The unruptured intracranial aneurysm treatment score: a multidisciplinary consensus.

OBJECTIVE We endeavored to develop an unruptured intracranial aneurysm (UIA) treatment score (UIATS) model that includes and quantifies key factors involved in clinical decision-making in the management of UIAs and to assess agreement for this model among specialists in UIA management and research. METHODS An international multidisciplinary (neurosurgery, neuroradiology, neurology, clinical epidemiology) group of 69 specialists was convened to develop and validate the UIATS model using a Delphi consensus. For internal (39 panel members involved in identification of relevant features) and external validation (30 independent external reviewers), 30 selected UIA cases were used to analyze agreement with UIATS management recommendations based on a 5-point Likert scale (5 indicating strong agreement). Interrater agreement (IRA) was assessed with standardized coefficients of dispersion (vr*) (vr* = 0 indicating excellent agreement and vr* = 1 indicating poor agreement). RESULTS The UIATS accounts for 29 key factors in UIA management. Agreement with UIATS (mean Likert scores) was 4.2 (95% confidence interval [CI] 4.1-4.3) per reviewer for both reviewer cohorts; agreement per case was 4.3 (95% CI 4.1-4.4) for panel members and 4.5 (95% CI 4.3-4.6) for external reviewers (p = 0.017). Mean Likert scores were 4.2 (95% CI 4.1-4.3) for interventional reviewers (n = 56) and 4.1 (95% CI 3.9-4.4) for noninterventional reviewers (n = 12) (p = 0.290). Overall IRA (vr*) for both cohorts was 0.026 (95% CI 0.019-0.033). CONCLUSIONS This novel UIA decision guidance study captures an excellent consensus among highly informed individuals on UIA management, irrespective of their underlying specialty. Clinicians can use the UIATS as a comprehensive mechanism for indicating how a large group of specialists might manage an individual patient with a UIA.

Preliminary human factors guidelines for traffic management centers.

Federal Highway Administration, ITS Joint Program Office, Washington, D. C.

Comparable systems analysis: evaluation of ten command centers as potential sites.

Turner-Fairbank Highway Research Center, McLean, Va.

Œuvres de P.E. Lemontey ...

t. 1-2. Raison, folie, petit cours de morale mis à la portée des vieux enfans; suivi des observateurs de la femme.--t. 3. Éloges, notices historiques et littéraires.--t. 4. Articles inédits extraits des mémoires de Dangeau.--t. 5. Essai sur l'établissement monarchique de Louis XIV.

Œuvres de P.E. Lemontey ...

Includes bibliographical references.

Memoires (inédits de l'abbé Morellet, suivis de sa correspondance avec M. le Comte R*** ...

Mode of access: Internet.

De auleao et proedria in theatro Graecorum ad Pollucis Onamast. IV. 19. [section symbol].121, 122.

[Progr.]

Carta em resposta de certo amigo da cidade de Lisboa a outro da villa de Santarem, em que se lançam os fundamentos sobre a verdade, ou incerteza da morte d'elrei d. Sebastião, XVI. rei de Portugal, na batalha de Alcacerquibir em Africa ...

Bound in calf by Lesort, gold tooled, inside borders.

The Hound of heaven

Bibliography: 4th prelim. leaf.

From theory-inspired to theory-based interventions : A protocol for developing and testing a methodology for linking behaviour change techniques to theoretical mechanisms of action

This research is funded by UK Medical Research Council grant number MR/L011115/1

From Theory-Inspired to Theory-Based Interventions : A Protocol for Developing and Testing a Methodology for Linking Behaviour Change Techniques to Theoretical Mechanisms of Action

This research is funded by UK Medical Research Council grant number MR/L011115/1. We would like to thank the 105 experts in behaviour change who have committed their time and offered their expertise for study 2 of this research. We are also very grateful to all those who sent us peer-reviewed behaviour change intervention descriptions for study 1. Finally, we would like thank Dr. Emma Beard and Dr. Dan Dediu for their statistical input and to all the researchers, particularly Holly Walton, who have assisted in the coding of papers for study 1.

Welland Canal Survey of Lands George Marlatt 1826, 1831

Two survey maps and descriptions of George Marlatt's land created by The Welland Canal Company. The first is from 1826, as described in the deed of November 21, 1826. The second survey was done on August 29, 1831 by George Keefer. Included is a written description of the land along with a drawing of the land. Noteable features for the first survey (p.85) include; line between Kelly and Marlatt's land, lot division. Noteable features for the second survey (p.87) include; road to Beaverdams, reservoir, bridges, road allowance, lot divisions, line between Kelly and Marlatt's land. Surveyor notes are seen in pencil on the map.See also Page 90-91

Complicaciones postoperatorias tempranas de la colporrafia anterior por técnica tradicional versus técnica de sitio específico

El prolapso del piso pélvico es una entidad frecuente, especialmente en pacientes postmenopáusicas y en su gran mayoría requiere tratamiento quirúrgico. En este estudio comparamos la aparición de complicaciones postoperatorias tempranas entre la colporrafia anterior con técnica clásica (TC) versus la colporrafia anterior con técnica de sitio especifico (CSE). Se realizó un estudio observacional analítico, retrospectivo, de dos cohortes de pacientes que requirieron colporrafia anterior entre agosto de 2009 hasta junio de 2012. Las características de cada grupo fueron homogéneas y comparables. El desenlace de mayor frecuencia fue dehiscencia de la línea de sutura, sin embargo, no se encontraron diferencias estadísticamente significativas entre las dos técnicas. La aparición de reprolapso temprano y el diagnóstico de abscesos o hematomas presentaron frecuencias que carecen de diferencia significativa. No hubo complicaciones tempranas graves tales como sangrado intraoperatoria mayor o lesiones vesicouretrales. Los resultados sugieren que las dos técnicas tienen una incidencia baja de complicaciones postoperatorias tempranas y por lo tanto parecen ser seguros dentro del manejo quirúrgico del prolapso del componente anterior del piso pélvico.