Sample records for year open study

  1. Comparable perioperative mortality outcomes in younger patients undergoing elective open and endovascular abdominal aortic aneurysm repair.

    PubMed

    Liang, Nathan L; Reitz, Katherine M; Makaroun, Michel S; Malas, Mahmoud B; Tzeng, Edith

    2018-05-01

    Evidence for benefit of endovascular aneurysm repair (EVAR) over open surgical repair for de novo infrarenal abdominal aortic aneurysms (AAAs) in younger patients remains conflicting because of heterogeneous study populations and small sample sizes. The objective of this study was to compare perioperative and short-term outcomes for EVAR and open surgery in younger patients using a large national disease and procedure-specific data set. We identified patients 65 years of age or younger undergoing first-time elective EVAR or open AAA repair from the Vascular Quality Initiative (2003-2014). We excluded patients with pararenal or thoracoabdominal aneurysms, those medically unfit for open repair, and those undergoing EVAR for isolated iliac aneurysms. Clinical and procedural characteristics were balanced using inverse propensity of treatment weighting. A supplemental analysis extended the study to those younger than 70 years. We identified 2641 patients, 73% (n = 1928) EVAR and 27% (n = 713) open repair. The median age was 62 years (interquartile range, 59-64 years), and 13% were female. The median follow-up time was 401 days (interquartile range, 357-459 days). Unadjusted perioperative survival was 99.6% overall (open repair, 99.1%; EVAR, 99.8%; P < .001), with 97.4% 1-year survival overall (open repair, 97.3%; EVAR, 97.4%; P = .9). Unadjusted reintervention rates were five (open repair) and seven (EVAR) reinterventions per 100 person-years (P = .8). After propensity weighting, the absolute incidence of perioperative mortality was <1% in both groups (open repair, 0.9%, EVAR, 0.2%; P < .001), and complication rates were low. Propensity-weighted survival (hazard ratio, 0.88; 95% confidence interval, 0.56-1.38; P = .6) and reintervention rates (open repair, 6; EVAR, 8; reinterventions per 100 person-years; P = .8) did not differ between the two interventions. The analysis of those younger than 70 years showed similar results. In this study of younger patients undergoing repair of infrarenal AAA, 30-day morbidity and mortality for both open surgery and EVAR are low, and the absolute mortality difference is small. The prior published perioperative mortality and 1-year survival benefit of EVAR over open AAA repair is not observed in younger patients. Further studies of long-term durability are needed to guide decision-making for open repair vs EVAR in this population. Copyright © 2017 Society for Vascular Surgery. Published by Elsevier Inc. All rights reserved.

  2. Cost-utility analysis of minimally invasive versus open multilevel hemilaminectomy for lumbar stenosis.

    PubMed

    Parker, Scott L; Adogwa, Owoicho; Davis, Brandon J; Fulchiero, Erin; Aaronson, Oran; Cheng, Joseph; Devin, Clinton J; McGirt, Matthew J

    2013-02-01

    Two-year cost-utility study comparing minimally invasive (MIS) versus open multilevel hemilaminectomy in patients with degenerative lumbar spinal stenosis. The objective of the study was to determine whether MIS versus open multilevel hemilaminectomy for degenerative lumbar spinal stenosis is a cost-effective advancement in lumbar decompression surgery. MIS-multilevel hemilaminectomy for degenerative lumbar spinal stenosis allows for effective treatment of back and leg pain while theoretically minimizing blood loss, tissue injury, and postoperative recovery. No studies have evaluated comprehensive healthcare costs associated with multilevel hemilaminectomy procedures, nor assessed cost-effectiveness of MIS versus open multilevel hemilaminectomy. Fifty-four consecutive patients with lumbar stenosis undergoing multilevel hemilaminectomy through an MIS paramedian tubular approach (n=27) versus midline open approach (n=27) were included. Total back-related medical resource utilization, missed work, and health state values [quality adjusted life years (QALYs), calculated from EuroQuol-5D with US valuation] were assessed after 2-year follow-up. Two-year resource use was multiplied by unit costs based on Medicare national allowable payment amounts (direct cost) and work-day losses were multiplied by the self-reported gross-of-tax wage rate (indirect cost). Difference in mean total cost per QALY gained for MIS versus open hemilaminectomy was assessed as incremental cost-effectiveness ratio (ICER: COST(MIS)-COST(OPEN)/QALY(MIS)-QALY(OPEN)). MIS versus open cohorts were similar at baseline. MIS and open hemilaminectomy were associated with an equivalent cumulative gain of 0.72 QALYs 2 years after surgery. Mean direct medical costs, indirect societal costs, and total 2-year cost ($23,109 vs. $25,420; P=0.21) were similar between MIS and open hemilaminectomy. MIS versus open approach was associated with similar total costs and utility, making it a cost equivalent technology compared with the traditional open approach. MIS versus open multilevel hemilaminectomy was associated with similar cost over 2 years while providing equivalent improvement in QALYs. In our experience, MIS versus open multilevel hemilaminectomy is a cost equivalent technology for patients with lumbar stenosis-associated radicular pain.

  3. Outcome comparison between thoracic endovascular and open repair for type B aortic dissection: A population-based longitudinal study.

    PubMed

    Chou, Hsiao-Ping; Chang, Hsiao-Ting; Chen, Chun-Ku; Shih, Chun-Che; Sung, Shih-Hsien; Chen, Tzeng-Ji; Chen, I-Ming; Lee, Ming-Hsun; Sheu, Ming-Huei; Wu, Mei-Han; Chang, Cheng-Yen

    2015-04-01

    Management of diseases of the descending thoracic aorta is trending from open surgery toward thoracic endovascular aortic repair (TEVAR), because TEVAR is reportedly associated with less perioperative mortality. However, comparisons between TEVAR and open surgery, adjusting for patient comorbidities, have not been well studied. In this nationwide population-based study, we compared the outcomes between TEVAR and open surgery in type B aortic dissection. From 2003 to 2009, data on patients with type B aortic dissection who underwent either open surgery or TEVAR were obtained from the National Health Insurance Research Database. Survival, length of stay, and complications were compared between TEVAR and open repair. To minimize possible bias, we performed an additional analysis after matching patients by age, sex, and propensity score. A total of 1661 patients were identified, of whom 1542 underwent open repair and 119 TEVAR. Patients in the TEVAR group were older (63.0 ± 15.4 years vs. 58.1 ± 13.1 years; p = 0.001), included more males, and had more preoperative comorbidities. Thirty-day mortality in the TEVAR group was significantly lower than that in the open repair group (4.2% vs. 17.8%; p < 0.001). The midterm survival rates in the unmatched cohort between the open surgery and TEVAR groups at 1 year, 2 years, 3 years, and 4 years were 76%, 73%, 71%, and 68% vs. 92%, 86%, 82%, and 79%, respectively. The length of stay in the TEVAR group was shorter than that in the open repair group (p = 0.001). The TEVAR group had less respiratory failure (p = 0.022) and fewer wound complications than the open repair group (p = 0.008). The matched cohort showed similar results. TEVAR for type B aortic dissection repair has less perioperative mortality, a shorter length of hospitalization, a higher midterm survival rate, less postoperative respiratory failure, and fewer wound complications than open surgery. Copyright © 2015. Published by Elsevier Taiwan.

  4. Long-Term, Open-Label Safety and Efficacy of Atomoxetine in Adults with ADHD: Final Report of a 4-Year Study

    ERIC Educational Resources Information Center

    Adler, Lenard A.; Spencer, Thomas J.; Williams, David W.; Moore, Rodney J.; Michelson, David

    2008-01-01

    Objective: Previously, data from 97 weeks of open-label atomoxetine treatment of adults with attention-deficit/hyperactivity disorder (ADHD) were reported. This final report of that study presents results from over 4 years of treatment. Method: Results were derived from the study of 384 patients (125 patients remaining in the open-label trial…

  5. Patterns and Predictors of Adoption Openness and Contact: 14 Years Postadoption

    ERIC Educational Resources Information Center

    Crea, Thomas M.; Barth, Richard P.

    2009-01-01

    Increased attention is being paid to open adoption arrangements between birth parents and adopted children and families. This study examines openness and contact among 469 adoptions at 14 years postadoption from the fourth wave of the California Long-Range Adoption Study (CLAS) and 378 adoptions matched across all waves. The proportion of families…

  6. A prospective study of the impact of opening a casino on gambling behaviours: 2- and 4-year follow-ups.

    PubMed

    Jacques, Christian; Ladouceur, Robert

    2006-10-01

    It is widely believed that the rate of pathological gambling is related to the accessibility and availability of gambling activities. Few empirical studies have yet been conducted to evaluate this hypothesis. Using a longitudinal prospective design, the current study evaluates the impact of a casino in Canada's Hull, Quebec region. A random sample of respondents from Hull (experimental group) and from Quebec City (comparison group) completed the South Oaks Gambling Screen (SOGS) and gambling- related questions before the opening of the Hull Casino (pretest), 1 year after the opening (posttest), and on follow-up at Years 2 and 4. Although, 1 year after the opening of the casino, we did observe an increase in playing casino games and in the maximum amount of money lost in 1 day's gambling, this trend was not maintained over time (2- and 4-year follow-ups). In the Hull cohort, the rate of at-risk and probable pathological gamblers and the number of criteria on the SOGS did not increase at the 2- and 4-year follow-ups. The residents' reluctance to open a local casino was generally stable over time following the casino's opening. The discussion raises different explanatory factors and focuses on the context of the Regional Exposure Model as a potentially more applicable measure of studying the expansion of gambling.

  7. Cost-effectiveness of minimally invasive versus open transforaminal lumbar interbody fusion for degenerative spondylolisthesis associated low-back and leg pain over two years.

    PubMed

    Parker, Scott L; Adogwa, Owoicho; Bydon, Ali; Cheng, Joseph; McGirt, Matthew J

    2012-07-01

    Minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF) for lumbar spondylolisthesis allows for surgical treatment of back and leg pain while theoretically minimizing tissue injury and accelerating overall recovery. Although the authors of previous studies have demonstrated shorter length of hospital stay and reduced blood loss with MIS versus open-TLIF, short- and long-term outcomes have been similar. No studies to date have evaluated the comprehensive health care costs associated with TLIF procedures or assessed the cost-utility of MIS- versus open-TLIF. As such, we set out to assess previously unstudied end points of health care cost and cost-utility associated with MIS- versus open-TLIF. Thirty patients undergoing MIS-TLIF (n=15) or open-TLIF (n=15) for grade I degenerative spondylolisthesis associated back and leg pain were prospectively studied. Total back-related medical resource use, missed work, and health-state values (quality-adjusted life years [QALYs], calculated from EQ-5D with U.S. valuation) were assessed after two-year follow-up. Two-year resource use was multiplied by unit costs on the basis of Medicare national allowable payment amounts (direct cost) and work-day losses were multiplied by the self-reported gross-of-tax wage rate (indirect cost). Difference in mean total cost per QALY gained for MIS- versus open-TLIF was assessed as incremental cost-effectiveness ratio (ICER: COSTmis-COSTopen/QALYmis-QALYopen). MIS versus open-TLIF cohorts were similar at baseline. By two years postoperatively, patients undergoing MIS- versus open-TLIF reported similar mean QALYs gained (0.50 vs. 0.41, P=0.17). Mean total two-year cost of MIS- and open-TLIF was $35,996 and $44,727, respectively. The $8,731 two-year cost savings of MIS- versus open-TLIF did not reach statistical significance (P=0.18) for this sample size. Although our limited sample size prevented statistical significance, MIS- versus open-TLIF was associated with reduced costs over two years while providing equivalent improvement in QALYs. MIS-TLIF allows patients to leave the hospital sooner, achieve narcotic independence sooner, and return to work sooner than open-TLIF. In our experience, MIS- versus open-TLIF is a cost reducing technology in the surgical treatment of medically refractory low-back and leg pain from grade I lumbar spondylolisthesis. Copyright © 2012 Elsevier Inc. All rights reserved.

  8. Risperidone in Children with Disruptive Behavior Disorders and Subaverage Intelligence: A 1-Year, Open-Label Study of 504 Patients

    ERIC Educational Resources Information Center

    Croonenberghs, Jan; Fegert, Joerg M.; Findling, Robert L.; de Smedt, Goedele; van Dongen, Stefan

    2005-01-01

    Objective: To determine the long-term safety and effectiveness of risperidone for severe disruptive behaviors in children. Method: A multisite, 1-year, open-label study of patients aged 5 to 14 years with disruptive behaviors and subaverage intelligence was conducted. Results: Seventy-three percent of the 504 patients enrolled completed the study.…

  9. Open adoption of infants: adoptive parents' feelings seven years later.

    PubMed

    Siegel, Deborah H

    2003-07-01

    Adoptions today increasingly include contact between adoptive and birth families. What do these "open adoptions" look like? How do the participants feel about them? This article, based on part of a longitudinal study that first examined adoptive parents' perceptions of their infants' open adoptions seven years ago, explores the parents' reactions now that their children are school age. This qualitative descriptive research revealed changes in the openness in the adoptions over time and identified four dimensions along which open adoptions vary. Findings showed parents' enthusiasm for the openness in their adoptions, regardless of the type and extent of openness. Implications for social work practice, education, and policy are explored.

  10. First Year Learning Experiences of University Undergraduates in the Use of Open Educational Resources in Online Learning

    ERIC Educational Resources Information Center

    Afolabi, Folashade

    2017-01-01

    This study investigated the first year University undergraduates' experiences in the use of open educational resources (OER) in online learning and their in-course achievement. The design selected for the study was survey and quasi-experimental. A total number of 106 University undergraduates participated in the study after a preliminary study was…

  11. Studying at the Open University of the Netherlands, Developments 1984-1987.

    ERIC Educational Resources Information Center

    Boon, J.; van Enckevort, G.

    A study examined the success of the first three years of the Dutch Open University's operation by analyzing data pertaining to students' backgrounds and academic progress while enrolled in the open university. The fact that registered inquiries about the Dutch Open University rose from 120,000 during the summer and autumn of 1984 to more than…

  12. Minimally invasive instrumentation without fusion during posterior thoracic corpectomies: a comparison of percutaneously instrumented nonfused segments with open instrumented fused segments.

    PubMed

    Lau, Darryl; Chou, Dean

    2017-07-01

    OBJECTIVE During the mini-open posterior corpectomy, percutaneous instrumentation without fusion is performed above and below the corpectomy level. In this study, the authors' goal was to compare the perioperative and long-term implant failure rates of patients who underwent nonfused percutaneous instrumentation with those of patients who underwent traditional open instrumented fusion. METHODS Adult patients who underwent posterior thoracic corpectomies with cage reconstruction between 2009 and 2014 were identified. Patients who underwent mini-open corpectomy had percutaneous instrumentation without fusion, and patients who underwent open corpectomy had instrumented fusion above and below the corpectomy site. The authors compared perioperative outcomes and rates of implant failure requiring reoperation between the open (fused) and mini-open (unfused) groups. RESULTS A total of 75 patients were identified, and 53 patients (32 open and 21 mini-open) were available for followup. The mean patient age was 52.8 years, and 56.6% of patients were male. There were no significant differences in baseline variables between the 2 groups. The overall perioperative complication rate was 15.1%, and there was no significant difference between the open and mini-open groups (18.8% vs 9.5%; p = 0.359). The mean hospital stay was 10.5 days. The open group required a significantly longer stay than the mini-open group (12.8 vs 7.1 days; p < 0.001). Overall implant failure rates requiring reoperation were 1.9% at 6 months, 9.1% at 1 year, and 14.7% at 2 years. There were no significant differences in reoperation rates between the open and mini-open groups at 6 months (3.1% vs 0.0%, p = 0.413), 1 year (10.7% vs 6.2%, p = 0.620), and 2 years (18.2% vs 8.3%, p = 0.438). The overall mean follow-up was 29.2 months. CONCLUSIONS These findings suggest that percutaneous instrumentation without fusion in mini-open transpedicular corpectomies offers similar implant failure and reoperation rates as open instrumented fusion as far out as 2 years of follow-up.

  13. Diameters of clearcut openings influence central Appalachian hardwood stem development - 10-year study

    Treesearch

    H. Clay Smith

    1981-01-01

    Appalachian hardwood stands in West Virginia were studied to determine how reproduction establishment and development were influenced by circular clearcut openings of different sizes, postlogging herbicide treatments, and site quality. Ten-year results indicate that circular clearcuts should be at least 1/2 acre to gain the silvicultural effects of larger clearcuts....

  14. An Analysis of Academic Achievement in Public Elementary Open-Enrollment Charter and Traditional Public Schools

    ERIC Educational Resources Information Center

    Benson, Tammy

    2012-01-01

    The purpose of this study was to examine two types of school organizational structures: elementary open-enrollment charter schools and elementary traditional public schools. The study examined the degree to which attendance rates (based upon the prior school year's data), class size and average number of years of teaching experience were related…

  15. Comparison of endovascular repair with branched stent graft and open repair for aortic arch aneurysm.

    PubMed

    Kawatou, Masahide; Minakata, Kenji; Sakamoto, Kazuhisa; Nakatsu, Taro; Tazaki, Junichi; Higami, Hirooki; Uehara, Kyokun; Yamazaki, Kazuhiro; Inoue, Kanji; Kimura, Takeshi; Sakata, Ryuzo

    2017-08-01

    Although conventional open repair is our preference for patients with aortic arch aneurysms, we have often chosen thoracic endovascular aneurysm repair (TEVAR) with a handmade branched stent graft (bTEVAR) in high-risk patients. The aim of this study was to compare the midterm clinical outcomes of our bTEVAR technique to those of the open repair. Between January 2007 and December 2014, we treated 129 patients with aortic arch aneurysm by means of either conventional open repair (OPEN, n = 61) or bTEVAR (n = 68) at our institution. The mean ages were 70.5 ± 12.7 years in the OPEN group and 72.7 ± 12.5 years in the bTEVAR group (P = 0.32). The aetiologies included true aneurysm in 101 patients (78.3%) and chronic dissection in 26 (20.1%). There were 2 (3.3%) in-hospital deaths in the OPEN group and 3 (4.4%) in the bTEVAR group. The mean follow-up duration was 3.0 ± 2.1 years (2.4 ± 1.9 years in the OPEN group and 3.6 ± 2.3 years in the bTEVAR group). There was no difference in 5-year aneurysm-related mortality between groups (10.7% in OPEN vs 12.8% in bTEVAR, P = 0.50). In terms of late additional procedures, however, none were required in the OPEN group, whereas 10 (15.4%) additional endovascular repairs and 4 (6.2%) open repairs were required in the bTEVAR group. Our bTEVAR could be performed with low early mortality, and it yielded similar midterm aneurysm-related mortality to that of conventional open repair. However, these patients undergoing this technique required more late additional procedures than those undergoing conventional open repair. © The Author 2017. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.

  16. Effects of long-term treatment with rotigotine transdermal system on dyskinesia in patients with early-stage Parkinson's disease.

    PubMed

    Giladi, Nir; Ghys, Liesbet; Surmann, Erwin; Boroojerdi, Babak; Jankovic, Joseph

    2014-12-01

    In two 6-month, double-blind, placebo-controlled studies, rotigotine transdermal system was well-tolerated and efficacious monotherapy in early-stage PD. This post hoc analysis of the long-term open-label extensions (NCT00594165; NCT00599196) of these studies assessed incidence and severity of dyskinesia in participants treated with rotigotine, with or without concomitant levodopa, for up to 6 years. Open-label rotigotine was titrated to optimal dose (≤16 mg/24 h). Concomitant levodopa was permitted. Dyskinesia data, recorded using the Unified Parkinson's Disease Rating Scale Part IV, were pooled from the two open-label studies. Of 596 participants who received open-label rotigotine, 299 (50%) remained at trial closure; no patient discontinued due to dyskinesia. In the two studies, median exposure to rotigotine was 1910 days (∼5 years, 3 months), and 1564.5 days (∼4 years, 3 months). During up to 6 years of open-label rotigotine, 423/596 (71%) received levodopa. Dyskinesias were reported in 115/596 (19%) participants, 90/115 (78%) of who developed dyskinesia after levodopa was added; 25 reported dyskinesia in the absence of levodopa (includes patients who never received open-label levodopa, and those who reported dyskinesia before starting concomitant levodopa). Dyskinesia severity data were available for 107 of the 115 participants. In 56/107 (52%) participants, dyskinesia was considered 'not disabling' for all occurrences; the worst-case severity was 'mildly disabling' for 33/107 (31%), and 'moderately' or 'severely disabling' for 18/107 (17%; 3% of total participants). During treatment with rotigotine in patients with PD for up to 6 years the incidence of dyskinesia was low, and the dyskinesia was generally 'not disabling' or 'mildly disabling'. Copyright © 2014 Elsevier Ltd. All rights reserved.

  17. The changing epidemiology of open fractures in vehicle occupants, pedestrians, motorcyclists and cyclists.

    PubMed

    Winkler, Dennis; Goudie, Stuart T; Court-Brown, Charles M

    2018-02-01

    To investigate the changing epidemiology of open fractures in vehicle occupants, pedestrians, motorcyclists and cyclists. Data on all non-spinal open fractures admitted to the Royal Infirmary of Edinburgh after a road traffic accident between 1988 and 2010 were collected and analysed to provide information about the changing epidemiology in different patient groups. Demographic information was collected on all patients with the severity of injury being analysed with the Injury Severity Score (ISS), Musculoskeletal Index (MSI) and the number of open fractures. The severity of the open fractures was analysed using the Gustilo classification. The 23-year study period was divided into four shorter periods and the results were compared. There were 696 patients treated in 23 years. Analysis showed that the incidence of RTA open fractures initially fell in both males and females and continued to fall in females during the 23 years. In males it levelled off about 2000. The age of the female patients also fell during the study period but it did not change in males. The only patient group to show an increased incidence of open fractures were cyclists. In vehicle occupants the incidence fell throughout the study period but it levelled off in pedestrians and motorcyclists. There was no difference in the severity of injury in any group during the study period. The most severe open fractures were those of the distal femur and femoral diaphysis although open tibial diaphyseal fractures were the most common fracture in all patient groups. Improved car design and road safety legislation has resulted in a reduction in the incidence of open fractures in vehicle occupants, pedestrians and motorcyclists. The most obvious group to have benefitted from this are older female pedestrians. The only group to show an increase in age during the study period were male motorcyclists. Copyright © 2017 Elsevier Ltd. All rights reserved.

  18. Extra-Curricular Social Studies in an Open Air History Museum

    ERIC Educational Resources Information Center

    Morris, Ronald Vaughan

    2008-01-01

    This article discusses extra-curricular social studies in an Open Air History Museum. Open Air History Museum, Conner Prairie Interpretive Park in Fishers, Indiana, is a cultural institution that encourages and supports talented students as they participate in an extra-curricular program. Ten-to sixteen-year-old youths "apply for jobs"…

  19. Open Textbooks and Increased Student Access and Outcomes

    ERIC Educational Resources Information Center

    Feldstein, Andrew; Martin, Mirta; Hudson, Amy; Warren, Kiara; Hilton, John, III; Wiley, David

    2012-01-01

    This study reports findings from a year-long pilot study during which 991 students in 9 core courses in the Virginia State University School of Business replaced traditional textbooks with openly licensed books and other digital content. The university made a deliberate decision to use open textbooks that were copyrighted under the Creative…

  20. Short-term Outcomes After Open and Laparoscopic Colostomy Creation.

    PubMed

    Ivatury, Srinivas Joga; Bostock Rosenzweig, Ian C; Holubar, Stefan D

    2016-06-01

    Colostomy creation is a common procedure performed in colon and rectal surgery. Outcomes by technique have not been well studied. This study evaluated outcomes related to open versus laparoscopic colostomy creation. This was a retrospective review of patients undergoing colostomy creation using univariate and multivariate propensity score analyses. Hospitals participating in the American College of Surgeons National Surgical Quality Improvement Program database were included. Data on patients were obtained from the American College of Surgeons National Surgical Quality Improvement Program 2005-2011 Participant Use Data Files. We measured 30-day mortality, 30-day complications, and predictors of 30-day mortality. A total of 2179 subjects were in the open group and 1132 in the laparoscopic group. The open group had increased age (open, 64 years vs laparoscopic, 60 years), admission from facility (17.0% vs 14.9%), and disseminated cancer (26.1% vs 21.4%). All were statistically significant. The open group had a significantly higher percentage of emergency operations (24.9% vs 7.9%). Operative time was statistically different (81 vs 86 minutes). Thirty-day mortality was significantly higher in the open group (8.7% vs 3.5%), as was any 30-day complication (25.4% vs 17.0%). Propensity-matching analysis on elective patients only revealed that postoperative length of stay and rate of any wound complication were statistically higher in the open group. Multivariate analysis for mortality was performed on the full, elective, and propensity-matched cohorts; age >65 years and dependent functional status were associated with an increased risk of mortality in all of the models. This study has the potential for selection bias and limited generalizability. Colostomy creation at American College of Surgeons National Surgical Quality Improvement Program hospitals is more commonly performed open rather than laparoscopically. Patient age >65 years and dependent functional status are associated with an increased risk of 30-day mortality.

  1. A Matched Case-Control Study on Open and Endovascular Treatment of Popliteal Artery Aneurysms.

    PubMed

    Dorigo, W; Fargion, A; Masciello, F; Piffaretti, G; Pratesi, G; Giacomelli, E; Pratesi, C

    2018-01-01

    To compare early and late results of open and endovascular management of popliteal artery aneurysm in a retrospective single-center matched case-control study Methods: From 1981 to 2015, 309 consecutive interventions for popliteal artery aneurysm were performed in our institution, in 59 cases with endovascular repair and in 250 cases with open repair. Endovascular repair was preferred in older asymptomatic patients, while open repair was offered more frequently to patients with a thrombosed popliteal artery aneurysm and a poor run-off status. A one-to-one coarsened exact matching on the basis of the baseline demographic, clinical, and anatomical covariates significantly different between the two treatment options was performed and two equivalent groups of 56 endovascular repairs and open repairs were generated. The two groups were compared in terms of perioperative results with χ 2 test and of follow-up outcomes with the Kaplan-Meier curves and log-rank test. There were no differences between the two groups in terms of perioperative outcomes. Median duration of follow-up was 38 months. Five-year survival rates were 94% in endovascular repair group and 89.5% in open repair group (p = 0.4, log-rank 0.6). Primary patency rates at 1, 3, and 5 years were 81%, 78%, and 72% in endovascular repair group and 82.5%, 80%, and 64% in open repair group (p = 0.8, log-rank 0.01). Freedom from reintervention at 5 years was 65.5% in endovascular repair group and 76% in open repair group (p = 0.2, log-rank 1.2). Secondary patency at 1, 3, and 5 years was 94%, 86%, and 74% in endovascular repair group, and 94%, 89%, and 71% in open repair group, respectively (p = 0.9, log-rank 0.01). The rates of limb preservation at 5 years were 94% in endovascular repair group and 86.4% in open repair group (p = 0.3, log-rank 0.8). Open repair and endovascular repair of popliteal artery aneurysms provided in this retrospective single-center experience similar perioperative and follow-up results in equivalent groups of patients.

  2. [Clinical evaluation of open and close treatment in pediatric condylar fractures].

    PubMed

    Han, Jing; Li, Zhi; Zhou, Haihua; Yang, Rongtao; Xiong, Guizhong; Li, Zubing

    2014-08-01

    To evaluate the long-term clinical and radiographic outcomes of open and close treatment of condylar fractures of mandible in children. A total of 78 cases (105 mandibular condylar fractures) were included in this study. All patients (younger than 12 years at the time of injury were followed up for at least 3 years. According to the classification of the condylar fractures, open or close treatment was chosen. Clinical outcomes were classified as favorable or unfavorable depending on the mouth opening, pattern of mouth opening, occlusion, facial symmetry. Condylar remodeling was defined as complete, moderate, or poor based on the radiographic findings. Depending on the classification, 14 sides of type I, 48 sides of type II and 43 sides of type III were included in this study. Open treatment was chosen in 51 sides and close treatment was chosen in 54 sides. Most of the patients acquired satisfactory clinical outcomes. Better radiologic remodeling of the condylar process was found in the patients treated by open treatment. Favorable long-term clinical outcomes were obtained in both open and close treatment of mandibular condylar fractures. A better morphological remodeling of condylar process was found in patients with open treatment.

  3. The Need for Participation in Open and Distance Education: The Open University Malaysia Experience

    ERIC Educational Resources Information Center

    Raghavan, Santhi; Kumar, P. Rajesh

    2007-01-01

    This paper provides an overview of adult learner participation in open and distance education by focusing participation needs based on selected socio-demographic variables such as age, years of working experience and monthly income. The related study involved a sample of 454 Open University Malaysia students from a number of learning centres…

  4. Children's communication about distressing events: the role of emotional openness and psychological attributes of family members.

    PubMed

    Lutz, Wilma J; Hock, Ellen; Kang, Min Ju

    2007-01-01

    This study documents the importance of emotional openness to the recovery process in families following traumatic events. In this longitudinal study, relationships are examined between emotional openness and parents' psychological attributes, and mothers' and children's open disclosure of feelings. After September 11, 2001, 48 mothers and their 11-year-old children were interviewed about their reactions to the terrorist attacks. Measures included interview-based scores of children's and mothers' degree of openness, mothers' openness assessed during pregnancy and infancy, and parental depression and anxiety in close relationships. Emotional openness is a stable and reliably measured construct. Mothers' emotional openness was significantly related to earlier assessments of openness, indicators of their own and their spouse's emotional health, and their children's open expression of emotion about the terrorist attacks.

  5. Open-Label Trial of Atomoxetine Hydrochloride in Adults with ADHD

    ERIC Educational Resources Information Center

    Johnson, Mats; Cederlund, Mats; Rastam, Maria; Areskoug, Bjorn; Gillberg, Christopher

    2010-01-01

    Background: While atomoxetine is an established treatment for attention-deficit/hyperactivity disorder in children, few studies have examined its efficacy for adults. Methods: Open-label trial of atomoxetine in 20 individuals with ADHD, aged 19-47 years, for 10 weeks, and a total of one year for responders. Results: Ten patients met primary…

  6. An Analysis of Patient Adherence to Treatment during a 1-Year, Open-Label Study of OROS[R] Methylphenidate in Children with ADHD

    ERIC Educational Resources Information Center

    Faraone, Stephen V.; Biederman, Joseph; Zimmerman, Brenda

    2007-01-01

    Objective: Treatment adherence is an important aspect of ADHD symptom management, but there are many factors that may influence adherence. Method: This analysis assessed adherence to OROS methylphenidate during a 1-year, open-label study in children. Adherence was defined as the number of days medication was taken divided by the number of days in…

  7. Long-term Durability of Infrainguinal Endovascular and Open Revascularization for Disabling Claudication.

    PubMed

    Khan, Sikandar Z; Rivero, Mariel; Cherr, Gregory S; Harris, Linda M; Dryjski, Maciej L; Dosluoglu, Hasan H

    2018-05-15

    Infrainguinal revascularization for disabling claudication (DC) is frequently performed, but long-term results are still unknown. In this study, we compared clinical outcomes of infrainguinal endovascular (EV) and open interventions for DC after the failure of medical management. One hundred ninety-four patients with DC (Rutherford category 3) who had open (n = 53) or EV (n = 141) interventions were grouped as open-great saphenous vein (GSV) (n = 21), open-prosthetic (n = 32), EV-Trans-Atlantic Inter-Society Consensus II (TASC II) A and B (AB) (n = 48), and EV-TASC II C and D (CD) (n = 93). Patency, primary clinical success (PCS; sustained improvement in symptoms without reintervention), and secondary clinical success (SCS; sustained improvement in symptoms with reintervention) rates were compared. Mean follow-up was 57 ± 33 months. Five-year primary patency was 58% in open-GSV, 40% in open-prosthetic, 72% in EV-AB, and 38% in EV-CD (P < 0.001). Five-year secondary patency was 77% in open-GSV, 50% in open-prosthetic, 96% in EV-AB, and 61% in EV-CD (P < 0.001). Freedom from major adverse limb events was 73% in open-GSV, 77% in EV-AB, 70% in EV-CD, and 67% in open-prosthetic (P = 0.279). Five-year PCS was 46% in open-GSV, 40% in open-prosthetic, 57% in EV-AB, and 44% in EV-CD (P = 0.02). Five-year SCS was 78% in open-GSV, 78% in open-prosthetic, 85% in EV-AB, and 84% in EV-CD (P = 0.732). A total of 116 reinterventions were performed, 10 in 6 limbs (27%) in open-GSV, 18 in 12 limbs (36%) in open-prosthetic, 26 in 15 limbs (24%) in EV-AB, and 62 in 39 limbs (36%) in EV-CD. Reinterventions included 71 (61%) EV and 45 (39%) open procedures. Durability of infrainguinal interventions in claudicants depends mainly on anatomic complexity of disease. Good long-term clinical success can be achieved with both open and EV interventions, albeit with high reintervention rates, especially in patients with TASC II C and D disease. A considerable subset of EV patients will eventually require surgical revascularization to maintain clinical benefit. In this study, almost 20% of patients undergoing EV for TASC II C and D disease eventually required surgical bypass. Copyright © 2018 Elsevier Inc. All rights reserved.

  8. Laparoscopic Complete Mesocolic Excision versus Open Complete Mesocolic Excision for Transverse Colon Cancer: Long-Term Survival Results of a Prospective Single Centre Non-Randomized Study.

    PubMed

    Storli, Kristian Eeg; Eide, Geir Egil

    2016-01-01

    Laparoscopic complete mesocolic excision (CME) used in the treatment of transverse colon cancer has been questioned on the basis of the technical challenges. The aim of this study was to evaluate the medium- and long-term clinical and survival outcomes after laparoscopic and open CME for transverse colon cancer and to compare the 2 approaches. This study was a retrospective non-randomized study of patients with prospectively registered data on open and laparoscopic CME for transverse colon cancer tumour-node-metastasis stages I-III operated on between 2007 and 2014. This was a single-centre study in a community teaching hospital. A total of 56 patients with transverse colon cancer were included, excluding those with tumours in the colonic flexures. The outcome aims were 4-year time to recurrence (TTR) and cancer-specific survival (CSS). Morbidity was also measured. The 4-year TTR was 93.9% in the laparoscopic group and 91.3% in the open group (p = 0.71). The 4-year CSS was 97.0% in the laparoscopic group and 91.3% in the open group (p = 0.42). This was a prospective single-institution study with a small sample size. Results of the study suggest that the laparoscopic CME approach might be the preferred approach for transverse colon cancer, especially regarding its benefits in terms of short-term morbidity, length of stay and oncological outcome. © 2016 S. Karger AG, Basel.

  9. The temporal outcomes of open versus arthroscopic knotted and knotless rotator cuff repair over 5 years

    PubMed Central

    Lucena, Thomas R; Lam, Patrick H; Millar, Neal L

    2015-01-01

    Background The present study aimed to determine how repair technique influenced structural and clinical outcomes at 5 years post-surgery. Methods Three cohorts of patients had repair of a symptomatic rotator cuff tear using (i) an open double-row mattress repair technique (n = 25); (ii) arthroscopic single-row simple suture knotted technique (n = 25); or (iii) arthroscopic single-row inverted mattress knotless technique (n = 36) by one surgeon. Standardized patient- and examiner-determined outcomes were obtained pre-operatively and postoperatively with a validated protocol, ultrasound were also performed at the same time. Results Retear occurred more often after open repair (48%) at 5 years than after arthroscopic knotted (33%) and arthroscopic knotless (26%) repair. Retear was associated with increasing age, pre-operative tear size and weaker pre-operative and 5 years postoperative cuff strength. Between 2 years and 5 years, the open repair group experienced an increase in the frequency of pain during activity, as well as in the difficulty experienced and the severity of pain during overhead activities (p < 0.05) and, at 5 years, also experienced more difficulty with overhead activities, compared to the arthroscopic knotless repair group. Conclusions At 5-year follow-up, arthroscopic rotator cuff repair techniques resulted in fewer retears and better outcomes compared to an open double-row technique. PMID:27582985

  10. Effect of eliminating open defecation on diarrhoeal morbidity: an ecological study of Nyando and Nambale sub-counties, Kenya.

    PubMed

    Njuguna, John

    2016-08-04

    Defecating in the open predisposes people to soil transmitted helminthes and diarrhoeal diseases. An estimated 5.6 million Kenyans defecate in the open. Kenya launched a program to eradicate open defecation by 2013 in the rural areas. By end of 2013, only two sub-counties had eliminated open defecation. These are Nambale and Nyando. The study looked at the impact of eradicating open defecation on diarrhea prevalence among children in these two sub-counties. Data on diarrhoea morbidity among children under 5 years was extracted from the Kenya Health Information System for all the sub-counties in Busia and Kisumu counties for 2012, 2013 and 2014 respectively. Prevalence was calculated for each sub-county in Kisumu for comparison with Nyando's. Prevalence was also calculated for each sub-county in Busia County and compared to that of Nambale sub-county. A Mann-Whitney U Test was done to test the null hypothesis that diarrhoea prevalence was similar in both open defecation and open defecation free sub-counties. A Mann-Whitney U Test revealed significant difference in diarrhoeal prevalence of open defecation sub-counties (Md = 18.4, n = 34) and open defecation free sub-counties (Md = 9.8, n = 5), U = 9, z = -3.2, p = .001. Among the two Counties, Nambale had the lowest prevalence. It recorded a decline from 9.8 to 5.7 % across the three years. Prevalence for diarrhoea cases in Nyando declined from 19.1 to 15.2 % across the three years. Nyando initially had the second highest prevalence in Kisumu County and by 2014 it had the lowest prevalence. The two sub-counties with open defecation free status had lower prevalence of diarrhoea cases compared to sub-counties which were yet to attain open defecation free status. This suggests that elimination of open defecation may reduce the number of diarrhoea cases.

  11. Long-term safety and tolerability of rotigotine transdermal system in patients with early-stage idiopathic Parkinson's disease: a prospective, open-label extension study.

    PubMed

    Elmer, Lawrence W; Surmann, Erwin; Boroojerdi, Babak; Jankovic, Joseph

    2012-06-01

    This prospective, open-label extension (SP702; NCT00594165) of a 6-month double-blind, randomized study investigated the long-term safety and tolerability of rotigotine transdermal system in early Parkinson's disease (PD). Patients with early-stage idiopathic PD received transdermal rotigotine for up to 6 years at optimal dose (up to 16 mg/24h). Adjunctive levodopa was allowed. Primary outcomes included adverse events (AEs) and extent of rotigotine exposure. Other outcomes included time to levodopa, incidence of dyskinesias, and efficacy using the Unified Parkinson's Disease Rating Scale (UPDRS) II+III total score. Of 217 patients entering the open-label study, 47% were still in the study upon closure; 24% withdrew because of AEs and 6% because of lack of efficacy. The median exposure to rotigotine was 1910 days (≈ 5 years, 3 months; range 1-2188 days). Most common AEs were somnolence (23% per patient-year), falls (17%), peripheral edema (14%), nausea (12%), and application site reactions (ASRs; 12%). 3% withdrew because of ASRs. 26% patients did not initiate levodopa; of those who did, fewer than half started levodopa in the first year. Dyskinesias were reported by 25% patients; the majority (83%) reported their first episode after initiating levodopa. Mean UPDRS II+III total scores remained below double-blind baseline for up to 2 years of open-label treatment. This is the longest interventional study of rotigotine conducted to date. Transdermal rotigotine was generally well tolerated for up to 6 years; AEs reported were similar to those observed in shorter studies and led to discontinuation in only 24% patients. Copyright © 2012 Elsevier Ltd. All rights reserved.

  12. Mastering developmental transitions in young and middle adulthood: the interplay of openness to experience and traditional gender ideology on women's self-efficacy and subjective well-being.

    PubMed

    Weiss, David; Freund, Alexandra M; Wiese, Bettina S

    2012-11-01

    The present research focuses on 2 factors that might help or hurt women to cope with the uncertainties associated with developmental transitions in modern societies (i.e., starting one's first job, graduating from high school, reentry to work after parental leave). We investigate (a) the role of openness to experience in coping with challenging transitions and (b) the (mal)adaptive consequences of adopting a traditional gender ideology. Starting with the assumption that transitional uncertainty has different consequences for women high or low in openness to experience, a first experiment (N = 61; 18-30 years) demonstrated that self-efficacy and well-being decrease after being confronted with transitional uncertainty among women low in openness. Two longitudinal studies investigated the (mal)adaptive consequences of adopting a traditional gender ideology for women high or low in openness in dealing with challenging transitions. Study 2 examined whether endorsing or rejecting traditional gender role beliefs might help female (but not male) students to maintain a sense of self-efficacy and subjective well-being during the transition of graduating from high school (N = 520, 17-22 years). Study 3 (N = 297; 20-53 years) tested the same model for women in middle adulthood during the transition from parental leave to reentry into work life. For both studies, latent growth analyses showed that endorsing traditional gender role beliefs contributed to self-efficacy and subjective well-being among women low in openness. By contrast, for women high in openness, rejecting traditional gender role beliefs had a positive effect on their relative level of self-efficacy and subjective well-being. Functions of ideologies in the context of challenging transitions are discussed.

  13. Evaluation of long-term stability of skeletal anterior open bite correction in adults treated with maxillary posterior segment intrusion using zygomatic miniplates.

    PubMed

    Marzouk, Eiman S; Kassem, Hassan E

    2016-07-01

    This study evaluated the long-term stability of maxillary molar intrusion and anterior open-bite correction in adults treated by maxillary posterior teeth intrusion with zygomatic miniplates. The sample included 26 skeletal anterior open-bite patients, who had maxillary posterior segment intrusion with zygomatic miniplates. Lateral cephalograms were taken at pretreatment, posttreatment, 1 year posttreatment, and 4 years posttreatment. The mean maxillary molar intrusion was 3.04 mm (P ≤0.01), and the mean bite closure was 6.93 mm (P ≤0.01). The intruded maxillary molars relapsed by 10.20% in the first year after treatment and by 13.37% by 4 years after treatment. Overbite relapsed by 8.19% and 11.18% after 1 year and 4 years posttreatment, respectively. The first year after treatment accounted for 76.29% and 73.2% of the total relapses of molar intrusion and overbite, respectively. The 4-year posttreatment relapse amounts of maxillary molar intrusion and overbite were positively correlated with the amount of pretreatment maxillary molar height and the initial open-bite severity, respectively, but negatively correlated with the amounts of maxillary molar intrusion and open-bite correction gained by treatment. Molar intrusion with zygomatic miniplates appears to be stable 4 years after treatment. Copyright © 2016 American Association of Orthodontists. Published by Elsevier Inc. All rights reserved.

  14. The use of secure anonymised data linkage to determine changes in healthcare utilisation following severe open tibial fractures.

    PubMed

    Page, Piers R J; Trickett, Ryan W; Rahman, Shakeel M; Walters, Angharad; Pinder, Leila M; Brooks, Caroline J; Hutchings, Hayley; Pallister, Ian

    2015-07-01

    Severe open fractures of the lower limbs are complex injuries requiring expert multidisciplinary management in appropriate orthoplastic centres. This study aimed to assess the impact of open fractures on healthcare utilisation and test the null hypotheses that there is no difference in healthcare utilisation between the year before and year after injury, and that there is no difference in healthcare utilisation in the year post-injury between patients admitted directly to an orthoplastic centre in keeping with the joint BOA/BAPRAS standards and those having initial surgery elsewhere. This retrospective cohort study utilising secure anonymised information linkage (SAIL), a novel databank of anonymised nationally pooled health records, recruited patients over 18 years of age sustaining severe open lower limb fractures managed primarily or secondarily at our centre and who had data available in the SAIL databank. 101 patients met inclusion criteria and 90 of these had records in the SAIL databank. The number of days in hospital, number of primary care attendances, number of outpatient attendances and number of emergency department attendances in the years prior and subsequent to injury were recorded. Patients sustaining open fractures had significantly different healthcare utilisation in the year after injury when compared with the year before, in terms of days spent in hospital (23.42 vs. 1.70, p=0.000), outpatient attendances (11.98 vs. 1.05, p=0.000), primary care attendances (29.48 vs. 11.99, p=0.000) and emergency department presentations (0.2 vs. 0.01, p=0.025). Patients admitted directly to orthoplastic centres had significantly fewer operations (1.78 vs. 3.31) and GP attendances (23.6 vs. 33.52) than those transferred in subsequent to initial management in other units. There is a significant increase in healthcare utilisation after open tibial fracture. Adherence to national standards minimises the impact of this on both patients and health services. Copyright © 2015 Elsevier Ltd. All rights reserved.

  15. Open Teaching: A New Way on E-Learning?

    ERIC Educational Resources Information Center

    Chiappe, Andres; Lee, Linda L.

    2017-01-01

    Open Teaching is currently considered an ambiguous and polysemic concept but has nevertheless become a growing global trend in ICT-based education. To identify key issues on the subject, this article presents a study on Open teaching that combines meta-synthesis and content analysis of research published over the last twenty years in major…

  16. Fluoxetine for the Treatment of Childhood Anxiety Disorders: Open-Label, Long-Term Extension to a Controlled Trial

    ERIC Educational Resources Information Center

    Clark, Duncan B.; Birmaher, Boris; Axelson, David; Monk, Kelly; Kalas, Catherine; Ehmann, Mary; Bridge, Jeffrey; Wood, D. Scott; Muthen, Bengt; Brent, David

    2005-01-01

    Objective: To assess the efficacy of fluoxetine for the long-term treatment of children and adolescents with anxiety disorders, including generalized anxiety disorder, separation anxiety disorder, and/or social phobia. Method: Children and adolescents (7-17 years old) with anxiety disorders were studied in open treatment for 1 year after they…

  17. Mandibular open-close motion in children with anterior crossbite occlusion.

    PubMed

    Tokutomi, Junko; Hayasaki, Haruaki; Saitoh, Issei; Iwase, Yoko; Fukami, Atsushi; Yamada, Chaiki; Takemoto, Yoshihiko; Inada, Emi; Yamasaki, Youichi

    2010-01-01

    Anterior crossbite (ACB) malocclusions are frequent; however, its characteristic functional features have not been fully described. The purpose of this study was to determine the characteristics of habitual mandibular open-close motion in children with ACB of their primary dentition. Two groups of children were selected for study; 17 with ACB (eight boys and nine girls; four years one month to seven years one month) and 19 with normal occlusion (eight boys and 11 girls; four years six months to six years seven months). The motion was recorded using an optoelectronic analysis system with six degrees-of-freedom. Mandibular incisor and condylar motion were analyzed by measuring their three-dimensional ranges and trajectories. Also estimated incisor and condylar pathways of the two groups were compared. Patients with ACB opened wider with more anterior-posterior condylar translation and more mandibular rotation. Although between-subject (inter-individual) variance of all variables in children with ACB was larger, they had less within-subject variance at the condyles. These results indicate that open-close mandibular motion in children with ACB is completely different from that of children with normal occlusion. The different motions might be related to morphological differences between the two groups.

  18. Using open data in near real time disaster analysis and knowledge generation

    NASA Astrophysics Data System (ADS)

    She, Jun

    2017-04-01

    This presentation will address the value of using open operational geo data in near real time disaster analysis and knowledge generation. In the past, mechanism analysis of a meteo-hyrological extreme event may take month and years with lots of resources since there exist many kinds of restrictions on the model and observation data, e.g., in availability, accessibility, adequacy in resolution, quality and delivery time etc. In recent years, thanks to the open data and open service programs such as Copernicus, EMODnet (European Marine Observation Data Network) and data sharing activities in ROOSs (Regional Operational Oceanography Systems) and national agencies, the disaster analysis become a much faster and efficient procedure. The study will present such a case study for analyzing a hundred-year storm event in January 2017 which affects Danish and German coasts in western Baltic Sea. The event and its forecasts have caused lots of attention in Danish and German media. However, the explanations on how the storm surge is formed and why the prediction is good or bad in this or that country are still largely absent in the media reports. All the data and plots used in the analysis are from open sources. It is found that with the open data, the spatiotemporal variation and the internal links between weather, sea level and water mass movements can be well understood. New knowledge on key factors for the unusual high waters in the western Baltic is obtained from this analysis. Finally, recommendations for using open operational data in generating open science are given.

  19. Laparoscopic extraperitoneal inguinal hernia repair versus open mesh repair: a prospective randomized controlled trial.

    PubMed

    Andersson, Bodil; Hallén, Magnus; Leveau, Per; Bergenfelz, Anders; Westerdahl, Johan

    2003-05-01

    This study was designed to compare an open tension-free technique (Lichtenstein repair) with a laparoscopic totally extraperitoneal hernia repair (TEP). One hundred sixty-eight men aged 30 to 65 years with primary or recurrent inguinal hernia were randomized to TEP or open mesh technique in the manner of Lichtenstein. Follow-up was after 1 and 6 weeks, and 1 year. Eighty-one patients were randomized to TEP, and 87 to open repair. For 1 patient in each group, the operation was converted to a different type of repair. No difference was seen in overall complications between the 2 groups. However, 1 patient in the TEP group underwent operation for small bowel obstruction after surgery. A higher frequency of postoperative hematomas was seen in the open group (P <.05). Patients in the TEP group consumed less analgesic after surgery (P <.001), returned to work earlier (P <.01), and had a shorter time to full recovery (P <.01). Two recurrences occurred in the TEP group 1 year after surgery. The TEP technique was associated with less postoperative pain, a shorter time to full recovery, and an earlier return to work compared with the open tension-free repair. No difference was seen in overall complications. However, 2 recurrences did occur after 1 year in the TEP group.

  20. Vividness and transformation of mental images in karate and ballet.

    PubMed

    Di Corrado, Donatella; Guarnera, Maria; Quartiroli, Alessandro

    2014-12-01

    While imagery research has become popular in recent years, little research has specifically investigated differences in imagery ability between open- and closed-skill sport activities. The purpose of this study was to investigate whether the type of task, open or closed, affects vividness and controllability differently. Thirty female classic dancers (closed skill), 30 female karate athletes (open skill), and 30 female non-athlete students, between 14 and 20 years of age (M = 17.0, SD = 1.6), participated. They completed the Vividness of Visual Imagery Questionnaire, the Vividness of Movement Imagery Questionnaire, and the Subtraction of Parts Task. There was no difference in imagery ability between open- and closed-skill sport groups. Furthermore, dancers and karatekas had higher mean scores on imagery ability than the non-athlete group. A positive correlation was observed between the two questionnaires, supporting findings on the componential basis of imagery. This study contributed to increase the research in the specific area of open- and closed-skill sports and imagery ability.

  1. Long term stability of learning outcomes in undergraduates after an open-inquiry instruction on thermal science

    NASA Astrophysics Data System (ADS)

    Persano Adorno, Dominique; Pizzolato, Nicola; Fazio, Claudio

    2018-02-01

    This paper investigates the efficacy of an open-inquiry approach to achieve a long term stability of physics instruction. This study represents the natural continuation of a research project started four years ago when a sample of thirty engineering undergraduates, having already attended traditional university physics instruction, were involved in a six-week long learning experience of open-inquiry research activities within the highly motivating context of developing a thermodynamically efficient space base on Mars. Four years later, we explore the effectiveness of that learning experience by analyzing the outcomes that the students achieved by answering again the same questionnaire that was administered them both prior to and immediately after those activities. As we did in the first work, students' answers were classified within three epistemological profiles. Now, a comparison among students' outcomes during the three phases, namely, preinstruction, postinstruction, and after four years has been carried out. Immediately after the open-inquiry experience, the students obtained significant benefits in terms of the strengthening of their practical and reasoning abilities, by proficiently applying the learned concepts to face and solve real-world problem situations. In this study, the students' answers do not highlight any significant regress towards their preinstruction profiles. The global robustness of the teaching strategy adopted four years ago is confirmed by a statistically significant comparison with a control group of students who experienced the same curricular instruction except for the open inquiry-based workshop. Nevertheless, some changes have been observed and discussed in the light of the answers the students provided to a short interview regarding their studying or working experiences across the four-year temporal window.

  2. Open and Minimally Invasive Transforaminal Lumbar Interbody Fusion: Comparison of Intermediate Results and Complications

    PubMed Central

    Hee, Hwan Tak

    2015-01-01

    Study Design Prospective study. Purpose To compare clinical and radiological outcomes of open vs. minimally invasive transforaminal lumbar interbody fusion (MI-TLIF). Overview of Literature MI-TLIF promises smaller incisions and less soft tissue dissection resulting in lower morbidity and faster recovery; however, it is technically challenging. Methods Twenty-five patients with MI-TLIF were compared with 25 matched open TLIF controls. A minimum 2 year follow-up and a statistical analysis of perioperative and long-term outcomes were performed. Potential complications were recorded. Results The mean ages for the open and MI-TLIF cases were 44.4 years (range, 19-69 years) and 43.6 years (range, 20-69 years), respectively. The male:female ratio was 13:12 for both groups. Average follow-up was 26.9 months for the MI-TLIF group and 29.3 months for the open group. Operative duration was significantly longer in the MI-TLIF group than that in the open group (p<0.05). No differences in estimated blood loss, duration to ambulation, or length of stay were found. Significant improvements in the Oswestry disability index and EQ-5D functional scores were observed at 6-, 12-, and 24-months in both groups, but no significant difference was detected between the groups. Fusion rates were comparable. Cage sizes were significantly smaller in the MI-TLIF group at the L5/S1 level (p<0.05). One patient had residual spinal stenosis at the MI-TLIF level, and one patient who underwent two-level MI-TLIF developed a deep vein thrombosis resulting in a pulmonary embolism. Conclusions MI-TLIF and open TLIF had comparable long-term benefits. Due to technical constraints, patients should be advised on the longer operative time and potential undersizing of cages at the L5S1 level. PMID:25901228

  3. Trends in Shoulder Stabilization Techniques Used in the United States Based on a Large Private-Payer Database.

    PubMed

    Riff, Andrew J; Frank, Rachel M; Sumner, Shelby; Friel, Nicole; Bach, Bernard R; Verma, Nikhil N; Romeo, Anthony A

    2017-12-01

    Arthroscopic stabilization is the most broadly used surgical procedure in the United States for management of recurrent shoulder instability. Latarjet coracoid transfer has been considered a salvage surgical procedure for failed arthroscopic repairs or cases of significant glenoid bone loss; however, with recent literature suggesting reduced risk of recurrent instability with Latarjet, several surgeons have advocated its broader utilization as a primary operation for treatment of shoulder instability. To determine trends in shoulder stabilization techniques used in the United States. Cross-sectional study. A retrospective analysis of a publicly available national insurance database was performed to identify shoulder stabilization procedures performed over 9 years (2007-2015). The following Current Procedural Terminology codes were searched: 29806 (arthroscopic stabilization), 23455 (open capsulolabral repair), 23466 (open capsular shift), 23462 (Latarjet coracoid transfer), and 23460 (open anterior capsulorrhaphy with other bone block augmentation). Outcomes of interest included (1) trends in the use of each technique throughout the study interval, (2) age and sex distributions of patients undergoing each technique, and (3) regional predilections for the use of each technique. Arthroscopic stabilization was the most broadly used shoulder stabilization procedure in the database (87%), followed by open Bankart (7%), Latarjet (3.2%), open capsular shift (2.6%), and alternative bone block procedure (0.8%). Throughout the study period, the incidence of arthroscopic stabilization and Latarjet increased (8% and 15% per year, respectively); the incidence of open capsular shift remained relatively constant; and the incidence of open Bankart decreased (9% per year). Arthroscopic stabilization, open Bankart, and Latarjet each had similar sex-based distributions (roughly 70% male), while open capsular shift and alternative bone block were relatively more common in females (54% and 50% male, respectively). The incidence of arthroscopic stabilization and Latarjet were greatest in the South and lowest in the Northeast. Arthroscopic stabilization remains the most commonly utilized stabilization technique in the United States. The use of the Latarjet procedure is steadily increasing and now rivals open Bankart stabilization among the most commonly used open stabilization techniques.

  4. Rational dosages of nutrients have a prolonged effect on learning disabilities.

    PubMed

    Carlton, R M; Ente, G; Blum, L; Heyman, N; Davis, W; Ambrosino, S

    2000-05-01

    Reports that administration of nutrients has increased the academic performance of learning-disabled children exist in the literature. To document the effects of nutrients on learning-disabled children in a controlled study. A randomized, double-blind, placebo-controlled crossover trial, which followed 1 year of open-label nutrients. Children who improved in the open-label trial were eligible to enter the controlled phase of the study. Subjects were enrolled from the general community through advertisements. Twenty children met the criteria for being learning disabled. Each child was tried out on some (but not necessarily all) of the B vitamins and minerals used in this study. These were administered semi-blinded for the first year; double-blinded in crossover rotations during the second year; and open-label in the ensuing years. At various time points, school-certified psychologists administered psychoeducational tests. School report cards were evaluated at baseline and for all subsequent periods. Twenty learning-disabled children entered the study, but 1 dropped out because of nausea. The remaining 19 children showed significant academic and behavioral improvements within a few weeks or months of open-label treatment with nutrient supplements. Some children gained 3 to 5 years in reading comprehension within the first year of treatment; and all children in special education classes became mainstreamed, and their grades rose significantly. Twelve of the children completed the 1-year double-blind phase, after which approximately half of the children chose to remain on the nutrients for at least 2 additional years. For those who discontinued, it took at least 1 year to begin to see the first indications of decline in academic performance, and another year for their grades to drop significantly. In contrast, for children who remained on nutrients, the gains continued the upward trend; at the end of year 4, the difference in scores between the 2 groups had reached statistical significance (P < .01). The overall results of this study tentatively support the concept that learning disabilities may in some cases be a nutrient-responsive disorder.

  5. Mapping inter-annual dynamics of open surface water bodies in Oklahoma from Landsat images in 1984 to 2015 at 30-m spatial resolution

    NASA Astrophysics Data System (ADS)

    Zou, Z.; Xiao, X.; Menarguez, M.; Dong, J.; Qin, Y.

    2016-12-01

    Open surface water bodies are important water resource for public supply, irrigation, livestock, and wildlife in Oklahoma. The inter-annual variation of Oklahoma water bodies directly affect the water availability for public supply, irrigation and cattle industry. In this study, tens of thousands of Landsat TM/ETM+ images from 1984 to 2015 were used to track the dynamics of open surface water bodies. Both water-related spectral indices and vegetation indices were used to map water bodies for individual images. The resultant maps show that Oklahoma year-long open surface water bodies varied significantly over the last 32 years, with an average annual water body area equals to 2300 km2, accounting for 1.27 % of the Oklahoma state area (181,037 km2). 4.3 million year-long water body pixels were detected in the 32-year accumulated water frequency map, corresponding to 3100 km2. Only 45% ( 1400 km2) of the those pixels had water throughout the 32 years, while the rest 55% pixels had a dry-up period. The smaller water bodies have a higher risk to dry up and a lower probability to have water throughout the years. Drought years could significantly decrease the number of small water bodies and shrink the area of large water bodies, while pluvial years could create large number of small seasonal water bodies. The significant influencing factors of current year water bodies include the precipitation and temperature of current year and the water body condition of the previous year. This water body dynamics study could be used to support water resource management, crop and livestock production, and biodiversity conservation in Oklahoma.

  6. Early experience with open heart surgery in a pioneer private hospital in West Africa: the Biket medical centre experience.

    PubMed

    Onakpoya, Uvie Ufuoma; Adenle, Adebisi David; Adenekan, Anthony Taiwo

    2017-01-01

    More than forty years after the first open heart surgery in Nigeria, all open heart surgeries were carried out in government-owned hospitals before the introduction of such surgeries in 2013 at Biket Medical Centre, a privately owned hospital in Osogbo, South-western Nigeria. The aim of this paper is to review our initial experience with open heart surgery in this private hospital. All patients who underwent open heart surgery between August 2013 and January 2014 were included in this prospective study. The medical records of the patients were examined and data on age, sex, diagnosis, type of surgery, cardiopulmonary bypass details, complications and length of hospital stay were extracted and the data was analysed using SPSS version 16. Eighteen patients comprising of 12 males and 6 females with ages ranging between 8 months and 52 years (mean= of 15.7 +/- 15 years) were studied. Pericardial patch closure of isolated ventricular septal defect was done in 7 patients (38.9%) while total correction of isolated tetralogy of Fallot was carried out in 5 patients (27.8%). Two patients had mitral valve repair for rheumatic mitral regurgitation. Sixty day mortality was 0%. Safe conduct of open heart surgery in the private hospital setting is feasible in Nigeria. It may be our only guarantee of hitch free and sustainable cardiac surgery.

  7. Personality trait development at the end of life: Antecedents and correlates of mean-level trajectories.

    PubMed

    Wagner, Jenny; Ram, Nilam; Smith, Jacqui; Gerstorf, Denis

    2016-09-01

    Empirical evidence over the past 20 years has documented that key aspects of personality traits change during adulthood. However, it is essentially an open question whether and how traits change at the very end of life and what role health, cognitive performance, perceived control, and social factors play in those changes. To examine these questions, we applied growth models to 13-year longitudinal data obtained from now-deceased participants in the Berlin Aging Study (N = 463; age at baseline M = 85.9 years, SD = 8.4; 51% men). Results revealed that neuroticism, on average, increases (about 0.3 SD in the last 10 years) and that this increase becomes even steeper at the end of life. In contrast, extraversion and openness decline rather steadily at the end of life (about -0.5 SD in the last 10 years). Additionally, poor health manifested as a risk factor for declines in extraversion and openness late in life but not neuroticism. Similar to earlier phases of life, better cognitive performance related to more openness. More loneliness was associated with higher neuroticism, whereas more social activity was associated with higher levels of extraversion and openness. Intriguing additional insights indicated that more personal control was associated with higher levels of extraversion and openness, whereas the feeling that one's life is controlled by others was associated with higher neuroticism but also with higher openness closer to death. We discuss potential pathways by which health, cognitive performance, control, and social inclusion resources and risk factors affect personality development late in life. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

  8. Single port laparoscopic and open surgical accesses of chronic peritoneal dialysis in children: A single center experience over 12 years

    PubMed Central

    Bıçakcı, Ünal; Genç, Gürkan; Tander, Burak; Günaydın, Mithat; Demirel, Dilek; Özkaya, Ozan; Rızalar, Rıza; Arıtürk, Ender; Bernay, Ferit

    2016-01-01

    INTRODUCTION: The aim of this study was to evaluate patients with end stage renal failure (ESRD) who underwent chronic peritoneal dialysis (CPD). The clinical outcomes of laparoscopic and open placements of catheters were compared. MATERIALS AND METHODS: We reviewed 49 (18 male and 31 female) children with CPD according to age, sex, cause of ESRD, catheter insertion method, kt/V rate, complications, presence of peritonitis, catheter survival rate between January 2002 and February 2014. RESULTS: Thirty-three patients were with open placement and 16 patients were with laparoscopic placement. The rate of the peritonitis is significantly less in patients with laparoscopic access than open access (n = 4 vs n = 25) (P <0.01). Patients with peritonitis were younger than those who had no attack of peritonitis (10.95 ± 0.8 years vs 13.4 ± 0.85 years). According to the development of complications, significant difference has not been found between the open (n = 9) and laparoscopic (n = 3) approaches except the peritonitis. Catheter survival rate for the first year was 95%, and for five years was 87.5%. There was no difference between open and laparoscopic group according to catheter survival rate. The mean kt/V which indicates the effectiveness of peritoneal dialysis was mean 2.26 ± 0.08. No difference was found between laparoscopic and open methods according to kt/V. CONCLUSION: Laparoscopic placement of CPD results in lower peritonitis rate. Catheter survival rate was excellent in both groups. Single port laparoscopic access for CPD catheter insertion is an effective and safe method. PMID:27073310

  9. Findings from a Multiyear Scale-Up Effectiveness Trial of Open Court Reading

    ERIC Educational Resources Information Center

    Vaden-Kiernan, Michael; Borman, Geoffrey; Caverly, Sarah; Bell, Nance; Sullivan, Kate; Ruiz de Castilla, Veronica; Fleming, Grace; Rodriguez, Debra; Henry, Chad; Long, Tracy; Hughes Jones, Debra

    2018-01-01

    This multiyear scale-up effectiveness study of Open Court Reading (OCR) involved approximately 4,500 students and more than 1,000 teachers per year in Grades K-5 from 49 elementary schools in seven districts across the country. Using a school-level cluster randomized trial design, we assessed the implementation and effectiveness of Open Court…

  10. Pre-Service Teachers' Attitudes toward Teaching Science and Their Science Learning at Indonesia Open University

    ERIC Educational Resources Information Center

    Suprapto, Nadi; Mursid, Ali

    2017-01-01

    This study focuses on attitudes toward (teaching) science and the learning of science for primary school among pre-service teachers at the Open University of Indonesia. A three-year longitudinal survey was conducted, involving 379 students as pre-service teachers (PSTs) from the Open University in Surabaya regional office. Attitudes toward…

  11. An Examination of the Association between Interviewer Question Type and Story-Grammar Detail in Child Witness Interviews about Abuse

    ERIC Educational Resources Information Center

    Feltis, Brooke B.; Powell, Martine B.; Snow, Pamela C.; Hughes-Scholes, Carolyn H.

    2010-01-01

    Objective: This study compared the effects of open-ended versus specific questions, and various types of open-ended questions, in eliciting story-grammar detail in child abuse interviews. Methods: The sample included 34 police interviews with child witnesses aged 5-15 years ("M" age = 9 years, 9 months). The interviewers' questions and their…

  12. Laparoscopic versus open resection for transverse and descending colon cancer: Short-term and long-term outcomes of a multicenter retrospective study of 1830 patients.

    PubMed

    Yamaguchi, Shigeki; Tashiro, Jo; Araki, Ryuichiro; Okuda, Junji; Hanai, Tsunekazu; Otsuka, Koki; Saito, Shuji; Watanabe, Masahiko; Sugihara, Kenichi

    2017-08-01

    Previous randomized controlled trials demonstrated similar oncological outcomes between laparoscopic and open colectomies, except for cases involving transverse colon and splenic flexure colon cancer. The objective of this study was to confirm the oncological safety and advantages of the short-term results of laparoscopic surgery for transverse and descending colon cancer in comparison with open surgery. The study data were retrospectively collected from the databases of 45 hospitals. Patients with transverse or descending colon cancer who underwent laparoscopic or open R0 resection were registered. The primary end-points were the 3-year overall survival and relapse-free survival rates according to pathological stage. The secondary end-points were the short-term results, including blood loss, operative time, diet intake, hospital stay, and postoperative complications. Of the 1830 eligible patients, 872 underwent open colectomy and 958 underwent laparoscopic colectomy. The median follow-up period was 38.4 months. The conversion rate to open resection was 4.5%. The 3-year overall survival rate of the laparoscopic group was significantly higher than that of the open group for stage I patients (96.2% vs 99.2%; P = 0.04); it was also higher for stage II (94.0% vs 95.5%) and stage III (87.4% vs 90.2%) patients, but there were no significant differences. The 3-year relapse-free survival rate of the laparoscopic group was significantly higher than that of the open group for stage I patients; there were no differences between the open and laparoscopic groups among the stage II and III patients. In the multivariate analyses, laparoscopic resection was a significant factor in relapse-free survival. Laparoscopic patients had significantly lower blood loss and a significantly longer operative time than the open groups. Also, postoperative hospital stay was significantly shorter and postoperative morbidity was significantly lower in the laparoscopic group. Although this retrospective study has limitations, we can conclude that laparoscopic surgery for transverse and descending colon cancer is oncologically safe and yields better short-term results than open surgery. © 2017 Japan Society for Endoscopic Surgery, Asia Endosurgery Task Force and John Wiley & Sons Australia, Ltd.

  13. Complication rates of open transvesical prostatectomy according to the Clavien-Dindo classification system.

    PubMed

    Oranusi, C K; Nwofor, Ame; Oranusi, I O

    2012-01-01

    Traditional open prostatectomies either transvesical or retropubic remains the reference standard for managing benign prostatic enlargement in some centers, especially in developing countries. The comparison of complication rates between the various types of open prostatectomies is usually a source of significant debate among urologists, most times with conflicting results. The Clavien-Dindo classification system is an excellent attempt at standardization of reporting complications associated with surgeries. We reviewed retrospectively the records of patients who had open transvesical prostatectomy (TVP) in three specialist urology centers in Anambra state, Southeast Nigeria, over a period of 5 years (January 2004-December 2009), with the aim of documenting medical and surgical complications arising from open TVP. These complications were then categorized according to the Clavien-Dindo system. A total of 362 patients had open TVP over the period under review. Of this number, 145 had documented evidence of complications. The mean age of the patients was 66.3 years (SD 9.4 years; range 49-96 years). The mean follow-up period was 27.8 months (SD 12.6 months; range 6-33 months). The overall complication rate for open TVP in this study was 40.1% (145/362). Complication rates for grades i, id, ii, iiia, and iiib were 0.8%, 0.6%, 35.1%, 0.6%, and 3.0%, respectively. Most complications of open TVP occur in the early postoperative period. Open TVP still remains a valid surgical option in contemporary environment where advanced techniques for transurethral resection of the prostate and laparoscopic prostatectomy are unavailable. Most complications occur in the early postoperative period, with bleeding requiring several units of blood transfusion accounting for the commonest complication. This should be explained to patients during the preoperative counselling.

  14. Role of tear location on outcomes of open primary repair of the anterior cruciate ligament: A systematic review of historical studies.

    PubMed

    van der List, Jelle P; DiFelice, Gregory S

    2017-10-01

    The general opinion is that outcomes of open primary repair of the anterior cruciate ligament (ACL) in the historical literature were disappointing. Since good outcomes of primary repair of proximal tears have recently been reported, we aimed to assess the role of tear location on open primary repair outcomes in the historical literature. All studies reporting outcomes of open primary ACL repair published between the inception of PubMed, Embase and Cochrane and 2000 were identified. Studies were included if tear location was reported. Outcome scores, return to sports, stability examinations, failures and patient satisfaction were collected and reviewed in the total study cohort and in a subgroup of studies treating only proximal tears. Spearman correlation analysis was performed between the percentage of proximal tears in the studies and all outcomes. Twenty-nine studies were included reporting outcomes of open primary in 1457 patients of which 72% had proximal and 23% midsubstance tears. Mean age was 30years, 65% were males, and mean follow-up was 3.6years. Good outcomes were noted in the total cohort, and excellent outcomes were noted following repair of proximal tears. Positive correlation was found between the percentage proximal tears in the studies and percentage satisfied patients (p=0.010). Tear location seems to have played a role on the outcomes of open primary ACL repair. Outcomes of open primary repair in patients with proximal tears were excellent, which confirms there may be a potential role for primary repair as treatment for proximal ACL tears. Copyright © 2017 Elsevier B.V. All rights reserved.

  15. Analytical Study of E-Learning Resources in National Open University of Nigeria

    ERIC Educational Resources Information Center

    Ajegbomogun, Fredrick Olatunji; Okunlaya, Rifqah Olufunmilayo Afolake; Alawiye, Mariam Kehinde

    2017-01-01

    This paper analyses e-learning resources in the National Open University of Nigeria (NOUN) using Abeokuta study center. Survey research method was adopted for this study. A questionnaire was designed and used to collect data for this study. A sample of 150 respondents was randomly selected from the final year students in the six schools of the…

  16. No difference in outcome for open versus arthroscopic rotator cuff repair: a prospective comparative trial.

    PubMed

    Bayle, Xavier; Pham, Thuy-Trang; Faruch, Marie; Gobet, Aurelie; Mansat, Pierre; Bonnevialle, Nicolas

    2017-12-01

    Arthroscopic techniques tend to become the gold standard in rotator cuff repair. However, little data are reported in the literature regarding the improvement of postoperative outcomes and re-tear rate relative to conventional open surgery. The aim of this study was to compare clinical outcomes and cuff integrity after arthroscopic versus open cuff repair. We prospectively assessed clinical outcomes and cuff integrity after an arthroscopic or open rotator cuff repair with a minimum follow-up of 12 months. Clinical evaluation was based on Constant score, Simple Shoulder Value (SSV) and American Shoulder and Elbow Score (ASES). Rotator cuff healing was explored with ultrasound. 44 patients in arthroscopic group A (mean age 56-year-old) and 43 in open group O (mean age 61-year-old) fulfilled the inclusion criteria. Tendons were repaired with a single row technique associated with biceps tenodesis and subacromial decompression. All objective clinical scores significantly improved postoperatively in both groups. No statistical difference was identified between group A and O regarding, respectively, Constant score (72 vs 75 points; p = 0.3), ASES score (88 vs 91 points; p = 0.3), and SSV (81 vs 85%). The overall rate of re-tear (Sugaya type IV or V) reached 7 and 9%, respectively, in group A and O (p = 0.8). This study did not prove any difference of arthroscopic over open surgery in case of rotator cuff repair regarding clinical outcome and cuff integrity at 1-year follow-up. Prospective comparative study.

  17. Switching from adalimumab to tofacitinib in the treatment of patients with rheumatoid arthritis.

    PubMed

    Genovese, Mark C; van Vollenhoven, Ronald F; Wilkinson, Bethanie; Wang, Lisy; Zwillich, Samuel H; Gruben, David; Biswas, Pinaki; Riese, Richard; Takiya, Liza; Jones, Thomas V

    2016-06-23

    Tofacitinib is an oral Janus kinase inhibitor for the treatment of rheumatoid arthritis (RA). The aim of this study was to explore the safety and efficacy of open-label tofacitinib following blinded treatment with adalimumab or tofacitinib for moderate to severe RA. Analyses included patients treated with adalimumab 40 mg once every 2 weeks or tofacitinib 10 mg twice daily (BID) with background methotrexate (MTX) in a 12-month randomized study (NCT00853385), who subsequently received tofacitinib 10 mg BID (with/without background MTX) in an open-label extension (NCT00413699). Patients with treatment-related serious adverse events (AEs) and serious or recurrent infections in the index study were excluded from the extension study. Exposure-adjusted incidence rates of safety-related events were assessed in 3-month and 12-month periods in the year before and in the year after switching. Efficacy was assessed 3 months before, at the time of, and 3 months after switching. There were 233 (107 adalimumab to tofacitinib 10 mg BID, 126 blinded to open-label tofacitinib 10 mg BID) patients included in these analyses. Patients in both treatment sequences had similar incidence rates (per 100 patient-years) of discontinuation due to AEs, serious AEs, and serious infections in the year before and in the year after switching. Incidence rates of AEs were increased in the first 3 months after switching compared with the last 3 months before switching in both treatment groups. Switching from either blinded adalimumab or tofacitinib to open-label tofacitinib resulted in numerically higher incidence of responders for signs and symptoms of disease and improved physical function. Treatment can be directly switched from adalimumab to tofacitinib. A similar safety and efficacy profile was seen when patients received open-label tofacitinib after receiving either blinded adalimumab or tofacitinib. ClinicalTrials.gov Identifiers: NCT00853385 , registered 27 February 2009; NCT00413699 , registered 18 December 2006.

  18. Timing of spring wild turkey hunting in relation to nest incubation

    USGS Publications Warehouse

    Casalena, Mary Jo; Everett, Rex; Vreeland, Wendy C.; Gregg, Ian D.; Diefenbach, Duane R.

    2016-01-01

    State wildlife agencies are often requested to open spring wild turkey (Meleagris gallopavo; hereafter, turkey) hunting seasons earlier to increase hunter satisfaction by hunters hearing more gobbling male turkeys. Timing of spring turkey hunting season in several states, including Pennsylvania, has been established to open, on average, near median date of incubation initiation of turkey nests. This is believed to reduce illegal and undesired hen harvest and possibly nest abandonment, while maintaining hunter satisfaction of hearing male turkeys when most hens are incubating eggs. However, Pennsylvania’s spring season structure was established in 1968. Given earlier spring phenology, and potentially more variation in spring weather due to climate change, there is concern that timing of nest incubation for turkeys in Pennsylvania could be changing. Therefore, our objective was to determine if nest incubation and opening of spring turkey hunting in Pennsylvania have continued to coincide. We attached satellite transmitters to 254 female turkeys during 2010–2014 and estimated median incubation initiation date to be 2 May, which was 2 days earlier than median date during a statewide study during 1953–1963 and 9 days earlier than during a smaller scale study in south–central Pennsylvania during 2000–2001. However, incubation initiation varied greatly among years and individual hens during all 3 studies. During 4 of 5 years of our study, Pennsylvania’s spring season opened 3 to 8 days prior to median date of incubation initiation. Over the 5 years, estimated initiation of incubation for first nesting attempts, measured from earliest date of incubation initiation to latest, was >2 months and maximum proportion of hens beginning incubation at any one time differed by several days to >1 week. Consequently, in years of late incubation, a constant season opening date set near the long-term median date of incubation initiation exposes few additional hens to risk and hunter satisfaction is likely maintained at greater levels than would be seen with a more conservative approach of opening the season later. Long-term and large scale studies using GPS transmitters that provide precise determination of incubation initiation will be useful to study environmental influences on initiation of incubation.

  19. Open cholecystectomy: Exposure and confidence of surgical trainees and new fellows.

    PubMed

    Campbell, Beth M; Lambrianides, Andreas L; Dulhunty, Joel M

    2018-03-01

    The laparoscopic approach to cholecystectomy has overtaken open procedures in terms of frequency, despite open procedures playing an important role in certain clinical situations. This study explored exposure and confidence of Australasian surgical trainees and new fellows in performing an open versus laparoscopic cholecystectomy. An online survey was disseminated via the Royal Australasian College of Surgeons to senior general surgery trainees (years 3-5 of surgical training) and new fellows (fellowship within the previous 5 years). The survey included questions regarding level of experience and confidence in performing an open cholecystectomy and converting from a laparoscopic to an open approach. A total of 135 participants responded; 58 (43%) were surgical trainees, 58 (43%) were fellows and 19 (14%) did not specify their level of training. Respondents who were involved in more than 20 open cholecystectomy procedures as an assistant or independent operator compared with those less exposed were more likely to feel confident to independently perform an elective open cholecystectomy (87.8% vs. 57.3%, P = 0.001), independently convert from a laparoscopic to open cholecystectomy (87.8% vs. 58.7%, P = 0.001) and independently perform an open cholecystectomy as a surgical consultant based on their level of exposure as a trainee (73.2% vs. 45.3%, P = 0.004). This study suggests the need to ensure surgical trainees are exposed to sufficient open cholecystectomies to enable confidence and skill with performing these procedures when indicated. Greater recognition of the need for exposure during training, including meaningful simulation, may assist. Crown Copyright © 2018. Published by Elsevier Ltd. All rights reserved.

  20. Metatarsalgia and Morton's Disease: Comparison of Outcomes Between Open Procedure and Neurectomy Versus Percutaneous Metatarsal Osteotomies and Ligament Release With a Minimum of 2 Years of Follow-Up.

    PubMed

    Bauer, Thomas; Gaumetou, Elodie; Klouche, Shahnaz; Hardy, Philippe; Maffulli, Nicola

    2015-01-01

    The present study compared the clinical results of open neurectomy versus a percutaneous procedure for Morton's disease. This was a retrospective study comparing the functional results after 2 surgical procedures: open neurectomy and a percutaneous procedure (with deep transverse metatarsal ligament release and distal metatarsal osteotomies). The present study included 52 patients (26 in each group), and the mean follow-up period was 4 (range 2 to 7) years. The patient evaluation criteria included the presence of painful symptoms of Morton's disease, American Orthopaedic Foot and Ankle Society (AOFAS) functional scale score, patient satisfaction, and delay for recovery. Percutaneous treatment of Morton's disease and open neurectomy produced complete relief of pain in 25 of 26 patients in each group. At the latest follow-up visit, the mean AOFAS score had significantly improved from 36 ± 11 preoperatively to a mean of 89 ± 18 (p < .001). After 2 years, the functional improvement obtained with the percutaneous procedure persisted, with a stable AOFAS score (96 ± 10). Persistent metatarsalgia was reported by patients who had undergone open neurectomy, with a significantly decreased AOFAS score (81 ± 21, p = .009). The percutaneous procedure for Morton's disease provided excellent functional outcomes (AOFAS score >90) significantly more often with a shorter delay than after open neurectomy (p = .03). At the latest follow-up visit, metatarsalgia due to plantar hyperpressure or bursitis and requiring plantar orthotics was present in 11 of 26 patients (44%) after open neurectomy and in 1 of 26 patients (4%) after the percutaneous procedure (p = .002). Percutaneous treatment of Morton's disease is a reliable procedure providing results as good as those after open neurectomy, with significantly better outcomes in the longer term and a lower rate of late metatarsalgia. Copyright © 2015 American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All rights reserved.

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

    Young, I.

    Singapore`s Economic Development Board (EDB) will team up with Mobil and Exxon in separate feasibility studies for the country`s third steam cracker project. Mobil recently announced it had signed a memorandum of understanding with EDB and Jurong Town Corp. to study a Smore » $$1.5-billion project for an 800,000-m.t./year ethylene plant for completion in about 2001. Exxon now intends to launch its own parallel study, with EDB also involved. {open_quotes}Both feasibility studies will be carried out separately and at the same time,{close_quotes} an EDB spokesperson tells CW. {open_quotes}EDB, as a developmental agency, will provide Mobil and Exxon with the necessary facilitation and support.{close_quotes} Exxon`s original plan had been to study a slightly smaller cracker, with capacity of about 650,000 m.t./year. Both companies are involved in aromatics production in Singapore. Both cracker studies are expected to take 12-15 months to complete. Sources do not rule out the possibility of Mobil and Exxon then teaming up for the project or both US majors going ahead with their own plants. {open_quotes}Exxon Chemical is being considered as a possible partner in the third plant,{close_quotes} confirms EDB assistant managing director Gong Wee Lik. {open_quotes}More petrochemical complexes could be built if conditions remain favorable-there`s no reason to stop at three,{close_quotes} he adds. Singapore`s second ethylene plant, a joint venture involving Shell and a Japanese consortium, is already under construction and is scheduled to start production in 1997. Its initial planned capacity is for 428,000 m.t./year of ethylene and 214,000 m.t./year of propylene. The plant will be built on Pulau Ayer Merbau, which is the site of the existing S$$2-billion complex built in 1984 and producing 450,000 m.t./year of ethylene and 225,000 m.t./year of propylene.« less

  2. Perspectives on Quality and Quality Assurance in Learner Support Areas at Three Southeast Asian Open Universities

    ERIC Educational Resources Information Center

    Darojat, Ojat; Nilson, Michelle; Kaufman, David

    2015-01-01

    While quality measures in higher education in general have gained significant and growing attention over the past 30 years, questions remain about quality in open universities. This research was an international comparative case study focusing on perceptions of quality and quality assurance (QA) in learner support areas at open universities. The…

  3. Towards Development of OER Derived Custom-Built Open Textbooks: A Baseline Survey of University Teachers at the University of the South Pacific

    ERIC Educational Resources Information Center

    Prasad, Deepak; Usagawa, Tsuyoshi

    2014-01-01

    Textbook prices have soared over the years, with several studies revealing many university students are finding it difficult to afford textbooks. Fortunately, two innovations--open educational resources (OER) and open textbooks--hold the potential to increase textbook affordability. Experts, though, have stated the obvious: that students can save…

  4. Downtown Study Centre: An Open-Ended ABE Program in an Urban Shopping Mall

    ERIC Educational Resources Information Center

    Harrison, David

    1976-01-01

    Describes an adult basic education facility after one year of operation in an urban shopping mall in Nanaimo, British Columbia, Canada. The center is an informal open-ended classroom and advising center where part-time adult learners study an individualized curriculum. Summarizes the major findings of a program evaluation. (EM)

  5. Infection rate in adult patients with open fractures treated at the emergency hospital and at the ULBRA university hospital in Canoas, Rio Grande do Sul, Brazil.

    PubMed

    Guerra, Marcelo Teodoro Ezequiel; Gregio, Fernando Machado; Bernardi, Adriane; Castro, Cyntia Cordeiro de

    2017-01-01

    To identify the infection rate in adult patients with open fractures treated at two tertiary hospitals in the city of Canoas, Rio Grande do Sul, Brazil. This quantitative descriptive study was conducted at Hospital de Pronto Socorro de Canoas. Eligible participants were adults aged 18-60 years with open fractures who were admitted to the orthopedic trauma service from January to May 2014 and followed-up for one year. A total of 133 patients with open fractures were included; most were men (92.48%), with a mean age of 36 years. There was a predominance of Gustilo-Anderson type III fractures. The infection rate was 18.80%, being more frequent in Gustilo-Anderson type III fractures (72.00%). The most commonly observed bacteria were Staphylococcus aureus and Enterobacter aerogenes . The infection rate in open fractures of patients initially treated at the emergency department of HPSC was 18.8%. The infections occurred predominantly in Gustilo-Anderson type III fractures. The bacteria with the highest incidence in infections were Staphylococcus aureus and Enterobacter aerogenes .

  6. 77 FR 21875 - Truth in Lending (Regulation Z)

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-04-12

    ... opening and during the first year after account opening. The proposal requests comment on whether to amend Regulation Z to apply the limitation only during the first year after account opening. DATES: Comments must... during the first year after account opening.\\4\\ This rule became effective on February 22, 2010. \\3\\ See...

  7. 78 FR 18795 - Truth in Lending (Regulation Z)

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-03-28

    ... applies prior to account opening and during the first year after account opening. This final rule amends Regulation Z to apply the limitation only during the first year after account opening. DATES: This rule is... during the first year after account opening. Id. This rule became effective on February 22, 2010. On...

  8. Speech-language therapy program for mouth opening in patients with oral and oropharyngeal cancer undergoing adjuvant radiotherapy: a pilot study.

    PubMed

    Marrafon, Caroline Somera; Matos, Leandro Luongo; Simões-Zenari, Marcia; Cernea, Claudio Roberto; Nemr, Katia

    2018-01-01

    Purpose Assess the effectiveness of an orofacial myofunctional therapeutic program in patients with oral or oropharyngeal cancer submitted to adjuvant radiotherapy through pre- and post-program comparison of maximum mandibular opening. Methods Prospective study involving five adult patients and five elderly patients postoperatively to oral cavity/oropharynx surgery who were awaiting the beginning of radiotherapy or had undergone fewer than five treatment sessions. The study participants had their maximum jaw opening measured using a sliding caliper at the beginning and end of the program. Two mobility exercises and three mandibular traction exercises were selected and weekly monitored presentially for 10 weeks. Descriptive data and pre- and post-therapy comparative measures were statistically analyzed using the Wilcoxon test. Results Ten patients (two women and eight men) with mean age of 58.4 years, median of 57.0 years, completed the therapeutic program. They presented mean maximum mandibular opening of 31.6 ± 11.7 and 36.4 ± 8.0 mm pre- and post-therapy, respectively (p =0.021). Conclusion The proposed orofacial myofunctional therapeutic program increased the maximum jaw opening of patients referred to adjuvant radiotherapy for oral cavity or oropharynx cancer treatment.

  9. Epidemiology of open-globe injuries in Iran: analysis of 2,340 cases in 5 years (report no. 1).

    PubMed

    Mansouri, Mohammadreza; Faghihi, Hooshang; Hajizadeh, Fedra; Rasoulinejad, Seyed Ahmed; Rajabi, Mohammad Taher; Tabatabaey, Ali; Shoaee, Shervan; Faghihi, Shaahin; Khabazkhoob, Mehdi

    2009-09-01

    To review characteristics of open-globe injuries presented to Farabi Eye Hospital, a large referral center for serious ocular injury in the capital city of Iran. A retrospective review of 2,340 open-globe injury patients during a 5-year period was performed. Data about any patient that was diagnosed as open-globe injury were collected from medical records. Of 2,340 patients, 1,904 (81.4%) were men. Mean age was 22.44 +/- 16.65 years (range, 4 months to 90 years). Seventy-five percent of cases were younger than 30 years, with a peak of 5 years. There were 561 patients who had an intraocular foreign body (24.7%). In patients younger than 16 years, a knife was the most prevalent cause (22%); in patients younger than 7 years, knives accounted for 33.6% of trauma etiology; and in patients more than 16 years, a projectile metallic foreign body was the most common cause, accounting for 27% of open-globe injuries. Endophthalmitis developed in 5.1% (117 cases). Factors that had a positive association with severity of ocular injury were visual acuity lower than 20/200 at admission, endophthalmitis, double perforation, and laceration length. According to Ocular Trauma Scoring, there was better visual prognosis in younger age groups, male sex, and intraocular foreign body groups. The rate of enucleation or evisceration was 5.3% (126 cases). We had a low sympathetic ophthalmia rate of 0.08%. The most prevalent trauma etiology is a projectile metallic foreign body in adults and a knife injury in children. Compared with other previous epidemiologic studies, we had younger patients, lower enucleations, and sympathetic ophthalmia.

  10. Toward Reproducible Computational Research: An Empirical Analysis of Data and Code Policy Adoption by Journals.

    PubMed

    Stodden, Victoria; Guo, Peixuan; Ma, Zhaokun

    2013-01-01

    Journal policy on research data and code availability is an important part of the ongoing shift toward publishing reproducible computational science. This article extends the literature by studying journal data sharing policies by year (for both 2011 and 2012) for a referent set of 170 journals. We make a further contribution by evaluating code sharing policies, supplemental materials policies, and open access status for these 170 journals for each of 2011 and 2012. We build a predictive model of open data and code policy adoption as a function of impact factor and publisher and find higher impact journals more likely to have open data and code policies and scientific societies more likely to have open data and code policies than commercial publishers. We also find open data policies tend to lead open code policies, and we find no relationship between open data and code policies and either supplemental material policies or open access journal status. Of the journals in this study, 38% had a data policy, 22% had a code policy, and 66% had a supplemental materials policy as of June 2012. This reflects a striking one year increase of 16% in the number of data policies, a 30% increase in code policies, and a 7% increase in the number of supplemental materials policies. We introduce a new dataset to the community that categorizes data and code sharing, supplemental materials, and open access policies in 2011 and 2012 for these 170 journals.

  11. Toward Reproducible Computational Research: An Empirical Analysis of Data and Code Policy Adoption by Journals

    PubMed Central

    Stodden, Victoria; Guo, Peixuan; Ma, Zhaokun

    2013-01-01

    Journal policy on research data and code availability is an important part of the ongoing shift toward publishing reproducible computational science. This article extends the literature by studying journal data sharing policies by year (for both 2011 and 2012) for a referent set of 170 journals. We make a further contribution by evaluating code sharing policies, supplemental materials policies, and open access status for these 170 journals for each of 2011 and 2012. We build a predictive model of open data and code policy adoption as a function of impact factor and publisher and find higher impact journals more likely to have open data and code policies and scientific societies more likely to have open data and code policies than commercial publishers. We also find open data policies tend to lead open code policies, and we find no relationship between open data and code policies and either supplemental material policies or open access journal status. Of the journals in this study, 38% had a data policy, 22% had a code policy, and 66% had a supplemental materials policy as of June 2012. This reflects a striking one year increase of 16% in the number of data policies, a 30% increase in code policies, and a 7% increase in the number of supplemental materials policies. We introduce a new dataset to the community that categorizes data and code sharing, supplemental materials, and open access policies in 2011 and 2012 for these 170 journals. PMID:23805293

  12. Open Abdomen Therapy with Vacuum and Mesh Mediated Fascial Traction After Aortic Repair: an International Multicentre Study.

    PubMed

    Acosta, Stefan; Seternes, Arne; Venermo, Maarit; Vikatmaa, Leena; Sörelius, Karl; Wanhainen, Anders; Svensson, Mats; Djavani, Khatereh; Björck, Martin

    2017-12-01

    Open abdomen therapy may be necessary to prevent or treat abdominal compartment syndrome (ACS). The aim of the study was to analyse the primary delayed fascial closure (PDFC) rate and complications after open abdomen therapy with vacuum and mesh mediated fascial traction (VACM) after aortic repair and to compare outcomes between those treated with open abdomen after primary versus secondary operation. This was a retrospective cohort, multicentre study in Sweden, Finland, and Norway, including consecutive patients treated with open abdomen and VACM after aortic repair at six vascular centres in 2006-2015. The primary endpoint was PDFC rate. Among 191 patients, 155 were men. The median age was 71 years (IQR 66-76). Ruptured abdominal aortic aneurysm (RAAA) occurred in 69.1%. Endovascular/hybrid and open repairs were performed in 49 and 142 patients, respectively. The indications for open abdomen were inability to close the abdomen (62%) at primary operation and ACS (80%) at secondary operation. Duration of open abdomen was 11 days (IQR 7-16) in 157 patients alive at open abdomen termination. The PDFC rate was 91.8%. Open abdomen initiated at primary (N=103), compared with secondary operation (N=88), was associated with less severe initial open abdomen status (p=.006), less intestinal ischaemia (p=.002), shorter duration of open abdomen (p=.007), and less renal replacement therapy (RRT, p<.001). In hospital mortality was 39.3%, and after entero-atmospheric fistula (N=9) was 88.9%. Seven developed graft infection within 6 months, 1 year mortality was 28.6%. Intestinal ischaemia (OR 3.71, 95% CI 1.55-8.91), RRT (OR 3.62, 95% CI 1.72-7.65), and age (OR 1.12, 95% CI 1.06-1.12), were independent factors associated with in hospital mortality, but not open abdomen initiated at primary versus secondary operation. VACM was associated with a high PDFC rate after prolonged open abdomen therapy following aortic repair. Patient outcomes seemed better when open abdomen was initiated at primary, compared with secondary operation but a selection effect is possible. Copyright © 2017 European Society for Vascular Surgery. Published by Elsevier Ltd. All rights reserved.

  13. Landscape fragmentation, severe drought, and the new Amazon forest fire regime.

    PubMed

    Alencar, Ane A; Brando, Paulo M; Asner, Gregory P; Putz, Francis E

    2015-09-01

    Changes in weather and land use are transforming the spatial and temporal characteristics of fire regimes in Amazonia, with important effects on the functioning of dense (i.e., closed-canopy), open-canopy, and transitional forests across the Basin. To quantify, document, and describe the characteristics and recent changes in forest fire regimes, we sampled 6 million ha of these three representative forests of the eastern and southern edges of the Amazon using 24 years (1983-2007) of satellite-derived annual forest fire scar maps and 16 years of monthly hot pixel information (1992-2007). Our results reveal that changes in forest fire regime properties differentially affected these three forest types in terms of area burned and fire scar size, frequency, and seasonality. During the study period, forest fires burned 15% (0.3 million ha), 44% (1 million ha), and 46% (0.6 million ha) of dense, open, and transitional forests, respectively. Total forest area burned and fire scar size tended to increase over time (even in years of average rainfall in open canopy and transitional forests). In dense forests, most of the temporal variability in fire regime properties was linked to El Nino Southern Oscillation (ENSO)-related droughts. Compared with dense forests, transitional and open forests experienced fires twice as frequently, with at least 20% of these forests' areas burning two or more times during the 24-year study period. Open and transitional forests also experienced higher deforestation rates than dense forests. During drier years, the end of the dry season was delayed by about a month, which resulted in larger burn scars and increases in overall area burned later in the season. These observations suggest that climate-mediated forest flammability is enhanced by landscape fragmentation caused by deforestation, as observed for open and transitional forests in the Eastern portion of the Amazon Basin.

  14. Complications of the retromandibular transparotid approach for low condylar neck and subcondylar fractures: a retrospective study

    PubMed Central

    2018-01-01

    Objectives The goal of this study was to evaluate the rates of complications, morbidity, and safety with the transparotid approach. Materials and Methods A retrospective study was conducted and consisted of 53 surgically treated patients in the past five years for low condylar neck and subcondylar fractures. Only patients with malocclusion and who underwent open reduction with internal fixation with the retromandibular transparotid approach were included. The examined parameters were postoperative suboptimal occlusion, deflection, saliva fistula, and facial nerve weakness. Results Fifty-three patients had an open reduction with internal fixation on 55 sides (41 males, 77.4%; mean age, 42 years [range, 18–72 years]). Four patients (7.5%) experienced transient facial nerve weakness of the marginal mandibular branch, but none was permanent. Four patients had a salivary fistula, and 5 patients showed postoperative malocclusion, where one needed repeat surgery after one year. One patient showed long-term deflection. No other complications were observed. Conclusion The retromandibular transparotid approach is a safe procedure for open reduction and internal fixation of low condylar neck and subcondylar fractures, and it has minimal complications. PMID:29732312

  15. A randomized trial of transanal hemorrhoidal dearterialization with anopexy compared with open hemorrhoidectomy in the treatment of hemorrhoids.

    PubMed

    Elmér, Solveig E; Nygren, Jonas O; Lenander, Claes E

    2013-04-01

    Doppler guidance in hemorrhoidal surgery has become more frequent during the past decade. The method is mainly studied in nonrandomized trials. Data from randomized controlled trials are lacking. The aim of this study was to compare early and midterm results of transanal hemorrhoidal dearterialization with anopexy to open hemorrhoidectomy. DESIGN, SETTINGS, PATIENTS, AND INTERVENTIONS: Forty patients with grade 2 to 3 hemorrhoids were randomly assigned to transanal hemorrhoidal dearterialization with anopexy (group A, n = 20) or open hemorrhoidectomy (group B, n = 20). A diary was used during the first 2 postoperative weeks. A self-reported symptom questionnaire was answered, and a clinical examination was performed preoperatively, after 2 to 4 months, and after 1 year. The main outcome measure was postoperative pain. Postoperative peak pain was lower in group A during the first week than in group B (p < 0.05), whereas no difference in overall pain was noted. More patients expressed normal well-being in group A (p = 0.045). Pain, bleeding, and the need for manual reduction of the hemorrhoids were all improved in both groups after 1 year (p < 0.05). Soiling had decreased after both methods at early follow-up. After 1 year, soiling was significantly decreased only after open hemorrhoidectomy. The grade of hemorrhoids was significantly reduced after 1 year for both methods, but there was a trend to more patients with remaining grade 2 hemorrhoids in group A (p = 0.06). There was no blinding, the sample size was small, and follow-up was for only 1 year. The questionnaire was not validated. The difference in postoperative pain between transanal hemorrhoidal dearterialization with anopexy and open hemorrhoidectomy may be less than expected based on previous literature.

  16. [Assemblage effect of ground arthropod community in desert steppe shrubs with different ages].

    PubMed

    Liu, Ren-Tao; Zhu, Fan; Chai, Yong-Qing

    2014-01-01

    Taking the 6-, 15-, 24- and 36-year-old Caragana intermedia shrubs in desert steppe as a subject, an investigation on soil properties and ground arthropod community was carried out under the shrub and in the open to probe into the assemblage effect of ground arthropod community in desert steppe shrubs with different ages. The results were as follows: 1) In the 6-year-old shrubland, significant differences were only found in soil physical properties (soil texture, soil moisture and electrical conductivity) between the microhabitats under shrub and in the open. Beginning from the 15-year-old shrubland, however, soil organic matter and nutrition (N, P) increased significantly. 2) A total of 27 groups were captured in the studied sites which dominated by Carabidae, Tenebrionidae and Formicidae. From 6- to 15-year-old shrubland, the number of dominant groups decreased while that of common groups increased for the ground arthropod community under the shrub. From 15- to 24- and 36-year-old shrubland, the difference between the microhabitats under the shrub and in the open decreased firstly, and then increased. Some special groups appeared under the shrub in the 36-year-old shrubland, and dung beetles became dominant. 3) In the 6- and 24-year-old shrublands, there were no significant differences in group richness, abundance, and diversity index between the microhabitats under the shrub and in the open. As for the 15- and 36-year-old shrublands, however, significant differences were observed. 4) The shrub age had a stronger effect on the distribution of ground arthropods living under the shrubs compared to that in the open. The changes in soil texture, pH and electrical conductivity could significantly influence on the distribution of ground arthropods under the shrub, also in the open to some degree. It was suggested that the development of shrubland had strong impact on assemblage effect of ground arthropods, which was closely correlated with the stand age and would affect the recovery of sandy grassland ecosystems.

  17. Safety of robotic prostatectomy over time: a national study of in-hospital injury.

    PubMed

    Chughtai, Bilal; Isaacs, Abby J; Mao, Jialin; Lee, Richard; Te, Alexis; Kaplan, Steven; Sedrakyan, Art

    2015-02-01

    To assess national trends of iatrogenic complications and associated burden of care among patients undergoing open and minimally invasive prostatectomy using a population-based cohort. Using the nationally representative cohort, we identified patients who were diagnosed with prostate cancer, and underwent prostatectomy during 2001 and 2011. We determined the risk of iatrogenic complication and length of stay (LOS) over time among open and minimally invasive surgery (MIS) patients. Hierarchical multivariable logistic regression was performed to assess the changes over time and elucidate independent predictors of iatrogenic complications. We identified 556,932 and 219,434 prostate cancer patients undergoing open and minimally invasive prostatectomy. We found that iatrogenic complications for MIS were less frequent in later years (years 09-11 vs. year 01-02 odds ratio (OR), 0.21; 95% confidence intervals (CI), 0.09-0.40). MIS was associated with higher risk of iatrogenic complications in early period (years 01-02 OR, 3.81; 95% CI, 1.72-8.41), but lower risk in late period (years 09-11 OR 0.72 95% CI 0.61-0.86). Patients who experienced iatrogenic complications tended to have longer LOS (Median: Open vs. MIS, 4 days vs. 3 day) than those who didn't (Median: Open vs. MIS, 2 days vs. 1 day), regardless of procedure type. We found that minimally invasive prostatectomy is associated with lower risk of iatrogenic complications when compared with open surgery (OS). However, as "learning curve" is overcome over time, MIS becomes safer than OS. Iatrogenic complications are not benign and seem to be associated with higher burden of inpatient care.

  18. Evaluation of total alloplastic temporo-mandibular joint replacement with two different types of prostheses: A three-year prospective study.

    PubMed

    Gonzalez-Perez, L-M; Gonzalez-Perez-Somarriba, B; Centeno, G; Vallellano, C; Montes-Carmona, J-F

    2016-11-01

    Temporo-Mandibular Joint (TMJ) replacement has been used clinically for years. The objective of this study was to evaluate outcomes achieved in patients with two different categories of TMJ prostheses. All patients who had a TMJ replacement (TMJR) implanted during the study period from 2006 through 2012 were included in this 3-year prospective study. All procedures were performed using the Biomet Microfixation TMJ Replacement System, and all involved replacing both the skull base component (glenoid fossa) and the mandibular condyle. Fifty-seven patients (38 females and 19 males), involving 75 TMJs with severe disease requiring reconstruction (39 unilateral, 18 bilateral) were operated on consecutively, and 68 stock prostheses and 7 custom-made prostheses were implanted. The mean age at surgery was 52.6±11.5 years in the stock group and 51.8±11.7 years in the custom-made group. In the stock group, after three years of TMJR, results showed a reduction in pain intensity from 6.4±1.4 to 1.6±1.2 (p<0.001), and an improvement in jaw opening from 2.7±0.9 cm to 4.2±0.7 cm (p<0.001). In the custom-made group, after three years of TMJR, results showed a reduction in pain intensity from 6.0±1.6 to 2.2±0.4 (p<0.001), and an improvement in jaw opening from 1.5±0.5 cm to 4.3±0.6 cm (p<0.001). No statistically significant differences between two groups were detected. The results of this three-year prospective study support the surgical placement of TMJ prostheses (stock prosthetic, and custom-made systems), and show that the approach is efficacious and safe, reduces pain, and improves maximum mouth opening movement, with few complications. As such, TMJR represents a viable technique and a stable long-term solution for cranio-mandibular reconstruction in patients with irreversible end-stage TMJ disease. Comparing stock and custom-made groups, no statistically significant differences were detected with respect to pain intensity reduction and maximum mouth opening improvement.

  19. Acute O3 damage on first year coppice sprouts of aspen and maple sprouts in an open-air experiment

    Treesearch

    Joseph N.T. Darbah; Wendy S. Jones; Andrew J. Burton; John Nagy; Mark E. Kubiske

    2011-01-01

    We studied the effect of high ozone (O3) concentration (110-490 nmol mol-1) on regenerating aspen (Populus tremuloides) and maple (Acer saccharum) trees at an open-air O3 pollution experiment near Rhinelander WI USA. This study is the first of its kind to examine...

  20. Open-angle glaucoma in patients with diabetic retinopathy at the Puerto Rico Medical Center.

    PubMed

    Cruz-lñigo, Yousef; Izquierdo, Natalio J; García, Omar; Pérez, Raúl

    2012-01-01

    The association of open-angle glaucoma (OAG) with diabetes mellitus remains controversial. We report on the frequency of open-angle glaucoma in patients having diabetic retinopathy in a population of the Puerto Rico Medical Center. A cross-sectional study of 1,442 patients was done. Only the chart of patients 40 years-of-age and older, with a diagnosis of diabetic retinopathy and/or open-angle glaucoma were included. Descriptive analysis was done. Unadjusted and gender-adjusted logistic regression analyses were used to estimate risk of developing open-angle glaucoma in patients with diabetic retinopathy for each subsequent decade. 1,040 patients were diagnosed with diabetic retinopathy from July 1, 2004 to June 30, 2009. Also, 402 patients were diagnosed with open-angle glaucoma from July 1, 2007 to June 30, 2009. Of the 1,040 patients with diabetic retinopathy, 64 patients (6.15%) also had OAG. According to our gender-adjusted logistic regression analysis the estimated risk of developing open-angle glaucoma for patients 40 years-of-age with diabetic retinopathy increased for each subsequent decade until the seventh decade, odds ratio = 5.07 (95% confidence interval: 1.62-15.86). Thereafter, it decreased, odds ratio = 2.07 (95% confidence interval: 0.36-11.82). Our findings suggest that Puerto Rico patients between 40 to 79 years of age with diabetic retinopathy have an increased risk of developing open-angle glaucoma with each subsequent decade. Screening for open-angle glaucoma in patients with diabetic retinopathy is of utmost importance in the aging Puerto Rico population to prevent blindness.

  1. DefenseLink Feature: Berlin Airlift

    Science.gov Websites

    Services Open House at Andrews Air Force Base FEATURE STORIES Wiesbaden Celebrates Airlift Anniversary Airlift Anniversary This year's Joint Service Open House commemorates the 60th anniversary of the Berlin Open House 2008 Joint Service Open House This year's Joint Service Open House commemorated the 60th

  2. A cost/utility analysis of open reduction and internal fixation versus cast immobilization for acute nondisplaced mid-waist scaphoid fractures.

    PubMed

    Davis, Erika N; Chung, Kevin C; Kotsis, Sandra V; Lau, Frank H; Vijan, Sandeep

    2006-04-01

    Open reduction and internal fixation and cast immobilization are both acceptable treatment options for nondisplaced waist fractures of the scaphoid. The authors conducted a cost/utility analysis to weigh open reduction and internal fixation against cast immobilization in the treatment of acute nondisplaced mid-waist scaphoid fractures. The authors used a decision-analytic model to calculate the outcomes and costs of open reduction and internal fixation and cast immobilization, assuming the societal perspective. Utilities were assessed from 50 randomly selected medical students using the time trade-off method. Outcome probabilities taken from the literature were factored into the calculation of quality-adjusted life-years associated with each treatment. The authors estimated medical costs using Medicare reimbursement rates, and costs of lost productivity were estimated by average wages obtained from the U.S. Bureau of Labor Statistics. Open reduction and internal fixation offers greater quality-adjusted life-years compared with casting, with an increase ranging from 0.21 quality-adjusted life-years for the 25- to 34-year age group to 0.04 quality-adjusted life-years for the > or =65-year age group. Open reduction and internal fixation is less costly than casting ($7940 versus $13,851 per patient) because of a longer period of lost productivity with casting. Open reduction and internal fixation is therefore the dominant strategy. When considering only direct costs, the incremental cost/utility ratio for open reduction and internal fixation ranges from $5438 per quality-adjusted life-year for the 25- to 34-year age group to $11,420 for the 55- to 64-year age group, and $29,850 for the > or =65-year age group. Compared with casting, open reduction and internal fixation is cost saving from the societal perspective ($5911 less per patient). When considering only direct costs, open reduction and internal fixation is cost-effective relative to other widely accepted interventions.

  3. A Prospective Comparative Study of Arthroscopic Versus Mini-Open Latarjet Procedure With a Minimum 2-Year Follow-up.

    PubMed

    Marion, Blandine; Klouche, Shahnaz; Deranlot, Julien; Bauer, Thomas; Nourissat, Geoffroy; Hardy, Philippe

    2017-02-01

    To compare postoperative pain during the first postoperative week and the position of the coracoid bone block at the anterior aspect of the glenoid after the arthroscopic and the mini-open Latarjet procedure. The secondary purpose was to assess functional results and recurrence after at least 2 years of follow-up. This comparative prospective study included patients who underwent a Latarjet-Bristow procedure for anterior shoulder instability in 2012. The Latarjet procedure was performed by a mini-open approach (G1) in one center and by an arthroscopic approach (G2) in the other. The main evaluation criterion was average shoulder pain during the first postoperative week assessed by the patient on a standard 10-cm visual analog scale (0-10). Secondary criteria were consumption of analgesics during the first week, the position of the coracoid bone block on radiograph and computed tomography scan at the 3-month follow-up and clinical outcomes (Western Ontario Score Index and new surgery) after at least 2 years of follow-up. Fifty-eight patients were included, 22 G1 and 36 G2, 13 women and 45 men, mean age 26.9 ± 7.7 years. The mean follow-up was 29.8 ± 4.4 months. There was significantly less pain in the arthroscopic Latarjet group than in the mini-open group during the first postoperative week (2.5 ± 1.4 vs 1.2 ± 1.2, P = .002) with comparable consumption of analgesics (P > .05). The arthroscopic Latarjet procedure resulted in a more lateral coracoid bone block (P = .04) and a better equatorial position than the mini-open technique (P = .02). Three patients underwent revision surgery (1 recurrence [2.8%], 1 block fracture, 1 screw ablation) in the arthroscopic group, none in the mini-open group (P = .54). At the final follow-up, the Western Ontario Score Index score was good in all patients (G1: 78.5 ± 7.5% vs G2: 82.3 ± 7%, P = .03). This prospective comparative study showed that the arthroscopic Latarjet procedure was significantly less painful than the mini-open procedure during the first postoperative week. The clinical outcomes were comparable after at least 2 years of follow-up. Level II, prospective comparative study. Copyright © 2016 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.

  4. A structural model of age, grey matter volumes, education, and personality traits.

    PubMed

    Kitamura, Soichiro; Yasuno, Fumihiko; Yamamoto, Akihide; Kazui, Hiroaki; Kudo, Takashi; Matsuoka, Kiwamu; Kiuchi, Kuniaki; Kosaka, Jun; Nagatsuka, Kazuyuki; Iida, Hidehiro; Kishimoto, Toshifumi

    2016-01-01

    When the relationship between ageing and changes in personality traits is considered, it is important to know how they are influenced by biological and environmental factors. The present study examined the relationships between various factors associated with the effect of ageing on personality traits, including structural changes of the brain and environmental factors such as education. We recruited 41 healthy subjects. We administered the NEO Five-Factor Inventory to assess personality factors. Magnetic resonance imaging was performed, and regional grey matter (GM) volumes were obtained. We identified associations in the correlation analysis of age, cerebral GM volume, years of education, and the personality trait of openness. Path analysis was used to estimate the relationships among these factors. The path analysis model of age, GM volume, years of education, and the personality trait of openness revealed that age has an indirect negative association with openness through GM volume and years of education. Ageing was related to a decrease in GM volume, which was in turn related to a decrease in the openness score. Older subjects generally had fewer years of education, which was related to a lower openness score. Maintaining openness against the effects of ageing is desirable, and our results imply that interventions against age-related cerebral atrophy and the promotion of opportunities for higher education may contribute to the development and stability of a healthy personality during the adult life course. © 2015 The Authors. Psychogeriatrics © 2015 Japanese Psychogeriatric Society.

  5. Personality and Reduced Incidence of Walking Limitation in Late Life: Findings From the Health, Aging, and Body Composition Study

    PubMed Central

    Ferrucci, Luigi; Costa, Paul T.; Faulkner, Kimberly; Rosano, Caterina; Satterfield, Suzanne; Ayonayon, Hilsa N.; Simonsick, Eleanor M.

    2012-01-01

    Objectives. To examine the association between openness to experience and conscientiousness and incident reported walking limitation. Method. The study population consisted of 786 men and women aged 71–81 years (M = 75 years, SD = 2.7) participating in the Health, Aging, and Body Composition—Cognitive Vitality Substudy. Results. Nearly 20% of participants (155/786) developed walking limitation during 6 years of follow-up. High openness was associated with a reduced risk of walking limitation (hazard ratio [HR] = 0.83, 95% confidence interval [CI] = 0.69–0.98), independent of sociodemographic factors, health conditions, and conscientiousness. This association was not mediated by lifestyle factors and was not substantially modified by other risk factors for functional disability. Conscientiousness was not associated with risk of walking limitation (HR = 0.91, 95% CI = 0.77–1.07). Discussion. Findings suggest that personality dimensions, specifically higher openness to experience, may contribute to functional resilience in late life. PMID:22437204

  6. [Workplace stress and its impact on the 16-year risk of myocardial infarction and stroke in an open female population aged 25-64 years in Russia/Siberia (WHO MONICA-psychosocial program)].

    PubMed

    Gafarov, V V; Panov, D O; Gromova, E A; Gagulin, I V; Gafarova, A V

    2015-01-01

    To determine the impact of workplace stress on the hazard ratio (HR) of myocardial infarction (M) and stroke in an open female population aged 25-64 years in Russia/Siberia (Novosibirsk) for 16 years. A random representative sample of 25-64-year-old women (n=870) residing in a Novosibirsk district was surveyed within the framework of the WHO program. Workplace stress was investigated using the Karasek scale; an attitude towards work and health prophylactic examinations was studied applying the Health Awareness and Attitude questionnaire of the WHO program. For 16 years (1994 to 2010), a cohort of all new cases of MI and stroke was examined employing the WHO program and all possible medical records. The Cox regression model was used to determine HR for MI and stroke in the open female population aged 25-64 years for 16 years. The prevalence of high-level stress in the open female population aged 25-64 years was 31.6%. The high level of job stress was associated with a high responsibility, impossibility to have a rest at the end of a working day, frequent professional dissatisfaction, and a reduced work capacity. During 16 years, the women having high-level job stress showed a 3.22- and 1.96-fold increases in the HR of MI (p<0.05) and stroke (p<0.05), respectively. The incidence of MI and stroke was higher in married women expressing job stress as managers or manual laborers and having high and low educational attainment. The prevalence of high-level workplace stress was substantial in the open population of 25-64-year-old women in Russia/Siberia (Novosibirsk). The stress-related HR of Ml and stroke was 3-2 times higher than in those without high-level stress. The HR of MI and stroke is affected by a social gradient.

  7. Size of clearcut opening affects species composition, growth rate, and stand characteristics.

    Treesearch

    Martin E. Dale; H. Clay Smith; Jeffrey N. Pearcy

    1995-01-01

    In the late 1950's and early 1960's, a series of studies was installed in the central hardwood forest to determine if size of clearcut opening affects the growth rate and species composition of new stands. In 1991, about 30 years after cutting, stand data were collected in 89 openings ranging in size from 0.04 to 1.61 acres. The number of stems per acre...

  8. Science of Materials: A Case Study of Intentional Teaching in the Early Years

    ERIC Educational Resources Information Center

    Hackling, Mark; Barratt-Pugh, Caroline

    2012-01-01

    Australia's Early Years Learning Framework and leading international researchers argue for more intentional and purposeful teaching of science in the early years. This case study of exemplary practice illustrates intentional teaching of science materials which opened-up learning opportunities in literacy and number. Student-led hands-on…

  9. LAKE MICHIGAN MASS BALANCE STUDY UPDATE

    EPA Science Inventory

    A 2005 field design of tributary and open Lake Michigan sampling will be discussed for the first time at this Council meeting. The sample design is expected to aid in determining whether or not contaminant loads and open lake concentrations have decreased over the past 10 years s...

  10. A Comparison of Open and Endoscopic Repair of Full-Thickness Tears of the Gluteus Medius Tendon at a Minimum of 2 Years Follow-up

    PubMed Central

    Nawabi, Danyal H.; Wentzel, Catherine; Ranawat, Anil S.; Bedi, Asheesh; Kelly, Bryan T.

    2015-01-01

    Objectives: Historically, tears of the gluteus medius tendon were repaired via an open approach yielding excellent outcomes. With the advent of hip arthroscopy, endoscopic techniques have been developed to repair abductor tears which have shown favorable early outcomes. The open technique may still be preferred for large tears with retraction (>4cm), but there is a paucity of data comparing open and endoscopic approaches. The purpose of this study was to compare the outcomes of open and endoscopic repair of full-thickness tears of the gluteus medius tendon. We hypothesized that the outcomes of the two approaches would be similar but that the open technique would have shorter surgical times. Methods: Between March 2010 and June 2012, 1267 patients (1518 hips) undergoing a hip preservation procedure were prospectively entered into a registry. From this cohort, we identified 27 patients (30 hips) that had undergone repair of the gluteus medius tendon with a minimum of 2 years follow-up. Nine patients (9 hips) had an open repair and 18 patients (21 hips) had an endoscopic repair. Patient-reported outcome scores, including the Modified Harris Hip Score (mHHS), the Hip Outcome Score-Activity of Daily Living (HOS-ADL), and the Sport-specific Subscale (HOS-SSS) were obtained preoperatively and at 1, 2, and 3 years postoperatively. Surgery time was obtained using operating room records. The femoral neck shaft angle (FNSA) and lateral center-edge angle (LCEA) were measured on preoperative radiographs. Continuous and categorical variables were compared between endoscopic and open abductor repair patients using independent-samples t-tests and chi-square or Fisher's exact tests (as appropriate), respectively. Given the limited sample size, no adjusted or matched analyses were performed. Results: The mean age (±SD) of the open and endoscopic groups was 62.0 ± 9.9 years and 51.6 ± 13.6 years respectively (p=0.05). There were 6 females (67%) in the open group and 17 females (94%) in the endoscopic group (p=0.09). Seven hips (78%) in the open group had varus necks (FNSA30°) compared to 15 hips (54%) in the endoscopic group (p=0.93). At a mean follow-up of 38.1 months (range, 24-87 months), there were large (> 35 points) and significant improvements (p0.8). One patient (11.1%) in the open group had a poor clinical outcome compared to 2 patients (11.1%) in the endoscopic group that required revision abductor repairs at 5 and 24 months respectively. The mean surgical time was 98.7 ± 21.3 minutes in the open and 122.0 ± 26.8 minutes in the endoscopic group (p=0.003). Conclusion: This study demonstrates that an open gluteus medius tendon repair results in a significant improvement in clinical outcome, that is similar to the scores seen after endoscopic repair. Varus femoral necks and acetabular overcoverage are common features of hips with abductor tears and may be useful diagnostic aids. The surgical time for an open technique is significantly shorter than the endoscopic technique. We recommend an open technique where an intra-articular hip arthroscopy is not required, or in those patients with large and retracted tears.

  11. The Legacy and Impact of Open University Women's/Gender Studies: 30 Years On

    ERIC Educational Resources Information Center

    Kirkup, Gill; Whitelegg, Elizabeth

    2013-01-01

    In 1983, the UK Open University (OU) offered its first women's/gender studies (WGS) course. Although a late entrant to the area, OU WGS courses were influential nationally and internationally for many feminists and WGS teachers and scholars. Not only did OU WGS courses have the largest WGS student cohort of any UK institution with over 8000…

  12. An Open-Label Study of Controlled-Release Melatonin in Treatment of Sleep Disorders in Children with Autism

    ERIC Educational Resources Information Center

    Giannotti, F.; Cortesi, F.; Cerquiglini, A.; Bernabei, P.

    2006-01-01

    Long-term effectiveness of controlled-release melatonin in 25 children, aged 2.6-9.6 years with autism without other coexistent pathologies was evaluated openly. Sleep patterns were studied using Children's Sleep Habits Questionnaire (CSHQ) and sleep diaries at baseline, after 1-3-6 months melatonin treatment and 1 month after discontinuation.…

  13. Developing Self-Efficacy through a Massive Open Online Course on Study Skills

    ERIC Educational Resources Information Center

    Padilla Rodriguez, Brenda Cecilia; Armellini, Alejandro

    2017-01-01

    Self-efficacy is a strong predictor of academic performance, and an area of interest for higher education institutions. This paper reports on a massive open online course (MOOC) on study skills, aimed at increasing self-efficacy. Participants (n = 32) were from Mexico and Colombia, with ages ranging from 21 to 45 years. At the beginning and the…

  14. Open-label extension studies: do they provide meaningful information on the safety of new drugs?

    PubMed

    Day, Richard O; Williams, Kenneth M

    2007-01-01

    The number of open-label extension studies being performed has increased enormously in recent years. Often it is difficult to differentiate between these extension studies and the double-blind, controlled studies that preceded them. If undertaken primarily to gather more patient-years of exposure to the new drug in order to understand and gain confidence in its safety profile, open-label extension studies can play a useful and legitimate role in drug development and therapeutics. However, this can only occur if the open-label extension study is designed, executed, analysed and reported competently. Most of the value accrued in open-label extension studies is gained from a refinement in the perception of the expected incidence of adverse effects that have most likely already been identified as part of the preclinical and clinical trial programme. We still have to rely heavily on post-marketing safety surveillance systems to alert us to type B (unpredictable) adverse reactions because open-label extension studies are unlikely to provide useful information about these types of often serious and relatively rare adverse reactions. Random allocation into test and control groups is needed to produce precise incidence data on pharmacologically expected, or type A, adverse effects. Some increased confidence about incidence rates might result from the open-label extension study; however, as these studies are essentially uncontrolled and biased, the data are not of great value. Other benefits have been proposed to be gained from open-label extension studies. These include ongoing access to an effective but otherwise unobtainable medicine by the volunteers who participated in the phase III pivotal trials. However, there are unappreciated ethical issues about the appropriateness of enrolling patients whose response to previous treatment is uncertain, largely because treatment allocation in the preceding randomised, double-blind, controlled trial has not been revealed at the time of entry into the open-label extension study. Negative aspects of open-label extension studies revolve around their use as a marketing tool, as they build a market for the drug and generate pressure for subsidised access to the drug from consumers and their physicians. Consumers, institutions where these studies are conducted and research ethics committees need to be convinced of the motives, as well as the quality, of the open-label extension study and its execution before supporting such studies. Open-label extension studies do have a legitimate but limited place in the clinical development of new medicines. The negative perceptions about these studies have arisen because of perversion of acceptable rationales for this type of study and a failure to recognise (or disclose) the limitations resulting from the inherent weaknesses in their design. Increased human exposure to a new medicine under reasonably controlled circumstances to increase confidence in the safety of the medicine is an acceptable rationale for an open-label extension study, and a useful activity to increase the knowledge of the safety profile of a new medicine. However, this goal is increasingly being achieved by means other than open-label extension studies.

  15. The development of open access journal publishing from 1993 to 2009.

    PubMed

    Laakso, Mikael; Welling, Patrik; Bukvova, Helena; Nyman, Linus; Björk, Bo-Christer; Hedlund, Turid

    2011-01-01

    Open Access (OA) is a model for publishing scholarly peer reviewed journals, made possible by the Internet. The full text of OA journals and articles can be freely read, as the publishing is funded through means other than subscriptions. Empirical research concerning the quantitative development of OA publishing has so far consisted of scattered individual studies providing brief snapshots, using varying methods and data sources. This study adopts a systematic method for studying the development of OA journals from their beginnings in the early 1990s until 2009. Because no comprehensive index of OA articles exists, systematic manual data collection from journal web sites was conducted based on journal-level data extracted from the Directory of Open Access Journals (DOAJ). Due to the high number of journals registered in the DOAJ, almost 5000 at the time of the study, stratified random sampling was used. A separate sample of verified early pioneer OA journals was also studied. The results show a very rapid growth of OA publishing during the period 1993-2009. During the last year an estimated 191 000 articles were published in 4769 journals. Since the year 2000, the average annual growth rate has been 18% for the number of journals and 30% for the number of articles. This can be contrasted to the reported 3,5% yearly volume increase in journal publishing in general. In 2009 the share of articles in OA journals, of all peer reviewed journal articles, reached 7,7%. Overall, the results document a rapid growth in OA journal publishing over the last fifteen years. Based on the sampling results and qualitative data a division into three distinct periods is suggested: The Pioneering years (1993-1999), the Innovation years (2000-2004), and the Consolidation years (2005-2009).

  16. The Development of Open Access Journal Publishing from 1993 to 2009

    PubMed Central

    Laakso, Mikael; Welling, Patrik; Bukvova, Helena; Nyman, Linus; Björk, Bo-Christer; Hedlund, Turid

    2011-01-01

    Open Access (OA) is a model for publishing scholarly peer reviewed journals, made possible by the Internet. The full text of OA journals and articles can be freely read, as the publishing is funded through means other than subscriptions. Empirical research concerning the quantitative development of OA publishing has so far consisted of scattered individual studies providing brief snapshots, using varying methods and data sources. This study adopts a systematic method for studying the development of OA journals from their beginnings in the early 1990s until 2009. Because no comprehensive index of OA articles exists, systematic manual data collection from journal web sites was conducted based on journal-level data extracted from the Directory of Open Access Journals (DOAJ). Due to the high number of journals registered in the DOAJ, almost 5000 at the time of the study, stratified random sampling was used. A separate sample of verified early pioneer OA journals was also studied. The results show a very rapid growth of OA publishing during the period 1993–2009. During the last year an estimated 191 000 articles were published in 4769 journals. Since the year 2000, the average annual growth rate has been 18% for the number of journals and 30% for the number of articles. This can be contrasted to the reported 3,5% yearly volume increase in journal publishing in general. In 2009 the share of articles in OA journals, of all peer reviewed journal articles, reached 7,7%. Overall, the results document a rapid growth in OA journal publishing over the last fifteen years. Based on the sampling results and qualitative data a division into three distinct periods is suggested: The Pioneering years (1993–1999), the Innovation years (2000–2004), and the Consolidation years (2005–2009). PMID:21695139

  17. Robotic thoracic surgery results in shorter hospital stay and lower postoperative pain compared to open thoracotomy: a matched pairs analysis.

    PubMed

    Darr, Christopher; Cheufou, Danjouma; Weinreich, Gerhard; Hachenberg, Thomas; Aigner, Clemens; Kampe, Sandra

    2017-10-01

    To evaluate postoperative pain intensity and length of hospital stay after open or robotic thoracic surgery in a standardized postoperative pain therapy setting. In the present retrospective (oberservation period: January 2015 until January 2016) study we matched data of 38 patients with robotic thoracic surgery ("robotic patients"; age: 62.2 years, male gender: 42.1%) with 38 patients with open thoracic surgery ("open patients"; age: 62.5 years, male gender: 42.1%). Power analysis indicated that 36 patients per group would be required. 68% of all patients received an epidural catheter, and 32% a systemic opioid based analgesia. Postoperative pain intensity in "robotic patients" was lower at rest on postoperative day 3-5 compared to "open patients" (NRS POD 3 robotic surgery 0.5±1.0 vs. open surgery 1.0±1.6, p = 0.04; NRS POD 4 robotic surgery 0,5 ± 1.0 vs. open surgery 1.1±1.3, p=0.04; NRS POD 5 robotic surgery 0.7 ± 1.0 vs. open surgery 1.5±1.5, p=0.003). Chest tube duration was shorter in "robotic patients" (2.9 ± 2.0 days vs. 4.9 ± 2.2 days; p < 0.001). Moreover, length of hospital stay was shorter in "robotic patients" than in "open patients" (6.9 days vs. 8.0 days; p = 0.02). There was no significant difference in postoperative opioid consumption between the groups. Nearly 95% of patients were discharged home with an oral opioid in both groups. Patients after robotic pulmonary resection experience lower postoperative pain and are discharged earlier from hospital than patients after open thoracic surgery. The study design is retrospectively.

  18. The safety and tolerability of rotigotine transdermal system over a 6-year period in patients with early-stage Parkinson's disease.

    PubMed

    Giladi, Nir; Boroojerdi, Babak; Surmann, Erwin

    2013-09-01

    This open-label extension (SP716; NCT00599196) of a 6-month, double-blind, randomized study (SP513) investigated the safety and tolerability of rotigotine transdermal system over up to ~6 years in patients with Parkinson's disease (PD; early-stage PD at double-blind enrollment). Eligible patients completing the 6-month study received optimal dose open-label rotigotine (≤ 16 mg/24 h) for up to ~6 years. Adjunctive levodopa was permitted. Primary outcomes included adverse events (AEs) and extent of rotigotine exposure. Analysis of adjunctive levodopa use, dyskinesias [unified Parkinson's disease rating scale (UPDRS) IV], and efficacy (UPDRS II + III total score) were also assessed. Of 381 patients enrolled in the open-label extension, 52 % were still in the study at time of closure; 24 % withdrew because of AEs and 6 % because of lack of efficacy. Patients received rotigotine for a median duration of 1,564.5 days (~4 years, 3 months; range 5-2, 145 days). 69 % of patients started supplemental levodopa; median time to levodopa was 485 days (~1 year, 4 months). Most common AEs (% per patient-year) were somnolence (18 %), application site reactions (12 %), nausea (9 %), peripheral edema (7 %), and fall (7 %). AEs indicative of impulsive-compulsive behavior were recorded in 25 (7 %) patients. Dyskinesias were experienced by 65 (17 %) patients; the majority [47 of 65 (72 %)] reported first dyskinesia after starting levodopa. Mean UPDRS II + III total scores remained below double-blind baseline for 4 years (assessment of all patients). In conclusion, rotigotine was generally well tolerated for up to ~6 years in patients with early-stage PD. The AEs reported were in line with previous studies of rotigotine transdermal system, with typical dopaminergic side effects and application site reactions seen.

  19. Long-Term Effects of an Extensive Cognitive Training on Personality Development.

    PubMed

    Sander, Julia; Schmiedek, Florian; Brose, Annette; Wagner, Gert G; Specht, Jule

    2017-08-01

    Previous research found that cognitive training increases the Big Five personality trait Openness to Experience during and some weeks after the intervention. The present study investigated whether long-term changes happen in Openness to Experience and other personality traits after an extensive cognitive training of memory and perceptual speed. The intervention group consisted of 204 adults (20-31 years and 65-80 years; 50% female) who received daily 1-hour cognitive training sessions for about 100 days. The control group consisted of 86 adults (21-29 years and 65-82 years; 51% female) who received no cognitive training. All participants answered the NEO Five-Factor Inventory before and 2 years after the cognitive training. Latent change models were applied that controlled for age group (young vs. old) and gender. In the long run, the cognitive training did not affect changes in any facet of Openness to Experience. This was true for young and old participants as well as for men and women. Instead, the cognitive training lowered the general increase of Conscientiousness. Even an extensive cognitive training on memory and perceptual speed does not serve as a sufficient intervention for enduring changes in Openness to Experiences or one of its facets. © 2016 Wiley Periodicals, Inc.

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

    Barbara Chapman

    OpenMP was not well recognized at the beginning of the project, around year 2003, because of its limited use in DoE production applications and the inmature hardware support for an efficient implementation. Yet in the recent years, it has been graduately adopted both in HPC applications, mostly in the form of MPI+OpenMP hybrid code, and in mid-scale desktop applications for scientific and experimental studies. We have observed this trend and worked deligiently to improve our OpenMP compiler and runtimes, as well as to work with the OpenMP standard organization to make sure OpenMP are evolved in the direction close tomore » DoE missions. In the Center for Programming Models for Scalable Parallel Computing project, the HPCTools team at the University of Houston (UH), directed by Dr. Barbara Chapman, has been working with project partners, external collaborators and hardware vendors to increase the scalability and applicability of OpenMP for multi-core (and future manycore) platforms and for distributed memory systems by exploring different programming models, language extensions, compiler optimizations, as well as runtime library support.« less

  1. Response perseveration and sensitivity to reward and punishment in boys with oppositional defiant disorder.

    PubMed

    Matthys, Walter; van Goozen, Stephanie H M; Snoek, Heddeke; van Engeland, Herman

    2004-12-01

    Response perseveration is the tendency to continue a response set for reward despite punishment. In the present study, response perseveration and sensitivity to reward and punishment were assessed in boys with oppositional defiant disorder (ODD). The study also examined the relation between punishment sensitivity and autonomic arousal. Nineteen ODD boys (mean age 9.8 years) and 20 normal control boys (NC) (mean age 9.7 years) were administered the door-opening task. In this task, the subject chooses either to open the next door or to stop playing; the opening of doors is initially rewarded and then increasingly punished. ODD boys opened more doors than NC boys. Following punishment, ODD boys took less time than NC boys before opening the next door, but did not differ from NC boys in time after reward. Mean skin conductance level was lower in ODD boys than in NC boys. The correlation coefficient between time after punishment and skin conductance level was moderately positive in the total sample. These results suggest that response perseveration in ODD boys is related to low punishment sensitivity and that skin conductance level is a marker of punishment sensitivity.

  2. Open-Source Data and the Study of Homicide.

    PubMed

    Parkin, William S; Gruenewald, Jeff

    2015-07-20

    To date, no discussion has taken place in the social sciences as to the appropriateness of using open-source data to augment, or replace, official data sources in homicide research. The purpose of this article is to examine whether open-source data have the potential to be used as a valid and reliable data source in testing theory and studying homicide. Official and open-source homicide data were collected as a case study in a single jurisdiction over a 1-year period. The data sets were compared to determine whether open-sources could recreate the population of homicides and variable responses collected in official data. Open-source data were able to replicate the population of homicides identified in the official data. Also, for every variable measured, the open-sources captured as much, or more, of the information presented in the official data. Also, variables not available in official data, but potentially useful for testing theory, were identified in open-sources. The results of the case study show that open-source data are potentially as effective as official data in identifying individual- and situational-level characteristics, provide access to variables not found in official homicide data, and offer geographic data that can be used to link macro-level characteristics to homicide events. © The Author(s) 2015.

  3. Effects of lexical characteristics and demographic factors on mandarin chinese open-set word recognition in children with cochlear implants.

    PubMed

    Liu, Haihong; Liu, Sha; Wang, Suju; Liu, Chang; Kong, Ying; Zhang, Ning; Li, Shujing; Yang, Yilin; Han, Demin; Zhang, Luo

    2013-01-01

    The purpose of this study was to examine the open-set word recognition performance of Mandarin Chinese-speaking children who had received a multichannel cochlear implant (CI) and examine the effects of lexical characteristics and demographic factors (i.e., age at implantation and duration of implant use) on Mandarin Chinese open-set word recognition in these children. Participants were 230 prelingually deafened children with CIs. Age at implantation ranged from 0.9 to 16.0 years, with a mean of 3.9 years. The Standard-Chinese version of the Monosyllabic Lexical Neighborhood test and the Multisyllabic Lexical Neighborhood test were used to evaluate the open-set word identification abilities of the children. A two-way analysis of variance was performed to delineate the lexical effects on the open-set word identification, with word difficulty and syllable length as the two main factors. The effects of age at implantation and duration of implant use on open-set, word-recognition performance were examined using correlational/regressional models. First, the average percent-correct scores for the disyllabic "easy" list, disyllabic "hard" list, monosyllabic "easy" list, and monosyllabic "hard" list were 65.0%, 51.3%, 58.9%, and 46.2%, respectively. For both the easy and hard lists, the percentage of words correctly identified was higher for disyllabic words than for monosyllabic words, Second, the CI group scored 26.3%, 31.3%, and 18.8 % points lower than their hearing-age-matched normal-hearing peers for 4, 5, and 6 years of hearing age, respectively. The corresponding gaps between the CI group and the chronological-age-matched normal-hearing group were 47.6, 49.6, and 42.4, respectively. The individual variations in performance were much greater in the CI group than in the normal-hearing group, Third, the children exhibited steady improvements in performance as the duration of implant use increased, especially 1 to 6 years postimplantation. Last, age at implantation had significant effects on postimplantation word-recognition performance. The benefit of early implantation was particularly evident in children 5 years old or younger. First, Mandarin Chinese-speaking pediatric CI users' open-set word recognition was influenced by the lexical characteristics of the stimuli. The score was higher for easy words than for hard words and was higher for disyllabic words than for monosyllabic words, Second, Mandarin-Chinese-speaking pediatric CI users exhibited steady progress in open-set word recognition as the duration of implant use increased. However, the present study also demonstrated that, even after 6 years of CI use, there was a significant deficit in open-set, word-recognition performance in the CI children compared with their normal-hearing peers. Third, age at implantation had significant effects on open-set, word-recognition performance. Early implanted children exhibited better performance than children implanted later.

  4. EXPANSION OF THE FREE CHOICE OPEN ENROLLMENT PROGRAM.

    ERIC Educational Resources Information Center

    FOX, DAVID J.

    THIS EVALUATION OF THE SECOND YEAR OF THE FREE CHOICE OPEN ENROLLMENT PROGRAM (OE) IN NEW YORK CITY'S PUBLIC SCHOOLS PRESENTS COMPARATIVE DATA FOR 26 RECEIVING AND 15 SENDING ELEMENTARY AND JUNIOR HIGH SCHOOLS. THE AREAS STUDIED WERE (1) CHILDRENS' CLASSROOM FUNCTIONING, (2) TEACHERS' CLASSROOM FUNCTIONING, (3) SCHOOL APPEARANCE, CLIMATE, AND…

  5. Laparoscopic extraperitoneal inguinal hernia repair versus open mesh repair: long-term follow-up of a randomized controlled trial.

    PubMed

    Hallén, Magnus; Bergenfelz, Anders; Westerdahl, Johan

    2008-03-01

    We have conducted a randomized controlled trial of totally extraperitoneal hernia repair (TEP) versus tension-free open repair (Lichtenstein repair); we have presented the results previously up to 1 year after the operation. The aim of this study was to compare patient outcome in both groups at a median follow-up of 7.3 years after operation. Of 168 patients included in a prospective, randomized controlled trial designed to compare TEP with an open tension-free technique, 154 patients (92%) answered a questionnaire and 147 patients (88%) were followed up at an outpatient clinic after a minimum of 6 years after operation. Overall, 89% of patients in the TEP group and 95% of patients in the open group reported complete long-term recovery (P = .23). Permanent impaired inguinal sensibility was more common in the open group (P = .004), whereas the proportion of patients with reported testicular pain was higher in the TEP group (P = .003). Three recurrences were found in the TEP group, and 4 recurrences were found in the open group (P = .99). Four patients in the TEP group underwent operations for complications related to the hernia repair (small bowel obstruction, umbilical hernia, testicular pain, and neuralgia). Overall, both groups showed good long-term results with low rates of recurrences. However, the TEP group was associated with a higher proportion of patients with long-term testicular pain, whereas impaired inguinal sensibility was more common in the open group.

  6. Influence of clerks' personality on their burnout in the clinical workplace: a longitudinal observation.

    PubMed

    Lin, Cheng-Chieh; Lin, Blossom Yen-Ju; Lin, Chia-Der

    2016-01-28

    The clinical training of medical students in clerkship is crucial to their future practice in healthcare services. This study investigates burnout during a 2-year clerkship training period as well as the role of personality traits on burnout during training. Ninety-four clerks at a tertiary medical centre who provided at least 10 responses to a routine survey on clinical rotation were included in this study, which spanned September 2013 to April 2015. Web-based, validated, structured, self-administered questionnaires were used to evaluate the clerks' personalities at the beginning of the first clerkship year, and regular surveys were conducted to evaluate their burnout at each clinical specialty rotation throughout the 2-year clerkship period. Overall, 2230 responses were analysed, and linear mixed-effects models were used to examine the repeated measures of the clerks. Our findings revealed that medical student burnout scores were lower in the second year than they were in the first year of clerkships. Using the Big Five personality factors, all of the propensities, namely extroversion, agreeableness, consciousness, emotional stability, and openness were related to different extents of burnout reduction in the first clerkship year (P < .05). However, only emotional stability and openness were related to clerks' reduced burnout in the second clerkship year. Furthermore, being female, older, and with accompanied living were more closely related to lower burnout compared with being male, younger, and living alone throughout the clerkship period. The students in the first-year clerkship, particularly those with higher burnout levels, had tendencies in the Big Five personality characteristics, exhibiting higher levels of introversion, antagonism, lack of direction, neuroticism, and not open to new experiences. The students in the second-year clerkship who do not exhibit a high propensity for emotional stability and openness should be of particular concern. The findings can serve as a reference for clinical teachers and mentors to effectively prevent and reduce the burnout of medical students during clerkship training at clinical workplaces.

  7. Orthodontic Treatment Timing and Modalities in Anterior Open Bite: Case Series Study

    PubMed Central

    Al Hamadi, Wisam; Saleh, Fayez; Kaddouha, Mohamad

    2017-01-01

    Objective: The purpose of this study was to present early and adult cases of anterior open bite that were treated efficiently using different treatment approaches and mechanics. Materials and Methods: Five patients of different age groups (from 7 to 27 years), suffering from a clear Anterior open bite deformity, were properly diagnosed and relevant treatment modality for each was selected. Results: Positive overbite was efficiently achieved for all patients. Conclusion: Patient compliance is a key factor in using removable habit breakers. However, fixed palatal crib gave the same results but in shorter time. Anterior open bite of skeletal components should be thoroughly evaluated before selecting camouflage or orthognathic surgery treatment modality. PMID:29299074

  8. Comparison between visual field defect in pigmentary glaucoma and primary open-angle glaucoma.

    PubMed

    Nilforushan, Naveed; Yadgari, Maryam; Jazayeri, Anisalsadat

    2016-10-01

    To compare visual field defect patterns between pigmentary glaucoma and primary open-angle glaucoma. Retrospective, comparative study. Patients with diagnosis of primary open-angle glaucoma (POAG) and pigmentary glaucoma (PG) in mild to moderate stages were enrolled in this study. Each of the 52 point locations in total and pattern deviation plot (excluding 2 points adjacent to blind spot) of 24-2 Humphrey visual field as well as six predetermined sectors were compared using SPSS software version 20. Comparisons between 2 groups were performed with the Student t test for continuous variables and the Chi-square test for categorical variables. Thirty-eight eyes of 24 patients with a mean age of 66.26 ± 11 years (range 48-81 years) in the POAG group and 36 eyes of 22 patients with a mean age of 50.52 ± 11 years (range 36-69 years) in the PG group were studied. (P = 0.00). More deviation was detected in points 1, 3, 4, and 32 in total deviation (P = 0.03, P = 0.015, P = 0.018, P = 0.023) and in points 3, 4, and 32 in pattern deviation (P = 0.015, P = 0.049, P = 0.030) in the POAG group, which are the temporal parts of the field. It seems that the temporal area of the visual field in primary open-angle glaucoma is more susceptible to damage in comparison with pigmentary glaucoma.

  9. Mid-term cost-effectiveness analysis of open and endovascular repair for ruptured abdominal aortic aneurysm.

    PubMed

    Rollins, K E; Shak, J; Ambler, G K; Tang, T Y; Hayes, P D; Boyle, J R

    2014-02-01

    Emergency endovascular repair (EVAR) for ruptured abdominal aortic aneurysm (rAAA) may have lower operative mortality rates than open surgical repair. Concerns remain that the early survival benefit after EVAR for rAAA may be offset by late reinterventions. The aim of this study was to compare reintervention rates and cost-effectiveness of EVAR and open repair for rAAA. A retrospective analysis was undertaken of patients with rAAA undergoing EVAR or open repair over 6 years. A health economic model developed for the cost-effectiveness of elective EVAR was used in the emergency setting. Sixty-two patients (mean age 77·9 years) underwent EVAR and 85 (mean age 75·9 years) had open repair of rAAA. Median follow-up was 42 and 39 months respectively. There was no significant difference in 30-day mortality rates after EVAR and open repair (18 and 26 per cent respectively; P = 0·243). Reintervention rates were also similar (32 and 31 per cent; P = 0·701). The mean cost per patient was €26,725 for EVAR and €30,297 for open repair, and the cost per life-year gained was €7906 and €9933 respectively (P = 0·561). Open repair had greater initial costs: longer procedural times (217 versus 178·5 min; P < 0·001) and intensive care stay (5·0 versus 1·0 days; P = 0·015). Conversely, EVAR had greater reintervention (€156,939 versus €35,335; P = 0·001) and surveillance (P < 0·001) costs. There was no significant difference in reintervention rates after EVAR or open repair for rAAA. EVAR was as cost-effective at mid-term follow-up. The increased procedural costs of open repair are not outweighed by greater surveillance and reintervention costs after EVAR. © 2014 BJS Society Ltd. Published by John Wiley & Sons Ltd.

  10. Macrobenthic community structure in the northern Saudi waters of the Gulf, 14 years after the 1991 oil spill.

    PubMed

    Joydas, T V; Qurban, Mohammad A; Al-Suwailem, Abdulaziz; Krishnakumar, P K; Nazeer, Zahid; Cali, N A

    2012-02-01

    The 1991 Gulf oil spill heavily impacted the coastal areas of the Saudi waters of the Arabian Gulf and recent studies have indicated that even 15 years after the incident, macrobenthos had not completely recovered in the sheltered bays in the affected region such as, Manifa Bay. This study investigates the community conditions of macrobenthos in the open waters in one of the impacted areas, Al-Khafji waters, about 14 years after the spill. Diversity measures and community structure analyses indicate a healthy status of polychaete communities. The BOPA index reveals that oil sensitive amphipods were recolonized in the study area. This confirms that the benthic communities of the oil spill impacted area had taken only <14 years to recover in the open waters of the impacted areas. The study also reveals the existence of three distinct polychaete communities along the depth and sediment gradients. Copyright © 2011 Elsevier Ltd. All rights reserved.

  11. Immediate costs of mini-open versus arthroscopic rotator cuff repair in an Asian population.

    PubMed

    Hui, Yik Jing; Teo, Alex Quok An; Sharma, Siddharth; Tan, Bryan Hsi Ming; Kumar, V Prem

    2017-01-01

    While there has been increasing interest in minimally invasive surgery, the expenses incurred by patients undergoing this form of surgery have not been comprehensively studied. The authors compared the costs borne by patients undergoing arthroscopic rotator cuff repair with the standard mini-open repair at a tertiary hospital in an Asian population. This was a retrospective cohort study. The authors studied the inpatient hospital bills of patients following rotator cuff tear repair between January 2010 and October 2014 via the hospital electronic medical records system. 148 patients had arthroscopic repair and 78 had mini-open repair. The cost of implants, consumables, and the total cost of hospitalization were analyzed. Operative times and length of stay for both procedures were also studied. Constant scores and American Shoulder Elbow Scores (ASES) were recorded preoperatively and at 1 year postoperatively. Three fellowship-trained surgeons performed arthroscopic repairs and one performed the mini-open repair. The cost of implants and consumables was significantly higher with arthroscopic repair. The duration of surgery was also significantly longer with that technique. There was no difference in length of stay between the two techniques. There was also no difference in Constant scores or ASES scores, both preoperatively and at 1 year postoperatively. The immediate costs of mini-open repair of rotator cuff tears are significantly less than that of arthroscopic repair. Most of the difference arises from the cost of implants and consumables. Equivalent functional outcomes from both techniques suggest that mini-open repair may be more cost-effective.

  12. Gender related Long-term Differences after Open Infrainguinal Surgery for Critical Limb Ischemia.

    PubMed

    Lejay, A; Schaeffer, M; Georg, Y; Lucereau, B; Roussin, M; Girsowicz, E; Delay, C; Schwein, A; Thaveau, F; Geny, B; Chakfe, N

    2015-10-01

    The role of gender on long-term infrainguinal open surgery outcomes still remains uncertain in critical limb ischemia patients. The aim of this study is to evaluate the gender-specific differences in patient characteristics and long-term clinical outcomes in terms of survival, primary patency and limb salvage among patients undergoing infrainguinal open surgery for CLI. All consecutive patients undergoing infrainguinal open surgery for critical limb ischemia between 2003 and 2012 were included. Survival, limb salvage and primary patency rates were assessed. Independent outcome determinants were identified by the Cox proportional hazard ratio using age and gender as adjustment factors. 584 patients (269 women and 315 men, mean age 76 and 71 years respectively) underwent 658 infrainguinal open surgery (313 in women and 345 in men). Survival rate at 6 years was lower among women compared to men with 53.5% vs 70.9% (p < 0.001). The same applied to primary patency (35.9% vs 52.4%, p < 0.001) and limb salvage (54.3% vs 81.1%, p < 0.001) at 6 years. Female-gender was an independent factor predicting death (hazard ratio 1.50), thrombosis (hazard ratio 2.37) and limb loss (hazard ratio 7.05) in age and gender-adjusted analysis. Gender-related disparity in critical limb ischemia open surgical revascularization outcomes still remains. Copyright © 2015 European Society for Vascular Surgery. Published by Elsevier Ltd. All rights reserved.

  13. Findings of a Research on the Students' Use of Time. A Case Study of the Anadolu University Open Education Faculty in Turkey. Educational Research Publications No. 017.

    ERIC Educational Resources Information Center

    Demiray, Ugur

    This study examines what fourth year Open Education Faculty students enrolled in economics and business administration education in Anadolu University's distance education program expect from their faculty in terms of leisure time activities and how they spend their leisure time. Additional questions addressed include the personal, social, and…

  14. How Do African American Young Adult Females (AAYAF) over 16 Years of Age Make Career Decisions?

    ERIC Educational Resources Information Center

    Grayson, Nancy Mathea

    2010-01-01

    Scope and Method of Study: The overall purpose of the study was to describe the perceptions regarding how AAYAF over 16 years of age plan and make career decisions. The study participants included ten AAYAF over 16 years of age. The young women were interviewed fact-to-face using a semi-structured open-ended questionnaire. The questionnaire was…

  15. An examination of the association between interviewer question type and story-grammar detail in child witness interviews about abuse.

    PubMed

    Feltis, Brooke B; Powell, Martine B; Snow, Pamela C; Hughes-Scholes, Carolyn H

    2010-06-01

    This study compared the effects of open-ended versus specific questions, and various types of open-ended questions, in eliciting story-grammar detail in child abuse interviews. The sample included 34 police interviews with child witnesses aged 5-15 years (M age=9 years, 9 months). The interviewers' questions and their relative sub-types were classified according to definitions reported in the child interview training literature. The children's responses were classified according to the proportion of story grammar and the prevalence of individual story grammar elements as defined by Stein and Glenn (1979). Open-ended questions were more effective at eliciting story grammar than specific questions. This finding was revealed across three age groups, two interview phases and irrespective of how question effectiveness was measured. However, not all types of open-ended questions were equally effective. Open-ended questions that encouraged a broad response, or asked the child to elaborate on a part of their account, elicited more story-grammar detail compared to open-ended questions that requested clarification of concepts or descriptions of the next (or another) activity or detail within a sequence. This study demonstrates that children's ability to provide story-grammar detail is maximised when there is minimal prompting from the interviewer. Given the association between story grammar production and victim credibility, greater guidance is warranted in interviewer training programs in relation to the effects and administration of different types of open-ended questions. Copyright 2010 Elsevier Ltd. All rights reserved.

  16. Upper extremity open fractures in hospitalized road traffic accident patients: adult versus pediatric cases.

    PubMed

    Rubin, Guy; Peleg, Kobi; Givon, Adi; Rozen, Nimrod

    2017-10-24

    Fractures in pediatrics show epidemiological characteristics which are different from fractures in adults. The objective of this study was to examine the injury profiles of open upper extremity fractures (UEFs) in all modes of injury related to road traffic accidents (RTAs) in adult and pediatric hospitalized patients. Data on 103,465 RTA patients between 1997 and 2013 whose records were entered in a centralized country trauma database were reviewed. Data on open UEFs related to mode of injury (car, motorcycle, bicycle, and pedestrian) was compared between adult (18+ years) and pediatric (0-17 years) RTA patients. Of 103,465 RTA cases, 17,263 (16.7%) had UEFs. Of 73,087 adults, 13,237 (18.1%) included UEFs and of 30,378 pediatric cases, 4026 (13.2%) included UEFs (p < 0.0001). Of 17,263 cases with UEFs, we reviewed 22,132 fractures with 2, 743 (12.4%) open fractures. Adults had a greater risk for open fractures (2221, 13%) than the pediatric cases (522, 10.3%) (p < 0.0001). Overall, of a total of 22,132 UEFs, most of the fractures were in the radius (22.8%), humerus (20.3%), clavicle (17.5%), and ulna (15.4%). The adult pedestrian group had a significantly higher risk for open UEFs than the pediatric group (11 vs 8%, p = 0.0012). This study demonstrates the difference between adult and pediatric open fractures in hospitalized RTAs. We showed that adults had a greater risk for open UEFs compared to children, and the adult pedestrian group particularly had a significantly higher risk for open UEFs than the pediatric group.

  17. Enhanced Component Performance Study: Air-Operated Valves 1998-2014

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

    Schroeder, John Alton

    2015-11-01

    This report presents a performance evaluation of air-operated valves (AOVs) at U.S. commercial nuclear power plants. The data used in this study are based on the operating experience failure reports from fiscal year 1998 through 2014 for the component reliability as reported in the Institute of Nuclear Power Operations (INPO) Consolidated Events Database (ICES). The AOV failure modes considered are failure-to-open/close, failure to operate or control, and spurious operation. The component reliability estimates and the reliability data are trended for the most recent 10-year period, while yearly estimates for reliability are provided for the entire active period. One statistically significantmore » trend was observed in the AOV data: The frequency of demands per reactor year for valves recording the fail-to-open or fail-to-close failure modes, for high-demand valves (those with greater than twenty demands per year), was found to be decreasing. The decrease was about three percent over the ten year period trended.« less

  18. Associations of Openness and Conscientiousness With Walking Speed Decline: Findings From the Health, Aging, and Body Composition Study

    PubMed Central

    Costa, Paul T.; Terracciano, Antonio; Ferrucci, Luigi; Faulkner, Kimberly; Coday, Mathilda (Mace) C.; Ayonayon, Hilsa N.; Simonsick, Eleanor M.

    2012-01-01

    Objectives. The objective of this study was to explore the associations between openness to experience and conscientiousness, two dimensions of the five-factor model of personality, and usual gait speed and gait speed decline. Method. Baseline analyses were conducted on 907 men and women aged 71–82 years participating in the Cognitive Vitality substudy of the Health, Aging, and Body Composition study. The longitudinal analytic sample consisted of 740 participants who had walking speed assessed 3 years later. Results. At baseline, gait speed averaged 1.2 m/s, and an average decline of 5% over the 3-year follow-up period was observed. Higher conscientiousness was associated with faster initial walking speed and less decline in walking speed over the study period, independent of sociodemographic characteristics. Lifestyle factors and disease status appear to play a role in the baseline but not the longitudinal association between conscientiousness and gait speed. Openness was not associated with either initial or decline in gait speed. Discussion. These findings extend the body of evidence suggesting a protective association between conscientiousness and physical function to performance-based assessment of gait speed. Future studies are needed to confirm these associations and to explore mechanisms that underlie the conscientiousness mobility connection in aging adults. PMID:22451484

  19. Large-scale stress factors affecting coral reefs: open ocean sea surface temperature and surface seawater aragonite saturation over the next 400 years

    NASA Astrophysics Data System (ADS)

    Meissner, K. J.; Lippmann, T.; Sen Gupta, A.

    2012-06-01

    One-third of the world's coral reefs have disappeared over the last 30 years, and a further third is under threat today from various stress factors. The main global stress factors on coral reefs have been identified as changes in sea surface temperature (SST) and changes in surface seawater aragonite saturation (Ωarag). Here, we use a climate model of intermediate complexity, which includes an ocean general circulation model and a fully coupled carbon cycle, in conjunction with present-day observations of inter-annual SST variability to investigate three IPCC representative concentration pathways (RCP 3PD, RCP 4.5, and RCP 8.5), and their impact on the environmental stressors of coral reefs related to open ocean SST and open ocean Ωarag over the next 400 years. Our simulations show that for the RCP 4.5 and 8.5 scenarios, the threshold of 3.3 for zonal and annual mean Ωarag would be crossed in the first half of this century. By year 2030, 66-85% of the reef locations considered in this study would experience severe bleaching events at least once every 10 years. Regardless of the concentration pathway, virtually every reef considered in this study (>97%) would experience severe thermal stress by year 2050. In all our simulations, changes in surface seawater aragonite saturation lead changes in temperatures.

  20. Functional Outcomes Following Laparoscopic Ileal Pouch-Anal Anastomosis in Patients with Chronic Ulcerative Colitis: Long-Term Follow-up of a Case-Matched Study.

    PubMed

    Baek, Se-Jin; Lightner, Amy L; Boostrom, Sarah Y; Mathis, Kellie L; Cima, Robert R; Pemberton, John H; Larson, David W; Dozois, Eric J

    2017-08-01

    Laparoscopic ileal pouch-anal anastomosis (L-IPAA) has been increasingly adopted over the last decade due to short-term patient-related benefits. Several studies have shown L-IPAA to be equivalent to open IPAA in terms of safety and short-term outcomes. However, few L-IPAA studies have examined long-term functional outcomes. We aimed to evaluate the long-term functional outcomes of L-IPAA as compared to open IPAA. A previous case-matched cohort study at our institution compared short-term outcomes between L-IPAA and open IPAA from 1998 to 2004. For this study, we selected all patients from this case-matched cohort study with chronic ulcerative colitis (CUC) who had follow-up functional data of greater than 1 year. Functional data was obtained through prospective surveys, which were sent annually to all IPAA patients postoperatively. One hundred and forty-nine patients (58 L-IPAA, 91 open IPAA) with a median 8-year duration of follow-up were identified. There were no differences in demographics and long-term surgical outcomes between groups. Stapled anastomosis was more common in the laparoscopic group (91.4 versus 54.9%, p < 0.001). Stool frequency during daytime (>6 stools, L-IPAA 32.8%, open 49.4%, p = 0.048) and nighttime (>2 stools, L-IPAA 13.8%, open 30.6%; p = 0.024) was significantly lower in the L-IPAA group. Ability to differentiate gas from stool was not different (p = 0.13). Rate of complete continence was similar in L-IPAA and open groups (L-IPAA 36.2%, open 21.8%, p = 0.060). There was no difference in use of medication to control stools, perianal skin irritation, voiding difficulty, sexual problems, and occupational change between groups. Subgroup analysis to evaluate for any group differences attributable to anastomotic technique demonstrated only that stapled anastomoses lead to more perianal skin irritation in the L-IPAA group (L-IPAA = 60.4% versus open IPAA = 38.8%; p = 0.031). Overall, L-IPAA has comparable functional results to the open approach with slightly lower daytime and nighttime stool frequency. This difference may be attributed to a greater number of stapled anastomoses performed in the laparoscopic cohort.

  1. Intra-Operative Predictors of difficult cholecystectomy and Conversion to Open Cholecystectomy - A New Scoring System.

    PubMed

    Ahmed, Nauman; Hassan, Maaz Ul; Tahira, Maham; Samad, Abdul; Rana, Hamad Naeem

    2018-01-01

    To evaluate the intra-operative scoring system to predict difficult cholecystectomy and conversion to open surgery. This descriptive study was conducted from March 2016 to August, 2016 in the Department of Surgery, Shalimar Hospital. The study recruited 120 patients of either gender, age greater than 18 years and indicated for laparoscopic cholecystectomy (LC). Intra-operatively all patients were evaluated using the new scoring system. The scoring system included five aspects; appearance and adhesion of Gall Bladder (GB), distension or contracture degree of GB, ease in access, local or septic complications, and time required for cystic artery and duct identification. The scoring system ranges from 0 to 10, classified as score of <2 being considered easy, 2 to 4 moderate, 5-7 very difficult, and 8 to 10, extreme. Patient demographic data (i.e. age, gender), co-morbidities, intra-operative scores using the scoring system and conversion to open were recorded. The data was analysed using statistical analysis software SPSS (IBM). Among one hundred and twenty participants, sixty seven percent were females and the mean age (years) was 43.05 ± 14.16. Co-morbidities were present in twenty percent patients with eleven diagnosed with diabetes, six with hypertension and five with both hypertension and diabetes. The conversion rate to open surgery was 6.7%. The overall mean intra-operative scores were 3.52 ± 2.23; however significant difference was seen in mean operative score of converted to open and those not converted to open (8.00 ± 0.92 Vs. 3.20 V 1.92; p-value = 0.001). Among eight cases converted to open, three (37.5%) were in very difficult category while five (62.5%) were in extreme category. Moreover, age greater than 40 years and being diabetic were also the risk factors for conversion to open surgery. The new intra-operative scoring system is a valuable assessment tool to predict difficult laparoscopic cholecystectomy and conversion parameters to open surgery and its utility could improve patient's clinical outcome indicated for laparoscopic cholecystectomy.

  2. Evaluation of total alloplastic temporo-mandibular joint replacement with two different types of prostheses: A three-year prospective study

    PubMed Central

    Gonzalez-Perez-Somarriba, Borja; Centeno, Gabriel; Vallellano, Carpóforo; Montes-Carmona, Jose-Francisco

    2016-01-01

    Background Temporo-Mandibular Joint (TMJ) replacement has been used clinically for years. The objective of this study was to evaluate outcomes achieved in patients with two different categories of TMJ prostheses. Material and Methods All patients who had a TMJ replacement (TMJR) implanted during the study period from 2006 through 2012 were included in this 3-year prospective study. All procedures were performed using the Biomet Microfixation TMJ Replacement System, and all involved replacing both the skull base component (glenoid fossa) and the mandibular condyle. Results Fifty-seven patients (38 females and 19 males), involving 75 TMJs with severe disease requiring reconstruction (39 unilateral, 18 bilateral) were operated on consecutively, and 68 stock prostheses and 7 custom-made prostheses were implanted. The mean age at surgery was 52.6±11.5 years in the stock group and 51.8±11.7 years in the custom-made group. In the stock group, after three years of TMJR, results showed a reduction in pain intensity from 6.4±1.4 to 1.6±1.2 (p<0.001), and an improvement in jaw opening from 2.7±0.9 cm to 4.2±0.7 cm (p<0.001). In the custom-made group, after three years of TMJR, results showed a reduction in pain intensity from 6.0±1.6 to 2.2±0.4 (p<0.001), and an improvement in jaw opening from 1.5±0.5 cm to 4.3±0.6 cm (p<0.001). No statistically significant differences between two groups were detected. Conclusions The results of this three-year prospective study support the surgical placement of TMJ prostheses (stock prosthetic, and custom-made systems), and show that the approach is efficacious and safe, reduces pain, and improves maximum mouth opening movement, with few complications. As such, TMJR represents a viable technique and a stable long-term solution for cranio-mandibular reconstruction in patients with irreversible end-stage TMJ disease. Comparing stock and custom-made groups, no statistically significant differences were detected with respect to pain intensity reduction and maximum mouth opening improvement. Key words:Temporo-mandibular joint, temporo-mandibular joint replacement, prosthesis, biomaterials, biomedical engineering, computer-aided design and manufacturing. PMID:27475697

  3. Cost-utility analysis of posterior minimally invasive fusion compared with conventional open fusion for lumbar spondylolisthesis

    PubMed Central

    Rampersaud, Y. Raja; Gray, Randolph; Lewis, Steven J.; Massicotte, Eric M.; Fehlings, Michael G.

    2011-01-01

    Background The utility and cost of minimally invasive surgical (MIS) fusion remain controversial. The primary objective of this study was to compare the direct economic impact of 1- and 2-level fusion for grade I or II degenerative or isthmic spondylolisthesis via an MIS technique compared with conventional open posterior decompression and fusion. Methods A retrospective cohort study was performed by use of prospective data from 78 consecutive patients (37 with MIS technique by 1 surgeon and 41 with open technique by 3 surgeons). Independent review of demographic, intraoperative, and acute postoperative data was performed. Oswestry disability index (ODI) and Short Form 36 (SF-36) values were prospectively collected preoperatively and at 1 year postoperatively. Cost-utility analysis was performed by use of in-hospital micro-costing data (operating room, nursing, imaging, laboratories, pharmacy, and allied health cost) and change in health utility index (SF-6D) at 1 year. Results The groups were comparable in terms of age, sex, preoperative hemoglobin, comorbidities, and body mass index. Groups significantly differed (P < .01) regarding baseline ODI and SF-6D scores, as well as number of 2-level fusions (MIS, 12; open, 20) and number of interbody cages (MIS, 45; open, 14). Blood loss (200 mL vs 798 mL), transfusions (0% vs 17%), and length of stay (LOS) (6.1 days vs 8.4 days) were significantly (P < .01) lower in the MIS group. Complications were also fewer in the MIS group (4 vs 12, P < .02). The mean cost of an open fusion was 1.28 times greater than that of an MIS fusion (P = .001). Both groups had significant improvement in 1-year outcome. The changes in ODI and SF-6D scores were not statistically different between groups. Multivariate regression analysis showed that LOS and number of levels fused were independent predictors of cost. Age and MIS were the only predictors of LOS. Baseline outcomes and MIS were predictors of 1-year outcome. Conclusion MIS posterior fusion for spondylolisthesis does reduce blood loss, transfusion requirements, and LOS. Both techniques provided substantial clinical improvements at 1 year. The cost utility of the MIS technique was considered comparable to that of the open technique. Level of Evidence Level III. PMID:25802665

  4. Imagery use of athletes in individual and team sports that require open and closed skill.

    PubMed

    Kizildag, Esen; Tiryaki, M Sefik

    2012-06-01

    This study compared use of imagery in elite male and female athletes in open and closed and individual or team sports. A total of 151 elite Turkish athletes ages 15 to 29 years old (males' M age=20.7 yr., SD=3.3; females' M age=20.0 yr., SD=3.5) from open-team sports (n=66), open-individual sports (n=26), and closed-individual sports (n=59) completed the sport imagery questionnaire. A significant multivariate effect of sport type was found. Univariate analyses indicated that male and female athletes in team open-skill sports and individual closed-skill sports used more motivational general-mastery imagery than did athletes in individual open-skill sports.

  5. Effect of preharvest understory treatment and group opening size on four-year survival of advance reproduction in the Boston Mountains of Arkansas

    Treesearch

    Martin A. Spetich; David L. Graney

    2003-01-01

    The purpose of this study was to examine survival of regeneration in small openings. Six forest stands were located in 1990 and three understory treatments were applied to each in early 1991. In each stand, six sizes of openings were created in 1992 ranging in size from 0.025 ac to 0.50 ac. Understory treatments consisted of: 1) no control of competing...

  6. Effect of preharvest understory treatment and group opening size on four-year survival of advance reproduction in the Boston Mountains of Arkansas

    Treesearch

    Martin A. Spetich; David L. Graney

    2003-01-01

    The purpose of this study was to examine survival of regeneration in small openings. Six forest stands were located in 1990 and three understory treatments were applied to each in early 1991. In each stand, six sizes of openings were created in 1992 ranging in size from 0.025 ac to 0.50 ac. Understory treatments consisted of: 1) no control of competing regeneration, 2...

  7. An exploration of students' perceptions and attitudes towards creativity in engineering education

    NASA Astrophysics Data System (ADS)

    Waller, David R.

    This study used a mixed methods approach to develop a broad and deep understanding of students’ perceptions towards creativity in engineering education. Studies have shown that students’ attitudes can have an impact on their motivation to engage in creative behavior. Using an ex-post facto independent factorial design, attitudes of value towards creativity, time for creativity, and creativity stereotypes were measured and compared across gender, year of study, engineering discipline, preference for open-ended problem solving, and confidence in creative abilities. Participants were undergraduate engineering students at Queen’s University from all years of study. A qualitative phenomenological methodology was adopted to study students’ understandings and experiences with engineering creativity. Eleven students participated in oneon- one interviews that provided depth and insight into how students experience and define engineering creativity, and the survey included open-ended items developed using the 10 Maxims of Creativity in Education as a guiding framework. The findings from the survey suggested that students had high value for creativity, however students in fourth year or higher had less value than those in other years. Those with preference for open-ended problem solving and high confidence valued creative more than their counterparts. Students who preferred open-ended problem solving and students with high confidence reported that time was less of a hindrance to their creativity. Males identified more with creativity stereotypes than females, however overall they were both low. Open-ended survey and interview results indicated that students felt they experienced creativity in engineering design activities. Engineering creativity definitions had two elements: creative action and creative characteristic. Creative actions were associated with designing, and creative characteristics were predominantly associated with novelty. Other barriers that emerged from the qualitative analysis were lack of opportunity, lack of assessment, and discomfort with creativity. It was concluded that a universal definition is required to establish clear and aligned understandings of engineering creativity. Instructors may want to consider demonstrating value by assessing creativity and establishing clear criteria in design projects. It is recommended that students be given more opportunities for practice through design activities and that they be introduced to design and creative thinking concepts early in their engineering education.

  8. The Fallacies of Open: Participatory Design, Infrastructuring, and the Pursuit of Radical Possibility

    ERIC Educational Resources Information Center

    West-Puckett, Stephanie; Smith, Anna; Cantrill, Christina; Zamora, Mia

    2018-01-01

    To better understand the impacts of participatory design in English language arts teacher education, this critical case study focuses on the National Writing Project's Connected Learning Massive, Open, Online Collaboration (CLMOOC) that engaged educators in playing with the connected learning framework. The authors draw from 5 years of interaction…

  9. Publishing in Discipline-Specific Open Access Journals: Opportunities and Outreach for Librarians

    ERIC Educational Resources Information Center

    Tomaszewski, Robert; Poulin, Sonia; MacDonald, Karen I.

    2013-01-01

    Open access (OA) journals promote the opportunity for peer-reviewed journal articles to be freely accessible. In recent years, the number of OA journals has exploded in all disciplines. Previous studies have identified print-based pedagogical discipline-specific journals outside the field of Library and Information Science (LIS) for librarians to…

  10. Participation in Ohio's Interdistrict Open Enrollment Option: An Investigation of the Supply-Side of Choice.

    ERIC Educational Resources Information Center

    Fowler, Frances C.

    People inspired by rational-choice theory are advocating choice policies. Their recommendations are based on implicit assumptions about how school leaders would respond to a choice system. This survey research study investigated the demographic characteristics of open and closed districts during Ohio's first year of full interdistrict open…

  11. 77 FR 47792 - Drawbridge Operation Regulation; Schuylkill River, Philadelphia, PA

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-08-10

    ... to have minimal impact on mariners due to no requests requiring openings for the past 13 years and no... requests requiring openings for the past 13 years. Vessels that can safely transit under the bridge (with a... from Conrail 13 years ago and there have been no requests requiring openings. Based on this lack of...

  12. 77 FR 16556 - Kootenai National Wildlife Refuge, Boundary County, ID; Final Comprehensive Conservation Plan and...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-03-21

    ... auto tour route that is open year- round to vehicles, walking, bicycling, jogging, dog walking (on... slightly over 5 miles of trails that are open to walking, jogging, and dog walking (on leash only) year... will remain open year round to vehicles, walking, bicycling, jogging, dog walking (on leash only...

  13. A Systematic Review of Tennis Elbow Surgery: Open Versus Arthroscopic Versus Percutaneous Release of the Common Extensor Origin.

    PubMed

    Pierce, Todd P; Issa, Kimona; Gilbert, Benjamin T; Hanly, Brian; Festa, Anthony; McInerney, Vincent K; Scillia, Anthony J

    2017-06-01

    To compare complications, function, pain, and patient satisfaction after conventional open, percutaneous, or arthroscopic release of the extensor origin for the treatment of lateral epicondylitis. A thorough review of 4 databases-PubMed, EBSCOhost, CINAHL (Cumulative Index to Nursing and Allied Health Literature) Plus, and Scopus-was performed to identify all studies that addressed surgical management of lateral epicondylitis. We included (1) studies published between 2000 and 2015 and (2) studies with clearly defined surgical techniques. We excluded (1) non-English-language manuscripts, (2) isolated case reports, (3) studies with fewer than 10 subjects, (4) animal studies, (5) studies with additional adjunctive procedures aside from release of the extensor origin, (6) clinical or systematic review manuscripts, (7) studies with a follow-up period of 6 months or less, and (8) studies in which less than 80% of patients completed follow-up. Each study was analyzed for complication rates, functional outcomes, pain, and patient satisfaction. Thirty reports were identified that included 848 open, 578 arthroscopic, and 178 percutaneous releases. Patients within each release group had a similar age (46 years vs 46 years vs 48 years; P = .9 and P = .4, respectively), whereas there was a longer follow-up time in patients who underwent surgery by an open technique (49.4 months vs 42.6 months vs 23 months, P < .001). There were no differences in complication rates among these techniques (3.8% vs 2.9% vs 3.9%; P = .5 and P = .9, respectively). However, open techniques were correlated with higher surgical-site infection rates than arthroscopic techniques (0.7% vs 0%, P = .04). Mean Disabilities of the Arm, Shoulder and Hand scores were substantially better with both open and arthroscopic techniques than with percutaneous release (19.9 points vs 21.3 points vs 29 points, P < .001). In addition, there was less pain reported in the arthroscopic and percutaneous release groups as opposed to their open counterparts (1.9 points vs 1.4 points vs 1.3 points, P < .0001). There were no differences among the techniques in patient satisfaction rate (93.7% vs 89% vs 88%; P = .08 and P = .07, respectively). Functional outcomes of open and arthroscopic releases may be superior to those of percutaneous release. In addition, patients may report less pain with arthroscopic and percutaneous techniques. Although the risk of complications is similar regardless of technique, patients may be counseled that their risk of infectious complications may be slightly higher with open releases. However, it is important to note that this statistical difference may not necessarily portend noticeable clinical differences. Level IV, systematic review of Level III and IV evidence. Copyright © 2017 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.

  14. A Prospective Randomized Trial to Assess Fixation Strategies for Severe Open Tibia Fractures: Modern Ring External Fixators Versus Internal Fixation (FIXIT Study).

    PubMed

    OʼToole, Robert V; Gary, Joshua L; Reider, Lisa; Bosse, Michael J; Gordon, Wade T; Hutson, James; Quinnan, Stephen M; Castillo, Renan C; Scharfstein, Daniel O; MacKenzie, Ellen J

    2017-04-01

    The treatment of high-energy open tibia fractures is challenging in both the military and civilian environments. Treatment with modern ring external fixation may reduce complications common in these patients. However, no study has rigorously compared outcomes of modern ring external fixation with commonly used internal fixation approaches. The FIXIT study is a prospective, multicenter randomized trial comparing 1-year outcomes after treatment of severe open tibial shaft fractures with modern external ring fixation versus internal fixation among men and women of ages 18-64. The primary outcome is rehospitalization for major limb complications. Secondary outcomes include infection, fracture healing, limb function, and patient-reported outcomes including physical function and pain. One-year treatment costs and patient satisfaction will be compared between the 2 groups, and the percentage of Gustilo IIIB fractures that can be salvaged without soft tissue flap among patients receiving external fixation will be estimated.

  15. The 2017 Bioinformatics Open Source Conference (BOSC).

    PubMed

    Harris, Nomi L; Cock, Peter J A; Chapman, Brad; Fields, Christopher J; Hokamp, Karsten; Lapp, Hilmar; Munoz-Torres, Monica; Tzovaras, Bastian Greshake; Wiencko, Heather

    2017-01-01

    The Bioinformatics Open Source Conference (BOSC) is a meeting organized by the Open Bioinformatics Foundation (OBF), a non-profit group dedicated to promoting the practice and philosophy of Open Source software development and Open Science within the biological research community. The 18th annual BOSC ( http://www.open-bio.org/wiki/BOSC_2017) took place in Prague, Czech Republic in July 2017. The conference brought together nearly 250 bioinformatics researchers, developers and users of open source software to interact and share ideas about standards, bioinformatics software development, open and reproducible science, and this year's theme, open data. As in previous years, the conference was preceded by a two-day collaborative coding event open to the bioinformatics community, called the OBF Codefest.

  16. Turkish Pupils' Conceptions of the Particulate Nature of Matter

    ERIC Educational Resources Information Center

    Boz, Yezdan

    2006-01-01

    The purpose of this research study is to explore year 6, 8 & 11 (13, 15 and 17 years old respectively) Turkish pupils' views about the particulate nature of matter within the context of phase changes. About 300 pupils participated in the study. Questionnaires distributed to year 6, 8 and 11 pupils included 6-item open-ended questions about (a)…

  17. Demographic Characteristics of a Maine Woodcock Population and Effects of Habitat Management

    USGS Publications Warehouse

    Dwyer, T.J.; Sepik, G.F.; Derleth, E.L.; McAuley, D.G.

    1988-01-01

    A population of American woodcock (Scolopax minor) was studied on a 3,401-ha area of the Moosehorn National Wildlife Refuge in northeastern Maine from 1976 through 1985. During 1976-83, from 4 to 64 clearcuts were created each year, opening up large contiguous blocks of forest. A combination of mist nets, ground traps, nightlighting techniques, and trained dogs were used to capture and band 1,884 birds during the first 5 years. Capture and recapture data (totaling 3,009 observations) were used with both demographically closed and open population models to estimate population size and, for open population models, summer survival. Flying young, especially young males, represented the greatest proportion of all captures; analysis showed that young males were more prone to capture than young females. Male courtship began about 24 March each year, usually when there was still snow in wooded areas. Males ~2 years old dominated singing grounds during April each year, but this situation changed and first-year males dominated singing grounds in May. Singing males shifted from older established singing grounds to new clearcuts soon after we initiated forest management. Many males were subdominant at singing grounds despite an abundance of unoccupied openings. Three hundred adult females were captured and, except for 1978, the majority were ~2 years old. The year in which female homing rate was lowest(1979) was preceded by the year with the largest number of l-year-old brood female captures and a summer drought. Summer survival of young was lowest in 1978 and was attributed to summer drought. The year 1979 had an abnormally cool and wet spring, and was the poorest for production of young. Capture ratios of young-to-adult females obtained by nightlighting could be used to predict production on our study area. Closed population model estimates did not seem to fit either young or adult data sets well. Instead, a partially open capture-recapture model that allowed death but no immigration seemed to fit best. Only the number of males in the population changed significantly during the study. An increase from 88 males in 1976 to 156 in 1980 was attributed to habitat management. Singingmale surveys on our area detected little change in the number of singing males, but our independent population estimates from mark-recapture data showed a larger total male population by 1980. Annual density estimates for all age and sex classes ranged from 19 to 25 birds/l00 ha. A hypothesis on the breeding system of the American woodcock is presented as well as a discussion of management implications, including the importance of creating high-quality habitat on private lands.

  18. Ten Years of Open Practice: A Reflection on the Impact of OpenLearn

    ERIC Educational Resources Information Center

    Law, Patrina; Jelfs, Anne

    2016-01-01

    The Open University (OU) makes a proportion of all its taught modules available to the public via OpenLearn each year. This process involves the modification, of module excerpts, showcasing subject matter and teaching approach. This activity serves both the University's social and business missions through the delivery of free courses to the…

  19. Where "Sign Language Studies" Has Led Us in Forty Years: Opening High School and University Education for Deaf People in Viet Nam through Sign Language Analysis, Teaching, and Interpretation

    ERIC Educational Resources Information Center

    Woodward, James; Hoa, Nguyen Thi

    2012-01-01

    This paper discusses how the Nippon Foundation-funded project "Opening University Education to Deaf People in Viet Nam through Sign Language Analysis, Teaching, and Interpretation," also known as the Dong Nai Deaf Education Project, has been implemented through sign language studies from 2000 through 2012. This project has provided deaf…

  20. Concerns of the Novice Physical Education Teacher

    ERIC Educational Resources Information Center

    Gordon, Evelyn J.

    2016-01-01

    The purpose of this case study was to examine novice physical education teachers in the first and second year of teaching. Participants included two novice physical education teachers, John in Year 1 and Mark in Year 2. Methodology included observations, semistructured interviews, and documents. Data were analyzed using open coding and constant…

  1. The OpenMP Implementation of NAS Parallel Benchmarks and its Performance

    NASA Technical Reports Server (NTRS)

    Jin, Hao-Qiang; Frumkin, Michael; Yan, Jerry

    1999-01-01

    As the new ccNUMA architecture became popular in recent years, parallel programming with compiler directives on these machines has evolved to accommodate new needs. In this study, we examine the effectiveness of OpenMP directives for parallelizing the NAS Parallel Benchmarks. Implementation details will be discussed and performance will be compared with the MPI implementation. We have demonstrated that OpenMP can achieve very good results for parallelization on a shared memory system, but effective use of memory and cache is very important.

  2. Ten-year diameter and basal area growth of trees surrounding small group selection openings

    Treesearch

    Philip M. McDonald; Martin W. Ritchie; Celeste S. Abbott

    1996-01-01

    The effects of small openings in forest stands has interested silviculturists and ecologists for years. Interest generally has centered on the vegetation in the openings, not on that immediately outside of them. Quantitative information on the growth of trees adjacent to group-selection openings, although often mentioned in forestry textbooks as contributing to cost...

  3. Easy to open? Exploring the 'openability' of hospital food and beverage packaging by older adults.

    PubMed

    Bell, Alison F; Walton, Karen L; Tapsell, Linda C

    2016-03-01

    Food is increasingly a packaged commodity, both in the community and in institutionalised settings such as hospitals, where many older people are malnourished. Previous research with patients aged over 65 years in NSW public hospitals identified difficulties opening milk, water, juices, cereal and tetra packs. The aim of this paper was to assess the ability of well older people living in the community to open food and beverage items routinely used in NSW hospitals in order to gain further insights into the older person/pack interaction and the role of hand and finger strength in pack opening. A sample of 40 older people in good health aged over 65 years from 3 community settings participated in the study. The attempts at pack opening were observed, the time taken to open the pack was measured and the correlation between grip and pinch strengths with opening times was determined. Tetra packs, water bottles, cereal, fruit cups, desserts, biscuits and cheese portions appeared to be the most difficult food products to open. Ten percent of the sample could not open the water bottles and 39% could not open cheese portions. The results were consistent with the previous research involving hospitalised older adults, adding emphasis to the conclusion that food and beverage packaging can be a potential barrier to adequate nutrition when particular types of packaged products are used in hospitals or the community. The ageing population is rapidly becoming a larger and more important group to consider in the provision of goods and services. Designers, manufacturers and providers of food and beverage products need to consider the needs and abilities of these older consumers to ensure good 'openability' and promote adequate nutritional intakes. Copyright © 2015 Elsevier Ltd. All rights reserved.

  4. The Pedagogic Architecture of MOOC: A Research Project on Educational Courses in Spanish

    ERIC Educational Resources Information Center

    Fernández-Díaz, Elia; Rodríguez-Hoyos, Carlos; Salvador, Adelina Calvo

    2017-01-01

    This study has been carried out within the context of the ECO European Project (E-learning, Communication Open-Data: Massive Mobile, Ubiquitous, and Open Learning) which is being financed by the European Union over four years (2014-17). It analyses the pedagogic architecture of MOOC on pedagogic/educational subjects in Spanish over one academic…

  5. Effects of Examiner Training on Open-Ended, Higher Taxonomic Level Questioning in Oral Certification Examinations.

    ERIC Educational Resources Information Center

    Des Marchais, Jacques E.; Jean, Pierre

    1993-01-01

    A 5-year study investigated the effect of training on question-asking skills of 42 licensing examiners in orthopedic surgery. Results indicate that a three-hour training session resulted in examiners' asking many more open-ended and/or problem-solving questions, suggesting the effectiveness of the training program. (Author/MSE)

  6. How MOOC Instructors View the Pedagogy and Purposes of Massive Open Online Courses

    ERIC Educational Resources Information Center

    Evans, Suzannah; Myrick, Jessica Gall

    2015-01-01

    Massive open online courses (MOOCs) have proliferated in recent years despite disagreement about the role of MOOCs in higher education and whether student outcomes are satisfactory. Taking a mixed-methods approach, the current study surveys professors who have taught MOOCs (n = 162) in order to better understand how MOOCs are perceived by…

  7. Communicating the Open Access Message: A Case Study from Ireland

    ERIC Educational Resources Information Center

    Lawton, Aoife

    2016-01-01

    Since 2009, Open Access (OA) Week has been celebrated worldwide in October each year. It is an opportunity for librarians to engage with the research community and demonstrate the value that they bring to their organisations in the area of disseminating scholarly output. Although thousands of events have been held since the inception of OA Week, a…

  8. Long Term Stability of Learning Outcomes in Undergraduates after an Open-Inquiry Instruction on Thermal Science

    ERIC Educational Resources Information Center

    Adorno, Dominique Persano; Pizzolato, Nicola; Fazio, Claudio

    2018-01-01

    This paper investigates the efficacy of an open-inquiry approach to achieve a long term stability of physics instruction. This study represents the natural continuation of a research project started four years ago when a sample of thirty engineering undergraduates, having already attended traditional university physics instruction, were involved…

  9. Shaping Software Engineering Curricula Using Open Source Communities: A Case Study

    ERIC Educational Resources Information Center

    Bowring, James; Burke, Quinn

    2016-01-01

    This paper documents four years of a novel approach to teaching a two-course sequence in software engineering as part of the ABET-accredited computer science curriculum at the College of Charleston. This approach is team-based and centers on learning software engineering in the context of open source software projects. In the first course, teams…

  10. Exploring the Relationship between Experienced Students' Preference for Open- and Closed-Book Examinations, Approaches to Learning and Achievement

    ERIC Educational Resources Information Center

    Karagiannopoulou, Evangelia; Milienos, Fotios S.

    2013-01-01

    The relationship between university students' approaches to learning and preference for the open- and closed-book examinations was investigated for 144 Greek undergraduate (56 third- and 88 fourth-year) students attending a Philosophy, Education and Psychology Department. The approaches were explored by the Approaches and Study Skills Inventory…

  11. Student Teachers' Experiences of Teaching Practice at Open and Distance Learning Institution in South Africa

    ERIC Educational Resources Information Center

    Mokoena, Sello

    2017-01-01

    This small-scale study focused on the experiences of student teachers towards teaching practice in an open and distance learning (ODL) institution in South Africa. The sample consisted of 65 fourth year students enrolled for Bachelor of Education, specializing in secondary school teaching. The mixed-method research design consisting of…

  12. Open Data, Open Source and Open Standards in chemistry: The Blue Obelisk five years on

    PubMed Central

    2011-01-01

    Background The Blue Obelisk movement was established in 2005 as a response to the lack of Open Data, Open Standards and Open Source (ODOSOS) in chemistry. It aims to make it easier to carry out chemistry research by promoting interoperability between chemistry software, encouraging cooperation between Open Source developers, and developing community resources and Open Standards. Results This contribution looks back on the work carried out by the Blue Obelisk in the past 5 years and surveys progress and remaining challenges in the areas of Open Data, Open Standards, and Open Source in chemistry. Conclusions We show that the Blue Obelisk has been very successful in bringing together researchers and developers with common interests in ODOSOS, leading to development of many useful resources freely available to the chemistry community. PMID:21999342

  13. Factors associated with the prevalence of anterior open bite among preschool children: A population-based study in Brazil

    PubMed Central

    Machado, Daniella Borges; Brizon, Valéria Silva Cândido; Ambrosano, Gláucia Maria Bovi; Madureira, Davidson Fróis; Gomes, Viviane Elisângela; de Oliveira, Ana Cristina Borges

    2014-01-01

    INTRODUCTION: The aim of this study was to identify factors associated with the prevalence of anterior open bite among five-year-old Brazilian children. METHODS: A cross-sectional study was undertaken using data from the National Survey of Oral Health (SB Brazil 2010). The outcome variable was anterior open bite classified as present or absent. The independent variables were classified by individual, sociodemographic and clinical factors. Data were analyzed through bivariate and multivariate analysis using SPSS statistical software (version 18.0) with a 95% level of significance. RESULTS: The prevalence of anterior open bite was 12.1%. Multivariate analysis showed that preschool children living in Southern Brazil had an increased chance of 1.8 more times of having anterior open bite (CI 95%: 1.16 - 3.02). Children identified with alterations in overjet had 14.6 times greater chances of having anterior open bite (CI 95%: 8.98 - 24.03). CONCLUSION: There was a significant association between anterior open bite and the region of Brazil where the children lived, the presence of altered overjet and the prevalence of posterior crossbite. PMID:25715723

  14. Cost-effectiveness of endovascular repair, open repair, and conservative management of splenic artery aneurysms.

    PubMed

    Hogendoorn, Wouter; Lavida, Anthi; Hunink, M G Myriam; Moll, Frans L; Geroulakos, George; Muhs, Bart E; Sumpio, Bauer E

    2015-06-01

    Open repair (OPEN) and conservative management (CONS) have been the treatments of choice for splenic artery aneurysms (SAAs) for many years. Endovascular repair (EV) has been increasingly used with good short-term results. In this study, we evaluated the cost-effectiveness of OPEN, EV, and CONS for the treatment of SAAs. A decision analysis model was developed using TreeAge Pro 2013 software (TreeAge Inc, Williamstown, Mass) to evaluate the cost-effectiveness of the different treatments for SAAs. A hypothetical cohort of 10,000 55-year-old female patients with SAAs was assessed in the reference-case analysis. Perioperative mortality, disease-specific mortality rates, complications, rupture risks, and reinterventions were retrieved from a recent and extensive meta-analysis. Costs were analyzed with the 2014 Medicare database. The willingness to pay was set to $60,000/quality-adjusted life years (QALYs). Outcomes evaluated were QALYs, costs from the health care perspective, and the incremental cost-effectiveness ratio (ICER). Extensive sensitivity analyses were performed and different clinical scenarios evaluated. Probabilistic sensitivity analysis was performed to include the uncertainty around the variables. A flowchart for clinical decision-making was developed. For a 55-year-old female patient with a SAA, EV has the highest QALYs (11.32; 95% credibility interval [CI], 9.52-13.17), followed by OPEN (10.48; 95% CI, 8.75-12.25) and CONS (10.39; 95% CI, 8.96-11.87). The difference in effect for 55-year-old female patients between EV and OPEN is 0.84 QALY (95% CI, 0.42-1.34), comparable with 10 months in perfect health. EV is more effective and less costly than OPEN and more effective and more expensive compared with CONS, with an ICER of $17,154/QALY. Moreover, OPEN, with an ICER of $223,166/QALY, is not cost-effective compared with CONS. In elderly individuals (age >78 years), the ICER of EV vs CONS is $60,503/QALY and increases further with age, making EV no longer cost-effective. Very elderly patients (age >93 years) have higher QALYs and lower costs when treated with CONS. The EV group has the highest number of expected reinterventions, followed by CONS and OPEN, and the number of expected reinterventions decreases with age. EV is the most cost-effective treatment for most patient groups with SAAs, independent of the sex and risk profile of the patient. EV is superior to OPEN, being both cost-saving and more effective in all age groups. Elderly patients should be considered for CONS, based on the high costs in relation to the very small gain in health when treated with EV. The very elderly should be treated with CONS. Copyright © 2015 Society for Vascular Surgery. Published by Elsevier Inc. All rights reserved.

  15. Ultrathin Silicon Sheet in the Management of Unilateral Post-traumatic Temporo-Mandibuar Joint Ankylosis in Children: A Good Alternative to Conventional Techniques.

    PubMed

    Aggarwal, Sushil Kumar; Ankur, Bhatnagar; Jain, R K

    2015-09-01

    We have described a new technique of using ultra-thin silicon sheet (0.2 mm) between two transected bony ends for temporo-mandibular joint (TMJ) ankylosis in children with advantages of short operative time, minimal foreign material insertion and faster recovery time post-operatively which makes our technique a good alternative to conventional techniques. Our study is a non-randomized prospective study conducted on 10 children aged between 4 and 15 years who presented to our tertiary care institute with severe trismus after traumatic injury and were willing to undergo this new technique. The main outcome measure taken into consideration was difference between pre-operative, intra-operative (on table) and post-operative mouth opening (minimum 2 years follow-up). The pre-operative mouth opening in our cases varied from 1 to 5 mm. The intra-operative mouth opening achieved ranged from 2.8 to 3.2 cm. The mouth opening was about more than 2.7 cm in all our cases at 2 years of follow-up. Our technique is a good alternative to conventional techniques used for TMJ ankylosis in children but few more randomized controlled trials are required to assess its effectiveness in comparison to conventional techniques and for universal adoption of this technique.

  16. Mouth opening in patients irradiated for head and neck cancer: a prospective repeated measures study.

    PubMed

    Kamstra, J I; Dijkstra, P U; van Leeuwen, M; Roodenburg, J L N; Langendijk, J A

    2015-05-01

    Aims of this prospective cohort study were (1) to analyze the course of mouth opening up to 48months post-radiotherapy (RT), (2) to assess risk factors predicting decrease in mouth opening, and (3) to develop a multivariable prediction model for change in mouth opening in a large sample of patients irradiated for head and neck cancer. Mouth opening was measured prior to RT (baseline) and at 6, 12, 18, 24, 36, and 48months post-RT. The primary outcome variable was mouth opening. Potential risk factors were entered into a linear mixed model analysis (manual backward-stepwise elimination) to create a multivariable prediction model. The interaction terms between time and risk factors that were significantly related to mouth opening were explored. The study population consisted of 641 patients: 70.4% male, mean age at baseline 62.3years (sd 12.5). Primary tumors were predominantly located in the oro- and nasopharynx (25.3%) and oral cavity (20.6%). Mean mouth opening at baseline was 38.7mm (sd 10.8). Six months post-RT, mean mouth opening was smallest, 36.7mm (sd 10.0). In the linear mixed model analysis, mouth opening was statistically predicted by the location of the tumor, natural logarithm of time post-RT in months (Ln (months)), gender, baseline mouth opening, and baseline age. All main effects interacted with Ln (months). The mean mouth opening decreased slightly over time. Mouth opening was predicted by tumor location, time, gender, baseline mouth opening, and age. The model can be used to predict mouth opening. Copyright © 2015 Elsevier Ltd. All rights reserved.

  17. Evaluation of the Citizenship Consciousness of the 8th Year Students

    ERIC Educational Resources Information Center

    Tonga, Deniz; Keles, Hamza

    2014-01-01

    The prime purpose of this study is to elucidate the awareness level of citizenship of 8th year students. That was why the answer of the question "what is the level of citizenship consciousness of the 8th year students" was sought. The study was designed according to the descriptive survey method with the use of a scale with 7 open ended…

  18. Clinical events after transitioning from apixaban versus warfarin to warfarin at the end of the Apixaban for Reduction in Stroke and Other Thromboembolic Events in Atrial Fibrillation (ARISTOTLE) trial.

    PubMed

    Granger, Christopher B; Lopes, Renato D; Hanna, Michael; Ansell, Jack; Hylek, Elaine M; Alexander, John H; Thomas, Laine; Wang, Junyuan; Bahit, M Cecilia; Verheugt, Freek; Lawrence, Jack; Xavier, Denis; Wallentin, Lars

    2015-01-01

    We sought to assess the occurrence of events after blinded study drug discontinuation and transition to open-label vitamin K antagonist (VKA) in ARISTOTLE. At the end of ARISTOTLE, blinded study drug was stopped, and open-label VKA was recommended. For patients completing the trial on blinded study drug, a 2-day bridging period with apixaban or apixaban placebo was recommended (while beginning open-label VKA). Outcomes were assessed during the 30 days after stopping blinded study drug. Of the 6,809 patients in the apixaban group and 6,588 in the warfarin group who completed the trial on study drug, there were 21 strokes or systemic emboli (4.02%/year) and 26 major bleeding (4.97%/year) events in the apixaban group (transitioning to VKA) and 5 strokes or systemic emboli (0.99%/year) and 10 major bleeding (1.97%/year) events in the warfarin group (continuing on VKA), with most of the imbalance between groups being after the first week. Similar results were seen in the first 30 days of the trial where warfarin-naive patients starting warfarin had a higher rate of stroke or systemic emboli (5.41%/year) than warfarin-experienced patients (1.42%/year), a pattern not seen when starting apixaban. No similar increase in events with apixaban versus warfarin was seen during temporary or permanent study drug discontinuation during the trial. The excess in thrombotic and bleeding events in the apixaban group after study drug discontinuation appears to be related to an increased risk associated with the initiation of a VKA rather than a direct effect of apixaban. Whether ≥2 days of apixaban bridging improves outcomes during VKA transition is unknown and deserves further evaluation. Copyright © 2014 Elsevier Inc. All rights reserved.

  19. Personality traits and perceptions of organisational justice.

    PubMed

    Törnroos, Maria; Elovainio, Marko; Hintsa, Taina; Hintsanen, Mirka; Pulkki-Råback, Laura; Jokela, Markus; Lehtimäki, Terho; Raitakari, Olli T; Keltikangas-Järvinen, Liisa

    2018-01-04

    This study examined the association between five-factor model personality traits and perceptions of organisational justice. The sample for the study comprised 903 participants (35-50 years old; 523 women) studied in 2007 and 2012. Measures used were the Neuroticism, Extraversion, Openness, Five-Factor Inventory questionnaire and the short organisational justice measure. The results showed that high neuroticism was associated with low distributive, procedural and interactional justice. Furthermore, high agreeableness was associated with high procedural and interactional justice and high openness with high distributive justice. This study suggests that neuroticism, agreeableness and openness are involved in perceptions of organisational justice and that personality should be considered in research and in practices at the workplace. © 2018 International Union of Psychological Science.

  20. Open-Label Milnacipran for Patients With Persistent Knee Pain 1 Year or Longer After Total Knee Arthroplasty: A Pilot Study

    PubMed Central

    Bolognesi, Michael P.

    2013-01-01

    Objective: The current study investigates whether milnacipran is effective in reducing pain and improving function in patients with persistent pain ≥ 1 year after total knee arthroplasty. Method: This was a 12-week open-label study of flexibly dosed milnacipran in patients (N = 5) experiencing chronic persistent knee pain ≥ 1 year following total knee arthroplasty in the absence of new injury, infection, or implant failure. Subjects were identified from October 2010 to August 2011 through the Duke University Medical Center orthopedic clinic (Durham, North Carolina), typically during 1-year postoperative follow-up visits, and were referred by their orthopedic surgeon. Results: Milnacipran treatment was associated with reduction in pain according to the primary outcome measure of the visual analog scale (VAS) score for pain (effect size of 1.15) and secondary outcome measures of Knee Society Score (KSS) evaluation subscale score (effect size of 1.37) and Medical Outcomes Study 36-item Short-Form Health Survey (SF-36) bodily pain subscale (effect size of 1.16) at week 12. Secondary outcome measures of functional change were mixed in such that, at week 12, the SF-36 physical functioning subscale showed improvement (effect size of 1.16), but the KSS function subscale score was just below the threshold for meaningful effect size (0.98). Conclusions: Open-label milnacipran demonstrated reduced pain and some evidence of functional improvement in this small sample of patients with chronic persistent pain 1 year or more after total knee arthroplasty such that well-powered studies are warranted. Trial Registration: ClinicalTrials.gov identifier: NCT01780389 PMID:24392250

  1. A Mixed-Methods Study Assessing Special Education Preservice Candidates' Preparedness for Their First Year of Teaching

    ERIC Educational Resources Information Center

    Tillman, Beverly A.; Richards, Stephen B.; Frank, Catherine Lawless

    2011-01-01

    This study employed a Likert-type survey, "Praxis/Pathwise" written observations, as well as guided and open-ended reflections to assess the perceptions of preparedness for the first year of teaching for special education student teaching candidates. Cooperating teachers completed the survey and "Praxis/Pathwise" observations.…

  2. Elastic nailing of tibia shaft fractures in young children up to 10 years of age.

    PubMed

    Heo, Jeong; Oh, Chang-Wug; Park, Kyeong-Hyeon; Kim, Joon-Woo; Kim, Hee-June; Lee, Jong-Chul; Park, Il-Hyung

    2016-04-01

    Although tibia shaft fractures in children usually have satisfactory results after closed reduction and casting, there are several surgical indications, including associated fractures and soft tissue injuries such as open fractures. Titanium elastic nails (TENs) are often used for pediatric tibia fractures, and have the advantage of preserving the open physis. However, complications such as delayed union or nonunion are not uncommon in older children or open fractures. In the present study, we evaluated children up to 10 years of age with closed or open tibial shaft fractures treated with elastic nailing technique. A total of 16 tibia shaft fractures treated by elastic nailing from 2001 to 2013 were reviewed. The mean patient age at operation was 7 years (range: 5-10 years). Thirteen of 16 cases were open fractures (grade I: 4, grade II: 6, grade IIIA: 3 cases); the other cases had associated fractures that necessitated operative treatments. Closed, antegrade intramedullary nailing was used to insert two nails through the proximal tibial metaphysis. All patients were followed up for at least one year after the injury. Outcomes were evaluated using modified Flynn's criteria, including union, alignment, leg length discrepancies, and complications. All fractures achieved union a mean of 16.1 weeks after surgery (range: 11-26 weeks). No patient reported knee pain or experienced any loss of knee or ankle motion. There was a case of superficial infection in a patient with grade III open fracture. Three patients reported soft tissue discomfort due to prominent TEN tips at the proximal insertion site, which required cutting the tip before union or removing the nail after union. At the last follow-up, there were no angular or rotational deformities over 10° in either the sagittal or coronal planes. With the exception of one case with an overgrowth of 15 mm, no patient showed shortening or overgrowth exceeding 10mm. Among final outcomes, 15 were excellent and 1 was satisfactory. Even with open fractures or soft tissue injuries, elastic nailing can achieve satisfactory results in young children, with minimal complications of delayed bone healing, or infection. Copyright © 2015 Elsevier Ltd. All rights reserved.

  3. The 2016 Bioinformatics Open Source Conference (BOSC).

    PubMed

    Harris, Nomi L; Cock, Peter J A; Chapman, Brad; Fields, Christopher J; Hokamp, Karsten; Lapp, Hilmar; Muñoz-Torres, Monica; Wiencko, Heather

    2016-01-01

    Message from the ISCB: The Bioinformatics Open Source Conference (BOSC) is a yearly meeting organized by the Open Bioinformatics Foundation (OBF), a non-profit group dedicated to promoting the practice and philosophy of Open Source software development and Open Science within the biological research community. BOSC has been run since 2000 as a two-day Special Interest Group (SIG) before the annual ISMB conference. The 17th annual BOSC ( http://www.open-bio.org/wiki/BOSC_2016) took place in Orlando, Florida in July 2016. As in previous years, the conference was preceded by a two-day collaborative coding event open to the bioinformatics community. The conference brought together nearly 100 bioinformatics researchers, developers and users of open source software to interact and share ideas about standards, bioinformatics software development, and open and reproducible science.

  4. Ease of opening of blistered solid dosage forms in a senior citizens target group.

    PubMed

    Braun-Münker, Myriam; Ecker, Felix

    2016-10-30

    Blisters differing in design and handling are established as packaging material for solid dosage forms. The ease of opening of blisters influences application and patient's compliance. In this study the influence of visibility and movability of solid dosage forms in blister packaging on both, easy opening and patient's satisfaction, were investigated by target group testing according to ONR CEN/TS 15945. For each testing 20 participants in the age of 65-80 years were recruited randomly. They opened the blisters on realistic terms without any auxiliary devices. Video documentation of the hands' movements was recorded to analyze the opening procedure. To show the influence of visibility of the dosage form in the blister, capsules size 1 were packed in transparent and opaque blisters. A moderate influence of the visibility on both, the ease of opening and patient satisfaction, was observed. A second study dealt with the movability of solid dosage forms in blisters. Therefore, three different sizes of tablets with similar shapes were packed in identical cavities. Limited movability was found as major criterion on effectiveness and effectivity of opening as well as on satisfaction with the opening procedure. Copyright © 2015 Elsevier B.V. All rights reserved.

  5. The "Open-Earedness" Hypothesis and the Development of Age-Related Aesthetic Reactions to Music in Elementary School Children

    ERIC Educational Resources Information Center

    Kopiez, Reinhard; Lehmann, Marco

    2008-01-01

    This study investigates age-related changes in musical preference in elementary school children. The tolerance towards unconventional musical styles has been called "open-earedness" (Hargreaves, 1982a), and it is assumed to decline with increasing age. Musical preferences of 186 students from grade 1 to 4 (age range: 6-10 years) were…

  6. Teaching Mathematics in Open Distance Learning (ODL): A Challenge to Quality Instruction?

    ERIC Educational Resources Information Center

    Kaino, L. M.

    2012-01-01

    Teaching mathematics through Open Distance Learning (ODL) has been a challenge to educators due to the nature of communication with learners and material delivery during instruction. In this paper, as a case study, we look at one mathematics module offered through ODL and the performance in the course for the past four years. A sample of 50…

  7. The Impact of Different Modalities on Student Retention and Overall Engagement Patterns in Open Online Courses

    ERIC Educational Resources Information Center

    Friðriksdóttir, Kolbrún

    2018-01-01

    This article presents an analysis of tracking data collected over eight years on 43,000 users on "Icelandic Online (IOL)," seven open, guided online courses in Icelandic as a second language. The main objective in this study is to (a) map out retention for all the "IOL" courses, (b) compare retention on the same course…

  8. Affordable and Open Textbooks: An Exploratory Study of Faculty Attitudes. Research & Occasional Paper Series. CSHE.9.09

    ERIC Educational Resources Information Center

    Harley, Diane; Lawrence, Shannon; Acord, Sophia Krzys; Dixson, Jason

    2009-01-01

    The Student Public Interest Research Groups (Student PIRGs)--who have been at the forefront of raising awareness about textbook affordability for much of the past decade--launched a two-year campaign (MakeTextbooksAffordable.org/statement) in 2007 to drive mainstream faculty's acceptance of open textbooks and other affordable alternatives in place…

  9. Seed release in serotinous lodgepole pine forests after mountain pine beetle outbreak.

    PubMed

    Teste, François P; Lieffers, Victor J; Landhausser, Simon M

    2011-01-01

    There are concerns that large-scale stand mortality due to mountain pine beetle (MPB) could greatly reduce natural regeneration of serotinous Rocky Mountain (RM) lodgepole pine (Pinus contorta var. latifolia) because the closed cones are held in place without the fire cue for cone opening. We selected 20 stands (five stands each of live [control], 3 years since MPB [3-yr-MPB], 6 years since MPB [6-yr-MPB], and 9 years since MPB [9-yr-MPB] mortality) in north central British Columbia, Canada. The goal was to determine partial loss of serotiny due to fall of crown-stored cones via breakage of branches and in situ opening of canopy cones throughout the 2008 and 2009 growing seasons. We also quantified seed release by the opening of forest-floor cones, loss of seed from rodent predation, and cone burial. Trees killed by MPB three years earlier dropped approximately 3.5 times more cones via branch breakage compared to live stands. After six years, MPB-killed stands had released 45% of their canopy seed bank through cone opening, cone fall due to breakage, and squirrel predation. Further losses of canopy seed banks are expected with time since we found 9-yr-MPB stands had 38% more open canopy cones. This was countered by the development of a modest forest-floor seed bank (6% of the original canopy seed bank) from burial of cones; this seed bank may be ecologically important if a fire or anthropogenic disturbance reexposes these cones. If adequate levels of regeneration are to occur, disturbances to create seedbeds must occur shortly after tree mortality, before the seed banks are lost. Our findings also suggest that the sustained seed rain (over at least nine years) after MPB outbreak may be beneficial for population growth of ground-foraging vertebrates. Our study adds insight to the seed ecology of serotinous pines under a potentially continental-wide insect outbreak, threatening vast forests adapted to regeneration after fire. Key words: biotic disturbance; cone burial; cone opening; Dendroctonus ponderosae; ground-foraging vertebrates; mountain pine beetle; natural regeneration; Pinus contorta var. latifolia; Rocky Mountain lodgepole pine; seed banks; serotiny (canopy seed storage); Tamiasciurus hudsonicus.

  10. Parameterization and scaling of Arctic ice conditions in the context of ice-atmosphere processes

    NASA Technical Reports Server (NTRS)

    Barry, R. G.; Heinrichs, J.; Steffen, K.; Maslanik, J. A.; Key, J.; Serreze, M. C.; Weaver, R. W.

    1994-01-01

    This report summarizes achievements during year three of our project to investigate the use of ERS-1 SAR data to study Arctic ice and ice/atmosphere processes. The project was granted a one year extension, and goals for the final year are outlined. The specific objects of the project are to determine how the development and evolution of open water/thin ice areas within the interior ice pack vary under different atmospheric synoptic regimes; compare how open water/thin ice fractions estimated from large-area divergence measurements differ from fractions determined by summing localized openings in the pack; relate these questions of scale and process to methods of observation, modeling, and averaging over time and space; determine whether SAR data might be used to calibrate ice concentration estimates from medium and low-rate bit sensors (AVHRR and DMSP-OLS) and the special sensor microwave imager (SSM/I); and investigate methods to integrate SAR data for turbulent heat flux parametrization at the atmosphere interface with other satellite data.

  11. Effect of open rhinoplasty on the smile line.

    PubMed

    Tabrizi, Reza; Mirmohamadsadeghi, Hoori; Daneshjoo, Danadokht; Zare, Samira

    2012-05-01

    Open rhinoplasty is an esthetic surgical technique that is becoming increasingly popular, and can affect the nose and upper lip compartments. The aim of this study was to evaluate the effect of open rhinoplasty on tooth show and the smile line. The study participants were 61 patients with a mean age of 24.3 years (range, 17.2 to 39.6 years). The surgical procedure consisted of an esthetic open rhinoplasty without alar resection. Analysis of tooth show was limited to pre- and postoperative (at 12 months) tooth show measurements at rest and the maximum smile with a ruler (when participants held their heads naturally). Statistical analyses were performed with SPSS 13.0, and paired-sample t tests were used to compare tooth show means before and after the operation. Analysis of the rest position showed no statistically significant change in tooth show (P = .15), but analysis of participants' maximum smile data showed a statistically significant increase in tooth show after surgery (P < .05). In contrast, Pearson correlation analysis showed a positive relation between rhinoplasty and tooth show increases in maximum smile, especially in subjects with high smile lines. This study shows that the nasolabial compartment is a single unit and any change in 1 part may influence the other parts. Further studies should be conducted to investigate these interactions. Copyright © 2012 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

  12. Open three-stage transthoracic oesophagectomy versus minimally invasive thoraco-laparoscopic oesophagectomy for oesophageal cancer: protocol for a multicentre prospective, open and parallel, randomised controlled trial.

    PubMed

    Mu, Juwei; Gao, Shugeng; Mao, Yousheng; Xue, Qi; Yuan, Zuyang; Li, Ning; Su, Kai; Yang, Kun; Lv, Fang; Qiu, Bin; Liu, Deruo; Chen, Keneng; Li, Hui; Yan, Tiansheng; Han, Yongtao; Du, Ming; Xu, Rongyu; Wen, Zhaoke; Wang, Wenxiang; Shi, Mingxin; Xu, Quan; Xu, Shun; He, Jie

    2015-11-17

    Oesophageal cancer is the eighth most common cause of cancer worldwide. In 2009 in China, the incidence and death rate of oesophageal cancer was 22.14 per 100 000 person-years and 16.77 per 100 000 person-years, respectively, the highest in the world. Minimally invasive oesophagectomy (MIO) was introduced into clinical practice with the aim of reducing the morbidity rate. The mechanisms of MIO may lie in minimising the reaction to surgical injury and inflammation. There are some randomised trials regarding minimally invasive versus open oesophagectomy, with 100-850 subjects enrolled. To date, no large randomised controlled trial comparing minimally invasive versus open oesophagectomy has been reported in China, where squamous cell carcinoma predominated over adenocarcinoma of the oesophagus. This is a 3 year multicentre, prospective, randomised, open and parallel controlled trial, which aims to compare the effectiveness of minimally invasive thoraco-laparoscopic oesophagectomy to open three-stage transthoracic oesophagectomy for resectable oesophageal cancer. Group A patients receive MIO which involves thoracoscopic oesophagectomy and laparoscopic gastric mobilisation with cervical anastomosis. Group B patients receive the open three-stage transthoracic oesophagectomy which involves a right thoracotomy and laparotomy with cervical anastomosis. Primary endpoints include respiratory complications within 30 days after operation. The secondary endpoints include other postoperative complications, influences on pulmonary function, intraoperative data including blood loss, operative time, the number and location of lymph nodes dissected, and mortality in hospital, the length of hospital stay, total expenses in hospital, mortality within 30 days, survival rate after 2 years, postoperative pain, and health-related quality of life (HRQoL). Three hundred and twenty-four patients in each group will be needed and a total of 648 patients will finally be enrolled into the study. The study protocol has been approved by the Institutional Ethics Committees of all participating institutions. The findings of this trial will be disseminated to patients and through peer-reviewed publications and international presentations. NCT02355249. 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/

  13. Cumulative incidence of graft infection after primary prosthetic aortic reconstruction in the endovascular era.

    PubMed

    Berger, P; Vaartjes, I; Moll, F L; De Borst, G J; Blankensteijn, J D; Bots, M L

    2015-05-01

    The introduction of endovascular techniques has had a major impact on the case mix of patients that undergo open aortic reconstruction. Hypothetically, this may also have increased the incidence of aortic graft infection (AGI). The aim of this study was to report on the short and mid-term incidence of AGI after primary open prosthetic aortic reconstruction in the endovascular era. From 2000 to 2010, all 514 patients in a tertiary referral university hospital, undergoing primary open prosthetic aortic reconstruction for aneurysmal or occlusive aortic disease with at least one aortic anastomosis were included. Data were obtained by retrospectively analyzing the medical records, by contacting patients or their general practitioner by telephone, and by merging the dataset with the national Cause of Death Register. AGI was defined as proven by cultures or clinically in combination with positive imaging results. The 30 day, 1 year, and 2 year incidence rates were computed using life table analysis and expressed as percentages with 95% confidence intervals (CI). AGI was diagnosed in 23 of the 514 included patients. 56% of the patients underwent elective surgery and 86% underwent surgery for an abdominal aortic aneurysm. The 30 day incidence was 1.6% (95% CI 0.4-2.8%), 1 year incidence was 3.6% (95% CI 1.7-5.5%), and 2 year incidence for AGI was 4.5% (95% CI 2.4-6.6%). The total number of person years (1058) yielded an AGI rate of 2.2 per 100 person years. The 2 year cumulative incidence of AGI following primary, open aortic procedures with at least one aortic anastomosis is considerable, at around 1 in 20. Copyright © 2015 European Society for Vascular Surgery. Published by Elsevier Ltd. All rights reserved.

  14. Cost Analysis of Endovascular versus Open Repair in the Treatment of Thoracic Aortic Aneurysms

    PubMed Central

    Gillen, Jacob R.; Schaheen, Basil W.; Yount, Kenan W.; Cherry, Kenneth J.; Kern, John A.; Kron, Irving L.; Upchurch, Gilbert R.; Lau, Christine L.

    2014-01-01

    Objective For descending thoracic aortic aneurysms (TAAs), it is generally considered that endovascular stents (TEVARs) reduce operative morbidity and mortality compared to open surgical repair. However, long-term differences in patient survival have not been demonstrated, and an increased need for aortic reintervention has been observed. Many assume that TEVAR becomes less cost effective through time due to higher rates of reintervention and surveillance imaging. This study investigated mid-term outcomes and hospital costs of TEVAR compared with open TAA repair. Methods This was a retrospective, single institution review of elective thoracic aortic aneurysm repairs between 2005 and 2012. Patient demographics, operative outcomes, reintervention rates, and hospital costs were assessed. The literature was also reviewed to determine commonly observed complication and reintervention rates for TEVAR and open repair. Monte Carlo simulation was utilized to model and forecast hospital costs for TEVAR and open TAA repair up to 3 years post-intervention. Results Our cohort consisted of 131 TEVARs and 27 open repairs. TEVAR patients were significantly older (67.2 vs. 58.7, p=0.02) and trended towards a more severe comorbidity profile. Operative mortality for TEVAR and open repair was 5.3% and 3.7%, respectively (p=1.0). There was a trend towards more complications in the TEVAR group, although not statistically significant (all p>0.05). In-hospital costs were significantly greater in the TEVAR group ($52,008 vs. $37,172, p=0.001). However, cost modeling utilizing reported complication and reintervention rates from the literature overlaid with our cost data produced a higher cost for the open group in-hospital ($55,109 vs. $48,006) and at 3 years ($58,426 vs. $52,825). Interestingly, TEVAR hospital costs, not reintervention rates, were the most significant driver of cost in the TEVAR group. Conclusions Our institutional data showed a trend toward lower mortality and complication rates with open TAA repair, with significantly lower costs within this cohort compared to TEVAR. These findings were likely at least in part due to the milder comorbidity profile within these patients. In contrast, cost modeling using Monte Carlo simulation demonstrated lower costs with TEVAR compared to open repair at all time points up to 3 years post-intervention. Our institutional data shows that with appropriate patient selection, open repair can be performed safely with low complication rates comparable to TEVAR. The cost model argues that despite the costs associated with more frequent surveillance imaging and reinterventions, TEVAR remains the more cost effective option even years after TAA repair. PMID:25449008

  15. Early intervention with tafamidis provides long-term (5.5-year) delay of neurologic progression in transthyretin hereditary amyloid polyneuropathy.

    PubMed

    Waddington Cruz, Márcia; Amass, Leslie; Keohane, Denis; Schwartz, Jeffrey; Li, Huihua; Gundapaneni, Balarama

    2016-09-01

    Transthyretin hereditary amyloid polyneuropathy, also traditionally known as transthyretin familial amyloid polyneuropathy (ATTR-FAP), is a rare, relentless, fatal hereditary disorder. Tafamidis, an oral, non-NSAID, highly specific transthyretin stabilizer, demonstrated safety and efficacy in slowing neuropathy progression in early-stage ATTRV30M-FAP in a 1.5-year, randomized, double-blind, placebo-controlled trial, and 1-year open-label extension study, with a second long-term open-label extension study ongoing. Subgroup analysis of the effectiveness of tafamidis in the pivotal study and its open-label extensions revealed a relatively cohesive cohort of patients with mild neuropathy (i.e. Neuropathy Impairment Score for Lower Limbs [NIS-LL] ≤ 10) at the start of active treatment. Early treatment with tafamidis for up to 5.5 years (≥1 dose of tafamidis meglumine 20 mg once daily during the original trial or after switching from placebo in its extension) resulted in sustained delay in neurologic progression and long-term preservation of nutritional status in this cohort. Mean (95% CI) changes from baseline in NIS-LL and mBMI were 5.3 (1.6, 9.1) points and -7.8 (-44.3, 28.8) kg/m 2 × g/L at 5.5 years, respectively. No new safety issues or side effects were identified. These data represent the longest prospective evaluation of tafamidis to date, confirm a favorable safety profile, and underscore the long-term benefits of early intervention with tafamidis. ClincalTrials.gov Identifier: NCT00409175, NCT00791492, and NCT00925002.

  16. Learning Curve Assessment of Robot-Assisted Radical Prostatectomy Compared with Open-Surgery Controls from the Premier Perspective Database

    PubMed Central

    Kreaden, Usha S.; Gabbert, Jessica; Thomas, Raju

    2014-01-01

    Abstract Introduction: The primary aims of this study were to assess the learning curve effect of robot-assisted radical prostatectomy (RARP) in a large administrative database consisting of multiple U.S. hospitals and surgeons, and to compare the results of RARP with open radical prostatectomy (ORP) from the same settings. Materials and Methods: The patient population of study was from the Premier Perspective Database (Premier, Inc., Charlotte, NC) and consisted of 71,312 radical prostatectomies performed at more than 300 U.S. hospitals by up to 3739 surgeons by open or robotic techniques from 2004 to 2010. The key endpoints were surgery time, inpatient length of stay, and overall complications. We compared open versus robotic, results by year of procedures, results by case volume of specific surgeons, and results of open surgery in hospitals with and without a robotic system. Results: The mean surgery time was longer for RARP (4.4 hours, standard deviation [SD] 1.7) compared with ORP (3.4 hours, SD 1.5) in the same hospitals (p<0.0001). Inpatient stay was shorter for RARP (2.2 days, SD 1.9) compared with ORP (3.2 days, SD 2.7) in the same hospitals (p<0.0001). The overall complications were less for RARP (10.6%) compared with ORP (15.8%) in the same hospitals, as were transfusion rates. ORP results in hospitals without a robot were not better than ORP with a robot, and pretreatment co-morbidity profiles were similar in all cohorts. Trending of results by year of procedure showed no differences in the three cohorts, but trending of RARP results by surgeon experience showed improvements in surgery time, hospital stay, conversion rates, and complication rates. Conclusions: During the initial 7 years of RARP development, outcomes showed decreased hospital stay, complications, and transfusion rates. Learning curve trends for RARP were evident for these endpoints when grouped by surgeon experience, but not by year of surgery. PMID:24350787

  17. The 2016 Bioinformatics Open Source Conference (BOSC)

    PubMed Central

    Harris, Nomi L.; Cock, Peter J.A.; Chapman, Brad; Fields, Christopher J.; Hokamp, Karsten; Lapp, Hilmar; Muñoz-Torres, Monica; Wiencko, Heather

    2016-01-01

    Message from the ISCB: The Bioinformatics Open Source Conference (BOSC) is a yearly meeting organized by the Open Bioinformatics Foundation (OBF), a non-profit group dedicated to promoting the practice and philosophy of Open Source software development and Open Science within the biological research community. BOSC has been run since 2000 as a two-day Special Interest Group (SIG) before the annual ISMB conference. The 17th annual BOSC ( http://www.open-bio.org/wiki/BOSC_2016) took place in Orlando, Florida in July 2016. As in previous years, the conference was preceded by a two-day collaborative coding event open to the bioinformatics community. The conference brought together nearly 100 bioinformatics researchers, developers and users of open source software to interact and share ideas about standards, bioinformatics software development, and open and reproducible science. PMID:27781083

  18. Open urethroplasty versus endoscopic urethrotomy--clarifying the management of men with recurrent urethral stricture (the OPEN trial): study protocol for a randomised controlled trial.

    PubMed

    Stephenson, Rachel; Carnell, Sonya; Johnson, Nicola; Brown, Robbie; Wilkinson, Jennifer; Mundy, Anthony; Payne, Steven; Watkin, Nick; N'Dow, James; Sinclair, Andrew; Rees, Rowland; Barclay, Stewart; Cook, Jonathan A; Goulao, Beatriz; MacLennan, Graeme; McPherson, Gladys; Jackson, Matthew; Rapley, Tim; Shen, Jing; Vale, Luke; Norrie, John; McColl, Elaine; Pickard, Robert

    2015-12-30

    Urethral stricture is a common cause of difficulty passing urine in men with prevalence of 0.5 %; about 62,000 men in the UK. The stricture is usually sited in the bulbar part of the urethra causing symptoms such as reduced urine flow. Initial treatment is typically by endoscopic urethrotomy but recurrence occurs in about 60% of men within 2 years. The best treatment for men with recurrent bulbar stricture is uncertain. Repeat endoscopic urethrotomy opens the narrowing but it usually scars up again within 2 years requiring repeated procedures. The alternative of open urethroplasty involves surgically reconstructing the urethra, which may need an oral mucosal graft. It is a specialist procedure with a longer recovery period but may give lower risk of recurrence. In the absence of firm evidence as to which is best, individual men have to trade off the invasiveness and possible benefit of each option. Their preference will be influenced by individual social circumstances, availability of local expertise and clinician guidance. The open urethroplasty versus endoscopic urethrotomy (OPEN) trial aims to better guide the choice of treatment for men with recurrent urethral strictures by comparing benefit over 2 years in terms of symptom control and need for further treatment. OPEN is a pragmatic, UK multicentre, randomised trial. Men with recurrent bulbar urethral strictures (at least one previous treatment) will be randomised to undergo endoscopic urethrotomy or open urethroplasty. Participants will be followed for 24 months after randomisation, measuring symptoms, flow rate, the need for re-intervention, health-related quality of life, and costs. The primary clinical outcome is the difference in symptom control over 24 months measured by the area under the curve (AUC) of a validated score. The trial has been powered at 90% with a type I error rate of 5% to detect a 0.1 difference in AUC measured on a 0-1 scale. The analysis will be based on all participants as randomised (intention-to-treat). The primary economic outcome is the incremental cost per quality-adjusted life year. A qualitative study will assess willingness to be randomised and hence ability to recruit to the trial. The OPEN Trial seeks to clarify relative benefit of the current options for surgical treatment of recurrent bulbar urethral stricture which differ in their invasiveness and resources required. Our feasibility study identified that participation would be limited by patient preference and differing recruitment styles of general and specialist urologists. We formulated and implemented effective strategies to address these issues in particular by inviting participation as close as possible to diagnosis. In addition re-calculation of sample size as recruitment progressed allowed more efficient design given the limited target population and funding constraints. Recruitment is now to target. ISRCTN98009168 Date of registration: 29 November 2012.

  19. The epidemiology of closed reduction for simple elbow dislocations and the incidence of early subsequent open reduction.

    PubMed

    Mayne, Ian P; Wasserstein, David; Modi, Chetan S; Henry, Patrick D G; Mahomed, Nizar; Veillette, Christian

    2015-01-01

    Simple elbow dislocations are often treated with closed reduction (CR); however, the rate of CR failure and factors that may predict failure have been largely underinvestigated. The objectives of this study were (1) to determine the incidence of elbow dislocations treated by CR in a universal health care system and (2) to identify patient characteristics associated with failed CR, defined as the subsequent need for open reduction. Patients ≥16 years old who underwent elbow CR by a physician between 1994 and 2010 were identified from administrative databases. Concurrent elbow fractures were excluded. The incidence density rate (IDR) of CR per 100,000 eligible person-years among the general population was calculated. Failed CR was defined as subsequent open reduction with or without ligament repair or reconstruction within 90 days. Patient and provider characteristics were modeled in a multivariate logistic regression for failure. The cohort consisted of 4878 patients (median age, 41 years) who underwent CR (IDR, 2.65 per 100,000 person-years), and 75 (1.5%) underwent subsequent open reduction with or without ligament repair or reconstruction (median time, 15 days). Young men (≤20 years) had the highest IDR (7.45 per 100,000 person-years), twice that of young women (P = .005). Patient characteristics associated with failed CR included older age (P = .001), admission to the hospital (P < .0001), >1 attempted CR (P = .001), and new orthopedic consultation in the 4 weeks after the CR (P = .02). Young men are at highest risk for CR for simple elbow dislocations; however, older patients are more likely to require open intervention, as are those with markers of a difficult reduction signifying potentially greater soft tissue damage. A comprehensive understanding of the epidemiology of simple elbow dislocation will aid management decisions. Copyright © 2015 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Elsevier Inc. All rights reserved.

  20. Looking for Ideas: Observation, Interpretation and Hypothesis-Making by 12-Year-Old Pupils Undertaking Science Investigations.

    ERIC Educational Resources Information Center

    Tomkins, Stephen P.; Tunnicliffe, Sue Dale

    2001-01-01

    Studies English comprehensive secondary school students' interpretation and hypothesis-making while 12 year-old students are observing a bottle ecosystem of brine shrimps without any prior instruction and keeping diaries. Studies students through the task of open-ended diary writing and through small group discussions about the scientific…

  1. The Case for Open Source: Open Source Has Made Significant Leaps in Recent Years. What Does It Have to Offer Education?

    ERIC Educational Resources Information Center

    Guhlin, Miguel

    2007-01-01

    Open source has continued to evolve and in the past three years the development of a graphical user interface has made it increasingly accessible and viable for end users without special training. Open source relies to a great extent on the free software movement. In this context, the term free refers not to cost, but to the freedom users have to…

  2. Graduating general surgery resident operative confidence: perspective from a national survey.

    PubMed

    Fonseca, Annabelle L; Reddy, Vikram; Longo, Walter E; Gusberg, Richard J

    2014-08-01

    General surgical training has changed significantly over the last decade with work hour restrictions, increasing subspecialization, the expanding use of minimally invasive techniques, and nonoperative management for solid organ trauma. Given these changes, this study was undertaken to assess the confidence of graduating general surgery residents in performing open surgical operations and to determine factors associated with increased confidence. A survey was developed and sent to general surgery residents nationally. We queried them regarding demographics and program characteristics, asked them to rate their confidence (rated 1-5 on a Likert scale) in performing open surgical procedures and compared those who indicated confidence with those who did not. We received 653 responses from the fifth year (postgraduate year 5) surgical residents: 69% male, 68% from university programs, and 51% from programs affiliated with a Veterans Affairs hospital; 22% from small programs, 34% from medium programs, and 44% from large programs. Anticipated postresidency operative confidence was 72%. More than 25% of residents reported a lack of confidence in performing eight of the 13 operations they were queried about. Training at a university program, a large program, dedicated research years, future fellowship plans, and training at a program that performed a large percentage of operations laparoscopically was associated with decreased confidence in performing a number of open surgical procedures. Increased surgical volume was associated with increased operative confidence. Confidence in performing open surgery also varied regionally. Graduating surgical residents indicated a significant lack of confidence in performing a variety of open surgical procedures. This decreased confidence was associated with age, operative volume as well as type, and location of training program. Analyzing and addressing this confidence deficit merits further study. Copyright © 2014 Elsevier Inc. All rights reserved.

  3. Evaluation of maximal mouth opening for healthy Indian children: Percentiles and impact of age, gender, and height.

    PubMed

    Patel, Shital M; Patel, Nehal H; Khaitan, Geet Gunjana A; Thanvi, Rashmi S; Patel, Parth; Joshi, Rajesh N

    2016-01-01

    Maximal mouth opening (MMO) is used as a marker of masticatory pathology. However, MMO among children varies considerably with their age, height, sex, and race. While accurate percentile of normal mouth opening and relationship with anthropometric measurement are not precisely defined for the Indian population, we designed prospective, observational study to define the percentiles for normal MMO in our children. A total of 985 children, 560 males and 425 females, in the age range of 5-18 years attending the pediatric clinic in a tertiary care center in Western India were studied. In addition to the basic demographic data, MMO was measured in these children. The children were asked to open their mouth maximally until no further opening was possible. The distance from the incisal edge of the upper incisor teeth to the incisal edge of the lower incisor teeth was measured using a calibrated fiber ruler. Statistical analysis was performed to assess the impact of other anthropometric measures such as age, gender, and height on MMO. The mean MMO for males was 44.24 (±5.84) mm and for females was 43.5 (±5.19) mm. Age- and height-related percentiles were created for girls and boys separately, showing the 5 th , 10 th , 25 th , 50 th , 75 th , 90 th , and 95 th percentiles from 5 through 18 years of age with 86-185 cm height. The MMO percentile range for different age and height groups is established for the normal children. The mouth opening seems to increase with the age and especially with the height as per the skeletal growth. Height affects mouth opening more than the age.

  4. Nosocomial infections and antibiotic resistance pattern in open-heart surgery patients at Imam Ali Hospital in Kermanshah, Iran.

    PubMed

    Heydarpour, Fatemeh; Rahmani, Youssef; Heydarpour, Behzad; Asadmobini, Atefeh

    2017-01-01

    Background: Patients undergoing open heart surgery have a relatively high risk of acquiring nosocomial infections. The development of antibiotic-resistant infections is associated with prolonged hospital stays and mortalities. Objectives: The present study was conducted to investigate nosocomial infections and the antibiotic resistance pattern in bacteria causing these infections in open heart surgery patients at Imam Ali Hospital in Kermanshah in the west of Iran over a 4-year period from March 2011 to March 2014. Materials and methods: The present cross-sectional study was conducted on 135 cases of nosocomial infection among open heart surgery patients. The demographic characteristics and the risk factors of each case of infection were recorded. The antibiotic susceptibility test was carried out using the Minimum Inhibitory Concentration (MIC) method based on the Clinical and Laboratory Standards Institute (CLSI) protocol. The data collected were then analyzed in SPSS-16. Results: Out of the 6,000 patients who underwent open heart surgery during this 4-year period at the selected hospital, nosocomial infections developed in 135 patients (2.25%), 59.3% of whom were female and 40.7% male. Surgery site infection (SSI), pneumonia (PNEU), urinary tract infection (UTI) and blood stream infection (BSI) affected 52.6%, 37%, 9.6% and 0.8% of the cases, respectively. E.coli , Klebsiella spp. and S. aureus were the most common bacteria causing the nosocomial infections. E. coli was most frequently resistant to imipenem (23.3%) Klebsiella spp. to gentamicin (38.5%) S. aureus to co-trimoxazole (54.2%). Conclusion: SSI had a high prevalence in this study. Further studies should therefore be conducted to examine the risk factors associated with SSI in open heart surgery. Various studies have shown that antibiotic resistance patterns are different in different regions. Finding a definitive treatment therefore requires an antibiogram.

  5. PWC Opens up

    ERIC Educational Resources Information Center

    Weinstein, Margery

    2011-01-01

    Coming up with the latest and greatest learning curriculum for employees year after year can be overwhelming--especially if one works for a small or mid-size company with minimal resources. Fortunately, there is a burgeoning trend that three-time No. 1 Top 125er PwC is helping to "open" up. In creating PwC Open University, the professional…

  6. 75 FR 50986 - Notice of Contract Proposal (NOCP) for Payments to Eligible Advanced Biofuel Producers

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-08-18

    ... remaining available Fiscal Year 2009 program funds. This Notice opens an application window for certain... opening a new application window from August 18, 2010 through September 17, 2010 to accept applications... opening a new application window to accept additional applications for the remaining available Fiscal Year...

  7. The Open Access Dilemma

    ERIC Educational Resources Information Center

    Pratt, Timothy

    2017-01-01

    Community colleges, with their commitment to open access, admit millions of students each year who are unprepared for college-level work, even though they have earned a high-school diploma. For decades the schools had a built-in base of students attracted to their open doors and relative affordability. But enrollment at public two-year college has…

  8. IAEA international studies on irradiation embrittlement of reactor pressure vessel steels

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

    Brumovsky, M.; Steele, L.E.

    1997-02-01

    In last 25 years, three phases a Co-operative Research Programme on Irradiation Embrittlement of Reactor Pressure Vessel Steels has been organized by the International Atomic Energy Agency. This programme started with eight countries in 1971 and finally 16 countries took part in phase III of the Programme in 1983. Several main efforts were put into preparation of the programme, but the principal task was concentrated on an international comparison of radiation damage characterization by different laboratories for steels of {open_quotes}old{close_quotes} (with high impurity contents) and {open_quotes}advanced{close_quotes} (with low impurity contents) types as well as on development of small scale fracturemore » mechanics procedures applicable to reactor pressure vessel surveillance programmes. This year, a new programme has been opened, concentrated mostly on small scale fracture mechanics testing.« less

  9. Long-term Safety and Efficacy of Tapentadol Extended Release Following up to 2 Years of Treatment in Patients With Moderate to Severe, Chronic Pain: Results of an Open-label Extension Trial.

    PubMed

    Buynak, Robert; Rappaport, Stephen A; Rod, Kevin; Arsenault, Pierre; Heisig, Fabian; Rauschkolb, Christine; Etropolski, Mila

    2015-11-01

    Tapentadol extended release (ER) has demonstrated efficacy and safety for the management of moderate to severe, chronic pain in adults. This study evaluated the long-term safety and tolerability of tapentadol ER in patients with chronic osteoarthritis or low back pain. Patients were enrolled in this 1-year, open-label extension study after completing one of two 15-week, placebo-controlled studies of tapentadol ER and oxycodone controlled release (CR) for osteoarthritis knee pain (NCT00421928) or low back pain (NCT00449176), a 7-week crossover study between tapentadol immediate release and tapentadol ER for low back pain (NCT00594516), or a 1-year safety study of tapentadol ER and oxycodone CR for osteoarthritis or low back pain (NCT00361504). After titrating the drug to an optimal dose, patients received tapentadol ER (100-250 mg BID) for up to 1 year (after finishing treatment in the preceding studies); patients who were previously treated with tapentadol ER in the 1-year safety study received tapentadol ER continuously for up to 2 years in total. Of the 1,154 patients in the safety population, 82.7% were aged >65 years and 57.9% were female; 50.1% had mild baseline pain intensity. Mean (SD) pain intensity scores (11-point numerical rating scale) were 3.9 (2.38) at baseline (end of preceding study) and 3.7 (2.42) at end point, indicating that pain relief was maintained during the extension study. Improvements in measures of quality of life (eg, EuroQol-5 Dimension and the 36-item Short Form Health Survey [SF-36]) health status questionnaires) achieved during the preceding studies were maintained during the open-label extension study. Tapentadol ER was associated with a safety and tolerability profile comparable to that observed in the preceding studies. The most common treatment-emergent adverse events (incidence ≥10%; n = 1154) were headache (13.1%), nausea (11.8%), and constipation (11.1%). Similar efficacy and tolerability results were shown for patients who received up to 2 years of tapentadol ER treatment. Pain relief and improvements in quality of life achieved during the preceding studies were maintained throughout this extension study, during which tapentadol ER was well tolerated for the long-term treatment of chronic osteoarthritis or low back pain over up to 2 years of treatment. (ClinicalTrials.gov identifier: NCT00487435.). Copyright © 2015. Published by Elsevier Inc.

  10. Open-label trial of atomoxetine hydrochloride in adults with ADHD.

    PubMed

    Johnson, Mats; Cederlund, Mats; Råstam, Maria; Areskoug, Björn; Gillberg, Christopher

    2010-03-01

    While atomoxetine is an established treatment for attention-deficit/hyperactivity disorder in children, few studies have examined its efficacy for adults. Open-label trial of atomoxetine in 20 individuals with ADHD, aged 19-47 years, for 10 weeks, and a total of one year for responders. Ten patients met primary efficacy criteria at 10 weeks. Only one patient completed the whole study. Six patients discontinued before 10 weeks and thirteen at 10 weeks or later, mainly because of side-effects (aggression, depressed mood, raised liver enzymes, thyroid hormones, diastolic blood pressure), decreasing efficacy or non-compliance. Fifty percent responded to treatment, but only one patient (5%) felt sufficient improvement to continue for one year. Dosage may have been too low, and baseline impairment too high, for atomoxetine to have sufficient effect on ADHD symptoms in our group of adults. The majority had few side-effects, but several terminated treatment because of adverse effects.

  11. A prospective, multi-institutional comparative effectiveness study of lumbar spine surgery in morbidly obese patients: does minimally invasive transforaminal lumbar interbody fusion result in superior outcomes?

    PubMed

    Adogwa, Owoicho; Carr, Kevin; Thompson, Paul; Hoang, Kimberly; Darlington, Timothy; Perez, Edgar; Fatemi, Parastou; Gottfried, Oren; Cheng, Joseph; Isaacs, Robert E

    2015-05-01

    Obese and morbidly obese patients undergoing lumbar spinal fusion surgery are a challenge to the operating surgeon. Minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF) and open-TLIF have been performed for many years with good results; however, functional outcomes after lumbar spine surgery in this subgroup of patients remain poorly understood. Furthermore, whether index MIS-TLIF or open-TLIF for the treatment of degenerative disc disease or spondylolisthesis in morbidly obese results in superior postoperative functional outcomes remains unknown. A total of 148 (MIS-TLIF: n = 40, open-TLIF: n = 108) obese and morbidly obese patients undergoing index lumbar arthrodesis for low back pain and/or radiculopathy between January 2003 and December 2010 were selected from a multi-institutional prospective data registry. We collected and analyzed data on patient demographics, postoperative complications, back pain, leg pain, and functional disability over 2 years. Patients completed the Oswestry Disability Index (ODI), Medical Outcomes Study Short-Form 36 (SF-36), and back and leg pain numerical rating scores before surgery and then at 12 and 24 months after surgery. Clinical outcomes and complication rates were compared between both patient cohorts. Compared with preoperative status, Visual Analog Scale (VAS) back and leg pain, ODI, and SF-36 physical component score/mental component score were improved in both groups. Both MIS-TLIF and open-TLIF patients showed similar 2-year improvement in VAS for back pain (MIS-TLIF: 2.42 ± 3.81 vs. open-TLIF: 2.33 ± 3.67, P = 0.89), VAS for leg pain (MIS-TLIF: 3.77 ± 4.53 vs. open-TLIF: 2.67 ± 4.10, P = 0.18), ODI (MIS-TLIF: 11.61 ± 25.52 vs. open-TLIF: 14.88 ± 22.07, P = 0.47), and SF-36 physical component score (MIS-TLIF: 8.61 ± 17.72 vs. open-TLIF: 7.61 ± 15.55, P = 0.93), and SF-36 mental component score (MIS-TLIF: 4.35 ± 22.71 vs. open-TLIF: 5.96 ± 21.09, P = 0.69). Postoperative complications rates between both cohorts were also not significantly divergent between (12.50% vs. 11.11%, P = 0.51). MIS-TLIF is a safe and viable option for lumbar fusion in morbidly obese patients and, compared with open-TLIF, resulted in similar improvement in pain and functional disability. Postoperative complications rates between both cohorts were also not significantly divergent. Copyright © 2015 Elsevier Inc. All rights reserved.

  12. Effects of breastfeeding and sucking habits on malocclusion in a birth cohort study.

    PubMed

    Peres, Karen Glazer; Barros, Aluísio J D; Peres, Marco Aurélio; Victora, César Gomes

    2007-06-01

    To estimate the prevalence of malocclusion and to examine the effects of breastfeeding and non-nutritive sucking habits on dentition in six-year-old children. A cross-sectional study was carried out nested into a birth cohort conducted in Pelotas, Southern Brazil, in 1999. A sample of 359 children was dentally examined and their mothers interviewed. Anterior open bite and posterior cross bite were recorded using the Foster & Hamilton criteria. Information regarding breastfeeding and non-nutritive sucking habits was collected at birth, in the first, third, sixth and 12th months of life, and at six years of age. Control variables included maternal schooling and child's birthweight, cephalic perimeter, and sex. Data were analyzed by Poisson regression. Prevalence of anterior open bite was 46.2%, and that of posterior cross bite was 18.2%. Non-nutritive sucking habits between 12 months and four years of age and digital sucking at age six years were the main risk factors for anterior open bite. Breastfeeding for less than nine months and regular use of pacifier between age 12 months and four years were risk factors for posterior cross bite. Interaction between duration of breastfeeding and the use of pacifier was identified for posterior cross bite. Given that breastfeeding is a protective factor for other diseases of infancy, our findings indicate that the common risks approach is the most appropriate for the prevention of posterior cross bite in primary or initial mixed dentition.

  13. Dropout rates in medical students at one school before and after the installation of admission tests in Austria.

    PubMed

    Reibnegger, Gilbert; Caluba, Hans-Christian; Ithaler, Daniel; Manhal, Simone; Neges, Heide Maria; Smolle, Josef

    2011-08-01

    Admission to medical studies in Austria since academic year 2005-2006 has been regulated by admission tests. At the Medical University of Graz, an admission test focusing on secondary-school-level knowledge in natural sciences has been used for this purpose. The impact of this important change on dropout rates of female versus male students and older versus younger students is reported. All 2,860 students admitted to the human medicine diploma program at the Medical University of Graz from academic years 2002-2003 to 2008-2009 were included. Nonparametric and semiparametric survival analysis techniques were employed to compare cumulative probability of dropout between demographic groups. Cumulative probability of dropout was significantly reduced in students selected by active admission procedure versus those admitted openly (P < .0001). Relative hazard ratio of selected versus openly admitted students was only 0.145 (95% CI, 0.106-0.198). Among openly admitted students, but not for selected ones, the cumulative probabilities for dropout were higher for females (P < .0001) and for older students (P < .0001). Generally, dropout hazard is highest during the second year of study. The introduction of admission testing significantly decreased the cumulative probability for dropout. In openly admitted students a significantly higher risk for dropout was found in female students and in older students, whereas no such effects can be detected after admission testing. Future research should focus on the sex dependence, with the aim of improving success rates among female applicants on the admission tests.

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

    ERIC Educational Resources Information Center

    Reid, Kenneth J.

    2012-01-01

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

  15. Social Studies Instructional Factors Causing Change in High School Students' Socio-political Attitudes over a Two-Year Period.

    ERIC Educational Resources Information Center

    Ehman, Lee H.

    The paper reports findings of a three year longitudinal study of high school student social and political attitudes. The hypothesis was that openness of social studies classroom climate would be related to change in social and political attitudes toward school and, to a lesser extent, to change in general social and political attitudes. Attitude…

  16. Opening Doors to Student Success: A Synthesis of Findings from an Evaluation at Six Community Colleges. Policy Brief

    ERIC Educational Resources Information Center

    Scrivener, Susan; Coghlan, Erin

    2011-01-01

    Only one-third of all students who enter community colleges with the intent to earn a degree or certificate actually meet this goal within six years. MDRC launched the Opening Doors Demonstration in 2003--the first large-scale random assignment study in a community college setting--to tackle this problem. Partnering with six community colleges,…

  17. Applying Open Source Software in a Development Context: Expectations and Experiences. A Case Study of a University in Uganda

    ERIC Educational Resources Information Center

    van Reijswoud, Victor; Mulo, Emmanuel

    2006-01-01

    Over recent years the issue of free and open source software (FOSS) for development in less developed countries (LDCs) has received increasing attention. In the beginning the benefits of FOSS for lower developed countries was only stressed by small groups of idealists like Richard Stallman. Now, however, it is moving into the hands of large…

  18. An Open Trial of Intensive Family Based Cognitive-Behavioral Therapy in Youth with Obsessive-Compulsive Disorder Who Are Medication Partial Responders or Nonresponders

    ERIC Educational Resources Information Center

    Storch, Eric A.; Lehmkuhl, Heather D.; Ricketts, Emily; Geffken, Gary R.; Marien, Wendi; Murphy, Tanya K.

    2010-01-01

    This study reports an open-trial of family-based cognitive-behavioral therapy (CBT) in children and adolescents with obsessive-compulsive disorder (OCD). Thirty primarily Caucasian youth with OCD (range = 7-19 years; 15 girls) who were partial responders or nonresponders to two or more medication trials that were delivered either serially or…

  19. Challenges Faced by African International Students at a Metropolitan Research University: A Phenomenological Case Study

    ERIC Educational Resources Information Center

    Evivie, Loretta Gbemudu

    2009-01-01

    The number of international students coming to the United States has increased from 48,486 in 1959-1960 to 623,805 in the 2007-2008 academic years (Open Doors, 2008). These students contributed $15.5 billion to the United States economy, making education the nation's fifth largest service export (Open Doors, 2008). The literature has focused on…

  20. It Is More than Knowledge Seeking: Examining the Effects of OpenCourseWare Lectures on Vocabulary Acquisition in English as a Foreign Language (EFL) Context

    ERIC Educational Resources Information Center

    Yang, Hui-Chi; Sun, Yu-Chih

    2013-01-01

    OpenCourseWare (OCW) has received increasing attention over the past few years in higher education. These courses provide appealing opportunities to view classes taught in well-established universities worldwide. The current study aims to examine how OCW lectures can serve as authentic learning materials to facilitate vocabulary acquisition for…

  1. Project-based physics labs using low-cost open-source hardware

    NASA Astrophysics Data System (ADS)

    Bouquet, F.; Bobroff, J.; Fuchs-Gallezot, M.; Maurines, L.

    2017-03-01

    We describe a project-based physics lab, which we proposed to third-year university students. These labs are based on new open-source low-cost equipment (Arduino microcontrollers and compatible sensors). Students are given complete autonomy: they develop their own experimental setup and study the physics topic of their choice. The goal of these projects is to let students to discover the reality of experimental physics. Technical specifications of the acquisition material and case studies are presented for practical implementation in other universities.

  2. Adding left atrial appendage closure to open heart surgery provides protection from ischemic brain injury six years after surgery independently of atrial fibrillation history: the LAACS randomized study.

    PubMed

    Park-Hansen, Jesper; Holme, Susanne J V; Irmukhamedov, Akhmadjon; Carranza, Christian L; Greve, Anders M; Al-Farra, Gina; Riis, Robert G C; Nilsson, Brian; Clausen, Johan S R; Nørskov, Anne S; Kruuse, Christina R; Rostrup, Egill; Dominguez, Helena

    2018-05-23

    Open heart surgery is associated with high occurrence of atrial fibrillation (AF), subsequently increasing the risk of post-operative ischemic stroke. Concomitant with open heart surgery, a cardiac ablation procedure is commonly performed in patients with known AF, often followed by left atrial appendage closure with surgery (LAACS). However, the protective effect of LAACS on the risk of cerebral ischemia following cardiac surgery remains controversial. We have studied whether LAACS in addition to open heart surgery protects against post-operative ischemic brain injury regardless of a previous AF diagnosis. One hundred eighty-seven patients scheduled for open heart surgery were enrolled in a prospective, open-label clinical trial and randomized to concomitant LAACS vs. standard care. Randomization was stratified by usage of oral anticoagulation (OAC) planned to last at least 3 months after surgery. The primary endpoint was a composite of post-operative symptomatic ischemic stroke, transient ischemic attack or imaging findings of silent cerebral ischemic (SCI) lesions. During a mean follow-up of 3.7 years, 14 (16%) primary events occurred among patients receiving standard surgery vs. 5 (5%) in the group randomized to additional LAACS (hazard ratio 0.3; 95% CI: 0.1-0.8, p = 0.02). In per protocol analysis (n = 141), 14 (18%) primary events occurred in the control group vs. 4 (6%) in the LAACS group (hazard ratio 0.3; 95% CI: 0.1-1.0, p = 0.05). In a real-world setting, LAACS in addition to elective open-heart surgery was associated with lower risk of post-operative ischemic brain injury. The protective effect was not conditional on AF/OAC status at baseline. LAACS study, clinicaltrials.gov NCT02378116 , March 4th 2015, retrospectively registered.

  3. Management of cystinuric patients: an observational, retrospective, single-centre analysis.

    PubMed

    Ahmed, Kamran; Khan, Mohammad Shamim; Thomas, Kay; Challacombe, Ben; Bultitude, Matthew; Glass, Jonathan; Tiptaft, Richard; Dasgupta, Prokar

    2008-01-01

    A critical appraisal of the management of patients with cystine stones treated in our unit in the past 6 years and to analyze the outcome of multimodality therapies. An observational, single-centre retrospective study. We reviewed the records of all patients with stones referred to our centre over a 6-year period from 1998 to 2005. Data recorded included demographic details, medical therapies received/prescribed, compliance with medical therapies, mode of treatment, stone clearance and any recurrence during this period of study. A total of 30 cystinuric patients were treated in our institution over the period of 6 years from 1998 to early 2005. Of these 16 were males and 14 females with an average age at last follow-up of 39 years (range 15-70). Two patients were successfully managed medically. The remaining patients (n = 28) underwent a total of 237 procedures (pre- and postreferral to our unit), with an average of 7.9 procedures per patient for 126 stone episodes (4.2 episodes/patient). The modes of treatment included extracorporeal shockwave lithotripsy (n = 143), ureterorenoscopy and intracorporeal lithotripsy (n = 50), percutaneous nephrolithotomy (n = 28) and open procedures (n = 16). Two patients needed open surgery at our unit. Prior to referral to our dedicated unit, patients had received treatment with extracorporeal shockwave lithotripsy (multiple sessions), ureteroscopy (n = 14), percutaneous nephrolithotomy (n = 4) and open stone removal (n = 14). Most of the stones at our unit were managed using minimally invasive therapies. Compliance of cystinuric patients with medical treatment is often poor and patients experience recurrent stone episodes requiring multiple interventions. Modern management of cystine calculi should be with staged minimally invasive procedures to avoid the complications of multiple open procedures wherever possible along with appropriate medical prophylaxis.

  4. Clinical comparison between open plating and minimally invasive plate osteosynthesis for displaced proximal humeral fractures: A prospective randomized controlled trial.

    PubMed

    Sohn, Hoon-Sang; Jeon, Yoon Sang; Lee, JuHan; Shin, Sang-Jin

    2017-06-01

    Recently, minimally invasive plate osteosynthesis (MIPO) has been widely used for the treatment of proximal humeral fractures. However, there is concern about whether the MIPO in comminuted proximal humeral fractures is also comparable to open plating. The purpose of this study was to compare the clinical and radiographic outcomes of open plating and MIPO for acute displaced proximal humeral fractures. In this prospective, randomized controlled study, 107 patients who had an acute proximal humeral fracture were randomized to either the open plating or MIPO techniques. Forty-five patients treated with open plating and 45 with the MIPO technique who were followed up at least 1year were evaluated. Shoulder functional assessment, operating time, several radiographic parameters, and complications were evaluated at final follow-up. The mean follow-up period was 15.0 months in the open plating and 14.3 months in the MIPO technique. There were no statistically significant differences in functional assessment scores and radiographic parameters between the two groups. High complications rates were found in 4-part fracture in both surgical methods The average operation time in the MIPO group were significantly lower compared to the open plating group (p<0.05). This study showed MIPO in proximal humerus fractures had similar clinical and radiographic outcomes compared to the open plating. However, the MIPO technique in proximal humerus fracture provided significantly shorter operation time than the open plating. Copyright © 2017 Elsevier Ltd. All rights reserved.

  5. The ESA scientific exploitation element results and outlook

    NASA Astrophysics Data System (ADS)

    Desnos, Yves-louis; Regner, Peter; Delwart, Steven; Benveniste, Jerome; Engdahl, Marcus; Donlon, Craig; Mathieu, Pierre-Philippe; Fernandez, Diego; Gascon, Ferran; Zehner, Claus; Davidson, Malcolm; Goryl, Philippe; Koetz, Benjamin; Pinnock, Simon

    2017-04-01

    The Scientific Exploitation of Operational Missions (SEOM) element of ESA's fourth Earth Observation Envelope Programme (EOEP4) prime objective is to federate, support and expand the international research community built up over the last 25 years exploiting ESA's EO missions. SEOM enables the science community to address new scientific research areas that are opened by the free and open access to data from operational EO missions. Based on community-wide recommendations, gathered through a series of international thematic workshops and scientific user consultation meetings, key research studies have been launched over the last years to further exploit data from the Sentinels (http://seom.esa.int/). During 2016 several Science users consultation workshops have been organized, new results from scientific studies have been published and open-source multi-mission scientific toolboxes have been distributed (SNAP 80000 users from 190 countries). In addition the first ESA Massive Open Online Courses on Climate from space have been deployed (20000 participants) and the second EO Open Science conference was organized at ESA in September 2016 bringing together young EO scientists and data scientists. The new EOEP5 Exploitation element approved in 2016 and starting in 2017 is taking stock of all precursor activities in EO Open Science and Innovation and in particular a workplan for ESA scientific exploitation activities has been presented to Member States taking full benefit of the latest information and communication technology. The results and highlights from current scientific exploitation activities will be presented and an outlook on the upcoming activities under the new EOEP5 exploitation element will be given.

  6. Genetic polymorphism in postoperative sepsis after open heart surgery in infants.

    PubMed

    Fakhri, Dicky; Djauzi, Samsuridjal; Murni, Tri Wahyu; Rachmat, Jusuf; Harahap, Alida Roswita; Rahayuningsih, Sri Endah; Mansyur, Muchtaruddin; Santoso, Anwar

    2016-05-01

    Sepsis is one of the complications following open heart surgery. Toll-like receptor 2 and toll-interacting protein polymorphism influence the immune response after open heart surgery. This study aimed to assess the genetic distribution of toll-like receptor 2 N199N and toll-interacting protein rs5743867 polymorphism in the development of postoperative sepsis. A prospective cohort study was conducted in 108 children <1-year old who underwent open heart surgery with a Basic Aristotle score ≥6. Patients with an accompanying congenital anomaly, human immunodeficiency virus infection, or history of previous open heart surgery were excluded. The patients' nutritional status and genetic polymorphism were assessed prior to surgery. The results of genetic polymorphism were obtained through genotyping. Patients' ages on the day of surgery and cardiopulmonary bypass times were recorded. The diagnosis of sepsis was established according to Surviving Sepsis Campaign criteria. Postoperative sepsis was observed in 21% of patients. There were 92.6% patients with toll-like receptor 2 N199N polymorphism and 52.8% with toll-interacting protein rs5743867 polymorphism. Toll-like receptor 2 N199N polymorphism tends to increase the risk of sepsis (odds ratio = 1.974; 95% confidence interval: 0.23-16.92; p = 0.504), while toll-interacting protein rs5743867 polymorphism tends to decrease the risk of sepsis (odds ratio = 0.496; 95% confidence interval: 0.19-1.27; p = 0.139) in infants <1-year old undergoing complex open heart surgery. © The Author(s) 2016.

  7. Endoscopic versus open bursectomy of lateral malleolar bursitis.

    PubMed

    Choi, Jae Hyuck; Lee, Kyung Tai; Lee, Young Koo; Kim, Dong Hyun; Kim, Jeong Ryoul; Chung, Woo Chull; Cha, Seung Do

    2012-06-01

    Compare the result of endoscopic versus open bursectomy in lateral malleolar bursitis. Prospective evaluation of 21 patients (22 ankles) undergoing either open or endoscopic excision of lateral malleolar bursitis. The median age was 64 (38-79) years old. The median postoperative follow-up was 15 (12-18) months. Those patients undergoing endoscopic excision showed a higher satisfaction rate (excellent 9, good 2) than open excision (excellent 4, good 3, fair 1). The wounds also healed earlier in the endoscopic group although the operation time was slightly longer. One patient in the endoscopic group had recurrence of symptoms but complications in the open group included one patient with skin necrosis, one patient with wound dehiscence, and two patients of with superficial peroneal nerve injury. Endoscopic resection of the lateral malleolar bursitis is a promising technique and shows favorable results compared to the open resection. Therapeutic studies-Investigating the result of treatment, Level II.

  8. Disease control and safety of belimumab plus standard therapy over 7 years in patients with systemic lupus erythematosus.

    PubMed

    Ginzler, Ellen M; Wallace, Daniel J; Merrill, Joan T; Furie, Richard A; Stohl, William; Chatham, W Winn; Weinstein, Arthur; McKay, James D; McCune, W Joseph; Zhong, Z John; Freimuth, William W; Petri, Michelle A

    2014-02-01

    To evaluate the efficacy/safety of belimumab plus standard therapy in patients (n = 449) with active systemic lupus erythematosus (SLE) treated up to 7 years (n = 177 currently ongoing). Patients (n = 345) who completed a double-blind, placebo-controlled, 52-week study of belimumab 1, 4, or 10 mg/kg and 24-week extension of belimumab (placebo switched to 10 mg/kg; belimumab same dose or switched to 10 mg/kg) could receive belimumab 10 mg/kg in an open-label continuation study (n = 296). Disease activity was analyzed in patients with active SLE at baseline of the initial study. Biomarker and SLE medication changes were evaluated, and adverse events (AE) were monitored throughout the study. Total belimumab exposure over 7 years (double-blind and open-label periods): 1746 patient-years. SLE Responder Index (SRI) response rates at Week 52 in autoantibody-positive patients: placebo, 29%; belimumab, 46% (p < 0.05). In the continuation study, 57% of auto-antibody-positive patients had an SRI response by Year 2 and 65% by Year 7; severe flares occurred in 19% with placebo and 17% with belimumab during the first year, with the annual rate declining to 2%-9% during years 2-7. Anti-dsDNA autoantibodies in patients positive for them at baseline had a progressive decline of 40%-60% from baseline over 2-7 years with belimumab. Corticosteroid use decreased over time with ≥ 50-55% reduction in median dose during years 5-7. Serious and overall annual AE rates, including infections, were generally stable or decreased during 7-year treatment. Disease control and safety profile were maintained in patients with active SLE taking belimumab plus standard therapy for up to 7 years. [ClinicalTrials.gov numbers: NCT00071487 and NCT00583362].

  9. 77 FR 20716 - Drawbridge Operation Regulation; Blackwater River, South Quay, VA

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-04-06

    ... passage of vessels. There have been no requests for openings in 11 years. DATES: This rule is effective... S189 Bridge across Blackwater River, mile 9.2, at South Quay VA. There has been no request for openings since the year 2000. The only industrial waterway user to request openings left the area in 2000. Since...

  10. 78 FR 67084 - Drawbridge Operation Regulation; Broad Creek, Laurel, DE

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-11-08

    ... provided information to the Coast Guard about the lack of any openings of the draw spans dating back to... requests for vessel openings of the drawbridge for over 30 years illustrates that the vessels that use this... transits have required an opening in 30 years. 2. Impact on Small Entities The Regulatory Flexibility Act...

  11. An Alternative Approach: Openness in Education over the Last 100 Years

    ERIC Educational Resources Information Center

    Baker, Fredrick W.

    2017-01-01

    What is the nature of openness, and what role has it played in education over the years? The concept of openness has traditionally been very difficult to define, and its history in education has often been ignored, obscured, or misrepresented in the literature, media, and popular culture. This paper provides an operational definition of openness…

  12. Move the Neighbourhood: Study design of a community-based participatory public open space intervention in a Danish deprived neighbourhood to promote active living.

    PubMed

    Pawlowski, Charlotte Skau; Winge, Laura; Carroll, Sidse; Schmidt, Tanja; Wagner, Anne Margrethe; Nørtoft, Kamilla Pernille Johansen; Lamm, Bettina; Kural, René; Schipperijn, Jasper; Troelsen, Jens

    2017-05-19

    A limited amount of research has examined the effect of changing public open spaces on active living. This paper will present the study protocol of a community-based intervention study co-designed in an interdisciplinary collaboration with community members to develop urban installations highly tailored to promote active living among children (10-13-years-old) and seniors (>60-years-old) in a deprived neighbourhood in Copenhagen. The study builds on a quasi-experimental study design with two sub-studies: 1) a children study and 2) a senior study. The interventions will be developed, designed and implemented in collaboration with local children and seniors, respectively, using different co-design tools and methods. We will evaluate the effect of the interventions on children's and senior's use of the new-built urban installations using accelerometers in combination with GPS as well as systematic observation using the System for Observing Play and Recreation in Communities (SOPARC). A process evaluation with focus groups consisting of the various stakeholders in the two sub-studies will be used to gain knowledge of the intervention processes. The paper presents new approaches in the field of public open space interventions through interdisciplinary collaboration, participatory co-design approach and combination of measurements. Using both effect and process evaluations the study will provide unique insights in the role and importance of the interdisciplinary collaboration, participatory processes, and tailoring changes in public open space to local needs and wishes. These results can be used to guide urban renewal projects in deprived neighbourhoods in the future. Retrospectively registered with study ID ISRCTN50036837 . Date of registration: 16 December 2016.

  13. Results of operative fixation of unstable ankle fractures in geriatric patients.

    PubMed

    Pagliaro, A J; Michelson, J D; Mizel, M S

    2001-05-01

    It is widely accepted that operative fixation of unstable ankle fractures yields predictably good outcomes in the general population. The current literature, however reports less acceptable results in the geriatric population age 65 years and older. The current study analyzes the outcome of the surgical treatment of unstable ankle fractures in patients at least 65 years old. Twenty three patient over 65 years old were surgically treated after sustaining 21 (91%) closed and 2 (9%) open grade II unstable ankle fractures. Fractures were classified according to the Danis-Weber and Lauge-Hansen schemes. Fracture type was predominantly Weber B (21/23, 91%), or supination external rotation stage IV (21/23, 91%). Fracture union rate was 100%. There were three significant complications including a lateral wound dehiscence with delayed fibular union in an open fracture dislocation, and two below knee amputations, neither of which was directly related to the fracture treatment. There were three minor complications; one superficial wound infection and two cases of prolonged incision drainage, all of which resolved without further surgical intervention. Complications were associated with open fractures and preexisting systemic disease. These results indicate that open reduction and internal fixation of unstable ankle fractures in geriatric patients is an efficacious treatment regime that with results that are comparable to the general population.

  14. Use of Ganga Hospital Open Injury Severity Scoring for determination of salvage versus amputation in open type IIIB injuries of lower limbs in children-An analysis of 52 type IIIB open fractures.

    PubMed

    Venkatadass, K; Grandhi, Tarani Sai Prasanth; Rajasekaran, S

    2017-11-01

    Open injuries in children are rare compared to adults. In children with major open injuries, there is no specific scoring system to guide when to amputate or salvage the limb. The use of available adult scoring systems may lead to errors in management. The role of Ganga Hospital Open Injury Severity Scoring (GHOISS) for open injuries in adults is well established and its applicability for pediatric open injuries has not been studied. This study was done to analyse the usefulness of GHOISS in pediatric open injuries and to compare it with MESS(Mangled Extremity Severity Score). All children (0-18 years) who were admitted with Open type IIIB injuries of lower limbs between January 2008 and March 2015 were included. MESS and GHOISS were calculated for all the patients. There were 50 children with 52 type IIIB Open injuries of which 39 had open tibial fractures and 13 had open femur fractures. Out of 52 type IIIB open injuries, 48 were salvaged and 4 were amputated. A MESS score of 7 and above had sensitivity of 25% for amputation while GHOISS of 17 and above was found to be more accurate for determining amputation with sensitivity of 75% and specificity of 93.75%. GHOISS is a reliable predictor of injury severity in type IIIB open fractures in children and can be used as a guide for decision-making. The use of MESS score in children has a lower predictive value compared to GHOISS in deciding amputation versus salvage. A GHOISS of 17 or more has the highest sensitivity and specificity to predict amputation. Copyright © 2017 Elsevier Ltd. All rights reserved.

  15. Reversal of the Hartmann's procedure: A comparative study of laparoscopic versus open surgery.

    PubMed

    Melkonian, Ernesto; Heine, Claudio; Contreras, David; Rodriguez, Marcelo; Opazo, Patricio; Silva, Andres; Robles, Ignacio; Rebolledo, Rolando

    2017-01-01

    The Hartmann's operation, although less frequently performed today, is still used when initial colonic anastomosis is too risky in the short term. However, the subsequent procedure to restore gastrointestinal continuity is associated with significant morbidity and mortality. The review of an institutional review board (IRB)-approved prospectively maintained database provided data on the Hartmann's reversal procedure performed by either laparoscopic or open technique at our institution. The data collected included: demographic data, operative approach, conversion for laparoscopic cases and perioperative morbidity and mortality. Over a 14-year period from January 1997 to August 2011, 74 Hartmann's reversal procedures were performed (laparoscopic surgery-49, open surgery-25). The average age was 55 years for the laparoscopic and 57 years for the open surgery group, respectively. Male patients represent 61% of both groups. There was no significant difference in operative time between the two groups (149 min vs 151 min; P = 0.95), and there was a tendency to lower morbidity (3/49-7.3% vs 4/25-16%; P = 0.24) in the laparoscopic surgery group. In the laparoscopic group, eight patients (16.3%) were converted to open surgery, mostly due to severe adhesions. The length of hospital stay was significantly shorter for the laparoscopic group (5 days vs 7 days; P = 0.44). The Hartmann's reversal procedure can be safely performed in the majority of the cases using a laparoscopic approach with a low morbidity rate and achieving a shorter hospital stay.

  16. The use of urinary bladder matrix in the treatment of complicated open wounds.

    PubMed

    Lanteri Parcells, Alexis; Abernathie, Brenon; Datiashvili, Ramazi

    2014-07-01

    Management of complicated open wounds represents a challenge when reconstructive options are not applicable. Urinary bladder matrix (UBM) provides a biocompatible material that allows inductivetissue remodeling. The use of urinary bladder matrix inthe treatment of 5 patients with complicated open wounds that failed toheal with conventional therapy is presented. A 3-year old male sustained a second-degree oil burn measuring 8 cm x 4 cm to his dorsal forearm; UBM was applied weekly and the wound epithelialized in 3 weeks. A 52-year old male sustained massive second and third degree burns to his leg after a fire; UBM was applied weekly and the wound epithelialized in 28 weeks. A 61-year old female sustained a severe crushing injury to her right knee. A gastrocnemius muscle transfer and rectus abdominus muscle free flap transfer both failed, then UBM and vacuum-assisted closure therapy were applied and the wound epithelialized in 24 weeks. A 54-year old female underwent a breast mastectomy and immediate reconstruction with pedicled transverse rectus abdominus flap. The patient developed partial necrosis and the wound was managed with UBM and vacuum-assisted closure therapy. The wound epithelialized in 12 weeks. A 36-year old female sustained severe degloving injuries to both hands with exposed metacarpals. Weekly application of UBM provided tissue remodeling over the bones, which allowed successful skin grafting and closure. These experiences show UBM to be an effective method in management of complicated open wounds in select cases. Further studies need to be implemented to confirm this conclusion.

  17. Assessment of Functional Rhinoplasty with Spreader Grafting Using Acoustic Rhinomanometry and Validated Outcome Measurements

    PubMed Central

    Paul, Marek A.; Kamali, Parisa; Chen, Austin D.; Ibrahim, Ahmed M. S.; Wu, Winona; Becherer, Babette E.; Medin, Caroline

    2018-01-01

    Background: Rhinoplasty is 1 of the most common aesthetic and reconstructive plastic surgical procedures performed within the United States. Yet, data on functional reconstructive open and closed rhinoplasty procedures with or without spreader graft placement are not definitive as only a few studies have examined both validated measurable objective and subjective outcomes of spreader grafting during rhinoplasty. The aim of this study was to utilize previously validated measures to assess objective, functional outcomes in patients who underwent open and closed rhinoplasty with spreader grafting. Methods: We performed a retrospective review of consecutive rhinoplasty patients. Patients with internal nasal valve insufficiency who underwent an open and closed approach rhinoplasty between 2007 and 2016 were studied. The Cottle test and Nasal Obstruction Symptom Evaluation survey was used to assess nasal obstruction. Patient-reported symptoms were recorded. Acoustic rhinometry was performed pre- and postoperatively. Average minimal cross-sectional area of the nose was measured. Results: One hundred seventy-eight patients were reviewed over a period of 8 years. Thirty-eight patients were included in this study. Of those, 30 patients underwent closed rhinoplasty and 8 open rhinoplasty. Mean age was 36.9 ± 18.4 years. The average cross-sectional area in closed and open rhinoplasty patients increased significantly (P = 0.019). There was a functional improvement in all presented cases using the Nasal Obstruction Symptom Evaluation scale evaluation. Conclusions: Closed rhinoplasty with spreader grafting may play a significant role in the treatment of nasal valve collapse. A closed approach rhinoplasty including spreader grafting is a viable option in select cases with objective and validated functional improvement. PMID:29707440

  18. Lateral Opening-wedge Distal Femoral Osteotomy: Pain Relief, Functional Improvement, and Survivorship at 5 Years.

    PubMed

    Cameron, James I; McCauley, Julie C; Kermanshahi, Arash Y; Bugbee, William D

    2015-06-01

    Distal femoral varus osteotomy may be used to treat valgus knee malalignment or to protect a knee compartment in which cartilage restoration surgery (such as osteochondral or meniscus allografting) has been performed. Medial closing-wedge osteotomy has demonstrated good success in treatment of osteoarthritis in published series, but few studies have evaluated distal femoral lateral opening-wedge osteotomy in terms of correction of deformity, pain and function, and survivorship. (1) Does lateral opening-wedge osteotomy lead to accurate correction? (2) What pain and function levels do patients experience after lateral opening-wedge osteotomy? (3) What are the nonunion, complication, and reoperation rates after lateral opening-wedge osteotomy? Between 2000 and 2010, we performed 40 distal femoral osteotomies. Two knees (two patients) underwent a medial closing-wedge osteotomy and were excluded from the present study. Thirty-eight knees (97%) in 36 patients were lateral opening-wedge varus-producing osteotomies; of those, 31 knees (82%) in 30 patients had followup at a minimum of 2 years (mean, 5 years; SD, 2; range, 2-12 years) and comprised the study population. The indications for osteotomy included symptomatic lateral compartment arthritis with clinical valgus deformity or a cartilage or meniscal defect in the lateral compartment with clinical valgus alignment. The study population was stratified into two groups based on reason for osteotomy: patients with isolated symptomatic lateral compartment arthritis (arthritis group; 19 knees [61%]) and patients who underwent joint preservation procedures including osteochondral allograft transplantation or meniscal allograft transplantation (joint preservation group; 12 knees [39%]). Data collection from our institution's osteotomy database included patient demographics, lower extremity coronal alignment, and operative details. Pain and function were measured preoperatively and postoperatively using the International Knee Documentation Committee (IKDC) score. Time to radiographic union, complications, and reoperations were recorded. Twenty-one of 31 knees had postoperative radiographic data available for review. Of these, seven of 15 knees in the arthritis group and three of six knees in the joint preservation group were within the correction goal of ± 3° from neutral mechanical alignment. In the arthritis group, the mean IKDC total score improved from 47 (SD, 15) preoperatively to 67 (SD, 10) postoperatively. In the joint preservation group, the mean IKDC total score improved from 36 (SD, 12) preoperatively to 62 (SD, 18) postoperatively. One nonunion occurred in the arthritis group. No postoperative complications were experienced. Ten knees in the arthritis group and six knees in the joint preservation group had additional surgery after the osteotomy, consisting primarily of hardware removal, arthroscopy for cartilage-related conditions, or conversion to arthroplasty. Survivorship at 5 years, with conversion to arthroplasty as the endpoint, was 74% in the arthritis group and 92% in the joint preservation group. Lateral opening-wedge distal femoral osteotomy was less accurate in correction of valgus deformity than expected, but the procedure was associated with improved knee pain and function scores. Our clinical and radiographic results are comparable to published series evaluating medial closing-wedge distal femoral osteotomy. Achieving our desired correction of ± 3° from neutral alignment was clinically difficult. An improved method of preoperative templating and refinement of the intraoperative technique may improve this. Future studies with more patients and longer followup will provide clarity on this topic. Level IV, therapeutic study.

  19. Open versus laparoscopic Roux-en-Y gastric bypass: a comparative study of over 25,000 open cases and the major laparoscopic bariatric reported series.

    PubMed

    Jones, Kenneth B; Afram, Joseph D; Benotti, Peter N; Capella, Rafael F; Cooper, C Gary; Flanagan, Latham; Hendrick, Steven; Howell, L Michael; Jaroch, Mark T; Kole, Kerry; Lirio, Oscar C; Sapala, James A; Schuhknecht, Michael P; Shapiro, Robert P; Sweet, William A; Wood, Michael H

    2006-06-01

    Laparoscopic bariatric surgery has experienced a rapid expansion of interest over the past 5 years, with a 470% increase. This rapid expansion has markedly increased overall cost, reducing surgical access. Many surgeons believe that the traditional open approach is a cheaper, safer, equally effective alternative. 16 highly experienced "open" bariatric surgeons with a combined total of 25,759 cases representing >200 surgeon years of experience, pooled their open Roux-en-Y gastric bypass (ORYGBP) data, and compared their results to the leading laparoscopic (LRYGBP) papers in the literature. In the overall series, the incisional hernia rate was 6.4% using the standard midline incision. Utilizing the left subcostal incision (LSI), it was only 0.3%. Return to surgery in <30 days was 0.7%, deaths 0.25%, and leaks 0.4%. Average length of stay was 3.4 days, and return to usual activity 21 days. Small bowel obstruction was significantly higher with the LRYGBP. Surgical equipment costs averaged approximately $3,000 less for "open" cases. LRYGBP had an added expense for longer operative time. This more than made up for the shorter length of stay with the laparoscopic approach. The higher cost, higher leak rate, higher rate of small bowel obstruction, and similar long-term weight loss results make the "open" RYGBP our preferred operation. If the incision is taken out of the equation (i.e. use of the LSI), the significant advantages of the open technique become even more obvious.

  20. Clinical characteristics and outcomes of fall-related open globe injuries in Japan.

    PubMed

    Morikawa, Shohei; Okamoto, Yoshifumi; Okamoto, Fumiki; Inomoto, Naoki; Ishikawa, Hiroto; Harimoto, Kozo; Ueda, Tetsuo; Sakamoto, Taiji; Oshika, Tetsuro

    2018-07-01

    To investigate the clinical characteristics and visual outcomes in patients with fall-related open globe injuries and to evaluate differences between fall-related and non-fall-related open globe injuries in Japan. A retrospective review of patients with open globe injury who presented to Japan-Clinical Research of Study (J-CREST) hospitals between 2005 and 2015 was enrolled. Clinical information including age, sex, initial visual acuity, final visual acuity, type of injury, status of the crystalline lens, zone of injury, wound length, presence of retinal detachment, proliferative vitreoretinopathy, expulsive hemorrhage, and endophthalmitis was recorded. A total of 374 eyes were enrolled, of which 120 (32.1%) suffered from fall-related injury with average age of 73.7 ± 15.9 years (range, 11-101 years). A majority of patients were female (55.8%). Of 120 patients with fall-related injury, 109 (90.8%) presented with rupture and 11 (9.2%) with laceration. A multiple regression analysis revealed that final visual acuity was significantly associated with initial visual acuity (r = 0.99, P < 0.001). Compared to non-fall-related open globe injuries, fall-related open globe injuries were associated with elderly age, female sex, poorer initial and final visual acuity, rupture, absence of the lens, larger wound size, retinal detachment, expulsive hemorrhage, and absence of endophthalmitis (P < 0.01). Fall-related open globe injuries were more frequent in elderly female and accompanied by larger wound lengths and severer ocular complications. Visual outcomes in patients with fall-related open globe injuries were related to initial visual acuity.

  1. Minimally Invasive and Open Distal Chevron Osteotomy for Mild to Moderate Hallux Valgus.

    PubMed

    Brogan, Kit; Lindisfarne, Edward; Akehurst, Harold; Farook, Usama; Shrier, Will; Palmer, Simon

    2016-11-01

    Minimally invasive surgical (MIS) techniques are increasingly being used in foot and ankle surgery but it is important that they are adopted only once they have been shown to be equivalent or superior to open techniques. We believe that the main advantages of MIS are found in the early postoperative period, but in order to adopt it as a technique longer-term studies are required. The aim of this study was to compare the 2-year outcomes of a third-generation MIS distal chevron osteotomy with a comparable traditional open distal chevron osteotomy for mild-moderate hallux valgus. Our null hypothesis was that the 2 techniques would yield equivalent clinical and radiographic results at 2 years. This was a retrospective cohort study. Eighty-one consecutive feet (49 MIS and 32 open distal chevron osteotomies) were followed up for a minimum 24 months (range 24-58). All patients were clinically assessed using the Manchester-Oxford Foot Questionnaire. Radiographic measures included hallux valgus angle, the intermetatarsal angle, hallux interphalangeal angle, metatarsal phalangeal joint angle, distal metatarsal articular angle, tibial sesamoid position, shape of the first metatarsal head, and plantar offset. Statistical analysis was done using Student t test or Wilcoxon rank-sum test for continuous data and Pearson chi-square test for categorical data. Clinical and radiologic postoperative scores in all domains were substantially improved in both groups (P < .001), but there was no statistically significant difference in improvement of any domain between open and MIS groups (P > .05). There were no significant differences in complications between the 2 groups ( > .5). The midterm results of this third-generation technique show that it was a safe procedure with good clinical outcomes and comparable to traditional open techniques for symptomatic mild-moderate hallux valgus. Level III, retrospective comparative study. © The Author(s) 2016.

  2. The WIYN Open Cluster Study: A 15-Year Report

    NASA Astrophysics Data System (ADS)

    Mathieu, Robert D.; WOCS Collaboration

    2013-06-01

    The WIYN 3.5m telescope combines large aperture, wide field of view and superb image quality. The WIYN consortium includes investigators in numerous areas of open cluster research. The combination spawned the WIYN Open Cluster Study (WOCS) over a decade ago, with the goals of producing 1) comprehensive photometric, astrometric and spectroscopic data for new fundamental open clusters and 2) addressing key astrophysical problems with these data. The set of core WOCS open clusters spans age and metallicity. Low reddening, solar proximity and richness were also desirable features in selecting core open clusters. More than 50 WIYN Open Cluster Study papers have been published in refereed journals. Highlights include: deep and wide-field photometry of NGC 188, NGC 2168 (M35), and NGC 6819 (WOCS I, II, XI and LII); deep and wide-field proper-motion studies of the old open clusters NGC 188, NGC 2682 (M67) and NGC 6791 (WOCS XVII, XXXIII and XLVI); comprehensive radial-velocity surveys of NGC 188, NGC 2168 and NGC 6819 (WOCS XXXII, XXIV, and XXXVIII); metallicity and lithium abundances in NGC 2168 (WOCS V); comprehensive definition of the hard-binary populations of NGC 188 and NGC 2168 (WOCS XXII and XLVIII); rotation period distributions in NGC 1039 (M34) and NGC 2168 (WOCS XXXV, XLIII, and XLV); study of chromospheric activity in NGC 2682 (WOCS XVIII); photometric variability surveys in NGC 188 and NGC 2682 (IX and XV); new Bayesian techniques for determination of cluster parameters (WOCS XXIII); a new infrared age-diagnostic for open clusters (WOCS XL); theoretical studies of stellar rotation (WOCS XIII and XIV); sophisticated N-body simulations of NGC 188 (WOCS LI); and the discovery of a high binary frequency and white dwarf companions among NGC 188 blue stragglers. While the WIYN 3.5m telescope remains at its heart, today the WIYN Open Cluster Study collaboration extends beyond both the WIYN observatory and consortium, and continues as a vital and productive exploration into these fundamental stellar systems. Publication list can be found at http://www.astro.ufl.edu ata/wocs/pubs.html. The WIYN Open Cluster Study has been continuously supported by grants from the National Science Foundation.

  3. Study Comparing Vein Integrity and Clinical Outcomes in Open Vein Harvesting and 2 Types of Endoscopic Vein Harvesting for Coronary Artery Bypass Grafting: The VICO Randomized Clinical Trial (Vein Integrity and Clinical Outcomes)

    PubMed Central

    Krishnamoorthy, Bhuvaneswari; Critchley, William R.; Thompson, Alexander J.; Payne, Katherine; Morris, Julie; Venkateswaran, Rajamiyer V.; Caress, Ann L.

    2018-01-01

    Background Current consensus statements maintain that endoscopic vein harvesting (EVH) should be standard care in coronary artery bypass graft surgery, but vein quality and clinical outcomes have been questioned. The VICO trial (Vein Integrity and Clinical Outcomes) was designed to assess the impact of different vein harvesting methods on vessel damage and whether this contributes to clinical outcomes after coronary artery bypass grafting. Methods In this single-center, randomized clinical trial, patients undergoing coronary artery bypass grafting with an internal mammary artery and with 1 to 4 vein grafts were recruited. All veins were harvested by a single experienced practitioner. We randomly allocated 300 patients into closed tunnel CO2 EVH (n=100), open tunnel CO2 EVH (n=100), and traditional open vein harvesting (n=100) groups. The primary end point was endothelial integrity and muscular damage of the harvested vein. Secondary end points included clinical outcomes (major adverse cardiac events), use of healthcare resources, and impact on health status (quality-adjusted life-years). Results The open vein harvesting group demonstrated marginally better endothelial integrity in random samples (85% versus 88% versus 93% for closed tunnel EVH, open tunnel EVH, and open vein harvesting; P<0.001). Closed tunnel EVH displayed the lowest longitudinal hypertrophy (1% versus 13.5% versus 3%; P=0.001). However, no differences in endothelial stretching were observed between groups (37% versus 37% versus 31%; P=0.62). Secondary clinical outcomes demonstrated no significant differences in composite major adverse cardiac event scores at each time point up to 48 months. The quality-adjusted life-year gain per patient was 0.11 (P<0.001) for closed tunnel EVH and 0.07 (P=0.003) for open tunnel EVH compared with open vein harvesting. The likelihood of being cost-effective, at a predefined threshold of £20 000 per quality-adjusted life-year gained, was 75% for closed tunnel EVH, 19% for open tunnel EVH, and 6% for open vein harvesting. Conclusions Our study demonstrates that harvesting techniques affect the integrity of different vein layers, albeit only slightly. Secondary outcomes suggest that histological findings do not directly contribute to major adverse cardiac event outcomes. Gains in health status were observed, and cost-effectiveness was better with closed tunnel EVH. High-level experience with endoscopic harvesting performed by a dedicated specialist practitioner gives optimal results comparable to those of open vein harvesting. Clinical Trial Registration URL: https://www.isrctn.com. International Standard Randomised Controlled Trial Registry Number: 91485426. PMID:28637880

  4. Openness to Using Non-cigarette Tobacco Products Among U.S. Young Adults

    PubMed Central

    Mays, Darren; Arrazola, René A.; Tworek, Cindy; Rolle, Italia V.; Neff, Linda J.; Portnoy, David B.

    2017-01-01

    Introduction National data indicate that the prevalence of non-cigarette tobacco product use is highest among young adults; however, little is known about their openness to use these products in the future and associated risk factors. This study sought to characterize openness to using non-cigarette tobacco products and associated factors among U.S. young adults. Methods In 2014, National Adult Tobacco Survey data (2012–2013) were analyzed to characterize openness to using the following tobacco products among all young adults aged 18–29 years (N=5,985): cigars; electronic cigarettes (“e-cigarettes”); hookah; pipe tobacco; chew, snuff, or dip; snus; and dissolvables. Among those who were not current users of each product, multivariable logistic regression was used to examine associations between demographics, cigarette smoking status, lifetime use of other non-cigarette products, perceived harm and addictiveness of smoking, and receipt of tobacco industry promotions and openness to using each product. Results Among all young adults, openness to using non-cigarette tobacco products was greatest for hookah (28.2%); e-cigarettes (25.5%); and cigars (19.1%). In multivariable analyses, which included non-current users of each product, non-current ever, current, and former smokers were more likely than never smokers to be open to using most examined products, as were men and adults aged 18–24 years. Receipt of tobacco industry promotions was associated with openness to using e-cigarettes; chew, snuff, or dip; and snus. Conclusions There is substantial openness to trying non-cigarette tobacco products among U.S. young adults. Young adults are an important population to consider for interventions targeting non-cigarette tobacco product use. PMID:26549502

  5. Openness to Using Non-cigarette Tobacco Products Among U.S. Young Adults.

    PubMed

    Mays, Darren; Arrazola, René A; Tworek, Cindy; Rolle, Italia V; Neff, Linda J; Portnoy, David B

    2016-04-01

    National data indicate that the prevalence of non-cigarette tobacco product use is highest among young adults; however, little is known about their openness to use these products in the future and associated risk factors. This study sought to characterize openness to using non-cigarette tobacco products and associated factors among U.S. young adults. In 2014, National Adult Tobacco Survey data (2012-2013) were analyzed to characterize openness to using the following tobacco products among all young adults aged 18-29 years (N=5,985): cigars; electronic cigarettes ("e-cigarettes"); hookah; pipe tobacco; chew, snuff, or dip; snus; and dissolvables. Among those who were not current users of each product, multivariable logistic regression was used to examine associations between demographics, cigarette smoking status, lifetime use of other non-cigarette products, perceived harm and addictiveness of smoking, and receipt of tobacco industry promotions and openness to using each product. Among all young adults, openness to using non-cigarette tobacco products was greatest for hookah (28.2%); e-cigarettes (25.5%); and cigars (19.1%). In multivariable analyses, which included non-current users of each product, non-current ever, current, and former smokers were more likely than never smokers to be open to using most examined products, as were men and adults aged 18-24 years. Receipt of tobacco industry promotions was associated with openness to using e-cigarettes; chew, snuff, or dip; and snus. There is substantial openness to trying non-cigarette tobacco products among U.S. young adults. Young adults are an important population to consider for interventions targeting non-cigarette tobacco product use. Published by Elsevier Inc.

  6. Open versus robotic-assisted transabdominal preperitoneal (R-TAPP) inguinal hernia repair: a multicenter matched analysis of clinical outcomes.

    PubMed

    Gamagami, R; Dickens, E; Gonzalez, A; D'Amico, L; Richardson, C; Rabaza, J; Kolachalam, R

    2018-04-26

    To compare the perioperative outcomes of initial, consecutive robotic-assisted transabdominal preperitoneal (R-TAPP) inguinal hernia repair (IHR) cases with consecutive open cases completed by the same surgeons. Multicenter, retrospective, comparative study of perioperative results from open and robotic IHR using standard univariate and multivariate regression analyses for propensity score matched (1:1) cohorts. Seven general surgeons at six institutions contributed 602 consecutive open IHR and 652 consecutive R-TAPP IHR cases. Baseline patient characteristics in the unmatched groups were similar with the exception of previous abdominal surgery and all baseline characteristics were comparable in the matched cohorts. In matched analyses, postoperative complications prior to discharge were comparable. However, from post discharge through 30 days, fewer patients experienced complications in the R-TAPP group than in the open group [4.3% vs 7.7% (p = 0.047)]. The R-TAPP group had no reoperations post discharge through 30 days of follow-up compared with five patients (1.1%) in the open group (p = 0.062), respectively. Multivariate logistic regression analysis which demonstrated patient age > 65 years and the open approach were risk factors for complications within 30 days post discharge in the matched group [age > 65 years: odds ratio (OR) = 3.33 (95% CI 1.89, 5.87; p < 0.0001); open approach: OR = 1.89 (95% CI 1.05, 3.38; p = 0.031)]. In this matched analysis, R-TAPP provides similar postoperative complications prior to discharge and a lower rate of postoperative complications through 30 days compared to open repair. R-TAPP is a promising and reproducible approach, and may facilitate adoption of minimally invasive repairs of inguinal hernias.

  7. Monitoring of Structural Components and Water Balance as AN Aid to Wetland Management Using Geospatial Techniques - a Case Study for Nalsarovar Lake, Gujarat

    NASA Astrophysics Data System (ADS)

    Murthy, T. V. R.; Panigrahy, S.

    2011-09-01

    The hydrologic variability greatly influences the structural components of wetlands that have a great bearing on habitats for avifauna, aquatic fauna including fish etc. This paper highlights the results of a study carried out to derive changes in open-water and vegetation, and also water balance for Nalsarovar Lake, Gujarat. MODIS 8-day composite data for three consecutive years viz 2002/03, 2003/04 and 2004/05 were used to study the seasonal and inter annual dynamics of water regime in the lake. Digital elevation model derived using Shuttle Radar Topographic Mission data with interpolated bottom topography was used to generate elevation contours and compute water volume from water spread data. The reference data of 2002 (drought year) shows the maximum extent of wetland to be 8.06 km2 with emergent vegetation of recorded as 2.36 km2 and open-water as 5.70 km2. The rainfall has an impact on the preferred habitat availability for various species of avifauna and it is noted that emergent vegetation present in the lake completely dried up by summer 2002, a rainfall deficit year but revived again in the preceding year i.e. 2003 which was a good rainfall year with 46.68 km2 under emergent vegetation and 61.96 km2 under open-water. The 2002 being a drought year has shown very low reference storage (0.256 MCM), which has shown a gradual decrease in the storage to 0.00019 MCM in March 2003. The reference storage also registered a steep increase to 18.165 MCM in October 2003 and decreased 1.264 MCM in March 2004. From this study it is evident that water level of about 9 m elevation at the end of the rainy season is found to be optimal for maintaining various habitats that in turn support the avifauna for the rest of the lean period.

  8. 77 FR 63727 - Drawbridge Operation Regulation; Schuylkill River, Philadelphia, PA

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-10-17

    ... 51 MGT of freight every year. However, over the past 13 years the bridge logs show that there has..., because there have been no requests for openings for the past 13 years, and there is no anticipated change... no requests for openings in 13 years. DATES: This rule is effective November 16, 2012. [[Page 63728...

  9. Safety and Tolerability of Methylphenidate in Preschool Children with ADHD

    ERIC Educational Resources Information Center

    Wigal, Tim; Greenhill, Laurence; Chuang, Shirley; McGough, James; Vitiello, Benedetto; Skrobala, Anne; Swanson, James; Wigal, Sharon; Abikoff, Howard; Kollins, Scott; McCracken, James; Riddle, Mark; Posner, Kelly; Ghuman, Jaswinder; Davies, Mark; Thorp, Ben; Stehli, Annamarie

    2006-01-01

    Objective: To report on the safety and tolerability of methylphenidate (MPH) 3- to 5-year-old children with attention-deficit/hyperactivity disorder (ADHD) during 1 year of treatment. Method: Exactly 183 children (3-5 years old) entered a treatment study of MPH, consisting of a 1-week open-label lead-in (n = 183); a 5-week placebo-controlled,…

  10. Study of the Open Loop and Closed Loop Oscillator Techniques

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

    Imel, George R.; Baker, Benjamin; Riley, Tony

    This report presents the progress and completion of a five-year study undertaken at Idaho State University of the measurement of very small worth reactivity samples comparing open and closed loop oscillator techniques.The study conclusively demonstrated the equivalency of the two techniques with regard to uncertainties in reactivity values, i.e., limited by reactor noise. As those results are thoroughly documented in recent publications, in this report we will concentrate on the support work that was necessary. For example, we describe in some detail the construction and calibration of a pilot rod for the closed loop system. We discuss the campaign tomore » measure the required reactor parameters necessary for inverse-kinetics. Finally, we briefly discuss the transfer of the open loop technique to other reactor systems.« less

  11. Study of the open loop and closed loop oscillator techniques

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

    Baker, Benjamin; Riley, Tony; Langbehn, Adam

    This paper presents some aspects of a five year study undertaken at Idaho State University of the measurement of very small worth reactivity samples comparing open and closed loop oscillator techniques. The study conclusively demonstrated the equivalency of the two techniques with regard to uncertainties in reactivity values, i.e., limited by reactor noise. As those results are thoroughly documented in recent publications, in this paper we will concentrate on the support work that was necessary. For example, we describe in some detail the construction and calibration of a pilot rod for the closed loop system. We discuss the campaign tomore » measure the required reactor parameters necessary for inverse-kinetics. Finally, we briefly discuss the transfer of the open loop technique to other reactor systems. (authors)« less

  12. Extending General Education to the Junior and Senior Years.

    ERIC Educational Resources Information Center

    Brown, Peggy, Ed.

    1982-01-01

    Activities are described that illustrate the ways new emphases on structure, liberal arts curriculum, attention to basic skills, a global approach, four-year study courses, and non-lecture pedagogy are being incorporated into college curricula across the country. An opening essay ("The General Education Reform: Accomplishments and Future Agenda")…

  13. Epidemiology of open fractures in sport: One centre’s 15-year retrospective study

    PubMed Central

    Wood, Alexander M; Robertson, Greg A J; MacLeod, Kirsty; Porter, Anna; Court-Brown, Charles M

    2017-01-01

    AIM To describe the epidemiology of sport-related open fractures from one centre’s adult patient population over a 15-year period. METHODS A retrospective review of a prospectively-collected database was performed: The database contained information all sport-related open fractures, sustained from 1995 to 2009 in the Edinburgh, Mid and East Lothian Populations. RESULTS Over the 15-year period, there were 85 fractures recorded in 84 patients. The annual incidence of open sport-related fractures was 0.01 per 1000 population. The mean age at injury was 29.2 years (range 15-67). There were 70 (83%) males and 14 females (17%). The 6 most common sports were soccer (n = 19, 22%), rugby (n = 9, 11%), cycling (n = 8, 9%), hockey (n = 8, 9%); horse riding (n = 6, 7%) and skiing (n = 6, 7%). The five most common anatomical locations were finger phalanges (n = 30, 35%); tibial diaphysis (n = 19, 23%); forearm (n = 12, 14%); ankle (n = 7, 8%) and metacarpals (n = 5, 6%). The mean injury severity score was 7.02. According to the Gustilo-Anderson classification system, 45 (53%) fractures were grade 1; 28 (33%) fractures were grade 2; 8 (9%) fractures were grade 3a; and 4 (5%) fractures were grade 3b. Out of the total number of fractures, 7 (8%) required plastic surgical intervention as part of management. The types of flaps used were split skin graft (n = 4), fasciocutaneous flaps (n = 2); and adipofascial flap (n = 1). CONCLUSION We analysed the epidemiology of open fractures secondary to sport in one centre over a 15-year period. Soccer and rugby were the most common causative sports while fractures of the finger phalanx and of the tibial diaphysis were the most common sites. Open fractures are uncommon in sport; however, when they are sustained they usually occur on muddy sport fields or forest tracks and therefore must be treated appropriately. It is important that clinicians and sports therapists have knowledge of these injuries, in order to ensure they are managed optimally. PMID:28808625

  14. Epidemiology of pediatric ocular trauma in the Chaoshan Region, China, 2001-2010.

    PubMed

    Cao, He; Li, Liping; Zhang, Mingzhi; Li, Hongni

    2013-01-01

    Ocular trauma is the leading cause of monocular visual disability and noncongenital unilateral blindness in children. This study describes the epidemiology and medical care associated with nonfatal pediatric (≤ 17 years of age) eye injury-related hospitalization in the largest industrial base for plastic toy production in China. A population-based retrospective study of patients hospitalized for ocular and orbital trauma in the ophthalmology departments of 3 major tertiary hospitals from 1st January 2001 to 31st December 2010 was performed. The study included 1035 injured eyes from 1018 patients over a 10-year period: 560 (54.1%) eyes exhibited open globe injuries, 402 (38.8%) eyes suffered closed globe injuries, 10 (1.0%) eyes suffered chemical injuries and 8 (0.8%) eyes exhibited thermal injuries, representing an average annual hospitalization rate of 0.37 per 10,000 (95% confidence interval [CI], 0.36-0.38) due to pediatric eye injury in the Chaoshan region. The mean patient age was 9.2 ± 4.4 years with a male-to-female ratio of 3.3:1 (P = 0.007). Children aged 6 to 11 years accounted for the highest percentage (40.8%, 416/1018) of hospitalization, 56.7% (236/416) of whom were hospitalized for open globe wounds. Injury occurred most frequently at home (73.1%). Open globe wounds cost the single most expensive financial burden (60.8%) of total charges with $998 ± 702 mean charges per hospitalization. Open globe wounds occurred at home are earmarked for the priorities to prevention strategies. Higher public awareness of protecting primary schoolchildren from home-related eye injuries should be strengthened urgently by legislation or regulation since the traditional industrial mode seems to remain the pattern for the foreseeable future. Further research that provide detailed information on the specific inciting agents of pediatric eye injuries are recommended for facilitating the development and targeting of appropriate injury prevention initiatives.

  15. Epidemiology of Pediatric Ocular Trauma in the Chaoshan Region, China, 2001–2010

    PubMed Central

    Cao, He; Li, Liping; Zhang, Mingzhi; Li, Hongni

    2013-01-01

    Background Ocular trauma is the leading cause of monocular visual disability and noncongenital unilateral blindness in children. This study describes the epidemiology and medical care associated with nonfatal pediatric (≤17 years of age) eye injury-related hospitalization in the largest industrial base for plastic toy production in China. Methods A population-based retrospective study of patients hospitalized for ocular and orbital trauma in the ophthalmology departments of 3 major tertiary hospitals from 1st January 2001 to 31st December 2010 was performed. Results The study included 1035 injured eyes from 1018 patients over a 10-year period: 560 (54.1%) eyes exhibited open globe injuries, 402 (38.8%) eyes suffered closed globe injuries, 10 (1.0%) eyes suffered chemical injuries and 8 (0.8%) eyes exhibited thermal injuries, representing an average annual hospitalization rate of 0.37 per 10,000 (95% confidence interval [CI], 0.36–0.38) due to pediatric eye injury in the Chaoshan region. The mean patient age was 9.2±4.4 years with a male-to-female ratio of 3.3∶1 (P = 0.007). Children aged 6 to 11 years accounted for the highest percentage (40.8%, 416/1018) of hospitalization, 56.7% (236/416) of whom were hospitalized for open globe wounds. Injury occurred most frequently at home (73.1%). Open globe wounds cost the single most expensive financial burden (60.8%) of total charges with $998±702 mean charges per hospitalization. Conclusions Open globe wounds occurred at home are earmarked for the priorities to prevention strategies. Higher public awareness of protecting primary schoolchildren from home-related eye injuries should be strengthened urgently by legislation or regulation since the traditional industrial mode seems to remain the pattern for the foreseeable future. Further research that provide detailed information on the specific inciting agents of pediatric eye injuries are recommended for facilitating the development and targeting of appropriate injury prevention initiatives. PMID:23593323

  16. Open Bankart repair for revision of failed prior stabilization: outcome analysis at a mean of more than 10 years.

    PubMed

    Neviaser, Andrew S; Benke, Michael T; Neviaser, Robert J

    2015-06-01

    The purpose of this study was to analyze the outcome of open Bankart repair for failed stabilization surgery at a mean follow-up of >10 years. Thirty patients underwent revision open Bankart repair by a single surgeon for failed prior stabilization surgery, with a standard technique and postoperative rehabilitation. All patients were referred by other surgeons. Evaluation was by an independent examiner, at a mean follow-up of 10.2 years. Evaluation included a history, physical examination for range of motion, outcome scores, recurrence, return to athletics, and radiographic examination. All cases had persistent Bankart and Hill-Sachs lesions. Failures included 14 patients with a failed single arthroscopic Bankart repair; 1 patient with 2 failed arthroscopic Bankart repairs; 1 patient with an arthroscopic failure and an open Bankart repair; 7 patients with failed open Bankart repairs; and 1 patient with a failed open Bankart repair, then a failed arthroscopic attempt. Two patients had had thermal capsulorrhaphy; 2 others had staple capsulorrhaphy, 1 with an open capsular shift and 1 after a failed arthroscopic Bankart repair, an open Bankart repair, and then a coracoid transfer. All arthroscopic Bankart repairs had anchors placed medial and superior on the glenoid neck. Mean motion loss compared with the normal contralateral side was as follows: elevation 1.15°, abduction 4.2°, external rotation at the side 3.2°, external rotation in abduction 5.1°, and internal rotation 0.6 vertebral levels (NS). No patient had an apprehension sign, pain, or instability. Of 23 who played sports, 22 resumed after. Outcomes scores were as follows: American Shoulder and Elbow Surgeons, 89.44; Rowe, 86.67; Western Ontario Shoulder Instability Index, 476.26. On radiographic examination, there were 13 normal radiographs and 7 with mild, 2 with moderate, and 0 with severe arthritic changes. The open Bankart repair offers a reliable, consistently successful option for revision of failed stabilizations. Copyright © 2015 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Elsevier Inc. All rights reserved.

  17. The Payer and Patient Cost Burden of Open Breast Conserving Procedures Following Percutaneous Breast Biopsy.

    PubMed

    Kimball, Chloe C; Nichols, Christine I; Vose, Joshua G

    2018-01-01

    Percutaneous core-needle biopsy (PCNB) is the standard of care to biopsy and diagnose suspicious breast lesions. Dependent on histology, many patients require additional open procedures for definitive diagnosis and excision. This study estimated the payer and patient out-of-pocket (OOP) costs, and complication risk, among those requiring at least 1 open procedure following PCNB. This retrospective study used the Truven Commercial database (2009-2014). Women who underwent PCNB, with continuous insurance, and no history of cancer, chemotherapy, radiation, or breast surgery in the prior year were included. Open procedures were defined as open biopsy or lumpectomy. Study follow-up ended at chemotherapy, radiation, mastectomy, or 90 days-whichever occurred first. In total, 143 771 patients (mean age 48) met selection criteria; 85.1% underwent isolated PCNB, 12.4% one open procedure, and 2.5% re-excision. Incidence of complications was significantly lower among those with PCNB alone (9.2%) vs 1 open procedure (15.6%) or re-excision (25.3%, P  < .001). Mean incremental commercial payments were US $13 190 greater among patients with 1 open procedure vs PCNB alone (US $17 125 vs US $3935, P  < .001), and US $4767 greater with re-excision (US $21 892) relative to 1 procedure. Mean patient OOP cost was US $858 greater for 1 open procedure vs PCNB alone (US $1527 vs US $669), and US $247 greater for re-excision vs 1 procedure. A meaningful proportion of patients underwent open procedure(s) following PCNB which was associated with increased complication risk and costs to both the payer and the patient. These results suggest a need for technologies to reduce the proportion of cases requiring open surgery and, in some cases, re-excision.

  18. Germany as a Study Abroad Destination of U.S. Students in the Science, Technology, Engineering and Mathematics (STEM) Fields

    ERIC Educational Resources Information Center

    Comp, David

    2010-01-01

    Of the 205,000 U.S. students abroad during the 2004-2005 academic year, only 6,557 or slightly more than 3% of them studied in Germany. The Ohio Alliance reports that only 13% of all U.S. students who studied abroad during the 2004-2005 academic year were from the STEM fields of study. The Institute of International Education Open Doors Report,…

  19. Incidence of Avascular Necrosis of the Femoral Head After Intramedullary Nailing of Femoral Shaft Fractures

    PubMed Central

    Kim, Ji Wan; Oh, Jong-Keon; Byun, Young-Soo; Shon, Oog-Jin; Park, Jai Hyung; Oh, Hyoung Keun; Shon, Hyun Chul; Park, Ki Chul; Kim, Jung Jae; Lim, Seung-Jae

    2016-01-01

    Abstract The goal of this study was to determine the incidence of avascular necrosis of the femoral head (AVNFH) after intramedullary nailing of femoral shaft fractures and to identify risk factors for developing AVNFH. We retrospectively reviewed all patients with femoral shaft fractures treated with antegrade intramedullary nailing at 10 institutions. Among the 703 patients enrolled, 161 patients were excluded leaving 542 patients in the study. Average age was 42.1 years with average follow-up of 26.3 months. Patient characteristics and fracture patterns as well as entry point of femoral nails were identified and the incidence of AVNFH was investigated. Patients were divided into 2 groups according to open versus closed physis, open versus closed fractures, and age (<20 versus ≥20 years). Overall incidence of AVNFH was 0.2% (1 of 542): the patient was 15-year-old boy. Of 25 patients with open physis, the incidence of AVNFH was 4%, whereas none of 517 patients with closed physis developed AVNFH (P < 0.001). The incidence of AVNFH in patients aged < 20 versus ≥20 years was 1.1% (1 of 93) and 0.0% (0 of 449), respectively (P = 0.172), which meant that the incidence of AVNFH was 0% in adult with femur shaft fracture. Of 61 patients with open fractures, the incidence of AVNFH was 0%. The number of cases with entry point at the trochanteric fossa or tip of the greater trochanter (GT) was 324 and 218, respectively, and the incidence of AVNFH was 0.3% and 0.0%, respectively (P = 0.412). In patients aged ≥20 years with isolated femoral shaft fracture, there was no case of AVNFH following antegrade intramedullary nailing regardless of the entry point. Therefore, our findings suggest that the risk of AVNFH following antegrade femoral nailing is extremely low in adult patients. PMID:26844518

  20. Early intervention with tafamidis provides long-term (5.5-year) delay of neurologic progression in transthyretin hereditary amyloid polyneuropathy

    PubMed Central

    Waddington Cruz, Márcia; Amass, Leslie; Keohane, Denis; Schwartz, Jeffrey; Li, Huihua; Gundapaneni, Balarama

    2016-01-01

    Abstract Transthyretin hereditary amyloid polyneuropathy, also traditionally known as transthyretin familial amyloid polyneuropathy (ATTR-FAP), is a rare, relentless, fatal hereditary disorder. Tafamidis, an oral, non-NSAID, highly specific transthyretin stabilizer, demonstrated safety and efficacy in slowing neuropathy progression in early-stage ATTRV30M-FAP in a 1.5-year, randomized, double-blind, placebo-controlled trial, and 1-year open-label extension study, with a second long-term open-label extension study ongoing. Subgroup analysis of the effectiveness of tafamidis in the pivotal study and its open-label extensions revealed a relatively cohesive cohort of patients with mild neuropathy (i.e. Neuropathy Impairment Score for Lower Limbs [NIS-LL] ≤ 10) at the start of active treatment. Early treatment with tafamidis for up to 5.5 years (≥1 dose of tafamidis meglumine 20 mg once daily during the original trial or after switching from placebo in its extension) resulted in sustained delay in neurologic progression and long-term preservation of nutritional status in this cohort. Mean (95% CI) changes from baseline in NIS-LL and mBMI were 5.3 (1.6, 9.1) points and −7.8 (−44.3, 28.8) kg/m2 × g/L at 5.5 years, respectively. No new safety issues or side effects were identified. These data represent the longest prospective evaluation of tafamidis to date, confirm a favorable safety profile, and underscore the long-term benefits of early intervention with tafamidis. Trial Registration: ClincalTrials.gov Identifier: NCT00409175, NCT00791492, and NCT00925002. PMID:27494299

  1. COBE DMR-normalized open inflation cold dark matter cosmogony

    NASA Technical Reports Server (NTRS)

    Gorski, Krzysztof M.; Ratra, Bharat; Sugiyama, Naoshi; Banday, Anthony J.

    1995-01-01

    A cut-sky orthogonal mode analysis of the 2 year COBE DMR 53 and 90 GHz sky maps (in Galactic coordinates) is used to determine the normalization of an open inflation model based on the cold dark matter (CDM) scenario. The normalized model is compared to measures of large-scale structure in the universe. Although the DMR data alone does not provide sufficient discriminative power to prefer a particular value of the mass density parameter, the open model appears to be reasonably consistent with observations when Omega(sub 0) is approximately 0.3-0.4 and merits further study.

  2. The value of urban open space: meta-analyses of contingent valuation and hedonic pricing results.

    PubMed

    Brander, Luke M; Koetse, Mark J

    2011-10-01

    Urban open space provides a number of valuable services to urban populations, including recreational opportunities, aesthetic enjoyment, environmental functions, and may also be associated with existence values. In separate meta-analyses of the contingent valuation (CV) and hedonic pricing (HP) literature we examine which physical, socio-economic, and study characteristics determine the value of open space. The dependent variable in the CV meta-regression is defined as the value of open space per hectare per year in 2003 US$, and in the HP model as the percentage change in house price for a 10 m decrease in distance to open space. Using a multi-level modelling approach we find in both the CV and HP analyses that there is a positive and significant relationship between the value of urban open space and population density, indicating that scarcity and crowdedness matter, and that the value of open space does not vary significantly with income. Further, urban parks are more highly valued than other types of urban open space (forests, agricultural and undeveloped land) and methodological differences in study design have a large influence on estimated values from both CV and HP. We also find important regional differences in preferences for urban open space, which suggests that the potential for transferring estimated values between regions is likely to be limited. Copyright © 2011 Elsevier Ltd. All rights reserved.

  3. Effects of riparian canopy opening and salmon carcass addition on the abundance and growth of resident salmonids

    Treesearch

    Margaret A. Wilzbach; Bret C. Harvey; Jason L. White; Rodney J. Nakamoto

    2005-01-01

    We studied the concurrent effects of riparian canopy opening and salmon carcass addition on salmonid biomass, density and growth rates in small streams over 2 years. In each of six streams in the Smith and Klamath River basins in northern California, red alder (Alnus rubra) and other hardwoods were removed along both banks of a 100-m reach to...

  4. Junior Primary Greek School Pupils' Perceptions of the City's Public Open Spaces and Especially of the Urban Square: A Case Study

    ERIC Educational Resources Information Center

    Papageorgiou, Nikoletta; Galani, Apostolia; Mavrikaki, Evangelia

    2016-01-01

    This work--part of a wider project aimed at engaging first year primary school pupils in public open-space design--explores the perceptions of junior primary school children as to the urban square. Data collection tools comprised semi-structured interviews, sketches and storytelling via puppet-animation. Our findings have shown that--according to…

  5. Anterior Segment Imaging Predicts Incident Gonioscopic Angle Closure.

    PubMed

    Baskaran, Mani; Iyer, Jayant V; Narayanaswamy, Arun K; He, Yingke; Sakata, Lisandro M; Wu, Renyi; Liu, Dianna; Nongpiur, Monisha E; Friedman, David S; Aung, Tin

    2015-12-01

    To investigate the incidence of gonioscopic angle closure after 4 years in subjects with gonioscopically open angles but varying degrees of angle closure detected on anterior segment optical coherence tomography (AS OCT; Visante; Carl Zeiss Meditec, Dublin, CA) at baseline. Prospective, observational study. Three hundred forty-two subjects, mostly Chinese, 50 years of age or older, were recruited, of whom 65 were controls with open angles on gonioscopy and AS OCT at baseline, and 277 were cases with baseline open angles on gonioscopy but closed angles (1-4 quadrants) on AS OCT scans. All subjects underwent gonioscopy and AS OCT at baseline (horizontal and vertical single scans) and after 4 years. The examiner performing gonioscopy was masked to the baseline and AS OCT data. Angle closure in a quadrant was defined as nonvisibility of the posterior trabecular meshwork by gonioscopy and visible iridotrabecular contact beyond the scleral spur in AS OCT scans. Gonioscopic angle closure in 2 or 3 quadrants after 4 years. There were no statistically significant differences in age, ethnicity, or gender between cases and controls. None of the control subjects demonstrated gonioscopic angle closure after 4 years. Forty-eight of the 277 subjects (17.3%; 95% confidence interval [CI], 12.8-23; P < 0.0001) with at least 1 quadrant of angle closure on AS OCT at baseline demonstrated gonioscopic angle closure in 2 or more quadrants, whereas 28 subjects (10.1%; 95% CI, 6.7-14.6; P < 0.004) demonstrated gonioscopic angle closure in 3 or more quadrants after 4 years. Individuals with more quadrants of angle closure on baseline AS OCT scans had a greater likelihood of gonioscopic angle closure developing after 4 years (P < 0.0001, chi-square test for trend for both definitions of angle closure). Anterior segment OCT imaging at baseline predicts incident gonioscopic angle closure after 4 years among subjects who have gonioscopically open angles and iridotrabecular contact on AS OCT at baseline. Copyright © 2015 American Academy of Ophthalmology. All rights reserved.

  6. Mini-open anterior instrumentation with diaphragm sparing for thoracolumbar idiopathic scoliosis: its technique and clinical results

    PubMed Central

    Zhu, Feng; Wang, Bin; Zhu, Zezhang; Yu, Yang; Sun, Xu; Ma, Weiwei

    2010-01-01

    The traditional method of thoracoabdominal retroperitoneal approach requires dissection of diaphragm which bears potential complications such as postoperatively weakened abdominal breathing and dysfunction of diaphragm. Mini-open anterior instrumentation with diaphragm sparing is designed to minimize the damage to diaphragm and improve cosmesis. This study compared the traditional anterior instrumentation and mini-open anterior instrumentation under the hypothesis that both results in similar surgical outcomes in treating thoracolumbar scoliosis. In Group A, 38 patients with an average age of 16.5 years underwent mini-open anterior instrumentation with diaphragm sparing. The average standing coronal Cobb angle was 56.4° in Group A. Thirty-eight patients with average age of 16.7 years in Group B received traditional open approach. The preoperative average Cobb angle was 55.8° in Group B. The average correction rate of coronal curve was 78% in group A while 75% in group B. No statistical difference between the two groups in terms of coronal curve correction, sagittal profile restoration and estimated blood loss was observed. The operation time was significantly higher in Group A than that in Group B. All patients in the two groups had good healing of incisions without neurological and instrumental complications during minimal 2 year follow-up. In Groups A and B, two patients suffered from pleural effusion, respectively. The wedging of the vertebral discs distal to the lowest fused level occurred in three and four patients in Group A and B, respectively. One case in group B was found to be suspicious pseudoarthrosis without loss of correction. Mini-open anterior instrumentation with diaphragm sparing could minimize the surgical invasion as well as achieve similar clinical outcomes compared with classical anterior approach. PMID:21181213

  7. CPT-hole closure

    USGS Publications Warehouse

    Noce, T.E.; Holzer, T.L.

    2003-01-01

    The long-term stability of deep holes 1.75 inches. (4.4 cm) in diameter by 98.4 feet (30 m) created by cone penetration testing (CPT) was monitored at a site in California underlain by Holocene and Pleistocene age alluvial fan deposits. Portions of the holes remained open both below and above the 28.6-foot (8.7 m)-deep water table for approximately three years, when the experiment was terminated. Hole closure appears to be a very slow process that may take decades in the stiff soils studied here. Other experience suggests holes in softer soils may also remain open. Thus, despite their small diameter, CPT holes may remain open for years and provide paths for rapid migration of contaminants. The observations confirm the need to grout holes created by CPT soundings as well as other direct-push techniques in areas where protection of shallow ground water is important.

  8. Data Sharing Effect on Article Citation Rate in Paleoceanography

    NASA Astrophysics Data System (ADS)

    Sears, J. R.

    2011-12-01

    The validation of scientific results requires reproducible methods and data. Often, however, data sets supporting research articles are not openly accessible and interlinked. This analysis tests whether open sharing and linking of supporting data through the PANGAEA° data library measurably increases the citation rate of articles published between 1993 and 2010 in the journal Paleoceanography as reported in the Thomson Reuters Web of Science database. The 12.85% (171) of articles with publicly available supporting data sets received 19.94% (8,056) of the aggregate citations (40,409). Publicly available data were thus significantly (p=0.007, 95% confidence interval) associated with about 35% more citations per article than the average of all articles sampled over the 18-year study period (1,331), and the increase is fairly consistent over time (14 of 18 years). This relationship between openly available, curated data and increased citation rate may incentivize researchers to share their data.

  9. 42 CFR 417.426 - Open enrollment requirements.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 42 Public Health 3 2013-10-01 2013-10-01 false Open enrollment requirements. 417.426 Section 417... Open enrollment requirements. (a) Basic requirements. (1) HMOs or CMPs must provide open enrollment for Medicare beneficiaries for at least 30 consecutive days during each contract year. (2) During open...

  10. 42 CFR 417.426 - Open enrollment requirements.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 42 Public Health 3 2014-10-01 2014-10-01 false Open enrollment requirements. 417.426 Section 417... Open enrollment requirements. (a) Basic requirements. (1) HMOs or CMPs must provide open enrollment for Medicare beneficiaries for at least 30 consecutive days during each contract year. (2) During open...

  11. 42 CFR 417.426 - Open enrollment requirements.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 42 Public Health 3 2012-10-01 2012-10-01 false Open enrollment requirements. 417.426 Section 417... Open enrollment requirements. (a) Basic requirements. (1) HMOs or CMPs must provide open enrollment for Medicare beneficiaries for at least 30 consecutive days during each contract year. (2) During open...

  12. Changes in down dead wood volume across a chronosequence of silvicultural openings in southern Indiana forests

    Treesearch

    Michael A. Jenkins; George R. Parker

    1997-01-01

    The volume and decay stages of down dead wood were evaluated across a chronosequence of 46 silvicultural openings and 10 uncut control stands to determine how down dead wood volume changes with stand development. Openings ranged in age from 8 to 26 years and were divided into three age groups: (1) 16 years. Individual logs...

  13. A Dozen Years after Open Source's 1998 Birth, It's Time for "OpenTechComm"

    ERIC Educational Resources Information Center

    Still, Brian

    2010-01-01

    2008 marked the 10-year Anniversary of the Open Source movement, which has had a substantial impact on not only software production and adoption, but also on the sharing and distribution of information. Technical communication as a discipline has taken some advantage of the movement or its derivative software, but this article argues not as much…

  14. Book Swap Now Open to All Employees | Poster

    Cancer.gov

    Not only did the year 2000 mark the start of a new millennium, the beginning of the Human Genome Project, and the opening of the International Space Station, but it was also the first year that the Scientific Library held its annual Book & Media Swap. Starting Nov. 12, the 15th annual Book Swap is open to all NCI at Frederick employees.

  15. Declining operative experience for junior level residents: Is this an unintended consequence of minimally invasive surgery?

    PubMed Central

    Mullen, Matthew G.; Salerno, Elise P.; Michaels, Alex D.; Hedrick, Traci L.; Sohn, Min-Woong; Smith, Philip W.; Schirmer, Bruce D.; Friel, Charles M.

    2016-01-01

    Introduction Our group has previously demonstrated an upward shift from junior to senior resident participation in common general surgery operations, traditionally performed by junior level residents. The objective of this study was to evaluate if this trend would correct over time. We hypothesized that junior resident case volume would improve. Methods A sample of essential laparoscopic and open general surgery procedures (appendectomy, inguinal herniorrhaphy, cholecystectomy, and partial colectomy) was chosen for analysis. The ACS NSQIP Participant Use Files were queried for these procedures between 2005–2012. Cases were stratified by participating resident post-graduate year (PGY) with ‘junior resident’ defined as PGY1–3. Logistic regression was performed to determine change in junior resident participation for each type of procedure over time. Results 185,335 cases were included in the study. For three of the operations we considered, the prevalence of laparoscopic surgery increased from 2005–2012 (all p<0.001). Cholecystectomy was an exception, which showed an unchanged proportion of cases performed laparoscopically across the study period (p=0.119). Junior resident participation decreased by 4.5%/year (p<0.001) for laparoscopic procedures and by 6.2%/year (p<0.001) for open procedures. The proportion of laparoscopic surgeries performed by junior level residents decreased for appendectomy by 2.6%/year (p<0.001) and cholecystectomy by 6.1%/year (p<0.001), whereas it was unchanged for inguinal herniorrhaphy (p=0.75) and increased for partial colectomy by 3.9%/year (p=0.003). A decline in junior resident participation was seen for all open surgeries, with appendectomy decreasing by 9.4%/year (p<0.001), cholecystectomy by 4.1%/year (p<0.002), inguinal herniorrhaphy by 10%/year (p<0.001) and partial colectomy by 2.9%/year (p<0.004). Conclusions Along with the proliferation of laparoscopy for common general surgical procedures there has been a concomitant reduction in the participation of junior level residents. As previously thought, familiarity with laparoscopy has not translated to redistribution of basic operations from senior to junior residents. This trend has significant implications for general surgery resident education. PMID:27066854

  16. Progress toward openness, transparency, and reproducibility in cognitive neuroscience.

    PubMed

    Gilmore, Rick O; Diaz, Michele T; Wyble, Brad A; Yarkoni, Tal

    2017-05-01

    Accumulating evidence suggests that many findings in psychological science and cognitive neuroscience may prove difficult to reproduce; statistical power in brain imaging studies is low and has not improved recently; software errors in analysis tools are common and can go undetected for many years; and, a few large-scale studies notwithstanding, open sharing of data, code, and materials remain the rare exception. At the same time, there is a renewed focus on reproducibility, transparency, and openness as essential core values in cognitive neuroscience. The emergence and rapid growth of data archives, meta-analytic tools, software pipelines, and research groups devoted to improved methodology reflect this new sensibility. We review evidence that the field has begun to embrace new open research practices and illustrate how these can begin to address problems of reproducibility, statistical power, and transparency in ways that will ultimately accelerate discovery. © 2017 New York Academy of Sciences.

  17. [Case-control study on transverse carpal ligament resection for the prevention of delayed carpal tunnel syndrome after distal radius fracture].

    PubMed

    Wang, Yan-jie; Wang, Shi-gang; Miao, Shu-juan; Su, Xia

    2011-06-01

    To investigate the effects of open reduction by palm side for the distal radius fracture and T shape plate internal fixation with simultaneous anterior transverse carpal ligament resection for the prevention of delayed carpal tunnel syndrome after operation. From March 2000 to March 2007, 32 patients (8 males and 24 females, ranging in age from 46 to 66 years) with distal radius fracture were treated with open reduction by palm side and T shape plate internal fixation with simultaneous anterior transverse carpal ligament resection; while 30 patients (7 males and 23 females,ranging in age from 45 to 65 years) only with open reduction by palm side and T shape plate internal fixation. The incidences of delayed carpal tunnel syndrome between the two groups were compared. Among 32 patients treated with open reduction by palm side and T shape plate internal fixation with anterior transverse carpal ligament resection, 3 patients had delayed carpal tunnel syndrome; while in 30 patients treated with open reduction by palm side and T shape plate internal fixation, 10 patients had delayed carpal tunnel syndrome. There was significant statistically difference (P < 0.05%). Simultaneous anterior transverse carpal ligament resection can effectively prevent the delayed carpal tunnel syndrome occurrence for the distal radius fracture with open reduction by palm side.

  18. Comparison of didactic lectures and open-group discussions in surgical teaching.

    PubMed

    Sirikumpiboon, Siripong

    2014-11-01

    The teaching of medicine has varied and has continued to develop until today. Most courses rely on the lecture although it may bring less benefit to students. Another teaching technique, the open group discussion, may not be the most effective, but is widely accepted as a teaching development especially for its overall improvement of student skills. Basically, the teaching of surgery has more limitations than other subjects because patients with critical conditions are required. The present study was designed to compare the effectiveness of these two teaching methods, the lecture and the open group discussion, in the Department of Surgery, Rajavithi Hospital. Fifth year medical students enrolled from 2554-2555 BE (AD 2011-2012) were recruited in the study and randomly divided in groups by the Office of Administration, College of Medicine, Rangsit University. A colorectal surgeon taught the subject, common anorectal disease, throughout the study year. The drawing method was used to randomize the members grouped by teaching methods. The assessment comprised multiple choice questions (MCQ) and multiple essay questions (MEQ). Seventy-three students (39 females, 34 males) were recruited. Students' basic characteristic showed no association between groups of teaching methods. Higher mean MEQ scores were found in the open discussion group (55.83%) compared with those taught by lecture (31.23%), exhibiting significant difference (p<0.001). With respect to MCQ1 and MCQ4, students in the open discussion group had higher scores than those in the lecture group), was also with statistical significance (p = 0.02). Teaching medicine differs from other disciplines. To achieve the most effective teaching performance, teaching methods may be limited in some subjects. This study was a partial project for teaching in the Department of Surgery. It was shown that students in the open discussion group had better MCQ and MEQ scores than those in the lecture group. In developing student skills, giving open discussion provided greater interaction between instructors and students. Importantly, the instructor should manage and facilitate questioning techniques to more effectively transfer course content.

  19. Open surgery versus endovascular approach in treatment of extracranial carotid artery aneurysms.

    PubMed

    Ni, Leng; Weng, Huiling; Pu, Zuo; Zheng, Yuehong; Liu, Bao; Ye, Wei; Zeng, Rong; Liu, Changwei

    2018-05-01

    The objective of this study was to investigate and to compare the early and long-term results of open surgery with endovascular intervention in the treatment of extracranial carotid artery aneurysms (ECCAs). A retrospective review of patients diagnosed with ECCAs who underwent open surgical or endovascular treatment from 1997 to 2017 was performed. Clinical characteristics, aneurysm profile, and treatment outcomes were recorded. Early results (<30 days) were evaluated in terms of mortality, perioperative stroke or transient ischemic attack, and cranial nerve injury. Late results were analyzed in terms of both overall and stroke-free survival and freedom from reinterventions. A total of 48 patients with ECCAs including 34 (70.8%) true aneurysms and 14 (29.2%) pseudoaneurysms were treated. The median age was 51 years, and 19 patients (39.6%) were men; 41 patients (85.4%) had symptoms, whereas 7 (14.6%) were asymptomatic. Among 48 patients, 32 patients (66.7%) underwent open surgery; endovascular repair was performed on 16 patients (33.3%). The 30-day stroke or transient ischemic attack rate was not significantly different between the open group (6.3% [2/32]) and the endovascular group (0% [0/16]; P = .307). Cranial nerve injuries occurred in eight patients in the open group (25%) and in no patient in the endovascular group (0%; P = .029). Median length of stay was significantly longer in the open group than in the endovascular group (20 vs 14 days, respectively; P = .013). Median follow-up was 46 months (range, 0-20 years), and no aneurysm-related death occurred during this period. Overall survival rates at 5 years were 88.7% (standard error [SE], 0.08) in the open group and 91.7% (SE, 0.08) in the endovascular group (P = .319; log-rank, .992). For the same time interval, stroke-free survival rates were 85.2% (SE, 0.10) in the open group and 92.2% (SE, 0.07) in the endovascular group (P = .653; log-rank, .201). One patient (1/28 [3.6%]) in the open group and two patients (2/16 [12.5%]) in the endovascular group underwent endovascular reinterventions because of restenosis during the follow-up period. Reintervention-free survival rates were 90.9% in the open group (SE, 0.09) and 69.2% in the endovascular group (SE, 0.21; P = .082; log-rank, 3.016). In this single-institutional experience, both operative and endovascular interventions for ECCAs provided acceptable early and 5-year results. The endovascular approach had significantly less cranial nerve injury and shorter length of hospital stay. Copyright © 2017 Society for Vascular Surgery. Published by Elsevier Inc. All rights reserved.

  20. Treatment outcomes of open pelvic fractures associated with extensive perineal injuries.

    PubMed

    Hasankhani, Ebrahim Ghayem; Omidi-Kashani, Farzad

    2013-12-01

    The main causes of death in patients with open pelviperineal injuries are uncontrollable bleeding and pelvic sepsis. The aim of this study was to evaluate the management outcomes of open pelvic fractures associated with extensive perineal injuries. We retrospectively studied 15 cases with open pelvic fractures associated with extensive perineal injuries (urethral and anal canal laceration) admitted between August 2006 and September 2010. Mechanism of injury, Injury Severity Score, associated injuries, hemodynamic status on arrival, resuscitation and transfusion requirements, operative techniques, intra- and postoperative complications, length of intensive care unit and hospital stay, and mortality were recorded in a computerised database for further evaluation and analysis. The male to female ratio was 12:3 with an average age of 38.6 years (ranged, 11 to 65 years). The average packed red blood cell units used were 8 units (ranged, 4 to 21 units). All patients were initially transferred to the operating room for colostomy, radical debridement and fixation of the pelvic fracture by an external fixator. One patient had acute renal failure, which improved with medical treatment and 2 patients (13.3%) died, one with type III anteroposterior compression fracture due to hemorrhagic shock and the other due to septicemia. Open pelvic fractures with extensive perineal injuries are associated with high mortality rates. Early diagnosis and appropriate treatment, including reanimation, colostomy, cystostomy, vigorous and repeated irrigation and debridement, and fixation by an external fixator can improve the outcomes and reduce the mortality rate.

  1. Comparative study of open and arthroscopic coracoid transfer for shoulder anterior instability (Latarjet)-clinical results at short term follow-up.

    PubMed

    Kordasiewicz, Bartłomiej; Małachowski, Konrad; Kicinski, Maciej; Chaberek, Sławomir; Pomianowski, Stanisław

    2017-05-01

    The aim of this study was to compare early clinical results after open and arthroscopic Latarjet stabilisation in anterior shoulder instability. Our hypothesis was the results of arthroscopic stabilisation were comparable with the results of open procedure. The clinical results of the patients after primary Latarjet procedure were analysed. Patients operated on between 2006 and 2011 using an open technique composed the OPEN group and patients operated on arthroscopically between 2011 and 2013 composed the ARTHRO group; 48 out of 55 shoulders (87%) in OPEN and 62 out of 64 shoulders (97%) in ARTHRO were available to follow-up. The average age at surgery was 28 years in OPEN and 26 years in ARTHRO. The mean follow-up was 54.2 months in OPEN and 23.4 months in ARTHRO. Intra-operative data were analysed regarding time of surgery, concomitant lesions and complications. Patient results were assessed with Walch-Duplay, Rowe, VAS scores and subjective self-evaluation of satisfaction and shoulder function. Computed tomography scan evaluation was used to assess the graft healing. Average time of surgery was significantly shorter in ARTHRO than OPEN: respectively 110 and 120 minutes. The number of intra-operative complications was six (12.5%) in OPEN and five (8.1%) in ARTHRO. The results were comparable in both groups, with no significant difference between OPEN and ARTHRO group: satisfaction rate - 96.8% and 91.9%, shoulder function - 92.2% and 90%, Walch-Duplay score - 83.9 and 76.7 respecively. A significant difference was reported in Rowe score: 87.8 in OPEN and 78.9 in ARTHRO. Another significant difference was found in the presence of "subjective apprehension"-a term referring to the subjective perception of instability with no signs of instability at clinical examination - 28.7% in OPEN and 50% in ARTHRO. Range of motion in both groups were comparable, however patients in OPEN had significantly lower loss of external rotation in adduction to the side comparing to the contralateral shoulder: 7° versus 14° in ARTHRO. Recurrence was reported in three cases in each group: 6.2% in OPEN and 4.8% in ARTHRO. A revision surgery was performed in four patients (9.3%) in OPEN and six (9.7%) in ARTHRO. Radiographic evaluation showed a significantly lower rate (5%) of graft healing problems (fracture, non-union and osteolysis) after arthroscopic stabilisation, however a partial osteolysis of the proximal part of the bone block was significantly more frequent (53.5%). The arthroscopic Latarjet stabilisation showed satisfactory and comparable results to open procedure. We recommend further investigation and development of arthroscopic technique. III.

  2. Satisfaction, function and repair integrity after arthroscopic versus mini-open rotator cuff repair.

    PubMed

    Barnes, L A Fink; Kim, H M; Caldwell, J-M; Buza, J; Ahmad, C S; Bigliani, L U; Levine, W N

    2017-02-01

    Advances in arthroscopic techniques for rotator cuff repair have made the mini-open approach less popular. However, the mini-open approach remains an important technique for repair for many surgeons. The aims of this study were to compare the integrity of the repair, the function of the shoulder and satisfaction post-operatively using these two techniques in patients aged > 50 years. We identified 22 patients treated with mini-open and 128 patients treated with arthroscopic rotator cuff repair of July 2007 and June 2011. The mean follow-up was two years (1 to 5). Outcome was assessed using the American Shoulder and Elbow Surgeons (ASES) and Simple Shoulder Test (SST) scores, and satisfaction. The integrity of the repair was assessed using ultrasonography. A power analysis ensured sufficient enrolment. There was no statistically significant difference between the age, function, satisfaction, or pain scores (p > 0.05) of the two groups. The integrity of the repair and the mean SST scores were significantly better in the mini-open group (91% of mini-open repairs were intact versus 60% of arthroscopic repairs, p = 0.023; mean SST score 10.9 (standard deviation (sd) 1.3) in the mini-open group; 8.9 (sd 3.5) in arthroscopic group; p = 0.003). The ASES scores were also higher in the mini-open group (mean ASES score 91.0 (sd 10.5) in mini-open group; mean 82.70 (sd 19.8) in the arthroscopic group; p = 0.048). The integrity of the repair and function of the shoulder were better after a mini-open repair than after arthroscopic repair of a rotator cuff tear in these patients. The functional difference did not translate into a difference in satisfaction. Mini-open rotator cuff repair remains a useful technique despite advances in arthroscopy. Cite this article: Bone Joint J 2017;99-B:245-9. ©2017 The British Editorial Society of Bone & Joint Surgery.

  3. 77 FR 5201 - Drawbridge Operation Regulation; Bear Creek, Dundalk, MD

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-02-02

    ... bridge opening to a 48-hour advance notice requirement for a bridge opening. Due to the lack of openings... this bridge has had fewer than 12 openings every year since 2008. The majority of these openings have... it difficult, logistically, to arrive at the bridge site for an opening within the current four hour...

  4. Conventional versus ultrasound-assisted liposuction in gynaecomastia surgery: a 13-year review.

    PubMed

    Wong, Kai Yuen; Malata, Charles M

    2014-07-01

    Numerous surgical techniques exist for gynaecomastia treatment. Although ultrasound-assisted liposuction (UAL) is thought to be more effective than conventional liposuction, to date there remains no objective and direct comparison of the two modalities. Hence, a comparative study was performed of a single surgeon's experience over 13 years using two definitive parameters, namely intraoperative conversion to open excision and postoperative revisional surgery rates. All gynaecomastia patients treated with UAL or conventional liposuction (1999-2012) were retrospectively studied. UAL was only available in the private sector and was used for all such patients with no other selection or exclusion criteria. A total of 219 patients (384 breasts) with a mean age of 29 years (range 12-74) were evaluated. UAL was utilised in 24% of breasts (47 patients, 91 breasts). Compared with conventional liposuction, UAL had significantly lower rates of intraoperative conversion to open excision (25% vs. 39%; p<0.05) and postoperative revision (2% vs. 19%; p<0.001) using Fisher's exact test. The haematoma rate for each technique was 1%. UAL is a more effective treatment modality for gynaecomastia than conventional liposuction as determined by intraoperative conversion to open surgery and subsequent need for revision. Copyright © 2014 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.

  5. Surgical Treatment of Rotator Cuff Tears After 65 Years of Age: A Systematic Review.

    PubMed

    Silva, Bruno Mota; Cartucho, António; Sarmento, Marco; Moura, Nuno

    2017-04-28

    The objective of this study was to analyze current evidence regarding surgical management of rotator cuff tears in patients of 65 years of age and above. Our hypothesis was that surgical repair of rotator cuff tears, in patients older than 65 years, conveys good outcome scores. We have not found a similar systematic review in current literature. Medline®, PubMed, Scopus, and the Cochrane Register of Controlled Trials were searched from January 1999 unto December 2015 for studies, regardless of language, including the words 'rotator cuff' and '65 years' or '70 years'. Inclusion criteria were studies (level I to IV) that reported clinical outcomes in patients older than 65 years, having undertaken surgical repair of a symptomatic rotator cuff tears. Arthroscopic, mini open and open techniques were included. Exclusion criteria were: studies with patients younger than 65 years, studies that did not use validated outcome evaluation scores as primary assessment tools and those with follow up under one year. This work followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses - PRISMA guidelines. Data abstracted included patient demographics, tear pattern, surgical procedures, clinical and repair results. Outcome scores were converted to percentages, allowing comparison of data between studies. After deep analysis, 14 studies met the inclusion criteria: 11 level IV studies, 1 level III study and 2 level II studies. Seven studies found statistically significant outcome improvements between pre and postoperative evaluations. All studies reported good or excellent surgical outcomes. Better results would probably be achieved if all studies had rigorous and homogeneous patient selection criteria, but the fact is, that even though this was not the case, the clinical scores remained favorable, and with statistically significant outcome improvement in all studies with prospectively collected data. Based on current literature, rotator cuff repair in patients older than 65 years imparts favorable improvement in clinical outcome scores and overall patient satisfaction.

  6. Functional studies in 79-year-olds. II. Upper extremity function.

    PubMed

    Lundgren-Lindquist, B; Sperling, L

    1983-01-01

    As part of the Gerontological and Geriatric Population Study of 79-year-old people in Göteborg, a representative subsample comprising 112 women and 93 men took part in a study of upper extremity function. Thirty-eight per cent of the women and 37% of the men had disorders in the upper extremities. The investigation included tests of co-ordination, static strength in the key-grip and the transversal volar grip, power capacity in opening jars and a bottle, basal movements in the upper extremities in personal hygiene and dressing activities, function in the kitchen e.g. reaching shelves, manual tasks including tests of pronation and supination of the forearm. In the key-grip as well as in the transversal volar grip men showed a generally larger decrease in strength with age than women compared to 70-year-olds in a previous population study. Significant correlations were found between strength in the key-grip and the performance time in the test of co-ordination. Women produced about 66% of the muscular force of the men when opening jars. Significant correlations were found between strength in the transversal volar grip and the maximal torque for opening the jars. Female and male subjects who were not capable of handling the electric plug in the manual ability test had significantly weaker strength in the key-grip. The importance of designing products and adapting the environment so as to correspond to the functional capacity of the elderly, is emphasized.

  7. Impacts of ditch blocking on peatland hydrology - the benefits of long-term monitoring

    NASA Astrophysics Data System (ADS)

    Holden, Joseph; Green, Sophie; Baird, Andy; Chapman, Pippa; Evans, Chris; Grayson, Richard

    2016-04-01

    A long-term field trial was conducted on a blanket peatland in North Wales. Twelve ditches were studied. After an initial monitoring period, eight of the ditches had peat dams installed a few metres apart along their entire length (dammed), four of these ditches were also partially infilled through bank reprofiling (reprofiled). Four ditches were left open with no dams or reprofiling (open). These 12 ditches and the surrounding peat were then monitored for a further 4 years. The effect of ditch blocking on local water tables was spatially highly variable but small overall (of the order of 2-3 cm) because the site, despite having ditches, already had relatively shallow water tables (medians within the upper 10 cm of the peat profile). An initial five-fold reduction in discharge occurred in ditches that had been dammed or reprofiled. However, there was evidence of a slow change over time in ditch flow at the site in subsequent years, with the overall volume of water leaving the dammed or reprofiled ditch weirs increasing per unit of rainfall to around twice that which occurred in the first year after the restoration. These changes were not observed in the open ditches. There was therefore clear evidence of the benefits of long-term monitoring as hydrological impacts in the first year after ditch blocking were very different from those in later years as the site conditions gradually changed. The additional water that flowed in later periods of the study from the blocked ditch catchments occurred in the form of a more continuously-flowing baseflow with fewer dry periods. The cause of this increase was related to changes in subsurface flow pathways in the peat in the aftermath of re-wetting. We show that these subsurface pathways mean that even in sloping blanket peatlands, the catchment areas for peatland ditches may be very different from that expressed by surface topography alone. Therefore, peatland studies that have estimated aerially-weighted water or carbon fluxes from one or two open or blocked ditches and where such data have also been used in upscaling estimates, need to be treated with caution.

  8. Sandia National Laboratories: Livermore Valley Open Campus (LVOC)

    Science.gov Websites

    Visiting the LVOC Locations Livermore Valley Open Campus (LVOC) Open engagement Expanding opportunities for open engagement of the broader scientific community. Building on success Sandia's Combustion Research Facility pioneered open collaboration over 30 years ago. Access to DOE-funded capabilities Expanding access

  9. Open Versus Laparoscopic Approach for Morgagni's Hernia in Infants and Children: A Systematic Review and Meta-Analysis.

    PubMed

    Lauriti, Giuseppe; Zani-Ruttenstock, Elke; Catania, Vincenzo D; Antounians, Lina; Lelli Chiesa, Pierluigi; Pierro, Agostino; Zani, Augusto

    2018-05-18

    The laparoscopic repair of Morgagni's hernia (MH) has been reported to be safe and feasible. However, it is still unclear whether laparoscopy is superior to open surgery in repairing MH. Using a defined search strategy, three investigators independently identified all comparative studies reporting data on open and laparoscopic MH repair in patients <18 years of age. Case reports and opinion articles were excluded. Meta-analysis was conducted according to PRISMA guidelines and using RevMan 5.3. Data are expressed as mean ± SD. Systematic review - Of 774 titles/abstracts screened, 51 full-text articles were analyzed. Three studies were included (92 patients), with 53 (58%) open approaches and 39 (42%) laparoscopy. Meta-analysis - The length of surgery was shorter in laparoscopy (50.5 ± 17.0 min) than in open procedure (90.0 ± 15.0 min; P < .00001). Laparoscopy shortened the length of hospital stay (2.1 ± 1.4 days) versus open surgery (4.5 ± 2.1 days; P < .00001). There was no difference with regards to complications (laparoscopy: 8.8% ± 5.5%, open: 9.4% ± 1.6%; P = .087) and recurrences (laparoscopy: 2.9% ± 5.0%, open: 5.7% ± 1.8%; P = .84). Comparative studies indicate that laparoscopic MH repair can be performed in infants and children. Laparoscopy is associated with shortened length of surgery and hospital stay in comparison to open procedure. Prospective randomized studies would be needed to confirm present data.

  10. Changes in sub-soil river water quality upon its open storage-a case study.

    PubMed

    Mohanty, A K; Satpathy, K K; Prasad, M V R

    2017-08-01

    A study was carried out to investigate the changes in the physicochemical and biological properties of sub-soil river water upon its storage in a man-made reservoir. Palar sub-soil and reservoir water samples were collated fortnightly for a period of 5 years (2010-2014). The open reservoir is used as a reliable raw water source for condenser cooling systems and for the demineralizing (DM) plant input of Fast Breeder Test Reactor (FBTR), Madras Atomic Power Station (MAPS), and other laboratories at Kalpakkam, southeast coast of India. Relatively high nutrient concentration was observed in the Palar sub-soil water, and a significant reduction in average concentration (μmol l -1 ) of phosphate (Palar 1.92; open reservoir 1.54) and nitrate (Palar 9.78; open reservoir 5.67) was observed from Palar to open reservoir. Substantial increase in pH (Palar 8.05; open reservoir 8.45), dissolved oxygen (mg l -1 ) (Palar 6.07; open reservoir 8.47), and chlorophyll-a (mg m -3 ) (Palar 1.66; open reservoir 8.43) values were noticed from the Palar sub-soil water to open reservoir water. It is concluded that sub-soil water with higher nutrient concentrations when stored openly, exposing to the sun, resulted in growth of plants, planktonic, and macrophytes, which led to substantial deterioration in water quality from its utility point of view as a condenser cooling medium and raw water input for DM plant.

  11. Paleontological Studies Integrated into a New Evolutionary Zoology.

    PubMed

    Kuratani, Shigeru; Fukatsu, Takema

    2017-02-01

    Zoological Letters, an open access online journal launched in 2015 is entering its third year of publication, and now seeks to drive new insights in evolutionary and comparative zoology by the inclusion of paleontological studies into its scope.

  12. First-Year Engineering Students' Views of the Nature of Engineering: Implications for Engineering Programmes

    ERIC Educational Resources Information Center

    Karatas, F. Ö.; Bodner, G. M.; Unal, Suat

    2016-01-01

    A study was conducted on the views of the nature of engineering held by 114 first-year engineering majors; the study built on prior work on views of the nature of science held by students, their instructors, and the general public. Open-coding analysis of responses to a 12-item questionnaire suggested that the participants held tacit beliefs that…

  13. CO2 AND N-FERTILIZATION EFFECTS ON FINE ROOT LENGTH, PRODUCTION, AND MORTALITY: A 4-YEAR PONDEROSA PINE STUDY

    EPA Science Inventory

    We conducted a 4-year study of Pinus ponderosa fine root (<2 mm) responses to atmospheric CO2 and N-fertilization. Seedlings were grown in open-top chambers at 3 CO2 levels (ambient, ambient+175 mol/mol, ambient+350 mol/mol) and 3 N-fertilization levels (0, 10, 20 g?m-2?yr-1). ...

  14. Comparative effectiveness of open versus minimally invasive sacroiliac joint fusion.

    PubMed

    Ledonio, Charles Gt; Polly, David W; Swiontkowski, Marc F; Cummings, John T

    2014-01-01

    The mainstay of sacroiliac joint disruption/degenerative sacroiliitis therapy has been nonoperative management. This nonoperative management often includes a regimen of physical therapy, chiropractic treatment, therapeutic injections, and possibly radiofrequency ablation at the discretion of the treating physician. When these clinical treatments fail, sacroiliac joint fusion has been recommended as the standard treatment. Open and minimally invasive (MIS) surgical techniques are typical procedures. This study aims to compare the perioperative measures and Oswestry Disability Index (ODI) outcomes associated with each of these techniques. A comparative retrospective chart review of patients with sacroiliac joint fusion and a minimum of 1 year of follow-up was performed. Perioperative measures and ODI scores were compared using the Fisher's exact test and two nonparametric tests, ie, the Mann-Whitney U test and the Wilcoxon signed-rank test. The results are presented as percent or median with range, as appropriate. Forty-nine patients from two institutions underwent sacroiliac joint fusion between 2006 and 2012. Ten patients were excluded because of incomplete data, leaving 39 evaluable patients, of whom 22 underwent open and 17 underwent MIS sacroiliac joint fusion. The MIS group was significantly older (median age 66 [39-82] years) than the open group (median age 51 [34-74] years). Surgical time and hospital stay were significantly shorter in the MIS group than in the open group. Preoperative ODI was significantly greater in the open group (median 64 [44-78]) than in the MIS group (median 53 [14-84]). Postoperative improvement in ODI was statistically significant within and between groups, with MIS resulting in greater improvement. The open and MIS sacroiliac joint fusion techniques resulted in statistically and clinically significant improvement for patients with degenerative sacroiliitis refractory to nonoperative management. However, the number of patients reaching the minimal clinically important difference and those showing overall improvement were greater in the MIS group.

  15. Comparative effectiveness of open versus minimally invasive sacroiliac joint fusion

    PubMed Central

    Ledonio, Charles GT; Polly, David W; Swiontkowski, Marc F; Cummings, John T

    2014-01-01

    Background The mainstay of sacroiliac joint disruption/degenerative sacroiliitis therapy has been nonoperative management. This nonoperative management often includes a regimen of physical therapy, chiropractic treatment, therapeutic injections, and possibly radiofrequency ablation at the discretion of the treating physician. When these clinical treatments fail, sacroiliac joint fusion has been recommended as the standard treatment. Open and minimally invasive (MIS) surgical techniques are typical procedures. This study aims to compare the perioperative measures and Oswestry Disability Index (ODI) outcomes associated with each of these techniques. Methods A comparative retrospective chart review of patients with sacroiliac joint fusion and a minimum of 1 year of follow-up was performed. Perioperative measures and ODI scores were compared using the Fisher’s exact test and two nonparametric tests, ie, the Mann–Whitney U test and the Wilcoxon signed-rank test. The results are presented as percent or median with range, as appropriate. Results Forty-nine patients from two institutions underwent sacroiliac joint fusion between 2006 and 2012. Ten patients were excluded because of incomplete data, leaving 39 evaluable patients, of whom 22 underwent open and 17 underwent MIS sacroiliac joint fusion. The MIS group was significantly older (median age 66 [39–82] years) than the open group (median age 51 [34–74] years). Surgical time and hospital stay were significantly shorter in the MIS group than in the open group. Preoperative ODI was significantly greater in the open group (median 64 [44–78]) than in the MIS group (median 53 [14–84]). Postoperative improvement in ODI was statistically significant within and between groups, with MIS resulting in greater improvement. Conclusion The open and MIS sacroiliac joint fusion techniques resulted in statistically and clinically significant improvement for patients with degenerative sacroiliitis refractory to nonoperative management. However, the number of patients reaching the minimal clinically important difference and those showing overall improvement were greater in the MIS group. PMID:24940087

  16. Beneficial effect of statins on total mortality in abdominal aortic aneurysm (AAA) repair.

    PubMed

    Mathisen, Sven Ross; Abdelnoor, Michael

    2017-10-01

    In this single center, retrospective cohort study we wished to compare early and total mortality for all patients treated for abdominal aortic aneurysms (AAA) with open surgery who were taking statins compared to those who were not. A cohort of 640 patients with AAA was treated with open surgery between 1999 and 2012. Patients were consecutively recruited from a source population of 390,000; 21.3% were female, and the median age was 73 years. The median follow-up was 3.93 years, with an interquartile range of 1.79-6.58 years. The total follow-up was 2855 patient-years. An explanatory strategy was used. The propensity score (PS) was implemented to control for selection bias and confounders. The crude effect of statin use showed a 78% reduction of the 30-day mortality. A stratified analysis using the Mantel-Haenszel method on quintiles of the PS gave an adjusted effect of the odds ratio equal to 0.43 (95% CI: 0.18-0.96), indicating a 57% reduction of the 30-day mortality for statin users. The adjusted rate ratio was 0.62 (95% CI: 0.45-0.83), indicating a reduction of long-term mortality of 38% for statin users compared to non-users for a median follow-up of 3.93 years. This retrospective cohort study showed a significant beneficial effect of statin use on early and long-term survival for patients treated with open surgery. To be conclusive, our results need to be replicated by a randomized clinical trial.

  17. A new neolithic circular enclosure in Central Germany

    NASA Astrophysics Data System (ADS)

    Kretzer, Olaf

    2015-08-01

    Today we know about 130 neolithic enclosures in Central Europe. About 20 of them are located in Germany. In the last years, there was a great discussion about the function of the openings: Are the openings aligned with points of the solstices? Or are the openings aligned with points of rising stars?Four years ago, a new neolithic circular enclosure was found in the northern part of Thuringia. With a diameter of about 50 meters it was not so large but it was the first evidence of a neolithic culture in Thuringia: the central part of Germany!7000 years ago, people with unknown identity built up three rings with three or four openings.With the help of various measurements we were able to determine in which directions the openings were aligned. We found a link between these directions and very interesting landmarks - an amazing connection between sky and landscape.

  18. [Does open access publishing increase the impact of scientific articles? An empirical study in the field of intensive care medicine].

    PubMed

    Riera, M; Aibar, E

    2013-05-01

    Some studies suggest that open access articles are more often cited than non-open access articles. However, the relationship between open access and citations count in a discipline such as intensive care medicine has not been studied to date. The present article analyzes the effect of open access publishing of scientific articles in intensive care medicine journals in terms of citations count. We evaluated a total of 161 articles (76% being non-open access articles) published in Intensive Care Medicine in the year 2008. Citation data were compared between the two groups up until April 30, 2011. Potentially confounding variables for citation counts were adjusted for in a linear multiple regression model. The median number (interquartile range) of citations of non-open access articles was 8 (4-12) versus 9 (6-18) in the case of open access articles (p=0.084). In the highest citation range (>8), the citation count was 13 (10-16) and 18 (13-21) (p=0.008), respectively. The mean follow-up was 37.5 ± 3 months in both groups. In the 30-35 months after publication, the average number (mean ± standard deviation) of citations per article per month of non-open access articles was 0.28 ± 0.6 versus 0.38 ± 0.7 in the case of open access articles (p=0.043). Independent factors for citation advantage were the Hirsch index of the first signing author (β=0.207; p=0.015) and open access status (β=3.618; p=0.006). Open access publishing and the Hirsch index of the first signing author increase the impact of scientific articles. The open access advantage is greater for the more highly cited articles, and appears in the 30-35 months after publication. Copyright © 2012 Elsevier España, S.L. and SEMICYUC. All rights reserved.

  19. Plant community development after 28 years in small group-selection openings

    Treesearch

    Philip M. McDonald; Phillip E. Reynolds

    1999-01-01

    Thirty openings, 9, 18, and 27 meters in diameter, were created by group-selection harvest on a high quality site in northern California in 1963. In 1991, or 28 years after site preparation, the plant community in the openings had stabilized at 55 species. A major shift was from annuals to perennials. New seedlings of ponderosa and sugar pine were able to become...

  20. 33 CFR 117.478 - Lower Grand River.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... about August 15 to about June 5 (the school year), the draw need not be opened from 6 a.m. to 8 a.m. and from 3 p.m. to 4:30 p.m., Monday through Friday except holidays. The draw shall open on signal at any... Grosse Tete, shall open on signal; except that, from about August 15 to about June 5 (the school year...

  1. 33 CFR 117.478 - Lower Grand River.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... about August 15 to about June 5 (the school year), the draw need not be opened from 6 a.m. to 8 a.m. and from 3 p.m. to 4:30 p.m., Monday through Friday except holidays. The draw shall open on signal at any... Grosse Tete, shall open on signal; except that, from about August 15 to about June 5 (the school year...

  2. 33 CFR 117.478 - Lower Grand River.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... about August 15 to about June 5 (the school year), the draw need not be opened from 6 a.m. to 8 a.m. and from 3 p.m. to 4:30 p.m., Monday through Friday except holidays. The draw shall open on signal at any... Grosse Tete, shall open on signal; except that, from about August 15 to about June 5 (the school year...

  3. 33 CFR 117.478 - Lower Grand River.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... about August 15 to about June 5 (the school year), the draw need not be opened from 6 a.m. to 8 a.m. and from 3 p.m. to 4:30 p.m., Monday through Friday except holidays. The draw shall open on signal at any... Grosse Tete, shall open on signal; except that, from about August 15 to about June 5 (the school year...

  4. Communication benefits of bilateral cochlear implantation. Retrospective study in 12-year-old children.

    PubMed

    Guerra-Jiménez, Gloria; Viera Artiles, Jaime; Mateos, Mar; González Aguado, Rocío; Falcón González, Juan Carlos; Borkoski Barreiro, Silvia; Ramos Macías, Angel

    2013-01-01

    Some studies suggest that simultaneous or sequential cochlear implantation in a short period of time offers additional benefits. There is controversy regarding the existence of an age limit after which a second implantation offers less benefit for the acquisition of communication skills. The objectives of this study were to confirm that sequential cochlear implantation offers benefits compared to unilateral implantation and to study whether, at 12 years of age, there are significant differences regarding the age at the time of the second implantation. Descriptive and observational study of a population of 12-year-old children carrying cochlear implants (n=69). A liminal pure tone audiometry and an open-field verbal discrimination test (disyllables, common phrases in an open context, with and without noise) were conducted to evaluate audiological benefits. Verbal discrimination results were better among patients who had been implanted before the age of 2 years, although the differences were not statistically significant (P>.5). Children who had received bilateral cochlear implants before the age of 2 years and with a period less than 4 years between both implants presented better verbal discrimination percentages (P<.05). In our sample, early cochlear implantation with a short period between both implants provided significant benefits regarding intelligibility. There seem to be a specific age and interimplant period, after which the auditory benefit on the first implant becomes reduced. Copyright © 2013 Elsevier España, S.L. All rights reserved.

  5. Quantitative Measurement of Vocal Fold Vibration in Male Radio Performers and Healthy Controls Using High-Speed Videoendoscopy

    PubMed Central

    Warhurst, Samantha; McCabe, Patricia; Heard, Rob; Yiu, Edwin; Wang, Gaowu; Madill, Catherine

    2014-01-01

    Purpose Acoustic and perceptual studies show a number of differences between the voices of radio performers and controls. Despite this, the vocal fold kinematics underlying these differences are largely unknown. Using high-speed videoendoscopy, this study sought to determine whether the vocal vibration features of radio performers differed from those of non-performing controls. Method Using high-speed videoendoscopy, recordings of a mid-phonatory/i/ in 16 male radio performers (aged 25–52 years) and 16 age-matched controls (aged 25–52 years) were collected. Videos were extracted and analysed semi-automatically using High-Speed Video Program, obtaining measures of fundamental frequency (f0), open quotient and speed quotient. Post-hoc analyses of sound pressure level (SPL) were also performed (n = 19). Pearson's correlations were calculated between SPL and both speed and open quotients. Results Male radio performers had a significantly higher speed quotient than their matched controls (t = 3.308, p = 0.005). No significant differences were found for f0 or open quotient. No significant correlation was found between either open or speed quotient with SPL. Discussion A higher speed quotient in male radio performers suggests that their vocal fold vibration was characterised by a higher ratio of glottal opening to closing times than controls. This result may explain findings of better voice quality, higher equivalent sound level and greater spectral tilt seen in previous research. Open quotient was not significantly different between groups, indicating that the durations of complete vocal fold closure were not different between the radio performers and controls. Further validation of these results is required to determine the aetiology of the higher speed quotient result and its implications for voice training and clinical management in performers. PMID:24971625

  6. Revision open Bankart surgery after arthroscopic repair for traumatic anterior shoulder instability.

    PubMed

    Cho, Nam Su; Yi, Jin Woong; Lee, Bong Gun; Rhee, Yong Girl

    2009-11-01

    Only a few studies have provided homogeneous analysis of open revision surgery after a failed arthroscopic Bankart procedure. Open Bankart revision surgery will be effective in a failed arthroscopic anterior stabilization but inevitably results in a loss of range of motion, especially external rotation. Case series; Level of evidence, 4. Twenty-six shoulders that went through traditional open Bankart repair as revision surgery after a failed arthroscopic Bankart procedure for traumatic anterior shoulder instability were enrolled for this study. The mean patient age at the time of revision surgery was 24 years (range, 16-38 years), and the mean duration of follow-up was 42 months (range, 25-97 months). The preoperative mean range of motion was 173 degrees in forward flexion and 65 degrees in external rotation at the side. After revision surgery, the ranges measured 164 degrees and 55 degrees, respectively (P = .024 and .012, respectively). At the last follow-up, the mean Rowe score was 81 points, with 88.5% of the patients reporting good or excellent results. After revision surgery, redislocation developed in 3 shoulders (11.5%), all of which had an engaging Hill-Sachs lesion and associated hyperlaxity (2+ or greater laxity on the sulcus sign). Open revision Bankart surgery for a failed arthroscopic Bankart repair can provide a satisfactory outcome, including a low recurrence rate and reliable functional return. In open revision Bankart surgery after failed stabilization for traumatic anterior shoulder instability, the surgeon should keep in mind the possibility of a postoperative loss of range of motion and a thorough examination for not only a Bankart lesion but also other associated lesions, including a bone defect or hyperlaxity, to lower the risk of redislocation.

  7. Report on annual utility oil buyers conference

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

    Stambler, K.

    1994-08-01

    What was discussed at this year`s Utility Oil Buyers` Conference is summarized. This year`s conference was held in Boston and there were over 200 attendees representing over 130 different companies from the utility, oil trading, consulting and inspection industries. Attendees for this year`s came from as far away as Italy and Argentina. The mood at this year`s conference was somber, as each sector is feeling the effects of the decline in residual fuel oil demand--due to natural gas displacement, non-utility generation and an economy that is still lethargic. The topics that were covered ranged from {open_quotes}Life after Order 636{close_quotes} tomore » {open_quotes}Does Residual Fuel Oil Have a Future in a Utility Steam Boiler?{close_quotes} to {open_quotes}The Future of Shipping after OPA of 1990.{close_quotes} In addition, there were several topics that have been or will be covered at this conference.« less

  8. Comparison of hybrid endovascular and open surgical repair for proximal aortic arch diseases.

    PubMed

    Kang, Woong Chol; Ko, Young-Guk; Shin, Eak Kyun; Park, Chul-Hyun; Choi, Donghoon; Youn, Young Nam; Lee, Do Yun

    2016-01-15

    To compare the outcomes of hybrid endovascular and open surgical repair for proximal aortic arch diseases. A total of 55 consecutive patients with aortic arch aneurysm or aortic dissection involving any of zone 0 to 1 (39 male, age 63.4 ± 14.3 years) underwent a hybrid endovascular repair (n=35) or open surgical repair (n=20) from 2006 to 2014 were analyzed retrospectively. Perioperative and late outcomes were compared. Baseline characteristics were similar between the two groups, except age and EuroSCORE II, which were higher in the hybrid group. Perioperative mortality or stroke was not significantly different between the two groups, however, tended to be lower in the hybrid repair group than in the open repair group (11.4% vs. 30.0%, p=0.144). Incidences of other morbidities did not differ. During follow-up, over-all survival was similar between the hybrid and the open repair was similar (87.3% vs. 79.7% at 1 year and 83.8% vs. 72.4% at 3 years; p=0.319). However, reintervention-free survival was significantly lower for hybrid repair compared with open repair (83.8% vs. 100% at 1 year and 65.7% vs. 100% at 3 years; p=0.022). Hybrid repair of proximal aortic disease showed comparable perioperative and late outcomes compared with open surgical repair despite a higher reintervention rate during follow-up. Therefore, hybrid repair may be considered as an acceptable treatment alternative to surgery especially in patients at high surgical risk. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  9. Open bite in prematurely born children.

    PubMed

    Harila, V; Heikkinen, T; Grön, M; Alvesalo, L

    2007-01-01

    The aims of this study were to: examine the expression of open bite in prematurely born children and discuss the etiological factors that may lead to bite it. The subjects were 328 prematurely born (<37 gestational weeks) Caucasoid and African American children and 1,804 full-term control children, who participated in the cross-sectional study of the Collaborative Perinatal Project in the 1960s and 1970s. Dental documents, including casts and photographs, were taken once at the age of 6-12 years in the mixed dentition. The occlusion was recorded by examining and measuring the hard stone casts. Vertical open bite was recorded only for full erupted teeth. The statistical method used was chi-square analysis. Significant differences in the incidence of anterior open bite (from left to right canine) was found between the preterm and control groups and between gender and ethnic groups. The prevalence of anterior open bite was nearly 9% in the preterm group and almost 7% in the control group. African Americans (9%) had a significantly greater incidence of open bite than Caucasians (3%; P<.0001). Generally, girls had a greater incidence of open bite than boys (8% vs 6%; P<.11). When the study groups were divided by prematurity, gender, and ethnic group, the prevalence of open bite was increased--especially in preterm African American boys compared to controls (11% vs 8%). The results show differences in the development of anterior open bite between ethnic and gender groups. Premature birth may also influence dental occlusal development. Of importance are the patient's: general health condition; respiratory infections; inadequate nasal- and mouth-breathing; oral habits; and other medical problems. Preterm children may be relatively more predisposed to etiological factors for the development of anterior open bite.

  10. Short- and long-term outcomes following laparoscopic vs open surgery for pathological T4 colorectal cancer: 10 years of experience in a single center.

    PubMed

    Yang, Zi-Feng; Wu, De-Qing; Wang, Jun-Jiang; Lv, Ze-Jian; Li, Yong

    2018-01-07

    To evaluate the short-term and long-term outcomes following laparoscopic vs open surgery for pathological T4 (pT4) colorectal cancer. We retrospectively analyzed the short- and long-term outcomes of proven pT4 colorectal cancer patients who underwent complete resection by laparoscopic or open surgery from 2006 to 2015 at Guangdong General Hospital. A total of 211 pT4 colorectal cancer patients were included in this analysis, including 101 cases in the laparoscopy (LAP) group and 110 cases in the open surgery (OPEN) group [including 15 (12.9%) cases of conversion to open surgery]. Clinical information (age, gender, body mass index, comorbidities, American Society of Anesthesiologists score, etc .) did not differ between the two groups. In terms of blood loss, postoperative complications and rate of recovery, the LAP group performed significantly more favorably ( P < 0.05). With regard to pT4a/b and combined organ resection, there were significantly more cases in the OPEN group ( P < 0.05). The 3- and 5-year overall survival rates were 74.9% and 60.5%, respectively, for the LAP group and 62.4% and 46.5%, respectively, for the OPEN group ( P = 0.060). The 3- and 5-year disease-free survival rates were 68.0% and 57.3%, respectively, for the LAP group and 55.8% and 39.8%, respectively, for the OPEN group ( P = 0.053). Multivariate analysis showed that IIIB/IIIC stage, lymph node status, and CA19-9 were significant predictors of overall survival. PT4a/b, IIIC stage, histological subtypes, CA19-9, and adjuvant chemotherapy were independent factors affecting disease-free survival. Laparoscopy is safely used in the treatment of pT4 colorectal cancer while offering advantages of minimal invasiveness and faster recovery. Laparoscopy is able to achieve good oncologic outcomes similar to those of open surgery. We recommend that laparoscopy be carried out in experienced centers. It is still required to screen the appropriate cases for laparoscopic surgery, optimize the preoperative diagnosis process, and reduce the conversion rate. Multi-center, prospective, and large-sample studies are required to assess these issues.

  11. Light, soil moisture, and tree reproduction in hardwood forest openings.

    Treesearch

    Leon S. Minckler; John D. Woerheide; Richard C. Schlesinger

    1973-01-01

    Light, soil moisture, and tree reproduction were measured at five positions in six openings on each of three aspects in southern Illinois. Amount of light received was clearly related to position in the light openings, opening size, and aspect. More moisture was available in the centers of the openings, although 4 years after openings were made the differences...

  12. Assessing Physicians' Intentions to Talk about Sex when They Vaccinate Nine-Year-Old to 15-Year-Old Girls against HPV

    ERIC Educational Resources Information Center

    Askelson, Natoshia M.; Campo, Shelly; Smith, Sandi; Lowe, John B.; Dennis, Leslie; Andsager, Julie

    2011-01-01

    The human papillomavirus (HPV) vaccine provides physicians with an opportunity to have conversations with girls about sex and sex-related topics. Current research suggests that these conversations are not happening. This study was designed to assess whether physicians would use the HPV vaccination as an opening to communicate with nine-year-old to…

  13. Long-term comparison of endovascular and open repair of abdominal aortic aneurysm.

    PubMed

    Lederle, Frank A; Freischlag, Julie A; Kyriakides, Tassos C; Matsumura, Jon S; Padberg, Frank T; Kohler, Ted R; Kougias, Panagiotis; Jean-Claude, Jessie M; Cikrit, Dolores F; Swanson, Kathleen M

    2012-11-22

    Whether elective endovascular repair of abdominal aortic aneurysm reduces long-term morbidity and mortality, as compared with traditional open repair, remains uncertain. We randomly assigned 881 patients with asymptomatic abdominal aortic aneurysms who were candidates for both procedures to either endovascular repair (444) or open repair (437) and followed them for up to 9 years (mean, 5.2). Patients were selected from 42 Veterans Affairs medical centers and were 49 years of age or older at the time of registration. More than 95% of the patients underwent the assigned repair. For the primary outcome of all-cause mortality, 146 deaths occurred in each group (hazard ratio with endovascular repair versus open repair, 0.97; 95% confidence interval [CI], 0.77 to 1.22; P=0.81). The previously reported reduction in perioperative mortality with endovascular repair was sustained at 2 years (hazard ratio, 0.63; 95% CI, 0.40 to 0.98; P=0.04) and at 3 years (hazard ratio, 0.72; 95% CI, 0.51 to 1.00; P=0.05) but not thereafter. There were 10 aneurysm-related deaths in the endovascular-repair group (2.3%) versus 16 in the open-repair group (3.7%) (P=0.22). Six aneurysm ruptures were confirmed in the endovascular-repair group versus none in the open-repair group (P=0.03). A significant interaction was observed between age and type of treatment (P=0.006); survival was increased among patients under 70 years of age in the endovascular-repair group but tended to be better among those 70 years of age or older in the open-repair group. Endovascular repair and open repair resulted in similar long-term survival. The perioperative survival advantage with endovascular repair was sustained for several years, but rupture after repair remained a concern. Endovascular repair led to increased long-term survival among younger patients but not among older patients, for whom a greater benefit from the endovascular approach had been expected. (Funded by the Department of Veterans Affairs Office of Research and Development; OVER ClinicalTrials.gov number, NCT00094575.).

  14. Ten-year outcomes of a randomised trial of laparoscopic versus open surgery for colon cancer.

    PubMed

    Deijen, Charlotte L; Vasmel, Jeanine E; de Lange-de Klerk, Elly S M; Cuesta, Miguel A; Coene, Peter-Paul L O; Lange, Johan F; Meijerink, W J H Jeroen; Jakimowicz, Jack J; Jeekel, Johannes; Kazemier, Geert; Janssen, Ignace M C; Påhlman, Lars; Haglind, Eva; Bonjer, H Jaap

    2017-06-01

    Laparoscopic surgery for colon cancer is associated with improved recovery and similar cancer outcomes at 3 and 5 years in comparison with open surgery. However, long-term survival rates have rarely been reported. Here, we present survival and recurrence rates of the Dutch patients included in the COlon cancer Laparoscopic or Open Resection (COLOR) trial at 10-year follow-up. Between March 1997 and March 2003, patients with non-metastatic colon cancer were recruited by 29 hospitals in eight countries and randomised to either laparoscopic or open surgery. Main inclusion criterion for the COLOR trial was solitary adenocarcinoma of the left or right colon. The primary outcome was disease-free survival at 3 years, and secondary outcomes included overall survival and recurrence. The 10-year follow-up data of all Dutch patients were collected. Analysis was by intention-to-treat. The trial was registered at ClinicalTrials.gov (NCT00387842). In total, 1248 patients were randomised, of which 329 were Dutch. Fifty-eight Dutch patients were excluded and 15 were lost to follow-up, leaving 256 patients for 10-year analysis. Median follow-up was 112 months. Disease-free survival rates were 45.2 % in the laparoscopic group and 43.2 % in the open group (difference 2.0 %; 95 % confidence interval (CI) -10.3 to 14.3; p = 0.96). Overall survival rates were 48.4 and 46.7 %, respectively (difference 1.7 %; 95 % CI -10.6 to 14.0; p = 0.83). Stage-specific analysis revealed similar survival rates for both groups. Sixty-two patients were diagnosed with recurrent disease, accounting for 29.4 % in the laparoscopic group and 28.2 % in the open group (difference 1.2 %; 95 % CI -11.1 to 13.5; p = 0.73). Seven patients had port- or wound-site recurrences (laparoscopic n = 3 vs. open n = 4). Laparoscopic surgery for non-metastatic colon cancer is associated with similar rates of disease-free survival, overall survival and recurrences as open surgery at 10-year follow-up.

  15. Progression of visual field in patients with primary open-angle glaucoma - ProgF study 1.

    PubMed

    Aptel, Florent; Aryal-Charles, Nishal; Giraud, Jean-Marie; El Chehab, Hussam; Delbarre, Maxime; Chiquet, Christophe; Romanet, Jean-Paul; Renard, Jean-Paul

    2015-12-01

    To evaluate the visual field rate of progression of patients with treated ocular hypertension (OHT) and primary open-angle glaucoma (POAG) in clinical practice, using the mean deviation (MD) and the visual field index (VFI). Non-interventional cohort study. From a large multicentre database representative of the French population, 441 eyes of 228 patients with treated OHT or POAG followed up at least 6 years with Humphrey 24.2 Sita-Standard visual field examination at least twice a year were identified. From initial data, eyes were classified in five groups: 121 with OHT, 188 with early glaucoma (MD greater than -6 dB), 45 with moderate glaucoma (MD -6 to -12 dB), 41 with advanced glaucoma (MD -12 to -18 dB) and 46 with severe glaucoma (MD less than -18 dB). Rate of progression during the follow-up period was calculated using the trend analysis of the Guided Progression Analysis software. The mean duration of follow-up was 8.4 ± 2.7 years and the mean number of visual field, 18.4 ± 3.5. In eyes with OHT, rate of progression was -0.09 dB/year (-0.17%VFI/year). In eyes with POAG, rate of progression was -0.32 dB/year (-0.83%VFI/year) in eyes with early glaucoma, -0.52 dB/year (-1.81%VFI/year) in moderate glaucoma, -0.54 dB/year (-2.35%VFI/year) in advanced glaucoma and -0.45 dB/year (-1.97%VFI/year) in severe glaucoma. In eyes with POAG, a significant progression (p < 0.05) was detected in 159 of 320 eyes (49.7%) with trend analysis and 117 of 320 eyes (36.6%, likely progression) or 183 of 320 eyes (57.2%, possible and likely progression) with event analysis. Primary open-angle glaucoma is a progressive disease in the majority of patients despite cautioned treatment and follow-up. The rate of progression varies greatly among subjects. © 2015 Acta Ophthalmologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.

  16. Safety, Tolerability, and Efficacy of Quetiapine in Youth with Schizophrenia or Bipolar I Disorder: A 26-Week, Open-Label, Continuation Study

    PubMed Central

    Pathak, Sanjeev; Earley, Willie R.; Liu, Sherry; DelBello, Melissa

    2013-01-01

    Abstract Objective The purpose of this study was to describe the safety, tolerability, and efficacy of quetiapine monotherapy continued for up to 26-weeks in youth with schizophrenia or bipolar I disorder. Methods Medically healthy boys and girls with a baseline Diagnostic and Statistical Manual of Mental Disorders, 4th ed. (DSM-IV-TR) diagnosis of schizophrenia (ages 13–17 years) or a manic episode of bipolar I disorder (ages 10–17 years) who participated in one of two acute, double-blind, placebo-controlled studies of immediate-release quetiapine were potentially eligible to enroll in a 26-week, open-label study. During the open-label study, quetiapine was flexibly dosed at 400–800 mg/day, with options to reduce dosing to 200 mg/day based on tolerability. Safety and tolerability outcomes assessed from open-label baseline to week 26 included adverse events (AEs), metabolic/laboratory parameters, extrapyramidal symptoms, suicidality, and vital signs. Results Of 381 patients enrolled in the open-label study (n=176, schizophrenia; n=205, bipolar disorder diagnosis), 237 patients (62.2%) completed the 26-week study period (71.0%, schizophrenia; 54.6%, bipolar disorder). The most common AEs reported during the study included somnolence, headache, sedation, weight increase, and vomiting. A total of 14.9% of patients experienced a shift to potentially clinically significant low levels of high-density lipoprotein cholesterol and 10.2% of patients experienced a shift to potentially clinically significant high triglyceride levels. Weight gain ≥7% was reported in 35.6% of patients between open-label baseline and final visit. After adjustment for normal growth, 18.3% of study participants experienced clinically significant weight gain (i.e., increase in body mass index ≥0.5 standard deviations from baseline). Conclusions In this 26-week study, quetiapine flexibly dosed at 400–800 mg/day, with options to reduce dosing based on tolerability, was generally safe and well tolerated in youth. Clinicians should monitor lipid profiles and weight gain in youth with schizophrenia or bipolar disorder during treatment with quetiapine. Clinical trial registration information Quetiapine Fumarate (Seroquel) in the Treatment of Adolescent Patients With Schizophrenia and Bipolar I Disorder (ANCHOR 150). Available at: http://clinicaltrials.gov/ct2/show/NCT00227305 PMID:24024534

  17. Students' Experiences of Clinic-Based Learning during a Final Year Veterinary Internship Programme

    ERIC Educational Resources Information Center

    Matthew, Susan M.; Taylor, Rosanne M.; Ellis, Robert A.

    2010-01-01

    This study investigated veterinary students' experiences of clinic-based learning (CBL) during a comprehensive final year internship programme. Open-ended surveys (n = 93) were used to gather qualitative data about students' conceptions of what is learned during CBL and their approaches to learning in clinics. Phenomenography was used for detailed…

  18. Mothers' and Fathers' Perceptions of Mutuality in Middle Childhood: The Domain of Intimacy

    ERIC Educational Resources Information Center

    Oliphant, Amy E.; Kuczynski, Leon

    2011-01-01

    This study investigated parents' experiences of closeness in their interactions with their children in middle childhood. Structured, open-ended interviews were conducted with mothers and fathers from 23 families (46 participants) with children aged between 7 and 11 years (M = 9.2 years). Qualitative analyses indicated that parents' experiences of…

  19. Case Study: International High School at Langley Park

    ERIC Educational Resources Information Center

    Wassl, Frishtah; Wilkin, Christine; Ward, Maggie

    2017-01-01

    The International High School at Langley Park (IHSLP) opened during the 2015-2016 school year. By the fourth year of operation, the school will be home to 400 English language learners (ELLs) new to the United States. Working in partnership with the Internationals Network for Public Schools, the school is designed around the "HELLO…

  20. Institutional Researchers' Use of Qualitative Research Methods for Institutional Accountability at Two Year Colleges in Texas

    ERIC Educational Resources Information Center

    Sethna, Bishar M.

    2011-01-01

    This study examined institutional researchers' use of qualitative methods to document institutional accountability and effectiveness at two-year colleges in Texas. Participants were Institutional Research and Effectiveness personnel. Data were collected through a survey consisting of closed and open ended questions which was administered…

  1. Follow Through Classroom Process Measurement and Pupil Growth (1970-71). Final Report.

    ERIC Educational Resources Information Center

    Soar, Robert S.

    This study presents results from the last year of a three-year adjunctive evaluation of classroom process measurement and pupil growth. A total of 289 classrooms involving eight experimental programs, ranging from open classrooms to contingency management classes, along with a comparison sample, were observed. Four observation instruments were…

  2. Comparison of second generation open-pollinated, mass control-pollinated, and varietal pine planting stock through 6 years on a North Mississippi site

    Treesearch

    Randall J. Rousseau; Scott D. Roberts; Billy L. Herrin

    2015-01-01

    Landowners face a wide array of loblolly pine genetic material to choose from at the time of regeneration. In general, most opt to plant open-pollinated second-generation stock (second-Gen OP) as previously recommended by either consultants or industry personnel. The goal of this study is to evaluate a selected second-Gen OP family, a selected mass control-pollinated...

  3. Open adoption: adoptive parents' reactions two decades later.

    PubMed

    Siegel, Deborah H

    2013-01-01

    Unlike in the past, most adoption agencies today offer birth parents and adoptive parents the opportunity to share identifying information and have contact with each other. To understand the impacts of different open adoption arrangements, a qualitative descriptive study using a snowball sample of 44 adoptive parents throughout New England began in 1988. Every seven years these parents who adopted infants in open adoptions have participated in tape-recorded interviews to explore their evolving reactions to their open adoption experiences. This article reports the results of in-depth interviews with these parents now that their children have reached young adulthood. This longitudinal research illuminates how open adoptions change over the course of childhood and adolescence, parents' feelings about open adoption, challenges that emerge in their relationships with their children's birth families, how those challenges are managed and viewed, and parents' advice for others living with open adoption and for clinical social work practice and policy. Findings reveal that regardless of the type of openness, these adoptive parents generally feel positive about knowing the birth parents and having contact with them, are comfortable with open adoption, and see it serving the child's best interests.

  4. Surgical Management of Ipsilateral Fracture of the Femur and Tibia in Adults (the Floating Knee): Postoperative Clinical, Radiological, and Functional Outcomes

    PubMed Central

    2011-01-01

    Background This study evaluated the outcomes of surgical management of ipsilateral femoral and tibial fractures in adults. Methods Fifteen patients (13 men, 2 women; mean age, 34.8 years; range, 18 to 65 years) were enrolled in this study. The fractures types were classified according to the classification by Fraser et al. as follows: type I (5), type IIa (3), IIb (4), IIc (3). Femur fractures were treated using locked intramedullary nails, plate-screws, or dynamic condylar screws, and tibia fractures were treated with an external fixator (in open fractures), or plate-screws, and locked intramedullary nailing. The mean follow-up duration was 2.2 years (range, 1.3 to 4 years). Results The extent of bony union according to the Karlstrom criteria was as follows: excellent, 8; good, 4; acceptable, 2; poor, 1. Conclusions The associated injuries and type of fracture (open, intra-articular, comminution) are prognostic factors in a floating knee. The best management of the associated injuries for good final outcome involves intramedullary nailing of both the fractures and postoperative rehabilitation. PMID:21629474

  5. 75 FR 10172 - Drawbridge Operation Regulation; Chester River, Chestertown, MD

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-03-05

    ... to the anticipated infrequency of requests for vessel openings of the drawbridge. DATES: This rule is... openings year-round due to the anticipated infrequency of requests for vessel openings of the drawbridge... shall open on signal if at least six hours notice is given. Bridge opening data, supplied by MDOT...

  6. Understanding Motivational System in Open Learning: Learners' Engagement with a Traditional Chinese-Based Open Educational Resource System

    ERIC Educational Resources Information Center

    Huang, Wenhao David; Wu, Chorng-Guang

    2017-01-01

    Learning has embraced the "open" process in recent years, as many educational resources are made available for free online. Existing research, however, has not provided sufficient evidence to systematically improve open learning interactions and engagement in open educational resource (OER) systems. This deficiency presents two…

  7. Eye-closure-triggered paroxysmal activity and cognitive impairment: a case report.

    PubMed

    Termine, Cristiano; Rubboli, Guido; Veggiotti, Pierangelo

    2006-01-01

    To study the neuropsychological status of an epileptic patient presenting with epileptic activity triggered by eye closure in a 14-year follow-up period. The patient was studied at 12 and 26 years of age; during this period he underwent periodical clinical evaluations and EEG investigations; brain magnetic resonance imaging (MRI) was performed at 12 years of age. A neuropsychological assessment was carried out both at 12 years of age (T0) and at 26 years of age. At T0 and T1, neuropsychological tests (digits and words span, graphoestesia, reactions time to auditory stimuli, sentences repetition, words repetition, digital gnosis, backward counting [i.e.,100-0]) were performed during video-EEG monitoring either with eyes closed or with eyes open, to evaluate possible transitory effects related to ongoing epileptic activity. Moreover, at T0 the patient underwent Wechsler Intelligence Scale for Children-Revised, and at T1 to Wechsler Adult Intelligence Scale-Revised. EEG recordings showed continuous epileptic activity triggered by eye closure, disappearing only with eyes opening, both at T0 and T1 (in this latter case, anteriorly predominant). The results of neuropsychological assessment during eyes closed as compared to performances with eyes open did not show significant differences, at T0 as well as at T1. Wechsler Intelligence scales showed a deterioration of performances at T1 with respect to T0; in addition, at T1, attention and short-term memory abnormalities, impairment in facial recognition and block design, and defective results in Continuous Performance Test and Wisconsin Card Sorting Test were observed. Lack of differences between the results of neuropsychological tests performed with eyes closed as compared to the eyes open condition suggests that in our patient epileptic activity did not cause transitory cognitive abnormalities. Deterioration of Wechsler Intelligence Scales in the follow-up period might be interpreted as the result of a disruption of cognitive processes possibly related to the persistence of a continuous epileptic activity during eye closure over the years. We speculate whether a dysfunction in posterior cortical areas involved in visual processing might be related to the impairment in face recognition and block design tests as well to eye closure sensitivity.

  8. Openness as a buffer against cognitive decline: The Openness-Fluid-Crystallized-Intelligence (OFCI) model applied to late adulthood.

    PubMed

    Ziegler, Matthias; Cengia, Anja; Mussel, Patrick; Gerstorf, Denis

    2015-09-01

    Explaining cognitive decline in late adulthood is a major research area. Models using personality traits as possible influential variables are rare. This study tested assumptions based on an adapted version of the Openness-Fluid-Crystallized-Intelligence (OFCI) model. The OFCI model adapted to late adulthood predicts that openness is related to the decline in fluid reasoning (Gf) through environmental enrichment. Gf should be related to the development of comprehension knowledge (Gc; investment theory). It was also assumed that Gf predicts changes in openness as suggested by the environmental success hypothesis. Finally, the OFCI model proposes that openness has an indirect influence on the decline in Gc through its effect on Gf (mediation hypothesis). Using data from the Berlin Aging Study (N = 516, 70-103 years at T1), these predictions were tested using latent change score and latent growth curve models with indicators of each trait. The current findings and prior research support environmental enrichment and success, investment theory, and partially the mediation hypotheses. Based on a summary of all findings, the OFCI model for late adulthood is suggested. (c) 2015 APA, all rights reserved).

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

    PubMed

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

    2018-05-04

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

  10. Laparoscopic Donor Nephrectomy: Early Experience at a Single Center in Pakistan.

    PubMed

    Mohsin, Rehan; Shehzad, Asad; Bajracharya, Uspal; Ali, Bux; Aziz, Tahir; Mubarak, Muhammed; Hashmi, Altaf; Rizvi, Adibul Hasan

    2018-04-01

    Laparoscopic donor nephrectomy has become the criterion standard for kidney retrieval from living donors. There is no information on the experience and outcomes of laparoscopic donor nephrectomy in Pakistan. The objective of the study was to identify benefits and harms of using laparoscopic compared with open nephrectomy techniques for renal allograft retrieval. In this a retrospective study, patient files from May 2014 to September 2015 were analyzed. Patients were divided into 2 groups: those with open donor nephrectomy and those with laparoscopic donor nephrectomy. Donor case files and operative notes were analyzed for age, sex, laterality, body mass index, warm ischemia time, perioperative and postoperative complications, surgery time, and length of hospital stay. Finally, serum creatinine patterns of both donors and recipients were analyzed. Data were analyzed using SPSS version 10 (SPSS: An IBM Company, IBM Corporation, Armonk, NY, USA). Of 388 total donors, 190 (49%) had open donor nephrectomy and 198 (51%) had laparoscopic donor nephrectomy. For both groups, most donors were older than 25 years with male preponderance. Left-to-right kidney donation ratio was markedly higher in the laparoscopic group than in the open donor nephrectomy group, with 6 cases of double renal artery also included in this study. There were no significant differences in surgery times between the 2 groups, whereas the laparoscopic donor nephrectomy group had shorter hospital stay. Analgesic requirements were markedly shorter in the laparoscopic donor nephrectomy group. The 1-year graft function was not significantly different between the 2 groups. The results for laparoscopic donor nephrectomy were comparable to those for open donor nephrectomy, and its acceptability was high. Laparoscopic donor nephrectomy should be the preferred approach for procuring the kidney graft.

  11. Neurological outcomes by mode of delivery for fetuses with open neural tube defects: A systematic review and meta-analysis.

    PubMed

    Tolcher, Mary C; Shazly, Sherif A; Shamshirsaz, Alireza A; Whitehead, William E; Espinoza, Jimmy; Vidaeff, Alex C; Belfort, Michael A; Nassr, Ahmed A

    2018-06-20

    Controversy exists regarding the optimal mode of delivery for fetuses with open neural tube defects. To compare neurological outcomes among infants with open neural tube defects who underwent vaginal compared to caesarean delivery. Electronic databases MEDLINE, EMBASE, Scopus, and Clinicaltrials. gov were searched from inception to November 2017. Eligible studies included observational or randomised studies comparing vaginal and caesarean delivery in pregnancies with fetal open neural tube defects who did not undergo prenatal repair. Two reviewers independently reviewed abstracts and full text articles. Outcomes were compared between vaginal and caesarean delivery and prelabour caesarean versus labour. The primary outcome was motor-anatomic level difference. Secondary outcomes included shunt requirement, sac disruption, meningitis, and ambulation at 2 years. Meta-analysis was performed and mean difference or odds ratios with 95% confidence interval calculated. Of 201 abstracts identified in the primary search, 9 studies (672 women) met eligibility criteria. Comparing vaginal and caesarean delivery, there was no significant difference in motor-anatomic level difference (mean difference -0.10, 95% CI -0.58-0.38; I 2 =57%). The vaginal delivery group was less likely to require a shunt or have sac disruption (OR 0.37, 95% CI 0.14-0.95 and OR 0.46, 95% CI 0.23-0.90, respectively). Comparisons by prelabour caesarean versus labour showed no significant difference in motor-anatomic level difference (OR 1.29, 95% CI -0.63-3.21) or ambulation at 2 years (OR 2.13, 95% CI 0.35-13.12). Caesarean delivery was not associated with improved neurological outcomes among fetuses with open neural tube defects. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

  12. [Epidemiologic outbreak of Legionnaire's disease in an open community: 10 years later].

    PubMed

    Císcar, M A; Barranco, M J; Peris, R; Ramón, M; Juan, G

    1994-01-01

    The aim of this study was to describe an outbreak of pneumonia due to L. pneumophila in Llutxent (Valencia) and to know the evolution of these patients 10 years after. The definition and identification of cases was carried out with the use of IFI techniques. An environmental and epidemiological study was performed for determining the origin and route of disease dissemination. The patients were clinically, functionally and serologically reviewed 10 years after. From July to August 1983, 35 cases of pneumonia were reported in Llutxent (rate = 1.5%). L. pneumophila serotype 1 was serologically identified and was also found in shower heads and toilet tanks (in the context of the entry of sand into the drinking water supply). Ten years after, the patients had no respiratory symptoms with titers of antibodies versus Legionella sp. being under 1/64. The authors emphasize the involvement of the distribution system for drinking water to the population in this first outbreak of Legionnaires disease in an open community. The health care measures taken were effective as demonstrated by no further pneumonias being recorded and after normalization of the rate of antibodies on a 10 year review.

  13. Adaptation of a web-based, open source electronic medical record system platform to support a large study of tuberculosis epidemiology

    PubMed Central

    2012-01-01

    Background In 2006, we were funded by the US National Institutes of Health to implement a study of tuberculosis epidemiology in Peru. The study required a secure information system to manage data from a target goal of 16,000 subjects who needed to be followed for at least one year. With previous experience in the development and deployment of web-based medical record systems for TB treatment in Peru, we chose to use the OpenMRS open source electronic medical record system platform to develop the study information system. Supported by a core technical and management team and a large and growing worldwide community, OpenMRS is now being used in more than 40 developing countries. We adapted the OpenMRS platform to better support foreign languages. We added a new module to support double data entry, linkage to an existing laboratory information system, automatic upload of GPS data from handheld devices, and better security and auditing of data changes. We added new reports for study managers, and developed data extraction tools for research staff and statisticians. Further adaptation to handle direct entry of laboratory data occurred after the study was launched. Results Data collection in the OpenMRS system began in September 2009. By August 2011 a total of 9,256 participants had been enrolled, 102,274 forms and 13,829 laboratory results had been entered, and there were 208 users. The system is now entirely supported by the Peruvian study staff and programmers. Conclusions The information system served the study objectives well despite requiring some significant adaptations mid-stream. OpenMRS has more tools and capabilities than it did in 2008, and requires less adaptations for future projects. OpenMRS can be an effective research data system in resource poor environments, especially for organizations using or considering it for clinical care as well as research. PMID:23131180

  14. Impact of Open Reduction on Surgical Strategies for Missed Monteggia Fracture in Children.

    PubMed

    Park, Hoon; Park, Kwang Won; Park, Kun Bo; Kim, Hyun Woo; Eom, Nam Kyu; Lee, Dong Hoon

    2017-07-01

    The aims of this study were to review our cases of missed Monteggia fracture treated by open reduction of the radial head with or without ulnar osteotomy and to investigate the indications for open reduction alone in surgical treatment of missed Monteggia fracture. We retrospectively reviewed 22 patients who presented with missed Monteggia fracture. The patients' mean age at the time of surgery was 7.6 years. The mean interval from injury to surgery was 16.1 months. The surgical procedure consisted of open reduction of the radiocapitellar joint followed by ulnar osteotomy without reconstruction of the annular ligament. The mean period of follow-up was 3.8 years. Radiographic assessment was performed for the maximum ulnar bow (MUB) and the location of the MUB. Clinical results were evaluated with the Mayo Elbow Performance Index and Kim's scores. Five patients underwent open reduction alone, and 17 patients underwent open reduction and ulnar osteotomy. When the MUB was less than 4 mm and the location of the MUB was in the distal 40% of the ulna, we could achieve reduction of the radial head without ulnar osteotomy. The radial head was maintained in a completely reduced position in 21 patients and was dislocated in one patient at final follow-up. Open reduction alone can be an attractive surgical option in select patients with missed Monteggia fracture with minimal bowing of the distal ulna. However, ulnar osteotomy should be considered in patients with a definite ulnar deformity. © Copyright: Yonsei University College of Medicine 2017

  15. [Opened vs. laparoscopic radical nephrectomy in renal adenocarcinoma cost comparison].

    PubMed

    Herranz Amo, F; Subirá Ríos, D; Hernández Fernández, C; Martínez Salamanca, J I; Monzó, J I; Cabello Benavente, R

    2006-10-01

    To undertake a cost comparison (cost minimization) between transperitoneal laparoscopic and opened nephrectomy in renal adenocarcinoma treatment. Retrospective study on the first 26 patients submitted to LN without intra or postoperative complications in the period 2002-2003, using as control 22 patients treated with ON with the same characteristics and in the same period. Demographic variables were evaluated (age, sex, tumor size, etc.), intraoperative (operative time and fungible material used) and postoperative (length of stay in Postanaesthesic Care Unit, Acute Pain Unit needs and hospital stay). Our Hospital costs plus those imputed during year 2003 to the Urology Service, as well as the cost of fungible material for the same year were applied, carrying out a comparison of costs between both groups. There were no differences between the demographic variables between both groups except in the tumor, bigger size in the opened nephrectomy (p=0,001). Transperitoneal laparoscopic was 29,4% globally more expensive than opened nephrectomy. The transperitoneal laparoscopic intraoperative cost (operating room, anesthesia and fungibles) the exceeded in 151,6% to that of the opened nephrectomy, whereas in the opened nephrectomy the postoperative cost was a 63 % higher than in the transperitoneal laparoscopic cases. Transperitoneal laparoscopic in our Center is more expensive than opened nephrectomy due to a major occupation of operating room and that the specific fungible material used at the surgical act has a very high cost. It would be necessary to drastically reduce surgical time and decrease fungible material expenses, thus transperitoneal laparoscopic procedure could be competitive in our Hospital.

  16. Is Xi Jinping a Reformer Similar to Deng Xiaoping

    DTIC Science & Technology

    2017-06-09

    core focus from ideology to economic development by announcing his policy of reform and opening up in 1978. His pragmatic policies resulted in...political stability, ideological openness, and sparked over thirty years of rapid economic growth. After 30 years since reform and opening up, China has...his commitment to rebalancing China’s economy. Despite the lack of significant progress on economic reforms, this paper finds that Xi is a reformer

  17. Polymer solar cells with enhanced open-circuit voltage and efficiency

    NASA Astrophysics Data System (ADS)

    Chen, Hsiang-Yu; Hou, Jianhui; Zhang, Shaoqing; Liang, Yongye; Yang, Guanwen; Yang, Yang; Yu, Luping; Wu, Yue; Li, Gang

    2009-11-01

    Following the development of the bulk heterojunction structure, recent years have seen a dramatic improvement in the efficiency of polymer solar cells. Maximizing the open-circuit voltage in a low-bandgap polymer is one of the critical factors towards enabling high-efficiency solar cells. Study of the relation between open-circuit voltage and the energy levels of the donor/acceptor in bulk heterojunction polymer solar cells has stimulated interest in modifying the open-circuit voltage by tuning the energy levels of polymers. Here, we show that the open-circuit voltage of polymer solar cells constructed based on the structure of a low-bandgap polymer, PBDTTT, can be tuned, step by step, using different functional groups, to achieve values as high as 0.76 V. This increased open-circuit voltage combined with a high short-circuit current density results in a polymer solar cell with a power conversion efficiency as high as 6.77%, as certified by the National Renewable Energy Laboratory.

  18. Bladder neck competency at rest in women with incontinence.

    PubMed

    English, S F; Amundsen, C L; McGuire, E J

    1999-02-01

    We determine the presence of an open bladder neck during video urodynamic studies and relate that finding to the presence of stress urinary incontinence. Patients presenting with urinary incontinence, voiding dysfunction or pelvic floor prolapse underwent video urodynamics. With the patient upright and after 200 ml. contrast material had been instilled into the bladder the bladder neck was viewed to determine if it was open or closed. At that point the abdominal leak point pressure was measured. Of 102 women, average age 56.5 years (range 31 to 82), 13% had an open bladder neck and demonstrable stress incontinence on video urodynamics with an average abdominal leak point pressure of 45 cm. water (range 26 to 90). Of those with stress incontinence on urodynamics 23% had an open bladder neck. No continent patient had an open bladder neck. The presence of an open bladder neck with the bladder filled to 200 ml. correlates strongly with the presence of stress incontinence.

  19. Illness data from the US Open Tennis Championships From 1994 to 2009.

    PubMed

    Sell, Katie; Hainline, Brian; Yorio, Michael; Kovacs, Mark

    2013-01-01

    To examine the incidence of illness and highlight gender differences in tennis players competing in a major professional tennis tournament over a 16-year period between 1994 and 2009. Descriptive epidemiology study of illness trends in professional tennis players. Archival data from the US Open Tennis Championships. Participants in the US Open Tennis Championships main draw from 1994 to 2009. Illness data collected at the US Open Tennis Championships between 1994 and 2009 were classified using guidelines presented in a sport-specific consensus statement. Each case was categorized according to the medical system effected and impact on play availability during the tournament. Illness rates were determined based on the exposure of an athlete to a match event and were calculated as the ratio of illness cases per 1000 match exposures (ME). The average number of illness cases over the 16-year period analyzed was 58.19 ± 12.02 per year (36.74 per 1000 ME) requiring assistance by the medical staff. Statistical analyses showed a significant fluctuation in illness cases related to the dermatological (DERM), gastrointestinal, renal/urogenital/gynecological, neurological, ophthalmic and otorhinolaryngological (ENT), and infectious medical systems (P < 0.05). The ENT and DERM conditions were the most commonly reported types of illness for both men and women. Numerous medical systems are susceptible to illness in tennis players. Sport-specific factors may influence susceptibility to common illnesses experienced by professional tennis players.

  20. Assessment of age of majority by measurement of open apices of the third molars using Cameriere's third molar maturity index.

    PubMed

    Sharma, Preeti; Wadhwan, Vijay; Ravi Prakash, S M; Aggarwal, Pooja; Sharma, Neeraj

    2017-01-01

    Evaluation of biological age of a living subject around the legal cutoff age for adulthood has become a grave concern for forensic experts in India, mainly due to the consequences of criminal obligations in judicial proceedings. Thus, this study was planned to examine the open apices of third molars in discriminating between individuals who are aged 18 years or older and who are not 18 years or older and to assign a cutoff for estimation of the age of 18 years. Orthopantomographs of 1062 individuals (14 and 23 years) were assessed, to verify Cameriere's third molar maturity index (I 3M ). The apical ends of the roots of the left mandibular third molar were analyzed. If the apical ends of the roots are completely closed, then I 3M is zero; otherwise, it is calculated as the sum of the distances between the inner sides of the two open apices divided by the tooth length. The sensitivity of the test for 0.08 value was 74.7% for males and 66% for females. Specificity was 83.6% for males and 79.6% for females. The probability that an Indian individual with an I 3M <0.08 in 18 years or older is 78% for males and 70.3% for females. I 3M is efficacious to determine age in Indian population.

  1. RCN Nurse of the Year 2016: 'Award win will open doors'.

    PubMed

    Cole, Elaine

    2017-01-04

    'The Nurse Awards have opened doors,' says Venetia Wynter-Blyth, RCN Nurse of the Year 2016. 'I cannot emphasise enough how many opportunities have been presented to us as a result of winning this award.'

  2. Meta-analysis of individual-patient data from EVAR-1, DREAM, OVER and ACE trials comparing outcomes of endovascular or open repair for abdominal aortic aneurysm over 5 years.

    PubMed

    Powell, J T; Sweeting, M J; Ulug, P; Blankensteijn, J D; Lederle, F A; Becquemin, J-P; Greenhalgh, R M

    2017-02-01

    The erosion of the early mortality advantage of elective endovascular aneurysm repair (EVAR) compared with open repair of abdominal aortic aneurysm remains without a satisfactory explanation. An individual-patient data meta-analysis of four multicentre randomized trials of EVAR versus open repair was conducted to a prespecified analysis plan, reporting on mortality, aneurysm-related mortality and reintervention. The analysis included 2783 patients, with 14 245 person-years of follow-up (median 5·5 years). Early (0-6 months after randomization) mortality was lower in the EVAR groups (46 of 1393 versus 73 of 1390 deaths; pooled hazard ratio 0·61, 95 per cent c.i. 0·42 to 0·89; P = 0·010), primarily because 30-day operative mortality was lower in the EVAR groups (16 deaths versus 40 for open repair; pooled odds ratio 0·40, 95 per cent c.i. 0·22 to 0·74). Later (within 3 years) the survival curves converged, remaining converged to 8 years. Beyond 3 years, aneurysm-related mortality was significantly higher in the EVAR groups (19 deaths versus 3 for open repair; pooled hazard ratio 5·16, 1·49 to 17·89; P = 0·010). Patients with moderate renal dysfunction or previous coronary artery disease had no early survival advantage under EVAR. Those with peripheral artery disease had lower mortality under open repair (39 deaths versus 62 for EVAR; P = 0·022) in the period from 6 months to 4 years after randomization. The early survival advantage in the EVAR group, and its subsequent erosion, were confirmed. Over 5 years, patients of marginal fitness had no early survival advantage from EVAR compared with open repair. Aneurysm-related mortality and patients with low ankle : brachial pressure index contributed to the erosion of the early survival advantage for the EVAR group. Trial registration numbers: EVAR-1, ISRCTN55703451; DREAM (Dutch Randomized Endovascular Aneurysm Management), NCT00421330; ACE (Anévrysme de l'aorte abdominale, Chirurgie versus Endoprothèse), NCT00224718; OVER (Open Versus Endovascular Repair Trial for Abdominal Aortic Aneurysms), NCT00094575. © 2017 The Authors. BJS published by John Wiley & Sons Ltd on behalf of BJS Society Ltd.

  3. Mandibular movement range in children.

    PubMed

    Machado, Barbara Cristina Zanandréa; Medeiros, Ana Paula Magalhães; Felício, Cláudia Maria de

    2009-01-01

    identification of the mandibular movement range is an important procedure in the evaluation of the stomatognathic system. However, there are few studies in children that focus on normal parameters or abnormalities. to determine the average range of mandibular movements in Brazilian children aged 6 to 12 years; to verify the difference between genders, in each age group, and between the different age groups: 6-8 years; 8.1-10 years; and 10.1-12 years. participants of the study were 240 healthy children selected among regular students from local schools of São Paulo State. The maximum mandibular opening, lateral excursion and protrusive movements, and deviation of the medium line, if present, were measured using a digital caliper. Student T test, Analysis of variance and Tukey test were considered significant for p < 0.05. the mean values observed in the studied sample were: 44.51mm for maximum mandibular opening; 7.71mm for lateral excursion to the right; 7.92mm for lateral excursion to the left; 7.45mm for protrusive movements. No statistical difference was observed between genders. There was a gradual increase in the range of mandibular movements, with significant differences mainly between the ages of 6-8 years and 10.1-12 years. during childhood the range of mandibular movements increases. Age should be considered in this analysis for a greater precision in the diagnosis.

  4. Use of a 1.0 Tesla open scanner for evaluation of pediatric and congenital heart disease: a retrospective cohort study.

    PubMed

    Lu, Jimmy C; Nielsen, James C; Morowitz, Layne; Musani, Muzammil; Ghadimi Mahani, Maryam; Agarwal, Prachi P; Ibrahim, El-Sayed H; Dorfman, Adam L

    2015-05-25

    Open cardiovascular magnetic resonance (CMR) scanners offer the potential for imaging patients with claustrophobia or large body size, but at a lower 1.0 Tesla magnetic field. This study aimed to evaluate the efficacy of open CMR for evaluation of pediatric and congenital heart disease. This retrospective, cross-sectional study included all patients ≤18 years old or with congenital heart disease who underwent CMR on an open 1.0 Tesla scanner at two centers from 2012-2014. Indications for CMR and clinical questions were extracted from the medical record. Studies were qualitatively graded for image quality and diagnostic utility. In a subset of 25 patients, signal-to-noise (SNR) and contrast-to-noise (CNR) ratios were compared to size- and diagnosis-matched patients with CMR on a 1.5 Tesla scanner. A total of 65 patients (median 17.3 years old, 60% male) were included. Congenital heart disease was present in 32 (50%), with tetralogy of Fallot and bicuspid aortic valve the most common diagnoses. Open CMR was used due to scheduling/equipment issues in 51 (80%), claustrophobia in 7 (11%), and patient size in 3 (5%); 4 patients with claustrophobia had failed CMR on a different scanner, but completed the study on open CMR without sedation. All patients had good or excellent image quality on black blood, phase contrast, magnetic resonance angiography, and late gadolinium enhancement imaging. There was below average image quality in 3/63 (5%) patients with cine images, and 4/15 (27%) patients with coronary artery imaging. SNR and CNR were decreased in cine and magnetic resonance angiography images compared to 1.5 Tesla. The clinical question was answered adequately in all but 2 patients; 1 patient with a Fontan had artifact from an embolization coil limiting RV volume analysis, and in 1 patient the right coronary artery origin was not well seen. Open 1.0 Tesla scanners can effectively evaluate pediatric and congenital heart disease, including patients with claustrophobia and larger body size. Despite minor artifacts and differences in SNR and CNR, the majority of clinical questions can be answered adequately, with some limitations with coronary artery imaging. Further evaluation is necessary to optimize protocols and image quality.

  5. Efficacy, safety and risk of augmentation of rotigotine for treating restless legs syndrome.

    PubMed

    Inoue, Yuichi; Hirata, Koichi; Hayashida, Kenichi; Hattori, Nobutaka; Tomida, Takayuki; Garcia-Borreguero, Diego

    2013-01-10

    The present study aimed to examine the long-term efficacy and safety of rotigotine treatment for restless legs syndrome (RLS), as well as the rate of clinically significant augmentation, in a 1-year open-label study of Japanese subjects. Japanese patients with RLS who had been treated with rotigotine or placebo in a double-blind trial were enrolled in a 1-year, open-label, uncontrolled extension study and treated with rotigotine at a dose of up to 3 mg/24 h after an 8-week titration phase. Outcomes included International Restless Legs Syndrome Study Group rating scale (IRLS scale), Pittsburgh Sleep Quality Index (PSQI), safety, and investigator-/expert panel-assessed augmentation (including Augmentation Severity Rating Scale). Overall, 185 patients entered the open-label study and 133 completed the study. IRLS and PSQI total scores improved throughout the 52-week treatment period (IRLS, from 23.2±5.1 to 7.8±7.6 and PSQI, from 8.0±3.1 to 5.0±2.9). Treatment-emergent adverse events were mild to moderate in severity, and included application site reactions (52.4%) and nausea (28.6%). Clinically significant augmentation occurred in five patients (2.7%). These results indicate a good long-term efficacy of rotigotine for treating RLS, with a relatively low risk of clinically significant augmentation. Copyright © 2012 Elsevier Inc. All rights reserved.

  6. A Case Study on German First Year Chemistry Student Teachers' Beliefs about Chemistry Teaching, and Their Comparison with Student Teachers from Other Science Teaching Domains

    ERIC Educational Resources Information Center

    Markic, Silvija; Eilks, Ingo

    2008-01-01

    This paper gives insights into the beliefs of 85 German first year chemistry student teachers about chemistry teaching and learning at the beginning of their teacher education. The study is based on student teachers' drawings of themselves in a typical classroom situation and four open questions. The approach evaluated: (I) Beliefs about Classroom…

  7. To What Extent Does Participation in Extracurricular Music Affect the Future Aspirations of 11-12-Year-Olds? A Small-Scale Investigation

    ERIC Educational Resources Information Center

    Denny, Eleanor

    2007-01-01

    I undertook this project as a 12-year-old student while studying research methods at the Children's Research Centre at the Open University. It has already been shown that doing music improves children's Mathematics and English scores. The aim of this study was to find out if it also raises the aspirations of the children taking part. A…

  8. A population-based study of familial Alzheimer disease: Linkage to chromosomes 14, 19, and 21

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

    Duijn, C.M. van; Hofman, A.; Hendriks, L.

    1994-10-01

    Linkage of Alzheimer disease (AD) to DNA markers on chromosomes 14, 19, and 21 was studied in 10 families in which the disease was apparently inherited as an autosomal dominant trait. Families were derived from a Dutch population-based epidemiologic study of early-onset AD. Although in all probands the onset of AD was at or before age 65 years, the mean age at onset was after age 65 years in four families (referred to as {open_quotes}LOAD{close_quotes}). Among the six families with early-onset AD (referred to as {open_quotes}EOAD,{close_quotes} i.e., mean age of onset of AD of relatives was at or before agemore » 65 years), conclusive linkage to 14q24.3 was found in one family with a very early onset (around 47 years), while linkage to the same region was excluded in two other families. For the LOAD families, predominantly negative lod scores were obtained, and the overall lod score excluded linkage to chromosome 14. The results with markers on chromosome 19 and chromosome 21 were not conclusive for EOAD and LOAD. The findings of our study confirm genetic heterogeneity within familial EOAD. 50 refs., 7 figs., 2 tabs.« less

  9. 77 FR 75554 - Drawbridge Operation Regulation; Apalachicola River, FL

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-12-21

    ... documented decrease in the number of requests for openings in the last three years. In 2010, the bridge opened 12 times for the passage of vessels. Eight of those openings were for either a United States Coast... opened four times for the passage of vessels. Three of those openings were for either a USCG vessel or...

  10. Is Conventional Open Repair for Abdominal Aortic Aneurysm Feasible in Nonagenarians?

    PubMed

    Uehara, Kyokun; Matsuda, Hitoshi; Inoue, Yosuke; Omura, Atsushi; Seike, Yoshimasa; Sasaki, Hiroaki; Kobayashi, Junjiro

    2017-09-25

    Background : Although endovascular repair for abdominal aortic aneurysm has been found to be beneficial in very elderly patients, some patients have contraindications to this procedure. For nonagenarians, the results of open repair remain unclear. The purpose of this study was to compare the outcomes of open vs. endovascular repair for abdominal aortic aneurysm in nonagenarian patients. Methods and Results : Fourteen patients undergoing open surgical repair and 24 undergoing endovascular repair for abdominal aortic aneurysm were evaluated. There was no significant difference in early mortality between the open and endovascular groups (0% vs. 4.1%, p=0.16). The open repair group required much longer hospital stays (26.4 vs. 10.6 days, respectively, p=0.003). Finally, 12 patients (86%) undergoing open repair vs. 21 (88%) undergoing endovascular repair returned home (p=0.49). During a mean follow-up period of 23.4±23.5 months, cumulative estimated 1- and 3-year survival rates were 90.0% and 48.0%, respectively in the open repair group and 90.6% and 54.9%, respectively in the endovascular repair group (p=0.51). Conclusion : Although endovascular repair for abdominal aortic aneurysm was superior in terms of recovery, the results of conventional open repair were acceptable even in nonagenarian patients. Open repair remains an alternative for patients with contraindications to endovascular repair.

  11. Rawification and the careful generation of open government data.

    PubMed

    Denis, Jérôme; Goëta, Samuel

    2017-10-01

    Drawing on a two-year ethnographic study within several French administrations involved in open data programs, this article aims to investigate the conditions of the release of government data - the rawness of which open data policies require. This article describes two sets of phenomena. First, far from being taken for granted, open data emerge in administrations through a progressive process that entails uncertain collective inquiries and extraction work. Second, the opening process draws on a series of transformations, as data are modified to satisfy an important criterion of open data policies: the need for both human and technical intelligibility. There are organizational consequences of these two points, which can notably lead to the visibilization or the invisibilization of data labour. Finally, the article invites us to reconsider the apparent contradiction between the process of data release and the existence of raw data. Echoing the vocabulary of one of the interviewees, the multiple operations can be seen as a 'rawification' process by which open government data are carefully generated. Such a notion notably helps to build a relational model of what counts as data and what counts as work.

  12. Laparoscopic and open subtotal colectomies have similar short-term results.

    PubMed

    Hoogenboom, Froukje J; Bosker, Robbert J I; Groen, Henk; Meijerink, Wilhelmus J H J; Lamme, Bas; Pierie, Jean Pierre E N

    2013-01-01

    Laparoscopic subtotal colectomy (STC) is a complex procedure. It is possible that short-term benefits for segmental resections cannot be attributed to this complex procedure. This study aims to assess differences in short-term results for laparoscopic versus open STC during a 15-year single-institute experience. We reviewed consecutive patients undergoing laparoscopic or open elective or subacute STC from January 1997 to December 2012. Fifty-six laparoscopic and 50 open STCs were performed. The operation time was significantly longer in the laparoscopic group, median 266 min (range 121-420 min), compared to 153 min (range 90-408 min) in the open group (p < 0.001). Median hospital stay showed no statistical difference, 14 days (range 1-129 days) in the laparoscopic and 13 days (range 1-85 days) in the open group. Between-group postoperative complications were not statistically different. Laparoscopic STC has short-term results similar to the open procedure, except for a longer operation time. The laparoscopic approach for STC is therefore only advisable in selected patients combined with extensive preoperative counseling. Copyright © 2013 S. Karger AG, Basel.

  13. Comparison of open and laparoscopic pyeloplasty in ureteropelvic junction obstruction surgery: report of 49 cases.

    PubMed

    Umari, Paolo; Lissiani, Andrea; Trombetta, Carlo; Belgrano, Emanuele

    2011-12-01

    This study aimed to evaluate laparoscopic dismembered pyeloplasty compared with open surgery and to determine whether the morbidity and outcome rates are different in each of these techniques. We report our 10-year experience with open and laparoscopic pyeloplasty at one istitution. From February 1999 to October 2010, 49 patients with ureteropelvic junction obstruction were assigned into two groups. 25 patients underwent open surgical pyeloplasty (period 1999-2010) and 24 underwent laparoscopic pyeloplasty (period 2004-2010). 25 patients undergoing open pyeloplasty had a retroperitoneal flank approach. Of the 24 laparoscopic cases 18 had a transperitoneal retrocolic access, 1 had a transperitoneal transmesocolic access and 5 had a retroperitoneal access. In all 49 cases an Anderson-Hynes dismembered pyeloplasty was used. We retrospectively compared the operative time, hospital stay, perioperative complications and follow-up of the two groups. Clinical symptoms were assessed before and after surgery, subjectively. Patients dermographic data were similar between the two groups with mean age of 42 years (range 6-78) and with a male/female ratio of 1:1.45. A crossing vessel could be identified in 37.5% (9/24) with laparoscopy vs. 32% (8/25) in open surgery. Compared with open procedures, laparoscopic procedures were associated with a longer mean operating time (274 vs 143 min), a shorter mean hospital stay (9.9 vs 15.8 day) and the perioperative complication rates were 16.7% for laparoscopic pyeloplasties and 20% for open pyeloplasties. The success rates were 90.5% for laparoscopy and 90.9% for open surgery. Average follow-up was 40.9 month for the laparoscopic group and 72.3 month for the open group. Failed procedures showed no improvement in loin pain or obstruction. The efficacy (in term of success rate and perioperative complications) of laparoscopic pyeloplasty is comparable to that of open pyeloplasty, with shorter mean hospital stay and better cosmetic results. These findings may suggest, that the laparoscopic dismembered pyeloplasty has the potential to replace open surgery and may be considered the first option for the treatment of ureteropelvic junction obstruction in expert hands.

  14. The divergent environmental characteristics of permanently-open, seasonally-open and normally-closed estuaries of south-western Australia

    NASA Astrophysics Data System (ADS)

    Chuwen, Benjamin M.; Hoeksema, Steeg D.; Potter, Ian C.

    2009-10-01

    This study has compared the environmental characteristics of the basins and saline lower reaches of the tributaries of eight estuaries on the south coast of Western Australia, which differ in their degree of connectivity with the ocean. Although four estuaries between 115.1° and 121.8° E along that coast remain permanently open to the ocean, the others only become open when the volume of river discharge is sufficient to breach the prominent sand bars at their mouths, which occurs annually following heavy winter and early spring rainfall in some estuaries (seasonally open) and infrequently in others (normally closed). Estuaries to the west of 118.5° E are predominantly permanently open, e.g. Oyster Harbour, or seasonally open, e.g. Broke, Irwin and Wilson inlets, whereas those further east, e.g. Wellstead Estuary and Hamersley, Culham and Stokes inlets, where annual rainfall and thus discharge are much lower, only become open after exceptionally heavy discharge. In permanently and seasonally-open estuaries, pronounced haloclines and oxyclines are present in the narrow rivers but not the wide basins where the waters are subjected to wind-driven mixing. The extent of cyclical seasonal fluctuations in environmental conditions differed markedly among the three seasonally-open estuaries and between years in one of those systems. These differences reflected variations in the relationship between the volume of fluvial discharge, which is determined by a combination of the amount of local rainfall, catchment size and extent of clearing of native vegetation, and the amount of intrusion by marine waters, which is largely controlled by the size and duration of the opening of the estuary mouth. The mean seasonal salinities in the basins of the three normally-closed estuaries increased over three years of very low rainfall to 64 in the deepest of these estuaries (Stokes Inlet) to 145 in Hamersley Inlet and to 296 in the shallowest estuary (Culham Inlet). These results demonstrate that the environmental characteristics of estuaries on the south coast of Western Australia differ markedly, even among those of the same type, e.g. seasonally-open estuaries or normally-closed estuaries.

  15. 76 FR 37039 - Drawbridge Operation Regulation; Passaic River, Harrison, NJ

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-06-24

    ... because the bridge has received few requests to open during past years. It is expected that an advance... during the past three years. The Coast Guard received a request from the owner of the bridge, National... requests to open during the past three years, the Coast Guard believes it is reasonable for the bridge...

  16. 76 FR 76634 - Drawbridge Operation Regulation; Blackwater River, South Quay, VA

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-12-08

    ... past 11 years and no anticipated change to vessel traffic. Small Entities Under the Regulatory... requests for openings for the past 11 years. Vessels that can safely transit under the bridge may do so at... openings in 11 years. DATES: Comments and related material must reach the Coast Guard on or before February...

  17. Open pneumothorax resulting from blunt thoracic trauma: a case report.

    PubMed

    McClintick, Colleen M

    2008-01-01

    Cases of open pneumothorax have been documented as early as 326 BC. Until the last 50 years, understanding of the epidemiology and treatment of penetrating chest trauma has arisen from military surgery. A better understanding of cardiopulmonary dynamics, advances in ventilatory support, and improvement in surgical technique have drastically improved treatment and increased the survival rate of patients with penetrating thoracic trauma. Open pneumothorax is rare in blunt chest trauma, but can occur when injury results in a substantial loss of the chest wall. This case study presents an adolescent who sustained a large open pneumothorax as a result of being run over by a car. Early and appropriate surgical intervention coupled with coordinated efforts by all members of the trauma team resulted in a positive outcome for this patient.

  18. Case-Matched Comparison of Long-Term Functional and Quality of Life Outcomes Following Laparoscopic Versus Open Ileal Pouch-Anal Anastomosis.

    PubMed

    Lavryk, Olga A; Stocchi, Luca; Ashburn, Jean H; Costedio, Meagan; Gorgun, Emre; Hull, Tracy L; Kessler, Hermann; Delaney, Conor P

    2018-05-21

    Laparoscopic ileal pouch-anal anastomosis (IPAA) is associated with recovery benefits when compared with open IPAA. There is limited data on long-term quality of life and functional outcomes, which this study aimed to assess. An IRB-approved, prospectively maintained database was queried to identify patients undergoing laparoscopic IPAA (L), case-matched with open IPAA (O) based on age ± 5 years, gender, body mass index (BMI) ± 5 kg/m 2 , diagnosis, date of surgery ± 3 years, stapled/handsewn anastomosis, omission of diverting loop ileostomy and length of follow-up ± 3 years. We assessed functional results, dietary, social, work, sexual restrictions and the Cleveland Clinic global quality of life score (CGQoL) at 1, 2, 3, 4, 5 and 10 years postoperatively. Functional outcomes were assessed based on number of stools (day/night) and seepage protection use (day/night). Variables were evaluated with Kaplan-Meier survival curves, uni- and multivariable analyses. Out of 4595 IPAAs, 529 patients underwent L, of whom 404 patients were well matched 1:1 to an equivalent number of O based on all criteria. Median follow-ups were 2 (0.5-17.8) versus 2.4 (0.5-22.2) years in L versus O, respectively (p = 0.18). L was associated with significantly decreased number of stools at night and less frequent pad usage at 1 year, both during the day and at night. Functional outcomes became similar during further follow-up. L was also associated with improved overall CGQoL, and energy scores at 1 year postoperatively, and decreased social restrictions for 1-2 years. There were no significant differences in quality of health, dietary, work or sexual restrictions. Laparoscopy was not associated with increased risk of pouch failure (p = 0.07) or significantly different causes of pouch failure when compared to O. Laparoscopic and open IPAA are associated with equivalent long-term functional outcomes, quality of life and pouch survival rates. Laparoscopic technique is associated with temporary benefits lasting 1 or 2 years.

  19. Geothermal Case Studies

    DOE Data Explorer

    Young, Katherine

    2014-09-30

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

  20. Trends of intervention for paediatric stone disease over the last two decades (2000-2015): A systematic review of literature.

    PubMed

    Pietropaolo, Amelia; Proietti, Silvia; Jones, Patrick; Rangarajan, Karan; Aboumarzouk, Omar; Giusti, Guido; Somani, Bhaskar K

    2017-12-01

    To ascertain the publication trends of interventions for paediatric kidney stone disease (KSD) we conducted a systematic review of literature over the last 16 years. With a rise of paediatric KSD and related interventions, a systematic review using PubMed was done over the last 16 years for all published papers on 'Paediatric stone disease intervention - ureteroscopy (URS), shockwave lithotripsy (SWL), percutaneous nephrolithotomy (PCNL), open stone surgery, and laparoscopic stone surgery'. The search was limited to English language articles with a published abstract, whilst case reports, animal and laboratory studies, were excluded. We also analysed the data in two time periods, period-1 (2000-2007) and period-2 (2008-2015). During the last 16-years, 339 papers were published on paediatric stone disease intervention on PubMed. This included papers on URS (95), PCNL (97), SWL (102), open stone surgery (34) and laparoscopic stone surgery (11). During period-1 and period-2 there were 30 and 65 papers on URS, 16 and 81 papers on PCNL, 33 and 60 papers on SWL, nine and 25 papers on open surgery, respectively. When comparing the two periods, there were 92 published papers for all interventions in period-1 and this had risen almost threefold to 247 papers in period-2. Our systematic review shows that intervention for KSD in the paediatric age group has risen over the last 8 years. Whilst URS, SWL, open surgery and laparoscopic surgery have all doubled, PCNL has risen fivefold reflecting an increase in the new minimally invasive PCNL techniques.

  1. Comparative effectiveness of minimally invasive versus open transforaminal lumbar interbody fusion: 2-year assessment of narcotic use, return to work, disability, and quality of life.

    PubMed

    Adogwa, Owoicho; Parker, Scott L; Bydon, Ali; Cheng, Joseph; McGirt, Matthew J

    2011-12-01

    Retrospective cohort comparison between minimally invasive (MIS) and open transforaminal lumbar interbody fusion (TLIF). To assess 2 earlier unstudied endpoints (duration of narcotic use and return to work) and long-term pain, disability, and quality of life (QOL) for MIS-TLIF versus open-TLIF. MIS-TLIF for lumbar spondylolithesis theoretically allows for surgical treatment of back and leg pain while minimizing blood loss and tissue injury. Although earlier studies have shown shorter hospital stay and equivocal 6 and 24 month outcomes with MIS-TLIF versus open-TLIF, the effect of MIS techniques on postoperative narcotic use and return to work are poorly understood. Thirty patients undergoing MIS-TLIF (n = 15) or open-TLIF (n = 15) for grade I degenerative spondylolithesis-associated back and leg pain were enrolled. Two-year outcomes were assessed through phone interview and it included pain [visual analog scale (VAS)], low-back disability (Oswestry disability index), EuroQol-5D, occupational disability, and narcotic use. MIS-TLIF versus open-TLIF cohorts were similar at baseline. Median [interquartile range (IQR)] length of hospitalization after surgery was significantly less for MIS-TLIF versus open-TLIF [3 (3 to 3) vs 5.5 (4 to 6) d], P = 0.001. MIS-TLIF versus open-TLIF patients showed similar 2-year improvement in VAS for back pain, VAS for leg pain, Oswestry disability index, and EuroQol-5D scores. Overall, median (IQR) length of postoperative narcotic use was 3.0 (1.4 to 4.6) weeks and significantly shorter for MIS-TLIF versus open-TLIF patients [2.0 (1.0 to 3.0) vs 4.0 (1.4 to 4.6) wk, P = 0.008]. Overall, median (IQR) time to return to work was 13.9 (2.2 to 25.5) weeks and significantly shorter for MIS-TLIF versus open-TLIF patients [8.5 (4.4 to 21.4) vs 17.1 (1.8 to 35.9) wk, P = 0.02]. Both MIS-TLIF and open-TLIF provide long-term improvement in pain, disability, and EuroQol-5D in patients with back and leg pain from grade I degenerative spondylolithesis. However, MIS-TLIF may allow for shortened hospital stays, reduced postoperative narcotic use, and accelerated return to work, reducing both direct medical costs and indirect costs of lost work productivity associated with TLIF procedures.

  2. 33 CFR 117.757 - Townsend Inlet.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... March of every year. (b) From 11 p.m. on December 24 until 11 p.m. on December 25, the draw need open... the fourth Sunday in March of every year, the draw need not open for vessels. If the fourth Sunday...

  3. Open access to MRI for general practitioners: 12 years' experience at one institution -- a retrospective analysis.

    PubMed

    Gough-Palmer, A L; Burnett, C; Gedroyc, W M

    2009-08-01

    The aim of this study was to evaluate 12 years of general practitioner (GP) use of open access MRI services at a single London teaching hospital. A retrospective analysis of reports from all GP requests for MRI scans between 1994 and 2005 was performed. The date, scanned body part, and requester details from 1798 scans requested by 209 individual GPs over a continuous 12-year period were recorded. All scans were then graded into four categories based on the severity of reported findings from normal to gross abnormality. Over the study period, GP requests as a percentage of the total (MRI) department workload remained low at approximately 2.6%. Spine, knee and brain requests constituted 86% (n = 1546) of requested scans. 48% (n = 868) of scans were reported as normal or minor degenerative changes only. 26% (n = 466) of scans demonstrated serious pathology that was likely to warrant hospital consultant referral. There was a wide range of scans requested per requester, from 1 to 240 over the period, with an average of 8.5 scans per GP. In conclusion, any department wishing to set up open access to MRI services for GPs could cover the majority of requests by offering spine, knee and brain imaging. The percentage of normal report rates for GP requests is comparable with previous studies of outpatient referrals. A large variation in requesting patterns between GPs suggests the need for increased communication between GPs and imaging departments to optimise use of the service.

  4. Short- and long-term outcomes of laparoscopic surgery vs open surgery for transverse colon cancer: a retrospective multicenter study.

    PubMed

    Kim, Jong Wan; Kim, Jeong Yeon; Kang, Byung Mo; Lee, Bong Hwa; Kim, Byung Chun; Park, Jun Ho

    2016-01-01

    The purpose of the present study was to compare the perioperative and oncologic outcomes between laparoscopic surgery and open surgery for transverse colon cancer. We conducted a retrospective review of patients who underwent surgery for transverse colon cancer at six Hallym University-affiliated hospitals between January 2005 and June 2015. The perioperative outcomes and oncologic outcomes were compared between laparoscopic and open surgery. Of 226 patients with transverse colon cancer, 103 underwent laparoscopic surgery and 123 underwent open surgery. There were no differences in the patient characteristics between the two groups. Regarding perioperative outcomes, the operation time was significantly longer in the laparoscopic group than in the open group (267.3 vs 172.7 minutes, P<0.001), but the time to soft food intake (6.0 vs 6.6 days, P=0.036) and the postoperative hospital stay (13.7 vs 15.7 days, P=0.018) were shorter in the laparoscopic group. The number of harvested lymph nodes was lower in the laparoscopic group than in the open group (20.3 vs 24.3, P<0.001). The 5-year overall survival (90.8% vs 88.6%, P=0.540) and disease-free survival (86.1% vs 78.9%, P=0.201) rates were similar in both groups. The present study showed that laparoscopic surgery is associated with several perioperative benefits and similar oncologic outcomes to open surgery for the resection of transverse colon cancer. Therefore, laparoscopic surgery offers a safe alternative to open surgery in patients with transverse colon cancer.

  5. Driving CZTS to the SQ Limit: Solving the Open Circuit Voltage Problem

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

    Haight, Richard A.; McCandless, Brian E.; Kummel, Andrew C.

    2016-12-15

    A key objective of this 3 year research effort was to reduce the open circuit voltage (Voc) deficit, defined as the difference between the absorber band gap and the measured Voc to below 475mV from values at the beginning of this work of 630-730mV. To achieve this reduction, along with the attendant goals of higher Voc and efficiency, detailed studies into the fundamental understanding of existing limitations were undertaken.

  6. Growth Patterns of the Neurocentral Synchondrosis (NCS) in Immature Cadaveric Vertebra.

    PubMed

    Blakemore, Laurel; Schwend, Richard; Akbarnia, Behrooz A; Dumas, Megan; Schmidt, John

    2018-03-01

    Gross anatomic study of osteological specimens. To evaluate the age of closure for the neurocentral synchondrosis (NCS) in all 3 regions of the spine in children aged 1 to 18 years old. The ossification of the human vertebra begins from a vertebral body ossification center and a pair of neural ossification centers located within the centrum called the NCS. These bipolar cartilaginous centers of growth contribute to the growth of the vertebral body, spinal canal, and posterior elements of the spine. The closure of the synchondroses is dependent upon location of the vertebra and previous studies range from 2 to 16 years of age. Although animal and cadaveric studies have been performed regarding NCS growth and early instrumentation's effect on its development, the effects of NCS growth disturbances are still not completely understood. The vertebrae of 32 children (1 to 18 y old) from the Hamann-Todd Osteological collection were analyzed (no 2 or 9 y old specimens available). Vertebrae studied ranged from C1 to L5. A total of 768 vertebral specimens were photographed on a background grid to allow for measurement calibration. Measurements of the right and left NCS, pedicle width at the NCS, and spinal canal area were taken using Scandium image-analysis software (Olympus Soft Imaging Solutions, Germany). The percentage of the growth plate still open was found by dividing the NCS by the pedicle width and multiplying by 100. Data were analyzed with JMP 11 software (SAS Institute Inc., Cary, NC). The NCS was 100% open in all 3 regions of the spine in the 1- to 3-year age group. The cervical NCS closed first with completion around 5 years of age. The lumbar NCS was nearly fully closed by age 11. Only the thoracic region remained open through age 17 years. The left and right NCS closed simultaneously as there was no statistical difference between them. In all regions of the spine, the NCS appeared to close sooner in males than in females. Spinal canal area increased with age up to 12 years old in the cervical and thoracic spine but did not significantly change after age 3 in the lumbar spine. In conclusion, closure of the NCS differed among the cervical, thoracic, and lumbar spine regions. The NCS reached closure in males before females even though females mature faster and reach skeletal maturity sooner than males. However, it is not determined whether the continued open NCS in females to a later age may be a factor in their increased rate of scoliosis.

  7. Open Educational Practices and Attitudes to Openness across India: Reporting the Findings of the Open Education Research Hub Pan-India Survey

    ERIC Educational Resources Information Center

    Perryman, Leigh-Anne; Seal, Tim

    2016-01-01

    In recent years India has shown a growing appetite for open educational resources (OER) and open educational practices (OEP). Despite this, there is a paucity of research on OER use and impact, the extensiveness of OEP, and attitudes towards openness in India. This paper reports on research intended to help fill that knowledge gap by conducting a…

  8. High prevalence of type 2 diabetes melitus and its risk factors among the rural population of Pondicherry, South India.

    PubMed

    Shrivastava, Saurabh RamBihariLal; Ghorpade, Arun Gangadhar

    2014-01-01

    We aimed to assess the prevalence of type-2 diabetes in rural Pondicherry and to study the determinants of Diabetes Mellitus (DM) in the rural population of Pondicherry, south Induia. It was a cross-sectional community-based study conducted from November 2010 to January 2012 in two of the field practice villages affiliated to a Medical College in Pondicherry. Sample size was calculated using open source software, Open Epi Version 2.3.10. The sampling frame comprised individuals aged above 25 years and single stage cluster random sampling was carried out. After obtaining the verbal informed consent each of the study participants were interviewed face-to-face using a pre-tested structured questionnaire. Data were analyzed using the SPSS version 16. The age of the study participants ranged from 25 to 98 years with mean of 42.6 (±13.7) and majority of the study participants 339 (32.5%) from the age-group of 30-39 years. The prevalence of diabetes was 19.8% (60-69 years), 17.1% (40-49 years), 16.8% (50-59 years), and 13.6% (>69 years) among study subjects. In univariate analysis, higher age, being educated, unemployed and poor was associated with higher risk of diabetes mellitus (DM). Furthermore, a high triglyceride level was significantly associated with increase in the risk of DM (adjusted odds ratio: 3.01; 95% CI: 1.86, 4.86). Type-2 diabetes mellitus (T2DM) is an important public health problem in the adults of rural Pondicherry. Among non-modifiable factors, higher age, better socio-educational background and positive family history of diabetes was significantly associated with T2DM.

  9. [Basic and clinical studies of pressure-independent damaging factors of open angle glaucoma].

    PubMed

    Araie, Makoto

    2011-03-01

    Pathogenesis of open-angle glaucoma involves both pressure-dependent damaging factors and pressure-independent damaging factors. The high prevalence of open-angle glaucoma with normal pressure (normal-tension glaucoma) in Japan implies that treatment of pressure-independent damaging factors in Japanese open-angle glaucoma patients is of importance. In an attempt to investigate the roles of pressure-independent damaging factors in open-angle glaucoma, we carried out basic and clinical studies and obtained the following results. 1. The rate of deterioration of visual field after trabeculectomy in normal tension glaucoma patients with post-operative intraocular pressure (IOP) of 10 mmHg was found to be -0.25 dB/year of mean deviation (MD), suggesting that contribution of pressure-independent damaging factors to the deterioration of MD in open-angle glaucoma is around -0.25 dB/year of mean deviation (MD). 2. Experiments using isolated purified cultured retinal ganglion cells (RGCs) indicated that calcium-channel blockers and some of antiglaucoma drugs showed neuroprotective effects on RGCs at concentrations of 0.01 microM or higher. 3. In mice, damage to RGCs resulted in secondary degeneration of neurons and activation of glial cells in the lateral geniculate nucleous (LGN) and superior colliculus, and these secondary changes in the central nervous system (CNS) due to RGC damage was partly ameliorated by systemic administration of memantine. 4. Mice experimental high IOP glaucoma models could be established using laser irradiation of the limbal area, and the usefulness of Tonolab in IOP measurements of mice eye was confirmed. 5. Monkey experimental high IOP glaucoma models revealed that in the glaucomatous optic nerve head vaso-constrictive reactions to an alpha-1 agonist was abolished, while vasodilative reaction to a prostaglandin FP receptor agonist was retained. 6. In monkeys with experimental high IOP glaucoma, secondary damage to neurons in the LGN and the glial reaction to it were also found, similar to the mice experiments. In living monkeys the glial reaction in the LGN could be observed by means of positron emission tomography. 7. In the LGN of monkeys with experimental high IOP glaucoma, the M-cell system was preferentially damaged in the early stage, while in the later stages both the M- and P-cell systems were damaged. 8. In a single-instituted prospective double-blinded clinical trial, oral administration of nilvadipine at 4 mg/day, a DHP calcium-channel blocker, was found to significantly retard the visual field progression in normal tension glaucoma patients over 3 years, while significantly increasing the choroidal and optic nerve blood flow by about 35%. 9. A multi-instituted prospective double-blinded clinical trial in normal tension glaucoma patients revealed that the rate of MD deterioration under monotherapy with either topical nipradilol or timolol was around -0.05 dB/year, thought to be considerably slower than -0.25 dB/year, the commonly estimated rate of MD deterioration by pressure-independent damaging factors. The current results indicate the possibility of treatment of pressure-independent damaging factors of open-angle glaucoma in Japanese open-angle glaucoma patients with oral nilvadipine and topical anti-glaucoma agents.

  10. Prevalence of malocclusion among mouth breathing children: do expectations meet reality?

    PubMed

    Souki, Bernardo Q; Pimenta, Giovana B; Souki, Marcelo Q; Franco, Leticia P; Becker, Helena M G; Pinto, Jorge A

    2009-05-01

    The aim of this study was to report epidemiological data on the prevalence of malocclusion among a group of children, consecutively admitted at a referral mouth breathing otorhinolaryngological (ENT) center. We assessed the association between the severity of the obstruction by adenoids/tonsils hyperplasia or the presence of allergic rhinitis and the prevalence of class II malocclusion, anterior open bite and posterior crossbite. Cross-sectional, descriptive study, carried out at an Outpatient Clinic for Mouth-Breathers. Dental inter-arch relationship and nasal obstructive variables were diagnosed and the appropriate cross-tabulations were done. Four hundred and one patients were included. Mean age was 6 years and 6 months (S.D.: 2 years and 7 months), ranging from 2 to 12 years. All subjects were evaluated by otorhinolaryngologists to confirm mouth breathing. Adenoid/tonsil obstruction was detected in 71.8% of this sample, regardless of the presence of rhinitis. Allergic rhinitis alone was found in 18.7% of the children. Non-obstructive mouth breathing was diagnosed in 9.5% of this sample. Posterior crossbite was detected in almost 30% of the children during primary and mixed dentitions and 48% in permanent dentition. During mixed and permanent dentitions, anterior open bite and class II malocclusion were highly prevalent. More than 50% of the mouth breathing children carried a normal inter-arch relationship in the sagital, transversal and vertical planes. Univariate analysis showed no significant association between the type of the obstruction (adenoids/tonsils obstructive hyperplasia or the presence of allergic rhinitis) and malocclusions (class II, anterior open bite and posterior crossbite). The prevalence of posterior crossbite is higher in mouth breathing children than in the general population. During mixed and permanent dentitions, anterior open bite and class II malocclusion were more likely to be present in mouth breathers. Although more children showed these malocclusions, most mouth breathing children evaluated in this study did not match the expected "mouth breathing dental stereotype". In this population of mouth breathing children, the obstructive size of adenoids or tonsils and the presence of rhinitis were not risk factors to the development of class II malocclusion, anterior open bite or posterior crossbite.

  11. Structure and biomass production of one- to seven-year-old intensively cultured jack pine plantation in Wisconsin.

    Treesearch

    J. Zavitkovski; David H. Dawson

    1978-01-01

    Spacing and rotation length effects were studied for 7 years in intensively cultured jack pine stands. Production culminated at age 5 in the densest planting and progressively later in more open spacing. Biomass production was two to several times higher than in jack pine plantations grown under traditional silvicultural systems.

  12. Opening the Window on Comprehensible Pronunciation after 19 Years: A Workplace Training Study

    ERIC Educational Resources Information Center

    Derwing, Tracey M.; Munro, Murray J.; Foote, Jennifer A.; Waugh, Erin; Fleming, Jason

    2014-01-01

    We present the outcomes of a pronunciation training program conducted in a workplace setting with second language speakers who had lived in an English-speaking environment for an average of 19 years. The research questions concerned whether improvement would occur in the learners' perception of certain segments and prosody; in the…

  13. Community College Campus Carry Policy Analysis

    ERIC Educational Resources Information Center

    Alvarado, Joel; Toppin, Sheila

    2017-01-01

    This study provides a policy network analysis on the implications of HB 792 and HB 280 at urban two-year open campuses, with specific attention to Georgia Piedmont Technical College (GPTC), a unit of the Technical College System of Georgia (TCSG). Georgia state legislators passed House Bills 792 and 280, which authorized any person 18 years of age…

  14. Preparing Students for Diverse Careers: Developing Career Literacy with Final-Year Writing Students

    ERIC Educational Resources Information Center

    Bennet, Dawn; Robertson, Rachel

    2015-01-01

    Graduates from generalist science and arts degrees can face diverse careers characterised by portfolios of simultaneous, self-managed roles. This paper reports from a study on identity and career literacy in which final-year professional writing and publishing students developed an ePortfolio and engaged in open blogging during their industry…

  15. Moving targets: Promoting physical activity in public spaces via open streets in the US.

    PubMed

    Hipp, J Aaron; Bird, Alyssa; van Bakergem, Margaret; Yarnall, Elizabeth

    2017-10-01

    Popularity of Open Streets, temporarily opening streets to communities and closing streets to vehicles, in the US has recently surged. As of January 2016, 122 cities have hosted an Open Streets program. Even with this great expansion, the sustainability of Open Streets remains a challenge in many cities and overall Open Streets in the US differ from their successful counterparts in Central and South America. Between summer 2015 and winter 2016, we reviewed the websites and social media of the 122 identified programs and interviewed 32 unique Open Streets programs. Websites and social media were reviewed for program initiation, number of Open Streets days, length of routes, duration of program, and reported participation. Interview questions focused on barriers and facilitators of expanding Open Streets and specific questioning regarding local evaluation activities. All interviews were transcribed verbatim and analyzed with constant comparative methodology. Over three-quarters of US Open Streets programs have been initiated since 2010, with median frequency of one time per year, 4h per date, and 5000-9999 participants. Seventy-seven percent of program routes are under 5km in length. Success of programs was measured by enthusiasm, attendance, social media, survey metrics, and sustainability. Thirteen of 32 program organizers expressed interest in expanding their programs to 12 dates per year, but noted consistent barriers to expansion including funding, permitting, and branding. Though many cities now host Open Streets programs, their ability to effect public health remains limited with few program dates per year. Coordinated efforts, especially around funding, permitting, and branding may assist in expanding program dates. Copyright © 2016 Elsevier Inc. All rights reserved.

  16. Endo-exuberance and abdominal aortic aneurysm management: have we gone too far?

    PubMed

    Sternbergh, W Charles

    2003-11-01

    new technology, such as endovascular abdominal aortic aneurysm repair (EVAR) may promote an 'irrational exuberance' for its application. nonsuprarenal AAA repairs performed at a single institution over a 7 year period were retrospectively studied. Method of repair, 30-day mortality and EVAR aortic neck anatomy were assessed. 431 AAA repairs were performed between January 1996 and June 2002, 238 (55%) open and 193 (45%) EVAR. The percentage of EVAR increased steadily from approximately 20% in 1996 and 1997 to a peak of 69.5% in 2000. However, in 2001-2002 the percentage of EVAR fell to approximately 40% of total repairs. In this time period our selection criteria for EVAR became more conservative, with treatment of fewer patients with short aortic necks (12.8 vs. 28.9% with neck length < or = 20 mm, p = 0.05; 3.8 vs. 10.8% with neck length < or = 15 mm, p = 0.1) or highly angulated necks (3.8 vs. 28.9% with neck angulation > or = 40 degrees, p = 0.04) in 2001-2002 versus 1999-2000, respectively. Institutional volume of AAA repairs doubled over the study period (p = 0.001). 30-day mortality over the study period for nonruptured EVAR and open AAA repair was 2.6 and 3.3%, respectively (p = NS). The complexity of open repairs increased significantly during the final 3 years of the review. the application of EVAR has fallen from a high of 69.5% of our AAA repairs in 2000 to approximately 40% in 2001-2002. More prudent patient selection in recent years regarding unfavorable aortic neck anatomy was felt to be a primary etiology of changes in overall EVAR utilization. The anticipated improvement in long-term results from EVAR await multi-year follow-up.

  17. Deconstructing tolerance with clobazam: Post hoc analyses from an open-label extension study.

    PubMed

    Gidal, Barry E; Wechsler, Robert T; Sankar, Raman; Montouris, Georgia D; White, H Steve; Cloyd, James C; Kane, Mary Clare; Peng, Guangbin; Tworek, David M; Shen, Vivienne; Isojarvi, Jouko

    2016-10-25

    To evaluate potential development of tolerance to adjunctive clobazam in patients with Lennox-Gastaut syndrome. Eligible patients enrolled in open-label extension study OV-1004, which continued until clobazam was commercially available in the United States or for a maximum of 2 years outside the United States. Enrolled patients started at 0.5 mg·kg -1 ·d -1 clobazam, not to exceed 40 mg/d. After 48 hours, dosages could be adjusted up to 2.0 mg·kg -1 ·d -1 (maximum 80 mg/d) on the basis of efficacy and tolerability. Post hoc analyses evaluated mean dosages and drop-seizure rates for the first 2 years of the open-label extension based on responder categories and baseline seizure quartiles in OV-1012. Individual patient listings were reviewed for dosage increases ≥40% and increasing seizure rates. Data from 200 patients were included. For patients free of drop seizures, there was no notable change in dosage over 24 months. For responder groups still exhibiting drop seizures, dosages were increased. Weekly drop-seizure rates for 100% and ≥75% responders demonstrated a consistent response over time. Few patients had a dosage increase ≥40% associated with an increase in seizure rates. Two-year findings suggest that the majority of patients do not develop tolerance to the antiseizure actions of clobazam. Observed dosage increases may reflect best efforts to achieve seizure freedom. It is possible that the clinical development of tolerance to clobazam has been overstated. NCT00518713 and NCT01160770. This study provides Class III evidence that the majority of patients do not develop tolerance to clobazam over 2 years of treatment. © 2016 American Academy of Neurology.

  18. Robotic Surgical System for Radical Prostatectomy: A Health Technology Assessment

    PubMed Central

    Wang, Myra; Xie, Xuanqian; Wells, David; Higgins, Caroline

    2017-01-01

    Background Prostate cancer is the second most common type of cancer in Canadian men. Radical prostatectomy is one of the treatment options available, and involves removing the prostate gland and surrounding tissues. In recent years, surgeons have begun to use robot-assisted radical prostatectomy more frequently. We aimed to determine the clinical benefits and harms of the robotic surgical system for radical prostatectomy (robot-assisted radical prostatectomy) compared with the open and laparoscopic surgical methods. We also assessed the cost-effectiveness of robot-assisted versus open radical prostatectomy in patients with clinically localized prostate cancer in Ontario. Methods We performed a literature search and included prospective comparative studies that examined robot-assisted versus open or laparoscopic radical prostatectomy for prostate cancer. The outcomes of interest were perioperative, functional, and oncological. The quality of the body of evidence was examined according to the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) Working Group criteria. We also conducted a cost–utility analysis with a 1-year time horizon. The potential long-term benefits of robot-assisted radical prostatectomy for functional and oncological outcomes were also evaluated in a 10-year Markov model in scenario analyses. In addition, we conducted a budget impact analysis to estimate the additional costs to the provincial budget if the adoption of robot-assisted radical prostatectomy were to increase in the next 5 years. A needs assessment determined that the published literature on patient perspectives was relatively well developed, and that direct patient engagement would add relatively little new information. Results Compared with the open approach, we found robot-assisted radical prostatectomy reduced length of stay and blood loss (moderate quality evidence) but had no difference or inconclusive results for functional and oncological outcomes (low to moderate quality evidence). Compared with laparoscopic radical prostatectomy, robot-assisted radical prostatectomy had no difference in perioperative, functional, and oncological outcomes (low to moderate quality evidence). Compared with open radical prostatectomy, our best estimates suggested that robot-assisted prostatectomy was associated with higher costs ($6,234) and a small gain in quality-adjusted life-years (QALYs) (0.0012). The best estimate of the incremental cost-effectiveness ratio (ICER) was $5.2 million per QALY gained. However, if robot-assisted radical prostatectomy were assumed to have substantially better long-term functional and oncological outcomes, the ICER might be as low as $83,921 per QALY gained. We estimated the annual budget impact to be $0.8 million to $3.4 million over the next 5 years. Conclusions There is no high-quality evidence that robot-assisted radical prostatectomy improves functional and oncological outcomes compared with open and laparoscopic approaches. However, compared with open radical prostatectomy, the costs of using the robotic system are relatively large while the health benefits are relatively small. PMID:28744334

  19. The effectiveness of a cognitive task analysis informed curriculum to increase self-efficacy and improve performance for an open cricothyrotomy.

    PubMed

    Campbell, Julia; Tirapelle, Leslie; Yates, Kenneth; Clark, Richard; Inaba, Kenji; Green, Donald; Plurad, David; Lam, Lydia; Tang, Andrew; Cestero, Ramon; Sullivan, Maura

    2011-01-01

    This study explored the effects of a cognitive task analysis (CTA)-informed curriculum to increase surgical skills performance and self-efficacy beliefs for medical students and postgraduate surgical residents learning how to perform an open cricothyrotomy. Third-year medical students and postgraduate year 2 and 3 surgery residents were assigned randomly to either the CTA group (n = 12) or the control group (n = 14). The CTA group learned the open cricothyrotomy procedure using the CTA curriculum. The control group received the traditional curriculum. The CTA group outperformed the control group significantly based on a 19-point checklist score (CTA mean score: 17.75, standard deviation [SD] = 2.34; control mean score: 15.14, SD = 2.48; p = 0.006). The CTA group also reported significantly higher self-efficacy scores based on a 140-point self-appraisal inventory (CTA mean score: 126.10, SD = 16.90; control: 110.67, SD = 16.8; p = 0.029). The CTA curriculum was effective in increasing the performance and self-efficacy scores for postgraduate surgical residents and medical students performing an open cricothyrotomy. Copyright © 2011 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

  20. Aggression and violence in psychiatric hospitals with and without open door policies: A 15-year naturalistic observational study.

    PubMed

    Schneeberger, Andres R; Kowalinski, Eva; Fröhlich, Daniela; Schröder, Katrin; von Felten, Stefanie; Zinkler, Martin; Beine, Karl H; Heinz, Andreas; Borgwardt, Stefan; Lang, Undine E; Bux, Donald A; Huber, Christian G

    2017-12-01

    Aggressive behavior and violence in psychiatric patients have often been quoted to justify more restrictive settings in psychiatric facilities. However, the effects of open vs. locked door policies on aggressive incidents remain unclear. This study had a naturalistic observational design and analyzed the occurrence of aggressive behavior as well as the use of seclusion or restraint in 21 German hospitals. The analysis included data from 1998 to 2012 and contained a total of n = 314,330 cases, either treated in one of 17 hospitals with (n = 68,135) or in one of 4 hospitals without an open door policy (n = 246,195). We also analyzed the data according to participants' stay on open, partially open, or locked wards. To compare hospital and ward types, we used generalized linear mixed-effects models on a propensity score matched subset (n = 126,268) and on the total dataset. The effect of open vs. locked door policy was non-significant in all analyses of aggressive behavior during treatment. Restraint or seclusion during treatment was less likely in hospitals with an open door policy. On open wards, any aggressive behavior and restraint or seclusion were less likely, whereas bodily harm was more likely than on closed wards. Hospitals with open door policies did not differ from hospitals with locked wards regarding different forms of aggression. Other restrictive interventions used to control aggression were significantly reduced in open settings. Open wards seem to have a positive effect on reducing aggression. Future research should focus on mental health care policies targeted at empowering treatment approaches, respecting the patient's autonomy and promoting reductions of institutional coercion. Copyright © 2017 Elsevier Ltd. All rights reserved.

  1. CMOST: an open-source framework for the microsimulation of colorectal cancer screening strategies.

    PubMed

    Prakash, Meher K; Lang, Brian; Heinrich, Henriette; Valli, Piero V; Bauerfeind, Peter; Sonnenberg, Amnon; Beerenwinkel, Niko; Misselwitz, Benjamin

    2017-06-05

    Colorectal cancer (CRC) is a leading cause of cancer-related mortality. CRC incidence and mortality can be reduced by several screening strategies, including colonoscopy, but randomized CRC prevention trials face significant obstacles such as the need for large study populations with long follow-up. Therefore, CRC screening strategies will likely be designed and optimized based on computer simulations. Several computational microsimulation tools have been reported for estimating efficiency and cost-effectiveness of CRC prevention. However, none of these tools is publicly available. There is a need for an open source framework to answer practical questions including testing of new screening interventions and adapting findings to local conditions. We developed and implemented a new microsimulation model, Colon Modeling Open Source Tool (CMOST), for modeling the natural history of CRC, simulating the effects of CRC screening interventions, and calculating the resulting costs. CMOST facilitates automated parameter calibration against epidemiological adenoma prevalence and CRC incidence data. Predictions of CMOST were highly similar compared to a large endoscopic CRC prevention study as well as predictions of existing microsimulation models. We applied CMOST to calculate the optimal timing of a screening colonoscopy. CRC incidence and mortality are reduced most efficiently by a colonoscopy between the ages of 56 and 59; while discounted life years gained (LYG) is maximal at 49-50 years. With a dwell time of 13 years, the most cost-effective screening is at 59 years, at $17,211 discounted USD per LYG. While cost-efficiency varied according to dwell time it did not influence the optimal time point of screening interventions within the tested range. Predictions of CMOST are highly similar compared to a randomized CRC prevention trial as well as those of other microsimulation tools. This open source tool will enable health-economics analyses in for various countries, health-care scenarios and CRC prevention strategies. CMOST is freely available under the GNU General Public License at https://gitlab.com/misselwb/CMOST.

  2. The Ecology of the Open Practitioner: A Conceptual Framework for Open Research

    ERIC Educational Resources Information Center

    Stagg, Adrian

    2017-01-01

    Open Educational Practices (OEP) have gained traction internationally over the last fifteen years, with individuals, institutions, and governments increasingly interested in the affordances of openness. Whilst initiatives, policies, and support mechanisms are evident, there is an ever-present danger of localised contexts being unintentionally…

  3. OpenCourseWare and Open Educational Resources: The Next Big Thing in Technology-Enhanced Education?

    ERIC Educational Resources Information Center

    Caudill, Jason G.

    2012-01-01

    OpenCourseWare (OCW) and Open Educational Resources (OER) are two new and closely related educational technologies. Both provide open access to learning materials for students and instructors via the Internet. These are for the moment still very young technologies. While they have grown dramatically in just ten years there is still relatively…

  4. 0 + 5 Vascular Surgery Residents' Operative Experience in General Surgery: An Analysis of Operative Logs from 12 Integrated Programs.

    PubMed

    Smith, Brigitte K; Kang, P Chulhi; McAninch, Chris; Leverson, Glen; Sullivan, Sarah; Mitchell, Erica L

    2016-01-01

    Integrated (0 + 5) vascular surgery (VS) residency programs must include 24 months of training in core general surgery. The Accreditation Council for Graduate Medical Education currently does not require specific case numbers in general surgery for 0 + 5 trainees; however, program directors have structured this time to optimize operative experience. The aim of this study is to determine the case volume and type of cases that VS residents are exposed to during their core surgery training. Accreditation council for graduate medical education operative logs for current 0 + 5 VS residents were obtained and retrospectively reviewed to determine general surgery case volume and distribution between open and laparoscopic cases performed. Standard statistical methods were applied. A total of 12 integrated VS residency programs provided operative case logs for current residents. A total of 41 integrated VS residents in clinical years 2 through 5. During the postgraduate year-1 training year, residents participated in significantly more open than laparoscopic general surgery cases (p < 0.0001). This difference was consistent over the first 3 years of training. The most frequently logged open general surgery cases are hernia repair (20%), skin and soft tissue (7.4%), and breast (6.3%). Residents in programs with core surgery over 3 years participated in significantly more general surgery operations compared with residents in programs with core surgery spread out over 4 years (p = 0.035). 0 + 5 VS residents perform significantly more open operations than laparoscopic operations during their core surgery training. The majority of these operations are minor, nonabdominal procedures. The 0 + 5 VS residency program general surgery operative training requirements should be reevaluated and case minimums defined. The general surgery training component of 0 + 5 VS residencies may need to be restructured to meet the needs of current and future trainees. Copyright © 2016 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

  5. Cardiovascular Safety of Droxidopa in Patients With Symptomatic Neurogenic Orthostatic Hypotension.

    PubMed

    White, William B; Hauser, Robert A; Rowse, Gerald J; Ziemann, Adam; Hewitt, L Arthur

    2017-04-01

    The norepinephrine prodrug droxidopa improves symptoms of neurogenic orthostatic hypotension, a condition that is associated with diseases of neurogenic autonomic failure (e.g., Parkinson disease, multiple system atrophy, pure autonomic failure). These conditions are more prevalent in older patients who also have cardiovascular co-morbidities. Hence, we evaluated the cardiovascular safety of droxidopa in patients with symptomatic neurogenic orthostatic hypotension who participated in randomized controlled studies (short-term studies of 1 to 2 weeks and an intermediate 8- to 10-week study) and long-term open-label studies. Rates of cardiovascular adverse events (AEs) for patients treated with droxidopa were 4.4% in the intermediate study and 10.8% in the long-term open-label studies. Adjusting for exposure time, cardiovascular AE rates were 0.30 events/patient-year in the short-term and intermediate studies and 0.15 events/patient-year in the long-term open-label studies. The incidence of treatment discontinuation due to blood pressure-related events was approximately 2.5%. Among patients with a history of cardiac disorders at baseline, the rates of cardiovascular-related and blood pressure-related AEs were nominally higher with droxidopa compared to placebo. Most of these events were minor atrial arrhythmias; none were major adverse cardiovascular events or deaths. In conclusion, small increases in cardiovascular AEs were observed with droxidopa compared to placebo; this was most evident in patients with preexisting cardiac disorders. Copyright © 2017 The Author(s). Published by Elsevier Inc. All rights reserved.

  6. Mystical Experiences Occasioned by the Hallucinogen Psilocybin Lead to Increases in the Personality Domain of Openness

    PubMed Central

    MacLean, Katherine A.; Johnson, Matthew W.; Griffiths, Roland R.

    2012-01-01

    A large body of evidence, including longitudinal analyses of personality change, suggests that core personality traits are predominantly stable after age 30. To our knowledge, no study has demonstrated changes in personality in healthy adults after an experimentally manipulated discrete event. Intriguingly, double-blind controlled studies have shown that the classic hallucinogen psilocybin occasions personally and spiritually significant mystical experiences that predict long-term changes in behaviors, attitudes and values. In the present report we assessed the effect of psilocybin on changes in the five broad domains of personality - Neuroticism, Extroversion, Openness, Agreeableness, and Conscientiousness. Consistent with participant claims of hallucinogen-occasioned increases in aesthetic appreciation, imagination, and creativity, we found significant increases in Openness following a high-dose psilocybin session. In participants who had mystical experiences during their psilocybin session, Openness remained significantly higher than baseline more than one year after the session. The findings suggest a specific role for psilocybin and mystical-type experiences in adult personality change. PMID:21956378

  7. Mystical experiences occasioned by the hallucinogen psilocybin lead to increases in the personality domain of openness.

    PubMed

    MacLean, Katherine A; Johnson, Matthew W; Griffiths, Roland R

    2011-11-01

    A large body of evidence, including longitudinal analyses of personality change, suggests that core personality traits are predominantly stable after age 30. To our knowledge, no study has demonstrated changes in personality in healthy adults after an experimentally manipulated discrete event. Intriguingly, double-blind controlled studies have shown that the classic hallucinogen psilocybin occasions personally and spiritually significant mystical experiences that predict long-term changes in behaviors, attitudes and values. In the present report we assessed the effect of psilocybin on changes in the five broad domains of personality - Neuroticism, Extroversion, Openness, Agreeableness, and Conscientiousness. Consistent with participant claims of hallucinogen-occasioned increases in aesthetic appreciation, imagination, and creativity, we found significant increases in Openness following a high-dose psilocybin session. In participants who had mystical experiences during their psilocybin session, Openness remained significantly higher than baseline more than 1 year after the session. The findings suggest a specific role for psilocybin and mystical-type experiences in adult personality change.

  8. Perioperative and mid-term oncologic outcomes of robotic assisted radical cystectomy with totally intracorporeal neobladder: Results of a propensity score matched comparison with open cohort from a single-centre series.

    PubMed

    Simone, Giuseppe; Tuderti, Gabriele; Misuraca, Leonardo; Anceschi, Umberto; Ferriero, Mariaconsiglia; Minisola, Francesco; Guaglianone, Salvatore; Gallucci, Michele

    2018-04-17

    In this study, we compared perioperative and oncologic outcomes of patients treated with either open or robot-assisted radical cystectomy and intracorporeal neobladder at a tertiary care center. The institutional prospective bladder cancer database was queried for "cystectomy with curative intent" and "neobladder". All patients underwent robot-assisted radical cystectomy and intracorporeal neobladder or open radical cystectomy and orthotopic neobladder for high-grade non-muscle invasive bladder cancer or muscle invasive bladder cancer with a follow-up length ≥2 years were included. A 1:1 propensity score matching analysis was used. Kaplan-Meier method was performed to compare oncologic outcomes of selected cohorts. Survival rates were computed at 1,2,3 and 4 years after surgery and the log rank test was applied to assess statistical significance between the matched groups. Overall, 363 patients (299 open and 64 robotic) were included. Open radical cystectomy patients were more frequently male (p = 0.08), with higher pT stages (p = 0.003), lower incidence of urothelial histologies (p = 0.05) and lesser adoption of neoadjuvant chemotherapy (<0.001). After applying the propensity score matching, 64 robot-assisted radical cystectomy patients were matched with 46 open radical cystectomy cases (all p ≥ 0.22). Open cohort showed a higher rate of perioperative overall complications (91.3% vs 42.2%, p 0.001). At Kaplan-Meier analysis robotic and open cohorts displayed comparable disease-free survival (log-rank p = 0.746), cancer-specific survival (p = 0.753) and overall-survival rates (p = 0.909). Robot-assisted radical cystectomy and intracorporeal neobladder provides comparable oncologic outcomes of open radical cystectomy and orthotopic neobladder at intermediate term survival analysis. Copyright © 2018 Elsevier Ltd, BASO ~ The Association for Cancer Surgery, and the European Society of Surgical Oncology. All rights reserved.

  9. Do work ability and job involvement channel later personal goals in retirement? An 11-year follow-up study.

    PubMed

    Feldt, Taru; Hyvönen, Katriina; Oja-Lipasti, Terhi; Kinnunen, Ulla; Salmela-Aro, Katariina

    2012-07-01

    The present study investigates the role of work ability and job involvement in personal life goals later in retirement. The study is based on longitudinal research on Finnish employees working in managerial positions. At the study baseline (in 1996), 120 employed managers responded to a questionnaire regarding their work ability and job involvement, and 11 years later (in 2007) when they were retired, they responded to an open-ended question regarding their personal goals. The retired participants were 58-76 years old (M = 66 years), and they had been retired for 1-10 years (M = 4.3 years, SD = 2.9). On the basis of the participants' responses to the open-ended question, six main content categories of personal goals were formed. According to these categories, the personal goals in retirement focused on (1) hobbies and leisure time, (2) social relationships, (3) health and well-being, (4) housing and finance, (5) self-development and ideology, and (6) other activities. The managers with better work ability and job involvement at the baseline of the study had fewer personal goals related to health and well-being later in retirement. In addition, better work ability predicted more personal goals related to self-development and ideology views. The preceding work ability and job involvement seem to channel personal goal pursuit in retirement. Thus, sustaining employees' work ability and job involvement are not only essential for developing employees' ability to cope with work demands but also for their functional capacity in their later stages of life, such as in retirement.

  10. Reforming Graduate Education.

    ERIC Educational Resources Information Center

    Webster, Zodiac

    1997-01-01

    Discusses the problem with the career track in graduate study in astronomy. Reports that the number of postdoctoral positions has doubled in the last ten years and far exceeds the number of tenure-track openings in astronomy departments. (DDR)

  11. [Evaluation of the clinical results of non-surgical treatment for pediatric sagittal fracture of mandibular condyle].

    PubMed

    Liu, Chang-kui; Tan, Xin-ying; Xu, Juan; Liu, Hua-wei; Liu, San-xia; Hu, Min

    2013-11-01

    To investigate the clinical results of occlusal splint in the treatment of sagittal fracture of mandibular condyle (SFMC) in children. Thirty-nine patients (48 condyles)aged 3-8 years with sagittal fracture of mandibular condyle were included in this study. All the patients were treated by occlusal splint.Slight open occlusion was maintained by occlusal splint for 3-6 months. Clinical and radiological examination was performed six mouths and every year after treatment. Good mandibular function was observed in 39 patients. Maximal mouth opening over 35 mm was achieved at 6 months. But 11 of the 39 patients presented with deviation on mouth opening at 6 months. The radiology showed an complete remodeling in 32 condyles (28 patients) and partial remodeling in 16 condyles (11 patients). Poor remodelling was not observed in any patients. Good clinical results can be obtained by using occlusal splint in the treatment of pediatric sagittal fracture of mandibular condyle.

  12. Predicting Adult Occupational Environments from Gender and Childhood Personality Traits

    PubMed Central

    Woods, Stephen A.; Hampson, Sarah E.

    2010-01-01

    To test aspects of a theory of the role of personality and gender on the development of vocational interests, and their subsequent effects on adult occupational choices, this study examined associations between childhood personality traits, gender, and occupational environments over 40 years later. Participants (N = 587) were assessed on the Big Five by their teachers when aged 6–12 years. In middle-age (late 40’s) they reported their occupation. Holland’s RIASEC vocational types (Realistic, Investigative, Artistic, Social, Enterprising, Conventional) were used to characterize the job environments of reported occupations. Childhood Openness/Intellect and Conscientiousness, but no other Big Five traits, were associated with occupational environments. For the most strongly sex-typed work environments, associations with Openness/Intellect were moderated by gender. Discussion of these findings suggested that the roots of the strongest gender stereotyping effects in occupations may be found not only in the social factors associated with gender, but also in the individual differences of children related to Openness/Intellect. PMID:20822206

  13. Maximum mouth opening and trismus in 143 patients treated for oral cancer: a 1-year prospective study.

    PubMed

    Wetzels, Jan-Willem G H; Merkx, Matthias A W; de Haan, Anton F J; Koole, Ron; Speksnijder, Caroline M

    2014-12-01

    Patients with oral cancer can develop restricted mouth opening (trismus) because of the oncologic treatment. Maximum mouth opening (MMO) was measured in 143 patients shortly before treatment and 0, 6, and 12 months posttreatment, and the results were analyzed using a linear mixed-effects model. In every patient, MMO decreased after treatment. The patients who underwent surgery, recovered partially by 6 and 12 months after treatment, whereas the patients who received both surgery and radiotherapy or primary radiotherapy did not recover. Tumor location, tumor size, and alcohol consumption had independent effects on MMO. Having trismus (MMO <35 mm) 1 year after treatment was associated most strongly with pretreatment MMO, receiving both surgery and radiotherapy, and maxillary or mandibular tumor involvement. Postoperative radiotherapy and maxillary or mandibular tumor involvement are the highest contributing risk factors to decreasing MMO and the subsequent development of trismus after oral cancer treatment. © 2014 Wiley Periodicals, Inc.

  14. Postoperative stiff shoulder after open rotator cuff repair: a 3- to 20-year follow-up study.

    PubMed

    Vastamäki, H; Vastamäki, M

    2014-12-01

    Stiffness after a rotator cuff tear is common. So is stiffness after an arthroscopic rotator cuff repair. In the literature, however, postoperative restriction of passive range of motion after open rotator cuff repair in shoulders with free passive range of motion at surgery has seldom been recognized. We hypothesize that this postoperative stiffness is more frequent than recognized and slows the primary postoperative healing after a rotator cuff reconstruction. We wondered how common is postoperative restriction of both active and passive range of motion after open rotator cuff repair in shoulders with free passive preoperative range of motion, how it recovers, and whether this condition influences short- and long-term results of surgery. We also explored factors predicting postoperative shoulder stiffness. We retrospectively identified 103 postoperative stiff shoulders among 416 consecutive open rotator cuff repairs, evaluating incidence and duration of stiffness, short-term clinical results and long-term range of motion, pain relief, shoulder strength, and functional results 3-20 (mean 8.7) years after surgery in 56 patients. The incidence of postoperative shoulder stiffness was 20%. It delayed primary postoperative healing by 3-6 months and resolved during a mean 6.3 months postoperatively. External rotation resolved first, corresponding to that of the controls at 3 months; flexion and abduction took less than 1 year after surgery. The mean summarized range of motion (flexion + abduction + external rotation) increased as high as 93% of the controls' range of motion by 6 months and 100% by 1 year. Flexion, abduction, and internal rotation improved to the level of the contralateral shoulders as did pain, strength, and function. Age at surgery and condition of the biceps tendon were related to postoperative stiffness. Postoperative stiff shoulder after open rotator cuff repair is a common complication resolving in 6-12 months with good long-term results. © The Finnish Surgical Society 2013.

  15. Higher surgeon annual volume, but not years of experience, is associated with reduced rates of postoperative complications and reoperations after open abdominal aortic aneurysm repair.

    PubMed

    Dubois, Luc; Allen, Britney; Bray-Jenkyn, Krista; Power, Adam H; DeRose, Guy; Forbes, Thomas L; Duncan, Audra; Shariff, Salimah Z

    2018-06-01

    Volume-outcome relationships for open abdominal aortic aneurysm (AAA) repair have received less attention in publicly funded health systems. Furthermore, the roles of surgeon seniority (years of experience) and composite volume (encompassing all major arterial cases) on outcomes after open AAA repair are less well known. We sought to determine the effects of surgeon volume, surgeon years of experience, and composite volume on outcomes after elective open AAA repairs performed in Ontario, Canada. Using a population-based, prospectively collected health administrative database, all elective open AAA repairs occurring in the province of Ontario from 2005 to 2014 were identified. Surgeon annual volume was classified by quintiles, with the highest volume quintile acting as the reference category. Multivariable logistic regression modeling was used, adjusting for patient factors (age, sex, comorbidities, year of procedure, income) to investigate the relationship between surgeon annual volume and 30-day mortality, 30-day major complications, 30-day reoperations, 1-year mortality, and 1-year reoperations (related to index procedure). The potential effects of annual surgeon composite volume and surgeon years of experience on postoperative outcomes were also explored. A total of 7211 elective open AAA repairs performed by 101 surgeons were identified between 2005 and 2014. Most of the operations were performed by vascular surgeons (81.5%), followed by cardiac (12.1%) and general surgeons (6.1%). Median number of procedures in the lowest quintile group was 3 repairs/y, whereas the highest quintile group performed 54 repairs/y. Overall 30-day mortality was 3%. No difference in mortality was detected in comparing the lowest with the highest volume groups (1.89% vs 3.01%; adjusted odds ratio [OR], 0.60; 95% confidence interval [CI], 0.27-1.33). The lowest volume group exhibited a higher 30-day complication rate (28.0% vs 20.4%; OR, 1.54; 95% CI, 1.15-2.06) and 30-day reoperation rate (10.53% vs 6.73%; OR, 1.64; 95% CI, 1.13-2.38) compared with the highest volume group. No effect of surgeon volume on 1-year mortality or 1-year reoperation was observed. Similarly, composite volume and surgeon years of experience were not associated with postoperative outcomes. In a single-payer system with a relatively high number of open AAA repairs/surgeon per year, surgeon annual volume had no effect on postoperative mortality but was associated with lower postoperative complication and reoperation rates. Copyright © 2017 Society for Vascular Surgery. Published by Elsevier Inc. All rights reserved.

  16. Mobile service for open data visualization on geo-based images

    NASA Astrophysics Data System (ADS)

    Lee, Kiwon; Kim, Kwangseob; Kang, Sanggoo

    2015-12-01

    Since the early 2010s, governments in most countries have adopted and promoted open data policy and open data platform. Korea are in the same situation, and government and public organizations have operated the public-accessible open data portal systems since 2011. The number of open data and data type have been increasing every year. These trends are more expandable or extensible on mobile environments. The purpose of this study is to design and implement a mobile application service to visualize various typed or formatted public open data with geo-based images on the mobile web. Open data cover downloadable data sets or open-accessible data application programming interface API. Geo-based images mean multi-sensor satellite imageries which are referred in geo-coordinates and matched with digital map sets. System components for mobile service are fully based on open sources and open development environments without any commercialized tools: PostgreSQL for database management system, OTB for remote sensing image processing, GDAL for data conversion, GeoServer for application server, OpenLayers for mobile web mapping, R for data analysis and D3.js for web-based data graphic processing. Mobile application in client side was implemented by using HTML5 for cross browser and cross platform. The result shows many advantageous points such as linking open data and geo-based data, integrating open data and open source, and demonstrating mobile applications with open data. It is expected that this approach is cost effective and process efficient implementation strategy for intelligent earth observing data.

  17. Open cholecystectomy in the laparoscopic era.

    PubMed

    Jenkins, P J; Paterson, H M; Parks, R W; Garden, O J

    2007-11-01

    As techniques in laparoscopic cholecystectomy have improved, surgeon experience of open cholecystectomy may be limited. This study examined the current indications for and techniques used in primary open cholecystectomy. Some 3100 consecutive patients undergoing elective or emergency cholecystectomy over a 5-year interval were identified from a prospective surgical audit database. Demographic, diagnostic and procedural data were examined. There were 123 (4.0 per cent) primary and 219 (7.4 per cent) converted open cholecystectomies. Some 48.0 and 45.6 per cent of patients in the primary open cholecystectomy and converted groups respectively were men, compared with 24.0 per cent of 2758 who had a successful laparoscopic procedure. Primary open cholecystectomy was employed principally for previous upper abdominal open surgery (22.7 per cent) and emergency operation for general peritonitis (19.5 per cent). The fundus-first approach was employed in 53.7 per cent of primary open procedures and 53.0 per cent of conversions, with subtotal excision in 4.9 and 13.2 per cent respectively. Primary open cholecystectomy remains a common procedure in the treatment of gallbladder disease despite the success of laparoscopic cholecystectomy. Successful outcome in difficult cases requires familiarity with specific techniques, exposure to which may be limited in current training programmes. Copyright (c) 2007 British Journal of Surgery Society Ltd.

  18. 4onse: four times open & non-conventional technology for sensing the environment

    NASA Astrophysics Data System (ADS)

    Cannata, Massimiliano; Ratnayake, Rangageewa; Antonovic, Milan; Strigaro, Daniele; Cardoso, Mirko; Hoffmann, Marcus

    2017-04-01

    The availability of complete, quality and dense monitoring hydro-meteorological data is essential to address a number of practical issues including, but not limited to, flood-water and urban drainage management, climate change impact assessment, early warning and risk management, now-casting and weather predictions. Thanks to the recent technological advances such as Internet Of Things, Big Data and Ubiquitous Internet, non-conventional monitoring systems based on open technologies and low cost sensors may represent a great opportunity either as a complement of authoritative monitoring network or as a vital source of information wherever existing monitoring networks are in decline or completely missing. Nevertheless, scientific literature on such a kind of open and non-conventional monitoring systems is still limited and often relates to prototype engineering and testing in rather limited case studies. For this reason the 4onse project aims at integrating existing open technologies in the field of Free & Open Source Software, Open Hardware, Open Data, and Open Standards and evaluate this kind of system in a real case (about 30 stations) for a medium period of 2 years to better scientifically understand strengths, criticalities and applicabilities in terms of data quality; system durability; management costs; performances; sustainability. The ultimate objective is to contribute in non-conventional monitoring systems adoption based on four open technologies.

  19. Transition of patients from blinded study drug to open-label anticoagulation: the ENGAGE AF-TIMI 48 trial.

    PubMed

    Ruff, Christian T; Giugliano, Robert P; Braunwald, Eugene; Mercuri, Michele; Curt, Valentin; Betcher, Joshua; Grip, Laura; Cange, Abby L; Crompton, Andrea E; Murphy, Sabina A; Deenadayalu, Naveen; Antman, Elliott M

    2014-08-12

    At the end of 2 previous trials, an excess of stroke and bleeding was observed in patients with AF randomized to a new oral anticoagulant (NOAC) who transitioned to a vitamin K antagonist (VKA). The ENGAGE AF-TIMI 48 (Effective Anticoagulation with Factor Xa Next Generation in Atrial Fibrillation-Thrombolysis in Myocardial Infarction 48) trial compared once-daily edoxaban to warfarin for stroke prevention in patients with AF. An end-of-trial transition plan was developed to minimize the risks of stroke due to inadequate anticoagulation and bleeding from excessive anticoagulation during this critical period. All patients on the blinded study drug at the trial's conclusion were included in this analysis. In pre-specified analyses, stroke, bleeding, and death that occurred through 30 days after the end-of-trial visit were stratified by randomized treatment allocation and open-label anticoagulant selected post-trial. Of the 13,642 patients taking the blinded study drug at the end of the trial, 9,304 (68.2%) were transitioned to open-label VKA and 4,258 patients (31.2%) to an NOAC. There were 21 strokes evenly distributed across the 3 randomized treatment arms: warfarin 7 (1.90%/year), edoxaban high dose 7 (1.89%/year), edoxaban low dose 7 (1.85%/year). Major bleeding was also similar across the 3 treatment arms: warfarin 11 (2.98%/year), edoxaban high dose 10 (2.69%/year), edoxaban low dose 18 (4.76%/year). In patients transitioned to VKA, 85% of patients had at least 1 INR ≥ 2 by day 14 after the transition and 99% by day 30. The ENGAGE AF-TIMI 48 transition plan protected patients from an excess of thrombotic and bleeding events and should be helpful in clinical practice when patients are transitioned between oral anticoagulants. (Global Study to Assess the Safety and Effectiveness of Edoxaban [DU-176b] vs Standard Practice of Dosing With Warfarin in Patients With Atrial Fibrillation [EngageAFTIMI48]; NCT00781391). Copyright © 2014 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

  20. Outcomes after peritoneal dialysis catheter placement.

    PubMed

    Carpenter, Jennifer L; Fallon, Sara C; Swartz, Sarah J; Minifee, Paul K; Cass, Darrell L; Nuchtern, Jed G; Pimpalwar, Ashwin P; Brandt, Mary L

    2016-05-01

    The purpose of this study was to review surgical outcomes after elective placement of peritoneal dialysis (PD) catheters in children with end-stage renal disease. Children with PD catheters placed between February 2002 and July 2014 were retrospectively reviewed. Outcomes were catheter life, late (>30days post-op) complications (catheter malfunction, catheter malposition, infection), and re-operation rates. Comparison groups included laparoscopic versus open placement, age<2, and weight<10kg. Univariate and multivariate analysis were performed. One hundred sixteen patients had 173 catheters placed (122 open, 51 laparoscopic) with an average patient age of 9.7±6.3years. Mean catheter life was similar in the laparoscopic and open groups (581±539days versus 574±487days, p=0.938). The late complication rate was higher for open procedures (57% versus 37%, p=0.013). Children age<2 or weight<10kg had higher re-operation rates (64% versus 42%, p=0.014 and 73% versus 40%, p=0.001, respectively). Adjusted for age and weight, open technique remained a risk factor for late complications (OR 2.44, 95% CI 1.20-4.95) but not re-operation. Laparoscopic placement appears to reduce the rate of late complications in children who require PD dialysis catheters. Children <2years age or <10kg remain at risk for complications regardless of technique. Copyright © 2016 Elsevier Inc. All rights reserved.

  1. The return of "Gasoline station-park" status into green-open space in DKI Jakarta Province

    NASA Astrophysics Data System (ADS)

    Kautsar, L. H. R.; Waryono, T.; Sobirin

    2017-07-01

    The development of gasoline stations in 1970 increased drastically due to the Government support through DKT Jaya Official Note (DKT Jakarta), resulting in a great number of the parks (green open space or RTH - Ruang Terbuka Hijau) converted into a gasoline station. Currently, to meet the RTH target (13.94 % RTH based RTRW [(Rencana Tata Ruang Wilayah) DKT Jakarta 2010], the policy was changed by Decree No.728 year 2009 and Governor Tnstruction No.75 year 2009. Land function of 27 gasoline stations unit must be returned. This study is to determine the appropriateness of gasoline Station-Park conversion into RTH based site and situation approach. The scope of this study was limited only to gasoline stations not converted into RTH. The methodology was the combination of AHP (Analytical Hierarchy Process) and ranking method. Site variables were meant for prone to flooding, the width of land for gasoline station, land status. Situation variables were meant for other public space, availability of other gasoline stations, gasoline stations service, road segments, and the proportions of built space. Analysis study used quantitative descriptive analysis. The results were three of the five gasoline stations were congruence to be converted into a green open space (RTH).

  2. The spatial-temporal dynamics of open surface water bodies in CONUS during 1984-2016

    NASA Astrophysics Data System (ADS)

    Zou, Z.; Xiao, X.; Dong, J.; Qin, Y.; Doughty, R.; Menarguez, M.; Wang, J.

    2017-12-01

    Open surface water bodies provided 80% of the total water withdrawals in the Contiguous United States (CONUS) in 1985-2010. The inter-annual variability and changing trends of surface water body areas have various impacts on the human society and ecosystems. This study made use of all Landsat 5, 7, and 8 surface reflectance archives ( 370,000 images) during 1984-2016 and a water index- and pixel-based approach to detect and map open surface water bodies in the cloud-based platform of Google Earth Engine. The year-long water body area and annual average water body area were calculated for each of the last 33 years and their inter-annual variations during 1984-2016 were analyzed through anomaly analysis while their changing trends were analyzed through linear regressions. The national annual average water body areas varied from 265,000 to 281,000 km2 during 1984-2016, which is 3% below to 3% above the mean value 274,000 km2. In state level, significant decreasing trends were found in both year-long and annual average water body areas in some states of dry climates in west and southwest U.S., including Oregon, Nevada, Utah, Arizona, New Mexico, and Oklahoma. In comparison, significant increasing trends were found in some states of wet climates in the southeast and north U.S., including Indiana, Ohio, New Jersey, Delaware, Virginia, Tennessee, North Carolina, South Carolina, Louisiana, Alabama, Georgia, North Dakota and South Dakota. Open surface water body areas in CONUS decreased in relatively dry areas but increased in relatively wet areas. The relationships between open surface water body area variability and climate factors (precipitation, temperature) and human impacts (water exploitation) were also analyzed.

  3. IGF-1 in autosomal dominant cerebellar ataxia - open-label trial.

    PubMed

    Sanz-Gallego, Irene; Rodriguez-de-Rivera, Francisco J; Pulido, Irene; Torres-Aleman, Ignacio; Arpa, Javier

    2014-01-01

    The objective of this clinical open-label trial was to test the safety, tolerability and efficacy of IGF-1 therapy for autosomal dominant cerebellar ataxia (ADCA) patients. A total of 19 molecularly confirmed patients with SCA3, 1 patient with SCA6 and 6 patients with SCA7 completed our study. They were 8 females and 18 males, 28 to 74 years of age (average ± SD: 49.3 ± 14.1). Patients were treated with IGF-1 therapy with a dosage of 50 μg/kg twice a day for 12 months. The efficacy of this therapy was assessed by change from baseline on the scale for the assessment and rating of ataxia (SARA). Ten patients, consecutively selected, continued their assigned dosages in a second year open-label extension trial. A statistically significant improvement in SARA scores was observed for patients with SCA3, patients with SCA7 and all patients grouped together after the first year of IGF-1 therapy, while a stabilization of the disease was confirmed during the second year (extension study). The single patient with SCA6 showed 3 improvement points in SARA score after 3 four-month periods of IGF-1 therapy when compared with baseline measurements. Our data indicate that IGF-1 is safe and well tolerated in general. Our data, in comparison with results from previous cohorts, indicate a trend for IGF-1 treatment to stabilize the disease progression for patients with SCA, indicating that IGF-1 therapy is able to decrease the progressivity of ADCA.

  4. Impact of the proposed I-326 crossing on the 500-year flood stages of the Congaree River near Columbia, South Carolina

    USGS Publications Warehouse

    Bennett, C.S.

    1984-01-01

    A two-dimensional finite-element surface water flow modeling system based on the shallow water equations was used to study the hydraulic impact of the proposed Interstate crossing on the 500-year flood. Infrared aerial photography was used to define regions of homogeneous roughness in the flood plain. Finite-element networks approximating flood plain topography were designed using elements of three roughness types. High water marks established during an 8-year flood that occurred in October 1976 were used to calibrate the model. The 500-year flood (630,000 cu ft/sec) was simulated using the dike on the left bank as the left boundary and the right edge of the flood plain as the right boundary. Simulations were performed without and with the proposed highway embankments in place. Detailed information was obtained about backwater effects upstream from the proposed highway embankments, changes in flow distribution resulting from embankments, and velocities in the vicinity of the bridge openings. The results of the study indicate that the four bridge openings in the right flood plain should be adequate to handle the 500-yr flood flow. Forty percent of the flow passes through the main channel bridge, while the remaining 60% of the flow passes through the three overflow bridges. Average velocities in the bridge openings ranged from 3.4 ft/sec to 6.9 ft/sec with a maximum vertically averaged velocity of 9.3 ft/sec occurring at the right edge of one of the overflow bridges. (Author 's abstract)

  5. Open wounds of the Achilles tendon in tropical settings: 36 cases at the Donka University Hospital in Guinea Conakry.

    PubMed

    Lamah, L; Diallo, M; Tékpa, J B D; Bah, M L; Keita, K; Sidime, S; Soumah, M T; Diallo, I

    2017-06-01

    The aim of this study was to analyze the epidemiologic, etiologic, and therapeutic aspects of open wounds of the Achilles tendon managed in the Donka University Hospital. This 3-year prospective included all patients admitted for an Achilles tendon injury. Closed injuries, suppurating wounds, and those that occurred more than 24 hours before admission were excluded. Surgical treatment consisted in debridement and tendon repair, with plaster cast protection for 6 weeks. The study included 36 patients with a mean age of 23.4 years, 29 of whom were male. The primary cause was traffic accidents (n = 21), mainly due to motorcycle taxis (n = 18). The mean follow-up was 9 months. Infection (7 cases) and skin necrosis (5 cases) were the main postoperative complications. The functional result, evaluated by the McComis score, was excellent in 20 cases, good or satisfactory in 10, and poor in 6 cases. Open injuries of the Achilles tendon are common in Guinea-Conakry and mostly due to motorcycle taxis. Outcome of surgical treatment depends on the severity of the injury. Infection and skin necrosis are frequent complications, and their management is challenging in this setting.

  6. [TAVI in 2018 : new indications and open questions].

    PubMed

    Fournier, Stephane; Roguelov, Christan; Monney, Pierre; Kirsch, Mathias; Eeckhout, Eric; Antiochos, Panagiotis; Lamsidri, Sabine; Muller, Olivier

    2018-05-23

    The last years, various large randomized studies have demonstrated the benefit of TAVI (transcatheter aortic valve implantation) over medical therapy or over conventional surgical treatment in inoperable or very high risk patients with symptomatic severe aortic stenosis. More recently, new data has also shown that among patients at intermediate risk, TAVI is at least as beneficial as surgical valve replacement. In this article, we will focus on the new recommendations of the European society of cardiology but also on issues that remain open.

  7. Overnight closed-loop insulin delivery with model predictive control: assessment of hypoglycemia and hyperglycemia risk using simulation studies.

    PubMed

    Wilinska, Malgorzata E; Budiman, Erwin S; Taub, Marc B; Elleri, Daniela; Allen, Janet M; Acerini, Carlo L; Dunger, David B; Hovorka, Roman

    2009-09-01

    Hypoglycemia and hyperglycemia during closed-loop insulin delivery based on subcutaneous (SC) glucose sensing may arise due to (1) overdosing and underdosing of insulin by control algorithm and (2) difference between plasma glucose (PG) and sensor glucose, which may be transient (kinetics origin and sensor artifacts) or persistent (calibration error [CE]). Using in silico testing, we assessed hypoglycemia and hyperglycemia incidence during over-night closed loop. Additionally, a comparison was made against incidence observed experimentally during open-loop single-night in-clinic studies in young people with type 1 diabetes mellitus (T1DM) treated by continuous SC insulin infusion. Simulation environment comprising 18 virtual subjects with T1DM was used to simulate overnight closed-loop study with a model predictive control (MPC) algorithm. A 15 h experiment started at 17:00 and ended at 08:00 the next day. Closed loop commenced at 21:00 and continued for 11 h. At 18:00, protocol included meal (50 g carbohydrates) accompanied by prandial insulin. The MPC algorithm advised on insulin infusion every 15 min. Sensor glucose was obtained by combining model-calculated noise-free interstitial glucose with experimentally derived transient and persistent sensor artifacts associated with FreeStyle Navigator (FSN). Transient artifacts were obtained from FSN sensor pairs worn by 58 subjects with T1DM over 194 nighttime periods. Persistent difference due to FSN CE was quantified from 585 FSN sensor insertions, yielding 1421 calibration sessions from 248 subjects with diabetes. Episodes of severe (PG < or = 36 mg/dl) and significant (PG < or = 45 mg/dl) hypoglycemia and significant hyperglycemia (PG > or = 300 mg/dl) were extracted from 18,000 simulated closed-loop nights. Severe hypoglycemia was not observed when FSN CE was less than 45%. Hypoglycemia and hyperglycemia incidence during open loop was assessed from 21 overnight studies in 17 young subjects with T1DM (8 males; 13.5 +/- 3.6 years of age; body mass index 21.0 +/- 4.0 kg/m2; duration diabetes 6.4 +/- 4.1 years; hemoglobin A1c 8.5% +/- 1.8%; mean +/- standard deviation) participating in the Artificial Pancreas Project at Cambridge. Severe and significant hypoglycemia during simulated closed loop occurred 0.75 and 17.11 times per 100 person years compared to 1739 and 3479 times per 100 person years during experimental open loop, respectively. Significant hyperglycemia during closed loop and open loop occurred 75 and 15,654 times per 100 person years, respectively. The incidence of severe and significant hypoglycemia reduced 2300- and 200-fold, respectively, during stimulated overnight closed loop with MPC compared to that observed during open-loop overnight clinical studies in young subjects with T1DM. Hyperglycemia was 200 times less likely. Overnight closed loop with the FSN and the MPC algorithm is expected to reduce substantially the risk of hypoglycemia and hyperglycemia. 2009 Diabetes Technology Society.

  8. Open source tools and toolkits for bioinformatics: significance, and where are we?

    PubMed

    Stajich, Jason E; Lapp, Hilmar

    2006-09-01

    This review summarizes important work in open-source bioinformatics software that has occurred over the past couple of years. The survey is intended to illustrate how programs and toolkits whose source code has been developed or released under an Open Source license have changed informatics-heavy areas of life science research. Rather than creating a comprehensive list of all tools developed over the last 2-3 years, we use a few selected projects encompassing toolkit libraries, analysis tools, data analysis environments and interoperability standards to show how freely available and modifiable open-source software can serve as the foundation for building important applications, analysis workflows and resources.

  9. 77 FR 29924 - Drawbridge Operation Regulation; Alabama River, AL

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-05-21

    ... maintained in the closed-to-navigation position, opening only for the passage of marine traffic. The bridge... of openings of the drawbridge, an average of one opening per year, the bridge owner requested a... schedule a bridge opening. Under this proposed rule, the MNBR will also remain in the closed-to-navigation...

  10. Assessments: An Open and Closed Case

    ERIC Educational Resources Information Center

    Khan, R. Nazim

    2015-01-01

    Open book assessment is not a new idea, but it does not seem to have gained ground in higher education. In particular, not much literature is available on open book examinations in mathematics and statistics in higher education. The objective of this paper is to investigate the appropriateness of open book assessments in a first-year business…

  11. Openness arrangements and psychological adjustment in adolescent adoptees.

    PubMed

    Von Korff, Lynn; Grotevant, Harold D; McRoy, Ruth G

    2006-09-01

    This is the 1st national study to examine whether the level of contact between adoptive and birth family members is associated with the behavioral and emotional adjustment of adolescents adopted in infancy (n = 92). Adoptive family members were interviewed twice, 8 years apart, to determine the level of contact taking place throughout adoptees' childhood and adolescence. The Child Behavior Checklist (T. M. Achenbach, 1991a) and Youth Self-Report (T. M. Achenbach, 1991b) were administered in adolescence. Adoptive parents' reports indicate no significant associations between openness and adolescent adjustment. Adoptees experiencing long-term direct contact reported significantly lower levels of externalizing than adoptees without contact. Adoption policies and legal procedures will best serve families by facilitating voluntary openness agreements that accommodate openness decisions on a case-by-case basis. Copyright (c) 2006 APA, all rights reserved.

  12. 2016 Results for Avian Monitoring at the TA-36 Minie Site, TA-39 Point 6, and TA-16 Burn Ground at Los Alamos National Laboratory

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

    Hathcock, Charles Dean; Thompson, Brent E.; Berryhill, Jesse Tobias

    Los Alamos National Security, LLC (LANS) biologists in the Environmental Compliance and Protection Division at Los Alamos National Laboratory (LANL) initiated a multi-year program in 2013 to monitor avifauna at two open detonation sites and one open burn site on LANL property. Monitoring results from these efforts are compared among years and with avifauna monitoring conducted at other areas across LANL. The objectives of this study are to determine whether LANL firing site operations impact bird abundance or diversity. LANS biologists completed the fourth year of this effort in 2016. The overall results from 2016 continue to indicate that operationsmore » are not negatively affecting bird populations. Data suggest that community structure may be changing at some sites and this trend will continue to be monitored.« less

  13. Margaret and Rachel McMillan: Their Influences on Open-Air Nursery Education and Early Years Teacher Education

    ERIC Educational Resources Information Center

    Liebovich, Betty

    2014-01-01

    Rachel and Margaret McMillan created an open-air nursery in Deptford, London that has influenced early years education for 100 years. Their vision for young children living in poverty and deprivation to have access to fresh air through outdoor learning, nutritious meals, and an enriching environment to explore and develop has been embraced and…

  14. 26 CFR 1.874-1 - Allowance of deductions and credits to nonresident alien individuals.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    .... Nonresident alien with effectively connected income. In Year 1, A, a computer programmer, opened an office in... failure to file. In Year 1, A, a computer programmer, opened an office in the United States to market and.... Example 6. Nonresident alien with prior filing history. A began a U.S. trade or business in Year 1 as a...

  15. Treatment and retention of relapsed anterior open-bite with low tongue posture and tongue-tie: A 10-year follow-up

    PubMed Central

    Seo, Yu-Jin; Kim, Su-Jung; Munkhshur, Janchivdorj; Chung, Kyu-Rhim; Ngan, Peter

    2014-01-01

    The purpose of the current report is to present 6-year long-term stability and 10-year follow-up data for an adult patient who was treated with a tongue elevator for relapsed anterior open-bite. The 19-year-old male patient presented with the chief complaint of difficulty in chewing his food. Collectively, clinical and radiographic examinations revealed an anterior open-bite, low tongue posture, and tongue-tie. The patient opted for orthodontic treatment alone, without any surgical procedure. A lingual frenectomy was recommended to avoid the risk of relapse, but the patient declined because he was not experiencing tongue discomfort. Initial treatment of the anterior open-bite with molar intrusion and tongue exercises was successful, but relapse occurred during the retention period. A tongue elevator was used for retreatment, because the approach was minimally invasive and suited the patient's requirements regarding discomfort, cost, and time. The appliance changed the tongue posture and generated an altered tongue force, which ultimately resulted in intrusive dentoalveolar effects, and a subsequent counterclockwise rotation of the mandible. The results showed long-term stability and were maintained for six years through continual use of the tongue elevator. The results of this case indicated that a tongue elevator could be used not only as an alternative treatment for open-bite, but also as an active retainer. PMID:25133135

  16. Health-related quality of life in the first year after laparoscopic radical prostatectomy compared with open radical prostatectomy.

    PubMed

    Hashine, Katsuyoshi; Nakashima, Takeshi; Iio, Hiroyuki; Ueno, Yoshiteru; Shimizu, Shinjiro; Ninomiya, Iku

    2014-07-01

    To assess health-related quality of life in the first year after laparoscopic radical prostatectomy compared with that after open radical prostatectomy. The subjects were 105 consecutive patients with localized prostate cancer treated with laparoscopic radical prostatectomy between January 2011 and June 2012. Health-related quality of life was evaluated using the International Prostate Symptom Score, Medical Outcome Study 8-Items Short Form Health Survey (SF-8) and Expanded Prostate Cancer Index Composite at baseline and 1, 3, 6 and 12 months after surgery. Comparisons were made with data for 107 consecutive patients treated with open radical prostatectomy between October 2005 and July 2007. The International Prostate Symptom Score change was similar in each group. The laparoscopic radical prostatectomy group had a better baseline Medical Outcome Study 8-Items Short Form Health Survey mental component summary score and a better Medical Outcome Study 8-Items Short Form Health Survey physical component summary score at 1 month after surgery. In Expanded Prostate Cancer Index Composite, obstructive/irritative symptoms did not differ between the groups, but urinary incontinence was worse until 12 months after surgery and particularly severe after 1 month in the laparoscopic radical prostatectomy group. The rate of severe urinary incontinence was much higher in the laparoscopic radical prostatectomy group in the early period. Urinary bother was worse in the laparoscopic radical prostatectomy group at 1 and 3 months, but did not differ between the groups thereafter. Urinary function and bother were good after nerve sparing procedures and did not differ between the groups. Bowel and sexual function and bother were similar in the two groups. Urinary function in the first year after laparoscopic radical prostatectomy is worse than that after open radical prostatectomy. © The Author 2014. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  17. Demonstration of an electrochemical liquid cell for operando transmission electron microscopy observation of the lithiation/delithiation behavior of Si nanowire battery anodes.

    PubMed

    Gu, Meng; Parent, Lucas R; Mehdi, B Layla; Unocic, Raymond R; McDowell, Matthew T; Sacci, Robert L; Xu, Wu; Connell, Justin Grant; Xu, Pinghong; Abellan, Patricia; Chen, Xilin; Zhang, Yaohui; Perea, Daniel E; Evans, James E; Lauhon, Lincoln J; Zhang, Ji-Guang; Liu, Jun; Browning, Nigel D; Cui, Yi; Arslan, Ilke; Wang, Chong-Min

    2013-01-01

    Over the past few years, in situ transmission electron microscopy (TEM) studies of lithium ion batteries using an open-cell configuration have helped us to gain fundamental insights into the structural and chemical evolution of the electrode materials in real time. In the standard open-cell configuration, the electrolyte is either solid lithium oxide or an ionic liquid, which is point-contacted with the electrode. This cell design is inherently different from a real battery, where liquid electrolyte forms conformal contact with electrode materials. The knowledge learnt from open cells can deviate significantly from the real battery, calling for operando TEM technique with conformal liquid electrolyte contact. In this paper, we developed an operando TEM electrochemical liquid cell to meet this need, providing the configuration of a real battery and in a relevant liquid electrolyte. To demonstrate this novel technique, we studied the lithiation/delithiation behavior of single Si nanowires. Some of lithiation/delithation behaviors of Si obtained using the liquid cell are consistent with the results from the open-cell studies. However, we also discovered new insights different from the open cell configuration-the dynamics of the electrolyte and, potentially, a future quantitative characterization of the solid electrolyte interphase layer formation and structural and chemical evolution.

  18. Open access publishing, article downloads, and citations: randomised controlled trial

    PubMed Central

    Lewenstein, Bruce V; Simon, Daniel H; Booth, James G; Connolly, Mathew J L

    2008-01-01

    Objective To measure the effect of free access to the scientific literature on article downloads and citations. Design Randomised controlled trial. Setting 11 journals published by the American Physiological Society. Participants 1619 research articles and reviews. Main outcome measures Article readership (measured as downloads of full text, PDFs, and abstracts) and number of unique visitors (internet protocol addresses). Citations to articles were gathered from the Institute for Scientific Information after one year. Interventions Random assignment on online publication of articles published in 11 scientific journals to open access (treatment) or subscription access (control). Results Articles assigned to open access were associated with 89% more full text downloads (95% confidence interval 76% to 103%), 42% more PDF downloads (32% to 52%), and 23% more unique visitors (16% to 30%), but 24% fewer abstract downloads (−29% to −19%) than subscription access articles in the first six months after publication. Open access articles were no more likely to be cited than subscription access articles in the first year after publication. Fifty nine per cent of open access articles (146 of 247) were cited nine to 12 months after publication compared with 63% (859 of 1372) of subscription access articles. Logistic and negative binomial regression analysis of article citation counts confirmed no citation advantage for open access articles. Conclusions Open access publishing may reach more readers than subscription access publishing. No evidence was found of a citation advantage for open access articles in the first year after publication. The citation advantage from open access reported widely in the literature may be an artefact of other causes. PMID:18669565

  19. Assessment of age of majority by measurement of open apices of the third molars using Cameriere's third molar maturity index

    PubMed Central

    Sharma, Preeti; Wadhwan, Vijay; Ravi Prakash, S. M.; Aggarwal, Pooja; Sharma, Neeraj

    2017-01-01

    Aims and Objectives: Evaluation of biological age of a living subject around the legal cutoff age for adulthood has become a grave concern for forensic experts in India, mainly due to the consequences of criminal obligations in judicial proceedings. Thus, this study was planned to examine the open apices of third molars in discriminating between individuals who are aged 18 years or older and who are not 18 years or older and to assign a cutoff for estimation of the age of 18 years. Materials and Methods: Orthopantomographs of 1062 individuals (14 and 23 years) were assessed, to verify Cameriere's third molar maturity index (I3M). The apical ends of the roots of the left mandibular third molar were analyzed. If the apical ends of the roots are completely closed, then I3Mis zero; otherwise, it is calculated as the sum of the distances between the inner sides of the two open apices divided by the tooth length. Results and Conclusion: The sensitivity of the test for 0.08 value was 74.7% for males and 66% for females. Specificity was 83.6% for males and 79.6% for females. The probability that an Indian individual with an I3M<0.08 in 18 years or older is 78% for males and 70.3% for females. I3Mis efficacious to determine age in Indian population. PMID:29263615

  20. Growth and yield responses of field-grown sweetpotato to elevated carbon dioxide

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

    Biswas, P.K.; Hileman, D.R.; Ghosh, P.P.

    1996-09-01

    Root crops are important in developing countries, where food supplies are frequently marginal. Increases in atmospheric CO{sub 2} usually lead to increases in plant growth and yield, but little is known about the response of root crops to CO{sub 2} enrichment under field conditions. This experiment was conducted to investigate the effects of CO{sub 2} enrichment on growth and yield of field-grown sweetpotato. Plants were grown in open-top chambers in the field at four CO{sub 2} levels ranging from 354 (ambient) to 665 {mu}mol mol{sup {minus}1} in two growing seasons. Shoot growth was not affected significantly by elevated CO{sub 2}.more » Yield of storage roots increased 46 and 75% at the highest CO{sub 2} level in the 2 yr. The yield enhancement occurred through increases in the number of storage roots in the second year. Storage-root/shoot ratios increased 44% and leaf nitrogen concentrations decreased by 24% at the highest CO{sub 2} level. A comparison of plants grown in the open field to plants grown in open-top chambers at ambient CO{sub 2} concentrations indicated that open-top chambers reduced shoot growth in the first year and storage-root yield in both years. These results are consistent with the majority of CO{sub 2}-enrichment studies done on pot-grown sweetpotato. 37 refs., 2 figs., 5 tabs.« less

  1. Long-term survival in laparoscopic vs open resection for colorectal liver metastases: inverse probability of treatment weighting using propensity scores.

    PubMed

    Lewin, Joel W; O'Rourke, Nicholas A; Chiow, Adrian K H; Bryant, Richard; Martin, Ian; Nathanson, Leslie K; Cavallucci, David J

    2016-02-01

    This study compares long-term outcomes between intention-to-treat laparoscopic and open approaches to colorectal liver metastases (CLM), using inverse probability of treatment weighting (IPTW) based on propensity scores to control for selection bias. Patients undergoing liver resection for CLM by 5 surgeons at 3 institutions from 2000 to early 2014 were analysed. IPTW based on propensity scores were generated and used to assess the marginal treatment effect of the laparoscopic approach via a weighted Cox proportional hazards model. A total of 298 operations were performed in 256 patients. 7 patients with planned two-stage resections were excluded leaving 284 operations in 249 patients for analysis. After IPTW, the population was well balanced. With a median follow up of 36 months, 5-year overall survival (OS) and recurrence-free survival (RFS) for the cohort were 59% and 38%. 146 laparoscopic procedures were performed in 140 patients, with weighted 5-year OS and RFS of 54% and 36% respectively. In the open group, 138 procedures were performed in 122 patients, with a weighted 5-year OS and RFS of 63% and 38% respectively. There was no significant difference between the two groups in terms of OS or RFS. In the Brisbane experience, after accounting for bias in treatment assignment, long term survival after LLR for CLM is equivalent to outcomes in open surgery. Crown Copyright © 2015. Published by Elsevier Ltd. All rights reserved.

  2. Long-term survival in laparoscopic vs open resection for colorectal liver metastases: inverse probability of treatment weighting using propensity scores

    PubMed Central

    Lewin, Joel W.; O'Rourke, Nicholas A.; Chiow, Adrian K.H.; Bryant, Richard; Martin, Ian; Nathanson, Leslie K.; Cavallucci, David J.

    2015-01-01

    Background This study compares long-term outcomes between intention-to-treat laparoscopic and open approaches to colorectal liver metastases (CLM), using inverse probability of treatment weighting (IPTW) based on propensity scores to control for selection bias. Method Patients undergoing liver resection for CLM by 5 surgeons at 3 institutions from 2000 to early 2014 were analysed. IPTW based on propensity scores were generated and used to assess the marginal treatment effect of the laparoscopic approach via a weighted Cox proportional hazards model. Results A total of 298 operations were performed in 256 patients. 7 patients with planned two-stage resections were excluded leaving 284 operations in 249 patients for analysis. After IPTW, the population was well balanced. With a median follow up of 36 months, 5-year overall survival (OS) and recurrence-free survival (RFS) for the cohort were 59% and 38%. 146 laparoscopic procedures were performed in 140 patients, with weighted 5-year OS and RFS of 54% and 36% respectively. In the open group, 138 procedures were performed in 122 patients, with a weighted 5-year OS and RFS of 63% and 38% respectively. There was no significant difference between the two groups in terms of OS or RFS. Conclusion In the Brisbane experience, after accounting for bias in treatment assignment, long term survival after LLR for CLM is equivalent to outcomes in open surgery. PMID:26902138

  3. Young children's acquisition of knowledge about the Earth: A longitudinal study.

    PubMed

    Hannust, Triin; Kikas, Eve

    2010-10-01

    This longitudinal study examined the acquisition of early knowledge of astronomy to determine whether children's knowledge at any point in time is consistent with a naive "mental model." Children were first assessed by means of open questions and drawing tasks at 2 and 3 years of age (N=143). The knowledge was reassessed over the course of the following 3 years. The results showed that although a few indications of naive mental models were found, in most cases young children's knowledge was fragmented and accurate knowledge was often expressed alongside inaccurate/synthetic ideas. Furthermore, it was shown that children need to know scientific facts before they start taking the global perspective when describing the world and, when faced with ambiguous open questions, children often experience difficulties that can induce them to change the types of answers they provide. Copyright 2010 Elsevier Inc. All rights reserved.

  4. Spatio-Temporal Assessment of Margalla Hills Forest by Using Landsat Imagery for Year 2000 and 2018

    NASA Astrophysics Data System (ADS)

    Batool, R.; Javaid, K.

    2018-04-01

    Environmental imbalance due to human activities has shown serious threat to ecosystem and produced negative impacts. The main goal of this study is to identify, monitor and classify temporal changes of forest cover, build up and open spaces in Margalla Hills National Park, Islamabad. Geographic Information Sciences (GISc) and Remote Sensing (RS) techniques has been used for the assessment of analysis. LANDSAT-7 Enhanced Thematic Mapper (ETM+) and LANDSAT-8 Operational Land Imager (OLI) were utilized for obtaining data of year 2000 and 2018. Temporal changes were evaluated after applying supervised classification and discrimination was analyzed by Per-Pixel based change detection. Results depicts forest cover decrease from 87 % to 74 % whereas build up has increased from 5 % to 7 % over the span. Consequences also justify the presence of open land in study area that has been increased from 2 % to 7 % respectively.

  5. The Perception of English Literature Students on E-Xamination and Online (Web-Based) Learning

    ERIC Educational Resources Information Center

    Iwuchukwu, Onyeka

    2014-01-01

    The purpose of this study is to investigate the perception of students on the implementation of e-examination and their preparedness for facilitation through a web-based learning platform at the National Open University of Nigeria. Information gathered from the year three and year four students who registered for courses in English Literature in…

  6. Training to Use the Scientific Method in a First-Year Physics Laboratory: A Case Study

    ERIC Educational Resources Information Center

    Sarasola, Ane; Rojas, Jose Félix; Okariz, Ana

    2015-01-01

    In this work, a specific implementation of a so-called experimental or open-ended laboratory is proposed and evaluated. Keeping in mind the scheduling limitations imposed by the context, first-year engineering physics laboratory practices have been revised in order to facilitate acquisition of the skills that are required in the experimental work.…

  7. Safety and Tolerability of Atomoxetine over 3 to 4 Years in Children with ADHD

    ERIC Educational Resources Information Center

    Donnelly, Craig; Bangs, Mark; Trzepacz, Paula; Jin, Ling; Zhang, Shuyu; Witte, Michael M.; Ball, Susan G.; Spencer, Thomas J.

    2009-01-01

    Data from 13 double-blind, placebo-controlled trials and three open-label extension studies were pooled to examine the safety of atomoxetine for treating attention deficit hyperactivity disorder in children and adolescents for less than or equal to three or four years. Results show that atomoxetine is safe and well tolerated in the subjects.

  8. The Employment Impact of the Des Moines Occupational Upgrading Project and Model Cities High School Equivalency Project: Project Year One Evaluation.

    ERIC Educational Resources Information Center

    Palomba, Neil A.; And Others

    This study was conducted to: (1) evaluate the Occupational Upgrading Project (OUP) and the Model Neighborhood High School Equivalency (HSE) Project's first year of operation, and (2) create baseline data from which future and more conclusive evaluation can be undertaken. Data were gathered by conducting open-ended interviews with the…

  9. Using open-ended data to enrich survey results on the meanings of self-rated health: a study among women in underprivileged communities in Beirut, Lebanon.

    PubMed

    Salem, Mylene Tewtel; Abdulrahim, Sawsan; Zurayk, Huda

    2009-12-01

    This study extends the debate on self-rated health by using different sources of data in the same study to explore the meanings of self-rated health among women who live in socio-economically disadvantaged communities in Beirut, Lebanon. Using data from the Urban Health Study, a cross-sectional household survey of 1,869 women between 15 and 59 years of age, multiple logistic regression models were developed to assess factors associated with self-rated health. Also, open-ended data was used to analyze women's explanations of their self-rated health ratings. Self-rated health was found to be a complex concept, associated not only with physical health but also with a combination of social, psychological, and behavioral factors. This open-ended analysis revealed new meanings of self-rated health that are often not included in self-rated health epidemiologic research, such as women's experiences with pain and fatigue, as well as exposure to financial stressors and the legacy of wars. We argue that triangulating survey and open-ended data provides a better understanding of the context-specific social and cultural meanings of self-rated health.

  10. Students' Experiences of Learning: Orientations to Learning, Perceptions of Gains, and Development as Learners.

    ERIC Educational Resources Information Center

    Morgan, Alistair; And Others

    Students' orientations to learning, their perceptions of gain from their studies at Great Britain's Open University, and their development as learners were studied. Thirty students were followed from their first university course, the Social Science Foundation Course, through their two subsequent years of study, using in-depth interviews to…

  11. Enabling Factors for Sustaining Open Defecation-Free Communities in Rural Indonesia: A Cross-Sectional Study.

    PubMed

    Odagiri, Mitsunori; Muhammad, Zainal; Cronin, Aidan A; Gnilo, Michael E; Mardikanto, Aldy K; Umam, Khaerul; Asamou, Yameha T

    2017-12-14

    Community Approaches to Total Sanitation (CATS) programmes, like the Sanitasi Total Berbasis Masyarakat (STBM) programme of the Government of Indonesia, have played a significant role in reducing open defecation though still little is known about the sustainability of the outcomes. We assessed the sustainability of verified Open Defecation Free (ODF) villages and explored the association between slippage occurrence and the strength of social norms through a government conducted cross-sectional data collection in rural Indonesia. The study surveyed 587 households and held focus group discussions (FGDs) in six ODF villages two years after the government's ODF verification. Overall, the slippage rate (i.e., a combination of sub-optimal use of a latrine and open defecation at respondent level) was estimated to be 14.5% (95% CI 11.6-17.3). Results of multivariate logistic regression analyses indicated that (1) weaker social norms, as measured by respondents' perceptions around latrine ownership coverage in their community, (2) a lack of all-year round water access, and (3) wealth levels (i.e., not being in the richest quintile), were found to be significantly associated with slippage occurrence. These findings, together with qualitative analysis, concluded that CATS programmes, including a combination of demand creation, removal of perceived constraints through community support mechanisms, and continued encouragement to pursue higher levels of services with post-ODF follow-up, could stabilize social norms and help to sustain longer-term latrine usage in study communities. Further investigation and at a larger scale, would be important to strengthen these findings.

  12. Enabling Factors for Sustaining Open Defecation-Free Communities in Rural Indonesia: A Cross-Sectional Study

    PubMed Central

    Odagiri, Mitsunori; Muhammad, Zainal; Cronin, Aidan A.; Gnilo, Michael E.; Mardikanto, Aldy K.; Umam, Khaerul; Asamou, Yameha T.

    2017-01-01

    Community Approaches to Total Sanitation (CATS) programmes, like the Sanitasi Total Berbasis Masyarakat (STBM) programme of the Government of Indonesia, have played a significant role in reducing open defecation though still little is known about the sustainability of the outcomes. We assessed the sustainability of verified Open Defecation Free (ODF) villages and explored the association between slippage occurrence and the strength of social norms through a government conducted cross-sectional data collection in rural Indonesia. The study surveyed 587 households and held focus group discussions (FGDs) in six ODF villages two years after the government’s ODF verification. Overall, the slippage rate (i.e., a combination of sub-optimal use of a latrine and open defecation at respondent level) was estimated to be 14.5% (95% CI 11.6–17.3). Results of multivariate logistic regression analyses indicated that (1) weaker social norms, as measured by respondents’ perceptions around latrine ownership coverage in their community, (2) a lack of all-year round water access, and (3) wealth levels (i.e., not being in the richest quintile), were found to be significantly associated with slippage occurrence. These findings, together with qualitative analysis, concluded that CATS programmes, including a combination of demand creation, removal of perceived constraints through community support mechanisms, and continued encouragement to pursue higher levels of services with post-ODF follow-up, could stabilize social norms and help to sustain longer-term latrine usage in study communities. Further investigation and at a larger scale, would be important to strengthen these findings. PMID:29240667

  13. Open clusters as laboratories: The angular momentum evolution of young stars

    NASA Technical Reports Server (NTRS)

    Stauffer, John R.

    1994-01-01

    This is the annual status report for the third year of our LTSA grant 'Open Clusters as Laboratories.' Because we have now had a few years to work on the project, we have started to produce and publish a large number of papers. We have been extremely successful in obtaining ROSAT observations of open clusters. With the demise of the PSPC on ROSAT, our main data source has come to an end and we will be able to concentrate on analyzing those data.

  14. Effect of zolpidem in chronic disorders of consciousness: a prospective open-label study

    PubMed Central

    Thonnard, Marie; Gosseries, Olivia; Demertzi, Athena; Lugo, Zulay; Vanhaudenhuyse, Audrey; Bruno, Marie-Aurélie; Chatelle, Camille; Thibaut, Aurore; Charland-Verville, Vanessa; Habbal, Dina; Schnakers, Caroline; Laureys, Steven

    2013-01-01

    Summary Zolpidem has been reported as an “awakening drug” in some patients with disorders of consciousness (DOC). We here present the results of a prospective open-label study in chronic DOC patients. Sixty patients (35±15 years; 18 females; mean time since insult ± SD: 4±5.5 years; 31 with traumatic etiology) with a diagnosis of vegetative state/unresponsive wakefulness syndrome (n=28) or minimally conscious state (n=32) were behaviorally assessed using the Coma Recovery Scale-Revised (CRS-R) before and one hour after administration of 10 mg of zolpidem. At the group level, the diagnosis did not change after intake of zolpidem (p=0.10) and CRS-R total scores decreased (p=0.01). Twelve patients (20%) showed improved behaviors and/or CRS-R total scores after zolpidem administration but in only one patient was the diagnosis after zolpidem intake found to show a significant improvement (functional object use), which suggested a change of diagnosis. However, in this patient, a double-blind placebo-controlled trial was performed in order to better specify the effects of zolpidem, but the patient, on this trial, failed to show any clinical improvements. The present open-label study therefore failed to show any clinically significant improvement (i.e., change of diagnosis) in any of the 60 studied chronic DOC patients. PMID:24598393

  15. Spectral power and functional connectivity changes during mindfulness meditation with eyes open: A magnetoencephalography (MEG) study in long-term meditators.

    PubMed

    Wong, W P; Camfield, D A; Woods, W; Sarris, J; Pipingas, A

    2015-10-01

    Whilst a number of previous studies have been conducted in order to investigate functional brain changes associated with eyes-closed meditation techniques, there is a relative scarcity in the literature with regards to changes occurring during eyes-open meditation. The current project used magnetoencephalography (MEG) to investigate differences in spectral power and functional connectivity between 11 long-term mindfulness meditators (LTMMs) with >5 years of experience and 12 meditation-naïve control participants both during baseline eyes-open rest and eyes-open open-monitoring (OM) mindfulness meditation. During resting with eyes-open, prior to meditating, greater mean alpha power was observed for LTMMs in comparison to controls. However, during the course of OM meditation, a significantly greater increase in theta power was observed over a broad fronto-centro-parietal region for control participants in comparison to LTMMs. In contrast, whole-head mean connectivity was found to be significantly greater for long-term meditators in comparison to controls in the theta band both during rest as well as during meditation. Additionally, mean connectivity was significantly lower for long-term meditators in the low gamma band during rest and significantly lower in both low and high gamma bands during meditation; and the variance of low-gamma connectivity scores for long-term meditators was significantly decreased compared to the control group. The current study provides important new information as to the trait functional changes in brain activity associated with long-term mindfulness meditation, as well as the state changes specifically associated with eyes-open open monitoring meditation techniques. Copyright © 2015 Elsevier B.V. All rights reserved.

  16. Short- and long-term outcomes of laparoscopic surgery vs open surgery for transverse colon cancer: a retrospective multicenter study

    PubMed Central

    Kim, Jong Wan; Kim, Jeong Yeon; Kang, Byung Mo; Lee, Bong Hwa; Kim, Byung Chun; Park, Jun Ho

    2016-01-01

    Purpose The purpose of the present study was to compare the perioperative and oncologic outcomes between laparoscopic surgery and open surgery for transverse colon cancer. Patients and methods We conducted a retrospective review of patients who underwent surgery for transverse colon cancer at six Hallym University-affiliated hospitals between January 2005 and June 2015. The perioperative outcomes and oncologic outcomes were compared between laparoscopic and open surgery. Results Of 226 patients with transverse colon cancer, 103 underwent laparoscopic surgery and 123 underwent open surgery. There were no differences in the patient characteristics between the two groups. Regarding perioperative outcomes, the operation time was significantly longer in the laparoscopic group than in the open group (267.3 vs 172.7 minutes, P<0.001), but the time to soft food intake (6.0 vs 6.6 days, P=0.036) and the postoperative hospital stay (13.7 vs 15.7 days, P=0.018) were shorter in the laparoscopic group. The number of harvested lymph nodes was lower in the laparoscopic group than in the open group (20.3 vs 24.3, P<0.001). The 5-year overall survival (90.8% vs 88.6%, P=0.540) and disease-free survival (86.1% vs 78.9%, P=0.201) rates were similar in both groups. Conclusion The present study showed that laparoscopic surgery is associated with several perioperative benefits and similar oncologic outcomes to open surgery for the resection of transverse colon cancer. Therefore, laparoscopic surgery offers a safe alternative to open surgery in patients with transverse colon cancer. PMID:27143915

  17. Open intensive care units: a global challenge for patients, relatives, and critical care teams.

    PubMed

    Cappellini, Elena; Bambi, Stefano; Lucchini, Alberto; Milanesio, Erika

    2014-01-01

    The aims of this study were to describe the current status of intensive care unit (ICU) visiting hours policies internationally and to explore the influence of ICUs' open visiting policies on patients', visitors', and staff perceptions, as well as on patients' outcomes. A review of the literature was done through MEDLINE, EMBASE, and Cumulative Index to Nursing and Allied Health Literature (CINAHL) databases. The following keywords were searched: "visiting," "hours," "ICU," "policy," and "intensive care unit." Inclusion criteria for the review were original research paper, adult ICU, articles published in the last 10 years, English or Italian language, and available abstract. Twenty-nine original articles, mainly descriptive studies, were selected and retrieved. In international literature, there is a wide variability about open visiting policies in ICUs. The highest percentage of open ICUs is reported in Sweden (70%), whereas in Italy there is the lowest rate (1%). Visiting hours policies and number of allowed relatives are variable, from limits of short precise segments to 24 hours and usually 2 visitors. Open ICUs policy/guidelines acknowledge concerns with visitor hand washing to prevent the risk of infection transmission to patients. Patients, visitors, and staff seem to be inclined to support open ICU programs, although physicians are more inclined to the enhancement of visiting hours than nurses. The percentages of open ICUs are very different among countries. It can be due to local factors, cultural differences, and lack of legislation or hospital policy. There is a need for more studies about the impact of open ICUs programs on patients' mortality, length of stay, infections' risk, and the mental health of patients and their relatives.

  18. Laparoscopic surgery for colorectal cancer is safe and has survival outcomes similar to those of open surgery in elderly patients with a poor performance status: subanalysis of a large multicenter case-control study in Japan.

    PubMed

    Niitsu, Hiroaki; Hinoi, Takao; Kawaguchi, Yasuo; Ohdan, Hideki; Hasegawa, Hirotoshi; Suzuka, Ichio; Fukunaga, Yosuke; Yamaguchi, Takashi; Endo, Shungo; Tagami, Soichi; Idani, Hitoshi; Ichihara, Takao; Watanabe, Kazuteru; Watanabe, Masahiko

    2016-01-01

    It remains controversial whether open or laparoscopic surgery should be indicated for elderly patients with colorectal cancer and a poor performance status. In those patients aged 80 years or older with Eastern Cooperative Oncology Group performance status score of 2 or greater who received elective surgery for stage 0 to stage III colorectal adenocarcinoma and had no concomitant malignancies and who were enrolled in a multicenter case-control study entitled "Retrospective study of laparoscopic colorectal surgery for elderly patients" that was conducted in Japan between 2003 and 2007, background characteristics and short-term and long-term outcomes for open surgery and laparoscopic surgery were compared. Of the 398 patients included, 295 underwent open surgery and 103 underwent laparoscopic surgery. There were no significant differences in the baseline characteristics between open surgery and laparoscopic surgery patients, except for previous abdominal surgery and TNM stage. The median operation duration was shorter with open surgery (open surgery, 153 min; laparoscopic surgery, 202 min; P < 0.001), and less blood loss occurred with laparoscopic surgery (median open surgery, 109 g; median laparoscopic surgery, 30 g; P < 0.001). An operation duration of 180 min or more (odds ratio, 1.97; 95 % confidence interval, 1.17-3.37; P = 0.011) and selection of laparoscopic surgery (odds ratio, 0.41; 95 % confidence interval, 0.22-0.75; P = 0.003) were statistically significant in the multivariate analysis for postoperative morbidity. Moreover, laparoscopic surgery did not result in an inferior overall survival rate compared with open surgery (log-rank test P = 0.289, 0.278, 0.346, 0.199, for all-stage, stage 0-I, stage II, and stage III disease, respectively). Laparoscopic surgery in elderly colorectal cancer patients with a poor performance status is safe and not inferior to open surgery in terms of overall survival.

  19. Toward elucidating the heat activation mechanism of the TRPV1 channel gating by molecular dynamics simulation

    PubMed Central

    Wen, Han; Qin, Feng; Zheng, Wenjun

    2016-01-01

    As a key cellular sensor, the TRPV1 cation channel undergoes a gating transition from a closed state to an open state in response to various physical and chemical stimuli including noxious heat. Despite years of study, the heat activation mechanism of TRPV1 gating remains enigmatic at the molecular level. Toward elucidating the structural and energetic basis of TRPV1 gating, we have performed molecular dynamics (MD) simulations (with cumulative simulation time of 3 μs), starting from the high-resolution closed and open structures of TRPV1 solved by cryo-electron microscopy. In the closed-state simulations at 30°C, we observed a stably closed channel constricted at the lower gate (near residue I679), while the upper gate (near residues G643 and M644) is dynamic and undergoes flickery opening/closing. In the open-state simulations at 60°C, we found higher conformational variation consistent with a large entropy increase required for the heat activation, and both the lower and upper gates are dynamic with transient opening/closing. Through ensemble-based structural analyses of the closed state vs. the open state, we revealed pronounced closed-to-open conformational changes involving the membrane proximal domain (MPD) linker, the outer pore, and the TRP helix, which are accompanied by breaking/forming of a network of closed/open-state specific hydrogen bonds. By comparing the closed-state simulations at 30°C and 60°C, we observed heat-activated conformational changes in the MPD linker, the outer pore, and the TRP helix that resemble the closed-to-open conformational changes, along with partial formation of the open-state specific hydrogen bonds. Some of the residues involved in the above key hydrogen bonds were validated by previous mutational studies. Taken together, our MD simulations have offered rich structural and dynamic details beyond the static structures of TRPV1, and promising targets for future mutagenesis and functional studies of the TRPV1 channel. PMID:27699868

  20. Water Relations, Diurnal Acidity Changes, and Productivity of a Cultivated Cactus, Opuntia ficus-indica.

    PubMed

    Acevedo, E; Badilla, I; Nobel, P S

    1983-07-01

    Physiological responses of the Crassulacean acid metabolism (CAM) plant Opuntia ficus-indica (Cactaceae) were studied on a commercial plantation in central Chile. Young cladodes (flattened stems) and flower buds exhibited daytime stomatal opening, whereas mature cladodes and fruit exhibited the nocturnal stomatal opening characteristic of CAM plants. Severe water stress suppressed the nocturnal stomatal opening by mature cladodes, but their high water vapor conductance occurring near dawn was not affected. Nocturnal acidity increases were not as sensitive to water stress as was the nocturnal stomatal opening. The magnitude of the nocturnal acidity increases depended on the total daily photosynthetically active radiation (PAR), being 90% PAR-saturated at 27 moles per square meter per day for a mean nighttime air temperature of 5 degrees C and at 20 moles per square meter per day for 18 degrees C. Inasmuch as the PAR received on unshaded vertical surfaces averaged about 21 moles per square meter per day, nocturnal acidity increases by the cladodes were on the verge of being PAR-limited in the field. The net assimilation rate, which was positive throughout the year, annually averaged 3.4 grams per square meter per day for 1.0- and 2.0-year-old plants. Plants that were 5.4 years old had 7.2 square meters of cladode surface area (both sides) and an annual dry weight productivity of 13 megagrams (metric tons) per hectare per year when their ground cover was 32%. This substantial productivity for a CAM plant was accompanied by the highest nocturnal acidity increase so far observed in the field, 0.78 mole H(+) per square meter.

  1. Water Relations, Diurnal Acidity Changes, and Productivity of a Cultivated Cactus, Opuntia ficus-indica1

    PubMed Central

    Acevedo, Edmundo; Badilla, Ignacio; Nobel, Park S.

    1983-01-01

    Physiological responses of the Crassulacean acid metabolism (CAM) plant Opuntia ficus-indica (Cactaceae) were studied on a commercial plantation in central Chile. Young cladodes (flattened stems) and flower buds exhibited daytime stomatal opening, whereas mature cladodes and fruit exhibited the nocturnal stomatal opening characteristic of CAM plants. Severe water stress suppressed the nocturnal stomatal opening by mature cladodes, but their high water vapor conductance occurring near dawn was not affected. Nocturnal acidity increases were not as sensitive to water stress as was the nocturnal stomatal opening. The magnitude of the nocturnal acidity increases depended on the total daily photosynthetically active radiation (PAR), being 90% PAR-saturated at 27 moles per square meter per day for a mean nighttime air temperature of 5°C and at 20 moles per square meter per day for 18°C. Inasmuch as the PAR received on unshaded vertical surfaces averaged about 21 moles per square meter per day, nocturnal acidity increases by the cladodes were on the verge of being PAR-limited in the field. The net assimilation rate, which was positive throughout the year, annually averaged 3.4 grams per square meter per day for 1.0- and 2.0-year-old plants. Plants that were 5.4 years old had 7.2 square meters of cladode surface area (both sides) and an annual dry weight productivity of 13 megagrams (metric tons) per hectare per year when their ground cover was 32%. This substantial productivity for a CAM plant was accompanied by the highest nocturnal acidity increase so far observed in the field, 0.78 mole H+ per square meter. PMID:16663084

  2. An open-label, 12-week clinical and sleep EEG study of nefazodone in chronic combat-related posttraumatic stress disorder.

    PubMed

    Gillin, J C; Smith-Vaniz, A; Schnierow, B; Rapaport, M H; Kelsoe, J; Raimo, E; Marler, M R; Goyette, L M; Stein, M B; Zisook, S

    2001-10-01

    We examined the effects of nefazodone on polysomnographic sleep measures and subjective reports of sleep quality and nightmares. as well as other symptoms, in patients with chronic combat-related posttraumatic stress disorder (PTSD) during a 12-week, open-label clinical trial. To our knowledge, this is the first polysomnographic study of treatment in patients with PTSD. The subjects were 12 male veterans (mean age = 54 years) who met DSM-IV diagnostic criteria for PTSD (mean duration = 30 years). All but I patient also met DSM-IV criteria for major depressive disorder. Patients were evaluated weekly with clinical ratings in an open-label clinical trial. Polysomnographic recordings for 2 consecutive nights were obtained before treatment and at 2, 4, 8, and 12 weeks. The dose of nefazodone was adjusted according to individual clinical needs. Final mean daily dose was 441 mg. The patients reported significantly fewer nightmares and sleep problems during treatment. Nevertheless, contrary to studies in depressed patients, nefazodone did not significantly affect polysomnographic sleep measures compared with baseline. In addition, the patients showed significant improvement in the Clinical Global Impressions of PTSD symptoms (global score, hyperarousals and intrusions subscales), the Clinician-Administered PTSD Scale (global, hyperarousal, and intrusions subscales), the Hamilton Rating Scale for Depression (HAM-D). and the Beck Depression Inventory (BDI). These patients with chronic, treatment-resistant, combat-related PTSD showed significant improvement of subjective symptoms of nightmares and sleep disturbance, as well as depression and PTSD symptoms. in this 12-week open-label clinical trial. Nevertheless, objective polysomnographic sleep measures did not change. Further studies, including double-blind. placebo-controlled trials, are needed to extend these findings and to understand the relationships between the physiology of sleep and symptoms of poor sleep and nightmares.

  3. Development of seven hardwood species in small forest openings: 22-year results

    Treesearch

    R.L. Johnson; R.M. Krinard

    1983-01-01

    Small forest openings planted with seven leading commercial tree species were completely dominated by yellow-poplar (Liriodendron tulipifera) that ave raged 90 feet tall after 22 years. Of the other planted species, swamp chestnut oak (Quercus michauxii) was most shade tolerant while shumard oaks (Q. shumardii),...

  4. A Year in the Life of an Open University Student in the United Kingdom.

    ERIC Educational Resources Information Center

    Ismail, Nazira

    1988-01-01

    Describes a Ugandan student's first-year experiences at the Open University in the United Kingdom. Discusses how the University operates; comments on course texts and supplementary materials; and presents a month-by-month breakdown of university and course activities and requirements. (GEA)

  5. A Crossover Study of Risperidone in Children, Adolescents and Adults with Mental Retardation

    ERIC Educational Resources Information Center

    Hellings, Jessica A.; Zarcone, Jennifer R.; Reese, R. Matthew; Valdovinos, Maria G.; Marquis, Janet G.; Fleming, Kandace K.; Schroeder, Stephen R.

    2006-01-01

    Risperidone has shown safety and efficacy for aggressive and destructive behaviors in short-term studies. This longer-duration study includes a broad sample. Forty subjects, aged 8-56 years (mean=22), all with mental retardation and 36 with autism spectrum disorders participated in this 22-week crossover study, with 24 weeks of open maintenance…

  6. The value of programmable shunt valves for the management of subdural collections in patients with hydrocephalus.

    PubMed

    Pachatouridis, Dimitrios; Alexiou, George A; Mihos, Evaggelos; Fotakopoulos, George; Voulgaris, Spyridon

    2013-01-01

    The aim of the present study was to assess the value of electromagnetic programmable shunt valves for the treatment of subdural collections. Adult patients with hydrocephalus of various causes that were treated with programmable shunt valves during the last ten years were retrospectively studied. In 127 patients, 139 electromagnetic programmable shunt valves were implanted. A nontraumatic subdural fluid collection was detected in 12 patients. The treatment of these patients consisted of reprogramming of the valve's opening pressure. In 5 patients small subdural hematomas were detected; 4 of these patients were treated by raising the opening pressure alone and one patient required surgical drainage and change of the pressure setting. Traumatic chronic subdural hematomas were detected in 6 patients. These patients were treated by surgical drainage and readjustment of the valve's opening pressure. The ability to treat a shunt-related complication, such as a subdural fluid collection, by reprogramming the valve's opening pressure to a higher setting is an advantage over nonprogrammable valves, and it enables the opening pressure to be slowly lowered once the fluid collection is reabsorbed. Based on our results, we believe that programmable shunt valves should be preferred.

  7. The Value of Programmable Shunt Valves for the Management of Subdural Collections in Patients with Hydrocephalus

    PubMed Central

    Alexiou, George A.; Mihos, Evaggelos; Fotakopoulos, George; Voulgaris, Spyridon

    2013-01-01

    Background. The aim of the present study was to assess the value of electromagnetic programmable shunt valves for the treatment of subdural collections. Methods. Adult patients with hydrocephalus of various causes that were treated with programmable shunt valves during the last ten years were retrospectively studied. In 127 patients, 139 electromagnetic programmable shunt valves were implanted. Results. A nontraumatic subdural fluid collection was detected in 12 patients. The treatment of these patients consisted of reprogramming of the valve's opening pressure. In 5 patients small subdural hematomas were detected; 4 of these patients were treated by raising the opening pressure alone and one patient required surgical drainage and change of the pressure setting. Traumatic chronic subdural hematomas were detected in 6 patients. These patients were treated by surgical drainage and readjustment of the valve's opening pressure. Conclusion. The ability to treat a shunt-related complication, such as a subdural fluid collection, by reprogramming the valve's opening pressure to a higher setting is an advantage over nonprogrammable valves, and it enables the opening pressure to be slowly lowered once the fluid collection is reabsorbed. Based on our results, we believe that programmable shunt valves should be preferred. PMID:24453855

  8. Developing Conceptual Framework for Revising Self-Learning Materials (SLMs) of the Open School (OS) of Bangladesh Open University (BOU) at a Digital Environment

    ERIC Educational Resources Information Center

    Yeasmin, Sabina; Murthy, C. R. K.

    2011-01-01

    Bangladesh Open University (BOU) runs school programs as part of its academic activities through open schooling since its inception. As of today, the Open School uses the first generation self-learning materials (SLMs) written, before an era, following an in-house style and template. The concerned faculty member corrects, every year, texts before…

  9. Developing Conceptual Framework for Revising Self-Learning Materials (SLMs) of the Open School (OS) of Bangladesh Open University (BOU) at a Digital Environment

    ERIC Educational Resources Information Center

    Yeasmin, Sabina; Murthy, C. R. K.

    2012-01-01

    Bangladesh Open University (BOU) runs school programs as part of its academic activities through open schooling since its inception. As of today, the Open School uses the first generation self-learning materials (SLMs) written, before an era, following an in-house style and template. The concerned faculty member corrects, every year, texts before…

  10. Understanding and applying open-path optical sensing data

    NASA Astrophysics Data System (ADS)

    Virag, Peter; Kricks, Robert J.

    1999-02-01

    During the last 10 years, open-path air monitors have evolved to yield reliable and effective measurements of single and multiple compounds on a real-time basis. To many individuals within the optical remote sensing community, the attributes of open-path and its the potential uses seem unlimited. Then why has the market has been stagnant for the last few years? The reason may center on how open-path information is applied and how well the end user understands that information. We constantly try to compare open-path data to risk/health or safety levels that are based for use at a single point and for a specific averaging period often far longer than a typical open-path data point. Often this approach is perceived as putting a square peg in a round hole. This perception may be well founded, as open-path data at times may need to go through extensive data manipulation and assumptions before it can be applied. This paper will review pervious open-path monitoring programs and their success in applying the data collected. We will also look at how open-path data is being currently used, some previous pitfalls in data use, alternate methods of data interpretation, and how open-path data can be best practically applied to fit current needs.

  11. Updated Assessment of an Open Rotor Airplane Using an Advanced Blade Design

    NASA Technical Reports Server (NTRS)

    Hendricks, Eric S.; Berton, Jeffrey J.; Haller, William J.; Tong, Michael T.; Guynn, Mark D.

    2013-01-01

    Application of open rotor propulsion systems (historically referred to as "advanced turboprops" or "propfans") to subsonic transport aircraft received significant attention and research in the 1970s and 1980s when fuel efficiency was the driving focus of aeronautical research. Recent volatility in fuel prices and concern for aviation's environmental impact have renewed interest in open rotor propulsion, and revived research by NASA and a number of engine manufacturers. Over the last few years, NASA has revived and developed analysis capabilities to assess aircraft designs with open rotor propulsion systems. These efforts have been described in several previous papers along with initial results from applying these capabilities. The initial results indicated that open rotor engines have the potential to provide large reductions in fuel consumption and emissions. Initial noise analysis indicated that current noise regulations can be met with modern baseline blade designs. Improved blades incorporating low-noise features are expected to result in even lower noise levels. This paper describes improvements to the initial assessment, plus a follow-on study using a more advanced open rotor blade design to power the advanced singleaisle transport. The predicted performance and environmental results of these two advanced open rotor concepts are presented and compared.

  12. Growth in retail-based clinics after nurse practitioner scope of practice reform.

    PubMed

    Brooks Carthon, J Margo; Sammarco, Therese; Pancir, Darcy; Chittams, Jesse; Wiltse Nicely, Kelly

    Retail clinics are largely staffed by nurse practitioners (NPs) and are a popular destination for nonemergent care. We examined if there was a relationship between NP practice regulations and retail clinic growth after the passage of a scope of practice (SOP) reform bill in Pennsylvania. General linear regression models were used to compare retail clinic openings in Pennsylvania, New Jersey, and Maryland between 2006 and 2013. From 2006 to 2008, Pennsylvania experienced a significant growth rate in net retail clinic openings per capita (p = .046), whereas New Jersey and Maryland experienced no significant increase (p = .109 and .053, respectively). From 2009 to 2013, Pennsylvania opened 0.20 clinics (p = .129), New Jersey opened 0.23 clinics (p = .086), and Maryland opened 0.34 clinics per capita per year (p = .017). Our study of three states with varying levels of SOP restraint reveals an association between relaxation of practice regulations and retail clinic growth. Copyright © 2016 Elsevier Inc. All rights reserved.

  13. Soft tissue management of children's open tibial fractures – a review of seventy children over twenty years

    PubMed Central

    Rao, P; Schaverien, MV; Stewart, KJ

    2010-01-01

    INTRODUCTION The management of open tibial fractures in children represents a unique reconstructive challenge. The aim of the study was to evaluate the management of paediatric open tibial fractures with particular regard to soft tissue management. PATIENTS AND METHODS A retrospective case-note analysis was performed for all children presenting with an open tibial fracture at a single institution over a 20-year period for 1985 to 2005. RESULTS Seventy children were reviewed of whom 41 were males and 29 females. Overall, 91% (n = 64) of children suffered their injury as a result of a vehicle-related injury. The severity of the fracture with respect to the Gustilo classification was: Grade I, 42% (n = 29); Grade II, 24% (n = 17); Grade III, 34% (n = 24; 7 Grade 3a, 16 Grade 3b, 1 Grade 3c). The majority of children were treated with external fixation and conservative measures, with a mean hospital in-patient stay of 13.3 days. Soft tissue cover was provided by plastic surgeons in 31% of all cases. Four cases of superficial wound infection occurred (6%), one case of osteomyelitis and one case of flap failure. The limb salvage was greater than 98%. CONCLUSIONS In this series, complications were associated with delayed involvement of plastic surgeons. Retrospective analysis has shown a decreased incidence of open tibial fractures which is reported in similar studies. Gustilo grade was found to correlate with length of hospital admission and plastic surgery intervention. We advocate, when feasible, the use of local fas-ciocutaneous flaps (such as distally based fasciocutaneous and adipofascial flaps), which showed a low complication rate in children. PMID:20501017

  14. Preschool Teacher Perceptions of Aggressive Behavior

    ERIC Educational Resources Information Center

    Stein, Misty

    2013-01-01

    The purpose of this grounded theory qualitative study was to identify teacher perceptions within the classroom of preschool violence and what, if any were the perceived associations between teacher perceptions and the problem of school violence up to and including incarceration in later years. The study included open interview questions for data…

  15. Analysis of Urban Forest Needs as Anthropogenic (CO2) Gas Absorbent in Semarang City

    NASA Astrophysics Data System (ADS)

    Febriani, Anisa Putri; Retnaningsih Soeprobowati, Tri; Maryono

    2018-02-01

    Green open space in cities in significant needs to maintenance environment quality. On of the critical function is to absorb increasing number of gas CO2. Therefore, developing urban forest in cities is very importance. The objective of the study is to determine the area of urban forest as CO2 gas anthropogenic absorb which is formed from fuel, diesel fuel, liquid petroleum gas. The study consists of (1) Analyzing the number of CO2 gas emission by calculating the needs of petroleum and gas based on the number of population, (2) Analyzing the power of gas absorption, (3) Measuring the air concentration of CO2 gas ambient based on daily traffic activities. This study shown that from year 2013 to year 2017, the increasing of urban forest is not so significant. For year 2013 the green open space in Semarang City are 373.67 hectares (7.5 percent from Semarang City area), consists of 239 parks, 11 public cemeteries, production forests, community forests, and urban forests, however the area of urban forest is not increase. The study assess that Antidesmabunius is one of the green species which high absorb capacity planted for Semarang. This trees produce 31,31 ton annually. This study proposed to fostering Antidesmabunius as one principle threes in Semarang urban forest.

  16. Montreal Archive of Sleep Studies: an open-access resource for instrument benchmarking and exploratory research.

    PubMed

    O'Reilly, Christian; Gosselin, Nadia; Carrier, Julie; Nielsen, Tore

    2014-12-01

    Manual processing of sleep recordings is extremely time-consuming. Efforts to automate this process have shown promising results, but automatic systems are generally evaluated on private databases, not allowing accurate cross-validation with other systems. In lacking a common benchmark, the relative performances of different systems are not compared easily and advances are compromised. To address this fundamental methodological impediment to sleep study, we propose an open-access database of polysomnographic biosignals. To build this database, whole-night recordings from 200 participants [97 males (aged 42.9 ± 19.8 years) and 103 females (aged 38.3 ± 18.9 years); age range: 18-76 years] were pooled from eight different research protocols performed in three different hospital-based sleep laboratories. All recordings feature a sampling frequency of 256 Hz and an electroencephalography (EEG) montage of 4-20 channels plus standard electro-oculography (EOG), electromyography (EMG), electrocardiography (ECG) and respiratory signals. Access to the database can be obtained through the Montreal Archive of Sleep Studies (MASS) website (http://www.ceams-carsm.ca/en/MASS), and requires only affiliation with a research institution and prior approval by the applicant's local ethical review board. Providing the research community with access to this free and open sleep database is expected to facilitate the development and cross-validation of sleep analysis automation systems. It is also expected that such a shared resource will be a catalyst for cross-centre collaborations on difficult topics such as improving inter-rater agreement on sleep stage scoring. © 2014 European Sleep Research Society.

  17. Open Courses, Informal, Social Learning and Mobile Photography

    ERIC Educational Resources Information Center

    McGuire, Mark

    2016-01-01

    This paper provides an overview of MOOCs (Massive Open Online Courses) and contextualizes them within the broader trends of open, informal and mobile learning. It then discuss Phonar Nation, a free, open, non-credit five-week photography course that was offered twice in 2014 using mobile media to reach youth from 12-18 years of age. The author…

  18. When Free Isn't Free: The Realities of Running Open Source in School

    ERIC Educational Resources Information Center

    Derringer, Pam

    2009-01-01

    Despite the last few years' growth in awareness of open-source software in schools and the potential savings it represents, its widespread adoption is still hampered. Randy Orwin, technology director of the Bainbridge Island School District in Washington State and a strong open-source advocate, cautions that installing an open-source…

  19. The Emergence of Open-Source Software in North America

    ERIC Educational Resources Information Center

    Pan, Guohua; Bonk, Curtis J.

    2007-01-01

    Unlike conventional models of software development, the open source model is based on the collaborative efforts of users who are also co-developers of the software. Interest in open source software has grown exponentially in recent years. A "Google" search for the phrase open source in early 2005 returned 28.8 million webpage hits, while…

  20. Postdural puncture headache is not an age-related symptom in children: a prospective, open-randomized, parallel group study comparing a22-gauge Quincke with a 22-gauge Whitacre needle.

    PubMed

    Kokki, H; Salonvaara, M; Herrgård, E; Onen, P

    1999-01-01

    Many reports have shown a low incidence of postdural puncture headache (PDPH) and other complaints in young children. The objective of this open-randomized, prospective, parallel group study was to compare the use of a cutting point spinal needle (22-G Quincke) with a pencil point spinal needle (22-G Whitacre) in children. We studied the puncture characteristics, success rate and incidence of postpuncture complaints in 57 children, aged 8 months to 15 years, following 98 lumbar punctures (LP). The patient/parents completed a diary at 3 and 7 days after LP. The response rate was 97%. The incidence of PDPH was similar, 15% in the Quincke group and 9% in the Whitacre group (P=0.42). The risk of developing a PDPH was not dependent on the age (r < 0.00, P=0.67). Eight of the 11 PDPHs developed in children younger than 10 years, the youngest being 23-months-old.

  1. The role of mitomycin C in surgery of the frontonasal recess: a prospective open pilot study.

    PubMed

    Amonoo-Kuofi, Kwame; Lund, Valerie J; Andrews, Peter; Howard, David J

    2006-01-01

    Mitomycin C (MMC) inhibits fibroblast proliferation. The objective of this study was to determine the efficacy of MMC in reducing frontal ostium stenosis after endoscopic sinus surgery. A prospective open pilot study was conducted in 28 patients who had undergone one or more previous surgical interventions for frontal sinusitis. MMC solution was applied to the frontal ostial region via an endoscopic or combined endoscopic and external approach. Patency of the frontal ostium was evaluated endoscopically during regular follow-up. If restenosis was observed further, endoscopic application of MMC was undertaken. There were 17 men and 11 women (mean age, 51.7 years; range, 26-86 years). Mean number of applications was 1.5 (range, 1:3). Mean follow-up was 19 months (range, 6-32 months). Patency rate was 86%. Mitomycin appears to have an important role in reducing postoperative scarring, which may obviate the need for repeated and more extensive surgery.

  2. Epidemiology of open tibia fractures in a population-based database: update on current risk factors and clinical implications.

    PubMed

    Weber, Christian David; Hildebrand, Frank; Kobbe, Philipp; Lefering, Rolf; Sellei, Richard M; Pape, Hans-Christoph

    2018-02-02

    Open tibia fractures usually occur in high-energy mechanisms and are commonly associated with multiple traumas. The purposes of this study were to define the epidemiology of open tibia fractures in severely injured patients and to evaluate risk factors for major complications. A cohort from a nationwide population-based prospective database was analyzed (TraumaRegister DGU ® ). Inclusion criteria were: (1) open or closed tibia fracture, (2) Injury Severity Score (ISS) ≥ 16 points, (3) age ≥ 16 years, and (4) survival until primary admission. According to the soft tissue status, patients were divided either in the closed (CTF) or into the open fracture (OTF) group. The OTF group was subdivided according to the Gustilo/Anderson classification. Demographic data, injury mechanisms, injury severity, surgical fracture management, hospital and ICU length of stay and systemic complications (e.g., multiple organ failure (MOF), sepsis, mortality) were collected and analyzed by SPSS (Version 23, IBM Inc., NY, USA). Out of 148.498 registered patients between 1/2002 and 12/2013; a total of 4.940 met the inclusion criteria (mean age 46.2 ± 19.4 years, ISS 30.4 ± 12.6 points). The CTF group included 2000 patients (40.5%), whereas 2940 patients (59.5%) sustained open tibia fractures (I°: 49.3%, II°: 27.5%, III°: 23.2%). High-energy trauma was the leading mechanism in case of open fractures. Despite comparable ISS and NISS values in patients with closed and open tibia fractures, open fractures were significantly associated with higher volume resuscitation (p < 0.001), more blood (p < 0.001), and mass transfusions (p = 0.006). While the rate of external fixation increased with the severity of soft tissue injury (37.6 to 76.5%), no major effect on mortality and other major complications was observed. Open tibia fractures are common in multiple trauma patients and are therefore associated with increased resuscitation requirements, more surgical procedures and increased in-hospital length of stay. However, increased systemic complications are not observed if a soft tissue adapted surgical protocol is applied.

  3. Evaluation of open-graded "F" mixtures for water sensitivity : final report.

    DOT National Transportation Integrated Search

    1993-07-01

    The Oregon Department of Transportation (ODOT) has increased their use of open-graded paving mixtures. During the last five years, ODOT has constructed several hundred miles of highways with open-graded "F" asphalt concrete mixtures. These pavements ...

  4. Prognosis of patients after open mitral commissurotomy. Actuarial analysis of late results in 100 patients.

    PubMed

    Housman, L B; Bonchek, L; Lambert, L; Grunkemeier, G; Starr, A

    1977-05-01

    The continuing controversy between proponents of open and closed commissurotomy might be clarified by analysis of late follow-up with modern actuarial techniques that provide a true perspective of patient risk. We have used open mitral commissurotomy exclusively for 15 years in 100 patients. There was one operative death from pancreatitis and one late death from cancer; the actuarially projected survival rate (+/- the standard error) at 10 years is 97 per cent (+/- 2). Thirteen patients had preoperative emboli, 6 of whom were in sinus rhythm and 7 in atrial fibrillation. Two patients had postoperative emboli, both in sinus rhythm. The actuarial chance of remaining free of embolism at 10 years is 97 per cent (+/- 2). Sixteen patients required reoperation on the mitral valve for functional deterioration. The remaining survivors were in Class I or II when last seen. The actuarial chance of not requiring a reoperation after 5 years is 91 per cent (+/- 4) and at 10 years, 38 per cent(+/- 16). Results in different centers are difficult to compare for many reasons, but imprecise statistical methods further obscure such comparisons. The use of actuarial techniques may help to define the role of open mitral commissurotomy.

  5. Respiratory symptoms of vendors in an open-air hawker center in brunei darussalam.

    PubMed

    Nazurah Bt Abdul Wahid, Nurul Nor; Balalla, N B P; Koh, David

    2014-01-01

    We studied respiratory problems among vendors exposed to cooking fumes in an open-air hawker center. Exposure to cooking fumes from either the use of fossil fuels or liquefied petroleum gas (LPG) has been shown to be associated with adverse respiratory health effects. We conducted a cross-sectional study among 67 food vendors exposed to cooking fumes as well as 18 merchandise sellers at an open-air hawker center in Brunei Darussalam. Past medical and smoking history and exposure to cooking fumes were obtained. The validated American Thoracic Society Questionnaire with a translated Malay version was used to ask for respiratory symptoms. Compared to merchandise sellers (n = 18), cooking vendors (n = 67) had a higher self-reported respiratory symptoms (50.7% for those cooking and 33.3% for merchandise sellers). Cough (28.3%) was the main respiratory symptom experienced in cooking vendors and breathlessness (22.2%) among merchandise sellers. Half (50.0%) of cooking vendors who worked for more than 10 years had cough and 27.3% had phlegm. Those cooking with charcoal were two times more likely to have cough than those cooking with LPG. Cooking vendors with a job duration of more than 10 years were thrice more likely to have cough. Cooking vendors in the open-air hawker center exposed to cooking fumes had more respiratory symptoms compared to non-exposed merchandise sellers. The type of fuel used for cooking and duration of work was associated with increased prevalence of cough.

  6. [A comparison of laparoscopic versus open repair for the surgical treatment of perforated peptic ulcers].

    PubMed

    Domínguez-Vega, Gerardo; Pera, Manuel; Ramón, José M; Puig, Sonia; Membrilla, Estela; Sancho, Joan; Grande, Luis

    2013-01-01

    To analyse the outcomes of laparoscopic versus open repair for perforated peptic ulcers (PPU). All patients undergoing PPU repair between January 2002 and March 2012 were included in the study. Demographic characteristics, operation time, complications, and length of hospital stay were evaluated. Two hundred and twelve patients (median age, 49 years) were included, 60 in the laparoscopic group and 52 in the open group. Patients operated laparoscopically were significantly younger and had a higher consumption of tobacco, alcohol and cannabis. Median acute symptoms time was shorter in the laparoscopic group (6h) compared to the open group (12h; P=.025) Symptoms time was shorter in the laparoscopic group. Median operating time was significantly longer in the laparoscopic group (104.5min vs. 76min, P=.025). The percentage of conversion to open repair was 25%. There was no difference in morbidity between 2 groups, but there were 3 deaths in the open group. Median hospital stay was significantly shorter in patients treated laparoscopically when compared with the open group (6 days vs. 8 days; P=.041). Laparoscopic and open repair are equally safe in the management of PPU. A shorter hospital stay can be achieved in the laparoscopic group. Copyright © 2012 AEC. Published by Elsevier Espana. All rights reserved.

  7. The effect of ziprasidone on metabolic syndrome risk factors in subjects with schizophrenia: a 1 year, open-label, prospective study.

    PubMed

    Chue, Pierre; Mandel, Francine S; Therrien, François

    2014-06-01

    Metabolic syndrome (MetS) is prevalent in subjects with schizophrenia-related psychotic disorders and contributes to increased rates of premature death due to cardiovascular disease. This study examined the impact of switching from another antipsychotic to ziprasidone on the distribution of the number of risk factors for MetS in subjects with schizophrenia or related psychotic disorders. In this 1 year, open-label, prospective study, all subjects received ziprasidone 40-160 mg/day. Standard exclusion criteria included treatment resistance, physical health disorders, and substance abuse. The primary end point was the percentage of subjects achieving a reduction from baseline of at least one risk factor for MetS at end point (week 52 or premature discontinuation) in the per-protocol population (treated for at least 16 weeks). Secondary end points included the mean change from baseline in number of MetS risk factors, the prevalence of MetS, individual MetS risk factors (waist circumference, blood pressure, fasting triglycerides, high-density lipoprotein cholesterol, and glucose), and 10 year coronary heart disease (Framingham score) risk. www.clinicaltrials.gov: NCT00748566. Of 114 evaluable subjects, 58.77% demonstrated one less MetS risk factor at week 52 (last observation carried forward) compared with baseline. Secondary end points also improved, with reductions in other metabolic parameters (fasting low-density lipoprotein cholesterol, total cholesterol and serum insulin, weight, body mass index and glycosylated hemoglobin [HbA1c]). The 10 year coronary heart disease risk decreased continually over time. The open-label and uncontrolled design is a limitation of the study. Ziprasidone treatment reduced both the rate of MetS and its individual risk factors in subjects with schizophrenia and related psychotic disorders. The results have implications for the selection of first-line treatments in schizophrenia and related psychotic disorders, and provide treatment options for subjects who have developed MetS as a result of other antipsychotics.

  8. Lower reoperation rate for recurrence after mesh versus sutured elective repair in small umbilical and epigastric hernias. A nationwide register study.

    PubMed

    Christoffersen, M W; Helgstrand, F; Rosenberg, J; Kehlet, H; Bisgaard, T

    2013-11-01

    Repair for a small (≤ 2 cm) umbilical and epigastric hernia is a minor surgical procedure. The most common surgical repair techniques are a sutured repair or a repair with mesh reinforcement. However, the optimal repair technique with regard to risk of reoperation for recurrence is not well documented. The aim of the present study was in a nationwide setup to investigate the reoperation rate for recurrence after small open umbilical and epigastric hernia repairs using either sutured or mesh repair. This was a prospective cohort study based on intraoperative registrations from the Danish Ventral Hernia Database (DVHD) of patients undergoing elective open mesh and sutured repair for small (≤ 2 cm) umbilical and epigastric hernias. Patients were included during a 4-year study period. A complete follow-up was obtained by combining intraoperative data from the DVHD with data from the Danish National Patient Register. The cumulative reoperation rates were obtained using cumulative incidence plot and compared with the log rank test. In total, 4,786 small (≤ 2 cm) elective open umbilical and epigastric hernia repairs were included. Age was median 48 years (range 18-95 years). Follow-up was 21 months (range 0-47 months). The cumulated reoperation rates for recurrence were 2.2 % for mesh reinforcement and 5.6 % for sutured repair (P = 0.001). The overall cumulated reoperation rate for sutured and mesh repairs was 4.8 %. In conclusion, reoperation rate for recurrence for small umbilical and epigastric hernias was significantly lower after mesh repair compared with sutured repair. Mesh reinforcement should be routine in even small umbilical or epigastric hernias to lower the risk of reoperation for recurrence avoid recurrence.

  9. Endovascular strategy or open repair for ruptured abdominal aortic aneurysm: one-year outcomes from the IMPROVE randomized trial

    PubMed Central

    Braithwaite, Bruce; Cheshire, Nicholas J.; Greenhalgh, Roger M.; Grieve, Richard; Hassan, Tajek B.; Hinchliffe, Robert; Howell, Simon; Moore, Fionna; Nicholson, Anthony A.; Soong, Chee V.; Thompson, Matt M.; Thompson, Simon G.; Ulug, Pinar; Heatley, Francine; Anjum, Aisha; Kalinowska, Gosia; Sweeting, Michael J.; Thompson, Simon G.; Gomes, Manuel; Grieve, Richard; Powell, Janet T.; Ashleigh, Ray; Gomes, Manuel; Greenhalgh, Roger M.; Grieve, Richard; Hinchliffe, Robert; Sweeting, Michael; Thompson, Matt M.; Thompson, Simon G.; Ulug, Pinar; Roberts, Ian; Bell, Peter R. F.; Cheetham, Anne; Stephany, Jenny; Warlow, Charles; Lamont, Peter; Moss, Jonathan; Tijssen, Jan; Braithwaite, Bruce; Nicholson, Anthony A.; Thompson, Matthew; Ashleigh, Ray; Thompson, Luke; Cheshire, Nicholas J.; Boyle, Jonathan R.; Serracino-Inglott, Ferdinand; Thompson, Matt M.; Hinchliffe, Robert J.; Bell, Rachel; Wilson, Noel; Bown, Matt; Dennis, Martin; Davis, Meryl; Ashleigh, Ray; Howell, Simon; Wyatt, Michael G.; Valenti, Domenico; Bachoo, Paul; Walker, Paul; MacSweeney, Shane; Davies, Jonathan N.; Rittoo, Dynesh; Parvin, Simon D.; Yusuf, Waquar; Nice, Colin; Chetter, Ian; Howard, Adam; Chong, Patrick; Bhat, Raj; McLain, David; Gordon, Andrew; Lane, Ian; Hobbs, Simon; Pillay, Woolagasen; Rowlands, Timothy; El-Tahir, Amin; Asquith, John; Cavanagh, Steve; Dubois, Luc; Forbes, Thomas L.; Ashworth, Emily; Baker, Sara; Barakat, Hashem; Brady, Claire; Brown, Joanne; Bufton, Christine; Chance, Tina; Chrisopoulou, Angela; Cockell, Marie; Croucher, Andrea; Dabee, Leela; Dewhirst, Nikki; Evans, Jo; Gibson, Andy; Gorst, Siobhan; Gough, Moira; Graves, Lynne; Griffin, Michelle; Hatfield, Josie; Hogg, Florence; Howard, Susannah; Hughes, Cían; Metcalfe, David; Lapworth, Michelle; Massey, Ian; Novick, Teresa; Owen, Gareth; Parr, Noala; Pintar, David; Spencer, Sarah; Thomson, Claire; Thunder, Orla; Wallace, Tom; Ward, Sue; Wealleans, Vera; Wilson, Lesley; Woods, Janet; Zheng, Ting

    2015-01-01

    Aims To report the longer term outcomes following either a strategy of endovascular repair first or open repair of ruptured abdominal aortic aneurysm, which are necessary for both patient and clinical decision-making. Methods and results This pragmatic multicentre (29 UK and 1 Canada) trial randomized 613 patients with a clinical diagnosis of ruptured aneurysm; 316 to an endovascular first strategy (if aortic morphology is suitable, open repair if not) and 297 to open repair. The principal 1-year outcome was mortality; secondary outcomes were re-interventions, hospital discharge, health-related quality-of-life (QoL) (EQ-5D), costs, Quality-Adjusted-Life-Years (QALYs), and cost-effectiveness [incremental net benefit (INB)]. At 1 year, all-cause mortality was 41.1% for the endovascular strategy group and 45.1% for the open repair group, odds ratio 0.85 [95% confidence interval (CI) 0.62, 1.17], P = 0.325, with similar re-intervention rates in each group. The endovascular strategy group and open repair groups had average total hospital stays of 17 and 26 days, respectively, P < 0.001. Patients surviving rupture had higher average EQ-5D utility scores in the endovascular strategy vs. open repair groups, mean differences 0.087 (95% CI 0.017, 0.158), 0.068 (95% CI −0.004, 0.140) at 3 and 12 months, respectively. There were indications that QALYs were higher and costs lower for the endovascular first strategy, combining to give an INB of £3877 (95% CI £253, £7408) or €4356 (95% CI €284, €8323). Conclusion An endovascular first strategy for management of ruptured aneurysms does not offer a survival benefit over 1 year but offers patients faster discharge with better QoL and is cost-effective. Clinical trial registration ISRCTN 48334791. PMID:25855369

  10. Endovascular strategy or open repair for ruptured abdominal aortic aneurysm: one-year outcomes from the IMPROVE randomized trial.

    PubMed

    2015-08-14

    To report the longer term outcomes following either a strategy of endovascular repair first or open repair of ruptured abdominal aortic aneurysm, which are necessary for both patient and clinical decision-making. This pragmatic multicentre (29 UK and 1 Canada) trial randomized 613 patients with a clinical diagnosis of ruptured aneurysm; 316 to an endovascular first strategy (if aortic morphology is suitable, open repair if not) and 297 to open repair. The principal 1-year outcome was mortality; secondary outcomes were re-interventions, hospital discharge, health-related quality-of-life (QoL) (EQ-5D), costs, Quality-Adjusted-Life-Years (QALYs), and cost-effectiveness [incremental net benefit (INB)]. At 1 year, all-cause mortality was 41.1% for the endovascular strategy group and 45.1% for the open repair group, odds ratio 0.85 [95% confidence interval (CI) 0.62, 1.17], P = 0.325, with similar re-intervention rates in each group. The endovascular strategy group and open repair groups had average total hospital stays of 17 and 26 days, respectively, P < 0.001. Patients surviving rupture had higher average EQ-5D utility scores in the endovascular strategy vs. open repair groups, mean differences 0.087 (95% CI 0.017, 0.158), 0.068 (95% CI -0.004, 0.140) at 3 and 12 months, respectively. There were indications that QALYs were higher and costs lower for the endovascular first strategy, combining to give an INB of £3877 (95% CI £253, £7408) or €4356 (95% CI €284, €8323). An endovascular first strategy for management of ruptured aneurysms does not offer a survival benefit over 1 year but offers patients faster discharge with better QoL and is cost-effective. ISRCTN 48334791. © The Author 2015. Published by Oxford University Press on behalf of the European Society of Cardiology.

  11. Recovery of mouth-opening after closed treatment of a fracture of the mandibular condyle: a longitudinal study.

    PubMed

    Niezen, E T; Stuive, I; Post, W J; Bos, R R M; Dijkstra, P U

    2015-02-01

    The aim of this retrospective study was to assess recovery of mouth opening after closed treatment of fractures of the mandibular condyle, and analyse which characteristics might influence recovery. We measured mouth opening in 142 patients (mean (SD) age 30 (14) years, 96 of whom were male) during follow-up at 3, 6, 13, 26, and 52 weeks after the injury. Fractures were assessed on radiographs. Data were analysed using a multilevel analysis. Half the fractures were of the low condylar neck (n=71). Thirty-seven patients had bilateral condylar fractures, 29 had dislocated fractures, and in 80 the fracture was displaced. One or more additional mandibular fractures were present in 68. During follow-up mean (SD) mouth opening increased to: 33.6 (9.6) at 3 weeks, 40.1 (10.0) at 6 weeks, 45.1 (9.6) at 13 weeks, 49.8 (9.5) at 26 weeks, and 52.6 (7.5) at 52 weeks. Older age, female sex, displaced fracture, bilateral fractures, additional mandibular fractures, and the interaction between follow-up time and additional mandibular fractures, were predictors of a less favourable recovery of mouth opening. Clinicians can use the results of this study to predict recovery of mouth opening after closed treatment of fractures of the mandibular condyle at first consultation. Copyright © 2014 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

  12. Motivating medical students to learn teamwork skills.

    PubMed

    Aarnio, Matti; Nieminen, Juha; Pyörälä, Eeva; Lindblom-Ylänne, Sari

    2010-01-01

    This study examined teaching teamwork skills to first-year medical students. Teamwork skills focused on verbal communication in PBL-tutorial sessions and in healthcare teams. The aim was to find out how to teach teamwork skills to first-year medical students and how to motivate them to learn these skills. Three consecutive classes of first-year medical students (N = 342) participated in teamwork skills module in the years 2006, 2007 and 2008. After the first year, the introduction to the topic was revised in order to be more motivating to medical students. After each module data were collected with a feedback questionnaire containing numerical and open questions. By analyzing the students' numerical answers and the content of students' open answers regarding the module, we examined how the revised introduction affected students' perceptions of the usefulness of the module. Medical students' feedback in the years 1 (n = 81), 2 (n = 99) and 3 (n = 95) showed that the students found the module in the second and third years significantly more useful than in the first year. These results support earlier findings that clearly stated clinical relevance motivates medical students. When introducing multidisciplinary subjects to medical students, it is important to think through the clinical relevance of the topic and how it is introduced to medical students.

  13. Open Innovation and the Evolving Federal R&D Enterprise

    EPA Science Inventory

    Open Innovation approaches, from crowdsourcing to prize competitions, are being adopted by federal agencies at an accelerating rate over the last ten years. Open Innovation is a problem‐solving approach that seeks to gather and develop external ideas and solutions in additi...

  14. An Open Science and Reproducible Research Primer for Landscape Ecologists

    EPA Science Inventory

    In recent years many funding agencies, some publishers, and even the United States government have enacted policies that encourage open science and strive for reproducibility; however, the knowledge and skills to implement open science and enable reproducible research are not yet...

  15. Monitoring LongBao Wetland Ecosystem in Tibetan Plateau using time-series SAR and Optical dataset

    NASA Astrophysics Data System (ADS)

    Brisco, B.; Wei, Q.; Xie, C.; Shao, Y.; Tian, B.; Li, K.

    2017-12-01

    As a highly productive and sensitive ecosystem, plateau wetlands provide indispensable habitats for the black-necked crane, an endangered species of crane. In this research, we focus on Longbao plateau wetland, the only habitat of black-necked crane in Tibetan Plateau, located in Yushu, Qinghai province, with an area of about 100 km2 and elevation about 4100 4200m. Monitoring Longbao wetland during the past 30 years using time series SAR and optical dataset and analysis its effect on black-necked crane have great significance for endangered species protection. Water and vegetation resources are two important indicators of wetland productivity. In this study, we aim at providing the open water area dynamics and the variation of vegetation during the past 30 years using SAR and optical imageries and analyzing their effect on black-necked cranes. The changes of the open water area and NDVI reflect the environment variety of Longbao wetland. And the relationship between these biological parameters and climates were analyzed, especially their influence on the black-necked cranes, which is the only kind of crane in the world that grows and breeds in the plateau. The method of level set segmentation with KummerU distribution was applied to open water bodies (wetlands) delimitation using time series SAR dataset, including Envisat-ASAR acquired from 2003 to 2010 and Radasat-2 from 2013 to 2014. Also the NDVI is calculated from Landsat images (acquired during 2003-2015) using google earth engine which is a cloud-based platform for planetary-scale environmental data analysis.The results indicate that the open water area fluctuates with seasons and reaches the maximum in summer. While in the spring and winter the wetland is usually covered by ice and snow. The highest values of NDVI occurred in years with a sufficient amount of precipitation. The abundant vegetation, water and suitable temperature of Longbao wetland in summer effectively promote the boost and growth of the chicks of black-necked cranes. The results of this study show that the open water area of Longbao wetland has expanded from 3.50km2 to 3.97km2 slowly from 2003 to 2014. The open water area has stronger correlation with precipitation than other climate factors. We will continue to analyze the change of NDVI and how they affect the black-necked crane.

  16. Sew it up! A Western Trauma Association multi-institutional study of enteric injury management in the postinjury open abdomen.

    PubMed

    Burlew, Clay Cothren; Moore, Ernest E; Cuschieri, Joseph; Jurkovich, Gregory J; Codner, Panna; Crowell, Kody; Nirula, Ram; Haan, James; Rowell, Susan E; Kato, Catherine M; MacNew, Heather; Ochsner, M Gage; Harrison, Paul B; Fusco, Cynthia; Sauaia, Angela; Kaups, Krista L

    2011-02-01

    Use of damage control surgery techniques has reduced mortality in critically injured patients but at the cost of the open abdomen. With the option of delayed definitive management of enteric injuries, the question of intestinal repair/anastomosis or definitive stoma creation has been posed with no clear consensus. The purpose of this study was to determine outcomes on the basis of management of enteric injuries in patients relegated to the postinjury open abdomen. Patients requiring an open abdomen after trauma from January 1, 2002 to December 31, 2007 were reviewed. Type of bowel repair was categorized as immediate repair, immediate anastomosis, delayed anastomosis, stoma and a combination. Logistic regression was used to determine independent effect of risk factors on leak development. During the 6-year study period, 204 patients suffered enteric injuries and were managed with an open abdomen. The majority was men (77%) sustaining blunt trauma (66%) with a mean age of 37.1 years±1.2 years and median Injury Severity Score of 27 (interquartile range=20-41). Injury patterns included 81 (40%) small bowel, 37 (18%) colonic, and 86 (42%) combined injuries. Enteric injuries were managed with immediate repair (58), immediate anastomosis (15), delayed anastomosis (96), stoma (10), and a combination (22); three patients died before definitive repair. Sixty-one patients suffered intra-abdominal complications: 35 (17%) abscesses, 15 (7%) leaks, and 11 (5%) enterocutaneous fistulas. The majority of patients with leaks had a delayed anastomosis; one patient had a right colon repair. Leak rate increased as one progresses toward the left colon (small bowel anastomoses, 3% leak rate; right colon, 3%; transverse colon, 20%; left colon, 45%). There were no differences in emergency department physiology, injury severity, transfusions, crystalloids, or demographic characteristics between patients with and without leak. Leak cases had higher 12-hour heart rate (148 vs. 125, p=0.02) and higher 12-hour base deficit (13.7 vs. 9.7, p=0.04), suggesting persistent shock and consequent hypoperfusion were related to leak development. There was a significant trend toward higher incidence of leak with closure day (χ for trend, p=0.01), with closure after day 5 having a four times higher likelihood of developing leak (3% vs. 12%, p=0.02). Repair or anastomosis of intestinal injuries should be considered in all patients. However, leak rate increases with fascial closure beyond day 5 and with left-sided colonic anastomoses. Investigating the physiologic basis for intestinal vulnerability of the left colon and in the open abdomen is warranted.

  17. A study of institutional spending on open access publication fees in Germany.

    PubMed

    Jahn, Najko; Tullney, Marco

    2016-01-01

    Publication fees as a revenue source for open access publishing hold a prominent place on the agendas of researchers, policy makers, and academic publishers. This study contributes to the evolving empirical basis for funding these charges and examines how much German universities and research organisations spent on open access publication fees. Using self-reported cost data from the Open APC initiative, the analysis focused on the amount that was being spent on publication fees, and compared these expenditure with data from related Austrian (FWF) and UK (Wellcome Trust, Jisc) initiatives, in terms of both size and the proportion of articles being published in fully and hybrid open access journals. We also investigated how thoroughly self-reported articles were indexed in Crossref, a DOI minting agency for scholarly literature, and analysed how the institutional spending was distributed across publishers and journal titles. According to self-reported data from 30 German universities and research organisations between 2005 and 2015, expenditures on open access publication fees increased over the years in Germany and amounted to € 9,627,537 for 7,417 open access journal articles. The average payment was € 1,298, and the median was € 1,231. A total of 94% of the total article volume included in the study was supported in accordance with the price cap of € 2,000, a limit imposed by the Deutsche Forschungsgemeinschaft (DFG) as part of its funding activities for open access funding at German universities. Expenditures varied considerably at the institutional level. There were also differences in how much the institutions spent per journal and publisher. These differences reflect, at least in part, the varying pricing schemes in place including discounted publication fees. With an indexing coverage of 99%, Crossref thoroughly indexed the open access journals articles included in the study. A comparison with the related openly available cost data from Austria and the UK revealed that German universities and research organisations primarily funded articles in fully open access journals. By contrast, articles in hybrid journal accounted for the largest share of spending according to the Austrian and UK data. Fees paid for hybrid journals were on average more expensive than those paid for fully open access journals.

  18. A study of institutional spending on open access publication fees in Germany

    PubMed Central

    Tullney, Marco

    2016-01-01

    Publication fees as a revenue source for open access publishing hold a prominent place on the agendas of researchers, policy makers, and academic publishers. This study contributes to the evolving empirical basis for funding these charges and examines how much German universities and research organisations spent on open access publication fees. Using self-reported cost data from the Open APC initiative, the analysis focused on the amount that was being spent on publication fees, and compared these expenditure with data from related Austrian (FWF) and UK (Wellcome Trust, Jisc) initiatives, in terms of both size and the proportion of articles being published in fully and hybrid open access journals. We also investigated how thoroughly self-reported articles were indexed in Crossref, a DOI minting agency for scholarly literature, and analysed how the institutional spending was distributed across publishers and journal titles. According to self-reported data from 30 German universities and research organisations between 2005 and 2015, expenditures on open access publication fees increased over the years in Germany and amounted to € 9,627,537 for 7,417 open access journal articles. The average payment was € 1,298, and the median was € 1,231. A total of 94% of the total article volume included in the study was supported in accordance with the price cap of € 2,000, a limit imposed by the Deutsche Forschungsgemeinschaft (DFG) as part of its funding activities for open access funding at German universities. Expenditures varied considerably at the institutional level. There were also differences in how much the institutions spent per journal and publisher. These differences reflect, at least in part, the varying pricing schemes in place including discounted publication fees. With an indexing coverage of 99%, Crossref thoroughly indexed the open access journals articles included in the study. A comparison with the related openly available cost data from Austria and the UK revealed that German universities and research organisations primarily funded articles in fully open access journals. By contrast, articles in hybrid journal accounted for the largest share of spending according to the Austrian and UK data. Fees paid for hybrid journals were on average more expensive than those paid for fully open access journals. PMID:27602289

  19. Blindness following bleb-related infection in open angle glaucoma.

    PubMed

    Yamada, Hiroki; Sawada, Akira; Kuwayama, Yasuaki; Yamamoto, Tetsuya

    2014-11-01

    To estimate the risk of blindness following bleb-related infection after trabeculectomy with mitomycin C in open angle glaucoma, utilizing data obtained from two prospective multicenter studies. The incidence of bleb-related infection in open angle glaucoma after the first or second glaucoma surgery was calculated using a Kaplan-Meier analysis and data from the Collaborative Bleb-related Infection Incidence and Treatment Study (CBIITS). The rate of blindness following bleb-related infection was calculated using data from the Japan Glaucoma Society Survey of Bleb-related Infection (JGSSBI). Finally, the rate of blindness following bleb-related infection after filtering surgery was estimated based on the above two data sets. Blindness was defined as an eye with a visual acuity of 0.04 or less. The incidences of development of bleb-related infection at 5 years were 2.6 ± 0.7 % (calculated cumulative incidence ± standard error) for all infections and 0.9 ± 0.4 % for endophthalmitis in all cases in the CBIITS data. The rates of blindness in the JGSSBI data were 14 % for the total cases with bleb-related infection and 30 % for the endophthalmitis subgroup. The rate of blindness developing within 5 years following trabeculectomy was estimated to be approximately 0.24-0.36 %. The rate of blindness following bleb-related infection within 5 years after trabeculectomy is considerable and thus careful consideration must be given to the indication for trabeculectomy and the selection of surgical techniques.

  20. Conservative management versus endovascular or open surgery in the spectrum of type B aortic dissection.

    PubMed

    Yuan, Xun; Mitsis, Andreas; Ghonem, Mohammed; Iakovakis, Ilias; Nienaber, Christoph A

    2018-01-01

    Type B aortic dissection is a life-threatening acute aortic condition often with acute ischemic signs or symptoms. With initial management focusing on alleviating malperfusion and pain, and avoiding propagation of dissection or rupture both systolic blood and pulse pressure should be reduced initially by an aggressive medical approach. In the setting of persistent signs of complications endovascular strategies have replaced open surgery and led to a fourfold increase in early survival and better long-term outcomes. An electronic health database search was performed on articles published between January 2006 and July 2017. Publications were included in this review if (I) the index aortic pathology was type B aortic (distal) dissection; (II) when medical management, open surgical replacement or thoracic endovascular aortic repair were among those options; (III) when at least one of all basic outcome criteria such as survival, spinal cord ischemia and cerebrovascular accident was reported; (IV) when ≥15 serial patients were included. A total of 62 studies were eligible and analysed. Our manuscript has summarized data collected over 12 years on management specific outcomes in the setting of distal aortic dissection and provides an up-to-date interpretation of the published evidence. For complicated cases, treated acutely, the 30-day or in-hospital mortality was 7.3% when managed by endovascular means, whereas the pooled rate for 30-day or in-hospital mortality was 19.0% when subjected to open repair. For acute uncomplicated type B dissection usually treated with blood pressure lowering medications, the pooled 30-day or in-hospital mortality rate was 2.4%. Survival rates at 5 years averaged at 60% (40% mortality). Freedom from any aortic event ranged from 34.0% to 83.9%, underlining an inherent risk of progression and late complications. For chronic complicated type B dissection, the rates of stroke, paraplegia and operative mortality following endovascular repair ranged from 5% to 13%, 2% to 13% and 2 to 13%, respectively, while 5-year survival rates after open repair ranged from 60% to 90%. In chronic uncomplicated type B dissection almost 90% of patients survive initial hospitalization and were subjected to medical management with a 5-year survival of 50-80%. However, up to 20-55% of medically treated patients develop aneurysmal degeneration after 5 years with an unknown risk of rupture. Currently, the less invasive strategy of endovascular repair (as compared to open surgery) provides improved 30-day or in-hospital survival in the setting of complicated acute type B aortic dissection and may seek broad application. Open surgical aortic reconstruction should be left to experienced aortic centres if endovascular management is not an option.

  1. Effects of the opening of the Qinghai-Tibet Railway on municipal solid waste management generation in Lhasa.

    PubMed

    Ding, Xu-Tong; Wang, Ji-Hua

    2018-03-01

    Lhasa, the capital of Tibet, is located on the Tibetan Plateau. Accelerated economic development and flourishing tourism resulting from the opening of the Qinghai-Tibet Railway (QTR) have increased solid waste generation and contamination in recent years. Using data from Lhasa Statistical Yearbooks and previous studies, this study estimates the future population of permanent residents and tourists using the least squares method to extrapolate the population from 2015-2025, and evaluates the effects of the QTR on municipal solid waste (MSW) generation in Lhasa and estimates future MSW generation. There were approximately 1.35 million tourists in 2008 when the QTR had been operating for 2 years and MSW generation was approximately 470 tons per day. The amount of MSW generated increased dramatically with time after opening the QTR. This study estimates that MSW generation will reach 962 tons per day in 2025. Due to the existence of the QTR, increasing numbers of people are traveling to Lhasa, and tourism has driven the development of the local economy. During the studies, the proportion of MSW produced by tourists increased from 2.99% to 20.06%, and it is estimated that it will increase to 33.49% in 2025. If the current trend continues, Lhasa will face significant challenges from garbage disposal. This study analyzes the current situation of urban garbage treatment in Lhasa, and it suggests several options for improvement to MSW generation, transportation equipment, disposal, and resource recycling.

  2. Scientific Journal Publishing: Yearly Volume and Open Access Availability

    ERIC Educational Resources Information Center

    Bjork, Bo-Christer; Roos, Annikki; Lauri, Mari

    2009-01-01

    Introduction: We estimate the total yearly volume of peer-reviewed scientific journal articles published world-wide as well as the share of these articles available openly on the Web either directly or as copies in e-print repositories. Method: We rely on data from two commercial databases (ISI and Ulrich's Periodicals Directory) supplemented by…

  3. Association between open or closed reduction and avascular necrosis in developmental dysplasia of the hip: A PRISMA-compliant meta-analysis of observational studies.

    PubMed

    Wang, Ya-Jie; Yang, Fan; Wu, Qi-Jun; Pan, Shi-Nong; Li, Lian-Yong

    2016-07-01

    The risk of avascular necrosis of the femoral head (AVN) after treatment of developmental dysplasia of the hip is associated with the method of reduction. Some authors have suggested that open reduction is a risk factor for AVN; however, this is controversial. To our knowledge, a quantitative comparison of the incidence of AVN between closed and open reduction has not been conducted. Published studies were identified by searching PubMed, EMBASE, and the Cochrane Library up to May, 2015, focusing on the incidence of AVN after closed or open reduction for developmental dysplasia of the hip in children aged <3 years. Patients were age-matched who were treated by either closed or open reduction, but without pelvic or femoral osteotomy. Two authors independently assessed eligibility and abstracted data. Discrepancies were discussed and resolved by consensus. We pooled the odds ratios (ORs) and 95% confidence intervals (95%CIs) from individual studies using a random-effects model and evaluated heterogeneity and publication bias. Nine retrospective studies were included in this analysis. The pooled OR for comparing open reduction with closed reduction for all grades of AVN was 2.26 (95%CI = 1.21-4.22), with moderate heterogeneity (I = 44.7%, P = 0.107). The pooled OR for grades II to IV AVN was 2.46 (95%CI = 0.93-6.51), with high heterogeneity (I = 69.6%, P = 0.003). A significant association was also found for the further surgery between open and closed reduction, with a pooled OR of 0.30 (95%CI = 0.15-0.60) and moderate heterogeneity (I = 46.4%, P = 0.133). No evidence of publication bias or significant heterogeneity between subgroups was detected by meta-regression analyses. Findings from this meta-analysis suggest that open reduction is a risk factor for the development of AVN compared with closed treatment. Future studies are warranted to investigate how open reduction combined with pelvis and/or femoral osteotomy affects the incidence of AVN.

  4. Factors associated with anterior open bite in children with developmental disabilities.

    PubMed

    de Castilho, Lia Silva; Abreu, Mauro Henrique Nogueira Guimarães; Pires E Souza, Luiz Gustavo de Almeida; Romualdo, Leiliane Teresinha de Almeida; Souza E Silva, Maria Elisa; Resende, Vera Lúcia Silva

    2018-01-01

    To investigate factors associated with anterior open bite in individuals aged from 2 to 33 years with developmental disabilities. This is a cross-sectional study. A total of 271 dental records were examined. The anterior open bite analyzed was determined based on clinic exam. These variables were also analyzed: gender, age, education level of mother, International Code of Diseases (ICD), mouth breathing, use of anticonvulsant drugs, hyperkinesis, pacifier use, thumb sucking, seizure, and involuntary movements. For the purposes of analysis, the individuals were categorized as being with and without anterior open bite. Variables with a p-value of < 0.25 in the bivariate analysis were incorporated into the logistic regression models. Mouth breathers had a 2.60-fold (95% CI: 1.35-5.01) greater chance of exhibiting anterior open bite than nasal breathers. Pacifier users are more likely to have an anterior open bite (3.32-fold, 95% CI: 1.62-6.77). Individuals with reported involuntary movements had a 2.66-fold (95% CI: 1.26-5.63) greater chance of exhibiting anterior open bite. Users of anticonvulsants drugs had a 3.05 (95% CI: 1.57-5.92) greater chance of showing anterior open bite. Involuntary movements, mouth breathing, using anticonvulsant drugs, and using pacifier are factors associated with anterior open bite in patients with developmental disabilities. © 2017 Special Care Dentistry Association and Wiley Periodicals, Inc.

  5. Cost and effectiveness of lung lobectomy by video-assisted thoracic surgery for lung cancer

    PubMed Central

    Mafé, Juan J.; Planelles, Beatriz; Asensio, Santos; Cerezal, Jorge; Inda, María-del-Mar; Lacueva, Javier; Esteban, Maria-Dolores; Hernández, Luis; Martín, Concepción; Baschwitz, Benno

    2017-01-01

    Background Video-assisted thoracic surgery (VATS) emerged as a minimally invasive surgery for diseases in the field of thoracic surgery. We herein reviewed our experience on thoracoscopic lobectomy for early lung cancer and evaluated Health System use. Methods A cost-effectiveness study was performed comparing VATS vs. open thoracic surgery (OPEN) for lung cancer patients. Demographic data, tumor localization, dynamic pulmonary function tests [forced vital capacity (FVC), forced expiratory volume in one second (FEV1), diffusion capacity (DLCO) and maximal oxygen uptake (VO2max)], surgical approach, postoperative details, and complications were recorded and analyzed. Results One hundred seventeen patients underwent lung resection by VATS (n=42, 36%; age: 63±9 years old, 57% males) or OPEN (n=75, 64%; age: 61±11 years old, 73% males). Pulmonary function tests decreased just after surgery with a parallel increasing tendency during first 12 months. VATS group tended to recover FEV1 and FVC quicker with significantly less clinical and post-surgical complications (31% vs. 53%, P=0.015). Costs including surgery and associated hospital stay, complications and costs in the 12 months after surgery were significantly lower for VATS (P<0.05). Conclusions The VATS approach surgery allowed earlier recovery at a lower cost than OPEN with a better cost-effectiveness profile. PMID:28932560

  6. The Perpetuation of Risk: Organizational and Institutional Policies and Practices in a Title 1 School

    ERIC Educational Resources Information Center

    McMahon, Brenda

    2011-01-01

    This empirical mixed methods study examines educators' understandings of student risk factors. The research was conducted in a Title 1 combination middle high school in the Florida panhandle that had been open for three years and had received a grade of F school in each of these years. In Florida, schools are graded according to the Florida…

  7. Learning Communities for Students in Developmental English: Impact Studies at Merced College and the Community College of Baltimore County

    ERIC Educational Resources Information Center

    Weissman, Evan; Cullinan, Dan; Cerna, Oscar; Safran, Stephanie; Richman, Phoebe

    2012-01-01

    Across the United States, community colleges offer millions of students an open-access, low-cost postsecondary education. However, of the students who enroll in community college hoping to earn a credential or transfer to a four-year institution, only about half achieve their goal within six years. For students who enter college needing…

  8. The Development of Co-Speech Gesture and Its Semantic Integration with Speech in 6- to 12-Year-Old Children with Autism Spectrum Disorders

    ERIC Educational Resources Information Center

    So, Wing-Chee; Wong, Miranda Kit-Yi; Lui, Ming; Yip, Virginia

    2015-01-01

    Previous work leaves open the question of whether children with autism spectrum disorders aged 6-12?years have delay in producing gestures compared to their typically developing peers. This study examined gestural production among school-aged children in a naturalistic context and how their gestures are semantically related to the accompanying…

  9. Understory fern community structure, growth and spore production responses to a large-scale hurricane experiment in a Puerto Rico rainforest

    Treesearch

    Joanne M. Sharpe; Aaron B. Shiels

    2014-01-01

    Ferns are abundant in most rainforest understories yet their responses to hurricanes have not been well studied. Fern community structure, growth and spore production were monitored for two years before and five years after a large-scale experiment that simulated two key components of severe hurricane disturbance: canopy openness and debris deposition. The canopy was...

  10. Deep Venous Procedures Performed in the National Health Service in England between 2005 and 2015.

    PubMed

    Lim, C S; Shalhoub, J; Davies, A H

    2017-10-01

    Recent advances in imaging technology and endovenous interventions have revolutionised the management of specific groups of patients with deep venous pathology. This study aimed to examine data published by Hospital Episode Statistics (HES) to assess trends in the number of endovascular and open surgical deep venous procedures performed in National Health Service (NHS) hospitals in England between 2005 and 2015. The main diagnosis of deep venous thrombosis (DVT), and total number of primary open and percutaneous procedures for deep venous pathology for patients admitted to the NHS hospitals in England from 2005 to 2015 were retrieved from the HES database and analysed. An overall declining trend in the annual number of admissions for a primary diagnosis of DVT was observed (linear regression r 2  = 0.9, p < .0001). The number of open surgical procedures for removal of thrombus remained largely unchanged (range 26-70); the frequency of percutaneous procedures increased steadily over the study period (range 0-311). The number of open surgical procedures relating to the vena cava fell between 2005 and 2009, and remained around 50 per year thereafter. Annual numbers of cases of deep venous bypass (range 17-33) and venous valve surgery (range 8-47) remained similar in trend over this period. The number of vena cava stent (range 0-405), other venous stent (range 0-316), and percutaneous venoplasty (range 0-972) procedures increased over the first 5 years of the study period. There is an increasing trend in relation to endovenous procedures but not open surgery, being carried out for deep venous pathology in the last decade in NHS hospitals in England. Despite a number of limitations with HES, the increase in the number of endovenous procedures shown is likely to have significant implications for the provision of care and healthcare resources for patients with deep venous pathology. Copyright © 2017 European Society for Vascular Surgery. Published by Elsevier Ltd. All rights reserved.

  11. Local and regional effects of reopening a tidal inlet on estuarine water quality, seagrass habitat, and fish assemblages

    NASA Astrophysics Data System (ADS)

    Milbrandt, Eric C.; Bartleson, Richard D.; Coen, Loren D.; Rybak, Olexandr; Thompson, Mark A.; DeAngelo, Jacquelyn A.; Stevens, Philip W.

    2012-06-01

    Blind Pass is an inlet that separates Sanibel and Captiva Islands in southwest Florida but has historically closed and opened by both anthropogenic and natural processes. In July 2010, a dredging project to open the small inlet between the two barrier islands was completed. The objective of this study was to use and supplement ongoing estuary-monitoring programs to examine the responses of water quality, seagrass habitat metrics, and fish assemblages both in the immediate vicinity of the inlet and at broader scales (up to 40 km2). As far as we are aware, there are no previous studies with this intensity of sampling, both before and after an inlet opening. Significant increases in salinity and turbidity were observed inside Blind Pass, with significant decreases in CDOM and chlorophyll a, however, the effects were not far-reaching and limited to less than 1.7 km from the inlet within Pine Island Sound. Seagrass habitat metrics were expected to respond rapidly after the inlet was opened given the reduced light attenuation. However, there were no changes in shoot densities, species composition, and epiphytic algae within the approximately one-year duration of the study. The reopening of the pass did not substantially change fish assemblage structure, except for those from deeper habitats. Although immediate increases in the abundances of estuarine-dependent species were predicted in shallow habitats post opening, this did not occur. In conclusion, the effects of reopening a relatively small ocean inlet on water quality were apparent in the immediate vicinity of the inlet (within 1.7 km), but far-reaching effects on water quality, seagrass metrics, and fish assemblages were not immediately apparent in this well-flushed estuary. If subtle changes in tidal exchange and circulation affect productivity of seagrasses or its fish assemblages at broad scales, it may take several years to reach a steady state.

  12. Robot-assisted minimally invasive thoraco-laparoscopic esophagectomy versus open transthoracic esophagectomy for resectable esophageal cancer, a randomized controlled trial (ROBOT trial).

    PubMed

    van der Sluis, Pieter C; Ruurda, Jelle P; van der Horst, Sylvia; Verhage, Roy J J; Besselink, Marc G H; Prins, Margriet J D; Haverkamp, Leonie; Schippers, Carlo; Rinkes, Inne H M Borel; Joore, Hans C A; Ten Kate, Fiebo Jw; Koffijberg, Hendrik; Kroese, Christiaan C; van Leeuwen, Maarten S; Lolkema, Martijn P J K; Reerink, Onne; Schipper, Marguerite E I; Steenhagen, Elles; Vleggaar, Frank P; Voest, Emile E; Siersema, Peter D; van Hillegersberg, Richard

    2012-11-30

    For esophageal cancer patients, radical esophagolymphadenectomy is the cornerstone of multimodality treatment with curative intent. Transthoracic esophagectomy is the preferred surgical approach worldwide allowing for en-bloc resection of the tumor with the surrounding lymph nodes. However, the percentage of cardiopulmonary complications associated with the transthoracic approach is high (50 to 70%).Recent studies have shown that robot-assisted minimally invasive thoraco-laparoscopic esophagectomy (RATE) is at least equivalent to the open transthoracic approach for esophageal cancer in terms of short-term oncological outcomes. RATE was accompanied with reduced blood loss, shorter ICU stay and improved lymph node retrieval compared with open esophagectomy, and the pulmonary complication rate, hospital stay and perioperative mortality were comparable. The objective is to evaluate the efficacy, risks, quality of life and cost-effectiveness of RATE as an alternative to open transthoracic esophagectomy for treatment of esophageal cancer. This is an investigator-initiated and investigator-driven monocenter randomized controlled parallel-group, superiority trial. All adult patients (age ≥ 18 and ≤ 80 years) with histologically proven, surgically resectable (cT1-4a, N0-3, M0) esophageal carcinoma of the intrathoracic esophagus and with European Clinical Oncology Group performance status 0, 1 or 2 will be assessed for eligibility and included after obtaining informed consent. Patients (n = 112) with resectable esophageal cancer are randomized in the outpatient department to either RATE (n = 56) or open three-stage transthoracic esophageal resection (n = 56). The primary outcome of this study is the percentage of overall complications (grade 2 and higher) as stated by the modified Clavien-Dindo classification of surgical complications. This is the first randomized controlled trial designed to compare RATE with open transthoracic esophagectomy as surgical treatment for resectable esophageal cancer. If our hypothesis is proven correct, RATE will result in a lower percentage of postoperative complications, lower blood loss, and shorter hospital stay, but with at least similar oncologic outcomes and better postoperative quality of life compared with open transthoracic esophagectomy. The study started in January 2012. Follow-up will be 5 years. Short-term results will be analyzed and published after discharge of the last randomized patient. Dutch trial register: NTR3291 ClinicalTrial.gov: NCT01544790.

  13. Cost comparison of laparoscopic colectomy versus open colectomy in colon cancer.

    PubMed

    Fitch, Kathryn; Bochner, Andrew; Keller, Deborah S

    2017-07-01

    Laparoscopic colectomy has been shown to be safe, oncologically comparable, and clinically beneficial over open colectomy for colon cancer, but utilization remains low. Objectives To evaluate the cost of laparoscopic colectomy vs open colectomy for colon cancer. The authors conducted a retrospective claims data analysis using the 2012 and 2013 Truven Health Analytics MarketScan Commercial Claims and Encounter Database. The denominator population consisted of individuals who had commercial insurance coverage in all months of 2012 and >1 month in 2013 and pharmacy coverage throughout eligibility. The study population included individuals aged 18-64 years who were identified with colon cancer in 2013 and underwent an elective inpatient open colectomy or laparoscopic colectomy between January and November 2013. The cost and re-admission rate of open vs laparoscopic colectomy were compared after risk, adjusting for comorbidities, demographics, and geographic region. During the study period, 1299 elective inpatient colon cancer colectomies were performed (open, n = 558; laparoscopic, n = 741). After risk adjustment, the laparoscopic vs open group was shown to have lower re-admission rates (6.61 and 10.93 per 100 cases, respectively, p = .0165), lower average re-admission costs ($1676 and $3151, respectively, p = .0309), and lower 30-day post-discharge healthcare utilization costs ($4842 and $7121, respectively, p = .0047). Average allowed cost for the combined inpatient and 30-day post-discharge period was lower for laparoscopic vs open colectomy cases ($36,395 and $44,226, respectively, p < .001). The cost of laparoscopic colectomy was found to be statistically significantly less than that of open colectomy in patients undergoing elective surgery for colon cancer.

  14. A Preliminary Examination of the Cost Savings and Learning Impacts of Using Open Textbooks in Middle and High School Science Classes

    ERIC Educational Resources Information Center

    Wiley, David; Hilton, John Levi, III; Ellington, Shelley; Hall, Tiffany

    2012-01-01

    Proponents of open educational resources claim that significant cost savings are possible when open textbooks displace traditional textbooks in the classroom. Over a period of two years, we worked with 20 middle and high school science teachers (collectively teaching approximately 3,900 students) who adopted open textbooks to understand the…

  15. Bupropion SR in Adolescents with Comorbid ADHD and Nicotine Dependence: A Pilot Study

    ERIC Educational Resources Information Center

    Upadhyaya, Himanshu P.; Brady, Kathleen T.; Wang, Wei

    2004-01-01

    Objective: Bupropion SR has been shown to be effective for the treatment of nicotine dependence in adults. This open-label pilot study was designed to examine the feasibility and preliminary tolerability of bupropion SR in adolescents with nicotine dependence. Method: Sixteen adolescents aged 12 to 19 years were enrolled in the study. Eleven of…

  16. Perspectives of Science Teacher Candidates Regarding Scientific Creativity and Critical Thinking

    ERIC Educational Resources Information Center

    Demir, Sibel

    2015-01-01

    This study was performed with the participation of 31 science teacher candidates in their second year of higher education, enrolled in the science education department of a university in Turkey. During the study, the teacher candidates were asked two open-ended questions. The validity of these questions developed specifically for this study was…

  17. Open exchange of data: the eGY pathway towards capacity building.

    NASA Astrophysics Data System (ADS)

    Barton, C.; Baker, D.; Cobabe-Ammann, E.; Fox, P.; Kihn, E.; Peterson, W. K.

    The Electronic Geophysical Year 2007-2008 eGY uses the 50-year anniversary of the acclaimed International Geophysical Year to advance open access to data information and services The International Polar Years of 1882-1882 and 1932-1933 taught us that free and open exchange of data between nations is cost effective The International Geophysical Year 1957-1958 taught us that free and open exchange of data between scientific disciplines generates new and exciting research The worldwide network of data centers and data standards initiated during IGY continues to foster research to this day And better things lie ahead As we approach the 50th anniversary of the IGY the development of distributed data systems allows worldwide connectivity to data and services at a level never before possible Such systems virtual observatories and so forth expand the free open and cross-disciplinary exchange of data by allowing users worldwide to access and manipulate data from principal data centers as well as from small previously isolated research groups The new information and communication technologies require that we adopt community-developed standards for data storage and description They also demand that we recognize and accommodate the shift in effort from the user to the provider that accompanies a change from the traditional user-pull to a modern provider-push data environment eGY provides an opportunity for coordinated discussions on data storage and description standards These standards have implications for the infrastructure needed to access and

  18. Thirty years of beta Pic and debris disks studies

    NASA Astrophysics Data System (ADS)

    Lagrange, Anne-Marie; Boccaletti, Anthony

    2015-01-01

    In the last 30 years, our knowledge of planetary systems has considerably evolved, in particular thanks to the development of observational techniques and computer simulations for modeling. From the observational point of view, emblematic discoveries thirty years ago have opened a way to dedicated studies, among which the IRAS detections of IR excess associated to dust surrounding main-sequence stars. Shortly after these discoveries, the first image of a debris disk around the star beta Pictoris in 1984 was made, followed in the 90's by the indirect detection of extrasolar planets and, a decade later, by the direct imaging of young giant planets. Beta Pictoris is a ground-breaking object for the study of formation and evolution of planetary systems. It is a unique system in many regards, as it is made of dust, planetesimals, comets and at least one giant planet. Observations with various techniques (imaging, spectroscopy, interferometry) at multiple wavelengths (from the UV to radio waves) have allowed significant progress in the understanding of this system. Yet, many questions are still open, and more results are expected in the coming decade thanks to the next generation of instruments like for instance ALMA, JWST, SPHERE and many others. To celebrate the thirtieth anniversary of the first debris disk image, we propose to gather experts on the analysis of beta Pictoris and interested colleagues to review and discuss the observational knowledge on this archetypal system (including the latest results), as well as its current understanding and related open questions to be addressed in the next decade, such as the history of the disk and planet formation, dynamical evolution, etc. Similar, well-studied debris disks systems with significant amount of observational data that allow in-depth modeling will be also presented and discussed. Second, in a two-days dedicated workshop, we will gather to define an action plan for the typically 3-5 next years to achieve a full, comprehensive description of the whole beta Pictoris system, and to organize the necessary work, and possible milestones. In the next years, a similar approach may, eventually, be applicable to other systems.

  19. Thirty years of beta Pic and debris disks studies

    NASA Astrophysics Data System (ADS)

    Lagrange, A.-M.; Boccaletti, A.

    2014-09-01

    In the last 30 years, our knowledge of planetary systems has considerably evolved, in particular thanks to the development of observational techniques and computer simulations for modeling. From the observational point of view, emblematic discoveries thirty years ago have opened a way to dedicated studies, among which the IRAS detections of IR excess associated to dust surrounding main-sequence stars. Shortly after these discoveries, the first image of a debris disk around the star beta Pictoris in 1984 was made, followed in the 90's by the indirect detection of extrasolar planets and, a decade later, by the direct imaging of young giant planets. Beta Pictoris is a ground-breaking object for the study of formation and evolution of planetary systems. It is a unique system in many regards, as it is made of dust, planetesimals, comets and at least one giant planet. Observations with various techniques (imaging, spectroscopy, interferometry) at multiple wavelengths (from the UV to radio waves) have allowed significant progress in the understanding of this system. Yet, many questions are still open, and more results are expected in the coming decade thanks to the next generation of instruments like for instance ALMA, JWST, SPHERE and many others. To celebrate the thirtieth anniversary of the first debris disk image, we propose to gather experts on the analysis of beta Pictoris and interested colleagues to review and discuss the observational knowledge on this archetypal system (including the latest results), as well as its current understanding and related open questions to be addressed in the next decade, such as the history of the disk and planet formation, dynamical evolution, etc. Similar, well-studied debris disks systems with significant amount of observational data that allow in-depth modeling will be also presented and discussed. Second, in a two-days dedicated workshop, we will gather to define an action plan for the typically 3-5 next years to achieve a full, comprehensive description of the whole beta Pictoris system, and to organize the necessary work, and possible milestones. In the next years, a similar approach may, eventually, be applicable to other systems.

  20. Open Day at SHMI.

    NASA Astrophysics Data System (ADS)

    Jarosova, M.

    2010-09-01

    During the World Meteorological Day there has been preparing "Open Day" at Slovak Hydrometeorological Institute. This event has more than 10 years traditions. "Open Day" is one of a lot of possibilities to give more information about meteorology, climatology, hydrology too to public. This "Day" is executed in whole Slovakia. People can visit the laboratories, the forecasting room....and meteo and clima measuring points. The most popular is visiting forecasting room. Visitors are interested in e.g. climatologic change in Slovakia territory, preparing weather forecasting, dangerous phenomena.... Every year we have more than 500 visitors.

  1. A case study on open innovation on Procter & Gamble. Part I: Innovation strategy over years

    NASA Astrophysics Data System (ADS)

    Agafitei, I. G.; Avasilcai, S.

    2015-11-01

    The purpose of the present paper is to analyse how product innovation process has been organized by a multinational company, such as Procter & Gamble. Since open innovation is a new approach on the local market, we have chosen to conduct a research in form of a case study showing the steps that the company has taken in order to involve other organizations to contribute to the development of new products. The paper will first describe what innovation management theory is suggesting. Following this, the mission and vision of Procter & Gamble will be analysed emphasizing its innovation efforts in time. The approach that the company has nowadays, related to development of new products, has its roots in several complex initiatives in the past, initiatives that have in their central attention the customer. Finally, it provides the research limitations and implications for future analysis on the case of Procter & Gamble open innovation approach.

  2. Open Tibial Inlay PCL Reconstruction: Surgical Technique and Clinical Outcomes.

    PubMed

    Vellios, Evan E; Jones, Kristofer J; McAllister, David R

    2018-06-01

    To review the current literature on clinical outcomes following open tibial inlay posterior cruciate ligament (PCL) reconstruction and provide the reader with a detailed description of the author's preferred surgical technique. Despite earlier biomechanical studies which demonstrated superiority of the PCL inlay technique when compared to transtibial techniques, recent longitudinal cohort studies have shown no significant differences in clinical or functional outcomes at 10-year follow-up. Furthermore, no significant clinical differences have been shown between graft types used and/or single- versus double-bundle reconstruction methods. The optimal treatment for the PCL-deficient knee remains unclear. Open tibial inlay PCL reconstruction is safe, reproducible, and avoids the "killer turn" that may potentially lead to graft weakening and failure seen in transtibial reconstruction methods. No significant differences in subjective outcomes or clinical laxity have been shown between single-bundle versus double-bundle reconstruction methods.

  3. The OSG Open Facility: an on-ramp for opportunistic scientific computing

    NASA Astrophysics Data System (ADS)

    Jayatilaka, B.; Levshina, T.; Sehgal, C.; Gardner, R.; Rynge, M.; Würthwein, F.

    2017-10-01

    The Open Science Grid (OSG) is a large, robust computing grid that started primarily as a collection of sites associated with large HEP experiments such as ATLAS, CDF, CMS, and DZero, but has evolved in recent years to a much larger user and resource platform. In addition to meeting the US LHC community’s computational needs, the OSG continues to be one of the largest providers of distributed high-throughput computing (DHTC) to researchers from a wide variety of disciplines via the OSG Open Facility. The Open Facility consists of OSG resources that are available opportunistically to users other than resource owners and their collaborators. In the past two years, the Open Facility has doubled its annual throughput to over 200 million wall hours. More than half of these resources are used by over 100 individual researchers from over 60 institutions in fields such as biology, medicine, math, economics, and many others. Over 10% of these individual users utilized in excess of 1 million computational hours each in the past year. The largest source of these cycles is temporary unused capacity at institutions affiliated with US LHC computational sites. An increasing fraction, however, comes from university HPC clusters and large national infrastructure supercomputers offering unused capacity. Such expansions have allowed the OSG to provide ample computational resources to both individual researchers and small groups as well as sizable international science collaborations such as LIGO, AMS, IceCube, and sPHENIX. Opening up access to the Fermilab FabrIc for Frontier Experiments (FIFE) project has also allowed experiments such as mu2e and NOvA to make substantial use of Open Facility resources, the former with over 40 million wall hours in a year. We present how this expansion was accomplished as well as future plans for keeping the OSG Open Facility at the forefront of enabling scientific research by way of DHTC.

  4. The OSG Open Facility: An On-Ramp for Opportunistic Scientific Computing

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

    Jayatilaka, B.; Levshina, T.; Sehgal, C.

    The Open Science Grid (OSG) is a large, robust computing grid that started primarily as a collection of sites associated with large HEP experiments such as ATLAS, CDF, CMS, and DZero, but has evolved in recent years to a much larger user and resource platform. In addition to meeting the US LHC community’s computational needs, the OSG continues to be one of the largest providers of distributed high-throughput computing (DHTC) to researchers from a wide variety of disciplines via the OSG Open Facility. The Open Facility consists of OSG resources that are available opportunistically to users other than resource ownersmore » and their collaborators. In the past two years, the Open Facility has doubled its annual throughput to over 200 million wall hours. More than half of these resources are used by over 100 individual researchers from over 60 institutions in fields such as biology, medicine, math, economics, and many others. Over 10% of these individual users utilized in excess of 1 million computational hours each in the past year. The largest source of these cycles is temporary unused capacity at institutions affiliated with US LHC computational sites. An increasing fraction, however, comes from university HPC clusters and large national infrastructure supercomputers offering unused capacity. Such expansions have allowed the OSG to provide ample computational resources to both individual researchers and small groups as well as sizable international science collaborations such as LIGO, AMS, IceCube, and sPHENIX. Opening up access to the Fermilab FabrIc for Frontier Experiments (FIFE) project has also allowed experiments such as mu2e and NOvA to make substantial use of Open Facility resources, the former with over 40 million wall hours in a year. We present how this expansion was accomplished as well as future plans for keeping the OSG Open Facility at the forefront of enabling scientific research by way of DHTC.« less

  5. Work satisfaction and dissatisfaction--caregivers' experiences after a two-year intervention in a newly opened nursing home.

    PubMed

    Häggström, Elisabeth; Skovdahl, Kirsti; Fläckman, Birgitta; Kihlgren, Annika L; Kihlgren, Mona

    2005-01-01

    The aim of the study was to investigate, from the narratives of nine enrolled nurses and one nurses' aide directly involved in patient care, the deeper meaning of work satisfaction and dissatisfaction when working with the older people. Both nationally and internationally, there is little research documented regarding the working situation of the enrolled nurses and nurses' aides who make up the majority of care for older people today. With this in mind, it is important to focus on how these occupational groups experience their work with the older residents in municipal care, following a two-year intervention. The study is part of a larger longitudinal study, with a quasi-experimental design within the municipal system of care for older people in Sweden. The investigation was carried out following a two-year intervention, which included: education, support and clinical supervision. The interviews were performed 12 and 24 months after start of the intervention and were analysed with a phenomenological-hermeneutic method inspired by Ricoeur's philosophy. The findings from these narratives illustrated a change compared with the findings from the first interviews, when the nursing home had just opened. There was a shift from a dominance of dissatisfaction with work, to a dominance of work satisfaction and this was expressed in the following themes: experience of a changed perspective, experience of open doors, and experience of closed doors. Each theme emerged from several different subthemes and each subtheme that had been expressed in the caregivers' narratives was interpreted. The study shows that the caregivers' experience of work satisfaction in the workplace exceeded their experience of dissatisfaction and that the intervention, consisting of: education, support, and supervision might have facilitated this positive development where the older residents were prioritized. It also shows that communication and understanding between management and staff had increased as the nursing home had opened. The findings can be used to help to prevent work dissatisfaction, and thereby increase work satisfaction for caregivers working in nursing homes.

  6. Viral Etiologies of Lower Respiratory Tract Infections Among Egyptian Children under Five Years of Age

    DTIC Science & Technology

    2012-12-13

    Infectious Diseases © 2012 Shafik et al. This is an open access article distributed under the terms of the Creative Commons Attribution License (http... SAR ) 18. NUMBER OF PAGES 19 19a. NAME OF RESPONSIBLE PERSON a. REPORT unclassified b. ABSTRACT unclassified c. THIS PAGE unclassified...in FLUAV burden between the two studies, particularly because the Tang et al. and Zhang et al. studies tested children up to 16 years of age. Other

  7. Glaucoma incidence in an unselected cohort of diabetic patients: is diabetes mellitus a risk factor for glaucoma? DARTS/MEMO collaboration. Diabetes Audit and Research in Tayside Study. Medicines Monitoring Unit.

    PubMed

    Ellis, J D; Evans, J M; Ruta, D A; Baines, P S; Leese, G; MacDonald, T M; Morris, A D

    2000-11-01

    To evaluate whether diabetes mellitus is a risk factor for the development of primary open angle glaucoma or ocular hypertension (OHT). A historical cohort study of an unselected population comprising all residents of the Tayside region of Scotland was performed using record linkage techniques followed by case note review. Ascertainment of prevalent diabetes was achieved using the Diabetes Audit and Research in Tayside Study (DARTS) validated regional diabetes register. Glaucoma and treated OHT were defined by encashment of community prescriptions and the statutory surgical procedure coding database. The study population comprised 6631 diabetic subjects and 166 144 non-diabetic subjects aged >40 years without glaucoma or OHT at study entry. 65 patients with diabetes and 958 without diabetes were identified as new cases of glaucoma or treated OHT during the 24 month study period, yielding a standardised morbidity ratio of 127 (95% CI, 96-158). Case note review demonstrated non-differential misclassification of prevalent glaucoma and OHT as incident disease (diabetic cohort 20%, non-diabetic cohort 24%; p=0.56) primarily as a result of non-compliance in medically treated disease. Removing misclassified cases and adjusting for age yielded an incidence of primary open angle glaucoma in diabetes of 1.1/1000 patient years (95% CI, 0.89-1. 31) compared to 0.7/1000 patient years (95% CI, 0.54-0.86) in the non-diabetic cohort; RR 1.57 (95% CI, 0.99-2.48). This study failed to confirm an association between diabetes mellitus and primary open angle glaucoma and ocular hypertension. A non-significant increase in diagnosed and treated disease in the diabetic population was observed, but evidence was also found that detection bias contributes to this association.

  8. Evaluation of the Trends, Concomitant Procedures, and Complications With Open and Arthroscopic Rotator Cuff Repairs in the Medicare Population

    PubMed Central

    Jensen, Andrew R.; Cha, Peter S.; Devana, Sai K.; Ishmael, Chad; Di Pauli von Treuheim, Theo; D’Oro, Anthony; Wang, Jeffrey C.; McAllister, David R.; Petrigliano, Frank A.

    2017-01-01

    Background: Medicare insures the largest population of patients at risk for rotator cuff tears in the United States. Purpose: To evaluate the trends in incidence, concomitant procedures, and complications with open and arthroscopic rotator cuff repairs in Medicare patients. Study Design: Cohort study; Level of evidence, 3. Methods: All Medicare patients who had undergone open or arthroscopic rotator cuff repair from 2005 through 2011 were identified with a claims database. Annual incidence, concomitant procedures, and postoperative complications were compared between these 2 groups. Results: In total, 372,109 rotator cuff repairs were analyzed. The incidence of open repairs decreased (from 6.0 to 4.3 per 10,000 patients, P < .001) while the incidence of arthroscopic repairs increased (from 4.5 to 7.8 per 10,000 patients, P < .001) during the study period. Patients in the arthroscopic group were more likely to have undergone concomitant subacromial decompression than those in the open group (87% vs 35%, P < .001), and the annual incidence of concomitant biceps tenodesis increased for both groups (from 3.8% to 11% for open and 2.2% to 16% for arthroscopic, P < .001). While postoperative complications were infrequent, patients in the open group were more likely to be diagnosed with infection within 6 months (0.86% vs 0.37%, P < .001) but no more likely to undergo operative debridement (0.43% vs 0.26%, P = .08). Additionally, patients in the open group were more likely to undergo intervention for shoulder stiffness within 1 year (1.4% vs 1.1%, P = .01). Conclusion: In the Medicare population, arthroscopic rotator cuff repairs have increased in incidence and now represent the majority of rotator cuff repair surgery. Among concomitant procedures, subacromial decompression was most commonly performed despite evidence suggesting a lack of efficacy. Infections and stiffness were rare complications that were slightly but significantly more frequent in open rotator cuff repairs. PMID:29051905

  9. A feasibility study to determine if there is a market for automatic meter-reading devices

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

    Hilberg, G.R.

    1996-08-01

    For many utilities the cost of manually reading meters is increasing due to personnel expenses and equipment costs. The current system of manual meters provides little ability for the utility to reduce costs. To reduce meter reading costs the utility must automate the manual system and reduce personnel expenses. A water utility in San Diego county was studied to calculate the cost of reading individual water meters. This would allow for the selective replacement of {open_quotes}high-cost{close_quotes} meters to quickly reduce meter-reading costs while limiting the necessary capital investments. As the {open_quotes}high-cost{close_quotes} meters are selectively replaced, a utility with a significantmore » difference in individual meter reading costs could save three to five dollars per meter per year. This study showed that the {open_quotes}high-cost{close_quotes} meters were six times more expensive to read than the average meter. Additionally, AMR systems increase the information available to consumers and to the utility on usage patterns and problems. The challenge was to cost effectively identify the {open_quotes}high-cost{close_quotes} meters. The costs to collect these data were less than $500.« less

  10. Gender Analysis in the Outcomes of a Lifestyle Intervention Among Patients Who Had an Open Heart Surgery.

    PubMed

    Kadda, Olga; Manginas, Athanasios; Stavridis, George; Balanos, Dimitris; Kotiou, Maria; Panagiotakos, Demosthenes B

    2016-01-01

    The aim of this study was to evaluate the gender-oriented differences in the outcomes of a lifestyle intervention trial (diet, smoking cessation, and exercise) among patients who had open heart surgery. A randomized, nonblind intervention study was performed on 500 patients who had open heart surgery. Immediately after hospital discharge, 250 patients were randomly allocated lifestyle intervention by receiving oral and written information in the form of a booklet with specific educational information for postoperative rehabilitation. The remaining 250 patients received the regular oral instructions. The applied lifestyle intervention proved to be beneficial only in men as far as quitting smoking (relative risk [RR]: 0.36, confidence interval [CI]: 0.16-0.80; P = .01) and returning to work (RR: 0.35, CI: 0.13-0.92; P = .03) are concerned. For both genders, no significant associations between dietary and physical activity recommendations were observed. Lifestyle nursing intervention immediately after open heart surgery had a beneficial effect on men 1 year after the surgery but not on women. Thus, there is a need for gender-specific studies among women. © The Author(s) 2015.

  11. Long-term treatment of Cushing's disease with pasireotide: 5-year results from an open-label extension study of a Phase III trial.

    PubMed

    Petersenn, S; Salgado, L R; Schopohl, J; Portocarrero-Ortiz, L; Arnaldi, G; Lacroix, A; Scaroni, C; Ravichandran, S; Kandra, A; Biller, B M K

    2017-07-01

    Treating hypercortisolism in patients with Cushing's disease after failed surgery often requires chronic medication, underlining the need for therapies with favourable long-term efficacy and safety profiles. In a randomised, double-blind study, 162 adult patients with persistent/recurrent or de novo Cushing's disease received pasireotide. Patients with mean urinary free cortisol at/below the upper limit of normal or clinical benefit at month 12 could continue receiving pasireotide during an open-ended, open-label phase, the outcomes of which are described herein. Sixteen patients received 5 years of pasireotide treatment. Among these, median (95% confidence interval) percentage change from baseline in mean urinary free cortisol was -82.6% (-89.0, -41.9) and -81.8% (-89.8, -67.4) at months 12 and 60. Eleven patients had mean urinary free cortisol ≤ upper limit of normal at month 60. Improvements in clinical signs were sustained during long-term treatment. The safety profile of pasireotide at 5 years was similar to that reported after 12 months. Fifteen of 16 patients experienced a hyperglycaemia-related adverse event; glycated haemoglobin levels were stable between months 6 and 60. Adverse events related to hyperglycaemia, bradycardia, gallbladder/biliary tract, and liver safety were most likely to first occur by month 6; adverse event severity did not tend to worsen over time. This represents the longest prospective trial of a medical therapy for Cushing's disease to date. A subset of patients treated with pasireotide maintained biochemical and clinical improvements for 5 years, with no new safety signals emerging. These data support the use of pasireotide as an effective long-term therapy for some patients with Cushing's disease.

  12. FNA diagnostic value in patients with neck masses in two teaching hospitals in Iran.

    PubMed

    Saatian, Minoo; Badie, Banafsheh Moradmand; Shahriari, Sogol; Fattahi, Fahimeh; Rasoolinejad, Mehrnaz

    2011-01-01

    The FNA (fine needle aspiration) procedure is simple, inexpensive, available and a safe method for the diagnosis of a neck mass. FNA has numerous advantages over open surgical biopsies as an initial diagnostic tool; therefore we decided to compare the accuracy of this method with open biopsy. This retrospective as well as descriptive study comparing preoperative FNA results with existing data in the Pathology Department in Bu-Ali and Amir Alam Hospitals. Our study included 100 patients with neck masses of which 22 were thyroid masses, 31 were salivary gland masses, and 47 were other masses. Age ranged from 3 years to 80 years with the mean age of 42.6 years. There were 59 men and 41 women. The Sensitivity was 72%, Specificity 87%, PPV 85%, NPV 75% and diagnostic Accuracy 79%. In this study we had also 26% false negative and 15% false positive. FNA is a valuable diagnostic tool in the management of neck masses; also it has been used for staging and planning of treatment for the wide and metastatic malignancy. This technique reduces the need for more invasive and costly procedures. According to the high sensitivity and high accuracy in this study, FNA can be used as the first step of diagnoses test in neck masses.

  13. The 2017 Bioinformatics Open Source Conference (BOSC)

    PubMed Central

    Harris, Nomi L.; Cock, Peter J.A.; Chapman, Brad; Fields, Christopher J.; Hokamp, Karsten; Lapp, Hilmar; Munoz-Torres, Monica; Tzovaras, Bastian Greshake; Wiencko, Heather

    2017-01-01

    The Bioinformatics Open Source Conference (BOSC) is a meeting organized by the Open Bioinformatics Foundation (OBF), a non-profit group dedicated to promoting the practice and philosophy of Open Source software development and Open Science within the biological research community. The 18th annual BOSC ( http://www.open-bio.org/wiki/BOSC_2017) took place in Prague, Czech Republic in July 2017. The conference brought together nearly 250 bioinformatics researchers, developers and users of open source software to interact and share ideas about standards, bioinformatics software development, open and reproducible science, and this year’s theme, open data. As in previous years, the conference was preceded by a two-day collaborative coding event open to the bioinformatics community, called the OBF Codefest. PMID:29118973

  14. Comparative study of open and arthroscopic coracoid transfer for shoulder anterior instability (Latarjet)-computed tomography evaluation at a short term follow-up. Part II.

    PubMed

    Kordasiewicz, Bartłomiej; Kicinski, Maciej; Małachowski, Konrad; Wieczorek, Janusz; Chaberek, Sławomir; Pomianowski, Stanisław

    2018-05-01

    The aim of this study was to evaluate and to compare the radiological parameters after arthroscopic and open Latarjet technique via evaluation of computed tomography (CT) scans. Our hypothesis was that the radiological results after arthroscopic stabilisation remained in the proximity of those results achieved after open stabilisation. CT scan evaluation results of patients after primary Latarjet procedure were analysed. Patients operated on between 2006 and 2011 using an open technique composed the OPEN group and patients operated on arthroscopically between 2011 and 2013 composed the ARTHRO group. Forty-three out of 55 shoulders (78.2%) in OPEN and 62 out of 64 shoulders (95.3%) in ARTHRO were available for CT scan evaluation. The average age at surgery was 28 years in OPEN and 26 years in ARTHRO. The mean follow-up was 54.2 months in OPEN and 23.4 months in ARTHRO. CT scan evaluation was used to assess graft fusion and osteolysis. Bone block position and screw orientation were assessed in the axial and the sagittal views. The subscapularis muscle fatty infiltration was evaluated according to Goutallier classification. The non-union rate was significantly higher in OPEN than in ARTHRO: 5 (11.9%) versus 1 (1.7%) (p < 0.05). The total graft osteolysis was significantly higher in the OPEN group: five cases (11.9%) versus zero in ARTHRO (p < 0.05). Graft fracture incidence was comparable in both groups: in two patients in ARTHRO (3.3%) and one case (2.4%) in the OPEN group (p > 0.05). These results should be evaluated very carefully due to significant difference in the follow-up of both groups. A significantly higher rate of partial graft osteolysis at the level of the superior screw was reported in ARTHRO with 32 patients (53.3%) versus 10 (23.8%) in OPEN (p < 0.05). In the axial view, 78.4% of patients in ARTHRO and 80.5% in OPEN had the coracoid bone block in an acceptable position (between 4 mm medially and 2 mm laterally). In the sagittal plane, the bone block was in an acceptable position between 2 and 5 o'clock in 86.7% of patients in ARTHRO and 90.2% in OPEN (p > 0.05). However, in the position between 3 and 5 o'clock there were 56.7% of the grafts in ARTHRO versus 87.8% in OPEN (p < 0.05). The screws were more parallel to the glenoid surface in ARTHRO-the angles were 12.3° for the inferior screw and 12.6° for the superior one. These angles in the OPEN group were respectively 15° and 17° (p < 0.05 and for the superior screw). There was no significant difference in the presence of fatty infiltration of the subscapularis muscle. Arthroscopic Latarjet stabilisation showed satisfactory radiographic results, comparable to the open procedure, however the short-term follow-up can bias this evaluation. Graft healing rate was very high in the arthroscopic technique, but yet osteolysis of the superior part of the graft and more superior graft position in the sagittal view were significantly different when compared to the open technique. The screw position was slightly more parallel to the glenoid via the arthroscopic technique. We recommend both further investigation and development of the arthroscopic technique. III.

  15. Flowers visited by hummingbirds in the open habitats of the southeastern Brazilian mountaintops: species composition and seasonality.

    PubMed

    Rodrigues, L C; Rodrigues, M

    2014-08-01

    The hummingbird-visited plant community located on the open-habitat mountaintop of the Espinhaço Range was studied for two years (from August 2007 to July 2009) in Serra do Cipó National Park, Southeastern Brazil (19° 15' S and 43° 31' W). The floral characteristics and flowering period of the hummingbird-visited plants was monthly recorded along trails located in three vegetation types: (1) typical campos rupestres (TCR), (2) open fields (OPF), and (3) capões de mata (CAM). Hummingbird visitation was observed in 51 plant species, 22 ornithophilous and 29 non-ornithophilous species. The TCR showed the greatest number of species visited (N = 38), followed by the OPF (N = 18) and CAM (N = 17). Six species of hummingbirds were recorded visiting flowers: Augastes scutatus, Campylopterus largipennis, Colibri serrirostris, Chlorostilbon lucidus, Eupetomena macroura and Phaethornis pretrei. This study demonstrates that the species richness and the number of ornithophilous species visited by the hummingbirds at the study site are more similar to hummingbird-plant communities of the Atlantic Forest than to those of the Cerrado communities and other Brazilian highland open-habitat communities. The plant families most visited by hummingbirds were Bromeliaceae and Asteraceae. Although the Asteraceae family is rarely used as a food resource for hummingbirds in other high and lowland communities, in the study site this family is used mainly by the endemic hummingbird Augastes scutatus. We found a large overlap of flowering throughout the year among the species visited by the hummingbirds. Thus, the nectar availability supports these resident hummingbirds. The present study also showed that the studied hummingbird-plant community is composed of many species endemic to the campos rupestres of the Espinhaço Range, some of which are considered to be in danger of extinction, thus constituting a unique and threatened community. Thus, understanding hummingbird-plant pollination dynamics becomes fundamental to the conservation of the campos rupestres.

  16. OPEN PROBLEM: Turbulence transition in pipe flow: some open questions

    NASA Astrophysics Data System (ADS)

    Eckhardt, Bruno

    2008-01-01

    The transition to turbulence in pipe flow is a longstanding problem in fluid dynamics. In contrast to many other transitions it is not connected with linear instabilities of the laminar profile and hence follows a different route. Experimental and numerical studies within the last few years have revealed many unexpected connections to the nonlinear dynamics of strange saddles and have considerably improved our understanding of this transition. The text summarizes some of these insights and points to some outstanding problems in areas where valuable contributions from nonlinear dynamics can be expected.

  17. A novel surgical management of hypopharyngeal branchial anomalies.

    PubMed

    Givens, Daniel J; Buchmann, Luke O; Park, Albert H

    2015-04-01

    To review our experience treating hypopharyngeal branchial anomalies utilizing an open transcervical approach that: (1) includes recurrent laryngeal nerve (RLN) monitoring and identification if needed; (2) resection of tract if present; and (3) a superiorly based sternothyroid muscle flap for closure. A retrospective chart review was performed to identify all patients at a tertiary level children's hospital with branchial anomalies from 2005 to 2014. The clinical presentation, evaluation, treatment and outcome were analyzed for those patients with hypopharyngeal branchial anomalies. Forty-seven patients who underwent excision of branchial anomalies with a known origin were identified. Thirteen patients had hypopharyngeal branchial anomalies. Six of these patients were treated by the authors of this study and are the focus of this analysis. All six underwent an open transcervical procedure with a sternothyroid muscle flap closure of a piriform sinus opening over a nine year period. Definitive surgery included a microlaryngoscopy and an open transcervical approach to close a fistula between the piriform sinus and neck with recurrent laryngeal nerve monitoring or dissection. A superiorly based sternothyroid muscle flap was used to close the sinus opening. There were no recurrences, recurrent laryngeal nerve injuries or other complications from these procedures. This study supports complete surgical extirpation of the fistula tract using an open cervical approach, recurrent laryngeal nerve monitoring or identification, and rotational muscle flap closure to treat patients with hypopharyngeal branchial anomalies. Published by Elsevier Ireland Ltd.

  18. Detection of heart disease by open access echocardiography: a retrospective analysis of general practice referrals

    PubMed Central

    Chambers, John; Kabir, Saleha; Cajeat, Eric

    2014-01-01

    Background Heart disease is difficult to detect clinically and it has been suggested that echocardiography should be available to all patients with possible cardiac symptoms or signs. Aim To analyse the results of 2 years of open access echocardiography for the frequency of structural heart disease according to request. Design and setting Retrospective database analysis in a teaching hospital open access echocardiography service. Method Reports of all open access transthoracic echocardiograms between January 2011 and December 2012 were categorised as normal, having minor abnormalities, or significant abnormalities according to the indication. Results There were 2343 open access echocardiograms performed and there were significant abnormalities in 29%, predominantly valve disease (n = 304, 13%), LV systolic dysfunction (n = 179, 8%), aortic dilatation (n = 80, 3%), or pulmonary hypertension (n = 91, 4%). If echocardiography had been targeted at a high-risk group, 267 with valve disease would have been detected (compared to 127 with murmur alone) and 139 with LV systolic dysfunction (compared to 91 with suspected heart failure alone). Most GP practices requested fewer than 10 studies, but 6 practices requested over 70 studies. Conclusion Open access echocardiograms are often abnormal but structural disease may not be suspected from the clinical request. Uptake by individual practices is patchy. A targeted expansion of echocardiography in patients with a high likelihood of disease is therefore likely to increase the detection of clinically important pathology. PMID:24567615

  19. Detection of heart disease by open access echocardiography: a retrospective analysis of general practice referrals.

    PubMed

    Chambers, John; Kabir, Saleha; Cajeat, Eric

    2014-02-01

    Heart disease is difficult to detect clinically and it has been suggested that echocardiography should be available to all patients with possible cardiac symptoms or signs. To analyse the results of 2 years of open access echocardiography for the frequency of structural heart disease according to request. Retrospective database analysis in a teaching hospital open access echocardiography service. Reports of all open access transthoracic echocardiograms between January 2011 and December 2012 were categorised as normal, having minor abnormalities, or significant abnormalities according to the indication. There were 2343 open access echocardiograms performed and there were significant abnormalities in 29%, predominantly valve disease (n = 304, 13%), LV systolic dysfunction (n = 179, 8%), aortic dilatation (n = 80, 3%), or pulmonary hypertension (n = 91, 4%). If echocardiography had been targeted at a high-risk group, 267 with valve disease would have been detected (compared to 127 with murmur alone) and 139 with LV systolic dysfunction (compared to 91 with suspected heart failure alone). Most GP practices requested fewer than 10 studies, but 6 practices requested over 70 studies. Open access echocardiograms are often abnormal but structural disease may not be suspected from the clinical request. Uptake by individual practices is patchy. A targeted expansion of echocardiography in patients with a high likelihood of disease is therefore likely to increase the detection of clinically important pathology.

  20. Assessing Student Openness to Inquiry-Based Learning in Precalculus

    ERIC Educational Resources Information Center

    Cooper, Thomas; Bailey, Brad; Briggs, Karen; Holliday, John

    2017-01-01

    The authors have completed a 2-year quasi-experimental study on the use of inquiry-based learning (IBL) in precalculus. This study included six traditional lecture-style courses and seven modified Moore method courses taught by three instructors. Both quantitative and qualitative analyses were used to investigate the attitudes and beliefs of the…

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