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PurposeThe overall contribution of this work is to provide a usable maturity model for collaborative scheduling (CS) that extends the literature, identifies inconsistencies in schedule development, and improves collaboration in the construction industry.Design/methodology/approachVia subject matter expert elicitation and focus groups, the maturity model establishes five pillars of collaboration—scheduling significance, planners and schedulers, scheduling representation, goal alignment with owner, and communication. The maturity model is then validated through iterative feedback and chi-squared statistical analysis of data obtained from a survey. The five pillars are tied to the literature and previous work in CS.FindingsThe analysis shows that current industry projects are not consistent in collaboration practice implementation, and the maturity model identifies areas for collaboration improvement. The study's contributions to the body of knowledge are (1) developing a maturity model-based approach to define and measure the current level of collaboration and (2) discovering the level of consistency in scheduling collaboration practice implementation.Practical implicationsThe findings provide a benchmark for self-evaluation and peer-to-peer comparison for project managers. The model is also useful for project managers to develop effective strategies for improvement on targeted dimensions and metrics.Originality/valueThe construction engineering and management (CEM) literature does not contain targeted models for scheduling collaboration in the context of maturity and, broadly speaking, neither does the literature at large. The literature also lacks actionable items as presented for the maturity model for collaborative scheduling (MMCS).

Background Healthcare delivery reorganization during the COVID-19 emergency may have had a significant impact on access to care for older adults with chronic conditions. Methods We investigated such impact among all adults with chronic conditions aged ≥65 years, identified through the electronic health databases of two local health agencies - ATS Brianza and ATS Bergamo - from the Lombardy region, Italy. We considered hospitalizations for 2020 compared to the average 2017-2019 and quantified differences using rate ratios (RRs). Results Overall, in 2017-2019 there were a mean of 374,855 older adults with ≥1 chronic condition per year in the two ATS and 405,371 in 2020. Hospitalizations significantly decreased from 84,624 (225.8/1000) in 2017-2019 to 78,345 (193.3/1000) in 2020 (RR 0.86). Declines were reported in individuals with many chronic conditions and for most Major Diagnostic Categories, except for diseases of the respiratory system. The strongest reductions were observed in hospitalizations for individuals with active tumours, particularly for surgical ones. Hospitalization rates increased in individuals with diabetes, likely due to COVID-19-related diseases. Conclusions Although determinants of the decrease in demand and supply for care among chronic older adults are to be further explored, this raises awareness on their impacts on chronic patients’ health in the medium and long run.

Publisher Copyright: © 2022 American Society for Engineering Management. The Critical Path Method (CPM), the Last Planner System (LPS) and location-based methods, such as the Line of Balance (LB), are discussed extensively in the technical literature about schedules. However, no discussion exists focusing on the differences and similarities of these methods in terms of their use in different countries. Using chi-squared and Fisher’s exact tests, this research compared three countries (Brazil, Finland, and United States) and the methods to evaluate both intra- and inter-country implementation to gain additional insights about their use. Results suggest statistically significant intra- and inter-country differences regarding how these methods are used, with a specific focus on mechanics in the countries, offering important information to address their various scheduling needs. The results reflect the current state of practice; engineering and construction managers should understand different ways of understanding scheduling. Such understanding can lead to more efficient communication with collaborators and when incorporating foreign teams in projects. The study identifies the need for further scientific explanation as to why these methods are used in the manner they are intra-country as well as adaptions made in inter-country relationships.

This research examines how the construction industry addresses the roles of schedulers and schedules, with the goal of improving current practices. We use a mixed-mode approach of qualitative and q...

Restrictions imposed to prevent SARS-CoV-2 transmission should be weighed against consequences on vulnerable groups' health. Lifestyles and disease management of older people with diabetes might have been differentially impacted compared to non-chronic individuals.A cross-sectional study (LOST in Lombardia) was conducted on a representative full sample of 4 400 older adults (17supth/sup-30supth/supNovember 2020), collecting data on lifestyles, mental health and access to care before and during the pandemic.We compared 947 (51.9%) people with diabetes and 879 (48.1%) healthy subjects reporting no chronic conditions. People with diabetes reported more frequently increased physical activity (odds ratio, OR 2.65, 95% confidence internals, CI 1.69-4.13), drinks/week reduction (OR 6.27, 95%CI 3.59-10.95), increased consumption of fruit (OR 2.06, 95%CI 1.62-2.63), vegetables (OR 1.41, 95%CI 1.10-1.82), fish (OR 2.51, 95%CI 1.74-3.64) and olive oil (OR 3.54, 95%CI 2.30-5.46). People with diabetes increased telephone contacts with general practitioners (OR 3.70, 95%CI 2.83-4.83), hospitalisations (OR 9.01, 95%CI 3.96-20.51), visits and surgeries cancellations (OR 3.37, 95%CI 2.58-4.42) and treatment interruptions (OR 1.95, 95%CI 1.33-2.86).Pandemic adverse effects occurred but are heterogenous in a population with chronic diseases, who seized the opportunity to improve health behaviours, despite health system difficulties guaranteeing routine care, within and beyond COVID-19.

This perspectives article addresses risk in cyber defense and identifies opportunities to incorporate risk analysis principles into the cybersecurity field. The Science of Security (SoS) initiative at the National Security Agency seeks to further and promote interdisciplinary research in cybersecurity. SoS organizes its research into the Five Hard Problems (5HP): (1) scalability and composability; (2) policy-governed secure collaboration; (3) security-metrics-driven evaluation, design, development, and deployment; (4) resilient architectures; and (5) understanding and accounting for human behavior. However, a vast majority of the research sponsored by SoS does not consider risk and when it does so, only implicitly. Therefore, we identify opportunities for risk analysis in each hard problem and propose approaches to address these objectives. Such collaborations between risk and cybersecurity researchers will enable growth and insight in both fields, as risk analysts may apply existing methodology in a new realm, while the cybersecurity community benefits from accepted practices for describing, quantifying, working with, and mitigating risk.

The practice of threat modeling to identify and mitigate, or eliminate, vulnerabilities, has a long history in military operations research. More recently, these practices are applied to the cyber domain to give a defender an increased advantage. Most cybersecurity research, however, is performed in the computer science and network infrastructure fields where the focus is on theory and infrastructure management. Consequently, the work is lacking traditional operations research perspectives in risk analysis, assessment, and decision support that may lead to a greater overall defensive posture. This chapter outlines several operations research techniques used in modeling cybersecurity threats and proposes a value model framework for security metrics and best practices that is supported by data and interviews with subject matter experts. The value model, which includes a framework that can be customized for any organization, is illustrated using notional data. Finally, through a survey of cyber professionals with both military and corporate industry experience, an inventory of valued attributes for a secure cyber system is provided, along with potential differences in values based on an organization’s history of attacks and/or breaches. This model, grounded in the principles of military operations research, will enable organizations to assess the performance of their respective cyber systems, manage risk, and continuously improve their processes.

A value model is developed for military logistics that fulfill emergent requests for tailored resupply packages from the sea. Asset tracking technologies, including radio frequency identification, barcoding, internal positioning systems (IPS), and camera-aided technology, are considered as alternatives to a multi-objective decision model. Model measures include registration of inventory in the system, stowage factor enablement, storage location precision, retrieval identification accuracy, system compatibility, and security. The decision model is presented using insights from subject matter experts. Given the requirements of selective offloading in dense storage environments, IPS is the preferred asset tracking technology. Sensitivity analysis and recommendations for engineering managers are provided.

Supplier quality management (SQM) is an important function in the construction industry. Many construction organizations place high importance on using quantitative analyses to select effective SQM practices that ensure that materials, assemblies, and fabricated equipment for the construction project are within quality specifications. However, traditional quantitative analysis methods may be limited because the process of acquiring enough data to conduct the analyses is time consuming and costly. This article discusses the use of principal component analysis (PCA) to analyze a number of SQM practices from construction organizations known for their effective SQM. PCA is useful in this study because the data available for analysis are small in size and multivariate. SQM practices are discussed extensively and validated with subject matter experts (SMEs) using the analytical hierarchy process (AHP). We show that supplier's work observation, supplier performance rating, inspection effort tracking, and...

With group judgments in the context of the Analytic Hierarchy Process (AHP) one would hope for broad consensus among the decision makers. However, in practice this will not always be the case, and significant dispersion may exist among the judgments. Too much dispersion violates the principle of Pareto Optimality at the comparison level and/or matrix level, and if this happens, then the group may be homogenous in some comparisons and heterogeneous in others. The question then arises as to what would be an appropriate aggregation scheme when a consensus cannot be reached and the decision makers are either unwilling or unable to revise their judgments. In particular, the traditional aggregation via the geometric mean has been shown to be inappropriate in such situations. In this paper, we propose a new method for aggregating judgments when the raw geometric mean cannot be used. Our work is motivated by a supply chain problem of managing spare parts in the nuclear power generation sector and can be applied whenever the AHP is used with judgments from multiple decision makers. The method makes use of principal components analysis (PCA) to combine the judgments into one aggregated value for each pairwise comparison. We show that this approach is equivalent to using a weighted geometric mean with the weights obtained from the PCA.

TPS384 Background: Men with intermediate risk prostate cancer are often recommended external beam radiation therapy (EBRT) with or without 4-6 months of androgen deprivation therapy (ADT). However, ADT can be associated with prolonged erectile dysfunction due to delayed testosterone recovery. Darolutamide is a second-generation androgen receptor with low blood-brain barrier penetration. We hypothesize that men who receive Darolutamide with RT rather than ADT with RT are able to achieve surrogate PSA endpoints indicative of long-term disease control while preserving erectile function. Methods: This is an open label, phase 2B, multi-center, randomized controlled trial. Eligibility criteria include intermediate risk prostate cancer, good erectile quality per the EPIC-26 questionnaire, and archival tissue suitable for submission to Decipher Biosciences (San Diego, CA). Men will be stratified by Decipher score (low/intermediate vs high), RT modality (EBRT vs Brachytherapy/stereotactic body radiation therapy/combination RT), and age (>65 vs

New physical effects in the dynamics of an ion confined in an anisotropic two-dimensional Paul trap are reported. The link between the occurrence of such manifestations and the accumulation of geometric phase stemming from the intrinsic or controlled lack of symmetry in the trap is brought to light. The possibility of observing in laboratory these anisotropy-based phenomena is briefly discussed., Comment: 10 pages. Acta Physica Hungarica B 2005

This paper presents a methodology for developing a spare parts inventory management system with a focus on the nuclear power sector. Often, demand for spare parts is highly intermittent and cannot be accurately forecasted through traditional methods. Examples include nuclear power generation equipment, ground space systems, and aircraft engine parts. We take a data-driven engineering management approach and develop a four-step methodology for spare parts management in such environments. These steps comprise an influence diagram for identifying relevant factors, weighting of influences through the analytic hierarchy process, grouping parts according to inventory criticality indices, and the development of base stock inventory policies for each group. This approach allows the system to be actively managed within a continuous improvement framework through employee engagement and input, and mathematical assumptions are not made in the models. To our knowledge, no such integrated, comprehensive methodology for spare parts has been developed. The techniques employed in this research can be effectively used together to holistically manage the entire spare parts process, or they may be used separately to manage portions of the process. This paper provides an overview of the methodology, and the entire approach is illustrated via a test bed nuclear power generation facility.

Oral cancer is usually treated combining surgery, radiation therapy and chemotherapy, following effective therapeutic protocols. Severe maxillary and mandibular bone atrophy resulting after therapies are usually treated with autologous bone grafting procedures even though these techniques often present a significant risk of postoperative complications and disadvantages. We describe the case of a 59-year-old woman presenting severe bone defect after being treated with surgery and radiotherapy for recurrent oral verrucous squamous cell carcinoma. We performed bone regeneration using Platelet-Derived Growth Factors (PDGF) in combination with autologous bone chips. Our procedure of bone regeneration allowed the placement of dental implants and the achievement of a good aesthetic and functional result. Regenerative surgery may enable the regeneration of substantial bone defects. Moreover, PDGF application decreases the risk of implant failure in irradiated patients.

Aim. Probiotics have been proposed as useful adjuncts in the management of halitosis and the results of studies investigating their use have been equivocal; probiotics are not universally accepted as a proven method to control oral malodor. The aim of this pilot study was to evaluate the modifications of the organoleptic quality of morning breath and the concentrations of oral VSC following the oral treatment with lozenges of Lactobacillus reuteri DSM 17938 in a cohort of bad breath patients. Methods. Patients were recruited among those referred for bad breath treatment to the Unit of Oral Hygiene and Prevention of the Dental Clinic; they were investigated for systemic diseases and examined to rule out periodontitis and other oral diseases and conditions. The following clinical features and indexes were recorded at baseline: dental conditions, plaque index, PSR, tongue coating index, subjective evaluation of the quality of the breath using a reference VAS (Visual Analogue Scale) with indices ranging from 0 to 10 (0 worst breath, acceptable 6, 10 good), breath organoleptic score and measurement of the concentration of oral VSC through the use of Interscan Halimeter®. For statistic purposes, the continuous VSC data were recoded as a discrete VSC score ranging from 0 to 3 in relation to the measured ppb value. After professional oral hygiene instructions, the patients were informed and randomly divided into two groups: group A underwent professional scaling and prescription of probiotic lozenges containing 108 CFU of Lactobacillus reuteri DSM17938; they were instructed to dissolve in the mouth one lozenge per day for seven days following the evening oral hygiene practice. Patients of the B group were prescribed the same course of probiotics lozenges without the professional hygienic phase. On the eighth day, the patients were re-examined recording PRS, plaque index, tongue coating and re-evaluated for subjective and organoleptic bad breath and VSC concentration. Results. 28 patients were recruited and investigated, aged between 18 and 61 (mean age 36.6 yrs), 14 females and 14 males. Patients in group A and group B showed similar values in the oral conditions and indexes recorded at baseline. Both groups showed reduction of bad breath parameters after the treatment; the mean reduction of relevant parameters i.e. subjective, organoleptic and VSC score were higher in the treatment group A - professional oral hygiene plus probiotic lozenges. Conclusion. The administration of the probiotic Lactobacillus reuteri as a mouth dissolving lozenge showed to be useful to decrease the subjective and objective levels of oral malodor. Further studies are needed to provide definitive data supporting the effectiveness of probiotics in the treatment of halitosis.

A microscopic master equation describing the dynamics of two qubits coupled via a nonlinear mediator is constructed supposing that the two qubits, as well as the nonlinear mode, interact, each with its own independent bosonic bath. Generally speaking the master equation derived in this way represents a more appropriate tool for studying the dynamics of open quantum systems. Indeed we show that it is more complex than the phenomenological master equation, constructed simply adding ad hoc dissipative terms.

In this paper, we review some results concerning the dissipative dynamics of two coupled qubits interacting with independent reservoirs. In particular, we focus on the role of counter-rotating terms in the qubit-qubit coupling, showing that their presence is the origin of stationary entanglement, which also turns out to be robust with respect to temperature. We also discuss the performances of different non-Markovian approaches in the description of the qubit-qubit dynamics, by considering a simplified exactly solvable Hamiltonian model.

The Stimulated Raman adiabatic passage (STIRAP) in three-state systems in the presence of quantum noise is considered. A comparison is made between different models, one based on a phenomenological introduction of decays, one traceable back to a microscopic description of the system-environment interaction. Effects related, to off-resonance in the coupling between the involved states are considered.

This paper overviews some recent S&T innovations in smart materials and structures at the Australian Defence Science and Technology Organisation (DSTO) under a Corporate Enabling Research Program (CERP) on Signatures, Materials and Energy. The CERP program includes development and transitioning of technology across the maritime, air and land domains, with the major focus of the smart materials program component being to increase the safety, availability and maintainability of Defence assets. Three specific examples are provided of the smart materials and structures program, ranging across the spectrum of technology readiness from new concept phase to technology transitioning, viz.: (i) Advances in smart sensing for prognostics-based platform management; (ii) Fabrication of nanostructured and ultrafine grained materials through top-down severe plastic deformation processing of bulk materials; (iii) Innovative application of carbon nanotubes/conducting polymers as artificial muscles for low-power propulsion and control of small autonomous underwater systems. In each case, the DSTO effort is underpinned by strong university or industry linkages to deliver challenging interdisciplinary S&T.

A key step on the road map to solid-state quantum information processing (and to a deeper understanding of many counterintuitive aspects of quantum mechanics) is the generation and manipulation of nonclassical correlations between different quantum systems. Within this framework, we analyze the possibility of generating maximally entangled states in a system of two superconducting flux qubits, as well as the effect of their own environments on the entanglement dynamics. The analysis reported here confirms that the phenomena of sudden birth and sudden death of the entanglement do not depend on the particular measure of the entanglement adopted.

We provide a microscopic derivation for the non-Markovian master equation for an atom-cavity system with cavity losses and show that they can induce population trapping in the atomic excited state, when the environment outside the cavity has a non-flat spectrum. Our results apply to hybrid solid state systems and can turn out to be helpful to find the most appropriate description of leakage in the recent developments of cavity quantum electrodynamics., Comment: 7 pages, 2 figures

A moisture model determines the moisture distribution in cellulose and oil. The model focuses on oil flow, moisture vapour pressure and the saturation properties of oil and cellulose. Measurements of material properties form the basis of each computation model. Direct measurements were performed. Samples of paper and pressboard were aged in oil. The measurements of moisture absorption were performed in air. For given moisture content the moisture vapour pressure reaches lower values than in previous results. Consequently, moisture values in oil reach lower values and the risk of bubbling at rising temperatures reduces. It has, for the first time, been established that bubbling requires a contribution of dissolved gas like air to reach critical vapour pressure levels to obtain bubbling at 150 °C hotspot and with 3% average moisture content and 1.2% in the hotspot respectively. Here oil must absorb on atmosphere air at 70 °C. Without dissolved gas an average moisture content of 4% and a hot spot temperature of about 165 °C would be necessary to come close to a risky condition. The low tendency to bubbling is also favoured by the reduced moisture content in the winding hotspot insulation which is caused by the temperature distribution due to axial oil gradient and winding gradient. The general calculation for individual spots in the transformer insulation like the hotspot is based on the moisture vapour pressure of cellulose and oil as the driving force of moisture migration. The axial temperature distribution, however, generates an axial gradient of moisture vapour pressures in oil. The cellulose insulation reaches the moisture pressure level of its neighbouring oil. The average cellulose moisture content provides basic information about the moisture condition. The calculation model is required to determine the moisture values in a transformer under operation conditions. Aging and bubbling considerations are based on the moisture content of the hotspot. Filling of a transformer with oil often happens at a moisture content of 5 ppm. At low temperatures and slow moisture diffusion into the bulk material the cellulose surface can develop extremely high moisture values. Therefore, a high temperature during filling is recommended. Furthermore, a transformer can, in principle, absorb moisture from the atmosphere or vice verse. The direction of migration is determined by the difference of local moisture vapour pressure between oil and atmosphere which depends on temperature and moisture. The slow migration velocity at low temperatures and tightness of the tank limits the value to below 7% moisture content in cellulose.

We propose an interferometric scheme based on an untrapped nano-object subjected to gravity. The motion of the center of mass (c.m.) of the free object is coupled to its internal spin system magnetically, and a free flight scheme is developed based on coherent spin control. The wave packet of the test object, under a spin-dependent force, may then be delocalized to a macroscopic scale. A gravity induced dynamical phase (accrued solely on the spin state, and measured through a Ramsey scheme) is used to reveal the above spatially delocalized superposition of the spin-nano-object composite system that arises during our scheme. We find a remarkable immunity to the motional noise in the c.m. (initially in a thermal state with moderate cooling), and also a dynamical decoupling nature of the scheme itself. Together they secure a high visibility of the resulting Ramsey fringes. The mass independence of our scheme makes it viable for a nano-object selected from an ensemble with a high mass variability. Given these advantages, a quantum superposition with a 100 nm spatial separation for a massive object of 10^{9} amu is achievable experimentally, providing a route to test postulated modifications of quantum theory such as continuous spontaneous localization.

Delayed diagnosis of injury (DDI) during hospitalization and missed injuries (MI) on autopsy in trauma deaths result in untoward outcomes. Autopsy is an effective educational tool for health care providers to evaluate trauma care. A retrospective study of trauma registry patients and coroner's records was categorized into groups 1 (alive patients) and 2 (trauma deaths) and analyzed. DDI incidence was similar in group 1 (1.8%) and group 2 (1.9%). Autopsy analysis (163 patients) yielded 139 MI in 94 patients (57.6%)

The scheme recently proposed in [M. Scala et al., Phys Rev Lett 111, 180403 (2013)], where a gravity-dependent phase shift is induced on the spin of a nitrogen-vacancy (NV) center in a trapped nanodiamond by the interaction between its magnetic moment and the quantized motion of the particle, provides a way to detect spatial quantum superpositions by means of spin measurements only. Here, the effect of unwanted coupling with other motional degrees of freedom is considered and we show that it does not affect the validity of the scheme. Both this coupling and the additional error source due to misalignment between the quantization axis of the NV center spin and the trapping axis are shown not to change the qualitative behavior of the system, so that a proof-of- principle experiment can be neatly performed. Our analysis, which shows that the scheme retains the important features of not requiring ground state cooling and of being resistant to thermal fluctuations, can be useful for the several schemes which have been proposed recently for testing macroscopic superpositions in trapped microsystems., Comment: 8 pages, 4 figures

The objective of this study was to assess adherence of childhood cancer survivors in comparison to cancer-free adults of comparable age and sex (or "controls") to the 2012 American Cancer Society (ACS) Guidelines on Nutrition and Physical Activity.As part of the Chicago Healthy Living Study, 431 childhood cancer survivors (18.5 ± 8.1 years from diagnosis) and 361 controls completed a structured, health-focused interview including the Block Brief Food Frequency Questionnaire and Modifiable Activity Questionnaire. From these data, modified adherence scores were computed based on ACS guidelines (maximum score of 8 reflecting complete adherence). Comparisons were made between survivors and controls and among racial-ethnic groups of survivors and controls.There was no difference in overall ACS adherence scores between survivors and controls (4.3 ± 1.5 vs. 4.2 ± 1.5, p = 0.54). As compared to controls, survivors, on average, had a lower body mass index or BMI (27.9 ± 7.0 vs. 29.3 ± 7.8 kg/m(2), p = 0.01) and consumed less fiber (9.2 ± 3.5 vs. 9.7 ± 3.8 g/1,000 kcal, p = 0.05). Within the survivor group, ACS adherence scores did not differ across racial-ethnic groups, but differences were observed with respect to component behaviors. Hispanic survivors had a higher BMI when compared to those of whites (29.2 ± 7.4 vs. 26.2 ± 5.3 kg/m(2), p = 0.001). Daily alcohol consumption was greater for whites among both survivors and controls as compared to other racial-ethnic groups (p 0.017 for all comparisons).Compared to controls, survivors were not practicing healthier behaviors. Among minority survivors, excess body weight, particularly among Hispanics, is a major concern. Assessment of these behaviors should be incorporated into survivor follow-up care.There is much room for improvement in educating and encouraging survivors to follow healthier diet and lifestyle routines to prevent obesity and further morbidity.

Current treatment of nasopharyngeal carcinomas includes radiation therapy (RT) alone or combined with chemotherapy and neck dissection. Consequently all patients with nasopharyngeal carcinomas are treated with RT. To evaluate the CT and MRI appearance of nasopharyngeal carcinomas treated with RT and the ability of CT and MRI to differentiate persistent or residual tumour from radio-induced changes of head and neck tissues. Post-treatment CT and MRI examinations of 28 patients with primary nasopharyngeal cancers treated with RT (6000–7500 cGy) were retrospectively evaluated. We divided the patients in three groups on the basis of the differences in the CT and MRI appearance of the primary tumours treated with RT 1. Responders (9 patients): complete resolution of tumour or reduction in tumour size = or > 75%; 2. Non-Responders (8 patients): persistent tumour or residual mass with reduction in tumour size = or < 50%; 3. Partial Responders: (11 patients) persistent residual mass with reduction in tumour size from 50% to 75% or persistent asymmetry of the mucosal surface. There are some points to analyse in the interpretation of CT and MRI imaging of post-treated nasopharynx: Transient changes of irradiated soft tissues are more prominent during the first three months after RT (increased en-hancement of the pharyngeal mucosa and thickening of the pharyngeal walls). Persis-tent changes are subgrouped in 1. Soft tissue changes: a. Glandular (major salivary glands scialoadenitis and fatty degeneration); b. Deep (reticulation and fibrous degeneration of pre- and post-styloid parapharyngeal fat; c. Visceral (retraction of the pharyngeal wall and distorsion of lateral recess); d. Nervous (radio-induced damage of the CNS such myelopathy and radionecrosis. 2. Bone tissue changes: a. Fatty degeneration of bone marrow of the skull base; b. Sclerosis of the cortical bone of the basisphenoid. 3. Sinonasal changes: Reactive chronic sinusitis. Perineural-perivascular spread and skull base erosion is indicative of a poor outcome. The patients of the third group may also be followed with seriated CT because they have a significant percentage of recurrence.

The aim of this study is to evaluate the impact of CT and MRI staging on the RT plan analyzing the patterns of spread of nasopharyngeal tumours. Pre-treatment CT and MRI examinations of 28 patients (28–65 years old, mean age 42; 16 men, 12 women) with primary nasopharyngeal cancer were retrospectively evaluated. CT and MRI in clinically known or suspected nasopharyngeal cancer showed in all cases the extent and spread of the pathologic tissue; consequently the Americal Joint Committee on Cancer (AJCC) staging system for primary nasopharyngeal tumours was strictly respected. Imaging permitted in all cases a good evaluation of neck nodes; retropharyngeal, junctional, jugulo-digastric and accessory spinal lymph nodes were correctly staged on the basis of size, density-intensity, shape and contrast enhancement. The impact of non- and minimally-invasive diagnostic imaging techniques on head and neck diseases is well known. Clinical evaluation of the nasopharynx and nearby deep fascial planes is hard and fiberoptic examination detects only mucosal surfaces of the organ. Consequently prognosis and therapy of nasopharyngeal carcinomas depend on CT and MR staging both of the primary site and neck nodes. The RT beam and portals are focused on the basis of imaging and the results of the therapy may be correctly investigated only by the comparative analysis of the first follow-up examination with pre-treatment morphological data.

Aufbauend auf die Berechnung der inneren Vorgange eines Transformators entsteht ein Monitoring- und Diagnosesystem, das dem Betreiber als Instrument zur optimalen Nutzung seines Transformators dient. Zusatzliche Sensorik berucksichtigt den Einflus von Feuchtigkeit sowie den Sicherheitsaspekt.

To investigate whether the immune system improvement induced by pidotimod increases the rate of spontaneous disappearance of vulvar papillomatous lesions, a multicenter, double-blind, placebo-controlled, randomized clinical trial was performed. Forty-nine patients (23 in the pidotimod group and 26 in the placebo group) with first diagnosis of vulvar papillomatosis as shown by clinical and histological findings underwent 90-day treatment with oral 800-mg pidotimod once a day or identical placebo. The main outcome measure was the difference between vulvar papillomatous infected area before and after treatment judged by the following: complete regression (complete disappearance of all papillomatous lesions); partial regression (a decrease of at least 75% of the infected area); no response (a decrease of less than 75% of the infected area or new viral lesions not present at baseline). Forty patients completed the trial according to the study protocol and were entered in the "per protocol" analysis of efficacy. Complete regression was observed in 12 of 18 patients (66.7%) receiving pidotimod compared with 7 of 22 patients (31.8%) receiving placebo. The total infected surface area at the end of treatment was 10.1 +/- 18.5 mm2 (mean +/- SD) in the pidotimod arm and 198.3 +/- 399.2 mm2 in the placebo arm (p < 0.05 between treatment). Notwithstanding the fact that better results were obtained in the pidotimod group, more data are needed to confirm our encouraging results.

Owing to a rise in necrotizing enterocolitis (NEC, stage ⩾ 2) among very low birth weight (VLBW, birth weight1500 g) infants from 4% in 2005 to 2006 to 10% in 2007 to 2008, we developed and implemented quality improvement (QI) initiatives. The objective was to evaluate the impact of QI initiatives on NEC incidence in VLBW infants.In September 2009, we developed an NEC QI multidisciplinary team that conducted literature reviews and reviewed practices from other institutions to develop a feeding protocol, which was implemented in December 2009. The team tracked intervention compliance and occurrence of NEC stage ⩾ 2. In May 2010, we reviewed our nasogastric tube practice and relevant literature to develop a second intervention that reduced nasogastric tube indwelling time. The infants were divided into three groups: baseline (January 2008 to Novovember 2009, n219), QI phase 1 (December 2009 to May 2010, n62) and QI phase 2 (June 2010 to November 2011, n170).The NEC incidence did not decrease after implementation of the feeding protocol in QI phase 1 (19.4%) but did decline significantly after changing nasogastric tube management in QI phase 2 (2.9%). Multivariable logistic regression analysis demonstrated a significant relationship between QI phase and the incidence of NEC.QI initiatives were effective in decreasing NEC incidence in our high human milk-feeding NICU. Nasogastric tube bacterial contamination may have contributed to our peak in NEC incidence.

We show how the interference between spatially separated states of the center of mass (COM) of a mesoscopic harmonic oscillator can be evidenced by coupling it to a spin and performing solely spin manipulations and measurements (Ramsey Interferometry). We propose to use an optically levitated diamond bead containing an NV center spin. The nano-scale size of the bead makes the motional decoherence due to levitation negligible. The form of the spin-motion coupling ensures that the scheme works for thermal states so that moderate feedback cooling suffices. No separate control or observation of the COM state is required and thereby one dispenses with cavities, spatially resolved detection and low mass-dispersion ensembles. The controllable relative phase in the Ramsey interferometry stems from a gravitational potential difference so that it uniquely evidences coherence between states which involve the whole nano-crystal being in spatially distinct locations., 5 pages, 2 figures, version accepted for publication in Physical Review Letters