Sample records for volume high volume usage

  1. [Pharmacological and mechanical support of the myocardium in perioperative period in cardio-surgical patients with chronic heart failure].

    PubMed

    Babaev, M A; Eremenko, A A; Ziuliaeva, T P; Fedulova, S V; Molochnikov, I O; Fominykh, M V; Poliakova, P V; Dzemeshkevich, S L

    2014-01-01

    The article deals with a retrospective study devoted to the combined methods of myocardial support in cardiosurgical patients with chronic heart failure (III-IY FC according to NYHA) and low myocardial reserves capacity (LVEF 28.3 +/- 9.4%). This methods include pharmacologic (Levosimendan) and mechanical support (IABP). During the work we have analyzed data of 116 patients and measured pressure in the pulmonary artery (mmHg), end-systolic volume (ESV ml), end-diastolic volume (ED, ml), stroke volume output (SVO, ml), left ventricular ejection fraction (LVEF, %). We evaluated the level of valvular insufficiency and pulmonary hypertension (PH) and BNP concentration (pg/ml). The following indications for the usage of pharmacological and/or mechanical myocardial support were identified: I) Preventive usage of pharmacological and/or mechanical myocardial support is recommended for patients with CHF III-IY FC (NYHA) and low left ventricular EF(< or = 35%), significant valvular insufficiency, PH, PICS (postinfarction cardiosclerosis); 2) The certain method of the support can be chosen with the help of Levosimendan infusion testing; 3) In case one of the above mentioned indications (point 1) or in case of mild reaction to levosimendan infusion in patients with the lesions of more than 2 coronary arteries (including the trunk of the left coronary artery) the usage of combined support is recommended; 4) In case of < or = 6 scores according to EUROSCORE scale, lesions of 2 or more coronary arteries, tricuspid insufficiency (TriI), PH, and high pressure in pulmonary artery (higher than the 2nd degree), high end-diastolic volume, end-systolic volume of LV the isolated usage of levosimendan is recommended; 5) In case of significant ischemic heart disease, PICS, lesions of more than 2 coronary arteries, (including the trunk of the left coronary artery) but without significant decrease of pressure in the pulmonary artery, end-diastolic volume, end-systolic volume and TriI the isolated usage of IABP is recommended.

  2. Proceedings of the ECOM Hybrid Microcircuit Symposium, 1976

    DTIC Science & Technology

    1976-06-01

    remove both stationary and moving clutter. The hex fast line receiver micrýocircuit is a thin film chip-and-wire microcircuit (shown in Figure 7) which...of the following: (a) multiple usage, (b) high volume production, or (c) moderate volume and multiple usage. These criteria are not hard and fast ...compounding when the circuit complexity increases. O particular concern are open or intermittent bonds, susceptibility to moisture and impurities in the

  3. Conspicuous vs customary location of hand hygiene agent dispensers on alcohol-based hand hygiene product usage in an intensive care unit.

    PubMed

    Thomas, Bruce W; Berg-Copas, Gina M; Vasquez, Donald G; Jackson, Brandy L; Wetta-Hall, Ruth

    2009-05-01

    Hand washing is considered the single most important nosocomial infection-control strategy, yet compliance rarely meets levels recommended by infection control authorities. To determine whether placement of hand hygiene foam dispensers in more conspicuous positions and closer proximity to patients would increase use of infection control agents as measured by volume of product used. Further, to ascertain the influence of dispenser placement vs the number of dispensers available on usage by volume. This prospective, observational study conducted in an intensive care unit was composed of three observation periods. A control period with standard agent dispenser location (8 dispensers) was followed by two experimental periods: (1) "conspicuous and immediate proximity to patient" placement (16 dispensers) and (2) standard locations with a dramatic increase in the number of dispensers (36 dispensers). Volume of use for alcohol-based hand hygiene agent during the three observation periods revealed a statistically significant increase in daily consumption after conspicuous and proximate positioning of dispensers (P<.001). However, increasing the number of dispensers did not increase agent use (P=.196). More conspicuous placement of dispensers containing alcohol-based hand hygiene agent (ie, immediate proximity to patients) resulted in statistically and clinically significant increases in product usage. An increase in the number of dispensers did not increase usage. The impact of dispenser positioning on usage by volume for these highly effective products should be considered when planning and implementing intensive care unit infection-control policies.

  4. Intrasystem Electromagnetic Compatibility Analysis Program. Volume 2. User’s Manual Usage Section

    DTIC Science & Technology

    1974-12-01

    AD-A008 527 INTRASYSTEM ELECTROMAGNETIC COMPATI- BILITY ANALYSIS PROGRAM. VOLUME II.USER’S MANUAL USAGE SECTION J. L. Bogdanor , et al McDonnell...NUMBERVolume II - User’s Manual Usage Section None 7. AUTHOR(&) 8. CONTRACT OR GRANT NUMBER(s) J.L. Bogdanor F30602-72-C-0277 R.A. Pearlman M.D. Siegel

  5. Norms and attitudes related to alcohol usage and driving : a review of the relevant literature. Volume 4, Report of focus groups

    DOT National Transportation Integrated Search

    1982-09-01

    This project provides information about norms and attitudes related to alcohol usage and driving. This volume reports the methodology, findings, discussion and conclusions of three focus groups: two with parents of teenaged drivers and one with adult...

  6. The long tail: a usage analysis of pre-1993 print biomedical journal literature

    PubMed Central

    Starr, Susan; Williams, Jeff

    2008-01-01

    Objective: The research analyzes usage of a major biomedical library's pre-1993 print journal collection. Methodology: In July 2003, in preparation for a renovation and expansion project, the Biomedical Library at the University of California, San Diego, moved all of its pre-1993 journal volumes off-site, with the exception of twenty-two heavily used titles. Patrons wishing to consult one of these stored volumes could request that it be delivered to the library for their use. In the spring of 2006, an analysis was made of these requests. Results: By July of 2006, 79,827 journal volumes published in 1992 or earlier had been requested from storage. The number of requests received declined with age of publication. The usage distribution exhibited a “long tail”: 50% of the 79,827 requests were for journal volumes published before 1986. The availability of electronic access dramatically reduced the chance that corresponding print journal volumes would be requested. Conclusions: The older biomedical print journal literature appears to be of continued value to the biomedical research community. When electronic access was provided to the older literature, demand for older print volumes declined dramatically. PMID:18219377

  7. Converting Constant Volume, Multizone Air Handling Systems to Energy Efficient Variable Air Volume Multizone Systems

    DTIC Science & Technology

    2017-10-26

    1 FINAL REPORT Converting Constant Volume, Multizone Air Handling Systems to Energy Efficient Variable Air Volume Multizone...Systems Energy and Water Projects Project Number: EW-201152 ERDC-CERL 26 October 2017 2 TABLE OF CONTENTS ACKNOWLEDGEMENTS...16 3.2.1 Energy Usage (Quantitative

  8. Time history solution program, L225 (TEV126). Volume 1: Engineering and usage

    NASA Technical Reports Server (NTRS)

    Kroll, R. I.; Tornallyay, A.; Clemmons, R. E.

    1979-01-01

    Volume 1 of a two volume document is presented. The usage of the convolution program L225 (TEV 126) is described. The program calculates the time response of a linear system by convoluting the impulsive response function with the time-dependent excitation function. The convolution is performed as a multiplication in the frequency domain. Fast Fourier transform techniques are used to transform the product back into the time domain to obtain response time histories. A brief description of the analysis used is presented.

  9. Volume of a laser-induced microjet

    NASA Astrophysics Data System (ADS)

    Kawamoto, Sennosuke; Hayasaka, Keisuke; Noguchi, Yuto; Tagawa, Yoshiyuki

    2015-11-01

    Needle-free injection systems are of great importance for medical treatments. In spite of their great potential, these systems are not commonly used. One of the common problems is strong pain caused by diffusion shape of the jet. To solve this problem, the usage of a high-speed highly-focused microjet as needle-free injection system is expected. It is thus crucial to control important indicators such as ejected volume of the jet for its safe application. We conduct experiments to reveal which parameter influences mostly the ejected volume. In the experiments, we use a glass tube of an inner diameter of 500 micro-meter, which is filled with the liquid. One end is connected to a syringe and the other end is opened. Radiating the pulse laser instantaneously vapors the liquid, followed by the generation of a shockwave. We find that the maximum volume of a laser-induced bubble is approximately proportional to the ejected volume. It is also found that the occurrence of cavitation does not affect the ejected volume while it changes the jet velocity.

  10. Animal health pharmaceutical industry.

    PubMed

    Carnevale, Richard A; Shryock, Thomas R

    2006-02-24

    The animal health pharmaceutical industry has proactively reported on the volumes of member company antimicrobial active ingredients sold in the U.S. At the individual company level, reporting of finished product distribution data to the FDA is a regulatory requirement, with applications to surveillance and pharmacovigilance. An accounting of product manufactured is done for purposes of good business practices, as well as marketing analyses. Additional applications of antimicrobial usage data might include use in risk assessments, such as for the FDA's Center for Veterinary Medicine Guidance for Industry #152 for the evaluation of the microbiological safety of antimicrobials intended for use in food animals. Compilation of national usage data will be a complex undertaking, hindered by issues such as confidentiality, auditing, field use practice variations, population dynamics (e.g. disease incidence, market conditions for poultry and livestock production), and generic usage. The amounts or volumes in pounds should be considered relative to the large number of animals under husbandry in the United States. Large volumes might seem impressive unless put into proper context. Until such time as a clearly defined application of national usage data is agreed, it is recommended that local usage programs will provide more useful information to perpetuate prudent antimicrobial use in animals.

  11. Facebook usage on smartphones and gray matter volume of the nucleus accumbens.

    PubMed

    Montag, Christian; Markowetz, Alexander; Blaszkiewicz, Konrad; Andone, Ionut; Lachmann, Bernd; Sariyska, Rayna; Trendafilov, Boris; Eibes, Mark; Kolb, Julia; Reuter, Martin; Weber, Bernd; Markett, Sebastian

    2017-06-30

    A recent study has implicated the nucleus accumbens of the ventral striatum in explaining why online-users spend time on the social network platform Facebook. Here, higher activity of the nucleus accumbens was associated with gaining reputation on social media. In the present study, we touched a related research field. We recorded the actual Facebook usage of N=62 participants on their smartphones over the course of five weeks and correlated summary measures of Facebook use with gray matter volume of the nucleus accumbens. It appeared, that in particular higher daily frequency of checking Facebook on the smartphone was robustly linked with smaller gray matter volumes of the nucleus accumbens. The present study gives additional support for the rewarding aspects of Facebook usage. Moreover, it shows the feasibility to include real life behavior variables in human neuroscientific research. Copyright © 2017 Elsevier B.V. All rights reserved.

  12. Novel Liquid Sorbent C02 Removal System for Microgravity Applications

    NASA Technical Reports Server (NTRS)

    Rogers, Tanya; Westover, Shayne; Graf, John

    2017-01-01

    Removing Carbon Dioxide (CO2) from a spacecraft environment for deep space exploration requires a robust system that is low in weight, power, and volume. Current state-of-the-art microgravity compatible CO2 removal systems, such as the carbon dioxide removal assembly (CDRA), utilize solid sorbents that demand high power usage due to high desorption temperatures and a large volume to accommodate for their comparatively low capacity for CO2. Additionally, solid sorbent systems contain several mechanical components that significantly reduce reliability and contribute to a large overall mass. A liquid sorbent based system has been evaluated as an alternative is proposed to consume 65% less power, weight, and volume than solid based CO2 scrubbers. This paper presents the design of a liquid sorbent CO2 removal system for microgravity applications.

  13. Conveyor belt care.

    PubMed

    1989-07-08

    Nurses, doctors, politicians and public have reacted to the prospect of high-volume hospital bed usage - conveyor belt care - by warning of a future-shock scenario of 'pro[Illegible Word] pea' patients whipped through dehumanising hospital treatment and promptly dumped crutchless into the community.

  14. Extending the usage of high volume fly ash in concrete.

    DOT National Transportation Integrated Search

    2014-07-01

    Concrete is the worlds most consumed man-made material. Unfortunately, the production of Portland cement, the active ingredient in : concrete, generates a significant amount of carbon dioxide. For each pound of cement produced, approximately one p...

  15. Robotic liquid handling and automation in epigenetics.

    PubMed

    Gaisford, Wendy

    2012-10-01

    Automated liquid-handling robots and high-throughput screening (HTS) are widely used in the pharmaceutical industry for the screening of large compound libraries, small molecules for activity against disease-relevant target pathways, or proteins. HTS robots capable of low-volume dispensing reduce assay setup times and provide highly accurate and reproducible dispensing, minimizing variation between sample replicates and eliminating the potential for manual error. Low-volume automated nanoliter dispensers ensure accuracy of pipetting within volume ranges that are difficult to achieve manually. In addition, they have the ability to potentially expand the range of screening conditions from often limited amounts of valuable sample, as well as reduce the usage of expensive reagents. The ability to accurately dispense lower volumes provides the potential to achieve a greater amount of information than could be otherwise achieved using manual dispensing technology. With the emergence of the field of epigenetics, an increasing number of drug discovery companies are beginning to screen compound libraries against a range of epigenetic targets. This review discusses the potential for the use of low-volume liquid handling robots, for molecular biological applications such as quantitative PCR and epigenetics.

  16. Variability in venom volume, flow rate and duration in defensive stings of five scorpion species.

    PubMed

    van der Meijden, Arie; Coelho, Pedro; Rasko, Mykola

    2015-06-15

    Scorpions have been shown to control their venom usage in defensive encounters, depending on the perceived threat. Potentially, the venom amount that is injected could be controlled by reducing the flow speed, the flow duration, or both. We here investigated these variables by allowing scorpions to sting into an oil-filled chamber, and recording the accreting venom droplets with high-speed video. The size of the spherical droplets on the video can then be used to calculate their volume. We recorded defensive stings of 20 specimens representing 5 species. Significant differences in the flow rate and total expelled volume were found between species. These differences are likely due to differences in overall size between the species. Large variation in both venom flow speed and duration are described between stinging events of single individuals. Both venom flow rate and flow duration correlate highly with the total expelled volume, indicating that scorpions may control both variables in order to achieve a desired end volume of venom during a sting. Copyright © 2015 Elsevier Ltd. All rights reserved.

  17. Microcomputer Applications for Health Care Professionals. Volume I. Curriculum Improvement Project. Region II.

    ERIC Educational Resources Information Center

    Bruce, Lucy

    This volume is one of three in a self-paced computer literacy course that gives allied health students a firm base of knowledge concerning computer usage in the hospital environment. It also develops skill in several applications software packages. Volume I contains materials for a three-hour course. A student course syllabus provides this…

  18. Microcomputer Applications for Health Care Professionals. Volume II. Curriculum Improvement Project. Region II.

    ERIC Educational Resources Information Center

    Bruce, Lucy

    This volume is one of three in a self-paced computer literacy course that gives allied health students a firm base of knowledge concerning computer usage in the hospital environment. It also develops skill in several applications software packages. Volume II contains materials for three one-hour courses on word processing applications, spreadsheet…

  19. Water stress from high-volume hydraulic fracturing potentially threatens aquatic biodiversity and ecosystem services in Arkansas, United States

    USGS Publications Warehouse

    Entrekin, Sally; Trainor, Anne; Saiers, James; Patterson, Lauren; Maloney, Kelly O.; Fargione, Joseph; Kiesecker, Joseph M.; Baruch-Mordo, Sharon; Konschnik, Katherine E.; Wiseman, Hannah; Nicot, Jean-Philippe; Ryan, Joseph N.

    2018-01-01

    Demand for high-volume, short duration water withdrawals could create water stress to aquatic organisms in Fayetteville Shale streams sourced for hydraulic fracturing fluids. We estimated potential water stress using permitted water withdrawal volumes and actual water withdrawals compared to monthly median, low, and high streamflows. Risk for biological stress was considered at 20% of long-term median and 10% of high- and low-flow thresholds. Future well build-out projections estimated potential for continued stress. Most water was permitted from small, free-flowing streams and “frack” ponds (dammed streams). Permitted 12-h pumping volumes exceeded median streamflow at 50% of withdrawal sites in June, when flows were low. Daily water usage, from operator disclosures, compared to median streamflow showed possible water stress in 7–51% of catchments from June–November, respectively. If 100% of produced water was recycled, per-well water use declined by 25%, reducing threshold exceedance by 10%. Future water stress was predicted to occur in fewer catchments important for drinking water and species of conservation concern due to the decline in new well installations and increased use of recycled water. Accessible and precise withdrawal and streamflow data are critical moving forward to assess and mitigate water stress in streams that experience high-volume withdrawals.

  20. Water Stress from High-Volume Hydraulic Fracturing Potentially Threatens Aquatic Biodiversity and Ecosystem Services in Arkansas, United States.

    PubMed

    Entrekin, Sally; Trainor, Anne; Saiers, James; Patterson, Lauren; Maloney, Kelly; Fargione, Joseph; Kiesecker, Joseph; Baruch-Mordo, Sharon; Konschnik, Katherine; Wiseman, Hannah; Nicot, Jean-Philippe; Ryan, Joseph N

    2018-02-20

    Demand for high-volume, short duration water withdrawals could create water stress to aquatic organisms in Fayetteville Shale streams sourced for hydraulic fracturing fluids. We estimated potential water stress using permitted water withdrawal volumes and actual water withdrawals compared to monthly median, low, and high streamflows. Risk for biological stress was considered at 20% of long-term median and 10% of high- and low-flow thresholds. Future well build-out projections estimated potential for continued stress. Most water was permitted from small, free-flowing streams and "frack" ponds (dammed streams). Permitted 12-h pumping volumes exceeded median streamflow at 50% of withdrawal sites in June, when flows were low. Daily water usage, from operator disclosures, compared to median streamflow showed possible water stress in 7-51% of catchments from June-November, respectively. If 100% of produced water was recycled, per-well water use declined by 25%, reducing threshold exceedance by 10%. Future water stress was predicted to occur in fewer catchments important for drinking water and species of conservation concern due to the decline in new well installations and increased use of recycled water. Accessible and precise withdrawal and streamflow data are critical moving forward to assess and mitigate water stress in streams that experience high-volume withdrawals.

  1. Disposable photonic integrated circuits for evanescent wave sensors by ultra-high volume roll-to-roll method.

    PubMed

    Aikio, Sanna; Hiltunen, Jussi; Hiitola-Keinänen, Johanna; Hiltunen, Marianne; Kontturi, Ville; Siitonen, Samuli; Puustinen, Jarkko; Karioja, Pentti

    2016-02-08

    Flexible photonic integrated circuit technology is an emerging field expanding the usage possibilities of photonics, particularly in sensor applications, by enabling the realization of conformable devices and introduction of new alternative production methods. Here, we demonstrate that disposable polymeric photonic integrated circuit devices can be produced in lengths of hundreds of meters by ultra-high volume roll-to-roll methods on a flexible carrier. Attenuation properties of hundreds of individual devices were measured confirming that waveguides with good and repeatable performance were fabricated. We also demonstrate the applicability of the devices for the evanescent wave sensing of ambient refractive index. The production of integrated photonic devices using ultra-high volume fabrication, in a similar manner as paper is produced, may inherently expand methods of manufacturing low-cost disposable photonic integrated circuits for a wide range of sensor applications.

  2. Papers and Studies in Contrastive Linguistics. Volume Twenty.

    ERIC Educational Resources Information Center

    Fisiak, Jacek, Ed.

    Papers on contrastive linguistics in this volume include: "Contrastive Discourse Analysis in Language Usage" (Juliane House); "Typology and Contrastive Analysis" (Vlasta Strakova); "On the Tenability of the Notion 'Pragmatic Equivalence' in Contrastive Analysis" (Karol Janicki); "On the Relevance of Phonetic,…

  3. Temporal and spatial behavior of pharmaceuticals in Narragansett Bay, Rhode Island, United States

    EPA Science Inventory

    The behavior of active pharmaceutical ingredients (APIs) in urban estuaries is not well understood. In this study, 15 high volume usage APIs were measured over a one year period throughout Narragansett Bay, RI, USA to determine factors controlling their concentration and distrib...

  4. Evaluation of anabolic steroid induced renal damage with sonography in bodybuilders.

    PubMed

    Kantarci, Umut H; Punduk, Zekine; Senarslan, Omer; Dirik, Alper

    2017-11-17

    The aim of this study was to investigate the effect of anabolic steroids on kidneys in bodybuilders. Twenty two bodybuilders were included in the study. Participants were divided into three groups according to the scheme of steroid usage: Group 1 (n=8, intramuscular 500 mg testosterone enanthate, intramuscular 400 mg nandrolone decanoate and oral 40 mg methandrostenolone for 12 weeks), Group 2 (n=7, intramuscular 500 mg testosterone enanthate, intramuscular 300 mg nandrolone decanoate and intramuscular 300 mg boldenone undecylenate for 16 weeks) and Group 3 (n=7, no steroid intake). Blood urea nitrogen (BUN), creatinine (Cr), urine microalbumin and electrolyte levels were measured. Renal volume, cortical thickness and echogenicity were obtained in ultrasonographic scans. Renal volume, cortical thickness, echogenicity and protein intake value were significantly higher in group 2 than group 1 and 3. Plasma levels of BUN and Cr in group 2 were significantly higher than other groups (p ˂ 0.001). Urine microalbumin and electrolyte levels were normal in all groups. The results of this study indicate that high protein intake, steroid usage, particularly the schemes, including boldenone undecylenate increases cortical echogenicity, thickness of renal parenchyma and renal volume in bodybuilders.

  5. Norms and attitudes related to alcohol usage and driving : a review of the relevant literature. Volume 3, Report of individual interviews

    DOT National Transportation Integrated Search

    1982-09-01

    This project provides information about norms and attitudes related to alcohol use and driving. This volume reports the methodology, findings, discussions, and conclusions of individual interviews conducted with early adolescents (ages 13-14), middle...

  6. IMPROVED BIOSAND FILTERS BY ENHANCED MONITORING AND DATA COLLECTION METHODS

    EPA Science Inventory

    The result of this project will be the development of a sensor that will automatically and accurately record BSF use, flow rate, and volume of water poured in. The quantitative volume and flow rate data output will be used to compare actual BSF frequency and usage patterns ...

  7. Norms and attitudes related to alcohol usage and driving : a review of the relevant literature. Volume 1 : a review of the literature

    DOT National Transportation Integrated Search

    1982-09-01

    This project provides information on norms and attitudes related to alcohol use and driving. This volume contains a review and analysis of the literature pertaining to attitude formation and change, attitudes towards alcohol use/abuse, attitudes asso...

  8. Wet Scrubber System Study. Volume II. Final Report and Bibliography.

    ERIC Educational Resources Information Center

    Calvert, Seymour; And Others

    This report is the second volume of a two-part study on wet scrubber systems. The study was undertaken to achieve the following objectives: (1) evaluate current engineering technology, (2) evaluate existing scrubber systems, (3) investigate present usage problems, (4) determine potential new applications, and (5) develop specific research…

  9. Automatic transfer function generation for volume rendering of high-resolution x-ray 3D digital mammography images

    NASA Astrophysics Data System (ADS)

    Alyassin, Abdal M.

    2002-05-01

    3D Digital mammography (3DDM) is a new technology that provides high resolution X-ray breast tomographic data. Like any other tomographic medical imaging modalities, viewing a stack of tomographic images may require time especially if the images are of large matrix size. In addition, it may cause difficulty to conceptually construct 3D breast structures. Therefore, there is a need to readily visualize the data in 3D. However, one of the issues that hinder the usage of volume rendering (VR) is finding an automatic way to generate transfer functions that efficiently map the important diagnostic information in the data. We have developed a method that randomly samples the volume. Based on the mean and the standard deviation of these samples, the technique determines the lower limit and upper limit of a piecewise linear ramp transfer function. We have volume rendered several 3DDM data using this technique and compared visually the outcome with the result from a conventional automatic technique. The transfer function generated through the proposed technique provided superior VR images over the conventional technique. Furthermore, the improvement in the reproducibility of the transfer function correlated with the number of samples taken from the volume at the expense of the processing time.

  10. Ultraviolet spectrometer and polarimeter (UVSP) catalog of observations. Volume 2: Experiments 30720-63057, April 1985 - February 1988

    NASA Technical Reports Server (NTRS)

    Henze, William, Jr.

    1993-01-01

    A catalog of observations (experiments) obtained by the Ultraviolet Spectrometer and Polarimeter (UVSP) on the Solar Maximum Mission (SMM) from Feb. 1980 to Nov. 1989 is presented. The information for each entry includes the time of each observation, the observed position of the Sun, the spacecraft roll angle, the slit used, and instrument parameters such as raster size, pixel spacing, wavelength, polarimeter usage, gate time, etc. The document is split into three volumes: Volume 1 contains experiments 1-30719 (February 1980-April 1985); Volume 2 contains experiments 30720-63057 (April 1985-February 1988); and Volume 3 contains experiments 63058-99771 (February 1988-November 1989).

  11. Ultraviolet spectrometer and polarimeter (UVSP) catalog of observations. Volume 1: Experiments 1-30719, February 1980 - April 1985

    NASA Technical Reports Server (NTRS)

    Henze, William, Jr.

    1993-01-01

    A catalog of observations (experiments) obtained by the Ultraviolet Spectrometer and Polarimeter (UVSP) on the Solar Maximum Mission (SMM) from Feb. 1980 to Nov. 1989 is presented. The information for each entry includes the time of each observation, the observed position of the Sun, the spacecraft roll angle, the slit used, and instrument parameters such as raster size, pixel spacing, wavelength, polarimeter usage, gate time, etc. The document is split into three volumes: Volume 1 contains experiments 1-30719 (February 1980-April 1985); Volume 2 contains experiments 30720-63057 (April 1985-February 1988); and Volume 3 contains experiments 63058-99771 (February l988-November 1989).

  12. Near infrared measurment of cotton fiber micronaire by portable near infrared instrumentation

    USDA-ARS?s Scientific Manuscript database

    Cotton production and usage is a global enterprise, and the export of U.S. cotton has increased dramatically. In the U.S., cotton is classed (and its primary quality parameters determined) by the Uster® High Volume Instrument (HVI), which must be maintained under tightly controlled laboratory envir...

  13. Source determination of benzotriazoles in sediment cores from two urban estuaries on the Atlantic Coast of the United States

    EPA Science Inventory

    Benzotriazoles (BZTs) are used in a broad range of commercial and industrial products, particularly as metal corrosion inhibitors and as ultraviolet (UV) light stabilizer additives in plastics and polymers. Their long-term usage and high production volumes have resulted in the r...

  14. Energy Information Abstracts Annual 1988. Volume 13.

    ERIC Educational Resources Information Center

    Yuster, Leigh C., Ed.; And Others

    This publication is a compilation of information and resource material concerning energy for the year 1988. The first section details the coverage and usage of this volume. Section 2 contains a review of events in 1988, a compilation of statistical information, an article concerning coal flyash utilization, and a listing of conferences and events…

  15. Norms and attitudes related to alcohol usage and driving : a review of the literature. Volume 2, A meta-analysis of primary prevention studies

    DOT National Transportation Integrated Search

    1982-09-01

    This project provides information on norms and attitudes related to alcohol use and driving. This volume contains a review and analysis of the literature pertaining to attitude formation and change, attitudes towards alcohol use/abuse, attitudes asso...

  16. Health Information System Simulation. Curriculum Improvement Project. Region II.

    ERIC Educational Resources Information Center

    Anderson, Beth H.; Lacobie, Kevin

    This volume is one of three in a self-paced computer literacy course that gives allied health students a firm base of knowledge concerning computer usage in the hospital environment. It also develops skill in several applications software packages. This volume contains five self-paced modules that allow students to interact with a health…

  17. 40 CFR 89.207 - Credit calculation.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ...) × (Volume) × (AvgPR) × (UL) × (Adjustment) × (10−6) (ii) For determining credit usage for all engine...) × (Volume) × (AvgPR) × (UL) × (10−6) Where: Std = the applicable Tier 1 NOX nonroad engine emission standard... for end-of-year compliance determination. AvgPR = the average power rating of all of the...

  18. U. S. research safety vehicle (RSV) phase I program. Volume III. RSV characteristics and performance specifications. Final report, Jan 1974--Apr 1975

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

    Andon, J.; Dodson, E.; Khadilkar, A.

    1975-06-01

    Current passenger car usage patterns and factors influencing usage are analyzed and projections of usage patterns in the mid-1980's are made. Current available data on six categories of vehicle accidents are analyzed and projections made of national accident patterns in the mid-80's; the effect of potential reductions in these projections as a result of safety programs and other factors related to driving safety are estimated. Based on the usage and accident projections, the characteristics of an RSV (weighing under 3,000 lbs C.W.) for operation in the mid-1980 traffic environment are described. A recommended set of specifications for the RSV aremore » developed considering the potential safety payoff accruing to an increased level of safety performance, the need for energy conservation, availability of material resources, and changes in vehicle mix. (An executive summary of this report is presented in Volume I).« less

  19. Low ERCP Volume Is Associated with More Industry Representative Interactions but Similar Training of Nurses.

    PubMed

    Keswani, Rajesh N; Malpas, Phyllis; Lynch, Sheryl E; Coté, Gregory A

    2016-03-01

    Data on ERCP nurses and associate (ERCP-NA) training and comfort are lacking. Healthcare industry representative (HCIR) influence may be greater in low-volume units (LVUs) due to decreased procedure and device familiarity. The aim of this study was to compare ERCP-NA training, safety, and HCIR relationships between LVU and high-volume unit (HVU) ERCP facilities. We conducted an electronic survey of all Society of Gastroenterology Nurses and Associates (SGNA) members assessing: (1) demographics and procedure volume, (2) ERCP training and radiation safety, and (3) HCIR interactions. Responses were stratified by ERCP volume. Among 832 SGNA member respondents (median age 55), 615 (74%) worked as an ERCP-NA; 41% derived from LVUs. The majority of ERCP-NAs, irrespective of unit volume, had observed <50 ERCPs before starting. Except for lead glasses, the majority (>80%) adhered to basic radiation safety, irrespective of unit volume. LVUs were more likely than HVU ERCP-NAs to agree that HCIRs were requested for intra-procedure assistance (24 vs. 19%, p = 0.008), asked for input on the next choice of device (22 vs. 15%, p = 0.01), and assist in device usage (27 vs. 22%, p = 0.04). Irrespective of volume, 30% agreed that they were more likely to utilize a company's devices if that HCIR was present. ERCP-NA training before independent participation in ERCP is suboptimal. HCIRs are frequently requested for assistance during ERCPs, especially in LVUs. HCIR impact on ERCP outcomes and device utilization and whether enhanced ERCP-NA training will impact the role of HCIR, require further study.

  20. Study of Manpower Requirements by Occupation for Alternative Technologies in the Energy-Related Industries, 1970-1990. Volumes I, IIA, and III.

    ERIC Educational Resources Information Center

    Gutmanis, Ivars; And Others

    The report presents the methodology used by the National Planning Association (NPA), under contract to the Federal Energy Administration (FEA), to estimate direct labor usage coefficients in some sixty different occupational categories involved in construction, operation, and maintenance of energy facilities. Volume 1 presents direct labor usage…

  1. Department of Defense Acquisition of Vaccine Production. Volume 1

    DTIC Science & Technology

    2000-12-01

    and by Science Applications International Corporation (SAIC) under a contract with the Office of the Director, Defense Research and Engineering...development clinical trials, manufacturing, and development; requires application of state-of- testing the-art research capability to problem solving...trials, vaccine recommending usage manufacturing scale, and logistics bodies (e.g., AFEB, ACIP) License application Prepare and submit -100 volume

  2. Design of ERIC Usage Studies. Volume I.

    ERIC Educational Resources Information Center

    ERIC Clearinghouse on Information Resources, Syracuse, NY.

    Tables showing the types of Educational Resources Information Center (ERIC) products and their dispersion provide background information for the executive summaries of usage study design reports focusing on three levels: (1) system operations; (2) subscribers to the services provided; and (3) the ultimate "end-users" of the service. The…

  3. Design of ERIC Usage Studies. Volume II.

    ERIC Educational Resources Information Center

    ERIC Clearinghouse on Information Resources, Syracuse, NY.

    This document contains reports examining research designs for Educational Resources Information Center (ERIC) usage studies at three levels: (1) system operations; (2) subscribers to the services provided; and (3) the ultimate "end-users" of the service. The first level report, which addresses ERIC as an information network, proposes two…

  4. Comparison of levonorgestrel-releasing intrauterine device with oral progestins in heavy menstrual bleeding (HMB) cases with uterine leiomyoma (LNG-IUD and oral progestin usage in myoma uteri).

    PubMed

    Tosun, Ayse Kavasoglu; Tosun, Ismet; Suer, Necdet

    2014-07-01

    To compare the effectiveness and acceptability of LNG-IUD with oral progesterone (norethisterone acetate; NETA) in achieving a reduction in volume of the myomas, hemoglobin levels, satisfaction of the women. This study includes randomized 30 women treated by LNG-IUD and randomized 30 women treated by oral norethisterone (NETA). All these participants in the study have received medical treatment and had been registered as patients in Istanbul Medeniyet University Göztepe Education and Research Hospital. Leiomyoma volumes and hemoglobin levels have been determined. In the third and sixth months, these measurements have been done again. We examined the adverse effects and the treatment continuity. For the statistical analysis of the findings NCSS [Number Cruncher Statistical System] 2007 & PASS 2008 program; student t, Mann Whitney U, Paired Samples t, Wilcoxon Signed Ranks, Ki-Kare, Fisher's Exact Ki-Kare tests have been used. After six months treatment, the reduction of bleeding determined by Visual Bleeding Score (VBS) in LNG-IUD group is 80% and in oral norethisteron group is 56%; in both groups leiomyoma volumes and hemoglobin levels were significantly high. LNG-IUD is a good alternative treatment to the oral progesterone in long term minimizing the hysterectomy for myoma uteri because of the good patient tolerance and easy usage.

  5. The three-dimensional Multi-Block Advanced Grid Generation System (3DMAGGS)

    NASA Technical Reports Server (NTRS)

    Alter, Stephen J.; Weilmuenster, Kenneth J.

    1993-01-01

    As the size and complexity of three dimensional volume grids increases, there is a growing need for fast and efficient 3D volumetric elliptic grid solvers. Present day solvers are limited by computational speed and do not have all the capabilities such as interior volume grid clustering control, viscous grid clustering at the wall of a configuration, truncation error limiters, and convergence optimization residing in one code. A new volume grid generator, 3DMAGGS (Three-Dimensional Multi-Block Advanced Grid Generation System), which is based on the 3DGRAPE code, has evolved to meet these needs. This is a manual for the usage of 3DMAGGS and contains five sections, including the motivations and usage, a GRIDGEN interface, a grid quality analysis tool, a sample case for verifying correct operation of the code, and a comparison to both 3DGRAPE and GRIDGEN3D. Since it was derived from 3DGRAPE, this technical memorandum should be used in conjunction with the 3DGRAPE manual (NASA TM-102224).

  6. A Survey of Journal Use Within the Undergraduate Library at the University of Illinois at Urbana-Champaign.

    ERIC Educational Resources Information Center

    Konopasek, Katherine; O'Brien, Nancy Patricia

    A survey was conducted from mid-January to mid-April 1980 in order to evaluate patterns of use for individual titles within the periodical section of the Undergraduate Library (UGL) of the University of Illinois at Urbana-Champaign. Bound volume usage was measured by affixing self-adhesive markers to volume spines when reshelving, and later…

  7. Methamphetamine users show greater than normal age-related cortical gray matter loss.

    PubMed

    Nakama, Helenna; Chang, Linda; Fein, George; Shimotsu, Ryan; Jiang, Caroline S; Ernst, Thomas

    2011-08-01

    Methamphetamine (Meth) abuse continues to be a major illicit drug of abuse. Neuroimaging findings suggest that Meth is neurotoxic and may alter various brain structures, but the effect of Meth on the aging brain has not been studied. The aim was to determine regional volumes of cortical gray matter in the brains of adult Meth users versus healthy control subjects, and their interaction with age and Meth-usage variables. Cross-sectional study Magnetic resonance imaging (MRI) Research Center located in a university-affiliated hospital. Thirty-four Meth-dependent subjects (21 men and 13 women; ages 33.1 ± 8.9 years), diagnosed according to DSM-IV criteria, and 31 healthy non-Meth user comparison subjects (23 men and 8 women ages 35.7 ± 8.4 years). Regional gray matter volumes were segmented automatically in all subjects and evaluated in relation to age, using high-resolution MRIs at 3.0 Tesla. After adjustment for the effects of cranium size, the Meth users showed enhanced cortical gray matter volume loss with age in the frontal (analysis of covariance interaction P = 0.02), occipital (interaction P = 0.01), temporal (interaction P < 0.001) and the insular lobes (interaction P = 0.01) compared to controls, independently of Meth-usage patterns. Additionally, Meth users showed smaller gray matter volumes than control subjects in several subregions (dorsolateral prefrontal: P = 0.02; orbitofrontal: P = 0.03; prefrontal: P = 0.047; superior temporal: P = 0.04). Methamphetamine users appear to show increased cortical gray matter loss with age which raises the possibility of accelerated decline in mental functioning. © 2011 The Authors, Addiction © 2011 Society for the Study of Addiction.

  8. Using high-order polynomial basis in 3-D EM forward modeling based on volume integral equation method

    NASA Astrophysics Data System (ADS)

    Kruglyakov, Mikhail; Kuvshinov, Alexey

    2018-05-01

    3-D interpretation of electromagnetic (EM) data of different origin and scale becomes a common practice worldwide. However, 3-D EM numerical simulations (modeling)—a key part of any 3-D EM data analysis—with realistic levels of complexity, accuracy and spatial detail still remains challenging from the computational point of view. We present a novel, efficient 3-D numerical solver based on a volume integral equation (IE) method. The efficiency is achieved by using a high-order polynomial (HOP) basis instead of the zero-order (piecewise constant) basis that is invoked in all routinely used IE-based solvers. We demonstrate that usage of the HOP basis allows us to decrease substantially the number of unknowns (preserving the same accuracy), with corresponding speed increase and memory saving.

  9. Atlas International de la vitalite Linguistique, Volume 1. Les langues constitutionnelles de l'Indie = International Atlas of Language Vitality. Volume 1: Constitutional Languages of India.

    ERIC Educational Resources Information Center

    McConnell, Grant D., Ed.; Gendron, Jean-Denis, Ed.

    This International atlas of language vitality offers a cartography of language functions, based on a quantitative measure of the vitality of each language. It covers the constitutional languages of India, and offers maps, graphs, and data tables illustrating the vitality ratings of 14 languages by state, domain of usage (religion, schools, mass…

  10. 40 CFR Table 3 to Subpart II of... - Summary of Recordkeeping and Reporting Requirements abc

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... abc Requirement All Opts. Rec Rep Option 1 Rec Rep Option 2 Rec Rep Option 3 Rec Rep Notification (§ 63.9(a)-(d)) X X Implementation plan (§ 63.787(b)) d X X Volume of coating applied at unaffected major sources (§ 63.781(b)) X Volume of each low-usage-exempt coating applied at affected sources (§ 63...

  11. 40 CFR Table 3 to Subpart II of... - Summary of Recordkeeping and Reporting Requirements abc

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... abc Requirement All Opts. Rec Rep Option 1 Rec Rep Option 2 Rec Rep Option 3 Rec Rep Notification (§ 63.9(a)-(d)) X X Implementation plan (§ 63.787(b)) d X X Volume of coating applied at unaffected major sources (§ 63.781(b)) X Volume of each low-usage-exempt coating applied at affected sources (§ 63...

  12. 40 CFR Table 3 to Subpart II of... - Summary of Recordkeeping and Reporting Requirements abc

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... abc Requirement All Opts. Rec Rep Option 1 Rec Rep Option 2 Rec Rep Option 3 Rec Rep Notification (§ 63.9(a)-(d)) X X Implementation plan (§ 63.787(b)) d X X Volume of coating applied at unaffected major sources (§ 63.781(b)) X Volume of each low-usage-exempt coating applied at affected sources (§ 63...

  13. 40 CFR Table 3 to Subpart II of... - Summary of Recordkeeping and Reporting Requirements abc

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... abc Requirement All Opts. Rec Rep Option 1 Rec Rep Option 2 Rec Rep Option 3 Rec Rep Notification (§ 63.9(a)-(d)) X X Implementation plan (§ 63.787(b)) d X X Volume of coating applied at unaffected major sources (§ 63.781(b)) X Volume of each low-usage-exempt coating applied at affected sources (§ 63...

  14. 40 CFR Table 3 to Subpart II of... - Summary of Recordkeeping and Reporting Requirements abc

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... abc Requirement All Opts. Rec Rep Option 1 Rec Rep Option 2 Rec Rep Option 3 Rec Rep Notification (§ 63.9(a)-(d)) X X Implementation plan (§ 63.787(b)) d X X Volume of coating applied at unaffected major sources (§ 63.781(b)) X Volume of each low-usage-exempt coating applied at affected sources (§ 63...

  15. Availability of epidemiologic data on humans exposed to animal carcinogens. II. Chemical uses and production volume

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

    Karstadt, M.; Bobal, R.

    1982-01-01

    We report further findings of a survey of manufacturers, processors, and importers of chemicals determined by the International Agency for Research on Cancer (IARC) to be animal carcinogens, but whose carcinogenicity in humans was considered uncertain because of inadequate epidemiologic data. We requested epidemiologic studies from the companies marketing or using any of the 75 IARC animal carcinogens in commerce in the United States. Eighteen of the 75 IARC animal carcinogens had volumes listed of 10(6) lb/year or greater, with 8 of the 13 chemicals for which studies had been completed or are in progress in this ''high volume'' category.more » The use category with the largest number of chemicals was drugs--19 of the 75 IARC animal carcinogens were in this category. However, none of the 13 chemicals included in epidemiologic studies was a drug. Seven of the 13 chemicals included in studies were used primarily as pesticides. We received little information on dyes and dye intermediates, experimental carcinogens, and drugs, all of which are produced in relatively low volumes; these categories represent 42 of the 75 IARC animal carcinogens. Low volumes and declining usage/production appear to be barriers to performance of epidemiologic studies. Information we received suggests that sometimes the problem of low production volume may be avoided by studying users rather than production workers. Overall, however, we expect few additional epidemiologic studies of the 75 IARC animal carcinogens.« less

  16. Self-Interaction Chromatography of mAbs: Accurate Measurement of Dead Volumes.

    PubMed

    Hedberg, S H M; Heng, J Y Y; Williams, D R; Liddell, J M

    2015-12-01

    Measurement of the second virial coefficient B22 for proteins using self-interaction chromatography (SIC) is becoming an increasingly important technique for studying their solution behaviour. In common with all physicochemical chromatographic methods, measuring the dead volume of the SIC packed column is crucial for accurate retention data; this paper examines best practise for dead volume determination. SIC type experiments using catalase, BSA, lysozyme and a mAb as model systems are reported, as well as a number of dead column measurements. It was observed that lysozyme and mAb interacted specifically with Toyopearl AF-Formyl dead columns depending upon pH and [NaCl], invalidating their dead volume usage. Toyopearl AF-Amino packed dead columns showed no such problems and acted as suitable dead columns without any solution condition dependency. Dead volume determinations using dextran MW standards with protein immobilised SIC columns provided dead volume estimates close to those obtained using Toyopearl AF-Amino dead columns. It is concluded that specific interactions between proteins, including mAbs, and select SIC support phases can compromise the use of some standard approaches for estimating the dead volume of SIC columns. Two other methods were shown to provide good estimates for the dead volume.

  17. Electrical-power-system data base for consumables analysis. Volume 2: Electrical equipment utilization

    NASA Technical Reports Server (NTRS)

    Pipher, M. D.; Green, P. A.; Wolfgram, D. F.

    1975-01-01

    A catalogue is presented of space shuttle electrical equipment as used within a standardized data base for EPS consumables analyses. The general function and expected usage of each type of electrical equipment are described, and the usage of specific equipment of each type in the performance of EPS consumables analyses is defined.

  18. A Method for Measuring Collection Expansion Rates and Shelf Space Capacities.

    ERIC Educational Resources Information Center

    Sapp, Gregg; Suttle, George

    1994-01-01

    Describes an effort to quantify annual collection expansion and shelf space capacities with a computer spreadsheet program. Methods used to quantify the space taken at the beginning of the project; to estimate annual rate of collection growth; and to plot stack space and usage, volume equivalents and usage, and growth capacity are covered.…

  19. Kinetic Glomerular Filtration Rate Equation Can Accommodate a Changing Body Volume: Derivation and Usage of the Formula.

    PubMed

    Chen, Sheldon

    2018-05-22

    Ascertaining a patient's kidney function is more difficult to do when the serum creatinine is changing than when it is stable. To accomplish the task, various kinetic clearance equations have been developed. To date, however, none of them have allowed for ongoing changes to the creatinine's volume of distribution. These diluting or concentrating effects on the [creatinine] can greatly impact the accuracy of kidney function assessment. Described herein is a model of creatinine kinetics that also accommodates volume changes. The differential equation is solved for the kinetic glomerular filtration rate (GFR), which is helpful information to the physician. Some of the equation's discontinuities, such as from dividing by a volume rate of zero, can be resolved by using limits. Being "volume-capable," the new kinetic equation reveals how a changing volume influences the maximum rate of rise in [creatinine], a parameter that heretofore was chosen empirically. To show the advantages of incorporating volume, the new and old kinetic equations are applied to a clinical case of overzealous fluid resuscitation. Appropriately, when the volume gain's dilution of [creatinine] is taken into account, the creatinine clearance is calculated to be substantially lower. In conclusion, the kinetic GFR equation has been upgraded to handle volume changes simultaneously with [creatinine] changes. Copyright © 2018. Published by Elsevier Inc.

  20. 40 CFR 52.254 - Organic solvent usage.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... volume of solvent: (1) A combination of hydrocarbons, alcohols, aldehydes, esters, ethers, or ketones... benzoate; 8 percent; (3) A combination of ethylbenzene, ketones having branched hydrocarbon structures...

  1. LSENS, a general chemical kinetics and sensitivity analysis code for homogeneous gas-phase reactions. 2: Code description and usage

    NASA Technical Reports Server (NTRS)

    Radhakrishnan, Krishnan; Bittker, David A.

    1994-01-01

    LSENS, the Lewis General Chemical Kinetics Analysis Code, has been developed for solving complex, homogeneous, gas-phase chemical kinetics problems and contains sensitivity analysis for a variety of problems, including nonisothermal situations. This report is part 2 of a series of three reference publications that describe LSENS, provide a detailed guide to its usage, and present many example problems. Part 2 describes the code, how to modify it, and its usage, including preparation of the problem data file required to execute LSENS. Code usage is illustrated by several example problems, which further explain preparation of the problem data file and show how to obtain desired accuracy in the computed results. LSENS is a flexible, convenient, accurate, and efficient solver for chemical reaction problems such as static system; steady, one-dimensional, inviscid flow; reaction behind incident shock wave, including boundary layer correction; and perfectly stirred (highly backmixed) reactor. In addition, the chemical equilibrium state can be computed for the following assigned states: temperature and pressure, enthalpy and pressure, temperature and volume, and internal energy and volume. For static problems the code computes the sensitivity coefficients of the dependent variables and their temporal derivatives with respect to the initial values of the dependent variables and/or the three rate coefficient parameters of the chemical reactions. Part 1 (NASA RP-1328) derives the governing equations describes the numerical solution procedures for the types of problems that can be solved by lSENS. Part 3 (NASA RP-1330) explains the kinetics and kinetics-plus-sensitivity-analysis problems supplied with LSENS and presents sample results.

  2. Westinghouse Modular Grinding Process - Enhancement of Volume Reduction for Hot Resin Supercompaction - 13491

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

    Fehrmann, Henning; Aign, Joerg

    2013-07-01

    In nuclear power plants (NPP) ion exchange (IX) resins are used in several systems for water treatment. Spent resins can contain a significant amount of contaminates which makes treatment for disposal of spent resins mandatory. Several treatment processes are available such as direct immobilization with technologies like cementation, bitumisation, polymer solidification or usage of a high integrity container (HIC). These technologies usually come with a significant increase in final waste volume. The Hot Resin Supercompaction (HRSC) is a thermal treatment process which reduces the resin waste volume significantly. For a mixture of powdered and bead resins the HRSC process hasmore » demonstrated a volume reduction of up to 75 % [1]. For bead resins only the HRSC process is challenging because the bead resins compaction properties are unfavorable. The bead resin material does not form a solid block after compaction and shows a high spring back effect. The volume reduction of bead resins is not as good as for the mixture described in [1]. The compaction properties of bead resin waste can be significantly improved by grinding the beads to powder. The grinding also eliminates the need for a powder additive.Westinghouse has developed a modular grinding process to grind the bead resin to powder. The developed process requires no circulation of resins and enables a selective adjustment of particle size and distribution to achieve optimal results in the HRSC or in any other following process. A special grinding tool setup is use to minimize maintenance and radiation exposure to personnel. (authors)« less

  3. Satellite services system analysis study. Volume 3: Service equipment requirements

    NASA Technical Reports Server (NTRS)

    1981-01-01

    Service equipment mission requirements are discussed. On-orbit operations, satellite classes, and reference missions are included. Service equipment usage and requirements are considered. Equipment identification methodology is discussed. Service equipment usage is analyzed, including initial launch, revisit, Earth return, and orbital storage. A summary of service requirements and equipment is presented, including service equipment status, even interaction, satellite features, and observations.

  4. Collecting conditions usage metadata to optimize current and future ATLAS software and processing

    NASA Astrophysics Data System (ADS)

    Rinaldi, L.; Barberis, D.; Formica, A.; Gallas, E. J.; Oda, S.; Rybkin, G.; Verducci, M.; ATLAS Collaboration

    2017-10-01

    Conditions data (for example: alignment, calibration, data quality) are used extensively in the processing of real and simulated data in ATLAS. The volume and variety of the conditions data needed by different types of processing are quite diverse, so optimizing its access requires a careful understanding of conditions usage patterns. These patterns can be quantified by mining representative log files from each type of processing and gathering detailed information about conditions usage for that type of processing into a central repository.

  5. Hydraulic fracturing water use variability in the United States and potential environmental implications

    PubMed Central

    Varela, Brian A.; Haines, Seth S.; Engle, Mark A.

    2015-01-01

    Abstract Until now, up‐to‐date, comprehensive, spatial, national‐scale data on hydraulic fracturing water volumes have been lacking. Water volumes used (injected) to hydraulically fracture over 263,859 oil and gas wells drilled between 2000 and 2014 were compiled and used to create the first U.S. map of hydraulic fracturing water use. Although median annual volumes of 15,275 m3 and 19,425 m3 of water per well was used to hydraulically fracture individual horizontal oil and gas wells, respectively, in 2014, about 42% of wells were actually either vertical or directional, which required less than 2600 m3 water per well. The highest average hydraulic fracturing water usage (10,000−36,620 m3 per well) in watersheds across the United States generally correlated with shale‐gas areas (versus coalbed methane, tight oil, or tight gas) where the greatest proportion of hydraulically fractured wells were horizontally drilled, reflecting that the natural reservoir properties influence water use. This analysis also demonstrates that many oil and gas resources within a given basin are developed using a mix of horizontal, vertical, and some directional wells, explaining why large volume hydraulic fracturing water usage is not widespread. This spatial variability in hydraulic fracturing water use relates to the potential for environmental impacts such as water availability, water quality, wastewater disposal, and possible wastewater injection‐induced earthquakes. PMID:26937056

  6. Hydraulic fracturing water use variability in the United States and potential environmental implications

    USGS Publications Warehouse

    Gallegos, Tanya J.; Varela, Brian A.; Haines, Seth S.; Engle, Mark A.

    2015-01-01

    Until now, up-to-date, comprehensive, spatial, national-scale data on hydraulic fracturing water volumes have been lacking. Water volumes used (injected) to hydraulically fracture over 263,859 oil and gas wells drilled between 2000 and 2014 were compiled and used to create the first U.S. map of hydraulic fracturing water use. Although median annual volumes of 15,275 m3 and 19,425 m3 of water per well was used to hydraulically fracture individual horizontal oil and gas wells, respectively, in 2014, about 42% of wells were actually either vertical or directional, which required less than 2600 m3 water per well. The highest average hydraulic fracturing water usage (10,000−36,620 m3 per well) in watersheds across the United States generally correlated with shale-gas areas (versus coalbed methane, tight oil, or tight gas) where the greatest proportion of hydraulically fractured wells were horizontally drilled, reflecting that the natural reservoir properties influence water use. This analysis also demonstrates that many oil and gas resources within a given basin are developed using a mix of horizontal, vertical, and some directional wells, explaining why large volume hydraulic fracturing water usage is not widespread. This spatial variability in hydraulic fracturing water use relates to the potential for environmental impacts such as water availability, water quality, wastewater disposal, and possible wastewater injection-induced earthquakes.

  7. Virtual industrial water usage and wastewater generation in the Middle East/North African region

    NASA Astrophysics Data System (ADS)

    Sakhel, S. R.; Geissen, S.-U.; Vogelpohl, A.

    2013-01-01

    This study deals with the quantification of volumes of water usage, wastewater generation, virtual water export, and wastewater generation from export for eight export relevant industries present in the Middle East/North Africa (MENA). It shows that about 3400 million m3 of water is used per annum while around 793 million m3 of wastewater is generated from products that are meant for domestic consumption and export. The difference between volumes of water usage and wastewater generation is due to water evaporation or injecting underground (oil wells pressure maintenance). The wastewater volume generated from production represents a population equivalent of 15.5 million in terms of wastewater quantity and 30.4 million in terms of BOD. About 409 million m3 of virtual water flows from MENA to EU27 (resulting from export of eight commodities) which is equivalent to 12.1% of the water usage of those industries and Libya is the largest virtual water exporter (about 87 million m3). Crude oil and refined petroleum products represent about 89% of the total virtual water flow, fertilizers represent around 10% and 1% remaining industries. EU27 poses the greatest indirect pressure on the Kuwaiti hydrological system where the virtual water export represents about 96% of the actual renewable water resources in this country. The Kuwaiti crude oil water use in relation to domestic water withdrawal is about 89% which is highest among MENA countries. Pollution of water bodies, in terms of BOD, due to production is very relevant for crude oil, slaughterhouses, refineries, olive oil, and tanneries while pollution due to export to EU27 is most relevant for crude oil industry and olive oil mills.

  8. Programmed administration of parathyroid hormone increases bone formation and reduces bone loss in hindlimb-unloaded ovariectomized rats

    NASA Technical Reports Server (NTRS)

    Turner, R. T.; Evans, G. L.; Cavolina, J. M.; Halloran, B.; Morey-Holton, E.

    1998-01-01

    Gonadal insufficiency and reduced mechanical usage are two important risk factors for osteoporosis. The beneficial effects of PTH therapy to reverse the estrogen deficiency-induced bone loss in the laboratory rat are well known, but the influence of mechanical usage in this response has not been established. In this study, the effects of programed administration of PTH on cancellous bone volume and turnover at the proximal tibial metaphysis were determined in hindlimb-unloaded, ovariectomized (OVX), 3-month-old Sprague-Dawley rats. PTH was administered to weight-bearing and hindlimb-unloaded OVX rats with osmotic pumps programed to deliver 20 microg human PTH (approximately 80 microg/kg x day) during a daily 1-h infusion for 7 days. Compared with sham-operated rats, OVX increased longitudinal and radial bone growth, increased indexes of cancellous bone turnover, and resulted in net resorption of cancellous bone. Hindlimb unloading of OVX rats decreased longitudinal and radial bone growth, decreased osteoblast number, increased osteoclast number, and resulted in a further decrease in cancellous bone volume compared with those in weight-bearing OVX rats. Programed administration of PTH had no effect on either radial or longitudinal bone growth in weight-bearing and hindlimb-unloaded OVX rats. PTH treatment had dramatic effects on selected cancellous bone measurements; PTH maintained cancellous bone volume in OVX weight-bearing rats and greatly reduced cancellous bone loss in OVX hindlimb-unloaded rats. In the latter animals, PTH treatment prevented the hindlimb unloading-induced reduction in trabecular thickness, but the hormone was ineffective in preventing either the increase in osteoclast number or the loss of trabecular plates. Importantly, PTH treatment increased the retention of a baseline flurochrome label, osteoblast number, and bone formation in the proximal tibial metaphysis regardless of the level of mechanical usage. These findings demonstrate that programed administration of PTH is effective in increasing osteoblast number and bone formation and has beneficial effects on bone volume in the absence of weight-bearing and gonadal hormones. We conclude that the actions of PTH on cancellous bone are independent of the level of mechanical usage.

  9. POLLUTION FROM PERSONAL ACTIONS, ACTIVITIES, AND ...

    EPA Pesticide Factsheets

    Perhaps more so than with any other class of anthropogenic chemicals, the occurrence of pharmaceuticals and personal care products (PPCPS) in the environment highlights the immediate, intimate, and inseparable connection between the personal activities of individual citizens and their environment. PPCPS, in contrast to other types of environmental contaminants, owe their origins in the environment directly to their worldwide, universal, frequent, highly dispersed, and individually small but cumulative usage by multitudes of individuals - as opposed to the larger, highly delineated, and more-controllable industrial manufacturing/usage of most high-volume synthetic chemicals. PPCPs are a diverse group of chemicals, used internally or externally with the bodies of humans and domestic animals (and agricultural plants), comprising a wide spectrum of chemical classes. In very general terms, PPCPs include: o- drugs (available by prescription or over-the-counter; including the new genre of

  10. LSENS, A General Chemical Kinetics and Sensitivity Analysis Code for Homogeneous Gas-Phase Reactions. Part 2; Code Description and Usage

    NASA Technical Reports Server (NTRS)

    Radhakrishnan, Krishnan; Bittker, David A.

    1994-01-01

    LSENS, the Lewis General Chemical Kinetics and Sensitivity Analysis Code, has been developed for solving complex, homogeneous, gas-phase chemical kinetics problems and contains sensitivity analysis for a variety of problems, including nonisothermal situations. This report is part II of a series of three reference publications that describe LSENS, provide a detailed guide to its usage, and present many example problems. Part II describes the code, how to modify it, and its usage, including preparation of the problem data file required to execute LSENS. Code usage is illustrated by several example problems, which further explain preparation of the problem data file and show how to obtain desired accuracy in the computed results. LSENS is a flexible, convenient, accurate, and efficient solver for chemical reaction problems such as static system; steady, one-dimensional, inviscid flow; reaction behind incident shock wave, including boundary layer correction; and perfectly stirred (highly backmixed) reactor. In addition, the chemical equilibrium state can be computed for the following assigned states: temperature and pressure, enthalpy and pressure, temperature and volume, and internal energy and volume. For static problems the code computes the sensitivity coefficients of the dependent variables and their temporal derivatives with respect to the initial values of the dependent variables and/or the three rate coefficient parameters of the chemical reactions. Part I (NASA RP-1328) derives the governing equations and describes the numerical solution procedures for the types of problems that can be solved by LSENS. Part III (NASA RP-1330) explains the kinetics and kinetics-plus-sensitivity-analysis problems supplied with LSENS and presents sample results.

  11. Oil County Traffic Safety Survey, 2012

    DOT National Transportation Integrated Search

    2012-09-01

    Over time, road usage in western North Dakota has changed. Interstate, highway, and low-volume unpaved roads have been used with greater frequency because of increased agricultural production and a growing energy sector. This evolution is especially ...

  12. Planetary geometry handbook: Venus positional data, 1988 - 2020, volume 2

    NASA Technical Reports Server (NTRS)

    Sergeyevsky, A. B.; Snyder, G. C.; Paulson, B. L.; Cunniff, R. A.

    1983-01-01

    Graphical data necessary for the analysis of planetary exploration missions to Venus are presented. Positional and geometric information spanning the time period from 1988 through 2020 is provided. The data and the usage are explained.

  13. Planetary geometry handbook: Mars positional data, 1990 - 2020, volume 3

    NASA Technical Reports Server (NTRS)

    Sergeyevsky, A. B.; Snyder, G. C.; Paulson, B. L.; Cunniff, R. A.

    1983-01-01

    Graphical data necessary for the analysis of planetary exploration missions to Mars are presented. Positional and geometric information spanning the time period from 1990 through 2020 is provided. The data and usage are explained.

  14. Planetary geometry handbook: Jupiter positional data, 1985 - 2020, volume 4

    NASA Technical Reports Server (NTRS)

    Sergeyevsky, A. B.; Snyder, G. C.; Paulson, B. L.; Cunniff, R. A.

    1983-01-01

    Graphical data necessary for the analysis of planetary exploration missions to Jupiter are presented. Positional and geometric information spanning the time period from 1985 through 2020 is provided. The data and their usage are explained.

  15. Planetary geometry handbook: Saturn positional data, 1985 - 2020, volume 5

    NASA Technical Reports Server (NTRS)

    Sergeyevsky, A. B.; Snyder, G. C.; Paulson, B. L.; Cunniff, R. A.

    1983-01-01

    Graphical data necessary for the analysis of planetary exploration missions to Saturn are presented. Positional and geometric information spanning the time period from 1985 through 2020 is provided. The data and their usage are explained.

  16. Pozzolanic Activity Assessment of LUSI (LUmpur SIdoarjo) Mud in Semi High Volume Pozzolanic Mortar

    PubMed Central

    Hardjito, Djwantoro; Antoni; Wibowo, Gunadi M.; Christianto, Danny

    2012-01-01

    LUSI mud obtained from the mud volcano in Sidoarjo, Indonesia, is a viable aluminosilicate material to be utilized as pozzolanic material. LUSI is an abbreviation of the local name of the mud, i.e., Lumpur Sidoarjo, meaning Sidoarjo mud. This paper reports the results of an investigation to assess the pozzolanic activity of LUSI mud, especially in semi high volume pozzolanic mortar. In this case, the amount of mud incorporated is between 30% to 40% of total cementitious material, by mass. The content of SiO2 in the mud is about 30%, whilst the total content of SiO2, Fe2O3 and Al2O3 is more than 70%. Particle size and degree of partial cement replacement by treated LUSI mud affect the compressive strength, the strength activity index (SAI), the rate of pozzolanic activity development, and the workability of mortar incorporating LUSI mud. Manufacturing semi high volume LUSI mud mortar, up to at least 40% cement replacement, is a possibility, especially with a smaller particle size of LUSI mud, less than 63 μm. The use of a larger percentage of cement replacement by LUSI mud does not show any adverse effect on the water demand, as the flow of the fresh mortar increased with the increase of percentage of LUSI mud usage.

  17. Identifying the usage patterns of methyl tert-butyl ether (MTBE) and other oxygenates in gasoline using gasoline surveys

    USGS Publications Warehouse

    Moran, M.J.; Clawges, R.M.; Zogorski, J.S.

    2000-01-01

    Data on the volumes of oxygenates and other compounds in gasoline are available from several sources collectively referred as gasoline surveys. The gasoline surveys provide the most definitive knowledge of which oxygenate, if any, and what volumes of that oxygenate are being used in various areas of the country. This information is important in water-quality assessments for relating the detection of MTBE in water to patterns of usage of MTBE in gasoline. General information on three surveys that have been conducted by the National Institute for Petroleum and Energy Research, the Motor Vehicle Manufacturers Association, and the EPA was presented. The samples were tested for physical properties and constituents including octane number, specific gravity, and volumes of olefins, aromatics, benzene, alcohols, and various ether oxygenates. The data in each survey had its own utility based on the type of assessment that is undertaken. Quality Assessment (NAWQA) Program. Using NAWQA data, the percent occurrence of MTBE in ground water in metropolitan areas that use substantial amounts of MTBE (> 5% by vol) was ??? 21%, compared to ??? 2% in areas that do not use substantial amounts of MTBE (< 5% by vol). When several other factors are considered in a logistic regression model including MTBE usage in RFG or OXY gasoline areas (??? 3% by vol) as a factor, a 4-6 fold increase in the detection frequency of MTBE in ground water was found when compared to areas that do not use MTBE or use it only for octane enhancement (< 3% by vol).

  18. The Comtesse De Genlis' "Théâtre À L'Usage Des Jeunes Personnes" (1779-1780): Educating for Order and Prejudice in Pre-Revolutionary France

    ERIC Educational Resources Information Center

    Pinto, Isabel

    2017-01-01

    This essay explores the educational contribution of the Comtesse de Genlis' "Théâtre à l'usage des jeunes personnes" ["Theatre of Education"] (1792/1779-1780), a four-volume collection of closet drama, in light of the social, political and cultural shifts occurring in France in the period prior to the French Revolution. In…

  19. Language Loyalty in South Africa. Volume 2: Using and Improving Usage in the Second Language - Some Opinions of White Adults in Urban Areas.

    ERIC Educational Resources Information Center

    Hauptfleisch, T.

    This report is the second in a series of four intended to study language attitudes and language maintenance among whites in the Republic of South Africa. The series is based on data provided by a large-scale survey conducted during 1973-74. The present report deals with attitudes towards using and improving usage in the second language.…

  20. Exploration of impact measures of safety belt use laws. Volume 1

    DOT National Transportation Integrated Search

    1990-02-01

    Author's abstract: This project identified, evaluated, and recommended indicators of safety belt use law (SBUL) impact (other than fatality reduction and observed belt usage), as well as institutional sources that collect them. The project involved a...

  1. Flushing Out Solutions.

    ERIC Educational Resources Information Center

    Baz, Jose

    1997-01-01

    Discusses the use of pressure-assist technology to cut water usage volume in schools. It answers questions concerning whether to retrofit school washrooms with pressure-assisted technology and how much water would be conserved. Where to get more information on washrooms is provided. (GR)

  2. Breast Radiotherapy with Mixed Energy Photons; a Model for Optimal Beam Weighting.

    PubMed

    Birgani, Mohammadjavad Tahmasebi; Fatahiasl, Jafar; Hosseini, Seyed Mohammad; Bagheri, Ali; Behrooz, Mohammad Ali; Zabiehzadeh, Mansour; Meskani, Reza; Gomari, Maryam Talaei

    2015-01-01

    Utilization of high energy photons (>10 MV) with an optimal weight using a mixed energy technique is a practical way to generate a homogenous dose distribution while maintaining adequate target coverage in intact breast radiotherapy. This study represents a model for estimation of this optimal weight for day to day clinical usage. For this purpose, treatment planning computed tomography scans of thirty-three consecutive early stage breast cancer patients following breast conservation surgery were analyzed. After delineation of the breast clinical target volume (CTV) and placing opposed wedge paired isocenteric tangential portals, dosimeteric calculations were conducted and dose volume histograms (DVHs) were generated, first with pure 6 MV photons and then these calculations were repeated ten times with incorporating 18 MV photons (ten percent increase in weight per step) in each individual patient. For each calculation two indexes including maximum dose in the breast CTV (Dmax) and the volume of CTV which covered with 95% Isodose line (VCTV, 95%IDL) were measured according to the DVH data and then normalized values were plotted in a graph. The optimal weight of 18 MV photons was defined as the intersection point of Dmax and VCTV, 95%IDL graphs. For creating a model to predict this optimal weight multiple linear regression analysis was used based on some of the breast and tangential field parameters. The best fitting model for prediction of 18 MV photons optimal weight in breast radiotherapy using mixed energy technique, incorporated chest wall separation plus central lung distance (Adjusted R2=0.776). In conclusion, this study represents a model for the estimation of optimal beam weighting in breast radiotherapy using mixed photon energy technique for routine day to day clinical usage.

  3. Geological Studies of the Salmon River Suture Zone and Adjoining Areas, West-Central Idaho and Eastern Oregon

    USGS Publications Warehouse

    Kuntz, Mel A.; Snee, Lawrence W.

    2007-01-01

    The papers in this volume describe petrologic, structural, and geochemical studies related to geographic areas adjacent to and including the Salmon River suture zone. We therefore start this volume by defining and giving a general description of that suture zone. The western margin of the North American continent was the setting for complex terrane accretion and large-scale terrane translation during Late Cretaceous and Eocene time. In western Idaho, the boundary that separates the Paleozoic-Mesozoic accreted oceanic, island-arc rocks on the west from Precambrian continental metamorphic and sedimentary rocks on the east is called the Salmon River suture zone (SRSZ). Readers will note that the term 'Salmon River suture zone' is used in the title of this volume and in the text of several of the papers and the term 'western Idaho suture zone' is used in several other papers in this volume. Both terms refer to the same geologic feature and reflect historical usage and custom; thus no attempt has been made by the editors to impose or demand a single term by the various authors of this volume. The suture zone is marked by strong lithologic and chemical differences. Rocks adjacent to the suture zone are characterized by high-grade metamorphism and much structural deformation. In addition, the zone was the locus of emplacement of plutons ranging in composition from tonalite to monzogranite during and after the final stages of accretion of the oceanic terrane to the North American continent. The contents of this paper consists of seven chapters.

  4. The ATLAS TAGS database distribution and management - Operational challenges of a multi-terabyte distributed database

    NASA Astrophysics Data System (ADS)

    Viegas, F.; Malon, D.; Cranshaw, J.; Dimitrov, G.; Nowak, M.; Nairz, A.; Goossens, L.; Gallas, E.; Gamboa, C.; Wong, A.; Vinek, E.

    2010-04-01

    The TAG files store summary event quantities that allow a quick selection of interesting events. This data will be produced at a nominal rate of 200 Hz, and is uploaded into a relational database for access from websites and other tools. The estimated database volume is 6TB per year, making it the largest application running on the ATLAS relational databases, at CERN and at other voluntary sites. The sheer volume and high rate of production makes this application a challenge to data and resource management, in many aspects. This paper will focus on the operational challenges of this system. These include: uploading the data from files to the CERN's and remote sites' databases; distributing the TAG metadata that is essential to guide the user through event selection; controlling resource usage of the database, from the user query load to the strategy of cleaning and archiving of old TAG data.

  5. Architectural constructs of Ampex DST

    NASA Technical Reports Server (NTRS)

    Johnson, Clay

    1993-01-01

    The DST 800 automated library is a high performance, automated tape storage system, developed by AMPEX, providing mass storage to host systems. Physical Volume Manager (PVM) is a volume server which supports either a DST 800, DST 600 stand alone tape drive, or a combination of DST 800 and DST 600 subsystems. The objective of the PVM is to provide the foundation support to allow automated and operator assisted access to the DST cartridges with continuous operation. A second objective is to create a data base about the media, its location, and its usage so that the quality and utilization of the media on which specific data is recorded and the performance of the storage system may be managed. The DST tape drive architecture and media provides several unique functions that enhance the ability to achieve high media space utilization and fast access. Access times are enhanced through the implementation of multiple areas (called system zones) on the media where the media may be unloaded. This reduces positioning time in loading and unloading the cartridge. Access times are also reduced through high speed positioning in excess of 800 megabytes per second. A DST cartridge can be partitioned into fixed size units which can be reclaimed for rewriting without invalidating other recorded data on the tape cartridge. Most tape management systems achieve space reclamation by deleting an entire tape volume, then allowing users to request a 'scratch tape' or 'nonspecific' volume when they wish to record data to tape. Physical cartridge sizes of 25, 75, or 165 gigabytes will make this existing process inefficient or unusable. The DST cartridge partitioning capability provides an efficient mechanism for addressing the tape space utilization problem.

  6. Proceedings of the Sixth General Meeting of the International VLBI Service for Geodesy and Astrometry

    NASA Technical Reports Server (NTRS)

    Behrend, Dirk (Editor); Baver, Karen D. (Editor)

    2010-01-01

    This volume is the proceedings of the sixth General Meeting of the International VLBI Service for Geodesy and Astrometry (IVS), held in Hobart, Tasmania, Australia, February 7-13, 2010. The contents of this volume also appear on the IVS Web site at http://ivscc.gsfc.nasa.gov/publications/gm2010. The keynote of the sixth GM was the new perspectives of the next generation VLBI system under the theme "VLBI2010: From Vision to Reality". The goal of the meeting was to provide an interesting and informative program for a wide cross-section of IVS members, including station operators, program managers, and analysts. This volume contains 88 papers. All papers were edited by the editors for usage of the English language, form, and minor content-related issues.

  7. Investigation on the Rheological Behavior of Fly Ash Cement Composites at Paste and Concrete Level

    NASA Astrophysics Data System (ADS)

    Thiyagarajan, Hemalatha; Mapa, Maitri; Kushwaha, Rakhi

    2018-06-01

    Towards developing sustainable concrete, nowadays, high volume replacement of cement with fly ash (FA) is more common. Though the replacement of fly ash at 20-30% is widely accepted due to its advantages at both fresh and hardened states, applicability and acceptability of high volume fly ash (HVFA) is not so popular due to some adverse effects on concrete properties. Nowadays to suit various applications, flowing concretes such as self compacting concrete is often used. In such cases, implications of usage of HVFA on fresh properties are required to be investigated. Further, when FA replacement is beyond 40% in cement, it results in the reduction of strength and in order to overcome this drawback, additions such as nano calcium carbonate (CC), lime sludge (LS), carbon nano tubes (CNT) etc. are often incorporated to HVFA concrete. Hence, in this study, firstly, the influence of replacement level of 20-80% FA on rheological property is studied for both cement and concrete. Secondly, the influence of additions such as LS, CC and CNT on rheological parameters are discussed. It is found that the increased FA content improved the flowability in paste as well as in concrete. In paste, the physical properties such as size and shape of fly ash is the reason for increased flowability whereas in concrete, the paste volume contributes dominantly for the flowability rather than the effect due to individual FA particle. Reduced density of FA increases the paste volume in FA concrete thus reducing the interparticle friction by completely coating the coarse aggregate.

  8. The Q continuum simulation: Harnessing the power of GPU accelerated supercomputers

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

    Heitmann, Katrin; Frontiere, Nicholas; Sewell, Chris

    2015-08-01

    Modeling large-scale sky survey observations is a key driver for the continuing development of high-resolution, large-volume, cosmological simulations. We report the first results from the "Q Continuum" cosmological N-body simulation run carried out on the GPU-accelerated supercomputer Titan. The simulation encompasses a volume of (1300 Mpc)(3) and evolves more than half a trillion particles, leading to a particle mass resolution of m(p) similar or equal to 1.5 . 10(8) M-circle dot. At thismass resolution, the Q Continuum run is currently the largest cosmology simulation available. It enables the construction of detailed synthetic sky catalogs, encompassing different modeling methodologies, including semi-analyticmore » modeling and sub-halo abundance matching in a large, cosmological volume. Here we describe the simulation and outputs in detail and present first results for a range of cosmological statistics, such as mass power spectra, halo mass functions, and halo mass-concentration relations for different epochs. We also provide details on challenges connected to running a simulation on almost 90% of Titan, one of the fastest supercomputers in the world, including our usage of Titan's GPU accelerators.« less

  9. High-performance technology for indexing of high volumes of Earth remote sensing data

    NASA Astrophysics Data System (ADS)

    Strotov, Valery V.; Taganov, Alexander I.; Kolesenkov, Aleksandr N.; Kostrov, Boris V.

    2017-10-01

    The present paper has suggested a technology for search, indexing, cataloging and distribution of aerospace images on the basis of geo-information approach, cluster and spectral analysis. It has considered information and algorithmic support of the system. Functional circuit of the system and structure of the geographical data base have been developed on the basis of the geographical online portal technology. Taking into account heterogeneity of information obtained from various sources it is reasonable to apply a geoinformation platform that allows analyzing space location of objects and territories and executing complex processing of information. Geoinformation platform is based on cartographic fundamentals with the uniform coordinate system, the geographical data base, a set of algorithms and program modules for execution of various tasks. The technology for adding by particular users and companies of images taken by means of professional and amateur devices and also processed by various software tools to the array system has been suggested. Complex usage of visual and instrumental approaches allows significantly expanding an application area of Earth remote sensing data. Development and implementation of new algorithms based on the complex usage of new methods for processing of structured and unstructured data of high volumes will increase periodicity and rate of data updating. The paper has shown that application of original algorithms for search, indexing and cataloging of aerospace images will provide an easy access to information spread by hundreds of suppliers and allow increasing an access rate to aerospace images up to 5 times in comparison with current analogues.

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

    PubMed

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

    2017-10-31

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

  11. Railroads and the Environment : Estimation of Fuel Consumption in Rail Transportation : Volume 1. Analytical Model

    DOT National Transportation Integrated Search

    1975-05-01

    The report describes an analytical approach to estimation of fuel consumption in rail transportation, and provides sample computer calculations suggesting the sensitivity of fuel usage to various parameters. The model used is based upon careful delin...

  12. Definition of technology development missions for early space station, orbit transfer vehicle servicing, volume 2

    NASA Technical Reports Server (NTRS)

    1983-01-01

    Propellant transfer, storage, and reliquefaction TDM; docking and berthing technology development mission; maintenance technology development mission; OTV/payload integration, space station interface/accommodations; combined TDM conceptual design; programmatic analysis; and TDM equipment usage are discussed.

  13. Two stroke homogenous charge compression ignition engine with pulsed air supplier

    DOEpatents

    Clarke, John M.

    2003-08-05

    A two stroke homogenous charge compression ignition engine includes a volume pulsed air supplier, such as a piston driven pump, for efficient scavenging. The usage of a homogenous charge tends to decrease emissions. The use of a volume pulsed air supplier in conjunction with conventional poppet type intake and exhaust valves results in a relatively efficient scavenging mode for the engine. The engine preferably includes features that permit valving event timing, air pulse event timing and injection event timing to be varied relative to engine crankshaft angle. The principle use of the invention lies in improving diesel engines.

  14. The Epidemiology and National Trends of Bearing Surface Usage in Primary Total Hip Arthroplasty in Korea

    PubMed Central

    Yoon, Pil Whan; Kim, Yunjung; Yoo, Seungmi; Lee, Sahnghoon; Kim, Hee Joong

    2016-01-01

    Background We analyzed the data for primary total hip arthroplasty (THA) in the Korean nationwide database to assess (1) the epidemiology and national trends of bearing surface usage in THAs and (2) the prevalence of each type of bearing surface according to age, gender, hospital type, primary payer, and hospital procedure volume. Methods A total of 30,881 THAs were analyzed using the Korean Health Insurance Review and Assessment Service database for 2007 through 2011. Bearing surfaces were sub-grouped according to device code for national health insurance claims and consisted of ceramic-on-ceramic (CoC), metal-on-polyethylene (MoP), ceramic-on-polyethylene (CoP), and metal-on-metal (MoM). The prevalence of each type of bearing surface was calculated and stratified by age, gender, hospital type, primary payer, and procedure volume of each hospital. Results CoC was the most frequently used bearing surface (76.7%), followed by MoP (11.9%), CoP (7.3%), and MoM (4.1%). The proportion of THAs using a CoC bearing surface increased steadily from 71.6% in 2007 to 81.4% in 2011, whereas the proportions using CoP, MoP, and MoM bearing surfaces decreased. The order of prevalence was identical to that in the general population regardless of age, gender, hospital type, primary payer, and hospital procedure volume. Conclusions The trends and epidemiology of bearing surface usage in THAs in Korea are different from those in other countries, and the CoC bearing surface is the most prevalent articulation. In future, the results of a large-scale study using nationwide data of THAs involving a CoC bearing surface will be reported in Korea. PMID:26929796

  15. The Epidemiology and National Trends of Bearing Surface Usage in Primary Total Hip Arthroplasty in Korea.

    PubMed

    Yoon, Pil Whan; Yoo, Jeong Joon; Kim, Yunjung; Yoo, Seungmi; Lee, Sahnghoon; Kim, Hee Joong

    2016-03-01

    We analyzed the data for primary total hip arthroplasty (THA) in the Korean nationwide database to assess (1) the epidemiology and national trends of bearing surface usage in THAs and (2) the prevalence of each type of bearing surface according to age, gender, hospital type, primary payer, and hospital procedure volume. A total of 30,881 THAs were analyzed using the Korean Health Insurance Review and Assessment Service database for 2007 through 2011. Bearing surfaces were sub-grouped according to device code for national health insurance claims and consisted of ceramic-on-ceramic (CoC), metal-on-polyethylene (MoP), ceramic-on-polyethylene (CoP), and metal-on-metal (MoM). The prevalence of each type of bearing surface was calculated and stratified by age, gender, hospital type, primary payer, and procedure volume of each hospital. CoC was the most frequently used bearing surface (76.7%), followed by MoP (11.9%), CoP (7.3%), and MoM (4.1%). The proportion of THAs using a CoC bearing surface increased steadily from 71.6% in 2007 to 81.4% in 2011, whereas the proportions using CoP, MoP, and MoM bearing surfaces decreased. The order of prevalence was identical to that in the general population regardless of age, gender, hospital type, primary payer, and hospital procedure volume. The trends and epidemiology of bearing surface usage in THAs in Korea are different from those in other countries, and the CoC bearing surface is the most prevalent articulation. In future, the results of a large-scale study using nationwide data of THAs involving a CoC bearing surface will be reported in Korea.

  16. Size and usage patterns of private TB drug markets in the high burden countries.

    PubMed

    Wells, William A; Ge, Colin Fan; Patel, Nitin; Oh, Teresa; Gardiner, Elizabeth; Kimerling, Michael E

    2011-05-04

    Tuberculosis (TB) control is considered primarily a public health concern, and private sector TB treatment has attracted less attention. Thus, the size and characteristics of private sector TB drug sales remain largely unknown. We used IMS Health data to analyze private TB drug consumption in 10 high burden countries (HBCs), after first mapping how well IMS data coverage overlapped with private markets. We defined private markets as any channels not used or influenced by national TB programs. Private markets in four countries--Pakistan, the Philippines, Indonesia and India--had the largest relative sales volumes; annually, they sold enough first line TB drugs to provide 65-117% of the respective countries' estimated annual incident cases with a standard 6-8 month regimen. First line drug volumes in five countries were predominantly fixed dose combinations (FDCs), but predominantly loose drugs in the other five. Across 10 countries, these drugs were available in 37 (loose drug) plus 74 (FDCs) distinct strengths. There were 54 distinct, significant first line manufacturers (range 2-11 per country), and most companies sold TB drugs in only a single study country. FDC markets were, however, more concentrated, with 4 companies capturing 69% of FDC volume across the ten countries. Among second line drugs, fluoroquinolones were widely available, with significant volumes used for TB in India, Pakistan and Indonesia. However, certain WHO-recommended drugs were not available and in general there were insufficient drug volumes to cover the majority of the expected burden of multidrug-resistant TB (MDR-TB). Private TB drug markets in several HBCs are substantial, stable, and complicated. This calls for appropriate policy and market responses, including expansion of Public-Private Mix (PPM) programs, greater reach, flexibility and appeal of public programs, regulatory and quality enforcement, and expansion of public MDR-TB treatment programs.

  17. Size and Usage Patterns of Private TB Drug Markets in the High Burden Countries

    PubMed Central

    Wells, William A.; Ge, Colin Fan; Patel, Nitin; Oh, Teresa; Gardiner, Elizabeth; Kimerling, Michael E.

    2011-01-01

    Background Tuberculosis (TB) control is considered primarily a public health concern, and private sector TB treatment has attracted less attention. Thus, the size and characteristics of private sector TB drug sales remain largely unknown. Methodology/Principal Findings We used IMS Health data to analyze private TB drug consumption in 10 high burden countries (HBCs), after first mapping how well IMS data coverage overlapped with private markets. We defined private markets as any channels not used or influenced by national TB programs. Private markets in four countries – Pakistan, the Philippines, Indonesia and India – had the largest relative sales volumes; annually, they sold enough first line TB drugs to provide 65–117% of the respective countries' estimated annual incident cases with a standard 6–8 month regimen. First line drug volumes in five countries were predominantly fixed dose combinations (FDCs), but predominantly loose drugs in the other five. Across 10 countries, these drugs were available in 37 (loose drug) plus 74 (FDCs) distinct strengths. There were 54 distinct, significant first line manufacturers (range 2–11 per country), and most companies sold TB drugs in only a single study country. FDC markets were, however, more concentrated, with 4 companies capturing 69% of FDC volume across the ten countries. Among second line drugs, fluoroquinolones were widely available, with significant volumes used for TB in India, Pakistan and Indonesia. However, certain WHO-recommended drugs were not available and in general there were insufficient drug volumes to cover the majority of the expected burden of multidrug-resistant TB (MDR-TB). Conclusions/Significance Private TB drug markets in several HBCs are substantial, stable, and complicated. This calls for appropriate policy and market responses, including expansion of Public-Private Mix (PPM) programs, greater reach, flexibility and appeal of public programs, regulatory and quality enforcement, and expansion of public MDR-TB treatment programs. PMID:21573227

  18. Load research manual. Volume 1. Load research procedures

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

    Brandenburg, L.; Clarkson, G.; Grund, Jr., C.

    1980-11-01

    This three-volume manual presents technical guidelines for electric utility load research. Special attention is given to issues raised by the load data reporting requirements of the Public Utility Regulatory Policies Act of 1978 and to problems faced by smaller utilities that are initiating load research programs. In Volumes 1 and 2, procedures are suggested for determining data requirements for load research, establishing the size and customer composition of a load survey sample, selecting and using equipment to record customer electricity usage, processing data tapes from the recording equipment, and analyzing the data. Statistical techniques used in customer sampling are discussedmore » in detail. The costs of load research also are estimated, and ongoing load research programs at three utilities are described. The manual includes guides to load research literature and glossaries of load research and statistical terms.« less

  19. Simulation model for wind energy storage systems. Volume II. Operation manual. [SIMWEST code

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

    Warren, A.W.; Edsinger, R.W.; Burroughs, J.D.

    1977-08-01

    The effort developed a comprehensive computer program for the modeling of wind energy/storage systems utilizing any combination of five types of storage (pumped hydro, battery, thermal, flywheel and pneumatic). An acronym for the program is SIMWEST (Simulation Model for Wind Energy Storage). The level of detail of SIMWEST is consistent with a role of evaluating the economic feasibility as well as the general performance of wind energy systems. The software package consists of two basic programs and a library of system, environmental, and load components. Volume II, the SIMWEST operation manual, describes the usage of the SIMWEST program, the designmore » of the library components, and a number of simple example simulations intended to familiarize the user with the program's operation. Volume II also contains a listing of each SIMWEST library subroutine.« less

  20. Comparison of optimized single and multifield irradiation plans of antiproton, proton and carbon ion beams.

    PubMed

    Bassler, Niels; Kantemiris, Ioannis; Karaiskos, Pantelis; Engelke, Julia; Holzscheiter, Michael H; Petersen, Jørgen B

    2010-04-01

    Antiprotons have been suggested as a possibly superior modality for radiotherapy, due to the energy released when antiprotons annihilate, which enhances the Bragg peak and introduces a high-LET component to the dose. However, concerns are expressed about the inferior lateral dose distribution caused by the annihilation products. We use the Monte Carlo code FLUKA to generate depth-dose kernels for protons, antiprotons, and carbon ions. Using these we then build virtual treatment plans optimized according to ICRU recommendations for the different beam modalities, which then are recalculated with FLUKA. Dose-volume histograms generated from these plans can be used to compare the different irradiations. The enhancement in physical and possibly biological dose from annihilating antiprotons can significantly lower the dose in the entrance channel; but only at the expense of a diffuse low dose background from long-range secondary particles. Lateral dose distributions are improved using active beam delivery methods, instead of flat fields. Dose-volume histograms for different treatment scenarios show that antiprotons have the potential to reduce the volume of normal tissue receiving medium to high dose, however, in the low dose region antiprotons are inferior to both protons and carbon ions. This limits the potential usage to situations where dose to normal tissue must be reduced as much as possible. Copyright 2010 Elsevier Ireland Ltd. All rights reserved.

  1. Random harmonic analysis program, L221 (TEV156). Volume 1: Engineering and usage

    NASA Technical Reports Server (NTRS)

    Miller, R. D.; Graham, M. L.

    1979-01-01

    A digital computer program capable of calculating steady state solutions for linear second order differential equations due to sinusoidal forcing functions is described. The field of application of the program, the analysis of airplane response and loads due to continuous random air turbulence, is discussed. Optional capabilities including frequency dependent input matrices, feedback damping, gradual gust penetration, multiple excitation forcing functions, and a static elastic solution are described. Program usage and a description of the analysis used are presented.

  2. A Computational Analysis of Complex Noun Phrases in Navy Messages

    DTIC Science & Technology

    1984-07-01

    Hirschman. Automated Determination of Suhlanguage Syntactic Usage. Proc. COLING 84) (current volume). [Hirschman 1082 ] Hirsehman, L. Constraints on...Restricted Semantic Domains. de Grnyter New York, 1082 . [Levi 1078] Levi, J.N. The Syntaz and Semantics of Com- plez Nominals, Academic Press, New York

  3. Purging of a multilayer insulation with dacron tuft spacer by gas diffusion

    NASA Technical Reports Server (NTRS)

    Sumner, I. E.; Fisk, W. J.

    1976-01-01

    The time and purge gas usage required to purge a multilayer insulation (MLI) panel with gaseous helium by means of gas diffusion to obtain a condensable gas (nitrogen) concentration of less than 1 percent within the panel are stipulated. Two different, flat, rectangular MLI panels, one incorporating a butt joint, were constructed of of 11 double-aluminized Mylar (DAM) radiation shields separated by Dacron tuft spacers. The DAM/Dacron tuft concept is known commercially as Superfloc. The nitrogen gas concentration as a function of time within the MLI panel could be adequately predicted by using a simple, one dimensional gas diffusion model in which the boundary conditions at the edge of the MLI panel were time dependent. The time and purge gas usage required to achieve 1 percent nitrogen gas concentration within the MLI panel varied from 208 to 86 minutes and 34.1 to 56.5 MLI panel purge volumes, respectively, for gaseous helium purge rates from 10 to 40 MLI panel volumes per hour.

  4. Tracking data in the office environment.

    PubMed

    Erickson, Ty B

    2010-09-01

    Data tracking in the office setting focuses on a narrow spectrum of the entire patient safety arena; however, when properly executed, data tracking increases staff members' awareness of the importance of patient safety. Data tracking is also a high-volume event and thereby continues to loop back on the consciousness of providers in all aspects of their practice. Improvement in date tracking will improve the collateral areas of patient safety such as proper medication usage, legibility of written communication, effective delegation of patient safety initiatives, and a collegial effort at developing teams for safety design processes.

  5. Invited Article: Indenter materials for high temperature nanoindentation

    NASA Astrophysics Data System (ADS)

    Wheeler, J. M.; Michler, J.

    2013-10-01

    As nanoindentation at high temperatures becomes increasingly popular, a review of indenter materials for usage at high temperatures is instructive for identifying appropriate indenter-sample materials combinations to prevent indenter loss or failure due to chemical reactions or wear during indentation. This is an important consideration for nanoindentation as extremely small volumes of reacted indenter material will have a significant effect on measurements. The high temperature hardness, elastic modulus, thermal properties, and chemical reactivities of diamond, boron carbide, silicon carbide, tungsten carbide, cubic boron nitride, and sapphire are discussed. Diamond and boron carbide show the best elevated temperature hardness, while tungsten carbide demonstrates the lowest chemical reactivity with the widest array of elements.

  6. Consequences of anorectal cancer atlas implementation in the cooperative group setting: radiobiologic analysis of a prospective randomized in silico target delineation study.

    PubMed

    Mavroidis, Panayiotis; Giantsoudis, Drosoula; Awan, Musaddiq J; Nijkamp, Jasper; Rasch, Coen R N; Duppen, Joop C; Thomas, Charles R; Okunieff, Paul; Jones, William E; Kachnic, Lisa A; Papanikolaou, Niko; Fuller, Clifton D

    2014-09-01

    The aim of this study is to ascertain the subsequent radiobiological impact of using a consensus guideline target volume delineation atlas. Using a representative case and target volume delineation instructions derived from a proposed IMRT rectal cancer clinical trial, gross tumor volume (GTV) and clinical/planning target volumes (CTV/PTV) were contoured by 13 physician observers (Phase 1). The observers were then randomly assigned to follow (atlas) or not-follow (control) a consensus guideline/atlas for anorectal cancers, and instructed to re-contour the same case (Phase 2). The atlas group was found to have increased tumor control probability (TCP) after the atlas intervention for both the CTV (p<0.0001) and PTV1 (p=0.0011) with decreasing normal tissue complication probability (NTCP) for small intestine, while the control group did not. Additionally, the atlas group had reduced variance in TCP for all target volumes and reduced variance in NTCP for the bowel. In Phase 2, the atlas group had increased TCP relative to the control for CTV (p=0.03). Visual atlas and consensus treatment guideline usage in the development of rectal cancer IMRT treatment plans reduced the inter-observer radiobiological variation, with clinically relevant TCP alteration for CTV and PTV volumes. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  7. Vacuum-assisted venous return reduces blood usage.

    PubMed

    Banbury, Michael K; White, Jennifer A; Blackstone, Eugene H; Cosgrove, Delos M

    2003-09-01

    To determine whether vacuum-assisted venous return has clinical advantages over conventional gravity drainage apart from allowing the use of smaller cannulas and shorter tubing. A total of 150 valve operations were performed at our institution between February and July 1999 using vacuum-assisted venous return with small venous cannulas connected to short tubing. These were compared with (1) 83 valve operations performed between April 1997 and January 1998 using the initial version of vacuum-assisted venous return, and (2) 124 valve operations performed between January and April of 1997 using conventional gravity drainage. Priming volume, hematocrit value, red blood cell usage, and total blood product usage were compared multivariably. These comparisons were covariate and propensity adjusted for dissimilarities between the groups and confirmed by propensity-matched pairs analysis. Priming volume was 1.4 +/- 0.4 L for small-cannula vacuum-assisted venous return, 1.7 +/- 0.4 L for initial vacuum-assisted venous return, and 2.0 +/- 0.4 L for gravity drainage (P <.0001). Smaller priming resulted in higher hematocrit values both at the beginning of cardiopulmonary bypass (27% +/- 5% compared with 26% +/- 4% and 25% +/- 4%, respectively, P <.0001) and at the end (30% +/- 4% compared with 28% +/- 4% and 27% +/- 4%, respectively, P <.0001). Red cell transfusions were used in 17% of the patients having small-cannula vacuum-assisted venous return, 27% of the initial patients having vacuum-assisted venous return, and 37% of the patients having gravity drainage (P =.001); total blood product usage was 19%, 27%, and 39%, respectively (P =.002). Although ministernotomy also was associated with reduced blood product usage (P <.004), propensity matching on type of sternotomy confirmed the association of vacuum-assisted venous return with lowered blood product usage. Vacuum-assisted venous return results in (1) higher hematocrit values during cardiopulmonary bypass and (2) decreased red cell and total blood product usage.

  8. Energy study of rail passenger transportation. Volume 4. Efficiency improvements and industry future. Final report

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

    Henderson, C.; Wilhelm, J.P.

    1979-08-01

    Measures that offer promise of efficiency improvements or economy in energy usage in rail passenger transportation are identified and described; the future of rail passenger transportation in the US is discussed; and possible future roles of Federal agencies are discussed.

  9. Storms and Water Usage; Swine Flu

    ERIC Educational Resources Information Center

    Edwards, C. C.; Muttiah, Daniel

    2009-01-01

    This article offers a contemporary, authentic application of quantitative reasoning based on media clips. Students analyze items from the media to answer mathematical questions related to the article. Volumes, economics, and growth rates of a pandemic are featured in the two clips presented. (Contains 4 figures and 1 table.)

  10. Functional Requirements for Onboard Management of Space Shuttle Consumables. Volume 2

    NASA Technical Reports Server (NTRS)

    Graf, P. J.; Herwig, H. A.; Neel, L. W.

    1973-01-01

    This report documents the results of the study "Functional Requirements for Onboard Management of Space Shuttle Consumables." The study was conducted for the Mission Planning and Analysis Division of the NASA Lyndon B. Johnson Space Center, Houston, Texas, between 3 July 1972 and 16 November 1973. The overall study program objective was two-fold. The first objective was to define a generalized consumable management concept which is applicable to advanced spacecraft. The second objective was to develop a specific consumables management concept for the Space Shuttle vehicle and to generate the functional requirements for the onboard portion of that concept. Consumables management is the process of controlling or influencing the usage of expendable materials involved in vehicle subsystem operation. The report consists of two volumes. Volume I presents a description of the study activities related to general approaches for developing consumable management, concepts for advanced spacecraft applications, and functional requirements for a Shuttle consumables management concept. Volume II presents a detailed description of the onboard consumables management concept proposed for use on the Space Shuttle.

  11. Exploring the Limits of High Altitude GPS for Future Lunar Missions

    NASA Technical Reports Server (NTRS)

    Ashman, Benjamin W.; Parker, Joel J.; Bauer, Frank H.; Esswein, Michael

    2018-01-01

    An increasing number of spacecraft are relying on the Global Positioning System (GPS) for navigation at altitudes near or above the GPS constellation itself - the region known as the Space Service Volume (SSV). While the formal definition of the SSV ends at geostationary altitude, the practical limit of high-altitude space usage is not known, and recent missions have demonstrated that signal availability is sufficient for operational navigation at altitudes halfway to the moon. This paper presents simulation results based on a high-fidelity model of the GPS constellation, calibrated and validated through comparisons of simulated GPS signal availability and strength with flight data from recent high-altitude missions including the Geostationary Operational Environmental Satellite 16 (GOES-16) and the Magnetospheric Multiscale (MMS) mission. This improved model is applied to the transfer to a lunar near-rectilinear halo orbit (NRHO) of the class being con- sidered for the international Deep Space Gateway concept. The number of GPS signals visible and their received signal strengths are presented as a function of receiver altitude in order to explore the practical upper limit of high-altitude space usage of GPS.

  12. Exploring the Limits of High Altitude GPS for Future Lunar Missions

    NASA Technical Reports Server (NTRS)

    Ashman, Benjamin W.; Parker, Joel J. K.; Bauer, Frank H.; Esswein, Michael

    2018-01-01

    An increasing number of spacecraft are relying on the Global Positioning System (GPS) for navigation at altitudes near or above the GPS constellation itself - the region known as the Space Service Volume (SSV). While the formal definition of the SSV ends at geostationary altitude, the practical limit of high-altitude space usage is not known, and recent missions have demonstrated that signal availability is sufficient for operational navigation at altitudes halfway to the moon. This paper presents simulation results based on a high-fidelity model of the GPS constellation, calibrated and validated through comparisons of simulated GPS signal availability and strength with flight data from recent high-altitude missions including the Geostationary Operational Environmental Satellite 16 (GOES-16) and the Magnetospheric Multiscale (MMS) mission. This improved model is applied to the transfer to a lunar near-rectilinear halo orbit (NRHO) of the class being considered for the international Deep Space Gateway concept. The number of GPS signals visible and their received signal strengths are presented as a function of receiver altitude in order to explore the practical upper limit of high-altitude space usage of GPS.

  13. Load research manual. Volume 2. Fundamentals of implementing load research procedures

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

    Brandenburg, L.; Clarkson, G.; Grund, Jr., C.

    This three-volume manual presents technical guidelines for electric utility load research. Special attention is given to issues raised by the load data reporting requirements of the Public Utility Regulatory Policies Act of 1978 and to problems faced by smaller utilities that are initiating load research programs. In Volumes 1 and 2, procedures are suggested for determining data requirements for load research, establishing the size and customer composition of a load survey sample, selecting and using equipment to record customer electricity usage, processing data tapes from the recording equipment, and analyzing the data. Statistical techniques used in customer sampling are discussedmore » in detail. The costs of load research also are estimated, and ongoing load research programs at three utilities are described. The manual includes guides to load research literature and glossaries of load research and statistical terms.« less

  14. A New Look at Data Usage by Using Metadata Attributes as Indicators of Data Quality

    NASA Technical Reports Server (NTRS)

    Won, Young-In; Wanchoo, Lalit; Behnke, Jeanne

    2016-01-01

    This study reviews the key metrics (users, distributed volume, and files) in multiple ways to gain an understanding of the significance of the metadata. Characterizing the usability of data by key metadata elements, such as discipline and study area, will assist in understanding how the user needs have evolved over time. The data usage pattern based on product level provides insight into the level of data quality. In addition, the data metrics by various services, such as the Open-source Project for a Network Data Access Protocol (OPeNDAP) and subsets, address how these services have extended the usage of data. Over-all, this study presents the usage of data and metadata by metrics analyses, which may assist data centers in better supporting the needs of the users.

  15. Buoyancy contribution to uncertainty of mass, conventional mass and force

    NASA Astrophysics Data System (ADS)

    Malengo, Andrea; Bich, Walter

    2016-04-01

    The conventional mass is a useful concept introduced to reduce the impact of the buoyancy correction in everyday mass measurements, thus avoiding in most cases its accurate determination, necessary in measurements of ‘true’ mass. Although usage of conventional mass is universal and standardized, the concept is considered as a sort of second-choice tool, to be avoided in high-accuracy applications. In this paper we show that this is a false belief, by elucidating the role played by covariances between volume and mass and between volume and conventional mass at the various stages of the dissemination chain and in the relationship between the uncertainties of mass and conventional mass. We arrive at somewhat counter-intuitive results: the volume of the transfer standard plays a comparatively minor role in the uncertainty budget of the standard under calibration. In addition, conventional mass is preferable to mass in normal, in-air operation, as its uncertainty is smaller than that of mass, if covariance terms are properly taken into account, and the uncertainty over-stating (typically) resulting from neglecting them is less severe than that (always) occurring with mass. The same considerations hold for force. In this respect, we show that the associated uncertainty is the same using mass or conventional mass, and, again, that the latter is preferable if covariance terms are neglected.

  16. Usage of personal music players in adolescents and its association with noise-induced hearing loss: A cross-sectional analysis of Ohrkan cohort study data.

    PubMed

    Twardella, Dorothee; Raab, Ulla; Perez-Alvarez, Carmelo; Steffens, Thomas; Bolte, Gabriele; Fromme, Hermann

    2017-01-01

    To describe personal music player (PMP) usage among adolescents, sociodemographic determinants and association with audiometric notches. Audiometric evaluation to assess hearing status, and standardized questionnaires to evaluate PMP listening behaviors, leisure noise exposures and self-reported hearing loss symptoms. Sociodemographic information was collected using a parent questionnaire. Noise exposure by PMP usage equivalent for a 40 h week was estimated based on self-reported volume and duration of use. A total of 2143 students (54% females) attending 9th grade in Regensburg, Germany, during 2009 to 2011. Overall, 85% of the students reported using PMPs. Exposure level exceeded 80 dB(A) in approximately one third, and 85 dB(A) in one quarter, of those who used PMP. An audiometric notch was found in 2.3% of participants, but was not significantly associated with higher PMP exposure. PMP exposure above the occupational limits of 80 and 85 dB(A) set by the Directive 2003/10/EC may be a risk factor for developing noise-induced hearing loss. Educational measures to ameliorate high risk behaviors in PMP usage are needed, particularly for socially disadvantaged groups.

  17. Increasing seat belt use among 8- to 15-year-olds. Volume II, appendices

    DOT National Transportation Integrated Search

    2008-05-01

    The broad aim of this research project was to determine the nature and causes of non-use of seat belts among 8- to 15year- olds, and to recommend interventions and strategic approaches to increase usage among this age group. This report summarizes fi...

  18. Increasing seat belt use among 8- to 15-year-olds. Volume I, findings

    DOT National Transportation Integrated Search

    2008-05-01

    The broad aim of this research project was to determine the nature and causes of non-use of seat belts among 8- to 15year- olds, and to recommend interventions and strategic approaches to increase usage among this age group. This report summarizes fi...

  19. Adaptive Technologies for Training and Education

    ERIC Educational Resources Information Center

    Durlach, Paula J., Ed; Lesgold, Alan M., Ed.

    2012-01-01

    This edited volume provides an overview of the latest advancements in adaptive training technology. Intelligent tutoring has been deployed for well-defined and relatively static educational domains such as algebra and geometry. However, this adaptive approach to computer-based training has yet to come into wider usage for domains that are less…

  20. Exploration of impact measures of safety belt use laws. Volume 2, Literature reviewed, expert team comments on indicators, and indicator catalog

    DOT National Transportation Integrated Search

    1990-02-01

    This project identified, evaluated, and recommended indicators of safety belt use law (SBUL) impact (other than fatality reduction and observed belt usage) as well as institutional sources that collect them. The project involved an extensive literatu...

  1. Achieving Better Buying Power through Acquisition of Open Architecture Software Systems: Volume 1

    DTIC Science & Technology

    2016-01-06

    supporting “Bring Your Own Devices” (BYOD)? 22 New business models for OA software components ● Franchising ● Enterprise licensing ● Metered usage...paths IP and cybersecurity requirements will need continuous attention! 35 New business models for OA software components ● Franchising ● Enterprise

  2. Definition of technology development missions for early space station, orbit transfer vehicle servicing. Volume 1: Executive summary

    NASA Technical Reports Server (NTRS)

    1983-01-01

    Orbital Transfer Vehicle (OTV) servicing study scope, propellant transfer, storage and reliquefaction technology development missions (TDM), docking and berthing TDM, maintenance TDM, OTV/payload integration TDM, combined TDMS design, summary space station accomodations, programmatic analysis, and TDM equipment operational usage are discussed.

  3. The Statistical Handbook on Technology.

    ERIC Educational Resources Information Center

    Berinstein, Paula

    This volume tells stories about the tools we use, but these narratives are told in numbers rather than in words. Organized by various aspects of society, each chapter uses tables and statistics to examine everything from budgets, costs, sales, trade, employment, patents, prices, usage, access and consumption. In each chapter, each major topic is…

  4. 40 CFR 63.10430 - What notifications must I submit and by when?

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... CATEGORIES (CONTINUED) National Emission Standards for Hospital Ethylene Oxide Sterilizers Notifications... the number of ethylene oxide sterilizers, the size (volume) of each, the number of aeration units, if any, the amount of annual ethylene oxide usage at the facility, the control technique used for each...

  5. Analysis of the Capacity of Google Trends to Measure Interest in Conservation Topics and the Role of Online News.

    PubMed

    Nghiem, Le T P; Papworth, Sarah K; Lim, Felix K S; Carrasco, Luis R

    2016-01-01

    With the continuous growth of internet usage, Google Trends has emerged as a source of information to investigate how social trends evolve over time. Knowing how the level of interest in conservation topics--approximated using Google search volume--varies over time can help support targeted conservation science communication. However, the evolution of search volume over time and the mechanisms that drive peaks in searches are poorly understood. We conducted time series analyses on Google search data from 2004 to 2013 to investigate: (i) whether interests in selected conservation topics have declined and (ii) the effect of news reporting and academic publishing on search volume. Although trends were sensitive to the term used as benchmark, we did not find that public interest towards conservation topics such as climate change, ecosystem services, deforestation, orangutan, invasive species and habitat loss was declining. We found, however, a robust downward trend for endangered species and an upward trend for ecosystem services. The quantity of news articles was related to patterns in Google search volume, whereas the number of research articles was not a good predictor but lagged behind Google search volume, indicating the role of news in the transfer of conservation science to the public.

  6. MODIS Technical Report Series. Volume 4: MODIS data access user's guide: Scan cube format

    NASA Technical Reports Server (NTRS)

    Kalb, Virginia L.; Goff, Thomas E.

    1994-01-01

    The software described in this document provides I/O functions to be used with Moderate Resolution Spectroradiometer (MODIS) level 1 and 2 data, and could be easily extended to other data sources. This data is in a scan cube data format: a 3-dimensional ragged array containing multiple bands which have resolutions ranging from 250 to 1000 meters. The complexity of the data structure is handled internally by the library. The I/O calls allow the user to access any pixel in any band through 'C' structure syntax. The high MODIS data volume (approaching half a terabyte per day) has been a driving factor in the library design. To avoid recopying data for user access, all I/O is performed through dynamic 'C' pointer manipulation. This manual contains background material on MODIS, several coding examples of library usage, in-depth discussions of each function, reference 'man' type pages, and several appendices with details of the included files used to customize a user's data product for use with the library.

  7. Hearing risk associated with the usage of personal listening devices among urban high school students in Malaysia.

    PubMed

    Sulaiman, A H; Seluakumaran, K; Husain, R

    2013-08-01

    To investigate listening habits and hearing risks associated with the use of personal listening devices among urban high school students in Malaysia. Cross-sectional, descriptive study. In total, 177 personal listening device users (13-16 years old) were interviewed to elicit their listening habits (e.g. listening duration, volume setting) and symptoms of hearing loss. Their listening levels were also determined by asking them to set their usual listening volume on an Apple iPod TM playing a pre-selected song. The iPod's sound output was measured with an artificial ear connected to a sound level meter. Subjects also underwent pure tone audiometry to ascertain their hearing thresholds at standard frequencies (0.5-8 kHz) and extended high frequencies (9-16 kHz). The mean measured listening level and listening duration for all subjects were 72.2 dBA and 1.2 h/day, respectively. Their self-reported listening levels were highly correlated with the measured levels (P < 0.001). Subjects who listened at higher volumes also tend to listen for longer durations (P = 0.012). Male subjects listened at a significantly higher volume than female subjects (P = 0.008). When sound exposure levels were compared with the recommended occupational noise exposure limit, 4.5% of subjects were found to be listening at levels which require mandatory hearing protection in the occupational setting. Hearing loss (≥25 dB hearing level at one or more standard test frequencies) was detected in 7.3% of subjects. Subjects' sound exposure levels from the devices were positively correlated with their hearing thresholds at two of the extended high frequencies (11.2 and 14 kHz), which could indicate an early stage of noise-induced hearing loss. Although the average high school student listened at safe levels, a small percentage of listeners were exposed to harmful sound levels. Preventive measures are needed to avoid permanent hearing damage in high-risk listeners. Copyright © 2013 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

  8. High call volume at poison control centers: identification and implications for communication

    PubMed Central

    CARAVATI, E. M.; LATIMER, S.; REBLIN, M.; BENNETT, H. K. W.; CUMMINS, M. R.; CROUCH, B. I.; ELLINGTON, L.

    2016-01-01

    Context High volume surges in health care are uncommon and unpredictable events. Their impact on health system performance and capacity is difficult to study. Objectives To identify time periods that exhibited very busy conditions at a poison control center and to determine whether cases and communication during high volume call periods are different from cases during low volume periods. Methods Call data from a US poison control center over twelve consecutive months was collected via a call logger and an electronic case database (Toxicall®). Variables evaluated for high call volume conditions were: (1) call duration; (2) number of cases; and (3) number of calls per staff member per 30 minute period. Statistical analyses identified peak periods as busier than 99% of all other 30 minute time periods and low volume periods as slower than 70% of all other 30 minute periods. Case and communication characteristics of high volume and low volume calls were compared using logistic regression. Results A total of 65,364 incoming calls occurred over 12 months. One hundred high call volume and 4885 low call volume 30 minute periods were identified. High volume periods were more common between 1500 and 2300 hours and during the winter months. Coded verbal communication data were evaluated for 42 high volume and 296 low volume calls. The mean (standard deviation) call length of these calls during high volume and low volume periods was 3 minutes 27 seconds (1 minute 46 seconds) and 3 minutes 57 seconds (2 minutes 11 seconds), respectively. Regression analyses revealed a trend for fewer overall verbal statements and fewer staff questions during peak periods, but no other significant differences for staff-caller communication behaviors were found. Conclusion Peak activity for poison center call volume can be identified by statistical modeling. Calls during high volume periods were similar to low volume calls. Communication was more concise yet staff was able to maintain a good rapport with callers during busy call periods. This approach allows evaluation of poison exposure call characteristics and communication during high volume periods. PMID:22889059

  9. High call volume at poison control centers: identification and implications for communication.

    PubMed

    Caravati, E M; Latimer, S; Reblin, M; Bennett, H K W; Cummins, M R; Crouch, B I; Ellington, L

    2012-09-01

    High volume surges in health care are uncommon and unpredictable events. Their impact on health system performance and capacity is difficult to study. To identify time periods that exhibited very busy conditions at a poison control center and to determine whether cases and communication during high volume call periods are different from cases during low volume periods. Call data from a US poison control center over twelve consecutive months was collected via a call logger and an electronic case database (Toxicall®).Variables evaluated for high call volume conditions were: (1) call duration; (2) number of cases; and (3) number of calls per staff member per 30 minute period. Statistical analyses identified peak periods as busier than 99% of all other 30 minute time periods and low volume periods as slower than 70% of all other 30 minute periods. Case and communication characteristics of high volume and low volume calls were compared using logistic regression. A total of 65,364 incoming calls occurred over 12 months. One hundred high call volume and 4885 low call volume 30 minute periods were identified. High volume periods were more common between 1500 and 2300 hours and during the winter months. Coded verbal communication data were evaluated for 42 high volume and 296 low volume calls. The mean (standard deviation) call length of these calls during high volume and low volume periods was 3 minutes 27 seconds (1 minute 46 seconds) and 3 minutes 57 seconds (2 minutes 11 seconds), respectively. Regression analyses revealed a trend for fewer overall verbal statements and fewer staff questions during peak periods, but no other significant differences for staff-caller communication behaviors were found. Peak activity for poison center call volume can be identified by statistical modeling. Calls during high volume periods were similar to low volume calls. Communication was more concise yet staff was able to maintain a good rapport with callers during busy call periods. This approach allows evaluation of poison exposure call characteristics and communication during high volume periods.

  10. Television, reading, and computer time: correlates of school-day leisure-time sedentary behavior and relationship with overweight in children in the U.S.

    PubMed

    Sisson, Susan B; Broyles, Stephanie T; Baker, Birgitta L; Katzmarzyk, Peter T

    2011-09-01

    The purposes were 1) to determine if different leisure-time sedentary behaviors (LTSB), such as TV/video/video game viewing/playing (TV), reading for pleasure (reading), and nonschool computer usage, were associated with childhood overweight status, and 2) to assess the social-ecological correlates of LTSB. The analytic sample was 33,117 (16,952 boys and 16,165 girls) participants from the 2003 National Survey of Children's Health. The cut-point for excessive TV and nonschool computer usage was ≥ 2 hr/day. High quantities of daily reading for pleasure were classified as ≥ 31 min/day. Weighted descriptive characteristics were calculated on the sample (means ± SE or frequency). Logistic regression models were used to determine if the LTSB were associated with overweight status and to examine social-ecological correlates. Over 35% of the sample was overweight. Odds of being overweight were higher in the 2 to 3 hr/day (OR: 1.48, 95% CI: 1.24, 1.76) and ≥ 4 hr/day (OR: 1.52, 95% CI: 1.22, 1.91) daily TV groups compared with none. Reading and nonschool computer usage was not associated with being overweight. TV was associated with overweight classification; however, nonschool computer usage and reading were not. Several individual, family, and community correlates were associated with high volumes of daily TV viewing.

  11. Heterogeneous Mobile Phone Ownership and Usage Patterns in Kenya

    PubMed Central

    Wesolowski, Amy; Eagle, Nathan; Noor, Abdisalan M.; Snow, Robert W.; Buckee, Caroline O.

    2012-01-01

    The rapid adoption of mobile phone technologies in Africa is offering exciting opportunities for engaging with high-risk populations through mHealth programs, and the vast volumes of behavioral data being generated as people use their phones provide valuable data about human behavioral dynamics in these regions. Taking advantage of these opportunities requires an understanding of the penetration of mobile phones and phone usage patterns across the continent, but very little is known about the social and geographical heterogeneities in mobile phone ownership among African populations. Here, we analyze a survey of mobile phone ownership and usage across Kenya in 2009 and show that distinct regional, gender-related, and socioeconomic variations exist, with particularly low ownership among rural communities and poor people. We also examine patterns of phone sharing and highlight the contrasting relationships between ownership and sharing in different parts of the country. This heterogeneous penetration of mobile phones has important implications for the use of mobile technologies as a source of population data and as a public health tool in sub-Saharan Africa. PMID:22558140

  12. Heterogeneous mobile phone ownership and usage patterns in Kenya.

    PubMed

    Wesolowski, Amy; Eagle, Nathan; Noor, Abdisalan M; Snow, Robert W; Buckee, Caroline O

    2012-01-01

    The rapid adoption of mobile phone technologies in Africa is offering exciting opportunities for engaging with high-risk populations through mHealth programs, and the vast volumes of behavioral data being generated as people use their phones provide valuable data about human behavioral dynamics in these regions. Taking advantage of these opportunities requires an understanding of the penetration of mobile phones and phone usage patterns across the continent, but very little is known about the social and geographical heterogeneities in mobile phone ownership among African populations. Here, we analyze a survey of mobile phone ownership and usage across Kenya in 2009 and show that distinct regional, gender-related, and socioeconomic variations exist, with particularly low ownership among rural communities and poor people. We also examine patterns of phone sharing and highlight the contrasting relationships between ownership and sharing in different parts of the country. This heterogeneous penetration of mobile phones has important implications for the use of mobile technologies as a source of population data and as a public health tool in sub-Saharan Africa.

  13. Computers into Classrooms: More Questions than Answers.

    ERIC Educational Resources Information Center

    Beynon, John, Ed.; Mackay, Hughie, Ed.

    This is one of a series of three books addressing the question of the nature of technological literacy. This volume, consisting of an introduction, an epilogue, and 12 chapters, focuses on classrooms and classroom processes involving computers and deals directly with teacher and student usage of microcomputers in teaching and learning. The 12…

  14. An Historical Albanian-English Dictionary: Part II, N-Z.

    ERIC Educational Resources Information Center

    Mann, Stuart E.

    The second of a two-volume, historical, Albanian-English dictionary, spanning a time period from 1496-1938, this reference work is based on Albanian word usage in literature and among the peasant culture. Entries are alphabetically listed from "n" through "z" with abbreviated reference to the word's bibliographic origin. Definitions are brief and…

  15. CANFAR+Skytree: A Cloud Computing and Data Mining System for Astronomy

    NASA Astrophysics Data System (ADS)

    Ball, N. M.

    2013-10-01

    This is a companion Focus Demonstration article to the CANFAR+Skytree poster (Ball 2013, this volume), demonstrating the usage of the Skytree machine learning software on the Canadian Advanced Network for Astronomical Research (CANFAR) cloud computing system. CANFAR+Skytree is the world's first cloud computing system for data mining in astronomy.

  16. Feasibility study of an Integrated Program for Aerospace vehicle Design (IPAD). Volume 5: Catalog of IPAD technical program elements

    NASA Technical Reports Server (NTRS)

    Gillette, W. B. (Editor); Southall, J. W. (Editor)

    1973-01-01

    The catalog is presented of technical program elements which are required to support the design activities for a subsonic and supersonic commercial transport. Information for each element consists of usage and storage information, ownership, status and an abstract describing the purpose of the element.

  17. A Case Study on TRICARE Online Web-enabled Appointing: Improving Utilization Rates at Navy Medical Treatment Facilities

    DTIC Science & Technology

    2009-10-20

    Low usage volume raised concerns about the effectiveness of TOL. In 2004, the eHealth Division of TMA Information Management conducted a study to...Case Study 31 (Version 15.8). Falls Church, VA: Department of Defense, TRICARE Management Activity, Information Management eHealth Division

  18. Intrasystem Analysis Program (IAP) Code Summaries.

    DTIC Science & Technology

    1983-05-01

    I - Ue’s Manual Engineering Section," RADC-TR-74-342, AD# A008526, December 1974. - 3. L. Bogdanor , R. A. Pearl--n, and M. .. Siegel, "Intrasystem...Electromagnetic Compatibility Analysis Program, Volume II - User’s Manual Usage Section," RADC-TR-74-342, AD# A008527, December 1974. i * J. L. Bogdanor

  19. Television and the American Family. Second Edition.

    ERIC Educational Resources Information Center

    Bryant, Jennings, Ed.; Bryant, J. Alison, Ed.

    Noting drastic changes in both television and the family since the 1990 edition, this revised volume provides an extensive consideration of television's role in the American family, from the uses families make of television and how extensions such as remote controls and VCRs affect usage, to the meanings families have for television, families'…

  20. Low rates of complications for carotid artery stenting are associated with a high clinician volume of carotid artery stenting and aortic endografting but not with a high volume of percutaneous coronary interventions.

    PubMed

    Modrall, J Gregory; Chung, Jayer; Kirkwood, Melissa L; Baig, M Shadman; Tsai, Shirling X; Timaran, Carlos H; Valentine, R James; Rosero, Eric B

    2014-07-01

    Prior studies have demonstrated improved clinical outcomes for surgeons with a high-volume experience with certain open vascular operations. A high-volume experience with carotid artery stenting (CAS) improves clinical outcomes. Moreover, it is not known whether experience with other endovascular procedures, including percutaneous coronary interventions (PCIs), is an adequate substitute for experience with CAS. The goal of this study was to quantify the effect of increasing clinician volume of CAS, endovascular aneurysm repair (EVAR), and thoracic endovascular aortic aneurysm repair (TEVAR), and PCI on the outcomes for CAS. The Nationwide Inpatient Sample was analyzed to identify patients undergoing CAS for the years 2005 to 2009. Clinicians were stratified into tertiles of low-volume, medium-volume, and high-volume groups by annual volume of CAS, EVAR/TEVAR, and PCI. Multiple logistic regression analyses were used to examine the relationship between clinician volume and a composite outcome of the in-hospital stroke and death rate after CAS. Between 2005 and 2009, 56,374 elective CAS procedures were performed nationwide, with a crude in-hospital stroke and death rate of 3.22%. A median of nine CAS procedures (interquartile range, 3-20) were performed annually per clinician. As expected, stroke and death rates for CAS decreased with increasing volume of CAS performed by a clinician (low-volume vs medium-volume vs high-volume: 4.43% vs 2.89% vs 2.27%; P = .0001). Similar patterns were noted between clinicians' volume of EVAR/TEVAR (low-volume vs medium-volume vs high-volume: 4.58% vs 3.18% vs 2.16%; P = .0023). In contrast, increasing PCI volume was not associated with decreased stroke and death rates after CAS (low-volume vs medium-volume vs high-volume: 2.99% vs 3.18% vs 3.55%; P = .35). After adjusting for patient and hospital characteristics, clinician volume of CAS (odds ratio [OR], 0.84; 95% confidence interval [CI], 0.74-0.94; P = .003) and EVAR/TEVAR (OR, 0.85; 95% CI, 0.75-0.97; P = .020) remained significant predictors of stroke and death after CAS, whereas increasing clinician volume of PCI was associated with significantly increasing likelihood of stroke or death after CAS (OR, 1.025; 95% CI, 1.004-1.047; P = .019). The stroke and death rate for CAS to treat carotid stenosis is inversely affected by the number of CAS and EVAR/TEVAR procedures performed by a clinician. In contrast, a high-volume experience with PCI is not associated with improved outcomes after CAS. Copyright © 2014 Society for Vascular Surgery. All rights reserved.

  1. Water usage for natural gas production through hydraulic fracturing in the United States from 2008 to 2014.

    PubMed

    Chen, Huan; Carter, Kimberly E

    2016-04-01

    Hydraulic fracturing has promoted the exploitation of shale oil and natural gas in the United States (U.S.). However, the large amounts of water used in hydraulic fracturing may constrain oil and natural gas production in the shale plays. This study surveyed the amounts of freshwater and recycled produced water used to fracture wells from 2008 to 2014 in Arkansas, California, Colorado, Kansas, Louisiana, Montana, North Dakota, New Mexico, Ohio, Oklahoma, Pennsylvania, Texas, West Virginia, and Wyoming. Results showed that the annual average water volumes used per well in most of these states ranged between 1000 m(3) and 30,000 m(3). The highest total amount of water was consumed in Texas with 457.42 Mm(3) of water used to fracture 40,521 wells, followed by Pennsylvania with 108.67 Mm(3) of water used to treat 5127 wells. Water usages ranged from 96.85 Mm(3) to 166.10 Mm(3) annually in Texas from 2012 to 2014 with more than 10,000 wells fractured during that time. The percentage of water used for hydraulic fracturing in each state was relatively low compared to water usages for other industries. From 2009 to 2014, 6.55% (median) of the water volume used in hydraulic fracturing contained recycled produced water or recycled hydraulic fracturing wastewater. 10.84% (median) of wells produced by hydraulic fracturing were treated with recycled produced water. The percentage of wells where recycled wastewater was used was lower, except in Ohio and Arkansas, where more than half of the wells were fractured using recycled produced water. The median recycled wastewater volume in produced wells was 7127 m(3) per well, more than half the median value in annual water used per well 11,259 m(3). This indicates that, for wells recycling wastewater, more than half of their water use consisted of recycled wastewater. Copyright © 2016 Elsevier Ltd. All rights reserved.

  2. COMO: a numerical model for predicting furnace performance in axisymmetric geometries. Volume 1. Technical summary. Final report

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

    Fiveland, W.A.; Oberjohn, W.J.; Cornelius, D.K.

    1985-12-01

    This report summarizes the work conducted during a 30-month contract with the United States Department of Energy (DOE) Pittsburgh Energy Technology Center (PETC). The general objective is to develop and verify a computer code capable of modeling the major aspects of pulverized coal combustion. Achieving this objective will lead to design methods applicable to industrial and utility furnaces. The combustion model (COMO) is based mainly on an existing Babcock and Wilcox (B and W) computer program. The model consists of a number of relatively independent modules that represent the major processes involved in pulverized coal combustion: flow, heterogeneous and homogeneousmore » chemical reaction, and heat transfer. As models are improved or as new ones are developed, this modular structure allows portions of the COMO model to be updated with minimal impact on the remainder of the program. The report consists of two volumes. This volume (Volume 1) contains a technical summary of the COMO model, results of predictions for gas phase combustion, pulverized coal combustion, and a detailed description of the COMO model. Volume 2 is the Users Guide for COMO and contains detailed instructions for preparing the input data and a description of the program output. Several example cases have been included to aid the user in usage of the computer program for pulverized coal applications. 66 refs., 41 figs., 21 tabs.« less

  3. JiTTree: A Just-in-Time Compiled Sparse GPU Volume Data Structure.

    PubMed

    Labschütz, Matthias; Bruckner, Stefan; Gröller, M Eduard; Hadwiger, Markus; Rautek, Peter

    2016-01-01

    Sparse volume data structures enable the efficient representation of large but sparse volumes in GPU memory for computation and visualization. However, the choice of a specific data structure for a given data set depends on several factors, such as the memory budget, the sparsity of the data, and data access patterns. In general, there is no single optimal sparse data structure, but a set of several candidates with individual strengths and drawbacks. One solution to this problem are hybrid data structures which locally adapt themselves to the sparsity. However, they typically suffer from increased traversal overhead which limits their utility in many applications. This paper presents JiTTree, a novel sparse hybrid volume data structure that uses just-in-time compilation to overcome these problems. By combining multiple sparse data structures and reducing traversal overhead we leverage their individual advantages. We demonstrate that hybrid data structures adapt well to a large range of data sets. They are especially superior to other sparse data structures for data sets that locally vary in sparsity. Possible optimization criteria are memory, performance and a combination thereof. Through just-in-time (JIT) compilation, JiTTree reduces the traversal overhead of the resulting optimal data structure. As a result, our hybrid volume data structure enables efficient computations on the GPU, while being superior in terms of memory usage when compared to non-hybrid data structures.

  4. Hydraulic modeling of clay ceramic water filters for point-of-use water treatment.

    PubMed

    Schweitzer, Ryan W; Cunningham, Jeffrey A; Mihelcic, James R

    2013-01-02

    The acceptability of ceramic filters for point-of-use water treatment depends not only on the quality of the filtered water, but also on the quantity of water the filters can produce. This paper presents two mathematical models for the hydraulic performance of ceramic water filters under typical usage. A model is developed for two common filter geometries: paraboloid- and frustum-shaped. Both models are calibrated and evaluated by comparison to experimental data. The hydraulic models are able to predict the following parameters as functions of time: water level in the filter (h), instantaneous volumetric flow rate of filtrate (Q), and cumulative volume of water produced (V). The models' utility is demonstrated by applying them to estimate how the volume of water produced depends on factors such as the filter shape and the frequency of filling. Both models predict that the volume of water produced can be increased by about 45% if users refill the filter three times per day versus only once per day. Also, the models predict that filter geometry affects the volume of water produced: for two filters with equal volume, equal wall thickness, and equal hydraulic conductivity, a filter that is tall and thin will produce as much as 25% more water than one which is shallow and wide. We suggest that the models can be used as tools to help optimize filter performance.

  5. The British Association of Urological Surgeons (BAUS) radical prostatectomy audit 2014/2015 - an update on current practice and outcomes by centre and surgeon case-volume.

    PubMed

    Khadhouri, Sinan; Miller, Catherine; Fowler, Sarah; Hounsome, Luke; McNeill, Alan; Adshead, Jim; McGrath, John S

    2018-02-01

    To describe contemporary radical prostatectomy (RP) practice using the British Association of Urological Surgeons (BAUS) data and audit project and to observe differences in practice in relation to surgeon or centre case-volume. Data on 13 920 RP procedures performed by 179 surgeons across 86 centres were recorded on the BAUS data and audit platform between 1 January 2014 and 31 December 2015. This equates to ~95% of total RPs performed over this period when compared to Hospital Episode Statistics (HES) data. Centre case-volumes were categorised as 'high' (>200), 'medium' (100-200) and 'low' (<100); surgeon case-volumes were categorised as 'high' (>100) and 'low' (<100). Differences in surgical practice and selected outcome measures were observed between groups. All data and volume categories were for the combined 2-year period. The median number of RPs performed over the 2-year period was 63.5 per surgeon and 164 per centre. Overall, surgical approach was robot-assisted laparoscopic RP (RALP) in 65%, laparoscopic RP (LRP) in 23%, and open RP (ORP) in 12%. The dominant approach in high-case-volume centres and by high-case-volume surgeons was RALP (74.3% and 69.2%, respectively). There was a greater percentage of ORPs reported by low-volume surgeons and centres when compared to higher volume equivalents. In all, 51.6% of all patients in this series underwent RP in high-case-volume centres using robot-assisted surgery (RAS). High-case-volume surgeons performed nerve-sparing (NS) procedures on 57.3% of their cases; low-volume surgeons performing NS on 48.2%. Overall, lymph node dissection (LND) rates were very similar across the groups. An 'extended' LND was more commonly performed in high-volume centres (22.1%). The median length of stay (LOS) was lowest in patients undergoing RALP at high-volume centres (1 day) and highest in ORP across all volume categories (3-4 days). Reported pT2 positive surgical margin (PSM) rate varied by technique, centre volume, and surgeon volume. In general, observed PSM rates were lower when RALP was the surgical approach (14.4%) and when high-volume surgeons were compared to low-volume surgeons (13.6% vs 17.7%). Transfusion rates were highest in ORP across all centres and surgeons (2.96-4.49%) compared to techniques using a minimally-invasive approach (0.25-2.41%). Training cases ranged from 0.5% in low-volume centres to 6.0% in high-volume centres. Compliance with data registration for centres and surgeons performing RP is high in the present series. Most RPs were performed in high-case-volume centres and by high-case-volume surgeons, with the most common approaches being minimally invasive and specifically RAS. High-case-volume centres and surgeons reported higher rates of extended LND and training cases. Higher-case-volume surgeons reported lower pT2 PSM rates, whilst the most marked differences in transfusion rates and LOS were seen when ORP was compared to minimally invasive approaches. Caution must be applied when interpreting these differences on the basis of this being registry data - causality cannot be assumed. © 2018 The Authors BJU International © 2018 BJU International Published by John Wiley & Sons Ltd.

  6. High tidal volume ventilation induces NOS2 and impairs cAMP- dependent air space fluid clearance.

    PubMed

    Frank, James A; Pittet, Jean-Francois; Lee, Hyon; Godzich, Micaela; Matthay, Michael A

    2003-05-01

    Tidal volume reduction during mechanical ventilation reduces mortality in patients with acute lung injury and the acute respiratory distress syndrome. To determine the mechanisms underlying the protective effect of low tidal volume ventilation, we studied the time course and reversibility of ventilator-induced changes in permeability and distal air space edema fluid clearance in a rat model of ventilator-induced lung injury. Anesthetized rats were ventilated with a high tidal volume (30 ml/kg) or with a high tidal volume followed by ventilation with a low tidal volume of 6 ml/kg. Endothelial and epithelial protein permeability were significantly increased after high tidal volume ventilation but returned to baseline levels when tidal volume was reduced. The basal distal air space fluid clearance (AFC) rate decreased by 43% (P < 0.05) after 1 h of high tidal volume but returned to the preventilation rate 2 h after tidal volume was reduced. Not all of the effects of high tidal volume ventilation were reversible. The cAMP-dependent AFC rate after 1 h of 30 ml/kg ventilation was significantly reduced and was not restored when tidal volume was reduced. High tidal volume ventilation also increased lung inducible nitric oxide synthase (NOS2) expression and air space total nitrite at 3 h. Inhibition of NOS2 activity preserved cAMP-dependent AFC. Because air space edema fluid inactivates surfactant and reduces ventilated lung volume, the reduction of cAMP-dependent AFC by reactive nitrogen species may be an important mechanism of clinical ventilator-associated lung injury.

  7. ATLAS, an integrated structural analysis and design system. Volume 2: System design document

    NASA Technical Reports Server (NTRS)

    Erickson, W. J. (Editor)

    1979-01-01

    ATLAS is a structural analysis and design system, operational on the Control Data Corporation 6600/CYBER computers. The overall system design, the design of the individual program modules, and the routines in the ATLAS system library are described. The overall design is discussed in terms of system architecture, executive function, data base structure, user program interfaces and operational procedures. The program module sections include detailed code description, common block usage and random access file usage. The description of the ATLAS program library includes all information needed to use these general purpose routines.

  8. Projected electric power demands for the Potomac Electric Power Company. Volume 1

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

    Estomin, S.; Kahal, M.

    1984-03-01

    This three-volume report presents the results of an econometric forecast of peak and electric power demands for the Potomac Electric Power Company (PEPCO) through the year 2002. Volume I describes the methodology, the results of the econometric estimations, the forecast assumptions and the calculated forecasts of peak demand and energy usage. Separate sets of models were developed for the Maryland Suburbs (Montgomery and Prince George's counties), the District of Columbia and Southern Maryland (served by a wholesale customer of PEPCO). For each of the three jurisdictions, energy equations were estimated for residential and commercial/industrial customers for both summer and wintermore » seasons. For the District of Columbia, summer and winter equations for energy sales to the federal government were also estimated. Equations were also estimated for street lighting and energy losses. Noneconometric techniques were employed to forecast energy sales to the Northern Virginia suburbs, Metrorail and federal government facilities located in Maryland.« less

  9. Cerebral gray matter volume in patients with chronic migraine: correlations with clinical features.

    PubMed

    Coppola, Gianluca; Petolicchio, Barbara; Di Renzo, Antonio; Tinelli, Emanuele; Di Lorenzo, Cherubino; Parisi, Vincenzo; Serrao, Mariano; Calistri, Valentina; Tardioli, Stefano; Cartocci, Gaia; Ambrosini, Anna; Caramia, Francesca; Di Piero, Vittorio; Pierelli, Francesco

    2017-12-08

    To date, few MRI studies have been performed in patients affected by chronic migraine (CM), especially in those without medication overuse. Here, we performed magnetic resonance imaging (MRI) voxel-based morphometry (VBM) analyses to investigate the gray matter (GM) volume of the whole brain in patients affected by CM. Our aim was to investigate whether fluctuations in the GM volumes were related to the clinical features of CM. Twenty untreated patients with CM without a past medical history of medication overuse underwent 3-Tesla MRI scans and were compared to a group of 20 healthy controls (HCs). We used SPM12 and the CAT12 toolbox to process the MRI data and to perform VBM analyses of the structural T1-weighted MRI scans. The GM volume of patients was compared to that of HCs with various corrected and uncorrected thresholds. To check for possible correlations, patients' clinical features and GM maps were regressed. Initially, we did not find significant differences in the GM volume between patients with CM and HCs (p < 0.05 corrected for multiple comparisons). However, using more-liberal uncorrected statistical thresholds, we noted that compared to HCs, patients with CM exhibited clusters of regions with lower GM volumes including the cerebellum, left middle temporal gyrus, left temporal pole/amygdala/hippocampus/pallidum/orbitofrontal cortex, and left occipital areas (Brodmann areas 17/18). The GM volume of the cerebellar hemispheres was negatively correlated with the disease duration and positively correlated with the number of tablets taken per month. No gross morphometric changes were observed in patients with CM when compared with HCs. However, using more-liberal uncorrected statistical thresholds, we observed that CM is associated with subtle GM volume changes in several brain areas known to be involved in nociception/antinociception, multisensory integration, and analgesic dependence. We speculate that these slight morphometric impairments could lead, at least in a subgroup of patients, to the development and continuation of maladaptive acute medication usage.

  10. North Dakota Academic Library Statistics; July 1973 through June 1974.

    ERIC Educational Resources Information Center

    North Dakota Library Notes, 1975

    1975-01-01

    The bulk of this volume is comprised of the statistical report forms submitted to the state library by all of the academic libraries in the state of North Dakota. The data presented for each library includes: print resources (books, documents, serials, and microforms); audiovisual holdings; collection use in terms of in-library usage, circulation,…

  11. National Childcare Consumer Study: 1975. Volume IV: Supplemental Documentation.

    ERIC Educational Resources Information Center

    Unco, Inc., Washington, DC.

    This document is the fourth and final report of a study sponsored by the Office of Child Development of the U.S. Department of Health, Education and Welfare to determine patterns of child care usage and related consumer preferences, attitudes and opinions about child care. The study was based on 4609 personal interviews conducted in 1975 from a…

  12. Online Courses Assessment through Measuring and Archetyping of Usage Data

    ERIC Educational Resources Information Center

    Kazanidis, Ioannis; Theodosiou, Theodosios; Petasakis, Ioannis; Valsamidis, Stavros

    2016-01-01

    Database files and additional log files of Learning Management Systems (LMSs) contain an enormous volume of data which usually remain unexploited. A new methodology is proposed in order to analyse these data both on the level of both the courses and the learners. Specifically, "regression analysis" is proposed as a first step in the…

  13. Impact of robotic technique and surgical volume on the cost of radical prostatectomy.

    PubMed

    Hyams, Elias S; Mullins, Jeffrey K; Pierorazio, Phillip M; Partin, Alan W; Allaf, Mohamad E; Matlaga, Brian R

    2013-03-01

    Our present understanding of the effect of robotic surgery and surgical volume on the cost of radical prostatectomy (RP) is limited. Given the increasing pressures placed on healthcare resource utilization, such determinations of healthcare value are becoming increasingly important. Therefore, we performed a study to define the effect of robotic technology and surgical volume on the cost of RP. The state of Maryland mandates that all acute-care hospitals report encounter-level and hospital discharge data to the Health Service Cost Review Commission (HSCRC). The HSCRC was queried for men undergoing RP between 2008 and 2011 (the period during which robot-assisted laparoscopic radical prostatectomy [RALRP] was coded separately). High-volume hospitals were defined as >60 cases per year, and high-volume surgeons were defined as >40 cases per year. Multivariate regression analysis was performed to evaluate whether robotic technique and high surgical volume impacted the cost of RP. There were 1499 patients who underwent RALRP and 2565 who underwent radical retropubic prostatectomy (RRP) during the study period. The total cost for RALRP was higher than for RRP ($14,000 vs 10,100; P<0.001) based primarily on operating room charges and supply charges. Multivariate regression demonstrated that RALRP was associated with a significantly higher cost (β coeff 4.1; P<0.001), even within high-volume hospitals (β coeff 3.3; P<0.001). High-volume surgeons and high-volume hospitals, however, were associated with a significantly lower cost for RP overall. High surgeon volume was associated with lower cost for RALRP and RRP, while high institutional volume was associated with lower cost for RALRP only. High surgical volume was associated with lower cost of RP. Even at high surgical volume, however, the cost of RALRP still exceeded that of RRP. As robotic surgery has come to dominate the healthcare marketplace, strategies to increase the role of high-volume providers may be needed to improve the cost-effectiveness of prostate cancer surgical therapy.

  14. An Initial Log Analysis of Usage Patterns on a Research Networking System

    PubMed Central

    Boland, Mary Regina; Trembowelski, Sylvia; Bakken, Suzanne; Weng, Chunhua

    2012-01-01

    Abstract Usage data for research networking systems (RNSs) are valuable but generally unavailable for understanding scientific professionals’ information needs and online collaborator seeking behaviors. This study contributes a method for evaluating RNSs and initial usage knowledge of one RNS obtained from using this method. We designed a log for an institutional RNS, defined categories of users and tasks, and analyzed correlations between usage patterns and user and query types. Our results show that scientific professionals spend more time performing deep Web searching on RNSs than generic Google users and we also show that retrieving scientist profiles is faster on an RNS than on Google (3.5 seconds vs. 34.2 seconds) whereas organization‐specific browsing on a RNS takes longer than on Google (117.0 seconds vs. 34.2 seconds). Usage patterns vary by user role, e.g., faculty performed more informational queries than administrators, which implies role‐specific user support is needed for RNSs. Clin Trans Sci 2012; Volume 5: 340–347 PMID:22883612

  15. Pharmaco-thermodynamics of deuterium-induced oedema in living rat brain via 1H2O MRI: implications for boron neutron capture therapy of malignant brain tumours

    NASA Astrophysics Data System (ADS)

    Medina, Daniel C.; Li, Xin; Springer, Charles S., Jr.

    2005-05-01

    In addition to its common usage as a tracer in metabolic and physiological studies, deuterium possesses anti-tumoural activity and confers protection against γ-irradiation. A more recent interest in deuterium emanates from the search for alternatives capable of improving neutron penetrance whilst reducing healthy tissue radiation dose deposition in boron neutron capture therapy of malignant brain tumours. Despite this potential clinical application, deuterium induces brain oedema, which is detrimental to neutron capture therapy. In this study, five adult male rats were titrated with deuterated drinking water while brain oedema was monitored via water proton magnetic resonance imaging. This report concludes that deuterium, as well as deuterium-induced brain oedema, possesses a uniform brain bio-distribution. At a steady-state blood fluid deuteration value of 16%, when the deuterium isotope fraction in drinking water was 25%, a mean oedematous volume change of 9 ± 2% (p-value <0.001) was observed in the rat brain—this may account for neurological and behavioural abnormalities found in mammals drinking highly deuterated water. In addition to characterizing the pharmaco-thermodynamics of deuterium-induced oedema, this report also estimates the impact of oedema on thermal neutron enhancement and effective dose reduction factors using simple linear transport calculations. While body fluid deuteration enhances thermal neutron flux penetrance and reduces dose deposition, oedema has the opposite effect because it increases the volume of interest, e.g., the brain volume. Thermal neutron enhancement and effective dose reduction factors could be reduced by as much as ~10% in the presence of a 9% water volume increase (oedema). All three authors have contributed equally to this work.

  16. Impact of Moodle-Based Online Curriculum on Thoracic Surgery In-Training Examination Scores.

    PubMed

    Antonoff, Mara B; Verrier, Edward D; Allen, Mark S; Aloia, Lauren; Baker, Craig; Fann, James I; Iannettoni, Mark D; Yang, Stephen C; Vaporciyan, Ara A

    2016-10-01

    The feasibility and efficacy of a web-based curriculum in supplementing thoracic surgical training was previously shown. However, the impact of curricular participation on validated knowledge tests remains unknown. We compared in-service training examination (ITE) results among trainees, stratified by curricular use. The national online curriculum was implemented in August 2013. We retrospectively reviewed trainees who participated in thoracic surgical training programs in both 2012 to 2013 and 2013 to 2014. Scores from the 2013 and 2014 ITEs were obtained, and curricular usage data were collected from site analytics. Trainees were separated into three groups according to 2013 ITE scores; within each group, changes in score for high- versus low-volume users were compared. 187 trainees took the ITE both years, with exposure to the online curriculum during only the second year. High-volume users' scores trended toward greater improvement than scores of low-volume users (+18.2% versus +13.0%, p = 0.199). When stratified by 2013 score, the lowest scoring quartile improved substantially, and the highest scoring quartile improved modestly, regardless of curricular use. However, for those individuals who achieved mid-range scores in 2013, there was a trend toward much greater improvement in score with heavier use of the curriculum (+17.0% versus +7.0%, p = 0.094). Among trainees who had access to the novel online curriculum during the second of 2 consecutive years, we evaluated the impact of curricular participation on ITE scores. The effect appears to be most pronounced in individuals with mid-range scores, in whom high curricular use led to the greatest improvement. Copyright © 2016 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

  17. A High-Order Finite Spectral Volume Method for Conservation Laws on Unstructured Grids

    NASA Technical Reports Server (NTRS)

    Wang, Z. J.; Liu, Yen; Kwak, Dochan (Technical Monitor)

    2001-01-01

    A time accurate, high-order, conservative, yet efficient method named Finite Spectral Volume (FSV) is developed for conservation laws on unstructured grids. The concept of a 'spectral volume' is introduced to achieve high-order accuracy in an efficient manner similar to spectral element and multi-domain spectral methods. In addition, each spectral volume is further sub-divided into control volumes (CVs), and cell-averaged data from these control volumes is used to reconstruct a high-order approximation in the spectral volume. Riemann solvers are used to compute the fluxes at spectral volume boundaries. Then cell-averaged state variables in the control volumes are updated independently. Furthermore, TVD (Total Variation Diminishing) and TVB (Total Variation Bounded) limiters are introduced in the FSV method to remove/reduce spurious oscillations near discontinuities. A very desirable feature of the FSV method is that the reconstruction is carried out only once, and analytically, and is the same for all cells of the same type, and that the reconstruction stencil is always non-singular, in contrast to the memory and CPU-intensive reconstruction in a high-order finite volume (FV) method. Discussions are made concerning why the FSV method is significantly more efficient than high-order finite volume and the Discontinuous Galerkin (DG) methods. Fundamental properties of the FSV method are studied and high-order accuracy is demonstrated for several model problems with and without discontinuities.

  18. Pilot scale repeated fed-batch fermentation processes of the wine yeast Dekkera bruxellensis for mass production of resveratrol from Polygonum cuspidatum.

    PubMed

    Kuo, Hsiao-Ping; Wang, Reuben; Lin, Yi-Sheng; Lai, Jinn-Tsyy; Lo, Yi-Chen; Huang, Shyue-Tsong

    2017-11-01

    Resveratrol has long been used as an ingredient in functional foods. Currently, Polygonum cuspidatum extract is the greatest natural source for resveratrol because of high concentrations of glycosidic-linked resveratrol. Thus, developing a cost-effective procedure to hydrolyze glucoside could substantially enhance resveratrol production from P. cuspidatum. This study selected Dekkera bruxellensis from several microorganisms based on its bioconversion and enzyme-specific activities. We demonstrated that the cells could be reused at least nine times while maintaining an average of 180.67U/L β-glucosidase activity. The average resveratrol bioconversion efficiency within five rounds of repeated usage was 108.77±0.88%. This process worked effectively when the volume was increased to 1200L, a volume at which approximately 35mgL -1 h -1 resveratrol per round was produced. This repeated fed-batch bioconversion process for resveratrol production is comparable to enzyme or cell immobilization strategies in terms of reusing cycles, but without incurring additional costs for immobilization. Copyright © 2017 Elsevier Ltd. All rights reserved.

  19. Delivery of electroconvulsive therapy in Canada: a first national survey report on usage, treatment practice, and facilities.

    PubMed

    Martin, Barry A; Delva, Nicholas John; Graf, Peter; Gosselin, Caroline; Enns, Murray W; Gilron, Ian; Jewell, Mark; Lawson, James Stuart; Milev, Roumen; Patry, Simon; Chan, Peter K Y

    2015-06-01

    The aims of this study were to document electroconvulsive therapy use in Canada with respect to treatment facilities and caseloads based on a survey of practice (Canadian Electroconvulsive Therapy Survey/Enquete Canadienne Sur Les Electrochocs-CANECTS/ECANEC) and to consider these findings in the context of guideline recommendations. All 1273 registered hospitals in Canada were contacted, and 175 sites were identified as providing electroconvulsive therapy; these sites were invited to complete a comprehensive questionnaire. The survey period was calendar year 2006 or fiscal year 2006/2007. National usage rates were estimated from the responses. Sixty-one percent of the sites completed the questionnaire; a further 10% provided caseload data. Seventy were identified as general; 31, as university teaching; and 21, as provincial psychiatric/other single specialty (psychiatric) hospitals. Caseload volumes ranged from a mean of fewer than 2 to greater than 30 treatments per week. Estimated national usage during the 1-year survey period was 7340 to 8083 patients (2.32-2.56 per 10,000 population) and 66,791 to 67,424 treatments (2.11-2.13 per 1000 population). The diagnostic indications, admission status, and protocols for course end points are described. The usage rates are in keeping with earlier Canadian data and with those from other jurisdictions. The difficulty obtaining caseload data from individual hospitals is indicative of the need for standardized data collection to support both clinical research and quality assurance. The wide variation in protocols for number of treatments per course indicates a need for better informed clinical guidelines. The broad range of caseload volumes suggests the need to review the economies of scale in the field.

  20. Daily cost of glaucoma medications in China.

    PubMed

    Gao, Ying; Wu, Lingling; Li, Aijun

    2007-01-01

    To determine and compare the daily cost of various glaucoma medications in China. The majority of glaucoma medications commercially available in China were included in this research. The total number of drops in 1 bottle of each medication was counted drop by drop. The mean volume per bottle of each medication was calculated. The cost per drop, number of days for both eyes usage per bottle, and daily cost was calculated. (1) The volume per drop ranged from 0.03 mL (brinzolamide 1%, travoprost 0.004%, bimatoprost 0.03%, and latanoprost 0.005%) to 0.05 mL (timolol 0.5%-Chengrui and pilocarpine 0.5% and 2%-Zhenrui). (2) The cost per bottle ranged from $0.69 (US dollar) (timolol 0.5%-Malaisuan Saimaluo'er) to $40.78 (latanoprost 0.005%). (3) The number of days for both eyes usage per bottle ranged from 52 days (bimatoprost 0.03%) to 11 days (pilocarpine nitrate 0.5%-Zhenrui). (4) The daily cost for both eyes usage from expensive to cheap were latanoprost 0.005%-$0.91, travoprost 0.004%-$0.77, brimonidine 0.2%-$0.61, bimatoprost 0.03%-$0.46, D-timolol 1%-$0.36, brinzolamide 1%-$0.34, pilocarpine 2%-Zhenrui-$0.28, levobunolol 0.5%-$0.25, betaxolol 0.25%-$0.24, pilocarpine 0.5%-Zhenrui-$0.18, pilocarpine 2%-Huming-$0.16, carteolol 1%-Mikelan-$0.15, carteolol 2%-Mikelan-$0.15, pilocarpine 1%-Huming-$0.10, timolol 0.5%-Chengrui-$0.08, timolol 0.5%-Malaisuan Saimaluo'er-$0.03. The daily cost of glaucoma medications in China ranged much more wildly than developed countries. These data may be useful in selecting medications for glaucoma therapy. The ophthalmic solution of prostaglandins is powerful in reducing intraocular pressure. However, its high price should be considered when selecting glaucoma medications in China.

  1. Emergency ultrasound usage among recent emergency medicine residency graduates of a convenience sample of 14 residencies.

    PubMed

    Dean, Anthony J; Breyer, Michael J; Ku, Bon S; Mills, Angela M; Pines, Jesse M

    2010-02-01

    Emergency Medicine (EM) residency graduates are trained to perform Emergency Medicine bedside ultrasound (EMBU). However, the degree to which they use this skill in their practice after graduation is unknown. We sought to test the amount and type of usage of EMBU among recent residency graduates, and how usage and barriers vary among various types of EM practice settings. Graduates from 14 EM residency programs in 2003-2005 were surveyed on their current practice setting and use of EMBU. There were 252 (73%) graduates who completed the survey. Of the 73% of respondents reporting access to EMBU, 98% had used it within the past 3 months. Access to EMBU was higher in academic (97%) vs. community teaching (79%) vs. community non-teaching settings (62%) (p < 0.001), and in Emergency Departments (EDs) where yearly census exceeded 60,000 visits (87% vs. 65%, p < 0.001). Physicians in academic settings reported "high use" of EMBU more frequently than those in community settings for most modalities. FAST (focused assessment by sonography in trauma) was the most common high-use application and the most useful in practice. The greatest impediment to EMBU use was "not enough time" (61%). Ultrasound usage among recent EM residency graduates is significantly higher in teaching than in community settings and in high-volume EDs. Its use is more widespread than in previous reports in all types of practice. There is a wide range of utilization of ultrasound in the various applications in emergency practice, with the evaluation of trauma being the most common. Copyright (c) 2010 Elsevier Inc. All rights reserved.

  2. Outcomes of PCI in Relation to Procedural Characteristics and Operator Volumes in the United States.

    PubMed

    Fanaroff, Alexander C; Zakroysky, Pearl; Dai, David; Wojdyla, Daniel; Sherwood, Matthew W; Roe, Matthew T; Wang, Tracy Y; Peterson, Eric D; Gurm, Hitinder S; Cohen, Mauricio G; Messenger, John C; Rao, Sunil V

    2017-06-20

    Professional guidelines have reduced the recommended minimum number to an average of 50 percutaneous coronary intervention (PCI) procedures performed annually by each operator. Operator volume patterns and associated outcomes since this change are unknown. The authors describe herein PCI operator procedure volumes; characteristics of low-, intermediate-, and high-volume operators; and the relationship between operator volume and clinical outcomes in a large, contemporary, nationwide sample. Using data from the National Cardiovascular Data Registry collected between July 1, 2009, and March 31, 2015, we examined operator annual PCI volume. We divided operators into low- (<50 PCIs per year), intermediate- (50 to 100 PCIs per year), and high- (>100 PCIs per year) volume groups, and determined the adjusted association between annual PCI volume and in-hospital outcomes, including mortality. The median annual number of procedures performed per operator was 59; 44% of operators performed <50 PCI procedures per year. Low-volume operators more frequently performed emergency and primary PCI procedures and practiced at hospitals with lower annual PCI volumes. Unadjusted in-hospital mortality was 1.86% for low-volume operators, 1.73% for intermediate-volume operators, and 1.48% for high-volume operators. The adjusted risk of in-hospital mortality was higher for PCI procedures performed by low- and intermediate-volume operators compared with those performed by high-volume operators (adjusted odds ratio: 1.16 for low versus high; adjusted odds ratio: 1.05 for intermediate vs. high volume) as was the risk for new dialysis post PCI. No volume relationship was observed for post-PCI bleeding. Many PCI operators in the United States are performing fewer than the recommended number of PCI procedures annually. Although absolute risk differences are small and may be partially explained by unmeasured differences in case mix between operators, there remains an inverse relationship between PCI operator volume and in-hospital mortality that persisted in risk-adjusted analyses. Copyright © 2017 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

  3. Factors influencing endometrial thickness in postmenopausal women.

    PubMed

    Hebbar, S; Chaya, V; Rai, L; Ramachandran, A

    2014-07-01

    Cut-off values for endometrial thickness (ET) in asymptomatic postmenopausal woman have been standardized. However, there are no comprehensive studies to document how various factors can influence the ET after the age of menopause. To study the various factors influencing the ET in postmenopausal women. This was a prospective observational study. A total of 110 postmenopausal women underwent detailed history taking, clinical examination, and transvaginal scan for uterine volume and ovarian volume. The volumes were calculated by using ellipsoid formula: Width × thickness × height × 0.523. The variation in ET with respect to the influencing factors such as age, duration of menopause, parity, body mass index (BMI), medical illness like diabetes/hypertension, drugs like tamoxifen, presence of myoma, uterine volume, ovarian volume, and serum estradiol (in selected patients) were measured. Descriptive analysis was performed using SPSS software (version 16, Chicago II, USA) to obtain mean, standard deviation (SD), 95% confidence intervals (CIs) and inter quartile ranges. Comparison of means was carried out using analysis of variance. The mean (SD) age of the patients was 55.4 (6.91) years (95% CI, 54.1, 56.7). The mean (SD) age at menopause was 47.95 (3.90) years (95% CI, 47.2, 48.7) and the mean (SD) duration of menopause was 7.27 (6.65) years (95% CI, 6.01, 8.53). The mean (SD) ET was 3.8 (2.3) mm (95% CI, 3.36, 4.23). Medical illness like diabetes and hypertension did not alter the ET. ET increased as BMI increased and it was statistically significant. The presence of myoma increased uterine volume significantly and was associated with thick endometrial stripe. Similarly, whenever the ovaries were visualized and as the ovarian volume increased, there was an increase in ET. When ET was > 4 mm (n = 37), they were offered endocel, of which 16 agreed to undergo the procedure. None were found to have endometrial cancer. This study suggests that parity, BMI, presence of myoma, tamoxifen usage, uterine volume, ovarian volume and serum estradiol influence the ET in postmenopausal women.

  4. Recurring priapism may be a symptom of voiding dysfunction – case report and literature review

    PubMed Central

    de Jesus, Lisieux Eyer; Teixeira, Leonardo; Bertelli, André

    2016-01-01

    ABSTRACT Recurring priapism is rare in pre-pubertal children and may be attributed to multiple causes. We propose that voiding dysfunction (VD) may also justify this symptom and detail a clinical case of recurring stuttering priapism associated to overactive bladder that completely resolved after usage of anticholinergics and urotherapy. Sacral parasympathetic activity is responsible for detrusor contraction and for spontaneous erections and a relationship between erections and bladder status has been proved in healthy subjects (morning erections) and models of medullar trauma. High bladder pressures and/or volumes, voiding incoordination and posterior urethritis can potentially trigger reflex erections. PMID:27256196

  5. Metrics: A Synoptic Analysis of User Data and Service Usage at GES DISC

    NASA Astrophysics Data System (ADS)

    Shie, C. L.; Kempler, S. J.; Alcott, G. T.; Lei, G. D.; Vadnais, E.

    2016-12-01

    The NASA Goddard Earth Sciences Data and Information Service Center (GES DISC) has provided massive Earth science data, information, and services to diverse research communities and general publics for decades. How to genuinely maintain our overall data and service quality, as well as continually improve serving our users (such as research scientists, applications scientists, general publics, and students) with better data services have always been our primary goal. A synoptic metric analysis involving the data and service usages by our diverse user communities at GES DISC that should help us better understand our overall data services, as well as further improve them has therefore been performed. The results of this metrics analysis, along with its purpose, which will be presented at the meeting can be genuinely categorized into the "Five Ws and One H" concept, seemingly cliché, yet by all means pertinent and useful. * What: Metrics involving our archived and served data products addressing useful info's such as "volume of data in archive"; "number of granules in archive"; "volume of data distributed"; "number of granules distributed"; "number of distinct users"; and "relative data usage". a) Remote Sensing: GPM/TRMM, AIRS, OCO-2, etc. b) Modeling: MERRA-2/MERRA, NLDAS, GLDAS, etc. c) Projects: MEaSUREs-2006, MEaSUREs-2012, etc. * Why: The goal: a synoptic (overall) metric analysis should help us better understand and learn from our overall user and data services so that we may further improve them accordingly. * When: Metrics for data during the past decade or longer. Trends or/and usages for specific seasons (e.g., summer or holidays) may also be studied. * Where: Maps showing users from global, continents, countries, and specific area of interests. * Who: Users from various domains/backgrounds: .gov, .edu, .com, .org, anonymous, countries. * How: Data download or service usage via HTTP, FTP, Giovanni, etc.

  6. Is the Distance Worth It? Patients With Rectal Cancer Traveling to High-Volume Centers Experience Improved Outcomes.

    PubMed

    Xu, Zhaomin; Becerra, Adan Z; Justiniano, Carla F; Boodry, Courtney I; Aquina, Christopher T; Swanger, Alex A; Temple, Larissa K; Fleming, Fergal J

    2017-12-01

    It is unclear whether traveling long distances to high-volume centers would compensate for travel burden among patients undergoing rectal cancer resection. The purpose of this study was to determine whether operative volume outweighs the advantages of being treated locally by comparing the outcomes of patients with rectal cancer treated at local, low-volume centers versus far, high-volume centers. This was a population-based study. The National Cancer Database was queried for patients with rectal cancer. Patients with stage II or III rectal cancer who underwent surgical resection between 2006 and 2012 were included. The outcomes of interest were margins, lymph node yield, receipt of neoadjuvant chemoradiation, adjuvant chemotherapy, readmission within 30 days, 30-day and 90-day mortality, and 5-year overall survival. A total of 18,605 patients met inclusion criteria; 2067 patients were in the long-distance/high-volume group and 1362 in the short-distance/low-volume group. The median travel distance was 62.6 miles for the long-distance/high-volume group and 2.3 miles for the short-distance/low-volume group. Patients who were younger, white, privately insured, and stage III were more likely to have traveled to a high-volume center. When controlled for patient factors, stage, and hospital factors, patients in the short-distance/low-volume group had lower odds of a lymph node yield ≥12 (OR = 0.51) and neoadjuvant chemoradiation (OR = 0.67) and higher 30-day (OR = 3.38) and 90-day mortality (OR = 2.07) compared with those in the long-distance/high-volume group. The short-distance/low-volume group had a 34% high risk of overall mortality at 5 years compared with the long-distance/high-volume group. We lacked data regarding patient and physician decision making and surgeon-specific factors. Our results indicate that when controlled for patient, tumor, and hospital factors, patients who traveled a long distance to a high-volume center had improved lymph node yield, neoadjuvant chemoradiation receipt, and 30- and 90-day mortality compared with those who traveled a short distance to a low-volume center. They also had improved 5-year survival. See Video Abstract at http://links.lww.com/DCR/A446.

  7. High volume data storage architecture analysis

    NASA Technical Reports Server (NTRS)

    Malik, James M.

    1990-01-01

    A High Volume Data Storage Architecture Analysis was conducted. The results, presented in this report, will be applied to problems of high volume data requirements such as those anticipated for the Space Station Control Center. High volume data storage systems at several different sites were analyzed for archive capacity, storage hierarchy and migration philosophy, and retrieval capabilities. Proposed architectures were solicited from the sites selected for in-depth analysis. Model architectures for a hypothetical data archiving system, for a high speed file server, and for high volume data storage are attached.

  8. Social Networking in Schools: Benefits and Risks; Review of the Research; Policy Considerations; and Current Practices. Information Capsule. Volume 1109

    ERIC Educational Resources Information Center

    Blazer, Christie

    2012-01-01

    The role that social media should play in education is being hotly debated in school districts across the country. The adoption of social networking for educational purposes lags behind the public's general usage because educators fear that students will be exposed to inappropriate online content, unwanted adult interactions, and bullying from…

  9. My Virtual Reading Coach: "An Analysis of Usage and Impact," 2013-14. Technical Note. Volume 3, Number 2

    ERIC Educational Resources Information Center

    Urdegar, Steven M.

    2014-01-01

    My Virtual Reading Coach (MVRC) is an online program for students who have been identified as struggling readers. It is used as an intervention within the Response to Intervention (RtI) framework, as well as for students with disabilities. The software addresses reading sub-skills (i.e., comprehension, fluency, phonemic awareness, phonics, and…

  10. National Trauma Institute: A National Coordinating Center for Trauma Research Funding

    DTIC Science & Technology

    2016-12-01

    comparing the effectiveness of modern ventilator modalities upon patients with ARDS/ALI does not exist. Low-tidal volume ventilation (ARDSNet...associated with better oxygenation , less sedative usage, and less ventilator -associated pneumonia compared with other ventilator modes. However, questions...hypercoagulable at baseline, and that further investigations into the effects of platelet activation and obesity, time-to-enoxaparin administration, and

  11. An Exploratory Study of ICT Use in English Language Learning among EFL University Students

    ERIC Educational Resources Information Center

    Tri, Dang Hoang; Nguyen, Nhung Hong Thi

    2014-01-01

    There has been a large volume of published studies describing the attitudes of teachers and students towards ICT usage to study English; nevertheless, limited research has been conducted to examine the use of ICT in terms of frequency of use, purposes, perceptions, and expectations among EFL students. Thus, the purpose of the current study was to…

  12. Word Watcher's Handbook, Including a Deletionary of the Most Abused and Misused Words.

    ERIC Educational Resources Information Center

    Martin, Phyllis

    The goal of this handbook of English usage and pronunciation is to save the job seeker from possible rejection, to improve the job holder's chances for promotion, to inspire the student to master the language, and to help everyone to avoid making errors in everyday conversation. Part one of the volume provides a "deletionary," a listing of words…

  13. Operational Assessment of Tools for Accelerating Leader Development (ALD): Volume 1, Capstone Report

    DTIC Science & Technology

    2009-06-01

    in units and user juries provided feedback on the tools. The pressures of the operational environment seriously limited the time available to work...following functions: account set-up, user authentication, learning management , usage monitoring, problem reporting, assessment data collection, data...especially sources of data) represented—demonstration/assessment manager , operations manager , Web site experts, users (target audience), data collectors

  14. The Moon Mineralogy (M3) Imaging Spectrometer: Early Assessment of the Spectral, Radiometric, Spatial and Uniformity Properties

    NASA Technical Reports Server (NTRS)

    Green, Robert O.; Pieters, C. M.; Boardman, J.; Barr, D.; Bruce, C.; Bousman, J.; Chatterjee, A.; Eastwood, M.; Essandoh, V.; Geier, S.; hide

    2009-01-01

    The Moon Mineralogy Mapper's (M3) is a high uniformity and high signal-to-noise ratio NASA imaging spectrometer that is a guest instrument on the Indian Chandrayaan-1 Mission to the Moon. The laboratory measured spectral, radiometric, spatial, and uniformity characteristics of the M3 instrument are given. The M3 imaging spectrometer takes advantage of a suite of critical enabling capabilities to achieve its measurement requirement with a mass of 8 kg, power usage of 15 W, and volume of 25X18X12 cm. The M3 detector and spectrometer are cooled by a multi-stage passive cooler. This paper presents early M3 performance assessment results.

  15. Analysis of the Capacity of Google Trends to Measure Interest in Conservation Topics and the Role of Online News

    PubMed Central

    Nghiem, Le T. P.; Papworth, Sarah K.; Lim, Felix K. S.; Carrasco, Luis R.

    2016-01-01

    With the continuous growth of internet usage, Google Trends has emerged as a source of information to investigate how social trends evolve over time. Knowing how the level of interest in conservation topics—approximated using Google search volume—varies over time can help support targeted conservation science communication. However, the evolution of search volume over time and the mechanisms that drive peaks in searches are poorly understood. We conducted time series analyses on Google search data from 2004 to 2013 to investigate: (i) whether interests in selected conservation topics have declined and (ii) the effect of news reporting and academic publishing on search volume. Although trends were sensitive to the term used as benchmark, we did not find that public interest towards conservation topics such as climate change, ecosystem services, deforestation, orangutan, invasive species and habitat loss was declining. We found, however, a robust downward trend for endangered species and an upward trend for ecosystem services. The quantity of news articles was related to patterns in Google search volume, whereas the number of research articles was not a good predictor but lagged behind Google search volume, indicating the role of news in the transfer of conservation science to the public. PMID:27028399

  16. Mass and Volume Optimization of Space Flight Medical Kits

    NASA Technical Reports Server (NTRS)

    Keenan, A. B.; Foy, Millennia Hope; Myers, Jerry

    2014-01-01

    Resource allocation is a critical aspect of space mission planning. All resources, including medical resources, are subject to a number of mission constraints such a maximum mass and volume. However, unlike many resources, there is often limited understanding in how to optimize medical resources for a mission. The Integrated Medical Model (IMM) is a probabilistic model that estimates medical event occurrences and mission outcomes for different mission profiles. IMM simulates outcomes and describes the impact of medical events in terms of lost crew time, medical resource usage, and the potential for medically required evacuation. Previously published work describes an approach that uses the IMM to generate optimized medical kits that maximize benefit to the crew subject to mass and volume constraints. We improve upon the results obtained previously and extend our approach to minimize mass and volume while meeting some benefit threshold. METHODS We frame the medical kit optimization problem as a modified knapsack problem and implement an algorithm utilizing dynamic programming. Using this algorithm, optimized medical kits were generated for 3 mission scenarios with the goal of minimizing the medical kit mass and volume for a specified likelihood of evacuation or Crew Health Index (CHI) threshold. The algorithm was expanded to generate medical kits that maximize likelihood of evacuation or CHI subject to mass and volume constraints. RESULTS AND CONCLUSIONS In maximizing benefit to crew health subject to certain constraints, our algorithm generates medical kits that more closely resemble the unlimited-resource scenario than previous approaches which leverage medical risk information generated by the IMM. Our work here demonstrates that this algorithm provides an efficient and effective means to objectively allocate medical resources for spaceflight missions and provides an effective means of addressing tradeoffs in medical resource allocations and crew mission success parameters.

  17. Modernization of Defense Logistics Standard Systems. Establishing the Functional Baseline. Volume 2. Appendix H

    DTIC Science & Technology

    1991-09-01

    and "DD" is the numeric value of the day (01-31). [61 Time ( TM ). The time type is symbolized by the representation " TM ." Format for this type is...VERSION ID M DT 06/06 M TM 04/04 M ID 01/01 M ID 05/05 ISA13 112 ISA14 113 ISA15 114 ISA16 115INTERCHANGE *ACKNOWLEDG. * S1TEST 14 * SUBELEMENT N CTRL...Max - 6 Date of the interchange. DLMS Usage: As above. 109 Interchange Time Type - TM Min - 4 Max - 4 Time of the interchange. DLMS Usage: As above

  18. MCNP-based computational model for the Leksell gamma knife.

    PubMed

    Trnka, Jiri; Novotny, Josef; Kluson, Jaroslav

    2007-01-01

    We have focused on the usage of MCNP code for calculation of Gamma Knife radiation field parameters with a homogenous polystyrene phantom. We have investigated several parameters of the Leksell Gamma Knife radiation field and compared the results with other studies based on EGS4 and PENELOPE code as well as the Leksell Gamma Knife treatment planning system Leksell GammaPlan (LGP). The current model describes all 201 radiation beams together and simulates all the sources in the same time. Within each beam, it considers the technical construction of the source, the source holder, collimator system, the spherical phantom, and surrounding material. We have calculated output factors for various sizes of scoring volumes, relative dose distributions along basic planes including linear dose profiles, integral doses in various volumes, and differential dose volume histograms. All the parameters have been calculated for each collimator size and for the isocentric configuration of the phantom. We have found the calculated output factors to be in agreement with other authors' works except the case of 4 mm collimator size, where averaging over the scoring volume and statistical uncertainties strongly influences the calculated results. In general, all the results are dependent on the choice of the scoring volume. The calculated linear dose profiles and relative dose distributions also match independent studies and the Leksell GammaPlan, but care must be taken about the fluctuations within the plateau, which can influence the normalization, and accuracy in determining the isocenter position, which is important for comparing different dose profiles. The calculated differential dose volume histograms and integral doses have been compared with data provided by the Leksell GammaPlan. The dose volume histograms are in good agreement as well as integral doses calculated in small calculation matrix volumes. However, deviations in integral doses up to 50% can be observed for large volumes such as for the total skull volume. The differences observed in treatment of scattered radiation between the MC method and the LGP may be important in this case. We have also studied the influence of differential direction sampling of primary photons and have found that, due to the anisotropic sampling, doses around the isocenter deviate from each other by up to 6%. With caution about the details of the calculation settings, it is possible to employ the MCNP Monte Carlo code for independent verification of the Leksell Gamma Knife radiation field properties.

  19. High Performance Schools Best Practices Manual. Volume I: Planning [and] Volume II: Design [and] Volume III: Criteria.

    ERIC Educational Resources Information Center

    Eley, Charles, Ed.

    This three-volume manual, focusing on California's K-12 public schools, presents guidelines for establishing schools that are healthy, comfortable, energy efficient, resource efficient, water efficient, secure, adaptable, and easy to operate and maintain. The first volume describes why high performance schools are important, what components are…

  20. Lower Mortality for Abdominal Aortic Aneurysm Repair in High-Volume Hospitals Is Contingent upon Nurse Staffing

    PubMed Central

    Wiltse Nicely, Kelly L; Sloane, Douglas M; Aiken, Linda H

    2013-01-01

    Objective To determine whether and to what extent the lower mortality rates for patients undergoing abdominal aortic aneurysm (AAA) repair in high-volume hospitals is explained by better nursing. Data Sources State hospital discharge data, Multi-State Nursing Care and Patient Safety Survey, and hospital characteristics from the AHA Annual Survey. Study Design Cross-sectional analysis of linked patient outcomes for individuals undergoing AAA repair in four states. Data Collection Secondary data sources. Principal Findings Favorable nursing practice environments and higher hospital volumes of AAA repair are associated with lower mortality and fewer failures-to-rescue in main-effects models. Furthermore, nurse staffing interacts with volume such that there is no mortality advantage observed in high-volume hospitals with poor nurse staffing. When hospitals have good nurse staffing, patients in low-volume hospitals are 3.4 times as likely to die and 2.6 times as likely to die from complications as patients in high-volume hospitals (p < .001). Conclusions Nursing is part of the explanation for lower mortality after AAA repair in high-volume hospitals. Importantly, lower mortality is not found in high-volume hospitals if nurse staffing is poor. PMID:23088426

  1. Is orbital volume associated with eyeball and visual cortex volume in humans?

    PubMed

    Pearce, Eiluned; Bridge, Holly

    2013-01-01

    In humans orbital volume increases linearly with absolute latitude. Scaling across mammals between visual system components suggests that these larger orbits should translate into larger eyes and visual cortices in high latitude humans. Larger eyes at high latitudes may be required to maintain adequate visual acuity and enhance visual sensitivity under lower light levels. To test the assumption that orbital volume can accurately index eyeball and visual cortex volumes specifically in humans. Structural Magnetic Resonance Imaging (MRI) techniques are employed to measure eye and orbit (n = 88) and brain and visual cortex (n = 99) volumes in living humans. Facial dimensions and foramen magnum area (a proxy for body mass) were also measured. A significant positive linear relationship was found between (i) orbital and eyeball volumes, (ii) eyeball and visual cortex grey matter volumes and (iii) different visual cortical areas, independently of overall brain volume. In humans the components of the visual system scale from orbit to eye to visual cortex volume independently of overall brain size. These findings indicate that orbit volume can index eye and visual cortex volume in humans, suggesting that larger high latitude orbits do translate into larger visual cortices.

  2. Is orbital volume associated with eyeball and visual cortex volume in humans?

    PubMed Central

    Pearce, Eiluned; Bridge, Holly

    2013-01-01

    Background In humans orbital volume increases linearly with absolute latitude. Scaling across mammals between visual system components suggests that these larger orbits should translate into larger eyes and visual cortices in high latitude humans. Larger eyes at high latitudes may be required to maintain adequate visual acuity and enhance visual sensitivity under lower light levels. Aim To test the assumption that orbital volume can accurately index eyeball and visual cortex volumes specifically in humans. Subjects & Methods Structural Magnetic Resonance Imaging (MRI) techniques are employed to measure eye and orbit (N=88), and brain and visual cortex (N=99) volumes in living humans. Facial dimensions and foramen magnum area (a proxy for body mass) were also measured. Results A significant positive linear relationship was found between (i) orbital and eyeball volumes, (ii) eyeball and visual cortex grey matter volumes, (iii) different visual cortical areas, independently of overall brain volume. Conclusion In humans the components of the visual system scale from orbit to eye to visual cortex volume independently of overall brain size. These findings indicate that orbit volume can index eye and visual cortex volume in humans, suggesting that larger high latitude orbits do translate into larger visual cortices. PMID:23879766

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

    PubMed

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

    2018-04-26

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

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

    PubMed

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

    2014-06-01

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

  5. The Surgeon Volume-outcome Relationship: Not Yet Ready for Policy.

    PubMed

    Modrall, J Gregory; Minter, Rebecca M; Minhajuddin, Abu; Eslava-Schmalbach, Javier; Joshi, Girish P; Patel, Shivani; Rosero, Eric B

    2018-05-01

    Increasing surgeon volume may improve outcomes for index operations. We hypothesized that there may be surrogate operative experiences that yield similar outcomes for surgeons with a low-volume experience with a specific index operation, such as esophagectomy. The relationship between surgeon volume and outcomes has potential implications for credentialing of surgeons. Restrictions of privileges based on surgeon volume are only reasonable if there is no substitute for direct experience with the index operation. This study was aimed at determining whether there are valid surrogates for direct experience with a sample index operation-open esophagectomy. The Nationwide Inpatient Sample (2003-2009) was utilized. Surgeons were stratified into low and high-volume groups based on annual volume of esophagectomy. Surrogate volume was defined as the aggregate annual volume per surgeon of upper gastrointestinal operations including excision of esophageal diverticulum, gastrectomy, gastroduodenectomy, and repair of diaphragmatic hernia. In all, 26,795 esophagectomies were performed nationwide (2003-2009), with a crude inhospital mortality rate of 5.2%. Inhospital mortality decreased with increasing volume of esophagectomies performed annually: 7.7% and 3.8% for low and high-volume surgeons, respectively (P < 0.0001). Among surgeons with a low-volume esophagectomy experience, increasing volume of surrogate operations improved the outcomes observed for esophagectomy: 9.7%, 7.1%, and 4.3% for low, medium, and high-surrogate-volume surgeons, respectively (P = 0.016). Both operation-specific volume and surrogate volume are significant predictors of inhospital mortality for esophagectomy. Based on these observations, it would be premature to limit hospital privileges based solely on operation-specific surgeon volume criteria.

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

    PubMed

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

    2007-10-01

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

  7. Puffing Topography and Nicotine Intake of Electronic Cigarette Users

    PubMed Central

    Behar, Rachel Z.; Hua, My; Talbot, Prue

    2015-01-01

    Background Prior electronic cigarette (EC) topography data are based on two video analyses with limited parameters. Alternate methods for measuring topography are needed to understand EC use and nicotine intake. Objectives This study evaluated EC topography with a CReSS Pocket device and quantified nicotine intake. Methods Validation tests on pressure drop, flow rate, and volume confirmed reliable performance of the CReSS Pocket device. Twenty participants used Blu Cigs and V2 Cigs for 10 minute intervals with a 10–15 minute break between brands. Brand order was reversed and repeated within 7 days Data were analyzed to determine puff duration, puff count, volume, flow rate, peak flow, and inter-puff interval. Nicotine intake was estimated from cartomizer fluid consumption and topography data. Results Nine patterns of EC use were identified. The average puff count and inter-puff interval were 32 puffs and 17.9 seconds. All participants, except one, took more than 20 puffs/10 minutes. The averages for puff duration (2.65 seconds/puff), volume/puff (51ml/puff), total puff volume (1,579 ml), EC fluid consumption (79.6 mg), flow rate (20 ml/s), and peak flow rate (27 ml/s) were determined for 10-minute sessions. All parameters except total puff count were significantly different for Blu versus V2 EC. Total volume for Blu versus V2 was four-times higher than for conventional cigarettes. Average nicotine intake for Blu and V2 across both sessions was 1.2 ± 0.5 mg and 1.4 ± 0.7 mg, respectively, which is similar to conventional smokers. Conclusions EC puffing topography was variable among participants in the study, but often similar within an individual between brands or days. Puff duration, inter-puff interval, and puff volume varied from conventional cigarette standards. Data on total puff volume and nicotine intake are consistent with compensatory usage of EC. These data can contribute to the development of a standard protocol for laboratory testing of EC products. PMID:25664463

  8. The Impact of Surgeon Volume on Perioperative Outcomes and Cost for Patients Receiving Robotic Partial Nephrectomy.

    PubMed

    Khandwala, Yash S; Jeong, In Gab; Kim, Jae Heon; Han, Deok Hyun; Li, Shufeng; Wang, Ye; Chang, Steven L; Chung, Benjamin I

    2017-09-01

    Little is known about the impact of surgeon volume on the success of the robot-assisted partial nephrectomy (RAPN). The objective of this study was to compare the perioperative outcomes and cost related to RAPN by annual surgeon volumes. Using the Premier Hospital Database, we retrospectively analyzed 39,773 patients who underwent RAPN between 2003 and 2015 in the United States. Surgeons for each index case were grouped into quintiles for each respective year. Outcomes were 90-day postoperative complications, operating room time (ORT), blood transfusion, length of stay, and direct hospital costs. Logistic regression and generalized linear models were used to identify factors predicting complications and cost. After accounting for patient and hospital demographics, high- and very high-volume surgeons had 40% and 42% decreased odds of having major complications (p = 0.045 and p = 0.027, respectively). Surgeons with higher volumes were associated with fewer odds of prolonged ORT (0.68 for low, 0.72 for intermediate, 0.56 for high, 0.44 for very high volume, all p < 0.05) and length of hospital stay (0.67 for intermediate, 0.51 for high, 0.45 for very high volume, all p < 0.01) compared with very low-volume surgeons. The 90-day hospital cost was also significantly lower for the surgeons with higher volume, but the statistical significance diminished after consideration of hospital clustering. Surgeons with very high RAPN volumes were found to have superior perioperative outcomes. Although cost of care appeared to correlate with surgeon volume, there may be other more influential factors predicting cost.

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

    PubMed

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

    2013-12-01

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

  10. Effects of different aerobic exercise programmes with nutritional intervention in sedentary adults with overweight/obesity and hypertension: EXERDIET-HTA study.

    PubMed

    Gorostegi-Anduaga, Ilargi; Corres, Pablo; MartinezAguirre-Betolaza, Aitor; Pérez-Asenjo, Javier; Aispuru, G Rodrigo; Fryer, Simon M; Maldonado-Martín, Sara

    2018-03-01

    Background Both exercise training and diet are recommended to prevent and control hypertension and overweight/obesity. Purpose The purpose of this study was to determine the effectiveness of different 16-week aerobic exercise programmes with hypocaloric diet on blood pressure, body composition, cardiorespiratory fitness and pharmacological treatment. Methods Overweight/obese, sedentary participants ( n = 175, aged 54.0 ± 8.2 years) with hypertension were randomly assigned into an attention control group (physical activity recommendations) or one of three supervised exercise groups (2 days/week: high-volume with 45 minutes of moderate-intensity continuous training (MICT), high-volume and high-intensity interval training (HIIT), alternating high and moderate intensities, and low-volume HIIT (20 minutes)). All variables were assessed pre- and post-intervention. All participants received the same hypocaloric diet. Results Following the intervention, there was a significant reduction in blood pressure and body mass in all groups with no between-group differences for blood pressure. However, body mass was significantly less reduced in the attention control group compared with all exercise groups (attention control -6.6%, high-volume MICT -8.3%, high-volume HIIT -9.7%, low-volume HIIT -6.9%). HIIT groups had significantly higher cardiorespiratory fitness than high-volume MICT, but there were no significant between-HIIT differences (attention control 16.4%, high-volume MICT 23.6%, high-volume HIIT 36.7%, low-volume HIIT 30.5%). Medication was removed in 7.6% and reduced in 37.7% of the participants. Conclusions The combination of hypocaloric diet with supervised aerobic exercise 2 days/week offers an optimal non-pharmacological tool in the management of blood pressure, cardiorespiratory fitness and body composition in overweight/obese and sedentary individuals with hypertension. High-volume HIIT seems to be better for reducing body mass compared with low-volume HIIT. The exercise-induced improvement in cardiorespiratory fitness is intensity dependent with low-volume HIIT as a time-efficient method in this population. ClinicalTrials.gov Registration: NCT02283047.

  11. High volume improves outcomes: The argument for centralization of rectal cancer surgery.

    PubMed

    Aquina, Christopher T; Probst, Christian P; Becerra, Adan Z; Iannuzzi, James C; Kelly, Kristin N; Hensley, Bradley J; Rickles, Aaron S; Noyes, Katia; Fleming, Fergal J; Monson, John R T

    2016-03-01

    Centralization of care to "centers of excellence" in Europe has led to improved oncologic outcomes; however, little is known regarding the impact of nonmandated regionalization of rectal cancer care in the United States. The Statewide Planning and Research Cooperative System (SPARCS) was queried for elective abdominoperineal and low anterior resections for rectal cancer from 2000 to 2011 in New York with the use of International Classification of Diseases, Ninth Revision codes. Surgeon volume and hospital volume were grouped into quartiles, and high-volume surgeons (≥ 10 resections/year) and hospitals (≥ 25 resections/year) were defined as the top quartile of annual caseload of rectal cancer resection and compared with the bottom 3 quartiles during analyses. Bivariate and multilevel regression analyses were performed to assess factors associated with restorative procedures, 30-day mortality, and temporal trends in these endpoints. Among 7,798 rectal cancer resections, the overall rate of no-restorative proctectomy and 30-day mortality decreased by 7.7% and 1.2%, respectively, from 2000 to 2011. In addition, there was a linear increase in the proportion of cases performed by both high-volume surgeons and high-volume hospitals and a decrease in the number of surgeons and hospitals performing rectal cancer surgery. High-volume surgeons at high-volume hospitals were associated independently with both less nonrestorative proctectomies (odds ratio 0.65, 95% confidence interval 0.48-0.89) and mortality (odds ratio 0.43, 95% confidence interval 0.21-0.87) rates. No patterns of significant improvement within the volume strata of the surgeon and hospitals were observed over time. This study suggests that the current trend toward regionalization of rectal cancer care to high-volume surgeons and high-volume centers has led to improved outcomes. These findings have implications regarding the policy of health care delivery in the United States, supporting referral to high-volume centers of excellence. Copyright © 2016 Elsevier Inc. All rights reserved.

  12. Achieving Good Perioperative Outcomes After Pancreaticoduodenectomy in a Low-Volume Setting: A 25-Year Experience

    PubMed Central

    Chedid, Aljamir D.; Chedid, Marcio F.; Winkelmann, Leonardo V.; Filho, Tomaz J. M. Grezzana; Kruel, Cleber D. P.

    2015-01-01

    Perioperative mortality following pancreaticoduodenectomy has improved over time and is lower than 5% in selected high-volume centers. Based on several large literature series on pancreaticoduodenectomy from high-volume centers, some defend that high annual volumes are necessary for good outcomes after pancreaticoduodenectomy. We report here the outcomes of a low annual volume pancreaticoduodenectomy series after incorporating technical expertise from a high-volume center. We included all patients who underwent pancreaticoduodenectomy performed by a single surgeon (ADC.) as treatment for periampullary malignancies from 1981 to 2005. Outcomes of this series were compared to those of 3 high-volume literature series. Additionally, outcomes for first 10 cases in the present series were compared to those of all 37 remaining cases in this series. A total of 47 pancreaticoduodenectomies were performed over a 25-year period. Overall in-hospital mortality was 2 cases (4.3%), and morbidity occurred in 23 patients (48.9%). Both mortality and morbidity were similar to those of each of the three high-volume center comparison series. Comparison of the outcomes for the first 10 to the remaining 37 cases in this series revealed that the latter 37 cases had inferior mortality (20% versus 0%; P = 0.042), less tumor-positive margins (50 versus 13.5%; P = 0.024), less use of intraoperative blood transfusions (90% versus 32.4%; P = 0.003), and tendency to a shorter length of in-hospital stay (20 versus 15.8 days; P = 0.053). Accumulation of surgical experience and incorporation of expertise from high-volume centers may enable achieving satisfactory outcomes after pancreaticoduodenectomy in low-volume settings whenever referral to a high-volume center is limited. PMID:25875555

  13. High-volume resistance training session acutely diminishes respiratory muscle strength.

    PubMed

    Hackett, Daniel A; Johnson, Nathan A; Chow, Chin-Moi

    2012-01-01

    This study investigated the effect of a high-volume compared to a low-volume resistance training session on maximal inspiratory pressure (MIP) and maximal expiratory pressure (MEP). Twenty male subjects with resistance training experience (6.2 ± 3.2 y), in a crossover trial, completed two resistance training protocols (high-volume: 5 sets per exercise; low-volume: 2 sets per exercise) and a control session (no exercise) on 3 separate occasions. MIP and MEP decreased by 13.6% (p < 0.01) and 14.7% (p < 0.01) respectively from pre-session MIP and MEP, following the high-volume session. MIP and MEP were unaffected following the low-volume or the control sessions. MIP returned to pre-session values after 40 minutes, whereas MEP remained significantly reduced after 60 minutes post-session by 9.2% compared to pre-session (p < 0.01). The findings suggest that the high-volume session significantly decreased MIP and MEP post-session, implicating a substantially increased demand on the respiratory muscles and that adequate recovery is mandatory following this mode of training. Key pointsRespiratory muscular strength performance is acutely diminished following a high-volume whole-body resistance training session.Greater ventilatory requirements and generation of IAP during the high-volume resistance training session may have contributed to the increased demand placed on the respiratory muscles.Protracted return of respiratory muscular strength performance to baseline levels may have implications for individuals prior to engaging in subsequent exercise bouts.

  14. Globally distributed software defined storage (proposal)

    NASA Astrophysics Data System (ADS)

    Shevel, A.; Khoruzhnikov, S.; Grudinin, V.; Sadov, O.; Kairkanov, A.

    2017-10-01

    The volume of the coming data in HEP is growing. The volume of the data to be held for a long time is growing as well. Large volume of data - big data - is distributed around the planet. The methods, approaches how to organize and manage the globally distributed data storage are required. The distributed storage has several examples for personal needs like own-cloud.org, pydio.com, seafile.com, sparkleshare.org. For enterprise-level there is a number of systems: SWIFT - distributed storage systems (part of Openstack), CEPH and the like which are mostly object storage. When several data center’s resources are integrated, the organization of data links becomes very important issue especially if several parallel data links between data centers are used. The situation in data centers and in data links may vary each hour. All that means each part of distributed data storage has to be able to rearrange usage of data links and storage servers in each data center. In addition, for each customer of distributed storage different requirements could appear. The above topics are planned to be discussed in data storage proposal.

  15. Storage management in Ada. Three reports. Volume 1: Storage management in Ada as a risk to the development of reliable software. Volume 2: Relevant aspects of language. Volume 3: Requirements of the language versus manifestations of current implementations

    NASA Technical Reports Server (NTRS)

    Auty, David

    1988-01-01

    The risk to the development of program reliability is derived from the use of a new language and from the potential use of new storage management techniques. With Ada and associated support software, there is a lack of established guidelines and procedures, drawn from experience and common usage, which assume reliable behavior. The risk is identified and clarified. In order to provide a framework for future consideration of dynamic storage management on Ada, a description of the relevant aspects of the language is presented in two sections: Program data sources, and declaration and allocation in Ada. Storage-management characteristics of the Ada language and storage-management characteristics of Ada implementations are differentiated. Terms that are used are defined in a narrow and precise sense. The storage-management implications of the Ada language are described. The storage-management options available to the Ada implementor and the implications of the implementor's choice for the Ada programmer are also described.

  16. Full-scale testing, production and cost analysis data for the advanced composite stabilizer for Boeing 737 aircraft. Volume 1: Technical summary

    NASA Technical Reports Server (NTRS)

    Aniversario, R. B.; Harvey, S. T.; Mccarty, J. E.; Parsons, J. T.; Peterson, D. C.; Pritchett, L. D.; Wilson, D. R.; Wogulis, E. R.

    1983-01-01

    The full scale ground test, ground vibration test, and flight tests conducted to demonstrate a composite structure stabilizer for the Boeing 737 aircraft and obtain FAA certification are described. Detail tools, assembly tools, and overall production are discussed. Cost analyses aspects covered include production costs, composite material usage factors, and cost comparisons.

  17. Drug Themes in Science Fiction. National Institute on Drug Abuse Research Issues 9.

    ERIC Educational Resources Information Center

    Silverberg, Robert

    This booklet is part of a series most of which focus on empirical research findings and major theoretical approaches in the area of drug usage. In this volume, the author has compiled a group of English-language short stories and novels which deal with the use of mind-altering drugs, all written since 1900 and falling within the literary category…

  18. The Future of Testing. Buros-Nebraska Symposium on Measurement and Testing (2nd, Lincoln, Nebraska, October 1984). Volume 2.

    ERIC Educational Resources Information Center

    Plake, Barbara S., Ed.; Witt, Joseph C., Ed.

    An introduction by Barbara S. Plake and Joseph C. Witt defines the task of this book as presenting nine conference papers discussing probable directions for the field of measurement and testing. In an effort to contribute to the improvement of test construction and test usage, areas of present concern and potentially important areas for the future…

  19. National Childcare Consumer Study: 1975. Volume II: Current Patterns of Childcare Use in the United States.

    ERIC Educational Resources Information Center

    Rodes, Thomas W.

    This is the second of three study reports on the national incidence of child care usage as well as consumer needs, preferences, attitudes and opinions on child care, based on 4609 personal interviews conducted in 1975 from a national probability sample of households with children under 14 years of age. The study was sponsored by the Office of…

  20. The Relationship Between Hospital Volume and Outcome in Bariatric Surgery at Academic Medical Centers

    PubMed Central

    Nguyen, Ninh T.; Paya, Mahbod; Stevens, C Melinda; Mavandadi, Shahrzad; Zainabadi, Kambiz; Wilson, Samuel E.

    2004-01-01

    Objective: To examine the effect of hospital volume of bariatric surgery on morbidity, mortality, and costs at academic centers. Summary Background Data: The American Society for Bariatric Surgery recently proposed categorization of certain bariatric surgery centers as “Centers of Excellence.” Some of the proposed inclusion criteria were hospital volume and operative outcomes. The volume–outcome relationship has been well established in several complex abdominal operations; however, few studies have examined this relationship in patients undergoing bariatric surgery. Methods: Using the International Classification of Diseases, 9th edition, diagnosis and procedure codes, we obtained data from the University HealthSystem Consortium Clinical Data Base for all patients who underwent Roux-en-Y gastric bypass for the treatment of morbid obesity between 1999 and 2002 (n = 24,166). Outcomes of bariatric surgery, including length of hospital stay, 30-day readmission, morbidity, observed and expected (risk-adjusted) mortality, and costs were compared between high-volume (>100 cases/year), medium-volume (50–100 cases/year), and low-volume hospitals (<50 cases/year). Results: There were 22 high-volume (n = 13,810), 27 medium-volume (n = 7634), and 44 low-volume (n = 2722) hospitals included in our study. Compared with low-volume hospitals, patients who underwent gastric bypass at high-volume hospitals had a shorter length of hospital stay (3.8 versus 5.1 days, P < 0.01), lower overall complications (10.2% versus 14.5%, P < 0.01), lower complications of medical care (7.8% versus 10.8%, P < 0.01), and lower costs ($10,292 versus $13,908, P < 0.01). The expected mortality rate was similar between high- and low-volume hospitals (0.6% versus 0.6%), demonstrating similarities in characteristics and severity of illness between groups. The observed mortality, however, was significantly lower at high-volume hospitals (0.3% versus 1.2%, P < 0.01). In a subset of patients older than 55 years, the observed mortality was 0.9% at high-volume centers compared with 3.1% at low-volume centers (P < 0.01). Conclusions: Bariatric surgery performed at hospitals with more than 100 cases annually is associated with a shorter length of stay, lower morbidity and mortality, and decreased costs. This volume–outcome relationship is even more pronounced for a subset of patients older than 55 years, for whom in-hospital mortality was 3-fold higher at low-volume compared with high-volume hospitals. High-volume hospitals also have a lower rate of overall postoperative and medical care complications, which may be related in part to formalization of the structures and processes of care. PMID:15383786

  1. A method for the direct injection and analysis of small volume human blood spots and plasma extracts containing high concentrations of organic solvents using revered-phase 2D UPLC/MS.

    PubMed

    Rainville, Paul D; Simeone, Jennifer L; Root, Dan S; Mallet, Claude R; Wilson, Ian D; Plumb, Robert S

    2015-03-21

    The emergence of micro sampling techniques holds great potential to improve pharmacokinetic data quality, reduce animal usage, and save costs in safety assessment studies. The analysis of these samples presents new challenges for bioanalytical scientists, both in terms of sample processing and analytical sensitivity. The use of two dimensional LC/MS with, at-column-dilution for the direct analysis of highly organic extracts prepared from biological fluids such as dried blood spots and plasma is demonstrated. This technique negated the need to dry down and reconstitute, or dilute samples with water/aqueous buffer solutions, prior to injection onto a reversed-phase LC system. A mixture of model drugs, including bromhexine, triprolidine, enrofloxacin, and procaine were used to test the feasibility of the method. Finally an LC/MS assay for the probe pharmaceutical rosuvastatin was developed from dried blood spots and protein-precipitated plasma. The assays showed acceptable recovery, accuracy and precision according to US FDA guidelines. The resulting analytical method showed an increase in assay sensitivity of up to forty fold as compared to conventional methods by maximizing the amount loaded onto the system and the MS response for the probe pharmaceutical rosuvastatin from small volume samples.

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

    PubMed

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

    2007-02-01

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

  3. Use of an Assistant Surgeon Does not Mitigate the Effect of Lead Surgeon Volume on Outcomes Following Open Repair of Intact Abdominal Aortic Aneurysms.

    PubMed

    Deery, Sarah E; O'Donnell, Thomas F X; Zettervall, Sara L; Darling, Jeremy D; Shean, Katie E; O'Malley, A James; Landon, Bruce E; Schermerhorn, Marc L

    2018-05-01

    While higher lead surgeon volume has been associated with lower mortality following open abdominal aortic aneurysm (AAA) repair, little is known about the impact of using an attending surgeon as assistant surgeon. The aim of this study was to determine whether the presence of an assistant surgeon, particularly a high volume assistant, mitigates the relationship between lead surgeon volume and outcomes. All Medicare beneficiaries who underwent intact, open AAA repair between 2003 and 2008 were evaluated and nested regression models were constructed to evaluate the relationship between surgeon and assistant volume and peri-operative mortality, adjusting for comorbid conditions and hospital volume. In total 28,590 repairs were studied, of which 19,284 (67.5%) were performed by a single surgeon and 9306 (32.5%) included an assistant surgeon. Of cases with an assistant, 12.3% included a high volume assistant surgeon. Lower volume surgeons more frequently used an assistant (lead surgeon Q1 volume: 40%; Q2: 36%; Q3: 34%; Q4: 29%; Q5: 27% [p < .01]). In cases with no assistant, adjusted peri-operative mortality varied monotonically with surgeon volume (Q1: 4.7%; Q2: 4.4%; Q3: 4.1%; Q4: 3.3%; Q5: 3.2%). However, the use of a high or a low volume assistant surgeon, compared with no attending surgeon as assistant, was not associated with lower peri-operative mortality in any lead surgeon volume quintile, even among those operations performed by the lowest volume lead surgeons. Employing an assistant surgeon does not improve outcomes amongst any quintile of volume of the lead surgeon. As surgeons perform fewer open AAA repairs in the modern era, these data imply that even the help of a high volume assistant surgeon may not mitigate the detrimental effect of a lower volume surgeon. Copyright © 2018 European Society for Vascular Surgery. Published by Elsevier B.V. All rights reserved.

  4. The Regionalization of Lumbar Spine Procedures in New York State: A 10-Year Analysis.

    PubMed

    Jancuska, Jeffrey; Adrados, Murillo; Hutzler, Lorraine; Bosco, Joseph

    2016-01-01

    A retrospective review of an administrative database. The purpose of this study is to determine the current extent of regionalization by mapping lumbar spine procedures according to hospital and patient zip code, as well as examine the rate of growth of lumbar spine procedures performed at high-, medium-, and low-volume institutions in New York State. The association between hospital and spine surgeon volume and improved patient outcomes is well established. There is no study investigating the actual process of patient migration to high-volume hospitals. New York Statewide Planning and Research Cooperative System (SPARCS) administrative data were used to identify 228,695 lumbar spine surgery patients from 2005 to 2014. The data included the patients' zip code, hospital of operation, and year of discharge. The volume of lumbar spine surgery in New York State was mapped according to patient and hospital 3-digit zip code. New York State hospitals were categorized as low, medium, and high volume and descriptive statistics were used to determine trends in changes in hospital volume. Lumbar spine surgery recipients are widely distributed throughout the state. Procedures are regionalized on a select few metropolitan centers. The total number of procedures grew 2.5% over the entire 10-year-period. High-volume hospital caseload increased 50%, from 7253 procedures in 2005 to 10,915 procedures in 2014. The number of procedures at medium and low-volume hospitals decreased 30% and 13%, respectively. Despite any concerted effort aimed at moving orthopedic patients to high-volume hospitals, migration to high-volume centers occurred. Public interest in quality outcomes and cost, as well as financial incentives among medical centers to increase market share, potentially influence the migration of patients to high-volume centers. Further regionalization has the potential to exacerbate the current level of disparities among patient populations at low and high-volume hospitals. 3.

  5. The Impact of Surgeon Volume on Perioperative Outcomes in Hysterectomy

    PubMed Central

    Vree, Florentien E. M.; Cohen, Sarah L.; Chavan, Niraj

    2014-01-01

    Background and Objectives: To estimate the effect of surgeon volume on key perioperative outcomes after all modes of hysterectomy. Methods: We performed a review of 1914 hysterectomies performed at a large, academic tertiary-care hospital. Women who underwent abdominal, laparoscopic, vaginal, or robotic hysterectomy for benign non-obstetric indications in 2006, 2009, and 2010 were included. Results: Gynecologic surgeons were categorized according their average annual hysterectomy case volume: low volume (<11 cases per year), intermediate volume (11–50 cases per year), and high-volume (>51 cases per year). Taking all modes of hysterectomy together, surgeries performed by high-volume surgeons required a shorter operative time (155.11 minutes vs 199.19–203.35 minutes, P < .001) and resulted in less estimated blood loss compared with low- and intermediate-volume surgeons (161.09 mL vs 205.58–237.96 mL, P < .001). The 3 surgical volume groups did not differ from each other significantly in the conversion to laparotomy, readmission rate, or incidence of intraoperative or postoperative complications. These findings were maintained when subgroup analyses were performed by type of hysterectomy, with few exceptions. In the subgroup of vaginal hysterectomies by intermediate-volume surgeons, there were slightly more postoperative complications. There were fewer intraoperative complications in laparoscopic/robotic hysterectomies performed by high-volume surgeons, though not statistically significant. Conclusions: Hysterectomies performed by high-volume surgeons at our institution during the 3-year study period were associated with shorter operative times and less estimated blood loss. PMID:24960479

  6. Hand hygiene compliance rates in the United States--a one-year multicenter collaboration using product/volume usage measurement and feedback.

    PubMed

    McGuckin, Maryanne; Waterman, Richard; Govednik, John

    2009-01-01

    Hand hygiene (HH) is the single most important factor in the prevention of health care-acquired infections. The 3 most frequently reported methods of measuring HH compliance are: (1) direct observation, (2) self-reporting by health care workers (HCWs), and (3) indirect calculation based on HH product usage. This article presents the results of a 12-month multicenter collaboration assessing HH compliance rates at US health care facilities by measuring product usage and providing feedback about HH compliance. Our results show that HH compliance at baseline was 26% for intensive care units (ICUs) and 36% for non-ICUs. After 12 months of measuring product usage and providing feedback, compliance increased to 37% for ICUs and 51% for non-ICUs. (ICU, P = .0119; non-ICU, P < .001). HH compliance in the United States can increase when monitoring is combined with feedback. However, HH still occurs at or below 50% compli- ance for both ICUs and non-ICUs.

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

    PubMed

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

    2015-05-01

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

  8. Emergency department imaging: are weather and calendar factors associated with imaging volume?

    PubMed

    Burns, K; Chernyak, V; Scheinfeld, M H

    2016-12-01

    To identify weather and calendar factors that would enable prediction of daily emergency department (ED) imaging volume to aid appropriate scheduling of imaging resources for efficient ED function. Daily ED triage and imaging volumes for radiography, computed tomography (CT), and ultrasound were obtained from hospital databases for the period between January 2011 and December 2013 at a large tertiary urban hospital with a Level II trauma centre. These data were tabulated alongside daily weather conditions (temperature, wind and precipitation), day of week, season, and holidays. Multivariate analysis was performed. Pearson correlations were used to measure the association between number of imaging studies performed and ED triage volume. For every additional 50 triaged patients, the odds of having high (imaging volume ≥90th percentile) radiography, CT, and ultrasound volume increased by 4.3 times (p<0.001), 1.5 times (p=0.02), and 1.4 times (p=0.02), respectively. Tuesday was an independent predictor of high radiography volume (odds ratio=2.8) and Monday was an independent predictor of high CT volume (odds ratio=3.0). Weekday status was an independent factor increasing the odds of a high US volume compared to Saturday (odds ratios ranging from 5.6-9.8). Weather factors and other calendar variables were not independent predictors of high imaging volume. Using Pearson correlations, ED triage volume correlated with number of radiographs, CT, and ultrasound examinations with r=0.73, 0.37, and 0.41, respectively (p<0.0001). As ED triage volume was found to be the only factor associated with imaging volume for all techniques, analysis of predictors of ED triage volumes at a particular healthcare facility would be useful to determine imaging needs. Although calendar and weather factors were found to be minor or non-significant independent predictors of ED imaging utilisation, these may be important in influencing the actual number of ED triages. Copyright © 2016 The Royal College of Radiologists. Published by Elsevier Ltd. All rights reserved.

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

    PubMed

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

    2013-04-01

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

  10. Association between provider volume and healthcare expenditures of patients with oral cancer in Taiwan: a population-based study.

    PubMed

    Chen, Li-Fu; Ho, Hsu-Chueh; Su, Yu-Chieh; Lee, Moon-Sing; Hung, Shih-Kai; Chou, Pesus; Lee, Ching-Chieh J; Lin, Li-Chu; Lee, Ching-Chih

    2013-01-01

    Oral cancer requires considerable utilization of healthcare services. Wide resection of the tumor and reconstruction with free flap are widely used. Due to high recurrence rate, close follow-up is mandatory. This study was conducted to explore the relationship between the healthcare expenditure of oncological surgery and one-year follow up and provider volume. From the National Health Insurance Research Database published by the Taiwanese National Health Research Institute, the authors selected a total of 1300 oral cancer patients who underwent tumor resection and free flap reconstruction in 2008. Hierarchical linear regression analysis was subsequently performed to explore the relationship between provider volume and expenditures of oncological surgery and one-year follow-up period. Emergency department (ED) visits and 30-day readmission rates were also analyzed. The mean expenditure for oncological surgery was $11080±4645 (all costs are given in U.S. dollars) and $10129±9248 for one-year follow up. For oncological surgery expenditure, oral cancer patients treated by low-volume surgeons had an additional $845 than those in high-volume surgeons in mixed model. For one-year follow-up expenditure, patients in low-volume hospitals had an additional $3439 than those in high-volume hospitals; patient in low-volume surgeons and medium-volume surgeons incurred an additional expenditure of $2065 and $1811 than those in high-volume surgeons. Oral cancer patients treated in low-volume hospitals incurred higher risk of 30-day readmission rate (odds ratio, 6.6; 95% confidence interval, 1.6-27). After adjusting for physician, hospital, and patient characteristics, low-volume provider performing wide excision with reconstructive surgery in oral cancer patients incurred significantly higher expenditure for oncological surgery and one-year healthcare per patient than did others with higher volumes. Treatment strategies adapted by high-volume providers should be further analyzed.

  11. Effect of provider volume on resource utilization for surgical procedures of the knee.

    PubMed

    Jain, Nitin; Pietrobon, Ricardo; Guller, Ulrich; Shankar, Anoop; Ahluwalia, Ajit S; Higgins, Laurence D

    2005-05-01

    Operating-room time and patient disposition on discharge are important determinants of healthcare resource utilization and cost. We examined the relation between these determinants and hospital/surgeon volume for anterior cruciate ligament (ACL) reconstruction and meniscectomy procedures. Patients undergoing ACL reconstruction (18,390 cases) and meniscectomy (123,012 cases) were extracted from the State Ambulatory Surgery Databases for the years 1997-2000. Surgeon and hospital volume were divided into low-, intermediate-, and high-volume categories. Multivariate logistic regression models were used to estimate the adjusted association between surgeon and hospital volume and patient discharge status and operating-room time. Patients undergoing ACL reconstruction or meniscectomy performed by low-volume surgeons were significantly more likely to be non-routinely discharged as compared to high-volume surgeons (adjusted odds ratio 3.5, 95% confidence interval 1.7-7.2 for ACL reconstruction; adjusted odds ratio 2.0, 95% confidence interval 1.6-2.3 for meniscectomy). The mean operating-room time for performing ACL reconstruction or meniscectomy was significantly higher in low- and intermediate-volume surgeons and hospitals as compared to high-volume surgeons and hospitals (p < or = 0.001). High-volume providers utilize healthcare resources more efficiently. Our findings may help surgeons and hospitals in optimizing resource utilization and cost for routinely-performed ambulatory surgery procedures.

  12. [Big Data: the great opportunities and challenges to microbiome and other biomedical research].

    PubMed

    Xu, Zhenjiang

    2015-02-01

    With the development of high-throughput technologies, biomedical data has been increasing exponentially in an explosive manner. This brings enormous opportunities and challenges to biomedical researchers on how to effectively utilize big data. Big data is different from traditional data in many ways, described as 3Vs - volume, variety and velocity. From the perspective of biomedical research, here I introduced the characteristics of big data, such as its messiness, re-usage and openness. Focusing on microbiome research of meta-analysis, the author discussed the prospective principles in data collection, challenges of privacy protection in data management, and the scalable tools in data analysis with examples from real life.

  13. Identification and feasibility test of specialized rural pedestrian safety training. Volume 3, PEDSAFE junior/senior high school materials

    DOT National Transportation Integrated Search

    1981-03-30

    This report (Volume 3 of four volumes) provides detailed descriptions of all printed program materials employed in the Junior/Senior High School PEDSAFE Program. Volume 1 of this report describes the conduct and sults of the evaluation of the entire ...

  14. High day-to-day reliability in lower leg volume measured by water displacement.

    PubMed

    Pasley, Jeffrey D; O'Connor, Patrick J

    2008-07-01

    The day-to-day reliability of lower leg volume is poorly documented. This investigation determined the day-to-day reliability of lower leg volume (soleus and gastrocnemius) measured using water displacement. Thirty young adults (15 men and 15 women) had their right lower leg volume measured by water displacement on five separate occasions. The participants performed normal activities of daily living and were measured at the same time of day after being seated for 30 min. The results revealed a high day-to-day reliability for lower leg volume. The mean percentage change in lower leg volume across days compared to day 1 ranged between 0 and 0.37%. The mean within subjects coefficient of variation in lower leg volume was 0.72% and the coefficient of variation for the entire sample across days ranged from 5.66 to 6.32%. A two way mixed model intraclass correlation (30 subjects x 5 days) showed that the lower leg volume measurement was highly reliable (ICC = 0.972). Foot and total lower leg volumes showed similarly high reliability. Water displacement offers a cost effective and reliable solution for the measurement of lower leg edema across days.

  15. Thresholds of glacier hydrologic change and emergent vulnerabilities in a tropical Andean waterscape

    NASA Astrophysics Data System (ADS)

    Mark, B. G.; Bury, J.; Carey, M.; McKenzie, J. M.; Huh, K. I.; Baraer, M.; Eddy, A.

    2011-12-01

    Over the past 50+ years, dramatic glacier mass loss in the Cordillera Blanca, Peru, has been causing downstream hydrologic transformations, with implications for domestic, agricultural and industrial water resources. Coincidental expansion of social and economic development throughout the Santa River watershed, which drains into the Pacific Ocean, raises concerns about sustaining future water supplies. Hydrologic models predict water shortages decades in the future, but conflicts have already arisen in the watershed due to either real or perceived shortages. Moreover, increased water usage since 1950 suggests resilience to presumed thresholds given a concomitant decrease in supply. Therefore modeled thresholds do not align well with historical realities. Our collaborative research couples multiscalar observations of changes in glacier volume, hydrology, and land usage with social and economic data about perceptions of and responses to environmental change. We also examine various water withdrawal mechanisms and institutions transecting the entire watershed: agriculture, land use, irrigation, hydroelectricity generation, and mining. We quantify glacier volume loss using multi-temporal surface elevation maps of selected valley glaciers based on state-of-the-art laser altimetry (LIDAR), ASTER satellite imagery and aerial photogrammetry spanning 1962 to 2008. Results show glacier surface area loss is between 30% and 86%, while measured volume loss is 2 to 12 times greater than empirically derived scaling relationships predict. Based on historical runoff and glacier data, the upper Santa River watershed is found to be on the descending limb of a conceptual multi-decadal hydrograph. The actual distribution of dry season water supply is illustrated based on a 2011 synoptic survey of Santa River discharge from the coastal effluent to headwaters. Our results suggest that critical changes in glacier volume and water supply are not perceived or acknowledged consistently amongst different water users, with the largest contrast along a vertical gradient. We argue that societal forces (e.g. political-economic circumstances, development trends, institutions, urbanization, cultural values, technological innovation, and social relations) have played vital roles in shaping water demands that have allowed water managers to avert perceived thresholds.

  16. The effect of chronic erythrocytic polycythemia and high altitude upon plasma and blood volumes.

    NASA Technical Reports Server (NTRS)

    Burton, R. R.; Smith, A. H.

    1972-01-01

    Comparison of two kinds of physiological chronic erythrocytic polycythemias in order to differentiate the specific effect of erythrocytic polycythemia from the general effects of high altitude upon the plasma volume. The two kinds were produced hormonally in female chickens, at sea level, or by protracted high-altitude exposures. It appears that the vascular system of the body may account for an increase in red blood cell mass either by reduction in plasma volume, or by no change in plasma volume, resulting in differential changes in total blood volumes.

  17. Blood Volume Response to Physical Activity and Inactivity

    DTIC Science & Technology

    2007-07-01

    feedback to promote volume excretion and maintain blood volume at its normal baseline level. Physical activity does not alter either arterial pressure or...although this is less clear. The increase in total blood volume then increases the ability to maintain a high stroke volume and a lower heart rate for...compelling evidence that reduced blood vol- ume with age may be a result of a sedentary, high caloric lifestyle rather than the aging process. There

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

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

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

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

  19. Leveraging human oversight and intervention in large-scale parallel processing of open-source data

    NASA Astrophysics Data System (ADS)

    Casini, Enrico; Suri, Niranjan; Bradshaw, Jeffrey M.

    2015-05-01

    The popularity of cloud computing along with the increased availability of cheap storage have led to the necessity of elaboration and transformation of large volumes of open-source data, all in parallel. One way to handle such extensive volumes of information properly is to take advantage of distributed computing frameworks like Map-Reduce. Unfortunately, an entirely automated approach that excludes human intervention is often unpredictable and error prone. Highly accurate data processing and decision-making can be achieved by supporting an automatic process through human collaboration, in a variety of environments such as warfare, cyber security and threat monitoring. Although this mutual participation seems easily exploitable, human-machine collaboration in the field of data analysis presents several challenges. First, due to the asynchronous nature of human intervention, it is necessary to verify that once a correction is made, all the necessary reprocessing is done in chain. Second, it is often needed to minimize the amount of reprocessing in order to optimize the usage of resources due to limited availability. In order to improve on these strict requirements, this paper introduces improvements to an innovative approach for human-machine collaboration in the processing of large amounts of open-source data in parallel.

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

    PubMed

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

    2010-02-01

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

  1. An overview of artificial intelligence and robotics. Volume 2: Robotics

    NASA Technical Reports Server (NTRS)

    Gevarter, W. B.

    1982-01-01

    This report provides an overview of the rapidly changing field of robotics. The report incorporates definitions of the various types of robots, a summary of the basic concepts, utilized in each of the many technical areas, review of the state of the art and statistics of robot manufacture and usage. Particular attention is paid to the status of robot development, the organizations involved, their activities, and their funding.

  2. Combat Service Support MOD II Design (CSS MOD II). Volume 2. Appendixes

    DTIC Science & Technology

    1986-10-01

    through contractual aoreement with Michael Jackson , Ltd. London. The spelling, syntax, and word usage adopted throughout the document have been made...to conform to army standards. The design teas members wish to thank the followin, individuals for their assistances Mr. John Cameron, Michael Jackson , Ltd...JSP) methodology is a product of Michael Jackson Systems, Ltd., London, England. In 1984, Dr. Wilbur Payne, Director, TRADOC Operations Research

  3. Technical aspects of positron emission tomography/computed tomography in radiotherapy treatment planning.

    PubMed

    Scripes, Paola G; Yaparpalvi, Ravindra

    2012-09-01

    The usage of functional data in radiation therapy (RT) treatment planning (RTP) process is currently the focus of significant technical, scientific, and clinical development. Positron emission tomography (PET) using ((18)F) fluorodeoxyglucose is being increasingly used in RT planning in recent years. Fluorodeoxyglucose is the most commonly used radiotracer for diagnosis, staging, recurrent disease detection, and monitoring of tumor response to therapy (Lung Cancer 2012;76:344-349; Lung Cancer 2009;64:301-307; J Nucl Med 2008;49:532-540; J Nucl Med 2007;48:58S-67S). All the efforts to improve both PET and computed tomography (CT) image quality and, consequently, lesion detectability have a common objective to increase the accuracy in functional imaging and thus of coregistration into RT planning systems. In radiotherapy, improvement in target localization permits reduction of tumor margins, consequently reducing volume of normal tissue irradiated. Furthermore, smaller treated target volumes create the possibility of dose escalation, leading to increased chances of tumor cure and control. This article focuses on the technical aspects of PET/CT image acquisition, fusion, usage, and impact on the physics of RTP. The authors review the basic elements of RTP, modern radiation delivery, and the technical parameters of coregistration of PET/CT into RT computerized planning systems. Copyright © 2012 Elsevier Inc. All rights reserved.

  4. Investigating the Energy-Water Usage Efficiency of the Reuse of Treated Municipal Wastewater for Artificial Groundwater Recharge.

    PubMed

    Fournier, Eric D; Keller, Arturo A; Geyer, Roland; Frew, James

    2016-02-16

    This project investigates the energy-water usage efficiency of large scale civil infrastructure projects involving the artificial recharge of subsurface groundwater aquifers via the reuse of treated municipal wastewater. A modeling framework is introduced which explores the various ways in which spatially heterogeneous variables such as topography, landuse, and subsurface infiltration capacity combine to determine the physical layout of proposed reuse system components and their associated process energy-water demands. This framework is applied to the planning and evaluation of the energy-water usage efficiency of hypothetical reuse systems in five case study regions within the State of California. Findings from these case study analyses suggest that, in certain geographic contexts, the water requirements attributable to the process energy consumption of a reuse system can exceed the volume of water that it is able to recover by as much as an order of magnitude.

  5. Trends and Utilization of Laser Prostatectomy in Ambulatory Surgical Procedures for the Treatment of Benign Prostatic Hyperplasia in New York State (2000-2011).

    PubMed

    Chughtai, Bilal I; Simma-Chiang, Vannita; Lee, Richard; Isaacs, Abby; Te, Alexis E; Kaplan, Steven A; Sedrakyan, Art

    2015-06-01

    There has been a significant change in surgical treatment of benign prostatic hypertrophy (BPH) over the last two decades. Most importantly, laser surgery (coagulation, vaporization, or enucleation) has been growing in popularity as an alternative to standard transurethral prostatectomy (TURP) or other procedures. Our goal was to analyze the trends of BPH surgeries and compare outcomes of laser surgery to TURP, the two most common alternative surgeries. We used the New York Statewide Planning and Research Cooperation System (SPARCS) data to identify patients diagnosed as having BPH who underwent BPH-related surgery from October 2000 to December 2011. Age, insurance, individual comorbidities, and average hospital volumes were assessed. Bivariate and multivariate regression models were used to analyze predictors of laser use. In-hospital outcomes were then compared between laser and TURP in a balanced propensity-matched cohort. Ninety thousand six hundred seventy patients underwent BPH surgery. Laser surgery usage increased from 6.4% to 44.5% over 10 years (p<0.0001). TURP declined significantly from 72.2% to 48.3% (p<0.0001). Patients with Medicaid were less likely to undergo laser therapy than those with private insurance (odds ratio [OR]: 0.58, 95% confidence interval [CI]: 0.48, 0.69). Mid- and high-volume institutions were more likely to use laser treatment than low-volume centers (OR: 2.26, 95% CI: 1.22, 4.2; OR: 4.07, 95% CI: 1.75, 9.46, respectively). In the matched cohort, both laser and TURP patients had similar complication rates with more frequent electrolyte disorders in TURP patients (2.9% vs 2.3%, p=0.001). TURP remains the most common procedure. However, the rate of use has declined over time. In contrast, laser use has significantly increased. Laser treatment was utilized more in younger patients, in those privately insured, in hospitals with high volumes of BPH procedures, and in patients with fewer comorbid conditions. Both surgeries are safe with no differences in terms of occurrences of morbidity and complications.

  6. Large volume continuous counterflow dialyzer has high efficiency

    NASA Technical Reports Server (NTRS)

    Mandeles, S.; Woods, E. C.

    1967-01-01

    Dialyzer separates macromolecules from small molecules in large volumes of solution. It takes advantage of the high area/volume ratio in commercially available 1/4-inch dialysis tubing and maintains a high concentration gradient at the dialyzing surface by counterflow.

  7. "Take the Volume Pledge" may result in disparity in access to care.

    PubMed

    Blanco, Barbara A; Kothari, Anai N; Blackwell, Robert H; Brownlee, Sarah A; Yau, Ryan M; Attisha, John P; Ezure, Yoshiki; Pappas, Sam; Kuo, Paul C; Abood, Gerard J

    2017-03-01

    "Take the Volume Pledge" proposes restricting pancreatectomies to hospitals that perform ≥20 per year. Our purpose was to identify those factors that characterize patients at risk for loss of access to pancreatic cancer care with enforcement of volume standards. Using the Healthcare Cost and Utilization Project State Inpatient Database from Florida, we identified patients who underwent pancreatectomy for pancreatic malignancy from 2007-2011. American Hospital Association and United States Census Bureau data were linked to patient-level data. High-volume hospitals were defined as performing ≥20 pancreatic resections per year. Univariable and multivariable statistics compared patient characteristics and utilization of high-volume hospitals. Classification and Regression Tree modeling was used to predict patients at risk for losing access to care. Our study included 1,663 patients. Five high-volume hospitals were identified, and they treated 1,056 (63.5%) patients. Patients residing far from high-volume hospitals, in areas with the highest population density, non-Caucasian ethnicity, and greater income had decreased odds of obtaining care at high-volume hospitals. Using these factors, we developed a Classification and Regression Tree-based predictive tool to identify these patients. Implementation of "Take the Volume Pledge" is an important step toward improving pancreatectomy outcomes; however, policymakers must consider the potential impact on limiting access and possible health disparities that may arise. Copyright © 2016 Elsevier Inc. All rights reserved.

  8. Liquid Metal Fast Breeder Reactor Program: Argonne facilities

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

    Stephens, S. V.

    1976-09-01

    The objective of the document is to present in one volume an overview of the Argonne National Laboratory test facilities involved in the conduct of the national LMFBR research and development program. Existing facilities and those under construction or authorized as of September 1976 are described. Each profile presents brief descriptions of the overall facility and its test area and data relating to its experimental and testing capability. The volume is divided into two sections: Argonne-East and Argonne-West. Introductory material for each section includes site and facility maps. The profiles are arranged alphabetically by title according to their respective locationsmore » at Argonne-East or Argonne-West. A glossary of acronyms and letter designations in common usage to describe organizations, reactor and test facilities, components, etc., involved in the LMFBR program is appended.« less

  9. Pushing quantitation limits in micro UHPLC-MS/MS analysis of steroid hormones by sample dilution using high volume injection.

    PubMed

    Márta, Zoltán; Bobály, Balázs; Fekete, Jenő; Magda, Balázs; Imre, Tímea; Mészáros, Katalin Viola; Szabó, Pál Tamás

    2016-09-10

    Ultratrace analysis of sample components requires excellent analytical performance in terms of limits of quantitation (LoQ). Micro UHPLC coupling with sensitive tandem mass spectrometry provides state of the art solutions for such analytical problems. Decreased column volume in micro LC limits the injectable sample volume. However, if analyte concentration is extremely low, it might be necessary to inject high sample volumes. This is particularly critical for strong sample solvents and weakly retained analytes, which are often the case when preparing biological samples (protein precipitation, sample extraction, etc.). In that case, high injection volumes may cause band broadening, peak distortion or even elution in dead volume. In this study, we evaluated possibilities of high volume injection onto microbore RP-LC columns, when sample solvent is diluted. The presented micro RP-LC-MS/MS method was optimized for the analysis of steroid hormones from human plasma after protein precipitation with organic solvents. A proper sample dilution procedure helps to increase the injection volume without compromising peak shapes. Finally, due to increased injection volume, the limit of quantitation can be decreased by a factor of 2-5, depending on the analytes and the experimental conditions. Copyright © 2016 Elsevier B.V. All rights reserved.

  10. Acute pesticide poisoning outcomes: a nationwide study in Taiwan.

    PubMed

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

    2015-03-01

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

  11. Case mix-adjusted cost of colectomy at low-, middle-, and high-volume academic centers.

    PubMed

    Chang, Alex L; Kim, Young; Ertel, Audrey E; Hoehn, Richard S; Wima, Koffi; Abbott, Daniel E; Shah, Shimul A

    2017-05-01

    Efforts to regionalize surgery based on thresholds in procedure volume may have consequences on the cost of health care delivery. This study aims to delineate the relationship between hospital volume, case mix, and variability in the cost of operative intervention using colectomy as the model. All patients undergoing colectomy (n = 90,583) at 183 academic hospitals from 2009-2012 in The University HealthSystems Consortium Database were studied. Patient and procedure details were used to generate a case mix-adjusted predictive model of total direct costs. Observed to expected costs for each center were evaluated between centers based on overall procedure volume. Patient and procedure characteristics were significantly different between volume tertiles. Observed costs at high-volume centers were less than at middle- and low-volume centers. According to our predictive model, high-volume centers cared for a less expensive case mix than middle- and low-volume centers ($12,786 vs $13,236 and $14,497, P < .01). Our predictive model accounted for 44% of the variation in costs. Overall efficiency (standardized observed to expected costs) was greatest at high-volume centers compared to middle- and low-volume tertiles (z score -0.16 vs 0.02 and -0.07, P < .01). Hospital costs and cost efficiency after an elective colectomy varies significantly between centers and may be attributed partially to the patient differences at those centers. These data demonstrate that a significant proportion of the cost variation is due to a distinct case mix at low-volume centers, which may lead to perceived poor performance at these centers. Copyright © 2016 Elsevier Inc. All rights reserved.

  12. Specialization and utilization after hepatectomy in academic medical centers.

    PubMed

    Shaw, Joshua J; Santry, Heena P; Shah, Shimul A

    2013-11-01

    Specialized procedures such as hepatectomy are performed by a variety of specialties in surgery. We aimed to determine whether variation exists among utilization of resources, cost, and patient outcomes by specialty, surgeon case volume, and center case volume for hepatectomy. We queried centers (n = 50) in the University Health Consortium database from 2007-2010 for patients who underwent elective hepatectomy in which specialty was designated general surgeon (n = 2685; 30%) or specialist surgeon (n = 6277; 70%), surgeon volume was designated high volume (>38 cases annually) and center volume was designated high volume (>100 cases annually). We then stratified our cohort by primary diagnosis, defined as primary tumor (n = 2241; 25%), secondary tumor (n = 5466; 61%), and benign (n = 1255; 14%). Specialist surgeons performed more cases for primary malignancy (primary 26% versus 15%) while general surgeons operated more for secondary malignancies (67% versus 61%) and benign disease (18% versus 13%). Specialists were associated with a shorter total length of stay (LOS) (5 d versus 6 d; P < 0.01) and lower in-hospital morbidity (7% versus 11%; P < 0.01). Patients treated by high volume surgeons or at high volume centers were less likely to die than those treated by low volume surgeons or at low volume centers, (OR 0.55; 95% CI 0.33-0.89) and (OR 0.44; 95% CI 0.13-0.56). Surgical specialization, surgeon volume and center volume may be important metrics for quality and utilization in complex procedures like hepatectomy. Further studies are necessary to link direct factors related to hospital performance in the changing healthcare environment. Copyright © 2013 Elsevier Inc. All rights reserved.

  13. Implementation of a New High-Volume Circular Stapler in Stapled Anopexy for Hemorrhoidal Disease: Is Patient's Short-Term Outcome Affected by a Higher Volume of Resected Tissue?

    PubMed

    Grotenhuis, Brechtje A; Nonner, Joost; de Graaf, Eelco J R; Doornebosch, Pascal G

    2017-11-02

    Stapled anopexy is a safe technique for the treatment of hemorrhoids but carries a higher risk of recurrence, which might be caused due to the limited volume of resected tissue. In this study, we investigated the introduction of a high-volume circular stapling device; in particular whether an increased amount of resected tissue could affect patients' short-term postoperative outcome. Between 2011 and 2015, stapled anopexy was performed for hemorrhoids and/or anal prolapse in 141 patients (n = 25 conventional PPH-3©-stapler versus n = 116 high-volume CHEX©-stapler). In this prospectively collected dataset, operation details and short-term postoperative outcome were compared. With the high-volume stapler, a significantly higher amount of tissue was resected: 9.8 g (range 6.2-11.4) vs. 6.4 g (range 4.9-8.8) with the conventional stapler, p < 0.01. Postoperative short-term outcome did not differ in terms of readmission and complication rates. In all 5 patients who underwent a redo operation for residual hemorrhoids or prolapse, the high-volume stapler was used in the primary operation. A high-volume stapling device for stapled anopexy was introduced safely with a significantly higher amount of resected tissue without a worse short-term outcome. However, it remains unclear whether higher stapling volumes may lead to improved long-term outcome with less reinterventions. © 2017 S. Karger AG, Basel.

  14. Outcomes of Cryoballoon Ablation in High- and Low-Volume Atrial Fibrillation Ablation Centres: A Russian Pilot Survey

    PubMed Central

    Mikhaylov, Evgeny N.; Lebedev, Dmitry S.; Pokushalov, Evgeny A.; Davtyan, Karapet V.; Ivanitskii, Eduard A.; Nechepurenko, Anatoly A.; Kosonogov, Alexey Ya.; Kolunin, Grigory V.; Morozov, Igor A.; Termosesov, Sergey A.; Maykov, Evgeny B.; Khomutinin, Dmitry N.; Eremin, Sergey A.; Mayorov, Igor M.; Romanov, Alexander B.; Shabanov, Vitaliy V.; Shatakhtsyan, Victoria; Tsivkovskii, Viktor; Revishvili, Amiran Sh.; Shlyakhto, Evgeny V.

    2015-01-01

    Purpose. The results of cryoballoon ablation (CBA) procedure have been mainly derived from studies conducted in experienced atrial fibrillation (AF) ablation centres. Here, we report on CBA efficacy and complications resulting from real practice of this procedure at both high- and low-volume centres. Methods. Among 62 Russian centres performing AF ablation, 15 (24%) used CBA technology for pulmonary vein isolation. The centres were asked to provide a detailed description of all CBA procedures performed and complications, if encountered. Results. Thirteen sites completed interviews on all CBAs in their centres (>95% of CBAs in Russia). Six sites were high-volume AF ablation (>100 AF cases/year) centres, and 7 were low-volume AF ablation. There was no statistical difference in arrhythmia-free rates between high- and low-volume centres (64.6 versus 60.8% at 6 months). Major complications developed in 1.5% of patients and were equally distributed between high- and low-volume centres. Minor procedure-related events were encountered in 8% of patients and were more prevalent in high-volume centres. Total event and vascular access site event rates were higher in women than in men. Conclusions. CBA has an acceptable efficacy profile in real practice. In less experienced AF ablation centres, the major complication rate is equal to that in high-volume centres. PMID:26640789

  15. Ninety day mortality following pancreatoduodenectomy in England: has the optimum centre volume been identified?

    PubMed

    Liu, Z; Peneva, I S; Evison, F; Sahdra, S; Mirza, D F; Charnley, R M; Savage, R; Moss, P A; Roberts, K J

    2018-06-09

    Mortality following pancreatoduodenectomy is related to centre volume although the optimal volume is not defined. Patients undergoing PD between 2001 and 2016 were identified from UK national databases. The effects of patient variables, centre volume and time period upon 90 day mortality were studied. 90 day mortality (970/14,935, 6.5%) was related to advanced age, comorbidity, diagnosis, ethnicity, deprivation, centre volume and time period. Mortality rates fell markedly from 10.0% in 2001-4 to 4.1% in 2013-16. There was no difference in 90 day mortality between high (36 -60 PD per year) and very high volume (>60) centres. However, patients operated upon at very high volume centres were more elderly (66, 58 -73 vs 65, 56 -72; median, IQR; p = 0.006), deprived (38.7 vs 34.6%; p < 0.001) and co morbid (48.9 vs 46.1%; p = 0.027). Although a plateau in the centre volume and mortality relationship appears to have been demonstrated those patients treated at the highest volume centres were at higher risk of mortality. This data suggests therefore that to further understand outcomes from specialist centres characteristics of the patient population should be defined, not just centre volume. Copyright © 2018. Published by Elsevier Ltd.

  16. Cell volume regulation and apoptotic volume decrease in rat distal colon superficial enterocytes.

    PubMed

    Antico, Stefania; Lionetto, Maria Giulia; Giordano, Maria Elena; Caricato, Roberto; Schettino, Trifone

    2013-01-01

    The colon epithelium is physiologically exposed to osmotic stress, and the activation of cell volume regulation mechanisms is essential in colonocyte physiology. Moreover, colon is characterized by a high apoptotic rate of mature cells balancing the high division rate of stem cells. The aim of the present work was to investigate the main cell volume regulation mechanisms in rat colon surface colonocytes and their role in apoptosis. Cell volume changes were measured by light microscopy and video imaging on colon explants; apoptosis sign appearance was monitored by confocal microscopy on annexin V/propidium iodide labeled explants. Superficial colonocytes showed a dynamic regulation of their cell volume during anisosmotic conditions with a Regulatory Volume Increase (RVI) response following hypertonic shrinkage and Regulatory Volume Decrease (RVD) response following hypotonic swelling. RVI was completely inhibited by bumetanide, while RVD was completely abolished by high K(+) or iberiotoxin treatment and by extracellular Ca(2+) removal. DIDS incubation was also able to affect the RVD response. When colon explants were exposed to H2O2 as apoptotic inducer, colonocytes underwent an isotonic volume decrease ascribable to Apoptotic Volume Decrease (AVD) within about four hours of exposure. AVD was shown to precede annexin V positivity. It was also inhibited by high K(+) or iberiotoxin treatment. Interestingly, treatment with iberiotoxin significantly inhibited apoptosis progression. In rat superficial colonocytes K(+) efflux through high conductance Ca(2+)-activated K(+) channels (BK channels) was demonstrated to be the main mechanism of RVD and to plays also a crucial role in the AVD process and in the progression of apoptosis. © 2013 S. Karger AG, Basel.

  17. Relative Impact of Surgeon and Hospital Volume on Operative Mortality and Complications Following Pancreatic Resection in Medicare Patients

    PubMed Central

    Mehta, Hemalkumar B.; Parmar, Abhishek D.; Adhikari, Deepak; Tamirisa, Nina P.; Dimou, Francesca; Jupiter, Daniel; Riall, Taylor S.

    2016-01-01

    Background Surgeon and hospital volume are both known to affect outcomes for patients undergoing pancreatic resection. The objective was to evaluate the relative effects of surgeon and hospital volume on 30-day mortality and 30-day complications after pancreatic resection among older patients. Materials and Methods The study used Texas Medicare data (2000–2012), identifying high-volume surgeons as those performing ≥4 pancreatic resections/year, and high-volume hospitals as those performing ≥11 pancreatic resections/year, on Medicare patients. Three-level hierarchical logistic regression models were used to evaluate the relative effects of surgeon and hospital volumes on mortality and complications, after adjusting for case mix differences. Results There were 2,453 pancreatic resections performed by 490 surgeons operating in 138 hospitals. 4.5% of surgeons and 6.5% of hospitals were high-volume. The overall 30-day mortality was 9.0%, and the 30-day complication rate was 40.6%. Overall, 8.9% of the variance in 30-day mortality was attributed to surgeon factors and 9.8% to hospital factors. For 30-day complications, 4.7% of the variance was attributed to surgeon factors and 1.2% to hospital factors. After adjusting for patient, surgeon and hospital characteristics, high surgeon volume (OR 0.54, 95% CI 0.33–0.87) and high hospital volume (OR, 0.52; 95% CI, 0.30–0.92) were associated with lower risk of mortality; high surgeon volume (OR 0.71, 95% CI 0.55–0.93) was also associated lower risk of 30-day complications. Conclusions Both hospital and surgeon factors contributed significantly to the observed variance in mortality, but only surgeon factors impacted complications. PMID:27565068

  18. Coronary revascularization in Japan. Part 2: comparison of facilities between 1997 and 1999.

    PubMed

    Tsuchihashi, M; Tsutsui, H; Shihara, M; Shigematsu, H; Yamamoto, S; Koike, G; Kono, S; Takeshita, A

    2001-12-01

    A nation-wide survey on the procedures and facilities of coronary revascularization, percutaneous coronary intervention (PCI) and coronary artery bypass grafting (CABG) conducted by the Japanese Coronary Intervention Study (JCIS) group during 1997 revealed that PCI is more often used than CABG and is mainly carried out in low-volume facilities without surgical backup. The present study aimed to investigate the temporal changes in the usage of revascularization therapies and facilities from 1997 to 1999. A questionnaire was mailed in 1998 to the delegates of 1,086 PCI and 582 CABG facilities identified by the previous survey, and 89% of PCIs surveyed and 94% of CABGs surveyed reported back. The number of PCI procedures had increased by 19% from 97,831 to 116,479 and that of CABG procedures also increased by 21% from 16,374 to 19,846. The ratio of PCI to CABG was 5.9 in 1999, showing no significant change from 6.0 in 1997. In parallel, the number of PCI and CABG facilities increased from 888 to 941 and from 442 to 453, respectively. The use of coronary stents and other interventional devices increased during these 2 years. Coronary stents were used regardless of the annual procedural volume of the facilities, whereas other interventional devices, directional and rotational coronary atherectomy, were used mainly in the high-volume laboratories (p<0.01). Beating-heart, off-pump CABG had increased from 2% to 11% of total cases. Continued monitoring of trends in PCI and CABG facilities and procedures will be needed for nation-wide assessment of the use of new technology.

  19. Involved-node radiotherapy in early-stage Hodgkin's lymphoma. Definition and guidelines of the German Hodgkin Study Group (GHSG).

    PubMed

    Eich, Hans Theodor; Müller, Rolf-Peter; Engenhart-Cabillic, Rita; Lukas, Peter; Schmidberger, Heinz; Staar, Susanne; Willich, Normann

    2008-08-01

    Radiotherapy of Hodgkin's Lymphoma has evolved from extended-field to involved-field (IF) radiotherapy reducing toxicity whilst maintaining high cure rates. Recent publications recommend further reduction in the radiation field to involved-node (IN) radiotherapy; however, this concept has never been tested in a randomized trial. The German Hodgkin Study Group aims to compare it with standard IF radiotherapy in their future HD17 trial. ALL patients must be examined by the radiation oncologist before the start of chemotherapy. At that time, patients must have complete staging CT scans. For patients with IN radiotherapy, a radiation planning CT before and after chemotherapy with patients in the treatment position is recommended. Fusion techniques, allowing the overlapping of the pre- and postchemotherapy CT scans, should be used. Usage of PET-CT scans with patients in the treatment position is recommended, whenever possible. The clinical target volume encompasses the initial volume of the Lymph node(s) before chemotherapy and incorporates the initial Location and extent of the disease taking the displacement of the normal tissues into account. The margin of the planning target volume should be 2 cm in axial and 3 cm in craniocaudal direction. If necessary, it can be reduced to 1-1.5 cm. To minimize Lung and cardiac toxicity, the target definition in the mediastinum is different. The concept of IN radiotherapy has been proposed as a means to further improve the therapeutic ratio by reducing the risk of radiation-induced toxicity, including second malignancies. Field sizes wiLL further decrease compared to IF radiotherapy.

  20. Increased gray-matter volume in medication-naive high-functioning children with autism spectrum disorder.

    PubMed

    Palmen, Saskia J M C; Hulshoff Pol, Hilleke E; Kemner, Chantal; Schnack, Hugo G; Durston, Sarah; Lahuis, Bertine E; Kahn, René S; Van Engeland, Herman

    2005-04-01

    To establish whether high-functioning children with autism spectrum disorder (ASD) have enlarged brains in later childhood, and if so, whether this enlargement is confined to the gray and/or to the white matter and whether it is global or more prominent in specific brain regions. Brain MRI scans were acquired from 21 medication-naive, high-functioning children with ASD between 7 and 15 years of age and 21 comparison subjects matched for gender, age, IQ, height, weight, handedness, and parental education, but not pubertal status. Patients showed a significant increase of 6% in intracranium, total brain, cerebral gray matter, cerebellum, and of more than 40% in lateral and third ventricles compared to controls. The cortical gray-matter volume was evenly affected in all lobes. After correction for brain volume, ventricular volumes remained significantly larger in patients. High-functioning children with ASD showed a global increase in gray-matter, but not white-matter and cerebellar volume, proportional to the increase in brain volume, and a disproportional increase in ventricular volumes, still present after correction for brain volume. Advanced pubertal development in the patients compared to the age-matched controls may have contributed to the findings reported in the present study.

  1. Changes in Saturday outpatient volume and billings after introducing the Saturday incentive programme to clinics in South Korea: a longitudinal cohort study using claims data from 2012 to 2014.

    PubMed

    Ha, Hyun Ji; Han, Kyu-Tae; Kim, Sun Jung; Sohn, Tae Yong; Jeon, Byungyool; Park, Eun-Cheol

    2016-06-09

    In October 2013, the South Korean government introduced an incentive programme to increase the availability of Saturday treatment at clinics, hoping to increase the role of primary care providers as gatekeepers to medical care. To the best of our knowledge, no one has yet investigated this programme's effect on overall outpatient care. Our study aims to analyse the change in Saturday outpatient volume and billings in clinics that adopted the Saturday incentive programme. Our study used 3 types of data from the period October 2012 to March 2014: National Health Insurance Service (NHIS) claims data, hospital evaluation data and medical institution data. These data consisted of 66 825 881 outpatient cases from 2837 clinics. Introducing the Saturday incentive programme. We performed a multilevel analysis that adjusted for clinic-level and outpatient-level variables to examine the difference in the percentage of Saturday outpatient volume and billings after introducing the Saturday incentive programme. The percentages of Saturday outpatient volume and billings were higher after introducing the programme (outpatient volume: β=2.065, p<0.001; outpatient billings: β=3.518, p<0.001). In addition, outpatient volume and billings on Friday and Saturday increased after introducing the programme, while those on weekdays, excluding Friday, decreased. Our findings suggest that the Saturday incentive programme has affected clinic outpatient care and is a worthwhile health policy in terms of promoting primary care. Thus, it may improve healthcare accessibility and quality of care, and prevent inappropriate usage such as emergency room visits by providing patients with weekend clinic hours. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  2. The Volume-outcome Relationship in Deceased Donor Kidney Transplantation and Implications for Regionalization.

    PubMed

    Barbas, Andrew S; Dib, Martin J; Rege, Aparna S; Vikraman, Deepak S; Sudan, Debra L; Knechtle, Stuart J; Scarborough, John E

    2018-06-01

    The aim of this study was to investigate the volume-outcome relationship in kidney transplantation by examining graft and patient outcomes using standardized risk adjustment (observed-to-expected outcomes). A secondary objective was to examine the geographic proximity of low, medium, and high-volume kidney transplant centers in the United States. The significant survival benefit of kidney transplantation in the context of a severe shortage of donor organs mandates strategies to optimize outcomes. Unlike for other solid organ transplants, the relationship between surgical volume and kidney transplant outcomes has not been clearly established. The Scientific Registry of Transplant Recipients was used to examine national outcomes for adults undergoing deceased donor kidney transplantation from January 1, 1999 to December 31, 2013 (15-year study period). Observed-to-expected rates of graft loss and patient death were compared for low, medium, and high-volume centers. The geographic proximity of low-volume centers to higher volume centers was determined to assess the impact of regionalization on patient travel burden. A total of 206,179 procedures were analyzed. Compared with low-volume centers, high-volume centers had significantly lower observed-to-expected rates of 1-month graft loss (0.93 vs 1.18, P<0.001), 1-year graft loss (0.97 vs 1.12, P<0.001), 1-month patient death (0.90 vs 1.29, P=0.005), and 1-year patient death (0.95 vs 1.15, P=0.001). Low-volume centers were frequently in close proximity to higher volume centers, with a median distance of 7 miles (interquartile range: 2 to 75). A robust volume-outcome relationship was observed for deceased donor kidney transplantation, and low-volume centers are frequently in close proximity to higher volume centers. Increased regionalization could improve outcomes, but should be considered carefully in light of the potential negative impact on transplant volume and access to care.

  3. Implications of improved diagnostic imaging of small nodal metastases in head and neck cancer: Radiotherapy target volume transformation and dose de-escalation.

    PubMed

    van den Bosch, Sven; Vogel, Wouter V; Raaijmakers, Cornelis P; Dijkema, Tim; Terhaard, Chris H J; Al-Mamgani, Abrahim; Kaanders, Johannes H A M

    2018-05-03

    Diagnostic imaging continues to evolve, and now has unprecedented accuracy for detecting small nodal metastasis. This influences the tumor load in elective target volumes and subsequently has consequences for the radiotherapy dose required to control disease in these volumes. Small metastases that used to remain subclinical and were included in elective volumes, will nowadays be detected and included in high-dose volumes. Consequentially, high-dose volumes will more often contain low-volume disease. These target volume transformations lead to changes in the tumor burden in elective and "gross" tumor volumes with implications for the radiotherapy dose prescribed to these volumes. For head and neck tumors, nodal staging has evolved from mere palpation to combinations of high-resolution imaging modalities. A traditional nodal gross tumor volume in the neck typically had a minimum diameter of 10-15 mm, while nowadays much smaller tumor deposits are detected in lymph nodes. However, the current dose levels for elective nodal irradiation were empirically determined in the 1950s, and have not changed since. In this report the radiobiological consequences of target volume transformation caused by modern imaging of the neck are evaluated, and theoretically derived reductions of dose in radiotherapy for head and neck cancer are proposed. The concept of target volume transformation and subsequent strategies for dose adaptation applies to many other tumor types as well. Awareness of this concept may result in new strategies for target definition and selection of dose levels with the aim to provide optimal tumor control with less toxicity. Copyright © 2018 The Authors. Published by Elsevier B.V. All rights reserved.

  4. Alveolar edema dispersion and alveolar protein permeability during high volume ventilation: effect of positive end-expiratory pressure.

    PubMed

    de Prost, Nicolas; Roux, Damien; Dreyfuss, Didier; Ricard, Jean-Damien; Le Guludec, Dominique; Saumon, Georges

    2007-04-01

    To evaluate whether PEEP affects intrapulmonary alveolar edema liquid movement and alveolar permeability to proteins during high volume ventilation. Experimental study in an animal research laboratory. 46 male Wistar rats. A (99m)Tc-labeled albumin solution was instilled in a distal airway to produce a zone of alveolar flooding. Conventional ventilation (CV) was applied for 30 min followed by various ventilation strategies for 3 h: CV, spontaneous breathing, and high volume ventilation with different PEEP levels (0, 6, and 8 cmH(2)O) and different tidal volumes. Dispersion of the instilled liquid and systemic leakage of (99m)Tc-albumin from the lungs were studied by scintigraphy. The instillation protocol produced a zone of alveolar flooding that stayed localized during CV or spontaneous breathing. High volume ventilation dispersed alveolar liquid in the lungs. This dispersion was prevented by PEEP even when tidal volume was the same and thus end-inspiratory pressure higher. High volume ventilation resulted in the leakage of instilled (99m)Tc-albumin from the lungs. This increase in alveolar albumin permeability was reduced by PEEP. Albumin permeability was more affected by the amplitude of tidal excursions than by overall lung distension. PEEP prevents the dispersion of alveolar edema liquid in the lungs and lessens the increase in alveolar albumin permeability due to high volume ventilation.

  5. Optimization of the convection volume in online post-dilution haemodiafiltration: practical and technical issues

    PubMed Central

    Chapdelaine, Isabelle; de Roij van Zuijdewijn, Camiel L.M.; Mostovaya, Ira M.; Lévesque, Renée; Davenport, Andrew; Blankestijn, Peter J.; Wanner, Christoph; Nubé, Menso J.; Grooteman, Muriel P.C.

    2015-01-01

    In post-dilution online haemodiafiltration (ol-HDF), a relationship has been demonstrated between the magnitude of the convection volume and survival. However, to achieve high convection volumes (>22 L per session) detailed notion of its determining factors is highly desirable. This manuscript summarizes practical problems and pitfalls that were encountered during the quest for high convection volumes. Specifically, it addresses issues such as type of vascular access, needles, blood flow rate, recirculation, filtration fraction, anticoagulation and dialysers. Finally, five of the main HDF systems in Europe are briefly described as far as HDF prescription and optimization of the convection volume is concerned. PMID:25815176

  6. Bottle Characteristics of Topical International Glaucoma Medications versus Local Brands in Saudi Arabia

    PubMed Central

    Al-Jumaian, Nasser; Malik, Rizwan; Khandekar, Rajiv; Al-Humaidan, Abdullah; Al-Madany, Rana; Al-Qahtani, Reham; Altowairqi, Ahmed; Al-Theeb, Abdulwahab; Zaman, Babar; Al-Djasim, Leyla; Craven, E. Randy; Edward, Deepak P.

    2016-01-01

    WHAT IS KNOWN AND OBJECTIVE: Physical bottle characteristics differ of brand name topical glaucoma medications and local generic equivalents. This study compares the bottle characteristics of international topical glaucoma brands versus local brands from the Kingdom of Saudi Arabia. METHODS: Data were collected on bottle drum volume, drop volume, bottle squeezability, bottle tip diameter, labels and instructions, cap color coding, and clarity of the drug label. Density-based calculations of drops in bottle volume were assessed using an analytic balance. Bottle tip diameter was measured using 0.05 mm Vernier calipers. A Likert scale-based questionnaire was used to evaluate the subjective opinions of patients on bottle squeezability, clarity of usage and storage instructions, and the consistency of the cap color coding. RESULTS: The volumes of international brands were statistically significantly higher than the local brands (P < 0.001). A number of drops per bottle and tip diameter were comparable between the international local brands. Cap color coding was inconsistent for international and local brands. Patients were dissatisfied with the label font size. Patients reported that the international and local brands were similar in terms of the ease of opening the bottle, instilling a drop, and the clarity of the instructions; but the local brands were subjectively easier to squeeze than international brands. WHAT IS NEW AND CONCLUSIONS: This is the first study to compare bottle characteristics of local Saudi Arabia brands with international brands. The bottle characteristics and patient feedback were similar between the local and international topical glaucoma medications. However, there were differences between the local and international brands in drug volume, bottle squeezability. Hence, patient compliance and drop dosage may differ based on the origin of manufacture. PMID:27994392

  7. Indicators for the Data Usage Index (DUI): an incentive for publishing primary biodiversity data through global information infrastructure.

    PubMed

    Ingwersen, Peter; Chavan, Vishwas

    2011-01-01

    A professional recognition mechanism is required to encourage expedited publishing of an adequate volume of 'fit-for-use' biodiversity data. As a component of such a recognition mechanism, we propose the development of the Data Usage Index (DUI) to demonstrate to data publishers that their efforts of creating biodiversity datasets have impact by being accessed and used by a wide spectrum of user communities. We propose and give examples of a range of 14 absolute and normalized biodiversity dataset usage indicators for the development of a DUI based on search events and dataset download instances. The DUI is proposed to include relative as well as species profile weighted comparative indicators. We believe that in addition to the recognition to the data publisher and all players involved in the data life cycle, a DUI will also provide much needed yet novel insight into how users use primary biodiversity data. A DUI consisting of a range of usage indicators obtained from the GBIF network and other relevant access points is within reach. The usage of biodiversity datasets leads to the development of a family of indicators in line with well known citation-based measurements of recognition.

  8. Regenerate Healing Outcomes in Unilateral Mandibular Distraction Osteogenesis Using Quantitative Histomorphometry

    PubMed Central

    Schwarz, Daniel A.; Arman, Krikor G.; Kakwan, Mehreen S.; Jamali, Ameen M.; Elmeligy, Ayman A.; Buchman, Steven R.

    2015-01-01

    Background The authors’ goal was to ascertain regenerate bone-healing metrics using quantitative histomorphometry at a single consolidation period. Methods Rats underwent either mandibular distraction osteogenesis (n=7) or partially reduced fractures (n=7); their contralateral mandibles were used as controls (n=11). External fixators were secured and unilateral osteotomies performed, followed by either mandibular distraction osteogenesis (4 days’ latency, then 0.3 mm every 12 hours for 8 days; 5.1 mm) or partially reduced fractures (fixed immediately postoperatively; 2.1 mm); both groups underwent 4 weeks of consolidation. After tissue processing, bone volume/tissue volume ratio, osteoid volume/tissue volume ratio, and osteocyte count per high-power field were analyzed by means of quantitative histomorphometry. Results Contralateral mandibles had statistically greater bone volume/tissue volume ratio and osteocyte count per high-power field compared with both mandibular distraction osteogenesis and partially reduced fractures by almost 50 percent, whereas osteoid volume/tissue volume ratio was statistically greater in both mandibular distraction osteogenesis specimens and partially reduced fractures compared with contralateral mandibles. No statistical difference in bone volume/tissue volume ratio, osteoid volume/tissue volume ratio, or osteocyte count per high-power field was found between mandibular distraction osteogenesis specimens and partially reduced fractures. Conclusions The authors’ findings demonstrate significantly decreased bone quantity and maturity in mandibular distraction osteogenesis specimens and partially reduced fractures compared with contralateral mandibles using the clinically analogous protocols. If these results are extrapolated clinically, treatment strategies may require modification to ensure reliable, predictable, and improved outcomes. PMID:20463629

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

    PubMed

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

    2013-01-01

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

  10. Using the internet to understand angler behavior in the information age

    USGS Publications Warehouse

    Martin, Dustin R.; Pracheil, Brenda M.; DeBoer, Jason A.; Wilde, Gene R.; Pope, Kevin L.

    2012-01-01

    Declining participation in recreational angling is of great concern to fishery managers because fishing license sales are an important revenue source for protection of aquatic resources. This decline is frequently attributed, in part, to increased societal reliance on electronics. Internet use by anglers is increasing and fishery managers may use the Internet as a unique means to increase angler participation. We examined Internet search behavior using Google Insights for Search, a free online tool that summarizes Google searches from 2004 to 2011 to determine (1) trends in Internet search volume for general fishing related terms and (2) the relative usefulness of terms related to angler recruitment programs across the United States. Though search volume declined for general fishing terms (e.g., fishing, fishing guide), search volume increased for social media and recruitment terms (e.g., fishing forum, family fishing) over the 7-year period. We encourage coordinators of recruitment programs to capitalize on anglers’ Internet usage by considering Internet search patterns when creating web-based information. Careful selection of terms used in web-based information to match those currently searched by potential anglers may help to direct traffic to state agency websites that support recruitment efforts.

  11. Can foam sclerotherapy be used to safely treat bilateral varicose veins?

    PubMed

    Bhogal, R H; Moffat, C E; Coney, P; Nyamekye, I K

    2012-02-01

    We assessed the use of ultrasound guided foam sclerotherapy (UGFS) to treat bilateral varicose veins either as synchronous or interval procedures. We specifically assessed total foam volume usage and its influence on early outcome and complications. We reviewed our prospectively compiled computerised database of patients with bilateral varicose veins who have undergone UGFS. Duplex findings, foam volumes used and clinical outcome were assessed. One hundred and twelve patients had undergone UGFS for bilateral varicose veins. Sixty-one had bilateral UGFS (122 legs) and 51 had interval UGFS (102 legs). Seventy-eight percent bilateral and 60% interval procedures were for single trunk disease. Median foam volumes per treatment episode were: 17.5 mls bilateral, and 10 mls interval FS. At two weeks 81% of legs had complete occlusion after bilateral UGFS compared to 70% after interval UGFS. One patient in the bilateral UGFS developed transient visual disturbance. There was no systemic complications in the interval UGFS. Bilateral foam sclerotherapy treatment did not adversly affect vein occlusion rates and there was no significant difference in complication rates between the two groups. Bilateral UGFS can be safely performed in selected patient presenting with bilateral varicose veins.

  12. A program to compute three-dimensional subsonic unsteady aerodynamic characteristics using the doublet lattic method, L216 (DUBFLX). Volume 1: Engineering and usage

    NASA Technical Reports Server (NTRS)

    Richard, M.; Harrison, B. A.

    1979-01-01

    The program input presented consists of configuration geometry, aerodynamic parameters, and modal data; output includes element geometry, pressure difference distributions, integrated aerodynamic coefficients, stability derivatives, generalized aerodynamic forces, and aerodynamic influence coefficient matrices. Optionally, modal data may be input on magnetic file (tape or disk), and certain geometric and aerodynamic output may be saved for subsequent use.

  13. Cost-effective safety treatments for low-volume roads.

    DOT National Transportation Integrated Search

    2012-08-01

    The majority of roadside safety guidance pertains to high-volume roads. Very little guidance exists to assist engineers in : treating common obstacles found alongside low-volume roads. In general, it is assumed that low traffic volumes can effectivel...

  14. ORIGINS AND RAMIFICATIONS OF PHARMACEUTICALS ...

    EPA Pesticide Factsheets

    Perhaps more so than with any other class of pollutants, the occurrence of pharmaceuticals and personal care products (PPCPS) in the environment highlights the immediate, intimate, and inseparable connection between the personal activities of individual citizens and their environment. PPCPS, in contrast to other types of pollutants, owe their origins in the environment directly to their worldwide, universal, frequent, highly dispersed, and individually small but cumulative usage by multitudes of individuals - as opposed to the larger, highly delineated, and more controllable industrial manufacturing/usage of most high- volume synthetic chemicals. Many PPCPs (as well as their metabolites and transformation products) can enter the environment following ingestion or application by the user or administration to domestic animals. Disposal of unused/expired PPCPs in landfills and in domestic sewage is another route to the environment. The aquatic environment serves as the major, ultimate receptacle for these chemicals, for which little is known with respect to actual or potential adverse effects. Domestic sewage treatment plants are not designed to remove PPCPS, and the efficiencies with which they are removed vary from nearly complete to ineffective. While PPCPs in the environment (or domestic drinking water) are not regulated, and even though their concentrations are extremely low (ng/L-@Lg/L), the consequences of exposure to multiple compounds having different as w

  15. POLLUTION FROM PERSONAL ACTIONS, ACTIVITIES, AND ...

    EPA Pesticide Factsheets

    Perhaps more so than with any other class of pollutants, the occurrence of pharmaceuticals and personal care products (PPCPs) in the environment highlights the immediate, intimate, and inseparable connection between the personal activities of individual citizens and their environment. PPCPs, in contrast to other types of pollutants, owe their origins in the environment directly to their worldwide, universal, frequent, highly dispersed, and individually small but cumulative usage by multitudes of individuals C as opposed to the larger, highly delineated, and more controllable industrial manufacturing/usage of most high-volume synthetic chemicals.Many PPCPs (as well as their metabolites and transformation products) can enter the environment following ingestion or application by the user or administration to domestic animals. Disposal of unused/expired PPCPs in landfills and in domestic sewage is another route to the environment. The aquatic environment serves as the major, ultimate receptacle for these chemicals, for which little is known with respect to actual or potential adverse effects. Domestic sewage treatment plants are not specifically engineered to remove PPCPs, and the efficiencies with which they are removed vary from nearly complete to ineffective. While PPCPs in the environment (or domestic drinking water) are not regulated, and even though their concentrations are extremely low (ng/L-?g/L), the consequences of exposure over multiple generations to m

  16. PHARMACEUTICALS AND PERSONAL CARE PRODUCTS ...

    EPA Pesticide Factsheets

    Perhaps more so than with any other class of pollutants, the occurrence of pharmaceuticals and personal care products (PPCPs) in the environment highlights the immediate, intimate, and inseparable connection between the personal activities of individual citizens and their environment. PPCPs, in contrast to other types of pollutants, owe their origins in the environment directly to their worldwide, universal, frequent, highly dispersed, and individually small but cumulative usage by multitudes of individuals ? as opposed to the larger, highly delineated, and more controllable industrial manufacturing/usage of most high-volume synthetic chemicals.Many PPCPs can enter the environment following ingestion or application by the user or administration to domestic animals. Disposal of unused/expired PPCPs in landfills and in domestic sewage is another route to the environment. The aquatic environment serves as the major, ultimate receptacle for these chemicals, for which little is known with respect to actual or potential adverse effects. Domestic sewage treatment plants are not specifically engineered to remove PPCPs, and the efficiencies with which they are removed vary from nearly complete to ineffective. While PPCPs in the environment (or domestic drinking water) are not regulated, and even though their concentrations are extremely low (ng/L- g/L), the consequences of exposure over multiple generations to multiple compounds having different as well as similar modes

  17. POLLUTION FROM PERSONAL ACTIONS, ACTIVITIES, AND ...

    EPA Pesticide Factsheets

    Perhaps more so than with any other class of pollutants, the occurrence of pharmaceuticals and personal care products (PPCPS) in the environment highlights the immediate, intimate, and inseparable connection between the personal activities of individual citizens and their environment. PPCPS, in contrast to other types of pollutants, owe their origins in the environment directly to their worldwide, universal, frequent, highly dispersed, and individually small but cumulative usage by multitudes of individuals - as opposed to the larger, highly delineated, and more controllable industrial manufacturing/usage of most high- volume synthetic chemicals. Many PPCPs (as well as their metabolites and transformation products) can enter the environment following ingestion or application by the user or administration to domestic animals. Disposal of unused/expired PPCPs in landfills and in domestic sewage is another route to the environment. 'Me aquatic environment serves as the major, ultimate receptacle for these chemicals, for which little is known with respect to actual or potential adverse effects. Domestic sewage treatment plants are not designed to remove PPCPS, and the efficiencies with which they are removed vary from nearly complete to ineffective. While PPCPs in the environment (or domestic drinking water) are not regulated, and even though their concentrations are extremely low (ng/L-@Lg/L), the consequences of exposure to multiple compounds having different as w

  18. PHARMACEUTICALS AND PERSONAL CARE PRODUCTS ...

    EPA Pesticide Factsheets

    Perhaps more so than with any other class of pollutants, the occurrence of pharmaceuticals and personal care products (PPCPS) in the environment highlights the immediate, intimate, and inseparable connection between the personal activities of individual citizens and their environment. PPCPS, in contrast to other types of pollutants, owe their origins in the environment directly to their worldwide, universal, frequent, highly dispersed, and individually small but cumulative usage by multitudes of individuals - as opposed to the larger, highly delineated, and more controllable industrial manufacturing/usage of most high- volume synthetic chemicals. Many PPCPs (as well as their metabolites and transformation products) can enter the environment following ingestion or application by the user or administration to domestic animals. Disposal of unused/expired PPCPs in landfills and in domestic sewage is another route to the environment. The aquatic environment serves as the major, ultimate receptacle for these chemicals, for which little is known with respect to actual or potential adverse effects. Domestic sewage treatment plants are not specifically engineered to remove PPCPS, and the efficiencies with which they are removed vary from nearly complete to ineffective. While PPCPs in the environment (or domestic drinking water) are not regulated, and even though their concentrations are extremely low (ng/L-ug/L), the consequences of exposure over multiple generations to

  19. Domestic Travel and Regional Migration for Parathyroid Surgery Among Patients Receiving Care at Academic Medical Centers in the United States, 2012-2014.

    PubMed

    Hinson, Andrew M; Hohmann, Samuel F; Stack, Brendan C

    2016-07-01

    To improve outcomes after parathyroidectomy, several organizations advocate for selective referral of patients to high-volume academic medical centers with dedicated endocrine surgery programs. The major factors that influence whether patients travel away from their local community and support system for perceived better care remain elusive. To assess how race/ethnicity and insurance status influence domestic travel patterns and selection of high- vs low-volume hospitals in different regions of the United States for parathyroid surgery. A retrospective study was conducted of 36 750 inpatients and outpatients discharged after undergoing parathyroidectomy identified in the University HealthSystem Consortium database from January 1, 2012, to December 31, 2014 (12 quarters total). Each US region (Northeast, Mid-Atlantic, Great Lakes, Central Plains, Southeast, Gulf Coast, and West) contained 20 or more low-volume hospitals (1-49 cases annually), 5 or more mid-volume hospitals (50-99 cases annually), and multiple high-volume hospitals (≥100 cases annually). Domestic medical travelers were defined as patients who underwent parathyroidectomy at a hospital in a different US region from which they resided and traveled more than 150 miles to the hospital. Distance traveled, regional destination, and relative use of high- vs low-volume hospitals. A total of 23 268 of the 36 750 patients (63.3%) had parathyroidectomy performed at high-volume hospitals. The mean (SD) age of the study cohort was 71.5 (16.2) years (95% CI, 71.4-71.7 years). The female to male ratio was 3:1. Throughout the study period, mean (SD) distance traveled was directly proportional to hospital volume (high-volume hospitals, 208.4 [455.1] miles; medium-volume hospitals, 50.5 [168.4] miles; low-volume hospitals, 27.7 [89.5] miles; P < .001). From 2012 to 2014, the annual volume of domestic medical travelers increased by 15.0% (from 961 to 1105), while overall volume increased by 4.9% (from 11 681 to 12 252; P = .03). Nearly all (2982 of 3113 [95.8%]) domestic medical travelers had surgery at high-volume hospitals, and most of these patients (2595 of 3113 [83.4%]) migrated to hospitals in the Southeast. Domestic medical travelers were significantly more likely to be white (2888 of 3113 [92.8%]; P < .001) and have private insurance (1934 of 3113 [62.1%]; P < .001). Most patients with private insurance (12 137 of 17 822 [68.1%]) and Medicare (9433 of 15 121 [62.4%]) had surgery at high-volume hospitals, while the largest proportion of patients with Medicaid and those who were uninsured had surgery at low-volume hospitals (1059 of 2715 [39.0%]). Centralization of parathyroid surgery is a reality in the United States. Significant disparities based on race and insurance coverage exist and may hamper access to the highest-volume surgeons and hospitals. Academic medical centers with dedicated endocrine surgery programs should consider strategic initiatives to reduce disparities within their respective regions.

  20. Hospital type- and volume-outcome relationships in esophageal cancer patients receiving non-surgical treatments.

    PubMed

    Hsu, Po-Kuei; Chen, Hui-Shan; Wang, Bing-Yen; Wu, Shiao-Chi; Liu, Chao-Yu; Shih, Chih-Hsun; Liu, Chia-Chuan

    2015-01-28

    To study the "hospital type-outcome" and "volume-outcome" relationships in patients with esophageal cancer who receive non-surgical treatments. A total of 6106 patients with esophageal cancer diagnosed between 2008 and 2011 were identified from a national population-based cancer registry in Taiwan. The hospital types were defined as medical center and non-medical center. The threshold for high-volume hospitals was based on a median volume of 225 cases between 2008 and 2011 (annual volume, >56 cases) or an upper quartile (>75%) volume of 377 cases (annual volume>94 cases). Cox regression analyses were used to determine the effects of hospital type and volume outcome on patient survival. A total of 3955 non-surgically treated patients were included in the survival analysis. In the unadjusted analysis, the significant prognostic factors included cT, cN, cM stage, hospital type and hospital volume (annual volume, >94 vs ≤94). The 1- and 3-year overall survival rates in the non-medical centers (36.2% and 13.2%, respectively) were significantly higher than those in the medical centers (33.5% and 11.3%, respectively; P=0.027). The 1- and 3-year overall survival rates in hospitals with an annual volume of ≤94 (35.3% and 12.6%, respectively) were significantly higher than those with an annual volume of >94 (31.1% and 9.4%, respectively; P=0.001). However, in the multivariate analysis, the hospital type was not statistically significant. Only cT, cN, and cM stages and hospital volume (annual volume>94 vs ≤94) were independent prognostic factors. Whether the treatment occurs in medical centers is not a significant prognostic factor. High-volume hospitals were not associated with better survival rates compared with low-volume hospitals.

  1. EVALUATION OF THE HIGH VOLUME COLLECTION SYSTEM (HVCS) FOR QUANTIFYING FUGITIVE ORGANIC VAPOR LEAKS

    EPA Science Inventory

    The report discusses a recently developed measurements technique that offers the potential for providing an easy-to-use and cost effective means to directly measure organic vapor leaks. The method, called High Volume Collection System (HVCS), uses a high volume sampling device an...

  2. The cost of cancer registry operations: Impact of volume on cost per case for core and enhanced registry activities

    PubMed Central

    Subramanian, Sujha; Tangka, Florence K.L.; Beebe, Maggie Cole; Trebino, Diana; Weir, Hannah K.; Babcock, Frances

    2016-01-01

    Background Cancer registration data is vital for creating evidence-based policies and interventions. Quantifying the resources needed for cancer registration activities and identifying potential efficiencies are critically important to ensure sustainability of cancer registry operations. Methods Using a previously validated web-based cost assessment tool, we collected activity-based cost data and report findings using 3 years of data from 40 National Program of Cancer Registry grantees. We stratified registries by volume: low-volume included fewer than 10,000 cases, medium-volume included 10,000–50,000 cases, and high-volume included >50,000 cases. Results Low-volume cancer registries incurred an average of $93.11 to report a case (without in-kind contributions) compared with $27.70 incurred by high-volume registries. Across all registries, the highest cost per case was incurred for data collection and abstraction ($8.33), management ($6.86), and administration ($4.99). Low- and medium-volume registries have higher costs than high-volume registries for all key activities. Conclusions Some cost differences by volume can be explained by the large fixed costs required for administering and performing registration activities, but other reasons may include the quality of the data initially submitted to the registries from reporting sources such as hospitals and pathology laboratories. Automation or efficiency improvements in data collection can potentially reduce overall costs. PMID:26702880

  3. Network bandwidth utilization forecast model on high bandwidth networks

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

    Yoo, Wuchert; Sim, Alex

    With the increasing number of geographically distributed scientific collaborations and the scale of the data size growth, it has become more challenging for users to achieve the best possible network performance on a shared network. We have developed a forecast model to predict expected bandwidth utilization for high-bandwidth wide area network. The forecast model can improve the efficiency of resource utilization and scheduling data movements on high-bandwidth network to accommodate ever increasing data volume for large-scale scientific data applications. Univariate model is developed with STL and ARIMA on SNMP path utilization data. Compared with traditional approach such as Box-Jenkins methodology,more » our forecast model reduces computation time by 83.2%. It also shows resilience against abrupt network usage change. The accuracy of the forecast model is within the standard deviation of the monitored measurements.« less

  4. Network Bandwidth Utilization Forecast Model on High Bandwidth Network

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

    Yoo, Wucherl; Sim, Alex

    With the increasing number of geographically distributed scientific collaborations and the scale of the data size growth, it has become more challenging for users to achieve the best possible network performance on a shared network. We have developed a forecast model to predict expected bandwidth utilization for high-bandwidth wide area network. The forecast model can improve the efficiency of resource utilization and scheduling data movements on high-bandwidth network to accommodate ever increasing data volume for large-scale scientific data applications. Univariate model is developed with STL and ARIMA on SNMP path utilization data. Compared with traditional approach such as Box-Jenkins methodology,more » our forecast model reduces computation time by 83.2percent. It also shows resilience against abrupt network usage change. The accuracy of the forecast model is within the standard deviation of the monitored measurements.« less

  5. Magnetic Resonance Lymphography-Guided Selective High-Dose Lymph Node Irradiation in Prostate Cancer

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

    Meijer, Hanneke J.M., E-mail: H.Meijer@rther.umcn.nl; Debats, Oscar A.; Kunze-Busch, Martina

    2012-01-01

    Purpose: To demonstrate the feasibility of magnetic resonance lymphography (MRL) -guided delineation of a boost volume and an elective target volume for pelvic lymph node irradiation in patients with prostate cancer. The feasibility of irradiating these volumes with a high-dose boost to the MRL-positive lymph nodes in conjunction with irradiation of the prostate using intensity-modulated radiotherapy (IMRT) was also investigated. Methods and Materials: In 4 prostate cancer patients with a high risk of lymph node involvement but no enlarged lymph nodes on CT and/or MRI, MRL detected pathological lymph nodes in the pelvis. These lymph nodes were identified and delineatedmore » on a radiotherapy planning CT to create a boost volume. Based on the location of the MRL-positive lymph nodes, the standard elective pelvic target volume was individualized. An IMRT plan with a simultaneous integrated boost (SIB) was created with dose prescriptions of 42 Gy to the pelvic target volume, a boost to 60 Gy to the MRL-positive lymph nodes, and 72 Gy to the prostate. Results: All MRL-positive lymph nodes could be identified on the planning CT. This information could be used to delineate a boost volume and to individualize the pelvic target volume for elective irradiation. IMRT planning delivered highly acceptable radiotherapy plans with regard to the prescribed dose levels and the dose to the organs at risk (OARs). Conclusion: MRL can be used to select patients with limited lymph node involvement for pelvic radiotherapy. MRL-guided delineation of a boost volume and an elective pelvic target volume for selective high-dose lymph node irradiation with IMRT is feasible. Whether this approach will result in improved outcome for these patients needs to be investigated in further clinical studies.« less

  6. Impact of hospital volume on hospital mortality, length of stay and total costs after pancreaticoduodenectomy.

    PubMed

    Yoshioka, R; Yasunaga, H; Hasegawa, K; Horiguchi, H; Fushimi, K; Aoki, T; Sakamoto, Y; Sugawara, Y; Kokudo, N

    2014-04-01

    High morbidity and mortality rates after pancreaticoduodenectomy (PD) have led to concentration of this surgery in high-volume centres, with improved outcomes. The extent to which better outcomes might be apparent in a healthcare system where the mortality rate is already low is unclear. The Japanese Diagnosis Procedure Combination database was used to identify patients undergoing PD between 2007 and 2010. Patient data included age, sex, co-morbidities at admission, type of hospital, type of PD, and the year in which the patient was treated. Hospital volume was defined as the number of PDs performed annually at each hospital, and categorized into quintiles: very low-, low-, medium-, high- and very high-volume groups. The Charlson co-morbidity index was calculated using the International Classification of Diseases, tenth revision, codes of co-morbidities. A total of 10 652 patients who underwent PD in 848 hospitals were identified. The overall in-hospital mortality rate after PD was 3·3 per cent (350 of 10 652), and for the groups ranged from 5·0 per cent for the very low-volume group to 1·4 per cent for the very high-volume group (P < 0·001). Multivariable analysis revealed a significant linear relationship between higher hospital volume and shorter postoperative length of stay compared with the very low-volume group, and between increasing hospital volume and lower total costs. A significant relationship exists between increasing hospital volume, lower in-hospital mortality, shorter length of stay and lower costs for patients undergoing PD in Japan. Centralization of PD in this healthcare system is therefore justified. © 2014 BJS Society Ltd. Published by John Wiley & Sons Ltd.

  7. Hospital volume of throughput and periprocedural and medium-term adverse events after percutaneous coronary intervention: retrospective cohort study of all 17,417 procedures undertaken in Scotland, 1997-2003.

    PubMed

    Burton, K R; Slack, R; Oldroyd, K G; Pell, A C H; Flapan, A D; Starkey, I R; Eteiba, H; Jennings, K P; Northcote, R J; Hillis, W Stewart; Pell, J P

    2006-11-01

    To determine whether percutaneous coronary intervention (PCI) hospital volume of throughput is associated with periprocedural and medium-term events, and whether any associations are independent of differences in case mix. Retrospective cohort study of all PCIs undertaken in Scottish National Health Service hospitals over a six-year period. All PCIs in Scotland during 1997-2003 were examined. Linkage to administrative databases identified events over two years' follow up. The risk of events by hospital volume at 30 days and two years was compared by using logistic regression and Cox proportional hazards models. Of the 17,417 PCIs, 4900 (28%) were in low-volume hospitals and 3242 (19%) in high-volume hospitals. After adjustment for case mix, there were no significant differences in risk of death or myocardial infarction. Patients treated in high-volume hospitals were less likely to require emergency surgery (adjusted odds ratio 0.18, 95% confidence interval (CI) 0.07 to 0.54, p = 0.002). Over two years, patients in high-volume hospitals were less likely to undergo surgery (adjusted hazard ratio 0.52, 95% CI 0.35 to 0.75, p = 0.001), but this was offset by an increased likelihood of further PCI. There was no net difference in coronary revascularisation or in overall events. Death and myocardial infarction were infrequent complications of PCI and did not differ significantly by volume. Emergency surgery was less common in high-volume hospitals. Over two years, patients treated in high-volume centres were as likely to undergo some form of revascularisation but less likely to undergo surgery.

  8. Crystal plasticity modeling of β phase deformation in Ti-6Al-4V

    NASA Astrophysics Data System (ADS)

    Moore, John A.; Barton, Nathan R.; Florando, Jeff; Mulay, Rupalee; Kumar, Mukul

    2017-10-01

    Ti-6Al-4V is an alloy of titanium that dominates titanium usage in applications ranging from mass-produced consumer goods to high-end aerospace parts. The material’s structure on a microscale is known to affect its mechanical properties but these effects are not fully understood. Specifically, this work will address the effects of low volume fraction intergranular β phase on Ti-6Al-4V’s mechanical response during the transition from elastic to plastic deformation. A crystal plasticity-based finite element model is used to fully resolve the deformation of the β phase for the first time. This high fidelity model captures mechanisms difficult to access via experiments or lower fidelity models. The results are used to assess lower fidelity modeling assumptions and identify phenomena that have ramifications for failure of the material.

  9. Use of HSM with Relational Databases

    NASA Technical Reports Server (NTRS)

    Breeden, Randall; Burgess, John; Higdon, Dan

    1996-01-01

    Hierarchical storage management (HSM) systems have evolved to become a critical component of large information storage operations. They are built on the concept of using a hierarchy of storage technologies to provide a balance in performance and cost. In general, they migrate data from expensive high performance storage to inexpensive low performance storage based on frequency of use. The predominant usage characteristic is that frequency of use is reduced with age and in most cases quite rapidly. The result is that HSM provides an economical means for managing and storing massive volumes of data. Inherent in HSM systems is system managed storage, where the system performs most of the work with minimum operations personnel involvement. This automation is generally extended to include: backup and recovery, data duplexing to provide high availability, and catastrophic recovery through use of off-site storage.

  10. Association of Competition Volume, Club Sports, and Sport Specialization With Sex and Lower Extremity Injury History in High School Athletes

    PubMed Central

    Post, Eric G.; Bell, David R.; Trigsted, Stephanie M.; Pfaller, Adam Y.; Hetzel, Scott J.; Brooks, M. Alison; McGuine, Timothy A.

    2017-01-01

    Background: High school athletes are increasingly encouraged to participate in 1 sport year-round to increase their sport skills. However, no study has examined the association of competition volume, club sport participation, and sport specialization with sex and lower extremity injury (LEI) in a large sample of high school athletes. Hypothesis: Increased competition volume, participating on a club team outside of school sports, and high levels of specialization will all be associated with a history of LEI. Girls will be more likely to engage in higher competition volume, participate on a club team, and be classified as highly specialized. Study Design: Cross-sectional study. Level of Evidence: Level 3. Methods: High school athletes completed a questionnaire prior to the start of their competitive season regarding their sport participation and previous injury history. Multivariable logistic regression analyses were used to investigate associations of competition volume, club sport participation, and sport specialization with history of LEI, adjusting for sex. Results: A cohort of 1544 high school athletes (780 girls; grades 9-12) from 29 high schools completed the questionnaire. Girls were more likely to participate at high competition volume (23.2% vs 11.0%, χ2 = 84.7, P < 0.001), participate on a club team (61.2% vs 37.2%, χ2 = 88.3, P < 0.001), and be highly specialized (16.4% vs 10.4%, χ2 = 19.7, P < 0.001). Athletes with high competition volume, who participated in a club sport, or who were highly specialized had greater odds of reporting a previous LEI than those with low competition volume (odds ratio [OR], 2.08; 95% CI, 1.55-2.80; P < 0.001), no club sport participation (OR, 1.50; 95% CI, 1.20-1.88; P < 0.001), or low specialization (OR, 2.58; 95% CI, 1.88-3.54; P < 0.001), even after adjusting for sex. Conclusion: Participating in high sport volume, on a club team, or being highly specialized was associated with history of LEI. Girls were more likely to participate at high volumes, be active on club teams, or be highly specialized, potentially placing them at increased risk of injury. Clinical Relevance: Youth athletes, parents, and clinicians should be aware of the potential risks of intense, year-round participation in organized sports. PMID:28628419

  11. Association of Competition Volume, Club Sports, and Sport Specialization With Sex and Lower Extremity Injury History in High School Athletes.

    PubMed

    Post, Eric G; Bell, David R; Trigsted, Stephanie M; Pfaller, Adam Y; Hetzel, Scott J; Brooks, M Alison; McGuine, Timothy A

    High school athletes are increasingly encouraged to participate in 1 sport year-round to increase their sport skills. However, no study has examined the association of competition volume, club sport participation, and sport specialization with sex and lower extremity injury (LEI) in a large sample of high school athletes. Increased competition volume, participating on a club team outside of school sports, and high levels of specialization will all be associated with a history of LEI. Girls will be more likely to engage in higher competition volume, participate on a club team, and be classified as highly specialized. Cross-sectional study. Level 3. High school athletes completed a questionnaire prior to the start of their competitive season regarding their sport participation and previous injury history. Multivariable logistic regression analyses were used to investigate associations of competition volume, club sport participation, and sport specialization with history of LEI, adjusting for sex. A cohort of 1544 high school athletes (780 girls; grades 9-12) from 29 high schools completed the questionnaire. Girls were more likely to participate at high competition volume (23.2% vs 11.0%, χ 2 = 84.7, P < 0.001), participate on a club team (61.2% vs 37.2%, χ 2 = 88.3, P < 0.001), and be highly specialized (16.4% vs 10.4%, χ 2 = 19.7, P < 0.001). Athletes with high competition volume, who participated in a club sport, or who were highly specialized had greater odds of reporting a previous LEI than those with low competition volume (odds ratio [OR], 2.08; 95% CI, 1.55-2.80; P < 0.001), no club sport participation (OR, 1.50; 95% CI, 1.20-1.88; P < 0.001), or low specialization (OR, 2.58; 95% CI, 1.88-3.54; P < 0.001), even after adjusting for sex. Participating in high sport volume, on a club team, or being highly specialized was associated with history of LEI. Girls were more likely to participate at high volumes, be active on club teams, or be highly specialized, potentially placing them at increased risk of injury. Youth athletes, parents, and clinicians should be aware of the potential risks of intense, year-round participation in organized sports.

  12. Lack of difference between continuous versus intermittent heparin infusion on maintenance of intra-arterial catheter in postoperative pediatric surgery: a randomized controlled study

    PubMed Central

    Witkowski, Maria Carolina; de Moraes, Maria Antonieta P.; Firpo, Cora Maria F.

    2013-01-01

    OBJECTIVE: To compare two systems of arterial catheters maintenance in postoperative pediatric surgery using intermittent or continuous infusion of heparin solution and to analyze adverse events related to the site of catheter insertion and the volume of infused heparin solution. METHODS: Randomized control trial with 140 patients selected for continuous infusion group (CIG) and intermittent infusion group (IIG). The variables analyzed were: type of heart disease, permanence time and size of the catheter, insertion site, technique used, volume of heparin solution and adverse events. The descriptive variables were analyzed by Student's t-test and the categorical variables, by chi-square test, being significant p<0.05. RESULTS: The median age was 11 (0-22) months, and 77 (55%) were females. No significant differences between studied variables were found, except for the volume used in CIG (12.0±1.2mL/24 hours) when compared to IIG (5.3±3.5mL/24 hours) with p<0.0003. CONCLUSIONS: The continuous infusion system and the intermittent infusion of heparin solution can be used for intra-arterial catheters maintenance in postoperative pediatric surgery, regardless of patient's clinical and demographic characteristics. Adverse events up to the third postoperative day occurred similarly in both groups. However, the intermittent infusion system usage in underweight children should be considered, due to the lower volume of infused heparin solution [ClinicalTrials.gov Identifier: NCT01097031]. PMID:24473958

  13. Effect of hospital volume on processes of breast cancer care: A National Cancer Data Base study.

    PubMed

    Yen, Tina W F; Pezzin, Liliana E; Li, Jianing; Sparapani, Rodney; Laud, Purushuttom W; Nattinger, Ann B

    2017-05-15

    The purpose of this study was to examine variations in delivery of several breast cancer processes of care that are correlated with lower mortality and disease recurrence, and to determine the extent to which hospital volume explains this variation. Women who were diagnosed with stage I-III unilateral breast cancer between 2007 and 2011 were identified within the National Cancer Data Base. Multiple logistic regression models were developed to determine whether hospital volume was independently associated with each of 10 individual process of care measures addressing diagnosis and treatment, and 2 composite measures assessing appropriateness of systemic treatment (chemotherapy and hormonal therapy) and locoregional treatment (margin status and radiation therapy). Among 573,571 women treated at 1755 different hospitals, 38%, 51%, and 10% were treated at high-, medium-, and low-volume hospitals, respectively. On multivariate analysis controlling for patient sociodemographic characteristics, treatment year and geographic location, hospital volume was a significant predictor for cancer diagnosis by initial biopsy (medium volume: odds ratio [OR] = 1.15, 95% confidence interval [CI] = 1.05-1.25; high volume: OR = 1.30, 95% CI = 1.14-1.49), negative surgical margins (medium volume: OR = 1.15, 95% CI = 1.06-1.24; high volume: OR = 1.28, 95% CI = 1.13-1.44), and appropriate locoregional treatment (medium volume: OR = 1.12, 95% CI = 1.07-1.17; high volume: OR = 1.16, 95% CI = 1.09-1.24). Diagnosis of breast cancer before initial surgery, negative surgical margins and appropriate use of radiation therapy may partially explain the volume-survival relationship. Dissemination of these processes of care to a broader group of hospitals could potentially improve the overall quality of care and outcomes of breast cancer survivors. Cancer 2017;123:957-66. © 2016 American Cancer Society. © 2016 American Cancer Society.

  14. Effect of spray volume on the deposition, viability and infectivity of entomopathogenic nematodes in a foliar spray on vegetables.

    PubMed

    Brusselman, Eva; Beck, Bert; Pollet, Sabien; Temmerman, Femke; Spanoghe, Pieter; Moens, Maurice; Nuyttens, David

    2012-10-01

    Spray volume can influence the amount of free water on the leaf surface and subsequently the ability of entomopathogenic nematodes (EPNs) to move. In this study, an investigation was made of the effect of spray volume (548, 730 and 1095 L ha(-1) ) on the deposition, viability and infectivity of EPNs against Galleria mellonella on savoy cabbage, cauliflower and leek. Increasing spray volume decreased nematode deposition on 7.1 cm2 leek leaf discs at a 15° angle with the spray nozzle. Although the number of living nematodes observed on leek after 240 min of exposure was not significantly different between the low-volume application (548 L ha(-1) ) and the high-volume application (1095 L ha(-1) ), a greater infectivity was obtained in the latter application. The higher number of droplets deposited on the leek discs in the high-volume application may have stimulated nematode movement. No significant effect of spray volume was observed on the relative deposition of Steinernema carpocapsae on the bottom side of cauliflower and savoy cabbage leaf discs. In spite of the low S. carpocapsae deposition on the bottom side of the savoy cabbage discs, high infectivity was obtained against G. mellonella. Using the lowest spray volume on savoy cabbage, infectivity decreased with increasing exposure time, while infectivity was not affected by exposure time when a spray volume of 730 L ha(-1) or more was used. Spray volume is an important application parameter, as it affects nematode infectivity. Future research should investigate the effect of spray volume in the field and its influence on the effect of adjuvants. Copyright © 2012 Society of Chemical Industry.

  15. Anchorage in Orthodontics: Three-dimensional Scanner Input.

    PubMed

    Nabbout, Fidele; Baron, Pascal

    2018-01-01

    The aim of this article is to re-evaluate anchorage coefficient values in orthodontics and their influence in the treatment decision through the usage of three-dimensional (3D) scanner. A sample of 80 patients was analyzed with the 3D scanner using the C2000 and Cepha 3DT softwares (CIRAD Montpellier, France). Tooth anatomy parameters (linear measurements, root, and crown volumes) were then calculated to determine new anchorage coefficients based on root volume. Data were collected and statistically evaluated with the StatView software (version 5.0). The anchorage coefficient values found in this study are compared to those established in previous studies. These new values affect and modify our approach in orthodontic treatment from the standpoint of anchorage. The use of new anchorage coefficient values has significant clinical implications in conventional and in microimplants-assisted orthodontic mechanics through the selection and delivery of the optimal force system (magnitude and moment) for an adequate biological response.

  16. Usage of FTIR-ATR as Non-Destructive Analysis of Selected Toxic Dyes

    NASA Astrophysics Data System (ADS)

    Bartošová, Alica; Blinová, Lenka; Sirotiak, Maroš; Michalíková, Anna

    2017-06-01

    The degradation of the environment which is due to the discharge of polluting wastewater from industrial sources poses a real problem in several countries. Textile industries use large volumes of water in their operations, discharging thus large volume of wastewater into the environment, most of which is untreated. The wastewater contains a variety of chemicals from various stages of process operations, including desizing, scouring, bleaching and dyeing. The main purpose of this paper is to introduce Infrared Spectrometry with Fourier transformation as a non-destructive method for study, identifation and rapid determination of selected representatives of cationic (Methylene Blue), azo (Congo Red, Eriochrome Black T) and nitroso (Naphthol Green B) dyes. In conjunction with the ATR technique, FTIR offers a reliable detection method of dyes without extraction by other dangerous substances. Spectral interpretation of dye spectra revealed valuable information about the identification and characterization of each group of dyes.

  17. 76 FR 1067 - Testing of Certain High Production Volume Chemicals; Second Group of Chemicals

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-01-07

    ... 2070-AD16 Testing of Certain High Production Volume Chemicals; Second Group of Chemicals AGENCY... processors of certain high production volume (HPV) chemical substances to conduct testing to obtain screening... potentially affected by this action if you manufacture (defined by statute to include import) or process any...

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

    PubMed

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

    2015-03-01

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

  19. Characterization factors for water footprint considering the scarcity of green and blue water sources

    NASA Astrophysics Data System (ADS)

    Oki, T.; Kondo, T.; Pokhrel, Y. N.; Hanasaki, N.

    2011-12-01

    The original concept of virtual water trade was invented to illustrate how much water demand can be reduced by importing food products (Allan 1996), and expanded for meat products and industrial products (Oki and Kanae, 2004). However, there was a confusion between "virtual trade of water" (original) and "trade of virtual water" (misinterpretation but widely accepted), and "virtual water" has been recognized as how much water was used to produce the commodity. Then, the concept has some analogy to carbon footprint (CFP) which is an indicator of total emission of greenhouse gases, and nowadays called water footprint (WFP, Hoekstra, 2004). However, WFP itself is just an inventory of water usages under the framework of life cycle assessment (LCA), and the volume of WFP does not necessary reflect the environmental impacts of water usages because consumptive water use of 100 liter from ground water in arid regions just before rainy season would have more environmental impacts than consumptive water use of 100 liter from rain water in humid regions during snow melt season. In the case of CFP, the emissions of five greenhouse gases except for CO2 were converted into CO2 equivalent volumes by considering the sensitivity for the global warming potential, and summed up into CFP. Here, we propose a new idea objectively determining the weights (characterization factors) for blue water usages, such as from river and ground water, to be converted into green water equivalent in each region and time. The weights are inversely proportional to the area required to obtain the same amount of green water, and water balance model can provide the basic information. The new concept was applied to the WFP of Japan through the imports of major crops. As an inventory, WFP was 15.5 km3/y of rain water, 2.2 km3/y of river water, and 2.0 km3/y of non-renewable and non-local water (NRNL water) for year 2000, however, considering the proposed characterization factors in each region (0.5 x 0.5 degree global grids) based on annual water balances, WFPs become 8.1 km3/y of river water and 22.0 km3/y of NRNL water. This new concept can be expanded into an idea of "global mean green water equivalent" volume of WFP.

  20. Variations in inpatient pediatric anesthesia in California from 2000 to 2009: a caseload and geographic analysis.

    PubMed

    Mudumbai, Seshadri C; Honkanen, Anita; Chan, Jia; Schmitt, Susan; Saynina, Olga; Hackel, Alvin; Gregory, George; Phibbs, Ciaran S; Wise, Paul H

    2014-12-01

    Regional referral systems are considered important for children hospitalized for surgery, but there is little information on existing systems. To examine geographic variations in anesthetic caseloads in California for surgical inpatients ≤6 years and to evaluate the feasibility of regionalizing anesthetic care. We reviewed California's unmasked patient discharge database between 2000 and 2009 to determine surgical procedures, dates, and inpatient anesthetic caseloads. Hospitals were classified as urban or rural and were further stratified as low, intermediate, high, and very high volume. We reviewed 257,541 anesthetic cases from 402 hospitals. Seventeen California Children's Services (CCS) hospitals conducted about two-thirds of all inpatient anesthetics; 385 non-CCS hospitals accounted for the rest. Urban hospitals comprised 82% of low- and intermediate-volume centers (n = 297) and 100% of the high- and very high-volume centers (n = 41). Ninety percent (n = 361) of hospitals performed <100 cases annually. Although potentially lower risk procedures such as appendectomies were the most frequent in urban low- and intermediate-volume hospitals, fairly complex neurosurgical and general surgeries were also performed. The median distance from urban lower-volume hospitals to the nearest high- or very high-volume center was 12 miles. Up to 98% (n = 40,316) of inpatient anesthetics at low- or intermediate-volume centers could have been transferred to higher-volume centers within 25 miles of smaller centers. Many urban California hospitals maintained low annual inpatient anesthetic caseloads for children ≤6 years while conducting potentially more complex procedures. Further efforts are necessary to define the scope of pediatric anesthetic care at urban low- and intermediate-volume hospitals in California. © 2014 John Wiley & Sons Ltd.

  1. Effects of growth, diving history, and high altitude on blood oxygen capacity in harbor seals

    NASA Technical Reports Server (NTRS)

    Kodama, A. M.; Elsner, R.; Pace, N.

    1977-01-01

    Blood volume and body composition for diving and nondiving harbor seals were measured at six-week intervals during a 10-month period of captitivity. Whole body hematocrit, red cell volume per kg of lean body mass, and total circulating hemoglobin per kg lean body mass were significantly higher in the diving group, but relatively large blood volumes expressed in terms of body weight (11-12%) were found in both groups. A pair of harbor seals exposed to high altitude for about three months registered significant increases in red cell volume, blood hemoglobin levels, and blood volume expressed in terms of body weight; results of alveolar gas analyses indicate that hyperventilation also occurred. These typical mammalian responses to hypoxia suggest that the harbor seal's large blood volume and high hemoglobin content are an expression of phylogenetic control, and that in spite of its adaptability to apnea during its diving life, the animal cannot be considered preacclimatized to high altitude.

  2. Adequacy in voided urine cytology specimens: The role of volume and a repeat void upon predictive values for high-grade urothelial carcinoma.

    PubMed

    VandenBussche, Christopher J; Rosenthal, Dorothy L; Olson, Matthew T

    2016-03-01

    Adequacy assessment is one of the most controversial and overlooked components in the daily practice of cytopathology, because it is generally determined from limited samples. Because voided urine varies widely in terms of its volume and cellularity, there is little consensus about the proper role for these variables in assessing specimen adequacy. In this study, the authors explored the role of volume in voided urine specimens to determine whether it plays a role in determining adequacy for the detection of high-grade urothelial carcinoma. Voided urine specimens received at the authors' laboratory over the 9.5 years since the introduction of the Johns Hopkins Template for Reporting Urinary Cytopathology were analyzed for correlations between volume, specimen adequacy, and the diagnosis of high-grade malignancy. The same data set also was queried to determine whether a patient who provided a voided low-volume specimen could yield a higher volume specimen and thereby increase adequacy. In total, 15,731 voided urine specimens with a cumulative volume of 891 liters originating from 8594 individual patients were analyzed. Specimen adequacy increased linearly for each increment of volume submitted to the laboratory up to 30 mL, after which the correlation was nonlinear. Low-volume specimens below this cutoff also had lower fractions of specimens that were diagnosed as malignant or suspicious. Volume is an important component in the evaluation of adequacy for voided urine cytology specimens. © 2015 American Cancer Society.

  3. Development of automatic visceral fat volume calculation software for CT volume data.

    PubMed

    Nemoto, Mitsutaka; Yeernuer, Tusufuhan; Masutani, Yoshitaka; Nomura, Yukihiro; Hanaoka, Shouhei; Miki, Soichiro; Yoshikawa, Takeharu; Hayashi, Naoto; Ohtomo, Kuni

    2014-01-01

    To develop automatic visceral fat volume calculation software for computed tomography (CT) volume data and to evaluate its feasibility. A total of 24 sets of whole-body CT volume data and anthropometric measurements were obtained, with three sets for each of four BMI categories (under 20, 20 to 25, 25 to 30, and over 30) in both sexes. True visceral fat volumes were defined on the basis of manual segmentation of the whole-body CT volume data by an experienced radiologist. Software to automatically calculate visceral fat volumes was developed using a region segmentation technique based on morphological analysis with CT value threshold. Automatically calculated visceral fat volumes were evaluated in terms of the correlation coefficient with the true volumes and the error relative to the true volume. Automatic visceral fat volume calculation results of all 24 data sets were obtained successfully and the average calculation time was 252.7 seconds/case. The correlation coefficients between the true visceral fat volume and the automatically calculated visceral fat volume were over 0.999. The newly developed software is feasible for calculating visceral fat volumes in a reasonable time and was proved to have high accuracy.

  4. Estimating merchantable volumes of second growth Douglas-fir stands from total cubic volume and associated stand characteristics.

    Treesearch

    Richard L. Williamson; Robert O. Curtis

    1980-01-01

    Equations are given for estimating merchantable volumes of second-growth Douglas-fir stands to specified breast-high and top-diameter limits, in cubic feet or board feet, from total volume in cubic feet and certain associated stand characteristics.

  5. A computer program to generate equations of motion matrices, L217 (EOM). Volume 1: Engineering and usage

    NASA Technical Reports Server (NTRS)

    Kroll, R. I.; Clemmons, R. E.

    1979-01-01

    The equations of motion program L217 formulates the matrix coefficients for a set of second order linear differential equations that describe the motion of an airplane relative to its level equilibrium flight condition. Aerodynamic data from FLEXSTAB or Doublet Lattice (L216) programs can be used to derive the equations for quasi-steady or full unsteady aerodynamics. The data manipulation and the matrix coefficient formulation are described.

  6. International Standard Payload Rack volume

    NASA Technical Reports Server (NTRS)

    2001-01-01

    Outer dimensions of the International Standard Payload Rack (ISPR) that will be used on the International Space Station (ISS) sets the envelope for scientists designing hardware for experiments in biological and physical sciences aboard ISS. The ISPR includes attachments to ISS utilities (electrical power, heating and cooling, data, fluids, vacuum, etc.) through standoffs that hold the racks in place in the lab modules. Usage will range from facilities that take entire racks to specialized drawers occupying a portion of a rack.

  7. Research@ARL: Autonomous Systems. Volume 2, Issue 2

    DTIC Science & Technology

    2013-07-01

    desired set of states at a specified time [19], [20], but these approaches do not account for switching costs , such as energy usage to charge a capacitive...efforts in this arena4. However, network infrastructure and protocols must account for the limited size and power of small platforms in comparison to...location to an interior one, they must alter their gait to account for the change in ground conditions from loosely packed soil to a hard surface. If the

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

    PubMed Central

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

    2015-01-01

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

  9. Dual-energy X-ray absorptiometry–based body volume measurement for 4-compartment body composition123

    PubMed Central

    Wilson, Joseph P; Mulligan, Kathleen; Fan, Bo; Sherman, Jennifer L; Murphy, Elizabeth J; Tai, Viva W; Powers, Cassidy L; Marquez, Lorena; Ruiz-Barros, Viviana

    2012-01-01

    Background: Total body volume (TBV), with the exclusion of internal air voids, is necessary to quantify body composition in Lohman's 4-compartment (4C) model. Objective: This investigation sought to derive a novel, TBV measure with the use of only dual-energy X-ray absorptiometry (DXA) attenuation values for use in Lohman's 4C body composition model. Design: Pixel-specific masses and volumes were calculated from low- and high-energy attenuation values with the use of first principle conversions of mass attenuation coefficients. Pixel masses and volumes were summed to derive body mass and total body volume. As proof of concept, 11 participants were recruited to have 4C measures taken: DXA, air-displacement plethysmography (ADP), and total body water (TBW). TBV measures with the use of only DXA (DXA-volume) and ADP-volume measures were compared for each participant. To see how body composition estimates were affected by these 2 methods, we used Lohman's 4C model to quantify percentage fat measures for each participant and compared them with conventional DXA measures. Results: DXA-volume and ADP-volume measures were highly correlated (R2 = 0.99) and showed no statistically significant bias. Percentage fat by DXA volume was highly correlated with ADP-volume percentage fat measures and DXA software-reported percentage fat measures (R2 = 0.96 and R2 = 0.98, respectively) but were slightly biased. Conclusions: A novel method to calculate TBV with the use of a clinical DXA system was developed, compared against ADP as proof of principle, and used in Lohman's 4C body composition model. The DXA-volume approach eliminates many of the inherent inaccuracies associated with displacement measures for volume and, if validated in larger groups of participants, would simplify the acquisition of 4C body composition to a single DXA scan and TBW measure. PMID:22134952

  10. Lactate response to different volume patterns of power clean.

    PubMed

    Date, Anand S; Simonson, Shawn R; Ransdell, Lynda B; Gao, Yong

    2013-03-01

    The ability to metabolize or tolerate lactate and produce power simultaneously can be an important determinant of performance. Current training practices for improving lactate use include high-intensity aerobic activities or a combination of aerobic and resistance training. Excessive aerobic training may have undesired physiological adaptations (e.g., muscle loss, change in fiber types). The role of explosive power training in lactate production and use needs further clarification. We hypothesized that high-volume explosive power movements such as Olympic lifts can increase lactate production and overload lactate clearance. Hence, the purpose of this study was to assess lactate accumulation after the completion of 3 different volume patterns of power cleans. Ten male recreational athletes (age 24.22 ± 1.39 years) volunteered. Volume patterns consisted of 3 sets × 3 repetition maximum (3RM) (low volume [LV]), 3 sets × 6 reps at 80-85% of 3RM (midvolume [MV]), and 3 sets × 9 reps at 70-75% of 3RM (high volume [HV]). Rest period was identical at 2 minutes. Blood samples were collected immediately before and after each volume pattern. The HV resulted in the greatest lactate accumulation (7.43 ± 2.94 mmol·L) vs. (5.27 ± 2.48 and 4.03 ± 1.78 mmol·L in MV and LV, respectively). Mean relative increase in lactate was the highest in HV (356.34%). The findings indicate that lactate production in power cleans is largely associated with volume, determined by number of repetitions, load, and rest interval. High-volume explosive training may impose greater metabolic demands than low-volume explosive training and may improve ability to produce power in the presence of lactate. The role of explosive power training in overloading the lactate clearance mechanism should be examined further, especially for athletes of intermittent sport.

  11. Association of Nurse-to-Patient Ratio with mortality and preventable complications following aortic valve replacement.

    PubMed

    Arkin, Nicole; Lee, Peter H U; McDonald, Kathryn; Hernandez-Boussard, Tina

    2014-03-01

    To examine hospital resources associated with patient outcomes for aortic valve replacement (AVR), including inpatient adverse events and mortality. We used the Nationwide Inpatient Sample to identify AVR procedures from 1998 to 2010 and the American Hospital Association Annual Survey to augment hospital characteristics. Primary outcomes included mortality and the development of adverse events, identified using standardized patient safety indicators (PSI). Patient and hospital characteristics associated with PSI development were evaluated using univariate and multivariate analyses. An estimated 410,157 AVRs at 5009 hospitals were performed in the US between 1998 and 2010. The number of procedures grew annually by 4.72% (p=0.0003) in high volume hospitals, 4.48% in medium volume hospitals (p<0.0001), and 2.03% in low volume hospitals (p=0.154). Mortality was highest in low volume hospitals, 4.70%, decreased from 4.14% to 3.73% in medium and high volume hospitals, respectively (p=0.0002). Rates of PSIs did not vary significantly across volume terciles (p=0.254). Multivariate logistic regression analysis showed low volume hospitals had increased risk of mortality as compared with high volume hospitals (odds ratio [OR]: 1.42; 95% confidence interval [CI]: 1.01 to 2.00), while hospital volume was not associated with adverse events. PSI development was associated with small hospitals as compared with large (OR: 1.63, 95% CI: 1.16 to 2.28) and inversely associated with higher nurse-to-patient ratio (OR: 0.94, 95% CI: 0.90 to 0.99). The volume-outcomes relationship was associated with mortality outcomes but not postoperative complications. We identified structural differences in hospital size, nurses-to-patient ratio, and nursing skill level indicative of high quality outcomes. © 2014 Wiley Periodicals, Inc.

  12. Impact of hospital volume on perioperative outcomes and costs of radical cystectomy: analysis of the Maryland Health Services Cost Review Commission database.

    PubMed

    Gorin, Michael A; Kates, Max; Mullins, Jeffrey K; Pierorazio, Phillip M; Matlaga, Brian R; Schoenberg, Mark P; Bivalacqua, Trinity J

    2014-02-01

    The objective of this study was to evaluate the impact of hospital case volume on perioperative outcomes and costs of radical cystectomy (RC) after controlling for differences in patient case mix. The Maryland Health Services Cost Review Commission database was queried for patients who underwent an open RC between 2000 and 2011. Patients were divided into tertiles based on hospital case volume. Groups were compared for differences in length of intensive care unit (ICU) stay, length of total hospital stay, rate of in-hospital deaths and procedure-related costs. In total, 1620 patients underwent a RC during the study period. Of these patients, 457 (28.2%) underwent surgery at 37 low volume centers, 465 (28.7%) at six mid volume centers and 698 (43.1%) at a single high volume center. The mean case volume of each group was 1.1, 7.0 and 63.5 RC/center/year, respectively. After controlling for marked differences in patient case mix, having surgery at the single high-volume center was independently associated with a decrease in length of ICU stay (coefficient = -0.41 days, 95% CI -0.78--0.05, p = 0.03), in-hospital mortality (OR 0.18, 95% CI 0.04-0.80, p = 0.02) and total medical costs (coefficient = -2.91k USD, 95% CI -4.15--1.67, p < 0.001). Decreased total costs were driven by reductions in charges associated with the operating room, drugs, radiology tests, labs, supplies and physical/occupational therapy (all p < 0.001). Undergoing RC at a high volume medical center was associated with improved outcomes and reduced costs. These data support the centralization of RC to high volume centers.

  13. Total and regional body volumes derived from dual-energy X-ray absorptiometry output.

    PubMed

    Wilson, Joseph P; Fan, Bo; Shepherd, John A

    2013-01-01

    Total body volume is an important health metric used to measure body density, shape, and multicompartmental body composition but is currently only available through underwater weighing or air displacement plethysmography (ADP). The objective of this investigation was to derive an accurate body volume from dual-energy X-ray absorptiometry (DXA)-reported measures for advanced body composition models. Volunteers received a whole body DXA scan and an ADP measure at baseline (N = 25) and 6 mo (N = 22). Baseline measures were used to calibrate body volume from the reported DXA masses of fat, lean, and bone mineral content. A second population (N = 385) from the National Health and Nutrition Examination Survey was used to estimate the test-retest precision of regional (arms, legs, head, and trunk) and total body volumes. Overall, we found that DXA-volume was highly correlated to ADP-volume (R² = 0.99). The 6-mo change in total DXA-volume was highly correlated to change in ADP-volume (R² = 0.98). The root mean square percent coefficient of variation precision of DXA-volume measures ranged from 1.1% (total) to 3.2% (head). We conclude that the DXA-volume method can measure body volume accurately and precisely, can be used in body composition models, could be an independent health indicator, and is useful as a prospective or retrospective biomarker of body composition. Copyright © 2013 The International Society for Clinical Densitometry. Published by Elsevier Inc. All rights reserved.

  14. High serum concentration of estradiol may be a risk factor of prostate enlargement in aging male in China.

    PubMed

    Xu, Ding; Wu, Yu; Shen, Haibo; Qian, Subo; Qi, Jun

    2018-06-18

    Assess the association between serum sex hormone level and prostate volume in men with benign prostatic hyperplasia (BPH). The study involved 239 BPH patients from January 2013 to June 2015 in our hospital. Each patient collected age, medical history, height, weight, body mass index, as well as a full examination of sex hormones, and transrectal ultrasound results. Estradiol (E2) was significantly associated with prostate volume (r = 0.151, p = .02) and transitional zone volume (r = 0.136, p = .035). The association was more significant after adjusting age and BMI (r = 0.253 and 0.250, p <.001). Patients were divided into two groups according to prostate volume and E2, respectively. E2 in patients with prostate volume ≤50 ml was significantly lower than those with prostate volume >50 ml. Prostate volume, transitional zone volume and age were all significantly higher in the patients with E2 ≥ 160 umol/l than those in the patients with E2 < 160 umol/l. Through logistics regression, E2 (p = .012, OR = 1.004) are the only independent risk factor for prostate volume. E2 is significantly associated with prostate volume. High concentrations of E2 may be a risk factor for the large volume of prostate.

  15. Does the usage of digital chest drainage systems reduce pleural inflammation and volume of pleural effusion following oncologic pulmonary resection?-A prospective randomized trial.

    PubMed

    De Waele, Michèle; Agzarian, John; Hanna, Waël C; Schieman, Colin; Finley, Christian J; Macri, Joseph; Schneider, Laura; Schnurr, Terri; Farrokhyar, Forough; Radford, Katherine; Nair, Parameswaran; Shargall, Yaron

    2017-06-01

    Prolonged air leak and high-volume pleural drainage are the most common causes for delays in chest tube removal following lung resection. While digital pleural drainage systems have been successfully used in the management of post-operative air leak, their effect on pleural drainage and inflammation has not been studied before. We hypothesized that digital drainage systems (as compared to traditional analog continuous suction), using intermittent balanced suction, are associated with decreased pleural inflammation and postoperative drainage volumes, thus leading to earlier chest tube removal. One hundred and three [103] patients were enrolled and randomized to either analog (n=50) or digital (n=53) drainage systems following oncologic lung resection. Chest tubes were removed according to standardized, pre-defined protocol. Inflammatory mediators [interleukin-1B (IL-1B), 6, 8, tumour necrosis factor-alpha (TNF-α)] in pleural fluid and serum were measured and analysed. The primary outcome of interest was the difference in total volume of postoperative fluid drainage. Secondary outcome measures included duration of chest tube in-situ, prolonged air-leak incidence, length of hospital stay and the correlation between pleural effusion formation, degree of inflammation and type of drainage system used. There was no significant difference in total amount of fluid drained or length of hospital stay between the two groups. A trend for shorter chest tube duration was found with the digital system when compared to the analog (P=0.055). Comparison of inflammatory mediator levels revealed no significant differences between digital and analog drainage systems. The incidence of prolonged post-operative air leak was significantly higher when using the analog system (9 versus 2 patients; P=0.025). Lobectomy was associated with longer chest tube duration (P=0.001) and increased fluid drainage when compared to sub-lobar resection (P<0.001), regardless of drainage system. Use of post-lung resection digital drainage does not appear to decrease pleural fluid formation, but is associated with decreased prolonged air leaks. Total pleural effusion volumes did not differ with the type of drainage system used. These findings support previously established benefits of the digital system in decreasing prolonged air leaks, but the advantages do not appear to extend to decreased pleural fluid formation.

  16. The Influence of Hospital Volume on Circumferential Resection Margin Involvement: Results of the Dutch Surgical Colorectal Audit.

    PubMed

    Gietelink, Lieke; Henneman, Daniel; van Leersum, Nicoline J; de Noo, Mirre; Manusama, Eric; Tanis, Pieter J; Tollenaar, Rob A E M; Wouters, Michel W J M

    2016-04-01

    This population-based study evaluates the association between hospital volume and CRM (circumferential resection margin) involvement, adjusted for other confounders, in rectal cancer surgery. A low hospital volume (<20 cases/year) was independently associated with a higher risk of CRM involvement (odds ratio=1.54; 95% CI: 1.12-2.11). To evaluate the association between hospital volume and CRM (circumferential resection margin) involvement in rectal cancer surgery. To guarantee the quality of surgical treatment of rectal cancer, the Association of Surgeons of the Netherlands has stated a minimal annual volume standard of 20 procedures per hospital. The influence of hospital volume has been examined for different outcome variables in rectal cancer surgery. Its influence on the pathological outcome (CRM) however remains unclear. As long-term outcomes are best predicted by the CRM status, this parameter is of essential importance in the debate on the justification of minimal volume standards in rectal cancer surgery. Data from the Dutch Surgical Colorectal Audit (2011-2012) were used. Hospital volume was divided into 3 groups, and baseline characteristics were described. The influence of hospital volume on CRM involvement was analyzed, in a multivariate model, between low- and high-volume hospitals, according to the minimal volume standards. This study included 5161 patients. CRM was recorded in 86% of patients. CRM involvement was 11% in low-volume group versus 7.7% and 7.9% in the medium- and high-volume group (P≤0.001). After adjustment for relevant confounders, the influence of hospital volume on CRM involvement was still significant odds ratio (OR) = 1.54; 95% CI: 1.12-2.11). The outcomes of this pooled analysis support minimal volume standards in rectal cancer surgery. Low hospital volume was independently associated with a higher risk of CRM involvement (OR = 1.54; 95% CI: 1.12-2.11).

  17. Development of a high resolution stepper motor prototype. Volume 2. Detailed results. Volume 3. Development rapport final relatif a un prototype de moteur pas a pas a grande resolution. Volume 2. Resultats detailles. Volume 3. Developpement. Final report

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

    Not Available

    1975-12-01

    This motor could be used to drive large solar panels of future satellites. Results of investigations concerning a breadboard model without a relaxation torque and a prototype with a relaxation torque are presented. For volume 1; see ESR-97066. (GRA)

  18. How do sock ply changes affect residual-limb fluid volume in people with transtibial amputation?

    PubMed

    Sanders, Joan E; Harrison, Daniel S; Allyn, Katheryn J; Myers, Timothy R; Ciol, Marcia A; Tsai, Elaine C

    2012-01-01

    The purpose of this research was to investigate the influence of sock addition and removal on residual-limb fluid volume in people using prosthetic limbs. We used bioimpedance analysis to measure residual-limb extracellular fluid volume on 28 transtibial amputee subjects during 30 min test sessions. Upon addition of a one-ply polyester sock, residual-limb fluid volume changes ranged from -4.0% to 0.8% (mean -0.9 +/- 1.3%) of the initial limb fluid volume. Changes for sock removal ranged from -1.2% to 2.8% (mean 0.5 +/- 0.8%). Subjects who reduced in fluid volume with both addition and removal of a sock and subjects with high positive ratios between the fluid-volume loss upon sock addition and gain upon sock removal (high add/remove [AR] ratios) tended to have arterial disease, were obese, and were smokers. Subjects with low positive AR ratios, subjects who increased in fluid volume both with sock addition and removal, and a single subject who increased in fluid volume with sock addition and decreased with sock removal tended to be nonsmokers and either individuals in good health without complications or individuals without arterial problems. Results are relevant for the anticipation of limb volume changes during prosthetic fitting and toward the design of adjustable-socket technologies.

  19. LSENS: A General Chemical Kinetics and Sensitivity Analysis Code for homogeneous gas-phase reactions. Part 1: Theory and numerical solution procedures

    NASA Technical Reports Server (NTRS)

    Radhakrishnan, Krishnan

    1994-01-01

    LSENS, the Lewis General Chemical Kinetics and Sensitivity Analysis Code, has been developed for solving complex, homogeneous, gas-phase chemical kinetics problems and contains sensitivity analysis for a variety of problems, including nonisothermal situations. This report is part 1 of a series of three reference publications that describe LENS, provide a detailed guide to its usage, and present many example problems. Part 1 derives the governing equations and describes the numerical solution procedures for the types of problems that can be solved. The accuracy and efficiency of LSENS are examined by means of various test problems, and comparisons with other methods and codes are presented. LSENS is a flexible, convenient, accurate, and efficient solver for chemical reaction problems such as static system; steady, one-dimensional, inviscid flow; reaction behind incident shock wave, including boundary layer correction; and perfectly stirred (highly backmixed) reactor. In addition, the chemical equilibrium state can be computed for the following assigned states: temperature and pressure, enthalpy and pressure, temperature and volume, and internal energy and volume. For static problems the code computes the sensitivity coefficients of the dependent variables and their temporal derivatives with respect to the initial values of the dependent variables and/or the three rate coefficient parameters of the chemical reactions.

  20. Lower-volume muscle-damaging exercise protects against high-volume muscle-damaging exercise and the detrimental effects on endurance performance.

    PubMed

    Burt, Dean; Lamb, Kevin; Nicholas, Ceri; Twist, Craig

    2015-07-01

    This study examined whether lower-volume exercise-induced muscle damage (EIMD) performed 2 weeks before high-volume muscle-damaging exercise protects against its detrimental effect on running performance. Sixteen male participants were randomly assigned to a lower-volume (five sets of ten squats, n = 8) or high-volume (ten sets of ten squats, n = 8) EIMD group and completed baseline measurements for muscle soreness, knee extensor torque, creatine kinase (CK), a 5-min fixed-intensity running bout and a 3-km running time-trial. Measurements were repeated 24 and 48 h after EIMD, and the running time-trial after 48 h. Two weeks later, both groups repeated the baseline measurements, ten sets of ten squats and the same follow-up testing (Bout 2). Data analysis revealed increases in muscle soreness and CK and decreases in knee extensor torque 24-48 h after the initial bouts of EIMD. Increases in oxygen uptake [Formula: see text], minute ventilation [Formula: see text] and rating of perceived exertion were observed during fixed-intensity running 24-48 h after EIMD Bout 1. Likewise, time increased and speed and [Formula: see text] decreased during a 3-km running time-trial 48 h after EIMD. Symptoms of EIMD, responses during fixed-intensity and running time-trial were attenuated in the days after the repeated bout of high-volume EIMD performed 2 weeks after the initial bout. This study demonstrates that the protective effect of lower-volume EIMD on subsequent high-volume EIMD is transferable to endurance running. Furthermore, time-trial performance was found to be preserved after a repeated bout of EIMD.

  1. High tidal volume decreases adult respiratory distress syndrome, atelectasis, and ventilator days compared with low tidal volume in pediatric burned patients with inhalation injury.

    PubMed

    Sousse, Linda E; Herndon, David N; Andersen, Clark R; Ali, Arham; Benjamin, Nicole C; Granchi, Thomas; Suman, Oscar E; Mlcak, Ronald P

    2015-04-01

    Inhalation injury, which is among the causes of acute lung injury and acute respiratory distress syndrome (ARDS), continues to represent a significant source of mortality in burned patients. Inhalation injury often requires mechanical ventilation, but the ideal tidal volume strategy is not clearly defined in burned pediatric patients. The aim of this study was to determine the effects of low and high tidal volume on the number of ventilator days, ventilation pressures, and incidence of atelectasis, pneumonia, and ARDS in pediatric burned patients with inhalation injury within 1 year post burn injury. From 1986 to 2014, inhalation injury was diagnosed by bronchoscopy in pediatric burned patients (n = 932). Patients were divided into 3 groups: unventilated (n = 241), high tidal volume (HTV, 15 ± 3 mL/kg, n = 190), and low tidal volume (LTV, 9 ± 3 mL/kg, n = 501). High tidal volume was associated with significantly decreased ventilator days (p < 0.005) and maximum positive end expiratory pressure (p < 0.0001) and significantly increased maximum peak inspiratory pressure (p < 0.02) and plateau pressure (p < 0.02) compared with those in patients with LTV. The incidence of atelectasis (p < 0.0001) and ARDS (p < 0.02) was significantly decreased with HTV compared with LTV. However, the incidence of pneumothorax was significantly increased in the HTV group compared with the LTV group (p < 0.03). High tidal volume significantly decreases ventilator days and the incidence of both atelectasis and ARDS compared with low tidal volume in pediatric burned patients with inhalation injury. Therefore, the use of HTV may interrupt sequences leading to lung injury in our patient population. Copyright © 2015 American College of Surgeons. Published by Elsevier Inc. All rights reserved.

  2. Recent technology and usage of plastic lenses in image taking objectives

    NASA Astrophysics Data System (ADS)

    Yamaguchi, Susumu; Sato, Hiroshi; Mori, Nobuyoshi; Kiriki, Toshihiko

    2005-09-01

    Recently, plastic lenses produced by injection molding are widely used in image taking objectives for digital cameras, camcorders, and mobile phone cameras, because of their suitability for volume production and ease of obtaining an advantage of aspherical surfaces. For digital camera and camcorder objectives, it is desirable that there is no image point variation with the temperature change in spite of employing several plastic lenses. At the same time, due to the shrinking pixel size of solid-state image sensor, there is now a requirement to assemble lenses with high accuracy. In order to satisfy these requirements, we have developed 16 times compact zoom objective for camcorder and 3 times class folded zoom objectives for digital camera, incorporating cemented plastic doublet consisting of a positive lens and a negative lens. Over the last few years, production volumes of camera-equipped mobile phones have increased substantially. Therefore, for mobile phone cameras, the consideration of productivity is more important than ever. For this application, we have developed a 1.3-mega pixels compact camera module with macro function utilizing the advantage of a plastic lens that can be given mechanically functional shape to outer flange part. Its objective consists of three plastic lenses and all critical dimensions related to optical performance can be determined by high precise optical elements. Therefore this camera module is manufactured without optical adjustment in automatic assembling line, and achieves both high productivity and high performance. Reported here are the constructions and the technical topics of image taking objectives described above.

  3. THE EPIDEMIOLOGY OF EMERGENCY DEPARTMENT THORACOTOMY IN A STATEWIDE TRAUMA SYSTEM: DOES CENTER VOLUME MATTER?

    PubMed

    Dumas, Ryan P; Seamon, Mark J; Smith, Brian P; Yang, Wei; Cannon, Jeremy W; Schwab, C William; Reilly, Patrick M; Holena, Daniel N

    2018-04-17

    The relationship between high volume and improved outcomes has been described for a host of elective high-impact, low-frequency procedures, but there are little data to support such a relationship in high-impact low-frequency procedures in trauma. Using emergency department thoracotomy (EDT) as a model, we hypothesized that patients presenting to centers with higher institutional volumes of EDT would have improved survival referent to those presenting to lower volume institutions. We queried the Pennsylvania Trauma Outcomes Study (PTOS) registry from 2007-2015 for all EDTs performed at level I and II centers identified by ICD-9 procedure codes and a location stamp indicating the emergency department. We examined patient-level risk factors for survival in univariate regression and multivariable regression models. Centers were divided into tertiles of mean annual EDT volume and the association between mean annual EDT volume and patient survival was examined using logistic regression after controlling for patient factors. 1,399 emergency department thoracotomies were performed at 28 centers. Overall survival was 6.8%. After controlling for patient age, mechanism of injury, signs of life, and injury severity, patients presenting to centers in the highest tertile of volume had significantly higher odds of survival compared to patients presenting to centers in the lowest tertile of volume (OR 4.56, 95% CI 1.43-14.50). Patients presenting to centers with higher mean annual volume of EDTs have improved survival compared to those presenting to institutions with lower mean annual EDT volume. Efforts to understand the etiology of this finding may lead to interventions to improve outcomes at lower volume centers. Level 3: Retrospective cohort study.

  4. Dissociation of the effects of preload volume and energy content on subjective appetite and food intake.

    PubMed

    Gray, Richard; French, Stephen; Robinson, Tristan; Yeomans, Martin

    2002-05-01

    Previous research suggests that enhancing the volume of a food preload without altering energy content can result in reduced appetite, although the limited evidence means that the conditions under which this effect will occur are not yet clear. In the present study, we used a Universal Eating Monitor (UEM) to record test meal intake constantly, in parallel with appetite ratings, following soup-based preloads that varied both in volume (150 vs. 450 ml) and energy density (1.4 vs. 4.2 kJ/ml). Healthy young men (n=20) received four different preload conditions (repeated measures) followed by unlimited hot pasta test meals (interval 30 min). They completed appetite ratings during and after each laboratory session, and food diaries for the afternoon and evening following each session. Subjective appetite after the preloads was reduced by the high-volume preloads relative to low-volume preloads, with no difference between the two at each volume level. This indicates an effect of volume, but no effect of energy. Test meal intake in the high-volume, high-energy-density condition was reduced relative to the other conditions, which did not differ from one another. This indicates an effect of total energy, but no effect of volume. The dissociation between these different measures of appetite might be explained in terms of largely cognitive influences on subjective appetite between preload and test meal, contrasted with stronger physiological influences on actual intake during the test meal. With regard to previous studies, it is argued that food volume is more influential under circumstances where gastric volume is closer to its normal limits.

  5. 76 FR 4549 - Testing of Certain High Production Volume Chemicals; Second Group of Chemicals; Technical Correction

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-01-26

    ... Testing of Certain High Production Volume Chemicals; Second Group of Chemicals; Technical Correction... production volume (HPV) chemical substances to obtain screening level data for health and environmental effects and chemical fate. This document is being issued to correct a typographical error concerning the...

  6. Lung Volume Reduction After Stereotactic Ablative Radiation Therapy of Lung Tumors: Potential Application to Emphysema

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

    Binkley, Michael S.; Shrager, Joseph B.; Stanford Cancer Institute, Stanford University School of Medicine, Stanford, California

    2014-09-01

    Purpose: Lung volume reduction surgery (LVRS) improves dyspnea and other outcomes in selected patients with severe emphysema, but many have excessive surgical risk for LVRS. We analyzed the dose-volume relationship for lobar volume reduction after stereotactic ablative radiation therapy (SABR) of lung tumors, hypothesizing that SABR could achieve therapeutic volume reduction if applied in emphysema. Methods and Materials: We retrospectively identified patients treated from 2007 to 2011 who had SABR for 1 lung tumor, pre-SABR pulmonary function testing, and ≥6 months computed tomographic (CT) imaging follow-up. We contoured the treated lobe and untreated adjacent lobe(s) on CT before and after SABRmore » and calculated their volume changes relative to the contoured total (bilateral) lung volume (TLV). We correlated lobar volume reduction with the volume receiving high biologically effective doses (BED, α/β = 3). Results: 27 patients met the inclusion criteria, with a median CT follow-up time of 14 months. There was no grade ≥3 toxicity. The median volume reduction of the treated lobe was 4.4% of TLV (range, −0.4%-10.8%); the median expansion of the untreated adjacent lobe was 2.6% of TLV (range, −3.9%-11.6%). The volume reduction of the treated lobe was positively correlated with the volume receiving BED ≥60 Gy (r{sup 2}=0.45, P=.0001). This persisted in subgroups determined by high versus low pre-SABR forced expiratory volume in 1 second, treated lobe CT emphysema score, number of fractions, follow-up CT time, central versus peripheral location, and upper versus lower lobe location, with no significant differences in effect size between subgroups. Volume expansion of the untreated adjacent lobe(s) was positively correlated with volume reduction of the treated lobe (r{sup 2}=0.47, P<.0001). Conclusions: We identified a dose-volume response for treated lobe volume reduction and adjacent lobe compensatory expansion after lung tumor SABR, consistent across multiple clinical parameters. These data serve to inform our ongoing prospective trial of stereotactic ablative volume reduction (SAVR) for severe emphysema in poor candidates for LVRS.« less

  7. Comparison of the outcomes for laparoscopic gastrectomy performed by the same surgeon between a low-volume hospital and a high-volume center.

    PubMed

    Kim, Min Gyu; Kwon, Sung Joon

    2014-05-01

    The volume-outcome relationship in laparoscopic surgery is controversial. This study was designed to identify differences in laparoscopic gastrectomy outcomes between a low-volume hospital and a high-volume center and to provide guidelines for overcoming the problems associated with a low-volume hospital. From April 2009 to November 2012, one surgeon performed 134 totally laparoscopic distal gastrectomies (TLDGs) at a high-volume center (HVC; ASAN Medical Center) and at a low-volume hospital (LVH; Hanyang University Guri Hospital). All laparoscopically assisted gastrectomies were excluded from this study. During the early period of laparoscopic gastrectomy at the low-volume hospital, TLDG with Roux-en-Y gastrojejunostomy (RYGJ) was performed according to the surgeon's choice. The reconstruction method was classified as gastroduodenostomy (GD) or RYGJ. Early surgical outcomes achieved at the LVH were investigated and compared with those obtained at the HVC. The early surgical outcomes differed significantly between the two hospitals. In particular, the postoperative complication rate for the patients who underwent TLDG RYGJ at the LVH was higher than at the HVC (LVH 15.4 % vs. HVC 0 %; p = 0.037). Furthermore, significant differences were observed in the mean operation time (TLDG GD: LVH 141.0 min vs. HVC 117.4 min, p = 0.001; TLDG RYGJ: LVH 186.3 min vs. HVC 134.6 min, p = 0.009) and length of hospital stay (TLDG GD: LVH 8.1 days vs. HVC 7.2 days, p = 0.044; TLDG RYGJ: LVH 11.5 day vs. HVC 6.8 day, p = 0.009). Although all the operations were performed by one experienced surgeon, the early surgical outcomes differed significantly between the low- and high-volume hospitals. Low-volume hospitals often lack well-trained surgical professionals such as first assistants and scrub nurses. Therefore, the authors recommend that a surgeon who works at an LVH should assess potential personnel shortages and find a solution before operating.

  8. Extracting patterns of database and software usage from the bioinformatics literature

    PubMed Central

    Duck, Geraint; Nenadic, Goran; Brass, Andy; Robertson, David L.; Stevens, Robert

    2014-01-01

    Motivation: As a natural consequence of being a computer-based discipline, bioinformatics has a strong focus on database and software development, but the volume and variety of resources are growing at unprecedented rates. An audit of database and software usage patterns could help provide an overview of developments in bioinformatics and community common practice, and comparing the links between resources through time could demonstrate both the persistence of existing software and the emergence of new tools. Results: We study the connections between bioinformatics resources and construct networks of database and software usage patterns, based on resource co-occurrence, that correspond to snapshots of common practice in the bioinformatics community. We apply our approach to pairings of phylogenetics software reported in the literature and argue that these could provide a stepping stone into the identification of scientific best practice. Availability and implementation: The extracted resource data, the scripts used for network generation and the resulting networks are available at http://bionerds.sourceforge.net/networks/ Contact: robert.stevens@manchester.ac.uk PMID:25161253

  9. Human albumin: old, new, and emerging applications.

    PubMed

    Rozga, Jacek; Piątek, Tomasz; Małkowski, Piotr

    2013-05-10

    Human serum albumin has been widely used in an array of clinical settings for nearly 7 decades. Although there is no evidence to support the use of albumin rather than crystalloid in acute volume resuscitation, many clinicians continue to use albumin because it has other important physiologic effects besides the oncotic function. In keeping with the improved understanding of albumin physiology and pathophysiology of many acute and chronic diseases, use of albumin for medical applications has increased in recent years. This, along with increased costs of manufacturing and lower production volume of medical-grade albumin, has lead to an ongoing shortage and rapid increase in albumin prices. This review is based on the analysis of major publications, related to albumin chemistry, physiology, and medical uses including guidelines developed by professional and governmental organizations. Results reflect current knowledge about the role of albumin in health and disease and relevance of albumin therapy in specific clinical settings. Albumin therapy is currently recommended in spontaneous bacterial peritonitis with ascites, refractory ascites not responsive to diuretics, large-volume paracentesis, post-paracentesis syndrome, and the treatment of hepatorenal syndrome as an adjunct to vasoconstrictors. New indications for albumin therapy are linked to the antioxidant activity of albumin and its effects on capillary integrity. In recent years, large-pore hemofiltration and albumin exchange have emerged as promising liver support therapies for liver failure and other toxic syndromes. They are designed to remove a broad range of blood-borne toxins and to restore normal functions of the circulating albumin by replacing defective forms of albumin and albumin molecules saturated with toxins with normal albumin. In view of the ongoing worldwide shortage and high cost of human albumin (native and recombinant), new usage criteria, protocols, and guidelines for appropriate utilization of albumin are needed.

  10. Tract-Specific Volume Loss on 3T MRI in Patients with Cervical Spondylotic Myelopathy.

    PubMed

    Hopkins, Benjamin S; Weber, Kenneth A; Cloney, Michael Brendan; Paliwal, Monica; Parrish, Todd B; Smith, Zachary A

    2018-04-11

    Case-control. The aim of this study was to understand the role of high-resolution magnetic resonance (MR) in identifying regional cord volume loss in cervical spondylotic myelopathy (CSM). Preliminary studies suggest that compression of the ventral region of the cord may contribute disproportionately to CSM symptomology; however, tract-specific data are lacking in the CSM population. The current study is the first to use 3T MR imaging (MRI) images of CSM patients to determine specific volume loss at the level of detail of individual descending white matter tracts. Twelve patients with CSM and 14 age-matched were enrolled prospectively and underwent 3-Tesla MRI of the cervical spine. Using the high-resolution images of the spinal cord, straightening and alignment with a template was performed and specific spinal cord tract volumes were measured using Spinal Cord Tool-box version 3.0.7. Modified Japanese orthopedic association (mJOA) and Nurick disability scores were collected in a prospective manner and were analyzed in relation to descending spinal tract volumes. Having CSM was predicted by anterior/posterior diameter, eccentricity of the cord [odds ratio (OR) 0.000000621, P = 0.004], ventral reticulospinal tract volume (OR 1.167, P = 0.063), lateral corticospinal tract volume (OR 1.034, P = 0.046), rubrospinal tract volume (OR 1.072, P = 0.011), and ventrolateral reticulospinal tract volume (OR 1.474, P = 0.005) on single variable logistic regression. Single variable linear regression showed decreases in anterior/posterior spinal cord diameter (P = 0.022), ventral reticulospinal tract volumes (P = 0.007), and ventrolateral reticulospinal tract volumes (P = 0.017) to significantly predict worsening mJOA scores. Similarly, decreases in ventral reticulospinal tract volumes significantly predicted increasing Nurick scores (P = 0.039). High-resolution 3T MRI can detect tract-specific volume loss in descending spinal cord tracts in CSM patients. Anterior/posterior spinal cord diameter, ventral reticulospinal tract, ventrolateral reticulospinal tract, lateral corticospinal tract, and rubrospinal tract volume loss are associated with CSM symptoms. 2.

  11. Lung-Protective Ventilation With Low Tidal Volumes and the Occurrence of Pulmonary Complications in Patients Without Acute Respiratory Distress Syndrome: A Systematic Review and Individual Patient Data Analysis.

    PubMed

    Neto, Ary Serpa; Simonis, Fabienne D; Barbas, Carmen S V; Biehl, Michelle; Determann, Rogier M; Elmer, Jonathan; Friedman, Gilberto; Gajic, Ognjen; Goldstein, Joshua N; Linko, Rita; Pinheiro de Oliveira, Roselaine; Sundar, Sugantha; Talmor, Daniel; Wolthuis, Esther K; Gama de Abreu, Marcelo; Pelosi, Paolo; Schultz, Marcus J

    2015-10-01

    Protective mechanical ventilation with low tidal volumes is standard of care for patients with acute respiratory distress syndrome. The aim of this individual patient data analysis was to determine the association between tidal volume and the occurrence of pulmonary complications in ICU patients without acute respiratory distress syndrome and the association between occurrence of pulmonary complications and outcome in these patients. Individual patient data analysis. ICU patients not fulfilling the consensus criteria for acute respiratory distress syndrome at the onset of ventilation. Mechanical ventilation with low tidal volume. The primary endpoint was development of a composite of acute respiratory distress syndrome and pneumonia during hospital stay. Based on the tertiles of tidal volume size in the first 2 days of ventilation, patients were assigned to a "low tidal volume group" (tidal volumes ≤ 7 mL/kg predicted body weight), an "intermediate tidal volume group" (> 7 and < 10 mL/kg predicted body weight), and a "high tidal volume group" (≥ 10 mL/kg predicted body weight). Seven investigations (2,184 patients) were included. Acute respiratory distress syndrome or pneumonia occurred in 23% of patients in the low tidal volume group, in 28% of patients in the intermediate tidal volume group, and in 31% of the patients in the high tidal volume group (adjusted odds ratio [low vs high tidal volume group], 0.72; 95% CI, 0.52-0.98; p = 0.042). Occurrence of pulmonary complications was associated with a lower number of ICU-free and hospital-free days and alive at day 28 (10.0 ± 10.9 vs 13.8 ± 11.6 d; p < 0.01 and 6.1 ± 8.1 vs 8.9 ± 9.4 d; p < 0.01) and an increased hospital mortality (49.5% vs 35.6%; p < 0.01). Ventilation with low tidal volumes is associated with a lower risk of development of pulmonary complications in patients without acute respiratory distress syndrome.

  12. Trends in Hospital Volume and Operative Mortality for High-Risk Surgery

    PubMed Central

    Finks, Jonathan F.; Osborne, Nicholas H.; Birkmeyer, John D.

    2011-01-01

    BACKGROUND There were numerous efforts in the United States during the previous decade to concentrate selected surgical procedures in high-volume hospitals. It remains unknown whether referral patterns for high-risk surgery have changed as a result and how operative mortality has been affected. METHODS We used national Medicare data to study patients undergoing one of eight different cancer and cardiovascular operations from 1999 through 2008. For each procedure, we examined trends in hospital volume and market concentration, defined as the proportion of Medicare patients undergoing surgery in the top decile of hospitals by volume per year. We used regression-based techniques to assess the effects of volume and market concentration on mortality over time, adjusting for case mix. RESULTS Median hospital volumes of four cancer resections (lung, esophagus, pancreas, and bladder) and of repair of abdominal aortic aneurysm (AAA) rose substantially. Depending on the procedure, higher hospital volumes were attributable to an increasing number of cases nationwide, an increasing market concentration, or both. Hospital volumes rose slightly for aortic-valve replacement but fell for coronary-artery bypass grafting and carotid endarterectomy. Operative mortality declined for all eight procedures, ranging from a relative decline of 8% for carotid endarterectomy (1.3% mortality in 1999 and 1.2% in 2008) to 36% for AAA repair (4.4% in 1999 and 2.8% in 2008). Higher hospital volumes explained a large portion of the decline in mortality for pancreatectomy (67% of the decline), cystectomy (37%), and esophagectomy (32%), but not for the other procedures. CONCLUSIONS Operative mortality with high-risk surgery fell substantially during the previous decade. Although increased market concentration and hospital volume have contributed to declining mortality with some high-risk cancer operations, declines in mortality with other procedures are largely attributable to other factors. (Funded by the National Institute on Aging.) PMID:21631325

  13. Influence of national centralization of oesophagogastric cancer on management and clinical outcome from emergency upper gastrointestinal conditions.

    PubMed

    Markar, S R; Mackenzie, H; Wiggins, T; Askari, A; Karthikesalingam, A; Faiz, O; Griffin, S M; Birkmeyer, J D; Hanna, G B

    2018-01-01

    In England in 2001 oesophagogastric cancer surgery was centralized. The aim of this study was to evaluate whether centralization of oesophagogastric cancer to high-volume centres has had an effect on mortality from different emergency upper gastrointestinal conditions. The Hospital Episode Statistics database was used to identify patients admitted to hospitals in England (1997-2012). The influence of oesophagogastric high-volume cancer centre status (20 or more resections per year) on 30- and 90-day mortality from oesophageal perforation, paraoesophageal hernia and perforated peptic ulcer was analysed. Over the study interval, 3707, 12 441 and 56 822 patients with oesophageal perforation, paraoesophageal hernia and perforated peptic ulcer respectively were included. There was a passive centralization to high-volume cancer centres for oesophageal perforation (26·9 per cent increase), paraoesophageal hernia (19·5 per cent increase) and perforated peptic ulcer (23·0 per cent increase). Management of oesophageal perforation in high-volume centres was associated with a reduction in 30-day (HR 0·58, 95 per cent c.i. 0·45 to 0·74) and 90-day (HR 0·62, 0·49 to 0·77) mortality. High-volume cancer centre status did not affect mortality from paraoesophageal hernia or perforated peptic ulcer. Annual emergency admission volume thresholds at which mortality improved were observed for oesophageal perforation (5 patients) and paraoesophageal hernia (11). Following centralization, the proportion of patients managed in high-volume cancer centres that reached this volume threshold was 88·0 per cent for oesophageal perforation, but only 30·3 per cent for paraoesophageal hernia. Centralization of low incidence conditions such as oesophageal perforation to high-volume cancer centres provides a greater level of expertise and ultimately reduces mortality. © 2017 BJS Society Ltd Published by John Wiley & Sons Ltd.

  14. Variation in critical care unit admission rates and outcomes for patients with acute coronary syndromes or heart failure among high- and low-volume cardiac hospitals.

    PubMed

    van Diepen, Sean; Bakal, Jeffrey A; Lin, Meng; Kaul, Padma; McAlister, Finlay A; Ezekowitz, Justin A

    2015-02-27

    Little is known about cross-hospital differences in critical care units admission rates and related resource utilization and outcomes among patients hospitalized with acute coronary syndromes (ACS) or heart failure (HF). Using a population-based sample of 16,078 patients admitted to a critical care unit with a primary diagnosis of ACS (n=14,610) or HF (n=1467) between April 1, 2003 and March 31, 2013 in Alberta, Canada, we stratified hospitals into high (>250), medium (200 to 250), or low (<200) volume based on their annual volume of all ACS and HF hospitalization. The percentage of hospitalized patients admitted to critical care units varied across low, medium, and high-volume hospitals for both ACS and HF as follows: 77.9%, 81.3%, and 76.3% (P<0.001), and 18.0%, 16.3%, and 13.0% (P<0.001), respectively. Compared to low-volume units, critical care patients with ACS and HF admitted to high-volume hospitals had shorter mean critical care stays (56.6 versus 95.6 hours, P<0.001), more critical care procedures (1.9 versus 1.2 per patient, <0.001), and higher resource-intensive weighting (2.8 versus 1.5, P<0.001). No differences in in-hospital mortality (5.5% versus 6.2%, adjusted odds ratio 0.93; 95% CI, 0.61 to 1.41) were observed between high- and low-volume hospitals; however, 30-day cardiovascular readmissions (4.6% versus 6.8%, odds ratio 0.77; 95% CI, 0.60 to 0.99) and cardiovascular emergency-room visits (6.6% versus 9.5%, odds ratio 0.80; 95% CI, 0.69 to 0.94) were lower in high-volume compared to low-volume hospitals. Outcomes stratified by ACS or HF admission diagnosis were similar. Cardiac patients hospitalized in low-volume hospitals were more frequently admitted to critical care units and had longer hospitals stays despite lower resource-intensive weighting. These findings may provide opportunities to standardize critical care utilization for ACS and HF patients across high- and low-volume hospitals. © 2015 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley Blackwell.

  15. Volume vs. intensity in the training of competitive swimmers.

    PubMed

    Faude, O; Meyer, T; Scharhag, J; Weins, F; Urhausen, A; Kindermann, W

    2008-11-01

    The present study aimed at comparing a high-volume, low-intensity vs. low-volume, high-intensity swim training. In a randomized cross-over design, 10 competitive swimmers performed two different 4-week training periods, each followed by an identical taper week. One training period was characterized by a high-training volume (HVT) whereas high-intensity training was prevalent during the other program (HIT). Before, after two and four weeks and after the taper week subjects performed psychometric and performance testing: profile of mood states (POMS), incremental swimming test (determination of individual anaerobic threshold, IAT), 100 m and 400 m. A small significant increase in IAT was observed after taper periods compared to pre-training (+ 0.01 m/s; p = 0.01). Maximal 100-m and 400-m times were not significantly affected by training. The POMS subscore of "vigor" decreased slightly after both training periods (p = 0.06). None of the investigated parameters showed a significant interaction between test-time and training type (p > 0.13). Nearly all (83 %) subjects swam personal best times during the 3 months after each training cycle. It is concluded that, for a period of 4 weeks, high-training volumes have no advantage compared to high-intensity training of lower volume.

  16. Renewable Electricity Futures Study - Volume One

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

    Hand, Maureen; Mai, Treui; Baldwin, Sam

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

  17. A program for calculating load coefficient matrices utilizing the force summation method, L218 (LOADS). Volume 1: Engineering and usage

    NASA Technical Reports Server (NTRS)

    Miller, R. D.; Anderson, L. R.

    1979-01-01

    The LOADS program L218, a digital computer program that calculates dynamic load coefficient matrices utilizing the force summation method, is described. The load equations are derived for a flight vehicle in straight and level flight and excited by gusts and/or control motions. In addition, sensor equations are calculated for use with an active control system. The load coefficient matrices are calculated for the following types of loads: translational and rotational accelerations, velocities, and displacements; panel aerodynamic forces; net panel forces; shears and moments. Program usage and a brief description of the analysis used are presented. A description of the design and structure of the program to aid those who will maintain and/or modify the program in the future is included.

  18. New laser technologies in the clinic of neurosurgery

    NASA Astrophysics Data System (ADS)

    Stupak, V. V.; Fomichev, N. G.; Tsvetovsky, S. B.; Dmitriev, A. B.; Kobosev, V. V.; Bagaev, S. N.; Mayorov, A. P.; Struts, S. G.

    2005-08-01

    In report summarized more then 10 experience of authors in Novosibirsk Traumatology and orthopedics research institute Neurosurgery clinic on usage of laser technologies in treatment of central nervous system tumors. On the basis of ND-YAG laser application original technologies have been developed and used in surgical treatment of patients with various neurosurgical pathology and protected by 8 Patents of the Russian Federation. 427 patients were operated on with the use of YAG:Nd3+ laser. Out of them 152 patients had extracerebral tumors of various volume and localization, 135 patients - spinal cord tumors, 74 patients - a pathology of cerebrospinal transition (Amold-Chiari syndrome of 1-2 types), and 66 patients - intramedullary tumors of deep localization. Results showed good results of laser technologies usage for central nervous system tumors removal.

  19. Rapid coupling between ice volume and polar temperature over the past 150,000 years.

    PubMed

    Grant, K M; Rohling, E J; Bar-Matthews, M; Ayalon, A; Medina-Elizalde, M; Ramsey, C Bronk; Satow, C; Roberts, A P

    2012-11-29

    Current global warming necessitates a detailed understanding of the relationships between climate and global ice volume. Highly resolved and continuous sea-level records are essential for quantifying ice-volume changes. However, an unbiased study of the timing of past ice-volume changes, relative to polar climate change, has so far been impossible because available sea-level records either were dated by using orbital tuning or ice-core timescales, or were discontinuous in time. Here we present an independent dating of a continuous, high-resolution sea-level record in millennial-scale detail throughout the past 150,000 years. We find that the timing of ice-volume fluctuations agrees well with that of variations in Antarctic climate and especially Greenland climate. Amplitudes of ice-volume fluctuations more closely match Antarctic (rather than Greenland) climate changes. Polar climate and ice-volume changes, and their rates of change, are found to covary within centennial response times. Finally, rates of sea-level rise reached at least 1.2 m per century during all major episodes of ice-volume reduction.

  20. The effects of low tidal ventilation on lung strain correlate with respiratory system compliance.

    PubMed

    Xie, Jianfeng; Jin, Fang; Pan, Chun; Liu, Songqiao; Liu, Ling; Xu, Jingyuan; Yang, Yi; Qiu, Haibo

    2017-02-03

    The effect of alterations in tidal volume on mortality of acute respiratory distress syndrome (ARDS) is determined by respiratory system compliance. We aimed to investigate the effects of different tidal volumes on lung strain in ARDS patients who had various levels of respiratory system compliance. Nineteen patients were divided into high (C high group) and low (C low group) respiratory system compliance groups based on their respiratory system compliance values. We defined compliance ≥0.6 ml/(cmH 2 O/kg) as C high and compliance <0.6 ml/(cmH 2 O/kg) as C low . End-expiratory lung volumes (EELV) at various tidal volumes were measured by nitrogen wash-in/washout. Lung strain was calculated as the ratio between tidal volume and EELV. The primary outcome was that lung strain is a function of tidal volume in patients with various levels of respiratory system compliance. The mean baseline EELV, strain and respiratory system compliance values were 1873 ml, 0.31 and 0.65 ml/(cmH 2 O/kg), respectively; differences in all of these parameters were statistically significant between the two groups. For all participants, a positive correlation was found between the respiratory system compliance and EELV (R = 0.488, p = 0.034). Driving pressure and strain increased together as the tidal volume increased from 6 ml/kg predicted body weight (PBW) to 12 ml/kg PBW. Compared to the C high ARDS patients, the driving pressure was significantly higher in the C low patients at each tidal volume. Similar effects of lung strain were found for tidal volumes of 6 and 8 ml/kg PBW. The "lung injury" limits for driving pressure and lung strain were much easier to exceed with increases in the tidal volume in C low patients. Respiratory system compliance affected the relationships between tidal volume and driving pressure and lung strain in ARDS patients. These results showed that increasing tidal volume induced lung injury more easily in patients with low respiratory system compliance. Clinicaltrials.gov identifier NCT01864668 , Registered 21 May 2013.

  1. The Centralization of Total Joint Arthroplasty in New York State An Analysis of 168,247 Cases.

    PubMed

    Adrados, Murillo; Theobald, Jason; Hutzler, Lorraine; Bosco, Joseph

    2016-11-01

    We identified 168,247 total hip and total knee arthroplasties performed in New York State between 2010 and 2012 to examine the evidence for increased geographical and institutional centralization of these procedures. We measured the increased growth of high volume institutions as compared to lower volume hospitals in New York State. We found a high proportion of total arthroplasties already performed in the dozen biggest hospitals in New York back in 2010 and a significant higher growth of these high volume, "centers of excellence," hospitals when compared to low volume hospitals.

  2. Brain morphology in older African Americans, Caribbean Hispanics, and whites from northern Manhattan.

    PubMed

    Brickman, Adam M; Schupf, Nicole; Manly, Jennifer J; Luchsinger, José A; Andrews, Howard; Tang, Ming X; Reitz, Christiane; Small, Scott A; Mayeux, Richard; DeCarli, Charles; Brown, Truman R

    2008-08-01

    Aging is accompanied by a decrease in brain volume and by an increase in cerebrovascular disease. To examine the effects of age, sex, race/ethnicity, and vascular disease history on measures of brain morphology, including relative brain volume, ventricular volume, hippocampus and entorhinal cortex volumes, and white matter hyperintensity (WMH) burden, in a large community-based cohort of racially/ethnically diverse older adults without dementia. The associations of age, sex, race/ethnicity, and self-reported vascular disease history with brain morphology were examined in a cross-sectional study using multiple linear regression analyses. Sex x race/ethnicity interactions were also considered. The Washington Heights-Inwood Columbia Aging Project, a community-based epidemiological study of older adults from 3 racial/ethnic groups (white, Hispanic, and African American) from northern Manhattan. Beginning in 2003, high-resolution quantitative magnetic resonance (MR) images were acquired in 769 participants without dementia. Relative brain volume (total brain volume/intracranial volume), ventricular volume, and hippocampus and entorhinal cortex volumes were derived manually on high-resolution MR images. White matter hyperintensities were quantified semiautomatically on fluid-attenuated inversion recovery-T2-weighted MR images. Older age was associated with decreased relative brain volume and with increased ventricular and WMH volumes. Hispanic and African American participants had larger relative brain volumes and more severe WMH burden than white participants, but the associations of these variables with age were similar across racial/ethnic groups. Compared with men, women had larger relative brain volumes. Vascular disease was associated with smaller relative brain volume and with higher WMH burden, particularly among African Americans. Older age and vascular disease, particularly among African Americans, are associated with increased brain atrophy and WMH burden. African American and Hispanic subjects have larger relative brain volumes and more WMH than white subjects. Racial/ethnic group differences in WMH severity seem to be partially attributable to differences in vascular disease. Future work will focus on the determinants and cognitive correlates of these differences.

  3. Statistics usage in the American Journal of Obstetrics and Gynecology: has anything changed?

    PubMed

    Welch, Gerald E; Gabbe, Steven G

    2002-03-01

    Our purpose was to compare statistical listing and usage between articles published in the American Journal of Obstetrics and Gynecology in 1994 with those published in 1999. All papers included in the obstetrics, fetus-placenta-newborn, and gynecology sections and the transactions of societies sections of the January through June 1999 issues of the American Journal of Obstetrics and Gynecology (volume 180, numbers 1 to 6) were reviewed for statistical usage. Each paper was given a rating for the cataloging of applied statistics and a rating for the appropriateness of statistical usage, when possible. These results were compared with the data collected on a similar review of articles published in 1994. Of the 238 available articles, 195 contained statistics and were reviewed. In comparison to the articles published in 1994, there were significantly more articles that completely cataloged applied statistics (74.3% vs 47.4%) (P <.0001), and there was a significant improvement in appropriateness of statistical usage (56.4% vs 30.3%) (P <.0001). Changes in the Instructions to Authors regarding the description of applied statistics and probable changes in the behavior of researchers and Editors have led to an improvement in the quality of statistics in papers published in the American Journal of Obstetrics and Gynecology.

  4. Indicators for the Data Usage Index (DUI): an incentive for publishing primary biodiversity data through global information infrastructure

    PubMed Central

    2011-01-01

    Background A professional recognition mechanism is required to encourage expedited publishing of an adequate volume of 'fit-for-use' biodiversity data. As a component of such a recognition mechanism, we propose the development of the Data Usage Index (DUI) to demonstrate to data publishers that their efforts of creating biodiversity datasets have impact by being accessed and used by a wide spectrum of user communities. Discussion We propose and give examples of a range of 14 absolute and normalized biodiversity dataset usage indicators for the development of a DUI based on search events and dataset download instances. The DUI is proposed to include relative as well as species profile weighted comparative indicators. Conclusions We believe that in addition to the recognition to the data publisher and all players involved in the data life cycle, a DUI will also provide much needed yet novel insight into how users use primary biodiversity data. A DUI consisting of a range of usage indicators obtained from the GBIF network and other relevant access points is within reach. The usage of biodiversity datasets leads to the development of a family of indicators in line with well known citation-based measurements of recognition. PMID:22373200

  5. Impact of case volume on survival of septic shock in patients with malignancies.

    PubMed

    Zuber, Benjamin; Tran, Thi-Chien; Aegerter, Philippe; Grimaldi, David; Charpentier, Julien; Guidet, Bertrand; Mira, Jean-Paul; Pène, Frédéric

    2012-01-01

    Septic shock is a frequent and severe complication in the course of malignancies. In a large multicenter cohort of septic shock patients with hematologic malignancies and solid tumors, we assessed the temporal trend in survival and the prognostic factors, with particular emphasis on case volume. A 12-yr multicenter retrospective cohort study of prospectively collected data. Cancer patients with septic shock were selected over a 12-yr period (1997-2008) from a French regional database (CUB-Réa). The following variables were extracted: demographic characteristics, type of malignancy, characteristics of infection, severity-of-illness score (Simplified Acute Physiology Score II), organ failure supports, and vital status. For each unit, a running mean annual volume of admissions was calculated for the purpose of categorization into volume tertiles. Prognostic factors were analyzed by a conditional multivariate logistic model after matching on a propensity score of being admitted to a high-volume unit and on the year of admission. None. A total of 3,437 patients were included in the study. The intensive care unit mortality rate dramatically dropped over time (from 70.4% in 1997 to 52.5% in 2008, relative decrease 25.4%, p < .001). Participating units were distributed into low-volume (< five patients per year), medium-volume (five to 12 patients per year), and high-volume (≥ 13 patients per year) tertiles. A medical cause for intensive care unit admission, Simplified Acute Physiology Score II, invasive mechanical ventilation, renal replacement therapy, fungal infections, and unknown microorganism were identified as poor prognostic factors. Case volume demonstrated a strong influence on survival, admission in a high-volume unit being associated with a marked decrease in mortality as compared to low-volume units (adjusted odds ratio 0.63; 95% confidence interval [0.46-0.87], p = .002). Survival of septic shock patients with malignancies markedly increased over the recent years. Furthermore, we identified case volume as a major prognostic factor in this setting.

  6. Dehydration, hemodynamics and fluid volume optimization after induction of general anesthesia.

    PubMed

    Li, Yuhong; He, Rui; Ying, Xiaojiang; Hahn, Robert G

    2014-01-01

    Fluid volume optimization guided by stroke volume measurements reduces complications of colorectal and high-risk surgeries. We studied whether dehydration or a strong hemodynamic response to general anesthesia increases the probability of fluid responsiveness before surgery begins. Cardiac output, stroke volume, central venous pressure and arterial pressures were measured in 111 patients before general anesthesia (baseline), after induction and stepwise after three bolus infusions of 3 ml/kg of 6% hydroxyethyl starch 130/0.4 (n=86) or Ringer's lactate (n=25). A subgroup of 30 patients who received starch were preloaded with 500 ml of Ringer's lactate. Blood volume changes were estimated from the hemoglobin concentration and dehydration was estimated from evidence of renal water conservation in urine samples. Induction of anesthesia decreased the stroke volume to 62% of baseline (mean); administration of fluids restored this value to 84% (starch) and 68% (Ringer's). The optimized stroke volume index was clustered around 35-40 ml/m2/beat. Additional fluid boluses increased the stroke volume by ≥10% (a sign of fluid responsiveness) in patients with dehydration, as suggested by a low cardiac index and central venous pressure at baseline and by high urinary osmolality, creatinine concentration and specific gravity. Preloading and the hemodynamic response to induction did not correlate with fluid responsiveness. The blood volume expanded 2.3 (starch) and 1.8 (Ringer's) times over the infused volume. Fluid volume optimization did not induce a hyperkinetic state but ameliorated the decrease in stroke volume caused by anesthesia. Dehydration, but not the hemodynamic response to the induction, was correlated with fluid responsiveness.

  7. Crystal plasticity modeling of β phase deformation in Ti-6Al-4V

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

    Moore, John A.; Barton, Nathan R.; Florando, Jeff

    Ti-6Al-4V is an alloy of titanium that dominates titanium usage in applications ranging from mass-produced consumer goods to high-end aerospace parts. The material's structure on a microscale is known to affect its mechanical properties but these effects are not fully understood. Specifically, this work will address the effects of low volume fraction intergranular β phase on Ti-6Al-4V's mechanical response during the transition from elastic to plastic deformation. A crystal plasticity-based finite element model is used to fully resolve the deformation of the β phase for the first time. This high fidelity model captures mechanisms difficult to access via experiments ormore » lower fidelity models. Lastly, the results are used to assess lower fidelity modeling assumptions and identify phenomena that have ramifications for failure of the material.« less

  8. Crystal plasticity modeling of β phase deformation in Ti-6Al-4V

    DOE PAGES

    Moore, John A.; Barton, Nathan R.; Florando, Jeff; ...

    2017-08-24

    Ti-6Al-4V is an alloy of titanium that dominates titanium usage in applications ranging from mass-produced consumer goods to high-end aerospace parts. The material's structure on a microscale is known to affect its mechanical properties but these effects are not fully understood. Specifically, this work will address the effects of low volume fraction intergranular β phase on Ti-6Al-4V's mechanical response during the transition from elastic to plastic deformation. A crystal plasticity-based finite element model is used to fully resolve the deformation of the β phase for the first time. This high fidelity model captures mechanisms difficult to access via experiments ormore » lower fidelity models. Lastly, the results are used to assess lower fidelity modeling assumptions and identify phenomena that have ramifications for failure of the material.« less

  9. Effect of Elevated Temperature on Mechanical Assets of Metakaolin Base Steel Fiber Reinforced Concrete

    NASA Astrophysics Data System (ADS)

    Vijay Anand, M.; Ibrahim, Azmi; Patil, Anand A.; Muthu, K. U.

    2017-06-01

    The fact of vast usage of concrete leads to important problems regarding its design and preparation of eco-friendly to obtain an economic cost of the product on varieties of time periods. Conventional ordinary Portland concrete may not able to meet its functional requisites as it found inconsistency in high temperature. The exposing of concrete structure to elevated temperature may be in case of rocket launching space ships, nuclear power plants. In this experiment, to enhance the high temperature resistance, pozzolanic materials and steel fibres are added to preserve the strength characteristics of concrete structure. In this analysis, the pozzolanic admixture MK is used as partial replacement of cementatious materials. The volume fraction of steel fibre is varied 0.25%, 0.5%, 0.75% and 1% by preserving MK as stationary for 10% replacement of cement. The strength parameters of concrete such as compressive strength, split tensile strength and flexural strength are studied.

  10. High-level waste storage tank farms/242-A evaporator Standards/Requirements Identification Document (S/RID), Volume 7. Revision 1

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

    Burt, D.L.

    1994-04-01

    The High-Level Waste Storage Tank Farms/242-A Evaporator Standards/Requirements Identification Document (S/RID) is contained in multiple volumes. This document (Volume 7) presents the standards and requirements for the following sections: Occupational Safety and Health, and Environmental Protection.

  11. Feasibility Study on Fully Automatic High Quality Translation: Volume II. Final Technical Report.

    ERIC Educational Resources Information Center

    Lehmann, Winifred P.; Stachowitz, Rolf

    This second volume of a two-volume report on a fully automatic high quality translation (FAHQT) contains relevant papers contributed by specialists on the topic of machine translation. The papers presented here cover such topics as syntactical analysis in transformational grammar and in machine translation, lexical features in translation and…

  12. Improved Homogeneity of the Transmit Field by Simultaneous Transmission with Phased Array and Volume Coil

    PubMed Central

    Avdievich, Nikolai I.; Oh, Suk-Hoon; Hetherington, Hoby P.; Collins, Christopher M.

    2010-01-01

    Purpose To improve the homogeneity of transmit volume coils at high magnetic fields (≥ 4 T). Due to RF field/ tissue interactions at high fields, 4–8 T, the transmit profile from head-sized volume coils shows a distinctive pattern with relatively strong RF magnetic field B1 in the center of the brain. Materials and Methods In contrast to conventional volume coils at high field strengths, surface coil phased arrays can provide increased RF field strength peripherally. In theory, simultaneous transmission from these two devices could produce a more homogeneous transmission field. To minimize interactions between the phased array and the volume coil, counter rotating current (CRC) surface coils consisting of two parallel rings carrying opposite currents were used for the phased array. Results Numerical simulations and experimental data demonstrate that substantial improvements in transmit field homogeneity can be obtained. Conclusion We have demonstrated the feasibility of using simultaneous transmission with human head-sized volume coils and CRC phased arrays to improve homogeneity of the transmit RF B1 field for high-field MRI systems. PMID:20677280

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

    PubMed Central

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

    2016-01-01

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

  14. What drives the prescribing of growth hormone preparations in England? Prices versus patient preferences

    PubMed Central

    Chapman, Stephen R; Fitzpatrick, Raymond W; Aladul, Mohammed I

    2017-01-01

    Objective The patent expiry of a number of biological medicines and the advent of biosimilars raised the expectations of healthcare commissioners that biosimilars would reduce the high cost of these medicines and produce potential savings to the NHS. We aimed to examine the prescribing pattern of different growth hormone preparations (ready to use and reconstitution requiring) in primary and secondary care in England to determine relative rates of decrease or increase and identify the possible factors influencing prescribing following the introduction of biosimilar growth hormone in 2008. Design Longitudinal observational study. Setting and data sources Primary care prescribing cost and volume data was derived from the NHS business services authority website, and for secondary care from the DEFINE database, between April 2011 and December 2015. Outcomes Quarterly prescribing analysis to examine trends and measure the relationship between usage and price. Results Expenditure and usage of growth hormone in primary care decreased by 17.91% and 7.29%, respectively, whereas expenditure and usage in secondary care increased by 68.41% and 100%, respectively, between April 2011 and December 2015. The usage of reconstitution requiring products significantly declined in primary care (R²=0.9292) and slightly increased in use in secondary care (R²=0.139). In contrast, the usage of ready-to-use products significantly increased in use in primary (R²=0.7526) and secondary care (R²=0.9633), respectively. Weak or no correlation existed between the usage and price of growth hormone preparations in primary and secondary care. Conclusions The price of growth hormone products was not the key factor influencing the prescribing of the biological medicines. The main driver for specific product selection was the ease of use and the number of steps in dose preparation. Prescribers appear to be taking into account patient preferences rather than cost in their prescribing decisions. PMID:28400458

  15. What drives the prescribing of growth hormone preparations in England? Prices versus patient preferences.

    PubMed

    Chapman, Stephen R; Fitzpatrick, Raymond W; Aladul, Mohammed I

    2017-04-11

    The patent expiry of a number of biological medicines and the advent of biosimilars raised the expectations of healthcare commissioners that biosimilars would reduce the high cost of these medicines and produce potential savings to the NHS. We aimed to examine the prescribing pattern of different growth hormone preparations (ready to use and reconstitution requiring) in primary and secondary care in England to determine relative rates of decrease or increase and identify the possible factors influencing prescribing following the introduction of biosimilar growth hormone in 2008. Longitudinal observational study. Primary care prescribing cost and volume data was derived from the NHS business services authority website, and for secondary care from the DEFINE database, between April 2011 and December 2015. Quarterly prescribing analysis to examine trends and measure the relationship between usage and price. Expenditure and usage of growth hormone in primary care decreased by 17.91% and 7.29%, respectively, whereas expenditure and usage in secondary care increased by 68.41% and 100%, respectively, between April 2011 and December 2015. The usage of reconstitution requiring products significantly declined in primary care (R²=0.9292) and slightly increased in use in secondary care (R²=0.139). In contrast, the usage of ready-to-use products significantly increased in use in primary (R²=0.7526) and secondary care (R²=0.9633), respectively. Weak or no correlation existed between the usage and price of growth hormone preparations in primary and secondary care. The price of growth hormone products was not the key factor influencing the prescribing of the biological medicines. The main driver for specific product selection was the ease of use and the number of steps in dose preparation. Prescribers appear to be taking into account patient preferences rather than cost in their prescribing decisions. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  16. Linear alkylbenzene sulfonates (LAS) in sewage sludges, soils and sediments: analytical determination and environmental safety considerations.

    PubMed

    De Henau, H; Mathijs, E; Hopping, W D

    1986-01-01

    Linear Alkylbenzenesulphonates (LAS), a major anionic surfactant used in laundry products, can be measured specifically in the environment by instrumental analysis. In addition to a desulphonation-gas chromatography approach, a method based on high performance liquid chromatography has been developed. The main features of the methods are outlined, and LAS concentrations measured in sewage sludge, sediments and sludge amended soils are reported. Knowledge of usage volumes, sewage treatment practices and environmental transport and transformation mechanisms has been used to predict concentrations of LAS. These calculated concentrations were found to agree well with those actually measured in the environment. Both measured and calculated ambient concentrations of LAS are below those which could produce potentially adverse effects in representative surface water, benthic and terrestrial organisms.

  17. A knowledge-based approach to configuration layout, justification, and documentation

    NASA Technical Reports Server (NTRS)

    Craig, F. G.; Cutts, D. E.; Fennel, T. R.; Case, C.; Palmer, J. R.

    1990-01-01

    The design, development, and implementation is described of a prototype expert system which could aid designers and system engineers in the placement of racks aboard modules on Space Station Freedom. This type of problem is relevant to any program with multiple constraints and requirements demanding solutions which minimize usage of limited resources. This process is generally performed by a single, highly experienced engineer who integrates all the diverse mission requirements and limitations, and develops an overall technical solution which meets program and system requirements with minimal cost, weight, volume, power, etc. This system architect performs an intellectual integration process in which the underlying design rationale is often not fully documented. This is a situation which lends itself to an expert system solution for enhanced consistency, thoroughness, documentation, and change assessment capabilities.

  18. A Knowledge-Based Approach to Configuration Layout, Justification, and Documentation

    NASA Technical Reports Server (NTRS)

    Craig, F. G.; Cutts, D. E.; Fennel, T. R.; Case, C. M.; Palmer, J. R.

    1991-01-01

    The design, development, and implementation of a prototype expert system which could aid designers and system engineers in the placement of racks aboard modules on the Space Station Freedom are described. This type of problem is relevant to any program with multiple constraints and requirements demanding solutions which minimize usage of limited resources. This process is generally performed by a single, highly experienced engineer who integrates all the diverse mission requirements and limitations, and develops an overall technical solution which meets program and system requirements with minimal cost, weight, volume, power, etc. This system architect performs an intellectual integration process in which the underlying design rationale is often not fully documented. This is a situation which lends itself to an expert system solution for enhanced consistency, thoroughness, documentation, and change assessment capabilities.

  19. Systems aspects of COBE science data compression

    NASA Technical Reports Server (NTRS)

    Freedman, I.; Boggess, E.; Seiler, E.

    1993-01-01

    A general approach to compression of diverse data from large scientific projects has been developed and this paper addresses the appropriate system and scientific constraints together with the algorithm development and test strategy. This framework has been implemented for the COsmic Background Explorer spacecraft (COBE) by retrofitting the existing VAS-based data management system with high-performance compression software permitting random access to the data. Algorithms which incorporate scientific knowledge and consume relatively few system resources are preferred over ad hoc methods. COBE exceeded its planned storage by a large and growing factor and the retrieval of data significantly affects the processing, delaying the availability of data for scientific usage and software test. Embedded compression software is planned to make the project tractable by reducing the data storage volume to an acceptable level during normal processing.

  20. The Acoustic Model Evaluation Committee (AMEC) Reports. Volume 3. Evaluation of the RAYMODE X Propagation Loss Model. Book 1

    DTIC Science & Technology

    1982-09-01

    and run on single sound speed profile. This model the UNIVAC 1108 computer. Other RAYMODE is in exteasive fleet usage, supporting versions were not...sought for significant disparities. (U) In addition to a sound speed versus depth or temperature versus depth plus a (U) Taken together, the two accuracy...as- constant salinity value, the program can sessment techniques, the Difference and access historical sound speed data FOM techniques, lead to

  1. Shuttle cryogenic supply system optimization study. Volume 4: Cryogenic cooling in environmental control systems

    NASA Technical Reports Server (NTRS)

    1973-01-01

    An analysis of cryogenic fluid cooling in the environmental control system of the space shuttle was conducted. The technique for treating the cryogenic fluid storage and supply tanks and subsystems as integrated systems was developed. It was concluded that a basic incompatibility exists between the heat generated and the cryogen usage rate and cryogens cannot be used to absorb the generated heat. The use of radiators and accumulators to provide additional cooling capability is recommended.

  2. Aircrew Automated Escape Systems (AAES) In-Service Usage Data Analyses. Volume 1. Papers Presented at the Annual SAFE Symposium (21st), San Antonio, Texas, 5,6,7,8 November 1983.

    DTIC Science & Technology

    1983-11-05

    NECK INJURIES, ANTHROPOMETRY . MAINTENANCE, AIRCREW LIFE SUPPORT SYSTEMS, EJECTION INJURIES, FLIGHT SURGEON’S REPORT I ABSTRACT (Continue en reverse...AND TUMBLE: fACTORS INFLUENCING FREQUENCY AND SEVERITY OF NECK INJURIES SUS- TAINED BY EJECTEES; JFISNAP AIMCREW ANTHROPOMETRY ANALYSIS AND SCREENING...1979 ....................................... 1-281 U.S. Navy Aviation Mishap Aircrew Anthropometry ; 1 January 1969 through 31 December 1979

  3. Functional requirements for onboard management of space shuttle consumables, volume 2.

    NASA Technical Reports Server (NTRS)

    Graf, P. J.; Herwig, H. A.; Neel, L. W.

    1973-01-01

    A study was conducted to develop the functional requirements for onboard management of space shuttle consumables. A specific consumables management concept for the space shuttle vehicle was developed and the functional requirements for the onboard portion of the concept were generated. Consumables management is the process of controlling or influencing the usage of expendable materials involved in vehicle subsystem operation. The subsystems considered in the study are: (1) propulsion, (2) power generation, and (3) environmental and life support.

  4. KAPSE (Kernel ADA Programming Support Environment) Interface Team Public Report. Volume 5.

    DTIC Science & Technology

    1985-08-01

    Computer Nons , April 1964. e The K Ma policy statent mde the Language Control Fcility Newsletter for the Ada Jovial Wmkng Group. e There will be a CRIS...cre-ed, the initial access control inA-mIion my be splied by the ACCSS parmeter. If non -nll, this parumter speci fi the initia access tolicontr olti...assigned, or controlled by the operating system to &,.sure consistent and non -conflicting usage by programs under execution. Examples of resources

  5. Command Control Group Behaviors. Objective 2. Command Control Training with Simulations

    DTIC Science & Technology

    1984-08-01

    made to Fort Leavenworth to obtain background information on simulation activities and2 usage, ARTEPs, and other related Army activities such as C SPR...Year Three, with the various volumes focusing on one or more key aspects of training with simulations. 1.5 RELATED ACTIVITIES As the research of Year...One was being conducted, it became apparent that a number of on-going Army activities may impact the final pr3duct and therefore have been, and

  6. Analysis of Defects in Trouser Manufacturing: Development of a Knowledge-Based Framework. Volume 1. Final Technical Report

    DTIC Science & Technology

    1992-02-28

    the primary goal of instituting remedial measures. Many apparel plants, as they function today in the United States, do not maintain an accu- rate...type of usage is the primary functional mode for FDAS. Alternatively, the user could suggest a defect to FDAS and let it find out if the defect is...Endeavor The primary objective of the research effort is to develop a knowledge-based system to an- alyze the causes of defects in apparel

  7. Three-dimensional Analysis of Nanomaterials by Scanning Probe Nanotomography

    NASA Astrophysics Data System (ADS)

    Efimov, Anton E.; Agapova, Olga I.; Mochalov, Konstantin E.; Agapov, Igor I.

    Micro and nanostructure of scaffolds made from fibroin of Bombyx mori silkworm by salt leaching technique was studied by scanning probe nanotomography. Nanopores with dimensions in range from 30 to 180 nm are observed in the scaffold volume. Three - dimensional analysis of obtained data shows that degree of scaffold nanoporosity is 0.5% and nanopores are not interconnected with each other. Usage of scanning probe nanotomography technique enables to obtain unique nanoscale information of 3D structure of biopolymer nanomaterials.

  8. Arm Volumetry Versus Upper Extremity Lymphedema Index: Validity of Upper Extremity Lymphedema Index for Body-Type Corrected Arm Volume Evaluation.

    PubMed

    Yamamoto, Nana; Yamamoto, Takumi; Hayashi, Nobuko; Hayashi, Akitatsu; Iida, Takuya; Koshima, Isao

    2016-06-01

    Volumetry, measurement of extremity volume, is a commonly used method for upper extremity lymphedema (UEL) evaluation. However, comparison between different patients with different physiques is difficult with volumetry, because body-type difference greatly affects arm volume. Seventy arms of 35 participants who had no history of arm edema or breast cancer were evaluated. Arm volume was calculated using a summed truncated cone model, and UEL index was calculated using circumferences and body mass index (BMI). Examinees' BMI was classified into 3 groups, namely, low BMI (BMI, <20 kg/m), middle BMI (BMI, 20-25 kg/m), and high BMI (BMI, >25 kg/m). Arm volume and UEL index were compared with corresponding BMI groups. Mean (SD) arm volume was 1090.9 (205.5) mL, and UEL index 96.9 (5.6). There were significant differences in arm volume between BMI groups [low BMI vs middle BMI vs high BMI, 945.2 (107.4) vs 1045.2 (87.5) vs 1443.1 (244.4) mL, P < 0.001]. There was no significant difference in UEL index between BMI groups [low BMI vs middle BMI vs high BMI, 97.2 (4.2) vs 96.6 (4.6) vs 96.7 (9.9), P > 0.5]. Arm volume significantly increased with increase of BMI, whereas UEL index stayed constant regardless of BMI. Upper extremity lymphedema index would allow better body-type corrected arm volume evaluation compared with arm volumetry.

  9. [Again review of research design and statistical methods of Chinese Journal of Cardiology].

    PubMed

    Kong, Qun-yu; Yu, Jin-ming; Jia, Gong-xian; Lin, Fan-li

    2012-11-01

    To re-evaluate and compare the research design and the use of statistical methods in Chinese Journal of Cardiology. Summary the research design and statistical methods in all of the original papers in Chinese Journal of Cardiology all over the year of 2011, and compared the result with the evaluation of 2008. (1) There is no difference in the distribution of the design of researches of between the two volumes. Compared with the early volume, the use of survival regression and non-parameter test are increased, while decreased in the proportion of articles with no statistical analysis. (2) The proportions of articles in the later volume are significant lower than the former, such as 6(4%) with flaws in designs, 5(3%) with flaws in the expressions, 9(5%) with the incomplete of analysis. (3) The rate of correction of variance analysis has been increased, so as the multi-group comparisons and the test of normality. The error rate of usage has been decreased form 17% to 25% without significance in statistics due to the ignorance of the test of homogeneity of variance. Many improvements showed in Chinese Journal of Cardiology such as the regulation of the design and statistics. The homogeneity of variance should be paid more attention in the further application.

  10. Perioperative fluid management: comparison of high, medium and low fluid volume on tissue oxygen pressure in the small bowel and colon.

    PubMed

    Hiltebrand, L B; Pestel, G; Hager, H; Ratnaraj, J; Sigurdsson, G H; Kurz, A

    2007-11-01

    Insufficient blood flow and oxygenation in the intestinal tract is associated with increased incidence of postoperative complications after bowel surgery. High fluid volume administration may prevent occult regional hypoperfusion and intestinal tissue hypoxia. We tested the hypothesis that high intraoperative fluid volume administration increases intestinal wall tissue oxygen pressure during laparotomy. In all, 27 pigs were anaesthetized, ventilated and randomly assigned to one of the three treatment groups (n = 9 in each) receiving low (3 mL kg-1 h-1), medium (7 mL kg-1 h-1) or high (20 mL kg-1 h-1) fluid volume treatment with lactated Ringer's solution. All animals received 30% and 100% inspired oxygen in random order. Cardiac index was measured with thermodilution and tissue oxygen pressure with a micro-oximetry system in the jejunum and colon wall and subcutaneous tissue. Groups receiving low and medium fluid volume treatment had similar systemic haemodynamics. The high fluid volume group had significantly higher mean arterial pressure, cardiac index and subcutaneous tissue oxygenation. Tissue oxygen pressures in the jejunum and colon were comparable in all three groups. The three different fluid volume regimens tested did not affect tissue oxygen pressure in the jejunum and colon, suggesting efficient autoregulation of intestinal blood flow in healthy subjects undergoing uncomplicated abdominal surgery.

  11. Going the Extra Mile: Improved Survival for Pancreatic Cancer Patients Traveling to High-volume Centers.

    PubMed

    Lidsky, Michael E; Sun, Zhifei; Nussbaum, Daniel P; Adam, Mohamed A; Speicher, Paul J; Blazer, Dan G

    2017-08-01

    This study compares outcomes following pancreaticoduodenectomy (PD) for patients treated at local, low-volume centers and those traveling to high-volume centers. Although outcomes for PD are superior at high-volume institutions, not all patients live in proximity to major medical centers. Theoretical advantages for undergoing surgery locally exist. The 1998 to 2012 National Cancer Data Base was queried for T1-3N0-1M0 pancreatic adenocarcinoma patients who underwent PD. Travel distances to treatment centers were calculated. Overlaying the upper and lower quartiles of travel distance with institutional volume established short travel/low-volume (ST/LV) and long travel/high-volume (LT/HV) cohorts. Overall survival was evaluated. Of 7086 patients, 773 ST/LV patients traveled ≤6.3 (median 3.2) miles to centers performing ≤3.3 PDs yearly, and 758 LT/HV patients traveled ≥45 (median 97.3) miles to centers performing ≥16 PDs yearly. LT/HV patients had higher stage disease (P < 0.001), but lower margin positivity (20.5% vs 25.9%, P = 0.01) and improved lymphadenectomy (16 vs 11 nodes, P < 0.01). Moreover, LT/HV patients had shorter hospitalizations (9 vs 12 days, P < 0.01) and lower 30-day mortality (2.0% vs 6.3%, P < 0.01) with similar 30-day readmission rates (10.1% vs 9.8%, P = 0.83). Despite more advanced disease, LT/HV patients had superior unadjusted survival (20.3 vs 15.7 months). After adjustment, travel to a high-volume center remained associated with reduced long-term mortality (hazard ratio 0.75, P < 0.01). Despite an increased travel burden, patients treated at high-volume centers had improved perioperative outcomes, short-term mortality, and overall survival. These data support ongoing efforts to centralize care for patients undergoing PD.

  12. CT volumetry of the skeletal tissues

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

    Brindle, James M.; Alexandre Trindade, A.; Pichardo, Jose C.

    2006-10-15

    Computed tomography (CT) is an important and widely used modality in the diagnosis and treatment of various cancers. In the field of molecular radiotherapy, the use of spongiosa volume (combined tissues of the bone marrow and bone trabeculae) has been suggested as a means to improve the patient-specificity of bone marrow dose estimates. The noninvasive estimation of an organ volume comes with some degree of error or variation from the true organ volume. The present study explores the ability to obtain estimates of spongiosa volume or its surrogate via manual image segmentation. The variation among different segmentation raters was exploredmore » and found not to be statistically significant (p value >0.05). Accuracy was assessed by having several raters manually segment a polyvinyl chloride (PVC) pipe with known volumes. Segmentation of the outer region of the PVC pipe resulted in mean percent errors as great as 15% while segmentation of the pipe's inner region resulted in mean percent errors within {approx}5%. Differences between volumes estimated with the high-resolution CT data set (typical of ex vivo skeletal scans) and the low-resolution CT data set (typical of in vivo skeletal scans) were also explored using both patient CT images and a PVC pipe phantom. While a statistically significant difference (p value <0.002) between the high-resolution and low-resolution data sets was observed with excised femoral heads obtained following total hip arthroplasty, the mean difference between high-resolution and low-resolution data sets was found to be only 1.24 and 2.18 cm{sup 3} for spongiosa and cortical bone, respectively. With respect to differences observed with the PVC pipe, the variation between the high-resolution and low-resolution mean percent errors was a high as {approx}20% for the outer region volume estimates and only as high as {approx}6% for the inner region volume estimates. The findings from this study suggest that manual segmentation is a reasonably accurate and reliable means for the in vivo estimation of spongiosa volume. This work also provides a foundation for future studies where spongiosa volumes are estimated by various raters in more comprehensive CT data sets.« less

  13. Dosimetric comparison of a 6-MV flattening-filter and a flattening-filter-free beam for lung stereotactic ablative radiotherapy treatment

    NASA Astrophysics Data System (ADS)

    Kim, Yon-Lae; Chung, Jin-Beom; Kim, Jae-Sung; Lee, Jeong-Woo; Kim, Jin-Young; Kang, Sang-Won; Suh, Tae-Suk

    2015-11-01

    The purpose of this study was to test the feasibility of clinical usage of a flattening-filter-free (FFF) beam for treatment with lung stereotactic ablative radiotherapy (SABR). Ten patients were treated with SABR and a 6-MV FFF beam for this study. All plans using volumetric modulated arc therapy (VMAT) were optimized in the Eclipse treatment planning system (TPS) by using the Acuros XB (AXB) dose calculation algorithm and were delivered by using a Varian TrueBeam ™ linear accelerator equipped with a high-definition (HD) multi-leaf collimator. The prescription dose used was 48 Gy in 4 fractions. In order to compare the plan using a conventional 6-MV flattening-filter (FF) beam, the SABR plan was recalculated under the condition of the same beam settings used in the plan employing the 6-MV FFF beam. All dose distributions were calculated by using Acuros XB (AXB, version 11) and a 2.5-mm isotropic dose grid. The cumulative dosevolume histograms (DVH) for the planning target volume (PTV) and all organs at risk (OARs) were analyzed. Technical parameters, such as total monitor units (MUs) and the delivery time, were also recorded and assessed. All plans for target volumes met the planning objectives for the PTV ( i.e., V95% > 95%) and the maximum dose ( i.e., Dmax < 110%) revealing adequate target coverage for the 6-MV FF and FFF beams. Differences in DVH for target volumes (PTV and clinical target volume (CTV)) and OARs on the lung SABR plans from the interchange of the treatment beams were small, but showed a marked reduction (52.97%) in the treatment delivery time. The SABR plan with a FFF beam required a larger number of MUs than the plan with the FF beam, and the mean difference in MUs was 4.65%. This study demonstrated that the use of the FFF beam for lung SABR plan provided better treatment efficiency relative to 6-MV FF beam. This strategy should be particularly beneficial for high dose conformity to the lung and decreased intra-fraction movements because of the shorter treatment delivery time. Future studies are necessary to assess the clinical outcome and the toxicity.

  14. Consequences of increasing convection onto patient care and protein removal in hemodialysis

    PubMed Central

    Duranton, Flore; Guzman, Caroline; Szwarc, Ilan; Vetromile, Fernando; Cazevieille, Chantal; Brunet, Philippe; Servel, Marie-Françoise; Le Quintrec, Moglie

    2017-01-01

    Introduction Recent randomised controlled trials suggest that on-line hemodiafiltration (OL-HDF) improves survival, provided that it reaches high convective volumes. However, there is scant information on the feasibility and the consequences of modifying convection volumes in clinics. Methods Twelve stable dialysis patients were treated with high-flux 1.8 m2 polysulphone dialyzers and 4 levels of convection flows (QUF) based on GKD-UF monitoring of the system, for 1 week each. The consequences on dialysis delivery (transmembrane pressure (TMP), number of alarms, % of achieved prescribed convection) and efficacy (mass removal of low and high molecular weight compounds) were analysed. Results TMP increased exponentially with QUF (p<0.001 for N >56,000 monitoring values). Beyond 21 L/session, this resulted into frequent TMP alarms requiring nursing staff interventions (mean ± SEM: 10.3 ± 2.2 alarms per session, p<0.001 compared to lower convection volumes). Optimal convection volumes as assessed by GKD-UF-max were 20.6 ± 0.4 L/session, whilst 4 supplementary litres were obtained in the maximum situation (24.5 ± 0.6 L/session) but the proportion of sessions achieving the prescribed convection volume decreased from 94% to only 33% (p<0.001). Convection increased high molecular weight compound removal and shifted the membrane cut-off towards the higher molecular weight range. Conclusions Reaching high convection volumes as recommended by the recent RCTs (> 20L) is feasible by setting an HDF system at its optimal conditions based upon the GKD-UF monitoring. Prescribing higher convection volumes resulted in instability of the system, provoked alarms, was bothersome for the nursing staff and the patients, rarely achieved the prescribed convection volumes and increased removal of high molecular weight compounds, notably albumin. PMID:28166268

  15. Consequences of increasing convection onto patient care and protein removal in hemodialysis.

    PubMed

    Gayrard, Nathalie; Ficheux, Alain; Duranton, Flore; Guzman, Caroline; Szwarc, Ilan; Vetromile, Fernando; Cazevieille, Chantal; Brunet, Philippe; Servel, Marie-Françoise; Argilés, Àngel; Le Quintrec, Moglie

    2017-01-01

    Recent randomised controlled trials suggest that on-line hemodiafiltration (OL-HDF) improves survival, provided that it reaches high convective volumes. However, there is scant information on the feasibility and the consequences of modifying convection volumes in clinics. Twelve stable dialysis patients were treated with high-flux 1.8 m2 polysulphone dialyzers and 4 levels of convection flows (QUF) based on GKD-UF monitoring of the system, for 1 week each. The consequences on dialysis delivery (transmembrane pressure (TMP), number of alarms, % of achieved prescribed convection) and efficacy (mass removal of low and high molecular weight compounds) were analysed. TMP increased exponentially with QUF (p<0.001 for N >56,000 monitoring values). Beyond 21 L/session, this resulted into frequent TMP alarms requiring nursing staff interventions (mean ± SEM: 10.3 ± 2.2 alarms per session, p<0.001 compared to lower convection volumes). Optimal convection volumes as assessed by GKD-UF-max were 20.6 ± 0.4 L/session, whilst 4 supplementary litres were obtained in the maximum situation (24.5 ± 0.6 L/session) but the proportion of sessions achieving the prescribed convection volume decreased from 94% to only 33% (p<0.001). Convection increased high molecular weight compound removal and shifted the membrane cut-off towards the higher molecular weight range. Reaching high convection volumes as recommended by the recent RCTs (> 20L) is feasible by setting an HDF system at its optimal conditions based upon the GKD-UF monitoring. Prescribing higher convection volumes resulted in instability of the system, provoked alarms, was bothersome for the nursing staff and the patients, rarely achieved the prescribed convection volumes and increased removal of high molecular weight compounds, notably albumin.

  16. Achieving high convection volumes in postdilution online hemodiafiltration: a prospective multicenter study

    PubMed Central

    Chapdelaine, Isabelle; Nubé, Menso J; Blankestijn, Peter J; Bots, Michiel L; Konings, Constantijn J A M; Kremer Hovinga, Ton K; Molenaar, Femke M; van der Weerd, Neelke C; Grooteman, Muriel P C

    2017-01-01

    Abstract Background. Available evidence suggests a reduced mortality risk for patients treated with high-volume postdilution hemodiafiltration (HDF) when compared with hemodialysis (HD) patients. As the magnitude of the convection volume depends on treatment-related factors rather than patient-related characteristics, we prospectively investigated whether a high convection volume (defined as ≥22 L/session) is feasible in the majority of patients (>75%). Methods. A multicenter study was performed in adult prevalent dialysis patients. Nonparticipating eligible patients formed the control group. Using a stepwise protocol, treatment time (up to 4 hours), blood flow rate (up to 400 mL/min) and filtration fraction (up to 33%) were optimized as much as possible. The convection volume was determined at the end of this optimization phase and at 4 and 8 weeks thereafter. Results. Baseline characteristics were comparable in participants (n = 86) and controls (n = 58). At the end of the optimization and 8 weeks thereafter, 71/86 (83%) and 66/83 (80%) of the patients achieved high-volume HDF (mean 25.5 ± 3.6 and 26.0 ± 3.4 L/session, respectively). While treatment time remained unaltered, mean blood flow rate increased by 27% and filtration fraction increased by 23%. Patients with <22 L/session had a higher percentage of central venous catheters (CVCs), a shorter treatment time and lower blood flow rate when compared with patients with ≥22 L/session. Conclusions. High-volume HDF is feasible in a clear majority of dialysis patients. Since none of the patients agreed to increase treatment time, these findings indicate that high-volume HDF is feasible just by increasing blood flow rate and filtration fraction. PMID:29225810

  17. Nonantibiotic macrolides prevent human neutrophil elastase-induced mucus stasis and airway surface liquid volume depletion.

    PubMed

    Tarran, Robert; Sabater, Juan R; Clarke, Tainya C; Tan, Chong D; Davies, Catrin M; Liu, Jia; Yeung, Arthur; Garland, Alaina L; Stutts, M Jackson; Abraham, William M; Phillips, Gary; Baker, William R; Wright, Clifford D; Wilbert, Sibylle

    2013-06-01

    Mucus clearance is an important component of the lung's innate defense system. A failure of this system brought on by mucus dehydration is common to both cystic fibrosis (CF) and chronic obstructive pulmonary disease (COPD). Mucus clearance rates are regulated by the volume of airway surface liquid (ASL) and by ciliary beat frequency (CBF). Chronic treatment with macrolide antibiotics is known to be beneficial to both CF and COPD patients. However, chronic macrolide usage may induce bacterial resistance. We have developed a novel macrolide, 2'-desoxy-9-(S)-erythromycylamine (GS-459755), that has significantly diminished antibiotic activity against Staphylococcus aureus, Streptococcus pneumonia, Moraxella catarrhalis, and Haemophilus influenzae. Since neutrophilia frequently occurs in chronic lung disease and human neutrophil elastase (HNE) induces mucus stasis by activating the epithelial sodium channel (ENaC), we tested the ability of GS-459755 to protect against HNE-induced mucus stasis. GS-459755 had no effect on HNE activity. However, GS-459755 pretreatment protected against HNE-induced ASL volume depletion in human bronchial epithelial cells (HBECs). The effect of GS-459755 on ASL volume was dose dependent (IC₅₀ ~3.9 μM) and comparable to the antibacterial macrolide azithromycin (IC₅₀ ~2.4 μM). Macrolides had no significant effect on CBF or on transepithelial water permeability. However, the amiloride-sensitive transepithelial voltage, a marker of ENaC activity, was diminished by macrolide pretreatment. We conclude that GS-459755 may limit HNE-induced activation of ENaC and may be useful for the treatment of mucus dehydration in CF and COPD without inducing bacterial resistance.

  18. A new gas dilution method for measuring body volume.

    PubMed Central

    Nagao, N; Tamaki, K; Kuchiki, T; Nagao, M

    1995-01-01

    This study was designed to examine the validity of a new gas dilution method (GD) for measuring human body volume and to compare its accuracy with the results obtained by the underwater weighing method (UW). We measured the volume of plastic bottles and 16 subjects (including two females), aged 18-42 years with each method. For the bottles, the volume measured by hydrostatic weighing was correlated highly (r = 1.000) with that measured by the new gas dilution method. For the subjects, the body volume determined by the two methods was significantly correlated (r = 0.998). However, the subject's volume measured by the gas dilution method was significantly larger than that by underwater weighing method. There was significant correlation (r = 0.806) between GD volume-UW volume and the body mass index (BMI), so that UW volume could be predicted from GD volume and BMI. It can be concluded that the new gas dilution method offers promising possibilities for future research in the population who cannot submerge underwater. PMID:7551760

  19. An Experimental Study of High Strength-High Volume Fly Ash Concrete for Sustainable Construction Industry

    NASA Astrophysics Data System (ADS)

    Kate, Gunavant K.; Thakare, Sunil B., Dr.

    2017-08-01

    Concrete is the most widely used building material in the construction of infrastructures such as buildings, bridges, highways, dams, and many other facilities. This paper reports the development, the basic idea, the main properties of high strength-high volume fly ash with application in concrete associated with the development and implementation of Sustainable Properties of High Volume Fly Ash Concrete (HVFAC) Mixtures and Early Age Shrinkage and mechanical properties of concrete for 7,28,56 and 90days. Another alternative to make environment-friendly concrete is the development of high strength-high-volume fly ash concrete which is an synthesized from materials of geological origin or by-product materials such as fly ash which is rich in silicon and aluminum. In this paper 6 concrete mixtures were produced to evaluate the effect of key parameters on the mechanical properties of concrete and its behavior. The study key parameters are; binder material content, cement replacement ratios, and the steel fibers used to High Volume Fly Ash mixtures for increasing performance of concrete.

  20. GSTM1 Gene Expression Correlates to Leiomyoma Volume Regression in Response to Mifepristone Treatment

    PubMed Central

    Engman, Mikael; Varghese, Suby; Lagerstedt Robinson, Kristina; Malmgren, Helena; Hammarsjö, Anna; Byström, Birgitta; L Lalitkumar, Parameswaran Grace; Gemzell-Danielsson, Kristina

    2013-01-01

    Progesterone receptor modulators, such as mifepristone are useful and well tolerated in reducing leiomyoma volume although with large individual variation. The objective of this study was to investigate the molecular basis for the observed leiomyoma volume reduction, in response to mifepristone treatment and explore a possible molecular marker for the selective usage of mifepristone in leiomyoma patients. Premenopausal women (N = 14) were treated with mifepristone 50 mg, every other day for 12 weeks prior to surgery. Women were arbitrarily sub-grouped as good (N = 4), poor (N = 4) responders to treatment or intermediate respondents (N = 3). Total RNA was extracted from leiomyoma tissue, after surgical removal of the tumour and the differential expression of genes were analysed by microarray. The results were analysed using Ingenuity Pathway Analysis software. The glutathione pathway was the most significantly altered canonical pathway in which the glutathione-s transferase mu 1 (GSTM1) gene was significantly over expressed (+8.03 folds) among the good responders compared to non responders. This was further confirmed by Real time PCR (p = 0.024). Correlation of immunoreactive scores (IRS) for GSTM1 accumulation in leiomyoma tissue was seen with base line volume change of leiomyoma R = −0.8 (p = 0.011). Furthermore the accumulation of protein GSTM1 analysed by Western Blot correlated significantly with the percentual leiomyoma volume change R = −0.82 (p = 0.004). Deletion of the GSTM1 gene in leiomyoma biopsies was found in 50% of the mifepristone treated cases, with lower presence of the GSTM1 protein. The findings support a significant role for GSTM1 in leiomyoma volume reduction induced by mifepristone and explain the observed individual variation in this response. Furthermore the finding could be useful to further explore GSTM1 as a biomarker for tailoring medical treatment of uterine leiomyomas for optimizing the response to treatment. Clinical Trials identifier www.clinicaltrials.gov: NCT00579475, Protocol date: November 2004. http://clinicaltrials.gov/ct2/show/NCT00579475 PMID:24324590

  1. Availability and temporal heterogeneity of water supply affect the vertical distribution and mortality of a belowground herbivore and consequently plant growth.

    PubMed

    Tsunoda, Tomonori; Kachi, Naoki; Suzuki, Jun-Ichirou

    2014-01-01

    We examined how the volume and temporal heterogeneity of water supply changed the vertical distribution and mortality of a belowground herbivore, and consequently affected plant biomass. Plantago lanceolata (Plantaginaceae) seedlings were grown at one per pot under different combinations of water volume (large or small volume) and heterogeneity (homogeneous water conditions, watered every day; heterogeneous conditions, watered every 4 days) in the presence or absence of a larva of the belowground herbivorous insect, Anomala cuprea (Coleoptera: Scarabaeidae). The larva was confined in different vertical distributions to top feeding zone (top treatment), middle feeding zone (middle treatment), or bottom feeding zone (bottom treatment); alternatively no larva was introduced (control treatment) or larval movement was not confined (free treatment). Three-way interaction between water volume, heterogeneity, and the herbivore significantly affected plant biomass. With a large water volume, plant biomass was lower in free treatment than in control treatment regardless of heterogeneity. Plant biomass in free treatment was as low as in top treatment. With a small water volume and in free treatment, plant biomass was low (similar to that under top treatment) under homogeneous water conditions but high under heterogeneous ones (similar to that under middle or bottom treatment). Therefore, there was little effect of belowground herbivory on plant growth under heterogeneous water conditions. In other watering regimes, herbivores would be distributed in the shallow soil and reduced root biomass. Herbivore mortality was high with homogeneous application of a large volume or heterogeneous application of a small water volume. Under the large water volume, plant biomass was high in pots in which the herbivore had died. Thus, the combinations of water volume and heterogeneity affected plant growth via the change of a belowground herbivore.

  2. The Volume-Outcome Relationship in Critical Care

    PubMed Central

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

    2015-01-01

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

  3. Association Between Hospital Case Volume and the Use of Bronchoscopy and Esophagoscopy During Head and Neck Cancer Diagnostic Evaluation

    PubMed Central

    Sun, Gordon H.; Aliu, Oluseyi; Moloci, Nicholas M.; Mondschein, Joshua K.; Burke, James F.; Hayward, Rodney A.

    2013-01-01

    Background There are no clinical guidelines on best practices for the use of bronchoscopy and esophagoscopy in diagnosing head and neck cancer. This retrospective cohort study examined variation in the use of bronchoscopy and esophagoscopy across hospitals in Michigan. Patients and Methods We identified 17,828 head and neck cancer patients in the 2006–2010 Michigan State Ambulatory Surgery Databases. We used hierarchical, mixed-effect logistic regression to examine whether a hospital’s risk-adjusted rate of concurrent bronchoscopy or esophagoscopy was associated with its case volume (<100, 100–999, or ≥1000 cases/hospital) for those undergoing diagnostic laryngoscopy. Results Of 9,218 patients undergoing diagnostic laryngoscopy, 1,191 (12.9%) received concurrent bronchoscopy and 1,675 (18.2%) underwent concurrent esophagoscopy. The median hospital rate of bronchoscopy was 2.7% (range 0–61.1%), and low-volume (OR 27.1 [95% CI 1.9, 390.7]) and medium-volume (OR 28.1 [95% CI 2.0, 399.0]) hospitals were more likely to perform concurrent bronchoscopy compared to high-volume hospitals. The median hospital rate of esophagoscopy was 5.1% (range 0–47.1%), and low-volume (OR 9.8 [95% CI 1.5, 63.7]) and medium-volume (OR 8.5 [95% CI 1.3, 55.0]) hospitals were significantly more likely to perform concurrent esophagoscopy relative to high-volume hospitals. Conclusions Head and neck cancer patients undergoing diagnostic laryngoscopy are much more likely to undergo concurrent bronchoscopy and esophagoscopy at low- and medium-volume hospitals than at high-volume hospitals. Whether this represents over-use of concurrent procedures or appropriate care that leads to earlier diagnosis and better outcomes merits further investigation. PMID:24114146

  4. The global contribution of energy consumption by product exports from China.

    PubMed

    Tang, Erzi; Peng, Chong

    2017-06-01

    This paper presents a model to analyze the mechanism of the global contribution of energy usage by product exports. The theoretical analysis is based on the perspective that contribution estimates should be in relatively smaller sectors in which the production characteristics could be considered, such as the productivity distribution for each sector. Then, we constructed a method to measure the global contribution of energy usage. The simple method to estimate the global contribution is the percentage of goods export volume compared to the GDP as a multiple of total energy consumption, but this method underestimates the global contribution because it ignores the structure of energy consumption and product export in China. According to our measurement method and based on the theoretical analysis, we calculated the global contribution of energy consumption only by industrial manufactured product exports in a smaller sector per industry or manufacturing sector. The results indicated that approximately 42% of the total energy usage in the whole economy for China in 2013 was contributed to foreign regions. Along with the primary products and service export in China, the global contribution of energy consumption for China in 2013 by export was larger than 42% of the total energy usage.

  5. GPU-based multi-volume ray casting within VTK for medical applications.

    PubMed

    Bozorgi, Mohammadmehdi; Lindseth, Frank

    2015-03-01

    Multi-volume visualization is important for displaying relevant information in multimodal or multitemporal medical imaging studies. The main objective with the current study was to develop an efficient GPU-based multi-volume ray caster (MVRC) and validate the proposed visualization system in the context of image-guided surgical navigation. Ray casting can produce high-quality 2D images from 3D volume data but the method is computationally demanding, especially when multiple volumes are involved, so a parallel GPU version has been implemented. In the proposed MVRC, imaginary rays are sent through the volumes (one ray for each pixel in the view), and at equal and short intervals along the rays, samples are collected from each volume. Samples from all the volumes are composited using front to back α-blending. Since all the rays can be processed simultaneously, the MVRC was implemented in parallel on the GPU to achieve acceptable interactive frame rates. The method is fully integrated within the visualization toolkit (VTK) pipeline with the ability to apply different operations (e.g., transformations, clipping, and cropping) on each volume separately. The implemented method is cross-platform (Windows, Linux and Mac OSX) and runs on different graphics card (NVidia and AMD). The speed of the MVRC was tested with one to five volumes of varying sizes: 128(3), 256(3), and 512(3). A Tesla C2070 GPU was used, and the output image size was 600 × 600 pixels. The original VTK single-volume ray caster and the MVRC were compared when rendering only one volume. The multi-volume rendering system achieved an interactive frame rate (> 15 fps) when rendering five small volumes (128 (3) voxels), four medium-sized volumes (256(3) voxels), and two large volumes (512(3) voxels). When rendering single volumes, the frame rate of the MVRC was comparable to the original VTK ray caster for small and medium-sized datasets but was approximately 3 frames per second slower for large datasets. The MVRC was successfully integrated in an existing surgical navigation system and was shown to be clinically useful during an ultrasound-guided neurosurgical tumor resection. A GPU-based MVRC for VTK is a useful tool in medical visualization. The proposed multi-volume GPU-based ray caster for VTK provided high-quality images at reasonable frame rates. The MVRC was effective when used in a neurosurgical navigation application.

  6. Environmental Studies in Nine Courses at Crescent Valley High. Project Reports, Volume 6, The Rachel Carson Project.

    ERIC Educational Resources Information Center

    Tanner, R. Thomas

    This document is the sixth of seven accompanying volumes included in the Rachel Carson Project. The project attempts to introduce environmental education lessons and units into existing courses of study within a high school curriculum rather than to implement environmental education through the introduction of new courses. This volume includes…

  7. Evaluation of Propiconazole Application Methods for Control of Oak Wilt in Texas Live Oaks

    Treesearch

    A. Dan Wilson; D.G. Lester

    1996-01-01

    Four fungicide application methods using the microencapsulated (blue) 14.3% EC formulation of propiconazole (Alamo), including a low-concentration high volume method, two high-concentration low volume microinjection methods, and a low-concentration intermediate volume soil drench method, were tested for effectiveness in controlling oak wilt in a mature natural stand of...

  8. Feasibility Study on Fully Automatic High Quality Translation: Volume I. Final Technical Report.

    ERIC Educational Resources Information Center

    Lehmann, Winifred P.; Stachowitz, Rolf

    The object of this theoretical inquiry is to examine the controversial issue of a fully automatic high quality translation (FAHQT) in the light of past and projected advances in linguistic theory and hardware/software capability. This first volume of a two-volume report discusses the requirements of translation and aspects of human and machine…

  9. Sewage sludge pasteurization by gamma radiation: Financial viability case studies

    NASA Astrophysics Data System (ADS)

    Swinwood, Jean F.; Kotler, Jiri

    This paper examines the financial viability of sewage sludge pasteurization by gamma radiation, by examining the following three North American scenarios: 1) Small volume sewage treatment plant experiencing high sludge disposal costs. 2) Large volume sewage treatment plant experiencing low sludge disposal costs. 3) Large volume sewage treatment plant experiencing high sludge disposal costs.

  10. Quantitative evaluation of high intensity signal on MIP images of carotid atherosclerotic plaques from routine TOF-MRA reveals elevated volumes of intraplaque hemorrhage and lipid rich necrotic core.

    PubMed

    Yamada, Kiyofumi; Song, Yan; Hippe, Daniel S; Sun, Jie; Dong, Li; Xu, Dongxiang; Ferguson, Marina S; Chu, Baocheng; Hatsukami, Thomas S; Chen, Min; Zhou, Cheng; Yuan, Chun

    2012-11-29

    Carotid intraplaque hemorrhage (IPH) and lipid rich necrotic core (LRNC) have been associated with accelerated plaque growth, luminal narrowing, future surface disruption and development of symptomatic events. The aim of this study was to evaluate the quantitative relationships between high intensity signals (HIS) in the plaque on TOF-MRA and IPH or LRNC volumes as measured by multicontrast weighted CMR. Seventy six patients with a suspected carotid artery stenosis or carotid plaque by ultrasonography underwent multicontrast carotid CMR. HIS presence and volume were measured from TOF-MRA MIP images while IPH and LRNC volumes were separately measured from multicontrast CMR. For detecting IPH, HIS on MIP images overall had high specificity (100.0%, 95% CI: 93.0 - 100.0%) but relatively low sensitivity (32%, 95% CI: 20.8 - 47.9%). However, the sensitivity had a significant increasing relationship with underlying IPH volume (p = 0.033) and degree of stenosis (p = 0.022). Mean IPH volume was 2.7 times larger in those with presence of HIS than in those without (142.8 ± 97.7 mm(3) vs. 53.4 ± 56.3 mm(3), p = 0.014). Similarly, mean LRNC volume was 3.4 times larger in those with HIS present (379.8 ± 203.4 mm(3) vs. 111.3 ± 122.7 mm(3), p = 0.001). There was a strong correlation between the volume of the HIS region and the IPH volume measured from multicontrast CMR (r = 0.96, p < 0.001). MIP images are easily reformatted from three minute, routine, clinical TOF sequences. High intensity signals in carotid plaque on TOF-MRA MIP images are associated with increased intraplaque hemorrhage and lipid-rich necrotic core volumes. The technique is most sensitive in patients with moderate to severe stenosis.

  11. Prognostic Factors for Hormone Sensitive Metastatic Prostate Cancer: Impact of Disease Volume

    PubMed

    Alhanafy, Alshimaa Mahmoud; Zanaty, Fouad; Ibrahem, Reda; Omar, Suzan

    2018-04-27

    Background and Aim: The optimal management of metastatic hormone-sensitive prostate cancer has been controversial in recent years with introduction of upfront chemohormonal treatment based on results of several Western studies. This changing landscape has renewed interest in the concept “disease volume”, the focus of the present study is the Egyptian patients. Methods: Patients with hormone sensitive metastatic prostate cancer presenting at Menoufia University Hospital, Egypt, during the period from June 2013 to May 2016, were enrolled. All received hormonal treatment. Radiologic images were evaluated and patients were stratified according to their disease volume into high or low, other clinical and pathological data that could affect survival also being collected and analyzed. Results: A total of 128 patients were included, with a median age of 70 years (53.9% ≥70). About 46% had co-morbidities, 62% having high volume disease. During the median follow up period of 28 months about half of the patients progressed and one third received chemotherapy. On univariate analysis, disease volume, performance status (PS), prostate specific antigen level (PSA) and presence of pain at presentation were identified as factors influencing overall survival. Multivariate analysis revealed the independent predictor factors for survival to be PS, PSA and disease volume. The median overall survival with 27 months was high volume versus 49 with low volume disease (hazard ratio 2.1; 95% CI 1.2 - 4.4; P=0.02). Median progression free survival was 19 months in the high volume, as compared with 48 months in the low volume disease patients (hazard ratio, 2.44; 95% CI, 1.42 – 7.4; P=0.009). Conclusions: Disease volume is a reliable predictor of survival which should be incorporated with other important factors as; patient performance status and comorbidities in treatment decision-making. Creative Commons Attribution License

  12. Synthesis, characterization and application of ion imprinted polymeric nanobeads for highly selective preconcentration and spectrophotometric determination of Ni2 + ion in water samples

    NASA Astrophysics Data System (ADS)

    Rajabi, Hamid Reza; Razmpour, Saham

    2016-01-01

    Here, the researchers report on the synthesis of ion imprinted polymeric (IIP) nanoparticles using a thermal polymerization strategy, and their usage for the separation of Ni2 + ion from water samples. The prepared Ni-IIP was characterized by colorimetry, FT-IR spectroscopy, and scanning electron microscopy. It was found that the particle size of the prepared particle to be 50-70 nm in diameter with the highly selective binding capability for Ni2 + ion, with reasonable adsorption and desorption process. After preconcentration, bound ions can be eluted with an aqueous solution of hydrochloric acid, after their complexation with dimethylglyoxime, these ions can be quantified by UV-Vis absorption spectrophotometry. The effect of various parameters on the extraction efficiency including pH of sample solution, adsorption and leaching times, initial sample volume, concentration and volume of eluent were investigated. In selectivity study, it was found that imprinting causes increased affinity of the prepared IIP toward Ni2 + ion over other ions such as Na+, K+, Ag+, Co2 +, Cu2 +, Cd2 +, Hg2 +, Pb2 +, Zn2 +, Mn2 +, Mg2 +, Cr3 +, and Fe3 +. The prepared IIP can be used and regenerated for at least eight times without any significant decrease in binding affinities. The prepared IIP is considered to be promising and selective sorbent for solid-phase extraction and preconcentration of Ni2 + ion from different water samples.

  13. Multi-functional layered structure having structural and radiation shielding attributes

    NASA Technical Reports Server (NTRS)

    Kaul, Raj K. (Inventor); Barghouty, Abdulnasser Fakhri (Inventor); Penn, Benjamin G. (Inventor); Hulcher, Anthony Bruce (Inventor)

    2010-01-01

    A cosmic and solar radiation shielding structure that also has structural attributes is comprised of three layers. The first layer is 30-42 percent by volume of ultra-high molecular weight (UHMW) polyethylene fibers, 18-30 percent by volume of graphite fibers, and a remaining percent by volume of an epoxy resin matrix. The second layer is approximately 68 percent by volume of UHMW polyethylene fibers and a remaining percent by volume of a polyethylene matrix. The third layer is a ceramic material.

  14. Reduction of Costs for Pelvic Exenteration Performed by High Volume Surgeons: Analysis of the Maryland Health Service Cost Review Commission Database.

    PubMed

    Althumairi, Azah A; Canner, Joseph K; Gorin, Michael A; Fang, Sandy H; Gearhart, Susan L; Wick, Elizabeth C; Safar, Bashar; Bivalacqua, Trinity J; Efron, Jonathan E

    2016-01-01

    High volume hospitals (HVHs) and high volume surgeons (HVSs) have better outcomes after complex procedures, but the association between surgeon and hospital volumes and patient outcomes is not completely understood. Our aim was to evaluate the impact of surgeon and hospital volumes, and their interaction, on postoperative outcomes and costs in patients undergoing pelvic exenteration (PE) in the state of Maryland. A review of the Maryland Health Services Cost Review Commission database between 2000 and 2011 was performed. Patients were compared for demographics and clinical variables. The differences in length of hospital stay , length of intensive care unit (ICU) stay, operating room (OR) cost, and total cost were compared for surgeon volume and hospital volume controlling for all other factors. Surgery performed by HVS at HVH had the shortest ICU stay and lowest OR cost. When PE was performed by a low volume surgeon at an HVH, the OR cost and total cost were the highest and increased by $2,683 (P < 0.0001) and $16,076 (P < 0.0001), respectively. OR costs reduced when surgery was performed by an HVS at an HVH ($-1632, P = 0.008). PE performed by HVS at HVH is significantly associated with lower OR costs and ICU stay. We feel this is indicative of lower complication rates and higher quality care.

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

    PubMed

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

    2014-07-01

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

  16. The interaction between physical activity and amount of baseline knee cartilage.

    PubMed

    Teichtahl, Andrew J; Wang, Yuanyuan; Heritier, Stephane; Wluka, Anita E; Strauss, Boyd J; Proietto, Joseph; Dixon, John B; Jones, Graeme; Cicuttini, Flavia M

    2016-07-01

    Conflicting reports of the effect of physical activity on knee cartilage may be due to the heterogeneity of populations examined and, in particular, the underlying health of the knee joint. This study examined the influence of recreational and occupational physical activity on cartilage volume loss. A total of 250 participants with no significant musculoskeletal disease were recruited. A gender-specific median cartilage volume split was used to define people in the lowest and highest 50% of baseline cartilage volume. Baseline recreational and occupational activity was examined by questionnaire, while cartilage volume was assessed by MRI at baseline and 2.4 years later. Significant interactions were demonstrable between physical activity and cartilage volume loss based on stratification of baseline cartilage volume (all P ⩽ 0.03). There was a dose-response relationship between frequently performed baseline occupational activities and medial cartilage volume loss in both the low (B = 0.2% per annum, 95% CI: 0.0, 0.04% per annum) and high (B = -0.2% per annum, 95% CI: -0.4, 0.0% per annum) baseline cartilage volume groups (P = 0.001 for interaction). Individuals with low baseline cartilage volume who were active in their occupation and/or recreational activity had greater medial cartilage volume loss than their more inactive counterparts (2.4% per annum vs 1.5% per annum, P = 0.02). Whereas people with less baseline cartilage volume are more at risk of structural knee damage with either heavy occupational or recreational workloads or both, individuals with high baseline cartilage volume may advantageously modify their risk for knee OA by participating in more frequent occupational physical activities. © The Author 2016. Published by Oxford University Press on behalf of the British Society for Rheumatology. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  17. Open-source Software for Demand Forecasting of Clinical Laboratory Test Volumes Using Time-series Analysis.

    PubMed

    Mohammed, Emad A; Naugler, Christopher

    2017-01-01

    Demand forecasting is the area of predictive analytics devoted to predicting future volumes of services or consumables. Fair understanding and estimation of how demand will vary facilitates the optimal utilization of resources. In a medical laboratory, accurate forecasting of future demand, that is, test volumes, can increase efficiency and facilitate long-term laboratory planning. Importantly, in an era of utilization management initiatives, accurately predicted volumes compared to the realized test volumes can form a precise way to evaluate utilization management initiatives. Laboratory test volumes are often highly amenable to forecasting by time-series models; however, the statistical software needed to do this is generally either expensive or highly technical. In this paper, we describe an open-source web-based software tool for time-series forecasting and explain how to use it as a demand forecasting tool in clinical laboratories to estimate test volumes. This tool has three different models, that is, Holt-Winters multiplicative, Holt-Winters additive, and simple linear regression. Moreover, these models are ranked and the best one is highlighted. This tool will allow anyone with historic test volume data to model future demand.

  18. Open-source Software for Demand Forecasting of Clinical Laboratory Test Volumes Using Time-series Analysis

    PubMed Central

    Mohammed, Emad A.; Naugler, Christopher

    2017-01-01

    Background: Demand forecasting is the area of predictive analytics devoted to predicting future volumes of services or consumables. Fair understanding and estimation of how demand will vary facilitates the optimal utilization of resources. In a medical laboratory, accurate forecasting of future demand, that is, test volumes, can increase efficiency and facilitate long-term laboratory planning. Importantly, in an era of utilization management initiatives, accurately predicted volumes compared to the realized test volumes can form a precise way to evaluate utilization management initiatives. Laboratory test volumes are often highly amenable to forecasting by time-series models; however, the statistical software needed to do this is generally either expensive or highly technical. Method: In this paper, we describe an open-source web-based software tool for time-series forecasting and explain how to use it as a demand forecasting tool in clinical laboratories to estimate test volumes. Results: This tool has three different models, that is, Holt-Winters multiplicative, Holt-Winters additive, and simple linear regression. Moreover, these models are ranked and the best one is highlighted. Conclusion: This tool will allow anyone with historic test volume data to model future demand. PMID:28400996

  19. Preoperative prognostic value of dynamic contrast-enhanced MRI-derived contrast transfer coefficient and plasma volume in patients with cerebral gliomas.

    PubMed

    Nguyen, T B; Cron, G O; Mercier, J F; Foottit, C; Torres, C H; Chakraborty, S; Woulfe, J; Jansen, G H; Caudrelier, J M; Sinclair, J; Hogan, M J; Thornhill, R E; Cameron, I G

    2015-01-01

    The prognostic value of dynamic contrast-enhanced MR imaging-derived plasma volume obtained in tumor and the contrast transfer coefficient has not been well-established in patients with gliomas. We determined whether plasma volume and contrast transfer coefficient in tumor correlated with survival in patients with gliomas in addition to other factors such as age, type of surgery, preoperative Karnofsky score, contrast enhancement, and histopathologic grade. This prospective study included 46 patients with a new pathologically confirmed diagnosis of glioma. The contrast transfer coefficient and plasma volume obtained in tumor maps were calculated directly from the signal-intensity curve without T1 measurements, and values were obtained from multiple small ROIs placed within tumors. Survival curve analysis was performed by dichotomizing patients into groups of high and low contrast transfer coefficient and plasma volume. Univariate analysis was performed by using dynamic contrast-enhanced parameters and clinical factors. Factors that were significant on univariate analysis were entered into multivariate analysis. For all patients with gliomas, survival was worse for groups of patients with high contrast transfer coefficient and plasma volume obtained in tumor (P < .05). In subgroups of high- and low-grade gliomas, survival was worse for groups of patients with high contrast transfer coefficient and plasma volume obtained in tumor (P < .05). Univariate analysis showed that factors associated with lower survival were age older than 50 years, low Karnofsky score, biopsy-only versus resection, marked contrast enhancement versus no/mild enhancement, high contrast transfer coefficient, and high plasma volume obtained in tumor (P < .05). In multivariate analysis, a low Karnofsky score, biopsy versus resection in combination with marked contrast enhancement, and a high contrast transfer coefficient were associated with lower survival rates (P < .05). In patients with glioma, those with a high contrast transfer coefficient have lower survival than those with low parameters. © 2015 by American Journal of Neuroradiology.

  20. Localized Arm Volume Index: A New Method for Body Type-Corrected Evaluation of Localized Arm Lymphedematous Volume Change.

    PubMed

    Yamamoto, Takumi; Yamamoto, Nana; Yoshimatsu, Hidehiko

    2017-10-01

    Volume measurement is a common evaluation for upper extremity lymphedema. However, volume comparison between different patients with different body types may be inappropriate, and it is difficult to evaluate localized limb volume change using arm volume. Localized arm volumes (Vk, k = 1-5) and localized arm volume indices (LAVIk) at 5 points (1, upper arm; 2, elbow; 3, forearm; 4, wrist; 5, hand) of 106 arms of 53 examinees with no arm edema were calculated based on physical measurements (arm circumferences and lengths and body mass index [BMI]). Interrater and intrarater reliabilities of LAVIk were assessed, and Vk and LAVIk were compared between lower BMI (BMI, <22 kg/m) group and higher BMI (BMI, ≥22 kg/m) group. Interrater and intrarater reliabilities of LAVIk were all high (all, r > 0.98). Between lower and higher BMI groups, significant differences were observed in all Vk (V1 [P = 6.8 × 10], V2 [P = 3.1 × 10], V3 [P = 1.1 × 10], V4 [P = 8.3 × 10], and V5 [P = 3.0 × 10]). Regarding localized arm volume index (LAVI) between groups, significant differences were seen in LAVI1 (P = 9.7 × 10) and LAVI5 (P = 1.2 × 10); there was no significant difference in LAVI2 (P = 0.60), LAVI3 (P = 0.61), or LAVI4 (P = 0.22). Localized arm volume index is a convenient and highly reproducible method for evaluation of localized arm volume change, which is less affected by body physique compared with arm volumetry.

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

    PubMed

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

    2016-12-01

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

  2. Hospital volume and other risk factors for in-hospital mortality among diverticulitis patients: A nationwide analysis

    PubMed Central

    Diamant, Michael J; Coward, Stephanie; Buie, W Donald; MacLean, Anthony; Dixon, Elijah; Ball, Chad G; Schaffer, Samuel; Kaplan, Gilaad G

    2015-01-01

    BACKGROUND: Previous studies have found that a higher volume of colorectal surgery was associated with lower mortality rates. While diverticulitis is an increasingly common condition, the effect of hospital volume on outcomes among diverticulitis patients is unknown. OBJECTIVE: To evaluate the relationship between hospital volume and other factors on in-hospital mortality among patients admitted for diverticulitis. METHODS: Data from the Nationwide Inpatient Sample (years 1993 to 2008) were analyzed to identify 822,865 patients representing 4,108,726 admissions for diverticulitis. Hospitals were divided into quartiles based on the volume of diverticulitis cases admitted over the study period, adjusted for years contributed to the dataset. Mortality according to hospital volume was modelled using logistic regression adjusting for age, sex, race, comorbidities, health care insurance, admission type, calendar year, colectomy, disease severity and clustering. Risk estimates were expressed as adjusted ORs with 95% CIs. RESULTS: Patients at high-volume hospitals were more likely to be admitted emergently, undergo surgical treatment and have more severe disease. In-hospital mortality was higher among the lowest quartile of hospital volume compared with the highest volume (OR 1.13 [95% CI 1.05 to 1.21]). In-hospital mortality was increased among patients admitted emergently (OR 2.58 [95% CI 2.40 to 2.78]) as well as those receiving surgical treatment (OR 3.60 [95% CI 3.42 to 3.78]). CONCLUSIONS: Diverticulitis patients admitted to hospitals with a low volume of diverticulitis cases had an increased risk for death compared with those admitted to high-volume centres. PMID:25965439

  3. The association between hospital volume and processes, outcomes, and costs of care for congestive heart failure

    PubMed Central

    Joynt, Karen E.; Orav, E. John; Jha, Ashish K.

    2012-01-01

    Background Congestive Heart Failure (CHF) is common and costly, and despite pharmacologic and technical advances, outcomes remain suboptimal. Objective To examine whether hospitals that have more experience caring for patients with CHF provide better, more efficient care. Design We used national Medicare claims data from 2006–2007 to examine the relationship between hospitals’ case volume and quality, outcomes, and costs for patients with CHF. Setting 4,095 U.S. hospitals Patients Medicare fee-for-service patients with a primary discharge diagnosis of CHF Measurements Hospital Quality Alliance (HQA) CHF process measures, 30-day risk-adjusted mortality rates, 30-day risk-adjusted readmission rates, and costs per discharge. Results Hospitals in the lowest volume group had lower performance on HQA measures than medium- or high-volume hospitals (80.2% versus 87.0% versus 89.1%, p<0.001). Within the low volume group, being admitted to a hospital with a higher case volume was associated with lower mortality, lower readmission, and higher costs. For example, in the lowest volume group of hospitals, an increase of 10 cases of CHF was associated with 1% lower odds of mortality, 1% lower odds of readmissions and $22 higher costs per case. We found similar though smaller relationships between case volume and both mortality and costs in the medium and high-volume hospital cohorts. Limitations Our analysis was limited to Medicare patients 65 years of age or older; risk adjustment was performed using administrative data. Conclusions Experience with managing CHF, as measured by an institution’s volume, is associated with higher quality of care and better outcomes for patients, but at a higher cost. Understanding which practices employed by high-volume institutions account for these advantages can help improve quality of care and clinical outcomes for all CHF patients. PMID:21242366

  4. Global trends in the awareness of sepsis: insights from search engine data between 2012 and 2017.

    PubMed

    Jabaley, Craig S; Blum, James M; Groff, Robert F; O'Reilly-Shah, Vikas N

    2018-01-17

    Sepsis is an established global health priority with high mortality that can be curtailed through early recognition and intervention; as such, efforts to raise awareness are potentially impactful and increasingly common. We sought to characterize trends in the awareness of sepsis by examining temporal, geographic, and other changes in search engine utilization for sepsis information-seeking online. Using time series analyses and mixed descriptive methods, we retrospectively analyzed publicly available global usage data reported by Google Trends (Google, Palo Alto, CA, USA) concerning web searches for the topic of sepsis between 24 June 2012 and 24 June 2017. Google Trends reports aggregated and de-identified usage data for its search products, including interest over time, interest by region, and details concerning the popularity of related queries where applicable. Outlying epochs of search activity were identified using autoregressive integrated moving average modeling with transfer functions. We then identified awareness campaigns and news media coverage that correlated with epochs of significantly heightened search activity. A second-order autoregressive model with transfer functions was specified following preliminary outlier analysis. Nineteen significant outlying epochs above the modeled baseline were identified in the final analysis that correlated with 14 awareness and news media events. Our model demonstrated that the baseline level of search activity increased in a nonlinear fashion. A recurrent cyclic increase in search volume beginning in 2012 was observed that correlates with World Sepsis Day. Numerous other awareness and media events were correlated with outlying epochs. The average worldwide search volume for sepsis was less than that of influenza, myocardial infarction, and stroke. Analyzing aggregate search engine utilization data has promise as a mechanism to measure the impact of awareness efforts. Heightened information-seeking about sepsis occurs in close proximity to awareness events and relevant news media coverage. Future work should focus on validating this approach in other contexts and comparing its results to traditional methods of awareness campaign evaluation.

  5. Postoperative liver volume was accurately predicted by a medical image three dimensional visualization system in hepatectomy for liver cancer.

    PubMed

    Cai, Wei; Fan, Yingfang; Hu, Haoyu; Xiang, Nan; Fang, Chihua; Jia, Fucang

    2017-06-01

    Liver cancer is the second most common cause of cancer death worldwide. The hepatectomy is the most effective and the only potentially curative treatment for patients with resectable neoplasm. Precisely preoperative assessment of remnant liver volume is essential in preventing postoperative liver failure. The aim of our study is to report our experience of using a medical image three dimensional (3D) visualization system (MI-3DVS), which was developed by our team, in assisting hepatectomy for patients with liver cancer. Between January 2010 and June 2016, 69 patients with liver cancer underwent hepatic resection based on the MI-3DVS were enrolled in this study. All patients underwent CT scan 5 days before the surgery and within 5 days after resection. CT images were reconstructed with the MI-3DVS to assist to perform hepatectomy. Simple linear regression, intra-class correlation coefficient (ICC) and Bland-Altman analysis were used to evaluate the relationship and agreement between actual excisional liver volume (AELV) and predicted excisional liver volume (PELV). Among 69 patients in this study, 62(89.85%) of them were diagnosed with hepatocellular carcinoma by histopathologic examination, and 41(59.42%) underwent major hepatectomy. The average AELV was 330.13 cm 3 and the average PELV was 287.67 cm 3 . The simple regression equation is AELV = 1.016 × PELV+30.39(r = 0.966; p < 0.0003). PELV (ICC = 0.964) achieved an excellent agreement with AELV with statistical significance (p < 0.001). 65 of 69 dots are in the range of 95% confidence interval in Bland-Altman analyses. The MI-3DVS has advantages of simple usage and convenient hold. It is accurate in assessment of postoperative liver volume and improve safety in liver resection. Copyright © 2017 Elsevier Ltd. All rights reserved.

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

    PubMed

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

    2015-12-22

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

  7. The Neutron Tomography Studies of the Rocks from the Kola Superdeep Borehole

    NASA Astrophysics Data System (ADS)

    Kichanov, S. E.; Kozlenko, D. P.; Ivankina, T. I.; Rutkauskas, A. V.; Lukin, E. V.; Savenko, B. N.

    The volume morphology of a gneiss sample K-8802 recovered from the deep of 8802 m of the Kola Superdeep Borehole and its surface homologue sample PL-36 have been studied by means of neutron radiography and tomography methods. The volumes and size distributions of a biotite-muscovite grains as well as grains orientation distribution have been obtained from experimental data. It was found that the average volumes of the biotite-muscovite grains in surface homologue sample is noticeably larger than the average volume of grains in the deep-seated gneiss sample K-8802. This drastically differences in grains volumes can be explained by the recrystallization processes in deep of the Kola Superdeep Borehole at high temperatures and high pressures.

  8. Outcomes and Costs for Major Lung Resection in the United States: Which Patients Benefit Most From High-Volume Referral?

    PubMed

    Wakeam, Elliot; Hyder, Joseph A; Lipsitz, Stuart R; Darling, Gail E; Finlayson, Samuel R G

    2015-09-01

    Accountable care organizations are designed to improve value by decreasing costs and maintaining quality. Strategies to maximize value are needed for high-risk surgery. We wanted to understand whether certain patient groups were differentially associated with better outcomes at high-volume hospitals in terms of quality and cost. In all, 37,746 patients underwent elective major lung resection in 1,273 hospitals in the Nationwide Inpatient Sample from 2007 to 2011. Patients were stratified by hospital volume quartile and substratified by preoperative mortality risk, age, and chronic obstructive pulmonary disease status. Mortality was evaluated using clustered multivariable hierarchical logistic regression controlling for patient comorbidity, demographics, and procedure. Adjusted cost was evaluated using generalized linear models fit to a gamma distribution. Patients were grouped into volume quartiles based on cases per year (less than 21, 21 to 40, 40 to 78, and more than 78). Patient characteristics and procedure mix differed across quartiles. Overall, mortality decreased across volume quartiles (lowest 1.9% versus highest 1.1%, p < 0.0001). Patients aged more than 80 years were associated with greater absolute and relative mortality rates than patients less than 60 years old in highest volume versus lowest volume hospitals (age more than 80 years, 4.2% versus 1.3%, p < 0.0001, odds ratio 3.31, 95% confidence interval: 1.89 to 5.80; age less than 60 years, 1.0% versus 0.8%, p = 0.19, odds ratio 1.38, 95% confidence interval: 0.74 to 2.56). Patients with high preoperative risk (more than 75th percentile) were also associated with lower absolute mortality in high-volume hospitals. Adjusted costs were not significantly different across quartiles or patient strata. Older patients show a significantly stronger volume-outcome relationship than patients less than 60 years of age. Costs were equivalent across volume quartile and patient strata. Selective patient referral may be a strategy to improve outcomes for elderly patients undergoing lung resection. Copyright © 2015 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

  9. [Austrian expenditures on psychopharmaceutical drugs between 2006 and 2013].

    PubMed

    Boeckle, Markus; Chetouani, Yasmine; Schrimpf, Marlene; Liegl, Gregor; Leitner, Anton; Pieh, Christoph

    2015-01-01

    Health costs, which are increasing at a yearly rate of 4 %, represent 11% and thus a large share of Austria's gross domestic product (GDP). High expenditures derive frommental health care costs, including medication. In this article we investigate whether the costs and usage of psychopharmaceutic products in Austria are rising. We did a descriptive analysis of the sales figures and number for packaging units of pharmaceutical products of ATC-classes N05 and N06 in all Austrian hospitals, pharmacies and medicine chests for the years 2006-2013. All data were provided free of charge by IMSHealth. The sales volume and number of prescribed packaging units of pharmaceuticals of ATC-classes N05 and N06 increased over the time period in question. In 2013, about 25% more packaging units were being sold than in 2006. Among the two ATC-classes, however, the indication subgroups developed differently. Expenditures increased a total of about 31%within the period of consideration. The increase in psycho-pharmaceutical sales exceeds the expansion rates of other health expenditures (17.8 %). During the 9 years of observation, 25% more psychopharmaceutical products were sold. This may result from increased prevalence of mental disorders, higher usage or an increment in prescriptions.

  10. Surgical volume-to-outcome relationship and monitoring of technical performance in pediatric cardiac surgery.

    PubMed

    Kalfa, David; Chai, Paul; Bacha, Emile

    2014-08-01

    A significant inverse relationship of surgical institutional and surgeon volumes to outcome has been demonstrated in many high-stakes surgical specialties. By and large, the same results were found in pediatric cardiac surgery, for which a more thorough analysis has shown that this relationship depends on case complexity and type of surgical procedures. Lower-volume programs tend to underperform larger-volume programs as case complexity increases. High-volume pediatric cardiac surgeons also tend to have better results than low-volume surgeons, especially at the more complex end of the surgery spectrum (e.g., the Norwood procedure). Nevertheless, this trend for lower mortality rates at larger centers is not universal. All larger programs do not perform better than all smaller programs. Moreover, surgical volume seems to account for only a small proportion of the overall between-center variation in outcome. Intraoperative technical performance is one of the most important parts, if not the most important part, of the therapeutic process and a critical component of postoperative outcome. Thus, the use of center-specific, risk-adjusted outcome as a tool for quality assessment together with monitoring of technical performance using a specific score may be more reliable than relying on volume alone. However, the relationship between surgical volume and outcome in pediatric cardiac surgery is strong enough that it ought to support adapted and well-balanced health care strategies that take advantage of the positive influence that higher center and surgeon volumes have on outcome.

  11. ( sup 99m Tc)diphosphonate uptake and hemodynamics in arthritis of the immature dog knee

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

    Hansen, E.S.; Soballe, K.; Henriksen, T.B.

    1991-03-01

    The relationship between (99mTc)diphosphonate uptake and bone hemodynamics was studied in canine carrageenan-induced juvenile chronic arthritis. Blood flow was determined with microspheres, plasma and red cell volumes were measured by labeled fibrinogen and red cells, and the microvascular volume and mean transit time of blood were calculated. Normal femoral epiphyses had lower central and higher subchondral blood flow and diphosphonate uptake values. Epiphyseal vascular volume was uniform, resulting in a greater transit time of blood centrally. In arthritis, blood flow and diphosphonate uptake were increased subchondrally and unaffected centrally, while epiphyseal vascular volume was increased throughout, leading to prolonged transitmore » time centrally. The normal metaphyses had low blood flow and diphosphonate uptake values in cancellous bone and very high values in growth plates, but a large vascular volume throughout. The mean transit time therefore was low in growth plates and high in adjacent cancellous bone. Arthritis caused decreased blood flow and diphosphonate uptake in growth plates but increased vascular volume and transit time of blood. Diphosphonate uptake correlated positively with blood flow and plasma volume and negatively with red cell volume in a nonlinear fashion. Thus, changes in diphosphonate uptake and microvascular hemodynamics occur in both epiphyseal and metaphyseal bone in chronic synovitis of the immature knee. The (99mTc)diphosphonate bone scan seems to reflect blood flow, plasma volume, and red cell volume of bone.« less

  12. Methods for determining enzymatic activity comprising heating and agitation of closed volumes

    DOEpatents

    Thompson, David Neil; Henriksen, Emily DeCrescenzo; Reed, David William; Jensen, Jill Renee

    2016-03-15

    Methods for determining thermophilic enzymatic activity include heating a substrate solution in a plurality of closed volumes to a predetermined reaction temperature. Without opening the closed volumes, at least one enzyme is added, substantially simultaneously, to the closed volumes. At the predetermined reaction temperature, the closed volumes are agitated and then the activity of the at least one enzyme is determined. The methods are conducive for characterizing enzymes of high-temperature reactions, with insoluble substrates, with substrates and enzymes that do not readily intermix, and with low volumes of substrate and enzyme. Systems for characterizing the enzymes are also disclosed.

  13. The impact on revenue of increasing patient volume at surgical suites with relatively high operating room utilization.

    PubMed

    Dexter, F; Macario, A; Lubarsky, D A

    2001-05-01

    We previously studied hospitals in the United States of America that are losing money despite limiting the hours that operating room (OR) staff are available to care for patients undergoing elective surgery. These hospitals routinely keep utilization relatively high to maximize revenue. We tested, using discrete-event computer simulation, whether increasing patient volume while being reimbursed less for each additional patient can reliably achieve an increase in revenue when initial adjusted OR utilization is 90%. We found that increasing the volume of referred patients by the amount expected to fill the surgical suite (100%/90%) would increase utilization by <1% for a hospital surgical suite (with longer duration cases) and 4% for an ambulatory surgery suite (with short cases). The increase in patient volume would result in longer patient waiting times for surgery and more patients leaving the surgical queue. With a 15% reduction in payment for the new patients, the increase in volume may not increase revenue and can even decrease the contribution margin for the hospital surgical suite. The implication is that for hospitals with a relatively high OR utilization, signing discounted contracts to increase patient volume by the amount expected to "fill" the OR can have the net effect of decreasing the contribution margin (i.e., profitability). Hospitals may try to attract new surgical volume by offering discounted rates. For hospitals with a relatively high operating room utilization (e.g., 90%), computer simulations predict that increasing patient volume by the amount expected to "fill" the operating room can have the net effect of decreasing contribution margin (i.e., profitability).

  14. Robust isotropic super-resolution by maximizing a Laplace posterior for MRI volumes

    NASA Astrophysics Data System (ADS)

    Han, Xian-Hua; Iwamoto, Yutaro; Shiino, Akihiko; Chen, Yen-Wei

    2014-03-01

    Magnetic resonance imaging can only acquire volume data with finite resolution due to various factors. In particular, the resolution in one direction (such as the slice direction) is much lower than others (such as the in-plane direction), yielding un-realistic visualizations. This study explores to reconstruct MRI isotropic resolution volumes from three orthogonal scans. This proposed super- resolution reconstruction is formulated as a maximum a posterior (MAP) problem, which relies on the generation model of the acquired scans from the unknown high-resolution volumes. Generally, the deviation ensemble of the reconstructed high-resolution (HR) volume from the available LR ones in the MAP is represented as a Gaussian distribution, which usually results in some noise and artifacts in the reconstructed HR volume. Therefore, this paper investigates a robust super-resolution by formulating the deviation set as a Laplace distribution, which assumes sparsity in the deviation ensemble based on the possible insight of the appeared large values only around some unexpected regions. In addition, in order to achieve reliable HR MRI volume, we integrates the priors such as bilateral total variation (BTV) and non-local mean (NLM) into the proposed MAP framework for suppressing artifacts and enriching visual detail. We validate the proposed robust SR strategy using MRI mouse data with high-definition resolution in two direction and low-resolution in one direction, which are imaged in three orthogonal scans: axial, coronal and sagittal planes. Experiments verifies that the proposed strategy can achieve much better HR MRI volumes than the conventional MAP method even with very high-magnification factor: 10.

  15. Beyond Volume: Hospital-Based Healthcare Technology for Better Outcomes in Cerebrovascular Surgical Patients Diagnosed With Ischemic Stroke: A Population-Based Nationwide Cohort Study From 2002 to 2013.

    PubMed

    Kim, Jae-Hyun; Park, Eun-Cheol; Lee, Sang Gyu; Lee, Tae-Hyun; Jang, Sung-In

    2016-03-01

    We examined whether the level of hospital-based healthcare technology was related to the 30-day postoperative mortality rates, after adjusting for hospital volume, of ischemic stroke patients who underwent a cerebrovascular surgical procedure. Using the National Health Insurance Service-Cohort Sample Database, we reviewed records from 2002 to 2013 for data on patients with ischemic stroke who underwent cerebrovascular surgical procedures. Statistical analysis was performed using Cox proportional hazard models to test our hypothesis. A total of 798 subjects were included in our study. After adjusting for hospital volume of cerebrovascular surgical procedures as well as all for other potential confounders, the hazard ratio (HR) of 30-day mortality in low healthcare technology hospitals as compared to high healthcare technology hospitals was 2.583 (P < 0.001). We also found that, although the HR of 30-day mortality in low healthcare technology hospitals with high volume as compared to high healthcare technology hospitals with high volume was the highest (10.014, P < 0.0001), cerebrovascular surgical procedure patients treated in low healthcare technology hospitals had the highest 30-day mortality rate, irrespective of hospital volume. Although results of our study provide scientific evidence for a hospital volume/30-day mortality rate relationship in ischemic stroke patients who underwent cerebrovascular surgical procedures, our results also suggest that the level of hospital-based healthcare technology is associated with mortality rates independent of hospital volume. Given these results, further research into what components of hospital-based healthcare technology significantly impact mortality is warranted.

  16. High School Symposium for Earth Systems Education (Columbus, Ohio, October 1994). Proceedings and Summary.

    ERIC Educational Resources Information Center

    Fortner, Rosanne W., Ed.; Mayer, Victor J., Ed.

    This volume contains the proceedings and summary for the Earth Systems Education high school symposium conducted in October, 1994. Selected participants were invited to contribute papers for inclusion in this volume so that other teachers can see how Earth Systems Education (ESE) looks in practice. The volume also contains the context for ESE in…

  17. Uncertainty in peat volume and soil carbon estimated using ground-penetrating radar and probing

    Treesearch

    Andrew D. Parsekian; Lee Slater; Dimitrios Ntarlagiannis; James Nolan; Stephen D. Sebestyen; Randall K. Kolka; Paul J. Hanson

    2012-01-01

    Estimating soil C stock in a peatland is highly dependent on accurate measurement of the peat volume. In this study, we evaluated the uncertainty in calculations of peat volume using high-resolution data to resolve the three-dimensional structure of a peat basin based on both direct (push probes) and indirect geophysical (ground-penetrating radar) measurements. We...

  18. Melt Electrospinning Writing of Highly Ordered Large Volume Scaffold Architectures.

    PubMed

    Wunner, Felix M; Wille, Marie-Luise; Noonan, Thomas G; Bas, Onur; Dalton, Paul D; De-Juan-Pardo, Elena M; Hutmacher, Dietmar W

    2018-05-01

    The additive manufacturing of highly ordered, micrometer-scale scaffolds is at the forefront of tissue engineering and regenerative medicine research. The fabrication of scaffolds for the regeneration of larger tissue volumes, in particular, remains a major challenge. A technology at the convergence of additive manufacturing and electrospinning-melt electrospinning writing (MEW)-is also limited in thickness/volume due to the accumulation of excess charge from the deposited material repelling and hence, distorting scaffold architectures. The underlying physical principles are studied that constrain MEW of thick, large volume scaffolds. Through computational modeling, numerical values variable working distances are established respectively, which maintain the electrostatic force at a constant level during the printing process. Based on the computational simulations, three voltage profiles are applied to determine the maximum height (exceeding 7 mm) of a highly ordered large volume scaffold. These thick MEW scaffolds have fully interconnected pores and allow cells to migrate and proliferate. To the best of the authors knowledge, this is the first study to report that z-axis adjustment and increasing the voltage during the MEW process allows for the fabrication of high-volume scaffolds with uniform morphologies and fiber diameters. © 2018 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

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

    PubMed

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

    2014-03-01

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

  20. Computational electromagnetic methods for transcranial magnetic stimulation

    NASA Astrophysics Data System (ADS)

    Gomez, Luis J.

    Transcranial magnetic stimulation (TMS) is a noninvasive technique used both as a research tool for cognitive neuroscience and as a FDA approved treatment for depression. During TMS, coils positioned near the scalp generate electric fields and activate targeted brain regions. In this thesis, several computational electromagnetics methods that improve the analysis, design, and uncertainty quantification of TMS systems were developed. Analysis: A new fast direct technique for solving the large and sparse linear system of equations (LSEs) arising from the finite difference (FD) discretization of Maxwell's quasi-static equations was developed. Following a factorization step, the solver permits computation of TMS fields inside realistic brain models in seconds, allowing for patient-specific real-time usage during TMS. The solver is an alternative to iterative methods for solving FD LSEs, often requiring run-times of minutes. A new integral equation (IE) method for analyzing TMS fields was developed. The human head is highly-heterogeneous and characterized by high-relative permittivities (107). IE techniques for analyzing electromagnetic interactions with such media suffer from high-contrast and low-frequency breakdowns. The novel high-permittivity and low-frequency stable internally combined volume-surface IE method developed. The method not only applies to the analysis of high-permittivity objects, but it is also the first IE tool that is stable when analyzing highly-inhomogeneous negative permittivity plasmas. Design: TMS applications call for electric fields to be sharply focused on regions that lie deep inside the brain. Unfortunately, fields generated by present-day Figure-8 coils stimulate relatively large regions near the brain surface. An optimization method for designing single feed TMS coil-arrays capable of producing more localized and deeper stimulation was developed. Results show that the coil-arrays stimulate 2.4 cm into the head while stimulating 3.0 times less volume than Figure-8 coils. Uncertainty quantification (UQ): The location/volume/depth of the stimulated region during TMS is often strongly affected by variability in the position and orientation of TMS coils, as well as anatomical differences between patients. A surrogate model-assisted UQ framework was developed and used to statistically characterize TMS depression therapy. The framework identifies key parameters that strongly affect TMS fields, and partially explains variations in TMS treatment responses.

  1. Low versus high volume of culture medium during embryo transfer: a randomized clinical trial.

    PubMed

    Sigalos, George Α; Michalopoulos, Yannis; Kastoras, Athanasios G; Triantafyllidou, Olga; Vlahos, Nikos F

    2018-04-01

    The aim of this prospective randomized control trial was to evaluate if the use of two different volumes (20-25 vs 40-45 μl) of media used for embryo transfer affects the clinical outcomes in fresh in vitro fertilization (IVF) cycles. In total, 236 patients were randomized in two groups, i.e., "low volume" group (n = 118) transferring the embryos with 20-25 μl of medium and "high volume" group (n = 118) transferring the embryos with 40-45 μl of medium. The clinical pregnancy, implantation, and ongoing pregnancy rates were compared between the two groups. No statistically significant differences were observed in clinical pregnancy (46.8 vs 54.3%, p = 0.27), implantation (23.7 vs 27.8%, p = 0.30), and ongoing pregnancy (33.3 vs 40.0%, p = 0.31) rates between low and high volume group, respectively. Higher volume of culture medium to load the embryo into the catheter during embryo transfer does not influence the clinical outcome in fresh IVF cycles. NCT03350646.

  2. Effects of obesity and exercise on testicular leptin signal transduction and testosterone biosynthesis in male mice.

    PubMed

    Yi, Xuejie; Gao, Haining; Chen, Dequan; Tang, Donghui; Huang, Wanting; Li, Tao; Ma, Tie; Chang, Bo

    2017-04-01

    To explore the role of the testicular leptin and JAK-STAT[leptin (LEP)-JAK-STAT] pathway in testosterone biosynthesis during juvenile stages and exercise for weight loss, male C57BL/6J mice were randomly divided into normal-diet and high-fat diet groups. After 10 wk, mice in the high-fat diet-fed group were further divided randomly into obese control, obese moderate-volume exercise, and obese high-volume exercise groups. Mice in the obese moderate-volume exercise group were provided with 2 h/day, 6 days/wk swimming exercise for 8 wk, and mice in the obese high-volume exercise group underwent twice the amount of daily exercise intervention as the obese moderate-volume exercise group. The results showed that a high-fat diet causes obesity, leptin resistance, inhibition of the testicular LEP-JAK-STAT pathway, decreased mRNA and protein expression of steroidogenic factor-1, steroidogenic acute regulatory protein, and the P -450 side-chain cleavage enzyme, a decrease in the serum testosterone-to-estradiol ratio, and declines in sperm quality parameters. Both moderate and high-volume exercise were able to reduce body fat and increase the mRNA and protein expression of LEP-JAK-STAT, but only moderate exercise significantly increased the mRNA and protein expression of steroidogenic factor-1, steroidogenic acute regulatory protein, and P -450 side-chain cleavage enzyme and significantly reversed the serum testosterone-to-estradiol ratio and sperm quality parameters. These findings suggest that by impairing the testicular LEP-JAK-STAT pathway, early-stage obesity inhibits the biosynthesis of testosterone and sexual development and reduces male reproductive potential. Long-term moderate and high-volume exercise can effectively reduce body fat and improve obesity-induced abnormalities in testicular leptin signal transduction, whereas only moderate-volume exercise can reverse the negative impacts of obesity on male reproductive function. Copyright © 2017 the American Physiological Society.

  3. Tabular Summary of the Third Follow-Up Questionnaire Data. Volume 1 [and] Volume 2 [and] Volume 3 [and] Volume 4. Sponsored Report Series NCES 79-228.

    ERIC Educational Resources Information Center

    Peng, Samuel S.; And Others

    Tabular summaries of the 153 numerical responses to the Second Followup Questionnaire items of the National Longitudinal Study of the High School Class of 1972 are presented--20,872 individuals responded. These items summarize participants' educational experiences and occupational attainments from October 1973 to October 1974; continuing or…

  4. Accurately determining log and bark volumes of saw logs using high-resolution laser scan data

    Treesearch

    R. Edward Thomas; Neal D. Bennett

    2014-01-01

    Accurately determining the volume of logs and bark is crucial to estimating the total expected value recovery from a log. Knowing the correct size and volume of a log helps to determine which processing method, if any, should be used on a given log. However, applying volume estimation methods consistently can be difficult. Errors in log measurement and oddly shaped...

  5. Perioperative patient safety indicators and hospital surgical volumes.

    PubMed

    Kitazawa, Takefumi; Matsumoto, Kunichika; Fujita, Shigeru; Yoshida, Ai; Iida, Shuhei; Nishizawa, Hirotoshi; Hasegawa, Tomonori

    2014-02-28

    Since the late 1990s, patient safety has been an important policy issue in developed countries. To evaluate the effectiveness of the activities of patient safety, it is necessary to quantitatively assess the incidence of adverse events by types of failure mode using tangible data. The purpose of this study is to calculate patient safety indicators (PSIs) using the Japanese Diagnosis Procedure Combination/per-diem payment system (DPC/PDPS) reimbursement data and to elucidate the relationship between perioperative PSIs and hospital surgical volume. DPC/PDPS data of the Medi-Target project managed by the All Japan Hospital Association were used. An observational study was conducted where PSIs were calculated using an algorithm proposed by the US Agency for Healthcare Research and Quality. We analyzed data of 1,383,872 patients from 188 hospitals who were discharged from January 2008 to December 2010. Among 20 provider level PSIs, four PSIs (three perioperative PSIs and decubitus ulcer) and mortality rates of postoperative patients were related to surgical volume. Low-volume hospitals (less than 33rd percentiles surgical volume per month) had higher mortality rates (5.7%, 95% confidence interval (CI), 3.9% to 7.4%) than mid- (2.9%, 95% CI, 2.6% to 3.3%) or high-volume hospitals (2.7%, 95% CI, 2.5% to 2.9%). Low-volume hospitals had more deaths among surgical inpatients with serious treatable complications (38.5%, 95% CI, 33.7% to 43.2%) than high-volume hospitals (21.4%, 95% CI, 19.0% to 23.9%). Also Low-volume hospitals had lower proportion of difficult surgeries (54.9%, 95% CI, 50.1% to 59.8%) compared with high-volume hospitals (63.4%, 95% CI, 62.3% to 64.6%). In low-volume hospitals, limited experience may have led to insufficient care for postoperative complications. We demonstrated that PSIs can be calculated using DPC/PDPS data and perioperative PSIs were related to hospital surgical volume. Further investigations focusing on identifying risk factors for poor PSIs and effective support to these hospitals are needed.

  6. Spontaneous breathing during lung-protective ventilation in an experimental acute lung injury model: high transpulmonary pressure associated with strong spontaneous breathing effort may worsen lung injury.

    PubMed

    Yoshida, Takeshi; Uchiyama, Akinori; Matsuura, Nariaki; Mashimo, Takashi; Fujino, Yuji

    2012-05-01

    We investigated whether potentially injurious transpulmonary pressure could be generated by strong spontaneous breathing and exacerbate lung injury even when plateau pressure is limited to <30 cm H2O. Prospective, randomized, animal study. University animal research laboratory. Thirty-two New Zealand White rabbits. Lavage-injured rabbits were randomly allocated to four groups to receive low or moderate tidal volume ventilation, each combined with weak or strong spontaneous breathing effort. Inspiratory pressure for low tidal volume ventilation was set at 10 cm H2O and tidal volume at 6 mL/kg. For moderate tidal volume ventilation, the values were 20 cm H2O and 7-9 mL/kg. The groups were: low tidal volume ventilation+spontaneous breathingweak, low tidal volume ventilation+spontaneous breathingstrong, moderate tidal volume ventilation+spontaneous breathingweak, and moderate tidal volume ventilation+spontaneous breathingstrong. Each group had the same settings for positive end-expiratory pressure of 8 cm H2O. Respiratory variables were measured every 60 mins. Distribution of lung aeration and alveolar collapse were histologically evaluated. Low tidal volume ventilation+spontaneous breathingstrong showed the most favorable oxygenation and compliance of respiratory system, and the best lung aeration. By contrast, in moderate tidal volume ventilation+spontaneous breathingstrong, the greatest atelectasis with numerous neutrophils was observed. While we applied settings to maintain plateau pressure at <30 cm H2O in all groups, in moderate tidal volume ventilation+spontaneous breathingstrong, transpulmonary pressure rose >33 cm H2O. Both minute ventilation and respiratory rate were higher in the strong spontaneous breathing groups. Even when plateau pressure is limited to <30 cm H2O, combined with increased respiratory rate and tidal volume, high transpulmonary pressure generated by strong spontaneous breathing effort can worsen lung injury. When spontaneous breathing is preserved during mechanical ventilation, transpulmonary pressure and tidal volume should be strictly controlled to prevent further lung injury.

  7. Sexual steroids in serum and prostatic tissue of human non-cancerous prostate (STERPROSER trial).

    PubMed

    Neuzillet, Yann; Raynaud, Jean-Pierre; Radulescu, Camélia; Fiet, Jean; Giton, Franck; Dreyfus, Jean-François; Ghoneim, Tarek P; Lebret, Thierry; Botto, Henry

    2017-11-01

    The specific involvement of the sex steroids in the growth of the prostatic tissue remains unclear. Sex steroid concentrations in plasma and in fresh surgical samples of benign central prostate were correlated to prostate volume. Monocentric prospective study performed between September 2014 and January 2017. Age, obesity parameters, and both serum and intraprostatic concentrations of sex steroids were collected complying with the latest Endocrine Society guidelines and the steroids assessed by GC/MS. Statistical calculations were adjusted for age and body mass index (BMI). Thirty-two patients, equally divided between normal- and high-volume prostate groups, were included in the analysis. High-volume prostate patients were older, heavier and had higher BMI. Comparison adjusted for age and BMI showed higher DHT concentrations in high-volume prostate. Both normal- and high-volume prostate tissues concentrate sex steroids in a similar way. Comparison of enzymatic activity surrogate marker ratios within tissue highlighted similar TT/E1 and TT/E2 ratios, and higher DHT/E1 ratio and lower DHT/PSA ratio in the high-volume prostates. STERPROSER trial provides evidence for higher DHT concentration in highvolume prostates, that could reflect either higher 5-alpha reductase expression or lower expression of downstream metabolizing enzymes such as 3a-hydoxysteroid dehydrogenase. © 2017 Wiley Periodicals, Inc.

  8. Partial molar volume of proteins studied by the three-dimensional reference interaction site model theory.

    PubMed

    Imai, Takashi; Kovalenko, Andriy; Hirata, Fumio

    2005-04-14

    The three-dimensional reference interaction site model (3D-RISM) theory is applied to the analysis of hydration effects on the partial molar volume of proteins. For the native structure of some proteins, the partial molar volume is decomposed into geometric and hydration contributions using the 3D-RISM theory combined with the geometric volume calculation. The hydration contributions are correlated with the surface properties of the protein. The thermal volume, which is the volume of voids around the protein induced by the thermal fluctuation of water molecules, is directly proportional to the accessible surface area of the protein. The interaction volume, which is the contribution of electrostatic interactions between the protein and water molecules, is apparently governed by the charged atomic groups on the protein surface. The polar atomic groups do not make any contribution to the interaction volume. The volume differences between low- and high-pressure structures of lysozyme are also analyzed by the present method.

  9. High correlations between MRI brain volume measurements based on NeuroQuant® and FreeSurfer.

    PubMed

    Ross, David E; Ochs, Alfred L; Tate, David F; Tokac, Umit; Seabaugh, John; Abildskov, Tracy J; Bigler, Erin D

    2018-05-30

    NeuroQuant ® (NQ) and FreeSurfer (FS) are commonly used computer-automated programs for measuring MRI brain volume. Previously they were reported to have high intermethod reliabilities but often large intermethod effect size differences. We hypothesized that linear transformations could be used to reduce the large effect sizes. This study was an extension of our previously reported study. We performed NQ and FS brain volume measurements on 60 subjects (including normal controls, patients with traumatic brain injury, and patients with Alzheimer's disease). We used two statistical approaches in parallel to develop methods for transforming FS volumes into NQ volumes: traditional linear regression, and Bayesian linear regression. For both methods, we used regression analyses to develop linear transformations of the FS volumes to make them more similar to the NQ volumes. The FS-to-NQ transformations based on traditional linear regression resulted in effect sizes which were small to moderate. The transformations based on Bayesian linear regression resulted in all effect sizes being trivially small. To our knowledge, this is the first report describing a method for transforming FS to NQ data so as to achieve high reliability and low effect size differences. Machine learning methods like Bayesian regression may be more useful than traditional methods. Copyright © 2018 Elsevier B.V. All rights reserved.

  10. Whole body and tissue blood volumes of two strains of rainbow trout (Oncorhynchus mykiss)

    USGS Publications Warehouse

    Gingerich, W.H.; Pityer, R.A.; Rach, J.J.

    1990-01-01

    1. Estimates of apparent packed cell, plasma and total blood volumes for the whole body and for 13 selected tissues were compared between Kamloops and Wytheville strains of rainbow trout (Oncorhynchus mykiss) by the simultaneous injection of two vascular tracers, radiolabeled trout erythrocytes (51Cr-RBC) and radioiodated bovine serum albumin (125I-BSA).2. Whole body total blood volume, plasma volume and packed cell volume were slightly, but not significantly greater in the Wytheville trout, whereas, the apparent plasma volumes and total blood volumes in 4 of 13 tissues were significantly greater in the Kamloops strain.3. Differences were most pronounced in highly perfused organs, such as the liver and kidney and in organs of digestion such as the stomach and intestines.4. Differences in blood volumes between the two strains may be related to the greater permeability of the vascular membranes in the Kamloops strain fish.

  11. Power law cross-correlations between price change and volume change of Indian stocks

    NASA Astrophysics Data System (ADS)

    Hasan, Rashid; Mohammed Salim, M.

    2017-05-01

    We study multifractal long-range correlations and cross-correlations of daily price change and volume change of 50 stocks that comprise Nifty index of National Stock Exchange, Mumbai, using MF-DFA and MF-DCCA methods. We find that the time series of price change are uncorrelated, whereas anti-persistent long-range multifractal correlations are found in volume change series. We also find antipersistent long-range multifractal cross-correlations between the time series of price change and volume change. As multifractality is a signature of complexity, we estimate complexity parameters of the time series of price change, volume change, and cross-correlated price-volume change by fitting the fourth-degree polynomials to their multifractal spectra. Our results indicate that the time series of price change display high complexity, whereas the time series of volume change and cross-correlated price-volume change display low complexity.

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

    PubMed

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

    2007-06-01

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

  13. Anchorage in Orthodontics: Three-dimensional Scanner Input

    PubMed Central

    Nabbout, Fidele; Baron, Pascal

    2018-01-01

    Aims and Objectives: The aim of this article is to re-evaluate anchorage coefficient values in orthodontics and their influence in the treatment decision through the usage of three-dimensional (3D) scanner. Materials and Methods: A sample of 80 patients was analyzed with the 3D scanner using the C2000 and Cepha 3DT softwares (CIRAD Montpellier, France). Tooth anatomy parameters (linear measurements, root, and crown volumes) were then calculated to determine new anchorage coefficients based on root volume. Data were collected and statistically evaluated with the StatView software (version 5.0). Results: The anchorage coefficient values found in this study are compared to those established in previous studies. These new values affect and modify our approach in orthodontic treatment from the standpoint of anchorage. Conclusion: The use of new anchorage coefficient values has significant clinical implications in conventional and in microimplants-assisted orthodontic mechanics through the selection and delivery of the optimal force system (magnitude and moment) for an adequate biological response. PMID:29629323

  14. A Comparison of Radical Perineal, Radical Retropubic, and Robot-Assisted Laparoscopic Prostatectomies in a Single Surgeon Series

    PubMed Central

    Mirza, Moben; Art, Kevin; Wineland, Logan; Tawfik, Ossama; Thrasher, J. Brantley

    2011-01-01

    Objective. We sought to compare positive surgical margin rates (PSM), estimated blood loss (EBL), and quality of life outcomes (QOL) among perineal (RPP), retropubic (RRP), and robot-assisted laparoscopic (RALP) prostatectomies. Methods. Records from 463 consecutive men undergoing RPP (92), RRP (180), or RALP (191) for clinically localized prostate cancer were retrospectively reviewed. Age, percent tumor volume, Gleason score, stage, EBL, PSM, and QOL using the expanded prostate cancer index composite (EPIC) were compared. Results. PSM were similar when adjusted for stage, grade, and volume. EBL was significantly less in the RALP (189 ml) group compared to both RPP (475 ml) and RRP (999 ml) groups. When corrected for nerve sparing, there were no differences in erectile function and sexual function amongst the three groups. Urinary summary and pad usage scores showed no significant differences. Conclusion. RPP, RRP, and RALP offer similar surgical and QOL outcomes. RALP and RPP demonstrate less EBL compared to RRP. PMID:22111001

  15. Binge consumption of ethanol during pregnancy leads to significant developmental delay of mouse embryonic brain

    NASA Astrophysics Data System (ADS)

    Sudheendran, Narendran; Bake, Shameena; Miranda, Rajesh C.; Larin, Kirill V.

    2014-03-01

    Consumption of alcohol during pregnancy can be severely detrimental to the development of the brain in fetuses. This study explores the usage of optical coherence tomography (OCT) to the study the effects of maternal consumption of ethanol on brain development in mouse fetuses. On gestational day 14.5, fetuses were collected and fixed in 4% paraformaldehyde. A swept-source OCT (SSOCT) system was used to acquire 3D images of the brain of ethanol-exposed and control fetuses. The volume of right and left brain ventricles were measured and used to compare between ethanol-exposed and control fetuses. A total of 5 fetuses were used for each of the two groups. The average volumes of the right and left ventricles were measured to be 0.35 and 0.15 mm3 for ethanol-exposed and control fetuses, respectively. The results demonstrated that there is an alcohol-induced developmental delay in mouse fetal brains.

  16. The usage of waste heat recovery units with improved heat engineering rates: theory and experimental research

    NASA Astrophysics Data System (ADS)

    Chebotarev, Victor; Koroleva, Alla; Pirozhnikova, Anastasia

    2017-10-01

    Use of recuperator in heat producing plants for utilization of natural gas combustion products allows to achieve the saving of gas fuel and also provides for environmental sanitation. Decrease of the volumes of natural gas combustion due to utilization of heat provides not only for reduction of harmful agents in the combustion products discharged into the atmosphere, but also creates conditions for increase of energy saving in heating processes of heat producing plants due to air overheating in the recuperator. Grapho-analytical method of determination of energy saving and reduction of discharges of combustion products into the atmosphere is represented in the article. Multifunctional diagram is developed, allowing to determine simultaneously savings from reduction of volumes of natural gas combusted and from reduction of amounts of harmful agents in the combustion products discharged into the atmosphere. Calculation of natural gas economy for heat producing plant taking into consideration certain capacity is carried out.

  17. Separation properties of aluminium-plastic laminates in post-consumer Tetra Pak with mixed organic solvent.

    PubMed

    Zhang, S F; Zhang, L L; Luo, K; Sun, Z X; Mei, X X

    2014-04-01

    The separation properties of the aluminium-plastic laminates in postconsumer Tetra Pak structure were studied in this present work. The organic solvent blend of benzene-ethyl alcohol-water was used as the separation reagent. Then triangle coordinate figure analysis was taken to optimize the volume proportion of various components in the separating agent and separation process. And the separation temperature of aluminium-plastic laminates was determined by the separation time, efficiency, and total mass loss of products. The results show that cost-efficient separations perform best with low usage of solvents at certain temperatures, for certain times, and within a certain range of volume proportions of the three components in the solvent agent. It is also found that similar solubility parameters of solvents and polyethylene adhesives (range 26.06-34.85) are a key factor for the separation of the aluminium-plastic laminates. Such multisolvent processes based on the combined-system concept will be vital to applications in the recycling industry.

  18. High lung volume increases stress failure in pulmonary capillaries

    NASA Technical Reports Server (NTRS)

    Fu, Z.; Costello, M. L.; Tsukimoto, K.; Prediletto, R.; Elliott, A. R.; Mathieu-Costello, O.; West, J. B.

    1992-01-01

    We previously showed that when pulmonary capillaries in anesthetized rabbits are exposed to a transmural pressure (Ptm) of approximately 40 mmHg, stress failure of the walls occurs with disruption of the capillary endothelium, alveolar epithelium, or sometimes all layers. The present study was designed to test whether stress failure occurred more frequently at high than at low lung volumes for the same Ptm. Lungs of anesthetized rabbits were inflated to a transpulmonary pressure of 20 cmH2O, perfused with autologous blood at 32.5 or 2.5 cmH2O Ptm, and fixed by intravascular perfusion. Samples were examined by both transmission and scanning electron microscopy. The results were compared with those of a previous study in which the lung was inflated to a transpulmonary pressure of 5 cmH2O. There was a large increase in the frequency of stress failure of the capillary walls at the higher lung volume. For example, at 32.5 cmH2O Ptm, the number of endothelial breaks per millimeter cell lining was 7.1 +/- 2.2 at the high lung volume compared with 0.7 +/- 0.4 at the low lung volume. The corresponding values for epithelium were 8.5 +/- 1.6 and 0.9 +/- 0.6. Both differences were significant (P less than 0.05). At 52.5 cmH2O Ptm, the results for endothelium were 20.7 +/- 7.6 (high volume) and 7.1 +/- 2.1 (low volume), and the corresponding results for epithelium were 32.8 +/- 11.9 and 11.4 +/- 3.7. At 32.5 cmH2O Ptm, the thickness of the blood-gas barrier was greater at the higher lung volume, consistent with the development of more interstitial edema. Ballooning of the epithelium caused by accumulation of edema fluid between the epithelial cell and its basement membrane was seen at 32.5 and 52.5 cmH2O Ptm. At high lung volume, the breaks tended to be narrower and fewer were oriented perpendicular to the axis of the pulmonary capillaries than at low lung volumes. Transmission and scanning electron microscopy measurements agreed well. Our findings provide a physiological mechanism for other studies showing increased capillary permeability at high states of lung inflation.

  19. Decreased contralateral breast volume after mastectomy, adjuvant chemotherapy, and anti-estrogen therapy, in particular in breasts with high density.

    PubMed

    Ishii, Naohiro; Ando, Jiro; Harao, Michiko; Takemae, Masaru; Kishi, Kazuo

    2017-10-01

    Adjuvant chemotherapy and anti-estrogenic therapy can result in decreased volume of the contralateral breast, following mastectomy for the treatment of breast cancer. However, no data on the effect of adjuvant therapy on contralateral breast volume have previously been reported. We aimed to evaluate the extent to which adjuvant therapy and differences in breast density contribute to decreased breast volume. We conducted a prospective cohort study, selecting 40 nonconsecutive patients who underwent immediate breast reconstruction with mastectomy and expander insertion followed by expander replacement. We measured the contralateral breast volume before each procedure. The extent of the change was analyzed with respect to adjuvant therapy and breast density measured by preoperative mammography. The greatest decrease in breast volume was 135.1 cm 3 . The decrease in breast volume was significantly larger in the adjuvant therapy (+) group, particularly in patients with high breast density, than in the adjuvant therapy (-) group. Significant differences between the chemotherapy (+), tamoxifen (+) group and the chemotherapy (-), tamoxifen (+) group were not found. Breast density scores had a range of 2.0-3.3 (mean: 2.8). In breast reconstruction, particularly when performed in one stage, preoperative mammography findings are valuable to plastic surgeons, and possible decreases in the contralateral breast volume due to adjuvant therapy, particularly in patients with high breast density, should be considered carefully. Copyright © 2017 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.

  20. The effect of perfluorocarbon vapour on the measurement of respiratory tidal volume during partial liquid ventilation.

    PubMed

    Davies, M W; Dunster, K R

    2000-08-01

    During partial liquid ventilation perfluorocarbon vapour is present in the exhaled gases. The volumes of these gases are measured by pneumotachometers. Error in measuring tidal volumes will give erroneous measurement of lung compliance during partial liquid ventilation. We aim to compare measured tidal volumes with and without perfluorocarbon vapour using tidal volumes suitable for use in neonates. Tidal volumes were produced with a 100 ml calibration syringe from 20 to 100 ml and with a calibrated Harvard rodent ventilator from 2.5 to 20 ml. Control tidal volumes were drawn from a humidifier chamber containing water vapour and the PFC tidal volumes were drawn from a humidifier chamber containing water and perfluorocarbon (FC-77) vapour. Tidal volumes were measured by a fixed orifice, target, differential pressure flowmeter (VenTrak) or a hot-wire anenometer (Bear Cub) placed between the calibration syringe or ventilator and the humidifier chamber. All tidal volumes measured with perfluorocarbon vapour were increased compared with control (ANOVA p < 0.001 and post t-test p < 0.0001). Measured tidal volume increased from 7 to 16% with the fixed orifice type flow-meter, and from 35 to 41% with the hot-wire type. In conclusion, perfluorocarbon vapour flowing through pneumotachometers gives falsely high tidal volume measurements. Calculation of lung compliance must take into account the effect of perfluorocarbon vapour on the measurement of tidal volume.

  1. Multivariate pattern analysis of obsessive-compulsive disorder using structural neuroanatomy.

    PubMed

    Hu, Xinyu; Liu, Qi; Li, Bin; Tang, Wanjie; Sun, Huaiqiang; Li, Fei; Yang, Yanchun; Gong, Qiyong; Huang, Xiaoqi

    2016-02-01

    Magnetic resonance imaging (MRI) studies have revealed brain structural abnormalities in obsessive-compulsive disorder (OCD) patients, involving both gray matter (GM) and white matter (WM). However, the results of previous publications were based on average differences between groups, which limited their usages in clinical practice. Therefore, the aim of this study was to examine whether the application of multivariate pattern analysis (MVPA) to high-dimensional structural images would allow accurate discrimination between OCD patients and healthy control subjects (HCS). High-resolution T1-weighted images were acquired from 33 OCD patients and 33 demographically matched HCS in a 3.0 T scanner. Differences in GM and WM volume between OCD and HCS were examined using two types of well-established MVPA techniques: support vector machine (SVM) and Gaussian process classifier (GPC). We also drew a receiver operating characteristic (ROC) curve to evaluate the performance of each classifier. The classification accuracies for both classifiers using GM and WM anatomy were all above 75%. The highest classification accuracy (81.82%, P<0.001) was achieved with the SVM classifier using WM information. Regional brain anomalies with high discriminative power were based on three distributed networks including the fronto-striatal circuit, the temporo-parieto-occipital junction and the cerebellum. Our study illustrated that both GM and WM anatomical features may be useful in differentiating OCD patients from HCS. WM volume using the SVM approach showed the highest accuracy in our population for revealing group differences, which suggested its potential diagnostic role in detecting highly enriched OCD patients at the level of the individual. Copyright © 2015 Elsevier B.V. and ECNP. All rights reserved.

  2. Hospital Volume and Operative Mortality in the Modern Era

    PubMed Central

    Reames, Bradley N.; Ghaferi, Amir A.; Birkmeyer, John D.; Dimick, Justin B.

    2014-01-01

    Background It is generally accepted that hospital volume is associated with mortality in high-risk procedures. However, as surgical safety has improved over the last decade, recent evidence has suggested that the inverse relationship has diminished or been eliminated. Objective To determine whether the relationship between hospital volume and mortality has changed over time. Methods Using national Medicare claims data from 2000 through 2009, we examined mortality among 3,282,127 patients who underwent one of eight gastrointestinal, cardiac, or vascular procedures. Hospitals were stratified into quintiles of operative volume. Using multivariable logistic regression models to adjust for patient characteristics, we examined the relationship between hospital volume and mortality, and assessed for changes over time. We performed sensitivity analyses using hierarchical logistic regression modeling with hospital-level random effects to confirm our results. Results Throughout the ten-year period, a significant inverse relationship was observed in all procedures. In five of the eight procedures studied, the strength of the volume-outcome relationship increased over time. In esophagectomy, for example, the adjusted odds ratio of mortality in very low volume hospitals compared to very high volume hospitals increased from 2.25 [95%CI: 1.57-3.23] in 2000-2001 to 3.68 [95%CI: 2.66-5.11] in 2008-2009. Only pancreatectomy showed a notable decrease in strength of the relationship over time, from 5.83 [95%CI: 3.64-9.36] in 2000-2001, to 3.08 [95%CI: 2.07 - 4.57] in 2008-2009. Conclusion For all procedures examined, higher volume hospitals had significantly lower mortality rates compared to lower volume hospitals. Despite recent improvements in surgical safety, the strong inverse relationship between hospital volume and mortality persists in the modern era. PMID:24368634

  3. Effects of Physician Volume on Readmission and Mortality in Elderly Patients with Heart Failure: Nationwide Cohort Study.

    PubMed

    Lee, Joo Eun; Park, Eun Cheol; Jang, Suk Yong; Lee, Sang Ah; Choy, Yoon Soo; Kim, Tae Hyun

    2018-03-01

    Readmission and mortality rates of patients with heart failure are good indicators of care quality. To determine whether hospital resources are associated with care quality for cardiac patients, we analyzed the effect of number of physicians and the combined effects of number of physicians and beds on 30-day readmission and 1-year mortality. We used national cohort sample data of the National Health Insurance Service (NHIS) claims in 2002-2013. Subjects comprised 2345 inpatients (age: >65 years) admitted to acute-care hospitals for heart failure. A multivariate Cox regression was used. Of the 2345 patients hospitalized with heart failure, 812 inpatients (34.6%) were readmitted within 30 days and 190 (8.1%) had died within a year. Heart-failure patients treated at hospitals with low physician volumes had higher readmission and mortality rates than high physician volumes [30-day readmission: hazard ratio (HR)=1.291, 95% confidence interval (CI)=1.020-1.633; 1-year mortality: HR=2.168, 95% CI=1.415-3.321]. Patients admitted to hospitals with low or middle bed and physician volume had higher 30-day readmission and 1-year mortality rates than those admitted to hospitals with high volume (30-day readmission: HR=2.812, 95% CI=1.561-5.066 for middle-volume beds & low-volume physicians, 1-year mortality: HR=8.638, 95% CI=2.072-36.02 for middle-volume beds & low-volume physicians). Physician volume is related to lower readmission and mortality for heart failure. Of interest, 30-day readmission and 1-year mortality were significantly associated with the combined effects of physician and institution bed volume. © Copyright: Yonsei University College of Medicine 2018

  4. Developing cost effective plans for low volume bridges

    DOT National Transportation Integrated Search

    2006-09-01

    There is currently an escalating concern across the state of Kansas with respect to the age : and condition of low volume bridges and methods available to modify or replace them. A : high percentage of low volume bridges in the state of Kansas requir...

  5. Characterization and Demonstrations of Laser-Induced Incandescence in both Normal and Low-Gravity

    NASA Technical Reports Server (NTRS)

    VanderWal, Randall L.

    1997-01-01

    Knowledge of soot volume fraction is important to a wide range of combustion studies in microgravity. Laser-induced incandescence (LII) offers high sensitivity, high temporal and spatial resolution in addition to geometric versatility for real-time determination of soot volume fraction. Implementation of LII into the 2.2 see drop tower at The NASA-Lewis Research Center along with system characterization is described. Absolute soot volume fraction measurements are presented for laminar and turbulent gas-jet flames in microgravity to illustrate the capabilities of LII in microgravity. Comparison between LII radial intensity profiles with soot volume fraction profiles determined through a full-field light extinction technique are also reported validating the accuracy of LII for soot volume fraction measurements in a microgravity environment.

  6. Automatic Perceptual Color Map Generation for Realistic Volume Visualization

    PubMed Central

    Silverstein, Jonathan C.; Parsad, Nigel M.; Tsirline, Victor

    2008-01-01

    Advances in computed tomography imaging technology and inexpensive high performance computer graphics hardware are making high-resolution, full color (24-bit) volume visualizations commonplace. However, many of the color maps used in volume rendering provide questionable value in knowledge representation and are non-perceptual thus biasing data analysis or even obscuring information. These drawbacks, coupled with our need for realistic anatomical volume rendering for teaching and surgical planning, has motivated us to explore the auto-generation of color maps that combine natural colorization with the perceptual discriminating capacity of grayscale. As evidenced by the examples shown that have been created by the algorithm described, the merging of perceptually accurate and realistically colorized virtual anatomy appears to insightfully interpret and impartially enhance volume rendered patient data. PMID:18430609

  7. The Impact of Hospital/Surgeon Volume on Acute Renal Failure and Mortality in Liver Transplantation: A Nationwide Cohort Study.

    PubMed

    Cheng, Chih-Wen; Liu, Fu-Chao; Lin, Jr-Rung; Tsai, Yung-Fong; Chen, Hsiu-Pin; Yu, Huang-Ping

    2016-01-01

    The aim of this study was to assess whether the case volume of surgeons and hospitals affects the rates of postoperative complications and survival after liver transplantation. This population-based retrospective cohort study included 2938 recipients of liver transplantation performed between 1998 and 2012, enrolled from the Taiwan National Health Insurance Research Database. They were divided into two groups, according to the cumulative case volume of their operating surgeons and the case volume of their hospitals. The duration of intensive care unit stay and post-transplantation hospitalization, postoperative complications, and mortality were analyzed. The results showed that, in the low and high case volume surgeons groups, respectively, acute renal failure occurred at the rate of 14.11% and 5.86% (p<0.0001), and the overall mortality rates were 19.61% and 12.44% (p<0.0001). In the low and high case volume hospital groups, respectively, acute renal failure occurred in 11% and 7.11% of the recipients (p = 0.0004), and the overall mortality was 18.44% and 12.86% (p<0.0001). These findings suggest that liver transplantation recipients operated on higher case volume surgeons or in higher case volume hospitals have a lower rate of acute renal failure and mortality.

  8. A novel magnetic resonance imaging segmentation technique for determining diffuse intrinsic pontine glioma tumor volume

    PubMed Central

    Singh, Ranjodh; Zhou, Zhiping; Tisnado, Jamie; Haque, Sofia; Peck, Kyung K.; Young, Robert J.; Tsiouris, Apostolos John; Thakur, Sunitha B.; Souweidane, Mark M.

    2017-01-01

    OBJECTIVE Accurately determining diffuse intrinsic pontine glioma (DIPG) tumor volume is clinically important. The aims of the current study were to 1) measure DIPG volumes using methods that require different degrees of subjective judgment; and 2) evaluate interobserver agreement of measurements made using these methods. METHODS Eight patients from a Phase I clinical trial testing convection-enhanced delivery (CED) of a therapeutic antibody were included in the study. Pre-CED, post–radiation therapy axial T2-weighted images were analyzed using 2 methods requiring high degrees of subjective judgment (picture archiving and communication system [PACS] polygon and Volume Viewer auto-contour methods) and 1 method requiring a low degree of subjective judgment (k-means clustering segmentation) to determine tumor volumes. Lin’s concordance correlation coefficients (CCCs) were calculated to assess interobserver agreement. RESULTS The CCCs of measurements made by 2 observers with the PACS polygon and the Volume Viewer auto-contour methods were 0.9465 (lower 1-sided 95% confidence limit 0.8472) and 0.7514 (lower 1-sided 95% confidence limit 0.3143), respectively. Both were considered poor agreement. The CCC of measurements made using k-means clustering segmentation was 0.9938 (lower 1-sided 95% confidence limit 0.9772), which was considered substantial strength of agreement. CONCLUSIONS The poor interobserver agreement of PACS polygon and Volume Viewer auto-contour methods high-lighted the difficulty in consistently measuring DIPG tumor volumes using methods requiring high degrees of subjective judgment. k-means clustering segmentation, which requires a low degree of subjective judgment, showed better interob-server agreement and produced tumor volumes with delineated borders. PMID:27391980

  9. Increasing the Accuracy of Volume and ADC Delineation for Heterogeneous Tumor on Diffusion-Weighted MRI: Correlation with PET/CT

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

    Gong, Nan-Jie; Wong, Chun-Sing, E-mail: drcswong@gmail.com; Chu, Yiu-Ching

    2013-10-01

    Purpose: To improve the accuracy of volume and apparent diffusion coefficient (ADC) measurements in diffusion-weighted magnetic resonance imaging (MRI), we proposed a method based on thresholding both the b0 images and the ADC maps. Methods and Materials: In 21 heterogeneous lesions from patients with metastatic gastrointestinal stromal tumors (GIST), gross lesion were manually contoured, and corresponding volumes and ADCs were denoted as gross tumor volume (GTV) and gross ADC (ADC{sub g}), respectively. Using a k-means clustering algorithm, the probable high-cellularity tumor tissues were selected based on b0 images and ADC maps. ADC and volume of the tissues selected using themore » proposed method were denoted as thresholded ADC (ADC{sub thr}) and high-cellularity tumor volume (HCTV), respectively. The metabolic tumor volume (MTV) in positron emission tomography (PET)/computed tomography (CT) was measured using 40% maximum standard uptake value (SUV{sub max}) as the lower threshold, and corresponding mean SUV (SUV{sub mean}) was also measured. Results: HCTV had excellent concordance with MTV according to Pearson's correlation (r=0.984, P<.001) and linear regression (slope = 1.085, intercept = −4.731). In contrast, GTV overestimated the volume and differed significantly from MTV (P=.005). ADC{sub thr} correlated significantly and strongly with SUV{sub mean} (r=−0.807, P<.001) and SUV{sub max} (r=−0.843, P<.001); both were stronger than those of ADC{sub g}. Conclusions: The proposed lesion-adaptive semiautomatic method can help segment high-cellularity tissues that match hypermetabolic tissues in PET/CT and enables more accurate volume and ADC delineation on diffusion-weighted MR images of GIST.« less

  10. Impact of case volume on outcome and performance of targeted temperature management in out-of-hospital cardiac arrest survivors.

    PubMed

    Lee, Seung Joon; Jeung, Kyung Woon; Lee, Byung Kook; Min, Yong Il; Park, Kyu Nam; Suh, Gil Joon; Kim, Kyung Su; Kang, Gu Hyun

    2015-01-01

    This study aimed to determine the effect of case volume on targeted temperature management (TTM) performance, incidence of adverse events, and neurologic outcome in comatose out-of-hospital cardiac arrest (OHCA) survivors treated with TTM. We used a Web-based, multicenter registry (Korean Hypothermia Network registry), to which 24 hospitals throughout the Republic of Korea participated to study adult (≥18 years) comatose out-of-hospital cardiac arrest patients treated with TTM between 2007 and 2012. The primary outcome was neurologic outcome at hospital discharge. The secondary outcomes were inhospital mortality, TTM performance, and adverse events. We extracted propensity-matched cohorts to control for bias. Multivariate logistic regression analysis was performed to assess independent risk factors for neurologic outcome. A total of 901 patients were included in this study; 544 (60.4%) survived to hospital discharge, and 248 (27.5%) were discharged with good neurologic outcome. The high-volume hospitals initiated TTM significantly earlier and had lower rates of hyperglycemia, bleeding, hypotension, and rebound hyperthermia. However, neurologic outcome and inhospital mortality were comparable between high-volume (27.7% and 44.6%, respectively) and low-volume hospitals (21.1% and 40.5%) in the propensity-matched cohorts. The adjusted odds ratio for the high-volume hospitals compared with low-volume hospitals was 1.506 (95% confidence interval, 0.875-2.592) for poor neurologic outcome. Higher TTM case volume was significantly associated with early initiation of TTM and lower incidence of adverse events. However, case volume had no association with neurologic outcome and inhospital mortality. Copyright © 2014 Elsevier Inc. All rights reserved.

  11. Effects of plyometric training volume and training surface on explosive strength.

    PubMed

    Ramírez-Campillo, Rodrigo; Andrade, David C; Izquierdo, Mikel

    2013-10-01

    The purpose of this study is to examine the effects of different volume and training surfaces during a short-term plyometric training program on neuromuscular performance. Twenty-nine subjects were randomly assigned to 4 groups: control group (CG, n = 5), moderate volume group (MVG, n = 9, 780 jumps), moderate volume hard surface group (MVGHS, n = 8, 780 jumps), and high volume group (HVG, n = 7, 1,560 jumps). A series of tests were performed by the subjects before and after 7 weeks of plyometric training. These tests were measurement of maximum strength (5 maximum repetitions [5RMs]), drop jumps (DJs) of varying heights (20, 40, and 60 cm), squat and countermovement jumps (SJ and CMJ, respectively), timed 20-m sprint, agility, body weight, and height. The results of the present study suggest that high training volume leads to a significant increase in explosive performance that requires fast stretch-shortening cycle (SSC) actions (such as DJ and sprint) in comparison to what is observed after a moderate training volume regimen. Second, when plyometric training is performed on a hard training surface (high-impact reaction force), a moderate training volume induces optimal stimulus to increase explosive performance requiring fast SSC actions (e.g., DJ), maximal dynamic strength enhancement, and higher training efficiency. Thus, a finding of interest in the study was that after 7 weeks of plyometric training, performance enhancement in maximal strength and in actions requiring fast SSC (such as DJ and sprint) were dependent on the volume of training and the surface on which it was performed. This must be taken into account when using plyometric training on different surfaces.

  12. Aldosterone and mortality in hemodialysis patients: role of volume overload.

    PubMed

    Hung, Szu-Chun; Lin, Yao-Ping; Huang, Hsin-Lei; Pu, Hsiao-Fung; Tarng, Der-Cherng

    2013-01-01

    Elevated aldosterone is associated with increased mortality in the general population. In patients on dialysis, however, the association is reversed. This paradox may be explained by volume overload, which is associated with lower aldosterone and higher mortality. We evaluated the relationship between aldosterone and outcomes in a prospective cohort of 328 hemodialysis patients stratified by the presence or absence of volume overload (defined as extracellular water/total body water >48%, as measured with bioimpedance). Baseline plasma aldosterone was measured before dialysis and categorized as low (<140 pg/mL), middle (140 to 280 pg/mL) and high (>280 pg/mL). Overall, 36% (n = 119) of the hemodialysis patients had evidence of volume overload. Baseline aldosterone was significantly lower in the presence of volume overload than in its absence. During a median follow-up of 54 months, 83 deaths and 70 cardiovascular events occurred. Cox multivariate analysis showed that by using the low aldosterone as the reference, high aldosterone was inversely associated with decreased hazard ratios for mortality (0.49; 95% confidence interval, 0.25-0.76) and first cardiovascular event (0.70; 95% confidence interval, 0.33-0.78) in the presence of volume overload. In contrast, high aldosterone was associated with an increased risk for mortality (1.97; 95% confidence interval, 1.69-3.75) and first cardiovascular event (2.01; 95% confidence interval, 1.28-4.15) in the absence of volume overload. The inverse association of aldosterone with adverse outcomes in hemodialysis patients is due to the confounding effect of volume overload. These findings support treatment of hyperaldosteronemia in hemodialysis patients who have achieved strict volume control.

  13. Relation of perioperative deaths to hospital volume among patients undergoing pancreatic resection for malignancy.

    PubMed Central

    Lieberman, M D; Kilburn, H; Lindsey, M; Brennan, M F

    1995-01-01

    OBJECTIVE: The authors examined the effect of hospital and surgeon volume on perioperative mortality rates after pancreatic resection for the treatment of pancreatic cancer. METHODS: Discharge abstracts from 1972 patients who had undergone pancreaticoduodenectomy or total pancreatectomy for malignancy in New York State between 1984 and 1991 were obtained from the Statewide Planning and Research Cooperative System. Logistic regression analysis was used to determine the relationship between hospital and surgeon experience to perioperative outcome. RESULTS: More than 75% of patients underwent resection at minimal-volume (fewer than 10 cases) or low-volume (10-50 cases) centers (defined as hospitals in which a minimal number of resections were performed in a given year), and these hospitals represented 98% of the institutions treating peripancreatic cancer. The two high-volume hospitals (more than 81 cases) demonstrated a significantly lower perioperative mortality rate (4.0%) compared with the minimal- (21.8%) and low-volume (12.3%) hospitals (p < 0.001). The perioperative mortality rate was 15.5% for low-volume (fewer than 9 cases) surgeons (defined as surgeons who had performed a minimal number of resections in any hospital in a given year) (n = 687) compared with 4.7% for high-volume (more than 41 cases) pancreatic surgeons (n = 4) (p < 0.001). Logistic regression analysis demonstrated that perioperative death is significantly (p < 0.05) related to hospital volume, but the surgeon's experience is not significantly related to perioperative deaths when hospital volume is controlled. CONCLUSIONS: These data support a defined minimum hospital experience for elective pancreatectomy for malignancy to minimize perioperative deaths. PMID:7487211

  14. Blood and Blood Product Conservation: Results of Strategies to Improve Clinical Outcomes in Open Heart Surgery Patients at a Tertiary Hospital.

    PubMed

    Khan, Junaid H; Green, Emily A; Chang, Jimmin; Ayala, Alexandria M; Barkin, Marilyn S; Reinys, Emily E; Stanton, Jeffrey; Stanten, Russell D

    2017-12-01

    Blood product usage is a quality outcome for patients undergoing cardiac surgery. To address an increase in blood product usage since the discontinuation of aprotinin, blood conservation strategies were initiated at a tertiary hospital in Oakland, CA. Improving transfusion rates for open heart surgery patients requiring Cardiopulmonary bypass (CPB) involved multiple departments in coordination. Specific changes to conserve blood product usage included advanced CPB technology upgrades, and precise individualized heparin dose response titration assay for heparin and protamine management. Retrospective analysis of blood product usage pre-implementation, post-CPB changes and post-Hemostasis Management System (HMS) implementation was done to determine the effectiveness of the blood conservation strategies. Statistically significant decrease in packed red blood cells, fresh frozen plasma, cryoprecipitate, and platelet usage over the stepped implementation of both technologies was observed. New oxygenator and centrifugal pump technologies reduced active circuitry volume and caused less damage to blood cells. Individualizing heparin and protamine dosing to a patient using the HMS led to transfusion reductions as well. Overall trends toward reductions in hospital length of stay and intensive care unit stay, and as a result, blood product cost and total hospitalization cost are positive over the period of implementation of both CPB circuit changes and HMS implementation. Although they are multifactorial in nature, these trends provide positive enforcement to the changes implemented.

  15. Conservative Surgical Approach to Restore Necrotic Columella in Patients Undergoing Neonatal Usage of Nasogastric Tube.

    PubMed

    Inchingolo, Francesco; Abenavoli, Fabio Massimo; De Angelis, Francesca; Orefici, Alessandro; Santacroce, Luigi; Dipalma, Gianna

    2017-01-01

    A common complication, related to the use of nasogastric tube during the 1 st day of life, is the necrosis of the columella. Esthetic damage in the early age typically leads to a healing request with very high result expectations. We aimed to develop and use an innovative surgical technique. We used our technique in four cases. Our technique requires two flaps designed with two paramedian release incisions. The two flaps will be sutured to what remains of the fibrous septum; finally, the two flaps will be sutured together in the medial region. Postoperative course was devoid of any complication. All patients gained esthetic improvements and an increase in the volume of the columella on the sagittal and frontal planes. This technique allows a conservative approach with low donor site morbidity and rapid postoperative course.

  16. Organochlorine pesticides and PCBs in air of southern Mexico (2002-2004)

    NASA Astrophysics Data System (ADS)

    Alegria, Henry A.; Wong, Fiona; Jantunen, Liisa M.; Bidleman, Terry F.; Figueroa, Miguel Salvador; Bouchot, Gerardo Gold; Moreno, Victor Ceja; Waliszewski, Stefan M.; Infanzon, Raul

    Air samples were collected in southern Mexico in 2002-2004 to determine the extent of contamination with organochlorine (OC) pesticides and polychlorinated biphenyls (PCBs). The ΣDDTs ranged from 239 to 2360 pg m -3. Other prominent OC pesticides were endosulfans, toxaphene and lindane. Pesticides detected in lower concentrations include chlordanes, dieldrin, and heptachlor. Proportions of DDT compounds suggested fresh use of DDT in some locations and a mix of fresh and aged residues at others. Ratios of trans-chlordane/ cis-chlordane were consistent with fresh chlordane usage or emission of residues from former termiticide applications. The ΣPCBs was relatively low at all sites. Concentrations of OC pesticides measured with passive samplers agreed well with those measured using high-volume samplers. Air back trajectory analysis suggests a complex pattern of regional atmospheric transport.

  17. Validation of geometric measurements of the left atrium and pulmonary veins for analysis of reverse structural remodeling following ablation therapy

    NASA Astrophysics Data System (ADS)

    Rettmann, M. E.; Holmes, D. R., III; Gunawan, M. S.; Ge, X.; Karwoski, R. A.; Breen, J. F.; Packer, D. L.; Robb, R. A.

    2012-03-01

    Geometric analysis of the left atrium and pulmonary veins is important for studying reverse structural remodeling following cardiac ablation therapy. It has been shown that the left atrium decreases in volume and the pulmonary vein ostia decrease in diameter following ablation therapy. Most analysis techniques, however, require laborious manual tracing of image cross-sections. Pulmonary vein diameters are typically measured at the junction between the left atrium and pulmonary veins, called the pulmonary vein ostia, with manually drawn lines on volume renderings or on image cross-sections. In this work, we describe a technique for making semi-automatic measurements of the left atrium and pulmonary vein ostial diameters from high resolution CT scans and multi-phase datasets. The left atrium and pulmonary veins are segmented from a CT volume using a 3D volume approach and cut planes are interactively positioned to separate the pulmonary veins from the body of the left atrium. The cut plane is also used to compute the pulmonary vein ostial diameter. Validation experiments are presented which demonstrate the ability to repeatedly measure left atrial volume and pulmonary vein diameters from high resolution CT scans, as well as the feasibility of this approach for analyzing dynamic, multi-phase datasets. In the high resolution CT scans the left atrial volume measurements show high repeatability with approximately 4% intra-rater repeatability and 8% inter-rater repeatability. Intra- and inter-rater repeatability for pulmonary vein diameter measurements range from approximately 2 to 4 mm. For the multi-phase CT datasets, differences in left atrial volumes between a standard slice-by-slice approach and the proposed 3D volume approach are small, with percent differences on the order of 3% to 6%.

  18. Botulinum toxin (Dysport) treatment of the spastic gastrocnemius muscle in children with cerebral palsy: a randomized trial comparing two injection volumes.

    PubMed

    Hu, Gwo-Chi; Chuang, Yao-Chia; Liu, Jen-Pei; Chien, Kuo-Liong; Chen, Yi-Min; Chen, Ying-Fang

    2009-01-01

    To compare the effect of equivalent doses in two different volumes of botulinum toxin type A (Dysport) on gastrocnemius spasticity. Single-blind, randomized, controlled trial. Hospital rehabilitation department. Twenty-two children with spastic diplegic or quadriplegic cerebral palsy. High (500 U/5 mL) and low (500 U/1 mL)-volume preparations of Dysport were injected into the gastrocnemius muscles, each child randomly receiving one preparation in the right and the other in the left leg. Dynamic ankle joint range of motion (ROM), passive ROM of the ankle joint, modified Ashworth Scale scores, and the areas of the compound muscle action potential assessed before treatment and at four and eight weeks post treatment. Both legs improved significantly. The mean (SD) improvements between baseline and the end of follow-up were 19.7 (10.83) degrees for dynamic ROM, 8.4 (9.19) degrees for passive ROM, -1.3 (0.6) for modified Ashworth Scale scores, and -9.4 (11.41) mV-ms for compound muscle action potential in the high-volume group; and 13.5 (10.45) degrees for dynamic ROM, 7.4 (7.88) for passive ROM, -0.9 (0.5) for modified Ashworth Scale scores, and -5.9 (7.50) mV-ms for areas of compound muscle action potential in the low-volume group. The high-volume preparation yielded significantly greater improvement in dynamic ROM (P<0.001), muscle tone (P < 0.001), and lower compound muscle action potential area (P = 0.006). A high-volume preparation of Dysport is more effective than a low volume in reducing spasticity in the gastrocnemius muscle.

  19. The cost of implementation of the Clinical Laboratory Improvement Amendments of 1988--the example of pediatric office-based cholesterol screening.

    PubMed

    Tershakovec, A M; Brannon, S D; Bennett, M J; Shannon, B M

    1995-08-01

    To measure the additional costs of office-based laboratory testing due to the implementation of the Clinical Laboratory Improvement Amendments of 1988 (CLIA '88), using cholesterol screening for children as an example. Four- to ten-year-old children who received their well child care at one of seven participating pediatric practices were screened for hypercholesterolemia. The average number of analyses per day and days per month were derived from the volume of testing completed by the practices. Nurses and technicians time in the screening process were measured and personnel costs were calculated based on salary and fringe benefit rates. Costs of supplies, analyzing control samples, instrument calibration, and instrument depreciation were included. Costs estimates of screening were then completed. CLIA '88 implementation costs were derived from appropriate proficiency testing and laboratory inspection programs. In six practices completing a low volume of testing, 2807 children (5 to 6 children per week) were screened during the observation period, while 414 (about 25 children per week) were screened in one high-volume practice implementing universal screening over a 4-month period. For the six low-volume practices, the cost of screening was $10.60 per child. This decreased to $5.47 for the high-volume practice. Estimated costs of CLIA '88 implementation, including additional proficiency testing and laboratory inspection, added $3.20 per test for the low-volume practices, and $0.71 per test for the high-volume testing. Implementation of CLIA adds significantly to the cost of office-based chemistry laboratory screening. Despite these additional expenses, the cost of testing is still within a reasonable charge for laboratory testing, and is highly sensitive to the volume of tests completed.

  20. Systematic review and meta-analysis of colon cleansing preparations in patients with inflammatory bowel disease

    PubMed Central

    Restellini, Sophie; Kherad, Omar; Bessissow, Talat; Ménard, Charles; Martel, Myriam; Taheri Tanjani, Maryam; Lakatos, Peter L; Barkun, Alan N

    2017-01-01

    AIM To performed a systematic review and meta-analysis to determine any possible differences in terms of effectiveness, safety and tolerability between existing colon-cleansing products in patients with inflammatory bowel disease. METHODS Systematic searches were performed (January 1980-September 2016) using MEDLINE, EMBASE, Scopus, CENTRAL and ISI Web of knowledge for randomized trials assessing preparations with or without adjuvants, given in split and non-split dosing, and in high (> 3 L) or low-volume (2 L or less) regimens. Bowel cleansing quality was the primary outcome. Secondary outcomes included patient willingness-to-repeat the procedure and side effects/complications. RESULTS Out of 439 citations, 4 trials fulfilled our inclusion criteria (n = 449 patients). One trial assessed the impact of adding simethicone to polyethylene glycol (PEG) 4 L with no effect on bowel cleansing quality, but a better tolerance. Another trial compared senna to castor oil, again without any differences in term of bowel cleansing. Two trials compared the efficacy of PEG high-volume vs PEG low-volume associated to an adjuvant in split-dose regimens: PEG low-dose efficacy was not different to PEG high-dose; OR = 0.84 (0.37-1.92). A higher proportion of patients were willing to repeat low-volume preparations vs high-volume; OR = 5.11 (1.31-20.0). CONCLUSION In inflammatory bowel disease population, PEG low-volume regimen seems not inferior to PEG high-volume to clean the colon, and yields improved willingness-to-repeat. Further additional research is urgently required to compare contemporary products in this population. PMID:28932092

  1. Systematic review and meta-analysis of colon cleansing preparations in patients with inflammatory bowel disease.

    PubMed

    Restellini, Sophie; Kherad, Omar; Bessissow, Talat; Ménard, Charles; Martel, Myriam; Taheri Tanjani, Maryam; Lakatos, Peter L; Barkun, Alan N

    2017-08-28

    To performed a systematic review and meta-analysis to determine any possible differences in terms of effectiveness, safety and tolerability between existing colon-cleansing products in patients with inflammatory bowel disease. Systematic searches were performed (January 1980-September 2016) using MEDLINE, EMBASE, Scopus, CENTRAL and ISI Web of knowledge for randomized trials assessing preparations with or without adjuvants, given in split and non-split dosing, and in high (> 3 L) or low-volume (2 L or less) regimens. Bowel cleansing quality was the primary outcome. Secondary outcomes included patient willingness-to-repeat the procedure and side effects/complications. Out of 439 citations, 4 trials fulfilled our inclusion criteria ( n = 449 patients). One trial assessed the impact of adding simethicone to polyethylene glycol (PEG) 4 L with no effect on bowel cleansing quality, but a better tolerance. Another trial compared senna to castor oil, again without any differences in term of bowel cleansing. Two trials compared the efficacy of PEG high-volume vs PEG low-volume associated to an adjuvant in split-dose regimens: PEG low-dose efficacy was not different to PEG high-dose; OR = 0.84 (0.37-1.92). A higher proportion of patients were willing to repeat low-volume preparations vs high-volume; OR = 5.11 (1.31-20.0). In inflammatory bowel disease population, PEG low-volume regimen seems not inferior to PEG high-volume to clean the colon, and yields improved willingness-to-repeat. Further additional research is urgently required to compare contemporary products in this population.

  2. Developing cost effective plans for low volume bridges

    DOT National Transportation Integrated Search

    2006-09-01

    There is currently an escalating concern across the state of Kansas with respect to the age and condition of low volume bridges and methods available to modify or replace them. A high percentage of low volume bridges in the state of Kansas require or...

  3. New Horizons in Adult Education. Volumes 3-7. 1989-1993.

    ERIC Educational Resources Information Center

    New Horizons in Adult Education, 1993

    1993-01-01

    Volume 3 includes the following: "Comparison of Computer and Audio Teleconferencing" (Norman Coombs); "Intellectual Suppression" [book review] (Roger Boshier). Contents of volume 4 are as follows: "Straight Time and Standard Brand Adult Education" (John Ohliger); "Comparison of Folk High Schools in Denmark, and…

  4. HIGH VOLUME INJECTION FOR GCMS ANALYSIS OF PARTICULATE ORGANIC SPECIES IN AMBIENT AIR

    EPA Science Inventory

    Detection of organic species in ambient particulate matter typically requires large air sample volumes, frequently achieved by grouping samples into monthly composites. Decreasing the volume of air sample required would allow shorter collection times and more convenient sample c...

  5. Novel genetic loci underlying human intracranial volume identified through genome-wide association.

    PubMed

    Adams, Hieab H H; Hibar, Derrek P; Chouraki, Vincent; Stein, Jason L; Nyquist, Paul A; Rentería, Miguel E; Trompet, Stella; Arias-Vasquez, Alejandro; Seshadri, Sudha; Desrivières, Sylvane; Beecham, Ashley H; Jahanshad, Neda; Wittfeld, Katharina; Van der Lee, Sven J; Abramovic, Lucija; Alhusaini, Saud; Amin, Najaf; Andersson, Micael; Arfanakis, Konstantinos; Aribisala, Benjamin S; Armstrong, Nicola J; Athanasiu, Lavinia; Axelsson, Tomas; Beiser, Alexa; Bernard, Manon; Bis, Joshua C; Blanken, Laura M E; Blanton, Susan H; Bohlken, Marc M; Boks, Marco P; Bralten, Janita; Brickman, Adam M; Carmichael, Owen; Chakravarty, M Mallar; Chauhan, Ganesh; Chen, Qiang; Ching, Christopher R K; Cuellar-Partida, Gabriel; Braber, Anouk Den; Doan, Nhat Trung; Ehrlich, Stefan; Filippi, Irina; Ge, Tian; Giddaluru, Sudheer; Goldman, Aaron L; Gottesman, Rebecca F; Greven, Corina U; Grimm, Oliver; Griswold, Michael E; Guadalupe, Tulio; Hass, Johanna; Haukvik, Unn K; Hilal, Saima; Hofer, Edith; Hoehn, David; Holmes, Avram J; Hoogman, Martine; Janowitz, Deborah; Jia, Tianye; Kasperaviciute, Dalia; Kim, Sungeun; Klein, Marieke; Kraemer, Bernd; Lee, Phil H; Liao, Jiemin; Liewald, David C M; Lopez, Lorna M; Luciano, Michelle; Macare, Christine; Marquand, Andre; Matarin, Mar; Mather, Karen A; Mattheisen, Manuel; Mazoyer, Bernard; McKay, David R; McWhirter, Rebekah; Milaneschi, Yuri; Mirza-Schreiber, Nazanin; Muetzel, Ryan L; Maniega, Susana Muñoz; Nho, Kwangsik; Nugent, Allison C; Loohuis, Loes M Olde; Oosterlaan, Jaap; Papmeyer, Martina; Pappa, Irene; Pirpamer, Lukas; Pudas, Sara; Pütz, Benno; Rajan, Kumar B; Ramasamy, Adaikalavan; Richards, Jennifer S; Risacher, Shannon L; Roiz-Santiañez, Roberto; Rommelse, Nanda; Rose, Emma J; Royle, Natalie A; Rundek, Tatjana; Sämann, Philipp G; Satizabal, Claudia L; Schmaal, Lianne; Schork, Andrew J; Shen, Li; Shin, Jean; Shumskaya, Elena; Smith, Albert V; Sprooten, Emma; Strike, Lachlan T; Teumer, Alexander; Thomson, Russell; Tordesillas-Gutierrez, Diana; Toro, Roberto; Trabzuni, Daniah; Vaidya, Dhananjay; Van der Grond, Jeroen; Van der Meer, Dennis; Van Donkelaar, Marjolein M J; Van Eijk, Kristel R; Van Erp, Theo G M; Van Rooij, Daan; Walton, Esther; Westlye, Lars T; Whelan, Christopher D; Windham, Beverly G; Winkler, Anderson M; Woldehawariat, Girma; Wolf, Christiane; Wolfers, Thomas; Xu, Bing; Yanek, Lisa R; Yang, Jingyun; Zijdenbos, Alex; Zwiers, Marcel P; Agartz, Ingrid; Aggarwal, Neelum T; Almasy, Laura; Ames, David; Amouyel, Philippe; Andreassen, Ole A; Arepalli, Sampath; Assareh, Amelia A; Barral, Sandra; Bastin, Mark E; Becker, Diane M; Becker, James T; Bennett, David A; Blangero, John; van Bokhoven, Hans; Boomsma, Dorret I; Brodaty, Henry; Brouwer, Rachel M; Brunner, Han G; Buckner, Randy L; Buitelaar, Jan K; Bulayeva, Kazima B; Cahn, Wiepke; Calhoun, Vince D; Cannon, Dara M; Cavalleri, Gianpiero L; Chen, Christopher; Cheng, Ching-Yu; Cichon, Sven; Cookson, Mark R; Corvin, Aiden; Crespo-Facorro, Benedicto; Curran, Joanne E; Czisch, Michael; Dale, Anders M; Davies, Gareth E; De Geus, Eco J C; De Jager, Philip L; de Zubicaray, Greig I; Delanty, Norman; Depondt, Chantal; DeStefano, Anita L; Dillman, Allissa; Djurovic, Srdjan; Donohoe, Gary; Drevets, Wayne C; Duggirala, Ravi; Dyer, Thomas D; Erk, Susanne; Espeseth, Thomas; Evans, Denis A; Fedko, Iryna O; Fernández, Guillén; Ferrucci, Luigi; Fisher, Simon E; Fleischman, Debra A; Ford, Ian; Foroud, Tatiana M; Fox, Peter T; Francks, Clyde; Fukunaga, Masaki; Gibbs, J Raphael; Glahn, David C; Gollub, Randy L; Göring, Harald H H; Grabe, Hans J; Green, Robert C; Gruber, Oliver; Gudnason, Vilmundur; Guelfi, Sebastian; Hansell, Narelle K; Hardy, John; Hartman, Catharina A; Hashimoto, Ryota; Hegenscheid, Katrin; Heinz, Andreas; Le Hellard, Stephanie; Hernandez, Dena G; Heslenfeld, Dirk J; Ho, Beng-Choon; Hoekstra, Pieter J; Hoffmann, Wolfgang; Hofman, Albert; Holsboer, Florian; Homuth, Georg; Hosten, Norbert; Hottenga, Jouke-Jan; Hulshoff Pol, Hilleke E; Ikeda, Masashi; Ikram, M Kamran; Jack, Clifford R; Jenkinson, Mark; Johnson, Robert; Jönsson, Erik G; Jukema, J Wouter; Kahn, René S; Kanai, Ryota; Kloszewska, Iwona; Knopman, David S; Kochunov, Peter; Kwok, John B; Lawrie, Stephen M; Lemaître, Hervé; Liu, Xinmin; Longo, Dan L; Longstreth, W T; Lopez, Oscar L; Lovestone, Simon; Martinez, Oliver; Martinot, Jean-Luc; Mattay, Venkata S; McDonald, Colm; McIntosh, Andrew M; McMahon, Katie L; McMahon, Francis J; Mecocci, Patrizia; Melle, Ingrid; Meyer-Lindenberg, Andreas; Mohnke, Sebastian; Montgomery, Grant W; Morris, Derek W; Mosley, Thomas H; Mühleisen, Thomas W; Müller-Myhsok, Bertram; Nalls, Michael A; Nauck, Matthias; Nichols, Thomas E; Niessen, Wiro J; Nöthen, Markus M; Nyberg, Lars; Ohi, Kazutaka; Olvera, Rene L; Ophoff, Roel A; Pandolfo, Massimo; Paus, Tomas; Pausova, Zdenka; Penninx, Brenda W J H; Pike, G Bruce; Potkin, Steven G; Psaty, Bruce M; Reppermund, Simone; Rietschel, Marcella; Roffman, Joshua L; Romanczuk-Seiferth, Nina; Rotter, Jerome I; Ryten, Mina; Sacco, Ralph L; Sachdev, Perminder S; Saykin, Andrew J; Schmidt, Reinhold; Schofield, Peter R; Sigurdsson, Sigurdur; Simmons, Andy; Singleton, Andrew; Sisodiya, Sanjay M; Smith, Colin; Smoller, Jordan W; Soininen, Hilkka; Srikanth, Velandai; Steen, Vidar M; Stott, David J; Sussmann, Jessika E; Thalamuthu, Anbupalam; Tiemeier, Henning; Toga, Arthur W; Traynor, Bryan J; Troncoso, Juan; Turner, Jessica A; Tzourio, Christophe; Uitterlinden, Andre G; Hernández, Maria C Valdés; Van der Brug, Marcel; Van der Lugt, Aad; Van der Wee, Nic J A; Van Duijn, Cornelia M; Van Haren, Neeltje E M; Van T Ent, Dennis; Van Tol, Marie-Jose; Vardarajan, Badri N; Veltman, Dick J; Vernooij, Meike W; Völzke, Henry; Walter, Henrik; Wardlaw, Joanna M; Wassink, Thomas H; Weale, Michael E; Weinberger, Daniel R; Weiner, Michael W; Wen, Wei; Westman, Eric; White, Tonya; Wong, Tien Y; Wright, Clinton B; Zielke, H Ronald; Zonderman, Alan B; Deary, Ian J; DeCarli, Charles; Schmidt, Helena; Martin, Nicholas G; De Craen, Anton J M; Wright, Margaret J; Launer, Lenore J; Schumann, Gunter; Fornage, Myriam; Franke, Barbara; Debette, Stéphanie; Medland, Sarah E; Ikram, M Arfan; Thompson, Paul M

    2016-12-01

    Intracranial volume reflects the maximally attained brain size during development, and remains stable with loss of tissue in late life. It is highly heritable, but the underlying genes remain largely undetermined. In a genome-wide association study of 32,438 adults, we discovered five previously unknown loci for intracranial volume and confirmed two known signals. Four of the loci were also associated with adult human stature, but these remained associated with intracranial volume after adjusting for height. We found a high genetic correlation with child head circumference (ρ genetic = 0.748), which indicates a similar genetic background and allowed us to identify four additional loci through meta-analysis (N combined = 37,345). Variants for intracranial volume were also related to childhood and adult cognitive function, and Parkinson's disease, and were enriched near genes involved in growth pathways, including PI3K-AKT signaling. These findings identify the biological underpinnings of intracranial volume and their link to physiological and pathological traits.

  6. Novel genetic loci underlying human intracranial volume identified through genome-wide association

    PubMed Central

    Adams, Hieab HH; Hibar, Derrek P; Chouraki, Vincent; Stein, Jason L; Nyquist, Paul A; Rentería, Miguel E; Trompet, Stella; Arias-Vasquez, Alejandro; Seshadri, Sudha; Desrivières, Sylvane; Beecham, Ashley H; Jahanshad, Neda; Wittfeld, Katharina; Van der Lee, Sven J; Abramovic, Lucija; Alhusaini, Saud; Amin, Najaf; Andersson, Micael; Arfanakis, Konstantinos; Aribisala, Benjamin S; Armstrong, Nicola J; Athanasiu, Lavinia; Axelsson, Tomas; Beiser, Alexa; Bernard, Manon; Bis, Joshua C; Blanken, Laura ME; Blanton, Susan H; Bohlken, Marc M; Boks, Marco P; Bralten, Janita; Brickman, Adam M; Carmichael, Owen; Chakravarty, M Mallar; Chauhan, Ganesh; Chen, Qiang; Ching, Christopher RK; Cuellar-Partida, Gabriel; Den Braber, Anouk; Doan, Nhat Trung; Ehrlich, Stefan; Filippi, Irina; Ge, Tian; Giddaluru, Sudheer; Goldman, Aaron L; Gottesman, Rebecca F; Greven, Corina U; Grimm, Oliver; Griswold, Michael E; Guadalupe, Tulio; Hass, Johanna; Haukvik, Unn K; Hilal, Saima; Hofer, Edith; Hoehn, David; Holmes, Avram J; Hoogman, Martine; Janowitz, Deborah; Jia, Tianye; Kasperaviciute, Dalia; Kim, Sungeun; Klein, Marieke; Kraemer, Bernd; Lee, Phil H; Liao, Jiemin; Liewald, David CM; Lopez, Lorna M; Luciano, Michelle; Macare, Christine; Marquand, Andre; Matarin, Mar; Mather, Karen A; Mattheisen, Manuel; Mazoyer, Bernard; McKay, David R; McWhirter, Rebekah; Milaneschi, Yuri; Mirza-Schreiber, Nazanin; Muetzel, Ryan L; Maniega, Susana Muñoz; Nho, Kwangsik; Nugent, Allison C; Olde Loohuis, Loes M; Oosterlaan, Jaap; Papmeyer, Martina; Pappa, Irene; Pirpamer, Lukas; Pudas, Sara; Pütz, Benno; Rajan, Kumar B; Ramasamy, Adaikalavan; Richards, Jennifer S; Risacher, Shannon L; Roiz-Santiañez, Roberto; Rommelse, Nanda; Rose, Emma J; Royle, Natalie A; Rundek, Tatjana; Sämann, Philipp G; Satizabal, Claudia L; Schmaal, Lianne; Schork, Andrew J; Shen, Li; Shin, Jean; Shumskaya, Elena; Smith, Albert V; Sprooten, Emma; Strike, Lachlan T; Teumer, Alexander; Thomson, Russell; Tordesillas-Gutierrez, Diana; Toro, Roberto; Trabzuni, Daniah; Vaidya, Dhananjay; Van der Grond, Jeroen; Van der Meer, Dennis; Van Donkelaar, Marjolein MJ; Van Eijk, Kristel R; Van Erp, Theo GM; Van Rooij, Daan; Walton, Esther; Westlye, Lars T; Whelan, Christopher D; Windham, Beverly G; Winkler, Anderson M; Woldehawariat, Girma; Wolf, Christiane; Wolfers, Thomas; Xu, Bing; Yanek, Lisa R; Yang, Jingyun; Zijdenbos, Alex; Zwiers, Marcel P; Agartz, Ingrid; Aggarwal, Neelum T; Almasy, Laura; Ames, David; Amouyel, Philippe; Andreassen, Ole A; Arepalli, Sampath; Assareh, Amelia A; Barral, Sandra; Bastin, Mark E; Becker, Diane M; Becker, James T; Bennett, David A; Blangero, John; van Bokhoven, Hans; Boomsma, Dorret I; Brodaty, Henry; Brouwer, Rachel M; Brunner, Han G; Buckner, Randy L; Buitelaar, Jan K; Bulayeva, Kazima B; Cahn, Wiepke; Calhoun, Vince D; Cannon, Dara M; Cavalleri, Gianpiero L; Chen, Christopher; Cheng, Ching-Yu; Cichon, Sven; Cookson, Mark R; Corvin, Aiden; Crespo-Facorro, Benedicto; Curran, Joanne E; Czisch, Michael; Dale, Anders M; Davies, Gareth E; De Geus, Eco JC; De Jager, Philip L; de Zubicaray, Greig I; Delanty, Norman; Depondt, Chantal; DeStefano, Anita L; Dillman, Allissa; Djurovic, Srdjan; Donohoe, Gary; Drevets, Wayne C; Duggirala, Ravi; Dyer, Thomas D; Erk, Susanne; Espeseth, Thomas; Evans, Denis A; Fedko, Iryna O; Fernández, Guillén; Ferrucci, Luigi; Fisher, Simon E; Fleischman, Debra A; Ford, Ian; Foroud, Tatiana M; Fox, Peter T; Francks, Clyde; Fukunaga, Masaki; Gibbs, J Raphael; Glahn, David C; Gollub, Randy L; Göring, Harald HH; Grabe, Hans J; Green, Robert C; Gruber, Oliver; Gudnason, Vilmundur; Guelfi, Sebastian; Hansell, Narelle K; Hardy, John; Hartman, Catharina A; Hashimoto, Ryota; Hegenscheid, Katrin; Heinz, Andreas; Le Hellard, Stephanie; Hernandez, Dena G; Heslenfeld, Dirk J; Ho, Beng-Choon; Hoekstra, Pieter J; Hoffmann, Wolfgang; Hofman, Albert; Holsboer, Florian; Homuth, Georg; Hosten, Norbert; Hottenga, Jouke-Jan; Hulshoff Pol, Hilleke E; Ikeda, Masashi; Ikram, M Kamran; Jack, Clifford R; Jenkinson, Mark; Johnson, Robert; Jönsson, Erik G; Jukema, J Wouter; Kahn, René S; Kanai, Ryota; Kloszewska, Iwona; Knopman, David S; Kochunov, Peter; Kwok, John B; Lawrie, Stephen M; Lemaître, Hervé; Liu, Xinmin; Longo, Dan L; Longstreth, WT; Lopez, Oscar L; Lovestone, Simon; Martinez, Oliver; Martinot, Jean-Luc; Mattay, Venkata S; McDonald, Colm; McIntosh, Andrew M; McMahon, Katie L; McMahon, Francis J; Mecocci, Patrizia; Melle, Ingrid; Meyer-Lindenberg, Andreas; Mohnke, Sebastian; Montgomery, Grant W; Morris, Derek W; Mosley, Thomas H; Mühleisen, Thomas W; Müller-Myhsok, Bertram; Nalls, Michael A; Nauck, Matthias; Nichols, Thomas E; Niessen, Wiro J; Nöthen, Markus M; Nyberg, Lars; Ohi, Kazutaka; Olvera, Rene L; Ophoff, Roel A; Pandolfo, Massimo; Paus, Tomas; Pausova, Zdenka; Penninx, Brenda WJH; Pike, G Bruce; Potkin, Steven G; Psaty, Bruce M; Reppermund, Simone; Rietschel, Marcella; Roffman, Joshua L; Romanczuk-Seiferth, Nina; Rotter, Jerome I; Ryten, Mina; Sacco, Ralph L; Sachdev, Perminder S; Saykin, Andrew J; Schmidt, Reinhold; Schofield, Peter R; Sigurdsson, Sigurdur; Simmons, Andy; Singleton, Andrew; Sisodiya, Sanjay M; Smith, Colin; Smoller, Jordan W; Soininen, Hilkka; Srikanth, Velandai; Steen, Vidar M; Stott, David J; Sussmann, Jessika E; Thalamuthu, Anbupalam; Tiemeier, Henning; Toga, Arthur W; Traynor, Bryan J; Troncoso, Juan; Turner, Jessica A; Tzourio, Christophe; Uitterlinden, Andre G; Valdés Hernández, Maria C; Van der Brug, Marcel; Van der Lugt, Aad; Van der Wee, Nic JA; Van Duijn, Cornelia M; Van Haren, Neeltje EM; Van 't Ent, Dennis; Van Tol, Marie-Jose; Vardarajan, Badri N; Veltman, Dick J; Vernooij, Meike W; Völzke, Henry; Walter, Henrik; Wardlaw, Joanna M; Wassink, Thomas H; Weale, Michael E; Weinberger, Daniel R; Weiner, Michael W; Wen, Wei; Westman, Eric; White, Tonya; Wong, Tien Y; Wright, Clinton B; Zielke, H Ronald; Zonderman, Alan B; Deary, Ian J; DeCarli, Charles; Schmidt, Helena; Martin, Nicholas G; De Craen, Anton JM; Wright, Margaret J; Launer, Lenore J; Schumann, Gunter; Fornage, Myriam; Franke, Barbara; Debette, Stéphanie; Medland, Sarah E; Ikram, M Arfan; Thompson, Paul M

    2016-01-01

    Intracranial volume reflects the maximally attained brain size during development, and remains stable with loss of tissue in late life. It is highly heritable, but the underlying genes remain largely undetermined. In a genome-wide association study of 32,438 adults, we discovered five novel loci for intracranial volume and confirmed two known signals. Four of the loci are also associated with adult human stature, but these remained associated with intracranial volume after adjusting for height. We found a high genetic correlation with child head circumference (ρgenetic=0.748), which indicated a similar genetic background and allowed for the identification of four additional loci through meta-analysis (Ncombined = 37,345). Variants for intracranial volume were also related to childhood and adult cognitive function, Parkinson’s disease, and enriched near genes involved in growth pathways including PI3K–AKT signaling. These findings identify biological underpinnings of intracranial volume and provide genetic support for theories on brain reserve and brain overgrowth. PMID:27694991

  7. Hospital esophagectomy volume and postoperative length of stay: A systematic review and meta-analysis.

    PubMed

    Giwa, Femi; Salami, Aitua; Abioye, Ajibola I

    2018-01-01

    Much attention in the volume-outcomes literature has focused on the empirical impact of surgical caseload on outcomes. However, relevant studies on the association between surgical volume and variables that potentially contribute to healthcare costs are limited. The objective of this study was to systematically elucidate a contemporary analysis of the empirical relationship between hospital esophagectomy volume and postoperative length of stay, a cost-related outcome. OvidSP, PubMed, EMBASE, Cochrane Central Register of Controlled Trials (CENTRAL), ISI Web of Science and OpenGrey were searched for relevant articles published from 2000 to 2016. High hospital esophagectomy volume was associated with reduced postoperative length of stay (mean: 3 days; 95%CI: 2.8, 3.2) and risk of prolonged length of stay (RR: 0.80, 95%CI: 0.74, 0.87) in a dose-response fashion. Complex surgeries performed at high surgical volume centers may be associated with overall decrease in postoperative length of stay, a cost-related outcome. Copyright © 2017 Elsevier Inc. All rights reserved.

  8. Graphene wrapped multiwalled carbon nanotubes dispersed nanofluids for heat transfer applications

    NASA Astrophysics Data System (ADS)

    Jyothirmayee Aravind, S. S.; Ramaprabhu, S.

    2012-12-01

    A two step method is employed for the preparation of graphene wrapped multiwalled carbon nanotubes (MWNT) dispersed nanofluids. Graphene wrapped MWNT composite is prepared by simple chemical vapor deposition technique and further purified prior to the synthesis of nanofluids. The functionalization of MWNT with the poly electrolyte, graphene drives out the need for surfactants or long term harsh chemical treatments as in the case of pristine carbon materials based nanofluids. The enhancement in thermal transport properties of surfactant free graphene wrapped MWNT composite in de-ionized (DI) water and ethylene glycol (EG) base fluids than that of pristine carbon nanomaterial based nanofluids indicates the potential usage of the hybrid composite based nanofluids in heat transfer applications. An enhancement in thermal conductivity of 11.3% and 13.7% has been attained with 0.04% volume fraction of hybrid composite based DI water and EG nanofluids at 25 °C. The nanocomposite possesses extreme stability in a variety of aqueous solvents without any surfactant. Electrical conductivity of the nanofluids analyzed as a function of volume fraction of nanoparticles and temperature shows a positive effect. Further, the analysis of forced convective heat transfer coefficients of the nanofluids flowing through a stain less steel tube shows significant enhancement in heat transfer, attributed to good aspect ratio of graphene wrapped MWNT and synergistic effect of high thermally conducting graphene and MWNT.

  9. LSENS: A General Chemical Kinetics and Sensitivity Analysis Code for homogeneous gas-phase reactions. Part 3: Illustrative test problems

    NASA Technical Reports Server (NTRS)

    Bittker, David A.; Radhakrishnan, Krishnan

    1994-01-01

    LSENS, the Lewis General Chemical Kinetics and Sensitivity Analysis Code, has been developed for solving complex, homogeneous, gas-phase chemical kinetics problems and contains sensitivity analysis for a variety of problems, including nonisothermal situations. This report is part 3 of a series of three reference publications that describe LSENS, provide a detailed guide to its usage, and present many example problems. Part 3 explains the kinetics and kinetics-plus-sensitivity analysis problems supplied with LSENS and presents sample results. These problems illustrate the various capabilities of, and reaction models that can be solved by, the code and may provide a convenient starting point for the user to construct the problem data file required to execute LSENS. LSENS is a flexible, convenient, accurate, and efficient solver for chemical reaction problems such as static system; steady, one-dimensional, inviscid flow; reaction behind incident shock wave, including boundary layer correction; and perfectly stirred (highly backmixed) reactor. In addition, the chemical equilibrium state can be computed for the following assigned states: temperature and pressure, enthalpy and pressure, temperature and volume, and internal energy and volume. For static problems the code computes the sensitivity coefficients of the dependent variables and their temporal derivatives with respect to the initial values of the dependent variables and/or the three rate coefficient parameters of the chemical reactions.

  10. A survey of antimicrobial usage in animals in South Africa with specific reference to food animals.

    PubMed

    Eagar, Hayley; Swan, Gerry; van Vuuren, Moritz

    2012-08-01

    The purpose of this study was to set a benchmark for a monitoring and surveillance programme on the volumes of antimicrobials available and consumed by animals for the benefit of animal health in South Africa. This survey was collated from data available from 2002 to 2004. The authorised antimicrobials available in South Africa were firstly reviewed. The majority of available antimicrobials were registered under the Stock Remedies Act 36 1947. Secondly, volumes of antimicrobials consumed were then surveyed and it was found that the majority of consumed antimicrobials were from the macrolide and pleuromutilin classes, followed by the tetracycline class, the sulphonamide class and lastly the penicillin class.Results showed that 68.5% of the antimicrobials surveyed were administered as in-feed medications. 17.5% of the total volume of antimicrobials utilised were parenteral antimicrobials, whereas antimicrobials for water medication constituted 12% of the total and 'other' dosage forms, for example the topical and aural dosage forms, constituted 1.5% of the total. Intramammary antimicrobials represented 0.04% of the total. The surveillance systems for veterinary antimicrobials used by other countries were scrutinised and compared. It was concluded that a combination of the surveillance systems applied by Australia and the United Kingdom is the best model (with modifications) to apply to the animal health industry in South Africa. Such a surveillance system, of the volumes of veterinary antimicrobials consumed, should ideally be implemented in conjunction with a veterinary antimicrobial resistance surveillance and monitoring programme. This will generate meaningful data that will contribute to the rational administration of antimicrobials in order to preserve the efficacy of the existing antimicrobials in South Africa.

  11. Nonantibiotic macrolides prevent human neutrophil elastase-induced mucus stasis and airway surface liquid volume depletion

    PubMed Central

    Sabater, Juan R.; Clarke, Tainya C.; Tan, Chong D.; Davies, Catrin M.; Liu, Jia; Yeung, Arthur; Garland, Alaina L.; Stutts, M. Jackson; Abraham, William M.; Phillips, Gary; Baker, William R.; Wright, Clifford D.; Wilbert, Sibylle

    2013-01-01

    Mucus clearance is an important component of the lung's innate defense system. A failure of this system brought on by mucus dehydration is common to both cystic fibrosis (CF) and chronic obstructive pulmonary disease (COPD). Mucus clearance rates are regulated by the volume of airway surface liquid (ASL) and by ciliary beat frequency (CBF). Chronic treatment with macrolide antibiotics is known to be beneficial to both CF and COPD patients. However, chronic macrolide usage may induce bacterial resistance. We have developed a novel macrolide, 2′-desoxy-9-(S)-erythromycylamine (GS-459755), that has significantly diminished antibiotic activity against Staphylococcus aureus, Streptococcus pneumonia, Moraxella catarrhalis, and Haemophilus influenzae. Since neutrophilia frequently occurs in chronic lung disease and human neutrophil elastase (HNE) induces mucus stasis by activating the epithelial sodium channel (ENaC), we tested the ability of GS-459755 to protect against HNE-induced mucus stasis. GS-459755 had no effect on HNE activity. However, GS-459755 pretreatment protected against HNE-induced ASL volume depletion in human bronchial epithelial cells (HBECs). The effect of GS-459755 on ASL volume was dose dependent (IC50 ∼3.9 μM) and comparable to the antibacterial macrolide azithromycin (IC50 ∼2.4 μM). Macrolides had no significant effect on CBF or on transepithelial water permeability. However, the amiloride-sensitive transepithelial voltage, a marker of ENaC activity, was diminished by macrolide pretreatment. We conclude that GS-459755 may limit HNE-induced activation of ENaC and may be useful for the treatment of mucus dehydration in CF and COPD without inducing bacterial resistance. PMID:23542952

  12. High-Grade Glioma Radiation Therapy Target Volumes and Patterns of Failure Obtained From Magnetic Resonance Imaging and {sup 18}F-FDOPA Positron Emission Tomography Delineations From Multiple Observers

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

    Kosztyla, Robert, E-mail: rkosztyla@bccancer.bc.ca; Chan, Elisa K.; Hsu, Fred

    Purpose: The objective of this study was to compare recurrent tumor locations after radiation therapy with pretreatment delineations of high-grade gliomas from magnetic resonance imaging (MRI) and 3,4-dihydroxy-6-[{sup 18}F]fluoro-L-phenylalanine ({sup 18}F-FDOPA) positron emission tomography (PET) using contours delineated by multiple observers. Methods and Materials: Nineteen patients with newly diagnosed high-grade gliomas underwent computed tomography (CT), gadolinium contrast-enhanced MRI, and {sup 18}F-FDOPA PET/CT. The image sets (CT, MRI, and PET/CT) were registered, and 5 observers contoured gross tumor volumes (GTVs) using MRI and PET. Consensus contours were obtained by simultaneous truth and performance level estimation (STAPLE). Interobserver variability was quantified bymore » the percentage of volume overlap. Recurrent tumor locations after radiation therapy were contoured by each observer using CT or MRI. Consensus recurrence contours were obtained with STAPLE. Results: The mean interobserver volume overlap for PET GTVs (42% ± 22%) and MRI GTVs (41% ± 22%) was not significantly different (P=.67). The mean consensus volume was significantly larger for PET GTVs (58.6 ± 52.4 cm{sup 3}) than for MRI GTVs (30.8 ± 26.0 cm{sup 3}, P=.003). More than 95% of the consensus recurrence volume was within the 95% isodose surface for 11 of 12 (92%) cases with recurrent tumor imaging. Ten (91%) of these cases extended beyond the PET GTV, and 9 (82%) were contained within a 2-cm margin on the MRI GTV. One recurrence (8%) was located outside the 95% isodose surface. Conclusions: High-grade glioma contours obtained with {sup 18}F-FDOPA PET had similar interobserver agreement to volumes obtained with MRI. Although PET-based consensus target volumes were larger than MRI-based volumes, treatment planning using PET-based volumes may not have yielded better treatment outcomes, given that all but 1 recurrence extended beyond the PET GTV and most were contained by a 2-cm margin on the MRI GTV.« less

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

    PubMed

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

    2014-01-01

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

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

    PubMed

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

    2012-11-01

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

  15. DMR (deacetylation and mechanical refining) processing of corn stover achieves high monomeric sugar concentrations (230 g L -1) during enzymatic hydrolysis and high ethanol concentrations (>10% v/v) during fermentation without hydrolysate purification or concentration

    DOE PAGES

    Chen, Xiaowen; Kuhn, Erik; Jennings, Edward W.; ...

    2016-04-01

    Distilling and purifying ethanol and other products from second generation lignocellulosic biorefineries adds significant capital and operating costs to biofuel production. The energy usage associated with distillation negatively affects plant gate costs and causes environmental and life-cycle impacts, and the lower titers in fermentation caused by lower sugar concentrations from pretreatment and enzymatic hydrolysis increase energy and water usage and ethanol production costs. In addition, lower ethanol titers increase the volumes required for enzymatic hydrolysis and fermentation vessels increase capital expenditure (CAPEX). Therefore, increasing biofuel titers has been a research focus in renewable biofuel production for several decades. In thismore » work, we achieved approximately 230 g L -1 of monomeric sugars after high solid enzymatic hydrolysis using deacetylation and mechanical refining (DMR) processed corn stover substrates produced at the 100 kg per day scale. The high sugar concentrations and low chemical inhibitor concentrations achieved by the DMR process allowed fermentation to ethanol with titers as high as 86 g L -1, which translates into approximately 10.9% v/v ethanol. To our knowledge, this is the first time that titers greater than 10% v/v ethanol in fermentations derived from corn stover without any sugar concentration or purification steps have been reported. As a result, the potential cost savings from high sugar and ethanol titers achieved by the DMR process are also reported using TEA analysis.« less

  16. DMR (deacetylation and mechanical refining) processing of corn stover achieves high monomeric sugar concentrations (230 g L -1) during enzymatic hydrolysis and high ethanol concentrations (>10% v/v) during fermentation without hydrolysate purification or concentration

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

    Chen, Xiaowen; Kuhn, Erik; Jennings, Edward W.

    Distilling and purifying ethanol and other products from second generation lignocellulosic biorefineries adds significant capital and operating costs to biofuel production. The energy usage associated with distillation negatively affects plant gate costs and causes environmental and life-cycle impacts, and the lower titers in fermentation caused by lower sugar concentrations from pretreatment and enzymatic hydrolysis increase energy and water usage and ethanol production costs. In addition, lower ethanol titers increase the volumes required for enzymatic hydrolysis and fermentation vessels increase capital expenditure (CAPEX). Therefore, increasing biofuel titers has been a research focus in renewable biofuel production for several decades. In thismore » work, we achieved approximately 230 g L -1 of monomeric sugars after high solid enzymatic hydrolysis using deacetylation and mechanical refining (DMR) processed corn stover substrates produced at the 100 kg per day scale. The high sugar concentrations and low chemical inhibitor concentrations achieved by the DMR process allowed fermentation to ethanol with titers as high as 86 g L -1, which translates into approximately 10.9% v/v ethanol. To our knowledge, this is the first time that titers greater than 10% v/v ethanol in fermentations derived from corn stover without any sugar concentration or purification steps have been reported. As a result, the potential cost savings from high sugar and ethanol titers achieved by the DMR process are also reported using TEA analysis.« less

  17. Just-in-Time Training for High-Risk Low-Volume Therapies: An Approach to Ensure Patient Safety.

    PubMed

    Helman, Stephanie; Lisanti, Amy Jo; Adams, Ann; Field, Cynthia; Davis, Katherine Finn

    2016-01-01

    High-risk low-volume therapies are those therapies that are practiced infrequently and yet carry an increased risk to patients because of their complexity. Staff nurses are required to competently manage these therapies to treat patients' unique needs and optimize outcomes; however, maintaining competence is challenging. This article describes implementation of Just-in-Time Training, which requires validation of minimum competency of bedside nurses managing high-risk low-volume therapies through direct observation of a return-demonstration competency checklist.

  18. Thermal activation parameters of plastic flow reveal deformation mechanisms in the CrMnFeCoNi high-entropy alloy

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

    Laplanche, Guillaume; Bonneville, J.; Varvenne, C.

    To reveal the operating mechanisms of plastic deformation in an FCC high-entropy alloy, the activation volumes in CrMnFeCoNi have been measured as a function of plastic strain and temperature between 77 K and 423 K using repeated load relaxation experiments. At the yield stress, σ y, the activation volume varies from ~60 b3 at 77 K to ~360 b 3 at 293 K and scales inversely with yield stress. With increasing plastic strain, the activation volume decreases and the trends follow the Cottrell-Stokes law, according to which the inverse activation volume should increase linearly with σ - σ y (Haasenmore » plot). This is consistent with the notion that hardening due to an increase in the density of forest dislocations is naturally associated with a decrease in the activation volume because the spacing between dislocations decreases. The values and trends in activation volume agree with theoretical predictions that treat the HEA as a high-concentration solid-solution-strengthened alloy. Lastly, these results demonstrate that this HEA deforms by the mechanisms typical of solute strengthening in FCC alloys, and thus indicate that the high compositional/structural complexity does not introduce any new intrinsic deformation mechanisms.« less

  19. Thermal activation parameters of plastic flow reveal deformation mechanisms in the CrMnFeCoNi high-entropy alloy

    DOE PAGES

    Laplanche, Guillaume; Bonneville, J.; Varvenne, C.; ...

    2017-10-06

    To reveal the operating mechanisms of plastic deformation in an FCC high-entropy alloy, the activation volumes in CrMnFeCoNi have been measured as a function of plastic strain and temperature between 77 K and 423 K using repeated load relaxation experiments. At the yield stress, σ y, the activation volume varies from ~60 b3 at 77 K to ~360 b 3 at 293 K and scales inversely with yield stress. With increasing plastic strain, the activation volume decreases and the trends follow the Cottrell-Stokes law, according to which the inverse activation volume should increase linearly with σ - σ y (Haasenmore » plot). This is consistent with the notion that hardening due to an increase in the density of forest dislocations is naturally associated with a decrease in the activation volume because the spacing between dislocations decreases. The values and trends in activation volume agree with theoretical predictions that treat the HEA as a high-concentration solid-solution-strengthened alloy. Lastly, these results demonstrate that this HEA deforms by the mechanisms typical of solute strengthening in FCC alloys, and thus indicate that the high compositional/structural complexity does not introduce any new intrinsic deformation mechanisms.« less

  20. Study of a tracking and data acquisition system for the 1990's. Volume 3: TDAS Communication Mission Model

    NASA Technical Reports Server (NTRS)

    Mccreary, T.

    1983-01-01

    A parametric description of the communication channels required between the user spacecraft to be supported and the user ground data systems is developed. Scenarios of mission models, which reflect a range of free flyers vs space platform usage as well as levels of NASA activity and potential support for military missions, and potential channel requirements which identify: (1) bounds on TDAS forward and return link data communication demand, and (2) the additional demand for providing navigation/tracking support are covered.

  1. New York City Police Department Automated Fuel Monitoring system. Volume I. Overview. Technical report

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

    McGrath, W.J.; McNamara, M.M.

    1981-10-01

    The New York City Police Department (NYCPD) Automated Fuel Monitoring system is briefly described from the original study, through system design, to implementation. The system provides complete control of fuel usage for an agency with 4,000 motor vehicles and 25,000 vehicle operators. As far as is known, it is the largest system of its kind installed to date. The system can be scaled up or down to meet the needs of other governmental units. Estimated annual cost savings to NYCPD are $2,000,000.

  2. New York City Police Department Automated Fuel Monitoring system. Volume II. Documentation report. Technical report

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

    McGrath, W.J.; McNamara, M.M.

    1981-11-16

    The New York City Police Department (NYCPD) Automated Fuel Monitoring system is briefly described from the original study, through system design, to implementation. The system provides complete control of fuel usage for an agency with 4,000 motor vehicles and 25,000 vehicle operators. As far as is known, it is the largest system of its kind installed to date. The system can be scaled up or down to meet the needs of other governmental units. Estimated annual cost savings to NYCPD are $2,000,000.

  3. Feasibility study of modern airships, phase 1. Volume 1: Summary and mission analysis (tasks 2 and 4)

    NASA Technical Reports Server (NTRS)

    Bloetscher, F.

    1975-01-01

    The histroy, potential mission application, and designs of lighter-than-air (LTA) vehicles are researched and evaluated. Missions are identified to which airship vehicles are potentially suited. Results of the mission analysis are combined with the findings of a parametric analysis to formulate the mission/vehicle combinations recommended for further study. Current transportation systems are surveyed and potential areas of competition are identified as well as potential missions resulting from limitations of these systems. Potential areas of military usage are included.

  4. NASTRAN benefits analysis. Volume 2: Final technical report

    NASA Technical Reports Server (NTRS)

    1972-01-01

    Baseline data are considered for comparisons of the costs and benefits of the NASA structural analysis program and to determine impacts and benefits to current users. To develop this information, questionnaires were mailed to users. Personal and telephone interviews were made to solicit further information. The questions in the questionnaire and in the interview were related to benefits derived from the programs, areas of needed improvement, and applicable usage comments. The collected information was compiled and analyzed. Methodology, analyses, and results are presented. The information is applicable to issues preceding NASTRAN Level 15.

  5. Study of water recovery and solid waste processing for aerospace and domestic applications. Volume 1: Final report summary

    NASA Technical Reports Server (NTRS)

    Guarneri, C. A.; Reed, A.; Renman, R. E.

    1972-01-01

    This study of water reclamation and waste disposal is directed toward a more efficient utilization of natural resources. From an ecological standpoint improved methods of land use, water processing equipment, and ideal population profiles are investigated. Methods are described whereby significant reduction in water usage can be achieved by the adoption of presently available and practically applied technological concepts. Allowances are made for social, natural, and economic contingencies which are likely to occur up to the year 2000.

  6. Proceedings of the IREAPS Technical Symposium (9th) Held in San Diego, California on September 14-16, 1982. Volume 1 (The National Shipbuilding Research Program)

    DTIC Science & Technology

    1982-01-01

    templates. Bends plate to radius of forming cylinder. One sided butt welds up through 5/8" using magnet bed for alignment. Automatically fits and welds...up to nine stiffeners per panel. Exit Butt Weld One sided butt welds stiffened bottom panels to Tank Top Fitting Area each other using magnet bed for...be over-emphasized! Benefits derived from the model are somewhat like magnetism . Model usage is inversely proportional to the square of the distance

  7. The Acoustic Model Evaluation Committee (AMEC) Reports. Volume 1. Model Evaluation Methodology and Implementation

    DTIC Science & Technology

    1982-09-01

    L . Anderson, formerly of the Naval Ocean Research and Development Activity, resulted in many refinements of the model...8217- )",,",z• "• •. ." ’ ’-,’’, L ’.,.’’.v ’..’’ -" .,, -’., -,...’’ .. i• ’,• . , i ’• . \\• v ’.t ,. . ," . ,. ,,,,_,.-,.,..’,’ .. ’ .’ -,1.-, -4...Mathematics its limitations. Where applicable, rec- omnendat ions wil L be made regarding (U) The model is examined in terms of model usage

  8. Integration of Diagnostics into Ground Equipment Study. Volume 1

    DTIC Science & Technology

    2004-07-30

    Marine Corps V-22, CH-53E, MH-53E, SH- 60B, MH- 60S /R, AH-1Z and UH -1Y aircraft. In addition, 30 systems are in delivery to the US Army Aviation Applied...simultaneous) can be connected to the VMEP system, which is based on a PC-104 platform and a 233MHz processor. The AH-64 Apache and UH - 60 Blackhawk are outfitted...34A Model-Based Health and Usage Monitoring and Diagnostic System for the UH - 60 Helicopter," Proceedings of the American Helicopter Society 57th

  9. Discordant transsexualism in male monozygotic twins: neuroanatomical and psychological differences.

    PubMed

    Andreazza, Tahiana Signorini; Costa, Angelo Brandelli; Massuda, Raffael; Salvador, Jaqueline; Silveira, Esalba Maria; Piccon, Felipe; Carvalho, Renata; Fontanari, Anna Martha Vaitses; Koff, Walter; Belmonte-de-Abreu, Paulo; Lobato, Maria Inês Rodrigues

    2014-02-01

    One monozygotic male twin pair discordant for transsexualism is described. Both twins were interviewed and tested with the Wechsler Adult Intelligence Scale battery for cognitive functions and they underwent magnetic resonance imaging to measure the volumes of specific cerebral structures. Interviews with the twins and their mother indicated no unusual medical or life history events that could have had a causal role in the emergence of the disorder. Both cognitive function testing and neuroimaging detected differences between the twins that could be related to unexplained epigenetic effects and exogenous hormone usage.

  10. The Influence of Spatial Variation in Chromatin Density Determined by X-Ray Tomograms on the Time to Find DNA Binding Sites

    PubMed Central

    Larabell, Carolyn A.; Le Gros, Mark A.; McQueen, David M.; Peskin, Charles S.

    2014-01-01

    In this work, we examine how volume exclusion caused by regions of high chromatin density might influence the time required for proteins to find specific DNA binding sites. The spatial variation of chromatin density within mouse olfactory sensory neurons is determined from soft X-ray tomography reconstructions of five nuclei. We show that there is a division of the nuclear space into regions of low-density euchromatin and high-density heterochromatin. Volume exclusion experienced by a diffusing protein caused by this varying density of chromatin is modeled by a repulsive potential. The value of the potential at a given point in space is chosen to be proportional to the density of chromatin at that location. The constant of proportionality, called the volume exclusivity, provides a model parameter that determines the strength of volume exclusion. Numerical simulations demonstrate that the mean time for a protein to locate a binding site localized in euchromatin is minimized for a finite, nonzero volume exclusivity. For binding sites in heterochromatin, the mean time is minimized when the volume exclusivity is zero (the protein experiences no volume exclusion). An analytical theory is developed to explain these results. The theory suggests that for binding sites in euchromatin there is an optimal level of volume exclusivity that balances a reduction in the volume searched in finding the binding site, with the height of effective potential barriers the protein must cross during the search process. PMID:23955281

  11. The estimation of bone cyst volume using the Cavalieri principle on computed tomography images.

    PubMed

    Say, Ferhat; Gölpınar, Murat; Kılınç, Cem Yalın; Şahin, Bünyamin

    2018-01-01

    To evaluate the volume of bone cyst using the planimetry method of the Cavalieri principle. A retrospective analysis was carried out on data from 25 computed tomography (CT) images of patients with bone cyst. The volume of the cysts was calculated by two independent observers using the planimetry method. The procedures were repeated 1 month later by each observer. The overall mean volume of the bone cyst was 29.25 ± 25.86 cm 3 . The mean bone cyst volumes calculated by the first observer for the first and second sessions were 29.18 ± 26.14 and 29.27 ± 26.19 cm 3 , respectively. The mean bone cyst volumes calculated by the second observer for the first and second sessions were 29.32 ± 26.36 and 29.23 ± 26.36 cm 3 , respectively. Statistical analysis showed no difference and high agreement between the first and second measurements of both observers. The Bland-Altman plots showed strong intraobserver and interobserver concordance in the measurement of the bone cyst volume. The mean total time necessary to obtain the cyst volume by the two observers was 5.27 ± 2.30 min. The bone cyst of the patients can be objectively evaluated using the planimetry method of the Cavalieri principle on CT. This method showed high interobserver and intraobserver agreement. This volume measurement can be used to evaluate cyst remodeling, including complete healing and cyst recurrence.

  12. A preliminary comparison of Landsat Thematic Mapper and SPOT-1 HRV multispectral data for estimating coniferous forest volume

    NASA Technical Reports Server (NTRS)

    Ripple, W. J.; Wang, S.; Isaacson, D. L.; Paine, D. P.

    1991-01-01

    Digital Landsat Thematic Mapper (TM) and SPOT high-resolution visible (HRV) images of coniferous forest canopies were compared in their relationship to forest wood volume using correlation and regression analyses. Significant inverse relationships were found between softwood volume and the spectral bands from both sensors (P less than 0.01). The highest correlations were between the log of softwood volume and the near-infrared bands.

  13. Throughput Benefit Assessment for Tactical Runway Configuration Management (TRCM)

    NASA Technical Reports Server (NTRS)

    Phojanamongkolkij, Nipa; Oseguera-Lohr, Rosa M.; Lohr, Gary W.; Fenbert, James W.

    2014-01-01

    The System-Oriented Runway Management (SORM) concept is a collection of needed capabilities focused on a more efficient use of runways while considering all of the factors that affect runway use. Tactical Runway Configuration Management (TRCM), one of the SORM capabilities, provides runway configuration and runway usage recommendations, monitoring the active runway configuration for suitability given existing factors, based on a 90 minute planning horizon. This study evaluates the throughput benefits using a representative sample of today's traffic volumes at three airports: Memphis International Airport (MEM), Dallas-Fort Worth International Airport (DFW), and John F. Kennedy International Airport (JFK). Based on this initial assessment, there are statistical throughput benefits for both arrivals and departures at MEM with an average of 4% for arrivals, and 6% for departures. For DFW, there is a statistical benefit for arrivals with an average of 3%. Although there is an average of 1% benefit observed for departures, it is not statistically significant. For JFK, there is a 12% benefit for arrivals, but a 2% penalty for departures. The results obtained are for current traffic volumes and should show greater benefit for increased future demand. This paper also proposes some potential TRCM algorithm improvements for future research. A continued research plan is being worked to implement these improvements and to re-assess the throughput benefit for today and future projected traffic volumes.

  14. Segmentation of brain volume based on 3D region growing by integrating intensity and edge for image-guided surgery

    NASA Astrophysics Data System (ADS)

    Tsagaan, Baigalmaa; Abe, Keiichi; Goto, Masahiro; Yamamoto, Seiji; Terakawa, Susumu

    2006-03-01

    This paper presents a segmentation method of brain tissues from MR images, invented for our image-guided neurosurgery system under development. Our goal is to segment brain tissues for creating biomechanical model. The proposed segmentation method is based on 3-D region growing and outperforms conventional approaches by stepwise usage of intensity similarities between voxels in conjunction with edge information. Since the intensity and the edge information are complementary to each other in the region-based segmentation, we use them twice by performing a coarse-to-fine extraction. First, the edge information in an appropriate neighborhood of the voxel being considered is examined to constrain the region growing. The expanded region of the first extraction result is then used as the domain for the next processing. The intensity and the edge information of the current voxel only are utilized in the final extraction. Before segmentation, the intensity parameters of the brain tissues as well as partial volume effect are estimated by using expectation-maximization (EM) algorithm in order to provide an accurate data interpretation into the extraction. We tested the proposed method on T1-weighted MR images of brain and evaluated the segmentation effectiveness comparing the results with ground truths. Also, the generated meshes from the segmented brain volume by using mesh generating software are shown in this paper.

  15. Radiation oncology services in the modern era: evolving patterns of usage and payments in the office setting for medicare patients from 2000 to 2010.

    PubMed

    Shen, Xinglei; Showalter, Timothy N; Mishra, Mark V; Barth, Sanford; Rao, Vijay; Levin, David; Parker, Laurence

    2014-07-01

    We evaluated long-term changes in the volume and payments for radiation oncology services in the intensity-modulated radiation therapy (IMRT) era from 2000 to 2010 using a database of Medicare claims. We used the Medicare Physician/Supplier Procedure Summary Master File (PSPSMF) for each year from 2000 to 2010 to tabulate the volume and payments for radiation oncology services. This database provides a summary of each billing code submitted to Medicare part B. We identified all codes used in radiation oncology services and categorized billing codes by treatment modality and place of service. We focused our analysis on office-based practices. Total office-based patient volume increased 8.2% from 2000 to 2010, whereas total payments increased 217%. Increase in overall payments increased dramatically from 2000 to 2007, but subsequently plateaued from 2008 to 2010. Increases in complexity of care, and image guidance in particular, have also resulted in higher payments. The cost of radiation oncology services increased from 2000 to 2010, mostly due to IMRT, but also with significant contribution from increased overall complexity of care. A cost adjustment occurred after 2007, limiting further growth of payments. Future health policy studies should explore the potential for further cost containment, including differences in use between freestanding and hospital outpatient facilities. Copyright © 2014 by American Society of Clinical Oncology.

  16. Breast Volume Measurement by Recycling the Data Obtained From 2 Routine Modalities, Mammography and Magnetic Resonance Imaging.

    PubMed

    Itsukage, Shizu; Sowa, Yoshihiro; Goto, Mariko; Taguchi, Tetsuya; Numajiri, Toshiaki

    2017-01-01

    Objective: Preoperative prediction of breast volume is important in the planning of breast reconstructive surgery. In this study, we prospectively estimated the accuracy of measurement of breast volume using data from 2 routine modalities, mammography and magnetic resonance imaging, by comparison with volumes of mastectomy specimens. Methods: The subjects were 22 patients (24 breasts) who were scheduled to undergo total mastectomy for breast cancer. Preoperatively, magnetic resonance imaging volume measurement was performed using a medical imaging system and the mammographic volume was calculated using a previously proposed formula. Volumes of mastectomy specimens were measured intraoperatively using a method based on Archimedes' principle and Newton's third law. Results: The average breast volumes measured on magnetic resonance imaging and mammography were 318.47 ± 199.4 mL and 325.26 ± 217.36 mL, respectively. The correlation coefficients with mastectomy specimen volumes were 0.982 for magnetic resonance imaging and 0.911 for mammography. Conclusions: Breast volume measurement using magnetic resonance imaging was highly accurate but requires data analysis software. In contrast, breast volume measurement with mammography requires only a simple formula and is sufficiently accurate, although the accuracy was lower than that obtained with magnetic resonance imaging. These results indicate that mammography could be an alternative modality for breast volume measurement as a substitute for magnetic resonance imaging.

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

    PubMed

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

    2011-04-01

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

  18. Breast Volume Measurement by Recycling the Data Obtained From 2 Routine Modalities, Mammography and Magnetic Resonance Imaging

    PubMed Central

    Itsukage, Shizu; Goto, Mariko; Taguchi, Tetsuya; Numajiri, Toshiaki

    2017-01-01

    Objective: Preoperative prediction of breast volume is important in the planning of breast reconstructive surgery. In this study, we prospectively estimated the accuracy of measurement of breast volume using data from 2 routine modalities, mammography and magnetic resonance imaging, by comparison with volumes of mastectomy specimens. Methods: The subjects were 22 patients (24 breasts) who were scheduled to undergo total mastectomy for breast cancer. Preoperatively, magnetic resonance imaging volume measurement was performed using a medical imaging system and the mammographic volume was calculated using a previously proposed formula. Volumes of mastectomy specimens were measured intraoperatively using a method based on Archimedes’ principle and Newton's third law. Results: The average breast volumes measured on magnetic resonance imaging and mammography were 318.47 ± 199.4 mL and 325.26 ± 217.36 mL, respectively. The correlation coefficients with mastectomy specimen volumes were 0.982 for magnetic resonance imaging and 0.911 for mammography. Conclusions: Breast volume measurement using magnetic resonance imaging was highly accurate but requires data analysis software. In contrast, breast volume measurement with mammography requires only a simple formula and is sufficiently accurate, although the accuracy was lower than that obtained with magnetic resonance imaging. These results indicate that mammography could be an alternative modality for breast volume measurement as a substitute for magnetic resonance imaging. PMID:29308107

  19. Olfactory bulb volume in Taiwanese patients with posttraumatic anosmia.

    PubMed

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

    2009-01-01

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

  20. Three-dimensional measurement of foot arch in preschool children

    PubMed Central

    2012-01-01

    Background The prevalence of flexible flatfoot is high among preschool-aged children, but the effects of treatment are inconclusive due to the unclear definitions of normal flatfoot. To date, a universally accepted evaluation method of the foot arch in children has not been completely established. Our aims of this study were to establish a new method to evaluate the foot arch from a three dimensional perspective and to investigate the flexibility of the foot arch among children aged from two to six. Methods A total of 44 children aged from two to six years of age were put into five age groups in this study. The navicular height was measured with one leg standing, and both feet were scanned separately in both sitting and one leg standing positions to compute the foot arch volume. The arch volume index, which represents the ratio of the difference in volume between sitting and one leg standing positions to the volume when sitting was calculated to demonstrate the flexibility of the foot arch. The differences of measured parameters between each aged group were analyzed by one-way ANOVA. Results The arch volumes when sitting and standing were highly correlated with the navicular height. The navicular height ranged from 15.75 to 27 mm, the arch volume when sitting ranged from 6,223 to 11,630 mm3, and the arch volume when standing from 3,111 to 7,848 mm3 from two to six years of age. The arch volume index showed a declining trend as age increased. Conclusion This study is the first to describe the foot arch with volume perspective in preschool-aged children. The foot arch volume was highly correlated with the navicular height. Research results show both navicular height index and arch volume index gradually increase with age from two to six. At the same time the arch also becomes rigid with age from two to six. These results could be applied for clinical evaluation of the foot arch and post-treatment evaluation. PMID:23009315

  1. High-Speed Friction-Stir Welding To Enable Aluminum Tailor-Welded Blanks

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

    Hovanski, Yuri; Upadhyay, Piyush; Carsley, John

    Current joining technologies for automotive aluminum alloys are utilized in low-volume and niche applications, and have yet to be scaled for the high-volume vehicle market. This study targeted further weight reduction, part reduction, and cost savings by enabling tailor-welded blank technology for aluminum alloys at high-volumes. While friction stir welding has been traditionally applied at linear velocities less than one meter per minute, high volume production applications demand the process be extended to higher velocities more amenable to cost sensitive production environments. Unfortunately, weld parameters and performance developed and characterized at low to moderate welding velocities do not directly translatemore » to high speed linear friction stir welding. Therefore, in order to facilitate production of high volume aluminum welded components, parameters were developed with a minimum welding velocity of three meters per minute. With an emphasis on weld quality, welded blanks were evaluated for post-weld formability utilizing a combination of numerical and experimental methods. Evaluation across scales was ultimately validated by stamping full-size production door inner panels made from dissimilar thickness aluminum tailor-welded blanks, which provided validation of the numerical and experimental analysis of laboratory scale tests.« less

  2. Enabling high speed friction stir welding of aluminum tailor welded blanks

    NASA Astrophysics Data System (ADS)

    Hovanski, Yuri

    Current welding technologies for production of aluminum tailor-welded blanks (TWBs) are utilized in low-volume and niche applications, and have yet to be scaled for the high-volume vehicle market. This study targeted further weight reduction, part reduction, and cost savings by enabling tailor-welded blank technology for aluminum alloys at high-volumes. While friction stir welding (FSW) has traditionally been applied at linear velocities less than one meter per minute, high volume production applications demand the process be extended to higher velocities more amenable to cost sensitive production environments. Unfortunately, weld parameters and performance developed and characterized at low to moderate welding velocities do not directly translate to high speed linear friction stir welding. Therefore, in order to facilitate production of high volume aluminum FSW components, parameters were developed with a minimum welding velocity of three meters per minute. With an emphasis on weld quality, welded blanks were evaluated for post-weld formability using a combination of numerical and experimental methods. Evaluation across scales was ultimately validated by stamping full-size production door inner panels made from dissimilar thickness aluminum tailor-welded blanks, which provided validation of the numerical and experimental analysis of laboratory scale tests.

  3. High-Speed Friction-Stir Welding to Enable Aluminum Tailor-Welded Blanks

    NASA Astrophysics Data System (ADS)

    Hovanski, Yuri; Upadhyay, Piyush; Carsley, John; Luzanski, Tom; Carlson, Blair; Eisenmenger, Mark; Soulami, Ayoub; Marshall, Dustin; Landino, Brandon; Hartfield-Wunsch, Susan

    2015-05-01

    Current welding technologies for production of aluminum tailor-welded blanks (TWBs) are utilized in low-volume and niche applications, and they have yet to be scaled for the high-volume vehicle market. This study targeted further weight reduction, part reduction, and cost savings by enabling tailor-welded blank technology for aluminum alloys at high volumes. While friction-stir welding (FSW) has been traditionally applied at linear velocities less than 1 m/min, high-volume production applications demand the process be extended to higher velocities more amenable to cost-sensitive production environments. Unfortunately, weld parameters and performance developed and characterized at low-to-moderate welding velocities do not directly translate to high-speed linear FSW. Therefore, to facilitate production of high-volume aluminum FSW components, parameters were developed with a minimum welding velocity of 3 m/min. With an emphasis on weld quality, welded blanks were evaluated for postweld formability using a combination of numerical and experimental methods. An evaluation across scales was ultimately validated by stamping full-size production door inner panels made from dissimilar thickness aluminum TWBs, which provided validation of the numerical and experimental analysis of laboratory-scale tests.

  4. Enhanced alveolar growth and remodeling in Guinea pigs raised at high altitude.

    PubMed

    Hsia, Connie C W; Carbayo, Juan J Polo; Yan, Xiao; Bellotto, Dennis J

    2005-05-12

    To examine the effects of chronic high altitude (HA) exposure on lung structure during somatic maturation, we raised male weanling guinea pigs at HA (3800m) for 1, 3, or 6 months, while their respective male littermates were simultaneously raised at low altitude (LA, 1200m). Under anaesthesia, airway pressure was measured at different lung volumes. The right lung was fixed at a constant airway pressure for morphometric analysis under light and electron microscopy. In animals raised at HA for 1 month, lung volume, alveolar surface area and alveolar-capillary blood volume (V(c)) were elevated above LA control values. Following 3-6 months of HA exposure, increases in lung volume and alveolar surface area persisted while the initial increase in V(c) normalized. Additional adaptation occurred, including a higher epithelial cell volume, septal tissue volume and capillary surface area, a lower alveolar duct volume and lower harmonic mean diffusion barrier resulting in higher membrane and lung diffusing capacities. These data demonstrate enhanced alveolar septal growth and progressive acinar remodeling during chronic HA exposure with long-term augmentation of alveolar dimensions as well as functional compensation in lung compliance and diffusive gas transport.

  5. Moderator's view: High-volume plasma exchange: pro, con and consensus.

    PubMed

    Kaplan, Andre A

    2017-09-01

    I have been asked to comment on the pro and con opinions regarding high-volume plasma exchange. The authors of both positions have provided cogent arguments and a reasonable approach to choosing the exchange volume for any given therapeutic plasma exchange. The major issue of relevance in this discussion is the nature of the toxins targeted for removal. These parameters include molecular weight, the apparent volume of distribution, the degree of protein binding, the biologic and chemical half-life, and the severity and rapidity of its toxicity. © The Author 2017. Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved.

  6. High air volume to low liquid volume aerosol collector

    DOEpatents

    Masquelier, Donald A.; Milanovich, Fred P.; Willeke, Klaus

    2003-01-01

    A high air volume to low liquid volume aerosol collector. A high volume flow of aerosol particles is drawn into an annular, centripetal slot in a collector which directs the aerosol flow into a small volume of liquid pool contained is a lower center section of the collector. The annular jet of air impinges into the liquid, imbedding initially airborne particles in the liquid. The liquid in the pool continuously circulates in the lower section of the collector by moving to the center line, then upwardly, and through assistance by a rotating deflector plate passes back into the liquid at the outer area adjacent the impinging air jet which passes upwardly through the liquid pool and through a hollow center of the collector, and is discharged via a side outlet opening. Any liquid droplets escaping with the effluent air are captured by a rotating mist eliminator and moved back toward the liquid pool. The collector includes a sensor assembly for determining, controlling, and maintaining the level of the liquid pool, and includes a lower centrally located valve assembly connected to a liquid reservoir and to an analyzer for analyzing the particles which are impinged into the liquid pool.

  7. Does surgeon volume matter in the outcome of endoscopic inguinal hernia repair?

    PubMed

    Köckerling, F; Bittner, R; Kraft, B; Hukauf, M; Kuthe, A; Schug-Pass, C

    2017-02-01

    For open and endoscopic inguinal hernia surgery, it has been demonstrated that low-volume surgeons with fewer than 25 and 30 procedures, respectively, per year are associated with significantly more recurrences than high-volume surgeons with 25 and 30 or more procedures, respectively, per year. This paper now explores the relationship between the caseload and the outcome based on the data from the Herniamed Registry. The prospective data of patients in the Herniamed Registry were analyzed using the inclusion criteria minimum age of 16 years, male patient, primary unilateral inguinal hernia, TEP or TAPP techniques and availability of data on 1-year follow-up. In total, 16,290 patients were enrolled between September 1, 2009, and February 1, 2014. Of the participating surgeons, 466 (87.6 %) had carried out fewer than 25 endoscopic/laparoscopic operations (low-volume surgeons) and 66 (12.4 %) surgeons 25 or more operations (high-volume surgeons) per year. Univariable (1.03 vs. 0.73 %; p = 0.047) and multivariable analysis [OR 1.494 (1.065-2.115); p = 0.023] revealed that low-volume surgeons had a significantly higher recurrence rate compared with the high-volume surgeons, although that difference was small. Multivariable analysis also showed that pain on exertion was negatively affected by a lower caseload <25 [OR 1.191 (1.062-1.337); p = 0.003]. While here, too, the difference was small, the fact that in that group there was a greater proportion of patients with small hernia defect sizes may have also played a role since the risk in that group was higher. In this analysis, no evidence was found that pain at rest [OR 1.052 (0.903-1.226); p = 0.516] or chronic pain requiring treatment [OR 1.108 (0.903-1.361); p = 0.326] were influenced by the surgeon volume. As confirmed by previously published studies, the data in the Herniamed Registry also demonstrated that the endoscopic/laparoscopic inguinal hernia surgery caseload impacted the outcome. However, given the overall high-quality level the differences between a "low-volume" surgeon and a "high-volume" surgeon were small. That was due to the use of a standardized technique, structured training as well as continuous supervision of trainees and surgeons with low annual caseload.

  8. High definition in vivo retinal volumetric video rate OCT at 0.6 Giga-voxels per second

    NASA Astrophysics Data System (ADS)

    Kolb, Jan Philip; Klein, Thomas; Wieser, Wolfgang; Draxinger, Wolfgang; Huber, Robert

    2015-07-01

    We present full volumetric high speed OCT imaging of the retina with multiple settings varying in volume size and volume rate. The volume size ranges from 255x255 A-scans to 160x40 A-scans with 450 samples per depth scan with volume rates varying between 20.8 V/s for the largest volumes to 195.2 V/s for the smallest. The system is based on a 1060nm Fourier domain mode locked (FDML) laser with 1.6MHz line rate. Scanning along the fast axis is performed with a 2.7 kHz or 4.3 kHz resonant scanner operated in bidirectional scanning mode, while a standard galvo scanner is used for the slow axis. The performance is analyzed with respect to various potential applications, like intraoperative OCT.

  9. Perioperative mortality in cats and dogs undergoing spay or castration at a high-volume clinic.

    PubMed

    Levy, J K; Bard, K M; Tucker, S J; Diskant, P D; Dingman, P A

    2017-06-01

    High volume spay-neuter (spay-castration) clinics have been established to improve population control of cats and dogs to reduce the number of animals admitted to and euthanazed in animal shelters. The rise in the number of spay-neuter clinics in the USA has been accompanied by concern about the quality of animal care provided in high volume facilities, which focus on minimally invasive, time saving techniques, high throughput and simultaneous management of multiple animals under various stages of anesthesia. The aim of this study was to determine perioperative mortality for cats and dogs in a high volume spay-neuter clinic in the USA. Electronic medical records and a written mortality log were used to collect data for 71,557 cats and 42,349 dogs undergoing spay-neuter surgery from 2010 to 2016 at a single high volume clinic in Florida. Perioperative mortality was defined as deaths occurring in the 24h period starting with the administration of the first sedation or anesthetic drugs. Perioperative mortality was reported for 34 cats and four dogs for an overall mortality of 3.3 animals/10,000 surgeries (0.03%). The risk of mortality was more than twice as high for females (0.05%) as for males (0.02%) (P=0.008) and five times as high for cats (0.05%) as for dogs (0.009%) (P=0.0007). High volume spay-neuter surgery was associated with a lower mortality rate than that previously reported in low volume clinics, approaching that achieved in human surgery. This is likely to be due to the young, healthy population of dogs and cats, and the continuous refinement of techniques based on experience and the skills and proficiency of teams that specialize in a limited spectrum of procedures. Copyright © 2017 Elsevier Ltd. All rights reserved.

  10. Estimating total maximum daily loads with the Stochastic Empirical Loading and Dilution Model

    USGS Publications Warehouse

    Granato, Gregory; Jones, Susan Cheung

    2017-01-01

    The Massachusetts Department of Transportation (DOT) and the Rhode Island DOT are assessing and addressing roadway contributions to total maximum daily loads (TMDLs). Example analyses for total nitrogen, total phosphorus, suspended sediment, and total zinc in highway runoff were done by the U.S. Geological Survey in cooperation with FHWA to simulate long-term annual loads for TMDL analyses with the stochastic empirical loading and dilution model known as SELDM. Concentration statistics from 19 highway runoff monitoring sites in Massachusetts were used with precipitation statistics from 11 long-term monitoring sites to simulate long-term pavement yields (loads per unit area). Highway sites were stratified by traffic volume or surrounding land use to calculate concentration statistics for rural roads, low-volume highways, high-volume highways, and ultraurban highways. The median of the event mean concentration statistics in each traffic volume category was used to simulate annual yields from pavement for a 29- or 30-year period. Long-term average yields for total nitrogen, phosphorus, and zinc from rural roads are lower than yields from the other categories, but yields of sediment are higher than for the low-volume highways. The average yields of the selected water quality constituents from high-volume highways are 1.35 to 2.52 times the associated yields from low-volume highways. The average yields of the selected constituents from ultraurban highways are 1.52 to 3.46 times the associated yields from high-volume highways. Example simulations indicate that both concentration reduction and flow reduction by structural best management practices are crucial for reducing runoff yields.

  11. Chronic Hypoxia Accentuates Dysanaptic Lung Growth.

    PubMed

    Llapur, Conrado J; Martínez, Myriam R; Grassino, Pedro T; Stok, Ana; Altieri, Héctor H; Bonilla, Federico; Caram, María M; Krowchuk, Natasha M; Kirby, Miranda; Coxson, Harvey O; Tepper, Robert S

    2016-08-01

    Adults born and raised at high altitudes have larger lung volumes and greater pulmonary diffusion capacity compared with adults at low altitude; however, it remains unclear whether the air and tissue volumes have comparable increases and whether there is a difference in airway size. To assess the effect of chronic hypoxia on lung growth using in vivo high-resolution computed tomography measurements. Healthy adults born and raised at moderate altitude (2,000 m above sea level; n = 19) and at low altitude (400 m above sea level; n = 23) underwent high-resolution computed tomography. Differences in total lung, air, and tissue volume, mean lung density, as well as airway lumen and wall areas in anatomically matched airways were compared between groups. No significant differences for age, sex, weight, or height were found between the two groups (P > 0.05). In a multivariate regression model, altitude was a significant contributor for total lung volume (P = 0.02), air volume (P = 0.03), and tissue volume (P = 0.03), whereby the volumes were greater for the moderate- versus the low-altitude group. However, altitude was not a significant contributor for mean lung density (P = 0.35) or lumen and wall areas in anatomically matched segmental, subsegmental, and subsubsegmental airways. Our findings suggest that the adult lung did not increase lung volume later in life by expansion of an existing number of alveoli, but rather from increased alveolarization early in life. In addition, chronic hypoxia accentuates dysanaptic lung growth by increasing the lung parenchyma but not the airways.

  12. The effects of contrast media volume on acute kidney injury after transcatheter aortic valve replacement: a systematic review and meta-analysis.

    PubMed

    Thongprayoon, Charat; Cheungpasitporn, Wisit; Podboy, Alexander J; Gillaspie, Erin A; Greason, Kevin L; Kashani, Kianoush B

    2016-11-01

    The goal of this systematic review was to assess the effects of contrast media volume on transcatheter aortic valve replacement-related acute kidney injury. A literature search was performed using Medline, EMbase, the Cochrane Database of Systematic Reviews, and clinicaltrials.gov from the inception of these databases through December 2015. Studies that reported relative risk, odds ratio, or hazard ratio comparing the risks of acute kidney injury following transcatheter aortic valve replacement in patients who received high contrast media volume were included. Pooled risk ratio (RR) and 95% confidence intervals (95% CI) were calculated using a random-effect, generic inverse variance method. Four cohort studies composed of 891 patients were included in the analyses to assess the risk of acute kidney injury after transcatheter aortic valve replacement in patients who received high contrast media volume. The pooled RR of acute kidney injury after transcatheter aortic valve replacement in patients who received a large volume of contrast media was 1.41 (95% CI, 0.87 to 2.28) compared with low contrast media volume. The meta-analysis was limited to studies using standard acute kidney injury definitions, and the pooled RR of acute kidney injury in patients who received high contrast media volume is 1.12 (95% CI, 0.78 to 1.62). Our meta-analysis shows no significant association between contrast media volume and risk of acute kidney injury after transcatheter aortic valve replacement. © 2016 Chinese Cochrane Center, West China Hospital of Sichuan University and John Wiley & Sons Australia, Ltd.

  13. System Would Regulate Low Gas Pressure

    NASA Technical Reports Server (NTRS)

    Frazer, Robert E.

    1994-01-01

    System intended to maintain gases in containers at pressures near atmospheric. Includes ballast volume in form of underinflated balloon that communicates with working volume. Balloon housed in rigid chamber not subjected to extremes of temperature of working volume. Pressure in chamber surrounding balloon regulated at ambient atmospheric pressure or at constant small differential pressure above or below ambient. Expansion and contraction of balloon accommodates expansion or contraction of gas during operational heating or cooling in working volume, maintaining pressure in working volume at ambient or constant differential above or below ambient. Gas lost from system due to leakage or diffusion, low-pressure sensor responds, signaling valve actuators to supply more gas to working volume. If pressure rises too high, overpressure relief valve opens before excessive pressure damages system.

  14. The volume and mean depth of Earth's lakes

    NASA Astrophysics Data System (ADS)

    Cael, B. B.; Heathcote, A. J.; Seekell, D. A.

    2017-01-01

    Global lake volume estimates are scarce, highly variable, and poorly documented. We developed a rigorous method for estimating global lake depth and volume based on the Hurst coefficient of Earth's surface, which provides a mechanistic connection between lake area and volume. Volume-area scaling based on the Hurst coefficient is accurate and consistent when applied to lake data sets spanning diverse regions. We applied these relationships to a global lake area census to estimate global lake volume and depth. The volume of Earth's lakes is 199,000 km3 (95% confidence interval 196,000-202,000 km3). This volume is in the range of historical estimates (166,000-280,000 km3), but the overall mean depth of 41.8 m (95% CI 41.2-42.4 m) is significantly lower than previous estimates (62-151 m). These results highlight and constrain the relative scarcity of lake waters in the hydrosphere and have implications for the role of lakes in global biogeochemical cycles.

  15. The dynamic volume changes of polymerising polymethyl methacrylate bone cement.

    PubMed

    Muller, Scott D; Green, Sarah M; McCaskie, Andrew W

    2002-12-01

    The Swedish hip register found an increased risk of early revision of vacuum-mixed cemented total hip replacements. The influence of cement mixing technique on the dynamic volume change in polymerising PMMA is not well understood and may be relevant to this observation. Applying Archimedes' principle, we have investigated the dynamic volume changes in polymerising cement and determined the influence of mixing technique. All specimens showed an overall volume reduction: hand-mixed 3.4% and vacuum-mixed 6.0%. Regression analysis of sectional porosity and volume reduction showed a highly significant relationship. Hand-mixed porous cement showed a transient volume increase before solidification. However, vacuum-mixed cement showed a progressive volume reduction throughout polymerisation. Transient expansion of porous cement occurs at the critical time of micro-interlock formation, possibly improving fixation. Conversely, progressive volume reduction of vacuum-mixed cement throughout the formation of interlock may damage fixation. Stable fixation of vacuum-mixed cement may depend on additional techniques to offset the altered volumetric behaviour of vacuum-mixed cement.

  16. Patella resurfacing during total knee arthroplasty: have we got the issue covered?

    PubMed

    Sandiford, Nemandra A; Alao, Uthman; Salamut, Wazirl; Weitzel, Stefan; Skinner, J A

    2014-12-01

    Management of the patella during total knee arthroplasty (TKA) is controversial. Multiple studies have examined mechanical and clinical results of TKA with native and resurfaced patellae with no clear consensus. We surveyed a large cohort of consultant surgeons in a questionnaire based study in order to assess the indications for patella resurfacing and to correlate practice with degree of specialization, experience and volume of procedures performed. Six hundred and nineteen surgeons were included. The main indication for patella resurfacing was patellofemoral arthritis. The ratio of those who always:sometimes:never resurfaced was 1:2:1 irrespective of experience or volume performed. There was no difference between knee specialists and non-specialists (p = 0.977) or between high and lower volume surgeons (p = 0.826). Senior and high volume surgeons tended to always resurface. The majority of surgeons only sometimes resurfaced the patella. The number who always and never resurfaced were similar. There was a tendency for more experienced and high volume surgeons to always resurface.

  17. Patella Resurfacing during Total Knee Arthroplasty: Have We Got the Issue Covered?

    PubMed Central

    Alao, Uthman; Salamut, Wazirl; Weitzel, Stefan; Skinner, J.A.

    2014-01-01

    Background Management of the patella during total knee arthroplasty (TKA) is controversial. Multiple studies have examined mechanical and clinical results of TKA with native and resurfaced patellae with no clear consensus. Methods We surveyed a large cohort of consultant surgeons in a questionnaire based study in order to assess the indications for patella resurfacing and to correlate practice with degree of specialization, experience and volume of procedures performed. Results Six hundred and nineteen surgeons were included. The main indication for patella resurfacing was patellofemoral arthritis. The ratio of those who always:sometimes:never resurfaced was 1:2:1 irrespective of experience or volume performed. There was no difference between knee specialists and non-specialists (p = 0.977) or between high and lower volume surgeons (p = 0.826). Senior and high volume surgeons tended to always resurface. Conclusions The majority of surgeons only sometimes resurfaced the patella. The number who always and never resurfaced were similar. There was a tendency for more experienced and high volume surgeons to always resurface. PMID:25436059

  18. Volume change measurements of rice by environmental scanning electron microscopy and stereoscopy.

    PubMed

    Tang, Xiaohu; De Rooij, Mario; De Jong, Liesbeth

    2007-01-01

    The measurement of volume change, which is induced by changing the relative humidity, is performed on rice by using environmental scanning electron microscope (ESEM) and stereoscopy techniques. The typical DeltaV% approximately RH curve of rice in both sorption and desorption can be categorized into three regions: low, intermediate, and high dependence on relative humidity from low- to high-relative humidity. The volume changes faster for rice samples with lower crystallinity, which is because the amorphous component is easier to absorb moisture than the crystalline component. The volume change behavior in various relative humidity environments is comparable with rice isotherm curve in sorption process though discrepancies exist in desorption, which are thought to be the presence of small pores and microstructure changes at high relative humidity. The volume in the desorption branch is less than that in the sorption branch at the same relative humidity, which can be attributed to the collapse of interior structures, existence of small pores, surface topography loss, and amylose leach.

  19. Validity for the simplified water displacement instrument to measure arm lymphedema as a result of breast cancer surgery.

    PubMed

    Sagen, Ase; Kåresen, Rolf; Skaane, Per; Risberg, May Arna

    2009-05-01

    To evaluate concurrent and construct validity for the Simplified Water Displacement Instrument (SWDI), an instrument for measuring arm volumes and arm lymphedema as a result of breast cancer surgery. Validity design. Hospital setting. Women (N=23; mean age, 64+/-11y) were examined 6 years after breast cancer surgery with axillary node dissection. Not applicable. The SWDI was included for measuring arm volumes to estimate arm lymphedema as a result of breast cancer surgery. A computed tomography (CT) scan was included to examine the cross-sectional areas (CSAs) in square millimeters for the subcutaneous tissue, for the muscle tissue, and for measuring tissue density in Hounsfield units. Magnetic resonance imaging (MRI) with T2-weighted sequences was included to show increased signal intensity in subcutaneous and muscle tissue areas. The affected arm volume measured by the SWDI was significantly correlated to the total CSA of the affected upper limb (R=.904) and also to the CSA of the subcutaneous tissue and muscles tissue (R=.867 and R=.725), respectively (P<.001). The CSA of the subcutaneous tissue for the upper limb was significantly larger compared with the control limb (11%). Tissue density measured in Hounsfield units did not correlate significantly with arm volume (P>.05). The affected arm volume was significantly larger (5%) than the control arm volume (P<.05). Five (22%) women had arm lymphedema defined as a 10% increase in the affected arm volume compared with the control arm volume, and an increased signal intensity was identified in all 5 women on MRI (T2-weighted, kappa=.777, P<.001). The SWDI showed high concurrent and construct validity as shown with significant correlations between the CSA (CT) of the subcutaneous and muscle areas of the affected limb and the affected arm volume (P>.001). There was a high agreement between those subjects who were diagnosed with arm lymphedema by using the SWDI and the increased signal intensity on MRI, with a kappa value of .777 (P<.001). High construct validity for the SWDI was confirmed for arm lymphedema as a volume increase, but it was not confirmed for lymphedema without an increase in arm volume (swelling). The SWDI is a simple and valid tool for estimating arm volume and arm lymphedema after breast cancer surgery.

  20. Industrial based volume manufacturing of lightweight aluminium alloy panel components with high-strength and complex-shape for car body and chassis structures

    NASA Astrophysics Data System (ADS)

    Anyasodor, Gerald; Koroschetz, Christian

    2017-09-01

    To achieve the high volume manufacture of lightweight passenger cars at economic cost as required in the automotive industry, low density materials and new process route will be needed. While high strength aluminium alloy grades: AA7075 and AA6082 may provide the alternative material solution, hot stamping process used for high-strength and ultrahigh strength steels such as boron steel 22mnb5 can enable the volume manufacture of panel components with high-strength and complex-shape for car body and chassis structures. These aluminium alloy grades can be used to manufacture panel components with possible yield strengths ≥ 500 MPa. Due to the differences in material behaviors, hot stamping process of 22mnb5 cannot be directly applied to high strength aluminium alloy grades. Despite recorded successes in laboratories, researches and niche hot forming processes of high strength aluminium alloy grades, not much have been achieved for adequate and efficient volume manufacturing system applicable in the automotive industry. Due to lack of such system and based on expert knowledge in hot stamping production-line, AP&T presents in this paper a hot stamping processing route for high strength aluminium alloys been suitable for production-line development and volume manufacturing.

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