1,577 research outputs found

    Adaptive Simulation of an Integrated Procurement-Inventory System with Incomplete Lead Time Information

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    The functions of procurement, inventory control and warehousing are shown to be an integrated system which requires consideration of the costs of all the related functions in order to specify an policy which has a minimum total cost for a desired level of service. A stochastic environment is assumed in which a Poisson distrubuted demand is known and initially only an estimate of the average lead time is available for each vendor. An adaptive model is developed which specifies a policy using a dynamic programming algorithm and then simulates on year\u27s activity utilizing the policy

    Adolescent BMI trajectories with clusters of physical activity and sedentary behavior: An exploratory analysis

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    Objective: The purpose of this study is to identify distinct body mass index (BMI) trajectories associated with weight classification, and to examine demographic characteristics and clusters of obesogenic behaviours in adolescents with these trajectories. Methods: Data were extracted from the National Institute of Child Health and Human Development Study of Early Child Care and Youth Development (n = 1,006, Grades 5–8). The independent variables were physical activity (accelerometer and child report), sports participation, television/video watching time and recreational computer use. The dependent variable was raw BMI. Growth mixture modelling, mixture modelling and independent t-test analyses were used. Results: Two distinct BMI trajectories were identified – one with the mean BMI within the Overweight–Obese classification (≥85th percentile) and the other within the healthy weight classification (5th– 84th percentile). Two clusters of physical and sedentary behaviours were identified in adolescents with the Overweight–Obese BMI trajectory. These clusters differed in the type of sedentary behaviour (computer vs. television/video). Three clusters were identified in adolescents with the Healthy Weight BMI trajectory. These clusters differed in levels of physical activity and types of sedentary behaviour. Conclusion: This study contributes to the understanding of multi-dimensional obesogenic behavioural patterns and highlights the importance of understanding types of sedentary behaviour in adolescents

    Management of incidentally detected heart murmurs in dogs and cats

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    A dog or a cat has an incidentally detected heart murmur if the murmur is an unexpected discovery during a veterinary consultation that was not initially focused on the cardiovascular system. This document presents approaches for managing dogs and cats that have incidentally-detected heart murmurs, with an emphasis on murmur characteristics, signalment profiling, and multifactorial decision-making to choose an optimal course for a given patient

    International Labor Standards, Soft Regulation, and National Government Roles

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    [Excerpt] In this article, we briefly describe the different approaches to the regulation of international labor standards, and then argue for a new role for national governments based on soft rather than hard regulation approaches. We argue that this new role shows potential for significantly enhancing progress in international labor standards, since it enables governments to articulate a position without having to deal with the enforcement issues that hard regulation mandates. We justify this new role for governments based on the increasing use of soft regulation in the international arena. Of course, this approach is not without its own problems, but given that existing approaches have all provided imperfect solutions to the problem of improving labor standards globally, re-visiting the role of national governments is in our view, highly important

    Thyroid Carcinoma Metastasis to Skull with Infringement of Brain: Treatment with Radioiodine

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    Background: Infringement by differentiated thyroid carcinoma on the brain is rare but, when suspected, the patient deserves special attention. A patient with an enlarging metastasis of thyroid carcinoma to the skull that was impinging on the brain illustrates diagnostic and therapeutic strategies applicable to the treatment of metastatic carcinoma. Methods: A case study was performed. Computed tomography (CT) and magnetic resonance imaging (MRI) were done, serum thyroglobulin was measured, and tumor responses to thyroxine and 131I treatments were monitored. Tumor dosimetry, enabled by scintigraphy with 131I employing single photon emission tomography fused with CT (SPECT-CT), was performed. Results: The metastasis was from a follicular variant of papillary thyroid carcinoma. During thyrotropin stimulation the tumor enlarged. The tumor decreased in volume after each of two 131I therapies. Dosimetry indicated delivery of 1970 and 2870cGy to the tumor and 35 and 42cGy to the brain, respectively, in the two treatments. The patient has survived for more than 11 years since diagnosis. Conclusions: A metastasis from a follicular variant of papillary carcinoma increased in volume during hypothyroidism producing more infringement on the brain. Beyond the effects of thyroxine therapy, 131I treatments induced recession of tumor volume. In patients with metastases that concentrate 131I, dosimetry with SPECT-CT can predict absorbed doses of radiation to the tumor and to the adjacent organs and thus lay a basis for data-based decisions on 131I therapies. Therapy may induce prolonged survival in patients with metastases infringing on the brain.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/78102/1/thy.2008.0426.pd

    Image denoising based on nonlocal Bayesian singular value thresholding and Stein's unbiased risk estimator

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    © 1992-2012 IEEE. Singular value thresholding (SVT)- or nuclear norm minimization (NNM)-based nonlocal image denoising methods often rely on the precise estimation of the noise variance. However, most existing methods either assume that the noise variance is known or require an extra step to estimate it. Under the iterative regularization framework, the error in the noise variance estimate propagates and accumulates with each iteration, ultimately degrading the overall denoising performance. In addition, the essence of these methods is still least squares estimation, which can cause a very high mean-squared error (MSE) and is inadequate for handling missing data or outliers. In order to address these deficiencies, we present a hybrid denoising model based on variational Bayesian inference and Stein's unbiased risk estimator (SURE), which consists of two complementary steps. In the first step, the variational Bayesian SVT performs a low-rank approximation of the nonlocal image patch matrix to simultaneously remove the noise and estimate the noise variance. In the second step, we modify the conventional SURE full-rank SVT and its divergence formulas for rank-reduced eigen-triplets to remove the residual artifacts. The proposed hybrid BSSVT method achieves better performance in recovering the true image compared with state-of-the-art methods

    Practical Dosimetry of 131I in Patients with Thyroid Carcinoma

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    Radioiodine treatments of patients with well-differentiated thyroid carcinoma have generally been safe and beneficial. Safety can be ensured while efficacy is increased through practical methods of dosimetry that measure body retention of 131I. Prescriptions for therapeutic 131I can be decreased when the retention level is high and increased when the level is low. Assays of serum free T4 will alert the physician to possible increased radiation to blood and bone marrow, and appreciable concentrations of free T4 are indications to reduce the therapeutic 131I. Carcinomas ≥1 cm in diameter that are not visible on diagnostic scintigraphy are unlikely to respond to the commonly prescribed mCi of 131I. Biologic responses to commonly prescribed levels of therapeutic 131I, as seen in toxic changes of normal tissues and in indices of tumor size, will be the final dosimeters. With lower levels of prescribed diagnostic 131I, stunning should not impair dosimetry. Thus, readily obtained measurements make dosimetry a practical method for improving carcinoma therapy with 131I.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/63166/1/10849780252824118.pd

    A mechanochemical model of striae distensae

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    Striae distensae, otherwise known as stretch marks, are common skin lesions found in a variety of clinical settings. They occur frequently during adolescence or pregnancy where there is rapid tissue expansion and in clinical situations associated with corticosteroid excess. Heralding their onset is the appearance of parallel inflammatory streaks aligned perpendicular to the direction of skin tension. Despite a considerable amount of investigative research, the pathogenesis of striae remains obscure. The interpretation of histologic samples – the major investigative tool – demonstrates an association between dermal lymphocytic inflammation, elastolysis, and a scarring response. Yet the primary causal factor in their aetiology is mechanical; either skin stretching due to underlying tissue expansion or, less frequently, a compromised dermis affected by normal loads. In this paper, we investigate the pathogenesis of striae by addressing the coupling between mechanical forces and dermal pathology. We develop a mathematical model that incorporates the mechanical properties of cutaneous fibroblasts and dermal extracellular matrix. By using linear stability analysis and numerical simulations of our governing nonlinear equations, we show that this quantitative approach may provide a realistic framework that may account for the initiating events
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