Sample records for advancing making progress

  1. Preventing Breast Cancer: Making Progress

    MedlinePlus

    ... Navigation Bar Home Current Issue Past Issues Preventing Breast Cancer: Making Progress Past Issues / Fall 2006 Table of ... 000 women will have been diagnosed with invasive breast cancer, and nearly 41,000 women will die from ...

  2. Decision Making Styles and Progress in Occupational Decision Making.

    ERIC Educational Resources Information Center

    Phillips, Susan D.; And Others

    1984-01-01

    Examined the role of rational, intuitive, and dependent decisional strategies in facilitating decisions about postcollege occupation among college students (N=71). Results indicated that the use of a dependent decision-making style was the single most powerful predictor of progress. (LLL)

  3. Advances in insect physiology. Progress in mosquito research

    USDA-ARS?s Scientific Manuscript database

    This book review briefly summarizes the most interesting topics/chapters from the book: "Advances in Insect Physiology: Progress in mosquito Research". The book is an excellent overview of the recent advances in mosquito biology. This volume encompasses 13 chapters from 32 contributing authors who ...

  4. Why is it hard to make progress in assessing children's decision-making competence?

    PubMed

    Hein, Irma M; Troost, Pieter W; Broersma, Alice; de Vries, Martine C; Daams, Joost G; Lindauer, Ramón J L

    2015-01-10

    For decades, the discussion on children's competence to consent to medical issues has concentrated around normative concerns, with little progress in clinical practices. Decision-making competence is an important condition in the informed consent model. In pediatrics, clinicians need to strike a proper balance in order to both protect children's interests when they are not fully able to do so themselves and to respect their autonomy when they are. Children's competence to consent, however, is currently not assessed in a standardized way. Moreover, the correlation between competence to give informed consent and age in children has never been systematically investigated, nor do we know which factors exactly contribute to children's competence.This article aims at identifying these gaps in knowledge and suggests options for dealing with the obstacles in empirical research in order to advance policies and practices regarding children's medical decision-making competence. Understanding children's competency is hampered by the law. Legislative regulations concerning competency are established on a strong presumption that persons older than a certain age are competent, whereas younger persons are not. Furthermore, a number of contextual factors are believed to be of influence on a child's decision-making competence: the developmental stage of children, the influence of parents and peers, the quality of information provision, life experience, the type of medical decision, and so on. Ostensibly, these diverse and extensive barriers hinder any form of advancement in this conflicted area. Addressing these obstacles encourages the discussion on children's competency, in which the most prominent question concerns the lack of a clear operationalization of children's competence to consent. Empirical data are needed to substantiate the discussion. The empirical approach offers an opportunity to give direction to the debate. Recommendations for future research include: studying a

  5. Decision-Making Accuracy of CBM Progress-Monitoring Data

    ERIC Educational Resources Information Center

    Hintze, John M.; Wells, Craig S.; Marcotte, Amanda M.; Solomon, Benjamin G.

    2018-01-01

    This study examined the diagnostic accuracy associated with decision making as is typically conducted with curriculum-based measurement (CBM) approaches to progress monitoring. Using previously published estimates of the standard errors of estimate associated with CBM, 20,000 progress-monitoring data sets were simulated to model student reading…

  6. 7 CFR 1486.406 - Will CCC make advance payments to Recipients?

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 7 Agriculture 10 2014-01-01 2014-01-01 false Will CCC make advance payments to Recipients? 1486... Reimbursements § 1486.406 Will CCC make advance payments to Recipients? (a) Policy. In general, CCC operates the EMP on a cost reimbursable basis. (b) Exception. Upon request, CCC may make advance payments to a...

  7. 7 CFR 1486.406 - Will CCC make advance payments to Recipients?

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 7 Agriculture 10 2012-01-01 2012-01-01 false Will CCC make advance payments to Recipients? 1486... Reimbursements § 1486.406 Will CCC make advance payments to Recipients? (a) Policy. In general, CCC operates the EMP on a cost reimbursable basis. (b) Exception. Upon request, CCC may make advance payments to a...

  8. 7 CFR 1486.406 - Will CCC make advance payments to Recipients?

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 7 Agriculture 10 2013-01-01 2013-01-01 false Will CCC make advance payments to Recipients? 1486... Reimbursements § 1486.406 Will CCC make advance payments to Recipients? (a) Policy. In general, CCC operates the EMP on a cost reimbursable basis. (b) Exception. Upon request, CCC may make advance payments to a...

  9. Registered nurses' decision-making regarding documentation in patients' progress notes.

    PubMed

    Tower, Marion; Chaboyer, Wendy; Green, Quentine; Dyer, Kirsten; Wallis, Marianne

    2012-10-01

    To examine registered nurses' decision-making when documenting care in patients' progress notes. What constitutes effective nursing documentation is supported by available guidelines. However, ineffective documentation continues to be cited as a major cause of adverse events for patients. Decision-making in clinical practice is a complex process. To make an effective decision, the decision-maker must be situationally aware. The concept of situation awareness and its implications for making safe decisions has been examined extensively in air safety and more recently is being applied to health. The study was situated in a naturalistic paradigm. Purposive sampling was used to recruit 17 registered nurses who used think-aloud research methods when making decisions about documenting information in patients' progress notes. Follow-up interviews were conducted to validate interpretations. Data were analysed systematically for evidence of cues that demonstrated situation awareness as nurses made decisions about documentation. Three distinct decision-making scenarios were illuminated from the analysis: the newly admitted patient, the patient whose condition was as expected and the discharging patient. Nurses used mental models for decision-making in documenting in progress notes, and the cues nurses used to direct their assessment of patients' needs demonstrated situation awareness at different levels. Nurses demonstrate situation awareness at different levels in their decision-making processes. While situation awareness is important, it is also important to use an appropriate decision-making framework. Cognitive continuum theory is suggested as a decision-making model that could support situation awareness when nurses made decisions about documenting patient care. Because nurses are key decision-makers, it is imperative that effective decisions are made that translate into safe clinical care. Including situation awareness training, combined with employing cognitive

  10. Advance care planning and proxy decision making for patients with advanced Parkinson disease.

    PubMed

    Kwak, Jung; Wallendal, Maggie S; Fritsch, Thomas; Leo, Gary; Hyde, Trevor

    2014-03-01

    To examine advance care planning practices and proxy decision making by family healthcare proxies for patients with advanced Parkinson disease (PD). Sixty-four spouses and adult children, self-designated as a/the healthcare proxy for advanced patients with PD, participated in a cross-sectional survey study. Sixty patients with PD (95%) had completed a living will, but only 38% had shared the document with a physician. Among three life-support treatments--cardiopulmonary resuscitation (CPR), ventilator, and feeding tube--47% of patients opted for CPR, 16% for ventilator, and 20% for feeding tube. Forty-two percent of proxies did not know patients' preferences for one or more of the three life-support treatments. Only 28% of proxies reported that patients wanted hospice. Patients who shared advance directives with a physician were significantly less likely to choose CPR and a feeding tube and they were more likely to choose hospice. In a hypothetical end-of-life (EOL) scenario, the majority of proxies chose comfort care as the EOL goal of care (53%) and pain and symptom management only as the course of treatment option (72%); these proxy choices for patients, however, were not associated with patients' preferences for life support. Patients' proxies preferred a form of shared decision making with other family members and physicians. Advance care planning is effective when patients, families, and healthcare professionals together consider future needs for EOL care decisions. Further efforts are needed by healthcare professionals to provide evidence-based education about care options and facilitate advanced discussion and shared decision making by the patient and families.

  11. Vemurafenib for BRAF V600 mutated advanced melanoma: results of treatment beyond progression.

    PubMed

    Scholtens, A; Geukes Foppen, M H; Blank, C U; van Thienen, J V; van Tinteren, H; Haanen, J B

    2015-03-01

    Selective BRAF inhibition (BRAFi) by vemurafenib or dabrafenib has become approved standard treatment in BRAF V600 mutated advanced stage melanoma. While the response rate is high, the response duration is limited with a progression-free survival (PFS) of 5-6months. Our observation of accelerated disease progression within some patients after stopping vemurafenib treatment has fostered the idea of treatment beyond progression (BRAFi TBP). In this retrospective study, we analysed 70 metastatic melanoma patients, treated at our institute, who experienced progression after prior objective response upon treatment with vemurafenib. Thirty-five patients that continued treatment beyond progression are compared with 35 patients who stopped BRAFi treatment at disease progression. Median overall survival beyond documented progression was found to be 5.2months versus 1.4months (95% confidence interval (CI): 3.8-7.4 versus 0.6-3.4; Log-Rank p=0.002) in favour of BRAFi TBP. In the multivariate survival analysis, stopping treatment at disease progression was significantly associated with shorter survival (hazard ratio: 1.92; 95% CI: 1.04-3.55; p=0.04). Our results suggest that continuing vemurafenib treatment beyond progression may be beneficial in advanced melanoma patients, who prior to progression responded to vemurafenib. Copyright © 2015 Elsevier Ltd. All rights reserved.

  12. 34 CFR 200.20 - Making adequate yearly progress.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... adequate yearly progress. A school or LEA makes AYP if it complies with paragraph (c) and with either paragraph (a) or (b) of this section separately in reading/language arts and in mathematics. (a)(1) A school... school or LEA, respectively, meets or exceeds the State's other academic indicators under § 200.19. (2...

  13. 34 CFR 200.20 - Making adequate yearly progress.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... adequate yearly progress. A school or LEA makes AYP if it complies with paragraph (c) and with either paragraph (a) or (b) of this section separately in reading/language arts and in mathematics. (a)(1) A school... school or LEA, respectively, meets or exceeds the State's other academic indicators under § 200.19. (2...

  14. 34 CFR 200.20 - Making adequate yearly progress.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... adequate yearly progress. A school or LEA makes AYP if it complies with paragraph (c) and with either paragraph (a) or (b) of this section separately in reading/language arts and in mathematics. (a)(1) A school... school or LEA, respectively, meets or exceeds the State's other academic indicators under § 200.19. (2...

  15. 34 CFR 200.20 - Making adequate yearly progress.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... adequate yearly progress. A school or LEA makes AYP if it complies with paragraph (c) and with either paragraph (a) or (b) of this section separately in reading/language arts and in mathematics. (a)(1) A school... school or LEA, respectively, meets or exceeds the State's other academic indicators under § 200.19. (2...

  16. 7 CFR 1486.406 - Will CCC make advance payments to Recipients?

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 7 Agriculture 10 2011-01-01 2011-01-01 false Will CCC make advance payments to Recipients? 1486... PROGRAM Contributions and Reimbursements § 1486.406 Will CCC make advance payments to Recipients? (a) Policy. In general, CCC operates the EMP on a cost reimbursable basis. (b) Exception. Upon request, CCC...

  17. 7 CFR 1486.406 - Will CCC make advance payments to Recipients?

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 7 Agriculture 10 2010-01-01 2010-01-01 false Will CCC make advance payments to Recipients? 1486... PROGRAM Contributions and Reimbursements § 1486.406 Will CCC make advance payments to Recipients? (a) Policy. In general, CCC operates the EMP on a cost reimbursable basis. (b) Exception. Upon request, CCC...

  18. Advanced teaching labs in physics - celebrating progress; challenges ahead

    NASA Astrophysics Data System (ADS)

    Peterson, Richard

    A few examples of optical physics experiments may help us first reflect on significant progress on how advanced lab initiatives may now be more effectively developed, discussed, and disseminated - as opposed to only 10 or 15 years back. Many cooperative developments of the last decade are having profound impacts on advanced lab workers and students. Central to these changes are the programs of the Advanced Laboratory Physics Association (ALPhA) (Immersions, BFY conferences), AAPT (advlab-l server, ComPADRE, apparatus competitions, summer workshops/sessions), APS (Reichert Award, FEd activities and sessions), and the Jonathan F. Reichert Foundation (ALPhA support and institution matched equipment grants for Immersion participants). Broad NSF support has helped undergird several of these initiatives. Two of the most significant challenges before this new advanced lab community are (a) to somehow enhance funding opportunities for teaching equipment and apparatus in an era of minimal NSF equipment support, and (b) to help develop a more complementary relationship between research-based advanced lab pedagogies and the development of fresh physics experiments that help enable the mentoring and experimental challenge of our students.

  19. Advance directives and outcomes of surrogate decision making before death.

    PubMed

    Silveira, Maria J; Kim, Scott Y H; Langa, Kenneth M

    2010-04-01

    Recent discussions about health care reform have raised questions regarding the value of advance directives. We used data from survey proxies in the Health and Retirement Study involving adults 60 years of age or older who had died between 2000 and 2006 to determine the prevalence of the need for decision making and lost decision-making capacity and to test the association between preferences documented in advance directives and outcomes of surrogate decision making. Of 3746 subjects, 42.5% required decision making, of whom 70.3% lacked decision-making capacity and 67.6% of those subjects, in turn, had advance directives. Subjects who had living wills were more likely to want limited care (92.7%) or comfort care (96.2%) than all care possible (1.9%); 83.2% of subjects who requested limited care and 97.1% of subjects who requested comfort care received care consistent with their preferences. Among the 10 subjects who requested all care possible, only 5 received it; however, subjects who requested all care possible were far more likely to receive aggressive care as compared with those who did not request it (adjusted odds ratio, 22.62; 95% confidence interval [CI], 4.45 to 115.00). Subjects with living wills were less likely to receive all care possible (adjusted odds ratio, 0.33; 95% CI, 0.19 to 0.56) than were subjects without living wills. Subjects who had assigned a durable power of attorney for health care were less likely to die in a hospital (adjusted odds ratio, 0.72; 95% CI, 0.55 to 0.93) or receive all care possible (adjusted odds ratio, 0.54; 95% CI, 0.34 to 0.86) than were subjects who had not assigned a durable power of attorney for health care. Between 2000 and 2006, many elderly Americans needed decision making near the end of life at a time when most lacked the capacity to make decisions. Patients who had prepared advance directives received care that was strongly associated with their preferences. These findings support the continued use of advance

  20. Progress making the top end optical assembly (TEOA) for the 4-meter Advanced Technology Solar Telescope

    NASA Astrophysics Data System (ADS)

    Canzian, Blaise; Barentine, J.; Arendt, J.; Bader, S.; Danyo, G.; Heller, C.

    2012-09-01

    L-3 Integrated Optical Systems (IOS) Division has been selected by the National Solar Observatory (NSO) to design and produce the Top End Optical Assembly (TEOA) for the 4-meter Advanced Technology Solar Telescope (ATST) to operate at Haleakal', Maui. ATST will perform to a very high optical performance level in a difficult thermal environment. The TEOA, containing the 0.65-meter silicon carbide secondary mirror and support, mirror thermal management system, mirror positioning and fast tip-tilt system, field stop with thermally managed heat dump, thermally managed Lyot stop, safety interlock and control system, and support frame, operates in the "hot spot" at the prime focus of the ATST and so presents special challenges. In this paper, we describe progress in the L-3 technical approach to meeting these challenges, including silicon carbide off-axis mirror design, fabrication, and high accuracy figuring and polishing all within L-3; mirror support design; the design for stray light control; subsystems for opto-mechanical positioning and high accuracy absolute mirror orientation sensing; Lyot stop design; and thermal management of all design elements to remain close to ambient temperature despite the imposed solar irradiance load.

  1. 7 CFR 1484.57 - Will FAS make advance payments to a Cooperator?

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 7 Agriculture 10 2014-01-01 2014-01-01 false Will FAS make advance payments to a Cooperator? 1484... FOR AGRICULTURAL COMMODITIES Contributions and Reimbursements § 1484.57 Will FAS make advance payments to a Cooperator? (a) Policy. In general, FAS operates the Cooperator program on a reimbursable basis...

  2. 7 CFR 1484.57 - Will FAS make advance payments to a Cooperator?

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 7 Agriculture 10 2013-01-01 2013-01-01 false Will FAS make advance payments to a Cooperator? 1484... FOR AGRICULTURAL COMMODITIES Contributions and Reimbursements § 1484.57 Will FAS make advance payments to a Cooperator? (a) Policy. In general, FAS operates the Cooperator program on a reimbursable basis...

  3. 7 CFR 1484.57 - Will FAS make advance payments to a Cooperator?

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 7 Agriculture 10 2012-01-01 2012-01-01 false Will FAS make advance payments to a Cooperator? 1484... FOR AGRICULTURAL COMMODITIES Contributions and Reimbursements § 1484.57 Will FAS make advance payments to a Cooperator? (a) Policy. In general, FAS operates the Cooperator program on a reimbursable basis...

  4. 7 CFR 1484.57 - Will FAS make advance payments to a Cooperator?

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 7 Agriculture 10 2010-01-01 2010-01-01 false Will FAS make advance payments to a Cooperator? 1484... DEVELOP FOREIGN MARKETS FOR AGRICULTURAL COMMODITIES Contributions and Reimbursements § 1484.57 Will FAS make advance payments to a Cooperator? (a) Policy. In general, FAS operates the Cooperator program on a...

  5. 7 CFR 1484.57 - Will FAS make advance payments to a Cooperator?

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 7 Agriculture 10 2011-01-01 2011-01-01 false Will FAS make advance payments to a Cooperator? 1484... DEVELOP FOREIGN MARKETS FOR AGRICULTURAL COMMODITIES Contributions and Reimbursements § 1484.57 Will FAS make advance payments to a Cooperator? (a) Policy. In general, FAS operates the Cooperator program on a...

  6. Associations Between Vitamin D Intake and Progression to Incident Advanced Age-Related Macular Degeneration

    PubMed Central

    Merle, Bénédicte M. J.; Silver, Rachel E.; Rosner, Bernard; Seddon, Johanna M.

    2017-01-01

    Purpose There is growing evidence of the importance of nutrition in age-related macular degeneration (AMD), but no prospective studies have explored the impact of vitamin D. We evaluated the association between vitamin D intake and progression to advanced AMD. Methods Among 2146 participants (3965 eyes), 541 (777 eyes) progressed from early or intermediate AMD to advanced disease (mean follow-up: 9.4 years) based on ocular imaging. Nutrients were log transformed and calorie adjusted. Survival analysis was used to assess associations between incident advanced disease and vitamin D intake. Neovascular disease (NV) and geographic atrophy (GA) were evaluated separately. Combined effects of dietary vitamin D and calcium were assessed based on high or low consumption of each nutrient. Results There was a lower risk of progression to advanced AMD in the highest versus lowest quintile of dietary vitamin D intake after adjustment for demographic, behavioral, ocular, and nutritional factors (hazard ratio [HR]: 0.60; 95% confidence interval [CI]: 0.43–0.83; P trend = 0.0007). Similar results were observed for NV (HR: 0.59; 95% CI: 0.39–0.89; P trend = 0.005) but not GA (HR: 0.83; 95% CI: 0.53–1.30; P trend = 0.35). A protective effect was observed for advanced AMD among participants with high vitamin D and low calcium compared to the group with low levels for each nutrient (HR: 0.67; 95% CI: 0.50–0.88; P = 0.005). When supplement use was considered, the effect was in the protective direction but was not significant. Conclusions A diet rich in vitamin D may prevent or delay progression to advanced AMD, especially NV. Additional exploration is needed to elucidate the potential protective role of vitamin D and its contribution to reducing visual loss. PMID:28892825

  7. Associations Between Vitamin D Intake and Progression to Incident Advanced Age-Related Macular Degeneration.

    PubMed

    Merle, Bénédicte M J; Silver, Rachel E; Rosner, Bernard; Seddon, Johanna M

    2017-09-01

    There is growing evidence of the importance of nutrition in age-related macular degeneration (AMD), but no prospective studies have explored the impact of vitamin D. We evaluated the association between vitamin D intake and progression to advanced AMD. Among 2146 participants (3965 eyes), 541 (777 eyes) progressed from early or intermediate AMD to advanced disease (mean follow-up: 9.4 years) based on ocular imaging. Nutrients were log transformed and calorie adjusted. Survival analysis was used to assess associations between incident advanced disease and vitamin D intake. Neovascular disease (NV) and geographic atrophy (GA) were evaluated separately. Combined effects of dietary vitamin D and calcium were assessed based on high or low consumption of each nutrient. There was a lower risk of progression to advanced AMD in the highest versus lowest quintile of dietary vitamin D intake after adjustment for demographic, behavioral, ocular, and nutritional factors (hazard ratio [HR]: 0.60; 95% confidence interval [CI]: 0.43-0.83; P trend = 0.0007). Similar results were observed for NV (HR: 0.59; 95% CI: 0.39-0.89; P trend = 0.005) but not GA (HR: 0.83; 95% CI: 0.53-1.30; P trend = 0.35). A protective effect was observed for advanced AMD among participants with high vitamin D and low calcium compared to the group with low levels for each nutrient (HR: 0.67; 95% CI: 0.50-0.88; P = 0.005). When supplement use was considered, the effect was in the protective direction but was not significant. A diet rich in vitamin D may prevent or delay progression to advanced AMD, especially NV. Additional exploration is needed to elucidate the potential protective role of vitamin D and its contribution to reducing visual loss.

  8. Progress on the Design of the Storage Ring Vacuum System for the Advanced Photon Source Upgrade Project

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

    Stillwell, B.; Billett, B.; Brajuskovic, B.

    2017-06-20

    Recent work on the design of the storage ring vacuum system for the Advanced Photon Source Upgrade project (APS-U) includes: revising the vacuum system design to accommodate a new lattice with reverse bend magnets, modifying the designs of vacuum chambers in the FODO sections for more intense incident synchrotron radiation power, modifying the design of rf-shielding bellows liners for better performance and reliability, modifying photon absorber designs to make better use of available space, and integrated planning of components needed in the injection, extraction and rf cavity straight sections. An overview of progress in these areas is presented.

  9. Advanced Ablative Insulators and Methods of Making Them

    NASA Technical Reports Server (NTRS)

    Congdon, William M.

    2005-01-01

    Advanced ablative (more specifically, charring) materials that provide temporary protection against high temperatures, and advanced methods of designing and manufacturing insulators based on these materials, are undergoing development. These materials and methods were conceived in an effort to replace the traditional thermal-protection systems (TPSs) of re-entry spacecraft with robust, lightweight, better-performing TPSs that can be designed and manufactured more rapidly and at lower cost. These materials and methods could also be used to make improved TPSs for general aerospace, military, and industrial applications.

  10. Advancing in the Career Decision-Making Process: The Role of Coping Strategies and Career Decision-Making Profiles

    ERIC Educational Resources Information Center

    Perez, Maya; Gati, Itamar

    2017-01-01

    We tested the associations among the career decision-making difficulties, the career decision status, and either (a) the career decision-making profiles of 575 young adults, or (b) the coping strategies of 379 young adults. As hypothesized, a more advanced decision status was negatively associated with both career decision-making difficulties…

  11. CE: Original Research: Creating an Evidence-Based Progression for Clinical Advancement Programs.

    PubMed

    Burke, Kathleen G; Johnson, Tonya; Sites, Christine; Barnsteiner, Jane

    2017-05-01

    : Background: The Institute of Medicine (IOM) and the Quality and Safety Education for Nurses (QSEN) project have identified six nursing competencies and supported their integration into undergraduate and graduate nursing curricula nationwide. But integration of those competencies into clinical practice has been limited, and evidence for the progression of competency proficiency within clinical advancement programs is scant. Using an evidence-based approach and building on the competencies identified by the IOM and QSEN, a team of experts at an academic health system developed eight competency domains and 186 related knowledge, skills, and attitudes (KSAs) for professional nursing practice. The aim of our study was to validate the eight identified competencies and 186 related KSAs and determine their developmental progression within a clinical advancement program. Using the Delphi technique, nursing leadership validated the newly identified competency domains and KSAs as essential to practice. Clinical experts from 13 Magnet-designated hospitals with clinical advancement programs then participated in Delphi rounds aimed at reaching consensus on the developmental progression of the 186 KSAs through four levels of clinical advancement. Two Delphi rounds resulted in consensus by the expert participants. All eight competency domains were determined to be essential at all four levels of clinical practice. At the novice level of practice, the experts identified a greater number of KSAs in the domains of safety and patient- and family-centered care. At more advanced practice levels, the experts identified a greater number of KSAs in the domains of professionalism, teamwork, technology and informatics, and continuous quality improvement. Incorporating the eight competency domains and the 186 KSAs into a framework for clinical advancement programs will likely result in more clearly defined role expectations; enhance accountability; and elevate and promote nursing practice

  12. FY2016 Advanced Batteries R&D Annual Progress Report

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

    None, None

    The Advanced Batteries research and development (R&D) subprogram within the DOE Vehicle Technologies Office (VTO) provides support and guidance for projects focusing on batteries for plug-in electric vehicles. Program targets focus on overcoming technical barriers to enable market success including: (1) significantly reducing battery cost, (2) increasing battery performance (power, energy, durability), (3) reducing battery weight & volume, and (4) increasing battery tolerance to abusive conditions such as short circuit, overcharge, and crush. This report describes the progress made on the research and development projects funded by the Battery subprogram in 2016. This section covers the Vehicle Technologies Office overview;more » the Battery subprogram R&D overview; Advanced Battery Development project summaries; and Battery Testing, Analysis, and Design project summaries. It also includes the cover and table of contents.« less

  13. Effect of the Contents in Advance Directives on Individuals' Decision-Making.

    PubMed

    Park, Jae Yoon; Lim, Chi-Yeon; Puurveen, Gloria; Kim, Do Yeun; Lee, Jae Hang; Do, Han Ho; Kim, Kyung Soo; Yoo, Kyung Don; Kim, Hyo Jin; Kim, Yunmi; Shin, Sung Joon

    2018-01-01

    Completing an advance directive offers individuals the opportunity to make informed choices about end-of-life care. However, these decisions could be influenced in different ways depending on how the information is presented. We randomly presented 185 participants with four distinct types of advance directive: neutrally framed (as reference), negatively framed, religiously framed, and a combination. Participants were asked which interventions they would like to receive at the end of life. Between 60% and 70% of participants responded "accept the special interventions" on the reference form. However, the majority (70%-90%) chose "refuse the interventions" on the negative form. With respect to the religious form, 70% to 80% chose "not decided yet." Participants who refused special life-sustaining treatments were older, female, and with better prior knowledge about advance directives. Our findings imply that the specific content of advance directives could affect decision-making with regard to various interventions for end-of-life care.

  14. Clinical Cancer Advances 2013: Annual Report on Progress Against Cancer from the American Society of Clinical Oncology.

    PubMed

    Patel, Jyoti D; Krilov, Lada; Adams, Sylvia; Aghajanian, Carol; Basch, Ethan; Brose, Marcia S; Carroll, William L; de Lima, Marcos; Gilbert, Mark R; Kris, Mark G; Marshall, John L; Masters, Gregory A; O'Day, Steven J; Polite, Blasé; Schwartz, Gary K; Sharma, Sunil; Thompson, Ian; Vogelzang, Nicholas J; Roth, Bruce J

    2014-01-10

    extremely challenging economic environment, we continue to make progress. Maintaining and accelerating that progress require that we keep our eyes on the future and pursue a path that builds on the stunning successes of the past. We must continue to show our policymakers the successes in cancer survival and quality of life (QOL) they have enabled, emphasizing the need to sustain our national investment in the remarkably productive US cancer research enterprise. We must also look to innovative methods for transforming how we care for-and learn from-patients with cancer. Consider, for example, that fewer than 5% of adult patients with cancer currently participate in clinical trials. What if we were able to draw lessons from the other 95%? This possibility led ASCO this year to launch CancerLinQ, a groundbreaking health information technology initiative that will provide physicians with access to vast quantities of clinical data about real-world patients and help achieve higher quality, higher value cancer care. As you read the following pages, I hope our collective progress against cancer over the past year inspires you. More importantly, I hope the pride you feel motivates you to help us accelerate the pace of scientific advancement. Clifford A. Hudis, MD, FACP President American Society of Clinical Oncology.

  15. Recent Progress in Advanced Materials for Lithium Ion Batteries

    PubMed Central

    Chen, Jiajun

    2013-01-01

    The development and commercialization of lithium ion batteries is rooted in material discovery. Promising new materials with high energy density are required for achieving the goal toward alternative forms of transportation. Over the past decade, significant progress and effort has been made in developing the new generation of Li-ion battery materials. In the review, I will focus on the recent advance of tin- and silicon-based anode materials. Additionally, new polyoxyanion cathodes, such as phosphates and silicates as cathode materials, will also be discussed. PMID:28809300

  16. Retinopathy of prematurity: mutations in the Norrie disease gene and the risk of progression to advanced stages.

    PubMed

    Haider, M Z; Devarajan, L V; Al-Essa, M; Srivastva, B S; Kumar, H; Azad, R; Rashwan, N

    2001-04-01

    Retinopathy of prematurity (ROP) is a retinal vascular disease that occurs in infants with short gestational age and low birth weight and may lead to retinal detachment and blindness. Missense mutations in the Norrie disease (ND) gene have been associated with the risk of progression to advanced stages in cases of ROP from the US and also in clinically similar ND and familial exudative vitreoretinopathy. We have screened two ND gene mutations, namely A105T and Val60Glu, by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) and allele-specific PCR methods, respectively, in 210 Kuwaiti premature newborns to replicate these findings in a different ethnic group. In the Kuwaiti premature newborn cohort, 115 of 210 babies had no eye problems and served as controls, while 95 were cases of ROP. In 71 of 95 ROP cases, the disease regressed spontaneously on or before stage 3, while in 24 of 95 ROP cases the disease progressed to advanced stages 4 and 5. In case of missense mutation (A105T), the AA genotype was detected in 96% of controls compared with 87% of ROP cases (NS); similarly no significant difference was found between spontaneously regressed ROP cases and those who progressed to advanced stages. For the Val60Glu mutation, no significant association was detected between the genotype and progression of ROP to advanced stages. Unlike data from the US, our findings from a Kuwaiti cohort of ROP cases and controls suggest a lack of association between the two ND gene mutations (A105T and Val60Glu) and ROP and the risk of progression of the disease to advanced stages.

  17. Pretreatment advanced lung cancer inflammation index (ALI) for predicting early progression in nivolumab-treated patients with advanced non-small cell lung cancer.

    PubMed

    Shiroyama, Takayuki; Suzuki, Hidekazu; Tamiya, Motohiro; Tamiya, Akihiro; Tanaka, Ayako; Okamoto, Norio; Nakahama, Kenji; Taniguchi, Yoshihiko; Isa, Shun-Ichi; Inoue, Takako; Imamura, Fumio; Atagi, Shinji; Hirashima, Tomonori

    2018-01-01

    Programmed death-ligand 1 (PD-L1) expression status is inadequate for indicating nivolumab in patients with non-small cell lung cancer (NSCLC). Because the baseline advanced lung cancer inflammation index (ALI) is reportedly associated with patient outcomes, we investigated whether the pretreatment ALI is prognostic in NSCLC patients treated with nivolumab. We retrospectively reviewed the medical records of all patients treated with nivolumab for advanced NSCLC between December 2015 and May 2016 at three Japanese institutes. Multivariate logistic regression and Cox proportional hazards models were used to assess the impact of the pretreatment ALI (and other inflammation-related parameters) on progression-free survival (PFS) and early progression (i.e., within 8 weeks after starting nivolumab). A total of 201 patients were analyzed; their median age was 68 years (range, 27-87 years), 67% were men, and 24% had an Eastern Cooperative Oncology Group (ECOG) performance status of 2 or higher. An ECOG performance status ≥2, serum albumin <3.7 g/dL, neutrophil-to-lymphocyte ratio ≥4, and ALI <18 were significantly associated with poor PFS and early progression on univariate analysis. Multivariate analyses revealed that pretreatment ALI <18 was independently associated with inferior PFS (median, 1.4 vs. 3.7 months, P < 0.001) and a higher likelihood of early progression (odds ratio, 2.76; 95% confidence interval 1.44-5.34; P = 0.002). The pretreatment ALI was found to be a significant independent predictor of early progression in patients with advanced NSCLC receiving nivolumab, and may help identify patients likely to benefit from continued nivolumab treatment in routine clinical practice. © 2017 The Authors. Cancer Medicine published by John Wiley & Sons Ltd.

  18. Developing an Initial Learning Progression for the Use of Evidence in Decision-Making Contexts

    ERIC Educational Resources Information Center

    Bravo-Torija, Beatriz; Jiménez-Aleixandre, María-Pilar

    2018-01-01

    This paper outlines an initial learning progression for the use of evidence to support scientific arguments in the context of decision-making. Use of evidence is a central feature of knowledge evaluation and, therefore, of argumentation. The proposal is based on the literature on argumentation and use of evidence in decision-making contexts. The…

  19. Medical decision-making capacity and its cognitive predictors in progressive MS: Preliminary evidence.

    PubMed

    Gerstenecker, Adam; Lowry, Kathleen; Myers, Terina; Bashir, Khurram; Triebel, Kristen L; Martin, Roy C; Marson, Daniel C

    2017-09-15

    Medical decision-making capacity (MDC) refers to the ability to make informed decisions about treatment and declines in cognition are associated with declines in MDC across multiple disease entities. However, although it is well known that cognitive impairment is prevalent in multiple sclerosis (MS), little is known about MDC in the disease. Data from 22 persons with progressive MS and 18 healthy controls were analyzed. All diagnoses were made by a board-certified neurologist with experience in MS. All study participants were administered a vignette-based measure of MDC and also a neuropsychological battery. Performance on three MDC consent standards (i.e., Appreciation, Reasoning, Understanding) was significantly lower for people with progressive MS as compared to healthy controls. In the progressive MS group, verbal fluency was the primary cognitive predictor for both Reasoning and Understanding consent standards. Verbal learning and memory was the primary cognitive predictor for Appreciation. MS severity was not significantly correlated with any MDC variable. MDC is a complex and cognitively mediated functional ability that is impaired in many people with progressive MS. Verbal measures of fluency and memory are strongly associated with MDC performances in the current sample of people with MS and could potentially be utilized to quickly screen for MDC impairment in MS. Copyright © 2017 Elsevier B.V. All rights reserved.

  20. Quantifying Disease Progression in Amyotrophic Lateral Sclerosis

    PubMed Central

    Simon, Neil G; Turner, Martin R; Vucic, Steve; Al-Chalabi, Ammar; Shefner, Jeremy; Lomen-Hoerth, Catherine; Kiernan, Matthew C

    2014-01-01

    Amyotrophic lateral sclerosis (ALS) exhibits characteristic variability of onset and rate of disease progression, with inherent clinical heterogeneity making disease quantitation difficult. Recent advances in understanding pathogenic mechanisms linked to the development of ALS impose an increasing need to develop strategies to predict and more objectively measure disease progression. This review explores phenotypic and genetic determinants of disease progression in ALS, and examines established and evolving biomarkers that may contribute to robust measurement in longitudinal clinical studies. With targeted neuroprotective strategies on the horizon, developing efficiencies in clinical trial design may facilitate timely entry of novel treatments into the clinic. PMID:25223628

  1. Advance directives: cancer patients' preferences and family-based decision making.

    PubMed

    Xing, Yan-Fang; Lin, Jin-Xiang; Li, Xing; Lin, Qu; Ma, Xiao-Kun; Chen, Jie; Wu, Dong-Hao; Wei, Li; Yin, Liang-Hong; Wu, Xiang-Yuan

    2017-07-11

    Advance directives are a sensitive issue among traditional Chinese people, who usually refrain from mentioning this topic until it is imperative. Medical decisions for cancer patients are made by their families, and these decisions might violate patients' personal will. This study aimed to examine the acceptance of advance directives among Chinese cancer patients and their families and patient participation in this procedure and, finally, to analyze the moral risk involved. While 246 patients and their family members refused official discussion of an advance directive, the remaining 166 patients and their families accepted the concept of an advance directive and signed a document agreeing to give up invasive treatment when the anti-cancer treatment was terminated. Of these, only 24 patients participated in the decision making. For 101 patients, anti-cancer therapy was ended prematurely with as many as 37 patients not told about their potential loss of health interests. Participants were 412 adult cancer patients from 9 leading hospitals across China. An advance directive was introduced to the main decision makers for each patient; if they wished to sign it, the advance directive would be systematically discussed. A questionnaire was given to the oncologists in charge of each patient to evaluate the interaction between families and patients, patients' awareness of their disease, and participation in an advance directive. Advance directives were not widely accepted among Chinese cancer patients unless anti-cancer therapy was terminated. Most cancer patients were excluded from the discussion of an advance directive.

  2. Progressive decline of decision-making performances during multiple sclerosis.

    PubMed

    Simioni, Samanta; Ruffieux, Christiane; Kleeberg, Joerg; Bruggimann, Laure; du Pasquier, Renaud A; Annoni, Jean-Marie; Schluep, Myriam

    2009-03-01

    The purpose of this study was to evaluate longitudinally, using the Iowa Gambling Task (IGT), the dynamics of decision-making capacity at a two-year interval (median: 2.1 years) in a group of patients with multiple sclerosis (MS) (n = 70) and minor neurological disability [Expanded Disability Status Scale (EDSS) < or = 2.5 at baseline]. Cognition (memory, executive functions, attention), behavior, handicap, and perceived health status were also investigated. Standardized change scores [(score at retest-score at baseline)/standard deviation of baseline score] were computed. Results showed that IGT performances decreased from baseline to retest (from 0.3, SD = 0.4 to 0.1, SD = 0.3, p = .005). MS patients who worsened in the IGT were more likely to show a decreased perceived health status and emotional well-being (SEP-59; p = .05 for both). Relapsing rate, disability progression, cognitive, and behavioral changes were not associated with decreased IGT performances. In conclusion, decline in decision making can appear as an isolated deficit in MS.

  3. Potential mechanisms of disease progression and management of advanced-phase chronic myeloid leukemia

    PubMed Central

    Jabbour, Elias J.; Hughes, Timothy P.; Cortés, Jorge E.; Kantarjian, Hagop M.; Hochhaus, Andreas

    2014-01-01

    Despite vast improvements in treatment of Philadelphia chromosome–positive chronic myeloid leukemia (CML) in chronic phase (CP), advanced stages of CML, accelerated phase or blast crisis, remain notoriously difficult to treat. Treatments that are highly effective against CML-CP produce disappointing results against advanced disease. Therefore, a primary goal of therapy should be to maintain patients in CP for as long as possible, by (1) striving for deep, early molecular response to treatment; (2) using tyrosine kinase inhibitors that lower risk of disease progression; and (3) more closely observing patients who demonstrate cytogenetic risk factors at diagnosis or during treatment. PMID:24050507

  4. Potential mechanisms of disease progression and management of advanced-phase chronic myeloid leukemia.

    PubMed

    Jabbour, Elias J; Hughes, Timothy P; Cortés, Jorge E; Kantarjian, Hagop M; Hochhaus, Andreas

    2014-07-01

    Despite vast improvements in the treatment of Philadelphia chromosome-positive chronic myeloid leukemia (CML) in chronic phase (CP), advanced stages of CML, accelerated phase or blast crisis, remain notoriously difficult to treat. Treatments that are highly effective against CML-CP produce disappointing results against advanced disease. Therefore, a primary goal of therapy should be to maintain patients in CP for as long as possible, by (1) striving for deep, early molecular response to treatment; (2) using tyrosine kinase inhibitors that lower risk of disease progression; and (3) more closely observing patients who demonstrate cytogenetic risk factors at diagnosis or during treatment.

  5. Adherence to a Mediterranean diet, genetic susceptibility, and progression to advanced macular degeneration: a prospective cohort study.

    PubMed

    Merle, Bénédicte M J; Silver, Rachel E; Rosner, Bernard; Seddon, Johanna M

    2015-11-01

    Adherence to a Mediterranean-type diet is linked to a lower risk of mortality and chronic disease, but the association with the progression of age-related macular degeneration (AMD) and genetic susceptibility is unknown. We examined the association of adherence to the Mediterranean diet and genetic susceptibility with progression to advanced AMD. Among 2525 subjects in the AREDS (Age-Related Eye Disease Study), 1028 eyes progressed to advanced AMD over 13 y. Baseline data for demographic and behavioral covariates were collected by using questionnaires. Dietary data were collected from food-frequency questionnaires. The alternate Mediterranean diet (aMeDi) score (range: 0-9) was constructed from individual intakes of vegetables, fruit, legumes, whole grains, nuts, fish, red and processed meats, alcohol, and the ratio of monounsaturated to saturated fats. Ten genetic loci in 7 genes [complement factor H (CFH), age-related maculopathy susceptibility 2/high-temperature requirement A serine peptidase 1 (ARMS2/HTRA1), complement component 2 (C2), complement factor B (CFB), complement component 3 (C3), collagen type VIII α 1 (COL8A1), and RAD51 paralog B (RAD51B)] were examined. Survival analysis was used to assess individual eyes for associations between incident AMD and aMeDi score, as well as interaction effects between aMeDi score and genetic variation on risk of AMD. A high aMeDi score (score of 6-9) was significantly associated with a reduced risk of progression to advanced AMD after adjustment for demographic, behavioral, ocular, and genetic covariates (HR: 0.74; 95% CI: 0.61, 0.91; P-trend = 0.007). The aMeDi score was significantly associated with a lower risk of incident advanced AMD among subjects carrying the CFH Y402H nonrisk (T) allele (P-trend = 0.0004, P-interaction = 0.04). The aMeDi score was not associated with AMD among subjects who were homozygous for the risk (C) allele. Higher adherence to a Mediterranean diet was associated with reduced risk of

  6. Recent Advances in Shared Decision Making for Mental Health

    PubMed Central

    Patel, Sapana R.; Bakken, Suzanne; Ruland, Cornelia

    2009-01-01

    Purpose of review To advance integration of shared decision making (SDM) into mental health care service delivery, researchers have outlined several priorities for future research [2–3]. These include: 1) SDM and its role in mental health care; 2) Patient and provider perspectives on SDM; 3) The degree to which SDM is practice in mental health settings; and 4) Outcomes of SDM in mental health populations. This article will review recent advances in these areas. Recent findings The current literature shows that 1) SDM can play a role in the mental health treatment process from entry into care to recovery; 2) Patients and providers find SDM acceptable and express a willingness to engage in SDM for reasons that are multifactorial; 3) Barriers to SDM exist in mental health decision making including patient preferences and provider level biases; and 4) Outcomes research provide encouraging preliminary evidence for feasibility and effectiveness of SDM during the mental health encounter. Summary Although there have not been a great number of SDM studies in mental health to date, the positive effects of SDM are comparable to those documented in general non-mental health patient groups, suggesting that future research is likely to be helpful for patients with psychiatric disorders. PMID:18852569

  7. Rethinking autonomy: decision making between patient and surgeon in advanced illnesses

    PubMed Central

    Hinshaw, Daniel B.

    2016-01-01

    Patients with advanced illness such as advanced stage cancer presenting with the need for possible surgical intervention can be some of the most challenging cases for a surgeon. Often there are multiple factors influencing the decisions made. For patients they are facing not just the effects of the disease on their body, but the stark realization that the disease will also limit their life. Not only are these factors a consideration when patients are making decisions, but also the desire to make the decision that is best for themselves, the autonomous decision. Also included in this process for the patient facing the possible need for an intervention is the surgeon. While patient autonomy remains one of the main principles within medicine, guiding treatment decisions, there is also the surgeon’s autonomy to be considered. Surgeons determine if there is even a possible intervention to be offered to patients, a decision making process that respects surgeons’ autonomous choices and includes elements of paternalism as surgeons utilize their expertise to make decisions. Included in the treatment decisions that are made and the care of the patient is the impact patients’ outcomes have on the surgeon, the inherent drive to be the best for the patient and desire for good outcomes for the patient. While both the patient’s and surgeon’s autonomy are a dynamic interface influencing decision making, the main goal for the patient facing a palliative procedure is that of making treatment decisions based on the concept of shared decision making, always giving primary consideration to the patient’s goals and values. Lastly, regardless of the decision made, it is the responsibility of surgeons to their patients to be a source of support through this challenging time. PMID:27004224

  8. Data-based Decision-making: Teachers' Comprehension of Curriculum-based Measurement Progress-monitoring Graphs

    ERIC Educational Resources Information Center

    van den Bosch, Roxette M.; Espin, Christine A.; Chung, Siuman; Saab, Nadira

    2017-01-01

    Teachers have difficulty using data from Curriculum-based Measurement (CBM) progress graphs of students with learning difficulties for instructional decision-making. As a first step in unraveling those difficulties, we studied teachers' comprehension of CBM graphs. Using think-aloud methodology, we examined 23 teachers' ability to…

  9. Development of a video-based education and process change intervention to improve advance cardiopulmonary resuscitation decision-making.

    PubMed

    Waldron, Nicholas; Johnson, Claire E; Saul, Peter; Waldron, Heidi; Chong, Jeffrey C; Hill, Anne-Marie; Hayes, Barbara

    2016-10-06

    Advance cardiopulmonary resuscitation (CPR) decision-making and escalation of care discussions are variable in routine clinical practice. We aimed to explore physician barriers to advance CPR decision-making in an inpatient hospital setting and develop a pragmatic intervention to support clinicians to undertake and document routine advance care planning discussions. Two focus groups, which involved eight consultants and ten junior doctors, were conducted following a review of the current literature. A subsequent iterative consensus process developed two intervention elements: (i) an updated 'Goals of Patient Care' (GOPC) form and process; (ii) an education video and resources for teaching advance CPR decision-making and communication. A multidisciplinary group of health professionals and policy-makers with experience in systems development, education and research provided critical feedback. Three key themes emerged from the focus groups and the literature, which identified a structure for the intervention: (i) knowing what to say; (ii) knowing how to say it; (iii) wanting to say it. The themes informed the development of a video to provide education about advance CPR decision-making framework, improving communication and contextualising relevant clinical issues. Critical feedback assisted in refining the video and further guided development and evolution of a medical GOPC approach to discussing and recording medical treatment and advance care plans. Through an iterative process of consultation and review, video-based education and an expanded GOPC form and approach were developed to address physician and systemic barriers to advance CPR decision-making and documentation. Implementation and evaluation across hospital settings is required to examine utility and determine effect on quality of care.

  10. Making advanced analytics work for you.

    PubMed

    Barton, Dominic; Court, David

    2012-10-01

    Senior leaders who write off the move toward big data as a lot of big talk are making, well, a big mistake. So argue McKinsey's Barton and Court, who worked with dozens of companies to figure out how to translate advanced analytics into nuts-and-bolts practices that affect daily operations on the front lines. The authors offer a useful guide for leaders and managers who want to take a deliberative approach to big data-but who also want to get started now. First, companies must identify the right data for their business, seek to acquire the information creatively from diverse sources, and secure the necessary IT support. Second, they need to build analytics models that are tightly focused on improving performance, making the models only as complex as business goals demand. Third, and most important, companies must transform their capabilities and culture so that the analytical results can be implemented from the C-suite to the front lines. That means developing simple tools that everyone in the organization can understand and teaching people why the data really matter. Embracing big data is as much about changing mind-sets as it is about crunching numbers. Executed with the right care and flexibility, this cultural shift could have payoffs that are, well, bigger than you expect.

  11. Information giving and decision-making in patients with advanced cancer: a systematic review.

    PubMed

    Gaston, Christine M; Mitchell, Geoffrey

    2005-11-01

    Patients with advanced, non-curable cancer face difficult decisions on further treatment, where a small increase in survival time must be balanced against the toxicity of the treatment. If patients want to be involved in these decisions, in keeping with current notions of autonomy and empowerment, they also require to be adequately informed both on the treatments proposed and on their own disease status and prognosis. A systematic review was performed on decision-making and information provision in patients with advanced cancer. Studies of interventions to improve information giving and encourage participation in decision-making were reviewed, including both randomised controlled trials and uncontrolled studies. Almost all patients expressed a desire for full information, but only about two-thirds wished to participate actively in decision-making. Higher educational level, younger age and female sex were predictive of a desire to participate in decision-making. Active decision-making was more common in patients with certain cancers (e.g. breast) than others (e.g. prostate). A number of simple interventions including question prompt sheets, audio-taping of consultations and patient decision aids have been shown to facilitate such involvement.

  12. FY2016 Advanced Batteries R&D Annual Progress Report - Part 4 of 5

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

    None, None

    The Advanced Batteries research and development (R&D) subprogram within the DOE Vehicle Technologies Office (VTO) provides support and guidance for projects focusing on batteries for plug-in electric vehicles. Program targets focus on overcoming technical barriers to enable market success including: (1) significantly reducing battery cost, (2) increasing battery performance (power, energy, durability), (3) reducing battery weight & volume, and (4) increasing battery tolerance to abusive conditions such as short circuit, overcharge, and crush. This report describes the progress made on the research and development projects funded by the Battery subprogram in 2016. This section covers Advanced Battery Materials Research (BMR)more » part 1.« less

  13. Progress on advanced dc and ac induction drives for electric vehicles

    NASA Technical Reports Server (NTRS)

    Schwartz, H. J.

    1982-01-01

    Progress is reported in the development of complete electric vehicle propulsion systems, and the results of tests on the Road Load Simulator of two such systems representative of advanced dc and ac drive technology are presented. One is the system used in the DOE's ETV-1 integrated test vehicle which consists of a shunt wound dc traction motor under microprocessor control using a transistorized controller. The motor drives the vehicle through a fixed ratio transmission. The second system uses an ac induction motor controlled by transistorized pulse width modulated inverter which drives through a two speed automatically shifted transmission. The inverter and transmission both operate under the control of a microprocessor. The characteristics of these systems are also compared with the propulsion system technology available in vehicles being manufactured at the inception of the DOE program and with an advanced, highly integrated propulsion system upon which technology development was recently initiated.

  14. FY2016 Advanced Batteries R&D Annual Progress Report - Part 5 of 5

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

    None, None

    The Advanced Batteries research and development (R&D) subprogram within the DOE Vehicle Technologies Office (VTO) provides support and guidance for projects focusing on batteries for plug-in electric vehicles. Program targets focus on overcoming technical barriers to enable market success including: (1) significantly reducing battery cost, (2) increasing battery performance (power, energy, durability), (3) reducing battery weight & volume, and (4) increasing battery tolerance to abusive conditions such as short circuit, overcharge, and crush. This report describes the progress made on the research and development projects funded by the Battery subprogram in 2016. This section cover Advanced Battery Materials Research (BMR)more » part 2, Battery500 Innovation Centers project summaries, and appendices.« less

  15. The emerging role of histology in the choice of first-line treatment of advanced non-small cell lung cancer: implication in the clinical decision-making.

    PubMed

    Rossi, Antonio; Maione, Paolo; Bareschino, Maria Anna; Schettino, Clorinda; Sacco, Paola Claudia; Ferrara, Marianna Luciana; Castaldo, Vincenzo; Gridelli, Cesare

    2010-01-01

    Lung cancer is the leading cause of cancer mortality worldwide. Non-small cell lung cancer (NSCLC), accounting for about 85% of all lung cancers, includes squamous carcinoma, adenocarcinoma and undifferentiated large cell carcinoma. The majority of patients have advanced disease at diagnosis, and medical treatment is the cornerstone of management. Several randomized trials comparing third-generation platinum-based doublets concluded that all such combinations are comparable in their clinical efficacy, failing to document a difference based on histology. However, recent evidences, arising from the availability of pemetrexed, have shown that histology represents an important variable in the decision making. The major progresses in the understanding cancer biology and mechanism of oncogenesis have allowed the development of several potential molecular targets for cancer treatment such as vascular growth factor and its receptors and epidermal growth factor receptor. Targeted drugs seem to be safer or more effective in a specific histology subtype. All of these data have led to choose the optimal first-line treatment of advanced NSCLC based on histologic diagnosis. However, this scenario raises a diagnostic issue: a specific diagnosis of NSCLC histologic subtype is mandatory. This review will discuss these new evidences in the first-line treatment of advanced NSCLC and their implication in the current clinical decision-making.

  16. Molecular basis of structural make-up of feeds in relation to nutrient absorption in ruminants, revealed with advanced molecular spectroscopy: A review on techniques and models

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

    Rahman, Md. Mostafizar; Yu, Peiqiang

    Progress in ruminant feed research is no more feasible only based on wet chemical analysis, which is merely able to provide information on chemical composition of feeds regardless of their digestive features and nutritive value in ruminants. Studying internal structural make-up of functional groups/feed nutrients is often vital for understanding the digestive behaviors and nutritive values of feeds in ruminant because the intrinsic structure of feed nutrients is more related to its overall absorption. In this article, the detail information on the recent developments in molecular spectroscopic techniques to reveal microstructural information of feed nutrients and the use of nutritionmore » models in regards to ruminant feed research was reviewed. The emphasis of this review was on (1) the technological progress in the use of molecular spectroscopic techniques in ruminant feed research; (2) revealing spectral analysis of functional groups of biomolecules/feed nutrients; (3) the use of advanced nutrition models for better prediction of nutrient availability in ruminant systems; and (4) the application of these molecular techniques and combination of nutrient models in cereals, co-products and pulse crop research. The information described in this article will promote better insight in the progress of research on molecular structural make-up of feed nutrients in ruminants.« less

  17. Let s make progress together!

    NASA Astrophysics Data System (ADS)

    Adriana, Mazare; Liliana, Gheorghian

    2015-04-01

    Let's make progress together! The "Theodor Balan" Secondary School in the urban area of Suceava County in northeastern Romania is involved in several different projects. In order to extend previous successful projects with the students, parents, teachers, businesses and local government representatives in science symposiums for civic projects within the concept of sustainable development, the school is continuing to develop various successful programs. "The battle" continues both in nature and in the classrooms, in order to preserve the environment and to discover new resources. To raise awareness about the importance of existing resources even at the level of individuals there is a constant concern for keeping up to date on what already exists and is well known, but at the same time to remove "barriers" and discover new horizons and resources. Scientific activities held in our school are an effective way to educate students and the community to which they belong. In our community, we discovered sources of drinking water polluted by nitrites from fertilizers used in agriculture. In order to inform and educate people in the area, our teachers have organized several educational activities. Its purpose was: -Knowledge of the importance of water for the environment and human health. -Reducing water pollution. Students have informed their families' about sustainable development acquired at school. In this way, the school manages to educate and change people's ideas. The ways and methods of adults' learning were practiced within a Grundtvig training course "It's never too late learning to learn" in February 2014, in Florence, Italy. The GIFT 2014 was a great occasion for the teachers and students, the county's educational department and the participants at the National Colloquia of Physics to discover new materials provided at the Conference and the latest news and topics in the world of science. The theme trips at the physics laboratories of "Alexandru Ioan Cuza

  18. New Rule Use Drives the Relation between Working Memory Capacity and Raven's Advanced Progressive Matrices

    ERIC Educational Resources Information Center

    Wiley, Jennifer; Jarosz, Andrew F.; Cushen, Patrick J.; Colflesh, Gregory J. H.

    2011-01-01

    The correlation between individual differences in working memory capacity and performance on the Raven's Advanced Progressive Matrices (RAPM) is well documented yet poorly understood. The present work proposes a new explanation: that the need to use a new combination of rules on RAPM problems drives the relation between performance and working…

  19. Are advance directives helpful for good end of life decision making: a cross sectional survey of health professionals.

    PubMed

    Peicius, Eimantas; Blazeviciene, Aurelija; Kaminskas, Raimondas

    2017-06-05

    This paper joins the debate over changes in the role of health professionals when applying advance directives to manage the decision-making process at the end of life care. Issues in relation to advance directives occur in clinical units in Lithuania; however, it remains one of the few countries in the European Union (EU) where the discussion on advance directives is not included in the health-care policy-making agenda. To encourage the discussion of advance directives, a study was designed to examine health professionals' understanding and preferences related to advance directives. In addition, the study sought to explore the views of health care professionals of the application of Advance Directives (AD) in clinical practice in Lithuania. A cross-sectional survey was conducted by interviewing 478 health professionals based at major health care centers in Kaunas district, Lithuania. The design of the study included the use of a questionnaire developed for this study and validated by a pilot study. The collected data were analyzed using standard descriptive statistical methods. The analysis of knowledge about AD revealed some statistically significant differences when comparing the respondents' profession and gender. The analysis also indicated key emerging themes among respondents including tranquility of mind, the longest possible life expectancy and freedom of choice. Further, the study findings revealed that more than half of the study participants preferred to express their will while alive by using advance directives. The study findings revealed a low level of knowledge on advance directives among health professionals. Most health professionals agreed that AD's improved end-of-life decision making while the majority of physicians appreciated AD as the best tool for sharing responsibilities in clinical practice in Lithuania. More physicians than nurses preferred the presence of advance directives to support their decision making in end-of-life situations.

  20. Staging laparoscopy improves treatment decision-making for advanced gastric cancer.

    PubMed

    Hu, Yan-Feng; Deng, Zhen-Wei; Liu, Hao; Mou, Ting-Yu; Chen, Tao; Lu, Xin; Wang, Da; Yu, Jiang; Li, Guo-Xin

    2016-02-07

    To evaluate the clinical value of staging laparoscopy in treatment decision-making for advanced gastric cancer (GC). Clinical data of 582 patients with advanced GC were retrospectively analyzed. All patients underwent staging laparoscopy. The strength of agreement between computed tomography (CT) stage, endoscopic ultrasound (EUS) stage, laparoscopic stage, and final stage were determined by weighted Kappa statistic (Kw). The number of patients with treatment decision-changes was counted. A χ(2) test was used to analyze the correlation between peritoneal metastasis or positive cytology and clinical characteristics. Among the 582 patients, the distributions of pathological T classifications were T2/3 (153, 26.3%), T4a (262, 45.0%), and T4b (167, 28.7%). Treatment plans for 211 (36.3%) patients were changed after staging laparoscopy was performed. Two (10.5%) of 19 patients in M1 regained the opportunity for potential radical resection by staging laparoscopy. Unnecessary laparotomy was avoided in 71 (12.2%) patients. The strength of agreement between preoperative T stage and final T stage was in almost perfect agreement (Kw = 0.838; 95% confidence interval (CI): 0.803-0.872; P < 0.05) for staging laparoscopy; compared with CT and EUS, which was in fair agreement. The strength of agreement between preoperative M stage and final M stage was in almost perfect agreement (Kw = 0.990; 95% CI: 0.977-1.000; P < 0.05) for staging laparoscopy; compared with CT, which was in slight agreement. Multivariate analysis revealed that tumor size (≥ 40 mm), depth of tumor invasion (T4b), and Borrmann type (III or IV) were significantly correlated with either peritoneal metastasis or positive cytology. The best performance in diagnosing P-positive was obtained when two or three risk factors existed. Staging laparoscopy can improve treatment decision-making for advanced GC and decrease unnecessary exploratory laparotomy.

  1. Advancing toward Shared Decision Making

    ERIC Educational Resources Information Center

    Muller, Lisa; Thorn, Judi

    2007-01-01

    In May 2004, a group of 25 teachers at Jenks High School in Oklahoma received an invitation to the Summer 2004 Advance. Although many organizations hold retreats for their employees, the administrators wanted to send a different message: we're not retreating; we're advancing! Like many states, Oklahoma suffered a school budget crisis during the…

  2. Clinical Cancer Advances 2018: Annual Report on Progress Against Cancer From the American Society of Clinical Oncology.

    PubMed

    Heymach, John; Krilov, Lada; Alberg, Anthony; Baxter, Nancy; Chang, Susan Marina; Corcoran, Ryan; Dale, William; DeMichele, Angela; Magid Diefenbach, Catherine S; Dreicer, Robert; Epstein, Andrew S; Gillison, Maura L; Graham, David L; Jones, Joshua; Ko, Andrew H; Lopez, Ana Maria; Maki, Robert G; Rodriguez-Galindo, Carlos; Schilsky, Richard L; Sznol, Mario; Westin, Shannon Neville; Burstein, Harold

    2018-04-01

    A MESSAGE FROM ASCO'S PRESIDENT I remember when ASCO first conceived of publishing an annual report on the most transformative research occurring in cancer care. Thirteen reports later, the progress we have chronicled is remarkable, and this year is no different. The research featured in ASCO's Clinical Cancer Advances 2018 report underscores the impressive gains in our understanding of cancer and in our ability to tailor treatments to tumors' genetic makeup. The ASCO 2018 Advance of the Year, adoptive cell immunotherapy, allows clinicians to genetically reprogram patients' own immune cells to find and attack cancer cells throughout the body. Chimeric antigen receptor (CAR) T-cell therapy-a type of adoptive cell immunotherapy-has led to remarkable results in young patients with acute lymphoblastic leukemia (ALL) and in adults with lymphoma and multiple myeloma. Researchers are also exploring this approach in other types of cancer. This advance would not be possible without robust federal investment in cancer research. The first clinical trial of CAR T-cell therapy in children with ALL was funded, in part, by grants from the National Cancer Institute (NCI), and researchers at the NCI Center for Cancer Research were the first to report on possible CAR T-cell therapy for multiple myeloma. These discoveries follow decades of prior research on immunology and cancer biology, much of which was supported by federal dollars. In fact, many advances that are highlighted in the 2018 Clinical Cancer Advances report were made possible thanks to our nation's support for biomedical research. Funding from the US National Institutes of Health and the NCI helps researchers pursue critical patient care questions and addresses vital, unmet needs that private industry has little incentive to take on. Federally supported cancer research generates the biomedical innovations that fuel the development and availability of new and improved treatments for patients. We need sustained federal

  3. Factors affecting long-term-care residents' decision-making processes as they formulate advance directives.

    PubMed

    Lambert, Heather C; McColl, Mary Ann; Gilbert, Julie; Wong, Jiahui; Murray, Gale; Shortt, Samuel E D

    2005-10-01

    The purpose of this study was to describe factors contributing to the decision-making processes of elderly persons as they formulate advance directives in long-term care. This study was qualitative, based on grounded theory. Recruitment was purposive and continued until saturation was reached. Nine residents of a long-term-care facility were interviewed by use of a semistructured format. Open and axial coding of interview transcripts were carried out and the factors contributing to the decision process were defined. Elders based their decisions primarily on information gathered from personal experiences with death and illness. They obtained very little information from professionals or the media. Major factors considered by elders as they weighed information included spiritual, emotional, and social considerations. The factors considered during the decision-making process were oriented more toward the individual's experiences and less on contributions from objective sources than anticipated. Decision making for advance directives is a highly personalized process. The approach of health professionals when assisting with end-of-life decision making should be planned with these contributing factors in mind, so that the services offered to the individuals in this population best meet their needs.

  4. Advanced MHD Algorithm for Solar and Space Science: lst Year Semi Annual Progress Report

    NASA Technical Reports Server (NTRS)

    Schnack, Dalton D.; Lionello, Roberto

    2003-01-01

    We report progress for the development of MH4D for the first and second quarters of FY2004, December 29, 2002 - June 6, 2003. The present version of MH4D can now solve the full viscous and resistive MHD equations using either an explicit or a semi-implicit time advancement algorithm. In this report we describe progress in the following areas. During the two last quarters we have presented poster at the EGS-AGU-EUG Joint Assembly in Nice, France, April 6-11, 2003, and a poster at the 2003 International Sherwood Theory Conference in Corpus Christi, Texas, April 28-30 2003. In the area of code development, we have implemented the MHD equations and the semi-implicit algorithm. The new features have been tested.

  5. Role of Advance Care Planning in Proxy Decision Making Among Individuals With Dementia and Their Family Caregivers.

    PubMed

    Kwak, Jung; De Larwelle, Jessica A; Valuch, Katharine O'Connell; Kesler, Toni

    2016-01-01

    Health care proxies make important end-of-life decisions for individuals with dementia. A cross-sectional survey was conducted to examine the role of advance care planning in proxy decision making for 141 individuals with cognitive impairment, Alzheimer's disease, or other types of dementia. Proxies who did not know the preferences of individuals with dementia for life support treatments reported greater understanding of their values. Proxies of individuals with dementia who did not want life support treatments anticipated receiving less support and were more uncertain in decision making. The greater knowledge proxies had about dementia trajectory, family support, and trust of physicians, the more informed, clearer, and less uncertain they were in decision making. In addition to advance care planning, multiple factors influence proxy decision making, which should be considered in developing interventions and future research to support informed decision making for individuals with dementia and their families. Copyright 2016, SLACK Incorporated.

  6. The Brain Trust: Advancement Services Helps Institutions Use Data Strategically to Meet Fundraising Goals

    ERIC Educational Resources Information Center

    Medlock, Vicky

    2012-01-01

    It was not all that many years ago that advancement services was thought of as the "back office"--a term that still makes veterans in the field cringe. Historically, the role of advancement services was keeping donor and alumni records up-to-date, processing gifts, sending receipts, and generating fundraising progress reports. However,…

  7. Family structure, experiences with end-of-life decision making, and who asked about advance directives impacts advance directive completion rates.

    PubMed

    Van Scoy, Lauren J; Howrylak, Judie; Nguyen, Anhthu; Chen, Melodie; Sherman, Michael

    2014-10-01

    Advance directives are an important but underutilized resource. Reasons for this underutilization need to be determined. We investigated factors associated with completion of advance directives among inpatients. We conducted prospective, structured interviews on family structure, health care, disease, and end-of-life experiences. We compared those with completed advance directives and those without. We interviewed 130 inpatients in an urban university hospital. We used bivariate analysis and logistic regression to identify characteristics of patients with living wills and health care proxies versus patients without them. Twenty-one percent of patients had a living will and 35% had a health care proxy. Patients with completed living wills were older (p≤0.0046), had more comorbidities (p=0.018), were widowed (p=0.02), and were more often admitted with chronic disease (p=0.009) compared to those without living wills. Patients with health care proxies were older (p<0.001), had religious affiliations (p=0.04), more children (p=0.03), and more often widowed (p≤0.001) than those without health care proxies. Patients were 10.8 times (95% confidence interval [CI] 4.59-25.3), 46.5 times (95% CI 15.1-139.4), and 68.6 times (95% CI 13.0-361.3) more likely to complete a living will when asked by medical staff, legal staff, or family and friends, respectively, than those not asked. Patients with health care proxies were 1.68 times (95% CI 0.81-3.47), 4.34 times (95% CI 1.50-12.6), and 18.0 times (95% CI 2.03-158.8) more likely to have been asked by the same groups. Patients with experience in end-of-life decision-making were 2.54 times more likely to possess a living will (95%CI 1.01-6.42) and 3.53 times more likely to possess a health care proxy (95% CI 1.51-8.25) than those without experiences. Having been asked about advance directives by medical staff, legal staff, or family and friends increases the likelihood that patients will possess an advance directive. Those with

  8. 125I Brachytherapy in Locally Advanced Nonsmall Cell Lung Cancer After Progression of Concurrent Radiochemotherapy

    PubMed Central

    Xiang, Zhanwang; Li, Guohong; Liu, Zhenyin; Huang, Jinhua; Zhong, Zhihui; Sun, Lin; Li, Chuanxing; Zhang, Funjun

    2015-01-01

    Abstract To investigate the safety and effectiveness of computed tomography (CT)-guided 125I seed implantation for locally advanced nonsmall cell lung cancer (NSCLC) after progression of concurrent radiochemotherapy (CCRT). We reviewed 78 locally advanced NSCLC patients who had each one cycle of first-line CCRT but had progressive disease identified from January 2006 to February 2015 at our institution. A total of 37 patients with 44 lesions received CT-guided percutaneous 125I seed implantation and second-line chemotherapy (group A), while 41 with 41 lesions received second-line chemotherapy (group B). Patients in group A and B received a total of 37 and 41 first cycle of CCRT treatment. The median follow-up was 19 (range 3–36) months. After the second treatment, the total response rate (RR) in tumor response accounted for 63.6% in group A, which was significantly higher than that of group B (41.5%) (P = 0.033). The median progression-free survival time (PFST) was 8.00 ± 1.09 months and 5.00 ± 0.64 months in groups A and B (P = 0.011). The 1-, 2-, and 3-year overall survival (OS) rates for group A were 56.8%, 16.2%, and 2.7%, respectively. For group B, OS rates were 36.6%, 9.8%, and 2.4%, respectively. The median OS time was 14.00 ± 1.82 months and 10.00 ± 1.37 months for groups A and B, respectively (P = 0.059). Similar toxicity reactions were found in both groups. Tumor-related clinical symptoms were significantly reduced and the patients’ quality of life was obviously improved. CT-guided 125I seed implantation proved to be potentially beneficial in treating localized advanced NSCLC; it achieved good local control rates and relieved clinical symptoms without increasing side effects. PMID:26656370

  9. [OMICS AND BIG DATA, MAJOR ADVANCES TOWARDS PERSONALIZED MEDICINE OF THE FUTURE?].

    PubMed

    Scheen, A J

    2015-01-01

    The increasing interest for personalized medicine evolves together with two major technological advances. First, the new-generation, rapid and less expensive, DNA sequencing method, combined with remarkable progresses in molecular biology leading to the post-genomic era (transcriptomics, proteomics, metabolomics). Second, the refinement of computing tools (IT), which allows the immediate analysis of a huge amount of data (especially, those resulting from the omics approaches) and, thus, creates a new universe for medical research, that of analyzed by computerized modelling. This article for scientific communication and popularization briefly describes the main advances in these two fields of interest. These technological progresses are combined with those occurring in communication, which makes possible the development of artificial intelligence. These major advances will most probably represent the grounds of the future personalized medicine.

  10. Perimetric progression using the Visual Field Index and the Advanced Glaucoma Intervention Study score and its clinical correlations.

    PubMed

    Gros-Otero, Juan; Castejón, Miguel; Paz-Moreno, Javier; Mikropoulos, Dimitrios; Teus, Miguel

    2015-01-01

    To evaluate the association between clinical parameters and the diagnosis of progression using VFI (Visual Field Index) and AGIS (Advanced Glaucoma Intervention Study) score in primary open angle glaucoma. Retrospective study of 517 visual fields of 78 eyes with primary open angle glaucoma analyzed with VFI and AGIS score. Clinical data registered included: age, sphere, pachimetry, basal intraocular pressure (IOP), and IOP during the follow up. Only the AGIS score diagnosis of progression was associated with the clinical parameters registered. Among the analyzed data, the mean IOP during follow up (p = 0.0005) and IOP at the third month of follow up (p = 0.004) were statistically associated with progression using the AGIS criteria. The diagnosis of perimetric progression using the AGIS score in the current study was closer to the real functional progression than the diagnosis using the VFI, as the former was associated with known risk factors for progression in glaucoma. Copyright © 2014 Spanish General Council of Optometry. Published by Elsevier Espana. All rights reserved.

  11. Therapeutic advances in multiple system atrophy and progressive supranuclear palsy.

    PubMed

    Poewe, Werner; Mahlknecht, Philipp; Krismer, Florian

    2015-09-15

    Multiple system atrophy (MSA) and progressive supranuclear palsy (PSP) are relentlessly progressive neurodegenerative diseases leading to severe disability and ultimately death within less than 10 y. Despite increasing efforts in basic and clinical research, effective therapies for these atypical parkinsonian disorders are lacking. Although earlier small clinical studies in MSA and PSP mainly focused on symptomatic treatment, advances in the understanding of the molecular underpinnings of these diseases and in the search for biomarkers have paved the way for the first large and well-designed clinical trials aiming at disease modification. Targets of intervention in these trials have included α-synuclein inclusion pathology in the case of MSA and tau-related mechanisms in PSP. Since 2013, four large randomized, placebo-controlled, double-blind disease-modification trials have been completed and published, using rasagiline (MSA), rifampicin (MSA), tideglusib (PSP), or davunetide (PSP). All of these failed to demonstrate signal efficacy with regard to the primary outcome measures. In addition, two randomized, placebo-controlled, double-blind trials have studied the efficacy of droxidopa in the symptomatic treatment of neurogenic orthostatic hypotension, including patients with MSA, with positive results in one trial. This review summarizes the design and the outcomes of these and other smaller trials published since 2013 and attempts to highlight priority areas of future therapeutic research in MSA and PSP. © 2015 International Parkinson and Movement Disorder Society. © 2015 International Parkinson and Movement Disorder Society.

  12. Coriolus versicolor polysaccharide peptide slows progression of advanced non-small cell lung cancer.

    PubMed

    Tsang, K W; Lam, C L; Yan, C; Mak, J C; Ooi, G C; Ho, J C; Lam, B; Man, R; Sham, J S; Lam, W K

    2003-06-01

    Non-small cell lung cancer (NSCLC) is a leading cause of cancer deaths, and over 60% of patients present with advanced stages. Although polysaccharide peptides (PSP), isolated from the fungus Coriolus versicolor, have been reported to have anti-tumor effects, its clinical efficacy has not been properly evaluated. Double-blind placebo-controlled randomized study to evaluate the effects of 28-day administration of PSP (Windsor Pharmaceutical, Hong Kong) on patients, who had completed conventional treatment for advanced NSCLC. Thirty-four patients, with no significant difference in their baseline demographic, clinical or tumor characteristics, or previous treatment regimes (P>0.05) were recruited into each of the PSP and control arms. After 28-day treatment, there was a significant improvement in blood leukocyte and neutrophil counts, serum IgG and IgM, and percent of body fat among the PSP, but not the control, patients (P<0.05). Although the evaluable PSP patients did not improve in NSCLC-related symptoms, there were significantly less PSP patients withdrawn due to disease progression, than their control counterparts (5.9 and 23.5%, respectively; P=0.04; OR 4.00). There was no reported adverse reaction attributable to the trial medications. PSP treatment appears to be associated with slower deterioration in patients with advanced NSCLC.

  13. Advanced ceramic matrix composites for TPS

    NASA Technical Reports Server (NTRS)

    Rasky, Daniel J.

    1992-01-01

    Recent advances in ceramic matrix composite (CMC) technology provide considerable opportunity for application to future aircraft thermal protection system (TPS), providing materials with higher temperature capability, lower weight, and higher strength and stiffness than traditional materials. The Thermal Protection Material Branch at NASA Ames Research Center has been making significant progress in the development, characterization, and entry simulation (arc-jet) testing of new CMC's. This protection gives a general overview of the Ames Thermal Protection Materials Branch research activities, followed by more detailed descriptions of recent advances in very-high temperature Zr and Hf based ceramics, high temperature, high strength SiC matrix composites, and some activities in polymer precursors and ceramic coating processing. The presentation closes with a brief comparison of maximum heat flux capabilities of advanced TPS materials.

  14. Progress in advanced high temperature materials technology

    NASA Technical Reports Server (NTRS)

    Freche, J. C.; Ault, G. M.

    1976-01-01

    Significant progress has recently been made in many high temperature material categories pertinent to such applications by the industrial community. These include metal matrix composites, superalloys, directionally solidified eutectics, coatings, and ceramics. Each of these material categories is reviewed and the current state-of-the-art identified, including some assessment, when appropriate, of progress, problems, and future directions.

  15. Advancing automation and robotics technology for the space station Freedom and for the US economy

    NASA Technical Reports Server (NTRS)

    Creedon, Jeremiah F.

    1989-01-01

    In April 1985, as required by Public Law 98-371, the NASA Advanced Technology Advisory Committee (ATAC) reported to Congress the results of its studies on advanced automation and robotics technology for use on the Freedom space station. This material was documented in the initial report (NASA Technical Memorandum 87566). A further requirement of the law was that ATAC follow NASA's progress in this area and report to Congress semiannually. This report is the eighth in a series of progress updates and covers the period between October 1, 1988, and March 31, 1989. NASA has accepted the basic recommendations of ATAC for its Space Station Freedom efforts. ATAC and NASA agree that the thrust of Congress is to build an advanced automation and robotics technology base that will support an evolutionary Space Station Freedom program and serve as a highly visible stimulator, affecting the U.S. long-term economy. The progress report identifies the work of NASA and the Freedom study contractors. It also describes research in progress, and it makes assessments of the advancement of automation and robotics technology on the Freedom space station.

  16. Advancing automation and robotics technology for the Space Station Freedom and for the US economy

    NASA Technical Reports Server (NTRS)

    1988-01-01

    In April 1985, as required by Public Law 98-371, the NASA Advanced Technology Advisory Committee (ATAC) reported to Congress the results of its studies on advanced automation and robotics technology for use on the Freedom space station. This material was documented in the initial report (NASA Technical Memorandum 87566). A further requirement of the law was that ATAC follow NASA's progress in this area and report to Congress semiannually. This report is the seventh in a series of progress updates and covers the period between April 1, 1988 and September 30, 1988. NASA has accepted the basic recommendations of ATAC for its Space Station Freedom efforts. ATAC and NASA agree that the thrust of Congress is to build an advanced automation and robotics technology base that will support an evolutionary Space Station Freedom program and serve as a highly visible stimulator, affecting the U.S. long-term economy. The progress report identifies the work of NASA and the Freedom study contractors. It also describes research in progress, and it makes assessments of the advancement of automation and robotics technology on the Freedom space station.

  17. FDA Approval Summary: Atezolizumab for the Treatment of Patients with Progressive Advanced Urothelial Carcinoma after Platinum‐Containing Chemotherapy

    PubMed Central

    Suzman, Daniel; Maher, V. Ellen; Zhang, Lijun; Tang, Shenghui; Ricks, Tiffany; Palmby, Todd; Fu, Wentao; Liu, Qi; Goldberg, Kirsten B.; Kim, Geoffrey; Pazdur, Richard

    2017-01-01

    Abstract Until recently in the United States, no products were approved for second‐line treatment of advanced urothelial carcinoma. On May 18, 2016, the U.S. Food and Drug Administration approved atezolizumab for the treatment of patients with locally advanced or metastatic urothelial carcinoma whose disease progressed during or following platinum‐containing chemotherapy or within 12 months of neoadjuvant or adjuvant treatment with platinum‐containing chemotherapy. Atezolizumab is a programmed death‐ligand 1 (PD‐L1) blocking antibody and represents the first approved product directed against PD‐L1. This accelerated approval was based on results of a single‐arm trial in 310 patients with locally advanced or metastatic urothelial carcinoma who had disease progression after prior platinum‐containing chemotherapy. Patients received atezolizumab 1,200 mg intravenously every 3 weeks until disease progression or unacceptable toxicity. Key efficacy measures were objective response rate (ORR), as assessed by Independent Review per RECIST 1.1, and duration of response (DoR). With a median follow‐up of 14.4 months, confirmed ORR was 14.8% (95% CI: 11.1, 19.3) in all treated patients. Median DoR was not reached and response durations ranged from 2.1+ to 13.8+ months. Of the 46 responders, 37 patients had an ongoing response for ≥ 6 months. The most common adverse reactions (≥20%) were fatigue, decreased appetite, nausea, urinary tract infection, pyrexia, and constipation. Infection and immune‐related adverse events also occurred, including pneumonitis, hepatitis, colitis, endocrine disorders, and rashes. Overall, the benefit‐risk assessment was favorable to support accelerated approval. The observed clinical benefits need to be verified in confirmatory trial(s). Implications for Practice. This accelerated approval of atezolizumab for second‐line use in advanced urothelial carcinoma provides patients with an effective, novel treatment option for

  18. FDA Approval Summary: Atezolizumab for the Treatment of Patients with Progressive Advanced Urothelial Carcinoma after Platinum-Containing Chemotherapy.

    PubMed

    Ning, Yang-Min; Suzman, Daniel; Maher, V Ellen; Zhang, Lijun; Tang, Shenghui; Ricks, Tiffany; Palmby, Todd; Fu, Wentao; Liu, Qi; Goldberg, Kirsten B; Kim, Geoffrey; Pazdur, Richard

    2017-06-01

    Until recently in the United States, no products were approved for second-line treatment of advanced urothelial carcinoma. On May 18, 2016, the U.S. Food and Drug Administration approved atezolizumab for the treatment of patients with locally advanced or metastatic urothelial carcinoma whose disease progressed during or following platinum-containing chemotherapy or within 12 months of neoadjuvant or adjuvant treatment with platinum-containing chemotherapy. Atezolizumab is a programmed death-ligand 1 (PD-L1) blocking antibody and represents the first approved product directed against PD-L1. This accelerated approval was based on results of a single-arm trial in 310 patients with locally advanced or metastatic urothelial carcinoma who had disease progression after prior platinum-containing chemotherapy. Patients received atezolizumab 1,200 mg intravenously every 3 weeks until disease progression or unacceptable toxicity. Key efficacy measures were objective response rate (ORR), as assessed by Independent Review per RECIST 1.1, and duration of response (DoR). With a median follow-up of 14.4 months, confirmed ORR was 14.8% (95% CI: 11.1, 19.3) in all treated patients. Median DoR was not reached and response durations ranged from 2.1+ to 13.8+ months. Of the 46 responders, 37 patients had an ongoing response for ≥ 6 months. The most common adverse reactions (≥20%) were fatigue, decreased appetite, nausea, urinary tract infection, pyrexia, and constipation. Infection and immune-related adverse events also occurred, including pneumonitis, hepatitis, colitis, endocrine disorders, and rashes. Overall, the benefit-risk assessment was favorable to support accelerated approval. The observed clinical benefits need to be verified in confirmatory trial(s). This accelerated approval of atezolizumab for second-line use in advanced urothelial carcinoma provides patients with an effective, novel treatment option for the management of their disease. This represents the first

  19. Intraoperative Monitoring: Recent Advances in Motor Evoked Potentials.

    PubMed

    Koht, Antoun; Sloan, Tod B

    2016-09-01

    Advances in electrophysiological monitoring have improved the ability of surgeons to make decisions and minimize the risks of complications during surgery and interventional procedures when the central nervous system (CNS) is at risk. Individual techniques have become important for identifying or mapping the location and pathway of critical neural structures. These techniques are also used to monitor the progress of procedures to augment surgical and physiologic management so as to reduce the risk of CNS injury. Advances in motor evoked potentials have facilitated mapping and monitoring of the motor tracts in newer, more complex procedures. Copyright © 2016 Elsevier Inc. All rights reserved.

  20. Factors Affecting Long-Term-Care Residents' Decision-Making Processes as They Formulate Advance Directives

    ERIC Educational Resources Information Center

    Lambert, Heather C.; McColl, Mary Ann; Gilbert, Julie; Wong, Jiahui; Murray, Gale; Shortt, Samuel E. D.

    2005-01-01

    Purpose: The purpose of this study was to describe factors contributing to the decision-making processes of elderly persons as they formulate advance directives in long-term care. Design and Methods: This study was qualitative, based on grounded theory. Recruitment was purposive and continued until saturation was reached. Nine residents of a…

  1. Post-Progression Survival Associated with Overall Survival in Patients with Advanced Non-Small-Cell Lung Cancer Receiving Docetaxel Monotherapy as Second-Line Chemotherapy.

    PubMed

    Kotake, Mie; Miura, Yosuke; Imai, Hisao; Mori, Keita; Sakurai, Reiko; Kaira, Kyoichi; Tomizawa, Yoshio; Minato, Koichi; Saito, Ryusei; Hisada, Takeshi

    2017-01-01

    In patients with non-small-cell lung cancer (NSCLC), the effects of second-line chemotherapy on overall survival (OS) might be confounded by subsequent therapies. Therefore, using individual-level data, we aimed to determine the relationships between progression-free survival (PFS) and post-progression survival (PPS) with OS in patients with advanced NSCLC treated with docetaxel monotherapy as second-line chemotherapy. Between April 2002 and December 2014, data from 86 patients with advanced NSCLC who underwent second-line docetaxel monotherapy following first-line treatment with platinum combination chemotherapy were analyzed. The relationships of PFS and PPS with OS were analyzed at the individual level. Spearman rank correlation and linear regression analyses showed that PPS was strongly associated with OS (r = 0.86, p < 0.05, R2 = 0.93), whereas PFS was moderately correlated with OS (r = 0.50, p < 0.05, R2 = 0.21). Performance status at the end of second-line treatment and the number of regimens after progression beyond second-line chemotherapy were significantly associated with PPS (p < 0.05). In patients with advanced NSCLC with unknown oncogenic driver mutations undergoing docetaxel monotherapy as second-line chemotherapy, when compared with PFS, PPS had a stronger association with OS. This finding suggests that subsequent treatment after disease progression following second-line docetaxel monotherapy has a significant influence on OS. © 2017 S. Karger AG, Basel.

  2. Impact of advanced monitoring variables on intraoperative clinical decision-making: an international survey.

    PubMed

    Joosten, Alexandre; Desebbe, Olivier; Suehiro, Koichi; Essiet, Mfonobong; Alexander, Brenton; Ricks, Cameron; Rinehart, Joseph; Faraoni, David; Cecconi, Maurizio; Van der Linden, Philippe; Cannesson, Maxime

    2017-02-01

    To assess the relationship between the addition of advanced monitoring variables and changes in clinical decision-making. A 15-questions survey was anonymously emailed to international experts and physician members of five anesthesia societies which focused on assessing treatment decisions of clinicians during three realistic clinical scenarios measured at two distinct time points. The first is when typical case information and basic monitoring (T1) were provided, and then once again after the addition of advanced monitoring variables (T2). We hypothesized that the addition of advanced variables would increase the incidence of an optimal therapeutic decision (a priori defined as the answer with the highest percentage of expert agreement) and decrease the variability among the physician's suggested treatments. The survey was completed by 18 experts and 839 physicians. Overall, adding advanced monitoring did not significantly increase physician response accuracy, with the least substantial changes noted on questions related to volume expansion or vasopressor administration. Moreover, advanced monitoring data did not significantly decrease the high level of initial practice variability in physician suggested treatments (P = 0.13), in contrast to the low variability observed within the expert group (P = 0.039). Additionally, 5-10 years of practice (P < 0.0001) and a cardiovascular subspecialty (P = 0.048) were both physician characteristics associated with a higher rate of optimal therapeutic decisions. The addition of advanced variables was of limited benefit for most physicians, further indicating the need for more in depth education on the clinical value and technical understanding of such variables.

  3. Cost-effectiveness of everolimus vs sunitinib in treating patients with advanced, progressive pancreatic neuroendocrine tumors in the United States.

    PubMed

    Casciano, Roman; Chulikavit, Maruit; Perrin, Allison; Liu, Zhimei; Wang, Xufang; Garrison, Louis P

    2012-01-01

    Everolimus (Afinitor) and sunitinib (Sutent) were recently approved to treat patients with advanced, progressive pancreatic neuroendocrine tumors (pNETs). (Afinitor is a registered trademark of Novartis Pharmaceuticals Corporation, East Hanover, NJ, USA; Sutent is a registered trademark of Pfizer Inc., New York, NY, USA.) This analysis examined the projected cost-effectiveness of everolimus vs sunitinib in this setting from a US payer perspective. A semi-Markov model was developed to simulate a cohort of patients with advanced, progressive pNET and to estimate the cost per life-year gained (LYG) and per quality-adjusted life-year (QALY) gained when treating with everolimus vs sunitinib. Efficacy data were based on a weight-adjusted indirect comparison of the agents using phase 3 trial data. Model health states included: stable disease with no adverse events, stable disease with adverse events, disease progression, and death. Therapy costs were based on wholesale acquisition cost. Other costs such as physician visits, tests, hospitalizations, and adverse event costs were obtained from literature and/or primary research. Utility inputs were based on primary research. Sensitivity analyses were conducted to test the model's robustness. In the base-case analysis, everolimus was associated with an incremental 0.448 LYG (0.304 QALYs) at an incremental cost of $12,673, resulting in an incremental cost-effectiveness ratio (ICER) of $28,281/LYG ($41,702/QALY gained). The ICER fell within the cost per QALY range for many widely used oncology drugs. Sensitivity analyses demonstrated that, overall, there is a trend that everolimus is cost-effective compared to sunitinib in this setting. Results of the indirect analysis were not statistically significant (p > 0.05). Assumptions that treatment patterns are the same across therapies may not represent real-world practice. While the analysis is limited by its reliance on an indirect comparison of two phase 3 studies, everolimus is

  4. Glioblastoma—Unraveling the Threads to Make Progress

    Cancer.gov

    Progress against the brain cancer glioblastoma has been slow. In this Cancer Currents post, Drs. Mark Gilbert and Terri Armstrong of NCI’s Neuro-Oncology Branch discuss what’s being done to change that.

  5. Challenges in shared decision making in advanced cancer care: a qualitative longitudinal observational and interview study.

    PubMed

    Brom, Linda; De Snoo-Trimp, Janine C; Onwuteaka-Philipsen, Bregje D; Widdershoven, Guy A M; Stiggelbout, Anne M; Pasman, H Roeline W

    2017-02-01

    Patients' preferences and expectations should be taken into account in treatment decision making in the last phase of life. Shared decision making (SDM) is regarded as a way to give the patient a central role in decision making. Little is known about how SDM is used in clinical practice in advanced cancer care. To examine whether and how the steps of SDM can be recognized in decision making about second- and third-line chemotherapy. Fourteen advanced cancer patients were followed over time using face-to-face in-depth interviews and observations of the patients' out-clinic visits. Interviews and outpatient clinic visits in which treatment options were discussed or decisions made were transcribed verbatim and analysed using open coding. Patients were satisfied with the decision-making process, but the steps of SDM were barely seen in daily practice. The creation of awareness about available treatment options by physicians was limited and not discussed in an equal way. Patients' wishes and concerns were not explicitly assessed, which led to different expectations about improved survival from subsequent lines of chemotherapy. To reach SDM in daily practice, physicians should create awareness of all treatment options, including forgoing treatment, and communicate the risk of benefit and harm. Open and honest communication is needed in which patients' expectations and concerns are discussed. Through this, the difficult process of decision making in the last phase of life can be facilitated and the focus on the best care for the specific patient is strengthened. © 2015 The Authors. Health Expectations Published by John Wiley & Sons Ltd.

  6. FY2016 Advanced Batteries R&D Annual Progress Report - Part 3 of 5

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

    None, None

    The Advanced Batteries research and development (R&D) subprogram within the DOE Vehicle Technologies Office (VTO) provides support and guidance for projects focusing on batteries for plug-in electric vehicles. Program targets focus on overcoming technical barriers to enable market success including: (1) significantly reducing battery cost, (2) increasing battery performance (power, energy, durability), (3) reducing battery weight & volume, and (4) increasing battery tolerance to abusive conditions such as short circuit, overcharge, and crush. This report describes the progress made on the research and development projects funded by the Battery subprogram in 2016. This section covers the summaries of the Appliedmore » Batteries Research for Transportation Projects part 2.« less

  7. FY2016 Advanced Batteries R&D Annual Progress Report - Part 2 of 5

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

    None, None

    The Advanced Batteries research and development (R&D) subprogram within the DOE Vehicle Technologies Office (VTO) provides support and guidance for projects focusing on batteries for plug-in electric vehicles. Program targets focus on overcoming technical barriers to enable market success including: (1) significantly reducing battery cost, (2) increasing battery performance (power, energy, durability), (3) reducing battery weight & volume, and (4) increasing battery tolerance to abusive conditions such as short circuit, overcharge, and crush. This report describes the progress made on the research and development projects funded by the Battery subprogram in 2016. This section covers the summaries of the Appliedmore » Batteries Research for Transportation Projects part 1.« less

  8. Association of microRNA-21 expression with clinicopathological characteristics and the risk of progression in advanced prostate cancer patients receiving androgen deprivation therapy.

    PubMed

    Guan, Yangbo; Wu, You; Liu, Yifei; Ni, Jian; Nong, Shaojun

    2016-08-01

    Despite androgen deprivation therapy (ADT) remains the mainstay therapy for advanced prostate cancer (PCa), the patients have widely variable durations of response to ADT. Unfortunately, there is limited knowledge of pre-treatment prognostic factors for response to ADT. Recently, microRNA-21 (miR-21) has been reported to play an important role in development of castration resistance of CaP. However, little is known about the expression of miR-21 in advanced PCa biopsy tissues, and data on its potential predictive value in advanced PCa are completely lacking. In this study, paraffin-embedded prostate carcinoma tissues obtained by needle biopsy from 85 advanced PCa patients were evaluated for the expression levels of miR-21 by quantitative real-time PCR (qRT-PCR). In situ hybridization (ISH) analysis was performed to further confirm the qRT-PCR results. Kaplan-Meier analysis and Cox proportional hazards regression models were performed to investigate the correlation between miR-21 expression and time to progression of advanced PCa patients. Compared with adjacent non-cancerous prostate tissues, the expression level of miR-21 was significantly increased in PCa tissues (PCa vs. non-cancerous prostate: 1.3273 ± 0.3207 vs. 0.9970 ± 0.2054, P < 0.001). By and large, in ISH analysis miR-21 was expressed at a higher level in tumor areas than in adjacent non-cancerous areas. Additionally, PCa patients with higher expression of miR-21 were significantly more likely to be of high Gleason score and high clinical stage (P < 0.05). There was no significant association between miR-21 expression and the initial prostate-specific antigen (PSA) level or age at diagnosis. Moreover, Kaplan-Meier survival analysis found that PCa patients with high miR-21 expression have shorter progression-free survival than those with low miR-21 expression. Furthermore, Multivariate Cox analysis revealed both miR-21 expression status (P = 0.040) and clinical stage (P = 0

  9. Recent Progresses and Development of Advanced Atomic Layer Deposition towards High-Performance Li-Ion Batteries

    PubMed Central

    Lu, Wei; Liang, Longwei; Sun, Xuan; Sun, Xiaofei; Wu, Chen; Hou, Linrui; Sun, Jinfeng

    2017-01-01

    Electrode materials and electrolytes play a vital role in device-level performance of rechargeable Li-ion batteries (LIBs). However, electrode structure/component degeneration and electrode-electrolyte sur-/interface evolution are identified as the most crucial obstacles in practical applications. Thanks to its congenital advantages, atomic layer deposition (ALD) methodology has attracted enormous attention in advanced LIBs. This review mainly focuses upon the up-to-date progress and development of the ALD in high-performance LIBs. The significant roles of the ALD in rational design and fabrication of multi-dimensional nanostructured electrode materials, and finely tailoring electrode-electrolyte sur-/interfaces are comprehensively highlighted. Furthermore, we clearly envision that this contribution will motivate more extensive and insightful studies in the ALD to considerably improve Li-storage behaviors. Future trends and prospects to further develop advanced ALD nanotechnology in next-generation LIBs were also presented. PMID:29036916

  10. FY 2005 Annual Progress Report for the DOE Hydrogen Program

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

    None

    In cooperation with industry, academia, national laboratories, and other government agencies, the Department of Energy's Hydrogen Program is advancing the state of hydrogen and fuel cell technologies in support of the President's Hydrogen Fuel Initiative. The initiative seeks to develop hydrogen, fuel cell, and infrastructure technologies needed to make it practical and cost-effective for Americans to choose to use fuel cell vehicles by 2020. Significant progress was made in fiscal year 2005 toward that goal.

  11. Antimicrobial graphene family materials: Progress, advances, hopes and fears.

    PubMed

    Lukowiak, Anna; Kedziora, Anna; Strek, Wieslaw

    2016-10-01

    Graphene-based materials have become very popular bionanotechnological instruments in the last few years. Since 2010, the graphene family materials have been recognized as worthy of attention due to its antimicrobial properties. Functionalization of graphene (or rather graphene oxide) surface creates the possibilities to obtain efficient antimicrobial agents. In this review, progress and advances in this field in the last few years are described and discussed. Special attention is devoted to materials based on graphene oxide in which specifically selected components significantly modify biological activity of this carbon structure. Short introduction concerns the physicochemical properties of the graphene family materials. In the section on antimicrobial properties, proposed mechanisms of activity against microorganisms are given showing enhanced action of nanocomposites also under light irradiation (photoinduced activity). Another important feature, i.e. toxicity against eukaryotic cells, is presented with up-to-date data. Taking into account all the information on the properties of the described materials and usefulness of the graphene family as antimicrobial agents, hopes and fears concerning their application are discussed. Finally, some examples of promising usage in medicine and other fields, e.g. in phytobiology and water remediation, are shown. Copyright © 2016 Elsevier B.V. All rights reserved.

  12. Curriculum-Based Measurement of Reading Progress Monitoring: The Importance of Growth Magnitude and Goal Setting in Decision Making

    ERIC Educational Resources Information Center

    Van Norman, Ethan R.; Christ, Theodore J.; Newell, Kirsten W.

    2017-01-01

    Research regarding the technical adequacy of growth estimates from curriculum-based measurement of reading progress monitoring data suggests that current decision-making frameworks are likely to yield inaccurate recommendations unless data are collected for extensive periods of time. Instances where data may not need to be collected for long…

  13. Advance Directive in End of Life Decision-Making among the Yoruba of South-Western Nigeria

    PubMed Central

    Jegede, Ayodele Samuel; Adegoke, Olufunke Olufunsho

    2017-01-01

    End-of-life decision making is value-laden within the context of culture and bioethics. Also, ethics committee role is difficult to understand on this, thus need for ethnomethodological perspective in an expanding bioethical age. Anthropological approach was utilized to document Yoruba definition and perspective of death, cultural beliefs about end-of-life decision making, factors influencing it and ethics committee role. Interviews were conducted among selected Yoruba resident in Akinyele LGA, Oyo State, Nigeria. Content analytical approach was used for data analysis. Yoruba culture, death is socially constructed having spiritual, physical and social significance. Relationship between the dying and significant others influences decision making. Hierarchy of authority informs implementing traditional advance directive. Socialization, gender, patriarchy, religious belief and tradition are major considerations in end-of-life decision making. Awareness, resource allocation and advocacy are important ethics committees’ roles. Further research into cultural diversity of end-of-life decision making will strengthen ethical practice in health care delivery. PMID:28344984

  14. Advance Directive in End of Life Decision-Making among the Yoruba of South-Western Nigeria.

    PubMed

    Jegede, Ayodele Samuel; Adegoke, Olufunke Olufunsho

    2016-11-01

    End-of-life decision making is value-laden within the context of culture and bioethics. Also, ethics committee role is difficult to understand on this, thus need for ethnomethodological perspective in an expanding bioethical age. Anthropological approach was utilized to document Yoruba definition and perspective of death, cultural beliefs about end-of-life decision making, factors influencing it and ethics committee role. Interviews were conducted among selected Yoruba resident in Akinyele LGA, Oyo State, Nigeria. Content analytical approach was used for data analysis. Yoruba culture, death is socially constructed having spiritual, physical and social significance. Relationship between the dying and significant others influences decision making. Hierarchy of authority informs implementing traditional advance directive. Socialization, gender, patriarchy, religious belief and tradition are major considerations in end-of-life decision making. Awareness, resource allocation and advocacy are important ethics committees' roles. Further research into cultural diversity of end-of-life decision making will strengthen ethical practice in health care delivery.

  15. Verification and Validation Process for Progressive Damage and Failure Analysis Methods in the NASA Advanced Composites Consortium

    NASA Technical Reports Server (NTRS)

    Wanthal, Steven; Schaefer, Joseph; Justusson, Brian; Hyder, Imran; Engelstad, Stephen; Rose, Cheryl

    2017-01-01

    The Advanced Composites Consortium is a US Government/Industry partnership supporting technologies to enable timeline and cost reduction in the development of certified composite aerospace structures. A key component of the consortium's approach is the development and validation of improved progressive damage and failure analysis methods for composite structures. These methods will enable increased use of simulations in design trade studies and detailed design development, and thereby enable more targeted physical test programs to validate designs. To accomplish this goal with confidence, a rigorous verification and validation process was developed. The process was used to evaluate analysis methods and associated implementation requirements to ensure calculation accuracy and to gage predictability for composite failure modes of interest. This paper introduces the verification and validation process developed by the consortium during the Phase I effort of the Advanced Composites Project. Specific structural failure modes of interest are first identified, and a subset of standard composite test articles are proposed to interrogate a progressive damage analysis method's ability to predict each failure mode of interest. Test articles are designed to capture the underlying composite material constitutive response as well as the interaction of failure modes representing typical failure patterns observed in aerospace structures.

  16. Progress in Materials and Component Development for Advanced Lithium-ion Cells for NASA's Exploration Missions

    NASA Technical Reports Server (NTRS)

    Reid, Concha, M.; Reid, Concha M.

    2011-01-01

    Vehicles and stand-alone power systems that enable the next generation of human missions to the Moon will require energy storage systems that are safer, lighter, and more compact than current state-of-the- art (SOA) aerospace quality lithium-ion (Li-ion) batteries. NASA is developing advanced Li-ion cells to enable or enhance the power systems for the Altair Lunar Lander, Extravehicular Activities spacesuit, and rovers and portable utility pallets for Lunar Surface Systems. Advanced, high-performing materials are required to provide component-level performance that can offer the required gains at the integrated cell level. Although there is still a significant amount of work yet to be done, the present state of development activities has resulted in the synthesis of promising materials that approach the ultimate performance goals. This report on interim progress of the development efforts will elaborate on the challenges of the development activities, proposed strategies to overcome technical issues, and present performance of materials and cell components.

  17. Making Progress as Leaders among University Staff

    ERIC Educational Resources Information Center

    Quah, Cheng Sim; Sim, Sandra Phek Lin

    2014-01-01

    This study examined the overview of how individuals in their respective teams operated and contributed to their organization. This study also identified the salient characteristics of how the respondents made progress as leaders in their respective faculties or departments towards identifying directions for innovative future practice through…

  18. Therapeutic effect of apatinib on overall survival is mediated by prolonged progression-free survival in advanced gastric cancer patients

    PubMed Central

    Shen, Sipeng; Shi, Qianwen; Bai, Jianling; Li, Jin; Qin, Shukui; Yu, Hao; Chen, Feng

    2017-01-01

    Apatinib is reported to significantly improve the overall survival (OS) of patients with advanced gastric cancer who have previously failed second-line chemotherapy. However, it is not well understood whether apatinib acts by improving progression or by prolonging post-progression survival. Here, based on phase III clinical trial data, the mediating effect of apatinib on patient overall survival was systematically quantified, through progression-free survival (PFS), post-progression survival (PPS), and the disease control rate (DCR). PFS was the primary mediator of the association between apatinib treatment and OS, with an indirect-effect mean survival time ratio of 1.63 (95%CI 1.35-1.97), which mediated 93.5% of the treatment effect. The DCR was also a significant mediator among secondary efficacy endpoints, and had an indirect-effect mean survival time ratio of 1.47 (95%CI 1.20-1.79, 50.9% mediated). Both primary and other targets of the DCR had similar results. The results indicated that apatinib treatment prolongs progression-free survival rather than post-progression survival, and in turn, leads to improved overall survival. Additionally, our study highlights the value of mediation analysis in clinical trials in providing additional information to build upon traditional primary analysis. PMID:27793017

  19. Therapeutic effect of apatinib on overall survival is mediated by prolonged progression-free survival in advanced gastric cancer patients.

    PubMed

    Huang, Lihong; Wei, Yongyue; Shen, Sipeng; Shi, Qianwen; Bai, Jianling; Li, Jin; Qin, Shukui; Yu, Hao; Chen, Feng

    2017-04-25

    Apatinib is reported to significantly improve the overall survival (OS) of patients with advanced gastric cancer who have previously failed second-line chemotherapy. However, it is not well understood whether apatinib acts by improving progression or by prolonging post-progression survival. Here, based on phase III clinical trial data, the mediating effect of apatinib on patient overall survival was systematically quantified, through progression-free survival (PFS), post-progression survival (PPS), and the disease control rate (DCR). PFS was the primary mediator of the association between apatinib treatment and OS, with an indirect-effect mean survival time ratio of 1.63 (95%CI 1.35-1.97), which mediated 93.5% of the treatment effect. The DCR was also a significant mediator among secondary efficacy endpoints, and had an indirect-effect mean survival time ratio of 1.47 (95%CI 1.20-1.79, 50.9% mediated). Both primary and other targets of the DCR had similar results. The results indicated that apatinib treatment prolongs progression-free survival rather than post-progression survival, and in turn, leads to improved overall survival. Additionally, our study highlights the value of mediation analysis in clinical trials in providing additional information to build upon traditional primary analysis.

  20. National Research Council Dialogue to Assess Progress on NASA's Advanced Modeling, Simulation and Analysis Capability and Systems Engineering Capability Roadmap Development

    NASA Technical Reports Server (NTRS)

    Aikins, Jan

    2005-01-01

    Contents include the following: General Background and Introduction of Capability Roadmaps. Agency Objective. Strategic Planning Transformation. Advanced Planning Organizational Roles. Public Involvement in Strategic Planning. Strategic Roadmaps and Schedule. Capability Roadmaps and Schedule. Purpose of NRC Review. Capability Roadmap Development (Progress to Date).

  1. Overview of research in progress at the Center of Excellence

    NASA Technical Reports Server (NTRS)

    Wandell, Brian A.

    1993-01-01

    The Center of Excellence (COE) was created nine years ago to facilitate active collaboration between the scientists at Ames Research Center and the Stanford Psychology Department. Significant interchange of ideas and personnel continues between Stanford and participating groups at NASA-Ames; the COE serves its function well. This progress report is organized into sections divided by project. Each section contains a list of investigators, a background statement, progress report, and a proposal for work during the coming year. The projects are: Algorithms for development and calibration of visual systems, Visually optimized image compression, Evaluation of advanced piloting displays, Spectral representations of color, Perception of motion in man and machine, Automation and decision making, and Motion information used for navigation and control.

  2. Animal research ethics in Africa: is Tanzania making progress?

    PubMed

    Seth, Misago; Saguti, Fredy

    2013-12-01

    The significance of animals in research cannot be over-emphasized. The use of animals for research and training in research centres, hospitals and schools is progressively increasing. Advances in biotechnology to improve animal productivity require animal research. Drugs being developed and new interventions or therapies being invented for cure and palliation of all sorts of animal diseases and conditions need to be tested in animals for their safety and efficacy at some stages of their development. Drugs and interventions for human use pass through a similar development process and must be tested pre-clinically in laboratory animals before clinical trials in humans can be conducted. Therefore, animals are important players in research processes which directly and indirectly benefit animals and humans. However, questions remain as to whether these uses of animals consider the best interests of animals themselves. Various research and training institutions in Tanzania have established some guidelines on animal use, including establishing animal ethics committees. However, most institutions have not established oversight committees. In institutions where there may be guidelines and policies, there are no responsible committees or units to directly oversee if and how these guidelines and policies are enforced; thus, implementation becomes difficult or impossible. This paper endeavours to raise some issues associated with the responsible use of animals in research and training in Tanzania and highlights suggestions for improvement of deficiencies that exist in order to bridge the gap between what ought to be practised and what is practised. © 2012 John Wiley & Sons Ltd.

  3. Are Substance Use Prevention Programs More Effective in Schools Making Adequate Yearly Progress? A Study of Project ALERT

    ERIC Educational Resources Information Center

    Clark, Heddy Kovach; Ringwalt, Chris L.; Shamblen, Stephen R.; Hanley, Sean M.; Flewelling, Robert L.

    2011-01-01

    This exploratory study sought to determine if a popular school-based drug prevention program might be effective in schools that are making adequate yearly progress (AYP). Thirty-four schools with grades 6 through 8 in 11 states were randomly assigned either to receive Project ALERT (n = 17) or to a control group (n = 17); of these, 10 intervention…

  4. [Nursing process in advanced cardiopulmonary resuscitation].

    PubMed

    Lucio Peña, Gerardo; Fuentes Leonardo, Ana María

    2002-01-01

    The process male nurse is a systematic and organized method to offer effective and efficient cares guided to the achievement of solving real problems of health, reducing the incidence and the duration. It is organized and systematic for that consists of five sequential and interrelated steps: Valuation, diagnostic, planning, execution and evaluation, in which are carried out interrelated actions, thought to maximize the long term results. The nurse process is based on the notion that the success of the cares is measured by the degree of effectiveness and the degree of satisfaction and the patient's progress. Applying this method in the Advanced Cardiac Live Support (ACLS) the identification of a cardiovascular or cardiopulmonary urgency was achieved that implies advanced treatment of the air road, defibrillation and appropriate medications to the circumstances. The ACLS challenges the nurses in charge from the patient's attention to make decisions quick low pressure and in dramatic scenes. Reason why it develops the flowing process male nurse in the advanced cardiopulmonary reanimation due to the incidence of these events in the National Institute of Cardiology Ignacio Chávez, which should guarantee the benefit of services in basic and advanced cardiopulmonary reanimation for personal with a high formation level in all the units of intensive cares and services of hospitalization in integrated form and stratified this way to avoid that it progresses to situations that cause the death or leave irreversible sequels since in the central nervous system the time it is a factor critical for the treatment of this events.

  5. Recent Progress in Using Advanced Characterization and Modeling Approaches to Study Radiation Effects in Oxide Ceramics

    DOE PAGES

    Bai, Xian-Ming

    2014-10-23

    I serve as a Guest Editor for the Nuclear Materials Committee of the TMS Structural Materials Division, and coordinated the topic ‘‘Radiation Effects in Oxide Ceramics and Novel LWR Fuels" for JOM in the December 2014 issue. I selected five articles related this topic. These articles talk about some recent progress of using advanced experimental and modeling tools to study radiation effects in oxide ceramics at atomistic scale and mesoscale. In this guest editor commentary article, I summarize the novel aspects of these papers and also provide some suggestions for future research directions.

  6. Evolution of surgical techniques for a progressive risk reduction.

    PubMed

    Amato, Bruno; Santoro, Mario; Izzo, Raffaele; Servillo, Giuseppe; Compagna, Rita; Di Domenico, Lorenza; Di Nardo, Veronica; Giugliano, Giuseppe

    2017-07-18

    Advanced age is a strong predictor of high perioperative mortality in surgical patients and patients aged 75 years and older have an elevated surgical risk, much higher than that of younger patients. Progressive advances in surgical techniques now make it possible to treat high-risk surgical patients with minimally invasive procedures. Endovascular techniques have revolutionized the treatment of several vascular diseases, in particular carotid stenosis, aortic pathologies, and severely incapacitating intermittent claudication or critical limb ischemia. The main advantages of the endovascular approach are the low complication rate, high rate of technical success and a good clinical outcome. Biliary stenting has improved the clinical status of severely ill patients with bile duct stricture before major surgery, and represents a good palliative therapy in the case of malignant biliary obstruction.

  7. NASA R and T aerospace plane vehicles: Progress and plans

    NASA Technical Reports Server (NTRS)

    Dixon, S. C.

    1985-01-01

    Progress made in key technologies such as materials, structures, aerothermodynamics, hypersonic aerodynamics, and hypersonic airbreathing propulsion are reported. Advances were made in more generic, areas such as active controls, flight computer hardware and software, and interdisciplinary analytical design methodology. These technology advances coupled with the development of and experiences with the Space Shuttle make feasible aerospace plane-type vehicles that meet the more demanding requirements of various DOD missions and/or an all-weather Shuttle II with reduced launch costs. Technology needs and high payoff technologies, and the technology advancements in propulsion, control-configured-vehicles, aerodynamics, aerothermodynamics, aerothermal loads, and materials and structures were studied. The highest payoff technologies of materials and structures including thermal-structural analysis and high temperature test techniques are emphasized. The high priority technology of propulsion, and plans, of what remains to be done rather than firm program commitments, are briefly discussed.

  8. Building to Make a Difference: Advanced Practice Nurses' Experience of Power.

    PubMed

    Schoales, Catherine A; Bourbonnais, Frances Fothergill; Rashotte, Judy

    2018-02-01

    Power is necessary for nurses to affect change in patient care and to move the nursing profession forward. Despite the evolving body of nursing research on power, there have been no studies that have investigated the nature of advanced practice nurses' (APNs') power. The purpose of this study was to explore the APNs' lived experience of power. Interpretive phenomenology guided the method and analysis. Eight APNs employed in a single Canadian tertiary care teaching health-care organization engaged in in-depth interviews. The overarching theme, building to make a difference, reflected the APNs' perception of power in their practice, which involved a passion to facilitate change in practice to improve patient care. Building to make a difference involved three themes: building on, building with, and building for. The APNs experienced more power-a process they described as power creep-when they used soft power that was shared with others to affect positive change in health care. These findings contribute to our understanding of how power is perceived and manifested in the APN role, thus further enabling organizations to create working conditions to support the APNs' endeavors to empower others.

  9. Advanced High-Temperature Engine Materials Technology Progresses

    NASA Technical Reports Server (NTRS)

    1995-01-01

    The objective of the Advanced High Temperature Engine Materials Technology Program (HITEMP) is to generate technology for advanced materials and structural analysis that will increase fuel economy, improve reliability, extend life, and reduce operating costs for 21st century civil propulsion systems. The primary focus is on fan and compressor materials (polymer-matrix composites--PMC's), compressor and turbine materials (superalloys, and metal-matrix and intermetallic-matrix composites--MMC's and IMC's) and turbine materials (ceramic-matrix composites--CMC's). These advanced materials are being developed by in-house researchers and on grants and contracts. NASA considers this program to be a focused materials and structures research effort that builds on our base research programs and supports component-development projects. HITEMP is coordinated with the Advanced Subsonic Technology (AST) Program and the Department of Defense/NASA Integrated High-Performance Turbine Engine Technology (IHPTET) Program. Advanced materials and structures technologies from HITEMP may be used in these future applications. Recent technical accomplishments have not only improved the state-of-the-art but have wideranging applications to industry. A high-temperature thin-film strain gage was developed to measure both dynamic and static strain up to 1100 C (2000 F). The gage's unique feature is that it is minimally intrusive. This technology, which received a 1995 R&D 100 Award, has been transferred to AlliedSignal Engines, General Electric Company, and Ford Motor Company. Analytical models developed at the NASA Lewis Research Center were used to study Textron Specialty Materials' manufacturing process for titanium-matrix composite rings. Implementation of our recommendations on tooling and processing conditions resulted in the production of defect free rings. In the Lincoln Composites/AlliedSignal/Lewis cooperative program, a composite compressor case is being manufactured with a Lewis

  10. Competence to Complete Psychiatric Advance Directives: Effects of Facilitated Decision Making

    PubMed Central

    Swanson, Jeffrey W.; Appelbaum, Paul S.; Swartz, Marvin S.; Ferron, Joelle; Van Dorn, Richard A.; Wagner, H. Ryan

    2013-01-01

    Psychiatric advance directives (PADs) statutes presume competence to complete these documents, but the range and dimensions of decisional competence among people who actually complete PADs is unknown. This study examines clinical and neuropsychological correlates of performance on a measure to assess competence to complete PADs and investigates the effects of a facilitated PAD intervention on decisional capacity. N = 469 adults with psychotic disorders were interviewed at baseline and then randomly assigned to either a control group in which they received written materials about PADs or to an intervention group in which they were offered an opportunity to meet individually with a trained facilitator to create a PAD. At baseline, domains on the Decisional Competence Assessment Tool for PADs (DCAT-PAD) were most strongly associated with IQ, verbal memory, abstract thinking, and psychiatric symptoms. At one-month follow-up, participants in the intervention group showed more improvement on the DCAT-PAD than controls, particularly among participants with pre-morbid IQ estimates below the median of 100. The results suggest that PAD facilitation is an effective method to boost competence of cognitively-impaired clients to write PADs and make treatment decisions within PADs, thereby maximizing the chances their advance directives will be valid. PMID:17294136

  11. FY2016 Advanced Combustion Engine Annual Progress Report

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

    None, None

    The Advanced Combustion Engine research and development (R&D) subprogram within the DOE Vehicle Technologies Office (VTO) provides support and guidance for many cutting-edge automotive technologies under development. Research focuses on addressing critical barriers to commercializing higher efficiency, very low emissions advanced internal combustion engines for passenger and commercial vehicles.

  12. FY2014 Advanced Combustion Engine Annual Progress Report

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

    None

    2015-03-01

    The Advanced Combustion Engine research and development (R&D) subprogram within the DOE Vehicle Technologies Office (VTO) provides support and guidance for many cutting-edge automotive technologies under development. Research focuses on addressing critical barriers to commercializing higher efficiency, very low emissions advanced internal combustion engines for passenger and commercial vehicles.

  13. FY2015 Advanced Combustion Engine Annual Progress Report

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

    Singh, Gurpreet; Gravel, Roland M.; Howden, Kenneth C.

    The Advanced Combustion Engine research and development (R&D) subprogram within the DOE Vehicle Technologies Office (VTO) provides support and guidance for many cutting-edge automotive technologies under development. Research focuses on addressing critical barriers to commercializing higher efficiency, very low emissions advanced internal combustion engines for passenger and commercial vehicles.

  14. Advanced coal conversion process demonstration. Technical progress report for the period July 1, 1995--September 30, 1995

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

    NONE

    1997-05-01

    This report describes the technical progress made on the Advanced Coal Conversion Process (ACCP) Demonstration Project from July 1, 1995 through September 30, 1995. The ACCP Demonstration Project is a US Department of Energy (DOE) Clean Coal Technology Project. This project demonstrates an advanced, thermal, coal upgrading process, coupled with physical cleaning techniques, that is designed to upgrade high-moisture, low-rank coals to a high-quality, low-sulfur fuel, registered as the SynCoal process. The coal is processed through three stages (two heating stages followed by an inert cooling stage) of vibrating fluidized bed reactors that remove chemically bound water, carboxyl groups, andmore » volatile sulfur compounds. After thermal upgrading, the cola is put through a deep-bed stratifier cleaning process to separate the pyrite-rich ash from the coal.« less

  15. A Summary on Progress in Materials Development for Advanced Lithium-ion Cells for NASA's Exploration Missions

    NASA Technical Reports Server (NTRS)

    Reid, Concha M.

    2011-01-01

    Vehicles and stand-alone power systems that enable the next generation of human missions to the moon will require energy storage systems that are safer, lighter, and more compact than current state-of-the-art (SOA) aerospace quality lithium-ion (Li-ion) batteries. NASA is developing advanced Li-ion cells to enable or enhance future human missions to Near Earth Objects, such as asteroids, planets, moons, libration points, and orbiting structures. Advanced, high-performing materials are required to provide component-level performance that can offer the required gains at the integrated cell level. Although there is still a significant amount of work yet to be done, the present state of development activities has resulted in the synthesis of promising materials that approach the ultimate performance goals. This paper on interim progress of the development efforts will present performance of materials and cell components and will elaborate on the challenges of the development activities and proposed strategies to overcome technical issues.

  16. Synthetic biology: advancing the design of diverse genetic systems

    PubMed Central

    Wang, Yen-Hsiang; Wei, Kathy Y.; Smolke, Christina D.

    2013-01-01

    A main objective of synthetic biology is to make the process of designing genetically-encoded biological systems more systematic, predictable, robust, scalable, and efficient. The examples of genetic systems in the field vary widely in terms of operating hosts, compositional approaches, and network complexity, ranging from a simple genetic switch to search-and-destroy systems. While significant advances in synthesis capabilities support the potential for the implementation of pathway- and genome-scale programs, several design challenges currently restrict the scale of systems that can be reasonably designed and implemented. Synthetic biology offers much promise in developing systems to address challenges faced in manufacturing, the environment and sustainability, and health and medicine, but the realization of this potential is currently limited by the diversity of available parts and effective design frameworks. As researchers make progress in bridging this design gap, advances in the field hint at ever more diverse applications for biological systems. PMID:23413816

  17. Baseline Fourier-Domain Optical Coherence Tomography Structural Risk Factors for Visual Field Progression in the Advanced Imaging for Glaucoma Study.

    PubMed

    Zhang, Xinbo; Dastiridou, Anna; Francis, Brian A; Tan, Ou; Varma, Rohit; Greenfield, David S; Schuman, Joel S; Sehi, Mitra; Chopra, Vikas; Huang, David

    2016-12-01

    To identify baseline structural parameters that predict the progression of visual field (VF) loss in patients with open-angle glaucoma. Multicenter cohort study. Participants from the Advanced Imaging for Glaucoma (AIG) study were enrolled and followed up. VF progression is defined as either a confirmed progression event on Humphrey Progression Analysis or a significant (P < .05) negative slope for VF index (VFI). Fourier-domain optical coherence tomography (FDOCT) was used to measure optic disc, peripapillary retinal nerve fiber layer (NFL), and macular ganglion cell complex (GCC) thickness parameters. A total of 277 eyes of 188 participants were followed up for 3.7 ± 2.1 years. VF progression was observed in 83 eyes (30%). Several baseline NFL and GCC parameters, but not disc parameters, were found to be significant predictors of progression on univariate Cox regression analysis. The most accurate single predictors were the GCC focal loss volume (FLV), followed closely by NFL-FLV. An abnormal GCC-FLV at baseline increased risk of progression by a hazard ratio of 3.1. Multivariate Cox analysis showed that combining age and central corneal thickness with GCC-FLV in a composite index called "Glaucoma Composite Progression Index" (GCPI) further improved the accuracy of progression prediction. GCC-FLV and GCPI were both found to be significantly correlated with the annual rate of change in VFI. Focal GCC and NFL loss as measured by FDOCT are the strongest predictors for VF progression among the measurements considered. Older age and thinner central corneal thickness can enhance the predictive power using the composite risk model. Copyright © 2016 Elsevier Inc. All rights reserved.

  18. Exposure to ACEI/ARB and β-Blockers Is Associated with Improved Survival and Decreased Tumor Progression and Hospitalizations in Patients with Advanced Colon Cancer1

    PubMed Central

    Engineer, Diana R; Burney, Basil O; Hayes, Teresa G; Garcia, Jose M

    2013-01-01

    BACKGROUND: Advanced colon cancer is associated with weight loss and decreased survival. Studies suggest that angiotensin and β-adrenergic blockade decrease colon cancer progression and ameliorate weight loss. This study aims to determine whether exposure to β-adrenoceptor blockers (BBs), angiotensin-converting enzyme inhibitors (ACEIs), or angiotensin receptor blockers (ARBs) is associated with decreased mortality, tumor progression, number of hospitalizations, or weight loss in colorectal cancer. METHODS: Retrospective chart review included patients with advanced colorectal cancer. Survival, stage, hospitalization, cancer progression, cancer treatment, and body weight history were collected. RESULTS: Two hundred sixty-two of 425 new stage III to IV colorectal cancer cases reviewed met the study criteria. Those exposed to ACEI/ARB, BB, or both were more likely to have diabetes, hypertension, and stage III colorectal cancer. Adjusting for age, presence of hypertension and diabetes, and stage, ACEI/ARB + BB exposure was associated with decreased mortality compared to unexposed individuals [hazard ratio (HR) = 0.5, confidence interval (CI) = 0.29–0.85; Cox regression, P = .01]. Fewer total and cancer-related hospitalizations and decreased cancer progression in the ACEI/ARB + BB group versus the unexposed group (HR = 0.59, CI = 0.36–0.99, P = .047) were seen. Exposure did not affect weight changes; furthermore, body weight changes from both prediagnosis and at diagnosis to 6, 12, 18, and 24 months postdiagnosis predicted survival. CONCLUSIONS: We have observed an association between exposure to a combination of ACEI/ARB + BB and increased survival, decreased hospitalizations, and decreased tumor progression in advanced colorectal cancer. Future studies will be needed to replicate these results and generalize them to broader populations. Determination of causality will require a randomized controlled trial. PMID:24151534

  19. Convergence of advances in genomics, team science, and repositories as drivers of progress in psychiatric genomics.

    PubMed

    Lehner, Thomas; Senthil, Geetha; Addington, Anjené M

    2015-01-01

    After many years of unfilled promise, psychiatric genetics has seen an unprecedented number of successes in recent years. We hypothesize that the field has reached an inflection point through a confluence of four key developments: advances in genomics; the orientation of the scientific community around large collaborative team science projects; the development of sample and data repositories; and a policy framework for sharing and accessing these resources. We discuss these domains and their effect on scientific progress and provide a perspective on why we think this is only the beginning of a new era in scientific discovery. Published by Elsevier Inc.

  20. The Evolving Treatment Landscape of Advanced Renal Cell Carcinoma in Patients Progressing after VEGF Inhibition

    PubMed Central

    Barata, Pedro C.; Ornstein, Moshe C.

    2017-01-01

    Despite significant changes in the therapeutic landscape of renal cell carcinoma, the majority of patients with metastatic disease eventually progress after first-line treatment with vascular endothelial growth factor receptors (VEGFR) tyrosine kinase inhibitor (TKI) therapy. Understanding existing data on subsequent therapies is crucial to define an optimal treatment sequence following first-line failure. This review examines the data supporting currently approved agents in this setting and provides a framework for decision-making regarding treatment sequencing beyond first-line therapy with VEGFR TKIs. PMID:28725539

  1. Learning to cooperate is essential for progress in physics

    NASA Astrophysics Data System (ADS)

    Dickau, Jonathan J.

    2012-06-01

    At the 10th Frontiers of Fundamental Physics symposium, Gerard't Hooft stated that, for some of the advances we hope to see in Physics during the future, there must be a great deal of cooperation between physicists from different disciplines, as well as mathematicians, programmers, technologists, and others. This requires us to evolve a new mindset; however, as so much of our past progress has come out of a fiercely competitive process - especially since a critical review of our ideas about reality remains essential to making clear progress and checking our progress. We must also address the fact that some frameworks appear incompatible, as with relativity and quantum mechanics, whose unification remains distant despite years of attempts to find a quantum gravity theory. I explore the idea that playful exploration, using both left-brained and right-brained approaches to learning, allows us to resolve conflicting ideas by taking advantage of innate human developmental and learning strategies and brain structure. It may thus foster the kind of interdisciplinary cooperation we are hoping to see.

  2. Slow Progress in Dune (Left Rear Wheel)

    NASA Technical Reports Server (NTRS)

    2005-01-01

    The left rear wheel of NASA's Mars Exploration Rover Opportunity makes slow but steady progress through soft dune material in this movie clip of frames taken by the rover's rear hazard identification camera over a period of several days. The sequence starts on Opportunity's 460th martian day, or sol (May 10, 2005) and ends 11 days later. In eight drives during that period, Opportunity advanced a total of 26 centimeters (10 inches) while spinning its wheels enough to have driven 46 meters (151 feet) if there were no slippage. The motion appears to speed up near the end of the clip, but that is an artifact of individual frames being taken less frequently.

  3. Slow Progress in Dune (Left Front Wheel)

    NASA Technical Reports Server (NTRS)

    2005-01-01

    The left front wheel of NASA's Mars Exploration Rover Opportunity makes slow but steady progress through soft dune material in this movie clip of frames taken by the rover's front hazard identification camera over a period of several days. The sequence starts on Opportunity's 460th martian day, or sol (May 10, 2005) and ends 11 days later. In eight drives during that period, Opportunity advanced a total of 26 centimeters (10 inches) while spinning its wheels enough to have driven 46 meters (151 feet) if there were no slippage. The motion appears to speed up near the end of the clip, but that is an artifact of individual frames being taken less frequently.

  4. Assessing Progress toward Accreditation Related Objectives: Evidence regarding the Use of Self-Efficacy as an Outcome in the Advanced Concentration Research Curriculum

    ERIC Educational Resources Information Center

    Holden, Gary; Barker, Kathleen; Rosenberg, Gary; Onghena, Patrick

    2007-01-01

    Objective: Assessing the achievement of social work educational outcomes is a requirement of the Council on Social Work Education's Educational Policy and Standards (EPAS). The Evaluation Self-Efficacy Scale (ESE) was created to assess student progress in advanced concentration courses focused on evaluation and thereby provide data regarding…

  5. Advance directives lessen the decisional burden of surrogate decision-making for the chronically critically ill.

    PubMed

    Hickman, Ronald L; Pinto, Melissa D

    2014-03-01

    To identify the relationships between advance directive status, demographic characteristics and decisional burden (role stress and depressive symptoms) of surrogate decision-makers (SDMs) of patients with chronic critical illness. Although the prevalence of advance directives among Americans has increased, SDMs are ultimately responsible for complex medical decisions of the chronically critically ill patient. Decisional burden has lasting psychological effects on SDMs. There is insufficient evidence on the influence of advance directives on the decisional burden of surrogate decision-makers of patients with chronic critical illness. The study was a secondary data analysis of cross-sectional data. Data were obtained from 489 surrogate decision-makers of chronically critically ill patients at two academic medical centres in Northeast Ohio, United States, between September 2005-May 2008. Data were collected using demographic forms and questionnaires. A single-item measure of role stress and the Center for Epidemiological Studies Depression (CESD) scale were used to capture the SDM's decisional burden. Descriptive statistics, t-tests, chi-square and path analyses were performed. Surrogate decision-makers who were nonwhite, with low socioeconomic status and low education level were less likely to have advance directive documentation for their chronically critically ill patient. The presence of an advance directive mitigates the decisional burden by directly reducing the SDM's role stress and indirectly lessening the severity of depressive symptoms. Most SDMs of chronically critically ill patients will not have the benefit of knowing the patient's preferences for life-sustaining therapies and consequently be at risk of increased decisional burden. Study results are clinically useful for patient education on the influence of advance directives. Patients may be informed that SDMs without advance directives are at risk of increased decisional burden and will require

  6. Strategic analytics: towards fully embedding evidence in healthcare decision-making.

    PubMed

    Garay, Jason; Cartagena, Rosario; Esensoy, Ali Vahit; Handa, Kiren; Kane, Eli; Kaw, Neal; Sadat, Somayeh

    2015-01-01

    Cancer Care Ontario (CCO) has implemented multiple information technology solutions and collected health-system data to support its programs. There is now an opportunity to leverage these data and perform advanced end-to-end analytics that inform decisions around improving health-system performance. In 2014, CCO engaged in an extensive assessment of its current data capacity and capability, with the intent to drive increased use of data for evidence-based decision-making. The breadth and volume of data at CCO uniquely places the organization to contribute to not only system-wide operational reporting, but more advanced modelling of current and future state system management and planning. In 2012, CCO established a strategic analytics practice to assist the agency's programs contextualize and inform key business decisions and to provide support through innovative predictive analytics solutions. This paper describes the organizational structure, services and supporting operations that have enabled progress to date, and discusses the next steps towards the vision of embedding evidence fully into healthcare decision-making. Copyright © 2014 Longwoods Publishing.

  7. FY 2007 Progress Report for Advanced Combustion Engine Technologies

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

    None, None

    2007-12-01

    Advanced combustion engines have great potential for achieving dramatic energy efficiency improvements in light-duty vehicle applications, where it is suited to both conventional and hybrid- electric powertrain configurations. Light-duty vehicles with advanced combustion engines can compete directly with gasoline engine hybrid vehicles in terms of fuel economy and consumer-friendly driving characteristics; also, they are projected to have energy efficiencies that are competitive with hydrogen fuel cell vehicles when used in hybrid applications.Advanced engine technologies being researched and developed by the Advanced Combustion Engine R&D Sub-Program will also allow the use of hydrogen as a fuel in ICEs and will providemore » an energy-efficient interim hydrogen-based powertrain technology during the transition to hydrogen/fuelcell-powered transportation vehicles.« less

  8. The Quest for Item Types Based on Information Processing: An Analysis of Raven's Advanced Progressive Matrices, with a Consideration of Gender Differences

    ERIC Educational Resources Information Center

    Vigneau, Francois; Bors, Douglas A.

    2008-01-01

    Various taxonomies of Raven's Advanced Progressive Matrices (APM) items have been proposed in the literature to account for performance on the test. In the present article, three such taxonomies based on information processing, namely Carpenter, Just and Shell's [Carpenter, P.A., Just, M.A., & Shell, P., (1990). What one intelligence test…

  9. U.S. Public Health Service Commissioned Corps pharmacists: making a difference in advancing the nation's health.

    PubMed

    Flowers, Louis; Wick, Jeannette; Figg, William Douglas; McClelland, Robert H; Shiber, Michael; Britton, James E; Ngo, Diem-Kieu H; Borders-Hemphill, Vicky; Mead, Christina; Zee, Jerry; Huntzinger, Paul

    2009-01-01

    To describe how U.S. Public Health Service (PHS) pharmacists serving in jobs that are normal for them, but considerably different than those found in the private sector, are making a difference in advancing the nation's health. Pharmacists who serve in the Commissioned Corps of PHS fill roles that are considerably different than their counterparts in the private sector. Their work takes them out from behind the counter and into the world. Pharmacy officers advance the health and safety of the nation by their involvement in the delivery of direct patient care to medically underserved people, national security, drug vigilance, research, and policy-making endeavors. PHS pharmacists fill essential public health leadership and service roles throughout the U.S. Department of Health and Human Services (HHS) and certain non-HHS federal agencies and programs. The Health Resources and Services Administration, National Institutes of Health, Federal Bureau of Prisons, Indian Health Service, Food and Drug Administration, and U.S. Coast Guard are among the many federal agencies in which pharmacy officers are assigned. In each setting, PHS pharmacists find traditional roles augmented with assignments and challenges that broaden the scope of their practice.

  10. Recent advances in understanding and managing chordomas.

    PubMed

    Youssef, Carl; Aoun, Salah G; Moreno, Jessica R; Bagley, Carlos A

    2016-01-01

    Chordomas are rare primary bone tumors arising from embryonic remnants of the notochord. They are slow-growing, locally aggressive, and destructive and typically involve the axial skeleton. Genetic studies have identified several mutations implicated in the pathogenesis of these tumors. Treatment poses a challenge given their insidious progression, degree of local invasion at presentation, and high recurrence rate. They tend to respond poorly to conventional chemotherapy and radiation. This makes radical resection the mainstay of their treatment. Recent advances in targeted chemotherapy and focused particle beam radiation, however, have improved the management and prognosis of these tumors.

  11. 20 CFR 411.205 - What if I disagree with the PM's decision about whether I am making timely progress toward self...

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... about whether I am making timely progress toward self-supporting employment? 411.205 Section 411.205 Employees' Benefits SOCIAL SECURITY ADMINISTRATION THE TICKET TO WORK AND SELF-SUFFICIENCY PROGRAM...-supporting employment? If you disagree with the PM's decision, you may request that we review the decision...

  12. Expanding Robust HCCI Operation with Advanced Valve and Fuel Control Technologies

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

    Szybist, J. P.; Confer, K.

    2012-09-11

    Delphi Automotive Systems and ORNL established this CRADA to advance the commercialization potential of the homogeneous charge compression ignition (HCCI) advanced combustion strategy for gasoline engine platforms. HCCI combustion has been shown by others to produce high diesel-like efficiency on a gasoline engine platform while simultaneously producing low NOX and particulate matter emissions. However, the commercialization barriers that face HCCI combustion are significant, with requirements for a more active engine control system, likely with next-cycle closed-loop feedback control, and with advanced valve train technologies to enable negative valve overlap conditions. In the partnership between Delphi and ORNL, each organization broughtmore » a unique and complementary set of skills to the project. Delphi has made a number of breakthroughs with production-intent valve train technologies and controls in recent years to make a part time production-intent HCCI engine plausible. ORNL has extensive knowledge and expertise with HCCI combustion, and also has a versatile research engine with hydraulic valve actuation (HVA) that is useful for guiding production of a cam-based HCCI system. Partnering these knowledge bases and capabilities was essential towards making progress to better understand HCCI combustion and the commercialization barriers that it faces. ORNL and Delphi maintained strong collaboration throughout the project. Meetings were held regularly, with additional reports, presentations, and meetings as necessary to maintain progress. Delphi provided guidance to ORNL regarding operational strategies to investigate on their single-cylinder research engine with HVA and data from their experimental multi-cylinder engine for modeling. ORNL provided single-cylinder engine data and modeling results.« less

  13. [Adequacy of clinical interventions in patients with advanced and complex disease. Proposal of a decision making algorithm].

    PubMed

    Ameneiros-Lago, E; Carballada-Rico, C; Garrido-Sanjuán, J A; García Martínez, A

    2015-01-01

    Decision making in the patient with chronic advanced disease is especially complex. Health professionals are obliged to prevent avoidable suffering and not to add any more damage to that of the disease itself. The adequacy of the clinical interventions consists of only offering those diagnostic and therapeutic procedures appropriate to the clinical situation of the patient and to perform only those allowed by the patient or representative. In this article, the use of an algorithm is proposed that should serve to help health professionals in this decision making process. Copyright © 2014 SECA. Published by Elsevier Espana. All rights reserved.

  14. Quantitative imaging biomarkers: the application of advanced image processing and analysis to clinical and preclinical decision making.

    PubMed

    Prescott, Jeffrey William

    2013-02-01

    The importance of medical imaging for clinical decision making has been steadily increasing over the last four decades. Recently, there has also been an emphasis on medical imaging for preclinical decision making, i.e., for use in pharamaceutical and medical device development. There is also a drive towards quantification of imaging findings by using quantitative imaging biomarkers, which can improve sensitivity, specificity, accuracy and reproducibility of imaged characteristics used for diagnostic and therapeutic decisions. An important component of the discovery, characterization, validation and application of quantitative imaging biomarkers is the extraction of information and meaning from images through image processing and subsequent analysis. However, many advanced image processing and analysis methods are not applied directly to questions of clinical interest, i.e., for diagnostic and therapeutic decision making, which is a consideration that should be closely linked to the development of such algorithms. This article is meant to address these concerns. First, quantitative imaging biomarkers are introduced by providing definitions and concepts. Then, potential applications of advanced image processing and analysis to areas of quantitative imaging biomarker research are described; specifically, research into osteoarthritis (OA), Alzheimer's disease (AD) and cancer is presented. Then, challenges in quantitative imaging biomarker research are discussed. Finally, a conceptual framework for integrating clinical and preclinical considerations into the development of quantitative imaging biomarkers and their computer-assisted methods of extraction is presented.

  15. Green Chemistry: Progress and Barriers

    NASA Astrophysics Data System (ADS)

    Green, Sarah A.

    2016-10-01

    Green chemistry can advance both the health of the environment and the primary objectives of the chemical enterprise: to understand the behavior of chemical substances and to use that knowledge to make useful substances. We expect chemical research and manufacturing to be done in a manner that preserves the health and safety of workers; green chemistry extends that expectation to encompass the health and safety of the planet. While green chemistry may currently be treated as an independent branch of research, it should, like safety, eventually become integral to all chemistry activities. While enormous progress has been made in shifting from "brown" to green chemistry, much more effort is needed to effect a sustainable economy. Implementation of new, greener paradigms in chemistry is slow because of lack of knowledge, ends-justify-the-means thinking, systems inertia, and lack of financial or policy incentives.

  16. Making Progress: Education and Culture in New Times.

    ERIC Educational Resources Information Center

    Carlson, Dennis

    The essays in this collection, although written at different times, are all part of a process of forming a democratic progressive educational policy and practice for the United States in the new historical era. Each chapter groups essays that critique some aspect of existing public school practice, explores the limitations of current reform…

  17. Improving Decision Making for Feeding Options in Advanced Dementia: A Randomized, Controlled Trial

    PubMed Central

    Hanson, Laura C.; Carey, Timothy S.; Caprio, Anthony J.; Lee, Tae Joon; Ersek, Mary; Garrett, Joanne; Jackman, Anne; Gilliam, Robin; Wessell, Kathryn; Mitchell, Susan L.

    2011-01-01

    Background Feeding problems are common in dementia, and decision-makers have limited understanding of treatment options. Objectives To test whether a decision aid improves quality of decision-making about feeding options in advanced dementia. Design Cluster randomized controlled trial. Setting 24 nursing homes in North Carolina Participants Residents with advanced dementia and feeding problems and their surrogates. Intervention Intervention surrogates received an audio or print decision aid on feeding options in advanced dementia. Controls received usual care. Measurements Primary outcome was the Decisional Conflict Scale (range 1–5) measured at 3 months; other main outcomes were surrogate knowledge, frequency of communication with providers, and feeding treatment use. Results 256 residents and surrogate decision-makers were recruited. Residents’ average age was 85; 67% were Caucasian and 79% were women. Surrogates’ average age was 59; 67% were Caucasian, and 70% were residents’ children. The intervention improved knowledge scores (16.8 vs 15.1, p<0.001). After 3 months, intervention surrogates had lower Decisional Conflict Scale scores than controls (1.65 vs. 1.90, p<0.001) and more often discussed feeding options with a health care provider (46% vs. 33%, p=0.04). Residents in the intervention group were more likely to receive a dysphagia diet (89% vs.76%, p=0.04), and showed a trend toward increased staff eating assistance (20% vs.10%, p=0.08). Tube feeding was rare in both groups even after 9 months (1 intervention vs. 3 control, p=0.34). Limitations Cluster randomization was necessary to avoid contamination, but limits blinding and may introduce bias by site effect. Conclusion A decision aid about feeding options in advanced dementia reduced decisional conflict for surrogates and increased their knowledge and communication about feeding options with providers. PMID:22091750

  18. Progress in Modeling and Simulation of Batteries

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

    Turner, John A

    2016-01-01

    Modeling and simulation of batteries, in conjunction with theory and experiment, are important research tools that offer opportunities for advancement of technologies that are critical to electric motors. The development of data from the application of these tools can provide the basis for managerial and technical decision-making. Together, these will continue to transform batteries for electric vehicles. This collection of nine papers presents the modeling and simulation of batteries and the continuing contribution being made to this impressive progress, including topics that cover: * Thermal behavior and characteristics * Battery management system design and analysis * Moderately high-fidelity 3D capabilitiesmore » * Optimization Techniques and Durability As electric vehicles continue to gain interest from manufacturers and consumers alike, improvements in economy and affordability, as well as adoption of alternative fuel sources to meet government mandates are driving battery research and development. Progress in modeling and simulation will continue to contribute to battery improvements that deliver increased power, energy storage, and durability to further enhance the appeal of electric vehicles.« less

  19. "Doctor, Make My Decisions": Decision Control Preferences, Advance Care Planning, and Satisfaction With Communication Among Diverse Older Adults.

    PubMed

    Chiu, Catherine; Feuz, Mariko A; McMahan, Ryan D; Miao, Yinghui; Sudore, Rebecca L

    2016-01-01

    Culturally diverse older adults may prefer varying control over medical decisions. Decision control preferences (DCPs) may profoundly affect advance care planning (ACP) and communication. To determine the DCPs of diverse, older adults and whether DCPs are associated with participant characteristics, ACP, and communication satisfaction. A total of 146 participants were recruited from clinics and senior centers in San Francisco. We assessed DCPs using the control preferences scale: doctor makes all decisions (low), shares with doctor (medium), makes own decisions (high). We assessed associations between DCPs and demographics; prior advance directives; ability to make in-the-moment goals of care decisions; self-efficacy, readiness, and prior asked questions; and satisfaction with patient-doctor communication (on a five-point Likert scale), using Chi-square and Kruskal-Wallis analysis of variance. Mean age was 71 ± 10 years, 53% were non-white, 47% completed an advance directive, and 70% made goals of care decisions. Of the sample, 18% had low DCPs, 33% medium, and 49% high. Older age was the only characteristic associated with DCPs (low: 75 ± 11 years, medium: 69 ± 10 years, high: 70 ± 9 years, P = 0.003). DCPs were not associated with ACP, in-the-moment decisions, or communication satisfaction. Readiness was the only question-asking behavior associated (low: 3.8 ± 1.2, medium: 4.1 ± 1.2, high: 4.3 ± 1.2, P = 0.05). Nearly one-fifth of diverse, older adults want doctors to make their medical decisions. Older age and lower readiness to ask questions were the only demographic variables significantly associated with low DCPs. Yet, older adults with low DCPs still engaged in ACP, asked questions, and reported communication satisfaction. Clinicians can encourage ACP and questions for all patients, but should assess DCPs to provide the desired amount of decision support. Copyright © 2016 American Academy of Hospice and Palliative Medicine. All

  20. Using the Advanced Progressive Matrices (Set I) to Assess Fluid Ability in a Short Time Frame: An Item Response Theory-Based Analysis

    ERIC Educational Resources Information Center

    Chiesi, Francesca; Ciancaleoni, Matteo; Galli, Silvia; Primi, Caterina

    2012-01-01

    This article is aimed at evaluating the possibility that Set I of the Advanced Progressive Matrices (APM-Set I) can be employed to assess fluid ability in a short time frame. The APM-Set I was administered to a sample of 1,389 primary and secondary school students. Confirmatory factor analysis attested to the unidimensionality of the scale. Item…

  1. Make the healthy choice the easy choice: using behavioral economics to advance a culture of health.

    PubMed

    Volpp, K G; Asch, D A

    2017-05-01

    Despite great advances in the science and technology of health care, a large gap separates theoretically achievable advances in health from what individuals and populations actually achieve. Human behavior sits on the final common pathway to so many of our health and health care goals, including the prevention and management of illness and the fostering of wellness. Behavioral economics is a relatively new field offering approaches to supplement many of the conventional approaches to improving health behaviors that rely on education or standard economic theory. While those conventional approaches presume that an educated public will naturally make decisions that optimize personal welfare, approaches derived from behavioral economics harness existing and predictable patterns of behavior that often lead people to make choices against their best interests. By keeping these predictable patterns of behavior in mind when designing health insurance, health care programs or the health-related aspects of everyday life, behavioral economists aim to meet people half-way: no longer asking them to reshape their behavior to something more health promoting, but helping the behavioral patterns they already follow lead them to better health. © The Author 2016. Published by Oxford University Press on behalf of the Association of Physicians. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  2. JTEC panel report on advanced composites in Japan

    NASA Technical Reports Server (NTRS)

    Diefendorf, R. J.; Grisaffe, S. J.; Hillig, W. B.; Perepezko, J. H.; Pipes, R. B.; Sheehan, J. E.

    1991-01-01

    The JTEC Panel on Advanced Composites visited Japan and surveyed the status and future directions of Japanese high performance ceramic and carbon fibers and their composites in metal, intermetallic, ceramic and carbon matrices. The panel's interests included not only what composite systems were chosen, but also how these systems were developed. A strong carbon and fiber industry makes Japan the leader in carbon fiber technology. Japan has initiated an oxidation resistant carbon/carbon composite program. The goals for this program are ambitious, and it is just starting, but its progress should be closely monitored in the United States.

  3. Atezolizumab in platinum-treated locally advanced or metastatic urothelial carcinoma: post-progression outcomes from the phase II IMvigor210 study.

    PubMed

    Necchi, A; Joseph, R W; Loriot, Y; Hoffman-Censits, J; Perez-Gracia, J L; Petrylak, D P; Derleth, C L; Tayama, D; Zhu, Q; Ding, B; Kaiser, C; Rosenberg, J E

    2017-12-01

    Conventional criteria for tumor progression may not fully reflect the clinical benefit of immunotherapy or appropriately guide treatment decisions. The phase II IMvigor210 study demonstrated the efficacy and safety of atezolizumab, a programmed death-ligand 1-directed antibody, in patients with platinum-treated locally advanced or metastatic urothelial carcinoma. Patients could continue atezolizumab beyond Response Evaluation Criteria In Solid Tumors (RECIST) v1.1 progression at the investigator's discretion: this analysis assessed post-progression outcomes in these patients. Patients were treated with atezolizumab 1200 mg i.v. every 3 weeks until loss of clinical benefit. Efficacy and safety outcomes in patients who experienced RECIST v1.1 progression and did, or did not, continue atezolizumab were analyzed descriptively. In total, 220 patients who experienced progression from the overall cohort (n = 310) were analyzed: 137 continued atezolizumab for ≥ 1 dose after progression, 19 received other systemic therapy, and 64 received no further systemic therapy. Compared with those who discontinued, patients continuing atezolizumab beyond progression were more likely to have had a baseline Eastern Cooperative Oncology Group performance status of 0 (43.1% versus 31.3%), less likely to have had baseline liver metastases (27.0% versus 41.0%), and more likely to have had an initial response to atezolizumab (responses in 11.7% versus 1.2%). Five patients (3.6%) continuing atezolizumab after progression had subsequent responses compared with baseline measurements. Median post-progression overall survival was 8.6 months in patients continuing atezolizumab, 6.8 months in those receiving another treatment, and 1.2 months in those receiving no further treatment. Atezolizumab exposure-adjusted adverse event frequencies were generally similar before and following progression. In this single-arm study, patients who continued atezolizumab beyond RECIST v1

  4. A Learning Progression for Elementary Students' Functional Thinking

    ERIC Educational Resources Information Center

    Stephens, Ana C.; Fonger, Nicole; Strachota, Susanne; Isler, Isil; Blanton, Maria; Knuth, Eric; Murphy Gardiner, Angela

    2017-01-01

    In this article we advance characterizations of and supports for elementary students' progress in generalizing and representing functional relationships as part of a comprehensive approach to early algebra. Our learning progressions approach to early algebra research involves the coordination of a curricular framework and progression, an…

  5. U.S. Public Health Service Commissioned Corps Pharmacists: Making a Difference in Advancing the Nation’s Health

    PubMed Central

    Flowers, Louis; Wick, Jeannette; Figg, William Douglas; McClelland, Robert H.; Shiber, Michael; Britton, James E.; Ngo, Diem-Kieu H.; Borders-Hemphill, Vicky; Mead, Christina; Zee, Jerry; Huntzinger, Paul

    2010-01-01

    Objective To describe how pharmacy officers in the Commissioned Corps are making a difference in protecting, promoting, and advancing health and safety of the Nation. Summary Pharmacists who serve in the Commissioned Corps of the United States Public Health Service fill roles that are considerably different than their counterparts in the private sector. Their work takes them out from behind the counter and into the world. Pharmacy officers advance the health and safety of the Nation by their involvement in the delivery of direct patient care to medically underserved people, national security, drug vigilance, research and policy-making endeavors. PHS pharmacists fill essential public health leadership and service roles throughout the U.S. Department of Health and Human Services (HHS) and certain non-HHS federal agencies and programs. The Federal Bureau of Prisons, Health Resources and Services Administration, Food and Drug Administration, United States Coast Guard, Indian Health Service, and National Institutes of Health are among the many federal agencies where pharmacy officers are assigned. Conclusion In each setting, pharmacists find traditional roles augmented with assignments and challenges that broaden the scope of their practice. PMID:19443327

  6. Advanced techniques for the storage and use of very large, heterogeneous spatial databases

    NASA Technical Reports Server (NTRS)

    Peuquet, Donna J.

    1987-01-01

    Progress is reported in the development of a prototype knowledge-based geographic information system. The overall purpose of this project is to investigate and demonstrate the use of advanced methods in order to greatly improve the capabilities of geographic information system technology in the handling of large, multi-source collections of spatial data in an efficient manner, and to make these collections of data more accessible and usable for the Earth scientist.

  7. The Effects of Assistant Principals' Decision-Making Processes on Advanced Diploma Rates in Long Island High Schools

    ERIC Educational Resources Information Center

    Murillo, Leo

    2017-01-01

    The purpose of this causal comparative study is to determine whether the assistant principal decision-making process and their years of experience influence the advanced diploma rates in high schools on Long Island, New York. The subjects for this study were 75 assistant principals in Long Island high schools during 2016. Assistant principals'…

  8. 48 CFR 52.232-16 - Progress Payments.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 48 Federal Acquisition Regulations System 2 2011-10-01 2011-10-01 false Progress Payments. 52.232... Progress Payments. As prescribed in 32.502-4(a), insert the following clause: Progress Payments (AUG 2010) The Government will make progress payments to the Contractor when requested as work progresses, but...

  9. European Archaeomagnetism: Progress and Problems

    NASA Astrophysics Data System (ADS)

    Evans, M. E.; Hoye, G.

    2009-05-01

    Much progress has been made since the seminal work of Giuseppe Folgheraiter (1856-1913) in the late 19th century. So much so that recent advances now make it possible to draw up complete isogonic and isoclinic maps for Europe and adjacent areas spanning the last three millennia (Pavon-Carrasco et al., 2009). Results based on multiple independent studies, with high precision and good age control are crucial and should be recognized as "anchor points" (e.g. Pompeii). On the other hand, the nagging problem of outliers persists. Among the possible causes are magnetic refraction, physical distortion, and inadequate chronological control. Some examples, drawn from our own investigations over the last 30 years, will be discussed in detail. These include previously unpublished data from a detailed study (more than 100 samples) of a kiln in southern Italy, and an apparently good (but aberrant) archaeodirection from a kiln in southern Spain.

  10. "It's like playing with your destiny": Bosnian immigrants' views of advance directives and end-of-life decision-making.

    PubMed

    Searight, H Russell; Gafford, Jennifer

    2005-07-01

    Patient autonomy is a primary value in US health care. It is assumed that patients want to be fully and directly informed about serious health conditions and want to engage in advance planning about medical care at the end-of-life. Written advance directives and proxy decision-makers are vehicles to promote autonomy when patients are no longer able to represent their wishes. Cross-cultural studies have raised questions about the universal acceptance of these health care values among all ethnicities. In the current investigation, Bosnian immigrants were interviewed about their views of physician-patient communication, advance directives, and locus of decision-making in serious illness. Many of the respondents indicated that they did not want to be directly informed of a serious illness. There was an expressed preference for physician- or family-based health care decisions. Advance directives and formally appointed proxies were typically seen as unnecessary and inconsistent with many respondents' personal values. The findings suggest that the value of individual autonomy and control over the health care decisions may not be applicable to cultures with a collectivist orientation.

  11. Using the Malcolm Baldrige "are we making progress" survey for organizational self-assessment and performance improvement.

    PubMed

    Shields, Judith A; Jennings, Jerry L

    2013-01-01

    A national healthcare company applied the Malcolm Baldrige Criteria for Performance Excellence and its "Are We Making Progress?" survey as an annual organizational self-assessment to identify areas for improvement. For 6 years, Liberty Healthcare Corporation reviewed the survey results on an annual basis to analyze positive and negative trends, monitor company progress toward targeted goals and develop new initiatives to address emerging areas for improvement. As such, the survey provided a simple and inexpensive methodology to gain useful information from employees at all levels and from multiple service sites and business sectors. In particular, it provided a valuable framework for assessing and improving the employees' commitment to the company's mission and values, high standards and ethics, quality of work, and customer satisfaction. The methodology also helped the company to incorporate the philosophy and principles of continuous quality improvement in a unified fashion. Corporate and local leadership used the same measure to evaluate the performance of individual programs relative to each other, to the company as a whole, and to the "best practices" standard of highly successful companies that received the Malcolm Baldrige National Quality Award. © 2012 National Association for Healthcare Quality.

  12. Comparison of Glaucoma Progression Detection by Optical Coherence Tomography and Visual Field.

    PubMed

    Zhang, Xinbo; Dastiridou, Anna; Francis, Brian A; Tan, Ou; Varma, Rohit; Greenfield, David S; Schuman, Joel S; Huang, David

    2017-12-01

    To compare longitudinal glaucoma progression detection using optical coherence tomography (OCT) and visual field (VF). Validity assessment. We analyzed subjects with more than 4 semi-annual follow-up visits (every 6 months) in the multicenter Advanced Imaging for Glaucoma Study. Fourier-domain optical coherence tomography (OCT) was used to map the thickness of the peripapillary retinal nerve fiber layer (NFL) and ganglion cell complex (GCC). OCT-based progression detection was defined as a significant negative trend for either NFL or GCC. VF progression was reached if either the event or trend analysis reached significance. The analysis included 356 glaucoma suspect/preperimetric glaucoma (GS/PPG) eyes and 153 perimetric glaucoma (PG) eyes. Follow-up length was 54.1 ± 16.2 months for GS/PPG eyes and 56.7 ± 16.0 for PG eyes. Progression was detected in 62.1% of PG eyes and 59.8% of GS/PPG eyes by OCT, significantly (P < .001) more than the detection rate of 41.8% and 27.3% by VF. In severity-stratified analysis of PG eyes, OCT had significantly higher detection rate than VF in mild PG (63.1% vs. 38.7%, P < .001), but not in moderate and advanced PG. The rate of NFL thinning slowed dramatically in advanced PG, but GCC thinning rate remained relatively steady and allowed good progression detection even in advanced disease. The Kaplan-Meier time-to-event analyses showed that OCT detected progression earlier than VF in both PG and GS/PPG groups. OCT is more sensitive than VF for the detection of progression in early glaucoma. While the utility of NFL declines in advanced glaucoma, GCC remains a sensitive progression detector from early to advanced stages. Copyright © 2017 Elsevier Inc. All rights reserved.

  13. [Visual field progression in glaucoma: cluster analysis].

    PubMed

    Bresson-Dumont, H; Hatton, J; Foucher, J; Fonteneau, M

    2012-11-01

    Visual field progression analysis is one of the key points in glaucoma monitoring, but distinction between true progression and random fluctuation is sometimes difficult. There are several different algorithms but no real consensus for detecting visual field progression. The trend analysis of global indices (MD, sLV) may miss localized deficits or be affected by media opacities. Conversely, point-by-point analysis makes progression difficult to differentiate from physiological variability, particularly when the sensitivity of a point is already low. The goal of our study was to analyse visual field progression with the EyeSuite™ Octopus Perimetry Clusters algorithm in patients with no significant changes in global indices or worsening of the analysis of pointwise linear regression. We analyzed the visual fields of 162 eyes (100 patients - 58 women, 42 men, average age 66.8 ± 10.91) with ocular hypertension or glaucoma. For inclusion, at least six reliable visual fields per eye were required, and the trend analysis (EyeSuite™ Perimetry) of visual field global indices (MD and SLV), could show no significant progression. The analysis of changes in cluster mode was then performed. In a second step, eyes with statistically significant worsening of at least one of their clusters were analyzed point-by-point with the Octopus Field Analysis (OFA). Fifty four eyes (33.33%) had a significant worsening in some clusters, while their global indices remained stable over time. In this group of patients, more advanced glaucoma was present than in stable group (MD 6.41 dB vs. 2.87); 64.82% (35/54) of those eyes in which the clusters progressed, however, had no statistically significant change in the trend analysis by pointwise linear regression. Most software algorithms for analyzing visual field progression are essentially trend analyses of global indices, or point-by-point linear regression. This study shows the potential role of analysis by clusters trend. However, for best

  14. Let's Make Data Count

    NASA Astrophysics Data System (ADS)

    Budden, A. E.; Abrams, S.; Chodacki, J.; Cruse, P.; Fenner, M.; Jones, M. B.; Lowenberg, D.; Rueda, L.; Vieglais, D.

    2017-12-01

    The impact of research has traditionally been measured by citations to journal publications and used extensively for evaluation and assessment in academia, but this process misses the impact and reach of data and software as first-class scientific products. For traditional publications, Article-Level Metrics (ALM) capture the multitude of ways in which research is disseminated and used, such as references and citations within social media and other journal articles. Here we present on the extension of usage and citation metrics collection to include other artifacts of research, namely datasets. The Make Data Count (MDC) project will enable measuring the impact of research data in a manner similar to what is currently done with publications. Data-level metrics (DLM) are a multidimensional suite of indicators measuring the broad reach and use of data as legitimate research outputs. By making data metrics openly available for reuse in a number of different ways, the MDC project represents an important first step on the path towards the full integration of data metrics into the research data management ecosystem. By assuring researchers that their contributions to scholarly progress represented by data corpora are acknowledged, data level metrics provide a foundation for streamlining the advancement of knowledge by actively promoting desirable best practices regarding research data management, publication, and sharing.

  15. End-of-life care in the 21st century: advance directives in universal rights discourse.

    PubMed

    Besirević, Violeta

    2010-03-01

    This article explores universal normative bases that could help to shape a workable legal construct that would facilitate a global use of advance directives. Although I believe that advance directives are of universal character, my primary aim in approaching this issue is to remain realistic. I will make three claims. First, I will argue that the principles of autonomy, dignity and informed consent, embodied in the Oviedo Convention and the UNESCO Declaration on Bioethics and Human Rights, could arguably be regarded as universal bases for the global use of advance directives. Second, I will demonstrate that, despite the apparent consensus of ethical authorities in support of their global use, it is unlikely, for the time being, that such consensus could lead to unqualified legal recognition of advance directives, because of different understandings of the nature of the international rules, meanings of autonomy and dignity which are context-specific and culture-specific, and existing imperfections that make advance directives either unworkable or hardly applicable in practice. The third claim suggests that the fact that the concept of the advance directive is not universally shared does not mean that it should not become so, but never as the only option in managing incompetent patients. A way to proceed is to prioritize work on developing higher standards in managing incompetent patients and on progressing towards the realization of universal human rights in the sphere of bioethics, by advocating a universal, legally binding international convention that would outlaw human rights violations in end-of-life decision-making.

  16. Advanced Separators for Lithium-Ion and Lithium-Sulfur Batteries: A Review of Recent Progress.

    PubMed

    Xiang, Yinyu; Li, Junsheng; Lei, Jiaheng; Liu, Dan; Xie, Zhizhong; Qu, Deyu; Li, Ke; Deng, Tengfei; Tang, Haolin

    2016-11-09

    Li-ion and Li-S batteries find enormous applications in different fields, such as electric vehicles and portable electronics. A separator is an indispensable part of the battery design, which functions as a physical barrier for the electrode as well as an electrolyte reservoir for ionic transport. The properties of the separators directly influence the performance of the batteries. Traditional polyolefin separators showed low thermal stability, poor wettability toward the electrolyte, and inadequate barrier properties to polysulfides. To improve the performance and durability of Li-ion and Li-S batteries, development of advanced separators is required. In this review, we summarize recent progress on the fabrication and application of novel separators, including the functionalized polyolefin separator, polymeric separator, and ceramic separator, for Li-ion and Li-S batteries. The characteristics, advantages, and limitations of these separators are discussed. A brief outlook for the future directions of the research in the separators is also provided. © 2016 Wiley-VCH Verlag GmbH & Co. KGaA, Weinheim.

  17. Basal values and changes of liver stiffness predict the risk of disease progression in compensated advanced chronic liver disease.

    PubMed

    Pons, Mònica; Simón-Talero, Macarena; Millán, Laura; Ventura-Cots, Meritxell; Santos, Begoña; Augustin, Salvador; Genescà, Joan

    2016-10-01

    Transient elastography has been proposed as a tool to predict the risk of decompensation in patients with chronic liver disease. We aimed to identify risk groups of disease progression, using a combination of baseline liver stiffness measurement (LSM) and its change over time (delta-LSM) in patients with compensated advanced chronic liver disease (cACLD). Ninety-four patients with baseline LSM ≥10kPa, Child-Pugh score 5 and without previous decompensation were included. A second LSM was performed during follow-up and data on liver function and liver-related events were collected. The primary endpoint was a composite that included death, liver decompensation and impairment in at least 1 point in Child-Pugh score. After a median follow-up of 43.6 months, 15% of patients presented the primary endpoint. Multivariate analysis identified baseline LSM (OR 1.12, P=0.002) and delta-LSM (OR 1.02, P=0.048) as independent predictors of the primary endpoint. A high risk group represented by patients with baseline LSM ≥21kPa and delta-LSM ≥10% (risk of progression 47.1%, 95% CI: 23-71%) was identified, while patients with LSM <21kPa and delta-LSM <10% presented zero risk of progression (P=0.03). Simple classification rules using baseline LSM and delta-LSM identify cACLD patients at low or high risk of disease progression. Copyright © 2016 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

  18. The Brahmaputra delta and its merger into an accretion wedge in advance of the progressive suturing between India and Asia

    NASA Astrophysics Data System (ADS)

    Seeber, L.; Ferguson, E. K.; Akhter, S. H.; Steckler, M. S.; Mondal, D. R.; Gale, J.; McHugh, C. M.; Paola, C.; Goodbred, S. L.

    2013-12-01

    The Tsangpo-Brahmaputra River is coupled with the progressive suturing of continental India with continental Asia. Since the Eocene onset of this ongoing collision, the delta of this river has advanced along the Indian margin in front of the suture. As the collision lifts the suture above sea level, progradation has kept the delta ahead of it, at sea level. The delta itself is confined between the still passive Indian continental margin and the advancing subduction boundary. Within this transition zone, the accretion prismof the active margin advanced progressively onto the delta and transformed it from a subsiding sediment sink to a rising and folding sediment source. The faster the accretionary prism grows, the faster the delta progrades to find new accommodation space; on the other hand, the prism advances faster upstream of the delta front where it finds more sediment to accrete. The strong mutual dependency of these processes represents a delicately balanced feedback between tectonics and sedimentation. The shape of the margin of India before and after the birth of the Dauki-Shillong structure modulates this interaction. We highlight this coupling between tectonics and sedimentation by examining structure and stratigraphy in the active foldbelt close to the current delta in Bangladesh and eastern India using field and published subsurface data. Insights include: 1) The shift of the Dauki boundary from a passive margin to a south-verging blind-thrust front is marked by a Quaternary foredeep. Foredeep growth buried along its axis formerly breached and eroded anticlines. Progressive growth of the buried Dauki fault has exposed this unconformity along the northern flank of the foredeep. 2) The rise and northward tilt of the Shillong/Dauki thrust-anticline during Quaternary is probably the cause of the Brahmaputra River avulsing from east of the massif to north and west of it. The Naga collision and the differential growth of the foldbelt south of the Dauki Fault

  19. 22 CFR 201.24 - Progress and advance payments.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... are payments to a supplier prior to, and in anticipation of, performance under a procurement contract. They are not based on actual performance or actual costs incurred. (b) Progress payments—(1) Conditions... predelivery costs that may have a material impact on a suppliers's working capital; (iii) The total FAS...

  20. Impact of health research on advances in knowledge, research capacity-building and evidence-informed policies: a case study on maternal mortality and morbidity in Brazil.

    PubMed

    Angulo-Tuesta, Antonia; Santos, Leonor Maria Pacheco; Natalizi, Daniel Alves

    2016-04-01

    National health research systems aim to generate high-quality knowledge so as to maintain and promote the population's health. This study aimed to analyze the impact of maternal mortality/morbidity research funded by the Brazilian Ministry of Health and institutional partners, on the dimensions: advancing in knowledge, research capacity-building and informing decision-making, within the framework of the Canadian Academy of Health Sciences. Descriptive study based on secondary data, conducted at a public university. The advancing in knowledge dimension was estimated from the principal investigators' publication counts and h-index. Data on research capacity-building were obtained from the Ministry of Health's information system. The informing decision-making dimension was analyzed from citations in Stork Network (Rede Cegonha) documents. Between 2002 and 2010, R$ 21.6 million were invested in 128 maternal mortality/morbidity projects. Over this period, the principal investigators published 174 articles, resulting in an h-index of 35, thus showing progress in the advancing in knowledge dimension. Within the research capacity-building dimension, training of 71 students (undergraduate/postgraduate) was observed. Progress in the informing decision-making dimension was modest: 73.5% of the 117 citations in the Stork Network documents were institutional documents and norms. One of the projects funded, the 2006/7 National Demography and Health Survey, was cited in program documents. Impacts were shown in the advancing in knowledge and research capacity-building dimensions. The health research system needs to incorporate research for evidence-informed policies.

  1. Benzene | Cancer Trends Progress Report

    Cancer.gov

    The Cancer Trends Progress Report, first issued in 2001, summarizes our nation's advances against cancer in relation to Healthy People targets set forth by the Department of Health and Human Services.

  2. Nitrate | Cancer Trends Progress Report

    Cancer.gov

    The Cancer Trends Progress Report, first issued in 2001, summarizes our nation's advances against cancer in relation to Healthy People targets set forth by the Department of Health and Human Services.

  3. Radon | Cancer Trends Progress Report

    Cancer.gov

    The Cancer Trends Progress Report, first issued in 2001, summarizes our nation's advances against cancer in relation to Healthy People targets set forth by the Department of Health and Human Services.

  4. Prevention | Cancer Trends Progress Report

    Cancer.gov

    The Cancer Trends Progress Report, first issued in 2001, summarizes our nation's advances against cancer in relation to Healthy People targets set forth by the Department of Health and Human Services.

  5. Arsenic | Cancer Trends Progress Report

    Cancer.gov

    The Cancer Trends Progress Report, first issued in 2001, summarizes our nation's advances against cancer in relation to Healthy People targets set forth by the Department of Health and Human Services.

  6. Cadmium | Cancer Trends Progress Report

    Cancer.gov

    The Cancer Trends Progress Report, first issued in 2001, summarizes our nation's advances against cancer in relation to Healthy People targets set forth by the Department of Health and Human Services.

  7. Sunburn | Cancer Trends Progress Report

    Cancer.gov

    The Cancer Trends Progress Report, first issued in 2001, summarizes our nation's advances against cancer in relation to Healthy People targets set forth by the Department of Health and Human Services.

  8. Highlights | Cancer Trends Progress Report

    Cancer.gov

    The Cancer Trends Progress Report, first issued in 2001, summarizes our nation's advances against cancer in relation to Healthy People targets set forth by the Department of Health and Human Services.

  9. Diagnosis | Cancer Trends Progress Report

    Cancer.gov

    The Cancer Trends Progress Report, first issued in 2001, summarizes our nation's advances against cancer in relation to Healthy People targets set forth by the Department of Health and Human Services.

  10. Acknowledgments | Cancer Trends Progress Report

    Cancer.gov

    The Cancer Trends Progress Report, first issued in 2001, summarizes our nation's advances against cancer in relation to Healthy People targets set forth by the Department of Health and Human Services.

  11. Introduction | Cancer Trends Progress Report

    Cancer.gov

    The Cancer Trends Progress Report, first issued in 2001, summarizes our nation's advances against cancer in relation to Healthy People targets set forth by the Department of Health and Human Services.

  12. Mortality | Cancer Trends Progress Report

    Cancer.gov

    The Cancer Trends Progress Report, first issued in 2001, summarizes our nation's advances against cancer in relation to Healthy People targets set forth by the Department of Health and Human Services.

  13. Survival | Cancer Trends Progress Report

    Cancer.gov

    The Cancer Trends Progress Report, first issued in 2001, summarizes our nation's advances against cancer in relation to Healthy People targets set forth by the Department of Health and Human Services.

  14. Incidence | Cancer Trends Progress Report

    Cancer.gov

    The Cancer Trends Progress Report, first issued in 2001, summarizes our nation's advances against cancer in relation to Healthy People targets set forth by the Department of Health and Human Services.

  15. Treatment | Cancer Trends Progress Report

    Cancer.gov

    The Cancer Trends Progress Report, first issued in 2001, summarizes our nation's advances against cancer in relation to Healthy People targets set forth by the Department of Health and Human Services.

  16. Home | Cancer Trends Progress Report

    Cancer.gov

    The Cancer Trends Progress Report, first issued in 2001, summarizes our nation's advances against cancer in relation to Healthy People targets set forth by the Department of Health and Human Services.

  17. Weight | Cancer Trends Progress Report

    Cancer.gov

    The Cancer Trends Progress Report, first issued in 2001, summarizes our nation's advances against cancer in relation to Healthy People targets set forth by the Department of Health and Human Services.

  18. Contrast Experiment on Advanced Treatment of Pharmaceutical and Paper-making Wastewater through Cinder Fenton-like Process

    NASA Astrophysics Data System (ADS)

    Xiaofeng, Jia; Xiaoyu, Chen; Wenning, Mai

    2018-06-01

    The Fenton-like process of catalyzing H2O2 with Fe2+ and cinder is adopted to subject pharmaceutical and paper-making wastewater to advanced treatment. The influence of each factor is determined using orthogonal experiment and single factor test. The optimal combination of influencing factors is 0.3mmol · L-1 of FeSO4 · 7H2O, [H2O2]:[Fe2+]=8:1 and 10g · L-1 of pyrites cinder. The reaction time in pharmaceutical wastewater and paper-making wastewater is 30min and 60min respectively, testifying to the fact that the reaction in pharmaceutical wastewater is faster than that in paper-making wastewater and the lower utilization rate of cinder in pharmaceutical wastewater. Under the optimal reaction condition, the COD removal rate of these two kinds of wastewater can reach as high as 65% and 72%. Characterized by simple operation and requiring less reagent dosage, this method does not have to regulate the pH of flooding water and allows the repeated usage of cinder.

  19. Advances and Progress in Chagas Disease Drug Discovery.

    PubMed

    Ferreira, Leonardo G; de Oliveira, Marcelo T; Andricopulo, Adriano D

    2016-01-01

    Chagas disease represents a serious burden for millions of people worldwide. Transmitted by the protozoan parasite Trypanosoma cruzi, this neglected tropical disease causes more than 10,000 deaths each year and is the main cause of heart failure in Latin America, where it is endemic. Although most cases are concentrated in Latin American countries, Chagas disease has been increasingly reported in non-endemic regions, where the low level of public awareness on the subject contributes to the growing prevalence of the disease. The available medicines are characterized by several safety and efficacy drawbacks that prevent millions of people, particularly those with advanced disease, from receiving adequate treatment. This urgent need has stimulated the emergence of diverse initiatives dedicated to the research and development (R&D) of novel therapeutic agents for Chagas disease. Public-private partnerships have been responsible for a significant increase in the investments in R&D programs and major advancements have been achieved over the past ten years. A number of collaborative projects have been leveraged by this organizational model, which privileges sharing of data, expertise, and resources between research institutions and pharmaceutical companies. Among the current strategies employed by these consortia, target-based and phenotypic screenings have achieved the most promising results. This article provides an overview on the current status and recent advances in Chagas disease drug discovery.

  20. Advancing functional dysconnectivity and atrophy in progressive supranuclear palsy.

    PubMed

    Brown, Jesse A; Hua, Alice Y; Trujllo, Andrew; Attygalle, Suneth; Binney, Richard J; Spina, Salvatore; Lee, Suzee E; Kramer, Joel H; Miller, Bruce L; Rosen, Howard J; Boxer, Adam L; Seeley, William W

    2017-01-01

    Progressive supranuclear palsy syndrome (PSP-S) results from neurodegeneration within a network of brainstem, subcortical, frontal and parietal cortical brain regions. It is unclear how network dysfunction progresses and relates to longitudinal atrophy and clinical decline. In this study, we evaluated patients with PSP-S (n = 12) and healthy control subjects (n = 20) at baseline and 6 months later. Subjects underwent structural MRI and task-free functional MRI (tf-fMRI) scans and clinical evaluations at both time points. At baseline, voxel based morphometry (VBM) revealed that patients with mild-to-moderate clinical symptoms showed structural atrophy in subcortex and brainstem, prefrontal cortex (PFC; supplementary motor area, paracingulate, dorsal and ventral medial PFC), and parietal cortex (precuneus). Tf-fMRI functional connectivity (FC) was examined in a rostral midbrain tegmentum (rMT)-anchored intrinsic connectivity network that is compromised in PSP-S. In healthy controls, this network contained a medial parietal module, a prefrontal-paralimbic module, and a subcortical-brainstem module. Baseline FC deficits in PSP-S were most severe in rMT network integrative hubs in the prefrontal-paralimbic and subcortical-brainstem modules. Longitudinally, patients with PSP-S had declining intermodular FC between the subcortical-brainstem and parietal modules, while progressive atrophy was observed in subcortical-brainstem regions (midbrain, pallidum) and posterior frontal (perirolandic) cortex. This suggested that later-stage subcortical-posterior cortical change may follow an earlier-stage subcortical-anterior cortical disease process. Clinically, patients with more severe baseline impairment showed greater subsequent prefrontal-parietal cortical FC declines and posterior frontal atrophy rates, while patients with more rapid longitudinal clinical decline showed coupled prefrontal-paralimbic FC decline. VBM and FC can augment disease monitoring in PSP-S by

  1. Advanced Team Decision Making: A Developmental Model

    DTIC Science & Technology

    1992-08-03

    role - right wing, center, goalie - but as they set up plays and bring the STRONG puck down the ice, those individuals begin to function TEAM... pulled the team member’s attention away from assigned work - Unwise use of a member’s expertise in designating roles or functions In these cases, advanced

  2. Why doesn't a family member of a person with advanced dementia use a substituted judgment when making a decision for that person?

    PubMed

    Hirschman, Karen B; Kapo, Jennifer M; Karlawish, Jason H T

    2006-08-01

    The objective of this study was to identify what standard of decision making a family member uses when making medical decisions for their relative with advanced dementia. Thirty family members of patients with advanced dementia from an Alzheimer disease center and a suburban long-term care facility were interviewed using a semistructured interview. All interviews were audiotaped, transcribed, and analyzed using qualitative data analysis techniques. Family members were split almost evenly in the standard they used when making medical decisions for their relative: substituted judgment (43%) or best interests (57%). However, few who used the substituted judgment standard viewed it as distinct from best interests. Instead, both standards were taken into consideration when making medical decisions. In addition to not having discussions about healthcare preferences, the reasons for not using a substituted judgment included: the need for family consensus, unrealistic expectations of the patient, the need to incorporate their relative's quality of life into the decision, and the influence of healthcare professionals. Family members who did not have discussions about healthcare preferences identified various barriers to the discussion, including waiting too long, avoiding the topic, and the patient's denial of dementia. These data suggest several reasons why surrogate decision-makers for persons with advanced dementia do not use the substituted judgment standard and the potential value of interventions that would allow patients with early-stage dementia and their family members to discuss healthcare preferences.

  3. Synergy between scientific advancement and technological innovation, illustrated by a mechanism-based model characterizing sodium-glucose cotransporter-2 inhibition.

    PubMed

    Zhang, Liping; Ng, Chee M; List, James F; Pfister, Marc

    2010-09-01

    Advances in experimental medicine and technological innovation during the past century have brought tremendous progress in modern medicine and generated an ever-increasing amount of data from bench and bedside. The desire to extend scientific knowledge motivates effective data integration. Technological innovation makes this possible, which in turn accelerates the advancement in science. This mutually beneficial interaction is illustrated by the development of an expanded mechanism-based model for understanding a novel mechanism, sodium-glucose cotransporter-2 SGLT2 inhibition for potential treatment of type 2 diabetes mellitus.

  4. Apatinib: A Review in Advanced Gastric Cancer and Other Advanced Cancers.

    PubMed

    Scott, Lesley J

    2018-05-01

    Apatinib [Aitan ® (brand name in China)], also known as rivoceranib, is a novel, small molecule, selective vascular endothelial growth factor receptor-2 (VEGFR-2) tyrosine kinase inhibitor and is the second anti-angiogenic drug to be approved in China for the treatment of advanced or metastatic gastric cancer. This article summarizes the pharmacological properties of apatinib and reviews its clinical use in chemotherapy-experienced patients with advanced gastric adenocarcinoma, including gastroesophageal adenocarcinoma (GEA), or with other advanced cancers such as non-small cell lung cancer (NSCLC), breast cancer, gynaecological cancers, hepatocellular carcinoma (HCC), thyroid cancer and sarcomas. As third- or subsequent-line therapy, oral apatinib significantly prolonged median progression-free survival (PFS) and overall survival (OS) compared with placebo and had a manageable safety profile in Chinese patients with advanced or metastatic gastric cancer or GEA participating in randomized, double-blind, multicentre, phase 2 and 3 trials. More limited evidence also supports it use as subsequent-line treatment in Chinese patients with other advanced or metastatic solid tumours, including NSCLC, breast cancer and HCC. Further clinical experience and long-term pharmacovigilance data are required to more definitively establish the efficacy and safety profile of apatinib, including its use in combination with other chemotherapy agents and its role in the management of other types of advanced or metastatic solid tumours. In the meantime, given its convenient administration regimen and the limited treatment options and poor prognosis for patients with advanced or metastatic solid tumours, apatinib is an important, emerging treatment option for adult patients with advanced gastric adenocarcinoma or GEA who have progressed or relapsed after chemotherapy.

  5. Cultural Neuroscience: Progress and Promise

    PubMed Central

    Chiao, Joan Y.; Cheon, Bobby K.; Pornpattanangkul, Narun; Mrazek, Alissa J.; Blizinsky, Katherine D.

    2013-01-01

    The nature and origin of human diversity has been a source of intellectual curiosity since the beginning of human history. Contemporary advances in cultural and biological sciences provide unique opportunities for the emerging field of cultural neuroscience. Research in cultural neuroscience examines how cultural and genetic diversity shape the human mind, brain and behavior across multiple time scales: situation, ontogeny and phylogeny. Recent progress in cultural neuroscience provides novel theoretical frameworks for understanding the complex interaction of environmental, cultural and genetic factors in the production of adaptive human behavior. Here, we provide a brief history of cultural neuroscience, theoretical and methodological advances, as well as empirical evidence of the promise of and progress in the field. Implications of this research for population health disparities and public policy are discussed. PMID:23914126

  6. Making sense of progressive non-fluent aphasia: an analysis of conversational speech

    PubMed Central

    Woollams, Anna M.; Hodges, John R.; Patterson, Karalyn

    2009-01-01

    The speech of patients with progressive non-fluent aphasia (PNFA) has often been described clinically, but these descriptions lack support from quantitative data. The clinical classification of the progressive aphasic syndromes is also debated. This study selected 15 patients with progressive aphasia on broad criteria, excluding only those with clear semantic dementia. It aimed to provide a detailed quantitative description of their conversational speech, along with cognitive testing and visual rating of structural brain imaging, and to examine which, if any features were consistently present throughout the group; as well as looking for sub-syndromic associations between these features. A consistent increase in grammatical and speech sound errors and a simplification of spoken syntax relative to age-matched controls were observed, though telegraphic speech was rare; slow speech was common but not universal. Almost all patients showed impairments in picture naming, syntactic comprehension and executive function. The degree to which speech was affected was independent of the severity of the other cognitive deficits. A partial dissociation was also observed between slow speech with simplified grammar on the one hand, and grammatical and speech sound errors on the other. Overlap between these sets of impairments was however, the rule rather than the exception, producing continuous variation within a single consistent syndrome. The distribution of atrophy was remarkably variable, with frontal, temporal and medial temporal areas affected, either symmetrically or asymmetrically. The study suggests that PNFA is a coherent, well-defined syndrome and that varieties such as logopaenic progressive aphasia and progressive apraxia of speech may be seen as points in a space of continuous variation within progressive non-fluent aphasia. PMID:19696033

  7. Abscopal effects of radiotherapy on advanced melanoma patients who progressed after ipilimumab immunotherapy.

    PubMed

    Grimaldi, Antonio M; Simeone, Ester; Giannarelli, Diana; Muto, Paolo; Falivene, Sara; Borzillo, Valentina; Giugliano, Francesca Maria; Sandomenico, Fabio; Petrillo, Antonella; Curvietto, Marcello; Esposito, Assunta; Paone, Miriam; Palla, Marco; Palmieri, Giuseppe; Caracò, Corrado; Ciliberto, Gennaro; Mozzillo, Nicola; Ascierto, Paolo A

    2014-01-01

    Cancer radiotherapy (RT) may induce what is referred to as the "abscopal effect," a regression of non-irradiated metastatic lesions distant from the primary tumor site directly subject to irradiation. This clinical response is rare, but has been surmised to be an immune-mediated phenomenon, suggesting that immunotherapy and RT could potentially synergize. Here, we report the outcome of patients with advanced melanoma treated with the immune checkpoint blockade monoclonal antibody antagonist, ipilimumab followed by RT. Patients were selected for enrollment at the National Cancer Institute "Fondazione G.Pascale" through the expanded access program in Italy. Those who experienced disease progression after ipilimumab thus received subsequent RT and were selected for analysis. Among 21 patients, 13 patients (62%) received RT to treat metastases in the brain and 8 received RT directed at extracranial sites. An abscopal response was observed in 11 patients (52%), 9 of whom had partial responses (43%) and 2 had stable disease (10%). The median time from RT to an abscopal response was 1 month (range 1-4). Median overall survival (OS) for all 21 patients was 13 months (range 6-26). Median OS for patients with abscopal responses was extended to 22.4 months (range 2.5-50.3) vs. 8.3 months (range 7.6-9.0) without. A local response to RT was detected in 13 patients (62%) and, of these, 11 patients (85%) had an abscopal response and abscopal effects were only observed among patients exhibiting a local response. These results suggest RT after ipilimumab may lead to abscopal responses in some patients with advanced melanoma correlating with prolonged OS. Our data also suggest that local responses to RT may be predictive of abscopal responses. Further research in larger randomized trials is needed to validate these results.

  8. Abscopal effects of radiotherapy on advanced melanoma patients who progressed after ipilimumab immunotherapy

    PubMed Central

    Grimaldi, Antonio M; Simeone, Ester; Giannarelli, Diana; Muto, Paolo; Falivene, Sara; Borzillo, Valentina; Giugliano, Francesca Maria; Sandomenico, Fabio; Petrillo, Antonella; Curvietto, Marcello; Esposito, Assunta; Paone, Miriam; Palla, Marco; Palmieri, Giuseppe; Caracò, Corrado; Ciliberto, Gennaro; Mozzillo, Nicola; Ascierto, Paolo A

    2014-01-01

    Cancer radiotherapy (RT) may induce what is referred to as the “abscopal effect,” a regression of non-irradiated metastatic lesions distant from the primary tumor site directly subject to irradiation. This clinical response is rare, but has been surmised to be an immune-mediated phenomenon, suggesting that immunotherapy and RT could potentially synergize. Here, we report the outcome of patients with advanced melanoma treated with the immune checkpoint blockade monoclonal antibody antagonist, ipilimumab followed by RT. Patients were selected for enrollment at the National Cancer Institute “Fondazione G.Pascale” through the expanded access program in Italy. Those who experienced disease progression after ipilimumab thus received subsequent RT and were selected for analysis. Among 21 patients, 13 patients (62%) received RT to treat metastases in the brain and 8 received RT directed at extracranial sites. An abscopal response was observed in 11 patients (52%), 9 of whom had partial responses (43%) and 2 had stable disease (10%). The median time from RT to an abscopal response was 1 month (range 1–4). Median overall survival (OS) for all 21 patients was 13 months (range 6–26). Median OS for patients with abscopal responses was extended to 22.4 months (range 2.5–50.3) vs. 8.3 months (range 7.6–9.0) without. A local response to RT was detected in 13 patients (62%) and, of these, 11 patients (85%) had an abscopal response and abscopal effects were only observed among patients exhibiting a local response. These results suggest RT after ipilimumab may lead to abscopal responses in some patients with advanced melanoma correlating with prolonged OS. Our data also suggest that local responses to RT may be predictive of abscopal responses. Further research in larger randomized trials is needed to validate these results. PMID:25083318

  9. Innovative technologies for powder metallurgy-based disk superalloys: Progress and proposal

    NASA Astrophysics Data System (ADS)

    Chong-Lin, Jia; Chang-Chun, Ge; Qing-Zhi, Yan

    2016-02-01

    Powder metallurgy (PM) superalloys are an important class of high temperature structural materials, key to the rotating components of aero engines. In the purview of the present challenges associated with PM superalloys, two novel approaches namely, powder preparation and the innovative spray-forming technique (for making turbine disk) are proposed and studied. Subsequently, advanced technologies like electrode-induction-melting gas atomization (EIGA), and spark-plasma discharge spheroidization (SPDS) are introduced, for ceramic-free superalloy powders. Presently, new processing routes are sought after for preparing finer and cleaner raw powders for disk superalloys. The progress of research in spray-formed PM superalloys is first summarized in detail. The spray-formed superalloy disks specifically exhibit excellent mechanical properties. This paper reviews the recent progress in innovative technologies for PM superalloys, with an emphasis on new ideas and approaches, central to the innovation driving techniques like powder processing and spray forming. Project supported by the National Natural Science Foundation of China (Grant Nos. 50974016 and 50071014).

  10. Advanced Telemetry System Development.

    DTIC Science & Technology

    Progress in advanced telemetry system development is described. Discussions are included of studies leading to the specification for design...characteristics of adaptive and analytical telemetry systems in which the information efficiently utilizes the data channel capacity. Also discussed are...Progress indicates that further sophistication of existing designs in telemetry will be less advantageous than the development of new systems of

  11. Making Advanced Computer Science Topics More Accessible through Interactive Technologies

    ERIC Educational Resources Information Center

    Shao, Kun; Maher, Peter

    2012-01-01

    Purpose: Teaching advanced technical concepts in a computer science program to students of different technical backgrounds presents many challenges. The purpose of this paper is to present a detailed experimental pedagogy in teaching advanced computer science topics, such as computer networking, telecommunications and data structures using…

  12. Director's Message | Cancer Trends Progress Report

    Cancer.gov

    The Cancer Trends Progress Report, first issued in 2001, summarizes our nation's advances against cancer in relation to Healthy People targets set forth by the Department of Health and Human Services.

  13. Contact Us | Cancer Trends Progress Report

    Cancer.gov

    The Cancer Trends Progress Report, first issued in 2001, summarizes our nation's advances against cancer in relation to Healthy People targets set forth by the Department of Health and Human Services.

  14. Summary Tables | Cancer Trends Progress Report

    Cancer.gov

    The Cancer Trends Progress Report, first issued in 2001, summarizes our nation's advances against cancer in relation to Healthy People targets set forth by the Department of Health and Human Services.

  15. Indoor Tanning | Cancer Trends Progress Report

    Cancer.gov

    The Cancer Trends Progress Report, first issued in 2001, summarizes our nation's advances against cancer in relation to Healthy People targets set forth by the Department of Health and Human Services.

  16. Early Detection | Cancer Trends Progress Report

    Cancer.gov

    The Cancer Trends Progress Report, first issued in 2001, summarizes our nation's advances against cancer in relation to Healthy People targets set forth by the Department of Health and Human Services.

  17. Data Sources | Cancer Trends Progress Report

    Cancer.gov

    The Cancer Trends Progress Report, first issued in 2001, summarizes our nation's advances against cancer in relation to Healthy People targets set forth by the Department of Health and Human Services.

  18. Fat Consumption | Cancer Trends Progress Report

    Cancer.gov

    The Cancer Trends Progress Report, first issued in 2001, summarizes our nation's advances against cancer in relation to Healthy People targets set forth by the Department of Health and Human Services.

  19. Secondhand Smoke | Cancer Trends Progress Report

    Cancer.gov

    The Cancer Trends Progress Report, first issued in 2001, summarizes our nation's advances against cancer in relation to Healthy People targets set forth by the Department of Health and Human Services.

  20. HPV Immunization | Cancer Trends Progress Report

    Cancer.gov

    The Cancer Trends Progress Report, first issued in 2001, summarizes our nation's advances against cancer in relation to Healthy People targets set forth by the Department of Health and Human Services.

  1. Smoking Cessation | Cancer Trends Progress Report

    Cancer.gov

    The Cancer Trends Progress Report, first issued in 2001, summarizes our nation's advances against cancer in relation to Healthy People targets set forth by the Department of Health and Human Services.

  2. Tobacco Use | Cancer Trends Progress Report

    Cancer.gov

    The Cancer Trends Progress Report, first issued in 2001, summarizes our nation's advances against cancer in relation to Healthy People targets set forth by the Department of Health and Human Services.

  3. Data Resources | Cancer Trends Progress Report

    Cancer.gov

    The Cancer Trends Progress Report, first issued in 2001, summarizes our nation's advances against cancer in relation to Healthy People targets set forth by the Department of Health and Human Services.

  4. Alcohol Consumption | Cancer Trends Progress Report

    Cancer.gov

    The Cancer Trends Progress Report, first issued in 2001, summarizes our nation's advances against cancer in relation to Healthy People targets set forth by the Department of Health and Human Services.

  5. Custom Report | Cancer Trends Progress Report

    Cancer.gov

    The Cancer Trends Progress Report, first issued in 2001, summarizes our nation's advances against cancer in relation to Healthy People targets set forth by the Department of Health and Human Services.

  6. Physical Activity | Cancer Trends Progress Report

    Cancer.gov

    The Cancer Trends Progress Report, first issued in 2001, summarizes our nation's advances against cancer in relation to Healthy People targets set forth by the Department of Health and Human Services.

  7. Quitting Smoking | Cancer Trends Progress Report

    Cancer.gov

    The Cancer Trends Progress Report, first issued in 2001, summarizes our nation's advances against cancer in relation to Healthy People targets set forth by the Department of Health and Human Services.

  8. NCI Dictionary | Cancer Trends Progress Report

    Cancer.gov

    The Cancer Trends Progress Report, first issued in 2001, summarizes our nation's advances against cancer in relation to Healthy People targets set forth by the Department of Health and Human Services.

  9. Advanced reflector materials for solar concentrators

    NASA Astrophysics Data System (ADS)

    Jorgensen, Gary; Williams, Tom; Wendelin, Tim

    1994-10-01

    This paper describes the research and development at the US National Renewable Energy Laboratory (NREL) in advanced reflector materials for solar concentrators. NREL's research thrust is to develop solar reflector materials that maintain high specular reflectance for extended lifetimes under outdoor service conditions and whose cost is significantly lower than existing products. Much of this work has been in collaboration with private-sector companies that have extensive expertise in vacuum-coating and polymer-film technologies. Significant progress and other promising developments will be discussed. These are expected to lead to additional improvements needed to commercialize solar thermal concentration systems and make them economically attractive to the solar manufacturing industry. To explicitly demonstrate the optical durability of candidate reflector materials in real-world service conditions, a network of instrumented outdoor exposure sites has been activated.

  10. Advanced systemic mastocytosis: from molecular and genetic progress to clinical practice.

    PubMed

    Ustun, Celalettin; Arock, Michel; Kluin-Nelemans, Hanneke C; Reiter, Andreas; Sperr, Wolfgang R; George, Tracy; Horny, Hans-Peter; Hartmann, Karin; Sotlar, Karl; Damaj, Gandhi; Hermine, Olivier; Verstovsek, Srdan; Metcalfe, Dean D; Gotlib, Jason; Akin, Cem; Valent, Peter

    2016-10-01

    Systemic mastocytosis is a heterogeneous disease characterized by the accumulation of neoplastic mast cells in the bone marrow and other organ organs/tissues. Mutations in KIT, most frequently KIT D816V, are detected in over 80% of all systemic mastocytosis patients. While most systemic mastocytosis patients suffer from an indolent disease variant, some present with more aggressive variants, collectively called "advanced systemic mastocytosis", which include aggressive systemic mastocytosis, systemic mastocytosis with an associated hematologic, clonal non mast cell-lineage disease, and mast cell leukemia. Whereas patients with indolent systemic mastocytosis have a near normal life expectancy, patients with advanced systemic mastocytosis have a reduced life expectancy. Although cladribine and interferon-alpha are of benefit in a group of patients with advanced systemic mastocytosis, no curative therapy is available for these patients except possible allogeneic hematopoietic stem cell transplantation. Recent studies have also revealed additional somatic defects (apart from mutations in KIT) in a majority of patients with advanced systemic mastocytosis. These include TET2, SRSF2, ASXL1, RUNX1, JAK2, and/or RAS mutations, which may adversely impact prognosis and survival in particular systemic mastocytosis with an associated hematological neoplasm. In addition, several additional signaling molecules involved in the abnormal proliferation of mast cells in systemic mastocytosis have been identified. These advances have led to a better understanding of the biology of advanced systemic mastocytosis and to the development of new targeted treatment concepts. Herein, we review the biology and pathogenesis of advanced systemic mastocytosis, with a special focus on novel molecular findings as well as current and evolving therapeutic options. Copyright© Ferrata Storti Foundation.

  11. Living with Advanced MS

    MedlinePlus

    ... whose health and safety are compromised by limited knowledge, understanding, and/or ability to access programs and benefits. Read More Read More Publication Managing Progressive MS An overview of symptom management, coping strategies when progressive MS makes the road ...

  12. Cost-effectiveness of Paclitaxel + Ramucirumab Combination Therapy for Advanced Gastric Cancer Progressing After First-line Chemotherapy in Japan.

    PubMed

    Saito, Shota; Muneoka, Yusuke; Ishikawa, Takashi; Akazawa, Kouhei

    2017-12-01

    The combination of paclitaxel + ramucirumab is a standard second-line treatment in patients with advanced gastric cancer. This therapy has been associated with increased median overall survival and progression-free survival compared with those with paclitaxel monotherapy. We evaluated the cost-effectiveness of paclitaxel + ramucirumab combination therapy in patients with advanced gastric cancer, from the perspective of health care payers in Japan. We constructed a Markov model to compare, over a time horizon of 3 years, the costs and effectiveness of the combination of paclitaxel + ramucirumab and paclitaxel alone as second-line therapies for advanced gastric cancer in Japan. Health outcomes were measured in life-years (LYs) and quality-adjusted (QA) LYs gained. Costs were calculated using year-2016 Japanese yen (¥1 = US $17.79) according to the social insurance reimbursement schedule and drug tariff of the fee-for-service system in Japan. Model robustness was addressed through 1-way and probabilistic sensitivity analyses. The costs and QALYs were discounted at a rate of 2% per year. The willingness-to-pay threshold was set at the World Health Organization's criterion of ¥12 million, because no consensus exists regarding the threshold for acceptable cost per QALY ratios in Japan's health policy. Paclitaxel + ramucirumab combination therapy was estimated to provide an additional 0.09 QALYs (0.10 LYs) at a cost of ¥3,870,077, resulting in an incremental cost-effectiveness ratio of ¥43,010,248/QALY. The incremental cost-effectiveness ratio for the combination therapy was >¥12 million/QALY in all of the 1-way and probabilistic sensitivity analyses. Adding ramucirumab to a regimen of paclitaxel in the second-line treatment of advanced gastric cancer is expected to provide a minimal incremental benefit at a high incremental cost per QALY. Based on our findings, adjustments in the price of ramucirumab, as well as improves in other clinical parameters such as survival

  13. Advancing Data Assimilation in Operational Hydrologic Forecasting: Progresses, Challenges, and Emerging Opportunities

    NASA Technical Reports Server (NTRS)

    Liu, Yuqiong; Weerts, A.; Clark, M.; Hendricks Franssen, H.-J; Kumar, S.; Moradkhani, H.; Seo, D.-J.; Schwanenberg, D.; Smith, P.; van Dijk, A. I. J. M.; hide

    2012-01-01

    Data assimilation (DA) holds considerable potential for improving hydrologic predictions as demonstrated in numerous research studies. However, advances in hydrologic DA research have not been adequately or timely implemented in operational forecast systems to improve the skill of forecasts for better informed real-world decision making. This is due in part to a lack of mechanisms to properly quantify the uncertainty in observations and forecast models in real-time forecasting situations and to conduct the merging of data and models in a way that is adequately efficient and transparent to operational forecasters. The need for effective DA of useful hydrologic data into the forecast process has become increasingly recognized in recent years. This motivated a hydrologic DA workshop in Delft, the Netherlands in November 2010, which focused on advancing DA in operational hydrologic forecasting and water resources management. As an outcome of the workshop, this paper reviews, in relevant detail, the current status of DA applications in both hydrologic research and operational practices, and discusses the existing or potential hurdles and challenges in transitioning hydrologic DA research into cost-effective operational forecasting tools, as well as the potential pathways and newly emerging opportunities for overcoming these challenges. Several related aspects are discussed, including (1) theoretical or mathematical aspects in DA algorithms, (2) the estimation of different types of uncertainty, (3) new observations and their objective use in hydrologic DA, (4) the use of DA for real-time control of water resources systems, and (5) the development of community-based, generic DA tools for hydrologic applications. It is recommended that cost-effective transition of hydrologic DA from research to operations should be helped by developing community-based, generic modeling and DA tools or frameworks, and through fostering collaborative efforts among hydrologic modellers, DA

  14. Advances in pancreatic cancer research: moving towards early detection.

    PubMed

    He, Xiang-Yi; Yuan, Yao-Zong

    2014-08-28

    Pancreatic ductal adenocarcinoma (PDAC) is one of the most lethal forms of cancer. Substantial progress has been made in the understanding of the biology of pancreatic cancer, and advances in patient management have been significant. However, most patients (nearly 80%) who present with locally advanced or metastatic disease have an extremely poor prognosis. Survival is better for those with malignant disease localized to the pancreas, because surgical resection at present offers the only chance of cure. Therefore, the early detection of pancreatic cancer may benefit patients with PDAC. However, its low rate of incidence and the limitations of current screening strategies make early detection difficult. Recent advances in the understanding of the pathogenesis of PDAC suggest that it is possible to detect PDAC in early stages and even identify precursor lesions. The presence of new-onset diabetes mellitus in the early phase of pancreatic cancer may provide clues for its early diagnosis. Advances in the identification of novel circulating biomarkers including serological signatures, autoantibodies, epigenetic markers, circulating tumor cells and microRNAs suggest that they can be used as potential tools for the screening of precursors and early stage PDAC in the future. However, proper screening strategies based on effective screening methodologies need to be tested for clinical application.

  15. FY2017 Electrification Annual Progress Report

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

    None

    During fiscal year 2017 (FY 2017), the U.S. Department of Energy (DOE) Vehicle Technologies Office (VTO) funded early stage research & development (R&D) projects that address Batteries and Electrification of the U.S. transportation sector. The VTO Electrification Sub-Program is composed of Electric Drive Technologies, and Grid Integration activities. The Electric Drive Technologies group conducts R&D projects that advance Electric Motors and Power Electronics technologies. The Grid and Charging Infrastructure group conducts R&D projects that advance Grid Modernization and Electric Vehicle Charging technologies. This document presents a brief overview of the Electrification Sub-Program and progress reports for its R&D projects. Eachmore » of the progress reports provide a project overview and highlights of the technical results that were accomplished in FY 2017.« less

  16. Nursing and the primacy of technological progress.

    PubMed

    Barnard, A

    1999-12-01

    This article identifies assumptions common to interpreting technological progress in contemporary nursing practice. Technology is described in terms of its characteristics and progress is identified as an ideological assumption influencing the way we think about, practice, and explain technology in contemporary nursing. Arguments associated with linear development, the elimination of scarcity, the technological imperative, the advancement of nursing, and technology as a neutral phenomenon are examined. It is argued that understanding progress assists us to develop insight into the relationship between technology and nursing.

  17. Advancing Ethical Neuroscience Research.

    PubMed

    Borah, B Rashmi; Strand, Nicolle K; Chillag, Kata L

    2016-12-01

    As neuroscience research advances, researchers, clinicians, and other stakeholders will face a host of ethical challenges. The Presidential Commission for the Study of Bioethical Issues (Bioethics Commission) has published two reports that provide recommendations on how to advance research endeavors ethically. The commission addressed, among other issues, how to prioritize different types of neuroscience research and how to include research participants who have impaired consent capacity. The Bioethics Commission's recommendations provide a foundation for ethical guidelines as neuroscience research advances and progresses. © 2016 American Medical Association. All Rights Reserved.

  18. The Role of the Advanced Practice Nurse in Geriatric Oncology Care.

    PubMed

    Morgan, Brianna; Tarbi, Elise

    2016-02-01

    To describe how the Advanced Practice Nurse (APN) is uniquely suited to meet the needs of older adults throughout the continuum of cancer, to explore the progress that APNs have made in gero-oncology care, and make suggestions for future directions. Google Scholar, PubMed, and CINAHL. Search terms included: "gero-oncology," "geriatric oncology," "Advanced Practice Nurse," "Nurse Practitioner," "older adult," "elderly," and "cancer." Over the last decade, APNs have made advances in caring for older adults with cancer by playing a role in prevention, screening, and diagnosis; through evidence-based gero-oncology care during cancer treatment; and in designing tailored survivorship care models. APNs must combat ageism in treatment choice for older adults, standardize comprehensive geriatric assessments, and focus on providing person-centered care, specifically during care transitions. APNs are well-positioned to help understand the complex relationship between risk factors, geriatric syndromes, and frailty and translate research into practice. Palliative care must expand beyond specialty providers and shift toward APNs with a focus on early advanced care planning. Finally, APNs should continue to establish multidisciplinary survivorship models across care settings, with a focus on primary care. Copyright © 2015 Elsevier Inc. All rights reserved.

  19. Research Advances

    ERIC Educational Resources Information Center

    King, Angela G.

    2004-01-01

    Research advances, a new feature in Journal of Chemical Engineering that brings information about innovations in current areas of research to high school and college science faculty with an intent to provide educators with timely descriptions of latest progress in research that can be integrated into existing courses to update course content and…

  20. Making Progress: The Use of Multiple Progress Reports to Enhance Advertising Students' Media Plan Term Projects

    ERIC Educational Resources Information Center

    Kritz, Gary H.; Lozada, Hector R.; Long, Mary M.

    2007-01-01

    Since the AACSB mandates that students demonstrate effective oral and written communication skills, it is imperative that business professors do what is necessary to improve such skills. The authors investigate whether the use of using multiple progress reports in an Advertising class project improves the final product. The data results show that…

  1. 38 CFR 21.7653 - Progress, conduct, and attendance.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... on which the school official who is responsible for determining whether a student is making progress...) Satisfactory pursuit of program. In order to receive educational assistance for pursuit of a program of education, a reservist must maintain satisfactory progress. Progress is unsatisfactory if the reservist does...

  2. Advanced computations in plasma physics

    NASA Astrophysics Data System (ADS)

    Tang, W. M.

    2002-05-01

    Scientific simulation in tandem with theory and experiment is an essential tool for understanding complex plasma behavior. In this paper we review recent progress and future directions for advanced simulations in magnetically confined plasmas with illustrative examples chosen from magnetic confinement research areas such as microturbulence, magnetohydrodynamics, magnetic reconnection, and others. Significant recent progress has been made in both particle and fluid simulations of fine-scale turbulence and large-scale dynamics, giving increasingly good agreement between experimental observations and computational modeling. This was made possible by innovative advances in analytic and computational methods for developing reduced descriptions of physics phenomena spanning widely disparate temporal and spatial scales together with access to powerful new computational resources. In particular, the fusion energy science community has made excellent progress in developing advanced codes for which computer run-time and problem size scale well with the number of processors on massively parallel machines (MPP's). A good example is the effective usage of the full power of multi-teraflop (multi-trillion floating point computations per second) MPP's to produce three-dimensional, general geometry, nonlinear particle simulations which have accelerated progress in understanding the nature of turbulence self-regulation by zonal flows. It should be emphasized that these calculations, which typically utilized billions of particles for thousands of time-steps, would not have been possible without access to powerful present generation MPP computers and the associated diagnostic and visualization capabilities. In general, results from advanced simulations provide great encouragement for being able to include increasingly realistic dynamics to enable deeper physics insights into plasmas in both natural and laboratory environments. The associated scientific excitement should serve to

  3. Advanced Computation in Plasma Physics

    NASA Astrophysics Data System (ADS)

    Tang, William

    2001-10-01

    Scientific simulation in tandem with theory and experiment is an essential tool for understanding complex plasma behavior. This talk will review recent progress and future directions for advanced simulations in magnetically-confined plasmas with illustrative examples chosen from areas such as microturbulence, magnetohydrodynamics, magnetic reconnection, and others. Significant recent progress has been made in both particle and fluid simulations of fine-scale turbulence and large-scale dynamics, giving increasingly good agreement between experimental observations and computational modeling. This was made possible by innovative advances in analytic and computational methods for developing reduced descriptions of physics phenomena spanning widely disparate temporal and spatial scales together with access to powerful new computational resources. In particular, the fusion energy science community has made excellent progress in developing advanced codes for which computer run-time and problem size scale well with the number of processors on massively parallel machines (MPP's). A good example is the effective usage of the full power of multi-teraflop MPP's to produce 3-dimensional, general geometry, nonlinear particle simulations which have accelerated progress in understanding the nature of turbulence self-regulation by zonal flows. It should be emphasized that these calculations, which typically utilized billions of particles for tens of thousands time-steps, would not have been possible without access to powerful present generation MPP computers and the associated diagnostic and visualization capabilities. In general, results from advanced simulations provide great encouragement for being able to include increasingly realistic dynamics to enable deeper physics insights into plasmas in both natural and laboratory environments. The associated scientific excitement should serve to stimulate improved cross-cutting collaborations with other fields and also to help attract

  4. Clinical benefit of continuing crizotinib therapy after initial disease progression in Chinese patients with advanced ALK-rearranged non-small-cell lung cancer

    PubMed Central

    Hong, Xiangchan; Chen, Qi; Ding, Lingyu; Liang, Ying; Zhou, Ningning; Fang, Wenfeng; Chen, Xinru; Wu, Haiying

    2017-01-01

    Purpose Although most patients with ALK-positive non?small-cell lung cancer (NSCLC) who benefit from treatment with crizotinib ultimately develop progressive disease (PD), continuing crizotinb beyond the initial PD (CBPD) in these patients may be beneficial. In this study, we investigated whether Chinese patients with advanced ALK-positive NSCLC benefit from CBPD, and whether any factors are predictive of a longer post-initial progression-free survival time (PFS2). Materials and Methods Data on 33 patients with ALK-positive NSCLC who achieved disease control with crizotinib were analyzed retrospectively. The impact of continued crizotinib therapy on the patients’ PFS2 time was assessed after adjusting for potential confounding factors. Results With initial crizotinib therapy, the objective response rate (ORR) and median PFS time (PFS1) in the 33 patients were 63.6% and 8.6 months, respectively. With continued crizotinib therapy after documentation of PD, the median PFS2 for all 33 patients was 16 weeks, and in those with CNS progression but systemic disease control it was 30 weeks. Patients who received local therapy after disease progression had a significantly longer PFS2 compared with those who did not (P = 0.039). Multivariable Cox regression analysis showed that the PFS1 with initial crizotinib treatment and local therapy were independent predictors of PFS2. Discussion This study provides further evidence of the benefit of continuing crizotinib therapy in Chinese patients with progressive ALK-positive NSCLC. Patients with a longer PFS1 and those who received local brain therapy would have a longer period of continuing crizotinib. PMID:28427213

  5. Clinical benefit of continuing crizotinib therapy after initial disease progression in Chinese patients with advanced ALK-rearranged non-small-cell lung cancer.

    PubMed

    Hong, Xiangchan; Chen, Qi; Ding, Lingyu; Liang, Ying; Zhou, Ningning; Fang, Wenfeng; Chen, Xinru; Wu, Haiying

    2017-06-20

    Although most patients with ALK-positive non-small-cell lung cancer (NSCLC) who benefit from treatment with crizotinib ultimately develop progressive disease (PD), continuing crizotinb beyond the initial PD (CBPD) in these patients may be beneficial. In this study, we investigated whether Chinese patients with advanced ALK-positive NSCLC benefit from CBPD, and whether any factors are predictive of a longer post-initial progression-free survival time (PFS2). Data on 33 patients with ALK-positive NSCLC who achieved disease control with crizotinib were analyzed retrospectively. The impact of continued crizotinib therapy on the patients' PFS2 time was assessed after adjusting for potential confounding factors. With initial crizotinib therapy, the objective response rate (ORR) and median PFS time (PFS1) in the 33 patients were 63.6% and 8.6 months, respectively. With continued crizotinib therapy after documentation of PD, the median PFS2 for all 33 patients was 16 weeks, and in those with CNS progression but systemic disease control it was 30 weeks. Patients who received local therapy after disease progression had a significantly longer PFS2 compared with those who did not (P = 0.039). Multivariable Cox regression analysis showed that the PFS1 with initial crizotinib treatment and local therapy were independent predictors of PFS2. This study provides further evidence of the benefit of continuing crizotinib therapy in Chinese patients with progressive ALK-positive NSCLC. Patients with a longer PFS1 and those who received local brain therapy would have a longer period of continuing crizotinib.

  6. Assessing Student Academic and Social Progress.

    ERIC Educational Resources Information Center

    Baird, Leonard L., Ed.

    Assessment of student progress in community colleges is necessary for several reasons; among them are accountability to the public, improvement of decision-making for both students and educators, and planning and evaluation of curricula. This sourcebook focuses on various types of student progress--vocational, social, academic, transfer--and on…

  7. Progress in Advanced Spray Combustion Code Integration

    NASA Technical Reports Server (NTRS)

    Liang, Pak-Yan

    1993-01-01

    A multiyear project to assemble a robust, muitiphase spray combustion code is now underway and gradually building up to full speed. The overall effort involves several university and government research teams as well as Rocketdyne. The first part of this paper will give an overview of the respective roles of the different participants involved, the master strategy, the evolutionary milestones, and an assessment of the state-of-the-art of various key components. The second half of this paper will highlight the progress made to date in extending the baseline Navier-Stokes solver to handle multiphase, multispecies, chemically reactive sub- to supersonic flows. The major hurdles to overcome in order to achieve significant speed ups are delineated and the approaches to overcoming them will be discussed.

  8. Meaningful crosstalk between biologists and physical scientists is essential for modern biology to progress.

    PubMed

    Dev, Sukhendu B

    2009-01-01

    The advances in biological sciences have been phenomenal since the structure of DNA was decoded, especially if one considers the input from physical sciences, not only in terms of analytical tools, but also understanding and solving some of the key problems in biology. In this article, I trace briefly the history of this transition, from physical sciences to biology, and argue that progress in modern biology can be accelerated if there is far more meaningful crosstalk between the biologists and the physical scientists, simply because biology has become far more complex and interdisciplinary, and the need for such crosstalk cannot be overemphasized. Without a concerted effort in this area progress will be hindered, and the two camps will continue to work on their own, using their own specialized language, thus making communication highly ineffective. I support my argument giving a vast array of examples and also quoting leading authorities.

  9. Scientific Discovery through Advanced Computing in Plasma Science

    NASA Astrophysics Data System (ADS)

    Tang, William

    2005-03-01

    Advanced computing is generally recognized to be an increasingly vital tool for accelerating progress in scientific research during the 21st Century. For example, the Department of Energy's ``Scientific Discovery through Advanced Computing'' (SciDAC) Program was motivated in large measure by the fact that formidable scientific challenges in its research portfolio could best be addressed by utilizing the combination of the rapid advances in super-computing technology together with the emergence of effective new algorithms and computational methodologies. The imperative is to translate such progress into corresponding increases in the performance of the scientific codes used to model complex physical systems such as those encountered in high temperature plasma research. If properly validated against experimental measurements and analytic benchmarks, these codes can provide reliable predictive capability for the behavior of a broad range of complex natural and engineered systems. This talk reviews recent progress and future directions for advanced simulations with some illustrative examples taken from the plasma science applications area. Significant recent progress has been made in both particle and fluid simulations of fine-scale turbulence and large-scale dynamics, giving increasingly good agreement between experimental observations and computational modeling. This was made possible by the combination of access to powerful new computational resources together with innovative advances in analytic and computational methods for developing reduced descriptions of physics phenomena spanning a huge range in time and space scales. In particular, the plasma science community has made excellent progress in developing advanced codes for which computer run-time and problem size scale well with the number of processors on massively parallel machines (MPP's). A good example is the effective usage of the full power of multi-teraflop (multi-trillion floating point computations

  10. Progress in oral personalized medicine: contribution of 'omics'.

    PubMed

    Glurich, Ingrid; Acharya, Amit; Brilliant, Murray H; Shukla, Sanjay K

    2015-01-01

    Precision medicine (PM), representing clinically applicable personalized medicine, proactively integrates and interprets multidimensional personal health data, including clinical, 'omics', and environmental profiles, into clinical practice. Realization of PM remains in progress. The focus of this review is to provide a descriptive narrative overview of: 1) the current status of oral personalized medicine; and 2) recent advances in genomics and related 'omic' and emerging research domains contributing to advancing oral-systemic PM, with special emphasis on current understanding of oral microbiomes. A scan of peer-reviewed literature describing oral PM or 'omic'-based research conducted on humans/data published in English within the last 5 years in journals indexed in the PubMed database was conducted using mesh search terms. An evidence-based approach was used to report on recent advances with potential to advance PM in the context of historical critical and systematic reviews to delineate current state-of-the-art technologies. Special focus was placed on oral microbiome research associated with health and disease states, emerging research domains, and technological advances, which are positioning realization of PM. This review summarizes: 1) evolving conceptualization of personalized medicine; 2) emerging insight into roles of oral infectious and inflammatory processes as contributors to both oral and systemic diseases; 3) community shifts in microbiota that may contribute to disease; 4) evidence pointing to new uncharacterized potential oral pathogens; 5) advances in technological approaches to 'omics' research that will accelerate PM; 6) emerging research domains that expand insights into host-microbe interaction including inter-kingdom communication, systems and network analysis, and salivaomics; and 7) advances in informatics and big data analysis capabilities to facilitate interpretation of host and microbiome-associated datasets. Furthermore, progress in

  11. Different impact of aspirin on renal progression in patients with predialysis advanced chronic kidney disease with or without previous stroke.

    PubMed

    Hsiao, Kuang-Chih; Huang, Jing-Yang; Lee, Chun-Te; Hung, Tung-Wei; Liaw, Yung-Po; Chang, Horng-Rong

    2017-04-01

    The benefit of reducing the risk of stroke against increasing the risk of renal progression associated with antiplatelet therapy in patients with advanced chronic kidney disease (CKD) is controversial. We enrolled 1301 adult patients with advanced CKD treated with erythropoiesis stimulating agents from January 1, 2002 to June 30, 2009 from the 2005 Longitudinal Health Insurance Database in Taiwan. All of the patients were followed until the development of the primary or secondary endpoints, or the end of the study (December 31, 2011). The primary endpoint was the development of ischemic stroke, and the secondary endpoints included hospitalization for bleeding events, cardiovascular mortality, all-cause mortality, and renal failure. The adjusted cumulative probability of events was calculated using multivariate Cox proportional regression analysis. Adjusted survival curves showed that the usage of aspirin was not associated with ischemic stroke, hospitalization for bleeding events, cardiovascular mortality or all-cause mortality, however, it was significantly associated with renal failure. In subgroup analysis, aspirin use was associated with renal failure in the patients with no history of stroke (HR, 1.41; 95% CI, 1.14-1.73), and there was a borderline interaction between previous stroke and the use of aspirin on renal failure (interaction p=0.0565). There was no significant benefit in preventing ischemic stroke in the patients with advanced CKD who received aspirin therapy. Furthermore, the use of aspirin was associated with the risk of renal failure in the patients with advanced CKD without previous stroke. Copyright © 2016 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved.

  12. Budget impact of everolimus for the treatment of progressive, well-differentiated, non-functional neuroendocrine tumors of gastrointestinal or lung origin that are advanced or metastatic.

    PubMed

    Rose, Darya B; Nellesen, Dave; Neary, Maureen P; Cai, Beilei

    2017-04-01

    Advanced neuroendocrine tumors (NETs) are a rare malignancy with considerable need for effective therapies. Everolimus is a mammalian target of rapamycin (mTOR) inhibitor approved by the US Food and Drug Administration (FDA) and European Medicines Agency (EMA) in 2016 for treatment of adults with progressive, well-differentiated, non-functional NETs of gastrointestinal (GI) or lung origin that are unresectable, locally advanced, or metastatic. To assess the 3-year budget impact for a typical US health plan following availability of everolimus for treatment of GI and lung NETs. Methods An economic model was developed that considered two perspectives: an entire health plan and a pharmacy budget. The total budget impact included costs of drug therapies, administration, hospitalizations, physician visits, monitoring, and adverse events (AEs). The pharmacy model only considered drug costs. In a US health plan with 1 million members, the model estimated 66 patients with well-differentiated, non-functional, and advanced or metastatic GI NETs and 20 with lung NETs undergoing treatment each year. Total budget impact in the first through third year after FDA approval ranged from $0.0568-$0.1443 per member per month (PMPM) for GI NETs and from $0.0181-$0.0355 PMPM for lung NETs. The total budget impact was lower than the pharmacy budget impact because it included cost offsets from administration and AE management for everolimus compared with alternative therapies (e.g. chemotherapies). Because GI and lung NETs are rare diseases with limited published data, several assumptions were made that may influence interpretation of results. The budget impact for everolimus was minimal in this rare disease area with a high unmet need, largely due to low disease prevalence. These results should be considered in the context of significant clinical benefits potentially provided by everolimus, including significantly longer progression-free survival (PFS) for advanced GI and lung NET

  13. Self-Advancing Step-Tap Drills

    NASA Technical Reports Server (NTRS)

    Pettit, Donald R.; Camarda, Charles J.; Penner, Ronald K.; Franklin, Larry D.

    2007-01-01

    Self-advancing tool bits that are hybrids of drills and stepped taps make it possible to form threaded holes wider than about 1/2 in. (about 13 mm) without applying any more axial force than is necessary for forming narrower pilot holes. These self-advancing stepped-tap drills were invented for use by space-suited astronauts performing repairs on reinforced carbon/carbon space-shuttle leading edges during space walks, in which the ability to apply axial drilling forces is severely limited. Self-advancing stepped-tap drills could also be used on Earth for making wide holes without applying large axial forces. A self-advancing stepped-tap drill (see figure) includes several sections having progressively larger diameters, typically in increments between 0.030 and 0.060 in. (between about 0.8 and about 1.5 mm). The tip section, which is the narrowest, is a pilot drill bit that typically has a diameter between 1/8 and 3/16 in. (between about 3.2 and about 4.8 mm). The length of the pilot-drill section is chosen, according to the thickness of the object to be drilled and tapped, so that the pilot hole is completed before engagement of the first tap section. Provided that the cutting-edge geometry of the drill bit is optimized for the material to be drilled, only a relatively small axial force [typically of the order of a few pounds (of the order of 10 newtons)] must be applied during drilling of the pilot hole. Once the first tap section engages the pilot hole, it is no longer necessary for the drill operator to apply axial force: the thread engagement between the tap and the workpiece provides the axial force to advance the tool bit. Like the pilot-drill section, each tap section must be long enough to complete its hole before engagement of the next, slightly wider tap section. The precise values of the increments in diameter, the thread pitch, the rake angle of the tap cutting edge, and other geometric parameters of the tap sections must be chosen, in consideration of

  14. A Randomized Controlled Trial of a Cardiopulmonary Resuscitation Video in Advance Care Planning for Progressive Pancreas and Hepatobiliary Cancer Patients

    PubMed Central

    Volandes, Angelo E.; Chen, Ling Y.; Gary, Kristen A.; Li, Yuelin; Agre, Patricia; Levin, Tomer T.; Reidy, Diane L.; Meng, Raymond D.; Segal, Neil H.; Yu, Kenneth H.; Abou-Alfa, Ghassan K.; Janjigian, Yelena Y.; Kelsen, David P.; O'Reilly, Eileen M.

    2013-01-01

    Abstract Background Cardiopulmonary resuscitation (CPR) is an important advance directive (AD) topic in patients with progressive cancer; however such discussions are challenging. Objective This study investigates whether video educational information about CPR engenders broader advance care planning (ACP) discourse. Methods Patients with progressive pancreas or hepatobiliary cancer were randomized to an educational CPR video or a similar CPR narrative. The primary end-point was the difference in ACP documentation one month posttest between arms. Secondary end-points included study impressions; pre- and post-intervention knowledge of and preferences for CPR and mechanical ventilation; and longitudinal patient outcomes. Results Fifty-six subjects were consented and analyzed. Rates of ACP documentation (either formal ADs or documented discussions) were 40% in the video arm (12/30) compared to 15% in the narrative arm (4/26), OR=3.6 [95% CI: 0.9–18.0], p=0.07. Post-intervention knowledge was higher in both arms. Posttest, preferences for CPR had changed in the video arm but not in the narrative arm. Preferences regarding mechanical ventilation did not change in either arm. The majority of subjects in both arms reported the information as helpful and comfortable to discuss, and they recommended it to others. More deaths occurred in the video arm compared to the narrative arm, and more subjects died in hospice settings in the video arm. Conclusions This pilot randomized trial addressing downstream ACP effects of video versus narrative decision tools demonstrated a trend towards more ACP documentation in video subjects. This trend, as well as other video effects, is the subject of ongoing study. PMID:23725233

  15. Three new genetic loci (R1210C in CFH, variants in COL8A1 and RAD51B) are independently related to progression to advanced macular degeneration.

    PubMed

    Seddon, Johanna M; Reynolds, Robyn; Yu, Yi; Rosner, Bernard

    2014-01-01

    To assess the independent impact of new genetic variants on conversion to advanced stages of AMD, controlling for established risk factors, and to determine the contribution of genes in predictive models. In this prospective longitudinal study of 2765 individuals, 777 subjects progressed to neovascular disease (NV) or geographic atrophy (GA) in either eye over 12 years. Recently reported genetic loci were assessed for their independent effects on incident advanced AMD after controlling for 6 established loci in 5 genes, and demographic, behavioral, and macular characteristics. New variants which remained significantly related to progression were then added to a final multivariate model to assess their independent effects. The contribution of genes to risk models was assessed using reclassification tables by determining risk within cross-classified quintiles for alternative models. THREE NEW GENETIC VARIANTS WERE SIGNIFICANTLY RELATED TO PROGRESSION: rare variant R1210C in CFH (hazard ratio (HR) 2.5, 95% confidence interval [CI] 1.2-5.3, P = 0.01), and common variants in genes COL8A1 (HR 2.0, 95% CI 1.1-3.5, P = 0.02) and RAD51B (HR 0.8, 95% CI 0.60-0.97, P = 0.03). The area under the curve statistic (AUC) was significantly higher for the 9 gene model (.884) vs the 0 gene model (.873), P = .01. AUC's for the 9 vs 6 gene models were not significantly different, but reclassification analyses indicated significant added information for more genes, with adjusted odds ratios (OR) for progression within 5 years per one quintile increase in risk score of 2.7, P<0.001 for the 9 vs 6 loci model, and OR 3.5, P<0.001 for the 9 vs. 0 gene model. Similar results were seen for NV and GA. Rare variant CFH R1210C and common variants in COL8A1 and RAD51B plus six genes in previous models contribute additional predictive information for advanced AMD beyond macular and behavioral phenotypes.

  16. Recent Progress in Producing Lignin-Based Carbon Fibers for Functional Applications

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

    Paul, Ryan; Burwell, Deanna; Dai, Xuliang

    Lignin, a biopolymer, has been investigated as a renewable and low-cost carbon fiber precursor since the 1960s. Although successful lab-scale production of lignin-based carbon fibers has been reported, there are currently not any commercial producers. This paper will highlight some of the known challenges with converting lignin-based precursors into carbon fiber, and the reported methods for purifying and modifying lignin to improve it as a precursor. Several of the challenges with lignin are related to its diversity in chemical structure and purity, depending on its biomass source (e.g. hardwood, softwood, grasses) and extraction method (e.g. organosolv, kraft). In order tomore » make progress in this field, GrafTech and Oak Ridge National Laboratory are collaborating to develop lignin-based carbon fiber technology and to demonstrate it in functional applications, as part of a cooperative agreement with the DOE Advanced Manufacturing Office. The progress made to date with producing lignin-based carbon fiber for functional applications, as well as developing and qualifying a supply chain and value proposition, are also highlighted.« less

  17. An incidence model of the cost of advanced prostate cancer in Spain.

    PubMed

    Hart, W M; Nazir, J; Baskin-Bey, E

    2014-02-01

    Prostate cancer (PCa) is the second leading cancer diagnosed among men. In Spain the incidence of PCa was 70.75 cases per 100,000 males. Advanced PCa has spread outside of the prostate capsule and may involve other parts of the body. The aim of this study was to estimate the lifetime costs of a cohort of advanced PCa patients diagnosed in Spain in 2012. A partitioned economic model was developed in EXCEL incorporating Spanish incidence, mortality, and cost data supplemented with data from the international literature. Progression from Stage III to Stage IV was permitted. Costs were discounted at the standard rate of 3%. Lifetime costs were presented on an individual basis and for the entire cohort of newly diagnosed Stage III and Stage IV PCa patients. Lifetime costs for advanced PCa were ∼€19,961 per patient (mean survival of 8.4 years). Using the projected incident cases for 2012 (3047), the total cost for the incident cohort of patients in 2012 would amount to €61 million. These results were more sensitive to changes in the ongoing costs (post-initial 12 months) of Stage III PCa, the rate of progression from Stage III to Stage IV, and the discount rate applied to costs. This study provides an estimate of the lifetime costs of advanced PCa in Spain and a framework for further research. The study is limited by the availability of long-term Spanish data and the need to make inferences from international studies. However, until long-term prospective or observational data do become available in Spain, based on the assumptions, the current results indicate that the burden of advanced PCa in Spain is substantial. Any treatments that could potentially reduce the economic burden of the disease should be of interest to healthcare decision makers.

  18. Ovarian Cancer Treatment | Cancer Trends Progress Report

    Cancer.gov

    The Cancer Trends Progress Report, first issued in 2001, summarizes our nation's advances against cancer in relation to Healthy People targets set forth by the Department of Health and Human Services.

  19. End of Life | Cancer Trends Progress Report

    Cancer.gov

    The Cancer Trends Progress Report, first issued in 2001, summarizes our nation's advances against cancer in relation to Healthy People targets set forth by the Department of Health and Human Services.

  20. Life After Cancer | Cancer Trends Progress Report

    Cancer.gov

    The Cancer Trends Progress Report, first issued in 2001, summarizes our nation's advances against cancer in relation to Healthy People targets set forth by the Department of Health and Human Services.

  1. Stage at Diagnosis | Cancer Trends Progress Report

    Cancer.gov

    The Cancer Trends Progress Report, first issued in 2001, summarizes our nation's advances against cancer in relation to Healthy People targets set forth by the Department of Health and Human Services.

  2. Kidney Cancer Treatment | Cancer Trends Progress Report

    Cancer.gov

    The Cancer Trends Progress Report, first issued in 2001, summarizes our nation's advances against cancer in relation to Healthy People targets set forth by the Department of Health and Human Services.

  3. Lung Cancer Treatment | Cancer Trends Progress Report

    Cancer.gov

    The Cancer Trends Progress Report, first issued in 2001, summarizes our nation's advances against cancer in relation to Healthy People targets set forth by the Department of Health and Human Services.

  4. Colorectal Cancer Treatment | Cancer Trends Progress Report

    Cancer.gov

    The Cancer Trends Progress Report, first issued in 2001, summarizes our nation's advances against cancer in relation to Healthy People targets set forth by the Department of Health and Human Services.

  5. Cervical Cancer Screening | Cancer Trends Progress Report

    Cancer.gov

    The Cancer Trends Progress Report, first issued in 2001, summarizes our nation's advances against cancer in relation to Healthy People targets set forth by the Department of Health and Human Services.

  6. Prostate Cancer Treatment | Cancer Trends Progress Report

    Cancer.gov

    The Cancer Trends Progress Report, first issued in 2001, summarizes our nation's advances against cancer in relation to Healthy People targets set forth by the Department of Health and Human Services.

  7. Bladder Cancer Treatment | Cancer Trends Progress Report

    Cancer.gov

    The Cancer Trends Progress Report, first issued in 2001, summarizes our nation's advances against cancer in relation to Healthy People targets set forth by the Department of Health and Human Services.

  8. Tobacco Use Initiation | Cancer Trends Progress Report

    Cancer.gov

    The Cancer Trends Progress Report, first issued in 2001, summarizes our nation's advances against cancer in relation to Healthy People targets set forth by the Department of Health and Human Services.

  9. Youth Tobacco Use | Cancer Trends Progress Report

    Cancer.gov

    The Cancer Trends Progress Report, first issued in 2001, summarizes our nation's advances against cancer in relation to Healthy People targets set forth by the Department of Health and Human Services.

  10. Lung Cancer Screening | Cancer Trends Progress Report

    Cancer.gov

    The Cancer Trends Progress Report, first issued in 2001, summarizes our nation's advances against cancer in relation to Healthy People targets set forth by the Department of Health and Human Services.

  11. Secondhand Smoke Exposure | Cancer Trends Progress Report

    Cancer.gov

    The Cancer Trends Progress Report, first issued in 2001, summarizes our nation's advances against cancer in relation to Healthy People targets set forth by the Department of Health and Human Services.

  12. Breast Cancer Treatment | Cancer Trends Progress Report

    Cancer.gov

    The Cancer Trends Progress Report, first issued in 2001, summarizes our nation's advances against cancer in relation to Healthy People targets set forth by the Department of Health and Human Services.

  13. Frequently Asked Questions | Cancer Trends Progress Report

    Cancer.gov

    The Cancer Trends Progress Report, first issued in 2001, summarizes our nation's advances against cancer in relation to Healthy People targets set forth by the Department of Health and Human Services.

  14. Prevention Summary Tables | Cancer Trends Progress Report

    Cancer.gov

    The Cancer Trends Progress Report, first issued in 2001, summarizes our nation's advances against cancer in relation to Healthy People targets set forth by the Department of Health and Human Services.

  15. Treatment Summary Tables | Cancer Trends Progress Report

    Cancer.gov

    The Cancer Trends Progress Report, first issued in 2001, summarizes our nation's advances against cancer in relation to Healthy People targets set forth by the Department of Health and Human Services.

  16. Red Meat Consumption | Cancer Trends Progress Report

    Cancer.gov

    The Cancer Trends Progress Report, first issued in 2001, summarizes our nation's advances against cancer in relation to Healthy People targets set forth by the Department of Health and Human Services.

  17. About the Report | Cancer Trends Progress Report

    Cancer.gov

    The Cancer Trends Progress Report, first issued in 2001, summarizes our nation's advances against cancer in relation to Healthy People targets set forth by the Department of Health and Human Services.

  18. Adult Tobacco Use | Cancer Trends Progress Report

    Cancer.gov

    The Cancer Trends Progress Report, first issued in 2001, summarizes our nation's advances against cancer in relation to Healthy People targets set forth by the Department of Health and Human Services.

  19. Prostate Cancer Screening | Cancer Trends Progress Report

    Cancer.gov

    The Cancer Trends Progress Report, first issued in 2001, summarizes our nation's advances against cancer in relation to Healthy People targets set forth by the Department of Health and Human Services.

  20. Colorectal Cancer Screening | Cancer Trends Progress Report

    Cancer.gov

    The Cancer Trends Progress Report, first issued in 2001, summarizes our nation's advances against cancer in relation to Healthy People targets set forth by the Department of Health and Human Services.

  1. Breast Cancer Screening | Cancer Trends Progress Report

    Cancer.gov

    The Cancer Trends Progress Report, first issued in 2001, summarizes our nation's advances against cancer in relation to Healthy People targets set forth by the Department of Health and Human Services.

  2. Sun-Protective Behavior | Cancer Trends Progress Report

    Cancer.gov

    The Cancer Trends Progress Report, first issued in 2001, summarizes our nation's advances against cancer in relation to Healthy People targets set forth by the Department of Health and Human Services.

  3. Epicure: a European epidemiological study of patients with an advanced or metastatic Urothelial Carcinoma (UC) having progressed to a platinum-based chemotherapy.

    PubMed

    Houédé, N; Locker, G; Lucas, C; Parra, H Soto; Basso, U; Spaeth, D; Tambaro, R; Basterretxea, L; Morelli, F; Theodore, C; Lusuardi, L; Lainez, N; Guillot, A; Tonini, G; Bielle, J; Del Muro, X Garcia

    2016-09-23

    Platinum-based systemic chemotherapy is considered the backbone for management of advanced urothelial carcinomas. However there is a lack of real world data on the use of such chemotherapy regimens, on patient profiles and on management after treatment failure. Fifty-one randomly selected physicians from 4 European countries registered 218 consecutive patients in progression or relapse following a first platinum-based chemotherapy. Patient characteristics, tumor history and treatment regimens, as well as the considerations of physicians on the management of urothelial carcinoma were recorded. A systemic platinum-based regimen had been administered as the initial chemotherapy in 216 patients: 15 in the neoadjuvant setting, 61 in adjuvant therapy conditions, 137 in first-line advanced setting and 3 in other conditions. Of these patients, 76 (35 %) were initially considered as cisplatin-unfit, mainly because of renal impairment (52 patients). After platinum failure, renal impairment was observed in 44 % of patients, ECOG Performance Status ≥ 2 in 17 %, hemoglobinemia < 10 g/dL in 16 %, hepatic metastases in 13 %. 80 % of these patients received further anticancer therapy. Immediately after failure of adjuvant/neoadjuvant chemotherapy, most subsequent anticancer treatments were chemotherapy doublets (35/58), whereas after therapy failure in the advanced setting most patients receiving further anticancer drugs were treated with a single agent (80/114). After first progression to chemotherapy, treatment decisions were mainly driven by Performance Status and prior response to chemotherapy (>30 % patients). The most frequent all-settings second anticancer therapy regimen was vinflunine (70 % of single-agent and 42 % of all subsequent treatments), the main reasons evoked by physicians (>1 out of 4) being survival benefit, safety and phase III evidence. In this daily practice experience, a majority of patients with urothelial carcinoma previously treated

  4. Progress in advanced high temperature turbine materials, coatings, and technology

    NASA Technical Reports Server (NTRS)

    Freche, J. C.; Ault, G. M.

    1977-01-01

    Material categories as well as coatings and recent turbine cooling developments are reviewed. Current state of the art is identified, and as assessment, when appropriate, of progress, problems, and future directions is provided.

  5. Clinical cancer advances 2011: Annual Report on Progress Against Cancer from the American Society of Clinical Oncology.

    PubMed

    Vogelzang, Nicholas J; Benowitz, Steven I; Adams, Sylvia; Aghajanian, Carol; Chang, Susan Marina; Dreyer, Zoann Eckert; Janne, Pasi A; Ko, Andrew H; Masters, Greg A; Odenike, Olatoyosi; Patel, Jyoti D; Roth, Bruce J; Samlowski, Wolfram E; Seidman, Andrew D; Tap, William D; Temel, Jennifer S; Von Roenn, Jamie H; Kris, Mark G

    2012-01-01

    A message from ASCO'S President. It has been forty years since President Richard Nixon signed the National Cancer Act of 1971, which many view as the nation's declaration of the "War on Cancer." The bill has led to major investments in cancer research and significant increases in cancer survival. Today, two-thirds of patients survive at least five years after being diagnosed with cancer compared with just half of all diagnosed patients surviving five years after diagnosis in 1975. The research advances detailed in this year's Clinical Cancer Advances demonstrate that improvements in cancer screening, treatment, and prevention save and improve lives. But although much progress has been made, cancer remains one of the world's most serious health problems. In the United States, the disease is expected to become the nation's leading cause of death in the years ahead as our population ages. I believe we can accelerate the pace of progress, provided that everyone involved in cancer care works together to achieve this goal. It is this viewpoint that has shaped the theme for my presidential term: Collaborating to Conquer Cancer. In practice, this means that physicians and researchers must learn from every patient's experience, ensure greater collaboration between members of a patient's medical team, and involve more patients in the search for cures through clinical trials. Cancer advocates, insurers, and government agencies also have important roles to play. Today, we have an incredible opportunity to improve the quality of cancer care by drawing lessons from the real-world experiences of patients. The American Society of Clinical Oncology (ASCO) is taking the lead in this area, in part through innovative use of health information technology. In addition to our existing quality initiatives, ASCO is working with partners to develop a comprehensive rapid-learning system for cancer care. When complete, this system will provide physicians with personalized, real

  6. Wearable Chemosensors: A Review of Recent Progress

    PubMed Central

    Qian, Ruo‐Can

    2017-01-01

    Abstract In recent years, there has been growing demand for wearable chemosensors for their important potential applications in mobile and electronic healthcare, patient self‐assessment, human motion monitoring, and so on. Innovations in wearable chemosensors are revolutionizing the modern lifestyle, especially the involvement of both doctors and patients in the modern healthcare system. The facile interaction of wearable chemosensors with the human body makes them favorable and convenient tools for the detection and long‐term monitoring of the chemical, biological, and physical status of the human body at a low cost with high performance. In this Minireview, we give a brief overview of the recent advances and developments in the field of wearable chemosensors, summarize the basic types of wearable chemosensors, and discuss their main functions and fabrication methods. At the end of this paper, the future development direction of wearable chemosensors is prospected. With continued interest and attention to this field, new exciting progress is expected in the development of innovative wearable chemosensors. PMID:29435397

  7. Solar Energy: Progress and Promise.

    ERIC Educational Resources Information Center

    Council on Environmental Quality, Washington, DC.

    This report discusses many of the economic and policy questions related to the widespread introduction of solar power, presents recent progress in developing solar technologies and advancing their economic feasibility, and reviews some recommendations that have been made for achieving the early introduction and sustained application of solar…

  8. Visual field progression in glaucoma: total versus pattern deviation analyses.

    PubMed

    Artes, Paul H; Nicolela, Marcelo T; LeBlanc, Raymond P; Chauhan, Balwantray C

    2005-12-01

    To compare visual field progression with total and pattern deviation analyses in a prospective longitudinal study of patients with glaucoma and healthy control subjects. A group of 101 patients with glaucoma (168 eyes) with early to moderately advanced visual field loss at baseline (average mean deviation [MD], -3.9 dB) and no clinical evidence of media opacity were selected from a prospective longitudinal study on visual field progression in glaucoma. Patients were examined with static automated perimetry at 6-month intervals for a median follow-up of 9 years. At each test location, change was established with event and trend analyses of total and pattern deviation. The event analyses compared each follow-up test to a baseline obtained from averaging the first two tests, and visual field progression was defined as deterioration beyond the 5th percentile of test-retest variability at three test locations, observed on three consecutive tests. The trend analyses were based on point-wise linear regression, and visual field progression was defined as statistically significant deterioration (P < 5%) worse than -1 dB/year at three locations, confirmed by independently omitting the last and the penultimate observation. The incidence and the time-to-progression were compared between total and pattern deviation analyses. To estimate the specificity of the progression analyses, identical criteria were applied to visual fields obtained in 102 healthy control subjects, and the rate of visual field improvement was established in the patients with glaucoma and the healthy control subjects. With both event and trend methods, pattern deviation analyses classified approximately 15% fewer eyes as having progressed than did the total deviation analyses. In eyes classified as progressing by both the total and pattern deviation methods, total deviation analyses tended to detect progression earlier than the pattern deviation analyses. A comparison of the changes observed in MD and the

  9. Progress toward Making Epoxy/Carbon-Nanotube Composites

    NASA Technical Reports Server (NTRS)

    Tiano, Thomas; Roylance, Margaret; Gassner, John; Kyle, William

    2008-01-01

    A modicum of progress has been made in an effort to exploit single-walled carbon nanotubes as fibers in epoxy-matrix/fiber composite materials. Two main obstacles to such use of carbon nanotubes are the following: (1) bare nanotubes are not soluble in epoxy resins and so they tend to agglomerate instead of becoming dispersed as desired; and (2) because of lack of affinity between nanotubes and epoxy matrices, there is insufficient transfer of mechanical loads between the nanotubes and the matrices. Part of the effort reported here was oriented toward (1) functionalization of single-walled carbon nanotubes with methyl methacrylate (MMA) to increase their dispersability in epoxy resins and increase transfer of mechanical loads and (2) ultrasonic dispersion of the functionalized nanotubes in tetrahydrofuran, which was used as an auxiliary solvent to aid in dispersing the functionalized nanotubes into a epoxy resin. In another part of this effort, poly(styrene sulfonic acid) was used as the dispersant and water as the auxiliary solvent. In one experiment, the strength of composite of epoxy with MMA-functionalized-nanotubes was found to be 29 percent greater than that of a similar composite of epoxy with the same proportion of untreated nanotubes.

  10. The Advanced Glaucoma Intervention Study (AGIS): 14. Distinguishing progression of glaucoma from visual field fluctuations.

    PubMed

    Kim, Jonghyeon; Dally, Leonard G; Ederer, Fred; Gaasterland, Douglas E; VanVeldhuisen, Paul C; Blackwell, Beth; Sullivan, E Kenneth; Prum, Bruce; Shafranov, George; Beck, Allen; Spaeth, George L

    2004-11-01

    To determine the least worsening of a visual field (VF) and the least number of confirming tests needed to identify progression of glaucomatous VF defects. Cohort study of participants in a clinical trial. Seven hundred fifty-two eyes of 565 patients with advanced glaucoma. Visual field tests were quantified with the Advanced Glaucoma Intervention Study (AGIS) VF defect score and the Humphrey Field Analyzer mean deviation (MD). Follow-up was 8 to 13 years. Two measures based on the AGIS VF defect score: (1) sustained decrease of VF (SDVF), a worsening from baseline by 2 (alternatively, 3 or 4) or more units and sustained for 2 (alternatively, 3) consecutive 6-month visits and (2) after the occurrence of SDVF, the average percent of eyes with worsening by 2 (alternatively, 3 or 4) or more units from baseline. Two similar measures based on MD. Based on the original AGIS criteria for SDVF (a worsening of 4 units in the AGIS score sustained during 3 consecutive 6-month visits), 31% of eyes had an SDVF. The percent of eyes with a sustained event increases by approximately 10% when either the minimum number of units of field loss or the minimum number of 6-month visits during which the loss is sustained decreases by 1. During 3 years of follow-up after a sustained event, a worsening of at least 2 units was found in 72% of eyes that had a 2-visit sustained event. The same worsening was found in 84% of eyes that had a 3-visit sustained event. Through the next 10 years after a sustained event, based on worsening of 2, 3, or 4 units at 2 or 3 consecutive tests, the loss reoccurred, on average, in >/=75% of study eyes. Results for MD are similar. In patients with advanced glaucoma, a single confirmatory test 6 months after a VF worsening indicates with at least 72% probability a persistent defect when the worsening is defined by at least 2 units of AGIS score or by at least 2 decibels of MD. When the number of confirmatory tests is increased from 1 to 2, the percentage of

  11. Decision-making and impulse control after frontal lobe injuries.

    PubMed

    Bechara, Antoine; Van Der Linden, Martial

    2005-12-01

    For a long time, the prefrontal cortex has been considered a 'nonfunctional' brain area, and understanding its function has lagged behind other areas. This is no longer true since appreciation of the vital role that this brain region plays in adaptive behaviors, and especially decision-making, is now evident more than ever. The present review highlights recent progress made in this area of research. Decision-making is a term often referred to in the psychological literature as one of the 'executive functions' that play a role in managing (like an executive) other cognitive functions, such as memory, attention, and language. Considerable research efforts have been directed towards differentiating various processes of executive functions, but much of this effort in the past has focused on the dorsolateral prefrontal cortex sector. Here we will review findings that address decision-making and its link to the ventromedial prefrontal cortex. Decision-making impairments as encountered in neurological and psychiatric patients are costly in terms of individual human suffering and in financial terms. In addition to its obvious value in advancing fundamental knowledge in neuroscience, understanding the neural mechanisms of decision-making is likely to have important practical consequences, including the understanding and management of neuropsychiatric disorders such as addiction, as well as the management of a considerable number of elderly people suffering from a decline in cognitive functions critical for decision-making, in spite of relatively intact memory and general intellect, which impact real-life matters that are important to themselves and their family.

  12. Re-challenge with pemetrexed in advanced mesothelioma: a multi-institutional experience

    PubMed Central

    2012-01-01

    Background Although first-line therapy for patients affected by advanced mesothelioma is well established, there is a lack of data regarding the impact of second-line treatment. Methods We retrospectively collected data of patients affected by advanced mesothelioma, already treated with first-line therapy based on pemetrexed and platin, with a response (partial response or stable disease) lasting at least 6 months, and re-treated with a pemetrexed-based therapy at progression. The primary objective was to describe time to progression and overall survival after re-treatment. Results Overall across several Italian oncological Institutions we found 30 patients affected by advanced mesothelioma, in progression after a 6-month lasting clinical benefit following a first-line treatment with cisplatin and pemetrexed, and re-challenged with a pemetrexed-based therapy. In these patients we found a disease control rate of 66%, with reduction of pain in 43% of patients. Overall time to progression and survival were promising for a second-line setting of patients with advanced mesothelioma, being 5.1 and 13.6 months, respectively. Conclusions In our opinion, when a patient has a long-lasting benefit from previous treatment with pemetrexed combined with a platin compound, the same treatment should be offered at progression. PMID:22943698

  13. Preferences and concerns for care needs in advanced Parkinson's disease: a qualitative study of couples.

    PubMed

    Habermann, Barbara; Shin, Ju Young

    2017-06-01

    To explore how couples with Parkinson's disease discuss their needs, concerns and preferences at the advanced stages of illness. The majority of care for people with Parkinson's disease is provided at home by family members. Parkinson's disease is characterised by a slow progressive decline with care needs often exceeding a decade. A descriptive qualitative study with 14 couples. Data were collected on two occasions over a one-month period using semi-structured interviews, with both individual and couple interviews. Data were analysed thematically by the research team. All participants discussed the strong desire to remain in their homes for as long as possible. For the people with Parkinson's disease, placement to long-term facilities was not an option to be considered. For spouses, there was an acknowledgement there may come a time when they could no longer continue to provide care. Concerns regarding falls, choking, voice production, financial strain and need for prognostic information from providers were influences on what they believed the future would hold and the decisions they would need to make. The need for improved communication between providers and Parkinson's disease couples is evident. Interventions to support the couple in their discussions and decision-making regarding remaining in the home or not, and options to support advanced care needs are required. Nurses can help support decision-making by providing tangible information regarding the advanced stages of Parkinson's disease including adequate prognostic information. © 2016 John Wiley & Sons Ltd.

  14. Advanced construction management for lunar base construction - Surface operations planner

    NASA Technical Reports Server (NTRS)

    Kehoe, Robert P.

    1992-01-01

    The study proposes a conceptual solution and lays the framework for developing a new, sophisticated and intelligent tool for a lunar base construction crew to use. This concept integrates expert systems for critical decision making, virtual reality for training, logistics and laydown optimization, automated productivity measurements, and an advanced scheduling tool to form a unique new planning tool. The concept features extensive use of computers and expert systems software to support the actual work, while allowing the crew to control the project from the lunar surface. Consideration is given to a logistics data base, laydown area management, flexible critical progress scheduler, video simulation of assembly tasks, and assembly information and tracking documentation.

  15. Nursing Education Transformation: Promising Practices in Academic Progression.

    PubMed

    Gorski, Mary Sue; Farmer, Patricia D; Sroczynski, Maureen; Close, Liz; Wortock, Jean M

    2015-09-01

    Health care has changed over the past decade; yet, nursing education has not kept pace with social and scientific advances. The Institute of Medicine report, The Future of Nursing: Leading Change, Advancing Health, called for a more highly educated nursing work-force and an improved nursing education system. Since the release of that report, the Future of Nursing: Campaign for Action, supported by the Robert Wood Johnson Foundation, AARP, and the AARP Foundation, has worked with nursing education leaders to better understand existing and evolving nursing education structures. Through a consensus-building process, four overarching promising practice models, with an emphasis on seamless academic progression, emerged to advance the goals of education transformation. Key nurse educators and other stakeholders refined those models through a series of meetings, collaborative partnerships, and focused projects that were held across the United States. This article summarizes that process and provides a description of the models, challenges, common themes, recommendations, and progress to date. Copyright 2015, SLACK Incorporated.

  16. Assessing Competing Demands and Charting a Course: A Phenomenological Study of Advanced Placement U.S. History Teachers' Decision Making and Course Planning

    ERIC Educational Resources Information Center

    Poole, Kerry D.

    2014-01-01

    Florida has experienced some of the greatest growth of Advanced Placement (AP) programs in recent years and student scores on the AP exams have evolved into a highly significant metric in evaluating student proficiency and teacher and school effectiveness. Despite this growth, it is not well known how AP teachers make decisions about the content…

  17. Progress in oral personalized medicine: contribution of ‘omics’

    PubMed Central

    Glurich, Ingrid; Acharya, Amit; Brilliant, Murray H.; Shukla, Sanjay K.

    2015-01-01

    Background Precision medicine (PM), representing clinically applicable personalized medicine, proactively integrates and interprets multidimensional personal health data, including clinical, ‘omics’, and environmental profiles, into clinical practice. Realization of PM remains in progress. Objective The focus of this review is to provide a descriptive narrative overview of: 1) the current status of oral personalized medicine; and 2) recent advances in genomics and related ‘omic’ and emerging research domains contributing to advancing oral-systemic PM, with special emphasis on current understanding of oral microbiomes. Design A scan of peer-reviewed literature describing oral PM or ‘omic’-based research conducted on humans/data published in English within the last 5 years in journals indexed in the PubMed database was conducted using mesh search terms. An evidence-based approach was used to report on recent advances with potential to advance PM in the context of historical critical and systematic reviews to delineate current state-of-the-art technologies. Special focus was placed on oral microbiome research associated with health and disease states, emerging research domains, and technological advances, which are positioning realization of PM. Results This review summarizes: 1) evolving conceptualization of personalized medicine; 2) emerging insight into roles of oral infectious and inflammatory processes as contributors to both oral and systemic diseases; 3) community shifts in microbiota that may contribute to disease; 4) evidence pointing to new uncharacterized potential oral pathogens; 5) advances in technological approaches to ‘omics’ research that will accelerate PM; 6) emerging research domains that expand insights into host–microbe interaction including inter-kingdom communication, systems and network analysis, and salivaomics; and 7) advances in informatics and big data analysis capabilities to facilitate interpretation of host and

  18. Recent Progress in Self-Supported Metal Oxide Nanoarray Electrodes for Advanced Lithium-Ion Batteries.

    PubMed

    Zhang, Feng; Qi, Limin

    2016-09-01

    The rational design and fabrication of electrode materials with desirable architectures and optimized properties has been demonstrated to be an effective approach towards high-performance lithium-ion batteries (LIBs). Although nanostructured metal oxide electrodes with high specific capacity have been regarded as the most promising alternatives for replacing commercial electrodes in LIBs, their further developments are still faced with several challenges such as poor cycling stability and unsatisfying rate performance. As a new class of binder-free electrodes for LIBs, self-supported metal oxide nanoarray electrodes have many advantageous features in terms of high specific surface area, fast electron transport, improved charge transfer efficiency, and free space for alleviating volume expansion and preventing severe aggregation, holding great potential to solve the mentioned problems. This review highlights the recent progress in the utilization of self-supported metal oxide nanoarrays grown on 2D planar and 3D porous substrates, such as 1D and 2D nanostructure arrays, hierarchical nanostructure arrays, and heterostructured nanoarrays, as anodes and cathodes for advanced LIBs. Furthermore, the potential applications of these binder-free nanoarray electrodes for practical LIBs in full-cell configuration are outlined. Finally, the future prospects of these self-supported nanoarray electrodes are discussed.

  19. Recent Progress in Self‐Supported Metal Oxide Nanoarray Electrodes for Advanced Lithium‐Ion Batteries

    PubMed Central

    Zhang, Feng

    2016-01-01

    The rational design and fabrication of electrode materials with desirable architectures and optimized properties has been demonstrated to be an effective approach towards high‐performance lithium‐ion batteries (LIBs). Although nanostructured metal oxide electrodes with high specific capacity have been regarded as the most promising alternatives for replacing commercial electrodes in LIBs, their further developments are still faced with several challenges such as poor cycling stability and unsatisfying rate performance. As a new class of binder‐free electrodes for LIBs, self‐supported metal oxide nanoarray electrodes have many advantageous features in terms of high specific surface area, fast electron transport, improved charge transfer efficiency, and free space for alleviating volume expansion and preventing severe aggregation, holding great potential to solve the mentioned problems. This review highlights the recent progress in the utilization of self‐supported metal oxide nanoarrays grown on 2D planar and 3D porous substrates, such as 1D and 2D nanostructure arrays, hierarchical nanostructure arrays, and heterostructured nanoarrays, as anodes and cathodes for advanced LIBs. Furthermore, the potential applications of these binder‐free nanoarray electrodes for practical LIBs in full‐cell configuration are outlined. Finally, the future prospects of these self‐supported nanoarray electrodes are discussed. PMID:27711259

  20. 40 CFR 35.938-6 - Progress payments to contractors.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 40 Protection of Environment 1 2010-07-01 2010-07-01 false Progress payments to contractors. 35... § 35.938-6 Progress payments to contractors. (a) Policy. EPA policy is that, except as State law otherwise provides, grantees should make prompt progress payments to prime contractors and prime contractors...

  1. A model for emergency department end-of-life communications after acute devastating events--part I: decision-making capacity, surrogates, and advance directives.

    PubMed

    Limehouse, Walter E; Feeser, V Ramana; Bookman, Kelly J; Derse, Arthur

    2012-09-01

    Making decisions for a patient affected by sudden devastating illness or injury traumatizes a patient's family and loved ones. Even in the absence of an emergency, surrogates making end-of-life treatment decisions may experience negative emotional effects. Helping surrogates with these end-of-life decisions under emergent conditions requires the emergency physician (EP) to be clear, making medical recommendations with sensitivity. This model for emergency department (ED) end-of-life communications after acute devastating events comprises the following steps: 1) determine the patient's decision-making capacity; 2) identify the legal surrogate; 3) elicit patient values as expressed in completed advance directives; 4) determine patient/surrogate understanding of the life-limiting event and expectant treatment goals; 5) convey physician understanding of the event, including prognosis, treatment options, and recommendation; 6) share decisions regarding withdrawing or withholding of resuscitative efforts, using available resources and considering options for organ donation; and 7) revise treatment goals as needed. Emergency physicians should break bad news compassionately, yet sufficiently, so that surrogate and family understand both the gravity of the situation and the lack of long-term benefit of continued life-sustaining interventions. EPs should also help the surrogate and family understand that palliative care addresses comfort needs of the patient including adequate treatment for pain, dyspnea, or anxiety. Part I of this communications model reviews determination of decision-making capacity, surrogacy laws, and advance directives, including legal definitions and application of these steps; Part II (which will appear in a future issue of AEM) covers communication moving from resuscitative to end-of-life and palliative treatment. EPs should recognize acute devastating illness or injuries, when appropriate, as opportunities to initiate end-of-life discussions and to

  2. Advanced information society(7)

    NASA Astrophysics Data System (ADS)

    Chiba, Toshihiro

    Various threats are hiding in advanced informationalized society. As we see car accident problems in motorization society light aspects necessarily accompy shady ones. Under the changing circumstances of advanced informationalization added values of information has become much higher. It causes computer crime, hacker, computer virus to come to the surface. In addition it can be said that infringement of intellectual property and privacy are threats brought by advanced information. Against these threats legal, institutional and insurance measures have been progressed, and newly security industry has been established. However, they are not adequate individually or totally. The future vision should be clarified, and countermeasures according to the visions have to be considered.

  3. The impact of advanced technology on critical care. Dilemmas in the making.

    PubMed

    Aarons, D E

    1998-12-01

    Advanced technology has enhanced our ability to diagnose and treat critically ill patients, thereby assisting in prolonging life for many. However, its high cost has been prohibitive, and it may impose more burdens than benefits on some patients. Although technological advances have accelerated social change, many have also fuelled legal and ethical concerns. Consequently, the rationale for the use of advanced technology in the care of critically ill patients should be clear and ethically justified.

  4. Predictors of Clinical Progression in HIV-1-Infected Adults Initiating Combination Antiretroviral Therapy with Advanced Disease in the Asia-Pacific Region: Results from the TREAT Asia HIV Observational Database

    PubMed Central

    Byakwaga, H.; Petoumenos, K.; Ananworanich, J.; Zhang, F.; Boyd, M. A.; Sirisanthana, T.; Li, P. C. K.; Lee, C.; Mean, C. V.; Saphonn, V.; Omar, S. F. S.; Pujari, S.; Phanuphak, P.; Lim, P. L.; Kumarasamy, N.; Chen, Y. M. A.; Merati, T. P.; Sungkanuparph, S.; Ditangco, R.; Oka, S.; Tau, G.; Zhou, J.; Law, M. G.; Emery, S.

    2013-01-01

    The majority of HIV-infected patients in developing countries commences combination antiretroviral therapy (cART) with advanced disease. We examined predictors of disease progression in patients initiating cART with CD4 count ≤200 cells/mm3 in the TREAT Asia HIV Observational Database. The main outcome measure was progression to either an AIDS-defining illness or death occurring 6 months after initiation of cART. We used survival analysis methods. A total of 1255 patients contributed 2696 person years of follow-up; 73 were diagnosed with AIDS and 9 died. The rate of progression to the combined end point was 3.0 per 100 person years. The factors significantly associated with a higher risk of disease progression were Indian ethnicity, infection through intravenous drug use, lower CD4 count, and hemoglobin ≤130 g/dL at 6 months. In conclusion, measurements of CD4 count and hemoglobin at month 6 may be useful for early identification of disease progression in resource-limited settings. PMID:23422741

  5. End-of-life decision making by family caregivers of persons with advanced dementia: A literature review of decision aids.

    PubMed

    Xie, Bo; Berkley, Amy S; Kwak, Jung; Fleischmann, Kenneth R; Champion, Jane Dimmitt; Koltai, Kolina S

    2018-01-01

    To investigate existing knowledge in the literature about end-of-life decision making by family caregivers of persons with dementia, focusing on decision aids for caregivers of persons with advanced dementia, and to identify gaps in the literature that can guide future research. A literature review through systematic searches in PubMed, CINAHL Plus with Full Text, and PsycINFO was conducted in February 2018; publications with full text in English and published in the past 10 years were selected in multiple steps. The final sample included five decision aids with predominantly Caucasian participants; three of them had control groups, and three used audiovisual technology in presenting the intervention materials. No other technology was used in any intervention. Existing interventions lacked tailoring of information to caregivers' preferences for different types and amounts of information necessary to make decisions consistent with patients' values. Research is needed in exploring the use of technology in decision aids that could provide tailored information to facilitate caregivers' decision making. More diverse samples are needed.

  6. 7 CFR 1485.18 - Advances.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... MARKETS FOR AGRICULTURAL COMMODITIES Market Access Program § 1485.18 Advances. (a) Policy. In general, CCC... payments to an MAP participant for generic promotion activities. Prior to making an advance, CCC may...

  7. 7 CFR 1485.18 - Advances.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... MARKETS FOR AGRICULTURAL COMMODITIES Market Access Program § 1485.18 Advances. (a) Policy. In general, CCC... payments to an MAP participant for generic promotion activities. Prior to making an advance, CCC may...

  8. Progress in Fully Automated Abdominal CT Interpretation

    PubMed Central

    Summers, Ronald M.

    2016-01-01

    OBJECTIVE Automated analysis of abdominal CT has advanced markedly over just the last few years. Fully automated assessment of organs, lymph nodes, adipose tissue, muscle, bowel, spine, and tumors are some examples where tremendous progress has been made. Computer-aided detection of lesions has also improved dramatically. CONCLUSION This article reviews the progress and provides insights into what is in store in the near future for automated analysis for abdominal CT, ultimately leading to fully automated interpretation. PMID:27101207

  9. Advanced Materials through Assembly of Nanocelluloses.

    PubMed

    Kontturi, Eero; Laaksonen, Päivi; Linder, Markus B; Nonappa; Gröschel, André H; Rojas, Orlando J; Ikkala, Olli

    2018-06-01

    There is an emerging quest for lightweight materials with excellent mechanical properties and economic production, while still being sustainable and functionalizable. They could form the basis of the future bioeconomy for energy and material efficiency. Cellulose has long been recognized as an abundant polymer. Modified celluloses were, in fact, among the first polymers used in technical applications; however, they were later replaced by petroleum-based synthetic polymers. Currently, there is a resurgence of interest to utilize renewable resources, where cellulose is foreseen to make again a major impact, this time in the development of advanced materials. This is because of its availability and properties, as well as economic and sustainable production. Among cellulose-based structures, cellulose nanofibrils and nanocrystals display nanoscale lateral dimensions and lengths ranging from nanometers to micrometers. Their excellent mechanical properties are, in part, due to their crystalline assembly via hydrogen bonds. Owing to their abundant surface hydroxyl groups, they can be easily modified with nanoparticles, (bio)polymers, inorganics, or nanocarbons to form functional fibers, films, bulk matter, and porous aerogels and foams. Here, some of the recent progress in the development of advanced materials within this rapidly growing field is reviewed. © 2018 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

  10. Technological advances in precision medicine and drug development.

    PubMed

    Maggi, Elaine; Patterson, Nicole E; Montagna, Cristina

    New technologies are rapidly becoming available to expand the arsenal of tools accessible for precision medicine and to support the development of new therapeutics. Advances in liquid biopsies, which analyze cells, DNA, RNA, proteins, or vesicles isolated from the blood, have gained particular interest for their uses in acquiring information reflecting the biology of tumors and metastatic tissues. Through advancements in DNA sequencing that have merged unprecedented accuracy with affordable cost, personalized treatments based on genetic variations are becoming a real possibility. Extraordinary progress has been achieved in the development of biological therapies aimed to even further advance personalized treatments. We provide a summary of current and future applications of blood based liquid biopsies and how new technologies are utilized for the development of biological therapeutic treatments. We discuss current and future sequencing methods with an emphasis on how technological advances will support the progress in the field of precision medicine.

  11. 7 CFR 4287.156 - Protective advances.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... preserves collateral and recovery is actually enhanced by making the advance. Protective advances will not...) Protective advances and interest thereon at the note rate will be guaranteed at the same percentage of loss... 7 Agriculture 15 2010-01-01 2010-01-01 false Protective advances. 4287.156 Section 4287.156...

  12. Chemical and Environmental Exposures | Cancer Trends Progress Report

    Cancer.gov

    The Cancer Trends Progress Report, first issued in 2001, summarizes our nation's advances against cancer in relation to Healthy People targets set forth by the Department of Health and Human Services.

  13. Methodology for Characterizing Trends | Cancer Trends Progress Report

    Cancer.gov

    The Cancer Trends Progress Report, first issued in 2001, summarizes our nation's advances against cancer in relation to Healthy People targets set forth by the Department of Health and Human Services.

  14. Cancer Survivors and Smoking | Cancer Trends Progress Report

    Cancer.gov

    The Cancer Trends Progress Report, first issued in 2001, summarizes our nation's advances against cancer in relation to Healthy People targets set forth by the Department of Health and Human Services.

  15. Smoke-free Home Rules | Cancer Trends Progress Report

    Cancer.gov

    The Cancer Trends Progress Report, first issued in 2001, summarizes our nation's advances against cancer in relation to Healthy People targets set forth by the Department of Health and Human Services.

  16. Tobacco Company Marketing Expenditures | Cancer Trends Progress Report

    Cancer.gov

    The Cancer Trends Progress Report, first issued in 2001, summarizes our nation's advances against cancer in relation to Healthy People targets set forth by the Department of Health and Human Services.

  17. Recent Updates and Archive | Cancer Trends Progress Report

    Cancer.gov

    The Cancer Trends Progress Report, first issued in 2001, summarizes our nation's advances against cancer in relation to Healthy People targets set forth by the Department of Health and Human Services.

  18. Trends at a Glance | Cancer Trends Progress Report

    Cancer.gov

    The Cancer Trends Progress Report, first issued in 2001, summarizes our nation's advances against cancer in relation to Healthy People targets set forth by the Department of Health and Human Services.

  19. Cancer Survivors and Obesity | Cancer Trends Progress Report

    Cancer.gov

    The Cancer Trends Progress Report, first issued in 2001, summarizes our nation's advances against cancer in relation to Healthy People targets set forth by the Department of Health and Human Services.

  20. Diet - Prevention Summary Table | Cancer Trends Progress Report

    Cancer.gov

    The Cancer Trends Progress Report, first issued in 2001, summarizes our nation's advances against cancer in relation to Healthy People targets set forth by the Department of Health and Human Services.

  1. Tobacco Policy/Regulatory Factors | Cancer Trends Progress Report

    Cancer.gov

    The Cancer Trends Progress Report, first issued in 2001, summarizes our nation's advances against cancer in relation to Healthy People targets set forth by the Department of Health and Human Services.

  2. Fruit and Vegetable Consumption | Cancer Trends Progress Report

    Cancer.gov

    The Cancer Trends Progress Report, first issued in 2001, summarizes our nation's advances against cancer in relation to Healthy People targets set forth by the Department of Health and Human Services.

  3. Progress in the treatment of Ewing sarcoma: are the rumors of the demise of cytotoxic chemotherapy premature?

    PubMed

    Rosen, G

    2015-05-01

    In this issue, Bollling et. al. review the development of treatment of Ewing sarcoma as it evolved over the past 30 years of clinical trials in Europe, largely under the leadership of Heribert Jurgens to whom this review is dedicated. The 44 authors were teachers, colleagues, students and co-investigators of Jurgens. The authors attribute the ability to make progress in the treatment of Ewing sarcoma through the establishment of larger and still larger cooperative studies in order to demonstrate statistically significant advances in the treatment of this rare disease. © Georg Thieme Verlag KG Stuttgart · New York.

  4. 2010 Summary of Advances in Autism Spectrum Disorder Research

    ERIC Educational Resources Information Center

    Interagency Autism Coordinating Committee, 2010

    2010-01-01

    As part of the Combating Autism Act of 2006, the members of the Interagency Autism Coordinating Committee (IACC) are required to develop an annual "Summary of Advances" to describe each year's top advances in autism spectrum disorder (ASD) research. These advances represent significant progress in the early diagnosis of ASD, understanding the…

  5. Three New Genetic Loci (R1210C in CFH, Variants in COL8A1 and RAD51B) Are Independently Related to Progression to Advanced Macular Degeneration

    PubMed Central

    Seddon, Johanna M.; Reynolds, Robyn; Yu, Yi; Rosner, Bernard

    2014-01-01

    Objectives To assess the independent impact of new genetic variants on conversion to advanced stages of AMD, controlling for established risk factors, and to determine the contribution of genes in predictive models. Methods In this prospective longitudinal study of 2765 individuals, 777 subjects progressed to neovascular disease (NV) or geographic atrophy (GA) in either eye over 12 years. Recently reported genetic loci were assessed for their independent effects on incident advanced AMD after controlling for 6 established loci in 5 genes, and demographic, behavioral, and macular characteristics. New variants which remained significantly related to progression were then added to a final multivariate model to assess their independent effects. The contribution of genes to risk models was assessed using reclassification tables by determining risk within cross-classified quintiles for alternative models. Results Three new genetic variants were significantly related to progression: rare variant R1210C in CFH (hazard ratio (HR) 2.5, 95% confidence interval [CI] 1.2–5.3, P = 0.01), and common variants in genes COL8A1 (HR 2.0, 95% CI 1.1–3.5, P = 0.02) and RAD51B (HR 0.8, 95% CI 0.60–0.97, P = 0.03). The area under the curve statistic (AUC) was significantly higher for the 9 gene model (.884) vs the 0 gene model (.873), P = .01. AUC’s for the 9 vs 6 gene models were not significantly different, but reclassification analyses indicated significant added information for more genes, with adjusted odds ratios (OR) for progression within 5 years per one quintile increase in risk score of 2.7, P<0.001 for the 9 vs 6 loci model, and OR 3.5, P<0.001 for the 9 vs. 0 gene model. Similar results were seen for NV and GA. Conclusions Rare variant CFH R1210C and common variants in COL8A1 and RAD51B plus six genes in previous models contribute additional predictive information for advanced AMD beyond macular and behavioral phenotypes. PMID:24498017

  6. Fluctuating capacity and advance decision-making in Bipolar Affective Disorder - Self-binding directives and self-determination.

    PubMed

    Gergel, Tania; Owen, Gareth S

    2015-01-01

    For people with Bipolar Affective Disorder, a self-binding (advance) directive (SBD), by which they commit themselves to treatment during future episodes of mania, even if unwilling, can seem the most rational way to deal with an imperfect predicament. Knowing that mania will almost certainly cause enormous damage to themselves, their preferred solution may well be to allow trusted others to enforce treatment and constraint, traumatic though this may be. No adequate provision exists for drafting a truly effective SBD and efforts to establish such provision are hampered by very valid, but also paralysing ethical, clinical and legal concerns. Effectively, the autonomy and rights of people with bipolar are being 'protected' through being denied an opportunity to protect themselves. From a standpoint firmly rooted in the clinical context and experience of mania, this article argues that an SBD, based on a patient-centred evaluation of capacity to make treatment decisions (DMC-T) and grounded within the clinician-patient relationship, could represent a legitimate and ethically coherent form of self-determination. After setting out background information on fluctuating capacity, mania and advance directives, this article proposes a framework for constructing such an SBD, and considers common objections, possible solutions and suggestions for future research. Copyright © 2015 The Authors. Published by Elsevier Ltd.. All rights reserved.

  7. Advanced Gas Turbine (AGT)

    NASA Technical Reports Server (NTRS)

    1983-01-01

    The development and progress of the Advanced Gas Turbine engine program is examined. An analysis of the role of ceramics in the design and major engine components is included. Projected fuel economy, emissions and performance standards, and versatility in fuel use are also discussed.

  8. Vemurafenib beyond progression in a patient with metastatic melanoma: a case report.

    PubMed

    Grimaldi, Antonio M; Simeone, Ester; Palla, Marco; Festino, Lucia; Caracò, Corrado; Mozzillo, Nicola; Petrillo, Antonella; Muto, Paolo; Ascierto, Paolo A

    2015-04-01

    The prognosis of metastatic melanoma has changed markedly in recent years because of the advent of newer targeted therapies such as BRAF inhibitors. However, the response to BRAF inhibitor therapy is frequently nondurable in patients with advanced melanoma. Novel approaches are thus needed to overcome resistance to these agents and to improve the management of advanced melanoma patients after disease progression. Here, we present the case of a 44-year-old man diagnosed with advanced melanoma in July 2010, harboring a BRAF mutation. Melanoma progressed during first-line chemotherapy with dacarbazine, but showed significant benefit after the initiation of vemurafenib on August 2011. Six months later, the patient experienced disease progression in left-obturator lymphadenopathy; still, anti-BRAF treatment was continued together with stereotactic radiotherapy, and was interrupted only shortly for intestinal occlusion secondary to melanoma metastasis of the bowel. When his conditions were stable, after 1 month of vemurafenib treatment discontinuation, anti-BRAF therapy was reinitiated, with a positive outcome. Vemurafenib treatment was definitively discontinued for disease progression in the brain, peritoneum, lymph node, intestine, and skin in March 2013, after about 20 months from initiation, and the patient died a few weeks later. The clinical case presented here shows that treatment beyond progression with vemurafenib can yield a survival benefit in melanoma patients whose disease progresses in a few sites, which can be treated with locoregional therapies. This clinical strategy needs further validation in prospective clinical trials.

  9. The prediction of progression-free and overall survival in women with an advanced stage of epithelial ovarian carcinoma.

    PubMed

    Gerestein, C G; Eijkemans, M J C; de Jong, D; van der Burg, M E L; Dykgraaf, R H M; Kooi, G S; Baalbergen, A; Burger, C W; Ansink, A C

    2009-02-01

    Prognosis in women with ovarian cancer mainly depends on International Federation of Gynecology and Obstetrics stage and the ability to perform optimal cytoreductive surgery. Since ovarian cancer has a heterogeneous presentation and clinical course, predicting progression-free survival (PFS) and overall survival (OS) in the individual patient is difficult. The objective of this study was to determine predictors of PFS and OS in women with advanced stage epithelial ovarian cancer (EOC) after primary cytoreductive surgery and first-line platinum-based chemotherapy. Retrospective observational study. Two teaching hospitals and one university hospital in the south-western part of the Netherlands. Women with advanced stage EOC. All women who underwent primary cytoreductive surgery for advanced stage EOC followed by first-line platinum-based chemotherapy between January 1998 and October 2004 were identified. To investigate independent predictors of PFS and OS, a Cox' proportional hazard model was used. Nomograms were generated with the identified predictive parameters. The primary outcome measure was OS and the secondary outcome measures were response and PFS. A total of 118 women entered the study protocol. Median PFS and OS were 15 and 44 months, respectively. Preoperative platelet count (P = 0.007), and residual disease <1 cm (P = 0.004) predicted PFS with a optimism corrected c-statistic of 0.63. Predictive parameters for OS were preoperative haemoglobin serum concentration (P = 0.012), preoperative platelet counts (P = 0.031) and residual disease <1 cm (P = 0.028) with a optimism corrected c-statistic of 0.67. PFS could be predicted by postoperative residual disease and preoperative platelet counts, whereas residual disease, preoperative platelet counts and preoperative haemoglobin serum concentration were predictive for OS. The proposed nomograms need to be externally validated.

  10. The Employment Retention and Advancement Project: Paths to Advancement for Single Parents

    ERIC Educational Resources Information Center

    Miller, Cynthia; Deitch, Victoria; Hill, Aaron

    2010-01-01

    Between 2000 and 2003, the Employment Retention and Advancement (ERA) project identified and implemented a diverse set of innovative models designed to promote employment stability and wage or earnings progression among low-income individuals, mostly current or former welfare recipients. The project's goal was to determine which strategies could…

  11. Boron removal and its concentration in aqueous solution through progressive freeze concentration.

    PubMed

    Wang, Li Pang

    2017-09-01

    This study explored the feasibility of progressive freeze concentration in boron removal and its concentration in aqueous solution. The influence of three key parameters in progressive freeze concentration on boron removal and concentration, namely, the advance speed of the ice front, the circumferential velocity of the stirrer, and the initial boron concentration, are investigated by conducting batch experiments. The results show that the effectiveness of boron removal increases with a lower advance speed of the ice front, a higher circumferential velocity of the stirrer, and a lower initial boron concentration. For a model boron solution with an initial concentration of 100 mg/L, the boron concentration in the ice phase after progressive freeze concentration is below 1 mg/L when the advance speed of the ice front is lower than 1 cm/h and the circumferential velocity of the stirrer is higher than 0.12 m/s. In addition, the concentration of boron in the liquid phase occurs simultaneously with progressive freeze concentration. Furthermore, the results also suggest that this method can be applied to the purification and concentration of not only organic molecules but also inorganic ions.

  12. Diagnosis of glaucoma and detection of glaucoma progression using spectral domain optical coherence tomography.

    PubMed

    Grewal, Dilraj S; Tanna, Angelo P

    2013-03-01

    With the rapid adoption of spectral domain optical coherence tomography (SDOCT) in clinical practice and the recent advances in software technology, there is a need for a review of the literature on glaucoma detection and progression analysis algorithms designed for the commercially available instruments. Peripapillary retinal nerve fiber layer (RNFL) thickness and macular thickness, including segmental macular thickness calculation algorithms, have been demonstrated to be repeatable and reproducible, and have a high degree of diagnostic sensitivity and specificity in discriminating between healthy and glaucomatous eyes across the glaucoma continuum. Newer software capabilities such as glaucoma progression detection algorithms provide an objective analysis of longitudinally obtained structural data that enhances our ability to detect glaucomatous progression. RNFL measurements obtained with SDOCT appear more sensitive than time domain OCT (TDOCT) for glaucoma progression detection; however, agreement with the assessments of visual field progression is poor. Over the last few years, several studies have been performed to assess the diagnostic performance of SDOCT structural imaging and its validity in assessing glaucoma progression. Most evidence suggests that SDOCT performs similarly to TDOCT for glaucoma diagnosis; however, SDOCT may be superior for the detection of early stage disease. With respect to progression detection, SDOCT represents an important technological advance because of its improved resolution and repeatability. Advancements in RNFL thickness quantification, segmental macular thickness calculation and progression detection algorithms, when used correctly, may help to improve our ability to diagnose and manage glaucoma.

  13. Advanced Modeling, Simulation and Analysis (AMSA) Capability Roadmap Progress Review

    NASA Technical Reports Server (NTRS)

    Antonsson, Erik; Gombosi, Tamas

    2005-01-01

    Contents include the following: NASA capability roadmap activity. Advanced modeling, simulation, and analysis overview. Scientific modeling and simulation. Operations modeling. Multi-special sensing (UV-gamma). System integration. M and S Environments and Infrastructure.

  14. Advancing staff development and progression in nursing.

    PubMed

    Narayanasamy, Aru; Narayanasamy, Mani

    Staff development in the NHS is integral to clinical governance and therefore important to health service providers. It is concerned with all the activities that advance knowledge, skills and attitudes of staff, embracing induction, mentorship, continuing professional development, learning beyond registration, performance appraisals, promotion, personal and professional development, and related activities. The recent contraction in nursing posts and services and competition for jobs means that only well-qualified staff with an impressive portfolio of staff development are likely to climb the career ladder. Nursing staff development and training needs in the NHS are huge and multifaceted. Healthcare providers need to invest in clear staff development strategies if they are to maintain their status as effective care delivery organizations in an increasingly competitive market-driven economy. This article examines the many features of staff development and highlights the benefits for both staff and organizations.

  15. Assessing the American Association of Neuroscience Nurses' Progress on the Institute of Medicine Report.

    PubMed

    Madden, Lori Kennedy; Hundley, Lynn; Summers, Debbie; Villanueva, Nancy; Walter, Suzy Mascaro

    2017-06-01

    The American Association of Neuroscience Nurses (AANN) has worked toward meeting the challenges and addressing the key messages from the 2010 Institute of Medicine report on the future of nursing. In 2012, AANN developed an article summarizing how the association has addressed key issues. Since that time, new recommendations have been made to advance nursing, and AANN has updated its strategic plan. The AANN has assessed organizational progress in these initiatives in a 2017 white paper. This process included review of plans since the initial report and proposal of further efforts the organization can make in shaping the future of neuroscience nursing. The purpose of this manuscript is to provide an overview of the AANN white paper.

  16. Infrared engineering for the advancement of science: A UK perspective

    NASA Astrophysics Data System (ADS)

    Baker, Ian M.

    2017-02-01

    Leonardo MW (formerly Selex ES) has been developing infrared sensors and cameras for over 62 years at two main sites at Southampton and Basildon. Funding mainly from UK MOD has seen the technology progress from single element PbSe sensors to advanced, high definition, HgCdTe cameras, widely deployed in many fields today. However, in the last 10 years the major challenges and research funding has come from projects within the scientific sphere, particularly: astronomy and space. Low photon flux, high resolution spectroscopy and fast frame rates are the motivation to drive the sensitivity of infrared detectors to the single photon level. These detectors make use of almost noiseless avalanche gain in HgCdTe to achieve the sensitivity and speed of response. Metal Organic Vapour Phase Epitaxy, MOVPE, grown on low-cost GaAs substrates, provides the capability for crucial bandgap engineering to suppress breakdown currents and allow high avalanche gain even in very low background conditions. This paper describes the progress so far and provides a glimpse of the future.

  17. Trastuzumab beyond progression in human epidermal growth factor receptor 2-positive advanced breast cancer: a german breast group 26/breast international group 03-05 study.

    PubMed

    von Minckwitz, Gunter; du Bois, Andreas; Schmidt, Marcus; Maass, Nicolai; Cufer, Tanja; de Jongh, Felix E; Maartense, Eduard; Zielinski, Christoph; Kaufmann, Manfred; Bauer, Wolfgang; Baumann, Klaus H; Clemens, Michael R; Duerr, Ralph; Uleer, Christoph; Andersson, Michael; Stein, Robert C; Nekljudova, Valentina; Loibl, Sibylle

    2009-04-20

    Trastuzumab shows clinical activity in human epidermal growth factor receptor 2 (HER-2)-positive early and advanced breast cancer. In the German Breast Group 26/Breast International Group 03-05 trial, we investigated if trastuzumab treatment should be continued beyond progression. Patients with HER-2-positive breast cancer that progresses during treatment with trastuzumab were randomly assigned to receive capecitabine (2,500 mg/m(2) body-surface area on days 1 through 14 [1,250 mg/m(2) semi-daily]) alone or with continuation of trastuzumab (6 mg/kg body weight) in 3-week cycles. The primary end point was time to progression. We randomly assigned 78 patients to capecitabine and 78 patients to capecitabine plus trastuzumab. Sixty-five events and 38 deaths in the capecitabine group and 62 events and 33 deaths in the capecitabine-plus-trastuzumab group occurred during 15.6 months of follow-up. Median times to progression were 5.6 months in the capecitabine group and 8.2 months in the capecitabine-plus-trastuzumab group with an unadjusted hazard ratio of 0.69 (95% CI, 0.48 to 0.97; two-sided log-rank P = .0338). Overall survival rates were 20.4 months (95% CI, 17.8 to 24.7) in the capecitabine group and 25.5 months (95% CI, 19.0 to 30.7) in the capecitabine-plus-trastuzumab group (P = .257). Overall response rates were 27.0% with capecitabine and 48.1% with capecitabine plus trastuzumab (odds ratio, 2.50; P = .0115). Continuation of trastuzumab beyond progression was not associated with increased toxicity. Continuation of trastuzumab plus capecitabine showed a significant improvement in overall response and time to progression compared with capecitabine alone in women with HER-2-positive breast cancer who experienced progression during trastuzumab treatment.

  18. Long-term outcome of enzyme-replacement therapy in advanced Fabry disease: evidence for disease progression towards serious complications

    PubMed Central

    Weidemann, F; Niemann, M; Störk, S; Breunig, F; Beer, M; Sommer, C; Herrmann, S; Ertl, G; Wanner, C

    2013-01-01

    Objective The long-term effects of enzyme-replacement therapy (ERT) in Fabry disease are unknown. Thus, the aim of this study was to determine whether ERT in patients with advanced Fabry disease affects progression towards ‘hard’ clinical end-points in comparison with the natural course of the disease. Methods A total of 40 patients with genetically proven Fabry disease (mean age 40 ± 9 years; n = 9 women) were treated prospectively with ERT for 6 years. In addition, 40 subjects from the Fabry Registry, matched for age, sex, chronic kidney disease stage and previous transient ischaemic attack (TIA), served as a comparison group. The main outcome was a composite of stroke, end-stage renal disease (ESRD) and death. Secondary outcomes included changes in myocardial left ventricular (LV) wall thickness and replacement fibrosis, change in glomerular filtration rate (GFR), new TIA and change in neuropathic pain. Results During a median follow-up of 6.0 years (bottom and top quartiles: 5.1, 7.2), 15 events occurred in 13 patients (n = 7 deaths, n = 4 cases of ESRD and n = 4 strokes). Sudden death occurred (n = 6) only in patients with documented ventricular tachycardia and myocardial replacement fibrosis. The annual progression of myocardial LV fibrosis in the entire cohort was 0.6 ± 0.7%. As a result, posterior end-diastolic wall thinning was observed (baseline, 13.2 ± 2.0 mm; follow-up, 11.4 ± 2.1 mm; P < 0.01). GFR decreased by 2.3 ± 4.6 mL min−1 per year. Three patients experienced a TIA. The major clinical symptom was neuropathic pain (n = 37), and this symptom improved in 25 patients. The event rate was not different between the ERT group and the untreated (natural history) group of the Fabry Registry. Conclusion Despite ERT, clinically meaningful events including sudden cardiac death continue to develop in patients with advanced Fabry disease. PMID:23586858

  19. Recent Progress in the Design of Advanced Cathode Materials and Battery Models for High-Performance Lithium-X (X = O2 , S, Se, Te, I2 , Br2 ) Batteries.

    PubMed

    Xu, Jiantie; Ma, Jianmin; Fan, Qinghua; Guo, Shaojun; Dou, Shixue

    2017-07-01

    Recent advances and achievements in emerging Li-X (X = O 2 , S, Se, Te, I 2 , Br 2 ) batteries with promising cathode materials open up new opportunities for the development of high-performance lithium-ion battery alternatives. In this review, we focus on an overview of recent important progress in the design of advanced cathode materials and battery models for developing high-performance Li-X (X = O 2 , S, Se, Te, I 2 , Br 2 ) batteries. We start with a brief introduction to explain why Li-X batteries are important for future renewable energy devices. Then, we summarize the existing drawbacks, major progress and emerging challenges in the development of cathode materials for Li-O 2 (S) batteries. In terms of the emerging Li-X (Se, Te, I 2 , Br 2 ) batteries, we systematically summarize their advantages/disadvantages and recent progress. Specifically, we review the electrochemical performance of Li-Se (Te) batteries using carbonate-/ether-based electrolytes, made with different electrode fabrication techniques, and of Li-I 2 (Br 2 ) batteries with various cell designs (e.g., dual electrolyte, all-organic electrolyte, with/without cathode-flow mode, and fuel cell/solar cell integration). Finally, the perspective on and challenges for the development of cathode materials for the promising Li-X (X = O 2 , S, Se, Te, I 2 , Br 2 ) batteries is presented. © 2017 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

  20. Effective Leadership Makes Schools Truly Inclusive

    ERIC Educational Resources Information Center

    McLeskey, James; Waldron, Nancy L.

    2015-01-01

    There's been much commitment and extensive legislation intended to make schools inclusive for all students but not much real progress in improving student outcomes. The authors review and assess several schools that have succeeded at making schools inclusive and effective for all students, including those with disabilities and draw some inferences…

  1. Progress toward an advanced condition monitoring system for reusable rocket engines

    NASA Technical Reports Server (NTRS)

    Maram, J.; Barkhoudarian, S.

    1987-01-01

    A new generation of advanced sensor technologies will allow the direct measurement of critical/degradable rocket engine components' health and the detection of degraded conditions before component deterioration affects engine performance, leading to substantial improvements in reusable engines' operation and maintenance. When combined with a computer-based engine condition-monitoring system, these sensors can furnish a continuously updated data base for the prediction of engine availability and advanced warning of emergent maintenance requirements. Attention is given to the case of a practical turbopump and combustion device diagnostic/prognostic health-monitoring system.

  2. The body electric 2.0: recent advances in developmental bioelectricity for regenerative and synthetic bioengineering.

    PubMed

    Mathews, Juanita; Levin, Michael

    2018-04-20

    Breakthroughs in biomedicine and synthetic bioengineering require predictive, rational control over anatomical structure and function. Recent successes in manipulating cellular and molecular hardware have not been matched by progress in understanding the patterning software implemented during embryogenesis and regeneration. A fundamental capability gap is driving desired changes in growth and form to address birth defects and traumatic injury. Here we review new tools, results, and conceptual advances in an exciting emerging field: endogenous non-neural bioelectric signaling, which enables cellular collectives to make global decisions and implement large-scale pattern homeostasis. Spatially distributed electric circuits regulate gene expression, organ morphogenesis, and body-wide axial patterning. Developmental bioelectricity facilitates the interface to organ-level modular control points that direct patterning in vivo. Cracking the bioelectric code will enable transformative progress in bioengineering and regenerative medicine. Copyright © 2018 Elsevier Ltd. All rights reserved.

  3. Advanced Nanostructured Anode Materials for Sodium-Ion Batteries.

    PubMed

    Wang, Qidi; Zhao, Chenglong; Lu, Yaxiang; Li, Yunming; Zheng, Yuheng; Qi, Yuruo; Rong, Xiaohui; Jiang, Liwei; Qi, Xinguo; Shao, Yuanjun; Pan, Du; Li, Baohua; Hu, Yong-Sheng; Chen, Liquan

    2017-11-01

    Sodium-ion batteries (NIBs), due to the advantages of low cost and relatively high safety, have attracted widespread attention all over the world, making them a promising candidate for large-scale energy storage systems. However, the inherent lower energy density to lithium-ion batteries is the issue that should be further investigated and optimized. Toward the grid-level energy storage applications, designing and discovering appropriate anode materials for NIBs are of great concern. Although many efforts on the improvements and innovations are achieved, several challenges still limit the current requirements of the large-scale application, including low energy/power densities, moderate cycle performance, and the low initial Coulombic efficiency. Advanced nanostructured strategies for anode materials can significantly improve ion or electron transport kinetic performance enhancing the electrochemical properties of battery systems. Herein, this Review intends to provide a comprehensive summary on the progress of nanostructured anode materials for NIBs, where representative examples and corresponding storage mechanisms are discussed. Meanwhile, the potential directions to obtain high-performance anode materials of NIBs are also proposed, which provide references for the further development of advanced anode materials for NIBs. © 2017 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

  4. DOE/JPL advanced thermionic technology program

    NASA Technical Reports Server (NTRS)

    1979-01-01

    Progress made in different tasks of the advanced thermionic technology program is described. The tasks include surface and plasma investigations (surface characterization, spectroscopic plasma experiments, and converter theory); low temperature converter development (tungsten emitter, tungsten oxide collector and tungsten emitter, nickel collector); component hardware development (hot shell development); flame-fired silicon carbide converters; high temperature and advanced converter studies; postoperational diagnostics; and correlation of design interfaces.

  5. MGMT expression levels predict disease stabilisation, progression-free and overall survival in patients with advanced melanomas treated with DTIC.

    PubMed

    Busch, Christian; Geisler, Jürgen; Lillehaug, Johan R; Lønning, Per Eystein

    2010-07-01

    Metastatic melanoma responds poorly to systemic treatment. We report the results of a prospective single institution study evaluating O(6)-methylguanine-DNA methyltransferase (MGMT) status as a potential predictive and/or prognostic marker among patients treated with dacarbazine (DTIC) 800-1000 mg/m(2) monotherapy administered as a 3-weekly schedule for advanced malignant melanomas. The study was approved by the Regional Ethical Committee. Surgical biopsies from metastatic or loco-regional deposits obtained prior to DTIC treatment were snap-frozen immediately upon removal and stored in liquid nitrogen up to processing. Median time from enrolment to end of follow-up was 67 months. MGMT expression levels evaluated by qRT-PCR correlated significantly to DTIC benefit (CR/PR/SD; p=0.005), time to progression (TTP) (p=0.005) and overall survival (OS) (p=0.003). MGMT expression also correlated to Breslow thickness in the primary tumour (p=0.014). While MGMT promoter hypermethylation correlated to MGMT expression, MGMT promoter hypermethylation did not correlate to treatment benefit, TTP or OS, suggesting that other factors may be critical in determining MGMT expression levels in melanomas. In a Cox proportional regression analysis, serum lactate dehydrogenase (LDH, p<0.001), MGMT expression (p=0.022) and p16(INK4a) expression (p=0.037) independently predicted OS, while TTP correlated to DTIC benefit after 6 weeks only (p=0.001). Our data reveal MGMT expression levels to be associated with disease stabilisation and prognosis in patients receiving DTIC monotherapy for advanced melanoma. The role of MGMT expression as a predictor to DTIC sensitivity versus a general prognostic factor in advanced melanomas warrants further evaluation. Copyright 2010 Elsevier Ltd. All rights reserved.

  6. Health information technology: strategic initiatives, real progress.

    PubMed

    Kolodner, Robert M; Cohn, Simon P; Friedman, Charles P

    2008-01-01

    We fully agree with Carol Diamond and Clay Shirky that deployment of health information technology (IT) is necessary but not sufficient for transforming U.S. health care. However, the recent work to advance health IT is far from an exercise in "magical thinking." It has been strategic thinking. To illustrate this, we highlight recent initiatives and progress under four focus areas: adoption, governance, privacy and security, and interoperability. In addition, solutions exist for health IT to advance rapidly without adversely affecting future policy choices. A broad national consensus is emerging in support of advancing health IT to enable the transformation of health and care.

  7. Creating Smarter Classrooms: Data-Based Decision Making for Effective Classroom Management

    ERIC Educational Resources Information Center

    Gage, Nicholas A.; McDaniel, Sara

    2012-01-01

    The term "data-based decision making" (DBDM) has become pervasive in education and typically refers to the use of data to make decisions in schools, from assessment of an individual student's academic progress to whole-school reform efforts. Research suggests that special education teachers who use progress monitoring data (a DBDM…

  8. FY2011 Annual Progress Report for Propulsion Materials

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

    Davis, Patrick B.; Schutte, Carol L.; Gibbs, Jerry L.

    Annual Progress Report for Propulsion Materials focusing on enabling and innovative materials technologies that are critical in improving the efficiency of advanced engines by providing enabling materials support for combustion, hybrid, and power electronics development.

  9. Anti-angiogenesis target therapy for advanced osteosarcoma

    PubMed Central

    Xie, Lu; Ji, Tao; Guo, Wei

    2017-01-01

    Osteosarcomas (OS), especially those with metastatic or unresectable disease, have limited treatment options. The greatest advancement in treatments occurred in the 1980s when multi-agent chemotherapy, including doxorubicin, cisplatin, high-dose methotrexate, and, in some regimens, ifosfamide, was demonstrated to improve overall survival compared with surgery alone. However, standard chemotherapeutic options have been limited by poor response rates in patients with relapsed or advanced cases. It has been reported that VEGFR expression correlates with the outcome of patients with osteosarcoma and circulating VEGF level has been associated with the development of lung metastasis. At present, it seems to us that progress has not been made since Grignani reported a phase II cohort trial of sorafenib and sorafenib combined with everolimus for advanced osteosarcoma, which, in a sense, have become a milestone as a second-line therapy for osteosarcoma. Although the recognization of muramyltripepetide phosphatidyl-ethanolamine has made some progress based on its combination with standard chemotherapy, its effect on refractory cases is controversial. Personalized comprehensive molecular profiling of high-risk osteosarcoma up to now has not changed the therapeutic prospect of advanced osteosarcoma significantly. Thus, how far have we moved forward and what therapeutic strategy should we prefer for anti-angiogenesis therapy? This review provides an overview of the most updated anti-angiogenesis therapy in OS and discusses some clinical options in order to maintain or even improve progression-free survival. PMID:28656259

  10. Measuring progress in nursing and midwifery globally.

    PubMed

    al-Gasseer, Naeema; Persaud, Vena

    2003-01-01

    To discuss issues and challenges encountered in the preliminary steps of identifying a core set of global indicators for measuring progress in nursing and midwifery development. Lack of a global and systematic approach for collecting evidence has undermined the ability to reliably measure progress. Description of general principles, scientific criteria, and strategic directions. WHO's organizational support and global conditions are forces that indicated appropriate timing for these strategic directions. Concerted efforts are needed in all countries to implement these directions to advance nursing and midwifery services.

  11. Nontraditional families and childhood progress through school.

    PubMed

    Rosenfeld, Michael J

    2010-08-01

    luse U.S. census data to perform the first large-sample, nationally representative tests of outcomes for children raised by same-sex couples. The results show that children of same-sex couples are as likely to make normal progress through school as the children of most other family structures. Heterosexual married couples are the family type whose children have the lowest rates of grade retention, but the advantage of heterosexual married couples is mostly due to their higher socioeconomic status. Children ofallfamily types (including children ofsame-sex couples) are far more likely to make normal progress through school than are children living in group quarters (such as orphanages and shelters).

  12. Recent advances in rechargeable battery materials: a chemist's perspective.

    PubMed

    Palacín, M Rosa

    2009-09-01

    The constant increase in global energy demand, together with the awareness of the finite supply of fossil fuels, has brought about an imperious need to take advantage of renewable energy sources. At the same time, concern over CO(2) emissions and future rises in the cost of gasoline has boosted technological efforts to make hybrid and electric vehicles available to the general public. Energy storage is a vital issue to be addressed within this scenario, and batteries are certainly a key player. In this tutorial review, the most recent and significant scientific advances in the field of rechargeable batteries, whose performance is dependent on their underlying chemistry, are covered. In view of its utmost current significance and future prospects, special emphasis is given to progress in lithium-based technologies.

  13. Advancing automation and robotics technology for the Space Station Freedom and for the US economy

    NASA Technical Reports Server (NTRS)

    1990-01-01

    The progress made by levels 1, 2, and 3 of the Office of Space Station in developing and applying advanced automation and robotics technology is described. Emphasis is placed upon the Space Station Freedom Program responses to specific recommendations made in the Advanced Technology Advisory Committee (ATAC) progress report 10, the flight telerobotic servicer, and the Advanced Development Program. Assessments are presented for these and other areas as they apply to the advancement of automation and robotics technology for the Space Station Freedom.

  14. Bangladesh making remarkable progress in population field.

    PubMed

    1998-01-01

    This article describes the progress made in reducing fertility in Bangladesh, and government goals for meeting future challenges. Fertility declined from 7.0 to 3.3 children/woman during 1975-96. Contraceptive prevalence increased from 3% to about 50% during 1971-96. Population in 1997, was about 123 million. Population is expected to increase to about 210 million by the year 2020. Bangladesh is one of the most densely populated countries. About 50% of the female population are unmarried and aged under 20 years. Adolescent fertility is very high at 171 births/1000 girls aged 15-19 years. About 30% of adolescents are mothers, and another 6% are pregnant with their first child. Female age at marriage increased to 18 years. The contraceptive prevalence rate among adolescents is only 25%. 20% of total population live in urban areas. Infant, child, and maternal mortality rates are still high. The long-term goal of the government is to reduce fertility to a 2-child family norm by 2002. The plan of action focuses on improved quality of care, intensifying program efforts in low performing areas, focusing on critical underserved groups, implementing family planning services in the Health Directorate, improving performance reporting and follow-up, strengthening IEC and community mobilization, carrying out critical training, enhancing collaboration between governmental and nongovernmental groups, and improving maternal, child, and reproductive health. A National Committee for the Implementation of the aforementioned Program of Action of the ICPD was set up in October 1994.

  15. Folates in plants: research advances and progress in crop biofortification

    NASA Astrophysics Data System (ADS)

    Gorelova, Vera; Ambach, Lars; Rébeillé, Fabrice; Stove, Christophe; Van Der Straeten, Dominique

    2017-03-01

    Folates, also known as B9 vitamins, serve as donors and acceptors in one-carbon (C1) transfer reactions. The latter are involved in synthesis of many important biomolecules, such as amino acids, nucleic acids and vitamin B5. Folates also play a central role in the methyl cycle that provides one-carbon groups for methylation reactions. The important functions fulfilled by folates make them essential in all living organisms. Plants, being able to synthesize folates de novo, serve as an excellent dietary source of folates for animals that lack the respective biosynthetic pathway. Unfortunately, the most important staple crops such as rice, potato and maize are rather poor sources of folates. Insufficient folate consumption is known to cause severe developmental disorders in humans. Two approaches are employed to fight folate deficiency: pharmacological supplementation in the form of folate pills and biofortification of staple crops. As the former approach is considered rather costly for the major part of the world population, biofortification of staple crops is viewed as a decent alternative in the struggle against folate deficiency. Therefore strategies, challenges and recent progress of folate enhancement in plants will be addressed in this review. Apart from the ever-growing need for the enhancement of nutritional quality of crops, the world population faces climate change catastrophes or environmental stresses, such as elevated temperatures, drought, salinity that severely affect growth and productivity of crops. Due to immense diversity of their biochemical functions, folates take part in virtually every aspect of plant physiology. Any disturbance to the plant folate metabolism leads to severe growth inhibition and, as a consequence, to a lower productivity. Whereas today’s knowledge of folate biochemistry can be considered very profound, evidence on the physiological roles of folates in plants only starts to emerge. In the current review we will discuss the

  16. Cognitive function and advanced kidney disease: longitudinal trends and impact on decision-making.

    PubMed

    Iyasere, Osasuyi; Okai, David; Brown, Edwina

    2017-02-01

    Background: Cognitive impairment commonly affects renal patients. But little is known about the influence of dialysis modality on cognitive trends or the influence of cognitive impairment on decision-making in renal patients. This study evaluated cognitive trends amongst chronic kidney disease (CKD), haemodialysis (HD) and peritoneal dialysis (PD) patients. The relationship between cognitive impairment and decision-making capacity (DMC) was also assessed. Methods: Patients were recruited from three outpatient clinics. Cognitive function was assessed 4-monthly for up to 2 years, using the Montreal Cognitive Assessment (MoCA) tool. Cognitive trends were assessed using mixed model analysis. DMC was assessed using the Macarthur Competency Assessment tool (MacCAT-T). MacCAT-T scores were compared between patients with cognitive impairment (MoCA <26) and those without. Results: In total, 102 (41 HD, 25 PD and 36 CKD) patients were recruited into the prospective study. After multivariate analysis, the total MoCA scores declined faster in dialysis compared with CKD patients [coefficient = -0.03, 95% confidence interval (95% CI) = -0.056 to - 0.004; P = 0.025]. The MoCA executive scores declined faster in the HD compared with PD patients (coefficient = -0.12, 95% CI = -0.233 to - 0.007; P = 0.037). DMC was assessed in 10 patients. Those with cognitive impairment had lower MacCAT-T compared with those without [median (interquartile range) 19 (17.9-19.6) versus 17.4 (16.3-18.4); P = 0.049]. Conclusions: Cognition declines faster in dialysis patients compared with CKD patients and in HD patients compared with PD patients. Cognitive impairment affects DMC in patients with advanced kidney disease.

  17. Crosscutting Technology Development at the Center for Advanced Separation Technologies

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

    Christopher E. Hull

    2006-09-30

    This Technical Progress Report describes progress made on the twenty nine subprojects awarded in the second year of Cooperative Agreement DE-FC26-02NT41607: Crosscutting Technology Development at the Center for Advanced Separation Technologies. This work is summarized in the body of the main report: the individual sub-project Technical Progress Reports are attached as Appendices.

  18. CROSSCUTTING TECHNOLOGY DEVELOPMENT AT THE CENTER FOR ADVANCED SEPARATION TECHNOLOGIES

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

    Christopher E. Hull

    2006-05-15

    This Technical Progress Report describes progress made on the twenty nine subprojects awarded in the second year of Cooperative Agreement DE-FC26-02NT41607: Crosscutting Technology Development at the Center for Advanced Separation Technologies. This work is summarized in the body of the main report: the individual sub-project Technical Progress Reports are attached as Appendices.

  19. Advanced Communications Architecture Demonstration Made Significant Progress

    NASA Technical Reports Server (NTRS)

    Carek, David Andrew

    2004-01-01

    Simulation for a ground station located at 44.5 deg latitude. The Advanced Communications Architecture Demonstration (ACAD) is a concept architecture to provide high-rate Ka-band (27-GHz) direct-to-ground delivery of payload data from the International Space Station. This new concept in delivering data from the space station targets scientific experiments that buffer data onboard. The concept design provides a method to augment the current downlink capability through the Tracking Data Relay Satellite System (TDRSS) Ku-band (15-GHz) communications system. The ACAD concept pushes the limits of technology in high-rate data communications for space-qualified systems. Research activities are ongoing in examining the various aspects of high-rate communications systems including: (1) link budget parametric analyses, (2) antenna configuration trade studies, (3) orbital simulations (see the preceding figure), (4) optimization of ground station contact time (see the following graph), (5) processor and storage architecture definition, and (6) protocol evaluations and dependencies.

  20. Tobacco Use - Prevention Summary Table | Cancer Trends Progress Report

    Cancer.gov

    The Cancer Trends Progress Report, first issued in 2001, summarizes our nation's advances against cancer in relation to Healthy People targets set forth by the Department of Health and Human Services.

  1. Chemical Exposures - Prevention Summary Table | Cancer Trends Progress Report

    Cancer.gov

    The Cancer Trends Progress Report, first issued in 2001, summarizes our nation's advances against cancer in relation to Healthy People targets set forth by the Department of Health and Human Services.

  2. Financial Burden of Cancer Care | Cancer Trends Progress Report

    Cancer.gov

    The Cancer Trends Progress Report, first issued in 2001, summarizes our nation's advances against cancer in relation to Healthy People targets set forth by the Department of Health and Human Services.

  3. Person-Years of Life Lost | Cancer Trends Progress Report

    Cancer.gov

    The Cancer Trends Progress Report, first issued in 2001, summarizes our nation's advances against cancer in relation to Healthy People targets set forth by the Department of Health and Human Services.

  4. Secondhand Smoke - Prevention Summary Table | Cancer Trends Progress Report

    Cancer.gov

    The Cancer Trends Progress Report, first issued in 2001, summarizes our nation's advances against cancer in relation to Healthy People targets set forth by the Department of Health and Human Services.

  5. HPV Immunization - Prevention Summary Table | Cancer Trends Progress Report

    Cancer.gov

    The Cancer Trends Progress Report, first issued in 2001, summarizes our nation's advances against cancer in relation to Healthy People targets set forth by the Department of Health and Human Services.

  6. Life After Cancer Summary Tables | Cancer Trends Progress Report

    Cancer.gov

    The Cancer Trends Progress Report, first issued in 2001, summarizes our nation's advances against cancer in relation to Healthy People targets set forth by the Department of Health and Human Services.

  7. Smoking Cessation - Prevention Summary Table | Cancer Trends Progress Report

    Cancer.gov

    The Cancer Trends Progress Report, first issued in 2001, summarizes our nation's advances against cancer in relation to Healthy People targets set forth by the Department of Health and Human Services.

  8. Cancer Survivors and Physical Activity | Cancer Trends Progress Report

    Cancer.gov

    The Cancer Trends Progress Report, first issued in 2001, summarizes our nation's advances against cancer in relation to Healthy People targets set forth by the Department of Health and Human Services.

  9. Clinicians' Advice to Quit Smoking | Cancer Trends Progress Report

    Cancer.gov

    The Cancer Trends Progress Report, first issued in 2001, summarizes our nation's advances against cancer in relation to Healthy People targets set forth by the Department of Health and Human Services.

  10. Diet, Physical Activity, and Weight | Cancer Trends Progress Report

    Cancer.gov

    The Cancer Trends Progress Report, first issued in 2001, summarizes our nation's advances against cancer in relation to Healthy People targets set forth by the Department of Health and Human Services.

  11. Zinc finger proteins in cancer progression.

    PubMed

    Jen, Jayu; Wang, Yi-Ching

    2016-07-13

    Zinc finger proteins are the largest transcription factor family in human genome. The diverse combinations and functions of zinc finger motifs make zinc finger proteins versatile in biological processes, including development, differentiation, metabolism and autophagy. Over the last few decades, increasing evidence reveals the potential roles of zinc finger proteins in cancer progression. However, the underlying mechanisms of zinc finger proteins in cancer progression vary in different cancer types and even in the same cancer type under different types of stress. Here, we discuss general mechanisms of zinc finger proteins in transcription regulation and summarize recent studies on zinc finger proteins in cancer progression. In this review, we also emphasize the importance of further investigations in elucidating the underlying mechanisms of zinc finger proteins in cancer progression.

  12. Progress Toward National Aeronautics Goals

    NASA Technical Reports Server (NTRS)

    Russo, Carlo J.; Sehra, Arun K.

    1999-01-01

    NASA has made definitive progress towards achieving several bold U.S. goals in aeronautics related to air breathing engines. The advanced technologies developed towards these goals span applications from general aviation to large subsonic and supersonic aircraft. The proof of successful technology development is demonstrated through successful technology transfer to U.S. industry and projected fleet impact. Specific examples of progress are discussed that quantifies the achievement towards these goals. In addition, a more detailed vision for NASA aeronautics is defined and key strategic issues are explored which invite international and national debate and involvement especially in reduced environmental impact for subsonic and supersonic aircraft, dramatic new capabilities in general aviation engines, and reduced development cycle time and costs.

  13. Hydromechanical Advanced Coal Excavator

    NASA Technical Reports Server (NTRS)

    Estus, Jay M.; Summers, David

    1990-01-01

    Water-jet cutting reduces coal dust and its hazards. Advanced mining system utilizes full-face, hydromechanical, continuous miner. Coal excavator uses high-pressure water-jet lances, one in each of cutting heads and one in movable lance, to make cuts across top, bottom and middle height, respectively, of coal face. Wedge-shaped cutting heads advance into lower and upper cuts in turn, thereby breaking coal toward middle cut. Thrust cylinders and walking pads advance excavator toward coal face.

  14. Recent advances and product enhancements in reflective cholesteric displays

    NASA Astrophysics Data System (ADS)

    Khan, Asad; Schneider, Tod; Miller, Nick; Marhefka, Duane; Ernst, Todd; Nicholson, Forrest; Doane, Joseph W.

    2005-04-01

    Bistable reflective cholesteric displays are a liquid crystal display technology developed to fill a market need for very low power displays on a low-cost, high resolution passive matrix. Their unique look, high reflectivity, bistability, and simple structure make them an ideal flat panel display choice for handheld or other portable devices where small lightweight batteries with long lifetimes are important. We discuss recent advances in cholesteric display technology at Kent Displays such as progress towards single layer black and white displays, standard products, lower cost display modules, and various interface options for cholesteric display applications. It will be shown that inclusion of radio frequency (rf) control options and serial peripheral interface (spi) can greatly enhance the cholesteric display module market penetration by enabling quick integration into end devices. Finally, some discussion will be on the progress of the development of flexible reflective cholesteric displays. These flexible displays can dramatically change industrial design methods by enabling curved surfaces with displays integrated in them. Additional discussion in the paper will include applications of various display modes including signs, hand held instrumentation, and the electronic book and reader.

  15. Effectiveness outcomes and health related quality of life impact of disease progression in patients with advanced nonsquamous NSCLC treated in real-world community oncology settings: results from a prospective medical record registry study.

    PubMed

    Walker, Mark S; Wong, William; Ravelo, Arliene; Miller, Paul J E; Schwartzberg, Lee S

    2017-08-14

    Treatment options for advanced nonsquamous non-small cell lung cancer (NSCLC) in the first line include platinum-based doublet therapy with or without bevacizumab. This study examined efficacy outcomes and patient reported outcomes (PROs) in a community oncology patient sample. Advanced nonsquamous NSCLC patients from 34 U.S. community oncology practices treated in first line with bevacizumab regimens (A platinum doublet; gemcitabine doublet; pemetrexed with platinum) or non-bevacizumab regimens (B platinum doublet; gemcitabine doublet; C pemetrexed with platinum) were recruited for this prospective study. Patient characteristics and clinical outcomes were accessed from routine care records. Three validated and widely used PRO measures of health related quality of life (HRQOL) and symptom burden were collected prospectively at each visit and up to one-year follow-up. Effectiveness outcomes were progression free survival (PFS) and overall survival (OS) assessed by Kaplan-Meier and Cox regression methods. PROs were analyzed with linear mixed model regression to examine changes over time, and the effect of disease progression. Of 147 patients in the study, 145 provided PRO data. Patients in treatment groups were: A (n = 66, 44.9%); B (n = 25, 17.0%); C (n = 56, 38.1%). A was associated with significantly longer OS than B (HR = 0.341, p = 0.0012), and significantly longer than C (HR = 0.602, p = 0.0354). PFS results were similar. Irrespective of regimen group and on 12/32 measures, patients showed significant and clinically meaningful worsening of symptoms and HRQOL at disease progression. After disease progression, the pattern of symptom and HRQOL change showed continued worsening. Bevacizumab-containing regimens were associated with longer PFS and OS compared with non-bevacizumab regimens. PRO measures show disease progression is associated with worsening HRQOL. Delaying disease progression can sustain better HRQL and reduce symptom burden.

  16. Making Polymeric Microspheres

    NASA Technical Reports Server (NTRS)

    Rhim, Won-Kyu; Hyson, Michael T.; Chung, Sang-Kun; Colvin, Michael S.; Chang, Manchium

    1989-01-01

    Combination of advanced techniques yields uniform particles for biomedical applications. Process combines ink-jet and irradiation/freeze-polymerization techniques to make polymeric microspheres of uniform size in diameters from 100 to 400 micrometer. Microspheres used in chromatography, cell sorting, cell labeling, and manufacture of pharmaceutical materials.

  17. Progress toward a Semantic eScience Framework; building on advanced cyberinfrastructure

    NASA Astrophysics Data System (ADS)

    McGuinness, D. L.; Fox, P. A.; West, P.; Rozell, E.; Zednik, S.; Chang, C.

    2010-12-01

    The configurable and extensible semantic eScience framework (SESF) has begun development and implementation of several semantic application components. Extensions and improvements to several ontologies have been made based on distinct interdisciplinary use cases ranging from solar physics, to biologicl and chemical oceanography. Importantly, these semantic representations mediate access to a diverse set of existing and emerging cyberinfrastructure. Among the advances are the population of triple stores with web accessible query services. A triple store is akin to a relational data store where the basic stored unit is a subject-predicate-object tuple. Access via a query is provided by the W3 Recommendation language specification SPARQL. Upon this middle tier of semantic cyberinfrastructure, we have developed several forms of semantic faceted search, including provenance-awareness. We report on the rapid advances in semantic technologies and tools and how we are sustaining the software path for the required technical advances as well as the ontology improvements and increased functionality of the semantic applications including how they are integrated into web-based portals (e.g. Drupal) and web services. Lastly, we indicate future work direction and opportunities for collaboration.

  18. Advance Care Planning for Serious Illness

    MedlinePlus

    ADVANCE CARE PLANNING FOR SERIOUS ILLNESS Making plans for the health care you want during a serious illness is called “advance care planning.” Planning involves learning about your illness, understanding choices ...

  19. Recent Progress in Light-Triggered Nanotheranostics for Cancer Treatment

    PubMed Central

    Zhang, Pengcheng; Hu, Chunhua; Ran, Wei; Meng, Jia; Yin, Qi; Li, Yaping

    2016-01-01

    Treatments of high specificity are desirable for cancer therapy. Light-triggered nanotheranostics (LTN) mediated cancer therapy could be one such treatment, as they make it possible to visualize and treat the tumor specifically in a light-controlled manner with a single injection. Because of their great potential in cancer therapy, many novel and powerful LTNs have been developed, and are mainly prepared from photosensitizers (PSs) ranging from small organic dyes such as porphyrin- and cyanine-based dyes, semiconducting polymers, to inorganic nanomaterials such as gold nanoparticles, transition metal chalcogenides, carbon nanotubes and graphene. Using LTNs and localized irradiation in combination, complete tumor ablation could be achieved in tumor-bearing animal models without causing significant toxicity. Given their great advances and promising future, we herein review LTNs that have been tested in vivo with a highlight on progress that has been made in the past a couple of years. The current challenges faced by these LTNs are also briefly discussed. PMID:27217830

  20. Recent Advances in Algal Genetic Tool Development

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

    R. Dahlin, Lukas; T. Guarnieri, Michael

    The goal of achieving cost-effective biofuels and bioproducts derived from algal biomass will require improvements along the entire value chain, including identification of robust, high-productivity strains and development of advanced genetic tools. Though there have been modest advances in development of genetic systems for the model alga Chlamydomonas reinhardtii, progress in development of algal genetic tools, especially as applied to non-model algae, has generally lagged behind that of more commonly utilized laboratory and industrial microbes. This is in part due to the complex organellar structure of algae, including robust cell walls and intricate compartmentalization of target loci, as well asmore » prevalent gene silencing mechanisms, which hinder facile utilization of conventional genetic engineering tools and methodologies. However, recent progress in global tool development has opened the door for implementation of strain-engineering strategies in industrially-relevant algal strains. Here, we review recent advances in algal genetic tool development and applications in eukaryotic microalgae.« less

  1. Recent Advances in Algal Genetic Tool Development

    DOE PAGES

    R. Dahlin, Lukas; T. Guarnieri, Michael

    2016-06-24

    The goal of achieving cost-effective biofuels and bioproducts derived from algal biomass will require improvements along the entire value chain, including identification of robust, high-productivity strains and development of advanced genetic tools. Though there have been modest advances in development of genetic systems for the model alga Chlamydomonas reinhardtii, progress in development of algal genetic tools, especially as applied to non-model algae, has generally lagged behind that of more commonly utilized laboratory and industrial microbes. This is in part due to the complex organellar structure of algae, including robust cell walls and intricate compartmentalization of target loci, as well asmore » prevalent gene silencing mechanisms, which hinder facile utilization of conventional genetic engineering tools and methodologies. However, recent progress in global tool development has opened the door for implementation of strain-engineering strategies in industrially-relevant algal strains. Here, we review recent advances in algal genetic tool development and applications in eukaryotic microalgae.« less

  2. Sequencing-based diagnostics for pediatric genetic diseases: progress and potential

    PubMed Central

    Tayoun, Ahmad Abou; Krock, Bryan; Spinner, Nancy B.

    2016-01-01

    Introduction The last two decades have witnessed revolutionary changes in clinical diagnostics, fueled by the Human Genome Project and advances in high throughput, Next Generation Sequencing (NGS). We review the current state of sequencing-based pediatric diagnostics, associated challenges, and future prospects. Areas Covered We present an overview of genetic disease in children, review the technical aspects of Next Generation Sequencing and the strategies to make molecular diagnoses for children with genetic disease. We discuss the challenges of genomic sequencing including incomplete current knowledge of variants, lack of data about certain genomic regions, mosaicism, and the presence of regions with high homology. Expert Commentary NGS has been a transformative technology and the gap between the research and clinical communities has never been so narrow. Therapeutic interventions are emerging based on genomic findings and the applications of NGS are progressing to prenatal genetics, epigenomics and transcriptomics. PMID:27388938

  3. Making progress: the role of cancer councils in Australia in indigenous cancer control

    PubMed Central

    2014-01-01

    Background Indigenous Australians have poorer outcomes from cancer for a variety of reasons including poorer participation in screening programs, later diagnosis, higher rates of cancer with poor prognosis and poorer uptake and completion of treatment. Cancer prevention and support for people with cancer is part of the core business of the State and Territory Cancer Councils. To support sharing of lessons learned, this paper reports an environmental scan undertaken in 2010 in cancer councils (CCs) nationwide that aimed to support Indigenous cancer control. Methods The methods replicated the approach used in a 2006 environmental scan of Indigenous related activity in CCs. The Chief Executive Officer of each CC nominated individuals for interview. Interviews explored staffing, projects, programs and activities to progress cancer control issues for Indigenous Australians, through phone or face-to-face interviews. Reported initiatives were tabulated using predetermined categories of activity and summaries were returned to interviewees, the Aboriginal and Torres Strait Islander Subcommittee and Chief Executive Officers for verification. Results All CCs participated and modest increases in activity had occurred in most states since 2006 through different means. Indigenous staff numbers were low and no Indigenous person had yet been employed in smaller CCs; no CC had an Indigenous Board member and efforts at capacity building were often directed outside of the organisation. Developing partnerships with Indigenous organisations were ongoing. Acknowledgement and specific mention of Indigenous people in policy was increasing. Momentum increased following the establishment of a national subcommittee which increased the profile of Indigenous issues and provided collegial and practical support for those committed to reducing Indigenous cancer disparities. Government funding of “Closing the Gap” and research in the larger CCs have been other avenues for increasing knowledge

  4. Making progress: the role of cancer councils in Australia in indigenous cancer control.

    PubMed

    Thompson, Sandra C; Shahid, Shaouli; DiGiacomo, Michelle; Pilkington, Leanne; Davidson, Patricia M

    2014-04-11

    Indigenous Australians have poorer outcomes from cancer for a variety of reasons including poorer participation in screening programs, later diagnosis, higher rates of cancer with poor prognosis and poorer uptake and completion of treatment. Cancer prevention and support for people with cancer is part of the core business of the State and Territory Cancer Councils. To support sharing of lessons learned, this paper reports an environmental scan undertaken in 2010 in cancer councils (CCs) nationwide that aimed to support Indigenous cancer control. The methods replicated the approach used in a 2006 environmental scan of Indigenous related activity in CCs. The Chief Executive Officer of each CC nominated individuals for interview. Interviews explored staffing, projects, programs and activities to progress cancer control issues for Indigenous Australians, through phone or face-to-face interviews. Reported initiatives were tabulated using predetermined categories of activity and summaries were returned to interviewees, the Aboriginal and Torres Strait Islander Subcommittee and Chief Executive Officers for verification. All CCs participated and modest increases in activity had occurred in most states since 2006 through different means. Indigenous staff numbers were low and no Indigenous person had yet been employed in smaller CCs; no CC had an Indigenous Board member and efforts at capacity building were often directed outside of the organisation. Developing partnerships with Indigenous organisations were ongoing. Acknowledgement and specific mention of Indigenous people in policy was increasing. Momentum increased following the establishment of a national subcommittee which increased the profile of Indigenous issues and provided collegial and practical support for those committed to reducing Indigenous cancer disparities. Government funding of "Closing the Gap" and research in the larger CCs have been other avenues for increasing knowledge and activity in Indigenous

  5. Scientific and Technological Progress and Job Qualification.

    ERIC Educational Resources Information Center

    Ivanov, N. P.

    Clarifying the influences determining how and to what extent highly qualified personnel are employed, this study discusses those sorts of economic and technological advances affecting employment potentials. Two main trends in scientific and technological progress--computerized industries and the high science-content of production--have so…

  6. Re-Evaluating Progression in an Era of Progress: A Review of First- and Second-Line Treatment Options in Anaplastic Lymphoma Kinase-Positive Non-Small Cell Lung Cancer.

    PubMed

    Castellanos, Emily H; Horn, Leora

    2016-06-01

    : The advent of crizotinib, the first small molecule inhibitor against anaplastic lymphoma kinase (ALK), has led to impressive advances in the care of patients with advanced ALK-rearranged non-small cell lung cancer. The development of second-generation ALK inhibitors, starting with the recent U.S. Food and Drug Administration approval of ceritinib, promises to expand the therapeutic landscape for this cohort of patients. With increasing use of molecularly targeted therapy options, it has been observed that disease progression in patients receiving targeted agents has a heterogeneous biology, manifesting as either oligoprogressive or widely progressive disease, which may require development of innovative treatment strategies. This review discusses the first- and second-generation ALK inhibitors approved or in clinical development, as well as the novel challenges and approaches to disease progression in patients on targeted agents. The identification of driver mutations in non-small cell lung cancer (NSCLC), most prominently epidermal growth factor receptor (EGFR) and anaplastic lymphoma kinase (ALK), has expanded treatment options for a significant cohort of patients. However, the success of targeted agents has brought new challenges, particularly regarding management of progression. Progression manifests heterogeneously, and management of oligoprogression may differ from diffusely progressive disease. Multiple options for treatment at progression exist, and it is becoming evident that selecting the best avenue of care requires understanding the biology and potential drivers of disease progression. This review discusses the array of treatment options available for patients with ALK-positive NSCLC, as well as evaluation and treatment of progressive disease. ©AlphaMed Press.

  7. Re-Evaluating Progression in an Era of Progress: A Review of First- and Second-Line Treatment Options in Anaplastic Lymphoma Kinase-Positive Non-Small Cell Lung Cancer

    PubMed Central

    Castellanos, Emily H.

    2016-01-01

    The advent of crizotinib, the first small molecule inhibitor against anaplastic lymphoma kinase (ALK), has led to impressive advances in the care of patients with advanced ALK-rearranged non-small cell lung cancer. The development of second-generation ALK inhibitors, starting with the recent U.S. Food and Drug Administration approval of ceritinib, promises to expand the therapeutic landscape for this cohort of patients. With increasing use of molecularly targeted therapy options, it has been observed that disease progression in patients receiving targeted agents has a heterogeneous biology, manifesting as either oligoprogressive or widely progressive disease, which may require development of innovative treatment strategies. This review discusses the first- and second-generation ALK inhibitors approved or in clinical development, as well as the novel challenges and approaches to disease progression in patients on targeted agents. Implications for Practice: The identification of driver mutations in non-small cell lung cancer (NSCLC), most prominently epidermal growth factor receptor (EGFR) and anaplastic lymphoma kinase (ALK), has expanded treatment options for a significant cohort of patients. However, the success of targeted agents has brought new challenges, particularly regarding management of progression. Progression manifests heterogeneously, and management of oligoprogression may differ from diffusely progressive disease. Multiple options for treatment at progression exist, and it is becoming evident that selecting the best avenue of care requires understanding the biology and potential drivers of disease progression. This review discusses the array of treatment options available for patients with ALK-positive NSCLC, as well as evaluation and treatment of progressive disease. PMID:27053502

  8. Content of Advance Directives for Individuals with Advanced Dementia

    PubMed Central

    Black, Betty S.; Phillips, Hilary; Fahrendorf, Sarah Richardson; Schwartz, Jack; Angelino, Andrew F.; Anderson, Danielle; Rabins, Peter V.

    2010-01-01

    Objectives To examine how people with end-stage dementia have conveyed their wishes for end-of-life care in advance directives. Methods The documents of 123 residents of three Maryland nursing homes, all with end-stage dementia, were reviewed. Results More years of education and White race were significantly associated with having an advance directive. With the exceptions of comfort care and pain treatment, advance directives were used primarily to restrict, not request, many forms of care at the end-of-life. Decisions about care for end-stage conditions such as Alzheimer's dementia are less often addressed in these documents than for terminal conditions and persistent vegetative state. Discussion In order for advance directives to better reflect a person's wishes, discussions with individuals and families about advance directives should include a range of care issues in the settings of terminal illness, persistent vegetative state or end-stage illness. These documents should be reviewed periodically to make certain they convey accurately the person's treatment preferences. PMID:18625761

  9. Patients with ALS show highly correlated progression rates in left and right limb muscles.

    PubMed

    Rushton, David J; Andres, Patricia L; Allred, Peggy; Baloh, Robert H; Svendsen, Clive N

    2017-07-11

    Amyotrophic lateral sclerosis (ALS) progresses at different rates between patients, making clinical trial design difficult and dependent on large cohorts of patients. Currently, there are few data showing whether the left and right limbs progress at the same or different rates. This study addresses rates of decline in specific muscle groups of patients with ALS and assesses whether there is a relationship between left and right muscles in the same patient, regardless of overall progression. A large cohort of patients was used to assess decline in muscle strength in right and left limbs over time using 2 different methods: The Tufts Quantitative Neuromuscular Exam and Accurate Test of Limb Isometric Strength protocol. Then advanced linear regression statistical methods were applied to assess progression rates in each limb. This report shows that linearized progression models can predict general slopes of decline with good accuracy. Critically, the data demonstrate that while overall decline is variable, there is a high degree of correlation between left and right muscle decline in ALS. This implies that irrespective of which muscle starts declining soonest or latest, their rates of decline following onset are more consistent. First, this study demonstrates a high degree of power when using unilateral treatment approaches to detect a slowing in disease progression in smaller groups of patients, thus allowing for paired statistical tests. These findings will be useful in transplantation trials that use muscle decline to track disease progression in ALS. Second, these findings discuss methods, such as tactical selection of muscle groups, which can improve the power efficiency of all ALS clinical trials. Copyright © 2017 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of the American Academy of Neurology.

  10. Remote Sensing of Aerosols from Satellites: Why Has It Been Do Difficult to Quantify Aerosol-Cloud Interactions for Climate Assessment, and How Can We Make Progress?

    NASA Technical Reports Server (NTRS)

    Kahn, Ralph A.

    2015-01-01

    The organizers of the National Academy of Sciences Arthur M. Sackler Colloquia Series on Improving Our Fundamental Understanding of the Role of Aerosol-Cloud Interactions in the Climate System would like to post Ralph Kahn's presentation entitled Remote Sensing of Aerosols from Satellites: Why has it been so difficult to quantify aerosol-cloud interactions for climate assessment, and how can we make progress? to their public website.

  11. Advancing automation and robotics technology for the space station and for the US economy

    NASA Technical Reports Server (NTRS)

    Nunamaker, Robert

    1988-01-01

    In April 1985, as required by Public Law 98-371, the NASA Advanced Technology Advisory Committee (ATAC) reported to Congress the results of its studies on advanced automation and robotics technology for use on the Space Station. This material was documented in the initial report (NASA Technical Memo 87566). A further requirement of the law was that ATAC follow NASA's progress in this area and report to Congress semiannually. This report is the sixth in a series of progress updates and covers the period between October 1, 1987 and March 1, 1988. NASA has accepted the basic recommendations of ATAC for its Space Station efforts. ATAC and NASA agree that the thrust of Congress is to build an advanced automation and robotics technology base that will support an evolutionary Space Station program and serve as a highly visible stimulator affecting the U.S. long-term economy. The progress report identifies the work of NASA and the Space Station study contractors, research in progress, and issues connected with the advancement of automation and robotics technology on the Space Station.

  12. Advancing automation and robotics technology for the space station and for the US economy

    NASA Technical Reports Server (NTRS)

    1986-01-01

    In April 1985, as required by Public Law 98-371, the NASA Advanced Technology Advisory Committee (ATAC) reported to Congress the results of its studies on advanced automation and robotics technology for use on the Space Station. This material was documented in the initial report (NASA Technical Memorandum 87566). A further requirement of the Law was that ATAC follow NASA's progress in this area and report to Congress semiannually. This report is the second in a series of progress updates and covers the period between October 4, 1985, and March 31, l986. NASA has accepted the basic recommendations of ATAC for its Space Station efforts. ATAC and NASA agree that thrust of Congress is to build an advanced automation and robotics technology base that will support an evolutionary Space Station Program and serve as a highly visible stimulator effecting the U.S. long-term economy. The progress report identifies the work of NASA and the Space Station study contractors, research in progress, and issues connected with the advancement of automation and robotics technology on the Space Station.

  13. Fluctuating capacity and advance decision-making in Bipolar Affective Disorder — Self-binding directives and self-determination

    PubMed Central

    Gergel, Tania; Owen, Gareth S.

    2015-01-01

    For people with Bipolar Affective Disorder, a self-binding (advance) directive (SBD), by which they commit themselves to treatment during future episodes of mania, even if unwilling, can seem the most rational way to deal with an imperfect predicament. Knowing that mania will almost certainly cause enormous damage to themselves, their preferred solution may well be to allow trusted others to enforce treatment and constraint, traumatic though this may be. No adequate provision exists for drafting a truly effective SBD and efforts to establish such provision are hampered by very valid, but also paralysing ethical, clinical and legal concerns. Effectively, the autonomy and rights of people with bipolar are being ‘protected’ through being denied an opportunity to protect themselves. From a standpoint firmly rooted in the clinical context and experience of mania, this article argues that an SBD, based on a patient-centred evaluation of capacity to make treatment decisions (DMC-T) and grounded within the clinician–patient relationship, could represent a legitimate and ethically coherent form of self-determination. After setting out background information on fluctuating capacity, mania and advance directives, this article proposes a framework for constructing such an SBD, and considers common objections, possible solutions and suggestions for future research. PMID:25939286

  14. Consensus statement of the International Summit on Intellectual Disability and Dementia related to end-of-life care in advanced dementia.

    PubMed

    McCallion, Philip; Hogan, Mary; Santos, Flavia H; McCarron, Mary; Service, Kathryn; Stemp, Sandy; Keller, Seth; Fortea, Juan; Bishop, Kathleen; Watchman, Karen; Janicki, Matthew P

    2017-11-01

    Adults with intellectual disability are affected by dementia at equivalent and elevated rates, many surviving into advanced age. End of life care and support considerations come into play among these individuals when most are in the advanced stage of dementia. A preliminary report summarizing available literature and making initial recommendations was developed by a workgroup, reviewed by all conference participants and then was finalized by the workgroup. The International Summit on Intellectual Disability and Dementia produced a report on End of life care in advanced dementia that provides a synthesis statement which encompasses defining the state of advanced dementia, proposes use of palliative care services (including hospice) and recommends special efforts for enabling advanced directives and advance care planning prior to the extensive progression of dementia. The Summit further recommended that when aiding adults with advanced dementia, the following be undertaken: integrative efforts between intellectual disability and palliative care providers, specialized training for carers on end of life care and supports, and involvement of adults with intellectual disability early on in their advance care planning. The Consensus recommendations will ensure greater and more appropriate support at end of life for persons with intellectual disabilities and advanced dementia. © 2017 John Wiley & Sons Ltd.

  15. Cancer Stem-like Cells Act via Distinct Signaling Pathways in Promoting Late Stages of Malignant Progression.

    PubMed

    da Silva-Diz, Victoria; Simón-Extremera, Pilar; Bernat-Peguera, Adrià; de Sostoa, Jana; Urpí, Maria; Penín, Rosa M; Sidelnikova, Diana Pérez; Bermejo, Oriol; Viñals, Joan Maria; Rodolosse, Annie; González-Suárez, Eva; Moruno, Antonio Gómez; Pujana, Miguel Ángel; Esteller, Manel; Villanueva, Alberto; Viñals, Francesc; Muñoz, Purificación

    2016-03-01

    Cancer stem-like cells (CSC) play key roles in long-term tumor propagation and metastasis, but their dynamics during disease progression are not understood. Tumor relapse in patients with initially excised skin squamous cell carcinomas (SCC) is characterized by increased metastatic potential, and SCC progression is associated with an expansion of CSC. Here, we used genetically and chemically-induced mouse models of skin SCC to investigate the signaling pathways contributing to CSC function during disease progression. We found that CSC regulatory mechanisms change in advanced SCC, correlating with aggressive tumor growth and enhanced metastasis. β-Catenin and EGFR signaling, induced in early SCC CSC, were downregulated in advanced SCC. Instead, autocrine FGFR1 and PDGFRα signaling, which have not been previously associated with skin SCC CSC, were upregulated in late CSC and promoted tumor growth and metastasis, respectively. Finally, high-grade and recurrent human skin SCC recapitulated the signaling changes observed in advanced mouse SCC. Collectively, our findings suggest a stage-specific switch in CSC regulation during disease progression that could be therapeutically exploited by targeting the PDGFR and FGFR1 pathways to block relapse and metastasis of advanced human skin SCC. ©2015 American Association for Cancer Research.

  16. Progress in the ecology and conservation of giant pandas.

    PubMed

    Wei, Fuwen; Swaisgood, Ronald; Hu, Yibo; Nie, Yonggang; Yan, Li; Zhang, Zejun; Qi, Dunwu; Zhu, Lifeng

    2015-12-01

    Giant panda (Ailuropoda melanoleuca) conservation is a possible success story in the making. If extinction of this iconic endangered species can be avoided, the species will become a showcase program for the Chinese government and its collaborators. We reviewed the major advancements in ecological science for the giant panda, examining how these advancements have contributed to panda conservation. Pandas' morphological and behavioral adaptations to a diet of bamboo, which bear strong influence on movement ecology, have been well studied, providing knowledge to guide management actions ranging from reserve design to climate change mitigation. Foraging ecology has also provided essential information used in the creation of landscape models of panda habitat. Because habitat loss and fragmentation are major drivers of the panda population decline, efforts have been made to help identify core habitat areas, establish where habitat corridors are needed, and prioritize areas for protection and restoration. Thus, habitat models have provided guidance for the Chinese governments' creation of 67 protected areas. Behavioral research has revealed a complex and efficient communication system and documented the need for protection of habitat that serves as a communication platform for bringing the sexes together for mating. Further research shows that den sites in old-growth forests may be a limiting resource, indicating potential value in providing alternative den sites for rearing offspring. Advancements in molecular ecology have been revolutionary and have been applied to population census, determining population structure and genetic diversity, evaluating connectivity following habitat fragmentation, and understanding dispersal patterns. These advancements form a foundation for increasing the application of adaptive management approaches to move panda conservation forward more rapidly. Although the Chinese government has made great progress in setting aside protected areas

  17. 40 CFR 35.938-6 - Progress payments to contractors.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... FEDERAL ASSISTANCE STATE AND LOCAL ASSISTANCE Grants for Construction of Treatment Works-Clean Water Act... should make prompt progress payment to subcontractors and suppliers for eligible construction, material... under a contract under an EPA construction grant. (b) Conditions of progress payments. For purposes of...

  18. 7 CFR 4287.156 - Protective advances.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... preserves collateral and recovery is actually enhanced by making the advance. Protective advances will not be made in lieu of additional loans. (a) The maximum loss to be paid by the Agency will never exceed...

  19. 7 CFR 4287.156 - Protective advances.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... preserves collateral and recovery is actually enhanced by making the advance. Protective advances will not be made in lieu of additional loans. (a) The maximum loss to be paid by the Agency will never exceed...

  20. Nontraditional Families and Childhood Progress Through School

    PubMed Central

    ROSENFELD, MICHAEL J.

    2010-01-01

    I use U.S. census data to perform the first large-sample, nationally representative tests of outcomes for children raised by same-sex couples. The results show that children of same-sex couples are as likely to make normal progress through school as the children of most other family structures. Heterosexual married couples are the family type whose children have the lowest rates of grade retention, but the advantage of heterosexual married couples is mostly due to their higher socioeconomic status. Children of all family types (including children of same-sex couples) are far more likely to make normal progress through school than are children living in group quarters (such as orphanages and shelters). PMID:20879687

  1. The promise of advanced technology for future air transports

    NASA Technical Reports Server (NTRS)

    Bower, R. E.

    1978-01-01

    Progress in all weather 4-D navigation and wake vortex attenuation research is discussed and the concept of time based metering of aircraft is recommended for increased emphasis. The far term advances in aircraft efficiency were shown to be skin friction reduction and advanced configuration types. The promise of very large aircraft, possibly all wing aircraft is discussed, as is an advanced concept for an aerial relay transportation system. Very significant technological developments were identified that can improve supersonic transport performance and reduce noise. The hypersonic transport was proposed as the ultimate step in air transportation in the atmosphere. Progress in the key technology areas of propulsion and structures was reviewed. Finally, the impact of alternate fuels on future air transports was considered and shown not to be a growth constraint.

  2. FY2017 Advanced Combustion Systems and Fuels Annual Progress Report

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

    None, None

    The Advanced Combustion Systems and Fuels Program supports VTO’s goal and focuses early-stage research and development (R&D) to improve understanding of the combustion processes, fuel properties, and emission control technologies while generating knowledge and insight necessary for industry to develop the next generation of engines.

  3. Palbociclib Combined with Fulvestrant in Premenopausal Women with Advanced Breast Cancer and Prior Progression on Endocrine Therapy: PALOMA-3 Results.

    PubMed

    Loibl, Sibylle; Turner, Nicholas C; Ro, Jungsil; Cristofanilli, Massimo; Iwata, Hiroji; Im, Seock-Ah; Masuda, Norikazu; Loi, Sherene; André, Fabrice; Harbeck, Nadia; Verma, Sunil; Folkerd, Elizabeth; Puyana Theall, Kathy; Hoffman, Justin; Zhang, Ke; Bartlett, Cynthia Huang; Dowsett, Mitchell

    2017-09-01

    The efficacy and safety of palbociclib, a cyclin-dependent kinase 4/6 inhibitor, combined with fulvestrant and goserelin was assessed in premenopausal women with advanced breast cancer (ABC) who had progressed on prior endocrine therapy (ET). One hundred eight premenopausal endocrine-refractory women ≥18 years with hormone receptor-positive (HR+)/human epidermal growth factor receptor 2-negative (HER2-) ABC were among 521 women randomized 2:1 (347:174) to fulvestrant (500 mg) ± goserelin with either palbociclib (125 mg/day orally, 3 weeks on, 1 week off) or placebo. This analysis assessed whether the overall tolerable safety profile and significant progression-free survival (PFS) improvement extended to premenopausal women. Potential drug-drug interactions (DDIs) and ovarian suppression with goserelin were assessed via plasma pharmacokinetics and biochemical analyses, respectively. (ClinicalTrials.gov identifier: NCT01942135) RESULTS: Median PFS for premenopausal women in the palbociclib ( n  = 72) versus placebo arm ( n  = 36) was 9.5 versus 5.6 months, respectively (hazard ratio, 0.50, 95% confidence interval: 0.29-0.87), and consistent with the significant PFS improvement in the same arms for postmenopausal women. Any-grade and grade ≤3 neutropenia, leukopenia, and infections were among the most frequent adverse events reported in the palbociclib arm with concurrent goserelin administration. Hormone concentrations were similar between treatment arms and confirmed sustained ovarian suppression. Clinically relevant DDIs were not observed. Palbociclib combined with fulvestrant and goserelin was an effective and well-tolerated treatment for premenopausal women with prior endocrine-resistant HR+/HER2- ABC. Inclusion of both premenopausal and postmenopausal women in pivotal combination ET trials facilitates access to novel drugs for young women and should be considered as a new standard for clinical trial design. PALOMA-3, the first registrational

  4. Patients' preferences for participation in treatment decision-making at the end of life: qualitative interviews with advanced cancer patients.

    PubMed

    Brom, Linda; Pasman, H Roeline W; Widdershoven, Guy A M; van der Vorst, Maurice J D L; Reijneveld, Jaap C; Postma, Tjeerd J; Onwuteaka-Philipsen, Bregje D

    2014-01-01

    Patients are often encouraged to participate in treatment decision-making. Most studies on this subject focus on choosing between different curative treatment types. In the last phase of life treatment decisions differ as they often put more emphasis on weighing quantity against quality of life, such as whether or not to start treatment aimed at life prolongation but with the possibility of side effects. This study aimed to obtain insight into cancer patients' preferences and the reasons for patients' preferred role in treatment decision-making at the end of life. 28 advanced cancer patients were included at the start of their first line treatment. In-depth interviews were held prior to upcoming treatment decisions whether or not to start a life prolonging treatment. The Control Preference Scale was used to start discussing the extent and type of influence patients wanted to have concerning upcoming treatment decision-making. Interviews were audio taped and transcribed. All patients wanted their physician to participate in the treatment decision-making process. The extent to which patients themselves preferred to participate seemed to depend on how patients saw their own role or assessed their own capabilities for participating in treatment decision-making. Patients foresaw a shift in the preferred level of participation to a more active role depending in the later phase of illness when life prolongation would become more limited and quality of life would become more important. Patients vary in how much involvement they would like to have in upcoming treatment decision-making. Individual patients' preferences may change in the course of the illness, with a shift to more active participation in the later phases. Communication about patients' expectations, wishes and preferences for participation in upcoming treatment decisions is of great importance. An approach in which these topics are openly discussed would be beneficial.

  5. Advanced Nursing Education: Critical Factors That Influence Diploma and Associate Degree Nurses to Advance.

    PubMed

    McGhie-Anderson, Rose Lavine

    The purpose of this study was to gain an understanding of the social processes associated with the decision of diploma and associate degree nurses to advance academically. Advanced nursing education needs to be pursued along the continuum of the nursing career path. This education process is indispensable to the role of nurses as educator, manager, nurse leader, and researcher who will effect policy changes, assume leadership roles as revolutionary thinkers, and implement paradigmatic shifts. Data were collected from two groups of participants using face-to-face, semistructured interviews. Group 1 consisted of diploma and associate degree nurses; Group 2 consisted of baccalaureate, masters, and doctoral degree nurses who have progressed academically. Emerging from the thick, rich data were core categories of rewarding, motivating, and supporting as critical factors that influence professional advancement. This qualitative study elucidated that professional advancement was the social process that grounds. The emergent theory was the theory of professional advancement.

  6. The Real-World Problem of Care Coordination: A Longitudinal Qualitative Study with Patients Living with Advanced Progressive Illness and Their Unpaid Caregivers

    PubMed Central

    Daveson, Barbara A.; Harding, Richard; Shipman, Cathy; Mason, Bruce L.; Epiphaniou, Eleni; Higginson, Irene J.; Ellis-Smith, Clare; Henson, Lesley; Munday, Dan; Nanton, Veronica; Dale, Jeremy R.; Boyd, Kirsty; Worth, Allison; Barclay, Stephen; Donaldson, Anne; Murray, Scott

    2014-01-01

    Objectives To develop a model of care coordination for patients living with advanced progressive illness and their unpaid caregivers, and to understand their perspective regarding care coordination. Design A prospective longitudinal, multi-perspective qualitative study involving a case-study approach. Methods Serial in-depth interviews were conducted, transcribed verbatim and then analyzed through open and axial coding in order to construct categories for three cases (sites). This was followed by continued thematic analysis to identify underlying conceptual coherence across all cases in order to produce one coherent care coordination model. Participants Fifty-six purposively sampled patients and 27 case-linked unpaid caregivers. Settings Three cases from contrasting primary, secondary and tertiary settings within Britain. Results Coordination is a deliberate cross-cutting action that involves high-quality, caring and well-informed staff, patients and unpaid caregivers who must work in partnership together across health and social care settings. For coordination to occur, it must be adequately resourced with efficient systems and services that communicate. Patients and unpaid caregivers contribute substantially to the coordination of their care, which is sometimes volunteered at a personal cost to them. Coordination is facilitated through flexible and patient-centered care, characterized by accurate and timely information communicated in a way that considers patients’ and caregivers’ needs, preferences, circumstances and abilities. Conclusions Within the midst of advanced progressive illness, coordination is a shared and complex intervention involving relational, structural and information components. Our study is one of the first to extensively examine patients’ and caregivers’ views about coordination, thus aiding conceptual fidelity. These findings can be used to help avoid oversimplifying a real-world problem, such as care coordination. Avoiding

  7. The real-world problem of care coordination: a longitudinal qualitative study with patients living with advanced progressive illness and their unpaid caregivers.

    PubMed

    Daveson, Barbara A; Harding, Richard; Shipman, Cathy; Mason, Bruce L; Epiphaniou, Eleni; Higginson, Irene J; Ellis-Smith, Clare; Henson, Lesley; Munday, Dan; Nanton, Veronica; Dale, Jeremy R; Boyd, Kirsty; Worth, Allison; Barclay, Stephen; Donaldson, Anne; Murray, Scott

    2014-01-01

    To develop a model of care coordination for patients living with advanced progressive illness and their unpaid caregivers, and to understand their perspective regarding care coordination. A prospective longitudinal, multi-perspective qualitative study involving a case-study approach. Serial in-depth interviews were conducted, transcribed verbatim and then analyzed through open and axial coding in order to construct categories for three cases (sites). This was followed by continued thematic analysis to identify underlying conceptual coherence across all cases in order to produce one coherent care coordination model. Fifty-six purposively sampled patients and 27 case-linked unpaid caregivers. Three cases from contrasting primary, secondary and tertiary settings within Britain. Coordination is a deliberate cross-cutting action that involves high-quality, caring and well-informed staff, patients and unpaid caregivers who must work in partnership together across health and social care settings. For coordination to occur, it must be adequately resourced with efficient systems and services that communicate. Patients and unpaid caregivers contribute substantially to the coordination of their care, which is sometimes volunteered at a personal cost to them. Coordination is facilitated through flexible and patient-centered care, characterized by accurate and timely information communicated in a way that considers patients' and caregivers' needs, preferences, circumstances and abilities. Within the midst of advanced progressive illness, coordination is a shared and complex intervention involving relational, structural and information components. Our study is one of the first to extensively examine patients' and caregivers' views about coordination, thus aiding conceptual fidelity. These findings can be used to help avoid oversimplifying a real-world problem, such as care coordination. Avoiding oversimplification can help with the development, evaluation and implementation of

  8. The Employment Retention and Advancement Project: Paths to Advancement for Single Parents. Executive Summary

    ERIC Educational Resources Information Center

    Miller, Cynthia; Deitch, Victoria; Hill, Aaron

    2010-01-01

    Between 2000 and 2003, the Employment Retention and Advancement (ERA) project identified and implemented a diverse set of innovative models designed to promote employment stability and wage or earnings progression among low-income individuals, mostly current or former welfare recipients. The project's goal was to determine which strategies could…

  9. NASA Advanced Supercomputing Facility Expansion

    NASA Technical Reports Server (NTRS)

    Thigpen, William W.

    2017-01-01

    The NASA Advanced Supercomputing (NAS) Division enables advances in high-end computing technologies and in modeling and simulation methods to tackle some of the toughest science and engineering challenges facing NASA today. The name "NAS" has long been associated with leadership and innovation throughout the high-end computing (HEC) community. We play a significant role in shaping HEC standards and paradigms, and provide leadership in the areas of large-scale InfiniBand fabrics, Lustre open-source filesystems, and hyperwall technologies. We provide an integrated high-end computing environment to accelerate NASA missions and make revolutionary advances in science. Pleiades, a petaflop-scale supercomputer, is used by scientists throughout the U.S. to support NASA missions, and is ranked among the most powerful systems in the world. One of our key focus areas is in modeling and simulation to support NASA's real-world engineering applications and make fundamental advances in modeling and simulation methods.

  10. Advancing Stage 2 Research on Measures for Monitoring Kindergarten Reading Progress

    ERIC Educational Resources Information Center

    Clemens, Nathan H.; Soohoo, Michelle M.; Wiley, Colby P.; Hsiao, Yu-Yu; Estrella, Ivonne; Allee-Smith, Paula J.; Yoon, Myeongsun

    2018-01-01

    Although several measures exist for frequently monitoring early reading progress, little research has specifically investigated their technical properties when administered on a frequent basis with kindergarten students. In this study, kindergarten students (N = 137) of whom the majority was receiving supplemental intervention for reading skills…

  11. NASA's Space Launch System: Development and Progress

    NASA Technical Reports Server (NTRS)

    Honeycutt, John; Lyles, Garry

    2016-01-01

    NASA is embarked on a new era of space exploration that will lead to new capabilities, new destinations, and new discoveries by both human and robotic explorers. Today, the International Space Station (ISS), supported by NASA's commercial partners, and robotic probes, are yielding knowledge that will help make this exploration possible. NASA is developing both the Orion crew vehicle and the Space Launch System (SLS) that will carry out a series of increasingly challenging missions that will eventually lead to human exploration of Mars. This paper will discuss the development and progress on the SLS. The SLS architecture was designed to be safe, affordable, and sustainable. The current configuration is the result of literally thousands of trade studies involving cost, performance, mission requirements, and other metrics. The initial configuration of SLS, designated Block 1, will launch a minimum of 70 metric tons (t) into low Earth orbit - significantly greater capability than any current launch vehicle. It is designed to evolve to a capability of 130 t through the use of upgraded main engines, advanced boosters, and a new upper stage. With more payload mass and volume capability than any rocket in history, SLS offers mission planners larger payloads, faster trip times, simpler design, shorter design cycles, and greater opportunity for mission success. Since the program was officially created in fall 2011, it has made significant progress toward first launch readiness of the Block 1 vehicle in 2018. Every major element of SLS continued to make significant progress in 2015. The Boosters element fired Qualification Motor 1 (QM-1) in March 2015, to test the 5-segment motor, including new insulation, joint, and propellant grain designs. The Stages element marked the completion of more than 70 major components of test article and flight core stage tanks. The Liquid Engines element conducted seven test firings of an RS-25 engine under SLS conditions. The Spacecraft

  12. NASA's SPACE LAUNCH SYSTEM: Development and Progress

    NASA Technical Reports Server (NTRS)

    Honeycutt, John; Lyles, Garry

    2016-01-01

    NASA is embarked on a new era of space exploration that will lead to new capabilities, new destinations, and new discoveries by both human and robotic explorers. Today, the International Space Station (ISS) and robotic probes are yielding knowledge that will help make this exploration possible. NASA is developing both the Orion crew vehicle and the Space Launch System (SLS) (Figure 1), that will carry out a series of increasingly challenging missions leading to human exploration of Mars. This paper will discuss the development and progress on the SLS. The SLS architecture was designed to be safe, affordable, and sustainable. The current configuration is the result of literally thousands of trade studies involving cost, performance, mission requirements, and other metrics. The initial configuration of SLS, designated Block 1, will launch a minimum of 70 metric tons (mT) (154,324 pounds) into low Earth orbit - significantly greater capability than any current launch vehicle. It is designed to evolve to a capability of 130 mT (286,601 pounds) through the use of upgraded main engines, advanced boosters, and a new upper stage. With more payload mass and volume capability than any existing rocket, SLS offers mission planners larger payloads, faster trip times, simpler design, shorter design cycles, and greater opportunity for mission success. Since the program was officially created in fall 2011, it has made significant progress toward launch readiness in 2018. Every major element of SLS continued to make significant progress in 2015. Engineers fired Qualification Motor 1 (QM-1) in March 2015 to test the 5-segment motor, including new insulation, joint, and propellant grain designs. More than 70 major components of test article and flight hardware for the Core Stage have been manufactured. Seven test firings have been completed with an RS-25 engine under SLS operating conditions. The test article for the Interim Cryogenic Propulsion Stage (ICPS) has also been completed

  13. Advances in targeting strategies for nanoparticles in cancer imaging and therapy.

    PubMed

    Yhee, Ji Young; Lee, Sangmin; Kim, Kwangmeyung

    2014-11-21

    In the last decade, nanoparticles have offered great advances in diagnostic imaging and targeted drug delivery. In particular, nanoparticles have provided remarkable progress in cancer imaging and therapy based on materials science and biochemical engineering technology. Researchers constantly attempted to develop the nanoparticles which can deliver drugs more specifically to cancer cells, and these efforts brought the advances in the targeting strategy of nanoparticles. This minireview will discuss the progress in targeting strategies for nanoparticles focused on the recent innovative work for nanomedicine.

  14. Advanced Ablative TPS

    NASA Technical Reports Server (NTRS)

    Gasch, Matthew J.

    2011-01-01

    Early NASA missions (Gemini, Apollo, Mars Viking) employed new ablative TPS that were tailored for the entry environment. After 40 years, heritage ablative TPS materials using Viking or Pathfinder era materials are at or near their performance limits and will be inadequate for future exploration missions. Significant advances in TPS materials technology are needed in order to enable any subsequent human exploration missions beyond Low Earth Orbit. This poster summarizes some recent progress at NASA in developing families of advanced rigid/conformable and flexible ablators that could potentially be used for thermal protection in planetary entry missions. In particular the effort focuses technologies required to land heavy (approx.40 metric ton) masses on Mars to facilitate future exploration plans.

  15. Using Steffe's Advanced Fraction Schemes

    ERIC Educational Resources Information Center

    McCloskey, Andrea V.; Norton, Anderson H.

    2009-01-01

    Recognizing schemes, which are different from strategies, can help teachers understand their students' thinking about fractions. Using Steffe's advanced fraction schemes, the authors describe a progression of development that upper elementary and middle school students might follow in understanding fractions. Each scheme can be viewed as a…

  16. Progress in Advanced Placement and International Baccalaureate in SREB States. Challenge to Lead

    ERIC Educational Resources Information Center

    Kaye, Rebecca Daugherty

    2006-01-01

    Southern Regional Education Board (SREB) states lead the nation in student participation in Advanced Placement and International Baccalaureate Programs. SREB states know that getting students engaged in a challenging high school curriculum is the most important step they can take to promote college readiness. Advanced Placement (AP) courses and…

  17. Advancing automation and robotics technology for the Space Station Freedom and for the U.S. economy

    NASA Technical Reports Server (NTRS)

    Lum, Henry, Jr.

    1992-01-01

    In April 1985, as required by Public Law 98-371, the NASA Advanced Technology Advisory Committee (ATAC) reported to Congress the results of its studies on advanced automation and robotics technology for use on Space Station Freedom. This material was documented in the initial report (NASA Technical Memorandum 87566). A further requirement of the law was that ATAC follow NASA's progress in this area and report to Congress semiannually. This report is the fifteenth in a series of progress updates and covers the period between 27 Feb. - 17 Sep. 1992. The progress made by Levels 1, 2, and 3 of the Space Station Freedom in developing and applying advanced automation and robotics technology is described. Emphasis was placed upon the Space Station Freedom program responses to specific recommendations made in ATAC Progress Report 14. Assessments are presented for these and other areas as they apply to the advancement of automation and robotics technology for Space Station Freedom.

  18. Understanding Optimal Military Decision Making: Year 2 Progress Report

    DTIC Science & Technology

    2014-01-01

    measures. ARMY RELEVANCY AND MILITARY APPLICATION AREAS Objectively defining, measuring, and developing a means to assess military optimal decision making...has the potential to enhance training and refine procedures supporting more efficient learning and task accomplishment. Through the application of...26.79 (12.39) 7.94 (62.38) N/A = Not applicable ; as it is not possible to calculate this particular variable. Table 2. Descriptive statistics of

  19. Progress in nanotechnology for healthcare.

    PubMed

    Raffa, V; Vittorio, O; Riggio, C; Cuschieri, A

    2010-06-01

    This review based on the Wickham lecture given by AC at the 2009 SMIT meeting in Sinaia outlines the progress made in nano-technology for healthcare. It describes in brief the nature of nano-materials and their unique properties which accounts for the significant research both in scientific institutions and industry for translation into new therapies embodied in the emerging field of nano-medicine. It stresses that the potential of nano-medicine to make significant inroads for more effective therapies both for life-threatening and life-disabling disorders will only be achieved by high-quality life science research. The first generation of passive nano-diagnostics based on nanoparticle contrast agents for magnetic resonance imaging is well established in clinical practice and new such contrast agents are undergoing early clinical evaluation. Likewise active (second generation) nano-therapies, exemplified by targeted control drug release systems are undergoing early clinical evaluation. The situation concerning other nano-materials such as carbon nanotubes (CNTs) and boron nitride nanotubes (BNNTs) is less advanced although considerable progress has been made on their coating for aqueous dispersion and functionalisation to enable carriage of drugs, genes and fluorescent markers. The main problem related to the clinical use of these nanotubes is that there is no consent among scientists on the fate of such nano-materials following injection or implantation in humans. Provided carbon nanotubes are manufactured to certain medical criteria (length around 1 mum, purity of 97-99% and low Fe content) they exhibit no cytotoxicity on cell cultures and demonstrate full bio-compatibility on in vivo animal studies. The results of recent experimental studies have demonstrated the potential of technologies based on CNTs for low voltage wireless electro-chemotherapy of tumours and for electro-stimulation therapies for cardiac, neurodegenerative and skeletal and visceral muscle

  20. 7 CFR 1485.18 - Advances.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... AGRICULTURE EXPORT PROGRAMS COOPERATIVE AGREEMENTS FOR THE DEVELOPMENT OF FOREIGN MARKETS FOR AGRICULTURAL COMMODITIES Market Access Program § 1485.18 Advances. (a) Policy. In general, CCC operates MAP and EIP/MAP on... participant for generic promotion activities. Prior to making an advance, CCC may require the participant to...

  1. Advancing Stage 2 Research on Measures for Monitoring Kindergarten Reading Progress.

    PubMed

    Clemens, Nathan H; Soohoo, Michelle M; Wiley, Colby P; Hsiao, Yu-Yu; Estrella, Ivonne; Allee-Smith, Paula J; Yoon, Myeongsun

    Although several measures exist for frequently monitoring early reading progress, little research has specifically investigated their technical properties when administered on a frequent basis with kindergarten students. In this study, kindergarten students ( N = 137) of whom the majority was receiving supplemental intervention for reading skills were monitored using Letter Sound Fluency, Phoneme Segmentation Fluency, Word Reading Fluency, Nonsense Word Fluency, Highly Decodable Passages, and Spelling on a biweekly basis between February and May. Acceptable reliability was observed for all measures. Analyses of slope validity using latent growth models, latent change score models, and slope differences according to level of year-end achievement indicated that the relation of slope to overall reading skills varied across the measures. A suggested approach to kindergarten students' reading progress is offered that includes Letter Sound Fluency and a measure of word-reading skills to provide a comprehensive picture of student growth toward important year-end reading outcomes.

  2. How We Make DNA Origami.

    PubMed

    Wagenbauer, Klaus F; Engelhardt, Floris A S; Stahl, Evi; Hechtl, Vera K; Stömmer, Pierre; Seebacher, Fabian; Meregalli, Letizia; Ketterer, Philip; Gerling, Thomas; Dietz, Hendrik

    2017-10-05

    DNA origami has attracted substantial attention since its invention ten years ago, due to the seemingly infinite possibilities that it affords for creating customized nanoscale objects. Although the basic concept of DNA origami is easy to understand, using custom DNA origami in practical applications requires detailed know-how for designing and producing the particles with sufficient quality and for preparing them at appropriate concentrations with the necessary degree of purity in custom environments. Such know-how is not readily available for newcomers to the field, thus slowing down the rate at which new applications outside the field of DNA nanotechnology may emerge. To foster faster progress, we share in this article the experience in making and preparing DNA origami that we have accumulated over recent years. We discuss design solutions for creating advanced structural motifs including corners and various types of hinges that expand the design space for the more rigid multilayer DNA origami and provide guidelines for preventing undesired aggregation and on how to induce specific oligomerization of multiple DNA origami building blocks. In addition, we provide detailed protocols and discuss the expected results for five key methods that allow efficient and damage-free preparation of DNA origami. These methods are agarose-gel purification, filtration through molecular cut-off membranes, PEG precipitation, size-exclusion chromatography, and ultracentrifugation-based sedimentation. The guide for creating advanced design motifs and the detailed protocols with their experimental characterization that we describe here should lower the barrier for researchers to accomplish the full DNA origami production workflow. © 2017 Wiley-VCH Verlag GmbH & Co. KGaA, Weinheim.

  3. Advanced regenerator testing in the Raytheon dual-use cryocoolerr

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

    Schaefer, B. R.; Bellis, L.; Ellis, M. J.

    2014-01-29

    Significant progress has been made on the Raytheon low cost space cryocooler called the Dual-Use Cryocooler (DUC). Most notably, the DUC has been integrated and tested with an advanced regenerator. The advanced regenerator is a drop-in replacement for stainless steel screens and has shown significant thermodynamic performance improvements. This paper will compare the performance of two different regenerators and explain the benefits of the advanced regenerator.

  4. Evaluating Youth Development Programs: Progress and Promise

    ERIC Educational Resources Information Center

    Roth, Jodie L.; Brooks-Gunn, Jeanne

    2016-01-01

    Advances in theories of adolescent development and positive youth development have greatly increased our understanding of how programs and practices with adolescents can impede or enhance their development. In this article the authors reflect on the progress in research on youth development programs in the last two decades, since possibly the…

  5. Comprehensive Trail Making Test

    ERIC Educational Resources Information Center

    Gray, Rebecca

    2006-01-01

    The Comprehensive Trail Making Test (CTMT) is designed to be used in neuropsychological assessment for the purposes of detecting effects of brain defects and deficits and in tracking progress in rehabilitation. More specific purposes include the detection of frontal lobe deficits, problems with psychomotor speed, visual search and sequencing,…

  6. Clinical trials in progressive multiple sclerosis: lessons learned and future perspectives

    PubMed Central

    Ontaneda, Daniel; Fox, Robert J.; Chataway, Jeremy

    2015-01-01

    Progressive multiple sclerosis is characterized by the gradual accrual of disability independent of relapses and can occur with disease onset (primary progressive) or preceded by a relapsing disease course (secondary progressive). An effective disease modifying treatment for progressive multiple sclerosis has not been identified, and the results of clinical trials to date have been generally disappointing. Ongoing advances in our understanding of pathogenesis, identification of novel targets for neuro-protection, and improved outcome measures have the potential to lead to effective treatments for progressive multiple sclerosis. In this review lessons learned from previous clinical trials and perspectives from current trials in progressive multiple sclerosis are summarized. Promising clinical, imaging, and biological markers will also be reviewed, along with novel clinical trial designs. PMID:25772899

  7. Monitoring Progress toward Successful K-12 STEM Education: A Nation Advancing?

    ERIC Educational Resources Information Center

    National Academies Press, 2013

    2013-01-01

    Following a 2011 report by the National Research Council (NRC) on successful K-12 education in science, technology, engineering, and mathematics (STEM), Congress asked the National Science Foundation to identify methods for tracking progress toward the report's recommendations. In response, the NRC convened the Committee on an Evaluation Framework…

  8. Progress in Earth System Modeling since the ENIAC Calculation

    NASA Astrophysics Data System (ADS)

    Fung, I.

    2009-05-01

    The success of the first numerical weather prediction experiment on the ENIAC computer in 1950 was hinged on the expansion of the meteorological observing network, which led to theoretical advances in atmospheric dynamics and subsequently the implementation of the simplified equations on the computer. This paper briefly reviews the progress in Earth System Modeling and climate observations, and suggests a strategy to sustain and expand the observations needed to advance climate science and prediction.

  9. Scientific Decision Making, Policy Decisions, and the Obesity Pandemic

    PubMed Central

    Hebert, James R.; Allison, David B.; Archer, Edward; Lavie, Carl J.; Blair, Steven N.

    2013-01-01

    Rising and epidemic rates of obesity in many parts of the world are leading to increased suffering and economic stress from diverting health care resources to treating a variety of serious, but preventable, chronic diseases etiologically linked to obesity, particularly type 2 diabetes mellitus and cardiovascular diseases. Despite decades of research into the causes of the obesity pandemic, we seem to be no nearer to a solution now than when the rise in body weights was first chronicled decades ago. The case is made that impediments to a clear understanding of the nature of the problem occur at many levels. These obstacles begin with defining obesity and include lax application of scientific standards of review, tenuous assumption making, flawed measurement and other methods, constrained discourse limiting examination of alternative explanations of cause, and policies that determine funding priorities. These issues constrain creativity and stifle expansive thinking that could otherwise advance the field in preventing and treating obesity and its complications. Suggestions are made to create a climate of open exchange of ideas and redirection of policies that can remove the barriers that prevent us from making material progress in solving a pressing major public health problem of the early 21st century. PMID:23726399

  10. A Benefit-Risk Analysis Approach to Capture Regulatory Decision-Making: Non-Small Cell Lung Cancer.

    PubMed

    Raju, G K; Gurumurthi, K; Domike, R; Kazandjian, D; Blumenthal, G; Pazdur, R; Woodcock, J

    2016-12-01

    Drug regulators around the world make decisions about drug approvability based on qualitative benefit-risk analyses. There is much interest in quantifying regulatory approaches to benefit and risk. In this work the use of a quantitative benefit-risk analysis was applied to regulatory decision-making about new drugs to treat advanced non-small cell lung cancer (NSCLC). Benefits and risks associated with 20 US Food and Drug Administration (FDA) decisions associated with a set of candidate treatments submitted between 2003 and 2015 were analyzed. For benefit analysis, the median overall survival (OS) was used where available. When not available, OS was estimated based on overall response rate (ORR) or progression-free survival (PFS). Risks were analyzed based on magnitude (or severity) of harm and likelihood of occurrence. Additionally, a sensitivity analysis was explored to demonstrate analysis of systematic uncertainty. FDA approval decision outcomes considered were found to be consistent with the benefit-risk logic. © 2016 American Society for Clinical Pharmacology and Therapeutics.

  11. Can fisheries management make substantial progress towards further reductions in sport fish PCB concentrations?

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

    Jackson, L.J.

    1995-12-31

    Great Lakes managers continue to be concerned by PCB concentrations in Great Lakes sport fish. A reduction in sport fish consumption advisory levels would heighten public concern and increase pressure on managers to reduce contaminant levels in sport fish. PCB concentrations in Great Lakes sediments remain high and exchange with the water column is significant. Atmospheric inputs help maintain PCB availability in the Great Lakes. However, it is not technically feasible to control sediment and atmospheric inputs. Here the author uses a detailed age-structured simulation model of chinook salmon, alewife and rainbow smelt to examine the potential for fish managementmore » actions to make progress towards reducing PCB concentrations of sport fish consumed by humans. Chinook salmon PCB concentrations were found to be more affected by prey PCB concentrations than chinook salmon growth rates. Salmonid predators selectively attack the largest prey, but these prey are likely the oldest and most contaminated. The interaction between size selective predation by chinook salmon and their growth rates suggests that there is an ideal stocking level of sport fish that should keep the average prey fish small, and therefore have relatively low PCE concentrations, but not reduce the age structure of the alewife population to include few reproductive individuals. These results are applicable to other stocked salmonids too, (e.g., lake trout, brown trout, coho salmon, steelhead) because they also exhibit size selective predation and their recruitment is primarily by stocking.« less

  12. Basic Research and Progress against Cancer

    Cancer.gov

    An infographic about the importance of basic research for making progress against cancer. The graphic shows the research milestones that led to the development and approval of crizotinib (Xalkori®) to treat certain non-small cell lung cancers.

  13. Medicaid Coverage of Tobacco Dependency Treatments | Cancer Trends Progress Report

    Cancer.gov

    The Cancer Trends Progress Report, first issued in 2001, summarizes our nation's advances against cancer in relation to Healthy People targets set forth by the Department of Health and Human Services.

  14. UV Exposure and Sun Protective Practices | Cancer Trends Progress Report

    Cancer.gov

    The Cancer Trends Progress Report, first issued in 2001, summarizes our nation's advances against cancer in relation to Healthy People targets set forth by the Department of Health and Human Services.

  15. Smoke-free Workplace Rules and Laws | Cancer Trends Progress Report

    Cancer.gov

    The Cancer Trends Progress Report, first issued in 2001, summarizes our nation's advances against cancer in relation to Healthy People targets set forth by the Department of Health and Human Services.

  16. Social Ecological Perspectives of Tube-Feeding Older Adults with Advanced Dementia: A Systematic Literature Review.

    PubMed

    Douglas, Joy W; Lawrence, Jeannine C; Turner, Lori W

    2017-01-01

    Dementia is a progressive, debilitating disease that often results in weight loss, malnutrition, and dehydration. Feeding tubes are often prescribed; however, this practice can lead to complications. The purpose of this systematic review was to examine the use of feeding tubes in elderly demented patients from a social ecological perspective. Results indicated that family members often receive inadequate decision-making education. Many health care professionals lack knowledge of evidence-based guidelines pertaining to feeding tube use. Organizational and financial reimbursement structures influence feeding tube use. Feeding practices for patients with advanced dementia is a complex issue, warranting approaches that target each level of the Social Ecological Model.

  17. The U.S. RERTR program status and progress.

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

    Travelli, A.

    1998-01-21

    The progress of the Reduced Enrichment Research and Test Reactor (RERTR) Program since its inception in 1978 is described. A brief summary of the results which the RERTR Program had achieved by the end of 1996 in collaboration with its many international partners is followed by a detailed review of the major events, findings, and activities of 1997. Significant progress has been made during the past year. In the area of U.S. acceptance of spent fuel from foreign research reactors, several shipments have taken place and additional are being planned. Intense fuel development activities are in progress, including procurement ofmore » equipment, screening of candidate materials, and production of microplates. Irradiation of the first series of microplates began in August 1997 in the Advanced Test Reactor, in Idaho. Progress has been made in the Russian RERTR program, which aims to develop and demonstrate within five years the technical means needed to convert Russian-supplied research reactors to LEU fuels. The study of an alternative LEU core for the FRM-II design has been extended to address, with favorable results, controversial performance issues which were raised at last year's meeting. Progress was also made on several aspects of producing molybdenum-99 from fission targets utilizing LEU instead of HEU. Various types of targets and processes are being pursued, with FDA approval of an LEU process projected to occur within two years. The feasibility of LEU Fuel conversion for three important DOE research reactors (BMRR, HFBR, and HFIR) has been evaluated by the RERTR program. In spite of the many momentous events which have occurred during the intervening years, and the excellent progress achieved, the most important challenges that the RERTR program faces today are not very different in type from those that were faced during the first RERTR meeting. Now, as then, the most important task is to develop new LEU fuels satisfying requirements which cannot be

  18. Sharing perspectives and experiences of doctoral fellows in the first cohort of Consortium for Advanced Research Training in Africa: 2011-2014.

    PubMed

    Adedokun, Babatunde; Nyasulu, Peter; Maseko, Fresier; Adedini, Sunday; Akinyemi, Joshua; Afolabi, Sulaimon; de Wet, Nicole; Sulaimon, Adedokun; Sambai, Caroline; Utembe, Wells; Opiyo, Rose; Awotidebe, Taofeek; Chirwa, Esnat; Nabakwe, Esther; Niragire, François; Uwizeye, Dieudonné; Niwemahoro, Celine; Kamndaya, Mphatso; Mwakalinga, Victoria; Otwombe, Kennedy

    2014-01-01

    Resolution of public health problems in Africa remains a challenge because of insufficient skilled human resource capacity. The Consortium for Advanced Research Training in Africa (CARTA) was established to enhance capacity in multi-disciplinary health research that will make a positive impact on population health in Africa. The first cohort of the CARTA program describes their perspectives and experiences during the 4 years of fellowship and puts forward suggestions for future progress and direction of research in Africa. The model of training as shown by the CARTA program is an effective model of research capacity building in African academic institutions. An expansion of the program is therefore warranted to reach out to more African academics in search of advanced research training.

  19. [Advanced organ failure in the elderly. Some issues from a geriatrics, palliative medicine and bioethics perspectives].

    PubMed

    Alonso-Renedo, Francisco Javier; González-Ercilla, Leire; Iráizoz-Apezteguía, Itziar

    2014-01-01

    To analyze the literature as regards the knowledge, skills and attitudes that these disciplines can provide in improving technical, ethical and human quality health care in the elderly with advanced organ failure, multimorbidity, frailty and progressive dementia. A comprehensive review focused on available references on the interrelationship between geriatric medicine and palliative medicine, education in bioethics, prognostic tools, functional status, and the humanization of health care. Advance care planning, comprehensive geriatric assessment, the study of the values of the patient and their introduction in decision-making process, as well as the need to promote moral, care, and healthcare organizational ethics, are essential elements to achieve this objective. Practitioners and healthcare organizations should seek excellence as a moral requirement. To achieve this, there is a priority to acquire virtues of care and fundamental concepts of geriatric and palliative medicine, assessing functional status, advance care planning and patient/family needs as essential issues to protect, care for and promote them in all care settings. Copyright © 2013 SEGG. Published by Elsevier Espana. All rights reserved.

  20. Randomized Controlled Trial of a Video Decision Support Tool for Cardiopulmonary Resuscitation Decision Making in Advanced Cancer

    PubMed Central

    Volandes, Angelo E.; Paasche-Orlow, Michael K.; Mitchell, Susan L.; El-Jawahri, Areej; Davis, Aretha Delight; Barry, Michael J.; Hartshorn, Kevan L.; Jackson, Vicki Ann; Gillick, Muriel R.; Walker-Corkery, Elizabeth S.; Chang, Yuchiao; López, Lenny; Kemeny, Margaret; Bulone, Linda; Mann, Eileen; Misra, Sumi; Peachey, Matt; Abbo, Elmer D.; Eichler, April F.; Epstein, Andrew S.; Noy, Ariela; Levin, Tomer T.; Temel, Jennifer S.

    2013-01-01

    Purpose Decision making regarding cardiopulmonary resuscitation (CPR) is challenging. This study examined the effect of a video decision support tool on CPR preferences among patients with advanced cancer. Patients and Methods We performed a randomized controlled trial of 150 patients with advanced cancer from four oncology centers. Participants in the control arm (n = 80) listened to a verbal narrative describing CPR and the likelihood of successful resuscitation. Participants in the intervention arm (n = 70) listened to the identical narrative and viewed a 3-minute video depicting a patient on a ventilator and CPR being performed on a simulated patient. The primary outcome was participants' preference for or against CPR measured immediately after exposure to either modality. Secondary outcomes were participants' knowledge of CPR (score range of 0 to 4, with higher score indicating more knowledge) and comfort with video. Results The mean age of participants was 62 years (standard deviation, 11 years); 49% were women, 44% were African American or Latino, and 47% had lung or colon cancer. After the verbal narrative, in the control arm, 38 participants (48%) wanted CPR, 41 (51%) wanted no CPR, and one (1%) was uncertain. In contrast, in the intervention arm, 14 participants (20%) wanted CPR, 55 (79%) wanted no CPR, and 1 (1%) was uncertain (unadjusted odds ratio, 3.5; 95% CI, 1.7 to 7.2; P < .001). Mean knowledge scores were higher in the intervention arm than in the control arm (3.3 ± 1.0 v 2.6 ± 1.3, respectively; P < .001), and 65 participants (93%) in the intervention arm were comfortable watching the video. Conclusion Participants with advanced cancer who viewed a video of CPR were less likely to opt for CPR than those who listened to a verbal narrative. PMID:23233708

  1. Randomized controlled trial of a video decision support tool for cardiopulmonary resuscitation decision making in advanced cancer.

    PubMed

    Volandes, Angelo E; Paasche-Orlow, Michael K; Mitchell, Susan L; El-Jawahri, Areej; Davis, Aretha Delight; Barry, Michael J; Hartshorn, Kevan L; Jackson, Vicki Ann; Gillick, Muriel R; Walker-Corkery, Elizabeth S; Chang, Yuchiao; López, Lenny; Kemeny, Margaret; Bulone, Linda; Mann, Eileen; Misra, Sumi; Peachey, Matt; Abbo, Elmer D; Eichler, April F; Epstein, Andrew S; Noy, Ariela; Levin, Tomer T; Temel, Jennifer S

    2013-01-20

    Decision making regarding cardiopulmonary resuscitation (CPR) is challenging. This study examined the effect of a video decision support tool on CPR preferences among patients with advanced cancer. We performed a randomized controlled trial of 150 patients with advanced cancer from four oncology centers. Participants in the control arm (n = 80) listened to a verbal narrative describing CPR and the likelihood of successful resuscitation. Participants in the intervention arm (n = 70) listened to the identical narrative and viewed a 3-minute video depicting a patient on a ventilator and CPR being performed on a simulated patient. The primary outcome was participants' preference for or against CPR measured immediately after exposure to either modality. Secondary outcomes were participants' knowledge of CPR (score range of 0 to 4, with higher score indicating more knowledge) and comfort with video. The mean age of participants was 62 years (standard deviation, 11 years); 49% were women, 44% were African American or Latino, and 47% had lung or colon cancer. After the verbal narrative, in the control arm, 38 participants (48%) wanted CPR, 41 (51%) wanted no CPR, and one (1%) was uncertain. In contrast, in the intervention arm, 14 participants (20%) wanted CPR, 55 (79%) wanted no CPR, and 1 (1%) was uncertain (unadjusted odds ratio, 3.5; 95% CI, 1.7 to 7.2; P < .001). Mean knowledge scores were higher in the intervention arm than in the control arm (3.3 ± 1.0 v 2.6 ± 1.3, respectively; P < .001), and 65 participants (93%) in the intervention arm were comfortable watching the video. Participants with advanced cancer who viewed a video of CPR were less likely to opt for CPR than those who listened to a verbal narrative.

  2. Progress in the development of advanced solar reflectors

    NASA Astrophysics Data System (ADS)

    Kennedy, C.; Jorgensen, G.

    1994-01-01

    Solar thermal technologies require large mirrors to provide concentrated sunlight for renewable power generation. Such materials must be inexpensive and maintain high specular reflectance for extended lifetimes in severe outdoor environments. Polymer reflectors are lighter than glass mirrors, offer greater system design flexibility, and have the potential for lower cost. During the past year, collaborative cost-shared research and development between the National Renewable Energy Laboratory (NREL) and industrial partners has identified candidate materials that perform better than the state-of-the-art commercial silvered-polymer reflectors in terms of corrosion degradation and resistance to delamination failure. Additional cooperative efforts will produce new alternative materials with reduced costs due to high speed production line capability. NREL welcomes continued and expanded interest and web coating industry involvement in developing advanced solar reflector materials.

  3. Disparate effects of single endothelin A and B receptor blocker therapy on the progression of renal injury in advanced renovascular disease

    PubMed Central

    Chade, Alejandro R.; Stewart, Nicholas J.; Peavy, Patrick R.

    2013-01-01

    We hypothesized that chronic specific endothelin (ET)-A receptor blockade therapy would reverse renal dysfunction and injury in advanced experimental renovascular disease. To test this, unilateral renovascular disease was induced in 19 pigs and after 6 weeks, single-kidney hemodynamics and function was quantified in vivo using computed-tomography. All pigs with renovascular disease were divided such that 7 were untreated, 7 were treated with ET-A blockers, and 5 were treated with ET-B blockers. Four weeks later, all pigs were re-studied in vivo, then euthanized and ex vivo studies performed on the stenotic kidney to quantify microvascular density, remodeling, renal oxidative stress, inflammation, and fibrosis. RBF, GFR, and redox status were significantly improved in the stenotic kidney after ET-A but not ET-B blockade. Furthermore, only ET-A blockade therapy reversed renal microvascular rarefaction and diminished remodeling, which was accompanied by a marked decreased in renal inflammatory and fibrogenic activity. Thus, ET-A but not ET-B blockade ameliorated renal injury in pigs with advanced renovascular disease by stimulating microvascular proliferation and decreasing the progression of microvascular remodeling, renal inflammation and fibrosis in the stenotic kidney. These effects were functionally consequential since ET-A blockade improved single kidney microvascular endothelial function, RBF, and GFR, and decreased albuminuria. PMID:24352153

  4. The ADvanced SEParation (ADSEP)

    NASA Technical Reports Server (NTRS)

    1998-01-01

    The ADvanced SEParation (ADSEP) commercial payload is making use of major advances in separation technology: The Phase Partitioning Experiment (PPE); the Micorencapsulation experiment; and the Hemoglobin Separation Experiment (HSE). Using ADSEP, commercial researchers will attempt to determine the partition coefficients for model particles in a two-phase system. With this information, researchers can develop a higher resolution, more effective cell isolation procedure that can be used for many different types of research and for improved health care. The advanced separation technology is already being made available for use in ground-based laboratories.

  5. Personalized Prediction of Glaucoma Progression Under Different Target Intraocular Pressure Levels Using Filtered Forecasting Methods.

    PubMed

    Kazemian, Pooyan; Lavieri, Mariel S; Van Oyen, Mark P; Andrews, Chris; Stein, Joshua D

    2018-04-01

    To generate personalized forecasts of how patients with open-angle glaucoma (OAG) experience disease progression at different intraocular pressure (IOP) levels to aid clinicians with setting personalized target IOPs. Secondary analyses using longitudinal data from 2 randomized controlled trials. Participants with moderate or advanced OAG from the Collaborative Initial Glaucoma Treatment Study (CIGTS) or the Advanced Glaucoma Intervention Study (AGIS). By using perimetric and tonometric data from trial participants, we developed and validated Kalman Filter (KF) models for fast-, slow-, and nonprogressing patients with OAG. The KF can generate personalized and dynamically updated forecasts of OAG progression under different target IOP levels. For each participant, we determined how mean deviation (MD) would change if the patient maintains his/her IOP at 1 of 7 levels (6, 9, 12, 15, 18, 21, or 24 mmHg) over the next 5 years. We also model and predict changes to MD over the same time horizon if IOP is increased or decreased by 3, 6, and 9 mmHg from the level attained in the trials. Personalized estimates of the change in MD under different target IOP levels. A total of 571 participants (mean age, 64.2 years; standard deviation, 10.9) were followed for a mean of 6.5 years (standard deviation, 2.8). Our models predicted that, on average, fast progressors would lose 2.1, 6.7, and 11.2 decibels (dB) MD under target IOPs of 6, 15, and 24 mmHg, respectively, over 5 years. In contrast, on average, slow progressors would lose 0.8, 2.1, and 4.1 dB MD under the same target IOPs and time frame. When using our tool to quantify the OAG progression dynamics for all 571 patients, we found no statistically significant differences over 5 years between progression for black versus white, male versus female, and CIGTS versus AGIS participants under different target IOPs (P > 0.05 for all). To our knowledge, this is the first clinical decision-making tool that generates personalized

  6. Checkpoint inhibition for advanced mucosal melanoma.

    PubMed

    Thierauf, Julia; Veit, Johannes A; Hess, Jochen; Treiber, Nicolai; Lisson, Catharina; Weissinger, Stephanie E; Bommer, Martin; Hoffmann, Thomas K

    2017-04-01

    Whereas anti-PD-1 therapy has demonstrated a significant and durable response against advanced cutaneous melanoma, conventional chemotherapies have shown only minor benefit against advanced mucosal melanoma. To investigate the efficacy of anti-PD-1 therapy in a small cohort of patients with mucosal melanoma of the head and neck. We analysed five patients with mucosal melanoma of the head and neck who received nivolumab or pembrolizumab, at an advanced stage. Expression of PD-L1 and PD-1 in all tumour samples was evaluated immunohistochemically. All patients received at least two cycles of nivolumab or pembrolizumab. The most severe adverse events were categorised as CTCAE (common terminology criteria for adverse events) Grade 2. All patients showed progressive disease after restaging at three and six months, and no partial or complete response was observed. Immunohistochemical staining demonstrated PD-L1 expression in less than 5% of tumour cells. Systemic therapy with either nivolumab or pembrolizumab showed no clinical response, however, tumour progression was identified in all patients using Response Evaluation Criteria In Solid Tumors (RECIST) v1.1 and immune-related response criteria (irRC) to evaluate tumour response.

  7. Minimising Same Error Repetition and Maximising Progress in SLA: An Integrated Method

    ERIC Educational Resources Information Center

    Gadd, Anna

    2016-01-01

    Alderson teaches us that, "progress should be the aim of all learning". With the purpose of ensuring progress and enhancing first year students' learning of Italian as a second language, research into feedback and repair was undertaken at The University of Western Australia. The research--funded by the UWA Centre for the Advancement of…

  8. Paradigms and progress in vocal fold restoration.

    PubMed

    Ford, Charles N

    2008-09-01

    Science advances occur through orderly steps, puzzle-solving leaps, or divergences from the accepted disciplinary matrix that occasionally result in a revolutionary paradigm shift. Key advances must overcome bias, criticism, and rejection. Examples in biological science include use of embryonic stem cells, recognition of Helicobacter pylori in the etiology of ulcer disease, and the evolution of species. Our work in vocal fold restoration reflects these patterns. We progressed through phases of tissue replacement with fillers and biological implants, to current efforts at vocal fold regeneration through tissue engineering, and face challenges of a new "systems biology" paradigm embracing genomics and proteomics.

  9. Molecular pathogenesis of hepatocellular carcinoma and impact of therapeutic advances

    PubMed Central

    Dhanasekaran, Renumathy; Bandoh, Salome; Roberts, Lewis R.

    2016-01-01

    Hepatocellular carcinoma (HCC) is a leading cause of cancer mortality and has an increasing incidence worldwide. HCC can be induced by multiple etiologies, is influenced by many risk factors, and has a complex pathogenesis. Furthermore, HCCs exhibit substantial heterogeneity, which compounds the difficulties in developing effective therapies against this highly lethal cancer. With advances in cancer biology and molecular and genetic profiling, a number of different mechanisms involved in the development and progression of HCC have been identified. Despite the advances in this area, the molecular pathogenesis of hepatocellular carcinoma is still not completely understood. This review aims to elaborate our current understanding of the most relevant genetic alterations and molecular pathways involved in the development and progression of HCC, and anticipate the potential impact of future advances on therapeutic drug development. PMID:27239288

  10. Promoting Shared Decision Making through Descriptive Inquiry

    ERIC Educational Resources Information Center

    Seher, Rachel; Traugh, Cecelia; Cheng, Alan

    2018-01-01

    This article shows how City-As-School, a progressive public school in New York City, used descriptive inquiry to deepen shared decision making, which is a central value of the school and part of a democratic way of life. Descriptive inquiry is a democratic knowledge-making process that was developed at the Prospect School in North Bennington,…

  11. The Imperative for Diversity: ARL's Progress and Role

    ERIC Educational Resources Information Center

    Dewey, Barbara I.

    2009-01-01

    The Association of Research Libraries' diversity initiatives, under the leadership of Duane Webster and member libraries, have had a visible and long-lasting influence on the makeup of academic librarianship. ARL's accomplishments and progress in advancing diversity comprise important milestones for librarianship and did not come without…

  12. Distinct neural substrates of visuospatial and verbal-analytic reasoning as assessed by Raven's Advanced Progressive Matrices.

    PubMed

    Chen, Zhencai; De Beuckelaer, Alain; Wang, Xu; Liu, Jia

    2017-11-24

    Recent studies revealed spontaneous neural activity to be associated with fluid intelligence (gF) which is commonly assessed by Raven's Advanced Progressive Matrices, and embeds two types of reasoning: visuospatial and verbal-analytic reasoning. With resting-state fMRI data, using global brain connectivity (GBC) analysis which averages functional connectivity of a voxel in relation to all other voxels in the brain, distinct neural correlates of these two reasoning types were found. For visuospatial reasoning, negative correlations were observed in both the primary visual cortex (PVC) and the precuneus, and positive correlations were observed in the temporal lobe. For verbal-analytic reasoning, negative correlations were observed in the right inferior frontal gyrus (rIFG), dorsal anterior cingulate cortex and temporoparietal junction, and positive correlations were observed in the angular gyrus. Furthermore, an interaction between GBC value and type of reasoning was found in the PVC, rIFG and the temporal lobe. These findings suggest that visuospatial reasoning benefits more from elaborate perception to stimulus features, whereas verbal-analytic reasoning benefits more from feature integration and hypothesis testing. In sum, the present study offers, for different types of reasoning in gF, first empirical evidence of separate neural substrates in the resting brain.

  13. Advances in Light Microscopy for Neuroscience

    PubMed Central

    Wilt, Brian A.; Burns, Laurie D.; Ho, Eric Tatt Wei; Ghosh, Kunal K.; Mukamel, Eran A.

    2010-01-01

    Since the work of Golgi and Cajal, light microscopy has remained a key tool for neuroscientists to observe cellular properties. Ongoing advances have enabled new experimental capabilities using light to inspect the nervous system across multiple spatial scales, including ultrastructural scales finer than the optical diffraction limit. Other progress permits functional imaging at faster speeds, at greater depths in brain tissue, and over larger tissue volumes than previously possible. Portable, miniaturized fluorescence microscopes now allow brain imaging in freely behaving mice. Complementary progress on animal preparations has enabled imaging in head-restrained behaving animals, as well as time-lapse microscopy studies in the brains of live subjects. Mouse genetic approaches permit mosaic and inducible fluorescence-labeling strategies, whereas intrinsic contrast mechanisms allow in vivo imaging of animals and humans without use of exogenous markers. This review surveys such advances and highlights emerging capabilities of particular interest to neuroscientists. PMID:19555292

  14. Phase II trial of pazopanib in advanced/progressive malignant pheochromocytoma and paraganglioma.

    PubMed

    Jasim, Sina; Suman, Vera J; Jimenez, Camilo; Harris, Pamela; Sideras, Kostandinos; Burton, Jill K; Worden, Francis Paul; Auchus, Richard J; Bible, Keith C

    2017-08-01

    Pheochromocytomas and paragangliomas (Pheo/PGL) are rare, vascular, sometimes malignant endocrine tumors. Case reports indicate the activity of vascular endothelium growth factor receptor-targeted kinase inhibitors in these cancers. To assess the antitumor activity and tolerability of pazopanib in progressive malignant Pheo/PGL. This multicenter Phase II trial (MC107C) enrolled individuals  ≥18 years old with disease progression ≤ 6 months prior to registration, Eastern Cooperative Oncology Group PS 0-2, and measurable disease (response evaluation criteria in solid tumors 1.0). Pazopanib was administered in 28-day cycles, with the regimen ultimately being as follows: cycle 1: 400 mg daily on days 1-14, cycle 2: 800 mg daily on days 1-14, and then cycle 2 + : 800 mg daily on all days. The study was halted due to poor accrual. Seven patients were enrolled (05/2011-11/2014). One patient withdrew consent prior to treatment, leaving six evaluable patients. Treatment was discontinued, due to the following reasons: disease progression (4); withdrawal (1); and grade 4 (Takotsubo) cardiomyopathy (1). The median number of cycles administered was 4 (range: 2-29, total: 49). Four patients had >1 dose reduction due to the following reasons: fatigue (1), abnormal liver tests (2), hypertension and (Takotsubo) cardiomyopathy (1), and headaches (1). Common severe (Common Terminology Criteria for Adverse Events v3.0 grades 3-5) toxicities were as follows: hypertension (3/6), (Takotsubo) cardiomyopathy (2/6), diarrhea (1/6), fatigue (1/6), headache (1/6), and hematuria (1/6). One confirmed partial response was observed in PGL (17%, duration 2.4 years); median progression-free survival and overall survival were 6.5 and 14.8 months, respectively. Pazopanib has activity in Pheo/PGL requiring more study; optimal alpha- and beta-blockade are imperative pre-therapy in patients with secretory tumors, as risk of hypertension and cardiomyopathy are potentially life

  15. Advance care planning for haemodialysis patients.

    PubMed

    Lim, Chi Eung Danforn; Ng, Rachel W C; Cheng, Nga Chong Lisa; Cigolini, Maria; Kwok, Cannas; Brennan, Frank

    2016-07-26

    End-stage kidney disease (ESKD) is a chronic, debilitative and progressive illness that may need interventions such as dialysis, transplantation, dietary and fluid restrictions. Most patients with ESKD will require renal replacement therapy, such as kidney transplantation or maintenance dialysis. Advance care planning traditionally encompass instructions via living wills, and concern patient preferences about interventions such as cardiopulmonary resuscitation and feeding tubes, or circumstances around assigning surrogate decision makers. Most people undergoing haemodialysis are not aware of advance care planning and few patients formalise their wishes as advance directives and of those who do, many do not discuss their decisions with a physician. Advance care planning involves planning for future healthcare decisions and preferences of the patient in advance while comprehension is intact. It is an essential part of good palliative care that likely improves the lives and deaths of haemodialysis patients. The objective of this review was to determine whether advance care planning in haemodialysis patients, compared with no or less structured forms of advance care planning, can result in fewer hospital admissions or less use of treatments with life-prolonging or curative intent, and if patient's wishes were followed at end-of-life. We searched the Cochrane Kidney and Transplant Specialised Register to 27 June 2016 through contact with the Information Specialist using search terms relevant to this review. We also searched the Cumulative Index of Nursing and Allied Health Literature (CINAHL), and Social Work Abstracts (OvidSP). All randomised controlled trials (RCTs) and quasi-RCTs (RCTs in which allocation to treatment was obtained by alternation, use of alternate medical records, date of birth or other predictable methods) looking at advance care planning versus no form of advance care planning in haemodialysis patients was considered for inclusion without language

  16. Evolving from academic to academic entrepreneur: overcoming barriers to scientific progress and finance.

    PubMed

    Miller, Andrew D

    2016-07-01

    The overall goal of my career as an academic chemist has always been the design and creation of advanced therapeutics and diagnostics that address unmet medical need in the management of chronic diseases. Realising this goal has been an immensely difficult process involving multidisciplinary problem-driven research at the chemistry-biology-medicine interfaces. With success in the laboratory, I started seriously to question the value of remaining an academic whose career is spent in the pursuit of knowledge and understanding alone without making any significant effort to translate knowledge and understanding gained into products of genuine utility for public benefit. Therefore, I elected by choice to become an academic entrepreneur, seeking opportunities wherever possible for the translation of the best of my personal and collaborative academic research work into potentially valuable and useful products. This choice has brought with it many unexpected difficulties and challenges. Nevertheless, progress bas been made and sufficient learnt to suggest that this would be an appropriate moment to take stock and provide some personal reflections on what it takes to design and create advanced therapeutics and diagnostics in the laboratory then seek to develop, innovate and translate the best towards market.

  17. Evaluating Youth Development Programs: Progress and Promise

    PubMed Central

    Brooks-Gunn, Jeanne

    2016-01-01

    Advances in theories of adolescent development and positive youth development have greatly increased our understanding of how programs and practices with adolescents can impede or enhance their development. In this paper the authors reflect on the progress in research on youth development programs in the last two decades, since possibly the first review of empirical evaluations by Roth, Brooks-Gunn, Murray, and Foster (1998). The authors use the terms Version 1.0, 2.0 and 3.0 to refer to changes in youth development research and programs over time. They argue that advances in theory and descriptive accounts of youth development programs (Version 2.0) need to be coupled with progress in definitions of youth development programs, measurement of inputs and outputs that incorporate an understanding of programs as contexts for development, and stronger design and evaluation of programs (Version 3.0). The authors also advocate for an integration of prevention and promotion research, and for use of the term youth development rather than positive youth development. PMID:28077922

  18. Nuclear Thermal Propulsion for Advanced Space Exploration

    NASA Technical Reports Server (NTRS)

    Houts, M. G.; Borowski, S. K.; George, J. A.; Kim, T.; Emrich, W. J.; Hickman, R. R.; Broadway, J. W.; Gerrish, H. P.; Adams, R. B.

    2012-01-01

    The fundamental capability of Nuclear Thermal Propulsion (NTP) is game changing for space exploration. A first generation Nuclear Cryogenic Propulsion Stage (NCPS) based on NTP could provide high thrust at a specific impulse above 900 s, roughly double that of state of the art chemical engines. Characteristics of fission and NTP indicate that useful first generation systems will provide a foundation for future systems with extremely high performance. The role of the NCPS in the development of advanced nuclear propulsion systems could be analogous to the role of the DC-3 in the development of advanced aviation. Progress made under the NCPS project could help enable both advanced NTP and advanced Nuclear Electric Propulsion (NEP).

  19. Accelerating Progress Against Cancer

    Cancer.gov

    Investment in cancer research is making a difference, but we still must overcome disparities in cancer incidence and mortality, and expand research to detect cancers earlier and develop more effective, less-toxic treatments. NCI supports research studies and programs across the country that are working to further advance cancer, research, and clinical care.

  20. Strategy in Regulatory Decision-Making for Management of Progressive Multifocal Leukoencephalopathy.

    PubMed

    Segec, A; Keller-Stanislawski, B; Vermeer, N S; Macchiarulo, C; Straus, S M; Hidalgo-Simon, A; De Bruin, M L

    2015-11-01

    Progressive multifocal leukoencephalopathy (PML) has been observed after the use of several medicines, including monoclonal antibodies. As these drugs play important roles in the therapeutic armamentarium, it is important to address the challenges that this severe adverse reaction poses to the safe use of medicines. Considering the need for consistent outcomes of regulatory decisions, the European Medicines Agency Pharmacovigilance Risk Assessment Committee (PRAC) used PML as an example to develop a systematic approach to labeling and risk minimization. © 2015 American Society for Clinical Pharmacology and Therapeutics.

  1. [Research advance on role of Coxsackie and adenovirus receptor (CAR) in tumor progression].

    PubMed

    Fan, Liang-Sheng; Chen, Gang; Ma, Ding

    2009-03-01

    Coxsackie and adenovirus receptor (CAR) is originally identified as the cellular receptor of 2-and 5-type adenoviruses. Many researches have suggested that CAR can affect the growth, adhesive ability and cytoskeleton of tumor cells, and has complicated functions in metastasis and invasion of tumors. Moreover, the expression of CAR has close relationship with tumor prognosis and cytoreduction mediated by adenoviruses. CAR has become a new hotspot in the research on mechanism of tumor progression and gene therapy. Our review focuses on the structure and function of CAR and its role in mediating occurrence and progression of tumor.

  2. Advancing automation and robotics technology for the Space Station Freedom and for the U.S. Economy

    NASA Technical Reports Server (NTRS)

    1991-01-01

    In April 1985, as required by Public Law 98-371, the NASA Advanced Technology Advisory Committee (ATAC) reported to Congress the results of its studies on advanced automation and robotics technology for use on Space Station Freedom. This material was documented in the initial report (NASA Technical Memorandum 87566). A further requirement of the law was that ATAC follow NASA's progress in this area and report to Congress semiannually. This report is the thirteenth in a series of progress updates and covers the period between 14 Feb. - 15 Aug. 1991. The progress made by Levels 1, 2, and 3 of the Space Station Freedom in developing and applying advanced automation and robotics technology is described. Emphasis was placed upon the Space Station Freedom Program responses to specific recommendations made in ATAC Progress Report 12, and issues of A&R implementation into Ground Mission Operations and A&R enhancement of science productivity. Assessments are presented for these and other areas as they apply to the advancement of automation and robotics technology for Space Station Freedom.

  3. Advancing automation and robotics technology for the Space Station Freedom and for the U.S. economy

    NASA Technical Reports Server (NTRS)

    1993-01-01

    In April 1985, as required by Public Law 98-371, the NASA Advanced Technology Advisory Committee (ATAC) reported to Congress the results of its studies on advanced automation and robotics technology for use on Space Station Freedom. This material was documented in the initial report (NASA Technical Memorandum 87566). A further requirement of the law was that ATAC follow NASA's progress in this area and report to Congress semiannually. This report is the sixteenth in a series of progress updates and covers the period between 15 Sep. 1992 - 16 Mar. 1993. The report describes the progress made by Levels 1, 2, and 3 of the Space Station Freedom in developing and applying advanced automation and robotics technology. Emphasis was placed upon the Space Station Freedom Program responses to specific recommendations made in ATAC Progress Report 15; and includes a status review of Space Station Freedom Launch Processing facilities at Kennedy Space Center. Assessments are presented for these and other areas as they apply to the advancement of automation and robotics technology for Space Station Freedom.

  4. Risk factors for progression to invasive carcinoma in patients with borderline ovarian tumors.

    PubMed

    Song, Taejong; Lee, Yoo-Young; Choi, Chel Hun; Kim, Tae-Joong; Lee, Jeong-Won; Bae, Duk-Soo; Kim, Byoung-Gie

    2014-09-01

    The aim of this study was to identify risk factors for progression to invasive carcinoma in patients with borderline ovarian tumors (BOTs). We performed a retrospective review of all patients treated and followed for BOTs between 1996 and 2011. Multivariate Cox proportional hazards model analysis was performed to identify independent risk factors for progression to invasive carcinoma. A total of 364 patients were identified. During the median follow-up of 53.8 months, 31 patients (8.5%) developed recurrent disease: 12 (3.3%) had recurrent disease with progression to invasive carcinoma, and 19 (5.2%) had recurrent disease with borderline histology. Disease-related deaths (7/364; 1.7%) were observed only in patients with progression to invasive carcinoma. The multivariate analysis showed that independent risk factors for progression to invasive carcinoma were advanced disease stage (hazard ratio [HR], 5.59; P = 0.005), age 65 years or older (HR, 5.13; P = 0.037), and the presence of microinvasion (HR, 3.71; P = 0.047). These 3 factors were also independently related to overall survival. Although patients with BOTs have an excellent prognosis, the risk of progression to invasive carcinoma and thereby death remains. Therefore, physicians should pay closer attention to BOT patients with these risk factors (ie, advanced disease stage, old age, and microinvasion), and more careful surveillance for progression to invasive carcinoma is needed.

  5. Progressive compressive imager

    NASA Astrophysics Data System (ADS)

    Evladov, Sergei; Levi, Ofer; Stern, Adrian

    2012-06-01

    We have designed and built a working automatic progressive sampling imaging system based on the vector sensor concept, which utilizes a unique sampling scheme of Radon projections. This sampling scheme makes it possible to progressively add information resulting in tradeoff between compression and the quality of reconstruction. The uniqueness of our sampling is that in any moment of the acquisition process the reconstruction can produce a reasonable version of the image. The advantage of the gradual addition of the samples is seen when the sparsity rate of the object is unknown, and thus the number of needed measurements. We have developed the iterative algorithm OSO (Ordered Sets Optimization) which employs our sampling scheme for creation of nearly uniform distributed sets of samples, which allows the reconstruction of Mega-Pixel images. We present the good quality reconstruction from compressed data ratios of 1:20.

  6. The Evolving Landscape of Healthcare-Associated Infections: Recent Advances in Prevention and a Road Map for Research

    PubMed Central

    Safdar, Nasia; Anderson, Deverick J.; Braun, Barbara I.; Carling, Philip; Cohen, Stuart; Donskey, Curtis; Drees, Marci; Harris, Anthony; Henderson, David K.; Huang, Susan S.; Juthani-Mehta, Manisha; Lautenbach, Ebbing; Linkin, Darren R.; Meddings, Jennifer; Miller, Loren G.; Milstone, Aaron; Morgan, Daniel; Sengupta, Sharmila; Varman, Meera; Yokoe, Deborah; Zerr, Danielle M.

    2014-01-01

    This white paper identifies knowledge gaps and new challenges in healthcare epidemiology research, assesses the progress made toward addressing research priorities, provides the Society for Healthcare Epidemiology of America (SHEA) Research Committee’s recommendations for high-priority research topics, and proposes a road map for making progress toward these goals. It updates the 2010 SHEA Research Committee document, “Charting the Course for the Future of Science in Healthcare Epidemiology: Results of a Survey of the Membership of SHEA,” which called for a national approach to healthcare-associated infections (HAIs) and a prioritized research agenda. This paper highlights recent studies that have advanced our understanding of HAIs, the establishment of the SHEA Research Network as a collaborative infrastructure to address research questions, prevention initiatives at state and national levels, changes in reporting and payment requirements, and new patterns in antimicrobial resistance. PMID:24709716

  7. Advanced Math? Write!

    ERIC Educational Resources Information Center

    Brandenburg, Sister M. Luka

    2002-01-01

    High-school mathematics teacher in Rock Island, Illinois, describes plan for using writing assignment to improve student understanding of advanced mathematics. Plan includes the following elements: Start small, be firm with students, make writing assignments count, and inform colleagues. (PKP)

  8. Measuring research progress in photovoltaics

    NASA Technical Reports Server (NTRS)

    Jackson, B.; Mcguire, P.

    1986-01-01

    The role and some results of the project analysis and integration function in the Flat-plate Solar Array (FSA) Project are presented. Activities included supporting the decision-making process, preparation of plans for project direction, setting goals for project activities, measuring progress within the project, and the development and maintenance of analytical models.

  9. 12 CFR 950.5 - Terms and conditions for advances.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... advances. (3) Exceptions. The advance pricing policies contained in paragraph (b)(1) of this section shall... longer maturities consistent with the safe and sound operation of the Bank. (b) Advance pricing—(1... administrative and operating costs associated with making such advances to members. (2) Differential pricing. (i...

  10. The Glass Ceiling: Progress and Persistent Challenges

    ERIC Educational Resources Information Center

    McLlwain, Wendy M.

    2012-01-01

    It has been written that since 2001, there has not been any significant progress and the glass ceiling is still intact. Women are still underrepresented in top positions (Anonymous, 2004). If this is true, the glass ceiling presents a major barrier between women and their desire to advance into executive or senior management positions. In addition…

  11. Making human junk: child labor as a health issue in the Progressive Era.

    PubMed Central

    Derickson, A

    1992-01-01

    The adverse health effects of work on approximately 2 million employed children troubled many in the United States during the early 20th century. Advocates of reform initially built a rationale for protective legislation primarily from informal, lay observations of the broad developmental outcomes of premature employment. In this endeavor, they projected a dismal scenario of impending national deterioration. This argument received strong criticism for the inadequacy of its corroborating evidence. In response, Progressive reformers emphasized the specific, measurable consequences of particular occupations. Increasingly, liberal advocates of the exclusion of boys and girls from the work force drew upon statistical compilations of occupational injuries and illnesses diagnosed by physicians. Despite their turn toward scientism, Progressives remained somewhat ambivalent about the sufficiency of quantitative data alone to achieve their aims. Images p1282-a p1285-a PMID:1503173

  12. Assessing Decision Making in Young Adult Romantic Relationships

    ERIC Educational Resources Information Center

    Vennum, Amber; Fincham, Frank D.

    2011-01-01

    Romantic relationships among young adults are rich with ambiguity and without a clear, universal progression emphasizing the need for active decision making. Lack of active decision making in romantic relationships can lead to increases in constraints (e.g. pregnancy, shared living space or finances) that promote the continuation of relationships…

  13. Smokefree Policies in Latin America and the Caribbean: Making Progress

    PubMed Central

    Sebrié, Ernesto M.; Schoj, Verónica; Travers, Mark J.; McGaw, Barbara; Glantz, Stanton A.

    2012-01-01

    We reviewed the adoption and implementation of smokefree policies in all Latin American and the Caribbean (LAC) countries. Significant progress has been achieved among LAC countries since the WHO Framework Convention on Tobacco Control (FCTC) was adopted in 2005. Both national and sub-national legislation have provided effective mechanisms to increase the fraction of the population protected from secondhand tobacco smoke. Civil society has actively promoted these policies and played a main role in enacting them and monitoring their enforcement. The tobacco industry, while continuing to oppose the approval and regulation of the laws at legislative and executive levels, has gone a step further by litigating against them in the Courts. As in the US and elsewhere, this litigation has failed to stop the legislation. PMID:22754484

  14. Advancing automation and robotics technology for the Space Station Freedom and for the US economy

    NASA Technical Reports Server (NTRS)

    1990-01-01

    In April 1985, the NASA Advanced Technology Advisory Committee (ATAC) reported to Congress the results of its studies on advanced automation and robotics technology for use on Space Station Freedom. This material was documented in the initial report (NASA Technical Memorandum 87566). The progress made by Levels 1, 2, and 3 of the Office of Space Station in developing and applying advanced automation and robotics technology are described. Emphasis was placed upon the Space Station Freedom Program responses to specific recommendations made in ATAC Progress Report 9, the Flight Telerobotic Servicer, the Advanced Development Program, and the Data Management System. Assessments are presented for these and other areas as they apply to the advancement of automation and robotics technology for the Space Station Freedom.

  15. Management of advanced prostate cancer in senior adults: the new landscape.

    PubMed

    Aapro, Matti S

    2012-01-01

    The landscape of treatment for advanced prostate cancer is continually evolving as new therapies are developed and guidelines are constantly updated. However, the management of older men with advanced disease is not optimal. Many men are denied chemotherapy based on their chronological age, not their health status. Androgen-deprivation therapy (ADT) remains the mainstay of first-line treatment of advanced disease. Once the disease becomes resistant to castration, docetaxel-based chemotherapy is the regulatory-approved standard of care, irrespective of age. The place of weekly docetaxel in patients with poor performance status and signs of frailty has to be further evaluated in clinical studies. New treatments are now available, or on the horizon, for disease that progresses during or after docetaxel therapy. Cabazitaxel and abiraterone have been shown to prolong survival, irrespective of age, and are already in clinical use having received regulatory approval. The optimal sequence for these two agents is still unknown, although there is some indication that in patients predicted to be poor responders to abiraterone (high Gleason score, progression during docetaxel therapy, rapid progression to castrate-resistant prostate cancer with ADT) cabazitaxel should be the preferred choice. Further advances are being investigated, with promising data reported from phase III trials.

  16. Advanced Robotics for Air Force Operations

    DTIC Science & Technology

    1989-06-01

    evaluated current and potential uses of advanced robotics to support Air Force systems, (2) recommended the most effective aplications of advanced robotics...manpower. Such a robot system would The boom would not only transfer fuel, be considerably more mobile and effi- 10 ADVANCED ROBOTICS FOR AIR FORCE...increased manpower resources in war tive clothing reduce vision, hearing, and make this an attractive potential appli- mobility , which further reduce

  17. Advancing automation and robotics technology for the Space Station Freedom and for the US economy

    NASA Technical Reports Server (NTRS)

    Lum, Henry, Jr.

    1992-01-01

    Described here is the progress made by Levels 1, 2, and 3 of the Space Station Freedom in developing and applying advanced automation and robotics technology. Emphasis was placed on the Space Station Freedom program responses to specific recommendations made in the Advanced Technology Advisory Committee (ATAC) Progress Report 13, and issues of A&R implementation into the payload operations integration Center at Marshall Space Flight Center. Assessments are presented for these and other areas as they apply to the advancement of automation and robotics technology for Space Station Freedom.

  18. Basic Research and Progress against Pediatric Cancer

    Cancer.gov

    An infographic about the importance of basic research for making progress against childhood cancers. Shows the milestones that led to development and approval of dinutuximab (Unituxin®) to treat neuroblastoma, a cancer seen mainly in children.

  19. Progress Evaluation of the National Estuary Program

    EPA Pesticide Factsheets

    A guidance to help the U.S. EPA determine whether the 28 programs included in NEP are making adequate progress implementing their CCMP and therefore merit continued funding under §320 of the Clean Water Act.

  20. Tobacco Policy/Regulatory Factors - Prevention Summary Table | Cancer Trends Progress Report

    Cancer.gov

    The Cancer Trends Progress Report, first issued in 2001, summarizes our nation's advances against cancer in relation to Healthy People targets set forth by the Department of Health and Human Services.

  1. Weight and Physical Activity - Prevention Summary Table | Cancer Trends Progress Report

    Cancer.gov

    The Cancer Trends Progress Report, first issued in 2001, summarizes our nation's advances against cancer in relation to Healthy People targets set forth by the Department of Health and Human Services.

  2. Establishing Benchmarks and Measuring Progress at "HSTW" Sites.

    ERIC Educational Resources Information Center

    Southern Regional Education Board (SREB), 2010

    2010-01-01

    Schools that join the "High Schools That Work (HSTW)" network are expected to show progress in changing school and classroom practices in ways that improve student achievement and readiness for postsecondary studies and careers. They are expected to focus on practices that have proven most effective in advancing student achievement.…

  3. Challenges and progress in making DNA-based AIS early ...

    EPA Pesticide Factsheets

    The ability of DNA barcoding to find additional species in hard-to-sample locations or hard-to-identify samples is well established. Nevertheless, adoption of DNA barcoding into regular monitoring programs has been slow, in part due to issues of standardization and interpretation that need resolving. In this presentation, we describe our progress towards incorporating DNA-based identification into broad-spectrum aquatic invasive species early-detection monitoring in the Laurentian Great Lakes. Our work uses community biodiversity information as the basis for evaluating survey performance for various taxonomic groups. Issues we are tackling in bringing DNA-based data to bear on AIS monitoring design include: 1) Standardizing methodology and work flow from field collection and sample handling through bioinformatics post-processing; 2) Determining detection sensitivity and accounting for inter-species differences in DNA amplification and primer affinity; 3) Differentiating sequencing and barcoding errors from legitimate new finds when range and natural history information is limited; and 4) Accounting for the different nature of morphology- vs. DNA-based biodiversity information in subsequent analysis (e.g., via species accumulation curves, multi-metric indices). not applicable

  4. Some observations on the interdigitation of advances in medical science and mathematics.

    PubMed

    Glamore, Michael James; West, James L; O'leary, James Patrick

    2013-12-01

    The immense advancement of our understanding of disease processes has not been a uniform progression related to the passage of time. Advances have been made in "lurches" and "catches" since the advent of the written word. There has been a remarkable interdependency between such advances in medicine and advances in mathematics that has proved beneficial to both. This work explores some of these critical relationships and documents how the individuals involved contributed to advances in each.

  5. Presence of novel compound BCR-ABL mutations in late chronic and advanced phase imatinib sensitive CML patients indicates their possible role in CML progression.

    PubMed

    Akram, Afia Muhammad; Iqbal, Zafar; Akhtar, Tanveer; Khalid, Ahmed Mukhtar; Sabar, Muhammad Farooq; Qazi, Mahmood Hussain; Aziz, Zeba; Sajid, Nadia; Aleem, Aamer; Rasool, Mahmood; Asif, Muhammad; Aloraibi, Saleh; Aljamaan, Khaled; Iqbal, Mudassar

    2017-04-03

    BCR-ABL kinase domain (K D ) mutations are well known for causing resistance against tyrosine kinase inhibitors (TKIs) and disease progression in chronic myeloid leukemia (CML). In recent years, compound BCR-ABL mutations have emerged as a new threat to CML patients by causing higher degrees of resistance involving multiple TKIs, including ponatinib. However, there are limited reports about association of compound BCR-ABL mutations with disease progression in imatinib (IM) sensitive CML patients. Therefore, we investigated presence of ABL-K D mutations in chronic phase (n = 41), late chronic phase (n = 33) and accelerated phase (n = 16) imatinib responders. Direct sequencing analysis was used for this purpose. Eleven patients (12.22%) in late-CP CML were detected having total 24 types of point mutations, out of which 8 (72.72%) harbored compound mutated sites. SH2 contact site mutations were dominant in our study cohort, with E355G (3.33%) being the most prevalent. Five patients (45%) all having compound mutated sites, progressed to advanced phases of disease during follow up studies. Two novel silent mutations G208G and E292E/E were detected in combination with other mutants, indicating limited tolerance for BCR-ABL1 kinase domain for missense mutations. However, no patient in early CP of disease manifested mutated ABL-K D . Occurrence of mutations was found associated with elevated platelet count (p = 0.037) and patients of male sex (p = 0.049). The median overall survival and event free survival of CML patients (n = 90) was 6.98 and 5.8 y respectively. The compound missense mutations in BCR-ABL kinase domain responsible to elicit disease progression, drug resistance or disease relapse in CML, can be present in yet Imatinib sensitive patients. Disease progression observed here, emphasizes the need of ABL-K D mutation screening in late chronic phase CML patients for improved clinical management of disease.

  6. FOUR-YEAR INCIDENCE AND PROGRESSION OF AGE-RELATED MACULAR DEGENERATION: THE LOS ANGELES LATINO EYE STUDY

    PubMed Central

    Varma, Rohit; Foong, Athena W.P.; Lai, Mei-Ying; Choudhury, Farzana; Klein, Ronald; Azen, Stanley P.

    2011-01-01

    Purpose To estimate 4-year incidence and progression of early and advanced age-related macular degeneration (AMD). Design Population-based cohort study. Methods A comprehensive ophthalmologic examination including stereoscopic fundus photography was performed on adult Latinos at baseline and follow-up. Photographs were graded using a modified Wisconsin Age-Related Maculopathy Grading System. For estimations of incidence and progression of AMD, the Age Related Eye Disease Study Scale was used. Main outcome measures are incidence and progression of early AMD (drusen type, drusen size, and retinal pigmentary abnormalities) and advanced AMD (exudative AMD and geographic atrophy). Results 4,658/6100 (76%) completed the follow-up examination. The 4-year incidence of early AMD was 7.5% (95%CI:6.6,8.4) and advanced AMD was 0.2% (95%CI:0.1,0.4). Progression of any AMD occurred in 9.3% (95%CI:8.4,10.3) of at-risk participants. Incidence and progression increased with age. Incidence of early AMD in the second eye (10.8%) was higher than incidence in the first eye (6.9%). Baseline presence of soft indistinct large drusen≥250μm in diameter was more likely to predict the 4-year incidence of pigmentary abnormalities, geographic atrophy, and exudative AMD than smaller or hard or soft distinct drusen. Conclusions Age-specific incidence and progression of AMD in Latinos are lower than in non-Hispanic whites. While incident early AMD is more often unilateral, the risk of its development in the second is higher than in the first eye. Older persons and those with soft indistinct large drusen had a higher risk of developing advanced AMD compared to those who were younger and did not have soft indistinct large drusen. PMID:20399926

  7. [Individual Progress Program for the Extremely Gifted Student in the Greater Seattle Area.

    ERIC Educational Resources Information Center

    Norsen, Barbara G.; Wick, Christine

    The Individual Progress Program (IPP) is an approach designed to serve extremely advanced gifted students (grades 1 through 9) in the Seattle area. IPP is intended to meet students' unmet educational needs by allowing them to progress at their own accelerated pace through a broadly based curriculum while also pursuing interest areas. The program…

  8. Advancing High-Quality Literacy Research in Juvenile Justice: Methodological and Practical Considerations

    ERIC Educational Resources Information Center

    Houchins, David E.; Jolivette, Kristine; Shippen, Margaret E.; Lambert, Richard

    2010-01-01

    Special education researchers have made noteworthy progress toward conceptualizing literacy research questions, designing quality studies, and disseminating the results of their research. These advancements have been made through the establishment and refinement of quality research indicators. Unfortunately, this progress has mostly eluded the…

  9. Thermal structures: Four decades of progress

    NASA Technical Reports Server (NTRS)

    Thornton, Earl A.

    1990-01-01

    Since the first supersonic flight in October 1947, the United States has designed, developed and flown flight vehicles within increasingly severe aerothermal environments. Over this period, major advances in engineering capabilities have occurred that will enable the design of thermal structures for high speed flight vehicles in the twenty-first century. Progress in thermal-structures is surveyed for the last four decades to provide a historical perspective for future efforts.

  10. Recent Sikorsky R and D progress

    NASA Technical Reports Server (NTRS)

    1988-01-01

    The recent activities and progress in four specific areas of Sikorsky's research and development program are summarized. Since the beginning of the S-76 design in 1974, Sikorsky has been aggressively developing the technology for using composite materials in helicopter design. Four specific topics are covered: advanced cockpit/controller efforts, fly-by-wire controls on RSRA/X-Wing, vibration control via higher harmonic control, and main rotor aerodynamic improvements.

  11. Progress and Compliance in Alcohol Abuse Treatment*

    PubMed Central

    Lien, Hsien-Ming; Lu, Mingshan; Ma, Ching-To Albert; McGuire, Thomas G.

    2009-01-01

    Improving patient compliance with physicians’ treatment or prescription recommendations is an important goal in medical practice. We examine the relationship between treatment progress and patient compliance. We hypothesize that patients balance expected benefits and costs during a treatment episode when deciding on compliance; a patient is more likely to comply if doing so results in an expected gain in health benefit. We use a unique data set of outpatient alcohol abuse treatment to identify a relationship between treatment progress and compliance. Treatment progress is measured by the clinician’s comments after each attended visit. Compliance is measured by a client attending a scheduled appointment, and continuing with treatment. We find that a patient who is making progress is less likely to drop out of treatment. We find no evidence that treatment progress raises the likelihood of a patient attending the next scheduled visit. Our results are robust to unobserved patient heterogeneity. PMID:20031241

  12. VEGF-A polymorphisms predict progression-free survival among advanced castration-resistant prostate cancer patients treated with metronomic cyclophosphamide

    PubMed Central

    Orlandi, P; Fontana, A; Fioravanti, A; Di Desidero, T; Galli, L; Derosa, L; Canu, B; Marconcini, R; Biasco, E; Solini, A; Francia, G; Danesi, R; Falcone, A; Bocci, G

    2013-01-01

    Background: No data are available on the pharmacogenetics of metronomic chemotherapy in prostate cancer. The aim of this study was to evaluate the association between VEGF-A sequence variants and prostate-specific antigen (PSA) progression, progression-free survival (PFS) and overall survival (OS), in advanced castration-resistant prostate cancer patients treated with metronomic cyclophosphamide (CTX), celecoxib and dexamethasone. Methods: Forty-three patients were enrolled, and genomic DNA was extracted. VEGF-A gene SNPs (−2578A/C, −634C/G, +936C/T) were analysed using TaqMan PCR assays. Hardy–Weinberg equilibrium was tested for each SNP, and genetic effects were evaluated by Fisher's exact test. PFS and OS were analysed with GraphPad Prism software, using the product limit method of Kaplan and Meier, and comparing survival curves using both the log-rank test and the Gehan–Wilcoxon test. We used Bonferroni correction to account for multiple testing, and a two-tailed P-value of <0.017 was considered statistically significant. Results: Overall, 20 patients (46%) experienced a reduction in PSA levels from baseline and, among them, 14 (32%) showed a confirmed PSA ≥50% decrease. In non-responders, the −2578CC genotype was more frequent (18.60% vs 2.33% in responders; P=0.0212) whereas the −634CC genotype frequency was 22.73% vs 0% in responders (P=0.0485). With regard to PFS, patients harbouring the −634CC genotype had a median PFS of 2.2 months whereas patients with the genotype −634CG/GG had a median PFS of 6.25 months (P=0.0042). Conclusion: The −634CC genotype is significantly associated with a shorter PFS in patients treated with a metronomic CTX schedule. PMID:23860526

  13. Intravital imaging reveals new ancillary mechanisms co-opted by cancer cells to drive tumor progression

    PubMed Central

    Lucas, Morghan C.; Timpson, Paul

    2016-01-01

    Intravital imaging is providing new insights into the dynamics of tumor progression in native tissues and has started to reveal the layers of complexity found in cancer. Recent advances in intravital imaging have allowed us to look deeper into cancer behavior and to dissect the interactions between tumor cells and the ancillary host niche that promote cancer development. In this review, we provide an insight into the latest advances in cancer biology achieved by intravital imaging, focusing on recently discovered mechanisms by which tumor cells manipulate normal tissue to facilitate disease progression. PMID:27239290

  14. [Eugenics: progress or backward movement?].

    PubMed

    González de Cancino, Emilssen

    2007-01-01

    Throughout this article there is a critical analysis of how genetics presents a dilemma for "human progress". So much so, that the legal world aims to create unequivocal norms and guarantees in relation with eugenics in order to avoid attempting against human dignity. The document makes the reader reflect on the ethical problems that eugenics can entail.

  15. Limited role of culture conversion for decision-making in individual patient care and for advancing novel regimens to confirmatory clinical trials.

    PubMed

    Phillips, Patrick P J; Mendel, Carl M; Burger, Divan A; Crook, Angela M; Crook, Angela; Nunn, Andrew J; Dawson, Rodney; Diacon, Andreas H; Gillespie, Stephen H

    2016-02-04

    Despite recent increased clinical trials activity, no regimen has proved able to replace the standard 6-month regimen for drug-sensitive tuberculosis. Understanding the relationship between microbiological markers measured during treatment and long-term clinical outcomes is critical to evaluate their usefulness for decision-making for both individual patient care and for advancing novel regimens into time-consuming and expensive pivotal phase III trials. Using data from the randomized controlled phase III trial REMoxTB, we evaluated sputum-based markers of speed of clearance of bacilli: time to smear negative status; time to culture negative status on LJ or in MGIT; daily rate of change of log10(TTP) to day 56; and smear or culture results at weeks 6, 8 or 12; as individual- and trial-level surrogate endpoints for long-term clinical outcome. Time to culture negative status on LJ or in MGIT, time to smear negative status and daily rate of change in log10(TTP) were each independent predictors of clinical outcome, adjusted for treatment (p <0.001). However, discrimination between low and high risk patients, as measured by the c-statistic, was modest and not much higher than the reference model adjusted for BMI, history of smoking, HIV status, cavitation, gender and MGIT TTP. Culture conversion during treatment for tuberculosis, however measured, has only a limited role in decision-making for advancing regimens into phase III trials or in predicting the outcome of treatment for individual patients. REMoxTB ClinicalTrials.gov number: NCT00864383.

  16. Neoadjuvant Chemotherapy in Locally Advanced and Borderline Resectable Nonsquamous Sinonasal Tumors (Esthesioneuroblastoma and Sinonasal Tumor with Neuroendocrine Differentiation)

    PubMed Central

    Patil, Vijay M.; Joshi, Amit; Noronha, Vanita; Sharma, Vibhor; Zanwar, Saurabh; Dhumal, Sachin; Kane, Shubhada; Pai, Prathamesh; D'Cruz, Anil; Chaturvedi, Pankaj; Bhattacharjee, Atanu; Prabhash, Kumar

    2016-01-01

    Introduction. Sinonasal tumors are chemotherapy responsive which frequently present in advanced stages making NACT a promising option for improving resection and local control in borderline resectable and locally advanced tumours. Here we reviewed the results of 25 such cases treated with NACT. Materials and Methods. Sinonasal tumor patients treated with NACT were selected for this analysis. These patients received NACT with platinum and etoposide for 2 cycles. Patients who responded and were amenable for gross total resection underwent surgical resection and adjuvant CTRT. Those who responded but were not amenable for resection received radical CTRT. Patients who progressed on NACT received either radical CTRT or palliative radiotherapy. Results. The median age of the cohort was 42 years (IQR 37–47 years). Grades 3-4 toxicity with NACT were seen in 19 patients (76%). The response rate to NACT was 80%. Post-NACT surgery was done in 12 (48%) patients and radical chemoradiation in 9 (36%) patients. The 2-year progression free survival and overall survival were 75% and 78.5%, respectively. Conclusion. NACT in sinonasal tumours has a response rate of 80%. The protocol of NACT followed by local treatment is associated with improvement in outcomes as compared to our historical cohort. PMID:26955484

  17. Advance Care Planning Beyond Advance Directives: Perspectives from Patients and Surrogates

    PubMed Central

    McMahan, Ryan; Knight, Sara J.; Fried, Terri R.; Sudore, Rebecca L.

    2014-01-01

    Context Advance care planning (ACP) has focused on documenting life-sustaining treatment preferences in advance directives (ADs). ADs alone may be insufficient to prepare diverse patients and surrogates for complex medical decisions. Objectives To understand what steps best prepare patients and surrogates for decision making. Methods We conducted 13 English/Spanish focus groups with participants from a Veterans Affairs and county hospital and the community. Seven groups included patients (n=38) aged ≥65 years, who reported making serious medical decisions. Six separate groups included surrogates (n=31), aged ≥18 years, who made decisions for others. Semi-structured focus groups asked what activities best prepared participants for decision making. Two investigators independently coded data and performed thematic content analysis. Disputes were resolved by consensus. Results Mean±SD patient age was 78±8 years and 61% were non-white. Mean±SD surrogate age was 57±10 years and 91% were non-white. Qualitative analysis identified four overarching themes about how to best prepare for decision making: 1) identify values based on past experiences and quality of life, 2) choose surrogates wisely and verify they understand their role, 3) decide whether to grant leeway in surrogate decision making, and 4) inform other family and friends of one's wishes to prevent conflict. Conclusion Beyond ADs, patients and surrogates recommend several additional steps to prepare for medical decision making including using past experiences to identify values, verifying the surrogate understands their role, deciding whether to grant surrogates leeway, and informing other family and friends of one's wishes. Future ACP interventions should consider incorporating these additional ACP activities. PMID:23200188

  18. Making the Most of MASINT and Advanced Geospatial Intelligence

    DTIC Science & Technology

    2012-04-10

    mining contracts and new job creation that ultimately supports economic development. This 22 type of forensic level analysis can make MASINT an...and Technology, ed. John D. Bossler (London: Taylor and Francis, 2002), 305 17 Jian Guo Liu and Philippa J. Mason, Essential Image Processing and

  19. Global progress in prevention of cardiovascular disease

    PubMed Central

    2017-01-01

    Although there is measurable global progress in prevention of cardiovascular disease (CVD), it has been highly uneven and inadequate, particularly in low- and middle-income countries. Voluntary global targets have helped to galvanize attention, resources and accountability on tobacco use, harmful use of alcohol, unhealthy diet and physical inactivity which are the major behavioural drivers of CVD. Many obstacles and challenges continue to impede the progress of cardiovascular prevention. The inclusion of noncommunicable diseases (NCDs) in the sustainable development agenda as a specific target, offers an unprecedented opportunity to further advance the global progress of cardiovascular prevention. In order to seize this opportunity, a paradigm shift is required in the way key challenges to cardiovascular prevention are addressed. Such an approach must provide leadership for intersectoral policy coherence, identify effective means of tackling commercial determinants of behavioural risk factors, use rights based arguments, enhance public engagement and ensure accountability. PMID:28529920

  20. Translational research in immune and inflammatory diseases; what are the challenges, expected advances, and innovative therapies?

    PubMed

    Joubert, Jean-Michel; Gottenberg, Jacques-Eric; Paintaud, Gilles; Augendre-Ferrante, Béatrice; Cans, Christophe; Cellier, Dominique; Chevalier, Marie-Pierre; Diaz, Isabelle; Filipecki, Jamila; Kahn, Jean-Emmanuel; Le Men, Johan; Mulleman, Denis; Urbain, Rémi; Vasmant, Daniel

    2014-01-01

    Despite very different aetiologies and clinical expressions, advancing knowledge in the physiopathology and treatment of immune and inflammatory diseases (IID) prompts us to consider them as a whole. These are chronic, often incapacitating and painful illnesses that progress and destroy organs. Management by discipline too often leads to erroneous diagnoses and sometimes inappropriate treatment. More integrated translational research would further understanding of the complex relationships between cytokines and organ damage, which vary with the conditions and patients, making it possible to develop new biomarkers and personalize treatment. The research in France has very many strengths but its organization is fragmented. Better coordinated research into IID, which could be based on creating a strategic valorization field (domaine de valorisation stratégique, DVS) and thematic multi-organization institute (Institut thématique multi-organismes ITMO), would advance patient management. © 2014 Société Française de Pharmacologie et de Thérapeutique.

  1. Advanced information society (11)

    NASA Astrophysics Data System (ADS)

    Nawa, Kotaro

    Late in the 1980's the information system of Japanese corporation has been operated strategically to strengthen its competitive position in markets rather than to make corporate management efficient. Therefore, information-oriented policy in the corporation is making remarkable progress. This policy expands the intelligence activity in the corporation and also leads to the extension of the market in an information industry. In this environment closed corporate system is transformed into open one. For this system network and database are important managerial resources.

  2. 34 CFR 668.34 - Satisfactory progress.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 34 Education 3 2010-07-01 2010-07-01 false Satisfactory progress. 668.34 Section 668.34 Education..., DEPARTMENT OF EDUCATION STUDENT ASSISTANCE GENERAL PROVISIONS Student Eligibility § 668.34 Satisfactory... requirements contained in § 668.32(f), the student must be making satisfactory under the provisions of...

  3. Mothering With Advanced Ovarian Cancer: "You've Got to Find That Little Thing That's Going to Make You Strong".

    PubMed

    Arida, Janet A; Bressler, Toby; Moran, Samantha; DʼArpino, Sara; Carr, Alaina; Hagan, Teresa L

    2018-02-27

    Mothers with ovarian cancer are at risk of experiencing additional demands given their substantial symptom burden and accelerated disease progression. This study describes the experience of mothers with ovarian cancer, elucidating the interaction between their roles as mothers and patients with cancer. We conducted a secondary analysis of focus groups with women with advanced ovarian cancer. Using descriptive coding, we developed a coding framework based on emerging findings and group consensus. We then identified higher-order themes capturing the breadth of experiences described by mothers with ovarian cancer. Eight of the 13 participants discussed motherhood. The mean age of participants was 48.38 (SD, 7.17) years. All women were white (9/9), most had some college education (6/9), and the majority were married (5/9). Mean time since diagnosis was 7.43 (SD, 4.69) months; more than half of women (5/9) were currently receiving treatment. Themes and exemplar quotes reflected participants' evolving self-identities from healthy mother to cancer patient to woman mothering with cancer. Subthemes related to how motherhood was impacted by symptoms, demands of treatment, and the need to gain acceptance of living with cancer. The experience of motherhood impacts how women experience cancer and how they evolve as survivors. Similarly, cancer influences mothering. Healthcare providers should understand and address the needs of mothers with ovarian cancer. This study adds to the limited literature in this area and offers insight into the unique needs faced by women mothering while facing advanced cancer.

  4. Teaching Staff Advanced Training: European Experience

    ERIC Educational Resources Information Center

    Kovalchuk, Vasyl

    2015-01-01

    The issue of teaching staff advanced training is paid much attention in many countries. In the Republic of Moldova progressive professional credits system is used. Credits are scored not only in assigning teaching degrees or issuing a certificate of continuing professional education, but also for teachers' evaluation at the educational…

  5. The Careless or the Conscientious: Who Profits Most from Goal Progress?

    ERIC Educational Resources Information Center

    Hulsheger, Ute R.; Maier, Gunter W.

    2010-01-01

    Although research indicates that making progress on personal work goals predicts positive job attitudes, little is known about the role of conscientiousness in moderating this relationship. Congruence theories suggest that job attitudes will be more dependent on goal progress when employees are high in conscientiousness, whereas compensation…

  6. Making the case for a model mental health advance directive statute.

    PubMed

    Clausen, Judy A

    2014-01-01

    Acute episodes of mental illness temporarily destroy the capacity required to give informed consent and often prevent people from realizing they are sick, causing them to refuse intervention. Once a person refuses treatment, the only way to obtain care is as an involuntary patient. Even in the midst of acute episodes, many people do not meet commitment criteria because they are not likely to injure themselves or others and are still able to care for their basic needs. Left untreated, the episode will likely spiral out of control. By the time the person finally meets strict commitment criteria, devastation has already occurred. This Article argues that an individual should have the right to enter a Ulysses arrangement, a special type of mental health advance directive that authorizes a doctor to administer treatment during a future episode even if the episode causes the individual to refuse care. The Uniform Law Commissioners enacted the Uniform Health-Care Decisions Act as a model statute to address all types of advance health care planning, including planning for mental illness. However, the Act focuses on end-of-life care and fails to address many issues faced by people with mental illness. For example, the Act does not empower people to enter Ulysses arrangements and eliminates writing and witnessing requirements that protect against fraud and coercion. This Article recommends that the Uniform Law Commissioners adopt a model mental health advance directive statute that empowers people to enter Ulysses arrangements and provides safeguards against abuse. Appendix A sets forth model provisions.

  7. Patient and Oncology Nurse Preferences for the Treatment Options in Advanced Melanoma: A Discrete Choice Experiment.

    PubMed

    Liu, Frank Xiaoqing; Witt, Edward A; Ebbinghaus, Scot; DiBonaventura Beyer, Grace; Basurto, Enrique; Joseph, Richard W

    2017-10-25

    Understanding the perceptions of patients and oncology nurses about the relative importance of benefits and risks associated with newer treatments of advanced melanoma can help to inform clinical decision-making. The aims of this study were to quantify and compare the views of patients and oncology nurses regarding the importance of attributes of treatments of advanced melanoma. A discrete choice experiment (DCE) was conducted in US-based oncology nurses and patients diagnosed with advanced melanoma. Patients and nurses were enlisted through online panels. In a series of scenarios, respondents had to choose between 2 hypothetical treatments, each with 7 attributes: mode of administration (MoA), dosing schedule (DS), median duration of therapy (DoT), objective response rate (ORR), progression-free survival (PFS), overall survival (OS), and grade 3 or 4 adverse events (AEs). Hierarchical Bayesian logistic regression models were used to estimate preference weights. A total of 200 patients with advanced melanoma and 150 oncology nurses participated. The relative importance estimates of attributes by patients and nurses, respectively, were as follows: OS, 33% and 28%; AEs, 29% and 26%; ORR, 25% and 27%; PFS, 12% and 15%; DS, 2% and 3%; DoT, 0% and 0%; and MoA, 0% and 0%. Both patients and oncology nurses valued OS, ORR, and AEs as the most important treatment attributes for advanced melanoma, followed by PFS, whereas DS, DoT, and MoA were given less value in their treatment decisions. Oncology nurses and patients have similar views on important treatment considerations for advanced melanoma, which can help build trust in shared decision-making.This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal.

  8. Workshop on Aeronautical Decision Making (ADM). Volume 1. Executive Summary

    DTIC Science & Technology

    1992-08-01

    expert and novice pilots when a real decision was required. Aeronautical Decision Making (ADM), Crew Resource Management (CRM), Advanced Qualification Program (AQP), Cognitive Task Analysis (CTA), Expert Decision Making (EDM)

  9. Recent progress in half-Heusler thermoelectric materials

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

    Huang, Lihong; Zhang, Qinyong; Yuan, Bo

    2016-04-15

    Highlights: • Summarize the recent progress and advances in HH thermoelectric materials. • Preparing nanocomposites could reduce thermal conductivity. • Introducing enhance phonon scattering could further reduce the thermal conductivity. • Forming ternary systems to reducing the cost effectively. • The new class of HHs presents another opportunity to further optimize the HH system. - Abstract: Half-Heusler (HH) thermoelectric (TE) materials have been attracting extensive research interest over the last two decades, owing to their thermal stability, mechanical strength, and moderate ZT. This material system are potential candidates for medium to high temperature applications, which is close to the temperaturemore » range of most industrial waste heat sources. In this mini-review article, we briefly summarize the recent progress and advances in HH thermoelectric materials. Some effectively available approaches, such as HH nanocomposites to reduce thermal conductivity, using larger atomic mass and size differences to enhance phonon scattering to further reduce the thermal conductivity, forming ternary systems following the cost effective approach. In addition, new thermoelectric HH members are also discussed in this article, which points out that many new HH compounds may be possible for TE applications.« less

  10. Phthalocyanine-Based Organic Thin-Film Transistors: A Review of Recent Advances.

    PubMed

    Melville, Owen A; Lessard, Benoît H; Bender, Timothy P

    2015-06-24

    Metal phthalocyanines (MPcs) are versatile conjugated macrocycles that have attracted a great deal of interest as active components in modern organic electronic devices. In particular, the charge transport properties of MPcs, their chemical stability, and their synthetic versatility make them ideal candidate materials for use in organic thin-film transistors (OTFTs). This article reviews recent progress in both the material design and device engineering of MPc-based OTFTs, including the introduction of solubilizing groups on the MPcs and the surface modification of substrates to induce favorable MPc self-assembly. Finally, a discussion on emerging niche applications based on MPc OTFTs will be explored, in addition to a perspective and outlook on these promising materials in OTFTs. The scope of this review is focused primarily on the advances made in the field of MPc-based OTFTs since 2008.

  11. Status of the Advanced Virgo gravitational wave detector

    NASA Astrophysics Data System (ADS)

    Acernese, F.; Adams, T.; Agatsuma, K.; Aiello, L.; Allocca, A.; Amato, A.; Antier, S.; Arnaud, N.; Ascenzi, S.; Astone, P.; Bacon, P.; Bader, M. K. M.; Baldaccini, F.; Ballardin, G.; Barone, F.; Barsuglia, M.; Barta, D.; Basti, A.; Bawaj, M.; Bazzan, M.; Bejger, M.; Belahcene, I.; Bersanetti, D.; Bertolini, A.; Bitossi, M.; Bizouard, M. A.; Bloemen, S.; Boer, M.; Bogaert, G.; Bondu, F.; Bonnand, R.; Boom, B. A.; Boschi, V.; Bouffanais, Y.; Bozzi, A.; Bradaschia, C.; Branchesi, M.; Briant, T.; Brillet, A.; Brisson, V.; Bulik, T.; Bulten, H. J.; Buskulic, D.; Buy, C.; Cagnoli, G.; Calloni, E.; Canepa, M.; Canizares, P.; Capocasa, E.; Carbognani, F.; Casanueva Diaz, J.; Casentini, C.; Cavalier, F.; Cavalieri, R.; Cella, G.; Cerboni Baiardi, L.; Cerretani, G.; Cesarini, E.; Chassande-Mottin, E.; Chincarini, A.; Chiummo, A.; Christensen, N.; Chua, S.; Ciolfi, R.; Cirone, A.; Cleva, F.; Coccia, E.; Cohadon, P.-F.; Colla, A.; Conti, L.; Cortese, S.; Coulon, J.-P.; Cuoco, E.; D'Antonio, S.; Dattilo, V.; Davier, M.; Degallaix, J.; de Laurentis, M.; Deléglise, S.; Del Pozzo, W.; De Rosa, R.; di Fiore, L.; di Giovanni, M.; di Girolamo, T.; di Lieto, A.; di Pace, S.; di Palma, I.; di Renzo, F.; Dolique, V.; Ducrot, M.; Fafone, V.; Farinon, S.; Ferrante, I.; Ferrini, F.; Fidecaro, F.; Fiori, I.; Fiorucci, D.; Flaminio, R.; Fournier, J.-D.; Frasca, S.; Frasconi, F.; Frey, V.; Gammaitoni, L.; Garufi, F.; Gemme, G.; Genin, E.; Gennai, A.; Germain, V.; Ghosh, A.; Ghosh, S.; Giazotto, A.; Gonzalez Castro, J. M.; Gosselin, M.; Gouaty, R.; Grado, A.; Granata, M.; Greco, G.; Groot, P.; Gruning, P.; Guidi, G. M.; Harms, J.; Heidmann, A.; Heitmann, H.; Hello, P.; Hemming, G.; Hoak, D.; Hofman, D.; Huet, D.; Intini, G.; Isac, J.-M.; Jacqmin, T.; Jaranowski, P.; Jonker, R. J. G.; Kéfélian, F.; Khan, I.; Koley, S.; Kowalska, I.; Królak, A.; Kutynia, A.; Lartaux-Vollard, A.; Lazzaro, C.; Leaci, P.; Leonardi, M.; Leroy, N.; Letendre, N.; Lorenzini, M.; Loriette, V.; Losurdo, G.; Lumaca, D.; Majorana, E.; Maksimovic, I.; Man, N.; Mantovani, M.; Marchesoni, F.; Marion, F.; Martelli, F.; Martellini, L.; Masserot, A.; Mastrogiovanni, S.; Meidam, J.; Merzougui, M.; Metzdorff, R.; Mezzani, F.; Michel, C.; Milano, L.; Miller, A.; Minazzoli, O.; Minenkov, Y.; Moggi, A.; Mohan, M.; Montani, M.; Mours, B.; Nardecchia, I.; Naticchioni, L.; Nelemans, G.; Neri, M.; Nichols, D.; Nissanke, S.; Nocera, F.; Palomba, C.; Paoletti, F.; Paoli, A.; Pasqualetti, A.; Passaquieti, R.; Passuello, D.; Patricelli, B.; Pedurand, R.; Perreca, A.; Piccinni, O. J.; Pichot, M.; Piergiovanni, F.; Pillant, G.; Pinard, L.; Poggiani, R.; Popolizio, P.; Porter, E. K.; Prodi, G. A.; Punturo, M.; Puppo, P.; Rapagnani, P.; Razzano, M.; Regimbau, T.; Rei, L.; Ricci, F.; Robinet, F.; Rocchi, A.; Rolland, L.; Romano, R.; Rosińska, D.; Ruggi, P.; Salconi, L.; Sassolas, B.; Schmidt, P.; Sentenac, D.; Sequino, V.; Sieniawska, M.; Singhal, A.; Sorrentino, F.; Stratta, G.; Swinkels, B. L.; Tacca, M.; Tiwari, S.; Tonelli, M.; Travasso, F.; Tringali, M. C.; Trozzo, L.; Tsang, K. W.; van Bakel, N.; van Beuzekom, M.; van den Brand, J. F. J.; van den Broeck, C.; van der Schaaf, L.; van Heijningen, J. V.; Vardaro, M.; Vasúth, M.; Vedovato, G.; Verkindt, D.; Vetrano, F.; Viceré, A.; Vinet, J.-Y.; Vocca, H.; Walet, R.; Wang, G.; Was, M.; Yvert, M.; Zadrożny, A.; Zelenova, T.; Zendri, J.-P.

    2017-10-01

    Advanced Virgo is the French-Italian second generation laser gravitational wave detector, successor of the Initial Virgo. This new interferometer keeps only the infrastructure of its predecessor and aims to be ten times more sensitive, with its first science run planned for 2017. This article gives an overview of the Advanced Virgo design and the technical choices behind it. Finally, the up-to-date progresses and the planned upgrade for the following years are detailed.

  12. Palliative care in advanced dementia.

    PubMed

    Merel, Susan E; Merel, Susan; DeMers, Shaune; Vig, Elizabeth

    2014-08-01

    Because neurodegenerative dementias are progressive and ultimately fatal, a palliative approach focusing on comfort, quality of life, and family support can have benefits for patients, families, and the health system. Elements of a palliative approach include discussion of prognosis and goals of care, completion of advance directives, and a thoughtful approach to common complications of advanced dementia. Physicians caring for patients with dementia should formulate a plan for end-of-life care in partnership with patients, families, and caregivers, and be prepared to manage common symptoms at the end of life in dementia, including pain and delirium. Copyright © 2014 Elsevier Inc. All rights reserved.

  13. Progress toward the maintenance and repair of degenerating retinal circuitry.

    PubMed

    Vugler, Anthony A

    2010-01-01

    Retinal diseases such as age-related macular degeneration and retinitis pigmentosa remain major causes of severe vision loss in humans. Clinical trials for treatment of retinal degenerations are underway and advancements in our understanding of retinal biology in health/disease have implications for novel therapies. A review of retinal biology is used to inform a discussion of current strategies to maintain/repair neural circuitry in age-related macular degeneration, retinitis pigmentosa, and Type 2 Leber congenital amaurosis. In age-related macular degeneration/retinitis pigmentosa, a progressive loss of rods/cones results in corruption of bipolar cell circuitry, although retinal output neurons/photoreceptive melanopsin cells survive. Visual function can be stabilized/enhanced after treatment in age-related macular degeneration, but in advanced degenerations, reorganization of retinal circuitry may preclude attempts to restore cone function. In Type 2 Leber congenital amaurosis, useful vision can be restored by gene therapy where central cones survive. Remarkable progress has been made in restoring vision to rodents using light-responsive ion channels inserted into bipolar cells/retinal ganglion cells. Advances in genetic, cellular, and prosthetic therapies show varying degrees of promise for treating retinal degenerations. While functional benefits can be obtained after early therapeutic interventions, efforts should be made to minimize circuitry changes as soon as possible after rod/cone loss. Advances in retinal anatomy/physiology and genetic technologies should allow refinement of future reparative strategies.

  14. Advance care planning and end-of-life decision making in dialysis: a randomized controlled trial targeting patients and their surrogates.

    PubMed

    Song, Mi-Kyung; Ward, Sandra E; Fine, Jason P; Hanson, Laura C; Lin, Feng-Chang; Hladik, Gerald A; Hamilton, Jill B; Bridgman, Jessica C

    2015-11-01

    Few trials have examined long-term outcomes of advance care planning (ACP) interventions. We examined the efficacy of an ACP intervention on preparation for end-of-life decision making for dialysis patients and surrogates and for surrogates' bereavement outcomes. A randomized trial compared an ACP intervention (Sharing Patient's Illness Representations to Increase Trust [SPIRIT]) to usual care alone, with blinded outcome assessments. 420 participants (210 dyads of prevalent dialysis patients and their surrogates) from 20 dialysis centers. Every dyad received usual care. Those randomly assigned to SPIRIT had an in-depth ACP discussion at the center and a follow-up session at home 2 weeks later. preparation for end-of-life decision making, assessed for 12 months, included dyad congruence on goals of care at end of life, patient decisional conflict, surrogate decision-making confidence, and a composite of congruence and surrogate decision-making confidence. bereavement outcomes, assessed for 6 months, included anxiety, depression, and posttraumatic distress symptoms completed by surrogates after patient death. adjusting for time and baseline values, dyad congruence (OR, 1.89; 95% CI, 1.1-3.3), surrogate decision-making confidence (β=0.13; 95% CI, 0.01-0.24), and the composite (OR, 1.82; 95% CI, 1.0-3.2) were better in SPIRIT than controls, but patient decisional conflict did not differ between groups (β=-0.01; 95% CI, -0.12 to 0.10). 45 patients died during the study. Surrogates in SPIRIT had less anxiety (β=-1.13; 95% CI, -2.23 to -0.03), depression (β=-2.54; 95% CI, -4.34 to -0.74), and posttraumatic distress (β=-5.75; 95% CI, -10.9 to -0.64) than controls. Study was conducted in a single US region. SPIRIT was associated with improvements in dyad preparation for end-of-life decision making and surrogate bereavement outcomes. Copyright © 2015 National Kidney Foundation, Inc. Published by Elsevier Inc. All rights reserved.

  15. Apatinib in the treatment of advanced lung adenocarcinoma with KRAS mutation.

    PubMed

    Zeng, Da-Xiong; Wang, Chang-Guo; Huang, Jian-An; Jiang, Jun-Hong

    2017-01-01

    Activating KRAS mutations in lung adenocarcinoma are characterized with treatment resistance and poor prognosis. As a small molecule inhibitor of vascular endothelial growth factor receptor-2 (VEGFR-2) tyrosine kinase, apatinib has been proven successful in advanced gastric cancer and breast cancer. In this study, we show the result of apatinib as salvage treatment in lung adenocarcinoma patients with KRAS mutation. Four advanced lung adenocarcinoma patients with KRAS mutation were orally administered apatinib (250 mg/d) after second-line treatment. One patient showed progressive disease, while 3 patients showed stable disease response to apatinib, with a median progression-free survival (PFS) of 3.8 months (1.5-5.5 months). The main toxicities were hoarseness and hemoptysis, which were manageable. Therefore, apatinib might be an optional choice for advanced lung adenocarcinoma patients with KRAS mutation in post second-line treatment.

  16. 6. CONSTRUCTION PROGRESS VIEW (EXTERIOR) OF TANK, CABLE CHASE, AND ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    6. CONSTRUCTION PROGRESS VIEW (EXTERIOR) OF TANK, CABLE CHASE, AND MOUNDED BUNKER. CONSTRUCTION WAS 99 PERCENT COMPLETE. CAMERA IS FACING WEST. INEL PHOTO NUMBER 65-5435, TAKEN OCTOBER 20, 1965. - Idaho National Engineering Laboratory, Advanced Reentry Vehicle Fusing System, Scoville, Butte County, ID

  17. Navigating the Trends and Most Recent Estimates Table | Cancer Trends Progress Report

    Cancer.gov

    The Cancer Trends Progress Report, first issued in 2001, summarizes our nation's advances against cancer in relation to Healthy People targets set forth by the Department of Health and Human Services.

  18. Bladder, Breast, and Colorectal Cancer- Treatment Summary Table | Cancer Trends Progress Report

    Cancer.gov

    The Cancer Trends Progress Report, first issued in 2001, summarizes our nation's advances against cancer in relation to Healthy People targets set forth by the Department of Health and Human Services.

  19. Incidence and Stage at Diagnosis - Diagnosis Summary Table | Cancer Trends Progress Report

    Cancer.gov

    The Cancer Trends Progress Report, first issued in 2001, summarizes our nation's advances against cancer in relation to Healthy People targets set forth by the Department of Health and Human Services.

  20. How strictly do dialysis patients want their advance directives followed?

    PubMed

    Sehgal, A; Galbraith, A; Chesney, M; Schoenfeld, P; Charles, G; Lo, B

    1992-01-01

    The Cruzan case and the Patient Self-Determination Act will encourage patients to specify in advance which life-sustaining treatments they would want if they become mentally incompetent. However, strictly following such advance directives may not always be in a patient's best interests. We sought to determine whether patients differ in how strictly they want advance directives followed. Interview study. Seven outpatient chronic dialysis centers. One hundred fifty mentally competent dialysis patients. Using a structured questionnaire, we asked the subjects whether they would want dialysis continued or stopped if they developed advanced Alzheimer's disease. We then asked how much leeway their physician and surrogate should have to override that advance directive if overriding were in their best interests. Subjects granting leeway were also asked what factors should be considered in making decisions for them. Subjects varied greatly in how much leeway they would give surrogates to override their advance directives: "no leeway" (39%), "a little leeway" (19%), "a lot of leeway" (11%), and "complete leeway" (31%). Subjects also varied in how much they wanted various factors considered in making decisions, such as pain or suffering, quality of life, possibility of a new treatment, indignity caused by continued treatment, financial impact of treatment on family members, and religious beliefs. Strictly following all advance directives may not truly reflect patients' preferences. To improve advance directives, we recommend that physicians explicitly ask patients how strictly they want their advance directives followed and what factors they want considered in making decisions.