Sample records for accurately controlled routine

  1. Analysis of routine pilot-controller communication

    NASA Technical Reports Server (NTRS)

    Morrow, Daniel G.; Lee, Alfred; Rodvold, Michelle

    1990-01-01

    Although pilot-controller communication is central to aviation safety, this area of aviation human factors has not been extensively researched. Most research has focused on what kinds of communication problems occur. A more complete picture of communication problems requires understanding how communication usually works in routine operations. A sample of routine pilot-controller communication in the TRACON environment is described. After describing several dimensions of routine communication, three kinds of communication problems are treated: inaccuracies such as incorrect readbacks, procedural deviations such as missing callsigns and readbacks, and nonroutine transactions where pilot and controller must deal with misunderstandings or other communication problems. Preliminary results suggest these problems are not frequent events in daily operations. However, analysis of the problems that do occur suggest some factors that may cause them.

  2. Analysis of routine communication in the air traffic control system

    NASA Technical Reports Server (NTRS)

    Clark, Herbert H.; Morrow, Daniel; Rodvoid, Michelle

    1990-01-01

    The present project has three related goals. The first is to describe the organization of routine controller-pilot communication. This includes identifying the basic units of communication and how they are organized into discourse, how controllers and pilots use language to achieve their goals, and what topics they discuss. The second goal is to identify the type and frequency of problems that interrupt routine information transfer and prompt pilots and controllers to focus on the communication itself. The authors analyze the costs of these problems in terms of communication efficiency, and the techniques used to resolve these problems. Third, the authors hope to identify factors associated with communication problems, such as deviations from conventional air traffic control procedures.

  3. 40 CFR 63.2251 - What are the requirements for the routine control device maintenance exemption?

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... the routine control device maintenance exemption? (a) You may request a routine control device..., explain why the maintenance cannot be accomplished during process shutdowns, describe how you plan to make... device is used to control a green rotary dryer, tube dryer, rotary strand dryer, or pressurized refiner...

  4. [Accurate diagnosis of Pseudomonas luteola in routine microbiology laboratory: on the occasion of two isolates].

    PubMed

    Çiçek, Muharrem; Hasçelik, Gülşen; Müştak, H Kaan; Diker, K Serdar; Şener, Burçin

    2016-10-01

    Pseudomonas luteola which was previously known as Chryseomonas luteola; is a gram-negative, non-fermentative, aerobic, motile, non-spore-forming bacillus. It is frequently found as a saprophyte in soil, water and other damp environments and is an opportunistic pathogen in patients with underlying medical disorders or with indwelling catheters. It has been reported as an uncommon cause of bacteremia, sepsis, septic arthritis, meningitis, endocarditis, and peritonitis. Thus, early and accurate identification of this rare species is important for the treatment and also to provide information about the epidemiology of P.luteola infections. This report was aimed to draw attention to the accurate identification of P.luteola in clinical samples, upon the isolation and identification in two cases in the medical microbiology laboratory of a university hospital. In February 2011, a 66-year-old man, with chronic obstructive pulmonary disease, coronary artery disease and aplastic anemia, was admitted to our hospital due to progressive dyspnea. A chest tube was inserted on the 20th day of admission by the reason of recurrent pleural effusion. Staphylococcus aureus and a non-fermentative gram-negative bacillus (NFGNB) with wrinkled, sticky yellow colonies were isolated from the pleural fluid sample obtained on the 9th day following the insertion of the chest tube. In February 2012, a 7-year-old male cystic fibrosis patient who had no signs and symptoms of acute pulmonary exacerbation was admitted to the hospital for a routine control. This patient had chronic colonization with Pseudomonas aeruginosa and S.aureus and his sputum sample obtained at this visit revealed isolation of P.aeruginosa, S.aureus, Aspergillus fumigatus and a wrinkled, sticky yellow NFGNB. Both of these NFGNB were identified as P.luteola by the Phoenix automated microbial identification system (BD Diagnostics, USA). To evaluate the microbiological characteristics of these two isolates, the strains were

  5. Method for accurate growth of vertical-cavity surface-emitting lasers

    DOEpatents

    Chalmers, Scott A.; Killeen, Kevin P.; Lear, Kevin L.

    1995-01-01

    We report a method for accurate growth of vertical-cavity surface-emitting lasers (VCSELs). The method uses a single reflectivity spectrum measurement to determine the structure of the partially completed VCSEL at a critical point of growth. This information, along with the extracted growth rates, allows imprecisions in growth parameters to be compensated for during growth of the remaining structure, which can then be completed with very accurate critical dimensions. Using this method, we can now routinely grow lasing VCSELs with Fabry-Perot cavity resonance wavelengths controlled to within 0.5%.

  6. Method for accurate growth of vertical-cavity surface-emitting lasers

    DOEpatents

    Chalmers, S.A.; Killeen, K.P.; Lear, K.L.

    1995-03-14

    The authors report a method for accurate growth of vertical-cavity surface-emitting lasers (VCSELs). The method uses a single reflectivity spectrum measurement to determine the structure of the partially completed VCSEL at a critical point of growth. This information, along with the extracted growth rates, allows imprecisions in growth parameters to be compensated for during growth of the remaining structure, which can then be completed with very accurate critical dimensions. Using this method, they can now routinely grow lasing VCSELs with Fabry-Perot cavity resonance wavelengths controlled to within 0.5%. 4 figs.

  7. [Study on Accurately Controlling Discharge Energy Method Used in External Defibrillator].

    PubMed

    Song, Biao; Wang, Jianfei; Jin, Lian; Wu, Xiaomei

    2016-01-01

    This paper introduces a new method which controls discharge energy accurately. It is achieved by calculating target voltage based on transthoracic impedance and accurately controlling charging voltage and discharge pulse width. A new defibrillator is designed and programmed using this method. The test results show that this method is valid and applicable to all kinds of external defibrillators.

  8. An accurate reactive power control study in virtual flux droop control

    NASA Astrophysics Data System (ADS)

    Wang, Aimeng; Zhang, Jia

    2017-12-01

    This paper investigates the problem of reactive power sharing based on virtual flux droop method. Firstly, flux droop control method is derived, where complicated multiple feedback loops and parameter regulation are avoided. Then, the reasons for inaccurate reactive power sharing are theoretically analyzed. Further, a novel reactive power control scheme is proposed which consists of three parts: compensation control, voltage recovery control and flux droop control. Finally, the proposed reactive power control strategy is verified in a simplified microgrid model with two parallel DGs. The simulation results show that the proposed control scheme can achieve accurate reactive power sharing and zero deviation of voltage. Meanwhile, it has some advantages of simple control and excellent dynamic and static performance.

  9. Controlling Hay Fever Symptoms with Accurate Pollen Counts

    MedlinePlus

    ... counts Share | Controlling Hay Fever Symptoms with Accurate Pollen Counts Seasonal allergic rhinitis known as hay fever is ... hay fever symptoms, it is important to monitor pollen counts so you can limit your exposure on days ...

  10. Verification and quality control of routine hematology analyzers.

    PubMed

    Vis, J Y; Huisman, A

    2016-05-01

    Verification of hematology analyzers (automated blood cell counters) is mandatory before new hematology analyzers may be used in routine clinical care. The verification process consists of several items which comprise among others: precision, accuracy, comparability, carryover, background and linearity throughout the expected range of results. Yet, which standard should be met or which verification limit be used is at the discretion of the laboratory specialist. This paper offers practical guidance on verification and quality control of automated hematology analyzers and provides an expert opinion on the performance standard that should be met by the contemporary generation of hematology analyzers. Therefore (i) the state-of-the-art performance of hematology analyzers for complete blood count parameters is summarized, (ii) considerations, challenges, and pitfalls concerning the development of a verification plan are discussed, (iii) guidance is given regarding the establishment of reference intervals, and (iv) different methods on quality control of hematology analyzers are reviewed. © 2016 John Wiley & Sons Ltd.

  11. Accurately controlled sequential self-folding structures by polystyrene film

    NASA Astrophysics Data System (ADS)

    Deng, Dongping; Yang, Yang; Chen, Yong; Lan, Xing; Tice, Jesse

    2017-08-01

    Four-dimensional (4D) printing overcomes the traditional fabrication limitations by designing heterogeneous materials to enable the printed structures evolve over time (the fourth dimension) under external stimuli. Here, we present a simple 4D printing of self-folding structures that can be sequentially and accurately folded. When heated above their glass transition temperature pre-strained polystyrene films shrink along the XY plane. In our process silver ink traces printed on the film are used to provide heat stimuli by conducting current to trigger the self-folding behavior. The parameters affecting the folding process are studied and discussed. Sequential folding and accurately controlled folding angles are achieved by using printed ink traces and angle lock design. Theoretical analyses are done to guide the design of the folding processes. Programmable structures such as a lock and a three-dimensional antenna are achieved to test the feasibility and potential applications of this method. These self-folding structures change their shapes after fabrication under controlled stimuli (electric current) and have potential applications in the fields of electronics, consumer devices, and robotics. Our design and fabrication method provides an easy way by using silver ink printed on polystyrene films to 4D print self-folding structures for electrically induced sequential folding with angular control.

  12. An Accurate Transmitting Power Control Method in Wireless Communication Transceivers

    NASA Astrophysics Data System (ADS)

    Zhang, Naikang; Wen, Zhiping; Hou, Xunping; Bi, Bo

    2018-01-01

    Power control circuits are widely used in transceivers aiming at stabilizing the transmitted signal power to a specified value, thereby reducing power consumption and interference to other frequency bands. In order to overcome the shortcomings of traditional modes of power control, this paper proposes an accurate signal power detection method by multiplexing the receiver and realizes transmitting power control in the digital domain. The simulation results show that this novel digital power control approach has advantages of small delay, high precision and simplified design procedure. The proposed method is applicable to transceivers working at large frequency dynamic range, and has good engineering practicability.

  13. Routine Responses to Disruption of Routines

    ERIC Educational Resources Information Center

    Guha, Mahua

    2015-01-01

    "Organisational routines" is a widely studied research area. However, there is a dearth of research on disruption of routines. The few studies on disruption of routines discussed problem-solving activities that are carried out in response to disruption. In contrast, this study develops a theory of "solution routines" that are a…

  14. Unsupervised daily routine and activity discovery in smart homes.

    PubMed

    Jie Yin; Qing Zhang; Karunanithi, Mohan

    2015-08-01

    The ability to accurately recognize daily activities of residents is a core premise of smart homes to assist with remote health monitoring. Most of the existing methods rely on a supervised model trained from a preselected and manually labeled set of activities, which are often time-consuming and costly to obtain in practice. In contrast, this paper presents an unsupervised method for discovering daily routines and activities for smart home residents. Our proposed method first uses a Markov chain to model a resident's locomotion patterns at different times of day and discover clusters of daily routines at the macro level. For each routine cluster, it then drills down to further discover room-level activities at the micro level. The automatic identification of daily routines and activities is useful for understanding indicators of functional decline of elderly people and suggesting timely interventions.

  15. Incremental cost of implementing residual insecticide treatment with delthametrine on top of intensive routine Aedes aegypti control.

    PubMed

    Baly, Alberto; Gonzalez, Karelia; Cabrera, Pedro; Popa, Julio C; Toledo, Maria E; Hernandez, Claudia; Montada, Domingo; Vanlerberghe, Veerle; Van der Stuyft, Patrick

    2016-05-01

    Information on the cost of implementing residual insecticide treatment (RIT) for Aedes control is scarce. We evaluated the incremental cost on top of intensive conventional routine activities of the Aedes control programme (ACP) in the city of Santiago de Cuba, Cuba. We conducted the cost analysis study in 2011-2012, from the perspective of the ACP. Data sources were bookkeeping records, activity registers of the Provincial ACP Centre and the accounts of an RIT implementation study in 21 clusters of on average four house blocks comprising 5180 premises. The annual cost of the routine ACP activities was 19.66 US$ per household. RIT applications in rounds at 4-month intervals covering, on average, 97.2% and using 8.5 g of delthametrine annually per household, cost 3.06 US$ per household per year. Delthametrine comprised 66.5% of this cost; the additional cost for deploying RIT comprised 15.6% of the total ACP routine cost and 27% of the cost related to routine adult stage Aedes control. The incremental cost of implementing RIT is high. It should be weighed against the incremental effect on the burden caused by the array of pathogens transmitted by Aedes. The cost could be reduced if the insecticide became cheaper, by limiting the number of yearly applications or by targeting transmission hot spots. © 2016 John Wiley & Sons Ltd.

  16. Linear signal noise summer accurately determines and controls S/N ratio

    NASA Technical Reports Server (NTRS)

    Sundry, J. L.

    1966-01-01

    Linear signal noise summer precisely controls the relative power levels of signal and noise, and mixes them linearly in accurately known ratios. The S/N ratio accuracy and stability are greatly improved by this technique and are attained simultaneously.

  17. Using routinely recorded data in the UK to assess outcomes in a randomised controlled trial: The Trials of Access.

    PubMed

    Powell, G A; Bonnett, L J; Tudur-Smith, C; Hughes, D A; Williamson, P R; Marson, A G

    2017-08-23

    In the UK, routinely recorded data may benefit prospective studies including randomised controlled trials (RCTs). In an on-going study, we aim to assess the feasibility of access and agreement of routinely recorded clinical and non-clinical data compared to data collected during a RCT using standard prospective methods. This paper will summarise available UK routinely recorded data sources and discuss our experience with the feasibility of accessing routinely recorded data for participants of a RCT before finally proposing recommendations for improving the access and implementation of routinely recorded data in RCTs. Setting: the case study RCT is the Standard and New Antiepileptic Drugs II (SANAD II) trial, a pragmatic, UK, multicentre, phase IV RCT assessing the clinical and cost-effectiveness of antiepileptic drug treatments for newly diagnosed epilepsy. 98 participants have provided written consent to permit the request of routinely recorded data. Study procedures: routinely recorded clinical and non-clinical data were identified and data requested through formal applications from available data holders for the duration that participants have been recruited into SANAD II. The feasibility of accessing routinely recorded data during a RCT is assessed and recommendations for improving access proposed. Secondary-care clinical and socioeconomic data is recorded on a national basis and can be accessed, although there are limitations in the application process. Primary-care data are recorded by a number of organisations on a de-identified basis but access for specific individuals has not been feasible. Access to data recorded by non-clinical sources, including The Department for Work and Pensions and The Driving and Vehicle Licensing Agency, was not successful. Recommendations discussed include further research to assess the attributes of routinely recorded data, an assessment of public perceptions and the development of strategies to collaboratively improve access to

  18. Randomised controlled trial of routine individual feedback to improve rationality and reduce numbers of test requests.

    PubMed

    Winkens, R A; Pop, P; Bugter-Maessen, A M; Grol, R P; Kester, A D; Beusmans, G H; Knottnerus, J A

    1995-02-25

    Feedback can be described as a way to provide information on doctors' performance to enable changes in future behaviour. Feedback is used with the aim of changing test-ordering behaviour. It can lead to reductions in test usage and cost savings. It is not sufficiently clear, however, whether feedback leads to more appropriate test use. Since 1985, the Diagnostic Coordinating Center Maastricht has been giving feedback on diagnostic tests as a routine health care activity to all family doctors in its region. Both quantity and quality of requests are discussed. In a randomised, controlled trial over 2.5 years, discussion of tests not included previously was added to the existing routine feedback. One group of family doctors (n = 39) received feedback on test-group A (electrocardiography, endoscopy, cervical smears, and allergy tests), the other (n = 40) on test-group B (radiographic and ultrasonographic tests). Thus, each group of doctors acted as a control group for the other. Changes in volume and rationality of requests were analysed. The number of requests decreased during the trial (p = 0.036). Request numbers decreased particularly for test-group A (p = 0.04). The proportion of requests that were non-rational decreased more in the intervention than in the control groups (p = 0.009). Rationality improved predominantly for test-group B (p = 0.043). Thus, routine feedback can change the quantity and quality of requests.

  19. [Use of PubMed to improve evidence-based medicine in routine urological practice].

    PubMed

    Rink, M; Kluth, L A; Shariat, S F; Chun, F K; Fisch, M; Dahm, P

    2013-03-01

    Applying evidence-based medicine in daily clinical practice is the basis of patient-centered medicine and knowledge of accurate literature acquisition skills is necessary for informed clinical decision-making. PubMed is an easy accessible, free bibliographic database comprising over 21 million citations from the medical field, life-science journals and online books. The article summarizes the effective use of PubMed in routine urological clinical practice based on a common case scenario. This article explains the simple use of PubMed to obtain the best search results with the highest evidence. Accurate knowledge about the use of PubMed in routine clinical practice can improve evidence-based medicine and also patient treatment.

  20. Children Can Accurately Monitor and Control Their Number-Line Estimation Performance

    ERIC Educational Resources Information Center

    Wall, Jenna L.; Thompson, Clarissa A.; Dunlosky, John; Merriman, William E.

    2016-01-01

    Accurate monitoring and control are essential for effective self-regulated learning. These metacognitive abilities may be particularly important for developing math skills, such as when children are deciding whether a math task is difficult or whether they made a mistake on a particular item. The present experiments investigate children's ability…

  1. Making sense of the shadows: priorities for creating a learning healthcare system based on routinely collected data

    PubMed Central

    Deeny, Sarah R; Steventon, Adam

    2015-01-01

    Socrates described a group of people chained up inside a cave, who mistook shadows of objects on a wall for reality. This allegory comes to mind when considering ‘routinely collected data’—the massive data sets, generated as part of the routine operation of the modern healthcare service. There is keen interest in routine data and the seemingly comprehensive view of healthcare they offer, and we outline a number of examples in which they were used successfully, including the Birmingham OwnHealth study, in which routine data were used with matched control groups to assess the effect of telephone health coaching on hospital utilisation. Routine data differ from data collected primarily for the purposes of research, and this means that analysts cannot assume that they provide the full or accurate clinical picture, let alone a full description of the health of the population. We show that major methodological challenges in using routine data arise from the difficulty of understanding the gap between patient and their ‘data shadow’. Strategies to overcome this challenge include more extensive data linkage, developing analytical methods and collecting more data on a routine basis, including from the patient while away from the clinic. In addition, creating a learning health system will require greater alignment between the analysis and the decisions that will be taken; between analysts and people interested in quality improvement; and between the analysis undertaken and public attitudes regarding appropriate use of data. PMID:26065466

  2. Versatile IEEE-488 data acquisition and control routines for a diode array spectrophotometer

    PubMed Central

    Shiundu, Paul M.

    1991-01-01

    The UV-visible diode array spectrophotometer is a work-horse instrument for many laboratories. This article provides simple data acquisition and control routines in Microsoft QuickBasic for a HP-8452A diode array spectrophotometer interfaced to an IBM PC/XT/AT, or compatible, microcomputer. These allow capture of full spectra and measure absorbance at one or several wavelengths at preset time intervals. The variance in absorbance at each wavelength is available as an option. PMID:18924888

  3. GC-C-IRMS in routine doping control practice: 3 years of drug testing data, quality control and evolution of the method.

    PubMed

    Polet, Michael; Van Eenoo, Peter

    2015-06-01

    In order to detect the misuse of endogenous anabolic steroids, doping control laboratories require methods that allow differentiation between endogenous steroids and their synthetic copies. Gas chromatography combustion isotope ratio mass spectrometry (GC-C-IRMS) is capable of measuring the carbon isotope ratio of urinary steroids and this allows differentiation between both. GC-C-IRMS and its application to doping control has evolved a lot during the last decade and so have the World Anti-Doping Agency (WADA) technical documents that describe how GC-C-IRMS should be applied. Especially the WADA technical document of 2014 introduced a number of obligatory quality controls and a fixed methodology that should be used by all the doping control laboratories. This document imposed more uniform methods between the laboratories in order to decrease the interlaboratory standard deviation and acquire similar results for the analysis of the same urine samples. In this paper, 3 years of drug testing data of our GC-C-IRMS method in routine doping control practice is described, with an emphasis on the new WADA technical document and its implementation. Useful data for other doping control laboratories is presented focussing on general method setup, quality control and data collected from routine samples. The paper concentrates on how IRMS results shift or remain similar by switching to the 2014 WADA technical document and gives insight in a straightforward approach to calculate the measurement uncertainty.

  4. Implementation of a physically based water percolation routine in the Crocus/SURFEX (V7.3) snowpack model

    NASA Astrophysics Data System (ADS)

    D'Amboise, Christopher J. L.; Müller, Karsten; Oxarango, Laurent; Morin, Samuel; Schuler, Thomas V.

    2017-09-01

    We present a new water percolation routine added to the one-dimensional snowpack model Crocus as an alternative to the empirical bucket routine. This routine solves the Richards equation, which describes flow of water through unsaturated porous snow governed by capillary suction, gravity and hydraulic conductivity of the snow layers. We tested the Richards routine on two data sets, one recorded from an automatic weather station over the winter of 2013-2014 at Filefjell, Norway, and the other an idealized synthetic data set. Model results using the Richards routine generally lead to higher water contents in the snow layers. Snow layers often reached a point at which the ice crystals' surface area is completely covered by a thin film of water (the transition between pendular and funicular regimes), at which feedback from the snow metamorphism and compaction routines are expected to be nonlinear. With the synthetic simulation 18 % of snow layers obtained a saturation of > 10 % and 0.57 % of layers reached saturation of > 15 %. The Richards routine had a maximum liquid water content of 173.6 kg m-3 whereas the bucket routine had a maximum of 42.1 kg m-3. We found that wet-snow processes, such as wet-snow metamorphism and wet-snow compaction rates, are not accurately represented at higher water contents. These routines feed back on the Richards routines, which rely heavily on grain size and snow density. The parameter sets for the water retention curve and hydraulic conductivity of snow layers, which are used in the Richards routine, do not represent all the snow types that can be found in a natural snowpack. We show that the new routine has been implemented in the Crocus model, but due to feedback amplification and parameter uncertainties, meaningful applicability is limited. Updating or adapting other routines in Crocus, specifically the snow compaction routine and the grain metamorphism routine, is needed before Crocus can accurately simulate the snowpack using the

  5. Routine obstetric ultrasound examinations in South Africa: cost and effect on perinatal outcome--a prospective randomised controlled trial.

    PubMed

    Geerts, L T; Brand, E J; Theron, G B

    1996-06-01

    To compare routine midtrimester with selective obstetric ultrasonography concerning the Health Service cost and the effect on perinatal outcome. A randomised controlled trial. Urban area served by Tygerberg Hospital, a tertiary referral centre in South Africa. Pregnant patients without risk factors for congenital anomalies referred for ultrasonography between 18 and 24 weeks of gestation. Between 18 and 24 weeks, a level one ultrasound examination was performed on study patients only. Except for the routine scan, both groups received the same antenatal care and could be referred later for additional scans as judged by their clinicians. Overall adverse perinatal outcome and use of antenatal and neonatal services. The groups did not differ significantly in their use of antenatal and neonatal services except for a greater number of ultrasound scans in the study group. More suspected postdate pregnancies occurred in control patients, as well as more amniocenteses for confirmation of lung maturity. More babies of low birthweight were born in the study group. The incidence of overall or major adverse perinatal outcome was comparable. Routine ultrasonography was accompanied by a considerable increase in costs. Selective use of obstetric ultrasonography did not increase the use of antenatal and neonatal services. Not routinely performing ultrasonography has led to considerable Health Service savings without increasing the risk for adverse perinatal outcome. It saved 75% of selected patients a referral to an ultrasound unit. Specific problems related to inaccurate gestational age determination need to be addressed.

  6. Accurate fluid force measurement based on control surface integration

    NASA Astrophysics Data System (ADS)

    Lentink, David

    2018-01-01

    Nonintrusive 3D fluid force measurements are still challenging to conduct accurately for freely moving animals, vehicles, and deforming objects. Two techniques, 3D particle image velocimetry (PIV) and a new technique, the aerodynamic force platform (AFP), address this. Both rely on the control volume integral for momentum; whereas PIV requires numerical integration of flow fields, the AFP performs the integration mechanically based on rigid walls that form the control surface. The accuracy of both PIV and AFP measurements based on the control surface integration is thought to hinge on determining the unsteady body force associated with the acceleration of the volume of displaced fluid. Here, I introduce a set of non-dimensional error ratios to show which fluid and body parameters make the error negligible. The unsteady body force is insignificant in all conditions where the average density of the body is much greater than the density of the fluid, e.g., in gas. Whenever a strongly deforming body experiences significant buoyancy and acceleration, the error is significant. Remarkably, this error can be entirely corrected for with an exact factor provided that the body has a sufficiently homogenous density or acceleration distribution, which is common in liquids. The correction factor for omitting the unsteady body force, {{{ {ρ f}} {1 - {ρ f} ( {{ρ b}+{ρ f}} )}.{( {{{{ρ }}b}+{ρ f}} )}}} , depends only on the fluid, {ρ f}, and body, {{ρ }}b, density. Whereas these straightforward solutions work even at the liquid-gas interface in a significant number of cases, they do not work for generalized bodies undergoing buoyancy in combination with appreciable body density inhomogeneity, volume change (PIV), or volume rate-of-change (PIV and AFP). In these less common cases, the 3D body shape needs to be measured and resolved in time and space to estimate the unsteady body force. The analysis shows that accounting for the unsteady body force is straightforward to non

  7. Cost of intensive routine control and incremental cost of insecticide-treated curtain deployment in a setting with low Aedes aegypti infestation.

    PubMed

    Baly, Alberto; Toledo, Maria Eugenia; Lambert, Isora; Benítez, Elizabeth; Rodriguez, Karina; Rodriguez, Esther; Vanlerberghe, Veerle; Stuyft, Patrick Van der

    2016-01-01

    Information regarding the cost of implementing insecticide-treated curtains (ITCs) is scarce. Therefore, we evaluated the ITC implementation cost, in addition to the costs of intensive conventional routine activities of the Aedes control program in the city of Guantanamo, Cuba. A cost-analysis study was conducted from the perspective of the Aedes control program, nested in an ITC effectiveness trial, during 2009-2010. Data for this study were obtained from bookkeeping records and activity registers of the Provincial Aedes Control Programme Unit and the account records of the ITC trial. The annual cost of the routine Aedes control program activities was US$16.80 per household (p.h). Among 3,015 households, 6,714 ITCs were distributed. The total average cost per ITC distributed was US$3.42, and 74.3% of this cost was attributed to the cost of purchasing the ITCs. The annualized costs p.h. of ITC implementation was US$3.80. The additional annualized cost for deploying ITCs represented 19% and 48.4% of the total cost of the routine Aedes control and adult-stage Aedes control programs, respectively. The trial did not lead to further reductions in the already relatively low Aedes infestation levels. At current curtain prices, ITC deployment can hardly be considered an efficient option in Guantanamo and other comparable environments.

  8. PyVCI: A flexible open-source code for calculating accurate molecular infrared spectra

    NASA Astrophysics Data System (ADS)

    Sibaev, Marat; Crittenden, Deborah L.

    2016-06-01

    The PyVCI program package is a general purpose open-source code for simulating accurate molecular spectra, based upon force field expansions of the potential energy surface in normal mode coordinates. It includes harmonic normal coordinate analysis and vibrational configuration interaction (VCI) algorithms, implemented primarily in Python for accessibility but with time-consuming routines written in C. Coriolis coupling terms may be optionally included in the vibrational Hamiltonian. Non-negligible VCI matrix elements are stored in sparse matrix format to alleviate the diagonalization problem. CPU and memory requirements may be further controlled by algorithmic choices and/or numerical screening procedures, and recommended values are established by benchmarking using a test set of 44 molecules for which accurate analytical potential energy surfaces are available. Force fields in normal mode coordinates are obtained from the PyPES library of high quality analytical potential energy surfaces (to 6th order) or by numerical differentiation of analytic second derivatives generated using the GAMESS quantum chemical program package (to 4th order).

  9. SILHIL Replication of Electric Aircraft Powertrain Dynamics and Inner-Loop Control for V&V of System Health Management Routines

    NASA Technical Reports Server (NTRS)

    Bole, Brian; Teubert, Christopher Allen; Cuong Chi, Quach; Hogge, Edward; Vazquez, Sixto; Goebel, Kai; George, Vachtsevanos

    2013-01-01

    Software-in-the-loop and Hardware-in-the-loop testing of failure prognostics and decision making tools for aircraft systems will facilitate more comprehensive and cost-effective testing than what is practical to conduct with flight tests. A framework is described for the offline recreation of dynamic loads on simulated or physical aircraft powertrain components based on a real-time simulation of airframe dynamics running on a flight simulator, an inner-loop flight control policy executed by either an autopilot routine or a human pilot, and a supervisory fault management control policy. The creation of an offline framework for verifying and validating supervisory failure prognostics and decision making routines is described for the example of battery charge depletion failure scenarios onboard a prototype electric unmanned aerial vehicle.

  10. Lesson Unplanning: Toward Transforming Routine Tasks into Non-Routine Problems

    ERIC Educational Resources Information Center

    Beghetto, Ronald A.

    2017-01-01

    How might teachers transform routine tasks into non-routine ones? The purpose of this article is to address this question. The article opens with a discussion of why non-routine problems require creative and original thought. Specifically, I discuss how non-routine problems require students to confront uncertainty and how uncertainty can serve as…

  11. Making sense of the shadows: priorities for creating a learning healthcare system based on routinely collected data.

    PubMed

    Deeny, Sarah R; Steventon, Adam

    2015-08-01

    Socrates described a group of people chained up inside a cave, who mistook shadows of objects on a wall for reality. This allegory comes to mind when considering 'routinely collected data'-the massive data sets, generated as part of the routine operation of the modern healthcare service. There is keen interest in routine data and the seemingly comprehensive view of healthcare they offer, and we outline a number of examples in which they were used successfully, including the Birmingham OwnHealth study, in which routine data were used with matched control groups to assess the effect of telephone health coaching on hospital utilisation.Routine data differ from data collected primarily for the purposes of research, and this means that analysts cannot assume that they provide the full or accurate clinical picture, let alone a full description of the health of the population. We show that major methodological challenges in using routine data arise from the difficulty of understanding the gap between patient and their 'data shadow'. Strategies to overcome this challenge include more extensive data linkage, developing analytical methods and collecting more data on a routine basis, including from the patient while away from the clinic. In addition, creating a learning health system will require greater alignment between the analysis and the decisions that will be taken; between analysts and people interested in quality improvement; and between the analysis undertaken and public attitudes regarding appropriate use of data. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  12. A double-blind, randomized, placebo-controlled trial of misoprostol and routine uterotonics for the prevention of postpartum hemorrhage.

    PubMed

    Fawole, Adeniran O; Sotiloye, Oladapo S; Hunyinbo, Kehinde I; Umezulike, Augustine C; Okunlola, Michael A; Adekanle, Daniel A; Osamor, Jonathan; Adeyanju, Olusoji; Olowookere, Olufemi O; Adekunle, Adeyemi O; Singata, Mandisa; Mangesi, Lindeka; Hofmeyr, George J

    2011-02-01

    To assess the effects of 400-μg sublingual misoprostol plus routine uterotonics on postpartum hemorrhage. A double-blind, placebo-controlled, randomized study was performed. After delivery of the child, eligible women received routine uterotonics and were randomly allocated to receive 400-μg misoprostol or placebo sublingually. The primary outcome measure was blood loss of at least 500 mL within 1 hour of taking the trial tablets. In total, 672 women received misoprostol and 673 received placebo. The baseline data were similar for both groups. Misoprostol plus routine uterotonics reduced postpartum blood loss, but the effect was not significant for blood loss of at least 500 mL (relative risk [RR] 0.96; 95% confidence interval [CI], 0.63-1.45) or blood loss of at least 1000 mL (RR 0.50; 95% CI, 0.15-1.66). Misoprostol also reduced the need for non-routine oxytocin, manual removal of the placenta, and hysterectomy, but these differences were not significant either. Misoprostol was associated with pyrexia and moderate/severe shivering. There was no death in either group. Misoprostol plus routine uterotonics resulted in modest reductions of blood loss in the third stage of labor, but the effects did not reach statistical significance. Larger studies are recommended. Copyright © 2010 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.

  13. A new methodology for accurate 3-dimensional coronary artery reconstruction using routine intravascular ultrasound and angiographic data: implications for widespread assessment of endothelial shear stress in humans.

    PubMed

    Bourantas, Christos V; Papafaklis, Michail I; Athanasiou, Lambros; Kalatzis, Fanis G; Naka, Katerina K; Siogkas, Panagiotis K; Takahashi, Saeko; Saito, Shigeru; Fotiadis, Dimitrios I; Feldman, Charles L; Stone, Peter H; Michalis, Lampros K

    2013-09-01

    To develop and validate a new methodology that allows accurate 3-dimensional (3-D) coronary artery reconstruction using standard, simple angiographic and intravascular ultrasound (IVUS) data acquired during routine catheterisation enabling reliable assessment of the endothelial shear stress (ESS) distribution. Twenty-two patients (22 arteries: 7 LAD; 7 LCx; 8 RCA) who underwent angiography and IVUS examination were included. The acquired data were used for 3-D reconstruction using a conventional method and a new methodology that utilised the luminal 3-D centreline to place the detected IVUS borders and anatomical landmarks to estimate their orientation. The local ESS distribution was assessed by computational fluid dynamics. In corresponding consecutive 3 mm segments, lumen, plaque and ESS measurements in the 3-D models derived by the centreline approach were highly correlated to those derived from the conventional method (r>0.98 for all). The centreline methodology had a 99.5% diagnostic accuracy for identifying segments exposed to low ESS and provided similar estimations to the conventional method for the association between the change in plaque burden and ESS (centreline method: slope= -1.65%/Pa, p=0.078; conventional method: slope= -1.64%/Pa, p=0.084; p =0.69 for difference between the two methodologies). The centreline methodology provides geometrically correct models and permits reliable ESS computation. The ability to utilise data acquired during routine coronary angiography and IVUS examination will facilitate clinical investigation of the role of local ESS patterns in the natural history of coronary atherosclerosis.

  14. How Reliable is the Acetabular Cup Position Assessment from Routine Radiographs?

    PubMed Central

    Carvajal Alba, Jaime A.; Vincent, Heather K.; Sodhi, Jagdeep S.; Latta, Loren L.; Parvataneni, Hari K.

    2017-01-01

    Abstract Background: Cup position is crucial for optimal outcomes in total hip arthroplasty. Radiographic assessment of component position is routinely performed in the early postoperative period. Aims: The aims of this study were to determine in a controlled environment if routine radiographic methods accurately and reliably assess the acetabular cup position and to assess if there is a statistical difference related to the rater’s level of training. Methods: A pelvic model was mounted in a spatial frame. An acetabular cup was fixed in different degrees of version and inclination. Standardized radiographs were obtained. Ten observers including five fellowship-trained orthopaedic surgeons and five orthopaedic residents performed a blind assessment of cup position. Inclination was assessed from anteroposterior radiographs of the pelvis and version from cross-table lateral radiographs of the hip. Results: The radiographic methods used showed to be imprecise specially when the cup was positioned at the extremes of version and inclination. An excellent inter-observer reliability (Intra-class coefficient > 0,9) was evidenced. There were no differences related to the level of training of the raters. Conclusions: These widely used radiographic methods should be interpreted cautiously and computed tomography should be utilized in cases when further intervention is contemplated. PMID:28852355

  15. Developing everyday routines.

    PubMed

    McNamara, Paula; Humphry, Ruth

    2008-05-01

    This study obtains a deeper understanding of the processes supporting the formation of young children's routines in a child care classroom. Eight infants and toddlers and their teachers from two child care classrooms were observed for 4 to 6 months during periods of regularly occurring activities. Detailed, moment-to-moment descriptions of their behaviors and interactions were analyzed. Eleven processes supported the development of children's routines. Teachers structured and guided the children's experiences in learning routines, and children initiated requests to do routines. The study also identified three processes where children invited, coached, and modeled, supporting one another in learning routines. Finally, familiar objects used in routines elicited the children's engagement.

  16. Are routine pelvic radiographs in major pediatric blunt trauma necessary?

    PubMed

    Lagisetty, Jyothi; Slovis, Thomas; Thomas, Ronald; Knazik, Stephen; Stankovic, Curt

    2012-07-01

    Screening pelvic radiographs to rule out pelvic fractures are routinely used for the initial evaluation of pediatric blunt trauma. Recently, the utility of routine pelvic radiographs in certain subsets of patients with blunt trauma has been questioned. There is a growing amount of evidence that shows the clinical exam is reliable enough to obviate the need for routine screening pelvic radiographs in children. To identify variables that help predict the presence or absence of pelvic fractures in pediatric blunt trauma. We conducted a retrospective study from January 2005 to January 2010 using the trauma registry at a level 1 pediatric trauma center. We analyzed all level 1 and level 2 trauma victims, evaluating history, exam and mechanism of injury for association with the presence or absence of a pelvic fracture. Of 553 level 1 and 2 trauma patients who presented during the study period, 504 were included in the study. Most of these children, 486/504 (96.4%), showed no evidence of a pelvic fracture while 18/504 (3.6%) had a pelvic fracture. No factors were found to be predictive of a pelvic fracture. However, we developed a pelvic fracture screening tool that accurately rules out the presence of a pelvic fracture P = 0.008, NPV 99, sensitivity 96, 8.98 (1.52-52.8). This screening tool combines eight high-risk clinical findings (pelvic tenderness, laceration, ecchymosis, abrasion, GCS <14, positive urinalysis, abdominal pain/tenderness, femur fracture) and five high-risk mechanisms of injury (unrestrained motor vehicle collision [MVC], MVC with ejection, MVC rollover, auto vs. pedestrian, auto vs. bicycle). Pelvic fractures in pediatric major blunt trauma can reliably be ruled out by using our pelvic trauma screening tool. Although no findings accurately identified the presence of a pelvic fracture, the screening tool accurately identified the absence of a fracture, suggesting that pelvic radiographs are not warranted in this subset of patients.

  17. System for routine surface anthropometry using reprojection registration

    NASA Astrophysics Data System (ADS)

    Sadleir, R. J.; Owens, R. A.; Hartmann, P. E.

    2003-11-01

    Range data measurement can be usefully applied to non-invasive monitoring of anthropometric changes due to disease, healing or during normal physiological processes. We have developed a computer vision system that allows routine capture of biological surface shapes and accurate measurement of anthropometric changes, using a structured light stripe triangulation system. In many applications involving relocation of soft tissue for image-guided surgery or anthropometry it is neither accurate nor practical to apply fiducial markers directly to the body. This system features a novel method of achieving subject re-registration that involves application of fiducials by a standard data projector. Calibration of this reprojector is achieved using a variation of structured lighting techniques. The method allows accurate and comparable repositioning of elastic surfaces. Tests of repositioning using the reprojector found a significant improvement in subject registration compared to an earlier method which used video overlay comparison only. It has a current application to the measurement of breast volume changes in lactating mothers, but may be extended to any application where repeatable positioning and measurement is required.

  18. Abortion in late Imperial China: routine birth control or crisis intervention?

    PubMed

    Sommer, Matthew H

    2010-01-01

    In late imperial China, a number of purported methods of abortion were known; but who actually attempted abortion and under what circumstances? Some historians have suggested that abortion was used for routine birth control, which presupposes that known methods were safe, reliable, and readily available. This paper challenges the qualitative evidence on which those historians have relied, and presents new evidence from Qing legal sources and modern medical reports to argue that traditional methods of abortion (the most common being abortifacient drugs) were dangerous, unreliable, and often cost a great deal of money. Therefore, abortion in practice was an emergency intervention in a crisis: either a medical crisis, in which pregnancy threatened a woman's health, or a social crisis, in which pregnancy threatened to expose a woman's extramarital sexual relations. Moreover, abortion was not necessarily available even to women who wanted one.

  19. Hydrogen atoms can be located accurately and precisely by x-ray crystallography.

    PubMed

    Woińska, Magdalena; Grabowsky, Simon; Dominiak, Paulina M; Woźniak, Krzysztof; Jayatilaka, Dylan

    2016-05-01

    Precise and accurate structural information on hydrogen atoms is crucial to the study of energies of interactions important for crystal engineering, materials science, medicine, and pharmacy, and to the estimation of physical and chemical properties in solids. However, hydrogen atoms only scatter x-radiation weakly, so x-rays have not been used routinely to locate them accurately. Textbooks and teaching classes still emphasize that hydrogen atoms cannot be located with x-rays close to heavy elements; instead, neutron diffraction is needed. We show that, contrary to widespread expectation, hydrogen atoms can be located very accurately using x-ray diffraction, yielding bond lengths involving hydrogen atoms (A-H) that are in agreement with results from neutron diffraction mostly within a single standard deviation. The precision of the determination is also comparable between x-ray and neutron diffraction results. This has been achieved at resolutions as low as 0.8 Å using Hirshfeld atom refinement (HAR). We have applied HAR to 81 crystal structures of organic molecules and compared the A-H bond lengths with those from neutron measurements for A-H bonds sorted into bonds of the same class. We further show in a selection of inorganic compounds that hydrogen atoms can be located in bridging positions and close to heavy transition metals accurately and precisely. We anticipate that, in the future, conventional x-radiation sources at in-house diffractometers can be used routinely for locating hydrogen atoms in small molecules accurately instead of large-scale facilities such as spallation sources or nuclear reactors.

  20. Hydrogen atoms can be located accurately and precisely by x-ray crystallography

    PubMed Central

    Woińska, Magdalena; Grabowsky, Simon; Dominiak, Paulina M.; Woźniak, Krzysztof; Jayatilaka, Dylan

    2016-01-01

    Precise and accurate structural information on hydrogen atoms is crucial to the study of energies of interactions important for crystal engineering, materials science, medicine, and pharmacy, and to the estimation of physical and chemical properties in solids. However, hydrogen atoms only scatter x-radiation weakly, so x-rays have not been used routinely to locate them accurately. Textbooks and teaching classes still emphasize that hydrogen atoms cannot be located with x-rays close to heavy elements; instead, neutron diffraction is needed. We show that, contrary to widespread expectation, hydrogen atoms can be located very accurately using x-ray diffraction, yielding bond lengths involving hydrogen atoms (A–H) that are in agreement with results from neutron diffraction mostly within a single standard deviation. The precision of the determination is also comparable between x-ray and neutron diffraction results. This has been achieved at resolutions as low as 0.8 Å using Hirshfeld atom refinement (HAR). We have applied HAR to 81 crystal structures of organic molecules and compared the A–H bond lengths with those from neutron measurements for A–H bonds sorted into bonds of the same class. We further show in a selection of inorganic compounds that hydrogen atoms can be located in bridging positions and close to heavy transition metals accurately and precisely. We anticipate that, in the future, conventional x-radiation sources at in-house diffractometers can be used routinely for locating hydrogen atoms in small molecules accurately instead of large-scale facilities such as spallation sources or nuclear reactors. PMID:27386545

  1. Modular thermal analyzer routine, volume 1

    NASA Technical Reports Server (NTRS)

    Oren, J. A.; Phillips, M. A.; Williams, D. R.

    1972-01-01

    The Modular Thermal Analyzer Routine (MOTAR) is a general thermal analysis routine with strong capabilities for performing thermal analysis of systems containing flowing fluids, fluid system controls (valves, heat exchangers, etc.), life support systems, and thermal radiation situations. Its modular organization permits the analysis of a very wide range of thermal problems for simple problems containing a few conduction nodes to those containing complicated flow and radiation analysis with each problem type being analyzed with peak computational efficiency and maximum ease of use. The organization and programming methods applied to MOTAR achieved a high degree of computer utilization efficiency in terms of computer execution time and storage space required for a given problem. The computer time required to perform a given problem on MOTAR is approximately 40 to 50 percent that required for the currently existing widely used routines. The computer storage requirement for MOTAR is approximately 25 percent more than the most commonly used routines for the most simple problems but the data storage techniques for the more complicated options should save a considerable amount of space.

  2. Accurate Detection of Dysmorphic Nuclei Using Dynamic Programming and Supervised Classification.

    PubMed

    Verschuuren, Marlies; De Vylder, Jonas; Catrysse, Hannes; Robijns, Joke; Philips, Wilfried; De Vos, Winnok H

    2017-01-01

    A vast array of pathologies is typified by the presence of nuclei with an abnormal morphology. Dysmorphic nuclear phenotypes feature dramatic size changes or foldings, but also entail much subtler deviations such as nuclear protrusions called blebs. Due to their unpredictable size, shape and intensity, dysmorphic nuclei are often not accurately detected in standard image analysis routines. To enable accurate detection of dysmorphic nuclei in confocal and widefield fluorescence microscopy images, we have developed an automated segmentation algorithm, called Blebbed Nuclei Detector (BleND), which relies on two-pass thresholding for initial nuclear contour detection, and an optimal path finding algorithm, based on dynamic programming, for refining these contours. Using a robust error metric, we show that our method matches manual segmentation in terms of precision and outperforms state-of-the-art nuclear segmentation methods. Its high performance allowed for building and integrating a robust classifier that recognizes dysmorphic nuclei with an accuracy above 95%. The combined segmentation-classification routine is bound to facilitate nucleus-based diagnostics and enable real-time recognition of dysmorphic nuclei in intelligent microscopy workflows.

  3. Accurate Detection of Dysmorphic Nuclei Using Dynamic Programming and Supervised Classification

    PubMed Central

    Verschuuren, Marlies; De Vylder, Jonas; Catrysse, Hannes; Robijns, Joke; Philips, Wilfried

    2017-01-01

    A vast array of pathologies is typified by the presence of nuclei with an abnormal morphology. Dysmorphic nuclear phenotypes feature dramatic size changes or foldings, but also entail much subtler deviations such as nuclear protrusions called blebs. Due to their unpredictable size, shape and intensity, dysmorphic nuclei are often not accurately detected in standard image analysis routines. To enable accurate detection of dysmorphic nuclei in confocal and widefield fluorescence microscopy images, we have developed an automated segmentation algorithm, called Blebbed Nuclei Detector (BleND), which relies on two-pass thresholding for initial nuclear contour detection, and an optimal path finding algorithm, based on dynamic programming, for refining these contours. Using a robust error metric, we show that our method matches manual segmentation in terms of precision and outperforms state-of-the-art nuclear segmentation methods. Its high performance allowed for building and integrating a robust classifier that recognizes dysmorphic nuclei with an accuracy above 95%. The combined segmentation-classification routine is bound to facilitate nucleus-based diagnostics and enable real-time recognition of dysmorphic nuclei in intelligent microscopy workflows. PMID:28125723

  4. Assessing the structure of non-routine decision processes in Airline Operations Control.

    PubMed

    Richters, Floor; Schraagen, Jan Maarten; Heerkens, Hans

    2016-03-01

    Unfamiliar severe disruptions challenge Airline Operations Control professionals most, as their expertise is stretched to its limits. This study has elicited the structure of Airline Operations Control professionals' decision process during unfamiliar disruptions by mapping three macrocognitive activities on the decision ladder: sensemaking, option evaluation and action planning. The relationship between this structure and decision quality was measured. A simulated task was staged, based on which think-aloud protocols were obtained. Results show that the general decision process structure resembles the structure of experts working under routine conditions, in terms of the general structure of the macrocognitive activities, and the rule-based approach used to identify options and actions. Surprisingly, high quality of decision outcomes was found to relate to the use of rule-based strategies. This implies that successful professionals are capable of dealing with unfamiliar problems by reframing them into familiar ones, rather than to engage in knowledge-based processing. Practitioner Summary: We examined the macrocognitive structure of Airline Operations Control professionals' decision process during a simulated unfamiliar disruption in relation to decision quality. Results suggest that successful professionals are capable of dealing with unfamiliar problems by reframing them into familiar ones, rather than to engage in knowledge-based processing.

  5. Effects of structured testing versus routine testing of blood glucose in diabetes self-management: A randomized controlled trial.

    PubMed

    Nishimura, Akiko; Harashima, Shin-Ichi; Fujita, Yoshihito; Tanaka, Daisuke; Wang, Yu; Liu, Yanyan; Inagaki, Nobuya

    2017-01-01

    To compare the effects of structured and routine testing regimens used in self-monitoring of blood glucose (SMBG) on glycemic control and diabetes self-management in insulin-naïve type 2 diabetes patients. Sixty-two outpatients with insulin-naïve type 2 diabetes were randomly allocated into two less-frequent SMBG usage groups: a structured testing group (STG) and a routine testing group (RTG). Subjects in STG measured 7-points on SMBG for 3 consecutive days once every two months without daily testing; subjects in RTG measured SMBG 3 times each week before breakfast on Monday and Friday and before dinner on Wednesday. The primary endpoint was HbA1c reduction. The secondary endpoints were change in body weight, blood pressure, treatment change, and self-management performance change. HbA1c levels were significantly decreased by 0.32% (3.50mmol/mol) in STG, partly because physicians changed medications more actively. In contrast, body weight and systolic/diastolic blood pressure were significantly reduced by 0.94kg and 6.8/4.7mmHg, respectively, in RTG, possibly related to the increased diet and exercise score in RTG. Structured testing without daily testing is beneficial for glycemic control; routine testing 3 times a week is more helpful for daily self-management. In low SMBG frequency usage, these two regimens can be utilized according to individual diabetic conditions. Copyright © 2017 Elsevier Inc. All rights reserved.

  6. The cost of routine Aedes aegypti control and of insecticide-treated curtain implementation.

    PubMed

    Baly, Alberto; Flessa, Steffen; Cote, Marilys; Thiramanus, Thirapong; Vanlerberghe, Veerle; Villegas, Elci; Jirarojwatana, Somchai; Van der Stuyft, Patrick

    2011-05-01

    Insecticide-treated curtains (ITCs) are promoted for controlling the Dengue vector Aedes aegypti. We assessed the cost of the routine Aedes control program (RACP) and the cost of ITC implementation through the RACP and health committees in Venezuela and through health volunteers in Thailand. The yearly cost of the RACP per household amounted to US$2.14 and $1.89, respectively. The ITC implementation cost over three times more, depending on the channel used. In Venezuela the RACP was the most efficient implementation-channel. It spent US$1.90 (95% confidence interval [CI]: 1.83; 1.97) per curtain distributed, of which 76.9% for the curtain itself. Implementation by health committees cost significantly (P = 0.02) more: US$2.32 (95% CI: 1.93; 2.61) of which 63% for the curtain. For ITC implementation to be at least as cost-effective as the RACP, at equal effectiveness and actual ITC prices, the attained curtain coverage and the adulticiding effect should last for 3 years.

  7. Children's behavioral pain reactions during local anesthetic injection using cotton-roll vibration method compared with routine topical anesthesia: A randomized controlled trial.

    PubMed

    Bagherian, Ali; Sheikhfathollahi, Mahmood

    2016-01-01

    Topical anesthesia has been widely advocated as an important component of atraumatic administration of intraoral local anesthesia. The aim of this study was to use direct observation of children's behavioral pain reactions during local anesthetic injection using cotton-roll vibration method compared with routine topical anesthesia. Forty-eight children participated in this randomized controlled clinical trial. They received two separate inferior alveolar nerve block or primary maxillary molar infiltration injections on contralateral sides of the jaws by both cotton-roll vibration (a combination of topical anesthesia gel, cotton roll, and vibration for physical distraction) and control (routine topical anesthesia) methods. Behavioral pain reactions of children were measured according to the author-developed face, head, foot, hand, trunk, and cry (FHFHTC) scale, resulting in total scores between 0 and 18. The total scores on the FHFHTC scale ranged between 0-5 and 0-10 in the cotton-roll vibration and control methods, respectively. The mean ± standard deviation values of total scores on FHFHTC scale were lower in the cotton-roll vibration method (1.21 ± 1.38) than in control method (2.44 ± 2.18), and this was statistically significant (P < 0.001). It may be concluded that the cotton-roll vibration method can be more helpful than the routine topical anesthesia in reducing behavioral pain reactions in children during local anesthesia administration.

  8. [Pharmacogenomics in routine medical care].

    PubMed

    Rosskopf, D; Meyer zu Schwabedissen, H E; Kroemer, H K; Siegmund, W

    2010-01-01

    Pharmacogenomics investigates inherited differences in drug responses including beneficial and adverse reactions. While a considerable amount of evidence for genetic influences on drug responses has been accumulated within the last decade, predominantly in small studies, its value in routine therapy is still a matter of debate. The aim of this review is to discuss well established examples where pharmacogenomic techniques can improve routine treatment. Examples include genotyping of CYP2D6 in the context of antidepressant therapy, analysis of TPMT variants for the prediction of mercaptopurine-induced bone marrow depression, VKORC1 and CYP2C9 analyses for a better control of anticoagulant administration and the SLCO1B1 variant in the context of statin-induced myopathies. Georg Thieme Verlag KG Stuttgart.New York.

  9. Maintaining routine despite ongoing exposure to terrorism: a healthy strategy for adolescents?

    PubMed

    Pat-Horenczyk, Ruth; Schiff, Miriam; Doppelt, Osnat

    2006-08-01

    To examine the association between ongoing terrorism and Israeli adolescents' routine activities. A total of 1336 junior high and high school students from Jerusalem (46.9% boys and 53.1% girls) self-reported on measures of maintaining or reducing their level of routine activities, perceived parental monitoring, posttraumatic symptoms (PTS) and functional impairment. We used linear regressions to explore possible associations between decreasing (or maintaining) level of routine activities, parental monitoring, and PTS and functional impairment. A majority of the adolescents reported that under the recurrent threat of terrorism they maintained their routine (i.e., 65.8% continued using public transportation). Similarly, more than half the students perceived their parents as encouraging them to maintain their routine activities. Furthermore, greater exposure to terrorism was associated with more PTS symptoms and functional impairment. Nonetheless, a reduced level of routine activities was a significant predictor for higher PTS and functional impairment, even after controlling for level of exposure to terrorism, gender and age. Similarly, perceived parental limiting of routine activities was a significant predictor for higher PTS and functional impairment, even after controlling for gender, age and the level of exposure to terrorism. Our results support practitioners' recommendations to encourage continuity in daily routine. Disruption of routine activities may result in the development of avoidance reactions that can lead to posttraumatic stress disorder.

  10. Emotional eating and routine restraint scores are associated with activity in brain regions involved in urge and self-control.

    PubMed

    Wood, Samantha M W; Schembre, Susan M; He, Qinghua; Engelmann, Jeffrey M; Ames, Susan L; Bechara, Antoine

    2016-10-15

    Researchers have proposed a variety of behavioral traits that may lead to weight gain and obesity; however, little is known about the neurocognitive mechanisms underlying these weight-related eating behaviors. In this study, we measured activation of reward circuitry during a task requiring response and inhibition to food stimuli. We assessed participants' emotional eating, external eating, and two subscales of dietary restraint-routine restraint and compensatory restraint-using the Weight-Related Eating Questionnaire. For routine restraint, we found positive associations with activation in the insula, dorsolateral prefrontal cortex, anterior cingulate cortex, orbitofrontal cortex and ventromedial prefrontal cortex in response to high-calorie versus low-calorie foods. For emotional eating, we found positive associations with insula and dorsolateral prefrontal cortex activation in response to high-calorie versus low-calorie foods. We also found positive associations between emotional eating and dorsolateral prefrontal cortex activation in response to approach versus inhibition towards high-calorie foods. Thus, our results demonstrate an increase in activation across brain regions related to self-control and urges in response to high-calorie food associated with both emotional eating and routine restraint. Overall, these results support the construct validity of both emotional eating and routine restraint and provide preliminary evidence that these subscales have similar neural correlates. Copyright © 2016 Elsevier Inc. All rights reserved.

  11. The Cost of Routine Aedes aegypti Control and of Insecticide-Treated Curtain Implementation

    PubMed Central

    Baly, Alberto; Flessa, Steffen; Cote, Marilys; Thiramanus, Thirapong; Vanlerberghe, Veerle; Villegas, Elci; Jirarojwatana, Somchai; Van der Stuyft, Patrick

    2011-01-01

    Insecticide-treated curtains (ITCs) are promoted for controlling the Dengue vector Aedes aegypti. We assessed the cost of the routine Aedes control program (RACP) and the cost of ITC implementation through the RACP and health committees in Venezuela and through health volunteers in Thailand. The yearly cost of the RACP per household amounted to US$2.14 and $1.89, respectively. The ITC implementation cost over three times more, depending on the channel used. In Venezuela the RACP was the most efficient implementation-channel. It spent US$1.90 (95% confidence interval [CI]: 1.83; 1.97) per curtain distributed, of which 76.9% for the curtain itself. Implementation by health committees cost significantly (P = 0.02) more: US$2.32 (95% CI: 1.93; 2.61) of which 63% for the curtain. For ITC implementation to be at least as cost-effective as the RACP, at equal effectiveness and actual ITC prices, the attained curtain coverage and the adulticiding effect should last for 3 years. PMID:21540384

  12. Accurate core position control in polymer optical waveguides using the Mosquito method for three-dimensional optical wiring

    NASA Astrophysics Data System (ADS)

    Date, Kumi; Ishigure, Takaaki

    2017-02-01

    Polymer optical waveguides with graded-index (GI) circular cores are fabricated using the Mosquito method, in which the positions of parallel cores are accurately controlled. Such an accurate arrangement is of great importance for a high optical coupling efficiency with other optical components such as fiber ribbons. In the Mosquito method that we developed, a core monomer with a viscous liquid state is dispensed into another liquid state monomer for cladding via a syringe needle. Hence, the core positions are likely to shift during or after the dispensing process due to several factors. We investigate the factors, specifically affecting the core height. When the core and cladding monomers are selected appropriately, the effect of the gravity could be negligible, so the core height is maintained uniform, resulting in accurate core heights. The height variance is controlled in +/-2 micrometers for the 12 cores. Meanwhile, larger shift in the core height is observed when the needle-tip position is apart from the substrate surface. One of the possible reasons of the needle-tip height dependence is the asymmetric volume contraction during the monomer curing. We find a linear relationship between the original needle-tip height and the core-height observed. This relationship is implemented in the needle-scan program to stabilize the core height in different layers. Finally, the core heights are accurately controlled even if the cores are aligned on various heights. These results indicate that the Mosquito method enables to fabricate waveguides in which the cores are 3-dimensionally aligned with a high position accuracy.

  13. Challenges in Routine Implementation and Quality Control of Rapid Diagnostic Tests for Malaria–Rufiji District, Tanzania

    PubMed Central

    McMorrow, Meredith L.; Masanja, M. Irene; Abdulla, Salim M. K.; Kahigwa, Elizeus; Kachur, S. Patrick

    2018-01-01

    Rapid diagnostic tests (RDTs) represent an alternative to microscopy for malaria diagnosis and have shown high sensitivity and specificity in a variety of study settings. Current World Health Organization (WHO) guidelines for quality control of RDTs provide detailed instructions on pre-field testing, but offer little guidance for quality assurance once RDTs are deployed in health facilities. From September 2006 to April 2007, we introduced a histidine-rich protein II (HRP2)-based RDT (Paracheck) for suspected malaria cases five years of age and older in nine health facilities in Rufiji District, Tanzania, to assess sensitivity and specificity of RDTs in routine use at rural health facilities. Thick blood smears were collected for all patients tested with RDTs and stained and read by laboratory personnel in each facility. Thick smears were subsequently reviewed by a reference microscopist to determine RDT sensitivity and specificity. In all nine health facilities, there were significant problems with the quality of staining and microscopy. Sensitivity and specificity of RDTs were difficult to assess given the poor quality of routine blood smear staining. Mean operational sensitivity of RDTs based on reference microscopy was 64.8%, but varied greatly by health facility, range 18.8–85.9%. Sensitivity of RDTs increased with increasing parasite density. Specificity remained high at 87.8% despite relatively poor slide quality. Institution of quality control of RDTs based on poor quality blood smear staining may impede reliable measurement of sensitivity and specificity and undermine confidence in the new diagnostic. There is an urgent need for the development of alternative quality control procedures for rapid diagnostic tests that can be performed at the facility level. PMID:18784230

  14. A routine quality assurance test for CT automatic exposure control systems.

    PubMed

    Iball, Gareth R; Moore, Alexis C; Crawford, Elizabeth J

    2016-07-08

    The study purpose was to develop and validate a quality assurance test for CT automatic exposure control (AEC) systems based on a set of nested polymethylmethacrylate CTDI phantoms. The test phantom was created by offsetting the 16 cm head phantom within the 32 cm body annulus, thus creating a three part phantom. This was scanned at all acceptance, routine, and some nonroutine quality assurance visits over a period of 45 months, resulting in 115 separate AEC tests on scanners from four manufacturers. For each scan the longitudinal mA modulation pattern was generated and measurements of image noise were made in two annular regions of interest. The scanner displayed CTDIvol and DLP were also recorded. The impact of a range of AEC configurations on dose and image quality were assessed at acceptance testing. For systems that were tested more than once, the percentage of CTDIvol values exceeding 5%, 10%, and 15% deviation from baseline was 23.4%, 12.6%, and 8.1% respectively. Similarly, for the image noise data, deviations greater than 2%, 5%, and 10% from baseline were 26.5%, 5.9%, and 2%, respectively. The majority of CTDIvol and noise deviations greater than 15% and 5%, respectively, could be explained by incorrect phantom setup or protocol selection. Barring these results, CTDIvol deviations of greater than 15% from baseline were found in 0.9% of tests and noise deviations greater than 5% from baseline were found in 1% of tests. The phantom was shown to be sensitive to changes in AEC setup, including the use of 3D, longitudinal or rotational tube current modulation. This test methodology allows for continuing performance assessment of CT AEC systems, and we recommend that this test should become part of routine CT quality assurance programs. Tolerances of ± 15% for CTDIvol and ± 5% for image noise relative to baseline values should be used. © 2016 The Authors

  15. An Accurately Controlled Antagonistic Shape Memory Alloy Actuator with Self-Sensing

    PubMed Central

    Wang, Tian-Miao; Shi, Zhen-Yun; Liu, Da; Ma, Chen; Zhang, Zhen-Hua

    2012-01-01

    With the progress of miniaturization, shape memory alloy (SMA) actuators exhibit high energy density, self-sensing ability and ease of fabrication, which make them well suited for practical applications. This paper presents a self-sensing controlled actuator drive that was designed using antagonistic pairs of SMA wires. Under a certain pre-strain and duty cycle, the stress between two wires becomes constant. Meanwhile, the strain to resistance curve can minimize the hysteresis gap between the heating and the cooling paths. The curves of both wires are then modeled by fitting polynomials such that the measured resistance can be used directly to determine the difference between the testing values and the target strain. The hysteresis model of strains to duty cycle difference has been used as compensation. Accurate control is demonstrated through step response and sinusoidal tracking. The experimental results show that, under a combination control program, the root-mean-square error can be reduced to 1.093%. The limited bandwidth of the frequency is estimated to be 0.15 Hz. Two sets of instruments with three degrees of freedom are illustrated to show how this type actuator could be potentially implemented. PMID:22969368

  16. Validity of Computer Adaptive Tests of Daily Routines for Youth with Spinal Cord Injury

    PubMed Central

    Haley, Stephen M.

    2013-01-01

    Objective: To evaluate the accuracy of computer adaptive tests (CATs) of daily routines for child- and parent-reported outcomes following pediatric spinal cord injury (SCI) and to evaluate the validity of the scales. Methods: One hundred ninety-six daily routine items were administered to 381 youths and 322 parents. Pearson correlations, intraclass correlation coefficients (ICC), and 95% confidence intervals (CI) were calculated to evaluate the accuracy of simulated 5-item, 10-item, and 15-item CATs against the full-item banks and to evaluate concurrent validity. Independent samples t tests and analysis of variance were used to evaluate the ability of the daily routine scales to discriminate between children with tetraplegia and paraplegia and among 5 motor groups. Results: ICC and 95% CI demonstrated that simulated 5-, 10-, and 15-item CATs accurately represented the full-item banks for both child- and parent-report scales. The daily routine scales demonstrated discriminative validity, except between 2 motor groups of children with paraplegia. Concurrent validity of the daily routine scales was demonstrated through significant relationships with the FIM scores. Conclusion: Child- and parent-reported outcomes of daily routines can be obtained using CATs with the same relative precision of a full-item bank. Five-item, 10-item, and 15-item CATs have discriminative and concurrent validity. PMID:23671380

  17. One year of campaigns in Cameroon: effects on routine health services

    PubMed Central

    Mounier-Jack, Sandra; Edengue, Jean Marie; Lagarde, Mylene; Baonga, Simon Franky; Ongolo-Zogo, Pierre

    2016-01-01

    Background: Targeted campaigns have been reported to disrupt routine health services in low- and middle-income countries. The objective of this study was to evaluate the average effect of public health campaigns over 1 year on routine services such as antenatal care, routine vaccination and outpatient services. Method: We collected daily activity data in 60 health facilities in two regions of Cameroon that traditionally undergo different intensities of campaign activity, the Centre region (low) and the Far North (high), to ascertain effects on routine services. For each outcome, we restricted our analysis to the public health centres for which good data were available and excluded private health facilities given their small number. We used segment-linear regression to account for the longitudinal nature of the data, and assessed whether the number of routine activities decreased in health facilities during periods when campaigns occurred. The analysis controlled for secular trends and serial correlation. Results: We found evidence that vaccination campaigns had a negative impact on routine activities, decreasing outpatient visits when they occurred (Centre: −9.9%, P = 0.079; Far North: −11.6%, P = 0.025). The average negative effect on routine services [outpatient visits −18% (P = 0.02) and antenatal consultations −70% [P = 0.001]) was most pronounced in the Far North during ‘intensive’ campaigns that usually require high mobilization of staff. Discussion: With an increasing number of interventions delivered by campaigns and in the context of elimination and eradication targets, these are important results for countries and agencies to consider. Achieving disease control targets hinges on ensuring high uptake of routine services. Therefore, we suggest that campaigns should systematically monitor ‘impact on routine services’, while also devising concrete strategies to mitigate potential adverse effects. PMID:27175031

  18. The statistical analysis of circadian phase and amplitude in constant-routine core-temperature data

    NASA Technical Reports Server (NTRS)

    Brown, E. N.; Czeisler, C. A.

    1992-01-01

    Accurate estimation of the phases and amplitude of the endogenous circadian pacemaker from constant-routine core-temperature series is crucial for making inferences about the properties of the human biological clock from data collected under this protocol. This paper presents a set of statistical methods based on a harmonic-regression-plus-correlated-noise model for estimating the phases and the amplitude of the endogenous circadian pacemaker from constant-routine core-temperature data. The methods include a Bayesian Monte Carlo procedure for computing the uncertainty in these circadian functions. We illustrate the techniques with a detailed study of a single subject's core-temperature series and describe their relationship to other statistical methods for circadian data analysis. In our laboratory, these methods have been successfully used to analyze more than 300 constant routines and provide a highly reliable means of extracting phase and amplitude information from core-temperature data.

  19. Healthy Habits, Happy Homes: methods and baseline data of a randomized controlled trial to improve household routines for obesity prevention.

    PubMed

    Taveras, Elsie M; McDonald, Julia; O'Brien, Ashley; Haines, Jess; Sherry, Bettylou; Bottino, Clement J; Troncoso, Karen; Schmidt, Marie Evans; Koziol, Renata

    2012-11-01

    To develop a home-based intervention for parents of 2-5 year old children to promote household routines to prevent overweight/obesity. We recruited 121 children from health centers in Boston between 2011 and 2012 and randomized 62 to intervention and 59 to the control condition. The 6-month intervention included 1) motivational coaching at home and by phone with a health educator, 2) mailed educational materials, and 3) weekly text messages. The intervention promoted three household routines: eating meals as a family, obtaining adequate sleep, and limiting screen time. Of the 121 children, mean (SD) age was 4.0 (1.1) years; 52% were Hispanic, 34% Black, and 14% White/Other. Nearly 60% of the sample had annual household incomes ≤ $20,000. Approximately 64% of families reported eating together ≥ 7 times per week, however, many meals were eaten in front of a TV. Over half of the children slept less than the recommended 11h/night and 78% viewed ≥ 2 h/day of screen time. Household routines that increase obesity risk were prevalent among low-income families in this study. If proven to be effective, promotion of household routines related to family meals, sleep, and screen time may prevent young children from becoming overweight/obese. Copyright © 2012 Elsevier Inc. All rights reserved.

  20. Routine versus aggressive upstream rhythm control for prevention of early atrial fibrillation in heart failure: background, aims and design of the RACE 3 study.

    PubMed

    Alings, M; Smit, M D; Moes, M L; Crijns, H J G M; Tijssen, J G P; Brügemann, J; Hillege, H L; Lane, D A; Lip, G Y H; Smeets, J R L M; Tieleman, R G; Tukkie, R; Willems, F F; Vermond, R A; Van Veldhuisen, D J; Van Gelder, I C

    2013-07-01

    Rhythm control for atrial fibrillation (AF) is cumbersome because of its progressive nature caused by structural remodelling. Upstream therapy refers to therapeutic interventions aiming to modify the atrial substrate, leading to prevention of AF. The Routine versus Aggressive upstream rhythm Control for prevention of Early AF in heart failure (RACE 3) study hypothesises that aggressive upstream rhythm control increases persistence of sinus rhythm compared with conventional rhythm control in patients with early AF and mild-to-moderate early systolic or diastolic heart failure undergoing electrical cardioversion. RACE 3 is a prospective, randomised, open, multinational, multicenter trial. Upstream rhythm control consists of angiotensin converting enzyme inhibitors and/or angiotensin receptor blockers, mineralocorticoid receptor antagonists, statins, cardiac rehabilitation therapy, and intensive counselling on dietary restrictions, exercise maintenance, and drug adherence. Conventional rhythm control consists of routine rhythm control therapy without cardiac rehabilitation therapy and intensive counselling. In both arms, every effort is made to keep patients in the rhythm control strategy, and ion channel antiarrhythmic drugs or pulmonary vein ablation may be instituted if AF relapses. Total inclusion will be 250 patients. If upstream therapy proves to be effective in improving maintenance of sinus rhythm, it could become a new approach to rhythm control supporting conventional pharmacological and non-pharmacological rhythm control.

  1. Rapid and accurate reversed-phase high-performance liquid chromatographic determination of conjugated bile acids in human bile for routine clinical applications. Therapeutic control during gallstone dissolution therapy.

    PubMed

    Swobodnik, W; Klüppelberg, U; Wechsler, J G; Volz, M; Normandin, G; Ditschuneit, H

    1985-05-03

    This paper introduces a new method to detect the taurine and glycine conjugates of five different bile acids (cholic acid, deoxycholic acid, chenodeoxycholic acid, ursodeoxycholic acid and lithocholic acid) in human bile. Advantages of this method are sufficient separation of compounds within a short period of time and a high rate of reproducibility. Using a mobile phase gradient of acetonitrile and water, modified with tetrabutylammonium hydrogen sulphate (0.0075 mol/l), we were able to maximize the differentiation between ursodeoxycholic acid and lithocholic acid, which is of primary interest during conservative gallstone dissolution therapy. Use of this gradient reduced analysis time to less than 0.5 h. Recovery rates for this modified method ranged from 94% to 100%, and reproducibility was 98%, sufficient for routine clinical applications.

  2. Massage-based bedtime routine: impact on sleep and mood in infants and mothers.

    PubMed

    Mindell, Jodi A; Lee, Christina I; Leichman, Erin S; Rotella, Katie N

    2018-01-01

    Establishment of a consistent bedtime routine is often recommended to families with young children with sleep difficulties. However, there are limited studies assessing specific bedtime routines in the treatment of infant and toddler sleep disturbances. Thus, the purpose of this study was to examine the impact of a massage-based bedtime routine on infant sleep, maternal sleep, and maternal mood. A total of 123 mothers and their 3- to 18-month-old infant were randomly assigned to a routine (one-week baseline of usual bedtime routine, two-weeks intervention) or control group (three-weeks of their usual bedtime routine). All mothers completed the Brief Infant Sleep Questionnaire (BISQ) on a weekly basis and measures of maternal sleep and mood (eg, Pittsburgh Sleep Quality Index, Epworth Sleepiness Scale, and Edinburgh Postnatal Depression Scale). This bedtime routine resulted in improvements in child and mother night wakings, maternal perceptions of child sleep and mood (ie, sleep problem, bedtime ease, and morning mood), and improvements in maternal sleep quality. No comparative changes were seen in the control group. Notably, other than number of night wakings for both the child and the mother, there were no changes in other sleep patterns including sleep onset latency, duration of night wakings, longest stretch of sleep, or sleep duration. This study supports recommending a massage-based routine in those families, with the codicil that improvements in maternal perceptions and maternal sleep will be noted, with few improvements in sleep itself other than night wakings. Copyright © 2017 Elsevier B.V. All rights reserved.

  3. Results of routine restaurant inspections can predict outbreaks of foodborne illness: the Seattle-King County experience.

    PubMed Central

    Irwin, K; Ballard, J; Grendon, J; Kobayashi, J

    1989-01-01

    To analyze the association between the results of routine inspections and foodborne outbreaks in restaurants, we conducted a matched case-control study using available data from Seattle-King County, Washington. Case restaurants were facilities with a reported foodborne outbreak between January 1, 1986 and March 31, 1987 (N = 28). Two control restaurants with no reported outbreaks during this period were matched to each case restaurant on county health district and date of routine inspection (N = 56). Data from the routine inspection that preceded the outbreak (for case restaurants) or the date-matched routine inspection (for control restaurants) were abstracted from computerized inspection records. Case restaurants had a significantly lower mean inspection score (83.8 on a 0 to 100 point scale) than control restaurants (90.9). Restaurants with poor inspection scores and violations of proper temperature controls of potentially hazardous foods were, respectively, five and ten times more likely to have outbreaks than restaurants with better results. Although this study demonstrates that Seattle-King County's routine inspection form can successfully identify restaurants at increased risk of foodborne outbreaks, it also illustrates that more emphasis on regulation and education is needed to prevent outbreaks in restaurants with poor inspection results. PMID:2705592

  4. Increased Exposure to Rigid Routines can Lead to Increased Challenging Behavior Following Changes to Those Routines.

    PubMed

    Bull, Leah E; Oliver, Chris; Callaghan, Eleanor; Woodcock, Kate A

    2015-06-01

    Several neurodevelopmental disorders are associated with preference for routine and challenging behavior following changes to routines. We examine individuals with Prader-Willi syndrome, who show elevated levels of this behavior, to better understand how previous experience of a routine can affect challenging behavior elicited by disruption to that routine. Play based challenges exposed 16 participants to routines, which were either adhered to or changed. Temper outburst behaviors, heart rate and movement were measured. As participants were exposed to routines for longer before a change (between 10 and 80 min; within participants), more temper outburst behaviors were elicited by changes. Increased emotional arousal was also elicited, which was indexed by heart rate increases not driven by movement. Further study will be important to understand whether current intervention approaches that limit exposure to changes, may benefit from the structured integration of flexibility to ensure that the opportunity for routine establishment is also limited.

  5. Enhancing the Simulation Speed of Sensor Network Applications by Asynchronization of Interrupt Service Routines

    PubMed Central

    Joe, Hyunwoo; Woo, Duk-Kyun; Kim, Hyungshin

    2013-01-01

    Sensor network simulations require high fidelity and timing accuracy to be used as an implementation and evaluation tool. The cycle-accurate and instruction-level simulator is the known solution for these purposes. However, this type of simulation incurs a high computation cost since it has to model not only the instruction level behavior but also the synchronization between multiple sensors for their causality. This paper presents a novel technique that exploits asynchronous simulations of interrupt service routines (ISR). We can avoid the synchronization overheads when the interrupt service routines are simulated without preemption. If the causality errors occur, we devise a rollback procedure to restore the original synchronized simulation. This concept can be extended to any instruction-level sensor network simulator. Evaluation results show our method can enhance the simulation speed up to 52% in the case of our experiments. For applications with longer interrupt service routines and smaller number of preemptions, the speedup becomes greater. In addition, our simulator is 2 to 11 times faster than the well-known sensor network simulator. PMID:23966200

  6. The significance of routines in nursing practice.

    PubMed

    Rytterström, Patrik; Unosson, Mitra; Arman, Maria

    2011-12-01

    The aim of this study was to illuminate the significance of routines in nursing practice. Clinical nursing is performed under the guidance of routines to varying degrees. In the nursing literature, routine is described as having both negative and positive aspects, but use of the term is inconsistent, and empirical evidence is sparse. In the research on organisational routines, a distinction is made between routine as a rule and routine as action. A qualitative design using a phenomenological-hermeneutic approach. Data collection from three focus groups focused on nurses' experience of routines. Seventeen individual interviews from a previous study focusing on caring culture were also analysed in a secondary qualitative analysis. All participants were employed as 'qualified nursing pool' nurses. Routines are experienced as pragmatic, obstructive and meaningful. The aim of the pragmatic routine was to ensure that daily working life works; this routine is practised more on the basis of rational arguments and obvious intentions. The obstructive routine had negative consequences for nursing practice and was described as nursing losing its humanity and violating the patient's integrity. The meaningful routine involved becoming one with the routine and for the nurses, it felt right and meaningful to adapt to it. Routines become meaningful when the individual action is in harmony with the cultural pattern on which the nursing work is based. Instead of letting contemporary practice passively become routine, routines can be assessed and developed using research and theoretical underpinnings as a starting point for nursing practice. Leaders have a special responsibility to develop and support meaningful routines. One approach could be to let wards examine their routines from a patient perspective on the basis of the themes of pragmatic, meaningful and obstructive routine. © 2010 Blackwell Publishing Ltd.

  7. Advanced flight design systems subsystem performance models. Sample model: Environmental analysis routine library

    NASA Technical Reports Server (NTRS)

    Parker, K. C.; Torian, J. G.

    1980-01-01

    A sample environmental control and life support model performance analysis using the environmental analysis routines library is presented. An example of a complete model set up and execution is provided. The particular model was synthesized to utilize all of the component performance routines and most of the program options.

  8. Clinical Impact of Accurate Point-of-Care Glucose Monitoring for Tight Glycemic Control in Severely Burned Children.

    PubMed

    Tran, Nam K; Godwin, Zachary R; Steele, Amanda N; Wolf, Steven E; Palmieri, Tina L

    2016-09-01

    The goal of this study was to retrospectively evaluate the clinical impact of an accurate autocorrecting blood glucose monitoring system in children with severe burns. Blood glucose monitoring system accuracy is essential for providing appropriate intensive insulin therapy and achieving tight glycemic control in critically ill patients. Unfortunately, few comparison studies have been performed to evaluate the clinical impact of accurate blood glucose monitoring system monitoring in the high-risk pediatric burn population. Retrospective analysis of an electronic health record system. Pediatric burn ICU at an academic medical center. Children (aged < 18 yr) with severe burns (≥ 20% total body surface area) receiving intensive insulin therapy guided by either a noncorrecting (blood glucose monitoring system-1) or an autocorrecting blood glucose monitoring system (blood glucose monitoring system-2). Patient demographics, insulin rates, and blood glucose monitoring system measurements were collected. The frequency of hypoglycemia and glycemic variability was compared between the two blood glucose monitoring system groups. A total of 122 patient charts from 2001 to 2014 were reviewed. Sixty-three patients received intensive insulin therapy using blood glucose monitoring system-1 and 59 via blood glucose monitoring system-2. Patient demographics were similar between the two groups. Mean insulin infusion rates (5.1 ± 3.8 U/hr; n = 535 paired measurements vs 2.4 ± 1.3 U/hr; n = 511 paired measurements; p < 0.001), glycemic variability, and frequency of hypoglycemic events (90 vs 12; p < 0.001) were significantly higher in blood glucose monitoring system-1-treated patients. Compared with laboratory measurements, blood glucose monitoring system-2 yielded the most accurate results (mean ± SD bias: -1.7 ± 6.9 mg/dL [-0.09 ± 0.4 mmol/L] vs 7.4 ± 13.5 mg/dL [0.4 ± 0.7 mmol/L]). Blood glucose monitoring system-2 patients achieve glycemic

  9. Implementation and application of moving average as continuous analytical quality control instrument demonstrated for 24 routine chemistry assays.

    PubMed

    Rossum, Huub H van; Kemperman, Hans

    2017-07-26

    General application of a moving average (MA) as continuous analytical quality control (QC) for routine chemistry assays has failed due to lack of a simple method that allows optimization of MAs. A new method was applied to optimize the MA for routine chemistry and was evaluated in daily practice as continuous analytical QC instrument. MA procedures were optimized using an MA bias detection simulation procedure. Optimization was graphically supported by bias detection curves. Next, all optimal MA procedures that contributed to the quality assurance were run for 100 consecutive days and MA alarms generated during working hours were investigated. Optimized MA procedures were applied for 24 chemistry assays. During this evaluation, 303,871 MA values and 76 MA alarms were generated. Of all alarms, 54 (71%) were generated during office hours. Of these, 41 were further investigated and were caused by ion selective electrode (ISE) failure (1), calibration failure not detected by QC due to improper QC settings (1), possible bias (significant difference with the other analyzer) (10), non-human materials analyzed (2), extreme result(s) of a single patient (2), pre-analytical error (1), no cause identified (20), and no conclusion possible (4). MA was implemented in daily practice as a continuous QC instrument for 24 routine chemistry assays. In our setup when an MA alarm required follow-up, a manageable number of MA alarms was generated that resulted in valuable MA alarms. For the management of MA alarms, several applications/requirements in the MA management software will simplify the use of MA procedures.

  10. [Quality of documentation of intraoperative and postoperative complications : improvement of documentation for a nationwide quality assurance program and comparison with routine data].

    PubMed

    Jakob, J; Marenda, D; Sold, M; Schlüter, M; Post, S; Kienle, P

    2014-08-01

    Complications after cholecystectomy are continuously documented in a nationwide database in Germany. Recent studies demonstrated a lack of reliability of these data. The aim of the study was to evaluate the impact of a control algorithm on documentation quality and the use of routine diagnosis coding as an additional validation instrument. Completeness and correctness of the documentation of complications after cholecystectomy was compared over a time interval of 12 months before and after implementation of an algorithm for faster and more accurate documentation. Furthermore, the coding of all diagnoses was screened to identify intraoperative and postoperative complications. The sensitivity of the documentation for complications improved from 46 % to 70 % (p = 0.05, specificity 98 % in both time intervals). A prolonged time interval of more than 6 weeks between patient discharge and documentation was associated with inferior data quality (incorrect documentation in 1.5 % versus 15 %, p < 0.05). The rate of case documentation within the 6 weeks after hospital discharge was clearly improved after implementation of the control algorithm. Sensitivity and specificity of screening for complications by evaluating routine diagnoses coding were 70 % and 85 %, respectively. The quality of documentation was improved by implementation of a simple memory algorithm.

  11. Automated particle correspondence and accurate tilt-axis detection in tilted-image pairs

    DOE PAGES

    Shatsky, Maxim; Arbelaez, Pablo; Han, Bong-Gyoon; ...

    2014-07-01

    Tilted electron microscope images are routinely collected for an ab initio structure reconstruction as a part of the Random Conical Tilt (RCT) or Orthogonal Tilt Reconstruction (OTR) methods, as well as for various applications using the "free-hand" procedure. These procedures all require identification of particle pairs in two corresponding images as well as accurate estimation of the tilt-axis used to rotate the electron microscope (EM) grid. Here we present a computational approach, PCT (particle correspondence from tilted pairs), based on tilt-invariant context and projection matching that addresses both problems. The method benefits from treating the two problems as a singlemore » optimization task. It automatically finds corresponding particle pairs and accurately computes tilt-axis direction even in the cases when EM grid is not perfectly planar.« less

  12. Understanding Smart Home Sensor Data for Ageing in Place Through Everyday Household Routines: A Mixed Method Case Study

    PubMed Central

    van Kasteren, Yasmin; Bradford, Dana; Karunanithi, Mohan; Ding, Hang

    2017-01-01

    Background An ongoing challenge for smart homes research for aging-in-place is how to make sense of the large amounts of data from in-home sensors to facilitate real-time monitoring and develop reliable alerts. Objective The objective of our study was to explore the usefulness of a routine-based approach for making sense of smart home data for the elderly. Methods Maximum variation sampling was used to select three cases for an in-depth mixed methods exploration of the daily routines of three elderly participants in a smart home trial using 180 days of power use and motion sensor data and longitudinal interview data. Results Sensor data accurately matched self-reported routines. By comparing daily movement data with personal routines, it was possible to identify changes in routine that signaled illness, recovery from bereavement, and gradual deterioration of sleep quality and daily movement. Interview and sensor data also identified changes in routine with variations in temperature and daylight hours. Conclusions The findings demonstrated that a routine-based approach makes interpreting sensor data easy, intuitive, and transparent. They highlighted the importance of understanding and accounting for individual differences in preferences for routinization and the influence of the cyclical nature of daily routines, social or cultural rhythms, and seasonal changes in temperature and daylight hours when interpreting information based on sensor data. This research has demonstrated the usefulness of a routine-based approach for making sense of smart home data, which has furthered the understanding of the challenges that need to be addressed in order to make real-time monitoring and effective alerts a reality. PMID:28611014

  13. Accurate diagnosis of prenatal cleft lip/palate by understanding the embryology

    PubMed Central

    Smarius, Bram; Loozen, Charlotte; Manten, Wendy; Bekker, Mireille; Pistorius, Lou; Breugem, Corstiaan

    2017-01-01

    Cleft lip with or without cleft palate (CP) is one of the most common congenital malformations. Ultrasonographers involved in the routine 20-wk ultrasound screening could encounter these malformations. The face and palate develop in a very characteristic way. For ultrasonographers involved in screening these patients it is crucial to have a thorough understanding of the embryology of the face. This could help them to make a more accurate diagnosis and save time during the ultrasound. Subsequently, the current postnatal classification will be discussed to facilitate the communication with the CP teams. PMID:29026689

  14. Ongoing revolution in bacteriology: routine identification of bacteria by matrix-assisted laser desorption ionization time-of-flight mass spectrometry.

    PubMed

    Seng, Piseth; Drancourt, Michel; Gouriet, Frédérique; La Scola, Bernard; Fournier, Pierre-Edouard; Rolain, Jean Marc; Raoult, Didier

    2009-08-15

    Matrix-assisted laser desorption ionization time-of-flight (MALDI-TOF) mass spectrometry accurately identifies both selected bacteria and bacteria in select clinical situations. It has not been evaluated for routine use in the clinic. We prospectively analyzed routine MALDI-TOF mass spectrometry identification in parallel with conventional phenotypic identification of bacteria regardless of phylum or source of isolation. Discrepancies were resolved by 16S ribosomal RNA and rpoB gene sequence-based molecular identification. Colonies (4 spots per isolate directly deposited on the MALDI-TOF plate) were analyzed using an Autoflex II Bruker Daltonik mass spectrometer. Peptidic spectra were compared with the Bruker BioTyper database, version 2.0, and the identification score was noted. Delays and costs of identification were measured. Of 1660 bacterial isolates analyzed, 95.4% were correctly identified by MALDI-TOF mass spectrometry; 84.1% were identified at the species level, and 11.3% were identified at the genus level. In most cases, absence of identification (2.8% of isolates) and erroneous identification (1.7% of isolates) were due to improper database entries. Accurate MALDI-TOF mass spectrometry identification was significantly correlated with having 10 reference spectra in the database (P=.01). The mean time required for MALDI-TOF mass spectrometry identification of 1 isolate was 6 minutes for an estimated 22%-32% cost of current methods of identification. MALDI-TOF mass spectrometry is a cost-effective, accurate method for routine identification of bacterial isolates in <1 h using a database comprising > or =10 reference spectra per bacterial species and a 1.9 identification score (Brucker system). It may replace Gram staining and biochemical identification in the near future.

  15. Effectiveness of Routine BCG Vaccination on Buruli Ulcer Disease: A Case-Control Study in the Democratic Republic of Congo, Ghana and Togo

    PubMed Central

    Phillips, Richard Odame; Phanzu, Delphin Mavinga; Beissner, Marcus; Badziklou, Kossi; Luzolo, Elysée Kalundieko; Sarfo, Fred Stephen; Halatoko, Wemboo Afiwa; Amoako, Yaw; Frimpong, Michael; Kabiru, Abass Mohammed; Piten, Ebekalisai; Maman, Issaka; Bidjada, Bawimodom; Koba, Adjaho; Awoussi, Koffi Somenou; Kobara, Basile; Nitschke, Jörg; Wiedemann, Franz Xaver; Kere, Abiba Banla; Adjei, Ohene; Löscher, Thomas; Fleischer, Bernhard; Bretzel, Gisela; Herbinger, Karl-Heinz

    2015-01-01

    Background The only available vaccine that could be potentially beneficial against mycobacterial diseases contains live attenuated bovine tuberculosis bacillus (Mycobacterium bovis) also called Bacillus Calmette-Guérin (BCG). Even though the BCG vaccine is still widely used, results on its effectiveness in preventing mycobacterial diseases are partially contradictory, especially regarding Buruli Ulcer Disease (BUD). The aim of this case-control study is to evaluate the possible protective effect of BCG vaccination on BUD. Methodology The present study was performed in three different countries and sites where BUD is endemic: in the Democratic Republic of the Congo, Ghana, and Togo from 2010 through 2013. The large study population was comprised of 401 cases with laboratory confirmed BUD and 826 controls, mostly family members or neighbors. Principal Findings After stratification by the three countries, two sexes and four age groups, no significant correlation was found between the presence of BCG scar and BUD status of individuals. Multivariate analysis has shown that the independent variables country (p = 0.31), sex (p = 0.24), age (p = 0.96), and presence of a BCG scar (p = 0.07) did not significantly influence the development of BUD category I or category II/III. Furthermore, the status of BCG vaccination was also not significantly related to duration of BUD or time to healing of lesions. Conclusions In our study, we did not observe significant evidence of a protective effect of routine BCG vaccination on the risk of developing either BUD or severe forms of BUD. Since accurate data on BCG strains used in these three countries were not available, no final conclusion can be drawn on the effectiveness of BCG strain in protecting against BUD. As has been suggested for tuberculosis and leprosy, well-designed prospective studies on different existing BCG vaccine strains are needed also for BUD. PMID:25569674

  16. Increased Exposure to Rigid Routines Can Lead to Increased Challenging Behavior Following Changes to Those Routines

    ERIC Educational Resources Information Center

    Bull, Leah E.; Oliver, Chris; Callaghan, Eleanor; Woodcock, Kate A.

    2015-01-01

    Several neurodevelopmental disorders are associated with preference for routine and challenging behavior following changes to routines. We examine individuals with Prader-Willi syndrome, who show elevated levels of this behavior, to better understand how previous experience of a routine can affect challenging behavior elicited by disruption to…

  17. Remote balance weighs accurately amid high radiation

    NASA Technical Reports Server (NTRS)

    Eggenberger, D. N.; Shuck, A. B.

    1969-01-01

    Commercial beam-type balance, modified and outfitted with electronic controls and digital readout, can be remotely controlled for use in high radiation environments. This allows accurate weighing of breeder-reactor fuel pieces when they are radioactively hot.

  18. Accurate simulation of backscattering spectra in the presence of sharp resonances

    NASA Astrophysics Data System (ADS)

    Barradas, N. P.; Alves, E.; Jeynes, C.; Tosaki, M.

    2006-06-01

    In elastic backscattering spectrometry, the shape of the observed spectrum due to resonances in the nuclear scattering cross-section is influenced by many factors. If the energy spread of the beam before interaction is larger than the resonance width, then a simple convolution with the energy spread on exit and with the detection system resolution will lead to a calculated spectrum with a resonance much sharper than the observed signal. Also, the yield from a thin layer will not be calculated accurately. We have developed an algorithm for the accurate simulation of backscattering spectra in the presence of sharp resonances. Albeit approximate, the algorithm leads to dramatic improvements in the quality and accuracy of the simulations. It is simple to implement and leads to only small increases of the calculation time, being thus suitable for routine data analysis. We show different experimental examples, including samples with roughness and porosity.

  19. SU-D-BRD-07: Evaluation of the Effectiveness of Statistical Process Control Methods to Detect Systematic Errors For Routine Electron Energy Verification

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

    Parker, S

    2015-06-15

    Purpose: To evaluate the ability of statistical process control methods to detect systematic errors when using a two dimensional (2D) detector array for routine electron beam energy verification. Methods: Electron beam energy constancy was measured using an aluminum wedge and a 2D diode array on four linear accelerators. Process control limits were established. Measurements were recorded in control charts and compared with both calculated process control limits and TG-142 recommended specification limits. The data was tested for normality, process capability and process acceptability. Additional measurements were recorded while systematic errors were intentionally introduced. Systematic errors included shifts in the alignmentmore » of the wedge, incorrect orientation of the wedge, and incorrect array calibration. Results: Control limits calculated for each beam were smaller than the recommended specification limits. Process capability and process acceptability ratios were greater than one in all cases. All data was normally distributed. Shifts in the alignment of the wedge were most apparent for low energies. The smallest shift (0.5 mm) was detectable using process control limits in some cases, while the largest shift (2 mm) was detectable using specification limits in only one case. The wedge orientation tested did not affect the measurements as this did not affect the thickness of aluminum over the detectors of interest. Array calibration dependence varied with energy and selected array calibration. 6 MeV was the least sensitive to array calibration selection while 16 MeV was the most sensitive. Conclusion: Statistical process control methods demonstrated that the data distribution was normally distributed, the process was capable of meeting specifications, and that the process was centered within the specification limits. Though not all systematic errors were distinguishable from random errors, process control limits increased the ability to detect systematic

  20. Understanding Smart Home Sensor Data for Ageing in Place Through Everyday Household Routines: A Mixed Method Case Study.

    PubMed

    van Kasteren, Yasmin; Bradford, Dana; Zhang, Qing; Karunanithi, Mohan; Ding, Hang

    2017-06-13

    An ongoing challenge for smart homes research for aging-in-place is how to make sense of the large amounts of data from in-home sensors to facilitate real-time monitoring and develop reliable alerts. The objective of our study was to explore the usefulness of a routine-based approach for making sense of smart home data for the elderly. Maximum variation sampling was used to select three cases for an in-depth mixed methods exploration of the daily routines of three elderly participants in a smart home trial using 180 days of power use and motion sensor data and longitudinal interview data. Sensor data accurately matched self-reported routines. By comparing daily movement data with personal routines, it was possible to identify changes in routine that signaled illness, recovery from bereavement, and gradual deterioration of sleep quality and daily movement. Interview and sensor data also identified changes in routine with variations in temperature and daylight hours. The findings demonstrated that a routine-based approach makes interpreting sensor data easy, intuitive, and transparent. They highlighted the importance of understanding and accounting for individual differences in preferences for routinization and the influence of the cyclical nature of daily routines, social or cultural rhythms, and seasonal changes in temperature and daylight hours when interpreting information based on sensor data. This research has demonstrated the usefulness of a routine-based approach for making sense of smart home data, which has furthered the understanding of the challenges that need to be addressed in order to make real-time monitoring and effective alerts a reality. ©Yasmin van Kasteren, Dana Bradford, Qing Zhang, Mohan Karunanithi, Hang Ding. Originally published in JMIR Mhealth and Uhealth (http://mhealth.jmir.org), 13.06.2017.

  1. Comprehensive self management and routine monitoring in chronic obstructive pulmonary disease patients in general practice: randomised controlled trial.

    PubMed

    Bischoff, Erik W M A; Akkermans, Reinier; Bourbeau, Jean; van Weel, Chris; Vercoulen, Jan H; Schermer, Tjard R J

    2012-11-28

    To assess the long term effects of two different modes of disease management (comprehensive self management and routine monitoring) on quality of life (primary objective), frequency and patients' management of exacerbations, and self efficacy (secondary objectives) in patients with chronic obstructive pulmonary disease (COPD) in general practice. 24 month, multicentre, investigator blinded, three arm, pragmatic, randomised controlled trial. 15 general practices in the eastern part of the Netherlands. Patients with COPD confirmed by spirometry and treated in general practice. Patients with very severe COPD or treated by a respiratory physician were excluded. A comprehensive self management programme as an adjunct to usual care, consisting of four tailored sessions with ongoing telephone support by a practice nurse; routine monitoring as an adjunct to usual care, consisting of 2-4 structured consultations a year with a practice nurse; or usual care alone (contacts with the general practitioner at the patients' own initiative). The primary outcome was the change in COPD specific quality of life at 24 months as measured with the chronic respiratory questionnaire total score. Secondary outcomes were chronic respiratory questionnaire domain scores, frequency and patients' management of exacerbations measured with the Nijmegen telephonic exacerbation assessment system, and self efficacy measured with the COPD self-efficacy scale. 165 patients were allocated to self management (n=55), routine monitoring (n=55), or usual care alone (n=55). At 24 months, adjusted treatment differences between the three groups in mean chronic respiratory questionnaire total score were not significant. Secondary outcomes did not differ, except for exacerbation management. Compared with usual care, more exacerbations in the self management group were managed with bronchodilators (odds ratio 2.81, 95% confidence interval 1.16 to 6.82) and with prednisolone, antibiotics, or both (3.98, 1.10 to 15

  2. Practical issues in implementing whole-genome-sequencing in routine diagnostic microbiology.

    PubMed

    Rossen, J W A; Friedrich, A W; Moran-Gilad, J

    2018-04-01

    Next generation sequencing (NGS) is increasingly being used in clinical microbiology. Like every new technology adopted in microbiology, the integration of NGS into clinical and routine workflows must be carefully managed. To review the practical aspects of implementing bacterial whole genome sequencing (WGS) in routine diagnostic laboratories. Review of the literature and expert opinion. In this review, we discuss when and how to integrate whole genome sequencing (WGS) in the routine workflow of the clinical laboratory. In addition, as the microbiology laboratories have to adhere to various national and international regulations and criteria for their accreditation, we deliberate on quality control issues for using WGS in microbiology, including the importance of proficiency testing. Furthermore, the current and future place of this technology in the diagnostic hierarchy of microbiology is described as well as the necessity of maintaining backwards compatibility with already established methods. Finally, we speculate on the question of whether WGS can entirely replace routine microbiology in the future and the tension between the fact that most sequencers are designed to process multiple samples in parallel whereas for optimal diagnosis a one-by-one processing of the samples is preferred. Special reference is made to the cost and turnaround time of WGS in diagnostic laboratories. Further development is required to improve the workflow for WGS, in particular to shorten the turnaround time, reduce costs, and streamline downstream data analyses. Only when these processes reach maturity will reliance on WGS for routine patient management and infection control management become feasible, enabling the transformation of clinical microbiology into a genome-based and personalized diagnostic field. Copyright © 2017 The Author(s). Published by Elsevier Ltd.. All rights reserved.

  3. Competing stimuli in the treatment of multiply controlled problem behavior during hygiene routines.

    PubMed

    Long, Ethan S; Hagopian, Louis P; Deleon, Iser G; Marhefka, Jean Marie; Resau, Dawn

    2005-01-01

    The current study describes the use of noncontingent competing stimuli in the treatment of problem behavior exhibited by three individuals during staff-assisted hygiene routines. Functional analyses revealed that particular topographies of problem behaviors appeared to be maintained by their own sensory consequences, whereas other topographies appeared to be maintained by escape from demands. Competing stimulus assessments were then conducted to identify items associated with low levels of automatically-maintained problem behavior and high levels of stimulus engagement. Stimuli associated with low levels of automatically-maintained problem behavior (competing stimuli) were then delivered noncontingently during staff-assisted hygiene routines that were problematic for each participant. In all three cases, substantial reductions in all problem behaviors were observed. These results are discussed in terms of the relative ease of this intervention and possible mechanisms underlying the effects of competing stimuli on behaviors maintained by different types of reinforcement.

  4. Legionella Risk Management and Control in Potable Water Systems: Argument for the Abolishment of Routine Testing

    PubMed Central

    Whiley, Harriet

    2016-01-01

    Legionella is an opportunistic pathogen of public health significance. One of the main sources of Legionella is potable water systems. As a consequence of aging populations there is an increasing demographic considered at high risk for Legionellosis and, as such, a review of the guidelines is required. Worldwide, Legionella has been detected from many potable water sources, suggesting it is ubiquitous in this environment. Previous studies have identified the limitations of the current standard method for Legionella detection and the high possibility of it returning both false negative and false positive results. There is also huge variability in Legionella test results for the same water sample when conducted at different laboratories. However, many guidelines still recommend the testing of water systems. This commentary argues for the removal of routine Legionella monitoring from all water distribution guidelines. This procedure is financially consuming and false negatives may result in managers being over-confident with a system or a control mechanism. Instead, the presence of the pathogen should be assumed and focus spent on managing appropriate control measures and protecting high-risk population groups. PMID:28029126

  5. Legionella Risk Management and Control in Potable Water Systems: Argument for the Abolishment of Routine Testing.

    PubMed

    Whiley, Harriet

    2016-12-24

    Legionella is an opportunistic pathogen of public health significance. One of the main sources of Legionella is potable water systems. As a consequence of aging populations there is an increasing demographic considered at high risk for Legionellosis and, as such, a review of the guidelines is required. Worldwide, Legionella has been detected from many potable water sources, suggesting it is ubiquitous in this environment. Previous studies have identified the limitations of the current standard method for Legionella detection and the high possibility of it returning both false negative and false positive results. There is also huge variability in Legionella test results for the same water sample when conducted at different laboratories. However, many guidelines still recommend the testing of water systems. This commentary argues for the removal of routine Legionella monitoring from all water distribution guidelines. This procedure is financially consuming and false negatives may result in managers being over-confident with a system or a control mechanism. Instead, the presence of the pathogen should be assumed and focus spent on managing appropriate control measures and protecting high-risk population groups.

  6. Implementing a routine, voluntary HIV testing program in a Massachusetts county prison.

    PubMed

    Liddicoat, Rebecca V; Zheng, Hui; Internicola, Jeanne; Werner, Barbara G; Kazianis, Arthur; Golan, Yoav; Rubinstein, Eric P; Freedberg, Kenneth A; Walensky, Rochelle P

    2006-11-01

    Although U.S. prison inmates have higher rates of HIV infection than the general population, most inmates are not routinely tested for HIV infection at prison entry. The study objective was to implement a routine, voluntary HIV testing program in a Massachusetts county prison. During admission, inmates were given group HIV pre-test counseling and were subsequently offered private HIV testing. This intervention was compared to a control period during which HIV testing was provided only upon inmate or physician request. Between November 2004 and April 2005, 1,004 inmates met inclusion criteria and were offered routine, voluntary HIV testing. Of these, 734 (73.1%) accepted, 2 (0.3%) were HIV-infected, and 457 (45.5%) had been tested for HIV in the previous year. The testing rate of 73.1% was significantly increased from the rate of 18.0% (318 of 1,723) during the control period (p<0.001). Among the inmates tested for HIV in the prior year, 78.2% had received their last HIV test in the prison setting. Careful attention should be paid to prevent redundancy of testing efforts in the prison population. Implementing a routine HIV testing program among prison inmates greatly increased testing rates compared to on-request testing.

  7. 42 CFR 493.931 - Routine chemistry.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 5 2010-10-01 2010-10-01 false Routine chemistry. 493.931 Section 493.931 Public... Proficiency Testing Programs by Specialty and Subspecialty § 493.931 Routine chemistry. (a) Program content and frequency of challenge. To be approved for proficiency testing for routine chemistry, a program...

  8. 42 CFR 493.931 - Routine chemistry.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 42 Public Health 5 2013-10-01 2013-10-01 false Routine chemistry. 493.931 Section 493.931 Public... Proficiency Testing Programs by Specialty and Subspecialty § 493.931 Routine chemistry. (a) Program content and frequency of challenge. To be approved for proficiency testing for routine chemistry, a program...

  9. 42 CFR 493.931 - Routine chemistry.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 42 Public Health 5 2012-10-01 2012-10-01 false Routine chemistry. 493.931 Section 493.931 Public... Proficiency Testing Programs by Specialty and Subspecialty § 493.931 Routine chemistry. (a) Program content and frequency of challenge. To be approved for proficiency testing for routine chemistry, a program...

  10. 42 CFR 493.931 - Routine chemistry.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 42 Public Health 5 2014-10-01 2014-10-01 false Routine chemistry. 493.931 Section 493.931 Public... Proficiency Testing Programs by Specialty and Subspecialty § 493.931 Routine chemistry. (a) Program content and frequency of challenge. To be approved for proficiency testing for routine chemistry, a program...

  11. 42 CFR 493.931 - Routine chemistry.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 5 2011-10-01 2011-10-01 false Routine chemistry. 493.931 Section 493.931 Public... Proficiency Testing Programs by Specialty and Subspecialty § 493.931 Routine chemistry. (a) Program content and frequency of challenge. To be approved for proficiency testing for routine chemistry, a program...

  12. The Effect of Corpus-Based Instruction on Pragmatic Routines

    ERIC Educational Resources Information Center

    Bardovi-Harlig, Kathleen; Mossman, Sabrina; Su, Yunwen

    2017-01-01

    This study compares the effect of using corpus-based materials and activities for the instruction of pragmatic routines under two conditions: implementing direct corpus searches by learners during classroom instruction and working with teacher-developed corpus-based materials. The outcome is compared to a repeated-test control group. Pragmatic…

  13. Children's Daily Routines during Kindergarten Transition

    ERIC Educational Resources Information Center

    Wildenger, Leah K.; McIntyre, Laura Lee; Fiese, Barbara H.; Eckert, Tanya L.

    2008-01-01

    Routines are an important feature of family life and functioning in families with young children. Common daily routines such as dinnertime, bedtime, and waking activities are powerful organizers of family behavior and may be instrumental to children and families during times of transition, such as elementary school entry. Daily routines were…

  14. Evolutionary Dynamics of Digitized Organizational Routines

    ERIC Educational Resources Information Center

    Liu, Peng

    2013-01-01

    This dissertation explores the effects of increased digitization on the evolutionary dynamics of organizational routines. Do routines become more flexible, or more rigid, as the mix of digital technologies and human actors changes? What are the mechanisms that govern the evolution of routines? The dissertation theorizes about the effects of…

  15. Competing Stimuli in the Treatment of Multiply Controlled Problem Behavior during Hygiene Routines

    ERIC Educational Resources Information Center

    Long, Ethan S.; Hagopian, Louis P.; DeLeon, Iser G.; Marhefka, Jean Marie; Resau, Dawn

    2005-01-01

    The current study describes the use of noncontingent competing stimuli in the treatment of problem behavior exhibited by three individuals during staff-assisted hygiene routines. Functional analyses revealed that particular topographies of problem behaviors appeared to be maintained by their own sensory consequences, whereas other topographies…

  16. Space shuttle atmospheric revitalization subsystem/active thermal control subsystem computer program (users manual)

    NASA Technical Reports Server (NTRS)

    1973-01-01

    A shuttle (ARS) atmosphere revitalization subsystem active thermal control subsystem (ATCS) performance routine was developed. This computer program is adapted from the Shuttle EC/LSS Design Computer Program. The program was upgraded in three noteworthy areas: (1) The functional ARS/ATCS schematic has been revised to accurately synthesize the shuttle baseline system definition. (2) The program logic has been improved to provide a more accurate prediction of the integrated ARS/ATCS system performance. Additionally, the logic has been expanded to model all components and thermal loads in the ARS/ATCS system. (3) The program is designed to be used on the NASA JSC crew system division's programmable calculator system. As written the new computer routine has an average running time of five minutes. The use of desk top type calculation equipment, and the rapid response of the program provides the NASA with an analytical tool for trade studies to refine the system definition, and for test support of the RSECS or integrated Shuttle ARS/ATCS test programs.

  17. An Accurate Temperature Correction Model for Thermocouple Hygrometers 1

    PubMed Central

    Savage, Michael J.; Cass, Alfred; de Jager, James M.

    1982-01-01

    Numerous water relation studies have used thermocouple hygrometers routinely. However, the accurate temperature correction of hygrometer calibration curve slopes seems to have been largely neglected in both psychrometric and dewpoint techniques. In the case of thermocouple psychrometers, two temperature correction models are proposed, each based on measurement of the thermojunction radius and calculation of the theoretical voltage sensitivity to changes in water potential. The first model relies on calibration at a single temperature and the second at two temperatures. Both these models were more accurate than the temperature correction models currently in use for four psychrometers calibrated over a range of temperatures (15-38°C). The model based on calibration at two temperatures is superior to that based on only one calibration. The model proposed for dewpoint hygrometers is similar to that for psychrometers. It is based on the theoretical voltage sensitivity to changes in water potential. Comparison with empirical data from three dewpoint hygrometers calibrated at four different temperatures indicates that these instruments need only be calibrated at, e.g. 25°C, if the calibration slopes are corrected for temperature. PMID:16662241

  18. Routine screening: informed consent, stigma and the waning of HIV exceptionalism.

    PubMed

    Wynia, Matthew K

    2006-01-01

    The Centers for Disease Control and Prevention (CDC) recently recommended that HIV screening should become routine for all adults in the United States. Implicit in the CDC proposal is the notion that pre-test counseling would be more limited than at present, and that written informed consent to screening would no longer be required. If widely implemented, routine testing would mark a tremendous shift in the US HIV screening strategy. There are a number of considerations used to determine what screening tests should be routine, and HIV fits the bill in almost every regard. Yet the stigma associated with HIV infection remains, making the CDC's recommendation highly controversial. Will minimizing requirements for pre-test counseling and special written informed consent lead to unexpected or unwanted HIV testing, or do these stringent counseling and consent requirements needlessly scare people away? Will widespread and routine testing be associated with declining stigmatization, or will it drive some patients away from seeking desperately needed health care? These are high stakes questions, and we're about to find out the answers.

  19. Real-Time Whole-Genome Sequencing for Routine Typing, Surveillance, and Outbreak Detection of Verotoxigenic Escherichia coli

    PubMed Central

    Scheutz, Flemming; Lund, Ole; Hasman, Henrik; Kaas, Rolf S.; Nielsen, Eva M.; Aarestrup, Frank M.

    2014-01-01

    Fast and accurate identification and typing of pathogens are essential for effective surveillance and outbreak detection. The current routine procedure is based on a variety of techniques, making the procedure laborious, time-consuming, and expensive. With whole-genome sequencing (WGS) becoming cheaper, it has huge potential in both diagnostics and routine surveillance. The aim of this study was to perform a real-time evaluation of WGS for routine typing and surveillance of verocytotoxin-producing Escherichia coli (VTEC). In Denmark, the Statens Serum Institut (SSI) routinely receives all suspected VTEC isolates. During a 7-week period in the fall of 2012, all incoming isolates were concurrently subjected to WGS using IonTorrent PGM. Real-time bioinformatics analysis was performed using web-tools (www.genomicepidemiology.org) for species determination, multilocus sequence type (MLST) typing, and determination of phylogenetic relationship, and a specific VirulenceFinder for detection of E. coli virulence genes was developed as part of this study. In total, 46 suspected VTEC isolates were characterized in parallel during the study. VirulenceFinder proved successful in detecting virulence genes included in routine typing, explicitly verocytotoxin 1 (vtx1), verocytotoxin 2 (vtx2), and intimin (eae), and also detected additional virulence genes. VirulenceFinder is also a robust method for assigning verocytotoxin (vtx) subtypes. A real-time clustering of isolates in agreement with the epidemiology was established from WGS, enabling discrimination between sporadic and outbreak isolates. Overall, WGS typing produced results faster and at a lower cost than the current routine. Therefore, WGS typing is a superior alternative to conventional typing strategies. This approach may also be applied to typing and surveillance of other pathogens. PMID:24574290

  20. Routine versus on demand removal of the syndesmotic screw; a protocol for an international randomised controlled trial (RODEO-trial).

    PubMed

    Dingemans, S A; Birnie, M F N; Sanders, F R K; van den Bekerom, M P J; Backes, M; van Beeck, E; Bloemers, F W; van Dijkman, B; Flikweert, E; Haverkamp, D; Holtslag, H R; Hoogendoorn, J M; Joosse, P; Parkkinen, M; Roukema, G; Sosef, N; Twigt, B A; van Veen, R N; van der Veen, A H; Vermeulen, J; Winkelhagen, J; van der Zwaard, B C; van Dieren, S; Goslings, J C; Schepers, T

    2018-01-31

    Syndesmotic injuries are common and their incidence is rising. In case of surgical fixation of the syndesmosis a metal syndesmotic screw is used most often. It is however unclear whether this screw needs to be removed routinely after the syndesmosis has healed. Traditionally the screw is removed after six to 12 weeks as it is thought to hamper ankle functional and to be a source of pain. Some studies however suggest this is only the case in a minority of patients. We therefore aim to investigate the effect of retaining the syndesmotic screw on functional outcome. This is a pragmatic international multicentre randomised controlled trial in patients with an acute syndesmotic injury for which a metallic syndesmotic screw was placed. Patients will be randomised to either routine removal of the syndesmotic screw or removal on demand. Primary outcome is functional recovery at 12 months measured with the Olerud-Molander Score. Secondary outcomes are quality of life, pain and costs. In total 194 patients will be needed to demonstrate non-inferiority between the two interventions at 80% power and a significance level of 0.025 including 15% loss to follow-up. If removal on demand of the syndesmotic screw is non-inferior to routine removal in terms of functional outcome, this will offer a strong argument to adopt this as standard practice of care. This means that patients will not have to undergo a secondary procedure, leading to less complications and subsequent lower costs. This study was registered at the Netherlands Trial Register (NTR5965), Clinicaltrials.gov ( NCT02896998 ) on July 15th 2016.

  1. Validation of Mode-S Meteorological Routine Air Report aircraft observations

    NASA Astrophysics Data System (ADS)

    Strajnar, B.

    2012-12-01

    The success of mesoscale data assimilation depends on the availability of three-dimensional observations with high spatial and temporal resolution. This paper describes an example of such observations, available through Mode-S air traffic control system composed of ground radar and transponders on board the aircraft. The meteorological information is provided by interrogation of a dedicated meteorological data register, called Meteorological Routine Air Report (MRAR). MRAR provides direct measurements of temperature and wind, but is only returned by a small fraction of aircraft. The quality of Mode-S MRAR data, collected at the Ljubljana Airport, Slovenia, is assessed by its comparison with AMDAR and high-resolution radiosonde data sets, which enable high- and low-level validation, respectively. The need for temporal smoothing of raw Mode-S MRAR data is also studied. The standard deviation of differences between smoothed Mode-S MRAR and AMDAR is 0.35°C for temperature, 0.8 m/s for wind speed and below 10 degrees for wind direction. The differences with respect to radiosondes are larger, with standard deviations of approximately 1.7°C, 3 m/s and 25 degrees for temperature, wind speed and wind direction, respectively. It is concluded that both wind and temperature observations from Mode-S MRAR are accurate and therefore potentially very useful for data assimilation in numerical weather prediction models.

  2. Consequences of routine delivery at 38 weeks for A-2 gestational diabetes.

    PubMed

    Rayburn, William F; Sokkary, Nancy; Clokey, Diana E; Moore, Lisa E; Curet, Luis B

    2005-11-01

    To report our intrapartum experience with routine delivery at 38 weeks of gestation of A-2 diabetic pregnancies requiring primarily oral hypoglycemic therapy. This retrospective study consisted of 143 consecutive women with gestational diabetes not controlled with diet alone (A-2). Each underwent a routine trial of labor at 38 weeks of gestation. The preinduction condition of the cervix, need for oxytocin, and primary cesarean rates were primary endpoints. For comparison, a control group during that same period consisted of 137 consecutive diet-controlled diabetic (A-1) pregnancies with the same eligibility criteria who underwent expectant management at 38 weeks. The study group was more likely to have an unfavorable cervix (75% versus 45%; p < 0.001) and to require oxytocin (76% versus 56%; p < 0.001). Early onset meconium was less common in the study group (3.5% versus 13.1%; p < 0.01). Primary cesarean rates were low and not different between the study and control groups (12.7% versus 11.7%; p < 0.8). The only stillbirth was in the control group and was associated with a tight double nuchal cord encirclement. Mean birth weights and the frequency of birth weights > 4000 g were not different between groups. Shoulder dystocia, low Apgar scores, and admissions to the special care nursery were infrequent in either group. No respiratory difficulties requiring resuscitation or prolonged nursery care were encountered. Routine delivery at 38 weeks in an A-2 diabetic population is not associated with additional intrapartum morbidity or a greater need for cesarean delivery.

  3. A Statistical Analysis of the Medicare Hospital Routine Nursing Salary Cost Differential

    PubMed Central

    Fitzmaurice, J. Michael

    1983-01-01

    From July 1971 (but effective retroactively to July 1, 1969) to October 1981, Medicare hospital reimbursement methods assumed that patients in the qualifying categories of the aged, pediatric, maternal, and kidney transplant cases consumed 8.5 percent more routine nursing resources than patients outside these categories. Consequently, the Medicare program paid this nursing differential to hospitals for all its hospitalized beneficiaries in these categories. The purpose of this study is to investigate whether hospitals with more qualifying Medicare patients do, in fact, have higher per diem routine nursing salary costs. This study tests this hypothesis while attempting to hold constant the influences of other factors such as local area wages, hospital size, occupancy rate, type of control, and geographic region. Using 1979 data from over 4,500 hospitals, and 1977, 1978, and 1979 data from a sample of 1200 hospitals, this study looks at the relationship between per diem hospital routine nursing salary costs and the proportion of qualifying Medicare routine patient days in two models. Model I incorporates the framework of the Section 223 routine cost limits and Model II incorporates a comprehensive set of variables representing the hospitals′ production and output characteristics. The evidence from this study provides little empirical basis to support the existence of a strong or sizeable relationship and, hence, does not support payment of the Medicare routine nursing salary cost differential. PMID:10310276

  4. Accurate EPR radiosensitivity calibration using small sample masses

    NASA Astrophysics Data System (ADS)

    Hayes, R. B.; Haskell, E. H.; Barrus, J. K.; Kenner, G. H.; Romanyukha, A. A.

    2000-03-01

    We demonstrate a procedure in retrospective EPR dosimetry which allows for virtually nondestructive sample evaluation in terms of sample irradiations. For this procedure to work, it is shown that corrections must be made for cavity response characteristics when using variable mass samples. Likewise, methods are employed to correct for empty tube signals, sample anisotropy and frequency drift while considering the effects of dose distribution optimization. A demonstration of the method's utility is given by comparing sample portions evaluated using both the described methodology and standard full sample additive dose techniques. The samples used in this study are tooth enamel from teeth removed during routine dental care. We show that by making all the recommended corrections, very small masses can be both accurately measured and correlated with measurements of other samples. Some issues relating to dose distribution optimization are also addressed.

  5. Monitoring circuit accurately measures movement of solenoid valve

    NASA Technical Reports Server (NTRS)

    Gillett, J. D.

    1966-01-01

    Solenoid operated valve in a control system powered by direct current issued to accurately measure the valve travel. This system is currently in operation with a 28-vdc power system used for control of fluids in liquid rocket motor test facilities.

  6. Evidence for Acute Electrophysiological and Cognitive Changes Following Routine Soccer Heading.

    PubMed

    Di Virgilio, Thomas G; Hunter, Angus; Wilson, Lindsay; Stewart, William; Goodall, Stuart; Howatson, Glyn; Donaldson, David I; Ietswaart, Magdalena

    2016-11-01

    There is growing concern around the effects of concussion and sub-concussive impacts in sport. Routine game-play in soccer involves intentional and repeated head impacts through ball heading. Although heading is frequently cited as a risk to brain health, little data exist regarding the consequences of this activity. This study aims to assess the immediate outcomes of routine football heading using direct and sensitive measures of brain function. Nineteen amateur football players (5 females; age 22±3y) headed machine-projected soccer balls at standardized speeds, modelling routine soccer practice. The primary outcome measure of corticomotor inhibition measured using transcranial magnetic stimulation, was assessed prior to heading and repeated immediately, 24h, 48h and 2weeks post-heading. Secondary outcome measures were cortical excitability, postural control, and cognitive function. Immediately following heading an increase in corticomotor inhibition was detected; further to these electrophysiological alterations, measurable reduction memory function were also found. These acute changes appear transient, with values normalizing 24h post-heading. Sub-concussive head impacts routine in soccer heading are associated with immediate, measurable electrophysiological and cognitive impairments. Although these changes in brain function were transient, these effects may signal direct consequences of routine soccer heading on (long-term) brain health which requires further study. Copyright © 2016 The Authors. Published by Elsevier B.V. All rights reserved.

  7. The Effect of Instruction on Pragmatic Routines in Academic Discussion

    ERIC Educational Resources Information Center

    Bardovi-Harlig, Kathleen; Mossman, Sabrina; Vellenga, Heidi E.

    2015-01-01

    This study investigates the effect of instruction on the acquisition of pragmatic routines used in academic discussion, specifically expressions of agreement, disagreement, and clarification. Thirty-seven learners, including an experimental group of 26 students and a control group of 11 students, participated in the study. Five intact classes…

  8. The inSIGHT study: costs and effects of routine hysteroscopy prior to a first IVF treatment cycle. A randomised controlled trial.

    PubMed

    Smit, Janine G; Kasius, Jenneke C; Eijkemans, Marinus J C; Koks, Carolien A M; Van Golde, Ron; Oosterhuis, Jurjen G E; Nap, Annemiek W; Scheffer, Gabrielle J; Manger, Petra A P; Hoek, Annemiek; Kaplan, Mesrure; Schoot, Dick B C; van Heusden, Arne M; Kuchenbecker, Walter K H; Perquin, Denise A M; Fleischer, Kathrin; Kaaijk, Eugenie M; Sluijmer, Alexander; Friederich, Jaap; Laven, Joop S E; van Hooff, Marcel; Louwe, Leonie A; Kwee, Janet; Boomgaard, Jantien J; de Koning, Corry H; Janssen, Ineke C A H; Mol, Femke; Mol, Ben W J; Torrance, Helen L; Broekmans, Frank J M

    2012-08-08

    In in vitro fertilization (IVF) and intracytoplasmatic sperm injection (ICSI) treatment a large drop is present between embryo transfer and occurrence of pregnancy. The implantation rate per embryo transferred is only 30%. Studies have shown that minor intrauterine abnormalities can be found in 11-45% of infertile women with a normal transvaginal sonography or hysterosalpingography. Two randomised controlled trials have indicated that detection and treatment of these abnormalities by office hysteroscopy after two failed IVF cycles leads to a 9-13% increase in pregnancy rate. Therefore, screening of all infertile women for intracavitary pathology prior to the start of IVF/ICSI is increasingly advocated. In absence of a scientific basis for such a policy, this study will assess the effects and costs of screening for and treatment of unsuspected intrauterine abnormalities by routine office hysteroscopy, with or without saline infusion sonography (SIS), prior to a first IVF/ICSI cycle. Multicenter randomised controlled trial in asymptomatic subfertile women, indicated for a first IVF/ICSI treatment cycle, with normal findings at transvaginal sonography. Women with recurrent miscarriages, prior hysteroscopy treatment and intermenstrual blood loss will not be included. Participants will be randomised for a routine fertility work-up with additional (SIS and) hysteroscopy with on-the-spot-treatment of predefined intrauterine abnormalities versus the regular fertility work-up without additional diagnostic tests. The primary study outcome is the cumulative ongoing pregnancy rate resulting in live birth achieved within 18 months of IVF/ICSI treatment after randomisation. Secondary study outcome parameters are the cumulative implantation rate; cumulative miscarriage rate; patient preference and patient tolerance of a SIS and hysteroscopy procedure. All data will be analysed according to the intention-to-treat principle, using univariate and multivariate logistic regression and

  9. Effect of supportive supervision on routine immunization service delivery-a randomized post-test study in Odisha.

    PubMed

    Som, Meena; Panda, Bhuputra; Pati, Sanghamitra; Nallala, Srinivas; Anasuya, Anita; Chauhan, Abhimanyu Singh; Sen, Ashish Kumar; Zodpey, Sanjay

    2014-06-30

    Routine immunization is a key child survival intervention. Issues related to quality of service delivery pose operational challenges in delivering effective immunization services. Accumulated evidences suggest that "supportive supervision" improves the quality of health care services. During 2009-10, Govt. of Odisha (GoO) and UNICEF jointly piloted this strategy in four districts to improve routine immunization. The present study aims to assess the effect of supportive supervision strategy on improvement of knowledge and practices on routine immunization among service providers. We adopted a 'post-test only' study design to compare the knowledge and practices of frontline health workers and their supervisors in four intervention districts with that of two control districts. Altogether we interviewed 170 supervisors and supervisees (health workers), each, using semi-structured interview schedules. We also directly observed 25 ice lined refrigerator (ILR) points in both groups of districts. The findings were compared with the baseline information, available only for the intervention districts. The health workers in the intervention districts displayed a higher knowledge score in selected items than in the control group. No significant difference in knowledge was observed between control and intervention supervisors. The management practices at ILR points on key routine immunization components were found to have improved significantly in intervention districts. The observed improvements in the ILR management practices indicate positive influence of supportive supervision. Higher level of domain knowledge among intervention health workers on specific items related to routine immunization could be due to successful transfer of knowledge from supervisors. A 'pre-post' study design should be undertaken to gain insights into the effectiveness of supportive supervision in improving routine immunization services.

  10. Knee arthroscopy routines and practice.

    PubMed

    Brattwall, M; Jacobson, E; Forssblad, M; Jakobsson, J

    2010-12-01

    Knee arthroscopy is one of most commonly performed day-case orthopaedic procedures, thus consuming huge medical resources. The aim of the present questionnaire survey was to study knee arthroscopy routines and practice. An electronic web-based survey including questions around pre-, per- and postoperative routines for elective knee arthroscopy was send to all orthopaedic units associated to the Swedish Arthroscopic Society (n = 60). Responses covering 37 centres out of 60 (response rate 62%) were returned. Preoperative radiograph routines varied considerable between centres; conventional radiograph varied between 5 and 100% and preoperative MRI between 5 and 80% of patients. General anaesthesia was the preferred intra-operative technique used in all centres (median 79% of patients), local anaesthesia with or without light sedation was used in all 28 out of the 37 centres responding (median 10% of cases) and spinal anaesthesia was used in 15 centres (median 5% of cases). Intra-articular local anaesthesia was provided in all but one of centres. Perioperative administration of oral NSAIDs was common (31 out 37), 6 centres (all teaching hospitals) did not routinely give pre- or postoperative NSAID. Analgesic prescription was provided on a regular base in 18 (49%) of centres; an NSAID being the most commonly prescribed. All but one centre provided written information and instruction at discharge. Referral to physiotherapy, prescribed sick leave and scheduled follow-up in the outpatient clinic diverged considerably. Routines and practice associated to elective knee arthroscopy differed; however, no clear differences in practice were seen between teaching centres, general or local hospitals apart from a lower usage of NSAID for perioperative analgesia. There is an obvious room for further standardisation in the routine handling of patients undergoing elective arthroscopy of the knee.

  11. Active Movement Warm-Up Routines

    ERIC Educational Resources Information Center

    Walter, Teri; Quint, Ashleigh; Fischer, Kim; Kiger, Joy

    2011-01-01

    This article presents warm-ups that are designed to physiologically and psychologically prepare students for vigorous physical activity. An active movement warm-up routine is made up of three parts: (1) active warm-up movement exercises, (2) general preparation, and (3) the energy system. These warm-up routines can be used with all grade levels…

  12. Treatment outcomes for human African Trypanosomiasis in the Democratic Republic of the Congo: analysis of routine program data from the world's largest sleeping sickness control program.

    PubMed

    Hasker, E; Mpanya, A; Makabuza, J; Mbo, F; Lumbala, C; Kumpel, J; Claeys, Y; Kande, V; Ravinetto, R; Menten, J; Lutumba, P; Boelaert, M

    2012-09-01

    To enable the human African trypanosomiasis (HAT) control program of the Democratic Republic of the Congo to generate data on treatment outcomes, an electronic database was developed. The database was piloted in two provinces, Bandundu and Kasai Oriental. In this study, we analysed routine data from the two provinces for the period 2006-2008. Data were extracted from case declaration cards and monthly reports available at national and provincial HAT coordination units and entered into the database. Data were retrieved for 15 086 of 15 741 cases reported in the two provinces for the period (96%). Compliance with post-treatment follow-up was very poor in both provinces; only 25% had undergone at least one post-treatment follow-up examination, <1% had undergone the required four follow-up examinations. Relapse rates among those presenting for follow-up were high in Kasai (18%) but low in Bandundu (0.3%). High relapse rates in Kasai and poor compliance with post-treatment follow-up in both provinces are important problems that the HAT control program urgently needs to address. Moreover, in analogy to tuberculosis control programs, HAT control programs need to adopt a recording and reporting routine that includes reporting on treatment outcomes. © 2012 Blackwell Publishing Ltd.

  13. Hyperventilation during routine electroencephalography: are three minutes really necessary?

    PubMed

    Watemberg, Nathan; Farkash, Michael; Har-Gil, Miki; Sezer, Taner; Goldberg-Stern, Hadassah; Alehan, Füsun

    2015-04-01

    Hyperventilation induces absence seizures in children with absence epilepsy, and routine electroencephalography studies include three minutes of hyperventilation. We studied the duration of hyperventilation required to provoke a first absence seizure to determine whether three minutes of the procedure are indeed necessary. Electroencephalography records of children who experienced absence seizures during hyperventilation were reviewed. The time from hyperventilation onset to a first and further seizure(s) was measured, and the occurrence of absences during the posthyperventilation phase was also noted. Sixty-two studies were evaluated. Mean time from hyperventilation onset to a first absence was 52 seconds (median 32 seconds). The vast majority (85.5%) had an absence within 90 seconds. Most (68%) children sustained a single event. All eight children with posthyperventilation seizures had experienced at least one event during hyperventilation. Our findings suggest that current guidelines for routine pediatric electroencephalography recording requiring three minutes of hyperventilation may not be clinically necessary. We found that the vast majority of children referred for suspected absence seizures experience a seizure less than 90 seconds after hyperventilation onset, and even more so by 120 seconds. Hence, a larger prospective study is warranted to establish more accurate hyperventilation duration parameters. We also suggest that once an absence seizure has been recorded at any time during hyperventilation, this procedure could be stopped, thus reducing the amount of discomfort for the child. Copyright © 2015 Elsevier Inc. All rights reserved.

  14. From strategy development to routine implementation: the cost of Intermittent Preventive Treatment in Infants for malaria control

    PubMed Central

    Manzi, Fatuma; Hutton, Guy; Schellenberg, Joanna; Tanner, Marcel; Alonso, Pedro; Mshinda, Hassan; Schellenberg, David

    2008-01-01

    Background Achieving the Millennium Development Goals for health requires a massive scaling-up of interventions in Sub Saharan Africa. Intermittent Preventive Treatment in infants (IPTi) is a promising new tool for malaria control. Although efficacy information is available for many interventions, there is a dearth of data on the resources required for scaling up of health interventions. Method We worked in partnership with the Ministry of Health and Social Welfare (MoHSW) to develop an IPTi strategy that could be implemented and managed by routine health services. We tracked health system and other costs of (1) developing the strategy and (2) maintaining routine implementation of the strategy in five districts in southern Tanzania. Financial costs were extracted and summarized from a costing template and semi-structured interviews were conducted with key informants to record time and resources spent on IPTi activities. Results The estimated financial cost to start-up and run IPTi in the whole of Tanzania in 2005 was US$1,486,284. Start-up costs of US$36,363 were incurred at the national level, mainly on the development of Behaviour Change Communication (BCC) materials, stakeholders' meetings and other consultations. The annual running cost at national level for intervention management and monitoring and drug purchase was estimated at US$459,096. Start-up costs at the district level were US$7,885 per district, mainly expenditure on training. Annual running costs were US$170 per district, mainly for printing of BCC materials. There was no incremental financial expenditure needed to deliver the intervention in health facilities as supplies were delivered alongside routine vaccinations and available health workers performed the activities without working overtime. The economic cost was estimated at 23 US cents per IPTi dose delivered. Conclusion The costs presented here show the order of magnitude of expenditures needed to initiate and to implement IPTi at national

  15. Accurately tracking single-cell movement trajectories in microfluidic cell sorting devices.

    PubMed

    Jeong, Jenny; Frohberg, Nicholas J; Zhou, Enlu; Sulchek, Todd; Qiu, Peng

    2018-01-01

    Microfluidics are routinely used to study cellular properties, including the efficient quantification of single-cell biomechanics and label-free cell sorting based on the biomechanical properties, such as elasticity, viscosity, stiffness, and adhesion. Both quantification and sorting applications require optimal design of the microfluidic devices and mathematical modeling of the interactions between cells, fluid, and the channel of the device. As a first step toward building such a mathematical model, we collected video recordings of cells moving through a ridged microfluidic channel designed to compress and redirect cells according to cell biomechanics. We developed an efficient algorithm that automatically and accurately tracked the cell trajectories in the recordings. We tested the algorithm on recordings of cells with different stiffness, and showed the correlation between cell stiffness and the tracked trajectories. Moreover, the tracking algorithm successfully picked up subtle differences of cell motion when passing through consecutive ridges. The algorithm for accurately tracking cell trajectories paves the way for future efforts of modeling the flow, forces, and dynamics of cell properties in microfluidics applications.

  16. Improving care coordination using organisational routines.

    PubMed

    Prætorius, Thim

    2016-01-01

    The purpose of this paper is to systematically apply theory of organisational routines to standardised care pathways. The explanatory power of routines is used to address open questions in the care pathway literature about their coordinating and organising role, the way they change and can be replicated, the way they are influenced by the organisation and the way they influence health care professionals. Theory of routines is systematically applied to care pathways in order to develop theoretically derived propositions. Care pathways mirror routines by being recurrent, collective and embedded and specific to an organisation. In particular, care pathways resemble standard operating procedures that can give rise to recurrent collective action patterns. In all, 11 propositions related to five categories are proposed by building on these insights: care pathways and coordination, change, replication, the organisation and health care professionals. Research limitations/implications - The paper is conceptual and uses care pathways as illustrative instances of hospital routines. The propositions provide a starting point for empirical research. The analysis highlights implications that health care professionals and managers have to consider in relation to coordination, change, replication, the way the organisation influences care pathways and the way care pathways influence health care professionals. Originality/value - Theory on organisational routines offers fundamental, yet unexplored, insights into hospital processes, including in particular care coordination.

  17. TargetCOPD: a pragmatic randomised controlled trial of targeted case finding for COPD versus routine practice in primary care: protocol.

    PubMed

    Jordan, Rachel E; Adab, Peymané; Jowett, Sue; Marsh, Jen L; Riley, Richard D; Enocson, Alexandra; Miller, Martin R; Cooper, Brendan G; Turner, Alice M; Ayres, Jon G; Cheng, Kar Keung; Jolly, Kate; Stockley, Robert A; Greenfield, Sheila; Siebert, Stanley; Daley, Amanda; Fitzmaurice, David A

    2014-10-04

    Many people with clinically significant chronic obstructive pulmonary disease (COPD) remain undiagnosed worldwide. There are a number of small studies which have examined possible methods of case finding through primary care, but no large RCTs that have adequately assessed the most cost-effective approach. In this study, using a cluster randomised controlled trial (RCT) in 56 general practices in the West Midlands, we plan to investigate the effectiveness and cost-effectiveness of a Targeted approach to case finding for COPD compared with routine practice. Using an individual patient RCT nested in the Targeted arm, we plan also to compare the effectiveness and cost-effectiveness of Active case finding using a postal questionnaire (with supplementary opportunistic questionnaires), and Opportunistic-only case finding during routine surgery consultations.All ever-smoking patients aged 40-79 years, without a current diagnosis of COPD and registered with participating practices will be eligible. Patients in the Targeted arm who report positive respiratory symptoms (chronic cough or phlegm, wheeze or dyspnoea) using a brief questionnaire will be invited for further spirometric assessment to ascertain whether they have COPD or not. Post-bronchodilator spirometry will be conducted to ATS standards using an Easy One spirometer by trained research assistants.The primary outcomes will be new cases of COPD and cost per new case identified, comparing targeted case finding with routine care, and two types of targeted case finding (active versus opportunistic). A multilevel logistic regression model will be used to model the probability of detecting a new case of COPD for each treatment arm, with clustering of patients (by practice and household) accounted for using a multi-level structure.A trial-based analysis will be undertaken using costs and outcomes collected during the trial. Secondary outcomes include the feasibility, efficiency, long-term cost-effectiveness, patient and

  18. Factors Related to Women's Childbirth Satisfaction in Physiologic and Routine Childbirth Groups

    PubMed Central

    Jafari, Elham; Mohebbi, Parvin; Mazloomzadeh, Saeideh

    2017-01-01

    Background: Women's satisfaction with childbirth is an important measure of the quality of maternity care services. This study aims to address factors related to women's childbirth satisfaction in physiological and routine childbirth groups. Materials and Methods: This descriptive-analytical study was conducted among 340 women in physiological and routine childbirth groups in 2012. Women were selected through convenience sampling method in the routine group and by census in the physiological group. Data were collected using a 5-part questionnaire composed of demographic and obstetrics details, Mackey's Childbirth Satisfaction Rating Scale (CSRS), satisfied with birth setting, Labor Agentry Scale (LAS), and Visual Analogue Scale (VAS), which was completed by interview 24 hours after childbirth. Data were analyzed using the Statistical Package for the Social Sciences version 18 software using Pearson correlation test, independent t-test, analysis of variance, and linear, multivariate regression model at the significant level of P < 0.05. Results: In both the physiological and routine childbirth groups, satisfaction was found related to the severity of pain (P < 0.05), self-control (P < 0.0001), and birth setting satisfaction (P < 0.0001). In the physiological group, satisfaction was significantly related to previous knowledge of childbirth (P = 0.024), attitude toward the recent pregnancy (P = 0.007), and perceived severity of pain (P = 0.016). However, in the routine group, satisfaction was related only to intentional pregnancy (P = 0.002). In neither group, satisfaction was related to demographic characteristics, maternal parity, and participation in pregnancy and childbirth classes or maternal feelings toward the onset of childbirth (P > 0.05). Conclusions: Improved physical structure and setting of birth room, nonmedical pain relief, mothers' involvement in the process of labor, and sense of being in control are associated with mothers' satisfaction. PMID

  19. Factors Related to Women's Childbirth Satisfaction in Physiologic and Routine Childbirth Groups.

    PubMed

    Jafari, Elham; Mohebbi, Parvin; Mazloomzadeh, Saeideh

    2017-01-01

    Women's satisfaction with childbirth is an important measure of the quality of maternity care services. This study aims to address factors related to women's childbirth satisfaction in physiological and routine childbirth groups. This descriptive-analytical study was conducted among 340 women in physiological and routine childbirth groups in 2012. Women were selected through convenience sampling method in the routine group and by census in the physiological group. Data were collected using a 5-part questionnaire composed of demographic and obstetrics details, Mackey's Childbirth Satisfaction Rating Scale (CSRS), satisfied with birth setting, Labor Agentry Scale (LAS), and Visual Analogue Scale (VAS), which was completed by interview 24 hours after childbirth. Data were analyzed using the Statistical Package for the Social Sciences version 18 software using Pearson correlation test, independent t -test, analysis of variance, and linear, multivariate regression model at the significant level of P < 0.05. In both the physiological and routine childbirth groups, satisfaction was found related to the severity of pain ( P < 0.05), self-control ( P < 0.0001), and birth setting satisfaction ( P < 0.0001). In the physiological group, satisfaction was significantly related to previous knowledge of childbirth ( P = 0.024), attitude toward the recent pregnancy ( P = 0.007), and perceived severity of pain ( P = 0.016). However, in the routine group, satisfaction was related only to intentional pregnancy ( P = 0.002). In neither group, satisfaction was related to demographic characteristics, maternal parity, and participation in pregnancy and childbirth classes or maternal feelings toward the onset of childbirth ( P > 0.05). Improved physical structure and setting of birth room, nonmedical pain relief, mothers' involvement in the process of labor, and sense of being in control are associated with mothers' satisfaction.

  20. Electrotactile Feedback Improves Performance and Facilitates Learning in the Routine Grasping Task.

    PubMed

    Isaković, Milica; Belić, Minja; Štrbac, Matija; Popović, Igor; Došen, Strahinja; Farina, Dario; Keller, Thierry

    2016-06-13

    Aim of this study was to investigate the feasibility of electrotactile feedback in closed loop training of force control during the routine grasping task. The feedback was provided using an array electrode and a simple six-level spatial coding, and the experiment was conducted in three amputee subjects. The psychometric tests confirmed that the subjects could perceive and interpret the electrotactile feedback with a high success rate. The subjects performed the routine grasping task comprising 4 blocks of 60 grasping trials. In each trial, the subjects employed feedforward control to close the hand and produce the desired grasping force (four levels). First (baseline) and the last (validation) session were performed in open loop, while the second and the third session (training) included electrotactile feedback. The obtained results confirmed that using the feedback improved the accuracy and precision of the force control. In addition, the subjects performed significantly better in the validation vs. baseline session, therefore suggesting that electrotactile feedback can be used for learning and training of myoelectric control.

  1. 42 CFR 493.1210 - Condition: Routine chemistry.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 5 2010-10-01 2010-10-01 false Condition: Routine chemistry. 493.1210 Section 493....1210 Condition: Routine chemistry. If the laboratory provides services in the subspecialty of Routine chemistry, the laboratory must meet the requirements specified in §§ 493.1230 through 493.1256, § 493.1267...

  2. 42 CFR 493.1210 - Condition: Routine chemistry.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 42 Public Health 5 2013-10-01 2013-10-01 false Condition: Routine chemistry. 493.1210 Section 493....1210 Condition: Routine chemistry. If the laboratory provides services in the subspecialty of Routine chemistry, the laboratory must meet the requirements specified in §§ 493.1230 through 493.1256, § 493.1267...

  3. 42 CFR 493.1210 - Condition: Routine chemistry.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 5 2011-10-01 2011-10-01 false Condition: Routine chemistry. 493.1210 Section 493....1210 Condition: Routine chemistry. If the laboratory provides services in the subspecialty of Routine chemistry, the laboratory must meet the requirements specified in §§ 493.1230 through 493.1256, § 493.1267...

  4. 42 CFR 493.1210 - Condition: Routine chemistry.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 42 Public Health 5 2012-10-01 2012-10-01 false Condition: Routine chemistry. 493.1210 Section 493....1210 Condition: Routine chemistry. If the laboratory provides services in the subspecialty of Routine chemistry, the laboratory must meet the requirements specified in §§ 493.1230 through 493.1256, § 493.1267...

  5. 42 CFR 493.1210 - Condition: Routine chemistry.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 42 Public Health 5 2014-10-01 2014-10-01 false Condition: Routine chemistry. 493.1210 Section 493....1210 Condition: Routine chemistry. If the laboratory provides services in the subspecialty of Routine chemistry, the laboratory must meet the requirements specified in §§ 493.1230 through 493.1256, § 493.1267...

  6. Routine history as compared to audio computer-assisted self-interview for prenatal care history taking.

    PubMed

    Mears, Molly; Coonrod, Dean V; Bay, R Curtis; Mills, Terry E; Watkins, Michelle C

    2005-09-01

    To compare endorsement rates obtained with audio computer-assisted self-interview versus routine prenatal history. A crosssectional study compared items captured with the routine history to those captured with a computer interview (computer screen displaying and computer audio reading questions, with responses entered by touch screen). The subjects were women (n=174) presenting to a public hospital clinic for prenatal care. The prevalence of positive responses using the computer interview was significantly greater (p < 0.01) than with the routine history for induced abortion (16.8% versus 4.0%), lifetime smoking (12.8% versus 5.2%), intimate partner violence (10.0% versus 2.4%), ectopic pregnancy (5.2% versus 1.1%) and family history of mental retardation (6.7% versus 0.6%). Significant differences were not found for history of spontaneous abortion, hypertension, epilepsy, thyroid disease, smoking during pregnancy, gynecologic surgery, abnormal Pap test, neural tube defect or cystic fibrosis family history. However, in all cases, prevalence was equal or greater with the computer interview. Women were more likely to report sensitive and high-risk behavior, such as smoking history, intimate partner violence and elective abortion, with the computer interview. The computer interview displayed equal or increased patient reporting of positive responses and may therefore be an accurate method of obtaining an initial history.

  7. Fast and accurate modeling of stray light in optical systems

    NASA Astrophysics Data System (ADS)

    Perrin, Jean-Claude

    2017-11-01

    The first problem to be solved in most optical designs with respect to stray light is that of internal reflections on the several surfaces of individual lenses and mirrors, and on the detector itself. The level of stray light ratio can be considerably reduced by taking into account the stray light during the optimization to determine solutions in which the irradiance due to these ghosts is kept to the minimum possible value. Unhappily, the routines available in most optical design software's, for example CODE V, do not permit all alone to make exact quantitative calculations of the stray light due to these ghosts. Therefore, the engineer in charge of the optical design is confronted to the problem of using two different software's, one for the design and optimization, for example CODE V, one for stray light analysis, for example ASAP. This makes a complete optimization very complex . Nevertheless, using special techniques and combinations of the routines available in CODE V, it is possible to have at its disposal a software macro tool to do such an analysis quickly and accurately, including Monte-Carlo ray tracing, or taking into account diffraction effects. This analysis can be done in a few minutes, to be compared to hours with other software's.

  8. Routines.

    DTIC Science & Technology

    1985-05-01

    ADAlS481 ROUTINES(U), NASSACNUSETTS INST OF TECH CANIRIDGE 1in ARTIFICIAL INTELLIGENCE LAS P E AfiRE NAY 85 AI- N -129 NSSS±4-7?-C-S3S9 UNCLSSIFIED F/G...Process representation 3 0. AGSTRAC? (Cal~ N 411 P011110 @do it 0600 01 MMRN& uIV.i eONlm- Regularities in the world give rise to regularities in, the way...sourcc code can wreak suhstantihd havoc. ............---... ... . . . . ........." ’.pa ". --.-. .. n . .’....p a’’. .. ’ .. ’-’..... ’..... 1

  9. A Comparative Study of Routine Laparoscopic Versus Open Appendectomy

    PubMed Central

    Yong, Jamy L.; Lam, Chi Ming

    2006-01-01

    Objective: We evaluated the outcomes of routine laparoscopy and laparoscopic appendectomy (LA) in patients with suspected appendicitis. This is a retrospective study of the outcomes of patients undergoing laparoscopic appendectomy compared with outcomes for patients undergoing open appendectomy (OA) during the time that LA came into use. Method: Results of patients managed with routine laparoscopy and LA for suspected acute appendicitis were reviewed and analyzed. The preoperative and intraoperative findings were recorded. The clinical outcomes were compared with those of patients undergoing OA in the preceding 10 months. Results: During the LA study period, 97 patients (47 men) with the median age of 34 years (range, 18 to 79) presented with clinical features of acute appendicitis. With the exclusion of 5 patients with open operations and 10 patients with other pathologies, 82 patients underwent laparoscopic appendectomy (Group A) for appendicitis. Thirty-one (37.8%) patients had complicated appendicitis (perforated or gangrenous appendicitis). Conversions were required in 6 patients (7.3%). During the OA period, 125 patients (57 men) with the median age of 42 (range, 19 to 79) years were operated on. With the exclusion of 6 patients with other pathologies, 119 underwent OA for acute appendicitis (Group B). Fifty-one (42.9%) had either perforated or gangrenous appendicitis. The median durations of surgery in Group A and Group B were 80 minutes (range, 40 to 195) and 60 minutes (range, 25 to 260), respectively (P<0.005). Postoperative complication rates were comparable between the 2 groups (13.4% in Group A versus 15.8% in Group B). The median hospital stay for patients in Group A and Group B were 3.0 days (range, 1 to 47) and 4.0 days (range, 1 to 47), respectively (P=0.037). Conclusions: We conclude that routine laparoscopy and LA for suspected acute appendicitis is safe and is associated with a significantly shorter hospital stay. Other intra

  10. Shaping the future: reforming routine emergency nursing work.

    PubMed

    Sbaih, L C

    2001-10-01

    The provision of emergency care, for many A&E nurses, is dependent upon taken-for-granted assumptions, associated with the ongoing management of the changing shape of the work. In particular, routine working practices and procedures reflect a collective ideology of A&E nursing labour which involves moving people on and out of the emergency department. Subscribing to this ideology and realizing good shape provides nurses with a feeling that they are in control of their work and have done a good job. Analysis of the NHS Plan has identified that the Government's goals for reform support as well as challenge the ways in which nurses currently strive towards maintaining the good shape of their work. In particular, the ideology of patient-centredness and the Chief Nursing Officer's ten key roles for nurses, provide an opportunity for nurses to explore the ways in which they can cultivate their routine activities and contribute to the shape of future emergency nursing work.

  11. Routines Are the Foundation of Classroom Management

    ERIC Educational Resources Information Center

    Lester, Robin Rawlings; Allanson, Patricia Bolton; Notar, Charles E.

    2017-01-01

    Classroom management is the key to learning. Routines are the foundation of classroom management. Students require structure in their lives. Routines provide that in all of their life from the time they awake until the time they go to bed. Routines in a school and in the classroom provide the environment for learning to take place. The paper is…

  12. Short structured general mental health in service training programme in Kenya improves patient health and social outcomes but not detection of mental health problems - a pragmatic cluster randomised controlled trial

    PubMed Central

    2013-01-01

    Trial design A pragmatic cluster randomised controlled trial. Methods Participants: Clusters were primary health care clinics on the Ministry of Health list. Clients were eligible if they were aged 18 and over. Interventions: Two members of staff from each intervention clinic received the training programme. Clients in both intervention and control clinics subsequently received normal routine care from their health workers. Objective: To examine the impact of a mental health inservice training on routine detection of mental disorder in the clinics and on client outcomes. Outcomes: The primary outcome was the rate of accurate routine clinic detection of mental disorder and the secondary outcome was client recovery over a twelve week follow up period. Randomisation: clinics were randomised to intervention and control groups using a table of random numbers. Blinding: researchers and clients were blind to group assignment. Results Numbers randomised: 49 and 50 clinics were assigned to intervention and control groups respectively. 12 GHQ positive clients per clinic were identified for follow up. Numbers analysed: 468 and 478 clients were followed up for three months in intervention and control groups respectively. Outcome: At twelve weeks after training of the intervention group, the rate of accurate routine clinic detection of mental disorder was greater than 0 in 5% versus 0% of the intervention and control groups respectively, in both the intention to treat analysis (p = 0.50) and the per protocol analysis (p =0.50). Standardised effect sizes for client improvement were 0.34 (95% CI = (0.01,0.68)) for the General Health Questionnaire, 0.39 ((95% CI = (0.22, 0.61)) for the EQ and 0.49 (95% CI = (0.11,0.87)) for WHODAS (using ITT analysis); and 0.43 (95% CI = (0.09,0.76)) for the GHQ, 0.44 (95% CI = (0.22,0.65)) for the EQ and 0.58 (95% CI = (0.18,0.97)) for WHODAS (using per protocol analysis). Harms: None identified. Conclusion The

  13. Exploring the use of routinely-available, retrospective data to study the association between malaria control scale-up and micro-economic outcomes in Zambia.

    PubMed

    Comfort, Alison; Leegwater, Anthony; Nakhimovsky, Sharon; Kansembe, Henry; Hamainza, Busiku; Bwalya, Benson; Alilio, Martin; Johns, Ben; Olsho, Lauren

    2017-01-04

    Country-level evidence on the impact of malaria control on micro-economic outcomes is vital for mobilizing domestic and donor resources for malaria control. Using routinely available survey data could facilitate this investigation in a cost-efficient way. The authors used Malaria Indicator Surveys (MIS) and Living Conditions Monitoring Survey (LCMS) data from 2006 to 2010 for all 72 districts in Zambia to relate malaria control scale-up with household food spending (proxy for household well-being), educational attainment and agricultural production. The authors used two quasi-experimental designs: (1) a generalized propensity score for a continuous treatment variable (defined as coverage from owning insecticide-treated bed nets and/or receipt of indoor residual spraying); and, (2) a district fixed effects model to assess changes in the outcome relative to changes in treatment pre-post scale-up. The unit of analysis was at district level. The authors also conducted simulations post-analysis to assess statistical power. Micro-economic outcomes increased (33% increase in food spending) concurrently with malaria control coverage (62% increase) from 2006 to 2010. Despite using data from all 72 districts, both analytic methods yielded wide confidence intervals that do not conclusively link outcomes and malaria control coverage increases. The authors cannot rule out positive, null or negative effects. The upper bound estimates of the results show that if malaria control coverage increases from 60 to 70%, food spending could increase up to 14%, maize production could increase up to 57%, and years of schooling could increase up to 0.5 years. Simulations indicated that the generalized propensity score model did not have good statistical power. While it is technically possible to use routinely available survey data to relate malaria control scale-up and micro-economic outcomes, it is not clear from this analysis that meaningful results can be obtained when survey data are

  14. The additional benefit of residual spraying and insecticide-treated curtains for dengue control over current best practice in Cuba: Evaluation of disease incidence in a cluster randomized trial in a low burden setting with intensive routine control.

    PubMed

    Toledo, Maria Eugenia; Vanlerberghe, Veerle; Rosales, Julio Popa; Mirabal, Mayelin; Cabrera, Pedro; Fonseca, Viviana; Gómez Padrón, Tania; Pérez Menzies, Mirtha; Montada, Domingo; Van der Stuyft, Patrick

    2017-11-01

    Aedes control interventions are considered the cornerstone of dengue control programmes, but there is scarce evidence on their effect on disease. We set-up a cluster randomized controlled trial in Santiago de Cuba to evaluate the entomological and epidemiological effectiveness of periodical intra- and peri-domiciliary residual insecticide (deltamethrin) treatment (RIT) and long lasting insecticide treated curtains (ITC). Sixty three clusters (around 250 households each) were randomly allocated to two intervention (RIT and ITC) and one control arm. Routine Aedes control activities (entomological surveillance, source reduction, selective adulticiding, health education) were applied in the whole study area. The outcome measures were clinical dengue case incidence and immature Aedes infestation. Effectiveness of tools was evaluated using a generalized linear regression model with a negative binomial link function. Despite significant reduction in Aedes indices (Rate Ratio (RR) 0.54 (95%CI 0.32-0.89) in the first month after RIT, the effect faded out over time and dengue incidence was not reduced. Overall, in this setting there was no protective effect of RIT or ITC over routine in the 17months intervention period, with for house index RR of 1.16 (95%CI 0.96-1.40) and 1.25 (95%CI 1.03-1.50) and for dengue incidence RR of 1.43 (95%CI 1.08-1.90) and 0.96 (95%CI 0.72-1.28) respectively. The monthly dengue incidence rate (IR) at cluster level was best explained by epidemic periods (Incidence Rate Ratio (IRR) 5.50 (95%CI 4.14-7.31)), the IR in bordering houseblocks (IRR 1.03 (95%CI 1.02-1.04)) and the IR pre-intervention (IRR 1.02 (95%CI 1.00-1.04)). Adding RIT to an intensive routine Aedes control programme has a transient effect on the already moderate low entomological infestation levels, while ITC did not have any effect. For both interventions, we didn't evidence impact on disease incidence. Further studies are needed to evaluate impact in settings with high Aedes

  15. Routine sputum culture

    MedlinePlus

    Sputum culture ... There, it is placed in a special dish (culture). It is then watched to see if bacteria ... Elsevier; 2018:chap 36. Chernecky CC, Berger BJ. Culture, routine. In: Chernecky CC, Berger BJ, eds. Laboratory ...

  16. Optimisation of the Future Routine Orbit for Mars Express

    NASA Technical Reports Server (NTRS)

    Carranza, Manuel; Companys, Vincente

    2007-01-01

    the aim at preserving propellant resources for a long time extension it has been agreed to stop the ground-track control. This requires now a more accurate science operation planning, with improved attitude pointing control. Finally, the approach to phase Mars Express to provide back-up relay functions for NASA Phoenix landing is explained. In the context of the routine trajectory optimisation a new requirement for close fly-bys at Phobos, with different observation geometries, has been specified. The approach to fulfill this requirement is explained.

  17. The inSIGHT study: costs and effects of routine hysteroscopy prior to a first IVF treatment cycle. A randomised controlled trial

    PubMed Central

    2012-01-01

    Background In in vitro fertilization (IVF) and intracytoplasmatic sperm injection (ICSI) treatment a large drop is present between embryo transfer and occurrence of pregnancy. The implantation rate per embryo transferred is only 30%. Studies have shown that minor intrauterine abnormalities can be found in 11–45% of infertile women with a normal transvaginal sonography or hysterosalpingography. Two randomised controlled trials have indicated that detection and treatment of these abnormalities by office hysteroscopy after two failed IVF cycles leads to a 9–13% increase in pregnancy rate. Therefore, screening of all infertile women for intracavitary pathology prior to the start of IVF/ICSI is increasingly advocated. In absence of a scientific basis for such a policy, this study will assess the effects and costs of screening for and treatment of unsuspected intrauterine abnormalities by routine office hysteroscopy, with or without saline infusion sonography (SIS), prior to a first IVF/ICSI cycle. Methods/design Multicenter randomised controlled trial in asymptomatic subfertile women, indicated for a first IVF/ICSI treatment cycle, with normal findings at transvaginal sonography. Women with recurrent miscarriages, prior hysteroscopy treatment and intermenstrual blood loss will not be included. Participants will be randomised for a routine fertility work-up with additional (SIS and) hysteroscopy with on-the-spot-treatment of predefined intrauterine abnormalities versus the regular fertility work-up without additional diagnostic tests. The primary study outcome is the cumulative ongoing pregnancy rate resulting in live birth achieved within 18 months of IVF/ICSI treatment after randomisation. Secondary study outcome parameters are the cumulative implantation rate; cumulative miscarriage rate; patient preference and patient tolerance of a SIS and hysteroscopy procedure. All data will be analysed according to the intention-to-treat principle, using univariate and

  18. Uniform data collection in routine clinical practice in cardiovascular patients for optimal care, quality control and research: The Utrecht Cardiovascular Cohort.

    PubMed

    Asselbergs, Folkert W; Visseren, Frank Lj; Bots, Michiel L; de Borst, Gert J; Buijsrogge, Marc P; Dieleman, Jan M; van Dinther, Baukje Gf; Doevendans, Pieter A; Hoefer, Imo E; Hollander, Monika; de Jong, Pim A; Koenen, Steven V; Pasterkamp, Gerard; Ruigrok, Ynte M; van der Schouw, Yvonne T; Verhaar, Marianne C; Grobbee, Diederick E

    2017-05-01

    Background Cardiovascular disease remains the major contributor to morbidity and mortality. In routine care for patients with an elevated cardiovascular risk or with symptomatic cardiovascular disease information is mostly collected in an unstructured manner, making the data of limited use for structural feedback, quality control, learning and scientific research. Objective The Utrecht Cardiovascular Cohort (UCC) initiative aims to create an infrastructure for uniform registration of cardiovascular information in routine clinical practice for patients referred for cardiovascular care at the University Medical Center Utrecht, the Netherlands. This infrastructure will promote optimal care according to guidelines, continuous quality control in a learning healthcare system and creation of a research database. Methods The UCC comprises three parts. UCC-1 comprises enrolment of all eligible cardiovascular patients in whom the same information will be collected, based on the Dutch cardiovascular management guideline. A sample of UCC-1 will be invited for UCC-2. UCC-2 involves an enrichment through extensive clinical measurements with emphasis on heart failure, cerebral ischaemia, arterial aneurysms, diabetes mellitus and elevated blood pressure. UCC-3 comprises on-top studies, with in-depth measurements in smaller groups of participants typically based on dedicated project grants. All participants are followed up for morbidity and mortality through linkage with national registries. Conclusion In a multidisciplinary effort with physicians, patients and researchers the UCC sets a benchmark for a learning cardiovascular healthcare system. UCC offers an invaluable resource for future high quality care as well as for first-class research for investigators.

  19. [How to Interpret and Use Routine Laboratory Data--Our Methods to Interpret Routine Laboratory Data--Chairmen's Introductory Remarks].

    PubMed

    Honda, Takayuki; Tozuka, Minoru

    2015-09-01

    In the reversed clinicopathological conference (R-CPC), three specialists in laboratory medicine interpreted routine laboratory data independently in order to understand the detailed state of a patient. R-CPC is an educational method to use laboratory data appropriately, and it is also important to select differential diagnoses in a process of clinical reasoning in addition to the present illness and physical examination. Routine laboratory tests can be performed repeatedly at a relatively low cost, and their time-series analysis can be performed. Interpretation of routine laboratory data is almost the same as taking physical findings. General findings are initially checked and then the state of each organ is examined. Although routine laboratory tests cost little, we can gain much more information from them about the patient than physical examinations.

  20. Facilitating Infant/Toddler Skills in Family-Child Routines.

    ERIC Educational Resources Information Center

    Stremel, Kathleen; And Others

    This paper on facilitating skill development of infants and toddlers with disabilities within family-child routines focuses on: (1) developing a routine analysis by incorporating multiple Individual Family Service Plan (IFSP) objectives into family-selected routines; (2) utilizing systematic family training procedures to integrate targeted skills…

  1. Explanation, motivation and question posing routines in university mathematics teachers' pedagogical discourse: a commognitive analysis

    NASA Astrophysics Data System (ADS)

    Viirman, Olov

    2015-11-01

    This paper investigates the teaching practices used by university mathematics teachers when lecturing, a topic within university mathematics education research which is gaining an increasing interest. In the study, a view of mathematics teaching as a discursive practice is taken, and Sfard's commognitive framework is used to investigate the teaching practices of seven Swedish university mathematics teachers on the topic of functions. The present paper looks at the discourse of mathematics teaching, presenting a categorization of the didactical routines into three categories - explanation, motivation and question posing routines. All of these are present in the discourses of all seven teachers, but within these general categories, a number of different sub-categories of routines are found, used in different ways and to different extent by the various teachers. The explanation routines include known mathematical facts, summary and repetition, different representations, everyday language, and concretization and metaphor; the motivation routines include reference to utility, the nature of mathematics, humour and result focus; and the question posing routines include control questions, asking for facts, enquiries and rhetorical questions. This categorization of question posing routines, for instance, complements those already found in the literature. In addition to providing a valuable insight into the teaching of functions at the university level, the categorizations presented in the study can also be useful for investigating the teaching of other mathematical topics.

  2. Routine operation of an Elliott 903 computer in a clinical chemistry laboratory

    PubMed Central

    Whitby, L. G.; Simpson, D.

    1973-01-01

    Experience gained in the last four years concerning the capabilities and limitations of an 8K Elliott 903 (18-bit word) computer with magnetic tape backing store in the routine operation of a clinical chemistry laboratory is described. Designed as a total system, routine operation has latterly had to be confined to data acquisition and process control functions, due primarily to limitations imposed by the choice of hardware early in the project. In this final report of a partially successful experiment the opportunity is taken to review mistakes made, especially at the start of the project, to warn potential computer users of pitfalls to be avoided. PMID:4580240

  3. How does routinely delivered cognitive-behavioural therapy for gambling disorder compare to "gold standard" clinical trial?

    PubMed

    Smith, David P; Fairweather-Schmidt, A Kate; Harvey, Peter W; Battersby, Malcolm W

    2018-03-01

    Currently, it is unknown whether treatment outcomes derived from randomized controlled trials (RCTs) of cognitive-behavioural therapy (CBT) for problem gamblers still hold when applied to patients seen in routine practice. Thus, data from an RCT of cognitive therapy versus exposure therapy for problem gambling versus patients of a gambling help service were compared. Assessments of problem gambling severity, psychosocial impairment, and alcohol use were undertaken at baseline and post-treatment and evaluated within a counterfactual framework. Findings showed that the contrast between routine CBT for pokies and horse betting had a significant effect, indicative of a 62% lower gambling urge score if routine CBT recipients had all been horse/track betters opposed to gambling with "pokies." However, the majority of contrasts indicated therapeutic outcomes achieved in routine CBT treatments were of equivalent robustness relative to RCT conditions. The present findings infer routine practice treatment outcomes are as efficacious as those generated in RCT contexts. Copyright © 2017 John Wiley & Sons, Ltd.

  4. SPIRIT: Systematic Planning of Intelligent Reuse of Integrated Clinical Routine Data. A Conceptual Best-practice Framework and Procedure Model.

    PubMed

    Hackl, W O; Ammenwerth, E

    2016-01-01

    Secondary use of clinical routine data is receiving an increasing amount of attention in biomedicine and healthcare. However, building and analysing integrated clinical routine data repositories are nontrivial, challenging tasks. As in most evolving fields, recognized standards, well-proven methodological frameworks, or accurately described best-practice approaches for the systematic planning of solutions for secondary use of routine medical record data are missing. We propose a conceptual best-practice framework and procedure model for the systematic planning of intelligent reuse of integrated clinical routine data (SPIRIT). SPIRIT was developed based on a broad literature overview and further refined in two case studies with different kinds of clinical routine data, including process-oriented nursing data from a large hospital group and high-volume multimodal clinical data from a neurologic intensive care unit. SPIRIT aims at tailoring secondary use solutions to specific needs of single departments without losing sight of the institution as a whole. It provides a general conceptual best-practice framework consisting of three parts: First, a secondary use strategy for the whole organization is determined. Second, comprehensive analyses are conducted from two different viewpoints to define the requirements regarding a clinical routine data reuse solution at the system level from the data perspective (BOTTOM UP) and at the strategic level from the future users perspective (TOP DOWN). An obligatory clinical context analysis (IN BETWEEN) facilitates refinement, combination, and integration of the different requirements. The third part of SPIRIT is dedicated to implementation, which comprises design and realization of clinical data integration and management as well as data analysis solutions. The SPIRIT framework is intended to be used to systematically plan the intelligent reuse of clinical routine data for multiple purposes, which often was not intended when the

  5. Raoult's law revisited: accurately predicting equilibrium relative humidity points for humidity control experiments.

    PubMed

    Bowler, Michael G; Bowler, David R; Bowler, Matthew W

    2017-04-01

    The humidity surrounding a sample is an important variable in scientific experiments. Biological samples in particular require not just a humid atmosphere but often a relative humidity (RH) that is in equilibrium with a stabilizing solution required to maintain the sample in the same state during measurements. The controlled dehydration of macromolecular crystals can lead to significant increases in crystal order, leading to higher diffraction quality. Devices that can accurately control the humidity surrounding crystals while monitoring diffraction have led to this technique being increasingly adopted, as the experiments become easier and more reproducible. Matching the RH to the mother liquor is the first step in allowing the stable mounting of a crystal. In previous work [Wheeler, Russi, Bowler & Bowler (2012). Acta Cryst. F 68 , 111-114], the equilibrium RHs were measured for a range of concentrations of the most commonly used precipitants in macromolecular crystallography and it was shown how these related to Raoult's law for the equilibrium vapour pressure of water above a solution. However, a discrepancy between the measured values and those predicted by theory could not be explained. Here, a more precise humidity control device has been used to determine equilibrium RH points. The new results are in agreement with Raoult's law. A simple argument in statistical mechanics is also presented, demonstrating that the equilibrium vapour pressure of a solvent is proportional to its mole fraction in an ideal solution: Raoult's law. The same argument can be extended to the case where the solvent and solute molecules are of different sizes, as is the case with polymers. The results provide a framework for the correct maintenance of the RH surrounding a sample.

  6. High Frequency QRS ECG Accurately Detects Cardiomyopathy

    NASA Technical Reports Server (NTRS)

    Schlegel, Todd T.; Arenare, Brian; Poulin, Gregory; Moser, Daniel R.; Delgado, Reynolds

    2005-01-01

    High frequency (HF, 150-250 Hz) analysis over the entire QRS interval of the ECG is more sensitive than conventional ECG for detecting myocardial ischemia. However, the accuracy of HF QRS ECG for detecting cardiomyopathy is unknown. We obtained simultaneous resting conventional and HF QRS 12-lead ECGs in 66 patients with cardiomyopathy (EF = 23.2 plus or minus 6.l%, mean plus or minus SD) and in 66 age- and gender-matched healthy controls using PC-based ECG software recently developed at NASA. The single most accurate ECG parameter for detecting cardiomyopathy was an HF QRS morphological score that takes into consideration the total number and severity of reduced amplitude zones (RAZs) present plus the clustering of RAZs together in contiguous leads. This RAZ score had an area under the receiver operator curve (ROC) of 0.91, and was 88% sensitive, 82% specific and 85% accurate for identifying cardiomyopathy at optimum score cut-off of 140 points. Although conventional ECG parameters such as the QRS and QTc intervals were also significantly longer in patients than controls (P less than 0.001, BBBs excluded), these conventional parameters were less accurate (area under the ROC = 0.77 and 0.77, respectively) than HF QRS morphological parameters for identifying underlying cardiomyopathy. The total amplitude of the HF QRS complexes, as measured by summed root mean square voltages (RMSVs), also differed between patients and controls (33.8 plus or minus 11.5 vs. 41.5 plus or minus 13.6 mV, respectively, P less than 0.003), but this parameter was even less accurate in distinguishing the two groups (area under ROC = 0.67) than the HF QRS morphologic and conventional ECG parameters. Diagnostic accuracy was optimal (86%) when the RAZ score from the HF QRS ECG and the QTc interval from the conventional ECG were used simultaneously with cut-offs of greater than or equal to 40 points and greater than or equal to 445 ms, respectively. In conclusion 12-lead HF QRS ECG employing

  7. Reliability of unstable periodic orbit based control strategies in biological systems.

    PubMed

    Mishra, Nagender; Hasse, Maria; Biswal, B; Singh, Harinder P

    2015-04-01

    Presence of recurrent and statistically significant unstable periodic orbits (UPOs) in time series obtained from biological systems is now routinely used as evidence for low dimensional chaos. Extracting accurate dynamical information from the detected UPO trajectories is vital for successful control strategies that either aim to stabilize the system near the fixed point or steer the system away from the periodic orbits. A hybrid UPO detection method from return maps that combines topological recurrence criterion, matrix fit algorithm, and stringent criterion for fixed point location gives accurate and statistically significant UPOs even in the presence of significant noise. Geometry of the return map, frequency of UPOs visiting the same trajectory, length of the data set, strength of the noise, and degree of nonstationarity affect the efficacy of the proposed method. Results suggest that establishing determinism from unambiguous UPO detection is often possible in short data sets with significant noise, but derived dynamical properties are rarely accurate and adequate for controlling the dynamics around these UPOs. A repeat chaos control experiment on epileptic hippocampal slices through more stringent control strategy and adaptive UPO tracking is reinterpreted in this context through simulation of similar control experiments on an analogous but stochastic computer model of epileptic brain slices. Reproduction of equivalent results suggests that far more stringent criteria are needed for linking apparent success of control in such experiments with possible determinism in the underlying dynamics.

  8. Reliability of unstable periodic orbit based control strategies in biological systems

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

    Mishra, Nagender; Singh, Harinder P.; Hasse, Maria

    2015-04-15

    Presence of recurrent and statistically significant unstable periodic orbits (UPOs) in time series obtained from biological systems is now routinely used as evidence for low dimensional chaos. Extracting accurate dynamical information from the detected UPO trajectories is vital for successful control strategies that either aim to stabilize the system near the fixed point or steer the system away from the periodic orbits. A hybrid UPO detection method from return maps that combines topological recurrence criterion, matrix fit algorithm, and stringent criterion for fixed point location gives accurate and statistically significant UPOs even in the presence of significant noise. Geometry ofmore » the return map, frequency of UPOs visiting the same trajectory, length of the data set, strength of the noise, and degree of nonstationarity affect the efficacy of the proposed method. Results suggest that establishing determinism from unambiguous UPO detection is often possible in short data sets with significant noise, but derived dynamical properties are rarely accurate and adequate for controlling the dynamics around these UPOs. A repeat chaos control experiment on epileptic hippocampal slices through more stringent control strategy and adaptive UPO tracking is reinterpreted in this context through simulation of similar control experiments on an analogous but stochastic computer model of epileptic brain slices. Reproduction of equivalent results suggests that far more stringent criteria are needed for linking apparent success of control in such experiments with possible determinism in the underlying dynamics.« less

  9. Reliability of unstable periodic orbit based control strategies in biological systems

    NASA Astrophysics Data System (ADS)

    Mishra, Nagender; Hasse, Maria; Biswal, B.; Singh, Harinder P.

    2015-04-01

    Presence of recurrent and statistically significant unstable periodic orbits (UPOs) in time series obtained from biological systems is now routinely used as evidence for low dimensional chaos. Extracting accurate dynamical information from the detected UPO trajectories is vital for successful control strategies that either aim to stabilize the system near the fixed point or steer the system away from the periodic orbits. A hybrid UPO detection method from return maps that combines topological recurrence criterion, matrix fit algorithm, and stringent criterion for fixed point location gives accurate and statistically significant UPOs even in the presence of significant noise. Geometry of the return map, frequency of UPOs visiting the same trajectory, length of the data set, strength of the noise, and degree of nonstationarity affect the efficacy of the proposed method. Results suggest that establishing determinism from unambiguous UPO detection is often possible in short data sets with significant noise, but derived dynamical properties are rarely accurate and adequate for controlling the dynamics around these UPOs. A repeat chaos control experiment on epileptic hippocampal slices through more stringent control strategy and adaptive UPO tracking is reinterpreted in this context through simulation of similar control experiments on an analogous but stochastic computer model of epileptic brain slices. Reproduction of equivalent results suggests that far more stringent criteria are needed for linking apparent success of control in such experiments with possible determinism in the underlying dynamics.

  10. When Routines Are Not so Routine: Exploring Coordination Work in Hospitals

    ERIC Educational Resources Information Center

    Haque, Saira Naim

    2010-01-01

    Many work processes take place through routines, or recurrent patterns of action. These activities involve individuals from several occupations working across spatial, temporal, and organizational boundaries. Crossing these professional, temporal and spatial boundaries has unique challenges which can lead to coordination failures. In these…

  11. Allergy to kiwi: is component-resolved diagnosis in routine clinical practice really impossible?

    PubMed

    Asero, R

    2012-04-01

    Kiwi allergy is frequent and can be the result of sensitization to a number of allergens showing different physicochemical characteristics. Component-resolved diagnosis of kiwi allergy is still unavailable in routine clinical practice. To investigate whether component resolved-diagnosis of kiwi allergy can be, at least in part, carried out by a proper combination of routinely available diagnostic tools. 63 adults with plant food allergy were studied 36 were kiwi-allergic while 27 were kiwi-tolerant and served as controls. Patients and controls underwent SPT with commercial peach and kiwi extracts, and with aprofilin-enriched date palm pollen extract (all by ALK-Abellò), and the measurement of IgE to birch, kiwi, and natural rubber latex. The in-vitro test showed poor sensitivity and specificity, as it scored positive in about 50% of patients and controls irrespective of clinical allergy to kiwi. The kiwi SPT showed overall poor sensitivity; however, it scored negative in all subjects with pollen food-allergy syndrome, was weakly positive in some lipid transfer protein-hypersensitive/kiwi tolerant subjects and in one latex-sensitized subject, and strongly positive in all subjects with primary kiwi sensitization. SPT with this commercial kiwi extract sensitively and specifically detects patients reacting to specific kiwi allergens. This can be useful to detect patients that are at risk of potentially severe reactions, particularly in case of co-sensitization to labile allergens, while we wait that the whole spectrum of kiwi allergens becomes available for routine in-vitro testing.

  12. Eating routines: Embedded, value based, modifiable, and reflective

    PubMed Central

    Jastran, Margaret; Bisogni, Carole A.; Sobal, Jeffery; Blake, Christine; Devine, Carol M.

    2009-01-01

    Eating routines are a compelling issue because recurring eating behaviors influence nutrition and health. As non-traditional and individualized eating patterns have become more common, new ways of thinking about routine eating practices are needed. This study sought to gain conceptual understanding of working adults' eating routines. Forty-two purposively sampled US adults reported food intake and contextual details about eating episodes in qualitative 24-hour dietary recalls conducted over 7 consecutive days. Using the constant comparative method, researchers analyzed interview transcripts for recurrent ways of eating that were either explicitly reported by study participants as “routines” or emergent in the data. Participants' eating routines included repetition in food consumption as well as eating context, and also involved sequences of eating episodes. Eating routines were embedded in daily schedules for work, family, and recreation. Participants maintained purposeful routines that helped balance tension between demands and values, but they modified routines as circumstances changed. Participants monitored and reflected upon their eating practices and tended to assess their practices in light of their personal identities. These findings provide conceptual insights for food choice researchers and present a perspective from which practitioners who work with individuals seeking to adopt healthful eating practices might usefully approach their tasks. PMID:18835305

  13. CPU timing routines for a CONVEX C220 computer system

    NASA Technical Reports Server (NTRS)

    Bynum, Mary Ann

    1989-01-01

    The timing routines available on the CONVEX C220 computer system in the Structural Mechanics Division (SMD) at NASA Langley Research Center are examined. The function of the timing routines, the use of the timing routines in sequential, parallel, and vector code, and the interpretation of the results from the timing routines with respect to the CONVEX model of computing are described. The timing routines available on the SMD CONVEX fall into two groups. The first group includes standard timing routines generally available with UNIX 4.3 BSD operating systems, while the second group includes routines unique to the SMD CONVEX. The standard timing routines described in this report are /bin/csh time,/bin/time, etime, and ctime. The routines unique to the SMD CONVEX are getinfo, second, cputime, toc, and a parallel profiling package made up of palprof, palinit, and palsum.

  14. The additional benefit of residual spraying and insecticide-treated curtains for dengue control over current best practice in Cuba: Evaluation of disease incidence in a cluster randomized trial in a low burden setting with intensive routine control

    PubMed Central

    Rosales, Julio Popa; Mirabal, Mayelin; Cabrera, Pedro; Fonseca, Viviana; Gómez Padrón, Tania; Pérez Menzies, Mirtha; Montada, Domingo; Van der Stuyft, Patrick

    2017-01-01

    Background Aedes control interventions are considered the cornerstone of dengue control programmes, but there is scarce evidence on their effect on disease. We set-up a cluster randomized controlled trial in Santiago de Cuba to evaluate the entomological and epidemiological effectiveness of periodical intra- and peri-domiciliary residual insecticide (deltamethrin) treatment (RIT) and long lasting insecticide treated curtains (ITC). Methodology/Principal findings Sixty three clusters (around 250 households each) were randomly allocated to two intervention (RIT and ITC) and one control arm. Routine Aedes control activities (entomological surveillance, source reduction, selective adulticiding, health education) were applied in the whole study area. The outcome measures were clinical dengue case incidence and immature Aedes infestation. Effectiveness of tools was evaluated using a generalized linear regression model with a negative binomial link function. Despite significant reduction in Aedes indices (Rate Ratio (RR) 0.54 (95%CI 0.32–0.89) in the first month after RIT, the effect faded out over time and dengue incidence was not reduced. Overall, in this setting there was no protective effect of RIT or ITC over routine in the 17months intervention period, with for house index RR of 1.16 (95%CI 0.96–1.40) and 1.25 (95%CI 1.03–1.50) and for dengue incidence RR of 1.43 (95%CI 1.08–1.90) and 0.96 (95%CI 0.72–1.28) respectively. The monthly dengue incidence rate (IR) at cluster level was best explained by epidemic periods (Incidence Rate Ratio (IRR) 5.50 (95%CI 4.14–7.31)), the IR in bordering houseblocks (IRR 1.03 (95%CI 1.02–1.04)) and the IR pre-intervention (IRR 1.02 (95%CI 1.00–1.04)). Conclusions Adding RIT to an intensive routine Aedes control programme has a transient effect on the already moderate low entomological infestation levels, while ITC did not have any effect. For both interventions, we didn’t evidence impact on disease incidence. Further

  15. Routine DNA testing

    USDA-ARS?s Scientific Manuscript database

    Routine DNA testing. It’s done once you’ve Marker-Assisted Breeding Pipelined promising Qantitative Trait Loci within your own breeding program and thereby established the performance-predictive power of each DNA test for your germplasm under your conditions. By then you are ready to screen your par...

  16. Effectiveness of core stabilization exercises and routine exercise therapy in management of pain in chronic non-specific low back pain: A randomized controlled clinical trial.

    PubMed

    Akhtar, Muhammad Waseem; Karimi, Hossein; Gilani, Syed Amir

    2017-01-01

    Low back pain is a frequent problem faced by the majority of people at some point in their lifetime. Exercise therapy has been advocated an effective treatment for chronic low back pain. However, there is lack of consensus on the best exercise treatment and numerous studies are underway. Conclusive studies are lacking especially in this part of the world. Thisstudy was designed to compare the effectiveness of specific stabilization exercises with routine physical therapy exerciseprovided in patients with nonspecific chronic mechanical low back pain. This is single blinded randomized control trial that was conducted at the department of physical therapy Orthopedic and Spine Institute, Johar Town, Lahore in which 120 subjects with nonspecific chronic low back pain participated. Subjects with the age between 20 to 60 years and primary complaint of chronic low back pain were recruited after giving an informed consent. Participants were randomly assigned to two treatment groups A & B which were treated with core stabilization exercise and routine physical therapy exercise respectively. TENS and ultrasound were given as therapeutic modalities to both treatment groups. Outcomes of the treatment were recorded using Visual Analogue Scale (VAS) pretreatment, at 2 nd , 4 th and 6 th week post treatment. The results of this study illustrate that clinical and therapeutic effects of core stabilization exercise program over the period of six weeks are more effective in terms of reduction in pain, compared to routine physical therapy exercise for similar duration. This study found significant reduction in pain across the two groups at 2 nd , 4 th and 6 th week of treatment with p value less than 0.05. There was a mean reduction of 3.08 and 1.71 on VAS across the core stabilization group and routine physical therapy exercise group respectively. Core stabilization exercise is more effective than routine physical therapy exercise in terms of greater reduction in pain in patients with

  17. [The controversy of routine articulator mounting in orthodontics].

    PubMed

    Wang, Li; Han, Xianglong; Bai, Ding

    2013-06-01

    Articulators have been widely used by clinicians of dentistry. But routine articulator mounting is still controversial in orthodontics. Orthodontists oriented by gnathology approve routine articulator mounting while nongnathologic orthodontists disapprove it. This article reviews the thoughts of orthodontist that they agree or disagree with routine articulator mounting based on the considerations of biting, temporomandibular disorder (TMD), periodontitis, and so on.

  18. Effectiveness of routine antihelminthic treatment on anaemia in pregnancy in Rufiji District, Tanzania: a cluster randomised controlled trial.

    PubMed

    Urassa, David P; Nystrom, Lennarth; Carlsted, Anders

    2011-09-01

    The aim of this study was to estimate the effect of an antihelminthic drug, given at booking and at term to antenatal care visits, on the prevalence of anaemia at term and 4 months post-partum in Rufiji district, Tanzania, the area with high prevalence of intestinal parasites. A cluster randomised controlled trial was conducted on 3080 pregnant women. Out of these 1475 (study arm) received albendazole and 1605 (control arm) placebo. All women also received routine daily iron folate supplements (36 mg iron and 5 mg folate), and sulphadoxine pyramethamine (SP) to prevent malaria. Haemoglobin levels were assessed at booking, at term and 4 months post-partum. At term, median and mean haemoglobin level and the prevalence of severe (< 70 g/l) and moderate (70-104 g/l) anaemia did not differ. The reduction in the prevalence of anaemia from booking to term, was significantly larger in the study arm compared to control arm (26.1% vs. 18.8%; p < 0.001). At four months postpartum, mean haemoglobin was higher in the study arm compared to the control arm (118 vs. 113; p < 0.0001) while the reduction in proportion of women with anaemia (Hb <105 g/dl) was significantly lower (30.6 vs. 21.2; p < 0.0001) in the study arm compared to the control arm. These findings support WHO's recommendation for anthelmintic treatment during pregnancy. However benefits for deworming may be limited in areas with an antenatal iron supplementation programme or low intensity of hookworm infections and hence future research should be directed towards the cost-effectiveness of the de-worming compared to other interventions for reducing anaemia in pregnancy.

  19. Daily Routines and Crime: Using Routine Activities as Measures of Hirschi's Involvement.

    ERIC Educational Resources Information Center

    Hawdon, James E.

    1999-01-01

    Reconstitutes the "involvement" aspect of T. Hirschi's bond theory to substitute routine-activity patterns (RAPs) for involvement. Self-reports of 108 college freshmen suggest that involvement reconstituted as RAPs is an effective predictor of minor acts of delinquency. (SLD)

  20. Fixed-Wing Micro Aerial Vehicle for Accurate Corridor Mapping

    NASA Astrophysics Data System (ADS)

    Rehak, M.; Skaloud, J.

    2015-08-01

    In this study we present a Micro Aerial Vehicle (MAV) equipped with precise position and attitude sensors that together with a pre-calibrated camera enables accurate corridor mapping. The design of the platform is based on widely available model components to which we integrate an open-source autopilot, customized mass-market camera and navigation sensors. We adapt the concepts of system calibration from larger mapping platforms to MAV and evaluate them practically for their achievable accuracy. We present case studies for accurate mapping without ground control points: first for a block configuration, later for a narrow corridor. We evaluate the mapping accuracy with respect to checkpoints and digital terrain model. We show that while it is possible to achieve pixel (3-5 cm) mapping accuracy in both cases, precise aerial position control is sufficient for block configuration, the precise position and attitude control is required for corridor mapping.

  1. Endogenous glucocorticoid analysis by liquid chromatography-tandem mass spectrometry in routine clinical laboratories.

    PubMed

    Hawley, James M; Keevil, Brian G

    2016-09-01

    Liquid chromatography-tandem mass spectrometry (LC-MS/MS) is a powerful analytical technique that offers exceptional selectivity and sensitivity. Used optimally, LC-MS/MS provides accurate and precise results for a wide range of analytes at concentrations that are difficult to quantitate with other methodologies. Its implementation into routine clinical biochemistry laboratories has revolutionised our ability to analyse small molecules such as glucocorticoids. Whereas immunoassays can suffer from matrix effects and cross-reactivity due to interactions with structural analogues, the selectivity offered by LC-MS/MS has largely overcome these limitations. As many clinical guidelines are now beginning to acknowledge the importance of the methodology used to provide results, the advantages associated with LC-MS/MS are gaining wider recognition. With their integral role in both the diagnosis and management of hypo- and hyperadrenal disorders, coupled with their widespread pharmacological use, the accurate measurement of glucocorticoids is fundamental to effective patient care. Here, we provide an up-to-date review of the LC-MS/MS techniques used to successfully measure endogenous glucocorticoids, particular reference is made to serum, urine and salivary cortisol. Copyright © 2016 Elsevier Ltd. All rights reserved.

  2. COPD management: role of symptom assessment in routine clinical practice

    PubMed Central

    van der Molen, Thys; Miravitlles, Marc; Kocks, Janwillem WH

    2013-01-01

    Patients with chronic obstructive pulmonary disease (COPD) present with a variety of symptoms that significantly impair health-related quality of life. Despite this, COPD treatment and its management are mainly based on lung function assessments. There is increasing evidence that conventional lung function measures alone do not correlate well with COPD symptoms and their associated impact on patients’ everyday lives. Instead, symptoms should be assessed routinely, preferably by using patient-centered questionnaires that provide a more accurate guide to the actual burden of COPD. Numerous questionnaires have been developed in an attempt to find a simple and reliable tool to use in everyday clinical practice. In this paper, we review three such patient-reported questionnaires recommended by the latest Global Initiative for Chronic Obstructive Lung Disease guidelines, ie, the modified Medical Research Council questionnaire, the clinical COPD questionnaire, and the COPD Assessment Test, as well as other symptom-specific questionnaires that are currently being developed. PMID:24143085

  3. Does routine gowning reduce nosocomial infection and mortality rates in a neonatal nursery? A Singapore experience.

    PubMed

    Tan, S G; Lim, S H; Malathi, I

    1995-11-01

    A 1 year prospective study on routine gowning before entering a neonatal unit was conducted in a maternity hospital in Singapore. This study was done based on previous work by Donowitz, Haque and Chagla and Agbayani et al., as there have been no known studies done in Singapore. The aim of the study was to test the hypothesis that routine gowning before entering a neonatal nursery does not reduce nosocomial infection and mortality rate. A total of 212 neonates from the neonatal intensive care unit (NICU) and 1694 neonates from the neonatal special care unit (NSCU) were studied. Neonates admitted during the 1 year study were assigned to the gowning (control) and no routine gowning (trial) group on every alternate 2 months. The hospital infection control nurse provided data on nosocomial infection. The overall nosocomial infection rate in the NICU was 24% (25 of 104 admissions) during gowning periods compared to 16.6% (18 of 108 admissions) when plastic aprons were not worn before entry. In the NSCU, the overall infection rate was 1.5% (12 of 800 admissions) during gowning periods compared to 2.1% (19 of 894 admissions) when no gown was worn before entry. Results of the study found no significant differences in the incidences of nosocomial infection and mortality in the neonates. The cost of gowns used during the no routine gowning periods was S$2012.8 compared to S$3708 used during the routine gowning procedure. The investigators recommend that routine gowning before entering a neonatal unit is not essential and cost effective for the purpose of reducing infection. Rather the focus should be on adequate handwashing by all hospital personnel and visitors before handling neonates.

  4. Cost-effectiveness of duloxetine versus routine treatment for U.S. patients with diabetic peripheral neuropathic pain.

    PubMed

    Wu, Eric Q; Birnbaum, Howard G; Mareva, Milena N; Le, T Kim; Robinson, Rebecca L; Rosen, Amy; Gelwicks, Steve

    2006-06-01

    The purpose of this study was to compare the cost-effectiveness of duloxetine versus routine treatment in management of diabetic peripheral neuropathic pain (DPNP). Two hundred thirty-three patients with DPNP who completed a 12-week, double-blind, placebo-controlled, randomized, multicenter duloxetine trial were re-randomized into a 52-week, open-label trial of duloxetine 60 mg twice daily versus routine treatment. Routine treatment included pain management therapies. Effectiveness was measured by using the bodily pain domain (BP) of the Medical Outcomes Study Short Form 36 (SF-36). Costs were analyzed from 3 perspectives: third party payer (direct medical costs), employer (direct and indirect medical costs), and societal (patient's out-of-pocket costs and total medical costs). Costs of study medications were not included because of limited data. Bootstrap method was applied to calculate statistical inference of the incremental cost-effectiveness ratio (ICER). Routine treatment most frequently used included gabapentin (56%), venlafaxine (36%), and amitripytline (15%). From employer and societal perspectives, duloxetine was cost-effective (ICER= -342 dollars and -429 dollars, respectively, per unit of SF-36 BP; both P routine DPNP treatment (both P < .05). From payer perspective, duloxetine trended toward cost-effectiveness (ICER= -249 dollars per unit of SF-36 BP; P controlled environment of a clinical trial. An analysis of real-world data would be beneficial. Evaluation of the cost and benefit of new pharmacologic treatments is highly desired by decision makers. From both employer perspective and societal perspective (including patient's out-of-pocket costs), this study demonstrated that duloxetine was more cost-effective than routine treatment in management of DPNP.

  5. Milne, a routine for the numerical solution of Milne's problem

    NASA Astrophysics Data System (ADS)

    Rawat, Ajay; Mohankumar, N.

    2010-11-01

    The routine Milne provides accurate numerical values for the classical Milne's problem of neutron transport for the planar one speed and isotropic scattering case. The solution is based on the Case eigen-function formalism. The relevant X functions are evaluated accurately by the Double Exponential quadrature. The calculated quantities are the extrapolation distance and the scalar and the angular fluxes. Also, the H function needed in astrophysical calculations is evaluated as a byproduct. Program summaryProgram title: Milne Catalogue identifier: AEGS_v1_0 Program summary URL:http://cpc.cs.qub.ac.uk/summaries/AEGS_v1_0.html Program obtainable from: CPC Program Library, Queen's University, Belfast, N. Ireland Licensing provisions: Standard CPC licence, http://cpc.cs.qub.ac.uk/licence/licence.html No. of lines in distributed program, including test data, etc.: 701 No. of bytes in distributed program, including test data, etc.: 6845 Distribution format: tar.gz Programming language: Fortran 77 Computer: PC under Linux or Windows Operating system: Ubuntu 8.04 (Kernel version 2.6.24-16-generic), Windows-XP Classification: 4.11, 21.1, 21.2 Nature of problem: The X functions are integral expressions. The convergence of these regular and Cauchy Principal Value integrals are impaired by the singularities of the integrand in the complex plane. The DE quadrature scheme tackles these singularities in a robust manner compared to the standard Gauss quadrature. Running time: The test included in the distribution takes a few seconds to run.

  6. Is routine drainage necessary after pancreaticoduodenectomy?

    PubMed Central

    Wang, Qiang; Jiang, Yong-Jian; Li, Ji; Yang, Feng; Di, Yang; Yao, Lie; Jin, Chen; Fu, De-Liang

    2014-01-01

    With the development of imaging technology and surgical techniques, pancreatic resections to treat pancreatic tumors, ampulla tumors, and other pancreatic diseases have increased. Pancreaticoduodenectomy, one type of pancreatic resection, is a complex surgery with the loss of pancreatic integrity and various anastomoses. Complications after pancreaticoduodenectomy such as pancreatic fistulas and anastomosis leakage are common and significantly associated with patient outcomes. Pancreatic fistula is one of the most important postoperative complications; this condition can cause intraperitoneal hemorrhage, septic shock, or even death. An effective way has not yet been found to avoid the occurrence of pancreatic fistula. In most medical centers, the frequency of pancreatic fistula has remained between 9% and 13%. The early detection and routine drainage of anastomotic fistulas, pancreatic fistulas, bleeding, or other intra-abdominal fluid collections after pancreatic resections are considered as important and effective ways to reduce postoperative complications and the mortality rate. However, many recent studies have argued that routine drainage after abdominal operations, including pancreaticoduodenectomies, does not affect the incidence of postoperative complications. Although inserting drains after pancreatic resections continues to be a routine procedure, its necessity remains controversial. This article reviews studies of the advantages and disadvantages of routine drainage after pancreaticoduodenectomy and discusses the necessity of this procedure. PMID:25009383

  7. Accurate image-charge method by the use of the residue theorem for core-shell dielectric sphere

    NASA Astrophysics Data System (ADS)

    Fu, Jing; Xu, Zhenli

    2018-02-01

    An accurate image-charge method (ICM) is developed for ionic interactions outside a core-shell structured dielectric sphere. Core-shell particles have wide applications for which the theoretical investigation requires efficient methods for the Green's function used to calculate pairwise interactions of ions. The ICM is based on an inverse Mellin transform from the coefficients of spherical harmonic series of the Green's function such that the polarization charge due to dielectric boundaries is represented by a series of image point charges and an image line charge. The residue theorem is used to accurately calculate the density of the line charge. Numerical results show that the ICM is promising in fast evaluation of the Green's function, and thus it is useful for theoretical investigations of core-shell particles. This routine can also be applicable for solving other problems with spherical dielectric interfaces such as multilayered media and Debye-Hückel equations.

  8. Comparison of performance of tile drainage routines in SWAT 2009 and 2012 in an extensively tile-drained watershed in the Midwest

    NASA Astrophysics Data System (ADS)

    Guo, Tian; Gitau, Margaret; Merwade, Venkatesh; Arnold, Jeffrey; Srinivasan, Raghavan; Hirschi, Michael; Engel, Bernard

    2018-01-01

    the validation results showed that the new routine has the potential to accurately simulate hydrologic processes in mildly sloped watersheds.

  9. PAin SoluTions In the Emergency Setting (PASTIES)--patient controlled analgesia versus routine care in emergency department patients with pain from traumatic injuries: randomised trial.

    PubMed

    Smith, Jason E; Rockett, Mark; S, Siobhan Creanor; Squire, Rosalyn; Hayward, Chris; Ewings, Paul; Barton, Andy; Pritchard, Colin; Eyre, Victoria; Cocking, Laura; Benger, Jonathan

    2015-06-21

    To determine whether patient controlled analgesia (PCA) is better than routine care in patients presenting to emergency departments with moderate to severe pain from traumatic injuries. Pragmatic, multicentre, parallel group, randomised controlled trial. Five English hospitals. 200 adults (71% (n = 142) male), aged 18 to 75 years, who presented to the emergency department requiring intravenous opioid analgesia for the treatment of moderate to severe pain from traumatic injuries and were expected to be admitted to hospital for at least 12 hours. PCA (n = 99) or nurse titrated analgesia (treatment as usual; n = 101). The primary outcome was total pain experienced over the 12 hour study period, derived by standardised area under the curve (scaled from 0 to 100) of each participant's hourly pain scores, captured using a visual analogue scale. Pre-specified secondary outcomes included total morphine use, percentage of study period in moderate/severe pain, percentage of study period asleep, length of hospital stay, and satisfaction with pain management. 200 participants were included in the primary analyses. Mean total pain experienced was 47.2 (SD 21.9) for the treatment as usual group and 44.0 (24.0) for the PCA group. Adjusted analyses indicated slightly (but not statistically significantly) lower total pain experienced in the PCA group than in the routine care group (mean difference 2.7, 95% confidence interval -2.4 to 7.8). Participants allocated to PCA used more morphine in total than did participants in the treatment as usual group (mean 44.3 (23.2) v 27.2 (18.2) mg; mean difference 17.0, 11.3 to 22.7). PCA participants spent, on average, less time in moderate/severe pain (36.2% (31.0) v 44.1% (31.6)), but the difference was not statistically significant. A higher proportion of PCA participants reported being perfectly or very satisfied compared with the treatment as usual group (86% (78/91) v 76% (74/98)), but this was also not statistically significant. PCA

  10. 42 CFR 493.1267 - Standard: Routine chemistry.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 5 2010-10-01 2010-10-01 false Standard: Routine chemistry. 493.1267 Section 493.1267 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES... Systems § 493.1267 Standard: Routine chemistry. For blood gas analyses, the laboratory must perform the...

  11. 42 CFR 493.1267 - Standard: Routine chemistry.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 5 2011-10-01 2011-10-01 false Standard: Routine chemistry. 493.1267 Section 493.1267 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES... Systems § 493.1267 Standard: Routine chemistry. For blood gas analyses, the laboratory must perform the...

  12. 42 CFR 493.1267 - Standard: Routine chemistry.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 42 Public Health 5 2012-10-01 2012-10-01 false Standard: Routine chemistry. 493.1267 Section 493.1267 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES... Systems § 493.1267 Standard: Routine chemistry. For blood gas analyses, the laboratory must perform the...

  13. 42 CFR 493.1267 - Standard: Routine chemistry.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 42 Public Health 5 2014-10-01 2014-10-01 false Standard: Routine chemistry. 493.1267 Section 493.1267 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES... Systems § 493.1267 Standard: Routine chemistry. For blood gas analyses, the laboratory must perform the...

  14. 42 CFR 493.1267 - Standard: Routine chemistry.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 42 Public Health 5 2013-10-01 2013-10-01 false Standard: Routine chemistry. 493.1267 Section 493.1267 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES... Systems § 493.1267 Standard: Routine chemistry. For blood gas analyses, the laboratory must perform the...

  15. Breaking the Waves: Routines and Rituals in Entrepreneurship Education

    ERIC Educational Resources Information Center

    Neergaard, Helle; Christensen, Dorthe Refslund

    2017-01-01

    Learning is related to the environment created for the learning experience. This environment is often highly routinized and involves a certain social structure, but in entrepreneurship education, such routinization and structure may actually counteract the learning goals. This article investigates how classroom routines and rituals impact on…

  16. Accurate calibration and control of relative humidity close to 100% by X-raying a DOPC multilayer

    DOE PAGES

    Ma, Yicong; Ghosh, Sajal K.; Bera, Sambhunath; ...

    2015-01-01

    Here in this study, we have designed a compact sample chamber that can achieve accurate and continuous control of the relative humidity (RH) in the vicinity of 100%. A 1,2-dioleoyl-sn-glycero-3-phosphocholine (DOPC) multilayer can be used as a humidity sensor by measuring its inter-layer repeat distance (d-spacing) via X-ray diffraction. We convert from DOPC d-spacing to RH according to a theory given in the literature and previously measured data of DOPC multilamellar vesicles in polyvinylpyrrolidone (PVP) solutions. This curve can be used for calibration of RH close to 100%, a regime where conventional sensors do not have sufficient accuracy. We demonstratemore » that this control method can provide RH accuracies of 0.1 to 0.01%, which is a factor of 10–100 improvement compared to existing methods of humidity control. Our method provides fine tuning capability of RH continuously for a single sample, whereas the PVP solution method requires new samples to be made for each PVP concentration. The use of this cell also potentially removes the need for an X-ray or neutron beam to pass through bulk water if one wishes to work close to biologically relevant conditions of nearly 100% RH.« less

  17. 42 CFR 493.841 - Standard; Routine chemistry.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 5 2010-10-01 2010-10-01 false Standard; Routine chemistry. 493.841 Section 493.841 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES... These Tests § 493.841 Standard; Routine chemistry. (a) Failure to attain a score of at least 80 percent...

  18. 42 CFR 493.841 - Standard; Routine chemistry.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 5 2011-10-01 2011-10-01 false Standard; Routine chemistry. 493.841 Section 493.841 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES... These Tests § 493.841 Standard; Routine chemistry. (a) Failure to attain a score of at least 80 percent...

  19. 42 CFR 493.841 - Standard; Routine chemistry.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 42 Public Health 5 2013-10-01 2013-10-01 false Standard; Routine chemistry. 493.841 Section 493.841 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES... These Tests § 493.841 Standard; Routine chemistry. (a) Failure to attain a score of at least 80 percent...

  20. 42 CFR 493.841 - Standard; Routine chemistry.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 42 Public Health 5 2014-10-01 2014-10-01 false Standard; Routine chemistry. 493.841 Section 493.841 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES... These Tests § 493.841 Standard; Routine chemistry. (a) Failure to attain a score of at least 80 percent...

  1. 42 CFR 493.841 - Standard; Routine chemistry.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 42 Public Health 5 2012-10-01 2012-10-01 false Standard; Routine chemistry. 493.841 Section 493.841 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES... These Tests § 493.841 Standard; Routine chemistry. (a) Failure to attain a score of at least 80 percent...

  2. Bayesian estimation of test characteristics of real-time PCR, bacteriological culture and California mastitis test for diagnosis of intramammary infections with Staphylococcus aureus in dairy cattle at routine milk recordings.

    PubMed

    Mahmmod, Yasser S; Toft, Nils; Katholm, Jørgen; Grønbæk, Carsten; Klaas, Ilka C

    2013-11-01

    Danish farmers can order a real-time PCR mastitis diagnostic test on routinely taken cow-level samples from milk recordings. Validation of its performance in comparison to conventional mastitis diagnostics under field conditions is essential for efficient control of intramammary infections (IMI) with Staphylococcus aureus (S. aureus). Therefore, the objective of this study was to estimate the sensitivity (Se) and specificity (Sp) of real-time PCR, bacterial culture (BC) and California mastitis test (CMT) for the diagnosis of the naturally occurring IMI with S. aureus in routinely collected milk samples using latent class analysis (LCA) to avoid the assumption of a perfect reference test. Using systematic random sampling, a total of 609 lactating dairy cows were selected from 6 dairy herds with bulk tank milk PCR cycle threshold (Ct) value ≤39 for S. aureus. At routine milk recordings, automatically obtained cow-level (composite) milk samples were analyzed by PCR and at the same milking, 2436 quarter milk samples were collected aseptically for BC and CMT. Results showed that 140 cows (23%) were positive for S. aureus IMI by BC while 170 cows (28%) were positive by PCR. Estimates of Se and Sp for PCR were higher than test estimates of BC and CMT. SeCMT was higher than SeBC however, SpBC was higher than SpCMT. SePCR was 91%, while SeBC was 53%, and SeCMT was 61%. SpPCR was 99%, while SpBC was 89%, and SpCMT was 65%. In conclusion, PCR has a higher performance than the conventional diagnostic tests (BC and CMT) suggesting its usefulness as a routine test for accurate diagnosis of S. aureus IMI from dairy cows at routine milk recordings. The use of LCA provided estimates of the test characteristics for two currently diagnostic tests (BC, CMT) and a novel technique (real-time PCR) for diagnosing S. aureus IMI under field conditions at routine milk recordings in Denmark. Copyright © 2013 Elsevier B.V. All rights reserved.

  3. Endotracheal Suctioning in Preterm Infants Using Four-Handed versus Routine Care

    PubMed Central

    Cone, Sharon; Pickler, Rita H.; Grap, Mary Jo; McGrath, Jacqueline; Wiley, Paul M.

    2013-01-01

    Objective To evaluate the effect of four-handed care on preterm infants’ physiologic and behavioral responses to and recovery from endotracheal suctioning versus routine endotracheal (ETT) suctioning. Design Randomized crossover design with infants as their own controls. Setting Single-family-room newborn intensive care unit in an academic health center. Participants Ten intubated infants on conventional ventilation with inline suctioning who were fewer than 37 weeks gestation at birth, and less than one week of age. Methods Each infant was observed twice on a single day. One observation involved routine ETT suctioning and one involved four-handed care. Physiologic and behavioral response data were collected. Results No differences were noted when comparing baseline heart rate (HR) or oxygen saturation (SpO2) data to those obtained during and after suctioning while in the routine care condition. In the four-handed care condition, mean SpO2 increased from preobservation 95.49 to during observation saturation 97.75 (p = .001). Salivary cortisol levels did not differ between groups at baseline or postsuctioning. No significant difference in behavior state was observed between the two conditions. More stress and defense behaviors occurred postsuctioning when infants received routine care as opposed to four-handed care (p = .001) and more self-regulatory behaviors were exhibited by infants during (p = .019) and after suctioning (p = .016) when receiving four-handed care. No statistical difference was found in the number of monitor call-backs postsuctioning. Conclusions Four-handed care during suctioning was associated with a decrease in stress and defense behaviors and an increase in self-regulatory behaviors. PMID:23316894

  4. Nutritional status in patients with active inflammatory bowel disease: prevalence of malnutrition and methods for routine nutritional assessment.

    PubMed

    Mijac, Dragana D; Janković, Goran L J; Jorga, Jagoda; Krstić, Miodrag N

    2010-08-01

    Malnutrition is a common feature of inflammatory bowel disease (IBD). There are numerous methods for the assessment of nutritional status, but the gold standard has not yet been established. The aims of the study were to estimate the prevalence of undernutrition and to evaluate methods for routine nutritional assessment of active IBD patients. Twenty-three patients with active Crohn disease, 53 patients with active ulcerative colitis and 30 controls were included in the study. The nutritional status was assessed by extensive anthropometric measurements, percentage of weight loss in the past 1-6 months and biochemical markers of nutrition. All investigated nutritional parameters were significantly different in IBD patients compared to control subjects, except MCV, tryglicerides and serum total protein level. Serum albumin level and body mass index (BMI) were the most predictive parameters of malnutrition. According to different assessment methods the prevalence of undernutrition and severe undernutrition in patients with active IBD were 25.0%-69.7% and 1.3%-31.6%, respectively, while in the control subjects no abnormalities have been detected. There was no statistically significant difference of nutritional parameters between UC and CD patients except lower mid-arm muscle circumference in UC group. Malnutrition is common in IBD patients. BMI and serum albumin are simple and convenient methods for the assessment of the nutritional status in IBD patients. Further studies with larger group of patients are necessary to elucidate the prevalence of malnutrition and the most accurate assessment methods in IBD patients.

  5. HERALD (health economics using routine anonymised linked data).

    PubMed

    Husain, Muhammad J; Brophy, Sinead; Macey, Steven; Pinder, Leila M; Atkinson, Mark D; Cooksey, Roxanne; Phillips, Ceri J; Siebert, Stefan

    2012-03-29

    Health economic analysis traditionally relies on patient derived questionnaire data, routine datasets, and outcomes data from experimental randomised control trials and other clinical studies, which are generally used as stand-alone datasets. Herein, we outline the potential implications of linking these datasets to give one single joined up data-resource for health economic analysis. The linkage of individual level data from questionnaires with routinely-captured health care data allows the entire patient journey to be mapped both retrospectively and prospectively. We illustrate this with examples from an Ankylosing Spondylitis (AS) cohort by linking patient reported study dataset with the routinely collected general practitioner (GP) data, inpatient (IP) and outpatient (OP) datasets, and Accident and Emergency department data in Wales. The linked data system allows: (1) retrospective and prospective tracking of patient pathways through multiple healthcare facilities; (2) validation and clarification of patient-reported recall data, complementing the questionnaire/routine data information; (3) obtaining objective measure of the costs of chronic conditions for a longer time horizon, and during the pre-diagnosis period; (4) assessment of health service usage, referral histories, prescribed drugs and co-morbidities; and (5) profiling and stratification of patients relating to disease manifestation, lifestyles, co-morbidities, and associated costs. Using the GP data system we tracked about 183 AS patients retrospectively and prospectively from the date of questionnaire completion to gather the following information: (a) number of GP events; (b) presence of a GP 'drug' read codes; and (c) the presence of a GP 'diagnostic' read codes. We tracked 236 and 296 AS patients through the OP and IP data systems respectively to count the number of OP visits; and IP admissions and duration. The results are presented under several patient stratification schemes based on disease

  6. Routines and Transitions: A Guide for Early Childhood Professionals

    ERIC Educational Resources Information Center

    Malenfont, Nicole

    2006-01-01

    In early childhood settings, children spend over 50 percent of their time on handwashing, dressing, napping, and other routines and transitions. "Routines and Transitions" is a guide to help turn these routine daily activities into learning experiences. By using transitions wisely, providers not only help children develop skills, but also run a…

  7. Safety of a quadrivalent meningococcal serogroups A, C, W and Y conjugate vaccine (MenACWY-CRM) administered with routine infant vaccinations: results of an open-label, randomized, phase 3b controlled study in healthy infants.

    PubMed

    Abdelnour, Arturo; Silas, Peter E; Lamas, Marta Raquel Valdés; Aragón, Carlos Fernándo Grazioso; Chiu, Nan-Chang; Chiu, Cheng-Hsun; Acuña, Teobaldo Herrera; Castrejón, Tirza De León; Izu, Allen; Odrljin, Tatjana; Smolenov, Igor; Hohenboken, Matthew; Dull, Peter M

    2014-02-12

    The highest risk for invasive meningococcal disease (IMD) is in infants aged <1 year. Quadrivalent meningococcal conjugate vaccination has the potential to prevent IMD caused by serogroups A, C, W and Y. This phase 3b, multinational, open-label, randomized, parallel-group, multicenter study evaluated the safety of a 4-dose series of MenACWY-CRM, a quadrivalent meningococcal conjugate vaccine, concomitantly administered with routine vaccinations to healthy infants. Two-month-old infants were randomized 3:1 to receive MenACWY-CRM with routine vaccines or routine vaccines alone at ages 2, 4, 6 and 12 months. Adverse events (AEs) that were medically attended and serious adverse events (SAEs) were collected from all subjects from enrollment through 18 months of age. In a subset, detailed safety data (local and systemic solicited reactions and all AEs) were collected for 7 days post vaccination. The primary objective was a non-inferiority comparison of the percentages of subjects with ≥1 severe systemic reaction during Days 1-7 after any vaccination of MenACWY-CRM plus routine vaccinations versus routine vaccinations alone (criterion: upper limit of 95% confidence interval [CI] of group difference <6%). A total of 7744 subjects were randomized with 1898 in the detailed safety arm. The percentage of subjects with severe systemic reactions was 16% after MenACWY-CRM plus routine vaccines and 13% after routine vaccines alone (group difference 3.0% (95% CI -0.8, 6.4%). Although the non-inferiority criterion was not met, post hoc analysis controlling for significant center and group-by-center differences revealed that MenACWY-CRM plus routine vaccinations was non-inferior to routine vaccinations alone (group difference -0.1% [95% CI -4.9%, 4.7%]). Rates of solicited AEs, medically attended AEs, and SAEs were similar across groups. In a large multinational safety study, a 4-dose series of MenACWY-CRM concomitantly administered with routine vaccines was clinically acceptable

  8. Parent-Implemented Bedtime Fading and Positive Routines for Children with Autism Spectrum Disorders

    ERIC Educational Resources Information Center

    Delemere, Emma; Dounavi, Katerina

    2018-01-01

    Sleep disorders affect a large portion of those with autism spectrum disorder. Behavioural interventions have been found to increase appropriate sleep behaviours. This study sought to examine the efficacy of two stimulus control interventions (bedtime fading and positive routines) on total sleep duration, sleep onset latency and frequency and…

  9. libvaxdata: VAX data format conversion routines

    USGS Publications Warehouse

    Baker, Lawrence M.

    2005-01-01

    libvaxdata provides a collection of routines for converting numeric data-integer and floating-point-to and from the formats used on a Digital Equipment Corporation1 (DEC) VAX 32-bit minicomputer (Brunner, 1991). Since the VAX numeric data formats are inherited from those used on a DEC PDP-11 16-bit minicomputer, these routines can be used to convert PDP-11 data as well. VAX numeric data formats are also the default data formats used on DEC Alpha 64-bit minicomputers running OpenVMS The libvaxdata routines are callable from Fortran or C. They require that the caller use two's-complement format for integer data and IEEE 754 format (ANSI/IEEE, 1985) for floating-point data. They also require that the 'natural' size of a C int type (integer) is 32 bits. That is the case for most modern 32-bit and 64-bit computer systems. Nevertheless, you may wish to consult the Fortran or C compiler documentation on your system to be sure. Some Fortran compilers support conversion of VAX numeric data on-the-fly when reading or writing unformatted files, either as a compiler option or a run-time I/O option. This feature may be easier to use than the libvaxdata routines. Consult the Fortran compiler documentation on your system to determine if this alternative is available to you. 1Later Compaq Computer Corporation, now Hewlett-Packard Company

  10. Design of a feedback-feedforward steering controller for accurate path tracking and stability at the limits of handling

    NASA Astrophysics Data System (ADS)

    Kapania, Nitin R.; Gerdes, J. Christian

    2015-12-01

    This paper presents a feedback-feedforward steering controller that simultaneously maintains vehicle stability at the limits of handling while minimising lateral path tracking deviation. The design begins by considering the performance of a baseline controller with a lookahead feedback scheme and a feedforward algorithm based on a nonlinear vehicle handling diagram. While this initial design exhibits desirable stability properties at the limits of handling, the steady-state path deviation increases significantly at highway speeds. Results from both linear and nonlinear analyses indicate that lateral path tracking deviations are minimised when vehicle sideslip is held tangent to the desired path at all times. Analytical results show that directly incorporating this sideslip tangency condition into the steering feedback dramatically improves lateral path tracking, but at the expense of poor closed-loop stability margins. However, incorporating the desired sideslip behaviour into the feedforward loop creates a robust steering controller capable of accurate path tracking and oversteer correction at the physical limits of tyre friction. Experimental data collected from an Audi TTS test vehicle driving at the handling limits on a full length race circuit demonstrates the improved performance of the final controller design.

  11. ANSYS duplicate finite-element checker routine

    NASA Technical Reports Server (NTRS)

    Ortega, R.

    1995-01-01

    An ANSYS finite-element code routine to check for duplicated elements within the volume of a three-dimensional (3D) finite-element mesh was developed. The routine developed is used for checking floating elements within a mesh, identically duplicated elements, and intersecting elements with a common face. A space shuttle main engine alternate turbopump development high pressure oxidizer turbopump finite-element model check using the developed subroutine is discussed. Finally, recommendations are provided for duplicate element checking of 3D finite-element models.

  12. Magnetic dipole moment estimation and compensation for an accurate attitude control in nano-satellite missions

    NASA Astrophysics Data System (ADS)

    Inamori, Takaya; Sako, Nobutada; Nakasuka, Shinichi

    2011-06-01

    Nano-satellites provide space access to broader range of satellite developers and attract interests as an application of the space developments. These days several new nano-satellite missions are proposed with sophisticated objectives such as remote-sensing and observation of astronomical objects. In these advanced missions, some nano-satellites must meet strict attitude requirements for obtaining scientific data or images. For LEO nano-satellite, a magnetic attitude disturbance dominates over other environmental disturbances as a result of small moment of inertia, and this effect should be cancelled for a precise attitude control. This research focuses on how to cancel the magnetic disturbance in orbit. This paper presents a unique method to estimate and compensate the residual magnetic moment, which interacts with the geomagnetic field and causes the magnetic disturbance. An extended Kalman filter is used to estimate the magnetic disturbance. For more practical considerations of the magnetic disturbance compensation, this method has been examined in the PRISM (Pico-satellite for Remote-sensing and Innovative Space Missions). This method will be also used for a nano-astrometry satellite mission. This paper concludes that use of the magnetic disturbance estimation and compensation are useful for nano-satellites missions which require a high accurate attitude control.

  13. [Routine episiotomy in modern obstetrics. Is it necessary?].

    PubMed

    Korczyński, Jerzy

    2002-01-01

    The study presents a literature review on the benefits and risk of the routine episiotomy during the second stage of labour. Perineal trauma complications as well as perinatal outcomes are discussed. The risk of stress incontinence and sexual dysfunction are described. New techniques for improve of perinatal outcomes and prevention of post partum incontinence are described. Routine episiotomy gives poor effects in many cases. Perineal massage during pregnancy, waterbirth, are most interesting methods to avoid routine episiotomy and improve the quality of life in post partum women.

  14. Routine intra-operative trans-oesophageal echocardiography yields better outcomes in surgical repair of CHD.

    PubMed

    Madriago, Erin J; Punn, Rajesh; Geeter, Natalie; Silverman, Norman H

    2016-02-01

    Trans-oesophageal echocardiographic imaging is valuable in the pre- and post-operative evaluation of children and adults with CHD; however, the frequency by which trans-oesophageal echocardiography guides the intra-operative course of patients is unknown. We retrospectively reviewed 1748 intra-operative trans-oesophageal echocardiograms performed between 1 October, 2005 and 31 December, 2010, and found 99 cases (5.7%) that required return to bypass, based in part upon the intra-operative echocardiographic findings. The diagnoses most commonly requiring further repair and subsequent imaging were mitral valve disease (20.9%), tricuspid valve disease (16.0%), atrioventricular canal defects (12.0%), and pulmonary valve disease (14.1%). The vast majority of those requiring immediate return to bypass benefited by avoiding subsequent operations and longer lengths of hospital stay. A total of 14 patients (0.8%) who received routine imaging required further surgical repair within 1 week, usually due to disease that developed over ensuing days. Patients who had second post-operative trans-oesophageal echocardiograms in the operating room rarely required re-operations, confirming the benefit of routine intra-operative imaging. This study represents a large single institutional review of intra-operative trans-oesophageal echocardiography, and confirms its applicability in the surgical repair of patients with CHD. Routine imaging accurately identifies patients requiring further intervention, does not confer additional risk of mortality or prolonged length of hospital stay, and prevents subsequent operations and associated sequelae in a substantial subset of patients. This study demonstrates the utility of echocardiography in intra-operative monitoring of surgical repair and highlights patients who are most likely to require return to bypass, as well as the co-morbidities of such manipulations.

  15. Routine cystoscopy after robotic gynecologic oncology surgery.

    PubMed

    Nguyen, My-Linh T; Stevens, Erin; LaFargue, Christopher J; Karsy, Michael; Pua, Tarah L; Gorelick, Constantine; Tedjarati, Sean S; Pradhan, Tana S

    2014-01-01

    Our aim was to determine whether the use of routine cystoscopy increases lower urinary tract injury detection (bladder and/or ureter) after robotic surgery performed by gynecologic oncologists. A retrospective chart review of patients who presented for robotic hysterectomy from 2009-2012 was performed at 2 separate academic medical centers, one that performed routine cystoscopy and one that did not. Statistical analysis was performed with t tests and χ2 tests. We identified 140 cases without cystoscopy and 109 cases with routine cystoscopy. There were no intraoperative or postoperative urinary injuries detected in either group. There were no significant differences in age and body mass index. In the non-cystoscopy group, a larger specimen size (P<.001), less blood loss (P=.013), and a longer mean operative time were observed (P<.0001). In the routine cystoscopy group, more lymphadenectomies were performed with hysterectomy (P=.007) and more patients underwent hysterectomy for ovarian cancer (P=.0192). There were no differences in surgical indications or secondary procedures including bilateral salpingo-oophorectomy, radical hysterectomy, ureterolysis, and pelvic organ prolapse-related procedures. The minimum follow-up period was 30 days in both groups. Routine use of cystoscopy did not appear to affect the detection rate of intraoperative lower urinary tract injury during robotic gynecologic surgery because this rate was zero in both groups. However, cystoscopy is relatively simple to perform and can be efficiently incorporated into robotic surgery to avoid the severe morbidity and possible litigation surrounding a urinary tract injury.

  16. Improving glycaemic control and life skills in adolescents with type 1 diabetes: A randomised, controlled intervention study using the Guided Self-Determination-Young method in triads of adolescents, parents and health care providers integrated into routine paediatric outpatient clinics

    PubMed Central

    2011-01-01

    Background Adolescents with type 1 diabetes face demanding challenges due to conflicting priorities between psychosocial needs and diabetes management. This conflict often results in poor glycaemic control and discord between adolescents and parents. Adolescent-parent conflicts are thus a barrier for health care providers (HCPs) to overcome in their attempts to involve both adolescents and parents in improvement of glycaemic control. Evidence-based interventions that involve all three parties (i.e., adolescents, parents and HCPs) and are integrated into routine outpatient clinic visits are lacking. The Guided Self-Determination method is proven effective in adult care and has been adapted to adolescents and parents (Guided Self-Determination-Young (GSD-Y)) for use in paediatric diabetes outpatient clinics. Our objective is to test whether GSD-Y used in routine paediatric outpatient clinic visits will reduce haemoglobin A1c (HbA1c) concentrations and improve adolescents' life skills compared with a control group. Methods/Design Using a mixed methods design comprising a randomised controlled trial and a nested qualitative evaluation, we will recruit 68 adolescents age 13 - 18 years with type 1 diabetes (HbA1c > 8.0%) and their parents from 2 Danish hospitals and randomise into GSD-Y or control groups. During an 8-12 month period, the GSD-Y group will complete 8 outpatient GSD-Y visits, and the control group will completes an equal number of standard visits. The primary outcome is HbA1c. Secondary outcomes include the following: number of self-monitored blood glucose values and levels of autonomous motivation, involvement and autonomy support from parents, autonomy support from HCPs, perceived competence in managing diabetes, well-being, and diabetes-related problems. Primary and secondary outcomes will be evaluated within and between groups by comparing data from baseline, after completion of the visits, and again after a 6-month follow-up. To illustrate how GSD

  17. Rapid, cost-effective and accurate quantification of Yucca schidigera Roezl. steroidal saponins using HPLC-ELSD method.

    PubMed

    Tenon, Mathieu; Feuillère, Nicolas; Roller, Marc; Birtić, Simona

    2017-04-15

    Yucca GRAS-labelled saponins have been and are increasingly used in food/feed, pharmaceutical or cosmetic industries. Existing techniques presently used for Yucca steroidal saponin quantification remain either inaccurate and misleading or accurate but time consuming and cost prohibitive. The method reported here addresses all of the above challenges. HPLC/ELSD technique is an accurate and reliable method that yields results of appropriate repeatability and reproducibility. This method does not over- or under-estimate levels of steroidal saponins. HPLC/ELSD method does not require each and every pure standard of saponins, to quantify the group of steroidal saponins. The method is a time- and cost-effective technique that is suitable for routine industrial analyses. HPLC/ELSD methods yield a saponin fingerprints specific to the plant species. As the method is capable of distinguishing saponin profiles from taxonomically distant species, it can unravel plant adulteration issues. Copyright © 2016 The Author(s). Published by Elsevier Ltd.. All rights reserved.

  18. Rapid targeted somatic mutation analysis of solid tumors in routine clinical diagnostics.

    PubMed

    Magliacane, Gilda; Grassini, Greta; Bartocci, Paola; Francaviglia, Ilaria; Dal Cin, Elena; Barbieri, Gianluca; Arrigoni, Gianluigi; Pecciarini, Lorenza; Doglioni, Claudio; Cangi, Maria Giulia

    2015-10-13

    Tumor genotyping is an essential step in routine clinical practice and pathology laboratories face a major challenge in being able to provide rapid, sensitive and updated molecular tests. We developed a novel mass spectrometry multiplexed genotyping platform named PentaPanel to concurrently assess single nucleotide polymorphisms in 56 hotspots of the 5 most clinically relevant cancer genes, KRAS, NRAS, BRAF, EGFR and PIK3CA for a total of 221 detectable mutations. To both evaluate and validate the PentaPanel performance, we investigated 1025 tumor specimens of 6 different cancer types (carcinomas of colon, lung, breast, pancreas, and biliary tract, and melanomas), systematically addressing sensitivity, specificity, and reproducibility of our platform. Sanger sequencing was also performed for all the study samples. Our data showed that PentaPanel is a high throughput and robust tool, allowing genotyping for targeted therapy selection of 10 patients in the same run, with a practical turnaround time of 2 working days. Importantly, it was successfully used to interrogate different DNAs isolated from routinely processed specimens (formalin-fixed paraffin embedded, frozen, and cytological samples), covering all the requirements of clinical tests. In conclusion, the PentaPanel platform can provide an immediate, accurate and cost effective multiplex approach for clinically relevant gene mutation analysis in many solid tumors and its utility across many diseases can be particularly relevant in multiple clinical trials, including the new basket trial approach, aiming to identify appropriate targeted drug combination strategies.

  19. SU-D-18C-05: Variable Bolus Arterial Spin Labeling MRI for Accurate Cerebral Blood Flow and Arterial Transit Time Mapping

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

    Johnston, M; Jung, Y

    2014-06-01

    Purpose: Arterial spin labeling (ASL) is an MRI perfusion imaging method from which quantitative cerebral blood flow (CBF) maps can be calculated. Acquisition with variable post-labeling delays (PLD) and variable TRs allows for arterial transit time (ATT) mapping and leads to more accurate CBF quantification with a scan time saving of 48%. In addition, T1 and M0 maps can be obtained without a separate scan. In order to accurately estimate ATT and T1 of brain tissue from the ASL data, variable labeling durations were invented, entitled variable-bolus ASL. Methods: All images were collected on a healthy subject with a 3Tmore » Siemens Skyra scanner. Variable-bolus Psuedo-continuous ASL (PCASL) images were collected with 7 TI times ranging 100-4300ms in increments of 700ms with TR ranging 1000-5200ms. All boluses were 1600ms when the TI allowed, otherwise the bolus duration was 100ms shorter than the TI. All TI times were interleaved to reduce sensitivity to motion. Voxel-wise T1 and M0 maps were estimated using a linear least squares fitting routine from the average singal from each TI time. Then pairwise subtraction of each label/control pair and averaging for each TI time was performed. CBF and ATT maps were created using the standard model by Buxton et al. with a nonlinear fitting routine using the T1 tissue map. Results: CBF maps insensitive to ATT were produced along with ATT maps. Both maps show patterns and averages consistent with literature. The T1 map also shows typical T1 contrast. Conclusion: It has been demonstrated that variablebolus ASL produces CBF maps free from the errors due to ATT and tissue T1 variations and provides M0, T1, and ATT maps which have potential utility. This is accomplished with a single scan in a feasible scan time (under 6 minutes) with low sensivity to motion.« less

  20. Adoption of routine telemedicine in Norway: the current picture

    PubMed Central

    Zanaboni, Paolo; Knarvik, Undine; Wootton, Richard

    2014-01-01

    Background Telemedicine appears to be ready for wider adoption. Although existing research evidence is useful, the adoption of routine telemedicine in healthcare systems has been slow. Objective We conducted a study to explore the current use of routine telemedicine in Norway, at national, regional, and local levels, to provide objective and up-to-date information and to estimate the potential for wider adoption of telemedicine. Design A top-down approach was used to collect official data on the national use of telemedicine from the Norwegian Patient Register. A bottom-up approach was used to collect complementary information on the routine use of telemedicine through a survey conducted at the five largest publicly funded hospitals. Results Results show that routine telemedicine has been adopted in all health regions in Norway and in 68% of hospitals. Despite being widely adopted, the current level of use of telemedicine is low compared to the number of face-to-face visits. Examples of routine telemedicine can be found in several clinical specialties. Most services connect different hospitals in secondary care, and they are mostly delivered as teleconsultations via videoconference. Conclusions Routine telemedicine in Norway has been widely adopted, probably for geographical reasons, as in other settings. However, the level of use of telemedicine in Norway is rather low, and it has significant potential for further development as an alternative to face-to-face outpatient visits. This study is a first attempt to map routine telemedicine at regional, institutional, and clinical levels, and it provides useful information to understand the adoption of telemedicine in routine healthcare and to measure change in future updates. PMID:24433942

  1. Design and implementation of a controlled clinical trial to evaluate the effectiveness and efficiency of routine opt-out rapid human immunodeficiency virus screening in the emergency department.

    PubMed

    Haukoos, Jason S; Hopkins, Emily; Byyny, Richard L; Conroy, Amy A; Silverman, Morgan; Eisert, Sheri; Thrun, Mark; Wilson, Michael; Boyett, Brian; Heffelfinger, James D

    2009-08-01

    In 2006, the Centers for Disease Control and Prevention (CDC) released revised recommendations for performing human immunodeficiency virus (HIV) testing in health care settings, including implementing routine rapid HIV screening, the use of an integrated opt-out consent, and limited prevention counseling. Emergency departments (EDs) have been a primary focus of these efforts. These revised CDC recommendations were primarily based on feasibility studies and have not been evaluated through the application of rigorous research methods. This article describes the design and implementation of a large prospective controlled clinical trial to evaluate the CDC's recommendations in an ED setting. From April 15, 2007, through April 15, 2009, a prospective quasi-experimental equivalent time-samples clinical trial was performed to compare the clinical effectiveness and efficiency of routine (nontargeted) opt-out rapid HIV screening (intervention) to physician-directed diagnostic rapid HIV testing (control) in a high-volume urban ED. In addition, three nested observational studies were performed to evaluate the cost-effectiveness and patient and staff acceptance of the two rapid HIV testing methods. This article describes the rationale, methodologies, and study design features of this program evaluation clinical trial. It also provides details regarding the integration of the principal clinical trial and its nested observational studies. Such ED-based trials are rare, but serve to provide valid comparisons between testing approaches. Investigators should consider similar methodology when performing future ED-based health services research.

  2. Lunate chondromalacia: evaluation of routine MRI sequences.

    PubMed

    Bordalo-Rodrigues, Marcelo; Schweitzer, Mark; Bergin, Diane; Culp, Randall; Barakat, Mohamed S

    2005-05-01

    Chondromalacia is a commonly encountered abnormality at arthroscopy and may be responsible for significant clinical symptoms and disability. In the wrist, the most common location for chondromalacia is the lunate bone. Consequently, we sought to study the accuracy of clinical MRI in the assessment of lunate articular cartilage. MR images of 34 patients who underwent arthroscopy and had an MRI examination within 1 month of surgery were evaluated by two reviewers for the presence and location of lunate cartilage defects and subchondral edema. Lunate cartilage defects were seen on MRI in 10 of the 13 patients with chondromalacia, but these defects were also incorrectly noted in three of 21 of patients without chondromalacia. The visible locations for cartilage defects were the ulnar aspect of the proximal lunate bone (n = 3), radial aspect of the proximal lunate bone (n = 4), ulnar aspect of the distal lunate bone (n = 2), and radial aspect of the distal lunate bone (n = 1). Subchondral marrow edema was observed in six of the 10 patients with chondromalacia seen on MRI; in all six patients, the edema was seen in the same quadrant as the cartilage defect. Marrow edema was detected in one patient without chondromalacia. We conclude that lunate chondromalacia can be accurately assessed using routine MRI sequences, although there are occasional false-positive interpretations.

  3. Accurate chromatic control and color rendering optimization in LED lighting systems using junction temperature feedback

    NASA Astrophysics Data System (ADS)

    Sisto, Marco Michele; Gauvin, Jonny

    2014-09-01

    Accurate color control of LED lighting systems is a challenging task: noticeable chromaticity shifts are commonly observed in mixed-color and phosphor converted LEDs due to intensity dimming. Furthermore, the emitted color varies with the LED temperature. We present a novel color control method for tri-chromatic and tetra-chromatic LEDs, which enable to set and maintain the LED emission at a target color, or combination of correlated color temperature (CCT) and intensity. The LED color point is maintained over variations in the LED junctions' temperatures and intensity dimming levels. The method does not require color feedback sensors, so to minimize system complexity and cost, but relies on estimation of the LED junctions' temperatures from the junction voltages. If operated with tetra-chromatic LEDs, the method allows meeting an additional optimization criterion: for example, the maximization of a color rendering metric like the Color Rendering Index (CRI) or the Color Quality Scale (CQS), thus providing a high quality and clarity of colors on the surface illuminated by the LED. We demonstrate the control of a RGBW LED at target D65 white point with CIELAB color difference metric triangle;a,bE < 1 for simultaneous variations of flux from approximately 30 lm to 100 lm and LED heat sink temperature from 25°C to 58°C. In the same conditions, we demonstrate a CCT error <1%. Furthermore, the method allows varying the LED CCT from 5500K to 8000K while maintaining luminance within 1% of target. Further work is ongoing to evaluate the stability of the method over LED aging.

  4. DEVELOPING AND INSTRUCTING PRE-PERFORMANCE ROUTINES FOR TENPIN BOWLING COMPETITIONS (1).

    PubMed

    Lee, Seungmin; Lee, Keunchul; Kwon, Sungho

    2015-06-01

    This preliminary study developed pre-performance routines for tenpin bowlers and instructed them. To develop the routine, the situations before throwing the ball were divided into four phases; participants were examined through interviews and observations. This study used an A-B design; the A stage included the development of the routines for 3 wk., while the B stage included the instruction and two evaluations of the routine consistency. Practice was implemented for 4 hr. per day for 9 wk. The participants noted they understood the developed routine easily and experienced an atmosphere similar to that of a competition during training through the routines. They found it difficult to practice the relaxation phase, but emphasized that the relaxation phase was helpful. Consistent routines were associated with an improved mental state and performance in a competition. This study suggests that pre-performance routines stabilize the mental state of the athletes, apparently giving them a competitive advantage.

  5. Accurate and ergonomic method of registration for image-guided neurosurgery

    NASA Astrophysics Data System (ADS)

    Henderson, Jaimie M.; Bucholz, Richard D.

    1994-05-01

    There has been considerable interest in the development of frameless stereotaxy based upon scalp mounted fiducials. In practice we have experienced difficulty in relating markers to the image data sets in our series of 25 frameless cases, as well as inaccuracy due to scalp movement and the size of the markers. We have developed an alternative system for accurately and conveniently achieving surgical registration for image-guided neurosurgery based on alignment and matching of patient forehead contours. The system consists of a laser contour digitizer which is used in the operating room to acquire forehead contours, editing software for extracting contours from patient image data sets, and a contour-match algorithm for aligning the two contours and performing data set registration. The contour digitizer is tracked by a camera array which relates its position with respect to light emitting diodes placed on the head clamp. Once registered, surgical instrument can be tracked throughout the procedure. Contours can be extracted from either CT or MRI image datasets. The system has proven to be robust in the laboratory setting. Overall error of registration is 1 - 2 millimeters in routine use. Image to patient registration can therefore be achieved quite easily and accurately, without the need for fixation of external markers to the skull, or manually finding markers on the scalp and image datasets. The system is unobtrusive and imposes little additional effort on the neurosurgeon, broadening the appeal of image-guided surgery.

  6. Motivation through Routine Documentation

    ERIC Educational Resources Information Center

    Koth, Laurie J.

    2016-01-01

    This informed commentary article offers a simple, effective classroom management strategy in which the teacher uses routine documentation to motivate students both to perform academically and to behave in a manner consistent with established classroom rules and procedures. The pragmatic strategy is grounded in literature, free to implement,…

  7. [Everyday stress, routines and bipolar spectrum].

    PubMed

    Gindre, C; Swendsen, J

    2010-06-01

    Bipolar patients relapse more frequently under conditions of stress, even when compliant with prescribed medication. Although the biological bases of stress reactivity remain widely debated, the disruption of biological or circadian rhythms has been suggested as one possible mechanism through which stress increases the risk of episodes. This hypothesis has gained support from recent evidence demonstrating that the disruption of social rhythms is particularly implicated in the onset of manic episodes. However, it is currently unknown to what extent bipolar patients may differ from normal controls in terms of the basic prevalence and nature of daily life routines, or if such individuals are more sensitive to the disruption of such rhythms following exposure to stress. Using a dimensional perspective of bipolar disorder, 1728 French university students were first screened concerning diverse psychological and clinical characteristics. Two hundred and twelve individuals at high or low-risk for mood and substance use disorders were then invited to participate in a week-long period of ambulatory monitoring using the experience sampling method (ESM). During this phase, participants were given a preprogrammed PDA microcomputer which provided ambulatory assessments of behaviour and stress at fixed intervals (randomized across participants). At the end of the ESM phase, the microcomputers were collected and structured diagnostic interviews were administered to each participant. For the purposes of the current study, analyses focused on a subsample of 92 individuals, reflecting the 28 participants who met lifetime criteria for a manic (n=15) or hypomanic episode (n=13), and the 64 individuals who were free of any lifetime disorder. Data were analyzed using hierarchical nonlinear (Bernoulli) models for repeated measures. Covariates included age, sex, frequency of substance use and cognitive vulnerabilities assessed at screening. A Bonferroni correction was applied to adjust

  8. Selective versus routine use of episiotomy for vaginal birth

    PubMed Central

    Jiang, Hong; Qian, Xu; Carroli, Guillermo; Garner, Paul

    2017-01-01

    Background Some clinicians believe that routine episiotomy, a surgical cut of the vagina and perineum, will prevent serious tears during childbirth. On the other hand, an episiotomy guarantees perineal trauma and sutures. Objectives To assess the effects on mother and baby of a policy of selective episiotomy ('only if needed') compared with a policy of routine episiotomy ('part of routine management') for vaginal births. Search methods We searched Cochrane Pregnancy and Childbirth's Trials Register (14 September 2016) and reference lists of retrieved studies. Selection criteria Randomised controlled trials (RCTs) comparing selective versus routine use of episiotomy, irrespective of parity, setting or surgical type of episiotomy. We included trials where either unassisted or assisted vaginal births were intended. Quasi-RCTs, trials using a cross-over design or those published in abstract form only were not eligible for inclusion in this review. Data collection and analysis Two authors independently screened studies, extracted data, and assessed risk of bias. A third author mediated where there was no clear consensus. We observed good practice for data analysis and interpretation where trialists were review authors. We used fixed-effect models unless heterogeneity precluded this, expressed results as risk ratios (RR) and 95% confidence intervals (CI), and assessed the certainty of the evidence using GRADE. Main results This updated review includes 12 studies (6177 women), 11 in women in labour for whom a vaginal birth was intended, and one in women where an assisted birth was anticipated. Two were trials each with more than 1000 women (Argentina and the UK), and the rest were smaller (from Canada, Germany, Spain, Ireland, Malaysia, Pakistan, Columbia and Saudi Arabia). Eight trials included primiparous women only, and four trials were in both primiparous and multiparous women. For risk of bias, allocation was adequately concealed and reported in nine trials; sequence

  9. Family Routines and School Readiness during the Transition to Kindergarten

    ERIC Educational Resources Information Center

    Ferretti, Larissa K.; Bub, Kristen L.

    2017-01-01

    Research Findings: Using data from 3,250 participants in the Early Childhood Longitudinal Study, Birth Cohort, we used structural equation modeling to investigate whether family routines (e.g., bedtime routine, reading routine) established in preschool predict children's school readiness (i.e., academic skills, social-emotional skills, and…

  10. Understanding Teachers' Routines to Inform Classroom Technology Design

    ERIC Educational Resources Information Center

    An, Pengcheng; Bakker, Saskia; Eggen, Berry

    2017-01-01

    Secondary school teachers have quite busy and complex routines in their classrooms. However, present classroom technologies usually require focused attention from teachers while being interacted with, which restricts their use in teachers' daily routines. Peripheral interaction is a human-computer interaction style that aims to enable interaction…

  11. Managing routine food choices in UK families: the role of convenience consumption.

    PubMed

    Carrigan, Marylyn; Szmigin, Isabelle; Leek, Sheena

    2006-11-01

    The paper explores the meaning of convenience food for UK mothers, investigating the relationship between mothers and their families' food. The study examines the role of convenience food within the food strategies of contemporary UK families, and aims to elicit consumption meanings in the broader social context of family relationships with food, their rituals, routines and conventions. The findings reveal convenience has multiple meanings for UK women, and that convenience food has been incorporated into reinterpreted versions of homemade and "proper" meals. A hierarchy of acceptable convenience food is presented by the mothers, who tackle complex and conflicting family routines by introducing convenience solutions. Rules of eating have evolved, yet remain essentially controlled by the mother in terms of nutrition. While the traditional model of "proper" food remains aspirational, contemporary family lifestyles require that convenience food become part of the equation.

  12. Fortran graphics routines for the Macintosh

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

    Shore, B.W.

    1992-06-01

    The Language Systems MPW Fortran is a popular Fortran compiler for the Macintosh. Unfortunately, it does not have any built-in calls to graphics routines (such as are available with Graflib on the NLTSS), so there is no simple way to make x-y plots from calls within Fortran. Instead, a file of data must be created and a commercial plotting routine (such as IGOR or KALEIDAGRAPH) or a spreadsheet with graphics (such as WINGZ) must be applied to post-process the data. The Macintosh does have available many built-in calls (to the Macintosh Toolbox) that allow drawing shapes and lines with quickdraw,more » but these are not designed for plotting functions and are difficult to learn to use. This work outlines some Fortran routines that can be called from LS Fortran to make the necessary calls to the Macintosh toolbox to create simple two-dimensional plots or contour plots. The source code DEMOGRAF.F shows how these routines may be used. DEMOGRAF.F simply demonstrates some Fortran subroutines that can be called with language systems MPW Fortran on the Macintosh to plot arrays of numbers. The subroutines essentially mimic the functionality that has been available at LTSS and NLTSS and UNICOS at LLNL. The graphics primitives are kept in four separate files, each containing several subroutines. The subroutines are compiled and stored in a library file, LIBgraf.o. Makefile is used to link this library to the source code. A discussion is included on requirements for interactive plotting of functions.« less

  13. User manual for two simple postscript output FORTRAN plotting routines

    NASA Technical Reports Server (NTRS)

    Nguyen, T. X.

    1991-01-01

    Graphics is one of the important tools in engineering analysis and design. However, plotting routines that generate output on high quality laser printers normally come in graphics packages, which tend to be expensive and system dependent. These factors become important for small computer systems or desktop computers, especially when only some form of a simple plotting routine is sufficient. With the Postscript language becoming popular, there are more and more Postscript laser printers now available. Simple, versatile, low cost plotting routines that can generate output on high quality laser printers are needed and standard FORTRAN language plotting routines using output in Postscript language seems logical. The purpose here is to explain two simple FORTRAN plotting routines that generate output in Postscript language.

  14. Learning from Homeschooling Routines

    ERIC Educational Resources Information Center

    Thomas, Jesse

    2016-01-01

    This study provides a rare opportunity to look inside the homeschool and to observe the routines of homeschooling families from across the United States. With more than 1000 survey participants, and nine parents selected for interviews, the compiled data were analyzed through open coding techniques. Meaningful aspects that arose from the routines…

  15. Thinking Routines: Replicating Classroom Practices within Museum Settings

    ERIC Educational Resources Information Center

    Wolberg, Rochelle Ibanez; Goff, Allison

    2012-01-01

    This article describes thinking routines as tools to guide and support young children's thinking. These learning strategies, developed by Harvard University's Project Zero Classroom, actively engage students in constructing meaning while also understanding their own thinking process. The authors discuss how thinking routines can be used in both…

  16. Routines in School Organizations: Creating Stability and Change

    ERIC Educational Resources Information Center

    Conley, Sharon; Enomoto, Ernestine K.

    2005-01-01

    Purpose: This paper presents routinized action theory as a way to examine the regular, habitual activities that occur in school organizations. Using this theoretical lens, school routines were analyzed in order to understand organizational stability and change. Design/methodology/approach: Using case study methods, three discrete cases are…

  17. First evaluation of automated specimen inoculation for wound swab samples by use of the Previ Isola system compared to manual inoculation in a routine laboratory: finding a cost-effective and accurate approach.

    PubMed

    Mischnik, Alexander; Mieth, Markus; Busch, Cornelius J; Hofer, Stefan; Zimmermann, Stefan

    2012-08-01

    Automation of plate streaking is ongoing in clinical microbiological laboratories, but evaluation for routine use is mostly open. In the present study, the recovery of microorganisms from the Previ Isola system plated polyurethane (PU) swab samples is compared to manually plated control viscose swab samples from wounds according to the CLSI procedure M40-A (quality control of microbiological transport systems). One hundred twelve paired samples (224 swabs) were analyzed. In 80/112 samples (71%), concordant culture results were obtained with the two methods. In 32/112 samples (29%), CFU recovery of microorganisms from the two methods was discordant. In 24 (75%) of the 32 paired samples with a discordant result, Previ Isola plated PU swabs were superior. In 8 (25%) of the 32 paired samples with a discordant result, control viscose swabs were superior. The quality of colony growth on culture media for further investigations was superior with Previ Isola inoculated plates compared to manual plating techniques. Gram stain results were concordant between the two methods in 62/112 samples (55%). In 50/112 samples (45%), the results of Gram staining were discordant between the two methods. In 34 (68%) of the 50 paired samples with discordant results, Gram staining of PU swabs was superior to that of control viscose swabs. In 16 (32%) of the 50 paired samples, Gram staining of control viscose swabs was superior to that of PU swabs. We report the first clinical evaluation of Previ Isola automated specimen inoculation for wound swab samples. This study suggests that use of an automated specimen inoculation system has good results with regard to CFU recovery, quality of Gram staining, and accuracy of diagnosis.

  18. First Evaluation of Automated Specimen Inoculation for Wound Swab Samples by Use of the Previ Isola System Compared to Manual Inoculation in a Routine Laboratory: Finding a Cost-Effective and Accurate Approach

    PubMed Central

    Mieth, Markus; Busch, Cornelius J.; Hofer, Stefan; Zimmermann, Stefan

    2012-01-01

    Automation of plate streaking is ongoing in clinical microbiological laboratories, but evaluation for routine use is mostly open. In the present study, the recovery of microorganisms from the Previ Isola system plated polyurethane (PU) swab samples is compared to manually plated control viscose swab samples from wounds according to the CLSI procedure M40-A (quality control of microbiological transport systems). One hundred twelve paired samples (224 swabs) were analyzed. In 80/112 samples (71%), concordant culture results were obtained with the two methods. In 32/112 samples (29%), CFU recovery of microorganisms from the two methods was discordant. In 24 (75%) of the 32 paired samples with a discordant result, Previ Isola plated PU swabs were superior. In 8 (25%) of the 32 paired samples with a discordant result, control viscose swabs were superior. The quality of colony growth on culture media for further investigations was superior with Previ Isola inoculated plates compared to manual plating techniques. Gram stain results were concordant between the two methods in 62/112 samples (55%). In 50/112 samples (45%), the results of Gram staining were discordant between the two methods. In 34 (68%) of the 50 paired samples with discordant results, Gram staining of PU swabs was superior to that of control viscose swabs. In 16 (32%) of the 50 paired samples, Gram staining of control viscose swabs was superior to that of PU swabs. We report the first clinical evaluation of Previ Isola automated specimen inoculation for wound swab samples. This study suggests that use of an automated specimen inoculation system has good results with regard to CFU recovery, quality of Gram staining, and accuracy of diagnosis. PMID:22692745

  19. Memory conformity affects inaccurate memories more than accurate memories.

    PubMed

    Wright, Daniel B; Villalba, Daniella K

    2012-01-01

    After controlling for initial confidence, inaccurate memories were shown to be more easily distorted than accurate memories. In two experiments groups of participants viewed 50 stimuli and were then presented with these stimuli plus 50 fillers. During this test phase participants reported their confidence that each stimulus was originally shown. This was followed by computer-generated responses from a bogus participant. After being exposed to this response participants again rated the confidence of their memory. The computer-generated responses systematically distorted participants' responses. Memory distortion depended on initial memory confidence, with uncertain memories being more malleable than confident memories. This effect was moderated by whether the participant's memory was initially accurate or inaccurate. Inaccurate memories were more malleable than accurate memories. The data were consistent with a model describing two types of memory (i.e., recollective and non-recollective memories), which differ in how susceptible these memories are to memory distortion.

  20. Routines of families with adolescents with autistic disorders: a comparison study.

    PubMed

    Bagatell, Nancy J; Cram, Megan; Alvarez, Christian G; Loehle, Laura

    2014-02-01

    Research has consistently shown that families with children with autism spectrum disorders (ASD) have difficulty engaging in family routines, yet little is known about families with adolescents with ASD. The purpose of this study is to compare the routines of families with adolescents with ASD (FASD) and families with typically developing adolescents. Twenty families in each group were compared using the Family Routines Inventory and supplemental questions. Data were analyzed using a Mann-Whitney U and content analysis. No significant difference between groups was found; however, there was a trending toward significance in the subscale of mealtime routines in both endorsement and adherence. Analysis of open-ended questions revealed differences in how routines were carried out. Occupational therapists should consider assessing and addressing routines of importance to FASD to increase family health and well-being. Further research is needed to better understand the routines of FASD.

  1. Contemporary epidemiological overview of malaria in Madagascar: operational utility of reported routine case data for malaria control planning.

    PubMed

    Howes, Rosalind E; Mioramalala, Sedera Aurélien; Ramiranirina, Brune; Franchard, Thierry; Rakotorahalahy, Andry Joeliarijaona; Bisanzio, Donal; Gething, Peter W; Zimmerman, Peter A; Ratsimbasoa, Arsène

    2016-10-18

    Malaria remains a major public health problem in Madagascar. Widespread scale-up of intervention coverage has led to substantial reductions in case numbers since 2000. However, political instability since 2009 has disrupted these efforts, and a resurgence of malaria has since followed. This paper re-visits the sub-national stratification of malaria transmission across Madagascar to propose a contemporary update, and evaluates the reported routine case data reported at this sub-national scale. Two independent malariometrics were evaluated to re-examine the status of malaria across Madagascar. First, modelled maps of Plasmodium falciparum infection prevalence (PfPR) from the Malaria Atlas Project were used to update the sub-national stratification into 'ecozones' based on transmission intensity. Second, routine reports of case data from health facilities were synthesized from 2010 to 2015 to compare the sub-national epidemiology across the updated ecozones over time. Proxy indicators of data completeness are investigated. The epidemiology of malaria is highly diverse across the island's ecological regions, with eight contiguous ecozones emerging from the transmission intensity PfPR map. East and west coastal areas have highest transmission year-round, contrasting with the central highlands and desert south where trends appear more closely associated with epidemic outbreak events. Ecozones have shown steady increases in reported malaria cases since 2010, with a near doubling of raw reported case numbers from 2014 to 2015. Gauges of data completeness suggest that interpretation of raw reported case numbers will underestimate true caseload as only approximately 60-75 % of health facility data are reported to the central level each month. A sub-national perspective is essential when monitoring the epidemiology of malaria in Madagascar and assessing local control needs. A robust assessment of the status of malaria at a time when intervention coverage efforts are being

  2. Computer routine adds plotting capabilities to existing programs

    NASA Technical Reports Server (NTRS)

    Harris, J. C.; Linnekin, J. S.

    1966-01-01

    PLOTAN, a generalized plot analysis routine written for the IBM 7094 computer, minimizes the difficulties in adding plot capabilities to large existing programs. PLOTAN is used in conjunction with a binary tape writing routine and has the ability to plot any variable on the intermediate binary tape as a function of any other.

  3. Analyzing the Trait of Routinization in Older Adults.

    ERIC Educational Resources Information Center

    Reich, John W.; Zautra, Alex J.

    1991-01-01

    Developed scale to assess routinization (tendency to maintain daily events of one's life in relatively unchanging and orderly pattern of regularity) among older adults. Findings from over 200 older adults revealed 2 underlying factors: Having Order and Routine in daily living and Disliking Disruption. Evidence was found for validity of the 20-item…

  4. Routine activities and victimization at school: the significance of gender.

    PubMed

    Popp, Ann Marie; Peguero, Anthony A

    2011-08-01

    Routine activities theory has not fully considered the role of gender in shaping victimization and yet, the research literature clearly demonstrates that gender is associated with an individual's risk of victimization. In addition to the pervasive effect of gender on victimization, gender shapes an individual's daily routines and thus may create a gender-specific relationship with victimization. This article explores the importance of gender in understanding the relationship between student's participation in extracurricular routine activities (e.g., student government, clubs, sports, and etc.) and the risk of victimization. From the Education Longitudinal Study of 2002, a sample of 10th-grade students was drawn for analyses. Hierarchical Generalized Linear Modeling was employed to explore the role of gender in the relationship between extracurricular routine activities and victimization at school. The results reveal that students' gender indeed interacts with several of the extracurricular routine activities creating gender-specific risks of victimization. This article highlights the importance of gender in explaining victimization and suggests researchers should consider how gender may interact with other routine activities and victimization.

  5. Evoked potentials recorded during routine EEG predict outcome after perinatal asphyxia.

    PubMed

    Nevalainen, Päivi; Marchi, Viviana; Metsäranta, Marjo; Lönnqvist, Tuula; Toiviainen-Salo, Sanna; Vanhatalo, Sampsa; Lauronen, Leena

    2017-07-01

    To evaluate the added value of somatosensory (SEPs) and visual evoked potentials (VEPs) recorded simultaneously with routine EEG in early outcome prediction of newborns with hypoxic-ischemic encephalopathy under modern intensive care. We simultaneously recorded multichannel EEG, median nerve SEPs, and flash VEPs during the first few postnatal days in 50 term newborns with hypoxic-ischemic encephalopathy. EEG background was scored into five grades and the worst two grades were considered to indicate poor cerebral recovery. Evoked potentials were classified as absent or present. Clinical outcome was determined from the medical records at a median age of 21months. Unfavorable outcome included cerebral palsy, severe mental retardation, severe epilepsy, or death. The accuracy of outcome prediction was 98% with SEPs compared to 90% with EEG. EEG alone always predicted unfavorable outcome when it was inactive (n=9), and favorable outcome when it was normal or only mildly abnormal (n=17). However, newborns with moderate or severe EEG background abnormality could have either favorable or unfavorable outcome, which was correctly predicted by SEP in all but one newborn (accuracy in this subgroup 96%). Absent VEPs were always associated with an inactive EEG, and an unfavorable outcome. However, presence of VEPs did not guarantee a favorable outcome. SEPs accurately predict clinical outcomes in newborns with hypoxic-ischemic encephalopathy and improve the EEG-based prediction particularly in those newborns with severely or moderately abnormal EEG findings. SEPs should be added to routine EEG recordings for early bedside assessment of newborns with hypoxic-ischemic encephalopathy. Copyright © 2017 International Federation of Clinical Neurophysiology. Published by Elsevier B.V. All rights reserved.

  6. Variation in the costs of delivering routine immunization services in Peru.

    PubMed Central

    Walker, D.; Mosqueira, N. R.; Penny, M. E.; Lanata, C. F.; Clark, A. D.; Sanderson, C. F. B.; Fox-Rushby, J. A.

    2004-01-01

    OBJECTIVE: Estimates of vaccination costs usually provide only point estimates at national level with no information on cost variation. In practice, however, such information is necessary for programme managers. This paper presents information on the variations in costs of delivering routine immunization services in three diverse districts of Peru: Ayacucho (a mountainous area), San Martin (a jungle area) and Lima (a coastal area). METHODS: We consider the impact of variability on predictions of cost and reflect on the likely impact on expected cost-effectiveness ratios, policy decisions and future research practice. All costs are in 2002 prices in US dollars and include the costs of providing vaccination services incurred by 19 government health facilities during the January-December 2002 financial year. Vaccine wastage rates have been estimated using stock records. FINDINGS: The cost per fully vaccinated child ranged from 16.63-24.52 U.S. Dollars in Ayacucho, 21.79-36.69 U.S. Dollars in San Martin and 9.58-20.31 U.S. Dollars in Lima. The volume of vaccines administered and wastage rates are determinants of the variation in costs of delivering routine immunization services. CONCLUSION: This study shows there is considerable variation in the costs of providing vaccines across geographical regions and different types of facilities. Information on how costs vary can be used as a basis from which to generalize to other settings and provide more accurate estimates for decision-makers who do not have disaggregated data on local costs. Future studies should include sufficiently large sample sizes and ensure that regions are carefully selected in order to maximize the interpretation of cost variation. PMID:15628205

  7. Variation in the costs of delivering routine immunization services in Peru.

    PubMed

    Walker, D; Mosqueira, N R; Penny, M E; Lanata, C F; Clark, A D; Sanderson, C F B; Fox-Rushby, J A

    2004-09-01

    Estimates of vaccination costs usually provide only point estimates at national level with no information on cost variation. In practice, however, such information is necessary for programme managers. This paper presents information on the variations in costs of delivering routine immunization services in three diverse districts of Peru: Ayacucho (a mountainous area), San Martin (a jungle area) and Lima (a coastal area). We consider the impact of variability on predictions of cost and reflect on the likely impact on expected cost-effectiveness ratios, policy decisions and future research practice. All costs are in 2002 prices in US dollars and include the costs of providing vaccination services incurred by 19 government health facilities during the January-December 2002 financial year. Vaccine wastage rates have been estimated using stock records. The cost per fully vaccinated child ranged from 16.63-24.52 U.S. Dollars in Ayacucho, 21.79-36.69 U.S. Dollars in San Martin and 9.58-20.31 U.S. Dollars in Lima. The volume of vaccines administered and wastage rates are determinants of the variation in costs of delivering routine immunization services. This study shows there is considerable variation in the costs of providing vaccines across geographical regions and different types of facilities. Information on how costs vary can be used as a basis from which to generalize to other settings and provide more accurate estimates for decision-makers who do not have disaggregated data on local costs. Future studies should include sufficiently large sample sizes and ensure that regions are carefully selected in order to maximize the interpretation of cost variation.

  8. Accurate Determination of Soluble Axl by Enzyme-Linked Immunosorbent Assay.

    PubMed

    Dengler, Mirko; Huber, Heidemarie; Müller, Christian J; Zellmer, Angela; Rauch, Peter; Mikulits, Wolfgang

    2016-11-01

    Levels of soluble Axl (sAxl) are routinely assessed in human sera by sandwich enzyme-linked immunosorbent assay (ELISA). Although sAxl values are suggested to diagnose different types of disorders, no uniform ELISA method is available, allowing the reliable interassay comparison between results. Furthermore, little is known about the stability of sAxl under storage conditions, which is a relevant parameter for biomedical trials. The evaluation of sAxl stability under various stress conditions and the determination of proper conditions to use the sAxl ELISA for routine clinical applications are of great interest. In this study, serum samples were subjected to freeze-thaw cycles and incubation at different temperatures to analyze the stability of sAxl by ELISA. Dilution and spike-in experiments were carried out to examine the impact of serum and diluent components on the ELISA performance. Various diluents and media were employed to resolve masking effects of the serum. The assay components were further optimized for long-term usability by treatment with stabilizers and validation under temperature stress. Indeed, sAxl showed long-term stability in serum during freeze-thaw cycles and incubation under temperature stress conditions. The dilution experiments revealed that unknown components in the serum caused masking effects that can be reduced by proper dilutions. The assay performance was further increased by using a standardized buffer system to dilute serum samples. Stabilization of coated plates and of streptavidin-horseradish peroxidase allowed long-term storage for up to 6 months. In sum, our data demonstrate proper ELISA conditions, allowing the accurate analysis of sAxl levels in human serum.

  9. Preserving Older Adults’ Routine Outdoor Activities in Contrasting Neighborhood Environments through a Physical Activity Intervention

    PubMed Central

    King, Abby C.; Salvo, Deborah; Banda, Jorge A.; Ahn, David K.; Chapman, James E.; Gill, Thomas M.; Fielding, Roger A.; Demons, Jamehl; Tudor-Locke, Catrine; Rosso, Andrea; Pahor, Marco; Frank, Lawrence D.

    2017-01-01

    While neighborhood design can potentially influence routine outdoor physical activities (PA), little is known concerning its effects on such activities among older adults attempting to increase their PA levels. We evaluated the effects of living in neighborhoods differing in compactness on changes in routine outdoor activities (e.g., walking, gardening, yard work) among older adults at increased mobility disability risk participating in the LIFE-Pilot PA trial (2003–07; ages 70–89 years; from Dallas, TX, San Francisco Bay area, Pittsburgh, PA, and Winston-Salem, NC). Analyses were conducted on the 400 LIFE-Pilot participants randomized to a one-year endurance-plus-strengthening PA intervention or health education control that completed one-year PA assessment (CHAMPS questionnaire). Outcomes of interest were exercise and leisure walking, walking for errands, and moderate-intensity gardening. Neighborhood compactness was assessed objectively using geographic information systems via a subsequent grant (2008–12). PA increased weekly exercise and leisure walking relative to control, irrespective of neighborhood compactness. However, walking for errands decreased significantly more in PA relative to control (net mean[SD] difference=16.2 minutes/week[7.7], p=.037), particularly among those living in less compact neighborhoods (net mean[SD] difference=29.8[10.8] minutes/week, p=.006). PA participants living in less compact neighborhoods maintained or increased participation in gardening and yard work to a greater extent than controls (net mean[SD] difference=29.3[10.8] minutes/week, p=.007). The results indicate that formal targeting of active transport as an adjunct to structured PA programs may be important to diminish potential compensatory responses in functionally impaired older adults. Structured endurance-plus-strengthening PA may help older adults maintain or increase such routine activities over time. Trial Registration clinicaltrials.gov Identifier= NCT

  10. Pancreatic resection without routine intraperitoneal drainage

    PubMed Central

    Fisher, William E; Hodges, Sally E; Silberfein, Eric J; Artinyan, Avo; Ahern, Charlotte H; Jo, Eunji; Brunicardi, F Charles

    2011-01-01

    Background Most surgeons routinely place intraperitoneal drains at the time of pancreatic resection but this practice has recently been challenged. Objective Evaluate the outcome when pancreatic resection is performed without operatively placed intraperitoneal drains. Methods In all, 226 consecutive patients underwent pancreatic resection. In 179 patients drains were routinely placed at the time of surgery and in 47 no drains were placed. Outcomes for these two cohorts were recorded in a prospective database and compared using the χ2- /Fisher's exact test for categorical variables, and Wilcoxon's test for continuous variables. Results Demographic, surgical and pathological details were similar between the two cohorts. Elimination of routine intraperitoneal drainage did not increase the frequency or severity of serious complications. However, when all grades of complications were considered, the number of patients that experienced any complication (65% vs. 47%, P = 0.020) and the median complication severity grade (1 vs. 0, P = 0.027) were increased in the group that had drains placed at the time of surgery. Eliminating intra-operative drains was associated with decreased delayed gastric emptying (24% vs. 9%, P = 0.020) and a trend towards decreased wound infection (12% vs. 2%, P = 0.054). The readmission rate (9% vs. 17% P = 0.007) and number of patients requiring post-operative percutaneous drains (2% vs. 11%, P = 0.001) was higher in patients who did not have operatively placed drains but there was no difference in the re-operation rate (4% vs. 0%, P = 0.210). Conclusion Abandoning the practice of routine intraperitoneal drainage after pancreatic resection may not increase the incidence or severity of severe post-operative complications. PMID:21689234

  11. The accuracy of two-dimensional planning for routine orthognathic surgery.

    PubMed

    Rustemeyer, Jan; Groddeck, Alexander; Zwerger, Stefan; Bremerich, Andreas

    2010-06-01

    Two-dimensional cephalometric planning software should be helpful for prediction of hard tissue outcome after bilateral sagittal split ramus osteotomy (BSSRO) or bimaxillary osteotomy, but transferring two-dimensional data to three-dimensions (including mock operation and surgery) may result in errors. The objective of this retrospective study was to analyze deviations between predicted results and postoperative outcome using cephalometric analyses, and to evaluate this procedure for daily use. Fifty-four subjects (mean (SD) age 26 (8) years) had a BSSRO (n=21) alone or in combination with Le Fort I osteotomy (n=33). Predictions were made for each case by cephalometric planning software and mock operations done with study models. Postoperative cephalograms were obtained after 14 days and compared with predicted cephalograms for sagittal (SNA, SNB, ANB,) and vertical (ArMeGo, ML-NSL, NL-NSL) measurements. Mean (SD) differences for all measurements varied between 1.3 degrees (1.1 degrees) and 2.2 degrees (1.6 degrees) for BSSRO; and between 1.1 degrees (1.3 degrees) and 2.2 degrees (1.6 degrees) for bimaxillary osteotomy. There were no significant differences between measurements or operations, indicating that the predictions were accurate. A difference of up to 8.5 degrees could be measured in a single case. Cephalometric prediction therefore remains an accurate tool for planning, particularly maxillary rearrangement in the vertical and sagittal dimension for routine operations. If greater shifts in the transversal dimension are necessary, exact planning should be adapted with three-dimensional planning devices to avoid significant differences. Copyright 2009 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

  12. Accurate differentiation of Mycobacterium chimaera from Mycobacterium intracellulare by MALDI-TOF MS analysis.

    PubMed

    Pranada, Arthur B; Witt, Ellen; Bienia, Michael; Kostrzewa, Markus; Timke, Markus

    2017-05-01

    The increasing number of infections caused by nontuberculous mycobacteria (NTM) has prompted the need for rapid and precise identification methods of these pathogens. Several studies report the applicability of MALDI-TOF mass spectrometry (MS) for identification of NTM. However, some closely related species have very similar spectral mass fingerprints, and until recently, Mycobacterium chimaera and M. intracellulare could not be separated from each other by MALDI-TOF MS. The conventional identification methods used in routine diagnostics have similar limitations. Recently, the differentiation of these two species within the Mycobacterium avium complex has become increasingly important due to reports of M. chimaera infections related to open heart surgery in Europe and in the USA. In this report, a method for the distinct differentiation of M. chimaera and M. intracellulare using a more detailed analysis of MALDI-TOF mass spectra is presented. Species-specific peaks could be identified and it was possible to assign all isolates (100 %) from reference strain collections as well as clinical isolates to the correct species. We have developed a model for the accurate identification of M. chimaera and M. intracellulare by MALDI-TOF MS. This approach has the potential for routine use in microbiology laboratories, as the model itself can be easily implemented into the software of the currently available systems by MALDI-TOF MS manufacturers.

  13. Routine Ultrasound and Limited Computed Tomography for the Diagnosis of Acute Appendicitis

    PubMed Central

    Wiersma, Fraukje; Bakker, Rutger F. R.; Merkus, Jos W. S.; Breslau, Paul J.; Hamming, Jaap F.

    2010-01-01

    Background Acute appendicitis continues to be a challenging diagnosis. Preoperative radiological imaging using ultrasound (US) or computed tomography (CT) has gained popularity as it may offer a more accurate diagnosis than classic clinical evaluation. The optimal implementation of these diagnostic modalities has yet to be established. The aim of the present study was to investigate a diagnostic pathway that uses routine US, limited CT, and clinical re-evaluation for patients with acute appendicitis. Methods A prospective analysis was performed of all patients presenting with acute abdominal pain at the emergency department from June 2005 until July 2006 using a structured diagnosis and management flowchart. Daily practice was mimicked, while ensuring a valid assessment of clinical and radiological diagnostic accuracies and the effect they had on patient management. Results A total of 802 patients were included in this analysis. Additional radiological imaging was performed in 96.3% of patients with suspected appendicitis (n = 164). Use of CT was kept to a minimum (17.9%), with a US:CT ratio of approximately 6:1. Positive and negative predictive values for the clinical diagnosis of appendicitis were 63 and 98%, respectively; for US 94 and 97%, respectively; and for CT 100 and 100%, respectively. The negative appendicitis rate was 3.3%, the perforation rate was 23.5%, and the missed perforated appendicitis rate was 3.4%. No (diagnostic) laparoscopies were performed. Conclusions A diagnostic pathway using routine US, limited CT, and clinical re-evaluation for patients with acute abdominal pain can provide excellent results for the diagnosis and treatment of appendicitis. PMID:20582544

  14. The Effect of Team Training Strategies on Team Mental Model Formation and Team Performance under Routine and Non-Routine Environmental Conditions

    ERIC Educational Resources Information Center

    Hamilton, Katherine L.

    2009-01-01

    The current study examined how the type of training a team receives (team coordination training vs. cross-training) influences the type of team mental model structures that form and how those mental models in turn impact team performance under different environmental condition (routine vs. non-routine). Three-hundred and fifty-two undergraduate…

  15. A microcomputer-based whole-body counter for personnel routine monitoring.

    PubMed

    Chou, H P; Tsai, T M; Lan, C Y

    1993-05-01

    The paper describes a cost-effective NaI(Tl) whole-body counter developed for routine examinations of worker intakes at an isotope production facility. Signal processing, data analysis and system operation are microcomputer-controlled for minimum human interactions. The pulse height analyzer is developed as an microcomputer add-on card for easy manipulation. The scheme for radionuclide analysis is aimed for fast running according to a knowledge base established from background samples and phantom experiments in conjunction with a multivariate regression analysis. Long-term stability and calibration with standards and in vivo measurements are reported.

  16. Atrial Fibrillation Management Strategies in Routine Clinical Practice: Insights from the International RealiseAF Survey

    PubMed Central

    Chiang, Chern-En; Naditch-Brûlé, Lisa; Brette, Sandrine; Silva-Cardoso, José; Gamra, Habib; Murin, Jan; Zharinov, Oleg J.; Steg, Philippe Gabriel

    2016-01-01

    Background Atrial fibrillation (AF) can be managed with rhythm- or rate-control strategies. There are few data from routine clinical practice on the frequency with which each strategy is used and their correlates in terms of patients’ clinical characteristics, AF control, and symptom burden. Methods RealiseAF was an international, cross-sectional, observational survey of 11,198 patients with AF. The aim of this analysis was to describe patient profiles and symptoms according to the AF management strategy used. A multivariate logistic regression identified factors associated with AF management strategy at the end of the visit. Results Among 10,497 eligible patients, 53.7% used a rate-control strategy, compared with 34.5% who used a rhythm-control strategy. In 11.8% of patients, no clear strategy was stated. The proportion of patients with AF-related symptoms (EHRA Class > = II) was 78.1% (n = 4396/5630) for those using a rate-control strategy vs. 67.8% for those using a rhythm-control strategy (p<0.001). Multivariate logistic regression analysis revealed that age <75 years or the paroxysmal or persistent form of AF favored the choice of a rhythm-control strategy. A change in strategy was infrequent, even in patients with European Heart Rhythm Association (EHRA) Class > = II. Conclusions In the RealiseAF routine clinical practice survey, rate control was more commonly used than rhythm control, and a change in strategy was uncommon, even in symptomatic patients. In almost 12% of patients, no clear strategy was stated. Physician awareness regarding optimal management strategies for AF may be improved. PMID:26800084

  17. Floating-point function generation routines for 16-bit microcomputers

    NASA Technical Reports Server (NTRS)

    Mackin, M. A.; Soeder, J. F.

    1984-01-01

    Several computer subroutines have been developed that interpolate three types of nonanalytic functions: univariate, bivariate, and map. The routines use data in floating-point form. However, because they are written for use on a 16-bit Intel 8086 system with an 8087 mathematical coprocessor, they execute as fast as routines using data in scaled integer form. Although all of the routines are written in assembly language, they have been implemented in a modular fashion so as to facilitate their use with high-level languages.

  18. A binary method for simple and accurate two-dimensional cursor control from EEG with minimal subject training.

    PubMed

    Kayagil, Turan A; Bai, Ou; Henriquez, Craig S; Lin, Peter; Furlani, Stephen J; Vorbach, Sherry; Hallett, Mark

    2009-05-06

    Brain-computer interfaces (BCI) use electroencephalography (EEG) to interpret user intention and control an output device accordingly. We describe a novel BCI method to use a signal from five EEG channels (comprising one primary channel with four additional channels used to calculate its Laplacian derivation) to provide two-dimensional (2-D) control of a cursor on a computer screen, with simple threshold-based binary classification of band power readings taken over pre-defined time windows during subject hand movement. We tested the paradigm with four healthy subjects, none of whom had prior BCI experience. Each subject played a game wherein he or she attempted to move a cursor to a target within a grid while avoiding a trap. We also present supplementary results including one healthy subject using motor imagery, one primary lateral sclerosis (PLS) patient, and one healthy subject using a single EEG channel without Laplacian derivation. For the four healthy subjects using real hand movement, the system provided accurate cursor control with little or no required user training. The average accuracy of the cursor movement was 86.1% (SD 9.8%), which is significantly better than chance (p = 0.0015). The best subject achieved a control accuracy of 96%, with only one incorrect bit classification out of 47. The supplementary results showed that control can be achieved under the respective experimental conditions, but with reduced accuracy. The binary method provides naïve subjects with real-time control of a cursor in 2-D using dichotomous classification of synchronous EEG band power readings from a small number of channels during hand movement. The primary strengths of our method are simplicity of hardware and software, and high accuracy when used by untrained subjects.

  19. Individual values, learning routines and academic procrastination.

    PubMed

    Dietz, Franziska; Hofer, Manfred; Fries, Stefan

    2007-12-01

    Academic procrastination, the tendency to postpone learning activities, is regarded as a consequence of postmodern values that are prominent in post-industrialized societies. When students strive for leisure goals and have no structured routines for academic tasks, delaying strenuous learning activities becomes probable. The model tested in this study posits that postmodern value orientations are positively related to procrastination and to a lack of daily routines concerning the performance of academic activities. In contrast, modern values are negatively related to procrastination and positively to learning routines. Academic procrastination, in-turn, should be associated with the tendency to prefer leisure activities to schoolwork in case of conflicts between these two life domains. Seven hundred and four students from 6th and 8th grade with a mean age of 13.5 years participated in the study. The sample included students from all tracks of the German educational system. Students completed a questionnaire containing two value prototypes as well as scales on learning routines and procrastination. Decisions in motivational conflicts were measured using two vignettes. Results from structural equation modelling supported the proposed model for the whole sample as well as for each school track. A planned course of the day can prevent procrastination and foster decisions for academic tasks in case of conflicts. Students' learning takes place within a societal context and reflects the values held in the respective culture.

  20. Visual Routines Are Associated with Specific Graph Interpretations

    ERIC Educational Resources Information Center

    Michal, Audrey L.; Franconeri, Steven L.

    2017-01-01

    We argue that people compare values in graphs with a "visual routine"--attending to data values in an ordered pattern over time. Do these visual routines exist to manage capacity limitations in how many values can be encoded at once, or do they actually affect the relations that are extracted? We measured eye movements while people…

  1. Daily life activity routine discovery in hemiparetic rehabilitation patients using topic models.

    PubMed

    Seiter, J; Derungs, A; Schuster-Amft, C; Amft, O; Tröster, G

    2015-01-01

    Monitoring natural behavior and activity routines of hemiparetic rehabilitation patients across the day can provide valuable progress information for therapists and patients and contribute to an optimized rehabilitation process. In particular, continuous patient monitoring could add type, frequency and duration of daily life activity routines and hence complement standard clinical scores that are assessed for particular tasks only. Machine learning methods have been applied to infer activity routines from sensor data. However, supervised methods require activity annotations to build recognition models and thus require extensive patient supervision. Discovery methods, including topic models could provide patient routine information and deal with variability in activity and movement performance across patients. Topic models have been used to discover characteristic activity routine patterns of healthy individuals using activity primitives recognized from supervised sensor data. Yet, the applicability of topic models for hemiparetic rehabilitation patients and techniques to derive activity primitives without supervision needs to be addressed. We investigate, 1) whether a topic model-based activity routine discovery framework can infer activity routines of rehabilitation patients from wearable motion sensor data. 2) We compare the performance of our topic model-based activity routine discovery using rule-based and clustering-based activity vocabulary. We analyze the activity routine discovery in a dataset recorded with 11 hemiparetic rehabilitation patients during up to ten full recording days per individual in an ambulatory daycare rehabilitation center using wearable motion sensors attached to both wrists and the non-affected thigh. We introduce and compare rule-based and clustering-based activity vocabulary to process statistical and frequency acceleration features to activity words. Activity words were used for activity routine pattern discovery using topic models

  2. Learning fast accurate movements requires intact frontostriatal circuits

    PubMed Central

    Shabbott, Britne; Ravindran, Roshni; Schumacher, Joseph W.; Wasserman, Paula B.; Marder, Karen S.; Mazzoni, Pietro

    2013-01-01

    The basal ganglia are known to play a crucial role in movement execution, but their importance for motor skill learning remains unclear. Obstacles to our understanding include the lack of a universally accepted definition of motor skill learning (definition confound), and difficulties in distinguishing learning deficits from execution impairments (performance confound). We studied how healthy subjects and subjects with a basal ganglia disorder learn fast accurate reaching movements. We addressed the definition and performance confounds by: (1) focusing on an operationally defined core element of motor skill learning (speed-accuracy learning), and (2) using normal variation in initial performance to separate movement execution impairment from motor learning abnormalities. We measured motor skill learning as performance improvement in a reaching task with a speed-accuracy trade-off. We compared the performance of subjects with Huntington's disease (HD), a neurodegenerative basal ganglia disorder, to that of premanifest carriers of the HD mutation and of control subjects. The initial movements of HD subjects were less skilled (slower and/or less accurate) than those of control subjects. To factor out these differences in initial execution, we modeled the relationship between learning and baseline performance in control subjects. Subjects with HD exhibited a clear learning impairment that was not explained by differences in initial performance. These results support a role for the basal ganglia in both movement execution and motor skill learning. PMID:24312037

  3. Comparing routine neurorehabilitation program with trunk exercises based on Bobath concept in multiple sclerosis: pilot study.

    PubMed

    Keser, Ilke; Kirdi, Nuray; Meric, Aydin; Kurne, Asli Tuncer; Karabudak, Rana

    2013-01-01

    This study compared trunk exercises based on the Bobath concept with routine neurorehabilitation approaches in multiple sclerosis (MS). Bobath and routine neurorehabilitation exercises groups were evaluated. MS cases were divided into two groups. Both groups joined a 3 d/wk rehabilitation program for 8 wk. The experimental group performed trunk exercises based on the Bobath concept, and the control group performed routine neurorehabilitation exercises. Additionally, both groups performed balance and coordination exercises. All patients were evaluated with the Trunk Impairment Scale (TIS), Berg Balance Scale (BBS), International Cooperative Ataxia Rating Scale (ICARS), and Multiple Sclerosis Functional Composite (MSFC) before and after the physiotherapy program. In group analysis, TIS, BBS, ICARS, and MSFC scores and strength of abdominal muscles were significantly different after treatment in both groups (p < 0.05). When the groups were compared, no significant differences were found in any parameters (p > 0.05). Although trunk exercises based on the Bobath concept are rarely applied in MS rehabilitation, the results of this study show that they are as effective as routine neurorehabilitation exercises. Therefore, trunk exercises based on the Bobath concept can be beneficial in MS rehabilitation programs.

  4. Identification of Escherichia coli and Trueperella pyogenes isolated from the uterus of dairy cows using routine bacteriological testing and Fourier transform infrared spectroscopy.

    PubMed

    Jaureguiberry, María; Madoz, Laura Vanina; Giuliodori, Mauricio Javier; Wagener, Karen; Prunner, Isabella; Grunert, Tom; Ehling-Schulz, Monika; Drillich, Marc; de la Sota, Rodolfo Luzbel

    2016-11-28

    Uterine disorders are common postpartum diseases in dairy cows. In practice, uterine treatment is often based on systemic or locally applied antimicrobials with no previous identification of pathogens. Accurate on-farm diagnostics are not available, and routine testing is time-consuming and cost intensive. An accurate method that could simplify the identification of uterine pathogenic bacteria and improve pathogen-specific treatments could be an important advance to practitioners. The objective of the present study was to evaluate whether a database built with uterine bacteria from European dairy cows could be used to identify bacteria from Argentinean cows by Fourier transformed infrared (FTIR) spectroscopy. Uterine samples from 64 multiparous dairy cows with different types of vaginal discharge (VD) were collected between 5 and 60 days postpartum, analyzed by routine bacteriological testing methods and then re-evaluated by FTIR spectroscopy (n = 27). FTIR spectroscopy identified Escherichia coli in 12 out of 14 samples and Trueperella pyogenes in 8 out of 10 samples. The agreement between the two methods was good with a Kappa coefficient of 0.73. In addition, the likelihood for bacterial growth of common uterine pathogens such as E. coli and T. pyogenes tended to increase with VD score. The odds for a positive result to E. coli or T. pyogenes was 1.88 times higher in cows with fetid VD than in herdmates with clear normal VD. We conclude that the presence of E. coli and T. pyogenes in uterine samples from Argentinean dairy cows can be detected with FTIR with the use of a database built with uterine bacteria from European dairy cows. Future studies are needed to determine if FTIR can be used as an alternative to routine bacteriological testing methods.

  5. CARE CR-Cardiovascular and cardiorespiratory Adaptations to Routine Exercise-based Cardiac Rehabilitation: a study protocol for a community-based controlled study with criterion methods.

    PubMed

    Nichols, Simon; Nation, Fiona; Goodman, Toni; Clark, Andrew L; Carroll, Sean; Ingle, Lee

    2018-01-27

    Cardiac rehabilitation (CR) reduces all-cause and cardiovascular mortality in patients with coronary heart disease (CHD). Much of this improvement has been attributed to the beneficial effects of structured exercise training. However, UK-based studies have not confirmed this. Improvements in survival and cardiovascular health are associated with concurrent improvements in cardiorespiratory fitness (CRF). It is therefore concerning that estimated CRF improvements resulting from UK-based CR are approximately one-third of those reported in international literature. Modest improvements in CRF suggest that UK CR exercise training programmes may require optimisation if long-term survival is to be improved. However, contemporary UK studies lack control data or use estimates of CRF change. Cardiovascular and cardiorespiratory Adaptations to Routine Exercise-based CR is a longitudinal, observational, controlled study designed to assess the short-term and long-term effect of CR on CRF, as well cardiovascular and cardiometabolic health. Patients will be recruited following referral to their local CR programme and will either participate in a routine, low-to-moderate intensity, 8-week (16 sessions) exercise-based CR programme or freely abstain from supervised exercise. Initial assessment will be conducted prior to exercise training, or approximately 2 weeks after referral to CR if exercise training is declined. Reassessment will coincide with completion of exercise training or 10 weeks after initial assessment for control participants. Participants will receive a final follow-up 12 months after recruitment. The primary outcome will be peak oxygen consumption determined using maximal cardiopulmonary exercise testing. Secondary outcomes will include changes in subclinical atherosclerosis (carotid intima-media thickness and plaque characteristics), body composition (dual X-ray absorptiometry) and cardiometabolic biomarkers. Ethical approval for this non-randomised controlled

  6. Method and apparatus for accurately manipulating an object during microelectrophoresis

    DOEpatents

    Parvin, Bahram A.; Maestre, Marcos F.; Fish, Richard H.; Johnston, William E.

    1997-01-01

    An apparatus using electrophoresis provides accurate manipulation of an object on a microscope stage for further manipulations add reactions. The present invention also provides an inexpensive and easily accessible means to move an object without damage to the object. A plurality of electrodes are coupled to the stage in an array whereby the electrode array allows for distinct manipulations of the electric field for accurate manipulations of the object. There is an electrode array control coupled to the plurality of electrodes for manipulating the electric field. In an alternative embodiment, a chamber is provided on the stage to hold the object. The plurality of electrodes are positioned in the chamber, and the chamber is filled with fluid. The system can be automated using visual servoing, which manipulates the control parameters, i.e., x, y stage, applying the field, etc., after extracting the significant features directly from image data. Visual servoing includes an imaging device and computer system to determine the location of the object. A second stage having a plurality of tubes positioned on top of the second stage, can be accurately positioned by visual servoing so that one end of one of the plurality of tubes surrounds at least part of the object on the first stage.

  7. Method and apparatus for accurately manipulating an object during microelectrophoresis

    DOEpatents

    Parvin, B.A.; Maestre, M.F.; Fish, R.H.; Johnston, W.E.

    1997-09-23

    An apparatus using electrophoresis provides accurate manipulation of an object on a microscope stage for further manipulations and reactions. The present invention also provides an inexpensive and easily accessible means to move an object without damage to the object. A plurality of electrodes are coupled to the stage in an array whereby the electrode array allows for distinct manipulations of the electric field for accurate manipulations of the object. There is an electrode array control coupled to the plurality of electrodes for manipulating the electric field. In an alternative embodiment, a chamber is provided on the stage to hold the object. The plurality of electrodes are positioned in the chamber, and the chamber is filled with fluid. The system can be automated using visual servoing, which manipulates the control parameters, i.e., x, y stage, applying the field, etc., after extracting the significant features directly from image data. Visual servoing includes an imaging device and computer system to determine the location of the object. A second stage having a plurality of tubes positioned on top of the second stage, can be accurately positioned by visual servoing so that one end of one of the plurality of tubes surrounds at least part of the object on the first stage. 11 figs.

  8. Do detour tasks provide accurate assays of inhibitory control?

    PubMed Central

    Whiteside, Mark A.; Laker, Philippa R.; Beardsworth, Christine E.

    2018-01-01

    Transparent Cylinder and Barrier tasks are used to purportedly assess inhibitory control in a variety of animals. However, we suspect that performances on these detour tasks are influenced by non-cognitive traits, which may result in inaccurate assays of inhibitory control. We therefore reared pheasants under standardized conditions and presented each bird with two sets of similar tasks commonly used to measure inhibitory control. We recorded the number of times subjects incorrectly attempted to access a reward through transparent barriers, and their latencies to solve each task. Such measures are commonly used to infer the differential expression of inhibitory control. We found little evidence that their performances were consistent across the two different Putative Inhibitory Control Tasks (PICTs). Improvements in performance across trials showed that pheasants learned the affordances of each specific task. Critically, prior experience of transparent tasks, either Barrier or Cylinder, also improved subsequent inhibitory control performance on a novel task, suggesting that they also learned the general properties of transparent obstacles. Individual measures of persistence, assayed in a third task, were positively related to their frequency of incorrect attempts to solve the transparent inhibitory control tasks. Neophobia, Sex and Body Condition had no influence on individual performance. Contrary to previous studies of primates, pheasants with poor performance on PICTs had a wider dietary breadth assayed using a free-choice task. Our results demonstrate that in systems or taxa where prior experience and differences in development cannot be accounted for, individual differences in performance on commonly used detour-dependent PICTS may reveal more about an individual's prior experience of transparent objects, or their motivation to acquire food, than providing a reliable measure of their inhibitory control. PMID:29593115

  9. A problem-solving routine for improving hospital operations.

    PubMed

    Ghosh, Manimay; Sobek Ii, Durward K

    2015-01-01

    The purpose of this paper is to examine empirically why a systematic problem-solving routine can play an important role in the process improvement efforts of hospitals. Data on 18 process improvement cases were collected through semi-structured interviews, reports and other documents, and artifacts associated with the cases. The data were analyzed using a grounded theory approach. Adherence to all the steps of the problem-solving routine correlated to greater degrees of improvement across the sample. Analysis resulted in two models. The first partially explains why hospital workers tended to enact short-term solutions when faced with process-related problems; and tended not seek longer-term solutions that prevent problems from recurring. The second model highlights a set of self-reinforcing behaviors that are more likely to address problem recurrence and result in sustained process improvement. The study was conducted in one hospital setting. Hospital managers can improve patient care and increase operational efficiency by adopting and diffusing problem-solving routines that embody three key characteristics. This paper offers new insights on why caregivers adopt short-term approaches to problem solving. Three characteristics of an effective problem-solving routine in a healthcare setting are proposed.

  10. Comparing childhood meal frequency to current meal frequency, routines, and expectations among parents.

    PubMed

    Friend, Sarah; Fulkerson, Jayne A; Neumark-Sztainer, Dianne; Garwick, Ann; Flattum, Colleen Freeh; Draxten, Michelle

    2015-02-01

    Little is known about the continuation of family meals from childhood to parenthood. This study aims to examine associations between parents' report of eating family meals while growing up and their current family meal frequency, routines, and expectations. Baseline data were used from the Healthy Home Offerings via the Mealtime Environment (HOME) Plus study, a randomized controlled trial with a program to promote healthful behaviors and family meals at home. Participants (160 parent/child dyads) completed data collection in 2011-2012 in the Minneapolis/St. Paul, MN metropolitan area. Parents were predominately female (95%) and white (77%) with a mean age of 41.3 years. General linear modeling examined relationships between parents' report of how often they ate family meals while growing up and their current family meal frequency, routines, and expectations as parents, controlling for parent age, education level, and race. Parental report of eating frequent family meals while growing up was positively and significantly associated with age, education, and self-identification as white (all p < .05). Compared to those who ate family meals less than three times/week or four to five times/week, parents who ate six to seven family meals/week while growing up reported significantly more frequent family meals with their current family (4.0, 4.2 vs. 5.3 family meals/week, p = .001). Eating frequent family meals while growing up was also significantly and positively associated with having current regular meal routines and meal expectations about family members eating together (both p < .05). Promoting family meals with children may have long-term benefits over generations. PsycINFO Database Record (c) 2015 APA, all rights reserved.

  11. Comparing Childhood Meal Frequency to Current Meal Frequency, Routines and Expectations Among Parents

    PubMed Central

    Friend, Sarah; Fulkerson, Jayne A.; Neumark-Sztainer, Dianne; Garwick, Ann; Flattum, Colleen Freech; Draxten, Michelle

    2015-01-01

    Little is known about the continuation of family meals from childhood to parenthood. This study aims to examine associations between parents’ report of eating family meals while growing up and their current family meal frequency, routines, and expectations. Baseline data were used from the Healthy Home Offerings via the Mealtime Environment (HOME) Plus study, a randomized controlled trial with a program to promote healthful behaviors and family meals at home. Participants (160 parent/child dyads) completed data collection in 2011–2012 in the Minneapolis/St. Paul, MN metropolitan area. Parents were predominately female (95%) and white (77%) with a mean age of 41.3 years. General linear modeling examined relationships between parents’ report of how often they ate family meals while growing up and their current family meal frequency, routines and expectations as parents, controlling for parent age, education level and race. Parental report of eating frequent family meals while growing up was positively and significantly associated with age, education and self-identification as white (all p<0.05). Compared to those who ate family meals less than three times/week or four to five times/week, parents who ate six to seven family meals/week while growing up reported significantly more frequent family meals with their current family (4.0, 4.2 vs 5.3 family meals/week, p=.001). Eating frequent family meals while growing up was also significantly and positively associated with having current regular meal routines and meal expectations about family members eating together (both p<.05). Promoting family meals with children may have long-term benefits over generations. PMID:25485670

  12. The Militarism of the Local Television: The Routine Framing of the Persian Gulf War.

    ERIC Educational Resources Information Center

    Reese, Stephen D.; Buckalew, Bob

    1995-01-01

    Examines the way one local television station covered the Persian Gulf War. Links coverage to the media routines of television newswork, showing how they act as coherent frames supportive of Gulf policy. Finds that the conflict frame placed anti-war protest in opposition to patriotism, and the control frame dealt with protest as a threat to social…

  13. Analysis of positive control STR experiments reveals that results obtained for FGA, D3S1358, and D13S317 condition the success rate of the analysis of routine reference samples.

    PubMed

    Murigneux, Valentine; Dufour, Anne-Béatrice; Lobry, Jean R; Pène, Laurent

    2014-07-01

    About 120,000 reference samples are analyzed each year in the Forensic Laboratory of Lyon. A total of 1640 positive control experiments used to validate and optimize the analytical method in the routine process were submitted to a multivariate exploratory data analysis approach with the aim of better understanding the underlying sources of variability. The peak heights of the 16 genetic markers targeted by the AmpFℓSTR(®) Identifiler(®) STR kit were used as variables of interest. Six different 3130xl genetic analyzers located in the same controlled environment were involved. Two major sources of variability were found: (i) the DNA load of the sample modulates all peak heights in a similar way so that the 16 markers are highly correlated, (ii) the genetic analyzer used with a locus-specific response for peak height and a better sensitivity for the most recently acquired. Three markers (FGA, D3S1358, and D13S317) were found to be of special interest to predict the success rate observed in the routine process. © 2014 American Academy of Forensic Sciences.

  14. Accurate and agile digital control of optical phase, amplitude and frequency for coherent atomic manipulation of atomic systems.

    PubMed

    Thom, Joseph; Wilpers, Guido; Riis, Erling; Sinclair, Alastair G

    2013-08-12

    We demonstrate a system for fast and agile digital control of laser phase, amplitude and frequency for applications in coherent atomic systems. The full versatility of a direct digital synthesis radiofrequency source is faithfully transferred to laser radiation via acousto-optic modulation. Optical beatnotes are used to measure phase steps up to 2π, which are accurately implemented with a resolution of ≤ 10 mrad. By linearizing the optical modulation process, amplitude-shaped pulses of durations ranging from 500 ns to 500 ms, in excellent agreement with the programmed functional form, are demonstrated. Pulse durations are limited only by the 30 ns rise time of the modulation process, and a measured extinction ratio of > 5 × 10(11) is achieved. The system presented here was developed specifically for controlling the quantum state of trapped ions with sequences of multiple laser pulses, including composite and bichromatic pulses. The demonstrated techniques are widely applicable to other atomic systems ranging across quantum information processing, frequency metrology, atom interferometry, and single-photon generation.

  15. A Prospective, Randomized Trial of Routine Duplex Ultrasound Surveillance on Arteriovenous Fistula Maturation.

    PubMed

    Han, Ahram; Min, Seung-Kee; Kim, Mi-Sook; Joo, Kwon Wook; Kim, Jungsun; Ha, Jongwon; Lee, Joongyub; Min, Sang-Il

    2016-10-07

    Use of arteriovenous fistulas, the most preferred type of access for hemodialysis, is limited by their high maturation failure rate. The aim of this study was to assess whether aggressive surveillance with routine duplex ultrasound and intervention can decrease the maturation failure rate of arteriovenous fistulas. We conducted a single-center, parallel-group, randomized, controlled trial of patients undergoing autogenous arteriovenous fistula. Patients were randomly assigned (1:1) to either the routine duplex or selective duplex group. In the routine duplex group, duplex ultrasound and physical examination were performed 2, 4, and 8 weeks postoperatively. In the selective duplex group, duplex examination was performed only when physical examination detected an abnormality. The primary end point was the maturation failure rate 8 weeks after fistula creation. Maturation failure was defined as the inability to achieve clinical maturation ( i.e. , a successful first use) and failure to achieve sonographic maturation (fistula flow >500 ml/min and diameter >6 mm) within 8 weeks. Between June 14, 2012, and June 25, 2014, 150 patients were enrolled (75 patients in each group), and 118 of those were included in the final analysis. The maturation failure rate was lower in the routine duplex group (8 of 59; 13.6%) than in the selective duplex group (15 of 59; 25.4%), but the difference was not statistically significant (odds ratio, 0.46; 95% confidence interval, 0.18 to 1.19; P =0.10). Factors associated with maturation failure were women (odds ratio, 3.84; 95% confidence interval, 1.05 to 14.06; P =0.04), coronary artery disease (odds ratio, 6.36; 95% confidence interval, 1.62 to 24.95; P <0.01), diabetes (odds ratio, 6.10; 95% confidence interval, 1.76 to 21.19; P <0.01), and the preoperative cephalic vein diameter (odds ratio, 0.30; 95% confidence interval, 0.13 to 0.71; P <0.01). Postoperative routine duplex surveillance failed to prove superiority compared with

  16. 42 CFR 414.220 - Inexpensive or routinely purchased items.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 3 2010-10-01 2010-10-01 false Inexpensive or routinely purchased items. 414.220... Durable Medical Equipment and Prosthetic and Orthotic Devices § 414.220 Inexpensive or routinely purchased items. (a) Definitions. (1) Inexpensive equipment means equipment the average purchase price of which...

  17. High-accurate optical fiber liquid level sensor

    NASA Astrophysics Data System (ADS)

    Sun, Dexing; Chen, Shouliu; Pan, Chao; Jin, Henghuan

    1991-08-01

    A highly accurate optical fiber liquid level sensor is presented. The single-chip microcomputer is used to process and control the signal. This kind of sensor is characterized by self-security and is explosion-proof, so it can be applied in any liquid level detecting areas, especially in the oil and chemical industries. The theories and experiments about how to improve the measurement accuracy are described. The relative error for detecting the measurement range 10 m is up to 0.01%.

  18. User's Manual: Routines for Radiative Heat Transfer and Thermometry

    NASA Technical Reports Server (NTRS)

    Risch, Timothy K.

    2016-01-01

    Determining the intensity and spectral distribution of radiation emanating from a heated surface has applications in many areas of science and engineering. Areas of research in which the quantification of spectral radiation is used routinely include thermal radiation heat transfer, infrared signature analysis, and radiation thermometry. In the analysis of radiation, it is helpful to be able to predict the radiative intensity and the spectral distribution of the emitted energy. Presented in this report is a set of routines written in Microsoft Visual Basic for Applications (VBA) (Microsoft Corporation, Redmond, Washington) and incorporating functions specific to Microsoft Excel (Microsoft Corporation, Redmond, Washington) that are useful for predicting the radiative behavior of heated surfaces. These routines include functions for calculating quantities of primary importance to engineers and scientists. In addition, the routines also provide the capability to use such information to determine surface temperatures from spectral intensities and for calculating the sensitivity of the surface temperature measurements to unknowns in the input parameters.

  19. Targeted case finding for chronic obstructive pulmonary disease versus routine practice in primary care (TargetCOPD): a cluster-randomised controlled trial.

    PubMed

    Jordan, Rachel E; Adab, Peymané; Sitch, Alice; Enocson, Alexandra; Blissett, Deirdre; Jowett, Sue; Marsh, Jen; Riley, Richard D; Miller, Martin R; Cooper, Brendan G; Turner, Alice M; Jolly, Kate; Ayres, Jon G; Haroon, Shamil; Stockley, Robert; Greenfield, Sheila; Siebert, Stanley; Daley, Amanda J; Cheng, K K; Fitzmaurice, David

    2016-09-01

    Many individuals with chronic obstructive pulmonary disease (COPD) remain undiagnosed worldwide. Health-care organisations are implementing case-finding programmes without good evidence of which are the most effective and cost-effective approaches. We assessed the effectiveness and cost-effectiveness of two alternative approaches to targeted case finding for COPD compared with routine practice. In this cluster-randomised controlled trial, participating general practices in the West Midlands, UK, were randomly assigned (1:1), via a computer-generated block randomisation sequence, to either a targeted case-finding group or a routine care group. Eligible patients were ever-smokers aged 40-79 years without a previously recorded diagnosis of COPD. Patients in the targeted case-finding group were further randomly assigned (1:1) via their household to receive either a screening questionnaire at the general practitioner (GP) consultation (opportunistic) or a screening questionnaire at the GP consultation plus a mailed questionnaire (active). Respondents reporting relevant respiratory symptoms were invited for post-bronchodilator spirometry. Patients, clinicians, and investigators were not masked to allocation, but group allocation was concealed from the researchers who performed the spirometry assessments. Primary outcomes were the percentage of the eligible population diagnosed with COPD within 1 year (defined as post-bronchodilator forced expiratory volume in 1 s [FEV1] to forced vital capacity [FVC] ratio <0·7 in patients with symptoms or a new diagnosis on their GP record) and cost per new COPD diagnosis. Multiple logistic and Poisson regression were used to estimate effect sizes. Costs were obtained from the trial. This trial is registered with ISRCTN, number ISRCTN14930255. From Aug 10, 2012, to June 22, 2014, 74 818 eligible patients from 54 diverse general practices were randomly assigned and completed the trial. At 1 year, 1278 (4%) cases of COPD were newly

  20. How to Analyze Routines in Teachers' Thinking Processes during Lesson Planning.

    ERIC Educational Resources Information Center

    Bromme, Rainer

    A justification for the study of teachers' routines, as they affect the preparation of lesson plans, prefaces this paper on teachers' thought processes during lesson planning. In focusing on the importance of research into teachers' routines, it is pointed out that lesson preparation and classroom routines permit teachers to direct attention to…

  1. Are patients referred to rehabilitation diagnosed accurately?

    PubMed

    Tederko, Piotr; Krasuski, Marek; Nyka, Izabella; Mycielski, Jerzy; Tarnacka, Beata

    2017-07-17

    An accurate diagnosis of the leading health condition and comorbidities is a prerequisite for safe and effective rehabilitation. The problem of diagnostic errors in physical and rehabilitation medicine (PRM) has not been addressed sufficiently. The responsibility of a referring physician is to determine indications and contraindications for rehabilitation. To assess the rate of and risk factors for inaccurate referral diagnoses (RD) in patients referred to a rehabilitation facility. We hypothesized that inaccurate RD would be more common in patients 1) referred by non-PRM physicians; 2) waiting longer for the admission; 3) older patients. Retrospective observational study. 1000 randomly selected patients admitted between 2012 and 2016 to a day- rehabilitation center (DRC). University DRC specialized in musculoskeletal diseases. On admission all cases underwent clinical verification of RD. Inappropriateness regarding primary diagnoses and comorbidities were noted. Influence of several factors affecting probability of inaccurate RD was analyzed with multiple binary regression model applied to 6 categories of diseases. The rate of inaccurate RD was 25.2%. Higher frequency of inaccurate RD was noted among patients referred by non-PRM specialists (30.3% vs 17.3% in cases referred by PRM specialists). Application of logit regression showed highly significant influence of the specialty of a referring physician on the odds of inaccurate RD (joint Wald test ch2(6)=38.98, p- value=0.000), controlling for the influence of other variables. This may reflect a suboptimal knowledge of the rehabilitation process and a tendency to neglect of comorbidities by non-PRM specialists. The rate of inaccurate RD did not correlate with time between referral and admission (joint Wald test of all odds ratios equal to 1, chi2(6)=5.62, p-value=0.467), however, mean and median waiting times were relatively short (35.7 and 25 days respectively).A high risk of overlooked multimorbidity was

  2. Antinuclear antibody determination in a routine laboratory.

    PubMed Central

    Feltkamp, T E

    1996-01-01

    Pitfalls in the method for demonstrating antinuclear antibodies (ANA) by the indirect immunofluorescence technique are described and the use of international standard preparations outlined. Determination of the optimal border dilution dividing positive from negative results is discussed. Each laboratory is a unique setting; it must define its own method, which should rarely be changed. One should not rely on copying methods from other laboratories or commercial firms, but the reproducibility of the nuclear substrate, the conjugate, and other variables should be controlled daily by the use of a control serum which has been related to the WHO standard preparation for ANA of the homogeneous type. Since many sera contain mixtures of different ANA, the results of routine tests are best expressed in titres or expressions of the intensity of fluorescence. The ANA test using the immunofluorescence technique should be used as a screening method for other tests allowing a more defined interpretation of the ANA. Each laboratory should individually determine the border between positive and negative results. Therefore about 200 sera from local healthy controls equally distributed over sex and age, and 100 sera from local patients with definite SLE should be tested. Since the local clinicians should become acquainted with this border it should rarely be changed. Finally each laboratory should participate regularly in national and international quality control rounds, where sera known to be difficult to interpret are tested. The judgment of the organisers of these rounds should stimulate improvements in the participating laboratories. PMID:8984936

  3. [Quality assurance using routine data. Is outcome quality now measurable?].

    PubMed

    Kostuj, T; Smektala, R

    2010-12-01

    Health service quality in Germany can be shown by the data from the external quality assurance program (BQS) but as these records are limited to the period of in-hospital stay no information about outcome after discharge from hospital can be obtained. Secondary routine administrative data contain information about long-term outcome, such as mortality, subsequent revision and the need for care following surgical treatment due to a hip fracture.Experiences in the use of secondary data dealing with treatment of hip fractures from the BQS are available in our department. In addition we analyzed routine administrative data from the health insurance companies Knappschaft Bahn-See and AOK in a cooperative study with the WidO (scientific institute of the AOK). These routine data clearly show a bias because of poor quality in coding as well as broad interpretation possibilities of some of the ICD-10 codes used.Consequently quality assurance using routine data is less valid than register-based conclusions. Nevertheless medical expertise is necessary to avoid misinterpretation of routine administrative data.

  4. Quantitative measurement of HER2 expression in breast cancers: comparison with 'real-world' routine HER2 testing in a multicenter Collaborative Biomarker Study and correlation with overall survival.

    PubMed

    Yardley, Denise A; Kaufman, Peter A; Huang, Weidong; Krekow, Lea; Savin, Michael; Lawler, William E; Zrada, Stephen; Starr, Alexander; Einhorn, Harvey; Schwartzberg, Lee S; Adams, John W; Lie, Yolanda; Paquet, Agnes C; Sperinde, Jeff; Haddad, Mojgan; Anderson, Steve; Brigino, Marlon; Pesano, Rick; Bates, Michael P; Weidler, Jodi; Bosserman, Linda

    2015-03-18

    Accurate assessment of HER2 status is critical in determining appropriate therapy for breast cancer patients but the best HER2 testing methodology has yet to be defined. In this study, we compared quantitative HER2 expression by the HERmark™ Breast Cancer Assay (HERmark) with routine HER2 testing by immunohistochemistry (IHC) and fluorescence in situ hybridization (FISH), and correlated HER2 results with overall survival (OS) of breast cancer patients in a multicenter Collaborative Biomarker Study (CBS). Two hundred and thirty-two formalin-fixed, paraffin-embedded breast cancer tissues and local laboratory HER2 testing results were provided by 11 CBS sites. HERmark assay and central laboratory HER2 IHC retesting were retrospectively performed in a blinded fashion. HER2 results by all testing methods were obtained in 192 cases. HERmark yielded a continuum of total HER2 expression (H2T) ranging from 0.3 to 403 RF/mm2 (approximately 3 logs). The distribution of H2T levels correlated significantly (P<0.0001) with all routine HER2 testing results. The concordance of positive and negative values (equivocal cases excluded) between HERmark and routine HER2 testing was 84% for local IHC, 96% for central IHC, 85% for local FISH, and 84% for local HER2 status. OS analysis revealed a significant correlation of shorter OS with HER2 positivity by local IHC (HR=2.6, P=0.016), central IHC (HR=3.2, P=0.015), and HERmark (HR=5.1, P<0.0001) in this cohort of patients most of whom received no HER2-targeted therapy. The OS curve of discordant low (HER2 positive but H2T low, 10% of all cases) was aligned with concordant negative (HER2 negative and H2T low, HR=1.9, P=0.444), but showed a significantly longer OS than concordant positive (HER2 positive and H2T high, HR=0.31, P=0.024). Conversely, the OS curve of discordant high (HER2 negative but H2T high, 9% of all cases) was aligned with concordant positive (HR=0.41, P=0.105), but showed a significantly shorter OS than concordant

  5. Cyclophosphamide administration routine in autoimmune rheumatic diseases: a review.

    PubMed

    Teles, Kaian Amorim; Medeiros-Souza, Patricia; Lima, Francisco Aires Correa; Araújo, Bruno Gedeon de; Lima, Rodrigo Aires Correa

    Cyclophosphamide is an alkylating agent widely used for the treatment of malignant neoplasia and which can be used in the treatment of multiple rheumatic diseases. Medication administration errors may lead to its reduced efficacy or increased drug toxicity. Many errors occur in the administration of injectable drugs. The present study aimed at structuring a routine for cyclophosphamide use, as well as creating a document with pharmacotherapeutic guidelines for the patient. The routine is schematized in three phases: pre-chemotherapy, administration of cyclophosphamide, and post-chemotherapy, taking into account the drugs to be administered before and after cyclophosphamide in order to prevent adverse effects, including nausea and hemorrhagic cystitis. Adverse reactions can alter laboratory tests; thus, this routine included clinical management for changes in white blood cells, platelets, neutrophils, and sodium, including cyclophosphamide dose adjustment in the case of kidney disease. Cyclophosphamide is responsible for other rare - but serious - side effects, for instance, hepatotoxicity, severe hyponatremia and heart failure. Other adverse reactions include hair loss, amenorrhea and menopause. In this routine, we also entered guidelines to post-chemotherapy patients. The compatibility of injectable drugs with the vehicle used has been described, as well as stability and infusion times. The routine aimed at the rational use of cyclophosphamide, with prevention of adverse events and relapse episodes, factors that may burden the health care system. Copyright © 2016 Elsevier Editora Ltda. All rights reserved.

  6. Impact of measles supplementary immunization activities on reaching children missed by routine programs.

    PubMed

    Portnoy, Allison; Jit, Mark; Helleringer, Stéphane; Verguet, Stéphane

    2018-01-02

    Measles supplementary immunization activities (SIAs) are vaccination campaigns that supplement routine vaccination programs with a recommended second dose opportunity to children of different ages regardless of their previous history of measles vaccination. They are conducted every 2-4 years and over a few weeks in many low- and middle-income countries. While SIAs have high vaccination coverage, it is unclear whether they reach the children who miss their routine measles vaccine dose. Determining who is reached by SIAs is vital to understanding their effectiveness, as well as measure progress towards measles control. We examined SIAs in low- and middle-income countries from 2000 to 2014 using data from the Demographic and Health Surveys. Conditional on a child's routine measles vaccination status, we examined whether children participated in the most recent measles SIA. The average proportion of zero-dose children (no previous routine measles vaccination defined as no vaccination date before the SIA) reached by SIAs across 14 countries was 66%, ranging from 28% in São Tomé and Príncipe to 91% in Nigeria. However, when also including all children with routine measles vaccination data, this proportion decreased to 12% and to 58% when imputing data for children with vaccination reported by the mother and vaccination marks on the vaccination card across countries. Overall, the proportions of zero-dose children reached by SIAs declined with increasing household wealth. Some countries appeared to reach a higher proportion of zero-dose children using SIAs than others, with proportions reached varying according to the definition of measles vaccination (e.g., vaccination dates on the vaccination card, vaccination marks on the vaccination card, and/or self-reported data). This suggests that some countries could improve their targeting of SIAs to children who miss other measles vaccine opportunities. Across all countries, SIAs played an important role in reaching

  7. Intelligent navigation and accurate positioning of an assist robot in indoor environments

    NASA Astrophysics Data System (ADS)

    Hua, Bin; Rama, Endri; Capi, Genci; Jindai, Mitsuru; Tsuri, Yosuke

    2017-12-01

    Intact robot's navigation and accurate positioning in indoor environments are still challenging tasks. Especially in robot applications, assisting disabled and/or elderly people in museums/art gallery environments. In this paper, we present a human-like navigation method, where the neural networks control the wheelchair robot to reach the goal location safely, by imitating the supervisor's motions, and positioning in the intended location. In a museum similar environment, the mobile robot starts navigation from various positions, and uses a low-cost camera to track the target picture, and a laser range finder to make a safe navigation. Results show that the neural controller with the Conjugate Gradient Backpropagation training algorithm gives a robust response to guide the mobile robot accurately to the goal position.

  8. Implementing Routine HIV Testing: The Role of State Law

    PubMed Central

    Wolf, Leslie E.; Donoghoe, Alexis; Lane, Tim

    2007-01-01

    In September 2006, the Centers for Disease Control and Prevention (CDC) recommended routine HIV testing for all Americans aged 13–64, which would eliminate requirements for written consent and pretest counseling as previously required. However, this approach may conflict with state requirements concerning pretest counseling and informed consent for HIV testing. Our survey of state HIV testing laws demonstrates that the majority of states have HIV testing requirements that are inconsistent with the CDC's recommendations. Moreover, states that have recently amended their laws have not eased the requirements for pretest counseling and informed consent. The reasons for the persistence of these legal requirements must be understood to effect policy changes to increase HIV testing. PMID:17925853

  9. Prescriptive Package. Improving Patrol Productivity. Volume I. Routine Patrol.

    ERIC Educational Resources Information Center

    Gay, William G.; Schack, Stephen

    Designed to assist police departments in improving the productivity of their patrol operations, this volume on routine patrol and a companion volume on specialized patrol operations are intended for use by various sizes of departments. The volume on routine patrol focuses on the major issues of patrol productivity and recommends a number of…

  10. An Element of Practical Knowledge in Education: Professional Routines

    ERIC Educational Resources Information Center

    Lacourse, France

    2011-01-01

    The question of practical knowledge and its teaching has arisen more perceptibly since the appearance of the aim to professionalize teachers. How can imperceptible knowledge such as professional routines be taught? To establish a social fabric and effective class management, it is essential to call on creative and adaptive professional routines.…

  11. How the Discovery Channel Television Show Mythbusters Accurately Depicts Science and Engineering Culture

    NASA Astrophysics Data System (ADS)

    Zavrel, Erik A.

    2011-04-01

    High school science teachers, of course, want to motivate their students to consider studying science and engineering (S&E) in college. However, many high school students are not familiar with what science and engineering actually entail. They may know science as little more than "systematic discovery" and engineering as nothing but "math-intensive design." Without appreciation for the rich culture of science and engineering, students will be unlikely to choose such a field of study. The Discovery Channel television show Mythbusters helps remedy the lack of understanding many people, especially young people, have about S&E. Mythbusters presents a highly accurate vignette of the culture of science and engineering. Episodes of the show were analyzed for instances in which the culture of science and engineering was accurately depicted. Many resources, including several publications of the National Research Council, informed the media analysis. To encourage more high school students to pursue S&E in college, they need to be exposed to the culture of S&E. Mythbusters provides a window into the often unseen realm of science and engineering, allowing its viewers, who are disproportionately represented among the young adult age bracket, to see what it means to conduct science and engineering on a routine basis. High school science instructors should look to Mythbusters to provide insight into the culture of S&E that textbooks often have difficulty conveying to students.

  12. Impact of Psychological Screening on Routine Outpatient Care of Hematopoietic Cell Transplantation Survivors

    PubMed Central

    Hoodin, Flora; Zhao, Lili; Carey, Jillian; Levine, John E.; Kitko, Carrie

    2017-01-01

    Hematopoietic cell transplantation (HCT) recipients are at high risk for psychological distress with reported prevalence rates as high as 40%. Although published guidelines advocate periodic routine screening, it is unclear how screening affects management of psychological symptoms at routine post-HCT outpatient clinic visits. We hypothesized that providers will be more likely to act on patients’ psychological symptoms if a screening survey is completed and reviewed prior to a clinic visit. We used a brief, diagnostically focused Patient Health Questionnaire (PHQ), to assess for depressive disorders, anxiety, substance abuse, and problems in occupational or interpersonal functioning (functional disruption). Adult HCT survivors were randomized to complete the PHQ prior to meeting with their medical provider (n = 50; experimental group) or afterwards (n = 51; control group). Providers used the experimental group PHQ results at their discretion during the visits. Both providers and patients rated their satisfaction with management of psychological concerns after the visit. The prevalence of clinically significant depression (21%), anxiety (14%), or suicidal ideation (8%) did not differ between the two groups. Patients in the experimental group were significantly more likely to have discussion of psychological symptoms than the control group (68% versus 49%, P = 0.05). Medical providers were significantly more satisfied with the management of psychological issues for the experimental group (P < 0.001). Patients with depression or anxiety were significantly more likely to prefer the PHQ be used at future visits (P = 0.02 and P = 0.001 respectively). These findings suggest an informative yet brief self-report psychological screen can be easily integrated into routine care of HCT survivors, stimulates discussion of psychological symptoms, and improves provider satisfaction with psychological symptom management. Future research will evaluate whether serial prospective

  13. Impact of psychological screening on routine outpatient care of hematopoietic cell transplantation survivors.

    PubMed

    Hoodin, Flora; Zhao, Lili; Carey, Jillian; Levine, John E; Kitko, Carrie

    2013-10-01

    Hematopoietic cell transplantation recipients are at high risk for psychological distress, with reported prevalence rates as high as 40%. Although published guidelines advocate periodic routine screening, it is unclear how screening affects management of psychological symptoms at routine post-HCT outpatient clinic visits. We hypothesized that providers will be more likely to act on patients' psychological symptoms if a screening survey is completed and reviewed before a clinic visit. We used a brief, diagnostically focused Patient Health Questionnaire (PHQ), to assess for depressive disorders, anxiety, substance abuse, and problems in occupational or interpersonal functioning (functional disruption). Adult HCT survivors were randomized to complete the PHQ before meeting with their medical provider (n = 50; experimental group) or afterwards (n = 51; control group). Providers used the experimental group PHQ results at their discretion during the visits. Both providers and patients rated their satisfaction with management of psychological concerns after the visit. The prevalence of clinically significant depression (21%), anxiety (14%), or suicidal ideation (8%) did not differ between the 2 groups. Patients in the experimental group were significantly more likely to have discussion of psychological symptoms than the control group (68% versus 49%, P = .05). Medical providers were significantly more satisfied with the management of psychological issues for the experimental group (P < .001). Patients with depression or anxiety were significantly more likely to prefer the PHQ be used at future visits (P = .02 and P = .001, respectively). These findings suggest an informative yet brief self-report psychological screen can be easily integrated into routine care of hematopoietic cell transplantation survivors, stimulates discussion of psychological symptoms, and improves provider satisfaction with psychological symptom management. Future research will evaluate whether serial

  14. 32 CFR 701.121 - Processing “routine use” disclosures.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... DEPARTMENT OF THE NAVY DOCUMENTS AFFECTING THE PUBLIC DON Privacy Program § 701.121 Processing “routine use... be in writing and state that it is being made under a “routine use” established by a specific PA... and maintain a disclosure accounting of the information released. (See § 701.111.) (b) Failure to cite...

  15. Predictors of routine episiotomy in primigravida women in Oman.

    PubMed

    Al-Ghammari, Khadija; Al-Riyami, Zainab; Al-Moqbali, Moza; Al-Marjabi, Fatma; Al-Mahrouqi, Basma; Al-Khatri, Amal; Al-Khasawneh, Esra M

    2016-02-01

    Episiotomy is still the most common surgical procedure performed on women, despite the evidence against its routine use. This cross-sectional study was conducted to determine the practice and predictors of routine episiotomy on primigravidae in Oman. Demographic data, reasons for and rate of performing routine episiotomies, and perceptions of 269 obstetricians, midwives and nurses from 11 hospitals in Oman regarding the procedure were recorded and analyzed. The rate of episiotomies was 66%. In terms of performing routine episiotomies (p<0.05): non-Omanis were 4.49 times more likely than Omanis; bachelor's degree-holders were 2.26 more likely than diploma-holders; and regional hospitals were 2.36 times more likely than tertiary hospitals. The majority perceived episiotomies "reduce spontaneous perineal tearing risk", "reduce shoulder dystocia complications", and allow for "easier suturing". The rate of episiotomies was higher than other similar contexts. An urgent intervention is necessary to curb this excessive practice, and create a culture of evidence-based practice to deal with misleading perceptions. Copyright © 2015 The Authors. Published by Elsevier Inc. All rights reserved.

  16. Attempts to control clothes-borne infection in a burn unit, 2. Clothing routines in clinical use and the epidemiology of cross-colonization.

    PubMed Central

    Ransjö, U.

    1979-01-01

    Previous investigations have shown that cross-contamination in a burn unit is mainly clothes-borne. New barrier garments have been designed and tried experimentally. The aim of the present study was to investigate the effects of different clothing routines on cross-contamination. In a long-term study, the rates and routes of colonizations with Staphylococcus aureus, Streptococcus groups A, B, C, F, and G and Pseudomonas aeruginosa were examined. The exogenous colonization rates were, with S. aureus 77%, with Streptococcus species 52% and with Ps. aeruginosa 32%. The colonization rate with Ps. aeruginosa was higher in patients with larger burns. Patients dispersed Streptococcus and Ps. aeruginosa as well as S. aureus into the air of their rooms in considerable amounts, but dispersers were not more important as sources of cross-colonization than non-dispersers. In comparison of clothing routines, there was no difference in overall colonization rates. The newly designed barrier garment that was made from apparently particle-tight material did not reduce the transfer of bacteria from patient to patient. A less rigid routine than that previously used did not increase the risk of cross-contamination. A thorough change of barrier dress after close contact nursing delayed the first exogenous S. aureus colonization from day 6 to day 14 after admission. This routine might be recommended for clinical use. Otherwise, methods must be developed for adequate selection of materials intended for barrier garments. Images Plate 1 PMID:109498

  17. PROCEDURES FOR ACCURATE PRODUCTION OF COLOR IMAGES FROM SATELLITE OR AIRCRAFT MULTISPECTRAL DIGITAL DATA.

    USGS Publications Warehouse

    Duval, Joseph S.

    1985-01-01

    Because the display and interpretation of satellite and aircraft remote-sensing data make extensive use of color film products, accurate reproduction of the color images is important. To achieve accurate color reproduction, the exposure and chemical processing of the film must be monitored and controlled. By using a combination of sensitometry, densitometry, and transfer functions that control film response curves, all of the different steps in the making of film images can be monitored and controlled. Because a sensitometer produces a calibrated exposure, the resulting step wedge can be used to monitor the chemical processing of the film. Step wedges put on film by image recording machines provide a means of monitoring the film exposure and color balance of the machines.

  18. Bedtime Routines for Young Children: A Dose-Dependent Association with Sleep Outcomes

    PubMed Central

    Mindell, Jodi A.; Li, Albert M.; Sadeh, Avi; Kwon, Robert; Goh, Daniel Y.T.

    2015-01-01

    Background: Establishment of a consistent bedtime routine (the activities that occur right before lights out) is often recommended as part of healthy sleep habits. However, no studies have investigated the dose-dependent association of a bedtime routine with sleep outcomes, especially in young children for whom they are particularly recommended. Thus, the aim of this study was to examine the associations of a consistent bedtime routine with sleep outcomes in young children (ages 0 through 5 y) in a large global sample and assess whether there is a dose-dependent relationship between the frequency of a bedtime routine both concurrently and retrospectively with sleep outcomes. Participants: Mothers of 10,085 children (Australia-New Zealand, Canada, China, Hong Kong, India, Japan, Korea, Malaysia, Philippines, Singapore, Thailand, United Kingdom, United States) completed the Brief Infant/Child Sleep Questionnaire. Results: A consistent bedtime routine was associated with better sleep outcomes, including earlier bedtimes, shorter sleep onset latency, reduced night wakings, and increased sleep duration. Decreased parent-perceived sleep problems and daytime behavior problems were also related to institution of a regular bedtime routine. Furthermore, there was a dose-dependent relationship, with better outcomes associated with increased “doses” of having a bedtime routine, both currently and retrospectively, and was found within both predominantly Asian and predominantly Caucasian cultural regions. Conclusions: These results indicate that having a regular nightly bedtime routine is associated with improved sleep in young children, and suggests that the more consistently a bedtime routine is instituted and the younger started the better. Citation: Mindell JA, Li AM, Sadeh A, Kwon R, Goh DY. Bedtime routines for young children: a dose-dependent association with sleep outcomes. SLEEP 2015;38(5):717–722. PMID:25325483

  19. Barcoding T Cell Calcium Response Diversity with Methods for Automated and Accurate Analysis of Cell Signals (MAAACS)

    PubMed Central

    Sergé, Arnauld; Bernard, Anne-Marie; Phélipot, Marie-Claire; Bertaux, Nicolas; Fallet, Mathieu; Grenot, Pierre; Marguet, Didier; He, Hai-Tao; Hamon, Yannick

    2013-01-01

    We introduce a series of experimental procedures enabling sensitive calcium monitoring in T cell populations by confocal video-microscopy. Tracking and post-acquisition analysis was performed using Methods for Automated and Accurate Analysis of Cell Signals (MAAACS), a fully customized program that associates a high throughput tracking algorithm, an intuitive reconnection routine and a statistical platform to provide, at a glance, the calcium barcode of a population of individual T-cells. Combined with a sensitive calcium probe, this method allowed us to unravel the heterogeneity in shape and intensity of the calcium response in T cell populations and especially in naive T cells, which display intracellular calcium oscillations upon stimulation by antigen presenting cells. PMID:24086124

  20. [Routine fluoroscopic investigations after primary bariatric surgery].

    PubMed

    Gärtner, D; Ernst, A; Fedtke, K; Jenkner, J; Schöttler, A; Reimer, P; Blüher, M; Schön, M R

    2016-03-01

    Staple line and anastomotic leakages are life-threatening complications after bariatric surgery. Upper gastrointestinal (GI) tract X-ray examination with oral administration of a water-soluble contrast agent can be used to detect leaks. The aim of this study was to evaluate the impact of routine upper GI tract fluoroscopy after primary bariatric surgery. Between January 2009 and December 2014 a total of 658 bariatric interventions were carried out of which 442 were primary bariatric operations. Included in this single center study were 307 sleeve gastrectomies and 135 Roux-en-Y gastric bypasses. Up to December 2012 upper GI tract fluoroscopy was performed routinely between the first and third postoperative days and the detection of leakages was evaluated. In the investigation period 8 leakages (2.6 %) after sleeve gastrectomy, 1 anastomotic leakage in gastrojejunostomy and 1 in jejunojejunostomy after Roux-en-Y gastric bypass occurred. All patients developed clinical symptoms, such as abdominal pain, tachycardia or fever. In one case the leakage was detected by upper GI fluoroscopy and in nine cases radiological findings were unremarkable. No leakages were detected in asymptomatic patients. Routine upper GI fluoroscopy is not recommended for uneventful postoperative courses after primary bariatric surgery.

  1. Mass spectrometry-based protein identification with accurate statistical significance assignment.

    PubMed

    Alves, Gelio; Yu, Yi-Kuo

    2015-03-01

    Assigning statistical significance accurately has become increasingly important as metadata of many types, often assembled in hierarchies, are constructed and combined for further biological analyses. Statistical inaccuracy of metadata at any level may propagate to downstream analyses, undermining the validity of scientific conclusions thus drawn. From the perspective of mass spectrometry-based proteomics, even though accurate statistics for peptide identification can now be achieved, accurate protein level statistics remain challenging. We have constructed a protein ID method that combines peptide evidences of a candidate protein based on a rigorous formula derived earlier; in this formula the database P-value of every peptide is weighted, prior to the final combination, according to the number of proteins it maps to. We have also shown that this protein ID method provides accurate protein level E-value, eliminating the need of using empirical post-processing methods for type-I error control. Using a known protein mixture, we find that this protein ID method, when combined with the Sorić formula, yields accurate values for the proportion of false discoveries. In terms of retrieval efficacy, the results from our method are comparable with other methods tested. The source code, implemented in C++ on a linux system, is available for download at ftp://ftp.ncbi.nlm.nih.gov/pub/qmbp/qmbp_ms/RAId/RAId_Linux_64Bit. Published by Oxford University Press 2014. This work is written by US Government employees and is in the public domain in the US.

  2. Accurate and computationally efficient prediction of thermochemical properties of biomolecules using the generalized connectivity-based hierarchy.

    PubMed

    Sengupta, Arkajyoti; Ramabhadran, Raghunath O; Raghavachari, Krishnan

    2014-08-14

    In this study we have used the connectivity-based hierarchy (CBH) method to derive accurate heats of formation of a range of biomolecules, 18 amino acids and 10 barbituric acid/uracil derivatives. The hierarchy is based on the connectivity of the different atoms in a large molecule. It results in error-cancellation reaction schemes that are automated, general, and can be readily used for a broad range of organic molecules and biomolecules. Herein, we first locate stable conformational and tautomeric forms of these biomolecules using an accurate level of theory (viz. CCSD(T)/6-311++G(3df,2p)). Subsequently, the heats of formation of the amino acids are evaluated using the CBH-1 and CBH-2 schemes and routinely employed density functionals or wave function-based methods. The calculated heats of formation obtained herein using modest levels of theory and are in very good agreement with those obtained using more expensive W1-F12 and W2-F12 methods on amino acids and G3 results on barbituric acid derivatives. Overall, the present study (a) highlights the small effect of including multiple conformers in determining the heats of formation of biomolecules and (b) in concurrence with previous CBH studies, proves that use of the more effective error-cancelling isoatomic scheme (CBH-2) results in more accurate heats of formation with modestly sized basis sets along with common density functionals or wave function-based methods.

  3. 75 FR 82121 - Privacy Act of 1974, as Amended; Proposed Routine Use

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-12-29

    ... SOCIAL SECURITY ADMINISTRATION Privacy Act of 1974, as Amended; Proposed Routine Use AGENCY: Social Security Administration (SSA). ACTION: Proposed routine use. SUMMARY: In accordance with the... routine use to our system of records entitled Master Files of Social Security Number (SSN) Holders and SSN...

  4. Community-driven demand creation for the use of routine viral load testing: a model to scale up routine viral load testing.

    PubMed

    Killingo, Bactrin M; Taro, Trisa B; Mosime, Wame N

    2017-11-01

    HIV treatment outcomes are dependent on the use of viral load measurement. Despite global and national guidelines recommending the use of routine viral load testing, these policies alone have not translated into widespread implementation or sufficiently increased access for people living with HIV (PLHIV). Civil society and communities of PLHIV recognize the need to close this gap and to enable the scale up of routine viral load testing. The International Treatment Preparedness Coalition (ITPC) developed an approach to community-led demand creation for the use of routine viral load testing. Using this Community Demand Creation Model, implementers follow a step-wise process to capacitate and empower communities to address their most pressing needs. This includes utlizing a specific toolkit that includes conducting a baseline assessment, developing a treatment education toolkit, organizing mobilization workshops for knowledge building, provision of small grants to support advocacy work and conducting benchmark evaluations. The Community Demand Creation Model to increase demand for routine viral load testing services by PLHIV has been delivered in diverse contexts including in the sub-Saharan African, Asian, Latin American and the Caribbean regions. Between December 2015 and December 2016, ITPC trained more than 240 PLHIV activists, and disbursed US$90,000 to network partners in support of their national advocacy work. The latter efforts informed a regional, community-driven campaign calling for domestic investment in the expeditious implementation of national viral load testing guidelines. HIV treatment education and community mobilization are critical components of demand creation for access to optimal HIV treatment, especially for the use of routine viral load testing. ITPC's Community Demand Creation Model offers a novel approach to achieving this goal. © 2017 The Authors. Journal of the International AIDS Society published by John Wiley & sons Ltd on behalf of

  5. Brief sexual histories and routine HIV/STD testing by medical providers.

    PubMed

    Lanier, Yzette; Castellanos, Ted; Barrow, Roxanne Y; Jordan, Wilbert C; Caine, Virginia; Sutton, Madeline Y

    2014-03-01

    Clinicians who routinely take patient sexual histories have the opportunity to assess patient risk for sexually transmitted diseases (STDs), including human immunodeficiency virus (HIV), and make appropriate recommendations for routine HIV/STD screenings. However, less than 40% of providers conduct sexual histories with patients, and many do not receive formal sexual history training in school. After partnering with a national professional organization of physicians, we trained 26 (US and US territory-based) practicing physicians (58% female; median age=48 years) regarding sexual history taking using both in-person and webinar methods. Trainings occurred during either a 6-h onsite or 2-h webinar session. We evaluated their post-training experiences integrating sexual histories during routine medical visits. We assessed use of sexual histories and routine HIV/STD screenings. All participating physicians reported improved sexual history taking and increases in documented sexual histories and routine HIV/STD screenings. Four themes emerged from the qualitative evaluations: (1) the need for more sexual history training; (2) the importance of providing a gender-neutral sexual history tool; (3) the existence of barriers to routine sexual histories/testing; and (4) unintended benefits for providers who were conducting routine sexual histories. These findings were used to develop a brief, gender-neutral sexual history tool for clinical use. This pilot evaluation demonstrates that providers were willing to utilize a sexual history tool in clinical practice in support of HIV/STD prevention efforts.

  6. Brief Sexual Histories and Routine HIV/STD Testing by Medical Providers

    PubMed Central

    Lanier, Yzette; Castellanos, Ted; Barrow, Roxanne Y.; Jordan, Wilbert C.; Caine, Virginia

    2014-01-01

    Abstract Clinicians who routinely take patient sexual histories have the opportunity to assess patient risk for sexually transmitted diseases (STDs), including human immunodeficiency virus (HIV), and make appropriate recommendations for routine HIV/STD screenings. However, less than 40% of providers conduct sexual histories with patients, and many do not receive formal sexual history training in school. After partnering with a national professional organization of physicians, we trained 26 (US and US territory-based) practicing physicians (58% female; median age=48 years) regarding sexual history taking using both in-person and webinar methods. Trainings occurred during either a 6-h onsite or 2-h webinar session. We evaluated their post-training experiences integrating sexual histories during routine medical visits. We assessed use of sexual histories and routine HIV/STD screenings. All participating physicians reported improved sexual history taking and increases in documented sexual histories and routine HIV/STD screenings. Four themes emerged from the qualitative evaluations: (1) the need for more sexual history training; (2) the importance of providing a gender-neutral sexual history tool; (3) the existence of barriers to routine sexual histories/testing; and (4) unintended benefits for providers who were conducting routine sexual histories. These findings were used to develop a brief, gender-neutral sexual history tool for clinical use. This pilot evaluation demonstrates that providers were willing to utilize a sexual history tool in clinical practice in support of HIV/STD prevention efforts. PMID:24564387

  7. Colocalization analysis in fluorescence micrographs: verification of a more accurate calculation of pearson's correlation coefficient.

    PubMed

    Barlow, Andrew L; Macleod, Alasdair; Noppen, Samuel; Sanderson, Jeremy; Guérin, Christopher J

    2010-12-01

    One of the most routine uses of fluorescence microscopy is colocalization, i.e., the demonstration of a relationship between pairs of biological molecules. Frequently this is presented simplistically by the use of overlays of red and green images, with areas of yellow indicating colocalization of the molecules. Colocalization data are rarely quantified and can be misleading. Our results from both synthetic and biological datasets demonstrate that the generation of Pearson's correlation coefficient between pairs of images can overestimate positive correlation and fail to demonstrate negative correlation. We have demonstrated that the calculation of a thresholded Pearson's correlation coefficient using only intensity values over a determined threshold in both channels produces numerical values that more accurately describe both synthetic datasets and biological examples. Its use will bring clarity and accuracy to colocalization studies using fluorescent microscopy.

  8. Learning Together and Working Apart: Routines for Organizational Learning in Virtual Teams

    ERIC Educational Resources Information Center

    Dixon, Nancy

    2017-01-01

    Purpose: Research suggests that teaming routines facilitate learning in teams. This paper identifies and details how specific teaming routines, implemented in a virtual team, support its continual learning. The study's focus was to generate authentic and descriptive accounts of the interviewees' experiences with virtual teaming routines.…

  9. Older adults' personal routine at time of hospitalization.

    PubMed

    Zisberg, Anna; Gur-Yaish, Nurit

    This study is the first to explore whether hospitalization disrupts the daily routines of dependent and independent older adults. Data were collected as part of a prospectively designed study from 330 hospitalized older adults age 70+. Patients reported prehospitalization frequency, duration, and timing of basic activities of daily living and leisure activities at hospital admission. Hospital routine was assessed on day of discharge. Results indicated that frequency and duration of most basic activities decreased during hospitalization; the sharpest decrease was in frequency of getting dressed. Showering occurred 2 h earlier in the hospital setting, and getting dressed occurred an hour and a half later. For dependent respondents, the greatest change was in duration; for independent respondents, the greatest change was in frequency. Given the importance of routine maintenance to health and well-being, understanding the dynamics of its disruption in the hospital setting is imperative. Copyright © 2016 Elsevier Inc. All rights reserved.

  10. Routine admission laboratory testing for general medical patients.

    PubMed

    Hubbell, F A; Frye, E B; Akin, B V; Rucker, L

    1988-06-01

    We evaluated the usefulness of commonly ordered routine admission laboratory tests in 301 patients admitted consecutively to the internal medicine wards of a university teaching hospital. Using a consensus analysis approach, three Department of Medicine faculty members reviewed the charts of admitted patients to determine the impact of the test results on patient care. The evaluated tests were the urinalysis, hematocrit, white blood cell count, platelet count, six-factor automated multiple analysis (serum sodium, potassium, chloride, bicarbonate, glucose, and blood urea nitrogen), prothrombin time, partial thromboplastin time, chest x-ray, and electrocardiogram. Forty-five percent of the 3,684 tests were ordered for patients without recognizable medical indications. Twelve percent of these routine tests were abnormal, 5% led to additional laboratory testing, but only 0.5% led to change in the treatment of patients. We conclude that the impact of routine admission laboratory testing on patient care is very small and that there is little justification for ordering tests solely because of hospital admission.

  11. Is routine dengue vector surveillance in central Brazil able to accurately monitor the Aedes aegypti population? Results from a pupal productivity survey.

    PubMed

    Pilger, Daniel; Lenhart, Audrey; Manrique-Saide, Pablo; Siqueira, Joao Bosco; da Rocha, Welington Tristão; Kroeger, Axel

    2011-09-01

    To assess how well the Aedes aegypti infestation rapid survey, Levantamento Rapido de Indice para Aedes aegypti (LIRAa), is able to accurately estimate dengue vector densities and target the most important breeding sites in Goiania, Brazil. In February 2009, a pupal productivity survey was conducted in 2 districts of the city of Goiania, central Brazil. The results were compared to those of LIRAas conducted in the same districts during the months before and after the pupal productivity survey. In the pupal productivity survey, 2,024 houses were surveyed and 2,969 water-holding containers were inspected. Discarded small water containers most frequently contained immature Ae. aegypti. The most pupal-productive containers were elevated water tanks, roof gutters and water holding roofs. Combined, these three containers accounted for <40% of all positive containers but produced >70% of all pupae. In the two districts where the pupal productivity survey was conducted, the house indices were 5.1 and 4.6 and the Breteau indices were 5.9 and 6.0. In contrast, the two LIRAs conducted in the same two districts resulted in an average house index of 1.5 and Breteau index of 2.5, with discarded items identified as the most frequently infested container type. Both the LIRAa and the pupal productivity survey identified discarded items as being most frequently infested with immature stages of Ae. aegypti, but the pupal productivity survey showed that elevated containers produced the greatest proportion of Ae. aegypti pupae (a proxy measure of adult vector density) and that the values of the Stegomyia indices were substantially underestimated by LIRAa. Although both surveys differ considerably in terms of sampling method and manpower, in the case of this study the LIRAa did not accurately identify or target the containers that were the most important to adult mosquito production. © 2011 Blackwell Publishing Ltd.

  12. Efficacy and effectiveness of tumour necrosis factor inhibitors in the treatment of rheumatoid arthritis in randomized controlled trials and routine clinical practice.

    PubMed

    Aaltonen, Kalle J; Ylikylä, Suvi; Tuulikki Joensuu, Jaana; Isomäki, Pia; Pirilä, Laura; Kauppi, Markku; Rannio, Tuomas; Eklund, Kari; Blom, Marja; Nordström, Dan

    2017-05-01

    Efficacy of TNF inhibitors in the treatment of RA assessed in randomized controlled trials (RCTs) may not be fully comparable to routine care owing to the stringent inclusion criteria. The objective of this study was to observe the effectiveness of TNF inhibitors in real-world patients and assess the patients' potential eligibility for the RCTs. RA patients starting a TNF-inhibitor treatment between 2004 and 2014 were identified from the National Register for Biologic Treatment in Finland, which is a longitudinal observational cohort study. Effectiveness was measured using the ACR and EULAR response criteria and by studying the proportion of patients reaching DAS28 remission. The patients' baseline characteristics were compared against the inclusion criteria of 27 RCTs. EULAR moderate and good treatment responses at 6 months were achieved by 69 and 40% of the users of the first TNF inhibitor, respectively. ACR20, ACR50 and ACR70 responses were reached by 48, 27 and 13%, respectively. DAS28 remission was reached by 47%. Only 7.6-44% of the patients would have been potentially eligible for the RCTs. The eligible patients had better treatment responses compared with the non-eligible patients. Different TNF inhibitors were mostly equipotent, but the usage of MTX co-therapy had a major influence on treatment response. Only a small proportion of patients would have been eligible for RCTs, and the efficacy of TNF inhibitors assessed in them cannot be generalized directly into Finnish routine health care. © The Author 2017. Published by Oxford University Press on behalf of the British Society for Rheumatology. All rights reserved. For Permissions, please email: journals.permissions@oup.com

  13. GPs' prescription routines and cooperation with other healthcare personnel before and after implementation of multidose drug dispensing.

    PubMed

    Wekre, Liv Johanne; Bakken, Kjersti; Garåsen, Helge; Grimsmo, Anders

    2012-08-01

    This study addresses GPs' attitudes towards multidose drug dispensing before and after implementation and their perceived experience of how multidose drug dispensing affects prescription and communication routines for patients in the home care services. This study contributes to a method triangulation with two other studies on the introduction of multidose drug dispensing in Trondheim. A controlled before-and-after study carried out in Trondheim (intervention) and Tromsø (control). A questionnaire was distributed to all GPs in the two towns in 2005 with a follow-up questionnaire in 2008. The GPs in Trondheim showed a positive attitude to multidose drug dispensing both before and after the implementation. Increased workload was reported, but still the GPs wanted the system to be continued. Most of the GPs reported a better overview of the patients' medication and a supposed reduction in medication errors. The GPs' prescription- and communication routines were changed only for the multidose drug users and not for the other patients in the home care services. The study supports the results presented in two previous publications according to GPs' positive attitude towards multidose drug dispensing, their better overview of the patients' medications, and improved cooperation with the pharmacy. This study adds to our understanding of prescription routines among GPs and the use of the medication module in the electronic health record.

  14. Accurate label-free 3-part leukocyte recognition with single cell lens-free imaging flow cytometry.

    PubMed

    Li, Yuqian; Cornelis, Bruno; Dusa, Alexandra; Vanmeerbeeck, Geert; Vercruysse, Dries; Sohn, Erik; Blaszkiewicz, Kamil; Prodanov, Dimiter; Schelkens, Peter; Lagae, Liesbet

    2018-05-01

    Three-part white blood cell differentials which are key to routine blood workups are typically performed in centralized laboratories on conventional hematology analyzers operated by highly trained staff. With the trend of developing miniaturized blood analysis tool for point-of-need in order to accelerate turnaround times and move routine blood testing away from centralized facilities on the rise, our group has developed a highly miniaturized holographic imaging system for generating lens-free images of white blood cells in suspension. Analysis and classification of its output data, constitutes the final crucial step ensuring appropriate accuracy of the system. In this work, we implement reference holographic images of single white blood cells in suspension, in order to establish an accurate ground truth to increase classification accuracy. We also automate the entire workflow for analyzing the output and demonstrate clear improvement in the accuracy of the 3-part classification. High-dimensional optical and morphological features are extracted from reconstructed digital holograms of single cells using the ground-truth images and advanced machine learning algorithms are investigated and implemented to obtain 99% classification accuracy. Representative features of the three white blood cell subtypes are selected and give comparable results, with a focus on rapid cell recognition and decreased computational cost. Copyright © 2018 The Authors. Published by Elsevier Ltd.. All rights reserved.

  15. Basophile: Accurate Fragment Charge State Prediction Improves Peptide Identification Rates

    DOE PAGES

    Wang, Dong; Dasari, Surendra; Chambers, Matthew C.; ...

    2013-03-07

    In shotgun proteomics, database search algorithms rely on fragmentation models to predict fragment ions that should be observed for a given peptide sequence. The most widely used strategy (Naive model) is oversimplified, cleaving all peptide bonds with equal probability to produce fragments of all charges below that of the precursor ion. More accurate models, based on fragmentation simulation, are too computationally intensive for on-the-fly use in database search algorithms. We have created an ordinal-regression-based model called Basophile that takes fragment size and basic residue distribution into account when determining the charge retention during CID/higher-energy collision induced dissociation (HCD) of chargedmore » peptides. This model improves the accuracy of predictions by reducing the number of unnecessary fragments that are routinely predicted for highly-charged precursors. Basophile increased the identification rates by 26% (on average) over the Naive model, when analyzing triply-charged precursors from ion trap data. Basophile achieves simplicity and speed by solving the prediction problem with an ordinal regression equation, which can be incorporated into any database search software for shotgun proteomic identification.« less

  16. Routine vaccination against chickenpox?

    PubMed

    2012-04-01

    Varicella-zoster virus (VZV) causes both varicella and herpes zoster. In 1995 a varicella vaccine was licensed in the USA and was incorporated into the routine vaccination programme for children; a decline of varicella among children and adults, and a reduction in associated hospitalisation, complications and mortality, has resulted. In the UK, a policy of targeted vaccination of at-risk groups has been in place since the vaccine was introduced. Here we review the evidence for the different approaches to VZV vaccination policy.

  17. 40 CFR 141.621 - Routine monitoring.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 40 Protection of Environment 24 2012-07-01 2012-07-01 false Routine monitoring. 141.621 Section 141.621 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) WATER PROGRAMS (CONTINUED) NATIONAL PRIMARY DRINKING WATER REGULATIONS Stage 2 Disinfection Byproducts Requirements § 141...

  18. 40 CFR 141.621 - Routine monitoring.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 40 Protection of Environment 23 2014-07-01 2014-07-01 false Routine monitoring. 141.621 Section 141.621 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) WATER PROGRAMS (CONTINUED) NATIONAL PRIMARY DRINKING WATER REGULATIONS Stage 2 Disinfection Byproducts Requirements § 141...

  19. 40 CFR 141.621 - Routine monitoring.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 40 Protection of Environment 23 2011-07-01 2011-07-01 false Routine monitoring. 141.621 Section 141.621 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) WATER PROGRAMS (CONTINUED) NATIONAL PRIMARY DRINKING WATER REGULATIONS Stage 2 Disinfection Byproducts Requirements § 141...

  20. 40 CFR 141.621 - Routine monitoring.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 40 Protection of Environment 24 2013-07-01 2013-07-01 false Routine monitoring. 141.621 Section 141.621 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) WATER PROGRAMS (CONTINUED) NATIONAL PRIMARY DRINKING WATER REGULATIONS Stage 2 Disinfection Byproducts Requirements § 141...

  1. Factors for radical creativity, incremental creativity, and routine, noncreative performance.

    PubMed

    Madjar, Nora; Greenberg, Ellen; Chen, Zheng

    2011-07-01

    This study extends theory and research by differentiating between routine, noncreative performance and 2 distinct types of creativity: radical and incremental. We also use a sensemaking perspective to examine the interplay of social and personal factors that may influence a person's engagement in a certain level of creative action versus routine, noncreative work. Results demonstrate that willingness to take risks, resources for creativity, and career commitment are associated primarily with radical creativity; that the presence of creative coworkers and organizational identification are associated with incremental creativity; and that conformity and organizational identification are linked with routine performance. Theoretical and managerial implications are discussed.

  2. Temperature, routine activities, and domestic violence: a reanalysis.

    PubMed

    Rotton, J; Cohn, E G

    2001-04-01

    It was hypothesized that base rate differences in the number of complaints made during daylight and nighttime hours were responsible for a previously reported, nonlinear relationship between temperature and domestic violence. This hypothesis was tested by subjecting calls for service in 1987 and 1988 in Minneapolis, to moderator-variable regression analyses with controls for time of day, day of the week, season, and their interactions as well as linear trend, major holidays, public school closings, the first day of the month, and other weather variables. Temporal variables explained 75% of the variance in calls for service. As hypothesized, the base rate artifact was responsible for an apparent downturn in violence at high temperatures: Fewer complaints were received during afternoon hours, because they happen to be the warmest time of the day. The results were interpreted in terms of routine activity theory.

  3. Routinely collected English birth data sets: comparisons and recommendations for reproductive epidemiology.

    PubMed

    Ghosh, Rebecca E; Ashworth, Danielle C; Hansell, Anna L; Garwood, Kevin; Elliott, Paul; Toledano, Mireille B

    2016-09-01

    In England there are four national routinely collected data sets on births: Office for National Statistics (ONS) births based on birth registrations; Hospital Episode Statistics (HES) deliveries (mothers' information); HES births (babies' information); and NHS Numbers for Babies (NN4B) based on ONS births plus gestational age and ethnicity information. This study describes and compares these data, with the aim of recommending the most appropriate data set(s) for use in epidemiological research and surveillance. We assessed the completeness and quality of the data sets in relation to use in epidemiological research and surveillance and produced detailed descriptive statistics on common reproductive outcomes for each data set including temporal and spatial trends. ONS births is a high quality complete data set but lacks interpretive and clinical information. HES deliveries showed good agreement with ONS births but HES births showed larger amounts of missing or unavailable data. Both HES data sets had improved quality from 2003 onwards, but showed some local spatial variability. NN4B showed excellent agreement with ONS and HES deliveries for the years available (2006-2010). Annual number of births increased by 17.6% comparing 2002 with 2010 (ONS births). Approximately 6% of births were of low birth weight (2.6% term low birth weight) and 0.5% were stillbirths. Routinely collected data on births provide a valuable resource for researchers. ONS and NN4B offer the most complete and accurate record of births. Where more detailed clinical information is required, HES deliveries offers a high quality data set that captures the majority of English births. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  4. NNLOPS accurate associated HW production

    NASA Astrophysics Data System (ADS)

    Astill, William; Bizon, Wojciech; Re, Emanuele; Zanderighi, Giulia

    2016-06-01

    We present a next-to-next-to-leading order accurate description of associated HW production consistently matched to a parton shower. The method is based on reweighting events obtained with the HW plus one jet NLO accurate calculation implemented in POWHEG, extended with the MiNLO procedure, to reproduce NNLO accurate Born distributions. Since the Born kinematics is more complex than the cases treated before, we use a parametrization of the Collins-Soper angles to reduce the number of variables required for the reweighting. We present phenomenological results at 13 TeV, with cuts suggested by the Higgs Cross section Working Group.

  5. RNAi as a Routine Route Toward Breast Cancer Therapy

    DTIC Science & Technology

    2013-09-01

    Award Number: W81XWH-08-1-0572 TITLE: RNAi as a Routine Route Toward Breast Cancer Therapy...To) 1 SEP 2012 - 31 AUG 2013 4. TITLE AND SUBTITLE RNAi as a Routine Route Toward Breast Cancer Therapy 5a. CONTRACT NUMBER...generation RNAi library and made that available to the breast cancer community. This resource has nearly 75,000 independent, sequence verified clones

  6. Adaptive Flexibility and Maladaptive Routines in Selecting Fast and Frugal Decision Strategies

    ERIC Educational Resources Information Center

    Broder, Arndt; Schiffer, Stefanie

    2006-01-01

    Decision routines unburden the cognitive capacity of the decision maker. In changing environments, however, routines may become maladaptive. In 2 experiments with a hypothetical stock market game (n = 241), the authors tested whether decision routines tend to persist at the level of decision strategies rather than at the level of options in…

  7. Continuity of care by a midwife team versus routine care during pregnancy and birth: a randomised trial.

    PubMed

    Rowley, M J; Hensley, M J; Brinsmead, M W; Wlodarczyk, J H

    1995-09-18

    To compare continuity of care from a midwife team with routine care from a variety of doctors and midwives. A stratified, randomised controlled trial. 814 women attending the antenatal clinic of a tertiary referral, university hospital. Women were randomly allocated to team care from a team of six midwives, or routine care from a variety of doctors and midwives. Antenatal, intrapartum and neonatal events; maternal satisfaction; and cost of treatment. 405 women were randomly allocated to team care and 409 to routine care; they delivered 385 and 386 babies, respectively. Team care women were more likely to attend antenatal classes (OR, 1.73; 95% CI, 1.23-2.42); less likely to use pethidine during labour (OR, 0.32; 95% CI, 0.22-0.46); and more likely to labour and deliver without intervention (OR, 1.73; 95% CI, 1.28-2.34). Babies of team care mothers received less neonatal resuscitation (OR, 0.59; 95% CI, 0.41-0.86), although there was no difference in Apgar scores at five minutes (OR, 0.86; 95% CI, 0.29-2.57). The stillbirth and neonatal death rate was the same for both groups of mothers with a singleton pregnancy (three deaths), but there were three deaths (birthweights of 600 g, 660 g, 1340 g) in twin pregnancies in the group receiving team care. Team care was rated better than routine care for all measures of maternal satisfaction. Team care meant a cost reduction of 4.5%. Continuity of care provided by a small team of midwives resulted in a more satisfying birth experience at less cost than routine care and fewer adverse maternal and neonatal outcomes. Although a much larger study would be required to provide adequate power to detect rare outcomes, our study found that continuity of care by a midwife team was as safe as routine care.

  8. Sexual Revictimization: A Routine Activity Theory Explanation.

    PubMed

    Culatta, Elizabeth; Clay-Warner, Jody; Boyle, Kaitlin M; Oshri, Assaf

    2017-04-01

    Research has shown that victims of sexual assault are at a significant risk of revictimization. We use routine activity theory to predict how sexual victimization in adolescence relates to depression, substance use, and ultimately revictimization as a young adult. We frame our research within routine activity theory and predict that sexual victimization increases substance use and depressive symptoms, both of which increase the likelihood of revictimization. We test the hypotheses with three waves of data from the Longitudinal Study of Violence Against Women. Using structural equation modeling, we examine the direct and indirect effects of previous sexual victimization, depressive symptoms, and substance use on the odds of victimization during the sophomore year of college. Results suggest that sexual victimization during the sophomore year of college is predicted directly by previous sexual victimization and also indirectly through depressive symptomology, though not substance use. Although understudied in the literature, depression is shown to mediate the relationship between victimization and revictimization, and this finding is consistent with routine activity theory, as well as the state dependence perspective on revictimization. Our findings suggest that depressive symptoms, a long acknowledged consequence of sexual victimization, should also be understood as a source of revictimization risk, indicating the importance of depression screening and intervention for decreasing sexual victimization.

  9. Controlling Microbial Byproducts using Model-Based Substrate Monitoring and Control Strategies

    NASA Technical Reports Server (NTRS)

    Smernoff, David T.; Blackwell, Charles; Mancinelli, Rocco L.; DeVincenzi, Donald (Technical Monitor)

    2000-01-01

    We have developed a computer-controlled bioreactor system to study various aspects of microbially-mediated nitrogen cycling. The system has been used to investigate methods for controlling microbial denitrification (the dissimilatory reduction of nitrate to N2O and N2) in hydroponic plant growth chambers. Such chambers are key elements of advanced life support systems being designed for use on long duration space missions, but nitrogen use efficiency in them is reduced by denitrification. Control software architecture was designed which permits the heterogeneous control of system hardware using traditional feedback control, and quantitative and qualitative models of various system features. Model-based feed forward control entails prediction of future systems in states and automated regulation of system parameters to achieve desired and avoid undesirable system states. A bacterial growth rate model based on the classic Monod model of saturation kinetics was used to evaluate the response of several individual denitrifying species to varying environmental conditions. The system and models are now being applied to mixed microbial communities harvested from the root zone of a hydroponic growth chamber. The use of a modified Monod organism interaction model was evaluated as a means of achieving more accurate description of the dynamic behavior of the communities. A minimum variance parameter estimation routine was also' used to calibrate the constant parameters in the model by iterative evaluation of substrate (nitrate) uptake and growth kinetics. This representation of processes and interactions aids in the formulation of control laws. The feed forward control strategy being developed will increase system autonomy, reduce crew intervention and limit the accumulation of undesirable waste products (NOx).

  10. Impact of routine episodic emissions on the expected frequency distribution of emissions from oil and gas production sources.

    NASA Astrophysics Data System (ADS)

    Smith, N.; Blewitt, D.; Hebert, L. B.

    2015-12-01

    In coordination with oil and gas operators, we developed a high resolution (< 1 min) simulation of temporal variability in well-pad oil and gas emissions over a year. We include routine emissions from condensate tanks, dehydrators, pneumatic devices, fugitive leaks and liquids unloading. We explore the variability in natural gas emissions from these individual well-pad sources, and find that routine short-term episodic emissions such as tank flashing and liquids unloading result in the appearance of a skewed, or 'fat-tail' distribution of emissions, from an individual well-pad over time. Additionally, we explore the expected variability in emissions from multiple wells with different raw gas composition, gas/liquids production volumes and control equipment. Differences in well-level composition, production volume and control equipment translate into differences in well-level emissions leading to a fat-tail distribution of emissions in the absence of operational upsets. Our results have several implications for recent studies focusing on emissions from oil and gas sources. Time scale of emission estimates are important and have important policy implications. Fat tail distributions may not be entirely driven by avoidable mechanical failures, and are expected to occur under routine operational conditions from short-duration emissions (e.g., tank flashing, liquid unloading). An understanding of the expected distribution of emissions for a particular population of wells is necessary to evaluate whether the observed distribution is more skewed than expected. Temporal variability in well-pad emissions make comparisons to annual average emissions inventories difficult and may complicate the interpretation of long-term ambient fenceline monitoring data. Sophisticated change detection algorithms will be necessary to identify when true operational upsets occur versus routine short-term emissions.

  11. Accurate Arabic Script Language/Dialect Classification

    DTIC Science & Technology

    2014-01-01

    Army Research Laboratory Accurate Arabic Script Language/Dialect Classification by Stephen C. Tratz ARL-TR-6761 January 2014 Approved for public...1197 ARL-TR-6761 January 2014 Accurate Arabic Script Language/Dialect Classification Stephen C. Tratz Computational and Information Sciences...Include area code) Standard Form 298 (Rev. 8/98) Prescribed by ANSI Std. Z39.18 January 2014 Final Accurate Arabic Script Language/Dialect Classification

  12. Routine systemic antibiotic prophylaxis for burn injuries in developing countries: A best evidence topic (BET)

    PubMed Central

    Stewart, Barclay T; Gyedu, Adam; Agbenorku, Pius; Amankwa, Richcane; Kushner, Adam L; Gibran, Nicole

    2015-01-01

    Background Burns are common in low- and middle-income countries (LMICs) and complicated by unhygienic conditions, malnutrition, use of high-risk homemade dressings and delayed presentation. Resultantly, use of routine systemic antibiotic prophylaxis (SAP) to prevent wound infection is common practice despite this intervention being abandoned in high-income countries due to increased antimicrobial resistance and non-bacterial suprainfection, Methods A best evidence topic (BET) was constructed using a structured protocol. The question addressed was: In LMICs, does routine use of SAP reduce burn wound infection, morbidity or mortality? Results From 704 retrieved records, 48 reports met criteria to be examined. Of those, 3 studies represented the best available evidence. Together, two randomized clinical trials (RCTs) and a retrospective cohort study reported no difference in the proportion of wound infection, any infection or length of hospital stay between SAP groups and controls. One RCT described a greater proportion of wounds infected with P. aeruginosa among SAP arms compared to controls. The studies had few participants and significant methodological weaknesses. Conclusion On the basis of limited, currently available evidence, the use of SAP cannot be recommended for patients in LMICs that present soon after burn injury. PMID:26260622

  13. The Association between Routinization and Cognitive Resources in Later Life

    ERIC Educational Resources Information Center

    Tournier, Isabelle; Mathey, Stephanie; Postal, Virginie

    2012-01-01

    The aim of this study was to investigate the association between routinization of daily life activities and cognitive resources during aging. Routinization could increase excessively during aging and become maladaptative in reducing individual resources. Fifty-two young participants (M = 20.8 years) and 62 older participants (M = 66.9 years)…

  14. The Effect of Heart Disease on Anesthetic Complications During Routine Dental Procedures in Dogs.

    PubMed

    Carter, Jennifer E; Motsinger-Reif, Alison A; Krug, William V; Keene, Bruce W

    Dental procedures are a common reason for general anesthesia, and there is widespread concern among veterinarians that heart disease increases the occurrence of anesthetic complications. Anxiety about anesthetizing dogs with heart disease is a common cause of referral to specialty centers. To begin to address the potential effect of heart disease on anesthetic complications in dogs undergoing anesthesia for routine dental procedures, we compared anesthetic complications in 100 dogs with heart disease severe enough to trigger referral to a specialty center (cases) to those found in 100 dogs without cardiac disease (controls) that underwent similar procedures at the same teaching hospital. Medical records were reviewed to evaluate the occurrence of anesthetic complications. No dogs died in either group, and no significant differences were found between the groups in any of the anesthetic complications evaluated, although dogs in the heart disease group were significantly older with higher American Society of Anesthesiologists scores. Midazolam and etomidate were used more frequently, and alpha-2 agonists used less frequently, in the heart disease group compared to controls. This study suggests dogs with heart disease, when anesthetized by trained personnel and carefully monitored during routine dental procedures, are not at significantly increased risk for anesthetic complications.

  15. Accurate Cell Division in Bacteria: How Does a Bacterium Know Where its Middle Is?

    NASA Astrophysics Data System (ADS)

    Howard, Martin; Rutenberg, Andrew

    2004-03-01

    I will discuss the physical principles lying behind the acquisition of accurate positional information in bacteria. A good application of these ideas is to the rod-shaped bacterium E. coli which divides precisely at its cellular midplane. This positioning is controlled by the Min system of proteins. These proteins coherently oscillate from end to end of the bacterium. I will present a reaction-diffusion model that describes the diffusion of the Min proteins, and their binding/unbinding from the cell membrane. The system possesses an instability that spontaneously generates the Min oscillations, which control accurate placement of the midcell division site. I will then discuss the role of fluctuations in protein dynamics, and investigate whether fluctuations set optimal protein concentration levels. Finally I will examine cell division in a different bacteria, B. subtilis. where different physical principles are used to regulate accurate cell division. See: Howard, Rutenberg, de Vet: Dynamic compartmentalization of bacteria: accurate division in E. coli. Phys. Rev. Lett. 87 278102 (2001). Howard, Rutenberg: Pattern formation inside bacteria: fluctuations due to the low copy number of proteins. Phys. Rev. Lett. 90 128102 (2003). Howard: A mechanism for polar protein localization in bacteria. J. Mol. Biol. 335 655-663 (2004).

  16. 32 CFR Appendix C to Part 310 - DoD Blanket Routine Uses

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 32 National Defense 2 2010-07-01 2010-07-01 false DoD Blanket Routine Uses C Appendix C to Part...) PRIVACY PROGRAM DOD PRIVACY PROGRAM Pt. 310, App. C Appendix C to Part 310—DoD Blanket Routine Uses (See paragraph (c) of § 310.22 of subpart E) A. Routine Use—Law Enforcement If a system of records maintained by...

  17. See, Say, Write: A Writing Routine for the Preschool Classroom

    ERIC Educational Resources Information Center

    Copp, Stefanie B.; Cabell, Sonia Q.; Tortorelli, Laura S.

    2016-01-01

    See, Say, Write is an adaptable classroom writing routine that teachers can use across a range of activities in the preschool classroom. This preschool writing routine offers an opportunity for teachers to build on a shared experience through engagement in rich conversation and writing. After a shared experience, teachers will provide a visual…

  18. Factors for Radical Creativity, Incremental Creativity, and Routine, Noncreative Performance

    ERIC Educational Resources Information Center

    Madjar, Nora; Greenberg, Ellen; Chen, Zheng

    2011-01-01

    This study extends theory and research by differentiating between routine, noncreative performance and 2 distinct types of creativity: radical and incremental. We also use a sensemaking perspective to examine the interplay of social and personal factors that may influence a person's engagement in a certain level of creative action versus routine,…

  19. Routine Activities and Victimization at School: The Significance of Gender

    ERIC Educational Resources Information Center

    Popp, Ann Marie; Peguero, Anthony A.

    2011-01-01

    Routine activities theory has not fully considered the role of gender in shaping victimization and yet, the research literature clearly demonstrates that gender is associated with an individual's risk of victimization. In addition to the pervasive effect of gender on victimization, gender shapes an individual's daily routines and thus may create a…

  20. Efficient linear algebra routines for symmetric matrices stored in packed form.

    PubMed

    Ahlrichs, Reinhart; Tsereteli, Kakha

    2002-01-30

    Quantum chemistry methods require various linear algebra routines for symmetric matrices, for example, diagonalization or Cholesky decomposition for positive matrices. We present a small set of these basic routines that are efficient and minimize memory requirements.

  1. Enhancement of hepatitis virus immunoassay outcome predictions in imbalanced routine pathology data by data balancing and feature selection before the application of support vector machines.

    PubMed

    Richardson, Alice M; Lidbury, Brett A

    2017-08-14

    Data mining techniques such as support vector machines (SVMs) have been successfully used to predict outcomes for complex problems, including for human health. Much health data is imbalanced, with many more controls than positive cases. The impact of three balancing methods and one feature selection method is explored, to assess the ability of SVMs to classify imbalanced diagnostic pathology data associated with the laboratory diagnosis of hepatitis B (HBV) and hepatitis C (HCV) infections. Random forests (RFs) for predictor variable selection, and data reshaping to overcome a large imbalance of negative to positive test results in relation to HBV and HCV immunoassay results, are examined. The methodology is illustrated using data from ACT Pathology (Canberra, Australia), consisting of laboratory test records from 18,625 individuals who underwent hepatitis virus testing over the decade from 1997 to 2007. Overall, the prediction of HCV test results by immunoassay was more accurate than for HBV immunoassay results associated with identical routine pathology predictor variable data. HBV and HCV negative results were vastly in excess of positive results, so three approaches to handling the negative/positive data imbalance were compared. Generating datasets by the Synthetic Minority Oversampling Technique (SMOTE) resulted in significantly more accurate prediction than single downsizing or multiple downsizing (MDS) of the dataset. For downsized data sets, applying a RF for predictor variable selection had a small effect on the performance, which varied depending on the virus. For SMOTE, a RF had a negative effect on performance. An analysis of variance of the performance across settings supports these findings. Finally, age and assay results for alanine aminotransferase (ALT), sodium for HBV and urea for HCV were found to have a significant impact upon laboratory diagnosis of HBV or HCV infection using an optimised SVM model. Laboratories looking to include machine

  2. Accelerated spike resampling for accurate multiple testing controls.

    PubMed

    Harrison, Matthew T

    2013-02-01

    Controlling for multiple hypothesis tests using standard spike resampling techniques often requires prohibitive amounts of computation. Importance sampling techniques can be used to accelerate the computation. The general theory is presented, along with specific examples for testing differences across conditions using permutation tests and for testing pairwise synchrony and precise lagged-correlation between many simultaneously recorded spike trains using interval jitter.

  3. Effect of inspiratory muscle training before cardiac surgery in routine care.

    PubMed

    Valkenet, Karin; de Heer, Frederiek; Backx, Frank J G; Trappenburg, Jaap C A; Hulzebos, Erik H J; Kwant, Simone; van Herwerden, Lex A; van de Port, Ingrid G L

    2013-05-01

    Inspiratory muscle training (IMT) before cardiac surgery has proved to be a promising intervention to reduce postoperative pneumonia in a randomized controlled trial setting. Effects of IMT in routine care have not been reported. The purpose of this study was to investigate the effect of IMT before cardiac surgery on postoperative pneumonia in routine care at a Dutch university medical center using propensity scoring. This was an observational cohort study. All candidates for cardiac surgery were preoperatively stratified by a physical therapist for low risk or high risk for postoperative pulmonary complications. Patients at high risk either engaged in an unsupervised IMT program (20 minutes a day) at home for at least 2 weeks before surgery (group 1) or received usual care (no IMT) (group 2). Results in terms of outcome measures were adjusted with propensity scores to reduce bias caused by nonrandom treatment assignment. The results showed that of the 94 patients at high risk in group 1, 1 patient (1.1%) developed a postoperative pneumonia. In group 2, 8 out of the 252 patients at high risk (3.2%) developed this pulmonary complication (adjusted odds ratio=0.34, 95% confidence interval=0.04-3.38). No significant differences were found regarding median (25th-75th percentile) ventilation time (7 [5-9] hours versus 7 [5-10] hours), length of stay in the intensive care unit (23 [21-24] hours versus 23 [21-25] hours), or total postoperative length of stay (7 [6-11] days versus 7 [5-9] days). The most important limitations of this study were confounding, incomplete data collection, and a low incidence of the primary outcome. Propensity scoring is believed to be a valuable tool of great potential interest to researchers in the field of observational studies. Whether IMT in routine care resulted in less postoperative pneumonia cannot be concluded.

  4. 38 CFR 4.46 - Accurate measurement.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... RATING DISABILITIES Disability Ratings The Musculoskeletal System § 4.46 Accurate measurement. Accurate... indispensable in examinations conducted within the Department of Veterans Affairs. Muscle atrophy must also be...

  5. 38 CFR 4.46 - Accurate measurement.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... RATING DISABILITIES Disability Ratings The Musculoskeletal System § 4.46 Accurate measurement. Accurate... indispensable in examinations conducted within the Department of Veterans Affairs. Muscle atrophy must also be...

  6. 38 CFR 4.46 - Accurate measurement.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... RATING DISABILITIES Disability Ratings The Musculoskeletal System § 4.46 Accurate measurement. Accurate... indispensable in examinations conducted within the Department of Veterans Affairs. Muscle atrophy must also be...

  7. 38 CFR 4.46 - Accurate measurement.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... RATING DISABILITIES Disability Ratings The Musculoskeletal System § 4.46 Accurate measurement. Accurate... indispensable in examinations conducted within the Department of Veterans Affairs. Muscle atrophy must also be...

  8. 38 CFR 4.46 - Accurate measurement.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... RATING DISABILITIES Disability Ratings The Musculoskeletal System § 4.46 Accurate measurement. Accurate... indispensable in examinations conducted within the Department of Veterans Affairs. Muscle atrophy must also be...

  9. Monochromatic, Rosseland mean, and Planck mean opacity routine

    NASA Astrophysics Data System (ADS)

    Semenov, D.

    2006-11-01

    Several FORTRAN77 codes were developed to compute frequency-dependent, Rosseland and Planck mean opacities of gas and dust in protoplanetary disks. The opacities can be computed for an ensemble of dust grains having various compositions (ices, silicates, organics, etc), sizes, topologies (homogeneous/composite aggregates, homogeneous/layered/composite spheres, etc.), porosities, and dust-to-gas ratio. Several examples are available. In addition, a very fast opacity routine to be used in modeling of the radiative transfer in hydro simulations of disks is available upon request (10^8 routine calls require about 30s on Pentium 4 3.0GHz).

  10. Politics of schism: routinization and social control in the International Socialists/Socialist Workers' Party

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

    Rayner, S.

    1985-01-01

    The received wisdom of social science holds that voluntary organizations founded on egalitarian principles, can only survive by undergoing transformation into hierarchical systems. The underlying logic of Weber, Michels and Toennies' descriptions is that social organizations sustain themselves over time by generating increasingly complex systems of rules that become sources of inequality. This article argues that routinization in voluntary groups does not consist of a gradual accumulation of rules that promote internal inequality. Instead, two analytically distinct steps are proposed: (1) construction of a distinctive organizational boundary, which is a necessary condition for (2) the ultimate imposition of a complexmore » organizational hierarchy. The case used to illustrate this argument is drawn from the history of the British Trotskyist movement prior to 1978. The argument itself is framed within a formal model of the sociology of knowledge called grid/group analysis.« less

  11. Feedback about More Accurate versus Less Accurate Trials: Differential Effects on Self-Confidence and Activation

    ERIC Educational Resources Information Center

    Badami, Rokhsareh; VaezMousavi, Mohammad; Wulf, Gabriele; Namazizadeh, Mahdi

    2012-01-01

    One purpose of the present study was to examine whether self-confidence or anxiety would be differentially affected by feedback from more accurate rather than less accurate trials. The second purpose was to determine whether arousal variations (activation) would predict performance. On Day 1, participants performed a golf putting task under one of…

  12. Manualized cognitive therapy versus cognitive-behavioral treatment-as-usual for social anxiety disorder in routine practice: A cluster-randomized controlled trial.

    PubMed

    Hoyer, Jürgen; Čolić, Jasmin; Pittig, Andre; Crawcour, Stephen; Moeser, Manuela; Ginzburg, Denise; Lin, Jihong; Wiltink, Joerg; Leibing, Eric; Stangier, Ulrich

    2017-08-01

    This study examined the effectiveness of manualized cognitive therapy (mCT) following the Clark-Wells approach versus non-manualized cognitive-behavioral treatment-as-usual (CBTAU) for social anxiety disorder (SAD) in routine practice. Forty-eight private practitioners were recruited within a multi-center trial and either received training in manualized CT for SAD or no such training. Practitioners treated 162 patients with SAD in routine practice (N = 107 completers, n = 57 for mCT, n = 50 for CBTAU). Social anxiety symptoms (Liebowitz Social Anxiety Scale; LSAS) and secondary measures were assessed before treatment, at treatment-hour 8, 15, and 25, at end of treatment, as well as 6 and 12 months after treatment. Patients in both groups showed significant reductions of SAD severity after treatment (d = 1.91 [mCT] and d = 1.80 [CBTAU], within-group effect sizes, intent-to-treat analyses, LSAS observer ratings), which remained stable at follow-up. There were no differences between groups in terms of symptom reduction and treatment duration. The present trial confirms the high effectiveness of CBTAU and mCT for SAD when practitioners conduct the treatments in routine practice. Additional training in the CT manual did not result in significant between-group effects on therapy outcome. Explanations for this unexpected result are discussed. Copyright © 2017 Elsevier Ltd. All rights reserved.

  13. A model for routine hospital-wide HIV screening: lessons learned and public health implications.

    PubMed

    Maxwell, Celia J; Sitapati, Amy M; Abdus-Salaam, Sayyida S; Scott, Victor; Martin, Marsha; Holt-Brockenbrough, Maya E; Retland, Nicole L

    2010-12-01

    Approximately 232700 (21%) of Americans are unaware of their HIV-seropositive status; this represents a potential for virus transmission. Revised recommendations from the Centers for Disease Control for HIV screening promote routine screening in the health care setting. We describe the implementation of a hospital-wide routine HIV screening program in the District of Columbia. Rapid HIV testing was conducted at Howard University Hospital on consenting patients at least 18 years of age using the OraSure OraQuick Advance Rapid HIV-1/2 Antibody Test. The study population includes Howard University Hospital patients who were offered HIV screening over a 12-month period at no cost. Screened patients received immediate test results and, for those patients found to be preliminarily reactive, confirmatory testing and linkage to care were offered. Of the 12836 patients who were offered testing, 7528 (58.6%) consented. Preliminary reactive test results were identified in 176 patients (2.3%). Overall, 45.5% were confirmed, of which 82.5% were confirmed positive. Screening protocol changes have led to 100% confirmation since implementation. Hospital-wide routine HIV screening is feasible and can be implemented effectively and efficiently. The HIV screening campaign instituted at Howard University Hospital identified a substantial number of HIV-positive individuals and provided critical connection to follow-up testing, counseling, and disease management services.

  14. Evaluation and selection guide of method of repair for routine maintenance

    DOT National Transportation Integrated Search

    2008-09-01

    The objective of this field guideline is to provide assistance for the pavement evaluation and selection of method of repair for routine maintenance relative to the extension of service life. First, a strategic overview of routine maintenance activit...

  15. Accurate positioning of long, flexible ARM's (Articulated Robotic Manipulator)

    NASA Technical Reports Server (NTRS)

    Malachowski, Michael J.

    1988-01-01

    An articulated robotic manipulator (ARM) system is being designed for space applications. Work being done on a concept utilizing an infinitely stiff laser beam for position reference is summarized. The laser beam is projected along the segments of the ARM, and the position is sensed by the beam rider modules (BRM) mounted on the distal ends of the segments. The BRM concept is the heart of the system. It utilizes a combination of lateral displacements and rotational and distance measurement sensors. These determine the relative position of the two ends of the segments with respect to each other in six degrees of freedom. The BRM measurement devices contain microprocessor controlled data acquisition and active positioning components. An indirect adaptive controller is used to accurately control the position of the ARM.

  16. Accurate Identification of Fear Facial Expressions Predicts Prosocial Behavior

    PubMed Central

    Marsh, Abigail A.; Kozak, Megan N.; Ambady, Nalini

    2009-01-01

    The fear facial expression is a distress cue that is associated with the provision of help and prosocial behavior. Prior psychiatric studies have found deficits in the recognition of this expression by individuals with antisocial tendencies. However, no prior study has shown accuracy for recognition of fear to predict actual prosocial or antisocial behavior in an experimental setting. In 3 studies, the authors tested the prediction that individuals who recognize fear more accurately will behave more prosocially. In Study 1, participants who identified fear more accurately also donated more money and time to a victim in a classic altruism paradigm. In Studies 2 and 3, participants’ ability to identify the fear expression predicted prosocial behavior in a novel task designed to control for confounding variables. In Study 3, accuracy for recognizing fear proved a better predictor of prosocial behavior than gender, mood, or scores on an empathy scale. PMID:17516803

  17. Accurate identification of fear facial expressions predicts prosocial behavior.

    PubMed

    Marsh, Abigail A; Kozak, Megan N; Ambady, Nalini

    2007-05-01

    The fear facial expression is a distress cue that is associated with the provision of help and prosocial behavior. Prior psychiatric studies have found deficits in the recognition of this expression by individuals with antisocial tendencies. However, no prior study has shown accuracy for recognition of fear to predict actual prosocial or antisocial behavior in an experimental setting. In 3 studies, the authors tested the prediction that individuals who recognize fear more accurately will behave more prosocially. In Study 1, participants who identified fear more accurately also donated more money and time to a victim in a classic altruism paradigm. In Studies 2 and 3, participants' ability to identify the fear expression predicted prosocial behavior in a novel task designed to control for confounding variables. In Study 3, accuracy for recognizing fear proved a better predictor of prosocial behavior than gender, mood, or scores on an empathy scale.

  18. The clock gene Period1 regulates innate routine behaviour in mice.

    PubMed

    Bechstein, Philipp; Rehbach, Nils-Jörn; Yuhasingham, Gowzekan; Schürmann, Christoph; Göpfert, Melanie; Kössl, Manfred; Maronde, Erik

    2014-04-22

    Laboratory mice are well capable of performing innate routine behaviour programmes necessary for courtship, nest-building and exploratory activities although housed for decades in animal facilities. We found that in mice inactivation of the clock gene Period1 profoundly changes innate routine behaviour programmes like those necessary for courtship, nest building, exploration and learning. These results in wild-type and Period1 mutant mice, together with earlier findings on courtship behaviour in wild-type and period-mutant Drosophila melanogaster, suggest a conserved role of Period-genes on innate routine behaviour. Additionally, both per-mutant flies and Period1-mutant mice display spatial learning and memory deficits. The profound influence of Period1 on routine behaviour programmes in mice, including female partner choice, may be independent of its function as a circadian clock gene, since Period1-deficient mice display normal circadian behaviour.

  19. Electronic circuit provides accurate sensing and control of dc voltage

    NASA Technical Reports Server (NTRS)

    Loftus, W. D.

    1966-01-01

    Electronic circuit used relay coil to sense and control dc voltage. The control relay is driven by a switching transistor that is biased to cutoff for all input up to slightly less than the threshold level.

  20. Clinical Neuropathology practice news 1-2014: Pyrosequencing meets clinical and analytical performance criteria for routine testing of MGMT promoter methylation status in glioblastoma

    PubMed Central

    Preusser, Matthias; Berghoff, Anna S.; Manzl, Claudia; Filipits, Martin; Weinhäusel, Andreas; Pulverer, Walter; Dieckmann, Karin; Widhalm, Georg; Wöhrer, Adelheid; Knosp, Engelbert; Marosi, Christine; Hainfellner, Johannes A.

    2014-01-01

    Testing of the MGMT promoter methylation status in glioblastoma is relevant for clinical decision making and research applications. Two recent and independent phase III therapy trials confirmed a prognostic and predictive value of the MGMT promoter methylation status in elderly glioblastoma patients. Several methods for MGMT promoter methylation testing have been proposed, but seem to be of limited test reliability. Therefore, and also due to feasibility reasons, translation of MGMT methylation testing into routine use has been protracted so far. Pyrosequencing after prior DNA bisulfite modification has emerged as a reliable, accurate, fast and easy-to-use method for MGMT promoter methylation testing in tumor tissues (including formalin-fixed and paraffin-embedded samples). We performed an intra- and inter-laboratory ring trial which demonstrates a high analytical performance of this technique. Thus, pyrosequencing-based assessment of MGMT promoter methylation status in glioblastoma meets the criteria of high analytical test performance and can be recommended for clinical application, provided that strict quality control is performed. Our article summarizes clinical indications, practical instructions and open issues for MGMT promoter methylation testing in glioblastoma using pyrosequencing. PMID:24359605

  1. Reducing routine vaccination dropout rates: evaluating two interventions in three Kenyan districts, 2014.

    PubMed

    Haji, Adam; Lowther, S; Ngan'ga, Z; Gura, Z; Tabu, C; Sandhu, H; Arvelo, Wences

    2016-02-16

    Globally, vaccine preventable diseases are responsible for nearly 20% of deaths annually among children <5 years old. Worldwide, many children dropout from the vaccination program, are vaccinated late, or incompletely vaccinated. We evaluated the impact of text messaging and sticker reminders to reduce dropouts from the vaccination program. The evaluation was conducted in three selected districts in Kenya: Machakos, Langata and Njoro. Three health facilities were selected in each district, and randomly allocated to send text messages or provide stickers reminding parents to bring their children for second and third dose of pentavalent vaccine, or to the control group (routine reminder) with next appointment date indicated on the well-child booklet. Children aged <12 months presenting for their first dose of pentavalent vaccine were enrolled. A dropout was defined as not returning for vaccination ≥ 2 weeks after scheduled date for third dose of pentavalent vaccine. We calculated dropout rate as a percentage of the difference between first and third pentavalent dose. We enrolled 1,116 children; 372 in each intervention and 372 controls between February and October 2014. Median age was 45 days old (range: 31-99 days), and 574 (51%) were male. There were 136 (12%) dropouts. Thirteen (4%) children dropped out among those who received text messages, 60 (16%) among who received sticker reminders, and 63 (17%) among the controls. Having a caregiver with below secondary education [Odds Ratio (OR) 1.8, 95% Confidence Interval (CI) 1.1-3.2], and residing >5 km from health facility (OR 1.6, CI 1.0-2.7) were associated with higher odds of dropping out. Those who received text messages were less likely to drop out compared to controls (OR 0.2, CI 0.04-0.8). There was no statistical difference between those who received stickers and controls (OR 0.9, CI 0.5-1.6). Text message reminders can reduce vaccination dropout rates in Kenya. We recommend the extended implementation of

  2. Flow Control and Measurement in Electric Propulsion Systems: Towards an AIAA Reference Standard

    NASA Technical Reports Server (NTRS)

    Snyder, John Steven; Baldwin, Jeff; Frieman, Jason D.; Walker, Mitchell L. R.; Hicks, Nathan S.; Polzin, Kurt A.; Singleton, James T.

    2013-01-01

    Accurate control and measurement of propellant flow to a thruster is one of the most basic and fundamental requirements for operation of electric propulsion systems, whether they be in the laboratory or on flight spacecraft. Hence, it is important for the electric propulsion community to have a common understanding of typical methods for flow control and measurement. This paper addresses the topic of propellant flow primarily for the gaseous propellant systems which have dominated laboratory research and flight application over the last few decades, although other types of systems are also briefly discussed. While most flight systems have employed a type of pressure-fed flow restrictor for flow control, both thermal-based and pressure-based mass flow controllers are routinely used in laboratories. Fundamentals and theory of operation of these types of controllers are presented, along with sources of uncertainty associated with their use. Methods of calibration and recommendations for calibration processes are presented. Finally, details of uncertainty calculations are presented for some common calibration methods and for the linear fits to calibration data that are commonly used.

  3. How complete and accurate is meningococcal disease notification?

    PubMed

    Breen, E; Ghebrehewet, S; Regan, M; Thomson, A P J

    2004-12-01

    Effective public health control of meningococcal disease (meningococcal meningitis and septicaemia) is dependent on complete, accurate and speedy notification. Using capture-recapture techniques this study assesses the completeness, accuracy and timeliness of meningococcal notification in a health authority. The completeness of meningococcal disease notification was 94.8% (95% confidence interval 93.2% to 96.2%); 91.2% of cases in 2001 were notified within 24 hours of diagnosis, but 28.0% of notifications in 2001 were false positives. Clinical staff need to be aware of the public health implications of a notification of meningococcal disease, and of failure of, or delay in notification. Incomplete or delayed notification not only leads to inaccurate data collection but also means that important public health measures may not be taken. A clinical diagnosis of meningococcal disease should be carefully considered between the clinician and the consultant in communicable disease control (CCDC). Otherwise, prophylaxis may be given unnecessarily, disease incidence inflated, and the benefits of control measures underestimated. Consultants in communicable disease control (CCDCs), in conjunction with clinical staff, should de-notify meningococcal disease if the diagnosis changes.

  4. Taking medicine at home - create a routine

    MedlinePlus

    ... page: //medlineplus.gov/ency/patientinstructions/000613.htm Taking medicine at home - create a routine To use the ... teeth. Find Ways to Help You Remember Your Medicines You can: Set the alarm on your clock, ...

  5. 10 CFR 71.87 - Routine determinations.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 10 Energy 2 2012-01-01 2012-01-01 false Routine determinations. 71.87 Section 71.87 Energy NUCLEAR...; (c) Each closure device of the packaging, including any required gasket, is properly installed and secured and free of defects; (d) Any system for containing liquid is adequately sealed and has adequate...

  6. 10 CFR 71.87 - Routine determinations.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 10 Energy 2 2011-01-01 2011-01-01 false Routine determinations. 71.87 Section 71.87 Energy NUCLEAR...; (c) Each closure device of the packaging, including any required gasket, is properly installed and secured and free of defects; (d) Any system for containing liquid is adequately sealed and has adequate...

  7. 10 CFR 71.87 - Routine determinations.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 10 Energy 2 2014-01-01 2014-01-01 false Routine determinations. 71.87 Section 71.87 Energy NUCLEAR...; (c) Each closure device of the packaging, including any required gasket, is properly installed and secured and free of defects; (d) Any system for containing liquid is adequately sealed and has adequate...

  8. 10 CFR 71.87 - Routine determinations.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 10 Energy 2 2013-01-01 2013-01-01 false Routine determinations. 71.87 Section 71.87 Energy NUCLEAR...; (c) Each closure device of the packaging, including any required gasket, is properly installed and secured and free of defects; (d) Any system for containing liquid is adequately sealed and has adequate...

  9. 10 CFR 71.87 - Routine determinations.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 10 Energy 2 2010-01-01 2010-01-01 false Routine determinations. 71.87 Section 71.87 Energy NUCLEAR...; (c) Each closure device of the packaging, including any required gasket, is properly installed and secured and free of defects; (d) Any system for containing liquid is adequately sealed and has adequate...

  10. A RCT comparing lumbosacral orthosis to routine physical therapy on postural stability in patients with chronic low back pain.

    PubMed

    Azadinia, Fatemeh; Ebrahimi-Takamjani, Ismail; Kamyab, Mojtaba; Parnianpour, Mohamad; Asgari, Morteza

    2017-01-01

    Background: Poor balance performance and impaired postural control have been frequently reported in patients with low back pain. However, postural control is rarely monitored during the course of treatment even though poor postural control may contribute to chronicity and recurrence of symptoms. Therefore, the present study aimed at investigating the effect of a nonextensible lumbosacral orthosis (LSO) versus routine physical therapy on postural stability of patients with nonspecific chronic low back pain. Methods: This was a randomized controlled trial conducted between November 2015 and May 2016 at the outpatient physical therapy clinic of the School of Rehabilitation Sciences. Patients with nonspecific chronic low back pain aged 20 to 55 years were randomly allocated to the intervention and control groups. Both groups received 8 sessions of physical therapy twice weekly for 4 weeks. The intervention group received nonextensible LSO in addition to routine physical therapy. Pain intensity, functional disability, fear of movement/ (re)injury, and postural stability in 3 levels of postural difficulty were measured before and after 4 weeks of intervention. A 2×2×3 mixed model of analysis of variance (ANOVA) was used to determine the main and interactive effects of the 3 factors including group, time, and postural difficulty conditions for each variable of postural stability. Results: The LSO and control groups displayed significant improvement in postural stability at the most difficult postural task conditions (P-value for 95% area ellipse was 0.003; and for phase plane, the mean total velocity and standard deviation of velocity was <0.001). Both groups exhibited a decrease in pain intensity, Oswestry Disability Index, and Tampa Scale of Kinesiophobia after 4 weeks of intervention. A significant difference between groups was found only for functional disability, with greater improvement in the orthosis group (t = 3.60, P<0.001). Conclusion: Both routine physical

  11. A RCT comparing lumbosacral orthosis to routine physical therapy on postural stability in patients with chronic low back pain

    PubMed Central

    Azadinia, Fatemeh; Ebrahimi-Takamjani, Ismail; Kamyab, Mojtaba; Parnianpour, Mohamad; Asgari, Morteza

    2017-01-01

    Background: Poor balance performance and impaired postural control have been frequently reported in patients with low back pain. However, postural control is rarely monitored during the course of treatment even though poor postural control may contribute to chronicity and recurrence of symptoms. Therefore, the present study aimed at investigating the effect of a nonextensible lumbosacral orthosis (LSO) versus routine physical therapy on postural stability of patients with nonspecific chronic low back pain. Methods: This was a randomized controlled trial conducted between November 2015 and May 2016 at the outpatient physical therapy clinic of the School of Rehabilitation Sciences. Patients with nonspecific chronic low back pain aged 20 to 55 years were randomly allocated to the intervention and control groups. Both groups received 8 sessions of physical therapy twice weekly for 4 weeks. The intervention group received nonextensible LSO in addition to routine physical therapy. Pain intensity, functional disability, fear of movement/ (re)injury, and postural stability in 3 levels of postural difficulty were measured before and after 4 weeks of intervention. A 2×2×3 mixed model of analysis of variance (ANOVA) was used to determine the main and interactive effects of the 3 factors including group, time, and postural difficulty conditions for each variable of postural stability. Results: The LSO and control groups displayed significant improvement in postural stability at the most difficult postural task conditions (P-value for 95% area ellipse was 0.003; and for phase plane, the mean total velocity and standard deviation of velocity was <0.001). Both groups exhibited a decrease in pain intensity, Oswestry Disability Index, and Tampa Scale of Kinesiophobia after 4 weeks of intervention. A significant difference between groups was found only for functional disability, with greater improvement in the orthosis group (t = 3.60, P<0.001). Conclusion: Both routine physical

  12. Individual Differences in Accurately Judging Personality From Text.

    PubMed

    Hall, Judith A; Goh, Jin X; Mast, Marianne Schmid; Hagedorn, Christian

    2016-08-01

    This research examines correlates of accuracy in judging Big Five traits from first-person text excerpts. Participants in six studies were recruited from psychology courses or online. In each study, participants performed a task of judging personality from text and performed other ability tasks and/or filled out questionnaires. Participants who were more accurate in judging personality from text were more likely to be female; had personalities that were more agreeable, conscientious, and feminine, and less neurotic and dominant (all controlling for participant gender); scored higher on empathic concern; self-reported more interest in, and attentiveness to, people's personalities in their daily lives; and reported reading more for pleasure, especially fiction. Accuracy was not associated with SAT scores but had a significant relation to vocabulary knowledge. Accuracy did not correlate with tests of judging personality and emotion based on audiovisual cues. This research is the first to address individual differences in accurate judgment of personality from text, thus adding to the literature on correlates of the good judge of personality. © 2015 Wiley Periodicals, Inc.

  13. Check-off logs for routine equipment maintenance.

    PubMed

    Brewster, M A; Carver, P H; Randolph, B

    1995-12-01

    The regulatory requirement for appropriate routine instrument maintenance documentation is approached by laboratories in numerous ways. Standard operating procedures (SOPs) may refer to maintenance listed in instrument manuals, may indicate "periodic" performance of an action, or may indicate specific tasks to be performed at certain frequencies. The Quality Assurance Unit (QAU) task of assuring the performance of these indicated maintenance tasks can be extremely laborious if these records are merged with other analysis records. Further, the lack of written maintenance schedules often leads to omission of infrequently performed tasks. We recommend creation of routine maintenance check-off logs for instruments with tasks grouped by frequency of expected performance. Usage of such logs should result in better laboratory compliance with SOPs and the compliance can be readily monitored by QAU or by regulatory agencies.

  14. An automated workflow for patient-specific quality control of contour propagation

    NASA Astrophysics Data System (ADS)

    Beasley, William J.; McWilliam, Alan; Slevin, Nicholas J.; Mackay, Ranald I.; van Herk, Marcel

    2016-12-01

    Contour propagation is an essential component of adaptive radiotherapy, but current contour propagation algorithms are not yet sufficiently accurate to be used without manual supervision. Manual review of propagated contours is time-consuming, making routine implementation of real-time adaptive radiotherapy unrealistic. Automated methods of monitoring the performance of contour propagation algorithms are therefore required. We have developed an automated workflow for patient-specific quality control of contour propagation and validated it on a cohort of head and neck patients, on which parotids were outlined by two observers. Two types of error were simulated—mislabelling of contours and introducing noise in the scans before propagation. The ability of the workflow to correctly predict the occurrence of errors was tested, taking both sets of observer contours as ground truth, using receiver operator characteristic analysis. The area under the curve was 0.90 and 0.85 for the observers, indicating good ability to predict the occurrence of errors. This tool could potentially be used to identify propagated contours that are likely to be incorrect, acting as a flag for manual review of these contours. This would make contour propagation more efficient, facilitating the routine implementation of adaptive radiotherapy.

  15. Predictors and variation of routine home discharge in critically ill adults with cystic fibrosis.

    PubMed

    Oud, Lavi; Chan, Yiu Ming

    2018-06-01

    The short-term outcomes of patients with cystic fibrosis (CF) surviving critical illness were not examined systematically. To determine the factors associated with and variation in rates of routine home discharge among ICU-managed adult CF patients. Predictors of routine home discharge and its hospital-level variation were examined in ICU-managed adults with cystic fibrosis in Texas during 2004-2013. Older age, rural residence, and severity of illness decreased odds of routine home discharge, while hospitalization in facilities accredited as part of the Cystic Fibrosis Foundation Care Center Network nearly doubled the odds of routine home discharge. The median (interquartile) adjusted rate of routine home discharge was 62.0% (31.5-82.5). The identified determinants of routine home discharge can inform clinical decision-making, while the demonstrated wide variation in adjusted across-hospital rates of routine home discharge of ICU-managed adults with CF can provide benchmark data for future quality improvement efforts. Published by Elsevier Inc.

  16. Guidelines for routine maintenance of concrete pavements.

    DOT National Transportation Integrated Search

    2008-04-01

    These guidelines were prepared from research conducted for the Texas Department of Transportation : (TxDOT) on two projects. The current project, which determined the distresses and categories, was project 0- : 5821 Develop Guidelines for Routine ...

  17. The clock gene Period1 regulates innate routine behaviour in mice

    PubMed Central

    Bechstein, Philipp; Rehbach, Nils-Jörn; Yuhasingham, Gowzekan; Schürmann, Christoph; Göpfert, Melanie; Kössl, Manfred; Maronde, Erik

    2014-01-01

    Laboratory mice are well capable of performing innate routine behaviour programmes necessary for courtship, nest-building and exploratory activities although housed for decades in animal facilities. We found that in mice inactivation of the clock gene Period1 profoundly changes innate routine behaviour programmes like those necessary for courtship, nest building, exploration and learning. These results in wild-type and Period1 mutant mice, together with earlier findings on courtship behaviour in wild-type and period-mutant Drosophila melanogaster, suggest a conserved role of Period-genes on innate routine behaviour. Additionally, both per-mutant flies and Period1-mutant mice display spatial learning and memory deficits. The profound influence of Period1 on routine behaviour programmes in mice, including female partner choice, may be independent of its function as a circadian clock gene, since Period1-deficient mice display normal circadian behaviour. PMID:24598427

  18. Physicians slow to e-mail routinely with patients.

    PubMed

    Boukus, Ellyn R; Grossman, Joy M; O'Malley, Ann S

    2010-10-01

    Some experts view e-mail between physicians and patients as a potential tool to improve physician-patient communication and, ultimately, patient care. Despite indications that many patients want to e-mail their physicians, physician adoption and use of e-mail with patients remains uncommon--only 6.7 percent of office-based physicians routinely e-mailed patients in 2008, according to a new national study from the Center for Studying Health System Change (HSC). Overall, about one-third of office-based physicians reported that information technology (IT) was available in their practice for e-mailing patients about clinical issues. Of those, fewer than one in five reported using e-mail with patients routinely; the remaining physicians were roughly evenly split between occasional users and non-users. Physicians in practices with access to electronic medical records and those working in health maintenance organizations (HMOs) or medical school settings were more likely to adopt and use e-mail to communicate with patients compared with other physicians. However, even among the highest users--physicians in group/staff-model HMOs--only 50.6 percent reported routinely e-mailing patients.

  19. Routine Work Environment Stress and PTSD Symptoms in Police Officers

    PubMed Central

    Maguen, Shira; Metzler, Thomas J.; McCaslin, Shannon E.; Inslicht, Sabra S.; Henn-Haase, Clare; Neylan, Thomas C.; Marmar, Charles R.

    2013-01-01

    This study examined the relationship between routine work environment stress and posttraumatic stress disorder (PTSD) symptoms in a sample of police officers (N = 180) who were first assessed during academy training and reassessed 1-year later. In a model that included gender, ethnicity, traumatic exposure prior to entering the academy, current negative life events, and critical incident exposure over the last year, routine work environment stress was most strongly associated with PTSD symptoms. We also found that routine work environment stress mediated the relationship between critical incident exposure and PTSD symptoms and between current negative life events and PTSD symptoms. Ensuring that the work environment is functioning optimally protects against the effects of duty-related critical incidents and negative life events outside police service. PMID:19829204

  20. Sequencing-based breast cancer diagnostics as an alternative to routine biomarkers.

    PubMed

    Rantalainen, Mattias; Klevebring, Daniel; Lindberg, Johan; Ivansson, Emma; Rosin, Gustaf; Kis, Lorand; Celebioglu, Fuat; Fredriksson, Irma; Czene, Kamila; Frisell, Jan; Hartman, Johan; Bergh, Jonas; Grönberg, Henrik

    2016-11-30

    Sequencing-based breast cancer diagnostics have the potential to replace routine biomarkers and provide molecular characterization that enable personalized precision medicine. Here we investigate the concordance between sequencing-based and routine diagnostic biomarkers and to what extent tumor sequencing contributes clinically actionable information. We applied DNA- and RNA-sequencing to characterize tumors from 307 breast cancer patients with replication in up to 739 patients. We developed models to predict status of routine biomarkers (ER, HER2,Ki-67, histological grade) from sequencing data. Non-routine biomarkers, including mutations in BRCA1, BRCA2 and ERBB2(HER2), and additional clinically actionable somatic alterations were also investigated. Concordance with routine diagnostic biomarkers was high for ER status (AUC = 0.95;AUC(replication) = 0.97) and HER2 status (AUC = 0.97;AUC(replication) = 0.92). The transcriptomic grade model enabled classification of histological grade 1 and histological grade 3 tumors with high accuracy (AUC = 0.98;AUC(replication) = 0.94). Clinically actionable mutations in BRCA1, BRCA2 and ERBB2(HER2) were detected in 5.5% of patients, while 53% had genomic alterations matching ongoing or concluded breast cancer studies. Sequencing-based molecular profiling can be applied as an alternative to histopathology to determine ER and HER2 status, in addition to providing improved tumor grading and clinically actionable mutations and molecular subtypes. Our results suggest that sequencing-based breast cancer diagnostics in a near future can replace routine biomarkers.

  1. Contextualising renal patient routines: Everyday space-time contexts, health service access, and wellbeing.

    PubMed

    McQuoid, Julia; Jowsey, Tanisha; Talaulikar, Girish

    2017-06-01

    Stable routines are key to successful illness self-management for the growing number of people living with chronic illness around the world. Yet, the influence of chronically ill individuals' everyday contexts in supporting routines is poorly understood. This paper takes a space-time geographical approach to explore the everyday space-time contexts and routines of individuals with chronic kidney disease (CKD). We ask: what is the relationship between renal patients' space-time contexts and their ability to establish and maintain stable routines, and, what role does health service access play in this regard? We draw from a qualitative case study of 26 individuals with CKD in Australia. Data comprised self-reported two day participant diaries and semi-structured interviews. Thematic analysis of interview transcripts was guided by an inductive-deductive approach. We examined the embeddedness of routines within the space-time contexts of participants' everyday lives. We found that participants' everyday space-time contexts were highly complex, especially for those receiving dialysis and/or employed, making routines difficult to establish and vulnerable to disruption. Health service access helped shape participants' everyday space-time contexts, meaning that incidences of unpredictability in accessing health services set-off 'ripple effects' within participants' space-time contexts, disrupting routines and making everyday life negotiation more difficult. The ability to absorb ripple effects from unpredictable health services without disrupting routines varied by space-time context. Implications of these findings for the deployment of the concept of routine in health research, the framing of patient success in self-managing illness, and health services design are discussed. In conclusion, efforts to understand and support individuals in establishing and maintaining routines that support health and wellbeing can benefit from approaches that contextualise and de

  2. Contextualising renal patient routines: Everyday space-time contexts, health service access, and wellbeing

    PubMed Central

    McQuoid, Julia; Jowsey, Tanisha; Talaulikar, Girish

    2017-01-01

    Stable routines are key to successful illness self-management for the growing number of people living with chronic illness around the world. Yet, the influence of chronically ill individuals’ everyday contexts in supporting routines is poorly understood. This paper takes a space-time geographical approach to explore the everyday space-time contexts and routines of individuals with chronic kidney disease (CKD). We ask: what is the relationship between renal patients’ space-time contexts and their ability to establish and maintain stable routines, and, what role does health service access play in this regard? We draw from a qualitative case study of 26 individuals with CKD in Australia. Data comprised self-reported two day participant diaries and semi-structured interviews. Thematic analysis of interview transcripts was guided by an inductive-deductive approach. We examined the embeddedness of routines within the space-time contexts of participants’ everyday lives. We found that participants’ everyday space-time contexts were highly complex, especially for those receiving dialysis and/or employed, making routines difficult to establish and vulnerable to disruption. Health service access helped shape participants’ everyday space-time contexts, meaning that incidences of unpredictability in accessing health services set-off ‘ripple effects’ within participants’ space-time contexts, disrupting routines and making everyday life negotiation more difficult. The ability to absorb ripple effects from unpredictable health services without disrupting routines varied by space-time context. Implications of these findings for the deployment of the concept of routine in health research, the framing of patient success in self-managing illness, and health services design are discussed. In conclusion, efforts to understand and support individuals in establishing and maintaining routines that support health and wellbeing can benefit from approaches that contextualise

  3. Learning, Dynamic Capabilities and Operating Routines: A Consumer Package Goods Company

    ERIC Educational Resources Information Center

    Swift, Peter E.; Hwang, Alvin

    2008-01-01

    Purpose: This paper seeks to present organizational learning processes of knowledge accumulation, articulation, codification and subsequent routine development in a marketing services organization where judgment and rules of thumb were more the norm than codified knowledge and explicit routines. The case illustrates how organizational learning…

  4. A MAP read-routine for IBM 7094 Fortran II binary tapes

    Treesearch

    Robert S. Helfman

    1966-01-01

    Two MAP (Macro Assembly Program) language routines are descrived. They permit Fortran IV programs to read binary tapes generated by Fortran II programs, on the IBM 7090 and 7094 computers. One routine is for use with 7040/44-IBSYS, the other for 7090/94-IBSYS.

  5. Text-message reminders increase uptake of routine breast screening appointments: a randomised controlled trial in a hard-to-reach population.

    PubMed

    Kerrison, R S; Shukla, H; Cunningham, D; Oyebode, O; Friedman, E

    2015-03-17

    There is a need for interventions to promote uptake of breast screening throughout Europe. We performed a single-blind randomised controlled trial to test whether text-message reminders were effective. Two thousand two hundred and forty women receiving their first breast screening invitation were included in the study and randomly assigned in a 1 : 1 ratio to receive either a normal invitation only (n=1118) or a normal invitation plus a text-message reminder 48 h before their appointment (n=1122). In the intention-to-treat analysis, uptake of breast screening was 59.1% among women in the normal invitation group and 64.4% in the text-message reminder group (χ(2)=6.47, odds ratio (OR): 1.26, 95% confidence intervals (CI): 1.05-1.48, P=0.01). Of the 1122 women assigned to the text-message reminder group, only 456 (41%) had a mobile number recorded by their GP and were thereby sent a text. In the per-protocol analysis, uptake by those in the control group who had a mobile number recorded on the GP system was 59.77% and by those in the intervention group who were sent a reminder 71.7% (χ(2)=14.12, OR=1.71, 95% CI=1.29-2.26, P<0.01). Sending women a text-message reminder before their first routine breast screening appointment significantly increased attendance. This information can be used to allocate resources efficiently to improve uptake without exacerbating social inequalities.

  6. Routine human-competitive machine intelligence by means of genetic programming

    NASA Astrophysics Data System (ADS)

    Koza, John R.; Streeter, Matthew J.; Keane, Martin

    2004-01-01

    Genetic programming is a systematic method for getting computers to automatically solve a problem. Genetic programming starts from a high-level statement of what needs to be done and automatically creates a computer program to solve the problem. The paper demonstrates that genetic programming (1) now routinely delivers high-return human-competitive machine intelligence; (2) is an automated invention machine; (3) can automatically create a general solution to a problem in the form of a parameterized topology; and (4) has delivered a progression of qualitatively more substantial results in synchrony with five approximately order-of-magnitude increases in the expenditure of computer time. Recent results involving the automatic synthesis of the topology and sizing of analog electrical circuits and controllers demonstrate these points.

  7. Chapter IX. Bedtime Routines in Toddlerhood: Prevalence, Consistency, and Associations with Nighttime Sleep

    PubMed Central

    Staples, Angela D.; Bates, John E.; Petersen, Isaac T.

    2016-01-01

    The ability to transition from wakefulness to sleep is one of the most important tasks in the development of sleep during early childhood. Although establishing regular bedtime routines for children with sleep problems can be clinically effective in reducing the number of signaled night awakenings and increasing amounts of sleep, it is unclear whether a regular bedtime routine would be associated with either the frequency of signaled night awakenings or nightly sleep minutes in a non-clinical sample of children. This study examined the role of a regular bedtime routine on the development of sleep regulation and consolidation in a community sample of young children. Adherence to a bedtime routine was concurrently associated with a greater amount of nightly sleep at 36 and 42 months. In addition, adherence to a bedtime routine predicted an increase in nightly sleep minutes over a six-month period. Finally, this study demonstrated that adherence to a bedtime routine was particularly supportive of developmental gains for children of mothers who used consistent parenting practices during the day. PMID:25704740

  8. Changing Family Routines at Kindergarten Entry Predict Biomarkers of Parental Stress

    ERIC Educational Resources Information Center

    DeCaro, Jason A.; Worthman, Carol M.

    2011-01-01

    This study tested associations among parenting stress prior to a child's kindergarten entry, the sustainability of family routines, and biomarkers of stress among parents following the kindergarten transition. Parents (N = 51) with higher prekindergarten scores on the Parenting Stress Index Short Form reported lower Family Routines Inventory…

  9. Benchmarking routine psychological services: a discussion of challenges and methods.

    PubMed

    Delgadillo, Jaime; McMillan, Dean; Leach, Chris; Lucock, Mike; Gilbody, Simon; Wood, Nick

    2014-01-01

    Policy developments in recent years have led to important changes in the level of access to evidence-based psychological treatments. Several methods have been used to investigate the effectiveness of these treatments in routine care, with different approaches to outcome definition and data analysis. To present a review of challenges and methods for the evaluation of evidence-based treatments delivered in routine mental healthcare. This is followed by a case example of a benchmarking method applied in primary care. High, average and poor performance benchmarks were calculated through a meta-analysis of published data from services working under the Improving Access to Psychological Therapies (IAPT) Programme in England. Pre-post treatment effect sizes (ES) and confidence intervals were estimated to illustrate a benchmarking method enabling services to evaluate routine clinical outcomes. High, average and poor performance ES for routine IAPT services were estimated to be 0.91, 0.73 and 0.46 for depression (using PHQ-9) and 1.02, 0.78 and 0.52 for anxiety (using GAD-7). Data from one specific IAPT service exemplify how to evaluate and contextualize routine clinical performance against these benchmarks. The main contribution of this report is to summarize key recommendations for the selection of an adequate set of psychometric measures, the operational definition of outcomes, and the statistical evaluation of clinical performance. A benchmarking method is also presented, which may enable a robust evaluation of clinical performance against national benchmarks. Some limitations concerned significant heterogeneity among data sources, and wide variations in ES and data completeness.

  10. Development and Validation of the Pediatric Diabetes Routines Questionnaire for Adolescents.

    PubMed

    Pierce, Jessica S; Jordan, Sara S; Arnau, Randolph C

    2018-04-06

    This study describes the development and psychometric evaluation of an adolescent self-report version of the Pediatric Diabetes Routines Questionnaire (PDRQ:A), a measure of diabetes-specific routines for youth with type 1 diabetes, and further validation of the parent-version (PDRQ:P) in an adolescent sample. Participants included 120 parent-adolescent dyads (ages 12-17) and an additional 24 parents who completed measures of diabetes-specific adolescent routines, general adolescent routines, diabetes self-care, and family support of youth diabetes care. The PDRQ:P/A demonstrated good internal consistency, test-retest reliability, and parent-child agreement, and adequate validity coefficients. Confirmatory factor analysis supported a one-factor model. Promising results were obtained. The PDRQ:P/A is a clinically feasible parent- and self-report measure that can provide valuable information regarding how frequently adolescents engage in their diabetes management tasks in a consistent manner. Addition of an adolescent report format will enhance the utility of the measure for clinical and research use.

  11. Eigenvalue routines in NASTRAN: A comparison with the Block Lanczos method

    NASA Technical Reports Server (NTRS)

    Tischler, V. A.; Venkayya, Vipperla B.

    1993-01-01

    The NASA STRuctural ANalysis (NASTRAN) program is one of the most extensively used engineering applications software in the world. It contains a wealth of matrix operations and numerical solution techniques, and they were used to construct efficient eigenvalue routines. The purpose of this paper is to examine the current eigenvalue routines in NASTRAN and to make efficiency comparisons with a more recent implementation of the Block Lanczos algorithm by Boeing Computer Services (BCS). This eigenvalue routine is now available in the BCS mathematics library as well as in several commercial versions of NASTRAN. In addition, CRAY maintains a modified version of this routine on their network. Several example problems, with a varying number of degrees of freedom, were selected primarily for efficiency bench-marking. Accuracy is not an issue, because they all gave comparable results. The Block Lanczos algorithm was found to be extremely efficient, in particular, for very large size problems.

  12. Episodic Contributions to Sequential Control: Learning from a Typist's Touch

    ERIC Educational Resources Information Center

    Crump, Matthew J. C.; Logan, Gordon D.

    2010-01-01

    Sequential control over routine action is widely assumed to be controlled by stable, highly practiced representations. Our findings demonstrate that the processes controlling routine actions in the domain of skilled typing can be flexibly manipulated by memory processes coding recent experience with typing particular words and letters. In two…

  13. A Nursing Intelligence System to Support Secondary Use of Nursing Routine Data

    PubMed Central

    Rauchegger, F.; Ammenwerth, E.

    2015-01-01

    Summary Background Nursing care is facing exponential growth of information from nursing documentation. This amount of electronically available data collected routinely opens up new opportunities for secondary use. Objectives To present a case study of a nursing intelligence system for reusing routinely collected nursing documentation data for multiple purposes, including quality management of nursing care. Methods The SPIRIT framework for systematically planning the reuse of clinical routine data was leveraged to design a nursing intelligence system which then was implemented using open source tools in a large university hospital group following the spiral model of software engineering. Results The nursing intelligence system is in routine use now and updated regularly, and includes over 40 million data sets. It allows the outcome and quality analysis of data related to the nursing process. Conclusions Following a systematic approach for planning and designing a solution for reusing routine care data appeared to be successful. The resulting nursing intelligence system is useful in practice now, but remains malleable for future changes. PMID:26171085

  14. Methods to improve routine bioassay monitoring for freshly separated, poorly transported plutonium

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

    Bihl, D.E.; Lynch, T.P.; Carbaugh, E.H.

    1988-09-01

    Several human cases involving inhalation of plutonium oxide at Hanford have shown clearance half-times from the lung that are much longer than the 500-day half-time recommended for class Y plutonium in Publication 30 of the International Commission on Radiological Protection(ICRP). The more tenaciously retained material is referred to as super class Y plutonium. The ability to detect super class Y plutonium by current routine bioassay measurements is shown to be poor. Pacific Northwest Laboratory staff involved in the Hanford Internal Dosimetry Program investigated four methods to se if improvements in routine monitoring of workers for fresh super class Y plutoniummore » are feasible. The methods were lung counting, urine sampling, fecal sampling, and use of diethylenetriaminepentaacetate (DTPA) to enhance urinary excretion. Use of DTPA was determined to be not feasible. Routine fecal sampling was found to be feasible but not recommended. Recommendations were made to improve the detection level for routine annual urinalysis and routine annual lung counting. 12 refs., 9 figs., 7 tabs.« less

  15. Routine use of humidification with nasal continuous positive airway pressure.

    PubMed

    Worsnop, C J; Miseski, S; Rochford, P D

    2010-09-01

    Heated humidification can reduce nasal symptoms caused by continuous positive airway pressure (CPAP) treatment, but its routine use has not been studied over the medium term in a randomized controlled trial. The aim of this study is to determine if heated humidification would reduce nasal symptoms and improve adherence with CPAP treatment in all patients with sleep apnoea irrespective of whether they had nasal symptoms initially. A randomized, parallel group design. Patients were treated for 3 months with a Fisher & Paykel HC201 pump with built-in heated humidification, or with the heater disabled and without water. Adherence was measured with a timer built into the pumps. Nasal symptoms were measured with a 10-cm visual analogue scale. There were 25 in the humidification group and 29 in the non-humidification group. After 12 weeks mean (standard deviation) adherence with CPAP was 4.7 (2.4) and 4.5 (2.2) hours per night respectively. Nasal symptoms that were reduced were nose blocked* 6 (12), 18 (26); sneezing* 4 (8), 15 (25); dry nose* 8 (12), 24 (33); stuffy nose* 7 (14), 22(31); dry mouth* 13 (18), 33(36); and runny nose* 6 (17), 14 (29). Parameters marked with an asterisk '*' had P < 0.05 with t-tests. The routine use of heated humidification with CPAP in all patients with sleep apnoea reduced nasal symptoms, but did not improve adherence. © 2010 The Authors. Internal Medicine Journal © 2010 Royal Australasian College of Physicians.

  16. Explaining variation in hospice visit intensity for routine home care.

    PubMed

    Stearns, Sally C; Sheingold, Steven; Zuckerman, Rachael B

    2014-01-01

    Medicare pays a flat per diem rate by level of hospice service without case-mix adjustment, although previous research shows that visit intensity varies considerably over the course of hospice episodes. Concerns pertain to the inherent financial incentives for routine home care, the most frequently used level, and whether payment efficiency can be improved using case-mix adjustment. The aim of this study was to assess variation in hospice visit intensity during hospice episodes by patient, hospice, and episode characteristics to inform policy discussions regarding hospice payment methods. This observational study used Medicare claims for hospice episodes in 2010. Multiple observations were constructed per episode phase (eg, days 1-14, 15-30, etc.). Episode phase and observed characteristics were regressed on average routine home care visit intensity per day; patient and hospice fixed effects controlled for unobserved characteristics. Visit intensity was constructed using national wages to weight visits by provider type. Observed patient characteristics included age, sex, race, diagnoses, venue of care, use of other hospice levels of care, and discharge status; hospice characteristics included ownership, affiliation, size, and urban/state location. Visit intensity varied substantially by episode phase. This pattern was largely invariant to observed patient and hospice characteristics, which explained <4% of variation in visit intensity per day after adjusting for episode phase. Unobserved patient characteristics explained approximately 85% of remaining variation. These results show that case-mix adjustment based on commonly observed factors would only minimally improve hospice payment methodology.

  17. Control of muscle relaxation during anesthesia: a novel approach for clinical routine.

    PubMed

    Stadler, Konrad S; Schumacher, Peter M; Hirter, Sibylle; Leibundgut, Daniel; Bouillon, Thomas W; Glattfelder, Adolf H; Zbinden, Alex M

    2006-03-01

    During general anesthesia drugs are administered to provide hypnosis, ensure analgesia, and skeletal muscle relaxation. In this paper, the main components of a newly developed controller for skeletal muscle relaxation are described. Muscle relaxation is controlled by administration of neuromuscular blocking agents. The degree of relaxation is assessed by supramaximal train-of-four stimulation of the ulnar nerve and measuring the electromyogram response of the adductor pollicis muscle. For closed-loop control purposes, a physiologically based pharmacokinetic and pharmacodynamic model of the neuromuscular blocking agent mivacurium is derived. The model is used to design an observer-based state feedback controller. Contrary to similar automatic systems described in the literature this controller makes use of two different measures obtained in the train-of-four measurement to maintain the desired level of relaxation. The controller is validated in a clinical study comparing the performance of the controller to the performance of the anesthesiologist. As presented, the controller was able to maintain a preselected degree of muscle relaxation with excellent precision while minimizing drug administration. The controller performed at least equally well as the anesthesiologist.

  18. Evaluation of routine enteric pathogens in hospitalized patients: A Canadian perspective

    PubMed Central

    Gough, Kevin; Alfa, Michelle; Harding, Godfrey

    1996-01-01

    Diarrhea is a frequently encountered problem in hospitalized patients. Since nosocomial spread of routine enteric pathogens such as Salmonella species, Shigella species, Campylobacter species and Escherichia coli O:157 H:7 seldom occurs, testing for these organisms in patients hospitalized for longer than three days has been questioned. The goal of this study was to determine the length of hospitalization preceding detection of routine enteric pathogens and Clostridium difficile cytotoxin, and to develop guidelines for enteric cultures from hospitalized patients. The enteric pathogens detected in 1991 were C difficile toxin B(+), 77%; Campylobacter species, 10%; Salmonella species, 9%; E coli O:157 H:7, 3%; and Shigella species, 1%. For 1992, these numbers were 86%, 9%, 3%, 2% and 0%, respectively. None of the routine enteric pathogens isolated in 1991 or 1992 was detected in patients after their second day of hospitalization. Routine cultures for enteric pathogens on hospitalized patients were eliminated in February 1993, and physician ordering practices were monitored. With the exception of one campylobacter isolate per year, all routine enteric pathogens isolated in 1993 and 1994 were detected by the second day of hospitalization. Compliance with the changed protocol was 76% measured over a four-month period in 1993 and 74% over the year 1994. Savings of $3,648.10 were associated with rejecting 191 ‘inappropriate’ specimens in 1994. It was concluded that routine enteric cultures are unnecessary for patients hospitalized more than two days, and that appreciable financial savings can be achieved if revised protocols for processing stool cultures are instituted. However, when enteric protocol changes are in place compliance must be evaluated to ensure appropriate utilization. PMID:22514438

  19. Should we reconsider the routine use of placebo controls in clinical research?

    PubMed

    Avins, Andrew L; Cherkin, Daniel C; Sherman, Karen J; Goldberg, Harley; Pressman, Alice

    2012-04-27

    Modern clinical-research practice favors placebo controls over usual-care controls whenever a credible placebo exists. An unrecognized consequence of this preference is that clinicians are more limited in their ability to provide the benefits of the non-specific healing effects of placebos in clinical practice. We examined the issues in choosing between placebo and usual-care controls. We considered why placebo controls place constraints on clinicians and the trade-offs involved in the choice of control groups. We find that, for certain studies, investigators should consider usual-care controls, even if an adequate placebo is available. Employing usual-care controls would be of greatest value for pragmatic trials evaluating treatments to improve clinical care and for which threats to internal validity can be adequately managed without a placebo-control condition. Intentionally choosing usual-care controls, even when a satisfactory placebo exists, would allow clinicians to capture the value of non-specific therapeutic benefits that are common to all interventions. The result could be more effective, patient-centered care that makes the best use of both specific and non-specific benefits of medical interventions.

  20. Cultural Responsiveness and Routines: When Center and Home Don't Match

    ERIC Educational Resources Information Center

    Gonzalez-Mena, Janet

    2010-01-01

    This article discusses cultural responsiveness and routines of child care centers that do not match what families are accustomed to at home. It can be difficult to discuss cultural differences in some routine caregiving activities because of the standards, rules, regulations, best practices, and health concerns that those trained in early…

  1. Accurate and Standardized Coronary Wave Intensity Analysis.

    PubMed

    Rivolo, Simone; Patterson, Tiffany; Asrress, Kaleab N; Marber, Michael; Redwood, Simon; Smith, Nicolas P; Lee, Jack

    2017-05-01

    Coronary wave intensity analysis (cWIA) has increasingly been applied in the clinical research setting to distinguish between the proximal and distal mechanical influences on coronary blood flow. Recently, a cWIA-derived clinical index demonstrated prognostic value in predicting functional recovery postmyocardial infarction. Nevertheless, the known operator dependence of the cWIA metrics currently hampers its routine application in clinical practice. Specifically, it was recently demonstrated that the cWIA metrics are highly dependent on the chosen Savitzky-Golay filter parameters used to smooth the acquired traces. Therefore, a novel method to make cWIA standardized and automatic was proposed and evaluated in vivo. The novel approach combines an adaptive Savitzky-Golay filter with high-order central finite differencing after ensemble-averaging the acquired waveforms. Its accuracy was assessed using in vivo human data. The proposed approach was then modified to automatically perform beat wise cWIA. Finally, the feasibility (accuracy and robustness) of the method was evaluated. The automatic cWIA algorithm provided satisfactory accuracy under a wide range of noise scenarios (≤10% and ≤20% error in the estimation of wave areas and peaks, respectively). These results were confirmed when beat-by-beat cWIA was performed. An accurate, standardized, and automated cWIA was developed. Moreover, the feasibility of beat wise cWIA was demonstrated for the first time. The proposed algorithm provides practitioners with a standardized technique that could broaden the application of cWIA in the clinical practice as enabling multicenter trials. Furthermore, the demonstrated potential of beatwise cWIA opens the possibility investigating the coronary physiology in real time.

  2. Variable-pulse switching circuit accurately controls solenoid-valve actuations

    NASA Technical Reports Server (NTRS)

    Gillett, J. D.

    1967-01-01

    Solid state circuit generating adjustable square wave pulses of sufficient power operates a 28 volt dc solenoid valve at precise time intervals. This circuit is used for precise time control of fluid flow in combustion experiments.

  3. Examining the cost of delivering routine immunization in Honduras.

    PubMed

    Janusz, Cara Bess; Castañeda-Orjuela, Carlos; Molina Aguilera, Ida Berenice; Felix Garcia, Ana Gabriela; Mendoza, Lourdes; Díaz, Iris Yolanda; Resch, Stephen C

    2015-05-07

    Many countries have introduced new vaccines and expanded their immunization programs to protect additional risk groups, thus raising the cost of routine immunization delivery. Honduras recently adopted two new vaccines, and the country continues to broaden the reach of its program to adolescents and adults. In this article, we estimate and examine the economic cost of the Honduran routine immunization program for the year 2011. The data were gathered from a probability sample of 71 health facilities delivering routine immunization, as well as 8 regional and 1 central office of the national immunization program. Data were collected on vaccinations delivered, staff time dedicated to the program, cold chain equipment and upkeep, vehicle use, infrastructure, and other recurrent and capital costs at each health facility and administrative office. Annualized economic costs were estimated from a modified societal perspective and reported in 2011 US dollars. With the addition of rotavirus and pneumococcal conjugate vaccines, the total cost for routine immunization delivery in Honduras for 2011 was US$ 32.5 million. Vaccines and related supplies accounted for 23% of the costs. Labor, cold chain, and vehicles represented 54%, 4%, and 1%, respectively. At the facility level, the non-vaccine system costs per dose ranged widely, from US$ 25.55 in facilities delivering fewer than 500 doses per year to US$ 2.84 in facilities with volume exceeding 10,000 doses per year. Cost per dose was higher in rural facilities despite somewhat lower wage rates for health workers in these settings; this appears to be driven by lower demand for services per health worker in sparsely populated areas, rather than increased cost of outreach. These more-precise estimates of the operational costs to deliver routine immunizations provide program managers with important information for mobilizing resources to help sustain the program and for improving annual planning and budgeting as well as longer

  4. Quick foot placement adjustments during gait are less accurate in individuals with focal cerebellar lesions.

    PubMed

    Hoogkamer, Wouter; Potocanac, Zrinka; Van Calenbergh, Frank; Duysens, Jacques

    2017-10-01

    Online gait corrections are frequently used to restore gait stability and prevent falling. They require shorter response times than voluntary movements which suggests that subcortical pathways contribute to the execution of online gait corrections. To evaluate the potential role of the cerebellum in these pathways we tested the hypotheses that online gait corrections would be less accurate in individuals with focal cerebellar damage than in neurologically intact controls and that this difference would be more pronounced for shorter available response times and for short step gait corrections. We projected virtual stepping stones on an instrumented treadmill while some of the approaching stepping stones were shifted forward or backward, requiring participants to adjust their foot placement. Varying the timing of those shifts allowed us to address the effect of available response time on foot placement error. In agreement with our hypothesis, individuals with focal cerebellar lesions were less accurate in adjusting their foot placement in reaction to suddenly shifted stepping stones than neurologically intact controls. However, the cerebellar lesion group's foot placement error did not increase more with decreasing available response distance or for short step versus long step adjustments compared to the control group. Furthermore, foot placement error for the non-shifting stepping stones was also larger in the cerebellar lesion group as compared to the control group. Consequently, the reduced ability to accurately adjust foot placement during walking in individuals with focal cerebellar lesions appears to be a general movement control deficit, which could contribute to increased fall risk. Copyright © 2017 Elsevier B.V. All rights reserved.

  5. Parent training for Attention Deficit/Hyperactivity Disorder: is it as effective when delivered as routine rather than as specialist care?

    PubMed

    Sonuga-Barke, Edmund J S; Thompson, Margaret; Daley, David; Laver-Bradbury, Cathy

    2004-11-01

    The effectiveness of parent training (PT) when delivered as part of specialist tier-two services for preschool AD/HD children has been recently demonstrated. To assess the effectiveness of the same PT programme when delivered as part of routine primary care by non-specialist nurses. A sample of 89 3-year-old children with preschool AD/HD took part in a controlled trial of an eight-week (one hour a week), health visitor delivered, PT package. Children, allocated randomly to PT (n = 59) and waiting list control (WLC; n = 30) groups, were compared. PT did not reduce AD/HD symptoms. Maternal well-being decreased in both PT and WLC groups. While PT is an effective intervention for preschool AD/HD when delivered in specialized settings, these benefits do not appear to generalize when programme are delivered as part of routine primary care by non-specialist nurses.

  6. Methods for synchronizing a countdown routine of a timer key and electronic device

    DOEpatents

    Condit, Reston A.; Daniels, Michael A.; Clemens, Gregory P.; Tomberlin, Eric S.; Johnson, Joel A.

    2015-06-02

    A timer key relating to monitoring a countdown time of a countdown routine of an electronic device is disclosed. The timer key comprises a processor configured to respond to a countdown time associated with operation of the electronic device, a display operably coupled with the processor, and a housing configured to house at least the processor. The housing has an associated structure configured to engage with the electronic device to share the countdown time between the electronic device and the timer key. The processor is configured to begin a countdown routine based at least in part on the countdown time, wherein the countdown routine is at least substantially synchronized with a countdown routine of the electronic device when the timer key is removed from the electronic device. A system and method for synchronizing countdown routines of a timer key and an electronic device are also disclosed.

  7. Routine Mapping of the Snow Depth Distribution on Sea Ice

    NASA Astrophysics Data System (ADS)

    Farrell, S. L.; Newman, T.; Richter-Menge, J.; Dattler, M.; Paden, J. D.; Yan, S.; Li, J.; Leuschen, C.

    2016-12-01

    The annual growth and retreat of the polar sea ice cover is influenced by the seasonal accumulation, redistribution and melt of snow on sea ice. Due to its high albedo and low thermal conductivity, snow is also a controlling parameter in the mass and energy budgets of the polar climate system. Under a changing climate scenario it is critical to obtain reliable and routine measurements of snow depth, across basin scales, and long time periods, so as to understand regional, seasonal and inter-annual variability, and the subsequent impacts on the sea ice cover itself. Moreover the snow depth distribution remains a significant source of uncertainty in the derivation of sea ice thickness from remote sensing measurements, as well as in numerical model predictions of future climate state. Radar altimeter systems flown onboard NASA's Operation IceBridge (OIB) mission now provide annual measurements of snow across both the Arctic and Southern Ocean ice packs. We describe recent advances in the processing techniques used to interpret airborne radar waveforms and produce accurate and robust snow depth results. As a consequence of instrument effects and data quality issues associated with the initial release of the OIB airborne radar data, the entire data set was reprocessed to remove coherent noise and sidelobes in the radar echograms. These reprocessed data were released to the community in early 2016, and are available for improved derivation of snow depth. Here, using the reprocessed data, we present the results of seven years of radar measurements collected over Arctic sea ice at the end of winter, just prior to melt. Our analysis provides the snow depth distribution on both seasonal and multi-year sea ice. We present the inter-annual variability in snow depth for both the Central Arctic and the Beaufort/Chukchi Seas. We validate our results via comparison with temporally and spatially coincident in situ measurements gathered during many of the OIB surveys. The results

  8. CERES: A Set of Automated Routines for Echelle Spectra

    NASA Astrophysics Data System (ADS)

    Brahm, Rafael; Jordán, Andrés; Espinoza, Néstor

    2017-03-01

    We present the Collection of Elemental Routines for Echelle Spectra (CERES). These routines were developed for the construction of automated pipelines for the reduction, extraction, and analysis of spectra acquired with different instruments, allowing the obtention of homogeneous and standardized results. This modular code includes tools for handling the different steps of the processing: CCD image reductions; identification and tracing of the echelle orders; optimal and rectangular extraction; computation of the wavelength solution; estimation of radial velocities; and rough and fast estimation of the atmospheric parameters. Currently, CERES has been used to develop automated pipelines for 13 different spectrographs, namely CORALIE, FEROS, HARPS, ESPaDOnS, FIES, PUCHEROS, FIDEOS, CAFE, DuPont/Echelle, Magellan/Mike, Keck/HIRES, Magellan/PFS, and APO/ARCES, but the routines can be easily used to deal with data coming from other spectrographs. We show the high precision in radial velocity that CERES achieves for some of these instruments, and we briefly summarize some results that have already been obtained using the CERES pipelines.

  9. Factors Associated with Routine Dental Attendance among Aboriginal Australians.

    PubMed

    Amarasena, Najith; Kapellas, Kostas; Skilton, Michael R; Maple-Brown, Louise J; Brown, Alex; Bartold, Mark; O'Dea, Kerin; Celermajer, David; Jamieson, Lisa M

    2016-01-01

    To determine factors associated with routine dental attendance in Aboriginal Australians. Data of 271 Aboriginal adults residing in Australia's Northern Territory were used. Routine dental attendance was defined as last visiting a dentist less than one year ago or visiting a dentist for a check-up. Both bivariate and multivariable analytical techniques were used. While 27% visited a dentist in the past year, 29% of these visited for a check-up. In bivariate analysis, being female, low psychological distress, and low clinical attachment loss (CAL) were associated with visiting a dentist within last year. Being aged younger than 39 years, male, no oral health impairment, being caries-free, low CAL, and low apolipoprotein B were associated with visiting for a check-up. Clinical attachment loss remained associated with visiting a dentist less than one year ago while being younger than 39 years and having no oral health impairment remained associated with usually visiting for a check-up in multivariable analysis. Younger age, no oral health impairment, and low CAL were associated with routine dental attendance among Indigenous Australians.

  10. Factors Associated with Routine Dental Attendance among Aboriginal Australians.

    PubMed

    Amarasena, Najith; Kapellas, Kostas; Skilton, Michael R; Maple-Brown, Louise J; Brown, Alex; Bartold, Mark; O'Dea, Kerin; Celermajer, David; Jamieson, Lisa M

    2016-02-01

    To determine factors associated with routine dental attendance in Aboriginal Australians. Data of 271 Aboriginal adults residing in Australia's Northern Territory were used. Routine dental attendance was defined as last visiting a dentist less than one year ago or visiting a dentist for a check-up. Both bivariate and multivariable analytical techniques were used. While 27% visited a dentist in the past year, 29% of these visited for a check-up. In bivariate analysis, being female, low psychological distress, and low clinical attachment loss (CAL) were associated with visiting a dentist within last year. Being aged younger than 39 years, male, no oral health impairment, being caries-free, low CAL, and low apolipoprotein B were associated with visiting for a check-up. Clinical attachment loss remained associated with visiting a dentist less than one year ago while being younger than 39 years and having no oral health impairment remained associated with usually visiting for a check-up in multivariable analysis. Younger age, no oral health impairment, and low CAL were associated with routine dental attendance among Indigenous Australians.

  11. Epidural analgesia during labour, routinely or on request: a cost-effectiveness analysis.

    PubMed

    Bonouvrié, Kimberley; van den Bosch, Anouk; Roumen, Frans J M E; van Kuijk, Sander M; Nijhuis, Jan G; Evers, Silvia M A A; Wassen, Martine M L H

    2016-12-01

    To assess the cost-effectiveness of routine labour epidural analgesia (EA), from a societal perspective, as compared with labour analgesia on request. Women delivering of a singleton in cephalic presentation beyond 36+0 weeks' gestation were randomly allocated to routine labour EA or analgesia on request in one university and one non-university teaching hospital in the Netherlands. Costs included all medical, non-medical and indirect costs from randomisation to 6 weeks postpartum. Effectiveness was defined as a non-operative, spontaneous vaginal delivery without EA-related maternal adverse effects. Incremental cost-effectiveness ratio (ICER) was defined as the ratio of the difference in costs and the difference in effectiveness between both groups. Data were analysed according to intention to treat and divided into a base case analysis and a sensitivity analysis. Total delivery costs in the routine EA group (n=233) were higher than in the labour on request group (n=255) (difference -€ 322, 95% CI -€ 60 to € 355) due to more medication costs (including EA), a longer stay in the labour ward, and more operations including caesarean sections. Total postpartum hospital costs in the routine EA group were lower (difference -€ 344, 95% CI -€ 1338 to € 621) mainly due to less neonatal admissions (difference -€ 472, 95% CI -€ 1297 to € 331), whereas total postpartum home and others costs were comparable (difference -€ 20, 95% CI -€ 267 to € 248, and -€ 1, 95% CI -€ 67 to € 284, respectively). As a result, the overall mean costs per woman were comparable between the routine EA group and the analgesia on request group (€ 8.708 and € 8.710, respectively, mean difference -€ 2, 95% CI -€ 1.012 to € 916). Routine labour EA resulted in more deliveries with maternal adverse effects, nevertheless the ICER remained low (€ 8; bootstrap 95% CI -€ 6.120 to € 8.659). The cost-effectiveness acceptability curve indicated a low probability that

  12. Routine hand hygiene audit by direct observation: has nemesis arrived?

    PubMed

    Gould, D J; Drey, N S; Creedon, S

    2011-04-01

    Infection prevention and control experts have expended valuable health service time developing and implementing tools to audit health workers' hand hygiene compliance by direct observation. Although described as the 'gold standard' approach to hand hygiene audit, this method is labour intensive and may be inaccurate unless performed by trained personnel who are regularly monitored to ensure quality control. New technological devices have been developed to generate 'real time' data, but the cost of installing them and using them during routine patient care has not been evaluated. Moreover, they do not provide as much information about the hand hygiene episode or the context in which hand hygiene has been performed as direct observation. Uptake of hand hygiene products offers an inexpensive alternative to direct observation. Although product uptake would not provide detailed information about the hand hygiene episode or local barriers to compliance, it could be used as a continuous monitoring tool. Regular inspection of the data by infection prevention and control teams and clinical staff would indicate when and where direct investigation of practice by direct observation and questioning of staff should be targeted by highly trained personnel to identify local problems and improve practice. Copyright © 2011 the Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved.

  13. Breast Volume Measurement by Recycling the Data Obtained From 2 Routine Modalities, Mammography and Magnetic Resonance Imaging.

    PubMed

    Itsukage, Shizu; Sowa, Yoshihiro; Goto, Mariko; Taguchi, Tetsuya; Numajiri, Toshiaki

    2017-01-01

    Objective: Preoperative prediction of breast volume is important in the planning of breast reconstructive surgery. In this study, we prospectively estimated the accuracy of measurement of breast volume using data from 2 routine modalities, mammography and magnetic resonance imaging, by comparison with volumes of mastectomy specimens. Methods: The subjects were 22 patients (24 breasts) who were scheduled to undergo total mastectomy for breast cancer. Preoperatively, magnetic resonance imaging volume measurement was performed using a medical imaging system and the mammographic volume was calculated using a previously proposed formula. Volumes of mastectomy specimens were measured intraoperatively using a method based on Archimedes' principle and Newton's third law. Results: The average breast volumes measured on magnetic resonance imaging and mammography were 318.47 ± 199.4 mL and 325.26 ± 217.36 mL, respectively. The correlation coefficients with mastectomy specimen volumes were 0.982 for magnetic resonance imaging and 0.911 for mammography. Conclusions: Breast volume measurement using magnetic resonance imaging was highly accurate but requires data analysis software. In contrast, breast volume measurement with mammography requires only a simple formula and is sufficiently accurate, although the accuracy was lower than that obtained with magnetic resonance imaging. These results indicate that mammography could be an alternative modality for breast volume measurement as a substitute for magnetic resonance imaging.

  14. Breast Volume Measurement by Recycling the Data Obtained From 2 Routine Modalities, Mammography and Magnetic Resonance Imaging

    PubMed Central

    Itsukage, Shizu; Goto, Mariko; Taguchi, Tetsuya; Numajiri, Toshiaki

    2017-01-01

    Objective: Preoperative prediction of breast volume is important in the planning of breast reconstructive surgery. In this study, we prospectively estimated the accuracy of measurement of breast volume using data from 2 routine modalities, mammography and magnetic resonance imaging, by comparison with volumes of mastectomy specimens. Methods: The subjects were 22 patients (24 breasts) who were scheduled to undergo total mastectomy for breast cancer. Preoperatively, magnetic resonance imaging volume measurement was performed using a medical imaging system and the mammographic volume was calculated using a previously proposed formula. Volumes of mastectomy specimens were measured intraoperatively using a method based on Archimedes’ principle and Newton's third law. Results: The average breast volumes measured on magnetic resonance imaging and mammography were 318.47 ± 199.4 mL and 325.26 ± 217.36 mL, respectively. The correlation coefficients with mastectomy specimen volumes were 0.982 for magnetic resonance imaging and 0.911 for mammography. Conclusions: Breast volume measurement using magnetic resonance imaging was highly accurate but requires data analysis software. In contrast, breast volume measurement with mammography requires only a simple formula and is sufficiently accurate, although the accuracy was lower than that obtained with magnetic resonance imaging. These results indicate that mammography could be an alternative modality for breast volume measurement as a substitute for magnetic resonance imaging. PMID:29308107

  15. Methodological Considerations for Use of Routine Health Information System Data to Evaluate Malaria Program Impact in an Era of Declining Malaria Transmission

    PubMed Central

    Ashton, Ruth A.; Bennett, Adam; Yukich, Joshua; Bhattarai, Achuyt; Keating, Joseph; Eisele, Thomas P.

    2017-01-01

    Abstract. Coverage of malaria control interventions is increasing dramatically across endemic countries. Evaluating the impact of malaria control programs and specific interventions on health indicators is essential to enable countries to select the most effective and appropriate combination of tools to accelerate progress or proceed toward malaria elimination. When key malaria interventions have been proven effective under controlled settings, further evaluations of the impact of the intervention using randomized approaches may not be appropriate or ethical. Alternatives to randomized controlled trials are therefore required for rigorous evaluation under conditions of routine program delivery. Routine health management information system (HMIS) data are a potentially rich source of data for impact evaluation, but have been underused in impact evaluation due to concerns over internal validity, completeness, and potential bias in estimates of program or intervention impact. A range of methodologies were identified that have been used for impact evaluations with malaria outcome indicators generated from HMIS data. Methods used to maximize internal validity of HMIS data are presented, together with recommendations on reducing bias in impact estimates. Interrupted time series and dose-response analyses are proposed as the strongest quasi-experimental impact evaluation designs for analysis of malaria outcome indicators from routine HMIS data. Interrupted time series analysis compares the outcome trend and level before and after the introduction of an intervention, set of interventions or program. The dose-response national platform approach explores associations between intervention coverage or program intensity and the outcome at a subnational (district or health facility catchment) level. PMID:28990915

  16. Patient decision aids in routine maternity care: Benefits, barriers, and new opportunities.

    PubMed

    Stevens, Gabrielle; Thompson, Rachel; Watson, Bernadette; Miller, Yvette D

    2016-02-01

    Participation in decision-making, supported by comprehensive and quality information provision, is increasingly emphasised as a priority for women in maternity care. Patient decision aids are tools that can offer women greater access to information and guidance to participate in maternity care decision-making. Relative to their evaluation in controlled settings, the implementation of patient decision aids in routine maternity care has received little attention and our understanding of which approaches may be effective is limited. This paper critically discusses the application of patient decision aids in routine maternity care and explores viable solutions for promoting their successful uptake. A range of patient decision aids have been developed for use within maternity care, and controlled trials have highlighted their positive impact on the decision-making process for women. Nevertheless, evidence of successful patient decision aid implementation in real world health care settings is lacking due to practical and ideological barriers that exist. Patient-directed social marketing campaigns are a relatively novel approach to patient decision aid delivery that may facilitate their adoption in maternity care, at least in the short-term, by overcoming common implementation barriers. Social marketing may also be particularly well suited to maternity care, given the unique characteristics of this health context. The potential of social marketing campaigns to facilitate patient decision aid adoption in maternity care highlights the need for pragmatic trials to evaluate their effectiveness. Identifying which sub-groups of women are more or less likely to respond to these strategies will further direct implementation. Copyright © 2015 Australian College of Midwives. Published by Elsevier Ltd. All rights reserved.

  17. The influence of daily routines on engaging in diabetes self-management.

    PubMed

    Fritz, Heather

    2014-05-01

    In contrast to previous research concerning the importance of routines in occupational engagement, most of which have largely focused on the routines of children and families, in this study a qualitative methodology was used to understand how routines function in a specific occupation: diabetes self-management (DSM). Ten low-income women participated in a multiple-methods study that involved completing a time-geographic diary (TGD) and participating in a TGD interview. Findings reveal that pre-existing routines must be changed so that they may better support engagement in DSM, and that such changes are tied to underlying habits and life situations. The experiences of study participants also showed that the distribution of daily occupations through time and across social spheres can be both supportive of and problematic for engaging in DSM. In addition, the structure and sequence of competing daily occupations influences the available time and opportunities for people to further develop their skills and become more adept self-managers. The implications of these findings for occupational science and therapy are discussed.

  18. The influence of daily routines on engaging in diabetes self-management

    PubMed Central

    Fritz, Heather

    2018-01-01

    Objective In contrast to previous research concerning the importance of routines in occupational engagement, most of which have largely focused on the routines of children and families, in this study a qualitative methodology was used to understand how routines function in a specific occupation: diabetes self-management (DSM). Methods Ten low-income women participated in a multiple-methods study that involved completing a time-geographic diary (TGD) and participating in a TGD interview. Results Findings reveal that pre-existing routines must be changed so that they may better support engagement in DSM, and that such changes are tied to underlying habits and life situations. The experiences of study participants also showed that the distribution of daily occupations through time and across social spheres can be both supportive of and problematic for engaging in DSM. In addition, the structure and sequence of competing daily occupations influences the available time and opportunities for people to further develop their skills and become more adept self-managers. Conclusions The implications of these findings for occupational science and therapy are discussed. PMID:24329181

  19. Dose Adjustment for Normal Eating (DAFNE) in routine clinical practice: who benefits?

    PubMed

    Keen, A J A; Duncan, E; McKillop-Smith, A; Evans, N D; Gold, A E

    2012-05-01

    To explore the effectiveness of Dose Adjustment for Normal Eating in routine clinical practice in the UK. Participants were 124 adults with Type 1 diabetes who had completed a Dose Adjustment for Normal Eating course. Data were collected before the course and again 1 year later on a variety of biological, psychological and social measures. There were a range of significant benefits consistent with Dose Adjustment for Normal Eating aims, including: better control among those with baseline HbA(1c) ≥ 81 mmol/mol (9.6%) (z = -2.8, P = 0.004); reduced number of participants reporting severe hypoglycaemia (χ² = 4.27, P = 0.039); total eradication of diabetic ketoacidosis (χ² = 4.17, P = 0.041) and lower diabetes-related distress (z = -4.5, P < 0.001). The most deprived of the clinic population were significantly under-represented (χ² = 17.8, P = 0.001) and the levels of clinical depression were unusually low. These results indicate that Dose Adjustment for Normal Eating delivered in routine clinical practice is associated with a range of benefits and that certain clinical and psychosocial characteristics are associated with better outcomes. © 2011 The Authors. Diabetic Medicine © 2011 Diabetes UK.

  20. The Necessity for Routine Pre-operative Ultrasound Mapping Before Arteriovenous Fistula Creation: A Meta-analysis.

    PubMed

    Georgiadis, G S; Charalampidis, D G; Argyriou, C; Georgakarakos, E I; Lazarides, M K

    2015-05-01

    Existing guidelines suggest routine use of pre-operative color Doppler ultrasound (DUS) vessel mapping before the creation of arteriovenous fistulae (AVF); however, there is controversy about its benefit over traditional clinical examination or selective ultrasound use. This was a systematic review and meta-analysis of randomized controlled trials (RCTs) comparing routine DUS mapping before the creation of AVF with patients for whom the decision for AVF placement was based on clinical examination and selective ultrasound use. A search of MEDLINE/PubMed, SCOPUS, and the Cochrane Library was carried out in June 2014. The analyzed outcome measures were the immediate failure rate and the early/midterm adequacy of the fistula for hemodialysis. Additionally, assessment of the methodological quality of the included studies was carried out. Five studies (574 patients) were analyzed. A random effects model was used to pool the data. The pooled odds ratio (OR) for the immediate failure rate was 0.32 (95% confidence interval [CI] 0.17-0.60; p < .01), which was significantly in favor of the DUS mapping group. The pooled OR for the early/midterm adequacy for hemodialysis was 0.66 (95% CI 0.42-1.03; p = .06), with a trend in favor of the DUS mapping group; however, subgroup analysis revealed that routine DUS mapping was more beneficial than selective DUS (p < .05). The available evidence, based mainly on moderate quality RCTs, suggests that the pre-operative clinical examination should always be supplemented with routine DUS mapping before AVF creation. This policy avoids negative surgical explorations and significantly reduces the immediate AVF failure rate. Copyright © 2015 European Society for Vascular Surgery. Published by Elsevier Ltd. All rights reserved.

  1. Nanomanufacturing of titania interfaces with controlled structural and functional properties by supersonic cluster beam deposition

    NASA Astrophysics Data System (ADS)

    Podestà, Alessandro; Borghi, Francesca; Indrieri, Marco; Bovio, Simone; Piazzoni, Claudio; Milani, Paolo

    2015-12-01

    Great emphasis is placed on the development of integrated approaches for the synthesis and the characterization of ad hoc nanostructured platforms, to be used as templates with controlled morphology and chemical properties for the investigation of specific phenomena of great relevance in interdisciplinary fields such as biotechnology, medicine, and advanced materials. Here, we discuss the crucial role and the advantages of thin film deposition strategies based on cluster-assembling from supersonic cluster beams. We select cluster-assembled nanostructured titania (ns-TiO2) as a case study to demonstrate that accurate control over morphological parameters can be routinely achieved, and consequently, over several relevant interfacial properties and phenomena, like surface charging in a liquid electrolyte, and proteins and nanoparticles adsorption. In particular, we show that the very good control of nanoscale morphology is obtained by taking advantage of simple scaling laws governing the ballistic deposition regime of low-energy, mass-dispersed clusters with reduced surface mobility.

  2. Nanomanufacturing of titania interfaces with controlled structural and functional properties by supersonic cluster beam deposition

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

    Podestà, Alessandro, E-mail: alessandro.podesta@mi.infn.it, E-mail: pmilani@mi.infn.it; Borghi, Francesca; Indrieri, Marco

    Great emphasis is placed on the development of integrated approaches for the synthesis and the characterization of ad hoc nanostructured platforms, to be used as templates with controlled morphology and chemical properties for the investigation of specific phenomena of great relevance in interdisciplinary fields such as biotechnology, medicine, and advanced materials. Here, we discuss the crucial role and the advantages of thin film deposition strategies based on cluster-assembling from supersonic cluster beams. We select cluster-assembled nanostructured titania (ns-TiO{sub 2}) as a case study to demonstrate that accurate control over morphological parameters can be routinely achieved, and consequently, over several relevantmore » interfacial properties and phenomena, like surface charging in a liquid electrolyte, and proteins and nanoparticles adsorption. In particular, we show that the very good control of nanoscale morphology is obtained by taking advantage of simple scaling laws governing the ballistic deposition regime of low-energy, mass-dispersed clusters with reduced surface mobility.« less

  3. Invasive meningococcal disease epidemiology and control measures: a framework for evaluation.

    PubMed

    Caro, J Jaime; Möller, Jörgen; Getsios, Denis; Coudeville, L; El-Hadi, Wissam; Chevat, Catherine; Nguyen, Van Hung; Caro, Ingrid

    2007-06-29

    Meningococcal disease can have devastating consequences. As new vaccines emerge, it is necessary to assess their impact on public health. In the absence of long-term real world data, modeling the effects of different vaccination strategies is required. Discrete event simulation provides a flexible platform with which to conduct such evaluations. A discrete event simulation of the epidemiology of invasive meningococcal disease was developed to quantify the potential impact of implementing routine vaccination of adolescents in the United States with a quadrivalent conjugate vaccine protecting against serogroups A, C, Y, and W-135. The impact of vaccination is assessed including both the direct effects on individuals vaccinated and the indirect effects resulting from herd immunity. The simulation integrates a variety of epidemiologic and demographic data, with core information on the incidence of invasive meningococcal disease and outbreak frequency derived from data available through the Centers for Disease Control and Prevention. Simulation of the potential indirect benefits of vaccination resulting from herd immunity draw on data from the United Kingdom, where routine vaccination with a conjugate vaccine has been in place for a number of years. Cases of disease are modeled along with their health consequences, as are the occurrence of disease outbreaks. When run without a strategy of routine immunization, the simulation accurately predicts the age-specific incidence of invasive meningococcal disease and the site-specific frequency of outbreaks in the Unite States. 2,807 cases are predicted annually, resulting in over 14,000 potential life years lost due to invasive disease. In base case analyses of routine vaccination, life years lost due to infection are reduced by over 45% (to 7,600) when routinely vaccinating adolescents 12 years of age at 70% coverage. Sensitivity analyses indicate that herd immunity plays an important role when this population is targeted for

  4. Obtaining Accurate Probabilities Using Classifier Calibration

    ERIC Educational Resources Information Center

    Pakdaman Naeini, Mahdi

    2016-01-01

    Learning probabilistic classification and prediction models that generate accurate probabilities is essential in many prediction and decision-making tasks in machine learning and data mining. One way to achieve this goal is to post-process the output of classification models to obtain more accurate probabilities. These post-processing methods are…

  5. Optimization of Maneuver Execution for Landsat-7 Routine Operations

    NASA Technical Reports Server (NTRS)

    Cox, E. Lucien, Jr.; Bauer, Frank H. (Technical Monitor)

    2000-01-01

    Multiple mission constraints were satisfied during a lengthy, strategic ascent phase. Once routine operations begin, the ongoing concern of maintaining mission requirements becomes an immediate priority. The Landsat-7 mission has tight longitude control box and Earth imaging that requires sub-satellite descending nodal equator crossing times to occur in a narrow 30minute range fifteen (15) times daily. Operationally, spacecraft maneuvers must'be executed properly to maintain mission requirements. The paper will discuss the importance of optimizing the altitude raising and plane change maneuvers, amidst known constraints, to satisfy requirements throughout mission lifetime. Emphasis will be placed not only on maneuver size and frequency but also on changes in orbital elements that impact maneuver execution decisions. Any associated trade-off arising from operations contingencies will be discussed as well. Results of actual altitude and plane change maneuvers are presented to clarify actions taken.

  6. Approaching system equilibrium with accurate or not accurate feedback information in a two-route system

    NASA Astrophysics Data System (ADS)

    Zhao, Xiao-mei; Xie, Dong-fan; Li, Qi

    2015-02-01

    With the development of intelligent transport system, advanced information feedback strategies have been developed to reduce traffic congestion and enhance the capacity. However, previous strategies provide accurate information to travelers and our simulation results show that accurate information brings negative effects, especially in delay case. Because travelers prefer to the best condition route with accurate information, and delayed information cannot reflect current traffic condition but past. Then travelers make wrong routing decisions, causing the decrease of the capacity and the increase of oscillations and the system deviating from the equilibrium. To avoid the negative effect, bounded rationality is taken into account by introducing a boundedly rational threshold BR. When difference between two routes is less than the BR, routes have equal probability to be chosen. The bounded rationality is helpful to improve the efficiency in terms of capacity, oscillation and the gap deviating from the system equilibrium.

  7. What Makes Me Screen for HIV? Perceived Barriers and Facilitators to Conducting Recommended Routine HIV Testing among Primary care Physicians in the Southeastern United States

    PubMed Central

    White, Becky L.; Walsh, Joan; Rayasam, Swati; Pathman, Donald E.; Adimora, Adaora A.; Golin, Carol E.

    2015-01-01

    The Centers for Disease Control and Prevention have recommended routinely testing patients (aged 13–64) for HIV since 2006. However, many physicians do not routinely test. From January 2011- March 2012, we conducted 18 in-depth individual interviews and explored primary care physicians’ perceptions of barriers and facilitators to implementing routine HIV testing in North Carolina. Physicians’ comments were categorized thematically and fell into five groups: policy, community, practice, physician and patient. Lack of universal reimbursement was identified as the major policy barrier. Participants believed endorsement from the United States Preventive Services Tasks Force would facilitate adoption of routine HIV testing policies. Physicians reported HIV/AIDS stigma, socially conservative communities, lack of confidentiality, and rural geography as community barriers. Physicians believed public HIV testing campaigns would legitimize testing and decrease stigma in communities. Physicians cited time constraints and competing clinical priorities as physician barriers that could be overcome by delegating testing to nursing staff. HIV test refusal, low HIV risk perception, and stigma emerged as patient barriers. Physicians recommended adoption of routine HIV testing for all patients to facilitate and destigmatize testing. Physicians continue to experience a variety of barriers when implementing routine HIV testing in primary care settings. Our findings support multilevel approaches to enhance physician routine HIV testing in primary care settings. PMID:24643412

  8. Individual Values, Learning Routines and Academic Procrastination

    ERIC Educational Resources Information Center

    Dietz, Franziska; Hofer, Manfred; Fries, Stefan

    2007-01-01

    Background: Academic procrastination, the tendency to postpone learning activities, is regarded as a consequence of postmodern values that are prominent in post-industrialized societies. When students strive for leisure goals and have no structured routines for academic tasks, delaying strenuous learning activities becomes probable. Aims: The…

  9. Integrating Communication Skills into Functional Routines & Activities.

    ERIC Educational Resources Information Center

    Stremel, Kathleen

    This training module on integrating communication skills into functional routines and activities is from the Mississippi Early Education Program for Children with Multiple Disabilities, a program designed to train Individuals with Disabilities Education Act Part H service coordinators and service providers to use family centered strategies. The…

  10. Developing a weather observation routine during ICARUS

    NASA Astrophysics Data System (ADS)

    Mei, F.; Hubbe, J. M.; de Boer, G.; Lawrence, D.; Shupe, M.; Ivey, M.; Dexheimer, D.; Schmid, B.

    2016-12-01

    Starting in 2014, the Atmospheric Radiation Measurement (ARM) program began a major reconfiguration to more tightly link measurements and atmospheric models. As part of this the reconfiguration, ARM's North Slope of Alaska (NSA) site is being upgraded to include additional observations to support modeling and process studies. The Inaugural Campaigns for ARM Research using Unmanned Systems (ICARUS) have been launched in 2016. This internal initiative at Oliktok Point, Alaska focus on developing routine operations of Unmanned Aerial Systems (UAS) and Tethered Balloon Systems (TBS). The main purpose of ICARUS is to collect spatial data about surface radiation, heat fluxes, and vertical profiles of the basic atmospheric state (temperature, humidity, and horizontal wind). Based on the data collected during ICARUS, we will develop the operation routines for each atmospheric state measurement, and then optimize the operation schedule to maximize the data collection capacity. The statistical representation of important atmospheric state parameters will be discussed.

  11. [The family in the Pediatric Unit: living with rules and hospital routines].

    PubMed

    Xavier, Daiani Modernel; Gomes, Giovana Calcagno; Santos, Silvana Sidney Costa; Lunardi, Valéria Lerch; Pintanel, Aline Campelo; Erdmann, Alacoque Lorenzini

    2014-01-01

    The study aimed to know, in Foucault's view, how the family caregiver of the child deals with the rules and routines in the hospital. Descriptive qualitative study, conducted in the second half of 2011. It had the Grounded Theory as methodological framework. It was developed in the pediatric unit of a university hospital in southern Brazil, with eighteen family caregivers. The data collection was performed by semi-structured interviews and the analysis through open, axial and selective coding. It was noticed that the family tends to conform to such rules and routines in the hospital, but recognizes the importance of its flexibility, exercising endurance, as dialoguing, or as trespassing such rules and routines, in search of autonomy, when they realize that these do not address their needs. It is important to use rules and routines to enable the family practices and spaces of freedom, autonomy and resistance.

  12. A New Cluster Analysis-Marker-Controlled Watershed Method for Separating Particles of Granular Soils.

    PubMed

    Alam, Md Ferdous; Haque, Asadul

    2017-10-18

    An accurate determination of particle-level fabric of granular soils from tomography data requires a maximum correct separation of particles. The popular marker-controlled watershed separation method is widely used to separate particles. However, the watershed method alone is not capable of producing the maximum separation of particles when subjected to boundary stresses leading to crushing of particles. In this paper, a new separation method, named as Monash Particle Separation Method (MPSM), has been introduced. The new method automatically determines the optimal contrast coefficient based on cluster evaluation framework to produce the maximum accurate separation outcomes. Finally, the particles which could not be separated by the optimal contrast coefficient were separated by integrating cuboid markers generated from the clustering by Gaussian mixture models into the routine watershed method. The MPSM was validated on a uniformly graded sand volume subjected to one-dimensional compression loading up to 32 MPa. It was demonstrated that the MPSM is capable of producing the best possible separation of particles required for the fabric analysis.

  13. A New Cluster Analysis-Marker-Controlled Watershed Method for Separating Particles of Granular Soils

    PubMed Central

    Alam, Md Ferdous

    2017-01-01

    An accurate determination of particle-level fabric of granular soils from tomography data requires a maximum correct separation of particles. The popular marker-controlled watershed separation method is widely used to separate particles. However, the watershed method alone is not capable of producing the maximum separation of particles when subjected to boundary stresses leading to crushing of particles. In this paper, a new separation method, named as Monash Particle Separation Method (MPSM), has been introduced. The new method automatically determines the optimal contrast coefficient based on cluster evaluation framework to produce the maximum accurate separation outcomes. Finally, the particles which could not be separated by the optimal contrast coefficient were separated by integrating cuboid markers generated from the clustering by Gaussian mixture models into the routine watershed method. The MPSM was validated on a uniformly graded sand volume subjected to one-dimensional compression loading up to 32 MPa. It was demonstrated that the MPSM is capable of producing the best possible separation of particles required for the fabric analysis. PMID:29057823

  14. Evidence-based new service package vs. routine service package for smoking cessation to prevent high risk patients from cardiovascular diseases (CVD): study protocol for randomized controlled trial.

    PubMed

    Aung, Myo Nyein; Yuasa, Motoyuki; Lorga, Thaworn; Moolphate, Saiyud; Fukuda, Hiroshi; Kitajima, Tsutomu; Yokokawa, Hirohide; Minematsu, Kazuo; Tanimura, Susumu; Hiratsuka, Yoshimune; Ono, Koichi; Naunboonruang, Prissana; Thinuan, Payom; Kawai, Sachio; Suya, Yaoyanee; Chumvicharana, Somboon; Marui, Eiji

    2013-12-05

    Smoking cessation is a high-priority intervention to prevent CVD events and deaths in developing countries. While several interventions to stop smoking have been proved successful, the question of how to increase their effectiveness and practicality in developing countries remains. In this study, a newly devised evidence-based smoking cessation service package will be compared with the existing service in a randomized controlled trial within the community setting of Thailand. This randomized control trial will recruit 440 current smokers at CVD risk because of being diabetic and/or hypertensive. Informed, consented participants will be randomly allocated into the new service-package arm and the routine service arm. The study will take place in the non-communicable disease clinics of the Maetha District Hospital, Lampang, northern Thailand. The new smoking-cessation service-package comprises (1) regular patient motivation and coaching from the same primary care nurse over a 3-month period; (2) monthly application of piCO + smokerlyzer to sustain motivation of smoker's quitting attempt and provide positive feedback over a 3-month period; (3) assistance by an assigned family member; (4) nicotine replacement chewing gum to relieve withdrawal symptoms. This new service will be compared with the traditional routine service comprising the 5A approach in a 1-year follow-up. Participants who consent to participate in the study but refuse to attempt quitting smoking will be allocated to the non-randomized arm, where they will be just followed up and monitored. Primary outcome of the study is smoking cessation rate at 1-year follow-up proven by breath analysis measuring carbomonoxide in parts per million in expired air. Secondary outcomes are smoking cessation rate at the 6-month follow-up, blood pressure and heart rate, CVD risk according to the Framingham general cardiovascular risk score, CVD events and deaths at the 12-month follow-up, and the cost-effectiveness of the

  15. Cloud cover and solar disk state estimation using all-sky images: deep neural networks approach compared to routine methods

    NASA Astrophysics Data System (ADS)

    Krinitskiy, Mikhail; Sinitsyn, Alexey

    2017-04-01

    Shortwave radiation is an important component of surface heat budget over sea and land. To estimate them accurate observations of cloud conditions are needed including total cloud cover, spatial and temporal cloud structure. While massively observed visually, for building accurate SW radiation parameterizations cloud structure needs also to be quantified using precise instrumental measurements. While there already exist several state of the art land-based cloud-cameras that satisfy researchers needs, their major disadvantages are associated with inaccuracy of all-sky images processing algorithms which typically result in the uncertainties of 2-4 octa of cloud cover estimates with the resulting true-scoring cloud cover accuracy of about 7%. Moreover, none of these algorithms determine cloud types. We developed an approach for cloud cover and structure estimating, which provides much more accurate estimates and also allows for measuring additional characteristics. This method is based on the synthetic controlling index, namely the "grayness rate index", that we introduced in 2014. Since then this index has already demonstrated high efficiency being used along with the technique namely the "background sunburn effect suppression", to detect thin clouds. This made it possible to significantly increase the accuracy of total cloud cover estimation in various sky image states using this extension of routine algorithm type. Errors for the cloud cover estimates significantly decreased down resulting the mean squared error of about 1.5 octa. Resulting true-scoring accuracy is more than 38%. The main source of this approach uncertainties is the solar disk state determination errors. While the deep neural networks approach lets us to estimate solar disk state with 94% accuracy, the final result of total cloud estimation still isn`t satisfying. To solve this problem completely we applied the set of machine learning algorithms to the problem of total cloud cover estimation

  16. Improved Submariner Eyewear for Routine Wear and Emergency Equipment Use Underway

    DTIC Science & Technology

    2010-01-15

    information. 2.0 DESCRIPTION Naval Submarine Medical Research Laboratory (NSMRL) is seeking information from the eyewear industry that will provide...Improved Submariner Eyewear for Routine Wear and Emergency Equipment Use Underway by Alison America, MA Wayne G. Horn, MD...Submariner Eyewear for Routine Wear and Emergency Equipment Use Underway 50818 Alison America, MA Wayne G. Horn, MD Naval Submarine Medical Research

  17. Improved Submariner Eyewear for Routine Wear and Emergency Equipment Use Underway

    DTIC Science & Technology

    2008-11-21

    Research Laboratory (NSMRL) is seeking information from the eyewear industry that will provide prescription eyewear frames for use when wearing an EAB...Improved Submariner Eyewear for Routine Wear and Emergency Equipment Use Underway by Alison America, MA Wayne G. Horn, MD...Submariner Eyewear for Routine Wear and Emergency Equipment Use Underway Authors: Alison America, MA Wayne G. Horn, MD Naval Submarine Medical Research

  18. An Input Routine Using Arithmetic Statements for the IBM 704 Digital Computer

    NASA Technical Reports Server (NTRS)

    Turner, Don N.; Huff, Vearl N.

    1961-01-01

    An input routine has been designed for use with FORTRAN or SAP coded programs which are to be executed on an IBM 704 digital computer. All input to be processed by the routine is punched on IBM cards as declarative statements of the arithmetic type resembling the FORTRAN language. The routine is 850 words in length. It is capable of loading fixed- or floating-point numbers, octal numbers, and alphabetic words, and of performing simple arithmetic as indicated on input cards. Provisions have been made for rapid loading of arrays of numbers in consecutive memory locations.

  19. A Machine Learned Classifier That Uses Gene Expression Data to Accurately Predict Estrogen Receptor Status

    PubMed Central

    Bastani, Meysam; Vos, Larissa; Asgarian, Nasimeh; Deschenes, Jean; Graham, Kathryn; Mackey, John; Greiner, Russell

    2013-01-01

    Background Selecting the appropriate treatment for breast cancer requires accurately determining the estrogen receptor (ER) status of the tumor. However, the standard for determining this status, immunohistochemical analysis of formalin-fixed paraffin embedded samples, suffers from numerous technical and reproducibility issues. Assessment of ER-status based on RNA expression can provide more objective, quantitative and reproducible test results. Methods To learn a parsimonious RNA-based classifier of hormone receptor status, we applied a machine learning tool to a training dataset of gene expression microarray data obtained from 176 frozen breast tumors, whose ER-status was determined by applying ASCO-CAP guidelines to standardized immunohistochemical testing of formalin fixed tumor. Results This produced a three-gene classifier that can predict the ER-status of a novel tumor, with a cross-validation accuracy of 93.17±2.44%. When applied to an independent validation set and to four other public databases, some on different platforms, this classifier obtained over 90% accuracy in each. In addition, we found that this prediction rule separated the patients' recurrence-free survival curves with a hazard ratio lower than the one based on the IHC analysis of ER-status. Conclusions Our efficient and parsimonious classifier lends itself to high throughput, highly accurate and low-cost RNA-based assessments of ER-status, suitable for routine high-throughput clinical use. This analytic method provides a proof-of-principle that may be applicable to developing effective RNA-based tests for other biomarkers and conditions. PMID:24312637

  20. An Examination of Latino Students' Homework Routines

    ERIC Educational Resources Information Center

    Martinez, Sylvia

    2011-01-01

    Homework appears to be positively associated with better student outcomes. Although some researchers have explored the connection between time spent on homework and minority student achievement, few have examined the homework routines of Latino youth. Interviews with Latino high school students show that they have some difficulty completing daily…

  1. Tuning-free controller to accurately regulate flow rates in a microfluidic network

    NASA Astrophysics Data System (ADS)

    Heo, Young Jin; Kang, Junsu; Kim, Min Jun; Chung, Wan Kyun

    2016-03-01

    We describe a control algorithm that can improve accuracy and stability of flow regulation in a microfluidic network that uses a conventional pressure pump system. The algorithm enables simultaneous and independent control of fluid flows in multiple micro-channels of a microfluidic network, but does not require any model parameters or tuning process. We investigate robustness and optimality of the proposed control algorithm and those are verified by simulations and experiments. In addition, the control algorithm is compared with a conventional PID controller to show that the proposed control algorithm resolves critical problems induced by the PID control. The capability of the control algorithm can be used not only in high-precision flow regulation in the presence of disturbance, but in some useful functions for lab-on-a-chip devices such as regulation of volumetric flow rate, interface position control of two laminar flows, valveless flow switching, droplet generation and particle manipulation. We demonstrate those functions and also suggest further potential biological applications which can be accomplished by the proposed control framework.

  2. Tuning-free controller to accurately regulate flow rates in a microfluidic network

    PubMed Central

    Heo, Young Jin; Kang, Junsu; Kim, Min Jun; Chung, Wan Kyun

    2016-01-01

    We describe a control algorithm that can improve accuracy and stability of flow regulation in a microfluidic network that uses a conventional pressure pump system. The algorithm enables simultaneous and independent control of fluid flows in multiple micro-channels of a microfluidic network, but does not require any model parameters or tuning process. We investigate robustness and optimality of the proposed control algorithm and those are verified by simulations and experiments. In addition, the control algorithm is compared with a conventional PID controller to show that the proposed control algorithm resolves critical problems induced by the PID control. The capability of the control algorithm can be used not only in high-precision flow regulation in the presence of disturbance, but in some useful functions for lab-on-a-chip devices such as regulation of volumetric flow rate, interface position control of two laminar flows, valveless flow switching, droplet generation and particle manipulation. We demonstrate those functions and also suggest further potential biological applications which can be accomplished by the proposed control framework. PMID:26987587

  3. Metamemory monitoring in mild cognitive impairment: Evidence of a less accurate episodic feeling-of-knowing.

    PubMed

    Perrotin, Audrey; Belleville, Sylvie; Isingrini, Michel

    2007-09-20

    This study aimed at exploring metamemory and specifically the accuracy of memory monitoring in mild cognitive impairment (MCI) using an episodic memory feeling-of-knowing (FOK) procedure. To this end, 20 people with MCI and 20 matched control participants were compared on the episodic FOK task. Results showed that the MCI group made less accurate FOK predictions than the control group by overestimating their memory performance on a recognition task. The MCI overestimation behavior was found to be critically related to the severity of their cognitive decline. In the light of recent neuroanatomical models showing the involvement of a temporal-frontal network underlying accurate FOK predictions, the role of memory and executive processes was evaluated. Thus, participants were also administered memory and executive neuropsychological tests. Correlation analysis revealed a between-group differential pattern indicating that FOK accuracy was primarily related to memory abilities in people with MCI, whereas it was specifically related to executive functioning in control participants. The lesser ability of people with MCI to assess their memory status accurately on an episodic FOK task is discussed in relation to both their subjective memory complaints and to their actual memory deficits which might be mediated by the brain vulnerability of their hippocampus and medial temporal system. It is suggested that their memory weakness may lead people with MCI to use other less reliable forms of memory monitoring.

  4. Computer routines for probability distributions, random numbers, and related functions

    USGS Publications Warehouse

    Kirby, W.

    1983-01-01

    Use of previously coded and tested subroutines simplifies and speeds up program development and testing. This report presents routines that can be used to calculate various probability distributions and other functions of importance in statistical hydrology. The routines are designed as general-purpose Fortran subroutines and functions to be called from user-written main progress. The probability distributions provided include the beta, chi-square, gamma, Gaussian (normal), Pearson Type III (tables and approximation), and Weibull. Also provided are the distributions of the Grubbs-Beck outlier test, Kolmogorov 's and Smirnov 's D, Student 's t, noncentral t (approximate), and Snedecor F. Other mathematical functions include the Bessel function, I sub o, gamma and log-gamma functions, error functions, and exponential integral. Auxiliary services include sorting and printer-plotting. Random number generators for uniform and normal numbers are provided and may be used with some of the above routines to generate numbers from other distributions. (USGS)

  5. Computer routines for probability distributions, random numbers, and related functions

    USGS Publications Warehouse

    Kirby, W.H.

    1980-01-01

    Use of previously codes and tested subroutines simplifies and speeds up program development and testing. This report presents routines that can be used to calculate various probability distributions and other functions of importance in statistical hydrology. The routines are designed as general-purpose Fortran subroutines and functions to be called from user-written main programs. The probability distributions provided include the beta, chisquare, gamma, Gaussian (normal), Pearson Type III (tables and approximation), and Weibull. Also provided are the distributions of the Grubbs-Beck outlier test, Kolmogorov 's and Smirnov 's D, Student 's t, noncentral t (approximate), and Snedecor F tests. Other mathematical functions include the Bessel function I (subzero), gamma and log-gamma functions, error functions and exponential integral. Auxiliary services include sorting and printer plotting. Random number generators for uniform and normal numbers are provided and may be used with some of the above routines to generate numbers from other distributions. (USGS)

  6. Accurate CT-MR image registration for deep brain stimulation: a multi-observer evaluation study

    NASA Astrophysics Data System (ADS)

    Rühaak, Jan; Derksen, Alexander; Heldmann, Stefan; Hallmann, Marc; Meine, Hans

    2015-03-01

    Since the first clinical interventions in the late 1980s, Deep Brain Stimulation (DBS) of the subthalamic nucleus has evolved into a very effective treatment option for patients with severe Parkinson's disease. DBS entails the implantation of an electrode that performs high frequency stimulations to a target area deep inside the brain. A very accurate placement of the electrode is a prerequisite for positive therapy outcome. The assessment of the intervention result is of central importance in DBS treatment and involves the registration of pre- and postinterventional scans. In this paper, we present an image processing pipeline for highly accurate registration of postoperative CT to preoperative MR. Our method consists of two steps: a fully automatic pre-alignment using a detection of the skull tip in the CT based on fuzzy connectedness, and an intensity-based rigid registration. The registration uses the Normalized Gradient Fields distance measure in a multilevel Gauss-Newton optimization framework and focuses on a region around the subthalamic nucleus in the MR. The accuracy of our method was extensively evaluated on 20 DBS datasets from clinical routine and compared with manual expert registrations. For each dataset, three independent registrations were available, thus allowing to relate algorithmic with expert performance. Our method achieved an average registration error of 0.95mm in the target region around the subthalamic nucleus as compared to an inter-observer variability of 1.12 mm. Together with the short registration time of about five seconds on average, our method forms a very attractive package that can be considered ready for clinical use.

  7. Development of a Digital Control for the Phase Contrast Imaging Alignment Feedback System

    NASA Astrophysics Data System (ADS)

    Hirata, M.; Marinoni, A.; Rost, J. C.; Davis, E. M.; Porkolab, M.

    2016-10-01

    The Phase Contrast Imaging diagnostic is an internal reference interferometer that images density fluctuations on a 32-element linear detector array. Since proper operation of the system requires accurate alignment of a CO2 laser beam on a phase plate, beam motion due to vibrations of the DIII-D vessel need to be compensated up to 1 kHz. The feedback network controlling the steering mirrors currently uses a linear analog controller, but a digital controller can provide improved stability performance and flexibility. A prototype was developed using an Arduino Due, a low-cost microcontroller, to assess performance capabilities. Digital control parameters will be developed based on the measured frequency and phase response of the physical components. Finally, testing of the digital feedback system and the required revisions will be done to achieve successful performance. This upgrade to the linear analog controller is expected to be used routinely on similar diagnostics in fusion devices, especially in view of restricted access to the machine hall. Work supported in part by the US Department of Energy under DE-FG02-94ER54235, DE-FC02-04ER54698, and the Science Undergraduate Laboratory Internships Program (SULI).

  8. Pink-Beam, Highly-Accurate Compact Water Cooled Slits

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

    Lyndaker, Aaron; Deyhim, Alex; Jayne, Richard

    2007-01-19

    Advanced Design Consulting, Inc. (ADC) has designed accurate compact slits for applications where high precision is required. The system consists of vertical and horizontal slit mechanisms, a vacuum vessel which houses them, water cooling lines with vacuum guards connected to the individual blades, stepper motors with linear encoders, limit (home position) switches and electrical connections including internal wiring for a drain current measurement system. The total slit size is adjustable from 0 to 15 mm both vertically and horizontally. Each of the four blades are individually controlled and motorized. In this paper, a summary of the design and Finite Elementmore » Analysis of the system are presented.« less

  9. 32 CFR 318.14 - Blanket routine uses.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... Armed Forces, information as to last known residential or home of record address may be provided to the... 32 National Defense 2 2011-07-01 2011-07-01 false Blanket routine uses. 318.14 Section 318.14 National Defense Department of Defense (Continued) OFFICE OF THE SECRETARY OF DEFENSE (CONTINUED) PRIVACY...

  10. 32 CFR 318.14 - Blanket routine uses.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... Armed Forces, information as to last known residential or home of record address may be provided to the... 32 National Defense 2 2010-07-01 2010-07-01 false Blanket routine uses. 318.14 Section 318.14 National Defense Department of Defense (Continued) OFFICE OF THE SECRETARY OF DEFENSE (CONTINUED) PRIVACY...

  11. BLS Machine-Readable Data and Tabulating Routines.

    ERIC Educational Resources Information Center

    DiFillipo, Tony

    This report describes the machine-readable data and tabulating routines that the Bureau of Labor Statistics (BLS) is prepared to distribute. An introduction discusses the LABSTAT (Labor Statistics) database and the BLS policy on release of unpublished data. Descriptions summarizing data stored in 25 files follow this format: overview, data…

  12. Widely applicable MATLAB routines for automated analysis of saccadic reaction times.

    PubMed

    Leppänen, Jukka M; Forssman, Linda; Kaatiala, Jussi; Yrttiaho, Santeri; Wass, Sam

    2015-06-01

    Saccadic reaction time (SRT) is a widely used dependent variable in eye-tracking studies of human cognition and its disorders. SRTs are also frequently measured in studies with special populations, such as infants and young children, who are limited in their ability to follow verbal instructions and remain in a stable position over time. In this article, we describe a library of MATLAB routines (Mathworks, Natick, MA) that are designed to (1) enable completely automated implementation of SRT analysis for multiple data sets and (2) cope with the unique challenges of analyzing SRTs from eye-tracking data collected from poorly cooperating participants. The library includes preprocessing and SRT analysis routines. The preprocessing routines (i.e., moving median filter and interpolation) are designed to remove technical artifacts and missing samples from raw eye-tracking data. The SRTs are detected by a simple algorithm that identifies the last point of gaze in the area of interest, but, critically, the extracted SRTs are further subjected to a number of postanalysis verification checks to exclude values contaminated by artifacts. Example analyses of data from 5- to 11-month-old infants demonstrated that SRTs extracted with the proposed routines were in high agreement with SRTs obtained manually from video records, robust against potential sources of artifact, and exhibited moderate to high test-retest stability. We propose that the present library has wide utility in standardizing and automating SRT-based cognitive testing in various populations. The MATLAB routines are open source and can be downloaded from http://www.uta.fi/med/icl/methods.html .

  13. 32 CFR Appendix C to Part 806b - DoD ‘Blanket Routine Uses’

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 32 National Defense 6 2013-07-01 2013-07-01 false DoD âBlanket Routine Usesâ C Appendix C to Part... PRIVACY ACT PROGRAM Pt. 806b, App. C Appendix C to Part 806b—DoD ‘Blanket Routine Uses’ Certain DoD... the issuance of a license, grant, or other benefit. c. Disclosure of Requested Information Routine Use...

  14. 32 CFR Appendix C to Part 806b - DoD ‘Blanket Routine Uses’

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 32 National Defense 6 2011-07-01 2011-07-01 false DoD âBlanket Routine Usesâ C Appendix C to Part... PRIVACY ACT PROGRAM Pt. 806b, App. C Appendix C to Part 806b—DoD ‘Blanket Routine Uses’ Certain DoD... the issuance of a license, grant, or other benefit. c. Disclosure of Requested Information Routine Use...

  15. Recurrent Disruptions of Rituals and Routines in Families with Paternal Alcohol Abuse

    ERIC Educational Resources Information Center

    Haugland, Bente Storm Mowatt

    2005-01-01

    Changes in rituals and routines between drinking and sobriety were examined in families in treatment due to paternal alcohol abuse. Information was gathered through a semistructured family interview. Recurrent disruptions of rituals and routines were found between different phases in the drinking cycle. Disruptions were found typically with regard…

  16. PAin SoluTions In the Emergency Setting (PASTIES); a protocol for two open-label randomised trials of patient-controlled analgesia (PCA) versus routine care in the emergency department

    PubMed Central

    Smith, Jason E; Rockett, Mark; Squire, Rosalyn; Hayward, Christopher J; Creanor, Siobhan; Ewings, Paul; Barton, Andy; Pritchard, Colin; Benger, Jonathan Richard

    2013-01-01

    Introduction Pain is the commonest reason that patients present to an emergency department (ED), but it is often not treated effectively. Patient controlled analgesia (PCA) is used in other hospital settings but there is little evidence to support its use in emergency patients. We describe two randomised trials aiming to compare PCA to nurse titrated analgesia (routine care) in adult patients who present to the ED requiring intravenous opioid analgesia for the treatment of moderate to severe pain and are subsequently admitted to hospital. Methods and analysis Two prospective multi-centre open-label randomised trials of PCA versus routine care in emergency department patients who require intravenous opioid analgesia followed by admission to hospital; one trial involving patients with traumatic musculoskeletal injuries and the second involving patients with non-traumatic abdominal pain. In each trial, 200 participants will be randomised to receive either routine care or PCA, and followed for the first 12 h of their hospital stay. The primary outcome measure is hourly pain score recorded by the participant using a visual analogue scale (VAS) over the 12 h study period, with the primary statistical analyses based on the area under the curve of these pain scores. Secondary outcomes include total opioid use, side effects, time spent asleep, patient satisfaction, length of hospital stay and incremental cost effectiveness ratio. Ethics and dissemination The study is approved by the South Central—Southampton A Research Ethics Committee (REC reference 11/SC/0151). Data collection will be completed by August 2013, with statistical analyses starting after all final data queries are resolved. Dissemination plans include presentations at local, national and international scientific meetings held by relevant Colleges and societies. Publications should be ready for submission during 2014. A lay summary of the results will be available to study participants on request, and

  17. Toward Accurate On-Ground Attitude Determination for the Gaia Spacecraft

    NASA Astrophysics Data System (ADS)

    Samaan, Malak A.

    2010-03-01

    The work presented in this paper concerns the accurate On-Ground Attitude (OGA) reconstruction for the astrometry spacecraft Gaia in the presence of disturbance and of control torques acting on the spacecraft. The reconstruction of the expected environmental torques which influence the spacecraft dynamics will be also investigated. The telemetry data from the spacecraft will include the on-board real-time attitude, which is of order of several arcsec. This raw attitude is the starting point for the further attitude reconstruction. The OGA will use the inputs from the field coordinates of known stars (attitude stars) and also the field coordinate differences of objects on the Sky Mapper (SM) and Astrometric Field (AF) payload instruments to improve this raw attitude. The on-board attitude determination uses a Kalman Filter (KF) to minimize the attitude errors and produce a more accurate attitude estimation than the pure star tracker measurement. Therefore the first approach for the OGA will be an adapted version of KF. Furthermore, we will design a batch least squares algorithm to investigate how to obtain a more accurate OGA estimation. Finally, a comparison between these different attitude determination techniques in terms of accuracy, robustness, speed and memory required will be evaluated in order to choose the best attitude algorithm for the OGA. The expected resulting accuracy for the OGA determination will be on the order of milli-arcsec.

  18. Taking a new biomarker into routine use – A perspective from the routine clinical biochemistry laboratory

    PubMed Central

    Sturgeon, Catharine; Hill, Robert; Hortin, Glen L; Thompson, Douglas

    2010-01-01

    There is increasing pressure to provide cost-effective healthcare based on “best practice.” Consequently, new biomarkers are only likely to be introduced into routine clinical biochemistry departments if they are supported by a strong evidence base and if the results will improve patient management and outcome. This requires convincing evidence of the benefits of introducing the new test, ideally reflected in fewer hospital admissions, fewer additional investigations and/or fewer clinic visits. Carefully designed audit and cost-benefit studies in relevant patient groups must demonstrate that introducing the biomarker delivers an improved and more effective clinical pathway. From the laboratory perspective, pre-analytical requirements must be thoroughly investigated at an early stage. Good stability of the biomarker in relevant physiological matrices is essential to avoid the need for special processing. Absence of specific timing requirements for sampling and knowledge of the effect of medications that might be used to treat the patients in whom the biomarker will be measured is also highly desirable. Analytically, automation is essential in modern high-throughput clinical laboratories. Assays must therefore be robust, fulfilling standard requirements for linearity on dilution, precision and reproducibility, both within- and between-run. Provision of measurements by a limited number of specialized reference laboratories may be most appropriate, especially when a new biomarker is first introduced into routine practice. PMID:21137030

  19. Routine use of PCR-restriction fragment length polymorphism analysis for identification of mycobacteria growing in liquid media.

    PubMed Central

    Taylor, T B; Patterson, C; Hale, Y; Safranek, W W

    1997-01-01

    A PCR-restriction fragment length polymorphism (PCR-RFLP) procedure capable of rapidly identifying 28 species of clinically encountered mycobacteria was evaluated for use in the routine identification of acid-fast isolates growing in BACTEC 12B and 13A liquid media. PCR-RFLP identified 100 of 103 acid-fast isolates recovered from 610 patient specimens submitted for culture during the study. The three isolates unidentifiable by PCR-RFLP produced restriction patterns not included in the PCR-RFLP algorithm and could therefore not be assigned to a species. These isolates were characterized by their morphologic and biochemical characteristics. Two of the isolates were identified as M. terrae complex and M. gordonae. The third isolate could not be definitively identified and could only be characterized as a Mycobacterium sp. most closely resembling M. chelonae. PCR-RFLP identifications agreed with the conventional identifications for 96 of the 100 isolates identified by PCR-RFLP. Subsequent identification of the four discordant isolates by gas chromatography analysis supported the PCR-RFLP identification of each isolate. Amplification products were also obtained from isolates of Streptococcus albus and Rhodococcus equi recovered from patient specimens; however, the restriction patterns of these nonmycobacterial species did not resemble the patterns of any mycobacterial species included in the PCR-RFLP algorithm. PCR-RFLP seems to be a reliable procedure for the routine identification of mycobacteria and has the potential for providing identifications of mycobacterial isolates which are more accurate than conventional identification techniques based on morphologic and biochemical characteristics. PMID:8968884

  20. The Xpert® MTB/RIF assay in routine diagnosis of pulmonary tuberculosis: A multicentre study in Lithuania.

    PubMed

    Pimkina, Edita; Zablockis, Rolandas; Nikolayevskyy, Vladyslav; Danila, Edvardas; Davidaviciene, Edita

    2015-11-01

    Drug-resistant tuberculosis (TB) is an important public health problem in Lithuania with MDR rates in new cases reaching 11% in 2012. Currently available diagnostic tools are not fully adequate for an accurate and rapid result for diagnosis of TB and MDR-TB. To evaluate the performance of Xpert(®) MTB/RIF assay for an early diagnosis of TB and detection of rifampicin (RIF) resistance in routine settings in Lithuania. A total of 833 individual respiratory samples obtained from patients previously treated for TB and MDR-TB contacts were tested using the Xpert MTB/RIF assay. Performance characteristics of the assay for TB and RIF resistance detection were calculated using culture and phenotypical DST results as a gold standard. The overall sensitivity and specificity of the Xpert MTB/RIF assay for TB detection were 93.7% and 91.7%, respectively with the sensitivity for smear-negative specimens reaching 82.5%. Resistance to RIF was detected in 81 (20.7%) primary specimens with no false negative results; there were 4/225 (1.8%) false-positives among strains sensitive to rifampicin. Overall sensitivity and specificity of the molecular assay for detection of RIF resistance calculated against phenotypic DST results were 100% and 98.2%, respectively. Our results demonstrate very good performance of the Xpert MTB/RIF assay for the detection of TB and RIF resistance on primary respiratory specimens. It provides strong evidence that implementation of the assay for routine laboratory diagnosis in high drug-resistance settings may improve and facilitate TB diagnosis. Copyright © 2015 Elsevier Ltd. All rights reserved.

  1. Automatic and accurate reconstruction of distal humerus contours through B-Spline fitting based on control polygon deformation.

    PubMed

    Mostafavi, Kamal; Tutunea-Fatan, O Remus; Bordatchev, Evgueni V; Johnson, James A

    2014-12-01

    The strong advent of computer-assisted technologies experienced by the modern orthopedic surgery prompts for the expansion of computationally efficient techniques to be built on the broad base of computer-aided engineering tools that are readily available. However, one of the common challenges faced during the current developmental phase continues to remain the lack of reliable frameworks to allow a fast and precise conversion of the anatomical information acquired through computer tomography to a format that is acceptable to computer-aided engineering software. To address this, this study proposes an integrated and automatic framework capable to extract and then postprocess the original imaging data to a common planar and closed B-Spline representation. The core of the developed platform relies on the approximation of the discrete computer tomography data by means of an original two-step B-Spline fitting technique based on successive deformations of the control polygon. In addition to its rapidity and robustness, the developed fitting technique was validated to produce accurate representations that do not deviate by more than 0.2 mm with respect to alternate representations of the bone geometry that were obtained through different-contact-based-data acquisition or data processing methods. © IMechE 2014.

  2. The role of routine preoperative EUS when performed after contrast enhanced CT in the diagnostic work-up in patients suspected of pancreatic or periampullary cancer.

    PubMed

    Cieslak, Kasia P; van Santvoort, Hjalmar C; Vleggaar, Frank P; van Leeuwen, Maarten S; ten Kate, Fibo J; Besselink, Marc G; Molenaar, I Quintus

    2014-01-01

    In patients suspected of pancreatic or periampullary cancer, abdominal contrast-enhanced computed tomography (CT) is the standard diagnostic modality. A supplementary endoscopic ultrasonography (EUS) is often performed, although there is only limited evidence of its additional diagnostic value. The aim of the study is to evaluate the additional diagnostic value of EUS over CT in deciding on exploratory laparotomy in patients suspected of pancreatic or periampullary cancer. We retrospectively analyzed 86 consecutive patients who routinely underwent CT and EUS before exploratory laparotomy with or without pancreatoduodenectomy for suspected pancreatic or periampullary carcinoma between 2007 and 2010. Primary outcomes were visibility of a mass, resectability on CT/EUS and resection with curative intent. A mass was visible on CT in 72/86 (84%) patients. In these 72 patients, EUS demonstrated a mass in 64/72 (89%) patients. Resectability was accurately predicted by CT in 65/72 (90%) and by EUS in 58/72 (81%) patients. In 14/86 (16%) patients no mass was seen on CT. EUS showed a mass in 12/14 (86%) of these patients. A malignant lesion was histological proven in 11/12 (92%) of these patients. Overall, resectability was accurately predicted by CT and EUS in 90% (77/86) and 84% (72/86), respectively. In patients with a visible mass on CT, suspected for pancreatic or periampullary cancer, EUS has no additional diagnostic value, does not influence the decision to perform laparotomy and should therefore not be performed routinely. In patients without a visible mass on CT, EUS is useful to confirm the presence of a tumor. Copyright © 2014 IAP and EPC. Published by Elsevier B.V. All rights reserved.

  3. An estimation of the clinical mastitis incidence per 100 cows per year based on routinely collected herd data.

    PubMed

    Santman-Berends, I M G A; Lam, T J G M; Keurentjes, J; van Schaik, G

    2015-10-01

    The aim of this study was to evaluate whether it was possible to (1) estimate the clinical mastitis incidence rate (CMI) for all Dutch dairy herds and (2) to detect farms with a high CMI based on routinely collected herd data. For this study, 240 dairy farms with a conventional milking system that participated in the milk recording program every 4 to 6 wk were randomly selected and agreed to participate. From the initial 240 herds, data of clinical mastitis (CM) registrations and routinely collected herd data of 227 herds were complete and could be used for analysis. Routinely collected herd data consisted of identification and registration records, antimicrobial usage, test-day records from the milk recording program, bulk tank milk (BTM) somatic cell count data and results of diagnostic tests on BTM samples. For each of the 227 herds, the CMI per 100 cows per year was calculated per quarter of the year and was combined with the available herd data. Two models were developed to predict the CMI for all dairy herds and to detect individual herds that belonged to the 25% herds with the highest CMI. Records of 156 (67%) herds were used for development of the models and the remaining 71 (33%) were used for validation. The model that estimated the CMI in all herds consisted of 11 explanatory variables. The observed and predicted averages of the validation herds were not significantly different. The model estimated a CMI per 100 cows per year of 32.5 cases (95% confidence interval=30.2-34.8), whereas the farmers registered 33.4 cases (95% confidence interval=29.5-37.4). The model that aimed at detecting individual herds with a high CMI contained 6 explanatory variables and could correctly classify 77% of all validation herds at the quarter-year level. The most important variables in the model were antibiotic usage for treating CM and BTM somatic cell count. In conclusion, models based on routinely collected herd data gave an accurate prediction of CMI for all Dutch dairy

  4. Early rehabilitation exercise program for inpatients during an acute exacerbation of chronic obstructive pulmonary disease: a randomized controlled trial.

    PubMed

    Tang, Clarice Y; Blackstock, Felicity C; Clarence, Michael; Taylor, Nicholas F

    2012-01-01

    To determine whether an early rehabilitation program was safe and feasible for patients during an acute exacerbation of chronic obstructive pulmonary disease (COPD). In this phase 1 randomized controlled trial, patients with an acute exacerbation of COPD admitted to the hospital were randomly allocated to a low-intensity exercise group, a moderate- to high-intensity exercise group, or a control group, who received routine physical therapy. In addition to routine physical therapy, patients in the exercise group had to participate in an exercise program. The program consisted of twice-daily aerobic and resistance exercise sessions. Primary outcomes were the number and classification of adverse events and program adherence. In 174 exercise sessions, there was 1 serious adverse event of arrhythmia in the low-intensity exercise group that resolved within 1 hour. There were 12 other minor adverse events involving 5 patients with no significant differences between groups. Patients completed an average of 80% of their scheduled sessions with no significant between-group differences. The exercise groups improved significantly in walking distance; however, no significant between-group differences were observed. There was preliminary evidence that it was safe and feasible to implement an exercise program for patients during an acute exacerbation of COPD. Additional studies with larger sample sizes are required to accurately evaluate program effectiveness.

  5. "How Was Your Weekend?": Developing the Interactional Competence in Managing Routine Inquiries

    ERIC Educational Resources Information Center

    Waring, Hansun Zhang

    2013-01-01

    Given the cross-cultural differences underlying interactional routines such as "How are you?" or "How was your weekend?", managing such routine inquiries can be problematic for second language learners. Based on data from an adult ESL (English as a second language) class, this conversation analytic study shows how learners develop their competence…

  6. Getting through to circadian oscillators: why use constant routines?

    NASA Technical Reports Server (NTRS)

    Duffy, Jeanne F.; Dijk, Derk-Jan

    2002-01-01

    Overt 24-h rhythmicity is composed of both exogenous and endogenous components, reflecting the product of multiple (periodic) feedback loops with a core pacemaker at their center. Researchers attempting to reveal the endogenous circadian (near 24-h) component of rhythms commonly conduct their experiments under constant environmental conditions. However, even under constant environmental conditions, rhythmic changes in behavior, such as food intake or the sleep-wake cycle, can contribute to observed rhythmicity in many physiological and endocrine variables. Assessment of characteristics of the core circadian pacemaker and its direct contribution to rhythmicity in different variables, including rhythmicity in gene expression, may be more reliable when such periodic behaviors are eliminated or kept constant across all circadian phases. This is relevant for the assessment of the status of the circadian pacemaker in situations in which the sleep-wake cycle or food intake regimes are altered because of external conditions, such as in shift work or jet lag. It is also relevant for situations in which differences in overt rhythmicity could be due to changes in either sleep oscillatory processes or circadian rhythmicity, such as advanced or delayed sleep phase syndromes, in aging, or in particular clinical conditions. Researchers studying human circadian rhythms have developed constant routine protocols to assess the status of the circadian pacemaker in constant behavioral and environmental conditions, whereas this technique is often thought to be unnecessary in the study of animal rhythms. In this short review, the authors summarize constant routine methodology and what has been learned from constant routines and argue that animal and human circadian rhythm researchers should (continue to) use constant routines as a step on the road to getting through to central and peripheral circadian oscillators in the intact organism.

  7. Apparatus for use in rapid and accurate controlled-potential coulometric analysis

    DOEpatents

    Frazzini, Thomas L.; Holland, Michael K.; Pietri, Charles E.; Weiss, Jon R.

    1981-01-01

    An apparatus for controlled-potential coulometric analysis of a solution includes a cell to contain the solution to be analyzed and a plurality of electrodes to contact the solution in the cell. Means are provided to stir the solution and to control the atmosphere above it. A potentiostat connected to the electrodes controls potential differences among the electrodes. An electronic circuit connected to the potentiostat provides analog-to-digital conversion and displays a precise count of charge transfer during a desired chemical process. This count provides a measure of the amount of an unknown substance in the solution.

  8. Drama and Routine in the Public Schools.

    ERIC Educational Resources Information Center

    Pondy, Louis R.; Huff, Anne S.

    A case study of curricular change compares two leading models of organizational change. One model stresses the uncertainty and disorder of major changes and views them as dramatic events. The other model sees major organizational shifts as the result of ordinary day-to-day processes and emphasizes their routine nature. For this study, the…

  9. Nonoperative management of blunt renal trauma: Is routine early follow-up imaging necessary?

    PubMed Central

    Malcolm, John B; Derweesh, Ithaar H; Mehrazin, Reza; DiBlasio, Christopher J; Vance, David D; Joshi, Salil; Wake, Robert W; Gold, Robert

    2008-01-01

    Background There is no consensus on the role of routine follow-up imaging during nonoperative management of blunt renal trauma. We reviewed our experience with nonoperative management of blunt renal injuries in order to evaluate the utility of routine early follow-up imaging. Methods We reviewed all cases of blunt renal injury admitted for nonoperative management at our institution between 1/2002 and 1/2006. Data were compiled from chart review, and clinical outcomes were correlated with CT imaging results. Results 207 patients were identified (210 renal units). American Association for the Surgery of Trauma (AAST) grades I, II, III, IV, and V were assigned to 35 (16%), 66 (31%), 81 (39%), 26 (13%), and 2 (1%) renal units, respectively. 177 (84%) renal units underwent routine follow-up imaging 24–48 hours after admission. In three cases of grade IV renal injury, a ureteral stent was placed after serial imaging demonstrated persistent extravasation. In no other cases did follow-up imaging independently alter clinical management. There were no urologic complications among cases for which follow-up imaging was not obtained. Conclusion Routine follow-up imaging is unnecessary for blunt renal injuries of grades I-III. Grade IV renovascular injuries can be followed clinically without routine early follow-up imaging, but urine extravasation necessitates serial imaging to guide management decisions. The volume of grade V renal injuries in this study is not sufficient to support or contest the need for routine follow-up imaging. PMID:18768088

  10. A novel method for routine quality assurance of volumetric-modulated arc therapy.

    PubMed

    Wang, Qingxin; Dai, Jianrong; Zhang, Ke

    2013-10-01

    Volumetric-modulated arc therapy (VMAT) is delivered through synchronized variation of gantry angle, dose rate, and multileaf collimator (MLC) leaf positions. The delivery dynamic nature challenges the parameter setting accuracy of linac control system. The purpose of this study was to develop a novel method for routine quality assurance (QA) of VMAT linacs. ArcCheck is a detector array with diodes distributing in spiral pattern on cylindrical surface. Utilizing its features, a QA plan was designed to strictly test all varying parameters during VMAT delivery on an Elekta Synergy linac. In this plan, there are 24 control points. The gantry rotates clockwise from 181° to 179°. The dose rate, gantry speed, and MLC positions cover their ranges commonly used in clinic. The two borders of MLC-shaped field seat over two columns of diodes of ArcCheck when the gantry rotates to the angle specified by each control point. The ratio of dose rate between each of these diodes and the diode closest to the field center is a certain value and sensitive to the MLC positioning error of the leaf crossing the diode. Consequently, the positioning error can be determined by the ratio with the help of a relationship curve. The time when the gantry reaches the angle specified by each control point can be acquired from the virtual inclinometer that is a feature of ArcCheck. The gantry speed between two consecutive control points is then calculated. The aforementioned dose rate is calculated from an acm file that is generated during ArcCheck measurements. This file stores the data measured by each detector in 50 ms updates with each update in a separate row. A computer program was written in MATLAB language to process the data. The program output included MLC positioning errors and the dose rate at each control point as well as the gantry speed between control points. To evaluate this method, this plan was delivered for four consecutive weeks. The actual dose rate and gantry speed were

  11. Routine recovery: an ethical plan for greatly increasing the supply of transplantable organs.

    PubMed

    Spital, Aaron; Taylor, James S

    2008-04-01

    All current organ procurement policies require some form of consent. Many families refuse to permit organ recovery from a recently deceased relative; therefore, the major cost of requiring consent is the loss of some lives that could have been saved through transplantation. Here, we argue for a much more efficient approach to organ procurement from brain dead individuals - routine recovery of all transplantable organs without consent. Careful analysis of the relevant literature shows that, compared with its competitors, routine recovery has the greatest potential to increase cadaveric organ procurement and save lives while causing very little harm. Furthermore, a recent survey suggests that 30% of the US public would already accept routine recovery even though the respondents were not educated regarding the value of this approach. Patients on the transplant waiting list are dying while organs that could have saved them are being buried or burned because of family refusal to allow posthumous organ procurement. Routine recovery would eliminate this tragic loss of life-saving organs without violating ethical principles. Indeed, we argue that of all the proposals designed to increase the supply of transplantable cadaveric organs, routine recovery is the best.

  12. Routine cognitive errors: a trait-like predictor of individual differences in anxiety and distress.

    PubMed

    Fetterman, Adam K; Robinson, Michael D

    2011-02-01

    Five studies (N=361) sought to model a class of errors--namely, those in routine tasks--that several literatures have suggested may predispose individuals to higher levels of emotional distress. Individual differences in error frequency were assessed in choice reaction-time tasks of a routine cognitive type. In Study 1, it was found that tendencies toward error in such tasks exhibit trait-like stability over time. In Study 3, it was found that tendencies toward error exhibit trait-like consistency across different tasks. Higher error frequency, in turn, predicted higher levels of negative affect, general distress symptoms, displayed levels of negative emotion during an interview, and momentary experiences of negative emotion in daily life (Studies 2-5). In all cases, such predictive relations remained significant with individual differences in neuroticism controlled. The results thus converge on the idea that error frequency in simple cognitive tasks is a significant and consequential predictor of emotional distress in everyday life. The results are novel, but discussed within the context of the wider literatures that informed them. © 2010 Psychology Press, an imprint of the Taylor & Francis Group, an Informa business

  13. RCL2, a potential formalin substitute for tissue fixation in routine pathological specimens.

    PubMed

    Masir, Noraidah; Ghoddoosi, Mahdiieh; Mansor, Suhada; Abdul-Rahman, Faridah; Florence, Chandramaya S; Mohamed-Ismail, Nor Azlin; Tamby, Mohammad-Rafaee; Md-Latar, Nani Harlina

    2012-04-01

    To investigate RCL2 as a fixative for tissue fixation in routine histopathological examination and to assess tissue suitability for ancillary investigations.   Forty-nine samples from 36 fresh specimens were cut into three equal pieces and fixed in RCL2 diluted in 100% ethanol, RCL2 in 95% ethanol, or neutral buffered formalin as control. Suitability for microtomy, quality of histomorphology, histochemistry, immunohistochemistry, fluorescent and silver in-situ hybridization analysis and extracted genomic DNA were assessed. Microtomy was straightforward in most tissue blocks, but there was difficulty in cutting in approximately a quarter of samples, which required careful handling by an experienced technician. There were no significant differences in tissue morphology between RCL2- and formalin-fixed tissues (P=0.08). Generally, the quality of histochemical staining, immunohistochemistry and in-situ hybridization were comparable to that of formalin-fixed tissues. Inconsistent immunoreactivity was noted, however, with antibodies against pan-cytokeratin and progesterone receptor. Genomic DNA concentration was higher in RCL2-fixed tissues. Using RCL2 diluted in 95% ethanol did not affect fixation quality. RCL2 is a potential formalin substitute suitable as a fixative for use in routine histopathological examination; however, difficulty in microtomy and occasional discrepancies in immunohistochemical reactivity require further optimization of the methodology. © 2012 Blackwell Publishing Ltd.

  14. Does 'anchor sleep' entrain circadian rhythms? Evidence from constant routine studies.

    PubMed Central

    Minors, D S; Waterhouse, J M

    1983-01-01

    Experiments have been performed in an isolation unit to investigate the effects of abnormal sleep-waking schedules upon circadian rhythms of renal excretion and deep-body temperature. In confirmation of previous work, nychthemeral rhythms appeared to be 'anchored' to a 24 h period if 4 h sleep was taken regularly each day, even though another 4 h was taken irregularly. The endogenous components were investigated by assessing circadian rhythmicity under constant routine conditions, that is, when rhythmic influences in the environment and sleep-waking pattern had been minimized. Analysis of the constant routine data indicated the presence of a rhythmic component which had been stabilized to a period of 24 h by the 'anchor sleep'. In addition, a delayed component was also present. The starting time of the constant routines produced a direct effect upon the rhythms, which was presumed to result from removing the 'masking' effect that sleep normally exerts upon rhythms. There was some evidence that the relative importance of the masking effect and the delayed component depended upon the variable under consideration. The implications of these findings, in terms of the effects of anchor sleep, the presence of more than one internal clock and the usefulness of constant routines, are discussed. PMID:6663508

  15. Comparison between the triglycerides standardization of routine methods used in Japan and the chromotropic acid reference measurement procedure used by the CDC Lipid Standardization Programme

    PubMed Central

    Nakamura, Masakazu; Iso, Hiroyasu; Kitamura, Akihiko; Imano, Hironori; Noda, Hiroyuki; Kiyama, Masahiko; Sato, Shinichi; Yamagishi, Kazumasa; Nishimura, Kunihiro; Nakai, Michikazu; Vesper, Hubert W; Teramoto, Tamio; Miyamoto, Yoshihiro

    2017-01-01

    Background The US Centers for Disease Control and Prevention ensured adequate performance of the routine triglycerides methods used in Japan by a chromotropic acid reference measurement procedure used by the Centers for Disease Control and Prevention lipid standardization programme as a reference point. We examined standardized data to clarify the performance of routine triglycerides methods. Methods The two routine triglycerides methods were the fluorometric method of Kessler and Lederer and the enzymatic method. The methods were standardized using 495 Centers for Disease Control and Prevention reference pools with 98 different concentrations ranging between 0.37 and 5.15 mmol/L in 141 survey runs. The triglycerides criteria for laboratories which perform triglycerides analyses are used: accuracy, as bias ≤5% from the Centers for Disease Control and Prevention reference value and precision, as measured by CV, ≤5%. Results The correlation of the bias of both methods to the Centers for Disease Control and Prevention reference method was: y (%bias) = 0.516 × (Centers for Disease Control and Prevention reference value) −1.292 (n = 495, R2 = 0.018). Triglycerides bias at medical decision points of 1.13, 1.69 and 2.26 mmol/L was −0.71%, −0.42% and −0.13%, respectively. For the combined precision, the equation y (CV) = −0.398 × (triglycerides value) + 1.797 (n = 495, R2 = 0.081) was used. Precision was 1.35%, 1.12% and 0.90%, respectively. It was shown that triglycerides measurements at Osaka were stable for 36 years. Conclusions The epidemiologic laboratory in Japan met acceptable accuracy goals for 88.7% of all samples, and met acceptable precision goals for 97.8% of all samples measured through the Centers for Disease Control and Prevention lipid standardization programme and demonstrated stable results for an extended period of time. PMID:26680645

  16. Efficiency of a pneumatic device in controlling cuff pressure of polyurethane-cuffed tracheal tubes: a randomized controlled study

    PubMed Central

    2013-01-01

    Background The primary objective of this study was to determine the efficiency of a pneumatic device in controlling cuff pressure (Pcuff) in patients intubated with polyurethane-cuffed tracheal tubes. Secondary objectives were to determine the impact of continuous control of Pcuff, and cuff shape on microaspiration of gastric contents. Methods Prospective randomized controlled study. All patients requiring intubation and mechanical ventilation ≥48 h were eligible. The first 32 patients were intubated with tapered polyurethane-cuffed, and the 32 following patients were intubated with cylindrical polyurethane-cuffed tracheal tubes. Patients randomly received 24 h of continuous control of Pcuff using a pneumatic device (Nosten®), and 24 h of routine care of Pcuff using a manometer. Target Pcuff was 25 cmH2O. Pcuff was continuously recorded, and pepsin was quantitatively measured in all tracheal aspirates during these periods. Results The pneumatic device was efficient in controlling Pcuff (med [IQ] 26 [24, 28] vs 22 [20, 28] cmH2O, during continuous control of Pcuff and routine care, respectively; p = 0.017). In addition, percentage of patients with underinflation (31% vs 68%) or overinflation (53% vs 100%) of tracheal cuff, and percentage of time spent with underinflation (0.9 [0, 17] vs 14% [4, 30]) or overinflation (0 [0, 2] vs 32% [9, 54]) were significantly (p < 0.001) reduced during continuous control of Pcuff compared with routine care. No significant difference was found in microaspiration of gastric content between continuous control of Pcuff compared with routine care, or between patients intubated with tapered compared with cylindrical polyurethane-cuffed tracheal tubes. Conclusion The pneumatic device was efficient in controlling Pcuff in critically ill patients intubated with polyurethane-cuffed tracheal tubes. Trial registration The Australian New Zealand Clinical Trials Registry (NCT01351259) PMID:24369057

  17. The Effectiveness of Online Cognitive Behavioral Treatment in Routine Clinical Practice

    PubMed Central

    Ruwaard, Jeroen; Lange, Alfred; Schrieken, Bart; Dolan, Conor V.; Emmelkamp, Paul

    2012-01-01

    Context Randomized controlled trails have identified online cognitive behavioral therapy as an efficacious intervention in the management of common mental health disorders. Objective To assess the effectiveness of online CBT for different mental disorders in routine clinical practice. Design An uncontrolled before-after study, with measurements at baseline, posttest, 6-week follow-up, and 1-year follow-up. Participants & Setting 1500 adult patients (female: 67%; mean age: 40 years) with a GP referral for psychotherapy were treated at a Dutch online mental health clinic for symptoms of depression (n = 413), panic disorder (n = 139), posttraumatic stress (n = 478), or burnout (n = 470). Interventions Manualized, web-based, therapist-assisted CBT, of which the efficacy was previously demonstrated in a series of controlled trials. Standardized duration of treatment varied from 5 weeks (online CBT for Posttraumatic stress) to 16 weeks (online CBT for Depression). Main Outcome Measures Validated self-report questionnaires of specific and general psychopathology, including the Beck Depression Inventory, the Impact of Event Scale, the Panic Disorder Severity Scale-Self Report, the Oldenburg Burnout Inventory, and the Depression Anxiety Stress Scales. Results Treatment adherence was 71% (n = 1071). Study attrition was 21% at posttest, 33% at 6-week FU and 65% at 1-year FU. Mixed-model repeated measures regression identified large short-term reductions in all measures of primary symptoms (d = 1.9±0.2 to d = 1.2±0.2; P<.001), which sustained up to one year after treatment. At posttest, rates of reliable improvement and recovery were 71% and 52% in the completer sample (full sample: 55%/40%). Patient satisfaction was high. Conclusions Results suggest that online therapist-assisted CBT may be as effective in routine practice as it is in clinical trials. Although pre-treatment withdrawal and long-term outcomes require further study, results warrant

  18. Population-Level Cost-Effectiveness of Implementing Evidence-Based Practices into Routine Care

    PubMed Central

    Fortney, John C; Pyne, Jeffrey M; Burgess, James F

    2014-01-01

    Objective The objective of this research was to apply a new methodology (population-level cost-effectiveness analysis) to determine the value of implementing an evidence-based practice in routine care. Data Sources/Study Setting Data are from sequentially conducted studies: a randomized controlled trial and an implementation trial of collaborative care for depression. Both trials were conducted in the same practice setting and population (primary care patients prescribed antidepressants). Study Design The study combined results from a randomized controlled trial and a pre-post-quasi-experimental implementation trial. Data Collection/Extraction Methods The randomized controlled trial collected quality-adjusted life years (QALYs) from survey and medication possession ratios (MPRs) from administrative data. The implementation trial collected MPRs and intervention costs from administrative data and implementation costs from survey. Principal Findings In the randomized controlled trial, MPRs were significantly correlated with QALYs (p = .03). In the implementation trial, patients at implementation sites had significantly higher MPRs (p = .01) than patients at control sites, and by extrapolation higher QALYs (0.00188). Total costs (implementation, intervention) were nonsignificantly higher ($63.76) at implementation sites. The incremental population-level cost-effectiveness ratio was $33,905.92/QALY (bootstrap interquartile range −$45,343.10/QALY to $99,260.90/QALY). Conclusions The methodology was feasible to operationalize and gave reasonable estimates of implementation value. PMID:25328029

  19. The 9 to 5 routine: advancing the understanding of occupational transition for new immigrants.

    PubMed

    Movsessian, Yeraz

    2013-01-01

    This paper offers a reflection on temporal routines that underscore daily work life and work transitions. This reflection includes views of a Canadian student who examines work transitions through lived experiences and observation of the Chilean work/home routine. A narrative reflection on lived experience is used to examine 9 to 5 work transitions. There is a blending of work and daily life routines that provide a balance for workers in Chile and there are differences across countries in the valuing of work and daily life routines. Narrative reflections about work and work transitions can highlight differences at the macro level that can yield personal insights into challenges in transitioning into work for new immigrants.

  20. A Gendered Lifestyle-Routine Activity Approach to Explaining Stalking Victimization in Canada.

    PubMed

    Reyns, Bradford W; Henson, Billy; Fisher, Bonnie S; Fox, Kathleen A; Nobles, Matt R

    2016-05-01

    Research into stalking victimization has proliferated over the last two decades, but several research questions related to victimization risk remain unanswered. Accordingly, the present study utilized a lifestyle-routine activity theoretical perspective to identify risk factors for victimization. Gender-based theoretical models also were estimated to assess the possible moderating effects of gender on the relationship between lifestyle-routine activity concepts and victimization risk. Based on an analysis of a representative sample of more than 15,000 residents of Canada from the Canadian General Social Survey (GSS), results suggested conditional support for lifestyle-routine activity theory and for the hypothesis that predictors of stalking victimization may be gender based. © The Author(s) 2015.

  1. The Environmental Heat Flux Routine, Version 4 (EHFR-4) and Multiple Reflections Routine (MRR). Volume 2: Programmers reference manual

    NASA Technical Reports Server (NTRS)

    Dietz, J. B.

    1973-01-01

    The EHFR program reference information which is presented consists of the following subprogram detailed data: purpose-description of the routine, a list of the calling programs, an argument list description, nomenclature definition, flow charts, and a compilation listing of each subprogram. Each of the EHFR subprograms were developed specifically for this routine and do not have an applicability of a general nature. Single precision accuracy available on the Univac 1108 is used exclusively in all but two of the 31 EHFR subprograms. The double precision variables required are identified in the nomenclature definition of the two subprograms that require them. A concise definition of the purpose, function, and capabilities is made in the subprogram description. The description references the appropriate Volume 1 sections of the report which contain the applicable detailed definitions, governing equations, and assumptions used. The compilation listing of each subprogram defines the program/data storage requirements, identifies the labeled block common data required, and identifies other subprograms called during execution. For Vol. 1, see N73-31842.

  2. 32 CFR Appendix C to Part 327 - DeCA Blanket Routine Uses

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 32 National Defense 2 2010-07-01 2010-07-01 false DeCA Blanket Routine Uses C Appendix C to Part...) PRIVACY PROGRAM DEFENSE COMMISSARY AGENCY PRIVACY ACT PROGRAM Pt. 327, App. C Appendix C to Part 327—DeCA... letting of a contract, or the issuance of a license, grant, or other benefit. (c) Routine Use—Disclosure...

  3. A MAP fixed-point, packing-unpacking routine for the IBM 7094 computer

    Treesearch

    Robert S. Helfman

    1966-01-01

    Two MAP (Macro Assembly Program) computer routines for packing and unpacking fixed point data are described. Use of these routines with Fortran IV Programs provides speedy access to quantities of data which far exceed the normal storage capacity of IBM 7000-series computers. Many problems that could not be attempted because of the slow access-speed of tape...

  4. Behavior Problems Inventory (BPI): Psychometric characteristics of an instrument for routine assessment of persons with psychoses and related disorders.

    PubMed

    Vázquez Morejón, Antonio J; Vázquez-Morejón, Raquel; Bellido Zanin, Gloria

    2018-03-22

    This study explores the psychometric characteristics of the Behavior Problems Inventory (BPI), an instrument for routine clinical assessment of behavior problems in outpatients with psychosis based on information provided by key family informants. Six hundred and twenty-one patients diagnosed with psychosis and bipolar affective disorder (ICD-10 F20-F31) attended at Community Mental Health Units were evaluated in routine reviews using the BPI and the Social Functioning Scale (SFS). Twenty-five subjects were simultaneously administered the Social Behavior Schedule (SBS) and 28 were again administered the BPI eight weeks later. The instrument shows adequate psychometric characteristics with high internal consistency and robust temporal reliability, as well as satisfactory concurrent and construct validity. Factor analysis identified three factors: Underactivity/Social Withdrawal, Active Problems and Lack of Impulse Control, with adequate saturation of the items on each of the factors. The BPI is easy to apply, reliable and valid, takes up little of valuable clinical time, allowing routine assessment in public service contexts for persons diagnosed with psychosis and bipolar affective disorder for whom key family informants are available. Published by Elsevier B.V.

  5. A convenient and accurate parallel Input/Output USB device for E-Prime.

    PubMed

    Canto, Rosario; Bufalari, Ilaria; D'Ausilio, Alessandro

    2011-03-01

    Psychological and neurophysiological experiments require the accurate control of timing and synchrony for Input/Output signals. For instance, a typical Event-Related Potential (ERP) study requires an extremely accurate synchronization of stimulus delivery with recordings. This is typically done via computer software such as E-Prime, and fast communications are typically assured by the Parallel Port (PP). However, the PP is an old and disappearing technology that, for example, is no longer available on portable computers. Here we propose a convenient USB device enabling parallel I/O capabilities. We tested this device against the PP on both a desktop and a laptop machine in different stress tests. Our data demonstrate the accuracy of our system, which suggests that it may be a good substitute for the PP with E-Prime.

  6. Profitable capitation requires accurate costing.

    PubMed

    West, D A; Hicks, L L; Balas, E A; West, T D

    1996-01-01

    In the name of costing accuracy, nurses are asked to track inventory use on per treatment basis when more significant costs, such as general overhead and nursing salaries, are usually allocated to patients or treatments on an average cost basis. Accurate treatment costing and financial viability require analysis of all resources actually consumed in treatment delivery, including nursing services and inventory. More precise costing information enables more profitable decisions as is demonstrated by comparing the ratio-of-cost-to-treatment method (aggregate costing) with alternative activity-based costing methods (ABC). Nurses must participate in this costing process to assure that capitation bids are based upon accurate costs rather than simple averages.

  7. New approach based on tetrahedral-mesh geometry for accurate 4D Monte Carlo patient-dose calculation

    NASA Astrophysics Data System (ADS)

    Han, Min Cheol; Yeom, Yeon Soo; Kim, Chan Hyeong; Kim, Seonghoon; Sohn, Jason W.

    2015-02-01

    In the present study, to achieve accurate 4D Monte Carlo dose calculation in radiation therapy, we devised a new approach that combines (1) modeling of the patient body using tetrahedral-mesh geometry based on the patient’s 4D CT data, (2) continuous movement/deformation of the tetrahedral patient model by interpolation of deformation vector fields acquired through deformable image registration, and (3) direct transportation of radiation particles during the movement and deformation of the tetrahedral patient model. The results of our feasibility study show that it is certainly possible to construct 4D patient models (= phantoms) with sufficient accuracy using the tetrahedral-mesh geometry and to directly transport radiation particles during continuous movement and deformation of the tetrahedral patient model. This new approach not only produces more accurate dose distribution in the patient but also replaces the current practice of using multiple 3D voxel phantoms and combining multiple dose distributions after Monte Carlo simulations. For routine clinical application of our new approach, the use of fast automatic segmentation algorithms is a must. In order to achieve, simultaneously, both dose accuracy and computation speed, the number of tetrahedrons for the lungs should be optimized. Although the current computation speed of our new 4D Monte Carlo simulation approach is slow (i.e. ~40 times slower than that of the conventional dose accumulation approach), this problem is resolvable by developing, in Geant4, a dedicated navigation class optimized for particle transportation in tetrahedral-mesh geometry.

  8. The Balancing Act: Student Classroom Placement Routines and the Uses of Data in Elementary Schools

    ERIC Educational Resources Information Center

    Park, Vicki; St. John, Elise; Datnow, Amanda; Choi, Bailey

    2017-01-01

    Purpose: The purpose of this paper is to examine how data are used in classroom placement routines. The authors explore educators' assumptions about the purposes of the classroom placement routine, detailing the ostensive (i.e. structure and template) and performative aspects of the routine itself, and the implications of data use for equity and…

  9. 40 CFR 124.212 - What procedures must I follow to make routine changes?

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... routine changes? 124.212 Section 124.212 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) WATER PROGRAMS PROCEDURES FOR DECISIONMAKING Procedures for RCRA Standardized Permit Maintaining A Standardized Permit § 124.212 What procedures must I follow to make routine changes? (a) You can...

  10. 78 FR 40542 - Privacy Act of 1974, As Amended: Proposed New Routine Use

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-07-05

    ... SOCIAL SECURITY ADMINISTRATION [Docket No. SSA-2013-0032] Privacy Act of 1974, As Amended: Proposed New Routine Use AGENCY: Social Security Administration. ACTION: New Proposed Routine Use...: Master Files of Social Security Number (SSN) Holders and SSN Applications, (60-0058) (the Enumeration...

  11. Routine Activities and Sexual Harassment in the Workplace.

    ERIC Educational Resources Information Center

    De Coster, Stacy; Estes, Sarah Beth; Mueller, Charles W.

    1999-01-01

    In criminology, routine activities of potential victims can be used to predict victimization. Application to organizational sexual harassment data shows that organizational features (proximity in job location, supervisor or work group guardianship) and individual characteristics (target attractiveness) can predict sexual harassment victimization,…

  12. Accurate Typing of Human Leukocyte Antigen Class I Genes by Oxford Nanopore Sequencing.

    PubMed

    Liu, Chang; Xiao, Fangzhou; Hoisington-Lopez, Jessica; Lang, Kathrin; Quenzel, Philipp; Duffy, Brian; Mitra, Robi David

    2018-04-03

    Oxford Nanopore Technologies' MinION has expanded the current DNA sequencing toolkit by delivering long read lengths and extreme portability. The MinION has the potential to enable expedited point-of-care human leukocyte antigen (HLA) typing, an assay routinely used to assess the immunologic compatibility between organ donors and recipients, but the platform's high error rate makes it challenging to type alleles with accuracy. We developed and validated accurate typing of HLA by Oxford nanopore (Athlon), a bioinformatic pipeline that i) maps nanopore reads to a database of known HLA alleles, ii) identifies candidate alleles with the highest read coverage at different resolution levels that are represented as branching nodes and leaves of a tree structure, iii) generates consensus sequences by remapping the reads to the candidate alleles, and iv) calls the final diploid genotype by blasting consensus sequences against the reference database. Using two independent data sets generated on the R9.4 flow cell chemistry, Athlon achieved a 100% accuracy in class I HLA typing at the two-field resolution. Copyright © 2018 American Society for Investigative Pathology and the Association for Molecular Pathology. Published by Elsevier Inc. All rights reserved.

  13. Changing the game: exploring infants' participation in early play routines

    PubMed Central

    Fantasia, Valentina; Fasulo, Alessandra; Costall, Alan; López, Beatriz

    2014-01-01

    Play has proved to have a central role in children's development, most notably in rule learning (Piaget, 1965; Sutton-Smith, 1979) and negotiation of roles and goals (Garvey, 1974; Bruner et al., 1976). Yet very little research has been done on early play. The present study focuses on early social games, i.e., vocal-kinetic play routines that mothers use to interact with infants from very early on. We explored 3-month-old infants and their mothers performing a routine game first in the usual way, then in two violated conditions: without gestures and without sound. The aim of the study is to investigate infants' participation and expectations in the game and whether this participation is affected by changes in the multimodal format of the game. Infants' facial expressions, gaze, and body movements were coded to measure levels of engagement and affective state across the three conditions. Results showed a significant decrease in Limbs Movements and expressions of Positive Affect, an increase in Gaze Away and in Stunned Expression when the game structure was violated. These results indicate that the violated game conditions were experienced as less engaging, either because of an unexpected break in the established joint routine, or simply because they were weaker versions of the same game. Overall, our results suggest that structured, multimodal play routines may constitute interactional contexts that only work as integrated units of auditory and motor resources, representing early communicative contexts which prepare the ground for later, more complex multimodal interactions, such as verbal exchanges. PMID:24936192

  14. Community Engagement in Liberia: Routine Immunization Post-Ebola.

    PubMed

    Bedford, Juliet; Chitnis, Ketan; Webber, Nance; Dixon, Phil; Limwame, Ken; Elessawi, Rania; Obregon, Rafael

    2017-01-01

    A national integrated polio, measles, and deworming campaign was implemented across Liberia May 8-14, 2015. The community engagement and social mobilization component of the campaign was based on structures that had been invested in during the Ebola response. This article provides an overview of the community engagement and social mobilization activities that were conducted and reports the key findings of a rapid qualitative assessment conducted immediately after the campaign that focused on community perceptions of routine immunization in the post-Ebola context. Focus group discussions and interviews were conducted across four counties in Liberia (Montserrado, Nimba, Bong, and Margibi). Thematic analysis identified the barriers preventing and drivers leading to the utilization of routine immunization. Community members also made recommendations and forwarded community-based solutions to encourage engagement with future health interventions, including uptake in vaccination campaigns. These should be incorporated in the development and implementation of future interventions and programs.

  15. BeerOz, a set of Matlab routines for the quantitative interpretation of spectrophotometric measurements of metal speciation in solution

    NASA Astrophysics Data System (ADS)

    Brugger, Joël

    2007-02-01

    The modelling of the speciation and mobility of metals under surface and hydrothermal conditions relies on the availability of accurate thermodynamic properties for all relevant minerals, aqueous species, gases and surface species. Spectroscopic techniques obeying the Beer-Lambert law can be used to obtain thermodynamic properties for reactions among aqueous species (e.g., ligand substitution; protonation). BeerOz is a set of Matlab routines designed to perform both qualitative and quantitative analysis of spectroscopic data following the Beer-Lambert law. BeerOz is modular and can be customised for particular experimental strategies or for simultaneous refinement of several datasets obtained using different techniques. Distribution of species calculations are performed using an implementation of the EQBRM code, which allows for customised activity coefficient calculations. BeerOz also contains routines to study the n-dimensional solution space, in order to provide realistic estimates of errors and test for the existence of multiple local minima and correlation between the different refined variables. The paper reviews the physical principles underlying the qualitative and quantitative analysis of spectroscopic data collected on aqueous speciation, in particular for studying successive ligand replacement reactions, and presents the non-linear least-squares algorithm implemented in BeerOz. The discussion is illustrated using UV-Vis spectra collected on acidic Fe(III) solutions containing varying LiCl concentrations, and showing the change from the hexaaquo Fe(H 2O) 63+ complex to the tetrahedral FeCl 4- complex.

  16. Improving quality of life through the routine use of the patient concerns inventory for head and neck cancer patients: a cluster preference randomized controlled trial.

    PubMed

    Rogers, Simon N; Lowe, Derek; Lowies, Cher; Yeo, Seow Tien; Allmark, Christine; Mcavery, Dominic; Humphris, Gerald M; Flavel, Robert; Semple, Cherith; Thomas, Steven J; Kanatas, Anastasios

    2018-04-18

    The consequences of treatment for Head and Neck cancer (HNC) patients has profound detrimental impacts such as impaired QOL, emotional distress, delayed recovery and frequent use of healthcare. The aim of this trial is to determine if the routine use of the Patients Concerns Inventory (PCI) package in review clinics during the first year following treatment can improve overall quality of life, reduce the social-emotional impact of cancer and reduce levels of distress. Furthermore, we aim to describe the economic costs and benefits of using the PCI. This will be a cluster preference randomised control trial with consultants either 'using' or 'not using' the PCI package at clinic. It will involve two centres Leeds and Liverpool. 416 eligible patients from at least 10 consultant clusters are required to show a clinically meaningful difference in the primary outcome. The primary outcome is the percentage of participants with less than good overall quality of life at the final one-year clinic as measured by the University of Washington QOL questionnaire version 4 (UWQOLv4). Secondary outcomes at one-year are the mean social-emotional subscale (UWQOLv4) score, Distress Thermometer (DT) score ≥ 4, and key health economic measures (QALY-EQ-5D-5 L; CSRI). This trial will provide knowledge on the effectiveness of a consultation intervention package based around the PCI used at routine follow-up clinics following treatment of head and neck cancer with curative intent. If this intervention is (cost) effective for patients, the next step will be to promote wider use of this approach as standard care in clinical practice. 32,382. Clinical Trials Identifier, NCT03086629 . Version 3.0, 1st July 2017.

  17. Can AERONET data be used to accurately model the monochromatic beam and circumsolar irradiances under cloud-free conditions in desert environment?

    NASA Astrophysics Data System (ADS)

    Eissa, Y.; Blanc, P.; Wald, L.; Ghedira, H.

    2015-07-01

    Routine measurements of the beam irradiance at normal incidence (DNI) include the irradiance originating from within the extent of the solar disc only (DNIS) whose angular extent is 0.266° ± 1.7 %, and that from a larger circumsolar region, called the circumsolar normal irradiance (CSNI). This study investigates if the spectral aerosol optical properties of the AERONET stations are sufficient for an accurate modelling of the monochromatic DNIS and CSNI under cloud-free conditions in a desert environment. The data from an AERONET station in Abu Dhabi, United Arab Emirates, and a collocated Sun and Aureole Measurement (SAM) instrument which offers reference measurements of the monochromatic profile of solar radiance, were exploited. Using the AERONET data both the radiative transfer models libRadtran and SMARTS offer an accurate estimate of the monochromatic DNIS, with a relative root mean square error (RMSE) of 5 %, a relative bias of +1 % and acoefficient of determination greater than 0.97. After testing two configurations in SMARTS and three in libRadtran for modelling the monochromatic CSNI, libRadtran exhibits the most accurate results when the AERONET aerosol phase function is presented as a Two Term Henyey-Greenstein phase function. In this case libRadtran exhibited a relative RMSE and a bias of respectively 22 and -19 % and a coefficient of determination of 0.89. The results are promising and pave the way towards reporting the contribution of the broadband circumsolar irradiance to standard DNI measurements.

  18. Accurate control of oxygen level in cells during culture on silicone rubber membranes with application to stem cell differentiation.

    PubMed

    Powers, Daryl E; Millman, Jeffrey R; Bonner-Weir, Susan; Rappel, Michael J; Colton, Clark K

    2010-01-01

    Oxygen level in mammalian cell culture is often controlled by placing culture vessels in humidified incubators with a defined gas phase partial pressure of oxygen (pO(2gas)). Because the cells are consuming oxygen supplied by diffusion, a difference between pO(2gas) and that experienced by the cells (pO(2cell)) arises, which is maximal when cells are cultured in vessels with little or no oxygen permeability. Here, we demonstrate theoretically that highly oxygen-permeable silicone rubber membranes can be used to control pO(2cell) during culture of cells in monolayers and aggregates much more accurately and can achieve more rapid transient response following a disturbance than on polystyrene and fluorinated ethylene-propylene copolymer membranes. Cell attachment on silicone rubber was achieved by physical adsorption of fibronectin or Matrigel. We use these membranes for the differentiation of mouse embryonic stem cells to cardiomyocytes and compare the results with culture on polystyrene or on silicone rubber on top of polystyrene. The fraction of cells that are cardiomyocyte-like increases with decreasing pO(2) only when using oxygen-permeable silicone membrane-based dishs, which contract on silicone rubber but not polystyrene. The high permeability of silicone rubber results in pO(2cell) being equal to pO(2gas) at the tissue-membrane interface. This, together with geometric information from histological sections, facilitates development of a model from which the pO(2) distribution within the resulting aggregates is computed. Silicone rubber membranes have significant advantages over polystyrene in controlling pO(2cell), and these results suggest they are a valuable tool for investigating pO(2) effects in many applications, such as stem cell differentiation. Copyright 2009 American Institute of Chemical Engineers

  19. 17 CFR 240.17Ad-10 - Prompt posting of certificate detail to master securityholder files, maintenance of accurate...

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... between co-transfer agents and recordkeeping transfer agents, maintenance of current control book... securityholder files, maintenance of accurate securityholder files, communications between co-transfer agents and recordkeeping transfer agents, maintenance of current control book, retention of certificate detail and “buy-in...

  20. 17 CFR 240.17Ad-10 - Prompt posting of certificate detail to master securityholder files, maintenance of accurate...

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... between co-transfer agents and recordkeeping transfer agents, maintenance of current control book... securityholder files, maintenance of accurate securityholder files, communications between co-transfer agents and recordkeeping transfer agents, maintenance of current control book, retention of certificate detail and “buy-in...

  1. 17 CFR 240.17Ad-10 - Prompt posting of certificate detail to master securityholder files, maintenance of accurate...

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... between co-transfer agents and recordkeeping transfer agents, maintenance of current control book... securityholder files, maintenance of accurate securityholder files, communications between co-transfer agents and recordkeeping transfer agents, maintenance of current control book, retention of certificate detail and “buy-in...

  2. Ab Initio Potential Energy Surfaces and the Calculation of Accurate Vibrational Frequencies

    NASA Technical Reports Server (NTRS)

    Lee, Timothy J.; Dateo, Christopher E.; Martin, Jan M. L.; Taylor, Peter R.; Langhoff, Stephen R. (Technical Monitor)

    1995-01-01

    Due to advances in quantum mechanical methods over the last few years, it is now possible to determine ab initio potential energy surfaces in which fundamental vibrational frequencies are accurate to within plus or minus 8 cm(exp -1) on average, and molecular bond distances are accurate to within plus or minus 0.001-0.003 Angstroms, depending on the nature of the bond. That is, the potential energy surfaces have not been scaled or empirically adjusted in any way, showing that theoretical methods have progressed to the point of being useful in analyzing spectra that are not from a tightly controlled laboratory environment, such as vibrational spectra from the interstellar medium. Some recent examples demonstrating this accuracy will be presented and discussed. These include the HNO, CH4, C2H4, and ClCN molecules. The HNO molecule is interesting due to the very large H-N anharmonicity, while ClCN has a very large Fermi resonance. The ab initio studies for the CH4 and C2H4 molecules present the first accurate full quartic force fields of any kind (i.e., whether theoretical or empirical) for a five-atom and six-atom system, respectively.

  3. Implementing shared decision-making in routine practice: barriers and opportunities.

    PubMed

    Holmes-Rovner, Margaret; Valade, Diane; Orlowski, Catherine; Draus, Catherine; Nabozny-Valerio, Barbara; Keiser, Susan

    2000-09-01

    OBJECTIVE: Determine feasibility of shared decision-making programmes in fee-for-service hospital systems including physicians' offices and in-patient facilities. DESIGN: Survey and participant observation. Data obtained during Phase 1 of a patient outcome study. SETTINGS AND PARTICIPANTS: Three hospitals in Michigan: one 299-bed rural regional hospital, one 650-bed urban community hospital, one 459-bed urban and suburban teaching hospital. All nurses and physicians who agreed to use the programmes participated in the evaluation (n = 34). INTERVENTION: Two shared decision-making(R) (SDP) multimedia programmes: surgical treatment choice for breast cancer and ischaemic heart disease treatment choice. MAIN OUTCOME MEASURES: (1) clinicians' evaluations of programme quality; (2) challenges in hospital settings; and (3) patient referral rates. RESULTS: SDP programmes were judged to be clear, accurate and about the right length and amount of information. Programmes were judged to be informative and appropriate for patients to see before making a decision. Clinicians were neutral about patients' desire to participate in treatment decision-making. Referral volume to SDPs was lower than expected: 24 patients in 7 months across three hospitals. Implementation challenges centred on time pressures in patient care. CONCLUSIONS: Productivity and time pressure in US health care severely constrain shared decision-making programme implementation. Physician referral may not be a reliable mechanism for patient access. Possible innovations include: (1) incorporation into the informed consent process; (2) provider or payer negotiated requirement in the routine hospital procedure to use the SDP as a quality indicator; and (3) payer reimbursement to professional providers who make SDP programmes available to patients.

  4. MATHEMATICAL ROUTINES FOR ENGINEERS AND SCIENTISTS

    NASA Technical Reports Server (NTRS)

    Kantak, A. V.

    1994-01-01

    The purpose of this package is to provide the scientific and engineering community with a library of programs useful for performing routine mathematical manipulations. This collection of programs will enable scientists to concentrate on their work without having to write their own routines for solving common problems, thus saving considerable amounts of time. This package contains sixteen subroutines. Each is separately documented with descriptions of the invoking subroutine call, its required parameters, and a sample test program. The functions available include: maxima, minima, and sort of vectors; factorials; random number generator (uniform or Gaussian distribution); complimentary error function; fast Fourier Transformation; Simpson's Rule integration; matrix determinate and inversion; Bessel function (J Bessel function for any order, and modified Bessel function for zero order); roots of a polynomial; roots of non-linear equation; and the solution of first order ordinary differential equations using Hamming's predictor-corrector method. There is also a subroutine for using a dot matrix printer to plot a given set of y values for a uniformly increasing x value. This package is written in FORTRAN 77 (Super Soft Small System FORTRAN compiler) for batch execution and has been implemented on the IBM PC computer series under MS-DOS with a central memory requirement of approximately 28K of 8 bit bytes for all subroutines. This program was developed in 1986.

  5. What is the value of the routine use of patient-reported outcome measures toward improvement of patient outcomes, processes of care, and health service outcomes in cancer care? A systematic review of controlled trials.

    PubMed

    Kotronoulas, Grigorios; Kearney, Nora; Maguire, Roma; Harrow, Alison; Di Domenico, David; Croy, Suzanne; MacGillivray, Stephen

    2014-05-10

    The systematic use of patient-reported outcome measures (PROMs) has been advocated as an effective way to standardize cancer practice. Yet, the question of whether PROMs can lead to actual improvements in the quality of patient care remains under debate. This review examined whether inclusion of PROM in routine clinical practice is associated with improvements in patient outcomes, processes of care, and health service outcomes during active anticancer treatment. A systematic review of five electronic databases (Medline, EMBASE, CINAHL [Cumulative Index to Nursing and Allied Health Literature], PsycINFO, and Psychology and Behavioral Sciences Collection [PBSC]) was conducted from database inception to May 2012 to locate randomized and nonrandomized controlled trials of patients receiving active anticancer treatment or supportive care irrespective of type of cancer. Based on prespecified eligibility criteria, we included 26 articles that reported on 24 unique controlled trials. Wide variability in the design and use of interventions delivered, outcomes evaluated, and cancer- and modality-specific context was apparent. Health service outcomes were only scarcely included as end points. Overall, the number of statistically significant findings were limited and PROMs' intervention effect sizes were predominantly small-to-moderate. The routine use of PROMs increases the frequency of discussion of patient outcomes during consultations. In some studies, PROMs are associated with improved symptom control, increased supportive care measures, and patient satisfaction. Additional effort is required to ensure patient adherence, as well as additional support to clinicians who will respond to patient concerns and issues, with clear system guidelines in place to guide their responses. More research is required to support PROM cost-benefit in terms of patient safety, clinician burden, and health services usage.

  6. Guardians to Counter Adolescent Drug Use?: Limitations of a Routine Activities Approach

    ERIC Educational Resources Information Center

    Bratt, Christopher

    2008-01-01

    Based on suggestions made by routine activities theory and data from two surveys, the present study discusses the use of adult guardians as a means to counter drug use among adolescents who seek out unsupervised routine activities with peers. Two surveys with 13- to 15-year-olds were conducted 4 years apart in a Norwegian town (Ns = 1,455 and…

  7. Investigating socio-economic inequity in access to and expenditures on routine immunization services in Anambra state.

    PubMed

    Sibeudu, Florence T; Uzochukwu, Benjamin S C; Onwujekwe, Obinna E

    2017-02-01

    Addressing existing inequities in the utilization of priority health services such as routine immunization is a current public health priority. Increasing access to routine immunization from the current low levels amongst all socio-economic status groups in Nigeria is challenging. However, little is known on the level of SES inequity in utilization of routine immunization services and such information which will inform the development of strategies for ensuring equitable provision of routine immunization services in the country. The study was a cross sectional household survey, which was undertaken in two randomly selected communities in Anambra State, southeast Nigeria. A pre-tested interviewer administered questionnaire was used to collect data on levels of access to RI by children under-2 years from randomly selected households. In each household, data was collected from the primary care givers or their representative (in their absence). The relationship between access to routine immunization and socio-economic status of households and other key variables was explored in data analysis. Households from high socio-economic status (well-off) groups utilized routine immunization services more than those that belong to low socio-economic status (poor) groups (X 2  = 9.97, p < 0.002). It was found that higher percentage of low socio-economic status households compared to the high socio-economic status households received routine immunization services at public health facilities. Households that belong to low socio-economic status groups had to travel longer distance to get to health facilities consequently incurring some transportation cost. The mean expenditures on service charge for routine immunization services (mostly informal payments) and transportation were US$1.84 and US$1.27 respectively. Logistic regression showed that access to routine immunization was positively related to socio-economic status and negatively related to distant of a household to a

  8. Selective vs routine midline episiotomy for the prevention of third- or fourth-degree lacerations in nulliparous women.

    PubMed

    Rodriguez, Alexander; Arenas, Edgar A; Osorio, Alba L; Mendez, Omar; Zuleta, John J

    2008-03-01

    The purpose of this study was to determine whether selective midline episiotomy contributes to the prevention of third- or fourth-degree perineal lacerations. A randomized controlled clinical trial was performed with 446 nulliparous women with deliveries after 28 weeks of pregnancy. Patients were randomized to undergo either routine episiotomy or selective episiotomy. In the selective episiotomy group, episiotomies were performed only in cases of imminent lacerations, fetal distress, or forceps delivery. In the group of 223 patients who underwent routine episiotomy, 32 (14.3%) had third- or fourth-degree perineal lacerations, as compared to 15 (6.8%) in the group of 222 patients undergoing selective episiotomy (relative risk, 2.12; 95% confidence interval, 1.18-3.81). Only reduction in third-degree lacerations was significant when analyzed separately. Moreover, periurethral, labia minora, and superficial vaginal lacerations were significantly more frequent in the selective episiotomy group. The policy of performing selective midline episiotomy in nulliparous patients results in a reduction in the risk of third-degree perineal lacerations.

  9. Evidence-based new service package vs. routine service package for smoking cessation to prevent high risk patients from cardiovascular diseases (CVD): study protocol for randomized controlled trial

    PubMed Central

    2013-01-01

    Background Smoking cessation is a high-priority intervention to prevent CVD events and deaths in developing countries. While several interventions to stop smoking have been proved successful, the question of how to increase their effectiveness and practicality in developing countries remains. In this study, a newly devised evidence-based smoking cessation service package will be compared with the existing service in a randomized controlled trial within the community setting of Thailand. Method/Design This randomized control trial will recruit 440 current smokers at CVD risk because of being diabetic and/or hypertensive. Informed, consented participants will be randomly allocated into the new service-package arm and the routine service arm. The study will take place in the non-communicable disease clinics of the Maetha District Hospital, Lampang, northern Thailand. The new smoking-cessation service-package comprises (1) regular patient motivation and coaching from the same primary care nurse over a 3-month period; (2) monthly application of piCO + smokerlyzer to sustain motivation of smoker’s quitting attempt and provide positive feedback over a 3-month period; (3) assistance by an assigned family member; (4) nicotine replacement chewing gum to relieve withdrawal symptoms. This new service will be compared with the traditional routine service comprising the 5A approach in a 1-year follow-up. Participants who consent to participate in the study but refuse to attempt quitting smoking will be allocated to the non-randomized arm, where they will be just followed up and monitored. Primary outcome of the study is smoking cessation rate at 1-year follow-up proven by breath analysis measuring carbomonoxide in parts per million in expired air. Secondary outcomes are smoking cessation rate at the 6-month follow-up, blood pressure and heart rate, CVD risk according to the Framingham general cardiovascular risk score, CVD events and deaths at the 12-month follow-up, and

  10. Guidance for Efficient Small Animal Imaging Quality Control.

    PubMed

    Osborne, Dustin R; Kuntner, Claudia; Berr, Stuart; Stout, David

    2017-08-01

    Routine quality control is a critical aspect of properly maintaining high-performance small animal imaging instrumentation. A robust quality control program helps produce more reliable data both for academic purposes and as proof of system performance for contract imaging work. For preclinical imaging laboratories, the combination of costs and available resources often limits their ability to produce efficient and effective quality control programs. This work presents a series of simplified quality control procedures that are accessible to a wide range of preclinical imaging laboratories. Our intent is to provide minimum guidelines for routine quality control that can assist preclinical imaging specialists in setting up an appropriate quality control program for their facility.

  11. Accurate screening for insulin resistance in PCOS women using fasting insulin concentrations.

    PubMed

    Lunger, Fabian; Wildt, Ludwig; Seeber, Beata

    2013-06-01

    The aims of this cross-sectional study were to evaluate the relative agreement of both static and dynamic methods of diagnosing IR in women with polycystic ovary syndrome (PCOS) and to suggest a simple screening method for IR. All participants underwent serial blood draws for hormonal profiling and lipid assessment, a 3 h, 75 g load oral glucose tolerance test (OGTT) with every 15 min measurements of glucose and insulin, and an ACTH stimulation test. The prevalence of IR ranged from 12.2% to 60.5%, depending on the IR index used. Based on largest area under the curve on receiver operating curve (ROC) analyses, the dynamic indices outperformed the static indices with glucose to insulin ratio and fasting insulin (fInsulin) demonstrating the best diagnostic properties. Applying two cut-offs representing fInsulin extremes (<7 and >13 mIU/l, respectively) gave the diagnosis in 70% of the patients with high accuracy. Currently utilized indices for assessing IR give highly variable results in women with PCOS. The most accurate indices based on dynamic testing can be time-consuming and labor-intensive. We suggest the use of fInsulin as a simple screening test, which can reduce the number of OGTTs needed to routinely assess insulin resistance in women with PCOS.

  12. 10 CFR 835.1003 - Workplace controls.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 10 Energy 4 2014-01-01 2014-01-01 false Workplace controls. 835.1003 Section 835.1003 Energy DEPARTMENT OF ENERGY OCCUPATIONAL RADIATION PROTECTION Design and Control § 835.1003 Workplace controls. During routine operations, the combination of engineered and administrative controls shall provide that...

  13. 10 CFR 835.1003 - Workplace controls.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 10 Energy 4 2013-01-01 2013-01-01 false Workplace controls. 835.1003 Section 835.1003 Energy DEPARTMENT OF ENERGY OCCUPATIONAL RADIATION PROTECTION Design and Control § 835.1003 Workplace controls. During routine operations, the combination of engineered and administrative controls shall provide that...

  14. 10 CFR 835.1003 - Workplace controls.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 10 Energy 4 2010-01-01 2010-01-01 false Workplace controls. 835.1003 Section 835.1003 Energy DEPARTMENT OF ENERGY OCCUPATIONAL RADIATION PROTECTION Design and Control § 835.1003 Workplace controls. During routine operations, the combination of engineered and administrative controls shall provide that...

  15. 10 CFR 835.1003 - Workplace controls.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 10 Energy 4 2012-01-01 2012-01-01 false Workplace controls. 835.1003 Section 835.1003 Energy DEPARTMENT OF ENERGY OCCUPATIONAL RADIATION PROTECTION Design and Control § 835.1003 Workplace controls. During routine operations, the combination of engineered and administrative controls shall provide that...

  16. 10 CFR 835.1003 - Workplace controls.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 10 Energy 4 2011-01-01 2011-01-01 false Workplace controls. 835.1003 Section 835.1003 Energy DEPARTMENT OF ENERGY OCCUPATIONAL RADIATION PROTECTION Design and Control § 835.1003 Workplace controls. During routine operations, the combination of engineered and administrative controls shall provide that...

  17. A new generation of cancer genome diagnostics for routine clinical use: overcoming the roadblocks to personalized cancer medicine.

    PubMed

    Heuckmann, J M; Thomas, R K

    2015-09-01

    The identification of 'druggable' kinase gene alterations has revolutionized cancer treatment in the last decade by providing new and successfully targetable drug targets. Thus, genotyping tumors for matching the right patients with the right drugs have become a clinical routine. Today, advances in sequencing technology and computational genome analyses enable the discovery of a constantly growing number of genome alterations relevant for clinical decision making. As a consequence, several technological approaches have emerged in order to deal with these rapidly increasing demands for clinical cancer genome analyses. Here, we describe challenges on the path to the broad introduction of diagnostic cancer genome analyses and the technologies that can be applied to overcome them. We define three generations of molecular diagnostics that are in clinical use. The latest generation of these approaches involves deep and thus, highly sensitive sequencing of all therapeutically relevant types of genome alterations-mutations, copy number alterations and rearrangements/fusions-in a single assay. Such approaches therefore have substantial advantages (less time and less tissue required) over PCR-based methods that typically have to be combined with fluorescence in situ hybridization for detection of gene amplifications and fusions. Since these new technologies work reliably on routine diagnostic formalin-fixed, paraffin-embedded specimens, they can help expedite the broad introduction of personalized cancer therapy into the clinic by providing comprehensive, sensitive and accurate cancer genome diagnoses in 'real-time'. © The Author 2015. Published by Oxford University Press on behalf of the European Society for Medical Oncology. All rights reserved. For permissions, please email: journals.permissions@oup.com.

  18. Diagnosing somatisation disorder (P75) in routine general practice using the International Classification of Primary Care.

    PubMed

    Schaefert, Rainer; Laux, Gunter; Kaufmann, Claudia; Schellberg, Dieter; Bölter, Regine; Szecsenyi, Joachim; Sauer, Nina; Herzog, Wolfgang; Kuehlein, Thomas

    2010-09-01

    (i) To analyze general practitioners' diagnosis of somatisation disorder (P75) using the International Classification of Primary Care (ICPC)-2-E in routine general practice. (ii) To validate the distinctiveness of the ICD-10 to ICPC-2 conversion rule which maps ICD-10 dissociative/conversion disorder (F44) as well as half of the somatoform categories (F45.0-2) to P75 and codes the other half of these disorders (F45.3-9), including autonomic organ dysfunctions and pain syndromes, as symptom diagnoses plus a psychosocial code in a multiaxial manner. Cross-sectional analysis of routine data from a German research database comprising the electronic patient records of 32 general practitioners from 22 practices. For each P75 patient, control subjects matched for age, gender, and practice were selected from the 2007 yearly contact group (YCG) without a P75 diagnosis using a propensity-score algorithm that resulted in eight controls per P75 patient. Of the 49,423 patients in the YCG, P75 was diagnosed in 0.6% (302) and F45.3-9 in 1.8% (883) of cases; overall, somatisation syndromes were diagnosed in 2.4% of patients. The P75 coding pattern coincided with typical characteristics of severe, persistent medically unexplained symptoms (MUS). F45.3-9 was found to indicate moderate MUS that otherwise showed little clinical difference from P75. Pain syndromes exhibited an unspecific coding pattern. Mild and moderate MUS were predominantly recorded as symptom diagnoses. Psychosocial codes were rarely documented. ICPC-2 P75 was mainly diagnosed in cases of severe MUS. Multiaxial coding appears to be too complicated for routine primary care. Instead of splitting P75 and F45.3-9 diagnoses, it is proposed that the whole MUS spectrum should be conceptualized as a continuum model comprising categorizations of uncomplicated (mild) and complicated (moderate and severe) courses. Psychosocial factors require more attention. Copyright (c) 2010 Elsevier Inc. All rights reserved.

  19. Validating soil phosphorus routines in the SWAT model

    USDA-ARS?s Scientific Manuscript database

    Phosphorus transfer from agricultural soils to surface waters is an important environmental issue. Commonly used models like SWAT have not always been updated to reflect improved understanding of soil P transformations and transfer to runoff. Our objective was to validate the ability of the P routin...

  20. 47 CFR 0.460 - Requests for inspection of records which are routinely available for public inspection.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... routinely available for public inspection. 0.460 Section 0.460 Telecommunication FEDERAL COMMUNICATIONS... § 0.460 Requests for inspection of records which are routinely available for public inspection. (a) Sections 0.453 and 0.455 list those Commission records which are routinely available for public inspection...