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  1. Quality improvement in neurology: AAN Parkinson disease quality measures

    PubMed Central

    Cheng, E.M.; Tonn, S.; Swain-Eng, R.; Factor, S.A.; Weiner, W.J.; Bever, C.T.

    2010-01-01

    Background: Measuring the quality of health care is a fundamental step toward improving health care and is increasingly used in pay-for-performance initiatives and maintenance of certification requirements. Measure development to date has focused on primary care and common conditions such as diabetes; thus, the number of measures that apply to neurologic care is limited. The American Academy of Neurology (AAN) identified the need for neurologists to develop measures of neurologic care and to establish a process to accomplish this. Objective: To adapt and test the feasibility of a process for independent development by the AAN of measures for neurologic conditions for national measurement programs. Methods: A process that has been used nationally for measure development was adapted for use by the AAN. Topics for measure development are chosen based upon national priorities, available evidence base from a systematic literature search, gaps in care, and the potential impact for quality improvement. A panel composed of subject matter and measure development methodology experts oversees the development of the measures. Recommendation statements and their corresponding level of evidence are reviewed and considered for development into draft candidate measures. The candidate measures are refined by the expert panel during a 30-day public comment period and by review by the American Medical Association for Current Procedural Terminology (CPT) II codes. All final AAN measures are approved by the AAN Board of Directors. Results: Parkinson disease (PD) was chosen for measure development. A review of the medical literature identified 258 relevant recommendation statements. A 28-member panel approved 10 quality measures for PD that included full specifications and CPT II codes. Conclusion: The AAN has adapted a measure development process that is suitable for national measurement programs and has demonstrated its capability to independently develop quality measures. GLOSSARY

  2. Awards, lectures, and fellowships sponsored by the AANS/CNS Section on Tumors.

    PubMed

    Lau, Darryl; Barker, Fred G; Aghi, Manish K

    2014-09-01

    A major goal of the Section on Tumors of the American Association of Neurological Surgery (AANS) and Congress of Neurological Surgeons (CNS) since it was founded in 1984 has been to foster both education and research in the field of brain tumor treatment and development. In support of this goal, the Section sponsors a number of awards, named lectures, and fellowships at the annual meetings of the AANS and CNS. In this article, we describe the awards given by the AANS/CNS Section on Tumors since its foundation, the recipients of the awards, and their philanthropic donors. The subsequent history of awardees and their work is briefly examined. Specifically for the Preuss and Mahaley Awards, this article also examines the rates of publication among the award-winning abstracts and achievement of grant funding by awardees.

  3. The 2017 AANS Presidential Address. A world of innovation.

    PubMed

    Boop, Frederick A

    2017-12-01

    The 2016 scientific meeting of the American Association of Neurological Surgeons (AANS) focused on the theme "A World of Innovation." In his presidential address, 2016 AANS President Frederick Boop compared the historical development of the specialty of neurological surgery with that of the development of global communications. In the early years, general surgeons training in the United States would spend post-residency time abroad learning from surgical masters in Europe and other places. Since Harvey Cushing's day, neurosurgeons from around the world continue to travel abroad, with many now coming to America for training at centers of excellence. Current clinical practice is defined by multi-national, multi-center clinical trials, and the AANS subsidiary NeuroPoint Alliance has positioned itself to serve as an international center for the oversight of such trials. The Neurosurgery Research & Education Foundation and the Journal of Neurosurgery Publishing Group have made it possible for a neurosurgeon anywhere with Internet access to learn relevant surgical anatomy, learn new neurosurgical procedures, and watch masters in the field perform operations via high-definition surgical videos at no cost via learning platforms such as the Rhoton Collection, the Neurosurgical Atlas, and Neurosurgical Focus video supplements. At the same time, patients are now traveling abroad to seek medical specialty care. Although the globalization of health care poses certain threats, it also presents neurosurgeons with a world of opportunities.

  4. The practice of neurology, 2000-2010: report of the AAN Member Research Subcommittee.

    PubMed

    Adornato, B T; Drogan, O; Thoresen, P; Coleman, M; Henderson, V W; Henry, K A; Liu, L; Mortimer, J A; Schneck, M J; Borenstein, A R

    2011-11-22

    To present an analysis of American Academy of Neurology (AAN) membership demographics and practice trends over the past decade. Data from the 2009 AAN Census and 2010 Practice Profile Form (PPF) surveys were compared to results from 2004 and 2000 surveys. The Census was sent to all AAN members, and the PPF was sent to a random sample of US practicing neurologists. Since 2000, AAN membership increased by 31%, and the number of US neurologist-members increased by 14%. Mean age of US neurologists increased from 48.6 to 53.3 years, and 23.9% of neurologists are women. There was a 15% increase in the proportion of neurologists relative to the US population, from 3.41 neurologists per 100,000 population in 2000 to 3.92 neurologists in 2009. In 2009, 24.1% of US neurologists were in solo practice, 27.8% were in a neurology group, and 35.6% were in multispecialty/university settings, with little change in practice arrangements over time. The top 5 practice interest areas were unchanged since 2004 as were the number of hours devoted to patient care (42.3) or total work hours per week (57.1). Little change was observed in performed procedures, except increased use of botulinum toxin and nerve blocks and a decline in lumbar punctures. Neurologists rely more on physician assistants to see follow-up and new patients independently (p < 0.001). Despite advances in neurologic diagnosis and therapy, there has been little change in practice characteristics of US neurologists.

  5. Neuromuscular Highlights-AAN 2005.

    PubMed

    Cheema, Zahid; Saperstein, David; Jackson, Carolyn; Newman, Daniel

    2006-06-01

    Summary of Neuromuscular Presentations at the 57 Annual AAN 2005 meeting in Miami Florida on topics of Facioscapulohumeral muscular dystrophy (FSHD), Duchenne muscular dystrophy (DMD), Diabetic Neuropathy, Charco Marie Tooth disease (CMT), Comparison of injected steroids versus Surgery for carpal tunnel syndrome, Rituximab in Anti-MAG associated polyneuropathy, Cannabis based medicine (CBM) in the treatment of neuropathic pain, utility of skin biopsy with intraepidermal nerve fiber density (IENFD) in sensory complaints, comparing sympathetic skin responses (SSRs) and skin biopsy in diagnosing small fiber sensory neuropathy, Chronic inflammatory demyelinating polyneuropathy (CIDP) clinical and electrophysiologic predictors, affect of limb warming in mild ulnar nerve conduction study (NCS) abnormalities, Tamoxifen affect in ALS, open label study of 3,4 DAP, Pyridostigmine and Ephedrine in fast channel syndrome, Mexilitine as an antimyotonia treatment in myotonic dystrophy (DM1), frontal lobe impairment evaluation in DM1 and DM2 patients and phenotype-genotype correlation in patients with dysferlinopathy.

  6. AAN Epilepsy Quality Measures in clinical practice: a survey of neurologists.

    PubMed

    Wasade, Vibhangini S; Spanaki, Marianna; Iyengar, Revathi; Barkley, Gregory L; Schultz, Lonni

    2012-08-01

    Epilepsy Quality Measures (EQM) were developed by the American Academy of Neurology (AAN) to convey standardization and eliminate gaps and variations in the delivery of epilepsy care (Fountain et al., 2011 [1]). The aim of this study was to identify adherence to these measures and other emerging practice standards in epilepsy care. A 15-item survey was mailed to neurologists in Michigan, USA, inquiring about their practice patterns in relation to EQM. One hundred thirteen of the 792 surveyed Michigan Neurologists responded (14%). The majority (83% to 94%) addressed seizure type and frequency, reviewed EEG and MRI, and provided pregnancy counseling to women of childbearing potential. Our survey identified gaps in practice patterns such as counseling about antiepileptic drug (AED) side effects and knowledge about referral for surgical therapy of intractable epilepsy. Statistical significance in the responses on the AAN EQM was noted in relation to number of years in practice, number of epilepsy patients seen, and additional fellowship training in epilepsy. Practice patterns assessment in relation to other comorbidities revealed that although bone health and sudden unexplained death in epilepsy are addressed mainly in patients at risk, depression is infrequently discussed. The findings in this study indicate that additional educational efforts are needed to increase awareness and to improve quality of epilepsy care at various points of health care delivery. Copyright © 2012 Elsevier Inc. All rights reserved.

  7. Psychometrics of the AAN Caregiver Driving Safety Questionnaire and contributors to caregiver concern about driving safety in older adults.

    PubMed

    Carvalho, Janessa O; Springate, Beth; Bernier, Rachel A; Davis, Jennifer

    2018-03-01

    ABSTRACTBackground:The American Academy of Neurology (AAN) updated their practice parameters in the evaluation of driving risk in dementia and developed a Caregiver Driving Safety Questionnaire, detailed in their original manuscript (Iverson Gronseth, Reger, Classen, Dubinsky, & Rizzo, 2010). They described four factors associated with decreased driving ability in dementia patients: history of crashes or citations, informant-reported concerns, reduced mileage, and aggressive driving. An informant-reported AAN Caregiver Driving Safety Questionnaire was designed with these elements, and the current study was the first to explore the factor structure of this questionnaire. Additionally, we examined associations between these factors and cognitive and behavioral measures in patients with mild cognitive impairment or early Alzheimer's disease and their informants. Exploratory factor analysis revealed a four-component structure, consistent with the theory behind the AAN scale composition. These four factor scores also were significantly associated with performance on cognitive screening instruments and informant reported behavioral dysfunction. Regressions revealed that behavioral dysfunction predicted caregiver concerns about driving safety beyond objective patient cognitive dysfunction. In this first known quantitative exploration of the scale, our results support continued use of this scale in office driving safety assessments. Additionally, patient behavioral changes predicted caregiver concerns about driving safety over and above cognitive status, which suggests that caregivers may benefit from psychoeducation about cognitive factors that may negatively impact driving safety.

  8. Reconciling the clinical practice guidelines on Bell's palsy from the AAO-HNSF and the AAN.

    PubMed

    Schwartz, Seth R; Jones, Stephanie L; Getchius, Thomas S D; Gronseth, Gary S

    2014-05-01

    Bell's palsy, named after the Scottish anatomist, Sir Charles Bell, is the most common acute mononeuropathy, or disorder affecting a single nerve, and is the most common diagnosis associated with facial nerve weakness/paralysis. In the past 2 years, both the American Academy of Neurology (AAN) and the American Academy of Otolaryngology-Head and Neck Surgery Foundation (AAO-HNSF) have published clinical practice guidelines aimed to improve the quality of care and outcomes for patients diagnosed with Bell's palsy. This commentary aims to address the similarities and differences in the scope and final recommendations made by each guideline development group.

  9. Vrouwen bij de Koninklijke Landmacht: Een Onderzoek naar de Maatregelen die het Behoud en de Doorstroom van Vrouwelijke Militairen Verbeteren (Women in the Royal Netherlands Army: Measures for Retention and Career Development)

    DTIC Science & Technology

    2007-02-01

    mannencultuur. Uit onderzoek blijkt dat vrouwelijke BBT-ers (Beroeps Bepaalde Tijd ) zicb goed tbuis voelen bij de (masculiene) organisatiecultuur van...de KL. Zij ervaren bovendien geen benadeling of negatieve bejegening. Vrouwelijke BOT-ers (Beroeps Onbepaalde Tijd ) geven daarentegen wel aan dat zij...arbeid en zorg. Meer tijd voor de thuissituatie, waarbij de werknemner zelf kan beslissen hoe zij deze fijd bet beste kan aanpassen aan de behoefte van

  10. Scatterometry

    NASA Astrophysics Data System (ADS)

    Stoffelen, Adrianus Cornelis Maria

    1996-10-01

    Een veelheid aan meteorologische metingen is dagelijks beschikbaar. De meeste van deze waarnemingen bevinden zich echter boven land, en met name windwaarnemingen boven de (Noord Atlantische) oceaan zijn schaars. Bij een westelijke luchtstroming is dit een duidelijke beperking voor de weers- en golfverwachtingen ten behoeve van Nederland. Juist dan is het gevaar voor bijvoorbeeld storm of overstroming het grootst. Ook in het aardse klimaatsysteem speelt de wind aan het oppervlak een grote rol en is de belangrijkste factor voor de aandrijving van de oceaancirculatie. De oceaancirculatie op zijn beurt is cruciaal voor de verschijnselen die samenhangen met bijvoorbeeld El Niño. Dit proefschift gaat over het scatterometer instrument dat vanuit de ruimte, zelfs onder een wolkendek, nauwkeurige en betrouwbare informatie geeft over de wind aan het oceaanoppervlak met een hoge mate van ruimtelijke consistentie. Tijdens de tweede wereldoorlog werden radars aan boord van schepen veelvuldig gebruikt voor de opsporing van vijandige vaartuigen. Hierbij werd vastgesteld dat de detectie slechter werd naarmate de wind aan het zeeoppervlak groter was. Proefondervindelijk was hiermee het principe van een wind scatterometer aangetoond. Al snel ontwikkelde zich dan ook de idee de wind aan het zeeoppervlak te meten met behulp van radar. Vanuit een vliegtuig of een satelliet word dan een microgolfbundel onder een schuine hoek naar het zeeoppervlak gestuurd. De microgolfstraling, met gewoonlijk een golflengte van enkele centimeters, wordt verstrooid aan het ruwe oppervlak, en een klein gedeelte van de uitgezonden puls keert terug naar het detectorgedeelte van de scatterometer. Het fysische fenomeen van belang voor de werking van de scatterometer is de aanwezigheid van zogeheten capillaire gavitatiegolven op het zeeoppervlak. Deze golven hebben een golflengte van enkele centimeters en reageren vrijwel instantaan op de sterkte van de wind. De verstrooiing van microgolven is op zijn beurt

  11. Educational Intervention Improves Compliance With AAN Guidelines for Return Epilepsy Visits: A Quality Improvement Project.

    PubMed

    Nelson, Gary R; Filloux, Francis M; Kerr, Lynne M

    2016-10-01

    In 2011, the American Academy of Neurology (AAN) released guidelines for return seizure visits detailing 8 points that should be addressed during such visits. These guidelines are designed to improve routine follow-up care for epilepsy patients. The authors performed a quality improvement project aimed at increasing compliance with these guidelines after educating providers about them. The authors performed a chart review before and after an intervention which included: education regarding the guidelines, providing materials to remind providers of the guidelines, and templates to facilitate compliance. The authors reviewed charts at 2 and 6 months after the intervention. Significant improvement in documentation of 4 of the 8 measures was observed after this educational intervention. This suggests that simple educational interventions may help providers change practice and can improve compliance with new guidelines while requiring minimal time and resources to implement. © The Author(s) 2016.

  12. An exploratory study of illegal gamblers in Hong Kong.

    PubMed

    Tessler, Andrew; El Beyrouty, Kareen; Crapnell, Natasha

    2017-01-01

    This study investigates the nature and behaviour of illegal gamblers in Hong Kong. A face-to-face street survey of 512 gamblers was conducted in Hong Kong between September and December 2015 with supplementary convenience sampling allowing for analysis of a total sample of 103 illegal gamblers. 56% of illegal gamblers recorded results consistent with this study's definition of 'excessive gambling' [i.e. moderate risk and problem gamblers under the Problem Gambling Severity Index (PGSI)]. 81% of surveyed illegal gamblers were male, 77% were aged between 30 and 49 and 67% were in blue collar occupations. Illegal gamblers bet more frequently on both legal and illegal games than their legal counterparts and spent more when they did bet. While this research did not indicate the direction of causality between illegal and excessive gambling, international work (de Bruin et al. in verslingerd aan meer dan een spel: Een onderzoek naar de aard en omvang van kansspelproblematiek in Nederland, WODC/CVO, Utrecht, http://www.lexandgaming.eu/nl/wp-content/uploads/2015/01/Verslingerd-aan-meer-dan-een-spel.pdf, 2005; Binde in What are the most harmful forms of gambling? Analysing problem gambling prevalence surveys, http://www.utbildning.gu.se/digitalAssets/1327/1327132_cefos-wp12.pdf, 2011) suggests that excessive gamblers are drawn to illegal gambling. Reform could allow excessive gambling by illegal gamblers to be better addressed and initial work suggests some financial benefits to Hong Kong.

  13. Onderzoek Naar de Bepaling van Wrijvingscoefficienten van een Voertuig uit Uitrolcurves (Research into the Determination of Friction Coefficients of a Vehicle from Deceleration Curves)

    DTIC Science & Technology

    1991-08-01

    en Aemne Vrwaarden Wo OndOrzoeks 8 FE 1 1 opdrchl aT00’ dn wet do bereflende F B 0 1 9 terzake tussen partilon geslOlen dw:Agsu overOerikomStf...Ongemlbric~~d 9 -028 14 :259 wwWmtmd.fl 59w IEEIIIIiiiarabIg𔃽 1 c~ Vrederikkazerle, Geb. InO 03 3.. ~ van den Burchlaal 312 03 173Telefoofl 070-3166394...1ILEIDING 6 2 HET FYSISCHE MODEL 8 3 ONDERZOEK AAN DE DIFFERENTIAALVERGELIJKING 11 3.1 Existentie en uniciteit van ccii oplossing 11 3.2 Continulleit en

  14. Prospective study of cost of care at multidisciplinary ALS centers adhering to American Academy of Neurology (AAN) ALS practice parameters.

    PubMed

    Boylan, Kevin; Levine, Todd; Lomen-Hoerth, Catherine; Lyon, Mary; Maginnis, Kimberly; Callas, Peter; Gaspari, Celeste; Tandan, Rup

    2015-01-01

    Multidisciplinary care in ALS is associated with longer survival, improved quality of life, and reduced hospital admissions, but there are no published data on institutional costs associated with multidisciplinary ALS care at U.S. centers. We prospectively examined institutional costs, adherence to AAN Practice Parameters and patient satisfaction in multidisciplinary ALS clinics at 18 U.S. ALS centers. Centers reported patient volumes; direct costs for staff salary/benefits, supplies and equipment; and institutional non-salary and overhead costs over a three-month period. In 1117 patients seen during this period, mean age was 61.5 years (range 25-91 years), 56% were male, and mean ALSFRS-R score was 29. Mean total salary/benefit cost per clinic day for all providers was $2964 (range $1692-$5236 across centers). Mean salary/benefit cost per patient per clinic was $507 (range $258-$806 across centers). Differences among centers in reporting non-salary costs prevented meaningful analysis. Practice parameter adherence and patient satisfaction were high. This prospective collaborative study demonstrates the direct financial burden of evidence-based multidisciplinary ALS care in the U.S.; more refined non-salary and overhead cost data are needed to evaluate the full cost impact of care. These data may be useful in supporting evidence-based models of patient centered care for ALS.

  15. The role of atmospheric stability/turbulence on wakes at the Egmond aan Zee offshore wind farm

    NASA Astrophysics Data System (ADS)

    Barthelmie, R. J.; Churchfield, M. J.; Moriarty, P. J.; Lundquist, J. K.; Oxley, G. S.; Hahn, S.; Pryor, S. C.

    2015-06-01

    The aim of the paper is to present results from the NREL SOWFA project that compares simulations from models of different fidelity to meteorological and turbine data from the Egmond aan Zee wind farm. Initial results illustrate that wake behavior and impacts are strongly impacted by turbulence intensity [1]. This includes both power losses from wakes and loading illustrated by the out of plane bending moment. Here we focus on understanding the relationship between turbulence and atmospheric stability and whether power losses due to wakes can effectively be characterized by measures of turbulence alone or whether atmospheric stability as a whole plays a fundamental role in wake behavior. The study defines atmospheric stability using the Monin-Obukhov length estimated based on the temperature difference between 116 and 70 m. The data subset selected using this method for the calculation of the Monin-Obukhov length indicate little diurnal or directional dependence of the stability classes but a dominance of stable classes in the spring/unstable classes in fall and of near-neutral classes at high wind speeds (Figure 2). The analysis is complicated by the need to define turbulence intensity. We can select the ratio of the standard deviation of wind speed to mean wind speed in each observation period using data from the meteorological mast, in which case a substantial amount of data must be excluded due to the presence of the wind farm. An alternative is to use data from the wind turbines which could provide a larger data set for analysis. These approaches are examined and compared to illustrate their robustness. Finally, power losses from wakes are categorized according to stability and/or turbulence in order to understand their relative importance in determining the behavior of wind turbine wakes.

  16. Antiepileptic drug selection for people with HIV/AIDS: evidence-based guidelines from the ILAE and AAN.

    PubMed

    Birbeck, Gretchen L; French, Jacqueline A; Perucca, Emilio; Simpson, David M; Fraimow, Henry; George, Jomy M; Okulicz, Jason F; Clifford, David B; Hachad, Houda; Levy, René H

    2012-01-01

    A joint panel of the American Academy of Neurology (AAN) and the International League Against Epilepsy (ILAE) convened to develop guidelines for selection of antiepileptic drugs (AEDs) among people with HIV/AIDS. The literature was systematically reviewed to assess the global burden of relevant comorbid entities, to determine the number of patients who potentially utilize AEDs and antiretroviral agents (ARVs), and to address AED-ARV interactions. Key findings from this literature search included the following: AED-ARV administration may be indicated in up to 55% of people taking ARVs. Patients receiving phenytoin may require a lopinavir/ritonavir dosage increase of approximately 50% to maintain unchanged serum concentrations (Level C). Patients receiving valproic acid may require a zidovudine dosage reduction to maintain unchanged serum zidovudine concentrations (Level C). Coadministration of valproic acid and efavirenz may not require efavirenz dosage adjustment (Level C). Patients receiving ritonavir/atazanavir may require a lamotrigine dosage increase of approximately 50% to maintain unchanged lamotrigine serum concentrations (Level C). Coadministration of raltegravir/atazanavir and lamotrigine may not require lamotrigine dosage adjustment (Level C). Coadministration of raltegravir and midazolam may not require midazolam dosage adjustment (Level C). Patients may be counseled that it is unclear whether dosage adjustment is necessary when other AEDs and ARVs are combined (Level U). It may be important to avoid enzyme-inducing AEDs in people on ARV regimens that include protease inhibitors or nonnucleoside reverse transcriptase inhibitors because pharmacokinetic interactions may result in virologic failure, which has clinical implications for disease progression and development of ARV resistance. If such regimens are required for seizure control, patients may be monitored through pharmacokinetic assessments to ensure efficacy of the ARV regimen (Level C). Wiley

  17. The role of atmospheric stability/turbulence on wakes at the Egmond aan Zee offshore wind farm

    DOE PAGES

    Barthelmie, R. J.; Churchfield, Matthew J.; Moriarty, Patrick J.; ...

    2015-06-18

    Here, the aim of the paper is to present results from the NREL SOWFA project that compares simulations from models of different fidelity to meteorological and turbine data from the Egmond aan Zee wind farm. Initial results illustrate that wake behavior and impacts are strongly impacted by turbulence intensity. This includes both power losses from wakes and loading illustrated by the out of plane bending moment. Here we focus on understanding the relationship between turbulence and atmospheric stability and whether power losses due to wakes can effectively be characterized by measures of turbulence alone or whether atmospheric stability as amore » whole plays a fundamental role in wake behavior. The study defines atmospheric stability using the Monin-Obukhov length estimated based on the temperature difference between 116 and 70 m. The data subset selected using this method for the calculation of the Monin-Obukhov length indicate little diurnal or directional dependence of the stability classes but a dominance of stable classes in the spring/unstable classes in fall and of near-neutral classes at high wind speeds. The analysis is complicated by the need to define turbulence intensity. We can select the ratio of the standard deviation of wind speed to mean wind speed in each observation period using data from the meteorological mast, in which case a substantial amount of data must be excluded due to the presence of the wind farm. An alternative is to use data from the wind turbines which could provide a larger data set for analysis. These approaches are examined and compared to illustrate their robustness. Finally, power losses from wakes are categorized according to stability and/or turbulence in order to understand their relative importance in determining the behavior of wind turbine wakes.« less

  18. American Academy of Neurology policy on pharmaceutical and device industry support.

    PubMed

    Hutchins, J C; Rydell, C M; Griggs, R C; Sagsveen, M; Bernat, J L

    2012-03-06

    To examine the American Academy of Neurology (AAN)'s prevention and limitation of conflicts of interest (COI) related to relationships with pharmaceutical and medical device manufacturers and other medically related commercial product and service companies (industry). We reviewed the AAN's polices governing its interactions with industry, mechanisms for enforcement, and the recent findings of the board-appointed COI task force, in the context of the 2009 David Rothman and colleagues' article in JAMA, the Council of Medical Specialty Societies (CMSS) Code for Interactions with Companies (Code), efforts of the American Medical Association in this area, and increased public and Congressional scrutiny of physician/physician organizations' relationships with industry. The AAN's Policy on Conflicts of Interest provides 4 mechanisms for addressing COI: avoidance, separation, disclosure, and regulation. The AAN's Principles Governing Academy Relationships with External Sources of Support, including recent amendments proposed by the COI task force, regulate industry interaction with AAN programming, products, and leadership. With the Policy, Principles, and other methods of COI prevention, the AAN meets or exceeds all recommendations of the CMSS Code. With its adherence to the Principles since 2004, the AAN has been a leader among professional medical associations in appropriately managing COI related to interactions with industry. Recent amendments to the Principles maintain the AAN's position as a leader in a time of increased public scrutiny of physicians' and professional medical associations' relationships with industry. The AAN is responsive to the recommendations of the COI task force, and has adopted the CMSS Code.

  19. Upholding professionalism: the disciplinary process of the American Academy of Neurology.

    PubMed

    Hutchins, John C; Sagsveen, Murray G; Larriviere, Dan

    2010-12-14

    To review the disciplinary process by which the American Academy of Neurology (AAN) enforces its formalized standards of professional conduct. We reviewed the AAN's Disciplinary Action Policy. We tracked the elapsed time from receipt to final decision of all allegations ("complaints") of improper conduct by AAN members submitted from 2004 to 2009. We placed each complaint into 1 of 4 categories: allegations of 1) improper expert witness testimony; 2) substandard care; 3) unprofessional conduct; 4) or both 2 and 3. We noted the type of complainant (AAN member or nonmember) and the final outcome for each complaint. The AAN's disciplinary process is a 5-step procedure with multiple reviewing bodies. From 2004 to 2009, the AAN received 3-16 complaints per year (total 58), with 16 filed each year in 2008 and 2009. Thirty-one complaints (53%) were submitted by nonmembers and 27 (47%) by members. Disciplinary action was recommended for 6 complaints (10.3%) with action taken in 3 (5.1%) and the member resigning in lieu of action in 3 (5.1%). The average number of days from receipt of complaint to final decision was 537, with an average of 890 days from 2004 to 2006, decreased to 184 days from 2007 to 2009. Recent revisions to the disciplinary process have increased efficiency and enhanced procedural safeguards. The AAN determined a mean of 12 months, from receipt of complaint to final decision rendered, is an appropriate benchmark when handling complaints. The AAN's disciplinary process upholds standards of professional conduct for AAN members and protects members from unsubstantiated complaints.

  20. Positive dermal hypersensitivity and specific antibodies in workers exposed to bio-engineered enzymes

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

    Biagini, R.E.; Henningsen, G.M.; Driscoll, R.

    1991-03-15

    Thirty-six employees who produced industrial enzymes from bio-engineered strains of bacteria and fungi were evaluated by skin prick testing and enzyme linked immunosorbent assays for specific IgE and IgG antibodies. The workers complained of asthma- and flu-like' symptoms which generally lessened away from work. The enzymes evaluated were {alpha}-amylase from A. niger (ind-AAN), B. licheniformis (ind-AAL) and B. subtilis (ind-AAS); purified {alpha}-amylase from B. subtilis (AAS) and A. niger (AAN); alkaline protease from B. licheniformis (ind-APL) and purified alkaline protease (APL); amylase glucosidase from A. niger (ind-AGN) and purified amylase glucosidase (AGN). Significantly positive skin tests were found for APL,more » AGN and ind-AAN. Significantly elevated specific IgE results were observed for AAN, AGN, and ind-AAN; elevated specific IgGs were observed for AAN, ind-AAN, ind-AAS, ind-AAL and ind-AGN. Radioimmunoassays of air filter samples (using sera with high Ab titers) for 4 of the ind-enzymes showed only ind-AAN at extremely high environmental levels. These results indicate that occupational exposure to some ind-enzymes causes immediate onset dermal hypersensitivity reactions. The results are equivocal as to whether these reactions are IgE mediated, as IgE titers were low. Contrary to this, IgG titers were extremely high and suggest that these biomarkers can be used as indicators of both individual exposure and environmental analyses.« less

  1. Storings analyse Ten Behoeve van het Materieelverzorgingsplan (Failure Analysis for the Maintenance Plan)

    DTIC Science & Technology

    1990-05-01

    oporachtnemer verwezen naar de ’Algemone Voorwaarden voor Onderzoeks- opdrachten TNO’. dan wet de betreflende terzake fijasen partlijen gesloten * 11 ...ixvulling van het onderhoudsschema 9 2.4 Invulling van het onderhoudsschema in de praktijk 14 2.5 Gonclusies 16 3 STORINGSANALYSES 18 3.1 ’Failure mode...nnfd- en subgroep (dit is een opdeling van bet systeem naar functioneel sanienhangende delen). Pa gina 9 - Het onderhoudsniveau waar jedere

  2. Bepaling Referentiewaarden voor Ergonomie en Warmtebelasting van Lichtgewicht Bommenpakken (Determination of Ergonomic and Thermal Load Tests and Assessment of Reference Values With Light Weight Bomb Disposal Suits)

    DTIC Science & Technology

    2008-05-01

    bommenpakken kunnen geven bij bewegingen worden gemeten met de volgende bewegingbeperkingtests: sit-and-reach, stand-and-reach, abductie van de armen ...anteflexie van de armen en beperking van zicht. Bij de sit-and-reach test komt een eventuele belernmering bij het voorover buigen naar voren. De...proefpersoon zit op de grond met de benen en armen gestrekt naar voren. Daarbij wordt de afstand tussen de tenen en de vingers gemeten (figuur 4). Als het pak

  3. A nuclear method to authenticate Buddha images

    NASA Astrophysics Data System (ADS)

    Khaweerat, S.; Ratanatongchai, W.; Channuie, J.; Wonglee, S.; Picha, R.; Promping, J.; Silva, K.; Liamsuwan, T.

    2015-05-01

    The value of Buddha images in Thailand varies dramatically depending on authentication and provenance. In general, people use their individual skills to make the justification which frequently leads to obscurity, deception and illegal activities. Here, we propose two non-destructive techniques of neutron radiography (NR) and neutron activation autoradiography (NAAR) to reveal respectively structural and elemental profiles of small Buddha images. For NR, a thermal neutron flux of 105 n cm-2s-1 was applied. NAAR needed a higher neutron flux of 1012 n cm-2 s-1 to activate the samples. Results from NR and NAAR revealed unique characteristic of the samples. Similarity of the profile played a key role in the classification of the samples. The results provided visual evidence to enhance the reliability of authenticity approval. The method can be further developed for routine practice which impact thousands of customers in Thailand.

  4. A Shovel-Ready Solution to Fill the Nursing Data Gap in the Interdisciplinary Clinical Picture.

    PubMed

    Keenan, Gail M; Lopez, Karen Dunn; Sousa, Vanessa E C; Stifter, Janet; Macieira, Tamara G R; Boyd, Andrew D; Yao, Yingwei; Herdman, T Heather; Moorhead, Sue; McDaniel, Anna; Wilkie, Diana J

    2018-01-01

    To critically evaluate 2014 American Academy of Nursing (AAN) call-to-action plan for generating interoperable nursing data. Healthcare literature. AAN's plan will not generate the nursing data needed to participate in big data science initiatives in the short term because Logical Observation Identifiers Names and Codes and Systematized Nomenclature of Medicine - Clinical Terms are not yet ripe for generating interoperable data. Well-tested viable alternatives exist. Authors present recommendations for revisions to AAN's plan and an evidence-based alternative to generating interoperable nursing data in the near term. These revisions can ultimately lead to the proposed terminology goals of the AAN's plan in the long term. © 2017 NANDA International, Inc.

  5. The American Academy of Neurology's top five choosing wisely recommendations.

    PubMed

    Langer-Gould, Annette M; Anderson, Wayne E; Armstrong, Melissa J; Cohen, Adam B; Eccher, Matthew A; Iverson, Donald J; Potrebic, Sonja B; Becker, Amanda; Larson, Rod; Gedan, Alicia; Getchius, Thomas S D; Gronseth, Gary S

    2013-09-10

    To discuss the American Academy of Neurology (AAN)'s Top Five Recommendations in the Choosing Wisely campaign promoting high-value neurologic medicine and physician-patient communication. The AAN published its Top Five Recommendations in February 2013 in collaboration with the American Board of Internal Medicine Foundation and Consumer Reports. A Choosing Wisely Working Group of 10 AAN members was formed to oversee the process and craft the evidence-based recommendations. AAN members were solicited for recommendations, the recommendations were sent out for external review, and the Working Group members (article authors) used a modified Delphi process to select their Top Five Recommendations. The Working Group submitted 5 neurologic recommendations to the AAN Practice Committee and Board of Directors; all 5 were approved by both entities in September 2012. Recommendation 1: Don't perform EEGs for headaches. Recommendation 2: Don't perform imaging of the carotid arteries for simple syncope without other neurologic symptoms. Recommendation 3: Don't use opioids or butalbital for treatment of migraine, except as a last resort. Recommendation 4: Don't prescribe interferon-β or glatiramer acetate to patients with disability from progressive, nonrelapsing forms of multiple sclerosis. Recommendation 5: Don't recommend carotid endarterectomy for asymptomatic carotid stenosis unless the complication rate is low (<3%).

  6. American Association of Neurological Surgeons

    MedlinePlus

    ... Discounted Online Courses for AANS Members Access Online Meetings and Course Calendar View a listing of neurosurgical ... Neurosurgical Societies Neurosurgery Blog 2018 AANS Annual Scientific Meeting NEUROSURGERY THE Privilege OF SERVICE April 28-May ...

  7. Simplification of the standard three-bag intravenous acetylcysteine regimen for paracetamol poisoning results in a lower incidence of adverse drug reactions.

    PubMed

    Wong, Anselm; Graudins, Andis

    2016-01-01

    Adverse reactions to intravenous (IV) acetylcysteine treatment in paracetamol overdose, are common. Previous studies suggest the incidence and severity of non-allergic anaphylactic reactions (NAARs) are influenced by the rate of acetylcysteine infusion. We compared the incidence of adverse drug events of a two-bag IV acetylcysteine regimen with that of the traditional three-bag regimen. This was a retrospective analysis of patients presenting with paracetamol overdose requiring treatment with acetylcysteine to three emergency departments. We prospectively identified all presentations where IV acetylcysteine was administered using a 20 h, two-bag regimen (200 mg/kg over 4 h followed by 100 mg/kg over 16 h) from February 2014 to June 2015. We compared this to an historical cohort treated with the 21 h three-bag IV regimen (150 mg/kg over 1 h, 50 mg/kg over 4 h and 100 mg/kg over 16 h) from October 2009 to October 2013. Medical and nursing notes were searched retrospectively for entries suggesting the presence of an adverse reaction. The primary outcome was incidence of NAARs and gastrointestinal reactions in each group. 389 presentations were treated with the three-bag regimen and 210 presentations received the two-bag regimen. NAARs were recorded more commonly with the three-bag acetylcysteine regimen than the two-bag regimen (10% vs 4.3%, p = 0.02, OR 2.5, 95% CI 1.1-5.8). There was no difference in reports of gastrointestinal reactions between cohorts (three-bag 39% vs two-bag 41%, p = 0.38, OR 1.17 95% CI (0.83-1.65)). The incidence of NAARs was significantly reduced by combining the first two bags of the traditional three-bag regimen and infusing these over 4 h at 50 mg/kg/hr. Simplifying the administration of acetylcysteine may have other benefits such as better utilisation of nursing time and reduced infusion administration errors. A two-bag 20 h acetylcysteine regimen was well tolerated and resulted in significantly fewer and milder NAARs than the standard

  8. Fanconi's syndrome, interstitial fibrosis and renal failure by aristolochic acid in Chinese herbs.

    PubMed

    Hong, Yin-Tai; Fu, Lin-Shien; Chung, Lin-Huei; Hung, Shien-Chung; Huang, Yi-Ting; Chi, Chin-Shiang

    2006-04-01

    Aristolochic acid-associated nephropathy (AAN) has been identified as a separate entity of progressive tubulo-interstitial nephropathy. Its characteristic pathological findings, including hypocellular interstitial fibrosis, intimal thickening of interlobular and afferent arterioles with glomeruli sparing or mild sclerosis, have been identified. Many cases of AAN in adults have been reported in Taiwan as well as throughout the world, but it has seldom been described in children. We report on a 10-year-old boy who presented with severe anemia, Fanconi's syndrome, and progressive renal failure. Renal biopsy revealed typical findings of AAN. Aristolochic acids I and II were identified from a Chinese herb mixture ingested by the boy. AAN was diagnosed after other etiologies had been excluded. The case demonstrates the hazards of Chinese herbs with regard to children's health in Taiwan and suggests that more attention should be paid to this issue.

  9. Brain&Life: The Magazine

    MedlinePlus

    ... About Us About Brain & Life About the AAN Neurology FAQ Subscribe for free Neurology for Everyday Living Powered by Trusted Neurologists Subscribe ... About Us About the AAN About Brain & Life Neurology FAQ Contact Us Privacy Policy Rights and Permissions ...

  10. International science at the annual meeting of the American Academy of Neurology.

    PubMed

    Henson, John W; Cascino, Gregory D; Post, Mary E

    2007-10-23

    The annual meeting of the American Academy of Neurology (AAN) is a major venue for presentation of the latest disease-related clinical and basic neurologic research and is attended by a large number of neurologists from countries outside the United States and Canada. One-third of annual meeting attendees and abstract submissions are international in origin, with wide variations between countries and world regions, and this proportion has remained stable for the past 5 years. By comparison, international neurologists constitute 12% (n = 2,485) of AAN membership, and international membership has declined slightly over the past 5 years compared to a 15% increase from the United States and Canada. The scientific topics covered by international abstracts are similar to those from the United States and Canada. Abstract acceptance rates are 15% lower for international submissions than for those from the United States and Canada although variations between countries are seen. Three times more European neurologists attend the annual meeting than are AAN members whereas Asian neurologists are more likely to be AAN members than to attend the annual meeting. The AAN is working to understand and address the issues that affect international physicians' decisions to participate in the annual meeting.

  11. Alopecic and Aseptic Nodules of the Scalp/Pseudocyst of the Scalp: Clinicopathological and Therapeutic Analyses in 11 Korean Patients.

    PubMed

    Seol, Jung Eun; Park, In Ho; Kim, Do Hyeong; Park, So Hee; Kang, Jeong Nan; Kim, Hyojin; Seo, Jong Keun

    2016-01-01

    Alopecic and aseptic nodule of the scalp (AANS) is a rare disease entity first reported in 1992 as pseudocyst of the scalp (PCS). Controversy exists regarding the histopathology and etiology of reported cases. We performed this study to analyze the clinical and histopathologic features of AANS/PCS in Korean patients. A retrospective review of medical records from 2008 to 2013 at Inje University Busan Paik Hospital was performed. Eleven patients were enrolled. All patients were male, and their mean age was 21.6 years. Most patients had a solitary nodule (10/11) located predominantly on the vertex. The mean nodule size was 20 mm. Inflammatory cell infiltration in the deep dermis was a histologic feature of AANS/PCS. Eight patients showed granulomatous infiltration. All patients were treated with short-term antibiotics and intralesional steroid injection. Our results suggest that dermatologists should consider AANS when diagnosing an alopecic nodule on the scalp. © 2015 S. Karger AG, Basel.

  12. Proteomics analysis of altered proteins in kidney of mice with aristolochic acid nephropathy using the fluorogenic derivatization-liquid chromatography-tandem mass spectrometry method.

    PubMed

    Lin, Chia-En; Chang, Wen-Shin; Lee, Jen-Ai; Chang, Ting-Ya; Huang, Yu-Shen; Hirasaki, Yoshiro; Chen, Hung-Shing; Imai, Kazuhiro; Chen, Shih-Ming

    2018-03-01

    Aristolochic acid (AA) causes interstitial renal fibrosis, called aristolochic acid nephropathy (AAN). There is no specific indicator for diagnosing AAN, so this study aimed to investigate the biomarkers for AAN using a proteomics method. The C3H/He female mice were given ad libitum AA-distilled water (0.5 mg/kg/day) and distilled water for 56 days in the AA and normal groups, respectively. The AA-induced proteins in the kidney were investigated using a proteomics study, including fluorogenic derivatization with 7-chloro-N-[2-(dimethylamino)ethyl]-2,1,3-benzoxadiazole-4-sulfonamide, followed by high-performance liquid chromatography analysis and liquid chromatography tandem mass spectrometry with a MASCOT database searching system. There were two altered proteins, thrombospondin type 1 (TSP1) and G protein-coupled receptor 87 (GPR87), in the kidney of AA-group mice on day 56. GPR87, a tumorigenesis-related protein, is reported for the first time in the current study. The renal interstitial fibrosis was certainly induced in the AA-group mice under histological examination. Based on the results of histological examination and the proteomics study, this model might be applied to AAN studies in the future. TSP1 might be a novel biomarker for AAN, and the further role of GPR87 leading to AA-induced tumorigenesis should be researched in future studies. Copyright © 2017 John Wiley & Sons, Ltd.

  13. Professional oversight of physician expert witnesses: an analysis of complaints to the Professional Conduct Committee of the American Association of Neurological Surgeons, 1992-2006.

    PubMed

    Kesselheim, Aaron S; Studdert, David M

    2009-01-01

    To investigate the role of the professional conduct review program that is operated by the American Association of Neurological Surgeons (AANS). The program adjudicates complaints against AANS members for their work as expert witnesses in medical malpractice litigation. Policymakers worry that physician expert witnesses who espouse unfounded views in malpractice cases may fuel inappropriate litigation. A growing number of professional societies have sought to oversee their members' work as expert witnesses by instituting standards to regulate this conduct and enforcing those standards through formal disciplinary procedures. The AANS runs the longest-established and busiest program of this kind in the country. Plaintiffs' lawyers and consumer advocates have questioned the even-handedness of this form of self-regulation. We reviewed the confidential case summaries of all 59 complaints involving charges of inappropriate expert witness testimony adjudicated by the AANS Professional Conduct Committee from 1992 to 2006. We developed descriptive categories for the characteristics of the complainant and respondent, the types of misconduct alleged, and the outcomes of the review, including penalties imposed. The most common type of allegation was presentation of testimony that misrepresented the standard of care. Nineteen complaints (32%) were dismissed, but 40 (68%) resulted in sanctions ranging from censure to expulsion from membership. Both the frequency of complaints and length of sanctions have increased in the last 4 years. Although the AANS is highly attentive to procedural fairness, the overwhelming majority (57/59, 97%) of complaints related to testimony from witnesses acting for plaintiffs. Professional organizations may play a useful role in oversight of expert witness conduct, provided they maintain procedural fairness and strive for impartiality, as the AANS program seems to have done. However, from a policy perspective, this form of oversight is incomplete and

  14. A First-cut Concept Map: The Irregular Adversary (Insurgent)

    DTIC Science & Technology

    2012-12-01

    conceptuel des AANE aidera le spécialiste du renseignement militaire à brosser pour le commandant un tableau plus global des AANE dans leur...Crandall et al. (2006), « il est sage de toujours considérer les schémas conceptuels comme des représentations « vivantes » plutôt que des « produits

  15. Ca 45 Uptake in Fracture Callus of Normal and Aminoacetonitrile-Treated Rats

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

    Bolognani, L.; Ponseti, T. V.

    1962-04-01

    Calcium content and Ca 45 uptake were measured in the fracture callus of normal and AAN-treated rats. It appears that total calcium deposition and Ca 45 uptake are both higher in the young callus, 5 and 10 days after fracture, of the AAN-treated animals. By the 20th day, mineralization of the callus in both groups is similar.

  16. In memoriam of Professor Theodore L. Munsat (1930-2013): his outstanding legacy with the WFN.

    PubMed

    Medina, Marco T

    2014-04-15

    The World Federation of Neurology (WFN) lost an outstanding leader on November 22, 2013 with the death of Professor Theodore Leon Munsat ("Ted"), in Waltham, Massachusetts, USA. Professor Munsat was Emeritus professor of Neurology at Tufts University School of Medicine and served the WFN in several capacities as trustee, chairman of the WFN Education and research committees, chairman of the WFN ALS Research group and founding director of the WFN Seminars in Clinical Neurology. He was president of the American Academy of Neurology (AAN), 1989-1991, chairman of the Continuing Educational Committee of the AAN and founding director of AAN's premier continuing medical education journal Continuum: Lifelong Learning in Neurology. He left an outstanding legacy with the WFN. Copyright © 2014. Published by Elsevier B.V.

  17. Inelastic processes in atomic collisions involving ground state and laser-prepared atoms

    NASA Astrophysics Data System (ADS)

    Planje, Willem Gilles

    1999-11-01

    In dit proefschrift worden experimenten beschreven waarbij ionen of atomen met een bepaalde snelheid op een ensemble van doelwitatomen worden gericht. Wanneer twee deeltjes elkaar voldoende genaderd hebben, vindt er wissel- werking plaats waarbij allerlei processen kunnen optreden. Deze processen resulteren in specieke eindproducten. Kennis over de interactie tussen twee botsingspartners wordt verkregen door te bekijken welke eindproducten ontstaan, en in welke mate. Een belangrijke grootheid die van invloed is op mogelijke processen is de onderlinge snelheid van de twee kernen, oftewel de botsingssnelheid. Wanneer de botsingssnelheid voldoende klein is dan kunnen de verschillende reactiemechanismen zowel kwalitatief als kwanti- tatief vaak goed voorspeld worden door het systeem te beschouwen als een kort-stondig molecuul, opgebouwd uit de twee botsende deeltjes. De ver- schillende processen die kunnen optreden worden gekwaliceerd afhankelijk van de vorming van bepaalde eindproducten. Ruwweg de volgende indeling kan gemaakt worden: 1. de interne structuur van de eindproducten zijn identiek aan die van de beginproducten. We spreken dan van een elastische botsing. 2. e en van de deeltjes of beiden worden in een aangeslagen toestand ge- bracht (of ge¨oniseerd). Dit zijn processen waarbij de herschikte elek- tronen zich bij de oorspronkelijke kern bevinden. We spreken dan van excitatie of ionisatie. 3. e en of meerdere elektronen bevinden zich bij de andere kern na de botsing (eventueel in aangeslagen toestand). We spreken dan van elek- tronenoverdracht. In het eerste deel van deze dissertatie worden botsingsexperimenten tussen heliumionen en natriumatomen beschreven waarbij het proces van elek- tronenoverdracht wordt onderzocht. Bij dit mechanisme is het buitenste 117?Samenvatting natriumelektron betrokken. Deze kan relatief gemakkelijk `overspringen' naar het heliumion wanneer deze zich dicht in de buurt van het natrium- atoom bevindt. Het elektron kan hierbij een

  18. A[Bi(3)Ti(4)O(13)] and A[Bi(3)PbTi(5)O(16)] (A = K, Cs): New n = 4 and n = 5 Members of the Layered Perovskite Series, A[A'(n)()(-)(1)B(n)()O(3)(n)()(+1)], and Their Hydrates.

    PubMed

    Gopalakrishnan, J.; Sivakumar, T.; Thangadurai, V.; Subbanna, G. N.

    1999-06-14

    We describe the synthesis and structural characterization of new layered bismuth titanates, A[Bi(3)Ti(4)O(13)] and A[Bi(3)PbTi(5)O(16)] for A = K, Cs, corresponding to n = 4 and 5 members of the Dion-Jacobson series of layered perovskites of the general formula, A[A'(n)()(-)(1)B(n)()O(3)(n)()(+1)]. These materials have been prepared by solid state reaction of the constituents containing excess alkali, which is required to suppress the formation of competitive Aurivillius phases. Unlike the isostructural niobates and niobium titanates of the same series, the new phases reported here are spontaneously hydrated-a feature which could make them potentially useful as photocatalysts for water splitting reaction. On hydration of the potassium compounds, the c axis expands by ca. 2 Å and loses its doubling [for example, the tetragonal lattice parameters of K[Bi(3)Ti(4)O(13)] and its dihydrate are respectively a = 3.900(1) Å, c = 37.57(2) Å; a = 3.885(1) Å, c = 20.82(4) Å]; surprisingly, the cesium analogues do not show a similar change on hydration.

  19. The effect of muscle weakness on the capability gap during gross motor function: a simulation study supporting design criteria for exoskeletons of the lower limb.

    PubMed

    Afschrift, Maarten; De Groote, Friedl; De Schutter, Joris; Jonkers, Ilse

    2014-08-04

    Enabling persons with functional weaknesses to perform activities of daily living (ADL) is one of the main challenges for the aging society. Powered orthoses, or exoskeletons, have the potential to support ADL while promoting active participation of the user. For this purpose, assistive devices should be designed and controlled to deliver assistance as needed (AAN). This means that the level of assistance should bridge the capability gap, i.e. the gap between the capabilities of the subjects and the task requirements. However, currently the actuators of exoskeletons are mainly designed using inverse dynamics (ID) based calculations of joint moments. The goal of the present study is to calculate the capability gap for the lower limb during ADL when muscle weakness is present, which is needed for appropriate selection of actuators to be integrated in exoskeletons. A musculoskeletal model (MM) is used to calculate the joint kinematics, joint kinetics and muscle forces of eight healthy subjects during ADL (gait, sit-to-stand, stand-to-sit, stair ascent, stair descent). Muscle weakness was imposed to the MM by a stepwise decrease in maximal isometric force imposed to all muscles. Muscle forces were calculated using static optimization. In order to compensate for muscle weakness, ideal moment actuators that represent the motors of an exoskeleton in the simulation were added to deliver AAN required to perform the task. The ID approach overestimates the required assistance since it relies solely on the demands of the task, whereas the AAN approach incorporates the capabilities of the subject. Furthermore, the ID approach delivers continuous support whereas the AAN approach targets the period where a capability gap occurs. The level of muscle weakness for which the external demands imposed by ADL can no longer be met by active muscle force production, is respectively 40%, 70%, 80% and 30%. The present workflow allows estimating the AAN during ADL for different levels of

  20. Prizes, lectures, and awards of the American Association of Neurological Surgeons/Congress of Neurological Surgeons Section on Tumors.

    PubMed

    Barker, Fred G; McDermott, Michael W

    2005-04-15

    An important goal of the Section on Tumors of the American Association of Neurological Surgeons (AANS) and Congress of Neurological Surgeons (CNS) since its founding in 1985 has been to foster both education and research in the field of brain tumor treatment. As one means of achieving this, the Section awards a number of prizes, research grants, and named lectures at the annual meetings of the AANS and CNS. After a brief examination of similar honors that were given in recognition of pioneering work by Knapp, Cushing, and other early brain tumor researchers, the authors describe the various awards given by the AANS/CNS Section on Tumors since its founding, their philanthropic donors, and the recipients of the awards. The subsequent career of the recipients is briefly examined, in terms of the rate of full publication of award-winning abstracts and achievement of grant funding by awardees.

  1. Atoh1-lineal neurons are required for hearing and for the survival of neurons in the spiral ganglion and brainstem accessory auditory nuclei

    PubMed Central

    Maricich, Stephen M.; Xia, Anping; Mathes, Erin L.; Wang, Vincent Y.; Oghalai, John S.; Fritzsch, Bernd; Zoghbi, Huda Y.

    2009-01-01

    Atoh1 is a basic helix-loop-helix transcription factor necessary for the specification of inner ear hair cells and central auditory system neurons derived from the rhombic lip. We used the Cre-loxP system and two Cre-driver lines (Egr2Cre and Hoxb1Cre) to delete Atoh1 from different regions of the cochlear nucleus (CN) and accessory auditory nuclei (AAN). Adult Atoh1-conditional knockout mice (Atoh1CKO) are behaviorally deaf, have diminished auditory brainstem evoked responses and disrupted CN and AAN morphology and connectivity. In addition, Egr2; Atoh1CKO mice lose spiral ganglion neurons in the cochlea and AAN neurons during the first 3 days of life, revealing a novel critical period in the development of these neurons. These new mouse models of predominantly central deafness illuminate the importance of the CN for support of a subset of peripheral and central auditory neurons. PMID:19741118

  2. Intelligent mobility for robotic vehicles in the army after next

    NASA Astrophysics Data System (ADS)

    Gerhart, Grant R.; Goetz, Richard C.; Gorsich, David J.

    1999-07-01

    The TARDEC Intelligent Mobility program addresses several essential technologies necessary to support the army after next (AAN) concept. Ground forces in the AAN time frame will deploy robotic unmanned ground vehicles (UGVs) in high-risk missions to avoid exposing soldiers to both friendly and unfriendly fire. Prospective robotic systems will include RSTA/scout vehicles, combat engineering/mine clearing vehicles, indirect fire artillery and missile launch platforms. The AAN concept requires high on-road and off-road mobility, survivability, transportability/deployability and low logistics burden. TARDEC is developing a robotic vehicle systems integration laboratory (SIL) to evaluate technologies and their integration into future UGV systems. Example technologies include the following: in-hub electric drive, omni-directional wheel and steering configurations, off-road tires, adaptive tire inflation, articulated vehicles, active suspension, mine blast protection, detection avoidance and evasive maneuver. This paper will describe current developments in these areas relative to the TARDEC intelligent mobility program.

  3. Development of a diabetes prevention program for Surinamese South Asians in the Netherlands.

    PubMed

    Nicolaou, Mary; Vlaar, Evalina; van Valkengoed, Irene; Middelkoop, Barend; Stronks, Karien; Nierkens, Vera

    2014-12-01

    Type 2 diabetes is highly prevalent among South Asian origin groups around the world. Not only is prevalence higher than in other ethnic groups, age at presentation is lower and these groups are more likely to experience complications. Evidence suggests that lifestyle interventions may prevent or delay the onset of diabetes. However, little is known about diabetes prevention in South Asians (SA). DH!AAN is a diabetes prevention program designed for Surinamese SA in The Netherlands. In this paper, we describe the theoretical frameworks and formative research that guided the development and cultural adaptation of DH!AAN. Cultural adaptation was based on analysis of the determinants of diet and physical activity, including socio-cultural factors, within our study population. This led to the incorporation of surface and deep structure elements in the intervention. One-to-one counseling by dieticians using motivational interviewing (MI) was the basis for the intervention. Additionally, we aimed to generate social support by including family members in parts of the intervention and group sessions to address issues relating to traditional food habits. We discuss our reflections on the development process and the choices made in developing this intervention. The results of DH!AAN will provide insight into the use of MI for this population group. Moreover, DH!AAN will provide evidence regarding the feasibility of diabetes prevention among South Asian populations. © The Author (2013). Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  4. Cohort Profile of the Goals Study: A Large-Scale Research of Physical Activity in Dutch Students

    ERIC Educational Resources Information Center

    de Groot, Renate H. M.; van Dijk, Martin L.; Kirschner, Paul A.

    2015-01-01

    The GOALS study (Grootschalig Onderzoek naar Activiteiten van Limburgse Scholieren [Large-scale Research of Activities in Dutch Students]) was set up to investigate possible associations between different forms of physical activity and inactivity with cognitive performance, academic achievement and mental well-being. It was conducted at a…

  5. Publication patterns of oral and poster presentations at the annual meetings of the Congress of Neurological Surgeons and the American Association of Neurological Surgeons.

    PubMed

    Patel, Akash J; Cherian, Jacob; Fox, Benjamin D; Whitehead, William E; Curry, Daniel J; Luerssen, Thomas G; Jea, Andrew

    2011-12-01

    National and international meetings, such as the Congress of Neurological Surgeons (CNS) and the American Association of Neurological Surgeons (AANS) meetings, provide a central location for the gathering and dissemination of research. The purpose of this study was to determine the publication rates of both oral and poster presentations at CNS and AANS meetings in peer-reviewed journals. The authors reviewed all accepted abstracts, presented as either oral or poster presentations, at the CNS and AANS meetings from 2003 to 2005. This information was then used to search PubMed to determine the rate of publication of the abstracts presented at the meetings. Abstracts were considered published if the data presented at the meeting was identical to that in the publication. The overall publication rate was 32.48% (1243 of 3827 abstracts). On average, 41.28% of oral presentations and 29.03% of poster presentations were eventually published. Of those studies eventually published, 98.71% were published within 5 years of presentation at the meeting. Published abstracts were published most frequently in the Journal of Neurosurgery and Neurosurgery. Approximately one-third of all presentations at the annual CNS and AANS meetings will be published in peer-reviewed, MEDLINE-indexed journals. These meetings are excellent forums for neurosurgical practitioners to be exposed to current research. Oral presentations have a significantly higher rate of eventual publication compared with poster presentations, reflecting their higher quality. The Journal of Neurosurgery and Neurosurgery have been the main outlets of neurosurgical research from these meetings.

  6. Readability of neurosurgery-related patient education materials provided by the American Association of Neurological Surgeons and the National Library of Medicine and National Institutes of Health.

    PubMed

    Schmitt, Paul J; Prestigiacomo, Charles J

    2013-11-01

    Most professional organizations now provide patient information material, and not all of this material is appropriate for the average American adult to comprehend. The National Institutes of Health (NIH) and the United States Department of Health and Human Services recommend that patient education materials be written at the sixth-grade level. Our aim was to assess the readability of neurosurgery-related patient education material and compare it with The American Medical Association, NIH, and United States Department of Health and Human Services recommendations. Materials provided by the American Association of Neurologic Surgeons (AANS) and the U.S. National Library of Medicine (NLM) and National Institutes of Health were assessed with the Flesch-Kincaid grade level and Flesch Reading Ease score with Microsoft Office Word software. None of the articles had Flesch-Kincaid grade levels at or below the sixth-grade level. All articles on the AANS Conditions and Treatments section were written at or above the ninth-grade level; three of the AANS Camera-Ready Fact Sheets and four of the NIH/NLM articles were written between the seventh- and eighth-grade levels. Current patient education material provided by the AANS is written well above the recommended level. Material from the NLM and NIH performed better, but was still above the recommended sixth-grade level. Education materials should contain information relevant to patients' conditions, be accurate in the information they present, and be written with the average patient in mind. Copyright © 2013 Elsevier Inc. All rights reserved.

  7. Readability and quality of wikipedia pages on neurosurgical topics.

    PubMed

    Modiri, Omeed; Guha, Daipayan; Alotaibi, Naif M; Ibrahim, George M; Lipsman, Nir; Fallah, Aria

    2018-03-01

    Wikipedia is the largest online encyclopedia with over 40 million articles, and generating 500 million visits per month. The aim of this study is to assess the readability and quality of Wikipedia pages on neurosurgical related topics. We selected the neurosurgical related Wikipedia pages based on the series of online patient information articles that are published by the American Association of Neurological Surgeons (AANS). We assessed readability of Wikipedia pages using five different readability scales (Flesch Reading Ease, Flesch Kincaid Grade Level, Gunning Fog Index, SMOG) Grade level, and Coleman-Liau Index). We used the Center for Disease Control (CDC) Clear Communication Index as well as the DISCERN Instrument to evaluate the quality of each Wikipedia article. We identified a total of fifty-five Wikipedia articles that corresponded with patient information articles published by the AANS. This constitutes 77.46% of the AANS topics. The mean Flesch Kincaid reading ease score for all of the Wikipedia articles we analyzed is 31.10, which indicates that a college-level education is necessary to understand them. In comparison to the readability analysis for the AANS articles, the Wikipedia articles were more difficult to read across every scale. None of the Wikipedia articles meet the CDC criterion for clear communications. Our analyses demonstrated that Wikipedia articles related to neurosurgical topics are associated with higher grade levels for reading and also below the expected levels of clear communications for patients. Collaborative efforts from the neurosurgical community are needed to enhance the readability and quality of Wikipedia pages related to neurosurgery. Copyright © 2018 Elsevier B.V. All rights reserved.

  8. Comparison of neurological healthcare oriented educational resources for patients on the internet.

    PubMed

    Punia, Vineet; Dagar, Anjali; Agarwal, Nitin; He, Wenzhuan; Hillen, Machteld

    2014-12-01

    The internet has become a major contributor to health literacy promotion. The average American reads at 7th-8th grade level and it is recommended to write patient education materials at or below 6th grade reading level. We tried to assess the level of literacy required to read and understand online patient education materials (OPEM) for neurological diseases from various internet resources. We then compared those to an assumed reference OPEM source, namely the patient education brochures from the American Academy of Neurology (AAN), the world's largest professional association of neurologists. Disease specific patient education brochures were downloaded from the AAN website. OPEM for these diseases were also accessed from other common online sources determined using a predefined criterion. All OPEM were converted to Microsoft Word (Microsoft Corp., Redmond, WA, USA) and their reading level was analyzed using Readability Studio Professional Edition version 2012.1 (Oleander Software, Vandalia, OH, USA). Descriptive analysis and analysis of variance were used to compare reading levels of OPEM from different resources. Medline Plus, Mayo clinic and Wikipedia qualified for OPEM analysis. All OPEM from these resources, including the AAN, were written above the recommended 6th grade reading level. They were also found to be "fairly difficult", "difficult" or "confusing" on the Flesch Reading Ease scale. AAN OPEM on average needed lower reading level, with Wikipedia OPEM being significantly (p<0.01) more difficult to read compared to the other three resources. OPEM on neurological diseases are being written at a level of reading complexity higher than the average American and the recommended reading levels. This may be undermining the utility of these resources. Copyright © 2014 Elsevier Ltd. All rights reserved.

  9. The 2012 AANS Presidential Address. We are neurosurgery.

    PubMed

    McCormick, Paul C

    2012-12-01

    The theme of the 80th Annual Meeting of the American Association of Neurological Surgeons and the title of this presidential address, "We are neurosurgery," is a simple 3-word affirmation of who neurosurgeons are, what they have achieved, and how much there is yet to accomplish. Recent advances in neurobiology and the clinical neurosciences have brought an unprecedented understanding of the human nervous system in both health and disease. As a specialty, neurosurgery has translated knowledge, expanded techniques, and incorporated technology to exponentially expand the science and scope of neurosurgical practice. However, the rapidly advancing, divergently evolving growth of neurosurgery has had profound effects on all aspects of neurosurgery. In this address, the author examines the contemporary meaning of the annual meeting's theme as it relates to the science, practice, specialty, and profession of neurosurgery, as well as the neurosurgeon. In doing so, the author reveals his interpretation of "We are neurosurgery," which he hopes will have an effect on others.

  10. Ex ante Implementatietoetsing van Beleid, Een Methodiek Gebaseerd op Synergie Tussen Risicomanagement en Verandermanagement (Ex Ante Test for Policy Implementation - A Method Based Upon Synergy Between Risk Management an Change Management)

    DTIC Science & Technology

    2006-12-01

    ante implementatietoetsing van beleid Een methodiek gebaseerd op synergie tussen risicomnanagemnent en verandermanagemnent Datuni december 2006 Auteur (s...te analyseren. Het de resultaten van de interviews gebruikct bij de theorie van risicomanagement en project Verandermanagernent bij de de ontwikkehing...Opdrachtnummer Hoewel expliciet is gekeken naar voorbeelden van risico’s bij Datum december 2006 Auteur (s) PROGRAMMA PR03ECT drs. R.C.T. de Haas drs

  11. Three-dimensional inversion of the magnetic field over the Easter-Nazca propagating rift near 25°S, 112°25‧W

    NASA Astrophysics Data System (ADS)

    Sempere, Jean-Christophe; Gee, Jeff; Naar, David F.; Hey, Richard N.

    1989-12-01

    The Easter microplate boundary configuration is being reorganized by rift propagation. A Sea Beam survey of the Easter-Nazca spreading center, which forms the eastern boundary of the microplate, has revealed the presence of a young propagating rift growing northward (Naar and Hey, 1986). The tip of the propagating rift is associated with a high-amplitude positive magnetic anomaly. We have performed a three-dimensional inversion of the magnetic field over the propagating rift tip area. The magnetization solution suggests that the western and eastern pseudofaults strike 014° and 338°, respectively, and converge near the rift tip. These orientations yield a propagation to spreading rate ratio of 1.5, slightly higher than the estimate of Naar and Hey (1986). Using the revised estimate of the full spreading rate along the Easter-Nazca spreading center near 25°S (80 mm/yr) (D. F. Naar and R. N. Hey, unpublished manuscript, 1989), we obtain a propagation rate of 120 mm/yr. Within 27-30 km of the rift tip, the propagating rift curves by about 15° to the east toward the failing rift, probably as a result of the interaction between the two offset spreading centers. As at the Galapagos propagating rift, rift propagation appears to be a very orderly process along the Easter-Nazca spreading center. The magnetization distribution that we obtain exhibits a high at the propagating rift tip. At other large ridge axis discontinuities, similar magnetization highs have been interpreted as being the result of the eruption of highly differentiated basalts enriched in iron. The origin of the high magnetization zone in the case of the Easter-Nazca propagating rift near 25°S may be more complex. Preliminary rock magnetic measurements of basalts recovered in the vicinity of the propagating rift confirm the presence of highly magnetized basalts but suggest that the relationship between high magnetization intensities and high Fe content is not straightforward.

  12. Rejected applications

    PubMed Central

    2014-01-01

    Objective: To review membership application materials (especially rejected applications) to the American Academy of Neurology (AAN) during its formative years (1947–1953). Methods: Detailed study of materials in the AAN Historical Collection. Results: The author identified 73 rejected applications. Rejected applicants (71 male, 2 female) lived in 25 states. The largest number was for the Associate membership category (49). These were individuals “in related fields who have made and are making contributions to the field of neurology.” By contrast, few applicants to Active membership or Fellowship status were rejected. The largest numbers of rejectees were neuropsychiatrists (19), neurosurgeons (16), and psychiatrists (14). Conclusion: The AAN, established in the late 1940s, was a small and politically vulnerable organization. A defining feature of the fledgling society was its inclusiveness; its membership was less restrictive than that of the older American Neurological Association. At the same time, the society needed to preserve its core as a neurologic society rather than one of psychiatry or neurosurgery. Hence, the balance between inclusiveness and exclusive identity was a difficult one to maintain. The Associate membership category, more than any other, was at the heart of this issue of self-definition. Associate members were largely practitioners of psychiatry or neurosurgery. Their membership was a source of consternation and was to be carefully been held in check during these critical formative years. PMID:24944256

  13. Rejected applications: an early American Academy of Neurology struggles to define its membership.

    PubMed

    Louis, Elan D

    2014-07-22

    To review membership application materials (especially rejected applications) to the American Academy of Neurology (AAN) during its formative years (1947-1953). Detailed study of materials in the AAN Historical Collection. The author identified 73 rejected applications. Rejected applicants (71 male, 2 female) lived in 25 states. The largest number was for the Associate membership category (49). These were individuals "in related fields who have made and are making contributions to the field of neurology." By contrast, few applicants to Active membership or Fellowship status were rejected. The largest numbers of rejectees were neuropsychiatrists (19), neurosurgeons (16), and psychiatrists (14). The AAN, established in the late 1940s, was a small and politically vulnerable organization. A defining feature of the fledgling society was its inclusiveness; its membership was less restrictive than that of the older American Neurological Association. At the same time, the society needed to preserve its core as a neurologic society rather than one of psychiatry or neurosurgery. Hence, the balance between inclusiveness and exclusive identity was a difficult one to maintain. The Associate membership category, more than any other, was at the heart of this issue of self-definition. Associate members were largely practitioners of psychiatry or neurosurgery. Their membership was a source of consternation and was to be carefully been held in check during these critical formative years. © 2014 American Academy of Neurology.

  14. Education research: a case-based bioethics curriculum for neurology residents.

    PubMed

    Tolchin, Benjamin; Willey, Joshua Z; Prager, Kenneth

    2015-03-31

    In 2012, the American Academy of Neurology (AAN) updated and expanded its ethics curriculum into Practical Ethics in Clinical Neurology, a case-based ethics curriculum for neurologists. We piloted a case-based bioethics curriculum for neurology residents using the framework and topics recommended by the AAN, matched to clinical cases drawn from Columbia's neurologic services. Our primary outcome was residents' ability to analyze and manage ethically complex cases as measured on precurriculum and postcurriculum multiple-choice quizzes. Secondary outcomes included precurriculum and postcurriculum self-assessed comfort in discussing and managing ethically complex cases, as well as attendance at ethics discussion sessions as compared to attendance at other didactic sessions. Resident performance on quizzes improved from 75.8% to 86.7% (p = 0.02). Comfort in discussing ethically complex cases improved from 6.4 to 7.4 on a 10-point scale (p = 0.03). Comfort in managing such cases trended toward improvement but did not reach statistical significance. Attendance was significantly better at ethics discussions (73.5%) than at other didactic sessions (61.7%, p = 0.04). Our formal case-based ethics curriculum for neurology residents, based on core topics drawn from the AAN's published curricula, was successfully piloted. Our study showed a statistically significant improvement in residents' ability to analyze and manage ethically complex cases as measured by multiple-choice tests and self-assessments. © 2015 American Academy of Neurology.

  15. Control strategies for effective robot assisted gait rehabilitation: the state of art and future prospects.

    PubMed

    Cao, Jinghui; Xie, Sheng Quan; Das, Raj; Zhu, Guo L

    2014-12-01

    A large number of gait rehabilitation robots, together with a variety of control strategies, have been developed and evaluated during the last decade. Initially, control strategies applied to rehabilitation robots were adapted from those applied to traditional industrial robots. However, these strategies cannot optimise effectiveness of gait rehabilitation. As a result, researchers have been investigating control strategies tailored for the needs of rehabilitation. Among these control strategies, assisted-as-needed (AAN) control is one of the most popular research topics in this field. AAN training strategies have gained the theoretical and practical evidence based backup from motor learning principles and clinical studies. Various approaches to AAN training have been proposed and investigated by research groups all around the world. This article presents a review on control algorithms of gait rehabilitation robots to summarise related knowledge and investigate potential trends of development. There are existing review papers on control strategies of rehabilitation robots. The review by Marchal-Crespo and Reinkensmeyer (2009) had a broad cover of control strategies of all kinds of rehabilitation robots. Hussain et al. (2011) had specifically focused on treadmill gait training robots and covered a limited number of control implementations on them. This review article encompasses more detailed information on control strategies for robot assisted gait rehabilitation, but is not limited to treadmill based training. It also investigates the potential to further develop assist-as-needed gait training based on assessments of patients' ability. In this paper, control strategies are generally divided into the trajectory tracking control and AAN control. The review covers these two basic categories, as well as other control algorithm and technologies derived from them, such as biofeedback control. Assessments on human gait ability are also included to investigate how to

  16. Evaluation of gas and carbon transport in a methanogenic bioelectrochemical system (BES).

    PubMed

    Dykstra, Christy M; Pavlostathis, Spyros G

    2017-05-01

    Bioelectrochemical systems (BESs) may be used to upgrade anaerobic digester biogas by directly converting CO 2 to CH 4 . The objective of this study was to evaluate gas (N 2 , CO 2 , CH 4 , and H 2 ) and carbon transport within a methanogenic BES. Four BES configurations were evaluated: abiotic anode with abiotic cathode (AAn-ACa), bioanode with abiotic cathode (BAn-ACa), abiotic anode with biocathode (AAn-BCa), and bioanode with biocathode (BAn-BCa). Transport of N 2 , a gas commonly used for flushing anoxic systems, out of the anode headspace ranged from 3.7 to 6.2 L/d-atm-m 2 , normalized to the proton exchange membrane (PEM) surface area and net driving pressure (NDP). CO 2 was transported from the cathode to the anode headspace at rates from 3.7 to 5.4 L/d-atm-m 2 . The flux of H 2 from cathode to anode headspace was 48% greater when the system had a biocathode (AAn-BCa) than when H 2 was produced at an abiotic cathode (BAn-ACa), even though the abiotic cathode headspace had 75% more H 2 than the AAn-BCa biocathode at the end of 1 day. A 7-day carbon balance of a batch-fed BAn-BCa BES showed transient microbial carbon storage and a net transport of carbon from anode to cathode. After a 7-day batch incubation, the CH 4 production in the biocathode was 27% greater on a molar basis than the initial CO 2 supplied to the biocathode headspace, indicating conversion of CO 2 produced in the anode. This research expands the current understanding of methanogenic BES operation, which may be used in improving the assessment of BES performance and/or in the development of alternative BES designs and mathematical models. Biotechnol. Bioeng. 2017;114: 961-969. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

  17. Vagus Nerve Stimulation for Treating Epilepsy

    MedlinePlus

    ... and their FAMILIES VAGUS NERVE STIMULATION FOR TREATING EPILEPSY This information sheet is provided to help you ... how vagus nerve stimulation (VNS) may help treat epilepsy. The American Academy of Neurology (AAN) is the ...

  18. Army Strategic Logistics Plan: Enabling Strategic Responsiveness Through a Revolution in Military Logistics

    DTIC Science & Technology

    2002-01-01

    D-5 AAN CSS Franchise Report...D-6 CSS Franchise Issues Summary for TDAPII...Appendix D. The ASLP groups the initiatives in the six investment categories of automation and communications, business process change, organizational

  19. Spacecraft operations automation: Automatic alarm notification and web telemetry display

    NASA Astrophysics Data System (ADS)

    Short, Owen G.; Leonard, Robert E.; Bucher, Allen W.; Allen, Bryan

    1999-11-01

    In these times of Faster, Better, Cheaper (FBC) spacecraft, Spacecraft Operations Automation is an area that is targeted by many Operations Teams. To meet the challenges of the FBC environment, the Mars Global Surveyor (MGS) Operations Team designed and quickly implemented two new low-cost technologies: one which monitors spacecraft telemetry, checks the status of the telemetry, and contacts technical experts by pager when any telemetry datapoints exceed alarm limits, and a second which allows quick and convenient remote access to data displays. The first new technology is Automatic Alarm Notification (AAN). AAN monitors spacecraft telemetry and will notify engineers automatically if any telemetry is received which creates an alarm condition. The second new technology is Web Telemetry Display (WTD). WTD captures telemetry displays generated by the flight telemetry system and makes them available to the project web server. This allows engineers to check the health and status of the spacecraft from any computer capable of connecting to the global internet, without needing normally-required specialized hardware and software. Both of these technologies have greatly reduced operations costs by alleviating the need to have operations engineers monitor spacecraft performance on a 24 hour per day, 7 day per week basis from a central Mission Support Area. This paper gives details on the design and implementation of AAN and WTD, discusses their limitations, and lists the ongoing benefits which have accrued to MGS Flight Operations since their implementation in late 1996.

  20. Who Do We Deploy for Psychological Operations: A Function Profile for TPT Members

    DTIC Science & Technology

    2008-01-01

    doet onderzoek om de ontwikkeling v’an PSYOPS in Nederland te ondersteunen. Een eerste stap, in het goed voorbereiden en uitvoeren van PSYOPS is het...bezit. De focus van het huidige project ligt op de selectiemethode van mensen die PSYOPS functies gaan vervullen. Naast Nederland zijn er ook andere NAVO...deze interviews kwam naar voren dat verschillende landen kampen met dezelfde problemen als Nederland wat betreft de selectie van het PSYOPS personeel

  1. Het SOWNet Experiment (The SOWNet Experiment)

    DTIC Science & Technology

    2008-07-01

    dat bet energieverbruik van de EQS zenders naar aanleiding van een gem-iddelde voertuigpassage circa 5 keer zo hoog is dan die van de SOWNet-zenders...code (I byte). * Een Belief- parameter (1 byte). * Een geheugenindex (2 bytes). * Lijst met Destination ID-codes, aangevuld met nullen. vaste omvang 10...verwachting voldoende hoog is zal de node alarm slaan. Als een sensor een object detecteert (hetzij als een False Alarm, hetzij doordat een object

  2. Multiple Sclerosis and Vitamin D

    MedlinePlus

    ... vitamin D and which were in the placebo group. Copyright © 2011 by AAN Enterprises, Inc. e99 Previous studies on vitamin D in MS did not have such a strong study design. They were more suscepti- ble to bias, and ...

  3. Complementary and Alternative Medicine for Multiple Sclerosis

    MedlinePlus

    ... Oral cannabis extract (OCE) – a cannabis pill • Synthetic tetrahydrocannabinol (THC) – a cannabis pill • Oromucosal cannabinoid spray – a spray ... Academy of Neurology AAN. com OCE and Synthetic THC OCE is taken orally (by mouth) in pill ...

  4. Elektrische Scheepsvoortstuwing en Supergeleiding: Een Literatuurstudie (Electric Ship Propulsion and Superconductivity: A Desk Study)

    DTIC Science & Technology

    1992-06-01

    opdraCmlgoeVO en e; opdrachtnemer verweren naar doeha ’Algemen. Voorwearden voor Onderzoeks- ONGERTJBRICEERD opdrachlefl son TNO’, dan wel do belreflende...Opomp’kaneal NaK isolatielaag mom ankerstroomn NaK max. niveau van NaK -as Figuur 4.7 Seriewchakeling van de schijven met NaK TNO-rappert PML 2824880131Pgn De...suporgeleidend worden uitgovocrd kin de constructie aanmerkelijk worden vereenvoudigd. Voor generatoren onder de 100 MW wegen de kosten, verbonden son de grotere

  5. Werkbelasting Bij Verkeers-En Gevechtsleiding. Deel 2 (Workload of Air Traffic and Air Combat Personnel. Part 2)

    DTIC Science & Technology

    1989-07-31

    de onderzaeker nadig had am van bet instituut naar de werkplek te reizen . Genaemde diensten waren er niet zeker van dat bet nag steeds druk zau zijn...tegen de tijd dat anderzoeker ter plaatse zau zijn. Daarap werd beslaten bij deze diensten twee midweken (dinsdag t/m donderdag) cantinu te observeren...eon onderzoek to doen. Do tijd tussen oproep en begin van het onderzoek was 30 tot 40 minuten. Hot onderzoek word afgebroken als do werkpiek vaorbij was

  6. Tweede Serie Ergonomietests Lichtgewicht Bommenpakken (Second Series of Ergonomic Tests on Lightweight Bomb Disposal Suits)

    DTIC Science & Technology

    2007-12-01

    warmtebelastingtests vast te stellen en (sit-and-reach, stand-and-reach. abductie referentiewaarden te bepalen door het van de arnen, anteflexie van de armen ...volgende, bewegingbeperkingtests: sit-and-reach, stand-and-reach. abductie van de armen , anteflexie van de armen en beperking van zicht. Bij de sit-and...gebogen op de rand van een tafel en houdt de armen zo ver mogeijk gestrekt naar voren op tafel. Daarbij wordt de afstand vanaf de rand van de tafel tot

  7. Bacillus coagulans GBI-30, 6086 increases plant protein digestion in a dynamic, computer-controlled in vitro model of the small intestine (TIM-1).

    PubMed

    Keller, D; Van Dinter, R; Cash, H; Farmer, S; Venema, K

    2017-05-30

    The aim of this study was to assess the potential of the probiotic Bacillus coagulans GBI-30, 6086 [GanedenBC 30 ] (BC30) to aid in protein digestion of alimentary plant proteins. To test this, three plant proteins, from pea, soy and rice, were digested in a validated in vitro model of the stomach and small intestine (TIM-1) in the absence and in the presence of BC30. Samples were taken from the TIM-1 fractions that mimic uptake of amino acids by the host and analysed for α-amino nitrogen (AAN) and total nitrogen (TN). Both were increased by BC30 for all three plant proteins sources. The ratio of TN/AAN indicated that for pea protein digestion was increased by BC30, but the degree of polymerisation of the liberated small peptides and free amino acids was not changed. For soy and rice, however, BC30 showed a 2-fold reduction in the TN/AAN ratio, indicating that the liberated digestion products formed during digestion in the presence of BC30 were shorter peptides and more free amino acids, than those liberated in the absence of BC30. As BC30 increased protein digestion and uptake in the upper gastrointestinal (GI) tract, it consequently also reduced the amount of protein that would be delivered to the colon, which could there be fermented into toxic metabolites by the gut microbiota. Thus, the enhanced protein digestion by BC30 showed a dual benefit: enhanced amino acid bioavailability from plant proteins in the upper GI tract, and a healthier environment in the colon.

  8. Cervical spine immobilization following blunt trauma: a systematic review of recent literature and proposed treatment algorithm.

    PubMed

    Lukins, Timothy R; Ferch, Richard; Balogh, Zsolt J; Hansen, Mitchell A

    2015-12-01

    Management of the cervical spine following blunt trauma is commonplace. In 2013, the American Association of Neurological Surgeons (AANS) and the Congress of Neurological Surgeons (CNS) published practice guidelines drawn from evidence dating to 2011. Since then, further publications have emerged that are reviewed, and a simple management algorithm produced to assist practitioners in Australian trauma centres. These publications attempt to shed light on two controversial scenarios, those being the management of symptomatic patients with negative computed tomography (CT) and management of the obtunded patient. The search strategy mirrored that of the AANS/CNS guidelines. A search of the National Library of Medicine (PubMed) database for manuscripts published between January 2011 and October 2014 was conducted. One reviewer extracted data from studies assessing the performance of various imaging modalities in identifying traumatic cervical spine injuries. In clinical scenarios where little evidence has emerged since the AANS/CNS guidelines, key manuscripts published prior to 2011 were identified from bibliographies. Awake, asymptomatic patients may be 'cleared' without further imaging. Awake, symptomatic patients without pathology on CT and without neurological deficit can safely be 'cleared' without magnetic resonance imaging. There is no longer a role for flexion-extension films. In the obtunded patient, findings remain conflicting. Several of these findings represent a departure from previous practices, including clearance of patients with non-neurological symptoms on the basis of CT and the exclusion of flexion-extension film in detecting injury. Management of the obtunded patient remains controversial. © 2015 Royal Australasian College of Surgeons.

  9. The Magnet Nursing Services Recognition Program

    PubMed Central

    Aiken, Linda H.; Havens, Donna S.; Sloane, Douglas M.

    2015-01-01

    OVERVIEW In an environment rife with controversy about patient safety in hospitals, medical error rates, and nursing shortages, consumers need to know how good the care is at their local hospitals. Nursing’s best kept secret is the single most effective mechanism for providing that type of comparative information to consumers, a seal of approval for quality nursing care: designation of magnet hospital status by the American Nurses Credentialing Center (ANCC). Magnet designation, or recognition of the “best” hospitals, was conceived in the early 1980s when the American Academy of Nursing (AAN) conducted a study to identify which hospitals attracted and retained nurses and which organizational features were shared by these successful hospitals, referred to as magnet hospitals. In the 1990s, the American Nurses Association (ANA), through the ANCC, established a formal program to acknowledge excellence in nursing services: the Magnet Nursing Services Recognition Program. The purpose of the current study is to examine whether hospitals selected for recognition by the ANCC application process—ANCC-accredited hospitals—are as successful in creating environments in which excellent nursing care is provided as the original AAN magnet hospitals were. We found that at ANCC-recognized magnet hospitals nurses had lower burnout rates and higher levels of job satisfaction and gave the quality of care provided at their hospitals higher ratings than did nurses at the AAN magnet hospitals. Our findings validate the ability of the Magnet Nursing Services Recognition Program to successfully identify hospitals that provide high-quality nursing care. PMID:19641439

  10. Deciphering the Molecular Mechanisms of Breast Cancer

    DTIC Science & Technology

    2005-03-01

    2007). Nicolas E., Lee M.G., Hakimi M.A., Cam H.P., Grewal S.I., Shiekhattar R. Fussion yeast homologs of human H3 lysinee 4 demethylase regulate a...Baillat D., Hakimi M.A., Naar A., Shilatifard A., Cooch N., Shiekhattar R. Integrator, a multiprotein mediator of small nuclear RNA processing...fractionof FLAG-BARD1 using anti-FLAG antibodies from H1299 of BRCA1 and BARD1 elute at a smaller molecular masscells. Nuclear extract from native H1299

  11. An Evaluation of Wind Turbine Technology at Peterson Air Force Base

    DTIC Science & Technology

    2005-03-01

    by the wind speed. Darrieus turbines are ordinarily inexpensive and are used for electricity generation and irrigation. One advantage to a...AN EVALUATION OF WIND TURBINE TECHNOLOGY...02 AN EVALUATION OF WIND TURBINE TECHNOLOGY AT PETERSON AIR FORCE BASE THESIS Presented to the Faculty Department of

  12. Regret and Responsibility Resolved? Evaluating Ordóñez and Connolly's (2000) Conclusions.

    PubMed

    Zeelenberg; van Dijk WW; Manstead

    2000-01-01

    T. Connolly, L. D. Ordo;aan;atez, and R. Coughlan (1997, Organizational Behavior and Human Decision Processes, 70, 73-85) argued, on the basis of 5 experiments, that regret need not be related to a sense of responsibility for the regretted outcome. We (M. Zeelenberg, W. W. van Dijk, & A. S. R. Manstead, 1998, Organizational Behavior and Human Decision Processes, 74, 254-272) showed in 2 experiments that this conclusion was premature, because it was based on an indirect measure of regret (i.e., overall happiness with the decision outcome). When regret was directly measured, the predicted effects of responsibility were found. L. D. Ordo;aan;atez and T. Connolly (2000, Organizational Behavior and Human Decision Processes, 81, 132-142) replicated our findings in 2 experiments. Based on their findings they arrived at 4 conclusions. In this rejoinder we first discuss Ordóñez and Connolly's new studies and we then discuss the validity of their 4 conclusions. Copyright 2000 Academic Press.

  13. Preventive Migraine Treatment

    PubMed Central

    Silberstein, Stephen D.

    2015-01-01

    Purpose of Review: This article reviews the evidence base for the preventive treatment of migraine. Recent Findings: Evidence-based guidelines for the preventive treatment of migraine have recently been published by the American Academy of Neurology (AAN) and the Canadian Headache Society (CHS), providing valuable guidance for clinicians. Strong evidence exists to support the use of metoprolol, timolol, propranolol, divalproex sodium, sodium valproate, and topiramate for migraine prevention, according to the AAN. Based on best available evidence, adverse event profile, and expert consensus, topiramate, propranolol, nadolol, metoprolol, amitriptyline, gabapentin, candesartan, Petasites (butterbur), riboflavin, coenzyme Q10, and magnesium citrate received a strong recommendation for use from the CHS. Summary: Migraine preventive drug treatments are underutilized in clinical practice. Principles of preventive treatment are important to improve compliance, minimize side effects, and improve patient outcomes. Choice of preventive treatment of migraine should be based on the presence of comorbid and coexistent illness, patient preference, reproductive potential and planning, and best available evidence. PMID:26252585

  14. AOP: An R Package For Sufficient Causal Analysis in Pathway-based Screening of Drugs and Chemicals for Adversity

    EPA Science Inventory

    Summary: How can I quickly find the key events in a pathway that I need to monitor to predict that a/an beneficial/adverse event/outcome will occur? This is a key question when using signaling pathways for drug/chemical screening in pharma-cology, toxicology and risk assessment. ...

  15. Sperwer After S/A TC. Military Aviation Requirements; An Approach to Address the New RNLA UAV Domain

    DTIC Science & Technology

    2003-09-02

    houder BVLn (t.z.t. over te dragen aan C-1Div) D-DMKLu (Airworthiness Authority RNLAF) BLS Type Certificate Holder (DM) Sagem (delegated TC Holder...1Div 1 ) Airworthiness Authority (RNLAF) TC-Houder (LE-21) Ontwerper, Producent, Sagem (JAR-21) Type certificaat (TC) Bewijzen van Luchtwaardig- heid

  16. Simulation-based training in brain death determination.

    PubMed

    MacDougall, Benjamin J; Robinson, Jennifer D; Kappus, Liana; Sudikoff, Stephanie N; Greer, David M

    2014-12-01

    Despite straightforward guidelines on brain death determination by the American Academy of Neurology (AAN), substantial practice variability exists internationally, between states, and among institutions. We created a simulation-based training course on proper determination based on the AAN practice parameters to address and assess knowledge and practice gaps at our institution. Our intervention consisted of a didactic course and a simulation exercise, and was bookended by before and after multiple-choice tests. The 40-min didactic course, including a video demonstration, covered all aspects of the brain death examination. Simulation sessions utilized a SimMan 3G manikin and involved a complete examination, including an apnea test. Possible confounders and signs incompatible with brain death were embedded throughout. Facilitators evaluated performance with a 26-point checklist based on the most recent AAN guidelines. A senior neurologist conducted all aspects of the course, including the didactic session, simulation, and debriefing session. Ninety physicians from multiple specialties have participated in the didactic session, 38 of whom have completed the simulation. Pre-test scores were poor (41.4 %), with attendings scoring higher than residents (46.6 vs. 40.4 %, p = 0.07), and neurologists and neurosurgeons significantly outperforming other specialists (53.9 vs. 38.9 %, p = 0.003). Post-test scores (73.3 %) were notably higher than pre-test scores (45.4 %). Participant feedback has been uniformly positive. Baseline knowledge of brain death determination among providers was low but improved greatly after the course. Our intervention represents an effective model that can be replicated at other institutions to train clinicians in the determination of brain death according to evidence-based guidelines.

  17. Hepatic amino nitrogen conversion and organ N-contents in hypothyroidism, with thyroxine replacement, and in hyperthyroid rats.

    PubMed

    Grøfte, T; Wolthers, T; Jensen, D S; Møller, N; Jørgensen, J O; Orskov, H; Vilstrup, H

    1997-02-01

    The role of thyroid hormones in the regulation of hepatic conversions of amino nitrogen to urea is unresolved. The present study was designed to assess ureagenesis in rats with experimentally well-established hypo- and hyperthyroidism. The possible role of propylthiuracil (PTU), used for induction of hypothyroidism, was ascertained during thyroxine replacement of PTU treated hypothyroid rats. Basal blood amino nitrogen concentrations (AAN), the urea nitrogen synthesis rate (UNSR) and the maximal hepatic capacity for urea nitrogen synthesis (CUNS) obtained during alanine infusion were determined together with N-contents in the soleus muscle and kidneys in experimentally hypothyroid rats (n = 19), upon thyroxine replacement (n = 14) and in experimentally hyperthyroid rats (n = 19). Hypothyroidism was induced by adding propylthiouracil (0.05%) to the drinking water for 5 weeks. Hyperthyroidism was induced by thyroxine 100 micrograms/100 g body weight. During hyperthyroidism, T3 fell to less than 10%, food intake was halved, and body weight fell by 13%. Basal blood AAN fell by 25% (p < 0.01), UNSR more than doubled (p < 0.01), and CUNS rose by 45% (p < 0.05). N-contents of the soleus muscle fell by 13% and by 20% in kidneys, respectively (p < 0.05). Thyroxine replacement normalized AAN, UNSR, CUNS and reduced N-loss to 7% in the soleus muscle (NS) and kidneys (p < 0.05), respectively. During hyperthyroidism, T3 rose five-fold, food intake rose by two thirds, and body weight fell by 10%. Basal AAN rose by 20% (p < 0.05), UNSR doubled (p < 0.01), and CUNS rose by 25% (p < 0.05). N-contents of the soleus muscle decreased by 19%, whereas kidney N-contents increased by 25% (p < 0.05). Overall liver function assessed by galactose elimination capacity did not differ among groups. Both conditions increased the rate of urea synthesis; in the hypothyroid state the hepatic waste of amino-N was limited by low blood concentration of amino-N, probably due to lower proteolysis. In

  18. Testing and Evaluation of Low-Light Sensors to Enhance Intelligence, Surveillance, and Reconnaissance (ISR) and Real-Time Situational Awareness

    DTIC Science & Technology

    2009-03-01

    infrared, thermal , or night vision applications. Understanding the true capabilities and limitations of the ALAN camera and its applicability to a...an option to more expensive infrared, thermal , or night vision applications. Ultimately, it will be clear whether the configuration of the Kestrel...45  A.  THERMAL CAMERAS................................................................................45  1

  19. How large is the typical subarachnoid hemorrhage? A review of current neurosurgical knowledge.

    PubMed

    Whitmore, Robert G; Grant, Ryan A; LeRoux, Peter; El-Falaki, Omar; Stein, Sherman C

    2012-01-01

    Despite the morbidity and mortality of subarachnoid hemorrhage (SAH), the average volume of a typical hemorrhage is not well defined. Animal models of SAH often do not accurately mimic the human disease process. The purpose of this study is to estimate the average SAH volume, allowing standardization of animal models of the disease. We performed a MEDLINE search of SAH volume and erythrocyte counts in human cerebrospinal fluid as well as for volumes of blood used in animal injection models of SAH, from 1956 to 2010. We polled members of the American Association of Neurological Surgeons (AANS) for estimates of typical SAH volume. Using quantitative data from the literature, we calculated the total volume of SAH as equal to the volume of blood clotted in basal cisterns plus the volume of dispersed blood in cerebrospinal fluid. The results of the AANS poll confirmed our estimates. The human literature yielded 322 publications and animal literature, 237 studies. Four quantitative human studies reported blood clot volumes ranging from 0.2 to 170 mL, with a mean of ∼20 mL. There was only one quantitative study reporting cerebrospinal fluid red blood cell counts from serial lumbar puncture after SAH. Dispersed blood volume ranged from 2.9 to 45.9 mL, and we used the mean of 15 mL for our calculation. Therefore, total volume of SAH equals 35 mL. The AANS poll yielded 176 responses, ranging from 2 to 350 mL, with a mean of 33.9 ± 4.4 mL. Based on our estimate of total SAH volume of 35 mL, animal injection models may now become standardized for more accurate portrayal of the human disease process. Copyright © 2012 Elsevier Inc. All rights reserved.

  20. State of Global Pediatric Neurosurgery Outreach: Survey by the International Education Subcommittee

    PubMed Central

    Davis, Matthew C.; Rocque, Brandon G.; Singhal, Ash; Ridder, Tom; Pattisapu, Jogi V.; Johnston, James M.

    2017-01-01

    Object Neurosurgical services are increasingly recognized as essential components of surgical care worldwide. Degree of interest among neurosurgeons regarding international work, and barriers to involvement in global neurosurgical outreach, are largely unexplored. We distributed a survey to members of the AANS/CNS Joint Section on Pediatric Neurosurgery to assess the state of global outreach among its members and identify barriers to involvement. Methods An internet-based questionnaire was developed by the International Education Subcommittee of the AANS/CNS Joint Section on Pediatric Neurosurgery, and distributed to pediatric neurosurgeons via the AANS/CNS Joint Section email contact list. Participants were surveyed on involvement in global neurosurgical outreach, geographic location, nature of participation, and barriers to further involvement. Results A 35.3% response rate was obtained, with 116 respondents completed the survey. 61% performed or taught neurosurgery in a developing country, 49% traveling at least annually. Africa was the most common region (54%), followed by South America (30%), through 29 separate organizing entities. Hydrocephalus was the most commonly treated condition (88%), followed by spinal dysraphism (74%) and tumor (68%). Most respondents obtained follow-up through communication from local surgeons (77%). 71% believed the international experience improved their practice, and 74% were very or extremely interested in working elsewhere. Interference with current practice (61%), cost (44%), and difficulty identifying international partners (43%) were the most commonly cited barriers to participation. Conclusion Any coordinated effort to expand global neurosurgical capacity begins with appreciation for the current state of outreach efforts. Increasing participation in global outreach will require addressing both real and perceived barriers to involvement. Creation and curation of a centralized online database of ongoing projects to facilitate

  1. Inception of a national multidisciplinary registry for stereotactic radiosurgery.

    PubMed

    Sheehan, Jason P; Kavanagh, Brian D; Asher, Anthony; Harbaugh, Robert E

    2016-01-01

    Stereotactic radiosurgery (SRS) represents a multidisciplinary approach to the delivery of ionizing high-dose radiation to treat a wide variety of disorders. Much of the radiosurgical literature is based upon retrospective single-center studies along with a few randomized controlled clinical trials. More timely and effective evidence is needed to enhance the consistency and quality of and clinical outcomes achieved with SRS. The authors summarize the creation and implementation of a national SRS registry. The American Association of Neurological Surgeons (AANS) through NeuroPoint Alliance, Inc., started a successful registry effort with its lumbar spine initiative. Following a similar approach, the AANS and NeuroPoint Alliance collaborated with corporate partners and the American Society for Radiation Oncology to devise a data dictionary for an SRS registry. Through administrative and financial support from professional societies and corporate partners, a framework for implementation of the registry was created. Initial plans were devised for a 3-year effort encompassing 30 high-volume SRS centers across the country. Device-specific web-based data-extraction platforms were built by the corporate partners. Data uploaders were then used to port the data to a common repository managed by Quintiles, a national and international health care trials company. Audits of the data for completeness and veracity will be undertaken by Quintiles to ensure data fidelity. Data governance and analysis are overseen by an SRS board comprising equal numbers of representatives from the AANS and NeuroPoint Alliance. Over time, quality outcome assessments and post hoc research can be performed to advance the field of SRS. Stereotactic radiosurgery offers a high-technology approach to treating complex intracranial disorders. Improvements in the consistency and quality of care delivered to patients who undergo SRS should be afforded by the national registry effort that is underway.

  2. State of global pediatric neurosurgery outreach: survey by the International Education Subcommittee.

    PubMed

    Davis, Matthew C; Rocque, Brandon G; Singhal, Ash; Ridder, Thomas; Pattisapu, Jogi V; Johnston, James M

    2017-08-01

    OBJECTIVE Neurosurgical services are increasingly recognized as essential components of surgical care worldwide. The degree of interest among neurosurgeons regarding international work, and the barriers to involvement in global neurosurgical outreach, are largely unexplored. The authors distributed a survey to members of the American Association of Neurological Surgeons/Congress of Neurological Surgeons (AANS/CNS) Joint Section on Pediatric Neurosurgery to assess the state of global outreach among its members and to identify barriers to involvement. METHODS An internet-based questionnaire was developed by the International Education Subcommittee of the AANS/CNS Joint Section on Pediatric Neurosurgery and distributed to pediatric neurosurgeons via the AANS/CNS Joint Section email contact list. Participants were surveyed on their involvement in global neurosurgical outreach, geographic location, nature of the participation, and barriers to further involvement. RESULTS A 35.3% response rate was obtained, with 116 respondents completing the survey. Sixty-one percent have performed or taught neurosurgery in a developing country, and 49% travel at least annually. Africa was the most common region (54%), followed by South America (30%), through 29 separate organizing entities. Hydrocephalus was the most commonly treated condition (88%), followed by spinal dysraphism (74%), and tumor (68%). Most respondents obtained follow-up through communications from local surgeons (77%). Seventy-one percent believed the international experience improved their practice, and 74% were very or extremely interested in working elsewhere. Interference with current practice (61%), cost (44%), and difficulty identifying international partners (43%) were the most commonly cited barriers to participation. CONCLUSIONS Any coordinated effort to expand global neurosurgical capacity begins with appreciation for the current state of outreach efforts. Increasing participation in global outreach will

  3. Updating the recommendations for treatment of tardive syndromes: A systematic review of new evidence and practical treatment algorithm.

    PubMed

    Bhidayasiri, Roongroj; Jitkritsadakul, Onanong; Friedman, Joseph H; Fahn, Stanley

    2018-06-15

    Management of tardive syndromes (TS) is challenging, with only a few evidence-based therapeutic algorithms reported in the American Academy of Neurology (AAN) guideline in 2013. To update the evidence-based recommendations and provide a practical treatment algorithm for management of TS by addressing 5 questions: 1) Is withdrawal of dopamine receptor blocking agents (DRBAs) an effective TS treatment? 2) Does switching from typical to atypical DRBAs reduce TS symptoms? 3) What is the efficacy of pharmacologic agents in treating TS? 4) Do patients with TS benefit from chemodenervation with botulinum toxin? 5) Do patients with TS benefit from surgical therapy? Systematic reviews were conducted by searching PsycINFO, Ovid MEDLINE, PubMed, EMBASE, Web of Science and Cochrane for articles published between 2012 and 2017 to identify new evidence published after the 2013 AAN guidelines. Articles were classified according to an AAN 4-tiered evidence-rating scheme. To the extent possible, for each study we attempted to categorize results based on the description of the population enrolled (tardive dyskinesia [TD], tardive dystonia, tardive tremor, etc.). Recommendations were based on the evidence. New evidence was combined with the existing guideline evidence to inform our recommendations. Deutetrabenazine and valbenazine are established as effective treatments of TD (Level A) and must be recommended as treatment. Clonazepam and Ginkgo biloba probably improve TD (Level B) and should be considered as treatment. Amantadine and tetrabenazine might be considered as TD treatment (Level C). Pallidal deep brain stimulation possibly improves TD and might be considered as a treatment for intractable TD (Level C). There is insufficient evidence to support or refute TS treatment by withdrawing causative agents or switching from typical to atypical DRBA (Level U). Copyright © 2018 Elsevier B.V. All rights reserved.

  4. Hereditary Deafness in a Former Fishing Village on the Dutch Coast

    ERIC Educational Resources Information Center

    Nyst, Victoria A. S.

    2016-01-01

    In communities with an increased prevalence of hereditary deafness, social, and linguistic adaptations are found in response. Aulbers (1959) describes a high prevalence of deafness in a fishing village on the Dutch coast: Katwijk aan Zee. This article aims to assess the current prevalence of deafness in Katwijk, as well as the current sign…

  5. Phthalic anhydride production from hemicellulose solutions: Technoeconomic analysis and life cycle assessment

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

    Lin, Zhaojia; Ierapetritou, Marianthi; Nikolakis, Vladimiros

    2015-07-14

    The process synthesis, technoeconomic analysis, and life cycle assessment (LCA) of a novel route for phthalic anhydride (PAN) production from hemicellulose solutions are presented. The production contains six steps including dehydration of xylose to furfural, reductive decarbonylation of furfural to furan, oxidation of furfural to maleic anhydride (MA), Diels-Alder cycloaddition of furan, and MA to exo-4,10-dioxa-tricyclo[5.2.1.0]dec-8-ene-3,5-dione followed by dehydration to PAN in the presence of mixture of methanesulfonic acid and acetic anhydride (AAN) which is converted to acetyl methanesulfonate and acetic acid (AAD), and dehydration of AAD to AAN. The minimum selling price of PAN is determined to be $810/metricmore » ton about half of oil-based PAN. The coproduction of high-value products is essential to improve the economics. Biomass feedstock contributes to the majority of cost. LCA results shows that biomass-based PAN has advantages over oil-based PAN to reduce climate change and fossil depletion however requires more water usage.« less

  6. Phthalic anhydride production from hemicellulose solutions: Technoeconomic analysis and life cycle assessment

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

    Lin, Zhaojia; Ierapetritou, Marianthi; Nikolakis, Vladimiros

    The process synthesis, technoeconomic analysis, and life cycle assessment (LCA) of a novel route for phthalic anhydride (PAN) production from hemicellulose solutions are presented. The production contains six steps including dehydration of xylose to furfural, reductive decarbonylation of furfural to furan, oxidation of furfural to maleic anhydride (MA), Diels-Alder cycloaddition of furan, and MA to exo-4,10-dioxa-tricyclo[5.2.1.0]dec-8-ene-3,5-dione followed by dehydration to PAN in the presence of mixture of methanesulfonic acid and acetic anhydride (AAN) which is converted to acetyl methanesulfonate and acetic acid (AAD), and dehydration of AAD to AAN. The minimum selling price of PAN is determined to be $810/metricmore » ton about half of oil-based PAN. The coproduction of high-value products is essential to improve the economics. Biomass feedstock contributes to the majority of cost. LCA results shows that biomass-based PAN has advantages over oil-based PAN to reduce climate change and fossil depletion however requires more water usage.« less

  7. Understanding English Non-Count Nouns and Indefinite Articles

    ERIC Educational Resources Information Center

    Tsuchida, Takehiro

    2010-01-01

    The fact that English non-count abstract nouns such as knowledge are compatible with the indefinite article a/an is not only perplexing for second language (L2) learners of English but also troublesome for both native and non-native English teachers. This paper does research on this curious phenomenon of English grammar to clarify its mechanism…

  8. Detainee Health Care: Essential Element of Stability Operations

    DTIC Science & Technology

    2012-03-22

    reported a lack of proper medical equipment to treat older chronically ill detainees.57 Physicians reported difficulties in transferring detainees...ascertains detainees’ baseline health and identifies medical needs which require immediate attention or chronic conditions for ongoing care, referral to a...an in- patient or out-patient basis. Long standing chronic injuries are common among detainees-these include injuries from gunshot wounds, shrapnel

  9. Charging Ahead into the Next Millennium: Proceedings of the Systems and Technology Symposium (20th) Held in Denver, Colorado on 7-10 June 1999

    DTIC Science & Technology

    1999-06-01

    Tactical Radar Correlator EV Electric Vehicle EW Electronic Warfare F ^^m F Frequency FA False Alarm FAO Foreign Area Officer FBE Fleet Battle... Electric Vehicle High Frequency Horsepower High-Performance Computing High Performance Computing and Communications High Performance Knowledge...A/D Analog-to-Digital A/G Air-to-Ground AAN Army After Next AAV Advanced Air Vehicle ABCCC Airborne Battlefield Command, Control and

  10. A Framework of Factors Influencing ANSA Decision Making (Structure des Facteurs Agissant sur le Processus Decisionel des Acteurs Armes non Etatiques)

    DTIC Science & Technology

    2010-12-01

    Contractor was tasked to systematically identify and critically assess scientific literature of relevance to elaborating a theory of ANSA strategic decision...processus décisionnel des AANE et permettra de déterminer quand et comment intervenir afin d’arriver à des résultats plus positifs. Les auteurs ont fait...Jackson 2009) .................................... 13 List of tables Table 1 Theories of decision making

  11. American Academy of Neurology - 69th Annual Meeting (April 22-28, 2017 - Boston, Massachusetts, USA).

    PubMed

    Dulsat, C

    2017-05-01

    The Annual Meeting of the American Academy of Neurology (AAN) is the largest conference convening neurology professionals from all over the world to share and discuss the latest breakthroughs in neurology treatment. The conference covers basic scientific research to clinical application through a wide range and interesting programs. This report covers some of the therapeutic highlights presented during the conference.

  12. Symposium on Turbulent Shear Flows (8th) Held in Munich, Germany on 9-11 September 1991. Volume 1. Sessions 1-18

    DTIC Science & Technology

    1991-09-01

    understood Y/8 - thraut its growth. self-prewrvng, and decay stage in 1II(-) ilC = detail The lare-scale horsesho vortex kept its ciroercy until the ed of...K li (fe undarmnta) Azast.5, serlyr A, .1,yse p..0 Fil1 h vraino moenu thckes In siniianl whene thea Ine beamc pas n touho the treg lo Aan th cetroth

  13. Resonance energy transfer between the active sites of creatine kinase from rabbit brain.

    PubMed

    Grossman, S H

    1990-09-03

    Resonance energy transfer was measured between the active site domains of the brain isozyme of creatine kinase (CK-BB). The reactive thiol near the active sites, one on each subunit of the dimeric protein, was derivatized using 5-[2-[iodoacetyl)amino)ethyl]aminonaphthalene-1-sulfonic acid (AED), 2-[4'-iodoacetamidoanilino]naphthalene-6-sulfonic acid (AANS) and 5-iodoacetamidofluorescein (AF). Suitable donor/acceptor protein conjugated hybrids were prepared by controlled kinetics producing CK-BB-AED/AF and CK-BB-AANS/AF. Transfer efficiencies, measured from the quenching of the donor lifetime and steady-state sensitized acceptor emission, ranged from 0.10 to 0.17. From determination of the donor/acceptor overlap integrals, donor quantum yields and attempts to delimit the orientation factor using steady-state and phase-resolved anisotropy measurements, it was found that a suitable estimate of the range between the active sites was between 45 and 57 A. This range is similar to that reported previously for the muscle isozyme of creatine kinase (Grossman, S.H. (1989) Biochemistry 28, 4894-4902) but is a significantly greater distance than detected for the hybrid, myocardial specific isozyme (Grossman, S.H. (1983) Biochemistry 22, 5369-5375).

  14. Effects of ruminal protein degradability and frequency of supplementation on nitrogen retention, apparent digestibility, and nutrient flux across visceral tissues in lambs fed low-quality forage.

    PubMed

    Atkinson, R L; Toone, C D; Robinson, T J; Harmon, D L; Ludden, P A

    2010-02-01

    Two experiments were conducted to determine the effect of ruminal protein degradability and supplementation frequency on intake, apparent digestibility, N retention, and nutrient flux across visceral tissues of lambs fed a low-quality forage diet. In both experiments, wethers were fed a basal diet of mature crested wheatgrass hay (4.2% CP) for ad libitum consumption plus 1 of 4 supplements: 1) a high RDP supplement provided daily (RDP-D), 2) the high RDP supplement provided on alternate days (RDP-A), 3) a high RUP provided on alternate days (RUP-A), or 4) a 50:50 mixture of the RDP and RUP supplements provided on alternate days. In Exp. 1, 12 lambs (29.9 +/- 2.7 kg initial BW) were used. Forage OM, NDF, and ADF intake were not affected by treatment. Total tract digestibilities (OM, NDF, ADF, and N) were unaffected (P >or= 0.15) by treatment. Neither protein degradability nor supplementation frequency had an effect (P >or= 0.52) on N retention. In Exp. 2, 15 lambs (34 +/- 4 kg initial BW) fitted with indwelling catheters in a hepatic vein, the hepatic portal vein, a mesenteric vein, and a mesenteric artery were used. Release of ammonia N by the portal-drained viscera (PDV) was reduced (P = 0.004) in alternate-day-supplemented lambs compared with RDP-D. Consequently, hepatic uptake of ammonia N was least (P = 0.003) in all alternate-day lambs. Alpha-amino nitrogen (AAN) release by the PDV and hepatic uptake of AAN were not affected by treatment or supplementation frequency. Additionally, hepatic output and PDV uptake of urea N were not affected by treatment. Hepatic N uptake (ammonia N + AAN) accounted for urea synthesized by the liver in all treatments; however, hepatic urea synthesis was approximately 4.5-fold less for RUP-A lambs. This suggests that the provision of AA as RUP may provide a delay in ureagenesis, thus altering the timing of N recycling.

  15. Is the Readability of Spine-Related Patient Education Material Improving?: An Assessment of Subspecialty Websites.

    PubMed

    Eltorai, Adam E M; Cheatham, Morgan; Naqvi, Syed S; Marthi, Siddharth; Dang, Victor; Palumbo, Mark A; Daniels, Alan H

    2016-06-01

    Analysis of spine-related patient education materials (PEMs) from subspecialty websites. The aim of this study was to assess the readability of spine-related PEMs and compare to readability data from 2008. Many spine patients use the Internet for health information. Several agencies recommend that the readability of online PEMs should be no greater than a sixth-grade reading level, as health literacy predicts health-related quality of life outcomes. This study evaluated whether the North American Spine Society (NASS), American Association of Neurological Surgeons (AANS), and American Academy of Orthopaedic Surgeons (AAOS) online PEMs meet recommended readability guidelines for medical information. All publicly accessible spine-related entries within the patient education section of the NASS, AANS, and AAOS websites were analyzed for grade level readability using the Flesch-Kincaid formula. Readability scores were also compared with a similar 2008 analysis. Comparative statistics were performed. A total of 125 entries from the subspecialty websites were analyzed. The average (SD) readability of the online articles was grade level 10.7 (2.3). Of the articles, 117 (93.6%) had a readability score above the sixth-grade level. The readability of the articles exceeded the maximum recommended level by an average of 4.7 grade levels (95% CI, 4.292-5.103; P < 0.001). Compared with 2008, the three societies published more spine-related patient education articles (61 vs. 125, P = 0.045) and the average readability level improved from 11.5 to 10.7 (P = 0.018). Of three examined societies, only one showed significant improvement over time. Our findings suggest that the spine-related PEMs on the NASS, AAOS, and AANS websites have readability levels that may make comprehension difficult for a substantial portion of the patient population. Although some progress has been made in the readability of PEMs over the past 7 years, additional improvement is necessary. 2.

  16. Time Domain Radar Laboratory Operating System Development and Transient EM Analysis.

    DTIC Science & Technology

    1981-09-01

    polarization of the return, arg used. Other similar methods use amplitude and phase differences or special properties of Rayleigh region scattering. All these...3ptias Inverse Scattering ... 19 2. "!xact" Inverse Scattering !Nethod .. 20 3. Other Methods ................... 21 C. REVIEW OF TDRL PROGRESS AT SPS...explicit independant variable in.most methods . In the past, frequency domain analysis has been the primary means of analyzing aan-monochromatic EM

  17. Proceedings of the Workshop on Software Engineering Foundations for End-User Programming (SEEUP 2009)

    DTIC Science & Technology

    2009-11-01

    interest of scientific and technical information exchange. This work is sponsored by the U.S. Department of Defense. The Software Engineering Institute is a...an interesting conti- nuum between how many different requirements a program must satisfy: the more complex and diverse the requirements, the more... Gender differences in approaches to end-user software development have also been reported in debugging feature usage [1] and in end-user web programming

  18. Selection of a Method for the Measurement of the Protection Factor in the Field (Selectie van een methode voor de meting van de gasmaskerprotectiefactor te velde)

    DTIC Science & Technology

    1998-06-01

    deeltjes in het masker, de luclitwegen of de detector worden protectiefactoren gevonden die in het algemneen te optimistisch zijn [11, 12]. De gevonden...zijn wel te relateren aan bepaalde activiteiten. 4.2.2 Natuurlijk atmosferisch stof Door de firma TSI is een apparaat ontwikkeld (Portacount) dat...onderdruk afnemen [5]. Door de firma Dynatech Nevada (USA) wordt een apparaat geproduceerd dat van dit principe gebruikmaakt. Het apparaat is voorzien

  19. Evaluation of Fuel Character Effects on J79 Engine Combustion System

    DTIC Science & Technology

    1979-06-01

    A. Overall Engine Description The J79 engine is a lightweight, high-thrust, axial - flow turbojet engine with variable afterburner thrust. This engine...thimbles are arranged to provide flow patterns for flame stabilization in the primary zone and mixing and turbine inlet temperature profile control at...measured with stainard )S𔃾Z orifices- Fuel flow races uere measured with calibrated turbine flotaMcers corrected for the density aan viscosity of each

  20. Toekomstvisie op Verstrekking en Ontwikkeling van Kleding op Basis van Scangegenereerde Gegevens (Scan Based Distribution and Development of Clothing)

    DTIC Science & Technology

    2006-07-01

    meting Maatke uzest rategi e Borstomvang =1 11 [104 ý󈧌 616 [120 124 Primair Tailleomvang =106 98 b02~ . 10 114 118 Secundair Halsomvang = 37,4 ý5 6 9 40...Vastgcsteld d.d. 3 juli 2006 Titel Ongerubriceerd M anagementuittrekscl Ongerubriceerd Samenvatting Ongerubriceerd Rapporttekst Ongerubriceerd Oplage . 9 ...kieding Het KPU bedrijf verstrekt kieding aan het Defensie-personeel en gebruikt daartoe een lichaamsscanner. Deze nieuwe techniek heeft gevolgen voor

  1. Improving clinical cognitive testing: report of the AAN Behavioral Neurology Section Workgroup.

    PubMed

    Daffner, Kirk R; Gale, Seth A; Barrett, A M; Boeve, Bradley F; Chatterjee, Anjan; Coslett, H Branch; D'Esposito, Mark; Finney, Glen R; Gitelman, Darren R; Hart, John J; Lerner, Alan J; Meador, Kimford J; Pietras, Alison C; Voeller, Kytja S; Kaufer, Daniel I

    2015-09-08

    To evaluate the evidence basis of single-domain cognitive tests frequently used by behavioral neurologists in an effort to improve the quality of clinical cognitive assessment. Behavioral Neurology Section members of the American Academy of Neurology were surveyed about how they conduct clinical cognitive testing, with a particular focus on the Neurobehavioral Status Exam (NBSE). In contrast to general screening cognitive tests, an NBSE consists of tests of individual cognitive domains (e.g., memory or language) that provide a more comprehensive diagnostic assessment. Workgroups for each of 5 cognitive domains (attention, executive function, memory, language, and spatial cognition) conducted evidence-based reviews of frequently used tests. Reviews focused on suitability for office-based clinical practice, including test administration time, accessibility of normative data, disease populations studied, and availability in the public domain. Demographic and clinical practice data were obtained from 200 respondents who reported using a wide range of cognitive tests. Based on survey data and ancillary information, between 5 and 15 tests in each cognitive domain were reviewed. Within each domain, several tests are highlighted as being well-suited for an NBSE. We identified frequently used single-domain cognitive tests that are suitable for an NBSE to help make informed choices about clinical cognitive assessment. Some frequently used tests have limited normative data or have not been well-studied in common neurologic disorders. Utilizing standardized cognitive tests, particularly those with normative data based on the individual's age and educational level, can enhance the rigor and utility of clinical cognitive assessment. © 2015 American Academy of Neurology.

  2. Neurocritical care education during neurology residency: AAN survey of US program directors.

    PubMed

    Sheth, K N; Drogan, O; Manno, E; Geocadin, R G; Ziai, W

    2012-05-29

    Limited information is available regarding the current state of neurocritical care education for neurology residents. The goal of our survey was to assess the need and current state of neurocritical care training for neurology residents. A survey instrument was developed and, with the support of the American Academy of Neurology, distributed to residency program directors of 132 accredited neurology programs in the United States in 2011. A response rate of 74% (98 of 132) was achieved. A dedicated neuroscience intensive care unit (neuro-ICU) existed in 64%. Fifty-six percent of residency programs offer a dedicated rotation in the neuro-ICU, lasting 4 weeks on average. Where available, the neuro-ICU rotation was required in the vast majority (91%) of programs. Neurology residents' exposure to the fundamental principles of neurocritical care was obtained through a variety of mechanisms. Of program directors, 37% indicated that residents would be interested in performing away rotations in a neuro-ICU. From 2005 to 2010, the number of programs sending at least one resident into a neuro-ICU fellowship increased from 14% to 35%. Despite the expansion of neurocritical care, large proportions of US neurology residents have limited exposure to a neuro-ICU and neurointensivists. Formal training in the principles of neurocritical care may be highly variable. The results of this survey suggest a charge to address the variability of resident education and to develop standardized curricula in neurocritical care for neurology residents.

  3. Forecasting Science and Technology for the Department of Defense

    DTIC Science & Technology

    2009-12-01

    Watson and Francis Crick announced that they had elucidated the structure of DNA and had therefore “discovered the secret of life.” While this was a...an organic chemist, figured out a process by which very small quantities of DNA could be amplified with high fidelity. This process, known as...polymerase chain reaction (PCR), for the first time, allowed scientists to produce DNA in large quantities. Roughly during this period, Leroy Hood and

  4. Job Oriented Training: Handleiding Serious Gaming (Job Oriented Training: Handleiding (Handbook) Serious Gaming)

    DTIC Science & Technology

    2008-09-01

    bijvoorbeeld de toekomstige uitzendgebieden in zich heeft. De praktijk gaat hierbij vooraf aan de theorie , de benodigde theoretische kennis wordt niet vooraf...rapportnummer TNO-DV 2008 A340 Opdrachtnummer Datum September 2008 Auteur (s) dr. A.H. van der Hulst ir. T.J. Muller maj C.L. Roos Rubricering rapport...Oriented Training toegepast. Dit betekent in essentie dat de leerlingen vanaf dag een, integrale missies uitvoeren en niet eerst de theorie wordt

  5. Consequences of the Introduction of Insensitive Munitions on Safety, Collateral Damage and Operations (consequenties van de invoering van mkm-munitie op veiligheid, gevolgschade en (internationaal) opereren

    DTIC Science & Technology

    2006-06-01

    van de werkzaamheden In dit rapport worden de gevolgen van initiatie van munitie door een ongewilde externe stimulus beschouwd aan de hand van reele...operationele scenario’s. Dit wordt vergeleken met de gevolgen in dezelfde scenario’s, waarin gebruik is gemaakt van Minder Kwetsbare Munitie (MKM). Naast...de historie van MKM wordt uitgelegd wat Inleiding of terroristische activiteiten, maar ook door MKM is. Vervolgens worden de gevolgen Munitie en de

  6. Alzheimer's disease. AMA Council on Scientific Affairs Reference Committee D.

    PubMed

    1998-08-01

    This report responds to Substitute Resolution 518, I-96, which asks that the AMA, in cooperation with appropriate medical specialty societies, study Alzheimer's disease (AD) and other dementias, with particular emphasis on their diagnosis and treatment, issues relating to patient and caregiver education, the financing of care of affected individuals, the identification of research needs, and consideration of issues pertaining to the quality of life of individuals with these conditions. This report is based on a review of guidelines produced by the Agency for Health Care Policy and Research (AHCPR), the American Academy of Neurology (AAN), the Veterans Health Administration (VHA), and the American Psychiatric Association (APA), combined with review of the latest published literature on AD and related disorders and consultation with experts in the field. This analysis was used as a basis for policy formulation. The guidelines reviewed were: (1) Recognition and Initial Assessment of Alzheimer's Disease and Related Disorders, published by the AHCPR; (2) Dementia Identification and Assessment, published by the VHA; (3) Practice Parameter: Diagnosis and Evaluation of Dementia. published by the AAN; and (4) Practice Guideline for the Treatment of Patients with Alzheimer's Disease and Other Dementias of Late Life, published by the APA. These documents are targeted for the following audiences: primary care physicians (VHA and AHCPR), neurologists (AAN), and psychiatrists (APA). Only the APA guide makes provision for continuity of care. The literature review revealed that ongoing research into AD focuses on three broad areas: etiology/risk factors, diagnosis and treatment. AD is a common and costly public health problem. With the increase in life expectancy in the United States, AD is expected to afflict approximately 14 million people within the next few decades. Irreversible dementia takes a heavy economic, social, physical, and psychological toll on patients and families

  7. Withholding Food and Water from Vegetative Patients in Military Hospitals: Constitutional and Practical Concerns

    DTIC Science & Technology

    1990-04-01

    privacy included the right to be free from such life-sustaining technology , since she was "irreversibly 0 doomed" anyway. 25 The unanimous court said...that opinions about a patient’s "quality of life" should be considered when deciding whether to use life-sustaining technology , and 70% believed that... technologically supplied respiration, nutrition or hydration.",8 7 The AAN agreed, calling artificial nutrition and hydration "analogous to other forms of

  8. Tussenrapportage Validatie Onderwijsvernieuwingen (Validation Assistant in Instructional Design)

    DTIC Science & Technology

    2007-05-01

    validatie onderwij svemieuwingen D)atum mei 2007 Auteur (s) drs. J.P. van Meer drs. G,J. Veldhuis dr. M.L. van Ernmerik M.G. van Schaik Rubricering...als doel om nog beter is het van belang dat het maken van keuzes Auteur (s) passende adviezen te kunnen genereren. binnen een moeilijk grijpbaar...benaderd door de theorie achter de onderwijsconcepten te toetsen aan het oordeel van de expert. Er zijn echter beperkingen in deze opzet denkbaar die

  9. Speed Measuring System (Detectoren en Signaalbewerking Voor Het Snelheidsmeetsysteem 4-01)

    DTIC Science & Technology

    1989-03-01

    een hogere nauwkeurigheid te halen dan san de voet van bet signasi mogelijk is bij een grote signaalaniplitude, Wanneer de S/L < 6 is wordt de drempel...snelheidsmeetsysteem 4-01 Niets Uilf deze ultgave mag worden vermenigvuldigd en of openbaar gemaakt door mlddel van druk fotokope microfilm autour~s): of op welke...andere wijze dan 006 zonder voorafgaarode toestemming van TNO J. van der Haven Hetlter I zage geven van net TNO-rappoit aan direct belanghebbenoen is

  10. Evaluatie Kennistechnologische Ondersteuning bij Diagnose van SEWACO systemen (Projectmanagementplan) (Evaluation of Knowledge Technological Support for Diagnosis of SEWACO Systems (Project Management Plan)

    DTIC Science & Technology

    1991-08-01

    diagnos van SE WACO systmnen/ AD-A245 424111 1fl1,l Niets uit deze uitgave mag warden vermenigvuldligd en/of oPenbaar gemaakt door middel van druk...fotakopie. microfilm of op welks andere whlze dan ook, zonder voorafgaande toeslemming van TNO. Hot ter inzage geven van het TNO-rapport aan direct...belanghebbenden is tegestaan. HYP. vanl OC dt Indian dit rapport in opdracht ward uitgebracht, wordt voor de, rechten en verpiichtingen van opdrachtgever en

  11. Validation of the Military Entrance Physical Strength Capacity Test

    DTIC Science & Technology

    1984-01-01

    Differences The following sections give an overview of the differences between men and women on the MEPSCAT, CPTs, and Physical Proficiency Tests. Hotellings T2...Ca 0 0 I Smm C C a C. * C a C a.* I S S& me * me m S emme a * Cme a me a a -e - a a em * U C me * 6*mem Ct 0 em* S a C.m C * S aaN me a I % ma cc

  12. Report on Functional Design Specification for the Automated Alphanumeric Data Entry System,

    DTIC Science & Technology

    1984-01-30

    map feature searches, and other specific activities of the operator to get a good estimate of the time it takes to carry out the process. We...Channel (aan-aade) Channel (natiral) Chapel Charco Chasa crat er basin stream area streaa flat flat locale plain locale school valley...island cliff cave ceaetery suxoit suaait s u a a i t ppl is land iA n q e plain canal channel church lake valley center center aouth

  13. Through the patient's eyes: the value of a comprehensive brain tumor center.

    PubMed

    Robin, Adam M; Walbert, Tobias; Mikkelsen, Tom; Kalkanis, Steven N; Rock, Jack; Lee, Ian; Rosenblum, Mark L

    2014-09-01

    Since the founding of the Tumor Section of the American Association of Neurological Surgeons (AANS) and the Congress of Neurological Surgeons (CNS) in 1984 much in neurosurgical oncology has changed. More than 40,000 papers have been published on glioma since the arrival of the AANS/CNS Tumor Section. Increasingly, research is focusing on more patient-centered care and quality of life. Preliminary work suggests that a greater emphasis on the patient and caregiver's experience of disease is crucial. Also, the provision of hope and appropriate information and communication with health care providers helps to lessen anxiety and promote improved quality of life. Lastly, our patients need a mechanism for continued symptom control and psychosocial support throughout their experience of this disease. An excellent venue for providing these facets of neurooncological patient care is the multidisciplinary brain tumor board and symptom management team. Herein, we present the philosophy and practice of the Hermelin Brain Tumor Center at the Henry Ford Health System as one type of approach to caring for the patient with a malignant glioma. The authors are aware of several brain tumor centers that share our philosophy and approach to patient care. Our comments are not meant to be exclusive to our experience and should be interpreted as representative of the growing movement in neurosurgery to provide comprehensive, multidisciplinary, patient-centered care.

  14. The Crc and Hfq proteins of Pseudomonas putida cooperate in catabolite repression and formation of ribonucleic acid complexes with specific target motifs.

    PubMed

    Moreno, Renata; Hernández-Arranz, Sofía; La Rosa, Ruggero; Yuste, Luis; Madhushani, Anjana; Shingler, Victoria; Rojo, Fernando

    2015-01-01

    The Crc protein is a global regulator that has a key role in catabolite repression and optimization of metabolism in Pseudomonads. Crc inhibits gene expression post-transcriptionally, preventing translation of mRNAs bearing an AAnAAnAA motif [the catabolite activity (CA) motif] close to the translation start site. Although Crc was initially believed to bind RNA by itself, this idea was recently challenged by results suggesting that a protein co-purifying with Crc, presumably the Hfq protein, could account for the detected RNA-binding activity. Hfq is an abundant protein that has a central role in post-transcriptional gene regulation. Herein, we show that the Pseudomonas putida Hfq protein can recognize the CA motifs of RNAs through its distal face and that Crc facilitates formation of a more stable complex at these targets. Crc was unable to bind RNA in the absence of Hfq. However, pull-down assays showed that Crc and Hfq can form a co-complex with RNA containing a CA motif in vitro. Inactivation of the hfq or the crc gene impaired catabolite repression to a similar extent. We propose that Crc and Hfq cooperate in catabolite repression, probably through forming a stable co-complex with RNAs containing CA motifs to result in inhibition of translation initiation. © 2014 Society for Applied Microbiology and John Wiley & Sons Ltd.

  15. Acidic Residues in the Hfq Chaperone Increase the Selectivity of sRNA Binding and Annealing.

    PubMed

    Panja, Subrata; Santiago-Frangos, Andrew; Schu, Daniel J; Gottesman, Susan; Woodson, Sarah A

    2015-11-06

    Hfq facilitates gene regulation by small non-coding RNAs (sRNAs), thereby affecting bacterial attributes such as biofilm formation and virulence. Escherichia coli Hfq recognizes specific U-rich and AAN motifs in sRNAs and target mRNAs, after which an arginine patch on the rim promotes base pairing between their complementary sequences. In the cell, Hfq must discriminate between many similar RNAs. Here, we report that acidic amino acids lining the sRNA binding channel between the inner pore and rim of the Hfq hexamer contribute to the selectivity of Hfq's chaperone activity. RNase footprinting, in vitro binding and stopped-flow fluorescence annealing assays showed that alanine substitution of D9, E18 or E37 strengthened RNA interactions with the rim of Hfq and increased annealing of non-specific or U-tailed RNA oligomers. Although the mutants were less able than wild-type Hfq to anneal sRNAs with wild-type rpoS mRNA, the D9A mutation bypassed recruitment of Hfq to an (AAN)4 motif in rpoS, both in vitro and in vivo. These results suggest that acidic residues normally modulate access of RNAs to the arginine patch. We propose that this selectivity limits indiscriminate target selection by E. coli Hfq and enforces binding modes that favor genuine sRNA and mRNA pairs. Copyright © 2015 Elsevier Ltd. All rights reserved.

  16. Do young children have adult-like syntactic categories? Zipf's law and the case of the determiner.

    PubMed

    Pine, Julian M; Freudenthal, Daniel; Krajewski, Grzegorz; Gobet, Fernand

    2013-06-01

    Generativist models of grammatical development assume that children have adult-like grammatical categories from the earliest observable stages, whereas constructivist models assume that children's early categories are more limited in scope. In the present paper, we test these assumptions with respect to one particular syntactic category, the determiner. This is done by comparing controlled measures of overlap in the set of nouns with which children and their caregivers use different instances of the determiner category in their spontaneous speech. In a series of studies, we show, first, that it is important to control for both sample size and vocabulary range when comparing child and adult overlap measures; second, that, once the appropriate controls have been applied, there is significantly less overlap in the nouns with which young children use the determiners a/an and the in their speech than in the nouns with which their caregivers use these same determiners; and, third, that the level of (controlled) overlap in the nouns that the children use with the determiners a/an and the increases significantly over the course of development. The implication is that children do not have an adult-like determiner category during the earliest observable stages, and that their knowledge of the determiner category only gradually approximates that of adults as a function of their linguistic experience. Copyright © 2013 Elsevier B.V. All rights reserved.

  17. Guidon-Watch: A Graphic Interface for Viewing a Knowledge-Based System.

    DTIC Science & Technology

    1985-08-01

    Research Center Department of the Navy University of Illinois Boerhaavelaan 2 Washington, DO 20350-1000 Department of Cmpuer Science2334 EN Leyden 1304...Dr. William L. Maloy 270 Crown Street Pittsburgh, PA 15213 Chief of Naval Education New Haven, CT 06510 and Training Dr. Kathleen IaPiana Naval Air...Mclean, VA 22102 1250 West 6th Street Campus Box 345 San Diego, CA 92101 Boulder, CO 8D302 Dr. Aan M. lesgoldlearning M.D Center Dr. Kathleen McKeown Dr

  18. Geautomatiseerde Verwerking van Militaire berichten Volgens ADatP-3 (Automated Processing of Military Messages According to ADatP-3)

    DTIC Science & Technology

    1992-06-01

    ATCCIS beoogt juist dat te bereiken door te werken aan ecn informatie model en een data element dictionary. TNO-rapport Pagina 9 Binnen bet C2...en distributie 44 4.3.2 Interface met de gebruiker 45 4.3.3 Interface met dc operationcle database 46 TNO-rapport Pagina 11 4.3.3.1 Interpretatie...die bezig zijn met het ontwikkelen en implementeren van berichtformaten. Deel I van de publicatie bevat de beschrijving van FORMETS, delen 11 , I11 en

  19. Adaptations of hepatic amino acid uptake and net utilisation contributes to nitrogen economy or waste in lambs fed nitrogen- or energy-deficient diets.

    PubMed

    Kraft, G; Ortigues-Marty, I; Durand, D; Rémond, D; Jardé, T; Bequette, B; Savary-Auzeloux, I

    2011-04-01

    We investigated the effect of relative changes in dietary nitrogen (N) and energy supply and the subsequent variations in net portal appearance (NPA) of nitrogenous and energy nutrients on the net amino acid (AA) uptake by the liver and net N supply to the peripheral tissues. Six lambs were catheterised across the splanchnic tissues and received, in a replicated Latin square, one of three dietary treatments. The diets were formulated to either match the requirements of N and energy (C), or supply only 0.8 of the N requirement (LN) or 0.8 of the energy requirement (LE). Net fluxes of AA and urea-N were measured across the portal-drained viscera, and estimation of arterial hepatic flow allowed the estimation of hepatic fluxes. Catheters were implanted into the portal and hepatic veins as well as in the abdominal aorta for the measurement of AA fluxes. Animals fed the LN diet showed more efficient N retention (0.59 of digested N) than did the C and LE diet (0.50 and 0.33, respectively; P < 0.001). The NPA of total AA-N for the LN diet was only 0.60 of the value measured for the control (C) diet (P < 0.01). Despite this, the total estimated AA-N net splanchnic fluxes were not significantly different across the three diets (3.3, 1.9 and 2.6 g total AA-N/day for C, LN and LE, respectively, P = 0.52). Thus, different metabolic regulations must have taken place across the liver between the three experimental diets. A combination of decreased net uptake of total AA-N by the liver of animals in the LN diet (0.61 of the C diet; P = 0.002) and reduced urinary urea-N production (0.52 of the C diet; P = 0.001) spared AA from catabolism in the LN diet relative to the other two diets. For the LE diet, the urinary urea-N output was 1.3 times the value of the C diet (P = 0.01). This may relate to an increased catabolism of AA by the muscle and/or, to a lesser extent, to an increased utilisation of AA for gluconeogenesis in the liver. These effects may explain the reduced whole body

  20. Impact of Saccharomyces cerevisiae strains on traditional sparkling wines production.

    PubMed

    Di Gianvito, Paola; Perpetuini, Giorgia; Tittarelli, Fabrizia; Schirone, Maria; Arfelli, Giuseppe; Piva, Andrea; Patrignani, Francesca; Lanciotti, Rosalba; Olivastri, Lino; Suzzi, Giovanna; Tofalo, Rosanna

    2018-07-01

    Sparkling wine fermentation is a challenge for yeasts due to the hostile conditions. A phenotype sought in starters is flocculation, because it reduces riddling time. For this reason, six flocculent Saccharomyces cerevisiae wine strains with different flocculation degree and autolytic activity and two commercial strains were tested for traditional sparkling wine production in a winery. Yeast viability, free aminoacids and high molecular weight nitrogen release and physico-chemical composition of sparkling wines were evaluated. Moreover, strains were tested for their aromatic potential. Obtained data revealed that flocculent yeasts presented oenological performances (in terms of fermentation rate, maximum pressure reached, free aminoacids - AAN and high molecular weight nitrogen - HMWN release) similar to the commercial strains. All considered strains were able to complete fermentation and viable cells of all strains were detected in all sparkling wines produced even after 6 months. F6789 and F10471 strains showed slow fermentation kinetics reaching the maximum of pressure at 180 days. Regarding nitrogen compounds release, FI strain was characterized by the highest amount of AAN and HMWN released, followed by F6789. Strains showed a considerable diversification in terms of number and amount of aroma molecules produced and sparkling wines obtained with autochthonous flocculent strains presented a higher amount of alcohols and esters already after 3 months. Further studies are necessary to select starter strains to improve traditional sparkling wines production. Copyright © 2018 Elsevier Ltd. All rights reserved.

  1. Neurosurgery Residency Websites: A Critical Evaluation.

    PubMed

    Skovrlj, Branko; Silvestre, Jason; Ibeh, Chinwe; Abbatematteo, Joseph M; Mocco, J

    2015-09-01

    To evaluate the accessibility of educational and recruitment content of Neurosurgery Residency Websites (NRWs). Program lists from the Fellowship and Residency Electronic Interactive Database (FREIDA), Electronic Residency Application Service (ERAS), and the American Association of Neurological Surgeons (AANS) were accessed for the 2015 Match. These databases were assessed for accessibility of information and responsive program contacts. Presence of online recruitment and education variables was assessed, and correlations between program characteristics and website comprehensiveness were made. All 103 neurosurgery residency programs had an NRW. The AANS database provided the most number of viable website links with 65 (63%). No links existed for 5 (5%) programs. A minority of programs contacts responded via e-mail (46%). A minority of recruitment (46%) and educational (49%) variables were available on the NRWs. Larger programs, as defined by the number of yearly residency spots and clinical faculty, maintained greater online content than smaller programs. Similar trends were seen with programs affiliated with a ranked medical school and hospital. Multiple prior studies have demonstrated that medical students applying to neurosurgery rely heavily on residency program websites. As such, the paucity of content on NRWs allows for future opportunity to optimize online resources for neurosurgery training. Making sure that individual programs provide relevant content, make the content easier to find and adhere to established web design principles could increase the usability of NRWs. Copyright © 2015 Elsevier Inc. All rights reserved.

  2. Summary of Synoptic Meteorological Observations. Siberian Coastal Marine Areas. Volume 3. Area 15 - Okhotsk Sea NE, Area 16 - West Coast Kamchatka, Area 17 - Tatar Strait N, Area 18 - Tatar Strait S, Area 19 - Okhotsk Sea SW, Area 20 - Sakhalin Island SE, Area 21 - Okhotsk Sea SE

    DTIC Science & Technology

    1975-10-01

    8217 " ■., . "■ ’■<*. PEKIODI IPRIDARY) 1939-197* (OVER-ALL) 1907-197* 1UCUST TtlU 17 ADEl 0016 HtST COAST KtMCHAUA 9A.AN 15J.JE rCT ntQ 0f AIR...8217—■ ■- ^"’"’""ÜIBMÜMIÜlffifattllll i^iuiimb&m<miiM& *J W \\j- \\j PEKIQOI (DVER-4LLI 1961-1974 OCTUBE« TABLE U (CONTI «Kt» 0016 HtST CUA$T ««^CHJTK» S4.1N

  3. Propagation Limitations of Navigation and Positioning Systems

    DTIC Science & Technology

    1977-02-01

    a aophiatiqutf, tel que . le proJet NAUSTAR andrlcain aatie- faltait aane doute la plupart dee beaoina. Si on prend en compta le facteur coöt, on ...rement "lu modal« gausaien, at c’ast da cette fasjon que le precision eat courammant ddflnie, (Ob- sarvona dka h prtfa«nt qu« 1’ on ne seralt paa...pour memoire un cartain nombre da raraeterletiquas aacondeitsa ’cnt •■■:■.-■■:* qual- ques unea t - le •ystteo eat-il paaaif ( l *installation da bord

  4. Analysis Methods and Models for Small Unit Operations

    DTIC Science & Technology

    2006-07-01

    wordt in andere studies ogebruikt orn a-an te geven welke op welke wijze operationele effectiviteit kan worden gekwalificeerd en gekwanuificeerd...the node ’Prediction’ is called a child of the node ’Success’ and the node ’Success’ is called a parent of the node ’Prediction’. Figure C.2 A simple...event A is a child of event B and event B is a child of event C ( C -- B -- A). The belief network or influence diagram has to be a directed network

  5. The 1985 ARI Survey of Army Recruits: Tabular Description of NPS (active) Army Accessions. Volume 2

    DTIC Science & Technology

    1987-04-01

    I «aa axpollaJ or auapandod I ftoutd a Job I lllwd or I «antod to Mrk Pull tlM. T MO borad , «aan’t laamlng anything uoaPul .... I get aarrlad ar...Go on an overnight hike . . . Tine up a car 128. Mow the graaa Balance a checkbook Plan a meal 130. Plan a menu for a party . . . Prepare the...no, Wiy not? 108. While attanding thla aehool, tc titom. If my/, of the following people did you talk to in deciding to anliet In the Any

  6. Trajectory Simulation Model for a Side- Thruster Guided MLRS-Type Vehicle

    DTIC Science & Technology

    1999-05-01

    km halen . Voor de toekomst heeft men behoefte aan een dracht van ongeveer 60 km. Het is de doelstelling van opdracht A95KL410 om kennis en inzicht...G.M.H.J.L. Gadiot Datum mei 1999 Opdrachtnr. A95KL410 Rapportnr. PML 1998-A80 Figuur M.I.- Lancering van een M26-raket vanaf een MLRS ’launcher’. De...Koninklijke Nederlandse Landmacht (KL) heeft het ’Multiple Launcher Rocket System’ (MLRS) in gebruik. Met de huidige uitrusting kan men een dracht van 30

  7. Kwaliteit van Expertsystemen: Algoritmen voor Integriteits-Controle (Quality of Expert Systems: Algorithms for Integrity Control)

    DTIC Science & Technology

    1990-03-01

    Dist~i~ Ulnre rbu~ on Una o~d0 9 ~ j 2 0 0 TNO rapport Pagina rappon no. .FEL-89-A312 f"It Kwaliteit van Expertsystemen: Algoritmen voor Integriteits...KNOWLEDGEBASE 7 2.1 Inleiding 7 2.2 Een uitbreiding op NIAM: E(xtended)NIAM 8 2.3 Specificatie in E(xtended)NIAM 11 2.4 Representatie in Prolog 13 3...instantiatie van cen ThO rapport Pagina 9 ’graph’ is gelijk aan ten propositie (ean uitspraak over dea werkelijkheid). ’Graph’- instantiaties zijn

  8. Practice guideline update summary: Botulinum neurotoxin for the treatment of blepharospasm, cervical dystonia, adult spasticity, and headache

    PubMed Central

    Simpson, David M.; Hallett, Mark; Ashman, Eric J.; Comella, Cynthia L.; Green, Mark W.; Gronseth, Gary S.; Armstrong, Melissa J.; Gloss, David; Potrebic, Sonja; Jankovic, Joseph; Karp, Barbara P.; Naumann, Markus; So, Yuen T.; Yablon, Stuart A.

    2016-01-01

    Objective: To update the 2008 American Academy of Neurology (AAN) guidelines regarding botulinum neurotoxin for blepharospasm, cervical dystonia (CD), headache, and adult spasticity. Methods: We searched the literature for relevant articles and classified them using 2004 AAN criteria. Results and recommendations: Blepharospasm: OnabotulinumtoxinA (onaBoNT-A) and incobotulinumtoxinA (incoBoNT-A) are probably effective and should be considered (Level B). AbobotulinumtoxinA (aboBoNT-A) is possibly effective and may be considered (Level C). CD: AboBoNT-A and rimabotulinumtoxinB (rimaBoNT-B) are established as effective and should be offered (Level A), and onaBoNT-A and incoBoNT-A are probably effective and should be considered (Level B). Adult spasticity: AboBoNT-A, incoBoNT-A, and onaBoNT-A are established as effective and should be offered (Level A), and rimaBoNT-B is probably effective and should be considered (Level B), for upper limb spasticity. AboBoNT-A and onaBoNT-A are established as effective and should be offered (Level A) for lower-limb spasticity. Headache: OnaBoNT-A is established as effective and should be offered to increase headache-free days (Level A) and is probably effective and should be considered to improve health-related quality of life (Level B) in chronic migraine. OnaBoNT-A is established as ineffective and should not be offered for episodic migraine (Level A) and is probably ineffective for chronic tension-type headaches (Level B). PMID:27164716

  9. Investigating the necessity of computed tomographic scans in children with headaches: a retrospective review.

    PubMed

    Gandhi, Rohit; Lewis, Evan Cole; Evans, Jeanette W; Sell, Erick

    2015-03-01

    Headaches are a common problem in the pediatric population. In 2002, the American Academy of Neurology (AAN) developed guidelines on neuroimaging for patients presenting with headache. Our objective was to determine the frequency of computed tomographic (CT) scanning ordered by a range of medical practitioners for pediatric patients presenting with primary headache. A retrospective chart review was conducted at the Children's Hospital of Eastern Ontario (CHEO), a tertiary care centre in Ontario. One hundred fifty-one records of patients referred to the outpatient neurology clinic at CHEO with ''headache'' or ''migraine'' as the primary complaint from 2004 to 2009 were randomly selected. Ninety-nine patients with normal neurologic examinations were ultimately included. Thirty-four patients (34%; 95% CI 25-45) had undergone CT scanning. None of the 34 CT scans (0%; 95% CI 0-10) showed significant findings, and none changed the headache diagnosis or management. Eleven (32%) of the CT scans were ordered by CHEO neurologists, 15 (44%) by community physicians, and 8 (24%) by CHEO emergency physicians. A high proportion of children presenting with primary headaches and a normal neurologic examination undergo CT scanning, despite well-established AAN guidelines regarding neuroimaging. Most of these CT scans do not appear to alter diagnosis and management. A variety of non-evidencebased factors may be encouraging physicians to overinvestigate this population and, as a result, increasing the risk of adverse events due to radiation exposure. Implementing initiatives at a site-based level that promote the use of established guidelines before performing CT scanning in this population may be beneficial.

  10. Species specific substrates and products choices of 4-O-acetyltransferase from Trichoderma brevicompactum.

    PubMed

    Sharma, Shikha; Kumari, Indu; Hussain, Razak; Ahmed, Mushtaq; Akhter, Yusuf

    2017-09-01

    Antagonistic species of Trichoderma such as T. harzianum, T. viride, T. virens and T. koningii are well-known biocontrol agents that have been reported to suppress pathogenic soil microbes and enhance the growth of crop plants. Secondary metabolites (SMs) including trichothecenes are responsible for its biocontrol activities. The trichothecenes, trichodermin and harzianum A (HA) are produced in species dependent manner respectively, by Trichoderma brevicompactum (TB) and Trichoderma arundinaceum (TA). The last step in the pathway involves the conversion of trichodermol into trichodermin or HA alternatively, which is catalyzed by 4-O-acetyltransferase (encoded by tri3 gene). Comparative sequence analysis of acetyltransferase enzyme of TB with other chloramphenicol acetyltransferase (CAT) family proteins revealed the conserved motif involved in the catalysis. Multiple substrate binding studies were carried out to explore the mechanism behind the two different outcomes. His188 was found to have a role in initial substrate binding. In the case of trichodermin synthesis, represented by ternary complex 1, the trichodermol and acetic anhydride (AAn), the two substrates come very close to each other during molecular simulation analysis so that interactions become possible between them and acetyl group may get transferred from AAn to trichodermol, and Tyr476 residue mediates this phenomenon resulting in the formation of trichodermin. However, in case of the HA biosynthesis using the TB version of enzyme, represented by ternary complex 2, the two substrates, trichodermol and octa-2Z,4E,6E-trienedioic acid (OCTA) did not show any such interactions. Copyright © 2017 Elsevier Inc. All rights reserved.

  11. Evidence-based guideline update: steroids and antivirals for Bell palsy: report of the Guideline Development Subcommittee of the American Academy of Neurology.

    PubMed

    Gronseth, Gary S; Paduga, Remia

    2012-11-27

    To review evidence published since the 2001 American Academy of Neurology (AAN) practice parameter regarding the effectiveness, safety, and tolerability of steroids and antiviral agents for Bell palsy. We searched Medline and the Cochrane Database of Controlled Clinical Trials for studies published since January 2000 that compared facial functional outcomes in patients with Bell palsy receiving steroids/antivirals with patients not receiving these medications. We graded each study (Class I-IV) using the AAN therapeutic classification of evidence scheme. We compared the proportion of patients recovering facial function in the treated group with the proportion of patients recovering facial function in the control group. Nine studies published since June 2000 on patients with Bell palsy receiving steroids/antiviral agents were identified. Two of these studies were rated Class I because of high methodologic quality. For patients with new-onset Bell palsy, steroids are highly likely to be effective and should be offered to increase the probability of recovery of facial nerve function (2 Class I studies, Level A) (risk difference 12.8%-15%). For patients with new-onset Bell palsy, antiviral agents in combination with steroids do not increase the probability of facial functional recovery by >7%. Because of the possibility of a modest increase in recovery, patients might be offered antivirals (in addition to steroids) (Level C). Patients offered antivirals should be counseled that a benefit from antivirals has not been established, and, if there is a benefit, it is likely that it is modest at best.

  12. Practice guideline update summary: Corticosteroid treatment of Duchenne muscular dystrophy: Report of the Guideline Development Subcommittee of the American Academy of Neurology.

    PubMed

    Gloss, David; Moxley, Richard T; Ashwal, Stephen; Oskoui, Maryam

    2016-02-02

    To update the 2005 American Academy of Neurology (AAN) guideline on corticosteroid treatment of Duchenne muscular dystrophy (DMD). We systematically reviewed the literature from January 2004 to July 2014 using the AAN classification scheme for therapeutic articles and predicated recommendations on the strength of the evidence. Thirty-four studies met inclusion criteria. In children with DMD, prednisone should be offered for improving strength (Level B) and pulmonary function (Level B). Prednisone may be offered for improving timed motor function (Level C), reducing the need for scoliosis surgery (Level C), and delaying cardiomyopathy onset by 18 years of age (Level C). Deflazacort may be offered for improving strength and timed motor function and delaying age at loss of ambulation by 1.4-2.5 years (Level C). Deflazacort may be offered for improving pulmonary function, reducing the need for scoliosis surgery, delaying cardiomyopathy onset, and increasing survival at 5-15 years of follow-up (Level C for each). Deflazacort and prednisone may be equivalent in improving motor function (Level C). Prednisone may be associated with greater weight gain in the first years of treatment than deflazacort (Level C). Deflazacort may be associated with a greater risk of cataracts than prednisone (Level C). The preferred dosing regimen of prednisone is 0.75 mg/kg/d (Level B). Over 12 months, prednisone 10 mg/kg/weekend is equally effective (Level B), with no long-term data available. Prednisone 0.75 mg/kg/d is associated with significant risk of weight gain, hirsutism, and cushingoid appearance (Level B). © 2016 American Academy of Neurology.

  13. Practice guideline update summary: Corticosteroid treatment of Duchenne muscular dystrophy

    PubMed Central

    Gloss, David; Moxley, Richard T.; Ashwal, Stephen; Oskoui, Maryam

    2016-01-01

    Objective: To update the 2005 American Academy of Neurology (AAN) guideline on corticosteroid treatment of Duchenne muscular dystrophy (DMD). Methods: We systematically reviewed the literature from January 2004 to July 2014 using the AAN classification scheme for therapeutic articles and predicated recommendations on the strength of the evidence. Results: Thirty-four studies met inclusion criteria. Recommendations: In children with DMD, prednisone should be offered for improving strength (Level B) and pulmonary function (Level B). Prednisone may be offered for improving timed motor function (Level C), reducing the need for scoliosis surgery (Level C), and delaying cardiomyopathy onset by 18 years of age (Level C). Deflazacort may be offered for improving strength and timed motor function and delaying age at loss of ambulation by 1.4–2.5 years (Level C). Deflazacort may be offered for improving pulmonary function, reducing the need for scoliosis surgery, delaying cardiomyopathy onset, and increasing survival at 5–15 years of follow-up (Level C for each). Deflazacort and prednisone may be equivalent in improving motor function (Level C). Prednisone may be associated with greater weight gain in the first years of treatment than deflazacort (Level C). Deflazacort may be associated with a greater risk of cataracts than prednisone (Level C). The preferred dosing regimen of prednisone is 0.75 mg/kg/d (Level B). Over 12 months, prednisone 10 mg/kg/weekend is equally effective (Level B), with no long-term data available. Prednisone 0.75 mg/kg/d is associated with significant risk of weight gain, hirsutism, and cushingoid appearance (Level B). PMID:26833937

  14. Laser and Optical Remote Sensing: Instrumentation and Techniques Topical Meeting Held in North Falmoth Massachusetts on September 28 - October 1, 1987. Volume 18. Technical Digest Series

    DTIC Science & Technology

    1987-10-01

    DOMoPment Of Laser aOd Spectral Equpmen for Dennis K. Killinger, thiewsrity of South F&oiAt Piresior MOsOsrmud of Abnssphsul MOlcular Gases , V. E . Zuev. U...Law, tiorms of Atmospheric Gases . V E . Zuev. V. P. Lopasov. Yu. N. Jan E van der I aan. SRI ,nte’r’at’ona* Operation of a low- Ponomnarev. L. N...9, p.1917, 1981. 2. VJuloev, Yu.AI.cdeg e , A.o.Gftrbeaekov, egas, nl wt eaeeg t o Inteatio@tonal Lcseo radtar 1o8ezence. o s nto, motazos , Catadr. N

  15. Size Effects in Epitaxial Films of Magnetite

    DTIC Science & Technology

    2002-06-03

    van Eemeren , J. aan de Stegge, 1727. WJ.M. de Jonge, Surf. Sci. 373 (1997) 85. [38] J.L. Dormann, T. Merceron, P. Renaudin, VA.M. Brabers, J. [20] S.A...Metals and Semiconductors, Trans Tech, Switzerland, 1994, p. __221. [4] G.A. Prinz, Phys. Today 48 (1995) 58. 100 - [5] P.J. van der Zaag. P.J.H...Bloemen. J.M. Gaines, R.M. Wolf, -10 -8 -6 -4 -2 0 2 4 6 8 10 P.A.A. van der Heijden, R.J.M. van de Veerdonk, W.J.M. velocity [mm/s] de Jonge, J. Magn. Magn

  16. A novel glutamine-rich putative transcriptional adaptor protein (TIG-1), preferentially expressed in placental and bone-marrow tissues.

    PubMed

    Abraham, S; Solomon, W B

    2000-09-19

    We used a subtractive hybridization protocol to identify novel expressed sequence tags (ESTs) corresponding to mRNAs whose expression was induced upon exposure of the human leukemia cell line K562 to the phorbol ester 12-O-tetradecanolyphorbol-13-acetate (TPA). The complete open reading frame of one of the novel ESTs, named TIG-1, was obtained by screening K562 cell and placental cDNA libraries. The deduced open reading frame of the TIG-1 cDNA encodes for a glutamine repeat-rich protein with a predicted molecular weight of 63kDa. The predicted open reading frame also contains a consensus bipartite nuclear localization signal, though no specific DNA-binding domain is found. The corresponding TIG-1 mRNA is ubiquitously expressed. Placental tissue expresses the TIG-1 mRNA 200 times more than the lowest expressing tissues such as kidney and lung. There is also preferential TIG-1 mRNA expression in cells of bone-marrow lineage.In-vitro transcription/translation of the TIG-1 cDNA yielded a polypeptide with an apparent molecular weight of 97kDa. Using polyclonal antibodies obtained from a rabbit immunized with the carboxy-terminal portion of bacterially expressed TIG-1 protein, a polypeptide with molecular weight of 97kDa was identified by Western blot analyses of protein lysates obtained from K562 cells. Cotransfection assays of K562 cells, using a GAL4-TIG-1 fusion gene and GAL4 operator-CAT, indicate that the TIG-1 protein may have transcriptional regulatory activity when tethered to DNA. We hypothesize that this novel glutamine-rich protein participates in a protein complex that regulates gene transcription. It has been demonstrated by Naar et al. (Naar, A.M., Beaurang, P.A., Zhou, S., Abraham, S., Solomon, W.B., Tjian, R., 1999, Composite co-activator ARC mediates chromatin-directed transcriptional activation. Nature 398, 828-830) that the amino acid sequences of peptide fragments obtained from a polypeptide found in a complex of proteins that alters chromatin

  17. The effects of test-enhanced learning on long-term retention in AAN annual meeting courses.

    PubMed

    Larsen, Douglas P; Butler, Andrew C; Aung, Wint Y; Corboy, John R; Friedman, Deborah I; Sperling, Michael R

    2015-02-17

    We measured the long-term retention of knowledge gained through selected American Academy of Neurology annual meeting courses and compared the effects of repeated quizzing (known as test-enhanced learning) and repeated studying on that retention. Participants were recruited from 4 annual meeting courses. All participants took a pretest. This randomized, controlled trial utilized a within-subjects design in which each participant experienced 3 different postcourse activities with each activity performed on different material. Each key information point from the course was randomized in a counterbalanced fashion among participants to one of the 3 activities: repeated short-answer quizzing, repeated studying, and no further exposure to the materials. A final test covering all information points from the course was taken 5.5 months after the course. Thirty-five participants across the 4 courses completed the study. Average score on the pretest was 36%. Performance on the final test showed that repeated quizzing led to significantly greater long-term retention relative to both repeated studying (55% vs 46%; t[34] = 3.28, SEM = 0.03, p = 0.01, d = 0.49) and no further exposure (55% vs 44%; t[34] = 3.16, SEM = 0.03, p = 0.01, d = 0.58). Relative to the pretest baseline, repeated quizzing helped participants to retain almost twice as much of the knowledge acquired from the course compared to repeated studying or no further exposure. Whereas annual meeting continuing medical education (CME) courses lead to long-term gains in knowledge, when repeated quizzing is added, retention is significantly increased. CME planners may consider adding repeated quizzing to increase the impact of their courses. © 2015 American Academy of Neurology.

  18. The effects of test-enhanced learning on long-term retention in AAN annual meeting courses

    PubMed Central

    Butler, Andrew C.; Aung, Wint Y.; Corboy, John R.; Friedman, Deborah I.; Sperling, Michael R.

    2015-01-01

    Objective: We measured the long-term retention of knowledge gained through selected American Academy of Neurology annual meeting courses and compared the effects of repeated quizzing (known as test-enhanced learning) and repeated studying on that retention. Methods: Participants were recruited from 4 annual meeting courses. All participants took a pretest. This randomized, controlled trial utilized a within-subjects design in which each participant experienced 3 different postcourse activities with each activity performed on different material. Each key information point from the course was randomized in a counterbalanced fashion among participants to one of the 3 activities: repeated short-answer quizzing, repeated studying, and no further exposure to the materials. A final test covering all information points from the course was taken 5.5 months after the course. Results: Thirty-five participants across the 4 courses completed the study. Average score on the pretest was 36%. Performance on the final test showed that repeated quizzing led to significantly greater long-term retention relative to both repeated studying (55% vs 46%; t[34] = 3.28, SEM = 0.03, p = 0.01, d = 0.49) and no further exposure (55% vs 44%; t[34] = 3.16, SEM = 0.03, p = 0.01, d = 0.58). Relative to the pretest baseline, repeated quizzing helped participants to retain almost twice as much of the knowledge acquired from the course compared to repeated studying or no further exposure. Conclusions: Whereas annual meeting continuing medical education (CME) courses lead to long-term gains in knowledge, when repeated quizzing is added, retention is significantly increased. CME planners may consider adding repeated quizzing to increase the impact of their courses. PMID:25609761

  19. Practice guideline update summary: Efficacy and tolerability of the new antiepileptic drugs I: Treatment of new-onset epilepsy: Report of the Guideline Development, Dissemination, and Implementation Subcommittee of the American Academy of Neurology and the American Epilepsy Society.

    PubMed

    Kanner, Andres M; Ashman, Eric; Gloss, David; Harden, Cynthia; Bourgeois, Blaise; Bautista, Jocelyn F; Abou-Khalil, Bassel; Burakgazi-Dalkilic, Evren; Llanas Park, Esmeralda; Stern, John; Hirtz, Deborah; Nespeca, Mark; Gidal, Barry; Faught, Edward; French, Jacqueline

    2018-06-13

    To update the 2004 American Academy of Neurology (AAN) guideline for treating new-onset focal or generalized epilepsy with second- and third-generation antiepileptic drugs (AEDs). The 2004 AAN criteria were used to systematically review literature (January 2003-November 2015), classify pertinent studies according to the therapeutic rating scheme, and link recommendations to evidence strength. Several second-generation AEDs are effective for new-onset focal epilepsy. Data are lacking on efficacy in new-onset generalized tonic-clonic seizures, juvenile myoclonic epilepsy, or juvenile absence epilepsy, and on efficacy of third-generation AEDs in new-onset epilepsy. Lamotrigine (LTG) should (Level B) and levetiracetam (LEV) and zonisamide (ZNS) may (Level C) be considered in decreasing seizure frequency in adults with new-onset focal epilepsy. LTG should (Level B) and gabapentin (GBP) may (Level C) be considered in decreasing seizure frequency in patients ≥60 years of age with new-onset focal epilepsy. Unless there are compelling adverse effect-related concerns, ethosuximide or valproic acid should be considered before LTG to decrease seizure frequency in treating absence seizures in childhood absence epilepsy (level B). No high-quality studies suggest clobazam, eslicarbazepine, ezogabine, felbamate, GBP, lacosamide, LEV, LTG, oxcarbazepine, perampanel, pregabalin, rufinamide, tiagabine, topiramate, vigabatrin, or ZNS is effective in treating new-onset epilepsy because no high-quality studies exist in adults of various ages. A recent Food and Drug Administration (FDA) strategy allows extrapolation of efficacy across populations; therefore, for focal epilepsy, eslicarbazepine and lacosamide (oral only for pediatric use) as add-on or monotherapy in persons ≥4 years old and perampanel as monotherapy received FDA approval. © 2018 American Academy of Neurology.

  20. A competency-based longitudinal core curriculum in medical neuroscience.

    PubMed

    Merlin, Lisa R; Horak, Holli A; Milligan, Tracey A; Kraakevik, Jeff A; Ali, Imran I

    2014-07-29

    Current medical educational theory encourages the development of competency-based curricula. The Accreditation Council for Graduate Medical Education's 6 core competencies for resident education (medical knowledge, patient care, professionalism, interpersonal and communication skills, practice-based learning, and systems-based practice) have been embraced by medical schools as the building blocks necessary for becoming a competent licensed physician. Many medical schools are therefore changing their educational approach to an integrated model in which students demonstrate incremental acquisition and mastery of all competencies as they progress through medical school. Challenges to medical schools include integration of preclinical and clinical studies as well as development of learning objectives and assessment measures for each competency. The Undergraduate Education Subcommittee (UES) of the American Academy of Neurology (AAN) assembled a group of neuroscience educators to outline a longitudinal competency-based curriculum in medical neuroscience encompassing both preclinical and clinical coursework. In development of this curriculum, the committee reviewed United States Medical Licensing Examination content outlines, Liaison Committee on Medical Education requirements, prior AAN-mandated core curricula for basic neuroscience and clinical neurology, and survey responses from educators in US medical schools. The newly recommended curriculum provides an outline of learning objectives for each of the 6 competencies, listing each learning objective in active terms. Documentation of experiences is emphasized, and assessment measures are suggested to demonstrate adequate achievement in each competency. These guidelines, widely vetted and approved by the UES membership, aspire to be both useful as a stand-alone curriculum and also provide a framework for neuroscience educators who wish to develop a more detailed focus in certain areas of study. © 2014 American Academy

  1. Virtual Screening of compounds to 1-deoxy-Dxylulose 5-phosphate reductoisomerase (DXR) from Plasmodium falciparum.

    PubMed

    Chaudhary, Kamal Kumar; Prasad, C V S Siva

    2014-01-01

    The 1-deoxy-D-xylulose 5-phosphate reductoisomerase (DXR) protein (Gen Bank ID AAN37254.1) from Plasmodium falciparum is a potential drug target. Therefore, it is of interest to screen DXR against a virtual library of compounds (at the ZINC database) for potential binders as possible inhibitors. This exercise helped to choose 10 top ranking molecules with ZINC00200163 [N-(2,2di methoxy ethyl)-6-methyl-2, 3, 4, 9-tetrahydro-1H-carbazol-1-amine] a having good fit (-6.43 KJ/mol binding energy) with the target protein. Thus, ZINC00200163 is identified as a potential molecule for further comprehensive characterization and in-depth analysis.

  2. Effects of phenobarbital on aniline metabolism in primary liver cell culture of rats with ethionine-induced liver disorder.

    PubMed

    Noguchi, M; Nitoh, S; Mabuchi, M; Kawai, Y

    1996-04-01

    In experiment 1, the amount of aniline (AN) metabolites in the primary cell culture medium of the liver cells obtained from ethionine (ET)-treated rats was compared with that of the control (normal) rats. Although the metabolites detected in both groups were p-aminophenol (p-AP), N-acetyl-p-AP (AAP), acetoanilide (AAN), AAP-glucuronide (AAPG), phenylhydroxylamine sulfate (PHAS) and p-AP-glucuronide (p-APG), the amount of AAP was lower and that of p-APG was markedly higher in the ET-treated rats than in the control rats. In experiment 2, phenobarbital (PB) was orally administered to the ET-treated and control rats at a dose of 100 mg/kg. The time course changes in AN metabolites in the primary cell culture medium of liver cells obtained at 2 or 48 hr after PB treatment were compared with those without PB treatment. In the ET-treated rats, the amount of PHAS was slightly higher at 2 hr after PB treatment, and that of AAP was lower and that of p-APG was higher at 48 hr after PB treatment as compared with those without PB treatment. In the control rats, the amounts of AAP, AAN, p-AP and p-APG at 2 hr after PB treatment remained lower than those without PB treatment, and that of AAP was markedly lower and that of p-APG was higher at 48 hr after PB treatment as compared with those without PB treatment. These findings indicated greater detoxication in the primary liver cell culture in the ET-treated rats than in the control rats. Furthermore, detoxication was greater in the primary cell culture of liver cell obtained from the ET-treated rats after PB treatment than from those without PB treatment, because the production of acetylates (AAP) decreased and p-APG increased (induction of conjugated enzyme) in the PB treatment group.

  3. Readability of spine-related patient education materials from subspecialty organization and spine practitioner websites.

    PubMed

    Vives, Michael; Young, Lyle; Sabharwal, Sanjeev

    2009-12-01

    Analysis of spine-related websites available to the general public. To assess the readability of spine-related patient educational materials available on professional society and individual surgeon or practice based websites. The Internet has become a valuable source of patient education material. A significant percentage of patients, however, find this Internet based information confusing. Healthcare experts recommend that the readability of patient education material be less than the sixth grade level. The Flesch-Kincaid grade level is the most widely used method to evaluate the readability score of textual material, with lower scores suggesting easier readability. We conducted an Internet search of all patient education documents on the North American Spine Society (NASS), American Association of Neurological Surgeons (AANS), the American Academy of Orthopaedic Surgeons (AAOS), and a sample of 10 individual surgeon or practice based websites. The Flesch-Kincaid grade level of each article was calculated using widely available Microsoft Office Word software. The mean grade level of articles on the various professional society and individual/practice based websites were compared. A total of 121 articles from the various websites were available and analyzed. All 4 categories of websites had mean Flesch-Kincaid grade levels greater than 10. Only 3 articles (2.5%) were found to be at or below the sixth grade level, the recommended readability level for adult patients in the United States. There were no significant differences among the mean Flesch-Kincaid grade levels from the AAOS, NASS, AANS, and practice-based web-sites (P = 0.065, ANOVA). Our findings suggest that most of the Spine-related patient education materials on professional society and practice-based websites have readability scores that may be too high, making comprehension difficult for a substantial portion of the United States adult population.

  4. Therapeutic approaches for treating hemophilia A using embryonic stem cells.

    PubMed

    Kasuda, Shogo; Tatsumi, Kohei; Sakurai, Yoshihiko; Shima, Midori; Hatake, Katsuhiko

    2016-06-01

    Hemophilia A is an X-linked rescessive bleeding disorder that results from F8 gene aberrations. Previously, we established embryonic stem (ES) cells (tet-226aa/N6-Ainv18) that secrete human factor VIII (hFVIII) by introducing the human F8 gene in mouse Ainv18 ES cells. Here, we explored the potential of cell transplantation therapy for hemophilia A using the ES cells. Transplant tet-226aa/N6-Ainv18 ES cells were injected into the spleens of severe combined immunodeficiency (SCID) mice, carbon tetrachloride (CCl4)-pretreated wild-type mice, and CCl4-pretreated hemophilia A mice. F8 expression was induced by doxycycline in drinking water, and hFVIII-antigen production was assessed in all cell transplantation experiments. Injecting the ES cells into SCID mice resulted in an enhanced expression of the hFVIII antigen; however, teratoma generation was confirmed in the spleen. Transplantation of ES cells into wild-type mice after CCl4-induced liver injury facilitated survival and engraftment of transplanted cells without teratoma formation, resulting in hFVIII production in the plasma. Although CCl4 was lethal to most hemophilia A mice, therapeutic levels of FVIII activity, as well as the hFVIII antigen, were detected in surviving hemophilia A mice after cell transplantation. Immunolocalization results for hFVIII suggested that transplanted ES cells might be engrafted at the periportal area in the liver. Although the development of a safer induction method for liver regeneration is required, our results suggested the potential for developing an effective ES-cell transplantation therapeutic model for treating hemophilia A in the future. Copyright © 2016 King Faisal Specialist Hospital & Research Centre. Published by Elsevier Ltd. All rights reserved.

  5. Theoretical study of metal noble-gas positive ions

    NASA Technical Reports Server (NTRS)

    Bauschlicher, Charles W., Jr.; Partridge, Harry; Langhoff, Stephen R.

    1989-01-01

    Theoretical calculations have been performed to determine the spectroscopic constant for the ground and selected low-lying electronic states of the transition-metal noble-gas ions Var(+), FeAr(+), CoAr(+), CuHe(+), CuAr(+), and CuKr(+). Analogous calculations have been performed for the ground states of the alkali noble-gas ions LiAr(+), LiKr(+), NaAr(+), and KAr(+) and the alkaline-earth noble-gas ion MgAr(+) to contrast the difference in binding energies between the simple and transition-metal noble-gas ions. The binding energies increase with increasing polarizability of the noble-gas ions, as expected for a charge-induced dipole bonding mechanism. It is found that the spectroscopic constants of the X 1Sigma(+) states of the alkali noble-gas ions are well described at the self-consistent field level. In contrast, the binding energies of the transition-metal noble-gas ions are substantially increased by electron correlation.

  6. Outcome-centered antiepileptic therapy: Rate, rhythm and relief.: Implementing AAN Epilepsy Quality Measures in clinical practice.

    PubMed

    D'Cruz, O'Neill

    2015-12-01

    Clinicians who manage patients with epilepsy are expected to assess the relevance of clinical trial results to their practice, integrate new treatments into the care algorithm, and implement epilepsy quality measures, with the overall goal of improving patient outcomes. A disease-based clinical framework that helps with choice and combinations of interventions facilitates provision of efficient, cost-effective, and high-quality care. This article addresses the current conceptual framework that informs clinical evaluation of epilepsy, explores gaps between development of treatment options, quality measures and clinical goals, and proposes an outcome-centered approach that bridges these gaps with the aim of improving patient and population-level clinical outcomes in epilepsy. Copyright © 2015 The Author. Published by Elsevier Inc. All rights reserved.

  7. The future of neurosurgery: a white paper on the recruitment and retention of women in neurosurgery.

    PubMed

    Benzil, Deborah L; Abosch, Aviva; Germano, Isabelle; Gilmer, Holly; Maraire, J Nozipo; Muraszko, Karin; Pannullo, Susan; Rosseau, Gail; Schwartz, Lauren; Todor, Roxanne; Ullman, Jamie; Zusman, Edie

    2008-09-01

    The leadership of Women in Neurosurgery (WINS) has been asked by the Board of Directors of the American Association of Neurological Surgeons (AANS) to compose a white paper on the recruitment and retention of female neurosurgical residents and practitioners. Neurosurgery must attract the best and the brightest. Women now constitute a larger percentage of medical school classes than men, representing approximately 60% of each graduating medical school class. Neurosurgery is facing a potential crisis in the US workforce pipeline, with the number of neurosurgeons in the US (per capita) decreasing. The number of women entering neurosurgery training programs and the number of board-certified female neurosurgeons is not increasing. Personal anecdotes demonstrating gender inequity abound among female neurosurgeons at every level of training and career development. Gender inequity exists in neurosurgery training programs, in the neurosurgery workplace, and within organized neurosurgery. The consistently low numbers of women in neurosurgery training programs and in the workplace results in a dearth of female role models for the mentoring of residents and junior faculty/practitioners. This lack of guidance contributes to perpetuation of barriers to women considering careers in neurosurgery, and to the lack of professional advancement experienced by women already in the field. There is ample evidence that mentors and role models play a critical role in the training and retention of women faculty within academic medicine. The absence of a critical mass of female neurosurgeons in academic medicine may serve as a deterrent to female medical students deciding whether or not to pursue careers in neurosurgery. There is limited exposure to neurosurgery during medical school. Medical students have concerns regarding gender inequities (acceptance into residency, salaries, promotion, and achieving leadership positions). Gender inequity in academic medicine is not unique to neurosurgery

  8. Lupus érythémateux systémique à début pédiatrique: à propos d'un cas

    PubMed Central

    Khlif, Sana; Hachicha, Hend; Frikha, Faten; Feki, Sawsan; Ben Ayed, Mourad; Bahloul, Zouhir; Masmoudi, Hatem

    2015-01-01

    Le lupus érythémateux systémique (LES) est une maladie systémique auto-immune d’étiologie inconnue qui touche essentiellement les femmes à l’âge adulte. Le lupus pédiatrique est une entité rare. Nous rapportons une nouvelle observation. Il s'agissait d'un nourrisson âgé de 7 mois qui présentait des lésions cutanées purpuriques, une polyarthrite fébrile. Le bilan immunologique était positif (AAN et anti-ADN). Une amélioration clinique et biologique a été notée sous corticothérapie générale avec une récidive lors de la dégression du traitement. PMID:26015845

  9. Treatment of tardive dyskinesia with tetrabenazine or valbenazine: a systematic review.

    PubMed

    Caroff, Stanley N; Aggarwal, Saurabh; Yonan, Charles

    2018-02-01

    Up to 30% of patients taking antipsychotics may develop tardive dyskinesia (TD). Recent evidence-based recommendations demonstrate an unmet need for effective TD management. This systematic review was designed to update the evidence for TD treatment, comparing two vesicular monoamine transporter 2 (VMAT2) inhibitors, tetrabenazine and valbenazine. Of 487 PubMed/Embase search results, 11 studies met the review criteria. Valbenazine efficacy was demonstrated in rigorously designed clinical trials that meet the guidelines for AAN Class I evidence. Due to differences in study designs and a lack of standardized and controlled trials with tetrabenazine, a formal meta-analysis comparing the agents was not possible. However, valbenazine appears to have fewer side effects and a more favorable once-daily dosing regimen for the treatment of TD.

  10. Identification, prevalence, and treatment of painful diabetic neuropathy in patients from a rural area in South Carolina.

    PubMed

    Pruitt, Jimmy; Moracho-Vilrriales, Carolina; Threatt, Tiffaney; Wagner, Sarah; Wu, Jun; Romero-Sandoval, E Alfonso

    2017-01-01

    Diabetic peripheral neuropathy (DPN) represents significant burdens to many patients and the public health-care system. Patients with diabetes in rural areas have higher risk of developing complications and having less access to proper treatment. We studied a rural population of patients with diabetes who attended a pharmacist-led free clinic for a diabetic education program. Our objectives were to 1) determine the prevalence of DPN and painful diabetic neuropathy (p-DN) in patients with type 2 diabetes; 2) assess the proportion of patients with DPN and p-DN left undocumented upon physician referral to a pharmacist-led free clinic; and 3) determine the appropriateness of pain medication regimen. We performed a retrospective analysis of clinical records of patients from the Presbyterian College School of Pharmacy (PCSP) Wellness Center located in Clinton, SC. Diagnoses of DPN and/or p-DN were obtained from referral notes in the clinical records and compared with results from foot examinations performed in the free clinic and clinical features. Medication regimens were also obtained and compared using American Academy of Neurology (AAN) treatment guidelines. Within our study population (n=111), the prevalence of DPN was 62.2% (national average of 28%-45%) and that of p-DN was 23.4% (national average of 11%-24%). In p-DN patients (n=26), 53.8% (n=14) had a documented diagnosis of p-DN by the referring physician, and 46.2% (n=12) were identified by the pharmacists. A total of 95% (19 of 20) of the patients treated for p-DN received adequate pharmacological agents, though suboptimal as per clinical guidelines. More than 50% of the patients used subtherapeutic doses of their medications. Gabapentin was the most frequently used medication in our population (65.4%). Patients in rural South Carolina had a higher prevalence of DPN and p-DN with >60% undocumented cases of p-DN. More than 95% of treated patients did not receive optimum therapy according to AAN guidelines.

  11. Naturalistic study of guideline implementation tool use via evaluation of website access and physician survey.

    PubMed

    Armstrong, Melissa J; Gronseth, Gary S; Dubinsky, Richard; Potrebic, Sonja; Penfold Murray, Rebecca; Getchius, Thomas S D; Rheaume, Carol; Gagliardi, Anna R

    2017-01-13

    Clinical guidelines support decision-making at the point-of-care but the onus is often on individual users such as physicians to implement them. Research shows that the inclusion of implementation tools in or with guidelines (GItools) is associated with guideline use. However, there is little research on which GItools best support implementation by individual physicians. The purpose of this study was to investigate naturalistic access and use of GItools produced by the American Academy of Neurology (AAN) to inform future tool development. Website accesses over six months were summarized for eight AAN guidelines and associated GItools published between July 2012 and August 2013. Academy members were surveyed about use of tools accompanying the sport concussion guideline. Data were analyzed using summary statistics and the Chi-square test. The clinician summary was accessed more frequently (29.0%, p < 0.001) compared with the slide presentation (26.8%), patient summary (23.2%) or case study (20.9%), although this varied by guideline topic. For the sport concussion guideline, which was accompanied by a greater variety of GItools, the mobile phone quick reference check application was most frequently accessed, followed by the clinician summary, patient summary, and slide presentation. For the sports concussion guideline survey, most respondents (response rate 21.8%, 168/797) were aware of the guideline (88.1%) and had read the guideline (78.6%). For GItool use, respondents indicated reading the reference card (51.2%), clinician summary (45.2%), patient summary (28.0%), mobile phone application (26.2%), and coach/athletic trainer summary (20.2%). Patterns of sports concussion GItool use were similar between respondents who said they had and had not yet implemented the guideline. Developers faced with resource limitations may wish to prioritize the development of printable or mobile application clinician summaries, which were accessed significantly more than other

  12. OMEGACAM and Gravitational Lensing

    NASA Astrophysics Data System (ADS)

    Christen, Fabrice Frédéric Thiébaut

    2007-04-01

    Het proefschrift van Fabrice Christen gaat over de ontwikkeling van nieuwe methoden voor het corrigeren van (digitale) foto's van melkwegstelsels. Met deze methoden kunnen de beelden uit het heelal beter worden geanalyseerd. Het eerste gedeelte is gewijd aan het werk dat bij ESO is uitgevoerd aan de CCD's van de OmegaCAM camera, het enige instrument van de VST. OmegaCAM is een optische groothoekcamera met een beeldveld van een vierkante graad, opgebouwd uit een mozaiek van 8 bij 4 CCD's. Van elk onderdeel moeten alle kenmerken volledig bekend zijn voordat het in het CCD mozaiek geplaatst kan worden. In het tweede deel van dit proefschrift wordt de ontwikkeling van een nieuwe methode voor het corrigeren van de ``point-spread function'' (PSF) en schatten van de ellipticiteit van de melkwegstelsels besproken. De nieuwe techniek wordt getest en vergeleken met een door sterrenkundigen algemeen gebruikte methode in het veld van zwaartekrachtslenzen, de Kaiser, Squire en Broadhurst (KSB) methode. De nieuwe methode, gebaseerd op shapelet ontleding (vergelijkbaar met wavelet ontleding), gaat verder, en is sneller en theoretisch preciezer dan de KSB methode. Door gebruik te maken van de gecorrigeerde ellipticiteit, kunnen we een statistische analyse uitvoeren om er een kosmisch vervormingssignaal uit te halen. De licht vervormde beelden van de melkwegstelsels bewij zen dat de niet-homogene massaverdeling op megaparsec-schaal voornamelijk bestaat uit grote hoeveelheden donkere materie. Verder vergelijken we de schattingen van de ellipticiteit van de shapelet en KSB methode. Bovendien voeren we ook nog een melkwegstelsel-melkwegstelsel lens analyse uit op de 50 VLT Fors1 afbeeldingen en slagen we erin de belangrijkste eigenschappen van de halo's van de stelsels, die zich op een afstand van een- tot tweeduizend megaparsec (1 parsec = 3,26 lichtjaar = 3,085 x 10^16 meter) bevinden, te bepalen door gebruik te maken van twee modellen van melkwegstelselhalo's. Vergeleken met andere

  13. Addressing Barriers to Minority Ethnic Students' Learning in a Performative Culture: Possible or Aan U Suuragelin? Niemozliwe? Nemoguce? ???????

    ERIC Educational Resources Information Center

    Gallagher, Kathleen; Beckett, Lori

    2014-01-01

    This article, written by a research-active teacher of English with an academic partner, recounts the circumstances of forging a partnership way of working in an urban high school that is consistently targeted for closure in the north of England. This is connected to performance and achievement against Ofsted inspection criteria and school data…

  14. Zuivere en toegepaste wetenschap in de tropen : biologisch onderzoek aan particuliere proefstations in Nederlands-Indië 1870-1940

    NASA Astrophysics Data System (ADS)

    van der Schoor, W. J.

    2012-04-01

    Most experiment stations originated from the cooperation between entrepreneurs and the government. From the 1890s onwards, the government, together with the well organised colonial entrepreneurs, established research departments for several plantation crops at the Botanical Gardens at Buitenzorg (now Bogor), that eventually became independent experiment stations in the first decades of the twentieth century. By the 1920s, the ‘proefstationswezen’ (experiment station system) numbered some fifteen private experiment stations or sub-stations. After the war, the private experiment stations together with the government experiment stations at Buitenzorg were to provide the backbone of Indonesian agricultural science. Dutch biologists in particular, made a striking plea for pursuing the natural sciences in the tropical colonies. First, they pointed out the scientific importance of the tropics. Secondly, they stressed the role of the natural sciences, in particular biology, as a natural ally of colonial agriculture. Pure science was seen as a leading force for technical and social progress. The third motive was the cultural value of science for the Netherlands and its colonies. The cultivation of science in the colonies gave international prestige and strengthened self-confidence in the imperial struggle around 1900. Science had a civilising effect; scientific research, however, was to remain in the hands of western, colonial scientists. From the 1880s and 1890s onward, the experiment stations in the Indies were characterised by their strategic aims and scientific orientation. Up to 1910, the ‘academic’ views of biologists like Treub and Went concerning science and practice were predominant, and research was considered to be the central aim. From 1910 onwards, advice became more central and special extension services were established at the experiment stations. Due to diverging views of science, tasks and aims became a battlefield for discussions in the next decades. In the background of these debates were the rise of Wageningen Agricultural College, the rise and institutionalisation of applied agricultural sciences and the increasing competition between Wageningen and university trained scientist. Genetics and breeding in particular were at the core of the research programmes. The practical aim of the breeding work, however, did not leave too much opportunity for more fundamental investigations. The impetus for pure research came from individual researchers. In tobacco and sugar cane breeding, new scientific theories provided inspiration, but to a large extent the practical breeding work built on nineteenth-century breeding techniques. In many respects, plant breeding and university genetics became separate disciplines. Circa one in six Dutch biologist worked for at least some time in the colony. The colonial experiment stations instilled a practical and pragmatic attitude to Dutch science into quite a number of biologists. Besides, the experiment stations system provided Dutch biologists with an extensive network and international contacts with fellow scientists, entrepreneurs and captains of industry. The scientific nationalism of Treub and Went, the bloom of the experiment stations and the ambitions of the Indies colonial elite did not result in the establishment of an independent, ‘Indische’ scientific community. Essentially, the Dutch East Indies were an exploitation province of Dutch science

  15. Clinical effectiveness of combined virtual reality and robot assisted fine hand motion rehabilitation in subacute stroke patients.

    PubMed

    Huang, Xianwei; Naghdy, Fazel; Naghdy, Golshah; Du, Haiping

    2017-07-01

    Robot-assisted therapy is regarded as an effective and reliable method for the delivery of highly repetitive rehabilitation training in restoring motor skills after a stroke. This study focuses on the rehabilitation of fine hand motion skills due to their vital role in performing delicate activities of daily living (ADL) tasks. The proposed rehabilitation system combines an adaptive assist-as-needed (AAN) control algorithm and a Virtual Reality (VR) based rehabilitation gaming system (RGS). The developed system is described and its effectiveness is validated through clinical trials on a group of eight subacute stroke patients for a period of six weeks. The impact of the training is verified through standard clinical evaluation methods and measuring key kinematic parameters. A comparison of the pre- and post-training results indicates that the method proposed in this study can improve fine hand motion rehabilitation training effectiveness.

  16. The yeast transcription elongation factor Spt4/5 is a sequence‐specific RNA binding protein

    PubMed Central

    Blythe, Amanda J.; Yazar‐Klosinski, Berra; Webster, Michael W.; Chen, Eefei; Vandevenne, Marylène; Bendak, Katerina; Mackay, Joel P.; Hartzog, Grant A.

    2016-01-01

    Abstract The heterodimeric transcription elongation factor Spt4/Spt5 (Spt4/5) tightly associates with RNAPII to regulate both transcriptional elongation and co‐transcriptional pre‐mRNA processing; however, the mechanisms by which Spt4/5 acts are poorly understood. Recent studies of the human and Drosophila Spt4/5 complexes indicate that they can bind nucleic acids in vitro. We demonstrate here that yeast Spt4/5 can bind in a sequence‐specific manner to single stranded RNA containing AAN repeats. Furthermore, we show that the major protein determinants for RNA‐binding are Spt4 together with the NGN domain of Spt5 and that the KOW domains are not required for RNA recognition. These findings attribute a new function to a domain of Spt4/5 that associates directly with RNAPII, making significant steps towards elucidating the mechanism behind transcriptional control by Spt4/5. PMID:27376968

  17. Enhanced Characterization of Niobium Surface Topography

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

    Chen Xu, Hui Tian, Charles Reece, Michael Kelley

    2011-12-01

    Surface topography characterization is a continuing issue for the Superconducting Radio Frequency (SRF) particle accelerator community. Efforts are underway to both to improve surface topography, and its characterization and analysis using various techniques. In measurement of topography, Power Spectral Density (PSD) is a promising method to quantify typical surface parameters and develop scale-specific interpretations. PSD can also be used to indicate how chemical processes modifiesy the roughnesstopography at different scales. However, generating an accurate and meaningful topographic PSD of an SRF surface requires careful analysis and optimization. In this report, polycrystalline surfaces with different process histories are sampled with AFMmore » and stylus/white light interferometer profilometryers and analyzed to indicate trace topography evolution at different scales. evolving during etching or polishing. Moreover, Aan optimized PSD analysis protocol will be offered to serve the SRF surface characterization needs is presented.« less

  18. [Physiotherapy in Women with Overactive Bladder].

    PubMed

    Henscher, U; Tholen, R; Kirschner-Hermanns, R

    2016-08-01

    As regards treatment for overactive bladder, physiotherapeutic interventions can be seen as an alternative to drug treatment. Targeted pelvic floor and bladder training is used to decrease the number of voids and the incontinence episodes or to increase the average voided volume in women with overactive bladder (3 systematic reviews with evidence level 1/1a).An additional option to treat women with overactive bladder is to use functional electrical stimulation and magnetic stimulation.2 systematic reviews 1 2 and 2 RCTs 3 4 reveal a low level of evidence (2 studies with level 2/2b) for the use of electrical stimulation (transcutaneous, vaginal or transanal) to reduce incontinence episodes and the number of voids and to increase the average voided volume. The trial from Yamanishi et al. (2014) shows that magnetic stimulation has a positive effect 5. Further studies are needed to evaluate the benefit of conservative treatment procedures for overactive bladder. © Georg Thieme Verlag KG Stuttgart · New York.

  19. Image-Based Focusing

    NASA Astrophysics Data System (ADS)

    Selker, Ted

    1983-05-01

    Lens focusing using a hardware model of a retina (Reticon RL256 light sensitive array) with a low cost processor (8085 with 512 bytes of ROM and 512 bytes of RAM) was built. This system was developed and tested on a variety of visual stimuli to demonstrate that: a)an algorithm which moves a lens to maximize the sum of the difference of light level on adjacent light sensors will converge to best focus in all but contrived situations. This is a simpler algorithm than any previously suggested; b) it is feasible to use unmodified video sensor arrays with in-expensive processors to aid video camera use. In the future, software could be developed to extend the processor's usefulness, possibly to track an actor by panning and zooming to give a earners operator increased ease of framing; c) lateral inhibition is an adequate basis for determining best focus. This supports a simple anatomically motivated model of how our brain focuses our eyes.

  20. Urinary bladder stone extraction and instruments compared in textbooks of Abul-Qasim Khalaf Ibn Abbas Alzahrawi (Albucasis) (930-1013) and Serefeddin Sabuncuoglu (1385-1470).

    PubMed

    Elcioglu, Omur; Ozden, Hilmi; Guven, Gul; Kabay, Sahin

    2010-09-01

    We investigated urinary bladder stone, surgical tools, and procedures in urologic sections of textbooks of Abul-Qasim Khalaf Ibn Abbas Alzahrawi (Albucasis) and Serefeddin Sabuncuoglu. In addition, we compared the relation of their textbooks with urologic surgery. Al-Tasreef Liman Aajaz Aan Al-Taaleef (Al-Tasreef), a surgery textbook written by Alzahrawi (who lived in Endulus between 930 and 1013) and Cerrahiyyetu'l-Haniyye, written by Sabuncuoglu (who lived in Turkey between 1385 and 1470) were evaluated with regard to urinary bladder stone and surgical instruments. The textbooks give information about urinary bladder stones. They include definitions of diseases, etiologies, and surgical techniques, and describe surgical tools. Cerrahiyyetu'l Haniyye is a colorful miniaturized textbook. The urinary bladder stone section in Cerrahiyyetu'l Haniyye is the translation of Al-Tasreef with some additional information and illustrations. Surgical tools and procedures described by the two physicians have reached to our century. Tools and procedures invented by Alzahrawi come to the present day in similar or developed styles.

  1. Delayed Anticipatory Spoken Language Processing in Adults with Dyslexia—Evidence from Eye-tracking.

    PubMed

    Huettig, Falk; Brouwer, Susanne

    2015-05-01

    It is now well established that anticipation of upcoming input is a key characteristic of spoken language comprehension. It has also frequently been observed that literacy influences spoken language processing. Here, we investigated whether anticipatory spoken language processing is related to individuals' word reading abilities. Dutch adults with dyslexia and a control group participated in two eye-tracking experiments. Experiment 1 was conducted to assess whether adults with dyslexia show the typical language-mediated eye gaze patterns. Eye movements of both adults with and without dyslexia closely replicated earlier research: spoken language is used to direct attention to relevant objects in the environment in a closely time-locked manner. In Experiment 2, participants received instructions (e.g., 'Kijk naar de(COM) afgebeelde piano(COM)', look at the displayed piano) while viewing four objects. Articles (Dutch 'het' or 'de') were gender marked such that the article agreed in gender only with the target, and thus, participants could use gender information from the article to predict the target object. The adults with dyslexia anticipated the target objects but much later than the controls. Moreover, participants' word reading scores correlated positively with their anticipatory eye movements. We conclude by discussing the mechanisms by which reading abilities may influence predictive language processing. Copyright © 2015 John Wiley & Sons, Ltd.

  2. Forsterite-Anorthite-CaTschermak-Enstatite (FACE): A geobarometer for plagioclase-bearing peridotites

    NASA Astrophysics Data System (ADS)

    Fumagalli, P.; Borghini, G.; Rampone, E.; Poli, S.

    2017-12-01

    Plagioclase peridotites can be the result of either metamorphic recrystallization, or diffuse melt-rock interactions. Although they represent an important geodynamic marker of shallow mantle exhumation, the accurate estimation of their barometric evolution is poorly constrained. Systematic correlations between pressure and composition of coexisting minerals within the plagioclase stability field have been reported in previous experimental studies. In this experimental study we present new constraints on the stability of plagioclase as a function of different Na2O/CaO bulk ratios, and we present a new geobarometer for mantle rocks. Experiments have been performed in a single-stage piston cylinder at 5-10 kbar, 1050-1150 °C at nominally anhydrous conditions using seeded gels of peridotite compositions (Na2O/CaO = 0.08-0.13; XCr = Cr/(Cr + Al) = 0.07-0.10). As expected, the increase of the bulk Na2O/CaO extends the plagioclase stability to higher pressure; in the Na2O enriched fertile lherzolite the plagioclase-spinel transition occurs between 9 and 10 kbar, 1100 °C; in the fertile lherzolite with Na2O/CaO = 0.08, it occurs between 8 and 9 kbar, 1100 °C. The present data together with previous experimental results provide a consistent database, covering a wide range of P-T conditions (3-9 kbar, 1000-1150 °C) and variable bulk compositions to be used to define and calibrate a geobarometer for plagioclase-bearing mantle rocks. We have empirically calibrated by least squares regression analysis of experimental data combined with MonteCarlo simulation the following pressure sensitive equilibrium: Mg2SiO4 Ol + CaAl2Si2O8 Pl = CaAl2SiO6 Cpx + Mg2Si2O6 OpxForsterite Anorthite Ca-Tschermak Enstatite We derive the following equation: P = 7.2 (±2.9) + 0.0078 (±0.0021) T + 0.0022 (±0.0001) T lnK R2= 0.93 where P is expressed in kbar and T in kelvin. K is the equilibrium constant K = aCa-Ts*aen / aan *afo, where aCaTs, aen, aan and afo are the activities of Ca-Tschermak in

  3. Dynamics and life histories of northern ungulates in changing environments

    NASA Astrophysics Data System (ADS)

    Hendrichsen, D. K.

    2011-12-01

    Regional climate and local weather conditions can profoundly influence life history parameters (growth, survival, fecundity) and population dynamics in northern ungulates (Post and Stenseth 1999, Coulson et al. 2001). The influence is both direct, for example through reduced growth or survival (Aanes et al. 2000, Tyler et al. 2008), and indirect, for example through changes in resource distribution, phenology and quality, changes which subsequently influence consumer dynamics (Post et al. 2008). By comparing and contrasting data from three spatially independent populations of ungulates, I discuss how variation in local weather parameters and vegetation growth influence spatial and temporal dynamics through changes in life history parameters and/or behavioural dynamics. The data originate from long term (11-15 years) monitoring data from three populations of ungulates in one subarctic and two high Arctic sites; semi-domesticated reindeer (Rangifer tarandus tarandus) in northern Norway, Svalbard reindeer (R. t. platyrhynchus) on Spitsbergen and muskoxen (Ovibos moschatus) in Northeast Greenland. The results show that juvenile animals can be particularly vulnerable to changes in their environment, and that this is mirrored to different degrees in the spatio-temporal dynamics of the three populations. Adverse weather conditions, acting either directly or mediated through access to and quality of vegetation, experienced by young early in life, or even by their dams during pregnancy, can lead to reduced growth, lower survival and reduced reproductive performance later in life. The influence of current climatic variation, and the predictions of how local weather conditions may change over time, differs between the three sites, resulting in potentially different responses in the three populations. Aanes R, Saether BE and Øritsland NA. 2000. Fluctuations of an introduced population of Svalbard reindeer: the effects of density dependence and climatic variation. Ecography

  4. [The effect of mood-stabilising drugs on cytokine levels in bipolar disorder: a systematic review].

    PubMed

    Van Den Ameele, S; van Diermen, L; Staels, W; Coppens, V; Dumont, G; Sabbe, B; Morrens, M

    Veranderde cytokineconcentraties bij personen met een bipolaire stoornis ten opzichte van controle-personen suggereren een rol van het immuunsysteem in de pathofysiologie van bipolaire stoornis. Farmacotherapie is een belangrijke verstorende factor in klinisch onderzoek naar cytokineconcentraties.
    DOEL: Evalueren van cytokineconcentraties bij medicatievrije patiënten met een bipolaire stoornis en van het effect van stemmingsstabiliserende geneesmiddelen op deze concentraties.
    METHODE: We doorzochten systematisch PubMed en Embase naar klinische studies die cytokineconcentraties bij medicatievrije patiënten met een bipolaire stoornis beschrijven of het effect van een individueel stemmingsstabiliserend geneesmiddel op deze concentraties evalueren.
    RESULTATEN: Van de 564 gescreende artikelen werden er 17 geïncludeerd. Resultaten bij medicatievrije patiënten toonden stemmingsgerelateerde cytokineveranderingen. Hoewel geen data over de kortetermijneffecten van lithium beschikbaar waren, was lithiumgebruik langer dan 2 maanden geassocieerd met normale cytokineconcentraties. Twee studies rapporteerden geen effect van valproïnezuur. We vonden geen studies over carbamazepine, lamotrigine of antipsychotica.
    CONCLUSIE: Dit systematisch literatuuroverzicht toont stemmingsgerelateerde cytokineveranderingen bij medicatievrije patiënten met een bipolaire stoornis met de meeste evidentie voor een pro-inflammatoire immuunrespons tijdens manie. Euthymie en langdurig lithiumgebruik zijn geassocieerd met normale cytokineconcentraties. Er is een belangrijke methodologische heterogeniteit en onvoldoende replicatie tussen studies. Longitudinale studies met medicatievrije beginmetingen, gerandomiseerde monotherapeutische behandelprotocollen en nauwkeurige monitoring van stemming zijn noodzakelijk.
    BACKGROUND: Alterations of the cytokine level in persons with bipolar disorder - when compared to controls - suggest that the immune system plays a role in the

  5. Production of salted and pressed anchovies (stolephorus sp.) and it's quality evaluation during storage.

    PubMed

    Siriskar, Dipty A; Khedkar, Gulab Dattarao; Lior, David

    2013-12-01

    Present study deals with the production of low cost salted and dried product from anchovy fish (Stolephorus spp.) using traditional technology application of different inhibitory factors to achieve a reasonable shelf life at ambient tropical temperature. Microbial safety, nutrient retention and product quality in terms of flavor and texture after rehydration have been tested. This product has been subjected to storage studies, with respect to product quality and microbial status. It can be kept well for a period of 5 weeks. The quality changes during storage are; decrease in sensory scores for the overall acceptance and also for the individual attributes. Increase in nitrogenous components such as Total Volatile Bases Nitrogen (TVB-N), Tri Methyl Amine Nitrogen (TMA-N) and Alpha Amino Nitrogen (AAN) was obtained with the advancement of the storage period. The lipid quality of the fish showed gradual increase in Preoxide Value (PV) and Free Fatty Acid (FFA) accompanied by decrease in flavor and odor scores. Activity of microorganisms showed a marginal increase with increase in storage period.

  6. Highlight report: Launch of a large integrated European in vitro toxicology project: EU-ToxRisk.

    PubMed

    Daneshian, Mardas; Kamp, Hennicke; Hengstler, Jan; Leist, Marcel; van de Water, Bob

    2016-05-01

    The integrated European project, EU-ToxRisk, proudly sees itself as "flagship" exploring new alternative-to-animal approaches to chemical safety evaluation. It promotes mechanism-based toxicity testing and risk assessment according to the principles laid down for toxicology for the twenty-first century. The project was officially launched in January 2016 with a kickoff meeting in Egmond aan Zee, the Netherlands. Over 100 scientists representing academia and industry as well as regulatory authorities attended the inaugural meeting. The project will integrate advances in in vitro and in silico toxicology, read-across methods, and adverse outcome pathways. EU-ToxRisk will continue to make use of the case study strategy deployed in SEURAT-1, a FP7 initiative ended in December 2015. Even though the development of new non-animal methods is one target of EU-ToxRisk, the project puts special emphasis on their acceptance and implementation in regulatory contexts. This €30 million Horizon 2020 project involves 38 European partners and one from the USA. EU-ToxRisk aims at the "development of a new way of risk assessment."

  7. Mixed-ligand cobalt(II) complexes of bioinorganic and medicinal relevance, involving dehydroacetic acid and β-diketones: Their synthesis, hyphenated experimental-DFT, thermal and bactericidal facets

    NASA Astrophysics Data System (ADS)

    Maurya, R. C.; Malik, B. A.; Mir, J. M.; Vishwakarma, P. K.; Rajak, D. K.; Jain, N.

    2015-11-01

    The present report pertains to synthesis and combined experimental-DFT studies of a series of four novel mixed-ligand complexes of cobalt(II) of the general composition [Co(dha)(L)(H2O)2], where dhaH = dehydroacetic acid, LH = β-ketoenolates viz., o-acetoacetotoluidide (o-aatdH), o-acetoacetanisidide (o-aansH), acetylacetone (acacH) or 1-benzoylacetone (1-bac). The resulting complexes were formulated based on elemental analysis, molar conductance, magnetic measurements, mass spectrometric, IR, electronic, electron spin resonance and cyclic voltammetric studies. The TGA based thermal behavior of one representative complex was evaluated. Molecular geometry optimizations and vibrational frequency calculations have been performed with Gaussian 09 software package by using density functional theory (DFT) methods with B3LYP/LANL2MB combination for dhaH and one of its complexes, [Co(dha)(1-bac)(H2O)2]. Theoretical data has been found in an excellent agreement with the experimental results. Based on experimental and theoretical data, suitable trans-octahedral structure has been proposed for the present class of complexes. Moreover, the complexes also showed a satisfactory antibacterial activity.

  8. The Impact of Social Media on Dissemination and Implementation of Clinical Practice Guidelines: A Longitudinal Observational Study.

    PubMed

    Narayanaswami, Pushpa; Gronseth, Gary; Dubinsky, Richard; Penfold-Murray, Rebecca; Cox, Julie; Bever, Christopher; Martins, Yolanda; Rheaume, Carol; Shouse, Denise; Getchius, Thomas S D

    2015-08-13

    Evidence-based clinical practice guidelines (CPGs) are statements that provide recommendations to optimize patient care for a specific clinical problem or question. Merely reading a guideline rarely leads to implementation of recommendations. The American Academy of Neurology (AAN) has a formal process of guideline development and dissemination. The last few years have seen a burgeoning of social media such as Facebook, Twitter, and LinkedIn, and newer methods of dissemination such as podcasts and webinars. The role of these media in guideline dissemination has not been studied. Systematic evaluation of dissemination methods and comparison of the effectiveness of newer methods with traditional methods is not available. It is also not known whether specific dissemination methods may be more effectively targeted to specific audiences. Our aim was to (1) develop an innovative dissemination strategy by adding social media-based dissemination methods to traditional methods for the AAN clinical practice guidelines "Complementary and alternative medicine in multiple sclerosis" ("CAM in MS") and (2) evaluate whether the addition of social media outreach improves awareness of the CPG and knowledge of CPG recommendations, and affects implementation of those recommendations. Outcomes were measured by four surveys in each of the two target populations: patients and physicians/clinicians ("physicians"). The primary outcome was the difference in participants' intent to discuss use of complementary and alternative medicine (CAM) with their physicians or patients, respectively, after novel dissemination, as compared with that after traditional dissemination. Secondary outcomes were changes in awareness of the CPG, knowledge of CPG content, and behavior regarding CAM use in multiple sclerosis (MS). Response rates were 25.08% (622/2480) for physicians and 43.5% (348/800) for patients. Awareness of the CPG increased after traditional dissemination (absolute difference, 95% confidence

  9. Moment analysis method as applied to the 2S --> 2P transition in cryogenic alkali metal/rare gas matrices.

    PubMed

    Terrill Vosbein, Heidi A; Boatz, Jerry A; Kenney, John W

    2005-12-22

    The moment analysis method (MA) has been tested for the case of 2S --> 2P ([core]ns1 --> [core]np1) transitions of alkali metal atoms (M) doped into cryogenic rare gas (Rg) matrices using theoretically validated simulations. Theoretical/computational M/Rg system models are constructed with precisely defined parameters that closely mimic known M/Rg systems. Monte Carlo (MC) techniques are then employed to generate simulated absorption and magnetic circular dichroism (MCD) spectra of the 2S --> 2P M/Rg transition to which the MA method can be applied with the goal of seeing how effective the MA method is in re-extracting the M/Rg system parameters from these known simulated systems. The MA method is summarized in general, and an assessment is made of the use of the MA method in the rigid shift approximation typically used to evaluate M/Rg systems. The MC-MCD simulation technique is summarized, and validating evidence is presented. The simulation results and the assumptions used in applying MA to M/Rg systems are evaluated. The simulation results on Na/Ar demonstrate that the MA method does successfully re-extract the 2P spin-orbit coupling constant and Landé g-factor values initially used to build the simulations. However, assigning physical significance to the cubic and noncubic Jahn-Teller (JT) vibrational mode parameters in cryogenic M/Rg systems is not supported.

  10. Management issues for women with epilepsy-Focus on pregnancy (an evidence-based review): I. Obstetrical complications and change in seizure frequency: Report of the Quality Standards Subcommittee and Therapeutics and Technology Assessment Subcommittee of the American Academy of Neurology and the American Epilepsy Society.

    PubMed

    Harden, Cynthia L; Hopp, Jennifer; Ting, Tricia Y; Pennell, Page B; French, Jacqueline A; Allen Hauser, W; Wiebe, Samuel; Gronseth, Gary S; Thurman, David; Meador, Kimford J; Koppel, Barbara S; Kaplan, Peter W; Robinson, Julian N; Gidal, Barry; Hovinga, Collin A; Wilner, Andrew N; Vazquez, Blanca; Holmes, Lewis; Krumholz, Allan; Finnell, Richard; Le Guen, Claire

    2009-05-01

    A committee assembled by the American Academy of Neurology (AAN) reassessed the evidence related to the care of women with epilepsy (WWE) during pregnancy, including the risk of pregnancy complications or other medical problems during pregnancy, change in seizure frequency, the risk of status epilepticus, and the rate of remaining seizure-free during pregnancy. The committee evaluated the available evidence according to a structured literature review and classification of relevant articles. For WWE who are taking antiepileptic drugs (AEDs), there is probably no substantially increased risk (>2 times expected) of cesarean delivery or late pregnancy bleeding, and probably no moderately increased risk (>1.5 times expected) of premature contractions or premature labor and delivery. There is possibly a substantially increased risk of premature contractions and premature labor and delivery during pregnancy for WWE who smoke. WWE should be counseled that seizure freedom for at least 9 months prior to pregnancy is probably associated with a high likelihood (84-92%) of remaining seizure-free during pregnancy. WWE who smoke should be counseled that they possibly have a substantially increased risk of premature contractions and premature labor and delivery.

  11. The Impact of Social Media on Dissemination and Implementation of Clinical Practice Guidelines: A Longitudinal Observational Study

    PubMed Central

    Gronseth, Gary; Dubinsky, Richard; Penfold-Murray, Rebecca; Cox, Julie; Bever Jr, Christopher; Martins, Yolanda; Rheaume, Carol; Shouse, Denise; Getchius, Thomas SD

    2015-01-01

    Background Evidence-based clinical practice guidelines (CPGs) are statements that provide recommendations to optimize patient care for a specific clinical problem or question. Merely reading a guideline rarely leads to implementation of recommendations. The American Academy of Neurology (AAN) has a formal process of guideline development and dissemination. The last few years have seen a burgeoning of social media such as Facebook, Twitter, and LinkedIn, and newer methods of dissemination such as podcasts and webinars. The role of these media in guideline dissemination has not been studied. Systematic evaluation of dissemination methods and comparison of the effectiveness of newer methods with traditional methods is not available. It is also not known whether specific dissemination methods may be more effectively targeted to specific audiences. Objective Our aim was to (1) develop an innovative dissemination strategy by adding social media-based dissemination methods to traditional methods for the AAN clinical practice guidelines “Complementary and alternative medicine in multiple sclerosis” (“CAM in MS”) and (2) evaluate whether the addition of social media outreach improves awareness of the CPG and knowledge of CPG recommendations, and affects implementation of those recommendations. Methods Outcomes were measured by four surveys in each of the two target populations: patients and physicians/clinicians (“physicians”). The primary outcome was the difference in participants’ intent to discuss use of complementary and alternative medicine (CAM) with their physicians or patients, respectively, after novel dissemination, as compared with that after traditional dissemination. Secondary outcomes were changes in awareness of the CPG, knowledge of CPG content, and behavior regarding CAM use in multiple sclerosis (MS). Results Response rates were 25.08% (622/2480) for physicians and 43.5% (348/800) for patients. Awareness of the CPG increased after traditional

  12. Velocity Measurements on the Electric Gun Developed at the TNO Prins Maurits Laboratory (Snelheidheidsmetingen aan de bij het Prins Maurits Laboratorium Ontwikkelde Electric Gun)

    DTIC Science & Technology

    1993-03-01

    8 2.3 De Flyer Plate Assembly (.FPA) 9 3 OPZET VAN DE MFTThIGEN 11 3.1 De djfferentjaalstroommetiflg 11 3.2 Stroommetingen 12 3.3...25 n11)" II )60 S. L) I.P014 25 ,rzit II ,0 8 9 28 ).7 I 10.7 273.0 2.15 43790 1.318 - - - IM,𔃺I5 25 Nr. 11 60 8.9 279.t) 125.9 274.1 2.22 44406 1...4 HWO-KLU 5 HWO-KM 6 DMKL J.A. van Gool 7/ 9 TDCK 10 Hoofddirecteur DO-TNO 11 Lid Inst jtuuts Advies Raad PMIL Prof. drs. P.J. van den Berg 12 Lid

  13. Systems Pharmacology Dissecting Holistic Medicine for Treatment of Complex Diseases: An Example Using Cardiocerebrovascular Diseases Treated by TCM.

    PubMed

    Wang, Yonghua; Zheng, Chunli; Huang, Chao; Li, Yan; Chen, Xuetong; Wu, Ziyin; Wang, Zhenzhong; Xiao, Wei; Zhang, Boli

    2015-01-01

    Holistic medicine is an interdisciplinary field of study that integrates all types of biological information (protein, small molecules, tissues, organs, external environmental signals, etc.) to lead to predictive and actionable models for health care and disease treatment. Despite the global and integrative character of this discipline, a comprehensive picture of holistic medicine for the treatment of complex diseases is still lacking. In this study, we develop a novel systems pharmacology approach to dissect holistic medicine in treating cardiocerebrovascular diseases (CCDs) by TCM (traditional Chinese medicine). Firstly, by applying the TCM active ingredients screened out by a systems-ADME process, we explored and experimentalized the signed drug-target interactions for revealing the pharmacological actions of drugs at a molecule level. Then, at a/an tissue/organ level, the drug therapeutic mechanisms were further investigated by a target-organ location method. Finally, a translational integrating pathway approach was applied to extract the diseases-therapeutic modules for understanding the complex disease and its therapy at systems level. For the first time, the feature of the drug-target-pathway-organ-cooperations for treatment of multiple organ diseases in holistic medicine was revealed, facilitating the development of novel treatment paradigm for complex diseases in the future.

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

    Churchfield, M. J.; Moriarty, P. J.; Hao, Y.

    The focus of this work is the comparison of the dynamic wake meandering model and large-eddy simulation with field data from the Egmond aan Zee offshore wind plant composed of 36 3-MW turbines. The field data includes meteorological mast measurements, SCADA information from all turbines, and strain-gauge data from two turbines. The dynamic wake meandering model and large-eddy simulation are means of computing unsteady wind plant aerodynamics, including the important unsteady meandering of wakes as they convect downstream and interact with other turbines and wakes. Both of these models are coupled to a turbine model such that power and mechanicalmore » loads of each turbine in the wind plant are computed. We are interested in how accurately different types of waking (e.g., direct versus partial waking), can be modeled, and how background turbulence level affects these loads. We show that both the dynamic wake meandering model and large-eddy simulation appear to underpredict power and overpredict fatigue loads because of wake effects, but it is unclear that they are really in error. This discrepancy may be caused by wind-direction uncertainty in the field data, which tends to make wake effects appear less pronounced.« less

  15. Systems Pharmacology Dissecting Holistic Medicine for Treatment of Complex Diseases: An Example Using Cardiocerebrovascular Diseases Treated by TCM

    PubMed Central

    Wang, Yonghua; Zheng, Chunli; Huang, Chao; Li, Yan; Chen, Xuetong; Wu, Ziyin; Wang, Zhenzhong; Xiao, Wei; Zhang, Boli

    2015-01-01

    Holistic medicine is an interdisciplinary field of study that integrates all types of biological information (protein, small molecules, tissues, organs, external environmental signals, etc.) to lead to predictive and actionable models for health care and disease treatment. Despite the global and integrative character of this discipline, a comprehensive picture of holistic medicine for the treatment of complex diseases is still lacking. In this study, we develop a novel systems pharmacology approach to dissect holistic medicine in treating cardiocerebrovascular diseases (CCDs) by TCM (traditional Chinese medicine). Firstly, by applying the TCM active ingredients screened out by a systems-ADME process, we explored and experimentalized the signed drug-target interactions for revealing the pharmacological actions of drugs at a molecule level. Then, at a/an tissue/organ level, the drug therapeutic mechanisms were further investigated by a target-organ location method. Finally, a translational integrating pathway approach was applied to extract the diseases-therapeutic modules for understanding the complex disease and its therapy at systems level. For the first time, the feature of the drug-target-pathway-organ-cooperations for treatment of multiple organ diseases in holistic medicine was revealed, facilitating the development of novel treatment paradigm for complex diseases in the future. PMID:26101539

  16. Pain in trigeminal neuralgia: neurophysiology and measurement: a comprehensive review

    PubMed Central

    Kumar, S; Rastogi, S; Kumar, S; Mahendra, P; Bansal, M; Chandra, L

    2013-01-01

    Abstract Trigeminal neuralgia (TN) is defined as sudden, usually unilateral, severe, brief, stabbing recurrent episodes of pain within the distribution of one or more branches of the trigeminal nerve. It is the most frequent cranial neuralgia, the incidence being 1 per 1,000,00 persons per year. Pain attacks start abruptly and last several seconds but may persist 1 to 2 minutes. The attacks are initiated by non painful physical stimulation of specific areas (trigger points or zones) that are located ipsilateral to the pain. After each episode, there is usually a refractive period during which stimulation of the trigger zone will not induce the pain. According to the European Federation of Neurological Societies (EFNS) guidelines on neuropathic pain assessment and the American Academy of Neurology (AAN)-EFNS guidelines on TN management the neurophysiological recording of trigeminal reflexes represents the most useful and reliable test for the neurophysiological diagnosis of trigeminal pains. The present article discusses different techniques for investigation of the trigeminal system by which an accurate topographical diagnosis and profile of sensory fiber pathology can be determined. With the aid of neurophysiological recordings and quantitative sensory testing, it is possible to approach a mechanism-based classification of orofacial pain. PMID:24701256

  17. Pain in trigeminal neuralgia: neurophysiology and measurement: a comprehensive review.

    PubMed

    Kumar, S; Rastogi, S; Kumar, S; Mahendra, P; Bansal, M; Chandra, L

    2013-01-01

    Trigeminal neuralgia (TN) is defined as sudden, usually unilateral, severe, brief, stabbing recurrent episodes of pain within the distribution of one or more branches of the trigeminal nerve. It is the most frequent cranial neuralgia, the incidence being 1 per 1,000,00 persons per year. Pain attacks start abruptly and last several seconds but may persist 1 to 2 minutes. The attacks are initiated by non painful physical stimulation of specific areas (trigger points or zones) that are located ipsilateral to the pain. After each episode, there is usually a refractive period during which stimulation of the trigger zone will not induce the pain. According to the European Federation of Neurological Societies (EFNS) guidelines on neuropathic pain assessment and the American Academy of Neurology (AAN)-EFNS guidelines on TN management the neurophysiological recording of trigeminal reflexes represents the most useful and reliable test for the neurophysiological diagnosis of trigeminal pains. The present article discusses different techniques for investigation of the trigeminal system by which an accurate topographical diagnosis and profile of sensory fiber pathology can be determined. With the aid of neurophysiological recordings and quantitative sensory testing, it is possible to approach a mechanism-based classification of orofacial pain.

  18. Feasibility and effectiveness of a targeted diabetes prevention program for 18 to 60-year-old South Asian migrants: design and methods of the DH!AAN study.

    PubMed

    Vlaar, Everlina M A; van Valkengoed, Irene G M; Nierkens, Vera; Nicolaou, Mary; Middelkoop, Barend J C; Stronks, Karien

    2012-05-23

    South Asian migrants are at particularly high risk of type 2 diabetes. Previous studies have shown that intensive lifestyle interventions may prevent the onset of diabetes. Such interventions have not been culturally adapted and evaluated among South Asians in industrialized countries. Therefore, we have set up a randomized controlled trial to study the effectiveness of a targeted lifestyle intervention for the risk of type 2 diabetes and cardiovascular risk factors among 18 to 60-year-old Hindustani Surinamese (South Asians) in The Hague, the Netherlands. Here we present the study design and describe the characteristics of those recruited. Between May 18, 2009 and October 11, 2010, we screened 2307 Hindustani Surinamese (18-60 years old) living in The Hague. We sent invitations to participate to those who had an impaired fasting glucose of 5.6-6.9 mmol/l, an impaired glucose tolerance of 7.8-11.0 mmol/L, a glycated hemoglobin level of 6.0% or more and/or a value of 2.39 or more for the homeostasis model assessment of estimated insulin resistance. In total, 536 people (56.1% of those eligible) participated. People with a higher level of education and a family history of type 2 diabetes were more likely to participate. The control and intervention groups were similar with regard to important background characteristics. The intervention group will receive a culturally targeted intervention consisting of dietary counseling using motivational interviewing and a supervised physical activity program. The control group will receive generic lifestyle advice. To determine the effectiveness, a physical examination (anthropometrics, cardiorespiratory test, lipid profile, and measures of oral glucose tolerance, glycated hemoglobin, and insulin) and interview (physical activity, diet, quality of life, and intermediate outcomes) were carried out at baseline and will be repeated at 1 year and 2 years. The process and the costs will be evaluated. This trial will provide insight into the feasibility and effectiveness of a targeted, intensive, lifestyle intervention for the risk of type 2 diabetes and cardiovascular risk factors among 18 to 60-year-old South Asians. Dutch Trial Register: NTR1499.

  19. [Impairment and disability in patients with a severe ischemic cerebral infarction at admission to the rehabilitation center and six months after stroke].

    PubMed

    Prevo, A J; Dijkman, M M; Le Fèvre, F A

    1998-03-21

    Evaluation of impairment and disability in stroke patients with a severe cortical infarction at admission as well as six months after the stroke. Prospective and descriptive study. Rehabilitation Centre Heliomare, Wijk aan Zee, the Netherlands. Between 1 January 1987 en 31 May 1992 stroke patients were admitted to the rehabilitation centre with a severe, first ever, cortical infarction without any comorbidity. The patients were dependent in activities of daily living and wheel-chair-bound. Motor and neuropsychological impairment and disability were evaluated at admission to the rehabilitation centre as well as six months after the stroke. Return to home and length of stay were evaluated. 43 patients were included. Recovery of arm and hand function was very poor (there was complete paresis at admission in 33 patients (77%) and six months after the CVA in 25 patients (58%)); recovery of the affected leg was reasonable (complete paresis in 10 (23%) and 0 patients, respectively). Cognitive deficits diminished in severity, but remained noticeable in three-quarters of the patients. Independent walking was achieved by 30 patients (70%), independence in personal activities of daily living by 32 patients (74%) and returning home by 36 patients (84%). The mean hospital stay was 26 weeks (SD: 9.26; range: 11-30). Prognosis of personal independence and returning home after a severe cortical infarction was rather good despite poor recovery of motor and cognitive impairment.

  20. Neurosurgery: A profession or a technical trade?

    PubMed Central

    Watts, Clark

    2014-01-01

    The American Association of Neurological Surgeons (AANS), 11 years ago converted its Internal Revenue Code (IRC) tax status from a 501 (c) (3) to a 501 (c) (6) entity. By doing so, the professional medical association, now a trade association, was able to more aggressively lobby, support political campaigns, and pursue business opportunities for its members. In the following decade, major changes were seen in the practice of neurosurgery, especially as it relates to spine surgery. With the majority of neurosurgeons limiting themselves to a spine practice, an increased number of spinal procedures, most noted in the Medicare population, was recorded. For example, a 15-fold increase in complex spinal fusions for spinal stenosis was seen between 2002 and 2007. While the basis for this increase was not readily apparent, it was associated with a reduction in reimbursement per case of about 50%, fueling the belief that the increase in complexity of surgery permitted recovery of fees in complex cases to off-set the loss of reimbursement for simpler cases. Considering the growth of spinal surgery within neurosurgery, and decrease funding for spine surgery, in the future there may be too many surgeons chasing too few dollars. There appears to be within neurosurgery a crisis developing where future manpower projections do not realistically match future anticipated specialty funding. PMID:25558426

  1. Essential arginine in subunit a and aspartate in subunit c of FoF1 ATP synthase: effect of repositioning within helix 4 of subunit a and helix 2 of subunit c.

    PubMed

    Langemeyer, Lars; Engelbrecht, Siegfried

    2007-07-01

    FoF1 ATP synthase couples proton flow through the integral membrane portion Fo (ab2c10) to ATP-synthesis in the extrinsic F1-part ((alphabeta)3gammadeltaepsilon) (Escherichia coli nomenclature and stoichiometry). Coupling occurs by mechanical rotation of subunits c10gammaepsilon relative to (alphabeta)3deltaab2. Two residues were found to be essential for proton flow through ab2c10, namely Arg210 in subunit a (aR210) and Asp61 in subunits c (cD61). Their deletion abolishes proton flow, but "horizontal" repositioning, by anchoring them in adjacent transmembrane helices, restores function. Here, we investigated the effects of "vertical" repositioning aR210, cD61, or both by one helical turn towards the N- or C-termini of their original helices. Other than in the horizontal the vertical displacement changes the positions of the side chains within the depth of the membrane. Mutant aR210A/aN214R appeared to be short-circuited in that it supported proton conduction only through EF1-depleted EFo, but not in EFoEF1, nor ATP-driven proton pumping. Mutant cD61N/cM65D grew on succinate, retained the ability to synthesize ATP and supported passive proton conduction but apparently not ATP hydrolysis-driven proton pumping.

  2. Evidence that the methylation state of the monoamine oxidase A (MAOA) gene predicts brain activity of MAO A enzyme in healthy men.

    PubMed

    Shumay, Elena; Logan, Jean; Volkow, Nora D; Fowler, Joanna S

    2012-10-01

    Human brain function is mediated by biochemical processes, many of which can be visualized and quantified by positron emission tomography (PET). PET brain imaging of monoamine oxidase A (MAO A)-an enzyme metabolizing neurotransmitters-revealed that MAO A levels vary widely between healthy men and this variability was not explained by the common MAOA genotype (VNTR genotype), suggesting that environmental factors, through epigenetic modifications, may mediate it. Here, we analyzed MAOA methylation in white blood cells (by bisulphite conversion of genomic DNA and subsequent sequencing of cloned DNA products) and measured brain MAO A levels (using PET and [(11)C]clorgyline, a radiotracer with specificity for MAO A) in 34 healthy non-smoking male volunteers. We found significant interindividual differences in methylation status and methylation patterns of the core MAOA promoter. The VNTR genotype did not influence the methylation status of the gene or brain MAO A activity. In contrast, we found a robust association of the regional and CpG site-specific methylation of the core MAOA promoter with brain MAO A levels. These results suggest that the methylation status of the MAOA promoter (detected in white blood cells) can reliably predict the brain endophenotype. Therefore, the status of MAOA methylation observed in healthy males merits consideration as a variable contributing to interindividual differences in behavior.

  3. Overview of SPICAV occultation results for the UV channel

    NASA Astrophysics Data System (ADS)

    Montmessin, Franck; Bertaux, Jean-Loup; Belyaev, Denis; Marcq, Emmanuel; Korablev, Oleg; Vandaele, Ann-Carine; Fedorova, Anna

    The SPICAV instrument onboard the Venus Express spacecraft is a multi-channel suite cov-ering the far ultraviolet to the mid-infrared. In this presentation, we will focus on the results obtained by the UV channel during stellar occultations observations. Stellar occultation tech-nique possesses well-known advantages: self-calibration, low sensitivity to instrument aging, simple laws of radiative transfer. In addition, occultation with stars permit to cover a broad range of latitudes at any given season and they provide optimal geometrical registration. Since Venus Express orbit insertion, several hundreds of occultations have been performed by SPI-CAV, yielding profiles of atmospheric constituents between 80 and 140 km. In the SPICAV UV range, CO2 possesses a broad signature shortward of 200 nm which allows one to retrieve CO2 concentration and subsequently to deduce atmospheric pressure and temperature profiles in the upper mesosphere and in the thermosphere. The Venusian thermosphere shows excessive variability, with the equivalent of more than three scale heights change in density in less than a few days. No other spectral signature besides that of CO2 and haze particles was expected to appear in SPICAV ultraviolet spectra at this altitude range but a consistent search was undertaken, revealing the presence of aan ozone at 100 km (¡108 cm-3) and of sulfur dioxide above 90 km at a concentration of 0.1 to 1 ppm.

  4. Operational prediction of rip currents using numerical model and nearshore bathymetry from video images

    NASA Astrophysics Data System (ADS)

    Sembiring, L.; Van Ormondt, M.; Van Dongeren, A. R.; Roelvink, J. A.

    2017-07-01

    Rip currents are one of the most dangerous coastal hazards for swimmers. In order to minimize the risk, a coastal operational-process based-model system can be utilized in order to provide forecast of nearshore waves and currents that may endanger beach goers. In this paper, an operational model for rip current prediction by utilizing nearshore bathymetry obtained from video image technique is demonstrated. For the nearshore scale model, XBeach1 is used with which tidal currents, wave induced currents (including the effect of the wave groups) can be simulated simultaneously. Up-to-date bathymetry will be obtained using video images technique, cBathy 2. The system will be tested for the Egmond aan Zee beach, located in the northern part of the Dutch coastline. This paper will test the applicability of bathymetry obtained from video technique to be used as input for the numerical modelling system by comparing simulation results using surveyed bathymetry and model results using video bathymetry. Results show that the video technique is able to produce bathymetry converging towards the ground truth observations. This bathymetry validation will be followed by an example of operational forecasting type of simulation on predicting rip currents. Rip currents flow fields simulated over measured and modeled bathymetries are compared in order to assess the performance of the proposed forecast system.

  5. Op weg naar een didactiek voor natuurkunde-experimenten op afstand : Ontwerp en evaluatie van een via internet uitvoerbaar experiment voor leerlingen uit het voortgezet onderwijs

    NASA Astrophysics Data System (ADS)

    Engelbarts, M. B. A.

    2009-02-01

    The subject of this thesis is a developmental study on “remote experimenting” in education. It concerns the development of a remote experiment that enables pre-university students to carry out a physics experiment at a distance via the internet. Remote experiments can offer several (practical) benefits when compared to conventional experiments but the desire to exploit these benefits put special demands on the design of the experiment, since the students might be conducting the experiment without a teacher in the vicinity. As a consequence of these demands it was decided to focus on exploring the possibilities and problems of remote experiments conducted in the absence of a teacher. The research was carried out in two cycles and focused on the development of a remote experiment that could be conducted autonomously by pre-university students to measure the speed of light in several media. This should answer the global question: What should a technically, as well as didactically, well-functioning remote experiment look like? The first cycle had an explorative character. It showed that technically the experiment already functioned quite well. However, many problems were observed concerning the content, and the way the students were tackling it. This led to two categories of recommendations. Concerning the content, the material should aim at making the students more aware of what they are doing and why they are doing it and several content related problems needed to be avoided. The second category of recommendations concerned the format of the material: the design and the working method. Special attention should be paid to designing a clear structure for the website and adding interaction and control, (feedback- and reflection facilities) to activate the students and guide them through the material. In the second research cycle these recommendations were followed by designing the material within the theoretical framework of the problem posing theory. A didactical structure was designed before writing the actual lesson material for the website describing the inter-related conceptual and content-related motivational pathway of the intended teaching-learning process. The lesson material was set up in such a way that the students are repeatedly confronted with a practical problem to solve and they play an active role in developing the method of measurement. Secondly, in an attempt to compensate for the absence of the teacher and support the teaching-learning process some format elements were developed and deployed like an automated question-, and feedback system that supported the students, activated them and gave them insight into their learning process and a ‘Where-am-I’-window that showed their current position within the material. This all had led to a technically as well as didactically well functioning remote experiment in which, at a global level, the line of reasoning was made explicit and recognizable for the students, and ad a local level was build up out of well connected successive activities and required the students to adopt an active attitude.

  6. AOP: An R Package For Sufficient Causal Analysis in Pathway ...

    EPA Pesticide Factsheets

    Summary: How can I quickly find the key events in a pathway that I need to monitor to predict that a/an beneficial/adverse event/outcome will occur? This is a key question when using signaling pathways for drug/chemical screening in pharma-cology, toxicology and risk assessment. By identifying these sufficient causal key events, we have fewer events to monitor for a pathway, thereby decreasing assay costs and time, while maximizing the value of the information. I have developed the “aop” package which uses backdoor analysis of causal net-works to identify these minimal sets of key events that are suf-ficient for making causal predictions. Availability and Implementation: The source and binary are available online through the Bioconductor project (http://www.bioconductor.org/) as an R package titled “aop”. The R/Bioconductor package runs within the R statistical envi-ronment. The package has functions that can take pathways (as directed graphs) formatted as a Cytoscape JSON file as input, or pathways can be represented as directed graphs us-ing the R/Bioconductor “graph” package. The “aop” package has functions that can perform backdoor analysis to identify the minimal set of key events for making causal predictions.Contact: burgoon.lyle@epa.gov This paper describes an R/Bioconductor package that was developed to facilitate the identification of key events within an AOP that are the minimal set of sufficient key events that need to be tested/monit

  7. Baicalin Protects Mice from Aristolochic Acid I-Induced Kidney Injury by Induction of CYP1A through the Aromatic Hydrocarbon Receptor

    PubMed Central

    Wang, Ke; Feng, Chenchen; Li, Chenggang; Yao, Jun; Xie, Xiaofeng; Gong, Likun; Luan, Yang; Xing, Guozhen; Zhu, Xue; Qi, Xinming; Ren, Jin

    2015-01-01

    Exposure to aristolochic acid I (AAI) can lead to aristolochic acid nephropathy (AAN), Balkan endemic nephropathy (BEN) and urothelial cancer. The induction of hepatic CYP1A, especially CYP1A2, was considered to detoxify AAI so as to reduce its nephrotoxicity. We previously found that baicalin had the strong ability to induce CYP1A2 expression; therefore in this study, we examined the effects of baicalin on AAI toxicity, metabolism and disposition, as well as investigated the underlying mechanisms. Our toxicological studies showed that baicalin reduced the levels of blood urea nitrogen (BUN) and creatinine (CRE) in AAI-treated mice and attenuated renal injury induced by AAI. Pharmacokinetic analysis demonstrated that baicalin markedly decreased AUC of AAI in plasma and the content of AAI in liver and kidney. CYP1A induction assays showed that baicalin exposure significantly increased the hepatic expression of CYP1A1/2, which was completely abolished by inhibitors of the Aromatic hydrocarbon receptor (AhR), 3ʹ,4ʹ-dimethoxyflavone and resveratrol, in vitro and in vivo, respectively. Moreover, the luciferase assays revealed that baicalin significantly increased the luciferase activity of the reporter gene incorporated with the Xenobiotic response elements recognized by AhR. In summary, baicalin significantly reduced the disposition of AAI and ameliorated AAI-induced kidney toxicity through AhR-dependent CYP1A1/2 induction in the liver. PMID:26204831

  8. Considerations in prophylaxis for tumor-associated epilepsy: prevention of status epilepticus and tolerability of newer generation AEDs.

    PubMed

    Wychowski, Thomas; Wang, Hongyue; Buniak, Liana; Henry, J Craig; Mohile, Nimish

    2013-11-01

    To identify risk factors for the development of tumor-associated epilepsy (TAE) and potential benefit of newer generation AEDs in seizure prevention. We performed an IRB approved retrospective study of newly diagnosed GBM patients at the University of Rochester between 1/1/05 and 5/13/11. Records were reviewed to describe demographics, seizure incidence, occurrence of status epilepticus, and AED use and toxicity. 172 patients with newly diagnosed GBM were included in the study. 53.4% developed TAE. 31.4% had seizure prior to diagnosis. 118 patients were seizure-free at diagnosis: 32.2% developed post-diagnosis TIE (PostTAE) and 60.2% remained seizure-free. 70 seizure-free patients received an AED peri-operatively. 36 were weaned off AEDs and 31 were continued. Incidence of PostTAE and time to first seizure were comparable in AED-treated and untreated patients. 4 PostTAE patients presented with status epilepticus (SE), all were not AED treated. AEDs were withdrawn in 10 patients due to toxicity: 9 from phenytoin and 1 from levetiracetam. There is a high incidence of PostTAE in GBM. Prophylactic AED therapy did not reduce PostTAE but may have prevented SE. Minimal toxicity was observed on 2nd generation AEDs. The high burden of epilepsy in this population and tolerability of newer AEDS suggest that AAN guidelines should be revisited. Copyright © 2013 Elsevier B.V. All rights reserved.

  9. Summary of Coating Surveys on the Four Air Command Frigates (Zeven Provincien Class) (Onderzoek naar de conditie van de coatingsystemen op vier luchtcommandofregatten (Zeven Provincien Klasse))

    DTIC Science & Technology

    2008-03-26

    of these inspections have been drafted into the following extensive reports for each frigate: * TQS-RAP-07-855/ gge of March 30, 2007 for Hr.Ms...34Evertsen" (LCF 4) * TQS-RAP-07-856/ gge of March 30, 2007 for Hr.Ms. "Tromp" (LCF 2) • TQS-RAP-07-857/ gge of March 30, 2007 for Hr.Ms. "De Ruyter" (LCF 3...34 TQS-RAP-08-3316/ gge of January 10, 2008 for Hr.Ms. -Zeven Provincien" (LCF 1) Each report consists of a description of results and all protocols made

  10. Bell's Palsy.

    PubMed

    Reich, Stephen G

    2017-04-01

    Bell's palsy is a common outpatient problem, and while the diagnosis is usually straightforward, a number of diagnostic pitfalls can occur, and a lengthy differential diagnosis exists. Recognition and management of Bell's palsy relies on knowledge of the anatomy and function of the various motor and nonmotor components of the facial nerve. Avoiding diagnostic pitfalls relies on recognizing red flags or features atypical for Bell's palsy, suggesting an alternative cause of peripheral facial palsy. The first American Academy of Neurology (AAN) evidence-based review on the treatment of Bell's palsy in 2001 concluded that corticosteroids were probably effective and that the antiviral acyclovir was possibly effective in increasing the likelihood of a complete recovery from Bell's palsy. Subsequent studies led to a revision of these recommendations in the 2012 evidence-based review, concluding that corticosteroids, when used shortly after the onset of Bell's palsy, were "highly likely" to increase the probability of recovery of facial weakness and should be offered; the addition of an antiviral to steroids may increase the likelihood of recovery but, if so, only by a very modest effect. Bell's palsy is characterized by the spontaneous acute onset of unilateral peripheral facial paresis or palsy in isolation, meaning that no features from the history, neurologic examination, or head and neck examination suggest a specific or alternative cause. In this setting, no further testing is necessary. Even without treatment, the outcome of Bell's palsy is favorable, but treatment with corticosteroids significantly increases the likelihood of improvement.

  11. Summary of evidence-based guideline update: evaluation and management of concussion in sports: report of the Guideline Development Subcommittee of the American Academy of Neurology.

    PubMed

    Giza, Christopher C; Kutcher, Jeffrey S; Ashwal, Stephen; Barth, Jeffrey; Getchius, Thomas S D; Gioia, Gerard A; Gronseth, Gary S; Guskiewicz, Kevin; Mandel, Steven; Manley, Geoffrey; McKeag, Douglas B; Thurman, David J; Zafonte, Ross

    2013-06-11

    To update the 1997 American Academy of Neurology (AAN) practice parameter regarding sports concussion, focusing on 4 questions: 1) What factors increase/decrease concussion risk? 2) What diagnostic tools identify those with concussion and those at increased risk for severe/prolonged early impairments, neurologic catastrophe, or chronic neurobehavioral impairment? 3) What clinical factors identify those at increased risk for severe/prolonged early postconcussion impairments, neurologic catastrophe, recurrent concussions, or chronic neurobehavioral impairment? 4) What interventions enhance recovery, reduce recurrent concussion risk, or diminish long-term sequelae? The complete guideline on which this summary is based is available as an online data supplement to this article. We systematically reviewed the literature from 1955 to June 2012 for pertinent evidence. We assessed evidence for quality and synthesized into conclusions using a modified Grading of Recommendations Assessment, Development and Evaluation process. We used a modified Delphi process to develop recommendations. Specific risk factors can increase or decrease concussion risk. Diagnostic tools to help identify individuals with concussion include graded symptom checklists, the Standardized Assessment of Concussion, neuropsychological assessments, and the Balance Error Scoring System. Ongoing clinical symptoms, concussion history, and younger age identify those at risk for postconcussion impairments. Risk factors for recurrent concussion include history of multiple concussions, particularly within 10 days after initial concussion. Risk factors for chronic neurobehavioral impairment include concussion exposure and APOE ε4 genotype. Data are insufficient to show that any intervention enhances recovery or diminishes long-term sequelae postconcussion. Practice recommendations are presented for preparticipation counseling, management of suspected concussion, and management of diagnosed concussion.

  12. Results of the American Academy of Neurology resident survey.

    PubMed

    Freeman, W D; Nolte, C M; Matthews, B R; Coleman, M; Corboy, J R

    2011-03-29

    To assess the effect of neurology residency education as trainees advance into independent practice, the American Academy of Neurology (AAN) elected to survey all graduating neurology residents at time of graduation and in 3-year cycles thereafter. A 22-question survey was sent to all neurology residents completing residency training in the United States in 2007. Of 523 eligible residents, 285 (54.5%) responded. Of these, 92% reported good to excellent quality teaching of basic neurology from their faculty; however, 47% noted less than ideal training in basic neuroscience. Two-thirds indicated that the Residency In-service Training Examination was used only as a self-assessment tool, but reports of misuse were made by some residents. After residency, 78% entered fellowships (with 61% choosing a fellowship based on interactions with a mentor at their institution), whereas 20% entered practice directly. After adjustment for the proportion of residents who worked before the duty hour rules were implemented and after their implementation, more than half reported improvement in quality of life (87%), education (60%), and patient care (62%). The majority of international medical graduates reported wanting to stay in the United States to practice rather than return to their country of residence. Neurology residents are generally satisfied with training, and most entered a fellowship. Duty hour implementation may have improved resident quality of life, but reciprocal concerns were raised about impact on patient care and education. Despite the majority of international trainees wishing to stay in the United States, stricter immigration laws may limit their entry into the future neurology workforce.

  13. Neurocritical Care Education During Residency: Opinions (NEURON) Study.

    PubMed

    Lerner, David P; Kim, Jennifer; Izzy, Saef

    2017-02-01

    The American Academy of Neurology (AAN) has established a core curriculum of topics for residency training in neurocritical care. At present there is limited data evaluating neurology residency education within the neurological intensive care unit. This study evaluates learner concerns with the neurological intensive care unit. The Communication Committee and Resident & Fellow Taskforce within the Neurocritical Care Society (NCS) developed an online survey that consisted of 20 selection and free-text based questions. The survey was distributed to NCS members and then to neurology residency program directors. Statistical analysis of neurocritical care exposure were completed with t or Fisher exact test with p-value <0.05 considered significant. A total of 95 individuals from 32 different residency programs (36.5 % response rate) responded to the questionnaire. Most individuals train with neurocritical care attendings, fellows and advanced practitioners and have neurocritical care exposure during multiple years of residency training. 54 % of responders cite improvement in education as a means to improve neurocritical care training. Those that raised concern had no difference in time in the neurocritical care unit (9.4 weeks vs 8.8 weeks), exposure to trained neurointensivists, neurocritical care fellows or advanced providers (p value 0.53, 0.19, 0.83, respectively). There is significant learner concern regarding education within the neurointensive care unit. Although there are educational guidelines and focused neurocritical care educational materials, these alone do not satisfy residents' educational needs. This study demonstrates the need for educational changes, but it does not assess best strategies nor curricular content.

  14. Probability distributions of linear statistics in chaotic cavities and associated phase transitions

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

    Vivo, Pierpaolo; Majumdar, Satya N.; Bohigas, Oriol

    2010-03-01

    We establish large deviation formulas for linear statistics on the N transmission eigenvalues (T{sub i}) of a chaotic cavity, in the framework of random matrix theory. Given any linear statistics of interest A=SIGMA{sub i=1}{sup N}a(T{sub i}), the probability distribution P{sub A}(A,N) of A generically satisfies the large deviation formula lim{sub N-}>{sub i}nfinity[-2 log P{sub A}(Nx,N)/betaN{sup 2}]=PSI{sub A}(x), where PSI{sub A}(x) is a rate function that we compute explicitly in many cases (conductance, shot noise, and moments) and beta corresponds to different symmetry classes. Using these large deviation expressions, it is possible to recover easily known results and to produce newmore » formulas, such as a closed form expression for v(n)=lim{sub N-}>{sub i}nfinity var(T{sub n}) (where T{sub n}=SIGMA{sub i}T{sub i}{sup n}) for arbitrary integer n. The universal limit v*=lim{sub n-}>{sub i}nfinity v(n)=1/2pibeta is also computed exactly. The distributions display a central Gaussian region flanked on both sides by non-Gaussian tails. At the junction of the two regimes, weakly nonanalytical points appear, a direct consequence of phase transitions in an associated Coulomb gas problem. Numerical checks are also provided, which are in full agreement with our asymptotic results in both real and Laplace space even for moderately small N. Part of the results have been announced by Vivo et al. [Phys. Rev. Lett. 101, 216809 (2008)].« less

  15. Is survival improved by the use of NIV and PEG in amyotrophic lateral sclerosis (ALS)? A post-mortem study of 80 ALS patients.

    PubMed

    Burkhardt, Christian; Neuwirth, Christoph; Sommacal, Andreas; Andersen, Peter M; Weber, Markus

    2017-01-01

    Non-invasive ventilation (NIV) and percutaneous gastrostomy (PEG) are guideline-recommended interventions for symptom management in amyotrophic lateral sclerosis (ALS). Their effect on survival is controversial and the impact on causes of death is unknown. To investigate the effect of NIV and PEG on survival and causes of death in ALS patients. Eighty deceased ALS patients underwent a complete post mortem analysis for causes of death between 2003 and 2015. Forty-two of these patients consented for genetic testing. Effects of NIV and PEG on survival and causes of death were analyzed in a multivariable Cox proportional hazard regression. Six patients, who requested assisted suicide causing drug-induced hypoxia, were excluded from final analysis. Respiratory failure was the main cause of death in 72 out of 74 patients. Fifteen out of 74 died of aspiration pneumonia 23/74 of bronchopneumonia and 8/74 of a combination of aspiration pneumonia and bronchopneumonia. Twenty died of hypoxia without concomitant infection, and six patients had pulmonary embolism alone or in combination with pneumonia. NIV (p = 0.01) and PEG (p<0.01) had a significant impact on survival. In patients using NIV bronchopneumonia was significantly more frequent (p <0.04) compared to non-NIV patients. This effect was even more pronounced in limb onset patients (p<0.002). Patients with C9orf72 hexanucleotide repeat expansions showed faster disease progression and shorter survival (p = 0.01). The use of NIV and PEG prolongs survival in ALS. This study supports current AAN and EFNS guidelines which recommend NIV and PEG as a treatment option in ALS. The risk of bronchopneumonia as cause of death may be increased by NIV.

  16. Summary of evidence-based guideline update: Evaluation and management of concussion in sports

    PubMed Central

    Giza, Christopher C.; Kutcher, Jeffrey S.; Ashwal, Stephen; Barth, Jeffrey; Getchius, Thomas S.D.; Gioia, Gerard A.; Gronseth, Gary S.; Guskiewicz, Kevin; Mandel, Steven; Manley, Geoffrey; McKeag, Douglas B.; Thurman, David J.; Zafonte, Ross

    2013-01-01

    Objective: To update the 1997 American Academy of Neurology (AAN) practice parameter regarding sports concussion, focusing on 4 questions: 1) What factors increase/decrease concussion risk? 2) What diagnostic tools identify those with concussion and those at increased risk for severe/prolonged early impairments, neurologic catastrophe, or chronic neurobehavioral impairment? 3) What clinical factors identify those at increased risk for severe/prolonged early postconcussion impairments, neurologic catastrophe, recurrent concussions, or chronic neurobehavioral impairment? 4) What interventions enhance recovery, reduce recurrent concussion risk, or diminish long-term sequelae? The complete guideline on which this summary is based is available as an online data supplement to this article. Methods: We systematically reviewed the literature from 1955 to June 2012 for pertinent evidence. We assessed evidence for quality and synthesized into conclusions using a modified Grading of Recommendations Assessment, Development and Evaluation process. We used a modified Delphi process to develop recommendations. Results: Specific risk factors can increase or decrease concussion risk. Diagnostic tools to help identify individuals with concussion include graded symptom checklists, the Standardized Assessment of Concussion, neuropsychological assessments, and the Balance Error Scoring System. Ongoing clinical symptoms, concussion history, and younger age identify those at risk for postconcussion impairments. Risk factors for recurrent concussion include history of multiple concussions, particularly within 10 days after initial concussion. Risk factors for chronic neurobehavioral impairment include concussion exposure and APOE ε4 genotype. Data are insufficient to show that any intervention enhances recovery or diminishes long-term sequelae postconcussion. Practice recommendations are presented for preparticipation counseling, management of suspected concussion, and management of

  17. Impact of the Accreditation Council for Graduate Medical Education work-hour regulations on neurosurgical resident education and productivity.

    PubMed

    Jagannathan, Jay; Vates, G Edward; Pouratian, Nader; Sheehan, Jason P; Patrie, James; Grady, M Sean; Jane, John A

    2009-05-01

    Recently, the Institute of Medicine examined resident duty hours and their impact on patient safety. Experts have suggested that reducing resident work hours to 56 hours per week would further decrease medical errors. Although some reports have indicated that cutbacks in resident duty hours reduce errors and make resident life safer, few authors have specifically analyzed the effect of the Accreditation Council for Graduate Medical Education (ACGME) duty-hour limits on neurosurgical resident education and the perceived quality of training. The authors have evaluated multiple objective surrogate markers of resident performance and quality of training to determine the impact of the 80-hour workweek. The United States Medical Licensing Examination (USMLE) Step 1 data on neurosurgical applicants entering ACGME-accredited programs between 1998 and 2007 (before and after the implementation of the work-hour rules) were obtained from the Society of Neurological Surgeons. The American Board of Neurological Surgery (ABNS) written examination scores for this group of residents were also acquired. Resident registration for and presentations at the American Association of Neurological Surgeons (AANS) annual meetings between 2002 and 2007 were examined as a measure of resident academic productivity. As a case example, the authors analyzed the distribution of resident training hours in the University of Virginia (UVA) neurosurgical training program before and after the institution of the 80-hour workweek. Finally, program directors and chief residents in ACGME-accredited programs were surveyed regarding the effects of the 80-hour workweek on patient care, resident training, surgical experience, patient safety, and patient access to quality care. Respondents were also queried about their perceptions of a 56-hour workweek. Despite stable mean USMLE Step 1 scores for matched applicants to neurosurgery programs between 2000 and 2008, ABNS written examination scores for residents

  18. ARISTOLOCHIC ACID I METABOLISM IN THE ISOLATED PERFUSED RAT KIDNEY

    PubMed Central

    Priestap, Horacio A.; Torres, M. Cecilia; Rieger, Robert A.; Dickman, Kathleen G.; Freshwater, Tomoko; Taft, David R.; Barbieri, Manuel A.; Iden, Charles R.

    2012-01-01

    Aristolochic acids are natural nitro-compounds found globally in the plant genus Aristolochia that have been implicated in the severe illness in humans termed aristolochic acid nephropathy (AAN). Aristolochic acids undergo nitroreduction, among other metabolic reactions, and active intermediates arise that are carcinogenic. Previous experiments with rats showed that aristolochic acid I (AA-I), after oral administration or injection, is subjected to detoxication reactions to give aristolochic acid Ia, aristolactam Ia, aristolactam I and their glucuronide and sulfate conjugates that can be found in urine and faeces. Results obtained with whole rats do not clearly define the role of liver and kidney in such metabolic transformation. In this study, in order to determine the specific role of the kidney on the renal disposition of AA-I and to study the biotransformations suffered by AA-I in this organ, isolated kidneys of rats were perfused with AA-I. AA-I and metabolite concentrations were determined in perfusates and urines using HPLC procedures. The isolated perfused rat kidney model showed that AA-I distributes rapidly and extensively in kidney tissues by uptake from the peritubular capillaries and the tubules. It was also established that the kidney is able to metabolize AA-I into aristolochic acid Ia, aristolochic acid Ia O-sulfate, aristolactam Ia, aristolactam I and aristolactam Ia O-glucuronide. Rapid demethylation and sulfation of AA-I in the kidney generate aristolochic acid Ia and its sulfate conjugate that are voided to the urine. Reduction reactions to give the aristolactam metabolites occur to a slower rate. Renal clearances showed that filtered AA-I is reabsorbed at the tubules whereas the metabolites are secreted. The unconjugated metabolites produced in the renal tissues are transported to both urine and perfusate whereas the conjugated metabolites are almost exclusively secreted to the urine. PMID:22118289

  19. Developing guidelines for return to play: consensus and evidence-based approaches.

    PubMed

    Echemendia, Ruben J; Giza, Christopher C; Kutcher, Jeffrey S

    2015-01-01

    Sports-related concussions are commonplace at all levels of play and across all age groups. The dynamic, evolving nature of this injury coupled with a lack of objective biomarkers creates a challenging management issue for the sports medicine team. Athletes who return to play following a concussion are known to be at higher risk for an additional brain injury, which necessitates a careful, informed return to play (RTP) process. The goal of this paper is to outline historical attempts at developing RTP guidelines and trace their evolution over time, culminating in a discussion of the process and outcomes of the most recent consensus statements/guidelines published by the international Concussion In Sport Group (CISG), the American Academy of Neurology (AAN), the National Athletic Trainers' Association, and the 2013 Team Physician Consensus Statement Update. An evaluation of the pros and cons of these guidelines is presented along with suggestions for future directions. In addition, the Institute of Medicine recently conducted a comprehensive report outlining the current state of evidence regarding youth concussions, which provides specific recommendations for future research. The different methodologies utilized in the development of consensus statements have distinct advantages and disadvantages, and both approaches add value to the everyday management of sports concussions. Importantly, the overall approach for management of sports concussion is remarkably similar using either consensus-based or formal evidence-based methods, which adds confidence to the current guidelines and allows practitioners to focus on accepted standards of clinical care. Moving forward, careful study designs need to be utilized to avoid bias in selection of research subjects, collection of data, and interpretation of results. Although useful, clinicians must venture beyond consensus statements to examine reviews of the literature that are published in much greater frequency than consensus

  20. Plasma apolipoprotein E and Alzheimer disease risk: the AIBL study of aging.

    PubMed

    Gupta, V B; Laws, S M; Villemagne, V L; Ames, D; Bush, A I; Ellis, K A; Lui, J K; Masters, C; Rowe, C C; Szoeke, C; Taddei, K; Martins, R N

    2011-03-22

    There is mounting evidence for the contribution of apoE to the pathophysiology of Alzheimer disease (AD). Studies also indicate that plasma apoE levels may reflect disease status, suggesting that apoE is a potential AD biomarker. However, while some studies of apoE levels in plasma have presented correlations with AD pathology, others have not. Thus, there is a lack of consensus as to the suitability of plasma apoE as an AD biomarker. The major objective of this cross-sectional study was to investigate total plasma apoE as well as levels of the apoE4 form in a large, highly characterized cohort which included both healthy controls and participants with early-stage AD. Total apoE and apoE4 were measured in 1,079 individuals drawn from the highly characterized Australian Imaging, Biomarkers and Lifestyle (AIBL) study. Total and isoform-specific plasma apoE levels were then compared with cerebral Aβ load, as assessed by PET using Pittsburgh compound B (PiB). Total apoE and apoE4 levels were found to be significantly lower in patients with AD in the entire cohort, and decrease with Aβ load in the PiB-PET subset. ApoE levels were significantly lower among ε4 homozygous individuals. In APOE ε3/ε4 heterozygote carriers, apoE4 levels decrease, indicating that apoE3 levels increase with disease. Analysis of cross-sectional data from the AIBL study indicates that plasma apoE levels are altered in AD and correlate with AD pathology level. The significance of these findings will be determined in the AIBL longitudinal study of aging. © 2011 by AAN Enterprises, Inc.

  1. Factors associated with career satisfaction and burnout among US neurosurgeons: results of a nationwide survey.

    PubMed

    McAbee, Joseph H; Ragel, Brian T; McCartney, Shirley; Jones, G Morgan; Michael, L Madison; DeCuypere, Michael; Cheng, Joseph S; Boop, Frederick A; Klimo, Paul

    2015-07-01

    OBJECT :The object of this study was to identify and quantify predictors of burnout and career satisfaction among US neurosurgeons. All US members (3247) of the American Association of Neurological Surgeons (AANS) were invited to participate in a survey between September and December 2012. Responses were evaluated through univariate analysis. Factors independently associated with burnout and career satisfaction were determined using multivariable logistic regression. Subgroup analysis of academic and nonacademic neurosurgeons was performed as well. The survey response rate was 24% (783 members). The majority of respondents were male, 40-60 years old, in a stable relationship, with children, working in a group or university practice, and trained in a subspecialty. More than 80% of respondents reported being at least somewhat satisfied with their career, and 70% would choose a career in neurosurgery again; however, only 26% of neurosurgeons believed their professional lives would improve in the future, and 52% believed it would worsen. The overall burnout rate was 56.7%. Factors independently associated with both burnout and career satisfaction included achieving a balance between work and life outside the hospital (burnout OR 0.45, satisfaction OR 10.0) and anxiety over future earnings and/or health care reform (burnout OR 1.96, satisfaction OR 0.32). While the burnout rate for nonacademic neurosurgeons (62.9%) was higher than that for academic neurosurgeons (47.7%), academicians who had practiced for over 20 years were less likely to be satisfied with their careers. The rates of burnout and career satisfaction were both high in this survey study of US neurosurgeons. The negative effects of burnout on the lives of surgeons, patients, and their families require further study and probably necessitate the development of interventional programs at local, regional, and even national levels.

  2. Oxidovanadium(IV) complexes involving dehydroacetic acid and β-diketones of bioinorganic and medicinal relevance: Their synthesis, characterization, thermal behavior and DFT aspects

    NASA Astrophysics Data System (ADS)

    Maurya, R. C.; Malik, B. A.; Mir, J. M.; Vishwakarma, P. K.

    2015-03-01

    Six new mixed-ligand complexes of oxidovanadium(IV) of the general composition [VO(dha)(L)(H2O)], where dhaH = dehydroacetic acid, LH = β-diketones, viz., acetoacetanilide (aaaH), o-acetoacetotoluidide (o-aatdH), o-acetoacetanisidide (o-aansH), acetylacetone (acacH), methyl acetoacetate (macacH) or ethyl acetoacetate (eacacH) have been synthesized by the reaction of VOSO4ṡ5H2O and the ligands given above in aqueous-ethanol medium. The resulting complexes have been characterized on the basis of elemental analyses, vanadium determination, molar conductance and magnetic measurements, mass spectrometry, thermogravimetric analysis, infrared and electron spin resonance spectral studies. The thermal decomposition processes of two representative complexes are discussed and the order of reaction (n) and the activation energy (Ea) for the particular decomposition steps have been calculated from thermogravimetric (TG) curve. Geometry optimizations were performed with the Gaussian 09 software package by using density functional theory (DFT) methods with Becke-3-Lee-Yang-Parr (B3LYP) hybrid exchange-correlation functional and the standard LANL2 MB basis set for dhaH and its complex [VO(dha)(acac)(H2O)]. Molecular surface electrostatic potentials (MSEP), vibrational frequency calculations, bond lengths, bond angles, dihedral angles, natural population analysis and calculations of molecular energies, HOMO and LUMO were made. No imaginary frequency was found in the optimized model compounds and hence ensures that the molecule is in the lowest point of the potential energy surface, that is, a energy minimum. Finally calculated results were applied to simulated Infrared spectra of the title compound which show good agreement with observed spectra. Based on experimental and theoretical data, suitable trans-octahedral structures have been proposed for these complexes.

  3. Factors influencing professional life satisfaction among neurologists.

    PubMed

    Teixeira-Poit, Stephanie M; Halpern, Michael T; Kane, Heather L; Keating, Michael; Olmsted, Murrey

    2017-06-19

    Predicted shortages in the supply of neurologists may limit patients' access to and quality of care for neurological disorders. Retaining neurologists already in practice provides one opportunity to support the overall supply of practicing neurologists. Understanding factors associated with professional life satisfaction (and dissatisfaction) and implementing policies to enhance satisfaction may encourage neurologists to remain in clinical practice. In this paper, we present results from the first study examining factors associated with professional life satisfaction among a large sample of U.S, neurologists. We collaborated with the AAN to survey a sample of U.S. neurologists about their professional life satisfaction. Analyses examined the association of physician and practice characteristics with aspects of professional life satisfaction, including satisfaction with their career in medicine, medical specialty, current position, relationship with colleagues, relationship with patients, work/life balance, and pay. The study population consisted of 625 neurologists. In multivariate regression analyses, no single group or population stratum indicated high (or low) responses to all aspects of satisfaction. Older neurologists reported higher satisfaction with career, specialty, and relationship with patients than younger neurologists. Female neurologists had significantly lower satisfaction with pay than male neurologists. Neurologists who spent more time in research and teaching had greater satisfaction with specialty, relationship with colleagues, and relationship with patients than those spending no time in research. Neurologists who practiced in small cities/rural areas reported lower satisfaction across multiple dimensions than those practicing in large urban areas. Neurologists in solo practice had greater satisfaction with the relationship with their patients, but lower satisfaction with pay. Satisfaction is a multidimensional construct that is associated with

  4. [Intermittent Explosive Disorder: A Controversial Diagnosis].

    PubMed

    Zapata, Juan Pablo; Palacio, Juan David

    2016-01-01

    Intermittent explosive disorder (IED) is aan externalizing externalising disorder characterized characterised by recurrent aggression episodes. Even though this disorder was described several decades ago, and it carries personal and social consequences, there is little in the medical scientific literature on this. bibliographic production about it is scanty. To perform a conceptualization conceptualisation of this disorder, through the review and bibliometric analysis of the available scientific articles. A search was performed in databases with the english English terms intermittent explosive disorder, impulse disorders control [MeSH], in combination with other terms. A bibliometric analysis in the GoPubMed® search engineer was also performed using all data obtained in the search. was also perfomed. IED prevalence ranges from 1.4% to 7%, it presents more frequently during middle adolescence, and with more noticeable repercussions in men males than in womenfemales. The psychopathological core of IED is the impulsive aggressive behaviour that presents in the form of «attacks» that occurs in response to a lower precipitating stimulus. Scientific publications about IED are few and relatively recent, and the vast majority is provided bycomes from the United States (56.56%), and headed by a single author. This fact highlights the need to replicate the findings described about the IED in order to demonstrate the validity and reliability of its diagnostic criteria. It is possible that doubts about the existence of a diagnosis lead have led to such a scant literature about the IED. Available studies about IED allow have allowed characterizing a group of subjects with episodes of impulsive aggression to be characterised, but this description requires replication in different latitudesneeds to be repeated in different areas. Copyright © 2015 Asociación Colombiana de Psiquiatría. Publicado por Elsevier España. All rights reserved.

  5. Practice Guideline Summary: Sudden Unexpected Death in Epilepsy Incidence Rates and Risk Factors: Report of the Guideline Development, Dissemination, and Implementation Subcommittee of the American Academy of Neurology and the American Epilepsy Society

    PubMed Central

    Harden, Cynthia; Tomson, Torbjörn; Gloss, David; Buchhalter, Jeffrey; Cross, J. Helen; Donner, Elizabeth; French, Jacqueline A.; Gil-Nagel, Anthony; Hesdorffer, Dale C.; Smithson, W. Henry; Spitz, Mark C.; Walczak, Thaddeus S.; Sander, Josemir W.; Ryvlin, Philippe

    2017-01-01

    Objective: To determine the incidence rates of sudden unexpected death in epilepsy (SUDEP) in different epilepsy populations and address the question of whether risk factors for SUDEP have been identified. Methods: Systematic review of evidence; modified Grading Recommendations Assessment, Development and Evaluation process for developing conclusions; recommendations developed by consensus. Results: Findings for incidence rates based on 12 Class I studies include the following: SUDEP risk in children with epilepsy (aged 0–17 years) is 0.22/1,000 patient-years (95% CI 0.16–0.31) (high confidence in evidence). SUDEP risk increases in adults to 1.2/1,000 patient-years (95% CI 0.64–2.32) (low confidence in evidence). The major risk factor for SUDEP is the occurrence of generalized tonic-clonic seizures (GTCS); the SUDEP risk increases in association with increasing frequency of GTCS occurrence (high confidence in evidence). Recommendations: Level B: Clinicians caring for young children with epilepsy should inform parents/guardians that in 1 year, SUDEP typically affects 1 in 4,500 children; therefore, 4,499 of 4,500 children will not be affected. Clinicians should inform adult patients with epilepsy that SUDEP typically affects 1 in 1,000 adults with epilepsy per year; therefore, annually 999 of 1,000 adults will not be affected. For persons with epilepsy who continue to experience GTCS, clinicians should continue to actively manage epilepsy therapies to reduce seizures and SUDEP risk while incorporating patient preferences and weighing the risks and benefits of any new approach. Clinicians should inform persons with epilepsy that seizure freedom, particularly freedom from GTCS, is strongly associated with decreased SUDEP risk. ABBREVIATIONS AAN: American Academy of Neurology AED: antiepileptic drug GTCS: generalized tonic-clonic seizures SUDEP: sudden unexpected death in epilepsy PMID:28684957

  6. Strategic Capacity RNLA Central Maintenance Depot for Electronic Materials (ECW), Investigation into the Future Workload of ECW. (Strategische Omvang Elektronische Centrale Werkplaats (ECW) onderzoek naar de toekomstige werkiast van ECW)

    DTIC Science & Technology

    1998-03-01

    9 2. Werkterrein van ECW ....................................................................... 11 3. Planning van instandhouding binnen de KL...onderhoud chemisch: calibratie en onderhoud 9 Simulatoren en trainingssytemen 10 PRTL en radlartechnologie algemeen 11 Wapensysteemgebonden elektronica (o.a...trainingssystemen (cel 9 ), PRTL en radar (cel 10), Wapensysteemgebonden elek- tronica (cel 11 ) en Elektronica algemeen (cel 15). Ontwikkelingen en materieel

  7. Preface

    NASA Astrophysics Data System (ADS)

    Sinton, John M.

    This volume is an outgrowth of IUGG Union Symposium 9 held during the 1987 IUGG General Assembly at Vancouver, Canada. This symposium, jointly sponsored by IAVCEI, IASPEI, ICL and IAGA, consisted of 31 presentations ranging in subject matter from melt segregation and melt focusing processes beneath mid-ocean ridges, to the structures of oceanic crust and ophiolite analogues, morphological variations in the accretion process, the structural evolution of specific spreading ridge systems, the interplay between magmatism and rifting, and the chemical and thermal balances involved in mid-ocean ridge hydrothermal systems. Six of those papers have been expanded in the present volume. These papers constitute several important advances in our understanding of the evolution of mid-ocean ridge systems. The recognition that transverse seismic anisotropy is an important characteristic of oceanic layer 2 (Fryer et al.) has profound implications for interpretations of crustal thicknesses based on seismic data, and appears to explain a longstanding enigma of marine seismology: the apparent thinning of upper crustal layers with age. An analysis of magnetic anomaly data and transform fault azimuths across the boundaries of the Pacific, Easter and Nazca plates (Naar and Hey) has resulted in the calculation of new, instantaneous plate motion models for a significant portion of the south Pacific plate boundaries, in addition to providing important constraints on the recent evolution of the Easter Microplate. A new kinematic model for the evolution of the Gorda Rise (Stoddard) reproduces the complex magnetic lineations of that area, and includes models for the generation of the President Jackson seamount chain. Phase equilibria are used to constrain the nature of magmas parental to differentiated lavas of Icelandic rift zones (Thy); these magmas contrast significantly with those for several other spreading ridges, with implications for the melting regimes operating there. The final two

  8. Bardoxolone methyl (BARD) ameliorates aristolochic acid (AA)-induced acute kidney injury through Nrf2 pathway.

    PubMed

    Wu, Juan; Liu, Xinhui; Fan, Jinjin; Chen, Wenfang; Wang, Juan; Zeng, Youjia; Feng, Xiaorang; Yu, Xueqing; Yang, Xiao

    2014-04-06

    Bardoxolone methyl (BARD) is an antioxidant modulator that acts through induction of the nuclear factor erythroid 2-related factor 2 (Nrf2) signaling pathway. This study aimed to investigate the role of BARD in protecting kidneys from aristolochic acid (AA)-induced acute kidney injury (AKI). Male C57BL/6 mice received intraperitoneal (i.p.) injections of aristolochic acid I (AAI) (5mg/kg/day) for 5 days to produce acute AA nephropathy (AAN) model. BARD (10mg/kg/day, i.p.) was applied for 7 consecutive days, starting 2 days prior to AAI administration. The mice in the AA group showed AKI as evidenced by worsening kidney function evaluated by blood urea nitrogen (BUN) and serum creatinine (SCr) levels, and severe tubulointerstitial injury marked by massive tubule necrosis in kidney tissues. BARD significantly reduced BUN and SCr levels which were elevated by AAI. Additionally, AAI-induced histopathological renal damage was ameliorated by BARD. Furthermore, the expression of Nrf2 was reduced, and its repressor Kelch-like ECH-associated protein 1 (Keap1) was increased significantly, whereas heme oxygenase-1 (HO-1) was upregulated and NAD(P)H quinone oxidoreductase-1 (NQO1) was barely increased in the cytoplasm of tubules in kidneys after treatment with AAI. BARD significantly upregulated renal Nrf2, NQO1 and HO-1 expression and downregulated Keap1 expression compared with those in the AA group. Moreover, it was found that Nrf2 was expressed both in the cytoplasm and nuclear of glomeruli and tubules, whereas NQO1 and HO-1 were localized in the cytoplasm of tubules only. In conclusion, AA-induced acute renal injury was associated with impaired Nrf2 activation and expression of its downstream target genes in renal tissues. BARD prevented renal damage induced by AAI, and this renoprotective effect may be exerted by activating the Nrf2 signaling pathway and increasing expression of the downstream target genes. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  9. Evaluation of biomass burning across North West Europe and its impact on air quality

    NASA Astrophysics Data System (ADS)

    Cordell, R. L.; Mazet, M.; Dechoux, C.; Hama, S. M. L.; Staelens, J.; Hofman, J.; Stroobants, C.; Roekens, E.; Kos, G. P. A.; Weijers, E. P.; Frumau, K. F. A.; Panteliadis, P.; Delaunay, T.; Wyche, K. P.; Monks, P. S.

    2016-09-01

    Atmospheric particulate pollution is a significant problem across the EU and there is concern that there may be an increasing contribution from biomass burning, driven by rising fuel prices and an increased interest in the use of renewable energy sources. This study was carried out to assess current levels of biomass burning and the contribution to total PM10 across five sites in North-West Europe; an area which is frequently affected by poor air quality. Biomass burning was quantified by the determination of levoglucosan concentrations from PM10 aerosol filters collected over a 14 month period in 2013/2014 and continued for a further 12 months at the UK site in Leicester. Levoglucosan levels indicated a distinct period of increased biomass combustion between November and March. Within this period monthly average concentrations ranged between 23 ± 9.7 and 283 ± 163 ng/m3, with Lille showing consistently higher levels than the sites in Belgium, the Netherlands and the UK. The estimated contribution to PM10 was, as expected, highest in the winter season where the season average percentage contribution was lowest in Wijk aan Zee at 2.7 ± 1.4% and again highest in Lille at 11.6 ± 3.8%, with a PM10 mass concentration from biomass that ranged from 0.56 μg/m3 in Leicester to 2.08 μg/m3 in Lille. Overall there was poor correlation between the levoglucosan concentrations measured at the different sites indicating that normally biomass burning would only affect atmospheric particulate pollution in the local area; however, there was evidence that extreme burning events such as the Easter fires traditionally held in parts of North-West Europe can have far wider ranging effects on air quality. Network validation measurements were also taken using a mobile monitoring station which visited the fixed sites to carry out concurrent collections of aerosol filters; the result of which demonstrated the reliability of both PM10 and levoglucosan measurements.

  10. A Test Case for the Source Inversion Validation: The 2014 ML 5.5 Orkney, South Africa Earthquake

    NASA Astrophysics Data System (ADS)

    Ellsworth, W. L.; Ogasawara, H.; Boettcher, M. S.

    2017-12-01

    The ML5.5 earthquake of August 5, 2014 occurred on a near-vertical strike slip fault below abandoned and active gold mines near Orkney, South Africa. A dense network of surface and in-mine seismometers recorded the earthquake and its aftershock sequence. In-situ stress measurements and rock samples through the damage zone and rupture surface are anticipated to be available from the "Drilling into Seismogenic Zones of M2.0-M5.5 Earthquakes in South African gold mines" project (DSeis) that is currently progressing toward the rupture zone (Science, doi: 10.1126/science.aan6905). As of 24 July, 95% of drilled core has been recovered from a 427m-section of the 1st hole from 2.9 km depth with minimal core discing and borehole breakouts. A 2nd hole is planned to intersect the fault at greater depth. Absolute differential stress will be measured along the holes and frictional characteristics of the recovered core will be determined in the lab. Surface seismic reflection data and exploration drilling from the surface down to the mining horizon at 3km depth is also available to calibrate the velocity structure above the mining horizon and image reflective geological boundaries and major faults below the mining horizon. The remarkable quality and range of geophysical data available for the Orkney earthquake makes this event an ideal test case for the Source Inversion Validation community using actual seismic data to determine the spatial and temporal evolution of earthquake rupture. We invite anyone with an interest in kinematic modeling to develop a rupture model for the Orkney earthquake. Seismic recordings of the earthquake and information on the faulting geometry can be found in Moyer et al. (2017, doi: 10.1785/0220160218). A workshop supported by the Southern California Earthquake Center will be held in the spring of 2018 to compare kinematic models. Those interested in participating in the modeling exercise and the workshop should contact the authors for additional

  11. Efficient Covalent Modification of Multiwalled Carbon Nanotubes with Diazotized Dyes in Water at Room Temperature.

    PubMed

    Bensghaïer, Asma; Lau Truong, Stéphanie; Seydou, Mahamadou; Lamouri, Aazdine; Leroy, Eric; Mičušik, Matej; Forro, Klaudia; Beji, Mohamed; Pinson, Jean; Omastová, Mária; Chehimi, Mohamed M

    2017-07-11

    Tetrafluoroborate salts of diazotized Azure A (AA-N 2 + ), Neutral Red (NR-N 2 + ) and Congo Red (CR-N 2 + ) dyes were prepared and reacted with multiwalled carbon nanotubes (MWCNTs) at room temperature, in water without any reducing agent. The as-modified MWCNTs were examined by IRATR, Raman spectroscopy, XPS, TGA, TEM, and cyclic voltammetry. The diazonium band located at ∼2350 cm -1 in the diazotized dye IR spectra vanished after attachment to the nanotubes whereas the Raman D/G peak ratio slightly increased after dye covalent attachment at a high initial diazonium/CNT mass ratio. XPS measurements show the loss of F 1s from the BF 4 - anion together with a clear change in the high-resolution C 1s region from the modified nanotubes. Thermogravimetric analyses proved substantial mass loadings of the organic grafts leveling off at 40.5, 34.3, and 50.7 wt % for AA, NR, and CR, respectively. High-resolution TEM pictures confirmed the presence of 1.5-7-nm-thick continuous amorphous layers on the nanotubes assigned to the aryl layers from the dyes. Cyclic voltammetry studies in acetonitrile (ACN) confirmed the grafting of the dyes; the latter retain their electrochemical behavior in the grafted state. The experimental results correlate remarkably well with quantum chemical calculations that indicate high binding energies between the dyes and the CNTs accounting for true covalent bonding (140-185 kJ/mol with the CNT-aryl distance <1.6 nm), though attachment by π stacking also contributes to obtaining stable hybrids. Finally, the pH-responsive character of the robust hybrids was demonstrated by a higher degree of protonation of Neutral Red-grafted CNTs at pH 2 compared to that of the neutral aqueous medium. This work demonstrates that diazotized dyes can be employed for the surface modification of MWCNTs in a very simple and efficient manner in water and at room temperature. The hybrids could be employed for many purposes such as optically pH-responsive materials

  12. Predicting symptomatic cerebral vasospasm after aneurysmal subarachnoid hemorrhage with an artificial neural network in a pediatric population.

    PubMed

    Skoch, Jesse; Tahir, Rizwan; Abruzzo, Todd; Taylor, John M; Zuccarello, Mario; Vadivelu, Sudhakar

    2017-12-01

    Artificial neural networks (ANN) are increasingly applied to complex medical problem solving algorithms because their outcome prediction performance is superior to existing multiple regression models. ANN can successfully identify symptomatic cerebral vasospasm (SCV) in adults presenting after aneurysmal subarachnoid hemorrhage (aSAH). Although SCV is unusual in children with aSAH, the clinical consequences are severe. Consequently, reliable tools to predict patients at greatest risk for SCV may have significant value. We applied ANN modeling to a consecutive cohort of pediatric aSAH cases to assess its ability to predict SCV. A retrospective chart review was conducted to identify patients < 21 years of age who presented with spontaneously ruptured, non-traumatic, non-mycotic, non-flow-related intracranial arterial aneurysms to our institution between January 2002 and January 2015. Demographics, clinical, radiographic, and outcome data were analyzed using an adapted ANN model using learned value nodes from the adult aneurysmal SAH dataset previously reported. The strength of the ANN prediction was measured between - 1 and 1 with - 1 representing no likelihood of SCV and 1 representing high likelihood of SCV. Sixteen patients met study inclusion criteria. The median age for aSAH patients was 15 years. Ten underwent surgical clipping and 6 underwent endovascular coiling for definitive treatment. One patient experienced SCV and 15 did not. The ANN applied here was able to accurately predict all 16 outcomes. The mean strength of prediction for those who did not exhibit SCV was - 0.86. The strength for the one patient who did exhibit SCV was 0.93. Adult-derived aneurysmal SAH value nodes can be applied to a simple AAN model to accurately predict SCV in children presenting with aSAH. Further work is needed to determine if ANN models can prospectively predict SCV in the pediatric aSAH population in toto; adapted to include mycotic, traumatic, and flow

  13. The current state of epilepsy guidelines: A systematic review.

    PubMed

    Sauro, Khara M; Wiebe, Samuel; Dunkley, Colin; Janszky, Jozsef; Kumlien, Eva; Moshé, Solomon; Nakasato, Nobukazu; Pedley, Timothy A; Perucca, Emilio; Senties, Horacio; Thomas, Sanjeev V; Wang, Yuping; Wilmshurst, Jo; Jetté, Nathalie

    2016-01-01

    The International League Against Epilepsy (ILAE) Epilepsy Guidelines Task Force, composed of 14 international members, was established in 2011 to identify, using systematic review methodology, international epilepsy clinical care guidelines, assess their quality, and determine gaps in areas of need of development. A systematic review of the literature (1985-2014) was performed in six electronic databases (e.g. Medline, Embase) using a broad search strategy without initial limits to language or study design. Six gray literature databases (e.g., American Academy of Neurology [AAN], ILAE) were also searched to minimize publication bias. Two independent reviewers screened abstracts, reviewed full text articles, and performed data abstraction. Descriptive statistics and a meta-analysis were generated. The search identified 10,926 abstracts. Of the 410 articles selected for full text review, 63 met our eligibility criteria for a guideline. Of those included, 54 were in English and 9 were in other languages (French, Spanish, and Italian). Of all guidelines, 29% did not specify the target age groups, 27% were focused on adults, 22% included only children, and 6% specifically addressed issues related to women with epilepsy. Guidelines included in the review were most often aimed at guiding clinical practice for status epilepticus (n = 7), first seizure (n = 6), drug-resistant epilepsy (n = 5), and febrile seizures (n = 4), among others. Most of the guidelines were therapeutic (n = 35) or diagnostic (n = 16) in nature. The quality of the guidelines using a 1-7 point scale (7 = highest) varied and was moderate overall (mean = 4.99 ± 1.05 [SD]). We identified substantial gaps in topics (e.g., epilepsy in the elderly) and there was considerable heterogeneity in methodologic quality. The findings should offer a valuable resource for health professionals caring for people with epilepsy, since they will help guide the prioritization, development, and dissemination of future

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

    Levova, Katerina; Moserova, Michaela; Nebert, Daniel W.

    Aristolochic acid causes a specific nephropathy (AAN), Balkan endemic nephropathy, and urothelial malignancies. Using Western blotting suitable to determine protein expression, we investigated in several transgenic mouse lines expression of NAD(P)H:quinone oxidoreductase (NQO1)—the most efficient cytosolic enzyme that reductively activates aristolochic acid I (AAI). The mouse tissues used were from previous studies [Arlt et al., Chem. Res. Toxicol. 24 (2011) 1710; Stiborova et al., Toxicol. Sci. 125 (2012) 345], in which the role of microsomal cytochrome P450 (CYP) enzymes in AAI metabolism in vivo had been determined. We found that NQO1 levels in liver, kidney and lung of Cyp1a1(−/−), Cyp1a2(−/−)more » and Cyp1a1/1a2(−/−) knockout mouse lines, as well as in two CYP1A-humanized mouse lines harboring functional human CYP1A1 and CYP1A2 and lacking the mouse Cyp1a1/1a2 orthologs, differed from NQO1 levels in wild-type mice. NQO1 protein and enzymic activity were induced in hepatic and renal cytosolic fractions isolated from AAI-pretreated mice, compared with those in untreated mice. Furthermore, this increase in hepatic NQO1 enzyme activity was associated with bioactivation of AAI and elevated AAI-DNA adduct levels in ex vivo incubations of cytosolic fractions with DNA and AAI. In conclusion, AAI appears to increase its own metabolic activation by inducing NQO1, thereby enhancing its own genotoxic potential. Highlights: ► NAD(P)H:quinone oxidoreductase expression in Cyp1a knockout and humanized CYP1A mice ► Reductive activation of the nephrotoxic and carcinogenic aristolochic acid I (AAI) ► NAD(P)H:quinone oxidoreductase is induced in mice treated with AAI. ► Induced hepatic enzyme activity resulted in elevated AAI-DNA adduct levels.« less

  15. Impact of genetic modulation of SULT1A enzymes on DNA adduct formation by aristolochic acids and 3-nitrobenzanthrone.

    PubMed

    Arlt, Volker M; Meinl, Walter; Florian, Simone; Nagy, Eszter; Barta, Frantisek; Thomann, Marlies; Mrizova, Iveta; Krais, Annette M; Liu, Maggie; Richards, Meirion; Mirza, Amin; Kopka, Klaus; Phillips, David H; Glatt, Hansruedi; Stiborova, Marie; Schmeiser, Heinz H

    2017-04-01

    Exposure to aristolochic acid (AA) causes aristolochic acid nephropathy (AAN) and Balkan endemic nephropathy (BEN). Conflicting results have been found for the role of human sulfotransferase 1A1 (SULT1A1) contributing to the metabolic activation of aristolochic acid I (AAI) in vitro. We evaluated the role of human SULT1A1 in AA bioactivation in vivo after treatment of transgenic mice carrying a functional human SULT1A1-SULT1A2 gene cluster (i.e. hSULT1A1/2 mice) and Sult1a1(-/-) mice with AAI and aristolochic acid II (AAII). Both compounds formed characteristic DNA adducts in the intact mouse and in cytosolic incubations in vitro. However, we did not find differences in AAI-/AAII-DNA adduct levels between hSULT1A1/2 and wild-type (WT) mice in all tissues analysed including kidney and liver despite strong enhancement of sulfotransferase activity in both kidney and liver of hSULT1A1/2 mice relative to WT, kidney and liver being major organs involved in AA metabolism. In contrast, DNA adduct formation was strongly increased in hSULT1A1/2 mice compared to WT after treatment with 3-nitrobenzanthrone (3-NBA), another carcinogenic aromatic nitro compound where human SULT1A1/2 is known to contribute to genotoxicity. We found no differences in AAI-/AAII-DNA adduct formation in Sult1a1(-/-) and WT mice in vivo. Using renal and hepatic cytosolic fractions of hSULT1A1/2, Sult1a1(-/-) and WT mice, we investigated AAI-DNA adduct formation in vitro but failed to find a contribution of human SULT1A1/2 or murine Sult1a1 to AAI bioactivation. Our results indicate that sulfo-conjugation catalysed by human SULT1A1 does not play a role in the activation pathways of AAI and AAII in vivo, but is important in 3-NBA bioactivation.

  16. Prevalence, incidence, and resolution of nocturnal polyuria in a longitudinal community-based study in older men: the Krimpen study.

    PubMed

    van Doorn, Boris; Blanker, Marco H; Kok, Esther T; Westers, Paul; Bosch, J L H Ruud

    2013-03-01

    Nocturnal polyuria (NP) is common in older men and can lead to nocturia. However, no longitudinal data are available on the natural history of NP. To determine prevalence, incidence, and resolution rates of NP. A longitudinal, community-based study was conducted among 1688 men aged 50-78 yr in Krimpen aan den IJssel, The Netherlands (reference date: 1995), with planned follow-up rounds at 2, 4, and 6 yr. NP was determined with frequency-volume charts. Two definitions of NP were used: (1) a nocturnal urine production (NUP) of >90 ml/h (NUP90) and (2) the nocturnal voided volume plus first morning void being >33% of the 24-h voided volume (NUV33). Nocturia was defined as two or more voids per night. We determined the prevalence of NP at each study round. At first follow-up, we determined the incidence in men without baseline NP and the resolution in men with baseline NP. Prevalence of NP in men with or without nocturia was also determined. At baseline, the prevalence of NUP90 was 15.0% and increased to 21.7% after 6.5 yr, whereas the prevalence of NUV33 was 77.8% at baseline and 80.5% after 6.5 yr. At 2.1 yr of follow-up, the incidences of NUP90 and NUV33 were 13.6% and 60.3%, respectively, and the resolution rates were 57.0% and 17.8%, respectively. Because of this fluctuation in NP, no reliable long-term incidences could be calculated. At baseline, NUP90 was prevalent in 27.7% of men with nocturia and in 8.0% of those without nocturia. At baseline, NUV33 was prevalent in 91.9% of men with nocturia and in 70.1% of men without nocturia. Due to the fluctuation of NP, it is advisable to first determine its chronicity and cause before starting treatment. Because of the high prevalence of NP in men without nocturia, NUV33 should be reconsidered as a discriminative definition of NP. Copyright © 2012. Published by Elsevier B.V.

  17. High-Resolution Monitoring of Coastal Dune Erosion and Growth Using an Unmanned Aerial Vehicle

    NASA Astrophysics Data System (ADS)

    Ruessink, G.; Markies, H.; Van Maarseveen, M.

    2014-12-01

    Coastal foredunes lose and gain sand through marine and aeolian processes, but coastal-evolution models that can accurately predict both wave-driven dune erosion and wind-blown dune growth are non-existing. This is, together with a limited understanding of coastal aeolian process dynamics, due to the lack of adequate field data sets from which erosion and supply volumes can be studied simultaneously. Here, we quantify coastal foredune dynamics using nine topographic surveys performed near Egmond aan Zee, The Netherlands, between September 2011 and March 2014 using an unmanned aerial vehicle (UAV). The approximately 0.75-km long study site comprises a 30-100 m wide sandy beach and a 20-25 m high foredune, of which the higher parts are densely vegetated with European marram grass. Using a structure-from-motion workflow, the 200-500 photographs taken during each UAV flight were processed into a point cloud, from which a geo-referenced digital surface model with a 0.25 x 0.25 m resolution was subsequently computed. Our data set contains two dune-erosion events, including that due to storm Xaver (December 2013), which caused one of the highest surge levels in the southern North Sea region for the last decades. Dune erosion during both events varied alongshore from the destruction of embryonic dunes on the upper beach to the slumping of the entire dune face. During the first storm (January 2012), erosion volumes ranged from 5 m3/m in the (former) embryonic dune field to over 40 m3/m elsewhere. During the subsequent 11 (spring - autumn) months, the foredune accreted by (on average) 8 m3/m, again with substantial alongshore variability (0 - 20 m3/m). Intriguingly, volume changes during the 2012-2013 winter were minimal. We will compare the observed aeolian supply rates with model predictions and discuss reasons for their temporal variability. Funded by the Dutch Organisation for Scientific Research NWO.

  18. Practice Parameter: Pharmacologic treatment of spasticity in children and adolescents with cerebral palsy (an evidence-based review)

    PubMed Central

    Delgado, M R.; Hirtz, D; Aisen, M; Ashwal, S; Fehlings, D L.; McLaughlin, J; Morrison, L A.; Shrader, M W.; Tilton, A; Vargus-Adams, J

    2010-01-01

    Objective: To evaluate published evidence of efficacy and safety of pharmacologic treatments for childhood spasticity due to cerebral palsy. Methods: A multidisciplinary panel systematically reviewed relevant literature from 1966 to July 2008. Results: For localized/segmental spasticity, botulinum toxin type A is established as an effective treatment to reduce spasticity in the upper and lower extremities. There is conflicting evidence regarding functional improvement. Botulinum toxin type A was found to be generally safe in children with cerebral palsy; however, the Food and Drug Administration is presently investigating isolated cases of generalized weakness resulting in poor outcomes. No studies that met criteria are available on the use of phenol, alcohol, or botulinum toxin type B injections. For generalized spasticity, diazepam is probably effective in reducing spasticity, but there are insufficient data on its effect on motor function and its side-effect profile. Tizanidine is possibly effective, but there are insufficient data on its effect on function and its side-effect profile. There were insufficient data on the use of dantrolene, oral baclofen, and intrathecal baclofen, and toxicity was frequently reported. Recommendations: For localized/segmental spasticity that warrants treatment, botulinum toxin type A should be offered as an effective and generally safe treatment (Level A). There are insufficient data to support or refute the use of phenol, alcohol, or botulinum toxin type B (Level U). For generalized spasticity that warrants treatment, diazepam should be considered for short-term treatment, with caution regarding toxicity (Level B), and tizanidine may be considered (Level C). There are insufficient data to support or refute use of dantrolene, oral baclofen, or continuous intrathecal baclofen (Level U). GLOSSARY AAN = American Academy of Neurology; AE = adverse event; AS = Ashworth scale; BoNT-A = botulinum toxin type A; BoNT-B = botulinum toxin

  19. Training Guidelines for Endovascular Ischemic Stroke Intervention: An International multi-society consensus document

    PubMed Central

    2016-01-01

    Contributors American Academy of Neurological Surgeons/ Congress of Neurological Surgeons (AANS/CNS): S.D. Lavine, K Cockroft, B Hoh, N Bambakidis, AA Khalessi, H Woo, H Riina. A. Siddiqui American Society of Neuroradiology (ASNR): J. A. Hirsch Asian Australasian Federation of Interventional and Therapeutic Neuroradiology (AAFITN): W. Chong Australian and New Zealand Society of Neuroradiology - Conjoint Committee for Recognition of Training in Interventional Neuroradiology (CCINR) representing the RANZCR (ANZSNR), ANZAN and NSA: H. Rice, J Wenderoth, P Mitchell, A Coulthard, TJ Signh, C Phatorous, M Khangure Canadian Interventional Neuro Group (CING): P. Klurfan, K. Terbrugge, D Iancu, T. Gunnarsson European Society of Neuroradiology (ESNR); O. Jansen, M. Muto European Society of Minimally Invasive Neurologic Therapy (ESMINT): I. Szikora L. Pierot P. Brouwer J. Gralla, S. Renowden, T. Andersson, J. Fiehler, F. Turjman, P. White, AC Januel, L Spelle, Z Kulcsar, R Chapot, L Spelle, A Biondi, S Dima, C Taschner, M Szajner, A Krajina Japanese Society for Neuroendovascular therapy (JSNET): N.Sakai, Y. Matsumaru, S. Yoshimura Sociedad Ibero Latino Americana de Neuroradiologica (SILAN): O.Diaz, P.Lylyk Society of NeuroInterventional Surgery (SNIS): M.V. Jayaraman, A. Patsalides, C. D. Gandhi, S.K.Lee, T. Abruzzo, B. Albani, S. A. Ansari, A.S. Arthur, B.W. Baxter, K.R.Bulsara, M. Chen, J.E.Delgado-Almandoz, J.F.Fraser, D.V. Heck, S.W. Hetts, M.S.Hussain, R.P. Klucznik, T.M. Leslie-Mawzi, W.J.Mack, R.A.McTaggart, P.M.Meyers, J. Mocco, C.J.Prestigiacomo, G.L.Pride, P.A.Rasmussen, R.M.Starke, P.J.Sunenshine, R.W.Tarr, D.F.Frei Society of Vascular and Interventional Neurology (SVIN): M.Ribo, R.G.Nogeuira, O.O. Zaidat, T. Jovin, I. Linfante, D. Yavagal, D. Liebeskind, R. Novakovic World Federation of Interventional and Therapeutic Neuroradiology (WFITN): S. Pongpech, G Rodesch, M Soderman, K ter Brugge, A. Taylor, T Krings, D Orbach, A. Biondi, L Picard, D C Suh, M. Tanaka, HQ

  20. PREFACE: 14th International Conference on Transport in Interacting Disordered Systems (TIDS-14)

    NASA Astrophysics Data System (ADS)

    Frydman, Aviad

    2012-07-01

    The '14th Transport in interacting disordered systems - TIDS14' conference took place during 5-8 September 2011 in Acre Israel. The conference was a continuation of the biennial meeting traditionally called HRP (hopping and related phenomena) and later named TIDS (transport in interacting disordered systems). Previous conferences took place in Trieste (1985), Bratislava (1987), Chapel Hill (1989), Marburg (1991), Glasgow (1993), Jerusalem (1995), Rackeve (1997), Murcia (1999), Shefayim (2001), Trieste (2003), Egmond, aan Zee (2005), Marburg (2007) and Rackeve (2009). Central to these conferences are systems that are characterized by a large degree of disorder and hence they lack translational symmetry. In such systems interactions are usually very important. Dramatic differences in the behavior of crystalline solids and the 'disordered' systems are possible. Some examples of the latter are amorphous materials, polymer aggregates, materials whose properties are governed by impurities, granular systems and biological systems. This conference series is notable for the pleasant atmosphere and fruitful exchange of ideas between theoreticians and experimentalists in these areas. This tradition was also maintained in the conference in Israel. Specific topics of TIDS14 included: hopping, electron and Coulomb glasses, Anderson localization and many body localization, noise, magneto-transport, metal-insulator and superconductor-insulator transition, transport through low dimensional and nanostructures, quantum coherence, interference and dephasing and other related topics. Over sixty scientists from fourteen countries participated in the conference and presented papers either as oral presentations or as posters in two sessions that took place during the conference. Many of these papers are included in these proceedings. I would like to thank all the conference participants for the interesting presentations, debates and discussions that created a stimulating but pleasant

  1. Gas Testing at the NBC-Filter of the M-Frigates of the Royal Dutch Navy According to the NATO Standard (Gastesten aan het NBC-Filter voor het M-Fregat van de oninklijke Marine volgens NAVO-eisen)

    DTIC Science & Technology

    1992-06-01

    man de eisen van bet NAVO.-document voldsan word.. Het AstroCarb-filter bleek voor alle geteste gassen gemakkelijk de vereiste doorbroaktijden te halen ...hill ?NO famwtyn J-3r d~mf tI~nq"M#-rI~ m t~w)-im TNO RCl1 U W2 AM " TNO-por PML1 32490333 Pagins 2 Samenvatting De gasbescherniende eigenschappen van ...De schoktest tastte de prestaties van bet filter niet man. Summary The gas protective properties of an AstroCarb 200 NBC filter which is usid in the

  2. Thermal energy storage with geothermal triplet for space heating and cooling

    NASA Astrophysics Data System (ADS)

    Bloemendal, Martin; Hartog, Niels

    2017-04-01

    focusses on energy balance and energy loss in the subsurface, well design requirements, working/operational conditions of each well, as well as building system components like the influence of weather conditions on performance of system components. At EGU we like to present and discuss the results of this research. references • Dekker, L.d., 2016. Bepalende factoren voor goed functionerende WKO, kennisplatform bodemenergie. • Graaf, A.d., Heijer, R., Postma, S., 2016. Evaluatie Wijzigingsbesluit bodemenergiesystemen. Buro 38 in commision of ministry of Intrastructure and environment, Cothen. • Kamp, H., 2015. Warmtevisie, ministry of economic affairs, Den Haag. • Ministry-of-Economic-affairs, 2016. Energieagenda, Naar een CO₂-arme energievoorziening. Ministry of Economic affairs, Den Haag.

  3. SU-E-T-362: Automatic Catheter Reconstruction of Flap Applicators in HDR Surface Brachytherapy

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

    Buzurovic, I; Devlin, P; Hansen, J

    2014-06-01

    Purpose: Catheter reconstruction is crucial for the accurate delivery of radiation dose in HDR brachytherapy. The process becomes complicated and time-consuming for large superficial clinical targets with a complex topology. A novel method for the automatic catheter reconstruction of flap applicators is proposed in this study. Methods: We have developed a program package capable of image manipulation, using C++class libraries of The-Visualization-Toolkit(VTK) software system. The workflow for automatic catheter reconstruction is: a)an anchor point is placed in 3D or in the axial view of the first slice at the tip of the first, last and middle points for the curvedmore » surface; b)similar points are placed on the last slice of the image set; c)the surface detection algorithm automatically registers the points to the images and applies the surface reconstruction filter; d)then a structured grid surface is generated through the center of the treatment catheters placed at a distance of 5mm from the patient's skin. As a result, a mesh-style plane is generated with the reconstructed catheters placed 10mm apart. To demonstrate automatic catheter reconstruction, we used CT images of patients diagnosed with cutaneous T-cell-lymphoma and imaged with Freiburg-Flap-Applicators (Nucletron™-Elekta, Netherlands). The coordinates for each catheter were generated and compared to the control points selected during the manual reconstruction for 16catheters and 368control point Results: The variation of the catheter tip positions between the automatically and manually reconstructed catheters was 0.17mm(SD=0.23mm). The position difference between the manually selected catheter control points and the corresponding points obtained automatically was 0.17mm in the x-direction (SD=0.23mm), 0.13mm in the y-direction (SD=0.22mm), and 0.14mm in the z-direction (SD=0.24mm). Conclusion: This study shows the feasibility of the automatic catheter reconstruction of flap applicators with a high

  4. Positive trends in neurosurgery enrollment and attrition: analysis of the 2000-2009 female neurosurgery resident cohort.

    PubMed

    Renfrow, Jaclyn J; Rodriguez, Analiz; Liu, Ann; Pilitsis, Julie G; Samadani, Uzma; Ganju, Aruna; Germano, Isabelle M; Benzil, Deborah L; Wolfe, Stacey Quintero

    2016-03-01

    Women compose a minority of neurosurgery residents, averaging just over 10% of matched applicants per year during this decade. A recent review by Lynch et al. raises the concern that women may be at a higher risk than men for attrition, based on analysis of a cohort matched between 1990 and 1999. This manuscript aims to characterize the trends in enrollment, attrition, and postattrition careers for women who matched in neurosurgery between 2000 and 2009. Databases from the American Association of Neurological Surgeons (AANS) and the American Board of Neurological Surgery (ABNS) were analyzed for all residents who matched into neurosurgery during the years 2000-2009. Residents were sorted by female gender, matched against graduation records, and if graduation was not reported from neurosurgery residency programs, an Internet search was used to determine the residents' alternative path. The primary outcome was to determine the number of women residents who did not complete neurosurgery training programs during 2000-2009. Secondary outcomes included the total number of women who matched into neurosurgery per year, year in training in which attrition occurred, and alternative career paths that these women chose to pursue. Women comprised 240 of 1992 (12%) matched neurosurgery residents during 2000-2009. Among female residents there was a 17% attrition rate, compared with a 5.3% male attrition rate, with an overall attrition rate of 6.7%. The majority who left the field did so within the first 3 years of neurosurgical training and stayed in medicine--pursuing anesthesia, neurology, and radiology. Although the percentage of women entering neurosurgical residency has continued to increase, this number is still disproportionate to the overall number of women in medicine. The female attrition rate in neurosurgery in the 2000-2009 cohort is comparable to that of the other surgical specialties, but for neurosurgery, there is disparity between the male and female attrition

  5. Synthesis and properties of unagglomerated nanocomposite particles for nanomedical applications

    NASA Astrophysics Data System (ADS)

    Rouse, Sarah M.

    2005-11-01

    Methods have been developed to prepare stable, unagglomerated active-medical-agent nanoparticles in a range of sizes, based on reverse-micelle microemulsion techniques. The process used to prepare monodisperse, spherical nanocomposite particles is based on methods originally outlined in detail by Adair et al. and Li et al. The "Molecular Dot" (MD) nanoparticles incorporate a variety of medically-active substances, such as organic fluorophores and therapeutic drugs, internally distributed in silica, titania, calcium phosphate, or calcium phospho-silicate matrices. The synthesis techniques have also been modified to produce nanoparticles containing combinations of fluorophores and medicinal agents, in order to monitor drug release and location. The specific biomedical application for the nanocomposite particles dictates the selection of core and shell-matrix materials. For example, the protective shell-matrices of the silica and titania MDs shield the active-medical agents from damage due to changes in pH, temperature, and other environmental effects. Conversely, the calcium phosphate and calcium phospho-silicate shell-matrix nanoparticles can potentially be engineered to dissolve in physiological environments. The method used to remove residual precursor materials while maintaining a well-dispersed assembly of nanoparticles is critical to the use of nanocolloids in medical applications. The dispersion approach is based on protection-dispersion theory tailored to accommodate the high surface areas and reactivity of sub-50 nm particles in aqueous or water/ethanol mixtures. Dispersion of the nanocomposite particles is further enhanced with the use of size-exclusion high performance liquid chromatography (HPLC) to simultaneously wash and disperse the nanocomposite particle suspensions. The state of dispersion of the nanosuspensions is evaluated using the average agglomeration number (AAN) approach in conjunction with other characterization techniques. The formulation of

  6. Quality improvement in neurology: dementia management quality measures.

    PubMed

    Odenheimer, Germaine; Borson, Soo; Sanders, Amy E; Swain-Eng, Rebecca J; Kyomen, Helen H; Tierney, Samantha; Gitlin, Laura; Forciea, Mary Ann; Absher, John; Shega, Joseph; Johnson, Jerry

    2014-03-01

    Professional and advocacy organizations have long urged that dementia should be recognized and properly diagnosed. With the passage of the National Alzheimer's Project Act in 2011, an Advisory Council for Alzheimer's Research, Care, and Services was convened to advise the Department of Health and Human Services. In May 2012, the Council produced the first National Plan to address Alzheimer's disease, and prominent in its recommendations is a call for quality measures suitable for evaluating and tracking dementia care in clinical settings. Although other efforts have been made to set dementia care quality standards, such as those pioneered by RAND in its series Assessing Care of Vulnerable Elders (ACOVE), practitioners, healthcare systems, and insurers have not widely embraced implementation. This executive summary (full manuscript available at www.neurology.org) reports on a new measurement set for dementia management developed by an interdisciplinary Dementia Measures Work Group (DWG) representing the major national organizations and advocacy organizations concerned with the care of individuals with dementia. The American Academy of Neurology (AAN), the American Geriatrics Society, the American Medical Directors Association, the American Psychiatric Association, and the American Medical Association-convened Physician Consortium for Performance Improvement led this effort. The ACOVE measures and the measurement set described here apply to individuals whose dementia has already been identified and properly diagnosed. Although similar in concept to ACOVE, the DWG measurement set differs in several important ways; it includes all stages of dementia in a single measure set, calls for the use of functional staging in planning care, prompts the use of validated instruments in patient and caregiver assessment and intervention, highlights the relevance of using palliative care concepts to guide care before the advanced stages of illness, and provides evidence-based support

  7. Astrochronology of a Late Oligocene to Early Miocene Magnetostratigraphy from the Northwest Atlantic

    NASA Astrophysics Data System (ADS)

    van Peer, T. E.; Xuan, C.; Liebrand, D.; Lippert, P. C.; Wilson, P. A.

    2016-12-01

    The Oligocene-Miocene Boundary is defined by the geomagnetic polarity reversal C6Cn.2n/C6Cn.2r with an astronomically tuned age of 23 Ma. For late Oligocene to early Miocene reversals, only a few records (mainly from the equatorial Pacific and South Atlantic) integrate magneto- and cyclo-stratigraphy with astronomical tuning. Reversal ages acquired from these records show differences up to 100 kyr. We report new astronomically tuned ages for reversals between 21-26.5 Ma, based on integrated palaeomagnetic and X-Ray Fluorescence (XRF) data from rapidly accumulated drift sediments (mean sedimentation rate of 2.5 cm/kyr) at Integrated Ocean Drilling Program (IODP) Site U1406 (northwest Atlantic). The natural remanence preserved in the sediments is relatively weak (especially at high demagnetisation steps) and prone to influence from measurement noise. We introduce an optimisation protocol to improve the estimation of component directions used to define the reversals. For each 1-cm interval measurement, the protocol searches for the combination of a fixed number of steps of demagnetisation data that minimises the maximum angular deviation, statistically excluding the noisy measurement steps. For the tuning, we use the logarithm of the calcium over potassium ratio ln(Ca/K) from XRF core scanning data, a proxy of carbonate content in the sediment. Spectral and wavelet analyses of the 140-m long ln(Ca/K) record highlight dominant obliquity (including the 178 and 1200 kyr modulation) and additional eccentricity forcing. Supported by preliminary stable isotope analysis on benthic foraminifera, we tuned ln(Ca/K) minima to obliquity minima and eccentricity maxima. The resulting age model yield new independent ages for all reversals between C6Ar/C6AAn to C8r/C9n. Our results are generally consistent (within an obliquity cycle) with the Ocean Drilling Program (ODP) Site 1090 age model [Billups et al., 2004], but deviate up to 80 kyr relative to ODP Site 1218 [Pälike et al

  8. Public health importance of triggers of myocardial infarction: a comparative risk assessment.

    PubMed

    Nawrot, Tim S; Perez, Laura; Künzli, Nino; Munters, Elke; Nemery, Benoit

    2011-02-26

    might have considerable public health relevance. The research on air pollution and health at Hasselt University is supported by a grant from the Flemish Scientific Fund (FWO, Krediet aan navorsers/G.0873.11), tUL-impulse financing, and bijzonder onderzoeksfonds (BOF) and at the Katholieke Universiteit Leuven by the sustainable development programme of BELSPO (Belgian Science Policy).

  9. Hepatic response to increased exogenous supply of plasma amino acids by infusion into the mesenteric vein of Holstein-Friesian cows in late gestation.

    PubMed

    Wray-Cahen, D; Metcalf, J A; Backwell, F R; Bequette, B J; Brown, D S; Sutton, J D; Lobley, G E

    1997-12-01

    The hepatic responses of late gestation, dry dairy cows to acute (6 h) infusions of an amino acid (AA) mixture (Synthamin; 0.0, 1.1, 2.2, 4.4, 8.8 and 17.6 mumol/min) into the mesenteric vein were determined. Neither blood flow nor O2 consumption across the portal-drained viscera (PDV) and liver was significantly altered by infusion. Similarly, there were no effects on net absorption, or hepatic removal, of acetate, propionate, butyrate or NH3. Glucose PDV appearance was unchanged but hepatic glucose production increased (P = 0.032) by 0.2 mumol/min per mumol/min of AA infused. Additional extraction of alanine, glycine (both infused) and glutamine (not infused) by the liver was sufficient to account for most of the extra C required for glucose synthesis. The N that would be liberated from these glucogenic AA would also account for a large proportion of the increase in urea-N produced in response to the AA infusion. This supports the concept of a correlation between gluconeogenesis and ureagenesis. Furthermore, the amide-N liberated from the extracted glutamine would contribute up to 0.17 of hepatic NH3 flux and assist in balancing N inputs into the carbamoyl phosphate and arginosuccinate entry points of the ornithine cycle. Rates of fractional extraction of the various AA by the liver were best fitted by linear equations, indicating that even at the highest rates of administration (approximately twice maximal physiological absorption) the transport systems were not saturated. Hepatic fractional extractions of infused essential AA were highest for methionine (0.83) and phenylalanine (0.87) with the lowest proportion removed observed for valine (0.25), leucine (0.30), lysine (0.31) and isoleucine (0.49). For the non-essential AA, the highest apparent fractional extractions were for glycine (0.73), arginine (0.79) and tyrosine (0.63) followed by alanine (0.54), proline (0.47) and serine (0.37). Hepatic removal of AA-N exceeded the increase in urea-N formation such

  10. [Tibiotalocalcaneal arthrodesis using a retrograde nail locked in the sagittal plane].

    PubMed

    Veselý, R; Procházka, V; Visna, P; Valentová, J; Savolt, J

    2008-04-01

    To evaluate our experience with the use of a retrograde nail locked in the sagittal plane for tibiotalocalcaneal arthrodesis indicated in severe post-traumatic arthritis of the ankle. Twenty patients, 16 men and four women at an average age of 58.7 years (range, 23 to 72) were evaluated. All patients had severe post-traumatic changes in the talocrural and talocalcaneal joints. Five patients also had an equinus deformity. In two patients arthrodesis followed the treatment of purulent arthritis of the talocrural joint. A local fasciocutaneous flap was used for soft tissue reconstruction in three patients. All patients were operated on using the standard surgical technique. METHODS With the patient in a supine position, reamed by hand with the use of a driving rod, a straight retrograde AAN Orthofix nail was inserted through the heel bone and talus into the distal tibia and locked in these bones in the sagittal plane. No complications such as injury to the neurovascular plexus or pseudoarthrosis were recorded. Four patients showed a reaction to the proximal locking screw on the proximal tibial surface, which was treated by earlier screw removal under topical anaesthesia. Due to infectious complications, the nail had to be removed prematurely in one patient. The average Foot Function Index was 12 points (range, 10 to 15) and the average ankle-hindfoot score was 67.6 points (range, 59 to 84). Thirteen patients (65 %) were not limited in their daily activities or recreational sports, six (30 %) experienced pain in sports but not daily activities and one patient (5 %) reported pain even when walking. All fusions healed in the correct position within 18 weeks. Tibiotalocalcaneal arthrodesis is not a frequent surgical procedure in either trauma surgery or orthopaedics. For this complicated procedure, rather than intramedullary nails, internal fixation with screws or plates or external fixation are preferred. The high rate of bony healing can be explained by maintenance of

  11. The Detroit Young Adult Asthma Project: Proposal for a Multicomponent Technology Intervention for African American Emerging Adults With Asthma.

    PubMed

    MacDonell, Karen; Naar, Sylvie; Gibson-Scipio, Wanda; Bruzzese, Jean-Marie; Wang, Bo; Brody, Aaron

    2018-05-07

    complete a series of computer-delivered asthma education modules matched for length, location, and method of delivery of the intervention session. Control participants will also receive text messages between intervention sessions. Message content will be the same for all control participants and contain general facts about asthma (not tailored). It is hypothesized that youth randomized to multicomponent technology-based intervention will show improvements in medication adherence (primary outcome) and asthma control (secondary outcome) compared with comparison condition at all postintervention follow-ups (3, 6, 9, and 12 months). The proposed study was funded by NHLBI from September 1, 2016 through August 31, 2021. This project will test a brief, technology-based intervention specifically targeting adherence to asthma controller medications in an under-researched population, African American emerging adults. If successful, our multicomponent technology-based intervention aimed at improving adherence to asthma medications has the potential to improve quality of life of minority emerging adults with asthma at relatively low cost. It could eventually be integrated into clinical settings and practice to reach a large number of emerging adults with asthma. ClinicalTrials.gov NCT03121157; https://clinicaltrials.gov/ct2/show/NCT03121157 (Archived by WebCite at http://www.webcitation.org/6wq4yWHPv). ©Karen MacDonell, Sylvie Naar, Wanda Gibson-Scipio, Jean-Marie Bruzzese, Bo Wang, Aaron Brody. Originally published in JMIR Research Protocols (http://www.researchprotocols.org), 07.05.2018.

  12. Comparing offshore wind farm wake observed from satellite SAR and wake model results

    NASA Astrophysics Data System (ADS)

    Bay Hasager, Charlotte

    2014-05-01

    Offshore winds can be observed from satellite synthetic aperture radar (SAR). In the FP7 EERA DTOC project, the European Energy Research Alliance project on Design Tools for Offshore Wind Farm Clusters, there is focus on mid- to far-field wind farm wakes. The more wind farms are constructed nearby other wind farms, the more is the potential loss in annual energy production in all neighboring wind farms due to wind farm cluster effects. It is of course dependent upon the prevailing wind directions and wind speed levels, the distance between the wind farms, the wind turbine sizes and spacing. Some knowledge is available within wind farm arrays and in the near-field from various investigations. There are 58 offshore wind farms in the Northern European seas grid connected and in operation. Several of those are spaced near each other. There are several twin wind farms in operation including Nysted-1 and Rødsand-2 in the Baltic Sea, and Horns Rev 1 and Horns Rev 2, Egmond aan Zee and Prinses Amalia, and Thompton 1 and Thompton 2 all in the North Sea. There are ambitious plans of constructing numerous wind farms - great clusters of offshore wind farms. Current investigation of offshore wind farms includes mapping from high-resolution satellite SAR of several of the offshore wind farms in operation in the North Sea. Around 20 images with wind farm wake cases have been retrieved and processed. The data are from the Canadian RADARSAT-1/-2 satellites. These observe in microwave C-band and have been used for ocean surface wind retrieval during several years. The satellite wind maps are valid at 10 m above sea level. The wakes are identified in the raw images as darker areas downwind of the wind farms. In the SAR-based wind maps the wake deficit is found as areas of lower winds downwind of the wind farms compared to parallel undisturbed flow in the flow direction. The wind direction is clearly visible from lee effects and wind streaks in the images. The wind farm wake cases

  13. THE RELIABILITY OF HAND-WRITTEN AND COMPUTERISED RECORDS OF BIRTH DATA COLLECTED AT BARAGWANATH HOSPITAL IN SOWETO

    PubMed Central

    Ellison, GTH; Richter, LM; de Wet, T; Harris, HE; Griesel, RD; McIntyre, JA

    2007-01-01

    This study examined the reliability of hand-written and computerised records of birth data collected during the Birth to Ten study at Baragwanath Hospital in Soweto. The reliability of record-keeping in hand-written obstetric and neonatal files was assessed by comparing duplicate records of six different variables abstracted from six different sections in these files. The reliability of computerised record-keeping was assessed by comparing the original hand-written record of each variable with records contained in the hospital’s computerised database. These data sets displayed similar levels of reliability which suggests that similar errors occurred when data were transcribed from one section of the files to the next, and from these files to the computerised database. In both sets of records reliability was highest for the categorical variable infant sex, and for those continuous variables (such as maternal age and gravidity) recorded with unambiguous units. Reliability was lower for continuous variables that could be recorded with different levels of precision (such as birth weight), those that were occasionally measured more than once, and those that could be measured using more than one measurement technique (such as gestational age). Reducing the number of times records are transcribed, categorising continuous variables, and standardising the techniques used for measuring and recording variables would improve the reliability of both hand-written and computerised data sets. OPSOMMING In hierdie studie is die betroubaarheid van handgeskrewe en gerekenariseerde rekords van ge boortedata ondersoek, wat versamel is gedurende die ‘Birth to Ten’ -studie aan die Baragwanath hospitaal in Soweto. Die betroubaarheid van handgeskrewe verloskundige en pasgeboortelike rekords is beoordeel deur duplikaatrekords op ses verskillende verander likes te vergelyk, wat onttrek is uit ses verskillende dele van die betrokke lêers. Die gerekenariseerde rekords se betroubaarheid

  14. Effects of prayer on the vital signs of patients with chronic kidney disease: randomized controlled trial.

    PubMed

    Brasileiro, Thaila Oliveira Zatiti; Prado, Andressa Anunciação de Oliveira; Assis, Bianca Bacelar de; Nogueira, Denismar Alves; Lima, Rogério Silva; Chaves, Erika de Cassia Lopes

    2017-07-20

    diferentes, durantes semanas alternadas. Os dados qualitativos foram organizados e analisados por meio da Análise Temática. A amostra totalizou 95 voluntários randomizados.Na análiseintragruposfoi observada uma redução estatisticamente significativa (P<0001) dos valores de pressão arterial, frequência cardíaca e respiratória em todas as análises das pessoas que receberam a prece. Aanálise qualitativa resultou nos temasA Prece em um "Lugar de Sofrimento" e Avaliação Positiva e nos subtemas Alívio do Sofrimento, Esperança de Superação, Enfrentamento do Tratamento Hemodialítico. A prece reduziu os valores da pressão arterial, frequência cardíaca e respiratória de pacientes com insuficiência renal crônica e a avaliação dos voluntários em relação à intervenção foi positiva. Registro Brasileiro de Ensaios Clínicos: RBR-2zv39y.

  15. Interactions between surface water and ground water and effects on mercury transport in the north-central Everglades

    USGS Publications Warehouse

    Harvey, Judson W.; Krupa, Steven L.; Gefvert, Cynthia; Mooney, Robert H.; Choi, Jungyill; King, Susan A.; Giddings, Jefferson B.

    2002-01-01

    (ENR), a prototype project for the STAs that began operation in 1994. Determining the effect of ground water on the mercury balance of the ENR treatment wetland was an important additional objective. In order to broaden the relevance of conclusions to all parts of the north-central Everglades, interactions between surface water and ground water and mercury also were investigated in Water Conservation Area 2A (WCA-2A) and, to a lesser extent, in two other WCA basins, WCA-2B and WCA-3A.An important conclusion of this study is that creation of the WCA basins, and accompanying water-resources management, have appreciably increased both recharge and discharge in the north-central Everglades compared with pre-drainage conditions. Recharge and discharge are highest near the northern and northwestern edges of the Everglades, in the relatively small basins such as ENR and the STAs that share borders with both WCA-1 and the EAA. All basins experienced greater increases in recharge relative to discharge, because of the effects that land subsidence and ground-water pumping outside the Everglades had on hydraulic gradients. The highest basin-wide estimate of recharge was measured in ENR, where recharge averaged 0.9 centimeter per day (cm/d) over a 4-year study period. For perspective, that estimate of recharge is the equivalent of 30 percent of pumped surface-water inflows and 230 percent of average daily precipitation in ENR. Ground-water discharge was 10 times smaller than recharge at ENR. The present study estimated a basin-averaged recharge for WCA-2A (0.2 cm/d) that was a factor of 4 smaller than ENR. Although preliminary, that estimate of recharge is 5 times higher than previous estimates (approximately 0.04 cm/d), probably because the newer measurements were able to quantify recharge and discharge at finer spatial and temporal scales. Recharge at WCA-2A is smaller than ENR because WCA-2A has a smaller topographic gradient (3 x 10-5 and 2 x 10-4 in WCA-2A and ENR, respective

  16. Structures, bonding, and reaction chemistry of the neutral organogallium(I) compounds (GaAr)n(n = 1 or 2) (Ar = terphenyl or related ligand): an experimental investigation of Ga-Ga multiple bonding.

    PubMed

    Hardman, Ned J; Wright, Robert J; Phillips, Andrew D; Power, Philip P

    2003-03-05

    with sodium readily gave Na(2)[Ar*GaGaAr*] (13) and Na(2)(Ar'GaGaAr') (14). The former species 13 had been synthesized previously by reduction of GaAr*Cl(2) with sodium and was described as having a Ga-Ga triple bond because of the short Ga-Ga distance and the electronic relationship between [Ar*GaGaAr*](2-) and the corresponding neutral group 14 alkyne analogues. Compound 14 has a similar structure featuring a trans-bent CGaGaC core, bridged by sodiums which were also coordinated to the flanking aryl rings of the Ar' ligands. The Ga-Ga bond length was found to be 2.347(1) A, which is slightly (ca. 0.02 A) longer than that reported for 13. Reaction of Ga[N(Dipp)C(Me)](2)CH, 15 (i.e., GaN(wedge)NDipp(2)), which is sterically related to 1, 4, and 6, with Fe(CO)(5) yielded Dipp(2)N(wedge)NGaFe(CO)(4) (16), whose Ga-Fe bond is slightly longer than that observed in 11. Reaction of the less bulky LiAr"(Ar"= C(6)H(3)-2,6-Mes(2)) with "GaI" afforded the new paramagnetic cluster Ga(11)Ar(4)" (17). The ready dissociation of 1, 4, and 6 in solution, the long Ga-Ga distance in 6, and the chemistry of these compounds showed that the Ga-Ga bonds are significantly weaker than single bonds. The reduction of 1 and 6 with sodium to give 13 and 14 supplies two electrons to the di-gallium unit to generate a single bond (in addition to the weak interaction in the neutral precursor) with retention of the trans-bent geometry. It was concluded that the stability of 13 and 14 depends on the matching size of the sodium ion, and the presence of Na-Ga and Na-Ar interactions that stabilize their Na(2)Ga(2) core structures.