Efficient logistic regression designs under an imperfect population identifier.

PubMed

Albert, Paul S; Liu, Aiyi; Nansel, Tonja

2014-03-01

Motivated by actual study designs, this article considers efficient logistic regression designs where the population is identified with a binary test that is subject to diagnostic error. We consider the case where the imperfect test is obtained on all participants, while the gold standard test is measured on a small chosen subsample. Under maximum-likelihood estimation, we evaluate the optimal design in terms of sample selection as well as verification. We show that there may be substantial efficiency gains by choosing a small percentage of individuals who test negative on the imperfect test for inclusion in the sample (e.g., verifying 90% test-positive cases). We also show that a two-stage design may be a good practical alternative to a fixed design in some situations. Under optimal and nearly optimal designs, we compare maximum-likelihood and semi-parametric efficient estimators under correct and misspecified models with simulations. The methodology is illustrated with an analysis from a diabetes behavioral intervention trial. © 2013, The International Biometric Society.

Identification of Shifts and Trends in Hydrometric Data in Canada Based on Several Detection Tests

NASA Astrophysics Data System (ADS)

Lauzon, N.; Lence, B. J.

2004-05-01

This work proposes new detection tests based on the Kohonen neural network and on fuzzy c-means for the identification of shifts and trends in data sequences. Annual mean and maximum flow sequences are considered as application case, for they have often been considered for the study of shifts and trends in hydrologic data. In recent years, several studies for the identification of trends have been accomplished with North American hydrometric data, often making use of only one detection test. The assumption here is that one cannot rely on only one test, and consequently several are employed in this work. A total of eight tests are considered, four for shifts and four for trends. Four of these tests, two for shifts and two for trends, are conventional statistical tests that are regularly employed, while the other four are developed based on the Kohonen neural network and on fuzzy c-means. Data from a group of 40 hydrometric stations across Canada are assessed for the detection of shifts and trends in time periods of 30, 40 and 50 years. While the results obtained confirm the conclusions of previous studies performed on similar groups of data, they also indicate that each test may behave differently from one another. For example, one test may detect a trend in a given sequence while the other tests do not, or vice-versa. Thus, the strategy of using several tests ensures not only that they may confirm each others diagnostics but also may complement each other in the case of divergent diagnostics, with the possibility of improving the final conclusion on the detection of shifts and trends. Using artificial intelligence techniques for the construction of detection tests constitutes also a departure from the use of statistics, and a discussion in this work on complementary studies (i.e. detection on multivariate cases) highlights the possibility of enhanced performance by the artificial intelligence-based tests compared with conventional detection tests.

[Difficulties of genetic counselling in rare, mainly neurogenetic disorders].

PubMed

Horváth, Emese; Nagy, Nikoletta; Széll, Márta

2014-08-03

In recent decades methods used for the investigation of the genetic background of rare diseases showed a great improvement. The aim of the authors was to demonstrate difficulties of genetic counselling and investigations in case of five rare, mainly neurogenetic diseases. During pre-test genetic counselling, the disease suspected from the clinical symptoms and the available genetic tests were considered. During post-test genetic counselling, the results of the genetic tests were discussed. In three of the five cases genetic tests identified the disease-causing genetic abnormalities, while in two cases the causative abnormalities were not identified. Despite a great improvement of the available genetic methods, the causative genetic abnormalities cannot be identified in some cases. The genetic counsellor has a key role in the assessment and interpretation of the results and in helping the family planning.

Testing the EKC hypothesis by considering trade openness, urbanization, and financial development: the case of Turkey.

PubMed

Ozatac, Nesrin; Gokmenoglu, Korhan K; Taspinar, Nigar

2017-07-01

This study investigates the environmental Kuznets curve (EKC) hypothesis for the case of Turkey from 1960 to 2013 by considering energy consumption, trade, urbanization, and financial development variables. Although previous literature examines various aspects of the EKC hypothesis for the case of Turkey, our model augments the basic model with several covariates to develop a better understanding of the relationship among the variables and to refrain from omitted variable bias. The results of the bounds test and the error correction model under autoregressive distributed lag mechanism suggest long-run relationships among the variables as well as proof of the EKC and the scale effect in Turkey. A conditional Granger causality test reveals that there are causal relationships among the variables. Our findings can have policy implications including the imposition of a "polluter pays" mechanism, such as the implementation of a carbon tax for pollution trading, to raise the urban population's awareness about the importance of adopting renewable energy and to support clean, environmentally friendly technology.

Public health consequences of a false-positive laboratory test result for Brucella--Florida, Georgia, and Michigan, 2005.

PubMed

2008-06-06

Human brucellosis, a nationally notifiable disease, is uncommon in the United States. Most human cases have occurred in returned travelers or immigrants from regions where brucellosis is endemic, or were acquired domestically from eating illegally imported, unpasteurized fresh cheeses. In January 2005, a woman aged 35 years who lived in Nassau County, Florida, received a diagnosis of brucellosis, based on results of a Brucella immunoglobulin M (IgM) enzyme immunoassay (EIA) performed in a commercial laboratory using analyte specific reagents (ASRs); this diagnosis prompted an investigation of dairy products in two other states. Subsequent confirmatory antibody testing by Brucella microagglutination test (BMAT) performed at CDC on the patient's serum was negative. The case did not meet the CDC/Council of State and Territorial Epidemiologists' (CSTE) definition for a probable or confirmed brucellosis case, and the initial EIA result was determined to be a false positive. This report summarizes the case history, laboratory findings, and public health investigations. CDC recommends that Brucella serology testing only be performed using tests cleared or approved by the Food and Drug Administration (FDA) or validated under the Clinical Laboratory Improvement Amendments (CLIA) and shown to reliably detect the presence of Brucella infection. Results from these tests should be considered supportive evidence for recent infection only and interpreted in the context of a clinically compatible illness and exposure history. EIA is not considered a confirmatory Brucella antibody test; positive screening test results should be confirmed by Brucella-specific agglutination (i.e., BMAT or standard tube agglutination test) methods.

Glandular Lesions of the Cervix in Clinical Practice: A Cytology, Histology, and Human Papillomavirus Correlation Study From 2 Institutions.

PubMed

Miller, Ross A; Mody, Dina R; Tams, Kimberlee C; Thrall, Michael J

2015-11-01

The Papanicolaou (Pap) test has indisputably decreased cervical cancer mortality, as rates have declined by up to 80% in the United States since its implementation. However, the Pap test is considered less sensitive for detecting glandular lesions than for detecting those of squamous origin. Some studies have even suggested an increasing incidence of cervical adenocarcinoma, which may be a consequence of a relatively reduced ability to detect glandular lesions with cervical cancer screening techniques. To evaluate the detection rate of glandular lesions with screening techniques currently used for cervical cancer screening and to provide insight as to which techniques are most efficacious in our study population. We retrospectively reviewed any available cytology, human papillomavirus (HPV), and histologic malignancy data in patients diagnosed with adenocarcinoma in situ and adenocarcinoma from 2 geographically and socioeconomically disparate hospital systems. Identified patients having had a negative/unsatisfactory Pap test within 5 years of adenocarcinoma in situ or adenocarcinoma tissue diagnosis were considered Pap test screening failures. Patients with negative HPV tests on cytology samples were considered HPV screening failures. One hundred thirty cases were identified (age range, 22-93 years); 39 (30%) had no Pap history in our files. Eight of 91 remaining cases (8.8%) were screening failures. The detected sensitivity for identifying adenocarcinoma in situ/adenocarcinoma in this study was 91.2% by cytology alone and 92.3% when incorporating HPV testing. The most common cytologic diagnosis was atypical glandular cells (25 cases), and those diagnosed with adenocarcinoma were 7.4 years older than those diagnosed with adenocarcinoma in situ (50.3 versus 42.9 years). Nine of 24 HPV-tested cases (37.5%) were called atypical squamous cell of undetermined significance on cytology. Our results highlight the importance of combined Pap and HPV cotesting. Although the number of cases identified is relatively small, our data suggest screening for squamous lesions facilitates the recognition of glandular lesions in the cervix. Additionally, increased use of combined Pap and HPV cotesting may decrease detection failure rates with regard to glandular lesions.

Statistical analyses of the relative risk.

PubMed Central

Gart, J J

1979-01-01

Let P1 be the probability of a disease in one population and P2 be the probability of a disease in a second population. The ratio of these quantities, R = P1/P2, is termed the relative risk. We consider first the analyses of the relative risk from retrospective studies. The relation between the relative risk and the odds ratio (or cross-product ratio) is developed. The odds ratio can be considered a parameter of an exponential model possessing sufficient statistics. This permits the development of exact significance tests and confidence intervals in the conditional space. Unconditional tests and intervals are also considered briefly. The consequences of misclassification errors and ignoring matching or stratifying are also considered. The various methods are extended to combination of results over the strata. Examples of case-control studies testing the association between HL-A frequencies and cancer illustrate the techniques. The parallel analyses of prospective studies are given. If P1 and P2 are small with large samples sizes the appropriate model is a Poisson distribution. This yields a exponential model with sufficient statistics. Exact conditional tests and confidence intervals can then be developed. Here we consider the case where two populations are compared adjusting for sex differences as well as for the strata (or covariate) differences such as age. The methods are applied to two examples: (1) testing in the two sexes the ratio of relative risks of skin cancer in people living in different latitudes, and (2) testing over time the ratio of the relative risks of cancer in two cities, one of which fluoridated its drinking water and one which did not. PMID:540589

Severe maternal morbidity due to respiratory disease and impact of 2009 H1N1 influenza A pandemic in Brazil: results from a national multicenter cross-sectional study.

PubMed

Pfitscher, L C; Cecatti, J G; Pacagnella, R C; Haddad, S M; Parpinelli, M A; Souza, J P; Quintana, S M; Surita, F G; Sousa, M H; Costa, M L

2016-05-21

The aim of this study was to assess the burden of respiratory disease, considering the influenza A pandemic season (H1N1pdm09), within the Brazilian Network for Surveillance of Severe Maternal Morbidity, and factors associated with worse maternal outcome. A multicenter cross-sectional study, involving 27 referral maternity hospitals in five Brazilian regions. Cases were identified in a prospective surveillance by using the WHO standardized criteria for potentially life-threatening conditions (PLTC) and maternal near miss (MNM). Women with severe complications from respiratory disease identified as suspected or confirmed cases of H1N1 influenza or respiratory failure were compared to those with other causes of severe morbidity. A review of suspected H1N1 influenza cases classified women as non-tested, tested positive and tested negative, comparing their outcomes. Factors associated with severe maternal outcome (SMO = MNM + MD) were assessed in both groups, in comparison to PLTC, using PR and 95 % CI adjusted for design effect of cluster sampling. Among 9555 cases of severe maternal morbidity, 485 (5 %) had respiratory disease. Respiratory disease occurred in one-quarter of MNM cases and two-thirds of MD. H1N1 virus was suspected in 206 cases with respiratory illness. Around 60 % of these women were tested, yielding 49 confirmed cases. Confirmed H1N1 influenza cases had worse adverse outcomes (MNM:MD ratio < 1 (0.9:1), compared to 12:1 in cases due to other causes), and a mortality index > 50 %, in comparison to 7.4 % in other causes of severe maternal morbidity. Delay in medical care was associated with SMO in all cases considered, with a two-fold increased risk among respiratory disease patients. Perinatal outcome was worse in cases complicated by respiratory disease, with increased prematurity, stillbirth, low birth weight and Apgar score < 7. Respiratory disease, especially considering the influenza season, is a very severe cause of maternal near miss and death. Increased awareness about this condition, preventive vaccination during pregnancy, early diagnosis and treatment are required to improve maternal health.

Providing Test Performance Feedback That Bridges Assessment and Instruction: The Case of Two Standardized English Language Tests in Japan

ERIC Educational Resources Information Center

Sawaki, Yasuyo; Koizumi, Rie

2017-01-01

This small-scale qualitative study considers feedback and results reported for two major large-scale English language tests administered in Japan: the Global Test of English Communication for Students (GTECfS) and the Eiken Test in Practical English Proficiency (Eiken). Specifically, it examines current score-reporting practices in student and…

Computer Adaptive Testing, Big Data and Algorithmic Approaches to Education

ERIC Educational Resources Information Center

Thompson, Greg

2017-01-01

This article critically considers the promise of computer adaptive testing (CAT) and digital data to provide better and quicker data that will improve the quality, efficiency and effectiveness of schooling. In particular, it uses the case of the Australian NAPLAN test that will become an online, adaptive test from 2016. The article argues that…

Acute and sub-chronic toxicity of four cytostatic drugs in zebrafish.

PubMed

Kovács, Róbert; Bakos, Katalin; Urbányi, Béla; Kövesi, Judit; Gazsi, Gyöngyi; Csepeli, Andrea; Appl, Ádám János; Bencsik, Dóra; Csenki, Zsolt; Horváth, Ákos

2016-08-01

The acute and sub-chronic effects of four cytostatic drugs-5-fluorouracil (5-FU), cisplatin (CisPt), etoposide (ET) and imatinib mesylate (IM)-on zebrafish (Danio rerio) were investigated. Acute tests were carried out in a static system in accordance with the OECD guideline 203 for adult fish and the draft guideline for fish embryos (FET test) in order to find the LC50 values of the four cytostatic drugs. Early-life stage toxicity test on zebrafish was conducted according the OECD guideline 210 using the cytostatic drugs 5-FU and IM in a semistatic system with the objective of investigating the sub-chronic effects of the cytostatic drugs on fish. In adult fish, the cytostatic drugs 5-FU and ET did not pass the limit test, thus, are considered non-toxic. In case of cisplatin, LC50 was calculated at 64.5 mg L(-1), whereas in case of IM, LC50 was at 70.8 mg L(-1). In the FET test, LC50 of 5-FU at 72-h post fertilization (hpf) was 2441.6 mg L(-1). In case of CisPt, LC50 was 349.9 mg L(-1) at 48 hpf and it progressively decreased to 81.3 mg L(-1) at 120 hpf. In addition, CisPt caused a significant delay in the hatch of larvae. In case of ET, LC50 values were not calculable as they were higher than 300 mg L(-1) at which concentration the substance crystallized in the solution. LC50 values of IM were 48 hpf; 158.3 mg L(-1) , 72 hpf; 141.6 mg L(-1), 96 hpf; 118.0 mg L(-1), and 120 hpf; 65.9 mg L(-1). In the Early-life Stage Test with 5-FU, embryonic deformities were not detected during the tests. Regarding mortalities, the 10 mg L(-1) concentration can be considered as LOEC, as statistically significant difference in mortalities was detected in this group alone. Concerning dry body weight and standard length, 1 mg L(-1) is the LOEC. In case of IM, the highest tested concentration (10 mg L(-1)) can be considered LOEC for mortalities, however, the treatment did not have an effect on the other investigated parameters (dry and wet weight, standard length). All four cytostatic drugs were characterized by low toxicity in zebrafish in acute and sub-chronic tests.

Excess Maternal Transmission of Markers in TCOF1 Among Cleft Palate Case-Parent Trios From Three Populations

PubMed Central

Sull, Jae Woong; Liang, Kung-Yee; Hetmanski, Jacqueline B.; Fallin, M. Daniele; Ingersoll, Roxanne G.; Park, Ji Wan; Wu-Chou, Yah-Huei; Chen, Philip K.; Chong, Samuel S.; Cheah, Felicia; Yeow, Vincent; Park, Beyoung Yun; Jee, Sun Ha; Jabs, Ethylin W.; Redett, Richard; Scott, Alan F.; Beaty, Terri H.

2009-01-01

Isolated cleft palate is among the most common human birth defects. The TCOF1 gene has been suggested as a candidate gene for cleft palate based on animal models. This study tests for association between markers in TCOF1 and isolated, nonsyndromic cleft palate using a case-parent trio design considering parent-of-origin effects. Case-parent trios from three populations (comprising a total of 81 case-parent trios) were genotyped for single nucleotide polymorphisms (SNPs) in the TCOF1 gene. We used the transmission disequilibrium test and the transmission asymmetry test on individual SNPs. When all trios were combined, the odds ratio for transmission of the minor allele, OR(transmission), was significant for SNP rs15251 (OR = 2.88, P = 0.007), as well as rs2255796 and rs2569062 (OR = 2.08, P = 0.03; OR = 2.43, P = 0.041; respectively) when parent of origin was not considered. The transmission asymmetry test also revealed one SNP (rs15251) showing excess maternal transmission significant at the P = 0.005 level (OR = 6.50). Parent-of-origin effects were assessed using the parent-of-origin likelihood ratio test on both SNPs and haplotypes. While the parent-of-origin likelihood ratio test was only marginally significant for this SNP (P = 0.136), analysis of haplotypes of rs2255796 and rs15251 suggested excess maternal transmission. Therefore, these data suggest TCOF1 may influence risk of cleft palate through a parent-of-origin effect. PMID:18688869

Study on the effects of flow in the volute casing on the performance of a sirocco fan

NASA Astrophysics Data System (ADS)

Adachi, Tsutomu; Sugita, Naohiro; Ohomori, Satoshi

2004-08-01

The flow at the exit from the runner blade of a centrifugal fan with forward curved blades (a sirocco fan) sometimes separates and becomes unstable. We have conducted many researches on the impeller shape of a sirocco fan, proper inlet and exit blade angles were considered to obtain optimum performance. In this paper, the casing shape were decided by changing the circumferential angle, magnifying angle and the width, 21 sorts of casings were used. Performance tests, inner flow velocity and pressure distributions were measured as well. Computational fluid dynamic calculations were also made and compared with the experimental results. Finally, the most suitable casing shape for best performance is considered.

The Right to Know and the Right Not to Know Revisited: Part One.

PubMed

Brownsword, Roger; Wale, Jeff

2017-01-01

Prompted by developments in human genetics, a recurrent bioethical question concerns a person's 'right to know' and 'right not to know' about genetic information held that is intrinsically related to or linked to them. In this paper, we will revisit the claimed rights in relation to two particular test cases. One concerns the rights of the 500,000 participants in UK Biobank (UKB) whose biosamples, already having been genotyped, will now be exome sequenced, and the other concerns the rights of pregnant women (and their children) who undergo non-invasive prenatal testing (NIPT)-a simple blood test that can reveal genetic information about both a foetus and its mother. This two-part paper is in four principal sections. First, we sketch the relevant features of our two test cases. Secondly, we consider the significance of recent legal jurisprudence in the UK and Singapore. Thirdly, we consider how, the jurisprudence apart, the claimed rights might be grounded. Fourthly, we consider the limits on the rights. We conclude with some short remarks about the kind of genetically aware society that we might want to be and how far there is still an opportunity meaningfully to debate the claimed rights.

A case study on the structural assessment of fire damaged building

NASA Astrophysics Data System (ADS)

Osman, M. H.; Sarbini, N. N.; Ibrahim, I. S.; Ma, C. K.; Ismail, M.; Mohd, M. F.

2017-11-01

This paper presents a case study on the structural assessment of building damaged by fire and discussed on the site investigations and test results prior to determine the existing condition of the building. The building was on fire for about one hour before it was extinguished. In order to ascertain the integrity of the building, a visual inspection was conducted for all elements (truss, beam, column and wall), followed by non-destructive, load and material tests. The load test was conducted to determine the ability of truss to resist service load, while the material test to determine the residual strength of the material. At the end of the investigation, a structural analysis was carried out to determine the new factor of safety by considering the residual strength. The highlighted was on the truss element due to steel behaviour that is hardly been predicted. Meanwhile, reinforced concrete elements (beam, column and wall) were found externally affected and caused its strength to be considered as sufficient for further used of building. The new factor of safety is equal to 2, considered as the minimum calculated value for the truss member. Therefore, this fire damaged building was found safe and can be used for further application.

Herbalife hepatotoxicity: Evaluation of cases with positive reexposure tests.

PubMed

Teschke, Rolf; Frenzel, Christian; Schulze, Johannes; Schwarzenboeck, Alexander; Eickhoff, Axel

2013-07-27

To analyze the validity of applied test criteria and causality assessment methods in assumed Herbalife hepatotoxicity with positive reexposure tests. We searched the Medline database for suspected cases of Herbalife hepatotoxicity and retrieved 53 cases including eight cases with a positive unintentional reexposure and a high causality level for Herbalife. First, analysis of these eight cases focused on the data quality of the positive reexposure cases, requiring a baseline value of alanine aminotransferase (ALT) < 5 upper limit of normal (N) before reexposure, with N as the upper limit of normal, and a doubling of the ALT value at reexposure as compared to the ALT value at baseline prior to reexposure. Second, reported methods to assess causality in the eight cases were evaluated, and then the liver specific Council for International Organizations of Medical Sciences (CIOMS) scale validated for hepatotoxicity cases was used for quantitative causality reevaluation. This scale consists of various specific elements with scores provided through the respective case data, and the sum of the scores yields a causality grading for each individual case of initially suspected hepatotoxicity. Details of positive reexposure test conditions and their individual results were scattered in virtually all cases, since reexposures were unintentional and allowed only retrospective rather than prospective assessments. In 1/8 cases, criteria for a positive reexposure were fulfilled, whereas in the remaining cases the reexposure test was classified as negative (n = 1), or the data were considered as uninterpretable due to missing information to comply adequately with the criteria (n = 6). In virtually all assessed cases, liver unspecific causality assessment methods were applied rather than a liver specific method such as the CIOMS scale. Using this scale, causality gradings for Herbalife in these eight cases were probable (n = 1), unlikely (n = 4), and excluded (n = 3). Confounding variables included low data quality, alternative diagnoses, poor exclusion of important other causes, and comedication by drugs and herbs in 6/8 cases. More specifically, problems were evident in some cases regarding temporal association, daily doses, exact start and end dates of product use, actual data of laboratory parameters such as ALT, and exact dechallenge characteristics. Shortcomings included scattered exclusion of hepatitis A-C, cytomegalovirus and Epstein Barr virus infection with only globally presented or lacking parameters. Hepatitis E virus infection was considered in one single patient and found positive, infections by herpes simplex virus and varicella zoster virus were excluded in none. Only one case fulfilled positive reexposure test criteria in initially assumed Herbalife hepatotoxicity, with lower CIOMS based causality gradings for the other cases than hitherto proposed.

Clinical value of the Treponema pallidum haemagglutination test.

PubMed

Robertson, D H; McMillan, A

1975-04-01

In 1,129 patients attending the Department for Sexually Transmitted Diseases, the serum was examined by three screening tests (VDRL slide, RPCF, and TPHA) and twelve cases of syphilis (1 per cent. of patients attenting the clinic) were discovered. Six of these patients were considered to have latent syphilis (5 acquired, 1 congenital) and were detected only by the TPHA; all six cases were confirmed by the FTA-ABS, The TPHA failed to detect three of the remaining six cases (2 primary and 1 very early, the latter in a contact of a patient with primary syphilis). All six cases were, however, detected by the VDRL. In seven cases, the TPHA was positive in the absence of other evidence of present or previous syphilis. In these cases the FTA-ABS was also negative. The clinical application of the TPHA test in the detection of syphilis is discussed.

Second order tensor finite element

NASA Technical Reports Server (NTRS)

Oden, J. Tinsley; Fly, J.; Berry, C.; Tworzydlo, W.; Vadaketh, S.; Bass, J.

1990-01-01

The results of a research and software development effort are presented for the finite element modeling of the static and dynamic behavior of anisotropic materials, with emphasis on single crystal alloys. Various versions of two dimensional and three dimensional hybrid finite elements were implemented and compared with displacement-based elements. Both static and dynamic cases are considered. The hybrid elements developed in the project were incorporated into the SPAR finite element code. In an extension of the first phase of the project, optimization of experimental tests for anisotropic materials was addressed. In particular, the problem of calculating material properties from tensile tests and of calculating stresses from strain measurements were considered. For both cases, numerical procedures and software for the optimization of strain gauge and material axes orientation were developed.

Compensatory parameters of intracranial space in giant hydrocephalus.

PubMed

Cieślicki, Krzysztof; Czepko, Ryszard

2009-01-01

The main goal of the present study is to examine compensatory parameters of intracranial space in giant hydrocephalus. We also assess the early and late outcome and analyse complications in shunted cases. Nine cases of giant hydrocephalus characterised by the value of Evans ratio > 0.5, ventricular index > 1.5, and the width of the third ventricle > 20 mm were considered. Using the lumbar infusion test and developed software we analysed the intracranial compensatory parameters typical for hydrocephalus. Based on the Marmarou model, the method depended on a repeated search for the best fitting curve corresponding to the progress of the test was used. Eight out of nine patients were therefore shunted. Patients were followed up for 9 months. Five out of eight shunted patients undoubtedly improved in a few days after surgery (62%). Complications (subdural hygromas/haematomas and intracerebral haematoma) developed in 5 (62%) cases in longer follow-up. A definite improvement was noted in 4 out of 8 operated cases (50%). To get the stable values of compensatory parameters, the duration of the infusion test must at least double the inflexion time of the test curve. All but one considered cases of giant hydrocephalus were characterized by lack of intracranial space reserve, significantly reduced rate of CSF secretion and by various degrees of elevated value of the resistance to outflow. Due to the significant number of complications and uncertain long-term improvement, great caution in decision making for shunting has to be taken.

Serum apolipoprotein A1 and haptoglobin, in patients with suspected drug-induced liver injury (DILI) as biomarkers of recovery

PubMed Central

Peta, Valentina; Tse, Chantal; Perazzo, Hugo; Munteanu, Mona; Ngo, Yen; Ngo, An; Ramanujam, Nittia; Verglas, Lea; Mallet, Maxime; Ratziu, Vlad; Thabut, Dominique; Rudler, Marika; Thibault, Vincent; Schuppe-Koistinen, Ina; Bonnefont-Rousselot, Dominique; Hainque, Bernard; Imbert-Bismut, Françoise; Merz, Michael; Kullak-Ublick, Gerd; Andrade, Raul; van Boemmel, Florian; Schott, Eckart

2017-01-01

Background There is a clear need for better biomarkers of drug-induced-liver-injury (DILI). Aims We aimed to evaluate the possible prognostic value of ActiTest and FibroTest proteins apoliprotein-A1, haptoglobin and alpha-2-macroglobulin, in patients with DILI. Methods We analyzed cases and controls included in the IMI-SAFE-T-DILI European project, from which serum samples had been stored in a dedicated biobank. The analyses of ActiTest and FibroTest had been prospectively scheduled. The primary objective was to analyze the performance (AUROC) of ActiTest components as predictors of recovery outcome defined as an ALT <2x the upper limit of normal (ULN), and BILI <2x ULN. Results After adjudication, 154 patients were considered to have DILI and 22 were considered to have acute liver injury without DILI. A multivariate regression analysis (ActiTest-DILI patent pending) combining the ActiTest components without BILI and ALT (used as references), apolipoprotein-A1, haptoglobin, alpha-2-macroglobulin and GGT, age and gender, resulted in a significant prediction of recovery with 67.0% accuracy (77/115) and an AUROC of 0.724 (P<0.001 vs. no prediction 0.500). Repeated apolipoprotein-A1 and haptoglobin remained significantly higher in the DILI cases that recovered (n = 65) versus those that did not (n = 16), at inclusion, at 4–8 weeks and at 8–12 weeks. The same results were observed after stratification on APAP cases and non-APAP cases. Conclusions We identified that apolipoprotein-A1 and haptoglobin had significant predictive values for the prediction of recovery at 12 weeks in DILI, enabling the construction of a new prognostic panel, the DILI-ActiTest, which needs to be independently validated. PMID:29287080

Confounding Brain Stem Function During Pediatric Brain Death Determination: Two Case Reports.

PubMed

Hansen, Gregory; Joffe, Ari R

2017-06-01

A patient who has been declared brain dead is considered to be both legally and clinically dead. However, we report 2 pediatric cases in which the patients demonstrated clinical signs of brain stem function that are not recognized or tested in current Canadian or US guidelines.

Polycythemia vera among participants of a nuclear weapons test

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

Sobell, J.L.; Codd, M.B.; Silverstein, M.N.

1987-03-06

Three letters-to-the-editors discuss the finding of a statistically significant excess of polycythemia vera cases among participants in the Smoky detonation. Had population-based incidence rates from Rochester been used to derive an expected incidence, and had only bona fide polycythemia vera cases been considered, as is the rule in most epidemiologic studies, the observed frequency of polycythemia vera among participants in the Smoky test would have been found to be well within chance expectations.

Cost-effectiveness of one-time genetic testing to minimize lifetime adverse drug reactions.

PubMed

Alagoz, O; Durham, D; Kasirajan, K

2016-04-01

We evaluated the cost-effectiveness of one-time pharmacogenomic testing for preventing adverse drug reactions (ADRs) over a patient's lifetime. We developed a Markov-based Monte Carlo microsimulation model to represent the ADR events in the lifetime of each patient. The base-case considered a 40-year-old patient. We measured health outcomes in life years (LYs) and quality-adjusted LYs (QALYs) and estimated costs using 2013 US$. In the base-case, one-time genetic testing had an incremental cost-effectiveness ratio (ICER) of $43,165 (95% confidence interval (CI) is ($42,769,$43,561)) per additional LY and $53,680 per additional QALY (95% CI is ($53,182,$54,179)), hence under the base-case one-time genetic testing is cost-effective. The ICER values were most sensitive to the average probability of death due to ADR, reduction in ADR rate due to genetic testing, mean ADR rate and cost of genetic testing.

Excess maternal transmission of markers in TCOF1 among cleft palate case-parent trios from three populations.

PubMed

Sull, Jae Woong; Liang, Kung-Yee; Hetmanski, Jacqueline B; Fallin, M Daniele; Ingersoll, Roxanne G; Park, Ji Wan; Wu-Chou, Yah-Huei; Chen, Philip K; Chong, Samuel S; Cheah, Felicia; Yeow, Vincent; Park, Beyoung Yun; Jee, Sun Ha; Jabs, Ethylin W; Redett, Richard; Scott, Alan F; Beaty, Terri H

2008-09-15

Isolated cleft palate is among the most common human birth defects. The TCOF1 gene has been suggested as a candidate gene for cleft palate based on animal models. This study tests for association between markers in TCOF1 and isolated, nonsyndromic cleft palate using a case-parent trio design considering parent-of-origin effects. Case-parent trios from three populations (comprising a total of 81 case-parent trios) were genotyped for single nucleotide polymorphisms (SNPs) in the TCOF1 gene. We used the transmission disequilibrium test and the transmission asymmetry test on individual SNPs. When all trios were combined, the odds ratio for transmission of the minor allele, OR(transmission), was significant for SNP rs15251 (OR = 2.88, P = 0.007), as well as rs2255796 and rs2569062 (OR = 2.08, P = 0.03; OR = 2.43, P = 0.041; respectively) when parent of origin was not considered. The transmission asymmetry test also revealed one SNP (rs15251) showing excess maternal transmission significant at the P = 0.005 level (OR = 6.50). Parent-of-origin effects were assessed using the parent-of-origin likelihood ratio test on both SNPs and haplotypes. While the parent-of-origin likelihood ratio test was only marginally significant for this SNP (P = 0.136), analysis of haplotypes of rs2255796 and rs15251 suggested excess maternal transmission. Therefore, these data suggest TCOF1 may influence risk of cleft palate through a parent-of-origin effect. Copyright 2008 Wiley-Liss, Inc.

Acceptable Interventions to Reduce Syphilis Transmission Among High-Risk Men Who Have Sex With Men in Los Angeles

PubMed Central

Plant, Aaron; Javanbakht, Marjan; Cross, John; Montoya, Jorge A.; Bolan, Robert; Kerndt, Peter R.

2015-01-01

Objectives. We examined perceptions of and attitudes toward existing and potential syphilis interventions, including case management and Web-based programs, to increase syphilis testing among high-risk men who have sex with men (MSM). Methods. Between October 2010 and June 2011, we conducted in-depth interviews with 19 MSM in Los Angeles, California, with repeat early syphilis infections (primary, secondary, and early latent syphilis) within the previous 5 years. We analyzed the interviews inductively to determine the most acceptable potential interventions. Results. Experiences with health department and community-based standard of care case management were generally positive. The most popular interventions among respondents included a Web site providing information on syphilis and syphilis testing, automated Web reminders to test, being paid to test, free online home testing kits, and preexposure prophylactic medication. Respondents’ beliefs that they would continue to practice high-risk sexual behaviors reinforced their reasons for wanting increased accessibility and convenient testing strategies. Conclusions. Public health officials should consider participant responses to potential interventions for syphilis, which suggest that high-risk MSM would consider testing more often or using other interventions. PMID:25602881

Occupational Airborne Contact Dermatitis From Proton Pump Inhibitors.

PubMed

DeKoven, Joel G; Yu, Ashley M

2015-01-01

Few published reports have described occupational contact dermatitis from proton pump inhibitor (PPI) exposure in the literature. We present an additional case of a 58-year-old male pharmaceutical worker with an occupational airborne allergic contact dermatitis to PPIs confirmed by patch testing. This is a novel report of workplace exposure to dexlansoprazole and esomeprazole PPIs with resultant clinical contact allergy and relevant positive patch test results to these 2 agents. A literature review of all previously reported cases of occupational contact dermatitis to PPI is summarized. The case also emphasizes the importance of even minute exposures when considering workplace accommodation.

OCULAR SYPHILIS IN A KIDNEY TRANSPLANT RECIPIENT

PubMed Central

ROMAO, Elen A.; BOLELLA, Valdes R.; NARDIN, Maria Estela P.; HABIB-SIMAO, Maria Lucia; FURTADO, João Marcelo; MOYSES-NETO, Miguel

2016-01-01

We present a case of ocular syphilis after a renal transplantation involving progressive vision loss without clinically identifiable ocular disease. Electroretinography showed signs of ischemia, especially in the internal retina. A serological test was positive for syphilis. Lumbar puncture revealed lymphocytic meningitis and a positive serologic test for syphilis in the cerebrospinal fluid. The patient was treated with penicillin, and had a quick vision improvement. In the case of transplant recipients, clinicians should always consider the diagnosis of ocular syphilis in cases with unexplained visual acuity decrement, as this condition may cause serious complications if not treated. PMID:27253748

Heat transfer direction dependence of heat transfer coefficients in annuli

NASA Astrophysics Data System (ADS)

Prinsloo, Francois P. A.; Dirker, Jaco; Meyer, Josua P.

2018-04-01

In this experimental study the heat transfer phenomena in concentric annuli in tube-in-tube heat exchangers at different annular Reynolds numbers, annular diameter ratios, and inlet fluid temperatures using water were considered. Turbulent flow with Reynolds numbers ranging from 15,000 to 45,000, based on the average bulk fluid temperature was tested at annular diameter ratios of 0.327, 0.386, 0.409 and 0.483 with hydraulic diameters of 17.00, 22.98, 20.20 and 26.18 mm respectively. Both heated and cooled annuli were investigated by conducting tests at a range of inlet temperatures between 10 °C to 30 °C for heating cases, and 30 °C to 50 °C for cooling cases. Of special interest was the direct measurement of local wall temperatures on the heat transfer surface, which is often difficult to obtain and evasive in data-sets. Continuous verification and re-evaluation of temperatures measurements were performed via in-situ calibration. It is shown that inlet fluid temperature and the heat transfer direction play significant roles on the magnitude of the heat transfer coefficient. A new adjusted Colburn j-factor definition is presented to describe the heating and cooling cases and is used to correlate the 894 test cases considered in this study.

[A case of legionnaire's disease in Germany (author's transl)].

PubMed

Missalek, W; Helmecke, G

1979-12-07

Severe bronchopneumonia in a 66-year-old patient failed to respond to sensitivity-tested antibiotics, with only erythromycin providing improvement. The indirect immunofluorescence test for legionnaire's disease gave a highly significant titre rise (eightfold). Legionnaire's disease should be considered in the differential diagnosis of treatment-resistant bronchopneumonia.

49 CFR 40.389 - What factors may the Director consider?

Code of Federal Regulations, 2012 CFR

2012-10-01

... WORKPLACE DRUG AND ALCOHOL TESTING PROGRAMS Public Interest Exclusions § 40.389 What factors may the... DOT agency regulation, the degree to which the noncompliance affects matters common to the DOT drug and alcohol testing program; (g) Other factors appropriate to the circumstances of the case. ...

Taking Costs and Diagnostic Test Accuracy into Account When Designing Prevalence Studies: An Application to Childhood Tuberculosis Prevalence.

PubMed

Wang, Zhuoyu; Dendukuri, Nandini; Pai, Madhukar; Joseph, Lawrence

2017-11-01

When planning a study to estimate disease prevalence to a pre-specified precision, it is of interest to minimize total testing cost. This is particularly challenging in the absence of a perfect reference test for the disease because different combinations of imperfect tests need to be considered. We illustrate the problem and a solution by designing a study to estimate the prevalence of childhood tuberculosis in a hospital setting. All possible combinations of 3 commonly used tuberculosis tests, including chest X-ray, tuberculin skin test, and a sputum-based test, either culture or Xpert, are considered. For each of the 11 possible test combinations, 3 Bayesian sample size criteria, including average coverage criterion, average length criterion and modified worst outcome criterion, are used to determine the required sample size and total testing cost, taking into consideration prior knowledge about the accuracy of the tests. In some cases, the required sample sizes and total testing costs were both reduced when more tests were used, whereas, in other examples, lower costs are achieved with fewer tests. Total testing cost should be formally considered when designing a prevalence study.

First case of chancroid in 14 years at the largest STI clinic in Paris, France.

PubMed

Fouéré, Sébastien; Lassau, François; Rousseau, Clotilde; Bagot, Martine; Janier, Michel

2016-08-01

We report the first case of chancroid seen at our clinic in 14 years. It was diagnosed by nuclear acid amplification test in a male patient returning from Madagascar. Although the disease is considered on the verge of disappearance even in tropical countries, its real potential for reemergence - due to new strains of Haemophilus ducreyi, underreporting and a lack of widespread use of molecular testing - could be underestimated. © The Author(s) 2016.

Legionella pneumophila serogroup 3 infection: importance of serology.

PubMed

Khanna, N; Meikle, A; Gillespie, L; Edwards, G; Lindsay, D

2012-08-01

We present a case of Legionella pneumophila serogroup 3 (LP3) infection in a patient with severe community-acquired pneumonia (CAP). The diagnosis was complicated by an initial equivocal L. pneumophila urinary antigen test, followed by two negative samples. LP3 was cultured from a sputum sample and the diagnosis was confirmed by serology 15 days into the admission. This case highlights the importance of considering non-LP1 serogroups as causes of CAP and the role of serological testing in diagnosis.

Herbalife hepatotoxicity: Evaluation of cases with positive reexposure tests

PubMed Central

Teschke, Rolf; Frenzel, Christian; Schulze, Johannes; Schwarzenboeck, Alexander; Eickhoff, Axel

2013-01-01

AIM: To analyze the validity of applied test criteria and causality assessment methods in assumed Herbalife hepatotoxicity with positive reexposure tests. METHODS: We searched the Medline database for suspected cases of Herbalife hepatotoxicity and retrieved 53 cases including eight cases with a positive unintentional reexposure and a high causality level for Herbalife. First, analysis of these eight cases focused on the data quality of the positive reexposure cases, requiring a baseline value of alanine aminotransferase (ALT) < 5 upper limit of normal (N) before reexposure, with N as the upper limit of normal, and a doubling of the ALT value at reexposure as compared to the ALT value at baseline prior to reexposure. Second, reported methods to assess causality in the eight cases were evaluated, and then the liver specific Council for International Organizations of Medical Sciences (CIOMS) scale validated for hepatotoxicity cases was used for quantitative causality reevaluation. This scale consists of various specific elements with scores provided through the respective case data, and the sum of the scores yields a causality grading for each individual case of initially suspected hepatotoxicity. RESULTS: Details of positive reexposure test conditions and their individual results were scattered in virtually all cases, since reexposures were unintentional and allowed only retrospective rather than prospective assessments. In 1/8 cases, criteria for a positive reexposure were fulfilled, whereas in the remaining cases the reexposure test was classified as negative (n = 1), or the data were considered as uninterpretable due to missing information to comply adequately with the criteria (n = 6). In virtually all assessed cases, liver unspecific causality assessment methods were applied rather than a liver specific method such as the CIOMS scale. Using this scale, causality gradings for Herbalife in these eight cases were probable (n = 1), unlikely (n = 4), and excluded (n = 3). Confounding variables included low data quality, alternative diagnoses, poor exclusion of important other causes, and comedication by drugs and herbs in 6/8 cases. More specifically, problems were evident in some cases regarding temporal association, daily doses, exact start and end dates of product use, actual data of laboratory parameters such as ALT, and exact dechallenge characteristics. Shortcomings included scattered exclusion of hepatitis A-C, cytomegalovirus and Epstein Barr virus infection with only globally presented or lacking parameters. Hepatitis E virus infection was considered in one single patient and found positive, infections by herpes simplex virus and varicella zoster virus were excluded in none. CONCLUSION: Only one case fulfilled positive reexposure test criteria in initially assumed Herbalife hepatotoxicity, with lower CIOMS based causality gradings for the other cases than hitherto proposed. PMID:23898368

Impact of single particle oscillations on screening of a test charge

NASA Astrophysics Data System (ADS)

Ramazanov, Tlekkabul S.; Moldabekov, Zhandos A.; Gabdullin, Maratbek T.

2018-06-01

Screening of a test charge by electrons oscillating in an external alternating electrical (laser) field is analyzed. It is shown that single particle oscillations lead to the creation of an oscillatory pattern of the test charge's potential at large distances. Analysis has been done by considering and neglecting the contribution of ions on the screening. Impact of the quantum diffraction (non-locality) and of the collisional damping on the test charge's potential is considered. It is shown that electrons are unable to provide screening of the test charge if the frequency of the induced single particle oscillations larger than the electron-plasma frequency. In the opposite case of low frequencies, the potential of the test charge changes its sign if the screening by ions is neglected.

METACOGNITIVE SCAFFOLDS IMPROVE SELF-JUDGMENTS OF ACCURACY IN A MEDICAL INTELLIGENT TUTORING SYSTEM

PubMed Central

Feyzi-Behnagh, Reza; Azevedo, Roger; Legowski, Elizabeth; Reitmeyer, Kayse; Tseytlin, Eugene; Crowley, Rebecca S.

2013-01-01

In this study, we examined the effect of two metacognitive scaffolds on the accuracy of confidence judgments made while diagnosing dermatopathology slides in SlideTutor. Thirty-one (N = 31) first- to fourth-year pathology and dermatology residents were randomly assigned to one of the two scaffolding conditions. The cases used in this study were selected from the domain of Nodular and Diffuse Dermatitides. Both groups worked with a version of SlideTutor that provided immediate feedback on their actions for two hours before proceeding to solve cases in either the Considering Alternatives or Playback condition. No immediate feedback was provided on actions performed by participants in the scaffolding mode. Measurements included learning gains (pre-test and post-test), as well as metacognitive performance, including Goodman-Kruskal Gamma correlation, bias, and discrimination. Results showed that participants in both conditions improved significantly in terms of their diagnostic scores from pre-test to post-test. More importantly, participants in the Considering Alternatives condition outperformed those in the Playback condition in the accuracy of their confidence judgments and the discrimination of the correctness of their assertions while solving cases. The results suggested that presenting participants with their diagnostic decision paths and highlighting correct and incorrect paths helps them to become more metacognitively accurate in their confidence judgments. PMID:24532850

METACOGNITIVE SCAFFOLDS IMPROVE SELF-JUDGMENTS OF ACCURACY IN A MEDICAL INTELLIGENT TUTORING SYSTEM.

PubMed

Feyzi-Behnagh, Reza; Azevedo, Roger; Legowski, Elizabeth; Reitmeyer, Kayse; Tseytlin, Eugene; Crowley, Rebecca S

2014-03-01

In this study, we examined the effect of two metacognitive scaffolds on the accuracy of confidence judgments made while diagnosing dermatopathology slides in SlideTutor. Thirty-one ( N = 31) first- to fourth-year pathology and dermatology residents were randomly assigned to one of the two scaffolding conditions. The cases used in this study were selected from the domain of Nodular and Diffuse Dermatitides. Both groups worked with a version of SlideTutor that provided immediate feedback on their actions for two hours before proceeding to solve cases in either the Considering Alternatives or Playback condition. No immediate feedback was provided on actions performed by participants in the scaffolding mode. Measurements included learning gains (pre-test and post-test), as well as metacognitive performance, including Goodman-Kruskal Gamma correlation, bias, and discrimination. Results showed that participants in both conditions improved significantly in terms of their diagnostic scores from pre-test to post-test. More importantly, participants in the Considering Alternatives condition outperformed those in the Playback condition in the accuracy of their confidence judgments and the discrimination of the correctness of their assertions while solving cases. The results suggested that presenting participants with their diagnostic decision paths and highlighting correct and incorrect paths helps them to become more metacognitively accurate in their confidence judgments.

Multimodal lung cancer screening using the ITALUNG biomarker panel and low dose computed tomography. Results of the ITALUNG biomarker study.

PubMed

Carozzi, Francesca Maria; Bisanzi, Simonetta; Carrozzi, Laura; Falaschi, Fabio; Lopes Pegna, Andrea; Mascalchi, Mario; Picozzi, Giulia; Peluso, Marco; Sani, Cristina; Greco, Luana; Ocello, Cristina; Paci, Eugenio

2017-07-01

Asymptomatic high-risk subjects, randomized in the intervention arm of the ITALUNG trial (1,406 screened for lung cancer), were enrolled for the ITALUNG biomarker study (n = 1,356), in which samples of blood and sputum were analyzed for plasma DNA quantification (cut off 5 ng/ml), loss of heterozygosity and microsatellite instability. The ITALUNG biomarker panel (IBP) was considered positive if at least one of the two biomarkers included in the panel was positive. Subjects with and without lung cancer diagnosis at the end of the screening cycle with LDCT (n = 517) were evaluated. Out of 18 baseline screen detected lung cancer cases, 17 were IBP positive (94%). Repeat screen-detected lung cancer cases were 18 and 12 of them positive at baseline IBP test (66%). Interval cancer cases (2-years) and biomarker tests after a suspect Non Calcific Nodule follow-up were investigated. The single test versus multimodal screening measures of accuracy were compared in a simulation within the screened ITALUNG intervention arm, considering screen-detected and interval cancer cases. Sensitivity was 90% at baseline screening. Specificity was 71 and 61% for LDCT and IBP as baseline single test, and improved at 89% with multimodal, combined screening. The positive predictive value was 4.3% for LDCT at baseline and 10.6% for multimodal screening. Multimodal screening could improve the screening efficiency at baseline and strategies for future implementation are discussed. If IBP was used as primary screening test, the LDCT burden might decrease of about 60%. © 2017 UICC.

Toxoplasma gondii seroprevalence and association with equine protozoal myeloencephalitis: A case-control study of Californian horses.

PubMed

James, K E; Smith, W A; Packham, A E; Conrad, P A; Pusterla, N

2017-06-01

While toxoplasmosis is not commonly considered a clinical disease of equines, previous seroprevalence studies have reported differing background rates of Toxoplasma gondii infection in horses globally. The objective of this study was to evaluate possible associations between T. gondii seroprevalence and clinical signs of equine protozoal myeloencephalitis (EPM) in horses. Using a case-control study design, 720 Californian horses with neurologic signs compatible with EPM were compared to healthy, non-neurologic horses for the presence of T. gondii antibodies (using indirect fluorescent antibody tests [IFAT]). Toxoplasma gondii seroprevalence among cases and controls was determined at standard serum cut-offs: 40, 80, 160, 320, and 640. At a T. gondii titre cut-off of 320, horses with clinical signs compatible with EPM had 3.55 times the odds of a seropositive test compared to those without clinical signs (P<0.01) when adjusted for covariates. When restricted to the autumn season and at the same titre cut-off, an EPM suspect horse had 6.4 times the odds of testing seropositive to T. gondii, compared to non-neurologic horses. The association between high T. gondii titres and clinical signs compatible with EPM is potentially reflective of toxoplasmosis in equines. Serologic testing of cerebrospinal fluid and isolation of T. gondii in EPM suspect cases should be considered. Future studies investigating the relationship between T. gondii and EPM are warranted. Copyright © 2017 Elsevier Ltd. All rights reserved.

The multicategory case of the sequential Bayesian pixel selection and estimation procedure

NASA Technical Reports Server (NTRS)

Pore, M. D.; Dennis, T. B. (Principal Investigator)

1980-01-01

A Bayesian technique for stratified proportion estimation and a sampling based on minimizing the mean squared error of this estimator were developed and tested on LANDSAT multispectral scanner data using the beta density function to model the prior distribution in the two-class case. An extention of this procedure to the k-class case is considered. A generalization of the beta function is shown to be a density function for the general case which allows the procedure to be extended.

Reliability and Model Fit

ERIC Educational Resources Information Center

Stanley, Leanne M.; Edwards, Michael C.

2016-01-01

The purpose of this article is to highlight the distinction between the reliability of test scores and the fit of psychometric measurement models, reminding readers why it is important to consider both when evaluating whether test scores are valid for a proposed interpretation and/or use. It is often the case that an investigator judges both the…

Algorithm and code development for unsteady three-dimensional Navier-Stokes equations

NASA Technical Reports Server (NTRS)

Obayashi, Shigeru

1991-01-01

A streamwise upwind algorithm for solving the unsteady 3-D Navier-Stokes equations was extended to handle the moving grid system. It is noted that the finite volume concept is essential to extend the algorithm. The resulting algorithm is conservative for any motion of the coordinate system. Two extensions to an implicit method were considered and the implicit extension that makes the algorithm computationally efficient is implemented into Ames's aeroelasticity code, ENSAERO. The new flow solver has been validated through the solution of test problems. Test cases include three-dimensional problems with fixed and moving grids. The first test case shown is an unsteady viscous flow over an F-5 wing, while the second test considers the motion of the leading edge vortex as well as the motion of the shock wave for a clipped delta wing. The resulting algorithm has been implemented into ENSAERO. The upwind version leads to higher accuracy in both steady and unsteady computations than the previously used central-difference method does, while the increase in the computational time is small.

Generalized reactions during skin testing with clindamycin in drug hypersensitivity: a report of 3 cases and review of the literature.

PubMed

Papakonstantinou, Eleni; Müller, Sabine; Röhrbein, Jan H; Wieczorek, Dorothea; Kapp, Alexander; Jakob, Thilo; Wedi, Bettina

2018-04-01

The diagnostic approach to drug hypersensitivity includes a detailed medical history, clinical examination, and skin testing and/or oral challenge with a culprit or alternative drug, depending on the type of reaction and the suspected drugs. Although skin testing is considered to be rather safe, cutaneous and systemic, including fatal, reactions have been described. To report 3 cases with generalized delayed reactions after skin testing with clindamycin, and to review the existing literature. Thorough clinical examination, blood tests and prick, intradermal and patch tests were performed in 3 patients. All patients experienced generalized maculopapular exanthema after intradermal and patch testing with clindamycin and amoxicillin in the first patient, and clindamycin alone in the second and third patient. None of the patients showed immediate reactions to skin tests, while positive intradermal reactions after 24 h to amoxicillin and clindamycin were observed in the first patient, and positive intradermal reactions after 24 h to clindamycin were observed in the second and third patients. Skin testing with clindamycin in the diagnosis of drug hypersensitivity carries some risk of adverse reactions. A stepwise and individual diagnostic work-up, considering potential risk factors, and testing in a specialized centre with emergency equipment available is highly recommended. © 2018 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Clinical Spectrum of Autoerythrocyte Sensitization Syndrome: A Series of Five Cases

PubMed Central

Thokchom, Nandakishore Singh; Pradeepa, D.; Hafi, N. A. Bishurul; Verma, Kapila

2018-01-01

Autoerythrocyte sensitization syndrome (Gardner Diamond syndrome or GDS) is a rare syndrome characterized by painful and spontaneous purpura commonly affecting adult women, and is mostly associated with psychiatric illness. Diagnosis is mainly based on clinical presentation, exclusion of other simulating diseases, and psychiatric evaluation. Only few cases have been reported till date. We report five cases of spontaneous purpura with a normal investigation profile, except for iron deficiency anemia in 1 patient, of which three had associated underlying psychiatric illness. Autoerythrocyte sensitization test was positive in all our cases. Patients presenting with painful bruises without significant medical history such as underlying bleeding disorder or drug history or history of trauma should be considered for autoerythrocyte sensitization syndrome, and managed accordingly. The present study is a case series of patients with characteristic features of autoerythrocyte sensitization syndrome, considering the rarity of the reports on its clinical spectra. PMID:29644197

Does health promote economic growth? Portuguese case study: from dictatorship to full democracy.

PubMed

Morgado, Sónia Maria Aniceto

2014-07-01

This paper revisits the debate on health and economic growth (Deaton in J Econ Lit 51:113-158, 2003) focusing on the Portuguese case by testing the relationship between growth and health. We test Portuguese insights, using time series data from 1960 to 2005, taking into account different variables (life expectancy, labour, capital, infant mortality) and considering the years that included major events on the political scene, such as the dictatorship and a closed economy (1960-1974), a revolution (1974) and full democracy and an open economy (1975-2005), factors that influence major economic, cultural, social and politic indicators. Therefore the analysis is carried out adopting Lucas' (J Monet Econ 22(1):3-42, 1988) endogenous growth model that considers human capital as one factor of production, it adopts a VAR (vector autoregressive) model to test the causality between growth and health. Estimates based on the VAR seem to confirm that economic growth influences the health process, but health does not promote growth, during the period under study.

Long lasting dysautonomia due to botulinum toxin B poisoning: clinical-laboratory follow up and difficulties in initial diagnosis.

PubMed

Potulska-Chromik, Anna; Zakrzewska-Pniewska, Beata; Szmidt-Sałkowska, Elżbieta; Lewandowski, Jacek; Siński, Maciej; Przyjałkowski, Witold; Kostera-Pruszczyk, Anna

2013-10-30

Botulism is an acute form of poisoning caused by one of four types (A, B, E, F) toxins produced by Clostridium botulinum, ananaerobic, spore forming bacillus. Usually diagnosis of botulism is considered in patients with predominant motor symptoms: muscle weakness with intact sensation and preserved mental function. We report a case of 56-year-old Caucasian female with a history of arterial hypertension, who presented with acute respiratory failure and bilateral ptosis misdiagnosed as brainstem ischemia. She had severe external and internal ophtalmoplegia, and autonomic dysfunction with neither motor nor sensory symptoms from upper and lower limbs. Diagnosis of botulinum toxin poisoning was made and confirmed by serum antibody testing in the mouse inoculation test. Ophtalmoplegia, autonomic dysfunction and respiratory failure can be caused by botulism. Early treatment and intensive care is essential for survival and recovery. The electrophysiological tests are crucial to correct and rapid diagnosis. Botulism (especially type B) should be considered in any case of acute or predominant isolated autonomic dysfunction.

Validation of a fully automated HER2 staining kit in breast cancer.

PubMed

Moelans, Cathy B; Kibbelaar, Robby E; van den Heuvel, Marius C; Castigliego, Domenico; de Weger, Roel A; van Diest, Paul J

2010-01-01

Testing for HER2 amplification and/or overexpression is currently routine practice to guide Herceptin therapy in invasive breast cancer. At present, HER2 status is most commonly assessed by immunohistochemistry (IHC). Standardization of HER2 IHC assays is of utmost clinical and economical importance. At present, HER2 IHC is most commonly performed with the HercepTest which contains a polyclonal antibody and applies a manual staining procedure. Analytical variability in HER2 IHC testing could be diminished by a fully automatic staining system with a monoclonal antibody. 219 invasive breast cancers were fully automatically stained with the monoclonal antibody-based Oracle HER2 Bond IHC kit and manually with the HercepTest. All cases were tested for amplification with chromogenic in situ hybridization (CISH). HercepTest yielded an overall sharper membrane staining, with less cytoplasmic and stromal background than Oracle in 17% of cases. Overall concordance between both IHC techniques was 89% (195/219) with a kappa value of 0.776 (95% CI 0.698-0.854), indicating a substantial agreement. Most (22/24) discrepancies between HercepTest and Oracle showed a weaker staining for Oracle. Thirteen of the 24 discrepant cases were high-level HER2 amplified by CISH, and in 12 of these HercepTest IHC better reflected gene amplification status. All the 13 HER2 amplified discrepant cases were at least 2+ by HercepTest, while 10/13 of these were at least 2+ for Oracle. Considering CISH as gold standard, sensitivity of HercepTest and Oracle was 91% and 83%, and specificity was 94% and 98%, respectively. Positive and negative predictive values for HercepTest and Oracle were 90% and 95% for HercepTest and 96% and 91% for Oracle, respectively. Fully-automated HER2 staining with the monoclonal antibody in the Oracle kit shows a high level of agreement with manual staining by the polyclonal antibody in the HercepTest. Although Oracle shows in general some more cytoplasmic staining and may be slightly less sensitive in picking up HER2 amplified cases, it shows a higher specificity and may be considered as an alternative method to evaluate the HER2 expression in breast cancer with potentially less analytical variability.

Seroprevalence of toxoplasmosis in Korean pregnant women.

PubMed

Song, Kyoung-Ju; Shin, Jong-Chul; Shin, Ho-Joon; Nam, Ho-Woo

2005-06-01

This study was performed in order to evaluate the sero-epidemiological status of toxoplasmosis in pregnant Korean women. Among 5,175 sera and 750 amniotic fluid samples obtained from pregnant women, 41 serum samples (0.79%) and 10 (1.33%) amniotic fluid samples tested positive for IgG antibodies by ELISA. Fifty one cases showing a score more than 0.25 on ELISA were tested for PCR reaction against the SAG1 gene. Only one case of the 51 ELISA positive cases exhibited a positive reaction on all tests. This case had a history of acute nephropyelitis during early pregnancy, but fortunately, had delivered a phenotypically healthy baby. In this study, the seroprevalence of toxoplasmosis in pregnant women was found to be comparatively low, consistent with previous reports from Korea. However our trials, performed with a variety of diagnostic tools, were considered to be useful for the precise diagnosis of congenital toxoplasmosis.

Impact Analyses and Tests of Metal Cask Considering Aircraft Engine Crash - 12308

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

Lee, Sanghoon; Choi, Woo-Seok; Kim, Ki-Young

2012-07-01

The structural integrity of a dual purpose metal cask currently under development by the Korea Radioactive Waste Management Cooperation (KRMC) is evaluated through analyses and tests under a high-speed missile impact considering the targeted aircraft crash conditions. The impact conditions were carefully chosen through a survey on accident cases and recommendations from the literature. The missile impact velocity was set at 150 m/s, and two impact orientations were considered. A simplified missile simulating a commercial aircraft engine is designed from an impact load history curve provided in the literature. In the analyses, the focus is on the evaluation of themore » containment boundary integrity of the metal cask. The analyses results are compared with the results of tests using a 1/3 scale model. The results show very good agreements, and the procedure and methodology adopted in the structural analyses are validated. While the integrity of the cask is maintained in one evaluation where the missile impacts the top side of the free standing cask, the containment boundary is breached in another case in which the missile impacts the center of the cask lid in a perpendicular orientation. A safety assessment using a numerical simulation of an aircraft engine crash into spent nuclear fuel storage systems is performed. A commercially available explicit finite element code is utilized for the dynamic simulation, and the strain rate effect is included in the modeling of the materials used in the target system and missile. The simulation results show very good agreement with the test results. It is noted that this is the first test considering an aircraft crash in Korea. (authors)« less

A comparison of fitness-case sampling methods for genetic programming

NASA Astrophysics Data System (ADS)

Martínez, Yuliana; Naredo, Enrique; Trujillo, Leonardo; Legrand, Pierrick; López, Uriel

2017-11-01

Genetic programming (GP) is an evolutionary computation paradigm for automatic program induction. GP has produced impressive results but it still needs to overcome some practical limitations, particularly its high computational cost, overfitting and excessive code growth. Recently, many researchers have proposed fitness-case sampling methods to overcome some of these problems, with mixed results in several limited tests. This paper presents an extensive comparative study of four fitness-case sampling methods, namely: Interleaved Sampling, Random Interleaved Sampling, Lexicase Selection and Keep-Worst Interleaved Sampling. The algorithms are compared on 11 symbolic regression problems and 11 supervised classification problems, using 10 synthetic benchmarks and 12 real-world data-sets. They are evaluated based on test performance, overfitting and average program size, comparing them with a standard GP search. Comparisons are carried out using non-parametric multigroup tests and post hoc pairwise statistical tests. The experimental results suggest that fitness-case sampling methods are particularly useful for difficult real-world symbolic regression problems, improving performance, reducing overfitting and limiting code growth. On the other hand, it seems that fitness-case sampling cannot improve upon GP performance when considering supervised binary classification.

Roles of airships in economic development

NASA Technical Reports Server (NTRS)

Beier, G. J.; Hidalgo, G. C.

1975-01-01

It is proposed that airships of known and tested technology could, in some cases, perform routine transport missions more economically than conventional transport modes. If infrastructure for direct surface transport is already in place or if such infrastructure can be justified by the size of the market and there are no unusual impediments to constructing it, then the airships of tested technology cannot normally compete. If, however, the surface routes would be unusually expensive or circuitous, or if they involve several transhipments, or if the market size is too small to spread infrastructure costs of conventional transport, the airships of tested technology present a workable alternative. A series of special cases are considered. The cases, though unusual, are not unique; there are several similar possible applications which, in total, would provide a reasonably large market for airships.

Unexpectedly high leprosy seroprevalence detected using a random surveillance strategy in midwestern Brazil: A comparison of ELISA and a rapid diagnostic test.

PubMed

Frade, Marco Andrey C; de Paula, Natália A; Gomes, Ciro M; Vernal, Sebastian; Bernardes Filho, Fred; Lugão, Helena B; de Abreu, Marilda M M; Botini, Patrícia; Duthie, Malcolm S; Spencer, John S; Soares, Rosa Castália F R; Foss, Norma T

2017-02-01

Leprosy diagnosis is mainly based on clinical evaluation, although this approach is difficult, especially for untrained physicians. We conducted a temporary campaign to detect previously unknown leprosy cases in midwestern Brazil and to compare the performance of different serological tests. A mobile clinic was stationed at the main bus terminal in Brasília, Brazil. Volunteers were quizzed and given a clinical exam to allow categorization as either patients, known contacts of patients or non-contacts, and blood was collected to determine anti-PGL-I and anti-LID-1 antibody titers by ELISA and by the NDO-LID rapid test. New cases of leprosy and the impact of performing this broad random surveillance strategy were evaluated. Accuracy values and concordance between the test results were evaluated among all groups. Four hundred thirty-four individuals were evaluated, and 44 (10.1%) were diagnosed with leprosy. Borderline forms were the most frequent presentation. Both tests presented higher positivity in those individuals with multibacillary disease. Serological tests demonstrated specificities arround 70% for anti-PGL-1 and anti-LID ELISA; and arround 40% for NDO-LID. Sensitivities ranged from 48 to 62%. A substantial agreement between NDO-LID and ELISA with concomitant positive results was found within leprosy patients (Kappa index = 0.79 CI95% 0.36-1.22). The unexpectedly high leprosy prevalence in this population indicates ongoing community-based exposure to Mycobacterium leprae antigens and high rates of subclinical infection. All tests showed low specificity and sensitivity values and therefore cannot be considered for use as stand-alone diagnostics. Rather, considering their positivity among MB patients and non-patients, these tests can be considered effective tools for screening and identifying individuals at high risk who might benefit from regular monitoring.

A comparison of theory and experiment for coupled rotor body stability of a bearingless rotor model in hover and forward flight

NASA Technical Reports Server (NTRS)

Mirick, Paul H.

1988-01-01

Seven cases were selected for correlation from a 1/5.86 Froude-scale experiment that examined several rotor designs which were being considered for full-scale flight testing as part of the Bearingless Main Rotor (BMR) program. The model rotor hub used in these tests consisted of back-to-back C-beams as flexbeam elements with a torque tube for pitch control. The first four cases selected from the experiment were hover tests which examined the effects on rotor stability of variations in hub-to-flexbeam coning, hub-to-flexbeam pitch, flexbeam-to-blade coning, and flexbeam-to-blade pitch. The final three cases were selected from the forward flight tests of optimum rotor configuration as defined during the hover test. The selected cases examined the effects of variations in forward speed, rotor speed, and shaft angle. Analytical results from Bell Helicopter Textron, Boeing Vertol, Sikorsky Aircraft, and the U.S. Army Aeromechanics Laboratory were compared with the data and the correlations ranged from poor-to-fair to fair-to-good.

Depression in nursing homes.

PubMed

Snowdon, John

2010-11-01

Although studies have shown the prevalence of depression in nursing homes to be high, under-recognition of depression in these facilities is widespread. Use of screening tests to enhance detection of depressive symptoms has been recommended. This paper aims to provoke discussion about optimal management of depression in nursing homes. The utility of the Cornell Scale for Depression in Dementia (CSDD) is considered. CSDD data relating to residents assessed in 2008-2009 were collected from three Sydney nursing homes. CSDD scores were available from 162 residents, though raters stated they were unable to score participants on at least one item in 47 cases. Scores of 13 or more were recorded for 23% of residents in these facilities, but in most of these cases little was documented in case files to show that the results had been discussed by staff, or that they led to interventions, or that follow-up testing was arranged. Results of CSDD testing should prompt care staff (including doctors) to consider causation of depression in cases where residents are identified as possibly depressed. In particular, there needs to be discussion of how to help residents to cope with disability, losses, and feelings of powerlessness. Research is needed, examining factors that might predict response to antidepressants, and what else helps. Accreditation of nursing homes could be made to depend partly on evidence that staff regularly search for, and (if found) ensure appropriate responses to, depression.

Sporotrichin Skin Test for the Diagnosis of Sporotrichosis.

PubMed

Bonifaz, Alexandro; Toriello, Conchita; Araiza, Javier; Ramírez-Soto, Max C; Tirado-Sánchez, Andrés

2018-05-09

Sporotrichosis is the most common implantation mycosis caused by several species of the Sporothrix schenckii complex. The gold standard for diagnosis is concerned with the isolation of the fungus; although, fresh examinations, staining, and biopsies are also helpful for this purpose. The sporotrichin is an antigenic complex comprised of a peptide-rhamnomannan, which is relevant with respect to pathogenic fungi; it is primarily used for serological and skin testing. We present a study regarding the use of sporotrichin as a diagnostic aid for cutaneous sporotrichosis. Furthermore, 138 cases with suspicion of sporotrichosis were included, 55 of which were proven through cultures. Moreover, out of these 55 cases, 52 (94.5%) tested positive for sporotrichin, while the negative cases corresponded to the disseminated cutaneous forms. We observed a sensitivity of 94.5% and a specificity of 95.2%. We consider that the use of sporotrichin as a skin test helps us as an auxiliary diagnosis before a positive sample culture.

Diagnostic Value of Leukocyte Esterase Test Strip Reagents for Rapid Clinical Diagnosis of Spontaneous Bacterial Peritonitis in Patients Admitted to Hospital Emergency Departments in Iran.

PubMed

Hashemian, Amir Masoud; Ahmadi, Koorosh; Zamani Moghaddam, Hamid; Zakeri, Hosein; Davoodi Navakh, Seyed Akbar; Sharifi, Mohammad Davood; Bahrami, Abdollah

2015-10-01

Spontaneous bacterial peritonitis (SBP) is a common and important clinical problem and is life-threatening in decompensated liver disease. Ascites fluid test by leukocyte esterase test strip has been recently proposed as an effective and rapid method to diagnose SBP in patients with cirrhosis. This study aimed to evaluate sensitivity and specificity of leukocyte esterase test strip in the diagnosis of SBP. The population of this research was all patients with cirrhosis and ascites admitted to the emergency room at Imam Reza (AS) hospital, Mashhad. A written consent was taken for inclusion in the study. 50 mL ascites sample was taken from all patients for use in a urine test strip (LER) (Urine Test Strips Convergys®Urine Matrix 11). The patient's ascites samples were evaluated for cell counting. Positive dipstick test for LER in this study considered as grade 3 +. The values of WBC > 500 cell/mm(3) or PMN > 250 cell/mm(3) considered as positive result of the gold standard method for the diagnosis of SBP. In this study, 100 patients with ascites due to cirrhosis, with an average age of 38.9 ± 6.54 years were evaluated. Twenty cases had positive results, of whom 17 cases were also detected based on the standard diagnostic criteria and other three cases were healthy individuals. Thus, sensitivity, specificity, positive and negative predictive values, and accuracy of the method were 95%, 96.3%, 85%, 97.5% and 95%, respectively. The use of leukocyte esterase urine dipstick test can be a quick and easy method in early diagnosis of SBP to start the treatment until preparation of SBP-cell count results.

The Role of Multiple-Group Measurement Invariance in Family Psychology Research

ERIC Educational Resources Information Center

Kern, Justin L.; McBride, Brent A.; Laxman, Daniel J.; Dyer, W. Justin; Santos, Rosa M.; Jeans, Laurie M.

2016-01-01

Measurement invariance (MI) is a property of measurement that is often implicitly assumed, but in many cases, not tested. When the assumption of MI is tested, it generally involves determining if the measurement holds longitudinally or cross-culturally. A growing literature shows that other groupings can, and should, be considered as well.…

Lorenzo P. v. Riles? Should the "Larry P." Prohibitions Be Extended to English Language Learners?: Considering Public Policy & IQ Testing in Schools

ERIC Educational Resources Information Center

Garcia, Ernest

2015-01-01

Other than being African American, little is known of Larry, the lead plaintiff in the legal case known as "Larry P. v. Riles" in 1971, which banned the use of standardized intelligence testing on African-American students in the State of California. As a result of such intelligence testing, Larry was diagnosed as being mildly mentally…

A Rare Case of Oestrogen Dermatitis.

PubMed

Bourgeault, Emilie; Bujold, Janie; Doucet, Marie-Eve

Oestrogen dermatitis is a rare disorder characterised by cyclical eruptions in association with a woman's menstrual cycle. A 43-year-old woman with an 8-year history of cyclical inguinal dermatitis, with a negative patch test, was tested with intradermal progesterone and oestrogen. Intradermal testing was positive for oestrogen only. In a female patient with cyclical dermatitis, it is important to consider oestrogen or progesterone dermatitis in the differential diagnosis.

Process Definition and Modeling Guidebook. Version 01.00.02

DTIC Science & Technology

1992-12-01

material (and throughout the guidebook)process defnition is considered to be the act of representing the important characteristics of a process in a...characterized by software standards and guidelines, software inspections and reviews, and more formalized testing (including test plans, test sup- port tools...paper-based approach works well for training, examples, and possibly even small pilot projects and case studies. However, large projects will benefit from

Statistical Inference for Quality-Adjusted Survival Time

DTIC Science & Technology

2003-08-01

survival functions of QAL. If an influence function for a test statistic exists for complete data case, denoted as ’i, then a test statistic for...the survival function for the censoring variable. Zhao and Tsiatis (2001) proposed a test statistic where O is the influence function of the general...to 1 everywhere until a subject’s death. We have considered other forms of test statistics. One option is to use an influence function 0i that is

Pseudohypoparathyroidism Type 1A-Subclinical Hypothyroidism and Rapid Weight Gain as Early Clinical Signs: A Clinical Review of 10 Cases

PubMed Central

Kayemba-Kay’s, Simon; Tripon, Cedric; Heron, Anne; Hindmarsh, Peter

2016-01-01

Objective: To evaluate the clinical signs and symptoms that would help clinicians to consider pseudohypoparathyroidism (PHP) type 1A as a diagnosis in a child. Methods: A retrospective review of the medical records of children diagnosed by erythrocyte Gsα activity and/or GNAS1 gene study and followed-up for PHP type 1A. Clinical and biochemical parameters along with epidemiological data were extracted and analyzed. Weight gain during infancy and early childhood was calculated as change in weight standard deviation score (SDS), using the French growth reference values. An upward gain in weight ≥0.67 SDS during these periods was considered indicative of overweight and/or obesity. Results: Ten cases of PHP type 1A were identified (mean age 41.1 months, range from 4 to 156 months). In children aged ≤2 years, the commonest clinical features were round lunar face, obesity (70%), and subcutaneous ossifications (60%). In older children, brachydactyly was present in 60% of cases. Seizures occurred in older children (3 cases). Short stature was common at all ages. Subclinical hypothyroidism was present in 70%, increased parathormone (PTH) in 83%, and hyperphosphatemia in 50%. Only one case presented with hypocalcemia. Erythrocyte Gsα activity tested in seven children was reduced; GNAS1 gene testing was performed in 9 children. Maternal transmission was the most common (six patients). In three other cases, the mutations were de novo, c.585delGACT in exon 8 (case 2) and c.344C>TP115L in exon 5 (cases 6&7). Conclusion: Based on our results, PHP type 1A should be considered in toddlers presenting with round face, rapid weight gain, subcutaneous ossifications, and subclinical hypothyroidism. In older children, moderate mental retardation, brachydactyly, afebrile seizures, short stature, and thyroid-stimulating hormone resistance are the most suggestive features. PMID:27467896

Multi-Objective Random Search Algorithm for Simultaneously Optimizing Wind Farm Layout and Number of Turbines

NASA Astrophysics Data System (ADS)

Feng, Ju; Shen, Wen Zhong; Xu, Chang

2016-09-01

A new algorithm for multi-objective wind farm layout optimization is presented. It formulates the wind turbine locations as continuous variables and is capable of optimizing the number of turbines and their locations in the wind farm simultaneously. Two objectives are considered. One is to maximize the total power production, which is calculated by considering the wake effects using the Jensen wake model combined with the local wind distribution. The other is to minimize the total electrical cable length. This length is assumed to be the total length of the minimal spanning tree that connects all turbines and is calculated by using Prim's algorithm. Constraints on wind farm boundary and wind turbine proximity are also considered. An ideal test case shows the proposed algorithm largely outperforms a famous multi-objective genetic algorithm (NSGA-II). In the real test case based on the Horn Rev 1 wind farm, the algorithm also obtains useful Pareto frontiers and provides a wide range of Pareto optimal layouts with different numbers of turbines for a real-life wind farm developer.

[Calcium supplementation uncovering lactose intolerance - a case report].

PubMed

Trifina, Eva; Geissler, Dietmar; Zwettler, Elisabeth; Klaushofer, Klaus; Mikosch, Peter

2012-03-01

A 44 yr-old female with osteoporosis had no relevant gastrointestinal symptoms and did not avoid any specific food. However, after prescription of a lactose-rich calcium supplementation, clinical symptoms suspicious for lactose intolerance occurred, which were thereafter confirmed by a lactose tolerance test. Lactose intolerance may present with only slight or subtle symptoms. Drugs containing lactose may induce or increase gastrointestinal symptoms in patients with lactose intolerance. In case of gastrointestinal symptoms occurring after the initiation of drugs containing lactose, the possibility of lactose intolerance should be considered and tested by lactose tolerance test or genetic testing for the LCT (-13910) polymorphism. Due to the prevalence of about 15-25% lactose intolerance in the Austrian population, lactose free drugs should be prescribed as widely as possible.

The strains recommended for use in the bacterial reverse mutation test (OECD guideline 471) can be certified as non-genetically modified organisms.

PubMed

Sugiyama, Kei-Ichi; Yamada, Masami; Awogi, Takumi; Hakura, Atsushi

2016-01-01

The bacterial reverse mutation test, commonly called Ames test, is used worldwide. In Japan, the genetically modified organisms (GMOs) are regulated under the Cartagena Domestic Law, and organisms obtained by self-cloning and/or natural occurrence would be exempted from the law case by case. The strains of Salmonella typhimurium and Escherichia coli recommended for use in the bacterial reverse mutation test (OECD guideline 471), have been considered as non-GMOs because they can be constructed by self-cloning or naturally occurring bacterial strains, or do not disturb the biological diversity. The present article explains the reasons why these tester strains should be classified as non-GMOs.

Clinical review of two fatal equine cases of infection with the insectivorous bat strain of Australian bat lyssavirus.

PubMed

Annand, E J; Reid, P A

2014-09-01

The first two confirmed cases of Australian bat lyssavirus (ABLV) infection in horses are presented. Both cases occurred in the same week in May 2013 in paddock mates in south-east Queensland. Australia has been one of only a few countries considered free from rabies-like viruses in domestic animal species. ABLV infection had previously only been confirmed in bats and humans. All three confirmed human cases were fatal, the latest in February 2013. An additional human case of possible abortive infection in 1996 has also been reported. Both equine cases reported here resulted in euthanasia. The risks of infection across other mammalian species are still to be determined. These two equine cases highlight that ABLV should be considered as a differential diagnosis in animals with similar clinical presentations in Australia. There is a need for greater awareness regarding the zoonotic risk, use of personal protective equipment, pre- and post-exposure prophylactic measures and laboratory diagnostic options. The authors recommend ABLV testing for all Australian cases of progressive equine neurological disease. © 2014 Australian Veterinary Association.

Backtracking Depth-Resolved Microstructures for Crystal Plasticity Identification—Part 1: Backtracking Microstructures

NASA Astrophysics Data System (ADS)

Shi, Qiwei; Latourte, Félix; Hild, François; Roux, Stéphane

2017-12-01

In situ mechanical tests performed on polycrystalline materials in a scanning electron microscope suffer from the lack of information on depth-resolved three-dimensional microstructures. The latter ones can be accessed with focused ion beam technology only postmortem, because it is destructive. The present study considers the challenge of backtracking this deformed microstructure to the reference state. This theoretical question is tackled on a numerical (synthetic) test case. A two-dimensional microstructure with one dimension along the depth is considered, and deformed using a crystal plasticity law. The proposed numerical strategy is shown to retrieve accurately the reference state.

Prenatal diagnosis of i(18q) and dup(18q) cases by quantitative fluorescent PCR

PubMed Central

Castro-Volio, Isabel; Ortíz-Morales, Fernando; Valle-Bourrouet, Luisa; Malespín-Bendaña, Wendy

2013-01-01

Particular sonographic fetal malformations are common in chromosome 18 aberrations, requiring invasive prenatal tests to confirm the diagnosis. Karyotyping is the gold standard assay in these cases, although it is a high complexity, expensive and approximately 2 weeks turnaround time test. On the contrary, quantitative fluorescent PCR is considered an accurate, simple, low cost and rapid assay, particularly useful for the diagnosis of aneuploidies of chromosomes 13, 18 and 21 and for the detection of maternal cell contamination of the sample. Clinical presentation of two cases of rare chromosome 18 defects, diagnosed using both techniques. One case was an isochromosome and the other was a partial duplication. Quantitative fluorescent PCR was an invaluable tool for the cytogenetics laboratory PMID:24045756

Testing for thrombophilia: an evidence‐based approach

PubMed Central

Merriman, L; Greaves, M

2006-01-01

Thrombophilia is a disorder of haemostasis in which there is a tendency for the occurrence of thrombosis. This tendency can be inherited or acquired. This review outlines common acquired and inherited thrombophilic conditions and discusses indications for testing. It is concluded that testing for acquired thrombophilic conditions should be considered in all cases of venous thrombosis, whereas testing for inherited thrombophilic conditions is unlikely to be helpful. If testing for inherited thrombophilia is to be carried out, the benefits, pitfalls and unwanted consequences of such testing should be taken into account. PMID:17099087

Prolonged disturbance of consciousness caused by severe hypophosphatemia: a report of two cases.

PubMed

Murakami, Takaaki; Yoshida, Masanori; Funazo, Tomoko; Matsuda, Yuki; Matsuo, Koji; Nambu, Takuo; Yonemitsu, Shin; Muro, Seiji; Oki, Shogo

2014-01-01

We herein describe two patients with a prolonged disturbance of consciousness due to severe hypophosphatemia. Case one presented with pneumococcal infection and acute exacerbation of chronic obstructive pulmonary disease and asthma. Case two presented with diabetic foot infections and diabetic ketoacidosis. Both patients responded to initial therapy for their primary diseases, but consciousness became worse in both cases. Their test results for impaired consciousness revealed severe hypophosphatemia; therefore, phosphate replacement therapy was administered, thus resulting in complete alertness. These cases demonstrate that we should consider the possibility of hypophosphatemia in critically ill patients with an altered consciousness.

‘Abnormal’ cervical imaging?: Cervical pneumatocysts – A case report of a cervical spine pneumatocyst

PubMed Central

Renshaw, Hanna; Patel, Amit; Boctor, Daniel Sherif Zakaria Matta; Hakmi, Mohamed Atef

2015-01-01

To our knowledge there are only 15 reported cases of pneumatocysts in the cervical spine, but awareness of their existence should help the clinician when diagnosing abnormalities in radiological images. When faced with intravertebral gas, in addition to considering more sinister causes, one should consider the differentials including pneumatocysts. Despite our relative lack of understanding of these benign lesions the knowledge that they can change over time should prevent unnecessary testing or treating. We present a patient who fell down stairs and was found to have cervical intravertebral gas, on computed tomography imaging, with the typical appearance of a pneumatocyst. PMID:26719615

'Abnormal' cervical imaging?: Cervical pneumatocysts - A case report of a cervical spine pneumatocyst.

PubMed

Renshaw, Hanna; Patel, Amit; Boctor, Daniel Sherif Zakaria Matta; Hakmi, Mohamed Atef

2015-10-01

To our knowledge there are only 15 reported cases of pneumatocysts in the cervical spine, but awareness of their existence should help the clinician when diagnosing abnormalities in radiological images. When faced with intravertebral gas, in addition to considering more sinister causes, one should consider the differentials including pneumatocysts. Despite our relative lack of understanding of these benign lesions the knowledge that they can change over time should prevent unnecessary testing or treating. We present a patient who fell down stairs and was found to have cervical intravertebral gas, on computed tomography imaging, with the typical appearance of a pneumatocyst.

Vaginal Enterobius vermicularis diagnosed on liquid-based cytology during Papanicolaou test cervical cancer screening: A report of two cases and a review of the literature.

PubMed

Tsai, Chun-Yi; Junod, Rachel; Jacot-Guillarmod, Martine; Beniere, Charles; Ziadi, Sonia; Bongiovanni, Massimo

2018-02-01

Enterobiasis is one of the most common human parasitic infections. It is considered an intestinal parasite, but cases of extra-intestinal affections exist, notably infections of the female genital tract. Enterobius vermicularis (EV) eggs (or ova) have been found in the cervical smears of two patients in our institute during the last 16 years. No gynaecological or gastrointestinal symptoms were reported, and there was no known intestinal infection in these two cases. A review of the available literature revealed rare cases of vaginal enterobiasis, with a wide range of clinical presentations, many patients being asymptomatic. The diagnosis may sometimes be difficult, mainly because of the lack of clinical suspicion. However, cytological identification of EV in cervico-vaginal smears is important, especially when considering the risk of ascending infections of the genital tract associated with severe complications. © 2017 Wiley Periodicals, Inc.

A Worst-Case Approach for On-Line Flutter Prediction

NASA Technical Reports Server (NTRS)

Lind, Rick C.; Brenner, Martin J.

1998-01-01

Worst-case flutter margins may be computed for a linear model with respect to a set of uncertainty operators using the structured singular value. This paper considers an on-line implementation to compute these robust margins in a flight test program. Uncertainty descriptions are updated at test points to account for unmodeled time-varying dynamics of the airplane by ensuring the robust model is not invalidated by measured flight data. Robust margins computed with respect to this uncertainty remain conservative to the changing dynamics throughout the flight. A simulation clearly demonstrates this method can improve the efficiency of flight testing by accurately predicting the flutter margin to improve safety while reducing the necessary flight time.

Comparison of shoulder internal rotation test with the elbow flexion test in the diagnosis of cubital tunnel syndrome.

PubMed

Ochi, Kensuke; Horiuchi, Yukio; Tanabe, Aya; Morita, Kozo; Takeda, Kentaro; Ninomiya, Ken

2011-05-01

To compare the shoulder internal rotation test-a new, provocative test-with the elbow flexion test in the diagnosis of cubital tunnel syndrome (CubTS). Twenty-five patients with CubTS were examined before and after surgery with 10 seconds each of the elbow flexion and shoulder internal rotation tests. Fifty-four asymptomatic individuals and 14 neuropathy patients with a diagnosis other than CubTS were also examined as control cases. For the shoulder internal rotation test, the patient's upper extremity was kept at 90° abduction, maximum internal rotation, and 10° flexion at the shoulder, with 90° elbow flexion and neutral position of the forearm and wrist, with finger extension. Test results were considered positive if any slight symptom attributable to CubTS occurred within 10 seconds. Extraneural pressure inside the cubital tunnel was intraoperatively measured with the positions of both the elbow flexion and shoulder internal rotation tests, in 15 of the CubTS cases. Statistical analyses were performed using Student's t-test with a confidence level of 95%. The preoperative sensitivity in CubTS cases was 80% in the 10-second shoulder internal rotation test and 36% in the 10-second elbow flexion test, and these differences were significant. None of the control cases had positive results in either test. All the CubTS cases improved with surgery; after surgery, neither test provoked symptoms in any surgical patient. The extraneural pressure increased in both provocative positions with no significant difference. Positive results for the 10-second shoulder internal rotation test were more sensitive than that for the elbow flexion test of the same duration and seemed specific to CubTS. Copyright © 2011 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.

The Method of Manufacturing Nonmetallic Test-Blocks on Different Sensitivity Classes

NASA Astrophysics Data System (ADS)

Kalinichenko, N. P.; Kalinichenko, A. N.; Lobanova, I. S.; Zaitseva, A. A.; Loboda, E. L.

2016-01-01

Nowadays in our modern world there is a vital question of quality control of details made from nonmetallic materials due to their wide spreading. Nondestructive penetrant testing is effective, and in some cases it is the only possible method of accidents prevention at high- risk sites. A brief review of check sample necessary for quality evaluation of penetrant materials is considered. There was offered a way of making agents for quality of penetrant materials testing according to different liquid penetrant testing sensibility classes.

Distributions of Characteristic Roots in Multivariate Analysis

DTIC Science & Technology

1976-07-01

stiidied by various authors, have been briefly discussed. Such distributional ies of four test criteria and a few less important ones which are...functions h. -nots have further been discussed in view of the power comparisons made in co. ion wich tests of three multivariate hypotheses. In addition...one- sample case has also been considered in terms of distributional aspects of the ch. roots and criteria for tests of two hypotheses on the

The Information a Test Provides on an Ability Parameter. Research Report. ETS RR-07-18

ERIC Educational Resources Information Center

Haberman, Shelby J.

2007-01-01

In item-response theory, if a latent-structure model has an ability variable, then elementary information theory may be employed to provide a criterion for evaluation of the information the test provides concerning ability. This criterion may be considered even in cases in which the latent-structure model is not valid, although interpretation of…

A case study of Membrane Testing, Integrity and Estimations of Log Removal Value per the Long Term 2 Enhanced Surface Water Treatment Rule.

EPA Science Inventory

The SWTR-LT2 Rule addresses the use of membranes that may be used to achieve credits for the reduction of Cryptosporidium. The LT2 Rule requires product-specific testing of membranes, considered an alternative filtration technology by the rule. LT2 Rule allows the product speci...

International STakeholder NETwork (ISTNET): Creating a ...

EPA Pesticide Factsheets

A major problem in developmental neurotoxicity (DNT) risk assessment is the lack of toxicological hazard information for most compounds. Therefore, new approaches are being considered to provide adequate experimental data that allow regulatory decisions. This process requires a matching of regulatory needs on the one hand and the opportunities provided by new test sys-tems and methods on the other hand. Alignment of academically and industrially-driven assay development with regulatory needs in the field of DNT is a core mission of the International STakeholder NETwork (ISNET) in DNT testing. The first meeting of ISTNET was held in Zur-ich on 23-24 January 2014 in order to explore the concept of adverse outcome pathway (AOP) to practical DNT testing. AOPs were considered promising tools to promote test systems develop-ment according to regulatory needs. Moreover, the AOP concept was identified as an important guiding principle to assemble predictive integrated testing strategies (ITSs) for DNT. The recommendations on a roadmap towards AOP-based DNT testing is considered a stepwise approach, operating initially with incomplete AOPs for compound grouping, and focussing on key events of neurodevelopment. Next steps to be considered in follow-up activities are the use of case studies to further apply the AOP concept in regulatory DNT testing, making use of AOP intersections (common key events) for economic development of screening assays, and address-ing the transit

Specifications for a coupled neutronics thermal-hydraulics SFR test case

NASA Astrophysics Data System (ADS)

Tassone, A.; Smirnov, A. D.; Tikhomirov, G. V.

2017-01-01

Coupling neutronics/thermal-hydraulics calculations for the design of nuclear reactors are a growing trend in the scientific community. This approach allows to properly represent the mutual feedbacks between the neutronic distribution and the thermal-hydraulics properties of the materials composing the reactor, details which are often lost when separate analysis are performed. In this work, a test case for a generation IV sodium-cooled fast reactor (SFR), based on the ASTRID concept developed by CEA, is proposed. Two sub-assemblies (SA) characterized by different fuel enrichment and layout are considered. Specifications for the test case are provided including geometrical data, material compositions, thermo-physical properties and coupling scheme details. Serpent and ANSYS-CFX are used as reference in the description of suitable inputs for the performing of the benchmark, but the use of other code combinations for the purpose of validation of the results is encouraged. The expected outcome of the test case are the axial distribution of volumetric power generation term (q‴), density and temperature for the fuel, the cladding and the coolant.

A Human Proximity Operations System test case validation approach

NASA Astrophysics Data System (ADS)

Huber, Justin; Straub, Jeremy

A Human Proximity Operations System (HPOS) poses numerous risks in a real world environment. These risks range from mundane tasks such as avoiding walls and fixed obstacles to the critical need to keep people and processes safe in the context of the HPOS's situation-specific decision making. Validating the performance of an HPOS, which must operate in a real-world environment, is an ill posed problem due to the complexity that is introduced by erratic (non-computer) actors. In order to prove the HPOS's usefulness, test cases must be generated to simulate possible actions of these actors, so the HPOS can be shown to be able perform safely in environments where it will be operated. The HPOS must demonstrate its ability to be as safe as a human, across a wide range of foreseeable circumstances. This paper evaluates the use of test cases to validate HPOS performance and utility. It considers an HPOS's safe performance in the context of a common human activity, moving through a crowded corridor, and extrapolates (based on this) to the suitability of using test cases for AI validation in other areas of prospective application.

Mutational analysis using Sanger and next generation sequencing in sporadic spindle cell hemangiomas: A study of 19 cases.

PubMed

Ten Broek, Roel W; Bekers, Elise M; de Leng, Wendy W J; Strengman, Eric; Tops, Bastiaan B J; Kutzner, Heinz; Leeuwis, Jan Willem; van Gorp, Joost M; Creytens, David H; Mentzel, Thomas; van Diest, Paul J; Eijkelenboom, Astrid; Flucke, Uta

2017-12-01

Spindle cell hemangioma (SCH) is a distinct vascular soft-tissue lesion characterized by cavernous blood vessels and a spindle cell component mainly occurring in the distal extremities of young adults. The majority of cases harbor heterozygous mutations in IDH1/2 sporadically or rarely in association with Maffucci syndrome. However, based on mosaicism and accordingly a low percentage of lesional cells harboring a mutant allele, detection can be challenging. We tested 19 sporadic SCHs by Sanger sequencing, multiplex ligation-dependent probe amplification (MLPA), conventional next generation sequencing (NGS), and NGS using a single molecule molecular inversion probes (smMIP)-based library preparation to compare their diagnostic value. Out of 10 cases tested by Sanger sequencing and 2 analyzed using MLPA, 4 and 1, respectively, revealed a mutation in IDH1 (p.R132C). The 7 remaining negative cases and additional 6 cases were investigated using smMIP/NGS, showing hot spot mutations in IDH1 (p.R132C) (8 cases) and IDH2 (3 cases; twice p.R172S and once p.R172G, respectively). One case was negative. Owing to insufficient DNA quality and insufficient coverage, 2 cases were excluded. In total, in 16 out of 17 cases successfully tested, an IDH1/2 mutation was found. Given that IDH1/2 mutations were absent in 161 other vascular lesions tested by smMIP/NGS, the mutation can be considered as highly specific for SCH. © 2017 Wiley Periodicals, Inc.

An analytical model for contaminant transport in landfill composite liners considering coupled effect of consolidation, diffusion, and degradation.

PubMed

Xie, Haijian; Yan, Huaxiang; Feng, Shijin; Wang, Qiao; Chen, Peixiong

2016-10-01

One-dimensional mathematical model is developed to investigate the behavior of contaminant transport in landfill composite liner system considering coupled effect of consolidation, diffusion, and degradation. The first- and second-type bottom boundary conditions are used to derive the steady-state and quasi-steady-state analytical solutions. The concentration profiles obtained by the proposed analytical solution are in good agreement with those obtained by the laboratory tests. The bottom concentration and flux of the soil liners can be greatly reduced when the degradation effect and porosity changing are considered. For the case under steady-state, the bottom flux and concentration for the case with t 1/2 =10 years can be 2.8 and 5.5 times lower than those of the case with t 1/2 =100 years, respectively. The bottom concentration and flux of the soil liners can be greatly reduced when the coefficient of volume compressibility decreases. For quasi-steady-state and with t 1/2 = 10 years, the bottom flux and concentration for the case with m v  = 0.02/MPa can be 17.4 and 21 times lower than the case with m v  = 0.5/MPa. This may be due to the fact that the true fluid velocity induced by consolidation is greater for the case with high coefficient of volume compressibility. The bottom flux for the case with single compacted clay liner (CCL) can be 1.5 times larger than that for the case with GMB/CCL considering diffusion and consolidation for DCM. The proposed analytical model can be used for verification of more complicated numerical models and assessment of the coupled effect of diffusion, consolidation, and degradation on contaminant transport in landfill liner systems.

Impact Testing of Composites for Aircraft Engine Fan Cases

NASA Technical Reports Server (NTRS)

Roberts, Gary D.; Revilock, Duane M.; Binienda, Wieslaw K.; Nie, Walter Z.; Mackenzie, S. Ben; Todd, Kevin B.

2001-01-01

Before composite materials can be considered for use in the fan case of a commercial jet engine, the performance of a composite structure under blade-out loads needs to be demonstrated. The objective of this program is to develop an efficient test and analysis method for evaluating potential composite case concepts. Ballistic impact tests were performed on laminated glass/epoxy composites in order to identify potential failure modes and to provide data for analysis. Flat 7x7 in. panels were impacted with cylindrical titanium projectiles, and 15 in. diameter half-rings were impacted with wedge-shaped titanium projectiles. Composite failure involved local fiber fracture as well as tearing and delamination on a larger scale. A 36 in. diameter full-ring subcomponent was proposed for larger scale testing. Explicit, transient, finite element analyses were used to evaluate impact dynamics and subsequent global deformation for the proposed full-ring subcomponent test. Analyses on half-ring and quarter ring configurations indicated that less expensive smaller scale tests could be used to screen potential composite concepts when evaluation of local impact damage is the primary concern.

The expert and the foreigner: Reflections of forensic transcultural psychopathology on a total of 86 reports by experts on criminal liability.

PubMed

Merzagora, Isabella; Amadasi, Alberto; Blandino, Alberto; Travaini, Guido

In recent times Italy has been experiencing massive migration flows, therefore the attention on the issue of crimes committed by foreigners is increasing. But within trials, in the evaluation of criminal liability of foreigners, how do experts deal with them? Do the performed evaluations take cultural diversity into account? The present study took origin from these questions and examined a total of 86 reports by experts on criminal liability of foreign persons (16 females and 70 males). Examinees have been declared indictable in 31 cases (36%), totally mentally ill in 40 cases (45%) and with diminished liability in 15 cases (17%); when liability was excluded, examinees were diagnosed in 11 cases with mood disorders, in 23 cases with personality disorders, in 4 cases with adaptation disorders and post-traumatic stress disorder and in 10 cases with different diagnoses (in some cases more than one diagnosis was present). None of the reports used the section of the DSM concerning "cultural framing". Tests were used in 48 surveys (56% of cases), with more tests for each examinee, for a total of 39 Rorschach, 14 Raven test, 8 Minnesota Multiphasic Personality Inventory - MMPI - 4 Wechsler Adult Intelligence Scale - WAIS - level test, 8 Thematic Apperception test. When subjects were diagnosed with mental disorder and with diminished liability, 42 (79%) were also socially dangerous. Results highlight the importance of the relationship between the expert and the foreigner. Many factors ought to be critically considered by experts dealing with foreigners, like cultural awareness, knowledge of verbal communication, critical consideration of meanings and diagnosis, knowledge of the foreigners' personal story, presence of tests with inexact information and cultural fallacy. Copyright © 2018 Elsevier Ltd. All rights reserved.

Assessment of Aerothermal Heating Augmentation Attributed to Surface Catalysis in High Enthalpy Shock Tunnel Flows

NASA Astrophysics Data System (ADS)

MacLean, M.; Holden, M.

2009-01-01

The effect of gas/surface interaction in making CFD predictions of convective heating has been considered with application to ground tests performed in high enthalpy shock tunnels where additional heating augmentation attributable to surface recombination has been observed for nitrogen, air and carbon dioxide flows. For test articles constructed of stainless steel and aluminum, measurements have been made with several types of heat transfer instrumentation including thin- film, calorimeter, and coaxial thermocouple sensors. These experiments have been modeled by computations made with the high quality, chemically reacting, Navier- Stokes solver, DPLR and the heating results compared. Some typical cases considered include results on an axisymmetric sphere-cone, axisymmetric spherical capsule, spherical capsule at angle of attack, and two- dimensional cylinder. In nitrogen flows, cases considered show a recombination probability on the order of 10-3, which agrees with published data. In many cases in air and CO2, measurements exceeding the predicted level of convective heating have been observed which are consistent with approximately complete recombination (to O2/N2 or CO2) on the surface of the model (sometimes called a super-catalytic wall). It has been recognized that the conclusion that this behavior is tied to an excessively high degree of catalytic efficiency is dependent on the current understanding of the freestream and shock-layer state of the gas.

Perilymphatic fistula in cabin attendants: an incapacitating consequence of flying with common cold.

PubMed

Klokker, Mads; Vesterhauge, Søren

2005-01-01

A perilymphatic fistula (PLF) is an abnormal communication between the inner ear and the middle ear that leaks perilymph. PLF is considered rare, but is known to occur during childbirth, straining, weightlifting, head trauma, and diving with middle ear equalizing problems. It has also, anecdotally, been described in connection with flying. The symptoms are uncharacteristic vertigo and, in some cases, hearing impairment and tinnitus. This study describes four cases of PLF during a period of 6 mo in a major Scandinavian airline company employing approximately 3000 cabin attendants (CAs). None of the cases were diagnosed at the primary health care level. All were referred to the Aviation Medical Center for investigation. The PLF diagnosis was based on the case history, Platform Pressure Test (a fistula test), and other vestibular tests. Only one CA has been able to return to flying duties. The article emphasizes the risk of flying with poor middle ear equalization and the necessity of reminding crews and airline companies to "never fly with a common cold".

Stratified Mucin-Producing Intraepithelial Lesion of the Cervix: Subtle Features Not to Be Missed.

PubMed

Schwock, Joerg; Ko, Hyang Mi; Dubé, Valérie; Rouzbahman, Marjan; Cesari, Matthew; Ghorab, Zeina; Geddie, William R

2016-01-01

Stratified mucin-producing intraepithelial lesion (SMILE) is an uncommon premalignant lesion of the uterine cervix. A detailed examination of preinvasive SMILE cases including a comparison of the cytologic features with usual-type adenocarcinoma in situ (AIS) and human papillomavirus (HPV) genotyping was performed. Excisions and preceding Papanicolaou (Pap) tests were retrieved from the files of 2 tertiary care centers. Histologic review estimated the lesional SMILE proportion. Pap tests were reviewed and assessed for architectural, cellular and background features. Cobas® HPV test was performed. 13 cases were identified. Mean/median patient age was 35/33 years (range 23-51 years). Concurrent high-grade squamous intraepithelial lesion was found in 10/13 (77%) and AIS in 8/13 (62%) cases. In 6 cases, SMILE was dominant (≥50%) and represented in 5/6 corresponding Pap tests. Cytology interpretations differed more often in the SMILE-dominant group (p < 0.05). SMILE and AIS had overlapping features. Feathering and prominent nucleoli were absent in SMILE. HPV DNA was detected in all 12 cases tested. HPV 18 was most common (7/12). Excisions with positive/suspicious margins were reported in 5/6 SMILE-dominant versus 3/7 nondominant cases. SMILE is best considered as an AIS variant for cytologic, etiologic and management purposes. Cytologic features overlap with AIS, but are more subtle and easily missed. HPV testing may play a role in facilitating SMILE detection. © 2016 S. Karger AG, Basel.

Simulation of fluid-structure interaction in micropumps by coupling of two commercial finite element programs

NASA Astrophysics Data System (ADS)

Klein, Andreas; Gerlach, Gerald

1998-09-01

This paper deals with the simulation of the fluid-structure interaction phenomena in micropumps. The proposed solution approach is based on external coupling of two different solvers, which are considered here as `black boxes'. Therefore, no specific intervention is necessary into the program code, and solvers can be exchanged arbitrarily. For the realization of the external iteration loop, two algorithms are considered: the relaxation-based Gauss-Seidel method and the computationally more extensive Newton method. It is demonstrated in terms of a simplified test case, that for rather weak coupling, the Gauss-Seidel method is sufficient. However, by simply changing the considered fluid from air to water, the two physical domains become strongly coupled, and the Gauss-Seidel method fails to converge in this case. The Newton iteration scheme must be used instead.

Economic evaluation of laboratory testing strategies for hospital-associated Clostridium difficile infection.

PubMed

Schroeder, Lee F; Robilotti, Elizabeth; Peterson, Lance R; Banaei, Niaz; Dowdy, David W

2014-02-01

Clostridium difficile infection (CDI) is the most common cause of infectious diarrhea in health care settings, and for patients presumed to have CDI, their isolation while awaiting laboratory results is costly. Newer rapid tests for CDI may reduce this burden, but the economic consequences of different testing algorithms remain unexplored. We used decision analysis from the hospital perspective to compare multiple CDI testing algorithms for adult inpatients with suspected CDI, assuming patient management according to laboratory results. CDI testing strategies included combinations of on-demand PCR (odPCR), batch PCR, lateral-flow diagnostics, plate-reader enzyme immunoassay, and direct tissue culture cytotoxicity. In the reference scenario, algorithms incorporating rapid testing were cost-effective relative to nonrapid algorithms. For every 10,000 symptomatic adults, relative to a strategy of treating nobody, lateral-flow glutamate dehydrogenase (GDH)/odPCR generated 831 true-positive results and cost $1,600 per additional true-positive case treated. Stand-alone odPCR was more effective and more expensive, identifying 174 additional true-positive cases at $6,900 per additional case treated. All other testing strategies were dominated by (i.e., more costly and less effective than) stand-alone odPCR or odPCR preceded by lateral-flow screening. A cost-benefit analysis (including estimated costs of missed cases) favored stand-alone odPCR in most settings but favored odPCR preceded by lateral-flow testing if a missed CDI case resulted in less than $5,000 of extended hospital stay costs and <2 transmissions, if lateral-flow GDH diagnostic sensitivity was >93%, or if the symptomatic carrier proportion among the toxigenic culture-positive cases was >80%. These results can aid guideline developers and laboratory directors who are considering rapid testing algorithms for diagnosing CDI.

Economic Evaluation of Laboratory Testing Strategies for Hospital-Associated Clostridium difficile Infection

PubMed Central

Robilotti, Elizabeth; Peterson, Lance R.; Banaei, Niaz; Dowdy, David W.

2014-01-01

Clostridium difficile infection (CDI) is the most common cause of infectious diarrhea in health care settings, and for patients presumed to have CDI, their isolation while awaiting laboratory results is costly. Newer rapid tests for CDI may reduce this burden, but the economic consequences of different testing algorithms remain unexplored. We used decision analysis from the hospital perspective to compare multiple CDI testing algorithms for adult inpatients with suspected CDI, assuming patient management according to laboratory results. CDI testing strategies included combinations of on-demand PCR (odPCR), batch PCR, lateral-flow diagnostics, plate-reader enzyme immunoassay, and direct tissue culture cytotoxicity. In the reference scenario, algorithms incorporating rapid testing were cost-effective relative to nonrapid algorithms. For every 10,000 symptomatic adults, relative to a strategy of treating nobody, lateral-flow glutamate dehydrogenase (GDH)/odPCR generated 831 true-positive results and cost $1,600 per additional true-positive case treated. Stand-alone odPCR was more effective and more expensive, identifying 174 additional true-positive cases at $6,900 per additional case treated. All other testing strategies were dominated by (i.e., more costly and less effective than) stand-alone odPCR or odPCR preceded by lateral-flow screening. A cost-benefit analysis (including estimated costs of missed cases) favored stand-alone odPCR in most settings but favored odPCR preceded by lateral-flow testing if a missed CDI case resulted in less than $5,000 of extended hospital stay costs and <2 transmissions, if lateral-flow GDH diagnostic sensitivity was >93%, or if the symptomatic carrier proportion among the toxigenic culture-positive cases was >80%. These results can aid guideline developers and laboratory directors who are considering rapid testing algorithms for diagnosing CDI. PMID:24478478

International STakeholder NETwork (ISTNET): creating a developmental neurotoxicity (DNT) testing road map for regulatory purposes.

PubMed

Bal-Price, Anna; Crofton, Kevin M; Leist, Marcel; Allen, Sandra; Arand, Michael; Buetler, Timo; Delrue, Nathalie; FitzGerald, Rex E; Hartung, Thomas; Heinonen, Tuula; Hogberg, Helena; Bennekou, Susanne Hougaard; Lichtensteiger, Walter; Oggier, Daniela; Paparella, Martin; Axelstad, Marta; Piersma, Aldert; Rached, Eva; Schilter, Benoît; Schmuck, Gabriele; Stoppini, Luc; Tongiorgi, Enrico; Tiramani, Manuela; Monnet-Tschudi, Florianne; Wilks, Martin F; Ylikomi, Timo; Fritsche, Ellen

2015-02-01

A major problem in developmental neurotoxicity (DNT) risk assessment is the lack of toxicological hazard information for most compounds. Therefore, new approaches are being considered to provide adequate experimental data that allow regulatory decisions. This process requires a matching of regulatory needs on the one hand and the opportunities provided by new test systems and methods on the other hand. Alignment of academically and industrially driven assay development with regulatory needs in the field of DNT is a core mission of the International STakeholder NETwork (ISTNET) in DNT testing. The first meeting of ISTNET was held in Zurich on 23-24 January 2014 in order to explore the concept of adverse outcome pathway (AOP) to practical DNT testing. AOPs were considered promising tools to promote test systems development according to regulatory needs. Moreover, the AOP concept was identified as an important guiding principle to assemble predictive integrated testing strategies (ITSs) for DNT. The recommendations on a road map towards AOP-based DNT testing is considered a stepwise approach, operating initially with incomplete AOPs for compound grouping, and focussing on key events of neurodevelopment. Next steps to be considered in follow-up activities are the use of case studies to further apply the AOP concept in regulatory DNT testing, making use of AOP intersections (common key events) for economic development of screening assays, and addressing the transition from qualitative descriptions to quantitative network modelling.

Evaluating Malaria Prevalence Using Clinical Diagnosis Compared with Microscopy and Rapid Diagnostic Tests in a Tertiary Healthcare Facility in Rivers State, Nigeria.

PubMed

Wogu, M N; Nduka, F O

2018-01-01

The World Health Organization's policy on laboratory test of all suspected malaria cases before treatment has not yielded significant effects in several rural areas of Sub-Saharan Africa due to inadequate diagnostic infrastructure, leading to high morbidity and mortality rates. A cross-sectional randomized study was conducted to evaluate the validity of clinical malaria diagnosis through comparison with microscopy and rapid diagnostic test kits (RDTs) using 1000 consenting outpatients of a tertiary hospital in Nigeria. Physicians conducted clinical diagnosis, and blood samples were collected through venous procedure and analyzed for malaria parasites using Giemsa microscopy and RDT kits. Microscopy was considered the diagnostic "gold standard" and all data obtained were statistically analyzed using Chi-square test with a P value <0.05 considered significant. Malaria prevalence values of 20.1%, 43.1%, and 29.7% were obtained for clinical diagnosis, microscopy, and RDTs, respectively ( P < 0.05). Values of 47.2%, 95.9%, and 77.8% were obtained for sensitivity, specificity, and diagnostic accuracy, respectively, in clinical diagnosis, while RDTs had sensitivity, specificity, and diagnostic accuracy values of 73.7%, 97.3%, and 88.3%, respectively, when compared to microscopy ( P < 0.05). Clinical diagnosed malaria cases should be confirmed with a parasite-based laboratory diagnosis and more qualitative research is needed to explore why clinicians still use clinical diagnosis despite reported cases of its ineffectiveness.

Pregnancy related listeriosis: treatment and control.

PubMed

Allerberger, Franz; Huhulescu, Steliana

2015-03-01

Listeriosis during pregnancy usually presents as an unremarkable febrile illness in the mother but can be fatal for the fetus and newborn. Reliable laboratory testing for early diagnosis is lacking. Serological antibody tests and bacteriological stool tests are not helpful since Listeria-specific antibodies and stool cultures yielding the organism can be found in healthy pregnant women. Because early diagnosis is difficult, diagnosis is usually made by culturing the pathogen from blood, cerebrospinal fluid, placenta or meconium. The mortality rate for fetal and newborn listeriosis remains approximately 20%. Two to three cases of pregnancy-associated listeriosis are reported annually in Austria among approximately 79,000 births, 20-30 cases are reported annually in Germany among approximately 680,000 births and 50-100 cases are reported annually in the USA among approximately 4 million births. Although Listeria infections in pregnancy are rare, they should be considered as a cause of fever of unknown origin during pregnancy.

Resolution of fish allergy: a case report.

PubMed

Solensky, Roland

2003-10-01

Fish allergy is one of the most common food allergies, and it is believed to be lifelong. There are no published reports, to my knowledge, of resolution of fish allergy. To report a case of resolution of IgE-mediated fish allergy. The patient was a 68-year-old man with a history of fish-induced anaphylaxis who had previously undergone prick-puncture skin testing to several fish species. Additional skin testing was performed in October 2002. Subsequently, he underwent an open challenge with halibut. The patient's previous skin tests showed him to have strongly positive reactions to several fish species. However, testing performed in October 2002 produced negative results to a number of fish species. In addition, he tolerated an open challenge with halibut. In the ensuing 8 months, he has regularly ingested salmon, cod, and halibut without experiencing any allergic reactions. This case illustrates that fish allergy is not invariably lifelong. Hence, allergists should consider reevaluating the allergy status of adults with a history of fish hypersensitivity.

Distinguishing between forensic science and forensic pseudoscience: testing of validity and reliability, and approaches to forensic voice comparison.

PubMed

Morrison, Geoffrey Stewart

2014-05-01

In this paper it is argued that one should not attempt to directly assess whether a forensic analysis technique is scientifically acceptable. Rather one should first specify what one considers to be appropriate principles governing acceptable practice, then consider any particular approach in light of those principles. This paper focuses on one principle: the validity and reliability of an approach should be empirically tested under conditions reflecting those of the case under investigation using test data drawn from the relevant population. Versions of this principle have been key elements in several reports on forensic science, including forensic voice comparison, published over the last four-and-a-half decades. The aural-spectrographic approach to forensic voice comparison (also known as "voiceprint" or "voicegram" examination) and the currently widely practiced auditory-acoustic-phonetic approach are considered in light of this principle (these two approaches do not appear to be mutually exclusive). Approaches based on data, quantitative measurements, and statistical models are also considered in light of this principle. © 2013.

Unidimensional Vertical Scaling in Multidimensional Space. Research Report. ETS RR-17-29

ERIC Educational Resources Information Center

Carlson, James E.

2017-01-01

In this paper, I consider a set of test items that are located in a multidimensional space, S[subscript M], but are located along a curved line in S[subscript M] and can be scaled unidimensionally. Furthermore, I am demonstrating a case in which the test items are administered across 6 levels, such as occurs in K-12 assessment across 6 grade…

Cushing's syndrome: Stepwise approach to diagnosis

PubMed Central

Lila, Anurag R.; Sarathi, Vijaya; Jagtap, Varsha S.; Bandgar, Tushar; Menon, Padmavathy; Shah, Nalini S.

2011-01-01

The projected prevalence of Cushing's syndrome (CS) inclusive of subclinical cases in the adult population ranges from 0.2–2% and it may no longer be considered as an orphan disease (2–3 cases/million/year). The recognition of CS by physicians is important for early diagnosis and treatment. Late-night salivary cortisol, dexamethasone suppressiontesti, or 24-h urine free cortisol are good screening tests. Positively screened cases need stepwise evaluation by an endocrinologist. This paper discusses the importance of screening for CS and suggests a stepwise diagnostic approach to a case of suspected hypercortisolism. PMID:22145134

Comprehensive Genomic Profiling Identifies Frequent Drug-Sensitive EGFR Exon 19 Deletions in NSCLC not Identified by Prior Molecular Testing.

PubMed

Schrock, Alexa B; Frampton, Garrett M; Herndon, Dana; Greenbowe, Joel R; Wang, Kai; Lipson, Doron; Yelensky, Roman; Chalmers, Zachary R; Chmielecki, Juliann; Elvin, Julia A; Wollner, Mira; Dvir, Addie; -Gutman, Lior Soussan; Bordoni, Rodolfo; Peled, Nir; Braiteh, Fadi; Raez, Luis; Erlich, Rachel; Ou, Sai-Hong Ignatius; Mohamed, Mohamed; Ross, Jeffrey S; Stephens, Philip J; Ali, Siraj M; Miller, Vincent A

2016-07-01

Reliable detection of drug-sensitive activating EGFR mutations is critical in the care of advanced non-small cell lung cancer (NSCLC), but such testing is commonly performed using a wide variety of platforms, many of which lack rigorous analytic validation. A large pool of NSCLC cases was assayed with well-validated, hybrid capture-based comprehensive genomic profiling (CGP) at the request of the individual treating physicians in the course of clinical care for the purpose of making therapy decisions. From these, 400 cases harboring EGFR exon 19 deletions (Δex19) were identified, and available clinical history was reviewed. Pathology reports were available for 250 consecutive cases with classical EGFR Δex19 (amino acids 743-754) and were reviewed to assess previous non-hybrid capture-based EGFR testing. Twelve of 71 (17%) cases with EGFR testing results available were negative by previous testing, including 8 of 46 (17%) cases for which the same biopsy was analyzed. Independently, five of six (83%) cases harboring C-helical EGFR Δex19 were previously negative. In a subset of these patients with available clinical outcome information, robust benefit from treatment with EGFR inhibitors was observed. CGP identifies drug-sensitive EGFR Δex19 in NSCLC cases that have undergone prior EGFR testing and returned negative results. Given the proven benefit in progression-free survival conferred by EGFR tyrosine kinase inhibitors in patients with these alterations, CGP should be considered in the initial presentation of advanced NSCLC and when previous testing for EGFR mutations or other driver alterations is negative. Clin Cancer Res; 22(13); 3281-5. ©2016 AACR. ©2016 American Association for Cancer Research.

Thermal analysis of insulated north-wall greenhouse with solar collector under passive mode

NASA Astrophysics Data System (ADS)

Chauhan, Prashant Singh; Kumar, Anil

2018-04-01

An insulated north wall greenhouse dryer has been fabricated and tested for no-load condition under passive mode. Testing has been conducted in two different cases. Case-I is considered for solar collector kept inside the dryer and Case-II is dryer without solar collector. Convective heat transfer coefficient and various heat transfer dimensionless numbers with have been calculated for thermal analysis. The maximum convective heat transfer coefficient is found 52.18 W/m2°C at 14 h during the first day for Case-I. The difference of the highest convective heat transfer coefficient of both cases was 8.34 W/m2°C. Net heat gain inside room curves are uniform and smooth for Case-I, which shows the steady heat generation process due to presence of solar collector inside the dryer. Above results depicts the effectiveness of solar collector and insulated north wall. The selection of suitable crop for drying can be done by analysing article's result.

Revisiting the Rossby Haurwitz wave test case with contour advection

NASA Astrophysics Data System (ADS)

Smith, Robert K.; Dritschel, David G.

2006-09-01

This paper re-examines a basic test case used for spherical shallow-water numerical models, and underscores the need for accurate, high resolution models of atmospheric and ocean dynamics. The Rossby-Haurwitz test case, first proposed by Williamson et al. [D.L. Williamson, J.B. Drake, J.J. Hack, R. Jakob, P.N. Swarztrauber, A standard test set for numerical approximations to the shallow-water equations on the sphere, J. Comput. Phys. (1992) 221-224], has been examined using a wide variety of shallow-water models in previous papers. Here, two contour-advective semi-Lagrangian (CASL) models are considered, and results are compared with previous test results. We go further by modifying this test case in a simple way to initiate a rapid breakdown of the basic wave state. This breakdown is accompanied by the formation of sharp potential vorticity gradients (fronts), placing far greater demands on the numerics than the original test case does. We also go further by examining other dynamical fields besides the height and potential vorticity, to assess how well the models deal with gravity waves. Such waves are sensitive to the presence or not of sharp potential vorticity gradients, as well as to numerical parameter settings. In particular, large time steps (convenient for semi-Lagrangian schemes) can seriously affect gravity waves but can also have an adverse impact on the primary fields of height and velocity. These problems are exacerbated by a poor resolution of potential vorticity gradients.

[Anaphylactic reaction to latex during spinal anesthesia: a case report].

PubMed

Ueda, Narumi; Kitamura, Rie; Wakamori, Takeshi; Nakamura, Kumi; Konishi, Keisuke

2008-05-01

A 46-year-old man, with a history of atopic dermatitis and bronchial asthma, underwent surgery for an inguinal hernia. Forty-three minutes subsequent to spinal anesthesia, the patient complained suddenly of dyspnea with wheezing. Blood pressure decreased and skin eruption was observed on his chest. Postoperative laboratory tests revealed high IgE concentration, and a skin test confirmed an allergy to latex. The patient's allergic reaction was easily overlooked because of his history of bronchial asthma and the possibility that the hypotension was caused by the high spinal anesthesia. Latex allergy should be considered in any suspicious case presenting with these symptoms during surgery. After recovery, a skin test should be used to confirm the allergy to avoid repeated allergic episodes.

Estimation of tunnel blockage from wall pressure signatures: A review and data correlation

NASA Technical Reports Server (NTRS)

Hackett, J. E.; Wilsden, D. J.; Lilley, D. E.

1979-01-01

A method is described for estimating low speed wind tunnel blockage, including model volume, bubble separation and viscous wake effects. A tunnel-centerline, source/sink distribution is derived from measured wall pressure signatures using fast algorithms to solve the inverse problem in three dimensions. Blockage may then be computed throughout the test volume. Correlations using scaled models or tests in two tunnels were made in all cases. In many cases model reference area exceeded 10% of the tunnel cross-sectional area. Good correlations were obtained regarding model surface pressures, lift drag and pitching moment. It is shown that blockage-induced velocity variations across the test section are relatively unimportant but axial gradients should be considered when model size is determined.

Mortality among PCR negative admitted Ebola suspects during the 2014/15 outbreak in Conakry, Guinea: A retrospective cohort study.

PubMed

Ingelbeen, Brecht; Bah, Elhadj Ibrahima; Decroo, Tom; Balde, Idrissa; Nordenstedt, Helena; van Griensven, Johan; De Weggheleire, Anja

2017-01-01

Non-cases are suspect Ebola Virus Disease (EVD) cases testing negative by EVD RT-PCR after admission to an Ebola Treatment Centre (ETC). Admitting non-cases to an ETC prompts concerns on case- and workload in the ETC, risk for nosocomial EVD infection, and delays in diagnosis and disease-specific treatment. We retrospectively analysed characteristics, outcomes and determinants of death of EVD cases and non-cases admitted to the Conakry ETC in Guinea between 03/2014 and 09/2015. Of the 2362 admitted suspects who underwent full confirmatory PCR testing, 1540 (65.2%) were non-cases; among them 727 needed repeated confirmatory PCR testing resulting in 2.5 days (average) in the ETC isolation ward. Twenty-one patients tested positive on the repeat test, most in a period of flawed sampling for the initial test and none after introduction of PCR confirmation with geneXpert. No readmissions following nosocomial EVD infection were recorded. No combination of symptoms yielded acceptable sensitivity and specificity to allow differentiating confirmed from non-cases. Symptoms as ocular bleeding/redness have high specificity, but limited usefulness as not common. Admission delay and age distribution were not different for both groups. In total, 98 (20.6%) of 475 deaths in the ETC were non-cases. Most died within 24 hours after admission. Living in Conakry (aOR 1.78 (1.08-2.96)) was the strongest risk factor for death. Weeks with higher admission load had lower case fatality among non-cases, probably because more acute (and treatable) illnesses of contacts of known cases were admitted. These findings show high numbers of potentially critically ill non-cases need to be considered when setting up triage and referral of EVD suspect cases. Symptoms and risk factors alone do not allow differentiating the non-cases. Integration of highly-sensitive EVD diagnostic methods with short turnaround time in the triage of peripheral hospitals and dropping the systematic 2nd PCR for symptomatic early presenters could limit delays in access to adapted care of cases and seriously ill non-cases. Whether feasible without compromising outbreak control, and under which conditions, should be further assessed.

Mortality among PCR negative admitted Ebola suspects during the 2014/15 outbreak in Conakry, Guinea: A retrospective cohort study

PubMed Central

Bah, Elhadj Ibrahima; Decroo, Tom; Balde, Idrissa; Nordenstedt, Helena; van Griensven, Johan; De Weggheleire, Anja

2017-01-01

Non-cases are suspect Ebola Virus Disease (EVD) cases testing negative by EVD RT-PCR after admission to an Ebola Treatment Centre (ETC). Admitting non-cases to an ETC prompts concerns on case- and workload in the ETC, risk for nosocomial EVD infection, and delays in diagnosis and disease-specific treatment. We retrospectively analysed characteristics, outcomes and determinants of death of EVD cases and non-cases admitted to the Conakry ETC in Guinea between 03/2014 and 09/2015. Of the 2362 admitted suspects who underwent full confirmatory PCR testing, 1540 (65.2%) were non-cases; among them 727 needed repeated confirmatory PCR testing resulting in 2.5 days (average) in the ETC isolation ward. Twenty-one patients tested positive on the repeat test, most in a period of flawed sampling for the initial test and none after introduction of PCR confirmation with geneXpert. No readmissions following nosocomial EVD infection were recorded. No combination of symptoms yielded acceptable sensitivity and specificity to allow differentiating confirmed from non-cases. Symptoms as ocular bleeding/redness have high specificity, but limited usefulness as not common. Admission delay and age distribution were not different for both groups. In total, 98 (20.6%) of 475 deaths in the ETC were non-cases. Most died within 24 hours after admission. Living in Conakry (aOR 1.78 (1.08–2.96)) was the strongest risk factor for death. Weeks with higher admission load had lower case fatality among non-cases, probably because more acute (and treatable) illnesses of contacts of known cases were admitted. These findings show high numbers of potentially critically ill non-cases need to be considered when setting up triage and referral of EVD suspect cases. Symptoms and risk factors alone do not allow differentiating the non-cases. Integration of highly-sensitive EVD diagnostic methods with short turnaround time in the triage of peripheral hospitals and dropping the systematic 2nd PCR for symptomatic early presenters could limit delays in access to adapted care of cases and seriously ill non-cases. Whether feasible without compromising outbreak control, and under which conditions, should be further assessed. PMID:28665950

Unexpectedly high leprosy seroprevalence detected using a random surveillance strategy in midwestern Brazil: A comparison of ELISA and a rapid diagnostic test

PubMed Central

Bernardes Filho, Fred; de Abreu, Marilda M. M.; Botini, Patrícia; Duthie, Malcolm S.; Spencer, John S.; Soares, Rosa Castália F. R.

2017-01-01

Background Leprosy diagnosis is mainly based on clinical evaluation, although this approach is difficult, especially for untrained physicians. We conducted a temporary campaign to detect previously unknown leprosy cases in midwestern Brazil and to compare the performance of different serological tests. Methods A mobile clinic was stationed at the main bus terminal in Brasília, Brazil. Volunteers were quizzed and given a clinical exam to allow categorization as either patients, known contacts of patients or non-contacts, and blood was collected to determine anti-PGL-I and anti-LID-1 antibody titers by ELISA and by the NDO-LID rapid test. New cases of leprosy and the impact of performing this broad random surveillance strategy were evaluated. Accuracy values and concordance between the test results were evaluated among all groups. Results Four hundred thirty-four individuals were evaluated, and 44 (10.1%) were diagnosed with leprosy. Borderline forms were the most frequent presentation. Both tests presented higher positivity in those individuals with multibacillary disease. Serological tests demonstrated specificities arround 70% for anti-PGL-1 and anti-LID ELISA; and arround 40% for NDO-LID. Sensitivities ranged from 48 to 62%. A substantial agreement between NDO-LID and ELISA with concomitant positive results was found within leprosy patients (Kappa index = 0.79 CI95% 0.36–1.22). Conclusions The unexpectedly high leprosy prevalence in this population indicates ongoing community-based exposure to Mycobacterium leprae antigens and high rates of subclinical infection. All tests showed low specificity and sensitivity values and therefore cannot be considered for use as stand-alone diagnostics. Rather, considering their positivity among MB patients and non-patients, these tests can be considered effective tools for screening and identifying individuals at high risk who might benefit from regular monitoring. PMID:28231244

Bacteriology testing of cardiovascular tissues: comparison of transport solution versus tissue testing.

PubMed

Díaz Rodríguez, R; Van Hoeck, B; Mujaj, B; Ngakam, R; Fan, Y; Bogaerts, K; Jashari, R

2016-06-01

Bacteriology testing is mandatory for quality control of recovered cardiovascular allografts (CVA). In this paper, two different bacteriology examinations (A tests) performed before tissue antibiotic decontamination were compared: transport solution filtration analysis (A1) and tissue fragment direct incubation (A2). For this purpose, 521 CVA (326 heart and 195 artery tissues) from 280 donors were collected and analyzed by the European Homograft Bank (EHB). Transport solution (A1) tested positive in 43.25 % of hearts and in 48.21 % of arteries, whereas the tissue samples (A2) tested positive in 38.34 % of hearts and 33.85 % of arteries. The main species identified in both A1 and A2 were Staphylococcus spp. in 55 and 26 % of cases, and Propionibacterium spp. in 8 and 19 %, respectively. Mismatches in bacteriology results between both initial tests A1 and A2 were found. 18.40 % of the heart valves were identified as positive by A1 whilst 13.50 % were considered positive by A2. For arteries, 20.51 % of cases were positive in A1 and negative in A2, and just 6.15 % of artery allografts presented contamination in the A2 test but were considered negative for the A1 test. Comparison between each A test with the B and C tests after antibiotic treatment of the allograft was also performed. A total decontamination rate of 70.8 % of initial positive A tests was obtained. Due to the described mismatches and different bacteria identification percentage, utilization of both A tests should be implemented in tissue banks in order to avoid false negatives.

Current strategies to avoid misdiagnosis of malaria.

PubMed

Hänscheid, T

2003-06-01

Malaria remains the most important parasitic disease, and tens of thousands of cases are imported into non-endemic countries annually. However, any single institution may see only a very few cases-this is probably the reason why laboratory and clinical misdiagnosis may not be uncommon. In the laboratory, unfamiliarity with microscopic diagnosis may be the main reason, considering the large number of laboratory staff who provide on-call services, often without expert help at hand, as well as the difficulty in detecting cases with low-level parasitemia. Staff should therefore be provided with continuing microscopic training to maintain proficiency. The complementary use of immunochromatographic rapid detection tests (RDTs) may be useful, especially during on-call hours, although, in order to ensure correct interpretation, their inherent limitations have to be well known. Diagnosis based on the polymerase chain reaction is still unsuitable for routine use, due to its long turnaround time, its cost, and its unavailability outside regular hours, although it may be helpful in selected cases. Once the alert clinician has considered the possibility of malaria, and suspicion continues to be high, malaria can be excluded by repeat smears or RDTs. However, the absence of clinical suspicion may not be infrequent, and may have more serious consequences. Depending on the local number of malaria cases seen, laboratory staff should have a low threshold for the decision to perform unsolicited malaria diagnostic tests on suspicious samples, especially if other laboratory tests are abnormal (e.g. thrombocytopenia, presence of atypical lymphocytes, or raised lactate dehydrogenase). The detection of intraleukocytic hemozoin during automated full blood counts is a promising new way to avoid misdiagnosis of clinically unsuspected malaria.

Evaluation of integration methods for hybrid simulation of complex structural systems through collapse

NASA Astrophysics Data System (ADS)

Del Carpio R., Maikol; Hashemi, M. Javad; Mosqueda, Gilberto

2017-10-01

This study examines the performance of integration methods for hybrid simulation of large and complex structural systems in the context of structural collapse due to seismic excitations. The target application is not necessarily for real-time testing, but rather for models that involve large-scale physical sub-structures and highly nonlinear numerical models. Four case studies are presented and discussed. In the first case study, the accuracy of integration schemes including two widely used methods, namely, modified version of the implicit Newmark with fixed-number of iteration (iterative) and the operator-splitting (non-iterative) is examined through pure numerical simulations. The second case study presents the results of 10 hybrid simulations repeated with the two aforementioned integration methods considering various time steps and fixed-number of iterations for the iterative integration method. The physical sub-structure in these tests consists of a single-degree-of-freedom (SDOF) cantilever column with replaceable steel coupons that provides repeatable highlynonlinear behavior including fracture-type strength and stiffness degradations. In case study three, the implicit Newmark with fixed-number of iterations is applied for hybrid simulations of a 1:2 scale steel moment frame that includes a relatively complex nonlinear numerical substructure. Lastly, a more complex numerical substructure is considered by constructing a nonlinear computational model of a moment frame coupled to a hybrid model of a 1:2 scale steel gravity frame. The last two case studies are conducted on the same porotype structure and the selection of time steps and fixed number of iterations are closely examined in pre-test simulations. The generated unbalance forces is used as an index to track the equilibrium error and predict the accuracy and stability of the simulations.

The case-only test for gene-environment interaction is not uniformly powerful: an empirical example

PubMed Central

Wu, Chen; Chang, Jiang; Ma, Baoshan; Miao, Xiaoping; Zhou, Yifeng; Liu, Yu; Li, Yun; Wu, Tangchun; Hu, Zhibin; Shen, Hongbing; Jia, Weihua; Zeng, Yixin; Lin, Dongxin; Kraft, Peter

2016-01-01

The case-only test has been proposed as a more powerful approach to detect gene-environment (G×E) interactions. This approach assumes that the genetic and environmental factors are independent. While it is well known that Type I error rate will increase if this assumption is violated, it is less widely appreciated that gene-environment correlation can also lead to power loss. We illustrate this phenomenon by comparing the performance of the case-only test to other approaches to detect G×E interactions in a genome-wide association study of esophageal squamous carcinoma (ESCC) in Chinese populations. Some of these approaches do not use information on the correlation between exposure and genotype (standard logistic regression), while others seek to use this information in a robust fashion to boost power without increasing Type I error (two-step, empirical Bayes and cocktail methods). G×E interactions were identified involving drinking status and two regions containing genes in the alcohol metabolism pathway, 4q23 and 12q24. Although the case-only test yielded the most significant tests of G×E interaction in the 4q23 region, the case-only test failed to identify significant interactions in the 12q24 region which were readily identified using other approaches. The low power of the case-only test in the 12q24 region is likely due to the strong inverse association between the SNPs in this region and drinking status. This example underscores the need to consider multiple approaches to detect gene-environment interactions, as different tests are more or less sensitive to different alternative hypotheses and violations of the gene-environment independence assumption. PMID:23595356

[Seasonal and regional distribution of tularemia cases in Amasya, Turkey].

PubMed

Yanık, Keramettin; Sarıaydın, Muzaffer; Uzun, M Önder; Çoban, Ahmet Yılmaz; Seçilmiş, Halil

2015-01-01

Tularemia have attracted attention due to increased number of cases since 2009 in Amasya region which is located at Central Blacksea Region of Turkey. The aims of this letter were to provide information about the disease, to emphasize the importance of early treatment due to the outbreak peak in our province between 2009-2012 and water chlorination in epidemic areas. A total of 250 tularemia-suspected patients (117 female, 133 male; mean age: 42 yrs) who were admitted to our hospital with the symptoms of sore throat, fever, malaise and/or presence of neck mass, from 20 different locations within last four years were included in the study. Serum samples of 73 (29.2%) patients yielded ≥ 1/160 titers with F.tularensis microagglutination test which were considered as positive. All positive cases presented with the oropharyngeal form of the disease. The year with the highest number of tularemia cases was 2010. When the regional distribution was evaluated, it was detected that positive cases have precipitated especially in the southeastern (highland area) and northeastern (lowland area) parts of Amasya (34/73; 46.6%). Majority of the tularemia cases (53/73; 72.6%) were identified in colder seasons. The number of cases in rural and urban centers have decreased after 2010. In conclusion, it is considered that the emergence of new cases is likely to persist due to the geographical characteristics of Amasya and occupational properties (livestock breeding) of the population. Therefore, the clinicians should consider tularemia in differential diagnosis of the cases originated from risky rural areas.

Allergic contact dermatitis to benzocaine: the importance of concomitant positive patch test results.

PubMed

González-Rodríguez, A J; Gutiérrez-Paredes, E M; Revert Fernández, Á; Jordá-Cuevas, E

2013-03-01

Local anesthetics are widely used in clinical practice, and adverse effects are not uncommon. Delayed hypersensitivity reactions are among the most common effects, but immediate-type reactions may also occur. Patch testing should be considered in patients with hypersensitivity reactions. We present a case of allergic contact dermatitis to benzocaine that was detected incidentally by patch testing and highlight the importance of correctly interpreting patch test results when there are concomitant positive reactions. Copyright © 2011 Elsevier España, S.L. and AEDV. All rights reserved.

Diagnostic power of laboratory tests for hereditary spherocytosis: a comparison study in 150 patients grouped according to molecular and clinical characteristics

PubMed Central

Bianchi, Paola; Fermo, Elisa; Vercellati, Cristina; Marcello, Anna P.; Porretti, Laura; Cortelezzi, Agostino; Barcellini, Wilma; Zanella, Alberto

2012-01-01

Background The laboratory diagnosis of hereditary spherocytosis commonly relies on NaCl-based or glycerol-based red cell osmotic fragility tests; more recently, an assay directly targeting the hereditary spherocytosis molecular defect (eosin-5′-maleimide-binding test) has been proposed. None of the available tests identifies all cases of hereditary spherocytosis. Design and Methods We compared the performances of the eosin-5′-maleimide-binding test, NaCl-osmotic fragility studies on fresh and incubated blood, the glycerol lysis test, the acidified glycerol lysis test, and the Pink test on a series of 150 patients with hereditary spherocytosis grouped according to clinical phenotype and the defective protein, with the final aim of finding the combination of tests associated with the highest diagnostic power, even in the mildest cases of hereditary spherocytosis. Results The eosin-5′-maleimide-binding test had a sensitivity of 93% and a specificity of 98% for detecting hereditary spherocytosis: the sensitivity was independent of the type and amount of molecular defect and of the clinical phenotype. The acidified glycerol lysis test and Pink test showed comparable sensitivity (95% and 91%). The sensitivity of NaCl osmotic fragility tests, commonly considered the gold standard for the diagnosis of hereditary spherocytosis, was 68% on fresh blood and 81% on incubated blood, and further decreased in compensated cases (53% and 64%, respectively). The combination of the eosin-5′-maleimide-binding test and acidified glycerol lysis test enabled all patients with hereditary spherocytosis to be identified. The eosin-5′-maleimide-binding test showed the greatest disease specificity. Conclusions Each type of test fails to diagnose some cases of hereditary spherocytosis. The association of an eosin-5′-maleimide-binding test and an acidified glycerol lysis test enabled identification of all patients with hereditary spherocytosis in this series and, therefore, represents a currently effective diagnostic strategy for hereditary spherocytosis including mild/compensated cases. PMID:22058213

Diplopia after Strabismus Surgery.

PubMed

Sharma, Medha; Hunter, David G

2018-01-01

Diplopia is a disappointing and, at times, unanticipated consequence of what might otherwise be considered anatomically successful strabismus surgery. In this study, we review the existing literature regarding diplopia after strabismus surgery in the context of the senior author's experience. We divide postoperative diplopia types into cases that occur in the setting of normal binocular vision (or "normal" suppression) vs. cases that are the consequence of rare or anomalous sensorial adaptations. We then discuss how to identify patients at greatest risk based on history and preoperative testing, and we offer strategies for managing these sometimes-challenging cases.

Syndromic Algorithms for Detection of Gambiense Human African Trypanosomiasis in South Sudan

PubMed Central

Palmer, Jennifer J.; Surur, Elizeous I.; Goch, Garang W.; Mayen, Mangar A.; Lindner, Andreas K.; Pittet, Anne; Kasparian, Serena; Checchi, Francesco; Whitty, Christopher J. M.

2013-01-01

Background Active screening by mobile teams is considered the best method for detecting human African trypanosomiasis (HAT) caused by Trypanosoma brucei gambiense but the current funding context in many post-conflict countries limits this approach. As an alternative, non-specialist health care workers (HCWs) in peripheral health facilities could be trained to identify potential cases who need testing based on their symptoms. We explored the predictive value of syndromic referral algorithms to identify symptomatic cases of HAT among a treatment-seeking population in Nimule, South Sudan. Methodology/Principal Findings Symptom data from 462 patients (27 cases) presenting for a HAT test via passive screening over a 7 month period were collected to construct and evaluate over 14,000 four item syndromic algorithms considered simple enough to be used by peripheral HCWs. For comparison, algorithms developed in other settings were also tested on our data, and a panel of expert HAT clinicians were asked to make referral decisions based on the symptom dataset. The best performing algorithms consisted of three core symptoms (sleep problems, neurological problems and weight loss), with or without a history of oedema, cervical adenopathy or proximity to livestock. They had a sensitivity of 88.9–92.6%, a negative predictive value of up to 98.8% and a positive predictive value in this context of 8.4–8.7%. In terms of sensitivity, these out-performed more complex algorithms identified in other studies, as well as the expert panel. The best-performing algorithm is predicted to identify about 9/10 treatment-seeking HAT cases, though only 1/10 patients referred would test positive. Conclusions/Significance In the absence of regular active screening, improving referrals of HAT patients through other means is essential. Systematic use of syndromic algorithms by peripheral HCWs has the potential to increase case detection and would increase their participation in HAT programmes. The algorithms proposed here, though promising, should be validated elsewhere. PMID:23350005

The impact of patents on the development of genome-based clinical diagnostics: an analysis of case studies

PubMed Central

Pierce, Brandon L.; Carlson, Christopher S.; Kuszler, Patricia C.; Stanford, Janet L.; Austin, Melissa A.

2010-01-01

Purpose Fragmented ownership of diagnostic gene patents has the potential to create an ‘anticommons’ in the area of genomic diagnostics, making it difficult and expensive to assemble the patent rights necessary to develop a panel of genetic tests. The objectives of this study were to identify U.S. patents that protect existing panels of genetic tests, describe how (or if) test providers acquired rights to these patents, and determine if fragmented patent ownership has inhibited the commercialization of these panels. Methods As case studies, we selected four clinical applications of genetic testing (cystic fibrosis, maturity-onset diabetes of the young, long QT syndrome, and hereditary breast cancer) that utilize tests protected by ≥3 U.S. patents. We summarized publically available information on relevant patents, test providers, licenses, and litigation. Results For each case study, all tests of major genes/mutations were patented, and at least one party held the collective rights to conduct all relevant tests, often as a result of licensing agreements. Conclusions We did not find evidence that fragmentation of patent rights has inhibited commercialization of genetic testing services. However, as knowledge of genetic susceptibility increases, it will be important to consider the potential consequences of fragmented ownership of diagnostic gene patents. PMID:19367193

Case study to illustrate an approach for detecting contamination and impurities in pesticide formulations.

PubMed

Karasali, Helen; Kasiotis, Konstantinos M; Machera, Kyriaki; Ambrus, Arpad

2014-11-26

Counterfeit pesticides threaten public health, food trade, and the environment. The present work draws attention to the importance of regular monitoring of impurities in formulated pesticide products. General screening revealed the presence of carbaryl as a contaminant in a copper oxychloride formulated product. In this paper, as a case study, a liquid chromatographic diode array-mass spectrometric method developed for general screening of pesticide products and quantitative determination of carbaryl together with its validation is presented. The proposed testing strategy is considered suitable for use as a general approach for testing organic contaminants and impurities in solid pesticide formulations.

Case Studies of Rock Reinforcement Components and Systems Testing

NASA Astrophysics Data System (ADS)

Thompson, A. G.; Villaescusa, E.

2014-09-01

Rock reinforcement is widely used in tunnels and surface and underground mines. A large number of proprietary products are available in various configurations of components. While the mechanical properties of the primary element are available from product brochures, the associated component properties may vary widely and adversely influence the overall performance of the system. Field pull out tests are most commonly used to measure the system response in the toe anchor region. However, the response of the collar region is less commonly considered but may be more important. Several case studies are described in which various components and systems of rock bolts and cable bolts have been subjected to static loading in the laboratory and in the field. The results generally demonstrate the importance of considering the properties of all the components and not simply those of the primary element. In some cases, the internal fixtures have strengths much less than the elements. Often it has also been found that the fixture at the collar has significantly less strength than the element and this will result in complete loss of function in restraining surface support hardware, such as plates, mesh and reinforced shotcrete.

Recent Developments in Silver/Zinc Rechargeable Cell Studies

NASA Technical Reports Server (NTRS)

Lewis, Harlan L.

2001-01-01

This viewgraph presentation discusses silver/zinc cell casing configurations and test results examining discharge capacity and silver migration comparisons. The following recommendations were proposed: 1) Use silver-treated cellophane instead of clear cellophane; 2) Use split wrap for cellophane whenever possible; and 3) Strongly consider use of sausage casing with PVA film in the following configuration: 1-mil (tubular) SC/1-mil PVA film/2.3-mil plain or 6-mil fiber-reinforced SC tubular.

Demonstration of the range over which the Langley Research Center digital computer charring ablation program (CHAP) can be used with confidence: Comparisons of CHAP predictions and test data for three ablation materials

NASA Technical Reports Server (NTRS)

Moyer, C. B.; Green, K. A.

1972-01-01

Comparisons of ablation calculations with the charring ablation computer code and ablation test data are presented over a wide range of environmental conditions in air for three materials: low-density nylon phenolic, Avcoat 5026-39HC/G, and a filled silicon elastomer. Heat fluxes considered range from over 500 Btu/sq ft-sec to less than 50 Btu/sq ft-sec. Pressures range from 0.5 atm to .004 atm. Enthalpies range from about 2000 Btu/lb to 18000 Btu/lb. Predictions of recession, pyrolysis penetration, and thermocouple responses are considered. Recession predictions for nylon phenolic are good as steady state is approached, but strongly transient cases are underpredicted. Pyrolysis penetrations and thermocouple responses are very well predicted. Recession amounts for Avcoat and silicone elastomer are less well predicted, although high heat flux cases near steady state are fairly satisfactory. Pyrolysis penetrations and thermocouple responses are very well predicted.

The effect of uncertainties in distance-based ranking methods for multi-criteria decision making

NASA Astrophysics Data System (ADS)

Jaini, Nor I.; Utyuzhnikov, Sergei V.

2017-08-01

Data in the multi-criteria decision making are often imprecise and changeable. Therefore, it is important to carry out sensitivity analysis test for the multi-criteria decision making problem. The paper aims to present a sensitivity analysis for some ranking techniques based on the distance measures in multi-criteria decision making. Two types of uncertainties are considered for the sensitivity analysis test. The first uncertainty is related to the input data, while the second uncertainty is towards the Decision Maker preferences (weights). The ranking techniques considered in this study are TOPSIS, the relative distance and trade-off ranking methods. TOPSIS and the relative distance method measure a distance from an alternative to the ideal and antiideal solutions. In turn, the trade-off ranking calculates a distance of an alternative to the extreme solutions and other alternatives. Several test cases are considered to study the performance of each ranking technique in both types of uncertainties.

Antepartum evaluation of the fetus and fetal well being.

PubMed

O'Neill, Erica; Thorp, John

2012-09-01

Despite widespread use of many methods of antenatal testing, limited evidence exists to demonstrate effectiveness at improving perinatal outcomes. An exception is the use of Doppler ultrasound in monitoring high-risk pregnancies thought to be at risk of placental insufficiency. Otherwise, obstetricians should proceed with caution and approach the initiation of a testing protocol by obtaining an informed consent. When confronted with an abnormal test, clinicians should evaluate with a second antenatal test and consider administering betamethasone, performing amniocentesis to assess lung maturity, and/or repeating testing to minimize the chance of iatrogenic prematurity in case of a healthy fetus.

Dysautonomia in a six-year-old mule in the United States.

PubMed

Wright, A; Beard, L; Bawa, B; Bras, J

2010-03-01

Equine dysautonomia, also known as equine grass sickness (EGS), is a well documented disease in several countries. To the authors' knowledge, EGS has not been reported previously in North America. This report describes EGS in a 6-year-old female mule in the USA. Failure initially to consider EGS resulted in a delayed diagnosis. EGS should be considered as a differential diagnosis and appropriate diagnostic tests performed in similar cases in North America.

Can machines think? A report on Turing test experiments at the Royal Society

NASA Astrophysics Data System (ADS)

Warwick, Kevin; Shah, Huma

2016-11-01

In this article we consider transcripts that originated from a practical series of Turing's Imitation Game that was held on 6 and 7 June 2014 at the Royal Society London. In all cases the tests involved a three-participant simultaneous comparison by an interrogator of two hidden entities, one being a human and the other a machine. Each of the transcripts considered here resulted in a human interrogator being fooled such that they could not make the 'right identification', that is, they could not say for certain which was the machine and which was the human. The transcripts presented all involve one machine only, namely 'Eugene Goostman', the result being that the machine became the first to pass the Turing test, as set out by Alan Turing, on unrestricted conversation. This is the first time that results from the Royal Society tests have been disclosed and discussed in a paper.

Genetic testing and its implications: human genetics researchers grapple with ethical issues.

PubMed

Rabino, Isaac

2003-01-01

To better understand ethical issues involved in the field of human genetics and promote debate within the scientific community, the author surveyed scientists who engage in human genetics research about the pros, cons, and ethical implications of genetic testing. This study contributes systematic data on attitudes of scientific experts. The survey finds respondents are highly supportive of voluntary testing and the right to know one's genetic heritage. The majority consider in utero testing and consequent pregnancy termination acceptable for cases involving likelihood of serious disease but disapprove for genetic reasons they consider arbitrary, leaving a gray area of distinguishing between treatment of disorders and enhancement still to be resolved. While safeguarding patient confidentiality versus protecting at-risk third parties (kin, reproductive partners) presents a dilemma, preserving privacy from misuse by institutional third parties (employers, insurers) garners strong consensus for legislation against discrimination. Finally, a call is made for greater genetic literacy.

Household Transmission of Ebola Virus: risks and preventive factors, Freetown, Sierra Leone, 2015.

PubMed

Reichler, Mary R; Bangura, James; Bruden, Dana; Keimbe, Charles; Duffy, Nadia; Thomas, Harold; Knust, Barbara; Farmar, Ishmail; Nichols, Erin; Jambai, Amara; Morgan, Oliver; Hennessy, Thomas

2018-04-06

Knowing risk factors for household transmission of Ebola virus is important to guide preventive measures during Ebola outbreaks. We enrolled all confirmed persons with Ebola who were the first case in a household from December 2014-April 2015 in Freetown, Sierra Leone, and their household contacts. Cases and contacts were interviewed, contacts followed prospectively through the 21-day incubation period, and secondary cases confirmed by laboratory testing. We enrolled 150 index Ebola cases and 838 contacts; 83 (9.9%) contacts developed Ebola during 21-day follow-up. In multivariable analysis, risk factors for transmission included index case death in the household, Ebola symptoms but no reported fever, age <20 years, more days with wet symptoms; and providing care to the index case (P<0.01 for each). Protective factors included avoiding the index case after illness onset and a piped household drinking water source (P<0.01 for each). To reduce Ebola transmission, communities should rapidly identify and follow-up all household contacts; isolate those with Ebola symptoms, including those without reported fever; and consider closer monitoring of contacts who provided care to a case. Households could consider efforts to minimize risk by designating one care provider for ill persons with all others avoiding the suspected case.

Glutathione S-transferase M1 (GSTM1) polymorphisms and lung cancer: a literature-based systematic HuGE review and meta-analysis.

PubMed

Carlsten, C; Sagoo, G S; Frodsham, A J; Burke, W; Higgins, J P T

2008-04-01

Multiple genes have been studied for potential associations with lung cancer. The gene most frequently associated with increased risk has been glutathione S-transferase M1 (GSTM1). The glutathione S-transferase enzyme family is known to catalyze detoxification of electrophilic compounds, including carcinogens, therapeutic drugs, environmental toxins, and products of oxidative stress. In this review, the authors summarize the available evidence associating lung cancer with the GSTM1 gene. They describe results from an updated meta-analysis of 98 published genetic association studies investigating the relation between the GSTM1 null variant and lung cancer risk including 19,638 lung cancer cases and 25,266 controls (counting cases and controls in each study only once). All studies considered, the GSTM1 null variant was associated with an increased risk of lung cancer (odds ratio (OR) = 1.22, 95% confidence interval (CI): 1.14, 1.30), but no increase in risk was seen (OR = 1.01, 95% CI: 0.91, 1.12) when only the five largest studies (>500 cases each) were considered. Furthermore, while GSTM1 null status conferred a significantly increased risk of lung cancer to East Asians (OR = 1.38, 95% CI: 1.24, 1.55), such a genotype did not confer increased risk to Caucasians. More data regarding the predictive value of GSTM1 genetic testing are needed before population-based testing may be reasonably considered.

Mild cognitive impairment: applicability of research criteria in a memory clinic and characterization of cognitive profile.

PubMed

Alladi, Suvarna; Arnold, Robert; Mitchell, Joanna; Nestor, Peter J; Hodges, John R

2006-04-01

We explored the applicability of recently proposed research criteria for mild cognitive impairment (MCI) in a memory clinic and changes in case definition related to which memory tests are used and the status of general cognitive function in MCI. A total of 166 consecutive GP referrals to the Cambridge Memory Clinic underwent comprehensive neuropsychological and psychiatric evaluation. Of 166 cases, 42 were excluded (significant depression 8, established dementia 29 and other disorders 5). Of 124 non-demented, non-depressed patients, 72 fulfilled Petersen's criteria for amnestic MCI based upon verbal memory performance [the Rey Auditory Verbal Learning Test (RAVLT)] and 90 met criteria if performance on verbal and/or non-verbal memory tests [the Rey figure recall or the Paired Associates Learning test (PAL)] was considered. Of the 90 broadly defined MCI cases, only 25 had pure amnesia: other subtle semantic and/or attention deficits were typically present. A further 12 were classed as non-amnestic MCI and 22 as 'worried well'. Definition of MCI varies considerably dependent upon the tests used for case definition. The majority have other cognitive deficits despite normal performance on the Mini-mental State Examination (MMSE) and intact activities of daily living (ADL) and fit within multi-domain MCI. Pure amnesic MCI is rare.

Teicoplanin allergy - an emerging problem in the anaesthetic allergy clinic.

PubMed

Savic, L C; Garcez, T; Hopkins, P M; Harper, N J N; Savic, S

2015-10-01

Anaphylaxis to teicoplanin appears to be extremely rare, with only one confirmed case report worldwide. Two anaesthetic allergy clinics in the UK have received a number of suspected cases referred for investigation, and we present here the first case series of teicoplanin allergy. We investigated 20 cases of suspected teicoplanin allergy, identified from the two clinics over a period of two years. We devised a set of five criteria to categorize the certainty of their diagnosis. These included: (1) reaction within 15 min of administration of teicoplanin, (2) ≥2 features of anaphylaxis present, (3) positive skin testing or challenge testing, (4) raised serum mast cell tryptase (MCT), (5) alternative diagnosis excluded. Based on these criteria we defined the likelihood of IgE-mediated allergy to teicoplanin as: definite-met all criteria; probable-met criteria 1.2 and 5, plus 3 or 4; uncertain-met criteria 1.2 and 5; excluded- any others. We identified 7 'definite', 7 'probable' and 2 'uncertain' cases of teicoplanin allergy. Four cases were excluded. IgE-mediated anaphylaxis to teicoplanin appears to be more common than previously thought. This is true even if only definitive cases are considered. Investigation of teicoplanin allergy is hampered by the lack of standardized skin test concentrations. In some cases, there was a severe clinical reaction, but without any skin test evidence of histamine release. The mechanism of reaction in these cases is not known and requires further study. © The Author 2015. Published by Oxford University Press on behalf of the British Journal of Anaesthesia. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Coupled incompressible Smoothed Particle Hydrodynamics model for continuum-based modelling sediment transport

NASA Astrophysics Data System (ADS)

Pahar, Gourabananda; Dhar, Anirban

2017-04-01

A coupled solenoidal Incompressible Smoothed Particle Hydrodynamics (ISPH) model is presented for simulation of sediment displacement in erodible bed. The coupled framework consists of two separate incompressible modules: (a) granular module, (b) fluid module. The granular module considers a friction based rheology model to calculate deviatoric stress components from pressure. The module is validated for Bagnold flow profile and two standardized test cases of sediment avalanching. The fluid module resolves fluid flow inside and outside porous domain. An interaction force pair containing fluid pressure, viscous term and drag force acts as a bridge between two different flow modules. The coupled model is validated against three dambreak flow cases with different initial conditions of movable bed. The simulated results are in good agreement with experimental data. A demonstrative case considering effect of granular column failure under full/partial submergence highlights the capability of the coupled model for application in generalized scenario.

Goodness-of-Fit Tests for Generalized Normal Distribution for Use in Hydrological Frequency Analysis

NASA Astrophysics Data System (ADS)

Das, Samiran

2018-04-01

The use of three-parameter generalized normal (GNO) as a hydrological frequency distribution is well recognized, but its application is limited due to unavailability of popular goodness-of-fit (GOF) test statistics. This study develops popular empirical distribution function (EDF)-based test statistics to investigate the goodness-of-fit of the GNO distribution. The focus is on the case most relevant to the hydrologist, namely, that in which the parameter values are unidentified and estimated from a sample using the method of L-moments. The widely used EDF tests such as Kolmogorov-Smirnov, Cramer von Mises, and Anderson-Darling (AD) are considered in this study. A modified version of AD, namely, the Modified Anderson-Darling (MAD) test, is also considered and its performance is assessed against other EDF tests using a power study that incorporates six specific Wakeby distributions (WA-1, WA-2, WA-3, WA-4, WA-5, and WA-6) as the alternative distributions. The critical values of the proposed test statistics are approximated using Monte Carlo techniques and are summarized in chart and regression equation form to show the dependence of shape parameter and sample size. The performance results obtained from the power study suggest that the AD and a variant of the MAD (MAD-L) are the most powerful tests. Finally, the study performs case studies involving annual maximum flow data of selected gauged sites from Irish and US catchments to show the application of the derived critical values and recommends further assessments to be carried out on flow data sets of rivers with various hydrological regimes.

[Clinical studies on flomoxef in the perinatal period infections].

PubMed

Chimura, T; Morisaki, N; Funayama, T

1991-06-01

We conducted clinical efficacy and safety tests of flomoxef (FMOX, 6315-S) in the perinatal infections and obtained the following results. 1. A total of 25 patients was treated: 16 patients with intrauterine infections, 2 patients with pelvioperitonitis, 4 patients with urinary tract infections and 3 patients with other infections. FMOX was injected at a daily dose of 2-4 g for 3-15 days (6-60 g for total dose) by intravenous drip infusion, intravenous injection or their combination. 2. The clinical efficacy rate was 96.0% of 25 patients: excellent in 4 cases (16.0%), good in 20 cases (80.0%) and poor in 1 case (4.0%). Bacteriological effects obtained were: eradicated in 14/16 cases (87.5%) replaced in 3 cases. 3. There were no subjective or objective side effects, nor were any abnormal laboratory test values attributable to the drug. From these findings, we consider that FMOX treatment appears to obtain good clinical and bacteriological responses and in safe in perinatal period infections.

Random matrix theory filters and currency portfolio optimisation

NASA Astrophysics Data System (ADS)

Daly, J.; Crane, M.; Ruskin, H. J.

2010-04-01

Random matrix theory (RMT) filters have recently been shown to improve the optimisation of financial portfolios. This paper studies the effect of three RMT filters on realised portfolio risk, using bootstrap analysis and out-of-sample testing. We considered the case of a foreign exchange and commodity portfolio, weighted towards foreign exchange, and consisting of 39 assets. This was intended to test the limits of RMT filtering, which is more obviously applicable to portfolios with larger numbers of assets. We considered both equally and exponentially weighted covariance matrices, and observed that, despite the small number of assets involved, RMT filters reduced risk in a way that was consistent with a much larger S&P 500 portfolio. The exponential weightings indicated showed good consistency with the value suggested by Riskmetrics, in contrast to previous results involving stocks. This decay factor, along with the low number of past moves preferred in the filtered, equally weighted case, displayed a trend towards models which were reactive to recent market changes. On testing portfolios with fewer assets, RMT filtering provided less or no overall risk reduction. In particular, no long term out-of-sample risk reduction was observed for a portfolio consisting of 15 major currencies and commodities.

Time-domain full-waveform inversion of Rayleigh and Love waves in presence of free-surface topography

NASA Astrophysics Data System (ADS)

Pan, Yudi; Gao, Lingli; Bohlen, Thomas

2018-05-01

Correct estimation of near-surface seismic-wave velocity when encountering lateral heterogeneity and free surface topography is one of the challenges to current shallow seismic. We propose to use time-domain full-waveform inversion (FWI) of surface waves, including both Rayleigh and Love waves, to solve this problem. We adopt a 2D time-domain finite-difference method with an improved vacuum formulation (IVF) to simulate shallow-seismic Rayleigh wave in presence of free-surface topography. We modify the IVF for SH-wave equation for the simulation of Love wave in presence of topographic free surface and prove its accuracy by benchmark tests. Checkboard model tests are performed in both cases when free-surface topography is included or neglected in FWI. Synthetic model containing a dipping planar free surface and lateral heterogeneity was then tested, in both cases of considering and neglecting free-surface topography. Both checkerboard and synthetic models show that Rayleigh- and Love-wave FWI have similar ability of reconstructing near-surface structures when free-surface topography is considered, while Love-wave FWI could reconstruct near-surface structures better than Rayleigh-wave when free-surface topography is neglected.

Use of enzyme-linked immunoassays for antibody to types C and D botulinum toxins for investigations of botulism in cattle.

PubMed

Gregory, A R; Ellis, T M; Jubb, T F; Nickels, R J; Cousins, D V

1996-02-01

The development of specific enzyme-linked immunosorbent assays (ELISA) for antibody to types C and D Clostridium botulinum toxins for investigation of botulism in cattle is described. Partially purified type C and D toxins were used as antigens to develop these ELISAs. Specificity of the ELISAs was evaluated on sera from 333 adult beef and dairy cattle from areas with no history or evidence of botulism in animals or water birds. The test was also evaluated on sera from 41 herds that included herds vaccinated against botulism, confirmed botulism cases and herds from areas where the disease is considered endemic. The ELISAs detected the presence of antibody to botulinum toxins in samples from vaccinated cattle and both convalescent and clinically normal animals from unvaccinated herds with outbreaks of botulism. Antibody was also found in unvaccinated animals from herds in which there had been no diagnosed botulism cases in areas where botulism was considered endemic. Sera from some unvaccinated cattle with high ELISA reactivity was shown to be protective for mice in botulinum toxin neutralisation tests. The use of these tests in investigations of botulism in cattle is discussed.

A tailored approach to BRAF and MLH1 methylation testing in a universal screening program for Lynch syndrome.

PubMed

Adar, Tomer; Rodgers, Linda H; Shannon, Kristen M; Yoshida, Makoto; Ma, Tianle; Mattia, Anthony; Lauwers, Gregory Y; Iafrate, Anthony J; Chung, Daniel C

2017-03-01

To determine the correlation between BRAF genotype and MLH1 promoter methylation in a screening program for Lynch syndrome (LS), a universal screening program for LS was established in two medical centers. Tumors with abnormal MLH1 staining were evaluated for both BRAF V600E genotype and MLH1 promoter methylation. Tumors positive for both were considered sporadic, and genetic testing was recommended for all others. A total 1011 colorectal cancer cases were screened for Lynch syndrome, and 148 (14.6%) exhibited absent MLH1 immunostaining. Both BRAF and MLH1 methylation testing were completed in 126 cases. Concordant results (both positive or both negative) were obtained in 86 (68.3%) and 16 (12.7%) cases, respectively, with 81% concordance overall. The positive and negative predictive values for a BRAF mutation in predicting MLH1 promoter methylation were 98.9% and 41%, respectively, and the negative predictive value fell to 15% in patients ≥70 years old. Using BRAF genotyping as a sole test to evaluate cases with absent MLH1 staining would have increased referral rates for genetic testing by 2.3-fold compared with MLH1 methylation testing alone (31% vs 13.5%, respectively, P<0.01). However, a hybrid approach that reserves MLH1 methylation testing for BRAF wild-type cases only would significantly decrease the number of methylation assays performed and reduce the referral rate for genetic testing to 12.7%. A BRAF mutation has an excellent positive predictive value but poor negative predictive value in predicting MLH1 promoter methylation. A hybrid use of these tests may reduce the number of low-risk patients referred to genetic counseling and facilitate wider implementation of Lynch syndrome screening programs.

Nonparametric estimation and testing of fixed effects panel data models

PubMed Central

Henderson, Daniel J.; Carroll, Raymond J.; Li, Qi

2009-01-01

In this paper we consider the problem of estimating nonparametric panel data models with fixed effects. We introduce an iterative nonparametric kernel estimator. We also extend the estimation method to the case of a semiparametric partially linear fixed effects model. To determine whether a parametric, semiparametric or nonparametric model is appropriate, we propose test statistics to test between the three alternatives in practice. We further propose a test statistic for testing the null hypothesis of random effects against fixed effects in a nonparametric panel data regression model. Simulations are used to examine the finite sample performance of the proposed estimators and the test statistics. PMID:19444335

Human West Nile virus infection in Bosnia and Herzegovina.

PubMed

Ahmetagić, Sead; Petković, Jovan; Hukić, Mirsada; Smriko-Nuhanović, Arnela; Piljić, Dilista

2015-02-01

To describe the first two cases of West Nile virus (WNV) neuroinvasive infections in Bosnia and Herzegovina. At the Clinic for Infectious Diseases of the University Clinical Centre Tuzla, Bosnia and Herzegovina (BiH), specific screening for WNV infection was performed on patients with neuroinvasive diseases from 1 August to 31 October 2013. Serum samples were tested for the presence of WNV IgM and IgG antibodies using enzyme-linked immunosorbent assay (ELISA); positive serum samples were further analyzed by detection of WNV nucleic acid of two distinct lineages (lineage 1 and lineage 2) in sera by RT-PCR. Three (out of nine) patients met clinical criteria, and two of them had high serum titre of WNV specific IgM antibodies (3.5 and 5.2). Serum RT-PCR testing was negative. Conformation by neutralization testing was not performed. Both cases represented with encephalitis. None of these cases had recent travel history in WNW endemic areas, or history of blood transfusion and organ transplantation, so they represented autochthonous cases. Although there were no previous reports of flavivirus infections in BiH, described cases had high titre of WNV specific antibodies in serum, and negative flavivirus-vaccination history, they were defined as probable cases because recommended testing for case confirmation was not performed. The West Nile virus should be considered a possible causative pathogen in this area, probably in patients with mild influenza-like disease of unknown origin and those with neuroinvasive disease during late summer and early autumn.

Paraneoplastic autoantibody panels: sensitivity and specificity, a retrospective cohort.

PubMed

Albadareen, Rawan; Gronseth, Gary; Goeden, Marcie; Sharrock, Matthew; Lechtenberg, Colleen; Wang, Yunxia

2017-06-01

Experts in the autoimmune paraneoplastic field recommend autoantibody testing as "panels" to improve the poor sensitivity of individual autoantibodies in detecting paraneoplastic neurological syndromes (PNS). The sensitivity of those panels was not reported to date in a fashion devoid of incorporation bias. We aimed to assess the collective sensitivity and specificity of one of the commonly used panels in detecting PNS. A single-centered retrospective cohort of all patients tested for paraneoplastic evaluation panel (PAVAL; test ID: 83380) over one year for the suspicion of PNS. Case adjudication was based on newly proposed diagnostic criteria in line with previously published literature, but modified to exclude serological status to avoid incorporation bias. Measures of diagnostic accuracy were subsequently calculated. Cases that failed to show association with malignancy within the follow-up time studied, reflecting a possibly pure autoimmune process was considered paraneoplastic-like syndromes. Out of 321 patients tested, 51 patients tested positive. Thirty-two patients met diagnostic criteria for paraneoplastic/paraneoplastic-like syndromes. The calculated collective sensitivity was 34% (95% CI: 17-53), specificity was 86% (95% CI: 81-90), Youden's index 0.2 and a positive clinical utility index 0.07 suggesting poor utility for case-detection. This is the first reported diagnostic accuracy measures of paraneoplastic panels without incorporation bias. Despite recommended panel testing to improve detection of PNS, sensitivity remains low with poor utility for case-detection. The high-calculated specificity suggests a possible role in confirming the condition in difficult cases suspicious for PNS, when enough supportive evidence is lacking on ancillary testing.

A review of the public health management of shigellosis in Australia in the era of culture-independent diagnostic testing.

PubMed

Tai, Alex Y C; Easton, Marion; Encena, Jess; Rotty, Jessica; Valcanis, Mary; Howden, Benjamin P; Slota-Kan, Simon; Gregory, Joy

2016-12-01

To review the national case definition for shigellosis following the introduction of culture independent diagnostic testing by clinical laboratories and provide evidence to reform jurisdictional public health practices for the management shigellosis., . A review of all Australian jurisdictional public health guidelines for shigellosis was conducted. Victorian 2014 shigellosis data were analysed: demographics and risk factors for cases identified by conventional culture or culture-independent diagnostic methods were described. There was considerable variation in reporting of cases to the National Notifiable Disease Surveillance System (NNDSS) by the eight Australian jurisdictions, with an array of classifications based on diagnostic testing methodologies. Analysis of Victorian 2014 shigellosis data found that culture positive cases were more likely to have reported men who have sex with men (MSM) as a risk factor than PCR positive only cases (p<0.0001) and less likely to have reported overseas travel during their incubation period (p<0.0001). Over a 10-year period (2005 to 2014), only two of 86 cases who were employed in high-risk occupations had ongoing positive faecal cultures after appropriate treatment. The national surveillance case definition for shigellosis should be reviewed to facilitate standardised reporting across Australia. All jurisdictions must consider the public health significance of PCR positive only results in their surveillance risk assessments to inform management of shigellosis cases. © 2016 Public Health Association of Australia.

Constrained inversion as a hypothesis testing tool, what can we learn about the lithosphere?

NASA Astrophysics Data System (ADS)

Moorkamp, Max; Stewart, Fishwick; Jones, Alan G.

2017-04-01

Inversion of geophysical data constrained by a reference model is typically used to guide the inversion of low resolution data towards a geologically plausible solution. For example, a migrated seismic section can provide the location of lithological boundaries for potential field inversions. Here we consider the inversion of long-period magnetotelluric data constrained by models generated through surface wave inversion. In this case, we do not consider the surface wave model inherently better in any sense and want to guide the magnetotelluric inversion towards this model, but we want to test the hypothesis that both datasets can be explained by models with similar structure. If the hypothesis test is successful, i.e. we can fit the observations with a conductivity model with structural similarity to the seismic model, we have found an alternative explanation compared to the individual inversion and can use the differences to learn about the resolution of the magnetotelluric data and can improve our interpretation. Conversely, if the test refutes our hypothesis of coincident structure, we have found features in the models that are sensed fundamentally different by both methods which is potentially instructive on the nature of the anomalies. We use a MT dataset acquired in central Botswana over the Okwa terrane and the adjacent Kaapvaal and Zimbabwe Cratons together with a tomographic model for the region to illustrate and test this approach. Here, various conductive structures have been identified that bridge the Moho. Furthermore, the thickness of the lithosphere inferred from the different methods differs. In both cases the question is in how far this is a result of the ill-posed nature of inversion and in how far these differences can be reconciled. Thus this dataset is an ideal test case for our hypothesis testing approach. Finally, we will demonstrate how we can use the results of the constrained inversion to extract conductivity-velocity relationships in the region and gain further insight into the composition and thermal structure of the lithosphere.

Regenerative braking strategies, vehicle safety and stability control systems: critical use-case proposals

NASA Astrophysics Data System (ADS)

Oleksowicz, Selim A.; Burnham, Keith J.; Southgate, Adam; McCoy, Chris; Waite, Gary; Hardwick, Graham; Harrington, Cian; McMurran, Ross

2013-05-01

The sustainable development of vehicle propulsion systems that have mainly focused on reduction of fuel consumption (i.e. CO2 emission) has led, not only to the development of systems connected with combustion processes but also to legislation and testing procedures. In recent years, the low carbon policy has made hybrid vehicles and fully electric vehicles (H/EVs) popular. The main virtue of these propulsion systems is their ability to restore some of the expended energy from kinetic movement, e.g. the braking process. Consequently new research and testing methods for H/EVs are currently being developed. This especially concerns the critical 'use-cases' for functionality tests within dynamic events for both virtual simulations, as well as real-time road tests. The use-case for conventional vehicles for numerical simulations and road tests are well established. However, the wide variety of tests and their great number (close to a thousand) creates a need for selection, in the first place, and the creation of critical use-cases suitable for testing H/EVs in both virtual and real-world environments. It is known that a marginal improvement in the regenerative braking ratio can significantly improve the vehicle range and, therefore, the economic cost of its operation. In modern vehicles, vehicle dynamics control systems play the principal role in safety, comfort and economic operation. Unfortunately, however, the existing standard road test scenarios are insufficient for H/EVs. Sector knowledge suggests that there are currently no agreed tests scenarios to fully investigate the effects of brake blending between conventional and regenerative braking as well as the regenerative braking interaction with active driving safety systems (ADSS). The paper presents seven manoeuvres, which are considered to be suitable and highly informative for the development and examination of H/EVs with regenerative braking capability. The critical manoeuvres presented are considered to be appropriate for examination of the regenerative braking mode according to ADSS. The manoeuvres are also important for investigation of regenerative braking system properties/functionalities that are specified by the legal requirements concerning H/EVs braking systems. The last part of this paper shows simulation results for one of the proposed manoeuvres that explicitly shows the usefulness of the manoeuvre.

Prolactinoma presenting as chronic anaemia with osteoporosis: a case report

PubMed Central

2010-01-01

Introduction Unexplained anaemia is a rare mode of presentation for prolactinoma. We describe a case of a man, with chronic anaemia ascribed to old age. Six years later, he was evaluated and diagnosed with a prolactinoma and resultant osteoporosis. Prolactinoma in old people may present insidiously with chronic anaemia and osteoporosis with or without sexual dysfunction. Case presentation We describe the case of a 70-year-old Caucasian man who presented with mild anaemia and tiredness. His anaemia was investigated and ascribed to senescence. Endocrine causes were not considered or tested for. Six years later, he was again referred. Reassessment and direct questioning revealed long-standing sexual dysfunction. It was also discovered that our patient had fractured his radius twice, with minor trauma, during the preceding year. His serum prolactin was massively increased and a magnetic resonance imaging (MRI) scan of the head demonstrated a pituitary mass consistent with a prolactinoma. Dual X-ray absorptiometry revealed osteoporosis. Treatment of the prolactinoma led to a reduction in his serum prolactin with a rise in his haemoglobin to normal levels. This suggested that the prolactinoma was present during the initial presentation and was the cause of his anaemia. Conclusion This case highlights the importance of fully evaluating and investigating unexplained anaemia in older people and that endocrine causes should be considered. Osteoporosis also requires evaluation with secondary causes considered. PMID:20205855

Anthelmintic resistance of nematodes in communally grazed goats in a semi-arid area of South Africa.

PubMed

Bakunzi, F R

2003-09-01

A survey was conducted on the occurrence of anthelmintic resistance of nematodes in communally grazed goats in a semi-arid area in South Africa. In herds belonging to 10 small-holder goat farmers, the efficacies of fenbendazole, levamisole and rafoxanide were tested by faecal egg count reduction (FECR) tests. Efficacies of 80% were considered a threshold for anthelmintic resistance. The FECR tests showed that all drugs tested more than 80% effective in most instances, but there were notable exceptions. In 1 case, rafoxanide was only 31% effective and in another case fenbendazole was only 47% effective. The occurrence of anthelmintic resistance in this farming sector is of concern. Steps should be taken to prevent its further spread and to avoid the development of a situation as on numerous commercial sheep farms in South Africa where resistance is very common.

Lead in school drinking water: Canada can and should address this important ongoing exposure source.

PubMed

Barn, Prabjit; Kosatsky, Tom

2011-01-01

Reducing all preventable lead exposures in children should be a public health priority given that blood lead levels in children that were once considered "safe" have since been associated with important neuro-developmental deficits. Limited Canadian data indicate that school drinking water can be an important component of children's overall exposure to lead. Outside of Ontario, however, Canadian schools are not required to test for lead in water; in most of Canada, school testing is case by case, typically initiated by parental concerns. Provinces and territories are encouraged to follow Ontario's example by instituting a routine school water lead testing program in order to identify facilities where action can result in a decrease in students' exposure to lead. Testing and remediation frameworks developed by the US Environmental Protection Agency, Health Canada, and the province of Ontario provide direction to school boards and local and provincial/territorial health authorities.

Multidimensional Scoring of Abilities: The Ordered Polytomous Response Case

ERIC Educational Resources Information Center

de la Torre, Jimmy

2008-01-01

Recent work has shown that multidimensionally scoring responses from different tests can provide better ability estimates. For educational assessment data, applications of this approach have been limited to binary scores. Of the different variants, the de la Torre and Patz model is considered more general because implementing the scoring procedure…

[Complicated urinary tract infections--from the perspective of the medical technologist].

PubMed

Nagasawa, Zenzo

2002-07-01

We would like to propose re-establishment of the protocol for ordering a clinical microbiology laboratory test after a bedside screening test using urine reagent strip when urinary tract infection is suspected. Media for isolation shall be chosen by the clinical microbiology laboratory after checking turbidity and microscopic examination of the urine specimen. In cases of complicated urinary tract infections, quantitative culture should be performed to investigate changes in the number of microorganism to grasp condition of super infection. In such infections, there are many cases in which multiple microorganism growth including glucose non-fermenting gram-negative bacilli can be recognized. Therefore, it is necessary to inspect colonies on media as long as possible (24 hrs culture may be short in some cases). The protocol for microorganism identification and susceptibility test for such specimen varies in each laboratory, considering the Health Insurance Point System (reimbursement system by MHW). It is necessary to communicate with physicians and to refer to past results to proceed with the laboratory test properly. Therefore, a Certified Clinical Microbiology Medical Technologist is needed and the role played by such staff is important.

Assessment of coliphage surrogates for testing drinking water treatment devices.

PubMed

Gerba, Charles P; Abd-Elmaksoud, Sherif; Newick, Huikheng; El-Esnawy, Nagwa A; Barakat, Ahmed; Ghanem, Hossam

2015-03-01

Test protocols have been developed by the United States Environmental Protection Agency (USEPA) and the World Health Organization (WHO) to test water treatment devices/systems that are used at the individual and home levels to ensure the removal of waterborne viruses. The goal of this study was to assess if coliphage surrogates could be used in this testing in place of the currently required use of animal or human enteric viruses. Five different coliphages (MS-2, PRD1, ΦX-174, Qβ, and fr) were compared to the removal of poliovirus type 1 (LSc-2ab) by eight different water treatment devices/systems using a general case and a challenge case (high organic load, dissolved solids, and turbidity) test water as defined by the USEPA. The performance of the units was rated as a pass/fail based on a 4 log removal/inactivation of the viruses. In all cases, a failure or a pass of the units/system for poliovirus also corresponded to a pass/fail by all of the coliphages. In summary, in using pass/fail criteria as recommended under USEPA guidelines for testing water treatment device/systems, the use of coliphages should be considered as an alternative to reduce cost and time of testing such devices/systems.

[Urinary pneumococcal or Legionella antigen detection tests and low-spectrum antibiotic therapy for community-acquired pneumonia].

PubMed

Roger, P-M; Risso, K; Hyvernat, H; Landraud, L; Vassallo, M; Dellamonica, J; de Salvador, F; Cua, E; Bernardin, G

2010-06-01

We performed urinary antigen tests for pneumococcus and Legionella for patients with community-acquired pneumonia (CAP), to prescribe a documented antibiotic therapy. We report the efficiency of low-spectrum antibiotic treatment, illustrating the inappropriateness of bacteriological respiratory sampling. Patients with CAP were enrolled from three different units; the pneumonia severity index was used to assess the disease. Respiratory samples were also listed. Low-spectrum antibiotic therapy was amoxicillin for pneumococcal infection, and macrolides or non-anti-pneumococcal fluoroquinolone for legionellosis. Six hundred and seventy-five CAP were diagnosed during the study period,, 150 with positive urinary antigen tests (23%), among which 108 pneumococcal infections (73%), 40 legionellosis (26%), and two mixed infections. The pneumonia severity index was 106+/-38. Amoxicillin was prescribed in 108 cases, fluoroquinolone in 24 cases, macrolide in 18 cases. The outcome was favourable for 138 patients (92%). Eighty three respiratory samples allowed identification of a bacterium for 58 patients (39%), among which 24 strains were not in the antibiotic spectrum: Haemophilus influenzae and Pseudmomonas aeruginosa in six cases, Staphylococcus aureus in five cases, Klebsiella pneumoniae in two cases, and another Gram negative bacillus in five cases. These strains were resistant in vitro to the prescribed treatment in 19/24 cases (79%). One out of 12 patients who died had a respiratory sample positive for Enterobacter spp strain resistant to the ongoing antibiotic treatment. The low-spectrum antibiotic therapy based on urinary antigen tests is efficient, and demonstrates respiratory tract colonisation with bacteriological strains usually considered as pathogenic.

A new approach to the use of α-fetoprotein as surveillance test for hepatocellular carcinoma in patients with cirrhosis

PubMed Central

Biselli, M; Conti, F; Gramenzi, A; Frigerio, M; Cucchetti, A; Fatti, G; D'Angelo, M; Dall'Agata, M; Giannini, E G; Farinati, F; Ciccarese, F; Andreone, P; Bernardi, M; Trevisani, F

2015-01-01

Background: Surveillance for hepatocellular carcinoma (HCC) is recommended in patients with cirrhosis. As α-fetoprotein (AFP) is considered a poor surveillance test, we tested the performance of its changes over time. Methods: Eighty patients were diagnosed with HCC (cases) during semiannual surveillance with ultrasonography and AFP measurement were recruited and matched for age, gender, etiology and Child-Pugh class with 160 contemporary cancer-free controls undergoing the same surveillance training group (TG). As a validation group (VG) we considered 36 subsequent patients diagnosed with HCC, matched 1 : 3 with contemporary cancer-free controls. α-Fetoprotein values at the time of HCC diagnosis (T0) and its changes over the 12 (Δ12) and 6 months (Δ6) before cancer detection were considered. Results: In both TG and VG, >80% of HCCs were found at an early stage. In TG, AFP significantly increased over time only in cases. T0 AFP and a positive Δ6 were independently associated with HCC diagnosis (odds ratio: 1.031 and 2.402, respectively). The area under the curve of T0 AFP was 0.76 and its best cutoff (BC) was 10 ng ml−1 (sensitivity 66.3%, specificity 80.6%). The combination of AFP >10 ng ml−1 or a positive Δ6 composite α-fetoprotein index (CAI) increased the sensitivity to 80% with a negative predictive value (NPV) of 86.2%. Negative predictive value rose to 99%, considering a cancer prevalence of 3%. In the VG, the AFP-BC was again 10 ng ml−1 (sensitivity 66.7%, specificity 88.9%), and CAI sensitivity was 80.6% with a NPV value of 90.5%. Conclusions: CAI achieves adequate sensitivity and NPV as a surveillance test for the early detection of HCC in cirrhosis. PMID:25314061

Groundwater flow and heat transport for systems undergoing freeze-thaw: Intercomparison of numerical simulators for 2D test cases

NASA Astrophysics Data System (ADS)

Grenier, Christophe; Anbergen, Hauke; Bense, Victor; Chanzy, Quentin; Coon, Ethan; Collier, Nathaniel; Costard, François; Ferry, Michel; Frampton, Andrew; Frederick, Jennifer; Gonçalvès, Julio; Holmén, Johann; Jost, Anne; Kokh, Samuel; Kurylyk, Barret; McKenzie, Jeffrey; Molson, John; Mouche, Emmanuel; Orgogozo, Laurent; Pannetier, Romain; Rivière, Agnès; Roux, Nicolas; Rühaak, Wolfram; Scheidegger, Johanna; Selroos, Jan-Olof; Therrien, René; Vidstrand, Patrik; Voss, Clifford

2018-04-01

In high-elevation, boreal and arctic regions, hydrological processes and associated water bodies can be strongly influenced by the distribution of permafrost. Recent field and modeling studies indicate that a fully-coupled multidimensional thermo-hydraulic approach is required to accurately model the evolution of these permafrost-impacted landscapes and groundwater systems. However, the relatively new and complex numerical codes being developed for coupled non-linear freeze-thaw systems require verification. This issue is addressed by means of an intercomparison of thirteen numerical codes for two-dimensional test cases with several performance metrics (PMs). These codes comprise a wide range of numerical approaches, spatial and temporal discretization strategies, and computational efficiencies. Results suggest that the codes provide robust results for the test cases considered and that minor discrepancies are explained by computational precision. However, larger discrepancies are observed for some PMs resulting from differences in the governing equations, discretization issues, or in the freezing curve used by some codes.

High Order Numerical Methods for LES of Turbulent Flows with Shocks

NASA Technical Reports Server (NTRS)

Kotov, D. V.; Yee, H. C.; Hadjadj, A.; Wray, A.; Sjögreen, B.

2014-01-01

Simulation of turbulent flows with shocks employing explicit subgrid-scale (SGS) filtering may encounter a loss of accuracy in the vicinity of a shock. In this work we perform a comparative study of different approaches to reduce this loss of accuracy within the framework of the dynamic Germano SGS model. One of the possible approaches is to apply Harten's subcell resolution procedure to locate and sharpen the shock, and to use a one-sided test filter at the grid points adjacent to the exact shock location. The other considered approach is local disabling of the SGS terms in the vicinity of the shock location. In this study we use a canonical shock-turbulence interaction problem for comparison of the considered modifications of the SGS filtering procedure. For the considered test case both approaches show a similar improvement in the accuracy near the shock.

Is diabetes mellitus a risk factor for HCV infection?

PubMed

Picerno, I; Di Pietro, A; Spataro, P; Di Benedetto, A; Romano, G; Scoglio, M E

2002-01-01

The aim of this study was to investigate whether or not the diabetes mellitus may be considered a risk factor for the HCV infection. The HCV seroprevalence was evaluated in 254 diabetic subjects, whose anamnestic data and risk factors are known, in comparison to 223 first-time blood donors, carefully age- and gender-matched. The statistical analysis showed that the studied groups belonged to the same population (Mann-Whitney U test) and that there were no significant differences between cases and controls as regards HCV prevalence (Yates corrected chi 2 test). The obtained data underline the importance of the control group selection, especially in the studies considering age-related pathologies. The authors disprove type 2 diabetes as a risk factor for the HCV infection and consider that this is a valid hypothesis only when the hepatitis C was unknown and not adequate prevention was used.

Pulmonary involvement of secondary syphilis.

PubMed

Ogawa, Yoshihiko; Imai, Yuichiro; Yoshihara, Shingo; Fujikura, Hiroyuki; Hirai, Nobuyasu; Sato, Masatoshi; Ogawa, Taku; Uno, Kenji; Kasahara, Kei; Yano, Hisakazu; Mikasa, Keiichi

2018-01-01

Pulmonary involvement in secondary syphilis is considered a rare occurrence; however, the number of cases has increased in the 2000s. This is likely due to the increased use of computed tomography scans and molecular diagnostic testing. We report a case of an HIV-positive man with pleural chest pain and bilateral subpleural nodules on chest computed tomography. His rapid plasma reagin and Treponema pallidum hemagglutination tests were positive, and the specimen of one of the pulmonary nodules obtained by transthoracic biopsy was positive for the polA gene of Treponema pallidum. Since clinical manifestations of syphilis are highly variable, clinicians should bear in mind that pleural chest pain with bilateral subpleural nodules can be caused by pulmonary syphilis.

Use of Patients With Diarrhea Who Test Negative for Rotavirus as Controls to Estimate Rotavirus Vaccine Effectiveness Through Case-Control Studies.

PubMed

Tate, Jacqueline E; Patel, Manish M; Cortese, Margaret M; Payne, Daniel C; Lopman, Benjamin A; Yen, Catherine; Parashar, Umesh D

2016-05-01

Case-control studies are often performed to estimate postlicensure vaccine effectiveness (VE), but the enrollment of controls can be challenging, time-consuming, and costly. We evaluated whether children enrolled in the same hospital-based diarrheal surveillance used to identify rotavirus cases but who test negative for rotavirus (test-negative controls) can be considered a suitable alternative to nondiarrheal hospital or community-based control groups (traditional controls). We compared calculated VE estimates as a function of varying values of true VE, attack rates of rotavirus and nonrotavirus diarrhea in the population, and sensitivity and specificity of the rotavirus enzyme immunoasssay. We also searched the literature to identify rotavirus VE studies that used traditional and test-negative control groups and compared VE estimates obtained using the different control groups. Assuming a 1% attack rate for severe rotavirus diarrhea, a 3% attack rate for severe nonrotavirus diarrhea in the population, a test sensitivity of 96%, and a specificity of 100%, the calculated VE estimates using both the traditional and test-negative control groups closely approximated the true VE for all values from 30% to 100%. As true VE decreased, the traditional case-control approach slightly overestimated the true VE and the test-negative case-control approach slightly underestimated this estimate, but the absolute difference was only ±0.2 percentage points. Field VE estimates from 10 evaluations that used both traditional and test-negative control groups were similar regardless of control group used. The use of rotavirus test-negative controls offers an efficient and cost-effective approach to estimating rotavirus VE through case-control studies. Published by Oxford University Press for the Infectious Diseases Society of America 2016. This work is written by (a) US Government employee(s) and is in the public domain in the US.

[The value of allergy survey in a retrospective series of 40 patients with burning-mouth syndrome (stomatodynia)].

PubMed

Machet, L; Le Dû, S; Bernez, A; Pillette-Delarue, M; Lelièvre, G; Hoarau, C; Hüttenberger, B; Vaillant, L

2008-02-01

By definition, stomatodynia or burning-mouth syndrome involves oral pain with no causes being found on history taking or examination. An allergic origin is often suspected by doctors and patients alike. In this study, we attempted to assess the value of epicutaneous tests in demonstrating allergic causes for patients presenting stomatodynia. This was a single-centre retrospective study of patients undergoing epicutaneous tests between 1996 and 2003 to screen for allergic causes of mouth pain not accounted for by any abnormalities seen during examination performed at consultations for mouth disease. Forty patients were included (11 male, 29 female; mean age: 58 years), and 39 were excluded. Sixteen patients presented at least one positive test, with a total of 35 positive tests in all. In decreasing order of frequency, the causes were metals, mercury derivatives (nickel salts: n=5; chrome salts: n=3; palladium salts: n=2; phenylmercuric acetate: n=2; thiomersal: n=2; cobalt salts: n=1; gold salts: n=1; mercury: n=1) and resins (acrylates: n=4). The relevance of these test results was considered probable in three cases and possible in five cases, associated with the existence of metals or resins in patients' mouths. The Peru balm test was positive in four cases but was not relevant. Tests for personal products were negative in all cases, with the exception of one case of resin from a prosthesis and one case of tixocortol pivalate. Type I stomatodynia (daily occurrence with gradually increase in discomfort throughout the day) and type II stomatodynia (permanent) are not normally attributable to allergies. However, for type III stomatodynia (non-permanent, with acute episodes followed by remission), an allergy survey guided by questioning may be undertaken to determine the cause, primarily prostheses or diet. The relevance of positive test results must be interpreted with caution in view of the incidence of positive epicutaneous tests for metals and Peru balm among the general population studied.

The Leukocyte Esterase Strip Test has Practical Value for Diagnosing Periprosthetic Joint Infection After Total Knee Arthroplasty: A Multicenter Study.

PubMed

Koh, In J; Han, Seung B; In, Yong; Oh, Kwang J; Lee, Dae H; Kim, Tae K

2017-11-01

Leukocyte esterase (LE) was recently reported to be an accurate marker for diagnosing periprosthetic joint infection (PJI) as defined by the Musculoskeletal Infection Society (MSIS) criteria. However, the diagnostic value of the LE test for PJI after total knee arthroplasty (TKA), the reliability of the subjective visual interpretation of the LE test, and the correlation between the LE test results and the current MSIS criteria remain unclear. This study prospectively enrolled 60 patients undergoing revision TKA for either PJI or aseptic failure. Serological marker, synovial fluid, and histological analyses were performed in all cases. The PJI group comprised 38 cases that met the MSIS criteria and the other 22 cases formed the aseptic group. All the LE tests were interpreted using both visual judgment and automated colorimetric reader. When "++" results were considered to indicate a positive PJI, the sensitivity, specificity, positive and negative predictive value, and diagnostic accuracy were 84, 100, 100, 79, and 90%, respectively. The visual interpretation agreed with the automated colorimetric reader in 90% of cases (Cronbach α = 0.894). The grade of the LE test was strongly correlated with the synovial white blood cell count (ρ = 0.695) and polymorphonuclear leukocyte percentage (ρ = 0.638) and moderately correlated with the serum C-reactive protein and erythrocyte sedimentation rate. The LE test has high diagnostic value for diagnosing PJI after TKA. Subjective visual interpretation of the LE test was reliable and valid for the current battery of PJI diagnostic tests according to the MSIS criteria. Copyright © 2017. Published by Elsevier Inc.

Detection of fetal cell-free DNA in maternal plasma for Down syndrome, Edward syndrome and Patau syndrome of high risk fetus

PubMed Central

Ke, Wei-Lin; Zhao, Wei-Hua; Wang, Xin-Yu

2015-01-01

Objective: The study aimed to validate the efficacy of detection of fetal cell-free DNA in maternal plasma of trisomy 21, 18 and 13 in a clinical setting. Methods: A total of 2340 women at high risk for Down syndrome based on maternal age, prenatal history or a positive sesum or sonographic screening test were offered prenatal noninvasive aneuploidy test. According to the prenatal noninvasive aneuploidy test, the pregnant women at high risk were offered amniocentesis karyotype analysis and the pregnant at low risk were followed up to make sure the newborn outcome. Results: The prenatal noninvasive aneuploidy test was positive for trisomy 21 in 17 cases, for trisomy 18 in 6 cases and for trisomy 13 in 1 case, which of all were confirmed by karyotype analysis. Newborns of low risk gestational woman detected by prenatal noninvasive aneuploidy for trisomy 21, 18, 13 were followed up and no one was found with trisomy. Conclusions: The prenatal noninvasive aneuploidy test is highly accurate for detection of trisomy 21, 18 and 13, which can be considered as a practical alternative for traditional invasive diagnostic procedures. PMID:26309618

Detection of fetal cell-free DNA in maternal plasma for Down syndrome, Edward syndrome and Patau syndrome of high risk fetus.

PubMed

Ke, Wei-Lin; Zhao, Wei-Hua; Wang, Xin-Yu

2015-01-01

The study aimed to validate the efficacy of detection of fetal cell-free DNA in maternal plasma of trisomy 21, 18 and 13 in a clinical setting. A total of 2340 women at high risk for Down syndrome based on maternal age, prenatal history or a positive sesum or sonographic screening test were offered prenatal noninvasive aneuploidy test. According to the prenatal noninvasive aneuploidy test, the pregnant women at high risk were offered amniocentesis karyotype analysis and the pregnant at low risk were followed up to make sure the newborn outcome. The prenatal noninvasive aneuploidy test was positive for trisomy 21 in 17 cases, for trisomy 18 in 6 cases and for trisomy 13 in 1 case, which of all were confirmed by karyotype analysis. Newborns of low risk gestational woman detected by prenatal noninvasive aneuploidy for trisomy 21, 18, 13 were followed up and no one was found with trisomy. The prenatal noninvasive aneuploidy test is highly accurate for detection of trisomy 21, 18 and 13, which can be considered as a practical alternative for traditional invasive diagnostic procedures.

Group Sequential Testing of the Predictive Accuracy of a Continuous Biomarker with Unknown Prevalence

PubMed Central

Koopmeiners, Joseph S.; Feng, Ziding

2015-01-01

Group sequential testing procedures have been proposed as an approach to conserving resources in biomarker validation studies. Previously, Koopmeiners and Feng (2011) derived the asymptotic properties of the sequential empirical positive predictive value (PPV) and negative predictive value curves, which summarize the predictive accuracy of a continuous marker, under case-control sampling. A limitation of their approach is that the prevalence can not be estimated from a case-control study and must be assumed known. In this manuscript, we consider group sequential testing of the predictive accuracy of a continuous biomarker with unknown prevalence. First, we develop asymptotic theory for the sequential empirical PPV and NPV curves when the prevalence must be estimated, rather than assumed known in a case-control study. We then discuss how our results can be combined with standard group sequential methods to develop group sequential testing procedures and bias-adjusted estimators for the PPV and NPV curve. The small sample properties of the proposed group sequential testing procedures and estimators are evaluated by simulation and we illustrate our approach in the context of a study to validate a novel biomarker for prostate cancer. PMID:26537180

Testing for genetic association taking into account phenotypic information of relatives.

PubMed

Uh, Hae-Won; Wijk, Henk Jan van der; Houwing-Duistermaat, Jeanine J

2009-12-15

We investigated efficient case-control association analysis using family data. The outcome of interest was coronary heart disease. We employed existing and new methods that take into account the correlations among related individuals to obtain the proper type I error rates. The methods considered for autosomal single-nucleotide polymorphisms were: 1) generalized estimating equations-based methods, 2) variance-modified Cochran-Armitage (MCA) trend test incorporating kinship coefficients, and 3) genotypic modified quasi-likelihood score test. Additionally, for X-linked single-nucleotide polymorphisms we proposed a two-degrees-of-freedom test. Performance of these methods was tested using Framingham Heart Study 500 k array data.

Validating a UAV artificial intelligence control system using an autonomous test case generator

NASA Astrophysics Data System (ADS)

Straub, Jeremy; Huber, Justin

2013-05-01

The validation of safety-critical applications, such as autonomous UAV operations in an environment which may include human actors, is an ill posed problem. To confidence in the autonomous control technology, numerous scenarios must be considered. This paper expands upon previous work, related to autonomous testing of robotic control algorithms in a two dimensional plane, to evaluate the suitability of similar techniques for validating artificial intelligence control in three dimensions, where a minimum level of airspeed must be maintained. The results of human-conducted testing are compared to this automated testing, in terms of error detection, speed and testing cost.

Diagnostic yield of hair and urine toxicology testing in potential child abuse cases.

PubMed

Stauffer, Stephanie L; Wood, Stephanie M; Krasowski, Matthew D

2015-07-01

Detection of drugs in a child may be the first objective finding that can be reported in cases of suspected child abuse. Hair and urine toxicology testing, when performed as part of the initial clinical evaluation for suspected child abuse or maltreatment, may serve to facilitate the identification of at-risk children. Furthermore, significant environmental exposure to a drug (considered by law to constitute child abuse in some states) may be identified by toxicology testing of unwashed hair specimens. In order to determine the clinical utility of hair and urine toxicology testing in this population we performed a retrospective chart review on all children for whom hair toxicology testing was ordered at our academic medical center between January 2004 and April 2014. The medical records of 616 children aged 0-17.5 years were reviewed for injury history, previous medication and illicit drug use by caregiver(s), urine drug screen result (if performed), hair toxicology result, medication list, and outcome of any child abuse evaluation. Hair toxicology testing was positive for at least one compound in 106 cases (17.2%), with unexplained drugs in 82 cases (13.3%). Of these, there were 48 cases in which multiple compounds (including combination of parent drugs and/or metabolites within the same drug class) were identified in the sample of one patient. The compounds most frequently identified in the hair of our study population included cocaine, benzoylecgonine, native (unmetabolized) tetrahydrocannabinol, and methamphetamine. There were 68 instances in which a parent drug was identified in the hair without any of its potential metabolites, suggesting environmental exposure. Among the 82 cases in which hair toxicology testing was positive for unexplained drugs, a change in clinical outcome was noted in 71 cases (86.5%). Urine drug screens (UDS) were performed in 457 of the 616 reviewed cases. Of these, over 95% of positive UDS results could be explained by iatrogenic drug administration. There were no cases in which a urine drug screen alone altered the outcome of a case. In summary, hair toxicology testing proved clinically useful in the evaluation of a child for suspected abuse; in contrast, urine drug testing showed low clinical yield. Copyright © 2015 Elsevier Ltd and Faculty of Forensic and Legal Medicine. All rights reserved.

Study of quality perception in medical images based on comparison of contrast enhancement techniques in mammographic images

NASA Astrophysics Data System (ADS)

Matheus, B.; Verçosa, L. B.; Barufaldi, B.; Schiabel, H.

2014-03-01

With the absolute prevalence of digital images in mammography several new tools became available for radiologist; such as CAD schemes, digital zoom and contrast alteration. This work focuses in contrast variation and how the radiologist reacts to these changes when asked to evaluated image quality. Three contrast enhancing techniques were used in this study: conventional equalization, CCB Correction [1] - a digitization correction - and value subtraction. A set of 100 images was used in tests from some available online mammographic databases. The tests consisted of the presentation of all four versions of an image (original plus the three contrast enhanced images) to the specialist, requested to rank each one from the best up to worst quality for diagnosis. Analysis of results has demonstrated that CCB Correction [1] produced better images in almost all cases. Equalization, which mathematically produces a better contrast, was considered the worst for mammography image quality enhancement in the majority of cases (69.7%). The value subtraction procedure produced images considered better than the original in 84% of cases. Tests indicate that, for the radiologist's perception, it seems more important to guaranty full visualization of nuances than a high contrast image. Another result observed is that the "ideal" scanner curve does not yield the best result for a mammographic image. The important contrast range is the middle of the histogram, where nodules and masses need to be seen and clearly distinguished.

Evaluating a point-of-care circulating cathodic antigen test (POC-CCA) to detect Schistosoma mansoni infections in a low endemic area in north-eastern Brazil.

PubMed

Bezerra, Fernando Schemelzer Moraes; Leal, Joames Kauffimann Freitas; Sousa, Mariana Silva; Pinheiro, Marta Cristhiany Cunha; Ramos, Alberto Novaes; Silva-Moraes, Vanessa; Katz, Naftale

2018-06-01

Schistosomiasis is still a public health problem in Brazil. The Kato-Katz test is the most frequently used diagnostic method for Schistosoma mansoni infection. However, it lacks sensitivity in areas of low prevalence. We have assessed the positivity rate of S. mansoni infection in Bananeiras, a village on Capistrano, Ceara, Brazil by performing a point-of-care test in urine to determine the circulating cathodic antigens (POC-CCA), and we compared the findings with those of the Kato-Katz technique for egg detection in stool and an enzyme-linked immunosorbent assay for specific antibodies against adult worms (SWAP-ELISA) in serum before treatment (baseline). Additionally, the POC-CCA and Kato-Katz test results were compared at one and two years post-treatment, and only POC-CCA strips were utilised for follow-up testing on urine samples at 3-6 weeks. Only one sample of stool and urine was collected per event. Overall, 258 individuals were investigated at the baseline. The POC-CCA test detected 10 (3.9%) positive cases; however, this amount increased to 30 (11.6%) when considering trace readings as positive (t + ), whereas the Kato-Katz method found only 4 (1.6%) positive cases and the SWAP-ELISA detected 105 (40.7%) positive cases. The consistency observed between a single POC-CCA (t + ) or (t-) and the Kato-Katz (three slides) was poor (Kappa indexes <0.20). The highest positivity rate as determined by CCA and Kato-Katz was found in adults. At the baseline, a praziquantel treatment was administered to all individuals regardless of their infection status. According to the POC-CCA test, 93% of the previous positive cases became negative by the third week after the treatment; this rate reached 100% at the sixth week assessment. The follow-up showed that of the 175 individuals evaluated at one year post-treatment, only one (0.6%) showed 'trace' results, and all the individuals were negative for eggs in the stool. At two years, all 185 examined individuals were negative by the Kato-Katz method, and 11 (5.9%) presented traces by POC-CCA. Our results indicate that a single POC-CCA test reveals a significantly higher number of positive cases than the Kato-Katz technique for diagnosing S. mansoni in a low endemic setting, when trace results are considered as positive cases. Nevertheless, the true significance of the trace is not clear. These findings reinforce the need to associate different tools for improved schistosomiasis diagnosis in individuals with low parasite burdens. Copyright © 2018. Published by Elsevier B.V.

Development of a Quantitative Decision Metric for Selecting the Most Suitable Discretization Method for SN Transport Problems

NASA Astrophysics Data System (ADS)

Schunert, Sebastian

In this work we develop a quantitative decision metric for spatial discretization methods of the SN equations. The quantitative decision metric utilizes performance data from selected test problems for computing a fitness score that is used for the selection of the most suitable discretization method for a particular SN transport application. The fitness score is aggregated as a weighted geometric mean of single performance indicators representing various performance aspects relevant to the user. Thus, the fitness function can be adjusted to the particular needs of the code practitioner by adding/removing single performance indicators or changing their importance via the supplied weights. Within this work a special, broad class of methods is considered, referred to as nodal methods. This class is naturally comprised of the DGFEM methods of all function space families. Within this work it is also shown that the Higher Order Diamond Difference (HODD) method is a nodal method. Building on earlier findings that the Arbitrarily High Order Method of the Nodal type (AHOTN) is also a nodal method, a generalized finite-element framework is created to yield as special cases various methods that were developed independently using profoundly different formalisms. A selection of test problems related to a certain performance aspect are considered: an Method of Manufactured Solutions (MMS) test suite for assessing accuracy and execution time, Lathrop's test problem for assessing resilience against occurrence of negative fluxes, and a simple, homogeneous cube test problem to verify if a method possesses the thick diffusive limit. The contending methods are implemented as efficiently as possible under a common SN transport code framework to level the playing field for a fair comparison of their computational load. Numerical results are presented for all three test problems and a qualitative rating of each method's performance is provided for each aspect: accuracy/efficiency, resilience against negative fluxes, and possession of the thick diffusion limit, separately. The choice of the most efficient method depends on the utilized error norm: in Lp error norms higher order methods such as the AHOTN method of order three perform best, while for computing integral quantities the linear nodal (LN) method is most efficient. The most resilient method against occurrence of negative fluxes is the simple corner balance (SCB) method. A validation of the quantitative decision metric is performed based on the NEA box-inbox suite of test problems. The validation exercise comprises two stages: first prediction of the contending methods' performance via the decision metric and second computing the actual scores based on data obtained from the NEA benchmark problem. The comparison of predicted and actual scores via a penalty function (ratio of predicted best performer's score to actual best score) completes the validation exercise. It is found that the decision metric is capable of very accurate predictions (penalty < 10%) in more than 83% of the considered cases and features penalties up to 20% for the remaining cases. An exception to this rule is the third test case NEA-III intentionally set up to incorporate a poor match of the benchmark with the "data" problems. However, even under these worst case conditions the decision metric's suggestions are never detrimental. Suggestions for improving the decision metric's accuracy are to increase the pool of employed data, to refine the mapping of a given configuration to a case in the database, and to better characterize the desired target quantities.

Thyrotoxicosis presenting as acute bulbar palsy.

PubMed

Mathew, Betsy; Devasia, Anup J; Ayyar, Vaggesh; Thyagaraj, Vijayasree; Francis, Geetha Ann

2011-06-01

Myopathy chiefly affecting the proximal muscles of the limbs is frequently seen in hyperthyroidism. But isolated acute bulbar palsy without skeletal muscle involvement is rare in thyrotoxicosis. We report the case of a 52 year old man who presented with severe dysphagia, dysphonia and bouts of aspiration. Laboratory testing revealed an underlying Graves' thyrotoxicosis. His symptoms recovered dramatically within 6 weeks with treatment of hyperthyroidism. This case is reported to emphasize that thyrotoxicosis should be considered in the differential diagnosis of dysphagia of obscure etiology.

Monitoring of civil infrastructures by interferometric radar: a review.

PubMed

Pieraccini, Massimiliano

2013-01-01

Ground-based radar interferometry is an increasingly popular technique for monitoring civil infrastructures. Many research groups, professionals, and companies have tested it in different operative scenarios, so it is time for a first systematic survey of the case studies reported in the literature. This review is addressed especially to the engineers and scientists interested to consider the applicability of the technique to their practice, so it is focused on the issues of the practical cases rather than on theory and principles, which are now well consolidated.

Prospective, multicenter clinical trial to validate new products for skin tests in the diagnosis of allergy to penicillin.

PubMed

Fernández, J; Torres, M J; Campos, J; Arribas-Poves, F; Blanca, M

2013-01-01

Allergy to penicillin is the most commonly reported type of drug hypersensitivity. Diagnosis is currently confirmed using skin tests with benzylpenicillin reagents, ie, penicilloyl-polylysine (PPL) as the major determinant of benzylpenicillin and benzylpenicillin, benzylpenicilloate and benzylpenilloate as a minor determinant mixture (MDM). To synthesize and assess the diagnostic capacity of 2 new benzylpenicillin reagents in patients with immediate hypersensitivity reactions to B-lactams: benzylpenicilloyl octa-L-lysine (BP-OL) as the major determinant and benzylpenilloate (penilloate) as the minor determinant. Prospective multicenter clinical trial performed in 18 Spanish centers. Efficacy was assessed by detection of positive skin test results in an allergic population and negative skin test results in a nonallergic, drug-exposed population. Sensitivity, specificity, and negative and positive predictive values were determined. The study sample comprised 94 allergic patients: 31 (35.23%) presented anaphylaxis, 4 (4.55%) anaphylactic shock, 51 (58.04%) urticaria, and 2 (2.27%) no specific condition. The culprit 8-lactams were amoxicillin in 63 cases (71.60%), benzypencillin in 14 cases (15.89%), cephalosporins in 2 cases (2.27%), other drugs in 3 cases (3.42%), and unidentified agents in 6 cases (6.82%). The results of testing with BP-OL were positive in 46 cases (52.3%); the results of testing with penilloate were positive in 33 cases (37.5%). When both reagents were taken into consideration, sensitivity reached 61.36% and specificity 100%. Skin testing with penilloate was significantly more often negative when the interval between the reaction and the study was longer. The sensitivity of BP-OL and penilloate was 61%. Considering that amoxicillin was the culprit drug in 71% of reactions, these results indicate that most patients were allergic to the whole group of penicillins. These data support the use of benzylpenicillin determinants in the diagnosis of allergy to beta-lactams, even in predominantly amoxicillin-allergic populations.

PubMed Central

2017-01-01

SUMMARY Differential diagnosis between peripheral and central spontaneous nystagmus can be difficult to classify (as peripheral or central) even on the basis of criteria recommended in the recent literature. The aim of this paper is to use the combination of spontaneous nystagmus and ocular tilt reaction to determine the site of origin of the disease that causes nystagmus. We propose to classify the nystagmus in: 1) "Uphill" nystagmus in which the nystagmus takes on an inclined plane and the direction of the fast phase is towards the hypertropic eye (this type of nystagmus is likely peripheral); 2) "Downhill" nystagmus when the nystagmus beats toward the hypotropic eye (this type of nystagmus is likely central); 3) "Flat" nystagmus when the plane on which nystagmus beats is perfectly horizontal: in this case, we cannot say anything about the site of lesion (it was only detected in 15% of cases). The spatial position of nystagmus vector has to be considered as an intrinsic characteristic of the nystagmus itself (as direction, frequency, angular velocity etc.) and must be reported in the description, possibly giving an indication of the site of damage (peripheral or central). In particular, similar results are obtained by comparing the inclination of the nystagmus with the head impulse test (HIT, considered the best bedside test now available). It seems that this sign may confirm HIT for safer diagnosis or replace it in case of doubt. In contrast, in case of "Flat" nystagmus (probably attributable to the fact that the utricular maculae are spared), HIT can replace observation of the plane of the nystagmus. Thus, the two signs confirm and integrate each other. The test does not require additional time and is not tedious for the patient. It is proposed that it be included in the evaluation of spontaneous nystagmus in everyday clinical practice. PMID:29327737

Well hydraulics in pumping tests with exponentially decayed rates of abstraction in confined aquifers

NASA Astrophysics Data System (ADS)

Wen, Zhang; Zhan, Hongbin; Wang, Quanrong; Liang, Xing; Ma, Teng; Chen, Chen

2017-05-01

Actual field pumping tests often involve variable pumping rates which cannot be handled by the classical constant-rate or constant-head test models, and often require a convolution process to interpret the test data. In this study, we proposed a semi-analytical model considering an exponentially decreasing pumping rate started at a certain (higher) rate and eventually stabilized at a certain (lower) rate for cases with or without wellbore storage. A striking new feature of the pumping test with an exponentially decayed rate is that the drawdowns will decrease over a certain period of time during intermediate pumping stage, which has never been seen before in constant-rate or constant-head pumping tests. It was found that the drawdown-time curve associated with an exponentially decayed pumping rate function was bounded by two asymptotic curves of the constant-rate tests with rates equaling to the starting and stabilizing rates, respectively. The wellbore storage must be considered for a pumping test without an observation well (single-well test). Based on such characteristics of the time-drawdown curve, we developed a new method to estimate the aquifer parameters by using the genetic algorithm.

Quantum entanglement for systems of identical bosons: II. Spin squeezing and other entanglement tests

NASA Astrophysics Data System (ADS)

Dalton, B. J.; Goold, J.; Garraway, B. M.; Reid, M. D.

2017-02-01

These two accompanying papers are concerned with entanglement for systems of identical massive bosons and the relationship to spin squeezing and other quantum correlation effects. The main focus is on two mode entanglement, but multi-mode entanglement is also considered. The bosons may be atoms or molecules as in cold quantum gases. The previous paper I dealt with the general features of quantum entanglement and its specific definition in the case of systems of identical bosons. Entanglement is a property shared between two (or more) quantum sub-systems. In defining entanglement for systems of identical massive particles, it was concluded that the single particle states or modes are the most appropriate choice for sub-systems that are distinguishable, that the general quantum states must comply both with the symmetrization principle and the super-selection rules (SSR) that forbid quantum superpositions of states with differing total particle number (global SSR compliance). Further, it was concluded that (in the separable states) quantum superpositions of sub-system states with differing sub-system particle number (local SSR compliance) also do not occur. The present paper II determines possible tests for entanglement based on the treatment of entanglement set out in paper I. Several inequalities involving variances and mean values of operators have been previously proposed as tests for entanglement between two sub-systems. These inequalities generally involve mode annihilation and creation operators and include the inequalities that define spin squeezing. In this paper, spin squeezing criteria for two mode systems are examined, and spin squeezing is also considered for principle spin operator components where the covariance matrix is diagonal. The proof, which is based on our SSR compliant approach shows that the presence of spin squeezing in any one of the spin components requires entanglement of the relevant pair of modes. A simple Bloch vector test for entanglement is also derived. Thus we show that spin squeezing becomes a rigorous test for entanglement in a system of massive bosons, when viewed as a test for entanglement between two modes. In addition, other previously proposed tests for entanglement involving spin operators are considered, including those based on the sum of the variances for two spin components. All of the tests are still valid when the present concept of entanglement based on the symmetrization and SSR criteria is applied. These tests also apply in cases of multi-mode entanglement, though with restrictions in the case of sub-systems each consisting of pairs of modes. Tests involving quantum correlation functions are also considered and for global SSR compliant states these are shown to be equivalent to tests involving spin operators. A new weak correlation test is derived for entanglement based on local SSR compliance for separable states, complementing the stronger correlation test obtained previously when this is ignored. The Bloch vector test is equivalent to one case of this weak correlation test. Quadrature squeezing for single modes is also examined but not found to yield a useful entanglement test, whereas two mode quadrature squeezing proves to be a valid entanglement test, though not as useful as the Bloch vector test. The various entanglement tests are considered for well-known entangled states, such as binomial states, relative phase eigenstates and NOON states—sometimes the new tests are satisfied while than those obtained in other papers are not. The present paper II then outlines the theory for a simple two mode interferometer showing that such an interferometer can be used to measure the mean values and covariance matrix for the spin operators involved in entanglement tests for the two mode bosonic system. The treatment is also generalized to cover multi-mode interferometry. The interferometer involves a pulsed classical field characterized by a phase variable and an area variable defined by the time integral of the field amplitude, and leads to a coupling between the two modes. For simplicity the center frequency was chosen to be resonant with the inter-mode transition frequency. Measuring the mean and variance of the population difference between the two modes for the output state of the interferometer for various choices of interferometer variables is shown to enable the mean values and covariance matrix for the spin operators for the input quantum state of the two mode system to be determined. The paper concludes with a discussion of several key experimental papers on spin squeezing.

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

Mohapi, N.; Hees, A.; Larena, J., E-mail: n.mohapi@gmail.com, E-mail: a.hees@ru.ac.za, E-mail: j.larena@ru.ac.za

The Einstein Equivalence Principle is a fundamental principle of the theory of General Relativity. While this principle has been thoroughly tested with standard matter, the question of its validity in the Dark sector remains open. In this paper, we consider a general tensor-scalar theory that allows to test the equivalence principle in the Dark sector by introducing two different conformal couplings to standard matter and to Dark matter. We constrain these couplings by considering galactic observations of strong lensing and of velocity dispersion. Our analysis shows that, in the case of a violation of the Einstein Equivalence Principle, data favourmore » violations through coupling strengths that are of opposite signs for ordinary and Dark matter. At the same time, our analysis does not show any significant deviations from General Relativity.« less

Human Infection with a Zoonotic Orthopoxvirus in the Country of Georgia

PubMed Central

Vora, Neil M.; Li, Yu; Geleishvili, Marika; Emerson, Ginny L.; Khmaladze, Ekaterine; Maghlakelidze, Giorgi; Navdarashvili, Archil; Zakhashvili, Khatuna; Kokhreidze, Maka; Endeladze, Marina; Mokverashvili, Gela; Satheshkumar, P.S.; Gallardo-Romero, Nadia; Goldsmith, Cynthia S.; Metcalfe, Maureen G.; Damon, Inger; Maes, Edmond F.; Reynolds, Mary G.; Morgan, Juliette; Carroll, Darin S.

2015-01-01

Summary During 2013, cutaneous lesions developed in two men in the country of Georgia after they were exposed to ill cows. The men had never received vaccination against smallpox. Tests of lesion material with the use of a quantitative real-time polymerase-chain-reaction assay for non–variola virus orthopoxviruses were positive, and DNA sequence analysis implicated a novel orthopoxvirus species. During the ensuing epidemiologic investigation, no additional human cases were identified. However, serologic evidence of exposure to an orthopoxvirus was detected in cows in the patients’ herd and in captured rodents and shrews. A third case of human infection that occurred in 2010 was diagnosed retrospectively during testing of archived specimens that were originally submitted for tests to detect anthrax. Orthopoxvirus infection should be considered in persons in whom cutaneous lesions develop after contact with animals. PMID:25806914

Test-retest reliability of the Progressive Isoinertial Lifting Evaluation (PILE).

PubMed

Lygren, Hildegunn; Dragesund, Tove; Joensen, Jón; Ask, Tove; Moe-Nilssen, Rolf

2005-05-01

A repeated measures single group design. To investigate test-retest reliability of Progressive Isoinertial Lifting Evaluation on patients with long lasting musculoskeletal problems related to the lumbar spine. Test-retest reliability has been satisfactory in healthy men. Test-retest reliability for clinical populations has not been reported. A total of 31 patients (17 women and 14 men) with long lasting low back pain participated in the study. The patients were tested twice at an interval of 2 days and at the same time of the day. The heaviest load that the patient could lift 4 times was used as outcome measure. The error of measurement indicates that the true result in 95% of cases will be within +/-4.5 kg from the measured value, while the difference between 2 measurements in 95% of cases will be less than 6.4 kg. Intra-class correlation (1,1) was 0.91. Relative test-retest reliability was high assessed by intra-class correlation, but absolute measurement variability reported as the smallest detectable difference has relevance for the interpretation of clinical test results and should also be considered.

Comprehensive evaluation of the child with intellectual disability or global developmental delays.

PubMed

Moeschler, John B; Shevell, Michael

2014-09-01

Global developmental delay and intellectual disability are relatively common pediatric conditions. This report describes the recommended clinical genetics diagnostic approach. The report is based on a review of published reports, most consisting of medium to large case series of diagnostic tests used, and the proportion of those that led to a diagnosis in such patients. Chromosome microarray is designated as a first-line test and replaces the standard karyotype and fluorescent in situ hybridization subtelomere tests for the child with intellectual disability of unknown etiology. Fragile X testing remains an important first-line test. The importance of considering testing for inborn errors of metabolism in this population is supported by a recent systematic review of the literature and several case series recently published. The role of brain MRI remains important in certain patients. There is also a discussion of the emerging literature on the use of whole-exome sequencing as a diagnostic test in this population. Finally, the importance of intentional comanagement among families, the medical home, and the clinical genetics specialty clinic is discussed. Copyright © 2014 by the American Academy of Pediatrics.

Comparison of performance of the test of memory malingering and word memory test in a criminal forensic sample.

PubMed

Fazio, Rachel L; Sanders, James Forrest; Denney, Robert L

2015-06-01

Compared with the amount of neuropsychological literature surrounding response bias in civil litigation, there is little regarding criminal cases. This study adds to the criminal forensic neuropsychological literature by comparing the Test of Memory Malingering (TOMM) and the Word Memory Test (WMT) in a criminal forensic setting utilizing a criterion-groups design. Subjects were classified into two groups based on their performance on at least two other freestanding performance validity tests. The WMT demonstrated good sensitivity (95.1%) but poor specificity (68.4%) when Genuine Memory Impaired Profiles (GMIPs) were not considered. Inclusion of GMIPs reduced the sensitivity to 56.1% but increased the specificity to 94.7%. The TOMM evidenced better sensitivity but poorer specificity than the WMT with GMIPs. Conjoint use of the tests was also considered. Receiver operating characteristics and other classification statistics for each measure are presented. Results support the use of these measures in a criminal forensic population. © The Author 2015. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Comparison of various contact algorithms for poroelastic tissues.

PubMed

Galbusera, Fabio; Bashkuev, Maxim; Wilke, Hans-Joachim; Shirazi-Adl, Aboulfazl; Schmidt, Hendrik

2014-01-01

Capabilities of the commercial finite element package ABAQUS in simulating frictionless contact between two saturated porous structures were evaluated and compared with those of an open source code, FEBio. In ABAQUS, both the default contact implementation and another algorithm based on an iterative approach requiring script programming were considered. Test simulations included a patch test of two cylindrical slabs in a gapless contact and confined compression conditions; a confined compression test of a porous cylindrical slab with a spherical porous indenter; and finally two unconfined compression tests of soft tissues mimicking diarthrodial joints. The patch test showed almost identical results for all algorithms. On the contrary, the confined and unconfined compression tests demonstrated large differences related to distinct physical and boundary conditions considered in each of the three contact algorithms investigated in this study. In general, contact with non-uniform gaps between fluid-filled porous structures could be effectively simulated with either ABAQUS or FEBio. The user should be aware of the parameter definitions, assumptions and limitations in each case, and take into consideration the physics and boundary conditions of the problem of interest when searching for the most appropriate model.

Surface modification of nano-silica on the ligament advanced reinforcement system for accelerated bone formation: primary human osteoblasts testing in vitro and animal testing in vivo

NASA Astrophysics Data System (ADS)

Li, Mengmeng; Wang, Shiwen; Jiang, Jia; Sun, Jiashu; Li, Yuzhuo; Huang, Deyong; Long, Yun-Ze; Zheng, Wenfu; Chen, Shiyi; Jiang, Xingyu

2015-04-01

The Ligament Advanced Reinforcement System (LARS) has been considered as a promising graft for ligament reconstruction. To improve its biocompatibility and effectiveness on new bone formation, we modified the surface of a polyethylene terephthalate (PET) ligament with nanoscale silica using atom transfer radical polymerization (ATRP) and silica polymerization. The modified ligament is tested by both in vitro and in vivo experiments. Human osteoblast testing in vitro exhibits an ~21% higher value in cell viability for silica-modified grafts compared with original grafts. Animal testing in vivo shows that there is new formed bone in the case of a nanoscale silica-coated ligament. These results demonstrate that our approach for nanoscale silica surface modification on LARS could be potentially applied for ligament reconstruction.The Ligament Advanced Reinforcement System (LARS) has been considered as a promising graft for ligament reconstruction. To improve its biocompatibility and effectiveness on new bone formation, we modified the surface of a polyethylene terephthalate (PET) ligament with nanoscale silica using atom transfer radical polymerization (ATRP) and silica polymerization. The modified ligament is tested by both in vitro and in vivo experiments. Human osteoblast testing in vitro exhibits an ~21% higher value in cell viability for silica-modified grafts compared with original grafts. Animal testing in vivo shows that there is new formed bone in the case of a nanoscale silica-coated ligament. These results demonstrate that our approach for nanoscale silica surface modification on LARS could be potentially applied for ligament reconstruction. Electronic supplementary information (ESI) available. See DOI: 10.1039/c5nr01439e

Clinical Practice Guideline for Physical Therapy Assessment and Treatment in Patients With Nonspecific Neck Pain.

PubMed

Bier, Jasper D; Scholten-Peeters, Wendy G M; Staal, J Bart; Pool, Jan; van Tulder, Maurits W; Beekman, Emmylou; Knoop, Jesper; Meerhoff, Guus; Verhagen, Arianne P

2018-03-01

The Royal Dutch Society for Physical Therapy (KNGF) issued a clinical practice guideline for physical therapists that addresses the assessment and treatment of patients with nonspecific neck pain, including cervical radiculopathy, in Dutch primary care. Recommendations were based on a review of published systematic reviews.During the intake, the patient is screened for serious pathologies and corresponding patterns. Patients with cervical radiculopathy can be included or excluded through corresponding signs and symptoms and possibly diagnostic tests (Spurling test, traction/distraction test, and Upper Limb Tension Test). History taking is done to gather information about patients' limitations, course of pain, and prognostic factors (eg, coping style) and answers to health-related questions.In case of a normal recovery (treatment profile A), management should be hands-off, and patients should receive advice from the physical therapist and possibly some simple exercises to supplement "acting as usual."In case of a delayed/deviant recovery (treatment profile B), the physical therapist is advised to use, in addition to the recommendations for treatment profile A, forms of mobilization and/or manipulation in combination with exercise therapy. Other interventions may also be considered. The physical therapist is advised not to use dry needling, low-level laser, electrotherapy, ultrasound, traction, and/or a cervical collar.In case of a delayed/deviant recovery with clear and/or dominant psychosocial prognostic factors (treatment profile C), these factors should first be addressed by the physical therapist, when possible, or the patient should be referred to a specialist, when necessary.In case of neck pain grade III (treatment profile D), the therapy resembles that for profile B, but the use of a cervical collar for pain reduction may be considered. The advice is to use it sparingly: only for a short period per day and only for a few weeks.

Validation of software for calculating the likelihood ratio for parentage and kinship.

PubMed

Drábek, J

2009-03-01

Although the likelihood ratio is a well-known statistical technique, commercial off-the-shelf (COTS) software products for its calculation are not sufficiently validated to suit general requirements for the competence of testing and calibration laboratories (EN/ISO/IEC 17025:2005 norm) per se. The software in question can be considered critical as it directly weighs the forensic evidence allowing judges to decide on guilt or innocence or to identify person or kin (i.e.: in mass fatalities). For these reasons, accredited laboratories shall validate likelihood ratio software in accordance with the above norm. To validate software for calculating the likelihood ratio in parentage/kinship scenarios I assessed available vendors, chose two programs (Paternity Index and familias) for testing, and finally validated them using tests derived from elaboration of the available guidelines for the field of forensics, biomedicine, and software engineering. MS Excel calculation using known likelihood ratio formulas or peer-reviewed results of difficult paternity cases were used as a reference. Using seven testing cases, it was found that both programs satisfied the requirements for basic paternity cases. However, only a combination of two software programs fulfills the criteria needed for our purpose in the whole spectrum of functions under validation with the exceptions of providing algebraic formulas in cases of mutation and/or silent allele.

Implementation of and Ada real-time executive: A case study

NASA Technical Reports Server (NTRS)

Laird, James D.; Burton, Bruce A.; Koppes, Mary R.

1986-01-01

Current Ada language implementations and runtime environments are immature, unproven and are a key risk area for real-time embedded computer system (ECS). A test-case environment is provided in which the concerns of the real-time, ECS community are addressed. A priority driven executive is selected to be implemented in the Ada programming language. The model selected is representative of real-time executives tailored for embedded systems used missile, spacecraft, and avionics applications. An Ada-based design methodology is utilized, and two designs are considered. The first of these designs requires the use of vendor supplied runtime and tasking support. An alternative high-level design is also considered for an implementation requiring no vendor supplied runtime or tasking support. The former approach is carried through to implementation.

Tumor mismatch repair immunohistochemistry and DNA MLH1 methylation testing of patients with endometrial cancer diagnosed at age younger than 60 years optimizes triage for population-level germline mismatch repair gene mutation testing.

PubMed

Buchanan, Daniel D; Tan, Yen Y; Walsh, Michael D; Clendenning, Mark; Metcalf, Alexander M; Ferguson, Kaltin; Arnold, Sven T; Thompson, Bryony A; Lose, Felicity A; Parsons, Michael T; Walters, Rhiannon J; Pearson, Sally-Ann; Cummings, Margaret; Oehler, Martin K; Blomfield, Penelope B; Quinn, Michael A; Kirk, Judy A; Stewart, Colin J; Obermair, Andreas; Young, Joanne P; Webb, Penelope M; Spurdle, Amanda B

2014-01-10

Clinicopathologic data from a population-based endometrial cancer cohort, unselected for age or family history, were analyzed to determine the optimal scheme for identification of patients with germline mismatch repair (MMR) gene mutations. Endometrial cancers from 702 patients recruited into the Australian National Endometrial Cancer Study (ANECS) were tested for MMR protein expression using immunohistochemistry (IHC) and for MLH1 gene promoter methylation in MLH1-deficient cases. MMR mutation testing was performed on germline DNA of patients with MMR-protein deficient tumors. Prediction of germline mutation status was compared for combinations of tumor characteristics, age at diagnosis, and various clinical criteria (Amsterdam, Bethesda, Society of Gynecologic Oncology, ANECS). Tumor MMR-protein deficiency was detected in 170 (24%) of 702 cases. Germline testing of 158 MMR-deficient cases identified 22 truncating mutations (3% of all cases) and four unclassified variants. Tumor MLH1 methylation was detected in 99 (89%) of 111 cases demonstrating MLH1/PMS2 IHC loss; all were germline MLH1 mutation negative. A combination of MMR IHC plus MLH1 methylation testing in women younger than 60 years of age at diagnosis provided the highest positive predictive value for the identification of mutation carriers at 46% versus ≤ 41% for any other criteria considered. Population-level identification of patients with MMR mutation-positive endometrial cancer is optimized by stepwise testing for tumor MMR IHC loss in patients younger than 60 years, tumor MLH1 methylation in individuals with MLH1 IHC loss, and germline mutations in patients exhibiting loss of MSH6, MSH2, or PMS2 or loss of MLH1/PMS2 with absence of MLH1 methylation.

Male gender and smoking are related to single, but not to multiple, human aortic aneurysms.

PubMed

Gutierrez, Paulo S; Leite, Thiago N P; Mangione, Fernanda M

2015-01-01

There is scanty information concerning multiple aortic aneurysms. Thus, we verified if clinical or pathological characteristics are different in patients with multiple (two or more) aortic aneurysms in comparison with those with only one. We selected at the necropsy files of the Heart Institute, São Paulo University School of Medicine, the last 100 cases with aortic aneurysms, comparing between the two groups: sex, age, presence of systemic arterial hypertension, diabetes, dyslipedemia, history of smoking habit, cause of the aneurysm, cause of death, and if the diagnosis was reached during life. Age was analysed by Mann-Whitney test, and the other variables by chi-square or Fisher's exact test. Multiple aneurysms corresponded to 14% of cases. The proportion of women among patients with multiple aneurysms was higher than among those with single aneurysm (64.3% versus 20.9%, P<.01), even if only cases with atherosclerosis were taken into consideration (women among multiple-6/10, 60.0%; among single-14/70, 20.0%; P=.01). Smoking was less reported in cases with multiple (4/14, 28.6%) than with single aneurysm (53/86, 61.6%; P=.04); considering cases with atherosclerosis, such difference decreases (40.0% of multiple versus 68.6% of single, P=.09). although atherosclerosis is present in most cases of both single and multiple aortic aneurysms, male gender and smoking, considered highly influential in such lesions, are less frequent in patients with multiple than in patients with single aneurysms. Thus mechanisms underlying multiple aortic aneurysms are probably different from those related to single, more common aneurysms. Copyright © 2015 Elsevier Inc. All rights reserved.

A weighted adjustment of a similarity transformation between two point sets containing errors

NASA Astrophysics Data System (ADS)

Marx, C.

2017-10-01

For an adjustment of a similarity transformation, it is often appropriate to consider that both the source and the target coordinates of the transformation are affected by errors. For the least squares adjustment of this problem, a direct solution is possible in the cases of specific-weighing schemas of the coordinates. Such a problem is considered in the present contribution and a direct solution is generally derived for the m-dimensional space. The applied weighing schema allows (fully populated) point-wise weight matrices for the source and target coordinates, both weight matrices have to be proportional to each other. Additionally, the solutions of two borderline cases of this weighting schema are derived, which only consider errors in the source or target coordinates. The investigated solution of the rotation matrix of the adjustment is independent of the scaling between the weight matrices of the source and the target coordinates. The mentioned borderline cases, therefore, have the same solution of the rotation matrix. The direct solution method is successfully tested on an example of a 3D similarity transformation using a comparison with an iterative solution based on the Gauß-Helmert model.

76 FR 58167 - Safety Standard for Play Yards

Federal Register 2010, 2011, 2012, 2013, 2014

2011-09-20

... standard and, in some cases, provide test results publicly. C. Incident Data The CPSC's Directorate for... Requirements''; and the Canadian standard, C.R.C., c. 932, ``Playpen Regulations.'' We considered the... the side rails. Some play yards collapsed into a V-shape. If a child's neck is caught in the V-shape...

Robust Optimum Invariant Tests for Random MANOVA Models.

DTIC Science & Technology

1986-10-01

are assumed to be independent normal with zero mean and dispersion o2 and o72 respectively, Roy and Gnanadesikan (1959) considered the prob- 2 2 lem of...Part II: The multivariate case. Ann. Math. Statist. 31, 939-968. [7] Roy, S.N. and Gnanadesikan , R. (1959). Some contributions to ANOVA in one or more

Perspectives on the Integration of Technology and Assessment

ERIC Educational Resources Information Center

Pellegrino, James W.; Quellmalz, Edys S.

2011-01-01

This paper considers uses of technology in educational assessment from the perspective of innovation and support for teaching and learning. It examines assessment cases drawn from contexts that include large-scale testing programs as well as classroom-based programs, and attempts that have been made to harness the power of technology to provide…

Efficiency of Nested-PCR in Detecting Asymptomatic Cases toward Malaria Elimination Program in an Endemic Area of Iran.

PubMed

Turki, Habibollah; Raeisi, Ahmad; Malekzadeh, Kianoosh; Ghanbarnejad, Amin; Zoghi, Samaneh; Yeryan, Masoud; Abedi Nejad, Masoumeh; Mohseni, Fatemeh; Shekari, Mohammad

2015-01-01

The aim of this study was to detect low parasite and asymptomatic malaria infections by means of three malaria diagnostic tests, in a low transmission region of Minab district, Hormozgan Province, southern Iran. Blood samples of 200 healthy volunteers from Bagh-e-Malek area were evaluated using microscopic, rapid diagnostic tests (RDT) and nested-PCR to inspect malaria parasite. The results showed no Plasmodium parasite in subjects by means of microscopy and RDT. However, 3 P. vivax positive samples (1.5%) were discovered by Nested-PCR while microscopy and RDT missed the cases. Microscopy as the gold standard method and RDT correctly identified 98.5% of cases, and molecular analysis is sensitive and reliable, especially in the detection of "asymptomatic" infections for active case surveillance. Regarding the existence of asymptomatic malaria in endemic area of Hormozgan, Iran, nested-PCR could be considered as a sensitive tool to interrupt malaria transmission in the country, beside the microscopic and RDT methods.

APU diaphragm testing

NASA Technical Reports Server (NTRS)

Shelley, Richard; Ross, William L., Sr.

1993-01-01

The Auxiliary Power Unit (APU) fuel (hydrazine) tanks were removed from the Columbia Shuttle during major modification of the vehicle, because of long-term hydrazine compatibility concerns. The three tanks had been in service for 11 years. As part of an effort to determine whether the useful life of the fuel tanks can be extended, examination of the ethylene propylene rubber (EPR) diaphragm and the metal casing from one of the APU tanks was required. NASA Johnson Space Center Propulsion and Power Division requested the NASA Johnson Space Center White Sands Test Facility to examine the EPR diaphragm for signs of degradation that might limit the life of its function in the APU tank and to examine the metal casing for signs of surface corrosion. No appreciable degradation of the EPR diaphragm was noted. A decrease in the tensile properties was found, but tensile failure is considered unlikely because the metal casing constrains the diaphragm, preventing it from elongating more than a few percent. The titanium casing showed no evidence of surface corrosion.

Process tracing in political science: What's the story?

PubMed

Crasnow, Sharon

2017-04-01

Methodologists in political science have advocated for causal process tracing as a way of providing evidence for causal mechanisms. Recent analyses of the method have sought to provide more rigorous accounts of how it provides such evidence. These accounts have focused on the role of process tracing for causal inference and specifically on the way it can be used with case studies for testing hypotheses. While the analyses do provide an account of such testing, they pay little attention to the narrative elements of case studies. I argue that the role of narrative in case studies is not merely incidental. Narrative does cognitive work by both facilitating the consideration of alternative hypotheses and clarifying the relationship between evidence and explanation. I consider the use of process tracing in a particular case (the Fashoda Incident) in order to illustrate the role of narrative. I argue that process tracing contributes to knowledge production in ways that the current focus on inference tends to obscure. Copyright © 2017 Elsevier Ltd. All rights reserved.

[Is hepatitis E just an imported infection in the Czech Republic?].

PubMed

Haasová, Zdenka; Kleinerová, Jana; Mestáková, Olga

2006-02-01

The article deals with the issue of virus hepatitis E (VHE) whose increased incidence emerged in some Moravian districts in the monitored period from January 2004 to June 2005. The uncoated RNA virus, which is not taxonomically classified at present, is considered to be a causative agent of VHE. In the BIO-PLUS, the company with limited liability, 1 078 sera samples from various hospital and outpatient departments were tested by the ELISA method. The positive IgG and IgM VHE antibodies were found in 24 cases, that corresponded to the clinic condition of patient and to the biochemical findings showing an acute hepatitis. Other virus hepatitis (VHA, VHB, VHC) as well as further hepatotrophic infections were negative in all cases. Until recently the VHE was considered as an imported infection from endemic areas. However, only seven of our 24 positive cases showed a stay abroad, the traveller history was negative in the rest. In our work 18 VHE cases, diagnosed in the infection departments of the hospitals in Breclav and Prostejov, are analysed in details in the referred period.

The first case of imported Borrelia miyamotoi disease concurrent with Lyme disease.

PubMed

Oda, Rentaro; Kutsuna, Satoshi; Sekikawa, Yoshiyuki; Hongo, Igen; Sato, Kozue; Ohnishi, Makoto; Kawabata, Hiroki

2017-05-01

Borrelia miyamotoi disease (BMD) is an emerging infectious disease caused by B. miyamotoi. Although BMD has been reported in the United States, Europe, and Japan, no case of imported BMD has been described in the world. Here, we report a 63-year-old American man living in Japan who presented with malaise, headache, myalgia, and arthralgia. We suspected Lyme disease because of his travel history to Minnesota and presence of erythema migrans. Serologic analysis supported our diagnosis, and doxycycline was administered for 14 days. However, we also suspected coinfection with BMD because of his fever, elevated liver function test results and his travel history. The patient was seropositive for the immunoglobulin M antibody to recombinant glycerophosphodiester phosphodiesterase, and was diagnosed with coinfection with BMD. This case suggests that BMD should be considered in febrile travelers returning from the Northeastern and Midwestern regions of the United States, and that BMD and Lyme disease coinfection should be considered to detect cases of imported BMD. Copyright © 2017 Japanese Society of Chemotherapy and The Japanese Association for Infectious Diseases. Published by Elsevier Ltd. All rights reserved.

CFD Validation Experiment of a Mach 2.5 Axisymmetric Shock-Wave/Boundary-Layer Interaction

NASA Technical Reports Server (NTRS)

Davis, David O.

2015-01-01

Experimental investigations of specific flow phenomena, e.g., Shock Wave Boundary-Layer Interactions (SWBLI), provide great insight to the flow behavior but often lack the necessary details to be useful as CFD validation experiments. Reasons include: 1.Undefined boundary conditions Inconsistent results 2.Undocumented 3D effects (CL only measurements) 3.Lack of uncertainty analysis While there are a number of good subsonic experimental investigations that are sufficiently documented to be considered test cases for CFD and turbulence model validation, the number of supersonic and hypersonic cases is much less. This was highlighted by Settles and Dodsons [1] comprehensive review of available supersonic and hypersonic experimental studies. In all, several hundred studies were considered for their database.Of these, over a hundred were subjected to rigorous acceptance criteria. Based on their criteria, only 19 (12 supersonic, 7 hypersonic) were considered of sufficient quality to be used for validation purposes. Aeschliman and Oberkampf [2] recognized the need to develop a specific methodology for experimental studies intended specifically for validation purposes.

[Management of pregnant women with recurrent herpes. Guidelines for clinical practice from the French College of Gynecologists, Obstetricians (CNGOF)].

PubMed

Anselem, O

2017-12-01

To provide guidelines for the management of woman with genital herpes during pregnancy or labor and with known history of genital herpes. MedLine and Cochrane Library databases search and review of the main foreign guidelines. Genital herpes ulceration during pregnancy in a woman with history of genital herpes correspond to a recurrence. In this situation, there is no need for virologic confirmation (Grade B). In case of recurrent herpes during pregnancy, antiviral therapy with acyclovir or valacyclovir can be administered but provide low efficiency on duration and severity of symptoms (Grade C). Antiviral treatment proposed is acyclovir (200mg 5 times daily) or valacyclovir (500mg twice daily) for 5 to 10 days (Grade C). Recurrent herpes is associated with a risk of neonatal herpes around 1% (LE3). Antiviral prophylaxis should be offered for women with recurrent genital herpes during pregnancy from 36 weeks of gestation and until delivery (Grade B). There is no evidence of the benefit of prophylaxis in case or recurrence only before the pregnancy. There is no recommendation for systematic prophylaxis for women with history of recurrent genital herpes and no recurrence during the pregnancy. At the onset of labor, virologic testing is indicated only in case of genital ulceration (Professional consensus). In case of recurrent genital herpes at the onset of labor, cesarean delivery will be all the more considered if the membranes are intact and/or in case of prematurity and/or in case of HIV positive woman and vaginal delivery will be all the more considered in case of prolonged rupture of membranes after 37 weeks of gestation in an HIV negative woman (Professional consensus). In case of recurrent genital herpes at the onset of labor and intact membranes, cesarean delivery should be considered. In case of recurrent genital herpes and prolonged rupture of membranes at term, the benefit of cesarean delivery is more questionable and vaginal delivery should be considered. Copyright © 2017. Published by Elsevier Masson SAS.

Application of lot quality assurance sampling for leprosy elimination monitoring--examination of some critical factors.

PubMed

Gupte, M D; Murthy, B N; Mahmood, K; Meeralakshmi, S; Nagaraju, B; Prabhakaran, R

2004-04-01

The concept of elimination of an infectious disease is different from eradication and in a way from control as well. In disease elimination programmes the desired reduced level of prevalence is set up as the target to be achieved in a practical time frame. Elimination can be considered in the context of national or regional levels. Prevalence levels depend on occurrence of new cases and thus could remain fluctuating. There are no ready pragmatic methods to monitor the progress of leprosy elimination programmes. We therefore tried to explore newer methods to answer these demands. With the lowering of prevalence of leprosy to the desired level of 1 case per 10000 population at the global level, the programme administrators' concern will be shifted to smaller areas e.g. national and sub-national levels. For monitoring this situation, we earlier observed that lot quality assurance sampling (LQAS), a quality control tool in industry was useful in the initially high endemic areas. However, critical factors such as geographical distribution of cases and adoption of cluster sampling design instead of simple random sampling design deserve attention before LQAS could generally be recommended. The present exercise was aimed at validating applicability of LQAS, and adopting these modifications for monitoring leprosy elimination in Tamil Nadu state, which was highly endemic for leprosy. A representative sample of 64000 people drawn from eight districts of Tamil Nadu state, India, with maximum allowable number of 25 cases was considered, using LQAS methodology to test whether leprosy prevalence was at or below 7 per 10000 population. Expected number of cases for each district was obtained assuming Poisson distribution. Goodness of fit for the observed and expected cases (closeness of the expected number of cases to those observed) was tested through chi(2). Enhancing factor (design effect) for sample size was obtained by computing the intraclass correlation. The survey actually covered a population of 62157 individuals, of whom 56469 (90.8%) were examined. Ninety-six cases were detected and this number far exceeded the critical value of 25. The number of cases for each district and the number of cases in the entire surveyed area both followed Poisson distribution. The intraclass correlation coefficients were close to zero and the design effect was observed to be close to one. Based on the LQAS exercises leprosy prevalence in the state of Tamil Nadu in India was above 7 per 10000. LQAS method using clusters was validated for monitoring leprosy elimination in high endemic areas. Use of cluster sampling makes this method further useful as a rapid assessment procedure. This method needs to be tested for its applicability in moderate and low endemic areas, where the sample size may need increasing. It is further possible to consider LQAS as a monitoring tool for elimination programmes with respect to other disease conditions.

Validation of catchment models for predicting land-use and climate change impacts. 2. Case study for a Mediterranean catchment

NASA Astrophysics Data System (ADS)

Parkin, G.; O'Donnell, G.; Ewen, J.; Bathurst, J. C.; O'Connell, P. E.; Lavabre, J.

1996-02-01

Validation methods commonly used to test catchment models are not capable of demonstrating a model's fitness for making predictions for catchments where the catchment response is not known (including hypothetical catchments, and future conditions of existing catchments which are subject to land-use or climate change). This paper describes the first use of a new method of validation (Ewen and Parkin, 1996. J. Hydrol., 175: 583-594) designed to address these types of application; the method involves making 'blind' predictions of selected hydrological responses which are considered important for a particular application. SHETRAN (a physically based, distributed catchment modelling system) is tested on a small Mediterranean catchment. The test involves quantification of the uncertainty in four predicted features of the catchment response (continuous hydrograph, peak discharge rates, monthly runoff, and total runoff), and comparison of observations with the predicted ranges for these features. The results of this test are considered encouraging.

Estimating healthcare costs of acute gastroenteritis and human campylobacteriosis in Switzerland.

PubMed

Schmutz, C; Mäusezahl, D; Bless, P J; Hatz, C; Schwenkglenks, M; Urbinello, D

2017-03-01

Rising numbers of campylobacteriosis case notifications in Switzerland resulted in an increased attention to acute gastroenteritis (AG) in general. Patients with a laboratory-confirmed Campylobacter infection perceive their disease as severe and around 15% of these patients are hospitalized. This study aimed at estimating healthcare costs due to AG and campylobacteriosis in Switzerland. We used official health statistics, data from different studies and expert opinion for estimating individual treatment costs for patients with different illness severity and for extrapolating overall costs due to AG and campylobacteriosis. We estimated that total Swiss healthcare costs resulting from these diseases amount to €29-45 million annually. Data suggest that patients with AG consulting a physician without a stool diagnostic test account for €9·0-24·2 million, patients with a negative stool test result for Campylobacter spp. for €12·3 million, patients testing positive for Campylobacter spp. for €1·8 million and hospitalized campylobacteriosis patients for €6·5 million/year. Healthcare costs of campylobacteriosis are high and most likely increasing in Switzerland considering that campylobacteriosis case notifications steadily increased in the past decade. Costs and potential cost savings for the healthcare system should be considered when designing sectorial and cross-sectorial interventions to reduce the burden of human campylobacteriosis in Switzerland.

Successful treatment of toxoplasmic encephalitis diagnosed early by polymerase chain reaction after allogeneic hematopoietic stem cell transplantation: two case reports and review of the literature.

PubMed

Miyagi, T; Itonaga, H; Aosai, F; Taguchi, J; Norose, K; Mochizuki, K; Fujii, H; Furumoto, A; Ohama, M; Karimata, K; Yamanoha, A; Taniguchi, H; Sato, S; Taira, N; Moriuchi, Y; Fukushima, T; Masuzaki, H; Miyazaki, Y

2015-08-01

Toxoplasmic encephalitis represents a rare, but often fatal infection after allogeneic hematopoietic stem cell transplantation. Polymerase chain reaction (PCR)-based preemptive therapy is considered promising for this disease, but is not routinely applied, especially in low seroprevalence countries including Japan. We encountered 2 cases of toxoplasmic encephalitis after transplantation that were successfully treated. The diagnosis of toxoplasmic encephalitis in these cases was confirmed by PCR testing when neurological symptoms were observed. Both patients received pyrimethamine and sulfadiazine treatments within 2 weeks of the development of neurological symptoms, and remained free of recurrence for 32 and 12 months. These results emphasized the importance of the PCR test and immediate treatment after diagnosis for the management of toxoplasmic encephalitis. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

First North American case of Hemoglobin Shepherds Bush (β 74[E18] Gly → Asp) in a central Pennsylvania family

PubMed Central

2014-01-01

Background Hemoglobin Shepherds Bush (Human Genome Variation Society name: HBB:c.224G > A) is an unstable hemoglobin variant resulting from a β 74 GGC to GAC mutation (Gly to Asp) that manifests clinically as hemolytic anemia or gall bladder disease due to chronic subclinical hemolysis. Case presentation We report a Pennsylvania family of English descent with this condition, first noticed in a 6-year-old female. The proband presented with splenomegaly, fatigue, dark urine and an elevated indirect bilirubin. Hemoglobin identification studies and subsequent genetic testing performed according to a systematic algorithm elucidated the diagnosis of Hb Shepherds Bush. Conclusions This is the first case of this rare hemoglobin variant identified in North America to our knowledge. It was identified using a systematic algorithm of diagnostic tests that should be followed whenever considering a rare hemoglobinopathy as part of the differential diagnosis. PMID:24428873

Multiple usage of the CD PLUS/UNIX system: performance in practice.

PubMed Central

Volkers, A C; Tjiam, I A; van Laar, A; Bleeker, A

1995-01-01

In August 1994, the CD PLUS/Ovid literature retrieval system based on UNIX was activated for the Faculty of Medicine and Health Sciences of Erasmus University in Rotterdam, the Netherlands. There were up to 1,200 potential users. Tests were carried out to determine the extent to which searching for literature was affected by other end users of the system. In the tests, search times and download times were measured in relation to a varying number of continuously active workstations. Results indicated a linear relationship between search times and the number of active workstations. In the "worst case" situation with sixteen active workstations, the time required for record retrieval increased by a factor of sixteen and downloading time by a factor of sixteen over the "best case" of no other active stations. However, because the worst case seldom, if ever, happens in real life, these results are considered acceptable. PMID:8547902

Multiple usage of the CD PLUS/UNIX system: performance in practice.

PubMed

Volkers, A C; Tjiam, I A; van Laar, A; Bleeker, A

1995-10-01

In August 1994, the CD PLUS/Ovid literature retrieval system based on UNIX was activated for the Faculty of Medicine and Health Sciences of Erasmus University in Rotterdam, the Netherlands. There were up to 1,200 potential users. Tests were carried out to determine the extent to which searching for literature was affected by other end users of the system. In the tests, search times and download times were measured in relation to a varying number of continuously active workstations. Results indicated a linear relationship between search times and the number of active workstations. In the "worst case" situation with sixteen active workstations, the time required for record retrieval increased by a factor of sixteen and downloading time by a factor of sixteen over the "best case" of no other active stations. However, because the worst case seldom, if ever, happens in real life, these results are considered acceptable.

[Do we always correctly interpret the results of statistical nonparametric tests].

PubMed

Moczko, Jerzy A

2014-01-01

Mann-Whitney, Wilcoxon, Kruskal-Wallis and Friedman tests create a group of commonly used tests to analyze the results of clinical and laboratory data. These tests are considered to be extremely flexible and their asymptotic relative efficiency exceeds 95 percent. Compared with the corresponding parametric tests they do not require checking the fulfillment of the conditions such as the normality of data distribution, homogeneity of variance, the lack of correlation means and standard deviations, etc. They can be used both in the interval and or-dinal scales. The article presents an example Mann-Whitney test, that does not in any case the choice of these four nonparametric tests treated as a kind of gold standard leads to correct inference.

Review of hepatitis B surveillance in China: improving information to frame future directions in prevention and control.

PubMed

Cui, Fuqiang; Drobeniuc, Jan; Hadler, Stephen C; Hutin, Yvan J; Ma, Fubao; Wiersma, Steve; Wang, Fuzhen; Wu, Jiang; Zheng, Hui; Zhou, Liwei; Zuo, Shuyan

2013-12-27

As the WHO verified that China reached the target of 1% prevalence of chronic hepatitis B infection among children targeted by universal hepatitis B immunization of newborns, the country considered new options for hepatitis B prevention and control. We reviewed hepatitis B surveillance in the broader context of viral hepatitis surveillance to propose recommendations to improve the system. We described surveillance for viral hepatitis in China with a specific focus on hepatitis B. We assessed critical attributes of the system, including data quality, predictive positive value and usefulness. While remarkable progress in hepatitis B immunization of infants and children has likely almost eliminated transmission in younger age groups, reported rates of hepatitis B increased steadily in China between 1990 and 2008, probably because of a failure to distinguish acute from chronic infections. Elements that prevented a clearer separation between acute and chronic cases included (1) missed opportunity to report cases accurately among clinicians, (2) low availability and use of tests to detect IgM against the hepatitis B core antigen (IgM anti-HBc) and (3) lack of systems to sort, manage and analyze surveillance data. To improve hepatitis B surveillance, China may consider (1) training clinicians to diagnose acute cases and to use IgM anti-HBc to confirm them, (2) improving access and use of validated IgM anti-HBc tests and (3) developing data management and analysis techniques that sort out acute from chronic cases. Copyright © 2013 Elsevier Ltd. All rights reserved.

CAA modeling of helicopter main rotor in hover

NASA Astrophysics Data System (ADS)

Kusyumov, Alexander N.; Mikhailov, Sergey A.; Batrakov, Andrey S.; Kusyumov, Sergey A.; Barakos, George

In this work rotor aeroacoustics in hover is considered. Farfield observers are used and the nearfield flow parameters are obtained using the in house HMB and commercial Fluent CFD codes (identical hexa-grids are used for both solvers). Farfield noise at a remote observer position is calculated at post processing stage using FW-H solver implemented in Fluent and HMB. The main rotor of the UH-1H helicopter is considered as a test case for comparison to experimental data. The sound pressure level is estimated for different rotor blade collectives and observation angles.

Leptospirosis in New Orleans.

PubMed

Toliver, Herman L; Krane, N Kevin

2014-02-01

Leptospirosis is an unusual but reemerging zoonotic infectious disease in the United States where the diagnosis may not be suspected when patients initially present. The case report of a patient from New Orleans who presented with jaundice, hypotension and acute kidney injury is presented. In this patient, a broad differential diagnosis was considered on presentation and serologic testing for leptospirosis eventually confirmed the diagnosis. A review of the clinical manifestations, diagnostic studies and treatment are discussed so that leptospirosis will be considered more carefully in the initial evaluation and management of similar patients.

Energy balance during underwater implosion of ductile metallic cylinders.

PubMed

Chamberlin, Ryan E; Guzas, Emily L; Ambrico, Joseph M

2014-11-01

Energy-based metrics are developed and applied to a numerical test case of implosion of an underwater pressure vessel. The energy metrics provide estimates of the initial energy in the system (potential energy), the energy released into the fluid as a pressure pulse, the energy absorbed by the imploding structure, and the energy absorbed by air trapped within the imploding structure. The primary test case considered is the implosion of an aluminum cylinder [diameter: 2.54 cm (1 in.), length: 27.46 cm (10.81 in.)] that collapses flat in a mode-2 shape with minimal fracture. The test case indicates that the structure absorbs the majority (92%) of the initial energy in the system. Consequently, the energy emitted as a pressure pulse into the fluid is a small fraction, approximately 5%, of the initial energy. The energy absorbed by the structure and the energy emitted into the fluid are calculated for additional simulations of underwater pressure vessel implosions. For all cases investigated, there is minimal fracture in the collapse, the structure absorbs more than 80% of the initial energy of the system, and the released pressure pulse carries away less than 6% of the initial energy.

In response to 'Can sugars be produced from fatty acids? A test case for pathway analysis tools'.

PubMed

Faust, Karoline; Croes, Didier; van Helden, Jacques

2009-12-01

In their article entitled 'Can sugars be produced from fatty acids? A test case for pathway analysis tools' de Figueiredo and co-authors assess the performance of three pathway prediction tools (METATOOL, PathFinding and Pathway Hunter Tool) using the synthesis of glucose-6-phosphate (G6P) from acetyl-CoA in humans as a test case. We think that this article is biased for three reasons: (i) the metabolic networks used as input for the respective tools were of very different sizes; (ii) the 'assessment' is restricted to two study cases; (iii) developers are inherently more skilled to use their own tools than those developed by other people. We extended the analyses led by de Figueiredo and clearly show that the apparent superior performance of their tool (METATOOL) is partly due to the differences in input network sizes. We also see a conceptual problem in the comparison of tools that serve different purposes. In our opinion, metabolic path finding and elementary mode analysis are answering different biological questions, and should be considered as complementary rather than competitive approaches. Supplementary data are available at Bioinformatics online.

Screening for ROS1 gene rearrangements in non-small cell lung cancers using immunohistochemistry with FISH confirmation is an effective method to identify this rare target

PubMed Central

Selinger, Christina I; Li, Bob T; Pavlakis, Nick; Links, Matthew; Gill, Anthony J; Lee, Adrian; Clarke, Stephen; Tran, Thang N; Lum, Trina; Yip, Po Yee; Horvath, Lisa; Yu, Bing; Kohonen-Corish, Maija RJ; O’Toole, Sandra A; Cooper, Wendy A

2016-01-01

Aims To assess the prevalence of ROS1 rearrangements in a retrospective and prospective diagnostic Australian cohort and evaluate the effectiveness of immunohistochemical screening. Methods A retrospective cohort of 278 early stage lung adenocarcinomas and an additional 104 prospective NSCLC cases referred for routine molecular testing were evaluated. ROS1 immunohistochemistry (IHC) was performed (D4D6 clone, Cell Signaling Technology) on all cases as well as fluorescence in situ hybridisation (FISH) using the ZytoVision and Abbott Molecular ROS1 FISH probes, with ≥15% of cells with split signals considered positive for rearrangement. Results Eighty eight cases (32%) from the retrospective cohort showed staining by ROS1 IHC, and one case (0.4%) showed ROS1 rearrangement by FISH. Nineteen of the prospective diagnostic cases showed ROS1 IHC staining of which 12 (12%) cases were confirmed as ROS1 rearranged by FISH. There were no ROS1 rearranged cases that showed no expression of ROS1 with IHC. The ROS1 rearranged cases in the prospective cohort were all EGFR wildtype and ALK rearrangement negative. The sensitivity of ROS1 IHC in the retrospective cohort was 100% and specificity was 76%. Conclusions ROS1 rearrangements are rare events in lung adenocarcinomas. Selection of cases for ROS1 FISH testing, by excluding EGFR/ALK positive cases and use of IHC to screen for potentially positive cases can be used to enrich for the likelihood of a identifying a ROS1 rearranged lung cancer and prevent the need to undertake expensive and time consuming FISH testing in all cases. PMID:27599111

Screening for ROS1 gene rearrangements in non-small-cell lung cancers using immunohistochemistry with FISH confirmation is an effective method to identify this rare target.

PubMed

Selinger, Christina I; Li, Bob T; Pavlakis, Nick; Links, Matthew; Gill, Anthony J; Lee, Adrian; Clarke, Stephen; Tran, Thang N; Lum, Trina; Yip, Po Y; Horvath, Lisa; Yu, Bing; Kohonen-Corish, Maija R J; O'Toole, Sandra A; Cooper, Wendy A

2017-02-01

To assess the prevalence of ROS1 rearrangements in a retrospective and prospective diagnostic Australian cohort and evaluate the effectiveness of immunohistochemical screening. A retrospective cohort of 278 early stage lung adenocarcinomas and an additional 104 prospective non-small-cell lung cancer (NSCLC) cases referred for routine molecular testing were evaluated. ROS1 immunohistochemistry (IHC) was performed (D4D6 clone, Cell Signaling Technology) on all cases as well as fluorescence in-situ hybridization (FISH) using the ZytoVision and Abbott Molecular ROS1 FISH probes, with ≥15% of cells with split signals considered positive for rearrangement. Eighty-eight cases (32%) from the retrospective cohort showed staining by ROS1 IHC, and one case (0.4%) showed ROS1 rearrangement by FISH. Nineteen of the prospective diagnostic cases showed ROS1 IHC staining, 12 (12%) cases of which were confirmed as ROS1 rearranged by FISH. There were no ROS1 rearranged cases that showed no expression of ROS1 with IHC. The ROS1 rearranged cases in the prospective cohort were all EGFR wild-type and anaplastic lymphoma kinase (ALK) rearrangement-negative. The sensitivity of ROS1 IHC in the retrospective cohort was 100% and specificity was 76%. ROS1 rearrangements are rare events in lung adenocarcinomas. Selection of cases for ROS1 FISH testing, by excluding EGFR/ALK-positive cases and use of IHC to screen for potentially positive cases, can be used to enrich for the likelihood of identifying a ROS1 rearranged lung cancer and prevent the need to undertake expensive and time-consuming FISH testing in all cases. © 2016 John Wiley & Sons Ltd.

Neurosyphilis as a great imitator: a case report.

PubMed

Sabre, Liis; Braschinsky, Mark; Taba, Pille

2016-07-28

Neurosyphilis is defined as any involvement of the central nervous system by the bacterium Treponema pallidum. Movement disorders as manifestations of syphilis have been reported quite rarely. We report a case of a 42-year-old Russian man living in Estonia with rapidly progressive dementia and movement disorders manifesting as myoclonus, cerebellar ataxia and parkinsonism. The mini mental state examination score was 12/30. After excluding different neurodegenerative causes, further diagnostic testing was consistent with neurosyphilis. Treatment with penicillin was started and 6 months later his mini mental state examination score was 25/30 and he had no myoclonus, parkinsonism or cerebellar dysfunction. Since syphilis is easily diagnosed and treatable, it should be considered and tested in patients with cognitive impairment and movement disorders.

Performance Enhancement of the Space Shuttle RSRM Nozzle-to-Case Joint Using a Carbon Rope Barrier

NASA Technical Reports Server (NTRS)

Ewing, M. E.; McGuire, J. R.; McWhorter, B. B.; Frost, D. L.

1999-01-01

A carbon rope "thermal barrier" is being considered as a component to enhance performance of the Reusable Solid Rocket Motor (RSRM) nozzle-to-case joint. Fundamental performance characteristics of the rope have been considered in this paper. In particular, resistance to erosion, ability to filter particulate matter, thermal capacitance, and flow resistance have been considered. Testing results have shown the rope to be resistant to the corrosive internal environment of the RSRM. The rope has also been shown to be an effective "slag barrier." A desirable feature of the rope would be the ability to act as a heat sink. However, analyses have indicated that the thermal capacitance of the rope is not large enough to reduce the temperature of an impinging gas stream below the ablation temperature of the 0-ring for significant time periods, The real value of the rope is its ability to act as a flow diffuser. Flow resistance test, were performed on the rope In the course of testing the rope between parallel plates, an undesirable "blow-by" phenomenon was observed when the compressive stress in the rope was smaller than the upstream gas pressure. It was found, however, that in the converging passage of the actual design, the rope would consistently "Self-seat" and thereby prevent blow-by, even in the absence of any precompression. Flow resistance values have been quantified for use in future analyses. The work presented here provides an initial thermal-fluid assessment of the rope for this application, and lays the groundwork for future development.

High-speed water impacts of flat plates in different ditching configuration through a Riemann-ALE SPH model

NASA Astrophysics Data System (ADS)

Marrone, S.; Colagrossi, A.; Chiron, L.; De Leffe, M.; Le Touzé, D.

2018-02-01

The violent water entry of flat plates is investigated using a Riemann-arbitrary Eulerian-Lagrangian (ALE) smoothed particle hydrodynamics (SPH) model. The test conditions are of interest for problems related to aircraft and helicopter emergency landing in water. Three main parameters are considered: the horizontal velocity, the approach angle (i.e., vertical to horizontal velocity ratio) and the pitch angle, α. Regarding the latter, small angles are considered in this study. As described in the theoretical work by Zhao and Faltinsen (1993), for small α a very thin, high-speed jet of water is formed, and the time-spatial gradients of the pressure field are extremely high. These test conditions are very challenging for numerical solvers. In the present study an enhanced SPH model is firstly tested on a purely vertical impact with deadrise angle α = 4°. An in-depth validation against analytical solutions and experimental results is carried out, highlighting the several critical aspects of the numerical modelling of this kind of flow, especially when pressure peaks are to be captured. A discussion on the main difficulties when comparing to model scale experiments is also provided. Then, the more realistic case of a plate with both horizontal and vertical velocity components is discussed and compared to ditching experiments recently carried out at CNR-INSEAN. In the latter case both 2-D and 3-D simulations are considered and the importance of 3-D effects on the pressure peak is discussed for α = 4° and α = 10°.

Dynamics of a vertical flight in the stationary gravitational field of a celestial body: Post-newtonian corrections and gravitational redshift

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

Imshennik, V. S., E-mail: imshennik@itep.r

2010-04-15

The standard problem of a radial motion of test particles in the stationary gravitational field of a spherically symmetric celestial body is solved and is used to determine the time features of this motion. The problem is solved for the equations of motion of general relativity (GR), and the time features are obtained in the post-Newtonian approximation, with linear GR corrections proportional to r{sub g}/r and {beta}{sup 2} (in the solution being considered, they are of the same order of smallness) being taken rigorously into account. Total times obtained by integrating the time differentials along the trajectories of motion aremore » considered as the time features in question. It is shown that, for any parameters of the motion, the proper time (which corresponds to watches comoving with a test particle) exceeds the time of watches at rest (watches at the surface of the celestial body being considered). The mass and the radius of the celestial body, as well as the initial velocity of the test particle, serve as arbitrary parameters of the motion. The time difference indicated above implies a leading role of the gravitational redshift, which decreases somewhat because of the opposite effect of the Doppler shift. The results are estimated quantitatively for the important (from the experimental point of view) case of vertical flights of rockets starting from the Earth's surface. In this case, the GR corrections, albeit being extremely small (a few microseconds for several hours of the flight), aremeasurable with atomic (quantum) watches.« less

Antioxidant enzymes levels in children with juvenile rheumatoid arthritis.

PubMed

Goţia, S; Popovici, I; Hermeziu, B

2001-01-01

Pathogenic mechanism of chronic inflammation is associated with increased production of superoxide anion and hydrogen peroxide. In the neutralization process of that anions, superoxid dismutase (SOD), catalase (CAT), and glutation peroxidase (GPx) are key enzymes. Aim of study consists of establishing of some clinic-biological correlations in JRA chronic inflammation in childhood between clinical status and determination of lipoperoxidation products and antioxidative enzymes in the blood. Blood samples were obtained from 20 patients admitted in 2nd Clinic of Pediatrics, 4-6 months after onset of disease, diagnosed with JRA, oligoarticular form (6 cases), poliarticular form (9 cases) and systemic form (5 cases), as compared to 10 control subjects. SOD, CAT, GPx were measured comparing with malonildialdehyde (MDA), seric glutation (GSH) and usual inflammatory tests (ESR, fibrinogen, CRP). Determinations were repeated after 6 weeks of treatment. In all our cases, level of antioxidant enzymes (CAT, GPx) was decreased at time of diagnosis, concomitant with increased MDA, SOD and inflammatory tests. In most of cases, after 6 weeks of correct anti-inflammatory treatment, levels of enzymatic antioxidant markers were still decreased, as compared to usual inflammatory tests that came back to normal. Persistent decreased antioxidant enzymatic activity was found in cases that need immunomodulatory activity (Methotrexat). Determination of antioxidant enzymes level can be considered an evolution marker in JRA. More studies are necessary to find if antioxidant potential of blood can be used as following marker for immunosuppressive therapy.

Diagnostic Strategy Used To Establish Etiologies of Encephalitis in a Prospective Cohort of Patients in England▿

PubMed Central

Ambrose, H. E.; Granerod, J.; Clewley, J. P.; Davies, N. W. S.; Keir, G.; Cunningham, R.; Zuckerman, M.; Mutton, K. J.; Ward, K. N.; Ijaz, S.; Crowcroft, N. S.; Brown, D. W. G.

2011-01-01

The laboratory diagnostic strategy used to determine the etiology of encephalitis in 203 patients is reported. An etiological diagnosis was made by first-line laboratory testing for 111 (55%) patients. Subsequent testing, based on individual case reviews, resulted in 17 (8%) further diagnoses, of which 12 (71%) were immune-mediated and 5 (29%) were due to infection. Seventy-five cases were of unknown etiology. Sixteen (8%) of 203 samples were found to be associated with either N-methyl-d-aspartate receptor or voltage-gated potassium channel complex antibodies. The most common viral causes identified were herpes simplex virus (HSV) (19%) and varicella-zoster virus (5%), while the most important bacterial cause was Mycobacterium tuberculosis (5%). The diagnostic value of testing cerebrospinal fluid (CSF) for antibody was assessed using 139 samples from 99 patients, and antibody was detected in 46 samples from 37 patients. Samples collected at 14 to 28 days were more likely to be positive than samples taken 0 to 6 days postadmission. Three PCR-negative HSV cases were diagnosed by the presence of virus-specific antibody in the central nervous system (CNS). It was not possible to make an etiological diagnosis for one-third of the cases; these were therefore considered to be due to unknown causes. Delayed sampling did not contribute to these cases. Twenty percent of the patients with infections with an unknown etiology showed evidence of localized immune activation within the CNS, but no novel viral DNA or RNA sequences were found. We conclude that a good standard of clinical investigation and thorough first-line laboratory testing allows the diagnosis of most cases of infectious encephalitis; testing for CSF antibodies allows further cases to be diagnosed. It is important that testing for immune-mediated causes also be included in a diagnostic algorithm. PMID:21865429

Biosafety assessment protocols for new organisms in New Zealand: Can they apply internationally to emerging technologies?

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

Barratt, B.I.P.; Moeed, A.; Malone, L.A.

2006-05-15

An analysis of established biosafety protocols for release into the environment of exotic plants and biological control agents for weeds and arthropod pests has been carried out to determine whether such protocols can be applied to relatively new and emerging technologies intended for the primary production industries, such as transgenic plants. Example case studies are described to indicate the scope of issues considered by regulators who make decisions on new organism releases. No transgenic plants have been released to date in New Zealand, but two field test approvals are described as examples. An analysis of the biosafety protocols has shownmore » that, while many of the risk criteria considered for decision-making by regulators are similar for all new organisms, a case-by-case examination of risks and potential impacts is required in order to fully assess risk. The value of post-release monitoring and validation of decisions made by regulators is emphasised.« less

New Whole-House Solutions Case Study: Evaluating Through-Wall Air Transfer Fans, Pittsburgh, Pennsylvania

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

None

2014-10-01

In this project, Building America team IBACOS performed field testing in a new construction unoccupied test house in Pittsburgh, Pennsylvania, to evaluate heating, ventilating, and air conditioning (HVAC) distribution systems during heating, cooling, and midseason conditions. The team evaluated a market-available through-wall air transfer fan system that provides air to the bedrooms.The relative ability of this system was considered with respect to relevant Air Conditioning Contractors of America and ASHRAE standards for house temperature uniformity and stability.

Aerothermodynamics of Blunt Body Entry Vehicles. Chapter 3

NASA Technical Reports Server (NTRS)

Hollis, Brian R.; Borrelli, Salvatore

2011-01-01

In this chapter, the aerothermodynamic phenomena of blunt body entry vehicles are discussed. Four topics will be considered that present challenges to current computational modeling techniques for blunt body environments: turbulent flow, non-equilibrium flow, rarefied flow, and radiation transport. Examples of comparisons between computational tools to ground and flight-test data will be presented in order to illustrate the challenges existing in the numerical modeling of each of these phenomena and to provide test cases for evaluation of Computational Fluid Dynamics (CFD) code predictions.

Aerothermodynamics of blunt body entry vehicles

NASA Astrophysics Data System (ADS)

Hollis, Brian R.; Borrelli, Salvatore

2012-01-01

In this chapter, the aerothermodynamic phenomena of blunt body entry vehicles are discussed. Four topics will be considered that present challenges to current computational modeling techniques for blunt body environments: turbulent flow, non-equilibrium flow, rarefied flow, and radiation transport. Examples of comparisons between computational tools to ground and flight-test data will be presented in order to illustrate the challenges existing in the numerical modeling of each of these phenomena and to provide test cases for evaluation of computational fluid dynamics (CFD) code predictions.

Vibrational multiconfiguration self-consistent field theory: implementation and test calculations.

PubMed

Heislbetz, Sandra; Rauhut, Guntram

2010-03-28

A state-specific vibrational multiconfiguration self-consistent field (VMCSCF) approach based on a multimode expansion of the potential energy surface is presented for the accurate calculation of anharmonic vibrational spectra. As a special case of this general approach vibrational complete active space self-consistent field calculations will be discussed. The latter method shows better convergence than the general VMCSCF approach and must be considered the preferred choice within the multiconfigurational framework. Benchmark calculations are provided for a small set of test molecules.

Sonographic Findings in Necrotizing Fasciitis: Two Ends of the Spectrum.

PubMed

Shyy, William; Knight, Roneesha S; Goldstein, Ruth; Isaacs, Eric D; Teismann, Nathan A

2016-10-01

Necrotizing fasciitis is a rare but serious disease, and early diagnosis is essential to reducing its substantial morbidity and mortality. The 2 cases presented show that the key clinical and radiographic features of necrotizing fasciitis exist along a continuum of severity at initial presentation; thus, this diagnosis should not be prematurely ruled out in cases that do not show the dramatic features familiar to most clinicians. Although computed tomography and magnetic resonance imaging are considered the most effective imaging modalities, the cases described here illustrate how sonography should be recommended as an initial imaging test to make a rapid diagnosis and initiate therapy.

Diabetes mellitus, diabetes insipidus, optic atrophy, and deafness: A case of Wolfram (DIDMOAD) syndrome.

PubMed

Maleki, Nasrollah; Bashardoust, Bahman; Zakeri, Anahita; Salehifar, Azita; Tavosi, Zahra

2015-01-01

To report a case of Wolfram syndrome (WS) characterized by diabetes mellitus, diabetes insipidus, progressive optic atrophy, and deafness. A 19-year-old female patient, a known case of diabetes mellitus type I from six years before, presented with progressive vision loss since four years earlier. On fundoscopic examination, she had bilateral optic atrophy without diabetic retinopathy. The patient also had diabetes insipidus, neurosensory deafness, and neurogenic bladder. WS should be considered a differential diagnosis in patients with diabetes mellitus who present with optic atrophy, and it is necessary to perform a hearing test as well as collecting 24-h urine output.

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

Coffrin, Carleton James; Hijazi, Hassan L; Van Hentenryck, Pascal R

Here this work revisits the Semidefine Programming (SDP) relaxation of the AC power flow equations in light of recent results illustrating the benefits of bounds propagation, valid inequalities, and the Convex Quadratic (QC) relaxation. By integrating all of these results into the SDP model a new hybrid relaxation is proposed, which combines the benefits from all of these recent works. This strengthened SDP formulation is evaluated on 71 AC Optimal Power Flow test cases from the NESTA archive and is shown to have an optimality gap of less than 1% on 63 cases. This new hybrid relaxation closes 50% ofmore » the open cases considered, leaving only 8 for future investigation.« less

Case definition for clinical and subclinical bacterial kidney disease (BKD) in Atlantic Salmon (Salmo salar L.) in New Brunswick, Canada.

PubMed

Boerlage, A S; Stryhn, H; Sanchez, J; Hammell, K L

2017-03-01

Bacterial kidney disease (BKD) is considered an important cause of loss in salmon aquaculture in Atlantic Canada. Causative agent of BKD is the Gram-positive bacteria Renibacterium salmoninarum. Infected salmon are often asymptomatic (subclinical infection), and the disease is considered chronic. One of the challenges in quantifying information from farm production and health records is the application of a standardized case definition. Case definitions for farm-level and cage-level clinical and subclinical BKD were developed using retrospective longitudinal data from aquaculture practices in New Brunswick, Canada, combining (i) industry records of weekly production data including mortalities, (ii) field observations for BKD using reports of veterinarians and/or fish health technicians, (iii) diagnostic submissions and test results and (iv) treatments used to control BKD. Case definitions were evaluated using veterinarians' expert judgements as reference standard. Eighty-nine and 66% of sites and fish groups, respectively, were associated with BKD at least once. For BKD present (subclinical or clinical), sensitivity and specificity of the case definition were 75-100% varying between event, fish group, site cycle and level (site pen). For clinical BKD, sensitivities were 29-64% and specificities 91-100%. Industry data can be used to develop sensitive case definitions. © 2016 John Wiley & Sons Ltd.

Biological false-positive venereal disease research laboratory test in cerebrospinal fluid in the diagnosis of neurosyphilis - a case-control study.

PubMed

Zheng, S; Lin, R J; Chan, Y H; Ngan, C C L

2018-03-01

There is no clear consensus on the diagnosis of neurosyphilis. The Venereal Disease Research Laboratory (VDRL) test from cerebrospinal fluid (CSF) has traditionally been considered the gold standard for diagnosing neurosyphilis but is widely known to be insensitive. In this study, we compared the clinical and laboratory characteristics of true-positive VDRL-CSF cases with biological false-positive VDRL-CSF cases. We retrospectively identified cases of true and false-positive VDRL-CSF across a 3-year period received by the Immunology and Serology Laboratory, Singapore General Hospital. A biological false-positive VDRL-CSF is defined as a reactive VDRL-CSF with a non-reactive Treponema pallidum particle agglutination (TPPA)-CSF and/or negative Line Immuno Assay (LIA)-CSF IgG. A true-positive VDRL-CSF is a reactive VDRL-CSF with a concordant reactive TPPA-CSF and/or positive LIA-CSF IgG. During the study period, a total of 1254 specimens underwent VDRL-CSF examination. Amongst these, 60 specimens from 53 patients tested positive for VDRL-CSF. Of the 53 patients, 42 (79.2%) were true-positive cases and 11 (20.8%) were false-positive cases. In our setting, a positive non-treponemal serology has 97.6% sensitivity, 100% specificity, 100% positive predictive value and 91.7% negative predictive value for a true-positive VDRL-CSF based on our laboratory definition. HIV seropositivity was an independent predictor of a true-positive VDRL-CSF. Biological false-positive VDRL-CSF is common in a setting where patients are tested without first establishing a serological diagnosis of syphilis. Serological testing should be performed prior to CSF evaluation for neurosyphilis. © 2017 European Academy of Dermatology and Venereology.

Trends in liability affecting technical writers

NASA Technical Reports Server (NTRS)

Driskill, L. P.

1981-01-01

Liability of technical writers for defective products is explored. Documents generated during a product's life cycle (including design memos, design tests, clinical trials, trial use reports, letters, and proposals) become relevant because they are likely to become the only available means of showing that the product was not defectively designed. These documents become the evidence that the product underwent balanced and well considered planning, development, testing, quality control, and field testing. The predicted increased involvement of technical writers in the prevention and defense of product liability claims is cited in view of a greater number of cases turning on "failure to warn".

Solwnd: A 3D Compressible MHD Code for Solar Wind Studies. Version 1.0: Cartesian Coordinates

NASA Technical Reports Server (NTRS)

Deane, Anil E.

1996-01-01

Solwnd 1.0 is a three-dimensional compressible MHD code written in Fortran for studying the solar wind. Time-dependent boundary conditions are available. The computational algorithm is based on Flux Corrected Transport and the code is based on the existing code of Zalesak and Spicer. The flow considered is that of shear flow with incoming flow that perturbs this base flow. Several test cases corresponding to pressure balanced magnetic structures with velocity shear flow and various inflows including Alfven waves are presented. Version 1.0 of solwnd considers a rectangular Cartesian geometry. Future versions of solwnd will consider a spherical geometry. Some discussions of this issue is presented.

Case Report of a Hypobaric Chamber Fitness to Fly Test in a Child With Severe Cystic Lung Disease.

PubMed

Loo, Sarah; Campbell, Andrew; Vyas, Julian; Pillarisetti, Naveen

2017-07-01

Patients with severe cystic lung disease are considered to be at risk for cyst rupture during air travel because of the possibility of increase in cyst size and impaired equilibration of pressure between the cysts and other parts of the lung. This may have clinically devastating consequences for the patient but may also result in significant costs for emergency alteration of flight schedule. We report the use of a hypobaric chamber to simulate cabin pressure changes encountered on a commercial flight to assess the safety to fly of a child with severe cystic lung disease secondary to Langerhans cell histiocytosis. The test did not result in an air leak, and the child subsequently undertook air travel without mishap. This is the first reported use of a hypobaric chamber test in a child with severe cystic lung disease. This test has the potential to be used as a fitness to fly test in children at risk for air leak syndromes who are being considered for air travel. Copyright © 2017 by the American Academy of Pediatrics.

Statistical Analysis of the Polarimetric Cloud Analysis and Seeding Test (POLCAST) Field Projects

NASA Astrophysics Data System (ADS)

Ekness, Jamie Lynn

The North Dakota farming industry brings in more than $4.1 billion annually in cash receipts. Unfortunately, agriculture sales vary significantly from year to year, which is due in large part to weather events such as hail storms and droughts. One method to mitigate drought is to use hygroscopic seeding to increase the precipitation efficiency of clouds. The North Dakota Atmospheric Research Board (NDARB) sponsored the Polarimetric Cloud Analysis and Seeding Test (POLCAST) research project to determine the effectiveness of hygroscopic seeding in North Dakota. The POLCAST field projects obtained airborne and radar observations, while conducting randomized cloud seeding. The Thunderstorm Identification Tracking and Nowcasting (TITAN) program is used to analyze radar data (33 usable cases) in determining differences in the duration of the storm, rain rate and total rain amount between seeded and non-seeded clouds. The single ratio of seeded to non-seeded cases is 1.56 (0.28 mm/0.18 mm) or 56% increase for the average hourly rainfall during the first 60 minutes after target selection. A seeding effect is indicated with the lifetime of the storms increasing by 41 % between seeded and non-seeded clouds for the first 60 minutes past seeding decision. A double ratio statistic, a comparison of radar derived rain amount of the last 40 minutes of a case (seed/non-seed), compared to the first 20 minutes (seed/non-seed), is used to account for the natural variability of the cloud system and gives a double ratio of 1.85. The Mann-Whitney test on the double ratio of seeded to non-seeded cases (33 cases) gives a significance (p-value) of 0.063. Bootstrapping analysis of the POLCAST set indicates that 50 cases would provide statistically significant results based on the Mann-Whitney test of the double ratio. All the statistical analysis conducted on the POLCAST data set show that hygroscopic seeding in North Dakota does increase precipitation. While an additional POLCAST field project would be necessary to obtain standardly accepted statistically significant results (p < 0.5) for the double ratio of precipitation amount, the obtained p-value of 0.063 is close and considering the positive result from other hygroscopic seeding experiments, the North Dakota Cloud Modification Project should consider implementation of hygroscopic seeding.

Implementation and utilization of the molecular tumor board to guide precision medicine.

PubMed

Harada, Shuko; Arend, Rebecca; Dai, Qian; Levesque, Jessica A; Winokur, Thomas S; Guo, Rongjun; Heslin, Martin J; Nabell, Lisle; Nabors, L Burt; Limdi, Nita A; Roth, Kevin A; Partridge, Edward E; Siegal, Gene P; Yang, Eddy S

2017-08-22

With rapid advances in genomic medicine, the complexity of delivering precision medicine to oncology patients across a university health system demanded the creation of a Molecular Tumor Board (MTB) for patient selection and assessment of treatment options. The objective of this report is to analyze our progress to date and discuss the importance of the MTB in the implementation of personalized medicine. Patients were reviewed in the MTB for appropriateness for comprehensive next generation sequencing (NGS) cancer gene set testing based on set criteria that were in place. Because profiling of stage IV lung cancer, colon cancer, and melanoma cancers were standard of care, these cancer types were excluded from this process. We subsequently analyzed the types of cases referred for testing and approved with regards to their results. 191 cases were discussed at the MTB and 132 cases were approved for testing. Forty-six cases (34.8%) had driver mutations that were associated with an active targeted therapeutic agent, including BRAF, PIK3CA, IDH1, KRAS , and BRCA1 . An additional 56 cases (42.4%) had driver mutations previously reported in some type of cancer. Twenty-two cases (16.7%) did not have any clinically significant mutations. Eight cases did not yield adequate DNA. 15 cases were considered for targeted therapy, 13 of which received targeted therapy. One patient experienced a near complete response. Seven of 13 had stable disease or a partial response. MTB at University of Alabama-Birmingham is unique because it reviews the appropriateness of NGS testing for patients with recurrent cancer and serves as a forum to educate our physicians about the pathways of precision medicine. Our results suggest that our detection of actionable mutations may be higher due to our careful selection. The application of precision medicine and molecular genetic testing for cancer patients remains a continuous educational process for physicians.

Chlamydia-induced septic polyarthritis in a dog.

PubMed

Lambrechts, N; Picard, J; Tustin, R C

1999-03-01

A systemic disease associated with pyrexia, lymphadenopathy, and arthropathy of several joints of the appendicular skeleton in a dog is described. Chlamydia-like organisms were detected on light-microscopic examination of a smear made from joint fluid aspirated from one of the affected joints. A group-specific lipopolysaccharide antigen shared by all Chlamydia spp. was demonstrated by direct fluorescent antibody staining of joint fluid, which also proved positive for chlamydia by means of the relevant polymerase chain reaction test. An indirect fluorescent antibody test on serum was also positive, although the complement fixation test was negative. Attempts to grow the organism from joint aspirates in the yolk sac of embryonating hens' eggs and on appropriate tissue cultures, however, failed. Chlamydia spp. are considered to have played an aetiological role in this case, making it the first substantiated case of naturally-occurring arthropathy in a dog due to chlamydiosis. The origin of the infection could not be traced.

Mechanical Behavior of Glidcop Al-15 at High Temperature and Strain Rate

NASA Astrophysics Data System (ADS)

Scapin, M.; Peroni, L.; Fichera, C.

2014-05-01

Strain rate and temperature are variables of fundamental importance for the definition of the mechanical behavior of materials. In some elastic-plastic models, the effects, coming from these two quantities, are considered to act independently. This approach should, in some cases, allow to greatly simplify the experimental phase correlated to the parameter identification of the material model. Nevertheless, in several applications, the material is subjected to dynamic load at very high temperature, as, for example, in case of machining operation or high energy deposition on metals. In these cases, to consider the effect of strain rate and temperature decoupled could not be acceptable. In this perspective, in this work, a methodology for testing materials varying both strain rate and temperature was described and applied for the mechanical characterization of Glidcop Al-15, a copper-based composite reinforced with alumina dispersion, often used in nuclear applications. The tests at high strain rate were performed using the Hopkinson Bar setup for the direct tensile tests. The heating of the specimen was performed using an induction coil system and the temperature was controlled on the basis of signals from thermocouples directly welded on the specimen surface. Varying the strain rate, Glidcop Al-15 shows a moderate strain-rate sensitivity at room temperature, while it considerably increases at high temperature: material thermal softening and strain-rate hardening are strongly coupled. The experimental data were fitted using a modified formulation of the Zerilli-Armstrong model able to reproduce this kind of behavior with a good level of accuracy.

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

Seth, Arpan; Klise, Katherine A.; Siirola, John D.

In the event of contamination in a water distribution network (WDN), source identification (SI) methods that analyze sensor data can be used to identify the source location(s). Knowledge of the source location and characteristics are important to inform contamination control and cleanup operations. Various SI strategies that have been developed by researchers differ in their underlying assumptions and solution techniques. The following manuscript presents a systematic procedure for testing and evaluating SI methods. The performance of these SI methods is affected by various factors including the size of WDN model, measurement error, modeling error, time and number of contaminant injections,more » and time and number of measurements. This paper includes test cases that vary these factors and evaluates three SI methods on the basis of accuracy and specificity. The tests are used to review and compare these different SI methods, highlighting their strengths in handling various identification scenarios. These SI methods and a testing framework that includes the test cases and analysis tools presented in this paper have been integrated into EPA’s Water Security Toolkit (WST), a suite of software tools to help researchers and others in the water industry evaluate and plan various response strategies in case of a contamination incident. Lastly, a set of recommendations are made for users to consider when working with different categories of SI methods.« less

Process capability determination of new and existing equipment

NASA Technical Reports Server (NTRS)

Mcclelland, H. T.; Su, Penwen

1994-01-01

The objective of this paper is to illustrate a method of determining the process capability of new or existing equipment. The method may also be modified to apply to testing laboratories. Long term changes in the system may be determined by periodically making new test parts or submitting samples from the original set to the testing laboratory. The technique described has been developed through a series of projects in special topics manufacturing courses and graduate student projects. It will be implemented as a standard experiment in an advanced manufacturing course in a new Manufacturing Engineering program at the University of Wisconsin-Stout campus. Before starting a project of this nature, it is important to decide on the exact question to be answered. In this case, it is desired to know what variation can be reasonably expected in the next part, feature, or test result produced. Generally, this question is answered by providing the process capability or the average value of a measured characteristic of the part or process plus or minus three standard deviations. There are two general cases to be considered: the part or test is made in large quantities with little change, or the process is flexible and makes a large variety of parts. Both cases can be accommodated; however, the emphasis in this report is on short run situations.

76 FR 40798 - Antidrug and Alcohol Misuse Prevention Programs for Personnel Engaged in Specified Aviation...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-07-12

... includes contractors and subcontractors. Contracting companies have two testing options: Option one is for... case today and as such, there are no alternatives to the final rule that could have been considered and... stations would be classified as small business under NAICS 488180, the FAA reviewed a recent study...

20 CFR Appendix C to Part 614 - Standard for Fraud and Overpayment Detection

Code of Federal Regulations, 2010 CFR

2010-04-01

... to claimants' entitlement to benefits paid to them in a sufficient proportion of cases to test the... post-audit or by industry surveys. The so-called “post-audit” is a matching of central office wage... concurrent benefit lists. A plan A. of investigation based on a sample post-audit will be considered as...

Preparing Pilots for Takeoff

ERIC Educational Resources Information Center

Ravage, Barbara

2012-01-01

Why would schools consider partnering with a vendor to operate a pilot? Why not just wait until the final product is released? For starters, pilots provide schools with a golden opportunity to get an early look at the software, take it for a test flight, and ask for changes tailored to their operating environment and business needs. In some cases,…

Is Bayesian Estimation Proper for Estimating the Individual's Ability? Research Report 80-3.

ERIC Educational Resources Information Center

Samejima, Fumiko

The effect of prior information in Bayesian estimation is considered, mainly from the standpoint of objective testing. In the estimation of a parameter belonging to an individual, the prior information is, in most cases, the density function of the population to which the individual belongs. Bayesian estimation was compared with maximum likelihood…

Treatment of fly ash for use in concrete

DOEpatents

Boxley, Chett [Park City, UT; Akash, Akash [Salt lake City, UT; Zhao, Qiang [Natick, MA

2012-05-08

A process for treating fly ash to render it highly usable as a concrete additive. A quantity of fly ash is obtained that contains carbon and which is considered unusable fly ash for concrete based upon foam index testing. The fly ash is mixed with an activator solution sufficient to initiate a geopolymerization reaction and for a geopolymerized fly ash. The geopolymerized fly ash is granulated. The geopolymerized fly ash is considered usable fly ash for concrete according to foam index testing. The geopolymerized fly ash may have a foam index less than 35% of the foam index of the untreated fly ash, and in some cases less than 10% of the foam index of the untreated fly ash. The activator solution may contain an alkali metal hydroxide, carbonate, silicate, aluminate, or mixtures thereof.

Treatment of fly ash for use in concrete

DOEpatents

Boxley, Chett; Akash, Akash; Zhao, Qiang

2013-01-08

A process for treating fly ash to render it highly usable as a concrete additive. A quantity of fly ash is obtained that contains carbon and which is considered unusable fly ash for concrete based upon foam index testing. The fly ash is mixed with an activator solution sufficient to initiate a geopolymerization reaction and for a geopolymerized fly ash. The geopolymerized fly ash is granulated. The geopolymerized fly ash is considered usable fly ash for concrete according to foam index testing. The geopolymerized fly ash may have a foam index less than 35% of the foam index of the untreated fly ash, and in some cases less than 10% of the foam index of the untreated fly ash. The activator solution may contain an alkali metal hydroxide, carbonate, silicate, aluminate, or mixtures thereof.

[Agricultural biotechnology safety assessment].

PubMed

McClain, Scott; Jones, Wendelyn; He, Xiaoyun; Ladics, Gregory; Bartholomaeus, Andrew; Raybould, Alan; Lutter, Petra; Xu, Haibin; Wang, Xue

2015-01-01

Genetically modified (GM) crops were first introduced to farmers in 1995 with the intent to provide better crop yield and meet the increasing demand for food and feed. GM crops have evolved to include a thorough safety evaluation for their use in human food and animal feed. Safety considerations begin at the level of DNA whereby the inserted GM DNA is evaluated for its content, position and stability once placed into the crop genome. The safety of the proteins coded by the inserted DNA and potential effects on the crop are considered, and the purpose is to ensure that the transgenic novel proteins are safe from a toxicity, allergy, and environmental perspective. In addition, the grain that provides the processed food or animal feed is also tested to evaluate its nutritional content and identify unintended effects to the plant composition when warranted. To provide a platform for the safety assessment, the GM crop is compared to non-GM comparators in what is typically referred to as composition equivalence testing. New technologies, such as mass spectrometry and well-designed antibody-based methods, allow better analytical measurements of crop composition, including endogenous allergens. Many of the analytical methods and their intended uses are based on regulatory guidance documents, some of which are outlined in globally recognized documents such as Codex Alimentarius. In certain cases, animal models are recommended by some regulatory agencies in specific countries, but there is typically no hypothesis or justification of their use in testing the safety of GM crops. The quality and standardization of testing methods can be supported, in some cases, by employing good laboratory practices (GLP) and is recognized in China as important to ensure quality data. Although the number of recommended, in some cases, required methods for safety testing are increasing in some regulatory agencies, it should be noted that GM crops registered to date have been shown to be comparable to their nontransgenic counterparts and safe . The crops upon which GM development are based are generally considered safe.

A new surgical technique for medial collateral ligament balancing: multiple needle puncturing.

PubMed

Bellemans, Johan; Vandenneucker, Hilde; Van Lauwe, Johan; Victor, Jan

2010-10-01

In this article, we present our experience with a new technique for medial soft tissue balancing, where we make multiple punctures in the medial collateral ligament (MCL) using a 19-gauge needle, to progressively stretch the MCL until a correct ligament balance is achieved. Ligament status was evaluated both before and after the procedure using computer navigation and mediolateral stress testing. The procedure was considered successful when 2 to 4-mm mediolateral joint line opening was obtained in extension and 2 to 6 mm in flexion. In 34 of 35 cases, a progressive correction of medial tightness was achieved according to the above described criteria. One case was considered overreleased in extension. Needle puncturing is a new, effective, and safe technique for progressive correction of MCL tightness in the varus knee. Copyright © 2010 Elsevier Inc. All rights reserved.

Development of a Test Facility for Air Revitalization Technology Evaluation

NASA Technical Reports Server (NTRS)

Lu, Sao-Dung; Lin, Amy; Campbell, Melissa; Smith, Frederick

2006-01-01

An active fault tolerant control (FTC) law is generally sensitive to false identification since the control gain is reconfigured for fault occurrence. In the conventional FTC law design procedure, dynamic variations due to false identification are not considered. In this paper, an FTC synthesis method is developed in order to consider possible variations of closed-loop dynamics under false identification into the control design procedure. An active FTC synthesis problem is formulated into an LMI optimization problem to minimize the upper bound of the induced-L2 norm which can represent the worst-case performance degradation due to false identification. The developed synthesis method is applied for control of the longitudinal motions of FASER (Free-flying Airplane for Subscale Experimental Research). The designed FTC law of the airplane is simulated for pitch angle command tracking under a false identification case.

Effects of target heating on experiments using Kα and Kβ diagnostics.

PubMed

Palmeri, P; Boutoux, G; Batani, D; Quinet, P

2015-09-01

We describe the impact of heating and ionization on emission from the target of Kα and Kβ radiation induced by the propagation of hot electrons generated by laser-matter interaction. We consider copper as a test case and, starting from basic principles, we calculate the changes in emission wavelength, ionization cross section, and fluorescence yield as Cu is progressively ionized. We have finally considered the more realistic case when hot electrons have a distribution of energies with average energies of 50 and 500 keV (representative respectively of "shock ignition" and of "fast ignition" experiments) and in which the ions are distributed according to ionization equilibrium. In addition, by confronting our theoretical calculations with existing data, we demonstrate that this study offers a generic theoretical background for temperature diagnostics in laser-plasma interactions.

Groundwater flow and heat transport for systems undergoing freeze-thaw: Intercomparison of numerical simulators for 2D test cases

DOE PAGES

Grenier, Christophe; Anbergen, Hauke; Bense, Victor; ...

2018-02-26

In high-elevation, boreal and arctic regions, hydrological processes and associated water bodies can be strongly influenced by the distribution of permafrost. Recent field and modeling studies indicate that a fully-coupled multidimensional thermo-hydraulic approach is required to accurately model the evolution of these permafrost-impacted landscapes and groundwater systems. However, the relatively new and complex numerical codes being developed for coupled non-linear freeze-thaw systems require verification. Here in this paper, this issue is addressed by means of an intercomparison of thirteen numerical codes for two-dimensional test cases with several performance metrics (PMs). These codes comprise a wide range of numerical approaches, spatialmore » and temporal discretization strategies, and computational efficiencies. Results suggest that the codes provide robust results for the test cases considered and that minor discrepancies are explained by computational precision. However, larger discrepancies are observed for some PMs resulting from differences in the governing equations, discretization issues, or in the freezing curve used by some codes.« less

First evidence of occupational asthma to argan powder in a cosmetic factory.

PubMed

Paris, C; Herin, F; Penven, E; Thaon, I; Richard, C; Jacquenet, S; Barbaud, A; Poussel, M

2016-04-01

Argan is used worldwide in numerous cosmetic products, as this fruit is supposed to have many beneficial properties on health. New cases of allergy can be expected with the growing use of argan. We investigated all workers (9) employed by a cosmetic factory and exposed to argan powder to identify possible allergies related to exposure to argan powder. Patients were investigated in the occupational disease department and, according to their symptoms, underwent pulmonary function testing, methacholine challenge, specific inhalation challenge to argan powder, skin prick tests, and immunoblotting analysis. We report three cases of occupational asthma to argan powder and a probable case of rhinitis. Fifteen argan proteins were recognized by the patients' IgE. Identification of proteins, cross-reactions to nuts, and ELISA inhibition tests suggested that some argan allergens can cross-react in vitro with hazelnut allergens, including 11S globulin and vicilin. High-level exposure to argan powder should be considered to be a potential cause of IgE-mediated allergy, and workers handling argan powder should be carefully investigated. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Characterisation and calculation of nonlinear vibrations in gas foil bearing systems-An experimental and numerical investigation

NASA Astrophysics Data System (ADS)

Hoffmann, Robert; Liebich, Robert

2018-01-01

This paper states a unique classification to understand the source of the subharmonic vibrations of gas foil bearing (GFB) systems, which will experimentally and numerically tested. The classification is based on two cases, where an isolated system is assumed: Case 1 considers a poorly balance rotor, which results in increased displacement during operation and interacts with the nonlinear progressive structure. It is comparable to a Duffing-Oscillator. In contrast, for case 2 a well/perfectly balanced rotor is assumed. Hence, the only source of nonlinear subharmonic whirling results from the fluid film self-excitation. Experimental tests with different unbalance levels and GFB modifications confirm these assumptions. Furthermore, simulations are able to predict the self-excitations and synchronous and subharmonic resonances of the experimental test. The numerical model is based on a linearised eigenvalue problem. The GFB system uses linearised stiffness and damping parameters by applying a perturbation method on the Reynolds Equation. The nonlinear bump structure is simplified by a link-spring model. It includes Coulomb friction effects inside the elastic corrugated structure and captures the interaction between single bumps.

Groundwater flow and heat transport for systems undergoing freeze-thaw: Intercomparison of numerical simulators for 2D test cases

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

Grenier, Christophe; Anbergen, Hauke; Bense, Victor

In high-elevation, boreal and arctic regions, hydrological processes and associated water bodies can be strongly influenced by the distribution of permafrost. Recent field and modeling studies indicate that a fully-coupled multidimensional thermo-hydraulic approach is required to accurately model the evolution of these permafrost-impacted landscapes and groundwater systems. However, the relatively new and complex numerical codes being developed for coupled non-linear freeze-thaw systems require verification. Here in this paper, this issue is addressed by means of an intercomparison of thirteen numerical codes for two-dimensional test cases with several performance metrics (PMs). These codes comprise a wide range of numerical approaches, spatialmore » and temporal discretization strategies, and computational efficiencies. Results suggest that the codes provide robust results for the test cases considered and that minor discrepancies are explained by computational precision. However, larger discrepancies are observed for some PMs resulting from differences in the governing equations, discretization issues, or in the freezing curve used by some codes.« less

A case of acute quadriplegia complicating Mediterranean spotted fever.

PubMed

Caroleo, Santo; Longo, Chiara; Pirritano, Domenico; Nisticò, Rita; Valentino, Paola; Iocco, Maurizio; Santangelo, Ermenegildo; Amantea, Bruno

2007-06-01

Mediterranean spotted fever is a rickettsiosis caused by Rickettsia conorii. Mediterranean spotted fever is considered to be a benign disease, however, approximately 10% of patients present with a severe systemic manifestation in which neurologic involvement occurs. We present a case of an 80-year-old man with a R. conorii infection who developed an acute quadriplegia secondary to an axonal polyneuropathy. The characteristic tache noire was observed on the lateral region of the thigh and elevated IgM antibody titres against R. conorii were detected by an indirect immunofluorescence test.

Second-Order Moller-Plesset Perturbation Theory for Molecular Dirac-Hartree-Fock Wave Functions

NASA Technical Reports Server (NTRS)

Dyall, Kenneth G.; Arnold, James O. (Technical Monitor)

1994-01-01

Moller-Plesset perturbation theory is developed to second order for a selection of Kramers restricted Dirac-Hartree-Fock closed and open-shell reference wave functions. The open-shell wave functions considered are limited to those with no more than two electrons in open shells, but include the case of a two-configuration SCF reference. Denominator shifts are included in the style of Davidson's OPT2 method. An implementation which uses unordered integrals with labels is presented, and results are given for a few test cases.

Monitoring of Civil Infrastructures by Interferometric Radar: A Review

PubMed Central

Pieraccini, Massimiliano

2013-01-01

Ground-based radar interferometry is an increasingly popular technique for monitoring civil infrastructures. Many research groups, professionals, and companies have tested it in different operative scenarios, so it is time for a first systematic survey of the case studies reported in the literature. This review is addressed especially to the engineers and scientists interested to consider the applicability of the technique to their practice, so it is focused on the issues of the practical cases rather than on theory and principles, which are now well consolidated. PMID:24106454

The role of attitudes towards the targets of behaviour in predicting and informing prenatal testing choices.

PubMed

Bryant, Louise D; Green, Josephine M; Hewison, Jenny

2010-12-01

Research considering the role of attitudes in prenatal testing choices has commonly focused on the relationship between the attitude towards undergoing testing and actual testing behaviour. In contrast, this study focused on the relationship between testing behaviour and attitudes towards the targets of the behaviour (in this case people with Down syndrome (DS) and having a baby with DS). A cross-sectional, prospective survey of 197 pregnant women measured attitudes towards the targets of prenatal testing along with intentions to use screening and diagnostic testing, and the termination of an affected pregnancy. Screening uptake was established via patient records. Although attitudes towards DS and having a baby with DS were significantly associated with screening uptake and testing and termination intentions, unfavourable attitudes were better than favourable ones at predicting these outcomes. For example, in the quartile of women with the 'most favourable' attitude towards people with DS 67% used screening although only 8% said they would terminate an affected pregnancy. Qualitative data suggested that not all women considered personal attitudes towards DS to be relevant to their screening decisions. This finding has implications for the way in which informed choice is currently understood and measured in the prenatal testing context.

Practice guideline summary: Use of fMRI in the presurgical evaluation of patients with epilepsy

PubMed Central

Szaflarski, Jerzy P.; Gloss, David; Binder, Jeffrey R.; Gaillard, William D.; Golby, Alexandra J.; Holland, Scott K.; Ojemann, Jeffrey; Spencer, David C.; Swanson, Sara J.; French, Jacqueline A.; Theodore, William H.

2017-01-01

Objective: To assess the diagnostic accuracy and prognostic value of functional MRI (fMRI) in determining lateralization and predicting postsurgical language and memory outcomes. Methods: An 11-member panel evaluated and rated available evidence according to the 2004 American Academy of Neurology process. At least 2 panelists reviewed the full text of 172 articles and selected 37 for data extraction. Case reports, reports with <15 cases, meta-analyses, and editorials were excluded. Results and recommendations: The use of fMRI may be considered an option for lateralizing language functions in place of intracarotid amobarbital procedure (IAP) in patients with medial temporal lobe epilepsy (MTLE; Level C), temporal epilepsy in general (Level C), or extratemporal epilepsy (Level C). For patients with temporal neocortical epilepsy or temporal tumors, the evidence is insufficient (Level U). fMRI may be considered to predict postsurgical language deficits after anterior temporal lobe resection (Level C). The use of fMRI may be considered for lateralizing memory functions in place of IAP in patients with MTLE (Level C) but is of unclear utility in other epilepsy types (Level U). fMRI of verbal memory or language encoding should be considered for predicting verbal memory outcome (Level B). fMRI using nonverbal memory encoding may be considered for predicting visuospatial memory outcomes (Level C). Presurgical fMRI could be an adequate alternative to IAP memory testing for predicting verbal memory outcome (Level C). Clinicians should carefully advise patients of the risks and benefits of fMRI vs IAP during discussions concerning choice of specific modality in each case. PMID:28077494

Eigenstates and dynamics of Hooke's atom: Exact results and path integral simulations

NASA Astrophysics Data System (ADS)

Gholizadehkalkhoran, Hossein; Ruokosenmäki, Ilkka; Rantala, Tapio T.

2018-05-01

The system of two interacting electrons in one-dimensional harmonic potential or Hooke's atom is considered, again. On one hand, it appears as a model for quantum dots in a strong confinement regime, and on the other hand, it provides us with a hard test bench for new methods with the "space splitting" arising from the one-dimensional Coulomb potential. Here, we complete the numerous previous studies of the ground state of Hooke's atom by including the excited states and dynamics, not considered earlier. With the perturbation theory, we reach essentially exact eigenstate energies and wave functions for the strong confinement regime as novel results. We also consider external perturbation induced quantum dynamics in a simple separable case. Finally, we test our novel numerical approach based on real-time path integrals (RTPIs) in reproducing the above. The RTPI turns out to be a straightforward approach with exact account of electronic correlations for solving the eigenstates and dynamics without the conventional restrictions of electronic structure methods.

On the Material Characterisation of Wind Turbine Blade Coatings: The Effect of Interphase Coating–Laminate Adhesion on Rain Erosion Performance

PubMed Central

Cortés, Enrique; Sánchez, Fernando; Madramany, Borja

2017-01-01

Rain erosion damage, caused by repeated droplet impact on wind turbine blades, is a major cause for concern, even more so at offshore locations with larger blades and higher tip speeds. Due to the negative economic influence of blade erosion, all wind turbine Original Equipment Manufacturers (OEMs) are actively seeking solutions. In most cases, since the surface coating plays a decisive role in the blade manufacture and overall performance, it has been identified as an area where a solution may be obtained. In this research, two main coating technologies have been considered: In-mould coatings (Gel coating) applied during moulding on the entire blade surface and the post-mould coatings specifically developed for Leading Edge Protection (LEP). The coating adhesion and erosion is affected by the shock waves created by the collapsing water droplets on impact. The stress waves are reflected and transmitted to the laminate substrate, so microstructural discontinuities in coating layers and interfaces play a key role on its degradation and may accelerate erosion by delamination. Analytical and numerical models are commonly used to relate lifetime prediction and to identify suitable coating and composite substrate combinations based on their potential stress reduction on the interface. Nevertheless, in order to use them, it is necessary to measure the contact adhesion resistance of the multi-layered system interfaces. The rain erosion performance is assessed using an accelerated testing technique, whereby the test material is repeatedly impacted at high speed with water droplets in a Whirling Arm Rain Erosion Rig (WARER). The materials, specifically the coating–laminate interphase region and acoustic properties, are further characterised by several laboratory tests, including Differential Scanning Calorimetry (DSC), pull-off testing, peeling–adhesion testing and nanoindentation testing. This body of work includes a number of case studies. The first case study compares two of the main coating technologies used in industry (i.e., gel coating and LEP); the second case investigates the effects of the in-mould gel coating curing; and the third considers the inclusion of a primer layer on a LEP configuration system. Following these case studies, the LEP is found to be a far superior coating due to its appropriate mechanical and acoustic properties and the interface between the coating and the substrate is highlighted as a key aspect, as poor adhesion can lead to delamination and, ultimately, premature failure of the coating. PMID:28956841

On the Material Characterisation of Wind Turbine Blade Coatings: The Effect of Interphase Coating-Laminate Adhesion on Rain Erosion Performance.

PubMed

Cortés, Enrique; Sánchez, Fernando; O'Carroll, Anthony; Madramany, Borja; Hardiman, Mark; Young, Trevor M

2017-09-28

Rain erosion damage, caused by repeated droplet impact on wind turbine blades, is a major cause for concern, even more so at offshore locations with larger blades and higher tip speeds. Due to the negative economic influence of blade erosion, all wind turbine Original Equipment Manufacturers (OEMs) are actively seeking solutions. In most cases, since the surface coating plays a decisive role in the blade manufacture and overall performance, it has been identified as an area where a solution may be obtained. In this research, two main coating technologies have been considered: In-mould coatings (Gel coating) applied during moulding on the entire blade surface and the post-mould coatings specifically developed for Leading Edge Protection (LEP). The coating adhesion and erosion is affected by the shock waves created by the collapsing water droplets on impact. The stress waves are reflected and transmitted to the laminate substrate, so microstructural discontinuities in coating layers and interfaces play a key role on its degradation and may accelerate erosion by delamination. Analytical and numerical models are commonly used to relate lifetime prediction and to identify suitable coating and composite substrate combinations based on their potential stress reduction on the interface. Nevertheless, in order to use them, it is necessary to measure the contact adhesion resistance of the multi-layered system interfaces. The rain erosion performance is assessed using an accelerated testing technique, whereby the test material is repeatedly impacted at high speed with water droplets in a Whirling Arm Rain Erosion Rig (WARER). The materials, specifically the coating-laminate interphase region and acoustic properties, are further characterised by several laboratory tests, including Differential Scanning Calorimetry (DSC), pull-off testing, peeling-adhesion testing and nanoindentation testing. This body of work includes a number of case studies. The first case study compares two of the main coating technologies used in industry (i.e., gel coating and LEP); the second case investigates the effects of the in-mould gel coating curing; and the third considers the inclusion of a primer layer on a LEP configuration system. Following these case studies, the LEP is found to be a far superior coating due to its appropriate mechanical and acoustic properties and the interface between the coating and the substrate is highlighted as a key aspect, as poor adhesion can lead to delamination and, ultimately, premature failure of the coating.

The borderline range of toxicological methods: Quantification and implications for evaluating precision.

PubMed

Leontaridou, Maria; Urbisch, Daniel; Kolle, Susanne N; Ott, Katharina; Mulliner, Denis S; Gabbert, Silke; Landsiedel, Robert

2017-01-01

Test methods to assess the skin sensitization potential of a substance usually use threshold criteria to dichotomize continuous experimental read-outs into yes/no conclusions. The threshold criteria are prescribed in the respective OECD test guidelines and the conclusion is used for regulatory hazard assessment, i.e., classification and labelling of the substance. We can identify a borderline range (BR) around the classification threshold within which test results are inconclusive due to a test method's biological and technical variability. We quantified BRs in the prediction models of the non-animal test methods DPRA, LuSens and h-CLAT, and of the animal test LLNA, respectively. Depending on the size of the BR, we found that between 6% and 28% of the substances in the sets tested with these methods were considered borderline. When the results of individual non-animal test methods were combined into integrated testing strategies (ITS), borderline test results of individual tests also affected the overall assessment of the skin sensitization potential of the testing strategy. This was analyzed for the 2-out-of-3 ITS: Four out of 40 substances (10%) were considered borderline. Based on our findings we propose expanding the standard binary classification of substances into "positive"/"negative" or "hazardous"/"non-hazardous" by adding a "borderline" or "inconclusive" alert for cases where test results fall within the borderline range.

Accuracy of polimerase chain reaction for the diagnosis of pleural tuberculosis.

PubMed

Trajman, Anete; da Silva Santos Kleiz de Oliveira, Elen Fabricia; Bastos, Mayara Lisboa; Belo Neto, Epaminondas; Silva, Edgar Manoel; da Silva Lourenço, Maria Cristina; Kritski, Afrânio; Oliveira, Martha Maria

2014-06-01

Polymerase chain reaction (PCR)-based techniques to detect Mycobacterium tuberculosis DNA in respiratory specimens have been increasingly used to diagnose pulmonary tuberculosis. Their use in non-respiratory specimens to diagnose extrapulmonary tuberculosis is, however, controversial. In this study, we estimated the accuracy of three in-country commercialized PCR-based diagnostic techniques in pleural fluid samples for the diagnosis of pleural tuberculosis. Patients underwent thoracenthesis for diagnosis purposes; pleural fluid aliquots were frozen and subsequently submitted to two real time PCR tests (COBAS(®)TAQMAN(®)MTB and Xpert(®)MTB/Rif) and one conventional PCR test (Detect-TB(®)). Two different reference standards were considered: probable tuberculosis (based on clinical grounds) and confirmed tuberculosis (bacteriologically or histologically). Ninety-three patients were included, of whom 65 with pleural tuberculosis, 35 of them confirmed. Sensitivities were 29% for COBAS(®)TAQMAN(®)MTB, 3% for Xpert(®)MTB/Rif and 3% for Detect-TB(®); specificities were 86%, 100% and 97% respectively, considering confirmed tuberculosis. Considering all cases, sensitivities were 16%, 3% and 2%, and specificities, 86%, 100%, and 97%. Compared to the 95% sensitivity of adenosine deaminase, the most sensitive test for pleural tuberculosis, the sensitivities of the three PCR-based tests were very low. We conclude that at present, there is no major place for such tests in routine clinical use. Copyright © 2014 Elsevier Ltd. All rights reserved.

On the selection of user-defined parameters in data-driven stochastic subspace identification

NASA Astrophysics Data System (ADS)

Priori, C.; De Angelis, M.; Betti, R.

2018-02-01

The paper focuses on the time domain output-only technique called Data-Driven Stochastic Subspace Identification (DD-SSI); in order to identify modal models (frequencies, damping ratios and mode shapes), the role of its user-defined parameters is studied, and rules to determine their minimum values are proposed. Such investigation is carried out using, first, the time histories of structural responses to stationary excitations, with a large number of samples, satisfying the hypothesis on the input imposed by DD-SSI. Then, the case of non-stationary seismic excitations with a reduced number of samples is considered. In this paper, partitions of the data matrix different from the one proposed in the SSI literature are investigated, together with the influence of different choices of the weighting matrices. The study is carried out considering two different applications: (1) data obtained from vibration tests on a scaled structure and (2) in-situ tests on a reinforced concrete building. Referring to the former, the identification of a steel frame structure tested on a shaking table is performed using its responses in terms of absolute accelerations to a stationary (white noise) base excitation and to non-stationary seismic excitations of low intensity. Black-box and modal models are identified in both cases and the results are compared with those from an input-output subspace technique. With regards to the latter, the identification of a complex hospital building is conducted using data obtained from ambient vibration tests.

A Psittacosis Outbreak among English Office Workers with Little or No Contact with Birds, August 2015.

PubMed

Mair-Jenkins, John; Lamming, Tracey; Dziadosz, Andy; Flecknoe, Daniel; Stubington, Thomas; Mentasti, Massimo; Muir, Peter; Monk, Philip

2018-04-27

On 14th August 2015 an office manager informed Public Health England of five employees known to have been diagnosed with pneumonia over the previous three weeks. We investigated to establish whether an outbreak occurred and to identify and control the source of infection. We undertook case finding for self-reported pneumonia cases at local businesses (July-August 2015). Clinical samples from a hospitalised case were tested for common respiratory pathogens, but returned negative results. Further testing confirmed Chlamydia psittaci infection in this case (serology and PCR).  We subsequently undertook C. psittaci testing for all cases, redefining them as confirmed ( C. psittaci PCR or high antibody titre via serology) or probable (inconclusive C. psittaci serology). Twenty-eight day exposure histories informed descriptive epidemiological analysis. We conducted an environmental investigation at the office to identify potential sources of exposure. We identified six office workers with pneumonia; four met case definitions (three confirmed, one probable) with symptom onset between 29th July and 4th August 2015. Workplace was the only epidemiological link and only one case reported limited, indirect bird contact. Environmental investigations identified pigeons roosting near the office which were being fed by workers (none cases). This was a probable outbreak of psittacosis with no direct bird-to-human contact reported. Cases recovered after receiving appropriate antibiotics. Feeding of pigeons was stopped. A deep clean of office ventilation systems was conducted and workers were advised to avoid bird contact.  We hypothesised that indirect environmental exposure to infected pigeons was to the source of this outbreak. This work provides evidence that health professionals should consider psittacosis in the differential diagnosis of cases of severe or atypical respiratory illness even without overt bird contact.

Palatini formulation of f( R, T) gravity theory, and its cosmological implications

NASA Astrophysics Data System (ADS)

Wu, Jimin; Li, Guangjie; Harko, Tiberiu; Liang, Shi-Dong

2018-05-01

We consider the Palatini formulation of f( R, T) gravity theory, in which a non-minimal coupling between the Ricci scalar and the trace of the energy-momentum tensor is introduced, by considering the metric and the affine connection as independent field variables. The field equations and the equations of motion for massive test particles are derived, and we show that the independent connection can be expressed as the Levi-Civita connection of an auxiliary, energy-momentum trace dependent metric, related to the physical metric by a conformal transformation. Similar to the metric case, the field equations impose the non-conservation of the energy-momentum tensor. We obtain the explicit form of the equations of motion for massive test particles in the case of a perfect fluid, and the expression of the extra force, which is identical to the one obtained in the metric case. The thermodynamic interpretation of the theory is also briefly discussed. We investigate in detail the cosmological implications of the theory, and we obtain the generalized Friedmann equations of the f( R, T) gravity in the Palatini formulation. Cosmological models with Lagrangians of the type f=R-α ^2/R+g(T) and f=R+α ^2R^2+g(T) are investigated. These models lead to evolution equations whose solutions describe accelerating Universes at late times.

Comparative evaluation of the IPCC AR5 CMIP5 versus the AR4 CMIP3 model ensembles for regional precipitation and their extremes over South America

NASA Astrophysics Data System (ADS)

Tolen, J.; Kodra, E. A.; Ganguly, A. R.

2011-12-01

The assertion that higher-resolution experiments or more sophisticated process models within the IPCC AR5 CMIP5 suite of global climate model ensembles improves precipitation projections over the IPCC AR4 CMIP3 suite remains a hypothesis that needs to be rigorously tested. The questions are particularly important for local to regional assessments at scales relevant for the management of critical infrastructures and key resources, particularly for the attributes of sever precipitation events, for example, the intensity, frequency and duration of extreme precipitation. Our case study is South America, where precipitation and their extremes play a central role in sustaining natural, built and human systems. To test the hypothesis that CMIP5 improves over CMIP3 in this regard, spatial and temporal measures of prediction skill are constructed and computed by comparing climate model hindcasts with the NCEP-II reanalysis data, considered here as surrogate observations, for the entire globe and for South America. In addition, gridded precipitation observations over South America based on rain gage measurements are considered. The results suggest that the utility of the next-generation of global climate models over the current generation needs to be carefully evaluated on a case-by-case basis before communicating to resource managers and policy makers.

Testing contamination source identification methods for water distribution networks

DOE PAGES

Seth, Arpan; Klise, Katherine A.; Siirola, John D.; ...

2016-04-01

In the event of contamination in a water distribution network (WDN), source identification (SI) methods that analyze sensor data can be used to identify the source location(s). Knowledge of the source location and characteristics are important to inform contamination control and cleanup operations. Various SI strategies that have been developed by researchers differ in their underlying assumptions and solution techniques. The following manuscript presents a systematic procedure for testing and evaluating SI methods. The performance of these SI methods is affected by various factors including the size of WDN model, measurement error, modeling error, time and number of contaminant injections,more » and time and number of measurements. This paper includes test cases that vary these factors and evaluates three SI methods on the basis of accuracy and specificity. The tests are used to review and compare these different SI methods, highlighting their strengths in handling various identification scenarios. These SI methods and a testing framework that includes the test cases and analysis tools presented in this paper have been integrated into EPA’s Water Security Toolkit (WST), a suite of software tools to help researchers and others in the water industry evaluate and plan various response strategies in case of a contamination incident. Lastly, a set of recommendations are made for users to consider when working with different categories of SI methods.« less

West Nile virus among hospitalized, febrile patients: a case for expanding diagnostic testing.

PubMed

Whitney, Ellen A Spotts; Heilpern, Katherine L; Woods, Christopher W; Bahn, C Christina; Franko, Elizabeth A; Del Rio, Carlos; Silk, Benjamin J; Ratcliff, Jonathan J; Bryant, Katherine A; Park, Mahin M; Watkins, Sandra J; Caram, Lauren B; Blumberg, Henry M; Berkelman, Ruth L

2006-01-01

In Georgia, most individuals reported with West Nile virus (WNV) disease have been diagnosed with West Nile neuroinvasive disease (WNND). Relatively few cases of West Nile Fever (WNF) are reported, and the burden of illness due to WNV is likely underestimated. From July through October 2003, WNV serologic testing was performed on enrolled patients>or=18 years of age with fever admitted to a large, urban hospital in Atlanta, Georgia through the emergency department (ED). Patients' history, clinical, and laboratory data were recorded. Residual blood drawn in the ED was tested to determine the presence of WNV IgG and IgM antibodies. Of 254 patients tested for WNV, four (1.6%) patients were positive for WNV IgM and IgG antibodies, and had a clinical illness compatible with WNV. None of the four positive patients were clinically suspected of having WNV infection; discharge diagnoses included pneumonia, migraine, stroke, and gout. These four patients accounted for 80% of all WNV diagnosed in this hospital, 44% of all cases in Fulton County, and 7% of all cases reported in Georgia in 2003. The occurrence of WNV disease may be substantially greater than currently reflected in disease statistics in Georgia and many other states. When indicators of WNV activity are present and patients are likely to have had intensive mosquito exposure, WNV should be considered in the differential diagnosis of seriously ill, febrile patients.

Impact of accelerated progression to AIDS on public health monitoring of late HIV diagnosis.

PubMed

Sabharwal, Charulata J; Sepkowitz, Kent; Mehta, Reshma; Shepard, Colin; Bodach, Sara; Torian, Lucia; Begier, Elizabeth M

2011-03-01

Some patients develop AIDS within a year of HIV infection ("accelerated progression"). Classifying such cases as late HIV diagnosis may lead to inaccurate evaluation of HIV testing efforts. We sought to determine this group's contribution to overall late diagnosis rates. To identify cases of accelerated progression (development of AIDS within 12 months of a negative HIV test), we reviewed published HIV seroconverter cohort studies and used New York City's (NYC) HIV/AIDS surveillance registry. From the literature review, three seroconverter cohort studies revealed that 1.0-3.6% of participants had accelerated progression to AIDS. Applying this frequency estimate to the number of new infections in NYC (4762) for 2006 calculated by the Centers for Diseases Control and Prevention's incidence formula, we estimated that 3.6-13.0% of 1317 NYC HIV cases who are diagnosed with AIDS within 12 months of HIV diagnosis are accelerated progressors, not persons HIV infected for many years who did not test and present with AIDS (i.e., delayed diagnosis). In addition, our analysis of the 2006 NYC surveillance registry confirmed the occurrence of accelerated progression in a population-based setting; 67 accelerated progressors were reported and 9 (13%) could be confirmed through follow-up medical record review. With increased HIV testing initiatives, the irreducible proportion of AIDS cases with accelerated progression must be considered when interpreting late diagnosis data.

New endemic foci of tick-borne encephalitis (TBE) identified in districts where testing for TBE was not available before 2009 in Poland

PubMed Central

2013-01-01

Background Tick-borne encephalitis (TBE) is found in limited endemic foci in Poland. Lack of diagnosis limits disease detection in non-endemic provinces. Methods In 2009, we enhanced TBE surveillance to confirm the location of endemic foci and inform vaccination policy. In 105 hospitals located in 11/16 provinces, we identified suspected TBE cases through admission ICD-10 codes indicating aseptic meningo-encephalitis or from specimens tested for TBE. The National Reference Laboratory confirmed cases at no cost, by testing serum and/or cerebrospinal fluid using ELISA method. We calculated TBE reported rates as the number of confirmed TBE cases per 100,000 inhabitants. Adjusting to neighbouring districts, we classified districts as non-endemic (<0.1 cases per 100,000 inhabitants), low endemic (> = 0.1 to <1), moderately endemic (> = 1 to <5) and highly endemic (> = 5). We compared surveillance data obtained in 2009 with 2004–2008 baseline data. Results Among 166,099 admissions, we identified 1,585 suspected TBE cases of which 256 were confirmed. Physicians reported more suspected cases among patients <40 years old (12 cases per 1,000 admissions) than among older patients (8 cases per 1,000 admissions). However, patients <40 years of age were confirmed less frequently (16%), than older patients (35%). Physicians reported more suspected cases in districts classed as endemic during 2004–2008 (12 cases per 1,000 admissions, 77% tested for TBE) than in districts classed as non-endemic (7 cases per 1,000 admissions, 59% tested). Of the 38 newly identified endemic districts, 31 were adjacent to 2004–2008 endemic districts and 7 were isolated. Conclusions Enhanced surveillance detected 38 new endemic districts to be considered for TBE vaccination. However, lack of consistent testing in districts believed to be TBE-free remained an obstacle for mapping TBE risk. Although the disease affects mostly older adults and the elderly, more attention is given to the diagnosis of TBE in young patients. Solutions need to be identified to sustain sensitive, acceptable and affordable TBE surveillance in all districts of Poland. Also, higher attention should be given to the diagnosis of TBE in the elderly. PMID:23777675

Allergies in orthopaedic and trauma surgery.

PubMed

Lohmann, C H; Hameister, R; Singh, G

2017-02-01

Hypersensitivity reactions to implants in orthopaedic and trauma surgery are a rare but devastating complication. They are considered as a delayed-type of hypersensitivity reaction (type IV), characterized by an antigen activation of sensitized T-lymphocytes releasing various cytokines and may result in osteoclast activation and bone resorption. Potential haptens are originated from metal alloys or bone-cement. A meta-analysis has confirmed a higher probability of developing a metal hypersensitivity postoperatively and noted a greater risk of failed replacements compared to stable implants. Hypersensitivity to implants may present with a variety of symptoms such as pain, joint effusion, delayed wound/bone healing, persistent secretion, allergic dermatitis (localized or systemic), clicking noises, loss of joint function, instability and failure of the implant. Various diagnostic options have been offered, including patch testing, metal alloy patch testing, histology, lymphocyte transformation test (LTT), memory lymphocyte immunostimulation assay (MELISA), leukocyte migration inhibition test (LIF) and lymphocyte activation test (LAT). No significant differences between in vivo and in vitro methods have been found. Due to unconvincing evidence for screening methods, predictive tests are not recommended for routine performance. Infectious aetiology always needs to be excluded. As there is a lack of evidence on large-scale studies with regards to the optimal treatment option, management currently relies on individual case-by-case decisions. Several options for patients with (suspected) metal-related hypersensitivity exist and may include materials based on ceramic, titanium or oxinium or modified surfaces. Promising results have been reported, but long-term experience is lacking. More large-scaled studies are needed in this context. In patients with bone-cement hypersensitivity, the component suspected for hypersensitivity should be avoided. The development of (predictive) biomarkers is considered as a major contribution for the future. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

Stress distribution in composite flatwise tension test specimens

NASA Technical Reports Server (NTRS)

Scott, Curtis A.; Pereira, J. Michael

1993-01-01

A finite element analysis was conducted to determine the stress distribution in typical graphite/epoxy composite flat wise tension (FWT) specimens under normal loading conditions. The purpose of the analysis was to determine the relationship between the applied load and the stress in the sample to evaluate the validity of the test as a means of measuring the out-of-plane strength of a composite laminate. Three different test geometries and three different material lay ups were modeled. In all cases, the out-of-plane component of stress in the test section was found to be uniform, with no stress concentrations, and very close to the nominal applied stress. The stress in the sample was found to be three-dimensional, and the magnitude of in-plane normal and shear stresses varied with the anisotropy of the test specimen. However, in the cases considered here, these components of stress were much smaller than the out-of-plane normal stress. The geometry of the test specimen had little influence on the results. It was concluded that the flat wise tension test provides a good measure of the out-of-plane strength for the representative materials that were studied.

Laboratory evaluation of 3M Petrifilms and University of Minnesota Bi-plates as potential on-farm tests for clinical mastitis.

PubMed

McCarron, J L; Keefe, G P; McKenna, S L B; Dohoo, I R; Poole, D E

2009-05-01

The objective was to determine test characteristics and compare 2 potential on-farm culture systems for clinical mastitis, the Minnesota Easy Culture System II Bi-plate and Petrifilm. The tests were evaluated using clinically positive mastitic milk samples (n = 282) to determine their ability to differentiate appropriate treatment groups; all cases that had gram-positive growth were considered treatment candidates (n = 161), whereas cases that grew gram-negative organisms only or yielded no bacterial growth were classified as no treatment (n = 121). For Petrifilm, both undiluted and 1:10 diluted milk samples were used. To create treatment categories, 2 types of Petrifilms were used, Aerobic Count (AC) and Coliform Count (CC). Both Bi-plates and Petrifilms were read after 24 h of incubation. Analysis was conducted at various colony count thresholds for the Petrifilm test system. The combination of Petrifilms that had the highest sensitivity classified a case as gram-negative if there were > or =20 colonies present on the CC. If there were <20 colonies present on the CC and >5 colonies present on the AC, a case would be classified as gram-positive. The Bi-plate had a sensitivity of 97.9% and a specificity of 68.6%. The Petrifilm test system had a sensitivity of 93.8% and a specificity of 70.1%. There was no significant difference in the sensitivities between the tests. All Bi-plates and Petrifilms were read by a laboratory technician and a group of masked readers with limited microbiology training. Kappa values for the masked readers were 0.75 for Bi-plates and 0.84 and 0.86 for AC and CC Petrifilms, respectively. The Bi-plate and Petrifilm were able to successfully categorize clinical cases of mastitis into 2 treatments based on their ability to detect the presence of a gram-positive organism. Neither method had the ability to determine if a sample was contaminated. The results of this study indicate that both tests were able to appropriately categorize cases, which could potentially result in a reduction in the quantity of antibiotics used to treat clinical cases of mastitis.

Ecotoxicity testing: science, politics and ethics.

PubMed

Walker, Colin H

2008-02-01

Animal welfare organisations have long been concerned about the use of animals for ecotoxicity testing. Ecotoxicity testing is a necessary part of the statutory risk assessment of chemicals that may be released into the environment. It is sometimes also carried out during the development of new chemicals and in the investigation of pollution in the field. This review considers the existing requirements for ecotoxicity testing, with particular reference to practices in the European Union, including the recent REACH system proposals, before discussing criticisms that have been made of existing practices for environmental risk assessment. These criticisms have been made on scientific and ethical grounds, as well as on questions of cost. A case is made for greater investment in the development of alternative testing methods, which could improve the science, as well as serving the cause of animal welfare. It has frequently been suggested that the statutory requirements for environmental risk assessment are too rigid and bureaucratic. A case is made for flexibility and the greater involvement of scientists in the risk assessment procedure, in the interests of both improved science and improved animal welfare.

The role of religion in decision-making on antenatal screening of congenital anomalies: a qualitative study amongst Muslim Turkish origin immigrants.

PubMed

Gitsels-van der Wal, Janneke T; Manniën, Judith; Ghaly, Mohammed M; Verhoeven, Pieternel S; Hutton, Eileen K; Reinders, Hans S

2014-03-01

to explore what role religious beliefs of pregnant Muslim women play in their decision-making on antenatal screening, particularly regarding congenital abnormalities and termination, and whether their interpretations of the religious doctrines correspond to the main sources of Islam. qualitative pilot study using in-depth interviews with pregnant Muslim women. one midwifery practice in a medium-sized city near Amsterdam participated in the study. 10 pregnant Muslim women of Turkish origin who live in a high density immigrant area and who attended primary midwives for antenatal care were included in the study. to explore the role of religion in decision-making on antenatal screening tests, a topic list was constructed, including four subjects: being a (practising) Muslim, the view on unborn life, the view on disabled life and the view on termination. To analyse the interviews, open and axial coding based on the Grounded Theory was used and descriptive and analytical themes were identified and interpreted. all 10 interviewees stated that their faith played a role in their decision-making on antenatal screening, specific to the combined test. They did not consider congenital anomalies as a problem and did not consider termination to be an option in case of a disabled fetus. However, the Islamic jurisprudence considers that termination is allowed if the fetus has serious abnormalities, but only before 19 weeks plus one day of gestation. religious convictions play a role regarding antenatal screening in pregnant Muslim women of Turkish origin. The interviewees did not consider a termination in case of an affected child. Women were unaware that within Islamic tradition there is the possibility of termination if a fetus has serious anomalies. Incomplete knowledge of religious doctrines may be influencing both decisions of antenatal screening and diagnostic tests uptake and of terminating a pregnancy for fetuses with serious anomalies. counsellors should be aware of the role of religious beliefs in the decision-making process on antenatal screening tests. Copyright © 2013 The Authors. Published by Elsevier Ltd.. All rights reserved.

AME position statement on adrenal incidentaloma.

PubMed

Terzolo, M; Stigliano, A; Chiodini, I; Loli, P; Furlani, L; Arnaldi, G; Reimondo, G; Pia, A; Toscano, V; Zini, M; Borretta, G; Papini, E; Garofalo, P; Allolio, B; Dupas, B; Mantero, F; Tabarin, A

2011-06-01

To assess currently available evidence on adrenal incidentaloma and provide recommendations for clinical practice. A panel of experts (appointed by the Italian Association of Clinical Endocrinologists (AME)) appraised the methodological quality of the relevant studies, summarized their results, and discussed the evidence reports to find consensus. Unenhanced computed tomography (CT) is recommended as the initial test with the use of an attenuation value of ≤10 Hounsfield units (HU) to differentiate between adenomas and non-adenomas. For tumors with a higher baseline attenuation value, we suggest considering delayed contrast-enhanced CT studies. Positron emission tomography (PET) or PET/CT should be considered when CT is inconclusive, whereas fine needle aspiration biopsy may be used only in selected cases suspicious of metastases (after biochemical exclusion of pheochromocytoma). HORMONAL ASSESSMENT: Pheochromocytoma and excessive overt cortisol should be ruled out in all patients, whereas primary aldosteronism has to be considered in hypertensive and/or hypokalemic patients. The 1 mg overnight dexamethasone suppression test is the test recommended for screening of subclinical Cushing's syndrome (SCS) with a threshold at 138 nmol/l for considering this condition. A value of 50 nmol/l virtually excludes SCS with an area of uncertainty between 50 and 138 nmol/l. Surgery is recommended for masses with suspicious radiological aspects and masses causing overt catecholamine or steroid excess. Data are insufficient to make firm recommendations for or against surgery in patients with SCS. However, adrenalectomy may be considered when an adequate medical therapy does not reach the treatment goals of associated diseases potentially linked to hypercortisolism.

Approaches to the safety assessment of engineered nanomaterials (ENM) in food.

PubMed

Cockburn, Andrew; Bradford, Roberta; Buck, Neil; Constable, Anne; Edwards, Gareth; Haber, Bernd; Hepburn, Paul; Howlett, John; Kampers, Frans; Klein, Christoph; Radomski, Marek; Stamm, Hermann; Wijnhoven, Susan; Wildemann, Tanja

2012-06-01

A systematic, tiered approach to assess the safety of engineered nanomaterials (ENMs) in foods is presented. The ENM is first compared to its non-nano form counterpart to determine if ENM-specific assessment is required. Of highest concern from a toxicological perspective are ENMs which have potential for systemic translocation, are insoluble or only partially soluble over time or are particulate and bio-persistent. Where ENM-specific assessment is triggered, Tier 1 screening considers the potential for translocation across biological barriers, cytotoxicity, generation of reactive oxygen species, inflammatory response, genotoxicity and general toxicity. In silico and in vitro studies, together with a sub-acute repeat-dose rodent study, could be considered for this phase. Tier 2 hazard characterisation is based on a sentinel 90-day rodent study with an extended range of endpoints, additional parameters being investigated case-by-case. Physicochemical characterisation should be performed in a range of food and biological matrices. A default assumption of 100% bioavailability of the ENM provides a 'worst case' exposure scenario, which could be refined as additional data become available. The safety testing strategy is considered applicable to variations in ENM size within the nanoscale and to new generations of ENM. Copyright © 2012 Elsevier Ltd. All rights reserved.

Stability of binaries. Part 1: Rigid binaries

NASA Astrophysics Data System (ADS)

Sharma, Ishan

2015-09-01

We consider the stability of binary asteroids whose members are possibly granular aggregates held together by self-gravity alone. A binary is said to be stable whenever each member is orbitally and structurally stable to both orbital and structural perturbations. To this end, we extend the stability test for rotating granular aggregates introduced by Sharma (Sharma, I. [2012]. J. Fluid Mech., 708, 71-99; Sharma, I. [2013]. Icarus, 223, 367-382; Sharma, I. [2014]. Icarus, 229, 278-294) to the case of binary systems comprised of rubble members. In part I, we specialize to the case of a binary with rigid members subjected to full three-dimensional perturbations. Finally, we employ the stability test to critically appraise shape models of four suspected binary systems, viz., 216 Kleopatra, 25143 Itokawa, 624 Hektor and 90 Antiope.

Prediction of Tensile Behavior of UHSFRC Considering the Flow Field in the Placing Dominated by Shear Flow.

PubMed

Moon, Joon-Shik; Kang, Su-Tae

2018-01-26

Considering the case of fabricating a UHSFRC (ultra-high strength fiber-reinforced concrete) beam with the method of one end placing and self-flowing to the other end, it was intended to simulate the variation of the fiber orientation distribution according to the flow distance and the variation of the resultant tensile behaviors. Then the validity of the simulation approach was shown by comparing the simulated results with experimental ones. A three-point bending test with a notched beam was adopted for the experiment and a finite element analysis was performed to obtain the simulated results for the bending test considering the flow-dependent tensile behavior of the UHSFRC. From the simulation for the fiber orientation distribution according to the flow distance, it could be found that the major change in the fiber orientation distribution took place within a short flow distance and most of the fibers became nearly aligned to the flow direction. After some flow distance, there was a not-so-remarkable variation in the fiber orientation distribution that could influence the tensile behavior of the composite. For this flow region, the consistent flexural test results, regardless of flow distance, demonstrate the reliability of the simulation.

The social dynamics of genetic testing: the case of Fragile-X.

PubMed

Nelkin, D

1996-12-01

This article considers a program to screen school children for Fragile-X Syndrome as a way to explore several features of the growing practice of genetic testing in American society. These include the common practice of predictive testing in nonclinical settings; the economic, entrepreneurial, and policy interests that are driving the development of genetic screening programs; and the public support for genetic testing even when there are no effective therapeutic interventions. Drawing from research on popular images of genetics, I argue that cultural beliefs and expectations, widely conveyed through popular narratives, are encouraging the search for diagnostic information and enhancing the appeal of genetic explanations for a growing range of conditions.

Domestically Acquired Legionnaires’ Disease: Two Case Reports and a Review of the Pertinent Literature

PubMed Central

Erdoğan, Haluk; Arslan, Hande

2016-01-01

Background: Legionella species may colonize in home water systems and cause Legionnaires’ disease (LD). We herein report two cases of sporadic LD associated with the solar energy-heated hot water systems of the patients’ houses. Case Report: A 60-year-old woman with chronic bronchitis and diabetes mellitus presented with a high fever, abdominal pain, and diarrhea. Physical examination revealed rales, and her chest radiograph showed a homogeneous density in the left lung. The Legionella urinary antigen test was positive, and an indirect fluorescent antibody test revealed a serum antibody titer of 1/520 for L. pneumophila serogroup 1. In the second case, a 66-year-old man with diabetes mellitus was treated for pneumonia at another hospital. After the patient’s general condition worsened and he required mechanical ventilation, he was referred to our hospital. The Legionella urinary antigen test was positive. Neither of the patients had been hospitalized or travelled within the previous month. Both patients used hot water storage tanks heated by solar energy; both also used an electrical device in the bathroom to heat the water when solar energy alone was insufficient. The hot water samples from the residences of both patients were positive for L. pneumophila sero-group 1. Conclusion: These cases show that domestic hot water systems heated by solar energy must be considered a possible source of community-acquired LD. PMID:27308081

Preliminary consideration of CFETR ITER-like case diagnostic system.

PubMed

Li, G S; Yang, Y; Wang, Y M; Ming, T F; Han, X; Liu, S C; Wang, E H; Liu, Y K; Yang, W J; Li, G Q; Hu, Q S; Gao, X

2016-11-01

Chinese Fusion Engineering Test Reactor (CFETR) is a new superconducting tokamak device being designed in China, which aims at bridging the gap between ITER and DEMO, where DEMO is a tokamak demonstration fusion reactor. Two diagnostic cases, ITER-like case and towards DEMO case, have been considered for CFETR early and later operating phases, respectively. In this paper, some preliminary consideration of ITER-like case will be presented. Based on ITER diagnostic system, three versions of increased complexity and coverage of the ITER-like case diagnostic system have been developed with different goals and functions. Version A aims only machine protection and basic control. Both of version B and version C are mainly for machine protection, basic and advanced control, but version C has an increased level of redundancy necessary for improved measurements capability. The performance of these versions and needed R&D work are outlined.

Preliminary consideration of CFETR ITER-like case diagnostic system

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

Li, G. S.; Liu, Y. K.; Gao, X.

2016-11-15

Chinese Fusion Engineering Test Reactor (CFETR) is a new superconducting tokamak device being designed in China, which aims at bridging the gap between ITER and DEMO, where DEMO is a tokamak demonstration fusion reactor. Two diagnostic cases, ITER-like case and towards DEMO case, have been considered for CFETR early and later operating phases, respectively. In this paper, some preliminary consideration of ITER-like case will be presented. Based on ITER diagnostic system, three versions of increased complexity and coverage of the ITER-like case diagnostic system have been developed with different goals and functions. Version A aims only machine protection and basicmore » control. Both of version B and version C are mainly for machine protection, basic and advanced control, but version C has an increased level of redundancy necessary for improved measurements capability. The performance of these versions and needed R&D work are outlined.« less

Environmental Niche Modelling of Phlebotomine Sand Flies and Cutaneous Leishmaniasis Identifies Lutzomyia intermedia as the Main Vector Species in Southeastern Brazil

PubMed Central

Meneguzzi, Viviane Coutinho; dos Santos, Claudiney Biral; Leite, Gustavo Rocha; Fux, Blima; Falqueto, Aloísio

2016-01-01

Cutaneous leishmaniasis (CL) is caused by a protozoan of the genus Leishmania and is transmitted by sand flies. The state of Espírito Santo (ES), an endemic area in southeast Brazil, has shown a considerably high prevalence in recent decades. Environmental niche modelling (ENM) is a useful tool for predicting potential disease risk. In this study, ENM was applied to sand fly species and CL cases in ES to identify the principal vector and risk areas of the disease. Sand flies were collected in 466 rural localities between 1997 and 2013 using active and passive capture. Insects were identified to the species level, and the localities were georeferenced. Twenty-one bioclimatic variables were selected from WorldClim. Maxent was used to construct models projecting the potential distribution for five Lutzomyia species and CL cases. ENMTools was used to overlap the species and the CL case models. The Kruskal–Wallis test was performed, adopting a 5% significance level. Approximately 250,000 specimens were captured, belonging to 43 species. The area under the curve (AUC) was considered acceptable for all models. The slope was considered relevant to the construction of the models for all the species identified. The overlay test identified Lutzomyia intermedia as the main vector of CL in southeast Brazil. ENM tools enable an analysis of the association among environmental variables, vector distributions and CL cases, which can be used to support epidemiologic and entomological vigilance actions to control the expansion of CL in vulnerable areas. PMID:27783641

Space shuttle solid rocket booster water entry cavity collapse loads

NASA Technical Reports Server (NTRS)

Keefe, R. T.; Rawls, E. A.; Kross, D. A.

1982-01-01

Solid rocket booster cavity collapse flight measurements included external pressures on the motor case and aft skirt, internal motor case pressures, accelerometers located in the forward skirt, mid-body area, and aft skirt, as well as strain gages located on the skin of the motor case. This flight data yielded applied pressure longitudinal and circumferential distributions which compare well with model test predictions. The internal motor case ullage pressure, which is below atmospheric due to the rapid cooling of the hot internal gas, was more severe (lower) than anticipated due to the ullage gas being hotter than predicted. The structural dynamic response characteristics were as expected. Structural ring and wall damage are detailed and are considered to be attributable to the direct application of cavity collapse pressure combined with the structurally destabilizing, low internal motor case pressure.

Phase averaging method for the modeling of the multiprobe and cutaneous cryosurgery

NASA Astrophysics Data System (ADS)

E Shilnikov, K.; Kudryashov, N. A.; Y Gaiur, I.

2017-12-01

In this paper we consider the problem of planning and optimization of the cutaneous and multiprobe cryosurgery operations. An explicit scheme based on the finite volume approximation of phase averaged Pennes bioheat transfer model is applied. The flux relaxation method is used for the stability improvement of scheme. Skin tissue is considered as strongly inhomogeneous media. Computerized planning tool is tested on model cryotip-based and cutaneous cryosurgery problems. For the case of cutaneous cryosurgery the method of an additional freezing element mounting is studied as an approach to optimize the cellular necrosis front propagation.

Tuberculous Otitis Media with Facial Paralysis Combined with Labyrinthitis

PubMed Central

Hwang, Gyu Ho; Jung, Jong Yoon; Yum, Gunhwee

2013-01-01

Tuberculosis otitis media is a very rare cause of otorrhea, so that it is infrequently considered in differential diagnosis because clinical symptoms are nonspecific, and standard microbiological and histological tests for tuberculosis often give false-negative results. We present a rare case presenting as a rapidly progressive facial paralysis with severe dizziness and hearing loss on the ipsilateral side that was managed with facial nerve decompression and anti-tuberculosis therapy. The objective of this article is to create an awareness of ear tuberculosis, and to consider tuberculosis in the differential diagnosis of chronic otitis media with complications. PMID:24653900

Tuberculous otitis media with facial paralysis combined with labyrinthitis.

PubMed

Hwang, Gyu Ho; Jung, Jong Yoon; Yum, Gunhwee; Choi, June

2013-04-01

Tuberculosis otitis media is a very rare cause of otorrhea, so that it is infrequently considered in differential diagnosis because clinical symptoms are nonspecific, and standard microbiological and histological tests for tuberculosis often give false-negative results. We present a rare case presenting as a rapidly progressive facial paralysis with severe dizziness and hearing loss on the ipsilateral side that was managed with facial nerve decompression and anti-tuberculosis therapy. The objective of this article is to create an awareness of ear tuberculosis, and to consider tuberculosis in the differential diagnosis of chronic otitis media with complications.

Telehealth technology in case/disease management.

PubMed

Park, Eun-Jun

2006-01-01

Case managers can better coordinate and facilitate chronic illness care by adopting telehealth technology. This article overviews four major categories of telehealth technology based on patients' roles in self-management: surveillance, testing peripherals and messaging, decision support aids, and online support groups related to patients' subordinate, structured, collaborative, and autonomous roles, respectively. These various telehealth technologies should be selected on the basis of patients' care needs and preferences. Moreover, when they are integrated with other clinical information systems, case management practice can be better performed. However, the specific role functions and skill sets needed to be competent in telehealth environments have not yet been clearly identified. Considering role ambiguity and stress among telehealth clinicians, clarifying relevant roles is an urgent task.

A case report of chronic granulomatous disease presenting with aspergillus pneumonia in a 2-month old girl.

PubMed

Lee, Eun; Oh, Seak Hee; Kwon, Ji Won; Kim, Byoung Ju; Yu, Jinho; Park, Chan Jeoung; Hong, Soo Jong

2010-06-01

Chronic granulomatous disease (CGD) is an uncommon inherited disorder caused by mutations in any of the genes encoding subunits of the superoxide-generating phagocyte NADPH oxidase system, which is essential for killing catalase producing bacteria and fungi, such as Aspergillus species, Staphylococcus aureus, Serratia marcescens, Nocardia species and Burkholderia cepacia. In case of a history of recurrent or persistent infections, immune deficiency should be investigated. Particularly, in the case of uncommon infections such as aspergillosis in early life, CGD should be considered. We describe here a case of CGD that presented with invasive pulmonary aspergillosis in a 2-month-old girl. We confirmed pulmonary aspergillosis noninvasively through a positive result from the culture of bronchial alveolar lavage fluid, positive serological test for Aspergillus antigen and radiology results. She was successfully treated with Amphotericin B and recombinant IFN-γ initially. Six weeks later after discharge, she was readmitted for pneumonia. Since there were infiltrates on the right lower lung, which were considered as residual lesions, voriconazole therapy was initiated. She showed a favorable response to the treatment and follow-up CT showed regression of the pulmonary infiltrates.

Future Sex Educator Perceptions of Rural versus Urban Instruction: A Case for Community-Centered Sexual Health Education

ERIC Educational Resources Information Center

Jones, Christina L.; Jensen, Robin E.; Selzer King, Abigail

2014-01-01

Instructors of sexual health courses in rural areas face unique challenges as they are often forced to use school-based prevention curricula field-tested in urban areas. Research has yet to consider what future sex educators' regional expectations are for their profession and how those expectations might have an impact on the classroom. Drawing…

A New Lifetime Distribution with Bathtube and Unimodal Hazard Function

NASA Astrophysics Data System (ADS)

Barriga, Gladys D. C.; Louzada-Neto, Francisco; Cancho, Vicente G.

2008-11-01

In this paper we propose a new lifetime distribution which accommodate bathtub-shaped, unimodal, increasing and decreasing hazard function. Some special particular cases are derived, including the standard Weibull distribution. Maximum likelihood estimation is considered for estimate the tree parameters present in the model. The methodology is illustrated in a real data set on industrial devices on a lite test.

Model Analysis and Model Creation: Capturing the Task-Model Structure of Quantitative Item Domains. Research Report. ETS RR-06-11

ERIC Educational Resources Information Center

Deane, Paul; Graf, Edith Aurora; Higgins, Derrick; Futagi, Yoko; Lawless, René

2006-01-01

This study focuses on the relationship between item modeling and evidence-centered design (ECD); it considers how an appropriately generalized item modeling software tool can support systematic identification and exploitation of task-model variables, and then examines the feasibility of this goal, using linear-equation items as a test case. The…

Some aspects of the analysis of geodetic strain observations in kinematic models

NASA Astrophysics Data System (ADS)

Welsch, W. M.

1986-11-01

Frequently, deformation processes are analyzed in static models. In many cases, this procedure is justified, in particular if the deformation occurring is a singular event. If. however, the deformation is a continuous process, as is the case, for instance, with recent crustal movements, the analysis in kinematic models is more commensurate with the problem because the factor "time" is considered an essential part of the model. Some specialities have to be considered when analyzing geodetic strain observations in kinematic models. They are dealt with in this paper. After a brief derivation of the basic kinematic model and the kinematic strain model, the following subjects are treated: the adjustment of the pointwise velocity field and the derivation of strain-rate parameters; the fixing of the kinematic reference system as part of the geodetic datum; statistical tests of models by testing linear hypotheses; the invariance of kinematic strain-rate parameters with respect to transformations of the coordinate-system and the geodetic datum; the interpolation of strain rates by finite-element methods. After the representation of some advanced models for the description of secular and episodic kinematic processes, the data analysis in dynamic models is regarded as a further generalization of deformation analysis.

Determination of rotor harmonic blade loads from acoustic measurements

NASA Technical Reports Server (NTRS)

Kasper, P. K.

1975-01-01

The magnitude of discrete frequency sound radiated by a rotating blade is strongly influenced by the presence of a nonuniform distribution of aerodynamic forces over the rotor disk. An analytical development and experimental results are provided for a technique by which harmonic blade loads are derived from acoustic measurements. The technique relates, on a one-to-one basis, the discrete frequency sound harmonic amplitudes measured at a point on the axis of rotation to the blade-load harmonic amplitudes. This technique was applied to acoustic data from two helicopter types and from a series of test results using the NASA-Langley Research Center rotor test facility. The inferred blade-load harmonics for the cases considered tended to follow an inverse power law relationship with harmonic blade-load number. Empirical curve fits to the data showed the harmonic fall-off rate to be in the range of 6 to 9 db per octave of harmonic order. These empirical relationships were subsequently used as input data in a compatible far field rotational noise prediction model. A comparison between predicted and measured off-axis sound harmonic levels is provided for the experimental cases considered.

Coexistence of two clades of enterovirus D68 in pediatric Swedish patients in the summer and fall of 2014.

PubMed

Dyrdak, Robert; Rotzén-Östlund, Maria; Samuelson, Agneta; Eriksson, Margareta; Albert, Jan

2015-01-01

In 2014, an outbreak of enterovirus D68 (EV-D68) was observed in North America, with cases of severe respiratory illness and a possible etiological link to cases of acute flaccid paralysis. EV-D68 has also been reported from European countries, but no data from Sweden are available. This study investigated respiratory specimens collected during July-October 2014 from 30 Swedish children aged 0-9 years who were positive for enterovirus and/or rhinovirus in routine clinical PCR. Seven samples were typed as EV-D68 by VP4/VP2 sequencing. Two genetically distinct EV-D68 variants coexisted. Six viruses belonged to clade B, the variant involved in the North American outbreak, and one virus belonged to clade A. Respiratory illness was the major symptom among EV-D68 infected patients and all fully recovered. This is the first report of EV-D68 in Sweden. Considering the current epidemiological situation, genotyping and specific EV-D68 testing should be considered in patients with severe respiratory illness who test positive for enterovirus or rhinovirus in routine diagnostics.

Prevalence of hyponatraemia in patients over the age of 65 who have an in-hospital fall.

PubMed

Lobo-Rodríguez, Carmen; García-Pozo, Ana M; Gadea-Cedenilla, Carmen; Moro-Tejedor, M Nieves; Pedraz Marcos, Azucena; Tejedor-Jorge, Alberto

2016-01-01

Hyponatraemia is the most common electrolyte disorder. Some studies have found that it increases morbidity and mortality. There are new lines of research that are investigating the link between hyponatraemia and patient falls. To determine if hyponatraemia is associated with falls in elderly hospitalised patients. Design observational, analytical, case-control study. Patients older than 65 years who had fallen during their hospitalisation at Gregorio Marañón Hospital (Madrid) were considered cases. Patients who did not fall were considered to be controls, paired according to the following variables: hospital ward, age, length of hospital stay, gender and Downton fall risk index. The sample size was 206 subjects. Socio-demographic factors, variables included in the falls record sheet, Downton fall risk index and sodium levels were studied (hyponatraemia was considered Na(+)< 135mmol/l). A descriptive analysis was performed to determine the sample homogeneity. The OR was calculated, and an analytical analysis using Chi-square test and a multivariate logistic regression analysis were also performed. Of 103 cases recruited, 61 were men (50.4%) and 42 were women (49.4%). Hyponatraemia was detected in 29 cases with an association with falls of P: 0.002. The adjusted OR was 3.708 (1.6-8.3), 95% CI. Risk factors for falls were identified as hyponatraemia and limb sensory deficits. Given that hyponatraemia could be considered a risk factor for falls, the inclusion of the determination of sodium level would be important for fall prevention strategies in the elderly. Copyright © 2016 Sociedad Española de Nefrología. Published by Elsevier España, S.L.U. All rights reserved.

Contact Eczema Caused by True Teak (Tectona Grandis)

PubMed Central

Krogh, H. K.

1962-01-01

An epidemiological study of occupational contact eczema in a furniture factory is presented. The localization, distribution, and clinical features of the skin lesions were characteristic of contact eczema caused by a sensitizing or irritating dust. True teak—Tectona grandis—was the cause of the skin condition. That teak is a fairly potent sensitizer and also contains primary irritants is fully confirmed by the present study. About half the employees who were heavily exposed to teak dust suffered from eczema and/or severe itching. Only 8% of those with slight exposure to teak dust experienced skin symptoms. Patch tests with native teak dust moistened with water were applied on 10 “controls” and 112 workers who were exposed to teak in various working procedures. Moistened teak dust produced toxic reactions in 20·5%, while native teak dust did not have primary irritant effects and was, therefore, considered to be the substance of choice for patch testing; 18·7% of the workers showed an allergic skin reaction to native teak dust. The diagnosis of allergic contact eczema was made in 12·5%, and 6·2% were considered to have latent allergy. Primary irritant (contact) eczema was considered to be present in four individuals who had experienced acute, transitory, eczematous eruptions during the hot part of the summer when they perspired freely. In these cases the patch test to native teak dust was negative. Desensitization or “hardening” was observed in four workers. In most cases the skin lesions were not severe enough to cause sickness absence. The cause of the relatively high percentage of sensitization to teak among the workers in the factory is discussed. The importance of suitable prophylactic measures is stressed. PMID:14459786

Relative value of computed tomography scanning and venous sampling in establishing the cause of primary hyperaldosteronism.

PubMed

Sheaves, R; Goldin, J; Reznek, R H; Chew, S L; Dacie, J E; Lowe, D G; Ross, R J; Wass, J A; Besser, G M; Grossman, A B

1996-03-01

The purpose of this study was to evaluate the relative merits of the postural stimulation test, adrenal computed tomography (CT) and venous sampling in the differential diagnosis of patients presenting with primary hyperaldosteronism. The records of 20 patients presenting with primary hyperaldosteronism were reviewed retrospectively. There were 15 patients with a unilateral aldosterone-producing adenoma (APA), four patients with idiopathic hyperaldosteronism (IHA) and one patient with primary adrenal hyperplasia (PAH). The postural stimulation test was based on measurements of plasma aldosterone and renin activity at 08.00 h and at noon after 4 h of ambulation. The CT scans of the adrenals were reviewed by a single radiologist. Bilateral venous sampling of adrenal veins was attempted in all patients and blood collected for aldosterone and cortisol assay. Plasma aldosterone concentration increased after 4 h of standing in all cases of hyperplasia but was also demonstrated in 10/15 patients with a surgically-proven APA. If one defines a significant postural rise as being greater than 30%, then 8/15 patients with APA can be considered as being posturally responsive. Computed tomography scanning correctly identified all 15 cases of APA and also classified correctly the remaining five cases of hyperplasia (four cases of IHA and one case of PAH). Venous sampling failed technically in 4/15 cases of APA and in one case of IHA: a total of 5/20 (25%,). A correct diagnosis of APA or IHA was established in all the remaining cases. However, the one case of PAH was treated successfully by adrenalectomy following venous sampling, which suggested a unilateral adrenal lesion: this one result was the only instance where venous sampling altered clinical decision-making. Computed tomography scanning may be used alone to confirm the cause of hyperaldosteronism where postural studies suggest an adrenal adenoma, and such patients may be considered for early surgery. Venous catheterization studies are not necessary routinely. but may still be useful in selected patients, particularly when CT scanning shows no clear lesion.

Thermodynamics with pressure and volume under charged particle absorption

NASA Astrophysics Data System (ADS)

Gwak, Bogeun

2017-11-01

We investigate the variation of the charged anti-de Sitter black hole under charged particle absorption by considering thermodynamic volume. When the energy of the particle is considered to contribute to the internal energy of the black hole, the variation exactly corresponds to the prediction of the first law of thermodynamics. Nevertheless, we find the decrease of the Bekenstein-Hawking entropy for extremal and near-extremal black holes under the absorption, which is an irreversible process. This violation of the second law of thermodynamics is only found when considering thermodynamic volume. We test the weak cosmic censorship conjecture affected by the violation. Fortunately, the conjecture is still valid, but extremal and near-extremal black holes do not change their configurations when any particle enters the black hole. This result is quite different from the case in which thermodynamic volume is not considered.

Twist effects in quantum vortices and phase defects

NASA Astrophysics Data System (ADS)

Zuccher, Simone; Ricca, Renzo L.

2018-02-01

In this paper we show that twist, defined in terms of rotation of the phase associated with quantum vortices and other physical defects effectively deprived of internal structure, is a property that has observable effects in terms of induced axial flow. For this we consider quantum vortices governed by the Gross-Pitaevskii equation (GPE) and perform a number of test cases to investigate and compare the effects of twist in two different contexts: (i) when this is artificially superimposed on an initially untwisted vortex ring; (ii) when it is naturally produced on the ring by the simultaneous presence of a central straight vortex. In the first case large amplitude perturbations quickly develop, generated by the unnatural setting of the initial condition that is not an analytical solution of the GPE. In the second case much milder perturbations emerge, signature of a genuine physical process. This scenario is confirmed by other test cases performed at higher twist values. Since the second setting corresponds to essential linking, these results provide new evidence of the influence of topology on physics.

Antenatal nephromegaly and propionic acidemia: a case report.

PubMed

Bernheim, Ségolène; Deschênes, Georges; Schiff, Manuel; Cussenot, Isabelle; Niel, Olivier

2017-03-30

Propionic acidemia (PA) is a rare but severe recessive autosomal disease, presenting with non specific signs in the first years of life. Prenatal diagnosis is invasive (amniocentesis) and limited to suspect cases. No screening test has been described, in particular no correlations between prenatal sonography and PA have been documented so far. We report the case of a boy with fetal bilateral nephromegaly and hyperechogenic kidneys, along with neonatal acute kidney injury; no etiology could be found in the first months of life. At 3 months of life, he presented with tachypnea and altered mental status, which lead to the diagnosis of PA. The renal ultrasound at 8 months of life, after a symptomatic treatment of PA had been initiated, showed a regression of the renal abnormalities. This case describes PA as a novel cause of large and hyperechogenic kidneys in the antenatal period. It suggests that, when confronted to fetal nephromegaly, hyperechogenic kidneys and risk factors of metabolic disease such as consanguineous parents, PA should be considered, and a prenatal test should be proposed.

A Next Generation Sequencing custom gene panel as first line diagnostic tool for atypical cases of syndromic obesity: Application in a case of Alström syndrome.

PubMed

Maltese, Paolo E; Iarossi, Giancarlo; Ziccardi, Lucia; Colombo, Leonardo; Buzzonetti, Luca; Crinò, Antonino; Tezzele, Silvia; Bertelli, Matteo

2018-02-01

Obesity phenotype can be manifested as an isolated trait or accompanied by multisystem disorders as part of a syndromic picture. In both situations, same molecular pathways may be involved to different degrees. This evidence is stronger in syndromic obesity, in which phenotypes of different syndromes may overlap. In these cases, genetic testing can unequivocally provide a final diagnosis. Here we describe a patient who met the diagnostic criteria for Alström syndrome only during adolescence. Genetic testing was requested at 25 years of age for a final confirmation of the diagnosis. The genetic diagnosis of Alström syndrome was obtained through a Next Generation Sequencing genetic test approach using a custom-designed gene panel of 47 genes associated with syndromic and non-syndromic obesity. Genetic analysis revealed a novel homozygous frameshift variant p.(Arg1550Lysfs*10) on exon 8 of the ALMS1 gene. This case shows the need for a revision of the diagnostic criteria guidelines, as a consequence of the recent advent of massive parallel sequencing technology. Indications for genetic testing reported in these currently accepted diagnostic criteria for Alström syndrome, were drafted when sequencing was expensive and time consuming. Nowadays, Next Generation Sequencing testing could be considered as first line diagnostic tool not only for Alström syndrome but, more generally, for all those atypical or not clearly distinguishable cases of syndromic obesity, thus avoiding delayed diagnosis and treatments. Early diagnosis permits a better follow-up and pre-symptomatic interventions. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

Occupational asthma due to manual metal-arc welding of special stainless steels.

PubMed

Hannu, T; Piipari, R; Kasurinen, H; Keskinen, H; Tuppurainen, M; Tuomi, T

2005-10-01

Occupational asthma (OA) can be induced by fumes of manual metal-arc welding on stainless steel. In recent years, the use of special stainless steels (SSS) with high chromium content has increased. This study presents two cases of OA caused by manual metal-arc welding on SSS. In both cases, the diagnosis of OA was based on respiratory symptoms, occupational exposure and positive findings in the specific challenge tests. In the first case, a 46-yr-old welder had experienced severe dyspnoea while welding SSS (SMO steel), but not in other situations. Challenge tests with both mild steel and stainless steel using a common electrode were negative. Welding SSS with a special electrode caused a delayed 37% drop in forced expiratory volume in one second (FEV1). In the second case, a 34-yr-old male had started to experience dyspnoea during the past few years, while welding especially SSS (Duplex steel). The workplace peak expiratory flow monitoring was suggestive of OA. Challenge tests with both mild steel and stainless steel using a common electrode did not cause bronchial obstruction. Welding SSS with a special electrode caused a delayed 31% drop in FEV1. In conclusion, exposure to manual metal-arc welding fumes of special stainless steel should be considered as a new cause of occupational asthma.

Comparison of the release of constituents from granular materials under batch and column testing.

PubMed

Lopez Meza, Sarynna; Garrabrants, Andrew C; van der Sloot, Hans; Kosson, David S

2008-01-01

Column leaching testing can be considered a better basis for assessing field impact data than any other available batch test method and thus provides a fundamental basis from which to estimate constituent release under a variety of field conditions. However, column testing is time-intensive compared to the more simplified batch testing, and may not always be a viable option when making decisions for material reuse. Batch tests are used most frequently as a simple tool for compliance or quality control reasons. Therefore, it is important to compare the release that occurs under batch and column testing, and establish conservative interpretation protocols for extrapolation from batch data when column data are not available. Five different materials (concrete, construction debris, aluminum recycling residue, coal fly ash and bottom ash) were evaluated via batch and column testing, including different column flow regimes (continuously saturated and intermittent unsaturated flow). Constituent release data from batch and column tests were compared. Results showed no significant difference between the column flow regimes when constituent release data from batch and column tests were compared. In most cases batch and column testing agreed when presented in the form of cumulative release. For arsenic in carbonated materials, however, batch testing underestimates the column constituent release for most LS ratios and also on a cumulative basis. For cases when As is a constituent of concern, column testing may be required.

[Clinical characteristics of whooping cough in neonates and antimicrobial resistance of the pathogenic bacteria].

PubMed

Luo, Jie; Wang, Hui-Xin; Yuan, Lin; Gu, Song; Jiang, Min; Ding, Yi-Jun; Guo, Dan; Yao, Kai-Hu; Wang, Ya-Juan

2014-10-01

To study the clinical characteristics of whooping cough in neonates and the antimicrobial resistance of the bacterial isolates. Clinical information of 7 neonates with whooping cough confirmed by bacterial culture was collected. The antimirobial resistance of the isolates was tested using E-test and disk diffusion methods. The children′s mothers or other family members had cough for more than 10 days in 6 neonates, in which four neonates contacted with 3 or more family members with cough. All the neonates had rhinobyon and slight cough at the beginning of the disease. Five cases presented typical spasmodic cough after 4-7 days of the onset. Five cases displayed cyanosis, four cases occurred apnea, three cases suffered breath holding, and only two cases had fever. Nares flaring and three depression signs were found in the physical examination. No bacteriostatic ring around the erythromycin disks were found for five bacterial isolates. The minimal inhibitory concentration (MIC) for erythromycin, azithromycin, clarithromycin and clindamycin were all >256 mg/L against the five isolates. Whooping cough should be considered for neonates with respiratory symptoms and a history of close contact with respiratory infection patients. Macrolide-resistant Bordetella pertussis is common in children with whooping cough.

[Analysis of sequelae of the latissimus dorsi flap removal. Report of 44 cases reviewed and tested].

PubMed

Legré, R; Boghossian, V; Servant, J M; Magalon, G; Bureau, H

1990-01-01

Since Tanzini, the latissimus dorsi muscle flap has been widely used in plastic surgery. Based on the experience of two plastic surgery units, we decided to try to define the sequelae of this operation. In order to simplify our analysis we only considered free flaps. Out study is based on 42 patients (26 pure muscular flaps and 16 musculo-cutaneous flaps). The sequelae were analysed in terms of aesthetic and functional criteria. The aesthetic sequelae appeared to be minima in the case of pure muscular flaps, but more severe in the case of musculo-cutaneous flaps. Functional sequelae in the shoulder were observed on muscle testing in 30% of cases, although there were no repercussions on sport or work activities. Analysis of spinal posture demonstrated a modification in the frontal plane in 40% of cases although this could not be clearly attributed to the donor site. On the basis of this study, we can conclude that the latissimus dorsi flap retains an important place in the therapeutic arsenal of plastic surgery due to its reliability and its minor cicatricial and functional sequelae at the donor site.

National Pyranometers comparison of solar thermal labs in Mexico

NASA Astrophysics Data System (ADS)

Castillo-Matadamas, H. A.; Molina-Vazquez, J. C.; Moreno-Quintanar, G.; Fuentes-Toledo, A.; Ortega-Avila, N.; Rodríguez-González, J. M.; Barrón-Mancilla, J. A.; Navarrete-Gonzalez, J. J.

2017-01-01

The results of the first national comparison of pyranometers used in testing laboratories of solar water heating are reported. In the comparison carried out at the facilities of Centro Nacional de Metrología (CENAM-México) participated three testing laboratories, a university and CENAM with seven secondary standards and first class pyranometers. The measurement results for all instruments were adequate, considering that the deviations found in all cases for global irradiance measurements greater than 500 W / m2 were in a band of +/- 2.5%, even though pyranometers have different dates of calibration.

Saliva antibody testing and vaccination in a mumps outbreak.

PubMed

Ramsay, M E; Brown, D W; Eastcott, H R; Begg, N T

1991-08-16

Saliva antibody testing was performed to describe the epidemiology of an outbreak of mumps and identify susceptible children. Thirty-three out of 171 children (19%) were designated susceptible. A past history of mumps illness was found to be unreliable. No further cases of mumps were notified after 28 susceptible children were given MMR vaccine. The use of MMR vaccination may have contributed to the control of this outbreak and its use should be considered where a defined population is expected to have a significant proportion of susceptible individuals.

Subcritical flutter testing and system identification

NASA Technical Reports Server (NTRS)

Houbolt, J. C.

1974-01-01

Treatment is given of system response evaluation, especially in application to subcritical flight and wind tunnel flutter testing of aircraft. An evaluation is made of various existing techniques, in conjuction with a companion survey which reports theoretical and analog experiments made to study the identification of system response characteristics. Various input excitations are considered, and new techniques for analyzing response are explored, particularly in reference to the prevalent practical case where unwanted input noise is present, such as caused by gusts or wind tunnel turbulence. Further developments are also made of system parameter identification techniques.

GSDO Program Hexavalent Chrome Alternatives: Final Pretreatments Test Report

NASA Technical Reports Server (NTRS)

Kessel, Kurt

2013-01-01

Hexavalent chrome free pretreatments should be considered for use on Ground Support Equipment (OSE) and Electrical Ground Support Equipment (EOSE). Both of the hexavalent chrome free pretreatments (Metalast TCP HF and SurTec 650C) evaluated by this project met, and in some instances exceeded, the requirements ofMIL-DTL-5541 "Chemical Conversion Coatings on Aluminum and Aluminum Alloys". For DC resistance measurements, both Metalast TCP HF and SurTec (!50C met initial requirements following assembly and in many cases continued to maintain passing readings for the duration of testing.

Influenza Illness among Case-Patients Hospitalized for Suspected Dengue, El Salvador, 2012.

PubMed

Chacon, Rafael; Clara, Alexey Wilfrido; Jara, Jorge; Armero, Julio; Lozano, Celina; El Omeiri, Nathalie; Widdowson, Marc-Alain; Azziz-Baumgartner, Eduardo

2015-01-01

We estimate the proportion of patients hospitalized for suspected dengue that tested positive for influenza virus in El Salvador during the 2012 influenza season. We tested specimens from 321 hospitalized patients: 198 patients with SARI and 123 patients with suspected dengue. Among 121 hospitalized suspected dengue (two co-infected excluded) patients, 28% tested positive for dengue and 19% positive for influenza; among 35 with suspected dengue and respiratory symptoms, 14% were positive for dengue and 39% positive for influenza. One percent presented co-infection between influenza and dengue. Clinicians should consider the diagnosis of influenza among patients with suspected dengue during the influenza season.

Manifestation of Central Diabetes Insipidus in a Patient with Thyroid Storm.

PubMed

Nakamichi, Akiko; Ocho, Kazuki; Oka, Kosuke; Yasuda, Miho; Hasegawa, Kou; Iwamuro, Masaya; Obika, Mikako; Rai, Kammei; Otsuka, Fumio

2018-02-28

We herein report a case of central diabetes insipidus complicated with thyroid storm. A middle-aged woman who was receiving treatment for Graves' disease suddenly complained of polydipsia, polyuria and general fatigue. Laboratory tests showed hyperthyroidism, hypernatremia, hypoosmolar urine and a decreased plasma vasopressin level. The occurrence of central diabetes insipidus with hyperthyroidism was revealed on the basis of pituitary magnetic resonance imaging, a water deprivation test and a desmopressin test. The clinical co-existence of diabetes insipidus and hyperthyroidism is very rare; however, the complication should be considered when hypernatremia and/or dehydration progress in patients with Graves's disease as a common autoimmune-related etiology.

High-Speed Device-Independent Quantum Random Number Generation without a Detection Loophole

NASA Astrophysics Data System (ADS)

Liu, Yang; Yuan, Xiao; Li, Ming-Han; Zhang, Weijun; Zhao, Qi; Zhong, Jiaqiang; Cao, Yuan; Li, Yu-Huai; Chen, Luo-Kan; Li, Hao; Peng, Tianyi; Chen, Yu-Ao; Peng, Cheng-Zhi; Shi, Sheng-Cai; Wang, Zhen; You, Lixing; Ma, Xiongfeng; Fan, Jingyun; Zhang, Qiang; Pan, Jian-Wei

2018-01-01

Quantum mechanics provides the means of generating genuine randomness that is impossible with deterministic classical processes. Remarkably, the unpredictability of randomness can be certified in a manner that is independent of implementation devices. Here, we present an experimental study of device-independent quantum random number generation based on a detection-loophole-free Bell test with entangled photons. In the randomness analysis, without the independent identical distribution assumption, we consider the worst case scenario that the adversary launches the most powerful attacks against the quantum adversary. After considering statistical fluctuations and applying an 80 Gb ×45.6 Mb Toeplitz matrix hashing, we achieve a final random bit rate of 114 bits /s , with a failure probability less than 10-5. This marks a critical step towards realistic applications in cryptography and fundamental physics tests.

A multi-case report of the pathways to and through genetic testing and cancer risk management for BRCA mutation-positive women aged 18–25

PubMed Central

Werner-Lin, Allison

2012-01-01

Much of the extant literature addressing the psychosocial aspects of BRCA1/2 mutation testing and risk management aggregates mutation carriers of all ages in study recruitment, data analysis, and interpretation. This analytic strategy does not adequately address the needs of the youngest genetic testing consumers, i.e., women aged 18–25. Despite low absolute cancer risk estimates before age 30, BRCA1/2 mutation-positive women aged 18–25 feel vulnerable to a cancer diagnosis but find themselves in a management quandary because the clinical utility of screening and prevention options are not yet well defined for such young carriers. We present three cases, selected from a larger study of 32 BRCA1/2 mutation-positive women who completed or considered genetic testing before age 25, to demonstrate the unique developmental, relational and temporal influences, as well as the challenges, experienced by very young BRCA mutation-positive women as they complete genetic testing and initiate cancer risk management. The first case describes the maturation of a young woman whose family participated in a national cancer registry. The second addresses the experiences and expectations of a young woman who completed genetic testing after learning that her unaffected father was a mutation carrier. The third case highlights the experiences of a young woman parentally bereaved in childhood, who presented for genetic counseling and testing due to intense family pressure. Together, these cases suggest that BRCA1/2-positive women aged 18–25 are challenged to reconcile their burgeoning independence from their families with risk-related support needs. Loved ones acting in ways meant to care for these young women may inadvertently apply pressure, convoluting family support dynamics and autonomous decision-making. Ongoing support from competent healthcare professionals will enable these young women to remain informed and receive objective counsel about their risk-management decisions. PMID:22864682

Stationary scalar clouds around a BTZ black hole

NASA Astrophysics Data System (ADS)

Ferreira, Hugo R. C.; Herdeiro, Carlos A. R.

2017-10-01

We establish the existence of stationary clouds of massive test scalar fields around BTZ black holes. These clouds are zero-modes of the superradiant instability and are possible when Robin boundary conditions (RBCs) are considered at the AdS boundary. These boundary conditions are the most general ones that ensure the AdS space is an isolated system, and include, as a particular case, the commonly considered Dirichlet or Neumann-type boundary conditions (DBCs or NBCs). We obtain an explicit, closed form, resonance condition, relating the RBCs that allow the existence of normalizable (and regular on and outside the horizon) clouds to the system's parameters. Such RBCs never include pure DBCs or NBCs. We illustrate the spatial distribution of these clouds, their energy and angular momentum density for some cases. Our results show that BTZ black holes with scalar hair can be constructed, as the non-linear realization of these clouds.

Sheep Feed and Scrapie, France

PubMed Central

Philippe, Sandrine; Ducrot, Christian; Roy, Pascal; Remontet, Laurent; Jarrige, Nathalie

2005-01-01

Scrapie is a small ruminant, transmissible spongiform encephalopathy (TSE). Although in the past scrapie has not been considered a zoonosis, the emergence of bovine spongiform encephalopathy, transmissible to humans and experimentally to sheep, indicates that risk exists for small ruminant TSEs in humans. To identify the risk factors for introducing scrapie into sheep flocks, a case-control study was conducted in France from 1999 to 2000. Ninety-four case and 350 control flocks were matched by location and main breed. Three main hypotheses were tested: direct contact between flocks, indirect environmental contact, and foodborne risk. Statistical analysis was performed by using adjusted generalized linear models with the complementary log-log link function, considering flock size as an offset. A notable effect of using proprietary concentrates and milk replacers was observed. The risk was heterogeneous among feed factories. Contacts between flocks were not shown to be a risk factor. PMID:16102318

Numerical simulation of tip vortices of wings in subsonic and transonic flows

NASA Technical Reports Server (NTRS)

Srinivasan, G. R.; Mccroskey, W. J.; Baeder, J. D.; Edwards, T. A.

1986-01-01

A multi block zonal algorithm which solves the thin-layer Navier-Stokes and the Euler equations is used to numerically simulate the formation and roll-up of the tip vortex in both subsonic and transonic flows. Four test cases which used small and large aspect ratio wings have been considered to examine the influence of the tip-cap shape, the tip planform and the free-stream Mach number. It appears that both the tip-planform and the tip-cap shape have some influence on the formation of the tip vortex, but its subsequent roll-up seems to be more influenced by the tip-planform shape. In general, a good definition of the formation and the roll-up of the tip vortex has been observed for all the cases considered here. Comparions of the numerical results with the limited, available experimental data show good agreement with both the surface pressures and the tip-vortex strength.

DFT-derived reactive potentials for the simulation of activated processes: the case of CdTe and CdTe:S.

PubMed

Hu, Xiao Liang; Ciaglia, Riccardo; Pietrucci, Fabio; Gallet, Grégoire A; Andreoni, Wanda

2014-06-19

We introduce a new ab initio derived reactive potential for the simulation of CdTe within density functional theory (DFT) and apply it to calculate both static and dynamical properties of a number of systems (bulk solid, defective structures, liquid, surfaces) at finite temperature. In particular, we also consider cases with low sulfur concentration (CdTe:S). The analysis of DFT and classical molecular dynamics (MD) simulations performed with the same protocol leads to stringent performance tests and to a detailed comparison of the two schemes. Metadynamics techniques are used to empower both Car-Parrinello and classical molecular dynamics for the simulation of activated processes. For the latter, we consider surface reconstruction and sulfur diffusion in the bulk. The same procedures are applied using previously proposed force fields for CdTe and CdTeS materials, thus allowing for a detailed comparison of the various schemes.

Violations of Assumptions in School-Based Single-Case Data: Implications for the Selection and Interpretation of Effect Sizes.

PubMed

Solomon, Benjamin George

2014-07-01

A wide variety of effect sizes (ESs) has been used in the single-case design literature. Several researchers have "stress tested" these ESs by subjecting them to various degrees of problem data (e.g., autocorrelation, slope), resulting in the conditions by which different ESs can be considered valid. However, on the back end, few researchers have considered how prevalent and severe these problems are in extant data and as a result, how concerned applied researchers should be. The current study extracted and aggregated indicators of violations of normality and independence across four domains of educational study. Significant violations were found in total and across fields, including low levels of autocorrelation and moderate levels of absolute trend. These violations affect the selection and interpretation of ESs at the individual study level and for meta-analysis. Implications and recommendations are discussed. © The Author(s) 2013.

Automated microaneurysm detection method based on double ring filter in retinal fundus images

NASA Astrophysics Data System (ADS)

Mizutani, Atsushi; Muramatsu, Chisako; Hatanaka, Yuji; Suemori, Shinsuke; Hara, Takeshi; Fujita, Hiroshi

2009-02-01

The presence of microaneurysms in the eye is one of the early signs of diabetic retinopathy, which is one of the leading causes of vision loss. We have been investigating a computerized method for the detection of microaneurysms on retinal fundus images, which were obtained from the Retinopathy Online Challenge (ROC) database. The ROC provides 50 training cases, in which "gold standard" locations of microaneurysms are provided, and 50 test cases without the gold standard locations. In this study, the computerized scheme was developed by using the training cases. Although the results for the test cases are also included, this paper mainly discusses the results for the training cases because the "gold standard" for the test cases is not known. After image preprocessing, candidate regions for microaneurysms were detected using a double-ring filter. Any potential false positives located in the regions corresponding to blood vessels were removed by automatic extraction of blood vessels from the images. Twelve image features were determined, and the candidate lesions were classified into microaneurysms or false positives using the rule-based method and an artificial neural network. The true positive fraction of the proposed method was 0.45 at 27 false positives per image. Forty-two percent of microaneurysms in the 50 training cases were considered invisible by the consensus of two co-investigators. When the method was evaluated for visible microaneurysms, the sensitivity for detecting microaneurysms was 65% at 27 false positives per image. Our computerized detection scheme could be improved for helping ophthalmologists in the early diagnosis of diabetic retinopathy.

Tick-borne encephalitis among U.S. travelers to Europe and Asia - 2000-2009.

PubMed

2010-03-26

Tick-borne encephalitis virus (TBEV) is the most common arbovirus transmitted by ticks in Europe. Approximately 10,000 cases of tick-borne encephalitis (TBE) are reported annually in Europe and Russia. Although TBE is endemic in parts of China, information regarding its incidence is limited. TBEV is closely related to Powassan virus (POWV), another tick-borne flavivirus that is a rare cause of encephalitis in North America and Russia; TBEV and POWV can cross-react in serologic tests. Before 2000, two cases of TBE in North American travelers to Europe were reported. State health officials or clinicians send specimens from patients with unexplained encephalitis to CDC as part of routine surveillance and diagnostic testing. CDC recently reviewed all 2000-2009 laboratory records to identify cases of TBE among U.S. travelers; the five cases identified are summarized in this report. All five cases had TBEV or POWV immunoglobulin M (IgM) antibodies in serum and were confirmed as acute TBE cases by plaque-reduction neutralization tests against both viruses. All four patients who had traveled to Europe or Russia had biphasic illnesses (a common feature of TBE) and made nearly complete recoveries. The fifth patient, the first reported case of TBE in a U.S. traveler to China, had a monophasic illness with severe encephalitis and neurologic sequelae. Health-care providers should be aware of TBE, should counsel travelers about measures to reduce exposure to tick bites, and should consider the diagnosis of TBE in travelers returning from TBE-endemic countries with meningitis or encephalitis.

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

Gearhart, Jared Lee; Adair, Kristin Lynn; Durfee, Justin David.

When developing linear programming models, issues such as budget limitations, customer requirements, or licensing may preclude the use of commercial linear programming solvers. In such cases, one option is to use an open-source linear programming solver. A survey of linear programming tools was conducted to identify potential open-source solvers. From this survey, four open-source solvers were tested using a collection of linear programming test problems and the results were compared to IBM ILOG CPLEX Optimizer (CPLEX) [1], an industry standard. The solvers considered were: COIN-OR Linear Programming (CLP) [2], [3], GNU Linear Programming Kit (GLPK) [4], lp_solve [5] and Modularmore » In-core Nonlinear Optimization System (MINOS) [6]. As no open-source solver outperforms CPLEX, this study demonstrates the power of commercial linear programming software. CLP was found to be the top performing open-source solver considered in terms of capability and speed. GLPK also performed well but cannot match the speed of CLP or CPLEX. lp_solve and MINOS were considerably slower and encountered issues when solving several test problems.« less

Chloroquine-resistant falciparum malaria in Madagascar and Kenya.

PubMed

Aronsson, B; Bengtsson, E; Björkman, A; Pehrson, P O; Rombo, L; Wahlgren, M

1981-08-01

3 African cases of chloroquine-resistent (RI) P. falciparum malaria, proved by recrudescences after administration of recommended doses and adequate serum levels of chloroquine, are described. The 3 patients, Swedish women aged 43, 27, and 41, had never visited areas where chloroquine-resistent P. falciparum is known to exist. 2 patients had taken regular prophylaxis with chloroquine, while the 3rd had interrupted chloroquine use with temporary use of pyrimethamine. All 3 were treated with chloroquine and had serum levels well above those considered necessary for cure of malaria due to sensitive strains of P. falciparum. All had recrudescences, ranging from 13 to 41 days after the previous chloroquine treatment. Reinfection was not possible for any of the patients and none took other drugs during the study period. In 2 cases the Rieckmann in vitro test for resistence failed. In 1 case from Madagascar the in vitro method described by Nguyen-Dinh and Trager produced results indicating resistence and in another case from Madagascar the results indicated probable resistence, but the procedure failed in the case from Kenya. The 2 cases mark the 1st time resistence has been reported from Madagascar. In vivo tests in all cases and in vitro results in 2 cases, together with the adequate serum levels of chloroquine, confirm that malaria due to chloroquine-resistent P. falciparum is being transmitted in some parts of Africa.

Cytomegalovirus (CMV) in cervical cancer screening tests: A series of 8 cases and review of the literature.

PubMed

Elgert, Paul A; Yee-Chang, Melissa; Simsir, Aylin

2018-04-26

Cytomegalovirus (CMV) is a ubiquitous infection typically affecting over 50% of the US population by age 40. We report 8 cases of CMV infections detected in cervical cancer screening tests, the largest series of cases thus far reported in gynecologic cytology specimens. A retrospective review of our pathology archival computer database was performed from January 1, 1994 through December 31, 2016 for CMV infections reported in cervical cytology specimens. The slides were retrieved for review if available. The eight patients ranged in age from 21-46 years, with a median age of 27 years and average age of 29.5 years. Two patients were significantly immunocompromised with one patient having AIDS and one patient diagnosed with autoimmune disease. The remaining six patients are considered immunocompetent. Cases were identified most often in the fall and winter months (6 of 8 cases). Seven cases were found using Surepath Pap (SP) liquid-based processing and one case was reported in a classic Papanicolaou smear (CPS). There was no correlation of cytologic presentation of CMV with a distinct cytohormonal pattern or inflammatory constituents. Rare diagnostic cells with changes of CMV infection were seen in 75% of the cases. The presence of CMV did not usually result in adverse patient outcome, except where CMV was one of the multiple opportunistic infections detected in the patient with AIDS. © 2018 Wiley Periodicals, Inc.

Basic problems and new potentials in monitoring sediment transport using Japanese pipe type geophone

NASA Astrophysics Data System (ADS)

Sakajo, Saiichi

2016-04-01

The authors have conducted a lot of series of monitoring of sediment transport by pipe type geophone in a model hydrological channel with various gradients and water discharge, using the various size of particles from 2 to 21 mm in the diameter. In the case of casting soils particle by particle into the water channel, 1,000 test cases were conducted. In the case of casting all soils at a breath into the water channel, 100 test cases were conducted. The all test results were totally analyzed by the conventional method, with visible judgement by video pictures. Then several important basic problems were found in estimating the volume and particle distributions by the conventional method, which was not found in the past similar studies. It was because the past studies did not consider the types of collisions between sediment particle and pipe. Based on these experiments, the authors have firstly implemented this idea into the old formula to estimate the amount of sediment transport. In the formula, two factors of 1) the rate of sensing in a single collision and 2) the rate of collided particles to a cast all soil particles were concretely considered. The parameters of these factors could be determined from the experimental results and it was found that the obtained formula could estimate grain size distribution. In this paper, they explain the prototype formula to estimate a set of volume and distribution of sediment transport. Another finding in this study is to propose a single collision as a river index to recognize its characteristics of sediment transport. This result could characterize the risk ranking of sediment transport in the rivers and mudflow in the mountainous rivers. Furthermore, in this paper the authors explain how the preciseness of the pipe geophone to sense the smaller sediment particles shall be improved, which has never been able to be sensed.

Deficits in executive and memory processes in delusional disorder: a case-control study.

PubMed

Ibanez-Casas, Inmaculada; De Portugal, Enrique; Gonzalez, Nieves; McKenney, Kathryn A; Haro, Josep M; Usall, Judith; Perez-Garcia, Miguel; Cervilla, Jorge A

2013-01-01

Delusional disorder has been traditionally considered a psychotic syndrome that does not evolve to cognitive deterioration. However, to date, very little empirical research has been done to explore cognitive executive components and memory processes in Delusional Disorder patients. This study will investigate whether patients with delusional disorder are intact in both executive function components (such as flexibility, impulsivity and updating components) and memory processes (such as immediate, short term and long term recall, learning and recognition). A large sample of patients with delusional disorder (n = 86) and a group of healthy controls (n = 343) were compared with regard to their performance in a broad battery of neuropsychological tests including Trail Making Test, Wisconsin Card Sorting Test, Colour-Word Stroop Test, and Complutense Verbal Learning Test (TAVEC). When compared to controls, cases of delusional disorder showed a significantly poorer performance in most cognitive tests. Thus, we demonstrate deficits in flexibility, impulsivity and updating components of executive functions as well as in memory processes. These findings held significant after taking into account sex, age, educational level and premorbid IQ. Our results do not support the traditional notion of patients with delusional disorder being cognitively intact.

How to assess the mutagenic potential of cosmetic products without animal tests?

PubMed

Speit, Günter

2009-08-01

Animal experiments (in vivo tests) currently play a key role in genotoxicity testing. Results from in vivo tests are, in many cases, decisive for the assessment of a mutagenic potential of a test compound. The Seventh Amendment to the European Cosmetics Directive will, however, ban the European marketing of cosmetic/personal care products that contain ingredients that have been tested in animal experiments. If genotoxicity testing is solely based on the currently established in vitro tests, the attrition rate for chemicals used in cosmetic products will greatly increase due to irrelevant positive in vitro test results. There is urgent need for new and/or improved in vitro genotoxicity tests and for modified test strategies. Test strategies should consider all available information on chemistry of the test substance/the chemical class (e.g. SAR, metabolic activation and dermal adsorption). Test protocols for in vitro genotoxicity tests should be sensitive and robust enough to ensure that negative results can be accepted with confidence. It should be excluded that positive in vitro test results are due to high cytotoxicity or secondary genotoxic effects which may be thresholded and/or only occur under in vitro test conditions. Consequently, further research is needed to establish the nature of thresholds in in vitro assays and to determine the potential for incorporation of mode of action data into future risk assessments. New/improved tests have to be established and validated, considering the use of (metabolically competent) primary (skin) cells, 3D skin models and cells with defined capacity for metabolic activation (e.g. genetically engineered cell lines). The sensitivity and specificity of new and improved genotoxicity tests has to be determined by testing a battery of genotoxic and non-genotoxic chemicals. New or adapted international guidelines will be needed for these tests. The establishment of such a new genotoxicity testing strategy will take time and the new in vitro genotoxicity testing will become much more complex and will require greater mechanistic understanding to build a weight of evidence decision, which will be demanding and time-consuming. At present, no validated alternative methods for the follow-up of positive results from the standard genotoxicity battery are available and an appropriate evaluation of the mutagenic potential of cosmetic ingredients without animal experiments is therefore not possible in many cases.

A comparison of the test-negative and the traditional case-control study designs for estimation of influenza vaccine effectiveness under nonrandom vaccination.

PubMed

Shi, Meng; An, Qian; Ainslie, Kylie E C; Haber, Michael; Orenstein, Walter A

2017-12-08

As annual influenza vaccination is recommended for all U.S. persons aged 6 months or older, it is unethical to conduct randomized clinical trials to estimate influenza vaccine effectiveness (VE). Observational studies are being increasingly used to estimate VE. We developed a probability model for comparing the bias and the precision of VE estimates from two case-control designs: the traditional case-control (TCC) design and the test-negative (TN) design. In both study designs, acute respiratory illness (ARI) patients seeking medical care testing positive for influenza infection are considered cases. In the TN design, ARI patients seeking medical care who test negative serve as controls, while in the TCC design, controls are randomly selected individuals from the community who did not contract an ARI. Our model assigns each study participant a covariate corresponding to the person's health status. The probabilities of vaccination and of contracting influenza and non-influenza ARI depend on health status. Hence, our model allows non-random vaccination and confounding. In addition, the probability of seeking care for ARI may depend on vaccination and health status. We consider two outcomes of interest: symptomatic influenza (SI) and medically-attended influenza (MAI). If vaccination does not affect the probability of non-influenza ARI, then VE estimates from TN studies usually have smaller bias than estimates from TCC studies. We also found that if vaccinated influenza ARI patients are less likely to seek medical care than unvaccinated patients because the vaccine reduces symptoms' severity, then estimates of VE from both types of studies may be severely biased when the outcome of interest is SI. The bias is not present when the outcome of interest is MAI. The TN design produces valid estimates of VE if (a) vaccination does not affect the probabilities of non-influenza ARI and of seeking care against influenza ARI, and (b) the confounding effects resulting from non-random vaccination are similar for influenza and non-influenza ARI. Since the bias of VE estimates depends on the outcome against which the vaccine is supposed to protect, it is important to specify the outcome of interest when evaluating the bias.

Chloramine-induced anaphylaxis while showering: a case report

PubMed Central

2012-01-01

Introduction Sodium-N-chlorine-p-toluene sulfonamide, commonly known as chloramine-T, is a derivative of chlorine which is widely used as a disinfectant. For many years, chloramine-T has been described as a cause of immediate-type hypersensitivity, especially with regard to asthma and rhinitis, and as a cause of occupational dermatoses in cleaning personnel in hospitals, although no anaphylactic reaction has yet been reported. Hence, to the best of our knowledge we present the first case of anaphylaxis to chloramine-T with evidence of specific immunoglobulin E antibodies. Case presentation We describe the case of a 25-year-old Caucasian woman who was in good health and with a negative history for atopy, including no respiratory symptoms of rhinitis or asthma, and with no professional exposure to chloramine-T. She, while showering, applied a chloramine-T solution to a skin area with folliculitis on her leg, and within a few minutes developed generalized urticaria and angioedema, followed by vomiting and collapse with loss of consciousness. A skin prick test with a chloramine-T solution at 10mg/mL concentration was positive, and specific immunoglobulin E to chloramine-T was quantified at a value of 2.9 optical density as measured by the enzyme allergosorbent test technique. Conclusion The strict cause-effect relationship and the results of the skin test and the in vitro test make certain the causative role of chloramine-T in this case of anaphylaxis. This suggests that chloramine-T, based on its wide use as a disinfectant, should be considered a possible cause in anaphylaxis of unknown origin. PMID:23009577

Cost effectiveness of OptiMal® rapid diagnostic test for malaria in remote areas of the Amazon Region, Brazil

PubMed Central

2010-01-01

Background In areas with limited structure in place for microscopy diagnosis, rapid diagnostic tests (RDT) have been demonstrated to be effective. Method The cost-effectiveness of the Optimal® and thick smear microscopy was estimated and compared. Data were collected on remote areas of 12 municipalities in the Brazilian Amazon. Data sources included the National Malaria Control Programme of the Ministry of Health, the National Healthcare System reimbursement table, hospitalization records, primary data collected from the municipalities, and scientific literature. The perspective was that of the Brazilian public health system, the analytical horizon was from the start of fever until the diagnostic results provided to patient and the temporal reference was that of year 2006. The results were expressed in costs per adequately diagnosed cases in 2006 U.S. dollars. Sensitivity analysis was performed considering key model parameters. Results In the case base scenario, considering 92% and 95% sensitivity for thick smear microscopy to Plasmodium falciparum and Plasmodium vivax, respectively, and 100% specificity for both species, thick smear microscopy is more costly and more effective, with an incremental cost estimated at US$549.9 per adequately diagnosed case. In sensitivity analysis, when sensitivity and specificity of microscopy for P. vivax were 0.90 and 0.98, respectively, and when its sensitivity for P. falciparum was 0.83, the RDT was more cost-effective than microscopy. Conclusion Microscopy is more cost-effective than OptiMal® in these remote areas if high accuracy of microscopy is maintained in the field. Decision regarding use of rapid tests for diagnosis of malaria in these areas depends on current microscopy accuracy in the field. PMID:20937094

Tinea cruris and tinea corporis masquerading as tinea indecisiva: case report and review of the literature.

PubMed

Sonthalia, Sidharth; Singal, Archana; Das, Shukla

2015-01-01

Tinea indecisiva is characterized by concentric scaly rings simulating tinea imbricata but caused by dermatophytes other than Trichophyton concentricum. Tinea indecisiva has been rarely reported. We report a unique case and review of the previously reported cases, pathogenesis, and management. An adult Indian man developed extensive tinea cruris and tinea corporis with concentric rings of scaly lesions over the groin, buttocks, and thighs following the use of oral corticosteroids and antifungal-steroid cream for 3 months. Mycologic and immunologic studies were performed for diagnosis. Diagnosis of tinea indecisiva was confirmed on the appearance of "ring-within-a-ring" lesions clinically and isolation of Trichophyton mentagrophytes var. interdigitale as the etiologic agent on mycologic testing. Intradermal testing with Trichophyton extract showed fluctuating hypersensitivity responses. Four-week treatment with daily oral terbinafine resulted in complete resolution. Tinea indecisiva should be considered in a patient with tinea imbricata-like lesions with local immunosuppression caused by a non-concentricum dermatophyte. © 2014 Canadian Dermatology Association.

[Hepatitis E: a Third World's hepatitis found in Belgium].

PubMed

Seivert, M; Belaiche, J; Delwaide, J

2008-09-01

Hepatitis E virus is the second cause of acute viral hepatitis of oral-fecal origin in the world. This virus has a vast distribution throughout the world and manifests itself either in epidemic or endemic-sporadic form in many developing countries. Usually, the cases of HEV infection in industrialized countries are observed after a history of travel in an endemic area. However, an increasing number of cases have been attributed to a HEV zoonotic form transmitted by swine. HEV infection can lead to deadly fulminant hepatic failure in 1-4% in the common population, but the mortality incidence reaches 20% in case of third trimester pregnant women infection. The diagnosis of HEV infection can be made using serological tests but today, RT-PCR is considered as the gold standard test. Unfortunately, this technique is not widely available in Belgium yet. There is no treatment for HEV infection, only prophylactic measures as hygiene and sewage treatment can stop epidemics. Recently, a new vaccine, still in research phase, has showed promising outcomes.

Pheochromocytoma diagnosed pathologically with previous negative serum markers.

PubMed

Heavner, Matthew G; Krane, Louis S; Winters, Shira M; Mirzazadeh, Majid

2015-10-01

Patients presenting with adrenal masses require workup with catecholamine or metabolite measurements to rule out pheochromocytoma. There is a select portion of patients with marker negative pheochromocytoma. The aim of this study is to compare patient characteristics and presentations between marker positive and marker negative tumors. We performed an IRB-approved retrospective chart review of 88 cases of pheochromocytoma excised at our institution from 1995 to 2013. We considered any abnormal elevation in diagnostic test to be marker-positive. Seventy-eight cases had laboratory results available. Among these, seven had no elevations in laboratory testing. There was no difference in age or tumor size, but marker-negative patients had higher BMI than marker-positive patients. Marker negative patients were more likely to present with vertigo/dizziness (P = 0.003). Neither was more likely to have a genetic syndrome associated with risk of pheochromocytoma. Marker-negative pheochromocytoma is uncommon, representing 9% of cases in our series. Of patients with adrenal masses or presentation suggesting catecholamine excess with normal labs, those with vertigo/dizziness may warrant a metaiodobenzylguanidine scan or repeat testing to avoid missing pheochromocytoma. Clinicians may need a high degree of suspicion for pheochromocytoma in patients with negative testing and elevated BMI. © 2015 Wiley Periodicals, Inc.

Legal standard of care: a shift from the traditional Bolam test.

PubMed

Samanta, Ash; Samanta, Jo

2003-01-01

An essential component of an action in negligence against a doctor is proof that the doctor failed to provide the required standard of care under the circumstances. Traditionally the standard of care in law has been determined according to the Bolam test. This is based on the principle that a doctor does not breach the legal standard of care, and is therefore not negligent, if the practice is supported by a responsible body of similar professionals. The Bolam principle, however, has been perceived as being excessively reliant upon medical testimony supporting the defendant. The judgment given by the House of Lords in the recent case of Bolitho imposes a requirement that the standard proclaimed must be justified on a logical basis and must have considered the risks and benefits of competing options. The effect of Bolitho is that the court will take a more enquiring stance to test the medical evidence offered by both parties in litigation, in order to reach its own conclusions. Recent case law shows how the court has applied the Bolitho approach in determining the standard of care in cases of clinical negligence. An understanding of this approach and of the shift from the traditional Bolam test is relevant to all medical practitioners, particularly in a climate that is increasingly litigious.

Initial impact and cost of a nationwide population screening campaign for diabetes in Brazil: A follow up study

PubMed Central

Toscano, Cristiana M; Duncan, Bruce B; Mengue, Sotero S; Polanczyk, Carísi Anne; Nucci, Luciana B; Costa e Forti, Adriana; Fonseca, Cláudio D; Schmidt, Maria Inês

2008-01-01

Background In 2001 Brazilian citizens aged 40 or older were invited to participate in a nationwide population screening program for diabetes. Capillary glucose screening tests and procedures for diagnostic confirmation were offered through the national healthcare system, diagnostic priority being given according to the severity of screening results. The objective of this study is to evaluate the initial impact of the program. Methods Positive testing was defined by a fasting capillary glucose ≥ 100 mg/dL or casual glucose ≥ 140 mg/dL. All test results were tabulated locally and aggregate data by gender and clinical categories were sent to the Ministry of Health. To analyze individual characteristics of screening tests performed, a stratified random sample of 90,106 tests was drawn. To describe the actions taken for positive screenees, a random sub-sample of 4,906 positive screenees was actively followed up through home interviews. Main outcome measures considered were the number of diabetes cases diagnosed and cost per case detected and incorporated into healthcare. Results Of 22,069,905 screening tests performed, we estimate that 3,417,106 (95% CI 3.1 – 3.7 million) were positive and that 346,168 (290,454 – 401,852) new cases were diagnosed (10.1% of positives), 319,157 (92.2%) of these being incorporated into healthcare. The number of screening tests needed to detect one case of diabetes was 64. As many cases of untreated but previously known diabetes were also linked to healthcare providers during the Campaign, the estimated number needed screen to incorporate one case into the healthcare system was 58. Total screening and diagnostic costs were US$ 26.19 million, the cost per diabetes case diagnosed being US$ 76. Results were especially sensitive to proportion of individuals returning for diagnostic confirmation. Conclusion This nationwide population-based screening program, conducted through primary healthcare services, demonstrates the feasibility, within the context of an organized national healthcare system, of screening campaigns for chronic diseases. Although overall costs were significant, cost per new case diagnosed was lower than previously reported. However, cost-effectiveness analysis based on more clinically significant outcomes needs to be conducted before this screening approach can be recommended in other settings. PMID:18808662

A controlled experiment in ground water flow model calibration

USGS Publications Warehouse

Hill, M.C.; Cooley, R.L.; Pollock, D.W.

1998-01-01

Nonlinear regression was introduced to ground water modeling in the 1970s, but has been used very little to calibrate numerical models of complicated ground water systems. Apparently, nonlinear regression is thought by many to be incapable of addressing such complex problems. With what we believe to be the most complicated synthetic test case used for such a study, this work investigates using nonlinear regression in ground water model calibration. Results of the study fall into two categories. First, the study demonstrates how systematic use of a well designed nonlinear regression method can indicate the importance of different types of data and can lead to successive improvement of models and their parameterizations. Our method differs from previous methods presented in the ground water literature in that (1) weighting is more closely related to expected data errors than is usually the case; (2) defined diagnostic statistics allow for more effective evaluation of the available data, the model, and their interaction; and (3) prior information is used more cautiously. Second, our results challenge some commonly held beliefs about model calibration. For the test case considered, we show that (1) field measured values of hydraulic conductivity are not as directly applicable to models as their use in some geostatistical methods imply; (2) a unique model does not necessarily need to be identified to obtain accurate predictions; and (3) in the absence of obvious model bias, model error was normally distributed. The complexity of the test case involved implies that the methods used and conclusions drawn are likely to be powerful in practice.Nonlinear regression was introduced to ground water modeling in the 1970s, but has been used very little to calibrate numerical models of complicated ground water systems. Apparently, nonlinear regression is thought by many to be incapable of addressing such complex problems. With what we believe to be the most complicated synthetic test case used for such a study, this work investigates using nonlinear regression in ground water model calibration. Results of the study fall into two categories. First, the study demonstrates how systematic use of a well designed nonlinear regression method can indicate the importance of different types of data and can lead to successive improvement of models and their parameterizations. Our method differs from previous methods presented in the ground water literature in that (1) weighting is more closely related to expected data errors than is usually the case; (2) defined diagnostic statistics allow for more effective evaluation of the available data, the model, and their interaction; and (3) prior information is used more cautiously. Second, our results challenge some commonly held beliefs about model calibration. For the test case considered, we show that (1) field measured values of hydraulic conductivity are not as directly applicable to models as their use in some geostatistical methods imply; (2) a unique model does not necessarily need to be identified to obtain accurate predictions; and (3) in the absence of obvious model bias, model error was normally distributed. The complexity of the test case involved implies that the methods used and conclusions drawn are likely to be powerful in practice.

Notes on testing non-inferiority under the partial verification design with a confirmatory procedure limited to screen positives.

PubMed

Lui, Kung-Jong

2012-05-01

When a new test with fewer invasions or less expenses to administer than the traditional test is developed, we may be interested in testing whether the former is non-inferior to the latter with respect to test accuracy. We define non-inferiority via both the odds ratio (OR) of correctly identifying a case and the OR of correctly identifying a non-case between two tests under comparison. We focus our discussion on testing the non-inferiority of a new screening test to a traditional screening test when a confirmatory procedure is performed only on patients with screen positives. On the basis of well-established methods for paired-sample data, we derive an asymptotic test procedure and an exact test procedure with respect to the two ORs defined here. Using Monte Carlo simulation, we evaluate the performance of these test procedures in a variety of situations. We note that the test procedures proposed here can also be applicable if we are interested in testing non-inferiority with respect to the ratio of sensitivities and the ratio of specificities. We discuss interval estimation of these ORs and sample size calculation based on the asymptotic test procedure considered here. We use the data taken from a study of the prostate-specific-antigen (PSA) test and the digital rectal examination (DRE) test to illustrate the practical use of these test procedures, interval estimators and sample size calculation formula. Copyright © 2012 Elsevier Inc. All rights reserved.

Refractive errors and cataract as causes of visual impairment in Brazil.

PubMed

Eduardo Leite Arieta, Carlos; Nicolini Delgado, Alzira Maria; José, Newton Kara; Temporini, Edméia Rita; Alves, Milton Ruiz; de Carvalho Moreira Filho, Djalma

2003-02-01

To identify the main causes of visual impairment (VA

Corrected goodness-of-fit test in covariance structure analysis.

PubMed

Hayakawa, Kazuhiko

2018-05-17

Many previous studies report simulation evidence that the goodness-of-fit test in covariance structure analysis or structural equation modeling suffers from the overrejection problem when the number of manifest variables is large compared with the sample size. In this study, we demonstrate that one of the tests considered in Browne (1974) can address this long-standing problem. We also propose a simple modification of Satorra and Bentler's mean and variance adjusted test for non-normal data. A Monte Carlo simulation is carried out to investigate the performance of the corrected tests in the context of a confirmatory factor model, a panel autoregressive model, and a cross-lagged panel (panel vector autoregressive) model. The simulation results reveal that the corrected tests overcome the overrejection problem and outperform existing tests in most cases. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

[Poles of American tegumentary leishmaniasis production in northern Paraná State, Brazil].

PubMed

Monteiro, Wuelton Marcelo; Neitzke, Herintha Coeto; Silveira, Thaís Gomes Verzignassi; Lonardoni, Maria Valdrinez Campana; Teodoro, Ueslei; Ferreira, Maria Eugênia Moreira Costa

2009-05-01

American tegumentary leishmaniasis is endemic in the State of Paraná, with 99.3% of the cases reported in the South of Brazil. Spatial distribution of the disease in northern Paraná was verified, identifying the most relevant geographic areas in epidemiological terms. The study used data recorded on epidemiological forms from the Teaching and Research Clinical Test Laboratory of the State University in Maringá, from 1987 to 2004. The study only included individuals that were infected in the municipalities (counties) in northern Paraná. Identification of the epidemiological units (poles and circuits) was based on spatial density of cases, according to the model proposed by the National Health Foundation, considering the most likely infection sites. Considering 1,933 reported cases, 1,611 were infected in northern Paraná. American tegumentary leishmaniasis distribution in Paraná State suggests two circuits for production of the disease: Paraná-Paranapanema, highlighting the Cinzas-Laranjinha, Tibagi, Ivaí-Pirapó, Piquiri, and Baixo Iguaçu poles, and Ribeira, highlighting the Alto Ribeira pole.

Orbiting dynamic compression laboratory

NASA Technical Reports Server (NTRS)

Ahrens, T. J.; Vreeland, T., Jr.; Kasiraj, P.; Frisch, B.

1984-01-01

In order to examine the feasibility of carrying out dynamic compression experiments on a space station, the possibility of using explosive gun launchers is studied. The question of whether powders of a refractory metal (molybdenum) and a metallic glass could be well considered by dynamic compression is examined. In both cases extremely good bonds are obtained between grains of metal and metallic glass at 180 and 80 kb, respectively. When the oxide surface is reduced and the dynamic consolidation is carried out in vacuum, in the case of molybdenum, tensile tests of the recovered samples demonstrated beneficial ultimate tensile strengths.

In situ observation of lubricant film formation in THR considering real conformity: The effect of diameter, clearance and material.

PubMed

Nečas, D; Vrbka, M; Urban, F; Gallo, J; Křupka, I; Hartl, M

2017-05-01

The aim of the present study is to provide an analysis of protein film formation in hip joint replacements considering real conformity based on in situ observation of the contact zone. The main attention is focused on the effect of implant nominal diameter, diametric clearance and material. For this purpose, a pendulum hip joint simulator equipped with electromagnetic motors enabling to apply continuous swinging flexion-extension motion was employed. The experimental configuration consists of femoral component (CoCrMo, BIOLOX®forte, BIOLOX®delta) and acetabular cup from optical glass fabricated according to the dimensions of real cups. Two nominal diameters were studied, 28 and 36mm, respectively, while different diametric clearances were considered. Initially, a static test focused on the protein adsorption onto rubbing surfaces was performed with 36mm implants. It was found that the development of adsorbed layer is much more stable in the case of metal head, indicating that the adsorption forces are stronger compared to ceramic. A consequential swinging test revealed that the fundamental parameter influencing the protein film formation is diametric clearance. Independently of implant diameter, film was much thicker when a smaller clearance was considered. An increase of implant size from 28mm to 36mm did not cause a substantial difference in film formation; however, the total film thickness was higher for smaller implant. In terms of material, metal heads formed a thicker film, while this fact can be, among others, also attributed to clearance, which is more than two times higher in the case of ceramic implant. Copyright © 2016 Elsevier Ltd. All rights reserved.

Método perturbativo aplicado a gravidade de quarta ordem e a relatividade geral corrigida pelo grupo de renormalização

NASA Astrophysics Data System (ADS)

Filho, Sebastião Mauro

2017-01-01

In this thesis we applied the perturbative method, on a classical level, to the fourth-order gravity and the Renormalization Group extended General Relativity (RGGR). We will consider auxiliary fields formulation for the general fourth-order gravity on an arbitrary curved back-ground to analyze the metric perturbations in this theory. The case of a Ricci-flat background was elaborated in detail. We noticed that the use of auxiliary fields helps to make the pertur-bative analysis easier and the results more clear. As an application we reconsider the stability problem of the Schwarzschild and Kerr black holes in the fourth-order gravity. We also used the perturbative method to develop the Newtonian and post-Newtonian limits of RGGR. In the Solar System, RGGR depends on a single dimensionless parameter 0, and this parameter is such that for 0 = 0 one fully recovers General Relativity in the Solar System. In order to study the Newtonian limit we used the conformal transformation technique and the dynamics of the Laplace-Runge-Lenz vector (LRL). In this way, we could estimate the upper bound for 0 within the Solar System in two case: the case where the external potential effect is considered and the another when it is not considered. Previously this parameter was constrained to be 0 < 10-21, without considering the external potential effect. However, as we showed, when such an effect is considered this bound increases by five orders of magnitude, O < 10-16. Moreover, we showed that under a certain approximation RGGR can be easily tested using the parametrized post-Newtonian (PPN) formalism.

Practice guideline summary: Use of fMRI in the presurgical evaluation of patients with epilepsy: Report of the Guideline Development, Dissemination, and Implementation Subcommittee of the American Academy of Neurology.

PubMed

Szaflarski, Jerzy P; Gloss, David; Binder, Jeffrey R; Gaillard, William D; Golby, Alexandra J; Holland, Scott K; Ojemann, Jeffrey; Spencer, David C; Swanson, Sara J; French, Jacqueline A; Theodore, William H

2017-01-24

To assess the diagnostic accuracy and prognostic value of functional MRI (fMRI) in determining lateralization and predicting postsurgical language and memory outcomes. An 11-member panel evaluated and rated available evidence according to the 2004 American Academy of Neurology process. At least 2 panelists reviewed the full text of 172 articles and selected 37 for data extraction. Case reports, reports with <15 cases, meta-analyses, and editorials were excluded. The use of fMRI may be considered an option for lateralizing language functions in place of intracarotid amobarbital procedure (IAP) in patients with medial temporal lobe epilepsy (MTLE; Level C), temporal epilepsy in general (Level C), or extratemporal epilepsy (Level C). For patients with temporal neocortical epilepsy or temporal tumors, the evidence is insufficient (Level U). fMRI may be considered to predict postsurgical language deficits after anterior temporal lobe resection (Level C). The use of fMRI may be considered for lateralizing memory functions in place of IAP in patients with MTLE (Level C) but is of unclear utility in other epilepsy types (Level U). fMRI of verbal memory or language encoding should be considered for predicting verbal memory outcome (Level B). fMRI using nonverbal memory encoding may be considered for predicting visuospatial memory outcomes (Level C). Presurgical fMRI could be an adequate alternative to IAP memory testing for predicting verbal memory outcome (Level C). Clinicians should carefully advise patients of the risks and benefits of fMRI vs IAP during discussions concerning choice of specific modality in each case. © 2017 American Academy of Neurology.

[Professional drivers and psychoactive substances consumption: results from medical surveillance at the workplace in Piedmont region].

PubMed

Rosso, G L; Feola, M; Rubinetto, Maria Paola; Petti, N; Rubinetto, L

2011-01-01

The use of psychoactive substances has been shown to be a risk factor for accidents in professional drivers. According to an approved Italian law, in order to detect dependency at the workplace the occupational health physician is called to assess the use of illicit drugs among professional drivers. The main purpose of this study was to investigate the use of psychoactive substances among professional drivers. From July to December 2008, rapid urine screening test was carried out on 198 professional drivers. All positive results from the screening stage were verified by specialized laboratories. We found 4 workers with a positive rapid urine screening test (7.1%), one of which was positive only for benzodiazepines and another positive test was not confirmed by specialized laboratory. By only considering illegal substances detected, 6.1% of the drivers tested positive. In this study, the high number of consumers among professional drivers ranged from 31 to 35 years old. Cannabis (THC) was the most frequently detected substance (seen in 10 over 12 cases,), after that was methadone (2/12 cases) and cocaine (1/12 case). We only had one case where more than one substance was found in the same subject (THC and cocaine). Five (41.7%) were former drug-addicts and public Pathological Addiction Services (Ser.T.) had previously followed them. Our results highlight the problem of drug consumption among professional drivers in Piedmont region. Health education and medical surveillance in workplace drug-testing may improve worker and third parties safety.

Comparison of Microbiological Flora in the External Auditory Canal of Normal Ear and an Ear with Acute Otitis Externa.

PubMed

Ghanpur, Asheesh Dora; Nayak, Dipak Ranjan; Chawla, Kiran; Shashidhar, V; Singh, Rohit

2017-09-01

Acute Otitis Externa (AOE) is also known as swimmer's ear. Investigations initiated during World War II firmly established the role of bacteria in the aetiology of Acute Otitis Externa. To culture the microbiological flora of the normal ear and compare it with the flora causing AOE and to know the role of normal ear canal flora and anaerobes in the aetiology. A prospective observational study was conducted on 64 patients clinically diagnosed with unilateral AOE. Ear swabs were taken from both the ears. Microbiological flora was studied considering diseased ear as test ear and the normal ear as the control. Aerobic and anaerobic cultures were done. Severity of the disease was assessed by subjective and objective scores. Effect of topical treatment with ichthammol glycerine pack was assessed after 48 hours and scores were calculated again. Patients with scores < 4 after pack removal were started on systemic antibiotics and were assessed after seven days of antibiotics course. Data was analysed using Paired t-test, Wilcoxon signed ranks test and Chi-square test. A p-value < 0.05 was considered significant. Pseudomonas aeruginosa (33%) was the most common bacteria cultured from the ear followed by Methicillin Resistant Staphylococcus aureus (MRSA) (18%). Patients with anaerobic organism in the test ear had severe symptoms and needed systemic antibiotic therapy. Most of the cases may respond to empirical antibiotic therapy. In cases with severe symptoms and the ones refractory to empirical treatment, a culture from the ear canal will not be a tax on the patient. This helps in giving a better understanding about the disease, causative organisms and helps in avoiding the use of inappropriate antibiotics that usually result in developing resistant strains of bacteria.

Acetabular revisions using porous tantalum components: A retrospective study with 5-10 years follow-up

PubMed Central

Evola, Francesco Roberto; Costarella, Luciano; Evola, Giuseppe; Barchitta, Martina; Agodi, Antonella; Sessa, Giuseppe

2017-01-01

AIM To evaluate the clinical and X-ray results of acetabular components and tantalum augments in prosthetic hip revisions. METHODS Fifty-eight hip prostheses with primary failure of the acetabular component were reviewed with tantalum implants. The clinical records and X-rays of these cases were retrospectively reviewed. Bone defect evaluations were based on preoperative CT scans and classified according to Paprosky criteria of Radiolucent lines and periprosthetic gaps; implant mobilization and osteolysis were evaluated by X-ray. An ad hoc database was created and statistical analyses were performed with SPSS software (IBM SPSS Statistics for Windows, version 23.0). Statistical analyses were carried out using the Student’s t test for independent and paired samples. A P value of < 0.05 was considered statistically significant and cumulative survival was calculated by the Kaplan-Meier method. RESULTS The mean follow-up was 87.6 ± 25.6 mo (range 3-120 mo). 25 cases (43.1%) were classified as minor defects, and 33 cases (56.9%) as major defects. The preoperative HHS rating improved significantly from a mean of 40.7 ± 6.1 (range: 29-53) before revision, to a mean of 85.8 ± 6.1 (range: 70-94) at the end of the follow-up (Student’s t test for paired samples: P < 0.001). Considering HHS only at the end of follow-up, no statistically significant difference was observed between patients with a major or minor defect (Student’s t test for independent samples: P > 0.05). Radiolucent lines were found in 4 implants (6.9%). Postoperative acetabular gaps were observed in 5 hips (8.6%). No signs of implant mobilization or areas of periprosthetic osteolysis were found in the x-rays at the final follow-up. Only 3 implants failed: 1 case of infection and 2 cases of instability. Defined as the end-point, cumulative survival at 10 years was 95% (for all reasons) and 100% for aseptic loosening of the acetabular component. CONCLUSION The medium-term use of prosthetic tantalum components in prosthetic hip revisions is safe and effective in a wide variety of acetabular bone defects. PMID:28808626

Acetabular revisions using porous tantalum components: A retrospective study with 5-10 years follow-up.

PubMed

Evola, Francesco Roberto; Costarella, Luciano; Evola, Giuseppe; Barchitta, Martina; Agodi, Antonella; Sessa, Giuseppe

2017-07-18

To evaluate the clinical and X-ray results of acetabular components and tantalum augments in prosthetic hip revisions. Fifty-eight hip prostheses with primary failure of the acetabular component were reviewed with tantalum implants. The clinical records and X-rays of these cases were retrospectively reviewed. Bone defect evaluations were based on preoperative CT scans and classified according to Paprosky criteria of Radiolucent lines and periprosthetic gaps; implant mobilization and osteolysis were evaluated by X-ray. An ad hoc database was created and statistical analyses were performed with SPSS software (IBM SPSS Statistics for Windows, version 23.0). Statistical analyses were carried out using the Student's t test for independent and paired samples. A P value of < 0.05 was considered statistically significant and cumulative survival was calculated by the Kaplan-Meier method. The mean follow-up was 87.6 ± 25.6 mo (range 3-120 mo). 25 cases (43.1%) were classified as minor defects, and 33 cases (56.9%) as major defects. The preoperative HHS rating improved significantly from a mean of 40.7 ± 6.1 (range: 29-53) before revision, to a mean of 85.8 ± 6.1 (range: 70-94) at the end of the follow-up (Student's t test for paired samples: P < 0.001). Considering HHS only at the end of follow-up, no statistically significant difference was observed between patients with a major or minor defect (Student's t test for independent samples: P > 0.05). Radiolucent lines were found in 4 implants (6.9%). Postoperative acetabular gaps were observed in 5 hips (8.6%). No signs of implant mobilization or areas of periprosthetic osteolysis were found in the x-rays at the final follow-up. Only 3 implants failed: 1 case of infection and 2 cases of instability. Defined as the end-point, cumulative survival at 10 years was 95% (for all reasons) and 100% for aseptic loosening of the acetabular component. The medium-term use of prosthetic tantalum components in prosthetic hip revisions is safe and effective in a wide variety of acetabular bone defects.

Applying DER-CAM for IIT Microgrid Explansion Planning

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

Shahidehpour, Mohammad; Li, Zuyi; Wang, Jianhui

The Distributed Energy Resources Customer Adoption Model (DER-CAM) is an economic and environmental model of customer DER adoption. This model has been in development at the Lawrence Berkeley National Laboratory since 2000. The objective of the model is to find optimal DER investments while minimizing total energy costs or carbon dioxide (CO2) emissions, or achieving a weighted objective that simultaneously considers both criteria. The Illinois Institute of Technology (IIT) Microgrid project started in August 2008, and the majority of the project was completed in May 2013. IIT Microgrid, funded mostly by a grant from the U.S. Department of Energy asmore » well as State and philanthropic contributions, empowers the campus consumers with the objective of establishing a smart microgrid that is highly reliable, economically viable, environmentally friendly, fuel-efficient, and resilient in extreme circumstances with a self-healing capability. In this project, we apply DER-CAM to study the expansion planning of the IIT Microgrid. First, the load data, environmental data, utility data, and technology data for the IIT Microgrid are gathered and organized to follow the DER-CAM input requirements. Then, DERCAM is applied to study the expansion planning of the IIT Microgrid for different cases, where different objectives in DER-CAM and different utility conditions are tested. Case 1 considers the objective of minimizing energy costs with fixed utility rates and 100% electric utility availability. Case 2 considers the objective of minimizing energy costs with real-time utility rates and 4 emergency weeks when the IIT Microgrid does not have access to the electric utility grid and has to operate in island mode. In Case 3, the utility rates are restored to fixed values and 100% electric utility availability is assumed, but a weighted multi-objective (Obj: a × costs + b × CO2 emissions, where a and b are weights for cost minimization and CO2 emissions minimization) is utilized to consider both energy costs and CO2 emissions. On the basis of the test results, the IIT Microgrid has the potential to benefit from investments in more DER technologies. The current annual energy costs and CO2 emissions for the IIT Microgrid are 6,495.1 k$ and 39,838.5 metric tons, respectively. This represents the baseline for this project.« less

Universal testing and treatment as an HIV prevention strategy: research questions and methods.

PubMed

Hayes, Richard; Sabapathy, Kalpana; Fidler, Sarah

2011-09-01

Achieving high coverage of antiretroviral treatment (ART) in resource-poor settings will become increasingly difficult unless HIV incidence can be reduced substantially. Universal voluntary counselling and testing followed by immediate initiation of ART for all those diagnosed HIV-positive (universal testing and treatment, UTT) has the potential to reduce HIV incidence dramatically but would be very challenging and costly to deliver in the short term. Early modelling work in this field has been criticised for making unduly optimistic assumptions about the uptake and coverage of interventions. In future work, it is important that model parameters are realistic and based where possible on empirical data. Rigorous research evidence is needed before the UTT approach could be considered for wide-scale implementation. This paper reviews the main areas that need to be explored. We consider in turn research questions related to the provision of services for universal testing, services for immediate treatment of HIV-positives and the population-level impact of UTT, and the research methods that could be used to address these questions. Ideally, initial feasibility studies should be carried out to investigate the acceptability, feasibility and uptake of UTT services. If these studies produce promising results, there would be a strong case for a cluster-randomised trial to measure the impact of a UTT intervention on HIV incidence, and we consider the main design features of such a trial.

Why Is There so Little Critical Physical Education Scholarship in the United States? The Case of "Fitnessgram"

ERIC Educational Resources Information Center

Gard, Michael; Pluim, Carolyn

2017-01-01

In posing the question in our title, we have set ourselves the task of trying to understand why so little scholarly scrutiny and questioning of "Fitnessgram"--a product designed to assist in the school-based physical fitness testing of young people--exists in the country of its origin and then consider the implications of this silence.…

Candidate CDTI procedures study

NASA Technical Reports Server (NTRS)

Ace, R. E.

1981-01-01

A concept with potential for increasing airspace capacity by involving the pilot in the separation control loop is discussed. Some candidate options are presented. Both enroute and terminal area procedures are considered and, in many cases, a technologically advanced Air Traffic Control structure is assumed. Minimum display characteristics recommended for each of the described procedures are presented. Recommended sequencing of the operational testing of each of the candidate procedures is presented.

Understanding Arabic-Speaking Skill Learning Strategies among Selected Malay Learners: A Case-Study at the International Islamic University Malaysia (IIUM)

ERIC Educational Resources Information Center

Haron, Sueraya Che; Ahmad, Ismail Sheikh; Mamat, Arifin; Mohamed, Ismaiel Hassanein Ahmed

2010-01-01

In Malaysia, studies have shown that most Malay learners learning Arabic Language exhibit weak Arabic speaking skill despite spending years of learning the language. However, given the same learning environment and experience, some of them could be considered as good Arabic speakers as revealed by the results of Arabic Placement Test conducted by…

Discriminating between Light- and Heavy-Tailed Distributions with Limit Theorem.

PubMed

Burnecki, Krzysztof; Wylomanska, Agnieszka; Chechkin, Aleksei

2015-01-01

In this paper we propose an algorithm to distinguish between light- and heavy-tailed probability laws underlying random datasets. The idea of the algorithm, which is visual and easy to implement, is to check whether the underlying law belongs to the domain of attraction of the Gaussian or non-Gaussian stable distribution by examining its rate of convergence. The method allows to discriminate between stable and various non-stable distributions. The test allows to differentiate between distributions, which appear the same according to standard Kolmogorov-Smirnov test. In particular, it helps to distinguish between stable and Student's t probability laws as well as between the stable and tempered stable, the cases which are considered in the literature as very cumbersome. Finally, we illustrate the procedure on plasma data to identify cases with so-called L-H transition.

Discriminating between Light- and Heavy-Tailed Distributions with Limit Theorem

PubMed Central

Chechkin, Aleksei

2015-01-01

In this paper we propose an algorithm to distinguish between light- and heavy-tailed probability laws underlying random datasets. The idea of the algorithm, which is visual and easy to implement, is to check whether the underlying law belongs to the domain of attraction of the Gaussian or non-Gaussian stable distribution by examining its rate of convergence. The method allows to discriminate between stable and various non-stable distributions. The test allows to differentiate between distributions, which appear the same according to standard Kolmogorov–Smirnov test. In particular, it helps to distinguish between stable and Student’s t probability laws as well as between the stable and tempered stable, the cases which are considered in the literature as very cumbersome. Finally, we illustrate the procedure on plasma data to identify cases with so-called L-H transition. PMID:26698863

An assessment of some non-gray global radiation models in enclosures

NASA Astrophysics Data System (ADS)

Meulemans, J.

2016-01-01

The accuracy of several non-gray global gas/soot radiation models, namely the Wide-Band Correlated-K (WBCK) model, the Spectral Line Weighted-sum-of-gray-gases model with one optimized gray gas (SLW-1), the (non-gray) Weighted-Sum-of-Gray-Gases (WSGG) model with different sets of coefficients (Smith et al., Soufiani and Djavdan, Taylor and Foster) was assessed on several test cases from the literature. Non-isothermal (or isothermal) participating media containing non-homogeneous (or homogeneous) mixtures of water vapor, carbon dioxide and soot in one-dimensional planar enclosures and multi-dimensional rectangular enclosures were investigated. For all the considered test cases, a benchmark solution (LBL or SNB) was used in order to compute the relative error of each model on the predicted radiative source term and the wall net radiative heat flux.

Gonorrhea in homosexual men.

PubMed Central

Austin, T. W.; Lent, B.; Pattison, F. L.

1978-01-01

Extragenital gonorrhea was seen in 65% of 54 cases of gonorrhea in 43 homosexual men attending a venereal diseases clinic between 1974 and 1977; in 21 cases the infection was extragenital only. This type of gonorrhea was often asymptomatic and was associated with a high rate of failure of initial treatment in 6 of the 50 cases in which the patient returned for follow-up assessment, and in 5 of the 6 the persistent infection was extragenital. Syphillis was seen concomitantly or had previously occurred in 6 of the 54 cases. Fifteen of 28 cases of primary, secondary or early latent syphilis seen in men during the same study period had occurred in homosexuals. Appropriate testing for extragenital gonorrhea and for syphilis is important in homosexual men who present for examination, and homosexuality with the possibility of extragenital gonorrhea should be considered in a man with syphilis of recent onset. PMID:709473

Gonorrhea in homosexual men.

PubMed

Austin, T W; Lent, B; Pattison, F L

1978-10-07

Extragenital gonorrhea was seen in 65% of 54 cases of gonorrhea in 43 homosexual men attending a venereal diseases clinic between 1974 and 1977; in 21 cases the infection was extragenital only. This type of gonorrhea was often asymptomatic and was associated with a high rate of failure of initial treatment in 6 of the 50 cases in which the patient returned for follow-up assessment, and in 5 of the 6 the persistent infection was extragenital. Syphillis was seen concomitantly or had previously occurred in 6 of the 54 cases. Fifteen of 28 cases of primary, secondary or early latent syphilis seen in men during the same study period had occurred in homosexuals. Appropriate testing for extragenital gonorrhea and for syphilis is important in homosexual men who present for examination, and homosexuality with the possibility of extragenital gonorrhea should be considered in a man with syphilis of recent onset.

Urban epidemic of bubonic plague in Majunga, Madagascar: epidemiological aspects.

PubMed

Boisier, P; Rasolomaharo, M; Ranaivoson, G; Rasoamanana, B; Rakoto, L; Andrianirina, Z; Andriamahefazafy, B; Chanteau, S

1997-05-01

After an absence of 62 years, an epidemic of plague occurred in the harbour city of Majunga (Madagascar) from July 1995 to March 1996, following sporadic cases in March and May 1995. By 15 March 1996, 617 clinically suspected cases of bubonic plague had been notified. Laboratory testing was carried out for 394 individuals: 60 (15.2%) were confirmed to have bubonic plague and 48 (12.2%) were considered as presumptive cases. The incidence was significantly higher in males in all age groups and in both sexes in the 5-19 age group. Twenty-four deaths were related to plague, but early treatment with streptomycin has confirmed its effectiveness insofar as the case-farality ratio was only 8.7% among confirmed and presumptive cases admitted to hospital. The difficulty of clinically diagnosing bubonic plague was affirmed. The disease met favourable conditions through the poverty and low level of hygiene prevalent in most parts of Majunga.

Epidemiology and Molecular Virus Characterization of Reemerging Rabies, South Africa

PubMed Central

Sartorius, Benn; Sabeta, Claude; Zulu, Gugulethu; Paweska, Janusz; Mogoswane, Mamokete; Sutton, Chris; Nel, Louis H.; Swanepoel, Robert; Leman, Patricia A.; Grobbelaar, Antoinette A.; Dyason, Edwin; Blumberg, Lucille

2007-01-01

The incidence of dog rabies in Limpopo Province, South Africa, increased from 5 cases in 2004 to 100 in 2006. Human rabies had last been confirmed in 1981, but investigations instituted after an index case was recognized in February 2006 identified 21 confirmed, 4 probable, and 5 possible human cases between August 5, 2005, and December 31, 2006. Twelve of these case-patients were identified retrospectively because the diagnosis of rabies was not considered: 6 of these patients consulted a traditional healer, 6 had atypical manifestations with prominent abdominal symptoms, and 6 of 7 patients tested had elevated liver enzyme activity. Molecular genetic analysis indicated that outbreak virus strains were most closely related to recent canine strains from southern Zimbabwe. Delayed recognition of the human cases may have resulted from decreased clinical suspicion after many years of effective control of the disease and the occurrence of atypical clinical presentations. PMID:18258039

n-Ethyl Pentylone-Related Deaths in Alabama.

PubMed

Atherton, Daniel; Dye, Daniel; Robinson, C Andrew; Beck, Rachel

2018-05-16

n-Ethyl pentylone (NEP) is a chemical substance derived from cathinone. Synthetic cathinones are an evolving group of drugs with stimulating, mind-altering effects sometimes referred to as novel or new psychoactive substances (NPS). There is scarce information in the medical literature regarding forensic cases in which NEP is detected in toxicological testing. We present four fatalities involving NEP from Alabama in 2017. Deaths were attributed to NEP toxicity in two cases (peripheral blood concentrations of 0.121 and 0.953 mg/L) and injuries caused by gunshot wounds in two cases (peripheral blood concentrations of 0.045 and 0.031 mg/L). One case involving NEP described an individual who exhibited classic CNS-stimulant induced erratic behavior before being found dead. These cases enhance the forensic literature regarding specific NPS like NEP and provide contextual reference for professionals considering the significance of NEP in toxicological interpretation. © 2018 American Academy of Forensic Sciences.

Pancytopenia in a surgical patient, a rare presentation of hyperthyroidism.

PubMed

Jha, Prabhat; Singh, Yogendra Prasad; Ghimire, Bikal; Jha, Binit Kumar

2014-12-15

Pancytopenia is a rare complication of hyperthyroidism. Various mechanisms have been described such as immunological, bone marrow suppression. The possibility of hyperthyroidism should be considered in patients with unexplained pancytopenia. There are many case reports showing the association between hyperthyroidism and pancytopenia. All of these reports show association between Graves disease and pancytopenia but our case shows association between Multinodular goitre and pancytopenia. Besides it is uncommon to find such association in a surgical patient. This case report describes a 62 yr old hindu female with splenic injury and pancytopenia. On further investigations the patient was found to have hyperthyroidism. Though the definite mechanism regarding the association of pancytopenia with hyperthyroidism isn't clear, various cases have been described in the literature. This case shows the diagnostic dilemma that can occur in patients with pancytopenia. Any patient with unexplained pancytopenia should undergo thyroid function tests to rule out hyperthyroidism.

Advancing the Selection of Neurodevelopmental Measures in Epidemiological Studies of Environmental Chemical Exposure and Health Effects

PubMed Central

Youngstrom, Eric; LaKind, Judy S.; Kenworthy, Lauren; Lipkin, Paul H.; Goodman, Michael; Squibb, Katherine; Mattison, Donald R.; Anthony, Bruno J.; Anthony, Laura Gutermuth

2010-01-01

With research suggesting increasing incidence of pediatric neurodevelopmental disorders, questions regarding etiology continue to be raised. Neurodevelopmental function tests have been used in epidemiology studies to evaluate relationships between environmental chemical exposures and neurodevelopmental deficits. Limitations of currently used tests and difficulties with their interpretation have been described, but a comprehensive critical examination of tests commonly used in studies of environmental chemicals and pediatric neurodevelopmental disorders has not been conducted. We provide here a listing and critical evaluation of commonly used neurodevelopmental tests in studies exploring effects from chemical exposures and recommend measures that are not often used, but should be considered. We also discuss important considerations in selecting appropriate tests and provide a case study by reviewing the literature on polychlorinated biphenyls. PMID:20195443

Reversible obstructive sleep apnea caused by occupational exposure to guar gum dust.

PubMed

Leznoff, A; Haight, J S; Hoffstein, V

1986-05-01

This report describes a case of reversible obstructive sleep apnea caused by occupational exposure to an inhaled allergen, guar gum powder. The patient, a pet food plant employee, also experienced severe cough, rhinitis, and conjunctivitis. Skin tests confirmed the specific guar allergy. Pharyngeal cross-sectional area was smaller than normal. Pulmonary function studies, histamine challenge tests, nasal air-flow resistance measurements, and nocturnal polysomnography were performed on 3 separate occasions: while the patient was working at his usual occupation, at the end of a 3-wk holiday, and after a guar dust challenge in an inhalation chamber. Pulmonary function and histamine challenge tests were consistently normal. At the time of the initial tests, nasal resistance was elevated, and nocturnal polysomnography revealed obstructive sleep apnea. After absence from work, obstructive sleep apnea resolved, and the nasal resistance returned to normal. After challenge with guar gum dust, the patient developed increased resistance to nasal air flow, and obstructive sleep apnea reappeared. This case demonstrates that allergy can cause reversible obstructive sleep apnea and that occupational exposure should be considered in the assessment of patients with this disease.

Case report of a false positive result of the Xpert® MTB/RIF assay for rifampicin resistance in Mycobacterium tuberculosis complex.

PubMed

Claessens, Jolien; Mathys, Vanessa; Derdelinckx, Inge; Saegeman, Veroniek

2017-06-01

In the present case, we report a false positive result for the detection of rifampicin (RIF) resistance by the Xpert ® MTB/RIF assay, version G4.Miliary Mycobacterium tuberculosis infection (miliary TB) was suspected in a 50-year old Angolan woman. Imaging of the thorax and abdomen displayed diffuse lesions. The Xpert ® MTB/RIF assay conducted on the broncho-alveolar lavage (BAL) fluid was positive for TB and positive for RIF resistance. Confirmatory molecular tests and the phenotypic drug susceptibility determination supported the diagnosis of TB but not RIF resistance. The patient was treated successfully with a conventional therapeutic scheme. Because, the Xpert ® MTB/RIF assay allows the simultaneous detection of TB and RIF resistance, the World Health Organisation (WHO) recommends its use as initial diagnostic test, over microscopy, culture and phenotypic drug susceptibility testing. Even though specificity of the Xpert ® MTB/RIF assay version G4 is high, false positive test results remain possible and have to be considered for the interpretation of the RIF resistance detection by Xpert ® MTB/RIF assay.

Evaluation of the equivocal test results of Treponema pallidum haemagglutination assay.

PubMed Central

Su, S J; Huang, S; Chung, C Y; Yang, H M; Chow, Y O

1990-01-01

Two hundred and eighty Rapid Plasma Reagin (RPR) positive sera with an emphasis on cases with negative and borderline positive Treponema pallidum haemagglutination assay (TPHA) results were selected. Modified TPHA (M-TPHA) and fluorescent treponemal antibody absorption (FTA-abs) tests were used for comparison. One hundred and twenty five samples were TPHA negative, of which 78 and 69 cases were also negative by M-TPHA and FTA-abs, respectively. Eighty one sera negative by TPHA at a titre of 1/80 and positive at 1/40, considered to be negative according to the manufacturer's instructions, were also negative by M-TPHA (n = 11) and by FTA-abs (n = 1). Fifty borderline positive TPHA specimens gave one negative result by both M-TPHA and FTA-abs. The remaining 24 sera were positive by all three tests. Because of the high percentage of TPHA negative results among the positive RPR sera which became reactive when rechecked by the FTA-abs, it is concluded that as a confirmatory test the TPHA should be used not instead of but in addition to the FTA-abs. PMID:2180985

Building Energy Simulation Test for Existing Homes (BESTEST-EX) (Presentation)

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

Judkoff, R.; Neymark, J.; Polly, B.

2011-12-01

This presentation discusses the goals of NREL Analysis Accuracy R&D; BESTEST-EX goals; what BESTEST-EX is; how it works; 'Building Physics' cases; 'Building Physics' reference results; 'utility bill calibration' cases; limitations and potential future work. Goals of NREL Analysis Accuracy R&D are: (1) Provide industry with the tools and technical information needed to improve the accuracy and consistency of analysis methods; (2) Reduce the risks associated with purchasing, financing, and selling energy efficiency upgrades; and (3) Enhance software and input collection methods considering impacts on accuracy, cost, and time of energy assessments. BESTEST-EX Goals are: (1) Test software predictions of retrofitmore » energy savings in existing homes; (2) Ensure building physics calculations and utility bill calibration procedures perform up to a minimum standard; and (3) Quantify impact of uncertainties in input audit data and occupant behavior. BESTEST-EX is a repeatable procedure that tests how well audit software predictions compare to the current state of the art in building energy simulation. There is no direct truth standard. However, reference software have been subjected to validation testing, including comparisons with empirical data.« less

[Gold salt alveolitis in 3 patients with rheumatoid arthritis].

PubMed

Music, E; Tomsic, M; Logar, D

1995-06-01

When the characteristic symptoms for an interstitial pulmonary disease arise in patients with rheumatoid arthritis, a drug-induced alveolitis should be considered in the differential diagnosis. In such cases, the administration of the drug and gold salts should be stopped. The cases of three patients with rheumatoid arthritis (RA) who had been treated with gold salts for 2 months (A), 23 months (B), and 36 months (C) are presented. The total dose of sodium aureothiomalate amounted to 280 mg for patient A, 1150 mg for patient B, and 2190 mg for patient C. Clinical signs, X-rays of the lungs, pulmonary function tests, and laboratory tests were evaluated for the three patients while, for patient A BAL as well as provocation tests were additionally performed before and after therapy. In this case, the histological picture of the lungs is presented; biopsies were taken during the first BAL. The clinical complaints of all 3 patients were similar, with the alveolitis being observed as diffuse in one case and above all in the upper regions in two cases on radiology. This led to differing degrees of diffusion disorders in the lungs. In patient A, the diagnosis was made in the stage of progressive fibrotic alveolitis and was treated with D-penicillamine. All 3 patients received steroids over 3-6 months and the gold salts were stopped. Because of the long duration and doubtful differential diagnosis for patient A with either rheumatoid lung or gold salt alveolitis, a provocation test with sodium aureothiomalate was performed. All 3 patients had blood eosinophilia while, in case A, a thrombopenia was also found. A gold salt alveolitis can occur as a side effect of gold salts in addition to skin vasculitis and hematological disorders. When the gold salt administration is not stopped a fibrotic alveolitis can develop. The provocation test can be diagnostically useful to distinguish between a rheumatoid lung and gold salt alveolitis.

Pressure and temperature fields associated with aero-optics tests. [transonic wind tunnel tests

NASA Technical Reports Server (NTRS)

Raman, K. R.

1980-01-01

The experimental investigation carried out in a 6 x 6 ft wind tunnel on four model configurations in the aero-optics series of tests are described. The data obtained on the random pressures (static and total pressures) and total temperatures are presented. In addition, the data for static pressure fluctuations on the Coelostat turret model are presented. The measurements indicate that the random pressures and temperature are negligible compared to their own mean (or steady state) values for the four models considered, thus allowing considerable simplification in the calculations to obtain the statistical properties of the density field. In the case of the Coelostat model tests these simplifications cannot be assumed a priori and require further investigation.

The qualification of the shuttle booster separation motors

NASA Technical Reports Server (NTRS)

Chase, C. A.; Fisher, K. M.; Eoff, W.

1978-01-01

Four booster separation motors (BSM) located at each end of every solid rocket booster (SRB) provide the needed side force to separate the boosters from the external tank at booster burnout. Four BSMs at the top of the SRB are located in a box pattern in the nose cone frustum. The four BSMs at the aft end of the SRB are arranged side-by-side on the SRB aft skirt. Aspects of BSM design and performance are considered, taking into account a motor design/performance summary, the case design, the insulation, the grain design, the nozzle/aft closure design, the ignition system, the propellant, and the motor assembly. Details of motor testing are also discussed, giving attention to development testing, qualification testing, and flight testing.

Fan Noise Source Diagnostic Test Computation of Rotor Wake Turbulence Noise

NASA Technical Reports Server (NTRS)

Nallasamy, M.; Envia, E.; Thorp, S. A.; Shabbir, A.

2002-01-01

An important source mechanism of fan broadband noise is the interaction of rotor wake turbulence with the fan outlet guide vanes. A broadband noise model that utilizes computed rotor flow turbulence from a RANS code is used to predict fan broadband noise spectra. The noise model is employed to examine the broadband noise characteristics of the 22-inch Source Diagnostic Test fan rig for which broadband noise data were obtained in wind tunnel tests at the NASA Glenn Research Center. A 9-case matrix of three outlet guide vane configurations at three representative fan tip speeds are considered. For all cases inlet and exhaust acoustic power spectra are computed and compared with the measured spectra where possible. In general, the acoustic power levels and shape of the predicted spectra are in good agreement with the measured data. The predicted spectra show the experimentally observed trends with fan tip speed, vane count, and vane sweep. The results also demonstrate the validity of using CFD-based turbulence information for fan broadband noise calculations.

Using Nuclear Medicine Imaging Wisely in Diagnosing Infectious Diseases

PubMed Central

Censullo, Andrea

2017-01-01

Abstract In recent years, there has been an increasing emphasis on efficient and accurate diagnostic testing, exemplified by the American Board of Internal Medicine’s “Choosing Wisely” campaign. Nuclear imaging studies can provide early and accurate diagnoses of many infectious disease syndromes, particularly in complex cases where the differential remains broad. This review paper offers clinicians a rational, evidence-based guide to approaching nuclear medicine tests, using an example case of methicillin-sensitive Staphylococcus aureus (MSSA) bacteremia in a patient with multiple potential sources. Fluorodeoxyglucose-positron emission tomography (FDG-PET) with computed tomography (CT) and sulfur colloid imaging with tagged white blood cell (WBC) scanning offer the most promise in facilitating rapid and accurate diagnoses of endovascular graft infections, vertebral osteomyelitis (V-OM), diabetic foot infections, and prosthetic joint infections (PJIs). However, radiologists at different institutions may have varying degrees of expertise with these modalities. Regardless, infectious disease consultants would benefit from knowing what nuclear medicine tests to order when considering patients with complex infectious disease syndromes. PMID:28480283

Pigmentary glaucoma accompanied by Usher syndrome.

PubMed

Koucheki, Behrooz; Jalali, Kamran Hodjat

2012-08-01

To report a case of pigmentary glaucoma (PG) accompanied by Usher syndrome. Case report. The results were presented after standard ocular examination, visual field test, anterior segment and fundus photography, electroretinography, and otolaryngology consultation were conducted. Typical retinitis pigmentosa, flat electroretinography, congenital sensorineural hearing loss, high intraocular pressure, Krukenberg spindle, iris concavity, radial iris transillumination defect, severe pigment deposition on the trabecular meshwork, and glaucomatous optic nerve damage were indicative of PG accompanied by Usher syndrome. In some rare cases, PG may coexist with Usher syndrome. Common findings of Usher syndrome, including night blindness, impaired vision, visual field defects, and retinal changes may distract the clinician from considering the diagnosis of glaucoma. Such association should be borne in mind to make a timely diagnosis and treatment possible.

Orthostatic hypotension as an unusual clinical manifestation of pheochromocytoma: a case report.

PubMed

Bortnik, Miriam; Occhetta, Eraldo; Marino, Paolo

2008-08-01

Pheochromocytoma is a rare endocrine tumor which can have a highly variable presentation related to increased catecholamine secretion. We report the case of a 74-year-old man in whom recurrent episodes of syncope due to orthostatic hypotension were the only clinical manifestations of this challenging entity. Diagnosis of pheochromocytoma was achieved by biochemical test samples and computed tomography scans. Surgical excision of the tumor resulted in clinical improvement with normalization of catecholamine concentrations and no more episodes of orthostatic hypotension during a follow-up of 24 months. Although rare, pheochromocytoma may frequently cause disorders of orthostatic tolerance; because of its meaningful implications, screening for this entity should be considered in case of recurrent syncopal episodes due to new-onset orthostatic hypotension.

Strengthening the SDP Relaxation of AC Power Flows with Convex Envelopes, Bound Tightening, and Valid Inequalities

DOE PAGES

Coffrin, Carleton James; Hijazi, Hassan L; Van Hentenryck, Pascal R

2016-12-01

Here this work revisits the Semidefine Programming (SDP) relaxation of the AC power flow equations in light of recent results illustrating the benefits of bounds propagation, valid inequalities, and the Convex Quadratic (QC) relaxation. By integrating all of these results into the SDP model a new hybrid relaxation is proposed, which combines the benefits from all of these recent works. This strengthened SDP formulation is evaluated on 71 AC Optimal Power Flow test cases from the NESTA archive and is shown to have an optimality gap of less than 1% on 63 cases. This new hybrid relaxation closes 50% ofmore » the open cases considered, leaving only 8 for future investigation.« less

NP-59 test for preoperative localization of primary hyperaldosteronism.

PubMed

Di Martino, Marcello; García Sanz, Iñigo; Muñoz de Nova, Jose Luis; Marín Campos, Cristina; Martínez Martín, Miguel; Domínguez Gadea, Luis

2017-03-01

Adrenal venous sampling is generally considered the gold standard to identify unilateral hormone production in cases of primary hyperaldosteronism. The aim of this study is to evaluate whether the iodine-131-6-β-iodomethyl-19-norcholesterol (NP-59) test may represent an alternative in selected cases. Patients submitted to laparoscopic adrenalectomy for suspected primary hyperaldosteronism (n = 27) were retrospectively reviewed. When nuclear medicine tests were preoperatively performed, their results were compared with the histopathologic findings and clinical improvement. Nuclear medicine tests were realized in 13 patients. In 11 (84.6%), a planar anterior and posterior NP-59 scintigraphy was performed and a SPECT/TC in two (15.4%). Scintigraphy indicated a preoperative lateralization in 12 out of 13 patients (92.3%). When the value of NP-59 tests was based on pathologic results, it showed a sensitivity of 90.9% and a positive predictive value of 83.3%. When the nuclear medicine test's performance was based on postoperative blood pressure control, both sensitivity and positive predictive value were 91.6%. Nuclear medicine tests represent a useful tool in the preoperative localisation of primary hyperaldosteronism with a high sensitivity and positive predictive value. In patients with contraindications to adrenal venous sampling like contrast allergies, or when it is inconclusive, scintigraphy can represent a useful and non-invasive alternative.

Intact or broken-apart RNA: an alternative concept for ALK fusion screening in non-small cell lung cancer (NSCLC).

PubMed

Kotoula, Vassiliki; Bobos, Mattheos; Vassilakopoulou, Maria; Tsolaki, Eleftheria; Chrisafi, Sofia; Psyrri, Amanda; Lazaridis, George; Papadopoulou, Kyriaki; Efstratiou, Ioannis; Michail-Strantzia, Catherine; Debelenko, Larisa V; Kosmidis, Paris; Fountzilas, George

2015-01-01

Anaplastic lymphoma kinase (ALK) break-apart fluorescent in situ hybridization (FISH) is currently used in diagnostics for the selection of non-small cell lung cancer (NSCLC) patients to receive crizotinib. We evaluated ALK status in NSCLC with a novel ALK mRNA test based on the break-apart FISH concept, which we called break-apart transcript (BAT) test. ALK5' and ALK3' transcript patterns were established with qPCR for ALK-expressing controls including fusion-negative neuroblastomas, as well as fusion-positive anaplastic large cell lymphomas and NSCLC. The BAT test was evaluated on 271 RNA samples from routinely processed paraffin NSCLC tissues. Test results were compared with ALK FISH (n=121), immunohistochemical (IHC) analysis (n=86), and automated quantitative analysis (AQUA, n=83). On the basis of the nonoverlapping ALK BAT patterns in ALK-expressing controls (P<0.0001), 8/174 adenocarcinomas (4.6%) among 259 informative NSCLC were predicted as fusion positive. Overall concordance for paired method results was high (94.1% to 98.8%) but mainly concerned negative prediction because of the limited availability of positive-matched cases. Tumors with 100% cytoplasmic IHC staining of any intensity (n=3) were positive for AQUA, FISH, and BAT test; tumors with lower IHC positivity and different staining patterns were AQUA-negative. Upon multiple reevaluations, ALK gene status was considered as originally misinterpreted by FISH in 3/121 cases (2.5%). Tumors with >4 ALK gene copies were associated with longer overall survival upon first-line chemotherapy. In conclusion, application of the ALK BAT test on routinely processed NSCLC tissues yields the same fusion partner independent information as ALK break-apart FISH but is more robust and cost-effective. The BAT concept may be considered for the development of further drug-predictive translocation tests.

Some Static Oscillatory and Free Body Tests of Blunt Bodies at Low Subsonic Speeds

NASA Technical Reports Server (NTRS)

Lichtenstein, Jacob H.; Fisher, Lewis R.; Scher, Stanley H.; Lawrence, George F.

1959-01-01

Some blunt-body shapes considered suitable for entry into the earth's atmosphere were tested by both static and oscillatory methods in the Langley stability tunnel. In addition, free-fall tests of some similar models were made in the Langley 20-foot free-spinning tunnel. The results of the tests show that increasing the flare of the body shape increased the dynamic stability and that for flat-faced shapes increasing the corner radius increased the stability. The test data from the Langley stability tunnel were used to compute the damping factor for the models tested in the langley 20-foot free-spinning tunnel. For these cases in which the damping factor was low, -1/2 or less, the stability was critical and sensitive to disturbance. When the damping factor was about -2, damping was generally obtained.

The botulinum neurotoxin LD50 test - problems and solutions.

PubMed

Bitz, Silke

2010-01-01

Apart from the fact that the LD50 test is generally considered a procedure causing severe distress, which alone should result in its immediate deletion, it also conflicts with the EU wide ban on cosmetic testing in animals in the case of Botulinum Neurotoxin (BoNT) testing. The European Pharmacopoeia monograph allows for the use of three alternative methods provided they are validated. However these alternative assays are neither implemented by the manufactures of BoNT products nor are they enforced by the responsible authorities, e.g. by deleting the LD50 from the European Pharmacopoeia. The number of animals used for the testing of BoNT is not officially recorded. However, data from an undercover investigation allow the estimation that the number of mice used in LD50tests for BoNT products is greater than 600,000 per year worldwide.

Effectiveness comparison of partially executed t-way test suite based generated by existing strategies

NASA Astrophysics Data System (ADS)

Othman, Rozmie R.; Ahmad, Mohd Zamri Zahir; Ali, Mohd Shaiful Aziz Rashid; Zakaria, Hasneeza Liza; Rahman, Md. Mostafijur

2015-05-01

Consuming 40 to 50 percent of software development cost, software testing is one of the most resource consuming activities in software development lifecycle. To ensure an acceptable level of quality and reliability of a typical software product, it is desirable to test every possible combination of input data under various configurations. Due to combinatorial explosion problem, considering all exhaustive testing is practically impossible. Resource constraints, costing factors as well as strict time-to-market deadlines are amongst the main factors that inhibit such consideration. Earlier work suggests that sampling strategy (i.e. based on t-way parameter interaction or called as t-way testing) can be effective to reduce number of test cases without effecting the fault detection capability. However, for a very large system, even t-way strategy will produce a large test suite that need to be executed. In the end, only part of the planned test suite can be executed in order to meet the aforementioned constraints. Here, there is a need for test engineers to measure the effectiveness of partially executed test suite in order for them to assess the risk they have to take. Motivated by the abovementioned problem, this paper presents the effectiveness comparison of partially executed t-way test suite generated by existing strategies using tuples coverage method. Here, test engineers can predict the effectiveness of the testing process if only part of the original test cases is executed.

Skin testing for immediate hypersensitivity to corticosteroids: a case series and literature review.

PubMed

Baker, A; Empson, M; The, R; Fitzharris, P

2015-03-01

Immediate hypersensitivity to corticosteroids is reported to occur with an incidence of 0.1%. The largest previous case series reporting corticosteroid skin testing has seven patients. We identified 23 patients (mean age 50 years, 65% female) from Auckland City Hospital who underwent skin testing (ST) for suspected corticosteroid hypersensitivity between July 2005 and April 2012. We performed a retrospective clinical case note review detailing clinical history of reaction, skin test results and subsequent management. Most patients (21/23) had a standard panel of testing with prednisolone, triamcinolone, methylprednisolone, hydrocortisone and dexamethasone. Skin tests used a 10% steroid stock concentration for skin prick tests (SPT) and dilutions of 1 : 1000, 1 : 100 and 1 : 10 for subsequent intradermal testing. A weal 3 mm greater than the negative control was considered positive. A total of 23 patients were identified who had skin testing for suspected acute hypersensitivity to corticosteroids, eight of which had a history of anaphylaxis. From 28 reactions (in 23 patients), the most common route of administration was intra-articular (13), followed by oral (7), intravenous (3) and other (5). Skin tests were positive in 8/23 patients, and 7/8 of these patients had a history of corticosteroid-associated anaphylaxis. Skin tests were positive at either the skin prick test or intradermal stages. There was evidence suggesting clinical and skin test cross-reactivity between corticosteroids in one patient. One patient had a positive skin test, but negative oral challenge suggesting the skin test was false positive. Skin tests were negative in 15/23 patients. One patient had a negative prednisolone skin test and positive unblinded oral challenge, suggesting a false-negative skin test. Skin testing can provide sufficient evidence to diagnose allergy in patients with a clear history of immediate hypersensitivity to corticosteroids such as anaphylaxis. Both skin prick and intradermal tests should be used. There is evidence of cross-reactivity between steroids, so a panel is recommended. False-positive and false-negative reactions do occur; however, the frequency is unknown. Challenge remains the only definitive way to demonstrate a safe alternative to use. As the largest case series described, this article provides new evidence for the interpretation of skin tests when investigating possible immediate hypersensitivity to corticosteroids. © 2014 John Wiley & Sons Ltd.

Cosmological implications of quantum entanglement in the multiverse

NASA Astrophysics Data System (ADS)

Kanno, Sugumi

2015-12-01

We explore the cosmological implications of quantum entanglement between two causally disconnected universes in the multiverse. We first consider two causally separated de Sitter spaces with a state which is initially entangled. We derive the reduced density matrix of our universe and compute the spectrum of vacuum fluctuations. We then consider the same system with an initially non-entangled state. We find that due to quantum interference scale dependent modulations may enter the spectrum for the case of initially non-entangled state. This gives rise to the possibility that the existence of causally disconnected universes may be experimentally tested by analyzing correlators in detail.

Solving time-dependent two-dimensional eddy current problems

NASA Technical Reports Server (NTRS)

Lee, Min Eig; Hariharan, S. I.; Ida, Nathan

1988-01-01

Results of transient eddy current calculations are reported. For simplicity, a two-dimensional transverse magnetic field which is incident on an infinitely long conductor is considered. The conductor is assumed to be a good but not perfect conductor. The resulting problem is an interface initial boundary value problem with the boundary of the conductor being the interface. A finite difference method is used to march the solution explicitly in time. The method is shown. Treatment of appropriate radiation conditions is given special consideration. Results are validated with approximate analytic solutions. Two stringent test cases of high and low frequency incident waves are considered to validate the results.

[Hypersensitivity to platinum salts and taxanes: The value of skin tests and tolerance induction procedures].

PubMed

Brault, F; Waton, J; Poreaux, C; Schmutz, J-L; Barbaud, A

2017-11-01

The rate of hypersensitivity reactions to platinum salts (PS) and taxanes (TX) is on the increase. The aim of our study was to show the value of skin testing and efficacy of rapid drug desensitization. This was a retrospective study conducted between January 2007 and February 2016 in patients consulting for immediate or delayed hypersensitivity to PS and TX. Skin prick tests (pT) and intradermal reaction tests (IDR) were performed according to the ENDA/EAACI recommendations. We used a 12-step desensitization protocol for rapid drug desensitization. Among the 99 patients included (30 men, 69 women, age 60.4) PS were suspected in 86 cases and taxanes in 13 cases. Skin tests were positive in 25 patients (7 pT, 18 IDR), 23 for platinum salts and 2 for taxanes. Rapid drug desensitization was proposed in 50 patients and performed in 33 (30 PS and 3 TX), proved effective in 29 patients, with protocol adaptation being necessary in 7 cases, and was ineffective in 4 patients. The skin tests for the latter 4 patients were positive. Seventy-five percent of patients with positive skin tests to oxaliplatin presented hypersensitivity reactions during desensitization, i.e. twice as many as patients having negative skin tests. Two percent of patient for PS and 7% for TX had cross reactivity. This French study confirms the efficacy of the 12-step protocol that allows patients to receive chemotherapy after hypersensitivity reaction. Skin test permits the detection of cross-reactions but their practice must be considered based on the patient's history. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

Comparative Study on High-Order Positivity-preserving WENO Schemes

NASA Technical Reports Server (NTRS)

Kotov, Dmitry V.; Yee, Helen M.; Sjogreen, Bjorn Axel

2013-01-01

The goal of this study is to compare the results obtained by non-positivity-preserving methods with the recently developed positivity-preserving schemes for representative test cases. In particular the more di cult 3D Noh and Sedov problems are considered. These test cases are chosen because of the negative pressure/density most often exhibited by standard high-order shock-capturing schemes. The simulation of a hypersonic nonequilibrium viscous shock tube that is related to the NASA Electric Arc Shock Tube (EAST) is also included. EAST is a high-temperature and high Mach number viscous nonequilibrium ow consisting of 13 species. In addition, as most common shock-capturing schemes have been developed for problems without source terms, when applied to problems with nonlinear and/or sti source terms these methods can result in spurious solutions, even when solving a conservative system of equations with a conservative scheme. This kind of behavior can be observed even for a scalar case (LeVeque & Yee 1990) as well as for the case consisting of two species and one reaction (Wang et al. 2012). For further information concerning this issue see (LeVeque & Yee 1990; Griffiths et al. 1992; Lafon & Yee 1996; Yee et al. 2012). This EAST example indicated that standard high-order shock-capturing methods exhibit instability of density/pressure in addition to grid-dependent discontinuity locations with insufficient grid points. The evaluation of these test cases is based on the stability of the numerical schemes together with the accuracy of the obtained solutions.

Serological Survey and Associated Risk Factors of Visceral Leish-maniasis in Qom Province, Central Iran.

PubMed

Rakhshanpour, Arash; Mohebali, Mehdi; Akhondi, Behnaz; Rahimi, Mohammad Taghi; Rokni, Mohammad Bagher

2014-01-01

Visceral leishmaniasis (VL) or kala-azar is considered as a parasitic disease caused by the species of Leishmania donovani complex which is intracellular parasites. This systemic disease is endemic in some parts of provinc-es of Iran. The aim of this study was to determine the seroprevalence of VL in Qom Province, central Iran using di-rect agglutination test (DAT). Overall, 1564 serum samples (800 males and 764 females) were collected from selected subjects by random-ized cluster sampling in 2011-2012. Sera were tested and analyzed by DAT. Before sampling; a questionnaire was filled out for each case. Data were analyzed using Chi-square test and multivariate logistic regression for risk factors analysis. Of 1564 individuals, 53 cases (3.38%) showed Leishmania specific antibodies as follows: with 1:400 titer 16 cases (1.02%), with 1:800 titer 20 cases (1.27%), with 1:1600 titer 16 cases (1.02%) whereas only one subject (0.06%) showed titers of ≥ 1:3200. There was no significant association between VL seropositivity and gender, age group and occupation. Binary logistic regression showed that rural areas was 0.44 times at higher risk of infection than urban areas (OR= 0.44; %95 CI= 0.25- 0.78). Although the seroprevalence of VL is relatively low in Qom Province, yet due to the importance of the disease, the surveillance system should be monitored by health authorities.

Serological Survey and Associated Risk Factors of Visceral Leish-maniasis in Qom Province, Central Iran

PubMed Central

RAKHSHANPOUR, Arash; MOHEBALI, Mehdi; AKHONDI, Behnaz; RAHIMI, Mohammad Taghi; ROKNI, Mohammad Bagher

2014-01-01

Abstract Background Visceral leishmaniasis (VL) or kala-azar is considered as a parasitic disease caused by the species of Leishmania donovani complex which is intracellular parasites. This systemic disease is endemic in some parts of provinc-es of Iran. The aim of this study was to determine the seroprevalence of VL in Qom Province, central Iran using di-rect agglutination test (DAT). Methods Overall, 1564 serum samples (800 males and 764 females) were collected from selected subjects by random-ized cluster sampling in 2011-2012. Sera were tested and analyzed by DAT. Before sampling; a questionnaire was filled out for each case. Data were analyzed using Chi-square test and multivariate logistic regression for risk factors analysis. Results Of 1564 individuals, 53 cases (3.38%) showed Leishmania specific antibodies as follows: with 1:400 titer 16 cases (1.02%), with 1:800 titer 20 cases (1.27%), with 1:1600 titer 16 cases (1.02%) whereas only one subject (0.06%) showed titers of ≥ 1:3200. There was no significant association between VL seropositivity and gender, age group and occupation. Binary logistic regression showed that rural areas was 0.44 times at higher risk of infection than urban areas (OR= 0.44; %95 CI= 0.25- 0.78). Conclusion Although the seroprevalence of VL is relatively low in Qom Province, yet due to the importance of the disease, the surveillance system should be monitored by health authorities. PMID:26060679

Design Authority in the Test Programme Definition: The Alenia Spazio Experience

NASA Astrophysics Data System (ADS)

Messidoro, P.; Sacchi, E.; Beruto, E.; Fleming, P.; Marucchi Chierro, P.-P.

2004-08-01

In addition, being the Verification and Test Programme a significant part of the spacecraft development life cycle in terms of cost and time, very often the subject of the mentioned discussion has the objective to optimize the verification campaign by possible deletion or limitation of some testing activities. The increased market pressure to reduce the project's schedule and cost is originating a dialecting process inside the project teams, involving program management and design authorities, in order to optimize the verification and testing programme. The paper introduces the Alenia Spazio experience in this context, coming from the real project life on different products and missions (science, TLC, EO, manned, transportation, military, commercial, recurrent and one-of-a-kind). Usually the applicable verification and testing standards (e.g. ECSS-E-10 part 2 "Verification" and ECSS-E-10 part 3 "Testing" [1]) are tailored to the specific project on the basis of its peculiar mission constraints. The Model Philosophy and the associated verification and test programme are defined following an iterative process which suitably combines several aspects (including for examples test requirements and facilities) as shown in Fig. 1 (from ECSS-E-10). The considered cases are mainly oriented to the thermal and mechanical verification, where the benefits of possible test programme optimizations are more significant. Considering the thermal qualification and acceptance testing (i.e. Thermal Balance and Thermal Vacuum) the lessons learned originated by the development of several satellites are presented together with the corresponding recommended approaches. In particular the cases are indicated in which a proper Thermal Balance Test is mandatory and others, in presence of more recurrent design, where a qualification by analysis could be envisaged. The importance of a proper Thermal Vacuum exposure for workmanship verification is also highlighted. Similar considerations are summarized for the mechanical testing with particular emphasis on the importance of Modal Survey, Static and Sine Vibration Tests in the qualification stage in combination with the effectiveness of Vibro-Acoustic Test in acceptance. The apparent relative importance of the Sine Vibration Test for workmanship verification in specific circumstances is also highlighted. Fig. 1. Model philosophy, Verification and Test Programme definition The verification of the project requirements is planned through a combination of suitable verification methods (in particular Analysis and Test) at the different verification levels (from System down to Equipment), in the proper verification stages (e.g. in Qualification and Acceptance).

Cluster of Leptospirosis Acquired Through River Surfing in Switzerland.

PubMed

Schreiber, Peter W; Aceto, Leonardo; Korach, Raphael; Marreros, Nelson; Ryser-Degiorgis, Marie-Pierre; Günthard, Huldrych F

2015-09-01

Background.  In Switzerland, leptospirosis is still considered as a travel-associated disease. After the surprising diagnosis of leptospirosis in a patient who was initially suspected as having primary human immunodeficiency virus infection, we recognized that acquisition of leptospirosis occurred through recreational activities and we identified additional affected individuals. Methods.  Detailed anamnesis, excluding occupational exposure, acquisition abroad, and pet contacts, enabled us to detect the source of infection and identify a cluster of leptospirosis. Convalescent sera testing was performed to confirm Leptospira infection. Microscopic agglutination tests were used to determine the infecting serovar. Results.  We identified a cluster of leptospirosis in young, previously healthy persons. Acquisition of leptospirosis was traced back to a surfing spot on a river in Switzerland (Reuss, Aargau). Clinical presentation was indistinct. Two of the 3 reported cases required hospitalization, and 1 case even suffered from meningitis. Serologic tests indicated infection with the serovar Grippotyphosa in all cases. With the exception of the case with meningitis, no antibiotics were administered, because leptospirosis was diagnosed after spontaneous resolution of most symptoms. Despite a prolonged period of convalescence in 2 cases, full recovery was achieved. Recent reports on beavers suffering from leptospirosis in this region underline the possible water-borne infection of the 3 cases and raise the question of potential wildlife reservoirs. Conclusions.  Insufficient awareness of caregivers, which may be promoted by the missing obligation to report human leptospirosis, combined with the multifaceted presentation of the disease result in significant underdiagnosis. More frequent consideration of leptospirosis as differential diagnosis is inevitable, particularly as veterinary data suggest re-emergence of the disease.

Molecular analysis of human T cell lymphotropic virus type 1 and 2 (HTLV-1/2) seroindeterminate blood donors from Northeast Iran: evidence of proviral tax, env, and gag sequences.

PubMed

Zanjani, Delaram Sayadpour; Shahabi, Majid; Talaei, Nasim; Afzalaghaee, Monavar; Tehranian, Farahnaz; Bazargani, Reihane

2011-02-01

Human T cell lymphotropic virus type 1 and 2 (HTLV-1/2) Western blot indeterminate results are a problem for blood banks in endemic areas. To determine the prevalence of HTLV-1/2 infection among indeterminate donors, we analyzed 130 cases from Mashhad, an HTLV-1/2 endemic area in Northeast Iran. The most frequent Western blot bands were GD21 alone (37.2%) followed by rgp46-2 alone (32.1%). We further tested 40 available DNA samples of these cases by PCR for viral sequences, tax, gag, and pol, and found five cases (12.5%) to be positive for two or three HTLV-1 genes. There were no significant age, sex, and blood group differences between PCR-positive and PCR-negative cases. Among PCR-positive individuals, the most prevalent Western blot bands were variable combinations of rgp46-1, GD21, and gp21. The mean of the optical density (OD) of the enzyme-linked immunosorbent assay (ELISA) test was significantly higher in PCR-positive individuals. The frequency of the rgp46-1 band was also significantly higher in PCR-positive cases compared to PCR-negative ones. In conclusion, the majority of HTLV-indeterminate donors lack the HTLV provirus and therefore are not considered infected. However, in some cases with higher ODs in the ELISA test and seroreactivity to env proteins, rgp46-1 and GD21 in particular may be indicative of infection and need further evaluation by molecular methods.

Cluster of Leptospirosis Acquired Through River Surfing in Switzerland

PubMed Central

Schreiber, Peter W.; Aceto, Leonardo; Korach, Raphael; Marreros, Nelson; Ryser-Degiorgis, Marie-Pierre; Günthard, Huldrych F.

2015-01-01

Background. In Switzerland, leptospirosis is still considered as a travel-associated disease. After the surprising diagnosis of leptospirosis in a patient who was initially suspected as having primary human immunodeficiency virus infection, we recognized that acquisition of leptospirosis occurred through recreational activities and we identified additional affected individuals. Methods. Detailed anamnesis, excluding occupational exposure, acquisition abroad, and pet contacts, enabled us to detect the source of infection and identify a cluster of leptospirosis. Convalescent sera testing was performed to confirm Leptospira infection. Microscopic agglutination tests were used to determine the infecting serovar. Results. We identified a cluster of leptospirosis in young, previously healthy persons. Acquisition of leptospirosis was traced back to a surfing spot on a river in Switzerland (Reuss, Aargau). Clinical presentation was indistinct. Two of the 3 reported cases required hospitalization, and 1 case even suffered from meningitis. Serologic tests indicated infection with the serovar Grippotyphosa in all cases. With the exception of the case with meningitis, no antibiotics were administered, because leptospirosis was diagnosed after spontaneous resolution of most symptoms. Despite a prolonged period of convalescence in 2 cases, full recovery was achieved. Recent reports on beavers suffering from leptospirosis in this region underline the possible water-borne infection of the 3 cases and raise the question of potential wildlife reservoirs. Conclusions. Insufficient awareness of caregivers, which may be promoted by the missing obligation to report human leptospirosis, combined with the multifaceted presentation of the disease result in significant underdiagnosis. More frequent consideration of leptospirosis as differential diagnosis is inevitable, particularly as veterinary data suggest re-emergence of the disease. PMID:26269796

Is very early hearing assessment always reliable in selecting patients for cochlear implants? A case series study.

PubMed

Bovo, R; Trevisi, P; Ghiselli, S; Benatti, A; Martini, A

2015-05-01

This study concerns a case series of 23 infants with a diagnosis of severe-to-profound hearing loss at 3 months old, who significantly improved (even reaching a normal auditory threshold) within their first year of life. All infants were routinely followed up with audiological tests every 2 months after being fitted with hearing aids as necessary. A reliable consistency between the various test findings (DPOAE, ABR, behavioral responses, CAEP and ECoG) clearly emerged in most cases during the follow-up, albeit at different times after birth. The series of infants included 7 cases of severe prematurity, 6 of cerebral or complex syndromic malformations, 5 healthy infants, 2 with asymptomatic congenital CMV infection, and 1 case each of hyperbilirubinemia, hypoxia, and sepsis. All term-born infants showed a significant improvement over their initial hearing threshold by 6 months of age, while in most of those born prematurely the first signs of threshold amelioration occurred beyond 70 weeks of gestational age, and even beyond 85 weeks in one case. Cochlear implantation (CI) should only be considered after a period of auditory stimulation and follow-up with electrophysiological and behavioral tests, and an accurate analysis of their correlation. In our opinion, CI can be performed after a period of 8 months in all term-born infants with persistent severe-to-profound hearing loss without risk of diagnostic error, whereas the follow-up for severely preterm infants should extend to at least 80 weeks of gestational age. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Case Series of Fatal Leptospira spp./Dengue Virus Co-Infections—Puerto Rico, 2010–2012

PubMed Central

Pérez Rodríguez, Nicole M.; Galloway, Renee; Blau, Dianna M.; Traxler, Rita; Bhatnagar, Julu; Zaki, Sherif R.; Rivera, Aidsa; Torres, Jose V.; Noyd, David; Santiago-Albizu, Xavier E.; García, Brenda Rivera; Tomashek, Kay M.; Bower, William A.; Sharp, Tyler M.

2014-01-01

Co-infection with pathogens that cause acute febrile illness creates a diagnostic challenge as a result of overlapping clinical manifestations. Here, we describe four fatal cases of Leptospira species/dengue virus co-infection in Puerto Rico. Although all patients sought care early, antibiotic administration was delayed for most. Steroids were administered to all patients, in most cases before antibiotics. These cases show the need for clinicians evaluating patients in or recently returned from the tropics with acute febrile illness to consider both dengue and leptospirosis. Furthermore, they illustrate the need for nucleic acid- or antigen-based rapid diagnostic tests to enable timely patient diagnosis and management. In particular, antibiotic therapy should be initiated early for patients with suspected leptospirosis, and steroids should not be administered to patients with suspected dengue. PMID:25092820

Reliability analysis and utilization of PEMs in space application

NASA Astrophysics Data System (ADS)

Jiang, Xiujie; Wang, Zhihua; Sun, Huixian; Chen, Xiaomin; Zhao, Tianlin; Yu, Guanghua; Zhou, Changyi

2009-11-01

More and more plastic encapsulated microcircuits (PEMs) are used in space missions to achieve high performance. Since PEMs are designed for use in terrestrial operating conditions, the successful usage of PEMs in space harsh environment is closely related to reliability issues, which should be considered firstly. However, there is no ready-made methodology for PEMs in space applications. This paper discusses the reliability for the usage of PEMs in space. This reliability analysis can be divided into five categories: radiation test, radiation hardness, screening test, reliability calculation and reliability assessment. One case study is also presented to illuminate the details of the process, in which a PEM part is used in a joint space program Double-Star Project between the European Space Agency (ESA) and China. The influence of environmental constrains including radiation, humidity, temperature and mechanics on the PEM part has been considered. Both Double-Star Project satellites are still running well in space now.

High-Speed Device-Independent Quantum Random Number Generation without a Detection Loophole.

PubMed

Liu, Yang; Yuan, Xiao; Li, Ming-Han; Zhang, Weijun; Zhao, Qi; Zhong, Jiaqiang; Cao, Yuan; Li, Yu-Huai; Chen, Luo-Kan; Li, Hao; Peng, Tianyi; Chen, Yu-Ao; Peng, Cheng-Zhi; Shi, Sheng-Cai; Wang, Zhen; You, Lixing; Ma, Xiongfeng; Fan, Jingyun; Zhang, Qiang; Pan, Jian-Wei

2018-01-05

Quantum mechanics provides the means of generating genuine randomness that is impossible with deterministic classical processes. Remarkably, the unpredictability of randomness can be certified in a manner that is independent of implementation devices. Here, we present an experimental study of device-independent quantum random number generation based on a detection-loophole-free Bell test with entangled photons. In the randomness analysis, without the independent identical distribution assumption, we consider the worst case scenario that the adversary launches the most powerful attacks against the quantum adversary. After considering statistical fluctuations and applying an 80  Gb×45.6  Mb Toeplitz matrix hashing, we achieve a final random bit rate of 114  bits/s, with a failure probability less than 10^{-5}. This marks a critical step towards realistic applications in cryptography and fundamental physics tests.

CO.sub.2 utilization in electrochemical systems

DOEpatents

Boxley, Chett; Akash, Akash; Zhao, Qiang

2013-01-22

A process for treating fly ash to render it highly usable as a concrete additive. A quantity of fly ash is obtained that contains carbon and which is considered unusable fly ash for concrete based upon foam index testing. The fly ash is mixed with a quantity of spray dryer ash (SDA) and water to initiate a geopolymerization reaction and form a geopolymerized fly ash. The geopolymerized fly ash is granulated. The geopolymerized fly ash is considered usable fly ash for concrete according to foam index testing. The geopolymerized fly ash may have a foam index less than 40%, and in some cases less than 20%, of the foam index of the untreated fly ash. An optional alkaline activator may be mixed with the fly ash and SDA to facilitate the geopolymerization reaction. The alkaline activator may contain an alkali metal hydroxide, carbonate, silicate, aluminate, or mixtures thereof.

Assessment of Hybrid High-Order methods on curved meshes and comparison with discontinuous Galerkin methods

NASA Astrophysics Data System (ADS)

Botti, Lorenzo; Di Pietro, Daniele A.

2018-10-01

We propose and validate a novel extension of Hybrid High-Order (HHO) methods to meshes featuring curved elements. HHO methods are based on discrete unknowns that are broken polynomials on the mesh and its skeleton. We propose here the use of physical frame polynomials over mesh elements and reference frame polynomials over mesh faces. With this choice, the degree of face unknowns must be suitably selected in order to recover on curved meshes the same convergence rates as on straight meshes. We provide an estimate of the optimal face polynomial degree depending on the element polynomial degree and on the so-called effective mapping order. The estimate is numerically validated through specifically crafted numerical tests. All test cases are conducted considering two- and three-dimensional pure diffusion problems, and include comparisons with discontinuous Galerkin discretizations. The extension to agglomerated meshes with curved boundaries is also considered.

Experimental test of nonlocal causality

PubMed Central

Ringbauer, Martin; Giarmatzi, Christina; Chaves, Rafael; Costa, Fabio; White, Andrew G.; Fedrizzi, Alessandro

2016-01-01

Explaining observations in terms of causes and effects is central to empirical science. However, correlations between entangled quantum particles seem to defy such an explanation. This implies that some of the fundamental assumptions of causal explanations have to give way. We consider a relaxation of one of these assumptions, Bell’s local causality, by allowing outcome dependence: a direct causal influence between the outcomes of measurements of remote parties. We use interventional data from a photonic experiment to bound the strength of this causal influence in a two-party Bell scenario, and observational data from a Bell-type inequality test for the considered models. Our results demonstrate the incompatibility of quantum mechanics with a broad class of nonlocal causal models, which includes Bell-local models as a special case. Recovering a classical causal picture of quantum correlations thus requires an even more radical modification of our classical notion of cause and effect. PMID:27532045

Treatment of fly ash for use in concrete

DOEpatents

Boxley, Chett [Park City, UT

2012-05-15

A process for treating fly ash to render it highly usable as a concrete additive. A quantity of fly ash is obtained that contains carbon and which is considered unusable fly ash for concrete based upon foam index testing. The fly ash is mixed with a quantity of spray dryer ash (SDA) and water to initiate a geopolymerization reaction and form a geopolymerized fly ash. The geopolymerized fly ash is granulated. The geopolymerized fly ash is considered usable fly ash for concrete according to foam index testing. The geopolymerized fly ash may have a foam index less than 40%, and in some cases less than 20%, of the foam index of the untreated fly ash. An optional alkaline activator may be mixed with the fly ash and SDA to facilitate the geopolymerization reaction. The alkaline activator may contain an alkali metal hydroxide, carbonate, silicate, aluminate, or mixtures thereof.

Experimental test of nonlocal causality.

PubMed

Ringbauer, Martin; Giarmatzi, Christina; Chaves, Rafael; Costa, Fabio; White, Andrew G; Fedrizzi, Alessandro

2016-08-01

Explaining observations in terms of causes and effects is central to empirical science. However, correlations between entangled quantum particles seem to defy such an explanation. This implies that some of the fundamental assumptions of causal explanations have to give way. We consider a relaxation of one of these assumptions, Bell's local causality, by allowing outcome dependence: a direct causal influence between the outcomes of measurements of remote parties. We use interventional data from a photonic experiment to bound the strength of this causal influence in a two-party Bell scenario, and observational data from a Bell-type inequality test for the considered models. Our results demonstrate the incompatibility of quantum mechanics with a broad class of nonlocal causal models, which includes Bell-local models as a special case. Recovering a classical causal picture of quantum correlations thus requires an even more radical modification of our classical notion of cause and effect.

Periastron shift for a spinning test particle around naked singularities

NASA Astrophysics Data System (ADS)

Mukherjee, Sajal

2018-06-01

In the present article, we investigate the Periastron precession for a spinning test particle moving in nearly circular orbits around naked singularities. We consider two well-known solutions that can produce a spacetime with naked singularity—(a) first, the Reissner-Nordström metric, which is a static charged solution with spherical symmetry, and (b) second, the stationary, axisymmetric Kerr metric. For simplicity, we only consider the motion confined on the equatorial plane in both these cases and solve exactly the Mathisson-Papapetrou equations. In addition, we analytically compute the Periastron precession within the framework of linear spin approximation. The inclusion of the spin parameter modifies the results with nonspinning particles and also reflects some interesting properties of the naked geometries. Furthermore, we carried out a numerical approach without any assumptions to probe the large order spin values. The implication of the spin-curvature coupling in connection with the naked geometries is also discussed.

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

Khalili, Farid; Danilishin, Stefan; Mueller-Ebhardt, Helge

We consider enhancing the sensitivity of future gravitational-wave detectors by using double optical spring. When the power, detuning and bandwidth of the two carriers are chosen appropriately, the effect of the double optical spring can be described as a 'negative inertia', which cancels the positive inertia of the test masses and thus increases their response to gravitational waves. This allows us to surpass the free-mass standard quantum limit (SQL) over a broad frequency band, through signal amplification, rather than noise cancellation, which has been the case for all broadband SQL-beating schemes so far considered for gravitational-wave detectors. The merit ofmore » such signal amplification schemes lies in the fact that they are less susceptible to optical losses than noise-cancellation schemes. We show that it is feasible to demonstrate such an effect with the Gingin High Optical Power Test Facility, and it can eventually be implemented in future advanced GW detectors.« less

Nickel and cobalt release from children's toys purchased in Denmark and the United States.

PubMed

Jensen, Peter; Hamann, Dathan; Hamann, Carsten R; Jellesen, Morten S; Jacob, Sharon E; Thyssen, Jacob P

2014-01-01

Nickel is the most common allergen detected by patch testing in children. There is an increasing number of cases in children who have not had exposure to piercing. Although the clinical relevance of nickel patch test reactions in children is sometimes uncertain, continued vigilance to identify new sources of nickel exposure in this age group is important. Recent case reports have described allergic nickel contact dermatitis in children following exposure to toys, but the magnitude of this problem is unknown. The aim of this study was to evaluate nickel and cobalt release from children's toys. We purchased 212 toys in 18 different retail and online stores in the United States and Denmark. Nickel and cobalt release was tested using the dimethylglyoxime and cobalt screening spot tests. A total of 73 toys (34.4%) released nickel, and none released cobalt. Toys are a commonly overlooked source of nickel exposure and sensitization. Therefore, dermatologists, allergists, and pediatricians should consider the role of toys in their evaluation of children with dermatitis, and the parents of children with positive nickel patch test reactions should be told that toys may release nickel and be a potential chemical source in the manifestation of allergic contact dermatitis.

High pressure combustion of liquid fuels. [alcohol and n-paraffin fuels

NASA Technical Reports Server (NTRS)

Canada, G. S.

1974-01-01

Measurements were made of the burning rates and liquid surface temperatures for a number of alcohol and n-paraffin fuels under natural and forced convection conditions. Porous spheres ranging in size from 0.64-1.9 cm O.D. were emloyed to simulate the fuel droplets. The natural convection cold gas tests considered the combustion in air of methanol, ethanol, propanol-1, n-pentane, n-heptane, and n-decane droplets at pressures up to 78 atmospheres. The pressure levels of the natural convection tests were high enough so that near critical combustion was observed for methanol and ethanol vaporization rates and liquid surface temperature measurements were made of droplets burning in a simulated combustion chamber environment. Ambient oxygen molar concentrations included 13%, 9.5% and pure evaporation. Fuels used in the forced convection atmospheric tests included those listed above for the natural convection tests. The ambient gas temperature ranged from 600 to 1500 K and the Reynolds number varied from 30 to 300. The high pressure forced convection tests employed ethanol and n-heptane as fuels over a pressure range of one to 40 atmospheres. The ambient gas temperature was 1145 K for the two combustion cases and 1255 K for the evaporation case.

A moist aquaplanet variant of the Held–Suarez test for atmospheric model dynamical cores

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

Thatcher, Diana R.; Jablonowski, Christiane

A moist idealized test case (MITC) for atmospheric model dynamical cores is presented. The MITC is based on the Held–Suarez (HS) test that was developed for dry simulations on “a flat Earth” and replaces the full physical parameterization package with a Newtonian temperature relaxation and Rayleigh damping of the low-level winds. This new variant of the HS test includes moisture and thereby sheds light on the nonlinear dynamics–physics moisture feedbacks without the complexity of full-physics parameterization packages. In particular, it adds simplified moist processes to the HS forcing to model large-scale condensation, boundary-layer mixing, and the exchange of latent and sensible heat betweenmore » the atmospheric surface and an ocean-covered planet. Using a variety of dynamical cores of the National Center for Atmospheric Research (NCAR)'s Community Atmosphere Model (CAM), this paper demonstrates that the inclusion of the moist idealized physics package leads to climatic states that closely resemble aquaplanet simulations with complex physical parameterizations. This establishes that the MITC approach generates reasonable atmospheric circulations and can be used for a broad range of scientific investigations. This paper provides examples of two application areas. First, the test case reveals the characteristics of the physics–dynamics coupling technique and reproduces coupling issues seen in full-physics simulations. In particular, it is shown that sudden adjustments of the prognostic fields due to moist physics tendencies can trigger undesirable large-scale gravity waves, which can be remedied by a more gradual application of the physical forcing. Second, the moist idealized test case can be used to intercompare dynamical cores. These examples demonstrate the versatility of the MITC approach and suggestions are made for further application areas. Furthermore, the new moist variant of the HS test can be considered a test case of intermediate complexity.« less

A moist aquaplanet variant of the Held–Suarez test for atmospheric model dynamical cores

DOE PAGES

Thatcher, Diana R.; Jablonowski, Christiane

2016-04-04

A moist idealized test case (MITC) for atmospheric model dynamical cores is presented. The MITC is based on the Held–Suarez (HS) test that was developed for dry simulations on “a flat Earth” and replaces the full physical parameterization package with a Newtonian temperature relaxation and Rayleigh damping of the low-level winds. This new variant of the HS test includes moisture and thereby sheds light on the nonlinear dynamics–physics moisture feedbacks without the complexity of full-physics parameterization packages. In particular, it adds simplified moist processes to the HS forcing to model large-scale condensation, boundary-layer mixing, and the exchange of latent and sensible heat betweenmore » the atmospheric surface and an ocean-covered planet. Using a variety of dynamical cores of the National Center for Atmospheric Research (NCAR)'s Community Atmosphere Model (CAM), this paper demonstrates that the inclusion of the moist idealized physics package leads to climatic states that closely resemble aquaplanet simulations with complex physical parameterizations. This establishes that the MITC approach generates reasonable atmospheric circulations and can be used for a broad range of scientific investigations. This paper provides examples of two application areas. First, the test case reveals the characteristics of the physics–dynamics coupling technique and reproduces coupling issues seen in full-physics simulations. In particular, it is shown that sudden adjustments of the prognostic fields due to moist physics tendencies can trigger undesirable large-scale gravity waves, which can be remedied by a more gradual application of the physical forcing. Second, the moist idealized test case can be used to intercompare dynamical cores. These examples demonstrate the versatility of the MITC approach and suggestions are made for further application areas. Furthermore, the new moist variant of the HS test can be considered a test case of intermediate complexity.« less

The case against compulsory casefinding in controlling AIDS--testing, screening and reporting.

PubMed

Gostin, L O; Curran, W J; Clark, M E

1987-01-01

The spread of acquired immune deficiency syndrome (AIDS) demands a comprehensive and effective public health response. Because no treatment or vaccine is currently available, traditional infection control measures are being considered. Proposals include compulsory testing and screening of selected high risk populations. The fairness and accuracy of compulsory screening programs depend upon the reliability of medical technology and the balancing of public health and individual confidentiality interests. This Article proposes criteria for evaluating compulsory testing and screening programs. It concludes that voluntary identification, education, and counselling of infected persons is the most effective means of encouraging the behavioral changes that are necessary to halt the spread of AIDS.

Immunohistochemistry for PMS2 and MSH6 alone can replace a four antibody panel for mismatch repair deficiency screening in colorectal adenocarcinoma.

PubMed

Hall, Geoffrey; Clarkson, Adele; Shi, Amanda; Langford, Eileen; Leung, Helen; Eckstein, Robert P; Gill, Anthony J

2010-01-01

Currently, testing for mismatch repair deficiency in colorectal cancers is initiated by performing immunohistochemistry with four antibodies (MLH1, PMS2, MSH2 and MSH6). If any one of these stains is negative the tumour is considered microsatellite unstable and, if clinical circumstances warrant it, the patient is offered genetic testing for Lynch's syndrome. Due to the binding properties of the mismatch repair heterodimer complexes, gene mutation and loss of MLH1 and MSH2 invariably result in the degradation of PMS2 and MSH6, respectively, but the converse is not true. We propose that staining for PMS2 and MSH6 alone will be sufficient to detect all cases of mismatch repair deficiency and should replace routine screening with all four antibodies. The electronic database of the department of Anatomical Pathology, Royal North Shore Hospital, Sydney, Australia, was searched for all colorectal carcinomas on which a four panel immunohistochemical microsatellite instability screen was performed. An audit of the slides for concordant loss of MLH1-PMS2 and MSH2-MSH6 was then undertaken. Unusual or discordant cases were reviewed and, in some cases, re-stained to confirm the staining pattern. Of 344 cases of colorectal cancer which underwent four antibody immunohistochemistry, 104 displayed loss of at least one mismatch repair protein. Of these, 100 showed concordant mismatch repair loss (i.e., loss of MLH1 and PMS2 or loss of MSH2 and MSH6). The four discordant cases comprised two single negative cases (1 MSH6 negative/MSH2 positive case, 1 PMS2 negative/MLH1 positive) and two triple negative (both MLH1/PMS2/MSH6 negative). The microsatellite instability (MSI) group showed a relatively high median age (69.3 years) due to the departmental policy of testing all cases with possible MSI morphology regardless of age. The sensitivity and specificity of a two panel test comprised of PMS2 and MSH6, compared to a four panel test, is 100%. No false negatives or positives were identified. We conclude that the two panel test should replace a four panel protocol for immunohistochemical screening for mismatch repair deficiency.

Demonstration of risk based, goal driven framework for hydrological field campaigns and inverse modeling with case studies

NASA Astrophysics Data System (ADS)

Harken, B.; Geiges, A.; Rubin, Y.

2013-12-01

There are several stages in any hydrological modeling campaign, including: formulation and analysis of a priori information, data acquisition through field campaigns, inverse modeling, and forward modeling and prediction of some environmental performance metric (EPM). The EPM being predicted could be, for example, contaminant concentration, plume travel time, or aquifer recharge rate. These predictions often have significant bearing on some decision that must be made. Examples include: how to allocate limited remediation resources between multiple contaminated groundwater sites, where to place a waste repository site, and what extraction rates can be considered sustainable in an aquifer. Providing an answer to these questions depends on predictions of EPMs using forward models as well as levels of uncertainty related to these predictions. Uncertainty in model parameters, such as hydraulic conductivity, leads to uncertainty in EPM predictions. Often, field campaigns and inverse modeling efforts are planned and undertaken with reduction of parametric uncertainty as the objective. The tool of hypothesis testing allows this to be taken one step further by considering uncertainty reduction in the ultimate prediction of the EPM as the objective and gives a rational basis for weighing costs and benefits at each stage. When using the tool of statistical hypothesis testing, the EPM is cast into a binary outcome. This is formulated as null and alternative hypotheses, which can be accepted and rejected with statistical formality. When accounting for all sources of uncertainty at each stage, the level of significance of this test provides a rational basis for planning, optimization, and evaluation of the entire campaign. Case-specific information, such as consequences prediction error and site-specific costs can be used in establishing selection criteria based on what level of risk is deemed acceptable. This framework is demonstrated and discussed using various synthetic case studies. The case studies involve contaminated aquifers where a decision must be made based on prediction of when a contaminant will arrive at a given location. The EPM, in this case contaminant travel time, is cast into the hypothesis testing framework. The null hypothesis states that the contaminant plume will arrive at the specified location before a critical value of time passes, and the alternative hypothesis states that the plume will arrive after the critical time passes. Different field campaigns are analyzed based on effectiveness in reducing the probability of selecting the wrong hypothesis, which in this case corresponds to reducing uncertainty in the prediction of plume arrival time. To examine the role of inverse modeling in this framework, case studies involving both Maximum Likelihood parameter estimation and Bayesian inversion are used.

Composite monocoque frame for a mountain bicycle: Testing and calculation

NASA Astrophysics Data System (ADS)

Castejón, L.; Miravete, A.; Ullod, J.; Larrodé, E.

1994-05-01

The present paper shows the way in which a monocoque frame of a mountain bicycle made of carbon fiber and kevlar laminate, a poliurethane foam core and different metallic stiffeners were analyzed. The study was performed in two parts, namely, a first part in which the bicycle was tested considering several static and dynamic cases and a second part carried out by using the F.E.M., from which vibration frequencies and modes were obtained, as well as the foam optimization to be used in the core. It was also possible to compare the results obtained in both parts.

Fatigue crack growth under variable amplitude loading

NASA Astrophysics Data System (ADS)

Sidawi, Jihad A.

1994-09-01

Fatigue crack growth tests were conducted on an Fe 510 E C-Mn steel and a submerged arc welded joint from the same material under constant, variable, and random loading amplitudes. Paris-Erdogan's crack growth rate law was tested for the evaluation of m and C using the stress intensity factor K, the J-integral, the effective stress intensity factor K(sub eff), and the root mean square stress intensity factor K(sub rms) fracture mechanics concepts. The effect of retardation and residual stresses resulting from welding was also considered. It was found that all concepts gave good life predictions in all cases.

(Full field) optical coherence tomography and applications

NASA Astrophysics Data System (ADS)

Buchroithner, Boris; Hannesschläger, Günther; Leiss-Holzinger, Elisabeth; Prylepa, Andrii; Heise, Bettina

2018-03-01

This paper illustrates specific features and use of optical coherence tomography (OCT) in the raster-scanning and in comparison in the full field version of this imaging technique. Cases for nondestructive testing are discussed alongside other application schemes. In particular monitoring time-dependent processes and probing of birefringent specimens are considered here. In the context of polymer testing birefringence mapping may often provide information about internal strain and stress states. Recent results obtained with conventional raster-scanning OCT systems, with (dual and single-shot) full field OCT configurations, and with polarization-sensitive versions of (full field) OCT are presented here.

Recommendations for publishing case studies of cell transplantation for spinal cord injury.

PubMed

Dobkin, Bruce H

2010-10-01

Cellular transplantation for subacute and chronic spinal cord injury (SCI) continues to proceed around the world, but clinicians and patients have only 10 English language publications of case reports and self-serving Web page anecdotes to guide them. Recent publications about the use of olfactory ensheathing, bone marrow stromal, and fetal tissue stem cells in human subjects are examined to assess the adequacy of their designs, conclusions, and interpretation. Case series reports to date reveal adverse responses to cellular therapy when clinicians look for these and no clear functional effects when a matched group that is not treated is compared. Rehabilitation that focuses on potential targets for sensorimotor and functional gains must precede a transplantation until a plateau of change is reached and then continue for at least 6 months if not a year. Criteria are listed as the minimum requirements for any further case series reports to be considered by journals in regard to cellular interventions for SCI. Based on available reports, the published interventions should not be given to additional patients. One or two of the strategies can be considered for testing in a randomized trial with blinded assessors and an independent data monitoring committee to examine for biological activity in patients with motor complete SCI of greater than 4 to 6 months duration.

Antinuclear Antibodies predict a higher number of Pregnancy Loss in Unexplained Recurrent Pregnancy Loss.

PubMed

Sakthiswary, R; Rajalingam, S; Norazman, M R; Hussein, H

The etiology of recurrent pregnancy loss (RPL) is unknown in a significant proportion of patients. Autoimmune processes have been implicated in the pathogenesis. The role of antinuclear antibody (ANA) in this context is largely undetermined. In an attempt to address the lack of evidence in this area, we explored the clinical significance of antinuclear antibody (ANA) in unexplained RPL. We studied 68 patients with RPL and 60 healthy controls from September 2005 to May 2012. All subjects were tested for ANA by immunofluorescence testing, and a titer of 1: 80 and above was considered positive. We compared the pregnancy outcome between the ANA positive and ANA negative RPL cases. The incidence of ANA positivity among the cases (35.3%) was significantly higher than the controls (13.3%) (p=0.005). ANA positive cases showed significantly higher number of RPL (p=0.006) and lower number of successful pregnancies (p=0.013) compared to the ANA negative cases . The ANA titre had a significant association with the number of RPL (p<0.05, r=0.724) but not with the number of successful pregnancies (p=0.054). ANA positivity predicts a less favorable pregnancy outcome in RPL. Our findings suggest that the ANA titre is a useful positive predictor of the number of RPL. Hence, ANA test is a potential prognostic tool for this condition which merits further research.

Anthrax in a backyard domestic dog in Ukraine: a case report.

PubMed

Blackburn, Jason K; Skrypnyk, Artem; Bagamian, Karoun H; Nikolich, Mikeljon P; Bezymennyi, Maksym; Skrypnyk, Valeriy

2014-08-01

Anthrax has been reported in domestic and wild dogs throughout much of the world. Generally, canids are considered resistant to anthrax, although there are several reports of anthrax deaths in both wild and domestic canid populations. Prior to 2012, anthrax had not been reported in dogs in Ukraine, despite a long history in livestock and wildlife. An outbreak involving at least one cow and one dog was reported from a backyard setting in southern Ukraine in August of 2012. Laboratory results and epizootic data were compiled from official investigation reports of regional and state veterinary services involved in the case response. A single dog died after being fed meat and bones from an illegally slaughtered heifer that died of anthrax 5 days earlier. On the evening of the dog's death, the dog refused food or water; however, there were no other clinical signs. Laboratory tests of dog tissue included traditional bacteriology for Bacillus anthracis, a small rodent bioassay for virulence, and immunoprecipitation tests (IPT). IPT was positive, viable B. anthracis colonies were cultured, and a bioassay confirmed virulence. This was the first confirmed case of canid anthrax in Ukraine. This case report serves to remind veterinary officials that anthrax can affect a wide number of species. We advise surveillance systems remain flexible and include animals that might not otherwise be tested.

Correlation of spacecraft thermal mathematical models to reference data

NASA Astrophysics Data System (ADS)

Torralbo, Ignacio; Perez-Grande, Isabel; Sanz-Andres, Angel; Piqueras, Javier

2018-03-01

Model-to-test correlation is a frequent problem in spacecraft-thermal control design. The idea is to determine the values of the parameters of the thermal mathematical model (TMM) that allows reaching a good fit between the TMM results and test data, in order to reduce the uncertainty of the mathematical model. Quite often, this task is performed manually, mainly because a good engineering knowledge and experience is needed to reach a successful compromise, but the use of a mathematical tool could facilitate this work. The correlation process can be considered as the minimization of the error of the model results with regard to the reference data. In this paper, a simple method is presented suitable to solve the TMM-to-test correlation problem, using Jacobian matrix formulation and Moore-Penrose pseudo-inverse, generalized to include several load cases. Aside, in simple cases, this method also allows for analytical solutions to be obtained, which helps to analyze some problems that appear when the Jacobian matrix is singular. To show the implementation of the method, two problems have been considered, one more academic, and the other one the TMM of an electronic box of PHI instrument of ESA Solar Orbiter mission, to be flown in 2019. The use of singular value decomposition of the Jacobian matrix to analyze and reduce these models is also shown. The error in parameter space is used to assess the quality of the correlation results in both models.

Assessment of urban pluvial flood risk and efficiency of adaptation options through simulations - A new generation of urban planning tools

NASA Astrophysics Data System (ADS)

Löwe, Roland; Urich, Christian; Sto. Domingo, Nina; Mark, Ole; Deletic, Ana; Arnbjerg-Nielsen, Karsten

2017-07-01

We present a new framework for flexible testing of flood risk adaptation strategies in a variety of urban development and climate scenarios. This framework couples the 1D-2D hydrodynamic simulation package MIKE FLOOD with the agent-based urban development model DAnCE4Water and provides the possibility to systematically test various flood risk adaptation measures ranging from large infrastructure changes over decentralised water management to urban planning policies. We have tested the framework in a case study in Melbourne, Australia considering 9 scenarios for urban development and climate and 32 potential combinations of flood adaptation measures. We found that the performance of adaptation measures strongly depended on the considered climate and urban development scenario and the other implementation measures implemented, suggesting that adaptive strategies are preferable over one-off investments. Urban planning policies proved to be an efficient means for the reduction of flood risk, while implementing property buyback and pipe increases in a guideline-oriented manner was too costly. Random variations in location and time point of urban development could have significant impact on flood risk and would in some cases outweigh the benefits of less efficient adaptation strategies. The results of our setup can serve as an input for robust decision making frameworks and thus support the identification of flood risk adaptation measures that are economically efficient and robust to variations of climate and urban layout.

Binary Hypothesis Testing With Byzantine Sensors: Fundamental Tradeoff Between Security and Efficiency

NASA Astrophysics Data System (ADS)

Ren, Xiaoqiang; Yan, Jiaqi; Mo, Yilin

2018-03-01

This paper studies binary hypothesis testing based on measurements from a set of sensors, a subset of which can be compromised by an attacker. The measurements from a compromised sensor can be manipulated arbitrarily by the adversary. The asymptotic exponential rate, with which the probability of error goes to zero, is adopted to indicate the detection performance of a detector. In practice, we expect the attack on sensors to be sporadic, and therefore the system may operate with all the sensors being benign for extended period of time. This motivates us to consider the trade-off between the detection performance of a detector, i.e., the probability of error, when the attacker is absent (defined as efficiency) and the worst-case detection performance when the attacker is present (defined as security). We first provide the fundamental limits of this trade-off, and then propose a detection strategy that achieves these limits. We then consider a special case, where there is no trade-off between security and efficiency. In other words, our detection strategy can achieve the maximal efficiency and the maximal security simultaneously. Two extensions of the secure hypothesis testing problem are also studied and fundamental limits and achievability results are provided: 1) a subset of sensors, namely "secure" sensors, are assumed to be equipped with better security countermeasures and hence are guaranteed to be benign, 2) detection performance with unknown number of compromised sensors. Numerical examples are given to illustrate the main results.

Effect of Periodontal Disease on Preeclampsia

PubMed Central

Sayar, F; Hoseini, M Sadat; Abbaspour, S

2011-01-01

Background: A lot of studies have shown periodontal diseases as a risk factor for adverse pregnancy outcomes. The association between periodontitis and preeclampsia has been studied recently with controversy. Considering the importance of preventing preeclampsia as a dangerous and life-threatening disease in pregnant women, the present study was carried out. Methods: Two hundred and ten pregnant women participated in this case-control study (105 controls & 105 cases) during years 2007 and 2008. Preeclamptic cases were defined as blood pressure ≥140/90mmHg and proteinuria +1. Control group were pregnant women with normal blood pressure without proteinuria. Both groups were examined during 48 hours after child delivery. Plaque Index (PLI), Pocket Depth (PD), Clinical Attachment Level (CAL), Bleeding On Probing (BOP), Gingival Recession (GR) were measured on all teeth except for third molars and recorded as periodontal examination. Data was analyzed using t-test, chi-square, and Mann-Whitney U statistical tests. Results: There was no significant difference between the two study groups for PD. CAL, GR, BOP significantly increased in the case group (P< 0.02). This study showed that preeclamptic cases were more likely to develop periodontal disease (P< 0.0001). Eighty three percent of the control group and 95% of the case group had periodontal disease (P< 0.005) which had shown that preeclamptic cases were 4.1 times more likely to have periodontal disease (OR= 4.1). Conclusion: Preeclamptic cases significantly had higher attachment loss and gingival recession than the control group. PMID:23113094

Bartter syndrome type 3 in an elderly complicated with adrenocorticotropin-deficiency.

PubMed

Tamagawa, Eri; Inaba, Hidefumi; Ota, Takayuki; Ariyasu, Hiroyuki; Kawashima, Hiromichi; Wakasaki, Hisao; Furuta, Hiroto; Nishi, Masahiro; Nakao, Taisei; Kaito, Hiroshi; Iijima, Kazumoto; Nakanishi, Koichi; Yoshikawa, Norishige; Akamizu, Takashi

2014-01-01

Bartter syndrome (BS) is a disorder with normotensive hypokalemic alkalosis and hyperreninemic hyperaldosteronemia. BS affects infants or early childhood. Patients with BS type 3 harbor mutation in CLCNKB, Cl channel Kb. Gitelman syndrome (GS) is a disorder in childhood, with mutation in SLC12A3. Isolated adrenocorticotropin deficiency (IAD) causes secondary adrenal insufficiency. Neither elderly cases, nor cases with IAD were previously reported in BS. A 72-year-old man was admitted with acute adrenal crisis. He had been treated for IAD for 19 years. He had no trouble during perinatal period, delivery, and growth. After the recovery from adrenal crisis, laboratory tests revealed hypokalemia; 3.0 mEq/L (normal: 3.5-4.5), impaired renal function: eGFR; 37.6 mL/min/1.73 m2, normomagnesemia; 2.1 mg/dL (1.7-2.3), hyperreninemia; 59.4 ng/mL/h (0.2-2.7), hyperaldosteronemia; 23.5 ng/dL (3.0-15.9), and normal urinary ratio of calcium/creatinine. In diuretic tests, he showed a fine response to furosemide, and a mild response to thiazide. In genetic tests, no mutation of SLC12A3 was found and homozygous mutation: c.1830 G > A in CLCNKB was shown. Thus he was diagnosed as BS type 3. Current case presented with unusual features as BS type 3, 1) his late and mild clinical manifestation suggested GS rather than BS, 2) laboratory data and diuretics tests did not show typical features as BS, and 3) IAD and chronic renal failure altered electrolyte metabolism. In conclusion, current case implies that BS type 3 should be considered even in elderly cases with normotensive hypokalemia, and highlights importance of endocrinological and genetic examinations.

Subjective vs. Documented Reality: A Case Study of Long-Term Real-Life Autobiographical Memory

ERIC Educational Resources Information Center

Mendelsohn, Avi; Furman, Orit; Navon, Inbal; Dudai, Yadin

2009-01-01

A young woman was filmed during 2 d of her ordinary life. A few months and then again a few years later she was tested for the memory of her experiences in those days while undergoing fMRI scanning. As time passed, she came to accept more false details as true. After months, activity of a network considered to subserve autobiographical memory was…

WENO schemes on arbitrary mixed-element unstructured meshes in three space dimensions

NASA Astrophysics Data System (ADS)

Tsoutsanis, P.; Titarev, V. A.; Drikakis, D.

2011-02-01

The paper extends weighted essentially non-oscillatory (WENO) methods to three dimensional mixed-element unstructured meshes, comprising tetrahedral, hexahedral, prismatic and pyramidal elements. Numerical results illustrate the convergence rates and non-oscillatory properties of the schemes for various smooth and discontinuous solutions test cases and the compressible Euler equations on various types of grids. Schemes of up to fifth order of spatial accuracy are considered.

A CLOUDY/XSPEC Interface

NASA Technical Reports Server (NTRS)

Porter, R. L.; Ferland, G. J.; Kraemer, S. B.; Armentrout, B. K.; Arnaud, K. A.; Turner, T. J.

2007-01-01

We discuss new functionality of the spectral simulation code CLOUDY which allows the user to calculate grids with one or more initial parameters varied and formats the predicted spectra in the standard FITS format. These files can then be imported into the x-ray spectral analysis software XSPEC and used as theoretical models for observations. We present and verify a test case. Finally, we consider a few observations and discuss our results.

Tail Buffeting

NASA Technical Reports Server (NTRS)

Abdrashitov, G.

1943-01-01

An approximate theory of buffeting is here presented, based on the assumption of harmonic disturbing forces. Two cases of buffeting are considered: namely, for a tail angle of attack greater and less than the stalling angle, respectively. On the basis of the tests conducted and the results of foreign investigators, a general analysis is given of the nature of the forced vibrations the possible load limits on the tail, and the methods of elimination of buffeting.

Uncertainty quantification for evaluating the impacts of fracture zone on pressure build-up and ground surface uplift during geological CO₂ sequestration

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

Bao, Jie; Hou, Zhangshuan; Fang, Yilin

2015-06-01

A series of numerical test cases reflecting broad and realistic ranges of geological formation and preexisting fault properties was developed to systematically evaluate the impacts of preexisting faults on pressure buildup and ground surface uplift during CO₂ injection. Numerical test cases were conducted using a coupled hydro-geomechanical simulator, eSTOMP (extreme-scale Subsurface Transport over Multiple Phases). For efficient sensitivity analysis and reliable construction of a reduced-order model, a quasi-Monte Carlo sampling method was applied to effectively sample a high-dimensional input parameter space to explore uncertainties associated with hydrologic, geologic, and geomechanical properties. The uncertainty quantification results show that the impacts onmore » geomechanical response from the pre-existing faults mainly depend on reservoir and fault permeability. When the fault permeability is two to three orders of magnitude smaller than the reservoir permeability, the fault can be considered as an impermeable block that resists fluid transport in the reservoir, which causes pressure increase near the fault. When the fault permeability is close to the reservoir permeability, or higher than 10⁻¹⁵ m² in this study, the fault can be considered as a conduit that penetrates the caprock, connecting the fluid flow between the reservoir and the upper rock.« less

Rectal Cancer Diagnosed after Cesarean Section in Which High Microsatellite Instability Indicated the Presence of Lynch Syndrome

PubMed Central

Okuda, Tomohiro; Ishii, Hiroshi; Yamashita, Sadao; Matsuo, Seiki; Okimura, Hiroyuki

2015-01-01

We report a case of rectal cancer with microsatellite instability (MSI) that probably resulted from Lynch syndrome and that was diagnosed after Cesarean section. The patient was a 28-year-old woman (gravid 1, para 1) without a significant medical history. At 35 gestational weeks, vaginal ultrasonography revealed a 5 cm tumor behind the uterine cervix, which was diagnosed as a uterine myoma. The tumor gradually increased in size and blocked the birth canal, resulting in the patient undergoing an emergency Cesarean section. Postoperatively, the tumor was diagnosed as rectal cancer with MSI. After concurrent chemoradiation therapy, a lower anterior resection was performed. The patient's family history revealed she met the criteria of the revised Bethesda guidelines for testing the colorectal tumor for MSI. Testing revealed that the tumor did indeed show high MSI and, combined with the family history, suggested this could be a case of Lynch syndrome. Our findings emphasize the importance of considering the possibility of Lynch syndrome in pregnant women with colorectal cancer, particularly those with a family history of this condition. We suggest that the presence of Lynch syndrome should also be considered for any young woman with endometrial, ovarian, or colorectal cancer. PMID:26064726

International travelers with infectious diseases determined by pathology results, Centers for Disease Control and Prevention - United States, 1995-2015.

PubMed

Angelo, Kristina M; Barbre, Kira; Shieh, Wun-Ju; Kozarsky, Phyllis E; Blau, Dianna M; Sotir, Mark J; Zaki, Sherif R

2017-09-01

The failure to consider travel-related diagnoses, the lack of diagnostic capacity for specialized laboratory testing, and the declining number of autopsies may affect the diagnosis and management of travel-related infections. Pre- and post-mortem pathology can help determine causes of illness and death in international travelers. We conducted a retrospective review of biopsy and autopsy specimens sent to the Infectious Diseases Pathology Branch laboratory (IDPBL) at the Centers for Disease Control and Prevention (CDC) for diagnostic testing from 1995 through 2015. Cases were included if the specimen submitted for diagnosis was from a traveler with prior international travel during the disease incubation period and the cause of illness or death was unknown at the time of specimen submission. Twenty-one travelers, six (29%) with biopsy specimens and 15 (71%) with autopsy specimens, met the inclusion criteria. Among the 15 travelers who underwent autopsies, the most common diagnoses were protozoal infections (7 travelers; 47%), including five malaria cases, followed by viral infections (6 travelers; 40%). Biopsy or autopsy specimens can assist in diagnosing infectious diseases in travelers, especially from pathogens not endemic in the U.S. CDC's IDPBL provides a useful resource for clinicians considering infectious diseases in returned travelers. Published by Elsevier Ltd.

Squeezing the halo bispectrum: a test of bias models

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

Dizgah, Azadeh Moradinezhad; Chan, Kwan Chuen; Noreña, Jorge

We study the halo-matter cross bispectrum in the presence of primordial non-Gaussianity of the local type. We restrict ourselves to the squeezed limit, for which the calculation are straightforward, and perform the measurements in the initial conditions of N-body simulations, to mitigate the contamination induced by nonlinear gravitational evolution. Interestingly, the halo-matter cross bispectrum is not trivial even in this simple limit as it is strongly sensitive to the scale-dependence of the quadratic and third-order halo bias. Therefore, it can be used to test biasing prescriptions. We consider three different prescription for halo clustering: excursion set peaks (ESP), local biasmore » and a model in which the halo bias parameters are explicitly derived from a peak-background split. In all cases, the model parameters are fully constrained with statistics other than the cross bispectrum. We measure the cross bispectrum involving one halo fluctuation field and two mass overdensity fields for various halo masses and collapse redshifts. We find that the ESP is in reasonably good agreement with the numerical data, while the other alternatives we consider fail in various cases. This suggests that the scale-dependence of halo bias also is a crucial ingredient to the squeezed limit of the halo bispectrum.« less

Spontaneous recovery of memory functions in an untreated case of anti NMDAR encephalitis - a reason to maintain hope.

PubMed

McIvor, Katherine; Moore, Perry

2017-01-01

Anti N-methyl-D-aspartate receptor (anti-NMDAR) encephalitis is an autoimmune disorder that was only fully discovered recently and neuropsychological outcome data remains sparse. We present the case of BA, a 19-year-old male, which illustrates the cognitive outcome in an untreated case over a time period of over 2½ years. We conducted three cognitive assessments, including tests of memory and executive functioning, over this time period and considered the evidence for reliable change in memory function using the Wechsler Advanced Clinical Solutions (ACS) serial assessment package. Our findings revealed mild memory problems 6 months post-discharge with, at best, static and potentially declining memory functioning at follow-up assessment 12 months post-discharge. However, the results of testing at 30 months post-discharge revealed significant improvements in immediate and delayed memory index performances. Our report of a case of anti-NMDAR encephalitis provides evidence for spontaneous improvements in memory functioning occurring more than 2 years after initial assessment and also demonstrates both the utility and potential limitations of the ACS serial assessment software when used in a relatively typical clinical assessment situation.

Distribution and presentation of Lyme borreliosis in Scotland - analysis of data from a national testing laboratory.

PubMed

Mavin, S; Watson, E J; Evans, R

2015-01-01

This study examines the distribution of laboratory-confirmed cases of Lyme borreliosis in Scotland and the clinical spectrum of presentations within NHS Highland. Methods General demographic data (age/sex/referring Health Board) from all cases of Lyme borreliosis serologically confirmed by the National Lyme Borreliosis Testing Laboratory from 1 January 2008 to 31 December 2013 were analysed. Clinical features of confirmed cases were ascertained from questionnaires sent to referring clinicians within NHS Highland during the study period. Results The number of laboratory-confirmed cases of Lyme borreliosis in Scotland peaked at 440 in 2010. From 2008 to 2013 the estimated average annual incidence was 6.8 per 100,000 (44.1 per 100,000 in NHS Highland). Of 594 questionnaires from NHS Highland patients: 76% had clinically confirmed Lyme borreliosis; 48% erythema migrans; 17% rash, 25% joint, 15% neurological and 1% cardiac symptoms. Only 61% could recall a tick bite. Conclusion The incidence of Lyme borreliosis may be stabilising in Scotland but NHS Highland remains an area of high incidence. Lyme borreliosis should be considered in symptomatic patients that have had exposure to ticks and not just those with a definite tick bite.

Two cases of paraoccupational asthma due to toluene diisocyanate (TDI).

PubMed

De Zotti, R; Muran, A; Zambon, F

2000-12-01

Two cases of paraoccupational asthma caused by toluene diisocyanate (TDI) are reported. The first patient was a metal worker in a machine shop situated near a factory producing polyurethane foam. Symptoms at work were not explainable by any specific exposure to irritants or allergens in the work site. As the patient recalled previous occasional work in the adjacent polyurethane factory with accompanying worsening of respiratory symptoms, a specific inhalation (SIC) test was performed with TDI, which confirmed the diagnosis of TDI asthma. The second case was a woman working part time as a secretary in the offices of her son's factory for varnishing wooden chairs. TDI was present in the products used in the varnishing shed. The SIC test confirmed the diagnosis of TDI asthma, despite the fact that the patient's job did not present risk of exposure to the substance. In both patients, symptoms disappeared when further exposure was avoided. These two cases confirm that paraoccupational exposure to TDI must be considered when evaluating patients with asthma not mediated by immunoglobulin E. They also suggest the need for more prospective studies evaluating the health risk for the general population living near polyurethane factories or other firms that use TDI.

Conjunctival impression cytology versus routine tear function tests for dry eye evaluation in contact lens wearers.

PubMed

Kumar, Prachi; Bhargava, Rahul; Arora, Yogesh C; Kaushal, Sidharth; Kumar, Manjushri

2015-01-01

Prolonged contact lens wear is often accompanied by dryness of the eyes. The aim of this study was to compare conjunctival impression cytology (CIC) and tear film tests such as tear film break up time (TBUT) and Schirmer test for dry eye evaluation in contact lens wearers and measure their correlation with dry eye symptoms. A case control study was done at three referral eye centers. The eyes of 230 contact lens users were compared to 250 eyes of age- and sex-matched controls. Participants were recruited based on their response to a questionnaire of dry eye symptoms, (Dry Eye Scoring System, DESS(©)) and measurements of TBUT, Schirmer test, and CIC was done. A correlation analysis between symptom severity and tear film tests was performed. Pearson's coefficient, R(2) > 0.5 was considered significant. As compared to controls (r (2) = 0.010), Nelson grade correlated significantly with dry eye symptoms (r (2) = 0.765), among cases. However, there was moderate correlation between dry eye symptoms, Schirmer test, and TBUT (r (2) = 0.557 and 0.530, respectively) among cases and a weak correlation among controls (r (2) = 0.130 and 0.054, respectively). The sensitivity of TBUT was 86.4%, specificity was 82.4%, positive likelihood ratio (LR) was 4.50 [95% confidence interval (CI) 3.46-5.85)], and negative LR was 0.09. The sensitivity of the Schirmer test was 48.2%, specificity 88%, LR 2.12 (95% CI 1.48-2.96), and negative LR 0.83. CIC correlates better than Schirmer and TBUT with dry eye symptoms. It may be the most appropriate test for dry-eye evaluation in contact lens wearers.

Major improvements in the quality of malaria case-management under the "test and treat" policy in Kenya.

PubMed

Zurovac, Dejan; Githinji, Sophie; Memusi, Dorothy; Kigen, Samuel; Machini, Beatrice; Muturi, Alex; Otieno, Gabriel; Snow, Robert W; Nyandigisi, Andrew

2014-01-01

Monitoring implementation of the "test and treat" case-management policy for malaria is an important component of all malaria control programmes in Africa. Unfortunately, routine information systems are commonly deficient to provide necessary information. Using health facility surveys we monitored health systems readiness and malaria case-management practices prior to and following implementation of the 2010 "test and treat" policy in Kenya. Between 2010 and 2013 six national, cross-sectional, health facility surveys were undertaken. The number of facilities assessed ranged between 172 and 176, health workers interviewed between 216 and 237 and outpatient consultations for febrile patients evaluated between 1,208 and 2,408 across six surveys. Comparing baseline and the last survey results, all readiness indicators showed significant (p<0.005) improvements: availability of parasitological diagnosis (55.2% to 90.7%); RDT availability (7.5% to 69.8%); total artemether-lumefantrine (AL) stock-out (27.2% to 7.0%); stock-out of one or more AL packs (59.5% to 21.6%); training coverage (0 to 50.2%); guidelines access (0 to 58.1%) and supervision (17.9% to 30.8%). Testing increased by 34.0% (23.9% to 57.9%; p<0.001) while testing and treatment according to test result increased by 34.2% (15.7% to 49.9%; p<0.001). Treatment adherence for test positive patients improved from 83.3% to 90.3% (p = 0.138) and for test negative patients from 47.9% to 83.4% (p<0.001). Significant testing and treatment improvements were observed in children and adults. There was no difference in practices with respect to the type and result of malaria test (RDT vs microscopy). Of eight dosing, dispensing and counseling tasks, improvements were observed for four tasks. Overall AL use for febrile patients decreased from 63.5% to 35.6% (p<0.001). Major improvements in the implementation of "test and treat" policy were observed in Kenya. Some gaps towards universal targets still remained. Other countries facing similar needs and challenges may consider health facility surveys to monitor malaria case-management.

Seasonality in pulmonary tuberculosis among migrant workers entering Kuwait

PubMed Central

Akhtar, Saeed; Mohammad, Hameed GHH

2008-01-01

Background There is paucity of data on seasonal variation in pulmonary tuberculosis (TB) in developing countries contrary to recognized seasonality in the TB notification in western societies. This study examined the seasonal pattern in TB diagnosis among migrant workers from developing countries entering Kuwait. Methods Monthly aggregates of TB diagnosis results for consecutive migrants tested between January I, 1997 and December 31, 2006 were analyzed. We assessed the amplitude (α) of the sinusoidal oscillation and the time at which maximum (θ°) TB cases were detected using Edwards' test. The adequacy of the hypothesized sinusoidal curve was assessed by χ2 goodness-of-fit test. Results During the 10 year study period, the proportion (per 100,000) of pulmonary TB cases among the migrants was 198 (4608/2328582), (95% confidence interval: 192 – 204). The adjusted mean monthly number of pulmonary TB cases was 384. Based on the observed seasonal pattern in the data, the maximum number of TB cases was expected during the last week of April (θ° = 112°; P < 0.001). The amplitude (± se) (α = 0.204 ± 0.04) of simple harmonic curve showed 20.4% difference from the mean to maximum TB cases. The peak to low ratio of adjusted number of TB cases was 1.51 (95% CI: 1.39 – 1.65). The χ2 goodness-of-test revealed that there was no significant (P > 0.1) departure of observed frequencies from the fitted simple harmonic curve. Seasonal component explained 55% of the total variation in the proportions of TB cases (100,000) among the migrants. Conclusion This regularity of peak seasonality in TB case detection may prove useful to institute measures that warrant a better attendance of migrants. Public health authorities may consider re-allocation of resources in the period of peak seasonality to minimize the risk of Mycobacterium tuberculosis infection to close contacts in this and comparable settings in the region having similar influx of immigrants from high TB burden countries. Epidemiological surveillance for the TB risk in the migrants in subsequent years and required chemotherapy of detected cases may contribute in global efforts to control this public health menace. PMID:18179720

[Formula: see text] regularity properties of singular parameterizations in isogeometric analysis.

PubMed

Takacs, T; Jüttler, B

2012-11-01

Isogeometric analysis (IGA) is a numerical simulation method which is directly based on the NURBS-based representation of CAD models. It exploits the tensor-product structure of 2- or 3-dimensional NURBS objects to parameterize the physical domain. Hence the physical domain is parameterized with respect to a rectangle or to a cube. Consequently, singularly parameterized NURBS surfaces and NURBS volumes are needed in order to represent non-quadrangular or non-hexahedral domains without splitting, thereby producing a very compact and convenient representation. The Galerkin projection introduces finite-dimensional spaces of test functions in the weak formulation of partial differential equations. In particular, the test functions used in isogeometric analysis are obtained by composing the inverse of the domain parameterization with the NURBS basis functions. In the case of singular parameterizations, however, some of the resulting test functions do not necessarily fulfill the required regularity properties. Consequently, numerical methods for the solution of partial differential equations cannot be applied properly. We discuss the regularity properties of the test functions. For one- and two-dimensional domains we consider several important classes of singularities of NURBS parameterizations. For specific cases we derive additional conditions which guarantee the regularity of the test functions. In addition we present a modification scheme for the discretized function space in case of insufficient regularity. It is also shown how these results can be applied for computational domains in higher dimensions that can be parameterized via sweeping.

Bilateral isolated submandibular gland mumps.

PubMed

Cheung, Linnea; Henderson, Arthur Harry; Banfield, Graham; Carswell, Andrew

2017-06-05

Isolated submandibular swellings pose a diagnostic challenge to the practising otolaryngologist. We report an unusual case of mumps isolated to bilateral submandibular glands. We discuss the case and the literature surrounding this condition and remind clinicians that mumps should be considered as a diagnosis in the presence of submandibular gland swelling in the absence of typical parotid swelling associated with mumps. Early consideration of this differential diagnosis, serological testing and a multidisciplinary approach may help to clinch the diagnosis earlier and prevent spread of the virus. © BMJ Publishing Group Ltd (unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Variance reduction for Fokker–Planck based particle Monte Carlo schemes

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

Gorji, M. Hossein, E-mail: gorjih@ifd.mavt.ethz.ch; Andric, Nemanja; Jenny, Patrick

Recently, Fokker–Planck based particle Monte Carlo schemes have been proposed and evaluated for simulations of rarefied gas flows [1–3]. In this paper, the variance reduction for particle Monte Carlo simulations based on the Fokker–Planck model is considered. First, deviational based schemes were derived and reviewed, and it is shown that these deviational methods are not appropriate for practical Fokker–Planck based rarefied gas flow simulations. This is due to the fact that the deviational schemes considered in this study lead either to instabilities in the case of two-weight methods or to large statistical errors if the direct sampling method is applied.more » Motivated by this conclusion, we developed a novel scheme based on correlated stochastic processes. The main idea here is to synthesize an additional stochastic process with a known solution, which is simultaneously solved together with the main one. By correlating the two processes, the statistical errors can dramatically be reduced; especially for low Mach numbers. To assess the methods, homogeneous relaxation, planar Couette and lid-driven cavity flows were considered. For these test cases, it could be demonstrated that variance reduction based on parallel processes is very robust and effective.« less

Molecular diagnosis of Legionella infections--Clinical utility of front-line screening as part of a pneumonia diagnostic algorithm.

PubMed

Gadsby, Naomi J; Helgason, Kristjan O; Dickson, Elizabeth M; Mills, Jonathan M; Lindsay, Diane S J; Edwards, Giles F; Hanson, Mary F; Templeton, Kate E

2016-02-01

Urinary antigen testing for Legionella pneumophila serogroup 1 is the leading rapid diagnostic test for Legionnaires' Disease (LD); however other Legionella species and serogroups can also cause LD. The aim was to determine the utility of front-line L. pneumophila and Legionella species PCR in a severe respiratory infection algorithm. L. pneumophila and Legionella species duplex real-time PCR was carried out on 1944 specimens from hospitalised patients over a 4 year period in Edinburgh, UK. L. pneumophila was detected by PCR in 49 (2.7%) specimens from 36 patients. During a LD outbreak, combined L. pneumophila respiratory PCR and urinary antigen testing had optimal sensitivity and specificity (92.6% and 98.3% respectively) for the detection of confirmed cases. Legionella species was detected by PCR in 16 (0.9%) specimens from 10 patients. The 5 confirmed and 1 probable cases of Legionella longbeachae LD were both PCR and antibody positive. Front-line L. pneumophila and Legionella species PCR is a valuable addition to urinary antigen testing as part of a well-defined algorithm. Cases of LD due to L. longbeachae might be considered laboratory-confirmed when there is a positive Legionella species PCR result and detection of L. longbeachae specific antibody response. Copyright © 2015 The British Infection Association. Published by Elsevier Ltd. All rights reserved.

Early Disseminated Lyme Disease Masquerading as Mononucleosis: A Case Report.

PubMed

Tumminello, Richard; Glaspey, Lindsey; Bhamidipati, Anita; Sheehan, Patrick; Patel, Sundip

2017-12-01

Disseminated Lyme disease can be difficult to diagnose, as it begins with nonspecific signs and symptoms, which, if not treated correctly, can lead to atrioventricular conduction blocks and meningitis. In addition, the diagnosis can be further complicated by potentially false-positive test results. We report a case of early-disseminated Lyme disease presenting with Borrelia meningitis and concomitant Lyme carditis, which was misdiagnosed as mononucleosis. A young, previously healthy patient had been hiking in the woods of upstate New York and 4 weeks later developed fever, night sweats, and myalgias. He was diagnosed with mononucleosis via a positive rapid heterophile agglutination antibody test to the Epstein-Barr virus at a walk-in clinic and was started on medications, but then subsequently developed left hip pain, a facial droop, and a very long first-degree atrioventricular conduction block. He went to the Emergency Department, where he had testing that confirmed disseminated Lyme disease. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: This case highlights the difficulty in early diagnosis of disseminated Lyme disease and how a potentially false-positive laboratory test can lead to the complications of Borrelia meningitis and Lyme carditis in untreated young healthy patients. Emergency physicians need to consider Lyme disease in patients with nonspecific signs and symptoms, especially if they have been outdoors for prolonged periods of time in Lyme-endemic areas. Copyright © 2017 Elsevier Inc. All rights reserved.

Human parvovirus B19 infection in a renal transplant recipient: a case report

PubMed Central

2013-01-01

Background Parvovirus B19 presents tropism for human erythroid progenitor cells, causing chronic anemia in organ transplant recipients, due to their suppressed humoral and cellular responses. Diagnosis may be achieved through serological tests for detection of anti-B19 antibodies. However, renal transplant recipients are not routinely tested for parvovirus B19 infection, since there is scanty data or consensus on screening for B19 infection, as well as for treatment or preventive management of transplanted patients. Case presentation Herein we report a kidney transplant recipient, who was unresponsive to treatment of severe anemia, and presented hypocellular hematopoietic marrow, megaloblastosis and hypoplasia of erythroid lineage with larger cells with clear nuclei chromatin and eosinophilic nuclear inclusions. This patient was seropositive for Epstein-Barr and Cytomegalovirus infections and negative for anti-parvovirus B19 IgM and IgG antibodies, although symptoms were suggestive of parvoviruses infection. A qualitative polymerase chain reaction testing for B19 in serum sample revealed positive results for B19 virus DNA. Conclusion This case report suggests that the diagnostic process for parvovirus B19 in renal transplant recipients should include a polymerase chain reaction assay to detect B19-DNA, since specific serological tests may be unreliable given their impaired humoral responses. These results also indicate the importance of considering parvovirus B19 infection in the differential diagnosis of persistent anemia in transplanted patients. PMID:23343210

Strengthened Ebola surveillance in France during a major outbreak in West Africa: March 2014-January 2016.

PubMed

Mailles, A; Noel, H; Pannetier, D; Rapp, C; Yazdanpanah, Y; Vandentorren, S; Chaud, P; Philippe, J M; Worms, B; Bruyand, M; Tourdjman, M; Nahon, M; Belchior, E; Lucas, E; Durand, J; Zurbaran, M; Vaux, S; Coignard, B; DE Valk, H; Baize, S; Quelet, S; Bourdillon, F

2017-12-01

Introduction An unprecedented outbreak of Ebola virus diseases (EVD) occurred in West Africa from March 2014 to January 2016. The French Institute for Public Health implemented strengthened surveillance to early identify any imported case and avoid secondary cases. Febrile travellers returning from an affected country had to report to the national emergency healthcare hotline. Patients reporting at-risk exposures and fever during the 21st following day from the last at-risk exposure were defined as possible cases, hospitalised in isolation and tested by real-time polymerase chain reaction. Asymptomatic travellers reporting at-risk exposures were considered as contact and included in a follow-up protocol until the 21st day after the last at-risk exposure. From March 2014 to January 2016, 1087 patients were notified: 1053 were immediately excluded because they did not match the notification criteria or did not have at-risk exposures; 34 possible cases were tested and excluded following a reliable negative result. Two confirmed cases diagnosed in West Africa were evacuated to France under stringent isolation conditions. Patients returning from Guinea (n = 531; 49%) and Mali (n = 113; 10%) accounted for the highest number of notifications. No imported case of EVD was detected in France. We are confident that our surveillance system was able to classify patients properly during the outbreak period.

Is Parenteral Levothyroxine Therapy Safe in Intractable Hypothyroidism?

PubMed

Peynirci, Hande; Taskiran, Bengur; Erturk, Erdinc; Sisman, Pınar; Ersoy, Canan

2018-06-01

A 32-year old woman was admitted to the hospital due to intractable hypothyroidism refractory to high dose of oral l-thyroxine therapy. She underwent total thyroidectomy and radioactive iodine therapy due to papillary thyroid cancer. After excluding poor adherence to therapy and malabsorption, levothyroxine absorption test was performed. No response was detected. Transient neurologic symptoms developed during the test. She developed 3 attacks consisting of neurologic symptoms during high dose administration. The patient was considered a case of isolated l-thyroxine malabsorption. She became euthyroid after intramuscular twice weekly l-thyroxine therapy. There are a few case reports regarding isolated l-thyroxine. We report successful long term results of twice weekly administered intramuscular l-thyroxine therapy. We also draw attention to neurologic side effects of high dose l-thyroxine therapy. Copyright © 2017 National Medical Association. Published by Elsevier Inc. All rights reserved.

Evaluating the aquatic toxicity of complex organic chemical mixtures: lessons learned from polycyclic aromatic hydrocarbon and petroleum hydrocarbon case studies.

PubMed

Landrum, Peter F; Chapman, Peter M; Neff, Jerry; Page, David S

2012-04-01

Experimental designs for evaluating complex mixture toxicity in aquatic environments can be highly variable and, if not appropriate, can produce and have produced data that are difficult or impossible to interpret accurately. We build on and synthesize recent critical reviews of mixture toxicity using lessons learned from 4 case studies, ranging from binary to more complex mixtures of primarily polycyclic aromatic hydrocarbons and petroleum hydrocarbons, to provide guidance for evaluating the aquatic toxicity of complex mixtures of organic chemicals. Two fundamental requirements include establishing a dose-response relationship and determining the causative agent (or agents) of any observed toxicity. Meeting these 2 requirements involves ensuring appropriate exposure conditions and measurement endpoints, considering modifying factors (e.g., test conditions, test organism life stages and feeding behavior, chemical transformations, mixture dilutions, sorbing phases), and correctly interpreting dose-response relationships. Specific recommendations are provided. Copyright © 2011 SETAC.

Acquired toxoplasmosis. A neglected cause of treatable nervous system disease.

PubMed

Townsend, J J; Wolinsky, J S; Baringer, J R; Johnson, P C

1975-05-01

The neurological manifestations of six cases of acquired central nervous system toxoplasmosis are compared with the 39 well-documented cases from the literature. Half of the patients had underlying systemic diseases (18 malignant neoplasms, two renal transplants, three collagen vascular diseases) treated with intensive immunosuppressive therapy. The remainder had primary toxoplasmosis. Three major neurological patterns were seen: (1) diffuse encephalopathy with or without seizures, (2) meningoencephalitis, and (3) singular or multiple progressive mass lesions. Routine neurological diagnostic studies were not helpful. The Sabin-Feldman dye test or IgM indirect fluorescent antibody test or both were effective in confirming the diagnosis. Twenty-seven patients died without a clinical diagnosis of toxoplasmosis. The diagnosis was made terminally in four additional patients. Thirteen of fourteen patients who received a full course of sulfadiazine or pyrimethamine or both did well. Toxoplasmosis should be considered in the immunosuppressed patient who appears with neurological involvement.

Lupus erythematosus cells in bone marrow: the only clue to a previously unsuspected diagnosis of systemic lupus erythematosus.

PubMed

Pujani, Mukta; Kushwaha, Shivani; Sethi, Neha; Beniwal, Anu; Shukla, Shailaja

2013-01-01

Systemic lupus erythematosus (SLE) is an autoimmune multisystem disease characterized by the development of antinuclear antibodies. Nowadays considered outdated, lupus erythematosus (LE) cell preparation served as a screening test for SLE for decades. However, the importance of discovering LE cells on routine cytology cannot be overemphasized. We report the case of a 30-year-old female in whom bone marrow aspiration (BMA) was performed during an investigative workup for pyrexia of unknown origin. The observation of LE cells in direct bone marrow smears (without the use of an anticoagulant) raised the suspicion of SLE, which was later confirmed by antinuclear antibody testing. In the present case, LE cells were observed on BMA performed for the investigation of fever of unknown origin. The unexpected observation of LE cells in BMA smears emphasizes the fact that good morphological observation of marrow aspirates can provide crucial clues to a previously unsuspected diagnosis.

Digital test assembly of truck parts with the IMMA-tool--an illustrative case.

PubMed

Hanson, L; Högberg, D; Söderholm, M

2012-01-01

Several digital human modelling (DHM) tools have been developed for simulation and visualisation of human postures and motions. In 2010 the DHM tool IMMA (Intelligently Moving Manikins) was introduced as a DHM tool that uses advanced path planning techniques to generate collision free and biomechanically acceptable motions for digital human models (as well as parts) in complex assembly situations. The aim of the paper is to illustrate how the IPS/IMMA tool is used at Scania CV AB in a digital test assembly process, and to compare the tool with other DHM tools on the market. The illustrated case of using the IMMA tool, here combined with the path planner tool IPS, indicates that the tool is promising. The major strengths of the tool are its user friendly interface, the motion generation algorithms, the batch simulation of manikins and the ergonomics assessment methods that consider time.

Wall modeled LES of wind turbine wakes with geometrical effects

NASA Astrophysics Data System (ADS)

Bricteux, Laurent; Benard, Pierre; Zeoli, Stephanie; Moureau, Vincent; Lartigue, Ghislain; Vire, Axelle

2017-11-01

This study focuses on prediction of wind turbine wakes when geometrical effects such as nacelle, tower, and built environment, are taken into account. The aim is to demonstrate the ability of a high order unstructured solver called YALES2 to perform wall modeled LES of wind turbine wake turbulence. The wind turbine rotor is modeled using an Actuator Line Model (ALM) while the geometrical details are explicitly meshed thanks to the use of an unstructured grid. As high Reynolds number flows are considered, sub-grid scale models as well as wall modeling are required. The first test case investigated concerns a wind turbine flow located in a wind tunnel that allows to validate the proposed methodology using experimental data. The second test case concerns the simulation of a wind turbine wake in a complex environment (e.g. a Building) using realistic turbulent inflow conditions.

Thrombo-ischaemic pinnal necrosis associated with fenbendazole treatment in a dog.

PubMed

Nuttall, T J; Burrow, R; Fraser, I; Kipar, A

2005-05-01

An 11-week-old, female West Highland white terrier was presented with necrosis of the distal third of both pinnae. Haematology, biochemistry and urinalysis, Coombs test, antinuclear antibody and cold autoagglutinin antibody tests were normal. A drug reaction to fenbendazole was diagnosed. The necrotic ear tips were surgically removed. Histopathology revealed extensive coagulative necrosis of the epidermis and superficial to mid-dermis, a moderate interstitial neutrophilic infiltrate and complete thrombotic occlusion and necrosis of blood vessels. There was also endothelial cell activation and proliferation with endothelial cell cushions protruding into the vascular lumen. Immunohistochemistry for factor VIII-related antigen confirmed endothelial cell involvement. This case represents an unusual, drug-induced, thrombo-ischaemic necrosis of the pinnae. It is also, to the authors' knowledge, the first report of fenbendazole sensitivity in a dog. The histopathology is similar to previous cases of proliferative thrombovascular pinnal necrosis, suggesting that drug reactions should be considered in this condition.

Enhancement of a 2D front-tracking algorithm with a non-uniform distribution of Lagrangian markers

NASA Astrophysics Data System (ADS)

Febres, Mijail; Legendre, Dominique

2018-04-01

The 2D front tracking method is enhanced to control the development of spurious velocities for non-uniform distributions of markers. The hybrid formulation of Shin et al. (2005) [7] is considered. A new tangent calculation is proposed for the calculation of the tension force at markers. A new reconstruction method is also proposed to manage non-uniform distributions of markers. We show that for both the static and the translating spherical drop test case the spurious currents are reduced to the machine precision. We also show that the ratio of the Lagrangian grid size Δs over the Eulerian grid size Δx has to satisfy Δs / Δx > 0.2 for ensuring such low level of spurious velocity. The method is found to provide very good agreement with benchmark test cases from the literature.

[A case of acquired immunodeficiency syndrome with ileocecal ulcer].

PubMed

Iwasaki, Tetsuyoshi; Saruta, Masayuki; Sawada, Ryoichi; Ide, Daisuke; Arihiro, Seiji; Matsuoka, Mika; Katoh, Tomohiro; Tajiri, Hisao

2015-10-01

We report a case of a patient with acquired immunodeficiency syndrome (AIDS) and ileocecal ulcer. A 31-year-old man was admitted with chief complaints of decreased body weight and abdominal pain. Colonoscopy revealed a round punched-out ulcer on the ileocecal valve. Initially, we suspected entero-Behçet's disease and simple ulcer as the cause of the ileocecal ulcer. However, after histologic examination of tissue biopsies obtained during colonoscopy, we diagnosed the patient as having cytomegalovirus (CMV) enteritis. Based on the patient's white blood cell depletion and CMV enteritis, we performed a human immunodeficiency virus (HIV) antibody test. The test was positive, and the diagnosis of AIDS was established. The number of patients with AIDS has been increasing in Japan; thus, we should consider the possibility of CMV enteritis and AIDS in young adult patients affected by ileocecal ulcer with no notable history.

Surface modification of nano-silica on the ligament advanced reinforcement system for accelerated bone formation: primary human osteoblasts testing in vitro and animal testing in vivo.

PubMed

Li, Mengmeng; Wang, Shiwen; Jiang, Jia; Sun, Jiashu; Li, Yuzhuo; Huang, Deyong; Long, Yun-Ze; Zheng, Wenfu; Chen, Shiyi; Jiang, Xingyu

2015-05-07

The Ligament Advanced Reinforcement System (LARS) has been considered as a promising graft for ligament reconstruction. To improve its biocompatibility and effectiveness on new bone formation, we modified the surface of a polyethylene terephthalate (PET) ligament with nanoscale silica using atom transfer radical polymerization (ATRP) and silica polymerization. The modified ligament is tested by both in vitro and in vivo experiments. Human osteoblast testing in vitro exhibits an ∼21% higher value in cell viability for silica-modified grafts compared with original grafts. Animal testing in vivo shows that there is new formed bone in the case of a nanoscale silica-coated ligament. These results demonstrate that our approach for nanoscale silica surface modification on LARS could be potentially applied for ligament reconstruction.

Dispersion and Input Control Capability in European Large Size Reverberant Acoustic Chambers

NASA Astrophysics Data System (ADS)

Yarza, A.; Lopez, J.; Ozores, E.

2012-07-01

The acoustic test in reverberant chamber is one of the load cases to be proved during the environmental test campaign that demonstrates the capability of a space- unit to survive the launch phase. The crucial requirement for the large size structures is often the survival of the acoustic vibration test, and can be defined as the design driver load case in many circumstances. In addition, the commercial market demands lighter structures as an objective to reduce costs. For an efficient optimisation of the product it is very important to have powerful structural analysis tools in order to obtain knowledge of the structural needs and to refine existing methods for the prediction of structural loads experienced during acoustic testing. In the same line, as part of the contributors involved in the test it is important to acquire knowledge of the characteristics of the reverberant chamber itself and the behaviour of the fluid. With this purpose, EADS CASA Espacio (ECE) has used the measured data of the parameters of the fluid extracted from test of the deployable reflectors validated in the past five years, with the final objective to improve and optimise the capability to face up the acoustic test. In this paper experimental data extracted from acoustic tests performed to space-units are presented. Information related to two European large size acoustic chambers are used. The pressure field inside the acoustic chamber has been post-processed with the objective to study the behaviour of the fluid during the test. The diffuseness of the pressure field and the control capability of the acoustic profile are parameters to be considered as contributors for the design of the structures. The homogeneity of the microphones’ measurements is taken into account to describe the dispersion of the pressure inside the reverberant chamber along the frequency domain. Upon of that, the capability of the facilities to control the input profile is analysed from a statistical point of view. The final conclusions allow defining the minimum tolerances to be considered based on the limits imposed by the chamber.

An Efficacious Multi-Objective Fuzzy Linear Programming Approach for Optimal Power Flow Considering Distributed Generation.

PubMed

Warid, Warid; Hizam, Hashim; Mariun, Norman; Abdul-Wahab, Noor Izzri

2016-01-01

This paper proposes a new formulation for the multi-objective optimal power flow (MOOPF) problem for meshed power networks considering distributed generation. An efficacious multi-objective fuzzy linear programming optimization (MFLP) algorithm is proposed to solve the aforementioned problem with and without considering the distributed generation (DG) effect. A variant combination of objectives is considered for simultaneous optimization, including power loss, voltage stability, and shunt capacitors MVAR reserve. Fuzzy membership functions for these objectives are designed with extreme targets, whereas the inequality constraints are treated as hard constraints. The multi-objective fuzzy optimal power flow (OPF) formulation was converted into a crisp OPF in a successive linear programming (SLP) framework and solved using an efficient interior point method (IPM). To test the efficacy of the proposed approach, simulations are performed on the IEEE 30-busand IEEE 118-bus test systems. The MFLP optimization is solved for several optimization cases. The obtained results are compared with those presented in the literature. A unique solution with a high satisfaction for the assigned targets is gained. Results demonstrate the effectiveness of the proposed MFLP technique in terms of solution optimality and rapid convergence. Moreover, the results indicate that using the optimal DG location with the MFLP algorithm provides the solution with the highest quality.

An Efficacious Multi-Objective Fuzzy Linear Programming Approach for Optimal Power Flow Considering Distributed Generation

PubMed Central

Warid, Warid; Hizam, Hashim; Mariun, Norman; Abdul-Wahab, Noor Izzri

2016-01-01

This paper proposes a new formulation for the multi-objective optimal power flow (MOOPF) problem for meshed power networks considering distributed generation. An efficacious multi-objective fuzzy linear programming optimization (MFLP) algorithm is proposed to solve the aforementioned problem with and without considering the distributed generation (DG) effect. A variant combination of objectives is considered for simultaneous optimization, including power loss, voltage stability, and shunt capacitors MVAR reserve. Fuzzy membership functions for these objectives are designed with extreme targets, whereas the inequality constraints are treated as hard constraints. The multi-objective fuzzy optimal power flow (OPF) formulation was converted into a crisp OPF in a successive linear programming (SLP) framework and solved using an efficient interior point method (IPM). To test the efficacy of the proposed approach, simulations are performed on the IEEE 30-busand IEEE 118-bus test systems. The MFLP optimization is solved for several optimization cases. The obtained results are compared with those presented in the literature. A unique solution with a high satisfaction for the assigned targets is gained. Results demonstrate the effectiveness of the proposed MFLP technique in terms of solution optimality and rapid convergence. Moreover, the results indicate that using the optimal DG location with the MFLP algorithm provides the solution with the highest quality. PMID:26954783

Cleanroom certification model

NASA Technical Reports Server (NTRS)

Currit, P. A.

1983-01-01

The Cleanroom software development methodology is designed to take the gamble out of product releases for both suppliers and receivers of the software. The ingredients of this procedure are a life cycle of executable product increments, representative statistical testing, and a standard estimate of the MTTF (Mean Time To Failure) of the product at the time of its release. A statistical approach to software product testing using randomly selected samples of test cases is considered. A statistical model is defined for the certification process which uses the timing data recorded during test. A reasonableness argument for this model is provided that uses previously published data on software product execution. Also included is a derivation of the certification model estimators and a comparison of the proposed least squares technique with the more commonly used maximum likelihood estimators.

Symptoms, Diagnosis, and Treatment of Cow's Milk Allergy.

PubMed

Vandenplas, Yvan; Marchand, Johan; Meyns, Lien

2015-01-01

The diagnosis and management of cow's milk allergy (CMA) is a topic of debate because there are no specific symptoms and reliable diagnostic tests. Literature was searched using databases to find original papers and reviews on this topic. A "challenge test" is still recommended as the most specific and sensitive diagnostic test, although a positive challenge test does not proof the involvement of the immune system. Only in the rare case of anaphylaxis, the challenge tests is not recommended. The Cow's Milk Symptom Score (CoMiSS) is an awareness tool for health care professionals to better recognize symptoms caused by the ingestion of cow's milk, but still needs validation. Today, the recommended diagnostic approach consists of an elimination diet with an extensive cow's milk based hydrolysate, followed by a challenge test. Amino acid based formula is reserved for the severe cases. Rice hydrolysates are gaining popularity, because they have been shown to be effective, have a better acceptability, and to be cheaper than the extensive cow's milk based hydrolysates. Soy infant formula may offer an additional alternative option as reviews concluded that about 10-15% of infants allergic to cow's milk will also react to soy. Gastro-intestinal microbiota manipulation may be of additional benefit in the treatment of CMA. The development of rice hydrolysates challenge the use of Today, extensive cow's milk based extensive hydrolysates remain the first option for the majority of patients and amino acid formula for the most severe cases. Rice hydrolysates and soy infant formula are considered as second choice options.

The Case for Universal Screening of Private Well Water Quality in the U.S. and Testing Requirements to Achieve It: Evidence from Arsenic.

PubMed

Zheng, Yan; Flanagan, Sara V

2017-08-03

The 1974 Safe Drinking Water Act (SDWA) regulates >170,000 public water systems to protect health, but not >13 million private wells. State and local government requirements for private well water testing are rare and inconsistent; the responsibility to ensure water safety remains with individual households. Over the last two decades, geogenic arsenic has emerged as a significant public health concern due to high prevalence in many rural American communities. We build the case for universal screening of private well water quality around arsenic, the most toxic and widespread of common private water contaminants. We argue that achieving universal screening will require policy intervention, and that testing should be made easy, accessible, and in many cases free to all private well households in the United States, considering the invisible, tasteless, odorless, and thus silent nature of arsenic. Our research has identified behavioral, situational and financial barriers to households managing their own well water safety, resulting in far from universal screening despite traditional public health outreach efforts. We observe significant socioeconomic disparities in arsenic testing and treatment when private water is unregulated. Testing requirements can be a partial answer to these challenges. Universal screening, achieved through local testing requirements complemented by greater community engagement targeting biologically and socioeconomically vulnerable groups, would reduce population arsenic exposure greater than any promotional efforts to date. Universal screening of private well water will identify the dangers hidden in America's drinking water supply and redirect attention to ensure safe water among affected households. https://doi.org/10.1289/EHP629.

Genetic Testing for Minors: Comparison between Italian and British Guidelines

PubMed Central

Tozzo, Pamela; Caenazzo, Luciana; Rodriguez, Daniele

2012-01-01

Genetic testing in children raises many important ethical, legal, and social issues. One of the main concerns is the ethically inappropriate genetic testing of minors. Various European countries established professional guidelines which reflect the different countries perspectives regarding the main ethical issues involved. In this paper, we analyze the Italian and the British guidelines by highlighting differences and similarities. We discuss presymptomatic, predictive, and carrier testing because we consider them to be the more ethically problematic types of genetic testing in minors. In our opinion, national guidelines should take into account the different needs in clinical practice. At the same time, in the case of genetic testing the national and supranational protection of minors could be strengthened by approving guidelines based on a common framework of principles and values. We suggest that the Oviedo Convention could represent an example of such a common framework or, at least, it could lead to articulate it. PMID:22567400

Enhancing the role of case managers with specialty populations: development and evaluation of a palliative care education program.

PubMed

Howell, Doris; Prestwich, Catherine; Laughlin, Emmy; Giga, Nasreen

2004-01-01

Palliative home care is an important component of the care system for patients at the end of life and case management is considered an essential element of the Canadian home care system. Case managers play a critical role in allocating resources, thus influencing the costs and the viability of palliative home care. Case management education programs focused on care coordination with specialty palliative care populations are nonexistent. An education program targeted at improving the knowledge and skills of case managers in allocating resources to palliative care populations was developed and pilot-tested in a metropolitan Canadian city home care program. Core curriculum was based on an initial learning needs assessment and used case-based problem solving to enhance case-management skills. An improvement in knowledge was noted on posttests and case managers described increased comfort and confidence in their role as case managers to this patient population. Home care organizations caring for palliative care populations must ensure case managers are prepared for case management roles with specialty populations if the home is to be rendered an appropriate and viable care setting for patients at the end of life.

International flight-related transmission of pandemic influenza A(H1N1)pdm09: an historical cohort study of the first identified cases in the United Kingdom

PubMed Central

Young, Nicholas; Pebody, Richard; Smith, Gillian; Olowokure, Babatunde; Shankar, Giri; Hoschler, Katja; Galiano, Monica; Green, Helen; Wallensten, Anders; Hogan, Angela; Oliver, Isabel

2014-01-01

Background Transporting over two billion passengers per year, global airline travel has the potential to spread emerging infectious diseases, both via transportation of infectious cases and through in-flight transmission. Current World Health Organization (WHO) guidance recommends contact tracing of passengers seated within two rows of a case of influenza during air travel. Objectives The objectives of this study were to describe flight-related transmission of influenza A(H1N1)pdm09 during a commercial flight carrying the first cases reported in the United Kingdom and to test the specific hypothesis that passengers seated within two rows of an infectious case are at greater risk of infection. Methods An historical cohort study, supplemented by contact tracing, enhanced surveillance data and laboratory testing, was used to establish a case status for passengers on board the flight. Results Data were available for 239 of 278 (86·0%) of passengers on the flight, of whom six were considered infectious in-flight and one immune. The attack rate (AR) was 10 of 232 (4·3%; 95% CI 1·7–6·9%). There was no evidence that the AR for those seated within two rows of an infectious case was different from those who were not (relative risk 0·9; 95% CI 0·2–3·1; P = 1·00). Laboratory testing using PCR and/or serology, available for 118 of 239 (49·4%) of the passengers, was largely consistent with clinically defined case status. Conclusions This study of A(H1N1)pdm09 does not support current WHO guidance regarding the contact tracing of passengers seated within two rows of an infectious case of influenza during air travel. PMID:24373291

International flight-related transmission of pandemic influenza A(H1N1)pdm09: an historical cohort study of the first identified cases in the United Kingdom.

PubMed

Young, Nicholas; Pebody, Richard; Smith, Gillian; Olowokure, Babatunde; Shankar, Giri; Hoschler, Katja; Galiano, Monica; Green, Helen; Wallensten, Anders; Hogan, Angela; Oliver, Isabel

2014-01-01

Transporting over two billion passengers per year, global airline travel has the potential to spread emerging infectious diseases, both via transportation of infectious cases and through in-flight transmission. Current World Health Organization (WHO) guidance recommends contact tracing of passengers seated within two rows of a case of influenza during air travel. The objectives of this study were to describe flight-related transmission of influenza A(H1N1)pdm09 during a commercial flight carrying the first cases reported in the United Kingdom and to test the specific hypothesis that passengers seated within two rows of an infectious case are at greater risk of infection. An historical cohort study, supplemented by contact tracing, enhanced surveillance data and laboratory testing, was used to establish a case status for passengers on board the flight. Data were available for 239 of 278 (86·0%) of passengers on the flight, of whom six were considered infectious in-flight and one immune. The attack rate (AR) was 10 of 232 (4·3%; 95% CI 1·7-6·9%). There was no evidence that the AR for those seated within two rows of an infectious case was different from those who were not (relative risk 0·9; 95% CI 0·2-3·1; P = 1·00). Laboratory testing using PCR and/or serology, available for 118 of 239 (49·4%) of the passengers, was largely consistent with clinically defined case status. This study of A(H1N1)pdm09 does not support current WHO guidance regarding the contact tracing of passengers seated within two rows of an infectious case of influenza during air travel. © 2013 The Authors. Influenza and Other Respiratory Viruses Published by John Wiley & Sons Ltd.

Chloramine-induced anaphylaxis while showering: a case report.

PubMed

D'Alò, Simona; De Pasquale, Tiziana; Incorvaia, Cristoforo; Illuminati, Ilenia; Mistrello, Gianni; Roncarolo, Daniela; Pucci, Stefano

2012-09-25

Sodium-N-chlorine-p-toluene sulfonamide, commonly known as chloramine-T, is a derivative of chlorine which is widely used as a disinfectant. For many years, chloramine-T has been described as a cause of immediate-type hypersensitivity, especially with regard to asthma and rhinitis, and as a cause of occupational dermatoses in cleaning personnel in hospitals, although no anaphylactic reaction has yet been reported. Hence, to the best of our knowledge we present the first case of anaphylaxis to chloramine-T with evidence of specific immunoglobulin E antibodies. We describe the case of a 25-year-old Caucasian woman who was in good health and with a negative history for atopy, including no respiratory symptoms of rhinitis or asthma, and with no professional exposure to chloramine-T. She, while showering, applied a chloramine-T solution to a skin area with folliculitis on her leg, and within a few minutes developed generalized urticaria and angioedema, followed by vomiting and collapse with loss of consciousness. A skin prick test with a chloramine-T solution at 10mg/mL concentration was positive, and specific immunoglobulin E to chloramine-T was quantified at a value of 2.9 optical density as measured by the enzyme allergosorbent test technique. The strict cause-effect relationship and the results of the skin test and the in vitro test make certain the causative role of chloramine-T in this case of anaphylaxis. This suggests that chloramine-T, based on its wide use as a disinfectant, should be considered a possible cause in anaphylaxis of unknown origin.

(Eco)toxicity and biodegradability of selected protic and aprotic ionic liquids.

PubMed

Peric, Brezana; Sierra, Jordi; Martí, Esther; Cruañas, Robert; Garau, Maria Antonia; Arning, Jürgen; Bottin-Weber, Ulrike; Stolte, Stefan

2013-10-15

Ionic liquids (ILs) are a promising group of compounds with a large variety of possible structures and uses. They are considered as a potential "green" replacement for traditional volatile organic solvents, but their impact on the environment is often neglected or not studied enough. In the present study, selected representatives of two ILs groups were analyzed: a new family of protic ILs (derived from aliphatic amines and organic acids) and some frequently used aprotic ILs (substituted imidazolium and piridinium chlorides). The aquatic toxicity (test organisms Vibrio fischeri, Pseudokirchneriella subcapitata and Lemna minor) and biodegradability tests were carried out. The additional tests with enzyme (acetylcholinesterase) and leukemia rat cells (IPC-81) provided more in-depth evaluation of toxicity. In our comparative hazard assessment protic ILs have EC50 values >100 mg L(-1) in all of the tests performed, except in the case of three representatives toward Lemna minor. They also show good biodegradability rates. The EC50 values for aprotic ILs are various orders of magnitude lower than the ones for protic ILs in most of the tests and they show a lower biodegradability potential. These findings indicate that protic ILs can be considered as environmentally safer alternatives for more toxic ILs and organic solvents. Copyright © 2013 Elsevier B.V. All rights reserved.

Less than severe worst case accidents

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

Sanders, G.A.

1996-08-01

Many systems can provide tremendous benefit if operating correctly, produce only an inconvenience if they fail to operate, but have extreme consequences if they are only partially disabled such that they operate erratically or prematurely. In order to assure safety, systems are often tested against the most severe environments and accidents that are considered possible to ensure either safe operation or safe failure. However, it is often the less severe environments which result in the ``worst case accident`` since these are the conditions in which part of the system may be exposed or rendered unpredictable prior to total system failure.more » Some examples of less severe mechanical, thermal, and electrical environments which may actually be worst case are described as cautions for others in industries with high consequence operations or products.« less

Hypervitaminosis A inducing intra-hepatic cholestasis--a rare case report.

PubMed

Ramanathan, Vivek S; Hensley, Gary; French, Samuel; Eysselein, Victor; Chung, David; Reicher, Sonya; Pham, Binh

2010-04-01

The use of over-the-counter supplements is commonplace in today's health conscious society. We present an unusual case of intrahepatic cholestasis caused by vitamin A intoxication. The patient consumed one Herbalife shake with two multivitamin tablets of the same brand for 12 years. When calculated this equated to more than the recommended daily allowance for vitamin A consumption. Deranged liver function tests were consistent with a cholestatic process. Liver biopsy was obtained and revealed features pathognomonic of vitamin A toxicity, without the usual fibrosis. When the supplements were ceased, his jaundice and alkaline phosphatase completely normalized. This case highlights the importance of health care providers documenting non-prescribed dietary supplements and considering them in the etiology of cholestatic liver disease. Copyright 2009 Elsevier Inc. All rights reserved.

Acute Kidney Injury due to Menstruation-related Disseminated Intravascular Coagulation in an Adenomyosis Patient: A Case Report

PubMed Central

Son, Jungmin; Seong, Eun Young; Song, Sang Heon; Lee, Soo Bong; Kang, Jin; Yang, Byeong Yun; Lee, Su Jin; Choi, Jong-Ryeol; Lee, Kyu-Sup; Kwak, Ihm Soo

2010-01-01

The authors report a case of acute kidney injury (AKI) resulting from menstruation-related disseminated intravascular coagulation (DIC) in an adenomyosis patient. A 40-yr-old woman who had received gonadotropin for ovulation induction therapy presented with anuria and an elevated serum creatinine level. Her medical history showed primary infertility with diffuse adenomyosis. On admission, her pregnancy test was negative and her menstrual cycle had started 1 day previously. Laboratory data were consistent with DIC, and it was believed to be related to myometrial injury resulting from heavy intramyometrial menstrual flow. Gonadotropin is considered to play an important role in the development of fulminant DIC. This rare case suggests that physicians should be aware that gonadotropin may provoke fulminant DIC in women with adenomyosis. PMID:20808684

Presentation and Treatment of Histoplasmosis in Pediatric Oncology Patients: Case Series and Review of the Literature.

PubMed

Hess, Jennifer; Fondell, Andrew; Fustino, Nicholas; Malik, Jeff; Rokes, Christopher

2017-03-01

Histoplasmosis is an endemic fungus in several regions of the United States. The diagnosis and treatment of this infection can be challenging in pediatric oncology patients. We present 5 patients diagnosed with histoplasmosis while receiving treatment at a midsize pediatric oncology center in Iowa. Two cases occurred in patients with acute lymphoblastic leukemia and 3 cases in patients with solid tumors. All patients were treated with antifungal therapy and demonstrated excellent clinical response. Histoplasmosis should be considered as a potential cause of nonspecific febrile illness, pulmonary masses, and bone marrow suppression in immunocompromised patients in endemic regions. Prompt and accurate diagnosis can facilitate timely antifungal therapy and avoidance of prolonged hospital stays, invasive testing, unnecessary antibiotics, and unwarranted anticancer therapies.

Evaluation of the dermal carcinogenicity of lubricant base oils by the mouse skin painting bioassay and other proposed methods.

PubMed

Chasey, K L; McKee, R H

1993-01-01

Lubricant base oils are petroleum products that are predominantly derived from the vacuum distillation of crude oil. Various types of refinement can be employed during the manufacturing process, and evidence suggests that certain of the associated process streams produce skin cancer. Polycyclic aromatic compounds (PACs), some of which are considered as the causative agents, are removed, concentrated or chemically converted during the refinement process. In order to understand the effects of various types of refinement processes on carcinogenic potential, 94 oils were evaluated in the mouse epidermal cancer bioassay. This Exxon database is unique, because of the wide range of crude oils and processing histories represented. Seven processing history classifications are described, and conclusions concerning the impacts of each refinement process on dermal carcinogenicity are discussed. This research also included an evaluation of selected biological and chemical test methods for predicting carcinogenic potential. These included a modified version of the Ames test for mutagenicity, as well as analytical characterizations of the polycyclic aromatic structures in the oils. For classification purposes, a sample was considered to be carcinogenic if it resulted in the production of two or more tumor-bearing animals (in test groups of either 40 or 50 animals). The modified Ames test was considered to be positive if the mutagenicity index was > or = 2.0, and PAC analyses were similarly designated as positive or negative according to proposed guidelines. All of the alternative test methods showed similar agreement with dermal carcinogenicity bioassay data; concordance values were > or = 80%. However, each test was incorrect in ca. 10%-20% of the cases evaluated.(ABSTRACT TRUNCATED AT 250 WORDS)

Recoiling from a Kick in the Head-On Case

NASA Technical Reports Server (NTRS)

Choi, Dae-Il; Kelly, Bernard J.; Boggs, William D.; Baker, John G.; Centrella, Joan; Van Meter, James

2007-01-01

Recoil "kicks" induced by gravitational radiation are expected in the inspiral and merger of black holes. Recently the numerical relativity community has begun to measure the significant kicks found when both unequal masses and spins are considered. Because understanding the cause and magnitude of each component of this kick may be complicated in inspiral simulations, we consider these effects in the context of a simple test problem. We study recoils from collisions of binaries with initially head-on trajectories, starting with the simplest case of equal masses with no spin; adding spin and varying the mass ratio, both separately and jointly. We find spin-induced recoils to be significant even in head-on configurations. Additionally, it appears that the scaling of transverse kicks with spins is consistent with post-Newtonian (PN) theory, even though the kick is generated in the nonlinear merger interaction, where PN theory should not apply. This suggests that a simple heuristic description might be effective in the estimation of spin-kicks.

Sanjad-Sakati syndrome with macrocytic anemia and failure to thrive: a case from South Jordan.

PubMed

Ajarmeh, Salma A; Al Tamimi, Eyad M

2018-04-25

Backgorund: Sanjad-Sakati syndrome (SSS) is a rare autosomal recessive disease caused by a deletion mutation (155-166del) in exon 3 of the TBCE gene on chromosome 1q42-43. The syndrome is characterized by primary hypoparathyroidism, typical dysmorphic features and severe growth retardation. We encountered a 2-year-old boy with hypocalcemia, failure to thrive and macrocytic anemia. The patient had the characteristic features of SSS and genetic testing confirmed that he was homozygous for the TBCE mutation. Although malabsorption was initially considered the cause of his symptoms, the results did not confirm that diagnosis. Our patient had cow milk protein allergy and folic acid deficiency, which has not been described in previous SSS cases. It was difficult to treat the patient's hyperphosphatemia and we ultimately selected sevelamer treatment, which was tolerated well and improved his hypocalcemia. SSS should be considered in the differential diagnosis of any infant with hypocalcemia, dysmorphism and failure to thrive.

Granulomatous uveitis and reactive arthritis as manifestations of post-streptococcal syndrome.

PubMed

Abderrahim, Kais; Chebil, Ahmed; Falfoul, Yosra; Bouladi, Mejda; El Matri, Leila

2015-10-01

To report a case of bilateral granulomatous post-streptococcal syndrome uveitis in association with reactive arthritis as manifestation of post-streptococcal syndrome. To our knowledge, this could represent the first reported case in the literature. A 9-year-old girl, with no past ocular history, presented with a 5-day history of bilateral blurred vision, red eyes, photophobia and walking difficulties because of a right ankle pain. Ophthalmic examination disclosed a visual acuity limited to hand motion, mutton-fat keratic precipitates, anterior chamber cells and posterior synechiae in both eyes. Ocular pressure was normal. Physical examination showed a fever (38 °C), inflammatory ankle arthritis and scarlet fever (streptococcal lesion). Anti-streptococcal lysine O titer was 419 μ/ml. The patient was treated with topical steroids, cycloplegics, high-dose oral steroids and preventive course of penicillin with total improvement and no recurrence. Post-streptococcal syndrome should be considered in the etiology of acute bilateral granulomatous uveitis in children, and anti-streptococcal lysine O titer should be considered in serodiagnostic testing.

Nonlinear optimal control policies for buoyancy-driven flows in the built environment

NASA Astrophysics Data System (ADS)

Nabi, Saleh; Grover, Piyush; Caulfield, Colm

2017-11-01

We consider optimal control of turbulent buoyancy-driven flows in the built environment, focusing on a model test case of displacement ventilation with a time-varying heat source. The flow is modeled using the unsteady Reynolds-averaged equations (URANS). To understand the stratification dynamics better, we derive a low-order partial-mixing ODE model extending the buoyancy-driven emptying filling box problem to the case of where both the heat source and the (controlled) inlet flow are time-varying. In the limit of a single step-change in the heat source strength, our model is consistent with that of Bower et al.. Our model considers the dynamics of both `filling' and `intruding' added layers due to a time-varying source and inlet flow. A nonlinear direct-adjoint-looping optimal control formulation yields time-varying values of temperature and velocity of the inlet flow that lead to `optimal' time-averaged temperature relative to appropriate objective functionals in a region of interest.

Case Study: An Ethics Case Study of HIV Prevention Research on Facebook: The Just/Us Study

PubMed Central

Breslin, Lindsey T.; Wright, Erin E.; Black, Sandra R.; Levine, Deborah; Santelli, John S.

2011-01-01

Objective To consider issues related to research with youth on social networking sites online. Methods Description of the data collection process from 1,588 participants in a randomized controlled trial testing the efficacy of HIV prevention education delivered on Facebook. Using respondent-driven sampling, staff-recruited participants are encouraged to recruit up to three friends to enroll in the study. Results Researchers should (a) consider whether an online social networking site is an appropriate place to implement a research study; (b) offer opportunities to review informed consent documents at multiple times and in multiple locations throughout the study; and (c) collect data outside the social networking site and store it behind secure firewalls to ensure it will not be accessible to any person on the social networking site. Conclusions Online social networks are growing in popularity. Conducting research on social media sites requires deliberate attention to consent, confidentiality, and security. PMID:21292724

Transfusion-associated cytomegalovirus mononucleosis.

PubMed Central

Lerner, P I; Sampliner, J E

1977-01-01

Transfusion-associated cytomegalovirus mononucleosis is generally considered only as a complication of extracorporeal circulation following cardiac surgery. Three cases following trauma were recognized in less than one year. Both massive and limited volume blood transfusions were involved. Hectic fever was a characteristic feature in these otherwise remarkably asymptomatic individuals, without the classic features of heterophile-positive infectious mononucleosis. Since the illness developed several weeks into the post-operative period after extensive thoracic or abdominal trauma surgery, the presence of an undrained abscess was naturally the major diagnostic concern. Atypical lymphocytosis, markers of altered immunity (cold agglutinins, rheumatoid factor) and moderate hepatic dysfunction were important laboratory clues. In one case, focal isotope defects in the spleen scan misleadingly suggested a septic complication. A false-positive monospot test initially obscured the correct serologic diagnosis in the same patient. Failure to consider this selflimited viral infection may be a critical factor leading to unnecessary surgery. Other viral agents capable of eliciting a similar syndrome are cited. Images Fig. 1. PMID:190955

Another case of "European hantavirus pulmonary syndrome" with severe lung, prior to kidney, involvement, and diagnosed by viral inclusions in lung macrophages.

PubMed

Gizzi, M; Delaere, B; Weynand, B; Clement, J; Maes, P; Vergote, V; Laenen, L; Hjelle, B; Verroken, A; Dive, A; Michaux, I; Evrard, P; Creytens, D; Bulpa, P

2013-10-01

Puumala virus (PUUV) is considered a classic Old World etiologic agent of nephropathia epidemica (NE), or hemorrhagic fever with renal syndrome (HFRS). HFRS is considered to be distinct from hantavirus (cardio-)pulmonary syndrome (HPS or HCPS), described in the New World. Here, we report a severe case, which fulfilled most, if not all, Centers for Disease Control and Prevention (CDC) criteria for HPS, needing non-invasive ventilation and subsequent acute hemodialysis. However, the etiological agent was PUUV, as proved by serological testing, real-time polymerase chain reaction (PCR), and sequencing. Viral antigen was detected by specific anti-PUUV immunostaining, showing, for the first time, greenish intracytoplasmic inclusions in bronchoalveolar lavage (BAL) macrophages. This case definitely confirms that HPS can be encountered during PUUV infections. Interestingly, special findings could render the diagnosis easier, such as greenish homogeneous cytoplasmic inclusions, surrounded by a fine clear halo in BAL macrophages. Therefore, although the diagnosis remains difficult before the onset of renal involvement, the occurrence of severe respiratory failure mimicking community-acquired pneumonia must alert the clinician for possible HPS, especially in endemic areas.

Numerical analysis of singular solutions of two-dimensional problems of asymmetric elasticity

NASA Astrophysics Data System (ADS)

Korepanov, V. V.; Matveenko, V. P.; Fedorov, A. Yu.; Shardakov, I. N.

2013-07-01

An algorithm for the numerical analysis of singular solutions of two-dimensional problems of asymmetric elasticity is considered. The algorithm is based on separation of a power-law dependence from the finite-element solution in a neighborhood of singular points in the domain under study, where singular solutions are possible. The obtained power-law dependencies allow one to conclude whether the stresses have singularities and what the character of these singularities is. The algorithm was tested for problems of classical elasticity by comparing the stress singularity exponents obtained by the proposed method and from known analytic solutions. Problems with various cases of singular points, namely, body surface points at which either the smoothness of the surface is violated, or the type of boundary conditions is changed, or distinct materials are in contact, are considered as applications. The stress singularity exponents obtained by using the models of classical and asymmetric elasticity are compared. It is shown that, in the case of cracks, the stress singularity exponents are the same for the elasticity models under study, but for other cases of singular points, the stress singularity exponents obtained on the basis of asymmetric elasticity have insignificant quantitative distinctions from the solutions of the classical elasticity.

Investigating the Relation between Women's Body Image and Unconsummated Marriage.

PubMed

Hosseini, Sara; Noroozi, Mahnaz; Montazery, Gita

2017-01-01

Unconsummated marriage is considered to be one of the complicated sexual issues that lead to multiple complications and problems for couples as well as the society. It is thought that this disorder is more common in traditional cultures and some religions such as Islam, Hinduism, and Judaism. The aim of this study was to determine the relation between women's body image and unconsummated marriage. This was a case-control study which was conducted among 50 women who had an unconsummated marriage (case group) and 100 women who had a consummated marriage (control group) in Isfahan, Iran during 2015-2016. Data were collected using the Multidimensional Body-Self Relations Questionnaire (MBSRQ). The data were analyzed using descriptive and inferential statistical tests. The total score of body image and all its components had no significant difference between both the groups of the case and the control ( P > 0.05). Considering that no relation was found between body image and unconsummated marriage and the religious culture of the Iranian society with conservative sexual norms, investigating unconsummated marriage with emphasis on cultural factors is recommended. Hence, such sexual disorders would be avoided and the number of affected people and challenges can be decreased.

Length requirements for numerical-relativity waveforms

NASA Astrophysics Data System (ADS)

Hannam, Mark; Husa, Sascha; Ohme, Frank; Ajith, P.

2010-12-01

One way to produce complete inspiral-merger-ringdown gravitational waveforms from black-hole-binary systems is to connect post-Newtonian (PN) and numerical-relativity (NR) results to create “hybrid” waveforms. Hybrid waveforms are central to the construction of some phenomenological models for gravitational-wave (GW) search templates, and for tests of GW search pipelines. The dominant error source in hybrid waveforms arises from the PN contribution, and can be reduced by increasing the number of NR GW cycles that are included in the hybrid. Hybrid waveforms are considered sufficiently accurate for GW detection if their mismatch error is below 3% (i.e., a fitting factor above 0.97). We address the question of the length requirements of NR waveforms such that the final hybrid waveforms meet this requirement, considering nonspinning binaries with q=M2/M1∈[1,4] and equal-mass binaries with χ=Si/Mi2∈[-0.5,0.5]. We conclude that, for the cases we study, simulations must contain between three (in the equal-mass nonspinning case) and ten (the χ=0.5 case) orbits before merger, but there is also evidence that these are the regions of parameter space for which the least number of cycles will be needed.

Expert scientific judgment and cancer risk assessment: a pilot study of pharmacokinetic data.

PubMed

Hawkins, N C; Graham, J D

1988-12-01

When high-dose tumor data are extrapolated to low doses, it is typically assumed that the dose of a carcinogen delivered to target cells is proportional to the dose administered to test animals, even at exposure levels below the experimental range. Since pharmacokinetic data are becoming available that in some cases question the validity of this assumption, risk assessors must decide whether to maintain the standard assumption. A pilot study of formaldehyde is reported that was undertaken to demonstrate how expert scientific judgment can help guide a controversial risk assessment where pharmacokinetic data are considered inconclusive. Eight experts on pharmacokinetic data were selected by a formal procedure, and each was interviewed personally using a structured interview protocol. The results suggest that expert scientific opinion is polarized in this case, a situation that risk assessors can respond to with a range of risk characterizations considered biologically plausible by the experts. Convergence of expert opinion is likely in this case of several specific research strategies ar executed in a competent fashion. Elicitation of expert scientific judgment is a promising vehicle for evaluating the quality of pharmacokinetic data, expressing uncertainty in risk assessment, and fashioning a research agenda that offers possible forging of scientific consensus.

Low-grade appendiceal mucinous neoplasm mimicking an adnexal mass.

PubMed

Cristian, Daniel Alin; Grama, Florin Andrei; Becheanu, Gabriel; Pop, Anamaria; Popa, Ileana; Şurlin, Valeriu; Stănilescu, Sorin; Bratu, Ana Magdalena; Burcoş, Traean

2015-01-01

We present a rare case of malignant epithelial neoplasm of the appendix, an uncommon disorder encountered in clinical practice, which poses a variety of diagnostic and therapeutic challenges. We report a particular case in which the appendix was abnormally located in the pelvis, mimicking an adnexal mass. Therefore, it was difficult to make the preoperative diagnosis on clinical examination, imaging studies and laboratory tests and we discovered the lesion during the diagnostic laparoscopy. No lymphadenopathy or mucinous ascites were found. The case was completely handled via the laparoscopic approach keeping the appendix intact during the operation. The frozen section, the detailed histopathology overview as well as multiple immunostaining with a complex panel of markers report diagnosed a low-grade appendiceal mucinous neoplasm (LAMN) with no invasion of the wall. No adjuvant therapy was considered needed. At a one-year follow-up oncological assessment, the patient was free of disease. In women with cystic mass in the right iliac fossa an appendiceal mucocele should be considered in the differential diagnosis. Laparoscopic appendectomy can represent an adequate operation for the appendiceal mucinous neoplasm if the histological report is clear and surgical precautionary measures are taken.

Clinically Unsuspected Prion Disease Among Patients With Dementia Diagnoses in an Alzheimer's Disease Database.

PubMed

Maddox, Ryan A; Blase, J L; Mercaldo, N D; Harvey, A R; Schonberger, L B; Kukull, W A; Belay, E D

2015-12-01

Brain tissue analysis is necessary to confirm prion diseases. Clinically unsuspected cases may be identified through neuropathologic testing. National Alzheimer's Coordinating Center (NACC) Minimum and Neuropathologic Data Set for 1984 to 2005 were reviewed. Eligible patients had dementia, underwent autopsy, had available neuropathologic data, belonged to a currently funded Alzheimer's Disease Center (ADC), and were coded as having an Alzheimer's disease clinical diagnosis or a nonprion disease etiology. For the eligible patients with neuropathology indicating prion disease, further clinical information, collected from the reporting ADC, determined whether prion disease was considered before autopsy. Of 6000 eligible patients in the NACC database, 7 (0.12%) were clinically unsuspected but autopsy-confirmed prion disease cases. The proportion of patients with dementia with clinically unrecognized but autopsy-confirmed prion disease was small. Besides confirming clinically suspected cases, neuropathology is useful to identify unsuspected clinically atypical cases of prion disease. © The Author(s) 2015.