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Search Results: 1 - 10 of 408706 matches for " Dan M. Fliss "
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Surgery versus Watchful Waiting in Patients with Craniofacial Fibrous Dysplasia – a Meta-Analysis
Moran Amit, Michael T. Collins, Edmond J. FitzGibbon, John A. Butman, Dan M. Fliss, Ziv Gil
PLOS ONE , 2011, DOI: 10.1371/journal.pone.0025179
Abstract: Background Fibrous dysplasia (FD) is a benign bone tumor which most commonly involves the craniofacial skeleton. The most devastating consequence of craniofacial FD (CFD) is loss of vision due to optic nerve compression (ONC). Radiological evidence of ONC is common, however the management of this condition is not well established. Our objective was to compare the long-term outcome of patients with optic nerve compression (ONC) due to craniofacial fibrous dysplasia (CFD) who either underwent surgery or were managed expectantly. Methodology/Principal Findings We performed a meta-analysis of 27 studies along with analysis of the records of a cohort of patients enrolled in National Institutes of Health (NIH) protocol 98-D-0145, entitled Screening and Natural History of Fibrous Dysplasia, with a diagnosis of CFD. The study group consisted of 241 patients; 122 were enrolled in the NIH study and 119 were extracted from cases published in the literature. The median follow-up period was 54 months (range, 6–228 months). A total of 368 optic nerves were investigated. All clinically impaired optic nerves (n = 86, 23.3%) underwent therapeutic decompression. Of the 282 clinically intact nerves, 41 (15%) were surgically decompressed and 241 (85%) were followed expectantly. Improvement in visual function was reported in fifty-eight (67.4%) of the clinically impaired nerves after surgery. In the intact nerves group, long-term stable vision was achieved in 31/45 (75.6%) of the operated nerves, compared to 229/241 (95.1%) of the non-operated ones (p = 0.0003). Surgery in asymptomatic patients was associated with visual deterioration (RR 4.89; 95% CI 2.26–10.59). Conclusions Most patients with CFD will remain asymptomatic during long-term follow-up. Expectant management is recommended in asymptomatic patients even in the presence of radiological evidence of ONC.
The Transcervical Approach for Parapharyngeal Space Pleomorphic Adenomas: Indications and Technique
Gilad Horowitz, Oded Ben-Ari, Oshri Wasserzug, Noam Weizman, Moshe Yehuda, Dan M. Fliss
PLOS ONE , 2014, DOI: 10.1371/journal.pone.0090210
Abstract: Background Head and Neck Parapharyngeal space tumors are rare. Pleomorphic Adenomas are the most common Parapharyngeal space tumors. The purpose of this study was to define preoperative criteria for enabling full extirpation of parapharyngeal space pleomorphic adenomas via the transcervical approach while minimizing functional and cosmetic morbidity. Methods The surgical records and medical charts of 19 females and 10 males with parapharyngeal space pleomorphic adenomas operated between 1993 and 2012 were reviewed. Results Fifteen patients were operated by a simple transcervical approach, 13 by a transparotid transcervical approach, and one by a transmandibular transcervical approach. Complications included facial nerve paralysis, infection, hemorrhage and first bite syndrome. There were three recurrences, but neither recurrence nor complications were associated with the type of surgical approach. Conclusion A simple transcervical approach is preferred for parapharyngeal space pleomorphic adenomas with narrow attachments to the deep lobe of the parotid gland and for pleomorphic adenomas originating in a minor salivary gland within the parapharyngeal space.
Cranialization of the Frontal Sinus for Secondary Mucocele Prevention following Open Surgery for Benign Frontal Lesions
Gilad Horowitz, Moran Amit, Oded Ben-Ari, Ziv Gil, Abraham Abergel, Nevo Margalit, Oren Cavel, Oshri Wasserzug, Dan M. Fliss
PLOS ONE , 2013, DOI: 10.1371/journal.pone.0083820
Abstract: Objective To compare frontal sinus cranialization to obliteration for future prevention of secondary mucocele formation following open surgery for benign lesions of the frontal sinus. Study Design Retrospective case series. Setting Tertiary academic medical center. Patients Sixty-nine patients operated for benign frontal sinus pathology between 1994 and 2011. Interventions Open excision of benign frontal sinus pathology followed by either frontal obliteration (n = 41, 59%) or frontal cranialization (n = 28, 41%). Main Outcome Measures The prevalence of post-surgical complications and secondary mucocele formation were compiled. Results Pathologies included osteoma (n = 34, 49%), mucocele (n = 27, 39%), fibrous dysplasia (n = 6, 9%), and encephalocele (n = 2, 3%). Complications included skin infections (n = 6), postoperative cutaneous fistula (n = 1), telecanthus (n = 4), diplopia (n = 3), nasal deformity (n = 2) and epiphora (n = 1). None of the patients suffered from postoperative CSF leak, meningitis or pneumocephalus. Six patients, all of whom had previously undergone frontal sinus obliteration, required revision surgery due to secondary mucocele formation. Statistical analysis using non-inferiority test reveal that cranialization of the frontal sinus is non-inferior to obliteration for preventing secondary mucocele formation (P<0.0001). Conclusion Cranialization of the frontal sinus appears to be a good option for prevention of secondary mucocele development after open excision of benign frontal sinus lesions.
Prevention of Cellular Suicide by Cytomegaloviruses
Patricia M. Fliss,Wolfram Brune
Viruses , 2012, DOI: 10.3390/v4101928
Abstract: As intracellular parasites, viruses rely on many host cell functions to ensure their replication. The early induction of programmed cell death (PCD) in infected cells constitutes an effective antiviral host mechanism to restrict viral spread within an organism. As a countermeasure, viruses have evolved numerous strategies to interfere with the induction or execution of PCD. Slowly replicating viruses such as the cytomegaloviruses (CMVs) are particularly dependent on sustained cell viability. To preserve viability, the CMVs encode several viral cell death inhibitors that target different key regulators of the extrinsic and intrinsic apoptosis pathways. The best-characterized CMV-encoded inhibitors are the viral inhibitor of caspase-8-induced apoptosis (vICA), viral mitochondrial inhibitor of apoptosis (vMIA), and viral inhibitor of Bak oligomerization (vIBO). Moreover, a viral inhibitor of RIP-mediated signaling (vIRS) that blocks programmed necrosis has been identified in the genome of murine CMV (MCMV), indicating that this cell death mode is a particularly important part of the antiviral host response. This review provides an overview of the known cell death suppressors encoded by CMVs and their mechanisms of action.
A Dirichlet-to-Neumann approach for the exact computation of guided modes in photonic crystal waveguides
Sonia Fliss
Mathematics , 2012,
Abstract: This works deals with one dimensional infinite perturbation - namely line defects - in periodic media. In optics, such defects are created to construct an (open) waveguide that concentrates light. The existence and the computation of the eigenmodes is a crucial issue. This is related to a self-adjoint eigenvalue problem associated to a PDE in an unbounded domain (in the directions orthogonal to the line defect), which makes both the analysis and the computations more complex. Using a Dirichlet-to-Neumann (DtN) approach, we show that this problem is equivalent to one set on a small neighborhood of the defect. On contrary to existing methods, this one is exact but there is a price to be paid : the reduction of the problem leads to a nonlinear eigenvalue problem of a fixed point nature.
Managing Cancer Pain at the End of Life with Multiple Strong Opioids: A Population-Based Retrospective Cohort Study in Primary Care
Wei Gao, Martin Gulliford, Michael I. Bennett, Fliss E. M. Murtagh, Irene J. Higginson
PLOS ONE , 2014, DOI: 10.1371/journal.pone.0079266
Abstract: Background End-of-life cancer patients commonly receive more than one type of strong opioid. The three-step analgesic ladder framework of the World Health Organisation (WHO) provides no guidance on multiple opioid prescribing and there is little epidemiological data available to inform practice. This study aims to investigate the time trend of such cases and the associated factors. Methods Strong opioid prescribing in the last three months of life of cancer patients were extracted from the General Practice Research Database (GPRD). The outcome variable was the number of different types of prescribed non-rescue doses of opioids (1 vs 2–4, referred to as a complex case). Associated factors were evaluated using prevalence ratios (PR) derived from multivariate log-binomial model, adjusting for clustering effects and potential confounding variables. Results Overall, 26.4% (95% CI: 25.6–27.1%) of 13,427 cancer patients (lung 41.7%, colorectal 19.1%, breast 18.6%, prostate 15.5%, head and neck 5.0%) were complex cases. Complex cases increased steadily over the study period (1.02% annually, 95%CI: 0.42–1.61%, p = 0.048) but with a small dip (7.5% reduction, 95%CI: ?0.03 to 17.8%) around the period of the Shipman case, a British primary care doctor who murdered his patients with opioids. The dip significantly affected the correlation of the complex cases with persistent increasing background opioid prescribing (weighted correlation coefficients pre-, post-Shipman periods: 0.98(95%CI: 0.67–1.00), p = 0.011; 0.14 (95%CI: ?0.85 to 0.91), p = 0.85). Multivariate adjusted analysis showed that the complex cases were predominantly associated with year of death (PRs vs 2000: 1.05–1.65), not other demographic and clinical factors except colorectal cancer (PR vs lung cancer: 1.24, 95%CI: 1.12–1.37). Conclusion These findings suggest that prescribing behaviour, rather than patient factors, plays an important role in multiple opioid prescribing at the end of life; highlighting the need for training and education that goes beyond the well-recognised WHO approach for clinical practitioners.
Exploring the Interstellar Media of Optically Compact Dwarf Galaxies
Hans P. Most,John M. Cannon,John J. Salzer,Jessica J. Rosenberg,Eric Engstrom,Palmer Fliss
Physics , 2013, DOI: 10.1088/0004-6256/145/6/150
Abstract: We present new Very Large Array HI spectral line, archival Sloan Digital Sky Survey, and archival Spitzer Space Telescope imaging of eight star-forming blue compact dwarf galaxies that were selected to be optically compact (optical radii less than 1 kpc). These systems have faint blue absolute magnitudes (M_B >= -17), ongoing star formation (based on emission-line selection by the H alpha or [OIII] lines), and are nearby (mean velocity = 3315 km/s = 45 Mpc). One galaxy in the sample, ADBS 113845+2008, is found to have an HI halo that extends 58 r-band scale lengths from its stellar body. In contrast, the rest of the sample galaxies have HI radii to optical-scale-length ratios ranging from 9.3 to 26. The size of the HI disk in the "giant disk" dwarf galaxy ADBS 113845+2008 appears to be unusual as compared to similarly compact stellar populations.
Multiple faults diagnosis using causal graph
Imtiez Fliss,Moncef Tagina
Computer Science , 2012,
Abstract: This work proposes to put up a tool for diagnosing multi faults based on model using techniques of detection and localization inspired from the community of artificial intelligence and that of automatic. The diagnostic procedure to be integrated into the supervisory system must therefore be provided with explanatory features. Techniques based on causal reasoning are a pertinent approach for this purpose. Bond graph modeling is used to describe the cause effect relationship between process variables. Experimental results are presented and discussed in order to compare performance of causal graph technique and classic methods inspired from artificial intelligence (DX) and control theory (FDI).
A Novel Fault Detection Approach combining Adaptive Thresholding and Fuzzy Reasoning
Imtiez fliss,Moncef Tagina
Computer Science , 2012,
Abstract: Fault detection methods have their pros and cons. Thus, it is possible that some methods can complement each other and offer consequently better diagnostic systems. The integration of various characteristics is a way to develop "hybrid" systems to overcome the limitations of individual strategies of each method. In this paper a novel detection module combining the use of adaptive threshold and fuzzy logic reasoning inspired by the Evsukoff's approach is proposed in order to reduce the rate of false alarms, guarantee more robustness to disturbances and assist the operator in making decisions. The proposed approach can be used in case of multiple faults detection. This approach is applied to a benchmark in diagnosis domain: the three-tank system. The results of the proposed detection module are then presented through a gradual palette of colors in the graphical interface of the system.
Exploiting Particle Swarm Optimization in Multiple Faults Fuzzy Detection
Imtiez Fliss,Moncef Tagina
Computer Science , 2012,
Abstract: In this paper an on-line multiple faults detection approach is first of all proposed. For efficiency, an optimal design of membership functions is required. Thus, the proposed approach is improved using Particle Swarm Optimization (PSO) technique. The inputs of the proposed approaches are residuals representing the numerical evaluation of Analytical Redundancy Relations. These residuals are generated due to the use of bond graph modeling. The results of the fuzzy detection modules are displayed as a colored causal graph. A comparison between the results obtained by using PSO and those given by the use of Genetic Algorithms (GA) is finally made. The experiments focus on a simulation of the three-tank hydraulic system, a benchmark in the diagnosis domain.
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