Flight Test Results: CTAS Cruise/Descent Trajectory Prediction Accuracy for En route ATC Advisories

NASA Technical Reports Server (NTRS)

Green, S.; Grace, M.; Williams, D.

1999-01-01

The Center/TRACON Automation System (CTAS), under development at NASA Ames Research Center, is designed to assist controllers with the management and control of air traffic transitioning to/from congested airspace. This paper focuses on the transition from the en route environment, to high-density terminal airspace, under a time-based arrival-metering constraint. Two flight tests were conducted at the Denver Air Route Traffic Control Center (ARTCC) to study trajectory-prediction accuracy, the key to accurate Decision Support Tool advisories such as conflict detection/resolution and fuel-efficient metering conformance. In collaboration with NASA Langley Research Center, these test were part of an overall effort to research systems and procedures for the integration of CTAS and flight management systems (FMS). The Langley Transport Systems Research Vehicle Boeing 737 airplane flew a combined total of 58 cruise-arrival trajectory runs while following CTAS clearance advisories. Actual trajectories of the airplane were compared to CTAS and FMS predictions to measure trajectory-prediction accuracy and identify the primary sources of error for both. The research airplane was used to evaluate several levels of cockpit automation ranging from conventional avionics to a performance-based vertical navigation (VNAV) FMS. Trajectory prediction accuracy was analyzed with respect to both ARTCC radar tracking and GPS-based aircraft measurements. This paper presents detailed results describing the trajectory accuracy and error sources. Although differences were found in both accuracy and error sources, CTAS accuracy was comparable to the FMS in terms of both meter-fix arrival-time performance (in support of metering) and 4D-trajectory prediction (key to conflict prediction). Overall arrival time errors (mean plus standard deviation) were measured to be approximately 24 seconds during the first flight test (23 runs) and 15 seconds during the second flight test (25 runs). The major source of error during these tests was found to be the predicted winds aloft used by CTAS. Position and velocity estimates of the airplane provided to CTAS by the ATC Host radar tracker were found to be a relatively insignificant error source for the trajectory conditions evaluated. Airplane performance modeling errors within CTAS were found to not significantly affect arrival time errors when the constrained descent procedures were used. The most significant effect related to the flight guidance was observed to be the cross-track and turn-overshoot errors associated with conventional VOR guidance. Lateral navigation (LNAV) guidance significantly reduced both the cross-track and turn-overshoot error. Pilot procedures and VNAV guidance were found to significantly reduce the vertical profile errors associated with atmospheric and aircraft performance model errors.

Cogeneration Technology Alternatives Study (CTAS). Volume 2: Analytical approach

NASA Technical Reports Server (NTRS)

Gerlaugh, H. E.; Hall, E. W.; Brown, D. H.; Priestley, R. R.; Knightly, W. F.

1980-01-01

The use of various advanced energy conversion systems were compared with each other and with current technology systems for their savings in fuel energy, costs, and emissions in individual plants and on a national level. The ground rules established by NASA and assumptions made by the General Electric Company in performing this cogeneration technology alternatives study are presented. The analytical methodology employed is described in detail and is illustrated with numerical examples together with a description of the computer program used in calculating over 7000 energy conversion system-industrial process applications. For Vol. 1, see 80N24797.

The Atmospheric Data Acquisition And Interpolation Process For Center-TRACON Automation System

NASA Technical Reports Server (NTRS)

Jardin, M. R.; Erzberger, H.; Denery, Dallas G. (Technical Monitor)

1995-01-01

The Center-TRACON Automation System (CTAS), an advanced new air traffic automation program, requires knowledge of spatial and temporal atmospheric conditions such as the wind speed and direction, the temperature and the pressure in order to accurately predict aircraft trajectories. Real-time atmospheric data is available in a grid format so that CTAS must interpolate between the grid points to estimate the atmospheric parameter values. The atmospheric data grid is generally not in the same coordinate system as that used by CTAS so that coordinate conversions are required. Both the interpolation and coordinate conversion processes can introduce errors into the atmospheric data and reduce interpolation accuracy. More accurate algorithms may be computationally expensive or may require a prohibitively large amount of data storage capacity so that trade-offs must be made between accuracy and the available computational and data storage resources. The atmospheric data acquisition and processing employed by CTAS will be outlined in this report. The effects of atmospheric data processing on CTAS trajectory prediction will also be analyzed, and several examples of the trajectory prediction process will be given.

Prediction of Emergent Heart Failure Death by Semi-Quantitative Triage Risk Stratification

PubMed Central

Van Spall, Harriette G. C.; Atzema, Clare; Schull, Michael J.; Newton, Gary E.; Mak, Susanna; Chong, Alice; Tu, Jack V.; Stukel, Thérèse A.; Lee, Douglas S.

2011-01-01

Objectives Generic triage risk assessments are widely used in the emergency department (ED), but have not been validated for prediction of short-term risk among patients with acute heart failure (HF). Our objective was to evaluate the Canadian Triage Acuity Scale (CTAS) for prediction of early death among HF patients. Methods We included patients presenting with HF to an ED in Ontario from Apr 2003 to Mar 2007. We used the National Ambulatory Care Reporting System and vital statistics databases to examine care and outcomes. Results Among 68,380 patients (76±12 years, 49.4% men), early mortality was stratified with death rates of 9.9%, 1.9%, 0.9%, and 0.5% at 1-day, and 17.2%, 5.9%, 3.8%, and 2.5% at 7-days, for CTAS 1, 2, 3, and 4–5, respectively. Compared to lower acuity (CTAS 4–5) patients, adjusted odds ratios (aOR) for 1-day death were 1.32 (95%CI; 0.93–1.88; p = 0.12) for CTAS 3, 2.41 (95%CI; 1.71–3.40; p<0.001) for CTAS 2, and highest for CTAS 1: 9.06 (95%CI; 6.28–13.06; p<0.001). Predictors of triage-critical (CTAS 1) status included oxygen saturation <90% (aOR 5.92, 95%CI; 3.09–11.81; p<0.001), respiratory rate >24 breaths/minute (aOR 1.96, 95%CI; 1.05–3.67; p = 0.034), and arrival by paramedic (aOR 3.52, 95%CI; 1.70–8.02; p = 0.001). While age/sex-adjusted CTAS score provided good discrimination for ED (c-statistic = 0.817) and 1-day (c-statistic = 0.724) death, mortality prediction was improved further after accounting for cardiac and non-cardiac co-morbidities (c-statistics 0.882 and 0.810, respectively; both p<0.001). Conclusions A semi-quantitative triage acuity scale assigned at ED presentation and based largely on respiratory factors predicted emergent death among HF patients. PMID:21853068

Design and evaluation of an advanced air-ground data-link system for air traffic control

NASA Technical Reports Server (NTRS)

Denbraven, Wim

1992-01-01

The design and evaluation of the ground-based portion of an air-ground data-link system for air traffic control (ATC) are described. The system was developed to support the 4D Aircraft/ATC Integration Study, a joint simulation experiment conducted at NASA's Ames and Langley Research Centers. The experiment focused on airborne and ground-based procedures for handling aircraft equipped with a 4D-Flight Management System (FMS) and the system requirements needed to ensure conflict-free traffic flow. The Center/TRACON Automation System (CTAS) at Ames was used for the ATC part of the experiment, and the 4D-FMS-equipped aircraft was simulated by the Transport Systems Research Vehicle (TSRV) simulator at Langley. The data-link system supported not only conventional ATC communications, but also the communications needed to accommodate the 4D-FMS capabilities of advanced aircraft. Of great significance was the synergism gained from integrating the data link with CTAS. Information transmitted via the data link was used to improve the monitoring and analysis capability of CTAS without increasing controller input workload. Conversely, CTAS was used to anticipate and create prototype messages, thus reducing the workload associated with the manual creation of data-link messages.

A Comparison of Center/TRACON Automation System and Airline Time of Arrival Predictions

NASA Technical Reports Server (NTRS)

Heere, Karen R.; Zelenka, Richard E.

2000-01-01

Benefits from information sharing between an air traffic service provider and a major air carrier are evaluated. Aircraft arrival time schedules generated by the NASA/FAA Center/TRACON Automation System (CTAS) were provided to the American Airlines System Operations Control Center in Fort Worth, Texas, during a field trial of a specialized CTAS display. A statistical analysis indicates that the CTAS schedules, based on aircraft trajectories predicted from real-time radar and weather data, are substantially more accurate than the traditional airline arrival time estimates, constructed from flight plans and en route crew updates. The improvement offered by CTAS is especially advantageous during periods of heavy traffic and substantial terminal area delay, allowing the airline to avoid large predictive errors with serious impact on the efficiency and profitability of flight operations.

Development and Preliminary Results of CTAS on Airline Operational Control Center Operations

NASA Technical Reports Server (NTRS)

Zelenka, Richard; Beatty, Roger; Falcone, Richard; Engelland, Shawn; Tobias, Leonard (Technical Monitor)

1998-01-01

Continued growth and expansion of air traffic and increased air carrier economic pressures have mandated greater flexibility and collaboration in air traffic management. The ability of airspace users to select their own routes, so called "free-flight", and to more actively manage their fleet operations for maximum economic advantage are receiving great attention. A first step toward greater airspace user and service provider collaboration is information sharing. In this work, arrival scheduling and airspace management data generated by the NASA/FAA Center/TRACON Automation System (CTAS) and used by the FAA service provider is shared with an airline with extensive operations within the CTAS operational domain. The design and development of a specialized airline CTAS "repeater" system is described, as well as some preliminary results of the impact and benefits of this information on the air carrier's operations. FAA controller per aircraft scheduling information, such as that provided by CTAS, has never before been shared in real-time with an airline. Expected airline benefits include improved fleet planning and arrival gate management, more informed "hold-go" decisions, and avoidance of costly aircraft diversions to alternate airports when faced with uncertain airborne arrival delays.

Development and Preliminary Results of CTAS on Airline Operational Control Center Operations

NASA Technical Reports Server (NTRS)

Zelenka, Richard; Beatty, Roger; Engelland, Shawn

2004-01-01

Continued growth and expansion of air traffic and increased air carrier economic pressures have mandated greater flexibility and collaboration in air traffic management. The ability of airspace users to select their own routes, so called "free-flight", and to more actively manage their fleet operations for maximum economic advantage are receiving great attention. A first step toward greater airspace user and service provider collaboration is information sharing. In this work, arrival scheduling and airspace management data generated by the NASA/FAA Center/TRACON Automation System (CTAS) and used by the FAA service provider is shared with an airline with extensive operations within the CTAS operational domain. The design and development of a specialized airline CTAS "repeater" system is described, as well as some preliminary results of the impact and benefits of this information on the air carrier's operations. FAA controller per aircraft scheduling information, such as that provided by CTAS, has never before been shared in real-time with an airline. Expected airline benefits include improved fleet planning and arrival gate management, more informed "hold-go decisions, and avoidance of costly aircraft diversions to alternate airports when faced with uncertain airborne arrival delays.

Design of Center-TRACON Automation System

NASA Technical Reports Server (NTRS)

Erzberger, Heinz; Davis, Thomas J.; Green, Steven

1993-01-01

A system for the automated management and control of terminal area traffic, referred to as the Center-TRACON Automation System (CTAS), is being developed at NASA Ames Research Center. In a cooperative program, NASA and FAA have efforts underway to install and evaluate the system at the Denver area and Dallas/Ft. Worth area air traffic control facilities. This paper will review CTAS architecture, and automation functions as well as the integration of CTAS into the existing operational system. CTAS consists of three types of integrated tools that provide computer-generated advisories for both en-route and terminal area controllers to guide them in managing and controlling arrival traffic efficiently. One tool, the Traffic Management Advisor (TMA), generates runway assignments, landing sequences and landing times for all arriving aircraft, including those originating from nearby feeder airports. TMA also assists in runway configuration control and flow management. Another tool, the Descent Advisor (DA), generates clearances for the en-route controllers handling arrival flows to metering gates. The DA's clearances ensure fuel-efficient and conflict free descents to the metering gates at specified crossing times. In the terminal area, the Final Approach Spacing Tool (FAST) provides heading and speed advisories that help controllers produce an accurately spaced flow of aircraft on the final approach course. Data bases consisting of several hundred aircraft performance models, airline preferred operational procedures, and a three dimensional wind model support the operation of CTAS. The first component of CTAS, the Traffic Management Advisor, is being evaluated at the Denver TRACON and the Denver Air Route Traffic Control Center. The second component, the Final Approach Spacing Tool, will be evaluated in several stages at the Dallas/Fort Worth Airport beginning in October 1993. An initial stage of the Descent Advisor tool is being prepared for testing at the Denver Center in late 1994. Operational evaluations of all three integrated CTAS tools are expected to begin at the two field sites in 1995.

A comprehensive statistical classifier of foci in the cell transformation assay for carcinogenicity testing.

PubMed

Callegaro, Giulia; Malkoc, Kasja; Corvi, Raffaella; Urani, Chiara; Stefanini, Federico M

2017-12-01

The identification of the carcinogenic risk of chemicals is currently mainly based on animal studies. The in vitro Cell Transformation Assays (CTAs) are a promising alternative to be considered in an integrated approach. CTAs measure the induction of foci of transformed cells. CTAs model key stages of the in vivo neoplastic process and are able to detect both genotoxic and some non-genotoxic compounds, being the only in vitro method able to deal with the latter. Despite their favorable features, CTAs can be further improved, especially reducing the possible subjectivity arising from the last phase of the protocol, namely visual scoring of foci using coded morphological features. By taking advantage of digital image analysis, the aim of our work is to translate morphological features into statistical descriptors of foci images, and to use them to mimic the classification performances of the visual scorer to discriminate between transformed and non-transformed foci. Here we present a classifier based on five descriptors trained on a dataset of 1364 foci, obtained with different compounds and concentrations. Our classifier showed accuracy, sensitivity and specificity equal to 0.77 and an area under the curve (AUC) of 0.84. The presented classifier outperforms a previously published model. Copyright © 2017 Elsevier Ltd. All rights reserved.

Assessment of CTAS ETA prediction capabilities

NASA Astrophysics Data System (ADS)

Bolender, Michael A.

1994-11-01

This report summarizes the work done to date in assessing the trajectory fidelity and estimated time of arrival (ETA) prediction capability of the NASA Ames Center TRACON Automation System (CTAS) software. The CTAS software suite is a series of computer programs designed to aid air traffic controllers in their tasks of safely scheduling the landing sequence of approaching aircraft. in particular, this report concerns the accuracy of the available measurements (e.g., position, altitude, etc.) that are input to the software, as well as the accuracy of the final data that is made available to the air traffic controllers.

Application of in vitro cell transformation assays in regulatory toxicology for pharmaceuticals, chemicals, food products and cosmetics.

PubMed

Vanparys, Philippe; Corvi, Raffaella; Aardema, Marilyn J; Gribaldo, Laura; Hayashi, Makoto; Hoffmann, Sebastian; Schechtman, Leonard

2012-04-11

Two year rodent bioassays play a key role in the assessment of carcinogenic potential of chemicals to humans. The seventh amendment to the European Cosmetics Directive will ban in 2013 the marketing of cosmetic and personal care products that contain ingredients that have been tested in animal models. Thus 2-year rodent bioassays will not be available for cosmetics/personal care products. Furthermore, for large testing programs like REACH, in vivo carcinogenicity testing is impractical. Alternative ways to carcinogenicity assessment are urgently required. In terms of standardization and validation, the most advanced in vitro tests for carcinogenicity are the cell transformation assays (CTAs). Although CTAs do not mimic the whole carcinogenesis process in vivo, they represent a valuable support in identifying transforming potential of chemicals. CTAs have been shown to detect genotoxic as well as non-genotoxic carcinogens and are helpful in the determination of thresholds for genotoxic and non-genotoxic carcinogens. The extensive review on CTAs by the OECD (OECD (2007) Environmental Health and Safety Publications, Series on Testing and Assessment, No. 31) and the proven within- and between-laboratories reproducibility of the SHE CTAs justifies broader use of these methods to assess carcinogenic potential of chemicals. Copyright © 2012 Elsevier B.V. All rights reserved.

CTAS: Computer intelligence for air traffic control in the terminal area

NASA Technical Reports Server (NTRS)

Erzberger, Heinz

1992-01-01

A system for the automated management and control of arrival traffic, referred to as the Center-TRACON Automation System (CTAS), has been designed by the ATC research group at NASA Ames research center. In a cooperative program, NASA and the FAA have efforts underway to install and evaluate the system at the Denver and Dallas/Ft. Worth airports. CTAS consists of three types of integrated tools that provide computer-generated intelligence for both Center and TRACON controllers to guide them in managing and controlling arrival traffic efficiently. One tool, the Traffic Management Advisor (TMA), establishes optimized landing sequences and landing times for aircraft arriving in the center airspace several hundred miles from the airport. In TRACON, TMA frequencies missed approach aircraft and unanticipated arrivals. Another tool, the Descent Advisor (DA), generates clearances for the center controllers handling at crossing times provided by TMA. In the TRACON, the final approach spacing tool (FAST) provides heading and speed clearances that produce and accurately spaced flow of aircraft on the final approach course. A data base consisting of aircraft performance models, airline preferred operational procedures and real time wind measurements contribute to the effective operation of CTAS. Extensive simulator evaluations of CTAS have demonstrated controller acceptance, delay reductions, and fuel savings.

Conflict-free trajectory planning for air traffic control automation

NASA Technical Reports Server (NTRS)

Slattery, Rhonda; Green, Steve

1994-01-01

As the traffic demand continues to grow within the National Airspace System (NAS), the need for long-range planning (30 minutes plus) of arrival traffic increases greatly. Research into air traffic control (ATC) automation at ARC has led to the development of the Center-TRACON Automation System (CTAS). CTAS determines optimum landing schedules for arrival traffic and assists controllers in meeting those schedules safely and efficiently. One crucial element in the development of CTAS is the capability to perform long-range (20 minutes) and short-range (5 minutes) conflict prediction and resolution once landing schedules are determined. The determination of conflict-free trajectories within the Center airspace is particularly difficult because of large variations in speed and altitude. The paper describes the current design and implementation of the conflict prediction and resolution tools used to generate CTAS advisories in Center airspace. Conflict criteria (separation requirements) are defined and the process of separation prediction is described. The major portion of the paper will describe the current implementation of CTAS conflict resolution algorithms in terms of the degrees of freedom for resolutions as well as resolution search techniques. The tools described in this paper have been implemented in a research system designed to rapidly develop and evaluate prototype concepts and will form the basis for an operational ATC automation system.

Assessment of a Novel Approach to Identify Trichiasis Cases Using Community Treatment Assistants in Tanzania.

PubMed

Greene, Gregory S; West, Sheila K; Mkocha, Harran; Munoz, Beatriz; Merbs, Shannath L

2015-12-01

Simple surgical intervention advocated by the World Health Organization can alleviate trachomatous trichiasis (TT) and prevent subsequent blindness. A large backlog of TT cases remain unidentified and untreated. To increase identification and referral of TT cases, a novel approach using standard screening questions, a card, and simple training for Community Treatment Assistants (CTAs) to use during Mass Drug Administration (MDA) was developed and evaluated in Kongwa District, a trachoma-endemic area of central Tanzania. A community randomized trial was conducted in 36 communities during MDA. CTAs in intervention villages received an additional half-day of training and a TT screening card in addition to the training received by CTAs in villages assigned to usual care. All MDA participants 15 years and older were screened for TT, and senior TT graders confirmed case status by evaluating all screened-positive cases. A random sample of those screened negative for TT and those who did not present at MDA were also evaluated by the master graders. Intervention CTAs identified 5.6 times as many cases (n = 50) as those assigned to usual care (n = 9, p < 0.05). While specificity was above 90% for both groups, the sensitivity for the novel screening tool was 31.2% compared to 5.6% for the usual care group (p < 0.05). CTAs appear to be viable resources for the identification of TT cases. Additional training and use of a TT screening card significantly increased the ability of CTAs to recognize and refer TT cases during MDA; however, further efforts are needed to improve case detection and reduce the number of false positive cases.

Terminal Air Flow Planning

NASA Technical Reports Server (NTRS)

Denery, Dallas G.; Erzberger, Heinz; Edwards, Thomas A. (Technical Monitor)

1998-01-01

The Center TRACON Automation System (CTAS) will be the basis for air traffic planning and control in the terminal area. The system accepts arriving traffic within an extended terminal area and optimizes the flow based on current traffic and airport conditions. The operational use of CTAS will be presented together with results from current operations.

75 FR 71379 - Registration of Swap Dealers and Major Swap Participants

Federal Register 2010, 2011, 2012, 2013, 2014

2010-11-23

.... Presently, all registered futures commission merchants (``FCMs''), introducing brokers (``IBs''), retail...., FCMs, IBs, RFEDs, CPOs and CTAs. The information called for includes the firm's full legal name and... Commission registrants (e.g., FCMs, IBs, RFEDs, CPOs or CTAs) are required to be registered. The term...

78 FR 67078 - Membership in a Registered Futures Association

Federal Register 2010, 2011, 2012, 2013, 2014

2013-11-08

... require that all persons registered with the Commission as introducing brokers (``IBs''), commodity pool... only with those IBs, CPOs or CTAs that also are NFA members. Therefore, given the NFA's status as the... from the universe of commodity professionals: FCMs, CPOs, CTAs and IBs.\\10\\ \\8\\ Membership in...

Severity of urban cycling injuries and the relationship with personal, trip, route and crash characteristics: analyses using four severity metrics

PubMed Central

Cripton, Peter A; Shen, Hui; Brubacher, Jeff R; Chipman, Mary; Friedman, Steven M; Harris, M Anne; Winters, Meghan; Reynolds, Conor C O; Cusimano, Michael D; Babul, Shelina; Teschke, Kay

2015-01-01

Objective To examine the relationship between cycling injury severity and personal, trip, route and crash characteristics. Methods Data from a previous study of injury risk, conducted in Toronto and Vancouver, Canada, were used to classify injury severity using four metrics: (1) did not continue trip by bike; (2) transported to hospital by ambulance; (3) admitted to hospital; and (4) Canadian Triage and Acuity Scale (CTAS). Multiple logistic regression was used to examine associations with personal, trip, route and crash characteristics. Results Of 683 adults injured while cycling, 528 did not continue their trip by bike, 251 were transported by ambulance and 60 were admitted to hospital for further treatment. Treatment urgencies included 75 as CTAS=1 or 2 (most medically urgent), 284 as CTAS=3, and 320 as CTAS=4 or 5 (least medically urgent). Older age and collision with a motor vehicle were consistently associated with increased severity in all four metrics and statistically significant in three each (both variables with ambulance transport and CTAS; age with hospital admission; and motor vehicle collision with did not continue by bike). Other factors were consistently associated with more severe injuries, but statistically significant in one metric each: downhill grades; higher motor vehicle speeds; sidewalks (these significant for ambulance transport); multiuse paths and local streets (both significant for hospital admission). Conclusions In two of Canada's largest cities, about one-third of the bicycle crashes were collisions with motor vehicles and the resulting injuries were more severe than in other crash circumstances, underscoring the importance of separating cyclists from motor vehicle traffic. Our results also suggest that bicycling injury severity and injury risk would be reduced on facilities that minimise slopes, have lower vehicle speeds, and that are designed for bicycling rather than shared with pedestrians. PMID:25564148

The Effectiveness of a Short Cognitive Behavioral Training Course on Awareness, Knowledge, and Transferability of Competencies in Clinical Practice.

PubMed

Mitchell, Andrew Edward Paul

2017-04-01

In this study, we investigated the effects of training on knowledge acquisition and core competencies in cognitive and behavioral therapy (CBT). Forty-three students attended 15 half-day, weekly sessions and were tested with the Cognitive Therapy Awareness Scale (CTAS) at weeks 1 and 15 in a before and after study. The students' case studies were assessed with competency items 7-12 on the Cognitive Rating Scale-Revised (CTS-R). Improvements in the CTAS were modest. Key competencies on the CTS-R subscales at week 15 were also observed. CBT knowledge acquisition might improve patients' outcomes through impact on competencies. © 2015 Wiley Periodicals, Inc.

Outcome Following a Negative CT Angiogram for Gastrointestinal Hemorrhage

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

Chan, Victoria, E-mail: drvictoriac@gmail.com; Tse, Donald, E-mail: donald.tse@gmail.com; Dixon, Shaheen, E-mail: shaheen7noorani@gmail.com

2015-04-15

ObjectiveThis study was designed to evaluate the role of a negative computed tomography angiogram (CTA) in patients who present with gastrointestinal (GI) hemorrhage.MethodsA review of all patients who had CTAs for GI hemorrhage over an 8-year period from January 2005 to December 2012 was performed. Data for patient demographics, location of hemorrhage, hemodynamic stability, and details of angiograms and/or the embolization procedure were obtained from the CRIS/PACS database, interventional radiology database, secure electronic medical records, and patient’s clinical notes.ResultsA total of 180 patients had 202 CTAs during the 8-year period: 87 CTAs were performed for upper GI hemorrhage (18 positivemore » for active bleeding, 69 negative) and 115 for lower GI hemorrhage (37 positive for active bleeding, 78 negative); 58.7 % (37/63) of patients with upper GI bleed and 77.4 % (48/62) of patients with lower GI bleed who had an initial negative CTA did not rebleed without the need for radiological or surgical intervention. This difference was statistically significant (p = 0.04). The relative risk of rebleeding, following a negative CTA, in lower GI bleeding versus upper GI bleeding patients is 0.55 (95 % confidence interval 0.32–0.95).ConclusionsPatients with upper GI bleed who had negative CTAs usually require further intervention to stop the bleeding. In contrast, most patients presenting with lower GI hemorrhage who had a negative first CTA were less likely to rebleed.« less

Conditioned taste aversions: From poisons to pain to drugs of abuse.

PubMed

Lin, Jian-You; Arthurs, Joe; Reilly, Steve

2017-04-01

Learning what to eat and what not to eat is fundamental to our well-being, quality of life, and survival. In particular, the acquisition of conditioned taste aversions (CTAs) protects all animals (including humans) against ingesting foods that contain poisons or toxins. Counterintuitively, CTAs can also develop in situations in which we know with absolute certainty that the food did not cause the subsequent aversive systemic effect. Recent nonhuman animal research, analyzing palatability shifts, has indicated that a wider range of stimuli than has been traditionally acknowledged can induce CTAs. This article integrates these new findings with a reappraisal of some known characteristics of CTA and presents a novel conceptual analysis that is broader and more comprehensive than previous accounts of CTA learning.

Conditioned taste aversions: From poisons to pain to drugs of abuse

PubMed Central

Lin, Jian-You; Arthurs, Joe; Reilly, Steve

2018-01-01

Learning what to eat and what not to eat is fundamental to our well-being, quality of life and survival. In particular, the acquisition of conditioned taste aversions (CTAs) protects all animals (including humans) against ingesting foods that contain poisons or toxins. Counterintuitively, CTAs can also develop in situations where we know with absolute certainty that the food did not cause the subsequent aversive systemic effect. Recent non-human animal research, analyzing palatability shifts, indicates that a wider range of stimuli than traditionally acknowledged can induce CTAs. This article integrates these new findings with a reappraisal of some known characteristics of CTA, and presents a novel conceptual analysis that is broader and more comprehensive than other accounts of CTA learning. PMID:27301407

Flight Crew Factors for CTAS/FMS Integration in the Terminal Area

NASA Technical Reports Server (NTRS)

Crane, Barry W.; Prevot, Thomas; Palmer, Everett A.; Shafto, M. (Technical Monitor)

2000-01-01

Center TRACON Automation System (CTAS)/Flight Management System (FMS) integration on the flightdeck implies flight crews flying coupled in highly automated FMS modes [i.e. Vertical Navigation (VNAV) and Lateral Navigation (LNAV)] from top of descent to the final approach phase of flight. Pilots may also have to make FMS route edits and respond to datalink clearances in the Terminal Radar Approach Control (TRACON) airspace. This full mission simulator study addresses how the introduction of these FMS descent procedures affect crew activities, workload, and performance. It also assesses crew acceptance of these procedures. Results indicate that the number of crew activities and workload ratings are significantly reduced below current day levels when FMS procedures can be flown uninterrupted, but that activity numbers increase significantly above current day levels and workload ratings return to current day levels when FMS procedures are interrupted by common ATC interventions and CTAS routing advisories. Crew performance showed some problems with speed control during FMS procedures. Crew acceptance of the FMS procedures and route modification requirements was generally high; a minority of crews expressed concerns about use of VNAV in the TRACON airspace. Suggestions for future study are discussed.

Comprehensive functional characterization of cancer–testis antigens defines obligate participation in multiple hallmarks of cancer

PubMed Central

Maxfield, Kimberly E.; Taus, Patrick J.; Corcoran, Kathleen; Wooten, Joshua; Macion, Jennifer; Zhou, Yunyun; Borromeo, Mark; Kollipara, Rahul K.; Yan, Jingsheng; Xie, Yang; Xie, Xian-Jin; Whitehurst, Angelique W.

2015-01-01

Tumours frequently activate genes whose expression is otherwise biased to the testis, collectively known as cancer–testis antigens (CTAs). The extent to which CTA expression represents epiphenomena or confers tumorigenic traits is unknown. In this study, to address this, we implemented a multidimensional functional genomics approach that incorporates 7 different phenotypic assays in 11 distinct disease settings. We identify 26 CTAs that are essential for tumor cell viability and/or are pathological drivers of HIF, WNT or TGFβ signalling. In particular, we discover that Foetal and Adult Testis Expressed 1 (FATE1) is a key survival factor in multiple oncogenic backgrounds. FATE1 prevents the accumulation of the stress-sensing BH3-only protein, BCL-2-Interacting Killer (BIK), thereby permitting viability in the presence of toxic stimuli. Furthermore, ZNF165 promotes TGFβ signalling by directly suppressing the expression of negative feedback regulatory pathways. This action is essential for the survival of triple negative breast cancer cells in vitro and in vivo. Thus, CTAs make significant direct contributions to tumour biology. PMID:26567849

Groundspeed filtering for CTAS

NASA Technical Reports Server (NTRS)

Slater, Gary L.

1994-01-01

Ground speed is one of the radar observables which is obtained along with position and heading from NASA Ames Center radar. Within the Center TRACON Automation System (CTAS), groundspeed is converted into airspeed using the wind speeds which CTAS obtains from the NOAA weather grid. This airspeed is then used in the trajectory synthesis logic which computes the trajectory for each individual aircraft. The time history of the typical radar groundspeed data is generally quite noisy, with high frequency variations on the order of five knots, and occasional 'outliers' which can be significantly different from the probable true speed. To try to smooth out these speeds and make the ETA estimate less erratic, filtering of the ground speed is done within CTAS. In its base form, the CTAS filter is a 'moving average' filter which averages the last ten radar values. In addition, there is separate logic to detect and correct for 'outliers', and acceleration logic which limits the groundspeed change in adjacent time samples. As will be shown, these additional modifications do cause significant changes in the actual groundspeed filter output. The conclusion is that the current ground speed filter logic is unable to track accurately the speed variations observed on many aircraft. The Kalman filter logic however, appears to be an improvement to the current algorithm used to smooth ground speed variations, while being simpler and more efficient to implement. Additional logic which can test for true 'outliers' can easily be added by looking at the difference in the a priori and post priori Kalman estimates, and not updating if the difference in these quantities is too large.

Flight Evaluation of Center-TRACON Automation System Trajectory Prediction Process

NASA Technical Reports Server (NTRS)

Williams, David H.; Green, Steven M.

1998-01-01

Two flight experiments (Phase 1 in October 1992 and Phase 2 in September 1994) were conducted to evaluate the accuracy of the Center-TRACON Automation System (CTAS) trajectory prediction process. The Transport Systems Research Vehicle (TSRV) Boeing 737 based at Langley Research Center flew 57 arrival trajectories that included cruise and descent segments; at the same time, descent clearance advisories from CTAS were followed. Actual trajectories of the airplane were compared with the trajectories predicted by the CTAS trajectory synthesis algorithms and airplane Flight Management System (FMS). Trajectory prediction accuracy was evaluated over several levels of cockpit automation that ranged from a conventional cockpit to performance-based FMS vertical navigation (VNAV). Error sources and their magnitudes were identified and measured from the flight data. The major source of error during these tests was found to be the predicted winds aloft used by CTAS. The most significant effect related to flight guidance was the cross-track and turn-overshoot errors associated with conventional VOR guidance. FMS lateral navigation (LNAV) guidance significantly reduced both the cross-track and turn-overshoot error. Pilot procedures and VNAV guidance were found to significantly reduce the vertical profile errors associated with atmospheric and airplane performance model errors.

Expression of Cancer/Testis Antigens in Prostate Cancer is Associated With Disease Progression

PubMed Central

Suyama, Takahito; Shiraishi, Takumi; Zeng, Yu; Yu, Wayne; Parekh, Nehal; Vessella, Robert L.; Luo, Jun; Getzenberg, Robert H.; Kulkarni, Prakash

2011-01-01

Background The cancer/testis antigens (CTAs) are a unique group of proteins normally expressed in germ cells but aberrantly expressed in several types of cancers including prostate cancer (PCa). However, their role in PCa has not been fully explored. Methods CTA expression profiling in PCa samples and cell lines was done utilizing a custom microarray that contained probes for two-thirds of all CTAs. The data were validated by quantitative PCR (Q-PCR). Functional studies were carried out by silencing gene expression with siRNA. DNA methylation was determined by methylation-specific PCR. Results A majority of CTAs expressed in PCa are located on the X chromosome (CT-X antigens). Several CT-X antigens from the MAGEA/CSAG subfamilies are coordinately upregulated in castrate-resistant prostate cancer (CRPC) but not in primary PCa. In contrast, PAGE4 is highly upregulated in primary PCa but is virtually silent in CRPC. Further, there was good correlation between the extent of promoter DNA methylation and CTA expression. Finally, silencing the expression of MAGEA2 the most highly upregulated member, significantly impaired proliferation of prostate cancer cells while increasing their chemosensitivity. Conclusions Considered together, the remarkable stage-specific expression patterns of the CT-X antigens strongly suggests that these CTAs may serve as unique biomarkers that could potentially be used to distinguish men with aggressive disease who need treatment from men with indolent disease not requiring immediate intervention. The data also suggest that the CT-X antigens may be novel therapeutic targets for CRPC for which there are currently no effective therapeutics. PMID:20583133

Cancer/Testis Antigens: “Smart” Biomarkers for Diagnosis and Prognosis of Prostate and Other Cancers

PubMed Central

Kulkarni, Prakash; Uversky, Vladimir N.

2017-01-01

A clinical dilemma in the management of prostate cancer (PCa) is to distinguish men with aggressive disease who need definitive treatment from men who may not require immediate intervention. Accurate prediction of disease behavior is critical because radical treatment is associated with high morbidity. Here, we highlight the cancer/testis antigens (CTAs) as potential PCa biomarkers. The CTAs are a group of proteins that are typically restricted to the testis in the normal adult but are aberrantly expressed in several types of cancers. Interestingly, >90% of CTAs are predicted to belong to the realm of intrinsically disordered proteins (IDPs), which do not have unique structures and exist as highly dynamic conformational ensembles, but are known to play important roles in several biological processes. Using prostate-associated gene 4 (PAGE4) as an example of a disordered CTA, we highlight how IDP conformational dynamics may regulate phenotypic heterogeneity in PCa cells, and how it may be exploited both as a potential biomarker as well as a promising therapeutic target in PCa. We also discuss how in addition to intrinsic disorder and post-translational modifications, structural and functional variability induced in the CTAs by alternate splicing represents an important feature that might have different roles in different cancers. Although it is clear that significant additional work needs to be done in the outlined direction, this novel concept emphasizing (multi)functionality as an important trait in selecting a biomarker underscoring the theranostic potential of CTAs that is latent in their structure (or, more appropriately, the lack thereof), and casts them as next generation or “smart” biomarker candidates. PMID:28362316

An Initial Study of Airport Arrival Heinz Capacity Benefits Due to Improved Scheduling Accuracy

NASA Technical Reports Server (NTRS)

Meyn, Larry; Erzberger, Heinz

2005-01-01

The long-term growth rate in air-traffic demand leads to future air-traffic densities that are unmanageable by today's air-traffic control system. I n order to accommodate such growth, new technology and operational methods will be needed in the next generation air-traffic control system. One proposal for such a system is the Automated Airspace Concept (AAC). One of the precepts of AAC is to direct aircraft using trajectories that are sent via an air-ground data link. This greatly improves the accuracy in directing aircraft to specific waypoints at specific times. Studies of the Center-TRACON Automation System (CTAS) have shown that increased scheduling accuracy enables increased arrival capacity at CTAS equipped airports.

Predictive and prognostic effect of CD133 and cancer-testis antigens in stage Ib-IIIA non-small cell lung cancer.

PubMed

Su, Chunxia; Xu, Ying; Li, Xuefei; Ren, Shengxiang; Zhao, Chao; Hou, Likun; Ye, Zhiwei; Zhou, Caicun

2015-01-01

CD133 and cancer-testis antigens (CTAs) may be potential predicted markers of adjuvant chemotherapy or immune therapy, and they may be the independent prognostic factor of NSCLC. Nowadays, there is still no predictive biomarker identified for the use of adjuvant chemotherapy in non-small cell lung cancer (NSCLC) patients. To clarify the role of CD133 and CTAs as a predictive marker for adjuvant chemotherapy or prognostic factors of overall survival, we performed a retrospective study in 159 stage Ib-IIIA NSCLC patients receiving adjuvant chemotherapy or observe from April 2003 to March 2004 in our institute. Clinical data and gene anaylisis results were collected, while CD133 and three CTAs (MAGE-A4, NY-ESO-1, MAGE-A10) were determined according to their monoclonal antibodies such as CD133, 57B, D8.38 and 3GA11 by immunohistochemistry. All CTAs were more frequently expressed in squamous cell carcinoma (SCC) (50.0%, 26.9%, 34.6%) than in adenocarcinoma (16.2%, 16.2%, 16.2%). CD133 was more frequently found in patients with adenocarcinoma (P=0.044). Negative expression of CD133 was associated with a significantly longer overall survival compared to positive expression of CD133 (62.5 vs. 48.5 months, P=0.035). When combined with MAGEA4, NY-ESO-1or MAGE-A10, patients' OS showed significantly difference among different combination. (CD133-MAGEA4-/CD133-MAGEA4+/CD133+MAGEA4-/CD133+MAGEA4+: 65.6 months vs.51.5 months vs.32.2 months vs.19.8 months, P=0.000, CD133-NY-ESO-1-/ CD133+NY-ESO-1-/CD133-NY-ESO-1+/ CD133+NY-ESO-1+: 57.8 months vs. 55.7 months vs. 44.6 months vs. 28.5 months, P=0.000, CD133-MAGEA10-/CD133+ MAGEA10-/CD133-MAGEA10-/CD133+MAGEA10+: 66.2 months vs. 57.2 months vs. 48.8 months vs. 41.4 months, P=0.001). There is no difference between patients received adjuvant chemotherapy or not, but subgroup analysis showed that the patients with CD133+NY-ESO-1+ expression who received chemotherapy will survive longer than not receive adjuvant chemotherapy (received vs. not received, 52.1 vs. 27.1 months, P=0.020). In the subgroup with EGFR mutation/ALK translocation/Ros1 translocation/Ret fusion, the trend remained but without a statistically significant difference. Multivariate COX regression analysis showed that stage, CD133, CD133-MAGEA4- and CD133-NY-ESO-1- are independent prognostic factors. In conclusion, CTAs (MAGE-A4, NY-ESO-1, MAGE-A10) were more likely expressed in patients with squamous cell carcinoma and when CTAs combined with CD133, they can be better prognostic factors. Patients with CD133+NY-ESO-1+ expression may survive longer when treated with adjuvant chemotherapy, which indicates that the CD133 and CTAs might be a potential marker to guide adjuvant chemotherapy in this population.

Characterization of a Cartilage-Like Engineered Biomass Using a Self-Aggregating Suspension Culture Model: Molecular Composition Using FT-IRIS

PubMed Central

Kim, Minwook; Kraft, Jeffrey J.; Volk, Andrew C.; Pugarelli, Joan; Pleshko, Nancy; Dodge, George R.

2011-01-01

Maintenance of chondrocyte phenotype and robust expression and organization of macromolecular components with suitable cartilaginous properties is an ultimate goal in cartilage tissue engineering. We used a self-aggregating suspension culture (SASC) method to produce an engineered cartilage, “cartilage tissue analog” (CTA). With an objective of understanding the stability of phenotype of the CTA over long periods, we cultured chondrocytes up to 4 years and analyzed the matrix. Both early (eCTAs) (6 months) and aged (aCTAs) (4 years) showed type II collagen throughout with higher concentrations near the edge. Using Fourier transform-infrared imaging spectroscopy (FT-IRIS), proteoglycan/collagen ratio of eCTA was 2.8 times greater than native cartilage at 1 week, but the ratio was balanced to native level (p = 0.017) by 36 weeks. Surprisingly, aCTAs maintained the hyaline characteristics, but there was evidence of calcification within the tissue with a distinct range of intensities. Mineral/matrix ratio of those aCTA with “intensive” calcification was significantly higher (p = 0.017) than the “partial,” but when compared to native bone the ratio of “intensive” aCTAs was 2.4 times lower. In this study we utilized the imaging approach of FT-IRIS and have shown that a biomaterial formed is compositionally closely related to natural cartilage for long periods in culture. We show that this culture platform can maintain a CTA for extended periods of time (4 years) and under those conditions signs of mineralization can be found. This method of cartilage tissue engineering is a promising method to generate cartilaginous biomaterial and may have potential to be utilized in both cartilage and boney repairs. PMID:21630329

Characterization of a cartilage-like engineered biomass using a self-aggregating suspension culture model: molecular composition using FT-IRIS.

PubMed

Kim, Minwook; Kraft, Jeffrey J; Volk, Andrew C; Pugarelli, Joan; Pleshko, Nancy; Dodge, George R

2011-12-01

Maintenance of chondrocyte phenotype and robust expression and organization of macromolecular components with suitable cartilaginous properties is an ultimate goal in cartilage tissue engineering. We used a self-aggregating suspension culture (SASC) method to produce an engineered cartilage, "cartilage tissue analog" (CTA). With an objective of understanding the stability of phenotype of the CTA over long periods, we cultured chondrocytes up to 4 years and analyzed the matrix. Both early (eCTAs) (6 months) and aged (aCTAs) (4 years) showed type II collagen throughout with higher concentrations near the edge. Using Fourier transform-infrared imaging spectroscopy (FT-IRIS), proteoglycan/collagen ratio of eCTA was 2.8 times greater than native cartilage at 1 week, but the ratio was balanced to native level (p = 0.017) by 36 weeks. Surprisingly, aCTAs maintained the hyaline characteristics, but there was evidence of calcification within the tissue with a distinct range of intensities. Mineral/matrix ratio of those aCTA with "intensive" calcification was significantly higher (p = 0.017) than the "partial," but when compared to native bone the ratio of "intensive" aCTAs was 2.4 times lower. In this study we utilized the imaging approach of FT-IRIS and have shown that a biomaterial formed is compositionally closely related to natural cartilage for long periods in culture. We show that this culture platform can maintain a CTA for extended periods of time (4 years) and under those conditions signs of mineralization can be found. This method of cartilage tissue engineering is a promising method to generate cartilaginous biomaterial and may have potential to be utilized in both cartilage and boney repairs. Copyright © 2011 Orthopaedic Research Society.

Expression of cancer/testis antigens in salivary gland carcinomas with reference to MAGE-A and NY-ESO-1 expression in adenoid cystic carcinoma.

PubMed

Beppu, Shintaro; Ito, Yohei; Fujii, Kana; Saida, Kosuke; Takino, Hisashi; Masaki, Ayako; Murase, Takayuki; Kusafuka, Kimihide; Iida, Yoshiyuki; Onitsuka, Tetsuro; Yatabe, Yasushi; Hanai, Nobuhiro; Hasegawa, Yasuhisa; Ijichi, Kei; Murakami, Shingo; Inagaki, Hiroshi

2017-08-01

Cancer/testis antigens (CTAs) are detected in cancer cells but not in healthy normal tissues, with the exception of gametogenic tissues. CTAs are highly immunogenic proteins, and thus represent ideal targets for cytotoxic T-lymphocyte-mediated specific immune therapy. The aim of this study was to screen CTA expression in various types of salivary gland carcinoma and to clarify clinicopathological significance of MAGE-A and NY-ESO-1 expression in adenoid cystic carcinomas (AdCCs) of the salivary gland, which is one of the most common salivary gland carcinomas, and usually has a fatal outcome. We used immunohistochemistry to examine the expression of four CTAs (MAGE-A, NY-ESO-1, CT7, and GAGE7) in various types of salivary gland carcinoma (n = 95). When carcinoma cases were divided into low-grade and intermediate/high-grade types, NY-ESO-1 and CT7 were expressed more frequently in intermediate/high-grade carcinomas. We then focused on MAGE-A and NY-ESO-1 expression in a large cohort of adenoid cystic carcinomas (AdCCs) (n = 46). MAGE-A and NY-ESO-1 were frequently expressed in AdCC; specifically, MAGE-A was expressed in >60% of the AdCC cases. MAGE-A expression and tumour site (minor salivary gland) were identified as independent risk factors for locoregional tumour recurrence. These findings suggest that CTAs may be expressed in a variety of salivary gland carcinomas, especially in those with higher histological grades. In addition, MAGE-A, which is frequently expressed in AdCC cases, may be a useful prognostic factor for poorer locoregional recurrence-free survival. © 2017 John Wiley & Sons Ltd.

Atmospheric and wind modeling for ATC

NASA Technical Reports Server (NTRS)

Slater, Gary L.

1990-01-01

The section on atmospheric modeling covers the following topics: the standard atmosphere, atmospheric variations, atmosphere requirements for ATC, and implementation of a software model for Center/Tracon Advisory System (CTAS). The section on wind modeling covers the following topics: wind data -- NOAA profiler system; wind profile estimation; incorporation of various data types into filtering scheme; spatial and temporal variation; and software implementation into CTAS. The appendices contain Matlab codes for atmospheric routines and for wind estimation.

Reperfusion is a more accurate predictor of follow-up infarct volume than recanalization: a proof of concept using CT in acute ischemic stroke patients.

PubMed

Soares, Bruno P; Tong, Elizabeth; Hom, Jason; Cheng, Su-Chun; Bredno, Joerg; Boussel, Loic; Smith, Wade S; Wintermark, Max

2010-01-01

The purpose of this study was to compare recanalization and reperfusion in terms of their predictive value for imaging outcomes (follow-up infarct volume, infarct growth, salvaged penumbra) and clinical outcome in acute ischemic stroke patients. Twenty-two patients admitted within 6 hours of stroke onset were retrospectively included in this study. These patients underwent a first stroke CT protocol including CT-angiography (CTA) and perfusion-CT (PCT) on admission, and similar imaging after treatment, typically around 24 hours, to assess recanalization and reperfusion. Recanalization was assessed by comparing arterial patency on admission and posttreatment CTAs; reperfusion, by comparing the volumes of CBV, CBF, and MTT abnormality on admission and posttreatment PCTs. Collateral flow was graded on the admission CTA. Follow-up infarct volume was measured on the discharge noncontrast CT. The groups of patients with reperfusion, no reperfusion, recanalization, and no recanalization were compared in terms of imaging and clinical outcomes. Reperfusion (using an MTT reperfusion index >75%) was a more accurate predictor of follow-up infarct volume than recanalization. Collateral flow and recanalization were not accurate predictors of follow-up infarct volume. An interaction term was found between reperfusion and the volume of the admission penumbra >50 mL. Our study provides evidence that reperfusion is a more accurate predictor of follow-up infarct volume in acute ischemic stroke patients than recanalization. We recommend an MTT reperfusion index >75% to assess therapy efficacy in future acute ischemic stroke trials that use perfusion-CT.

Cogeneration Technology Alternatives Study (CTAS). Volume 1: Summary

NASA Technical Reports Server (NTRS)

Barna, G. J.; Burns, R. K.; Sagerman, G. D.

1980-01-01

Various advanced energy conversion systems that can use coal or coal-derived fuels for industrial cogeneration applications were compared to provide information needed by DOE to establish research and development funding priorities for advanced-technology systems that could significantly advance the use of coal or coal-derived fuels in industrial cogeneration. Steam turbines, diesel engines, open-cycle gas turbines, combined cycles, closed-cycle gas turbines, Stirling engines, phosphoric acid fuel cells, molten carbonate fuel cells, and thermionics were studied with technology advancements appropriate for the 1985-2000 time period. The various advanced systems were compared and evaluated for wide diversity of representative industrial plants on the basis of fuel energy savings, annual energy cost savings, emissions savings, and rate of return on investment as compared with purchasing electricity from a utility and providing process heat with an on-site boiler. Also included in the comparisons and evaluations are results extrapolated to the national level.

Cancer testis antigens and NY-BR-1 expression in primary breast cancer: prognostic and therapeutic implications.

PubMed

Balafoutas, Dimitrios; zur Hausen, Axel; Mayer, Sebastian; Hirschfeld, Marc; Jaeger, Markus; Denschlag, Dominik; Gitsch, Gerald; Jungbluth, Achim; Stickeler, Elmar

2013-06-03

Cancer-testis antigens (CTA) comprise a family of proteins, which are physiologically expressed in adult human tissues solely in testicular germ cells and occasionally placenta. However, CTA expression has been reported in various malignancies. CTAs have been identified by their ability to elicit autologous cellular and or serological immune responses, and are considered potential targets for cancer immunotherapy. The breast differentiation antigen NY-BR-1, expressed specifically in normal and malignant breast tissue, has also immunogenic properties. Here we evaluated the expression patterns of CTAs and NY-BR-1 in breast cancer in correlation to clinico-pathological parameters in order to determine their possible impact as prognostic factors. The reactivity pattern of various mAbs (6C1, MA454, M3H67, 57B, E978, GAGE #26 and NY-BR-1 #5) were assessed by immunohistochemistry in a tissue micro array series of 210 randomly selected primary invasive breast cancers in order to study the diversity of different CTAs (e.g. MAGE-A, NY-ESO-1, GAGE) and NY-BR-1. These expression data were correlated to clinico-pathological parameters and outcome data including disease-free and overall survival. Expression of at least one CTA was detectable in the cytoplasm of tumor cells in 37.2% of the cases. NY-BR-1 expression was found in 46.6% of tumors, respectively. Overall, CTA expression seemed to be linked to adverse prognosis and M3H67 immunoreactivity specifically was significantly correlated to shorter overall and disease-free survival (p=0.000 and 0.024, respectively). Our findings suggest that M3H67 immunoreactivity could serve as potential prognostic marker in primary breast cancer patients. The exclusive expression of CTAs in tumor tissues as well as the frequent expression of NY-BR-1 could define new targets for specific breast cancer therapies.

Multicenter AIDS Cohort Study Quantitative Coronary Plaque Progression Study: rationale and design.

PubMed

Nakanishi, Rine; Post, Wendy S; Osawa, Kazuhiro; Jayawardena, Eranthi; Kim, Michael; Sheidaee, Nasim; Nezarat, Negin; Rahmani, Sina; Kim, Nicholas; Hathiramani, Nicolai; Susarla, Shriraj; Palella, Frank; Witt, Mallory; Blaha, Michael J; Brown, Todd T; Kingsley, Lawrence; Haberlen, Sabina A; Dailing, Christopher; Budoff, Matthew J

2018-01-01

The association of HIV with coronary atherosclerosis has been established; however, the progression of coronary atherosclerosis over time among participants with HIV is not well known. The Multicenter AIDS Cohort Study Quantitative Coronary Plaque Progression Study is a large prospective multicenter study quantifying progression of coronary plaque assessed by serial coronary computed tomography angiography (CTA). HIV-infected and uninfected men who were enrolled in the Multicenter AIDS Cohort Study Cardiovascular Substudy were eligible to complete a follow-up contrast coronary CTA 3-6 years after baseline. We measured coronary plaque volume and characteristics (calcified and noncalcified plaque including fibrous, fibrous-fatty, and low attenuation) and vulnerable plaque among HIV-infected and uninfected men using semiautomated plaque software to investigate the progression of coronary atherosclerosis over time. We describe a novel, large prospective multicenter study investigating incidence, transition of characteristics, and progression in coronary atherosclerosis quantitatively assessed by serial coronary CTAs among HIV-infected and uninfected men.

The effect of medical trainees on pediatric emergency department flow: a discrete event simulation modeling study.

PubMed

Genuis, Emerson D; Doan, Quynh

2013-11-01

Providing patient care and medical education are both important missions of teaching hospital emergency departments (EDs). With medical school enrollment rising, and ED crowding becoming an increasing prevalent issue, it is important for both pediatric EDs (PEDs) and general EDs to find a balance between these two potentially competing goals. The objective was to determine how the number of trainees in a PED affects patient wait time, total ED length of stay (LOS), and rates of patients leaving without being seen (LWBS) for PED patients overall and stratified by acuity level as defined by the Pediatric Canadian Triage and Acuity Scale (CTAS) using discrete event simulation (DES) modeling. A DES model of an urban tertiary care PED, which receives approximately 40,000 visits annually, was created and validated. Thirteen different trainee schedules, which ranged from averaging zero to six trainees per shift, were input into the DES model and the outcome measures were determined using the combined output of five model iterations. An increase in LOS of approximately 7 minutes was noted to be associated with each additional trainee per attending emergency physician working in the PED. The relationship between the number of trainees and wait time varied with patients' level of acuity and with the degree of PED utilization. Patient wait time decreased as the number of trainees increased for low-acuity visits and when the PED was not operating at full capacity. With rising numbers of trainees, the PED LWBS rate decreased in the whole department and in the CTAS 4 and 5 patient groups, but it rose in patients triaged CTAS 3 or higher. A rising numbers of trainees was not associated with any change to flow outcomes for CTAS 1 patients. The results of this study demonstrate that trainees in PEDs have an impact mainly on patient LOS and that the effect on wait time differs between patients presenting with varying degrees of acuity. These findings will assist PEDs in finding a balance between providing high-quality medical education and timely patient care. © 2013 by the Society for Academic Emergency Medicine.

Immunomodulatory action of SGI-110, a hypomethylating agent, in acute myeloid leukemia cells

PubMed Central

Srivastava, Pragya; Paluch, Benjamin E.; Matsuzaki, Junko; James, Smitha R.; Collamat-Lai, Golda; Karbach, Julia; Nemeth, Michael J.; Taverna, Pietro; Karpf, Adam R.; Griffiths, Elizabeth A.

2017-01-01

The mechanism of clinical action for the FDA approved hypomethylating drugs azacitidine and decitabine remains unresolved and in this context the potential immunomodulatory effect of these agents on leukemic cells is an area of active investigation. Induced expression of methylated Cancer Testis Antigen (CTA) genes has been demonstrated in leukemic cell lines following exposure to hypomethylating drugs in vitro. SGI-110 is a novel hypomethylating dinucleotide with prolonged in vivo exposure and clinical activity in patients with MDS and AML. We demonstrate that this agent, like decitabine, produces robust re-expression of the CTAs NY-ESO-1 and MAGE-A, both in vitro and in leukemia-bearing AML xenografts. Upregulation of these genes in vitro was sufficient to induce cytotoxicity by HLA-compatible CD8+ T-cells specific for NY-ESO-1, a well-recognized and immunogenic CTA. Additionally, exposure to SGI-110 enhances MHC class I and co-stimulatory molecule expression, potentially contributing to recognition of CTAs. SGI-110, like the parent compound decitabine, induces expression of CTAs and might modulate immune recognition of myeloid malignancy. PMID:25260825

Influence of Scan Duration on Pulmonary Capillary Hemorrhage Induced by Diagnostic Ultrasound.

PubMed

Miller, Douglas L; Dong, Zhihong; Dou, Chunyan; Raghavendran, Krishnan

2016-08-01

Diagnostic ultrasound can induce pulmonary capillary hemorrhage (PCH) in rats and display this as "comet tail" artifacts (CTAs) after a time delay. To test the hypothesis that no PCH occurs for brief scans, anesthetized rats were scanned using a 6-MHz linear array for different durations. PCH was characterized by ultrasound CTAs, micro-computed tomography (μCT), and measurements of fixed lung tissue. The μCT images revealed regions of PCH, sometimes penetrating the entire depth of a lobe, which were reflected in the fixed tissue measurements. At -3 dB of power, PCH was substantial for 300-s scans, but not significant for 25-s scans. At 0 dB, PCH was not strongly dependent on scan durations of 300 to 10 s. Contrary to the hypothesis, CTAs were not evident during most 10-s scans (p > 0.05), but PCH was significant (p = 0.02), indicating that PCH could occur without evidence of the injury in the images. Copyright © 2016 World Federation for Ultrasound in Medicine & Biology. Published by Elsevier Inc. All rights reserved.

Comparison of Integrated Gasifier-Combined Cycle and AFB-steam turbine systems for industrial cogeneration

NASA Technical Reports Server (NTRS)

Nainiger, J. J.; Abbott, J. M.; Burns, R. K.

1981-01-01

In the cogeneration technology alternatives study (CTAS) a number of advanced coal fired systems were examined and systems using a integrated coal gasifier IGCC or a fluid bed combustor AFB were found to yield attractive cogeneration results in industrial cogeneration applications. A range of site requirements and cogeneration sizing strategies using ground rules based on CTAS were used in comparing an IGCC and an AFB. The effect of time variations in site requirements and the sensitivity to fuel and electricity price assumptions are examined. The economic alternatives of industrial or utility ownership are also considered. The results indicate that the IGCC system has potentially higher fuel and emission savings and could be an attractive option for utility ownership. The AFB steam turbine system has a potentially higher return on investment and could be attractive assuming industrial ownership.

The Future of Air Traffic Management

NASA Technical Reports Server (NTRS)

Denery, Dallas G.; Erzberger, Heinz; Edwards, Thomas A. (Technical Monitor)

1998-01-01

A system for the control of terminal area traffic to improve productivity, referred to as the Center-TRACON Automation System (CTAS), is being developed at NASA's Ames Research Center under a joint program with the FAA. CTAS consists of a set of integrated tools that provide computer-generated advisories for en-route and terminal area controllers. The premise behind the design of CTAS has been that successful planning of traffic requires accurate trajectory prediction. Data bases consisting of representative aircraft performance models, airline preferred operational procedures and a three dimensional wind model support the trajectory prediction. The research effort has been the design of a set of automation tools that make use of this trajectory prediction capability to assist controllers in overall management of traffic. The first tool, the Traffic Management Advisor (TMA), provides the overall flow management between the en route and terminal areas. A second tool, the Final Approach Spacing Tool (FAST) provides terminal area controllers with sequence and runway advisories to allow optimal use of the runways. The TMA and FAST are now being used in daily operations at Dallas/Ft. Worth airport. Additional activities include the development of several other tools. These include: 1) the En Route Descent Advisor that assist the en route controller in issuing conflict free descents and ascents; 2) the extension of FAST to include speed and heading advisories and the Expedite Departure Path (EDP) that assists the terminal controller in management of departures; and 3) the Collaborative Arrival Planner (CAP) that will assist the airlines in operational decision making. The purpose of this presentation is to review the CTAS concept and to present the results of recent field tests. The paper will first discuss the overall concept and then discuss the status of the individual tools.

Piloted simulation of an air-ground profile negotiation process in a time-based Air Traffic Control environment

NASA Technical Reports Server (NTRS)

Williams, David H.; Green, Steven M.

1993-01-01

Historically, development of airborne flight management systems (FMS) and ground-based air traffic control (ATC) systems has tended to focus on different objectives with little consideration for operational integration. A joint program, between NASA's Ames Research Center (Ames) and Langley Research Center (Langley), is underway to investigate the issues of, and develop systems for, the integration of ATC and airborne automation systems. A simulation study was conducted to evaluate a profile negotiation process (PNP) between the Center/TRACON Automation System (CTAS) and an aircraft equipped with a four-dimensional flight management system (4D FMS). Prototype procedures were developed to support the functional implementation of this process. The PNP was designed to provide an arrival trajectory solution which satisfies the separation requirements of ATC while remaining as close as possible to the aircraft's preferred trajectory. Results from the experiment indicate the potential for successful incorporation of aircraft-preferred arrival trajectories in the CTAS automation environment. Fuel savings on the order of 2 percent to 8 percent, compared to fuel required for the baseline CTAS arrival speed strategy, were achieved in the test scenarios. The data link procedures and clearances developed for this experiment, while providing the necessary functionality, were found to be operationally unacceptable to the pilots. In particular, additional pilot control and understanding of the proposed aircraft-preferred trajectory, and a simplified clearance procedure were cited as necessary for operational implementation of the concept.

Induction of cancer testis antigen expression in circulating acute myeloid leukemia blasts following hypomethylating agent monotherapy

PubMed Central

Srivastava, Pragya; Paluch, Benjamin E.; Matsuzaki, Junko; James, Smitha R.; Collamat-Lai, Golda; Blagitko-Dorfs, Nadja; Ford, Laurie Ann; Naqash, Rafeh; Lübbert, Michael; Karpf, Adam R.; Nemeth, Michael J.; Griffiths, Elizabeth A.

2016-01-01

Cancer testis antigens (CTAs) are promising cancer associated antigens in solid tumors, but in acute myeloid leukemia, dense promoter methylation silences their expression. Leukemia cell lines exposed to HMAs induce expression of CTAs. We hypothesized that AML patients treated with standard of care decitabine (20mg/m2 per day for 10 days) would demonstrate induced expression of CTAs. Peripheral blood blasts serially isolated from AML patients treated with decitabine were evaluated for CTA gene expression and demethylation. Induction of NY-ESO-1 and MAGEA3/A6, were observed following decitabine. Re-expression of NY-ESO-1 and MAGEA3/A6 was associated with both promoter specific and global (LINE-1) hypomethylation. NY-ESO-1 and MAGEA3/A6 mRNA levels were increased irrespective of clinical response, suggesting that these antigens might be applicable even in patients who are not responsive to HMA therapy. Circulating blasts harvested after decitabine demonstrate induced NY-ESO-1 expression sufficient to activate NY-ESO-1 specific CD8+ T-cells. Induction of CTA expression sufficient for recognition by T-cells occurs in AML patients receiving decitabine. Vaccination against NY-ESO-1 in this patient population is feasible. PMID:26883197

Profile negotiation: An air/ground automation integration concept for managing arrival traffic

NASA Technical Reports Server (NTRS)

Williams, David H.; Arbuckle, P. Douglas; Green, Steven M.; Denbraven, Wim

1993-01-01

NASA Ames Research Center and NASA Langley Research Center conducted a joint simulation study to evaluate a profile negotiation process (PNP) between a time-based air traffic control ATC system and an airplane equipped with a four dimensional flight management system (4D FMS). Prototype procedures were developed to support the functional implementation of this process. The PNP was designed to provide an arrival trajectory solution that satisfies the separation requirements of ATC while remaining as close as possible to the airplane's preferred trajectory. The Transport Systems Research Vehicle cockpit simulator was linked in real-time to the Center/TRACON Automation System (CTAS) for the experiment. Approximately 30 hours of simulation testing were conducted over a three week period. Active airline pilot crews and active Center controller teams participated as test subjects. Results from the experiment indicate the potential for successful incorporation of airplane preferred arrival trajectories in the CTAS automation environment. Controllers were able to consistently and effectively negotiate nominally conflict-free trajectories with pilots flying a 4D-FMS-equipped airplane. The negotiated trajectories were substantially closer to the airplane's preference than would have otherwise been possible without the PNP. Airplane fuel savings relative to baseline CTAS were achieved in the test scenarios. The datalink procedures and clearances developed for this experiment, while providing the necessary functionality, were found to be operationally unacceptable to the pilots. Additional pilot control and understanding of the proposed airplane-preferred trajectory and a simplified clearance procedure were cited as necessary for operational implementation of the concept. From the controllers' perspective, the main concerns were the ability of the 4D airplane to accurately track the negotiated trajectory and the workload required to support the PNP as implemented in this study.

Confirming the Factor Structure of the Cognitive Test Anxiety Scale: Comparing the Utility of Three Solutions

ERIC Educational Resources Information Center

Cassady, Jerrell C.; Finch, W. Holmes

2014-01-01

This study validated the factor structure of a popular assessment of learner's cognitive test anxiety. Following recent findings in a study with Argentinean students' use of the Spanish version of the Cognitive Test Anxiety Scale (CTAS), this study tested the factor structure using data from 742 students who completed the original English version…

Connecting the Dots--From Planning to Implementation: Translating Commitments into Action in a Strategic Planning Process

ERIC Educational Resources Information Center

Mieso, Rob Roba

2010-01-01

This study examines the implementation of the Commitments to Action (CTAs) that were developed for the Outreach Institutional Initiative (OII) as part of the 2006 strategic planning process at De Anza College. Although the strategic planning process identified four Institutional Initiatives (IIs) [Outreach, Individualized Attention to Student…

Energy and cost savings results for advanced technology systems from the Cogeneration Technology Alternatives Study /CTAS/

NASA Technical Reports Server (NTRS)

Sagerman, G. D.; Barna, G. J.; Burns, R. K.

1979-01-01

The Cogeneration Technology Alternatives Study (CTAS), a program undertaken to identify the most attractive advanced energy conversion systems for industrial cogeneration applications in the 1985-2000 time period, is described, and preliminary results are presented. Two cogeneration options are included in the analysis: a topping application, in which fuel is input to the energy conversion system which generates electricity and waste heat from the conversion system is used to provide heat to the process, and a bottoming application, in which fuel is burned to provide high temperature process heat and waste heat from the process is used as thermal input to the energy conversion system which generates energy. Steam turbines, open and closed cycle gas turbines, combined cycles, diesel engines, Stirling engines, phosphoric acid and molten carbonate fuel cells and thermionics are examined. Expected plant level energy savings, annual energy cost savings, and other results of the economic analysis are given, and the sensitivity of these results to the assumptions concerning fuel prices, price of purchased electricity and the potential effects of regional energy use characteristics is discussed.

Expression of cancer-testis antigens MAGE-A4 and MAGE-C1 in oral squamous cell carcinoma.

PubMed

Montoro, José Raphael de Moura Campos; Mamede, Rui Celso Martins; Neder Serafini, Luciano; Saggioro, Fabiano Pinto; Figueiredo, David Livingstone Alves; Silva, Wilson Araújo da; Jungbluth, Achim A; Spagnoli, Giulio Cesare; Zago, Marco Antônio

2012-08-01

Tumor markers are genes or their products expressed exclusively or preferentially in tumor cells and cancer-testis antigens (CTAs) form a group of genes with a typical expression pattern expressed in a variety of malignant neoplasms. CTAs are considered potential targets for cancer vaccines. It is possible that the CTA MAGE-A4 (melanoma antigen) and MAGE-C1 are expressed in carcinoma of the oral cavity and are related with survival. This study involved immunohistochemical analysis of 23 patients with oral squamous cell carcinoma (SCC) and was carried out using antibodies for MAGE-A4 and MAGE-C1. Fisher's exact test and log-rank test were used to evaluate the results. The expression of the MAGE-A4 and MAGE-C1 were 56.5% and 47.8% without statistical difference in studied variables and survival. The expression of at least 1 CTA was present in 78.3% of the patients, however, without correlation with clinicopathologic variables and survival. Copyright © 2011 Wiley Periodicals, Inc.

Validation of different pediatric triage systems in the emergency department

PubMed Central

Aeimchanbanjong, Kanokwan; Pandee, Uthen

2017-01-01

BACKGROUND: Triage system in children seems to be more challenging compared to adults because of their different response to physiological and psychosocial stressors. This study aimed to determine the best triage system in the pediatric emergency department. METHODS: This was a prospective observational study. This study was divided into two phases. The first phase determined the inter-rater reliability of five triage systems: Manchester Triage System (MTS), Emergency Severity Index (ESI) version 4, Pediatric Canadian Triage and Acuity Scale (CTAS), Australasian Triage Scale (ATS), and Ramathibodi Triage System (RTS) by triage nurses and pediatric residents. In the second phase, to analyze the validity of each triage system, patients were categorized as two groups, i.e., high acuity patients (triage level 1, 2) and low acuity patients (triage level 3, 4, and 5). Then we compared the triage acuity with actual admission. RESULTS: In phase I, RTS illustrated almost perfect inter-rater reliability with kappa of 1.0 (P<0.01). ESI and CTAS illustrated good inter-rater reliability with kappa of 0.8–0.9 (P<0.01). Meanwhile, ATS and MTS illustrated moderate to good inter-rater reliability with kappa of 0.5–0.7 (P<0.01). In phase II, we included 1 041 participants with average age of 4.7±4.2 years, of which 55% were male and 45% were female. In addition 32% of the participants had underlying diseases, and 123 (11.8%) patients were admitted. We found that ESI illustrated the most appropriate predicting ability for admission with sensitivity of 52%, specificity of 81%, and AUC 0.78 (95%CI 0.74–0.81). CONCLUSION: RTS illustrated almost perfect inter-rater reliability. Meanwhile, ESI and CTAS illustrated good inter-rater reliability. Finally, ESI illustrated the appropriate validity for triage system. PMID:28680520

Expression analysis of cancer-testis genes in prostate cancer reveals candidates for immunotherapy.

PubMed

Faramarzi, Sepideh; Ghafouri-Fard, Soudeh

2017-09-01

Prostate cancer is a prevalent disorder among men with a heterogeneous etiological background. Several molecular events and signaling perturbations have been found in this disorder. Among genes whose expressions have been altered during the prostate cancer development are cancer-testis antigens (CTAs). This group of antigens has limited expression in the normal adult tissues but aberrant expression in cancers. This property provides them the possibility to be used as cancer biomarkers and immunotherapeutic targets. Several CTAs have been shown to be immunogenic in prostate cancer patients and some of the have entered clinical trials. Based on the preliminary data obtained from these trials, it is expected that CTA-based therapeutic options are beneficial for at least a subset of prostate cancer patients.

Regulatory assessment of reproductive toxicology data.

PubMed

Davidson, Elizabeth

2013-01-01

This chapter outlines a regulator's personal approach to the assessment of reproductive toxicology data in the context of the assessment of the overall nonclinical data package for pharmaceutical agents. Using as a framework the International Conference on Harmonisation Common Technical Document headings, guidance is provided on the expectations of regulators for the presentation and discussion of the data by the applicant to facilitate the risk assessment process. Consideration is given to the use of reproductive toxicology data in the assessment process for both clinical trial applications (CTAs) and marketing authorization applications (MAAs). Suggestions for some guiding principles in drafting of the various product information documents (for example the Investigator's Brochure (IB) for CTAs and the Nonclinical Overview and Summary of Product Characteristics for MAAs) are included.

Fully automatic multi-atlas segmentation of CTA for partial volume correction in cardiac SPECT/CT

NASA Astrophysics Data System (ADS)

Liu, Qingyi; Mohy-ud-Din, Hassan; Boutagy, Nabil E.; Jiang, Mingyan; Ren, Silin; Stendahl, John C.; Sinusas, Albert J.; Liu, Chi

2017-05-01

Anatomical-based partial volume correction (PVC) has been shown to improve image quality and quantitative accuracy in cardiac SPECT/CT. However, this method requires manual segmentation of various organs from contrast-enhanced computed tomography angiography (CTA) data. In order to achieve fully automatic CTA segmentation for clinical translation, we investigated the most common multi-atlas segmentation methods. We also modified the multi-atlas segmentation method by introducing a novel label fusion algorithm for multiple organ segmentation to eliminate overlap and gap voxels. To evaluate our proposed automatic segmentation, eight canine 99mTc-labeled red blood cell SPECT/CT datasets that incorporated PVC were analyzed, using the leave-one-out approach. The Dice similarity coefficient of each organ was computed. Compared to the conventional label fusion method, our proposed label fusion method effectively eliminated gaps and overlaps and improved the CTA segmentation accuracy. The anatomical-based PVC of cardiac SPECT images with automatic multi-atlas segmentation provided consistent image quality and quantitative estimation of intramyocardial blood volume, as compared to those derived using manual segmentation. In conclusion, our proposed automatic multi-atlas segmentation method of CTAs is feasible, practical, and facilitates anatomical-based PVC of cardiac SPECT/CT images.

Cogeneration Technology Alternatives Study (CTAS). Volume 6: Computer data. Part 2: Residual-fired nocogeneration process boiler

NASA Technical Reports Server (NTRS)

Knightly, W. F.

1980-01-01

About fifty industrial processes from the largest energy consuming sectors were used as a basis for matching a similar number of energy conversion systems that are considered as candidate which can be made available by the 1985 to 2000 time period. The sectors considered included food, textiles, lumber, paper, chemicals, petroleum, glass, and primary metals. The energy conversion systems included steam and gas turbines, diesels, thermionics, stirling, closed cycle and steam injected gas turbines, and fuel cells. Fuels considered were coal, both coal and petroleum based residual and distillate liquid fuels, and low Btu gas obtained through the on site gasification of coal. Computer generated reports of the fuel consumption and savings, capital costs, economics and emissions of the cogeneration energy conversion systems (ECS's) heat and power matched to the individual industrial processes are presented. National fuel and emissions savings are also reported for each ECS assuming it alone is implemented. Two nocogeneration base cases are included: coal fired and residual fired process boilers.

Cogeneration Technology Alternatives Study (CTAS). Volume 6: Computer data. Part 1: Coal-fired nocogeneration process boiler, section A

NASA Technical Reports Server (NTRS)

Knightly, W. F.

1980-01-01

About fifty industrial processes from the largest energy consuming sectors were used as a basis for matching a similar number of energy conversion systems that are considered as candidate which can be made available by the 1985 to 2000 time period. The sectors considered included food, textiles, lumber, paper, chemicals, petroleum, glass, and primary metals. The energy conversion systems included steam and gas turbines, diesels, thermionics, stirling, closed cycle and steam injected gas turbines, and fuel cells. Fuels considered were coal, both coal and petroleum based residual and distillate liquid fuels, and low Btu gas obtained through the on site gasification of coal. Computer generated reports of the fuels consumption and savings, capital costs, economics and emissions of the cogeneration energy conversion systems (ECS's) heat and power matched to the individual industrial processes are presented. National fuel and emissions savings are also reported for each ECS assuming it alone is implemented. Two nocogeneration base cases are included: coal fired and residual fired process boilers.

Cogeneration Technology Alternatives Study (CTAS). Volume 6: Computer data. Part 1: Coal-fired nocogeneration process boiler, section B

NASA Technical Reports Server (NTRS)

Knightly, W. F.

1980-01-01

About fifty industrial processes from the largest energy consuming sectors were used as a basis for matching a similar number of energy conversion systems that are considered as candidate which can be made available by the 1985 to 2000 time period. The sectors considered included food, textiles, lumber, paper, chemicals, petroleum, glass, and primary metals. The energy conversion systems included steam and gas turbines, diesels, thermionics, stirling, closed cycle and steam injected gas turbines, and fuel cells. Fuels considered were coal, both coal and petroleum based residual and distillate liquid fuels, and low Btu gas obtained through the on site gasification of coal. Computer generated reports of the fuel consumption and savings, capital costs, economics and emissions of the cogeneration energy conversion systems (ECS's) heat and power matched to the individual industrial processes are presented. National fuel and emissions savings are also reported for each ECS assuming it alone is implemented. Two nocogeneration base cases are included: coal fired and residual fired process boilers.

Relationship between increasing concentrations of two carcinogens and statistical image descriptors of foci morphology in the cell transformation assay.

PubMed

Callegaro, Giulia; Corvi, Raffaella; Salovaara, Susan; Urani, Chiara; Stefanini, Federico M

2017-06-01

Cell Transformation Assays (CTAs) have long been proposed for the identification of chemical carcinogenicity potential. The endpoint of these in vitro assays is represented by the phenotypic alterations in cultured cells, which are characterized by the change from the non-transformed to the transformed phenotype. Despite the wide fields of application and the numerous advantages of CTAs, their use in regulatory toxicology has been limited in part due to concerns about the subjective nature of visual scoring, i.e. the step in which transformed colonies or foci are evaluated through morphological features. An objective evaluation of morphological features has been previously obtained through automated digital processing of foci images to extract the value of three statistical image descriptors. In this study a further potential of the CTA using BALB/c 3T3 cells is addressed by analysing the effect of increasing concentrations of two known carcinogens, benzo[a]pyrene and NiCl 2 , with different modes of action on foci morphology. The main result of our quantitative evaluation shows that the concentration of the considered carcinogens has an effect on foci morphology that is statistically significant for the mean of two among the three selected descriptors. Statistical significance also corresponds to visual relevance. The statistical analysis of variations in foci morphology due to concentration allowed to quantify morphological changes that can be visually appreciated but not precisely determined. Therefore, it has the potential of providing new quantitative parameters in CTAs, and of exploiting all the information encoded in foci. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

Thermo-responsive hydrogels for intravitreal injection and biomolecule release

NASA Astrophysics Data System (ADS)

Drapala, Pawel

In this dissertation, we develop an injectable polymer system to enable localized and prolonged release of therapeutic biomolecules for improved treatment of Age-Related Macular Degeneration (AMD). Thermo-responsive hydrogels derived from N-isopropylacrylamide (NIPAAm) and cross-linked with poly(ethylene glycol) (PEG) poly(L-Lactic acid) (PLLA) copolymer were synthesized via free-radical polymerization. These materials were investigated for (a) phase change behavior, (b) in-vitro degradation, (c) capacity for controlled drug delivery, and (d) biocompatibility. The volume-phase transition temperature (VPTT) of the PNIPAAm- co-PEG-b-PLLA hydrogels was adjusted using hydrophilic and hydrophobic moieties so that it is ca. 33°C. These hydrogels did not initially show evidence of degradation at 37°C due to physical cross-links of collapsed PNIPAAm. Only after addition of glutathione chain transfer agents (CTA)s to the precursor did the collapsed hydrogels become fully soluble at 37°C. CTAs significantly affected the release kinetics of biomolecules; addition of 1.0 mg/mL glutathione to 3 mM cross-linker accelerated hydrogel degradation, resulting in 100% release in less than 2 days. This work also explored the effect of PEGylation in order to tether biomolecules to the polymer matrix. It was demonstrated that non-site-specific PEGylation can postpone the burst release of solutes (up to 10 days in hydrogels with 0.5 mg/mL glutathione). Cell viability assays showed that at least two 20-minute buffer extraction steps were needed to remove cytotoxic elements from the hydrogels. Clinically-used therapeutic biomolecules LucentisRTM and AvastinRTM were demonstrated to be both stable and bioactive after release form PNIPAAm-co-PEG-b-PLLA hydrogels. The thermo-responsive hydrogels presented here offer a promising platform for the localized delivery of proteins such as recombinant antibodies.

Next Generation CTAS Tools

NASA Technical Reports Server (NTRS)

Erzberger, Heinz

2000-01-01

The FAA's Free Flight Phase 1 Office is in the process of deploying the current generation of CTAS tools, which are the Traffic Management Advisor (TMA) and the passive Final Approach Spacing Tool (pFAST), at selected centers and airports. Research at NASA is now focussed on extending the CTAS software and computer human interfaces to provide more advanced capabilities. The Multi-center TMA (McTMA) is designed to operate at airports where arrival flows originate from two or more centers whose boundaries are in close proximity to the TRACON boundary. McTMA will also include techniques for routing arrival flows away from congested airspace and around airspace reserved for arrivals into other hub airports. NASA is working with FAA and MITRE to build a prototype McTMA for the Philadelphia airport. The active Final Approach Spacing Tool (aFAST) provides speed and heading advisories to help controllers achieve accurate spacing between aircraft on final approach. These advisories will be integrated with those in the existing pFAST to provide a set of comprehensive advisories for controlling arrival traffic from the TRACON boundary to touchdown at complex, high-capacity airports. A research prototype of aFAST, designed for the Dallas-Fort Worth is in an advanced stage of development. The Expedite Departure Path (EDP) and Direct-To tools are designed to help controllers guide departing aircraft out of the TRACON airspace and to climb to cruise altitude along the most efficient routes.

Expression and clinical significance of MAGE and NY-ESO-1 cancer-testis antigens in adenoid cystic carcinoma of the head and neck.

PubMed

Veit, Johannes A; Heine, Daniela; Thierauf, Julia; Lennerz, Jochen; Shetty, Subasch; Schuler, Patrick J; Whiteside, Theresa; Beutner, Dirk; Meyer, Moritz; Grünewald, Inga; Ritter, Gerd; Gnjatic, Sacha; Sikora, Andrew G; Hoffmann, Thomas K; Laban, Simon

2016-07-01

Adenoid cystic carcinoma (ACC) of the head and neck is a rare but highly malignant tumor. Cancer-testis antigens (CTAs) represent an immunogenic family of cancer-specific proteins and thus represent an attractive target for immunotherapy. Eighty-four cases of ACC were identified, the CTAs pan-Melanoma antigen (pan-MAGE; M3H67) and New York esophageal squamous cell carcinoma (NY-ESO-1; E978) were detected immunohistochemically (IHC) and correlated with clinical data. Expression of NY-ESO-1 was found in 48 of 84 patients (57.1%) and of pan-MAGE in 28 of 84 patients (31.2%). Median overall survival (OS) in NY-ESO-1 positive versus negative patients was 130.8 and 282.0 months (p = .223), respectively. OS in pan-MAGE positive versus negative patients was 105.3 and 190.5 months, respectively (p = .096). Patients expressing both NY-ESO-1 and pan-MAGE simultaneously had significantly reduced OS with a median of 90.5 months compared with 282.0 months in negative patients (p = .047). A significant fraction of patients with ACC show expression of the CTAs NY-ESO-1 and/or pan-MAGE with promising immunotherapeutic implications. © 2016 Wiley Periodicals, Inc. Head Neck 38: 1008-1016, 2016. © 2016 Wiley Periodicals, Inc.

Maltopentaose-conjugated CTA for RAFT polymerization generating nanostructured bioresource-block copolymer.

PubMed

Togashi, Daichi; Otsuka, Issei; Borsali, Redouane; Takeda, Koichi; Enomoto, Kazushi; Kawaguchi, Seigou; Narumi, Atsushi

2014-12-08

We now describe the synthesis of a new family of oligosaccharide-conjugated functional molecules, which act as chain transfer agents (CTAs) for the reversible addition-fragmentation chain transfer (RAFT) polymerization. The synthesis was started from the catalyst-free direct N-glycosyl reaction of 5-azidopentylamine onto maltopentaose (Mal5) in dry methanol at room temperature and subsequent N-protected reaction with acetic anhydride, producing a stable oligosaccharide-building block, such as Mal5 with an azidopentyl group (Mal5-N3). The azido group was hydrogenated using platinum dioxide (PtO2) as a catalyst to give Mal5 with aminopentyl group (Mal5-NH2), which was then reacted with CTA molecules bearing activated ester moieties. These reactions produced Mal5-modified macro-CTAs (Mal5-CTAs, 1), which were used for the RAFT polymerizations of styrene (St) and methyl methacrylate (MMA) in DMF. The polymerizations were performed using the [M]0/[1]0 values ranging from 50 to 600, affording the Mal5-hybrid amphiphilic block copolymers (BCPs), such as Mal5-polystyrene (2) and Mal5-poly(methyl methacrylate) (3), with a quantitative end-functionality and the controlled molecular weights between 4310 and 20 300 g mol(-1). The small-angle X-ray scattering (SAXS) measurements were accomplished for 2 and 3 to ensure their abilities to form phase separated structures in their bulk states with the increasing temperatures from 30 to 190 °C. The featured results were observed for 2 (ϕMal5 = 0.14) and 3 (ϕMal5 = 0.16) at temperatures above 100 °C, where ϕMal5 denotes the volume fraction of the Mal5 unit in the BCP sample. For both BCP samples, the primary scattering peaks q* were clearly observed together with the higher-ordered scattering peaks √2q* and √3q*. Thus, these Mal5-hybrid amphiphilic BCP samples have a body centered cubic (BCC) phase morphology. The domain spacing (d) values of the BCC morphology for 2 (ϕMal5 = 0.14) and 3 (ϕMal5 = 0.16) were 10.4 and 9.55 nm, respectively, which were determined using Bragg's relation (d = 2π/q*). The present RAFT agents were shown to eventually provide the phase separated structural polymeric materials in which 5.4 nm bioresource-spherical domains were periodically arrayed at the interval of about 10 nm.

Cogeneration Technology Alternatives Study (CTAS) Volume 5: Analytical approach and results

NASA Technical Reports Server (NTRS)

1980-01-01

Data and information in the area of advanced energy conversion systems for industrial cogeneration applications in the 1985 to 2000 time period are provided. Six current and thirty-six advanced energy conversion systems were defined and combined with appropriate balance of plant equipment. Twenty-six industrial processes were selected from among the high energy consuming industries to serve as a framework for the study. Each conversion system was analyzed as a cogenerator with each industrial plant. Fuel consumption, costs, and environmental intrusion were evaluated and compared to corresponding traditional values. Various cogeneration strategies were analyzed and both topping and bottoming (using industrial by-product heat) applications were included. The advanced energy conversion technologies indicated reduced fuel consumption, costs, and emissions. Typically fuel energy savings of 10 to 25 percent were predicted compared to traditional on site furnaces and utility electricity. Gas turbines and combined cycles indicated high overall annual cost savings. Steam turbines and gas turbines produced high estimated returns. In some applications, diesels were most efficient. The advanced technologies used coal derived fuels, or coal with advanced fluid bed combustion or on site gasification systems.

76 FR 7975 - Commodity Pool Operators and Commodity Trading Advisors: Amendments to Compliance Obligations

Federal Register 2010, 2011, 2012, 2013, 2014

2011-02-11

...The Commodity Futures Trading Commission is proposing to amend its existing regulations and proposing one new regulation regarding Commodity Pool Operators and Commodity Trading Advisors. The Commission is proposing a new data collection for CPOs and CTAs that is consistent with the data collection required under the Dodd-Frank Act. The proposed amendments would: Rescind the exemptions from registration provided in the Commission's regulations; rescind the relief from the certification requirement for annual reports provided to operators of certain pools only offered to qualified eligible persons (``QEPs''); modify the criteria for claiming relief under the Commission's regulations; and require the annual filing of notices claiming exemptive relief. Finally, the proposal includes new risk disclosure requirements for CPOs and CTAs regarding swap transactions.

Human Factors Report: TMA Operational Evaluations 1996 and 1998

NASA Technical Reports Server (NTRS)

Lee, Katharine K.; Quinn, Cheryl M.; Hoang, Ty; Sanford, Beverly D.

2000-01-01

The Traffic Management Advisor (TMA) is a component of the Center-TRACON Automation System (CTAS), a suite of decision-support tools for the air traffic control (ATC) environment which is being developed at NASA Ames Research Center. TMA has been operational at the ATC facilities in Dallas/Fort Worth, Texas, since an operational field evaluation in 1996. The Operational Evaluation demonstrated significant benefits, including an approximately 5 percent increase in airport capacity. This report describes the human factors results from the 1996 Operational Evaluation and an investigation of TMA usage performed two years later, during the 1998 TMA Daily Use Field Survey. The results described are instructive for CTAS focused development, and provide valuable lessons for future research in ATC decision-support tools where it is critical to merge a well-defined, complex work environment with advanced automation.

77 FR 11251 - Commodity Pool Operators and Commodity Trading Advisors: Compliance Obligations

Federal Register 2010, 2011, 2012, 2013, 2014

2012-02-24

...The Commodity Futures Trading Commission is adopting amendments to its existing part 4 regulations and promulgating one new regulation regarding Commodity Pool Operators and Commodity Trading Advisors. The Commission is also adopting new data collections for CPOs and CTAs that are consistent with a data collection required under the Dodd-Frank Act for entities registered with both the Commission and the Securities and Exchange Commission. The adopted amendments rescind the exemption from registration; rescind relief from the certification requirement for annual reports provided to operators of certain pools offered only to qualified eligible persons (QEPs; modify the criteria for claiming relief); and require the annual filing of notices claiming exemptive relief under several sections of the Commission's regulations. Finally, the adopted amendments include new risk disclosure requirements for CPOs and CTAs regarding swap transactions.

RoMEO Studies 8: Self-Archiving: The Logic behind the Colour-Coding Used in the Copyright Knowledge Bank

ERIC Educational Resources Information Center

Jenkins, Celia; Probets, Steve; Oppenheim, Charles; Hubbard, Bill

2007-01-01

Purpose: The purpose of this research is to show how the self-archiving of journal papers is a major step towards providing open access to research. However, copyright transfer agreements (CTAs) that are signed by an author prior to publication often indicate whether, and in what form, self-archiving is allowed. The SHERPA/RoMEO database enables…

Cogeneration Technology Alternatives Study (CTAS). Volume 5: Cogeneration systems results

NASA Technical Reports Server (NTRS)

Gerlaugh, H. E.; Hall, E. W.; Brown, D. H.; Priestley, R. R.; Knightly, W. F.

1980-01-01

The use of various advanced energy conversion systems is examined and compared with each other and with current technology systems for savings in fuel energy, costs, and emissions in individual plants and on a national level. About fifty industrial processes from the largest energy consuming sectors were used as a basis for matching a similar number of energy conversion systems that are considered as candidate which can be made available by the 1985 to 2000 time period. The sectors considered included food, textiles, lumber, paper, chemicals, petroleum, glass, and primary metals. The energy conversion systems included steam and gas turbines, diesels, thermionics, stirling, closed cycle and steam injected gas turbines, and fuel cells. Fuels considered were coal, both coal and petroleum based residual and distillate liquid fuels, and low Btu gas obtained through the on site gasification of coal. The methodology and results of matching the cogeneration energy conversion systems to approximately 50 industrial processes are described. Results include fuel energy saved, levelized annual energy cost saved, return on investment, and operational factors relative to the noncogeneration base cases.

Autism in the emergency department.

PubMed

Cohen-Silver, Justine Heather; Muskat, Barbara; Ratnapalan, Savithiri

2014-10-01

This is a retrospective chart review of autistic patients presenting to the emergency department (ED) in a tertiary care pediatric center during the year 2011. There were 160 ED visits by 130 patients, 25% of visits were repeated, and 20% were admitted to the hospital. There were 126 (79%) male and 34 (21%) female patients mean age of 12 years, 79% had comorbid health conditions. Forty percent were CTAS 2 (Canadian Triage Acuity Score) acuity, 42% of visits were CTAS 3 acuity, and 7% rated their pain as "severe." Visits were for behavior (10%), neurological concern (13%), 3% dental related, and the remainder were for gastrointestinal infections and other complaints. Average length of stay was 6 hours 21 minutes, with 2-hour wait to start assessment with physician. Autism is a prevalent diagnosis and patients with autism are accessing the ED. We hope to use these demographic findings to better serve these patients and their families. © The Author(s) 2014.

Effects of ATC automation on precision approaches to closely space parallel runways

NASA Technical Reports Server (NTRS)

Slattery, R.; Lee, K.; Sanford, B.

1995-01-01

Improved navigational technology (such as the Microwave Landing System and the Global Positioning System) installed in modern aircraft will enable air traffic controllers to better utilize available airspace. Consequently, arrival traffic can fly approaches to parallel runways separated by smaller distances than are currently allowed. Previous simulation studies of advanced navigation approaches have found that controller workload is increased when there is a combination of aircraft that are capable of following advanced navigation routes and aircraft that are not. Research into Air Traffic Control automation at Ames Research Center has led to the development of the Center-TRACON Automation System (CTAS). The Final Approach Spacing Tool (FAST) is the component of the CTAS used in the TRACON area. The work in this paper examines, via simulation, the effects of FAST used for aircraft landing on closely spaced parallel runways. The simulation contained various combinations of aircraft, equipped and unequipped with advanced navigation systems. A set of simulations was run both manually and with an augmented set of FAST advisories to sequence aircraft, assign runways, and avoid conflicts. The results of the simulations are analyzed, measuring the airport throughput, aircraft delay, loss of separation, and controller workload.

Objective scoring of transformed foci in BALB/c 3T3 cell transformation assay by statistical image descriptors.

PubMed

Urani, C; Corvi, R; Callegaro, G; Stefanini, F M

2013-09-01

In vitro cell transformation assays (CTAs) have been shown to model important stages of in vivo carcinogenesis and have the potential to predict carcinogenicity in humans. Advantages of CTAs are their ability of revealing both genotoxic and non-genotoxic carcinogens while reducing both experimental costs and the number of animals used. The endpoint of the CTA is foci formation, and requires classification under light microscopy based on morphology. Thus current limitations for the wide adoption of the assay partially depend on a fair degree of subjectivity in foci scoring. An objective evaluation may be obtained after separating foci from background monolayer in the digital image, and quantifying values of statistical descriptors which are selected to capture eye-scored morphological features. The aim of this study was to develop statistical descriptors to be applied to transformed foci of BALB/c 3T3, which cover foci size, multilayering and invasive cell growth into the background monolayer. Proposed descriptors were applied to a database of 407 foci images to explore the numerical features, and to illustrate open problems and potential solutions. Copyright © 2013 Elsevier Ltd. All rights reserved.

Time-variable gravity fields and ocean mass change from 37 months of kinematic Swarm orbits

NASA Astrophysics Data System (ADS)

Lück, Christina; Kusche, Jürgen; Rietbroek, Roelof; Löcher, Anno

2018-03-01

Measuring the spatiotemporal variation of ocean mass allows for partitioning of volumetric sea level change, sampled by radar altimeters, into mass-driven and steric parts. The latter is related to ocean heat change and the current Earth's energy imbalance. Since 2002, the Gravity Recovery and Climate Experiment (GRACE) mission has provided monthly snapshots of the Earth's time-variable gravity field, from which one can derive ocean mass variability. However, GRACE has reached the end of its lifetime with data degradation and several gaps occurred during the last years, and there will be a prolonged gap until the launch of the follow-on mission GRACE-FO. Therefore, efforts focus on generating a long and consistent ocean mass time series by analyzing kinematic orbits from other low-flying satellites, i.e. extending the GRACE time series. Here we utilize data from the European Space Agency's (ESA) Swarm Earth Explorer satellites to derive and investigate ocean mass variations. For this aim, we use the integral equation approach with short arcs (Mayer-Gürr, 2006) to compute more than 500 time-variable gravity fields with different parameterizations from kinematic orbits. We investigate the potential to bridge the gap between the GRACE and the GRACE-FO mission and to substitute missing monthly solutions with Swarm results of significantly lower resolution. Our monthly Swarm solutions have a root mean square error (RMSE) of 4.0 mm with respect to GRACE, whereas directly estimating constant, trend, annual, and semiannual (CTAS) signal terms leads to an RMSE of only 1.7 mm. Concerning monthly gaps, our CTAS Swarm solution appears better than interpolating existing GRACE data in 13.5 % of all cases, when artificially removing one solution. In the case of an 18-month artificial gap, 80.0 % of all CTAS Swarm solutions were found closer to the observed GRACE data compared to interpolated GRACE data. Furthermore, we show that precise modeling of non-gravitational forces acting on the Swarm satellites is the key for reaching these accuracies. Our results have implications for sea level budget studies, but they may also guide further research in gravity field analysis schemes, including satellites not dedicated to gravity field studies.

Tailoring advanced technologies for air traffic control : the importance of the development process

DOT National Transportation Integrated Search

1995-04-01

This paper describes a process that is currently being applied to the : development and assessment of an advanced air traffic control (ATC) system, the : Center TRACON Automation System (CTAS). This process deviates from established : practices of AT...

The Dynamic Planner: The Sequencer, Scheduler, and Runway Allocator for Air Traffic Control Automation

NASA Technical Reports Server (NTRS)

Wong, Gregory L.; Denery, Dallas (Technical Monitor)

2000-01-01

The Dynamic Planner (DP) has been designed, implemented, and integrated into the Center-TRACON Automation System (CTAS) to assist Traffic Management Coordinators (TMCs), in real time, with the task of planning and scheduling arrival traffic approximately 35 to 200 nautical miles from the destination airport. The TMC may input to the DP a series of current and future scheduling constraints that reflect the operation and environmental conditions of the airspace. Under these constraints, the DP uses flight plans, track updates, and Estimated Time of Arrival (ETA) predictions to calculate optimal runway assignments and arrival schedules that help ensure an orderly, efficient, and conflict-free flow of traffic into the terminal area. These runway assignments and schedules can be shown directly to controllers or they can be used by other CTAS tools to generate advisories to the controllers. Additionally, the TMC and controllers may override the decisions made by the DP for tactical considerations. The DP will adapt to computations to accommodate these manual inputs.

Cell transformation assays for prediction of carcinogenic potential: state of the science and future research needs

PubMed Central

Creton, Stuart; Aardema, Marilyn J.; Carmichael, Paul L.; Harvey, James S.; Martin, Francis L.; Newbold, Robert F.; O’Donovan, Michael R.; Pant, Kamala; Poth, Albrecht; Sakai, Ayako; Sasaki, Kiyoshi; Scott, Andrew D.; Schechtman, Leonard M.; Shen, Rhine R.; Tanaka, Noriho; Yasaei, Hemad

2012-01-01

Cell transformation assays (CTAs) have long been proposed as in vitro methods for the identification of potential chemical carcinogens. Despite showing good correlation with rodent bioassay data, concerns over the subjective nature of using morphological criteria for identifying transformed cells and a lack of understanding of the mechanistic basis of the assays has limited their acceptance for regulatory purposes. However, recent drivers to find alternative carcinogenicity assessment methodologies, such as the Seventh Amendment to the EU Cosmetics Directive, have fuelled renewed interest in CTAs. Research is currently ongoing to improve the objectivity of the assays, reveal the underlying molecular changes leading to transformation and explore the use of novel cell types. The UK NC3Rs held an international workshop in November 2010 to review the current state of the art in this field and provide directions for future research. This paper outlines the key points highlighted at this meeting. PMID:21852270

Laser ``M'egajoule'' cryogenic target program: from target fabrication to conformation of the deuterium-tritium ice layer

NASA Astrophysics Data System (ADS)

Collier, Rémy; Durut, Frédéric; Reneaume, Benoît; Chicane, Cédric; Théobald, Marc; Breton, Olivier; Martin, Michel; Fleury, Emmanuel; Vincent-Viry, Olivier; Bachelet, Franck; Jeannot, Laurent; Geoffray, Isabelle; Botrel, Ronan; Dauteuil, Christophe; Hermerel, Cyril; Choux, Alexandre; Bednarczyk, Sophie; Legaie, Olivier

2008-11-01

For the French inertial confinement fusion (ICF) experiments, cryogenic target assemblies (CTAs) for the LMJ program are manufactured and filled at CEA Valduc (Dijon) in the cryogenic targets filling station (IRCC). They will be moved at about 20 K into a transport cryostat for cryogenic targets and will be driven from CEA/Valduc to CEA/CESTA (Bordeaux). Cryogenic targets will then be transferred by several cryogenic grippers on the cryogenic target positioner before shots. The CTA has to meet severe specifications and involves a lot of challenging tasks for its manufacture. To fill CTAs by permeation with deuterium-tritium (DT), the IRCC need to meet strict thermal, mechanical and dimensional specifications. To obtain a good combustion yield, a very homogenous DT ice layer and very smooth roughness at 1.5 K below the DT triple point are also required. This paper deals with the up to date main issues in the different fields of the LMJ cryogenic target program.

Evaluation of Isoprene Chain Extension from PEO Macromolecular Chain Transfer Agents for the Preparation of Dual, Invertible Block Copolymer Nanoassemblies.

PubMed

Bartels, Jeremy W; Cauët, Solène I; Billings, Peter L; Lin, Lily Yun; Zhu, Jiahua; Fidge, Christopher; Pochan, Darrin J; Wooley, Karen L

2010-09-14

Two RAFT-capable PEO macro-CTAs, 2 and 5 kDa, were prepared and used for the polymerization of isoprene which yielded well-defined block copolymers of varied lengths and compositions. GPC analysis of the PEO macro-CTAs and block copolymers showed remaining unreacted PEO macro-CTA. Mathematical deconvolution of the GPC chromatograms allowed for the estimation of the blocking efficiency, about 50% for the 5 kDa PEO macro-CTA and 64% for the 2 kDa CTA. Self assembly of the block copolymers in both water and decane was investigated and the resulting regular and inverse assemblies, respectively, were analyzed with DLS, AFM, and TEM to ascertain their dimensions and properties. Assembly of PEO-b-PIp block copolymers in aqueous solution resulted in well-defined micelles of varying sizes while the assembly in hydrophobic, organic solvent resulted in the formation of different morphologies including large aggregates and well-defined cylindrical and spherical structures.

Scientific and regulatory challenges in evaluating clinical trial protocols for HIV-1/AIDS vaccines - A review from a regulatory perspective.

PubMed

Sheets, Rebecca L; Zhou, TieQun; Knezevic, Ivana

2016-03-01

Clinical development of prophylactic HIV/AIDS vaccines presents many scientific challenges that result in challenges for regulators reviewing clinical trial applications (CTAs). The World Health Organization (WHO) has the responsibility to provide technical support to these regulators. The search for an HIV/AIDS vaccine will only succeed through well-designed, -conducted and -controlled human efficacy studies reviewed and approved by regulators in countries worldwide, particularly in countries where the epidemic has hit hardest, such as in sub-Saharan Africa and Asia. This review summarizes the current candidates in development and focuses on challenges regulators face when reviewing CTAs, such as the evolving landscape of "standard of prevention," trials in adolescents, adaptive trial designs, correlates of protection and their analysis, and access to successful vaccines. There are many unknowns in the field of HIV/AIDS vaccine development and often, there is not a clear right or wrong approach because of the scientific challenges described in this review. Consequently, regulators should not feel that decisions need be made in isolation, when there are many available international collaborative efforts and opportunities to seek expert advice. The WHO provides many such opportunities and support to regulators across the globe. Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.

Challenges of Field Testing The Traffic Monitoring Advisor in an Operational Air Traffic Control Facility

DOT National Transportation Integrated Search

1997-01-01

The Traffic Management Advisor (TMA), the sequence and schedule tool of the : Center/TRACON Automation System (CTAS), was evaluated at the Fort Worth Center : (ZFW) in the summer of 1996. This paper describes the challenges encountered : during the v...

Cogeneration Technology Alternatives Study (CTAS). Volume 6: Computer data. Part 1: Coal-fired nocogeneration process boiler, section A

NASA Technical Reports Server (NTRS)

Knightly, W. F.

1980-01-01

Various advanced energy conversion systems (ECS) are compared with each other and with current technology systems for their savings in fuel energy, costs, and emissions in individual plants and on a national level. About fifty industrial processes from the largest energy consuming sectors were used as a basis for matching a similar number of energy conversion systems that are considered as candidates which can be made available by the 1985 to 2000 time period. The sectors considered included food, textiles, lumber, paper, chemicals, petroleum, glass, and primary metals. The energy conversion systems included steam and gas turbines, diesels, thermionics, stirling, closed cycle and steam injected gas turbines, and fuel cells. Fuels considered were coal, both coal and petroleum based residual and distillate liquid fuels, and low Btu gas obtained through the on-site gasification of coal. Computer generated reports of the fuel consumption and savings, capital costs, economics and emissions of the cogeneration energy conversion systems (ECS's) heat and power matched to the individual industrial processes are presented for coal fired process boilers. National fuel and emissions savings are also reported for each ECS assuming it alone is implemented.

Cogeneration Technology Alternatives Study (CTAS). Volume 3: Industrial processes

NASA Technical Reports Server (NTRS)

Palmer, W. B.; Gerlaugh, H. E.; Priestley, R. R.

1980-01-01

Cogenerating electric power and process heat in single energy conversion systems rather than separately in utility plants and in process boilers is examined in terms of cost savings. The use of various advanced energy conversion systems are examined and compared with each other and with current technology systems for their savings in fuel energy, costs, and emissions in individual plants and on a national level. About fifty industrial processes from the target energy consuming sectors were used as a basis for matching a similar number of energy conversion systems that are considered as candidate which can be made available by the 1985 to 2000 time period. The sectors considered included food, textiles, lumber, paper, chemicals, petroleum, glass, and primary metals. The energy conversion systems included steam and gas turbines, diesels, thermionics, stirling, closed cycle and steam injected gas turbines, and fuel cells. Fuels considered were coal, both coal and petroleum based residual and distillate liquid fuels, and low Btu gas obtained through the on site gasification of coal. An attempt was made to use consistent assumptions and a consistent set of ground rules specified by NASA for determining performance and cost. Data and narrative descriptions of the industrial processes are given.

An Exploration of Radiation Physics in Electromagnetics

NASA Technical Reports Server (NTRS)

Lee, Katherine K.

2005-01-01

Contents include the following: NASA's Missions and Aeronautics Research. Today's Air Traffic Control System. Development of Decision-Support Tools. The Center-TRACON Automation System (CTAS). The Traffic Management Advisor (TMA). The Multi-Center Traffic Management Advisor (McTMA). The Surface Management System (SMS). Future Directions: The Joint Planning and Development Office.

Dynamic Weather Routes Architecture Overview

NASA Technical Reports Server (NTRS)

Eslami, Hassan; Eshow, Michelle

2014-01-01

Dynamic Weather Routes Architecture Overview, presents the high level software architecture of DWR, based on the CTAS software framework and the Direct-To automation tool. The document also covers external and internal data flows, required dataset, changes to the Direct-To software for DWR, collection of software statistics, and the code structure.

76 FR 43874 - Privacy of Consumer Financial Information; Conforming Amendments Under Dodd-Frank Act

Federal Register 2010, 2011, 2012, 2013, 2014

2011-07-22

... pool operators (``CPOs''), and introducing brokers (``IBs''). The scope of the part 160 rules mirrors... respect to those Commission-regulated entities that were previously complying with part 160--FCMs, IBs... regulations currently applies to several types of Commission-regulated entities, including FCMs, IBs, CTAs...

Cogeneration Technology Alternatives Study (CTAS). Volume 3: Energy conversion system characteristics

NASA Technical Reports Server (NTRS)

1980-01-01

Six current and thirty-six advanced energy conversion systems were defined and combined with appropriate balance of plant equipment. Twenty-six industrial processes were selected from among the high energy consuming industries to serve as a frame work for the study. Each conversion system was analyzed as a cogenerator with each industrial plant. Fuel consumption, costs, and environmental intrusion were evaluated and compared to corresponding traditional values. The advanced energy conversion technologies indicated reduced fuel consumption, costs, and emissions. Fuel energy savings of 10 to 25 percent were predicted compared to traditional on site furnaces and utility electricity. With the variety of industrial requirements, each advanced technology had attractive applications. Fuel cells indicated the greatest fuel energy savings and emission reductions. Gas turbines and combined cycles indicated high overall annual savings. Steam turbines and gas turbines produced high estimated returns. In some applications, diesels were most efficient. The advanced technologies used coal derived fuels, or coal with advanced fluid bed combustion or on site gasifications. Data and information for both current and advanced energy conversion technology are presented. Schematic and physical descriptions, performance data, equipment cost estimates, and predicted emissions are included. Technical developments which are needed to achieve commercialization in the 1985-2000 period are identified.

Contributions to the AIAA Guidance, Navigation and Control Conference

NASA Technical Reports Server (NTRS)

Campbell, S. D. (Editor)

2002-01-01

This report contains six papers presented by the Lincoln Laboratory Air Traffic Control Systems Group at the American Institute of Aeronautics & Astronautics (AIAA) Guidance, Navigation and Control (GNC) conference on 6-9 August 2001 in Montreal, Canada. The work reported was sponsored by the NASA Advanced Air Transportation Technologies (AATT) program and the FAA Free Flight Phase 1 (FFP1) program. The papers are based on studies completed at Lincoln Laboratory in collaboration with staff at NASA Ames Research Center. These papers were presented in the Air Traffic Automation Session of the conference and fall into three major areas: Traffic Analysis & Benefits Studies, Weather/Automation Integration and Surface Surveillance. In the first area, a paper by Andrews & Robinson presents an analysis of the efficiency of runway operations at Dallas/Ft. Worth using a tool called PARO, and a paper by Welch, Andrews & Robinson presents a delay benefit results for the Final Approach Spacing Tool (FAST). In the second area, a paper by Campbell, et al describes a new weather distribution systems for the Center/TRACON Automation System (CTAS) that allows ingestion of multiple weather sources, and a paper by Vandevenne, Lloyd & Hogaboom describes the use of the NOAA Eta model as a backup wind data source for CTAS. Also in this area, a paper by Murphy & Campbell presents initial steps towards integrating weather impacted routes into FAST. In the third area, a paper by Welch, Bussolari and Atkins presents an initial operational concept for using surface surveillance to reduce taxi delays.

Center-TRACON Automation System (CTAS) En Route Trajectory Predictor Requirements and Capabilities

NASA Technical Reports Server (NTRS)

Vivona, Robert; Cate, Karen Tung

2013-01-01

This requirements framework document is designed to support the capture of requirements and capabilities for state-of-the-art trajectory predictors (TPs). This framework has been developed to assist TP experts in capturing a clear, consistent, and cross-comparable set of requirements and capabilities. The goal is to capture capabilities (types of trajectories that can be built), functional requirements (including inputs and outputs), non-functional requirements (including prediction accuracy and computational performance), approaches for constraint relaxation, and input uncertainties. The sections of this framework are based on the Common Trajectory Predictor structure developed by the FAA/Eurocontrol Cooperative R&D Action Plan 16 Committee on Common Trajectory Prediction. It is assumed that the reader is familiar with the Common TP Structure.1 This initial draft is intended as a first cut capture of the En Route TS Capabilities and Requirements. As such, it contains many annotations indicating possible logic errors in the CTAS code or in the description provided. It is intended to work out the details of the annotations with NASA and to update this document at a later time.

Variability of Origin of Splanchnic and Renal Vessels From the Thoracoabdominal Aorta.

PubMed

Mazzaccaro, D; Malacrida, G; Nano, G

2015-01-01

To analyze the variability of origin of the celiac trunk (CT), the superior mesenteric artery (SMA), the right renal artery (RRA), and the left renal artery (LRA) in terms of mutual distances, angle from the sagittal aortic axis (clock position), and ostial diameters on computed tomography angiographies (CTAs) in three groups of patients. One hundred and fifty CTAs of 50 patients with a non-dilated thoracoabdominal aorta (group A), 50 with thoracoabdominal aneurysm (B), and 50 with infrarenal aneurysm (C) were reviewed. The measurements performed on CTAs, as well as the patients' age, sex, and body surface area, were analyzed. p values <.05 were considered statistically significant. The clock position of the CT and the SMA, the diameters of all vessels, and the distance of the CTeSMA followed a Gaussian distribution. In contrast, the clock position of the renal vessels did not follow a normal distribution, and nor did the distances of the SMA-RRA, SMA-LRA, RRA-LRA or the distances between the renal arteries and the aortic bifurcation. The same values did not differ significantly among the three groups, with the exception of the distances between the renal arteries and the aortic bifurcation, significantly greater in group C. The clock position of the LRA and the distances of the SMA-LRA, SMA-RRA, RRA-LRA and between both renal arteries and the aortic bifurcation showed a significant correlation with the increase of aortic diameter. The anatomic variability of the origin of both the CT and the SMA in terms of clock position and mutual distances followed a Gaussian distribution, regardless of group. The same applies to the ostial diameters of renal and visceral vessels. In contrast, the origin of the renal vessels had a statistically significant heterogeneity that seemed to be correlated with the increase of aortic diameter in the mesenteric and renal aortic region.

When are CT angiograms indicated for patients with lower extremity fractures? A review of 275 extremities.

PubMed

Monazzam, Shafagh; Goodell, Parker B; Salcedo, Edgardo S; Nelson, Sandahl H; Wolinsky, Philip R

2017-01-01

Computed tomography angiogram (CTA) is frequently utilized to detect vascular injuries even without examination findings indicating a vascular injury. We had the following hypotheses: (1) a CTA for lower extremity fractures with no clinical signs of a vascular injury is not indicated, and (2) fracture location and pattern would correlate with the risk of a vascular injury. A retrospective review was conducted on patients who had an acute lower extremity fracture(s) and a CTA. Their charts were reviewed for multiple factors including the presence or absence of hard or soft signs of a vascular injury, soft tissue status, and fracture location/pattern. Every CTA radiology report was reviewed and any vascular intervention or amputation resulting from a vascular injury was recorded. Statistical analysis was performed. Of the 275 CTAs of fractured extremities reviewed, 80 (29%) had a positive CTA finding and 16 (6%) required treatment. A total of 109 (40%) of the extremities had no hard or soft signs; all had normal CTAs. Having at least one hard or soft sign was a significant risk factor for having a positive CTA. An open fracture, isolated proximal third fibula fracture, distal and shaft tibia fractures, and the presence of multiple fractures in one extremity were also associated with an increased risk for having a positive CTA. We found no evidence to support the routine use of CTAs to evaluate lower extremity fractures unless at least one hard or soft sign is present. The presence of an open fracture, distal tibia or tibial shaft fractures, multiple fractures in one extremity, and/or an isolated proximal third fibula fracture increases the risk of having a finding consistent with a vascular injury on a CTA. Only 6% of the cases required treatment, and all of them had diminished or absent distal pulses on presentation. Diagnostic test, level III.

CT angiography spot sign in intracerebral hemorrhage predicts active bleeding during surgery.

PubMed

Brouwers, H Bart; Raffeld, Miriam R; van Nieuwenhuizen, Koen M; Falcone, Guido J; Ayres, Alison M; McNamara, Kristen A; Schwab, Kristin; Romero, Javier M; Velthuis, Birgitta K; Viswanathan, Anand; Greenberg, Steven M; Ogilvy, Christopher S; van der Zwan, Albert; Rinkel, Gabriel J E; Goldstein, Joshua N; Klijn, Catharina J M; Rosand, Jonathan

2014-09-02

To determine whether the CT angiography (CTA) spot sign marks bleeding complications during and after surgery for spontaneous intracerebral hemorrhage (ICH). In a 2-center study of consecutive spontaneous ICH patients who underwent CTA followed by surgical hematoma evacuation, 2 experienced readers (blinded to clinical and surgical data) reviewed CTAs for spot sign presence. Blinded raters assessed active intraoperative and postoperative bleeding. The association between spot sign and active intraoperative bleeding, postoperative rebleeding, and residual ICH volumes was evaluated using univariable and multivariable logistic regression. A total of 95 patients met inclusion criteria: 44 lobar, 17 deep, 33 cerebellar, and 1 brainstem ICH; ≥1 spot sign was identified in 32 patients (34%). The spot sign was the only independent marker of active bleeding during surgery (odds ratio [OR] 3.4; 95% confidence interval [CI] 1.3-9.0). Spot sign (OR 4.1; 95% CI 1.1-17), female sex (OR 6.9; 95% CI 1.7-37), and antiplatelet use (OR 4.6; 95% CI 1.2-21) were predictive of postoperative rebleeding. Larger residual hematomas and postoperative rebleeding were associated with higher discharge case fatality (OR 3.4; 95% CI 1.1-11) and a trend toward increased case fatality at 3 months (OR 2.9; 95% CI 0.9-8.8). The CTA spot sign is associated with more intraoperative bleeding, more postoperative rebleeding, and larger residual ICH volumes in patients undergoing hematoma evacuation for spontaneous ICH. The spot sign may therefore be useful to select patients for future surgical trials. © 2014 American Academy of Neurology.

The Center/TRACON Automation System (CTAS): A video presentation

NASA Technical Reports Server (NTRS)

Green, Steven M.; Freeman, Jeannine

1992-01-01

NASA Ames, working with the FAA, has developed a highly effective set of automation tools for aiding the air traffic controller in traffic management within the terminal area. To effectively demonstrate these tools, the video AAV-1372, entitled 'Center/TRACON Automation System,' was produced. The script to the video is provided along with instructions for its acquisition.

Cogeneration Technology Alternatives Study (CTAS). Volume 1: Summary report

NASA Technical Reports Server (NTRS)

Gerlaugh, H. E.; Hall, E. W.; Brown, D. H.; Priestley, R. R.; Knightly, W. F.

1980-01-01

Large savings can be made in industry by cogenerating electric power and process heat in single energy conversion systems rather than separately in utility plants and in process boilers. About fifty industrial processes from the largest energy consuming sectors were used as a basis for matching a similar number of energy conversion systems that are considered as candidates which can be made available by the 1985 to 2000 time period. The sectors considered included food, textiles, lumber, paper, chemicals, petroleum, glass, and primary metals. The energy conversion systems included steam and gas turbines, diesels, thermionics, stirling, closed-cycle and steam injected gas turbines, and fuel cells. Fuels considered were coal, both coal and petroleum-based residual and distillate liquid fuels, and low Btu gas obtained through the on-site gasification of coal. An attempt was made to use consistent assumptions and a consistent set of ground rules for determining performance and cost in individual plants and on a national level. It was found that: (1) atmospheric and pressurized fluidized bed steam turbine systems were the most attractive of the direct coal-fired systems; and (2) open-cycle gas turbines with heat recovery steam generators and combined-cycles with NO(x) emission reduction and moderately increased firing temperatures were the most attractive of the coal-derived liquid-fired systems.

Overview of Human-Centric Space Situational Awareness Science and Technology

DTIC Science & Technology

2012-09-01

AGI), the developers of Satellite Tool Kit ( STK ), has provided demonstrations of innovative SSA visualization concepts that take advantage of the...needs inherent with SSA. RH has conducted CTAs and developed work-centered human-computer interfaces, visualizations , and collaboration technologies...all end users. RH’s Battlespace Visualization Branch researches methods to exploit the visual channel primarily to improve decision making and

76 FR 11701 - Amendments to Commodity Pool Operator and Commodity Trading Advisor Regulations Resulting From...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-03-03

... require CPOs and CTAs to make and keep certain books and records relating to commodity interest trading... existing Regulation 1.3(yy) along with reference to the term ``swap'' as defined in Section 1a(47) of the... make and keep certain books and records generated by the swap transactions in which they engage on...

Human Factors Assessment: The Passive Final Approach Spacing Tool (pFAST) Operational Evaluation

NASA Technical Reports Server (NTRS)

Lee, Katharine K.; Sanford, Beverly D.

1998-01-01

Automation to assist air traffic controllers in the current terminal and en route air traff ic environments is being developed at Ames Research Center in conjunction with the Federal Aviation Administration. This automation, known collectively as the Center-TRACON Automation System (CTAS), provides decision- making assistance to air traffic controllers through computer-generated advisories. One of the CTAS tools developed specifically to assist terminal area air traffic controllers is the Passive Final Approach Spacing Tool (pFAST). An operational evaluation of PFAST was conducted at the Dallas/Ft. Worth, Texas, Terminal Radar Approach Control (TRACON) facility. Human factors data collected during the test describe the impact of the automation upon the air traffic controller in terms of perceived workload and acceptance. Results showed that controller self-reported workload was not significantly increased or reduced by the PFAST automation; rather, controllers reported that the levels of workload remained primarily the same. Controller coordination and communication data were analyzed, and significant differences in the nature of controller coordination were found. Controller acceptance ratings indicated that PFAST was acceptable. This report describes the human factors data and results from the 1996 Operational Field Evaluation of Passive FAST.

Viable Circumstances for Financial Negotiations in Pakistan Contracting Process

DTIC Science & Technology

2015-06-01

Submission BIW Bath Iron Works BPA Blanket Purchase Agreement CERP Center for Economic Research in Pakistan CICA Competition in Contracting Act CJCS...IDIQ contracts, blanket purchase agreements ( BPAs ), and contractors team arrangements (CTAs) by fulfilling all pre-requisites of government...wide commercial purchase card (FAR 13.301) 2. Purchase orders (FAR 13.302) 3. Blanket purchase agreements ( BPAs ; FAR13.303) 4. Imprest fund and

Achievement Emotions and Achievement Goals in Support of the Convergent, Divergent and Criterion Validity of the Spanish-Cognitive Test Anxiety Scale

ERIC Educational Resources Information Center

Sánchez-Rosas, Javier; Furlan, Luis Alberto

2017-01-01

Based on the control-value theory of achievement emotions and theory of achievement goals, this research provides evidence of convergent, divergent, and criterion validity of the Spanish Cognitive Test Anxiety Scale (S-CTAS). A sample of Argentinean undergraduates responded to several scales administered at three points. At time 1 and 3, the…

Using GRIDVIEW to Better Understand the Early Bombardment History of the Moon, Mars and Earth

NASA Technical Reports Server (NTRS)

Frey, Herbert

2012-01-01

For more than a decade we have used GRIDVIEW to help analyze topographic and related data for Mars and more recently for the Moon. Our focus has been to employ the stretching, contouring, profiling, circle-fitting and other capabilities of GRIDVIEW to search for Quasi-Circular Depressions (CTAs) in MOLA, LOLA and other topographic data, and for Circular Thin Areas (CTAs) in Mars and Moon model crustal thickness data. Both QCDs and CTAs likely represent buried or obscured impact craters not readily visible in image data. We found clear evidence for a much larger population of buried impact craters in the northern lowlands of Mars (Frey et al. 2002), suggesting that part of the Red Planet is not significantly younger than the southern highlands. Edgar and Frey (2008) found that the N(300) crater retention ages of both areas were essentially identical, a conclusion confirmed by Wyatt (unpublished data) using more recent crustal thickness data for Mars. MOLA topographic data and MOLA-derived crustal thickness data were used to both identify a large number of previously unrecognized very large impact basins (D> 1000 km) on Mars and to determine relative crater retention ages for them (Frey, 2008). The distribution of N(300) CRAs suggested most formed in a relatively short interval of time. This dating also suggested the main magnetic field of Mars disappeared during this period (Lillis et al., 2008), because only the youngest basins systematically lack a remagnetized signature. Similar QCD and CTA analysis of first Clementine (Frey, 2011) and more recently LOLA topographic and LOLA-derived crustal thickness data for the Moon (Frey et al., 2011) revealed a significantly larger population of impact basins > 300 km in diameter than previously known. N(50) CRAs suggest a two-peak distribution of ages (Frey, 2012). An improved counting process confirms the two peaks, perhaps indicating both a pre-Nectaris Early Heavy Bombardment (EHB) as well as a Late Heavy Bombardment (LHB) on the Moon (Frey and Burgess, 2012, this meeting), with obvious implications for the early bombardment history of the Earth.

Morphological parameters associated with ruptured posterior communicating aneurysms.

PubMed

Ho, Allen; Lin, Ning; Charoenvimolphan, Nareerat; Stanley, Mary; Frerichs, Kai U; Day, Arthur L; Du, Rose

2014-01-01

The rupture risk of unruptured intracranial aneurysms is known to be dependent on the size of the aneurysm. However, the association of morphological characteristics with ruptured aneurysms has not been established in a systematic and location specific manner for the most common aneurysm locations. We evaluated posterior communicating artery (PCoA) aneurysms for morphological parameters associated with aneurysm rupture in that location. CT angiograms were evaluated to generate 3-D models of the aneurysms and surrounding vasculature. Univariate and multivariate analyses were performed to evaluate morphological parameters including aneurysm volume, aspect ratio, size ratio, distance to ICA bifurcation, aneurysm angle, vessel angles, flow angles, and vessel-to-vessel angles. From 2005-2012, 148 PCoA aneurysms were treated in a single institution. Preoperative CTAs from 63 patients (40 ruptured, 23 unruptured) were available and analyzed. Multivariate logistic regression revealed that smaller volume (p = 0.011), larger aneurysm neck diameter (0.048), and shorter ICA bifurcation to aneurysm distance (p = 0.005) were the most strongly associated with aneurysm rupture after adjusting for all other clinical and morphological variables. Multivariate subgroup analysis for patients with visualized PCoA demonstrated that larger neck diameter (p = 0.018) and shorter ICA bifurcation to aneurysm distance (p = 0.011) were significantly associated with rupture. Intracerebral hemorrhage was associated with smaller volume, larger maximum height, and smaller aneurysm angle, in addition to lateral projection, male sex, and lack of hypertension. We found that shorter ICA bifurcation to aneurysm distance is significantly associated with PCoA aneurysm rupture. This is a new physically intuitive parameter that can be measured easily and therefore be readily applied in clinical practice to aid in the evaluation of patients with PCoA aneurysms.

Morphological Parameters Associated with Ruptured Posterior Communicating Aneurysms

PubMed Central

Ho, Allen; Lin, Ning; Charoenvimolphan, Nareerat; Stanley, Mary; Frerichs, Kai U.; Day, Arthur L.; Du, Rose

2014-01-01

The rupture risk of unruptured intracranial aneurysms is known to be dependent on the size of the aneurysm. However, the association of morphological characteristics with ruptured aneurysms has not been established in a systematic and location specific manner for the most common aneurysm locations. We evaluated posterior communicating artery (PCoA) aneurysms for morphological parameters associated with aneurysm rupture in that location. CT angiograms were evaluated to generate 3-D models of the aneurysms and surrounding vasculature. Univariate and multivariate analyses were performed to evaluate morphological parameters including aneurysm volume, aspect ratio, size ratio, distance to ICA bifurcation, aneurysm angle, vessel angles, flow angles, and vessel-to-vessel angles. From 2005–2012, 148 PCoA aneurysms were treated in a single institution. Preoperative CTAs from 63 patients (40 ruptured, 23 unruptured) were available and analyzed. Multivariate logistic regression revealed that smaller volume (p = 0.011), larger aneurysm neck diameter (0.048), and shorter ICA bifurcation to aneurysm distance (p = 0.005) were the most strongly associated with aneurysm rupture after adjusting for all other clinical and morphological variables. Multivariate subgroup analysis for patients with visualized PCoA demonstrated that larger neck diameter (p = 0.018) and shorter ICA bifurcation to aneurysm distance (p = 0.011) were significantly associated with rupture. Intracerebral hemorrhage was associated with smaller volume, larger maximum height, and smaller aneurysm angle, in addition to lateral projection, male sex, and lack of hypertension. We found that shorter ICA bifurcation to aneurysm distance is significantly associated with PCoA aneurysm rupture. This is a new physically intuitive parameter that can be measured easily and therefore be readily applied in clinical practice to aid in the evaluation of patients with PCoA aneurysms. PMID:24733151

Evaluation of Trajectory Errors in an Automated Terminal-Area Environment

NASA Technical Reports Server (NTRS)

Oseguera-Lohr, Rosa M.; Williams, David H.

2003-01-01

A piloted simulation experiment was conducted to document the trajectory errors associated with use of an airplane's Flight Management System (FMS) in conjunction with a ground-based ATC automation system, Center-TRACON Automation System (CTAS) in the terminal area. Three different arrival procedures were compared: current-day (vectors from ATC), modified (current-day with minor updates), and data link with FMS lateral navigation. Six active airline pilots flew simulated arrivals in a fixed-base simulator. The FMS-datalink procedure resulted in the smallest time and path distance errors, indicating that use of this procedure could reduce the CTAS arrival-time prediction error by about half over the current-day procedure. Significant sources of error contributing to the arrival-time error were crosstrack errors and early speed reduction in the last 2-4 miles before the final approach fix. Pilot comments were all very positive, indicating the FMS-datalink procedure was easy to understand and use, and the increased head-down time and workload did not detract from the benefit. Issues that need to be resolved before this method of operation would be ready for commercial use include development of procedures acceptable to controllers, better speed conformance monitoring, and FMS database procedures to support the approach transitions.

Explicit Disassociation of a Conditioned Stimulus and Unconditioned Stimulus during Extinction Training Reduces Both Time to Asymptotic Extinction and Spontaneous Recovery of a Conditioned Taste Aversion

ERIC Educational Resources Information Center

Mickley, G. Andrew; DiSorbo, Anthony; Wilson, Gina N.; Huffman, Jennifer; Bacik, Stephanie; Hoxha, Zana; Biada, Jaclyn M.; Kim, Ye-Hyun

2009-01-01

Conditioned taste aversions (CTAs) may be acquired when an animal consumes a novel taste (CS) and then experiences the symptoms of poisoning (US). This aversion may be extinguished by repeated exposure to the CS alone. However, following a latency period in which the CS is not presented, the CTA will spontaneously recover (SR). In the current…

Preparation and Cross-Linking of All-Acrylamide Diblock Copolymer Nano-Objects via Polymerization-Induced Self-Assembly in Aqueous Solution

PubMed Central

2017-01-01

Various carboxylic acid-functionalized poly(N,N-dimethylacrylamide) (PDMAC) macromolecular chain transfer agents (macro-CTAs) were chain-extended with diacetone acrylamide (DAAM) by reversible addition–fragmentation chain transfer (RAFT) aqueous dispersion polymerization at 70 °C and 20% w/w solids to produce a series of PDMAC–PDAAM diblock copolymer nano-objects via polymerization-induced self-assembly (PISA). TEM studies indicate that a PDMAC macro-CTA with a mean degree of polymerization (DP) of 68 or higher results in the formation of well-defined spherical nanoparticles with mean diameters ranging from 40 to 150 nm. In contrast, either highly anisotropic worms or polydisperse vesicles are formed when relatively short macro-CTAs (DP = 40–58) are used. A phase diagram was constructed to enable accurate targeting of pure copolymer morphologies. Dynamic light scattering (DLS) and aqueous electrophoresis studies indicated that in most cases these PDMAC–PDAAM nano-objects are surprisingly resistant to changes in either solution pH or temperature. However, PDMAC40–PDAAM99 worms do undergo partial dissociation to form a mixture of relatively short worms and spheres on adjusting the solution pH from pH 2–3 to around pH 9 at 20 °C. Moreover, a change in copolymer morphology from worms to a mixture of short worms and vesicles was observed by DLS and TEM on heating this worm dispersion to 50 °C. Postpolymerization cross-linking of concentrated aqueous dispersions of PDMAC–PDAAM spheres, worms, or vesicles was performed at ambient temperature using adipic acid dihydrazide (ADH), which reacts with the hydrophobic ketone-functionalized PDAAM chains. The formation of hydrazone groups was monitored by FT-IR spectroscopy and afforded covalently stabilized nano-objects that remained intact on exposure to methanol, which is a good solvent for both blocks. Rheological studies indicated that the cross-linked worms formed a stronger gel compared to linear precursor worms. PMID:28260814

Well-defined single polymer nanoparticles for the antibody-targeted delivery of chemotherapeutic agents.

PubMed

Lane, D D; Chiu, D Y; Su, F Y; Srinivasan, S; Kern, H B; Press, O W; Stayton, P S; Convertine, A J

2015-02-28

Aqueous reversible addition-fragmentation chain transfer (RAFT) polymerization was employed to prepare a series of linear copolymers of N,N-dimethylacrylamide (DMA) and 2-hydroxyethylacrylamide (HEAm) with narrow Đ values over a molecular weight range spanning three orders of magnitude (10 3 to 10 6 Da). Trithiocarbonate-based RAFT chain transfer agents (CTAs) were grafted onto these scaffolds using carbodiimide chemistry catalyzed with DMAP. The resultant graft chain transfer agent (gCTA) was subsequently employed to synthesize polymeric brushes with a number of important vinyl monomer classes including acrylamido, methacrylamido, and methacrylate. Brush polymerization kinetics were evaluated for the aqueous RAFT polymerization of DMA from a 10 arm gCTA. Polymeric brushes containing hydroxyl functionality were further functionalized in order to prepare 2nd generation gCTAs which were subsequently employed to prepare polymers with a brushed-brush architecture with molecular weights in excess of 10 6 Da. These resultant single particle nanoparticles (SNPs) were employed as drug delivery vehicles for the anthracycline-based drug doxorubicin via copolymerization of DMA with a protected carbazate monomer (bocSMA). Cell-specific targeting functionality was also introduced via copolymerization with a biotin-functional monomer (bioHEMA). Drug release of the hydrazone linked doxorubicin was evaluated as function of pH and serum and chemotherapeutic activity was evaluated in SKOV3 ovarian cancer cells.

Completion of the Circle of Willis Varies by Gender, Age, and Indication for Computed Tomography Angiography.

PubMed

Zaninovich, Orel A; Ramey, Wyatt L; Walter, Christina M; Dumont, Travis M

2017-10-01

The circle of Willis (CoW) is the foremost anastomosis and blood distribution center of the brain. Its effectiveness depends on its completion and the size and patency of its vessels. Gender-related and age-related anatomic variations in the CoW may play an important role in the pathogenesis of cerebrovascular diseases. In this study, we analyzed computed tomography angiograms (CTAs) to assess for differences in CoW completion related to gender, age, and indication for CTA. A total of 834 CTAs were retrospectively analyzed for all CoW vessels to compare the incidence of complete CoW and variation frequency based on gender, age, and indication. The incidence of complete CoW was 37.1% overall. CoW completion showed a statistically significant decrease with increasing age for all age groups in both men (47.0%, 29.4%, 18.8%) and women (59.1%, 44.2%, 30.9%). Completion was greater in women (43.8%) than in men (31.2%) overall and for all age groups. These gender differences were all statistically significant except for the 18-39 years age group. The most frequent of the 28 CoW variations were absent posterior communicating artery (PCOM) bilaterally (17.1%), right PCOM (15.3%), and left PCOM (10.9%). Ischemic stroke and the 18-39 years age group of hemorrhagic stroke showed a statistically significant reduction in completion relative to trauma. The incidence of complete CoW is likely greater in women for all age groups and likely decreases with age in both genders. The most frequently absent vessel is likely the PCOM, either unilaterally or bilaterally. Completion may play a role in ischemic stroke and a subset of patients with hemorrhagic stroke. Copyright © 2017 Elsevier Inc. All rights reserved.

A retrospective review of vital signs and clinical outcomes of febrile infants younger than 3 months old presenting to the emergency department.

PubMed

Chong, Shu-Ling; Ong, Gene Yong-Kwang; Chin, Wendy Yi Wen; Chua, John Mingzhou; Nair, Praseetha; Ong, Alicia Shu Zhen; Ng, Kee Chong; Maconochie, Ian

2018-01-01

Febrile infants younger than 3 months old present a diagnostic dilemma to the emergency physician. We aim to describe a large population of febrile infants less than 3 months old presenting to a pediatric emergency department (ED) and to assess the performance of current heart rate guidelines in the prediction of serious infections (SI). We performed a retrospective review of febrile infants younger than 3 months old, between March 2015 and Feb 2016, in a large tertiary pediatric ED. We documented the primary outcome of SI for each infant, as well as the clinical findings, vital signs, and Severity Index Score (SIS). We assessed the performance of the Paediatric Canadian Triage and Acuity Scale (PaedCTAS), Advanced Pediatric Life Support (APLS) guidelines and Fleming normal reference values, using sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and area under receiver operating characteristics curve (AUC). 1057 infants were analyzed, with 326 (30.6%) infants diagnosed with SI. High temperature, tachycardia, and low SIS score were significantly associated with SI. Item analysis showed that the SIS performance was driven by the presence of mottling (p = 0.003) and high temperature (p<0.001). The APLS guideline had the highest sensitivity (66.0%, 95% CI 60.5-71.1%), NPV (73.3%, 95% CI 69.7-76.5%) and AUC (0.538), while the PaedCTAS (2 standard deviation from normal) had the highest specificity (98.5%, 95% CI 97.3-99.3%) and PPV (55.2%, 95% CI 32.7-71.0%). Current guidelines on infantile heart rates have a variable performance. In our study, the APLS heart rate guidelines performed with the highest sensitivity, but no individual guideline predicted for SIs satisfactorily.

Time-Resolved C-Arm Computed Tomographic Angiography Derived From Computed Tomographic Perfusion Acquisition: New Capability for One-Stop-Shop Acute Ischemic Stroke Treatment in the Angiosuite.

PubMed

Yang, Pengfei; Niu, Kai; Wu, Yijing; Struffert, Tobias; Dorfler, Arnd; Schafer, Sebastian; Royalty, Kevin; Strother, Charles; Chen, Guang-Hong

2015-12-01

Multimodal imaging using cone beam C-arm computed tomography (CT) may shorten the delay from ictus to revascularization for acute ischemic stroke patients with a large vessel occlusion. Largely because of limited temporal resolution, reconstruction of time-resolved CT angiography (CTA) from these systems has not yielded satisfactory results. We evaluated the image quality and diagnostic value of time-resolved C-arm CTA reconstructed using novel image processing algorithms. Studies were done under an Institutional Review Board approved protocol. Postprocessing of data from 21 C-arm CT dynamic perfusion acquisitions from 17 patients with acute ischemic stroke were done to derive time-resolved C-arm CTA images. Two observers independently evaluated image quality and diagnostic content for each case. ICC and receiver-operating characteristic analysis were performed to evaluate interobserver agreement and diagnostic value of this novel imaging modality. Time-resolved C-arm CTA images were successfully generated from 20 data sets (95.2%, 20/21). Two observers agreed well that the image quality for large cerebral arteries was good but was more limited for small cerebral arteries (distal to M1, A1, and P1). receiver-operating characteristic curves demonstrated excellent diagnostic value for detecting large vessel occlusions (area under the curve=0.987-1). Time-resolved CTAs derived from C-arm CT perfusion acquisitions provide high quality images that allowed accurate diagnosis of large vessel occlusions. Although image quality of smaller arteries in this study was not optimal ongoing modifications of the postprocessing algorithm will likely remove this limitation. Adding time-resolved C-arm CTAs to the capabilities of the angiography suite further enhances its suitability as a one-stop shop for care for patients with acute ischemic stroke. © 2015 American Heart Association, Inc.

Rate of Contrast Extravasation on CT Angiography Predicts Hematoma Expansion and Mortality in Primary Intracerebral Hemorrhage

PubMed Central

Brouwers, H. Bart; Battey, Thomas W.K.; Musial, Hayley H.; Ciura, Viesha A.; Falcone, Guido J.; Ayres, Alison M.; Vashkevich, Anastasia; Schwab, Kristin; Viswanathan, Anand; Anderson, Christopher D.; Greenberg, Steven M.; Pomerantz, Stuart R.; Ortiz, Claudia J.; Goldstein, Joshua N.; Gonzalez, R. Gilberto; Rosand, Jonathan; Romero, Javier M.

2015-01-01

Background and Purpose In primary intracerebral hemorrhage (ICH), the presence of contrast extravasation following CT angiography (CTA), termed the ‘spot sign’, predicts hematoma expansion and mortality. Since the biological underpinnings of the spot sign are not fully understood, we investigated whether the rate of contrast extravasation - which may reflect the rate of bleeding - predicts expansion and mortality beyond the simple presence of the spot sign. Methods Consecutive ICH patients with first-pass CTA followed by a 90-second delayed post-contrast CT (delayed CTA) were included. CTAs were reviewed for spot sign presence by two blinded readers. Spot sign volumes on first-pass and delayed CTA and ICH volumes were measured using semi-automated software. Extravasation rates were calculated and tested for association with hematoma expansion and mortality using uni- and multivariable logistic regression. Results 162 patients were included, 48 (30%) of whom had ≥1 spot sign. Median spot sign volume was 0.04mL on first-pass CTA and 0.4mL on delayed CTA. Median extravasation rate was 0.23mL/min overall, and 0.30mL/min among expanders versus 0.07mL/min in non-expanders. Extravasation rates were also significantly higher in patients who died in hospital: 0.27mL/min versus 0.04mL/min. In multivariable analysis, the extravasation rate was independently associated with in-hospital mortality (OR1.09 [95%CI 1.04–1.18], p=0.004), 90-day mortality (OR1.15 [95%CI 1.08–1.27], p=0.0004), and hematoma expansion (OR1.03 [95%CI 1.01–1.08], p=0.047). Conclusions Contrast extravasation rate, or spot sign growth, further refines the ability to predict hematoma expansion and mortality. Our results support the hypothesis that the spot sign directly measures active bleeding in acute ICH. PMID:26243220

Rate of Contrast Extravasation on Computed Tomographic Angiography Predicts Hematoma Expansion and Mortality in Primary Intracerebral Hemorrhage.

PubMed

Brouwers, H Bart; Battey, Thomas W K; Musial, Hayley H; Ciura, Viesha A; Falcone, Guido J; Ayres, Alison M; Vashkevich, Anastasia; Schwab, Kristin; Viswanathan, Anand; Anderson, Christopher D; Greenberg, Steven M; Pomerantz, Stuart R; Ortiz, Claudia J; Goldstein, Joshua N; Gonzalez, R Gilberto; Rosand, Jonathan; Romero, Javier M

2015-09-01

In primary intracerebral hemorrhage, the presence of contrast extravasation after computed tomographic angiography (CTA), termed the spot sign, predicts hematoma expansion and mortality. Because the biological underpinnings of the spot sign are not fully understood, we investigated whether the rate of contrast extravasation, which may reflect the rate of bleeding, predicts expansion and mortality beyond the simple presence of the spot sign. Consecutive intracerebral hemorrhage patients with first-pass CTA followed by a 90-second delayed postcontrast CT (delayed CTA) were included. CTAs were reviewed for spot sign presence by 2 blinded readers. Spot sign volumes on first-pass and delayed CTA and intracerebral hemorrhage volumes were measured using semiautomated software. Extravasation rates were calculated and tested for association with hematoma expansion and mortality using uni- and multivariable logistic regressions. One hundred and sixty-two patients were included, 48 (30%) of whom had ≥1 spot sign. Median spot sign volume was 0.04 mL on first-pass CTA and 0.4 mL on delayed CTA. Median extravasation rate was 0.23 mL/min overall and 0.30 mL/min among expanders versus 0.07 mL/min in nonexpanders. Extravasation rates were also significantly higher in patients who died in hospital: 0.27 mL/min versus 0.04 mL/min. In multivariable analysis, the extravasation rate was independently associated with in-hospital mortality (odds ratio, 1.09 [95% confidence interval, 1.04-1.18], P=0.004), 90-day mortality (odds ratio, 1.15 [95% confidence interval, 1.08-1.27]; P=0.0004), and hematoma expansion (odds ratio, 1.03 [95% confidence interval, 1.01-1.08]; P=0.047). Contrast extravasation rate, or spot sign growth, further refines the ability to predict hematoma expansion and mortality. Our results support the hypothesis that the spot sign directly measures active bleeding in acute intracerebral hemorrhage. © 2015 American Heart Association, Inc.

Development of the Surface Management System Integrated with CTAS Arrival Tools

NASA Technical Reports Server (NTRS)

Jung, Yoon C.; Jara, Dave

2005-01-01

The Surface Management System (SMS) developed by NASA Ames Research Center in coordination with the Federal Aviation Administration (FAA) is a decision support tool to help tower traffic coordinators and Ground/Local controllers in managing and controlling airport surface traffic in order to increase capacity, efficiency, and flexibility. SMS provides common situation awareness to personnel at various air traffic control facilities such as airport traffic control towers (ATCT s), airline ramp towers, Terminal Radar Approach Control (TRACON), and Air Route Traffic Control Center (ARTCC). SMS also provides a traffic management tool to assist ATCT traffic management coordinators (TMCs) in making decisions such as airport configuration and runway load balancing. The Build 1 of the SMS tool was installed and successfully tested at Memphis International Airport (MEM) and received high acceptance scores from ATCT controllers and coordinators, as well as airline ramp controllers. NASA Ames Research Center continues to develop SMS under NASA s Strategic Airspace Usage (SAU) project in order to improve its prediction accuracy and robustness under various modeling uncertainties. This paper reports the recent development effort performed by the NASA Ames Research Center: 1) integration of Center TRACON Automation System (CTAS) capability with SMS and 2) an alternative approach to obtain airline gate information through a publicly available website. The preliminary analysis results performed on the air/surface traffic data at the DFW airport have shown significant improvement in predicting airport arrival demand and IN time at the gate. This paper concludes with recommendations for future research and development.

Energy and cost saving results for advanced technology systems from the Cogeneration Technology Alternatives Study (CTAS)

NASA Technical Reports Server (NTRS)

Sagerman, G. D.; Barna, G. J.; Burns, R. K.

1979-01-01

An overview of the organization and methodology of the Cogeneration Technology Alternatives Study is presented. The objectives of the study were to identify the most attractive advanced energy conversion systems for industrial cogeneration applications in the future and to assess the advantages of advanced technology systems compared to those systems commercially available today. Advanced systems studied include steam turbines, open and closed cycle gas turbines, combined cycles, diesel engines, Stirling engines, phosphoric acid and molten carbonate fuel cells and thermionics. Steam turbines, open cycle gas turbines, combined cycles, and diesel engines were also analyzed in versions typical of today's commercially available technology to provide a base against which to measure the advanced systems. Cogeneration applications in the major energy consuming manufacturing industries were considered. Results of the study in terms of plant level energy savings, annual energy cost savings and economic attractiveness are presented for the various energy conversion systems considered.

Advanced Cogeneration Technology Economic Optimization Study (ACTEOS)

NASA Technical Reports Server (NTRS)

Nanda, P.; Ansu, Y.; Manuel, E. H., Jr.; Price, W. G., Jr.

1980-01-01

The advanced cogeneration technology economic optimization study (ACTEOS) was undertaken to extend the results of the cogeneration technology alternatives study (CTAS). Cost comparisons were made between designs involving advanced cogeneration technologies and designs involving either conventional cogeneration technologies or not involving cogeneration. For the specific equipment cost and fuel price assumptions made, it was found that: (1) coal based cogeneration systems offered appreciable cost savings over the no cogeneration case, while systems using coal derived liquids offered no costs savings; and (2) the advanced cogeneration systems provided somewhat larger cost savings than the conventional systems. Among the issues considered in the study included: (1) temporal variations in steam and electric demands; (2) requirements for reliability/standby capacity; (3) availability of discrete equipment sizes; (4) regional variations in fuel and electricity prices; (5) off design system performance; and (6) separate demand and energy charges for purchased electricity.

CTAS and NASA Air Traffic Management Fact Sheets for En Route Descent Advisor and Surface Management System

NASA Technical Reports Server (NTRS)

Lee, Katharine

2004-01-01

The Surface Management System (SMS) is a decision support tool that will help controllers, traffic managers, and NAS users manage the movements of aircraft on the surface of busy airports, improving capacity, efficiency, and flexibility. The Advanced Air Transportation Technologies (AATT) Project at NASA is developing SMS in cooperation with the FAA's Free Flight Phase 2 (FFP2) pro5ram. SMS consists of three parts: a traffic management tool, a controller tool, and a National Airspace System (NAS) information tool.

A retrospective review of vital signs and clinical outcomes of febrile infants younger than 3 months old presenting to the emergency department

PubMed Central

Chong, Shu-Ling; Ong, Gene Yong-Kwang; Chin, Wendy Yi Wen; Chua, John Mingzhou; Nair, Praseetha; Ong, Alicia Shu Zhen; Ng, Kee Chong; Maconochie, Ian

2018-01-01

Objectives Febrile infants younger than 3 months old present a diagnostic dilemma to the emergency physician. We aim to describe a large population of febrile infants less than 3 months old presenting to a pediatric emergency department (ED) and to assess the performance of current heart rate guidelines in the prediction of serious infections (SI). Materials and methods We performed a retrospective review of febrile infants younger than 3 months old, between March 2015 and Feb 2016, in a large tertiary pediatric ED. We documented the primary outcome of SI for each infant, as well as the clinical findings, vital signs, and Severity Index Score (SIS). We assessed the performance of the Paediatric Canadian Triage and Acuity Scale (PaedCTAS), Advanced Pediatric Life Support (APLS) guidelines and Fleming normal reference values, using sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and area under receiver operating characteristics curve (AUC). Results 1057 infants were analyzed, with 326 (30.6%) infants diagnosed with SI. High temperature, tachycardia, and low SIS score were significantly associated with SI. Item analysis showed that the SIS performance was driven by the presence of mottling (p = 0.003) and high temperature (p<0.001). The APLS guideline had the highest sensitivity (66.0%, 95% CI 60.5–71.1%), NPV (73.3%, 95% CI 69.7–76.5%) and AUC (0.538), while the PaedCTAS (2 standard deviation from normal) had the highest specificity (98.5%, 95% CI 97.3–99.3%) and PPV (55.2%, 95% CI 32.7–71.0%). Conclusions Current guidelines on infantile heart rates have a variable performance. In our study, the APLS heart rate guidelines performed with the highest sensitivity, but no individual guideline predicted for SIs satisfactorily. PMID:29304160

Source Attribution of Cyanides Using Anionic Impurity Profiling, Stable Isotope Ratios, Trace Elemental Analysis and Chemometrics.

PubMed

Mirjankar, Nikhil S; Fraga, Carlos G; Carman, April J; Moran, James J

2016-02-02

Chemical attribution signatures (CAS) for chemical threat agents (CTAs), such as cyanides, are being investigated to provide an evidentiary link between CTAs and specific sources to support criminal investigations and prosecutions. Herein, stocks of KCN and NaCN were analyzed for trace anions by high performance ion chromatography (HPIC), carbon stable isotope ratio (δ(13)C) by isotope ratio mass spectrometry (IRMS), and trace elements by inductively coupled plasma optical emission spectroscopy (ICP-OES). The collected analytical data were evaluated using hierarchical cluster analysis (HCA), Fisher-ratio (F-ratio), interval partial least-squares (iPLS), genetic algorithm-based partial least-squares (GAPLS), partial least-squares discriminant analysis (PLSDA), K nearest neighbors (KNN), and support vector machines discriminant analysis (SVMDA). HCA of anion impurity profiles from multiple cyanide stocks from six reported countries of origin resulted in cyanide samples clustering into three groups, independent of the associated alkali metal (K or Na). The three groups were independently corroborated by HCA of cyanide elemental profiles and corresponded to countries each having one known solid cyanide factory: Czech Republic, Germany, and United States. Carbon stable isotope measurements resulted in two clusters: Germany and United States (the single Czech stock grouped with United States stocks). Classification errors for two validation studies using anion impurity profiles collected over five years on different instruments were as low as zero for KNN and SVMDA, demonstrating the excellent reliability associated with using anion impurities for matching a cyanide sample to its factory using our current cyanide stocks. Variable selection methods reduced errors for those classification methods having errors greater than zero; iPLS-forward selection and F-ratio typically provided the lowest errors. Finally, using anion profiles to classify cyanides to a specific stock or stock group for a subset of United States stocks resulted in cross-validation errors ranging from 0 to 5.3%.

Evaluation in context: ATC automation in the field

NASA Technical Reports Server (NTRS)

Harwood, Kelly; Sanford, Beverly

1994-01-01

The process for incorporating advanced technologies into complex aviation systems is as important as the final product itself. This paper described a process that is currently being applied to the development and assessment of an advanced ATC automation system, CTAS. The key element of the process is field exposure early in the system development cycle. The process deviates from current established practices of system development -- where field testing is an implementation endpoint -- and has been deemed necessary by the FAA for streamlining development and bringing system functions to a level of stability and usefulness. Methods and approaches for field assessment are borrowed from human factors engineering, cognitive engineering, and usability engineering and are tailored for the constraints of an operational ATC environment. To date, the focus has been on the qualitative assessment of the match between TMA capabilities and the context for their use. Capturing the users' experience with the automation tool and understanding tool use in the context of the operational environment is important, not only for developing a tool that is an effective problem-solving instrument but also for defining meaningful operational requirements. Such requirements form the basis for certifying the safety and efficiency of the system. CTAS is the first U.S. advanced ATC automation system of its scope and complexity to undergo this field development and assessment process. With the rapid advances in aviation technologies and our limited understanding of their impact on system performance, it is time we opened our eyes to new possibilities for developing, validating, and ultimately certifying complex aviation systems.

Computer order entry systems in the emergency department significantly reduce the time to medication delivery for high acuity patients.

PubMed

Syed, Shahbaz; Wang, Dongmei; Goulard, Debbie; Rich, Tom; Innes, Grant; Lang, Eddy

2013-07-05

Computerized physician order entry (CPOE) systems are designed to increase safety and improve quality of care; however, their impact on efficiency in the ED has not yet been validated. This study examined the impact of CPOE on process times for medication delivery, laboratory utilization and diagnostic imaging in the early, late and control phases of a regional ED-CPOE implementation. Three tertiary care hospitals serving a population in excess of 1 million inhabitants that initiated the same CPOE system during the same 3-week time window. Patients were stratified into three groupings: Control, Early CPOE and Late CPOE (n = 200 patients per group/hospital site). Eligible patients consisted of a stratified (40% CTAS 2 and 60% CTAS 3) random sample of all patients seen 30 days preceding CPOE implementation (Control), 30 days immediately after CPOE implementation (Early CPOE) and 5-6 months after CPOE implementation (Late CPOE). Primary outcomes were time to (TT) from physician assignment (MD-sign) up to MD-order completion. An ANOVA and t-test were employed for statistical analysis. In comparison with control, TT 1st MD-Ordered Medication decreased in both the Early and Late CPOE groups (102.6 min control, 62.8 Early and 65.7 late, p < 0.001). TT 1st MD-ordered laboratory results increased in both the Early and Late CPOE groups compared to Control (76.4, 85.3 and 73.8 min, respectively, p < 0.001). TT 1st X-Ray also significantly increased in both the Early and Late CPOE groups (80.4, 84.8 min, respectively, compared to 68.1, p < 0.001). Given that CT and ultrasound imaging inherently takes increased time, these imaging studies were not included, and only X-ray was examined. There was no statistical difference found between TT discharge and consult request. Regional implementation of CPOE afforded important efficiencies in time to medication delivery for high acuity ED patients. Increased times observed for laboratory and radiology results may reflect system issues outside of the emergency department and as a result of potential confounding may not be a reflection of CPOE impact.

Preface: Chemical Forensics

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

Fraga, Carlos G.

This virtual special issue is devoted to chemical forensics, a developing scientific discipline that aims to provide information to support the attribution of a chemical (or mixture) of interest to its source. This process is carried out through the analysis of the chemical itself or associated material constituents to address investigative, legal or intelligence questions. “Source” refers to how, where and when a chemical was handled or produced. Source information is critical in investigations of incidents of chemicals used for illicit or nefarious purposes, especially when toxic chemicals are used as weapons. The Chemical Weapons Convention (CWC), an international disarmamentmore » treaty that entered into force in 1997, prohibits the use of chemicals as weapons. This treaty has 192 States Parties (the countries who have joined the treaty) encompassing more than 98% of the global population and landmass, yet chemical attacks have continued to increase since this treaty was opened for signature to the governments of the world in 1993. The first notorious use of a chemical weapon since 1993 was by the Aum Shinrikyo cult whose sarin attack on the Tokyo subway system in March 1995 killed 13 and drove another 6,000 to seek medical treatment. More recently, over 160 alleged chemical attacks have been reported in Syria and Iraq with both governments and terrorist groups being accused, and casualties numbering in the thousands. Additionally, recent high profile nerve agent poisoning of dissidents from North Korea and Russia illustrate a willingness to use chemical threat agents (CTAs) with impunity. Given the threat posed by those that choose to use CTAs as weapons, there is a dire need for advancements in chemical forensics that can be used in investigations and inquiries to help find and hold to account, the perpetrators of chemical attacks.« less

When the Sound Becomes the Goal. 4E Cognition and Teleomusicality in Early Infancy

PubMed Central

Schiavio, Andrea; van der Schyff, Dylan; Kruse-Weber, Silke; Timmers, Renee

2017-01-01

In this paper we explore early musical behaviors through the lenses of the recently emerged “4E” approach to mind, which sees cognitive processes as Embodied, Embedded, Enacted, and Extended. In doing so, we draw from a range of interdisciplinary research, engaging in critical and constructive discussions with both new findings and existing positions. In particular, we refer to observational research by French pedagogue and psychologist François Delalande, who examined infants' first “sound discoveries” and individuated three different musical “conducts” inspired by the “phases of the game” originally postulated by Piaget. Elaborating on such ideas we introduce the notion of “teleomusicality,” which describes the goal-directed behaviors infants adopt to explore and play with sounds. This is distinguished from the developmentally earlier “protomusicality,” which is based on music-like utterances, movements, and emotionally relevant interactions (e.g., with primary caregivers) that do not entail a primary focus on sound itself. The development from protomusicality to teleomusicality is discussed in terms of an “attentive shift” that occurs between 6 and 10 months of age. This forms the basis of a conceptual framework for early musical development that emphasizes the emergence of exploratory, goal-directed (i.e., sound-oriented), and self-organized musical actions in infancy. In line with this, we provide a preliminary taxonomy of teleomusical processes discussing “Original Teleomusical Acts” (OTAs) and “Constituted Teleomusical Acts” (CTAs). We argue that while OTAs can be easily witnessed in infants' exploratory behaviors, CTAs involve the mastery of more specific and complex goal-directed chains of actions central to musical activity. PMID:28993745

Preface: Chemical Forensics

DOE PAGES

Fraga, Carlos G.

2018-04-22

This virtual special issue is devoted to chemical forensics, a developing scientific discipline that aims to provide information to support the attribution of a chemical (or mixture) of interest to its source. This process is carried out through the analysis of the chemical itself or associated material constituents to address investigative, legal or intelligence questions. “Source” refers to how, where and when a chemical was handled or produced. Source information is critical in investigations of incidents of chemicals used for illicit or nefarious purposes, especially when toxic chemicals are used as weapons. The Chemical Weapons Convention (CWC), an international disarmamentmore » treaty that entered into force in 1997, prohibits the use of chemicals as weapons. This treaty has 192 States Parties (the countries who have joined the treaty) encompassing more than 98% of the global population and landmass, yet chemical attacks have continued to increase since this treaty was opened for signature to the governments of the world in 1993. The first notorious use of a chemical weapon since 1993 was by the Aum Shinrikyo cult whose sarin attack on the Tokyo subway system in March 1995 killed 13 and drove another 6,000 to seek medical treatment. More recently, over 160 alleged chemical attacks have been reported in Syria and Iraq with both governments and terrorist groups being accused, and casualties numbering in the thousands. Additionally, recent high profile nerve agent poisoning of dissidents from North Korea and Russia illustrate a willingness to use chemical threat agents (CTAs) with impunity. Given the threat posed by those that choose to use CTAs as weapons, there is a dire need for advancements in chemical forensics that can be used in investigations and inquiries to help find and hold to account, the perpetrators of chemical attacks.« less

Demonstration of a Safety Analysis on a Complex System

NASA Technical Reports Server (NTRS)

Leveson, Nancy; Alfaro, Liliana; Alvarado, Christine; Brown, Molly; Hunt, Earl B.; Jaffe, Matt; Joslyn, Susan; Pinnell, Denise; Reese, Jon; Samarziya, Jeffrey;

Comparison of image quality and radiation dose between fixed tube current and combined automatic tube current modulation in craniocervical CT angiography.

PubMed

Lee, E J; Lee, S K; Agid, R; Howard, P; Bae, J M; terBrugge, K

2009-10-01

The combined automatic tube current modulation (ATCM) technique adapts and modulates the x-ray tube current in the x-y-z axis according to the patient's individual anatomy. We compared image quality and radiation dose of the combined ATCM technique with those of a fixed tube current (FTC) technique in craniocervical CT angiography performed with a 64-section multidetector row CT (MDCT) system. A retrospective review of craniocervical CT angiograms (CTAs) by using combined ATCM (n = 25) and FTC techniques (n = 25) was performed. Other CTA parameters, such as kilovolt (peak), matrix size, FOV, section thickness, pitch, contrast agent, and contrast injection techniques, were held constant. We recorded objective image noise in the muscles at 2 anatomic levels: radiation exposure doses (CT dose index volume and dose-length product); and subjective image quality parameters, such as vascular delineation of various arterial vessels, visibility of small arterial detail, image artifacts, and certainty of diagnosis. The Mann-Whitney U test was used for statistical analysis. No significant difference was detected in subjective image quality parameters between the FTC and combined ATCM techniques. Most subjects in both study groups (49/50, 98%) had acceptable subjective artifacts. The objective image noise values at shoulder level did not show a significant difference, but the noise value at the upper neck was higher with the combined ATCM (P < .05) technique. Significant reduction in radiation dose (18% reduction) was noted with the combined ATCM technique (P < .05). The combined ATCM technique for craniocervical CTA performed at 64-section MDCT substantially reduced radiation exposure dose but maintained diagnostic image quality.

Thymidine kinase 1 as a molecular target for boron neutron capture therapy of brain tumors

PubMed Central

Barth, Rolf F.; Yang, Weilian; Wu, Gong; Swindall, Michele; Byun, Youngjoo; Narayanasamy, Sureshbabu; Tjarks, Werner; Tordoff, Kevin; Moeschberger, Melvin L.; Eriksson, Staffan; Binns, Peter J.; Riley, Kent J.

2008-01-01

The purpose of the present study was to evaluate the effectiveness of a 3-carboranyl thymidine analogue (3CTA), 3-[5-{2-(2,3-dihydroxyprop-1-yl)-o-carboran-1-yl}pentan-1-yl] thymidine, designated N5–2OH, for boron neutron capture therapy (BNCT) of brain tumors using the RG2 rat glioma model. Target validation was established using the thymidine kinase (TK) 1(+) wild-type, murine L929 cell line and its TK1(−) mutant counterpart, which were implanted s.c. (s.c.) into nude mice. Two intratumoral (i.t.) injections of 10B-enriched N5–2OH were administered to tumor-bearing mice at 2-hour intervals, after which BNCT was carried out at the Massachusetts Institute of Technology (MIT) Research Reactor. Thirty days after BNCT, mice bearing TK1(+) L929 tumors had a 15× reduction in tumor volume compared with TK1(−) controls. Based on these favorable results, BNCT studies were then initiated in rats bearing intracerebral (i.c.) RG2 gliomas, after i.c. administration of N5–2OH by Alzet osmotic pumps, either alone or in combination with i.v. (i.v.) boronophenylalanine (BPA), a drug that has been used clinically. The mean survival times (MSTs) of RG2 glioma bearing rats were 45.6 ± 7.2 days, 35.0 ± 3.3days, and 52.9 ± 8.9 days, respectively, for animals that received N5–2OH, BPA, or both. The differences between the survival plots of rats that received N5–2OH and BPA alone were highly significant (P = 0.0003). These data provide proof-of-principle that a 3CTA can function as a boron delivery agent for NCT. Further studies are planned to design and synthesize 3CTAs with enhanced chemical and biological properties, and increased therapeutic efficacy. PMID:18981415

Effect of the different chain transfer agents on molecular weight and optical properties of poly(methyl methacrylate)

NASA Astrophysics Data System (ADS)

Çetinkaya, Onur; Demirci, Gökhan; Mergo, Paweł

2017-08-01

Investigation of molecular weight and optical properties of poly(methyl metacrylate) (PMMA) polymerized in house with different chain transfer agents was studied. Isopropyl alcohol (IPA), n-butyl mercaptan (nBMC) and pentamethyl disilane (PMDS) were used as chain transfer agents. The molecular weight (Mw) of PMMA samples were measured by Ostwald viscometer. Mw of bulk polymer samples were decreased with increase the concentration of chain transfer agents (CTA). Since reactivity of used CTAs is not same, molecular weights of samples which were produced with different type of CTA but same concentration of CTA was varied. Higher concentration of n-BMC showed higher scattering. Transmission of samples could not be correlated with different concentration of CTA. Refractive index of samples was not affected by concentration of CTA nevertheless higher molecular weight of CTA showed higher refractive index.

Fatty degeneration of the rotator cuff muscles on pre- and postoperative CT arthrography (CTA): is the Goutallier grading system reliable?

PubMed

Lee, Eugene; Choi, Jung-Ah; Oh, Joo Han; Ahn, Soyeon; Hong, Sung Hwan; Chai, Jee Won; Kang, Heung Sik

2013-09-01

To retrospectively evaluate fatty degeneration (FD) of rotator cuff muscles on CTA using Goutallier's grading system and quantitative measurements with comparison between pre- and postoperative states. IRB approval was obtained for this study. Two radiologists independently reviewed pre- and postoperative CTAs of 43 patients (24 males and 19 females, mean age, 58.1 years) with 46 shoulders confirmed as full-thickness tears with random distribution. FD of supraspinatus, infraspinatus/teres minor, and subscapularis was assessed using Goutallier's system and by quantitative measurements of Hounsfield units (HUs) on sagittal images. Changes in FD grades and HUs were compared between pre- and postoperative CTAs and analyzed with respect to preoperative tear size and postoperative cuff integrity. The correlations between qualitative grades and quantitative measurements and their inter-observer reliabilities were also assessed. There was statistically significant correlation between FD grades and HU measurements of all muscles on pre- and postoperative CTA (p < 0.05). Inter-observer reliability of fatty degeneration grades were excellent to substantial on both pre- and postoperative CTA in supraspinatus (0.8685 and 0.8535) and subscapularis muscles (0.7777 and 0.7972), but fair in infraspinatus/teres minor muscles (0.5791 and 0.5740); however, quantitative Hounsfield units measurements showed excellent reliability for all muscles (ICC: 0.7950 and 0.9346 for SST, 0.7922 and 0.8492 for SSC, and 0.9254 and 0.9052 for IST/TM). No muscle showed improvement of fatty degeneration after surgical repair on qualitative and quantitative assessments; there was no difference in changes of fatty degeneration after surgical repair according to preoperative tear size and post-operative cuff integrity (p > 0.05). The average dose-length product (DLP, mGy · cm) was 365.2 mGy · cm (range, 323.8-417.2 mGy · cm) and estimated average effective dose was 5.1 mSv. Goutallier grades correlated well with HUs of rotator cuff muscles. Reliability was excellent for both systems, except for FD grade of IST/TM muscles, which may be more reliably assessed using quantitative measurements.

Cost-effectiveness of lower extremity compression ultrasound in emergency department patients with a high risk of hemodynamically stable pulmonary embolism.

PubMed

Ward, Michael J; Sodickson, Aaron; Diercks, Deborah B; Raja, Ali S

2011-01-01

Computed tomography angiograms (CTAs) for patients with suspected pulmonary embolism (PE) are being ordered with increasing frequency from the emergency department (ED). Strategies are needed to safely decrease the utilization of CTs to control rising health care costs and minimize the associated risks of anaphylaxis, contrast-induced nephropathy, and radiation-induced carcinogenesis. The use of compression ultrasonography (US) to identify deep vein thromboses (DVTs) in hemodynamically stable patients with signs and symptoms suggestive of PE is highly specific for the diagnosis of PE and may represent a cost-effective alternative to CT imaging.   The objective was to analyze the cost-effectiveness of a selective CT strategy incorporating the use of compression US to diagnose and treat DVT in patients with a high pretest probability of PE. The authors constructed a decision analytic model to evaluate the scenario of an otherwise healthy 59-year-old female in whom PE was being considered as a diagnosis. Two strategies were used. The selective CT strategy began with a screening compression US. Negative studies were followed up with a CTA, while patients with positive studies identifying a DVT were treated as though they had a PE and were anticoagulated. The universal CT strategy used CTA as the initial test, and anticoagulation was based on the CT result. Costs were estimated from the 2009 Medicare data for hospital reimbursement, and professional fees were obtained from the 2009 National Physician Fee Schedule. Clinical probabilities were obtained from existing published data, and sensitivity analyses were performed across plausible ranges for all clinical variables. In the base case, the selective CT strategy cost $1,457.70 less than the universal CT strategy and resulted in a gain of 0.0213 quality-adjusted life-years (QALYs). Sensitivity analyses confirm that the selective CT strategy is dominant above both a pretest probability for PE of 8.3% and a compression US specificity of 87.4%. A selective CT strategy using compression US is cost-effective for patients provided they have a high pretest probability of PE. This may reduce the need for, and decrease the adverse events associated with, CTAs. © 2010 by the Society for Academic Emergency Medicine.

A Multiple Agent Model of Human Performance in Automated Air Traffic Control and Flight Management Operations

NASA Technical Reports Server (NTRS)

Corker, Kevin; Pisanich, Gregory; Condon, Gregory W. (Technical Monitor)

1995-01-01

A predictive model of human operator performance (flight crew and air traffic control (ATC)) has been developed and applied in order to evaluate the impact of automation developments in flight management and air traffic control. The model is used to predict the performance of a two person flight crew and the ATC operators generating and responding to clearances aided by the Center TRACON Automation System (CTAS). The purpose of the modeling is to support evaluation and design of automated aids for flight management and airspace management and to predict required changes in procedure both air and ground in response to advancing automation in both domains. Additional information is contained in the original extended abstract.

System for Better Spacing of Airplanes En Route

NASA Technical Reports Server (NTRS)

Green, Steven; Erzberger, Heinz

2004-01-01

An improved method of computing the spacing of airplanes en route, and software to implement the method, have been invented. The purpose of the invention is to help air-traffic controllers minimize those deviations of the airplanes from the trajectories preferred by their pilots that are needed to make the airplanes comply with miles-in-trail spacing requirements. The software is meant to be a modular component of the Center TRACON Automation System (CTAS) (TRACON signifies "terminal radar approach control"). The invention reduces controllers workloads and reduces fuel consumption by reducing the number of corrective clearances needed to achieve conformance with specified flow rates, without causing conflicts, while providing for more efficient distribution of spacing workload upstream and across air-traffic-control sectors.

Research Traffic Management Advisor (rTMA) Up-level Final Report

NASA Technical Reports Server (NTRS)

Capps, Richard A.

2013-01-01

The FAA Time Based Flow Management (TBFM) Program provides for operational use and continued development of the Traffic Management Advisor (TMA) technology that NASA demonstrated in 1996. Although NASA's Center-TRACON Automation System (CTAS) software baseline includes advanced versions of TMA, some research activities are better served by a version of TMA that more closely matches the FAA's TBFM software. Beginning in 2009, NASA created Research TMA (rTMA) to enable researchers to work with FAA TBFM software in a research environment. The original rTMA was derived from TBFM v3.10 and later up-leveled to TBFM v3.12. This report documents the most recent up-level effort in which rTMA was re-derived from TBFM v4.00.07.

Does Iterative Reconstruction Lower CT Radiation Dose: Evaluation of 15,000 Examinations

PubMed Central

Noël, Peter B.; Renger, Bernhard; Fiebich, Martin; Münzel, Daniela; Fingerle, Alexander A.; Rummeny, Ernst J.; Dobritz, Martin

2013-01-01

Purpose Evaluation of 15,000 computed tomography (CT) examinations to investigate if iterative reconstruction (IR) reduces sustainably radiation exposure. Method and Materials Information from 15,000 CT examinations was collected, including all aspects of the exams such as scan parameter, patient information, and reconstruction instructions. The examinations were acquired between January 2010 and December 2012, while after 15 months a first generation IR algorithm was installed. To collect the necessary information from PACS, RIS, MPPS and structured reports a Dose Monitoring System was developed. To harvest all possible information an optical character recognition system was integrated, for example to collect information from the screenshot CT-dose report. The tool transfers all data to a database for further processing such as the calculation of effective dose and organ doses. To evaluate if IR provides a sustainable dose reduction, the effective dose values were statistically analyzed with respect to protocol type, diagnostic indication, and patient population. Results IR has the potential to reduce radiation dose significantly. Before clinical introduction of IR the average effective dose was 10.1±7.8mSv and with IR 8.9±7.1mSv (p*=0.01). Especially in CTA, with the possibility to use kV reduction protocols, such as in aortic CTAs (before IR: average14.2±7.8mSv; median11.4mSv /with IR:average9.9±7.4mSv; median7.4mSv), or pulmonary CTAs (before IR: average9.7±6.2mSV; median7.7mSv /with IR: average6.4±4.7mSv; median4.8mSv) the dose reduction effect is significant(p*=0.01). On the contrary for unenhanced low-dose scans of the cranial (for example sinuses) the reduction is not significant (before IR:average6.6±5.8mSv; median3.9mSv/with IR:average6.0±3.1mSV; median3.2mSv). Conclusion The dose aspect remains a priority in CT research. Iterative reconstruction algorithms reduce sustainably and significantly radiation dose in the clinical routine. Our results illustrate that not only in studies with a limited number of patients but also in the clinical routine, IRs provide long-term dose saving. PMID:24303035

Does iterative reconstruction lower CT radiation dose: evaluation of 15,000 examinations.

PubMed

Noël, Peter B; Renger, Bernhard; Fiebich, Martin; Münzel, Daniela; Fingerle, Alexander A; Rummeny, Ernst J; Dobritz, Martin

2013-01-01

Evaluation of 15,000 computed tomography (CT) examinations to investigate if iterative reconstruction (IR) reduces sustainably radiation exposure. Information from 15,000 CT examinations was collected, including all aspects of the exams such as scan parameter, patient information, and reconstruction instructions. The examinations were acquired between January 2010 and December 2012, while after 15 months a first generation IR algorithm was installed. To collect the necessary information from PACS, RIS, MPPS and structured reports a Dose Monitoring System was developed. To harvest all possible information an optical character recognition system was integrated, for example to collect information from the screenshot CT-dose report. The tool transfers all data to a database for further processing such as the calculation of effective dose and organ doses. To evaluate if IR provides a sustainable dose reduction, the effective dose values were statistically analyzed with respect to protocol type, diagnostic indication, and patient population. IR has the potential to reduce radiation dose significantly. Before clinical introduction of IR the average effective dose was 10.1±7.8mSv and with IR 8.9±7.1mSv (p*=0.01). Especially in CTA, with the possibility to use kV reduction protocols, such as in aortic CTAs (before IR: average14.2±7.8mSv; median11.4mSv /with IR:average9.9±7.4mSv; median7.4mSv), or pulmonary CTAs (before IR: average9.7±6.2mSV; median7.7mSv /with IR: average6.4±4.7mSv; median4.8mSv) the dose reduction effect is significant(p*=0.01). On the contrary for unenhanced low-dose scans of the cranial (for example sinuses) the reduction is not significant (before IR:average6.6±5.8mSv; median3.9mSv/with IR:average6.0±3.1mSV; median3.2mSv). The dose aspect remains a priority in CT research. Iterative reconstruction algorithms reduce sustainably and significantly radiation dose in the clinical routine. Our results illustrate that not only in studies with a limited number of patients but also in the clinical routine, IRs provide long-term dose saving.

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

Mirjankar, Nikhil S.; Fraga, Carlos G.; Carman, April J.

Chemical attribution signatures (CAS) for chemical threat agents (CTAs) are being investigated to provide an evidentiary link between CTAs and specific sources to support criminal investigations and prosecutions. In a previous study, anionic impurity profiles developed using high performance ion chromatography (HPIC) were demonstrated as CAS for matching samples from eight potassium cyanide (KCN) stocks to their reported countries of origin. Herein, a larger number of solid KCN stocks (n = 13) and, for the first time, solid sodium cyanide (NaCN) stocks (n = 15) were examined to determine what additional sourcing information can be obtained through anion, carbon stablemore » isotope, and elemental analyses of cyanide stocks by HPIC, isotope ratio mass spectrometry (IRMS), and inductively coupled plasma optical emission spectroscopy (ICP-OES), respectively. The HPIC anion data was evaluated using the variable selection methods of Fisher-ratio (F-ratio), interval partial least squares (iPLS), and genetic algorithm-based partial least squares (GAPLS) and the classification methods of partial least squares discriminate analysis (PLSDA), K nearest neighbors (KNN), and support vector machines discriminate analysis (SVMDA). In summary, hierarchical cluster analysis (HCA) of anion impurity profiles from multiple cyanide stocks from six reported country of origins resulted in cyanide samples clustering into three groups: Czech Republic, Germany, and United States, independent of the associated alkali metal (K or Na). The three country groups were independently corroborated by HCA of cyanide elemental profiles and corresponded to countries with known solid cyanide factories. Both the anion and elemental CAS are believed to originate from the aqueous alkali hydroxides used in cyanide manufacture. Carbon stable isotope measurements resulted in two clusters: Germany and United States (the single Czech stock grouped with United States stocks). The carbon isotope CAS is believed to originate from the carbon source and process used to make the HCN utilized in cyanide synthesis. Classification errors for two validation studies using anion impurity profiles collected over five years on different instruments were as low as zero for KNN and SVMDA, demonstrating the excellent reliability (so far) of using anion impurities for matching a cyanide sample to its country of manufacture (i.e., factory). Variable selection reduced errors for those classification methods having errors greater than zero with iPLS-forward selection, and F-ratio typically providing the lowest errors. Finally, using anion profiles to match cyanides to a specific stock or stock group resulted in cross-validation errors ranging from zero to 5.3%.« less

Distribution of Large Visible and Buried Impact Basins on Mars: Comparison with Free-Air Gravity, Crustal Thickness and Magnetization Models

NASA Technical Reports Server (NTRS)

Frey, H. V.

2004-01-01

A comparison of the distribution of visible and buried impact basins (Quasi-Circular Depressions or QCDs) on Mars > 200 km in diameter with free air gravity, crustal thickness and magnetization models shows some QCDs have coincident gravity anomalies but most do not. Very few QCDs have closely coincident magnetization anomalies, and only the oldest of the very large impact basins have strong magnetic anomalies within their main rings. Crustal thickness data show a large number of Circular Thinned Areas (CTAs). Some of these correspond to known impact basins, while others may represent buried impact basins not always recognized as QCDs in topography data alone. If true, the buried lowlands may be even older than we have previously estimated.

An analysis of landing rates and separations at the Dallas/Fort Worth International Airport

NASA Technical Reports Server (NTRS)

Ballin, Mark G.; Erzberger, Heinz

1996-01-01

Advanced air traffic management systems such as the Center/TRACON Automation System (CTAS) should yield a wide range of benefits, including reduced aircraft delays and controller workload. To determine the traffic-flow benefits achievable from future terminal airspace automation, live radar information was used to perform an analysis of current aircraft landing rates and separations at the Dallas/Fort Worth International Airport. Separation statistics that result when controllers balance complex control procedural constraints in order to maintain high landing rates are presented. In addition, the analysis estimates the potential for airport capacity improvements by determining the unused landing opportunities that occur during rush traffic periods. Results suggest a large potential for improving the accuracy and consistency of spacing between arrivals on final approach, and they support earlier simulation findings that improved air traffic management would increase capacity and reduce delays.

The Challenges of Field Testing the Traffic Management Advisor (TMA) in an Operational Air Traffic Control Facility

NASA Technical Reports Server (NTRS)

Hoang, Ty; Swenson, Harry N.

1997-01-01

The Traffic Management Advisor (TMA), the sequence and schedule tool of the Center/TRACON Automation System (CTAS), was evaluated at the Fort Worth Center (ZFW) in the summer of 1996. This paper describes the challenges encountered during the various phases of the TMA field evaluation, which included system (hardware and software) installation, personnel training, and data collection. Operational procedures were developed and applied to the evaluation process that would ensure air safety. The five weeks of field evaluation imposed minimal impact on the hosting facility and provided valuable engineering and human factors data. The collection of data was very much an opportunistic affair, due to dynamic traffic conditions. One measure of the success of the TMA evaluation is that, rather than remove TMA after the evaluation until it could be fully implemented, the prototype TMA is in continual use at ZFW as the fully operational version is readied for implementation.

Collaborative Arrival Planning: Data Sharing and User Preference Tools

NASA Technical Reports Server (NTRS)

Zelenka, Richard E.; Edwards, Thomas A. (Technical Monitor)

1998-01-01

Air traffic growth and air carrier economic pressures have motivated efforts to increase the flexibility of the air traffic management process and change the relationship between the air traffic control service provider and the system user. One of the most visible of these efforts is the U.S. government/industry "free flight" initiative, in which the service provider concentrates on safety and cross-airline fairness, and the user on their business objectives and operating preferences, including selecting their own path and speed in real-time. In the terminal arrival phase of flight, severe restrictions and rigid control are currently placed on system users, typically without regard for individual user operational preferences. Airborne delays applied to arriving aircraft into capacity constrained airports are imposed on a first-come, first-serve basis, and thus do not allow the system user to plan for or prioritize late arrivals, or to economically optimize their arrival sequence. A central tenant of the free-flight operating paradigm is collaboration between service providers and users in reaching air traffic management decisions. Such collaboration would be particularly beneficial to an airline's "hub" operation, where off-schedule arrival aircraft are a consistent problem, as they cause serious air-port ramp difficulties, rippling airline scheduling effects, and result in large economic inefficiencies. Greater collaboration can also lead to increased airport capacity and decrease the severity of over-capacity rush periods. In the NASA Collaborative Arrival Planning (CAP) project, both independent exchange of real-time data between the service provider and system user and collaborative decision support tools are addressed. Data exchange of real-time arrival scheduling, airspace management, and air carrier fleet data between the FAA service provider and an air carrier is being conducted and evaluated. Collaborative arrival decision support tools to allow intra-airline arrival preferences are being developed and simulated. The CAP project is part of and leveraged from the NASA/FAA Center TRACON Automation System (CTAS), a fielded set of decision support tools that provide computer generated advisories for both enroute and terminal area controllers to manage and control arrival traffic more efficiently. In this paper, the NASA Collaborative Arrival Planning project is outlined and recent results detailed, including the real-time use of CTAS arrival scheduling data by a major air carrier and simulations of tactical and strategic user preference decision support tools.

Improving the Inventory of Large Lunar Basins: Using LOLA Data to Test Previous Candidates and Search for New Ones

NASA Technical Reports Server (NTRS)

Frey, H. V.; Meyer, H. M.; Romine, G. C.

2012-01-01

Topography and crustal thickness data from LOLA altimetry were used to test the validity of 98 candidate large lunar basins derived from photogeologic and earlier topographic and crustal thickness data, and to search for possible new candidates. We eliminate 23 previous candidates but find good evidence for 20 new candidates. The number of basins greater than 300 km diameter on the Moon is almost certainly a factor 2 (maybe 3?) larger than the number of named features having basin-like topography. Unified Lunar Control Net 2005 data [1] and model crustal thickness data [2] were previously used to search for possible previously unrecognized large lunar impact basins [3,4]. An inventory of 98 candidate topographic basins greater than 300 km in diameter was found [5]. This includes 33 named features (only those having basin-like topography) out of the 45 listed by Wilhelms [6], 38 additional Quasi-Circular Depressions (QCDs) found in the ULCN2005 topography, and 27 Circular Thin Areas (CTAs) found in model crustal thickness data [2]. Most named features and additional QCDs have strong CTA signatures, but there may be a class of CTAs that are not easily recognized in the old and low resolution ULCN2005 topography. Lunar Orbiter Laser Altimeter (LOLA) data have recently become publically available. We used these data to (a) refine the center and ring diameters of known basins, (b) test the viability of the candidate basins previously found (as described above), and (c) search for additional candidate basins not revealed by the earlier lower resolution data. We used the LOLA topography directly but also a recent new model crustal thickness data that includes Kaguya gravity data [7]. We repeated a Topographic Expression (TE) and a Crustal Thickness Expression (CTE) scoring exercise originally done with the basins found in ULCN and earlier model crustal thickness data [5]. Each candidate was scored on a scale from 0 (no topographic basin or circular thin area signature) to 5 (strong circular low or strong circular thin area signature). These were combined into a total score used to rank the probability for each candidate basin. We used the same GRIDVIEW software to stretch, contour and profile the LOLA and new crustal thickness data as was done with the ULCN2005 and older model crustal thickness data.

A Laboratory Glass-Cockpit Flight Simulator for Automation and Communications Research

NASA Technical Reports Server (NTRS)

Pisanich, Gregory M.; Heers, Susan T.; Shafto, Michael G. (Technical Monitor)

1995-01-01

A laboratory glass-cockpit flight simulator supporting research on advanced commercial flight deck and Air Traffic Control (ATC) automation and communication interfaces has been developed at the Aviation Operations Branch at the NASA Ames Research Center. This system provides independent and integrated flight and ATC simulator stations, party line voice and datalink communications, along with video and audio monitoring and recording capabilities. Over the last several years, it has been used to support the investigation of flight human factors research issues involving: communication modality; message content and length; graphical versus textual presentation of information, and human accountability for automation. This paper updates the status of this simulator, describing new functionality in the areas of flight management system, EICAS display, and electronic checklist integration. It also provides an overview of several experiments performed using this simulator, including their application areas and results. Finally future enhancements to its ATC (integration of CTAS software) and flight deck (full crew operations) functionality are described.

Topics in this issue: cancer testes antigens, immune checkpoints, inflammation associated with ischemia-reperfusion and integrin targeting.

PubMed

Bot, Adrian; Chiriva-Internati, Maurizio

2012-10-01

This issue of the International Reviews of Immunology is dedicated to several topics: cancer immunotherapy, and basic and translational aspects of immunity. Two reviews, one focused on breast and the other on lung cancer, highlight the need to redefine the cancer testes antigens (CTAs) as novel information regarding their expression profile and biological role emerges. Two other reviews showcase pivotal molecules that keep in check immunity at two different levels: the transcription factor autoimmune regulator (AIRE) important to negative selection of the T-cell repertoire, and CD22 that limits the antigen-initiated B-cell response. Two other articles focus on the debated role of Toll-like receptors (TLRs) and inflammation in general, in ischemia-reperfusion lesions that follow cardiovascular disorders and stroke. Last but not the least, this issue hosts a review that discusses the role and translational potential of the α4 integrin for the treatment of inflammatory bowel disease (IBD).

Overview of the TILDAE High-Altitude Balloon Mission

NASA Astrophysics Data System (ADS)

Godbole, N. H.; Maruca, B.; Marino, R.; Sundkvist, D. J.; Constantin, S.; Zimmerman, H.; Carbone, V.

2016-12-01

Though the presence of intermittent turbulence in the stratosphere has been well established, much remains unknown about it. In situ observations of this phenomenon, which have provided the greatest detail of it, have typically been achieved via sounding balloons (i.e., small balloons which burst at peak altitude) carrying constant-temperature "hot wire" anemometers (CTAs). The Turbulence and Intermittency Long-Duration Atmospheric Experiment (TILDAE) was developed to test a new paradigm for stratospheric observations. Rather than flying on a sounding balloon, TILDAE was incorporated as an "add-on" experiment to the payload of a NASA long-duration balloon mission that launched in January, 2016 from McMurdo Station, Antarctica. Furthermore, TILDAE's key instrument was a sonic anemometer, which (relative to a CTA) provides better-calibrated measurements of wind velocity and more-robust separation of velocity components. This presentation focuses on the technical details of TILDAE's instrumentation and the performance thereof during its flight. Potential design improvements for future flights are also discussed.

Emergency medicine summary code for reporting CT scan results: implementation and survey results.

PubMed

Lam, Joanne; Coughlin, Ryan; Buhl, Luce; Herbst, Meghan; Herbst, Timothy; Martillotti, Jared; Coughlin, Bret

2018-06-01

The purpose of the study was to assess the emergency department (ED) providers' interest and satisfaction with ED CT result reporting before and after the implementation of a standardized summary code for all CT scan reporting. A summary code was provided at the end of all CTs ordered through the ED from August to October of 2016. A retrospective review was completed on all studies performed during this period. A pre- and post-survey was given to both ED and radiology providers. A total of 3980 CT scans excluding CTAs were ordered with 2240 CTs dedicated to the head and neck, 1685 CTs dedicated to the torso, and 55 CTs dedicated to the extremities. Approximately 74% CT scans were contrast enhanced. Of the 3980 ED CT examination ordered, 69% had a summary code assigned to it. Fifteen percent of the coded CTs had a critical or diagnostic positive result. The introduction of an ED CT summary code did not show a definitive improvement in communication. However, the ED providers are in consensus that radiology reports are crucial their patients' management. There is slightly increased satisfaction with the providers with less than 5 years of experience with the ED CT codes compared to more seasoned providers. The implementation of a user-friendly summary code may allow better analysis of results, practice improvement, and quality measurements in the future.

Previously Unrecognized Large Lunar Impact Basins Revealed by Topographic Data

NASA Technical Reports Server (NTRS)

Frey, Herbert V.

2008-01-01

The discovery of a large population of apparently buried impact craters on Mars, revealed as Quasi- Circular Depressions (QCDs) in Mars Orbiting Laser Altimeter (MOLA) data [1,2,3] and as Circular Thin Areas (CTAs) [4] in crustal thickness model data [5] leads to the obvious question: are there unrecognized impact features on the Moon and other bodies in the solar system? Early analysis of Clementine topography revealed several large impact basins not previously known [6,7], so the answer certainly is "Yes." How large a population of previously undetected impact basins, their size frequency distribution, and how much these added craters and basins will change ideas about the early cratering history and Late Heavy Bombardment on the Moon remains to be determined. Lunar Orbiter Laser Altimeter (LOLA) data [8] will be able to address these issues. As a prelude, we searched the state-of-the-art global topographic grid for the Moon, the Unified Lunar Control Net (ULCN) [9] for evidence of large impact features not previously recognized by photogeologic mapping, as summarized by Wilhelms [lo].

Computed Tomography Angiography in Patients Evaluated for Acute Pulmonary Embolism with Low Serum D-dimer Levels: A Prospective Study.

PubMed

Gimber, Lana Hirai; Travis, R Ing; Takahashi, Jayme M; Goodman, Torrey L; Yoon, Hyo-Chun

2009-01-01

Pulmonary computed tomography angiography (CTA) and the Wells criteria both have interobserver variability in the assessment of pulmonary embolism (PE). Quantitative D-dimer assay findings have been shown to have a high negative predictive value in patients with low pretest probability of PE. Evaluate roles for clinical probability and CTA in Emergency Department (ED) patients suspected of acute PE but having a low serum D-dimer level. Prospective observational study of ED patients with possible PE who underwent pulmonary CTA and had D-dimer levels

Carotid and vertebral injury study (CAVIS) technique for characterization of blunt traumatic aneurysms with reliability assessment.

PubMed

Griessenauer, Christoph J; Foreman, Paul; Shoja, Mohammadali M; Kicielinski, Kimberly P; Deveikis, John P; Walters, Beverly C; Harrigan, Mark R

2015-04-01

Traumatic aneurysms occur in up to 20% of blunt traumatic extracranial carotid artery injuries. Currently there is no standardized method for characterization of traumatic aneurysms. For the carotid and vertebral injury study (CAVIS), a prospective study of traumatic cerebrovascular injury, we established a method for aneurysm characterization and tested its reliability. Saccular aneurysm size was defined as the greatest linear distance between the expected location of the normal artery wall and the outer edge of the aneurysm lumen ("depth"). Fusiform aneurysm size was defined as the "depth" and longitudinal distance ("length") paralleling the normal artery. The size of the aneurysm relative to the normal artery was also assessed. Reliability measurements were made using four raters who independently reviewed 15 computed tomographic angiograms (CTAs) and 13 digital subtraction angiograms (DSAs) demonstrating a traumatic aneurysm of the internal carotid artery. Raters categorized the aneurysms as either "saccular" or "fusiform" and made measurements. Five scans of each imaging modality were repeated to evaluate intra-rater reliability. Fleiss's free-marginal multi-rater kappa (κ), Cohen's kappa (κ), and interclass correlation coefficient (ICC) determined inter- and intra-rater reliability. Inter-rater agreement as to the aneurysm "shape" was almost perfect for CTA (κ = 0.82) and DSA (κ = 0.897). Agreements on aneurysm "depth," "length," "aneurysm plus parent artery," and "parent artery" for CTA and DSA were excellent (ICC > 0.75). Intra-rater agreement as to aneurysm "shape" was substantial to almost perfect (κ > 0.60). The CAVIS method of traumatic aneurysm characterization has remarkable inter- and intra-rater reliability and will facilitate further studies of the natural history and management of extracranial cerebrovascular traumatic aneurysms. © The Author(s) 2015 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

Effect of Norbinaltorphimine on Δ9-Tetrahydrocannabinol (THC)-Induced Taste Avoidance in Adolescent and Adult Sprague-Dawley Rats

PubMed Central

Flax, Shaun M.; Wakeford, Alison G.P.; Cheng, Kejun; Rice, Kenner C.; Riley, Anthony L.

2017-01-01

Rationale The aversive effects of Δ9-tetrahydrocannabinol (THC) are mediated by activity at the kappa opioid receptor (KOR) as assessed in adult animals; however, no studies have assessed KOR involvement in the aversive effects of THC in adolescents. Given that adolescents have been reported to be insensitive to the aversive effects induced by KOR agonists, a different mechanism might mediate the aversive effects of THC in this age group. Objectives The present study was designed to assess the impact of KOR antagonism on the aversive effects of THC in adolescent and adult rats using the conditioned taste avoidance (CTA) procedure. Methods Following a single pretreatment injection of norbinaltorphimine (norBNI; 15 mg/kg), CTAs induced by THC (0, 0.56, 1.0, 1.8 and 3.2 mg/kg) were assessed in adolescent (n = 84) and adult (n = 83) Sprague Dawley rats. Results The KOR antagonist, norBNI, had weak and inconsistent effects on THC-induced taste avoidance in adolescent rats in that norBNI both attenuated and strengthened taste avoidance dependent on dose and trial. norBNI had limited impact on the final one-bottle avoidance and no effects on the two-bottle preference test. Interestingly, norBNI had no effect on THC-induced taste avoidance in adult rats as well. Conclusions That norBNI had no significant effect on THC-induced avoidance in adults and a minor and inconsistent effect in adolescents demonstrates that the aversive effects of THC are not mediated by KOR activity as assessed by the CTA design in Sprague Dawley rats. PMID:26025420

Effect of norbinaltorphimine on ∆⁹-tetrahydrocannabinol (THC)-induced taste avoidance in adolescent and adult Sprague-Dawley rats.

PubMed

Flax, Shaun M; Wakeford, Alison G P; Cheng, Kejun; Rice, Kenner C; Riley, Anthony L

2015-09-01

The aversive effects of ∆(9)-tetrahydrocannabinol (THC) are mediated by activity at the kappa opioid receptor (KOR) as assessed in adult animals; however, no studies have assessed KOR involvement in the aversive effects of THC in adolescents. Given that adolescents have been reported to be insensitive to the aversive effects induced by KOR agonists, a different mechanism might mediate the aversive effects of THC in this age group. The present study was designed to assess the impact of KOR antagonism on the aversive effects of THC in adolescent and adult rats using the conditioned taste avoidance (CTA) procedure. Following a single pretreatment injection of norbinaltorphimine (norBNI; 15 mg/kg), CTAs induced by THC (0, 0.56, 1.0, 1.8, and 3.2 mg/kg) were assessed in adolescent (n = 84) and adult (n = 83) Sprague-Dawley rats. The KOR antagonist, norBNI, had weak and inconsistent effects on THC-induced taste avoidance in adolescent rats in that norBNI both attenuated and strengthened taste avoidance dependent on dose and trial. norBNI had limited impact on the final one-bottle avoidance and no effects on the two-bottle preference test. Interestingly, norBNI had no effect on THC-induced taste avoidance in adult rats as well. That norBNI had no significant effect on THC-induced avoidance in adults, and a minor and inconsistent effect in adolescents demonstrates that the aversive effects of THC are not mediated by KOR activity as assessed by the CTA design in Sprague-Dawley rats.

Fact Sheets of CTAS and NASA Decision-Support Tools and Concepts

NASA Technical Reports Server (NTRS)

Lee, Katharine

2004-01-01

Distributed Air/Ground (DAG) Traffic Management (TM) is an integrated operational concept in which flight deck crews, air traffic service providers and aeronautical operational control personnel use distributed decision-making to enable user preferences and increase system capacity, while meeting air traffic management (ATM) requirements. It is a possible operational mode under the Free Flight concept outlined by the RTCA Task Force 3. The goal of DAG-TM is to enhance user flexibility/efficiency and increase system capacity, without adversely affecting system safety or restricting user accessibility to the National Airspace System (NAS). DAG-TM will be accomplished with a human-centered operational paradigm enabled by procedural and technological innovations. These innovations include automation aids, information sharing and Communication, Navigation, and Surveillance (CNS) / ATM technologies. The DAG-TM concept is intended to eliminate static restrictions to the maximum extent possible. In this paradigm, users may plan and operate according to their preferences - as the rule rather than the exception - with deviations occumng eyond the year 2015. Out of a total of 15 concept elements, 4 have been selected for initial sutidies (see Key Elements in sidebar). DAG-TM research is being performed at Ames, Glenn, and Langley Research Centers.

Carotid Consensus Panel duplex criteria can replace modified University of Washington criteria without affecting accuracy.

PubMed

Kim, Ann H; Augustin, Gener; Shevitz, Andrew; Kim, Hannah; Trivonovich, Michael R; Powell, Alexis R; Kumins, Norman; Tarr, Robert; Kashyap, Vikram S

2018-04-01

The decision to intervene for internal carotid stenosis often depends on the degree of stenosis seen on duplex ultrasound (US). The aim of this study is to compare the diagnostic accuracy of two criteria: modified University of Washington (UW) and 2003 Carotid Consensus Panel (CCP). All patients undergoing US in an accredited (IAC) vascular laboratory from January 2010 to June 2015 were reviewed ( n=18,772 US exams). Patients receiving a neck computed tomography angiography (CTA) within 6 months of the US were included in the study ( n=254). The degree of stenosis was determined by UW/CCP criteria and confirmed on CTA images using North American Symptomatic Carotid Endarterectomy Trial (NASCET)/European Carotid Surgery Trial (ECST) schema. Kappa analysis with 95% confidence intervals (CIs) were utilized to determine duplex-CTA agreement. A total of 417 carotid arteries from 221 patients were assessed in this study. The modified UW criteria accurately classified 266 (63.9%, kappa = 0.321, 95% CI 0.255 to 0.386) cases according to NASCET-derived measurements. The sensitivity, specificity, and accuracy at ≥ 60% stenosis were 65.7%, 81.3%, and 81.9%. The CCP criteria resulted in 296 (70.9%) accurate diagnoses (kappa = 0.359, 95% CI 0.280 to 0.437). At ≥ 70% stenosis, the sensitivity, specificity and accuracy were 38.8%, 91.6%, and 87.1% for NASCET. Comparison of the duplex results to ECST-derived CTA measurements revealed a similar trend (UW 53.1%, κ = 0.301 vs CCP 62.1%, κ = 0.315). The CCP criteria demonstrate a higher concordance rate with measurements taken from CTAs. The CCP criteria may be more sensitive in classifying clinically significant degrees of stenosis without a loss in diagnostic accuracy.

The emergency to home project: impact of an emergency department care coordinator on hospital admission and emergency department utilization among seniors.

PubMed

Bond, Christopher Matthew; Freiheit, Elizabeth A; Podruzny, Lesley; Kingsly, Alianu Akawakun; Wang, Dongmei; Davenport, Jamie; Gutscher, Abram; Askin, Cathy; Taylor, Allison; Lee, Vivian; Choo, Queenie; Lang, Eddy Samuel

2014-01-01

Seniors comprise 14% to 21% of all emergency department (ED) visits, yet are disproportionately larger users of ED and inpatient resources. ED care coordinators (EDCCs) target seniors at risk for functional decline and connect them to home care and other community services in hopes of avoiding hospitalization. The goal of this study was to measure the association between the presence of EDCCs and admission rates for seniors aged ≥ 65. Secondary outcomes included length of stay, recidivism at 30 days, and revisit resulting in admission at 30 days. This was a matched pairs study using administrative data from eight EDs in six Alberta cities. Four of these hospitals were intervention sites, in which patients were seen by an EDCC, while the other four sites had no EDCC presence. All seniors aged ≥ 65 with a discharge diagnosis of fall or musculoskeletal pathology were included. Cases were matched by CTAS category, age, gender, mode of arrival, and home living environment. McNemar's test for matched pairs was used to compare admission and recidivism rates at EDCC and non-EDCC hospitals. A paired t-test was used to compare length of stay between groups. There were no statistically significant differences for baseline admission rate, revisit rate at 30 days, and readmission rate at 30 days between EDCC and non-EDCC patients. This study showed no reduction in senior patients' admission rates, recidivism at 30 days, or hospital length of stay when comparing seniors seen by an EDCC with those not seen by an EDCC.

Computed Tomography Angiography in Patients Evaluated for Acute Pulmonary Embolism with Low Serum D-dimer Levels: A Prospective Study

PubMed Central

Gimber, Lana Hirai; Travis, R Ing; Takahashi, Jayme M; Goodman, Torrey L; Yoon, Hyo-Chun

2009-01-01

Context: Pulmonary computed tomography angiography (CTA) and the Wells criteria both have interobserver variability in the assessment of pulmonary embolism (PE). Quantitative D-dimer assay findings have been shown to have a high negative predictive value in patients with low pretest probability of PE. Objective: Evaluate roles for clinical probability and CTA in Emergency Department (ED) patients suspected of acute PE but having a low serum D-dimer level. Design: Prospective observational study of ED patients with possible PE who underwent pulmonary CTA and had D-dimer levels ≤1.0 μg/mL. Main Outcome: Clinical probability of PE determined by ED physicians using standard published criteria; pulmonary CTAs read by initial and study radiologists kept unaware of D-dimer results. Results: In 16 months, 744 patients underwent pulmonary CTA, with 347 study participants who had a D-dimer level ≤ 1.0 μg/mL. In one participant, CTA showed a PE that was agreed on by both the initial and study radiologists. In six participants, the initial findings were reported as positive for PE but were not interpreted as positive by the study radiologist. In none of these participants was PE diagnosed on the basis of clinical probability, of findings on ancillary studies and three-month follow-up examination, or by another radiologist, unaware of findings, acting as a tiebreaker. Conclusion: Pulmonary CTA findings positive for acute embolism should be viewed with caution, especially if the suspected PE is in a distal segmental or subsegmental artery in a patient with a serum D-dimer level of ≤1.0 μg/mL. Furthermore, the Wells criteria may be of limited additional value in this group of patients with low D-dimer levels because most will have low or intermediate clinical probability of PE. PMID:20740096

Utilization of cardiac computed tomography angiography and outpatient invasive coronary angiography in Ontario, Canada.

PubMed

Roifman, Idan; Rezai, Mohammad R; Wijeysundera, Harindra C; Chow, Benjamin J W; Wright, Graham A; Tu, Jack V

2015-01-01

Cardiac computed tomography angiography (coronary CTA) has emerged as a non-invasive method of diagnosing coronary artery disease. The extent of utilization and uptake of this technology since initiation of its funding by the government of Ontario is unknown. The aim of our study was to examine coronary CTA utilization and the rates of elective invasive coronary angiography and revascularization before and after funding initiation. We studied all coronary CTAs performed on adults in Ontario after initiation of funding. We also used an interrupted time series analysis to compare the average monthly rates of invasive angiography and revascularization before and after initiation of funding. There was an initial steep increase in age-and sex-standardized rates of coronary CTA from 5.0 to 11.4/100,000 over the first two quarters after funding initiation. Afterwards, there was a gradual increase in utilization from 11.4 to 17.1/100,000 over two subsequent calendar years. There was a significant reduction in both the mean monthly outpatient invasive coronary angiography (from 20.7 to 19.9 per 100,000 (p = 0.0004)) and revascularization (from 4.9 to 4.4 per 100,000 (p < 0.0001)) rates in the three years following introduction of the coronary CTA billing code as compared to the three prior to its introduction. Since the introduction of coronary CTA funding in Ontario, there has been a steady and controlled increase in its utilization. The increasing use of coronary CTA was associated with a reduction in both the rates of invasive angiography and revascularization. Copyright © 2015 Society of Cardiovascular Computed Tomography. Published by Elsevier Inc. All rights reserved.

Automation for Air Traffic Control: The Rise of a New Discipline

NASA Technical Reports Server (NTRS)

Erzberger, Heinz; Tobias, Leonard (Technical Monitor)

1997-01-01

The current debate over the concept of Free Flight has renewed interest in automated conflict detection and resolution in the enroute airspace. An essential requirement for effective conflict detection is accurate prediction of trajectories. Trajectory prediction is, however, an inexact process which accumulates errors that grow in proportion to the length of the prediction time interval. Using a model of prediction errors for the trajectory predictor incorporated in the Center-TRACON Automation System (CTAS), a computationally fast algorithm for computing conflict probability has been derived. Furthermore, a method of conflict resolution has been formulated that minimizes the average cost of resolution, when cost is defined as the increment in airline operating costs incurred in flying the resolution maneuver. The method optimizes the trade off between early resolution at lower maneuver costs but higher prediction error on the one hand and late resolution with higher maneuver costs but lower prediction errors on the other. The method determines both the time to initiate the resolution maneuver as well as the characteristics of the resolution trajectory so as to minimize the cost of the resolution. Several computational examples relevant to the design of a conflict probe that can support user-preferred trajectories in the enroute airspace will be presented.

Engaged at the extremes: residents' perspectives on clinical teaching assessment.

PubMed

Myers, Kathryn; Zibrowski, Elaine M; Lingard, Lorelei

2012-10-01

Although academic centers rely on assessments from medical trainees regarding the effectiveness of their faculty as teachers, little is known about how trainees conceptualize and approach their role as assessors of their clinical supervisors. In 2010, using a constructivist grounded theory approach, five focus group interviews were conducted with 19 residents from an internal medicine residency program. A constant comparative analysis of emergent themes was conducted. Residents viewed clinical teaching assessment (CTA) as a time-consuming task with little reward. They reported struggling throughout the academic year to meet their CTA obligations and described several shortcut strategies they used to reduce their burden. Rather than conceptualizing their assessments as a conduit for both formative and summative feedback, residents perceived CTA as useful for the surveillance of clinical supervisors at the extremes of the spectrum of teaching effectiveness. They put the most effort, including the crafting of written comments, into the CTAs of these outliers. Trainees desired greater transparency in the CTA process and were skeptical regarding the anonymity and perceived validity of their faculty appraisals. Individual and system-based factors conspire to influence postgraduate medical trainees' motivation for generating high-quality appraisals of clinical teaching. Academic centers need to address these factors if they want to maximize the usefulness of these assessments.

The role of injection cues in the production of the morphine preexposure effect in taste aversion learning.

PubMed

Davis, Catherine M; de Brugada, Isabel; Riley, Anthony L

2010-05-01

The attenuation of an LiCl-induced conditioned taste aversion (CTA) by LiCl preexposure is mediated primarily by associative blocking via injection-related cues. Given that preexposure to morphine attenuates morphine-induced CTAs, it was of interest to determine whether injection cues also mediate this effect. Certain morphine-induced behaviors such as analgesic tolerance are controlled associatively, via injection-related cues. Accordingly, animals in the present experiments were preexposed to morphine (or vehicle) every other day for five total exposures, followed by an extinction phase, in which the subjects were given saline injections (or no treatment) for 8 (Experiment 1) or 16 (Experiment 2) consecutive days. All of the animals then received five CTA trials with morphine (or vehicle). The morphine-preexposed animals in Experiment 1 displayed an attenuation of the morphine CTA that was unaffected by extinction saline injections, suggesting that blocking by injection cues during morphine preexposure does not mediate this effect. All of the morphine-preexposed subjects in Experiment 2 displayed a weakened preexposure effect, an effect inconsistent with a selective extinction of drug-associated stimuli. The attenuating effects of morphine preexposure in aversion learning are most likely controlled by nonassociative mechanisms, like drug tolerance.

Overview of and first observations from the TILDAE High-Altitude Balloon Mission

NASA Astrophysics Data System (ADS)

Maruca, Bennett A.; Marino, Raffaele; Sundkvist, David; Godbole, Niharika H.; Constantin, Stephane; Carbone, Vincenzo; Zimmerman, Herb

2017-04-01

Though the presence of intermittent turbulence in the stratosphere has been well established, much remains unknown about it. In situ observations of this phenomenon, which have provided the greatest details of it, have mostly been achieved via sounding balloons (i.e., small balloons which burst at peak altitude) carrying constant-temperature hot-wire anemometers (CTAs). The Turbulence and Intermittency Long-Duration Atmospheric Experiment (TILDAE) was developed to test a new paradigm for stratospheric observations. Rather than flying on a sounding balloon, TILDAE was incorporated as an add-on experiment to the payload of a NASA long-duration balloon mission that launched in January 2016 from McMurdo Station, Antarctica. Furthermore, TILDAE's key instrument was a sonic anemometer, which (relative to a CTA) provides better-calibrated measurements of wind velocity and a more robust separation of velocity components. During the balloon's ascent, TILDAE's sonic anemometer provided atmospheric measurements up to an altitude of about 18 km, beyond which the ambient air pressure was too low for the instrument to function properly. Efforts are currently underway to scientifically analyze these observations of small-scale fluctuations in the troposphere, tropopause, and stratosphere and to develop strategies for increasing the maximum operating altitude of the sonic anemometer.

Morphological Variables Associated With Ruptured Middle Cerebral Artery Aneurysms.

PubMed

Zhang, Jian; Can, Anil; Mukundan, Srinivasan; Steigner, Michael; Castro, Victor M; Dligach, Dmitriy; Finan, Sean; Yu, Sheng; Gainer, Vivian; Shadick, Nancy A; Savova, Guergana; Murphy, Shawn; Cai, Tianxi; Wang, Zhong; Weiss, Scott T; Du, Rose

2018-05-30

Geometric factors of intracranial aneurysms and surrounding vasculature could affect the risk of aneurysm rupture. However, large-scale assessments of morphological parameters correlated with intracranial aneurysm rupture in a location-specific manner are scarce. To investigate the morphological characteristics associated with ruptured middle cerebral artery (MCA) aneurysms. Five hundred sixty-one patients with 638 MCA aneurysms diagnosed between 1990 and 2016 who had available computed tomography angiography (CTA) were included in this study. CTAs were evaluated using the Vitrea Advanced Visualization software for 3-dimensional (3D) reconstruction. Morphological parameters examined in each model included aneurysm projection, wall irregularity, presence of a daughter dome, presence of hypoplastic or aplastic A1 arteries and hypoplastic or fetal posterior communicating arteries (PCoA), aneurysm height and width, neck diameter, bottleneck factor, aspect and size ratio, height/width ratio, and diameters and angles of surrounding parent and daughter vessels. Univariable and multivariable statistical analyses were performed to determine the association of morphological characteristics with rupture of MCA aneurysms. Logistic regression was used to build a predictive MCA score. Greater bottleneck and size ratio, and irregular, multilobed, temporally projecting MCA aneurysms are associated with higher rupture risk, whereas higher M1/M2 ratio, larger width, and the presence of an ipsilateral or bilateral hypoplastic PCoA were inversely associated with rupture. The MCA score had good predictive capacity with area under the receiver operating curve = 0.88. These practical morphological parameters specific to MCA aneurysms are easy to assess when examining 3D reconstructions of unruptured aneurysms and could aid in risk evaluation in these patients.

Risks to the Superior Gluteal Neurovascular Bundle During Iliosacral and Transsacral Screw Fixation: A Computed Tomogram Arteriography Study.

PubMed

Maslow, Jed; Collinge, Cory A

2017-12-01

Iliosacral (IS) and transsacral (TS) screws are popular techniques to repair complicated injuries to the pelvis. The anatomy of the superior gluteal neurovasculature (SG NV bundle) is well described as running along the posterior ilium, providing innervation and perfusion to important abductor muscles. The method of pelvis fixation least likely to injure the SG NV bundle is unknown. Twenty uninjured patients with a contrasted computed tomogram of the pelvis and lower extremities (CTA) were evaluated. Starting points for an S1 IS screw and S1 and S2 TS screws were estimated on the "ghost" lateral CTA image for those pelvi with safe corridors (>9 mm diameter). The distance from the projected screw to the SG artery was measured. A distance of <3.65 mm (half of a 7.3-mm screw's diameter) was considered likely for NV bundle injury. Of 40 pelvi CTAs (single sides), 10 pelvi (25%) were determined to be inappropriate for an S1 TS screw. The average distances from the screw starting point and the artery were 25.3 mm (±9.2) for S1 IS, 12.4 mm (±9.0) for S1 TS, and 23.5 mm (±10.7) for S2 TS screws, respectively. Ten S1 TS screws (25%) and no S1 IS or S2 TS screws were projected to have caused injury to the SG NV bundle (P < 0.001). Inserting S1 IS and S2 TS screws put the SG NV anatomy at significantly less risk than S1 TS screws. This information may aid in choosing the "best" fixation option for patients with pelvic ring trauma requiring surgery.

Dissociation between peripheral blood chimerism and tolerance to hindlimb composite tissue transplants: preferential localization of chimerism in donor bone.

PubMed

Rahhal, Dina N; Xu, Hong; Huang, Wei-Chao; Wu, Shengli; Wen, Yujie; Huang, Yiming; Ildstad, Suzanne T

2009-09-27

Mixed chimerism induces donor-specific tolerance to composite tissue allotransplants (CTAs). In the present studies, we used a nonmyeloablative conditioning approach to establish chimerism and promote CTA acceptance. Wistar Furth (RT1A(u)) rats were conditioned with 600 to 300 cGy total body irradiation (TBI, day-1), and 100 x 10(6) T-cell-depleted ACI (RT1A(abl)) bone marrow cells were transplanted on day 0, followed by a 11-day course of tacrolimus and one dose of antilymphocyte serum (day 10). Heterotopic osteomyocutaneous flap transplantation was performed 4 to 6 weeks after bone marrow transplantation. Mixed chimerism was initially achieved in almost all recipients, but long-term acceptance of CTA was only achieved in rats treated with 600 cGy TBI. When anti-alphabeta-T-cell receptor (TCR) monoclonal antibody (mAb) (day-3) was added into the regimens, donor chimerism was similar to recipients preconditioned without anti-alphabeta-TCR mAb. However, the long-term CTA survival was significantly improved in chimeras receiving more than or equal to 300 cGy TBI plus anti-alphabeta-TCR mAb. Higher levels of donor chimerism were associated with CTA acceptance. The majority of flap acceptors lost peripheral blood chimerism within 6 months. However, donor chimerism persisted in the transplanted bone at significantly higher levels compared with other hematopoietic compartments. The compartment donor chimerism may be responsible for the maintenance of tolerance to CTA. Long-term acceptors were tolerant to a donor skin graft challenge even in the absence of peripheral blood chimerism. Mixed chimerism established by nonmyeloablative conditioning induces long-term acceptance of CTA, which is associated with persistent chimerism preferentially in the transplanted donor bone.

Alternative diagnoses based on CT angiography of the chest in patients with suspected pulmonary thromboembolism

PubMed Central

Ferreira, Eleci Vaz; Gazzana, Marcelo Basso; Sarmento, Muriel Bossle; Guazzelli, Pedro Arends; Hoffmeister, Mariana Costa; Guerra, Vinicius André; Seligman, Renato; Knorst, Marli Maria

2016-01-01

Objective : To determine the prevalence of alternative diagnoses based on chest CT angiography (CTA) in patients with suspected pulmonary thromboembolism (PTE) who tested negative for PTE, as well as whether those alternative diagnoses had been considered prior to the CTA. Methods : This was a cross-sectional, retrospective study involving 191 adult patients undergoing CTA for suspected PTE between September of 2009 and May of 2012. Chest X-rays and CTAs were reviewed to determine whether the findings suggested an alternative diagnosis in the cases not diagnosed as PTE. Data on symptoms, risk factors, comorbidities, length of hospital stay, and mortality were collected. Results : On the basis of the CTA findings, PTE was diagnosed in 47 cases (24.6%). Among the 144 patients not diagnosed with PTE via CTA, the findings were abnormal in 120 (83.3%). Such findings were consistent with an alternative diagnosis that explained the symptoms in 75 patients (39.3%). Among those 75 cases, there were only 39 (20.4%) in which the same alterations had not been previously detected on chest X-rays. The most common alternative diagnosis, made solely on the basis of the CTA findings, was pneumonia (identified in 20 cases). Symptoms, risk factors, comorbidities, and the in-hospital mortality rate did not differ significantly between the patients with and without PTE. However, the median hospital stay was significantly longer in the patients with PTE than in those without (18.0 and 9.5 days, respectively; p = 0.001). Conclusions : Our results indicate that chest CTA is useful in cases of suspected PTE, because it can confirm the diagnosis and reveal findings consistent with an alternative diagnosis in a significant number of patients. PMID:26982039

Contrast extravasation on CT angiography predicts hematoma expansion and mortality in acute traumatic subdural hemorrhage.

PubMed

Romero, J M; Kelly, H R; Delgado Almandoz, J E; Hernandez-Siman, J; Passanese, J C; Lev, M H; González, R G

2013-08-01

The presence of active contrast extravasation at CTA predicts hematoma expansion and in-hospital mortality in patients with nontraumatic intracerebral hemorrhage. This study aims to determine the frequency and predictive value of the contrast extravasation in patients with aSDH. We retrospectively reviewed 157 consecutive patients who presented to our emergency department over a 9-year period with aSDH and underwent CTA at admission and a follow-up NCCT within 48 hours. Two experienced readers, blinded to clinical data, reviewed the CTAs to assess for the presence of contrast extravasation. Medical records were reviewed for baseline clinical characteristics and in-hospital mortality. aSDH maximum width in the axial plane was measured on both baseline and follow-up NCCTs, with hematoma expansion defined as >20% increase from baseline. Active contrast extravasation was identified in 30 of 199 discrete aSDHs (15.1%), with excellent interobserver agreement (κ = 0.80; 95% CI, 0.7-0.9). The presence of contrast extravasation indicated a significantly increased risk of hematoma expansion (odds ratio, 4.5; 95% CI, 2.0-10.1; P = .0001) and in-hospital mortality (odds ratio, 7.6; 95% CI, 2.6-22.3; P = 0.0004). In a multivariate analysis controlled for standard risk factors, the presence of contrast extravasation was an independent predictor of aSDH expansion (P = .001) and in-hospital mortality (P = .0003). Contrast extravasation stratifies patients with aSDH into those at high risk and those at low risk of hematoma expansion and in-hospital mortality. This distinction could affect patient treatment, clinical trial selection, and possible surgical intervention.

Stimulation of the dorsal periaqueductal gray enhances spontaneous recovery of a conditioned taste aversion

PubMed Central

Mickley, G. Andrew; Ketchesin, Kyle D.; Ramos, Linnet; Luchsinger, Joseph R.; Rogers, Morgan M.; Wiles, Nathanael R.; Hoxha, Nita

2012-01-01

Due to its relevance to clinical practice, extinction of learned fears has been a major focus of recent research. However, less is known about the means by which conditioned fears re-emerge (i.e., spontaneously recover) as time passes or contexts change following extinction. The periaqueductal gray represents the final common pathway mediating defensive reactions to fear and we have reported previously that the dorsolateral PAG (dlPAG) exhibits a small but reliable increase in neural activity (as measured by c-fos protein immunoreactivity) when spontaneous recovery (SR) of a conditioned taste aversion (CTA) is reduced. Here we extend these correlational studies to determine if inducing dlPAG c-fos expression through electrical brain stimulation could cause a reduction in SR of a CTA. Male Sprague-Dawley rats acquired a strong aversion to saccharin (conditioned stimulus; CS) and then underwent CTA extinction through multiple non-reinforced exposures to the CS. Following a 30-day latency period after asymptotic extinction was achieved; rats either received stimulation of the dorsal PAG (dPAG) or stimulation of closely adjacent structures. Sixty minutes following the stimulation, rats were again presented with the saccharin solution as we tested for SR of the CTA. The brain stimulation evoked c-fos expression around the tip of the electrodes. However, stimulation of the dPAG failed to reduce SR of the previously extinguished CTA. In fact, dPAG stimulation caused rats to significantly suppress their saccharin drinking (relative to controls) – indicating an enhanced SR. These data refute a cause-and-effect relationship between enhanced dPAG c-fos expression and a reduction in SR. However, they highlight a role for the dPAG in modulating SR of extinguished CTAs. PMID:23183042

A comparison between taste avoidance and conditioned disgust reactions induced by ethanol and lithium chloride in preweanling rats.

PubMed

Arias, Carlos; Pautassi, Ricardo Marcos; Molina, Juan Carlos; Spear, Norman E

2010-09-01

Adult rats display taste avoidance and disgust reactions when stimulated with gustatory stimuli previously paired with aversive agents such as lithium chloride (LiCl). By the second postnatal week of life, preweanling rats also display specific behaviors in response to a tastant conditioned stimulus (CS) that predicts LiCl-induced malaise. The present study compared conditioned disgust reactions induced by LiCl or ethanol (EtOH) in preweanling rats. In Experiment 1 we determined doses of ethanol and LiCl that exert similar levels of conditioned taste avoidance. After having equated drug dosage in terms of conditioned taste avoidance, 13-day-old rats were given a single pairing of a novel taste (saccharin) and either LiCl or ethanol (2.5 g/kg; Experiment 2). Saccharin intake and emission of disgust reactions were assessed 24 and 48 hr after training. Pups given paired presentations of saccharin and the aversive agents (ethanol or LiCl) consumed less saccharin during the first testing day than controls. These pups also showed more aversive behavioral reactions to the gustatory CS than controls. Specifically, increased amounts of grooming, general activity, head shaking, and wall climbing as well as reduced mouthing were observed in response to the CS. Conditioned aversive reactions but not taste avoidance were still evident on the second testing day. In conclusion, a taste CS paired with postabsorptive effects of EtOH and LiCl elicited a similar pattern of conditioned rejection reactions in preweanling rats. These results suggest that similar mechanisms may be underlying CTAs induced by LiCl and a relatively high EtOH dose.

High-Risk Carotid Plaques Identified by CT-Angiogram can Predict Acute Myocardial Infarction

PubMed Central

Mosleh, Wassim; Adib, Keenan; Natdanai, Punnanithinont; Carmona-Rubio, Andres; Karki, Roshan; Paily, Jacienta; Ahmed, Mohamed Abdel-Aal; Vakkalanka, Sujit; Madam, Narasa; Gudleski, Gregory D; Chung, Charles; Sharma, Umesh C

2016-01-01

Purpose Prior studies identified the incremental value of non-invasive imaging by CT-angiogram (CTA) to detect high-risk coronary atherosclerotic plaques. Due to their superficial locations, larger calibers and motion-free imaging, the carotid arteries provide the best anatomic access for the non-invasive characterization of atherosclerotic plaques. We aim to assess the ability of predicting obstructive coronary artery disease (CAD) or acute myocardial infarction (MI) based on high-risk carotid plaque features identified by CTA. Methods We retrospectively examined carotid CTAs of 492 patients that presented with acute stroke to characterize the atherosclerotic plaques of the carotid arteries and examined development of acute MI and obstructive CAD within 12-months. Carotid lesions were defined in terms of calcifications (large or speckled), presence of low-attenuation plaques, positive remodeling, and presence of napkin ring sign (NRS). Adjusted relative risks were calculated for each plaque features. Results Patients with speckled (<3mm) calcifications and/or larger calcifications on CTA had a higher risk of developing an MI and/or obstructive CAD within one year compared to patients without [adjusted RR of 7.51, 95%CI 1.26 to 73.42, P= 0.001]. Patients with low-attenuation plaques on CTA had a higher risk of developing an MI and/or obstructive CAD within one year than patients without [adjusted RR of 2.73, 95%CI 1.19 to 8.50, P= 0.021]. Presence of carotid calcifications and low-attenuation plaques also portended higher sensitivity (100% and 79.17%, respectively) for the development of acute MI. Conclusions Presence of carotid calcifications and low-attenuation plaques can predict the risk of developing acute MI and/or obstructive CAD within 12-months. Given their high sensitivity, their absence can reliably exclude 12-month events. PMID:27866279

High-risk carotid plaques identified by CT-angiogram can predict acute myocardial infarction.

PubMed

Mosleh, Wassim; Adib, Keenan; Natdanai, Punnanithinont; Carmona-Rubio, Andres; Karki, Roshan; Paily, Jacienta; Ahmed, Mohamed Abdel-Aal; Vakkalanka, Sujit; Madam, Narasa; Gudleski, Gregory D; Chung, Charles; Sharma, Umesh C

2017-04-01

Prior studies identified the incremental value of non-invasive imaging by CT-angiogram (CTA) to detect high-risk coronary atherosclerotic plaques. Due to their superficial locations, larger calibers and motion-free imaging, the carotid arteries provide the best anatomic access for the non-invasive characterization of atherosclerotic plaques. We aim to assess the ability of predicting obstructive coronary artery disease (CAD) or acute myocardial infarction (MI) based on high-risk carotid plaque features identified by CTA. We retrospectively examined carotid CTAs of 492 patients that presented with acute stroke to characterize the atherosclerotic plaques of the carotid arteries and examined development of acute MI and obstructive CAD within 12-months. Carotid lesions were defined in terms of calcifications (large or speckled), presence of low-attenuation plaques, positive remodeling, and presence of napkin ring sign. Adjusted relative risks were calculated for each plaque features. Patients with speckled (<3 mm) calcifications and/or larger calcifications on CTA had a higher risk of developing an MI and/or obstructive CAD within 1 year compared to patients without (adjusted RR of 7.51, 95%CI 1.26-73.42, P = 0.001). Patients with low-attenuation plaques on CTA had a higher risk of developing an MI and/or obstructive CAD within 1 year than patients without (adjusted RR of 2.73, 95%CI 1.19-8.50, P = 0.021). Presence of carotid calcifications and low-attenuation plaques also portended higher sensitivity (100 and 79.17%, respectively) for the development of acute MI. Presence of carotid calcifications and low-attenuation plaques can predict the risk of developing acute MI and/or obstructive CAD within 12-months. Given their high sensitivity, their absence can reliably exclude 12-month events.

TRACON Aircraft Arrival Planning and Optimization Through Spatial Constraint Satisfaction

NASA Technical Reports Server (NTRS)

Bergh, Christopher P.; Krzeczowski, Kenneth J.; Davis, Thomas J.; Denery, Dallas G. (Technical Monitor)

1995-01-01

A new aircraft arrival planning and optimization algorithm has been incorporated into the Final Approach Spacing Tool (FAST) in the Center-TRACON Automation System (CTAS) developed at NASA-Ames Research Center. FAST simulations have been conducted over three years involving full-proficiency, level five air traffic controllers from around the United States. From these simulations an algorithm, called Spatial Constraint Satisfaction, has been designed, coded, undergone testing, and soon will begin field evaluation at the Dallas-Fort Worth and Denver International airport facilities. The purpose of this new design is an attempt to show that the generation of efficient and conflict free aircraft arrival plans at the runway does not guarantee an operationally acceptable arrival plan upstream from the runway -information encompassing the entire arrival airspace must be used in order to create an acceptable aircraft arrival plan. This new design includes functions available previously but additionally includes necessary representations of controller preferences and workload, operationally required amounts of extra separation, and integrates aircraft conflict resolution. As a result, the Spatial Constraint Satisfaction algorithm produces an optimized aircraft arrival plan that is more acceptable in terms of arrival procedures and air traffic controller workload. This paper discusses the current Air Traffic Control arrival planning procedures, previous work in this field, the design of the Spatial Constraint Satisfaction algorithm, and the results of recent evaluations of the algorithm.

Steps Towards the Integration of Conflict Resolution with Metering and Scheduling

NASA Technical Reports Server (NTRS)

McNally, B. David; Edwards, Thomas (Technical Monitor)

1998-01-01

NASA Ames Research Center is developing decision support tool technology for air traffic controllers to improve the efficiency and capacity of National Airspace System. The goal is to provide technology, tools and procedures that result in the highest possible level of user preferred trajectories whenever possible with safe and efficient traffic management when necessary. The work is being conducted under the NASA Advanced Air Transportation Technology Program in cooperation with the FAA through the Inter-Agency Integrated Product Team. The objective is to develop technology and procedures that lead towards a seamless integration of conflict resolution with metering and scheduling for arrival aircraft and en route aircraft that are under metering restrictions. A requirement is that the integration incorporate user preferred trajectories. The ultimate goal is the implementation and validation of the Descent Advisor (DA) concept which provides clearance advisories to a sector controller that simultaneously meet metering constraints, are conflict free, incorporate a user preferred (e.g., minimum fuel) descent profile, and generally require no further corrective clearance as the aircraft transitions from en route cruise into the TRACON. The DA concept may also be applied to en route aircraft under metering constraints, e.g., miles-in-trail. To achieve the DA concept a stepwise development and field evaluation is anticipated. This paper addresses the initial steps towards implementation of the DA. The Traffic Management Advisor (TMA) computes arrival time sequence and required delay information for display to the sector controller during periods when arrivals must be metered due to landing rate restrictions at the airport. The Initial Conflict Probe (ICP) compares trajectory predictions for all aircraft and alerts the controller when any two aircraft are predicted to violate separation standards (5 mi. and 2000 ft. in en route airspace). ICP also includes a trial planning function allowing the controller to develop and check a separate "what if" trajectory for conflict resolution. TMA and ICP currently operate independent of one another and have separate controller displays. The TMA meter list is on the radar controller's plan view display. The ICP is still under development, but the current concept calls for a list of predicted conflicts at the data controller position. The research described herein address two steps towards the implementation of DA. The first is to develop a concept for integrated display of conflict and metering information on a controller's display. The objective is to provide the controller with situational awareness of one problem while he develops a solution to the other. The next step is to expand the concept for display of automated clearance advisories for one problem (e.g., metering) which take into account the other problems (e.g., conflicts). Information to be communicated between TMA and ICP to facilitate' manual or automated advisories is being identified as the concept matures. In order to study the ICP/TMA integration concept the CTAS conflict probe capability has been adapted to Ft. Worth Center. The system is being validated in the laboratory with all-track data and for non -interference with TMA, TMA is already running as a daily use prototype at Ft. Worth Center. A laboratory prototype system has been developed under the CTAS baseline which combines conflict and metering information on a common user interface. Elements of the user interface are shown in Figure 1. In this simple illustration the user sees the simultaneous effect of a trial plan on meter fix delay and conflict status. Delay information is shown in the aircraft flight data block, the meter list, and the TMA timeline. Experience during Descent Advisor development and observations at Ft. Worth Center high and low attitude arrival sectors during metering suggests that manual trial planning will be unworkable during rush periods due to high controller workload.

CT Angiography of Peripheral Arterial Disease by 256-Slice Scanner: Accuracy, Advantages and Disadvantages Compared to Digital Subtraction Angiography.

PubMed

Mishra, Atul; Jain, Narendra; Bhagwat, Anand

2017-07-01

Peripheral arterial occlusive disease (PAOD) may cause disabling claudication or critical limb ischemia. Multidetector computed tomography (CT) technology has evolved to the level of 256-slice CT scanners which has significantly improved the spatial and temporal resolution of the images. This has provided the capability of chasing the contrast bolus at a fast speed enabling angiographic imaging of long segments of the body. These images can be reconstructed in various planes and various modes for detailed analysis of the peripheral vascular diseases which helps in making treatment decision. The aim of this retrospective study was to compare the CT angiograms (CTAs) of all cases of PAOD done by 256-slice CT scanner at a tertiary care vascular center and comparing these images with the digital subtraction angiograms (DSAs) of these patients. The retrospective study included 53 patients who underwent both CTA and DSA at our center over a period of 3 years from March 2013 to March 2016. The CTA showed high sensitivity (93%) and specificity (92.7%) for overall assessment of degree of stenosis in a vascular segment in cases of aortic and lower limb occlusive disease. The assessment of lesions of infrapopliteal segment was comparatively inferior (sensitivity 91.6%, accuracy 73.3%, and positive predictive value 78.5%), more so in the presence of significant calcification. The advantages of CTA were its noninvasive nature, ability to image large area of body, almost no adverse effects to the patients, and better assessment of vessel wall disease. However, the CTA assessment of collaterals was inferior with a sensitivity of only 62.7% as compared to DSA. Overall, 256-slice CTA provides fast and accurate imaging of vascular tree which can restrict DSA only in few selected cases as a problem-solving tool where clinico-radiological mismatch is present.

Evaluation of intra-aortic CT angiography performances for the visualisation of spinal vascular malformations' angioarchitecture.

PubMed

Clarençon, Frédéric; Di Maria, Federico; Sourour, Nader-Antoine; Gabrieli, Joseph; Nouet, Aurélien; Shotar, Eimad; Cormier, Evelyne; Fahed, Robert; Cornu, Philippe; Chiras, Jacques

2016-10-01

To evaluate the performances of the CT-angiography by direct intra-aortic contrast media injection (IA-CTA) for spinal vascular malformations (SVMs)' imaging. Thirteen patients (8 males, 5 females, mean age: 56 y) with suspected SVM underwent IA-CTAs by direct intra-aortic iodinated contrast media injection (5 cc/s; 100 cc) via an arterial femoral or humeral access. Two independent observers evaluated the angioarchitecture of the SVMs and the visualisation of both the Adamkiewicz artery and the anterior spinal artery. Then a consensus was obtained between the 2 reviewers; the results of the IA-CTA were finally compared with those of the full spinal DSA evaluated in consensus. The IA-CTA was feasible in all cases and depicted the SVM in all except one case (92 %). Interrater agreement was good for the location of the SVMs' level. Intermodality (IA-CTA/DSA) agreement was excellent for the level and side of the shunt point, as well as for the SVM subtype evaluation. In 77 % of the cases, the Adamkiewicz artery was satisfactorily seen at the same time on IA-CTA. IA-CTA is a new technique that seems helpful to reach a better understanding of SMVs and may help to tailor more precisely their treatment. • IA-CTA is an accurate technique for the SVMs' angioarchitecture analysis • IA-CTA can locate, at the same time, the Adamkiewicz artery (AKA) • IA-CTA may be helpful in elderly patients with troublesome vasculature.

PROTOCOL FOR REDUCING TIME TO ANTIBIOTICS IN FEBRILE NEONATES PRESENTING TO THE EMERGENCY DEPARTMENT: A QUALITY IMPROVEMENT INITIATIVE

PubMed Central

Boutin, A

2017-01-01

Abstract BACKGROUND: Febrile neonates are at high risk of morbidity and mortality from infectious causes. This risk further increases if antibiotics are not received in a timely manner. Current guidelines recommend early initiation (less than 1 hour) of antibiotics for patients with severe sepsis. Time-to-antibiotic administration (TAA) should also be targeted as a quality-of-care (QOC) measure for febrile neonates. A previous evaluation showed that most of these patients were not receiving antibiotics in the first hour at our emergency department (ED). OBJECTIVES: We evaluated whether a simple quality improvement protocol would improve the proportion of febrile neonates receiving antibiotics within 60 minutes of arrival to the ED. DESIGN/METHODS: This was a pre-post intervention study conducted in the ED of an academic pediatric tertiary care hospital with an annual volume of approximately 83,000 patients in 2014-2016. Participants were a random sample of all children younger than 28 days old visiting the ED for a febrile illness. The new protocol, which consisted for the nurses, after triage, to place the patients directly in the resuscitation room for immediate assessment by a physician, was implemented in February 2016. Previously, these children were triaged level 2 on the Canadian Triage and Acuity Scale (CTAS), flagged and placed in a regular examination room waiting for the physician assessment. With the new protocol, IV access, blood culture, urine analysis and culture were immediately obtained by the nurse in charge with the concomitant assessment by the attending physician. Forty charts prior to and 50 charts after protocol initiation were reviewed by an archivist using a standardized form between 2014-2015 and 2016, respectively. The primary outcome was TAA. This was defined as the time from initial ED registration to the beginning of antibiotics infusion. As a secondary outcome, all cases were reviewed individually to determine barriers to rapid antibiotic administration (day, evening, or night shifts, other treatments or investigations, number of attempts for intravenous access) and to elicit new quality improvement strategies. RESULTS: During the study periods a total of 178 (pre) and 135 (post) patients fulfilled the inclusion criteria. Among the random samples, 6/50 (12%) of patients received their antibiotics within 60 minutes in the post-intervention period compared to 0/40 (0%) in the pre-implementation period (difference 12%; 95 CI: 1-24%). Within 90 minutes, the proportion improved from 1/40 (2.5%) to 29/50 (58%) (difference 56%; 95 CI: 38-68%). Median TAA in febrile neonates decreased from 182 minutes (interquartile range, 147-219 minutes) in the pre-implementation period to 85 minutes (interquartile range, 73-115 minutes) in the post-implementation period. The main obstacle to the goal of 60 minutes for TAA was the difficulty to get IV access as well as antibiotic availability. CONCLUSION: In this study, a new protocol mandating the immediate transfer of febrile neonate from triage to the resuscitation room improved proportion of febrile neonates receiving antibiotics in less than 60 minutes in our ED. Our results suggest that simple interventions can reduce TAA in a selected group of patients presenting to the ED.

En route Spacing Tool: Efficient Conflict-free Spacing to Flow-Restricted Airspace

NASA Technical Reports Server (NTRS)

Green, S.

1999-01-01

This paper describes the Air Traffic Management (ATM) problem within the U.S. of flow-restricted en route airspace, an assessment of its impact on airspace users, and a set of near-term tools and procedures to resolve the problem. The FAA is committed, over the next few years, to deploy the first generation of modem ATM decision support tool (DST) technology under the Free-Flight Phase-1 (FFp1) program. The associated en route tools include the User Request Evaluation Tool (URET) and the Traffic Management Advisor (TMA). URET is an initial conflict probe (ICP) capability that assists controllers with the detection and resolution of conflicts in en route airspace. TMA orchestrates arrivals transitioning into high-density terminal airspace by providing controllers with scheduled times of arrival (STA) and delay feedback advisories to assist with STA conformance. However, these FFPl capabilities do not mitigate the en route Miles-In-Trail (MIT) restrictions that are dynamically applied to mitigate airspace congestion. National statistics indicate that en route facilities (Centers) apply Miles-In-Trail (MIT) restrictions for approximately 5000 hours per month. Based on results from this study, an estimated 45,000 flights are impacted by these restrictions each month. Current-day practices for implementing these restrictions result in additional controller workload and an economic impact of which the fuel penalty alone may approach several hundred dollars per flight. To mitigate much of the impact of these restrictions on users and controller workload, a DST and procedures are presented. The DST is based on a simple derivative of FFP1 technology that is designed to introduce a set of simple tools for flow-rate (spacing) conformance and integrate them with conflict-probe capabilities. The tool and associated algorithms are described based on a concept prototype implemented within the CTAS baseline in 1995. A traffic scenario is used to illustrate the controller's use of the tool, and potential display options are presented for future controller evaluation.

Safety of coronary CT angiography and functional testing for stable chest pain in the PROMISE trial: A randomized comparison of test complications, incidental findings, and radiation dose.

PubMed

Lu, Michael T; Douglas, Pamela S; Udelson, James E; Adami, Elizabeth; Ghoshhajra, Brian B; Picard, Michael H; Roberts, Rhonda; Lee, Kerry L; Einstein, Andrew J; Mark, Daniel B; Velazquez, Eric J; Carter, William; Ridner, Michael; Al-Khalidi, Hussein R; Hoffmann, Udo

Coronary computed tomography angiography (CTA) and functional testing strategies for stable chest pain yield similar outcomes; one aspect that may guide test choice is safety. We compared test safety (test complications, incidental findings, and effective radiation dose) between CTA and functional testing as-tested in PROMISE (PROspective Multicenter Imaging Study for Evaluation of Chest Pain). In the subgroup whose physicians intended nuclear stress over other functional tests if randomized to the functional arm, we compared radiation dose of CTA versus nuclear stress and identified characteristics associated with dose. Of 9470 patients, none had major and <1% had minor complications (CTA: 0.8% [37/4633] vs. functional: 0.6% [27/4837]). CTA identified more incidental findings (11.6% [539/4633] vs. 0.7% [34/4837], p < 0.001), most commonly pulmonary nodules (9.4%, 437/4633). CTA had similar 90-day cumulative radiation dose to functional testing. However, in the subgroup whose physicians intended nuclear stress (CTA 3147; nuclear 3203), CTA had lower median index test (8.8 vs. 12.6 mSv, p < 0.001) and 90-day cumulative (11.6 vs. 13.1 mSv, p < 0.001) dose, independent of patient characteristics. The lowest nuclear doses employed 1-day Tc-99m protocols (12.2 mSv). The lowest CTA doses were at sites performing ≥500 CTAs/year (6.9 mSv) and with advanced (latest available) CT scanners (5.5 mSv). Complications were negligibly rare for both CTA and functional testing. CTA detects more incidental findings. Compared to nuclear stress testing, CTA's lower radiation dose, independent of patient characteristics, makes it an attractive test choice. Radiation dose varies with imaging protocol, indicating opportunities to further reduce dose. (ClinicalTrials.gov number, NCT01174550). Copyright © 2017 Society of Cardiovascular Computed Tomography. Published by Elsevier Inc. All rights reserved.

A System Concept for Facilitating User Preferences in En Route Airspace

NASA Technical Reports Server (NTRS)

Vivona, R. A.; Ballin, M. G.; Green, S. M.; Bach, R. E.; McNally, B. D.

1996-01-01

The Federal Aviation Administration is trying to make its air traffic management system more responsive to the needs of the aviation community by exploring the concept of 'free flight' for aircraft flying under instrument flight rules. A logical first step toward free flight could be made without significantly altering current air traffic control (ATC) procedures or requiring new airborne equipment by designing a ground-based system to be highly responsive to 'user preference' in en route airspace while providing for an orderly transition to the terminal area. To facilitate user preference in all en route environments, a system based on an extension of the Center/TRACON Automation System (CTAS) is proposed in this document. The new system would consist of two integrated components. An airspace tool (AT) focuses on unconstrained en route aircraft (e.g., not transitioning to the terminal airspace), taking advantage of the relatively unconstrained nature of their flights and using long-range trajectory prediction to provide cost-effective conflict resolution advisories to sector controllers. A sector tool (ST) generates efficient advisories for all aircraft, with a focus on supporting controllers in analyzing and resolving complex, highly constrained traffic situations. When combined, the integrated AT/ST system supports user preference in any air route traffic control center sector. The system should also be useful in evaluating advanced free-flight concepts by serving as a test bed for future research. This document provides an overview of the design concept, explains its anticipated benefits, and recommends a development strategy that leads to a deployable system.

Development and evaluation of a profile negotiation process for integrating aircraft and air traffic control automation

NASA Technical Reports Server (NTRS)

Green, Steven M.; Denbraven, Wim; Williams, David H.

1993-01-01

The development and evaluation of the profile negotiation process (PNP), an interactive process between an aircraft and air traffic control (ATC) that integrates airborne and ground-based automation capabilities to determine conflict-free trajectories that are as close to an aircraft's preference as possible, are described. The PNP was evaluated in a real-time simulation experiment conducted jointly by NASA's Ames and Langley Research Centers. The Ames Center/TRACON Automation System (CTAS) was used to support the ATC environment, and the Langley Transport Systems Research Vehicle (TSRV) piloted cab was used to simulate a 4D Flight Management System (FMS) capable aircraft. Both systems were connected in real time by way of voice and data lines; digital datalink communications capability was developed and evaluated as a means of supporting the air/ground exchange of trajectory data. The controllers were able to consistently and effectively negotiate nominally conflict-free vertical profiles with the 4D-equipped aircraft. The actual profiles flown were substantially closer to the aircraft's preference than would have been possible without the PNP. However, there was a strong consensus among the pilots and controllers that the level of automation of the PNP should be increased to make the process more transparent. The experiment demonstrated the importance of an aircraft's ability to accurately execute a negotiated profile as well as the need for digital datalink to support advanced air/ground data communications. The concept of trajectory space is proposed as a comprehensive approach for coupling the processes of trajectory planning and tracking to allow maximum pilot discretion in meeting ATC constraints.

A Vision of the Future Air Traffic Control System

NASA Technical Reports Server (NTRS)

Erzberger, Heinz

2000-01-01

The air transportation system is on the verge of gridlock, with delays and cancelled flights this summer reaching all time highs. As demand for air transportation continues to increase, the capacity needed to accommodate the growth in traffic is falling farther and farther behind. Moreover, it has become increasingly apparent that the present system cannot be scaled up to provide the capacity increases needed to meet demand over the next 25 years. NASA, working with the Federal Aviation Administration and industry, is pursuing a major research program to develop air traffic management technologies that have the ultimate goal of doubling capacity while increasing safety and efficiency. This seminar will describe how the current system operates, what its limitations are and why a revolutionary "shift in paradigm" is needed to overcome fundamental limitations in capacity and safety. For the near term, NASA has developed a portfolio of software tools for air traffic controllers, called the Center-TRACON Automation System (CTAS), that provides modest gains in capacity and efficiency while staying within the current paradigm. The outline of a concept for the long term, with a deployment date of 2015 at the earliest, has recently been formulated and presented by NASA to a select group of industry and government stakeholders. Automated decision making software, combined with an Internet in the sky that enables sharing of information and distributes control between the cockpit and the ground, is key to this concept. However, its most revolutionary feature is a fundamental change in the roles and responsibilities assigned to air traffic controllers.

Blood volume analysis: a new technique and new clinical interest reinvigorate a classic study.

PubMed

Manzone, Timothy A; Dam, Hung Q; Soltis, Daniel; Sagar, Vidya V

2007-06-01

Blood volume studies using the indicator dilution technique and radioactive tracers have been performed in nuclear medicine departments for over 50 y. A nuclear medicine study is the gold standard for blood volume measurement, but the classic dual-isotope blood volume study is time-consuming and can be prone to technical errors. Moreover, a lack of normal values and a rubric for interpretation made volume status measurement of limited interest to most clinicians other than some hematologists. A new semiautomated system for blood volume analysis is now available and provides highly accurate results for blood volume analysis within only 90 min. The availability of rapid, accurate blood volume analysis has brought about a surge of clinical interest in using blood volume data for clinical management. Blood volume analysis, long a low-volume nuclear medicine study all but abandoned in some laboratories, is poised to enter the clinical mainstream. This article will first present the fundamental principles of fluid balance and the clinical means of volume status assessment. We will then review the indicator dilution technique and how it is used in nuclear medicine blood volume studies. We will present an overview of the new semiautomated blood volume analysis technique, showing how the study is done, how it works, what results are provided, and how those results are interpreted. Finally, we will look at some of the emerging areas in which data from blood volume analysis can improve patient care. The reader will gain an understanding of the principles underlying blood volume assessment, know how current nuclear medicine blood volume analysis studies are performed, and appreciate their potential clinical impact.

The relationship between patient volume and mortality in American trauma centres: a systematic review of the evidence.

PubMed

Caputo, Lisa M; Salottolo, Kristin M; Slone, Denetta Sue; Mains, Charles W; Bar-Or, David

2014-03-01

To synthesise published and unpublished findings examining the relationship between institutional trauma centre volume or trauma patient volume per surgeon and mortality. Evidence on the relationship between patient volume and survival in trauma patients is inconclusive in the literature and remains controversial. A literature search was performed to identify studies published between 1976 and 2013 via MEDLINE (Pubmed) and the Cumulative Index to Nursing and Allied Health Literature (EbscoHost) as well as footnote chasing. Abstracts from appropriate conferences and ProQuest Dissertations and Theses were also searched. Inclusion criteria required studies to be original research published in English that examined the relationship between mortality and either institutional or per surgeon volume in American trauma centres. We employed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) Statement checklist and flowchart. The Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach was employed to rate the quality of the evidence. Of 1392 studies reviewed, 19 studies met defined inclusion criteria; all studies were retrospective. The definition of volume was heterogeneous across the studies. Patient population and analysis methods also varied across the studies. Sixteen studies (84%) examined the relationship between institutional trauma centre volume and mortality. Of the 16 studies, 12 examined the volume of severely injured patients and eight examined overall trauma patient volume. High institutional volume was associated with at least somewhat improved mortality in ten of 16 studies (63%); however, nearly half of these studies found only some subpopulations experienced benefits. In the remaining six studies, volume was not associated with any benefits. Four studies (25%) analysed the impact of surgeon volume on mortality. High volume per surgeon was associated with improved mortality in only one of four studies (25%). The studies were extremely heterogeneous, thus definitive conclusions cannot be drawn regarding optimal volume before a clear advantage in survival is observed. A prospective study defining volume as a continuous variable is warranted to support current admission criteria for American trauma patients. Copyright © 2013 Elsevier Ltd. All rights reserved.

Status of groundwater levels and storage volume in the Equus Beds aquifer near Wichita, Kansas, 2012 to 2014

USGS Publications Warehouse

Hansen, Cristi V.; Whisnant, Joshua A.; Lanning-Rush, Jennifer L.

2014-01-01

There was a larger percentage storage-volume increase since 1993 in the central part of the study area than in either the basin storage area or the entire study area. Storage-volume in the central part of the study area during winter 2012, summer 2013, winter 2013, and winter 2014 recovered about 46,300 acre-feet or more compared to the storage volume in 1993. In summer 2012 and winter 2013, the storage-volume increase since 1993 was larger in the central part of the study area than in the entire study area, indicating the storage-volume increases in the central part of the study area offset decreases in storage volume in the rest of the study area. The larger increase in storage volume in the central part of the study area than in the rest of the study area probably was because of the Integrated Local Water Supply Program strategy that reduced city pumpage from the Equus Beds aquifer by about 40 percent. The current (winter 2014) storage volumes in the entire study area and the central part of the study area are about 94 and 96 percent of their respective predevelopment storage volumes or about 3,067,000 and 962,000 acre-feet, respectively.

A systematic review of the impact of volume of surgery and specialization on patient outcome.

PubMed

Chowdhury, M M; Dagash, H; Pierro, A

2007-02-01

Volume of surgery and specialization may affect patient outcome. Articles examining the effects of one or more of three variables (hospital volume of surgery, surgeon volume and specialization) on outcome (measured by length of hospital stay, mortality and complication rate) were analysed. Reviews, opinion articles and observational studies were excluded. The methodological quality of each study was assessed, a correlation between the variables analysed and the outcome accepted if it was significant. The search identified 55,391 articles published between 1957 and 2002; 1075 were relevant to the study, of which 163 (9,904,850 patients) fulfilled the entry criteria. These 163 examined 42 different surgical procedures, spanning 13 surgical specialities. None were randomized and 40 investigated more than one variable. Hospital volume was reported in 127 studies; high-volume hospitals had significantly better outcomes in 74.2 per cent of studies, but this effect was limited in prospective studies (40 per cent). Surgeon volume was reported in 58 studies; high-volume surgeons had significantly better outcomes in 74 per cent of studies. Specialization was reported in 22 studies; specialist surgeons had significantly better outcomes than general surgeons in 91 per cent of studies. The benefit of high surgeon volume and specialization varied in magnitude between specialities. High surgeon volume and specialization are associated with improved patient outcome, while high hospital volume is of limited benefit. Copyright (c) 2007 British Journal of Surgery Society Ltd.

Are PCI Service Volumes Associated with 30-Day Mortality? A Population-Based Study from Taiwan.

PubMed

Yu, Tsung-Hsien; Chou, Ying-Yi; Wei, Chung-Jen; Tung, Yu-Chi

2017-11-09

The volume-outcome relationship has been discussed for over 30 years; however, the findings are inconsistent. This might be due to the heterogeneity of service volume definitions and categorization methods. This study takes percutaneous coronary intervention (PCI) as an example to examine whether the service volume was associated with PCI 30-day mortality, given different service volume definitions and categorization methods. A population-based, cross-sectional multilevel study was conducted. Two definitions of physician and hospital volume were used: (1) the cumulative PCI volume in a previous year before each PCI; (2) the cumulative PCI volume within the study period. The volume was further treated in three ways: (1) a categorical variable based on the American Heart Association's recommendation; (2) a semi-data-driven categorical variable based on k-means clustering algorithm; and (3) a data-driven categorical variable based on the Generalized Additive Model. The results showed that, after adjusting the patient-, physician-, and hospital-level covariates, physician volume was associated inversely with PCI 30-day mortality, but hospital volume was not, no matter which definitions and categorization methods of service volume were applied. Physician volume is negatively associated with PCI 30-day mortality, but the results might vary because of definition and categorization method.

Quantification of sweat gland volume and innervation in neuropathy: Correlation with thermoregulatory sweat testing.

PubMed

Loavenbruck, Adam; Wendelschaefer-Crabbe, Gwen; Sandroni, Paola; Kennedy, William R

2014-10-01

No study has correlated thermoregulatory sweat testing (TST) with histopathologic study of sweat glands (SGs) and SG nerve fibers (SGNFs). We studied 10 neuropathy patients in whom anhidrosis was found by TST and 10 matched controls. Skin biopsies were taken from both anhidrotic and sweating skin and immunohistochemical staining was done for nerves and basement membrane. For each biopsy, total tissue volume, total SG volume, and total SGNF length were measured. SGNF length per biopsy volume, SG volume per biopsy volume (SG%), and SGNF length per SG volume were calculated. SGNF length per biopsy volume was reduced in anhidrotic site biopsies of patients compared with controls. SG% was decreased and SGNF length per SG volume increased in patients compared with controls. The results suggest a concomitant loss of SG volume and SGNF length in neuropathy, with greater loss of SGNFs in anhidrotic skin, possibly exceeding collateral reinnervation. Copyright © 2014 Wiley Periodicals, Inc.

A new model for the origin of Type-B and Fluffy Type-A CAIs: Analogies to remelted compound chondrules

NASA Astrophysics Data System (ADS)

Rubin, Alan E.

2012-06-01

In the scenario developed here, most types of calcium-aluminum-rich inclusions (CAIs) formed near the Sun where they developed Wark-Lovering rims before being transported by aerodynamic forces throughout the nebula. The amount of ambient dust in the nebula varied with heliocentric distance, peaking in the CV-CK formation location. Literature data show that accretionary rims (which occur outside the Wark-Lovering rims) around CAIs contain substantial 16O-rich forsterite, suggesting that, at this time, the ambient dust in the nebula consisted largely of 16O-rich forsterite. Individual sub-millimeter-size Compact Type-A CAIs (each surrounded by a Wark-Lovering rim) collided in the CV-CK region and stuck together (in a manner similar to that of sibling compound chondrules); the CTAs were mixed with small amounts of 16O-rich mafic dust and formed centimeter-size compound objects (large Fluffy Type-A CAIs) after experiencing minor melting. In contrast to other types of CAIs, centimeter-size Type-B CAIs formed directly in the CV-CK region after gehlenite-rich Compact Type-A CAIs collided and stuck together, incorporated significant amounts of 16O-rich forsteritic dust (on the order of 10-15%) and probably some anorthite, and experienced extensive melting and partial evaporation. (Enveloping compound chondrules formed in an analogous manner.) In those cases where appreciably higher amounts of 16O-rich forsterite (on the order of 25%) (and perhaps minor anorthite and pyroxene) were incorporated into compound Type-A objects prior to melting, centimeter-size forsterite-bearing Type-B CAIs (B3 inclusions) were produced. Type-B1 inclusions formed from B2 inclusions that collided with and stuck to melilite-rich Compact Type-A CAIs and experienced high-temperature processing.

Novel potential serological prostate cancer biomarkers using CT100+ cancer antigen microarray platform in a multi-cultural South African cohort

PubMed Central

Adeola, Henry A.; Smith, Muneerah; Kaestner, Lisa; Blackburn, Jonathan M.; Zerbini, Luiz F.

2016-01-01

There is a growing need for high throughput diagnostic tools for early diagnosis and treatment monitoring of prostate cancer (PCa) in Africa. The role of cancer-testis antigens (CTAs) in PCa in men of African descent is poorly researched. Hence, we aimed to elucidate the role of 123 Tumour Associated Antigens (TAAs) using antigen microarray platform in blood samples (N = 67) from a South African PCa, Benign prostatic hyperplasia (BPH) and disease control (DC) cohort. Linear (fold-over-cutoff) and differential expression quantitation of autoantibody signal intensities were performed. Molecular signatures of candidate PCa antigen biomarkers were identified and analyzed for ethnic group variation. Potential cancer diagnostic and immunotherapeutic inferences were drawn. We identified a total of 41 potential diagnostic/therapeutic antigen biomarkers for PCa. By linear quantitation, four antigens, GAGE1, ROPN1, SPANXA1 and PRKCZ were found to have higher autoantibody titres in PCa serum as compared with BPH where MAGEB1 and PRKCZ were highly expressed. Also, p53 S15A and p53 S46A were found highly expressed in the disease control group. Statistical analysis by differential expression revealed twenty-four antigens as upregulated in PCa samples, while 11 were downregulated in comparison to BPH and DC (FDR = 0.01). FGFR2, COL6A1and CALM1 were verifiable biomarkers of PCa analysis using urinary shotgun proteomics. Functional pathway annotation of identified biomarkers revealed similar enrichment both at genomic and proteomic level and ethnic variations were observed. Cancer antigen arrays are emerging useful in potential diagnostic and immunotherapeutic antigen biomarker discovery. PMID:26885621

Classification of gutter type in parallel stenting during endovascular aortic aneurysm repair.

PubMed

Overeem, Simon P; Boersen, Johannes T; Schuurmann, Richte C L; Groot Jebbink, Erik; Slump, Cornelis H; Reijnen, Michel M P J; de Vries, Jean-Paul P M

2017-08-01

Gutters can be described as the loss of continuous apposition between the main body of the endograft, the chimney stent graft, and the aortic wall. Gutters have been associated with increased risk of type IA endoleaks and are considered to be the Achilles' heel of chimney endovascular aneurysm repair (ch-EVAR). However, there is no classification yet to classify and quantify gutter types after ch-EVAR. Different gutter types can be distinguished by their morphologic appearance in two- and three-dimensional views and reconstructed slices perpendicular to the center lumen line. Three main categories are defined by (1) the most proximal beginning of the gutter, (2) the length of gutter alongside the endograft, and (3) its distal end. Type A gutters originate at the proximal fabric of an endograft, type B gutters originate as loss of apposition of the chimney stent graft in the branch vessel, and type C gutters start below the fabric of the endograft. To determine eventual changes of gutter size during follow-up computed tomography angiograms (CTAs), measurements may be performed with dedicated software on the follow-up CTA scan to assess the extent of gutters over the aortic circumference, ranging from 0° to 360° of freedom, together with the maximum gap between the endograft material and the aortic wall as it appears on reconstructed axial CTA scan slices. The proposed gutter classification enables a uniform nomenclature in the current ch-EVAR literature and a more accurate risk assessment of gutter-associated endoleaks. Moreover, it allows monitoring of eventual progression of gutter size during follow-up. Copyright © 2016 Society for Vascular Surgery. Published by Elsevier Inc. All rights reserved.

Correlation of ultrasound estimated placental volume and umbilical cord blood volume in term pregnancy.

PubMed

Pannopnut, Papinwit; Kitporntheranunt, Maethaphan; Paritakul, Panwara; Kongsomboon, Kittipong

2015-01-01

To investigate the correlation between ultrasound measured placental volume and collected umbilical cord blood (UCB) volume in term pregnancy. An observational cross-sectional study of term singleton pregnant women in the labor ward at Maha Chakri Sirindhorn Medical Center was conducted. Placental thickness, height, and width were measured using two-dimensional (2D) ultrasound and calculated for placental volume using the volumetric mathematic model. After the delivery of the baby, UCB was collected and measured for its volume immediately. Then, birth weight, placental weight, and the actual placental volume were analyzed. The Pearson's correlation was used to determine the correlation between each two variables. A total of 35 pregnant women were eligible for the study. The mean and standard deviation of estimated placental volume and actual placental volume were 534±180 mL and 575±118 mL, respectively. The median UCB volume was 140 mL (range 98-220 mL). The UCB volume did not have a statistically significant correlation with the estimated placental volume (correlation coefficient 0.15; p=0.37). However, the UCB volume was significantly correlated with the actual placental volume (correlation coefficient 0.62; p<0.001) and birth weight (correlation coefficient 0.38; p=0.02). The estimated placental volume by 2D ultrasound was not significantly correlated with the UCB volume. Further studies to establish the correlation between the UCB volume and the estimated placental volume using other types of placental imaging may be needed.

Mars power system concept definition study. Volume 2: Appendices

NASA Technical Reports Server (NTRS)

Littman, Franklin D.

1994-01-01

This report documents the work performed by Rockwell International's Rocketdyne Division on NASA Contract No. NAS3-25808 (Task Order No. 16) entitled 'Mars Power System Definition Study'. This work was performed for NASA's Lewis Research Center (LeRC). The report is divided into two volumes as follows: Volume 1 - Study Results; and Volume 2 - Appendices. The results of the power system characterization studies, operations studies, and technology evaluations are summarized in Volume 1. The appendices include complete, standalone technology development plans for each candidate power system that was investigated.

Research Studies Index. Authors and Subjects. Volume 1 through Volume 43 (1929-1975).

ERIC Educational Resources Information Center

Drazan, Joseph, Comp.; Scott, Paula, Comp.

This volume contains author and subject indexes for volumes 1 through 43 (1929-1975) of "Research Studies," a scholarly, multi-disciplinary quarterly published at Washington State University. Each author index entry includes the title, volume, and inclusive pagination of the article. The subject index is a keyword-out-of-context…

Estimation of feline renal volume using computed tomography and ultrasound.

PubMed

Tyson, Reid; Logsdon, Stacy A; Werre, Stephen R; Daniel, Gregory B

2013-01-01

Renal volume estimation is an important parameter for clinical evaluation of kidneys and research applications. A time efficient, repeatable, and accurate method for volume estimation is required. The purpose of this study was to describe the accuracy of ultrasound and computed tomography (CT) for estimating feline renal volume. Standardized ultrasound and CT scans were acquired for kidneys of 12 cadaver cats, in situ. Ultrasound and CT multiplanar reconstructions were used to record renal length measurements that were then used to calculate volume using the prolate ellipsoid formula for volume estimation. In addition, CT studies were reconstructed at 1 mm, 5 mm, and 1 cm, and transferred to a workstation where the renal volume was calculated using the voxel count method (hand drawn regions of interest). The reference standard kidney volume was then determined ex vivo using water displacement with the Archimedes' principle. Ultrasound measurement of renal length accounted for approximately 87% of the variability in renal volume for the study population. The prolate ellipsoid formula exhibited proportional bias and underestimated renal volume by a median of 18.9%. Computed tomography volume estimates using the voxel count method with hand-traced regions of interest provided the most accurate results, with increasing accuracy for smaller voxel sizes in grossly normal kidneys (-10.1 to 0.6%). Findings from this study supported the use of CT and the voxel count method for estimating feline renal volume in future clinical and research studies. © 2012 Veterinary Radiology & Ultrasound.

Study of Alternate Space Shuttle Concepts. Volume 2, Part 2: Concept Analysis and Definition

NASA Technical Reports Server (NTRS)

1971-01-01

This is the final report of a Phase A Study of Alternate Space Shuttle Concepts by the Lockheed Missiles & Space Company (LMSC) for the National Aeronautics and Space Administration George C. Marshall Space Flight Center (MSFC). The eleven-month study, which began on 30 June 1970, is to examine the stage-and-one-half and other Space Shuttle configurations and to establish feasibility, performance, cost, and schedules for the selected concepts. This final report consists of four volumes as follows: Volume I - Executive Summary, Volume II - Concept Analysis and Definition, Volume III - Program Planning, and Volume IV - Data Cost Data. This document is Volume II, Concept Analysis and Definition.

Impacts of Outer Continental Shelf (OCS) development on recreation and tourism. Volume 2. Final report and case studies

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

Not Available

The final report for the project is comprised of five volumes. The volume presents the study conclusions, summarizes the methodology used (more detail is found in Volume 3), discusses four case study applications of the model, and contains profiles of coastal communities in an Appendix.

SU-F-T-40: Can CBCT Images Be Used for Volume Studies of Prostate Seed Implants for Boost Treatment?

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

Xu, H; Lee, S; Diwanji, T

Purpose: In our clinic, the planning CT is used for definitive and boost low-dose-rate (LDR) brachytherapy treatments to determine the ultrasound volume in the operating room (OR) at the time of the implant. While the CT overestimation of OR volume is known, a larger estimation discrepancy has been observed for boost treatments. A possible reason is the prostate size reduction during EBRT for boost patients. Since cone-beam CT (CBCT) is often used as routine imaging guidance of EBRT, this prostate volume change may be captured. This study investigates if CBCT taken during EBRT includes the volume change information and thereforemore » beats CT in estimating the prostate OR volumes. Methods: 9 prostate patients treated with EBRT (45Gy in 1.8Gy per fractions to the whole pelvis) and I-125 seed implants (108Gy) were involved in this study. During EBRT, CBCT image guidance was performed on a weekly basis. For each patient, the prostate volumes on the first and the last available CBCT images were manually contoured by a physician. These volumes were then compared to each other and with the contoured volumes from the planning CT and from the ultrasound images in the OR. Results: The first and the last CBCT images did not show significant prostate volume change. Their average +/− standard deviation of prostate volumes were 24.4cc+/−14.6cc and 29.9cc+/−16.1cc, respectively (T-test p=0.68). The ratio of the OR volume to the last CBCT (0.71+/−0.21) was not significantly different from the ratio of OR volumes to the planning CT (0.61+/−0.13) (p=0.25). Conclusion: In this study, CBCT does not show significant prostate volume changes during EBRT. CBCT and CT volumes are quite consistent and no improvement of volume estimation using CBCT is observed. The advantage of CBCT as a replacement of CT for volume study of boost LDR brachytherapy is limited.« less

Can technical factors explain the volume-outcome relationship in gastric bypass surgery?

PubMed

Smith, Mark D; Patterson, Emma; Wahed, Abdus S; Belle, Steven H; Courcoulas, Anita P; Flum, David; Khandelwal, Saurabh; Mitchell, James E; Pomp, Alfons; Pories, Walter J; Wolfe, Bruce

2013-01-01

The existence of a relationship between surgeon volume and patient outcome has been reported for different complex surgical operations. This relationship has also been confirmed for patients undergoing Roux-en-Y gastric bypass (RYGB) in the Longitudinal Assessment of Bariatric Surgery (LABS) study. Despite multiple studies demonstrating volume-outcome relationships, fewer studies investigate the causes of this relationship. The purpose of the present study is to understand possible explanations for the volume-outcome relationship in LABS. LABS includes a 10-center, prospective study examining 30-day outcomes after bariatric surgery. The relationship between surgeon annual RYGB volume and incidence of a composite endpoint (CE) has been published previously. Technical aspects of RYGB surgery were compared between high and low volume surgeons. The previously published model was adjusted for select technical factors. High-volume surgeons (>100 RYGBs/yr) were more likely to perform a linear stapled gastrojejunostomy, use fibrin sealant, and place a drain at the gastrojejunostomy compared with low-volume surgeons (<25 RYGBs/yr), and less likely to perform an intraoperative leak test. After adjusting for the newly identified technical factors, the relative risk of CE was .93 per 10 RYGB/yr increase in volume, compared with .90 for clinical risk adjustment alone. High-volume surgeons exhibited certain differences in technique compared with low-volume surgeons. After adjusting for these differences, the strength of the volume-outcome relationship previously found was reduced only slightly, suggesting that other factors are also involved. Copyright © 2013 American Society for Bariatric Surgery. All rights reserved.

Age accounts for racial differences in ischemic stroke volume in a population-based study.

PubMed

Zakaria, Tarek; Lindsell, Christopher J; Kleindorfer, Dawn; Alwell, Kathleen; Moomaw, Charles J; Woo, Daniel; Szaflarski, Jerzy P; Khoury, Jane; Miller, Rosie; Broderick, Joseph P; Kissela, Brett

2008-01-01

The stroke volume among black ischemic stroke patients in phase I of the population-based Greater Cincinnati/Northern Kentucky Stroke Study (GCNKSS) was smaller than reported among acute stroke studies, with a median stroke volume of 2.5 cm. However, it is not known if stroke volume was similar between black and white patients within the same study population. Phase II of the GCNKSS identified all ischemic strokes between July 1993 and June 1994. The stroke volume was estimated by study physicians using the modified ellipsoid method. Analysis of stroke volume by race, sex and age was performed for strokes with a measurable lesion of >or=0.5 cm(3). Among verified cases of ischemic stroke, 334 patients were eligible for this analysis. There were 191 whites (57%) and 143 blacks (43%). The mean age was 69.4 years. The median stroke volume for all patients was 8.8 cm(3) (range 0.5-540), with a mean of 36.4 cm(3). Stroke volume was not different between men and women, and it tended to increase with age. Although stroke volume was significantly higher among whites, age was a confounding factor. Subsequent analysis of stroke volume stratified by age showed no difference between blacks and whites in any age group. Our data show that most ischemic stroke lesions, regardless of the race, are of small size, and this may be an important reason for the low percentage of strokes treated currently with tissue-type plasminogen activator. The association of age with stroke volume requires further study. Copyright 2008 S. Karger AG, Basel.

Food habits of Nyctinomops macrotis at a maternity roost in New Mexico, as indicated by analysis of guano

USGS Publications Warehouse

Sparks, D.W.; Valdez, E.W.

2003-01-01

We examined 56 fecal pellets from under a maternity colony of big free-tailed bats (Nyctinomops macrotis) in the Jemez Mountains of northern New Mexico. The most important food items, listed in order of decreasing percent volume, were Cicadellidae, leafhoppers (26.7% volume, 58.9% frequency); Ichneumonidae, Ichneumon wasps (19.3% volume, 35.7% frequency); and Lepidoptera, moths (17.2% volume, 82.1% frequency). Overall, the most important orders as prey consumed, listed by decreasing percent volume, were Homoptera (27.6% volume, 62.5% frequency), Hymenoptera (19.5% volume, 37.5% frequency), Lepidoptera (17.2% volume, 82.1% frequency), Hemiptera (11.7% volume, 37.5% frequency), and Diptera (10.6% volume, 50.0% frequency). Our study documents an unusually varied diet, as previous studies indicated that these bats fed almost exclusively on moths.

Does Categorization Method Matter in Exploring Volume-Outcome Relation? A Multiple Categorization Methods Comparison in Coronary Artery Bypass Graft Surgery Surgical Site Infection.

PubMed

Yu, Tsung-Hsien; Tung, Yu-Chi; Chung, Kuo-Piao

2015-08-01

Volume-infection relation studies have been published for high-risk surgical procedures, although the conclusions remain controversial. Inconsistent results may be caused by inconsistent categorization methods, the definitions of service volume, and different statistical approaches. The purpose of this study was to examine whether a relation exists between provider volume and coronary artery bypass graft (CABG) surgical site infection (SSI) using different categorization methods. A population-based cross-sectional multi-level study was conducted. A total of 10,405 patients who received CABG surgery between 2006 and 2008 in Taiwan were recruited. The outcome of interest was surgical site infection for CABG surgery. The associations among several patient, surgeon, and hospital characteristics was examined. The definition of surgeons' and hospitals' service volume was the cumulative CABG service volumes in the previous year for each CABG operation and categorized by three types of approaches: Continuous, quartile, and k-means clustering. The results of multi-level mixed effects modeling showed that hospital volume had no association with SSI. Although the relation between surgeon volume and surgical site infection was negative, it was inconsistent among the different categorization methods. Categorization of service volume is an important issue in volume-infection study. The findings of the current study suggest that different categorization methods might influence the relation between volume and SSI. The selection of an optimal cutoff point should be taken into account for future research.

Effects of obesity on lung volume and capacity in children and adolescents: a systematic review

PubMed Central

Winck, Aline Dill; Heinzmann-Filho, João Paulo; Soares, Rafaela Borges; da Silva, Juliana Severo; Woszezenki, Cristhiele Taís; Zanatta, Letiane Bueno

2016-01-01

Abstract Objective: To assess the effects of obesity on lung volume and capacity in children and adolescents. Data source: This is a systematic review, carried out in Pubmed, Lilacs, Scielo and PEDro databases, using the following Keywords: Plethysmography; Whole Body OR Lung Volume Measurements OR Total Lung Capacity OR Functional Residual Capacity OR Residual Volume AND Obesity. Observational studies or clinical trials that assessed the effects of obesity on lung volume and capacity in children and adolescents (0-18 years) without any other associated disease; in English; Portuguese and Spanish languages were selected. Methodological quality was assessed by the Agency for Healthcare Research and Quality. Data synthesis: Of the 1,030 articles, only four were included in the review. The studies amounted to 548 participants, predominantly males, with sample size ranging from 45 to 327 individuals. 100% of the studies evaluated nutritional status through BMI (z-score) and 50.0% reported the data on abdominal circumference. All demonstrated that obesity causes negative effects on lung volume and capacity, causing a reduction mainly in functional residual capacity in 75.0% of the studies; in the expiratory reserve volume in 50.0% and in the residual volume in 25.0%. The methodological quality ranged from moderate to high, with 75.0% of the studies classified as having high methodological quality. Conclusions: Obesity causes deleterious effects on lung volume and capacity in children and adolescents, mainly by reducing functional residual capacity, expiratory reserve volume and residual volume. PMID:27130483

Designing Studies of Extension Program Results: A Resource for Program Leaders and Specialists. Volume II--Abstracts.

ERIC Educational Resources Information Center

Rivera, William M., Ed.; And Others

These abstracts of 42 studies of extension program results, which make up the second volume of a two-volume resource, are intended to advise state administrative program leaders and others with program evaluation responsibilities of how to design studies of cooperative extension programs. Designed to support volume I, which refers to these…

Operationally Efficient Propulsion System Study (OEPSS) data book. Executive summary

NASA Technical Reports Server (NTRS)

Wong, George S.

1990-01-01

The study was initiated to identify operations problems and cost drivers for current propulsion systems and to identify technology and design approaches to increase the operational efficiency and reduce operations costs for future propulsion systems. To provide readily usable data for the Advanced Launch System (ALS) program, the results of the Operationally Efficient Propulsion System Study (OEPSS) were organized into a series of OEPSS Data Books as follows: Volume 1, Generic Ground Operations Data; Volume 2, Ground Operations Problems; Volume 3, Operations Technology; Volume 4, OEPSS Design Concepts; and Volume 5, OEPSS Final Review Briefing, which summarizes the activities and results of the study. Summarized here are the salient results of the first year. A synopsis of each volume listed above is presented.

Which Kind of Provider’s Operation Volumes Matters? Associations between CABG Surgical Site Infection Risk and Hospital and Surgeon Operation Volumes among Medical Centers in Taiwan

PubMed Central

Yu, Tsung-Hsien; Tung, Yu-Chi; Chung, Kuo-Piao

2015-01-01

Background Volume-infection relationships have been examined for high-risk surgical procedures, but the conclusions remain controversial. The inconsistency might be due to inaccurate identification of cases of infection and different methods of categorizing service volumes. This study takes coronary artery bypass graft (CABG) surgical site infections (SSIs) as an example to examine whether a relationship exists between operation volumes and SSIs, when different SSIs case identification, definitions and categorization methods of operation volumes were implemented. Methods A population-based cross-sectional multilevel study was conducted. A total of 7,007 patients who received CABG surgery between 2006 and 2008 from19 medical centers in Taiwan were recruited. SSIs associated with CABG surgery were identified using International Classification of Diseases, 9th Revision, Clinical Modification (ICD-9 CM) codes and a Classification and Regression Trees (CART) model. Two definitions of surgeon and hospital operation volumes were used: (1) the cumulative CABG operation volumes within the study period; and (2) the cumulative CABG operation volumes in the previous one year before each CABG surgery. Operation volumes were further treated in three different ways: (1) a continuous variable; (2) a categorical variable based on the quartile; and (3) a data-driven categorical variable based on k-means clustering algorithm. Furthermore, subgroup analysis for comorbidities was also conducted. Results This study showed that hospital volumes were not significantly associated with SSIs, no matter which definitions or categorization methods of operation volume, or SSIs case identification approaches were used. On the contrary, the relationships between surgeon’s volumes varied. Most of the models demonstrated that the low-volume surgeons had higher risk than high-volume surgeons. Conclusion Surgeon volumes were more important than hospital volumes in exploring the relationship between CABG operation volumes and SSIs in Taiwan. However, the relationships were not robust. Definitions and categorization methods of operation volume and correct identification of SSIs are important issues for future research. PMID:26053035

Hippocampal and Parahippocampal Volumes in Schizophrenia: A Structural MRI Study

PubMed Central

Sim, Kang; DeWitt, Iain; Ditman, Tali; Zalesak, Martin; Greenhouse, Ian; Goff, Donald; Weiss, Anthony P; Heckers, Stephan

2006-01-01

Smaller medial temporal lobe volume is a frequent finding in studies of patients with schizophrenia, but the relative contributions of the hippocampus and three surrounding cortical regions (entorhinal cortex, perirhinal cortex, and parahippocampal cortex) are poorly understood. We tested the hypothesis that the volumes of medial temporal lobe regions are selectively changed in schizophrenia. We studied 19 male patients with schizophrenia and 19 age-matched male control subjects. Hippocampal and cortical volumes were estimated using a three-dimensional morphometric protocol for the analysis of high-resolution structural magnetic resonance images, and repeated measures ANOVA was used to test for region-specific differences. Patients had smaller overall medial temporal lobe volumes compared to controls. The volume difference was not specific for either region or hemisphere. The finding of smaller medial temporal lobe volumes in the absence of regional specificity has important implications for studying the functional role of the hippocampus and surrounding cortical regions in schizophrenia. PMID:16319377

Volume-outcome associations after major hepatectomy for hepatocellular carcinoma: a nationwide Taiwan study.

PubMed

Lu, Chih-Cheng; Chiu, Chong-Chi; Wang, Jhi-Joung; Chiu, Yu-Hsien; Shi, Hon-Yi

2014-06-01

The objective of this study was to explore volume-outcome associations after major hepatectomy for hepatocellular carcinoma (HCC). This population-based cohort study retrospectively analyzed 23,107 major hepatectomies for HCC patients from 1998 to 2009. Relationships between hospital/surgeon volume and patient outcome were analyzed by propensity score matching (PSM). Five-year overall survival (OS) was estimated by Kaplan-Meier method, and differences were compared by log-rank test. The mean length of stay (LOS) after major hepatectomy was 18.1 days, and the mean hospital cost was US$5,088.2. After PSM, the mean OS in high- and low-volume hospitals was 71.1 months (standard deviation (SD) 0.7 months) and 68.6 months (SD 0.6 months), respectively; the mean OS in high- and low-volume surgeons was 78.5 months (SD 0.7 months) and 66.9 months (SD 0.7 months), respectively. The PSM analysis showed that treatment by high-volume hospitals and treatment by high-volume surgeons were both associated with significantly shorter LOS, lower hospital cost, and longer survival compared to their low-volume counterparts (P < 0.001). The results of this nationwide study support the regionalization of HCC treatment by hospital volume and by surgeon volume. High surgeon volume revealed both short- and long-term benefits. The applicability of PSM in volume-outcome analysis may also be confirmed.

Bladder filling variation during conformal radiotherapy for rectal cancer

NASA Astrophysics Data System (ADS)

Sithamparam, S.; Ahmad, R.; Sabarudin, A.; Othman, Z.; Ismail, M.

2017-05-01

Conformal radiotherapy for rectal cancer is associated with small bowel toxicity mainly diarrhea. Treating patients with a full bladder is one of the practical solutions to reduce small bowel toxicity. Previous studies on prostate and cervix cancer patients revealed that maintaining consistent bladder volume throughout radiotherapy treatment is challenging. The aim of this study was to measure bladder volume variation throughout radiotherapy treatment. This study also measured the association between bladder volume changes and diarrhea. Twenty two rectal cancer patients were recruited prospectively. Patients were planned for treatment with full bladder following departmental bladder filling protocol and the planning bladder volume was measured during CT-simulation. During radiotherapy, the bladder volume was measured weekly using cone-beam computed tomography (CBCT) and compared to planning bladder volume. Incidence and severity of diarrhea were recorded during the weekly patient review. There was a negative time trend for bladder volume throughout five weeks treatment. The mean bladder volume decreased 18 % from 123 mL (SD 54 mL) during CT-simulation to 101 mL (SD 71 mL) on the 5th week of radiotherapy, but the decrease is not statistically significant. However, there was a large variation of bladder volume within each patient during treatment. This study showed an association between changes of bladder volume and diarrhea (P = 0.045). In conclusion bladder volume reduced throughout radiotherapy treatment for conformal radiotherapy for rectal cancer and there was a large variation of bladder volume within patients.

A Survey and Analysis of Military Computer-Based Systems: A Two Part Study. Volume II. A Descriptive and Predictive Model for Evaluating Instructional Systems. Final Report.

ERIC Educational Resources Information Center

McDonnell Douglas Astronautics Co. - East, St. Louis, MO.

This is the second volume of a two volume study. The first volume examined the literature to identify authoring aids for developing instructional materials, and to identify information clearing houses for existing materials. The purpose of this volume was to develop a means for assessing the cost versus expected benefits of innovations in…

The Volume-Outcome Relationship in Critical Care

PubMed Central

Wallace, David J.; Yordanov, Youri; Trinquart, Ludovic; Blomkvist, Josefin; Angus, Derek C.; Kahn, Jeremy M.; Ravaud, Philippe; Guidet, Bertrand

2015-01-01

OBJECTIVE: The purpose of this study was to systematically review the research on volume and outcome relationships in critical care. METHODS: From January 1, 2001, to April 30, 2014, MEDLINE and EMBASE were searched for studies assessing the relationship between admission volume and clinical outcomes in critical illness. Bibliographies were reviewed to identify other articles of interest, and experts were contacted about missing or unpublished studies. Of 127 studies reviewed, 46 met inclusion criteria, covering seven clinical conditions. Two investigators independently reviewed each article using a standardized form to abstract information on key study characteristics and results. RESULTS: Overall, 29 of the studies (63%) reported a statistically significant association between higher admission volume and improved outcomes. The magnitude of the association (mortality OR between the lowest vs highest stratum of volume centers), as well as the thresholds used to characterize high volume, varied across clinical conditions. Critically ill patients with cardiovascular (n = 7, OR = 1.49 [1.11-2.00]), respiratory (n = 12, OR = 1.20 [1.04-1.38]), severe sepsis (n = 4, OR = 1.17 [1.03-1.33]), hepato-GI (n = 3, OR = 1.30 [1.08-1.78]), neurologic (n = 3, OR = 1.38 [1.22-1.57]), and postoperative admission diagnoses (n = 3, OR = 2.95 [1.05-8.30]) were more likely to benefit from admission to higher-volume centers compared with lower-volume centers. Studies that controlled for ICU or hospital organizational factors were less likely to find a significant volume-outcome relationship than studies that did not control for these factors. CONCLUSIONS: Critically ill patients generally benefit from care in high-volume centers, with more substantial benefits in selected high-risk conditions. This relationship may in part be mediated by specific ICU and hospital organizational factors. PMID:25927593

Acute pesticide poisoning outcomes: a nationwide study in Taiwan.

PubMed

Chen, Chieh-Fan; Lin, Hsing-Lin; Chou, Huei-Yin; Hsu, Wen-Chi; Shi, Hon-Yi

2015-03-01

This study presents the findings of a nationwide study of acute pesticide poisoning (APP) outcomes, including outcome predictors such as physician and hospital volume and associated factors. This study of data contained in the Taiwan National Health Insurance Research Database analysed 27 046 patients who had been hospitalised for APP from January 1996 to December 2007. Patient characteristics were then compared among quartiles. The primary outcome measures were length of stay (LOS) and hospital treatment cost. Effect size (ES) was compared among three equally divided periods, and multiple regression models were used to identify outcome predictors. The overall prevalence of APP per 100 000 patients decreased from 12.43 in 1996 to 6.87 in 2007. The LOS for APP treatment was negatively associated with physician volume during the study period. Both LOS and hospital treatment cost were lowest in the high hospital volume subgroup. Comparisons of LOS and hospital treatment cost among the three periods showed that high-volume hospitals and high-volume physicians had better ESs compared to low-volume hospitals and low-volume physicians. Age and number of co-morbidities had significant positive associations with LOS, while admission year, male gender, hospital level, hospital volume and physician volume had significant negative associations with LOS (p<0.05). Hospital treatment cost and hospital level correlated positively with admission year, number of co-morbidities and LOS but correlated negatively with hospital volume and physician volume (p<0.05). In APP patients, treatment by a high-volume physician can reduce LOS and treatment cost. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Mortality differences by surgical volume among patients with stomach cancer: a threshold for a favorable volume-outcome relationship.

PubMed

Choi, Hyeok; Yang, Seong-Yoon; Cho, Hee-Seung; Kim, Woorim; Park, Eun-Cheol; Han, Kyu-Tae

2017-07-17

Many studies have assessed the volume-outcome relationship in cancer patients, but most focused on better outcomes in higher volume groups rather than identifying a specific threshold that could assist in clinical decision-making for achieving the best outcomes. The current study suggests an optimal volume for achieving good outcome, as an extension of previous studies on the volume-outcome relationship in stomach cancer patients. We used National Health Insurance Service (NHIS) Sampling Cohort data during 2004-2013, comprising healthcare claims for 2550 patients with newly diagnosed stomach cancer. We conducted survival analyses adopting the Cox proportional hazard model to investigate the association of three threshold values for surgical volume of stomach cancer patients for cancer-specific mortality using the Youden index. Overall, 17.10% of patients died due to cancer during the study period. The risk of mortality among patients who received surgical treatment gradually decreased with increasing surgical volume at the hospital, while the risk of mortality increased again in "high" surgical volume hospitals, resulting in a j-shaped curve (mid-low = hazard ratio (HR) 0.773, 95% confidence interval (CI) 0.608-0.983; mid-high = HR 0.541, 95% CI 0.372-0.788; high = HR 0.659, 95% CI 0.473-0.917; ref = low). These associations were especially significant in regions with unsubstantial surgical volumes and less severe cases. The optimal surgical volume threshold was about 727.3 surgical cases for stomach cancer per hospital over the 1-year study period in South Korea. However, such positive effects decreased after exceeding a certain volume of surgeries.

An Independent Scientific Assessment of Well Stimulation in California Volume III

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

Jane C.S. Long; Laura C. Feinstein; Birkholzer, Jens

This study is issued in three volumes. Volume I, issued in January 2015, describes how well stimulation technologies work, how and where operators deploy these technologies for oil and gas production in California, and where they might enable production in the future. Volume II, issued in July 2015, discusses how well stimulation could affect water, atmosphere, seismic activity, wildlife and vegetation, and human health. Volume II reviews available data, and identifies knowledge gaps and alternative practices that could avoid or mitigate these possible impacts. Volume III, this volume, presents case studies that assess environmental issues and qualitative risks for specificmore » geographic regions. The Summary Report summarizes key findings, conclusions and recommendations of all three volumes.« less

An Independent Scientific Assessment of Well Stimulation in California Volume II

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

Jane C.S. Long; Laura C. Feinstein; Corinne E. Bachmann

This study is issued in three volumes. Volume I, issued in January 2015, describes how well stimulation technologies work, how and where operators deploy these technologies for oil and gas production in California, and where they might enable production in the future. Volume II, the present volume, discusses how well stimulation could affect water, atmosphere, seismic activity, wildlife and vegetation, and human health. Volume II reviews available data, and identifies knowledge gaps and alternative practices that could avoid or mitigate these possible impacts. Volume III, also issued in July 2015, presents case studies that assess environmental issues and qualitative risksmore » for specific geographic regions. A final Summary Report summarizes key findings, conclusions and recommendations of all three volumes.« less

Effects of obesity on lung volume and capacity in children and adolescents: a systematic review.

PubMed

Winck, Aline Dill; Heinzmann-Filho, João Paulo; Soares, Rafaela Borges; da Silva, Juliana Severo; Woszezenki, Cristhiele Taís; Zanatta, Letiane Bueno

2016-12-01

To assess the effects of obesity on lung volume and capacity in children and adolescents. This is a systematic review, carried out in Pubmed, Lilacs, Scielo and PEDro databases, using the following Keywords: Plethysmography; Whole Body OR Lung Volume Measurements OR Total Lung Capacity OR Functional Residual Capacity OR Residual Volume AND Obesity. Observational studies or clinical trials that assessed the effects of obesity on lung volume and capacity in children and adolescents (0-18 years) without any other associated disease; in English; Portuguese and Spanish languages were selected. Methodological quality was assessed by the Agency for Healthcare Research and Quality. Of the 1,030 articles, only four were included in the review. The studies amounted to 548 participants, predominantly males, with sample size ranging from 45 to 327 individuals. 100% of the studies evaluated nutritional status through BMI (z-score) and 50.0% reported the data on abdominal circumference. All demonstrated that obesity causes negative effects on lung volume and capacity, causing a reduction mainly in functional residual capacity in 75.0% of the studies; in the expiratory reserve volume in 50.0% and in the residual volume in 25.0%. The methodological quality ranged from moderate to high, with 75.0% of the studies classified as having high methodological quality. Obesity causes deleterious effects on lung volume and capacity in children and adolescents, mainly by reducing functional residual capacity, expiratory reserve volume and residual volume. Copyright © 2016 Sociedade de Pediatria de São Paulo. Publicado por Elsevier Editora Ltda. All rights reserved.

Orbito-frontal cortex and thalamus volumes in the patients with obsessive-compulsive disorder before and after cognitive behavioral therapy.

PubMed

Atmaca, Murad; Yildirim, Hanefi; Yilmaz, Seda; Caglar, Neslihan; Mermi, Osman; Korkmaz, Sevda; Akaslan, Unsal; Gurok, M Gurkan; Kekilli, Yasemin; Turkcapar, Hakan

2018-07-01

Background The effect of a variety of treatment modalities including psychopharmacological and cognitive behavioral therapy on the brain volumes and neurochemicals have not been investigated enough in the patients with obsessive-compulsive disorder. Therefore, in the present study, we aimed to investigate the effect of cognitive behavioral therapy on the volumes of the orbito-frontal cortex and thalamus regions which seem to be abnormal in the patients with obsessive-compulsive disorder. We hypothesized that there would be change in the volumes of the orbito-frontal cortex and thalamus. Methods Twelve patients with obsessive-compulsive disorder and same number of healthy controls were included into the study. At the beginning of the study, the volumes of the orbito-frontal cortex and thalamus were compared by using magnetic resonance imaging. In addition, volumes of these regions were measured before and after the cognitive behavioral therapy treatment in the patient group. Results The patients with obsessive-compulsive disorder had greater left and right thalamus volumes and smaller left and right orbito-frontal cortex volumes compared to those of healthy control subjects at the beginning of the study. When we compared baseline volumes of the patients with posttreatment ones, we detected that thalamus volumes significantly decreased throughout the period for both sides and that the orbito-frontal cortex volumes significantly increased throughout the period for only left side. Conclusions In summary, we found that cognitive behavioral therapy might volumetrically affect the key brain regions involved in the neuroanatomy of obsessive-compulsive disorder. However, future studies with larger sample are required.

Measuring pedestrian volumes and conflicts. Volume 1, Pedestrian volume sampling

DOT National Transportation Integrated Search

1987-12-01

This final report presents the findings, conclusions, and recommendations of the study conducted to develop a model to predict pedestrian volumes using small sampling schemes. This research produced four pedestrian volume prediction models (i.e., 1-,...

SATCOM antenna siting study on P-3C aircraft, volume 2

NASA Technical Reports Server (NTRS)

Bensman, D. A.; Marhefka, R. J.

1991-01-01

This volume contains an antenna location study for the P-3C aircraft. From this location study, a determination can be made of the complete antenna system required to achieve the desired pattern and polarization coverage. The antenna used is the same Batwing airborne UHF satellite communications antenna use in volume 1. The aircraft model used in the majority of the locations studied is the simple cylindrical aircraft model defined in volume 1.

The Development of Concepts of Deviance in Children. Volumes I [and] II: The Development of Concepts of Handicaps: An Interview Study. Volume III: Coding Manual for Interviews about Concepts of Handicaps. Final Report.

ERIC Educational Resources Information Center

Budoff, Milton; And Others

This three volume report presents findings from an interview study with 103 children and adults regarding their awareness and conceptions of handicapping conditions and from a followup study of preschool handicapped and nonhandicapped students. Volume I details the design and results of the interview study focusing on Ss in five age groups:…

In vivo estimation of normal amygdala volume from structural MRI scans with anatomical-based segmentation.

PubMed

Siozopoulos, Achilleas; Thomaidis, Vasilios; Prassopoulos, Panos; Fiska, Aliki

2018-02-01

Literature includes a number of studies using structural MRI (sMRI) to determine the volume of the amygdala, which is modified in various pathologic conditions. The reported values vary widely mainly because of different anatomical approaches to the complex. This study aims at estimating of the normal amygdala volume from sMRI scans using a recent anatomical definition described in a study based on post-mortem material. The amygdala volume has been calculated in 106 healthy subjects, using sMRI and anatomical-based segmentation. The resulting volumes have been analyzed for differences related to hemisphere, sex, and age. The mean amygdalar volume was estimated at 1.42 cm 3 . The mean right amygdala volume has been found larger than the left, but the difference for the raw values was within the limits of the method error. No intersexual differences or age-related alterations have been observed. The study provides a method for determining the boundaries of the amygdala in sMRI scans based on recent anatomical considerations and an estimation of the mean normal amygdala volume from a quite large number of scans for future use in comparative studies.

Renewable Electricity Futures Study - Volume One

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

Hand, Maureen; Mai, Treui; Baldwin, Sam

Renewable Electricity Futures Study - Volume One. This is part of a series of four volumes describing exploring a high-penetration renewable electricity future for the United States of America. This data set is provides data for the entire volume one document and includes all data for the charts and graphs included in the document.

Snow and Ice Control Materials for Texas Roads; VOLUME 1: Literature and Best Practices Review; VOLUME 2: Field Trials and Laboratory Study

DOT National Transportation Integrated Search

2017-03-01

This report provides findings from a four-year research study of snow and ice control materials for winter weather roadway maintenance applications in Texas. The report is presented in two volumes. Volume 1 is a literature review and best practices r...

General Revenue Sharing Data Study: Executive Summary. Volume I.

ERIC Educational Resources Information Center

Wilson, Reese C.; Bowditch, E. Francis, Jr.

The results of the General Revenue Sharing Data Study carried out by Stanford Research Institute for the Office of Revenue Sharing are reported in four volumes. This volume, Executive Summary, presents highlights excerpted from Volumes II, III, and IV. Emphasis is placed on those findings, conclusions, and recommendations that deserve special…

Increasing preload volume with water reduces rated appetite but not food intake in healthy men even with minimum delay between preload and test meal.

PubMed

Gray, Richard W; French, Stephen J; Robinson, Tristan M; Yeomans, Martin R

2003-02-01

The role of gastric volume in the short-term control of eating in humans remains unclear, with some studies reporting that food volume alone can reduce appetite but others finding no such effect. A recent study in our laboratory, found effects of preload volume on subjective appetite (hunger, fullness) but not intake, and found effects of preload energy on intake but not appetite. That study used an interval of 30 min between serving preloads and the test meal, and the present study attempted to maximise the effects of the volume manipulation by removing the delay between the preload and test meal. We administered four soup-based preloads varying in volume (150 and 450 ml) using water, and energy density (1.4 and 4.2 kJ/ml) using maltodextrin, producing three energy levels (209, 629, 629 and 1886 kJ; repeated measures). These were followed immediately by an unlimited hot pasta lunch, during which food weight was monitored continuously by computer. Increasing soup volume at constant energy (629 kJ) reduced appetite ratings, but not intake. In contrast, increasing soup energy at constant volume (450 ml) reduced intake, without affecting appetite. The discrepancies between our results and other reported studies suggest that volume is more influential when intakes are large, or that there may be a threshold concentration for nutrients in the GI tract before volume alone is tangibly expressed in subsequent eating.

A systematic review of the impact of center volume in dialysis.

PubMed

Pieper, Dawid; Mathes, Tim; Marshall, Mark Roger

2015-12-22

A significant relationship exists between the volume of surgical procedures that a given center performs and subsequent outcomes. It seems plausible that such a volume-outcome relationship is also present in dialysis. MEDLINE and EMBASE were searched in November 2014 for non-experimental studies evaluating the association between center volume and patient outcomes [mortality, morbidity, peritonitis, switch to hemodialysis (HD) or any other treatment], without language restrictions or other limits. Selection of relevant studies, data extraction and critical appraisal were performed by two independent reviewers. We did not perform meta-analysis due to clinical and methodological heterogeneity (e.g. different volume categories). 16 studies met out inclusion criteria. Most studies were performed in the US. The study quality ranged from fair to good. Only few items were judged to have a high risk of bias, while many items were judged to have an unclear risk of bias due to insufficient reporting. All 10 studies that analyzed peritoneal dialysis (PD) technique survival by modeling switch to HD or any other treatment as an outcome showed a statistical significant effect. The relative effect measures ranged from 0.25 to 0.94 (median 0.73) in favor of high volume centers. All nine studies indicated a lower mortality for PD in high volume centers, but only study was statistical significant. This systematic review supports a volume-outcome relationship in peritoneal dialysis with respect to switch to HD or any other treatment. An effect on mortality is probably present in HD. Further research is needed to identify and understand the associations of center volume that are causally related to patient benefit.

1978-79 Michigan Social Studies Textbook Study, Volume I.

ERIC Educational Resources Information Center

Chapman, John, M., Ed.

This document represents Volume I of a two volume study to determine the extent to which four elementary level social studies programs reflect the multi-racial, multi-cultural nature of American society. The document is presented in three parts. Part I covers the Michigan Social Studies Textbook Act, an historical overview of previous Michigan…

Post-traumatic changes in, and effect of colloid osmotic pressure on the distribution of body water.

PubMed

Böck, J C; Barker, B C; Clinton, A G; Wilson, M B; Lewis, F R

1989-09-01

The aim of this study was to define the post-traumatic changes in body fluid compartments and to evaluate the effect of plasma colloid osmotic pressure (COP) on the partitioning of body fluid between these compartments. Forty-two measurements of plasma volume (green dye), extracellular volume (bromine), and total body water (deuterium) were done in ten traumatized patients (mean Injury Severity Score, ISS, = 34) and 23 similar control studies were done in eight healthy volunteers who were in stable fluid balance. Interstitial volume, intracellular volume, and blood volume were calculated from measured fluid spaces and hematocrit; COP was directly measured. Studies in volunteers on consecutive days indicated good reproducibility, with coefficients of variation equal to 3.5% for COP, 6.3% for plasma volume, 4.5% for extracellular volume, and 4.9% for total body water. COP values extended over the entire range seen clinically, from 10 to 30 mmHg. Interstitial volume was increased by 55% in patients, but intracellular volume was decreased by 10%. We conclude (1) that posttraumatic peripheral edema resulting from hemodilution is located in the interstitial compartment, with no intracellular space expansion; and (2) that interstitial volume, but not intracellular volume, is closely related to plasma COP.

A comparison between plaque-based and vessel-based measurement for plaque component using volumetric intravascular ultrasound radiofrequency data analysis.

PubMed

Shin, Eun-Seok; Garcia-Garcia, Hector M; Garg, Scot; Serruys, Patrick W

2011-04-01

Although percent plaque components on plaque-based measurement have been used traditionally in previous studies, the impact of vessel-based measurement for percent plaque components have yet to be studied. The purpose of this study was therefore to correlate percent plaque components derived by plaque- and vessel-based measurement using intravascular ultrasound virtual histology (IVUS-VH). The patient cohort comprised of 206 patients with de novo coronary artery lesions who were imaged with IVUS-VH. Age ranged from 35 to 88 years old, and 124 patients were male. Whole pullback analysis was used to calculate plaque volume, vessel volume, and absolute and percent volumes of fibrous, fibrofatty, necrotic core, and dense calcium. The plaque and vessel volumes were well correlated (r = 0.893, P < 0.001). There was a strong correlation between percent plaque components volumes calculated by plaque and those calculated by vessel volumes (fibrous; r = 0.927, P < 0.001, fibrofatty; r = 0.972, P < 0.001, necrotic core; r = 0.964, P < 0.001, dense calcium; r = 0.980, P < 0.001,). Plaque and vessel volumes correlated well to the overall plaque burden. For percent plaque component volume, plaque-based measurement was also highly correlated with vessel-based measurement. Therefore, the percent plaque component volume calculated by vessel volume could be used instead of the conventional percent plaque component volume calculated by plaque volume.

Satellite Power Systems (SPS) concept definition study. Volume 6: SPS technology requirements and verification

NASA Technical Reports Server (NTRS)

Hanley, G.

1978-01-01

Volume 6 of the SPS Concept Definition Study is presented and also incorporates results of NASA/MSFC in-house effort. This volume includes a supporting research and technology summary. Other volumes of the final report that provide additional detail are as follows: (1) Executive Summary; (2) SPS System Requirements; (3) SPS Concept Evolution; (4) SPS Point Design Definition; (5) Transportation and Operations Analysis; and Volume 7, SPS Program Plan and Economic Analysis.

Data availability and feasibility of various techniques to predict response to volume expansion in critically ill patients

PubMed Central

Lanspa, Michael J.; Briggs, Benjamin J.; Hirshberg, Eliotte L.; Pratt, Cristina M.; Grissom, Colin K.; Brown, Samuel M.

2017-01-01

Objective: The accuracy of various techniques to predict response to volume expansion in shock has been studied, but less well known is how feasible these techniques are in the ICU. Methods: This is a prospective observation single-center study of inpatients from a mixed profile ICU who received volume expansion. At time of volume expansion, we determined whether a particular technique to predict response was feasible, according to rules developed from available literature and nurse assessment. Results: We studied 214 volume expansions in 97 patients. The most feasible technique was central venous pressure (50%), followed by vena cava collapsibility, (47%) passive leg raise (42%), and stroke volume variation (22%). Aortic velocity variation, and pulse pressure variation, and were rarely feasible (1% each). In 37% of volume expansions, no technique that we assessed was feasible. Conclusions: Techniques to predict response to volume expansion are infeasible in many patients in shock. PMID:28971030

Pituitary volumes are changed in patients with conversion disorder.

PubMed

Atmaca, Murad; Baykara, Sema; Mermi, Osman; Yildirim, Hanefi; Akaslan, Unsal

2016-03-01

Our study group previously measured pituitary volumes and found a relationship between somatoform disoders and pituitary volumes. Therefore, in conversion disorder, another somatoform disorder, we hypothesized that pituitary gland volumes would be reduced. Twenty female patients and healthy controls were recruited to the present investigation. The volumes of the pituitary gland were determined by using a 1.5 Tesla magnetic resonance scanner. We found that the pituitary gland volumes of the patients with conversion disorder were significantly smaller than those of healthy control subjects. In the patients with conversion disorder but not in the healthy control group, a significant negative correlation between the duration of illness and pituitary gland volume was determined. In summary, in the present study, we suggest that the patients with conversion disorder have smaller pituitary volumes compared to those of healthy control subjects. Further studies should confirm our data and ascertain whether volumetric alterations determined in the patients with conversion disorder can be changed with treatment or if they change over time.

Free volume dependent fluorescence property of PMMA composite: Positron annihilation studies

NASA Astrophysics Data System (ADS)

Ravindrachary, V.; Praveena, S. D.; Bhajantri, R. F.; Ismayil, Crasta, Vincent

2013-02-01

The free volume related fluorescence properties of chalcone chromophore [1-(4-methylphenyl)-3-(4-N, N, dimethylaminophenyl)-2-propen-1-one doped Poly(methyl methacrylate) have been studied using fluorescence spectroscopy and Positron Annihilation lifetime spectroscopy techniques. The fluorescence spectra show that the fluorescence behavior depends on the free volume dependent polymer microstructure and varies with dopant concentration with in the composite. The origin and variation of fluorescence is understood by twisted internal charge transfer state as well as free volume. The Positron annihilation study shows that the free volume related microstructure of the composite is vary with doping level.

Sarawak-west Kalimantan interconnection study. Final report. Volume 1, executive summary. Volume 2, main report. Export trade information

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

NONE

1995-01-06

The study, conducted by Sargent & Lundy, was funded by the U.S. Trade and Development Agency on behalf of the Sarawak Electricity Supply Corporation. The purpose of the project is to determine the feasibility of an interconnection of the electric power systems of Sarawak and West Kalimantan as is being done elsewhere in the region. The report presents technical and economic evaluations and assesses the realibility of the system after the interconnection. The study is divided into three volumes. The report combines the Executive Summary (Volume 1) and the Main Report (Volume 2).

Operationally Efficient Propulsion System Study (OEPSS) data book. Volume 1: Generic ground operations data

NASA Technical Reports Server (NTRS)

Byrd, Raymond J.

1990-01-01

This study was initiated to identify operations problems and cost drivers for current propulsion systems and to identify technology and design approaches to increase the operational efficiency and reduce operations costs for future propulsion systems. To provide readily usable data for the Advance Launch System (ALS) program, the results of the Operationally Efficient Propulsion System Study (OEPSS) were organized into a series of OEPSS Data Books as follows: Volume 1, Generic Ground Operations Data; Volume 2, Ground Operations Problems; Volume 3, Operations Technology; Volume 4, OEPSS Design Concepts; and Volume 5, OEPSS Final Review Briefing, which summarizes the activities and results of the study. This volume presents ground processing data for a generic LOX/LH2 booster and core propulsion system based on current STS experience. The data presented includes: top logic diagram, process flow, activities bar-chart, loaded timelines, manpower requirements in terms of duration, headcount and skill mix per operations and maintenance instruction (OMI), and critical path tasks and durations.

Investigation of relation between visceral and subcutaneous abdominal fat volumes and calcified aortic plaques via multislice computed tomography.

PubMed

Efe, Duran; Aygün, Fatih; Acar, Türker; Yildiz, Melda; Gemici, Kazım

2015-08-01

The present study investigated effect of subcutaneous fat volume and abdominal visceral fat volume on aortic atherosclerosis via multislice computed tomography. The present study comprised 424 subjects who underwent non-contrast-enhanced abdominal CT in our clinic between June 2012 and June 2013. Using dedicated software visceral fat volume was calculated for each individual and then subcutaneous fat volume was calculated by subtracting visceral fat volume from total fat volume. By dividing visceral fat volume/subcutaneous fat volume participants were assigned to three groups according to their mean visceral fat volume/subcutaneous fat volume: Group 1 consisted of subjects with visceral fat volume/subcutaneous fat volume lower than 0.48 (Group 1 < 0.48); Group 2 consisted of subjects with visceral fat volume/subcutaneous fat volume equal to or higher than 0.48 and lower than 0.69 (0.48 ≤ Group 2 < 0.69); and Group 3 consisted of subjects with visceral fat volume/subcutaneous fat volume equal to or higher than 0.69 (Group 3 ≥ 0.69). The mean abdominal aortic calcium scores according to Agatston scoring (au) were 136.8 ± 418.7 au in Group 1, 179.9 ± 463 au in Group 2 and 212.2 ± 486.9 in Group 3, respectively. We have demonstrated a significant correlation between visceral fat volume and abdominal aorta atherosclerosis, while there was absence of significant correlation between subcutaneous fat volume and abdominal atherosclerosis. © The Author(s) 2014.

Bivariate Heritability of Total and Regional Brain Volumes: the Framingham Study

PubMed Central

DeStefano, Anita L.; Seshadri, Sudha; Beiser, Alexa; Atwood, Larry D.; Massaro, Joe M.; Au, Rhoda; Wolf, Philip A.; DeCarli, Charles

2009-01-01

Heritability and genetic and environmental correlations of total and regional brain volumes were estimated from a large, generally healthy, community-based sample, to determine if there are common elements to the genetic influence of brain volumes and white matter hyperintensity volume. There were 1538 Framingham Heart Study participants with brain volume measures from quantitative magnetic resonance imaging (MRI) who were free of stroke and other neurological disorders that might influence brain volumes and who were members of families with at least two Framingham Heart Study participants. Heritability was estimated using variance component methodology and adjusting for the components of the Framingham stroke risk profile. Genetic and environmental correlations between traits were obtained from bivariate analysis. Heritability estimates ranging from 0.46 to 0.60, were observed for total brain, white matter hyperintensity, hippocampal, temporal lobe, and lateral ventricular volumes. Moderate, yet significant, heritability was observed for the other measures. Bivariate analyses demonstrated that relationships between brain volume measures, except for white matter hyperintensity, reflected both moderate to strong shared genetic and shared environmental influences. This study confirms strong genetic effects on brain and white matter hyperintensity volumes. These data extend current knowledge by showing that these two different types of MRI measures do not share underlying genetic or environmental influences. PMID:19812462

Accurate assessment of breast volume: a study comparing the volumetric gold standard (direct water displacement measurement of mastectomy specimen) with a 3D laser scanning technique.

PubMed

Yip, Jia Miin; Mouratova, Naila; Jeffery, Rebecca M; Veitch, Daisy E; Woodman, Richard J; Dean, Nicola R

2012-02-01

Preoperative assessment of breast volume could contribute significantly to the planning of breast-related procedures. The availability of 3D scanning technology provides us with an innovative method for doing this. We performed this study to compare measurements by this technology with breast volume measurement by water displacement. A total of 30 patients undergoing 39 mastectomies were recruited from our center. The volume of each patient's breast(s) was determined with a preoperative 3D laser scan. The volume of the mastectomy specimen was then measured in the operating theater by water displacement. There was a strong linear association between breast volumes measured using the 2 different methods when using a Pearson correlation (r = 0.95, P < 0.001). The mastectomy mean volume was defined by the equation: mastectomy mean volume = (scan mean volume × 1.03) -70.6. This close correlation validates the Cyberware WBX Scanner as a tool for assessment of breast volume.

Volume associations in total hip arthroplasty: a nationwide Taiwan population-based study.

PubMed

Shi, Hon-Yi; Chang, Je-Ken; Chiu, Herng-Chia

2013-12-01

This cohort study retrospectively analyzed 78,364 THAs performed from 1998 to 2009. The mean hospital charge for all THAs performed during the study period was $4,131.9 dollars. The average hospital charges for high-volume hospitals and surgeons were 6% and 7% lower, respectively, than those for low-volume hospitals and surgeons. Analysis by propensity score matching showed that hospital charges significantly differed between THA procedures performed by high- and low-volume hospitals ($3,285.8 dollars versus $4,816.2 dollars, respectively) and between THA procedures performed by high- and low-volume surgeons, ($3,438.5 dollars versus $4,404.7 dollars, respectively) (P < 0.001). The data indicate that analysis and emulation of the treatment strategies used by high-volume hospitals and by high-volume surgeons may reduce overall hospital charges. Copyright © 2013 Elsevier Inc. All rights reserved.

Incidence of missed inferior alveolar nerve blocks in vital asymptomatic subjects and in patients with symptomatic irreversible pulpitis.

PubMed

Fowler, Sara; Reader, Al; Beck, Mike

2015-05-01

The purpose of this retrospective study was to determine the incidence of missed inferior alveolar nerve (IAN) blocks by using a 1- or 2-cartridge volume of 2% lidocaine with 1:100,000 epinephrine in vital asymptomatic teeth and in emergency patients with symptomatic irreversible pulpitis. As part of 37 studies, 3169 subjects/patients were evaluated for missed IAN blocks. The study included 2450 asymptomatic subjects and 719 emergency patients presenting with symptomatic irreversible pulpitis. Each subject or patient received either a 1- or 2-cartridge volume of 2% lidocaine with 1:100,000 epinephrine. A missed block was defined as no lip numbness at 15-20 minutes after the IAN block. The effect of anesthetic volume on the incidence of missed blocks was assessed by using mixed models logistic regression with individual studies as a random effect. The incidence of missed blocks for asymptomatic subjects was 6.3% for the 1-cartridge volume and 3.8% for the 2-cartridge volume. For patients presenting with irreversible pulpitis, the incidence of missed blocks was 7.7% for the 1-cartridge volume and 2.3% for the 2-cartridge volume. In both asymptomatic subjects and patients with irreversible pulpitis, the 2-cartridge volume was significantly (P = .0395) better than the 1-cartridge volume. There were no significant effects for pulpal diagnosis (P = .7523) or the pulpal diagnosis and anesthetic volume interaction (P = .3973). Concerning missed IAN blocks, we concluded that administration of a 2-cartridge volume was significantly better (P = .0395) than a 1-cartridge volume in both asymptomatic subjects and emergency patients presenting with irreversible pulpitis. Copyright © 2015 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

How large is the typical subarachnoid hemorrhage? A review of current neurosurgical knowledge.

PubMed

Whitmore, Robert G; Grant, Ryan A; LeRoux, Peter; El-Falaki, Omar; Stein, Sherman C

2012-01-01

Despite the morbidity and mortality of subarachnoid hemorrhage (SAH), the average volume of a typical hemorrhage is not well defined. Animal models of SAH often do not accurately mimic the human disease process. The purpose of this study is to estimate the average SAH volume, allowing standardization of animal models of the disease. We performed a MEDLINE search of SAH volume and erythrocyte counts in human cerebrospinal fluid as well as for volumes of blood used in animal injection models of SAH, from 1956 to 2010. We polled members of the American Association of Neurological Surgeons (AANS) for estimates of typical SAH volume. Using quantitative data from the literature, we calculated the total volume of SAH as equal to the volume of blood clotted in basal cisterns plus the volume of dispersed blood in cerebrospinal fluid. The results of the AANS poll confirmed our estimates. The human literature yielded 322 publications and animal literature, 237 studies. Four quantitative human studies reported blood clot volumes ranging from 0.2 to 170 mL, with a mean of ∼20 mL. There was only one quantitative study reporting cerebrospinal fluid red blood cell counts from serial lumbar puncture after SAH. Dispersed blood volume ranged from 2.9 to 45.9 mL, and we used the mean of 15 mL for our calculation. Therefore, total volume of SAH equals 35 mL. The AANS poll yielded 176 responses, ranging from 2 to 350 mL, with a mean of 33.9 ± 4.4 mL. Based on our estimate of total SAH volume of 35 mL, animal injection models may now become standardized for more accurate portrayal of the human disease process. Copyright © 2012 Elsevier Inc. All rights reserved.

Change in brain and lesion volumes after CEE therapies: the WHIMS-MRI studies.

PubMed

Coker, Laura H; Espeland, Mark A; Hogan, Patricia E; Resnick, Susan M; Bryan, R Nick; Robinson, Jennifer G; Goveas, Joseph S; Davatzikos, Christos; Kuller, Lewis H; Williamson, Jeff D; Bushnell, Cheryl D; Shumaker, Sally A

2014-02-04

To determine whether smaller brain volumes in older women who had completed Women's Health Initiative (WHI)-assigned conjugated equine estrogen-based hormone therapy (HT), reported by WHI Memory Study (WHIMS)-MRI, correspond to a continuing increased rate of atrophy an average of 6.1 to 7.7 years later in WHIMS-MRI2. A total of 1,230 WHI participants were contacted: 797 (64.8%) consented, and 729 (59%) were rescanned an average of 4.7 years after the initial MRI scan. Mean annual rates of change in total brain volume, the primary outcome, and rates of change in ischemic lesion volumes, the secondary outcome, were compared between treatment groups using mixed-effect models with adjustment for trial, clinical site, age, intracranial volumes, and time between MRI measures. Total brain volume decreased an average of 3.22 cm(3)/y in the active arm and 3.07 cm(3)/y in the placebo arm (p = 0.53). Total ischemic lesion volumes increased in both arms at a rate of 0.12 cm(3)/y (p = 0.88). Conjugated equine estrogen-based postmenopausal HT, previously assigned at WHI baseline, did not affect rates of decline in brain volumes or increases in brain lesion volumes during the 4.7 years between the initial and follow-up WHIMS-MRI studies. Smaller frontal lobe volumes were observed as persistent group differences among women assigned to active HT compared with placebo. Women with a history of cardiovascular disease treated with active HT, compared with placebo, had higher rates of accumulation in white matter lesion volume and total brain lesion volume. Further study may elucidate mechanisms that explain these findings.

Educational Objectives and Academic Performance in Higher Education. Volume 1. Prediction of Academic Performance. Volume 2. Aims and Objectives.

ERIC Educational Resources Information Center

Entwistle, Noel J.; And Others

1977-01-01

Volume 1 discusses a large-scale follow-up study of the correlates of academic success in 2,595 college students. Volume 2 presents a philosophical and historical approach to studying educational objectives. (Available in microfiche from: Carfax Publishing Company, Haddon House, Dorchester-on-Thames, Oxford 0X9 8JZ, England.) (CP)

Inpatient Volume and Quality of Mental Health Care Among Patients With Unipolar Depression.

PubMed

Rasmussen, Line Ryberg; Mainz, Jan; Jørgensen, Mette; Videbech, Poul; Johnsen, Søren Paaske

2018-04-26

The relationship between inpatient volume and the quality of mental health care remains unclear. This study examined the association between inpatient volume in psychiatric hospital wards and quality of mental health care among patients with depression admitted to wards in Denmark. In a nationwide, population-based cohort study, 17,971 patients (N=21,120 admissions) admitted to psychiatric hospital wards between 2011 and 2016 were identified from the Danish Depression Database. Inpatient volume was categorized into quartiles according to the individual ward's average caseload volume per year during the study period: low volume (quartile 1, <102 inpatients per year), medium volume (quartile 2, 102-172 inpatients per year), high volume (quartile 3, 173-227 inpatients per year) and very high volume (quartile 4, >227 inpatients per year). Quality of mental health care was assessed by receipt of process performance measures reflecting national clinical guidelines for care of depression. Compared with patients admitted to low-volume psychiatric hospital wards, patients admitted to very-high-volume wards were more likely to receive a high overall quality of mental health care (≥80% of the recommended process performance measures) (adjusted relative risk [ARR]=1.78, 95% confidence interval [CI]=1.02-3.09) as well as individual processes of care, including a somatic examination (ARR=1.35, CI=1.03-1.78). Admission to very-high-volume psychiatric hospital wards was associated with a greater chance of receiving guideline-recommended process performance measures for care of depression.

Effect of hydration status on atrial and ventricular volumes and function in healthy adult volunteers.

PubMed

Schantz, Daryl I; Dragulescu, Andreea; Memauri, Brett; Grotenhuis, Heynric B; Seed, Mike; Grosse-Wortmann, Lars

2016-10-01

Assessment of cardiac chamber volumes is a fundamental part of cardiac magnetic resonance (CMR) imaging. While the effects of inter- and intraobserver variability have been studied and have a recognized effect on the comparability of serial cardiac MR imaging studies, the effect of differences in hydration status has not been evaluated. To evaluate the effects of volume administration on cardiac chamber volumes. Thirteen healthy adults underwent a baseline cardiac MR to evaluate cardiac chamber volumes after an overnight fast. They were then given two saline boluses of 10 ml/kg of body weight and the cardiac MR was repeated immediately after each bolus. From the baseline scan to the final scan there was a significant increase in all four cardiac chamber end-diastolic volumes. Right atrial volumes increased 8.0%, from 61.1 to 66.0 ml/m2 (P<0.001), and left atrial volumes increased 10.0%, from 50.0 to 55.0 ml/m2 (P<0.001). Right ventricular volumes increased 6.0%, from 91.1 to 96.5 ml/m2 (P<0.001), and left ventricular volumes increased 3.2%, from 87.0 to 89.8 ml/m2 (P<0.001). Hydration status has a significant effect on the end-diastolic volumes of all cardiac chambers assessed by cardiac MR. Thus, hydration represents a "variable" that should be taken into account when assessing cardiac chamber volumes, especially when performing serial imaging studies in a patient.

Correlation between differential renal function estimation using CT-based functional renal parenchymal volume and (99m)Tc - DTPA renal scan.

PubMed

Sarma, Debanga; Barua, Sasanka K; Rajeev, T P; Baruah, Saumar J

2012-10-01

Nuclear renal scan is currently the gold standard imaging study to determine differential renal function. We propose helical CT as single modality for both the anatomical and functional evaluation of kidney with impaired function. In the present study renal parenchymal volume is measured and percent total renal volume is used as a surrogate marker for differential renal function. The objective of this study is to correlate between differential renal function estimation using CT-based renal parenchymal volume measurement with differential renal function estimation using (99m)TC - DTPA renal scan. Twenty-one patients with unilateral obstructive uropathy were enrolled in this prospective comparative study. They were subjected to (99m)Tc - DTPA renal scan and 64 slice helical CT scan which estimates the renal volume depending on the reconstruction of arterial phase images followed by volume rendering and percent renal volume was calculated. Percent renal volume was correlated with percent renal function, as determined by nuclear renal scan using Pearson coefficient. RESULTS AND OBSERVATION: A strong correlation is observed between percent renal volume and percent renal function in obstructed units (r = 0.828, P < 0.001) as well as in nonobstructed units (r = 0.827, P < 0.001). There is a strong correlation between percent renal volume determined by CT scan and percent renal function determined by (99m)TC - DTPA renal scan both in obstructed and in normal units. CT-based percent renal volume can be used as a single radiological tests for both functional and anatomical assessment of impaired renal units.

The capability of satellite borne remote sensors to measure stratospheric trace constituents. Volume 1: Background and requirements

NASA Technical Reports Server (NTRS)

Keitz, E. L.

1978-01-01

Volume 1 of a three volume report issued as MITRE/METREX Technical Report is presented. This volume contains a synthesis of the results of two previous MITRE/METREX studies and an update of the information. These studies deal with a comprehensive review of stratospheric trace constituent measurement requirements. The scope of the study was restricted to those contituents which fall into the general category of air pollutants.

Does Stroke Volume Increase During an Incremental Exercise? A Systematic Review

PubMed Central

Vieira, Stella S.; Lemes, Brunno; de T. C. de Carvalho, Paulo; N. de Lima, Rafael; S. Bocalini, Danilo; A. S. Junior, José; Arsa, Gisela; A. Casarin, Cezar; L. Andrade, Erinaldo; J. Serra, Andrey

2016-01-01

Introduction: Cardiac output increases during incremental-load exercise to meet metabolic skeletal muscle demand. This response requires a fast adjustment in heart rate and stroke volume. The heart rate is well known to increase linearly with exercise load; however, data for stroke volume during incremental-load exercise are unclear. Our objectives were to (a) review studies that have investigated stroke volume on incremental load exercise and (b) summarize the findings for stroke volume, primarily at maximal-exercise load. Methods: A comprehensive review of the Cochrane Library’s, Embase, Medline, SportDiscus, PubMed, and Web of Sci-ence databases was carried out for the years 1985 to the present. The search was performed between February and June 2014 to find studies evaluating changes in stroke volume during incremental-load exercise. Controlled and uncontrolled trials were evaluated for a quality score. Results: The stroke volume data in maximal-exercise load are inconsistent. There is evidence to hypothesis that stroke volume increases during maximal-exercise load, but other lines of evidence indicate that stroke volume reaches a plateau under these circumstances, or even decreases. Conclusion: The stroke volume are unclear, include contradictory evidence. Additional studies with standardized reporting for subjects (e.g., age, gender, physical fitness, and body position), exercise test protocols, and left ventricular function are required to clarify the characteristics of stroke volume during incremental maximal-exercise load. PMID:27347221

Effective orbital volume and eyeball position: an MRI study.

PubMed

Detorakis, Efstathios T; Drakonaki, Eleni; Papadaki, Efrosini; Pallikaris, Ioannis G; Tsilimbaris, Miltiadis K

2010-10-01

Previous studies have examined factors affecting the position of the eyeball to the orbit. This study examined the role of effective orbital volume (EOV), defined as the difference between orbital and eyeball volume, as a determinant of eyeball position, using MRI scans. Forty-six patients were recruited from the Department of Ophthalmology of the University Hospital of Heraklion, Crete Greece. Patients with a history of orbital disease were excluded. Distances between eyeball poles and orbital landmarks were measured in T1 weighted transverse, sagittal and coronal orbital images. The protrusion of the eyeball in the sagittal and transverse planes was recorded. The volume of the eyeball and bony orbit, the EOV, the volume of the extraocular muscles as well as clinical information (age, gender, Hertel exophthalmometry) were also recorded. EOV was significantly associated with orbital volume but not with eyeball volume. EOV was also significantly associated with transverse and sagittal globe protrusions. Females displayed significantly lower orbital and eyeball volumes as well as EOV than males but higher transverse globe protrusion than males. Variations in EOV are associated with orbital volume rather than with eyeball volume. EOV is associated with globe protrusion and may be taken into account in the planning of various procedures, including orbital decompression, treatment of enophthalmos or the size of orbital implants following enucleation.

Volumetric Analysis of Alveolar Bone Defect Using Three-Dimensional-Printed Models Versus Computer-Aided Engineering.

PubMed

Du, Fengzhou; Li, Binghang; Yin, Ningbei; Cao, Yilin; Wang, Yongqian

2017-03-01

Knowing the volume of a graft is essential in repairing alveolar bone defects. This study investigates the 2 advanced preoperative volume measurement methods: three-dimensional (3D) printing and computer-aided engineering (CAE). Ten unilateral alveolar cleft patients were enrolled in this study. Their computed tomographic data were sent to 3D printing and CAE software. A simulated graft was used on the 3D-printed model, and the graft volume was measured by water displacement. The volume calculated by CAE software used mirror-reverses technique. The authors compared the actual volumes of the simulated grafts with the CAE software-derived volumes. The average volume of the simulated bone grafts by 3D-printed models was 1.52 mL, higher than the mean volume of 1.47 calculated by CAE software. The difference between the 2 volumes was from -0.18 to 0.42 mL. The paired Student t test showed no statistically significant difference between the volumes derived from the 2 methods. This study demonstrated that the mirror-reversed technique by CAE software is as accurate as the simulated operation on 3D-printed models in unilateral alveolar cleft patients. These findings further validate the use of 3D printing and CAE technique in alveolar defect repairing.

Students' Reasoning about Invariance of Volume as a Quantity

ERIC Educational Resources Information Center

Kara, Melike

2013-01-01

The aims of this study were to investigate how upper-elementary-grade students compare the volume of rectangular prisms of equal volume (specifically, students' noticing and reasoning for invariance of volume and coordination of the three linear dimensions of rectangular prisms) and how students' levels of sophistication in volume measurement…

Report on Federal Productivity. Volume 2, Productivity Case Studies.

ERIC Educational Resources Information Center

Joint Financial Management Improvement Program, Washington, DC.

Volume 2 contains 15 productivity case studies which illustrate and expand on the causal factors mentioned in volume 1. The cases illustrate many different approaches to productivity measurement improvement. The case studies are: Development of an Output-Productivity Measure for the Air Force Medical Service; Measuring Effectiveness and Efficiency…

A Curriculum Activities Guide to Water Pollution and Environmental Studies, Volume II - Appendices.

ERIC Educational Resources Information Center

Hershey, John T., Ed.; And Others

This publication, Volume II of a two volume set of water pollution studies, contains seven appendices which support the studies. Appendix 1, Water Quality Parameters, consolidates the technical aspects of water quality including chemical, biological, computer program, and equipment information. Appendix 2, Implementation, outlines techniques…

The GABRB1 gene is associated with thalamus volume and modulates the association between thalamus volume and intelligence.

PubMed

Zhu, Bi; Chen, Chuansheng; Xue, Gui; Lei, Xuemei; Li, Jin; Moyzis, Robert K; Dong, Qi; Lin, Chongde

2014-11-15

The GABRB1 gene encodes the beta 1 subunit of the gamma-aminobutyric acid A receptor (GABA A receptor), which is responsible for mediating inhibitory neurotransmission in the thalamus. Potential relationships between the GABRB1 gene, thalamus volume, and intelligence have been suggested by previous clinical studies, but have not been directly examined among nonclinical samples. The current study collected structural MRI, genetic, and behavioral data from 316 healthy Chinese adults (including 187 females and 129 males), and examined associations between GABRB1 variants, thalamus volume, and intelligence (measured by the Wechsler Adult Intelligence Scale Revised). After controlling for intracranial volume, sex, and age, GABRB1 genetic polymorphism at the SNP rs7435958 had the strongest association with thalamus volume (p = 0.002 and 0.00008 for left and right thalamus volumes, respectively), with GG homozygotes having smaller bilateral thalamus volumes than the other genotypes. Furthermore, there were positive correlations between bilateral thalamus volumes and intelligence, especially for GABRB1 rs7435958 GG female homozygotes (r's = 0.31 and 0.29, p < 0.01, for the correlations of intelligence with left and right thalamus volumes, respectively). This study provides the first evidence for the involvement of the GABRB1 gene in the thalamus structure and their interactive effects on intelligence. Future studies of the thalamus-intelligence associations should consider genetic factors as potential moderators. Copyright © 2014 Elsevier Inc. All rights reserved.

Education for Rural Development - A Portfolio of Studies. Volume 3: Health and Nutrition Education.

ERIC Educational Resources Information Center

United Nations Educational, Scientific and Cultural Organization, Bangkok (Thailand). Asian Centre for Educational Innovation for Development.

Volume 3 of a five-volume portfolio of studies reflecting different facets of the concept of education for rural development contains three studies on health and nutrition. The first study, "Health Education in Rural Development," by K. D. Ariyadasa (Sri Lanka), discusses the role of education in the transmission of health and integrated…

Native Hawaiians Study Commission: Report on the Culture, Needs and Concerns of Native Hawaiians. Final Report. Volume II. Claims of Conscience: A Dissenting Study of the Culture, Needs and Concerns of Native Hawaiians.

ERIC Educational Resources Information Center

Department of the Interior, Washington, DC.

Volume II of the final report of the Native Hawaiians Study Commission (NHSC) on the culture, needs, and concerns of native Hawaiians, this book contains a formal dissent to the conclusions and recommendations presented in Volume I made by three of the NHSC commissioners. Its principal criticism is that Volume I fails to address the underlying…

White matter volume loss in amyotrophic lateral sclerosis: A meta-analysis of voxel-based morphometry studies.

PubMed

Chen, Guangxiang; Zhou, Baiwan; Zhu, Hongyan; Kuang, Weihong; Bi, Feng; Ai, Hua; Gu, Zhongwei; Huang, Xiaoqi; Lui, Su; Gong, Qiyong

2018-04-20

Structural neuroimaging studies of white matter (WM) volume in amyotrophic lateral sclerosis (ALS) using voxel-based morphometry (VBM) have yielded inconsistent findings. This study aimed to perform a quantitative voxel-based meta-analysis using effect-size signed differential mapping (ES-SDM) to establish a statistical consensus between published studies for WM volume alterations in ALS. The pooled meta-analysis revealed significant WM volume losses in the bilateral supplementary motor areas (SMAs), bilateral precentral gyri (PGs), left middle cerebellar peduncle and right cerebellum in patients with ALS, involving the corticospinal tract (CST), interhemispheric fibers, subcortical arcuate fibers, projection fibers to the striatum and cortico-ponto-cerebellar tract. The meta-regression showed that the ALS functional rating scale-revised (ALSFRS-R) was positively correlated with decreased WM volume in the bilateral SMAs, whereas illness duration was negatively correlated with WM volume reduction in the right SMA. This study provides a thorough profile of WM volume loss in ALS and robust evidence that ALS is a multisystem neurodegenerative disease that involves a variety of subcortical WM tracts extending beyond motor cortex involvement. Copyright © 2018 Elsevier Inc. All rights reserved.

Brain tissue volumes in the general elderly population. The Rotterdam Scan Study.

PubMed

Ikram, M Arfan; Vrooman, Henri A; Vernooij, Meike W; van der Lijn, Fedde; Hofman, Albert; van der Lugt, Aad; Niessen, Wiro J; Breteler, Monique M B

2008-06-01

We investigated how volumes of cerebrospinal fluid (CSF), grey matter (GM) and white matter (WM) varied with age, sex, small vessel disease and cardiovascular risk factors in the Rotterdam Scan Study. Participants (n=490; 60-90 years) were non-demented and 51.0% had hypertension, 4.9% had diabetes mellitus, 17.8% were current smoker and 54.0% were former smoker. We segmented brain MR-images into GM, normal WM, white matter lesion (WML) and CSF. Brain infarcts were rated visually. Volumes were expressed as percentage of intra-cranial volume. With increasing age, volumes of total brain, normal WM and total WM decreased; that of GM remained unchanged; and that of WML increased, in both men and women. Excluding persons with infarcts did not alter these results. Persons with larger load of small vessel disease had smaller brain volume, especially normal WM volume. Diastolic blood pressure, diabetes mellitus and current smoking were also related to smaller brain volume. In the elderly, higher age, small vessel disease and cardiovascular risk factors are associated with smaller brain volume, especially WM volume.

Factors that influence minority use of high-volume hospitals for colorectal cancer care.

PubMed

Huang, Lyen C; Tran, Thuy B; Ma, Yifei; Ngo, Justine V; Rhoads, Kim F

2015-05-01

Previous studies suggest that minorities cluster in low-quality hospitals despite living close to better performing hospitals. This may contribute to persistent disparities in cancer outcomes. The purpose of this work was to examine how travel distance, insurance status, and neighborhood socioeconomic factors influenced minority underuse of high-volume hospitals for colorectal cancer. The study was a retrospective, cross-sectional, population-based study. All hospitals in California from 1996 to 2006 were included. Patients with colorectal cancer diagnosed and treated in California between 1996 and 2006 were identified using California Cancer Registry data. Multivariable logistic regression models predicting high-volume hospital use were adjusted for age, sex, race, stage, comorbidities, insurance status, and neighborhood socioeconomic factors. A total of 79,231 patients treated in 417 hospitals were included in the study. High-volume hospitals were independently associated with an 8% decrease in the hazard of death compared with other settings. A lower proportion of minorities used high-volume hospitals despite a higher proportion living nearby. Although insurance status and socioeconomic factors were independently associated with high-volume hospital use, only socioeconomic factors attenuated differences in high-volume hospital use of black and Hispanic patients compared with white patients. The use of cross-sectional data and racial and ethnic misclassifications were limitations in this study. Minority patients do not use high-volume hospitals despite improved outcomes and geographic access. Low socioeconomic status predicts low use of high-volume settings in select minority groups. Our results provide a roadmap for developing interventions to increase the use of and access to higher quality care and outcomes. Increasing minority use of high-volume hospitals may require community outreach programs and changes in physician referral practices.

1978-79 Michigan Social Studies Textbook Study, Volume II.

ERIC Educational Resources Information Center

Chapman, John M., Ed.

This document, Volume II of a two-volume report on the extent to which four elementary level social studies programs reflect the multi-racial, multi-cultural nature of American society, contains individual reports of each reviewer. Fifteen reviewers examined textbooks and accompanying instructional materials according to the degree to which they…

Partial volume correction and image analysis methods for intersubject comparison of FDG-PET studies

NASA Astrophysics Data System (ADS)

Yang, Jun

2000-12-01

Partial volume effect is an artifact mainly due to the limited imaging sensor resolution. It creates bias in the measured activity in small structures and around tissue boundaries. In brain FDG-PET studies, especially for Alzheimer's disease study where there is serious gray matter atrophy, accurate estimate of cerebral metabolic rate of glucose is even more problematic due to large amount of partial volume effect. In this dissertation, we developed a framework enabling inter-subject comparison of partial volume corrected brain FDG-PET studies. The framework is composed of the following image processing steps: (1)MRI segmentation, (2)MR-PET registration, (3)MR based PVE correction, (4)MR 3D inter-subject elastic mapping. Through simulation studies, we showed that the newly developed partial volume correction methods, either pixel based or ROI based, performed better than previous methods. By applying this framework to a real Alzheimer's disease study, we demonstrated that the partial volume corrected glucose rates vary significantly among the control, at risk and disease patient groups and this framework is a promising tool useful for assisting early identification of Alzheimer's patients.

True Volumes of Slope Failure Estimated From a Quaternary Mass-Transport Deposit in the Northern South China Sea

NASA Astrophysics Data System (ADS)

Sun, Qiliang; Alves, Tiago M.; Lu, Xiangyang; Chen, Chuanxu; Xie, Xinong

2018-03-01

Submarine slope failure can mobilize large amounts of seafloor sediment, as shown in varied offshore locations around the world. Submarine landslide volumes are usually estimated by mapping their tops and bases on seismic data. However, two essential components of the total volume of failed sediments are overlooked in most estimates: (a) the volume of subseismic turbidites generated during slope failure and (b) the volume of shear compaction occurring during the emplacement of failed sediment. In this study, the true volume of a large submarine landslide in the northern South China Sea is estimated using seismic, multibeam bathymetry and Ocean Drilling Program/Integrated Ocean Drilling Program well data. The submarine landslide was evacuated on the continental slope and deposited in an ocean basin connected to the slope through a narrow moat. This particular character of the sea floor provides an opportunity to estimate the amount of strata remobilized by slope instability. The imaged volume of the studied landslide is 1035 ± 64 km3, 406 ± 28 km3 on the slope and 629 ± 36 km3 in the ocean basin. The volume of subseismic turbidites is 86 km3 (median value), and the volume of shear compaction is 100 km3, which are 8.6% and 9.7% of the landslide volume imaged on seismic data, respectively. This study highlights that the original volume of the failed sediments is significantly larger than that estimated using seismic and bathymetric data. Volume loss related to the generation of landslide-related turbidites and shear compaction must be considered when estimating the total volume of failed strata in the submarine realm.

Brain volume reduction after whole-brain radiotherapy: quantification and prognostic relevance.

PubMed

Hoffmann, Christian; Distel, Luitpold; Knippen, Stefan; Gryc, Thomas; Schmidt, Manuel Alexander; Fietkau, Rainer; Putz, Florian

2018-01-22

Recent studies have questioned the value of adding whole-brain radiotherapy (WBRT) to stereotactic radiosurgery (SRS) for brain metastasis treatment. Neurotoxicity, including radiation-induced brain volume reduction, could be one reason why not all patients benefit from the addition of WBRT. In this study, we quantified brain volume reduction after WBRT and assessed its prognostic significance. Brain volumes of 91 patients with cerebral metastases were measured during a 150-day period after commencing WBRT and were compared with their pretreatment volumes. The average daily relative change in brain volume of each patient, referred to as the "brain volume reduction rate," was calculated. Univariate and multivariate Cox regression analyses were performed to assess the prognostic significance of the brain volume reduction rate, as well as of 3 treatment-related and 9 pretreatment factors. A one-way analysis of variance was used to compare the brain volume reduction rate across recursive partitioning analysis (RPA) classes. On multivariate Cox regression analysis, the brain volume reduction rate was a significant predictor of overall survival after WBRT (P < 0.001), as well as the number of brain metastases (P = 0.002) and age (P = 0.008). Patients with a relatively favorable prognosis (RPA classes 1 and 2) experienced significantly less brain volume decrease after WBRT than patients with a poor prognosis (RPA class 3) (P = 0.001). There was no significant correlation between delivered radiation dose and brain volume reduction rate (P = 0.147). In this retrospective study, a smaller decrease in brain volume after WBRT was an independent predictor of longer overall survival. © The Author(s) 2017. Published by Oxford University Press on behalf of the Society for Neuro-Oncology. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com

The impact of hospital obstetric volume on maternal outcomes in term, non-low-birthweight pregnancies

PubMed Central

Snowden, Jonathan M.; Cheng, Yvonne W.; Emeis, Cathy L.; Caughey, Aaron B.

2014-01-01

Objective The impact of hospital obstetric volume specifically on maternal outcomes remains under-studied. We examined the impact of hospital obstetric volume on maternal outcomes in low-risk women delivering non-low-birthweight infants at term. Study Design We conducted a retrospective cohort study of term, singleton, non-low-birthweight live births between 2007 – 2008 in California. Deliveries were categorized by hospital obstetric volume categories, separately for non-rural hospitals (Category 1: 50 – 1,199 deliveries per year; Category 2: 1,200 – 2,399; Category 3: 2,400 – 3,599, and Category 4: ≥3,600) and rural hospitals (Category R1: 50 – 599 births per year; Category R2: 600 – 1,699; Category R3: ≥1,700). Maternal outcomes were compared using the chi-square test and multivariable logistic regression. Results There were 736,643 births in 267 hospitals that met study criteria. After adjusting for confounders, there were higher rates of postpartum hemorrhage in the lowest-volume rural hospitals (Category R1 aOR 3.06; 95% CI 1.51 – 6.23). Rates of chorioamnionitis, endometritis, severe perineal lacerations, and wound infection did not differ between volume categories. Longer lengths of stay were observed after maternal complications (e.g., chorioamnionitis) in the lowest-volume hospitals (16.9% prolonged length of stay in Category 1 hospitals versus 10.5% in Category 4 hospitals; aOR, 1.91; 95% CI, 1.01 – 3.61 ). Conclusion After confounder adjustment, few maternal outcomes differed by hospital obstetric volume. However, elevated odds of postpartum hemorrhage in low-volume rural hospitals raises the possibility that maternal outcomes may differ by hospital volume and geography. Further research is needed on maternal outcomes in hospitals of different obstetric volumes. PMID:25263732

Major depressive episodes over the course of 7 years and hippocampal subfield volumes at 7 tesla MRI: the PREDICT-MR study.

PubMed

Wisse, L E M; Biessels, G J; Stegenga, B T; Kooistra, M; van der Veen, P H; Zwanenburg, J J M; van der Graaf, Y; Geerlings, M I

2015-04-01

Smaller hippocampal volumes have been associated with major depressive disorder (MDD). The hippocampus consists of several subfields that may be differentially related to MDD. We investigated the association of occurrence of major depressive episodes (MDEs), assessed five times over seven years, with hippocampal subfield and entorhinal cortex volumes at 7 tesla MRI. In this prospective study of randomly selected general practice attendees, MDEs according to DSM-IV-R criteria were assessed at baseline and after 6, 12, 39 and 84 months follow-up. At the last follow-up, a T2 (0.7 mm(3)) 7 tesla MRI scan was obtained in 47 participants (60±10 years). The subiculum, cornu ammonis (CA) 1 to 3, dentate gyrus&CA4 and entorhinal cortex volumes were manually segmented according a published protocol. Of the 47 participants, 13 had one MDE and 5 had multiple MDEs. ANCOVAs, adjusted for age, sex, education and intracranial volume, revealed no significant differences in hippocampal subfield or entorhinal cortex volumes between participants with and without an MDE in the preceding 84 months. Multiple episodes were associated with smaller subiculum volumes (B=-0.03 mL/episode; 95% CI -0.06; -0.003), but not with the other hippocampal subfield volumes, entorhinal cortex, or total hippocampal volume. A limitation of this study is the small sample size which makes replication necessary. In this exploratory study, we found that an increasing number of major depressive episodes was associated with smaller subiculum volumes in middle-aged and older persons, but not with smaller volumes in other hippocampal subfields or the entorhinal cortex. Copyright © 2014 Elsevier B.V. All rights reserved.

[Liver volume, intrahepatic fat and body weight in the course of a lifestyle interventional study: Analysis with quantitative MR-based methods].

PubMed

Bongers, M N; Stefan, N; Fritsche, A; Häring, H-U; Nikolaou, K; Schick, F; Machann, J

2015-04-01

The aim of this study was to investigate potential associations between changes in liver volume, the amount of intrahepatic lipids (IHL) and body weight during lifestyle interventions. In a prospective study 150 patients with an increased risk for developing type 2 diabetes mellitus were included who followed a caloric restriction diet for 6 months. In the retrospective analysis 18 women and 9 men (age range 22-71 years) with an average body mass index (BMI) of 32 kg/m(2) were enrolled. The liver volume was determined at the beginning and after 6 months by three-dimensional magnetic resonance imaging (3D-MRI, echo gradient, opposed-phase) and IHLs were quantified by volume-selective MR spectroscopy in single voxel stimulated echo acquisition mode (STEAM). Univariable and multivariable correlation analyses between changes of liver volume (Δliver volume), intrahepatic lipids (ΔIHL) and body weight (ΔBW) were performed. Univariable correlation analysis in the whole study cohort showed associations between ΔIHL and ΔBW (r = 0.69; p < 0.0001), ΔIHL and Δliver volume (r = 0.66; p = 0.0002) as well as ΔBW and Δliver volume (r = 0.5; p = 0.0073). Multivariable correlation analysis revealed that changes of liver volume are primarily determined by changes in IHL independent of changes in body weight (β = 0.0272; 95% CI: 0.0155-0.034; p < 0.0001). Changes of liver volume during lifestyle interventions are independent of changes of body weight primarily determined by changes of IHL. These results show the reversibility of augmented liver volume in steatosis if it is possible to reduce IHLs during lifestyle interventions.

When high-volume PCI operators in high-volume hospitals move to lower volume hospitals-Do they still maintain high volume and quality of outcomes?

PubMed

Lu, Tsung-Hsueh; Li, Sheng-Tun; Liang, Fu-Wen; Lee, Jo-Chi; Yin, Wei-Hsian

2017-10-31

The aim of this quasi-experimental study was to examine whether high-volume percutaneous coronary intervention (PCI) operators still maintain high volume and quality of outcomes when they moved to lower volume hospitals. Systematic reviews have indicated that high-volume PCI operators and hospitals have higher quality outcomes. However, little is known on whether high PCI volume and high quality outcomes are mainly due to operator characteristics (i.e., skill and experience) and is portable across organizations or whether it is due to hospital characteristics (i.e., equipment, team, and management system) and is less portable. We used Taiwan National Health Insurance claims data 2000-2012 to identify 98 high-volume PCI operators, 10 of whom moved from one hospital to another during the study period. We compared the PCI volume, risk-adjusted mortality ratio, and major adverse cardiovascular event (MACE) ratio before and after moving. Of the 10 high-volume operators who moved, 6 moved from high- to moderate- or low-volume hospitals, with median annual PCI volumes (interquartile range) of 130 (117-165) in prior hospitals and 54 (46-84) in subsequent hospitals (the hospital the operator moved to), and the remaining 4 moved from high to high-volume hospitals, with median annual PCI volumes (interquartile range) of 151 (133-162) in prior hospitals and 193 (178-239) in subsequent hospitals. No significant differences were observed in the risk-adjusted mortality ratios and MACE ratios between high-volume operators and matched controls before and after moving. High-volume operators cannot maintain high volume when they moved from high to moderate or low-volume hospitals; however, the quality of care is maintained. High PCI volume and high-quality outcomes are less portable and more hospital bound. © 2017 Wiley Periodicals, Inc.

Parents and Federal Education Programs. Volume 4: Title VII. The Study of Parental Involvement.

ERIC Educational Resources Information Center

Cadena-Munoz, Raquel; Keesling, J. Ward

This fourth volume in a seven-volume study is part of a larger study of parental involvement in four federal programs in selected school districts across the country. Presented here are results of an intensive examination of school district programs funded by Title VII of the Elementary and Secondary Education Act. Site studies of Title VII…

Education for Rural Development - A Portfolio of Studies. Volume 4: Manpower, Science, and Technology and Extension Education.

ERIC Educational Resources Information Center

United Nations Educational, Scientific and Cultural Organization, Bangkok (Thailand). Asian Centre for Educational Innovation for Development.

Volume 4 in a five-volume portfolio of studies reflecting different facets of the concept of education for rural development consists of three studies. The first study, "Planning for Meeting Manpower Requirements and Training for Self-Employment in Rural Areas," by Jose R. Vergara (Philippines), analyzes the scenario of growth and…

Risk adjustment for case mix and the effect of surgeon volume on morbidity.

PubMed

Maas, Matthew B; Jaff, Michael R; Rordorf, Guy A

2013-06-01

Retrospective studies of large administrative databases have shown higher mortality for procedures performed by low-volume surgeons, but the adequacy of risk adjustment in those studies is in doubt. To determine whether the relationship between surgeon volume and outcomes is an artifact of case mix using a prospective sample of carotid endarterectomy cases. Observational cohort study from January 1, 2008, through December 31, 2010, with preoperative, immediate postoperative, and 30-day postoperative assessments acquired by independent monitors. Urban, tertiary academic medical center. All 841 patients who underwent carotid endarterectomy performed by a vascular surgeon or cerebrovascular neurosurgeon at the institution. Carotid endarterectomy without another concurrent surgery. Stroke, death, and other surgical complications occurring within 30 days of surgery along with other case data. A low-volume surgeon performed 40 or fewer cases per year. Variables used in a comparison administrative database study, as well as variables identified by our univariate analysis, were used for adjusted analyses to assess for an association between low-volume surgeons and the rate of stroke and death as well as other complications. RESULTS The rate of stroke and death was 6.9% for low-volume surgeons and 2.0% for high-volume surgeons (P = .001). Complications were similarly higher (13.4% vs 7.2%, P = .008). Low-volume surgeons performed more nonelective cases. Low-volume surgeons were significantly associated with stroke and death in the unadjusted analysis as well as after adjustment with variables used in the administrative database study (odds ratio, 3.61; 95% CI, 1.70-7.67, and odds ratio, 3.68; 95% CI, 1.72-7.89, respectively). However, adjusting for the significant disparity of American Society of Anesthesiologists Physical Status classification in case mix eliminated the effect of surgeon volume on the rate of stroke and death (odds ratio, 1.65; 95% CI, 0.59-4.64) and other complications. Variables selected for risk adjustment in studies using administrative databases appear to be inadequate to control for case mix bias between low-volume and high-volume surgeons. Risk adjustment should empirically analyze for case mix imbalances between surgeons to identify meaningful risk modifiers in clinical practice such as the American Society of Anesthesiologists Physical Status classification. A true relationship between surgeon volume and outcomes remains uncertain, and caution is advised in developing policies based on these findings.

Comparison of volume estimation methods for pancreatic islet cells

NASA Astrophysics Data System (ADS)

Dvořák, JiřÃ.­; Å vihlík, Jan; Habart, David; Kybic, Jan

2016-03-01

In this contribution we study different methods of automatic volume estimation for pancreatic islets which can be used in the quality control step prior to the islet transplantation. The total islet volume is an important criterion in the quality control. Also, the individual islet volume distribution is interesting -- it has been indicated that smaller islets can be more effective. A 2D image of a microscopy slice containing the islets is acquired. The input of the volume estimation methods are segmented images of individual islets. The segmentation step is not discussed here. We consider simple methods of volume estimation assuming that the islets have spherical or ellipsoidal shape. We also consider a local stereological method, namely the nucleator. The nucleator does not rely on any shape assumptions and provides unbiased estimates if isotropic sections through the islets are observed. We present a simulation study comparing the performance of the volume estimation methods in different scenarios and an experimental study comparing the methods on a real dataset.

Unbiased estimation of the calcaneus volume using the Cavalieri principle on computed tomography images.

PubMed

Acer, N; Bayar, B; Basaloglu, H; Oner, E; Bayar, K; Sankur, S

2008-11-20

The size and shape of tarsal bones are especially relevant when considering some orthopedic diseases such as clubfoot. For this reason, the measurements of the tarsal bones have been the subject of many studies, none of which has used stereological methods to estimate the volume. In the present stereological study, we estimated the volume of calcaneal bone of normal feet and dry bones. We used a combination of the Cavalieri principle and computer tomographic scans taken from eight males and nine dry calcanei to estimate the volumes of calcaneal bones. The mean volume of dry calcaneal bones was estimated, producing mean results using the point-counting method and Archimedes principle being 49.11+/-10.7 or 48.22+/-11.92 cm(3), respectively. A positive correlation was found between anthropometric measurements and the volume of calcaneal bones. The findings of the present study using the stereological methods could provide data for the evaluation of normal and pathological volumes of calcaneal bones.

Thyroid Volume and Its Relation to Anthropometric Measures in a Healthy Cuban Population

PubMed Central

Turcios, Silvia; Lence-Anta, Juan J.; Santana, Jose-Luis; Pereda, Celia M.; Velasco, Milagros; Chappe, Mae; Infante, Idalmis; Bustillo, Marlene; García, Anabel; Clero, Enora; Maillard, Stephane; Rodriguez, Regla; Xhaard, Constance; Ren, Yan; Rubino, Carole; Ortiz, Rosa M.; de Vathaire, Florent

2015-01-01

Objectives The aim of this study was to describe the thyroid volume in healthy adults by ultrasound and to correlate this volume with some anthropometric measures and other differentiated thyroid cancer risk factors. Study Design Thyroid volume and anthropometric measures were recorded in a sample of 100 healthy adults, including 21 men and 79 women aged 18-50 years, living in a non-iodine-deficient area of Havana city. Results The average thyroid volume was 6.6 ± 0.26 ml; it was higher in men (7.3 ml) than in women (6.4 ml; p = 0.15). In the univariate analysis, thyroid volume was correlated with all anthropometric measures, but in the multivariate analysis, body surface area was found to be the only significant anthropometric parameter. Thyroid volume was also higher in current or former smokers and in persons with blood group AB or B. Conclusion Specific reference values of thyroid volume as a function of body surface area could be used for evaluating thyroid volume in clinical practice. The relation between body surface area and thyroid volume is coherent with what is known about the relation of thyroid volume to thyroid cancer risk, but the same is not true about the relation between thyroid volume and smoking habit. PMID:25960963

COMPARATIVE EFFECTIVENESS OF AN ADJUSTABLE TRANSFEMORAL PROSTHETIC INTERFACE ACCOMMODATING VOLUME FLUCTUATION: CASE STUDY

PubMed Central

Kahle, Jason T.; Klenow, Tyler D.; Highsmith, M. Jason

2016-01-01

The socket-limb interface is vital for functionality and provides stability and mobility for the amputee. Volume fluctuation can lead to compromised fit and function. Current socket technology does not accommodate for volume fluctuation. An adjustable interface may improve function and comfort by filling this technology gap. The purpose of this study was to compare the effectiveness of the standard of care (SOC) ischial ramus containment to an adjustable transfemoral prosthetic interface socket in the accommodation of volume fluctuation. A prospective experimental case study using repeated measures of subjective and performance outcome measures between socket conditions was employed. In the baseline volume condition, the adjustable socket improved subjective and performance measures 19% to 37% over SOC, whereas the two-minute walk test demonstrated equivalence. In the volume loss condition, the adjustable socket improved all subjective and performance measures 22% to 93%. All aggregated data improved 16% to 50% compared with the SOC. In simulated volume gain, the SOC socket failed, while the subject was able to complete the protocol using the adjustable socket. In this case study, the SOC socket was inferior to the comparative adjustable transfemoral amputation interface in subjective and performance outcomes. There is a lack of clinical trials and evidence comparing socket functional outcomes related to volume fluctuation. PMID:28066526

Additive gene-environment effects on hippocampal structure in healthy humans.

PubMed

Rabl, Ulrich; Meyer, Bernhard M; Diers, Kersten; Bartova, Lucie; Berger, Andreas; Mandorfer, Dominik; Popovic, Ana; Scharinger, Christian; Huemer, Julia; Kalcher, Klaudius; Pail, Gerald; Haslacher, Helmuth; Perkmann, Thomas; Windischberger, Christian; Brocke, Burkhard; Sitte, Harald H; Pollak, Daniela D; Dreher, Jean-Claude; Kasper, Siegfried; Praschak-Rieder, Nicole; Moser, Ewald; Esterbauer, Harald; Pezawas, Lukas

2014-07-23

Hippocampal volume loss has been related to chronic stress as well as genetic factors. Although genetic and environmental variables affecting hippocampal volume have extensively been studied and related to mental illness, limited evidence is available with respect to G × E interactions on hippocampal volume. The present MRI study investigated interaction effects on hippocampal volume between three well-studied functional genetic variants (COMT Val158Met, BDNF Val66Met, 5-HTTLPR) associated with hippocampal volume and a measure of environmental adversity (life events questionnaire) in a large sample of healthy humans (n = 153). All three variants showed significant interactions with environmental adversity with respect to hippocampal volume. Observed effects were additive by nature and driven by both recent as well as early life events. A consecutive analysis of hippocampal subfields revealed a spatially distinct profile for each genetic variant suggesting a specific role of 5-HTTLPR for the subiculum, BDNF Val66Met for CA4/dentate gyrus, and COMT Val158Met for CA2/3 volume changes. The present study underscores the importance of G × E interactions as determinants of hippocampal volume, which is crucial for the neurobiological understanding of stress-related conditions, such as mood disorders or post-traumatic stress disorder (PTSD). Copyright © 2014 the authors 0270-6474/14/349917-10$15.00/0.

Three dimensional ultrasonography for advanced neurosonography (Neurosofe-3d). Analysis of acquisition-related factors influencing the quality of the brain volumes.

PubMed

Maiz, Nerea; Alonso, Ignacio; Belar, María; Burgos, Jorge; Irasarri, Ana; Molina, Francisca S; de Paco, Catalina; Pijoan, José I; Plasencia, Walter; Rodó, Carlota; Rodríguez, M Angeles; Tajada, Mauricio; Tubau, Albert

2016-11-01

To evaluate the acquisition-related factors influencing the quality of the brain volumes for further study of advanced neurosonography. This was a prospective multicentre study. Five centres were asked to include five cases each, acquiring two volumes per case, at different gestational ages. Ten operators performed an advanced neurosonography per case. The potential influence of the following factors on the number of evaluable structures was assessed: vaginal/ abdominal acquisition, position of the head, gestational age, subjective quality of the volume and the acquiring operator itself. Four hundred and thirty-two evaluations were included in the study. A total of 80% of the structures were evaluated satisfactorily in the axial plane, 67.1% and 55.1% in the coronal and sagittal plane, respectively. Sagittal volumes acquired transvaginally had a better quality than those acquired transabdominally. Gestational age affected the quality of axial and sagittal volumes (p < 0.001), and the best quality was obtained between 20 and 27 weeks. In axial and sagittal volumes, the head position influenced the percentage of structures visualized (p < 0.001, p < 0.001). Factors affecting the quality of the volume for advanced neurosonography are gestational age, fetal head position, transvaginal acquisition in sagittal volumes, the acquiring operator and the subjective quality of the volume. © 2016 John Wiley & Sons, Ltd. © 2016 John Wiley & Sons, Ltd.

Use of the Electronic Medical Record to Assess Pancreas Size in Type 1 Diabetes

PubMed Central

Virostko, John; Hilmes, Melissa; Eitel, Kelsey; Moore, Daniel J.; Powers, Alvin C.

2016-01-01

Aims This study harnessed the electronic medical record to assess pancreas volume in patients with type 1 diabetes (T1D) and matched controls to determine whether pancreas volume is altered in T1D and identify covariates that influence pancreas volume. Methods This study included 25 patients with T1D and 25 age-, sex-, and weight-matched controls from the Vanderbilt University Medical Center enterprise data warehouse. Measurements of pancreas volume were made from medical imaging studies using magnetic resonance imaging (MRI) or computed tomography (CT). Results Patients with T1D had a pancreas volume 47% smaller than matched controls (41.16 ml vs. 77.77 ml, P < 0.0001) as well as pancreas volume normalized by subject body weight, body mass index, or body surface area (all P < 0.0001). Pancreatic volume was smaller with a longer duration of T1D across the patient population (N = 25, P = 0.04). Additionally, four individual patients receiving multiple imaging scans displayed progressive declines in pancreas volume over time (~ 6% of volume/year), whereas five controls scanned a year apart did not exhibit a decline in pancreas size (P = 0.03). The pancreas was uniformly smaller on the right and left side of the abdomen. Conclusions Pancreas volume declines with disease duration in patients with T1D, suggesting a protracted pathological process that may include the exocrine pancreas. PMID:27391588

Change of mean platelet volume values in asthmatic children as an inflammatory marker.

PubMed

Tuncel, T; Uysal, P; Hocaoglu, A B; Erge, D O; Karaman, O; Uzuner, N

2012-01-01

Asthma is the most common chronic disease of childhood in industrialised countries. T helper-2 (Th-2) cells, mast cells and eosinophils have a role in inflammation of asthma. Recently it was shown that platelets also play a role in asthma. Mean platelet volume shows platelet size and reflects platelet activation. The aim of this retrospective study is to evaluate levels of mean platelet volume in asthmatic patients during asymptomatic periods and exacerbations compared with healthy controls. The study consisted of 100 asthmatic patients (male/female: 55/45, mean age: 8.2±3.3) and 49 age and sex matched healthy children as a control group. Mean platelet volume values of asthmatic patients during asymptomatic period were 7.7±0.8fL while mean platelet volume values in asthmatics during exacerbation were 7.8±0.9fL. Comparison of mean platelet volume values of asthmatic patients and healthy controls both in acute asthmatic attack and asymptomatic period showed no difference (p>0.05). Comparison of mean platelet volume values at asthmatic attack and asymptomatic period also had no difference (p>0.05). The presence of atopy, infection, eosinophilia, elevated immunoglobulin E, and severity of acute asthmatic attack did not influence mean platelet volume values. The results of our study suggest that mean platelet volume values may not be used as a marker in bronchial asthma, although prospective studies with larger number of patients are needed to evaluate the role of mean platelet volume in asthma. Copyright © 2011 SEICAP. Published by Elsevier Espana. All rights reserved.

Pineal gland volume in primary insomnia and healthy controls: a magnetic resonance imaging study.

PubMed

Bumb, Jan M; Schilling, Claudia; Enning, Frank; Haddad, Leila; Paul, Franc; Lederbogen, Florian; Deuschle, Michael; Schredl, Michael; Nolte, Ingo

2014-06-01

Little is known about the relation between pineal volume and insomnia. Melatonin promotes sleep processes and, administered as a drug, it is suitable to improve primary and secondary sleep disorders in humans. Recent magnetic resonance imaging studies suggest that human plasma and saliva melatonin levels are partially determined by the pineal gland volume. This study compares the pineal volume in a group of patients with primary insomnia to a group of healthy people without sleep disturbance. Pineal gland volume (PGV) was measured on the basis of high-resolution 3 Tesla MRI (T1-magnetization prepared rapid gradient echo) in 23 patients and 27 controls, matched for age, gender and educational status. Volume measurements were performed conventionally by manual delineation of the pineal borders in multi-planar reconstructed images. Pineal gland volume was significantly smaller (P < 0.001) in patients (48.9 ± 26.6 mm(3) ) than in controls (79 ± 30.2 mm(3) ). In patients PGV correlated negatively with age (r = -0.532; P = 0.026). Adjusting for the effect of age, PGV and rapid eye movement (REM) latency showed a significant positive correlation (rS  = 0.711, P < 0.001) in patients. Pineal volume appears to be reduced in patients with primary insomnia compared to healthy controls. Further studies are needed to clarify whether low pineal volume is the basis or the consequence of functional sleep changes to elucidate the molecular pathology for the pineal volume loss in primary insomnia. © 2014 European Sleep Research Society.

Hippocampal volume changes following electroconvulsive therapy: a systematic review and meta-analysis.

PubMed

Wilkinson, Samuel T; Sanacora, Gerard; Bloch, Michael H

2017-05-01

Reduced hippocampal volume is one of the most consistent morphological findings in Major Depressive Disorder (MDD). Electroconvulsive therapy (ECT) is the most effective therapy for MDD, yet its mechanism of action remains poorly understood. Animal models show that ECT induces several neuroplastic processes, which lead to hippocampal volume increases. We conducted a meta-analysis of ECT studies in humans to investigate its effects on hippocampal volume. PubMed was searched for studies examining hippocampal volume before and after ECT. A random-effects model was used for meta-analysis with standardized mean difference (SMD) of the change in hippocampal volume before and after ECT as the primary outcome. Nine studies involving 174 participants were included. Total hippocampal volumes increased significantly following ECT compared to pre-treatment values (SMD=1.10; 95% CI 0.80-1.39; z=7.34; p<0.001; k=9). Both right (SMD=1.01; 95% CI 0.72-1.30; z=6.76; p<0.001; k=7) and left (SMD=0.87; 95% CI 0.51-1.23; z=4.69; p<0.001; k=7) hippocampal volumes were also similarly increased significantly following ECT. We demonstrated no correlation between improvement in depression symptoms with ECT and change in total hippocampal volume (beta=-1.28, 95% CI -4.51-1.95, z=-0.78, p=0.44). We demonstrate fairly consistent increases in hippocampal volume bilaterally following ECT treatment. The relationship among these volumetric changes and clinical improvement and cognitive side effects of ECT should be explored by larger, multisite studies with harmonized imaging methods.

Fluid responsiveness predicted by transcutaneous partial pressure of oxygen in patients with circulatory failure: a prospective study.

PubMed

Xu, Jingyuan; Peng, Xiao; Pan, Chun; Cai, Shixia; Zhang, Xiwen; Xue, Ming; Yang, Yi; Qiu, Haibo

2017-12-01

Significant effort has been devoted to defining parameters for predicting fluid responsiveness. Our goal was to study the feasibility of predicting fluid responsiveness by transcutaneous partial pressure of oxygen (PtcO 2 ) in the critically ill patients. This was a single-center prospective study conducted in the intensive care unit of a tertiary care teaching hospital. Shock patients who presented with at least one clinical sign of inadequate tissue perfusion, defined as systolic blood pressure <90 mmHg or a decrease >40 mmHg in previously hypertensive patients or the need for vasopressive drugs; urine output <0.5 ml/kg/h for 2 h; tachycardia; lactate >4 mmol/l, for less than 24 h in the absence of a contraindication for fluids were eligible to participate in the study. PtcO 2 was continuously recorded before and during a passive leg raising (PLR) test, and then before and after a 250 ml rapid saline infusion in 10 min. Fluid responsiveness is defined as a change in the stroke volume ≥10% after 250 ml of volume infusion. Thirty-four patients were included, and 14 responded to volume expansion. In the responders, the mean arterial pressure, central venous pressure, cardiac output, stroke volume and PtcO 2 increased significantly, while the heart rate decreased significantly by both PLR and volume expansion. Changes in the stroke volume induced either by PLR or volume expansion were significantly greater in responders than in non-responders. The correlation between the changes in PtcO 2 and stroke volume induced by volume expansion was significant. Volume expansion induced an increase in the PtcO 2 of 14% and PLR induced an increase in PtcO 2 of 13% predicted fluid responsiveness. This study suggested the changes in PtcO 2 induced by volume expansion and a PLR test predicted fluid responsiveness in critically ill patients. Trial registration NCT02083757.

Causes and consequences of reduced blood volume in space flight - A multi-discipline modeling study

NASA Technical Reports Server (NTRS)

Leonard, J. I.

1983-01-01

A group of mathematical models of various physiological systems have been developed and applied to studying problems associated with adaptation to weightlessness. One biomedical issue which could be addressed by at least three of these models from varying perspectives was the reduction in blood volume that universally occurs in astronauts. Accordingly, models of fluid-electrolyte, erythropoiesis, and cardiovascular regulation were employed to study the causes and consequences of blood volume loss during space flight. This analysis confirms the notion that alterations of blood volume are central to an understanding of adaptation to prolonged space flight. More importantly, the modeling studies resulted in specific hypotheses accounting for plasma volume and red cell mass losses and testable predictions concerning the behavior of the circulatory system.

The Relationship between Volume Conservation and a Volume Algorithm for a Rectangular Parallelepiped.

ERIC Educational Resources Information Center

Feghali, Issa Nehme

This study was designed to investigate the relationship between the level of conservation of displaced volume and the degree to which sixth-grade children learn the volume algorithm of a cuboid, namely, volume equals weight times length times height. The problem chosen is based on an apparent discrepancy between the present school programs and…

A Comparison of Height-Accumulation and Volume-Equation Methods for Estimating Tree and Stand Volumes

Treesearch

R.B. Ferguson; V. Clark Baldwin

1995-01-01

Estimating tree and stand volume in mature plantations is time consuming, involving much manpower and equipment; however, several sampling and volume-prediction techniques are available. This study showed that a well-constructed, volume-equation method yields estimates comparable to those of the often more time-consuming, height-accumulation method, even though the...

Aircraft Electrical Systems Specialist (AFSC 42350), Volumes 1-3, and Change Supplement, Volume 3.

ERIC Educational Resources Information Center

Savage, Leslie R.

This three-volume student text is designed for use by Air Force personnel enrolled in a self-study extension course for aircraft electrical systems specialists. Covered in the individual volumes are career field fundamentals, electrical systems and test equipment, and aircraft control and warning systems. Each volume in the set contains a series…

Calculus Students' Understanding of Volume

ERIC Educational Resources Information Center

Dorko, Allison; Speer, Natasha M.

2013-01-01

Researchers have documented difficulties that elementary school students have in understanding volume. Despite its importance in higher mathematics, we know little about college students' understanding of volume. This study investigated calculus students' understanding of volume. Clinical interview transcripts and written responses to volume…

Tri-level study of the causes of traffic accidents, volume 2 : special analyses.

DOT National Transportation Integrated Search

1979-05-01

This final report is comprised of two volumes. Volume I provides causal result tabulations and related analyses. Volume II presents several special analysis reports dealing with driver vision knowledge, psychological make-up, etc. Human, environmenta...

Semiautomatic regional segmentation to measure orbital fat volumes in thyroid-associated ophthalmopathy. A validation study.

PubMed

Comerci, M; Elefante, A; Strianese, D; Senese, R; Bonavolontà, P; Alfano, B; Bonavolontà, B; Brunetti, A

2013-08-01

This study was designed to validate a novel semi-automated segmentation method to measure regional intra-orbital fat tissue volume in Graves' ophthalmopathy. Twenty-four orbits from 12 patients with Graves' ophthalmopathy, 24 orbits from 12 controls, ten orbits from five MRI study simulations and two orbits from a digital model were used. Following manual region of interest definition of the orbital volumes performed by two operators with different levels of expertise, an automated procedure calculated intra-orbital fat tissue volumes (global and regional, with automated definition of four quadrants). In patients with Graves' disease, clinical activity score and degree of exophthalmos were measured and correlated with intra-orbital fat volumes. Operator performance was evaluated and statistical analysis of the measurements was performed. Accurate intra-orbital fat volume measurements were obtained with coefficients of variation below 5%. The mean operator difference in total fat volume measurements was 0.56%. Patients had significantly higher intra-orbital fat volumes than controls (p<0.001 using Student's t test). Fat volumes and clinical score were significantly correlated (p<0.001). The semi-automated method described here can provide accurate, reproducible intra-orbital fat measurements with low inter-operator variation and good correlation with clinical data.

Design Recommendations for Concrete Tunnel Linings : Volume I. Results of Model Tests and Analytical Parameter Studies.

DOT National Transportation Integrated Search

1983-11-01

Volume 1 of this report describes model tests and analytical studies based on experience, interviews with design engineers, and literature reviews, carried out to develop design recommendations for concrete tunnel linings. Volume 2 contains the propo...

Insular Volume Reduction in Patients with Social Anxiety Disorder

PubMed Central

Kawaguchi, Akiko; Nemoto, Kiyotaka; Nakaaki, Shutaro; Kawaguchi, Takatsune; Kan, Hirohito; Arai, Nobuyuki; Shiraishi, Nao; Hashimoto, Nobuhiko; Akechi, Tatsuo

2016-01-01

Despite the fact that social anxiety disorder (SAD) is highly prevalent, there have been only a few structural imaging studies. Moreover, most of them reported about a volume reduction in amygdale, which plays a key role in the neural function of SAD. Insula is another region of interest. Its hyperactivity in regard to processing negative emotional information or interoceptive awareness has been detected in patients with SAD. Referring to these studies, we hypothesized that insular volumes might reduce in patients with SAD and made a comparison of insular volumes between 13 patients with SAD and 18 healthy controls with matched age and gender using voxel-based morphometry. As a result, we found a significant volume reduction in insula in the SAD group. Our results suggest that the patients with SAD might have an insular volume reduction apart from amygdala. Since insula plays a critical role in the pathology of SAD, more attention should be paid not only to functional study but also morphometrical study of insula. PMID:26834652

Volume, Conservation and Instruction: A Classroom Based Solomon Four Group Study of Conflict.

ERIC Educational Resources Information Center

Rowell, J. A.; Dawson, C. J.

1981-01-01

Summarizes a study to widen the applicability of Piagetian theory-based conflict methodology from individual situations to entire classes. A Solomon four group design was used to study effects of conflict instruction on students' (N=127) ability to conserve volume of noncompressible matter and to apply that knowledge to gas volume. (Author/JN)

The Oxford Handbook of Deaf Studies, Language, and Education, Volume 2

ERIC Educational Resources Information Center

Marschark, Marc, Ed.; Spencer, Patricia Elizabeth, Ed.

2010-01-01

"The Oxford Handbook of Deaf Studies, Language, and Education, Volume 2," is an updated edition of the landmark original volume. A range of international experts present a comprehensive overview of the field of deaf studies, language, and education. This area has grown dramatically over the past forty years. From work on the linguistics…

Association between surgeon volume and hospitalisation costs for patients with oral cancer: a nationwide population base study in Taiwan.

PubMed

Lee, C-C; Ho, H-C; Jack, Lee C-C; Su, Y-C; Lee, M-S; Hung, S-K; Chou, Pesus

2010-02-01

Oral cancer leads to a considerable use of and expenditure on health care. Wide resection of the tumour and reconstruction with a pedicle flap/free flap is widely used. This study was conducted to explore the relationship between hospitalisation costs and surgeon case volume when this operation was performed. A population-based study. This study uses data for the years 2005-2006 obtained from the National Health Insurance Research Database published in the Taiwanese National Health Research Institute. From this population-based data, the authors selected a total of 2663 oral cancer patients who underwent tumour resection and reconstruction. Case volume relationships were based on the following criteria; low-, medium-, high-, very high-volume surgeons were defined by or= 56 resections with reconstruction, respectively. Hierarchical linear regression analysis was subsequently performed to explore the relationship between surgeon case volume and the cost and length of hospitalisation. The mean hospitalisation cost among the 2663 patients was US$ 9528 (all costs are given in US dollars). After adjusting for physician, hospital, and patient characteristics in a hierarchical linear regression model, the cost per patient for low-volume surgeons was found to be US$ 741 (P = 0.012) higher than that for medium-volume surgeons, US$ 1546 (P < 0.001) higher than that for high-volume surgeons, and US$ 1820 (P < 0.001) higher than that for very-high-volume surgeons. After adjustment for physician, hospital, and patient characteristics, the hierarchical linear regression model revealed that the mean length of stay per patient for low-volume surgeons was the highest (P < 0.001). After adjustment for physician, hospital, and patient characteristics, low-volume surgeons performing wide excision with reconstructive surgery in oral cancer patients incurred significantly higher costs and longer hospital stays per patient than did other surgeons. Treatment strategies adopted by high- and very-high-volume surgeons should be analysed further and utilised more widely.

Right ventricular volumes assessed by echocardiographic three-dimensional knowledge-based reconstruction compared with magnetic resonance imaging in a clinical setting.

PubMed

Neukamm, Christian; Try, Kirsti; Norgård, Gunnar; Brun, Henrik

2014-01-01

A technique that uses two-dimensional images to create a knowledge-based, three-dimensional model was tested and compared to magnetic resonance imaging. Measurement of right ventricular volumes and function is important in the follow-up of patients after pulmonary valve replacement. Magnetic resonance imaging is the gold standard for volumetric assessment. Echocardiographic methods have been validated and are attractive alternatives. Thirty patients with tetralogy of Fallot (25 ± 14 years) after pulmonary valve replacement were examined. Magnetic resonance imaging volumetric measurements and echocardiography-based three-dimensional reconstruction were performed. End-diastolic volume, end-systolic volume, and ejection fraction were measured, and the results were compared. Magnetic resonance imaging measurements gave coefficient of variation in the intraobserver study of 3.5, 4.6, and 5.3 and in the interobserver study of 3.6, 5.9, and 6.7 for end-diastolic volume, end-systolic volume, and ejection fraction, respectively. Echocardiographic three-dimensional reconstruction was highly feasible (97%). In the intraobserver study, the corresponding values were 6.0, 7.0, and 8.9 and in the interobserver study 7.4, 10.8, and 13.4. In comparison of the methods, correlations with magnetic resonance imaging were r = 0.91, 0.91, and 0.38, and the corresponding coefficient of variations were 9.4, 10.8, and 14.7. Echocardiography derived volumes (mL/m(2)) were significantly higher than magnetic resonance imaging volumes in end-diastolic volume 13.7 ± 25.6 and in end-systolic volume 9.1 ± 17.0 (both P < .05). The knowledge-based three-dimensional right ventricular volume method was highly feasible. Intra and interobserver variabilities were satisfactory. Agreement with magnetic resonance imaging measurements for volumes was reasonable but unsatisfactory for ejection fraction. Knowledge-based reconstruction may replace magnetic resonance imaging measurements for serial follow-up, whereas magnetic resonance imaging should be used for surgical decision making.

Learning curve in transradial cardiac catheterization: procedure-related parameters stratified by operators' transradial volume.

PubMed

Kasasbeh, Ehab S; Parvez, Babar; Huang, Robert L; Hasselblad, Michele Marie; Glazer, Mark D; Salloum, Joseph G; Cleator, John H; Zhao, David X

2012-11-01

To determine whether radial artery access is associated with a reduction in fluoroscopy time, procedure time, and other procedural variables over a 27-month period during which the radial artery approach was incorporated in a single academic Medical Center. Although previous studies have demonstrated a relationship between increased volume and decreased procedural time, no studies have looked at the integration of radial access over time. Data were collected from consecutive patients who presented to the Vanderbilt University Medical Center cardiac catheterization laboratory from January 1, 2009 to April 1, 2011. Patients who underwent radial access diagnostic catheterization with and without percutaneous coronary intervention were included in this study. A total of 1112 diagnostic cardiac catheterizations through the radial access site were analyzed. High-volume, intermediate-volume, and low-volume operators were grouped based on the percentage of procedures performed through a radial approach. From 2009 to 2011, there was a significant decrease in fluoroscopy time in all operator groups for diagnostic catheterization (P=.035). The high-volume operator group had 1.88 and 3.66 minute reductions in fluoroscopy time compared to the intermediate- and low-volume operator groups, respectively (both P<.001). Likewise, the intermediate-volume operator group had a 1.77 minute improvement compared to the low-volume operator group, but this did not reach statistical significance (P=.102). The improvement in fluoroscopy time and other procedure-related parameters was seen after approximately 25 cases with further improvement after 75 cases. The incorporation of the radial access approach in the cardiac catheterization laboratory led to a decrease in fluoroscopy time for each operator and operator group over the last 3 years. Our data demonstrated that higher-volume radial operators have better procedure, room, and fluoroscopy times when compared to intermediate- and low-volume operators. However, lower-volume operators have a reduction in procedure-related parameters with increased radial cases. Number of procedures needed to become sufficient was demonstrated in the current study.

Greater Cincinnati/Northern Kentucky Stroke Study: volume of first-ever ischemic stroke among blacks in a population-based study.

PubMed

Kissela, B; Broderick, J; Woo, D; Kothari, R; Miller, R; Khoury, J; Brott, T; Pancioli, A; Jauch, E; Gebel, J; Shukla, R; Alwell, K; Tomsick, T

2001-06-01

The volume of ischemic stroke on CT scans has been studied in a standardized fashion in acute stroke therapy trials with median volumes between 10.5 to 55 cm(3). The volume of first-ever ischemic stroke in the population is not known. The first phase of the population-based Greater Cincinnati/Northern Kentucky Stroke Study identified all ischemic strokes occurring in blacks in the greater Cincinnati region between January and June of 1993. The patients in this phase of the study who had a first-ever ischemic clinical stroke were identified, and the volume of ischemic stroke was measured. There were 257 verified clinical cases of ischemic stroke, of which 181 had a first-ever ischemic infarct. Imaging was available for 150 of these patients, and 79 had an infarct on the CT or MRI study that was definitely or possibly related to the clinical symptoms. For these patients, volumetric measurements were performed by means of the modified ellipsoid method. The median volume of first-ever ischemic stroke for the 79 patients was 2.5 cm(3) (interquartile range, 0.5 to 8.8 cm(3)). There was a significant relation between location of lesion and infarct size (P<0.001) and between volume and mechanism of stroke (P=0.001). The volume of first-ever ischemic stroke among blacks in our population-based study is smaller than has been previously reported in acute stroke therapy trials. The large proportion of small, mild strokes in blacks may be an important reason for the low percentage of patients who meet the inclusion criteria for tissue plasminogen activator. Further study is necessary to see if these results are generalizable to a multiracial population.

The Health Services Mobility Study Method of Task Analysis and Curriculum Design. Research Report No. 11. Volume 3: Using the Computer to Develop Job Ladders.

ERIC Educational Resources Information Center

Gilpatrick, Eleanor

This document is volume 3 of a four-volume report which describes the components of the Health Services Mobility Study (HSMS) method of task analysis, job ladder design, and curriculum development. Divided into four chapters, volume 3 is a manual for using HSMS computer based statistical procedures to design job structures and job ladders. Chapter…

Volume of logging residues in Oregon, Washington, and California—initial results from a 1969-70 study.

Treesearch

James O. Howard

1971-01-01

A study conducted during 1969-70 in Oregon, Washington, and California indicates that the average net volume of logging residues ranged from 325 to 3,156 cubic feet per acre. The highest volume was on National Forests in the Douglas-fir region, which averaged 2.5 times greater than private lands. The lowest volumes of residue were found in the ponderosa pine region...

Association of over-the-counter pharmaceutical sales with influenza-like-illnesses to patient volume in an urgent care setting.

PubMed

Liu, Timothy Y; Sanders, Jason L; Tsui, Fu-Chiang; Espino, Jeremy U; Dato, Virginia M; Suyama, Joe

2013-01-01

We studied the association between OTC pharmaceutical sales and volume of patients with influenza-like-illnesses (ILI) at an urgent care center over one year. OTC pharmaceutical sales explain 36% of the variance in the patient volume, and each standard deviation increase is associated with 4.7 more patient visits to the urgent care center (p<0.0001). Cross-correlation function analysis demonstrated that OTC pharmaceutical sales are significantly associated with patient volume during non-flu season (p<0.0001), but only the sales of cough and cold (p<0.0001) and thermometer (p<0.0001) categories were significant during flu season with a lag of two and one days, respectively. Our study is the first study to demonstrate and measure the relationship between OTC pharmaceutical sales and urgent care center patient volume, and presents strong evidence that OTC sales predict urgent care center patient volume year round.

Benefit-Cost Analysis of Integrated Paratransit Systems : Volume 3. Scenario Analysis.

DOT National Transportation Integrated Search

1979-09-01

This is the third volume of a six-volume report documenting the results of a study entitled "Benefit-Cost Analysis of Integrated Paratransit Systems." This volume provides detailed results of a series of scenario analyses designed to determine the im...

Measurement of gastric meal and secretion volumes using magnetic resonance imaging

PubMed Central

Hoad, C.L.; Parker, H.; Hudders, N.; Costigan, C.; Cox, E.F.; Perkins, A.C.; Blackshaw, P.E.; Marciani, L.; Spiller, R.C.; Fox, M.R.; Gowland, P.A.

2015-01-01

MRI can assess multiple gastric functions without ionizing radiation. However, time consuming image acquisition and analysis of gastric volume data, plus confounding of gastric emptying measurements by gastric secretions mixed with the test meal have limited its use to research centres. This study presents an MRI acquisition protocol and analysis algorithm suitable for the clinical measurement of gastric volume and secretion volume. Reproducibility of gastric volume measurements was assessed using data from 10 healthy volunteers following a liquid test meal with rapid MRI acquisition within one breath-hold and semi-automated analysis. Dilution of the ingested meal with gastric secretion was estimated using a respiratory-triggered T1 mapping protocol. Accuracy of the secretion volume measurements was assessed using data from 24 healthy volunteers following a mixed (liquid/solid) test meal with MRI meal volumes compared to data acquired using gamma scintigraphy (GS) on the same subjects studied on a separate study day. The mean (SD) coefficient of variance between 3 observers for both total gastric contents (including meal, secretions and air) and just the gastric contents (meal and secretion only) was 3 (2) % at large gastric volumes (> 200 ml). Mean (SD) secretion volumes post meal ingestion were 64 (51) ml and 110 (40) ml at 15 and 75 minutes respectively. Comparison with GS meal volumes, showed that MRI meal only volume (after correction for secretion volume) were similar to GS, with a linear regression gradient (std err) of 1.06 (0.10) and intercept −11 (24) ml. In conclusion, (i) rapid acquisition removed the requirement to image during prolonged breath-hold (ii) semi-automatic analysis greatly reduced time required to derive measurements and (iii) correction for secretion volumes provides accurate assessment of gastric meal volumes and emptying. Together these features provide the scientific basis of a protocol which would be suitable in clinical practice. PMID:25592405

Temporal trends and volume-outcome associations after traumatic brain injury: a 12-year study in Taiwan.

PubMed

Shi, Hon-Yi; Hwang, Shiuh-Lin; Lee, King-Teh; Lin, Chih-Lung

2013-04-01

The purpose of this study was to evaluate temporal trends in traumatic brain injury (TBI); the impact of hospital volume and surgeon volume on length of stay (LOS), hospitalization cost, and in-hospital mortality rate; and to explore predictors of these outcomes in a nationwide population in Taiwan. This population-based patient cohort study retrospectively analyzed 16,956 patients who had received surgical treatment for TBI between 1998 and 2009. Bootstrap estimation was used to derive 95% confidence intervals for differences in effect sizes. Hierarchical linear regression models were used to predict outcomes. Patients treated in very-high-volume hospitals were more responsive than those treated in low-volume hospitals in terms of LOS (-0.11; 95% CI -0.20 to -0.03) and hospitalization cost (-0.28; 95% CI -0.49 to -0.06). Patients treated by high-volume surgeons were also more responsive than those treated by low-volume surgeons in terms of LOS (-0.19; 95% CI -0.37 to -0.01) and hospitalization cost (-0.43; 95% CI -0.81 to -0.05). The mean LOS was 24.3 days and the average LOS for very-high-volume hospitals and surgeons was 61% and 64% shorter, respectively, than that for low-volume hospitals and surgeons. The mean hospitalization cost was US $7,292.10, and the average hospitalization cost for very-high-volume hospitals and surgeons was 19% and 22% lower, respectively, than that for low-volume hospitals and surgeons. Advanced age, male sex, high Charlson Comorbidity Index score, treatment in a low-volume hospital, and treatment by a low-volume surgeon were significantly associated with adverse outcomes (p < 0.001). The data suggest that annual surgical volume is the key factor in surgical outcomes in patients with TBI. The results improve the understanding of medical resource allocation for this surgical procedure, and can help to formulate public health policies for optimizing hospital resource utilization for related diseases.

Total target volume is a better predictor of whole brain dose from gamma stereotactic radiosurgery than the number, shape, or location of the lesions

PubMed Central

Narayanasamy, Ganesh; Smith, Adam; Van Meter, Emily; McGarry, Ronald; Molloy, Janelle A.

2013-01-01

Purpose: To assess the hypothesis that the volume of whole brain that receives a certain dose level is primarily dependent on the treated volume rather than on the number, shape, or location of the lesions. This would help a physician validate the suitability of GammaKnife® based stereotactic radiosurgery (GKSR) prior to treatment. Methods: Simulation studies were performed to establish the hypothesis for both oblong and spherical shaped lesions of various numbers and sizes. Forty patients who underwent GKSR [mean age of 54 years (range 7–80), mean number of lesions of 2.5 (range 1–6), and mean lesion volume of 4.4 cm3 (range 0.02–22.2 cm3)] were also studied retrospectively. Following recommendations of QUANTEC, the volume of brain irradiated by the 12 Gy (VB12) isodose line was measured and a power-law based relation is proposed here for estimating VB12 from the known tumor volume and the prescription dose. Results: In the simulation study on oblong, spherical, and multiple lesions, the volume of brain irradiated by 50%, 10%, and 1% of maximum dose was found to have linear, linear, and exponentially increasing dependence on the volume of the treated region, respectively. In the retrospective study on 40 GKSR patients, a similar relationship was found to predict the brain dose with a Spearman correlation coefficient >0.9. In both the studies, the volume of brain irradiated by a certain dose level does not have a statistically significant relationship (p ≥ 0.05) with the number, shape, or position of the lesions. The measured VB12 agrees with calculation to within 1.7%. Conclusions: The results from the simulation and the retrospective clinical studies indicate that the volume of whole brain that receives a certain percentage of the maximum dose is primarily dependent on the treated volume and less on the number, shape, and location of the lesions. PMID:24007147

Measurement, variation, and scaling of osteocyte lacunae: a case study in birds.

PubMed

D'Emic, Michael D; Benson, Roger B J

2013-11-01

Basic issues surrounding osteocyte biology are still poorly understood, including the variability of osteocyte morphology within and among bones, individuals, and species. Several studies have suggested that the volume or shape of osteocytes (or their lacunae) is related to bone and/or organismal growth rate or metabolism, but the nature of this relationship, if any, is unclear. Furthermore, several studies have linked osteocyte lacuna volume with genome size or growth rate and suggested that osteocyte lacuna volume is unrelated to body size. Herein the scaling of osteocyte lacuna volume with body mass, growth and basal metabolic rates, genome size, and red blood cell size is examined using a broad sample of extant birds within a phylogenetic framework. Over 12,000 osteocyte lacuna axes were measured in a variety of bones from 34 avian and four non-avian dinosaur species. Osteocyte lacunae in parallel-fibered bone are scalene ellipsoids; their morphology and volume cannot be reliably estimated from any single thin section, and using a prolate ellipsoid model to estimate osteocyte lacuna volume results in a substantial (ca. 2-7 times) underestimate relative to true lacunar volume. Orthogonal thin sections reveal that in birds, even when only observing parallel-fibered, primary, cortical bone, intra-skeletal variation in osteocyte lacuna volume and shape is very high (volumes vary by a factor of 5.4 among different bones), whereas variation among homologous bones of the same species is low (1.2-44%; mean=12%). Ordinary and phylogenetically informed bivariate and multiple regressions demonstrate that in birds, osteocyte volume scales significantly but weakly with body mass and mass-specific basal metabolic rate and moderately with genome size, but not with erythrocyte size. Avian whole-body growth rate and osteocyte lacuna volume are weakly and inversely related. Finally, we present the first three-dimensionally calculated osteocyte volumes for several non-avian dinosaurs, which are much larger than previously reported values and smaller than those of large extant avians. Osteocyte volumes estimated from a single transverse section and assuming prolate morphology, as done in previous studies, are relative underestimates in theropod dinosaurs compared to sauropod dinosaurs, raising the possibility that no major change in osteocyte volumes (and genome size) occurred within Theropoda on the lineage leading to birds. Osteocyte volume is intertwined with several organismal attributes whose relative importance varies at a number of hierarchical levels. © 2013.

Association of center volume with outcomes in critically ill children with acute asthma.

PubMed

Gupta, Punkaj; Tang, Xinyu; Gossett, Jeffrey M; Gall, Christine M; Lauer, Casey; Rice, Tom B; Carroll, Christopher L; Kacmarek, Robert M; Wetzel, Randall C

2014-07-01

Little is known about the relation between center volume and outcomes in children requiring intensive care unit (ICU) admission for acute asthma. To evaluate the association of center volume with the odds of receiving positive pressure ventilation and length of ICU stay. Patients 2 to 18 years of age with the primary diagnosis of asthma were included (2009-2012). Center volume was defined as the average number of mechanical ventilator cases per year for any diagnoses during the study period. In multivariable analysis, the odds of receiving positive pressure ventilation (invasive and noninvasive ventilation) and ICU length of stay were evaluated as a function of center volume. Fifteen thousand eighty-three patients from 103 pediatric ICUs with the primary diagnosis of acute asthma met the inclusion criteria. Seven hundred fifty-two patients (5%) received conventional mechanical ventilation and 964 patients (6%) received noninvasive ventilation. In multivariable analysis, center volume was not associated with the odds of receiving any form of positive pressure ventilation in children with acute asthma, with the exception of high- to medium-volume centers. However, ICU length of stay varied with center volume and was noted to be longer in low-volume centers compared with medium- and high-volume centers. In children with acute asthma, this study establishes a relation between center volume and ICU length of stay. However, this study fails to show any significant relation between center volume and the odds of receiving positive pressure ventilation; further analyses are needed to evaluate this relation in more detail. Copyright © 2014 American College of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

Change in brain and lesion volumes after CEE therapies

PubMed Central

Espeland, Mark A.; Hogan, Patricia E.; Resnick, Susan M.; Bryan, R. Nick; Robinson, Jennifer G.; Goveas, Joseph S.; Davatzikos, Christos; Kuller, Lewis H.; Williamson, Jeff D.; Bushnell, Cheryl D.; Shumaker, Sally A.

2014-01-01

Objectives: To determine whether smaller brain volumes in older women who had completed Women's Health Initiative (WHI)-assigned conjugated equine estrogen–based hormone therapy (HT), reported by WHI Memory Study (WHIMS)-MRI, correspond to a continuing increased rate of atrophy an average of 6.1 to 7.7 years later in WHIMS-MRI2. Methods: A total of 1,230 WHI participants were contacted: 797 (64.8%) consented, and 729 (59%) were rescanned an average of 4.7 years after the initial MRI scan. Mean annual rates of change in total brain volume, the primary outcome, and rates of change in ischemic lesion volumes, the secondary outcome, were compared between treatment groups using mixed-effect models with adjustment for trial, clinical site, age, intracranial volumes, and time between MRI measures. Results: Total brain volume decreased an average of 3.22 cm3/y in the active arm and 3.07 cm3/y in the placebo arm (p = 0.53). Total ischemic lesion volumes increased in both arms at a rate of 0.12 cm3/y (p = 0.88). Conclusions: Conjugated equine estrogen–based postmenopausal HT, previously assigned at WHI baseline, did not affect rates of decline in brain volumes or increases in brain lesion volumes during the 4.7 years between the initial and follow-up WHIMS-MRI studies. Smaller frontal lobe volumes were observed as persistent group differences among women assigned to active HT compared with placebo. Women with a history of cardiovascular disease treated with active HT, compared with placebo, had higher rates of accumulation in white matter lesion volume and total brain lesion volume. Further study may elucidate mechanisms that explain these findings. PMID:24384646

Innovation Agents: Vocational Education and Training Skills and Innovation in Australian Industries and Firms. Volume 2

ERIC Educational Resources Information Center

Toner, Phillip; Marceau, Jane; Hall, Richard; Considine, Gillian

2004-01-01

This volume is a companion to "Innovation Agents: VET Skills and Innovation in Australian Industries and Firms. Volume 1". The detailed report of the project is contained in Volume 1 while Volume 2 contains the appendices: (1) Data tables for construction of the composite index of innovation; (2) Case study interview schedule; and (3)…

Olfactory bulb volume in Taiwanese patients with posttraumatic anosmia.

PubMed

Jiang, Rong-San; Chai, Jyh-Wen; Chen, Wen-Hsien; Fuh, Wen-Bin; Chiang, Chin-Ming; Chen, Clayton Chi-Chang

2009-01-01

Olfactory bulb (OB) volume has been shown to be an indicator of olfactory function. However, few studies have been done in Asia to investigate the influence of different disorders on OB volume. Data from patients with posttraumatic anosmia were collected in our department. Their olfactory thresholds were assessed by the phenyl ethyl alcohol threshold test. They were treated with a course of high-dose steroid, and followed up for at least 3 months without any olfactory improvement. Magnetic resonance imaging was subsequently used to measure patients' OB volumes. Subjects who self-reported their olfactory function was normal were also included in the control group for comparison. Fifty-four patients with posttraumatic anosmia and 30 subjects who self-reported their olfactory function was normal were enrolled in this study. The mean right OB volume was 45.2 mm3, and the mean left OB volume was 46.3 mm3 in patients with posttraumatic anosmia. The mean right OB volume was 59.7 mm3, and the mean left OB volume was 66.0 mm3 in control subjects. The OB volumes were significantly lower in patients with posttraumatic anosmia. OB volumes were significantly lower in Taiwanese patients with posttraumatic anosmia.

The volume of the human knee joint.

PubMed

Matziolis, Georg; Roehner, Eric; Windisch, Christoph; Wagner, Andreas

2015-10-01

Despite its clinical relevance, particularly in septic knee surgery, the volume of the human knee joint has not been established to date. Therefore, the objective of this study was to determine knee joint volume and whether or not it is dependent on sex or body height. Sixty-one consecutive patients (joints) who were due to undergo endoprosthetic joint replacement were enrolled in this prospective study. During the operation, the joint volume was determined by injecting saline solution until a pressure of 200 mmHg was achieved in the joint. The average volume of all knee joints was 131 ± 53 (40-290) ml. The volume was not found to be dependent on sex, but it was dependent on the patients' height (R = 0.312, p = 0.014). This enabled an estimation of the joint volume according to V = 1.6 height - 135. The considerable inter-individual variance of the knee joint volume would suggest that it should be determined or at least estimated according to body height if the joint volume has consequences for the diagnostics or therapy of knee disorders.

High-level waste borosilicate glass: A compendium of corrosion characteristics. Volume 2

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

Cunnane, J.C.; Bates, J.K.; Bradley, C.R.

The objective of this document is to summarize scientific information pertinent to evaluating the extent to which high-level waste borosilicate glass corrosion and the associated radionuclide release processes are understood for the range of environmental conditions to which waste glass may be exposed in service. Alteration processes occurring within the bulk of the glass (e.g., devitrification and radiation-induced changes) are discussed insofar as they affect glass corrosion.This document is organized into three volumes. Volumes I and II represent a tiered set of information intended for somewhat different audiences. Volume I is intended to provide an overview of waste glass corrosion,more » and Volume 11 is intended to provide additional experimental details on experimental factors that influence waste glass corrosion. Volume III contains a bibliography of glass corrosion studies, including studies that are not cited in Volumes I and II. Volume I is intended for managers, decision makers, and modelers, the combined set of Volumes I, II, and III is intended for scientists and engineers working in the field of high-level waste.« less

RESIDUAL LIMB VOLUME CHANGE: SYSTEMATIC REVIEW OF MEASUREMENT AND MANAGEMENT

PubMed Central

Sanders, JE; Fatone, S

2014-01-01

Management of residual limb volume affects decisions regarding timing of fit of the first prosthesis, when a new prosthetic socket is needed, design of a prosthetic socket, and prescription of accommodation strategies for daily volume fluctuations. The purpose of this systematic review was to assess what is known about measurement and management of residual limb volume change in persons with lower-limb amputation. Publications that met inclusion criteria were grouped into three categories: (I) descriptions of residual limb volume measurement techniques; (II) studies on people with lower-limb amputation investigating the effect of residual limb volume change on clinical care; and (III) studies of residual limb volume management techniques or descriptions of techniques for accommodating or controlling residual limb volume. The review showed that many techniques for the measurement of residual limb volume have been described but clinical use is limited largely because current techniques lack adequate resolution and in-socket measurement capability. Overall, there is limited evidence regarding the management of residual limb volume, and the evidence available focuses primarily on adults with trans-tibial amputation in the early post-operative phase. While we can draw some insights from the available research about residual limb volume measurement and management, further research is required. PMID:22068373

[Morbidity and mortality rates in relation to the "surgeon factor" after duodenopancreatectomy].

PubMed

Targarona, Javier; Pando, Elizabeth; Garatea, Rafael; Vavoulis, Alexandra; Montoya, Eduardo

2007-10-01

The present study was designed to determine whether the surgeon factor has an independent effect on morbidity and mortality rates after duodenopancreatectomy. Between October 2002 and December 2006, we performed a study of 119 patients who underwent duodenopancreatectomy. The surgeons were divided into 3 groups according to the number of interventions they performed each year: a low volume group (three Whipple procedures per year), a medium volume group (four to 10 Whipple procedures per year) and a high volume group (> 10 Whipple procedures per year). The morbidity rate was higher in the low volume group (82%) than in the high volume group (35%). Length of hospital stay was clearly longer in the low and medium volume groups (27 days, and 21 days) than in the high volume group (17 days). Comparison of the results of the 3 groups revealed that the group performing three or less interventions per year (low volume) had the highest mortality rate (47%), while the group performing more than 10 interventions per year (high volume) had a very low mortality rate (4%). We found that the volume-to-surgeon ratio was inversely proportional to morbidity, length of hospital stay, return to oral intake, and mortality rates. Therefore, increasing surgical volume could improve morbidity and mortality rates.

Paediatric ECMO at low-volume paediatric cardiac centres in the Nordic countries.

PubMed

Veien, M; Lindberg, L; Tynkkynen, P; Ravn, H B

2015-03-01

Extracorporeal membrane oxygenation (ECMO) is a life-saving resource-intensive technology for patients with respiratory and/or circulatory failure. We aimed to evaluate outcome data from three Nordic paediatric centres comparing with data from the International Registry of the Extracorporeal Life Support Organization (ELSO) and selected high-volume single-centre studies. One-hundred nineteen patients < 19 years from 2002 to 2012 were enrolled. Data on demographics and outcome were collected using a standardised registration form. Outcome data were compared with the ELSO registry and high-volume single-centre studies. Demographics, indications and diagnosis were similar to the ELSO register. Survival after ECMO was similar to outcome data from the ELSO register, apart from paediatric cardiac ECMO, where a significantly better survival to discharge was seen in the Nordic centres (68% vs. 49%; P = 0.03). Comparison with high-volume centres in the period after 2005 demonstrated a significantly better survival after cardiac ECMO in a single high-volume centre study, whereas four studies had significantly lower survival after cardiac ECMO. No significant difference was seen in children receiving respiratory ECMO in the Nordic centres and high-volume centres. Survival after ECMO in three low-volume Nordic centres demonstrated comparable outcome data with ELSO data and data from high-volume centres. We believe regular quality assurance surveys, as the present study, should be performed in order to maintain excellent therapy within the individual ECMO centres. © 2015 The Acta Anaesthesiologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.

MX Siting Investigation Geotechnical Evaluation. Volume IA. Nevada-Utah Verification Studies, FY 79.

DTIC Science & Technology

1979-08-24

JUSTIFICATION E ECTE DISTRIUrION, D AVAILABILITY CODES DIST AVAIL AND/OR SPECIAL DATE ACCESSIONED 11 * Original contains color plates: All DTIC reproduct- IA...White River North, Garden- Coal , Reveille-Railroad and Big Smoky CDPs. Section 11.0 briefly explains previous work performed in Dry Lake and Ralston...Hamlin CDP Volume V - White River North CDP Volume VI - Garden- Coal CDP Volume VII - Reveille-Railroad CDP Volume VIII - Big Smoky CDP Volume IX - Dry

[Estimation of volume of pleural fluid and its impact on spirometrical parameters].

PubMed

Karwat, Krzysztof; Przybyłowski, Tadeusz; Bielicki, Piotr; Hildebrand, Katarzyna; Nowacka-Mazurek, Magdalena; Nasiłowski, Jacek; Rubinsztajn, Renata; Chazan, Ryszarda

2014-03-01

In the course of various diseases, there is an accumulation of fluid in the pleural cavities. Pleural fluid accumulation causes thoracic volume expansion and reduction of volume lungs, leading to formation of restrictive disorders. The aim of the study was to estimate the volume of pleural fluid by ultrasonography and to search for the relationship between pleural fluid volume and spirometrical parameters. The study involved 46 patients (26 men, 20 women) aged 65.7 +/- 14 years with pleural effusions who underwent thoracentesis. Thoracentesis was preceded by ultrasonography of the pleura, spirometry test and plethysmography. The volume of the pleural fluid was calculated with the Goecke' and Schwerk' (GS) or Padykuła (P) equations. The obtained values were compared with the actual evacuated volume. The median volume of the removed pleural fluid was 950 ml. Both underestimated the evacuated volume (the median volume 539 ml for GS and 648 ml for P, respectively). Pleural fluid removal resulted in a statistically significant improvement in VC (increase 0.20 +/- 0.35 ; p < 0.05), FEV1 (increase 0.16 +/- 0.32 l; p < 0.05), TLC (increase 0.30 +/- 0.58 l; p < 0.05) and PEF (0.37 +/- 1 l/s; p < 0.05) CONCLUSIONS: Pleural fluid removal causes a significant improvement in lung function parameters. The analyzed equations for fluid volume calculation do not correlate with the actual volume.

Quantitative analysis of aortic regurgitation: real-time 3-dimensional and 2-dimensional color Doppler echocardiographic method--a clinical and a chronic animal study

NASA Technical Reports Server (NTRS)

Shiota, Takahiro; Jones, Michael; Tsujino, Hiroyuki; Qin, Jian Xin; Zetts, Arthur D.; Greenberg, Neil L.; Cardon, Lisa A.; Panza, Julio A.; Thomas, James D.

2002-01-01

BACKGROUND: For evaluating patients with aortic regurgitation (AR), regurgitant volumes, left ventricular (LV) stroke volumes (SV), and absolute LV volumes are valuable indices. AIM: The aim of this study was to validate the combination of real-time 3-dimensional echocardiography (3DE) and semiautomated digital color Doppler cardiac flow measurement (ACM) for quantifying absolute LV volumes, LVSV, and AR volumes using an animal model of chronic AR and to investigate its clinical applicability. METHODS: In 8 sheep, a total of 26 hemodynamic states were obtained pharmacologically 20 weeks after the aortic valve noncoronary (n = 4) or right coronary (n = 4) leaflet was incised to produce AR. Reference standard LVSV and AR volume were determined using the electromagnetic flow method (EM). Simultaneous epicardial real-time 3DE studies were performed to obtain LV end-diastolic volumes (LVEDV), end-systolic volumes (LVESV), and LVSV by subtracting LVESV from LVEDV. Simultaneous ACM was performed to obtain LVSV and transmitral flows; AR volume was calculated by subtracting transmitral flow volume from LVSV. In a total of 19 patients with AR, real-time 3DE and ACM were used to obtain LVSVs and these were compared with each other. RESULTS: A strong relationship was found between LVSV derived from EM and those from the real-time 3DE (r = 0.93, P <.001, mean difference (3D - EM) = -1.0 +/- 9.8 mL). A good relationship between LVSV and AR volumes derived from EM and those by ACM was found (r = 0.88, P <.001). A good relationship between LVSV derived from real-time 3DE and that from ACM was observed (r = 0.73, P <.01, mean difference = 2.5 +/- 7.9 mL). In patients, a good relationship between LVSV obtained by real-time 3DE and ACM was found (r = 0.90, P <.001, mean difference = 0.6 +/- 9.8 mL). CONCLUSION: The combination of ACM and real-time 3DE for quantifying LV volumes, LVSV, and AR volumes was validated by the chronic animal study and was shown to be clinically applicable.

Research Results of the National Day Care Study. Final Report of the National Day Care Study. Volume II.

ERIC Educational Resources Information Center

Travers, Jeffrey; And Others

This final report of the National Day Care Study (NDCS), Volume II, provides researchers, social scientists and lay readers with information for judging the soundness of the evidence underlying NDCS conclusions about relationships between regulatable center characteristics and the outcome of care for the child. Thus, Volume II makes free use of…

Orbitofrontal and caudate volumes in cannabis users: a multi-site mega-analysis comparing dependent versus non-dependent users.

PubMed

Chye, Yann; Solowij, Nadia; Suo, Chao; Batalla, Albert; Cousijn, Janna; Goudriaan, Anna E; Martin-Santos, Rocio; Whittle, Sarah; Lorenzetti, Valentina; Yücel, Murat

2017-07-01

Cannabis (CB) use and dependence are associated with regionally specific alterations to brain circuitry and substantial psychosocial impairment. The objective of this study was to investigate the association between CB use and dependence, and the volumes of brain regions critically involved in goal-directed learning and behaviour-the orbitofrontal cortex (OFC) and caudate. In the largest multi-site structural imaging study of CB users vs healthy controls (HC), 140 CB users and 121 HC were recruited from four research sites. Group differences in OFC and caudate volumes were investigated between HC and CB users and between 70 dependent (CB-dep) and 50 non-dependent (CB-nondep) users. The relationship between quantity of CB use and age of onset of use and caudate and OFC volumes was explored. CB users (consisting of CB-dep and CB-nondep) did not significantly differ from HC in OFC or caudate volume. CB-dep compared to CB-nondep users exhibited significantly smaller volume in the medial and the lateral OFC. Lateral OFC volume was particularly smaller in CB-dep females, and reduced volume in the CB-dep group was associated with higher monthly cannabis dosage. Smaller medial OFC volume may be driven by CB dependence-related mechanisms, while smaller lateral OFC volume may be due to ongoing exposure to cannabinoid compounds. The results highlight a distinction between cannabis use and dependence and warrant examination of gender-specific effects in studies of CB dependence.

Automated linking of suspicious findings between automated 3D breast ultrasound volumes

NASA Astrophysics Data System (ADS)

Gubern-Mérida, Albert; Tan, Tao; van Zelst, Jan; Mann, Ritse M.; Karssemeijer, Nico

2016-03-01

Automated breast ultrasound (ABUS) is a 3D imaging technique which is rapidly emerging as a safe and relatively inexpensive modality for screening of women with dense breasts. However, reading ABUS examinations is very time consuming task since radiologists need to manually identify suspicious findings in all the different ABUS volumes available for each patient. Image analysis techniques to automatically link findings across volumes are required to speed up clinical workflow and make ABUS screening more efficient. In this study, we propose an automated system to, given the location in the ABUS volume being inspected (source), find the corresponding location in a target volume. The target volume can be a different view of the same study or the same view from a prior examination. The algorithm was evaluated using 118 linkages between suspicious abnormalities annotated in a dataset of ABUS images of 27 patients participating in a high risk screening program. The distance between the predicted location and the center of the annotated lesion in the target volume was computed for evaluation. The mean ± stdev and median distance error achieved by the presented algorithm for linkages between volumes of the same study was 7.75±6.71 mm and 5.16 mm, respectively. The performance was 9.54±7.87 and 8.00 mm (mean ± stdev and median) for linkages between volumes from current and prior examinations. The proposed approach has the potential to minimize user interaction for finding correspondences among ABUS volumes.

Optimizing Wartime Materiel Delivery: An Overview of DoD containerization. Volume 2. Framework for Action to Address DoD Containerization Issues

DOT National Transportation Integrated Search

1988-10-01

This second volume of the study entitled, Optimizing Wartime Materiel Delivery: An Overview of DOD Containerization Efforts, -outlines a framework for action to address containerization issues identified in Volume I. The objectives of the study inclu...

Lung Volume Measured during Sequential Swallowing in Healthy Young Adults

ERIC Educational Resources Information Center

Hegland, Karen Wheeler; Huber, Jessica E.; Pitts, Teresa; Davenport, Paul W.; Sapienza, Christine M.

2011-01-01

Purpose: Outcomes from studying the coordinative relationship between respiratory and swallow subsystems are inconsistent for sequential swallows, and the lung volume at the initiation of sequential swallowing remains undefined. The first goal of this study was to quantify the lung volume at initiation of sequential swallowing ingestion cycles and…

The National Teaching & Learning Forum, Volume 1, 1991-92.

ERIC Educational Resources Information Center

Rhem, James, Ed.

1992-01-01

Volume One of this 12 page newsletter includes six issues. Typical features include: a lead article; Research Watch; ERIC Tracks; Case Studies; Case Study Responses; Curriculum; Teaching Assistants (TA) Forum; and Profile (personal and Programmatic). Major articles included in volume one are: "Faculty and Students: Different Ways of…

Longitudinal Assessment of Synovial, Lymph Node, and Bone Volumes in Inflammatory Arthritis in Mice using in vivo MRI and micro-CT

PubMed Central

Proulx, Steven T.; Kwok, Edmund; You, Zhigang; Papuga, M. Owen; Beck, Christopher A.; Shealy, David J.; Ritchlin, Christopher T.; Awad, Hani A.; Boyce, Brendan F.; Xing, Lianping; Schwarz, Edward M.

2009-01-01

Objective Development of longitudinal 3D outcomes of inflammation and bone erosion in murine arthritis using contrast enhanced (CE) MRI and in vivo micro-CT; and in a pilot study, to determine the value of entrance criteria by age versus synovial volume in therapeutic intervention studies. Methods CE-MRI and in vivo micro-CT was performed on TNF-Tg and WT littermates to quantify the synovial and popliteal lymph node (LN) volumes and patella and talus bone volumes, respectively, which were validated with histology. These longitudinal outcome measures were used to assess the natural history of inflammatory-erosive arthritis. We also performed anti-TNF versus placebo efficacy studies in TNF-Tg mice in which treatment was initiated either by age (4–5 months) or synovial volume (3mm3 as detected by CE-MRI). Linear regression was performed to analyze the correlation between synovitis and focal erosion. Results CE-MRI demonstrated the highly variable nature of TNF-induced joint inflammation. Initiation of treatment by synovial volume produced significantly larger treatment effects on synovial volume (p=0.04) and lymph node volume (p<0.01) than initiation by age. By correlating the MRI and microCT data we were able to demonstrate a significant relationship between changes in synovial and patellar volumes (R2 =0.75; p<0.01). Conclusion In vivo CE-MRI and micro-CT 3D outcome measures are powerful tools that accurately demonstrate the progression of inflammatory-erosive arthritis in mice. These methods can be used to identify mice with arthritis of similar severity before intervention studies are initiated and thus minimize heterogeneity in outcome studies of chronic arthritis seen between genetically identical littermates. PMID:18050199

Analysis of the Volumes of the Posterior Cranial Fossa, Cerebellum, and Herniated Tonsils Using the Stereological Methods in Patients with Chiari Type I Malformation

PubMed Central

Vurdem, Ümit Erkan; Acer, Niyazi; Ertekin, Tolga; Savranlar, Ahmet; İnci, Mehmet Fatih

2012-01-01

Objective. The aim of this study was to determine the posterior cranial fossa volume, cerebellar volume, and herniated tonsillar volume in patients with chiari type I malformation and control subjects using stereological methods. Material and Methods. These volumes were estimated retrospectively using the Cavalieri principle as a point-counting technique. We used magnetic resonance images taken from 25 control subjects and 30 patients with chiari type I malformation. Results. The posterior cranial fossa volume in patients with chiari type I malformation was significantly smaller than the volume in the control subjects (P < 0.05). In the chiari type I malformation group, the cerebellar volume was smaller than the control group, but this difference was not statistically significant (P > 0.05). In the chiari type I malformation group, the ratio of cerebellar volume to posterior cranial fossa volume was higher than in the control group. We also found a positive correlation between the posterior cranial fossa volume and cerebellar volume for each of the groups (r = 0.865, P < 0.001). The mean (±SD) herniated tonsillar volume and length were 0.89 ± 0.50 cm3 and 9.63 ± 3.37 mm in the chiari type I malformation group, respectively. Conclusion. This study has shown that posterior cranial fossa and cerebellum volumes can be measured by stereological methods, and the ratio of these measurements can contribute to the evaluation of chiari type I malformation cases. PMID:22629166

Measurement of gastric meal and secretion volumes using magnetic resonance imaging

NASA Astrophysics Data System (ADS)

Hoad, C. L.; Parker, H.; Hudders, N.; Costigan, C.; Cox, E. F.; Perkins, A. C.; Blackshaw, P. E.; Marciani, L.; Spiller, R. C.; Fox, M. R.; Gowland, P. A.

2015-02-01

MRI can assess multiple gastric functions without ionizing radiation. However, time consuming image acquisition and analysis of gastric volume data, plus confounding of gastric emptying measurements by gastric secretions mixed with the test meal have limited its use to research centres. This study presents an MRI acquisition protocol and analysis algorithm suitable for the clinical measurement of gastric volume and secretion volume. Reproducibility of gastric volume measurements was assessed using data from 10 healthy volunteers following a liquid test meal with rapid MRI acquisition within one breath-hold and semi-automated analysis. Dilution of the ingested meal with gastric secretion was estimated using a respiratory-triggered T1 mapping protocol. Accuracy of the secretion volume measurements was assessed using data from 24 healthy volunteers following a mixed (liquid/solid) test meal with MRI meal volumes compared to data acquired using gamma scintigraphy (GS) on the same subjects studied on a separate study day. The mean ± SD coefficient of variance between 3 observers for both total gastric contents (including meal, secretions and air) and just the gastric contents (meal and secretion only) was 3  ±  2% at large gastric volumes (>200 ml). Mean ± SD secretion volumes post meal ingestion were 64  ±  51 ml and 110  ±  40 ml at 15 and 75 min, respectively. Comparison with GS meal volumes, showed that MRI meal only volume (after correction for secretion volume) were similar to GS, with a linear regression gradient ± std err of 1.06  ±  0.10 and intercept -11  ±  24 ml. In conclusion, (i) rapid volume acquisition and respiratory triggered T1 mapping removed the requirement to image during prolonged breath-holds (ii) semi-automatic analysis greatly reduced the time required to derive measurements and (iii) correction for secretion volumes provided accurate assessment of gastric meal volumes and emptying. Together these features provide the scientific basis of a protocol which would be suitable in clinical practice.

Embryonic cardiac morphometry in Carnegie stages 15-23, from the Complutense University of Madrid Institute of Embryology Human Embryo Collection.

PubMed

Arráez-Aybar, L A; Turrero-Nogués, A; Marantos-Gamarra, D G

2008-01-01

We performed a morphometric study of cardiac development on human embryos to complement the scarce data on human embryonic cardiac morphometry and to attempt to establish, from these, algorithms describing cardiac growth during the second month of gestation. Thirty human embryos from Carnegie stages 15-23 were included in the study. Shrinkage and compression effects from fixation and inclusion in paraffin were considered in our calculations. Growth of the cardiac (whole heart) volume and volume of ventricular myocardium through the Carnegie stages were analysed by ANOVA. Linear correlation was used to describe the relationship between the ventricular myocardium and cardiac volumes. Comparisons of models were carried out through the R2 statistic. The relationship volume of ventricular myocardium versus cardiac volume is expressed by the equation: cardiac volume = 0.6266 + 2.4778 volume of ventricular myocardium. The relationship cardiac volume versus crown-rump length is expressed by the equation: cardiac volume = 1.3 e(0.126 CR length), where e is the base of natural logarithms. At a clinical level, these results can contribute towards the establishment of a normogram for cardiac development, useful for the design of strategies for early diagnosis of congenital heart disease. They can also help in the study of embryogenesis, for example in the discussion of ventricular trabeculation. Copyright 2007 S. Karger AG, Basel.

3D photography is a reliable method of measuring infantile haemangioma volume over time.

PubMed

Robertson, Sarah A; Kimble, Roy M; Storey, Kristen J; Gee Kee, Emma L; Stockton, Kellie A

2016-09-01

Infantile haemangiomas are common lesions of infancy. With the development of novel treatments utilised to accelerate their regression, there is a need for a method of assessing these lesions over time. Volume is an ideal assessment method because of its quantifiable nature. This study investigated whether 3D photography is a valid tool for measuring the volume of infantile haemangiomas over time. Thirteen children with infantile haemangiomas presenting to the Vascular Anomalies Clinic, Royal Children's Hospital/Lady Cilento Children's Hospital treated with propranolol were included in the study. Lesion volume was assessed using 3D photography at presentation, one month and three months follow up. Intrarater reliability was determined by retracing all images several months after the initial mapping. Interrater reliability of the 3D camera software was determined by two investigators, blinded to each other's results, independently assessing infantile haemangioma volume. Lesion volume decreased significantly between presentation and three-month follow-up (p<0.001). Volume intra- and interrater reliability were excellent with ICC 0.991 (95% CI 0.982, 0.995) and 0.978 (95% CI 0.955, 0.989), respectively. This study demonstrates images taken with the 3D LifeViz™ camera and lesion volume calculated with Dermapix® software is a reliable method for assessing infantile haemangioma volume over time. Copyright © 2016 Elsevier Inc. All rights reserved.

An analysis of malar fat volume in two age groups: implications for craniofacial surgery.

PubMed

Corey, Christina L; Popelka, Gerald R; Barrera, Jose E; Most, Sam P

2012-12-01

Objective To evaluate how malar fat pad (MFP) volumes vary with age, after controlling for gender and body mass index (BMI). Study Design A prospective case-control study evaluating volume of the MFP in women of two age groups. Methods Soft tissue dimensions were measured in eight subjects using magnetic resonance imaging. A multiplanar localizing sequence, followed in sagittal and coronal orientations using a turbo spin echo sequence, was performed to define the MFP. Volumetric calculations were then performed using a 3D image analysis application (Dextroscope, Volume Interactions, Republic of Singapore) to circumscribe areas, orient dimensions, and calculate volumes of the MFP. Results These data reveal no significant difference in the mean (standard deviation) right MFP (p = 0.50), left MFP (p = 0.41), or total MFP (p = 0.45) volumes when comparing the two age groups. In addition, these data indicate that there was no correlation between age and total MFP volume (Pearson correlation coefficient 0.27). Moreover, there was no correlation between age and the ratio of total volume/BMI (Pearson correlation coefficient -0.18). Conclusions Although the sample size of this study was small, these data indicate that ptosis of midfacial fat is more important than volume loss in midfacial aging. These data would suggest repositioning as the primary modality for craniofacial reconstruction.

Smaller hippocampal volumes predict lower antidepressant response/remission rates in depressed patients: A meta-analysis.

PubMed

Colle, Romain; Dupong, Irène; Colliot, Olivier; Deflesselle, Eric; Hardy, Patrick; Falissard, Bruno; Ducreux, Denis; Chupin, Marie; Corruble, Emmanuelle

2016-08-15

Whether hippocampal volume predicts response and/or remission after antidepressant treatment of major depressive episodes (MDE) in major depressive disorder (MDD) remains unclear. We meta-analysed prospective studies comparing baseline hippocampal volume in patients with or without response/remission after antidepressant treatment. Pubmed, Embase and Google Scholar were searched for studies of patients with current MDE in MDD, with hippocampal volume assessments at baseline, initiation of antidepressant drug treatment, and prospective assessment of response/remission after treatment. Six studies (374 patients), of which two were positive and four negative, were meta-analysed. Compared to responders/remitters, patients who failed to achieve response/remission had smaller total hippocampus volumes at baseline (mean volume difference = 260 mm 3 , 95% CI [93; 427], P = 0.002). These results remained significant in patients under 60 years of age (P = 0.02), in those over 60 years old (P = 0.04), and for right (P = 0.006) and left (P = 0.02) hippocampi. The probability of non-response/non-remission was 68.6% for patients with a total hippocampal volume at least 10% lower than the average, and 47.1% for patients with a total hippocampal volume 10% higher than the average. In depressed patients treated with antidepressant drugs, smaller hippocampal volumes predict lower response/remission rates.

Theoretical study for volume changes associated with the helix-coil transition of peptides.

PubMed

Imai, T; Harano, Y; Kovalenko, A; Hirata, F

2001-12-01

We calculate the partial molar volumes and their changes associated with the coil(extended)-to-helix transition of two types of peptide, glycine-oligomer and glutamic acid-oligomer, in aqueous solutions by using the Kirkwood-Buff solution theory coupled with the three-dimensional reference interaction site model (3D-RISM) theory. The volume changes associated with the transition are small and positive. The volume is analyzed by decomposing it into five contributions following the procedure proposed by Chalikian and Breslauer: the ideal volume, the van der Waals volume, the void volume, the thermal volume, and the interaction volume. The ideal volumes and the van der Waals volumes do not change appreciably upon the transition. In the both cases of glycine-peptide and glutamic acid-peptide, the changes in the void volumes are positive, while those in the thermal volumes are negative, and tend to balance those in the void volumes. The change in the interaction volume of glycine-peptide does not significantly contribute, while that of glutamic acid-peptide makes a negative contribution. Copyright 2001 John Wiley & Sons, Inc. Biopolymers 59: 512-519, 2001

Commencement Bay Study. Volume I. Summary and Synthesis.

DTIC Science & Technology

1981-12-31

Volume II Land and Water Use Volume VI Physical Oceanography Volume III Fish and Wetlands Volume VII Sediments, Noise, Climate and Volume IV...Invertebrates Air Quality, Birds IS. KEY WORDS (Conthwe an fever"e *#do I 06ee87 end idenltf by block -her) Salmonids Wetlands Noise Aesthetics Marine Fish ...ENVIRONMENT 18 4 .1 GENERAL 18 4.2 BENTHIC INVERTSBRATUS 19 4.3 COMMERCIAL AND RECREATIONAL SHELLFISH 22 4.4 FISH 23 4.4.1 juvenile and Adult Salonids 24 4.4.2

Cross-sectional changes in lung volume measured by electrical impedance tomography are representative for the whole lung in ventilated preterm infants.

PubMed

van der Burg, Pauline S; Miedema, Martijn; de Jongh, Frans H; Frerichs, Inez; van Kaam, Anton H

2014-06-01

Electrical impedance tomography measures lung volume in a cross-sectional slice of the lung. Whether these cross-sectional volume changes are representative of the whole lung has only been investigated in adults, showing conflicting results. This study aimed to compare cross-sectional and whole lung volume changes using electrical impedance tomography and respiratory inductive plethysmography. A prospective, single-center, observational, nonrandomized study. The study was conducted in a neonatal ICU in the Netherlands. High-frequency ventilated preterm infants with respiratory distress syndrome. Cross-sectional and whole lung volume changes were continuously and simultaneously measured by, respectively, electrical impedance tomography and respiratory inductive plethysmography during a stepwise recruitment procedure. End-expiratory lung volume changes were assessed by mapping the inflation and deflation limbs using both the pressure/impedance and pressure/inductance pairs and characterized by calculating the inflection points. In addition, oscillatory tidal volume changes were assessed at each pressure step. Twenty-three infants were included in the study. Of these, eight infants had to be excluded because the quality of the registration was insufficient for analysis (two electrical impedance tomography and six respiratory inductive plethysmography). In the remaining 15 infants (gestational age 28.0 ± 2.6 wk; birth weight 1,027 ± 514 g), end-expiratory lung volume changes measured by electrical impedance tomography were significantly correlated to respiratory inductive plethysmography measurements in 12 patients (mean r = 0.93 ± 0.05). This was also true for the upper inflection point on the inflation (r = 0.91, p < 0.01) and deflation limb (r = 0.83, p < 0.01). In 13 patients, impedance and inductance data also correlated significantly on oscillatory tidal volume/pressure relationships (mean r = 0.81 ± 0.18). This study shows that cross-sectional lung volume changes measured by electrical impedance tomography are representative for the whole lung and that this concept also applies to newborn infants.

Effects of the liver volume and donor steatosis on errors in the estimated standard liver volume.

PubMed

Siriwardana, Rohan Chaminda; Chan, See Ching; Chok, Kenneth Siu Ho; Lo, Chung Mau; Fan, Sheung Tat

2011-12-01

An accurate assessment of donor and recipient liver volumes is essential in living donor liver transplantation. Many liver donors are affected by mild to moderate steatosis, and steatotic livers are known to have larger volumes. This study analyzes errors in liver volume estimation by commonly used formulas and the effects of donor steatosis on these errors. Three hundred twenty-five Asian donors who underwent right lobe donor hepatectomy were the subjects of this study. The percentage differences between the liver volumes from computed tomography (CT) and the liver volumes estimated with each formula (ie, the error percentages) were calculated. Five popular formulas were tested. The degrees of steatosis were categorized as follows: no steatosis [n = 178 (54.8%)], ≤ 10% steatosis [n = 128 (39.4%)], and >10% to 20% steatosis [n = 19 (5.8%)]. The median errors ranged from 0.6% (7 mL) to 24.6% (360 mL). The lowest was seen with the locally derived formula. All the formulas showed a significant association between the error percentage and the CT liver volume (P < 0.001). Overestimation was seen with smaller liver volumes, whereas underestimation was seen with larger volumes. The locally derived formula was most accurate when the liver volume was 1001 to 1250 mL. A multivariate analysis showed that the estimation error was dependent on the liver volume (P = 0.001) and the anthropometric measurement that was used in the calculation (P < 0.001) rather than steatosis (P ≥ 0.07). In conclusion, all the formulas have a similar pattern of error that is possibly related to the anthropometric measurement. Clinicians should be aware of this pattern of error and the liver volume with which their formula is most accurate. Copyright © 2011 American Association for the Study of Liver Diseases.

Weight versus volume in breast surgery: an observational study

PubMed Central

Parmar, Chetan; West, Malcolm; Pathak, Samir; Nelson, J; Martin, Lee

2011-01-01

Objectives The study hypothesis is to assess correlation of breast specimen weight versus volume. Design Consecutive patients undergoing breast surgery at a single tertiary referral centre during a 6-month period were included. Specimen weight was measured in grams. Direct volume measurements were performed using water displacement. Data including side of the breast, age and menstrual status of the patient were noted. Setting Knowledge of breast volume provides an objective guide in facilitating the achievements of balance in reconstructive operations. Surgeons use intraoperative weight measurements from individual breasts to calculate the breast volume assuming that weight is equal to the volume of the specimen. However, it is unclear whether weight accurately reveals the true volume of resection. Participants Forty-one patients were included in the study with 28 having bilateral surgeries, 13 having unilateral procedures giving a total of 69 breast specimens. Main outcome measures Breast specimen weight correlation to breast specimen volume. Results The mean age of the group was 42.4 years. Fifty-two specimens were from premenopausal patients and 17 were of postmenopausal. Thirty-five were left-sided. Twenty-six patients had bilateral breast reduction, two had bilateral mastectomy, nine had a unilateral mastectomy and four patients had a unilateral breast reduction. The difference between weight and volume of these breasts was 36.4 units (6.6% difference). The difference in measurement of weight and volume in premenopausal was 37.6 units compared to 32.6 units in postmenopausal women. The density was 1.07 and 1.06, respectively. This was statistically not significant. Conclusions No significant difference between volume and weight was seen in this series. Furthermore, we are unable to support the notion that premenopausal patients have a significant difference in the proportion of fatty and glandular tissue as there was little difference between the weight and the volume. An easy, clinically proper formula for the quantification of actual breast volume has yet to be derived. PMID:22140613

Weight versus volume in breast surgery: an observational study.

PubMed

Parmar, Chetan; West, Malcolm; Pathak, Samir; Nelson, J; Martin, Lee

2011-11-01

The study hypothesis is to assess correlation of breast specimen weight versus volume. Consecutive patients undergoing breast surgery at a single tertiary referral centre during a 6-month period were included. Specimen weight was measured in grams. Direct volume measurements were performed using water displacement. Data including side of the breast, age and menstrual status of the patient were noted. Knowledge of breast volume provides an objective guide in facilitating the achievements of balance in reconstructive operations. Surgeons use intraoperative weight measurements from individual breasts to calculate the breast volume assuming that weight is equal to the volume of the specimen. However, it is unclear whether weight accurately reveals the true volume of resection. Forty-one patients were included in the study with 28 having bilateral surgeries, 13 having unilateral procedures giving a total of 69 breast specimens. Breast specimen weight correlation to breast specimen volume. The mean age of the group was 42.4 years. Fifty-two specimens were from premenopausal patients and 17 were of postmenopausal. Thirty-five were left-sided. Twenty-six patients had bilateral breast reduction, two had bilateral mastectomy, nine had a unilateral mastectomy and four patients had a unilateral breast reduction. The difference between weight and volume of these breasts was 36.4 units (6.6% difference). The difference in measurement of weight and volume in premenopausal was 37.6 units compared to 32.6 units in postmenopausal women. The density was 1.07 and 1.06, respectively. This was statistically not significant. No significant difference between volume and weight was seen in this series. Furthermore, we are unable to support the notion that premenopausal patients have a significant difference in the proportion of fatty and glandular tissue as there was little difference between the weight and the volume. An easy, clinically proper formula for the quantification of actual breast volume has yet to be derived.

Exploring Dutch surgeons' views on volume-based policies: a qualitative interview study.

PubMed

Mesman, Roos; Faber, Marjan J; Westert, Gert P; Berden, Bart

2018-01-01

Objective In many countries, the evidence for volume-outcome associations in surgery has been transferred into policy. Despite the large body of research that exists on the topic, qualitative studies aimed at surgeons' views on, and experiences with, these volume-based policies are lacking. We interviewed Dutch surgeons to gain more insight into the implications of volume-outcome policies for daily clinical practice, as input for effective surgical quality improvement. Methods Semi-structured interviews were conducted with 20 purposively selected surgeons from a stratified sample for hospital type and speciality. The interviews were recorded, transcribed verbatim and underwent inductive content analysis. Results Two overarching themes were inductively derived from the data: (1) minimum volume standards and (2) implications of volume-based policies. Although surgeons acknowledged the premise 'more is better', they were critical about the validity and underlying evidence for minimum volume standards. Patients often inquire about caseload, which is met with both understanding and discomfort. Surgeons offered many examples of controversies surrounding the process of determining thresholds as well as the ways in which health insurers use volume as a purchasing criterion. Furthermore, being held accountable for caseload may trigger undesired strategic behaviour, such as unwarranted operations. Volume-based policies also have implications for the survival of low-volume providers and affect patient travel times, although the latter is not necessarily problematic in the Dutch context. Conclusions Surgeons in this study acknowledged that more volume leads to better quality. However, validity issues, undesired strategic behaviour and the ways in which minimum volume standards are established and applied have made surgeons critical of current policy practice. These findings suggest that volume remains a controversial quality measure and causes polarization that is not conducive to a collective effort for quality improvement. We recommend enforcing thresholds that are based on the best achievable level of consensus and assessing additional criteria when passing judgement on quality of care.

A Systematic Review and Meta-Analysis of the Relationship Between Hospital Volume and the Outcomes of Percutaneous Coronary Intervention

PubMed Central

Lin, Xiaojun; Tao, Hongbing; Cai, Miao; Liao, Aihua; Cheng, Zhaohui; Lin, Haifeng

2016-01-01

Abstract Previous reviews have suggested that hospital volume is inversely related to in-hospital mortality. However, percutaneous coronary intervention (PCI) practices have changed substantially in recent years, and whether this relationship persists remains controversial. A systematic search was performed using PubMed, Embase, and the Cochrane Library to identify studies that describe the effect of hospital volume on the outcomes of PCI. Critical appraisals of the methodological quality and the risk of bias were conducted independently by 2 authors. Fourteen of 96 potentiality relevant articles were included in the analysis. Twelve of the articles described the relationship between hospital volume and mortality and included data regarding odds ratios (ORs); 3 studies described the relationship between hospital volume and long-term survival, and only 1 study included data regarding hazard ratios (HRs). A meta-analysis of postoperative mortality was performed using a random effects model, and the pooled effect estimate was significantly in favor of high volume providers (OR: 0.79; 95% confidence interval [CI], 0.72–0.86; P < 0.001). A systematic review of long-term survival was performed, and a trend toward better long-term survival in high volume hospitals was observed. This meta-analysis only included studies published after 2006 and revealed that postoperative mortality following PCI correlates significantly and inversely with hospital volume. However, the magnitude of the effect of volume on long-term survival is difficult to assess. Additional research is necessary to confirm our findings and to elucidate the mechanism underlying the volume–outcome relationship. PMID:26844508

Quantification of right ventricular volume in dogs: a comparative study between three-dimensional echocardiography and computed tomography with the reference method magnetic resonance imaging.

PubMed

Sieslack, Anne K; Dziallas, Peter; Nolte, Ingo; Wefstaedt, Patrick; Hungerbühler, Stephan O

2014-10-12

Right ventricular (RV) volume and function are important diagnostic and prognostic factors in dogs with primary or secondary right-sided heart failure. The complex shape of the right ventricle and its retrosternal position make the quantification of its volume difficult. For that reason, only few studies exist, which deal with the determination of RV volume parameters. In human medicine cardiac magnetic resonance imaging (CMRI) is considered to be the reference technique for RV volumetric measurement (Nat Rev Cardiol 7(10):551-563, 2010), but cardiac computed tomography (CCT) and three-dimensional echocardiography (3DE) are other non-invasive methods feasible for RV volume quantification. The purpose of this study was the comparison of 3DE and CCT with CMRI, the gold standard for RV volumetric quantification. 3DE showed significant lower and CCT significant higher right ventricular volumes than CMRI. Both techniques showed very good correlations (R > 0.8) with CMRI for the volumetric parameters end-diastolic volume (EDV) and end-systolic volume (ESV). Ejection fraction (EF) and stroke volume (SV) were not different when considering CCT and CMRI, whereas 3DE showed a significant higher EF and lower SV than CMRI. The 3DE values showed excellent intra-observer variability (<3%) and still acceptable inter-observer variability (<13%). CCT provides an accurate image quality of the right ventricle with comparable results to the reference method CMRI. CCT overestimates the RV volumes; therefore, it is not an interchangeable method, having the disadvantage as well of needing general anaesthesia. 3DE underestimated the RV-Volumes, which could be explained by the worse image resolution. The excellent correlation between the methods indicates a close relationship between 3DE and CMRI although not directly comparable. 3DE is a promising technique for RV volumetric quantification, but further studies in awake dogs and dogs with heart disease are necessary to evaluate its usefulness in veterinary cardiology.

Assessing the quality of the volume-outcome relationship in uro-oncology.

PubMed

Mayer, Erik K; Purkayastha, Sanjay; Athanasiou, Thanos; Darzi, Ara; Vale, Justin A

2009-02-01

To assess systematically the quality of evidence for the volume-outcome relationship in uro-oncology, and thus facilitate the formulating of health policy within this speciality, as 'Implementation of Improving Outcome Guidance' has led to centralization of uro-oncology based on published studies that have supported a 'higher volume-better outcome' relationship, but improved awareness of methodological drawbacks in health service research has questioned the strength of this proposed volume-outcome relationship. We systematically searched previous relevant reports and extracted all articles from 1980 onwards assessing the volume-outcome relationship for cystectomy, prostatectomy and nephrectomy at the institution and/or surgeon level. Studies were assessed for their methodological quality using a previously validated rating system. Where possible, meta-analytical methods were used to calculate overall differences in outcome measures between low and high volume healthcare providers. In all, 22 studies were included in the final analysis; 19 of these were published in the last 5 years. Only four studies appropriately explored the effect of both the institution and surgeon volume on outcome measures. Mortality and length of stay were the most frequently measured outcomes. The median total quality scores within each of the operation types were 8.5, 9 and 8 for cystectomy, prostatectomy and nephrectomy, respectively (possible maximum score 18). Random-effects modelling showed a higher risk of mortality in low-volume institutions than in higher-volume institutions for both cystectomy and nephrectomy (odds ratio 1.88, 95% confidence interval 1.54-2.29, and 1.28, 1.10-1.49, respectively). The methodological quality of volume-outcome research as applied to cystectomy, prostatectomy and nephrectomy is only modest at best. Accepting several limitations, pooled analysis confirms a higher-volume, lower-mortality relationship for cystectomy and nephrectomy. Future research should focus on the development of a quality framework with a validated scoring system for the bench-marking of data to improve validity and facilitate rational policy-making within the speciality of uro-oncology.

Comparison of posterior fossa volumes and clinical outcomes after decompression of Chiari malformation Type I.

PubMed

Khalsa, Siri Sahib S; Siu, Alan; DeFreitas, Tiffani A; Cappuzzo, Justin M; Myseros, John S; Magge, Suresh N; Oluigbo, Chima O; Keating, Robert F

2017-05-01

OBJECTIVE Previous studies have indicated an association of Chiari malformation Type I (CM-I) and a small posterior fossa. Most of these studies have been limited by 2D quantitative methods, and more recent studies utilizing 3D methodologies are time-intensive with manual segmentation. The authors sought to develop a more automated tool to calculate the 3D posterior fossa volume, and correlate its changes after decompression with surgical outcomes. METHODS A semiautomated segmentation program was developed, and used to compare the pre- and postoperative volumes of the posterior cranial fossa (PCF) and the CSF spaces (cisterna magna, prepontine cistern, and fourth ventricle) in a cohort of pediatric patients with CM-I. Volume changes were correlated with postoperative symptomatic improvements in headache, syrinx, tonsillar descent, cervicomedullary kinking, and overall surgical success. RESULTS Forty-two pediatric patients were included in this study. The mean percentage increase in PCF volume was significantly greater in patients who showed clinical improvement versus no improvement in headache (5.89% vs 1.54%, p < 0.05) and tonsillar descent (6.52% vs 2.57%, p < 0.05). Overall clinical success was associated with a larger postoperative PCF volume increase (p < 0.05). These clinical improvements were also significantly associated with a larger increase in the volume of the cisterna magna (p < 0.05). The increase in the caudal portion of the posterior fossa volume was also larger in patients who showed improvement in syrinx (6.63% vs 2.58%, p < 0.05) and cervicomedullary kinking (9.24% vs 3.79%, p < 0.05). CONCLUSIONS A greater increase in the postoperative PCF volume, and specifically an increase in the cisterna magna volume, was associated with a greater likelihood of clinical improvements in headache and tonsillar descent in patients with CM-I. Larger increases in the caudal portion of the posterior fossa volume were also associated with a greater likelihood of improvement in syrinx and cervicomedullary kinking.

Preliminary Crater Retention Ages for an Expanded Inventory of Large Lunar Basins

NASA Technical Reports Server (NTRS)

Frey, H. V.

2012-01-01

Based on LOLA topography and a new crustal thickness model, the number of candidate lunar basins greater than 300 km in diameter is at least a factor 2 larger than the traditional number based on photogeology alone, and may be as high as 95. Preliminary N(50) crater retention ages for this population of candidate basins shows two distinct peaks. Frey [1] suggested, based on Clementine-era topography (ULCN2005) and a crustal thickness model based on Lunar Prospector data [2], that there could be as many as 98 lunar basins greater than 300 km diameter. Many of the weaker cases have not stood up to recent testing [3,4,5] using LOLA data and a newer crustal thickness model based on Kaguya gravity data and LOLA topography data [6]. As described in companion abstracts [4,5], we have deleted from the earlier inventory 1 more named feature (Sikorsky- Rittenhouse; LOLA data show that its diameter is actually less than 300 km), 11 Quasi-Circular Depressions (QCDs) identified in the ULCN topography, and 11 Circular Thin Areas (CTAs) found in the earlier crustal thickness model [2]. We did this by repeating the scoring exercise originally done in [1] but with the new data [4,5]. Topographic Expression (TE) and Crustal Thickness Expression (CTE) scores were determined for each candidate on a scale of 0 to 5 (5 being a strong, circular signature, 0 for those with no discernible circular topographic or crustal thickness signature). These scores are added together to produce a Summary Score which has a range of 0 to 10. We eliminated all candidates with a Summary Score less than 3, as well as other cases where, for example, the TE went to zero because what looked like a single large circular QCD in the lower resolution ULCN data was in fact a cluster of smaller deep impacts readily apparent in the newer higher resolution LOLA data. This process reduced the original inventory from 98 to 75 candidates.

Advisory Systems Save Time, Fuel for Airlines

NASA Technical Reports Server (NTRS)

2012-01-01

Heinz Erzberger never thought the sky was falling, but he knew it could benefit from enhanced traffic control. Throughout the 1990s, Erzberger led a team at Ames Research Center to develop a suite of automated tools to reduce restrictions and improve the efficiency of air traffic control operations. Called CTAS, or Center-TRACON (Terminal Radar Approach Control) Automation System, the software won NASA s Software of the Year award in 1998, and one of the tools in the suite - the traffic management advisor - was adopted by the Federal Aviation Administration and implemented at traffic control centers across the United States. Another one of the tools, Direct-To, has followed a different path. The idea behind Direct-To, explains Erzberger, a senior scientist at Ames, was that airlines could save fuel and money by shortening the routes they flew between take-off and landing. Aircraft are often limited to following established airways comprised of inefficient route segments. The routes are not easily adjusted because neither the pilot nor the aircraft controller can anticipate the constantly changing air traffic situation. To make the routes more direct while in flight, Erzberger came up with an idea for a software algorithm that could automatically examine air traffic in real-time, check to see if a shortcut was available, and then check for conflicts. If there were no conflicts and the shortcut saved more than 1 minute of flight time, the controller could be notified. "I was trying to figure out what goes on in the pilot and controller s minds when they decide to guide the aircraft in a certain way. That resulted in a different kind analysis," Erzberger says. As the engineer s idea went from theory to practice, in 2001, NASA demonstrated Direct-To in the airspace of Dallas-Ft. Worth. Estimations based on the demonstration found the technology was capable of saving 900 flying minutes per day for the aircraft in the test area.

Documentation of the GLAS fourth order general circulation model. Volume 1: Model documentation

NASA Technical Reports Server (NTRS)

Kalnay, E.; Balgovind, R.; Chao, W.; Edelmann, J.; Pfaendtner, J.; Takacs, L.; Takano, K.

1983-01-01

The volume 1, of a 3 volume technical memoranda which contains a documentation of the GLAS Fourth Order General Circulation Model is presented. Volume 1 contains the documentation, description of the stratospheric/tropospheric extension, user's guide, climatological boundary data, and some climate simulation studies.

Evidence of Time-Of-Day Pricing In the United States. Volume 2, Appendices and Case Studies

DOT National Transportation Integrated Search

1984-05-01

This is the companion volume to the research report, Evidence on Time of Transit Pricing in the United States. This volume serves as an expanded appendix to the Volume 1 report, principally providing detailed case-by-case summaries on experiences wit...

Subcortical intelligence: caudate volume predicts IQ in healthy adults.

PubMed

Grazioplene, Rachael G; G Ryman, Sephira; Gray, Jeremy R; Rustichini, Aldo; Jung, Rex E; DeYoung, Colin G

2015-04-01

This study examined the association between size of the caudate nuclei and intelligence. Based on the central role of the caudate in learning, as well as neuroimaging studies linking greater caudate volume to better attentional function, verbal ability, and dopamine receptor availability, we hypothesized the existence of a positive association between intelligence and caudate volume in three large independent samples of healthy adults (total N = 517). Regression of IQ onto bilateral caudate volume controlling for age, sex, and total brain volume indicated a significant positive correlation between caudate volume and intelligence, with a comparable magnitude of effect across each of the three samples. No other subcortical structures were independently associated with IQ, suggesting a specific biological link between caudate morphology and intelligence. © 2014 Wiley Periodicals, Inc.

Satellite Power Systems (SPS) concept definition study, exhibit C. Volume 4: Transportation analysis

NASA Technical Reports Server (NTRS)

Hanley, G. M.

1979-01-01

Volume 4 of a seven volume Satellite Power Systems (SPS) is presented. This volume is divided into the following sections: (1) transportation systems elements; (2) transportation systems requirements; (3) heavy lift launch vehicles (HLLV); (4) LEO-GEO transportation; (5) on-orbit mobility systems; (6) personnel transfer systems; and (7) cost and programmatics. Three appendixes are also provided and they include: horizontal takeoff (single stage to orbit technical summary); HLLV reference vehicle trajectory and trade study data; and electric orbital transfer vehicle sizing.

Working Papers in Dialogue Modeling, Volume 2.

ERIC Educational Resources Information Center

Mann, William C.; And Others

The technical working papers that comprise the two volumes of this document are related to the problem of creating a valid process model of human communication in dialogue. In Volume 2, the first paper concerns study methodology, and raises such issues as the choice between system-building and process-building, and the advantages of studying cases…

Market projections of cellulose nanomaterial-enabled products-- Part 2: Volume estimates

Treesearch

John Cowie; E.M. (Ted) Bilek; Theodore H. Wegner; Jo Anne Shatkin

2014-01-01

Nanocellulose has enormous potential to provide an important materials platform in numerous product sectors. This study builds on previous work by the same authors in which likely high-volume, low-volume, and novel applications for cellulosic nanomaterials were identified. In particular, this study creates a transparent methodology and estimates the potential annual...

Efficacy and safety of tolvaptan in heart failure patients with volume overload despite the standard treatment with conventional diuretics: a phase III, randomized, double-blind, placebo-controlled study (QUEST study).

PubMed

Matsuzaki, Masunori; Hori, Masatsugu; Izumi, Tohru; Fukunami, Masatake

2011-12-01

Diuretics are recommended to treat volume overload with heart failure (HF), however, they may cause serum electrolyte imbalance, limiting their use. Moreover, patients with advanced HF could poorly respond to these diuretics. In this study, we evaluated the efficacy and safety of Tolvaptan, a competitive vasopressin V2-receptor antagonist developed as a new drug to treat volume overload in HF patients. A phase III, multicenter, randomized, double-blind, placebo-controlled parallel study was performed to assess the efficacy and safety of tolvaptan in treating HF patients with volume overload despite the use of conventional diuretics. One hundred and ten patients were randomly assigned to receive either placebo or 15 mg/day tolvaptan for 7 consecutive days. Compared with placebo, tolvaptan administered for 7 days significantly reduced body weight and improved symptoms associated with volume overload. The safety profile of tolvaptan was considered acceptable for clinical use with minimal adverse effects. Tolvaptan reduced volume overload and improved congestive symptoms associated with HF by a potent water diuresis (aquaresis).

Meta-analysis of associations between childhood adversity and hippocampus and amygdala volume in non-clinical and general population samples.

PubMed

Calem, Maria; Bromis, Konstantinos; McGuire, Philip; Morgan, Craig; Kempton, Matthew J

2017-01-01

Studies of psychiatric populations have reported associations between childhood adversity and volumes of stress-related brain structures. This meta-analysis investigated these associations in non-clinical samples and therefore independent of the effects of severe mental health difficulties and their treatment. The MEDLINE database was searched for magnetic resonance imaging studies measuring brain structure in adults with and without childhood adversity. Fifteen eligible papers (1781 participants) reporting hippocampal volumes and/or amygdala volumes were pooled using a random effects meta-analysis. Those with childhood adversity had lower hippocampus volumes (hedges g = - 0.15, p  = 0.010). Controlling for gender, this difference became less evident (hedges g = - 0.12, p  = 0.124). This association differed depending on whether studies included participants with some psychopathology, though this may be due to differences in the type of adversity these studies examined. There was no strong evidence of any differences in amygdala volume. Childhood adversity may have only a modest impact on stress-related brain structures in those without significant mental health difficulties.

A Novel Application for the Cavalieri Principle: A Stereological and Methodological Study

PubMed Central

Altunkaynak, Berrin Zuhal; Altunkaynak, Eyup; Unal, Deniz; Unal, Bunyamin

2009-01-01

Objective The Cavalieri principle was applied to consecutive pathology sections that were photographed at the same magnification and used to estimate tissue volumes via superimposing a point counting grid on these images. The goal of this study was to perform the Cavalieri method quickly and practically. Materials and Methods In this study, 10 adult female Sprague Dawley rats were used. Brain tissue was removed and sampled both systematically and randomly. Brain volumes were estimated using two different methods. First, all brain slices were scanned with an HP ScanJet 3400C scanner, and their images were shown on a PC monitor. Brain volume was then calculated based on these images. Second, all brain slices were photographed in 10× magnification with a microscope camera, and brain volumes were estimated based on these micrographs. Results There was no statistically significant difference between the volume measurements of the two techniques (P>0.05; Paired Samples t Test). Conclusion This study demonstrates that personal computer scanning of serial tissue sections allows for easy and reliable volume determination based on the Cavalieri method. PMID:25610077

A novel application for the cavalieri principle: a stereological and methodological study.

PubMed

Altunkaynak, Berrin Zuhal; Altunkaynak, Eyup; Unal, Deniz; Unal, Bunyamin

2009-08-01

The Cavalieri principle was applied to consecutive pathology sections that were photographed at the same magnification and used to estimate tissue volumes via superimposing a point counting grid on these images. The goal of this study was to perform the Cavalieri method quickly and practically. In this study, 10 adult female Sprague Dawley rats were used. Brain tissue was removed and sampled both systematically and randomly. Brain volumes were estimated using two different methods. First, all brain slices were scanned with an HP ScanJet 3400C scanner, and their images were shown on a PC monitor. Brain volume was then calculated based on these images. Second, all brain slices were photographed in 10× magnification with a microscope camera, and brain volumes were estimated based on these micrographs. There was no statistically significant difference between the volume measurements of the two techniques (P>0.05; Paired Samples t Test). This study demonstrates that personal computer scanning of serial tissue sections allows for easy and reliable volume determination based on the Cavalieri method.

Deceased Organ Donor Management: Does Hospital Volume Matter?

PubMed

Patel, Madhukar S; Mohebali, Jahan; Sally, Mitchell; Groat, Tahnee; Vagefi, Parsia A; Chang, David C; Malinoski, Darren J

2017-03-01

Identification of strategies to improve organ donor use remains imperative. Despite the association between hospital volume and outcomes for many common disease processes, there have been no studies that assess the impact of organ donor hospital volume on organ yield. A prospective observational study of all deceased organ donors managed by 10 organ procurement organizations across United Network for Organ Sharing regions 4, 5, and 6 was conducted from February 2012 to June 2015. To study the impact of hospital volume on organ yield, each donor was placed into a hospital-volume quartile based on the number of donors managed by their hospital. Stepwise logistic regression was used to identify the independent effect of hospital volume on the primary outcomes measure of having ≥4 organs transplanted per donor. Data from 4,427 donors across 384 hospitals were collected and hospitals were assigned quartiles based on their volume of deceased donors. Hospitals managed a mean ± SD of 3.3 ± 5.2 donors per hospital per year. After adjusting for age, ethnicity, donor type, blood type, BMI, creatinine, and organ procurement organization/donor service area, being managed in hospitals within the highest volume quartile remained a positive independent predictor of ≥4 organs transplanted per donor (odds ratio = 1.52; 95% CI 1.29 to 1.79; p < 0.001). Deceased organ donor hospital volume impacts organ yield, with the highest-volume centers being 52% more likely to achieve ≥4 organs transplanted per donor. Efforts should be made to share practices from these higher-volume centers and consideration should be given to centralization of donor care. Published by Elsevier Inc.

The Impact of Hospital/Surgeon Volume on Acute Renal Failure and Mortality in Liver Transplantation: A Nationwide Cohort Study.

PubMed

Cheng, Chih-Wen; Liu, Fu-Chao; Lin, Jr-Rung; Tsai, Yung-Fong; Chen, Hsiu-Pin; Yu, Huang-Ping

2016-01-01

The aim of this study was to assess whether the case volume of surgeons and hospitals affects the rates of postoperative complications and survival after liver transplantation. This population-based retrospective cohort study included 2938 recipients of liver transplantation performed between 1998 and 2012, enrolled from the Taiwan National Health Insurance Research Database. They were divided into two groups, according to the cumulative case volume of their operating surgeons and the case volume of their hospitals. The duration of intensive care unit stay and post-transplantation hospitalization, postoperative complications, and mortality were analyzed. The results showed that, in the low and high case volume surgeons groups, respectively, acute renal failure occurred at the rate of 14.11% and 5.86% (p<0.0001), and the overall mortality rates were 19.61% and 12.44% (p<0.0001). In the low and high case volume hospital groups, respectively, acute renal failure occurred in 11% and 7.11% of the recipients (p = 0.0004), and the overall mortality was 18.44% and 12.86% (p<0.0001). These findings suggest that liver transplantation recipients operated on higher case volume surgeons or in higher case volume hospitals have a lower rate of acute renal failure and mortality.

Carpal tunnel and median nerve volume changes after tunnel release in patients with the carpal tunnel syndrome: a magnetic resonance imaging (MRI) study.

PubMed

Crnković, T; Trkulja, V; Bilić, R; Gašpar, D; Kolundžić, R

2016-05-01

Our aim was to study the dynamics of the post-surgical canal and nerve volumes and their relationships to objective [electromyoneurography (EMNG)] and subjective (pain) outcomes. Forty-seven patients with carpal tunnel syndrome (CTS) (median age 52, range 23-75 years) with a prominent narrowing of the median nerve within the canal (observed during carpal tunnel release) were evaluated clinically using EMNG and magnetic resonance imagining (MRI) before and at 90 and 180 days post-surgery. Canal and nerve volumes increased, EMNG findings improved and pain resolved during the follow-up. Increase in tunnel volume was independently associated with increased nerve volume. A greater post-surgical nerve volume was independently associated with a more prominent resolution of pain, but not with the extent of EMNG improvement, whereas EMNG improvement was not associated with pain resolution. Data confirm that MRI can detect even modest changes in the carpal tunnel and median nerve volume and that tunnel release results in tunnel and nerve-volume increases that are paralleled by EMNG and clinical improvements. Taken together, these observations suggest that MRI could be used to objectivise persistent post-surgical difficulties in CTS patients. Level of evidence 3 (follow-up study).

The safe volume threshold for chest drain removal following pulmonary resection.

PubMed

Yap, Kok Hooi; Soon, Jia Lin; Ong, Boon Hean; Loh, Yee Jim

2017-11-01

A best evidence topic in thoracic surgery was written according to a structured protocol. The question addressed was 'In patients undergoing pulmonary resection, is there a safe drainage volume threshold for chest drain removal?' Altogether 1054 papers were found, of which 5 papers represented the best evidence. The authors, journal, date and country of publication, patient group studied, study type, relevant outcomes and results of these papers are tabulated. Chest drainage threshold, where used, ranged from 250 to 500 ml/day. Both randomized controlled trials showed no significant difference in reintervention rates with a higher chest drainage volume threshold. Four studies that performed analysis on other complications showed no statistical significant difference with a higher chest drainage volume threshold. Four studies evaluating length of hospital stay showed reduced or no difference in the length of stay with a higher chest drainage volume threshold. Two cohort studies reported the mortality rate of 0-0.01% with a higher chest drainage volume threshold. We conclude that early chest drain removal after pulmonary resection, accepting a higher chest drainage volume threshold of 250-500 ml/day is safe, and may result in shorter hospital stay without increasing reintervention, morbidity or mortality. © The Author 2017. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.

Better diet quality relates to larger brain tissue volumes: The Rotterdam Study.

PubMed

Croll, Pauline H; Voortman, Trudy; Ikram, M Arfan; Franco, Oscar H; Schoufour, Josje D; Bos, Daniel; Vernooij, Meike W

2018-05-16

To investigate the relation of diet quality with structural brain tissue volumes and focal vascular lesions in a dementia-free population. From the population-based Rotterdam Study, 4,447 participants underwent dietary assessment and brain MRI scanning between 2005 and 2015. We excluded participants with an implausible energy intake, prevalent dementia, or cortical infarcts, leaving 4,213 participants for the current analysis. A diet quality score (0-14) was calculated reflecting adherence to Dutch dietary guidelines. Brain MRI was performed to obtain information on brain tissue volumes, white matter lesion volume, lacunes, and cerebral microbleeds. The associations of diet quality score and separate food groups with brain structures were assessed using multivariable linear and logistic regression. We found that better diet quality related to larger brain volume, gray matter volume, white matter volume, and hippocampal volume. Diet quality was not associated with white matter lesion volume, lacunes, or microbleeds. High intake of vegetables, fruit, whole grains, nuts, dairy, and fish and low intake of sugar-containing beverages were associated with larger brain volumes. A better diet quality is associated with larger brain tissue volumes. These results suggest that the effect of nutrition on neurodegeneration may act via brain structure. More research, in particular longitudinal research, is needed to unravel direct vs indirect effects between diet quality and brain health. © 2018 American Academy of Neurology.

Lack of gender effects on gray matter volumes in adolescent generalized anxiety disorder.

PubMed

Liao, Mei; Yang, Fan; Zhang, Yan; He, Zhong; Su, Linyan; Li, Lingjiang

2014-02-01

Previous epidemiological and clinical studies have reported gender differences in prevalence and clinical features of generalized anxiety disorder (GAD). Such gender differences in clinical phenomenology suggest that the underlying neural circuitry of GAD could also be different in males and females. This study aimed to explore the possible gender effect on gray matter volumes in adolescents with GAD. Twenty-six adolescent GAD patients and 25 healthy controls participated and underwent high-resolution structural magnetic resonance scans. Voxel-based morphometry (VBM) was used to investigate gray matter alterations. Our study revealed a significant diagnosis main effect in the right putamen, with larger gray matter volumes in GAD patients compared to healthy controls, and a significant gender main effect in the left precuneus/posterior cingulate cortex, with larger gray matter volumes in males compared to females. No gender-by-diagnosis interaction effect was found in this study. The relatively small sample size in this study might result in a lack of power to demonstrate gender effects on brain structure in GAD. The results suggested that there are differences in gray matter volumes between males and females, but gray matter volumes in GAD are not influenced by gender. © 2013 Published by Elsevier B.V.

Combined low-volume polyethylene glycol solution plus stimulant laxatives versus standard-volume polyethylene glycol solution: A prospective, randomized study of colon cleansing before colonoscopy

PubMed Central

Hookey, Lawrence C; Depew, William T; Vanner, Stephen J

2006-01-01

INTRODUCTION The effectiveness of polyethylene glycol solutions (PEG) for colon cleansing is often limited by the inability of patients to drink adequate portions of the 4 L solution. The aim of the present study was to determine whether a reduced volume of PEG combined with stimulant laxatives would be better tolerated and as or more effective than the standard dose. METHODS Patients undergoing outpatient colonoscopy were randomly assigned to receive either low-volume PEG plus sennosides (120 mg oral sennosides syrup followed by 2 L PEG) or the standard volume preparation (4 L PEG). The subjects rated the tolerability of the preparations and their symptoms. Colonoscopists were blind to the colonic cleansing preparation and graded the cleansing efficacy using a validated tool (the Ottawa scale). RESULTS The low-volume PEG plus sennosides preparation was significantly better tolerated than the standard large volume PEG (P<0.001) but was less efficacious (P=0.03). Thirty-eight per cent of patients in the large volume PEG group were unable to finish the preparation, compared with only 6% in the reduced volume group. There were no adverse events reported. CONCLUSIONS Although the low-volume PEG plus sennosides preparation was better tolerated, it was not as effective as standard large-volume PEG. However, in view of the significant difference in tolerance, further research investigating possible improvements in the reduced-volume regimen seems warranted. PMID:16482236

Physiological Effects of Training.

DTIC Science & Technology

1985-06-25

applies only to short-term programs, the resting heart rate is norrally reduced as a result of aerobic training in all age groups. I0 Studies with ...in order to maintain cardiao output in conjunction with a decreased heart rate, stroke volume has to Increase. Stroke volume increases in the...volume is partially due too increased end diastolic volume. Thus, the pumping ability of the heart , I.e. increased stroke volume, is improved with

Surgeon and Hospital Volume as Quality Indicators for CABG in Taiwan: Examining Hazard to Mortality and Accounting for Unobserved Heterogeneity

PubMed Central

Hockenberry, Jason M; Lien, Hsien-Ming; Chou, Shin-Yi

2010-01-01

Objective To investigate whether provider volume has an impact on the hazard of mortality for coronary artery bypass grafting (CABG) patients in Taiwan. Data Sources/Study Setting Multiple sources of linked data from the National Health Insurance Program in Taiwan. Study Design The linked data were used to identify 27,463 patients who underwent CABG without concomitant angioplasty or valve procedures and the surgeon and hospital volumes. Generalized estimating equations and hazard models were estimated to assess the impact of volume on mortality. The hazard modeling technique used accounts for bias stemming from unobserved heterogeneity. Principal Findings Both surgeon and hospital volume quartiles are inversely related to the hazard of mortality after CABG. Patients whose surgeon is in the three higher volume quartiles have lower 1-, 3-, 6-, and 12-month mortality after CABG, while only those having their procedure performed at the highest quartile of volume hospitals have lower mortality outcomes. Conclusions Mortality outcomes are related to provider CABG volume in Taiwan. Unobserved heterogeneity is a concern in the volume–outcome relationship; after accounting for it, surgeon volume effects on short-term mortality are large. Using models controlling for unobserved heterogeneity and examining longer term mortality may still differentiate provider quality by volume. PMID:20662948

Three-Dimensional Analysis of Long-Term Midface Volume Change After Vertical Vector Deep-Plane Rhytidectomy.

PubMed

Jacono, Andrew A; Malone, Melanie H; Talei, Benjamin

2015-07-01

Facial aging is a complicated process that includes volume loss and soft tissue descent. This study provides quantitative 3-dimensional (3D) data on the long-term effect of vertical vector deep-plane rhytidectomy on restoring volume to the midface. To determine if primary vertical vector deep-plane rhytidectomy resulted in long-term volume change in the midface. We performed a prospective study on patients undergoing primary vertical vector deep-plane rhytidectomy to quantitate 3D volume changes in the midface. Quantitative analysis of volume changes was made using the Vectra 3D imaging software (Canfield Scientific, Inc, Fairfield, New Jersey) at a minimum follow-up of 1 year. Forty-three patients (86 hemifaces) were analyzed. The average volume gained in each hemi-midface after vertical vector deep-plane rhytidectomy was 3.2 mL. Vertical vector deep-plane rhytidectomy provides significant long-term augmentation of volume in the midface. These quantitative data demonstrate that some midface volume loss is related to gravitational descent of the cheek fat compartments and that vertical vector deep-plane rhytidectomy may obviate the need for other volumization procedures such as autologous fat grafting in selected cases. 4 Therapeutic. © 2015 The American Society for Aesthetic Plastic Surgery, Inc. Reprints and permission: journals.permissions@oup.com.

Age-related changes of nasal cavity and conchae volumes and volume fractions in children: a stereological study.

PubMed

Ertekin, T; Değermenci, M; Nisari, M; Unur, E; Coşkun, A

2016-01-01

The anatomy of the human nasal cavity (NC) is complex and its structures are closely related to the functions of the NC. Studies which assessing the mean volumes of NC and conchae are very infrequent. The purpose of current study is to investigate development of NC and conchae according to age and sex by using stereological method. This retrospective volumetric study was carried out on 342 individuals (166 females and 176 males) between 0 and 18 years old with no pathological conditions or medical procedures that affected the skeletal morphology of the NC. Volumetric estimations were determined on computed tomography (CT) images using point-counting approach of stereological methods. NC, inferior nasal conchae (INC) and middle nasal conchae (MNC) volume measurements that obtained using point-counting method were increased with age in both sexes until 15 years old. Regardless of gender; no significant difference was determined between the left and right values for NC, conchae volumes and choanae measurements. Generally, significant differences were determined in NC and INC volumes according to gender after they reached maximum growth period. According to age the volume ratios of INC to NC and MNC to NC were ranged from 18% to 32% and 9% to15%, respectively. The current study demonstrated that the point-counting method is effective in determining volume estimation of NC and is well suited for CT studies. Our results could provide volumetric indexes for the NC and conchae, which could help the physician for both patient selections for surgery, and for the assessment of any surgical technique used to treatment of nasal obstruction. (.

Assessment of liver volume with computed tomography and comparison of findings with ultrasonography.

PubMed

Bora, Aydın; Alptekin, Cem; Yavuz, Alpaslan; Batur, Abdussamet; Akdemir, Zülküf; Berköz, Mehmet

2014-12-01

In this study, we aimed to investigate the impact of non-alcoholic hepatic steatosis on the liver volume. As investigating hepatic steatosis, we utilized computed tomography (CT) to determine the degree of steatosis and we utilized hepatobiliary ultrasonography (USG) for densitometry and correlation. As hepatosteatosis group, 35 patients over 18 years of age and whose abdominal CT scans were requested by several clinics and performed routinely were included in this study, and as control group, 40 healthy subjects without hepatosteatosis (clinically and radiologically) and correlated with hepatosteatosis group in terms of age and gender were included in this study. CT densitometry and liver attenuation index (LAI) of all individuals who participated in our study were calculated, and contrast images of patients were transferred to CT-Volume Software (Siemens Syngo Multimodality Workplace; Version VE52A). In this study, interactive and automated volume measurement techniques were used together. The volumes were measured separately in patient and control group. In this study for each stage in USG, there was found a direct correlation in terms of LAI and volume, and this correlation was statistically significant (p < 0.01). Furthermore, statistical significance between size and USG stage draws attention (p < 0.05). A significance relationship between USG stage and age could not be determined. As a result, we have reached the conclusion that CT densitometry can be used as an assistive technique along with USG to determine the degree of steatosis in the non-alcoholic fatty liver disease, and there is a positive linear correlation between the liver size and volume, and liver volume increases in the non-alcoholic fatty liver disease.

Progressive brain changes in children and adolescents with early-onset psychosis: A meta-analysis of longitudinal MRI studies.

PubMed

Fraguas, David; Díaz-Caneja, Covadonga M; Pina-Camacho, Laura; Janssen, Joost; Arango, Celso

2016-06-01

Studies on longitudinal brain volume changes in patients with early-onset psychosis (EOP) are particularly valuable for understanding the neurobiological basis of brain abnormalities associated with psychosis. However, findings have not been consistent across studies in this population. We aimed to conduct a meta-analysis on progressive brain volume changes in children and adolescents with EOP. A systematic literature search of magnetic resonance imaging (MRI) studies comparing longitudinal brain volume changes in children and adolescents with EOP and healthy controls was conducted. The annualized rates of relative change in brain volume by region of interest (ROI) were used as raw data for the meta-analysis. The effect of age, sex, duration of illness, and specific diagnosis on volume change was also evaluated. Five original studies with 156 EOP patients (mean age at baseline MRI in the five studies ranged from 13.3 to 16.6years, 67.31% males) and 163 age- and sex-matched healthy controls, with a mean duration of follow-up of 2.46years (range 2.02-3.40), were included. Frontal gray matter (GM) was the only region in which significant differences in volume change over time were found between patients and controls (Hedges' g -0.435, 95% confidence interval (CI): -0.678 to -0.193, p<0.001). Younger age at baseline MRI was associated with greater loss of temporal GM volume over time in patients as compared with controls (p=0.005). Within patients, a diagnosis of schizophrenia was related to greater occipital GM volume loss over time (p=0.001). Compared with healthy individuals, EOP patients show greater progressive frontal GM loss over the first few years after illness onset. Age at baseline MRI and diagnosis of schizophrenia appear to be significant moderators of particular specific brain volume changes. Copyright © 2014 Elsevier B.V. All rights reserved.

Association of Over-The-Counter Pharmaceutical Sales with Influenza-Like-Illnesses to Patient Volume in an Urgent Care Setting

PubMed Central

Liu, Timothy Y.; Sanders, Jason L.; Tsui, Fu-Chiang; Espino, Jeremy U.; Dato, Virginia M.; Suyama, Joe

2013-01-01

We studied the association between OTC pharmaceutical sales and volume of patients with influenza-like-illnesses (ILI) at an urgent care center over one year. OTC pharmaceutical sales explain 36% of the variance in the patient volume, and each standard deviation increase is associated with 4.7 more patient visits to the urgent care center (p<0.0001). Cross-correlation function analysis demonstrated that OTC pharmaceutical sales are significantly associated with patient volume during non-flu season (p<0.0001), but only the sales of cough and cold (p<0.0001) and thermometer (p<0.0001) categories were significant during flu season with a lag of two and one days, respectively. Our study is the first study to demonstrate and measure the relationship between OTC pharmaceutical sales and urgent care center patient volume, and presents strong evidence that OTC sales predict urgent care center patient volume year round. PMID:23555647

Geospatial cross-correlation analysis of Oklahoma earthquakes and saltwater disposal volume 2011 - 2016

NASA Astrophysics Data System (ADS)

Pollyea, R.; Mohammadi, N.; Taylor, J. E.

2017-12-01

The annual earthquake rate in Oklahoma increased dramatically between 2009 and 2016, owing in large part to the rapid proliferation of salt water disposal wells associated with unconventional oil and gas recovery. This study presents a geospatial analysis of earthquake occurrence and SWD injection volume within a 68,420 km2 area in north-central Oklahoma between 2011 and 2016. The spatial co-variability of earthquake occurrence and SWD injection volume is analyzed for each year of the study by calculating the geographic centroid for both earthquake epicenter and volume-weighted well location. In addition, the spatial cross correlation between earthquake occurrence and SWD volume is quantified by calculating the cross semivariogram annually for a 9.6 km × 9.6 km (6 mi × 6 mi) grid over the study area. Results from these analyses suggest that the relationship between volume-weighted well centroids and earthquake centroids generally follow pressure diffusion space-time scaling, and the volume-weighted well centroid predicts the geographic earthquake centroid within a 1σ radius of gyration. The cross semivariogram calculations show that SWD injection volume and earthquake occurrence are spatially cross correlated between 2014 and 2016. These results also show that the strength of cross correlation decreased from 2015 to 2016; however, the cross correlation length scale remains unchanged at 125 km. This suggests that earthquake mitigation efforts have been moderately successful in decreasing the strength of cross correlation between SWD volume and earthquake occurrence near-field, but the far-field contribution of SWD injection volume to earthquake occurrence remains unaffected.

Pre- and postoperative radiotherapy for extremity soft tissue sarcoma: Evaluation of inter-observer target volume contouring variability among French sarcoma group radiation oncologists.

PubMed

Sargos, P; Charleux, T; Haas, R L; Michot, A; Llacer, C; Moureau-Zabotto, L; Vogin, G; Le Péchoux, C; Verry, C; Ducassou, A; Delannes, M; Mervoyer, A; Wiazzane, N; Thariat, J; Sunyach, M P; Benchalal, M; Laredo, J D; Kind, M; Gillon, P; Kantor, G

2018-04-01

The purpose of this study was to evaluate, during a national workshop, the inter-observer variability in target volume delineation for primary extremity soft tissue sarcoma radiation therapy. Six expert sarcoma radiation oncologists (members of French Sarcoma Group) received two extremity soft tissue sarcoma radiation therapy cases 1: one preoperative and one postoperative. They were distributed with instructions for contouring gross tumour volume or reconstructed gross tumour volume, clinical target volume and to propose a planning target volume. The preoperative radiation therapy case was a patient with a grade 1 extraskeletal myxoid chondrosarcoma of the thigh. The postoperative case was a patient with a grade 3 pleomorphic undifferentiated sarcoma of the thigh. Contour agreement analysis was performed using kappa statistics. For the preoperative case, contouring agreement regarding GTV, gross tumour volume GTV, clinical target volume and planning target volume were substantial (kappa between 0.68 and 0.77). In the postoperative case, the agreement was only fair for reconstructed gross tumour volume (kappa: 0.38) but moderate for clinical target volume and planning target volume (kappa: 0.42). During the workshop discussion, consensus was reached on most of the contour divergences especially clinical target volume longitudinal extension. The determination of a limited cutaneous cover was also discussed. Accurate delineation of target volume appears to be a crucial element to ensure multicenter clinical trial quality assessment, reproducibility and homogeneity in delivering RT. radiation therapy RT. Quality assessment process should be proposed in this setting. We have shown in our study that preoperative radiation therapy of extremity soft tissue sarcoma has less inter-observer contouring variability. Copyright © 2018 Société française de radiothérapie oncologique (SFRO). Published by Elsevier SAS. All rights reserved.

Memory performance, global cerebral volumes and hippocampal subfield volumes in long-term survivors of Out-of-Hospital Cardiac Arrest.

PubMed

Ørbo, Marte C; Vangberg, Torgil R; Tande, Pål M; Anke, Audny; Aslaksen, Per M

2018-05-01

We explored the associations between global brain volumes, hippocampal subfield volumes and verbal memory performance in long-term survivors of out-of-hospital cardiac arrest (OHCA). Three months after OHCA, survivors and healthy, age-matched controls were assessed with cerebral MRI and the California Verbal Learning Test-II (CVLT-II). Volumetric brain segmentation was performed automatically by FreeSurfer. Twenty-six OHCA survivors who were living independently in regular homes at the time of assessment and 19 controls participated in the study. Thirteen of the survivors had been conscious upon arrival to the emergency department. The other 13 survivors had 0.5-7 days of inpatient coma before recovery. Memory was poorer in the OHCA group that had been comatose beyond initial hospital admission compared to both other groups. Total cortical volumes, total hippocampus volumes and several hippocampal subfield volumes were significantly smaller in the OHCA group comatose beyond initial hospital admission compared to controls. No significant differences between the OHCA group conscious upon emergency department arrival and the other two groups were found for brain volumes. No significant differences were observed between any groups for white matter or total subcortical volumes. In OHCA survivors with recovery from inpatient coma, the various CVLT-II trials were significantly, but differentially, correlated to total gray matter volume, cortical volume and the hippocampal subfield subiculum. In this small, single-site study, both hippocampal volume and cortical volume were smaller in good outcome OHCA survivors 3 months after resuscitation in comparison to healthy controls. Smaller cerebral volumes were correlated with poorer memory performance. Copyright © 2018 Elsevier B.V. All rights reserved.

Longitudinal changes in kidney parenchymal volume associated with renal artery stenting.

PubMed

Modrall, J Gregory; Timaran, Carlos H; Rosero, Eric B; Chung, Jayer; Plummer, Mitchell; Valentine, R James; Trimmer, Clayton

2012-03-01

This study assessed the longitudinal changes in renal volume after renal artery stenting (RAS) to determine if renal mass is preserved by stenting. The study cohort consisted of 38 patients with longitudinal imaging available for renal volume quantification before and after RAS. Renal volume was estimated as (kidney length) × (width) × (depth/2) based on preoperative renal imaging. For each patient, the clinical response of blood pressure (BP) and renal function to RAS was categorized according to modified American Heart Association guidelines. Changes in renal volume were assessed using paired nonparametric analyses. The cohort was a median age of 69 years (interquartile range [IQR], 60-74 years). A favorable BP response was observed in 11 of 38 patients (28.9%). At a median interval between imaging studies of 21 months (IQR, 13-32 months), ipsilateral renal volume was significantly increased from baseline (146.8 vs 133.8 cm(3);P = .02). This represents a 6.9% relative increase in ipsilateral kidney volume from baseline. A significant negative correlation between preoperative renal volume and the relative change in renal volume postoperatively (r = -0.42; P = .0055) suggests that smaller kidneys experienced the greatest gains in renal volume after stenting. It is noteworthy that the 25 patients with no change in BP or renal function-clinical failures using traditional definitions-experienced a 12% relative increase in ipsilateral renal volume after RAS. Multivariate analysis determined that stable or improved renal volume after stenting was an independent predictor of stable or improved long-term renal function (odds ratio, 0.008; 95% confidence interval, 0.000-0.206; P = .004). These data lend credence to the belief that RAS preserves renal mass in some patients. This benefit of RAS even extends to those patients who would be considered treatment failures by traditional definitions. Patients with stable or increased renal volume after RAS had more stable renal function during long-term follow-up, whereas patients with renal volume loss after stenting were prone to deterioration of renal function. Published by Mosby, Inc.

Tract-Specific Volume Loss on 3T MRI in Patients with Cervical Spondylotic Myelopathy.

PubMed

Hopkins, Benjamin S; Weber, Kenneth A; Cloney, Michael Brendan; Paliwal, Monica; Parrish, Todd B; Smith, Zachary A

2018-04-11

Case-control. The aim of this study was to understand the role of high-resolution magnetic resonance (MR) in identifying regional cord volume loss in cervical spondylotic myelopathy (CSM). Preliminary studies suggest that compression of the ventral region of the cord may contribute disproportionately to CSM symptomology; however, tract-specific data are lacking in the CSM population. The current study is the first to use 3T MR imaging (MRI) images of CSM patients to determine specific volume loss at the level of detail of individual descending white matter tracts. Twelve patients with CSM and 14 age-matched were enrolled prospectively and underwent 3-Tesla MRI of the cervical spine. Using the high-resolution images of the spinal cord, straightening and alignment with a template was performed and specific spinal cord tract volumes were measured using Spinal Cord Tool-box version 3.0.7. Modified Japanese orthopedic association (mJOA) and Nurick disability scores were collected in a prospective manner and were analyzed in relation to descending spinal tract volumes. Having CSM was predicted by anterior/posterior diameter, eccentricity of the cord [odds ratio (OR) 0.000000621, P = 0.004], ventral reticulospinal tract volume (OR 1.167, P = 0.063), lateral corticospinal tract volume (OR 1.034, P = 0.046), rubrospinal tract volume (OR 1.072, P = 0.011), and ventrolateral reticulospinal tract volume (OR 1.474, P = 0.005) on single variable logistic regression. Single variable linear regression showed decreases in anterior/posterior spinal cord diameter (P = 0.022), ventral reticulospinal tract volumes (P = 0.007), and ventrolateral reticulospinal tract volumes (P = 0.017) to significantly predict worsening mJOA scores. Similarly, decreases in ventral reticulospinal tract volumes significantly predicted increasing Nurick scores (P = 0.039). High-resolution 3T MRI can detect tract-specific volume loss in descending spinal cord tracts in CSM patients. Anterior/posterior spinal cord diameter, ventral reticulospinal tract, ventrolateral reticulospinal tract, lateral corticospinal tract, and rubrospinal tract volume loss are associated with CSM symptoms. 2.

Voxel-based morphometry in Alzheimers disease and mild cognitive impairment: Systematic review of studies addressing the frontal lobe.

PubMed

Ribeiro, Luís Gustavo; Busatto, Geraldo

2016-01-01

Voxel-based morphometry (VBM) is a useful approach for investigating neurostructural brain changes in dementia. We systematically reviewed VBM studies of Alzheimer's disease (AD) and mild cognitive impairment (MCI), specifically focusing on grey matter (GM) atrophy in the frontal lobe. Two searches were performed on the Pubmed database. A set of exclusion criteria was applied to ensure the selection of only VBM studies that directly investigated GM volume abnormalities in AD and/or MCI patients compared to cognitively normal controls. From a total of 46 selected articles, 35 VBM studies reported GM volume reductions in the frontal lobe. The frontal subregions, where most of the volume reductions were reported, included the inferior, superior and middle frontal gyri, as well as the anterior cingulate gyrus. We also found studies in which reduced frontal GM was detected in MCI patients who converted to AD. In a minority of studies, correlations between frontal GM volumes and behavioural changes or cognitive deficits in AD patients were investigated, with variable findings. Results of VBM studies indicate that the frontal lobe should be regarded as an important brain area when investigating GM volume deficits in association with AD. Frontal GM loss might not be a feature specific to late AD only. Future VBM studies involving large AD samples are warranted to further investigate correlations between frontal volume deficits and both cognitive impairment and neuropsychiatric symptoms.

Calibration of automatic performance measures - speed and volume data: volume 2, evaluation of the accuracy of approach volume counts and speeds collected by microwave sensors.

DOT National Transportation Integrated Search

2016-05-01

This study evaluated the accuracy of approach volumes and free flow approach speeds collected by the Wavetronix : SmartSensor Advance sensor for the Signal Performance Metrics system of the Utah Department of Transportation (UDOT), : using the field ...

Space shuttle inflight and postflight fluid shifts measured by leg volume changes.

PubMed

Moore, T P; Thornton, W E

1987-09-01

This is a study of the inflight and postflight leg volume changes associated with spaceflight on Space Shuttle missions. The results of this study show an inflight volume loss of 2 L from lower extremities, 1 L from each leg, representing an 11.6% volume change. The vast majority of this change appears to be a shift in body fluids, both intravascular and extravascular. The fluid shift occurs rapidly on Mission Day 1 (MD-1), with it being essentially complete by 6 to 10 h. The regional origin of shift and leg volume change shows a far greater absolute volume (708 ml vs. 318 ml) and percentage (69% vs. 31%) of the total change coming from the thigh as compared to the lower leg. Postflight, the return of fluid to the lower extremities occurs rapidly with the majority of volume return complete within 1.5 h postlanding. At 1 week postflight there is a residual leg volume decrement of 283 ml or 3.2% that is probably due to tissue loss secondary to atrophic deconditioning and weight loss.

Recurrence interval analysis of trading volumes

NASA Astrophysics Data System (ADS)

Ren, Fei; Zhou, Wei-Xing

2010-06-01

We study the statistical properties of the recurrence intervals τ between successive trading volumes exceeding a certain threshold q . The recurrence interval analysis is carried out for the 20 liquid Chinese stocks covering a period from January 2000 to May 2009, and two Chinese indices from January 2003 to April 2009. Similar to the recurrence interval distribution of the price returns, the tail of the recurrence interval distribution of the trading volumes follows a power-law scaling, and the results are verified by the goodness-of-fit tests using the Kolmogorov-Smirnov (KS) statistic, the weighted KS statistic and the Cramér-von Mises criterion. The measurements of the conditional probability distribution and the detrended fluctuation function show that both short-term and long-term memory effects exist in the recurrence intervals between trading volumes. We further study the relationship between trading volumes and price returns based on the recurrence interval analysis method. It is found that large trading volumes are more likely to occur following large price returns, and the comovement between trading volumes and price returns is more pronounced for large trading volumes.

Gray matter alteration in isolated congenital anosmia patient: a voxel-based morphometry study.

PubMed

Yao, Linyin; Yi, Xiaoli; Wei, Yongxiang

2013-09-01

Decreased volume of gray matter (GM) was observed in olfactory loss in patients with neurodegenerative disorder. However, GM volume has not yet been investigated in isolated congenital anosmia (ICA) people. We herewith investigated the volume change of gray matter of an ICA boy by morphometric analysis of magnetic resonance images (voxel-based morphometry), and compared with that of 20 age-matched healthy controls. ICA boy presented a significant decrease in GM volume in the orbitofrontal cortex, anterior cingulate cortex, middle cingulate cortex, thalamus, insular cortex, cerebellum, precuneus, gyrus rectus, subcallosal gyrus, middle temporal gyrus, fusiform gyrus and piriform cortex. No significant GM volume increase was detected in other brain areas. The pattern of GM atrophy was similar as previous literature reported. Our results identified similar GM volume alterations regardless of the causes of olfactory impairment. Decreased GM volume was not only shown in olfactory bulbs, olfactory tracts and olfactory sulcus, also in primary olfactory cortex and the secondary cerebral olfactory areas in ICA people. This is the first study to evaluate GM volume alterations in ICA people.

Recurrence interval analysis of trading volumes.

PubMed

Ren, Fei; Zhou, Wei-Xing

2010-06-01

We study the statistical properties of the recurrence intervals τ between successive trading volumes exceeding a certain threshold q. The recurrence interval analysis is carried out for the 20 liquid Chinese stocks covering a period from January 2000 to May 2009, and two Chinese indices from January 2003 to April 2009. Similar to the recurrence interval distribution of the price returns, the tail of the recurrence interval distribution of the trading volumes follows a power-law scaling, and the results are verified by the goodness-of-fit tests using the Kolmogorov-Smirnov (KS) statistic, the weighted KS statistic and the Cramér-von Mises criterion. The measurements of the conditional probability distribution and the detrended fluctuation function show that both short-term and long-term memory effects exist in the recurrence intervals between trading volumes. We further study the relationship between trading volumes and price returns based on the recurrence interval analysis method. It is found that large trading volumes are more likely to occur following large price returns, and the comovement between trading volumes and price returns is more pronounced for large trading volumes.

Analysis of change in timber volume on non-Federal timberlands in Washington.

Treesearch

Daniel D. Oswald

1986-01-01

This report presents the findings of a study conducted to determine change in per acre timber volume on non-Federal timberlands in Washington from the mid-1960’s to 1978-80. The basis for the-study was the measurement of 1,576 permanent plots at two occasions. The study findings include estimates of change in volume and of the components of change-growth, mortality,...

Use of an Assistant Surgeon Does not Mitigate the Effect of Lead Surgeon Volume on Outcomes Following Open Repair of Intact Abdominal Aortic Aneurysms.

PubMed

Deery, Sarah E; O'Donnell, Thomas F X; Zettervall, Sara L; Darling, Jeremy D; Shean, Katie E; O'Malley, A James; Landon, Bruce E; Schermerhorn, Marc L

2018-05-01

While higher lead surgeon volume has been associated with lower mortality following open abdominal aortic aneurysm (AAA) repair, little is known about the impact of using an attending surgeon as assistant surgeon. The aim of this study was to determine whether the presence of an assistant surgeon, particularly a high volume assistant, mitigates the relationship between lead surgeon volume and outcomes. All Medicare beneficiaries who underwent intact, open AAA repair between 2003 and 2008 were evaluated and nested regression models were constructed to evaluate the relationship between surgeon and assistant volume and peri-operative mortality, adjusting for comorbid conditions and hospital volume. In total 28,590 repairs were studied, of which 19,284 (67.5%) were performed by a single surgeon and 9306 (32.5%) included an assistant surgeon. Of cases with an assistant, 12.3% included a high volume assistant surgeon. Lower volume surgeons more frequently used an assistant (lead surgeon Q1 volume: 40%; Q2: 36%; Q3: 34%; Q4: 29%; Q5: 27% [p < .01]). In cases with no assistant, adjusted peri-operative mortality varied monotonically with surgeon volume (Q1: 4.7%; Q2: 4.4%; Q3: 4.1%; Q4: 3.3%; Q5: 3.2%). However, the use of a high or a low volume assistant surgeon, compared with no attending surgeon as assistant, was not associated with lower peri-operative mortality in any lead surgeon volume quintile, even among those operations performed by the lowest volume lead surgeons. Employing an assistant surgeon does not improve outcomes amongst any quintile of volume of the lead surgeon. As surgeons perform fewer open AAA repairs in the modern era, these data imply that even the help of a high volume assistant surgeon may not mitigate the detrimental effect of a lower volume surgeon. Copyright © 2018 European Society for Vascular Surgery. Published by Elsevier B.V. All rights reserved.

The Influence of Hospital Volume on Circumferential Resection Margin Involvement: Results of the Dutch Surgical Colorectal Audit.

PubMed

Gietelink, Lieke; Henneman, Daniel; van Leersum, Nicoline J; de Noo, Mirre; Manusama, Eric; Tanis, Pieter J; Tollenaar, Rob A E M; Wouters, Michel W J M

2016-04-01

This population-based study evaluates the association between hospital volume and CRM (circumferential resection margin) involvement, adjusted for other confounders, in rectal cancer surgery. A low hospital volume (<20 cases/year) was independently associated with a higher risk of CRM involvement (odds ratio=1.54; 95% CI: 1.12-2.11). To evaluate the association between hospital volume and CRM (circumferential resection margin) involvement in rectal cancer surgery. To guarantee the quality of surgical treatment of rectal cancer, the Association of Surgeons of the Netherlands has stated a minimal annual volume standard of 20 procedures per hospital. The influence of hospital volume has been examined for different outcome variables in rectal cancer surgery. Its influence on the pathological outcome (CRM) however remains unclear. As long-term outcomes are best predicted by the CRM status, this parameter is of essential importance in the debate on the justification of minimal volume standards in rectal cancer surgery. Data from the Dutch Surgical Colorectal Audit (2011-2012) were used. Hospital volume was divided into 3 groups, and baseline characteristics were described. The influence of hospital volume on CRM involvement was analyzed, in a multivariate model, between low- and high-volume hospitals, according to the minimal volume standards. This study included 5161 patients. CRM was recorded in 86% of patients. CRM involvement was 11% in low-volume group versus 7.7% and 7.9% in the medium- and high-volume group (P≤0.001). After adjustment for relevant confounders, the influence of hospital volume on CRM involvement was still significant odds ratio (OR) = 1.54; 95% CI: 1.12-2.11). The outcomes of this pooled analysis support minimal volume standards in rectal cancer surgery. Low hospital volume was independently associated with a higher risk of CRM involvement (OR = 1.54; 95% CI: 1.12-2.11).

Environmental Studies in Nine Courses at Crescent Valley High. Project Reports, Volume 6, The Rachel Carson Project.

ERIC Educational Resources Information Center

Tanner, R. Thomas

This document is the sixth of seven accompanying volumes included in the Rachel Carson Project. The project attempts to introduce environmental education lessons and units into existing courses of study within a high school curriculum rather than to implement environmental education through the introduction of new courses. This volume includes…

Study of New Youth Initiatives in Apprenticeship. Interim Report. Volume 1: Summary and Issues.

ERIC Educational Resources Information Center

CSR, Inc., Washington, DC.

This first volume of the interim report on the Study of New Youth Initiatives in Apprenticeship presents a discussion of site visit findings and implementation issues related to the United States Department of Labor's Apprenticeship-School Linkage Demonstrations. (Volume 2, site visit reports, is available separately as CE 032 792.) Chapter 1…

Study of New Youth Initiatives in Apprenticeship. Interim Report. Volume 2: Site Visit Reports.

ERIC Educational Resources Information Center

CSR, Inc., Washington, DC.

This second volume of the interim report provides detailed case study reports on each of the eight Youth Apprenticeship Projects. (Volume 1, an overview of data from the site visits, is available separately as CE 032 791.) Discussion areas covered in each site visit report are local context/operational environment, administrative information,…

State Programs Supporting Health Manpower Training: An Inventory. Volume 1. Report and Tables.

ERIC Educational Resources Information Center

Public Health Service (DHEW), Washington, DC. Bureau of Health Manpower.

A detailed statistical review of state support for health manpower training during 1973, 1974, and 1975 with an inventory of state expenditures for specific health occupations in 32 states are presented in Volume One of this two-volume study conducted for the Health Resources Administration. Objectives of the study included: investigation of the…

A Curriculum Activities Guide to Water Pollution and Environmental Studies, Volume I - Activities.

ERIC Educational Resources Information Center

Hershey, John T., Ed.; And Others

This publication, Volume I of a two volume set, consists of many tested water pollution study activities. The activities are grouped into four headings: (1) Hydrologic Cycle, (2) Human Activities, (3) Ecological Perspectives, and (4) Social and Political Factors. Three levels of activities are provided: (1) those which increase awareness, (2)…

Biomedical and Behavioral Research Scientists: Their Training and Supply. Volume 2: Statistical Tables.

ERIC Educational Resources Information Center

National Academy of Sciences - National Research Council, Washington, DC. Office of Scientific and Engineering Personnel.

Volume Two of a three volume set of the Biomedical and Behavioral Research Scientists study presents tables of data which were required for the study's development by the National Research Council. Data from these tables were obtained from the Association of American Medical Colleges, the American Dental Association, the American Medical…

Environmental Studies in the Physical Sciences. Project Reports, Volume 3, The Rachel Carson Project.

ERIC Educational Resources Information Center

Tanner, R. Thomas

This document is the third of seven accompanying volumes included in the Rachel Carson Project. The project attempts to introduce environmental education lessons and units into existing courses of study within a high school rather than to implement environmental education through the introduction of new courses. This volume reports the…

A Study of Teachers' Sense of Efficacy. Final Report, Volume II. [Appendices].

ERIC Educational Resources Information Center

Ashton, Patricia T.; And Others

This volume contains the appendices for the report on the Teacher Efficacy Study, an investigation of teachers' sense of efficacy and the extent to which teachers believe they can have a positive effect on student learning and achievement. Included in this volume are: (1) middle school site descriptions; (2) the middle school questionnaire; (3)…

Weight Measurement and Volumetric Displacement of Breast Implants and Tissue Expanders: Why Port and Shell Volumes Matter in Breast Reconstruction, Augmentation, and Revision.

PubMed

Wenzel, Chad G; Wacholtz, William F; Janssen, David A; Bengtson, Bradley P

2015-10-01

There are significant differences in weight and volumetric characteristics between silicone and saline breast implants of which most plastic surgeons are unaware. Phase I of this study was a weight measurement focused on recording differences in the weight of saline volumes instilled versus recorded weights of saline implants and expanders. Phase II compared displaced volume differences of tissue expanders with instilled volumes. As a result of this study, surgeons should now be able to precisely calculate the volume created for breast pocket development, allowing for accurate matching of expander and final breast implant. Copyright © 2015 Elsevier Inc. All rights reserved.

Bench performance of ventilators during simulated paediatric ventilation.

PubMed

Park, M A J; Freebairn, R C; Gomersall, C D

2013-05-01

This study compares the accuracy and capabilities of various ventilators using a paediatric acute respiratory distress syndrome lung model. Various compliance settings and respiratory rate settings were used. The study was done in three parts: tidal volume and FiO2 accuracy; pressure control accuracy and positive end-expiratory pressure (PEEP) accuracy. The parameters set on the ventilator were compared with either or both of the measured parameters by the test lung and the ventilator. The results revealed that none of the ventilators could consistently deliver tidal volumes within 1 ml/kg of the set tidal volume, and the discrepancy between the delivered volume and the volume measured by the ventilator varied greatly. The target tidal volume was 8 ml/kg, but delivered tidal volumes ranged from 3.6-11.4 ml/kg and the volumes measured by the ventilator ranged from 4.1-20.6 ml/kg. All the ventilators maintained pressure within 20% of the set pressure, except one ventilator which delivered pressures of up to 27% higher than the set pressure. Two ventilators maintained PEEP within 10% of the prescribed PEEP. The majority of the readings were also within 10%. However, three ventilators delivered, at times, PEEPs over 20% higher. In conclusion, as lung compliance decreases, especially in paediatric patients, some ventilators perform better than others. This study highlights situations where ventilators may not be able to deliver, nor adequately measure, set tidal volumes, pressure, PEEP or FiO2.

SU-E-J-242: Volume-Dependence of Quantitative Imaging Features From CT and CE-CT Images of NSCLC

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

Fave, X; Fried, D; UT Health Science Center Graduate School of Biomedical Sciences, Houston, TX

Purpose: To determine whether tumor volume plays a significant role in the values obtained for texture features when they are extracted from computed tomography (CT) images of non-small cell lung cancer (NSCLC). We also sought to identify whether features can be reliably measured at all volumes or if a minimum volume threshold should be recommended. Methods: Eleven features were measured on 40 CT and 32 contrast-enhanced CT (CECT) patient images for this study. Features were selected for their prognostic/diagnostic value in previous publications. Direct correlations between these textures and volume were evaluated using the Spearman correlation coefficient. Any texture thatmore » the Wilcoxon rank-sum test was used to compare the variation above and below a volume cutoff. Four different volume thresholds (5, 10, 15, and 20 cm{sup 3}) were tested. Results: Four textures were found to be significantly correlated with volume in both the CT and CE-CT images. These were busyness, coarseness, gray-level nonuniformity, and run-length nonuniformity with correlation coefficients of 0.92, −0.96, 0.94, and 0.98 for the CT images and 0.95, −0.97, 0.98, and 0.98 for the CE-CT images. After volume normalization, the correlation coefficients decreased substantially. For the data obtained from the CT images, the results of the Wilcoxon rank-sum test were significant when volume thresholds of 5–15 cm3 were used. No volume threshold was shown to be significant for the CE-CT data. Conclusion: Equations for four features that have been used in several published studies were found to be volume-dependent. Future studies should consider implementing normalization factors or removing these features entirely to prevent this potential source of redundancy or bias. This work was supported in part by National Cancer Institute grant R03CA178495-01. Xenia Fave is a recipient of the American Association of Physicists in Medicine Graduate Fellowship.« less

Low Plasma Volume in Normotensive Formerly Preeclamptic Women Predisposes to Hypertension.

PubMed

Scholten, Ralph R; Lotgering, Fred K; Hopman, Maria T; Van Dijk, Arie; Van de Vlugt, Maureen; Janssen, Mirian C H; Spaanderman, Marc E A

2015-11-01

Formerly preeclamptic women are at risk for cardiovascular disease. Low plasma volume may reflect latent hypertension and potentially links preeclampsia with chronic cardiovascular disease. We hypothesized that low plasma volume in normotensive formerly preeclamptic women predisposes to hypertension. We longitudinally studied n=104 formerly preeclamptic women in whom plasma volume was measured 3 to 30 months after the preeclamptic pregnancy. Cardiovascular variables were assessed at 2 points in time (3-30 months postpartum and 2-5 years thereafter). Study population was divided into low plasma volume (≤1373 mL/m(2)) and normal plasma volume (>1373 mL/m(2)). Primary end point was hypertension at the second visit: defined as ≥140 mm Hg systolic or ≥90 mm Hg diastolic. Secondary outcome of this study was change in traditional cardiovascular risk profile between visits. Variables correlating univariately with change in blood pressure between visits were introduced in regression analysis. Eighteen of 104 (17%) formerly preeclamptic women who were normotensive at first visit had hypertension at second evaluation 2 to 5 years later. Hypertension developed more often in women with low plasma volume (10/35 [29%]) than in women with normal plasma volume (8/69 [12%]; odds ratio, 3.2; 95% confidence interval, 1.4-8.6). After adjustments, relationship between plasma volume status and subsequent hypertension persisted (adjusted odds ratio, 3.0; 95% confidence interval, 1.1-8.5). Mean arterial pressure at second visit correlated inverse linearly with plasma volume (r=-0.49; P<0.01). Initially normotensive formerly preeclamptic women have 17% chance to develop hypertension within 5 years. Women with low plasma volume have higher chance to develop hypertension than women with normal plasma volume. Clinically, follow-up of blood pressure seems warranted in women with history of preeclampsia, even when initially normotensive. © 2015 American Heart Association, Inc.

Relationship between Testicular Volume and Conventional or Nonconventional Sperm Parameters

PubMed Central

Condorelli, Rosita; Calogero, Aldo E.; La Vignera, Sandro

2013-01-01

Background. Reduced testicular volume (TV) (<12 cm3) is associated with lower testicular function. Several studies explored the conventional sperm parameters (concentration, motility, and morphology) and the endocrine function (gonadotropins and testosterone serum concentrations) in the patients with reduction of TV. No other parameters have been examined. Aim. This study aims at evaluating some biofunctional sperm parameters by flow cytometry in the semen of men with reduced TV compared with that of subjects with normal TV. Methods. 78 patients without primary scrotal disease were submitted to ultrasound evaluation of the testis. They were divided into two groups according to testicular volume: A Group, including 40 patients with normal testicular volume (TV > 15 cm3) and B Group, including 38 patients with reduced testicular volume (TV ≤ 12 cm3). All patients underwent serum hormone concentration, conventional and biofunctional (flow cytometry) sperm parameters evaluation. Results. With regard to biofunctional sperm parameters, all values (mitochondrial membrane potential, phosphatidylserine externalization, chromatin compactness, and DNA fragmentation) were strongly negatively correlated with testicular volume (P < 0.0001). Conclusions. This study for the first time in the literature states that the biofunctional sperm parameters worsen and with near linear correlation, with decreasing testicular volume. PMID:24089610

Chloroplast Osmotic Adjustment and Water Stress Effects on Photosynthesis 1

PubMed Central

Gupta, Ashima Sen; Berkowitz, Gerald A.

1988-01-01

Previous studies have suggested that chloroplast stromal volume reduction may mediate the inhibition of photosynthesis under water stress. In this study, the effects of spinach (Spinacia oleracea, var `Winter Bloomsdale') plant water deficits on chloroplast photosynthetic capacity, solute concentrations in chloroplasts, and chloroplast volume were studied. In situ (gas exchange) and in vitro measurements indicated that chloroplast photosynthetic capacity was maintained during initial leaf water potential (Ψw) and relative water content (RWC) decline. During the latter part of the stress period, photosynthesis dropped precipitously. Chloroplast stromal volume apparently remained constant during the initial period of decline in RWC, but as leaf Ψw reached −1.2 megapascals, stromal volume began to decline. The apparent maintenance of stromal volume over the initial RWC decline during a stress cycle suggested that chloroplasts are capable of osmotic adjustment in response to leaf water deficits. This hypothesis was confirmed by measuring chloroplast solute levels, which increased during stress. The results of these experiments suggest that stromal volume reduction in situ may be associated with loss of photosynthetic capacity and that one mechanism of photosynthetic acclimation to low Ψw may involve stromal volume maintenance. PMID:16666266

A serine residue in ClC-3 links phosphorylation-dephosphorylation to chloride channel regulation by cell volume.

PubMed

Duan, D; Cowley, S; Horowitz, B; Hume, J R

1999-01-01

In many mammalian cells, ClC-3 volume-regulated chloride channels maintain a variety of normal cellular functions during osmotic perturbation. The molecular mechanisms of channel regulation by cell volume, however, are unknown. Since a number of recent studies point to the involvement of protein phosphorylation/dephosphorylation in the control of volume-regulated ionic transport systems, we studied the relationship between channel phosphorylation and volume regulation of ClC-3 channels using site-directed mutagenesis and patch-clamp techniques. In native cardiac cells and when overexpressed in NIH/3T3 cells, ClC-3 channels were opened by cell swelling or inhibition of endogenous PKC, but closed by PKC activation, phosphatase inhibition, or elevation of intracellular Ca2+. Site-specific mutational studies indicate that a serine residue (serine51) within a consensus PKC-phosphorylation site in the intracellular amino terminus of the ClC-3 channel protein represents an important volume sensor of the channel. These results provide direct molecular and pharmacological evidence indicating that channel phosphorylation/dephosphorylation plays a crucial role in the regulation of volume sensitivity of recombinant ClC-3 channels and their native counterpart, ICl.vol.

The Accuracy and Precision of Flow Measurements Using Phase Contrast Techniques

NASA Astrophysics Data System (ADS)

Tang, Chao

Quantitative volume flow rate measurements using the magnetic resonance imaging technique are studied in this dissertation because the volume flow rates have a special interest in the blood supply of the human body. The method of quantitative volume flow rate measurements is based on the phase contrast technique, which assumes a linear relationship between the phase and flow velocity of spins. By measuring the phase shift of nuclear spins and integrating velocity across the lumen of the vessel, we can determine the volume flow rate. The accuracy and precision of volume flow rate measurements obtained using the phase contrast technique are studied by computer simulations and experiments. The various factors studied include (1) the partial volume effect due to voxel dimensions and slice thickness relative to the vessel dimensions; (2) vessel angulation relative to the imaging plane; (3) intravoxel phase dispersion; (4) flow velocity relative to the magnitude of the flow encoding gradient. The partial volume effect is demonstrated to be the major obstacle to obtaining accurate flow measurements for both laminar and plug flow. Laminar flow can be measured more accurately than plug flow in the same condition. Both the experiment and simulation results for laminar flow show that, to obtain the accuracy of volume flow rate measurements to within 10%, at least 16 voxels are needed to cover the vessel lumen. The accuracy of flow measurements depends strongly on the relative intensity of signal from stationary tissues. A correction method is proposed to compensate for the partial volume effect. The correction method is based on a small phase shift approximation. After the correction, the errors due to the partial volume effect are compensated, allowing more accurate results to be obtained. An automatic program based on the correction method is developed and implemented on a Sun workstation. The correction method is applied to the simulation and experiment results. The results show that the correction significantly reduces the errors due to the partial volume effect. We apply the correction method to the data of in vivo studies. Because the blood flow is not known, the results of correction are tested according to the common knowledge (such as cardiac output) and conservation of flow. For example, the volume of blood flowing to the brain should be equal to the volume of blood flowing from the brain. Our measurement results are very convincing.

Sexual dimorphism of volume reduction but not cognitive deficit in fetal alcohol spectrum disorders: A combined diffusion tensor imaging, cortical thickness and brain volume study.

PubMed

Treit, Sarah; Chen, Zhang; Zhou, Dongming; Baugh, Lauren; Rasmussen, Carmen; Andrew, Gail; Pei, Jacqueline; Beaulieu, Christian

2017-01-01

Quantitative magnetic resonance imaging (MRI) has revealed abnormalities in brain volumes, cortical thickness and white matter microstructure in fetal alcohol spectrum disorders (FASD); however, no study has reported all three measures within the same cohort to assess the relative magnitude of deficits, and few studies have examined sex differences. Participants with FASD (n = 70; 30 females; 5-32 years) and healthy controls (n = 74; 35 females; 5-32 years) underwent cognitive testing and MRI to assess cortical thickness, regional brain volumes and fractional anisotropy (FA)/mean diffusivity (MD) of white matter tracts. A significant effect of group, age-by-group, or sex-by-group was found for 9/9 volumes, 7/39 cortical thickness regions, 3/9 white matter tracts, and 9/10 cognitive tests, indicating group differences that in some cases differ by age or sex. Volume reductions for several structures were larger in males than females, despite similar deficits of cognition in both sexes. Correlations between brain structure and cognitive scores were found in females of both groups, but were notably absent in males. Correlations within a given MRI modality (e.g. total brain volume and caudate volume) were prevalent in both the control and FASD groups, and were more numerous than correlations between measurement types (e.g. volumes and diffusion tensor imaging) in either cohort. This multi-modal MRI study finds widespread differences of brain structure in participants with prenatal alcohol exposure, and to a greater extent in males than females which may suggest attenuation of the expected process of sexual dimorphism of brain structure during typical development.

Sleep-disordered breathing, brain volume, and cognition in older individuals with heart failure.

PubMed

Moon, Chooza; Melah, Kelsey E; Johnson, Sterling C; Bratzke, Lisa C

2018-06-19

Sleep-disordered breathing is common in individuals with heart failure and may contribute to changes in the brain and decreased cognition. However, limited research has explored how the apnea-hypopnea index contributes to brain structure and cognition in this population. The aims of this study were to explore how the apnea-hypopnea index is associated with brain volume and cognition in heart failure patients. Data of 28 heart failure patients (mean age = 67.93; SD = 5.78) were analyzed for this cross-sectional observational study. We evaluated the apnea-hypopnea index using a portable multichannel sleep-monitoring device. All participants were scanned using 3.0 Tesla magnetic resonance imaging and neuropsychological tests. Brain volume was evaluated using a voxel-based morphometry method with T1-weighted images. We used multiple regressions to analyze how the apnea-hypopnea index is associated with brain volume and cognition. We found an inverse association between apnea-hypopnea index scores and white matter volume (β = -0.002, p = 0.026), but not in gray matter volume (β = -0.001, p = 0.237). Higher apnea-hypopnea index was associated with reduced regional gray and white matter volume (p < 0.001, uncorrected). Cognitive scores were not associated with the apnea-hypopnea index (p-values were >0.05). Findings from this study provide exploratory evidence that higher apnea-hypopnea index may be associated with greater brain volume reduction in heart failure patients. Future studies are needed to establish the relationship between sleep-disordered breathing, brain volume, and cognition in heart failure samples. © 2018 The Authors. Brain and Behavior published by Wiley Periodicals, Inc.

Lower amygdala volume in men is associated with childhood aggression, early psychopathic traits, and future violence.

PubMed

Pardini, Dustin A; Raine, Adrian; Erickson, Kirk; Loeber, Rolf

2014-01-01

Reduced amygdala volume has been implicated in the development of severe and persistent aggression and the development of psychopathic personality. With longitudinal data, the current study examined whether male subjects with lower amygdala volume have a history of aggression and psychopathic features dating back to childhood and are at increased risk for engaging in future aggression/violence. Participants were selected from a longitudinal study of 503 male subjects initially recruited when they were in the first grade in 1986-1987. At age 26, a subsample of 56 men with varying histories of violence was recruited for a neuroimaging substudy. Automated segmentation was used to index individual differences in amygdala volume. Analyses examined the association between amygdala volume and levels of aggression and psychopathic features of participants measured in childhood and adolescence. Analyses also examined whether amygdala volume was associated with violence and psychopathic traits assessed at a 3-year follow-up. Men with lower amygdala volume exhibited higher levels of aggression and psychopathic features from childhood to adulthood. Lower amygdala volume was also associated with aggression, violence, and psychopathic traits at a 3-year follow-up, even after controlling for earlier levels of these features. All effects remained after accounting for several potential confounds. This represents the first prospective study to demonstrate that men with lower amygdala volume have a longstanding history of aggression and psychopathic features and are at increased risk for committing future violence. Studies should further examine whether specific amygdala abnormalities might be a useful biomarker for severe and persistent aggression. Copyright © 2014 Society of Biological Psychiatry. Published by Elsevier Inc. All rights reserved.

Ocean Optics Protocols for Satellite Ocean Color Sensor Validation. Volume 4; Inherent Optical Properties: Instruments, Characterizations, Field Measurements and Data Analysis Protocols; Revised

NASA Technical Reports Server (NTRS)

Mueller, J. L. (Editor); Fargion, Giuletta S. (Editor); McClain, Charles R. (Editor); Pegau, Scott; Zaneveld, J. Ronald V.; Mitchell, B. Gregg; Kahru, Mati; Wieland, John; Stramska, Malgorzat

2003-01-01

This document stipulates protocols for measuring bio-optical and radiometric data for the Sensor Intercomparison and Merger for Biological and Interdisciplinary Oceanic Studies (SIMBIOS) Project activities and algorithm development. The document is organized into 6 separate volumes as Ocean Optics Protocols for Satellite Ocean Color Sensor Validation, Revision 4. Volume I: Introduction, Background and Conventions; Volume II: Instrument Specifications, Characterization and Calibration; Volume III: Radiometric Measurements and Data Analysis Methods; Volume IV: Inherent Optical Properties: Instruments, Characterization, Field Measurements and Data Analysis Protocols; Volume V: Biogeochemical and Bio-Optical Measurements and Data Analysis Methods; Volume VI: Special Topics in Ocean Optics Protocols and Appendices. The earlier version of Ocean Optics Protocols for Satellite Ocean Color Sensor Validation, Revision 3 (Mueller and Fargion 2002, Volumes 1 and 2) is entirely superseded by the six volumes of Revision 4 listed above.

Ocean Optics Protocols for Satellite Ocean Color Sensor Validation. Volume 6; Special Topics in Ocean Optics Protocols and Appendices; Revised

NASA Technical Reports Server (NTRS)

Mueller, J. L. (Editor); Fargion, Giulietta S. (Editor); McClain, Charles R. (Editor)

2003-01-01

This document stipulates protocols for measuring bio-optical and radiometric data for the Sensor Intercomparison and Merger for Biological and Interdisciplinary Oceanic Studies (SIMBIOS) Project activities and algorithm development. The document is organized into 6 separate volumes as Ocean Optics Protocols for Satellite Ocean Color Sensor Validation, Revision 4. Volume I: Introduction, Background and Conventions; Volume II: Instrument Specifications, Characterization and Calibration; Volume III: Radiometric Measurements and Data Analysis Methods; Volume IV: Inherent Optical Properties: Instruments, Characterization, Field Measurements and Data Analysis Protocols; Volume V: Biogeochemical and Bio-Optical Measurements and Data Analysis Methods; Volume VI: Special Topics in Ocean Optics Protocols and Appendices. The earlier version of Ocean Optics Protocols for Satellite Ocean Color Sensor Validation, Revision 3 (Mueller and Fargion 2002, Volumes 1 and 2) is entirely superseded by the six volumes of Revision 4 listed above.

Detection of atomic scale changes in the free volume void size of three-dimensional colorectal cancer cell culture using positron annihilation lifetime spectroscopy.

PubMed

Axpe, Eneko; Lopez-Euba, Tamara; Castellanos-Rubio, Ainara; Merida, David; Garcia, Jose Angel; Plaza-Izurieta, Leticia; Fernandez-Jimenez, Nora; Plazaola, Fernando; Bilbao, Jose Ramon

2014-01-01

Positron annihilation lifetime spectroscopy (PALS) provides a direct measurement of the free volume void sizes in polymers and biological systems. This free volume is critical in explaining and understanding physical and mechanical properties of polymers. Moreover, PALS has been recently proposed as a potential tool in detecting cancer at early stages, probing the differences in the subnanometer scale free volume voids between cancerous/healthy skin samples of the same patient. Despite several investigations on free volume in complex cancerous tissues, no positron annihilation studies of living cancer cell cultures have been reported. We demonstrate that PALS can be applied to the study in human living 3D cell cultures. The technique is also capable to detect atomic scale changes in the size of the free volume voids due to the biological responses to TGF-β. PALS may be developed to characterize the effect of different culture conditions in the free volume voids of cells grown in vitro.

Failure of replicating the association between hippocampal volume and 3 single-nucleotide polymorphisms identified from the European genome-wide association study in Asian populations.

PubMed

Li, Ming; Ohi, Kazutaka; Chen, Chunhui; He, Qinghua; Liu, Jie-Wei; Chen, Chuansheng; Luo, Xiong-Jian; Dong, Qi; Hashimoto, Ryota; Su, Bing

2014-12-01

Hippocampal volume is a key brain structure for learning ability and memory process, and hippocampal atrophy is a recognized biological marker of Alzheimer's disease. However, the genetic bases of hippocampal volume are still unclear although it is a heritable trait. Genome-wide association studies (GWASs) on hippocampal volume have implicated several significantly associated genetic variants in Europeans. Here, to test the contributions of these GWASs identified genetic variants to hippocampal volume in different ethnic populations, we screened the GWAS-identified candidate single-nucleotide polymorphisms in 3 independent healthy Asian brain imaging samples (a total of 990 subjects). The results showed that none of these single-nucleotide polymorphisms were associated with hippocampal volume in either individual or combined Asian samples. The replication results suggested a complexity of genetic architecture for hippocampal volume and potential genetic heterogeneity between different ethnic populations. Copyright © 2014 Elsevier Inc. All rights reserved.

Detection of Atomic Scale Changes in the Free Volume Void Size of Three-Dimensional Colorectal Cancer Cell Culture Using Positron Annihilation Lifetime Spectroscopy

PubMed Central

Castellanos-Rubio, Ainara; Merida, David; Garcia, Jose Angel; Plaza-Izurieta, Leticia; Fernandez-Jimenez, Nora; Plazaola, Fernando; Bilbao, Jose Ramon

2014-01-01

Positron annihilation lifetime spectroscopy (PALS) provides a direct measurement of the free volume void sizes in polymers and biological systems. This free volume is critical in explaining and understanding physical and mechanical properties of polymers. Moreover, PALS has been recently proposed as a potential tool in detecting cancer at early stages, probing the differences in the subnanometer scale free volume voids between cancerous/healthy skin samples of the same patient. Despite several investigations on free volume in complex cancerous tissues, no positron annihilation studies of living cancer cell cultures have been reported. We demonstrate that PALS can be applied to the study in human living 3D cell cultures. The technique is also capable to detect atomic scale changes in the size of the free volume voids due to the biological responses to TGF-β. PALS may be developed to characterize the effect of different culture conditions in the free volume voids of cells grown in vitro. PMID:24392097

Recent regulatory experience of low-Btu coal gasification. Volume III. Supporting case studies

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

Ackerman, E.; Hart, D.; Lethi, M.

The MITRE Corporation conducted a five-month study for the Office of Resource Applications in the Department of Energy on the regulatory requirements of low-Btu coal gasification. During this study, MITRE interviewed representatives of five current low-Btu coal gasification projects and regulatory agencies in five states. From these interviews, MITRE has sought the experience of current low-Btu coal gasification users in order to recommend actions to improve the regulatory process. This report is the third of three volumes. It contains the results of interviews conducted for each of the case studies. Volume 1 of the report contains the analysis of themore » case studies and recommendations to potential industrial users of low-Btu coal gasification. Volume 2 contains recommendations to regulatory agencies.« less

Dry Volume Fracturing Simulation of Shale Gas Reservoir

NASA Astrophysics Data System (ADS)

Xu, Guixi; Wang, Shuzhong; Luo, Xiangrong; Jing, Zefeng

2017-11-01

Application of CO2 dry fracturing technology to shale gas reservoir development in China has advantages of no water consumption, little reservoir damage and promoting CH4 desorption. This paper uses Meyer simulation to study complex fracture network extension and the distribution characteristics of shale gas reservoirs in the CO2 dry volume fracturing process. The simulation results prove the validity of the modified CO2 dry fracturing fluid used in shale volume fracturing and provides a theoretical basis for the following study on interval optimization of the shale reservoir dry volume fracturing.

[Target volume margins for lung cancer: internal target volume/clinical target volume].

PubMed

Jouin, A; Pourel, N

2013-10-01

The aim of this study was to carry out a review of margins that should be used for the delineation of target volumes in lung cancer, with a focus on margins from gross tumour volume (GTV) to clinical target volume (CTV) and internal target volume (ITV) delineation. Our review was based on a PubMed literature search with, as a cornerstone, the 2010 European Organisation for Research and Treatment of Cancer (EORTC) recommandations by De Ruysscher et al. The keywords used for the search were: radiotherapy, lung cancer, clinical target volume, internal target volume. The relevant information was categorized under the following headings: gross tumour volume definition (GTV), CTV-GTV margin (first tumoural CTV then nodal CTV definition), in field versus elective nodal irradiation, metabolic imaging role through the input of the PET scanner for tumour target volume and limitations of PET-CT imaging for nodal target volume definition, postoperative radiotherapy target volume definition, delineation of target volumes after induction chemotherapy; then the internal target volume is specified as well as tumoural mobility for lung cancer and respiratory gating techniques. Finally, a chapter is dedicated to planning target volume definition and another to small cell lung cancer. For each heading, the most relevant and recent clinical trials and publications are mentioned. Copyright © 2013. Published by Elsevier SAS.

Chemical Laser Facility Study. Volume III. Cost Analysis.

DTIC Science & Technology

Chemical Laser Test Facility. The design criteria for the architectural and engineering design of the facility are presented in Volume I and the design requirements for the Laser Test System are presented in Volume II.

Specificity of abnormal brain volume in major depressive disorder: a comparison with borderline personality disorder.

PubMed

Depping, Malte S; Wolf, Nadine D; Vasic, Nenad; Sambataro, Fabio; Thomann, Philipp A; Christian Wolf, R

2015-03-15

Abnormal brain volume has been frequently demonstrated in major depressive disorder (MDD). It is unclear if these findings are specific for MDD since aberrant brain structure is also present in disorders with depressive comorbidity and affective dysregulation, such as borderline personality disorder (BPD). In this transdiagnostic study, we aimed to investigate if regional brain volume loss differentiates between MDD and BPD. Further, we tested for associations between brain volume and clinical variables within and between diagnostic groups. 22 Females with a DSM-IV diagnosis of MDD, 17 females with a DSM-IV diagnosis of BPD and without comorbid posttraumatic stress disorder, and 22 age-matched female healthy controls (HC) were investigated using magnetic resonance imaging. High-resolution structural data were analyzed using voxel-based morphometry. A significant (p<0.05, cluster-corrected) volume decrease of the anterior cingulate cortex (ACC) was found in MDD compared to HC, as opposed to volume decreases of the amygdala in BPD compared to both HC and MDD. Sensitivity and specificity of regional gray matter volume for a diagnosis of MDD were modest to fair. Amygdala volume was related to depressive symptoms across the entire patient sample. Potential limitations of this study include the modest sample size and the heterogeneous psychotropic drug treatment. ACC volume reduction is more pronounced in MDD with an intermediate degree of volume loss in BPD compared to HC. In contrast, amygdala volume loss is more pronounced in BPD compared to MDD, yet amygdala volume is associated with affective symptom expression in both disorders. Copyright © 2014 Elsevier B.V. All rights reserved.

Treatment Planning and Volumetric Response Assessment for Yttrium-90 Radioembolization: Semiautomated Determination of Liver Volume and Volume of Tumor Necrosis in Patients with Hepatic Malignancy

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

Monsky, Wayne L., E-mail: wayne.monsky@ucdmc.ucdavis.edu; Garza, Armando S.; Kim, Isaac

Purpose: The primary purpose of this study was to demonstrate intraobserver/interobserver reproducibility for novel semiautomated measurements of hepatic volume used for Yttrium-90 dose calculations as well as whole-liver and necrotic-liver (hypodense/nonenhancing) tumor volume after radioembolization. The secondary aim was to provide initial comparisons of tumor volumetric measurements with linear measurements, as defined by Response Evaluation Criteria in Solid Tumors criteria, and survival outcomes. Methods: Between 2006 and 2009, 23 consecutive radioembolization procedures were performed for 14 cases of hepatocellular carcinoma and 9 cases of hepatic metastases. Baseline and follow-up computed tomography obtained 1 month after treatment were retrospectively analyzed. Threemore » observers measured liver, whole-tumor, and tumor-necrosis volumes twice using semiautomated software. Results: Good intraobserver/interobserver reproducibility was demonstrated (intraclass correlation [ICC] > 0.9) for tumor and liver volumes. Semiautomated measurements of liver volumes were statistically similar to those obtained with manual tracing (ICC = 0.868), but they required significantly less time to perform (p < 0.0001, ICC = 0.088). There was a positive association between change in linear tumor measurements and whole-tumor volume (p < 0.0001). However, linear measurements did not correlate with volume of necrosis (p > 0.05). Dose, change in tumor diameters, tumor volume, and necrotic volume did not correlate with survival (p > 0.05 in all instances). However, Kaplan-Meier curves suggest that a >10% increase in necrotic volume correlated with survival (p = 0.0472). Conclusion: Semiautomated volumetric analysis of liver, whole-tumor, and tumor-necrosis volume can be performed with good intraobserver/interobserver reproducibility. In this small retrospective study, measurements of tumor necrosis were suggested to correlate with survival.« less

Genetic Overlap Between Schizophrenia and Volumes of Hippocampus, Putamen, and Intracranial Volume Indicates Shared Molecular Genetic Mechanisms.

PubMed

Smeland, Olav B; Wang, Yunpeng; Frei, Oleksandr; Li, Wen; Hibar, Derrek P; Franke, Barbara; Bettella, Francesco; Witoelar, Aree; Djurovic, Srdjan; Chen, Chi-Hua; Thompson, Paul M; Dale, Anders M; Andreassen, Ole A

2018-06-06

Schizophrenia (SCZ) is associated with differences in subcortical brain volumes and intracranial volume (ICV). However, little is known about the underlying etiology of these brain alterations. Here, we explored whether brain structure volumes and SCZ share genetic risk factors. Using conditional false discovery rate (FDR) analysis, we integrated genome-wide association study (GWAS) data on SCZ (n = 82315) and GWAS data on 7 subcortical brain volumes and ICV (n = 11840). By conditioning the FDR on overlapping associations, this statistical approach increases power to discover genetic loci. To assess the credibility of our approach, we studied the identified loci in larger GWAS samples on ICV (n = 26577) and hippocampal volume (n = 26814). We observed polygenic overlap between SCZ and volumes of hippocampus, putamen, and ICV. Based on conjunctional FDR < 0.05, we identified 2 loci shared between SCZ and ICV implicating genes FOXO3 (rs10457180) and ITIH4 (rs4687658), 2 loci shared between SCZ and hippocampal volume implicating SLC4A10 (rs4664442) and SPATS2L (rs1653290), and 2 loci shared between SCZ and volume of putamen implicating DCC (rs4632195) and DLG2 (rs11233632). The loci shared between SCZ and hippocampal volume or ICV had not reached significance in the primary GWAS on brain phenotypes. Proving our point of increased power, 2 loci did reach genome-wide significance with ICV (rs10457180) and hippocampal volume (rs4664442) in the larger GWAS. Three of the 6 identified loci are novel for SCZ. Altogether, the findings provide new insights into the relationship between SCZ and brain structure volumes, suggesting that their genetic architectures are not independent.

Pressure-volume Relationship in the Stress-echocardiography Laboratory: Does (Left Ventricular End-diastolic) Size Matter?

PubMed

Bombardini, Tonino; Mulieri, Louis A; Salvadori, Stefano; Costantino, Marco Fabio; Scali, Maria Chiara; Marzilli, Mario; Picano, Eugenio

2017-02-01

The variation between rest and peak stress end-systolic pressure-volume relation is an afterload-independent index of left ventricular contractility. Whether and to what extent it depends on end-diastolic volume remains unclear. The aim of this study was to assess the dependence of the delta rest-stress end-systolic pressure-volume relation on end-diastolic volume in patients with negative stress echo and all ranges of resting left ventricular function. We analyzed interpretable data obtained in 891 patients (593 men, age 63 ± 12 years) with ejection fraction 47% ± 12%: 338 were normal or near-normal or hypertensive; 229 patients had coronary artery disease; and 324 patients had ischemic or nonischemic dilated cardiomyopathy. They were studied with exercise (n = 172), dipyridamole (n = 482) or dobutamine (n = 237) stress echocardiography. The end-systolic pressure-volume relation was evaluated at rest and peak stress from raw measurement of systolic arterial pressure by cuff sphygmomanometer and end-systolic volume by biplane Simpson rule 2-dimensional echocardiography. Absolute values of delta rest-stress end-systolic pressure-volume relation were higher for exercise and dobutamine than for dipyridamole. In the overall population, an inverse relationship between end-systolic pressure-volume relation and end-diastolic volume was present at rest (r 2 = 0.69, P < .001) and peak stress (r 2 = 0.56, P < .001), but was absent if the delta rest-stress end-systolic pressure-volume relation was considered (r 2 = 0.13). Left ventricular end-diastolic volume does not affect the rest-stress changes in end-systolic pressure-volume relation in either normal or abnormal left ventricles during physical or pharmacological stress. Copyright © 2016 Sociedad Española de Cardiología. Published by Elsevier España, S.L.U. All rights reserved.

The effect of surgeon and hospital volume on shoulder arthroplasty perioperative quality metrics.

PubMed

Singh, Anshu; Yian, Edward H; Dillon, Mark T; Takayanagi, Miwa; Burke, Mary F; Navarro, Ronald A

2014-08-01

There has been a significant increase in both the incidence of shoulder arthroplasty and the number of surgeons performing these procedures. Literature regarding the relationship between surgeon or hospital volume and the performance of modern shoulder arthroplasty is limited. This study examines the effect of surgeon or hospital shoulder arthroplasty volume on perioperative metrics related to shoulder hemiarthroplasty, total shoulder arthroplasty, and reverse shoulder arthroplasty. Blood loss, length of stay, and operative time were the main endpoints analyzed. Prospective data were analyzed from a multicenter shoulder arthroplasty registry; 1176 primary shoulder arthroplasty cases were analyzed. Correlation and analysis of covariance were used to examine the association between surgeon and hospital volume and perioperative metrics adjusting for age, sex, and body mass index. Surgeon volume is inversely correlated with length of stay for hemiarthroplasty and total shoulder arthroplasty and with blood loss and operative time for all 3 procedures. Hospital volume is inversely correlated with length of stay for hemiarthroplasty, with blood loss for total and reverse shoulder arthroplasty, and with operative time for all 3 procedures. High-volume surgeons performed shoulder arthroplasty 30 to 50 minutes faster than low-volume surgeons did. Higher surgeon and hospital case volumes led to improved perioperative metrics with all shoulder arthroplasty procedures, including reverse total shoulder arthroplasty, which has not been previously described in the literature. Surgeon volume had a larger effect on metrics than hospital volume did. This study supports the concept that complex shoulder procedures are, on average, performed more efficiently by higher volume surgeons in higher volume centers. Copyright © 2014 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Mosby, Inc. All rights reserved.

The Journal of the Society for Accelerative Learning and Teaching. (Volume 5, Numbers 3 through Volume 6, Number 4).

ERIC Educational Resources Information Center

Journal of the Society for Accelerative Learning and Teaching, 1981

1981-01-01

Numbers 3 and 4 of volume 5 and numbers 1 through 4 of volume 6 of the journal, spanning fall 1980 through winter 1981, include articles concerning the individualized study center; consciousness, psychology, and education; suggestive-accelerative learning and suggestopedia; creativity; brain lateralization; the Lozanov method; biofeedback and…

LEARN JAPANESE--ELEMENTARY SCHOOL TEXT, VOLUME II.

ERIC Educational Resources Information Center

SATO, YAEKO; AND OTHERS

THIS TEXT WAS WRITTEN FOR THE USE OF THE ELEMENTARY SCHOOL TEACHER OF JAPANESE. IT IS TO BE USED IN THE SECOND SEMESTER OF JAPANESE LANGUAGE STUDY AND FOLLOWS THE AUDIO-LINGUAL ORIENTATION OF VOLUME I. THE MAIN GOAL OF BOTH VOLUMES IS "TO ELEVATE THE PUPIL'S MOTIVATION AND TO CULTIVATE PROPER PRONUNCIATION HABITS." THE NEW ITEMS IN VOLUME II…

Lung Volume during Swallowing: Single Bolus Swallows in Healthy Young Adults

ERIC Educational Resources Information Center

Hegland, Karen M. Wheeler; Huber, Jessica E.; Pitts, Teresa; Sapienza, Christine M.

2009-01-01

Purpose: This study examined the relationship between swallowing and lung volume initiation in healthy adults during single swallows of boluses differing in volume and consistency. Differences in lung volume according to respiratory phase surrounding the swallow were also assessed. Method: Nine men and 11 women between the ages of 19 and 28 years…

Apprentice Machinist (AFSC 53130), Volumes 1-4, and Change Supplement (AFSC 42730).

ERIC Educational Resources Information Center

Air Univ., Gunter AFS, Ala. Extension Course Inst.

This four-volume student learning package is designed for use by Air Force personnel enrolled in a self-study extension course for apprentice machinists. The package consists of four volumes of instructional text and four workbooks. Covered in the individual volumes are machine shop fundamentals, lathe work, shaper and contour machine work, and…

The relationship of waist circumference and body mass index to grey matter volume in community dwelling adults with mild obesity.

PubMed

Hayakawa, Y K; Sasaki, H; Takao, H; Yoshikawa, T; Hayashi, N; Mori, H; Kunimatsu, A; Aoki, S; Ohtomo, K

2018-02-01

Previous work has shown that high body mass index (BMI) is associated with low grey matter volume. However, evidence on the relationship between waist circumference (WC) and brain volume is relatively scarce. Moreover, the influence of mild obesity (as indexed by WC and BMI) on brain volume remains unclear. This study explored the relationships between WC and BMI and grey matter volume in a large sample of Japanese adults. The participants were 792 community-dwelling adults (523 men and 269 women). Brain magnetic resonance images were collected, and the correlation between WC or BMI and global grey matter volume were analysed. The relationships between WC or BMI and regional grey matter volume were also investigated using voxel-based morphometry. Global grey matter volume was not correlated with WC or BMI. Voxel-based morphometry analysis revealed significant negative correlations between both WC and BMI and regional grey matter volume. The areas correlated with each index were more widespread in men than in women. In women, the total area of the regions significantly correlated with WC was slightly greater than that of the regions significantly correlated with BMI. Results show that both WC and BMI were inversely related to regional grey matter volume, even in Japanese adults with somewhat mild obesity. Especially in populations with less obesity, such as the female participants in current study, WC may be more sensitive than BMI as a marker of grey matter volume differences associated with obesity.

Mismatching between nest volume and clutch volume reduces egg survival and fledgling success in black-tailed gulls

PubMed Central

Yoo, Jeong-Chil

2016-01-01

Abstract A longstanding suggestion posits that parents prefer to match nest volume and clutch size (clutch volume), but few studies have tested this in colonial seabirds that nest in the open. Here, we demonstrate the effects of nest–clutch volume matching on egg survival, hatching, and fledgling success in black-tailed gulls Larus crassirostris on Hongdo Island, Korea. We show that the volume mismatch, defined as the difference between nest volume and total egg volume (the sum of all eggs’ volume in the clutch), was positively related to egg and chick mortality caused by predation, but was not significantly related to hatching success incurred by insulation during the incubation period. Although nest volume was negatively related to laying date, we found that the mismatch was positively related to laying date. Our results support the claim that well-matched nest–clutch volume may contribute to survival of eggs and chicks, and ultimately breeding success. PMID:29491934

The effect of water volume and mixing time on physical properties of bread made from modified cassava starch-wheat composite flour

NASA Astrophysics Data System (ADS)

Srirejeki, S.; Manuhara, G. J.; Amanto, B. S.; Atmaka, W.; Laksono, P. W.

2018-03-01

Modification of cassava starch with soaking in the whey (by product on cheese production) resulted in changes of the flour characteristics. Adjustments of processing condition are important to be studied in the making of bread from modified cassava starch and wheat composite flour (30:70). This research aims to determine the effect of water volume and mixing time on the physical properties of the bread. The experimental design of this research was Completely Randomized Factorial Design (CRFD) with two factors which were water volume and mixing time. The variation of water volume significantly affected on bread height, dough volume, dough specific volume, and crust thickness. The variation of mixing time had a significant effect on the increase of dough volume and dough specific volume. The combination of water volume and mixing time had a significant effect on dough height, bread volume, bread specific volume, baking expansion, and weight loss.

An experimental result of estimating an application volume by machine learning techniques.

PubMed

Hasegawa, Tatsuhito; Koshino, Makoto; Kimura, Haruhiko

2015-01-01

In this study, we improved the usability of smartphones by automating a user's operations. We developed an intelligent system using machine learning techniques that periodically detects a user's context on a smartphone. We selected the Android operating system because it has the largest market share and highest flexibility of its development environment. In this paper, we describe an application that automatically adjusts application volume. Adjusting the volume can be easily forgotten because users need to push the volume buttons to alter the volume depending on the given situation. Therefore, we developed an application that automatically adjusts the volume based on learned user settings. Application volume can be set differently from ringtone volume on Android devices, and these volume settings are associated with each specific application including games. Our application records a user's location, the volume setting, the foreground application name and other such attributes as learning data, thereby estimating whether the volume should be adjusted using machine learning techniques via Weka.

Brain morphology in older African Americans, Caribbean Hispanics, and whites from northern Manhattan.

PubMed

Brickman, Adam M; Schupf, Nicole; Manly, Jennifer J; Luchsinger, José A; Andrews, Howard; Tang, Ming X; Reitz, Christiane; Small, Scott A; Mayeux, Richard; DeCarli, Charles; Brown, Truman R

2008-08-01

Aging is accompanied by a decrease in brain volume and by an increase in cerebrovascular disease. To examine the effects of age, sex, race/ethnicity, and vascular disease history on measures of brain morphology, including relative brain volume, ventricular volume, hippocampus and entorhinal cortex volumes, and white matter hyperintensity (WMH) burden, in a large community-based cohort of racially/ethnically diverse older adults without dementia. The associations of age, sex, race/ethnicity, and self-reported vascular disease history with brain morphology were examined in a cross-sectional study using multiple linear regression analyses. Sex x race/ethnicity interactions were also considered. The Washington Heights-Inwood Columbia Aging Project, a community-based epidemiological study of older adults from 3 racial/ethnic groups (white, Hispanic, and African American) from northern Manhattan. Beginning in 2003, high-resolution quantitative magnetic resonance (MR) images were acquired in 769 participants without dementia. Relative brain volume (total brain volume/intracranial volume), ventricular volume, and hippocampus and entorhinal cortex volumes were derived manually on high-resolution MR images. White matter hyperintensities were quantified semiautomatically on fluid-attenuated inversion recovery-T2-weighted MR images. Older age was associated with decreased relative brain volume and with increased ventricular and WMH volumes. Hispanic and African American participants had larger relative brain volumes and more severe WMH burden than white participants, but the associations of these variables with age were similar across racial/ethnic groups. Compared with men, women had larger relative brain volumes. Vascular disease was associated with smaller relative brain volume and with higher WMH burden, particularly among African Americans. Older age and vascular disease, particularly among African Americans, are associated with increased brain atrophy and WMH burden. African American and Hispanic subjects have larger relative brain volumes and more WMH than white subjects. Racial/ethnic group differences in WMH severity seem to be partially attributable to differences in vascular disease. Future work will focus on the determinants and cognitive correlates of these differences.

The Volume-outcome Relationship in Deceased Donor Kidney Transplantation and Implications for Regionalization.

PubMed

Barbas, Andrew S; Dib, Martin J; Rege, Aparna S; Vikraman, Deepak S; Sudan, Debra L; Knechtle, Stuart J; Scarborough, John E

2018-06-01

The aim of this study was to investigate the volume-outcome relationship in kidney transplantation by examining graft and patient outcomes using standardized risk adjustment (observed-to-expected outcomes). A secondary objective was to examine the geographic proximity of low, medium, and high-volume kidney transplant centers in the United States. The significant survival benefit of kidney transplantation in the context of a severe shortage of donor organs mandates strategies to optimize outcomes. Unlike for other solid organ transplants, the relationship between surgical volume and kidney transplant outcomes has not been clearly established. The Scientific Registry of Transplant Recipients was used to examine national outcomes for adults undergoing deceased donor kidney transplantation from January 1, 1999 to December 31, 2013 (15-year study period). Observed-to-expected rates of graft loss and patient death were compared for low, medium, and high-volume centers. The geographic proximity of low-volume centers to higher volume centers was determined to assess the impact of regionalization on patient travel burden. A total of 206,179 procedures were analyzed. Compared with low-volume centers, high-volume centers had significantly lower observed-to-expected rates of 1-month graft loss (0.93 vs 1.18, P<0.001), 1-year graft loss (0.97 vs 1.12, P<0.001), 1-month patient death (0.90 vs 1.29, P=0.005), and 1-year patient death (0.95 vs 1.15, P=0.001). Low-volume centers were frequently in close proximity to higher volume centers, with a median distance of 7 miles (interquartile range: 2 to 75). A robust volume-outcome relationship was observed for deceased donor kidney transplantation, and low-volume centers are frequently in close proximity to higher volume centers. Increased regionalization could improve outcomes, but should be considered carefully in light of the potential negative impact on transplant volume and access to care.

Initial 12-h operative fluid volume is an independent risk factor for pleural effusion after hepatectomy.

PubMed

Cheng, Xiang; Wu, Jia-Wei; Sun, Ping; Song, Zi-Fang; Zheng, Qi-Chang

2016-12-01

Pleural effusion after hepatectomy is associated with significant morbidity and prolonged hospital stays. Several studies have addressed the risk factors for postoperative pleural effusion. However, there are no researches concerning the role of the initial 12-h operative fluid volume. The aim of this study was to evaluate whether the initial 12-h operative fluid volume during liver resection is an independent risk factor for pleural effusion after hepatectomy. In this study, we retrospectively analyzed clinical data of 470 patients consecutively undergoing elective hepatectomy between January 2011 and December 2012. We prospectively collected and retrospectively analyzed baseline and clinical data, including preoperative, intraoperative, and postoperative variables. Univariate and multivariate analyses were carried out to identify whether the initial 12-h operative fluid volume was an independent risk factor for pleural effusion after hepatectomy. The multivariate analysis identified 2 independent risk factors for pleural effusion: operative time [odds ratio (OR)=10.2] and initial 12-h operative fluid volume (OR=1.0003). Threshold effect analyses revealed that the initial 12 h operative fluid volume was positively correlated with the incidence of pleural effusion when the initial 12-h operative fluid volume exceeded 4636 mL. We conclude that the initial 12-h operative fluid volume during liver resection and operative time are independent risk factors for pleural effusion after hepatectomy. Perioperative intravenous fluids should be restricted properly.

Abnormal cerebellar morphometry in abstinent adolescent marijuana users

PubMed Central

Medina, Krista Lisdahl; Nagel, Bonnie J.; Tapert, Susan F.

2010-01-01

Background Functional neuroimaging data from adults have, in general, found frontocerebellar dysfunction associated with acute and chronic marijuana (MJ) use (Loeber & Yurgelun-Todd, 1999). One structural neuroimaging study found reduced cerebellar vermis volume in young adult MJ users with a history of heavy polysubstance use (Aasly et al., 1993). The goal of this study was to characterize cerebellar volume in adolescent chronic MJ users following one month of monitored abstinence. Method Participants were MJ users (n=16) and controls (n=16) aged 16-18 years. Extensive exclusionary criteria included history of psychiatric or neurologic disorders. Drug use history, neuropsychological data, and structural brain scans were collected after 28 days of monitored abstinence. Trained research staff defined cerebellar volumes (including three cerebellar vermis lobes and both cerebellar hemispheres) on high-resolution T1-weighted magnetic resonance images. Results Adolescent MJ users demonstrated significantly larger inferior posterior (lobules VIII-X) vermis volume (p<.009) than controls, above and beyond effects of lifetime alcohol and other drug use, gender, and intracranial volume. Larger vermis volumes were associated with poorer executive functioning (p’s<.05). Conclusions Following one month of abstinence, adolescent MJ users had significantly larger posterior cerebellar vermis volumes than non-using controls. These greater volumes are suggested to be pathological based on linkage to poorer executive functioning. Longitudinal studies are needed to examine typical cerebellar development during adolescence and the influence of marijuana use. PMID:20413277

Intrathoracic Fat Measurements Using Multidetector Computed Tomography (MDCT): Feasibility and Reproducibility

PubMed Central

Stojanovska, Jadranka; Ibrahim, El-Sayed H.; Chughtai, Aamer R.; Jackson, Elizabeth A.; Gross, Barry H.; Jacobson, Jon A.; Tsodikov, Alexander; Daneshvar, Brian; Long, Benjamin D.; Chenevert, Thomas L.; Kazerooni, Ella A.

2017-01-01

Intrathoracic fat volume, more specifically, epicardial fat volume, is an emerging imaging biomarker of adverse cardiovascular events. The purpose of this work is to show the feasibility and reproducibility of intrathoracic fat volume measurement applied to contrast-enhanced multidetector computed tomography images. A retrospective cohort study of 62 subjects free of cardiovascular disease (55% females, age = 49 ± 11 years) conducted from 2008 to 2011 formed the study group. Intrathoracic fat volume was defined as all fat voxels measuring −50 to −250 Hounsfield Unit within the intrathoracic cavity from the level of the pulmonary artery bifurcation to the heart apex. The intrathoracic fat was separated into epicardial and extrapericardial fat by tracing the pericardium. The measurements were obtained by 2 readers and compared for interrater reproducibility. The fat volume measurements for the study group were 141 ± 72 cm3 for intrathoracic fat, 58 ± 27 cm3 for epicardial fat, and 84 ± 50 cm3 for extrapericardial fat. There was no statistically significant difference in intrathoracic fat volume measurements between the 2 readers, with correlation coefficients of 0.88 (P = .55) for intrathoracic fat volume and −0.12 (P = .33) for epicardial fat volume. Voxel-based measurement of intrathoracic fat, including the separation into epicardial and extrapericardial fat, is feasible and highly reproducible from multidetector computed tomography scans. PMID:28626797

Delayed recall, hippocampal volume and Alzheimer neuropathology: findings from the Nun Study.

PubMed

Mortimer, J A; Gosche, K M; Riley, K P; Markesbery, W R; Snowdon, D A

2004-02-10

To examine the associations of hippocampal volume and the severity of neurofibrillary lesions determined at autopsy with delayed verbal recall performance evaluated an average of 1 year prior to death. Hippocampal volumes were computed using postmortem brain MRI from the first 56 scanned participants of the Nun Study. Quantitative neuropathologic studies included lesion counts, Braak staging, and determination of whether neuropathologic criteria for Alzheimer disease (AD) were met. Multiple regression was used to assess the association of hippocampal volume and neuropathologic lesions with the number of words (out of 10) recalled on the Consortium to Establish a Registry for Alzheimer's Disease Delayed Word Recall Test administered an average of 1 year prior to death. When entered separately, hippocampal volume, Braak stage, and the mean neurofibrillary tangle counts in the CA-1 region of the hippocampus and the subiculum were strongly associated with the number of words recalled after a delay, adjusting for age and education. When hippocampal volume was entered together with each neuropathologic index, only hippocampal volume retained a significant association with the delayed recall measure. The association between hippocampal volume and the number of words recalled was present in both demented and nondemented individuals as well as in those with and without substantial AD neurofibrillary pathology. The association of neurofibrillary tangles with delayed verbal recall may reflect associated hippocampal atrophy.

Brain volumes in psychotic youth with schizophrenia and mood disorders

PubMed Central

El-Sayed, Mohamed; Steen, R. Grant; Poe, Michele D.; Bethea, T. Carter; Gerig, Guido; Lieberman, Jeffrey; Sikich, Linmarie

2010-01-01

Background We sought to test the hypothesis that deficits in grey matter volume are characteristic of psychotic youth with early-onset schizophrenia-spectrum disorders (EOSS) but not of psychotic youth with early-onset mood disorders (EOMD). Methods We used magnetic resonance imaging to examine brain volume in 24 psychotic youth (13 male, 11 female) with EOSS (n = 12) or EOMD (n = 12) and 17 healthy controls (10 male, 7 female). We measured the volume of grey and white matter using an automated segmentation program. Results After adjustment for age and intracranial volume, whole brain volume was lower in the EOSS patients than in the healthy controls (p = 0.001) and EOMD patients (p = 0.002). The EOSS patients had a deficit in grey matter volume (p = 0.005), especially in the frontal (p = 0.003) and parietal (p = 0.006) lobes, with no significant differences in white matter volume. Limitations The main limitations of our study were its small sample size and the inclusion of patients with depression and mania in the affective group. Conclusion Adolescents with EOSS have grey matter deficits compared with healthy controls and psychotic adolescents with EOMD. Our results suggest that grey matter deficits are not generally associated with psychosis but may be specifically associated with schizophrenia. Larger studies with consistent methods are needed to reconcile the contradictory findings among imaging studies involving psychotic youth. PMID:20569649

Pharmacokinetic evidence for improved ophthalmic drug delivery by reduction of instilled volume.

PubMed

Patton, T F

1977-07-01

The bioavailability of topically applied pilocarpine nitrate was studied as a function of instilled volume. As the instilled volume decreased, the fraction of dose absorbed increased. The relationship between fraction absorbed and instilled volume was not direct, but appropriate adjustment of instilled volume and concentration should permit substantial dosage reductions without sacrifice of drug concentration in the eye. The implications of these findings from both a therapeutic and toxicity standpoint are discussed.

Parsing partial molar volumes of small molecules: a molecular dynamics study.

PubMed

Patel, Nisha; Dubins, David N; Pomès, Régis; Chalikian, Tigran V

2011-04-28

We used molecular dynamics (MD) simulations in conjunction with the Kirkwood-Buff theory to compute the partial molar volumes for a number of small solutes of various chemical natures. We repeated our computations using modified pair potentials, first, in the absence of the Coulombic term and, second, in the absence of the Coulombic and the attractive Lennard-Jones terms. Comparison of our results with experimental data and the volumetric results of Monte Carlo simulation with hard sphere potentials and scaled particle theory-based computations led us to conclude that, for small solutes, the partial molar volume computed with the Lennard-Jones potential in the absence of the Coulombic term nearly coincides with the cavity volume. On the other hand, MD simulations carried out with the pair interaction potentials containing only the repulsive Lennard-Jones term produce unrealistically large partial molar volumes of solutes that are close to their excluded volumes. Our simulation results are in good agreement with the reported schemes for parsing partial molar volume data on small solutes. In particular, our determined interaction volumes() and the thickness of the thermal volume for individual compounds are in good agreement with empirical estimates. This work is the first computational study that supports and lends credence to the practical algorithms of parsing partial molar volume data that are currently in use for molecular interpretations of volumetric data.

Peripheral telomere length and hippocampal volume in adolescents with major depressive disorder.

PubMed

Henje Blom, E; Han, L K M; Connolly, C G; Ho, T C; Lin, J; LeWinn, K Z; Simmons, A N; Sacchet, M D; Mobayed, N; Luna, M E; Paulus, M; Epel, E S; Blackburn, E H; Wolkowitz, O M; Yang, T T

2015-11-10

Several studies have reported that adults with major depressive disorder have shorter telomere length and reduced hippocampal volumes. Moreover, studies of adult populations without major depressive disorder suggest a relationship between peripheral telomere length and hippocampal volume. However, the relationship of these findings in adolescents with major depressive disorder has yet to be explored. We examined whether adolescent major depressive disorder is associated with altered peripheral telomere length and hippocampal volume, and whether these measures relate to one another. In 54 unmedicated adolescents (13-18 years) with major depressive disorder and 63 well-matched healthy controls, telomere length was assessed from saliva using quantitative polymerase chain reaction methods, and bilateral hippocampal volumes were measured with magnetic resonance imaging. After adjusting for age and sex (and total brain volume in the hippocampal analysis), adolescents with major depressive disorder exhibited significantly shorter telomere length and significantly smaller right, but not left hippocampal volume. When corrected for age, sex, diagnostic group and total brain volume, telomere length was not significantly associated with left or right hippocampal volume, suggesting that these cellular and neural processes may be mechanistically distinct during adolescence. Our findings suggest that shortening of telomere length and reduction of hippocampal volume are already present in early-onset major depressive disorder and thus unlikely to be only a result of accumulated years of exposure to major depressive disorder.

Intracranial Volume and Whole Brain Volume in Infants With Unicoronal Craniosynostosis

PubMed Central

Hill, Cheryl A.; Vaddi, S.; Moffitt, Amanda; Kane, A.A.; Marsh, Jeffrey L.; Panchal, Jayesh; Richtsmeier, Joan T.; Aldridge, Kristina

2011-01-01

Objective Craniosynostosis has been hypothesized to result in alterations of the brain and cerebral blood flow due to reduced intracranial volume, potentially leading to cognitive deficits. In this study we test the hypothesis that intracranial volume and whole brain volume in infants with unilateral coronal synostosis differs from those in unaffected infants. Design Our study sample consists of magnetic resonance images acquired from 7- to 72-week-old infants with right unilateral coronal synostosis prior to surgery (n = 10) and age-matched unaffected infants (n = 10). We used Analyze 9.0 software to collect three cranial volume measurements. We used nonparametric tests to determine whether the three measures differ between the two groups. Correlations were calculated between age and the three volume measures in each group to determine whether the growth trajectory of the measurements differ between children with right unicoronal synostosis and unaffected infants. Results Our results show that the three volume measurements are not reduced in infants with right unicoronal synostosis relative to unaffected children. Correlation analyses between age and various volume measures show similar correlations in infants with right unicoronal synostosis compared with unaffected children. Conclusions Our results show that the relationship between brain size and intracranial size in infants with right unicoronal synostosis is similar to that in unaffected children, suggesting that reduced intracranial volume is not responsible for alterations of the brain in craniosynostosis. PMID:20815706

Endoscopic transnasal approach for the treatment of isolated medial orbital blow-out fractures: a prospective study of preoperative and postoperative orbital volume change.

PubMed

Kim, KyoungHoon; Song, KyeongHo; Choi, SooJong; Bae, YongChan; Choi, ChiWon; Oh, HeungChan; Lee, JaeWoo; Nam, SuBong

2012-02-01

Endoscopic transnasal reduction is a safe and effective technique for the treatment of blow-out fractures of the medial orbital wall. However, because this approach does not use rigid permanent material for reconstruction of the fractured medial orbital wall, some degree of herniation of the orbital contents may occur after the intraethmoidal packing material is removed. The purpose of this study was to evaluate the change in orbital volume in patients with medial orbital wall fractures treated through an endoscopic transnasal approach. This study was a prospective analysis that includes 20 patients who underwent endoscopic transnasal reduction of medial orbital wall fractures between April 2007 and December 2008. Computer-assisted orbital volume measurements were made using axial computed tomography. The mean (standard deviation [SD]) volume increase was 2.00 (0.92) cm(3) and the mean (SD) dimension of the fractured orbital wall was 2.76 (0.83) cm(2). After endoscopic surgery, an average (SD) volume decrease of 2.15 (0.91) cm(3) was achieved with ethmoid sinus packing. After removal of the packing materials, 1.14 (0.78) cm(3) increase of the orbital volume was observed. The dimension of the orbital wall fracture significantly correlated with the increased preoperative orbital volume (P = 0.002, r = 0.609); the preoperative increase in the orbital volume also significantly correlated with volume relapse after removal of the packing (P = 0.023, r = 0.452). These findings suggest that in broad orbital wall fractures, reconstruction of the orbital wall by rigid materials or prolongation of the packing period should be considered, because orbital volume can increase again after packing removal, and may thus lead to postoperative complications.

What Is the Standard Volume to Increase a Cup Size for Breast Augmentation Surgery? A Novel Three-Dimensional Computed Tomographic Approach.

PubMed

King, Nina-Marie; Lovric, Vedran; Parr, William C H; Walsh, W R; Moradi, Pouria

2017-05-01

Breast augmentation surgery poses many challenges, and meeting the patient's expectations is one of the most important. Previous reports equate 100 cc to a one-cup-size increase; however, no studies have confirmed this between commercially available bras. The aim of this study was to identify the volume increase between cup sizes across different brands and the relationship with implant selection. Five bra cup sizes from three different companies were analyzed for their volume capacity. Three methods were used to calculate the volume of the bras: (1) linear measurements; (2) volume measurement by means of water displacement; and (3) volume calculation after three-dimensional reconstruction of serial radiographic data (computed tomography). The clinical arm consisted of 79 patients who underwent breast augmentation surgery from February 1, 2014, to June 30, 2016. Answers from a short questionnaire in combination with the implant volume were analyzed. Across all three brands, the interval volume increase varied between sizes, but not all were above 100 cc. There was some variation in the volume capacity of the same cup size among the different brands. The average incremental increase in bra cup size across all three brands in the laboratory arm was 135 cc. The mean volume increase per cup size was 138.23 cc in the clinical arm. This article confirms that there is no standardization within the bra manufacturing industry. On the basis of this study, patients should be advised that 130 to 150 cc equates to a one-cup-size increase. Bras with narrower band widths need 130 cc and wider band widths require 150 cc to increase one cup size.

Evaluation of a new 3-dimensional color Doppler flow method to quantify flow across the mitral valve and in the left ventricular outflow tract: an in vitro study.

PubMed

Kimura, Sumito; Streiff, Cole; Zhu, Meihua; Shimada, Eriko; Datta, Saurabh; Ashraf, Muhammad; Sahn, David J

2014-02-01

The aim of this study was to assess the accuracy, feasibility, and reproducibility of determining stroke volume from a novel 3-dimensional (3D) color Doppler flow quantification method for mitral valve (MV) inflow and left ventricular outflow tract (LVOT) outflow at different stroke volumes when compared with the actual flow rate in a pumped porcine cardiac model. Thirteen freshly harvested pig hearts were studied in a water tank. We inserted a latex balloon into each left ventricle from the MV annulus to the LVOT, which were passively pumped at different stroke volumes (30-80 mL) using a calibrated piston pump at increments of 10 mL. Four-dimensional flow volumes were obtained without electrocardiographic gating. The digital imaging data were analyzed offline using prototype software. Two hemispheric flow-sampling planes for color Doppler velocity measurements were placed at the MV annulus and LVOT. The software computed the flow volumes at the MV annulus and LVOT within the user-defined volume and cardiac cycle. This novel 3D Doppler flow quantification method detected incremental increases in MV inflow and LVOT outflow in close agreement with pumped stroke volumes (MV inflow, r = 0.96; LVOT outflow, r = 0.96; P < .01). Bland-Altman analysis demonstrated overestimation of both (MV inflow, 5.42 mL; LVOT outflow, 4.46 mL) with 95% of points within 95% limits of agreement. Interobserver variability values showed good agreement for all stroke volumes at both the MV annulus and LVOT. This study has shown that the 3D color Doppler flow quantification method we used is able to compute stroke volumes accurately at the MV annulus and LVOT in the same cardiac cycle without electrocardiographic gating. This method may be valuable for assessment of cardiac output in clinical studies.

Influence of infusion volume on the ocular hemodynamic effects of peribulbar anesthesia.

PubMed

Lung, Solveig; Luksch, Alexandra; Weigert, Günther; Georgopoulos, Michael; Menapace, Rupert; Polska, Elzbieta; Garhofer, Gerhard; Findl, Oliver; Schmetterer, Leopold

2006-09-01

To test the hypothesis that ocular blood-flow response to peribulbar anesthesia can be reduced by using a smaller volume of anesthetic mixture. Departments of Ophthalmology and Clinical Pharmacology, Medical University of Vienna, Vienna, Austria. Twenty patients scheduled for bilateral age-related cataract surgery were enrolled in a prospective randomized balanced observer-masked crossover study. Two study days with a 2 mL injection volume or 5 mL injection volume used for peribulbar anesthesia were scheduled. On 1 study day, patients received the 1-dose regimen and on the other study day, when the contralateral eye had surgery, patients received the other injection volume. On both study days, the anesthetic mixture consisted of an equal amount of lidocaine, bupivacaine, and hyaluronidase independently of the injection volume. Intraocular pressure (IOP), blood pressure, and pulse rate were measured noninvasively. Ocular fundus pulsation amplitude (FPA) and peak systolic and end diastolic flow velocities in the central retinal artery were measured with laser interferometry and color Doppler imaging, respectively. The results were recorded as means +/- SD. Peribulbar anesthesia increased IOP and reduced FPA and flow velocities in the central retinal artery. The effects on IOP (5 mL, 35.1% +/- 16.0%; 2 mL, 14.1% +/- 14.1%; P<.001) and ocular hemodynamic parameters (FPA: 5 mL, -17.5% +/- 7.8%/2 mL, -7.3% +/- 7.2%, P<.001; peak systolic velocity: 5 mL, -19.5% +/- 10.7%/2 mL, -10.6% +/- 9.8%, P = .013; end diastolic velocity: 5 mL, -16.7% +/- 6.2%/2 mL, -8.4% +/- 7.3%, P = .005) were more pronounced with the 5 mL injection volume than with the 2 mL injection volume. An injection volume of 2 mL instead of 5 mL reduced the ocular blood-flow response to peribulbar anesthesia. This procedure may be used in patients with ocular vascular disease to reduce the incidence of anesthesia-induced ischemia and loss of vision.

Kidney volume measurement methods for clinical studies on autosomal dominant polycystic kidney disease

PubMed Central

Sharma, Kanishka; Caroli, Anna; Quach, Le Van; Petzold, Katja; Bozzetto, Michela; Serra, Andreas L.; Remuzzi, Giuseppe; Remuzzi, Andrea

2017-01-01

Background In autosomal dominant polycystic kidney disease (ADPKD), total kidney volume (TKV) is regarded as an important biomarker of disease progression and different methods are available to assess kidney volume. The purpose of this study was to identify the most efficient kidney volume computation method to be used in clinical studies evaluating the effectiveness of treatments on ADPKD progression. Methods and findings We measured single kidney volume (SKV) on two series of MR and CT images from clinical studies on ADPKD (experimental dataset) by two independent operators (expert and beginner), twice, using all of the available methods: polyline manual tracing (reference method), free-hand manual tracing, semi-automatic tracing, Stereology, Mid-slice and Ellipsoid method. Additionally, the expert operator also measured the kidney length. We compared different methods for reproducibility, accuracy, precision, and time required. In addition, we performed a validation study to evaluate the sensitivity of these methods to detect the between-treatment group difference in TKV change over one year, using MR images from a previous clinical study. Reproducibility was higher on CT than MR for all methods, being highest for manual and semiautomatic contouring methods (planimetry). On MR, planimetry showed highest accuracy and precision, while on CT accuracy and precision of both planimetry and Stereology methods were comparable. Mid-slice and Ellipsoid method, as well as kidney length were fast but provided only a rough estimate of kidney volume. The results of the validation study indicated that planimetry and Stereology allow using an importantly lower number of patients to detect changes in kidney volume induced by drug treatment as compared to other methods. Conclusions Planimetry should be preferred over fast and simplified methods for accurately monitoring ADPKD progression and assessing drug treatment effects. Expert operators, especially on MR images, are required for performing reliable estimation of kidney volume. The use of efficient TKV quantification methods considerably reduces the number of patients to enrol in clinical investigations, making them more feasible and significant. PMID:28558028

Regional Differences in Brain Volume Predict the Acquisition of Skill in a Complex Real-Time Strategy Videogame

ERIC Educational Resources Information Center

Basak, Chandramallika; Voss, Michelle W.; Erickson, Kirk I.; Boot, Walter R.; Kramer, Arthur F.

2011-01-01

Previous studies have found that differences in brain volume among older adults predict performance in laboratory tasks of executive control, memory, and motor learning. In the present study we asked whether regional differences in brain volume as assessed by the application of a voxel-based morphometry technique on high resolution MRI would also…

Parent and Community Involvement in Education. Volume I: Findings and Conclusions. Studies of Education Reform.

ERIC Educational Resources Information Center

Rutherford, Barry; And Others

Genuine educational reform depends on developing relationships with the home, community groups, politicians, and the business community (Seeley, 1981). This volume is the first of three volumes that are products of a 3.5 year study of education reform, with a focus on the role of parent, family, and community involvement in the middle grades. The…

The Nature of Middle School Mathematics Teachers' Pedagogical Content Knowledge: The Case of The Volume of Prisms

ERIC Educational Resources Information Center

Tekin-Sitrava, Reyhan; Isiksal-Bostan, Mine

2018-01-01

This study investigated middle school teachers' knowledge of students' misconceptions and the sources of these misconceptions related to the volume of prisms. This case study investigated four middle school teachers who taught 8th grade students in Ankara (Turkey). Based on the analysis of the data, two misconceptions related to the volume of…

National Day Care Study First Annual Report. Volume III: Information Management and Data Collection Systems.

ERIC Educational Resources Information Center

Goodrich, Nancy; And Others

Volume III of the National Day Care Study First Annual Report funded by the Office of Child Development describes the information management system which was developed and tested during Phase I. In addition, the volume includes overviews of the sample instruments from the three major data collection systems developed during the year: the Research…

Computer Chips and Paper Clips. Technology and Women's Employment. Volume II. Case Studies and Policy Perspectives.

ERIC Educational Resources Information Center

Hartmann, Heidi I., Ed.; And Others

This volume contains 12 papers commissioned by the Panel on Technology and Women's Employment. "Technology, Women, and Work: Policy Perspectives" (Eli Ginzberg) is an overview that provides a context for the volume. The four case studies in Part II describe the impact of information technology in the insurance industry, among bookkeepers, among…

Greater cerebellar gray matter volume in car drivers: an exploratory voxel-based morphometry study

PubMed Central

Sakai, Hiroyuki; Ando, Takafumi; Sadato, Norihiro; Uchiyama, Yuji

2017-01-01

Previous functional neuroimaging studies have identified multiple brain areas associated with distinct aspects of car driving in simulated traffic environments. Few studies, however, have examined brain morphology associated with everyday car-driving experience in real traffic. Thus, the aim of the current study was to identify gray matter volume differences between drivers and non-drivers. We collected T1-weighted structural brain images from 73 healthy young adults (36 drivers and 37 non-drivers). We performed a whole-brain voxel-based morphometry analysis to examine between-group differences in regional gray matter volume. Compared with non-drivers, drivers showed significantly greater gray matter volume in the left cerebellar hemisphere, which has been associated with cognitive rather than motor functioning. In contrast, we found no brain areas with significantly greater gray matter volume in non-drivers compared with drivers. Our findings indicate that experience with everyday car driving in real traffic is associated with greater gray matter volume in the left cerebellar hemisphere. This brain area may be involved in abilities that are critical for driving a car, but are not commonly or frequently used during other daily activities. PMID:28417971

Greater cerebellar gray matter volume in car drivers: an exploratory voxel-based morphometry study.

PubMed

Sakai, Hiroyuki; Ando, Takafumi; Sadato, Norihiro; Uchiyama, Yuji

2017-04-18

Previous functional neuroimaging studies have identified multiple brain areas associated with distinct aspects of car driving in simulated traffic environments. Few studies, however, have examined brain morphology associated with everyday car-driving experience in real traffic. Thus, the aim of the current study was to identify gray matter volume differences between drivers and non-drivers. We collected T1-weighted structural brain images from 73 healthy young adults (36 drivers and 37 non-drivers). We performed a whole-brain voxel-based morphometry analysis to examine between-group differences in regional gray matter volume. Compared with non-drivers, drivers showed significantly greater gray matter volume in the left cerebellar hemisphere, which has been associated with cognitive rather than motor functioning. In contrast, we found no brain areas with significantly greater gray matter volume in non-drivers compared with drivers. Our findings indicate that experience with everyday car driving in real traffic is associated with greater gray matter volume in the left cerebellar hemisphere. This brain area may be involved in abilities that are critical for driving a car, but are not commonly or frequently used during other daily activities.

Change of the human taste bud volume over time.

PubMed

Srur, Ehab; Stachs, Oliver; Guthoff, Rudolf; Witt, Martin; Pau, Hans Wilhelm; Just, Tino

2010-08-01

The specific aim of this study is to measure the taste volume in healthy human subjects over a 2.5-month period and to demonstrate morphological changes of the peripheral taste organs. Eighteen human taste buds in four fungiform papillae (fPap) were examined over a 10-week period. The fungiform papillae investigated were selected based on the form of the papillae or the arrangement of surface taste pores. Measurements were performed over 10 consecutive weeks, with five scans in a day once a week. The following parameters were measured: height and diameter of the taste bud, diameter of the fungiform papilla and diameter of the taste pore. The findings of this exploratory study indicated that (1) taste bud volumes changed over a 10-week period, (2) the interval between two volume maxima within the 10-week period was 3-5 weeks, and (3) the diameter of the fPap did not correlate with the volume of a single taste bud or with the volume of all taste buds in the fPap within the 10-week period. This exploratory in vivo study revealed changes in taste bud volumes in healthy humans with age-related gustatory sensitivity. These findings need to be considered when studying the effect of denervation of fungiform papillae in vivo using confocal microscopy. Crown Copyright 2009. Published by Elsevier Ireland Ltd. All rights reserved.

Low rates of complications for carotid artery stenting are associated with a high clinician volume of carotid artery stenting and aortic endografting but not with a high volume of percutaneous coronary interventions.

PubMed

Modrall, J Gregory; Chung, Jayer; Kirkwood, Melissa L; Baig, M Shadman; Tsai, Shirling X; Timaran, Carlos H; Valentine, R James; Rosero, Eric B

2014-07-01

Prior studies have demonstrated improved clinical outcomes for surgeons with a high-volume experience with certain open vascular operations. A high-volume experience with carotid artery stenting (CAS) improves clinical outcomes. Moreover, it is not known whether experience with other endovascular procedures, including percutaneous coronary interventions (PCIs), is an adequate substitute for experience with CAS. The goal of this study was to quantify the effect of increasing clinician volume of CAS, endovascular aneurysm repair (EVAR), and thoracic endovascular aortic aneurysm repair (TEVAR), and PCI on the outcomes for CAS. The Nationwide Inpatient Sample was analyzed to identify patients undergoing CAS for the years 2005 to 2009. Clinicians were stratified into tertiles of low-volume, medium-volume, and high-volume groups by annual volume of CAS, EVAR/TEVAR, and PCI. Multiple logistic regression analyses were used to examine the relationship between clinician volume and a composite outcome of the in-hospital stroke and death rate after CAS. Between 2005 and 2009, 56,374 elective CAS procedures were performed nationwide, with a crude in-hospital stroke and death rate of 3.22%. A median of nine CAS procedures (interquartile range, 3-20) were performed annually per clinician. As expected, stroke and death rates for CAS decreased with increasing volume of CAS performed by a clinician (low-volume vs medium-volume vs high-volume: 4.43% vs 2.89% vs 2.27%; P = .0001). Similar patterns were noted between clinicians' volume of EVAR/TEVAR (low-volume vs medium-volume vs high-volume: 4.58% vs 3.18% vs 2.16%; P = .0023). In contrast, increasing PCI volume was not associated with decreased stroke and death rates after CAS (low-volume vs medium-volume vs high-volume: 2.99% vs 3.18% vs 3.55%; P = .35). After adjusting for patient and hospital characteristics, clinician volume of CAS (odds ratio [OR], 0.84; 95% confidence interval [CI], 0.74-0.94; P = .003) and EVAR/TEVAR (OR, 0.85; 95% CI, 0.75-0.97; P = .020) remained significant predictors of stroke and death after CAS, whereas increasing clinician volume of PCI was associated with significantly increasing likelihood of stroke or death after CAS (OR, 1.025; 95% CI, 1.004-1.047; P = .019). The stroke and death rate for CAS to treat carotid stenosis is inversely affected by the number of CAS and EVAR/TEVAR procedures performed by a clinician. In contrast, a high-volume experience with PCI is not associated with improved outcomes after CAS. Copyright © 2014 Society for Vascular Surgery. All rights reserved.

Reference database of lung volumes and capacities in wistar rats from 2 to 24 months.

PubMed

Filho, Wilson Jacob; Fontinele, Renata Gabriel; de Souza, Romeu Rodrigues

2014-01-01

This study determines the effects of growing and aging on lung physiological volumes and capacities and the incidence of inflammation in the small airways with age in rats. A reference database comprising of body weight gain, lung physiological volumes and capacities and an anatomopathological study of lung lesions over 240 Wistar rats from two to 24 -mo, is described. Tidal volume (TV), minute respiratory volume (MRV), and forced vital capacity (FVC) decreased during the first six months of life and then remain constant until 24 -mo of age. The respiratory frequency (Rf) and dynamical compliance (Cdyn) maintain at constant values from 2 to 24- mo of age; the functional residual capacity (FRC) increases in the first 6 -mo and then remains constant up to 24 -mo. It was verified a less intensive inflammation in the small airways with age, when compared with the median and large airways. This study showed the normal parameters for lung volumes and capacities and the incidence of infections for growing and aging male and female rats. The age-related data on these main respiratory parameters in rats would be useful in studies of aging-related disorders using this model and for safety pharmacology studies necessary for the development of drugs.

Cerebral gray matter volume variation in female-to-male transsexuals: a voxel-based morphometric study.

PubMed

Kim, Tae-Hoon; Kim, Seok-Kwun; Jeong, Gwang-Woo

2015-12-16

Several studies seem to support the hypothesis that brain anatomy is associated with transsexualism. However, these studies were still limited because few neuroanatomical findings have been obtained from female-to-male (FtM) transsexuals. This study compared the cerebral regional volumes of gray matter (GM) between FtM transsexuals and female controls using a voxel-based morphometry. Twelve FtM transsexuals who had undergone sex-reassignment surgery and 15 female controls participated in this study. Both groups were age matched and right-handed, with no history of neurological illness. Fifteen female controls were recruited to determine whether GM volumes in FtM transsexuals more closely resembled individuals who shared their biological sex. MRI data were processed using SPM 8 with the diffeomorphic anatomical registration through exponentiated Lie algebra (DARTEL). FtM transsexuals showed significantly larger volumes of the thalamus, hypothalamus, midbrain, gyrus rectus, head of caudate nucleus, precentral gyrus, and subcallosal area compared with the female controls. However, the female controls showed a significantly larger volume in the superior temporal gyrus including Heschl's gyrus and Rolandic operculum. These findings confirm that the volume difference in brain substructures in FtM transsexuals is likely to be associated with transsexualism and that transsexualism is probably associated with distinct cerebral structures, determining gender identity.

Validation of multi-detector computed tomography as a non-invasive method for measuring ovarian volume in macaques (Macaca fascicularis).

PubMed

Jones, Jeryl C; Appt, Susan E; Werre, Stephen R; Tan, Joshua C; Kaplan, Jay R

2010-06-01

The purpose of this study was to validate low radiation dose, contrast-enhanced, multi-detector computed tomography (MDCT) as a non-invasive method for measuring ovarian volume in macaques. Computed tomography scans of four known-volume phantoms and nine mature female cynomolgus macaques were acquired using a previously described, low radiation dose scanning protocol, intravenous contrast enhancement, and a 32-slice MDCT scanner. Immediately following MDCT, ovaries were surgically removed and the ovarian weights were measured. The ovarian volumes were determined using water displacement. A veterinary radiologist who was unaware of actual volumes measured ovarian CT volumes three times, using a laptop computer, pen display tablet, hand-traced regions of interest, and free image analysis software. A statistician selected and performed all tests comparing the actual and CT data. Ovaries were successfully located in all MDCT scans. The iliac arteries and veins, uterus, fallopian tubes, cervix, ureters, urinary bladder, rectum, and colon were also consistently visualized. Large antral follicles were detected in six ovaries. Phantom mean CT volume was 0.702+/-SD 0.504 cc and the mean actual volume was 0.743+/-SD 0.526 cc. Ovary mean CT volume was 0.258+/-SD 0.159 cc and mean water displacement volume was 0.257+/-SD 0.145 cc. For phantoms, the mean coefficient of variation for CT volumes was 2.5%. For ovaries, the least squares mean coefficient of variation for CT volumes was 5.4%. The ovarian CT volume was significantly associated with actual ovarian volume (ICC coefficient 0.79, regression coefficient 0.5, P=0.0006) and the actual ovarian weight (ICC coefficient 0.62, regression coefficient 0.6, P=0.015). There was no association between the CT volume accuracy and mean ovarian CT density (degree of intravenous contrast enhancement), and there was no proportional or fixed bias in the CT volume measurements. Findings from this study indicate that MDCT is a valid non-invasive technique for measuring the ovarian volume in macaques.

Hospital volume and mortality for 25 types of inpatient treatment in German hospitals: observational study using complete national data from 2009 to 2014.

PubMed

Nimptsch, Ulrike; Mansky, Thomas

2017-09-06

To explore the existence and strength of a relationship between hospital volume and mortality, to estimate minimum volume thresholds and to assess the potential benefit of centralisation of services. Observational population-based study using complete German hospital discharge data (Diagnosis-Related Group Statistics (DRG Statistics)). All acute care hospitals in Germany. All adult patients hospitalised for 1 out of 25 common or medically important types of inpatient treatment from 2009 to 2014. Risk-adjusted inhospital mortality. Lower inhospital mortality in association with higher hospital volume was observed in 20 out of the 25 studied types of treatment when volume was categorised in quintiles and persisted in 17 types of treatment when volume was analysed as a continuous variable. Such a relationship was found in some of the studied emergency conditions and low-risk procedures. It was more consistently present regarding complex surgical procedures. For example, about 22 000 patients receiving open repair of abdominal aortic aneurysm were analysed. In very high-volume hospitals, risk-adjusted mortality was 4.7% (95% CI 4.1 to 5.4) compared with 7.8% (7.1 to 8.7) in very low volume hospitals. Theminimum volume above which risk of death would fall below the average mortality was estimated as 18 cases per year. If all hospitals providing this service would perform at least 18 cases per year, one death among 104 (76 to 166) patients could potentially be prevented. Based on complete national hospital discharge data, the results confirmed volume-outcome relationships for many complex surgical procedures, as well as for some emergency conditions and low-risk procedures. Following these findings, the study identified areas where centralisation would provide a benefit for patients undergoing the specific type of treatment in German hospitals and quantified the possible impact of centralisation efforts. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Association Between Infrapatellar Fat Pad Volume and Knee Structural Changes in Patients with Knee Osteoarthritis.

PubMed

Cai, Jingyu; Xu, Jianhua; Wang, Kang; Zheng, Shuang; He, Fan; Huan, Shuting; Xu, Shengqing; Zhang, Hui; Laslett, Laura; Ding, Changhai

2015-10-01

The function of the infrapatellar fat pad (IPFP) in knee osteoarthritis (OA) remains uncertain. This study aimed to examine cross-sectional associations between IPFP volume and knee structures in patients with knee OA. The study included 174 patients with clinical knee OA (mean age, 55.5 yrs). Fat-suppressed 3-D T1-weighted spoiled gradient recall magnetic resonance imaging (MRI) was used to measure the IPFP and cartilage volume. T2-weighted fast spin echo MRI was used to assess cartilage defects and bone marrow lesions (BML). Radiographic knee osteophytes and joint space narrowing (JSN) were assessed using the Osteoarthritis Research Society International atlas. After adjustment for potential confounders, greater IPFP volume was associated with greater tibial and patellar cartilage volume (all p < 0.05), and fewer cartilage defects at all sites (OR 0.88-0.91, all p < 0.05). IPFP volume was associated with presence of BML at lateral tibial and medial femoral sites (OR 0.88-0.91, all p < 0.05) and osteophytes at lateral tibiofemoral compartment (OR 0.88, p < 0.05). IPFP volume was not significantly associated with JSN. Greater IPFP volume was associated with greater knee cartilage volume and fewer structural abnormalities, suggesting a protective role of IPFP size in knee OA.

[Definition of low threshold volumes for quality assurance: conceptual and methodological issues involved in the definition and evaluation of thresholds for volume outcome relations in clinical care].

PubMed

Wetzel, Hermann

2006-01-01

In a large number of mostly retrospective association studies, a statistical relationship between volume and quality of health care has been reported. However, the relevance of these results is frequently limited by methodological shortcomings. In this article, criteria for the evidence and definition of thresholds for volume-outcome relations are proposed, e.g. the specification of relevant outcomes for quality indicators, analysis of volume as a continuous variable with an adequate case-mix and risk adjustment, accounting for cluster effects and considering mathematical models for the derivation of cut-off values. Moreover, volume thresholds are regarded as surrogate parameters for the indirect classification of the quality of care, whose diagnostic validity and effectiveness in improving health care quality need to be evaluated in prospective studies.

Measurement of lung volumes from supine portable chest radiographs.

PubMed

Ries, A L; Clausen, J L; Friedman, P J

1979-12-01

Lung volumes in supine nonambulatory patients are physiological parameters often difficult to measure with current techniques (plethysmograph, gas dilution). Existing radiographic methods for measuring lung volumes require standard upright chest radiographs. Accordingly, in 31 normal supine adults, we determined helium-dilution functional residual and total lung capacities and measured planimetric lung field areas (LFA) from corresponding portable anteroposterior and lateral radiographs. Low radiation dose methods, which delivered less than 10% of that from standard portable X-ray technique, were utilized. Correlation between lung volume and radiographic LFA was highly significant (r = 0.96, SEE = 10.6%). Multiple-step regressions using height and chest diameter correction factors reduced variance, but weight and radiographic magnification factors did not. In 17 additional subjects studied for validation, the regression equations accurately predicted radiographic lung volume. Thus, this technique can provide accurate and rapid measurement of lung volume in studies involving supine patients.

The relationships between breast volume, breast dense volume and volumetric breast density with body mass index, body fat mass and ethnicity

NASA Astrophysics Data System (ADS)

Zakariyah, N.; Pathy, N. B.; Taib, N. A. M.; Rahmat, K.; Judy, C. W.; Fadzil, F.; Lau, S.; Ng, K. H.

2016-03-01

It has been shown that breast density and obesity are related to breast cancer risk. The aim of this study is to investigate the relationships of breast volume, breast dense volume and volumetric breast density (VBD) with body mass index (BMI) and body fat mass (BFM) for the three ethnic groups (Chinese, Malay and Indian) in Malaysia. We collected raw digital mammograms from 2450 women acquired on three digital mammography systems. The mammograms were analysed using Volpara software to obtain breast volume, breast dense volume and VBD. Body weight, BMI and BFM of the women were measured using a body composition analyser. Multivariable logistic regression was used to determine the independent predictors of increased overall breast volume, breast dense volume and VBD. Indians have highest breast volume and breast dense volume followed by Malays and Chinese. While Chinese are highest in VBD, followed by Malay and Indian. Multivariable analysis showed that increasing BMI and BFM were independent predictors of increased overall breast volume and dense volume. Moreover, BMI and BFM were independently and inversely related to VBD.

Effect of Hospital Volume on Prosthesis Use and Mortality in Aortic Valve Operations in the Elderly.

PubMed

McNeely, Christian; Markwell, Stephen; Filson, Kathryn; Hazelrigg, Stephen; Vassileva, Christina

2016-02-01

This study was designed to examine the effect of hospital procedural volume on outcomes in aortic valve replacement (AVR) in the elderly. The study included 277,928 Medicare beneficiaries who underwent AVR from 2000 through 2009 at one of 1,255 participating hospitals. Operative mortality and the use of mechanical prostheses were analyzed according to hospital annual procedural volume. Annual AVR volume was divided into 5 different categories: the smallest volume group with less than 10 AVRs per year to the largest group averaging more than 70 AVRs per year. The overall observed operative mortality rate was 7.3%; for isolated AVR it was 5.5%. Lower-volume hospitals exhibited increased adjusted operative mortality: 10 cases or fewer per year--odds ratio (OR), 1.55; 95% confidence interval (CI), 1.39 to 1.72; 11 to 20 cases per year--OR, 1.35; 95% CI, 1.23 to 1.47; 21 to 40 cases per year--OR, 1.15; 95% CI, 1.06 to 1.25; 41 to 70 cases per year--OR, 1.10; 95% CI, 1.01 to 1.20 relative to those hospitals performing more than 70 cases per year. The discrepancy in operative mortality between low- and high-volume hospitals diverged during the study. Mechanical valve use decreased with increasing hospital volume (p = 0.0001). Mechanical valves were used in 64.5% of AVRs in hospitals with an annual AVR volume less than 10 in contrast to only 25.4% in hospitals with an annual AVR volume more than 70. After adjustment, the use of mechanical valves was independently associated with increased operative mortality (OR, 1.15; 95% CI, 1.11-1.19). Low-volume centers were characterized by increased adjusted operative mortality and greater use of mechanical prostheses, a trend that persisted during the 10-year course of the study. These data would support the center-of-excellence concept for AVR and may be particularly relevant in the elderly population. Copyright © 2016 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

MRI Brain Volume Measurements in Infantile Neuronal Ceroid Lipofuscinosis

PubMed Central

Baker, Eva H.; Levin, Sondra W.; Zhang, Zhongjian; Mukherjee, Anil B.

2016-01-01

Background Infantile neuronal ceroid lipofuscinosis (INCL) is a devastating neurodegenerative storage disease caused by palmitoyl-protein thioesterase-1 (PPT1) deficiency. PPT1 deficiency impairs degradation of palmitoylated proteins (constituents of ceroid) by lysosomal hydrolases. Consequent lysosomal ceroid accumulation leads to neuronal injury, resulting in rapid neurodegeneration and childhood demise. As part of a project studying treatment benefits of a combination of cysteamine bitartrate and N-acetylcysteine, we made serial measurements of patients’ brain volumes using MRI. Methods Ten INCL patients participating in a treatment/follow-up study underwent brain MRI that included high resolution T1-weighted images. After manual placement of a mask delineating the surface of the brain, a maximum-likelihood classifier was applied to determine total brain volume, further subdivided as cerebrum, cerebellum, brainstem, and thalamus. Patients’ brain volumes were compared to those of a normal population. Results Major subdivisions of the brain followed similar trajectories with different timing. The cerebrum demonstrated early, rapid volume loss, and may never have been normal postnatally. The thalamus dropped out of the normal range around age 6 months, cerebellum around age 2 years, and brainstem around age 3 years. Discussion Rapid cerebral volume loss was expected based upon previous qualitative reports. Because our study did not include a non-treatment arm, and because progression of brain volumes in INCL has not previously been quantified, we could not determine whether our intervention had a beneficial effect on brain volumes. However, the level of quantitative detail in this study allows it to serve as a reference for evaluation of future therapeutic interventions. PMID:27765741

4D computed tomography scans for conformal thoracic treatment planning: is a single scan sufficient to capture thoracic tumor motion?

NASA Astrophysics Data System (ADS)

Tseng, Yolanda D.; Wootton, Landon; Nyflot, Matthew; Apisarnthanarax, Smith; Rengan, Ramesh; Bloch, Charles; Sandison, George; St. James, Sara

2018-01-01

Four dimensional computed tomography (4DCT) scans are routinely used in radiation therapy to determine the internal treatment volume for targets that are moving (e.g. lung tumors). The use of these studies has allowed clinicians to create target volumes based upon the motion of the tumor during the imaging study. The purpose of this work is to determine if a target volume based on a single 4DCT scan at simulation is sufficient to capture thoracic motion. Phantom studies were performed to determine expected differences between volumes contoured on 4DCT scans and those on the evaluation CT scans (slow scans). Evaluation CT scans acquired during treatment of 11 patients were compared to the 4DCT scans used for treatment planning. The images were assessed to determine if the target remained within the target volume determined during the first 4DCT scan. A total of 55 slow scans were compared to the 11 planning 4DCT scans. Small differences were observed in phantom between the 4DCT volumes and the slow scan volumes, with a maximum of 2.9%, that can be attributed to minor differences in contouring and the ability of the 4DCT scan to adequately capture motion at the apex and base of the motion trajectory. Larger differences were observed in the patients studied, up to a maximum volume difference of 33.4%. These results demonstrate that a single 4DCT scan is not adequate to capture all thoracic motion throughout treatment.

Lift cruise fan V/STOL aircraft conceptual design study T-39 modification. Volume 1: Technical report

NASA Technical Reports Server (NTRS)

Elliott, D. W.

1976-01-01

The conversion of two T-39 aircraft into lift cruise fan research and technology vehicles is discussed. The concept is based upon modifying the T-39A (NA265-40) Sabreliner airframe into a V/STOL configuration by incorporating two LCF-459 lift cruise fans and three YJ-97 gas generators. The propulsion concept provides the thrust for horizontal flight or lift for vertical flight by deflection of bifurcated nozzles while maintaining engine out safety throughout the flight envelope. The configuration meets all the study requirements specified for the design with control powers in VTOL and conversion in excess of the requirement making it an excellent vehicle for research and development. The study report consists of two volumes; Volume 1 (Reference a) contains background data detailed description and technical substantiation of the aircraft. Volume 2 includes cost data, scheduling and program planning not addressed in Volume 1.

The Effect of Pressure-Controlled Ventilation and Volume-Controlled Ventilation in Prone Position on Pulmonary Mechanics and Inflammatory Markers.

PubMed

Şenay, Hasan; Sıvacı, Remziye; Kokulu, Serdar; Koca, Buğra; Bakı, Elif Doğan; Ela, Yüksel

2016-08-01

The aim of this present study is to compare the effect of pressure-controlled ventilation and volume-controlled ventilation on pulmonary mechanics and inflammatory markers in prone position. The study included 41 patients undergoing to vertebrae surgery. The patients were randomized into two groups: Group 1 received volume-controlled ventilation, while group 2 received pressure-controlled ventilation. The demographic data, pulmonary mechanics, the inflammatory marker levels just after the induction of anesthetics, at the 6th and 12th hours, and gas analysis from arterial blood samples taken at the beginning and the 30th minute were recorded. The inflammatory marker levels increased in both groups, without any significant difference among groups. Peak inspiratory pressure level was higher in the volume-controlled ventilation group. This study revealed that there is no difference regarding inflammatory marker levels between volume- and pressure-controlled ventilation.

Muscle volume is related to trabecular and cortical bone architecture in typically developing children

PubMed Central

Bajaj, Deepti; Allerton, Brianne M.; Kirby, Joshua T.; Miller, Freeman; Rowe, David A.; Pohlig, Ryan T.; Modlesky, Christopher M.

2016-01-01

Introduction Muscle is strongly related to cortical bone architecture in children; however, the relationship between muscle volume and trabecular bone architecture is poorly studied. The aim of this study was to determine if muscle volume is related to trabecular bone architecture in children and if the relationship is different than the relationship between muscle volume and cortical bone architecture. Materials and methods Forty typically developing children (20 boys and 20 girls; 6 to 12 y) were included in the study. Measures of trabecular bone architecture [apparent trabecular bone volume to total volume (appBV/TV), trabecular number (appTb.N), trabecular thickness (appTb.Th), and trabecular separation (appTb.Sp)] in the distal femur, cortical bone architecture [(cortical volume, medullary volume, total volume, polar moment of inertia (J) and section modulus (Z)] in the midfemur, muscle volume in the midthigh and femur length were assessed using magnetic resonance imaging. Total and moderate-to-vigorous physical activity were assessed using an accelerometer-based activity monitor worn around the waist for four days. Calcium intake was assessed using diet records. Relationships among the measures were tested using multiple linear regression analysis. Results Muscle volume was moderately-to-strongly related to measures of trabecular bone architecture [appBV/TV (r = 0.81, appTb.N (r = 0.53), appTb.Th (r = 0.67), appTb.Sp (r = −0.71; all p < 0.001] but more strongly related to measures of cortical bone architecture [cortical volume (r = 0.96), total volume (r = 0.94), Z (r = 0.94) and J (r = 0.92; all p < 0.001)]. Similar relationships were observed between femur length and measures of trabecular (p < 0.01) and cortical (p < 0.001) bone architecture. Sex, physical activity and calcium intake were not related to any measure of bone architecture (p > 0.05). Because muscle volume and femur length were strongly related (r = 0.91, p < 0.001), muscle volume was scaled for femur length (muscle volume/femur length2.77). When muscle volume/femur length2.77 was included in a regression model with femur length, sex, physical activity and calcium intake, muscle volume/femur length2.77 was a significant predictor of appBV/TV, appTb.Th and appTb.Sp (partial r = 0.44 to 049, p < 0.05) and all measures of cortical bone architecture (partial r = 0.47 to 054; p < 0.01). Conclusions The findings suggest that muscle volume in the midthigh is related to trabecular bone architecture in the distal femur of children. The relationship is weaker than the relationship between muscle volume in the midthigh and cortical bone architecture in the midfemur, but the discrepancy is driven, in large part, by the greater dependence of cortical bone architecture measures on femur length. PMID:26187197

Association of Very Low-Volume Practice With Vascular Surgery Outcomes in New York.

PubMed

Mao, Jialin; Goodney, Philip; Cronenwett, Jack; Sedrakyan, Art

2017-08-01

Little research has focused on very low-volume surgery, especially in the context of decreasing vascular surgery volume with the adoption of endovascular procedures. To investigate the existence and outcomes of open abdominal aortic aneurysm repair (OAR) and carotid endarterectomy (CEA) performed by very low-volume surgeons in New York. This cohort study examined inpatient data of patients undergoing elective OAR or CEA from 2000 to 2014 from all New York hospitals. Surgeons who performed 1 or less designated procedure per year on average were considered very low volume, as opposed to higher-volume surgeons. Temporal trends of the existence of very low-volume practice were evaluated. Hierarchical logistic regression was used to compare in-hospital outcomes and health care resource use between patients treated by very low-volume surgeons and higher-volume surgeons for both OAR and CEA, adjusting for patient, surgeon, and hospital characteristics. There were 8781 OAR procedures and 68 896 CEA procedures included in the study. The mean (SD) patient age was 71.7 (8.4) years for OAR and 71.5 (9.1) years for CEA. A total of 614 surgeons performed OAR and 1071 performed CEA in New York during the study period. Of these, 318 (51.8%) and 512 (47.8%), respectively, were very low-volume surgeons. Very low-volume surgeons were less likely to be vascular surgeons. The number and proportion of very low-volume surgeons decreased over years. Compared with patients treated by higher-volume surgeons, those treated by very low-volume surgeons were more likely to have higher in-hospital mortality (odds ratio [OR], 2.09; 95% CI, 1.41-3.08) following OAR and higher risks of postoperative myocardial infarction (OR, 1.83; 95% CI, 1.03-3.26) and stroke (OR, 1.78; 95% CI, 1.21-2.62) following CEA. Patients treated by very low-volume surgeons also had greater health care resource use following both surgeries, including prolonged length of stay (OR, 1.37; 95% CI, 1.11-1.70) following OAR as well as higher charges (OR, 1.28; 95% CI, 1.01-1.62) and increased 30-day readmission (OR, 1.30; 95% CI 1.04-1.62) following CEA. The OAR and CEA procedures performed by very low-volume surgeons resulted in worse postoperative outcomes and greater lengths of stay. Although the percentage of very low-volume surgeons declined from 2000 to 2014, it remains concerning, given ready access to higher-volume surgeons. Future research is needed to understand the existence of this practice pattern in other surgical fields. Efforts to eliminate this practice pattern are warranted to ensure high-quality care for all patients.

Pharmacodynamic effects of pilocarpine eye drop enhanced by decreasing its volume of instillation.

PubMed

Lal, A; Kataria, V; Rajpal, A; Khanna, N

1995-07-01

Previous studies have proved that as the volume of the drug solution instilled into the eye is decreased, the fraction of the dose absorbed into the ocular tissue is increased and the adverse drug reactions lowered. The present study investigated the acute effects of different drop volumes (10 microliters, 20 microliters, 40 microliters, and 80 microliters) of pilocarpine nitrate (2%) on pupil diameter, heart rate, and adverse reaction profile, in 12 healthy human volunteers. The drop volumes of 10 microliters and 20 microliters produced more miosis and less side effects than 40 microliters and 80 microliters drop volumes. This may be due to more penetration of the drug into the ocular tissue and less drainage into the nasolacrimal system.

The Neutron Tomography Studies of the Rocks from the Kola Superdeep Borehole

NASA Astrophysics Data System (ADS)

Kichanov, S. E.; Kozlenko, D. P.; Ivankina, T. I.; Rutkauskas, A. V.; Lukin, E. V.; Savenko, B. N.

The volume morphology of a gneiss sample K-8802 recovered from the deep of 8802 m of the Kola Superdeep Borehole and its surface homologue sample PL-36 have been studied by means of neutron radiography and tomography methods. The volumes and size distributions of a biotite-muscovite grains as well as grains orientation distribution have been obtained from experimental data. It was found that the average volumes of the biotite-muscovite grains in surface homologue sample is noticeably larger than the average volume of grains in the deep-seated gneiss sample K-8802. This drastically differences in grains volumes can be explained by the recrystallization processes in deep of the Kola Superdeep Borehole at high temperatures and high pressures.

Voxel-based morphometry in Alzheimers disease and mild cognitive impairment: Systematic review of studies addressing the frontal lobe

PubMed Central

Ribeiro, Luís Gustavo; Busatto, Geraldo

2016-01-01

ABSTRACT Voxel-based morphometry (VBM) is a useful approach for investigating neurostructural brain changes in dementia. We systematically reviewed VBM studies of Alzheimer's disease (AD) and mild cognitive impairment (MCI), specifically focusing on grey matter (GM) atrophy in the frontal lobe. Methods: Two searches were performed on the Pubmed database. A set of exclusion criteria was applied to ensure the selection of only VBM studies that directly investigated GM volume abnormalities in AD and/or MCI patients compared to cognitively normal controls. Results: From a total of 46 selected articles, 35 VBM studies reported GM volume reductions in the frontal lobe. The frontal subregions, where most of the volume reductions were reported, included the inferior, superior and middle frontal gyri, as well as the anterior cingulate gyrus. We also found studies in which reduced frontal GM was detected in MCI patients who converted to AD. In a minority of studies, correlations between frontal GM volumes and behavioural changes or cognitive deficits in AD patients were investigated, with variable findings. Conclusion: Results of VBM studies indicate that the frontal lobe should be regarded as an important brain area when investigating GM volume deficits in association with AD. Frontal GM loss might not be a feature specific to late AD only. Future VBM studies involving large AD samples are warranted to further investigate correlations between frontal volume deficits and both cognitive impairment and neuropsychiatric symptoms. PMID:29213441

Love Canal Emergency Declaration Area habitability study. Volume 5. Peer review summary: TRC (Technical Review Committee) responses. Final report

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

Not Available

Environmental studies were conducted to provide data that could be used by the Commissioner of Health for the State of New York in determining whether the Emergency Declaration Area surrounding the Love Canal hazardous-waste site is habitable. These volumes (II through IV) were reviewed by a peer-review panel of expert scientists. The scientists concluded that each of the three environmental studies was well planned and well executed. Volume V summarizes the peer review and gives additional information or clarifications as requested during the peer review. Volume V also provides additional supplemental statistical analyses requested by the peer reviewer panel.

Frequency and predictors of return to incentive spirometry volume baseline after cardiac surgery.

PubMed

Harton, Suzanne C; Grap, Mary Jo; Savage, Laura; Elswick, R K

2007-01-01

Incentive spirometry (IS) is routinely used in most clinical settings, but evaluation of patient efficacy of IS is not standardized. The purpose of this study was to describe the degree and predictors of return to preoperative IS volume after cardiac surgery. IS volumes were documented in 69 subjects (71% men; mean age, 59 years) undergoing cardiac surgery during the preoperative evaluation and twice daily postoperatively. Nineteen percent of subjects achieved their IS preoperative volume by hospital discharge. Based on highest volume achieved, subjects achieved an average of 75% of their preoperative volume by discharge, and only age and number of bypass grafts predicted return to preoperative IS volume. These data may assist nurses and patients to set realistic goals for postoperative IS volume achievement.

Environmental Technology Verification (ETV) Program Case Studies: Demonstrating Program Outcomes, Volume III

EPA Science Inventory

This booklet, ETV Program Case Studies: Demonstrating Program Outcomes, Volume III contains two case studies, addressing verified environmental technologies for decentalized wastewater treatment and converting animal waste to energy. Each case study contains a brief description ...

Effect of volume fraction of alpha and transformed beta on the high cycle fatigue properties of bimodal Ti6Al4V alloy

NASA Astrophysics Data System (ADS)

Jadhav, Shital; Powar, Amit; Patil, Sandip; Supare, Ashish; Farane, Bhagwan; Singh, Rajkumar, Dr.

2017-05-01

The present study was performed to investigate the effect of volume fraction of alpha and transformed beta phase on the high-cycle fatigue (HCF) properties of the bimodal titanium Ti6Al4V alloy. The effect of such morphology on mechanical properties was studied using tensile and rotating bending fatigue test as per ASTM standards. Microstructures and fractography of the specimens were studied using optical and scanning electron microscopy (SEM) respectively.Ti6Al4V alloy samples were heat treated to have three distinctive volume fractions of alpha and transformed beta phase. With an increase in quench delay from 30,50 and 70 sec during quenching after solutionizing temperature of 967°C, the volume fraction of alpha was found to be increased from 20% to 67%. Tests on tensile and rotating bending fatigue showed that the specimen with 20% volume fraction of alpha phase exhibited the highest tensile and fatigue strength, however the properties gets deteriorate with increase in volume fraction of alpha.

From field data to volumes: constraining uncertainties in pyroclastic eruption parameters

NASA Astrophysics Data System (ADS)

Klawonn, Malin; Houghton, Bruce F.; Swanson, Donald A.; Fagents, Sarah A.; Wessel, Paul; Wolfe, Cecily J.

2014-07-01

In this study, we aim to understand the variability in eruption volume estimates derived from field studies of pyroclastic deposits. We distributed paper maps of the 1959 Kīlauea Iki tephra to 101 volcanologists worldwide, who produced hand-drawn isopachs. Across the returned maps, uncertainty in isopach areas is 7 % across the well-sampled deposit but increases to over 30 % for isopachs that are governed by the largest and smallest thickness measurements. We fit the exponential, power-law, and Weibull functions through the isopach thickness versus area1/2 values and find volume estimate variations up to a factor of 4.9 for a single map. Across all maps and methodologies, we find an average standard deviation for a total volume of s = 29 %. The volume uncertainties are largest for the most proximal ( s = 62 %) and distal field ( s = 53 %) and small for the densely sampled intermediate deposit ( s = 8 %). For the Kīlauea Iki 1959 eruption, we find that the deposit beyond the 5-cm isopach contains only 2 % of the total erupted volume, whereas the near-source deposit contains 48 % and the intermediate deposit 50 % of the total volume. Thus, the relative uncertainty within each zone impacts the total volume estimates differently. The observed uncertainties for the different deposit regions in this study illustrate a fundamental problem of estimating eruption volumes: while some methodologies may provide better fits to the isopach data or rely on fewer free parameters, the main issue remains the predictive capabilities of the empirical functions for the regions where measurements are missing.

The Impact of Hospital Closures and Hospital and Population Characteristics on Increasing Emergency Department Volume: A Geographic Analysis.

PubMed

Lee, David C; Carr, Brendan G; Smith, Tony E; Tran, Van C; Polsky, Daniel; Branas, Charles C

2015-12-01

Emergency visits are rising nationally, whereas the number of emergency departments is shrinking. However, volume has not increased uniformly at all emergency departments. It is unclear what factors account for this variability in emergency volume growth rates. The objective of this study was to test the association of hospital and population characteristics and the effect of hospital closures with increases in emergency department volume. The study team analyzed emergency department volume at New York State hospitals from 2004 to 2010 using data from cost reports and administrative databases. Multivariate regression was used to evaluate characteristics associated with emergency volume growth. Spatial analytics and distances between hospitals were used in calculating the predicted impact of hospital closures on emergency department use. Among the 192 New York hospitals open from 2004 to 2010, the mean annual increase in emergency department visits was 2.7%, but the range was wide (-5.5% to 11.3%). Emergency volume increased nearly twice as fast at tertiary referral centers (4.8%) and nonurban hospitals (3.7% versus urban at 2.1%) after adjusting for other characteristics. The effect of hospital closures also strongly predicted variation in growth. Emergency volume is increasing faster at specific hospitals: tertiary referral centers, nonurban hospitals, and those near hospital closures. This study provides an understanding of how emergency volume varies among hospitals and predicts the effect of hospital closures in a statewide region. Understanding the impact of these factors on emergency department use is essential to ensure that these populations have access to critical emergency services.

Effects of cumulative illness severity on hippocampal gray matter volume in major depression: a voxel-based morphometry study.

PubMed

Zaremba, Dario; Enneking, Verena; Meinert, Susanne; Förster, Katharina; Bürger, Christian; Dohm, Katharina; Grotegerd, Dominik; Redlich, Ronny; Dietsche, Bruno; Krug, Axel; Kircher, Tilo; Kugel, Harald; Heindel, Walter; Baune, Bernhard T; Arolt, Volker; Dannlowski, Udo

2018-02-08

Patients with major depression show reduced hippocampal volume compared to healthy controls. However, the contribution of patients' cumulative illness severity to hippocampal volume has rarely been investigated. It was the aim of our study to find a composite score of cumulative illness severity that is associated with hippocampal volume in depression. We estimated hippocampal gray matter volume using 3-tesla brain magnetic resonance imaging in 213 inpatients with acute major depression according to DSM-IV criteria (employing the SCID interview) and 213 healthy controls. Patients' cumulative illness severity was ascertained by six clinical variables via structured clinical interviews. A principal component analysis was conducted to identify components reflecting cumulative illness severity. Regression analyses and a voxel-based morphometry approach were used to investigate the influence of patients' individual component scores on hippocampal volume. Principal component analysis yielded two main components of cumulative illness severity: Hospitalization and Duration of Illness. While the component Hospitalization incorporated information from the intensity of inpatient treatment, the component Duration of Illness was based on the duration and frequency of illness episodes. We could demonstrate a significant inverse association of patients' Hospitalization component scores with bilateral hippocampal gray matter volume. This relationship was not found for Duration of Illness component scores. Variables associated with patients' history of psychiatric hospitalization seem to be accurate predictors of hippocampal volume in major depression and reliable estimators of patients' cumulative illness severity. Future studies should pay attention to these measures when investigating hippocampal volume changes in major depression.

Probabilistic risk assessment of the Space Shuttle. Phase 3: A study of the potential of losing the vehicle during nominal operation. Volume 4: System models and data analysis

NASA Technical Reports Server (NTRS)

Fragola, Joseph R.; Maggio, Gaspare; Frank, Michael V.; Gerez, Luis; Mcfadden, Richard H.; Collins, Erin P.; Ballesio, Jorge; Appignani, Peter L.; Karns, James J.

1995-01-01

In this volume, volume 4 (of five volumes), the discussion is focussed on the system models and related data references and has the following subsections: space shuttle main engine, integrated solid rocket booster, orbiter auxiliary power units/hydraulics, and electrical power system.

Duplication, Gaps and Coordination of Publicly Funded Skill Training Programs in 20 Cities. Volume II.

ERIC Educational Resources Information Center

National Planning Association, Washington, DC. Center for Priority Analysis.

A study of duplications in public skill training programs in twenty American cities resulted in a two-volume report. Volume One (ED 068 706) summarized and drew conclusions from the individual city reports contained in Volume Two. "Skill training" is used to mean all programs whose major purpose is the imparting of marketable skills to…

Reduced volume of Heschl's gyrus in tinnitus.

PubMed

Schneider, Peter; Andermann, Martin; Wengenroth, Martina; Goebel, Rainer; Flor, Herta; Rupp, André; Diesch, Eugen

2009-04-15

The neural basis of tinnitus is unknown. Recent neuroimaging studies point towards involvement of several cortical and subcortical regions. Here we demonstrate that tinnitus may be associated with structural changes in the auditory cortex. Using individual morphological segmentation, the medial partition of Heschl's gyrus (mHG) was studied in individuals with and without chronic tinnitus using magnetic resonance imaging. Both the tinnitus and the non-tinnitus group included musicians and non-musicians. Patients exhibited significantly smaller mHG gray matter volumes than controls. In unilateral tinnitus, this effect was almost exclusively seen in the hemisphere ipsilateral to the affected ear. In bilateral tinnitus, mHG volume was substantially reduced in both hemispheres. The tinnitus-related volume reduction was found across the full extent of mHG, not only in the high-frequency part usually most affected by hearing loss-induced deafferentation. However, there was also evidence for a relationship between volume reduction and hearing loss. Correlations between volume and hearing level depended on the subject group as well as the asymmetry of the hearing loss. The volume changes observed may represent antecedents or consequences of tinnitus and tinnitus-associated hearing loss and also raise the possibility that small cortical volume constitutes a vulnerability factor.

[Influence of postural changes on the variations of blood volume in hemodialysis and reincidence post-dialysis blood volume].

PubMed

López Ramón, I; Muro, B; Azcona, M; Moleres, M; Sagüés, C; Maeztu, B; Zubía, A; Martínez de Irujo, S

1997-01-01

The aim of the present work is to study the possible increment of blood volume, in the seated as well as the lying position, and to analyse the influence of changes of posture on the changes of blood volume during the hemodialysis. 17 patients were studied, evaluating the variations of the hematocrit in the extracorporeal circuit on entry into the dialyzer, by means of a photometric system (Crit-Line Instrument, Izasa). Every 15 minutes the values of the hematocrit were taken and heir repercussion in the blood volume in different changes of posture. Initially all of the patients improved their blood volume, both seated and lying down. During the session of hemodialysis and ultrafiltration, with the patient in a seated position, an important drop in the blood volume was noticed; this was the case in the 1st, 2nd and 3rd hours. This drop improved when the patient adopted a lying position and there was a "reincidence of post-dialysis blood volume" at the end. According to these results, the supine posture improves the refill, confirming that the patients position influences the vascular refill.

Comparison of orbital volume obtained by tomography and rapid prototyping.

PubMed

Roça, Guilherme Berto; Foggiatto, José Aguiomar; Ono, Maria Cecilia Closs; Ono, Sergio Eiji; da Silva Freitas, Renato

2013-11-01

This study aims to compare orbital volume obtained by helical tomography and rapid prototyping. The study sample was composed of 6 helical tomography scans. Eleven healthy orbits were identified to have their volumes measured. The volumetric analysis with the helical tomography utilized the same protocol developed by the Plastic Surgery Unit of the Federal University of Paraná. From the CT images, 11 prototypes were created, and their respective volumes were analyzed in 2 ways: using software by SolidWorks and by direct analysis, when the prototype was filled with saline solution. For statistical analysis, the results of the volumes of the 11 orbits were considered independent. The average orbital volume measurements obtained by the method of Ono et al was 20.51 cm, the average obtained by the SolidWorks program was 20.64 cm, and the average measured using the prototype method was 21.81 cm. The 3 methods demonstrated a strong correlation between the measurements. The right and left orbits of each patient had similar volumes. The tomographic method for the analysis of orbital volume using the Ono protocol yielded consistent values, and by combining this method with rapid prototyping, both reliability validations of results were enhanced.

The validity of ultrasound estimation of muscle volumes.

PubMed

Infantolino, Benjamin W; Gales, Daniel J; Winter, Samantha L; Challis, John H

2007-08-01

The purpose of this study was to validate ultrasound muscle volume estimation in vivo. To examine validity, vastus lateralis ultrasound images were collected from cadavers before muscle dissection; after dissection, the volumes were determined by hydrostatic weighing. Seven thighs from cadaver specimens were scanned using a 7.5-MHz ultrasound probe (SSD-1000, Aloka, Japan). The perimeter of the vastus lateralis was identified in the ultrasound images and manually digitized. Volumes were then estimated using the Cavalieri principle, by measuring the image areas of sets of parallel two-dimensional slices through the muscles. The muscles were then dissected from the cadavers, and muscle volume was determined via hydrostatic weighing. There was no statistically significant difference between the ultrasound estimation of muscle volume and that estimated using hydrostatic weighing (p > 0.05). The mean percentage error between the two volume estimates was 0.4% +/- 6.9. Three operators all performed four digitizations of all images from one randomly selected muscle; there was no statistical difference between operators or trials and the intraclass correlation was high (>0.8). The results of this study indicate that ultrasound is an accurate method for estimating muscle volumes in vivo.

Penguin lungs and air sacs: implications for baroprotection, oxygen stores and buoyancy.

PubMed

Ponganis, P J; St Leger, J; Scadeng, M

2015-03-01

The anatomy and volume of the penguin respiratory system contribute significantly to pulmonary baroprotection, the body O2 store, buoyancy and hence the overall diving physiology of penguins. Therefore, three-dimensional reconstructions from computerized tomographic (CT) scans of live penguins were utilized to measure lung volumes, air sac volumes, tracheobronchial volumes and total body volumes at different inflation pressures in three species with different dive capacities [Adélie (Pygoscelis adeliae), king (Aptenodytes patagonicus) and emperor (A. forsteri) penguins]. Lung volumes scaled to body mass according to published avian allometrics. Air sac volumes at 30 cm H2O (2.94 kPa) inflation pressure, the assumed maximum volume possible prior to deep dives, were two to three times allometric air sac predictions and also two to three times previously determined end-of-dive total air volumes. Although it is unknown whether penguins inhale to such high volumes prior to dives, these values were supported by (a) body density/buoyancy calculations, (b) prior air volume measurements in free-diving ducks and (c) previous suggestions that penguins may exhale air prior to the final portions of deep dives. Based upon air capillary volumes, parabronchial volumes and tracheobronchial volumes estimated from the measured lung/airway volumes and the only available morphometry study of a penguin lung, the presumed maximum air sac volumes resulted in air sac volume to air capillary/parabronchial/tracheobronchial volume ratios that were not large enough to prevent barotrauma to the non-collapsing, rigid air capillaries during the deepest dives of all three species, and during many routine dives of king and emperor penguins. We conclude that volume reduction of airways and lung air spaces, via compression, constriction or blood engorgement, must occur to provide pulmonary baroprotection at depth. It is also possible that relative air capillary and parabronchial volumes are smaller in these deeper-diving species than in the spheniscid penguin of the morphometry study. If penguins do inhale to this maximum air sac volume prior to their deepest dives, the magnitude and distribution of the body O2 store would change considerably. In emperor penguins, total body O2 would increase by 75%, and the respiratory fraction would increase from 33% to 61%. We emphasize that the maximum pre-dive respiratory air volume is still unknown in penguins. However, even lesser increases in air sac volume prior to a dive would still significantly increase the O2 store. More refined evaluations of the respiratory O2 store and baroprotective mechanisms in penguins await further investigation of species-specific lung morphometry, start-of-dive air volumes and body buoyancy, and the possibility of air exhalation during dives. © 2015. Published by The Company of Biologists Ltd.

Contractor for geopressured-geothermal sites: Final contract report, Volume 1, fiscal years 1986--1990 (5 years), testing of wells through October 1990. Appendix A, Volume 2, Gladys McCall Site (Cameron Parish LA); Appendix B-1, Volume 3, Pleasant Bayou Site; Appendix B-2, Volume 4, Pleasant Bayou Site; Appendix C, Volume 5, Willis Hulin Site

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

Not Available

1992-09-01

Field tests and studies were conducted to determine the production behavior of geopressured-geothermal reservoirs and their potential as future energy sources. Results are presented for Gladys McCall Site, Pleasant Bayou Site, and Hulin Site.

Optimizing working space in porcine laparoscopy: CT measurement of the effects of intra-abdominal pressure.

PubMed

Vlot, John; Wijnen, Rene; Stolker, Robert Jan; Bax, Klaas

2013-05-01

Several factors may affect volume and dimensions of the working space in laparoscopic surgery. The precise impact of these factors has not been well studied. In a porcine model, we used computed tomographic (CT) scanning for measuring working space volume and distances. In a first series of experiments, we studied the relationship between intra-abdominal pressure (IAP) and working space. Eleven 20 kg pigs were studied under standardized anesthesia and volume-controlled ventilation. Cardiorespiratory parameters were monitored continuously, and blood gas samples were taken at different IAP levels. Respiratory rate was increased when ETCO₂ exceeded 7 kPa. Breath-hold CT scans were made at IAP levels of 0, 5, 10, and 15 mmHg. Insufflator volumes were compared to CT-measured volumes. Maximum dimensions of pneumoperitoneum were measured on reconstructed CT images. Respiratory rate had to be increased in three animals. Mild hypercapnia and acidosis occurred at 15 mmHg IAP. Peak inspiratory pressure rose significantly at 10 and 15 mmHg. CT-measured volume increased relatively by 93 % from 5 to 10 mmHg IAP and by 19 % from 10 to 15 mmHg IAP. Comparing CT volumes to insufflator volumes gave a bias of 76 mL. The limits of agreement were -0.31 to +0.47, a range of 790 mL. The internal anteroposterior diameter increased by 18 % by increasing IAP from 5 to 10 mmHg and by 5 % by increasing IAP from 10 to 15 mmHg. At 15 mmHg, the total relative increase of the pubis-diaphragm distance was only 6 %. Abdominal width did not increase. CT allows for precise calculation of the actual CO₂ pneumoperitoneum volume, whereas the volume of CO₂ released by the insufflator does not. Increasing IAP up to 10 mmHg achieved most gain in volume and in internal anteroposterior diameter. At an IAP of 10 mmHg, higher peak inspiratory pressure was significantly elevated.

Volumetric MRI study of brain in children with intrauterine exposure to cocaine, alcohol, tobacco, and marijuana.

PubMed

Rivkin, Michael J; Davis, Peter E; Lemaster, Jennifer L; Cabral, Howard J; Warfield, Simon K; Mulkern, Robert V; Robson, Caroline D; Rose-Jacobs, Ruth; Frank, Deborah A

2008-04-01

The objective of this study was to use volumetric MRI to study brain volumes in 10- to 14-year-old children with and without intrauterine exposure to cocaine, alcohol, cigarettes, or marijuana. Volumetric MRI was performed on 35 children (mean age: 12.3 years; 14 with intrauterine exposure to cocaine, 21 with no intrauterine exposure to cocaine) to determine the effect of prenatal drug exposure on volumes of cortical gray matter; white matter; subcortical gray matter; cerebrospinal fluid; and total parenchymal volume. Head circumference was also obtained. Analyses of each individual substance were adjusted for demographic characteristics and the remaining 3 prenatal substance exposures. Regression analyses adjusted for demographic characteristics showed that children with intrauterine exposure to cocaine had lower mean cortical gray matter and total parenchymal volumes and smaller mean head circumference than comparison children. After adjustment for other prenatal exposures, these volumes remained smaller but lost statistical significance. Similar analyses conducted for prenatal ethanol exposure adjusted for demographics showed significant reduction in mean cortical gray matter; total parenchymal volumes; and head circumference, which remained smaller but lost statistical significance after adjustment for the remaining 3 exposures. Notably, prenatal cigarette exposure was associated with significant reductions in cortical gray matter and total parenchymal volumes and head circumference after adjustment for demographics that retained marginal significance after adjustment for the other 3 exposures. Finally, as the number of exposures to prenatal substances grew, cortical gray matter and total parenchymal volumes and head circumference declined significantly with smallest measures found among children exposed to all 4. CONCLUSIONS; These data suggest that intrauterine exposures to cocaine, alcohol, and cigarettes are individually related to reduced head circumference; cortical gray matter; and total parenchymal volumes as measured by MRI at school age. Adjustment for other substance exposures precludes determination of statistically significant individual substance effect on brain volume in this small sample; however, these substances may act cumulatively during gestation to exert lasting effects on brain size and volume.

Ocean Optics Protocols for Satellite Ocean Color Sensor Validation, Revision 4, Volume IV: Inherent Optical Properties: Instruments, Characterizations, Field Measurements and Data Analysis Protocols

NASA Technical Reports Server (NTRS)

Mueller, J. L.; Fargion, G. S.; McClain, C. R. (Editor); Pegau, S.; Zanefeld, J. R. V.; Mitchell, B. G.; Kahru, M.; Wieland, J.; Stramska, M.

2003-01-01

This document stipulates protocols for measuring bio-optical and radiometric data for the Sensor Intercomparision and Merger for Biological and Interdisciplinary Oceanic Studies (SIMBIOS) Project activities and algorithm development. The document is organized into 6 separate volumes as Ocean Optics Protocols for Satellite Ocean Color Sensor Validation, Revision 4. Volume I: Introduction, Background, and Conventions; Volume II: Instrument Specifications, Characterization and Calibration; Volume III: Radiometric Measurements and Data Analysis Methods; Volume IV: Inherent Optical Properties: Instruments, Characterization, Field Measurements and Data Analysis Protocols; Volume V: Biogeochemical and Bio-Optical Measurements and Data Analysis Methods; Volume VI: Special Topics in Ocean Optics Protocols and Appendices. The earlier version of Ocean Optics Protocols for Satellite Ocean Color Sensor Validation, Revision 3 is entirely superseded by the six volumes of Revision 4 listed above.

Auto-recognition of surfaces and auto-generation of material removal volume for finishing process

NASA Astrophysics Data System (ADS)

Kataraki, Pramod S.; Salman Abu Mansor, Mohd

2018-03-01

Auto-recognition of a surface and auto-generation of material removal volumes for the so recognised surfaces has become a need to achieve successful downstream manufacturing activities like automated process planning and scheduling. Few researchers have contributed to generation of material removal volume for a product but resulted in material removal volume discontinuity between two adjacent material removal volumes generated from two adjacent faces that form convex geometry. The need for limitation free material removal volume generation was attempted and an algorithm that automatically recognises computer aided design (CAD) model’s surface and also auto-generate material removal volume for finishing process of the recognised surfaces was developed. The surfaces of CAD model are successfully recognised by the developed algorithm and required material removal volume is obtained. The material removal volume discontinuity limitation that occurred in fewer studies is eliminated.

Complementary effect of patient volume and quality of care on hospital cost efficiency.

PubMed

Choi, Jeong Hoon; Park, Imsu; Jung, Ilyoung; Dey, Asoke

2017-06-01

This study explores the direct effect of an increase in patient volume in a hospital and the complementary effect of quality of care on the cost efficiency of U.S. hospitals in terms of patient volume. The simultaneous equation model with three-stage least squares is used to measure the direct effect of patient volume and the complementary effect of quality of care and volume. Cost efficiency is measured with a data envelopment analysis method. Patient volume has a U-shaped relationship with hospital cost efficiency and an inverted U-shaped relationship with quality of care. Quality of care functions as a moderator for the relationship between patient volume and efficiency. This paper addresses the economically important question of the relationship of volume with quality of care and hospital cost efficiency. The three-stage least square simultaneous equation model captures the simultaneous effects of patient volume on hospital quality of care and cost efficiency.

Strategies for Small Volume Resuscitation: Hyperosmotic-Hyperoncotic Solutions, Hemoglobin Based Oxygen Carriers and Closed-Loop Resuscitation

NASA Technical Reports Server (NTRS)

Kramer, George C.; Wade, Charles E.; Dubick, Michael A.; Atkins, James L.

2004-01-01

Introduction: Logistic constraints on combat casualty care preclude traditional resuscitation strategies which can require volumes and weights 3 fold or greater than hemorrhaged volume. We present a review of quantitative analyses of clinical and animal data on small volume strategies using 1) hypertonic-hyperosmotic solutions (HHS); 2) hemoglobin based oxygen carriers (HBOCs) and 3) closed-loop infusion regimens.Methods and Results: Literature searches and recent queries to industry and academic researchers have allowed us to evaluate the record of 81 human HHS studies (12 trauma trials), 19 human HBOCs studies (3trauma trials) and two clinical studies of closed-loop resuscitation.There are several hundreds animal studies and at least 82 clinical trials and reports evaluating small volume7.2%-7.5% hypertonic saline (HS) most often combined with colloids, e.g., dextran (HSD) or hetastarch(HSS). HSD and HSS data has been published for 1,108 and 392 patients, respectively. Human studies have documented volume sparing and hemodynamic improvements. Meta-analyses suggest improved survival for hypotensive trauma patients treated with HSD with significant reductions in mortality found for patients with blood pressure < 70 mmHg, head trauma, and penetrating injury requiring surgery. HSD and HSS have received regulatory approval in 14 and 3 countries, respectively, with 81,000+ units sold. The primary reported use was head injury and trauma resuscitation. Complications and reported adverse events are surprisingly rare and not significantly different from other solutions.HBOCs are potent volume expanders in addition to oxygen carriers with volume expansion greater than standard colloids. Several investigators have evaluated small volume hyperoncotic HBOCs or HS-HBOC formulations for hypotensive and normotensive resuscitation in animals. A consistent finding in resuscitation with HBOCs is depressed cardiac output. There is some evidence that HBOCs more efficiently unload oxygen from plasma hemoglobin as well as facilitate RBC unloading. We analyzed one volunteer study, 15 intraoperative trials, and 3 trauma studies using HBOCs. Perioperative studies generally suggest ability to deliver oxygen, but one trauma trial using HBOCs (HemAssist) for treatment of trauma resulted in a dramatic increase in mortality, while an intraoperative trauma study using Polyheme demonstrated reductions in blood use and lower mortality compared to historic controls of patients refusing blood. Transfusion reductions with HBOC use have been modest. Two HBOCs (Hemopure and Polyheme) are now in new or planned large-scale multicenter prehospital trials of trauma treatment. A new implementation of small volume resuscitation is closed-loop resuscitation (CLR), which employs microprocessors to titrate just enough fluid to reach a physiologic target . Animal studies suggest less risk of rebleeding in uncontrolled hemorrhage and a reduction in fluid needs with CLR. The first clinical application of CLR was treatment of burn shock and the US Army. Conclusions: Independently sponsored civilian trauma trials and clinical evaluations in operational combat conditions of different small volume strategies are warranted.

A Quantitative Analysis of the Relationship between Medicare Payment and Service Volume for Glaucoma Procedures from 2005 through 2009.

PubMed

Gong, Dan; Jun, Lin; Tsai, James C

2015-05-01

To calculate the association between Medicare payment and service volume for 6 commonly performed glaucoma procedures. Retrospective, longitudinal database study. A 100% dataset of all glaucoma procedures performed on Medicare Part B beneficiaries within the United States from 2005 to 2009. Fixed-effects regression model using Medicare Part B carrier data for all 50 states and the District of Columbia, controlling for time-invariant carrier-specific characteristics, national trends in glaucoma service volume, Medicare beneficiary population, number of ophthalmologists, and income per capita. Payment-volume elasticities, defined as the percent change in service volume per 1% change in Medicare payment, for laser trabeculoplasty (Current Procedural Terminology [CPT] code 65855), trabeculectomy without previous surgery (CPT code 66170), trabeculectomy with previous surgery (CPT code 66172), aqueous shunt to reservoir (CPT code 66180), laser iridotomy (CPT code 66761), and scleral reinforcement with graft (CPT code 67255). The payment-volume elasticity was nonsignificant for 4 of 6 procedures studied: laser trabeculoplasty (elasticity, -0.27; 95% confidence interval [CI], -1.31 to 0.77; P = 0.61), trabeculectomy without previous surgery (elasticity, -0.42; 95% CI, -0.85 to 0.01; P = 0.053), trabeculectomy with previous surgery (elasticity, -0.28; 95% CI, -0.83 to 0.28; P = 0.32), and aqueous shunt to reservoir (elasticity, -0.47; 95% CI, -3.32 to 2.37; P = 0.74). Two procedures yielded significant associations between Medicare payment and service volume. For laser iridotomy, the payment-volume elasticity was -1.06 (95% CI, -1.39 to -0.72; P < 0.001): for every 1% decrease in CPT code 66761 payment, laser iridotomy service volume increased by 1.06%. For scleral reinforcement with graft, the payment-volume elasticity was -2.92 (95% CI, -5.72 to -0.12; P = 0.041): for every 1% decrease in CPT code 67255 payment, scleral reinforcement with graft service volume increased by 2.92%. This study calculated the association between Medicare payment and service volume for 6 commonly performed glaucoma procedures and found varying magnitudes of payment-volume elasticities, suggesting that the volume response to changes in Medicare payments, if present, is not uniform across all Medicare procedures. Copyright © 2015 American Academy of Ophthalmology. Published by Elsevier Inc. All rights reserved.

Wayside Energy Storage Study : Volume 1. Summary.

DOT National Transportation Integrated Search

1979-02-01

Volume I summarizes an in-depth application study which was conducted to determine the practicality and viability of using large wayside flywheels to recuperate braking energy from freight trains on long downgrades. The study examined the route struc...