI) studying higher education (HE) in Jordan. Four hundred and sixty PAI studying in Jordan answered a questionnaire assessing factors related to HE in both countries. Lenient admission requirements and cultural-language similarity explain Jordan's…

Coming to Journalism: A Comparative Case Study of Postgraduate Students in Dublin and Amman

ERIC Educational Resources Information Center

O'Boyle, Neil; Knowlton, Steven

2015-01-01

This article presents findings from a pilot study of postgraduate journalism students in Dublin and Amman. The study compared professional outlooks and social characteristics of students in both contexts and examined institutional settings. The study finds that journalism students in Dublin and Amman have very similar views on the profession,…

Nonlinearity Role in Long-Term Interaction of the Ocean Gravity Waves

DTIC Science & Technology

2012-09-30

3 4 =s We found that in the fetch-limited case the wind forcing index s is similar to the time domain situation, and the wind forcing is given by...of its evolution. Fig.5 gives a graphical summary of four reference cases of self-similar evolution of wind-driven waves. These cases are shown as...different R, tangents of one-parametric dependencies H~TR height-to-period in logarithmic axes. Reference cases of growing wind sea are shown as

I-66--a case study

DOT National Transportation Integrated Search

1982-01-01

The Arlington-Fairfax County section of 1-66 is similar to many : urban highway projects, yet in many ways this project represents a : milestone in urban transportation planning. 1-66, not unlike many : others, required non-technical political groups...

The Exceptional Responders Initiative: Welcoming More Cases

Cancer.gov

The initiative is studying tissue, clinical, and genomic data from patients with cancer who have had dramatic and long-lasting responses to standard and experimental treatments that were not seen in similar patients who received the same treatment.

DNA barcode reference library for Iberian butterflies enables a continental-scale preview of potential cryptic diversity

PubMed Central

Dincă, Vlad; Montagud, Sergio; Talavera, Gerard; Hernández-Roldán, Juan; Munguira, Miguel L.; García-Barros, Enrique; Hebert, Paul D. N.; Vila, Roger

2015-01-01

How common are cryptic species - those overlooked because of their morphological similarity? Despite its wide-ranging implications for biology and conservation, the answer remains open to debate. Butterflies constitute the best-studied invertebrates, playing a similar role as birds do in providing models for vertebrate biology. An accurate assessment of cryptic diversity in this emblematic group requires meticulous case-by-case assessments, but a preview to highlight cases of particular interest will help to direct future studies. We present a survey of mitochondrial genetic diversity for the butterfly fauna of the Iberian Peninsula with unprecedented resolution (3502 DNA barcodes for all 228 species), creating a reliable system for DNA-based identification and for the detection of overlooked diversity. After compiling available data for European butterflies (5782 sequences, 299 species), we applied the Generalized Mixed Yule-Coalescent model to explore potential cryptic diversity at a continental scale. The results indicate that 27.7% of these species include from two to four evolutionary significant units (ESUs), suggesting that cryptic biodiversity may be higher than expected for one of the best-studied invertebrate groups and regions. The ESUs represent important units for conservation, models for studies of evolutionary and speciation processes, and sentinels for future research to unveil hidden diversity. PMID:26205828

Comparison of organs' shapes with geometric and Zernike 3D moments.

PubMed

Broggio, D; Moignier, A; Ben Brahim, K; Gardumi, A; Grandgirard, N; Pierrat, N; Chea, M; Derreumaux, S; Desbrée, A; Boisserie, G; Aubert, B; Mazeron, J-J; Franck, D

2013-09-01

The morphological similarity of organs is studied with feature vectors based on geometric and Zernike 3D moments. It is particularly investigated if outliers and average models can be identified. For this purpose, the relative proximity to the mean feature vector is defined, principal coordinate and clustering analyses are also performed. To study the consistency and usefulness of this approach, 17 livers and 76 hearts voxel models from several sources are considered. In the liver case, models with similar morphological feature are identified. For the limited amount of studied cases, the liver of the ICRP male voxel model is identified as a better surrogate than the female one. For hearts, the clustering analysis shows that three heart shapes represent about 80% of the morphological variations. The relative proximity and clustering analysis rather consistently identify outliers and average models. For the two cases, identification of outliers and surrogate of average models is rather robust. However, deeper classification of morphological feature is subject to caution and can only be performed after cross analysis of at least two kinds of feature vectors. Finally, the Zernike moments contain all the information needed to re-construct the studied objects and thus appear as a promising tool to derive statistical organ shapes. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

What ethics for case managers? Literature review and discussion.

PubMed

Corvol, Aline; Moutel, Grégoire; Somme, Dominique

2016-11-01

Little is known about case managers' ethical issues and professional values. This article presents an overview of ethical issues in case managers' current practice. Findings are examined in the light of nursing ethics, social work ethics and principle-based biomedical ethics. A systematic literature review was performed to identify and analyse empirical studies concerning ethical issues in case management programmes. It was completed by systematic content analysis of case managers' national codes of ethics. Only nine empirical studies were identified, eight of them from North America. The main dilemmas were how to balance system goals against the client's interest and client protection against autonomy. Professional codes of ethics shared important similarities, but offered different responses to these two dilemmas. We discuss the respective roles of professional and organizational ethics. Further lines of research are suggested. © The Author(s) 2015.

Very high-energy electron (VHEE) beams in radiation therapy; Treatment plan comparison between VHEE, VMAT, and PPBS.

PubMed

Schüler, Emil; Eriksson, Kjell; Hynning, Elin; Hancock, Steven L; Hiniker, Susan M; Bazalova-Carter, Magdalena; Wong, Tony; Le, Quynh-Thu; Loo, Billy W; Maxim, Peter G

2017-06-01

The aim of this study was to evaluate the performance of very high-energy electron beams (VHEE) in comparison to clinically derived treatment plans generated with volumetric modulated arc therapy (VMAT) and proton pencil beam scanning (PPBS) technology. We developed a custom optimization script that could be applied automatically across modalities to eliminate operator bias during IMRT optimization. Four clinical cases were selected (prostate cancer, lung cancer, pediatric brain tumor, and head and neck cancer (HNC)). The VHEE beams were calculated in the EGSnrc/DOSXYZnrc Monte Carlo code for 100 and 200 MeV beams. Treatment plans with VHEE, VMAT, and PPBS were optimized in a research version of RayStation using an in-house developed script to minimize operator bias between the different techniques. The in-house developed script generated similar or superior plans to the clinically used plans. In the comparisons between the modalities, the integral dose was lowest for the PPBS-generated plans in all cases. For the prostate case, the 200 MeV VHEE plan showed reduced integral dose and reduced organ at risk (OAR) dose compared to the VMAT plan. For all other cases, both the 100 and the 200 MeV VHEE plans were superior to the VMAT plans, and the VHEE plans showed better conformity and lower spinal cord dose in the pediatric brain case and lower brain stem dose in the HNC case when compared to the PPBS plan. The automated optimization developed in this study generated similar or superior plans as compared to the clinically used plan and represents an unbiased approach to compare treatment plans generated for different modalities. In the present study, we also show that VHEE plans are similar or superior to VMAT plans with reduced mean OAR dose and increased target conformity for a variety of clinical cases, and VHEE plans can even achieve reductions in OAR doses compared to PPBS plans for shallow targets. With increased VHEE energy, better conformity and even higher reductions in mean OAR doses are achieved. On the whole, VHEE was intermediate between photon VMAT and PPBS for OAR sparing. © 2017 American Association of Physicists in Medicine.

A hybrid clustering approach for multivariate time series - A case study applied to failure analysis in a gas turbine.

PubMed

Fontes, Cristiano Hora; Budman, Hector

2017-11-01

A clustering problem involving multivariate time series (MTS) requires the selection of similarity metrics. This paper shows the limitations of the PCA similarity factor (SPCA) as a single metric in nonlinear problems where there are differences in magnitude of the same process variables due to expected changes in operation conditions. A novel method for clustering MTS based on a combination between SPCA and the average-based Euclidean distance (AED) within a fuzzy clustering approach is proposed. Case studies involving either simulated or real industrial data collected from a large scale gas turbine are used to illustrate that the hybrid approach enhances the ability to recognize normal and fault operating patterns. This paper also proposes an oversampling procedure to create synthetic multivariate time series that can be useful in commonly occurring situations involving unbalanced data sets. Copyright © 2017 ISA. Published by Elsevier Ltd. All rights reserved.

Case-based retrieval framework for gene expression data.

PubMed

Anaissi, Ali; Goyal, Madhu; Catchpoole, Daniel R; Braytee, Ali; Kennedy, Paul J

2015-01-01

The process of retrieving similar cases in a case-based reasoning system is considered a big challenge for gene expression data sets. The huge number of gene expression values generated by microarray technology leads to complex data sets and similarity measures for high-dimensional data are problematic. Hence, gene expression similarity measurements require numerous machine-learning and data-mining techniques, such as feature selection and dimensionality reduction, to be incorporated into the retrieval process. This article proposes a case-based retrieval framework that uses a k-nearest-neighbor classifier with a weighted-feature-based similarity to retrieve previously treated patients based on their gene expression profiles. The herein-proposed methodology is validated on several data sets: a childhood leukemia data set collected from The Children's Hospital at Westmead, as well as the Colon cancer, the National Cancer Institute (NCI), and the Prostate cancer data sets. Results obtained by the proposed framework in retrieving patients of the data sets who are similar to new patients are as follows: 96% accuracy on the childhood leukemia data set, 95% on the NCI data set, 93% on the Colon cancer data set, and 98% on the Prostate cancer data set. The designed case-based retrieval framework is an appropriate choice for retrieving previous patients who are similar to a new patient, on the basis of their gene expression data, for better diagnosis and treatment of childhood leukemia. Moreover, this framework can be applied to other gene expression data sets using some or all of its steps.

The use of scenarios for long-range planning by investor-owned electric utilities in the Pacific Northwest

NASA Astrophysics Data System (ADS)

Lyons, John V.

Scenario planning is a method of organizing and understanding large amounts of quantitative and qualitative data for leaders to make better strategic decisions. There is a lack of academic research about scenario planning with a subsequent shortage of definitions and theories. This study utilized a case study methodology to analyze scenario planning by investor-owned electric utilities in the Pacific Northwest in their integrated resource planning (IRP) process. The cases include Avista Corporation, Idaho Power, PacifiCorp, Portland General Electric, and Puget Sound Energy. This study sought to determine how scenario planning was used, what scenario approach was used, the scenario outcomes, and the similarities and differences in the scenario planning processes. The literature review of this study covered the development of scenario planning, common definitions and theories, approaches to scenario development, and scenario outcomes. A research methodology was developed to classify the scenario development approach into intuitive, hybrid, or quantitative approaches; and scenario outcomes of changed thinking, stories of plausible futures, improved decision making, and enhanced organizational learning. The study found all three forms of scenario planning in the IRPs. All of the cases used a similar approach to IRP development. All of the cases had at least improved decision making as an outcome of scenario planning. Only one case demonstrated all four scenario outcomes. A critical finding was a correlation between the use of the intuitive approach and the use of all scenario outcomes. Another major finding was the unique use of predetermined elements, which are normally consistent across scenarios, but became critical uncertainties in some of the scenarios in the cases for this study. This finding will need to be confirmed by future research as unique to the industry or an aberration. An unusually high number of scenarios were found for cases using the hybrid approach, which was unexpected based on the literature. This work expanded the methods for studying scenario planning, enhanced the body of scholarly works on scenario planning, and provided a starting point for additional research concerning the use of scenario planning by electric utilities.

Associations of daily pediatric asthma emergency department visits with air pollution in Newark, NJ: utilizing time-series and case-crossover study designs.

PubMed

Gleason, Jessie A; Fagliano, Jerald A

2015-10-01

Asthma is one of the most common chronic diseases affecting children. This study assesses the associations of ozone and fine particulate matter (PM2.5) with pediatric emergency department visits in the urban environment of Newark, NJ. Two study designs were utilized and evaluated for usability. We obtained daily emergency department visits among children aged 3-17 years with a primary diagnosis of asthma during April to September for 2004-2007. Both a time-stratified case-crossover study design with bi-directional control sampling and a time-series study design were utilized. Lagged effects (1-d through 5-d lag, 3-d average, and 5-d average) of ozone and PM2.5 were explored and a dose-response analysis comparing the bottom 5th percentile of 3-d average lag ozone with each 5 percentile increase was performed. Associations of interquartile range increase in same-day ozone were similar between the time-series and case-crossover study designs (RR = 1.08, 95% CI 1.04-1.12) and (OR = 1.10, 95% CI 1.06-1.14), respectively. Similar associations were seen for 1-day lag and 3-day average lag ozone levels. PM2.5 was not associated with the outcome in either study design. Dose-response assessment indicated a statistically significant and increasing association around 50-55 ppb consistent for both study designs. Ozone was statistically positively associated with pediatric asthma ED visits in Newark, NJ. Our results were generally comparable across the time-series and case-crossover study designs, indicating both are useful to assess local air pollution impacts.

Molecular identification of poisonous mushrooms using nuclear ITS region and peptide toxins: a retrospective study on fatal cases in Thailand.

PubMed

Parnmen, Sittiporn; Sikaphan, Sujitra; Leudang, Siriwan; Boonpratuang, Thitiya; Rangsiruji, Achariya; Naksuwankul, Khwanruan

2016-02-01

Cases of mushroom poisoning in Thailand have increased annually. During 2008 to 2014, the cases reported to the National Institute of Health included 57 deaths; at least 15 died after ingestion of amanitas, the most common lethal wild mushrooms inhabited. Hence, the aims of this study were to identify mushroom samples from nine clinically reported cases during the 7-year study period based on nuclear ITS sequence data and diagnose lethal peptide toxins using a reversed phase LC-MS method. Nucleotide similarity was identified using BLAST search of the NCBI database and the Barcode of Life Database (BOLD). Clade characterization was performed by maximum likelihood and Bayesian phylogenetic approaches. Based on BLAST and BOLD reference databases our results yielded high nucleotide similarities of poisonous mushroom samples to A. exitialis and A. fuliginea. Detailed phylogenetic analyses showed that all mushroom samples fall into their current classification. Detection of the peptide toxins revealed the presence of amatoxins and phallotoxins in A. exitialis and A. fuliginea. In addition, toxic α-amanitin was identified in a new provisional species, Amanita sp.1, with the highest toxin quantity. Molecular identification confirmed that the mushrooms ingested by the patients were members of the lethal amanitas in the sections Amanita and Phalloideae. In Thailand, the presence of A. exitialis was reported here for the first time and all three poisonous mushroom species provided new and informative data for clinical studies.

Seasonal variation of acute toxoplasmic lymphadenopathy in the United States.

PubMed

Contopoulos-Ioannidis, D; Talucod, J; Maldonado, Y; Montoya, J G

2015-07-01

We describe the seasonal variation of acute toxoplasmosis in the United States. Acute toxoplasmic lymphadenopathy (ATL) can be a surrogate of acute toxoplasmosis in patients in whom the date of onset of lymphadenopathy matches the window of acute infection predicted by serological tests performed at a reference laboratory. We used the electronic database of the Palo Alto Medical Foundation Toxoplasma Serology Laboratory (PAMF-TSL) (1997-2011) to identify cases of ATL. We tested the uniformity of distribution of ATL cases per month, across the 12 calendar months, using circular statistics uniformity tests. We identified 112 consecutive cases of ATL. The distribution of cases was not uniform across the 12 calendar months. We observed the highest peak of cases in December and a second highest peak in September. Similar months were identified in patients with acute toxoplasmosis in rural areas in France. The results were similar when we performed weighted analyses, weighting for the total number of Toxoplasma gondii IgG tests performed per month in the PAMF-TSL laboratory. This is the largest study to date of the seasonal variation of ATL in the United States. Physicians should advise high-risk individuals to avoid risk factors associated with T. gondii infections especially around those months.

Pertussis (whooping cough) epidemiology in Waikato, New Zealand: 2000-2009.

PubMed

Wall, Richard; Bell, Anita; Theobald, Jason

2011-04-15

To describe the epidemiology of pertussis in the Waikato region of New Zealand between 2000 and 2009, and to identify any differences in case characteristics between epidemic and non-epidemic periods. Waikato pertussis notification data for the period 1 January 2000 to 31 December 2009 was analysed to identify any trends in the rates and distribution of key variables. Characteristics of case notifications were compared between an identified epidemic and non-epidemic period. Pertussis notification rates in the Waikato region were higher than national rates but followed a similar yearly pattern. Epidemics were identified in the years 2000 and 2004. The age distribution of pertussis cases changed over the decade with an increasing percentage in older age groups. Notification rates were higher in Europeans than Maori and in the least deprived NZDep group compared to the most deprived. In contrast, hospitalisation rates were higher in Maori than Europeans and in the most deprived NZDep groups. No clear differences in case characteristics were identified between an epidemic and non-epidemic period. The epidemiology of pertussis in Waikato is similar to that reported elsewhere in New Zealand. Further studies are required to clearly identify whether there are differences in case characteristics between epidemic and non-epidemic periods.

Oral hygiene, dentition, sexual habits and risk of oral cancer

PubMed Central

Talamini, R; Vaccarella, S; Barbone, F; Tavani, A; Vecchia, C La; Herrero, R; Muñoz, N; Franceschi, S

2000-01-01

In an Italian case-control study of oral cancer, number of missing teeth and other aspects of dental care were similar, but the general condition of the mouth, as indicated by gum bleeding, tartar deposits and mucosal irritation, was worse among oral cancer cases than controls. No differences were detected in sexual practices (including oral sex) and (previous) sexually transmitted infections. © 2000 Cancer Research Campaign PMID:11027440

An inter-laboratory comparison study on transfer, persistence and recovery of DNA from cable ties.

PubMed

Steensma, Kristy; Ansell, Ricky; Clarisse, Lindy; Connolly, Edward; Kloosterman, Ate D; McKenna, Louise G; van Oorschot, Roland A H; Szkuta, Bianca; Kokshoorn, Bas

2017-11-01

To address questions on the activity that led to the deposition of biological traces in a particular case, general information on the probabilities of transfer, persistence and recovery of cellular material in relevant scenarios is necessary. These figures may be derived from experimental data described in forensic literature when conditions relevant to the case were included. The experimental methodology regarding sampling, DNA extraction, DNA typing and profile interpretation that were used to generate these published data may differ from those applied in the case and thus the applicability of the literature data may be questioned. To assess the level of variability that different laboratories obtain when similar exhibits are analysed, we performed an inter-laboratory study between four partner laboratories. Five sets of 20 cable ties bound by different volunteers were distributed to the participating laboratories and sampled and processed according to the in-house protocols. Differences were found for the amount of retrieved DNA, as well as for the reportability and composition of the DNA profiles. These differences also resulted in different probabilities of transfer, persistence and recovery for each laboratory. Nevertheless, when applied to a case example, these differences resulted in similar assignments of weight of evidence given activity-level propositions. Copyright © 2017 Elsevier B.V. All rights reserved.

A clinico-epidemiological study of herpes zoster.

PubMed

Aggarwal, S K; Radhakrishnan, S

2016-04-01

Herpes zoster is a common viral infection of skin caused by reactivation of varicella zoster virus infection from the spinal ganglia. The clinico-epidemiological patterns of this disease in an Indian setting required to be studied. A cross sectional study was conducted on all consecutive cases of herpes zoster reporting to the Dermatology Outpatient Department at a Tertiary Care Hospital in Bangalore during a period of one year from 01 Jun 2013 to 31 May 2014. Detailed history, examination, HIV screening and Tzanck smear were carried out in all cases. 84 cases of herpes zoster were seen with a mean age of 30 years. Majority (39%) of cases were seen in the 21-30 year age group. Thoracic segments were involved in 65.4%, cervical in 11.9%, cranial in 11.5%, lumbar in 8.3% and sacral segments in 3.5%. 63% of cases had zoster associated pain. One case had motor involvement.3.57% of the patients were HIV positive. This study shows a lower age incidence of herpes zoster HIV positivity and zoster associated pain as compared to other studies. The pattern of segmental involvement in herpes zoster seen in this study was similar to other studies.

Impact of organised mammography screening on breast cancer mortality in a case–control and cohort study

PubMed Central

Heinävaara, Sirpa; Sarkeala, Tytti; Anttila, Ahti

2016-01-01

Background: The usefulness of case–control studies has been questioned. Our aim was to evaluate the long-term effect of screening on breast cancer mortality within the population-based mammography programme in Finland using a case–control design, and to compare the analyses with the earlier cohort study. Methods: The cases were women invited to screening, diagnosed and died from breast cancer in 1992–2011 while being 50–84 years at death. We chose 10 controls for each case with non-restrictive eligibility criteria. Our data included 1907 cases and 18 978 matched controls. We analysed associations between the screening participation and the risk of breast cancer death using the conditional Cox proportional hazards model. The effect estimates were corrected for self-selection bias. Results: An overall effect of screening was 0.67 (95% confidence interval (CI): 0.49–0.90), and that remained unchanged over time. Analyses with matching criteria comparable to the cohort study yielded an effect (0.70, 95% CI: 0.49–1.00) in 1992–2003 similar to that of the previous cohort analysis (0.72, 95% CI: 0.56–0.88). Conclusions: Organised mammography screening decreases mortality from breast cancer by 33% among the participants. If made comparable, a case–cohort study can yield effect estimates similar to a cohort study. PMID:27010748

Comparison of radiographic joint space width and magnetic resonance imaging for prediction of knee replacement: A longitudinal case-control study from the Osteoarthritis Initiative.

PubMed

Eckstein, Felix; Boudreau, Robert; Wang, Zhijie; Hannon, Michael J; Duryea, Jeff; Wirth, Wolfgang; Cotofana, Sebastian; Guermazi, Ali; Roemer, Frank; Nevitt, Michael; John, Markus R; Ladel, Christoph; Sharma, Leena; Hunter, David J; Kwoh, C Kent

2016-06-01

To evaluate whether change in fixed-location measures of radiographic joint space width (JSW) and cartilage thickness by MRI predict knee replacement. Knees replaced between 36 and 60 months' follow-up in the Osteoarthritis Initiative were each matched with one control by age, sex and radiographic status. Radiographic JSW was determined from fixed flexion radiographs and subregional femorotibial cartilage thickness from 3 T MRI. Changes between the annual visit before replacement (T0) and 2 years before T0 (T-2) were compared using conditional logistic regression. One hundred and nineteen knees from 102 participants (55.5 % women; age 64.2 ± 8.7 [mean ± SD] years) were studied. Fixed-location JSW change at 22.5 % from medial to lateral differed more between replaced and control knees (case-control [cc] OR = 1.57; 95 % CI: 1.23-2.01) than minimum medial JSW change (ccOR = 1.38; 95 % CI: 1.11-1.71). Medial femorotibial cartilage loss displayed discrimination similar to minimum JSW, and central tibial cartilage loss similar to fixed-location JSW. Location-independent thinning and thickening scores were elevated prior to knee replacement. Discrimination of structural progression between knee pre-placement cases versus controls was stronger for fixed-location than minimum radiographic JSW. MRI displayed similar discrimination to radiography and suggested greater simultaneous cartilage thickening and loss prior to knee replacement. • Fixed-location JSW predicts surgical knee replacement more strongly than minimum JSW. • MRI predicts knee replacement with similar accuracy to radiographic JSW. • MRI reveals greater cartilage thinning and thickening prior to knee replacement.

Maintaining Momentum toward Graduation: OER and the Course Throughput Rate

ERIC Educational Resources Information Center

Hilton, John, III; Fischer, Lane; Wiley, David; Williams, Linda

2016-01-01

"Open Educational Resources" (OER) have the potential to replace traditional textbooks in higher education. Previous studies indicate that use of OER results in high student and faculty satisfaction, lower costs, and similar or better educational outcomes. In this case study, we compared students using traditional textbooks with those…

Social Support for Online Learning: Perspectives of Nursing Students

ERIC Educational Resources Information Center

Munich, Kim

2014-01-01

The purpose of this study was to identify supports beyond the educator that contributed to undergraduate and graduate nursing students' ability and motivation to learn online. Case study methodology similar to Stake (2000) was bounded or contained by undergraduate and graduate online courses. Twenty-nine undergraduate and graduate nursing…

Three years of experience: the Italian registry and safety data update.

PubMed

Mancardi, G L; Tedeschi, G; Amato, M P; D'Alessandro, R; Drago, F; Milanese, C; Popoli, P; Rossi, P; Savettieri, G; Tola, M R; Comi, G; Pozzilli, C; Bertolotto, A; Marrosu, M G; Grimaldi, L M E; Laroni, A; Vanacore, N; Covezzoli, A; De Rosa, M; Piccinni, C; Montanaro, N; Periotto, L; Iommelli, R; Tomino, C; Provinciali, L

2011-01-01

At the end of 2006, a pharmacovigilance program on natalizumab was settled by the Italian Pharmaceutical Agency, and on January 2007, multiple sclerosis patients poorly responding to the immunomodulating therapies or with an aggressive clinical form of disease from onset initiated to be registered and to receive the medication. On February 2010, almost 3,000 cases have been treated with natalizumab. The drop-out rate is 10%. Almost 800 cases received cycles of natalizumab for more than 18 months. One case of PML was reported and other adverse events are similar to those described in phase III studies. The majority of cases remained stable, while in 25% of cases, an improvement of disability was documented.

A case of death of the driver due to environmental asphyxia by liquid nitrogen leakage in the cabin of the car during a road accident

PubMed

Raczkowska, Zuzanna; Samojłowicz, Dorota

2013-01-01

Nitrogen causes environmental asphyxia by displacing oxygen in the air leading to death. The study presents a case of a death of a driver death who was transporting flasks with liquid nitrogen that depressurized during an accident. The mechanism and cause of death were determined based on the result of the autopsy and histopathologic examination. The authors emphasize the relevance of accident scene inspection during establishing the cause of death in similar cases.

A survey of major east coast snowstorms, 1960-1983. Part 2: Case studies of eighteen storms

NASA Technical Reports Server (NTRS)

Kocin, P. J.; Uccellini, L. W.

1985-01-01

Snowfall, surface and upper air charts, and available satellite images are presented for eighteen major East Coast snowstorms that occurred between 1960 and 1983. The charts and descriptions of key fields are provided so that students, weather forecasters, and researchers alike can visualize how a large sample of major winter cyclones form and intensify. Although there are noted similarities in certain aspects of the surface and upper tropospheric development of the storms, significant case-to-case variability precludes the ability to effectively composite these weather systems.

The economic case for low carbon waste management in rapidly growing cities in the developing world: The case of Palembang, Indonesia.

PubMed

Papargyropoulou, Effie; Colenbrander, Sarah; Sudmant, Andrew Heshedahl; Gouldson, Andy; Tin, Lee Chew

2015-11-01

The provision of appropriate waste management is not only an indicator of development but also of broader sustainability. This is particularly relevant to expanding cities in developing countries faced with rising waste generation and associated environmental health problems. Despite these urgent issues, city authorities often lack the evidence required to make well-informed decisions. This study evaluates the carbon and economic performance of low-carbon measures in the waste sector at a city level, within the context of a developing country. Palembang in Indonesia is used as a case of a medium-sized city in a newly industrialized country, with relevance to other similar cities in the developing world. Evidence suggests that the waste sector can achieve substantial carbon emission reductions, and become a carbon sink, in a cost effective way. Hence there is an economic case for a low carbon development path for Palembang, and possibly for other cities in developing and developed countries facing similar challenges. Copyright © 2015 Elsevier Ltd. All rights reserved.

Pathology of Minamata disease.

PubMed

Eto, K

1997-01-01

Minamata disease, or methylmercury poisoning, was first discovered in 1956 around Minamata Bay, Kumamoto Prefecture, Japan. A similar epidemic occurred in 1965 along the Agano River, Niigata Prefecture, Japan. The neuropathology of Minamata disease has been well studied; this review focuses on human cases of Minamata disease in Kumamoto Prefecture. Nervous system lesions associated with Minamata disease have a characteristic distribution. In the cerebral cortex, the calcarine cortex was found to be involved in all cases of Minamata disease, particularly along the calcarine fissure. The destruction of nerve tissue was prominent in the anterior portions of the calcarine cortex. Occasionally, the centrifugal route from the visual and visual association areas (internal sagittal stratum) showed secondary degeneration in prolonged cases after acute onset. Postcentral, precentral, and temporal transverse cortices showed similar changes, though they were less severe. Intense lesions in the precentral cortex caused the development of secondary bilateral degeneration of the pyramidal tracts. In the cerebellum, the lesions occurred deeper in the hemisphere. The granule cell population was most affected. In the peripheral nerves, sensory nerves were more affected than motor nerves. Secondary degeneration of Goll's tracts was occasionally seen in prolonged or chronic cases.

Risk factors for near-fatal asthma. A case-control study in hospitalized patients with asthma.

PubMed

Turner, M O; Noertjojo, K; Vedal, S; Bai, T; Crump, S; Fitzgerald, J M

1998-06-01

We prospectively recruited patients admitted to the hospital with severe asthma to comprehensively evaluate the association of historical and physiologic features with the risk of near-fatal asthma (NFA). A case-control study design was used. All patients admitted with NFA (cases) were identified prospectively and compared with asthma patients admitted during the same period without respiratory failure (controls). Nineteen cases (age: 40.2 +/- 12.0 yr) (mean +/- SD) and 80 controls (age: 36 +/- 13.5 yr) were enrolled. Duration of asthma, gender, smoking status, ethnicity, and prevalence of atopy were similar in the case and control groups. More than 80% of patients in both groups reported worsening symptoms for more than 48 h before admission, and more than 50% were worse for longer than 7 d. There was no difference in degree of airways obstruction or bronchial hyperresponsiveness (PC20). Perception of dyspnea was similar in the cases and controls, but among cases the males had greater impairment than the females (Borg score: 1.9 +/- 1. 4 versus 3.9 +/- 1.2: p = 0.05). Univariate analysis identified a history of previous mechanical ventilation (OR: 27.5; 95% CI: 6.60 to 113.7), admission to the intensive care unit (ICU) (OR: 9.9; 95% CI: 3.0 to 32.9), history of worse asthma during January and February (OR: 3.5; 95% CI: 1.0 to 11.8), and use of air-conditioning (OR: 15.0; 95% CI: 1.3 to 166) as risk factors for NFA. Of concern was the dependence of most patients (59.8%) on the emergency department (ED) for initial care, and the small number of cases (16%) in which patients visited a physician before admission to the hospital. We have confirmed risk factors identified previously in retrospective studies of fatal and NFA, and have also shown that hospitalized patients with asthma, irrespective of severity of their asthma, share several characteristics, especially in terms of their failure to respond to worsening asthma.

Optimized model tuning in medical systems.

PubMed

Kléma, Jirí; Kubalík, Jirí; Lhotská, Lenka

2005-12-01

In medical systems it is often advantageous to utilize specific problem situations (cases) in addition to or instead of a general model. Decisions are then based on relevant past cases retrieved from a case memory. The reliability of such decisions depends directly on the ability to identify cases of practical relevance to the current situation. This paper discusses issues of automated tuning in order to obtain a proper definition of mutual case similarity in a specific medical domain. The main focus is on a reasonably time-consuming optimization of the parameters that determine case retrieval and further utilization in decision making/ prediction. The two case studies - mortality prediction after cardiological intervention, and resource allocation at a spa - document that the optimization process is influenced by various characteristics of the problem domain.

Do hernia operations in african international cooperation programmes provide good quality?

PubMed

Gil, J; Rodríguez, J M; Hernández, Q; Gil, E; Balsalobre, M D; González, M; Torregrosa, N; Verdú, T; Alcaráz, M; Parrilla, P

2012-12-01

Hernia is especially prevalent in developing countries where the population is obliged to undertake strenuous work in order to survive, and International Cooperation Programmes are helping to solve this problem. However, the quality of surgical interventions is unknown. The objective of the present study was to evaluate the quality of hernia repair processes carried out by the Surgical Solidarity Charity in Central African States. A total of 524 cases of inguinal hernia repair carried out in Cameroon and Mali during 2005 to 2009 were compared with 386 cases treated in a Multicentre Spanish Study (2003). General data (clinical, demographic, etc.), type of surgery, complications, and effectiveness and efficiency indicators were collected. Preoperative studies in the Spanish group were greater in number than in the African group. The use of local anesthesia was similar. Antibiotic prophylaxis was higher in the African group (100% to 75.4%). The use of mesh was similar. The incidence of hematomas was higher in the Spanish group (11.61% to 4.61%), but the incidence of infection of the wound and of hernia recurrence was similar, although follow-up was only carried out in 20.97% in the African group (70% in the Spanish group). Hospital stay of more than 24 h was higher in the Spanish group. The standard quality of surgery for the treatment of hernia in developing countries with few instrumental means, and in sub-optimal surgical conditions is similar to that provided in Spain.

Interpreting potential markers of storage and rehearsal: Implications for studies of verbal short-term memory and neuropsychological cases.

PubMed

Wang, Xiaoli; Logie, Robert H; Jarrold, Christopher

2016-08-01

Neuropsychological studies of verbal short-term memory have often focused on two signature effects - phonological similarity and word length - the absence of which has been taken to indicate problems in phonological storage and rehearsal respectively. In the present study we present a possible alternative reading of such data, namely that the absence of these effects can follow as a consequence of an individual's poor level of recall. Data from a large normative sample of 251 adult participants were re-analyzed under the assumption that the size of phonological similarity and word length effects are proportional to an individual's overall level of recall. For both manipulations, when proportionalized effects were plotted against memory span, the same function fit the data in both auditory and visual presentation conditions. Furthermore, two additional sets of single-case data were broadly comparable to those that would be expected for an individual's level of verbal short-term memory performance albeit with some variation across tasks. These findings indicate that the absolute magnitude of phonological similarity and word length effects depends on overall levels of recall, and that these effects are necessarily eliminated at low levels of verbal short-term memory performance. This has implications for how one interprets any variation in the size of these effects, and raises serious questions about the causal direction of any relationship between impaired verbal short-term memory and the absence of phonological similarity or word length effects.

Typecasting catchments: Classification, directionality, and the pursuit of universality

NASA Astrophysics Data System (ADS)

Smith, Tyler; Marshall, Lucy; McGlynn, Brian

2018-02-01

Catchment classification poses a significant challenge to hydrology and hydrologic modeling, restricting widespread transfer of knowledge from well-studied sites. The identification of important physical, climatological, or hydrologic attributes (to varying degrees depending on application/data availability) has traditionally been the focus for catchment classification. Classification approaches are regularly assessed with regard to their ability to provide suitable hydrologic predictions - commonly by transferring fitted hydrologic parameters at a data-rich catchment to a data-poor catchment deemed similar by the classification. While such approaches to hydrology's grand challenges are intuitive, they often ignore the most uncertain aspect of the process - the model itself. We explore catchment classification and parameter transferability and the concept of universal donor/acceptor catchments. We identify the implications of the assumption that the transfer of parameters between "similar" catchments is reciprocal (i.e., non-directional). These concepts are considered through three case studies situated across multiple gradients that include model complexity, process description, and site characteristics. Case study results highlight that some catchments are more successfully used as donor catchments and others are better suited as acceptor catchments. These results were observed for both black-box and process consistent hydrologic models, as well as for differing levels of catchment similarity. Therefore, we suggest that similarity does not adequately satisfy the underlying assumptions being made in parameter regionalization approaches regardless of model appropriateness. Furthermore, we suggest that the directionality of parameter transfer is an important factor in determining the success of parameter regionalization approaches.

Laparoscopic Sleeve Gastrectomy for Morbid Obesity in Patients After Orthotopic Liver Transplant: a Matched Case-Control Study.

PubMed

Tsamalaidze, Levan; Stauffer, John A; Arasi, Lisa C; Villacreses, Diego E; Franco, Jose Salvador Serrano; Bowers, Steven; Elli, Enrique F

2018-02-01

Obesity is frequently encountered in patients with orthotopic liver transplant (OLT). The role of bariatric surgery is still unclear for this specific population. The aim of this study was to review our experience with laparoscopic sleeve gastrectomy (LSG) after OLT. We performed a retrospective case-control study of patients undergoing LSG after OLT from 2010 to 2016. OLT-LSG patients were matched by age, sex, body mass index (BMI), and year to non-OLT patients undergoing LSG. Demographics, operative variables, postoperative events, and long-term weight loss with comorbidity resolution were collected and compared between cases and controls. Of 303 patients undergoing LSG, 12 (4%) had previous OLT. They were matched to 36 non-OLT patients. No difference was found between groups in the American Society of Anesthesiologists class, mean operative time, or postoperative morbidity. The non-OLT group, however, had a significantly shorter mean hospital stay than the OLT group (1.7 vs 3.1 days; P < .001). There were no conversions to open procedures. For patients with long-term follow-up, change in BMI after LSG was similar between the groups, but the non-OLT patients had significantly more excess body weight loss at 2 years (53.7 vs 45.2%; P < .001). Similar resolution of comorbid conditions was noted in both groups. LSG caused no changes in dosage of immunosuppressive medications, and no liver complications occurred. LSG after OLT in appropriately selected patients appears to have similar outcomes to LSG in non-OLT patients.

Quantifying the Diversity and Similarity of Surgical Procedures Among Hospitals and Anesthesia Providers.

PubMed

Dexter, Franklin; Ledolter, Johannes; Hindman, Bradley J

2016-01-01

In this Statistical Grand Rounds, we review methods for the analysis of the diversity of procedures among hospitals, the activities among anesthesia providers, etc. We apply multiple methods and consider their relative reliability and usefulness for perioperative applications, including calculations of SEs. We also review methods for comparing the similarity of procedures among hospitals, activities among anesthesia providers, etc. We again apply multiple methods and consider their relative reliability and usefulness for perioperative applications. The applications include strategic analyses (e.g., hospital marketing) and human resource analytics (e.g., comparisons among providers). Measures of diversity of procedures and activities (e.g., Herfindahl and Gini-Simpson index) are used for quantification of each facility (hospital) or anesthesia provider, one at a time. Diversity can be thought of as a summary measure. Thus, if the diversity of procedures for 48 hospitals is studied, the diversity (and its SE) is being calculated for each hospital. Likewise, the effective numbers of common procedures at each hospital can be calculated (e.g., by using the exponential of the Shannon index). Measures of similarity are pairwise assessments. Thus, if quantifying the similarity of procedures among cases with a break or handoff versus cases without a break or handoff, a similarity index represents a correlation coefficient. There are several different measures of similarity, and we compare their features and applicability for perioperative data. We rely extensively on sensitivity analyses to interpret observed values of the similarity index.

Cognitive Behavioural Relating Therapy (CBRT) for voice hearers: a case study.

PubMed

Paulik, Georgie; Hayward, Mark; Birchwood, Max

2013-10-01

There has been a recent focus on the interpersonal nature of the voice hearing experience, with studies showing that similar patterns of relating exist between voice hearer and voice as between voice hearer and social others. Two recent therapeutic approaches to voices, Cognitive Therapy for Command Hallucinations and Relating Therapy, have been developed to address patterns of relating and power imbalances between voice hearer and voice. This paper presents a novel intervention that combines elements of these two therapies, named Cognitive Behavioural Relating Therapy (CBRT). The application of CBRT is illustrated through a clinical case study. The clinical case study showed changes in patterns of relating, improved self-esteem and reductions in voice-related distress. The outcomes provide preliminary support for the utility of CBRT when working with voice hearers.

A case-control study of Nocardia mastitis in Nova Scotia dairy herds

PubMed Central

Ferns, Lyn; Dohoo, Ian; Donald, Alan

1991-01-01

A case-control study was conducted to identify herd production, housing, and hygienic and therapeutic factors associated with a diagnosis of Nocardia mastitis in dairy herds in Nova Scotia. The data were collected by on-farm interviews with owners of 54 case and 54 control herds. Logistic regression was used to study risk factors. The use of dry cow products containing neomycin, including two specific dry cow products, was strongly associated with a diagnosis of Nocardia mastitis in a herd. Other factors which increased the risk of Nocardia mastitis were higher levels of production, larger herd size, and a large percentage of cows treated with dry cow products. These results are compared to results from a similar study carried out in Ontario. PMID:17423896

GIMDA: Graphlet interaction-based MiRNA-disease association prediction.

PubMed

Chen, Xing; Guan, Na-Na; Li, Jian-Qiang; Yan, Gui-Ying

2018-03-01

MicroRNAs (miRNAs) have been confirmed to be closely related to various human complex diseases by many experimental studies. It is necessary and valuable to develop powerful and effective computational models to predict potential associations between miRNAs and diseases. In this work, we presented a prediction model of Graphlet Interaction for MiRNA-Disease Association prediction (GIMDA) by integrating the disease semantic similarity, miRNA functional similarity, Gaussian interaction profile kernel similarity and the experimentally confirmed miRNA-disease associations. The related score of a miRNA to a disease was calculated by measuring the graphlet interactions between two miRNAs or two diseases. The novelty of GIMDA lies in that we used graphlet interaction to analyse the complex relationships between two nodes in a graph. The AUCs of GIMDA in global and local leave-one-out cross-validation (LOOCV) turned out to be 0.9006 and 0.8455, respectively. The average result of five-fold cross-validation reached to 0.8927 ± 0.0012. In case study for colon neoplasms, kidney neoplasms and prostate neoplasms based on the database of HMDD V2.0, 45, 45, 41 of the top 50 potential miRNAs predicted by GIMDA were validated by dbDEMC and miR2Disease. Additionally, in the case study of new diseases without any known associated miRNAs and the case study of predicting potential miRNA-disease associations using HMDD V1.0, there were also high percentages of top 50 miRNAs verified by the experimental literatures. © 2017 The Authors. Journal of Cellular and Molecular Medicine published by John Wiley & Sons Ltd and Foundation for Cellular and Molecular Medicine.

[Reconstruction of facial soft tissue defects with pedicled expanded flaps].

PubMed

Yangqun, Li; Yong, Tang; Wen, Chen; Zhe, Yang; Muxin, Zhao; Lisi, Xu; Chunmei, Hu; Yuanyuan, Liu; Ning, Ma; Jun, Feng; Weixin, Wang

2014-09-01

To investigate the application of pedicled expanded flaps for the reconstruction of facial soft tissue defects. The expanded skin flaps, pedicled with orbicularis oculi muscle, submental artery, the branch of facial artery, superficial temporal artery, interior upper arm artery, had similar texture and color as facial soft tissue. The pedicled expanded flaps have repaired the facial soft tissue defects. Between Jan. 2003 to Dec. 2013, 157 cases with facial soft tissue defects were reconstructed by pedicled expanded flaps. Epidermal necrosis happened at the distal end of 8 expanded flaps, pedicled with interior upper arm artery(4 cases), orbicularis oculi muscle(3 cases) and submental artery(1 case), which healed spontaneously after dressing. All the other flaps survived completely with similar color and inconspicuous scar. 112 cases were followed up for 8 months to 8 years. Satisfactory results were achieved in 75 cases. 37 cases with hypertrophic scar at incisions need secondary operation. Island pedicled expanded flap with similar texture and color as facial soft tissue is suitable for facial soft tissue defects. The facial extra-incision and large dog-ear deformity could be avoided.

Are there socioeconomic differences in myocardial infarction event rates and fatality among patients with angina pectoris?

PubMed Central

Manderbacka, Kristiina; Hetemaa, Tiina; Keskimäki, Ilmo; Luukkainen, Pekka; Koskinen, Seppo; Reunanen, Antti

2006-01-01

Background Systematic socioeconomic differences in mortality have been reported among myocardial infarction (MI) patients in many countries, including Finland. The findings have been similar irrespective of country, study period, age group, or length of follow up, but few studies have examined the disparities among other groups of coronary patients. This study examined whether similar socioeconomic differences in outcomes exist among patients with angina pectoris (AP). Methods The data were based on individual register linkages among a population based 40–79 year‐old cohort of 61 350 patients with incident AP or MI during 1995–1998 in Finland. Two year coronary heart disease mortality and one year MI incidence and its 28 day case fatality was studied among AP patients using Cox's and logistic regression analysis, and the results compared with those of the MI patient group. Results A clear socioeconomic pattern was found in two year coronary heart disease (CHD) mortality: the lower the socioeconomic group the higher the mortality risk. The socioeconomic patterning of mortality was similar to that found among MI patients. Controlling for comorbidity or disease severity did not change the results. Among AP patients a similar pattern was also found in MI incidence during the follow up, but no systematic socioeconomic differences were detected in its 28 day case fatality. Conclusions Socioeconomic differences in CHD outcomes also exist among angina patients. These results suggest that targeted measures of secondary prevention are needed among CHD patients with lower socioeconomic status to reduce socioeconomic disparities in fatal and non‐fatal coronary events. PMID:16614336

Clinical phenotype-based gene prioritization: an initial study using semantic similarity and the human phenotype ontology.

PubMed

Masino, Aaron J; Dechene, Elizabeth T; Dulik, Matthew C; Wilkens, Alisha; Spinner, Nancy B; Krantz, Ian D; Pennington, Jeffrey W; Robinson, Peter N; White, Peter S

2014-07-21

Exome sequencing is a promising method for diagnosing patients with a complex phenotype. However, variant interpretation relative to patient phenotype can be challenging in some scenarios, particularly clinical assessment of rare complex phenotypes. Each patient's sequence reveals many possibly damaging variants that must be individually assessed to establish clear association with patient phenotype. To assist interpretation, we implemented an algorithm that ranks a given set of genes relative to patient phenotype. The algorithm orders genes by the semantic similarity computed between phenotypic descriptors associated with each gene and those describing the patient. Phenotypic descriptor terms are taken from the Human Phenotype Ontology (HPO) and semantic similarity is derived from each term's information content. Model validation was performed via simulation and with clinical data. We simulated 33 Mendelian diseases with 100 patients per disease. We modeled clinical conditions by adding noise and imprecision, i.e. phenotypic terms unrelated to the disease and terms less specific than the actual disease terms. We ranked the causative gene against all 2488 HPO annotated genes. The median causative gene rank was 1 for the optimal and noise cases, 12 for the imprecision case, and 60 for the imprecision with noise case. Additionally, we examined a clinical cohort of subjects with hearing impairment. The disease gene median rank was 22. However, when also considering the patient's exome data and filtering non-exomic and common variants, the median rank improved to 3. Semantic similarity can rank a causative gene highly within a gene list relative to patient phenotype characteristics, provided that imprecision is mitigated. The clinical case results suggest that phenotype rank combined with variant analysis provides significant improvement over the individual approaches. We expect that this combined prioritization approach may increase accuracy and decrease effort for clinical genetic diagnosis.

Similarity in Bilateral Isolated Internal Orbital Fractures.

PubMed

Chen, Hung-Chang; Cox, Jacob T; Sanyal, Abanti; Mahoney, Nicholas R

2018-04-13

In evaluating patients sustaining bilateral isolated internal orbital fractures, the authors have observed both similar fracture locations and also similar expansion of orbital volumes. In this study, we aim to investigate if there is a propensity for the 2 orbits to fracture in symmetrically similar patterns when sustaining similar trauma. A retrospective chart review was performed studying all cases at our institution of bilateral isolated internal orbital fractures involving the medial wall and/or the floor at the time of presentation. The similarity of the bilateral fracture locations was evaluated using the Fisher's exact test. The bilateral expanded orbital volumes were analyzed using the Wilcoxon signed-rank test to assess for orbital volume similarity. Twenty-four patients with bilateral internal orbital fractures were analyzed for fracture location similarity. Seventeen patients (70.8%) had 100% concordance in the orbital subregion fractured, and the association between the right and the left orbital fracture subregion locations was statistically significant (P < 0.0001). Fifteen patients were analyzed for orbital volume similarity. The average orbital cavity volume was 31.2 ± 3.8 cm on the right and 32.0 ± 3.7 cm on the left. There was a statistically significant difference between right and left orbital cavity volumes (P = 0.0026). The data from this study suggest that an individual who suffers isolated bilateral internal orbital fractures has a statistically significant similarity in the location of their orbital fractures. However, there does not appear to be statistically significant similarity in the expansion of the orbital volumes in these patients.

Subtle trisomy 12q24.3 and subtle monosomy 22q13.3: three new cases and review.

PubMed

Rodríguez, Laura; Martínez Guardia, Nieves; Herens, Christian; Jamar, Mauricette; Verloes, Alain; López, Fermina; Santos Muñoz, José; Martínez-Frías, María Luisa

2003-10-01

The high resolution G-bands (850 bands) karyotype have made it possible to identify small chromosome anomalies (5 megabases) which are now microscopically visible. New techniques have been improved, such as the Fluorescent in situ hybridization (FISH) with subtelomeric probes, which can be employed to detect cryptic chromosome alterations not visible microscopically. We present three cases which had been remitted for a high resolution karyotype. The high resolution G-band karyotype and the FISH techniques led us to conclude that the three cases were carriers of a similar subtle chromosomal alteration. Case I is a new born female with developmental and psychomotor delay, hypotonia, and long limbs with arachnodactily. A high resolution G-band karyotype showed an abnormal chromosome 22. FISH techniques confirmed a der(22)t(12;22)(q24.31;q13.3). Case II is a 12-year-old girl, with growth retardation, long shaped face with thick eyebrows, smooth philtrum, and thin upper lip with severe mental retardation (still no language), with a phenotype very similar to that of his sister: long shaped face, thick eyebrows, smooth philtrum, and thin upper lip. A high resolution G-band karyotype also showed in Case II and III an abnormal chromosome 22, studied by FISH techniques which confirmed a der(22)t(12;22)(q24.3;q13.3) in both cases. Copyright 2003 Wiley-Liss, Inc.

Pedestrian hybrid beacon guide : recommendations and case study.

DOT National Transportation Integrated Search

2014-01-01

A pedestrian hybrid beacon (PHB) is a traffic control : device similar to a European pedestrian signal : (PELICAN) that was imported to the US and adapted by : engineers in Arizona to increase motorists awareness of : pedestrian crossings at uncon...

Acute coronary syndrome in women of reproductive age

PubMed Central

Idris, Nazimah; Aznal, Sharifah Sulaiha; Chin, Sze-Piaw; Ahmad, Wan Azman Wan; Rosman, Azhari; Jeyaindran, Sinnadurai; Ismail, Omar; Zambahari, Robaayah; Sim, Kui Hian

2011-01-01

Background There is scarce or no data on prevalence and presentation of acute coronary syndrome (ACS) among women of reproductive age. Furthermore, whether women of reproductive age presenting with ACS have the same risk factors as men and older women is not known. Objective To analyze factors associated with ACS in women of reproductive age in comparison with older women and men of a similar age group. Methodology A total of 9702 cases of acute coronary syndrome over a 3-year period ( 2006–2008) from the National Cardiovascular Disease database were analyzed, with focus on women of reproductive age (20–<40 years), looking into association with ethnicity, comorbid illness, and the ACS stratum. Comparison with older women (40–<60 years; Control 1) and men of similar age group (Control 2) was made and analyzed using Fisher’s exact test and chi-square test when necessary. Results From a total of 9702 cases, 2344 (24.2%) were women. Of these, 45 (1.9%) were women between 20 and <40 years, which is significantly lower than the two controls (older women 30.8%, and men of same age 6.2%, respectively; P < 0.0001). The distribution of ethnicity shows a similar pattern between the study group and the controls, but patients of Indian ethnicity were over-represented when compared with the Malaysian demographics of general population (31.3% versus 7.1%; P < 0.0001). ACS in women of reproductive age was associated with diabetes mellitus in 37.8%, hypertension in 40.0%, and dyslipidemia in 24.4% of cases, similar to men of the same age but significantly lower than the older women (P < 0.0001). Smoking is not a major risk factor in the study group, where only 6.7% ever smoked, similar to older women (6.8%, P = 1.000) and significantly much less compared with men of the same age (84.1%; P < 0.0001). Regarding the ACS stratum, a significantly higher percentage of women in the study group had ST-segment elevation myocardial infarction compared with older women (P = 0.0085) but less than that of men of similar age (P = 0.0187). Conclusion ACS is rare in women of reproductive age. Diabetes, hypertension, and Indian ethnicity were identified as important contributors. PMID:22140324

Back and neck pain disability and upper limb symptoms of home healthcare workers: A case-control study from Northern Italy.

PubMed

Riccò, Matteo; Pezzetti, Federica; Signorelli, Carlo

2017-03-30

Work-related musculoskeletal disorders (MSD) are quite frequent in healthcare workers (HCWs), but data about MSD in home-based healthcare workers (HHWs) are lacking. In this study we describe the prevalence of MSD among Italian HHWs. A case-control study was carried out among 300 random-selected female HCWs, the sample comprising 100 HHWs, 100 HCWs with a low exposure to patient handling (MAPO - Movimentazione e Assistenza Pazienti Ospedalizzati - Movement and Assistance of Hospital Patients index 0-5) and 100 HCWs with high exposure to patient handling (MAPO index ≥ 5.01). As a negative control group, 200 visual display unit workers were also randomly selected. Musculoskeletal disorder cases were collected using a standardized case definition. A multivariate logistic regression analysis was performed comparing the MSD prevalence in the 4 groups. The overall prevalence of MSD was 17% in the reference group and 28.3% for HCWs. HHWs and HCWs with MAPO index ≥ 5.01 had similar prevalence of neck pain (9% and 11%, respectively), whereas lumbosacral pain prevalence was higher in the HHWs group (31%), with similar results in residential HCWs groups (21% in MAPO index 0-5 group and 25% in MAPO index ≥ 5.01 group). HCWs of group MAPO index ≥ 5.01 and HHWs showed the higher prevalence of upper limb complaints, with a prevalence of 20% and 10%, respectively. In multivariate regression analysis, prevalence of MSD complaints was quite similar in HHWs (adjusted odds ratio (OR_adj) = 2.335, 95% confidence interval (CI): 1.318-4.138) and in HCWs of the group MAPO ≥ 5.01 (OR_adj = 2.729, 95% CI: 1.552-4.797). The prevalence of MSD in the examined HCWs was relatively high, with HHWs appearing as a particularly high-risk group for lumbosacral back pain. In higher exposed HCWs, upper-limb symptoms were particularly frequent, probably reflecting the different tasks required to manage residential and homebased patients. In conclusion, this study reaffirms the high prevalence of MSD in HHWs, seemly similar to high-risk residential groups. Int J Occup Med Environ Health 2017;30(2):291-304. This work is available in Open Access model and licensed under a CC BY-NC 3.0 PL license.

Celiac disease serum markers and recurrent pregnancy loss.

PubMed

Sharshiner, Rita; Romero, Stephanie T; Bardsley, Tyler R; Branch, D Ware; Silver, Robert M

2013-12-01

Celiac disease has been associated with numerous unfavorable health outcomes, including pregnancy complications such as infertility, preterm birth, and preeclampsia. However, the association between celiac disease and recurrent pregnancy loss (RPL) remains uncertain. Our purpose was to compare serum markers of celiac disease in women with and without RPL. Therefore, we performed a case-control study of 116 women with unexplained recurrent pregnancy loss and 116 age-matched controls. Maternal sera were analyzed for immunoglobulin A (IgA) and immunoglobulin G (IgG) tissue transglutaminase (tTG) antibodies and endomysial (EM) antibodies. Groups were similar with regard to age, race and ethnicity, and BMI. One case and one control tested positive (≥20 Units) for IgA tTG antibodies and mean levels of IgA tTG antibodies were similar in cases and controls (5.5±2.86 versus 6.0±12.45; p=0.16). No cases or controls were positive for IgG tTG antibodies. However, cases had higher levels of IgG tTG antibody compared with controls (4.0±2.40 versus 3.3±1.30; p=0.0064). One subject (a control) tested positive for IgA EM antibodies and no subjects tested positive for IgG EM antibodies. In conclusion, positive results for tTG and EM antibodies were similar in women with and without RPL. Given these results, testing for occult celiac disease is not recommended in the evaluation of women with idiopathic RPL. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

Short frontal plane fractures involving the dorsoproximal articular surface of the proximal phalanx: Description of the injury and a technique for repair.

PubMed

Wright, I M; Minshall, G J

2018-01-01

Chip fractures of the dorsoproximal articular margin of the proximal phalanx are common injuries in racehorses. Large fractures can extend distal to the joint capsule insertion and have been described as dorsal frontal fractures. To report the location and morphology of short frontal plane fractures involving the dorsoproximal articular surface of the proximal phalanx and describe a technique for repair under arthroscopic and radiographic guidance. Single centre retrospective case study. Case records of horses with frontal plane fractures restricted to the dorsoproximal epiphysis and metaphysis of the proximal phalanx referred to Newmarket Equine Hospital were retrieved, images reviewed and lesion morphology described. A technique for repair and the results obtained are reported. A total of 22 fractures in 21 horses commencing at the proximal articular surface exited the dorsal cortex of the proximal phalanx distal to the metacarpophalangeal/metatarsophalangeal joint capsule in 17 hind- and five forelimbs. All were in Thoroughbred racehorses. In 16 cases these were acute racing or training injuries; 20 fractures were medial, one lateral and one was midline. All were repaired with a single lag screw using arthroscopic and radiographically determined landmarks. A total of 16 horses raced after surgery with performance data similar to their preinjury levels. The study demonstrates substantial morphological similarities between individual lesions supporting a common pathophysiology, but does not identify precise causation. There are no cases managed differently that might permit assessment of the comparative efficacy of the treatment described. Short frontal plane fractures involving the dorsoproximal margin of the proximal phalanx that exit the bone distal to the metacarpophalangeal/metatarsophalangeal joint capsule have substantial morphological similarities, are amenable to minimally invasive repair and carry a good prognosis for return to training and racing. © 2017 EVJ Ltd.

What Is the Best Way to Measure Surgical Quality? Comparing the American College of Surgeons National Surgical Quality Improvement Program versus Traditional Morbidity and Mortality Conferences.

PubMed

Zhang, Jacques X; Song, Diana; Bedford, Julie; Bucevska, Marija; Courtemanche, Douglas J; Arneja, Jugpal S

2016-04-01

Morbidity and mortality conferences have played a traditional role in tracking complications. Recently, the American College of Surgeons National Surgical Quality Improvement Program Pediatrics (ACS NSQIP-P) has gained popularity as a risk-adjusted means of addressing quality assurance. The purpose of this article is to report an analysis of the two methodologies used within pediatric plastic surgery to determine the best way to manage quality. ACS NSQIP-P and morbidity and mortality data were extracted for 2012 and 2013 at a quaternary care institution. Overall complication rates were compared statistically, segregated by type and severity, followed by a subset comparison of ACS NSQIP-P-eligible cases only. Concordance and discordance rates between the two methodologies were determined. One thousand two hundred sixty-one operations were performed in the study period. Only 51.4 percent of cases were ACS NSQIP-P eligible. The overall complication rates of ACS NSQIP-P (6.62 percent) and morbidity and mortality conferences (6.11 percent) were similar (p = 0.662). Comparing for only ACS NSQIP-P-eligible cases also yielded a similar rate (6.62 percent versus 5.71 percent; p = 0.503). Although different complications are tracked, the concordance rate for morbidity and mortality and ACS NSQIP-P was 35.1 percent and 32.5 percent, respectively. The ACS NSQIP-P database is able to accurately track complication rates similarly to morbidity and mortality conferences, although it samples only half of all procedures. Although both systems offer value, limitations exist, such as differences in definitions and purpose. Because of the rigor of the ACS NSQIP-P, we recommend that it be expanded to include currently excluded cases and an extension of the study interval.

An exploratory study demonstrating the diagnostic ability of healthcare professionals in primary care using online case studies for common skin conditions.

PubMed

Tucker, Rod; Patel, Mahendra; Layton, Alison L; Walton, Shernaz

2014-04-01

To compare the diagnostic ability of pharmacists, nurses and general practitioners (GPs) for a range of skin conditions. An online study comprising 10 specifically developed dermatological case studies containing a digital image of the skin condition and a short case history. A total of 60 participants (20 representing each of pharmacists, GPs and primary care nurses) were required to identify the skin condition as well as the features in the case history that supported the diagnosis and the recommended first-line management approach for the condition. The mean diagnostic scores for each group were GPs = 8.8 (95% confidence interval, CI, 7.9-9.6), pharmacists = 6.2 (95% CI, 5.4-6.9) and nurses = 7.0 (95% CI, 6.1-7.9). Post hoc analysis revealed that the difference in mean diagnostic scores was significant (P < 0.05) between GPs and both pharmacists and nurses. However, pharmacists' diagnostic accuracy was similar to GPs' for some skin conditions such as tinea corporis, scabies and plantar warts and overall at least 40% of pharmacists correctly identified all conditions. This small study has demonstrated that for all of the skin conditions considered, pharmacists' overall diagnostic scores were significantly different from those of GPs but similar to those of nurses for the conditions assessed. However, further work with a larger sample is required to determine the accuracy of these preliminary findings and to establish whether advice given by pharmacists in practice results in the appropriate course of action being taken. © 2013 Royal Pharmaceutical Society.

Clinical implications of the proposed ICD-11 PTSD diagnostic criteria.

PubMed

Barbano, Anna C; van der Mei, Willem F; Bryant, Richard A; Delahanty, Douglas L; deRoon-Cassini, Terri A; Matsuoka, Yutaka J; Olff, Miranda; Qi, Wei; Ratanatharathorn, Andrew; Schnyder, Ulrich; Seedat, Soraya; Kessler, Ronald C; Koenen, Karestan C; Shalev, Arieh Y

2018-05-14

Projected changes to post-traumatic stress disorder (PTSD) diagnostic criteria in the upcoming International Classification of Diseases (ICD)-11 may affect the prevalence and severity of identified cases. This study examined differences in rates, severity, and overlap of diagnoses using ICD-10 and ICD-11 PTSD diagnostic criteria during consecutive assessments of recent survivors of traumatic events. The study sample comprised 3863 survivors of traumatic events, evaluated in 11 longitudinal studies of PTSD. ICD-10 and ICD-11 diagnostic rules were applied to the Clinician-Administered PTSD Scale (CAPS) to derive ICD-10 and ICD-11 diagnoses at different time intervals between trauma occurrence and 15 months. The ICD-11 criteria identified fewer cases than the ICD-10 across assessment intervals (range -47.09% to -57.14%). Over 97% of ICD-11 PTSD cases met concurrent ICD-10 PTSD criteria. PTSD symptom severity of individuals identified by the ICD-11 criteria (CAPS total scores) was 31.38-36.49% higher than those identified by ICD-10 criteria alone. The latter, however, had CAPS scores indicative of moderate PTSD. ICD-11 was associated with similar or higher rates of comorbid mood and anxiety disorders. Individuals identified by either ICD-10 or ICD-11 shortly after traumatic events had similar longitudinal course. This study indicates that significantly fewer individuals would be diagnosed with PTSD using the proposed ICD-11 criteria. Though ICD-11 criteria identify more severe cases, those meeting ICD-10 but not ICD-11 criteria remain in the moderate range of PTSD symptoms. Use of ICD-11 criteria will have critical implications for case identification in clinical practice, national reporting, and research.

Functional and anatomical differences between continent and incontinent men post radical prostatectomy on urodynamics and 3T MRI: a pilot study.

PubMed

Cameron, Anne P; Suskind, Anne M; Neer, Charlene; Hussain, Hero; Montgomery, Jeffrey; Latini, Jerilyn M; DeLancey, John O

2015-08-01

There are competing hypotheses about the etiology of post prostatectomy incontinence (PPI). The purpose of this study was to determine the anatomical and functional differences between men with and without PPI. Case-control study of continent and incontinent men after radical prostatectomy who underwent functional and anatomic studies with urodynamics and 3.0 Tesla MRI. All men were at least 12 months post prostatectomy and none had a history of pelvic radiation or any prior surgery for incontinence. Baseline demographics, surgical approach, and pathology were similar between incontinent (cases) (n = 14) and continent (controls) (n = 12) men. Among the cases, the average 24 hr pad weight was 400.0 ± 176.9 g with a mean of 2.4 ± 0.7 pads per day. Urethral pressure profiles at rest did not significantly differ between groups; however, with a Kegel maneuver the rise in urethral pressure was 2.6 fold higher in controls. On MRI, the urethral length was 31-35% shorter and the bladder neck was 28.9° more funneled in cases. There were no differences in levator ani muscle size between groups. There was distortion of the sphincter area in 85.7% of cases and in 16.7% of controls (P = 0.001). Men with PPI were not able to increase urethral pressure with a Kegel maneuver despite similar resting urethral pressure profiles. Additionally, incontinent men had shorter urethras and were more likely to have distortion of the sphincter area. All suggesting that the sphincter in men with PPI is both diminutive and poorly functional. © 2014 Wiley Periodicals, Inc.

FUNCTIONAL AND ANATOMICAL DIFFERENCES BETWEEN CONTINENT AND INCONTINENT MEN POST RADICAL PROSTATECTOMY ON URODYNAMICS AND 3T MRI: A PILOT STUDY

PubMed Central

Cameron, Anne P.; Suskind, Anne M.; Neer, Charlene; Hussain, Hero; Montgomery, Jeffrey; Latini, Jerilyn M.; DeLancey, John O

2014-01-01

Aims There are competing hypotheses about the etiology of post prostatectomy incontinence (PPI).The purpose of this study was to determine the anatomical and functional differences between men with and without PPI. Methods Case control study of continent and incontinent men after radical prostatectomy who underwent functional and anatomic studies with urodynamics and 3.0 Tesla MRI. All men were at least 12 months post prostatectomy and none had a history of pelvic radiation or any prior surgery for incontinence. Results Baseline demographics, surgical approach and pathology were similar between incontinent (cases) (n=14) and continent (controls) (n=12) men. Among the cases, the average 24 hour pad weight was 400.0 ±176.9 grams with a mean of 2.4 ±0.7 pads per day. Urethral pressure profiles at rest did not significantly differ between groups; however with a Kegel maneuver the rise in urethral pressure was 2.6 fold higher in controls. On MRI, the urethral length was 31–35% shorter and the bladder neck was 28.9 degrees more funneled in cases. There were no differences in levator ani muscle size between groups. There was distortion of the sphincter area in 85.7% of cases and in 16.7% of controls (p=0.001). Conclusions Men with PPI were not able to increase urethral pressure with a Kegel maneuver despite similar resting urethral pressure profiles. Additionally, incontinent men had shorter urethras and were more likely to have distortion of the sphincter area. All suggesting that the sphincter in men with PPI is both diminutive and poorly functional. PMID:24752967

[Diagnosis of lung embolism. Prospective study].

PubMed

Melcher, G A; Frauchiger, B; Brunner, W; Nager, F

1987-01-31

In a prospective study over the years 1983-1985, 300 cases of acute pulmonary embolism were analyzed in relation to predisposing factors, clinical signs, arterial blood gas analysis and isotope perfusion scanning. Comparison of this prospective study with an earlier retrospective one showed similar results, with the exception of isotope scanning, an investigation which has gained increasing diagnostic reliability (highly suggestive results in 94% of patients with massive pulmonary embolism and in 64% with submassive pulmonary embolism). In two thirds of the cases the diagnosis was established during the first day after hospitalisation. In 10% of the patients pulmonary embolism occurred despite anticoagulant therapy.

Epidemiology of Measles Cases in South Darfur State, Sudan, 2011-2015.

PubMed

Musa, Taha Hussein; Kambo, Rehab Ibrahim; Ahmed, Abdelkareem Abdallah; Musa, Hassan Hussein

2017-12-01

Case-based surveillance measles data was defined according to World Health Organization (WHO) guidelines. A total of 511 measles cases were studied from 2011 to 2015 in Southern Darfur State, Sudan and 58.1% of cases were confirmed from Nyala city. About 43.4% of cases were males, 56.6% of cases were female, and 47.7% were children under five years old. Similarity, within February to June, the cases increased by 8.0% in children vaccinated through measles campaign, and 5.3% in children that used child vaccination card and 78.7% in unvaccinated one. The epidemiologically linked (EPI-Linked) measles cases declined from 2011 to 2015; consequently, Measles still remain to be a significant challenge in south Darfur state, Sudan. Copyright © 2017 The Editorial Board of Biomedical and Environmental Sciences. Published by China CDC. All rights reserved.

A cross-species analysis method to analyze animal models' similarity to human's disease state

PubMed Central

2012-01-01

Background Animal models are indispensable tools in studying the cause of human diseases and searching for the treatments. The scientific value of an animal model depends on the accurate mimicry of human diseases. The primary goal of the current study was to develop a cross-species method by using the animal models' expression data to evaluate the similarity to human diseases' and assess drug molecules' efficiency in drug research. Therefore, we hoped to reveal that it is feasible and useful to compare gene expression profiles across species in the studies of pathology, toxicology, drug repositioning, and drug action mechanism. Results We developed a cross-species analysis method to analyze animal models' similarity to human diseases and effectiveness in drug research by utilizing the existing animal gene expression data in the public database, and mined some meaningful information to help drug research, such as potential drug candidates, possible drug repositioning, side effects and analysis in pharmacology. New animal models could be evaluated by our method before they are used in drug discovery. We applied the method to several cases of known animal model expression profiles and obtained some useful information to help drug research. We found that trichostatin A and some other HDACs could have very similar response across cell lines and species at gene expression level. Mouse hypoxia model could accurately mimic the human hypoxia, while mouse diabetes drug model might have some limitation. The transgenic mouse of Alzheimer was a useful model and we deeply analyzed the biological mechanisms of some drugs in this case. In addition, all the cases could provide some ideas for drug discovery and drug repositioning. Conclusions We developed a new cross-species gene expression module comparison method to use animal models' expression data to analyse the effectiveness of animal models in drug research. Moreover, through data integration, our method could be applied for drug research, such as potential drug candidates, possible drug repositioning, side effects and information about pharmacology. PMID:23282076

Comparative study of outcomes following laparoscopic Roux-en-Y gastric bypass and sleeve gastrectomy in morbidly obese patients: A case control study.

PubMed

Garg, Harshit; Priyadarshini, Pratyusha; Aggarwal, Sandeep; Agarwal, Samagra; Chaudhary, Rachna

2017-04-16

To compare the impact of laparoscopic Roux-en-Y gastric bypass (LRYGB) and laparoscopic sleeve gastrectomy (LSG) on weight loss and obesity related comorbidities over two year follow-up via case control study design. Forty patients undergoing LRYGB, who completed their two year follow-up were matched with 40 patients undergoing LSG for age, gender, body mass index and presence of type 2 diabetes mellitus (T2DM). Data of these patients was retrospectively reviewed to compare the outcome in terms of weight loss and improvement in comorbidities, i.e ., T2DM, hypertension (HTN), obstructive sleep apnea syndrome (OSAS), hypothyroidism and gastroesophageal reflux disease (GERD). Percentage excess weight loss (EWL%) was similar in LRYGB and LSG groups at one year follow-up (70.5% vs 66.5%, P = 0.36) while it was significantly greater for LRYGB group after two years as compared to LSG group (76.5% vs 67.9%, P = 0.04). The complication rate after LRYGB and LSG was similar (10% vs 7.5%, P = 0.99). The median duration of T2DM and mean number of oral hypoglycemic agents were higher in LRYGB group than LSG group (7 years vs 5 years and 2.2 vs 1.8 respectively, P < 0.05). Both LRYGB and LSG had significant but similar improvement in T2DM, HTN, OSAS and hypothyroidism. However, GERD resolved in all patients undergoing LRYGB while it resolved in only 50% cases with LSG. Eight point three percent patients developed new-onset GERD after LSG. LRYGB has better outcomes in terms of weight loss two years after surgery as compared to LSG. The impact of LRYGB and LSG on T2DM, HTN, OSAS and hypothyroidism is similar. However, LRYGB has significant resolution of GERD as compared to LSG.

Measuring the Evolution of Ontology Complexity: The Gene Ontology Case Study

PubMed Central

Dameron, Olivier; Bettembourg, Charles; Le Meur, Nolwenn

2013-01-01

Ontologies support automatic sharing, combination and analysis of life sciences data. They undergo regular curation and enrichment. We studied the impact of an ontology evolution on its structural complexity. As a case study we used the sixty monthly releases between January 2008 and December 2012 of the Gene Ontology and its three independent branches, i.e. biological processes (BP), cellular components (CC) and molecular functions (MF). For each case, we measured complexity by computing metrics related to the size, the nodes connectivity and the hierarchical structure. The number of classes and relations increased monotonously for each branch, with different growth rates. BP and CC had similar connectivity, superior to that of MF. Connectivity increased monotonously for BP, decreased for CC and remained stable for MF, with a marked increase for the three branches in November and December 2012. Hierarchy-related measures showed that CC and MF had similar proportions of leaves, average depths and average heights. BP had a lower proportion of leaves, and a higher average depth and average height. For BP and MF, the late 2012 increase of connectivity resulted in an increase of the average depth and average height and a decrease of the proportion of leaves, indicating that a major enrichment effort of the intermediate-level hierarchy occurred. The variation of the number of classes and relations in an ontology does not provide enough information about the evolution of its complexity. However, connectivity and hierarchy-related metrics revealed different patterns of values as well as of evolution for the three branches of the Gene Ontology. CC was similar to BP in terms of connectivity, and similar to MF in terms of hierarchy. Overall, BP complexity increased, CC was refined with the addition of leaves providing a finer level of annotations but decreasing slightly its complexity, and MF complexity remained stable. PMID:24146805

A cross-species analysis method to analyze animal models' similarity to human's disease state.

PubMed

Yu, Shuhao; Zheng, Lulu; Li, Yun; Li, Chunyan; Ma, Chenchen; Li, Yixue; Li, Xuan; Hao, Pei

2012-01-01

Animal models are indispensable tools in studying the cause of human diseases and searching for the treatments. The scientific value of an animal model depends on the accurate mimicry of human diseases. The primary goal of the current study was to develop a cross-species method by using the animal models' expression data to evaluate the similarity to human diseases' and assess drug molecules' efficiency in drug research. Therefore, we hoped to reveal that it is feasible and useful to compare gene expression profiles across species in the studies of pathology, toxicology, drug repositioning, and drug action mechanism. We developed a cross-species analysis method to analyze animal models' similarity to human diseases and effectiveness in drug research by utilizing the existing animal gene expression data in the public database, and mined some meaningful information to help drug research, such as potential drug candidates, possible drug repositioning, side effects and analysis in pharmacology. New animal models could be evaluated by our method before they are used in drug discovery. We applied the method to several cases of known animal model expression profiles and obtained some useful information to help drug research. We found that trichostatin A and some other HDACs could have very similar response across cell lines and species at gene expression level. Mouse hypoxia model could accurately mimic the human hypoxia, while mouse diabetes drug model might have some limitation. The transgenic mouse of Alzheimer was a useful model and we deeply analyzed the biological mechanisms of some drugs in this case. In addition, all the cases could provide some ideas for drug discovery and drug repositioning. We developed a new cross-species gene expression module comparison method to use animal models' expression data to analyse the effectiveness of animal models in drug research. Moreover, through data integration, our method could be applied for drug research, such as potential drug candidates, possible drug repositioning, side effects and information about pharmacology.

Balancing Academic and Professional Pedagogies: A Comparative Study of Two Accounting Departments in South Africa and the UK

ERIC Educational Resources Information Center

van der Merwe, Nico; McChlery, Stuart; Visser, Sarah Susanna

2014-01-01

The paper adds to extant professional education literature by reflecting on apparent differences in pedagogy of similar professional programmes of study, allowing deeper insight into the unique strand of higher education influenced by the professions. A comparative international case study approach is adopted of an interpretive qualitative nature…

Exploring Teacher Concerns of Pre-Collegiate Urban Teaching Academy Students

ERIC Educational Resources Information Center

Fletcher, Edward C., Jr.; Dicicco, Michael

2017-01-01

The purpose of this study was to explore whether the concerns of a group of pre-collegiate students enrolled in an urban teaching academy (UTA) program were unique or similar to those found in earlier studies using Fuller's model as a framework for analysis. Using an instrumental case study approach, findings indicated that the UTA students…

Parent Education for Dialogic Reading: Online and Face-to-Face Delivery Methods

ERIC Educational Resources Information Center

Beschorner, Beth; Hutchison, Amy

2016-01-01

This study explored the impact of a parent education program and the contextual factors that influenced the experiences of families in the program. Seventeen parents completed a 9-week, face-to-face program and 15 parents completed a similar online program. This study was designed as a multiple case study and utilized multimethods for data…

Preparing Novice Principals in Australia and Turkey: How Similar Are Their Needs?

ERIC Educational Resources Information Center

Wildy, Helen; Clarke, Simon; Styles, Irene; Beycioglu, Kadir

2010-01-01

Part of a 13-nation, cross-cultural study of the extent to which principals perceive their pre-appointment experiences had prepared them for the job, the International Study of Principal Preparation (ISPP), this paper compares the responses of novice principals in Turkey and Western Australia. Using a survey based on data from case studies of…

The value of computed tomography in myasthenia gravis

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

Brown, L.R.; Muhm, J.R.; Sheedy, P.F. II

1983-01-01

In a 5 year study, 19 patients with myasthenia gravis were studied by computed tomography (CT) and underwent thymectomy. CT was accurate in detecting the nine true thymic masses but could not differentiate thymomas from nonthymomatous masses, including thymic cysts. No thymoma was found in a patient under 25 years of age. In one case, the 18 sec scanner could not differentiate a large gland from a thymoma. In eight cases, glands with histologic thymic hyperplasia and histologically normal thymus appeared to be similar and could not be differentiated by CT.

Studies of the Suitability of Fowlpox as Decontamination and Thermal Stability Simulant for Variola Major

DTIC Science & Technology

2009-01-01

that 77.6% of cases are still protected against severe disease 70 years after vaccination [5]. Vaccina virus, long considered the prototype of variola...major, has been used as both a simulant and vaccine for variola major. They show remarkable sequence similarity; however, vaccinia virus does not...Another gene shows similar homology to a protein found in yeast, human, tomato and fruit fly. Secondly, the fowlpox genome contains host range genes

Robotic assisted gastrectomy compared with open resection: a case-matched study.

PubMed

Caruso, Riccardo; Vicente, Emilio; Quijano, Yolanda; Ielpo, Benedetto; Duran, Hipolito; Diaz, Eduardo; Fabra, Isabel; Ferri, Valentina

2018-05-04

In recent years, increasingly sophisticated tools have allowed for more complex robotic surgery. Robotic gastrectomy, however, is adopted in only a few selected centers. The goals of this study were to examine the adoption of robotic gastrectomy and to compare outcomes between open and robotic gastric resections. This is a case-matched analysis of patients who underwent robotic and open gastric resection performed at Sanchinarro University Hospital, Madrid from November 2011 to February 2017. Patient data were obtained retrospectively. Clinicopathologic characteristics and perioperative and postoperative outcomes were recorded and analyzed. Two groups of demographically similar patients were analyzed: the robotic group (n = 20) and the open surgery group (n = 19). The patient characteristics of the two groups have been compared. Robotic resection resulted in less blood loss, shorter postoperative hospital stay, and a longer operating time. The two groups had similar complication rates. Pathological data were similar for both procedures. Robotic gastrectomy for locally advanced gastric carcinoma is safe, and long-term outcomes are comparable to those patients who underwent open resection. Robotic gastrectomy resulted in a shorter hospital stay, less blood loss and morbidity comparable with the outcomes of open gastrectomy.

The incubation period of Buruli ulcer (Mycobacterium ulcerans infection) in Victoria, Australia - Remains similar despite changing geographic distribution of disease.

PubMed

Loftus, Michael J; Trubiano, Jason A; Tay, Ee Laine; Lavender, Caroline J; Globan, Maria; Fyfe, Janet A M; Johnson, Paul D R

2018-03-01

Buruli ulcer (BU) is a geographically-restricted infection caused by Mycobacterium ulcerans; contact with an endemic region is the primary risk factor for disease acquisition. Globally, efforts to estimate the incubation period of BU are often hindered as most patients reside permanently in endemic areas. However, in the south-eastern Australian state of Victoria, a significant proportion of people who acquire BU are visitors to endemic regions. During a sustained outbreak of BU on the Bellarine peninsula we estimated a mean incubation period of 4.5 months. Since then cases on the Bellarine peninsula have declined but a new endemic area has developed centred on the Mornington peninsula. Retrospective review of 443 cases of BU notified in Victoria between 2013 and 2016. Telephone interviews were performed to identify all cases with a single visit to an endemic region, or multiple visits within a one month period. The incubation period was defined as the time between exposure to an endemic region and symptom onset. Data were subsequently combined with those from our earlier study incorporating cases from 2002 to 2012. Among the 20 new cases identified in short-term visitors, the mean incubation period was 143 days (4.8 months), very similar to the previous estimate of 135 days (4.5 months). This was despite the predominant exposure location shifting from the Bellarine peninsula to the Mornington peninsula. We found no association between incubation period and age, sex, location of exposure, duration of exposure to an endemic region or location of BU lesion. Our study confirms the mean incubation period of BU in Victoria to be between 4 and 5 months. This knowledge can guide clinicians and suggests that the mode of transmission of BU is similar in different geographic regions in Victoria.

The inference from a single case: moral versus scientific inferences in implementing new biotechnologies.

PubMed

Hofmann, B

2008-06-01

Are there similarities between scientific and moral inference? This is the key question in this article. It takes as its point of departure an instance of one person's story in the media changing both Norwegian public opinion and a brand-new Norwegian law prohibiting the use of saviour siblings. The case appears to falsify existing norms and to establish new ones. The analysis of this case reveals similarities in the modes of inference in science and morals, inasmuch as (a) a single case functions as a counter-example to an existing rule; (b) there is a common presupposition of stability, similarity and order, which makes it possible to reason from a few cases to a general rule; and (c) this makes it possible to hold things together and retain order. In science, these modes of inference are referred to as falsification, induction and consistency. In morals, they have a variety of other names. Hence, even without abandoning the fact-value divide, there appear to be similarities between inference in science and inference in morals, which may encourage communication across the boundaries between "the two cultures" and which are relevant to medical humanities.

"It Is Like Putting Fire in the Children's Hands": A Comparative Case Study of Pre-Service Teachers' Knowledge of and Beliefs about Education for Democracy in an Established and Emerging Post-Conflict Democracy

ERIC Educational Resources Information Center

Lanahan, Brian K.; Phillips, Michele S.

2014-01-01

This report documents and compares two cases of pre-service elementary teachers' beliefs about democracy and education for democracy in the USA and Bosnia and Herzegovina along with contextual factors influencing the similarities and differences among these beliefs. Findings suggest that US pre-service elementary teachers have a self-proclaimed…

Just War Theory and Presidential Discourse Prior to Conflict

DTIC Science & Technology

2014-12-04

Case for Combat , Edward J. Lordan lists last resort as a theme, among others, that has been used to persuade Americans to enter conflicts from the...Topic This paper studies the public statements of US presidents to ascertain justifications for war or armed intervention. Edward J. Lordan used a...similar approach in his book The Case for Combat : How Presidents Persuade Americans to go to War. In it, he examines presidential messaging and the

Analysis of risk factors for schizophrenia with two different case definitions: a nationwide register-based external validation study.

PubMed

Sørensen, Holger J; Larsen, Janne T; Mors, Ole; Nordentoft, Merete; Mortensen, Preben B; Petersen, Liselotte

2015-03-01

Different case definitions of schizophrenia have been used in register based research. However, no previous study has externally validated two different case definitions of schizophrenia against a wide range of risk factors for schizophrenia. We investigated hazard ratios (HRs) for a wide range of risk factors for ICD-10 DCR schizophrenia using a nationwide Danish sample of 2,772,144 residents born in 1955-1997. We compared one contact only (OCO) (the case definition of schizophrenia used in Danish register based studies) with two or more contacts (TMC) (a case definition of at least 2 inpatient contacts with schizophrenia). During the follow-up, the OCO definition included 15,074 and the TMC 7562 cases; i.e. half as many. The TMC case definition appeared to select for a worse illness course. A wide range of risk factors were uniformly associated with both case definitions and only slightly higher risk estimates were found for the TMC definition. Choosing at least 2 inpatient contacts with schizophrenia (TMC) instead of the currently used case definition would result in almost similar risk estimates for many well-established risk factors. However, this would also introduce selection and include considerably fewer cases and reduce power of e.g. genetic studies based on register-diagnosed cases only. Copyright © 2015 Elsevier B.V. All rights reserved.

Telomere length and early trauma in schizophrenia.

PubMed

Riley, Gabriella; Perrin, Mary; Vaez-Azizi, Leila M; Ruby, Eugene; Goetz, Raymond R; Dracxler, Roberta; Walsh-Messinger, Julie; Keefe, David L; Buckley, Peter F; Szeszko, Philip R; Malaspina, Dolores

2018-04-02

Childhood trauma is emerging as a risk factor for schizophrenia, but its mechanism with respect to etiology is unknown. One possible pathway is through leucocyte telomere length (LTL) shortening, a measure of cellular aging associated with trauma. This study examined early trauma and LTL shortening in schizophrenia and considered sex effects. The early trauma inventory (ETI) was administered to 48 adults with DSM-5 schizophrenia and 18 comparison participants. LTL was measured using qPCR. Cases had significantly more global trauma (F=4.10, p<0.01) and traumatic events (F=11.23, p<0.001), but case and control groups had similar LTL (1.91±0.74 and 1.83±0.62: p=0.68). The association of early trauma and LTL differed by sex in cases and controls (Fisher's R: Z<0.05). Significant negative associations were shown in male cases and, conversely, in female controls. For example, physical punishment was associated LTL shortening in males' cases (r=-0.429, p<01). Only female controls showed significant telomere shortening in association with early trauma. This data confirms the substantial excess of early trauma among schizophrenia cases. There were significant sex-differences in the relationship of the trauma to LTL, with only male cases showing the expected shortening. There were converse sex effects in the control group. Mean LTL was notably similar in cases and controls, despite the trauma-related shortening in male cases, cigarette smoking, older age and chronic illness of the cases. Factors may lengthen LTL in some schizophrenia cases. The converse sex differences in the cases are consistent with findings defective sexual differentiation in schizophrenia, consistent with other findings in the field. Copyright © 2018 Elsevier B.V. All rights reserved.

Accurate Prediction of Motor Failures by Application of Multi CBM Tools: A Case Study

NASA Astrophysics Data System (ADS)

Dutta, Rana; Singh, Veerendra Pratap; Dwivedi, Jai Prakash

2018-02-01

Motor failures are very difficult to predict accurately with a single condition-monitoring tool as both electrical and the mechanical systems are closely related. Electrical problem, like phase unbalance, stator winding insulation failures can, at times, lead to vibration problem and at the same time mechanical failures like bearing failure, leads to rotor eccentricity. In this case study of a 550 kW blower motor it has been shown that a rotor bar crack was detected by current signature analysis and vibration monitoring confirmed the same. In later months in a similar motor vibration monitoring predicted bearing failure and current signature analysis confirmed the same. In both the cases, after dismantling the motor, the predictions were found to be accurate. In this paper we will be discussing the accurate predictions of motor failures through use of multi condition monitoring tools with two case studies.

Application of the multi-disciplinary thematic seminar method in two homecare cases - a comparative study.

PubMed

Scandurra, Isabella; Hägglund, Maria; Koch, Sabine

2008-01-01

A significant problem with current health information technologies is that they poorly support collaborative work of healthcare professionals, sometimes leading to a fragmentation of workflow and disruption of healthcare processes. This paper presents two homecare cases, both applying multi-disciplinary thematic seminars (MdTS) as a collaborative method for user needs elicitation and requirements specification. This study describes the MdTS application to elicit user needs from different perspectives to coincide with collaborative professions' work practices in two cases. Despite different objectives, the two cases validated that MdTS emphasized the "points of intersection" in cooperative work. Different user groups with similar, yet distinct needs reached a common understanding of the entire work process, agreed upon requirements and participated in the design of prototypes supporting cooperative work. MdTS was applicable in both exploratory and normative studies aiming to elicit the specific requirements in a cooperative environment.

A Gaussian random field model for similarity-based smoothing in Bayesian disease mapping.

PubMed

Baptista, Helena; Mendes, Jorge M; MacNab, Ying C; Xavier, Miguel; Caldas-de-Almeida, José

2016-08-01

Conditionally specified Gaussian Markov random field (GMRF) models with adjacency-based neighbourhood weight matrix, commonly known as neighbourhood-based GMRF models, have been the mainstream approach to spatial smoothing in Bayesian disease mapping. In the present paper, we propose a conditionally specified Gaussian random field (GRF) model with a similarity-based non-spatial weight matrix to facilitate non-spatial smoothing in Bayesian disease mapping. The model, named similarity-based GRF, is motivated for modelling disease mapping data in situations where the underlying small area relative risks and the associated determinant factors do not vary systematically in space, and the similarity is defined by "similarity" with respect to the associated disease determinant factors. The neighbourhood-based GMRF and the similarity-based GRF are compared and accessed via a simulation study and by two case studies, using new data on alcohol abuse in Portugal collected by the World Mental Health Survey Initiative and the well-known lip cancer data in Scotland. In the presence of disease data with no evidence of positive spatial correlation, the simulation study showed a consistent gain in efficiency from the similarity-based GRF, compared with the adjacency-based GMRF with the determinant risk factors as covariate. This new approach broadens the scope of the existing conditional autocorrelation models. © The Author(s) 2016.

An ecological study of cancer incidence in Port Hope, Ontario from 1992 to 2007.

PubMed

Chen, Jing; Moir, Deborah; Lane, Rachel; Thompson, Patsy

2013-03-01

A plant processing radium and uranium ores has been operating in the town of Port Hope since 1932. Given the nuclear industry located in the community and ongoing public health concerns, cancer incidence rates in Port Hope were studied for a recent 16 year period (1992-2007) for continued periodic cancer incidence surveillance of the community. The cancer incidence in the local community for all cancers combined was similar to the Ontario population, health regions with similar socio-economic characteristics in Ontario and in Canada, and the Canadian population. No statistically significant differences in childhood cancer, leukaemia or other radiosensitive cancer incidence were observed, with the exception of statistically significant elevated lung cancer incidence among women. However, the statistical significance was reduced or disappeared when the comparison was made to populations with similar socio-economic characteristics. These findings are consistent with previous ecological, case-control and cohort studies conducted in Port Hope, environmental assessments, and epidemiological studies conducted elsewhere on populations living around similar facilities or exposed to similar environmental contaminants. Although the current study covered an extended period of time, the power to detect risk at the sub-regional level of analysis was limited since the Port Hope population is small (16,500). The study nevertheless indicated that large differences in cancer incidence are not occurring in Port Hope compared to other similar communities and the general population.

Quantifying similarity of pore-geometry in nanoporous materials

DOE PAGES

Lee, Yongjin; Barthel, Senja D.; Dłotko, Paweł; ...

2017-05-23

In most applications of nanoporous materials the pore structure is as important as the chemical composition as a determinant of performance. For example, one can alter performance in applications like carbon capture or methane storage by orders of magnitude by only modifying the pore structure. For these applications it is therefore important to identify the optimal pore geometry and use this information to find similar materials. But, the mathematical language and tools to identify materials with similar pore structures, but different composition, has been lacking. We develop a pore recognition approach to quantify similarity of pore structures and classify themmore » using topological data analysis. This then allows us to identify materials with similar pore geometries, and to screen for materials that are similar to given top-performing structures. Using methane storage as a case study, we also show that materials can be divided into topologically distinct classes requiring different optimization strategies.« less

Signs of Mood and Anxiety Disorders in Chimpanzees

PubMed Central

Ferdowsian, Hope R.; Durham, Debra L.; Kimwele, Charles; Kranendonk, Godelieve; Otali, Emily; Akugizibwe, Timothy; Mulcahy, J. B.; Ajarova, Lilly; Johnson, Cassie Meré

2011-01-01

Background In humans, traumatic experiences are sometimes followed by psychiatric disorders. In chimpanzees, studies have demonstrated an association between traumatic events and the emergence of behavioral disturbances resembling posttraumatic stress disorder (PTSD) and depression. We addressed the following central question: Do chimpanzees develop posttraumatic symptoms, in the form of abnormal behaviors, which cluster into syndromes similar to those described in human mood and anxiety disorders? Methodology/Principal Findings In phase 1 of this study, we accessed case reports of chimpanzees who had been reportedly subjected to traumatic events, such as maternal separation, social isolation, experimentation, or similar experiences. We applied and tested DSM-IV criteria for PTSD and major depression to published case reports of 20 chimpanzees identified through PrimateLit. Additionally, using the DSM-IV criteria and ethograms as guides, we developed behaviorally anchored alternative criteria that were applied to the case reports. A small number of chimpanzees in the case studies met DSM-IV criteria for PTSD and depression. Measures of inter-rater reliability, including Fleiss' kappa and percentage agreement, were higher with use of the alternative criteria for PTSD and depression. In phase 2, the alternative criteria were applied to chimpanzees living in wild sites in Africa (n = 196) and chimpanzees living in sanctuaries with prior histories of experimentation, orphanage, illegal seizure, or violent human conflict (n = 168). In phase 2, 58% of chimpanzees living in sanctuaries met the set of alternative criteria for depression, compared with 3% of chimpanzees in the wild (p = 0.04), and 44% of chimpanzees in sanctuaries met the set of alternative criteria for PTSD, compared with 0.5% of chimpanzees in the wild (p = 0.04). Conclusions/Significance Chimpanzees display behavioral clusters similar to PTSD and depression in their key diagnostic criteria, underscoring the importance of ethical considerations regarding the use of chimpanzees in experimentation and other captive settings. PMID:21698223

Community Colleges' Use of the Web to Communicate Their Mission: Slights of Commission and Omission

ERIC Educational Resources Information Center

Hegeman, Diane L.; Davies, Timothy Gray; Banning, James H.

2007-01-01

This basic interpretive qualitative study identified, described, and interpreted community college mission statement messages as they appeared in print and on the web site. The study analyzed each institution's similar, different, unique, and unintended messages. The within-case inductive analysis found emergent mission statement messages in the…

A Change of Administration: A Significant Organizational Life Event.

ERIC Educational Resources Information Center

Stine, Deborah E.

The case study presented in this paper illustrates how the succession process for principals is similar to that described by Gabarro in his study of corporate succession. Leader succession involves five major stages: (1) taking hold; (2) immersion; (3) reshaping; (4) consolidation; and (5) refinement. Success most frequently occurs in conjunction…

Merit Aid in North Carolina: A Case Study of a "Nonevent"

ERIC Educational Resources Information Center

Ness, Erik C.; Mistretta, Molly A.

2010-01-01

Since the adoption of Georgia's HOPE (Helping Outstanding Pupils Educationally) scholarship program, seven additional Southeastern states have adopted similar merit-based financial aid programs, most of which are also funded by state lotteries. This study examines why North Carolina after adopting a state lottery in 2005 did not allocate its…

Sex Discrimination in Professional Employment: A Case Study.

ERIC Educational Resources Information Center

Osterman, Paul

1979-01-01

A study analyzed sex discrimination with data on over 700 professional employees in a metropolitan publishing firm. It was found that the sex differential in earnings within clusters of similar jobs was much greater if marriage and children variables were excluded: men received a large "payoff" from being married and having children. (JH)

Introductory Textbooks and Plagiarism in Higher Education: A Case Study from Economics.

ERIC Educational Resources Information Center

Richardson, Paul

2002-01-01

Textbooks are powerful technologies that are foundational to introductory level courses. In the research site of an introductory economic classroom, the textbook is positioned as having status similar to that of a canonical religious text. This study investigated how student reading and writing can be problematic when introductory level courses…

Two Related Approaches to Teacher Professional Learning in the Asia Pacific Region

ERIC Educational Resources Information Center

White, Allan

2007-01-01

This paper examines the similarities and differences between two successful programmes of teacher professional learning. Firstly, Lesson Study developed in Japan over 40 years ago. It examines practice either through direct observation or through classroom artefacts and case studies. It assumes that teacher learning will be more meaningful and…

Dental care of autistic children within the non-specialized Public Dental Service.

PubMed

Fahlvik-Planefeldt, C; Herrström, P

2001-01-01

Children with an autistic disorder may need more dental care and may also be more difficult to treat than healthy children. This study compared oral health in autistic and healthy children. Also explored was the dental management of autistic children within the non-specialized Public Dental Service. The study was designed as a case-control study with all cases of autistic disorders aged 3-19 years identified within a primary care area in southwest Sweden. One dentist did a clinical investigation of cases and one control per case. The patients, or their parents, answered a questionnaire. 28 patients were identified and 20 (71%) agreed to participate in the study. Cases and controls had a similar prevalence of fillings, caries, gingivitis and degree of oral hygiene. However, the need of orthodontic treatment seemed to be greater among the autistic children. According to a standardised assessment, autistic children were less able to cooperate in the dental treatment. Approximately 30% of the cases had occasionally been subjected to specialized dental care. The results of this study indicate that the care provided to autistic children within the non-specialized Public Dental Service is satisfactory, provided that there is access to a paediatric dentist when necessary.

Evaluation of a Teleform-based data collection system: a multi-center obesity research case study.

PubMed

Jenkins, Todd M; Wilson Boyce, Tawny; Akers, Rachel; Andringa, Jennifer; Liu, Yanhong; Miller, Rosemary; Powers, Carolyn; Ralph Buncher, C

2014-06-01

Utilizing electronic data capture (EDC) systems in data collection and management allows automated validation programs to preemptively identify and correct data errors. For our multi-center, prospective study we chose to use TeleForm, a paper-based data capture software that uses recognition technology to create case report forms (CRFs) with similar functionality to EDC, including custom scripts to identify entry errors. We quantified the accuracy of the optimized system through a data audit of CRFs and the study database, examining selected critical variables for all subjects in the study, as well as an audit of all variables for 25 randomly selected subjects. Overall we found 6.7 errors per 10,000 fields, with similar estimates for critical (6.9/10,000) and non-critical (6.5/10,000) variables-values that fall below the acceptable quality threshold of 50 errors per 10,000 established by the Society for Clinical Data Management. However, error rates were found to widely vary by type of data field, with the highest rate observed with open text fields. Copyright © 2014 Elsevier Ltd. All rights reserved.

Convective aggregation in idealised models and realistic equatorial cases

NASA Astrophysics Data System (ADS)

Holloway, Chris

2015-04-01

Idealised explicit convection simulations of the Met Office Unified Model are shown to exhibit spontaneous self-aggregation in radiative-convective equilibrium, as seen previously in other models in several recent studies. This self-aggregation is linked to feedbacks between radiation, surface fluxes, and convection, and the organization is intimately related to the evolution of the column water vapour (CWV) field. To investigate the relevance of this behaviour to the real world, these idealized simulations are compared with five 15-day cases of real organized convection in the tropics, including multiple simulations of each case testing sensitivities of the convective organization and mean states to interactive radiation, interactive surface fluxes, and evaporation of rain. Despite similar large-scale forcing via lateral boundary conditions, systematic differences in mean CWV, CWV distribution shape, and the length scale of CWV features are found between the different sensitivity runs, showing that there are at least some similarities in sensitivities to these feedbacks in both idealized and realistic simulations.

Convective aggregation in idealised models and realistic equatorial cases

NASA Astrophysics Data System (ADS)

Holloway, C. E.

2014-12-01

Idealised explicit convection simulations of the Met Office Unified Model are shown to exhibit spontaneous self-aggregation in radiative-convective equilibrium, as seen previously in other models in several recent studies. This self-aggregation is linked to feedbacks between radiation, surface fluxes, and convection, and the organization is intimately related to the evolution of the column water vapor (CWV) field. To investigate the relevance of this behavior to the real world, these idealized simulations are compared with five 15-day cases of real organized convection in the tropics, including multiple simulations of each case testing sensitivities of the convective organization and mean states to interactive radiation, interactive surface fluxes, and evaporation of rain. Despite similar large-scale forcing via lateral boundary conditions, systematic differences in mean CWV, CWV distribution shape, and the length scale of CWV features are found between the different sensitivity runs, showing that there are at least some similarities in sensitivities to these feedbacks in both idealized and realistic simulations.

Some Possible Cases of Escape Mimicry in Neotropical Butterflies.

PubMed

Pinheiro, C E G; Freitas, A V L

2014-10-01

The possibility that escape or evasive mimicry evolved in butterflies and other prey insects in a similar fashion to classical Batesian and Müllerian mimicry has long been advanced in the literature. However, there is a general disagreement among lepidopterists and evolutionary biologists on whether or not escape mimicry exists, as well as in which mimicry rings this form of mimicry has evolved. Here, we review some purported cases of escape mimicry in Neotropical butterflies and suggest new mimicry rings involving several species of Archaeoprepona, Prepona, and Doxocopa (the "bright blue bands" ring) and species of Colobura and Hypna (the "creamy bands" ring) where the palatability of butterflies, their ability to escape predator attacks, geographic distribution, relative abundance, and co-occurrence in the same habitats strongly suggest that escape mimicry is involved. In addition, we also indicate other butterfly taxa whose similarities of coloration patterns could be due to escape mimicry and would constitute important case studies for future investigation.

CD56 Expression in Odontogenic Cysts and Tumors.

PubMed

Jaafari-Ashkavandi, Zohreh; Dehghani-Nazhvani, Ali; Razmjouyi, Faranak

2014-01-01

Background and aims. Odontogenic cysts and tumors have a wide spectrum of clinical characteristics that lead to the different management strategies. Since definite diagnosis is difficult in some cases, it has been suggested that CD56 may be a candidate marker for definitive diagnosis of some odontogenic tumors. The present study was designed to examine CD56 expression in lesions with histopathological similarities. Materials and methods. In this cross-sectional, analytical study the subjects were 22 ameloblastomas, 13 dentigerous cysts, 10 keratocystic odontogenic tumors (KCOT), 4 adenomatoid odontogenic tumors (AOT), 3 orthokeratinized odonto-genic cysts, 3 calcifying odontogenic cysts (COC) and one glandular odontogenic cyst (GOC). All the samples were examined for CD56 immunoreactivity. Data were analyzed using chi-square test. Results. Twenty cases (91%) of ameloblastomas, 3 (75%) AOT, 4 (40%) KCOT and one case of GOC were positive for CD56. None of the dentigerous cysts, COC and orthokeratinized odontogenic cysts was CD56-positive. There was a significant difference in the CD56 expression between ameloblastoma and dentigerous cyst, as well as COC. Also, KCOT showed significantly higher expression than orthokeratinized odontogenic cyst. Conclusion. In this study CD56 expression was limited to the odontogenic tumors and more aggressive cystic lesions. This marker can be a useful aid for distinguishing cysts and tumors from similar lesions.

Genetic aspects of Huntington's disease in Latin America. A systematic review.

PubMed

Castilhos, R M; Augustin, M C; Santos, J A; Perandones, C; Saraiva-Pereira, M L; Jardim, L B

2016-03-01

We aimed to present a systematic review on Huntington's disease (HD) in Latin America (LA). PubMed and LILACS were searched up to March 2015, reporting confirmed HD cases in LA. Case series, cross-sectional, case-control, and prospective studies were included. From 534 communications, 47 were eligible. Population-based studies were not found; minimal prevalence of 0.5-4/100,000 was estimated for Venezuela and Mexico. Geographical isolates were well characterized in Venezuela and in Peru. CAG repeats at HTT gene varied between 7-33 and 37-112 in normal and expanded alleles, respectively. Intermediate alleles were found in 4-10% of controls. Ages at onset and the expanded CAG repeats correlated with r from - 0.55 to -0.91. While haplotype patterns of Venezuelan and Brazilian chromosomes were similar to those observed in Europeans, haplotypes from Peruvian HD patients did not match the same pattern. The limited number of papers found suggests that HD is poorly diagnosed in LA. Minimal prevalence seemed to be halfway between those of Caucasians and Asians. Range of CAG repeats was similar to those of Europeans. Haplotype studies indicate that majority of HD patients might be of Caucasian descent; an Asian origin for some Peruvian patients was proposed. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

The Keys to Governance and Stakeholder Engagement: The Southeast Michigan Beacon Community Case Study

PubMed Central

Des Jardins, Terrisca R.

2014-01-01

Community-based health information exchanges (HIEs) and efforts to consolidate and house data are growing, given the advent of Accountable Care Organizations (ACOs) under the Affordable Care Act and other similar population health focused initiatives. The Southeast Michigan Beacon Community (SEMBC) can be looked to as one case study that offers lessons learned, insights on challenges faced and accompanying workarounds related to governance and stakeholder engagement. The SEMBC case study employs an established Data Warehouse Governance Framework to identify and explain the necessary governance and stakeholder engagement components, particularly as they relate to community-wide data sharing and data warehouses or repositories. Perhaps the biggest lesson learned through the SEMBC experience is that community-based work is hard. It requires a great deal of community leadership, collaboration and resources. SEMBC found that organizational structure and guiding principles needed to be continually revisited and nurtured in order to build the relationships and trust needed among stakeholder organizations. SEMBC also found that risks and risk mitigation tactics presented challenges and opportunities at the outset and through the duration of the three year pilot period. Other communities across the country embarking on similar efforts need to consider realistic expectations about community data sharing infrastructures and the accompanying and necessary governance and stakeholder engagement fundamentals. PMID:25848612

Optimization of plasma amplifiers

DOE PAGES

Sadler, James D.; Trines, Raoul M. G. M.; Tabak, Max; ...

2017-05-24

Here, plasma amplifiers offer a route to side-step limitations on chirped pulse amplification and generate laser pulses at the power frontier. They compress long pulses by transferring energy to a shorter pulse via the Raman or Brillouin instabilities. We present an extensive kinetic numerical study of the three-dimensional parameter space for the Raman case. Further particle-in-cell simulations find the optimal seed pulse parameters for experimentally relevant constraints. The high-efficiency self-similar behavior is observed only for seeds shorter than the linear Raman growth time. A test case similar to an upcoming experiment at the Laboratory for Laser Energetics is found tomore » maintain good transverse coherence and high-energy efficiency. Effective compression of a 10kJ, nanosecond-long driver pulse is also demonstrated in a 15-cm-long amplifier.« less

Optimization of plasma amplifiers

NASA Astrophysics Data System (ADS)

Sadler, James D.; Trines, Raoul M. Â. G. Â. M.; Tabak, Max; Haberberger, Dan; Froula, Dustin H.; Davies, Andrew S.; Bucht, Sara; Silva, Luís O.; Alves, E. Paulo; Fiúza, Frederico; Ceurvorst, Luke; Ratan, Naren; Kasim, Muhammad F.; Bingham, Robert; Norreys, Peter A.

2017-05-01

Plasma amplifiers offer a route to side-step limitations on chirped pulse amplification and generate laser pulses at the power frontier. They compress long pulses by transferring energy to a shorter pulse via the Raman or Brillouin instabilities. We present an extensive kinetic numerical study of the three-dimensional parameter space for the Raman case. Further particle-in-cell simulations find the optimal seed pulse parameters for experimentally relevant constraints. The high-efficiency self-similar behavior is observed only for seeds shorter than the linear Raman growth time. A test case similar to an upcoming experiment at the Laboratory for Laser Energetics is found to maintain good transverse coherence and high-energy efficiency. Effective compression of a 10 kJ , nanosecond-long driver pulse is also demonstrated in a 15-cm-long amplifier.

Lipomatous hemangiopericytoma in a child: A case report with immunohistochemical evaluation

PubMed Central

Madala, Jayakiran; Guttikonda, Venkateswara Rao; Korlepara, Rajani

2015-01-01

Lipomatous hemangiopericytomas are rare soft-tissue tumors that show areas of hemangiopericytoma like vascular pattern admixed with lipid containing cells. It is now considered a subtype of solitary fibrous tumor due to histopathological and immunohistochemical similarities. To date, only a few cases have been adequately reported in the medical literature. A case of lipomatous hemangiopericytoma in an 11-year-old female patient is presented and the clinical, histopathological and immunohistochemical features are discussed, along with a literature review. To the best of our knowledge, this is the first known case of a lipomatous hemangiopericytoma in a pediatric patient. Our case report further emphasizes that a number of studies should be evaluated to delineate hemangiopericytomas from solitary fibrous tumors. PMID:26097315

[Characteristics of case management programs and their potential for patient empowerment].

PubMed

Grün, Oskar; Maier, Manfred

2008-01-01

Different types of case management programs have been increasingly developed for health care systems. This study, therefore, aimed to identify similarities and differences of case management programs, to estimate their shaping with special emphasis on patient empowerment, and to develop an instrument for their differentiation. During an interdisciplinary seminar for students, eight different case management programs were selected and analyzed. Five characteristics of case management programs were identified: type of case, extent of functions, players involved, limits of availability and need for resources. The programs were categorized into information-, provider-, disease- or patient centred. With these characteristics the selected programs could be exactly described and their potential for patient empowerment could be assessed. This newly developed tool for describing case management programs allows for their sufficient differentiation. The potential for patient empowerment apparently is most prominent in patient centred programs.

Comparing disciplines: outcomes of non melanoma cutaneous malignant lesions in oral and maxillofacial surgery and dermatology.

PubMed

Thavarajah, M; Szamocki, S; Komath, D; Cascarini, L; Heliotis, M

2015-01-01

300 cases of non-melanoma cutaneous lesion procedures carried out by the Oral and Maxillofacial Surgery and Dermatology departments in a North West London hospital over a 6 month period between September 2011 and February 2012 were included in a retrospective case control study. The results from each speciality were compared. The mean age of the OMFS group was 75.8 years compared to 69.9 years in the dermatology group. There was no statistically significant difference in gender between the 2 groups. The OMFS group treated a higher proportion of atypical (17%) and malignant (64.9%) cases compared to the dermatology group (11.3% and 50.5% respectively). This could also account for the fact that the OMFS group carried out a higher number of full excisions compared to dermatology. Both groups had a similar number of false positives (a benign lesion initially diagnosed as malignant) and a similar proportion of false negatives (a malignant lesion initially diagnosed as benign). Overall, the results show that both specialities had similar outcomes when managing non-melanoma cutaneous lesions. Both groups adhere to the guidelines set out by the British Association of Dermatologists and the National Institute of Clinical Excellence when managing such lesions. Crown Copyright © 2014. Published by Elsevier Ltd. All rights reserved.

The inferior impact of antibody-mediated rejection on the clinical outcome of kidney allografts that develop de novo thrombotic microangiopathy.

PubMed

Wu, Kaiyin; Budde, Klemens; Schmidt, Danilo; Neumayer, Hans-Hellmut; Lehner, Lukas; Bamoulid, Jamal; Rudolph, Birgit

2016-02-01

Antibody-mediated rejection (AMR) can induce and develop thrombotic microangiopathy (TMA) in renal allografts. A definitive AMR (dAMR) co-presents three diagnostic features. A suspicious AMR (sAMR) is designated when one of the three features is missing. Thirty-two TMA cases overlapping with AMR (AMR+ TMA) were studied, which involved 14 cases of sAMR+ TMA and 18 cases of dAMR+ TMA. Thirty TMA cases free of AMR features (AMR- TMA) were enrolled as control group. The ratio of complete response to treatment was similar between AMR- TMA and AMR+ TMA group (23.3% vs. 12.5%, p = 0.33), or between sAMR+ TMA and dAMR+ TMA group (14.3% vs. 11.1%, p = 0.79). At eight yr post-transplantation, the death-censored graft survival (DCGS) rate of AMR- TMA group was 62.8%, which was significantly higher than 28.0% of AMR+ TMA group (p = 0.01), but similar between sAMR+ TMA and dAMR+ TMA group (30.0% vs. 26.7%, p = 0.92). Overall, the intimal arteritis and the broad HLA (Human leukocyte antigens) mismatches were closely associated with over time renal allograft failure. The AMR+ TMA has inferior long-term graft survival, but grafts with sAMR+ TMA or dAMR+ TMA have similar characteristics and clinical courses. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Perinatal outcome in singleton pregnancies complicated with preeclampsia and eclampsia in Ecuador.

PubMed

Phoa, K Y N; Chedraui, P; Pérez-López, F R; Wendte, J F; Ghiabi, S; Vrijkotte, T; Pinto, P

2016-07-01

Preeclampsia in Ecuador is an understudied subject since available epidemiological data are scarce. The aim of this study was to describe perinatal outcomes among singleton pregnancies complicated with preeclampsia and eclampsia in a sample of low-income Ecuadorian women. Pregnant women complicated with preeclampsia (mild and severe) and eclampsia (defined according to criteria of the ACOG) delivering at the Enrique C. Sotomayor Obstetrics and Gynecology Hospital, Guayaquil, Ecuador were surveyed with a structured questionnaire containing maternal (socio-demographic) and neonatal data. Perinatal outcomes were compared according to severity of clinical presentation. A total of 163 women with preeclampsia [mild (23.9%), severe (68.7%) and eclampsia (7.4%)] were surveyed. Perinatal mortality and stillbirth rate was similar among studied groups (mild vs. severe preeclampsia/eclampsia cases). However, severe cases displayed higher rates of adverse perinatal outcomes: lower birth Apgar scores, more preterm births, and more low birth weight and small for gestational age infants. Caesarean-section rate and the number of admissions to intensive or intermediate neonatal care were higher in severe cases. A similar trend was found when analysis excluded preterm gestations. In conclusion, in this specific low-income Ecuadorian population perinatal outcome was adverse in pregnancies complicated with severe preeclampsia/eclampsia.

The Potential Benefit of Radiotherapy with Protons in Head and Neck Cancer with Respect to Normal Tissue Sparing: A Systematic Review of Literature

PubMed Central

Bijl, Hendrik P.; Schilstra, Cornelis; Pijls-Johannesma, Madelon; Langendijk, Johannes A.

2011-01-01

Purpose. Clinical studies concerning head and neck cancer patients treated with protons reporting on radiation-induced side effects are scarce. Therefore, we reviewed the literature regarding the potential benefits of protons compared with the currently used photons in terms of lower doses to normal tissue and the potential for fewer subsequent radiation-induced side effects, with the main focus on in silico planning comparative (ISPC) studies. Materials and Methods. A literature search was performed by two independent researchers on ISPC studies that included proton-based and photon-based irradiation techniques. Results. Initially, 877 papers were retrieved and 14 relevant and eligible ISPC studies were identified and included in this review. Four studies included paranasal sinus cancer cases, three included nasopharyngeal cancer cases, and seven included oropharyngeal, hypopharyngeal, and/or laryngeal cancer cases. Seven studies compared the most sophisticated photon and proton techniques: intensity-modulated photon therapy versus intensity-modulated proton therapy (IMPT). Four studies compared different proton techniques. All studies showed that protons had a lower normal tissue dose, while keeping similar or better target coverage. Two studies found that these lower doses theoretically translated into a significantly lower incidence of salivary dysfunction. Conclusion. The results of ISPC studies indicate that protons have the potential for a significantly lower normal tissue dose, while keeping similar or better target coverage. Scanned IMPT probably offers the most advantage and will allow for a substantially lower probability of radiation-induced side effects. The results of these ISPC studies should be confirmed in properly designed clinical trials. PMID:21349950

Simulations of the vortex in the Dellenback abrupt expansion, resembling a hydro turbine draft tube operating at part-load

NASA Astrophysics Data System (ADS)

Nilsson, H.

2012-11-01

This work presents an OpenFOAM case-study, based on the experimental studies of the swirling flow in the abrupt expansion by Dellenback et al.[1]. The case yields similar flow conditions as those of a helical vortex rope in a hydro turbine draft tube working at part-load. The case-study is set up similar to the ERCOFTAC Conical Diffuser and Centrifugal Pump OpenFOAM case-studies [2,3], making all the files available and the results fully reproducable using OpenSource software. The mesh generation is done using m4 scripting and the OpenFOAM built-in blockMesh mesh generator. The swirling inlet boundary condition is specified as an axi-symmetric profile. The outlet boundary condition uses the zeroGradient condition for all variables except for the pressure, which uses the fixed mean value boundary condition. The wall static pressure is probed at a number of locations during the simulations, and post-processing of the time-averaged solution is done using the OpenFOAM sample utility. Gnuplot scripts are provided for plotting the results. The computational results are compared to one of the operating conditions studied by Dellenback, and measurements for all the experimentally studied operating conditions are available in the case-study. Results from five cases are here presented, based on the kEpsilon model, the kOmegaSST model, and a filtered version of the same kOmegaSST model, named kOmegaSSTF [4,5]. Two different inlet boundary conditions are evaluated. It is shown that kEpsilon and kOmegaSST give steady solutions, while kOmegaSSTF gives a highly unsteady solution. The time-averaged solution of the kOmegaSSTF model is much more accurate than the other models. The kEpsilon and kOmegaSST models are thus unable to accurately model the effect of the large-scale unsteadiness, while kOmegaSSTF resolves those scales and models only the smaller scales. The use of two different boundary conditions shows that the boundary conditions are more important than the choice between kEpsilon and kOmegaSST, for the results just after the abrupt expansion.

[Cerebral gliosarcoma: clinico-pathologic study of 8 cases].

PubMed

Ayadi, Lobna; Charfi, Slim; Khabir, Abdemajid; Kalle, Rim; Sellami, Ahmed; Makni, Saloua; Boudawara, Zaher; Sellami-Boudawara, Tahya

2010-03-01

Gliosarcomas are biphasic neoplasms composed of a glioblastoma admixed to a sarcomatous component with different lines of differentiation. Histogenesis of these tumors is still discussed. Our objective is to specify clinical and pathological characteristics of this rare neoplasm and to discuss its histogenesis. Retrospective study of eight cases of gliosarcomas diagnosed between January 1998 and December 2004. Clinical, radiological, therapeutic and follow-up data were reviewed. Histological features and immunohistochemical results were also included in this review. Five patients were male, three women with a median age of 50.7 (range 31-74 years). Symptoms were dominated by intracranial hypertension and paralysis. The most common location was parietal or temporo-parietal (5 cases: 62.5%). Pathological exam including histochemical and immunohistochemical study confirmed the diagnosis of gliosarcoma in all cases. Sarcomatous component had features of fibrosarcoma in 5 cases, osteosarcoma in 2 cases and malignant fibrous histiocytoma in 1 case. All patients were treated by surgical excision (complete in five cases and partial in three cases). Adjuvant radiotherapy was received in three cases. One patient was lost on follow-up. Two patients died from postoperative. complications and the five remaining patients died with a medium follow up of 9 months (extremes: 2-24 months). Clinical, radiological and follow-up features of gliosarcomas share great similarities with glioblastomas. Histopathological, histochemical and immunohistochemical studies are helpful in accuracy diagnosis. Recent cytogenetic and molecular data support a monoclonal origin for these tumors.

Characterization of Statin-Associated Myopathy Case Reports in Thailand Using the Health Product Vigilance Center Database.

PubMed

Boonmuang, Pornwalai; Nathisuwan, Surakit; Chaiyakunapruk, Nathorn; Suwankesawong, Wimon; Pokhagul, Pattreya; Teerawattanapong, Nattawat; Supsongserm, Pairin

2013-09-01

HMG-CoA reductase inhibitors [statins], a widely prescribed cholesterol-lowering therapy, are associated with muscle-related adverse events. While characteristics of such events are well documented in Western countries, little data exists for the Thai population. The aim of this study was to determine the characteristics of patients, type and dosing of statin, and to identify patterns of drug use that may be associated with such adverse events using the national pharmacovigilance database known as Thai Vigibase. Muscle-related adverse events involving statins in the Thai Vigibase from 1996 to December 2009 were identified. For each report, the following information was extracted: patient demographics, co-morbidities, detailed information of adverse event, detailed information of suspected drug, treatment and outcome, as well as causality assessment and quality of reports. Descriptive statistics were performed for all study variables. A total of 198 cases of statin-associated muscle-related adverse events were identified. Mean age was 61.4 ± 12.4 years of age and 59.6% were female. Simvastatin, atorvastatin, rosuvastatin and cerivastatin were implicated as the suspected drug in 163 (82.3%), 24 (12.1%), 10 (5.1%) and 1 (0.5%) cases, respectively. Rhabdomyolysis accounted for 55.6% of all muscle-related adverse events. Drug interactions known to enhance such toxicity of statins were identified in 40.9% of the total set of reports. Similar to studies from Western countries, fibrates, HIV protease inhibitors, non-dihydropyridine calcium channel blockers, azole antifungals and macrolides were commonly found in such cases. Interestingly, colchicine has been identified as the second most common drug interaction in our database. Case fatality rates were 0.9, 1.6 and 16.7%, when there were 0, 1 and ≥2 interacting drugs, respectively. Characteristics of muscle-related adverse events with statins in the Thai population showed some similarities and differences compared with Western countries. Such similarities included advanced age, female sex, certain co-morbidities and drug interactions. While the majority of interacting drugs are well known, a big proportion of cases of statin-colchicine interaction attributed to long-term use of colchicine in Thailand was noted and should be further investigated. Based on these results, an attempt to avoid dangerous and well-known drug interactions among statin users should be implemented nationwide.

Leadership and organisational effectiveness--lessons to be drawn from education?

PubMed

Joyce, Pauline

2009-05-01

The aim of this paper is to present findings of a case study on organisational effectiveness in an education setting and draw similarities with a healthcare setting, focusing on the school principal and nurse leader. The study was carried out in a primary school setting and focuses on a principal (as leader). The school, which will be named St Senan's for the case study, is a typical tall structure, has a staff of 30 (teachers and special needs' assistants) and a student number of 117. A case study methodology was used. Data was collected by interviewing the principal, two teachers, two students and a parent, in this order. In addition, a Parents' Council meeting was observed and document analysis was carried out on measurements which reflected some critical success factors for the school. Interviews from students and teachers in addition to observation notes indicate that the principal's leadership impacts on organisational effectiveness in the school. The findings are located in the context of education with similarities being drawn from nursing. It is how the leader leads in the context of the organisation setting which is paramount. In other words it is not possible to take a set of general critical success factors for a school or healthcare setting and apply these widely. The paper concludes by proposing the use of a quality framework to contextualise the findings of the case and promote further discussion in the context of nurse leaders. The paper suggests that comparisons can be made between school principals and nurse leaders.

Integrated Safety Risk Reduction Approach to Enhancing Human-Rated Spaceflight Safety

NASA Astrophysics Data System (ADS)

Mikula, J. F. Kip

2005-12-01

This paper explores and defines the current accepted concept and philosophy of safety improvement based on a Reliability enhancement (called here Reliability Enhancement Based Safety Theory [REBST]). In this theory a Reliability calculation is used as a measure of the safety achieved on the program. This calculation may be based on a math model or a Fault Tree Analysis (FTA) of the system, or on an Event Tree Analysis (ETA) of the system's operational mission sequence. In each case, the numbers used in this calculation are hardware failure rates gleaned from past similar programs. As part of this paper, a fictional but representative case study is provided that helps to illustrate the problems and inaccuracies of this approach to safety determination. Then a safety determination and enhancement approach based on hazard, worst case analysis, and safety risk determination (called here Worst Case Based Safety Theory [WCBST]) is included. This approach is defined and detailed using the same example case study as shown in the REBST case study. In the end it is concluded that an approach combining the two theories works best to reduce Safety Risk.

Acute pulmonary emphysema in death by hanging: a morphometric digital study.

PubMed

Castiglioni, Claudia; Baumann, Pia; Fracasso, Tony

2016-09-01

Acute pulmonary emphysema (APE) has been described in cases of mechanical asphyxia such as ligature or manual strangulation but not in cases of hanging. In this study, we wanted to verify by morphometric digital analysis of lung tissue whether APE occurs in death by hanging.We investigated 16 cases of hanging (eight complete, eight incomplete), 10 cases of freshwater drowning (positive control group), and 10 cases of acute external bleeding (negative control group). Tissue sections were obtained from each pulmonary lobe. For each slide, five fields were randomly selected. The area of every alveolar space was measured by image analysis software. The mean alveolar area (MAA) was calculated for each group.In incomplete hanging, MAA was significantly higher than that observed in complete hanging and similar to the one observed in freshwater drowning.APE in cases of incomplete hanging can be considered as a sign of vitality. The high number of conditions that can cause alveolar distension (that were excluded in this study) limits the applicability of this vital sign in the routine forensic practice.

Listeriosis--a review of eighty-four cases.

PubMed

Paul, M L; Dwyer, D E; Chow, C; Robson, J; Chambers, I; Eagles, G; Ackerman, V

1994-04-18

To review the epidemiology, risk factors for acquisition, clinical features and outcomes of Listeria monocytogenes infection in Sydney. A retrospective study over the period 1983-1992 at four university teaching hospitals in Sydney. Cases were identified from microbiology laboratory records of the isolation of L. monocytogenes from sterile sites. Eighty-four cases were reviewed, with 72 patients (86%) having a predisposing underlying condition, including 13 perinatal patients (15%). Septicaemia (56%) and central nervous system disease (41%) were the major clinical presentations. Nineteen patients (23%) had hospital-associated infection. A mortality of 21% (18 patients) was directly attributable to L. monocytogenes infection, with another 10% (nine patients) dying of their underlying disease during admission. The 84 cases represented 80% of all L. monocytogenes cases occurring in Sydney during the study period. Listeriosis is predominantly a disease of the elderly or of immunosuppressed individuals, pregnant women and neonates. The presentation and outcome in these groups are similar to those reported in other Western countries. A significant feature of this study was the number of cases occurring in already hospitalised patients, suggesting that L. monocytogenes may be an important hospital-associated pathogen in immunocompromised patients.

Integrating evidence-based practices for increasing cancer screenings in safety net health systems: a multiple case study using the Consolidated Framework for Implementation Research.

PubMed

Liang, Shuting; Kegler, Michelle C; Cotter, Megan; Emily, Phillips; Beasley, Derrick; Hermstad, April; Morton, Rentonia; Martinez, Jeremy; Riehman, Kara

2016-08-02

Implementing evidence-based practices (EBPs) to increase cancer screenings in safety net primary care systems has great potential for reducing cancer disparities. Yet there is a gap in understanding the factors and mechanisms that influence EBP implementation within these high-priority systems. Guided by the Consolidated Framework for Implementation Research (CFIR), our study aims to fill this gap with a multiple case study of health care safety net systems that were funded by an American Cancer Society (ACS) grants program to increase breast and colorectal cancer screening rates. The initiative funded 68 safety net systems to increase cancer screening through implementation of evidence-based provider and client-oriented strategies. Data are from a mixed-methods evaluation with nine purposively selected safety net systems. Fifty-two interviews were conducted with project leaders, implementers, and ACS staff. Funded safety net systems were categorized into high-, medium-, and low-performing cases based on the level of EBP implementation. Within- and cross-case analyses were performed to identify CFIR constructs that influenced level of EBP implementation. Of 39 CFIR constructs examined, six distinguished levels of implementation. Two constructs were from the intervention characteristics domain: adaptability and trialability. Three were from the inner setting domain: leadership engagement, tension for change, and access to information and knowledge. Engaging formally appointed internal implementation leaders, from the process domain, also distinguished level of implementation. No constructs from the outer setting or individual characteristics domain differentiated systems by level of implementation. Our study identified a number of influential CFIR constructs and illustrated how they impacted EBP implementation across a variety of safety net systems. Findings may inform future dissemination efforts of EBPs for increasing cancer screening in similar settings. Moreover, our analytic approach is similar to previous case studies using CFIR and hence could facilitate comparisons across studies.

On vortex bursting

NASA Technical Reports Server (NTRS)

Werle, H.

1984-01-01

Vortex bursting is studied by means of visualization. The physical behavior of the phenomenon is emphasized, and its similarity with boundary layer separation or wake bursting becomes apparent. The essential influence of an increasing pressure gradient on the initiation, the position and the type of bursting is clearly confirmed. The evolution of the phenomena as a function of several parameters is analyzed in the case of delta wings, alone or installed on aircraft models, and compared with the results of similar wind tunnel or flight tests.

Gelatinous Marrow Transformation Associated with Imatinib: Case Report and Literature Review

PubMed Central

Jiang, B.; Yellapragada, S.; Thiagarajan, P.

2017-01-01

Gelatinous marrow transformation (GMT) is a rare condition observed in severe illness or malnutrition, in which the bone marrow contains amorphous “gelatinous” extracellular material, and histopathology demonstrates varied degrees of fat cell atrophy and loss of hematopoietic elements. An association of GMT with imatinib use in chronic myeloid leukemia (CML) has been reported recently. The objective of this study is to describe a case of GMT associated with imatinib use and review the existing similar cases in the literature to identify epidemiological patterns and potential imatinib-induced mechanisms leading to gelatinous conversion. PMID:28133556

GeneYenta: a phenotype-based rare disease case matching tool based on online dating algorithms for the acceleration of exome interpretation.

PubMed

Gottlieb, Michael M; Arenillas, David J; Maithripala, Savanie; Maurer, Zachary D; Tarailo Graovac, Maja; Armstrong, Linlea; Patel, Millan; van Karnebeek, Clara; Wasserman, Wyeth W

2015-04-01

Advances in next-generation sequencing (NGS) technologies have helped reveal causal variants for genetic diseases. In order to establish causality, it is often necessary to compare genomes of unrelated individuals with similar disease phenotypes to identify common disrupted genes. When working with cases of rare genetic disorders, finding similar individuals can be extremely difficult. We introduce a web tool, GeneYenta, which facilitates the matchmaking process, allowing clinicians to coordinate detailed comparisons for phenotypically similar cases. Importantly, the system is focused on phenotype annotation, with explicit limitations on highly confidential data that create barriers to participation. The procedure for matching of patient phenotypes, inspired by online dating services, uses an ontology-based semantic case matching algorithm with attribute weighting. We evaluate the capacity of the system using a curated reference data set and 19 clinician entered cases comparing four matching algorithms. We find that the inclusion of clinician weights can augment phenotype matching. © 2015 WILEY PERIODICALS, INC.

Organizational Culture in a Successful Primary School: An Ethnographic Case Study

ERIC Educational Resources Information Center

Negis-Isik, Ayse; Gursel, Musa

2013-01-01

Even though they are perceived similar from outside, all schools have distinct characteristics and a culture that differ them from other schools. School culture, is one of the important factors that play role in school efficiency and success. The purpose of this study was to examine the culture of a successful school profoundly. This study was a…

Developing an Exemplary Fine Arts Program: A Multiple Case-Study of Three Private Institutions of Higher Education

ERIC Educational Resources Information Center

Filippelli, James Anthony

2014-01-01

This study intended to identify commonalities of fine arts programs at selected private liberal arts colleges and universities in order to ultimately develop an exemplary fine arts program in a similar setting. This study searched for answers to three research questions within the context of art, music, dance, and theatre. The first research…

A Comparative Study of Faculty Members' Career Advancement (Promotion) Systems in the United States and the Islamic Republic of Iran: "Case Analysis of the University of Tehran and Portland State University"

ERIC Educational Resources Information Center

Tanaomi, Mohammad Mehdi; Asaadi, Robert Reza

2017-01-01

This article examines the similarities and differences in the systems for faculty career advancement in higher education institutions in the United States and the Islamic Republic of Iran. The analysis focuses on two specific cases: the University of Tehran and Portland State University. Through this paired comparison, we draw out the similarities…

Using a personal digital assistant to document clinical pharmacy services in an intensive care unit.

PubMed

Lau, A; Balen, R M; Lam, R; Malyuk, D L

2001-07-01

Management Case Studies describe approaches to real-life management problems in health systems. Each installment is a brief description of a problem and how it was dealt with. The cases are intended to help readers deal with similar experiences in their own work sites. Problem solving, not hypothesis testing, is emphasized. Successful resolution of the management issue is not a criterion for publication--important lessons can be learned from failures, too.

Changing epidemiology of intentional antidepressant drug overdose in Victoria, Australia.

PubMed

Wong, Anselm; Taylor, David McD; Ashby, Karen; Robinson, Jeff

2010-08-01

To determine the epidemiology of intentional antidepressant drug overdose (OD), over an extended time period, in Victoria, Australia. Retrospective epidemiological study of all cases reported to the Victorian Emergency Minimum Dataset (VEMD) January 1998 to December 2007 and calls to the Victorian Poisons Information Centre (VPIC) June 2005 to September 2008. 5467 VEMD cases were analysed. 3169 (57.9%) cases involved selective serotonin reuptake inhibitors (SSRIs) and 1149 (21%) involved tricyclic antidepressants (TCAs). Sertraline (1252, 22.9% cases) was the most common drug. During 2001, the peak year of OD, there were 8.8 OD/100 000 population in the SSRI group and 3.8 OD/100 000 population in the TCA group. Trends over the study period showed increasing SSRI and 'other' newer antidepressant prescription rates and decreases for TCA and monoamine oxidase inhibitors (MAOI). However, the risks of OD in all drug classes were similar and OD/100 000 prescriptions trended downwards for all drug classes over time. 1833 VPIC calls were analysed. Calls relating to SSRIs were the most common yet SSRI OD was associated with significantly fewer symptoms (p < 0.001) and fewer patients with Poisoning Severity Score classifications of moderate or severe (p < 0.01). Antidepressant OD patterns are changing. Antidepressant OD incidence is following prescribing trends. The risk of OD is similar for all drug classes. Absolute numbers of OD and OD/100 000 prescriptions are decreasing for all drug classes.

Logistic Model to Support Service Modularity for the Promotion of Reusability in a Web Objects-Enabled IoT Environment.

PubMed

Kibria, Muhammad Golam; Ali, Sajjad; Jarwar, Muhammad Aslam; Kumar, Sunil; Chong, Ilyoung

2017-09-22

Due to a very large number of connected virtual objects in the surrounding environment, intelligent service features in the Internet of Things requires the reuse of existing virtual objects and composite virtual objects. If a new virtual object is created for each new service request, then the number of virtual object would increase exponentially. The Web of Objects applies the principle of service modularity in terms of virtual objects and composite virtual objects. Service modularity is a key concept in the Web Objects-Enabled Internet of Things (IoT) environment which allows for the reuse of existing virtual objects and composite virtual objects in heterogeneous ontologies. In the case of similar service requests occurring at the same, or different locations, the already-instantiated virtual objects and their composites that exist in the same, or different ontologies can be reused. In this case, similar types of virtual objects and composite virtual objects are searched and matched. Their reuse avoids duplication under similar circumstances, and reduces the time it takes to search and instantiate them from their repositories, where similar functionalities are provided by similar types of virtual objects and their composites. Controlling and maintaining a virtual object means controlling and maintaining a real-world object in the real world. Even though the functional costs of virtual objects are just a fraction of those for deploying and maintaining real-world objects, this article focuses on reusing virtual objects and composite virtual objects, as well as discusses similarity matching of virtual objects and composite virtual objects. This article proposes a logistic model that supports service modularity for the promotion of reusability in the Web Objects-enabled IoT environment. Necessary functional components and a flowchart of an algorithm for reusing composite virtual objects are discussed. Also, to realize the service modularity, a use case scenario is studied and implemented.

Logistic Model to Support Service Modularity for the Promotion of Reusability in a Web Objects-Enabled IoT Environment

PubMed Central

Chong, Ilyoung

2017-01-01

Due to a very large number of connected virtual objects in the surrounding environment, intelligent service features in the Internet of Things requires the reuse of existing virtual objects and composite virtual objects. If a new virtual object is created for each new service request, then the number of virtual object would increase exponentially. The Web of Objects applies the principle of service modularity in terms of virtual objects and composite virtual objects. Service modularity is a key concept in the Web Objects-Enabled Internet of Things (IoT) environment which allows for the reuse of existing virtual objects and composite virtual objects in heterogeneous ontologies. In the case of similar service requests occurring at the same, or different locations, the already-instantiated virtual objects and their composites that exist in the same, or different ontologies can be reused. In this case, similar types of virtual objects and composite virtual objects are searched and matched. Their reuse avoids duplication under similar circumstances, and reduces the time it takes to search and instantiate them from their repositories, where similar functionalities are provided by similar types of virtual objects and their composites. Controlling and maintaining a virtual object means controlling and maintaining a real-world object in the real world. Even though the functional costs of virtual objects are just a fraction of those for deploying and maintaining real-world objects, this article focuses on reusing virtual objects and composite virtual objects, as well as discusses similarity matching of virtual objects and composite virtual objects. This article proposes a logistic model that supports service modularity for the promotion of reusability in the Web Objects-enabled IoT environment. Necessary functional components and a flowchart of an algorithm for reusing composite virtual objects are discussed. Also, to realize the service modularity, a use case scenario is studied and implemented. PMID:28937590

Strategic relatedness in mergers and financial performance: the case of the health maintenance organization industry in the United States.

PubMed

Weech-Maldonado, Robert

2002-11-01

Knowledge and identification of strategic factors associated with favourable post-acquisition performance can be of benefit to both managers and shareholders. From a management perspective, the identification of contextual factors that can influence postmerger performance is 'strategic' in nature, and should be considered in the analysis of future acquisitions. Within the context of the health maintenance organization (HMO) industry, this study examines the impact of strategic relatedness on postmerger financial performance. Strategic relatedness is conceptualized as similarity between the acquirer and target HMOs in terms of operational efficiency, marketing orientation, organizational structure and profit orientation. Regression analysis showed that similarity in operational efficiency and similarity in HMO structure were associated with better postmerger financial performance. However, marketing orientation similarity and profit orientation similarity were not significantly related to postmerger performance. This finding suggests that HMO mergers involving firms with similar strategic orientations and similar approaches to the delivery of care have greater strategic fit and experience better financial performance.

[The case of an adult man with savant syndrome in the course of autism spectrum disorder].

PubMed

Sipowicz, Kasper; Pietras, Tadeusz

2017-07-21

The paper reports on a case of 57-year man with autism spectrum disorder and epilepsy with an unusual feature of calendar calculation. Namely, this is the case of savant syndrome, which appears rarely in the course of various neuropsychiatric disorders. Commorbidity of epilepsy and autism particularly predispose to the aforementioned syndrome. In the presented case, apart from the calendar calculation, the man has high language abilities. As previous studies suggest, the extraordinary abilities among persons with savant syndrome works similarly to the language module in healthy persons. Savant syndrome may appear in any patient with neuropsychiatric disorders, particularly in those suffering from autism spectrum disorder with comorbid epilepsy.

Computer-aided tracking and characterization of homicides and sexual assaults (CATCH)

NASA Astrophysics Data System (ADS)

Kangas, Lars J.; Terrones, Kristine M.; Keppel, Robert D.; La Moria, Robert D.

1999-03-01

When a serial offender strikes, it usually means that the investigation is unprecedented for that police agency. The volume of incoming leads and pieces of information in the case(s) can be overwhelming as evidenced by the thousands of leads gathered in the Ted Bundy Murders, Atlanta Child Murders, and the Green River Murders. Serial cases can be long term investigations in which the suspect remains unknown and continues to perpetrate crimes. With state and local murder investigative systems beginning to crop up, it will become important to manage that information in a timely and efficient way by developing computer programs to assist in that task. One vital function will be to compare violent crime cases from different jurisdictions so investigators can approach the investigation knowing that similar cases exist. CATCH (Computer Aided Tracking and Characterization of Homicides) is being developed to assist crime investigations by assessing likely characteristics of unknown offenders, by relating a specific crime case to other cases, and by providing a tool for clustering similar cases that may be attributed to the same offenders. CATCH is a collection of tools that assist the crime analyst in the investigation process by providing advanced data mining and visualization capabilities.These tools include clustering maps, query tools, geographic maps, timelines, etc. Each tool is designed to give the crime analyst a different view of the case data. The clustering tools in CATCH are based on artificial neural networks (ANNs). The ANNs learn to cluster similar cases from approximately 5000 murders and 3000 sexual assaults residing in a database. The clustering algorithm is applied to parameters describing modus operandi (MO), signature characteristics of the offenders, and other parameters describing the victim and offender. The proximity of cases within a two-dimensional representation of the clusters allows the analyst to identify similar or serial murders and sexual assaults.

The epistemically virtuous clinician.

PubMed

Marcum, James A

2009-01-01

Today, modern Western medicine is facing a quality-of-care crisis that is undermining the patient-physician relationship. In this paper, a notion of the epistemically virtuous clinician is proposed in terms of both the reliabilist and responsibilist versions of virtue epistemology, in order to help address this crisis. To that end, a clinical case study from the literature is first reconstructed. The reliabilist intellectual virtues, including the perceptual and conceptual virtues, are then discussed and applied to the case study. Next, a similar method is employed to examine the responsibilist intellectual virtues, including curiosity, courage, honesty, and humility, and to apply them to the case study. To round out the discussion, the love of knowledge and both theoretical and practical wisdom are explored and applied to the case study. The paper concludes with a brief discussion of how the notion of an epistemically virtuous clinician addresses the quality-of-care crisis, in terms of the connection between ethical and intellectual virtues, and of the notion's implications for medical education.

Key aspects in managing safety when working with multiple contractors: A case study.

PubMed

Drupsteen, Linda; Rasmussen, Hanna B; Ustailieva, Erika; van Kampen, Jakko

2015-01-01

Working with multiple contractors in a shared workplace can introduce and increase safety risks due to complexity. The aim of this study was to explore how safety issues are recognized in a specific case and to identify whether clients and contractors perceive problems similarly. The safety issues are explored through a brief survey and a workshop in the maintenance department of a logistics company. The results indicate that culture and behavior are recognized differently by clients and by contractors. The contractors and client had different perceptions of involvement of contractors by the client. The contractors complained on lack of involvement, which was not fully recognized by the client. The case study used a practical approach to show differences in perception of safety within a project. The study illustrates the need for more applied studies and interventions on contractor safety.

[Usefulness of clinical, radiologic, and endoscopic studies in chronic diseases of the terminal ileum: analysis of 36 cases].

PubMed

Arista Nasr, J; Gamboa Domínguez, A

1992-01-01

With the purpose of defining which is the most frequent chronic pathology of the terminal ileum in a reference center (INNSZ), and establish the diagnostic accuracy of the preoperative procedures used, 36 resection specimens were reviewed histopathologically. The diseases found in decreasing frequency were: Crohn's disease, tuberculosis, carcinoids, lymphomas, endometriosis and leiomyomas. Seventy-seven percent of the cases were benign and the rest malignant. The number of cases in which the preoperative diagnosis was right or included among the differential diagnosis was as follows: clinical study 44%, radiological study 48%, endoscopical study 32% and histological study by means of endoscopic biopsy 20%. The most frequent differential diagnosis were Crohn's disease, tuberculosis and intestinal lymphoma. It is concluded that chronic disease of the ileum represents frequently a diagnostic problem due to their clinical, endoscopical and radiological similarities which may only be solved by histological analysis of the surgical specimens.

A comparison of film and computer workstation measurements of degenerative spondylolisthesis: intraobserver and interobserver reliability.

PubMed

Bolesta, Michael J; Winslow, Lauren; Gill, Kevin

2010-06-01

A comparison of measurements of degenerative spondylolisthesis made on film and on computer workstations. To determine whether the 2 methodologies are comparable in some of the parameters used to assess lumbar degenerative spondylolisthesis. Digital radiology has been replacing analog radiographs. In scoliosis, several studies have shown that measurements made on digital and analog films are similar and that they are also similar to those made on computer workstations. Such work has not been done in spondylolisthesis. Twenty-four cases of lumbar degenerative spondylolisthesis were identified from our clinic practice. Three observers measured anterior displacement, sagittal rotation, and lumbar lordosis on digital films using the same protractor and pencil. The same parameters were measured on the same studies at clinical workstations. All measurements were repeated 2 weeks later. A statistician determined the intra and interobserver reliability of the 2 measurement methods and the degree of agreement between the 2 methods. The differences between the first and second readings did reach statistical significance in some cases, but none of them were large enough to be clinically meaningful. The interclass correlation coefficients (ICCs) were >or=0.80 except for one (0.67). The difference among the 3 observers was similarly statistically significant in a few instances but not enough to influence clinical decisions and with good ICCs (0.67 and better). Similarly, the differences in the 2 methods were small, and ICCs ranged from 0.69 to 0.98. This study supports the use of computer workstation measurements in lumbar degenerative spondylolisthesis. The parameters used in this study were comparable, whether measured on film or at clinical workstations.

Serious adverse events after HPV vaccination: a critical review of randomized trials and post-marketing case series.

PubMed

Martínez-Lavín, Manuel; Amezcua-Guerra, Luis

2017-10-01

This article critically reviews HPV vaccine serious adverse events described in pre-licensure randomized trials and in post-marketing case series. HPV vaccine randomized trials were identified in PubMed. Safety data were extracted. Post-marketing case series describing HPV immunization adverse events were reviewed. Most HPV vaccine randomized trials did not use inert placebo in the control group. Two of the largest randomized trials found significantly more severe adverse events in the tested HPV vaccine arm of the study. Compared to 2871 women receiving aluminum placebo, the group of 2881 women injected with the bivalent HPV vaccine had more deaths on follow-up (14 vs. 3, p = 0.012). Compared to 7078 girls injected with the 4-valent HPV vaccine, 7071 girls receiving the 9-valent dose had more serious systemic adverse events (3.3 vs. 2.6%, p = 0.01). For the 9-valent dose, our calculated number needed to seriously harm is 140 (95% CI, 79–653) [DOSAGE ERROR CORRECTED] . The number needed to vaccinate is 1757 (95% CI, 131 to infinity). Practically, none of the serious adverse events occurring in any arm of both studies were judged to be vaccine-related. Pre-clinical trials, post-marketing case series, and the global drug adverse reaction database (VigiBase) describe similar post-HPV immunization symptom clusters. Two of the largest randomized HPV vaccine trials unveiled more severe adverse events in the tested HPV vaccine arm of the study. Nine-valent HPV vaccine has a worrisome number needed to vaccinate/number needed to harm quotient. Pre-clinical trials and post-marketing case series describe similar post-HPV immunization symptoms.

Clinical Features and Molecular Epidemiology of CMY-Type β-Lactamase-Producing Escherichia coli

PubMed Central

Sidjabat, Hanna E.; Paterson, David L.; Qureshi, Zubair A.; Adams-Haduch, Jennifer M.; O’Keefe, Alexandra; Pascual, Alvaro; Rodríguez-Baño, Jesús; Doi, Yohei

2009-01-01

Background Knowledge on the clinical features of infections caused by Escherichia coli producing plasmid-mediated AmpC β-lactamase is limited. Of the several groups of plasmid-mediated AmpC β-lactamase, CMY-type β-lactamase is the most common in the United States. Methods We prospectively identified E. coli producing CMY-type β-lactamase and collected clinical data over a seven-month period. A retrospective cohort study was performed to identify features associated with these cases, using cases due to extended-spectrum β-lactamase (ESBL)-producing E. coli as controls. Pulsed-field gel electrophoresis (PFGE), plasmid analysis and phylogenetic typing were performed. Results Twenty-two cases with CMY-producing E. coli and 25 cases with ESBL-producing E. coli were identified. The demographics of the patients were similar between the CMY and ESBL cohorts. CMY cases were significantly more likely to represent symptomatic infection compared with ESBL cases (P=0.028). The CMY-type β-lactamase was identified as CMY-2 or its variants. Ninety-four percent of the CMY-producing isolates belonged to E. coli phylogenetic groups B2 and D, which are associated with virulence. Many of them shared similar plasmid profiles, whereas the PFGE profiles were diverse. Co-resistance to non-β-lactam antimicrobials was common. Conclusion In Pittsburgh, CMY-producing E. coli is almost as common as ESBL-producing E. coli and causes symptomatic infection in the majority of cases. PMID:19187027

The relationship between maternal nutritional status and spontaneous abortion.

PubMed

Neela, J; Raman, L

1997-01-01

The incidence of pregnancy wastage is high among poor women. Though the aetiology of spontaneous abortion is multifactorial, nutritional deficiency is considered to be an important contributory factor. A case-control study was conducted to assess the relationship between maternal vitamin status and spontaneous abortion. The incidence of anaemia (15%), and riboflavin (84%) and folate deficiency (24.5%) were similar among the cases and controls. Vitamin A levels were higher in the study group compared to those in controls. The results suggest that various nutrient deficiencies have no correlation with the occurrence of spontaneous abortion. The role of increased vitamin A levels needs to be studied further.

Clinical Signs and Blood Test Results Among Humans Infected With Zoonotic Simian Foamy Virus: A Case-Control Study.

PubMed

Buseyne, Florence; Betsem, Edouard; Montange, Thomas; Njouom, Richard; Bilounga Ndongo, Chanceline; Hermine, Olivier; Gessain, Antoine

2018-06-05

A spillover of simian foamy virus (SFV) to humans, following bites from infected nonhuman primates (NHPs), is ongoing in exposed populations. These retroviruses establish persistent infections of unknown physiological consequences to the human host. We performed a case-control study to compare 24 Cameroonian hunters infected with gorilla SFV and 24 controls matched for age and ethnicity. A complete physical examination and blood test were performed for all participants. Logistic regression and Wilcoxon signed rank tests were used to compare cases and controls. The cases had significantly lower levels of hemoglobin than the controls (median, 12.7 vs 14.4 g/dL; P = .01). Basophil levels were also significantly lower in cases than controls, with no differences for other leukocyte subsets. Cases had significantly higher urea, creatinine, protein, creatinine phosphokinase, and lactate dehydrogenase levels and lower bilirubin levels than controls. Cases and controls had similar frequencies of general, cutaneous, gastrointestinal, neurological, and cardiorespiratory signs. The first case-control study of apparently healthy SFV-infected Cameroonian hunters showed the presence of hematological abnormalities. A thorough clinical and laboratory workup is now needed to establish the medical relevance of these observations because more than half of cases had mild or moderate anemia. NCT03225794.

Genealogy construction in a historically isolated population: application to genetic studies of rheumatoid arthritis in the Pima Indian.

PubMed

Lin, J P; Hirsch, R; Jacobsson, L T; Scott, W W; Ma, L D; Pillemer, S R; Knowler, W C; Kastner, D L; Bale, S J

1999-01-01

Due to the characteristics of complex traits, many traits may not be amenable to traditional epidemiologic methods. We illustrate an approach that defines an isolated population as the "unit" for carrying out studies of complex disease. We provide an example using the Pima Indians, a relatively isolated population, in which the incidence and prevalence of Type 2 diabetes, gallbladder disease, and rheumatoid arthritis (RA) are significantly increased compared with the general U.S. population. A previous study of RA in the Pima utilizing traditional methods failed to detect a genetic effect on the occurrence of the disease. Our approach involved constructing a genealogy for this population and using a genealogic index to investigate familial aggregation. We developed an algorithm to identify biological relationships among 88 RA cases versus 4,000 subsamples of age-matched individuals from the same population. Kinship coefficients were calculated for all possible pairs of RA cases, and similarly for the subsamples. The sum of the kinship coefficient among all combination of RA pairs, 5.92, was significantly higher than the average of the 4,000 subsamples, 1.99 (p < 0.001), and was elevated over that of the subsamples to the level of second cousin, supporting a genetic effect in the familial aggregation. The mean inbreeding coefficient for the Pima was 0.00009, similar to that reported for other populations; none of the RA cases were inbred. The Pima genealogy can be anticipated to provide valuable information for the genetic study of diseases other than RA. Defining an isolated population as the "unit" in which to assess familial aggregation may be advantageous, especially if there are a limited number of cases in the study population.

Chronic hepatitis C--assessment in civil law: a case study.

PubMed

Santos, Bruno Miguel; Sousa, Paula; Mena, Filomena; Costa, Graça Santos; Corte-Real, Francisco; Vieira, Duarte Nuno

2010-02-01

This article describes the case of a 58-year-old man who asked for an assessment of physical damage of a civil nature, having been diagnosed with chronic hepatitis C for which he blamed a blood transfusion, supposedly contaminated with hepatitis C virus (HCV). After studying the documentary information, a number of presuppositions were drawn up with a view to determining the causal nexus, but this could not be proved. The assessment of situations like this is not common in civil law. This article is intended to add to the body of information on the forensic assessment of similar cases. Copyright 2009 Elsevier Ltd and Faculty of Forensic and Legal Medicine. Published by Elsevier Ltd. All rights reserved.

Research participation experiences of informants of suicide and control cases: taken from a case-control psychological autopsy study of people who died by suicide.

PubMed

Wong, Paul W C; Chan, Wincy S C; Beh, Philip S L; Yau, Fiona W S; Yip, Paul S F; Hawton, Keith

2010-01-01

Ethical issues have been raised about using the psychological autopsy approach in the study of suicide. The impact on informants of control cases who participated in case-control psychological autopsy studies has not been investigated. (1) To investigate whether informants of suicide cases recruited by two approaches (coroners' court and public mortuaries) respond differently to the initial contact by the research team. (2) To explore the reactions, reasons for participation, and comments of both the informants of suicide and control cases to psychological autopsy interviews. (3) To investigate the impact of the interviews on informants of suicide cases about a month after the interviews. A self-report questionnaire was used for the informants of both suicide and control cases. Telephone follow-up interviews were conducted with the informants of suicide cases. The majority of the informants of suicide cases, regardless of the initial route of contact, as well as the control cases were positive about being approached to take part in the study. A minority of informants of suicide and control cases found the experience of talking about their family member to be more upsetting than expected. The telephone follow-up interviews showed that none of the informants of suicide cases reported being distressed by the psychological autopsy interviews. The acceptance rate for our original psychological autopsy study was modest. The findings of this study are useful for future participants and researchers in measuring the potential benefits and risks of participating in similar sensitive research. Psychological autopsy interviews may be utilized as an active engagement approach to reach out to the people bereaved by suicide, especially in places where the postvention work is underdeveloped.

Dandy-Walker malformation: a review of 78 cases diagnosed by prenatal sonography.

PubMed

Has, Recep; Ermiş, Hayri; Yüksel, Atil; Ibrahimoğlu, Lem'i; Yildirim, Alkan; Sezer, Hande Delier; Başaran, Seher

2004-01-01

The purpose of this study was to determine the associated abnormalities and clinical outcomes of fetuses with Dandy-Walker malformations. Sonograms and medical reports of 78 cases were reviewed and information regarding each outcome was collected from autopsy records, hospital charts and specialists caring for the surviving infants. We identified 64 fetuses with classic Dandy-Walker malformation (DW) and 14 fetuses with Dandy-Walker variant (DWV). A high proportion (44.8%) of the parents were consanguineous. The spectrum and proportion of central nervous system (67.1 vs. 71.4%; p = 1.0) and other malformations (43.7 vs. 64.2%; p = 0.57) associated with DW and DWV were similar. Chromosome abnormalities were found in 9 of the 51 (17.6%) fetuses that underwent karyotype analysis. Only 4 of 64 (6.2%) DW and 3 of 14 (21.4%) DWV infants survived (p 0.14), and all surviving infants with DW or DWV had neurological disorders. DW and DWV cases show so many similarities that a clear-cut distinction is difficult. There was no significant difference in the spectrum of associated anomalies and postnatal prognosis between DW and DWV cases. Copyright 2004 S. Karger AG, Basel

The effect of ambient air temperature and precipitation on monthly counts of salmonellosis in four regions of Kazakhstan, Central Asia, in 2000-2010.

PubMed

Grjibovski, A M; Kosbayeva, A; Menne, B

2014-03-01

We studied associations between monthly counts of laboratory-confirmed cases of salmonellosis, ambient air temperature and precipitation in four settings in Kazakhstan. We observed a linear association between the number of cases of salmonellosis and mean monthly temperature during the same months only in Astana: an increase of 1°C was associated with a 5·5% [95% confidence interval (CI) 2·2-8·8] increase in the number of cases. A similar association, although not reaching the level of significance was observed in the Southern Kazakhstan region (3·5%, 95% CI -2·1 to 9·1). Positive association with precipitation with lag 2 was found in Astana: an increase of 1 mm was associated with a 0·5% (95% CI 0·1-1·0) increase in the number of cases. A similar association, but with lag 0 was observed in Southern Kazakhstan region (0·6%, 95% CI 0·1-1·1). The results may have implications for the future patterns of salmonellosis in Kazakhstan with regard to climate change.

The London Fibromyalgia Epidemiology Study: comparing the demographic and clinical characteristics in 100 random community cases of fibromyalgia versus controls.

PubMed

White, K P; Speechley, M; Harth, M; Ostbye, T

1999-07-01

To identify demographic and clinical features that distinguish fibromyalgia (FM) from other chronic widespread pain. We identified 100 confirmed FM cases, 76 widespread pain controls, and 135 general controls in a random community survey of 3395 noninstitutionalized adults living in London, Ontario. FM cases were distinguished from pain controls using the 1990 American College of Rheumatology (ACR) classification criteria for FM. The mean age of FM cases was 47.8 years (range 19 to 86), the same as for pain controls; 86% of FM cases were female versus 67.1% of pain controls (p < 0.01). FM cases were less educated than general controls (p = 0.03). Male and female FM cases were similar, except females were older and reported more major symptoms (both p = 0.02). FM cases reported more severe pain and fatigue, more symptoms, more major symptoms, and worse overall health than pain controls or general controls. The most commonly reported major symptoms among FM cases were musculoskeletal pain (77.3%), fatigue (77.3%), severe fatigue lasting 24 h after minimal activity (77.0%), nonrestorative sleep (65.7%), and insomnia (56.0%). Subjects with 11-14 tender points were more similar to those with 15-18 tender points than to those with 7-10 points in 11 of 14 clinical variables. On multivariate analysis, 4 symptoms distinguished FM cases from pain controls: pain severity (p = 0.004), severe fatigue lasting 24 h after minimal activity (p = 0.006), weakness (p = 0.008), and self-reported swelling of neck glands (p = 0.01). In the general population, adults who meet the ACR definition of FM appear to have distinct features compared to those with chronic widespread pain who do not meet criteria.

Optimal Surgery for Mid-Transverse Colon Cancer: Laparoscopic Extended Right Hemicolectomy Versus Laparoscopic Transverse Colectomy.

PubMed

Matsuda, Takeru; Sumi, Yasuo; Yamashita, Kimihiro; Hasegawa, Hiroshi; Yamamoto, Masashi; Matsuda, Yoshiko; Kanaji, Shingo; Oshikiri, Taro; Nakamura, Tetsu; Suzuki, Satoshi; Kakeji, Yoshihiro

2018-04-02

Although the feasibility and safety of laparoscopic surgery for transverse colon cancer have been shown by the recent studies, the optimal laparoscopic approach for mid-transverse colon cancer is controversial. We retrospectively analyzed the data of patients with the mid-transverse colon cancer at our institutions between January 2007 and April 2017. Thirty-eight and 34 patients who received extended right hemicolectomy and transverse colectomy, respectively, were enrolled. There were no significant differences in operating time, blood loss, and hospital stay between the two groups. Postoperative complications developed in 10 of 34 patients (29.4%; wound infection: 2 cases, anastomotic leakage: 2 cases, bowel obstruction: 1 case, incisional hernia: 2 cases, others: 3 cases) for the transverse colectomy group and in 4 of 38 patients (10.5%; wound infection: 1 case, anastomotic leakage: 0 case, bowel obstruction: 2 cases, incisional hernia: 0 case, others: 1 case) for the extended right hemicolectomy group (P = 0.014). Although the median number of harvested #221 and #222 LNs was similar between the two groups (6 vs. 8, P = 0.710, and 3 vs. 2, P = 0.256, respectively), that of #223 was significantly larger in extended right hemicolectomy than in transverse colectomy (3 vs. 1, P = 0.038). The 5-year disease-free and overall survival rates were 92.4 and 90.3% for the extended right hemicolectomy group, and 95.7 and 79.6% for the transverse colectomy group (P = 0.593 and P = 0.638, respectively). Laparoscopic extended right hemicolectomy and laparoscopic transverse colectomy offer similar oncological outcomes for mid-transverse colon cancer. Laparoscopic extended right hemicolectomy might be associated with fewer postoperative complications.

Similarity based false-positive reduction for breast cancer using radiographic and pathologic imaging features

NASA Astrophysics Data System (ADS)

Pai, Akshay; Samala, Ravi K.; Zhang, Jianying; Qian, Wei

2010-03-01

Mammography reading by radiologists and breast tissue image interpretation by pathologists often leads to high False Positive (FP) Rates. Similarly, current Computer Aided Diagnosis (CADx) methods tend to concentrate more on sensitivity, thus increasing the FP rates. A novel method is introduced here which employs similarity based method to decrease the FP rate in the diagnosis of microcalcifications. This method employs the Principal Component Analysis (PCA) and the similarity metrics in order to achieve the proposed goal. The training and testing set is divided into generalized (Normal and Abnormal) and more specific (Abnormal, Normal, Benign) classes. The performance of this method as a standalone classification system is evaluated in both the cases (general and specific). In another approach the probability of each case belonging to a particular class is calculated. If the probabilities are too close to classify, the augmented CADx system can be instructed to have a detailed analysis of such cases. In case of normal cases with high probability, no further processing is necessary, thus reducing the computation time. Hence, this novel method can be employed in cascade with CADx to reduce the FP rate and also avoid unnecessary computational time. Using this methodology, a false positive rate of 8% and 11% is achieved for mammography and cellular images respectively.

Value is in the eye of the beholder: early visual cortex codes monetary value of objects during a diverted attention task.

PubMed

Persichetti, Andrew S; Aguirre, Geoffrey K; Thompson-Schill, Sharon L

2015-05-01

A central concern in the study of learning and decision-making is the identification of neural signals associated with the values of choice alternatives. An important factor in understanding the neural correlates of value is the representation of the object itself, separate from the act of choosing. Is it the case that the representation of an object within visual areas will change if it is associated with a particular value? We used fMRI adaptation to measure the neural similarity of a set of novel objects before and after participants learned to associate monetary values with the objects. We used a range of both positive and negative values to allow us to distinguish effects of behavioral salience (i.e., large vs. small values) from effects of valence (i.e., positive vs. negative values). During the scanning session, participants made a perceptual judgment unrelated to value. Crucially, the similarity of the visual features of any pair of objects did not predict the similarity of their value, so we could distinguish adaptation effects due to each dimension of similarity. Within early visual areas, we found that value similarity modulated the neural response to the objects after training. These results show that an abstract dimension, in this case, monetary value, modulates neural response to an object in visual areas of the brain even when attention is diverted.

"They Make You Invisible": Negotiating Power at the Academic Intersections of Ethnicity, Gender, and Class

ERIC Educational Resources Information Center

Briscoe, Felecia M.

2009-01-01

This Foucauldian case study examines the academic conflicts of Mexican American women and girls, how they negotiate those conflicts, and the identity effects of their negotiations. It extends Gloria Anzaldua's (1999) work and builds upon those who have studied the schooling experiences of Mexican American women and girls. Similar conflicts for…

Extraction of ethanol with higher carboxylic acid solvents and their toxicity to yeast

USDA-ARS?s Scientific Manuscript database

In a screening exercise for ethanol-selective extraction solvents, partitioning of ethanol and water from a 5 wt% aqueous solution into several C8 – C18 carboxylic acids was studied. Results for the acids are compared with those from alcohols of similar structure. In all cases studied, the acids exh...

Genetic Variance for Autism Screening Items in an Unselected Sample of Toddler-Age Twins

ERIC Educational Resources Information Center

Stilp, Rebecca L. H.; Gernsbacher, Morton Ann; Schweigert, Emily K.; Arneson, Carrie L.; Goldsmith, H. Hill

2010-01-01

Objective: Twin and family studies of autistic traits and of cases diagnosed with autism suggest high heritability; however, the heritability of autistic traits in toddlers has not been investigated. Therefore, this study's goals were (1) to screen a statewide twin population using items similar to the six critical social and communication items…

Chinese International Students' and Faculty Members' Views of Plagiarism in Higher Education

ERIC Educational Resources Information Center

Grigg, Alan

2016-01-01

As the enrollment of Chinese international students (CIS) increased at a private institution in the Midwest, so did suspected cases of plagiarism. This study addressed the problem of how faculty members grappled with CIS' interpretation and application of Western-based views of plagiarism. The purpose of the study was to identify similarities and…

Tutoring Strategies: A Case Study Comparing Learning Center Tutors and Academic Department Tutors

ERIC Educational Resources Information Center

Bailey, Geoffrey K.

2010-01-01

Peer tutoring at the postsecondary level has been studied extensively, particularly over the last twenty years. Peer tutoring programs are common across institutional type and size in the United States (Boylan, Bonham, Bliss, & Saxon, 1995; Maxwell, 2001) given students' preferences for tutors who share age and status similarity (Cohen, 1986;…

Student Teachers in Tibet: A Case Study.

ERIC Educational Resources Information Center

Su, Zhixin; Hawkins, John N.; Zhao, Chunhua; Huang, Tao

2002-01-01

Compared Tibetan student teachers' characteristics and attitudes to those of their mainstream Chinese counterparts. Surveys, interviews, observations, and document reviews revealed both similarities and differences. Tibetan student teachers tended to be middle class males, choose teaching for intrinsic reasons, and hesitate to commit themselves to…

Digital Immigrant Teacher Perceptions of an Extended Cyberhunt Strategy

ERIC Educational Resources Information Center

du Plessis, Andre; Webb, Paul

2012-01-01

This quantitative and qualitative interpretive exploratory case study investigates whether exposure to an Internet based "Extended Cyberhunt" strategy enables teachers to attain a set of outcomes similar to Prensky's "Essential 21st Century Skills" and the "Critical Outcomes of the South African National Curriculum…

Interpreting Early Career Trajectories

ERIC Educational Resources Information Center

Barnatt, Joan; Gahlsdorf Terrell, Dianna; D'Souza, Lisa Andries; Jong, Cindy; Cochran-Smith, Marilyn; Viesca, Kara Mitchell; Gleeson, Ann Marie; McQuillan, Patrick; Shakman, Karen

2017-01-01

Career decisions of four teachers are explored through the concept of figured worlds in this qualitative, longitudinal case study. Participants were purposefully chosen for similarity at entry, with a range of career trajectories over time. Teacher career paths included remaining in one school, repeated changes in schools, attrition after…

Equality under the Law

ERIC Educational Resources Information Center

Hamilton, Lemondra V.

2014-01-01

The purpose of this case study was to examine how Mississippi Valley State University (MVSU) implemented the negotiated ruling of the "Ayers" desegregation lawsuit and settlement to empower the institution and similarly situated historically black colleges and universities (HBCUs). The spoken and written words of three administrators of…

Turning Knowledge into Success: The Role of Collaboration in Knowledge Management Implementation

ERIC Educational Resources Information Center

Hizmetli, Handan

2014-01-01

This case study describes five phases that a community college went through in developing its use of knowledge management practices to improve their student outcomes and recommends how other colleges can similarly benefit from knowledge management in meeting their goals.

Science, Law, and the Pursuit of Knowledge: Should Unethical Research Be Considered for Scientific Knowledge?

ERIC Educational Resources Information Center

Moore, Randy

2002-01-01

Describes similarities and differences between science and law in terms of truth, validity of facts, objectives, and research designs. Discusses ethical issues in teaching science and law and presents two case studies, Nazi hypothermia research and phosgene. (KHR)

Self-Directed Teacher Learning in Collaborative Contexts

ERIC Educational Resources Information Center

Slavit, David; Roth McDuffie, Amy

2013-01-01

Two related case studies of secondary mathematics teachers examine the roles and conditions helpful in initiating, directing, and/or supporting teachers' own professional development. Using multiple data sources from school-based and professional settings, we applied analytic induction to identify patterns of similarities and differences in…

Turbulent Flow Over Large Roughness Elements: Effect of Frontal and Plan Solidity on Turbulence Statistics and Structure

NASA Astrophysics Data System (ADS)

Placidi, M.; Ganapathisubramani, B.

2018-04-01

Wind-tunnel experiments were carried out on fully-rough boundary layers with large roughness (δ /h ≈ 10, where h is the height of the roughness elements and δ is the boundary-layer thickness). Twelve different surface conditions were created by using LEGO™ bricks of uniform height. Six cases are tested for a fixed plan solidity (λ _P) with variations in frontal density (λ _F), while the other six cases have varying λ _P for fixed λ _F. Particle image velocimetry and floating-element drag-balance measurements were performed. The current results complement those contained in Placidi and Ganapathisubramani (J Fluid Mech 782:541-566, 2015), extending the previous analysis to the turbulence statistics and spatial structure. Results indicate that mean velocity profiles in defect form agree with Townsend's similarity hypothesis with varying λ _F, however, the agreement is worse for cases with varying λ _P. The streamwise and wall-normal turbulent stresses, as well as the Reynolds shear stresses, show a lack of similarity across most examined cases. This suggests that the critical height of the roughness for which outer-layer similarity holds depends not only on the height of the roughness, but also on the local wall morphology. A new criterion based on shelter solidity, defined as the sheltered plan area per unit wall-parallel area, which is similar to the `effective shelter area' in Raupach and Shaw (Boundary-Layer Meteorol 22:79-90, 1982), is found to capture the departure of the turbulence statistics from outer-layer similarity. Despite this lack of similarity reported in the turbulence statistics, proper orthogonal decomposition analysis, as well as two-point spatial correlations, show that some form of universal flow structure is present, as all cases exhibit virtually identical proper orthogonal decomposition mode shapes and correlation fields. Finally, reduced models based on proper orthogonal decomposition reveal that the small scales of the turbulence play a significant role in assessing outer-layer similarity.

Vitamin D and the risk of preeclampsia--a nested case-control study.

PubMed

Gidlöf, Sebastian; Silva, Aldo T; Gustafsson, Sven; Lindqvist, Pelle G

2015-08-01

We aimed to determine the relation between vitamin D deficiency in early pregnancy and preeclampsia. In a nested case-control study of 2496 pregnant women, we identified 39 women who developed preeclampsia and 120 non-preeclamptic controls. Blood was sampled in 12th gestational week and analyzed for serum vitamin D. Vitamin D levels were similar in women who developed preeclampsia, 52.2 ± 20.5 nmol/L, and controls, 48.6 ± 20.5 nmol/L, p = 0.3. In addition, vitamin D deficiency (<50 nmol/L) was found in a similar proportion of control group (51.7%) as those with severe preeclampsia (41.2%). Women with vitamin D deficiency were 3 cm shorter than those with normal vitamin D levels (p = 0.002). Our data do not support the hypothesis that vitamin D deficiency in early pregnancy is associated with preeclampsia, but we cannot rule out a relation later in gestation. © 2015 Nordic Federation of Societies of Obstetrics and Gynecology.

Contrasting trends of tuberculosis in the cities of San Pedro Sula and Tegucigalpa, Honduras, 2005-2014.

PubMed

Varela-Martínez, Cecilia; Yadon, Zaida E; Marín, Diana; Heldal, Einar

2016-01-01

Objective To 1) describe and compare the trends of tuberculosis (TB) case notification rates (CNRs) and treatment outcomes in the two largest cities in Honduras (San Pedro Sula and Tegucigalpa) for the period 2005-2014 and 2) identify possible related socioeconomic and health sector factors. Methods This retrospective ecological operational research study used aggregated data from the National TB Program (socioeconomic and health sector information and individual data from the 2014 TB case notification report). Results TB CNRs declined steadily over the study period in Tegucigalpa (from 46 to 28 per 100 000 inhabitants) but remained high in San Pedro Sula (decreasing from 89 to 78 per 100 000 inhabitants). Similar trends were observed for smear-positive TB. While presumptive TB cases examined were similar for both cities, in San Pedro Sula the proportions of presumptive cases with a positive smear; (7.7% versus 3.6%) relapses (8.9% versus 4.2%); and patients lost to follow-up (10.9% versus 2.7%) were significantly higher, and the treatment success lower (75.7% versus 87.0%). San Pedro Sula had lower annual income per capita, fewer public sector health workers and facilities, and a higher and increasing homicide index. The 2014 TB case data from San Pedro Sula showed a significantly lower median age and a higher proportion of assembly plant workers, prisoners, drug abusers, and diabetes. Conclusions The TB rate was higher and treatment success lower, and health care resources and socio-demographic indicators less favorable, in San Pedro Sula versus Tegucigalpa. City authorities, the NTP, and the health sector overall should strengthen early case detection, treatment, and infection control, involving both public and private health sectors.

Characteristic Cytokine and Chemokine Profiles in Encephalitis of Infectious, Immune-Mediated, and Unknown Aetiology

PubMed Central

Michael, Benedict D.; Griffiths, Michael J.; Granerod, Julia; Brown, David; Davies, Nicholas W. S.; Borrow, Ray; Solomon, Tom

2016-01-01

Background Encephalitis is parenchymal brain inflammation due to infectious or immune-mediated processes. However, in 15–60% the cause remains unknown. This study aimed to determine if the cytokine/chemokine-mediated host response can distinguish infectious from immune-mediated cases, and whether this may give a clue to aetiology in those of unknown cause. Methods We measured 38 mediators in serum and cerebrospinal fluid (CSF) of patients from the Health Protection Agency Encephalitis Study. Of serum from 78 patients, 38 had infectious, 20 immune-mediated, and 20 unknown aetiology. Of CSF from 37 patients, 20 had infectious, nine immune-mediated and eight unknown aetiology. Results Heat-map analysis of CSF mediator interactions was different for infectious and immune-mediated cases, and that of the unknown aetiology group was similar to the infectious pattern. Higher myeloperoxidase (MPO) concentrations were found in infectious than immune-mediated cases, in serum and CSF (p = 0.01 and p = 0.006). Serum MPO was also higher in unknown than immune-mediated cases (p = 0.03). Multivariate analysis selected serum MPO; classifying 31 (91%) as infectious (p = 0.008) and 17 (85%) as unknown (p = 0.009) as opposed to immune-mediated. CSF data also selected MPO classifying 11 (85%) as infectious as opposed to immune-mediated (p = 0.036). CSF neutrophils were detected in eight (62%) infective and one (14%) immune-mediated cases (p = 0.004); CSF MPO correlated with neutrophils (p<0.0001). Conclusions Mediator profiles of infectious aetiology differed from immune-mediated encephalitis; and those of unknown cause were similar to infectious cases, raising the hypothesis of a possible undiagnosed infectious cause. Particularly, neutrophils and MPO merit further investigation. PMID:26808276

Characteristic Cytokine and Chemokine Profiles in Encephalitis of Infectious, Immune-Mediated, and Unknown Aetiology.

PubMed

Michael, Benedict D; Griffiths, Michael J; Granerod, Julia; Brown, David; Davies, Nicholas W S; Borrow, Ray; Solomon, Tom

2016-01-01

Encephalitis is parenchymal brain inflammation due to infectious or immune-mediated processes. However, in 15-60% the cause remains unknown. This study aimed to determine if the cytokine/chemokine-mediated host response can distinguish infectious from immune-mediated cases, and whether this may give a clue to aetiology in those of unknown cause. We measured 38 mediators in serum and cerebrospinal fluid (CSF) of patients from the Health Protection Agency Encephalitis Study. Of serum from 78 patients, 38 had infectious, 20 immune-mediated, and 20 unknown aetiology. Of CSF from 37 patients, 20 had infectious, nine immune-mediated and eight unknown aetiology. Heat-map analysis of CSF mediator interactions was different for infectious and immune-mediated cases, and that of the unknown aetiology group was similar to the infectious pattern. Higher myeloperoxidase (MPO) concentrations were found in infectious than immune-mediated cases, in serum and CSF (p = 0.01 and p = 0.006). Serum MPO was also higher in unknown than immune-mediated cases (p = 0.03). Multivariate analysis selected serum MPO; classifying 31 (91%) as infectious (p = 0.008) and 17 (85%) as unknown (p = 0.009) as opposed to immune-mediated. CSF data also selected MPO classifying 11 (85%) as infectious as opposed to immune-mediated (p = 0.036). CSF neutrophils were detected in eight (62%) infective and one (14%) immune-mediated cases (p = 0.004); CSF MPO correlated with neutrophils (p<0.0001). Mediator profiles of infectious aetiology differed from immune-mediated encephalitis; and those of unknown cause were similar to infectious cases, raising the hypothesis of a possible undiagnosed infectious cause. Particularly, neutrophils and MPO merit further investigation.

Effect of abacavir on acute changes in biomarkers associated with cardiovascular dysfunction.

PubMed

Patel, Pragna; Bush, Tim; Overton, Turner; Baker, Jason; Hammer, John; Kojic, Erna; Conley, Lois; Henry, Keith; Brooks, John T

2012-01-01

This study examined the effect of abacavir on acute changes in biomarkers associated with cardiovascular dysfunction. Among the Study to Understand the Natural History of HIV/AIDS in the Era of Effective therapy (SUN) participants, we identified 25 individuals (cases) who were HLA-B5701-negative and who had ≥ 2 weeks without abacavir exposure at one visit and ≥ 2 weeks with abacavir exposure at the consecutive visit while maintaining viral suppression. We identified 43 individuals (controls) similarly unexposed and exposed to tenofovir. We assessed concentrations of prothrombin fragment F(1+2), D-dimer, high-sensitivity C-reactive protein, interleukin-8, intercellular adhesion molecule-1, vascular adhesion molecule-1, E-selectin, P-selectin, serum amyloid A and serum amyloid P. We examined the median percentage change of these biomarkers from the unexposed to exposed state among cases and controls compared with the expected assay variability using a sign test, and compared changes among cases with controls using the Wilcoxon rank-sum test. Baseline characteristics were similar between cases and controls: median age 45 versus 46 years, 80% versus 81% male, 64% versus 63% non-Hispanic White and median CD4(+) T-cell count 538 versus 601 cells/mm(3), respectively. Mean exposure times were 65 and 15 weeks for abacavir and tenofovir, respectively. We observed no significant changes in biomarkers from the unexposed to exposed state among cases or controls compared with the expected assay variability. We found that no biomarkers were significantly increased among cases compared with controls; however, prothrombin fragment F(1+2) was significantly lower among controls (P=0.035). In virologically suppressed contemporary HIV-infected patients, abacavir exposure was not associated with increases in biomarkers associated with increased cardiovascular risk.

Effect of database profile variation on drug safety assessment: an analysis of spontaneous adverse event reports of Japanese cases

PubMed Central

Nomura, Kaori; Takahashi, Kunihiko; Hinomura, Yasushi; Kawaguchi, Genta; Matsushita, Yasuyuki; Marui, Hiroko; Anzai, Tatsuhiko; Hashiguchi, Masayuki; Mochizuki, Mayumi

2015-01-01

Background The use of a statistical approach to analyze cumulative adverse event (AE) reports has been encouraged by regulatory authorities. However, data variations affect statistical analyses (eg, signal detection). Further, differences in regulations, social issues, and health care systems can cause variations in AE data. The present study examined similarities and differences between two publicly available databases, ie, the Japanese Adverse Drug Event Report (JADER) database and the US Food and Drug Administration Adverse Event Reporting System (FAERS), and how they affect signal detection. Methods Two AE data sources from 2010 were examined, ie, JADER cases (JP) and Japanese cases extracted from the FAERS (FAERS-JP). Three methods for signals of disproportionate reporting, ie, the reporting odds ratio, Bayesian confidence propagation neural network, and Gamma Poisson Shrinker (GPS), were used on drug-event combinations for three substances frequently recorded in both systems. Results The two databases showed similar elements of AE reports, but no option was provided for a shareable case identifier. The average number of AEs per case was 1.6±1.3 (maximum 37) in the JP and 3.3±3.5 (maximum 62) in the FAERS-JP. Between 5% and 57% of all AEs were signaled by three quantitative methods for etanercept, infliximab, and paroxetine. Signals identified by GPS for the JP and FAERS-JP, as referenced by Japanese labeling, showed higher positive sensitivity than was expected. Conclusion The FAERS-JP was different from the JADER. Signals derived from both datasets identified different results, but shared certain signals. Discrepancies in type of AEs, drugs reported, and average number of AEs per case were potential contributing factors. This study will help those concerned with pharmacovigilance better understand the use and pitfalls of using spontaneous AE data. PMID:26109846

Ovarian Brenner tumors and Walthard nests: a histologic and immunohistochemical study.

PubMed

Roma, Andres A; Masand, Ramya P

2014-12-01

Brenner tumors are composed of urothelial/transitional-type epithelium and, hence, are morphologically similar to Walthard nests and tubal/mesothelial transitional metaplasia. In this study, we analyzed immunohistochemical markers on Brenner tumors to explore Müllerian as well as Wolffian and germ cell derivation. We also attempted to explore their possible association with tubal/paratubal Walthard nests/transitional metaplasia, using the same immunostains. Thirty-two consecutive cases of Brenner tumors were identified. Thirteen (43%) of the patients had Walthard nests in the tubal/periovarian soft tissue. All Brenner tumors were diffusely positive for GATA3 (strongly positive in 30/32 and weakly positive in the remaining 2) and negative for PAX8, PAX2, and SALL4. Similarly, all Walthard nests were positive for GATA3, whereas only 3 (23%) of 13 showed occasional PAX8 expression; all were negative for PAX2 and SALL4. In our study, more than 40% of Brenner tumors had associated Walthard nests. The similar morphology and immunoprofile of Brenner tumors and Walthard nests suggest a probable link between Brenner tumors and Walthard nests. Two additional cases presented highlight small transitional lesions involving the ovary: a possible precursor lesion or the initial steps of Brenner tumor formation. Brenner tumors and most Walthard nests lacked staining for Müllerian (PAX8 and PAX2) and germ cell tumor markers (SALL4). Copyright © 2014 Elsevier Inc. All rights reserved.

CD56+ blastic transformation of chronic myeloid leukemia involving the skin.

PubMed

Kaddu, S; Beham-Schmid, C; Zenahlik, P; Kerl, H; Cerroni, L

1999-11-01

We report on two patients with chronic myeloid leukemia (CML) who presented blastic transformation involving the skin, with leukemic infiltrates showing unusual morphologic and immunohistologic characteristics. Both patients were elderly men with a 36-month and a 40-month history of CML, respectively. They presented with disseminated, reddish to violaceous papules and plaques (case 1), and with localized reddish nodules on the left temporal area (case 2). Concurrent features of blastic transformation in the bone marrow were observed in one patient (case 1). Histopathologic examination of skin lesions revealed similar features in both cases. There was a moderate to dense dermal infiltrate composed mainly of medium-sized atypical mononuclear myeloid precursor cells with only few relatively well-differentiated cells of the granulocytic series. Histochemical staining for naphthol-ASD-chloroacetate esterase revealed strong positivity (>50% of neoplastic cells) in case 2 and only scattered positivity (< 10% of neoplastic cells) in case 1. Immunohistologic analysis performed on paraffin-embedded sections showed in both cases variable reactivity of neoplastic cells for leucocyte common antigen (CD45), lysozyme, myeloperoxidase, CD11c, CD15, CD43, CD66, CD68, HLA-DR, and the neural cell adhesion molecule (NCAM) CD56. A negative reaction was observed for CD3, CD34, and TdT. The immunohistologic findings were remarkably similar to those reported for acute myeloid leukemia (AML) with monocytic differentiation (French-American-British [FAB] classification, subtype M4). Examination of blasts from the bone marrow performed in one patient (case 1) revealed a similar phenotype also with CD56 expression. In conclusion, our observations show that specific cutaneous infiltrates in CML may show morphologic and immunohistochemical characteristics similar to those observed in AML with monocytic differentiation. Moreover, specific cutaneous manifestations of CML may express CD56.

Rethinking sources of representative controls for the conduct of case-control studies in minority populations.

PubMed

Bandera, Elisa V; Chandran, Urmila; Zirpoli, Gary; McCann, Susan E; Ciupak, Gregory; Ambrosone, Christine B

2013-05-31

Recruitment of controls remains a challenge in case-control studies and particularly in studies involving minority populations. We compared characteristics of controls recruited through random digit dialing (RDD) to those of community controls enrolled through churches, health events and other outreach sources among women of African ancestry (AA) participating in the Women's Circle of Health Study, a case-control study of breast cancer. Odds ratios and 95% confidence intervals were also computed using unconditional logistic regression to evaluate the impact of including the community controls for selected variables relevant to breast cancer and for which there were significant differences in distribution between the two control groups. Compared to community controls (n=347), RDD controls (n=207) had more years of education and higher income, lower body mass index, were more likely to have private insurance, and less likely to be single. While the percentage of nulliparous women in the two groups was similar, community controls tended to have more children, have their first child at a younger age, and were less likely to breastfeed their children. Dietary intake was similar in the two groups. Compared to census data, the combination of RDD and community controls seems to be more representative of the general population than RDD controls alone. Furthermore, the inclusion of the community group had little impact on the magnitude of risk estimates for most variables, while enhancing statistical power. Community-based recruitment was found to be an efficient and feasible method to recruit AA controls.

Evaluating the use of friend or family controls in epidemiologic case-control studies.

PubMed

Zhong, Charlie; Cockburn, Myles; Cozen, Wendy; Voutsinas, Jenna; Lacey, James V; Luo, Jianning; Sullivan-Halley, Jane; Bernstein, Leslie; Wang, Sophia S

2017-02-01

Traditional methodologies for identifying and recruiting controls in epidemiologic case-control studies, such as random digit dialing or neighborhood walk, suffer from declining response rates. Here, we revisit the feasibility and comparability of using alternative sources of controls, specifically friend and family controls. We recruited from a recently completed case-control study of non-Hodgkin lymphoma (NHL) among women in Los Angeles County where controls from the parent study were ascertained by neighborhood walk. We calculated participation rates and compared questionnaire responses between the friend/family controls and the original matched controls from the parent study. Of the 182 NHL case patients contacted, 111 (61%) agreed to participate in our feasibility study. 70 (63%) provided contact information for potential friend and/or family member controls. We were able to successfully contact and recruit a friend/family member for 92% of the case patients. This represented 46 friend controls and 54 family controls. Family controls significantly differed from original matched controls by sex and household income. Other characteristics were similar between friend controls and the original study's neighborhood controls. The apparent comparability of neighborhood controls to friend and family controls among respondents in this study suggests that these alternative methods of control identification can serve as a complementary source of eligible controls in epidemiologic case-control studies. Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.

A case-control study of domestic kitchen microbiology and sporadic Salmonella infection.

PubMed

Parry, S M; Slader, J; Humphrey, T; Holmes, B; Guildea, Z; Palmer, S R

2005-10-01

The microbiology of domestic kitchens in the homes of subjects who had suffered sporadic Salmonella infection (cases) was compared with control domestic kitchens. Case and control dishcloths and refrigerator swabs were examined for the presence of Salmonella spp., total Enterobacteriaceae counts and total aerobic colony counts. Salmonella spp. were isolated from both case and control dishcloths and refrigerators but there were no significant differences between the two groups. Colony counts were similar in case and control dishcloths and refrigerator swabs. There was no relationship between the total counts and presence of Salmonella . There was no evidence that cases of Salmonella infection were more likely to have kitchens which were contaminated with these bacteria or have higher bacterial counts than controls. Total bacterial counts were poor indicators of Salmonella contamination of the domestic kitchen environment. Further factors which could not be identified by a study of this design may increase risk of Salmonella food poisoning. These factors may include individual susceptibility of the patient. Alternatively, sporadic cases of Salmonella food poisoning may arise from food prepared outside the home.

Drug repurposing in pharmaceutical industry and its impact on market access: market access implications.

PubMed

Murteira, Susana; Millier, Aurélie; Toumi, Mondher

2014-01-01

Drug repurposing is a group of development strategies employed in order to overcome some of the hurdles innate to drug research and development. Drug repurposing includes drug repositioning, reformulation and combination. This study aimed to identify the determinants of successful market access outcome for drug repurposing in the United States of America (USA) and in Europe. The case studies of repurposing strategies were identified through a systematic review of the literature. Price information and reimbursement conditions for all the case studies were collected mainly through access of public datasources. A list of attributes that could be associated with market access outcome (price level and reimbursement conditions) was developed, discussed, and validated by an external expert group. Detailed information for all attributes was researched and collected for each case study. Bivariate regression models were conducted to identify factors associated with price change for all repurposing cases. A similar analysis was performed for reformulation and repositioning cases, in the USA and in Europe, separately. A significance level of 5% was used for all analyses. A total of 144 repurposing case studies were included in the statistical analysis for evaluation of mean price change. Combination cases (the combination of two or more individual drug components) were excluded from the statistical analysis due to the low number of cases retrieved. The main attributes associated with a significant price increase for overall repurposing cases were 'change in administration setting to hospital' (374%, p<0.0001), 'addressing unmet needs' (69%, p<0.05), 'reformulations belonging to Group 3'-that is, change in administration route (117%, p<0.001), and being a repurposed product with the 'same brand name' as the original product (65%, p<0.05). We found that the ability of the repurposed product to address unmet needs, a reformulation where the target product had a different administration route than the source product, and having a similar brand name for repurposed and original products, were variables that impacted a positive price change for repurposed drugs overall. Our research results also suggested that orphan designation could have a positive impact for repositioning in the USA, in particular. Although a change of administration from ambulatory to hospital setting seemed to be significantly correlated with a price increase for the target product, only one case was retrieved for this parameter; as such, it was not possible to infer a firm correlation between this parameter and a change in price.

Drug repurposing in pharmaceutical industry and its impact on market access: market access implications

PubMed Central

Murteira, Susana; Millier, Aurélie; Toumi, Mondher

2014-01-01

Background Drug repurposing is a group of development strategies employed in order to overcome some of the hurdles innate to drug research and development. Drug repurposing includes drug repositioning, reformulation and combination. Objective This study aimed to identify the determinants of successful market access outcome for drug repurposing in the United States of America (USA) and in Europe. Methods The case studies of repurposing strategies were identified through a systematic review of the literature. Price information and reimbursement conditions for all the case studies were collected mainly through access of public datasources. A list of attributes that could be associated with market access outcome (price level and reimbursement conditions) was developed, discussed, and validated by an external expert group. Detailed information for all attributes was researched and collected for each case study. Bivariate regression models were conducted to identify factors associated with price change for all repurposing cases. A similar analysis was performed for reformulation and repositioning cases, in the USA and in Europe, separately. A significance level of 5% was used for all analyses. Results A total of 144 repurposing case studies were included in the statistical analysis for evaluation of mean price change. Combination cases (the combination of two or more individual drug components) were excluded from the statistical analysis due to the low number of cases retrieved. The main attributes associated with a significant price increase for overall repurposing cases were ‘change in administration setting to hospital’ (374%, p<0.0001), ‘addressing unmet needs’ (69%, p<0.05), ‘reformulations belonging to Group 3’—that is, change in administration route (117%, p<0.001), and being a repurposed product with the ‘same brand name’ as the original product (65%, p<0.05). Conclusion We found that the ability of the repurposed product to address unmet needs, a reformulation where the target product had a different administration route than the source product, and having a similar brand name for repurposed and original products, were variables that impacted a positive price change for repurposed drugs overall. Our research results also suggested that orphan designation could have a positive impact for repositioning in the USA, in particular. Although a change of administration from ambulatory to hospital setting seemed to be significantly correlated with a price increase for the target product, only one case was retrieved for this parameter; as such, it was not possible to infer a firm correlation between this parameter and a change in price. PMID:27226833

On the equivalence of case-crossover and time series methods in environmental epidemiology.

PubMed

Lu, Yun; Zeger, Scott L

2007-04-01

The case-crossover design was introduced in epidemiology 15 years ago as a method for studying the effects of a risk factor on a health event using only cases. The idea is to compare a case's exposure immediately prior to or during the case-defining event with that same person's exposure at otherwise similar "reference" times. An alternative approach to the analysis of daily exposure and case-only data is time series analysis. Here, log-linear regression models express the expected total number of events on each day as a function of the exposure level and potential confounding variables. In time series analyses of air pollution, smooth functions of time and weather are the main confounders. Time series and case-crossover methods are often viewed as competing methods. In this paper, we show that case-crossover using conditional logistic regression is a special case of time series analysis when there is a common exposure such as in air pollution studies. This equivalence provides computational convenience for case-crossover analyses and a better understanding of time series models. Time series log-linear regression accounts for overdispersion of the Poisson variance, while case-crossover analyses typically do not. This equivalence also permits model checking for case-crossover data using standard log-linear model diagnostics.

A Systematic Review of the Huntington Disease-Like 2 Phenotype.

PubMed

Anderson, David G; Walker, Ruth H; Connor, Myles; Carr, Jonathan; Margolis, Russell L; Krause, Amanda

2017-01-01

Huntington Disease-like 2 (HDL2) is a neurodegenerative disorder similar to Huntington Disease (HD) in its clinical phenotype, genetic characteristics, neuropathology and longitudinal progression. Proposed specific differences include an exclusive African ancestry, lack of eye movement abnormalities, increased Parkinsonism, and acanthocytes in HDL2. The objective was to determine the similarities and differences between HD and HDL2 by establishing the clinical phenotype of HDL2 with the published cases. A literature review of all clinically described cases of HDL2 until the end of 2016 was performed and a descriptive analysis was carried out. Sixty-nine new cases were described between 2001 and 2016. All cases had likely African ancestry, and most were found in South Africa and the USA. Many features were found to be similar to HD, including a strong negative correlation between repeat length and age of onset. Chorea was noted in 48/57 cases (84%). Dementia was reported in 74% patients, and Parkinsonism in 37%. Psychiatric features were reported in 44 out of 47 cases. Patients with chorea had lower expanded repeat lengths compared to patients without chorea. Eye movements were described in 19 cases, 8 were abnormal. Acanthocytes were detected in 4 of the 13 patients tested. Nineteen out of 20 MRIs were reported as abnormal with findings similar to HD. This review clarifies some aspects of the HDL2 phenotype and highlights others which require further investigation. Features that are unique to HDL2 have been documented in a minority of subjects and require prospective validation.

Building the evidence on simulation validity: comparison of anesthesiologists' communication patterns in real and simulated cases.

PubMed

Weller, Jennifer; Henderson, Robert; Webster, Craig S; Shulruf, Boaz; Torrie, Jane; Davies, Elaine; Henderson, Kaylene; Frampton, Chris; Merry, Alan F

2014-01-01

Effective teamwork is important for patient safety, and verbal communication underpins many dimensions of teamwork. The validity of the simulated environment would be supported if it elicited similar verbal communications to the real setting. The authors hypothesized that anesthesiologists would exhibit similar verbal communication patterns in routine operating room (OR) cases and routine simulated cases. The authors further hypothesized that anesthesiologists would exhibit different communication patterns in routine cases (real or simulated) and simulated cases involving a crisis. Key communications relevant to teamwork were coded from video recordings of anesthesiologists in the OR, routine simulation and crisis simulation and percentages were compared. The authors recorded comparable videos of 20 anesthesiologists in the two simulations, and 17 of these anesthesiologists in the OR, generating 400 coded events in the OR, 683 in the routine simulation, and 1,419 in the crisis simulation. The authors found no significant differences in communication patterns in the OR and the routine simulations. The authors did find significant differences in communication patterns between the crisis simulation and both the OR and the routine simulations. Participants rated team communication as realistic and considered their communications occurred with a similar frequency in the simulations as in comparable cases in the OR. The similarity of teamwork-related communications elicited from anesthesiologists in simulated cases and the real setting lends support for the ecological validity of the simulation environment and its value in teamwork training. Different communication patterns and frequencies under the challenge of a crisis support the use of simulation to assess crisis management skills.

Particle statistics and lossy dynamics of ultracold atoms in optical lattices

NASA Astrophysics Data System (ADS)

Yago Malo, J.; van Nieuwenburg, E. P. L.; Fischer, M. H.; Daley, A. J.

2018-05-01

Experimental control over ultracold quantum gases has made it possible to investigate low-dimensional systems of both bosonic and fermionic atoms. In closed one-dimensional systems there are many similarities in the dynamics of local quantities for spinless fermions and strongly interacting "hard-core" bosons, which on a lattice can be formalized via a Jordan-Wigner transformation. In this study, we analyze the similarities and differences for spinless fermions and hard-core bosons on a lattice in the presence of particle loss. The removal of a single fermion causes differences in local quantities compared with the bosonic case because of the different particle exchange symmetry in the two cases. We identify deterministic and probabilistic signatures of these dynamics in terms of local particle density, which could be measured in ongoing experiments with quantum gas microscopes.

Social Construction of a Segregated Urban Space and Its Effects on Education: A Case Study of the Balmikis of Delhi

ERIC Educational Resources Information Center

Ganguly, Sriti

2018-01-01

While segregation of Dalit habitations is assumed to be a characteristic primarily of the rural, studies indicate that a similar spatial organisation is reproduced in urban spaces as well where large populations, particularly of poor Dalits, continue to live in segregated settlements. This article draws on an exploratory study conducted in one…

Reserve lithium-thionyl chloride battery for missile applications

NASA Astrophysics Data System (ADS)

Planchat, J. P.; Descroix, J. P.; Sarre, G.

A comparative performance study has been conducted for silver-zinc, thionyl chloride, and thermal batteries designed for such missile applications as ICBM guidance system power supplies. Attention is given to each of the three candidates' conformity to requirements concerning mechanical configuration, electrochemical design, electrolyte reservoir, external case, and gas generator. The silver-zinc and Li-SOCl2 candidates employ similar cell configurations and yield comparable performance. The thermal battery is found to be incapable of meeting battery case temperature-related requirements.

Sexual abuse in Chinese children in Hong Kong: a review of 134 cases.

PubMed

Ho, T P; Mak, F L

1992-12-01

This is a retrospective study of 134 cases of sexual abuse in Chinese children aged 16 years or under in Hong Kong. The data with respect to the victim's age, sex, severity and type (intra- or extrafamilial) of abuse, perpetrator's characteristics and family disturbances were analysed. The overall profile is similar to that reported in the West. The reasons for the apparently low prevalence, younger age of victim and low proportion of male victims are discussed.

Electrical and Mechanical Behavior of Nano-Filled Polymers through Molecular Dynamics Simulations

DTIC Science & Technology

2009-03-27

that case. The length of the fibers can be fixed or vary within a specified range; in the later case, every time a new fiber is going to be added to...trends and values of the simulation are similar to the experimental ones. The experimental values refer to MWCNT /PVDF composites with an average aspect...concentrations disagree with the multi wall carbon nanotube/poly(vinylidene fluoride) - MWCNT /PVDF - composite study by Wang and Dang [17] (0.0161), and

A Retrospective Case Series of Carbon Fiber Plate Fixation of Ankle Fractures.

PubMed

Pinter, Zachariah W; Smith, Kenneth S; Hudson, Parke W; Jones, Caleb W; Hadden, Ryan; Elattar, Osama; Shah, Ashish

2018-06-01

Distal fibula fractures represent a common problem in orthopaedics. When fibula fractures require operative fixation, implants are typically made from stainless steel or titanium alloys. Carbon fiber implants have been used elsewhere in orthopaedics for years, and their advantages include a modulus of elasticity similar to that of bone, biocompatibility, increased fatigue strength, and radiolucency. This study hypothesized that carbon fiber plates would provide similar outcomes for ankle fracture fixation as titanium and steel implants. A retrospective chart review was performed of 30 patients who underwent fibular open reduction and internal fixation (ORIF). The main outcomes assessed were postoperative union rate and complication rate. The nonunion or failure rate for carbon fiber plates was 4% (1/24), and the union rate was 96% (23/24). The mean follow-up time was 20 months, and the complication rate was 8% (2/24). Carbon fiber plates are a viable alternative to metal plates in ankle fracture fixation, demonstrating union and complication rates comparable to those of traditional fixation techniques. Their theoretical advantages and similar cost make them an attractive implant choice for ORIF of the fibula. However, further studies are needed for extended follow-up and inclusion of larger patient cohorts. Level IV: Retrospective Case series.

Ovarian endometriomas and IVF: a retrospective case-control study

PubMed Central

2011-01-01

We performed this retrospective case-control study analyzing 428 first-attempt in vitro fertilization (IVF) cycles, among which 254 involved women with a previous or present diagnosis of ovarian endometriosis. First, the results of these 254 cycles were compared with 174 cycles involving patients with proven non-endometriotic tubal infertility having similar age and body mass index. Women with ovarian endometriosis had a significantly higher cancellation rate, but similar pregnancy, implantation and delivery rates as patients with tubal infertility. Second, among the women with ovarian endometriosis, the women with a history of laparoscopic surgery for ovarian endometriomas prior to IVF and no visual endometriosis at ovum pick-up (n = 112) were compared with the non-operated women and visual endometriomas at ovum pick-up (n = 142). Patients who underwent ovarian surgery before IVF had significantly shorter period, lower antral follicle count and required higher gonadotropin doses than patients with non-operated endometriomas. The two groups of women with a previous or present ovarian endometriosis did, however, have similar pregnancy, implantation and live birth rates. In conclusion, ovarian endometriosis does not reduce IVF outcome compared with tubal factor. Furthermore, laparoscopic removal of endometriomas does not improve IVF results, but may cause a decrease of ovarian responsiveness to gonadotropins. PMID:21679474

Low-cost and no-cost practice to achieve energy efficiency of government office buildings: A case study in federal territory of Malaysia

NASA Astrophysics Data System (ADS)

Tahir, Mohamad Zamhari; Nawi, Mohd Nasrun Mohd; Ibrahim, Amlus

2016-08-01

This paper presents the findings of a case study to achieve energy-efficient performance of conventional office buildings in Malaysia. Two multi-storey office buildings in Federal Territory of Malaysia have been selected. The aim is to study building energy saving potential then to highlight the appropriate measures that can be implemented. Data was collected using benchmarking method by comparing the measured consumption to other similar office buildings and a series of preliminary audit which involves interviews, a brief review of utility and operating data as well as a walkthrough in the buildings. Additionally, in order to get a better understanding of major energy consumption in the selected buildings, general audit have been conducted to collect more detailed information about building operation. In the end, this study emphasized low-cost and no-cost practice to achieve energy efficiency with significant results in some cases.

Culture, risk factors and suicide in rural China: a psychological autopsy case control study.

PubMed

Zhang, J; Conwell, Y; Zhou, L; Jiang, C

2004-12-01

Previous research on sociocultural factors for Chinese suicide have been basically limited to single case studies or qualitative research with ethnographic methodology. The current study examines the major risk factors and some cultural uniqueness related to Chinese rural suicide using a quantitative design. This is a case control study with 66 completed suicides and 66 living controls obtained from psychological autopsy interviews in rural China. Both bivariate analyses and the multiple regression model have found that the Chinese rural suicide patterns are basically similar to those in most other cultures in the world: strong predictors of rural Chinese suicide are the psychopathological, psychological, and physical health variables, followed by social support and negative and stressful life events. Other significant correlates include lower education, poverty, religion, and family disputes. Culture has an important impact on suicide patterns in a society.

Culture, risk factors and suicide in rural China: a psychological autopsy case control study

PubMed Central

Zhang, J.; Conwell, Y.; Zhou, L.; Jiang, C.

2009-01-01

Objective Previous research on sociocultural factors for Chinese suicide have been basically limited to single case studies or qualitative research with ethnographic methodology. The current study examines the major risk factors and some cultural uniqueness related to Chinese rural suicide using a quantitative design. Method This is a case control study with 66 completed suicides and 66 living controls obtained from psychological autopsy interviews in rural China. Results Both bivariate analyses and the multiple regression model have found that the Chinese rural suicide patterns are basically similar to those in most other cultures in the world: strong predictors of rural Chinese suicide are the psychopathological, psychological, and physical health variables, followed by social support and negative and stressful life events. Other significant correlates include lower education, poverty, religion, and family disputes. Conclusion Culture has an important impact on suicide patterns in a society. PMID:15521827

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

Roper, J; Bradshaw, B; Godette, K

Purpose: To create a knowledge-based algorithm for prostate LDR brachytherapy treatment planning that standardizes plan quality using seed arrangements tailored to individual physician preferences while being fast enough for real-time planning. Methods: A dataset of 130 prior cases was compiled for a physician with an active prostate seed implant practice. Ten cases were randomly selected to test the algorithm. Contours from the 120 library cases were registered to a common reference frame. Contour variations were characterized on a point by point basis using principle component analysis (PCA). A test case was converted to PCA vectors using the same process andmore » then compared with each library case using a Mahalanobis distance to evaluate similarity. Rank order PCA scores were used to select the best-matched library case. The seed arrangement was extracted from the best-matched case and used as a starting point for planning the test case. Computational time was recorded. Any subsequent modifications were recorded that required input from a treatment planner to achieve an acceptable plan. Results: The computational time required to register contours from a test case and evaluate PCA similarity across the library was approximately 10s. Five of the ten test cases did not require any seed additions, deletions, or moves to obtain an acceptable plan. The remaining five test cases required on average 4.2 seed modifications. The time to complete manual plan modifications was less than 30s in all cases. Conclusion: A knowledge-based treatment planning algorithm was developed for prostate LDR brachytherapy based on principle component analysis. Initial results suggest that this approach can be used to quickly create treatment plans that require few if any modifications by the treatment planner. In general, test case plans have seed arrangements which are very similar to prior cases, and thus are inherently tailored to physician preferences.« less

Long-range dependence in earthquake-moment release and implications for earthquake occurrence probability.

PubMed

Barani, Simone; Mascandola, Claudia; Riccomagno, Eva; Spallarossa, Daniele; Albarello, Dario; Ferretti, Gabriele; Scafidi, Davide; Augliera, Paolo; Massa, Marco

2018-03-28

Since the beginning of the 1980s, when Mandelbrot observed that earthquakes occur on 'fractal' self-similar sets, many studies have investigated the dynamical mechanisms that lead to self-similarities in the earthquake process. Interpreting seismicity as a self-similar process is undoubtedly convenient to bypass the physical complexities related to the actual process. Self-similar processes are indeed invariant under suitable scaling of space and time. In this study, we show that long-range dependence is an inherent feature of the seismic process, and is universal. Examination of series of cumulative seismic moment both in Italy and worldwide through Hurst's rescaled range analysis shows that seismicity is a memory process with a Hurst exponent H ≈ 0.87. We observe that H is substantially space- and time-invariant, except in cases of catalog incompleteness. This has implications for earthquake forecasting. Hence, we have developed a probability model for earthquake occurrence that allows for long-range dependence in the seismic process. Unlike the Poisson model, dependent events are allowed. This model can be easily transferred to other disciplines that deal with self-similar processes.

Counseling Children and Adolescents: Rational Emotive Behavior Therapy and Humanism.

ERIC Educational Resources Information Center

Vernon, Ann

1996-01-01

Describes specific parallels between rational emotive behavior therapy and humanism. Places specific emphasis on the application of these principles with children and adolescents. Concepts are illustrated with case studies and a description of the similarities between rational emotive and humanistic, or affective, education. Highlights emotional…

A Study of the Development of Steady and Periodic Unsteady Turbulent Wakes Through Curved Channels at Positive, Zero, and Negative Streamwise Pressure Gradients, Part 1

NASA Technical Reports Server (NTRS)

Schobeiri, M. T.; John, J.

1996-01-01

The turbomachinery wake flow development is largely influenced by streamline curvature and streamwise pressure gradient. The objective of this investigation is to study the development of the wake under the influence of streamline curvature and streamwise pressure gradient. The experimental investigation is carried out in two phases. The first phase involves the study of the wake behind a stationary circular cylinder (steady wake) in curved channels at positive, zero, and negative streamwise pressure gradients. The mean velocity and Reynolds stress components are measured using a X-hot-film probe. The measured quantities obtained in probe coordinates are transformed to a curvilinear coordinate system along the wake centerline and are presented in similarity coordinates. The results of the steady wakes suggest strong asymmetry in velocity and Reynolds stress components. However, the velocity defect profiles in similarity coordinates are almost symmetrical and follow the same distribution as the zero pressure gradient straight wake. The results of Reynolds stress distributions show higher values on the inner side of the wake than the outer side. Other quantities, including the decay of maximum velocity defect, growth of wake width, and wake integral parameters, are also presented for the three different pressure gradient cases of steady wake. The decay rate of velocity defect is fastest for the negative streamwise pressure gradient case and slowest for the positive pressure gradient case. Conversely, the growth of the wake width is fastest for the positive streamwise pressure gradient case and slowest for the negative streamwise pressure gradient. The second phase studies the development of periodic unsteady wakes generated by the circular cylinders of the rotating wake generator in a curved channel at zero streamwise pressure gradient. Instantaneous velocity components of the periodic unsteady wakes, measured with a stationary X-hot-film probe, are analyzed by the phase averaging techniques. The temporal distribution of velocity and Reynolds stress components obtained in a stationary frame of reference are transformed to a spatial distribution in a relative frame of reference. Profiles of phase-averaged velocity and Reynolds stress distributions in the relative frame of reference and similarity coordinates are presented. The velocity defect and Reynolds stress distributions agree with the results of the wake development behind a stationary cylinder in the curved channel at zero streamwise pressure gradient. The phase-averaged third-order correlations, presented in the relative frame of reference and similarity coordinates, show pronounced asymmetric features.

Modeling of electrical and mesoscopic circuits at quantum nanoscale from heat momentum operator

NASA Astrophysics Data System (ADS)

El-Nabulsi, Rami Ahmad

2018-04-01

We develop a new method to study electrical circuits at quantum nanoscale by introducing a heat momentum operator which reproduces quantum effects similar to those obtained in Suykens's nonlocal-in-time kinetic energy approach for the case of reversible motion. The series expansion of the heat momentum operator is similar to the momentum operator obtained in the framework of minimal length phenomenologies characterized by the deformation of Heisenberg algebra. The quantization of both LC and mesoscopic circuits revealed a number of motivating features like the emergence of a generalized uncertainty relation and a minimal charge similar to those obtained in the framework of minimal length theories. Additional features were obtained and discussed accordingly.

A clinicopathological review of 34 cases of inflammatory breast disease showing an association between corynebacteria infection and granulomatous mastitis.

PubMed

Taylor, Graeme B; Paviour, Sue D; Musaad, Sahar; Jones, Wayne O; Holland, David J

2003-04-01

Granulomatous mastitis is a rare condition of unknown aetiology. The great majority of cases has not been associated with bacterial pathogens if women with mammary tuberculosis are excluded. We noted that some women in Auckland with a histological diagnosis of granulomatous mastitis had both microbiological and histological evidence of corynebacteria infection and aimed to study this further. Thirty-four women were reviewed who presented with inflammatory breast disease and had microbiological specimens from which corynebacteria were isolated and/or histological specimens containing coryneform bacteria. These 34 cases were compared with 28 controls with similar histology but no evidence of corynebacteria infection. Twenty-seven (79%) of the cases and 21 (75%) of the controls had histological and/or cytological evidence of suppurative granulomas. Fourteen of the 34 cases also had Gram-positive bacilli (GPB), recognisable as coryneform bacteria, in histological sections. In all cases the bacilli were confined to empty spaces, consistent with dissolved lipid, and were surrounded by neutrophils and, frequently, suppurative granulomas. Corynebacterium species were isolated from 52 of 116 microbiological specimens taken from the 34 cases. Forty of these 52 cultures were pure. Twenty-four of the cultures were further classified biochemically and using 16S rRNA gene sequencing. Twenty of the 24 were lipophilic Corynebacterium species and 14 were identified as Corynebacterium kroppenstedtii. The cases were more likely to present with fever or neutrophilia and more often formed sinuses than the controls but other clinical features were similar. Maori and Pacific Islanders accounted for 77% of the women across both groups. We suggest granulomatous mastitis can be associated with corynebacteria infection, particularly infection by C. kroppenstedtii. The significance of this finding, which has previously been described in only a single case report, is discussed.

The morphologic and immunohistochemical spectrum of papillary renal cell carcinoma: study including 132 cases with pure type 1 and type 2 morphology as well as tumors with overlapping features.

PubMed

Chevarie-Davis, Myriam; Riazalhosseini, Yasser; Arseneault, Madeleine; Aprikian, Armen; Kassouf, Wassim; Tanguay, Simon; Latour, Mathieu; Brimo, Fadi

2014-07-01

Papillary renal cell carcinomas (pRCC) are classically divided into type 1 and 2 tumors. However, many cases do not fulfill all the criteria for either type. We describe the clinical, morphologic, and immunohistochemical (IHC) features of 132 pRCCs to better characterize the frequency and nature of tumors with overlapping features. Cases were reviewed and classified; IHC evaluation of CK7, EMA, TopoIIα, napsin A, and AMACR was performed on 95 cases. The frequencies of type 1, type 2, and "overlapping" pRCC were 25%, 28%, and 47%, respectively. The 2 categories of "overlapping" tumors were: (1) cases with bland cuboidal cells but no basophilic cytoplasm (type A); and (2) cases with predominantly type 1 histology admixed with areas showing prominent nucleoli (type B). The pathologic stage of "overlapping" cases showed concordance with type 1 tumors. Using the 2 discriminatory markers (CK7, EMA), "type A" cases were similar to type 1. Although the high-nuclear grade areas of "type B" tumors showed some staining differences from their low-nuclear grade counterpart, their IHC profile was closer to type 1. Single nucleotide polymorphism array results, although preliminary and restricted to only 9 cases (3 with overlapping features), also seemed to confirm those findings. In conclusion, we demonstrate that variations in cytoplasmic quality and/or presence of high-grade nuclei in tumors otherwise displaying features of type 1 pRCCs are similar in stage and IHC profile those with classic type 1 histology, suggesting that their spectrum might be wider than originally described.

The Legal System and Alzheimer's Disease: Social Workers and Lawyers' Perceptions and Experiences.

PubMed

Werner, Perla; Doron, Israel Issi

2016-01-01

The expected increase in the number of people living with Alzheimer's disease (AD) worldwide will be accompanied by an increase in the number of cases involving persons with AD brought up to the courts. This study examined the perceptions and experiences of social workers and lawyers regarding these cases. Three focus groups including social workers and lawyers (n = 26) were conducted. Two main themes were raised by the participants: (a) the role of social workers and lawyers in court cases regarding AD, and (b) the need for improving legal encounters involving persons with AD. Similarities and differences were found in both professionals' interpretations of these shared themes. Results of this study emphasize the need for increasing the knowledge and interprofessional training provided to social workers and lawyers involved in legal cases dealing with issues involving persons with Alzheimer's disease.

Grindability of alpha-case formed on cast titanium.

PubMed

Koike, Marie; Jacobson, David; Chan, Kwai S; Okabe, Toru

2009-09-01

The hardened alpha-case (alpha-case) layer inevitably forms on the surface of titanium castings when prepared by investment casting. Because the hardness of the alpha-case is incomparable to that of the interior structure, the perception exists that the alpha-case is difficult to remove during cutting, grinding and polishing. Grindability (ease of grinding) of cast cpTi and cast Ti-6Al-4V was evaluated by grinding cast specimens incrementally using a SiC abrasive wheel. The present study revealed that the presence of the brittle alpha-case with lower fracture toughness is beneficial in grinding titanium. The alpha-case on the ductile cpTi can be ground much easier than its bulk interior structure. In less ductile Ti-6Al-4V, the grinding rate is much higher than that of cpTi, and the alpha-case and its interior structure are at similar levels since the fracture toughness of its alpha-case and the bulk material is not large enough.

The effect of body shape on weight-for-height and mid-upper arm circumference based case definitions of acute malnutrition in Ethiopian children.

PubMed

Myatt, Mark; Duffield, Arabella; Seal, Andrew; Pasteur, Frances

2009-01-01

Nutritional anthropometry surveys from Somalia and Ethiopia have reported that standard weight-for-height z-score (WHZ) and mid-upper arm circumference (MUAC) case definitions return different estimates of the prevalence of acute malnutrition in pastoralist livelihood zones but similar estimates of the prevalence of acute malnutrition in the agrarian livelihood zones. A study undertaken in Somalia to investigate this finding reported that children from pastoralist livelihood zones tended to have longer limbs and lower SSRs than children from agrarian livelihood zones. The present study investigated the relationship between weight-for-height and body shape and the relationship between MUAC and body shape in different populations of Ethiopian children. Six cross-sectional nutritional anthropometry surveys were undertaken. The combined survey datasets form the study sample. Data sources were grouped according to the livelihood zone from which data originated (either settled agrarian or semi-nomadic pastoralist). Case definitions of acute malnutrition using WHZ calculated using the NCHS and WHO reference populations and MUAC uncorrected for age or height were used. The SSR was used as an index of body shape. The association between body shape and the different case definitions of acute malnutrition were investigated using standard statistical techniques. Weight-for-height and MUAC case definitions yielded similar estimates of the prevalence of acute malnutrition in agrarian children but different estimates of the prevalence of acute malnutrition in pastoralist children. These populations also exhibit different SSRs. The SSR is an important predictor of weight-for-height. The SSR is a poor predictor of MUAC. WHZ and WHZ case status in children are associated with body shape and may overestimate the prevalence of acute malnutrition in some populations. Consideration should be given as to whether WHZ should be replaced by MUAC for the purposes of estimating the prevalence of acute malnutrition.

Comparison of the clinical presentations of Naegleria fowleri primary amoebic meningoencephalitis with pneumococcal meningitis: a case-control study.

PubMed

Zahid, Mohammad Faizan; Saad Shaukat, Muhammad Hamza; Ahmed, Bilal; Beg, Mohammad Asim; Kadir, Muhammad Masood; Mahmood, Syed Faisal

2016-08-01

Primary amoebic meningoencephalitis (PAM) is a rare but fatal infection caused by Naegleria fowleri. The infection is acquired by deep nasal irrigation with infected water. Patients present with signs and symptoms similar to pneumococcal meningitis, leading to delayed diagnosis and treatment and hence high mortality. We conducted a case-control study comparing culture proven cases of PAM with pneumococcal meningitis presenting to our center between April 2008 and September 2014. Only patients with blood and/or cerebrospinal fluid cultures positive for Streptococcus pneumoniae during the same time period were included for comparison. There were 19 cases of PAM and pneumococcal meningitis, each. When comparing PAM with pneumococcal meningitis, patients with PAM were more likely to be male (89.5 vs. 36.8 %), younger (mean age: 30 vs. 59 years), present with seizures (42.1 vs. 5.3 %). Both groups of patients presented with similar vital signs and there were no remarkable differences on physical examinations, Glasgow Coma Scale scores, laboratory and radiological investigations and cerebrospinal fluid parameters. PAM was also more likely to present if the city's average maximum temperature was higher in the previous week (mean: 34.6 vs. 30 °C). There was history of fresh water contact in only one patient. On multivariate analysis, PAM was more likely if patients presented when the city's average maximum temperature was high, being young males. PAM and pneumococcal meningitis remain virtually indistinguishable; however, these predictive features should be validated in a prospective study and may lead to a viable algorithm for early management of these patients.

Transient and asymptotic behaviour of the binary breakage problem

NASA Astrophysics Data System (ADS)

Mantzaris, Nikos V.

2005-06-01

The general binary breakage problem with power-law breakage functions and two families of symmetric and asymmetric breakage kernels is studied in this work. A useful transformation leads to an equation that predicts self-similar solutions in its asymptotic limit and offers explicit knowledge of the mean size and particle density at each point in dimensionless time. A novel moving boundary algorithm in the transformed coordinate system is developed, allowing the accurate prediction of the full transient behaviour of the system from the initial condition up to the point where self-similarity is achieved, and beyond if necessary. The numerical algorithm is very rapid and its results are in excellent agreement with known analytical solutions. In the case of the symmetric breakage kernels only unimodal, self-similar number density functions are obtained asymptotically for all parameter values and independent of the initial conditions, while in the case of asymmetric breakage kernels, bimodality appears for high degrees of asymmetry and sharp breakage functions. For symmetric and discrete breakage kernels, self-similarity is not achieved. The solution exhibits sustained oscillations with amplitude that depends on the initial condition and the sharpness of the breakage mechanism, while the period is always fixed and equal to ln 2 with respect to dimensionless time.

MOST: most-similar ligand based approach to target prediction.

PubMed

Huang, Tao; Mi, Hong; Lin, Cheng-Yuan; Zhao, Ling; Zhong, Linda L D; Liu, Feng-Bin; Zhang, Ge; Lu, Ai-Ping; Bian, Zhao-Xiang

2017-03-11

Many computational approaches have been used for target prediction, including machine learning, reverse docking, bioactivity spectra analysis, and chemical similarity searching. Recent studies have suggested that chemical similarity searching may be driven by the most-similar ligand. However, the extent of bioactivity of most-similar ligands has been oversimplified or even neglected in these studies, and this has impaired the prediction power. Here we propose the MOst-Similar ligand-based Target inference approach, namely MOST, which uses fingerprint similarity and explicit bioactivity of the most-similar ligands to predict targets of the query compound. Performance of MOST was evaluated by using combinations of different fingerprint schemes, machine learning methods, and bioactivity representations. In sevenfold cross-validation with a benchmark Ki dataset from CHEMBL release 19 containing 61,937 bioactivity data of 173 human targets, MOST achieved high average prediction accuracy (0.95 for pKi ≥ 5, and 0.87 for pKi ≥ 6). Morgan fingerprint was shown to be slightly better than FP2. Logistic Regression and Random Forest methods performed better than Naïve Bayes. In a temporal validation, the Ki dataset from CHEMBL19 were used to train models and predict the bioactivity of newly deposited ligands in CHEMBL20. MOST also performed well with high accuracy (0.90 for pKi ≥ 5, and 0.76 for pKi ≥ 6), when Logistic Regression and Morgan fingerprint were employed. Furthermore, the p values associated with explicit bioactivity were found be a robust index for removing false positive predictions. Implicit bioactivity did not offer this capability. Finally, p values generated with Logistic Regression, Morgan fingerprint and explicit activity were integrated with a false discovery rate (FDR) control procedure to reduce false positives in multiple-target prediction scenario, and the success of this strategy it was demonstrated with a case of fluanisone. In the case of aloe-emodin's laxative effect, MOST predicted that acetylcholinesterase was the mechanism-of-action target; in vivo studies validated this prediction. Using the MOST approach can result in highly accurate and robust target prediction. Integrated with a FDR control procedure, MOST provides a reliable framework for multiple-target inference. It has prospective applications in drug repurposing and mechanism-of-action target prediction.

Trauma and conditional risk of posttraumatic stress disorder in two American Indian reservation communities.

PubMed

Beals, Janette; Belcourt-Dittloff, Annjeanette; Garroutte, Eva M; Croy, Calvin; Jervis, Lori L; Whitesell, Nancy Rumbaugh; Mitchell, Christina M; Manson, Spero M

2013-06-01

To determine conditional risk of posttraumatic stress disorder (PTSD) in two culturally distinct American Indian reservation communities. Data derived from the American Indian Service Utilization, Psychiatric Epidemiology, Risk and Protective Factors Project, a cross-sectional population-based survey that was completed between 1997 and 2000. This study focused on 1,967 participants meeting the DSM-IV criteria for trauma exposure. Traumas were grouped into interpersonal, non-interpersonal, witnessed, and "trauma to close others" categories. Analyses examined distribution of worst traumas, conditional rates of PTSD following exposure, and distributions of PTSD cases deriving from these events. Bivariate and multivariate logistic regressions estimated associations of lifetime PTSD with trauma type. Overall, 15.9 % of those exposed to DSM-IV trauma qualified for lifetime PTSD, a rate comparable to similar US studies. Women were more likely to develop PTSD than were men. The majority (60 %) of cases of PTSD among women derived from interpersonal trauma exposure (in particular, sexual and physical abuse); among men, cases were more evenly distributed across trauma categories. Previous research has demonstrated higher rates of both trauma exposure and PTSD in American Indian samples compared to other Americans. This study shows that conditional rates of PTSD are similar to those reported elsewhere, suggesting that the elevated prevalence of this disorder in American Indian populations is largely due to higher rates of trauma exposure.

A residual stress study in similar and dissimilar welds

DOE PAGES

Eisazadeh, Hamid; Goldak, John A.; Aidun, Daryush K.; ...

2016-04-01

Residual strain distributions in similar and dissimilar welds were measured using neutron diffraction (ND) method. Then, using three strain components, three-dimensional stress states were calculated. The results were used to determine the effect of the martensitic phase transformation and material properties on residual stress (RS) distribution. It was observed that smaller longitudinal RS was induced in the low carbon steel side of dissimilar weld when compared to its similar weld. Also, it was found that the transverse RS near and within the weld zone (WZ) in dissimilar weld exhibited a distinctive trend, with tensile mode reaching the yield strength ofmore » the base metal (BM). In order to characterize the WZ in dissimilar weld, we deployed optical microscopy, hardness, and energy dispersive X-ray spectroscopy (EDAX). This study not only provides further insight into the RS state in similar and dissimilar welds; it also delivers important consequences of phase transformation in the latter case.« less

Description of the case mix experienced by chiropractic students during a clinical internship.

PubMed

Puhl, Aaron A; Reinhart, Christine J; Injeyan, H Stephen; Tibbles, Anthony

2017-10-01

The primary objective of this study was to describe the case mix experienced by chiropractic students during their clinical internship at the Canadian Memorial Chiropractic College. Secondary objectives were to characterize teaching clinic patient populations, assess the similarity to previously published data for practicing chiropractors, and describe the treatment plans being recommended by interns. A prospective, observational study was conducted using a convenience sample of 24 chiropractic interns. Data were collected by interns using a standardized form that was completed for each new patient and each new complaint examined during the 1-year internship. Standardized forms included data regarding patient demographics, complaint characteristics, and treatment recommendations. Data were included for 23 of 24 participating interns, who described 828 patients and a total of 948 unique complaint presentations. Overall, 60% of patients were female, 86% were 18 to 64 years old, and 23% were naive to chiropractic care. Of all presenting complaints, 93% were pain-based, 67% were chronic, 65% included spinal complaints, and 7% presented with red flags; individual interns' experiences were variable and are described. On average, treatment recommendations called for 9.4 visits and often included multimodal treatment approaches, most commonly soft-tissue therapies (91%), home-based active care (84%), and spine manipulation (70%). The findings of this study suggest that patients presenting to CMCC teaching clinics are similar to those reported previously to attend private chiropractic clinics. While all participating interns encountered multiple complex clinical cases, very few had experience with pediatric populations. This study adds to the few that detail the characteristics of patients attending chiropractic teaching clinics; to our knowledge it is the first to describe average case loads of chiropractic interns.

Direct simulation of a self-similar plane wake

NASA Technical Reports Server (NTRS)

Moser, Robert D.; Rogers, Michael M.

1994-01-01

Direct simulations of two time-developing turbulent wakes have been performed. Initial conditions for the simulations were obtained from two realizations of a direct simulation of a turbulent boundary layer at momentum thickness Reynolds number 670. In addition, extra two dimensional disturbances were added in one of the cases to mimic two dimensional forcing. The unforced wake is allowed to evolve long enough to attain self similarity. The mass-flux Reynolds number (equivalent to the momentum thickness Reynolds number in spatially developing wakes) is 2000, which is high enough for a short k(exp -5/3) range to be evident in the streamwise one dimensional velocity spectrum. Several turbulence statistics have been computed by averaging in space and over the self-similar period in time. The growth rate in the unforced flow is low compared to experiments, but when this growth-rate difference is accounted for, the statistics of the unforced case are in reasonable agreement with experiments. However, the forced case is significantly different. The growth rate, turbulence Reynolds number, and turbulence intensities are as much as ten times larger in the forced case. In addition, the forced flow exhibits large-scale structures similar to those observed in transitional wakes, while the unforced flow does not.

[Auricular arrhythmia in Steinert's myotonia. Apropos of a case with a familial study].

PubMed

Chagnon, A; Vidal, M E

1983-02-24

A case of bradycardia-tachycardia syndrome leading to the late discovery of Steinert syndrome is reported. There is a discrepancy between the frequency of the main features of the bradycardia-tachycardia syndrome (sinoatrial block and atrial flutter in our observation) usually reported in Steinert disease and the fact that no case similar to ours seems to have yet been reported; this suggests definite underrating. Insertion of a pacemaker should avoid sudden death from a conduction disturbance. The heart should be carefully monitored in patients with myotonic dystrophy; conversely, this diagnosis should be considered in the etiologic diagnosis of myocardiopathies.

Homeopathic approach in the treatment of patients with mental disability.

PubMed

Dolce Filho, R

2006-01-01

The author describes his experience assisting mentally disabled patients with homeopathy. In these patients' anamneses, common traits shared by some syndromes, pathologies and behaviour, were taken into consideration, mainly to choose the most characteristic symptoms in each case. The study includes 58 cases of patients suffering from this pathology: 28 females and 30 males, ages ranging from 1 to 49 years (mean 20). Forty-seven had some improvement. Homeopathy is a useful alternative to relieve pathologies associated with mental disability. In those cases in which there were similarities between remedy and whole symptomatology, improvements in adaptation skills and in overall health were observed.

A Case Study Approach to Nursing Home Placement: Smooth and Difficult Cases and Implications for Nursing.

PubMed

Koplow, Sarah M; Gallo, Agatha M; Knafl, Kathleen A; Vincent, Catherine; Paun, Olimpia; Gruss, Valerie

2015-07-01

Nursing home placement is one of the most challenging aspects of the caregiving journey. A case study approach was used to understand the experiences of caregivers during the first few months following nursing home placement. Two caregivers were selected from a larger qualitative descriptive study because their experiences exemplified smooth and difficult transitions for both themselves and their older family member. The caregivers were interviewed shortly after placement and 3 months post-placement. Four major contextual issues were identified that indicated the similarities and differences between the two cases, including (a) the caregiver's relationship with the older adult during the home caregiving time and post nursing home placement, (b) the circumstances surrounding placement, (c) support systems, and (d) continued involvement in care post-placement. Nursing home staff who understand these issues and address concerns through family-centered care can ease the transition and promote successful collaborations between staff and families. Copyright 2015, SLACK Incorporated.

Investigation of Rossby-number similarity in the neutral boundary layer using large-eddy simulation

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

Ohmstede, W.D.; Cederwall, R.T.; Meyers, R.E.

One special case of particular interest, especially to theoreticians, is the steady-state, horizontally homogeneous, autobarotropic (PLB), hereafter referred to as the neutral boundary layer (NBL). The NBL is in fact a 'rare' atmospheric phenomenon, generally associated with high-wind situations. Nevertheless, there is a disproportionate interest in this problem because Rossby-number similarity theory provides a sound approach for addressing this issue. Rossby-number similarity theory has rather wide acceptance, but because of the rarity of the 'true' NBL state, there remains an inadequate experimental database for quantifying constants associated with the Rossby-number similarity concept. Although it remains a controversial issue, it hasmore » been proposed that large-eddy simulation (LES) is an alternative to physical experimentation for obtaining basic atmospherc 'data'. The objective of the study reported here is to investigate Rossby-number similarity in the NBL using LES. Previous studies have not addressed Rossby-number similarity explicitly, although they made use of it in the interpretation of their results. The intent is to calculate several sets of NBL solutions that are ambiguous relative to the their respective Rossby numbers and compare the results for similarity, or the lack of it. 14 refs., 1 fig.« less

DK phocomelia phenotype (von Voss-Cherstvoy syndrome) caused by somatic mosaicism for del(13q).

PubMed

Bamforth, J S; Lin, C C

1997-12-31

DK phocomelia (von Voss-Cherstvoy syndrome) is a rare condition characterized by radial ray defects, occipital encephalocoele, and urogenital abnormalities. Lubinsky et al. [1994: Am J Med Genet 52:272-278] pointed out similarities between this and the del(13q) syndrome. To date, all reported cases of DK phocomelia have been apparently normal chromosomally. We report on a case of DK phocomelia in which the proposita had normal lymphocyte chromosomes, but was mosaic in fibroblasts for del(13)(q12). Fibroblast chromosomes studies on other cases of DK phocomelia have not been reported: this raises the possibility that some cases of DK phocomelia may be somatic mosaics for del(13)(q12).

Predictive Modeling of Human Perception Subjectivity: Feasibility Study of Mammographic Lesion Similarity

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

Xu, Songhua; Tourassi, Georgia

2012-01-01

The majority of clinical content-based image retrieval (CBIR) studies disregard human perception subjectivity, aiming to duplicate the consensus expert assessment of the visual similarity on example cases. The purpose of our study is twofold: (i) discern better the extent of human perception subjectivity when assessing the visual similarity of two images with similar semantic content, and (ii) explore the feasibility of personalized predictive modeling of visual similarity. We conducted a human observer study in which five observers of various expertise were shown ninety-nine triplets of mammographic masses with similar BI-RADS descriptors and were asked to select the two masses withmore » the highest visual relevance. Pairwise agreement ranged between poor and fair among the five observers, as assessed by the kappa statistic. The observers' self-consistency rate was remarkably low, based on repeated questions where either the orientation or the presentation order of a mass was changed. Various machine learning algorithms were explored to determine whether they can predict each observer's personalized selection using textural features. Many algorithms performed with accuracy that exceeded each observer's self-consistency rate, as determined using a cross-validation scheme. This accuracy was statistically significantly higher than would be expected by chance alone (two-tailed p-value ranged between 0.001 and 0.01 for all five personalized models). The study confirmed that human perception subjectivity should be taken into account when developing CBIR-based medical applications.« less

The Hands-Off Pilot Study of the Skills for Ethical Action Instructional Materials. Volume I: The Case Studies.

ERIC Educational Resources Information Center

Research for Better Schools, Inc., Philadelphia, PA.

Recognizing that similar approaches to moral education operate differently in different school settings, this paper assesses the methods and impact of a moral education course (Skills for Ethical Action, SEA) in six junior high school settings. SEA is an instructional program designed to teach seventh, eighth, and ninth grade students a…

Urban Educational Change: Building Trust and Alignment among Fragmented Coalitions of Color

ERIC Educational Resources Information Center

Stewart, Tricia J.; Finnigan, Kara S.

2017-01-01

This article is a historical case study of an attempt to build a citywide coalition in Rochester, NY. The coalition wanted to improve urban education by implementing community based wrap-around supports in a similar form as the well-respected Harlem Children's Zone. Our study found that groups had difficulty creating buy-in for this reform effort…

Gendered Universities and the Wage Gap: Case Study of a Pay Equity Audit in an Australian University

ERIC Educational Resources Information Center

Currie, Jan; Hill, Beverley

2013-01-01

Studies worldwide have found that women's pay lags behind men's in academia. This article describes pay equity policies in Australia and overseas and the use of a pay equity audit as a strategic tool to reduce gender inequities at The University of Western Australia (UWA). As a research-intensive university, UWA resembles similar universities…

Word and Number Reading in the Brain: Evidence from a Voxel-Based Lesion-Symptom Mapping Study

ERIC Educational Resources Information Center

Piras, Fabrizio; Marangolo, Paola

2009-01-01

The high incidence of number transcoding deficits in aphasic subjects suggests there is a strong similarity between language and number domains. However, recent single case studies of subjects who showed a dissociation between word and number word transcoding led us to hypothesize that the two types of stimuli are represented independently in the…

An Examination of Resource Allocation Strategies and Finance Adequacy: Case Studies of American Samoa Department of Education Secondary Schools

ERIC Educational Resources Information Center

Nikolao-Mutini, Akenese Epifania

2012-01-01

The purpose of this study was to analyze American Samoa Department of Education (ASDE) and collect allocation of resources data and determine how the resources are used to increase student performance among a purposeful sample of three public high schools with similar demographics, challenges, fiscal constraints and funding sources located in the…

Cholera and shigellosis: different epidemiology but similar responses to climate variability.

PubMed

Cash, Benjamin A; Rodó, Xavier; Emch, Michael; Yunus, Md; Faruque, Abu S G; Pascual, Mercedes

2014-01-01

Comparative studies of the associations between different infectious diseases and climate variability, such as the El Niño-Southern Oscillation, are lacking. Diarrheal illnesses, particularly cholera and shigellosis, provide an important opportunity to apply a comparative approach. Cholera and shigellosis have significant global mortality and morbidity burden, pronounced differences in transmission pathways and pathogen ecologies, and there is an established climate link with cholera. In particular, the specific ecology of Vibrio cholerae is often invoked to explain the sensitivity of that disease to climate. The extensive surveillance data of the International Center for Diarrheal Disease Research, Bangladesh are used here to revisit the known associations between cholera and climate, and to address their similarity to previously unexplored patterns for shigellosis. Monthly case data for both the city of Dhaka and a rural area known as Matlab are analyzed with respect to their association with El Niño and flooding. Linear correlations are examined between flooding and cumulative cases, as well as for flooding and El Niño. Rank-correlation maps are also computed between disease cases in the post-monsoon epidemic season and sea surface temperatures in the Pacific. Similar climate associations are found for both diseases and both locations. Increased cases follow increased monsoon flooding and increased sea surface temperatures in the preceding winter corresponding to an El Niño event. The similarity in association patterns suggests a systemic breakdown in population health with changing environmental conditions, in which climate variability acts primarily through increasing the exposure risk of the human population. We discuss these results in the context of the on-going debate on the relative importance of the environmental reservoir vs. secondary transmission, as well as the implications for the use of El Niño as an early indicator of flooding and enteric disease risk.

Cholera and Shigellosis: Different Epidemiology but Similar Responses to Climate Variability

PubMed Central

Cash, Benjamin A.; Rodó, Xavier; Emch, Michael; Yunus, Md.; Faruque, Abu S. G.; Pascual, Mercedes

2014-01-01

Background Comparative studies of the associations between different infectious diseases and climate variability, such as the El Niño-Southern Oscillation, are lacking. Diarrheal illnesses, particularly cholera and shigellosis, provide an important opportunity to apply a comparative approach. Cholera and shigellosis have significant global mortality and morbidity burden, pronounced differences in transmission pathways and pathogen ecologies, and there is an established climate link with cholera. In particular, the specific ecology of Vibrio cholerae is often invoked to explain the sensitivity of that disease to climate. Methods and Findings The extensive surveillance data of the International Center for Diarrheal Disease Research, Bangladesh are used here to revisit the known associations between cholera and climate, and to address their similarity to previously unexplored patterns for shigellosis. Monthly case data for both the city of Dhaka and a rural area known as Matlab are analyzed with respect to their association with El Niño and flooding. Linear correlations are examined between flooding and cumulative cases, as well as for flooding and El Niño. Rank-correlation maps are also computed between disease cases in the post-monsoon epidemic season and sea surface temperatures in the Pacific. Similar climate associations are found for both diseases and both locations. Increased cases follow increased monsoon flooding and increased sea surface temperatures in the preceding winter corresponding to an El Niño event. Conclusions The similarity in association patterns suggests a systemic breakdown in population health with changing environmental conditions, in which climate variability acts primarily through increasing the exposure risk of the human population. We discuss these results in the context of the on-going debate on the relative importance of the environmental reservoir vs. secondary transmission, as well as the implications for the use of El Niño as an early indicator of flooding and enteric disease risk. PMID:25229494

Estimation Methods for Non-Homogeneous Regression - Minimum CRPS vs Maximum Likelihood

NASA Astrophysics Data System (ADS)

Gebetsberger, Manuel; Messner, Jakob W.; Mayr, Georg J.; Zeileis, Achim

2017-04-01

Non-homogeneous regression models are widely used to statistically post-process numerical weather prediction models. Such regression models correct for errors in mean and variance and are capable to forecast a full probability distribution. In order to estimate the corresponding regression coefficients, CRPS minimization is performed in many meteorological post-processing studies since the last decade. In contrast to maximum likelihood estimation, CRPS minimization is claimed to yield more calibrated forecasts. Theoretically, both scoring rules used as an optimization score should be able to locate a similar and unknown optimum. Discrepancies might result from a wrong distributional assumption of the observed quantity. To address this theoretical concept, this study compares maximum likelihood and minimum CRPS estimation for different distributional assumptions. First, a synthetic case study shows that, for an appropriate distributional assumption, both estimation methods yield to similar regression coefficients. The log-likelihood estimator is slightly more efficient. A real world case study for surface temperature forecasts at different sites in Europe confirms these results but shows that surface temperature does not always follow the classical assumption of a Gaussian distribution. KEYWORDS: ensemble post-processing, maximum likelihood estimation, CRPS minimization, probabilistic temperature forecasting, distributional regression models

Thermo-elastic-plastic analysis for elastic component under high temperature fatigue crack growth rate

NASA Astrophysics Data System (ADS)

Ali, Mohammed Ali Nasser

The research project presents a fundamental understanding of the fatigue crack growth mechanisms of AISI 420 martensitic stainless steel, based on the comparison analysis between the theoretical and numerical modelling, incorporating research findings under isothermal fatigue loading for solid cylindrical specimen and the theoretical modelling with the numerical simulation for tubular specimen when subjected to cyclic mechanical loading superimposed by cyclic thermal shock.The experimental part of this research programme studied the fatigue stress-life data for three types of surface conditions specimen and the isothermal stress-controlled fatigue testing at 300 °C - 600 °C temperature range. It is observed that the highest strength is obtained for the polished specimen, while the machined specimen shows lower strength, and the lowest strength is the notched specimen due to the high effect of the stress concentration. The material behaviour at room and high temperatures shows an initial hardening, followed by slow extension until fully plastic saturation then followed by crack initiation and growth eventually reaching the failure of the specimen, resulting from the dynamic strain ageing occurred from the transformation of austenitic microstructure to martensite and also, the nucleation of precipitation at grain boundaries and the incremental temperature increase the fatigue crack growth rate with stress intensity factor however, the crack growth rate at 600 °C test temperature is less than 500 °C because of the creep-fatigue taking place.The theoretical modelling presents the crack growth analysis and stress and strain intensity factor approaches analysed in two case studies based on the addition of thermo-elastic-plastic stresses to the experimental fatigue applied loading. Case study one estimates the thermal stresses superimposed sinusoidal cyclic mechanical stress results in solid cylinder under isothermal fatigue simulation. Case study two estimates the transient thermal stresses superimposed on cyclic mechanical loading results in hollow cylinder under thermal shock in heating case and down shock cooling case. The combination of stress and strain intensity factor theoretical calculations with the experimental output recorded data shows a similar behaviour with increasing temperature, and there is a fair correlation between the profiles at the beginning and then divergence with increasing the crack length. The transient influence of high temperature in case two, giving a very high thermal shock stress as a heating or cooling effects, shifting up the combined stress, when applied a cyclic mechanical load in fraction of seconds, and the reputations of these shocks, causing a fast failure under high thermal shock stress superimposed with mechanical loading.Finally, the numerical modelling analyses three cases studied were solved due to the types of loading and types of specimen geometry by using finite element models constructed through the ANSYS Workbench version 13.0. The first case is a low cyclic fatigue case for a solid cylinder specimen simulated by applying a cyclic mechanical loading. The second is an isothermal fatigue case for solid cylinder specimen simulated by supplying different constant temperatures on the outer surface with cyclic mechanical loading, where the two cases are similar to the experimental tests and the third case, is a thermo-mechanical fatigue for a hollow cylinder model by simulating a thermal up-shock generated due to transient heating on the outer surface of the model or down shock cooling on the inner surface with the cyclic mechanical loading. The results show a good agreement with the experimental data in terms of alternative stress and life in the first case. In case two results show the strain intensity factor is increases with increasing temperature similar to the theoretical solution due to the influence of the modulus of elasticity and the difference in life estimation with the experimental output record is related to the input data made of theoretical physical properties and the experimental stress-life data.

Knowledge-based model building of proteins: concepts and examples.

PubMed Central

Bajorath, J.; Stenkamp, R.; Aruffo, A.

1993-01-01

We describe how to build protein models from structural templates. Methods to identify structural similarities between proteins in cases of significant, moderate to low, or virtually absent sequence similarity are discussed. The detection and evaluation of structural relationships is emphasized as a central aspect of protein modeling, distinct from the more technical aspects of model building. Computational techniques to generate and complement comparative protein models are also reviewed. Two examples, P-selectin and gp39, are presented to illustrate the derivation of protein model structures and their use in experimental studies. PMID:7505680

Giant fibroadenomatoid hyperplasia of the breast: a case report.

PubMed

Zhang, Hao; Wang, Xin-Lu; Ren, Wei-Dong; Shi, Tie-Mei

2014-01-01

Fibroadenomatoid hyperplasia of the breast (FAHB) is a rare benign breast lesion and its clinical features are similar to fibroadenoma and fibrocystic changes. FAHB has been previously termed sclerosing lobular hyperplasia, fibroadenomatosis, fibroadenomatoid change, or fibroadenomatoid mastopathy. Typically, FAHB is derived from stroma and epithelia. The pathologic characteristics of FAHB are microfocal lobulocentric proliferation of stroma accompanied by epithelial and myoepithelial components resembling similar histological changes, as found in fibroadenoma, apocrine hyperplasia, intraductal hyperplasia, and lobular hyperplasia. FAHB could be present as a localized or diffused pattern in pathology. Most cases show no well-circumscribed mass lesions and no apparent capsules; it is usually identified as an incidental finding in other benign lesions or in random sampling in cancerous breast tissues. FAHB is categorized as a benign proliferative breast disease and it has previously been reported; however, the authors believe this study may be the first case with two giant masses reported. Fiber adenoma hyperplasia is a rare cystic hyperplasia of breast pathology and its ultrasonographic manifestations are easily confused with breast cancer. Comparative MRI ultrasound analysis will help make the differential diagnosis. © 2014 S. Karger AG, Basel.

Detecting and (not) dealing with plagiarism in an engineering paper: beyond CrossCheck-a case study.

PubMed

Zhang, Xin-xin; Huo, Zhao-lin; Zhang, Yue-hong

2014-06-01

In papers in areas such as engineering and the physical sciences, figures, tables and formulae are the basic elements to communicate the authors' core ideas, workings and results. As a computational text-matching tool, CrossCheck cannot work on these non-textual elements to detect plagiarism. Consequently, when comparing engineering or physical sciences papers, CrossCheck may return a low similarity index even when plagiarism has in fact taken place. A case of demonstrated plagiarism involving engineering papers with a low similarity index is discussed, and editor's experiences and suggestions are given on how to tackle this problem. The case shows a lack of understanding of plagiarism by some authors or editors, and illustrates the difficulty of getting some editors and publishers to take appropriate action. Consequently, authors, journal editors, and reviewers, as well as research institutions all are duty-bound not only to recognize the differences between ethical and unethical behavior in order to protect a healthy research environment, and also to maintain consistent ethical publishing standards.

Virtual reality training improves students' knowledge structures of medical concepts.

PubMed

Stevens, Susan M; Goldsmith, Timothy E; Summers, Kenneth L; Sherstyuk, Andrei; Kihmm, Kathleen; Holten, James R; Davis, Christopher; Speitel, Daniel; Maris, Christina; Stewart, Randall; Wilks, David; Saland, Linda; Wax, Diane; Panaiotis; Saiki, Stanley; Alverson, Dale; Caudell, Thomas P

2005-01-01

Virtual environments can provide training that is difficult to achieve under normal circumstances. Medical students can work on high-risk cases in a realistic, time-critical environment, where students practice skills in a cognitively demanding and emotionally compelling situation. Research from cognitive science has shown that as students acquire domain expertise, their semantic organization of core domain concepts become more similar to those of an expert's. In the current study, we hypothesized that students' knowledge structures would become more expert-like as a result of their diagnosing and treating a patient experiencing a hematoma within a virtual environment. Forty-eight medical students diagnosed and treated a hematoma case within a fully immersed virtual environment. Student's semantic organization of 25 case-related concepts was assessed prior to and after training. Students' knowledge structures became more integrated and similar to an expert knowledge structure of the concepts as a result of the learning experience. The methods used here for eliciting, representing, and evaluating knowledge structures offer a sensitive and objective means for evaluating student learning in virtual environments and medical simulations.

Implications of low-power He-Ne laser and monochromatic red light biostimulation in the metabolism of proteins and glucosides

NASA Astrophysics Data System (ADS)

Onac, I.; Pop, L.; Ungur, Rodica; Giurgiu, Ioana

2001-06-01

We checked the changes occurring in the metabolism of proteins (seric cholinesterase, total proteins) and in the metabolism of glycosides (seric glucose) in Cavia cobaia. A simple blind study was carried out and the results were checked on the first, tenth and twentieth days of treatment. The data thus obtained were graphically represented and statistically processed according to the Duncan test. The technique and treatment doses were similar and they were compared with the data obtained from controls and environment controls. In the groups biostimulated with He-Ne laser, seric cholinesterase levels increased proportionally with the dose reaching a peak on day 10, which was not the case with the controls. Monochromatic red light caused a similar but quantitatively lower effect. The same results were obtained in the case of seric proteins as well, however, the effect did not depend on the dose and it was less significant statistically than in the case of seric cholinesterase both in laser treated and in monochromatic red light treated groups.

Cholera: a comparison of the 2008-9 and 2010 Outbreaks in Kadoma City, Zimbabwe

PubMed Central

Maponga, Brian Abel; Chirundu, Daniel; Gombe, Notion Tafara; Tshimanga, Mufuta; Bangure, Donewell; Takundwa, Lucia

2015-01-01

Introduction Kadoma City experienced cholera outbreaks in 2008-9, and 2010, affecting 6,393 and 123 people, respectively. A study was conducted to compare epidemiology of the cholera outbreaks. Methods A descriptive cross sectional study was conducted, analyzing line list data for the 2 outbreaks. Proportions, means were generated and compared using the Chi Square test at 5% level of significance. Results Cholera cases were similar by gender and age, with the 20-30 years group being most affected. Rimuka township contributed 80% and 100% of city cases in 2008-9 and 2010, respectively, p value = 0.000. In 2008-9, 91% of cholera cases presented within 2 days compared to 98% in 2010. Delay seeking treatment increased from 58% to 73% (p value = 0.001), with gender, and place equally affected. The 2010 outbreak evolved faster, resulting in higher proportion being managed in CTU. CFR was 2% in 2008-9, and 3.3% in 2010 (p value =0.31). Conclusion The 2008-9 and 2010 cholera outbreaks were similar by age and gender. Rimuka Township was most affected by the outbreaks. There was worsening of delay seeking treatment. The 2010 outbreak was more rapid, leading to early opening of CTC. CFR was consistently above 1%. PMID:26113952

Infection by rhinovirus: similarity of clinical signs included in the case definition of influenza IAn/H1N1.

PubMed

de Oña Navarro, Maria; Melón García, Santiago; Alvarez-Argüelles, Marta; Fernández-Verdugo, Ana; Boga Riveiro, Jose Antonio

2012-08-01

Although new influenza virus (IAn/H1N1) infections are mild and indistinguishable from any other seasonal influenza virus infections, there are few data on comparisons of the clinical features of infection with (IAn/H1N1) and with other respiratory viruses. The incidence, clinical aspects and temporal distribution of those respiratory viruses circulating during flu pandemic period were studied. Respiratory samples from patients with acute influenza-like symptoms were collected from May 2009 to December 2009. Respiratory viruses were detected by conventional culture methods and genome amplification techniques. Although IAn/H1N1 was the virus most frequently detected, several other respiratory viruses co-circulated with IAn/H1N1 during the pandemic period, especially rhinovirus. The similarity between clinical signs included in the clinical case definition for influenza and those caused by other respiratory viruses, particularly rhinovirus, suggest that a high percentage of viral infections were clinically diagnosed as case of influenza. Our study offers useful information to face future pandemics caused by influenza virus, indicating that differential diagnoses are required in order to not overestimate the importance of the pandemic. Copyright © 2011 Elsevier España, S.L. All rights reserved.

Follicular lymphoma in the palate with clinical appearance similar to salivary gland tumors.

PubMed

Lima, Marina de Deus Moura; Artico, Gabriela; Soares, Fernando Augusto; Martins, Marília Trierveiler; Alves, Fabio Abreu

2010-09-01

Intraoral presentation of follicular lymphoma is rare, and only three cases in the palate have been reported to date. The present case report describes an uncommon case of follicular lymphoma affecting the palate. The clinical aspect was similar to salivary gland neoplasm, and an incisional biopsy was important to establish the correct diagnosis and consequently to plan the treatment. Also discussed is the differential diagnosis among follicular lymphoma, mucosa-associated lymphoid tissue lymphoma, and follicular lymphoid hyperplasia with regard to the histopathologic and immunohistochemical features.

Miscommunication across Cultures: The Case of Marketing in Indian English. Revised.

ERIC Educational Resources Information Center

Frank, Jane

A study of intercultural business communication problems compared three examples of direct marketing sales letters similar in function, format, content, and targeted recipient but originating in different cultures (India, England, and the United States) and companies. The letters were directed to a single prospective purchaser of "Who's…

Two Models for Implementing Senior Mentor Programs in Academic Medical Settings

ERIC Educational Resources Information Center

Corwin, Sara J.; Bates, Tovah; Cohan, Mary; Bragg, Dawn S.; Roberts, Ellen

2007-01-01

This paper compares two models of undergraduate geriatric medical education utilizing senior mentoring programs. Descriptive, comparative multiple-case study was employed analyzing program documents, archival records, and focus group data. Themes were compared for similarities and differences between the two program models. Findings indicate that…

Productivity and Job Security: Attrition--Benefits and Problems.

ERIC Educational Resources Information Center

National Center for Productivity and Quality of Working Life, Washington, DC.

Three case studies are presented to document different approaches to providing the job security which would encourage acceptance of technological changes that could result in productivity improvements. The intent is to assist union and management practitioners in handling similar problems in their own firms. Focus is on the utility of attrition…

Combining In Vivo, In Vitro And Toxicokinetics Data In Readacross: A Case Study Using Caffeine (SOT)

EPA Science Inventory

Readacross can be used to fill data gaps in chemical safety assessment. Readacross starts with the identification and evaluation of source analogs, including assessment of the physicochemical and mechanistic similarity of source analogs. We describe an approach to quantitative re...

Improving toxicity extrapolation using molecular sequence similarity: A case study of pyrethroids and the sodium ion channel

EPA Science Inventory

A significant challenge in ecotoxicology has been determining chemical hazards to species with limited or no toxicity data. Currently, extrapolation tools like U.S. EPA’s Web-based Interspecies Correlation Estimation (Web-ICE; www3.epa.gov/webice) models categorize toxicity...

Gesturing by Speakers with Aphasia: How Does It Compare?

ERIC Educational Resources Information Center

Mol, Lisette; Krahmer, Emiel; van de Sandt-Koenderman, Mieke

2013-01-01

Purpose: To study the independence of gesture and verbal language production. The authors assessed whether gesture can be semantically compensatory in cases of verbal language impairment and whether speakers with aphasia and control participants use similar depiction techniques in gesture. Method: The informativeness of gesture was assessed in 3…

Similarities of School Shootings in Rural and Small Town Communities.

ERIC Educational Resources Information Center

Kidd, Scott T.; Meyer, Cheryl L.

2002-01-01

A study examined characteristics common among young offenders from rural communities who were involved in multiple-fatality school shootings. Data on six cases involving eight offenders revealed six common offender characteristics: verbal threats, peer rejection, interest in violent media, previous violent behavior, suicidal ideation, and violent…

Case Studies in Job Analysis and Training Evaluation.

ERIC Educational Resources Information Center

McKillip, Jack

2001-01-01

An information technology certification program was evaluated by 1,671 systems engineers using job analysis that rated task importance. Professional librarians (n=527) rated importance of their tasks in similar fashion. Results of scatter diagrams provided evidence to enhance training effectiveness by focusing on job tasks significantly related to…

The GIS map coloring support decision-making system based on case-based reasoning and simulated annealing algorithm

NASA Astrophysics Data System (ADS)

Deng, Shuang; Xiang, Wenting; Tian, Yangge

2009-10-01

Map coloring is a hard task even to the experienced map experts. In the GIS project, usually need to color map according to the customer, which make the work more complex. With the development of GIS, more and more programmers join the project team, which lack the training of cartology, their coloring map are harder to meet the requirements of customer. From the experience, customers with similar background usually have similar tastes for coloring map. So, we developed a GIS color scheme decision-making system which can select color schemes of similar customers from case base for customers to select and adjust. The system is a BS/CS mixed system, the client side use JSP and make it possible for the system developers to go on remote calling of the colors scheme cases in the database server and communicate with customers. Different with general case-based reasoning, even the customers are very similar, their selection may have difference, it is hard to provide a "best" option. So, we select the Simulated Annealing Algorithm (SAA) to arrange the emergence order of different color schemes. Customers can also dynamically adjust certain features colors based on existing case. The result shows that the system can facilitate the communication between the designers and the customers and improve the quality and efficiency of coloring map.

[The role of ecological studies to evaluate the impact of an enviromental factor on health: a case study on the results of the SENTIERI project].

PubMed

Donato, Francesco; Raffetti, Elena

2014-01-01

A case-study regarding the results of the SENTIERI project on the Brescia-Caffaro NPCS (National Priority Contaminated Site) is reported. This area has been polluted mainly by polychlorinated biphenyls (PCBs), which have been classified recently by the International Agency for Research on Cancer as human carcinogens (group 1), with sufficient evidence for melanoma and limited for non-Hodgkin lymphoma (NHL) and breast cancer. The 3rd report of the SENTIERI project (2014) has shown an excess of cancer incidence with respect to the expected, on the basis of the incidence rates from the pool of Centre-North Italy cancer registries, but a mortality similar to that expected according to the regional rates, for melanoma, NHL and breast cancer. Furthermore, a higher than expected incidence has been found for various cancers which are not associated a priori with PCB exposure. The Brescia Local Health Authority has also carried out an analysis of cancer incidence, which has shown an incidence in the area similar to other ones in North Italy and a cluster of cases centered on Brescia town for melanoma only. A possible explanation of these discrepancies is the use of different reference populations for the comparisons (Region and pool of Centre-North Italy cancer registries), besides possible confounding bias. We discuss here the most critical aspects of modern ecological studies, their potential information content and interpretation limits.

The effect of compliance on contact lens case contamination.

PubMed

Tilia, Daniel; Lazon de la Jara, Percy; Zhu, Hua; Naduvilath, Thomas J; Holden, Brien A

2014-03-01

To determine the efficacy of written instructions on contact lens case hygiene and to quantify the effect of noncompliance on contact lens case contamination. Data were retrospectively analyzed from 16 prospective, 3-month daily-wear studies during which six commercially available silicone hydrogel contact lenses and seven lens care solutions (LCS) were tested following a similar protocol. Verbal instructions regarding case hygiene (rinse case with LCS, not tap water) were given in nine studies, while the same instructions were given verbally and in written format in seven studies. A survey on contact lens, LCS, and lens case hygiene was completed at 1- and 3-month visits and compliance with case hygiene instructions was determined. Regular contact lens cases were used for 1 month and collected for microbial analysis at the 1- and 3-month visits. The rate of case contamination and the types of microbes contaminating cases were evaluated. Participants given verbal and written instructions were more likely to be compliant with case hygiene instructions than those just given verbal instructions (odds ratio [OR]: 2.19, p < 0.001, 95% confidence interval [CI]: 1.40-3.44). The overall case contamination rate was 79%. Use of tap water to rinse contact lens cases was associated with significantly more cases contaminated with Gram-negative bacteria (GNB) (30% vs. 10%, p < 0.001), a greater risk of GNB case contamination (OR: 2.91, p < 0.001. 95% CI: 1.72-4.92), and a higher quantity of GNB in cases (mean colony-forming unit/case ± SD: 28,286 ± 131,935 vs. 6477 ± 60,447, p < 0.001). Lens case hygiene can be improved by effective communication of instructions. Contact lens wearers should be actively discouraged from rinsing contact lens cases with tap water because of the increased risk of GNB contamination.

Identification of Suitable Areas for West Nile Virus Circulation in Tunisia.

PubMed

Ben Hassine, T; Conte, A; Calistri, P; Candeloro, L; Ippoliti, C; De Massis, F; Danzetta, M L; Bejaoui, M; Hammami, S

2017-04-01

West Nile virus (WNV) is a mosquito-transmitted Flavivirus belonging to the Japanese encephalitis antigenic complex of the Flaviviridae family. It is transmitted primarily by the bite of infected mosquitoes, particularly Culex spp. and Aedes/Ochlerotatus spp., which acquire the virus by feeding on viraemic birds. Humans, horses and other mammals are regarded as incidental or dead-end hosts. In the last decades, an increasing number of cases of WNV infection in horses and humans have been notified in the Mediterranean basin. In Tunisia, human cases of WNV-related meningoencephalitis were detected in 1997, 2003, 2007, 2010, 2011 and 2012. Based on the analysis of climatic and environmental conditions found in the locations where human cases have been reported in 2012, the aim of this study was to identify similar areas in Tunisia potentially at risk of disease occurrence. Data related to 85 neuroinvasive West Nile fever (WNF) human cases were georeferenced and a set of environmental and climatic variables (wetlands and humid areas, normalized difference vegetation index (NDVI), temperatures and elevation, migratory bird settlements) were used in the analysis. Areas, ecologically similar to those where human cases were detected, were identified using the Mahalanobis distance statistic. A leave-one-out cross-validation was performed to validate the sensitivity of the model, and 78 of 85 points were correctly classified. © 2015 Blackwell Verlag GmbH.

[Morphological findings in fatal cases of hantavirus cardiopulmonary syndrome. Report of 7 autopsies].

PubMed

Guzmán G, Pablo; Tapia E, Oscar; Villaseca H, Miguel; Araya O, Juan; Antonio P, Lilia; Lee O, Bolívar; Roa S, Juan

2010-10-01

Hantavirus cardiopulmonary syndrome (HCPS) is an acute infectious disease characterized by sudden cardiorespiratory failure and high mortality, caused by a RNA virus of the genus Hantavirus, family Bunyaviridae, 15% of Chilean cases have been detected in the Araucania Region. To determine in fatal cases of HCPS, clinical and morphological characteristics. Descriptive-retrospective analysis of seven fatal cases with postmortem study of HCPS, attended between 1997 and 2009 at the Hospital of Temuco, Chile. Cases were young patients from rural areas, and presented as an illness of progressive respiratory failure, with leukocytosis, thrombocytopenia and bilateral interstitial pulmonary infiltrates. Main morphological findings were marked intersticial and intraalveolar pulmonary edema, with minimal epithelial injury and mononuclear cell intersticial infiltrate and mild edematous intersticial inflamatory process. Epidemiological, clinical and laboratory background allow to suspect HCPS. In fatal cases, the autopsy makes possible to discard other similar pathologies and provide tissue for confirmation of the disease.

Rocky Mountain Spotted Fever Characterization and Comparison to Similar Illnesses in a Highly Endemic Area—Arizona, 2002–2011

PubMed Central

Traeger, Marc S.; Regan, Joanna J.; Humpherys, Dwight; Mahoney, Dianna L.; Martinez, Michelle; Emerson, Ginny L.; Tack, Danielle M.; Geissler, Aimee; Yasmin, Seema; Lawson, Regina; Hamilton, Charlene; Williams, Velda; Levy, Craig; Komatsu, Kenneth; McQuiston, Jennifer H.; Yost, David A.

2015-01-01

Background Rocky Mountain spotted fever (RMSF) has emerged as a significant cause of morbidity and mortality since 2002 on tribal lands in Arizona. The explosive nature of this outbreak and the recognition of an unexpected tick vector, Rhipicephalus sanguineus, prompted an investigation to characterize RMSF in this unique setting and compare RMSF cases to similar illnesses. Methods We compared medical records of 205 patients with RMSF and 175 with non-RMSF illnesses that prompted RMSF testing during 2002–2011 from 2 Indian reservations in Arizona. Results RMSF cases in Arizona occurred year-round and peaked later (July–September) than RMSF cases reported from other US regions. Cases were younger (median age, 11 years) and reported fever and rash less frequently, compared to cases from other US regions. Fever was present in 81% of cases but not significantly different from that in patients with non-RMSF illnesses. Classic laboratory abnormalities such as low sodium and platelet counts had small and subtle differences between cases and patients with non-RMSF illnesses. Imaging studies reflected the variability and complexity of the illness but proved unhelpful in clarifying the early diagnosis. Conclusions RMSF epidemiology in this region appears different than RMSF elsewhere in the United States. No specific pattern of signs, symptoms, or laboratory findings occurred with enough frequency to consistently differentiate RMSF from other illnesses. Due to the nonspecific and variable nature of RMSF presentations, clinicians in this region should aggressively treat febrile illnesses and sepsis with doxycycline for suspected RMSF. PMID:25697743

[A study of otitis externa associated with Malassezia].

PubMed

Shiota, Ryoko; Kaneko, Takamasa; Yano, Hiroaki; Takeshita, Kimiko; Nishioka, Keiko; Makimura, Koichi

2009-01-01

Malassezia-positive smears can be recognized from otitis externa, however, there are few references in the literature to the relation between Malassezia and otitis externa. Therefore, the bacterial and clinical characteristics of 72 cases (63 patients) with otitis externa were investigated at the Department of Otorhinolaryngology, Takinomiya General Hospital to analyze this. Thirty-seven cases were bacterial otitis externa, 20 cases were fungal otitis externa, and 15 cases were etiological agents unknown in this study. The causative organisms in fungal otitis externa were the genera Aspergillus (10 cases), Malassezia (5) and Candida (5), respectively. We suspected that 5 cases were caused by Malassezia because Malassezia cell counts were greater than 10 per field (x 400), and a large number of Malassezia were isolated from all cases. In these cases, many squamous epithelial cells were observed by direct examination, and cells from the middle or basal layer of the ear canal were also recognized in three cases. Therefore, accelerated turnover of epidermal cells of the ear canal was suggested. The main symptoms were itching and fullness in the ear, with observations of redness and erosion in objective deterioration, and we felt that these conditions were similar to seborrheic dermatitis (SD). In addition, these five cases were confirmed as fungus-related otitis externa by their improvement with antifungal agents.

Systematic review: Eosinophilic esophagitis in Asian countries

PubMed Central

Kinoshita, Yoshikazu; Ishimura, Norihisa; Oshima, Naoki; Ishihara, Shunji

2015-01-01

AIM: To investigate the prevalence and the clinical characteristics of Asian patients with eosinophilic esophagitis. METHODS: We conducted a systematic search of the PubMed and Web of Science databases for original studies, case series, and individual case reports of eosinophilic esophagitis in Asian countries published from January 1980 to January 2015. We found 66 and 80 articles in the PubMed and Web of Science databases, respectively; 24 duplicate articles were removed. After excluding animal studies, articles not written in English, and meeting abstracts, 25 articles containing 217 patients were selected for analysis. RESULTS: Sample size-weighted mean values were determined for all pooled prevalence data and clinical characteristics. The mean age of the adult patients with eosinophilic esophagitis was approximately 50 years, and 73% of these patients were male. They frequently presented with allergic diseases including bronchial asthma, allergic rhinitis, food allergy, and atopic dermatitis. Bronchial asthma was the most frequent comorbid allergic disease, occurring in 24% of patients with eosinophilic esophagitis. Dysphagia was the primary symptom reported; 44% of the patients complained of dysphagia. Although laboratory blood tests are not adequately sensitive for an accurate diagnosis of eosinophilic esophagitis, endoscopic examinations revealed abnormal findings typical of this disease, including longitudinal furrows and concentric rings, in 82% of the cases. One-third of the cases responded to proton pump inhibitor administration. CONCLUSION: The characteristics of eosinophilic esophagitis in Asian patients were similar to those reported in Western patients, indicating that this disease displays a similar pathogenesis between Western and Asian patients. PMID:26217096

Clinicopathological Features of Intraductal Pancreatic Neuroendocrine Tumors.

PubMed

Chang, Xiao-Yan; Jia, Cong-Wei; Meng, Yun-Xiao; Chen, Jie

2016-10-10

Objective To evaluate the clinical and pathologic characteristics of intraductal pancreatic neuroendocrine tumors (PanNETs). Methods Four cases of intraductal PanNETs were studied by light microscopy and immunohistochemistry with the analysis of morphologic features and review of relevant literatures. Results Two female patients and two male patients aged 41- 58 years were enrolled in this study. The chief complaint was abdominal pain in two patients,vomiting in one patient,and jaundice in the last patient. Imaging examination showed intraductal neoplasm with diagnosis as intraductal papillary mucinous neoplasm (IPMN) in case 1; space-occupying lesions were found in the head of pancreas in the other three cases with pancreatic ductal ectasia and distal pancreatic atrophy. Grossly the masses were located in pancreatic main duct and invaded into surrounding pancreatic parachyma. Microscopically the tumors arranged with solid pattern,with some trabecular structures in the last two cases. Small duct and ductules were seen in intraductal PanNETs. The immunohistochemical expression showed that SYN and CgA were positive in neoplastic cells and negative in small duct and ductules.Conclusions Intraductal PanNETs are rare conditions. The clinical symptoms and imaging findings are similar to IPMN or pancreatic carcinoma. The tumors are located within pancreatic duct partly and can invade the pancreatic parenchyma. Microscopically the neuroendocrine tumors mix with small duct and forms ductulo-insular structure,which should be differentiated with mixed ductal endocrine carcinoma. The grade and prognosis are similar to those of classical neuroendocrine tumors.

Systematic review: Eosinophilic esophagitis in Asian countries.

PubMed

Kinoshita, Yoshikazu; Ishimura, Norihisa; Oshima, Naoki; Ishihara, Shunji

2015-07-21

To investigate the prevalence and the clinical characteristics of Asian patients with eosinophilic esophagitis. We conducted a systematic search of the PubMed and Web of Science databases for original studies, case series, and individual case reports of eosinophilic esophagitis in Asian countries published from January 1980 to January 2015. We found 66 and 80 articles in the PubMed and Web of Science databases, respectively; 24 duplicate articles were removed. After excluding animal studies, articles not written in English, and meeting abstracts, 25 articles containing 217 patients were selected for analysis. Sample size-weighted mean values were determined for all pooled prevalence data and clinical characteristics. The mean age of the adult patients with eosinophilic esophagitis was approximately 50 years, and 73% of these patients were male. They frequently presented with allergic diseases including bronchial asthma, allergic rhinitis, food allergy, and atopic dermatitis. Bronchial asthma was the most frequent comorbid allergic disease, occurring in 24% of patients with eosinophilic esophagitis. Dysphagia was the primary symptom reported; 44% of the patients complained of dysphagia. Although laboratory blood tests are not adequately sensitive for an accurate diagnosis of eosinophilic esophagitis, endoscopic examinations revealed abnormal findings typical of this disease, including longitudinal furrows and concentric rings, in 82% of the cases. One-third of the cases responded to proton pump inhibitor administration. The characteristics of eosinophilic esophagitis in Asian patients were similar to those reported in Western patients, indicating that this disease displays a similar pathogenesis between Western and Asian patients.

Rural Industrialization in the Ozarks: Case Study of a New Shirt Plant at Gassville, Arkansas. Agricultural Economic Report No. 123.

ERIC Educational Resources Information Center

Jordon, Max F.

To determine the short term effects of a large apparel plant on the economy of a relatively isolated, highly rural Ozark area (8 counties), characterized by low income and few employment opportunities, this study compared 1959 data on the study area and the state of Arkansas with similar post plant data (1960-1963). Data were compared on income…

Jaccard Similarity Leads to the Marczewski-Steinhaus Topology for Information Retrieval.

ERIC Educational Resources Information Center

Rousseau, Ronald

1998-01-01

Demonstrates that if the similarity function of a retrieval system leads to a (pseudo-) metric, the retrieval, similarity and Everett-Cater metric topology coincide and are different from the discrete topology; this is the case if documents are represented by lists, using the Jaccard similarity measure. The corresponding metric is the…

Major depressive disorder in a family study of obsessive-compulsive disorder with pediatric probands.

PubMed

Hanna, Gregory L; Himle, Joseph A; Hanna, Barbara S; Gold, Katherine J; Gillespie, Brenda W

2011-06-01

This study examined the comorbidity of obsessive-compulsive disorder (OCD) with major depressive disorder (MDD) in a family study of OCD with pediatric probands. This study assessed the lifetime prevalence of MDD in 141 first-degree relatives (FDR) and 452 second-degree relatives (SDR) of pediatric probands with OCD and healthy controls, and identified variables associated with MDD in case FDR. All available FDR were directly interviewed blind to proband status; parents were also interviewed to assess the family psychiatric history of FDR and SDR. Best-estimate diagnoses were made using all sources of information. Data were analyzed with logistic regression and robust Cox regression models. Lifetime MDD prevalence was significantly higher in case than in control FDR (30.4 versus 15.4%). Lifetime MDD prevalence was significantly higher in FDR of case probands with MDD than in FDR of case probands without MDD or control FDR (46.3 versus 19.7 versus 15.4%, respectively). MDD in case FDR was significantly associated with MDD in case probands and with age and OCD in those relatives. Lifetime MDD prevalence was similar in case and control SDR. However, lifetime MDD prevalence was significantly higher in SDR of case probands with MDD than in SDR of case probands without MDD or control SDR (31.9 versus 16.8 versus 15.4%, respectively). MDD prevalence was significantly higher in both FDR and SDR of case probands with MDD than in relatives of case probands without MDD or control relatives, suggesting that pediatric OCD comorbid with MDD is a complex familial syndrome. © 2011 Wiley-Liss, Inc.

Tuberculosis in Auckland autopsies, revisited.

PubMed

Lum, Dennis; Koelmeyer, Timothy

2005-03-11

To review the cases of tuberculosis found at autopsy in the Auckland Coronial Autopsy Service in the previous 10 years, and compare the results with that of a similar study for the period 1975 to 1992. Cases which were not diagnosed prior to autopsy are scrutinised as to why the diagnosis may have been missed. A computerised search of the Forensic Pathology Department database at Auckland Hospital for cases of tuberculosis or atypical mycobacterial infection found at autopsy was done. Basic demographic data, past medical history, and police reports were analysed. The cases were placed into five groups for analysis. A total of 30 cases of tuberculosis (including 3 cases of atypical mycobacterial infection) were found. A large proportion (70%) was undiagnosed before death, and each case was potentially infective. Two cases had respiratory symptoms suggestive of tuberculosis, and a further 5 cases had generalised symptoms which were unexplained yet tuberculosis was not considered. In those cases that were missed, the autopsy played a vital role by identifying the previously undiagnosed cases of tuberculosis and ensuring contact screening. Awareness of tuberculosis and its increasing prevalence in New Zealand is essential for minimising missed diagnoses.

Description of two waterborne disease outbreaks in France: a comparative study with data from cohort studies and from health administrative databases.

PubMed

Mouly, D; Van Cauteren, D; Vincent, N; Vaissiere, E; Beaudeau, P; Ducrot, C; Gallay, A

2016-02-01

Waterborne disease outbreaks (WBDO) of acute gastrointestinal illness (AGI) are a public health concern in France. Their occurrence is probably underestimated due to the lack of a specific surveillance system. The French health insurance database provides an interesting opportunity to improve the detection of these events. A specific algorithm to identify AGI cases from drug payment reimbursement data in the health insurance database has been previously developed. The purpose of our comparative study was to retrospectively assess the ability of the health insurance data to describe WBDO. Data from the health insurance database was compared with the data from cohort studies conducted in two WBDO in 2010 and 2012. The temporal distribution of cases, the day of the peak and the duration of the epidemic, as measured using the health insurance data, were similar to the data from one of the two cohort studies. However, health insurance data accounted for 54 cases compared to the estimated 252 cases accounted for in the cohort study. The accuracy of using health insurance data to describe WBDO depends on the medical consultation rate in the impacted population. As this is never the case, data analysis underestimates the total number of AGI cases. However this data source can be considered for the development of a detection system of a WBDO in France, given its ability to describe an epidemic signal.

Fuzzy Similarity and Fuzzy Inclusion Measures in Polyline Matching: A Case Study of Potential Streams Identification for Archaeological Modelling in GIS

NASA Astrophysics Data System (ADS)

Ďuračiová, Renata; Rášová, Alexandra; Lieskovský, Tibor

2017-12-01

When combining spatial data from various sources, it is often important to determine similarity or identity of spatial objects. Besides the differences in geometry, representations of spatial objects are inevitably more or less uncertain. Fuzzy set theory can be used to address both modelling of the spatial objects uncertainty and determining the identity, similarity, and inclusion of two sets as fuzzy identity, fuzzy similarity, and fuzzy inclusion. In this paper, we propose to use fuzzy measures to determine the similarity or identity of two uncertain spatial object representations in geographic information systems. Labelling the spatial objects by the degree of their similarity or inclusion measure makes the process of their identification more efficient. It reduces the need for a manual control. This leads to a more simple process of spatial datasets update from external data sources. We use this approach to get an accurate and correct representation of historical streams, which is derived from contemporary digital elevation model, i.e. we identify the segments that are similar to the streams depicted on historical maps.

ICU telemedicine and critical care mortality: a national effectiveness study

PubMed Central

Kahn, Jeremy M; Le, Tri Q.; Barnato, Amber E.; Hravnak, Marilyn; Kuza, Courtney C.; Pike, Francis; Angus, Derek C.

2015-01-01

Background Intensive care unit (ICU) telemedicine is an increasingly common strategy for improving the outcome of critical care, but its overall impact is uncertain. Objectives To determine the effectiveness of ICU telemedicine in a national sample of hospitals and quantify variation in effectiveness across hospitals. Research design We performed a multi-center retrospective case-control study using 2001–2010 Medicare claims data linked to a national survey identifying United States hospitals adopting ICU telemedicine. We matched each adopting hospital (cases) to up to 3 non-adopting hospitals (controls) based on size, case-mix and geographic proximity during the year of adoption. Using ICU admissions from 2 years before and after the adoption date, we compared outcomes between case and control hospitals using a difference-in-differences approach. Results 132 adopting case hospitals were matched to 389 similar non-adopting control hospitals. The pre- and post-adoption unadjusted 90-day mortality was similar in both case hospitals (24.0% vs. 24.3%, p=0.07) and control hospitals (23.5% vs. 23.7%, p<0.01). In the difference-in-differences analysis, ICU telemedicine adoption was associated with a small relative reduction in 90-day mortality (ratio of odds ratios: 0.96, 95% CI = 0.95–0.98, p<0.001). However, there was wide variation in the ICU telemedicine effect across individual hospitals (median ratio of odds ratios: 1.01; interquartile range 0.85–1.12; range 0.45–2.54). Only 16 case hospitals (12.2%) experienced statistically significant mortality reductions post-adoption. Hospitals with a significant mortality reduction were more likely to have large annual admission volumes (p<0.001) and be located in urban areas (p=0.04) compared to other hospitals. Conclusions Although ICU telemedicine adoption resulted in a small relative overall mortality reduction, there was heterogeneity in effect across adopting hospitals, with large-volume urban hospitals experiencing the greatest mortality reductions. PMID:26765148

Electron scale magnetic reconnection in the turbulent magnetosheath: Kinetic PIC simulation study

NASA Astrophysics Data System (ADS)

Sharma, P.; Shay, M. A.; Drake, J. F.; Phan, T.; Haggerty, C. C.; TenBarge, J. M.; Cassak, P.; Swisdak, M.

2017-12-01

Recent MMS observations have revealed electron scale reconnection in the turbulent magnetosheath. Surprisingly, although one of the reconnection events is associated with a very strong guide field, the ions show no coupling to the reconnection dynamics. We first review the MMS observations. Then, using kinetic PIC simulations with similar plasma conditions, we study reconnection at electron scales and show that the reconnection exhibits whistler-like dynamics similar to the case of anti-parallel reconnection rather than the kinetic Alfven wave dynamics that is often associated with reconnection with a strong guide field. We study the factors controlling this behavior and discuss the implications for reconnection and turbulence at electron scales in both the magnetosheath and solar wind.

Lupus mastitis: a mimicker of breast carcinoma

PubMed Central

Warne, Richard Roger; Taylor, Donna; Segal, Amanda; Irish, Ashley

2011-01-01

The authors present a case of lupus mastitis which was initially diagnosed following an incisional biopsy of a breast lump, with similar pathology found 2 years later after an ultrasound guided biopsy of the same lump. The woman had been diagnosed 7 years before with systemic lupus erythematosus. The radiological and pathological features are presented in this report with discussion of similar cases in the literature. PMID:22669997

Penile carcinoma presenting as inguinal bubo, masquerading as a venereal disease.

PubMed

Gupta, Vishal; Rai, Ajay; Mutha, Shreyans; Firdaus Ali, Mohammad; Sharma, Vinod K

2016-03-01

We report a case of penile carcinoma presenting as an inguinal bubo in a young man. The associated painful genital ulcer and history of high-risk sexual behaviour raised a strong suspicion of a sexually transmitted infection. We review the literature for similar cases, highlight the similarities with venereal disease and discuss the differential diagnosis of inguinal bubo. © The Author(s) 2016.

A note on the self-similar solutions to the spontaneous fragmentation equation

NASA Astrophysics Data System (ADS)

Breschi, Giancarlo; Fontelos, Marco A.

2017-05-01

We provide a method to compute self-similar solutions for various fragmentation equations and use it to compute their asymptotic behaviours. Our procedure is applied to specific cases: (i) the case of mitosis, where fragmentation results into two identical fragments, (ii) fragmentation limited to the formation of sufficiently large fragments, and (iii) processes with fragmentation kernel presenting a power-like behaviour.

Unilateral terminal aphalangia in father and daughter--exogenous or genetic cause?

PubMed

Neumann, L; Pelz, J; Kunze, J

1998-07-24

Published cases of familial unilateral terminal transverse defects are scarce. We report on a morphologically similar defect of the hand in a father and his daughter. The hand anomaly is similar in both, but on the opposite side. Thalidomide was taken in the sensitive period of the pregnancy by the father's mother. To our knowledge this is the second description of unilateral terminal aphalangia in successive generations. In order to evaluate the possible genetic basis we analyze epidemiological studies in respect to the recurrence risk of cases with isolated limb reduction defects. We compare reports of familial occurrence concerning the degree of relationship as well as the pattern of malformation. The latter seems to be an important aspect from an evolutionary and a developmental viewpoint. For our observation an autosomal dominant transmission is the most likely although multifactorial determination cannot be excluded.

Optimal Electrodynamic Tether Phasing Maneuvers

NASA Technical Reports Server (NTRS)

Bitzer, Matthew S.; Hall, Christopher D.

2007-01-01

We study the minimum-time orbit phasing maneuver problem for a constant-current electrodynamic tether (EDT). The EDT is assumed to be a point mass and the electromagnetic forces acting on the tether are always perpendicular to the local magnetic field. After deriving and non-dimensionalizing the equations of motion, the only input parameters become current and the phase angle. Solution examples, including initial Lagrange costates, time of flight, thrust plots, and thrust angle profiles, are given for a wide range of current magnitudes and phase angles. The two-dimensional cases presented use a non-tilted magnetic dipole model, and the solutions are compared to existing literature. We are able to compare similar trajectories for a constant thrust phasing maneuver and we find that the time of flight is longer for the constant thrust case with similar initial thrust values and phase angles. Full three-dimensional solutions, which use a titled magnetic dipole model, are also analyzed for orbits with small inclinations.

[Cardiac index, oxygen and serum lactate consumption in infants with hypovolemic and septic shock].

PubMed

Gaytán Becerril, A; Olvera Hidalgo, C; Vieto Rodríguez, E E; Chávez Angeles, D S; Elena Salas, M

1980-01-01

Determination was made of cardiac output (using the stain dilution technique), gases in blood and serum lactate levels in eight infants with hypovolemic shock and sixteen with septic shock. The data were carried to indexes (values per square meter of body surface). In children with hypovolemic shock the cardiac index was 1.88 +/- 0.031/min/m,2 while in septic patients it was 4.02 +/- 1.011/min/m2. The peripheral resistances were 3,079 din/min/cm.5 in hypovolemic cases and 907 din/min in the septic. In both groups serum lactante levels rised close to 4 mM 61. Oxigen consumption was found low in hypovolemic patients and slightly high in the septic. It is concluded that our data are similar to those reported in similar studies in adults and hypodynamic shock is shown in hypovolemic patients, while hyperdynamic shock appears in septic cases.

Primary adenocarcinoma of the thymus: an immunohistochemical and molecular study with review of the literature

PubMed Central

2013-01-01

Background Primary adenocarcinoma of thymus is extremely rare. Case presentation This is a case of primary adenocarcinoma with intestinal differentiation and focal mucin production in the thymus. Thymic cyst was associated with this tumor. Intestinal differentiation was confirmed by immunohistochemical stain with positivity for CDX-2, CK20, villin, MOC31 and focal positivity of CK7. Array comperative genomic hybridization (CGH) analysis showed a complex pattern of chromosomal imbalances including homozygous deletion at the HLA locus in chromosomal region 6p21.32. Conclusion This rare tumor shows a similar genetic aberration with other studied thymic epithelial tumors. PMID:23725376

Where Lies the Fault in Diagnosing Dhat Syndrome among Females? Understanding through a Case Study.

PubMed

Kar, Sujita Kumar; Singh, Amit

2017-01-01

Dhat syndrome is a culture-bound syndrome of South-East Asia, common in young men. However, similar entity has also been described in female patients who attribute their symptoms to nonpathological or physiological vaginal discharge. The current diagnostic system for psychiatric illnesses does not encompass Dhat syndrome in females, and so these group of patients receive alternative diagnoses such as somatoform disorder or depression. As a result of which the focus of unique Dhat syndrome-centered management gets weakened, affecting the clinical outcome. This case study focuses on the diagnostic dilemmas related to Dhat syndrome in females and pitfalls in the current diagnostic system.

Black widow spider bite: a case study.

PubMed

Gaisford, Kristine; Kautz, Donald D

2011-01-01

This article is a case study of a patient cared for in the hours before her death. After the patient's death, we learned the patient died of a black widow spider bite. This article sheds light on the potential seriousness of this venom and allows for more rapid detection and treatment of those who are unfortunate enough to be bitten. The authors have documented the sequence of events for the patient, outlined the care the patient received, examined the pathophysiology of the body to a spider bite, and then made a passionate appeal for other nurses who work in critical care to do the same with patients in similar situations.

Paediatric Rome III Criteria-Related Abdominal Pain Is Associated With Helicobacter pylori and Not With Calprotectin.

PubMed

Sýkora, Josef; Huml, Michal; Siala, Konrad; Pomahačová, Renáta; Jehlička, Petr; Liška, Jiří; Kuntscherová, Jana; Schwarz, Jan

2016-10-01

Abdominal pain-related functional gastrointestinal disorders in children include functional dyspepsia, functional abdominal pain, irritable bowel syndrome, and abdominal migraine. We aimed to evaluate a possible association between functional abdominal pain disorders and Helicobacter pylori infection and faecal calprotectin level. Prospective observational study including consecutive children with functional gastrointestinal disorders fulfilling Rome III criteria (cases) and age/sex-matched healthy controls. H pylori has been detected by biopsy-based tests and stool-antigen detection, faecal calprotectin by enzyme-linked immunosorbent assay. A total of 56 cases (27 with functional dyspepsia) and 56 controls were enrolled. H pylori being detected in 17 of 56 cases (30.4%) and 4 of 56 controls (7.1%, odds ratio: 5.7; 95% confidence interval [CI]: 1.8-18.2, P = 0.003). H pylori was detected significantly more frequently in cases with functional dyspepsia (14/27, 51.9% odds ratio: 14.0; 95% CI: 3.9-49.7, P = 0.00001) than in controls and not in cases with other well-recognized functional gastrointestinal complaints (3/29, 10.3%). The median faecal calprotectin level was similar in cases (7.8 μg/g, 95% CI: 7.8-8.4) including those with gastritis, and controls (9.1 μg/g, 95% CI: 7.8-11.3). Gastritis features were more frequent in H pylori-infected and noninfected cases with functional dyspepsia (27/27, 100%) than in cases with other abdominal functional complaints (15/29, 51.7%, P = 0.007). H pylori gastritis and noninfectious gastritis were associated with functional dyspepsia in children referred for abdominal pain-related functional gastrointestinal disorders while faecal calprotectin is not a predictor of gastritis and is similar in children with functional abdominal pain symptoms and in controls.

Characteristics of medication overdose presentations to the ED: how do they differ from illicit drug overdose and self-harm cases?

PubMed

Buykx, Penny; Dietze, Paul; Ritter, Alison; Loxley, Wendy

2010-07-01

Medication overdose accounts for >80% of hospital presentations for self-harm. Previous research has identified typical characteristics of medication overdose cases; however, these cases have not been well differentiated from other similar presentations, namely (1) illicit drug overdose and (2) self-harm by means other than overdose. A 12-month audit of medication overdose cases (both intentional and unintentional) attending the emergency department (ED) of a major metropolitan public hospital in Melbourne, Australia was conducted. Comparison was made with patients attending for illicit drug overdose or for self-harm by means other than overdose. Medication overdose cases (n=453) showed a broadly comparable profile with those found in earlier studies (predominantly female gender, aged in their 30s and referred for psychosocial assessment). A similar though not identical profile was noted for self-harm cases (n=545). In contrast, patients attending for illicit drug overdose (n=409) could be characterised as male, in their 20s and not referred for psychosocial assessment. Illicit drug overdose cases were more likely than either the medication overdose or self-harm cases to be triaged in the most urgent category (19.3, 3.8 and 3.9% respectively), suggesting a high level of acuity in this group. However, the illicit drug overdose group on average spent less time in the ED than medication overdose patients, and were less likely to require hospital admission. On both demographic and treatment variables, patients attending the ED following a medication overdose more closely resemble those attending for self-harm by means other than overdose than those attending for illicit drug overdose.

Lymphoepithelioma-like Carcinoma of the Breast: A Case Report

PubMed Central

Top, Ömer Erdinç; Vardar, Enver; Yağcı, Ayşe; Deniz, Senem; Öztürk, Rafet; Zengel, Baha

2014-01-01

Lymphoepithelioma-like carcinoma carries similar histopathological features with lymphoepithelioma typically located in the nasopharynx. Lymphoepithelioma-like carcinoma of the breast can be mistaken for breast lymphoma or medullary carcinoma due to the undifferentiated appearance of tumor cells and presence of prominent lymphoid component. Lymphoepithelioma-like carcinoma is rare, and the similarity between medullary carcinoma of the breast makes it difficult to distinguish these two tumors. In the presented case, neither lymph node nor distant metastases were detected. Breast lymphoepithelioma-like carcinoma is extremely rare with only 21 reported cases in the literature. Herein we present a 59-year-old woman with lymphoepithelioma-like carcinoma of the breast along with the cases previously published in the literature. PMID:28331666

Relationship of spermatoscopy, prostatic acid phosphatase activity and prostate-specific antigen (p30) assays with further DNA typing in forensic samples from rape cases.

PubMed

Romero-Montoya, Lydia; Martínez-Rodríguez, Hugo; Pérez, Miguel Antonio; Argüello-García, Raúl

2011-03-20

In the forensic laboratory the biological analyses for rape investigation commonly include vaginal swabs as sample material combined to biochemical tests including sperm cytology (SC) and detection of acid phosphatase activity (AP) and prostate-specific antigen (PSA, p30) for the conclusive identification of semen components. Most reports comparing these tests relied on analysis of semen samples or donor swabs taken under controlled conditions; however their individual or combined efficacy under real live sampling conditions in different laboratories is largely unknown. We carried out SC, APA and PSA analyses in vaginal swabs collected from casework rapes submitted to Mexican Forensic Laboratories at Texcoco and Toluca. On the basis of positive and negative results from each assay and sample, data were classified into eight categories (I-VIII) and compared with those obtained in the two only similar studies reported in Toronto, Canada and Hong Kong, China. SC and APA assays had the higher overall positivity in Toluca and Texcoco samples respectively and otherwise PSA had a lower but very similar positivity between these two laboratories. When compared to the previous studies some similarities were found, namely similar frequencies (at a ratio of approximately 1 out of 3) of samples being positive or negative by all techniques (Categories I and VI respectively) and a comparable overall positivity of APA and SC but higher than that of PSA. Indeed the combined results of using SC, APA and PSA tests was considered as conclusive for semen detection from approximately 1 out of 3 cases (Category I) to approximately 1 out of 2 cases in a scenario where at least SC is positive, strongly presumptive in 2 out of 3 cases (with at least one test positive) and the remainder 1 out of 3 cases (Category VI) suggested absence of semen. By determining Y-STR polymorphisms (12-loci) in additional samples obtained at Toluca laboratory, complete DNA profiles were determined from all Category I samples, none marker was detected from all Category VI samples and mostly partial profiles were obtained from samples of other categories. These observations give an overview on the variability in efficacy of each test performed at different laboratories and provide a general notion about the in praxis contribution of SC, APA and PSA tests for further DNA typing in the forensic analysis of rape. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

Killing and Noether Symmetries of Plane Symmetric Spacetime

NASA Astrophysics Data System (ADS)

Shamir, M. Farasat; Jhangeer, Adil; Bhatti, Akhlaq Ahmad

2013-09-01

This paper is devoted to investigate the Killing and Noether symmetries of static plane symmetric spacetime. For this purpose, five different cases have been discussed. The Killing and Noether symmetries of Minkowski spacetime in cartesian coordinates are calculated as a special case and it is found that Lie algebra of the Lagrangian is 10 and 17 dimensional respectively. The symmetries of Taub's universe, anti-deSitter universe, self similar solutions of infinite kind for parallel perfect fluid case and self similar solutions of infinite kind for parallel dust case are also explored. In all the cases, the Noether generators are calculated in the presence of gauge term. All these examples justify the conjecture that Killing symmetries form a subalgebra of Noether symmetries (Bokhari et al. in Int. J. Theor. Phys. 45:1063, 2006).

Similarity networks as a knowledge representation for space applications

NASA Technical Reports Server (NTRS)

Bailey, David; Thompson, Donna; Feinstein, Jerald

1987-01-01

Similarity networks are a powerful form of knowledge representation that are useful for many artificial intelligence applications. Similarity networks are used in applications ranging from information analysis and case based reasoning to machine learning and linking symbolic to neural processing. Strengths of similarity networks include simple construction, intuitive object storage, and flexible retrieval techniques that facilitate inferencing. Therefore, similarity networks provide great potential for space applications.

Clinical, virologic, and immunologic outcomes in lymphoma survivors and in cancer-free, HIV-1-infected patients: a matched cohort study.

PubMed

Spagnuolo, Vincenzo; Travi, Giovanna; Galli, Laura; Cossarini, Francesca; Guffanti, Monica; Gianotti, Nicola; Salpietro, Stefania; Lazzarin, Adriano; Castagna, Antonella

2013-08-01

The objective of this study was to compare immunologic, virologic, and clinical outcomes between living human immunodeficiency virus (HIV)-infected individuals who had a diagnosis of lymphoma versus outcomes in a control group of cancer-free, HIV-infected patients. In this matched cohort study, patients in the case group were survivors of incident lymphomas that occurred between 1997 and June 2010. Controls were living, cancer-free, HIV-infected patients who were matched to cases at a 4:1 ratio by age, sex, nadir CD4 cell count, and year of HIV diagnosis. The date of lymphoma diagnosis served as the baseline in cases and in the corresponding controls. In total, 62 patients (cases) who had lymphoma (20 with Hodgkin disease [HD] and 42 with non-Hodgkin lymphoma [NHL]) were compared with 211 controls. The overall median follow-up was 4.8 years (interquartile range, 2.0-7.9 years). The CD4 cell count at baseline was 278 cells/mm³ (interquartile range, 122-419 cells/mm³) in cases versus 421 cells/mm³ (interquartile range, 222-574 cells/mm³) in controls (P = .003). At the last available visit, the CD4 cell count was 412 cells/mm³ (range, 269-694 cells/mm³) in cases versus 518 cells/mm³ (interquartile range, 350-661 cells/mm³) in controls (P = .087). The proportion of patients who achieved virologic success increased from 30% at baseline to 74% at the last available visit in cases (P = .008) and from 51% to 81% in controls (P = .0286). Patients with HD reached higher CD4 cell counts at their last visit than patients with NHL (589 cells/mm³ [range, 400-841 cells/mm³] vs 332 cells/mm³ [interquartile range, 220-530 cells/mm³], respectively; P = .003). Virologic success was similar between patients with HD and patients with NHL at the last visit. Forty cases (65%) and 76 controls (36%) experienced at least 1 clinical event after baseline (P < .0001); cases were associated with a shorter time to occurrence of the first clinical event compared with controls (P < .0001). HIV-infected lymphoma survivors experienced more clinical events than controls, especially during the first year of follow-up, but they reached similar long-term immunologic and virologic outcomes. © 2013 American Cancer Society.

[Pathological and biochemical studies of 30 Niigata autopsy cases related to Minamata disease].

PubMed

Eto, Komyo; Takahashi, Hitoshi; Kakita, Akiyoshi; Tokunaga, Hidehiro; Yasutake, Akira; Nakano, Atsuhiro; Sawada, Masumi; Kinjo, Yoshihide

2007-01-01

To reevaluate pathologically and biochemically 30 autopsy cases related to Minamata disease (MD) in Niigata Prefecture (NP) and compare the findings with those of autopsy cases related to MD in Kumamoto Prefecture (KP). Recently, a set of pathological materials of these 30 autopsy cases has been sent from the Brain Research Institute at the University of Niigata to the National Institute for Minamata Disease (NIMD). The materials from each autopsy case were reexamined at the NIMD. There were no postnatal and fetal cases of MD in the NP autopsy materials. The contents of total mercury (T-Hg), methylmercury (Me-Hg), inorganic mercury (I-Hg) and selenium were measured in the organs of cerebrum, cerebellum, liver and kidney. The contents of T-Hg, Me-Hg and I-Hg were much higher in two cases than in controls. The pathological findings leading to the diagnosis of MD in the NP cases were essentially the same as those in KP, including the peripheral nerve lesions. In the most severely affected case of MD in NP, formation of multiple vacuoles of various sizes was observed in the cerebellar cortex, which was never encountered in the KP cases. The KP lesions were similar to that observed in an acute case of Me-Hg-treated common marmoset studied in the NIMD. The pathological features were essentially the same between the adult cases of MD in NP and KP.

Peripheral dysgraphia characterized by the co-occurrence of case substitutions in uppercase and letter substitutions in lowercase writing.

PubMed

Di Pietro, M; Schnider, A; Ptak, R

2011-10-01

Patients with peripheral dysgraphia due to impairment at the allographic level produce writing errors that affect the letter-form and are characterized by case confusions or the failure to write in a specific case or style (e.g., cursive). We studied the writing errors of a patient with pure peripheral dysgraphia who had entirely intact oral spelling, but produced many well-formed letter errors in written spelling. The comparison of uppercase print and lowercase cursive spelling revealed an uncommon pattern: while most uppercase errors were case substitutions (e.g., A - a), almost all lowercase errors were letter substitutions (e.g., n - r). Analyses of the relationship between target letters and substitution errors showed that errors were neither influenced by consonant-vowel status nor by letter frequency, though word length affected error frequency in lowercase writing. Moreover, while graphomotor similarity did not predict either the occurrence of uppercase or lowercase errors, visuospatial similarity was a significant predictor of lowercase errors. These results suggest that lowercase representations of cursive letter-forms are based on a description of entire letters (visuospatial features) and are not - as previously found for uppercase letters - specified in terms of strokes (graphomotor features). Copyright © 2010 Elsevier Srl. All rights reserved.

Characterization of Seasonal Influenza Virus Type and Subtypes Isolated from Influenza Like Illness Cases of 2012.

PubMed

Upadhyay, B P; Ghimire, P; Tashiro, M; Banjara, M R

Background Seasonal influenza is one of the increasing public health burdens in Nepal. Objective The objective of this study was to isolate and characterize the influenza virus type and subtypes of Nepal. Method A total of 1536 throat swab specimens were collected from January to December 2012. Total ribonucleic acid was extracted using Qiagen viral nucleic acid extraction kit and polymerase chain reaction assay was performed following the US; CDC Real-time PCR protocol. Ten percent of positive specimens were inoculated onto Madin-Darby Canine Kidney cells. Isolates were characterized by using reference ferret antisera. Result Of the total specimens (n=1536), influenza virus type A was detected in 196 (22%) cases; of which 194 (99%) were influenza A (H1N1) pdm09 and 2 (1 %) were influenza A/H3 subtype. Influenza B was detected in 684 (76.9%) cases. Influenza A (H1N1) pdm09, A/H3 and influenza B virus were antigenically similar to the recommended influenza virus vaccine candidate of the year 2012. Although sporadic cases of influenza were observed throughout the year, peak was observed during July to November. Conclusion Similar to other tropical countries, A (H1N1) pdm09, A/H3 and influenza B viruses were co-circulated in Nepal.

Contaminant Leach Testing of Hanford Tank 241-C-104 Residual Waste

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

Cantrell, Kirk J.; Snyder, Michelle M.V.; Wang, Guohui

2015-07-01

Leach testing of Tank C-104 residual waste was completed using batch and column experiments. Tank C-104 residual waste contains exceptionally high concentrations of uranium (i.e., as high as 115 mg/g or 11.5 wt.%). This study was conducted to provide data to develop contaminant release models for Tank C-104 residual waste and Tank C-104 residual waste that has been treated with lime to transform uranium in the waste to a highly insoluble calcium uranate (CaUO4) or similar phase. Three column leaching cases were investigated. In the first case, C-104 residual waste was leached with deionized water. In the second case, crushedmore » grout was added to the column so that deionized water contacted the grout prior to contacting the waste. In the third case, lime was mixed in with the grout. Results of the column experiments demonstrate that addition of lime dramatically reduces the leachability of uranium from Tank C-104 residual waste. Initial indications suggest that CaUO4 or a similar highly insoluble calcium rich uranium phase forms as a result of the lime addition. Additional work is needed to definitively identify the uranium phases that occur in the as received waste and the waste after the lime treatment.« less

SEQATOMS: a web tool for identifying missing regions in PDB in sequence context.

PubMed

Brandt, Bernd W; Heringa, Jaap; Leunissen, Jack A M

2008-07-01

With over 46 000 proteins, the Protein Data Bank (PDB) is the most important database with structural information of biological macromolecules. PDB files contain sequence and coordinate information. Residues present in the sequence can be absent from the coordinate section, which means their position in space is unknown. Similarity searches are routinely carried out against sequences taken from PDB SEQRES. However, there no distinction is made between residues that have a known or unknown position in the 3D protein structure. We present a FASTA sequence database that is produced by combining the sequence and coordinate information. All residues absent from the PDB coordinate section are masked with lower-case letters, thereby providing a view of these residues in the context of the entire protein sequence, which facilitates inspecting 'missing' regions. We also provide a masked version of the CATH domain database. A user-friendly BLAST interface is available for similarity searching. In contrast to standard (stand-alone) BLAST output, which only contains upper-case letters, our output retains the lower-case letters of the masked regions. Thus, our server can be used to perform BLAST searching case-sensitively. Here, we have applied it to the study of missing regions in their sequence context. SEQATOMS is available at http://www.bioinformatics.nl/tools/seqatoms/.

Research designs and making causal inferences from health care studies.

PubMed

Flannelly, Kevin J; Jankowski, Katherine R B

2014-01-01

This article summarizes the major types of research designs used in healthcare research, including experimental, quasi-experimental, and observational studies. Observational studies are divided into survey studies (descriptive and correlational studies), case-studies and analytic studies, the last of which are commonly used in epidemiology: case-control, retrospective cohort, and prospective cohort studies. Similarities and differences among the research designs are described and the relative strength of evidence they provide is discussed. Emphasis is placed on five criteria for drawing causal inferences that are derived from the writings of the philosopher John Stuart Mill, especially his methods or canons. The application of the criteria to experimentation is explained. Particular attention is given to the degree to which different designs meet the five criteria for making causal inferences. Examples of specific studies that have used various designs in chaplaincy research are provided.

Epidemiology of primary brain tumors in the Middle Eastern population in California, USA 2001-2005.

PubMed

Nasseri, Kiumarss; Mills, John R

2009-01-01

The fast growing Middle Eastern (ME) population has rarely been studied in the U.S.. The purpose of this study was to compare the epidemiology of primary brain tumors in this ethnic population with the non-Hispanic, non-Middle Eastern White (NHNMW) in California. ME cases were identified by surname in the California cancer registry and ME population estimates were based on ancestry. Data for 683 cases of primary brain tumors (429 benign, 238 malignant, 16 uncertain) in the ME and 15,589 cases (8352 benign, 6812 malignant, 425 uncertain) in the NHNMW were available for this study. ME patients were significantly (p < 0.05) younger and their age-adjusted incidence rates per 100,000 for benign tumors of 10.0 in men and 17.6 in women were higher than similar rates of 7.3 and 10.6 in the NHNMW group (p < 0.05). Rates for malignant tumors were similar. Meningioma was the main histology responsible for the observed increase in patients over 40 years of age. Also increased were benign tumors of the pituitary and pineal glands. The overall mortality in patients with benign tumors was significantly lower than malignant tumors. This study presents a significantly high incidence of benign meningioma in the ME population in California. This may be due to higher susceptibility or exposure of this ethnic group to the risk factor(s) for this neoplasm. Considering the reported causal association of benign meningioma with childhood radiation exposure from Israel, exposure to this risk factor in this ethnic group needs to be evaluated in future studies.

Polymorphisms of the lipoprotein lipase gene as genetic markers for stroke in colombian population: a case control study.

PubMed

Velásquez Pereira, Leydi Carolina; Vargas Castellanos, Clara Inés; Silva Sieger, Federico Arturo

2016-12-30

To analyze if there is an association between the presence of polymorphisms in the LPL gene (rs320, rs285 and rs328) with development of acute ischemic stroke in Colombian population. In a case control design, 133 acute ischemic stroke patients (clinical diagnosis and x-ray CT) and 269 subjects without stroke as controls were studied. PCR -RFLP technique was used to detect rs320, rs285 and rs328 polymorphisms in the LPL gene. In the present research was not found any association between any of the LPL gene polymorphism and acute ischemic stroke in the population studied; the allele and genotypic frequencies of the studied polymorphisms were similar in cases and controls and followed the Hardy-Weinberg equilibrium. The study was approved by the IRB and each subject signed the informed consent. LPL gene polymorphisms are not genetic markers for the development of stroke in the Colombian sample used.

On the costs of parallel processing in dual-task performance: The case of lexical processing in word production.

PubMed

Paucke, Madlen; Oppermann, Frank; Koch, Iring; Jescheniak, Jörg D

2015-12-01

Previous dual-task picture-naming studies suggest that lexical processes require capacity-limited processes and prevent other tasks to be carried out in parallel. However, studies involving the processing of multiple pictures suggest that parallel lexical processing is possible. The present study investigated the specific costs that may arise when such parallel processing occurs. We used a novel dual-task paradigm by presenting 2 visual objects associated with different tasks and manipulating between-task similarity. With high similarity, a picture-naming task (T1) was combined with a phoneme-decision task (T2), so that lexical processes were shared across tasks. With low similarity, picture-naming was combined with a size-decision T2 (nonshared lexical processes). In Experiment 1, we found that a manipulation of lexical processes (lexical frequency of T1 object name) showed an additive propagation with low between-task similarity and an overadditive propagation with high between-task similarity. Experiment 2 replicated this differential forward propagation of the lexical effect and showed that it disappeared with longer stimulus onset asynchronies. Moreover, both experiments showed backward crosstalk, indexed as worse T1 performance with high between-task similarity compared with low similarity. Together, these findings suggest that conditions of high between-task similarity can lead to parallel lexical processing in both tasks, which, however, does not result in benefits but rather in extra performance costs. These costs can be attributed to crosstalk based on the dual-task binding problem arising from parallel processing. Hence, the present study reveals that capacity-limited lexical processing can run in parallel across dual tasks but only at the expense of extraordinary high costs. (c) 2015 APA, all rights reserved).

Evaluation of the Consequences of a Cistern Truck Accident While Transporting Dangerous Substances through a Tunnel.

PubMed

Malecha, Ziemowit M; Poliski, Jarosaw; Chorowski, Maciej

2017-12-01

The transportation of dangerous substances by truck carriers harbors important safety issues in both road and mine tunnels. Even though traffic conditions in road and mine tunnels are different, the potential geometric and hydrodynamic similarities can lead to similar effects from the uncontrolled leakage of the dangerous material. This work was motivated by the design study of the LAGUNA-LBNO (Large Apparatus studying Grand Unification and Neutrino Astrophysics and Long Baseline Neutrino Oscillations) project. The considered neutrino detector requires a huge amount of liquid argon, which must be transported down the tunnel. The present work focuses on the estimation of the most credible incident and the resulting consequences in the case of a truck accident in the tunnel. The approach and tools used in the present work are generic and can be adapted to other similar situations. © 2017 Society for Risk Analysis.

Prediction using patient comparison vs. modeling: a case study for mortality prediction.

PubMed

Hoogendoorn, Mark; El Hassouni, Ali; Mok, Kwongyen; Ghassemi, Marzyeh; Szolovits, Peter

2016-08-01

Information in Electronic Medical Records (EMRs) can be used to generate accurate predictions for the occurrence of a variety of health states, which can contribute to more pro-active interventions. The very nature of EMRs does make the application of off-the-shelf machine learning techniques difficult. In this paper, we study two approaches to making predictions that have hardly been compared in the past: (1) extracting high-level (temporal) features from EMRs and building a predictive model, and (2) defining a patient similarity metric and predicting based on the outcome observed for similar patients. We analyze and compare both approaches on the MIMIC-II ICU dataset to predict patient mortality and find that the patient similarity approach does not scale well and results in a less accurate model (AUC of 0.68) compared to the modeling approach (0.84). We also show that mortality can be predicted within a median of 72 hours.

Introduction of a computer-based surgical platform in the surgical care of patients with newly diagnosed uterine cancer: outcomes and impact on approach.

PubMed

Leitao, Mario M; Briscoe, Gabriel; Santos, Kevin; Winder, Abigail; Jewell, Elizabeth L; Hoskins, William J; Chi, Dennis S; Abu-Rustum, Nadeem R; Sonoda, Yukio; Brown, Carol L; Levine, Douglas A; Barakat, Richard R; Gardner, Ginger J

2012-05-01

To assess the introduction of computer-based surgery (ie, robotic surgery [RBT]) in the treatment of patients with newly diagnosed uterine cancer. We identified all patients who presented to our institution for initial surgical care of newly diagnosed uterine cancer from 5/1/07-12/31/10. Perioperative outcomes of laparotomy cases were compared to those of laparoscopic (LSC) or RBT cases. Complications within 30 days of surgery were graded. Of 752 patients, the planned approach was laparotomy in 103 (14%), LSC in 302 (40%), and RBT in 347 (46%). The rate of laparotomy for any reason (planned or converted) was 39% in 2007 compared to 18% in 2010 (P<0.001). Preoperative characteristics for LSC and RBT cases were similar, except 10% versus 15%, respectively, were morbidly obese (P=0.049). The extent of procedure, total nodal counts, and overall complications were similar between the LSC and RBT cases. The median length of stay was shorter for RBT cases (P<0.001). The median total room and operative times were longer for RBT cases (P<0.001), mainly due to cases in which the surgeon had less than ~40 RBT cases of experience. Robotics can be efficiently introduced into the surgical care of patients with newly diagnosed uterine cancers. RBT cases require the same operative times as LSC cases after accounting for the 40-case learning curve. Both approaches result in similar excellent patient outcomes and remain reasonable approaches for this disease. The introduction of robotics may lead to further reduction in the rate of laparotomy. Copyright © 2012 Elsevier Inc. All rights reserved.

Comparison of risk factors for seropositivity to feline immunodeficiency virus and feline leukemia virus among cats: a case-case study.

PubMed

Chhetri, Bimal K; Berke, Olaf; Pearl, David L; Bienzle, Dorothee

2015-02-10

Feline immunodeficiency virus (FIV) and feline leukemia virus (FeLV) are reported to have similar risk factors and similar recommendations apply to manage infected cats. However, some contrasting evidence exists in the literature with regard to commonly reported risk factors. In this study, we investigated whether the known risk factors for FIV and FeLV infections have a stronger effect for either infection. This retrospective study included samples from 696 cats seropositive for FIV and 593 cats seropositive for FeLV from the United States and Canada. Data were collected during two cross sectional studies, where cats were tested using IDEXX FIV/FeLV ELISA kits. To compare the effect of known risk factors for FIV infection compared to FeLV, using a case-case study design, random intercept logistic regression models were fit including cats' age, sex, neuter status, outdoor exposure, health status and type of testing facility as independent variables. A random intercept for testing facility was included to account for clustering expected in testing practices at the individual clinics and shelters. In the multivariable random intercept model, the odds of FIV compared to FeLV positive ELISA results were greater for adults (OR = 2.09, CI: 1.50-2.92), intact males (OR = 3.14, CI: 1.85-3.76), neutered males (OR = 2.68, CI: 1.44- 3.14), cats with outdoor access (OR = 2.58, CI: 1.85-3.76) and lower for cats with clinical illness (OR = 0.60, 95% CI: 0.52-0.90). The variance components obtained from the model indicated clustering at the testing facility level. Risk factors that have a greater effect on FIV seropositivity include adulthood, being male (neutered or not) and having access to outdoors, while clinical illness was a stronger predictor for FeLV seropositivity. Further studies are warranted to assess the implications of these results for the management and control of these infections.

Differences in Behavior and Brain Activity during Hypothetical and Real Choices.

PubMed

Camerer, Colin; Mobbs, Dean

2017-01-01

Real behaviors are binding consequential commitments to a course of action, such as harming another person, buying an Apple watch, or fleeing from danger. Cognitive scientists are generally interested in the psychological and neural processes that cause such real behavior. However, for practical reasons, many scientific studies measure behavior using only hypothetical or imagined stimuli. Generalizing from such studies to real behavior implicitly assumes that the processes underlying the two types of behavior are similar. We review evidence of similarity and differences in hypothetical and real mental processes. In many cases, hypothetical choice tasks give an incomplete picture of brain circuitry that is active during real choice. Copyright © 2016. Published by Elsevier Ltd.

The general Lie group and similarity solutions for the one-dimensional Vlasov-Maxwell equations

NASA Technical Reports Server (NTRS)

Roberts, D.

1985-01-01

The general Lie point transformation group and the associated reduced differential equations and similarity forms for the solutions are derived here for the coupled (nonlinear) Vlasov-Maxwell equations in one spatial dimension. The case of one species in a background is shown to admit a larger group than the multispecies case. Previous exact solutions are shown to be special cases of the above solutions, and many of the new solutions are found to constrain the form of the distribution function much more than, for example, the BGK solutions do. The individual generators of the Lie group are used to find the possible subgroups. Finally, a simple physical argument is given to show that the asymptotic solution for a one-species, one-dimensional plasma is one of the general similarity solutions.

Comparing Teachers' Non-Teaching Roles in Curriculum Reforms from an Organization Studies Perspective: Cases from Botswana and South Africa

ERIC Educational Resources Information Center

Addy, Nii Antiaye

2012-01-01

In Sub-Saharan Africa, the academic aims of curriculum reforms and the teaching roles related to them are similar, but non-teaching roles are likely to vary across countries. Taking an organization studies perspective, this article compares teachers' roles in reform along the Botswana-South Africa border. Though these teachers share language and…

Persistent psychotic symptoms after long-term heavy use of mephedrone: A two-case series.

PubMed

Barrio, Pablo; Gaskell, Matthew; Goti, Javier; Vilardell, Sergi; Fàbregas, Josep Maria

2016-06-15

Mephedrone (4-methylmethcathinone) is a synthetic stimulant drug of the cathinone class. Similar effects to those of cocaine and ecstasy are reported by users, with a high addictive potential. Given its increasing rate of consumption in Europe, it is getting more and more attention from the addiction field. In spite of that, little is known about the long-term consequences of prolonged heavy use. The two following cases might depict some of them. Case 1 was a middle-age man who reported three years of intravenous use of mephedrone. He used to binge for several days in a row. Psychotic symptoms appeared after a few months, especially paranoid delusions. Sent to aftercare in a therapeutic community, delusions kept reappearing after prolonged abstinence. A good response to risperidone was observed. Case 2 was a young man who used mephedrone heavily for two years, always snorted. Upon admission to the therapeutic community, the patient reported auditory hallucinations that partially remitted with olanzapine. Both cases showed a good insight and no personality deterioration. Given its similarities to other substances that are known to induce psychotic symptoms, and the increasing consumption of mephedrone around Europe, similar cases are expected in the near future. Conventional antipsychotic treatment seems a reasonable pharmacological approach.

A sham case-control study of effectiveness of DTP-Hib-hepatitis B vaccine against rotavirus acute gastroenteritis in Kenya

PubMed Central

2014-01-01

Background In many GAVI-eligible countries, effectiveness of new vaccines will be evaluated by case-control methodology. To inform the design and assess selection bias of a future case-control study of rotavirus vaccine effectiveness (VE) in western Kenya, we performed a sham case-control study evaluating VE of pentavalent vaccine (DTP-Hib-HepB) against rotavirus acute gastroenteritis (AGE). Methods From ongoing rotavirus surveillance, we defined cases as children 12 weeks to 23 months old with EIA-confirmed rotavirus AGE. We enrolled one community-based and two hospital-based control groups. We collected vaccination status from cards at enrollment, or later in homes, and evaluated VE by logistic regression. Results We enrolled 91 cases (64 inpatient, 27 outpatient), 252 non-rotavirus AGE facility-based controls (unmatched), 203 non-AGE facility-based controls (age-matched) and 271 community controls (age-matched). Documented receipt of 3 pentavalent doses was 77% among cases and ranged from 81-86% among controls. One percent of cases and 0-2% of controls had no pentavalent doses. The adjusted odds ratio of three versus zero doses for being a case was 3.27 (95% CI 0.01-1010) for community controls and 0.69 (95% CI 0.06-7.75) for non-rotavirus hospital-based AGE controls, translating to VE of -227% and 31%, respectively, with wide confidence intervals. (No facility-based non-AGE controls were unvaccinated.) Similar results were found for ≥2 pentavalent doses and for severe rotavirus AGE. Conclusions The study showed that it is feasible to carry out a real case control in the study area, but this needs to be done as soon as the vaccine is introduced to capture the real impact. Sham case-control or pilot studies before vaccine introduction can be useful in designing case-control VE studies. PMID:24517198

A sham case-control study of effectiveness of DTP-Hib-hepatitis B vaccine against rotavirus acute gastroenteritis in Kenya.

PubMed

Khagayi, Sammy; Tate, Jacqueline E; Onkoba, Reuben; Parashar, Umesh; Odhiambo, Frank; Burton, Deron; Laserson, Kayla; Feikin, Daniel R

2014-02-11

In many GAVI-eligible countries, effectiveness of new vaccines will be evaluated by case-control methodology. To inform the design and assess selection bias of a future case-control study of rotavirus vaccine effectiveness (VE) in western Kenya, we performed a sham case-control study evaluating VE of pentavalent vaccine (DTP-Hib-HepB) against rotavirus acute gastroenteritis (AGE). From ongoing rotavirus surveillance, we defined cases as children 12 weeks to 23 months old with EIA-confirmed rotavirus AGE. We enrolled one community-based and two hospital-based control groups. We collected vaccination status from cards at enrollment, or later in homes, and evaluated VE by logistic regression. We enrolled 91 cases (64 inpatient, 27 outpatient), 252 non-rotavirus AGE facility-based controls (unmatched), 203 non-AGE facility-based controls (age-matched) and 271 community controls (age-matched). Documented receipt of 3 pentavalent doses was 77% among cases and ranged from 81-86% among controls. One percent of cases and 0-2% of controls had no pentavalent doses. The adjusted odds ratio of three versus zero doses for being a case was 3.27 (95% CI 0.01-1010) for community controls and 0.69 (95% CI 0.06-7.75) for non-rotavirus hospital-based AGE controls, translating to VE of -227% and 31%, respectively, with wide confidence intervals. (No facility-based non-AGE controls were unvaccinated.) Similar results were found for ≥2 pentavalent doses and for severe rotavirus AGE. The study showed that it is feasible to carry out a real case control in the study area, but this needs to be done as soon as the vaccine is introduced to capture the real impact. Sham case-control or pilot studies before vaccine introduction can be useful in designing case-control VE studies.

Candidemia in neonatal intensive care units: Barcelona, Spain.

PubMed

Rodriguez, Dolors; Almirante, Benito; Park, Benjamin J; Cuenca-Estrella, Manuel; Planes, Ana M; Sanchez, Ferran; Gene, Amadeu; Xercavins, Mariona; Fontanals, Dionisia; Rodriguez-Tudela, Juan L; Warnock, David W; Pahissa, Albert

2006-03-01

Candida spp. are increasingly important hospital-acquired pathogens in neonatal intensive care units (NICU) and cause considerable mortality in preterm infants. Most studies have been limited to a single institution. The aim of this study was to determine the epidemiology of candidemia in all Barcelona NICUs. We conducted prospective population-based surveillance for candidemia in Barcelona, Spain, during 2002-2003. This report focuses on the results from 5 participating hospitals with NICUs. We detected 24 cases, resulting in an annual incidence of 32.6 cases per 100,000 live births and 1.1 cases per 100 NICU discharges. Median gestational age was 27.5 weeks (range, 24-40.5), and there were 21 cases among very low birth weight infants. Among the 20 (83%) cases evaluated for the presence of end organ infection, endophthalmitis occurred in 2 cases, and endocarditis, meningitis and peritonitis occurred in 1 case each. Candida parapsilosis was the most frequent species isolated (67%). All isolates were fluconazole-susceptible. Crude mortality was 21%. The preponderance of C. parapsilosis candidemias observed in Barcelona NICUs is similar to reports from the literature. Morbidity and mortality associated with neonatal candidemia remain high.

Changes in Student Perceptions and Study Strategies Over Time in a Veterinary Clinical Pathology Course Using Case-Based Instruction.

PubMed

Fernandez, Nicole J; Wagg, Catherine R; Warren, Amy L

2018-06-13

Veterinary students are challenged to develop new, nonlinear ways of thinking as they learn diagnostic reasoning skills. To support this process, we use real-life cases in our clinical pathology course. Changes in student perceptions regarding the use of cases and changes in study strategies over time have not been previously investigated or compared to student grades. Students participated in three voluntary online surveys that included 4-point Likert scale questions and open-ended questions on the helpfulness of cases for learning and study strategies used during the course. We used Friedman tests to detect any differences in perceptions over time; McNemar's test and "Wilcoxon signed-rank tests were used to detect any differences in study strategies over time. Fisher's exact tests'were used to examine the association between the Likert scale responses and grades in quartiles. Before beginning the course, 29% of students responded that cases were very helpful to their learning, with similar "responses for helpfulness in applying course material and grasping important concepts. There was a significant trend of increasing positivity over the duration of the course, with 74% responding that cases were very helpful at the end of the course. The most-reported study strategy was working individually on cases before the midterm (74% of students), and the most helpful study strategy was attending class regularly (88% reported it as very "helpful). Study strategies did not change significantly over time. Overall, perceptions and study strategies did not vary significantly with grades.

[Traditional Chinese medicine syndrome factors of patients with HIV infection or AIDS in China].

PubMed

Jiang, Feng; Fu, Lin-chun; Ma, Jian-ping; Zhou, Qing; Peng, Bo; Xie, Shi-ping; Guo, Hui-jun; Dong, Yong-xin; Ma, Xiu-lan; Guo, Xuan-xian; Xie, Zhong-li; Hu, Yan-ping; Li, Qing-ya; Li, Hua-wei; Jin, Yan-tao

2011-09-01

To study the characteristics of traditional Chinese medicine (TCM) syndrome factors of patients from different areas of China with human immunodeficiency virus (HIV) infection or acquired immunodeficiency syndrome (AIDS). A cross-sectional investigation study was conducted in Henan, Guangdong and Yunnan Provinces and Xinjiang Uygur Autonomous Region of China from October 2008 to August 2010. Based on literature review and expert opinion, a clinical questionnaire of TCM syndromes was drawn up. This survey was carried out after the investigators were professionally trained. Wenfeng III Auxiliary Diagnosis and Treat System of TCM was used to analyze the frequencies of AIDS patients' signs and symptoms with scores above 70 of syndrome factors respectively. Based on this work, syndrome factors of AIDS were analyzed in different areas. There were 608 HIV/AIDS cases investigated from October 2008 to August 2010 in total; among them, 276 cases were from Henan, 126 cases from Guangdong, 120 cases from Xinjiang and 86 cases from Yunnan. The results of syndrome factor analysis indicated that the syndromes of four provinces were similar. HIV/AIDS patients in the four areas exhibited qi deficiency, blood deficiency, yin deficiency, yang deficiency, dampness, phlegm, qi stagnation and essence deficiency syndromes. Patients in each area also had their own characteristics, such as that the scores of dampness of Guangdong and yin deficiency of Xinjiang were higher than the other syndromes, whereas the scores of Henan Province were higher than the other areas. AIDS patients had higher scores of syndromes than HIV-infected patients. HIV/AIDS patients from different areas had similar syndrome elements. The theory of "AIDS toxin injuring primordial qi" can sum up the TCM etiology and pathogenesis of HIV/AIDS.

Balloon-Assisted Tracking Use Reduces Radial Artery Access Failure in an Experienced Radial Center and is Feasible During Primary PCI for STEMI.

PubMed

Obaid, Daniel; Hailan, Ahmed; Chase, Alexander; Dorman, Stephen; Jenkins, Geraint; Raybould, Adrian; Ramsey, Mark; Thomas, Phillip; Smith, David; Ionescu, Adrian

2017-07-01

This prospective study assesses balloon-assisted tracking (BAT) in reducing radial access failure during percutaneous coronary intervention (PCI). Arterial spasm prevents PCI from the radial artery in a small percentage of cases. A total of 2223 consecutive patients undergoing PCI from the radial approach were analyzed. Radial access failure mode and requirement for crossover to femoral access during a 12-month run-in period were compared with the following 14-month period with routine BAT usage. During the 14-month study period, 1334 radial PCIs were attempted. Twenty-six patients switched to femoral at an early stage, while 76 encountered radial spasm and underwent successful BAT in 69 cases (91%), giving a total crossover rate to femoral of 33/1334 (2.5%). Utilizing BAT rather than a femoral puncture reduced our institution's radial-femoral crossover rate from 7.6% to 2.5% (P<.01), which is also significantly lower than the radial-femoral crossover rate in the 12 months before BAT implementation (6.1%; P<.01). Mean procedure times were similar for those requiring BAT compared with conventional radial access (51.3 ± 21.3 min vs 47.9 ± 23.7 min; P=.23), and those crossing straight to femoral (BAT not attempted) (60.7 ± 31.9 min; P=.10). Mean first device/balloon time for the BAT-assisted primary PCI cases (22.6 ± 9.4 min) was similar to cases that had radial difficulties and converted to femoral without attempting BAT (25.8 ± 13.4 min; P=.54). BAT allowed catheter passage despite radial spasm in 91% of cases, significantly reducing the institution's rate of femoral crossover. During radial spasm in primary PCI, using BAT did not delay reperfusion compared with femoral crossover.