Sample records for care pfc author

  1. 14 CFR 158.5 - Authority to impose PFC's.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 14 Aeronautics and Space 3 2011-01-01 2011-01-01 false Authority to impose PFC's. 158.5 Section...) AIRPORTS PASSENGER FACILITY CHARGES (PFC'S) General § 158.5 Authority to impose PFC's. Subject to the... service airport to impose a PFC of $1, $2, $3, $4, or $4.50 on passengers enplaned at such an airport. No...

  2. 14 CFR 158.5 - Authority to impose PFC's.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 14 Aeronautics and Space 3 2013-01-01 2013-01-01 false Authority to impose PFC's. 158.5 Section...) AIRPORTS PASSENGER FACILITY CHARGES (PFC'S) General § 158.5 Authority to impose PFC's. Subject to the... service airport to impose a PFC of $1, $2, $3, $4, or $4.50 on passengers enplaned at such an airport. No...

  3. 14 CFR 158.5 - Authority to impose PFC's.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 14 Aeronautics and Space 3 2014-01-01 2014-01-01 false Authority to impose PFC's. 158.5 Section...) AIRPORTS PASSENGER FACILITY CHARGES (PFC'S) General § 158.5 Authority to impose PFC's. Subject to the... service airport to impose a PFC of $1, $2, $3, $4, or $4.50 on passengers enplaned at such an airport. No...

  4. 14 CFR 158.5 - Authority to impose PFC's.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 14 Aeronautics and Space 3 2010-01-01 2010-01-01 false Authority to impose PFC's. 158.5 Section...) AIRPORTS PASSENGER FACILITY CHARGES (PFC'S) General § 158.5 Authority to impose PFC's. Subject to the... service airport to impose a PFC of $1, $2, $3, $4, or $4.50 on passengers enplaned at such an airport. No...

  5. 14 CFR 158.5 - Authority to impose PFC's.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 14 Aeronautics and Space 3 2012-01-01 2012-01-01 false Authority to impose PFC's. 158.5 Section...) AIRPORTS PASSENGER FACILITY CHARGES (PFC'S) General § 158.5 Authority to impose PFC's. Subject to the... service airport to impose a PFC of $1, $2, $3, $4, or $4.50 on passengers enplaned at such an airport. No...

  6. 14 CFR 158.85 - Termination of authority to impose PFC's.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 14 Aeronautics and Space 3 2014-01-01 2014-01-01 false Termination of authority to impose PFC's... TRANSPORTATION (CONTINUED) AIRPORTS PASSENGER FACILITY CHARGES (PFC'S) Termination § 158.85 Termination of authority to impose PFC's. (a) The FAA begins proceedings to terminate the public agency's authority to...

  7. 14 CFR 158.85 - Termination of authority to impose PFC's.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 14 Aeronautics and Space 3 2010-01-01 2010-01-01 false Termination of authority to impose PFC's... TRANSPORTATION (CONTINUED) AIRPORTS PASSENGER FACILITY CHARGES (PFC'S) Termination § 158.85 Termination of authority to impose PFC's. (a) The FAA begins proceedings to terminate the public agency's authority to...

  8. 14 CFR 158.85 - Termination of authority to impose PFC's.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 14 Aeronautics and Space 3 2013-01-01 2013-01-01 false Termination of authority to impose PFC's... TRANSPORTATION (CONTINUED) AIRPORTS PASSENGER FACILITY CHARGES (PFC'S) Termination § 158.85 Termination of authority to impose PFC's. (a) The FAA begins proceedings to terminate the public agency's authority to...

  9. 14 CFR 158.85 - Termination of authority to impose PFC's.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 14 Aeronautics and Space 3 2011-01-01 2011-01-01 false Termination of authority to impose PFC's... TRANSPORTATION (CONTINUED) AIRPORTS PASSENGER FACILITY CHARGES (PFC'S) Termination § 158.85 Termination of authority to impose PFC's. (a) The FAA begins proceedings to terminate the public agency's authority to...

  10. 14 CFR 158.85 - Termination of authority to impose PFC's.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 14 Aeronautics and Space 3 2012-01-01 2012-01-01 false Termination of authority to impose PFC's... TRANSPORTATION (CONTINUED) AIRPORTS PASSENGER FACILITY CHARGES (PFC'S) Termination § 158.85 Termination of authority to impose PFC's. (a) The FAA begins proceedings to terminate the public agency's authority to...

  11. 14 CFR 158.30 - PFC Authorization at Non-Hub Airports.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... (CONTINUED) AIRPORTS PASSENGER FACILITY CHARGES (PFC'S) Application and Approval § 158.30 PFC Authorization... public agency's notice of intent about its PFC program, the FAA will issue a written acknowledgment of... its entirety, the public agency may implement its PFC program. The public agency's implementation must...

  12. 14 CFR 158.30 - PFC Authorization at Non-Hub Airports.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... (CONTINUED) AIRPORTS PASSENGER FACILITY CHARGES (PFC'S) Application and Approval § 158.30 PFC Authorization... public agency's notice of intent about its PFC program, the FAA will issue a written acknowledgment of... its entirety, the public agency may implement its PFC program. The public agency's implementation must...

  13. 14 CFR 158.30 - PFC Authorization at Non-Hub Airports.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... (CONTINUED) AIRPORTS PASSENGER FACILITY CHARGES (PFC'S) Application and Approval § 158.30 PFC Authorization... public agency's notice of intent about its PFC program, the FAA will issue a written acknowledgment of... its entirety, the public agency may implement its PFC program. The public agency's implementation must...

  14. 14 CFR 158.30 - PFC Authorization at Non-Hub Airports.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... (CONTINUED) AIRPORTS PASSENGER FACILITY CHARGES (PFC'S) Application and Approval § 158.30 PFC Authorization... public agency's notice of intent about its PFC program, the FAA will issue a written acknowledgment of... its entirety, the public agency may implement its PFC program. The public agency's implementation must...

  15. 14 CFR 158.30 - PFC Authorization at Non-Hub Airports.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... (CONTINUED) AIRPORTS PASSENGER FACILITY CHARGES (PFC'S) Application and Approval § 158.30 PFC Authorization... public agency's notice of intent about its PFC program, the FAA will issue a written acknowledgment of... its entirety, the public agency may implement its PFC program. The public agency's implementation must...

  16. 14 CFR 158.33 - Duration of authority to impose a PFC before project implementation.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... ADMINISTRATION, DEPARTMENT OF TRANSPORTATION (CONTINUED) AIRPORTS PASSENGER FACILITY CHARGES (PFC'S) Application and Approval § 158.33 Duration of authority to impose a PFC before project implementation. (a) A... 14 Aeronautics and Space 3 2011-01-01 2011-01-01 false Duration of authority to impose a PFC...

  17. 14 CFR 158.33 - Duration of authority to impose a PFC before project implementation.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... ADMINISTRATION, DEPARTMENT OF TRANSPORTATION (CONTINUED) AIRPORTS PASSENGER FACILITY CHARGES (PFC'S) Application and Approval § 158.33 Duration of authority to impose a PFC before project implementation. (a) A... 14 Aeronautics and Space 3 2010-01-01 2010-01-01 false Duration of authority to impose a PFC...

  18. 14 CFR 158.33 - Duration of authority to impose a PFC before project implementation.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... ADMINISTRATION, DEPARTMENT OF TRANSPORTATION (CONTINUED) AIRPORTS PASSENGER FACILITY CHARGES (PFC'S) Application and Approval § 158.33 Duration of authority to impose a PFC before project implementation. (a) A... 14 Aeronautics and Space 3 2014-01-01 2014-01-01 false Duration of authority to impose a PFC...

  19. 14 CFR 158.33 - Duration of authority to impose a PFC before project implementation.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... ADMINISTRATION, DEPARTMENT OF TRANSPORTATION (CONTINUED) AIRPORTS PASSENGER FACILITY CHARGES (PFC'S) Application and Approval § 158.33 Duration of authority to impose a PFC before project implementation. (a) A... 14 Aeronautics and Space 3 2013-01-01 2013-01-01 false Duration of authority to impose a PFC...

  20. 14 CFR 158.33 - Duration of authority to impose a PFC before project implementation.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... ADMINISTRATION, DEPARTMENT OF TRANSPORTATION (CONTINUED) AIRPORTS PASSENGER FACILITY CHARGES (PFC'S) Application and Approval § 158.33 Duration of authority to impose a PFC before project implementation. (a) A... 14 Aeronautics and Space 3 2012-01-01 2012-01-01 false Duration of authority to impose a PFC...

  1. 14 CFR 158.31 - Duration of authority to impose a PFC after project implementation.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ..., DEPARTMENT OF TRANSPORTATION (CONTINUED) AIRPORTS PASSENGER FACILITY CHARGES (PFC'S) Application and Approval....S.C. 47524 and 47526, and the authority to collect the PFC is terminated under that statute's... 14 Aeronautics and Space 3 2014-01-01 2014-01-01 false Duration of authority to impose a PFC after...

  2. 14 CFR 158.31 - Duration of authority to impose a PFC after project implementation.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ..., DEPARTMENT OF TRANSPORTATION (CONTINUED) AIRPORTS PASSENGER FACILITY CHARGES (PFC'S) Application and Approval....S.C. 47524 and 47526, and the authority to collect the PFC is terminated under that statute's... 14 Aeronautics and Space 3 2011-01-01 2011-01-01 false Duration of authority to impose a PFC after...

  3. 14 CFR 158.31 - Duration of authority to impose a PFC after project implementation.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ..., DEPARTMENT OF TRANSPORTATION (CONTINUED) AIRPORTS PASSENGER FACILITY CHARGES (PFC'S) Application and Approval....S.C. 47524 and 47526, and the authority to collect the PFC is terminated under that statute's... 14 Aeronautics and Space 3 2012-01-01 2012-01-01 false Duration of authority to impose a PFC after...

  4. 14 CFR 158.31 - Duration of authority to impose a PFC after project implementation.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ..., DEPARTMENT OF TRANSPORTATION (CONTINUED) AIRPORTS PASSENGER FACILITY CHARGES (PFC'S) Application and Approval....S.C. 47524 and 47526, and the authority to collect the PFC is terminated under that statute's... 14 Aeronautics and Space 3 2013-01-01 2013-01-01 false Duration of authority to impose a PFC after...

  5. 14 CFR 158.31 - Duration of authority to impose a PFC after project implementation.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ..., DEPARTMENT OF TRANSPORTATION (CONTINUED) AIRPORTS PASSENGER FACILITY CHARGES (PFC'S) Application and Approval....S.C. 47524 and 47526, and the authority to collect the PFC is terminated under that statute's... 14 Aeronautics and Space 3 2010-01-01 2010-01-01 false Duration of authority to impose a PFC after...

  6. PFC Decontamination of a Metal Surface and the Recycling of a Spent PFC Solution

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

    Jung, C.H.; Won, H.J.; Oh, W.Z.

    2006-07-01

    PFC (per-fluorocarbon) ultrasonic decontamination behavior of loosely contaminated metal specimens such as a plate, pipe, welding and a crevice specimen in a mixed solution of PFC and an anionic surfactant was investigated. Perfluoroheptane (C{sub 7}F{sub 16}) was used as a PFC ultrasonic media. The contaminants were completely removed for almost all of the tested specimens except for the longest pipe length specimen. For the 6-cm long specimen, 98.5 % of the contaminants were removed. For the recycling of the PFC solution, a distillation test for the spent PFC solution was also performed. The results show that 97.5 % of themore » PFC was recycled without a loss of the decontamination efficiency. (authors)« less

  7. vlPFC-vmPFC-Amygdala Interactions Underlie Age-Related Differences in Cognitive Regulation of Emotion.

    PubMed

    Silvers, Jennifer A; Insel, Catherine; Powers, Alisa; Franz, Peter; Helion, Chelsea; Martin, Rebecca E; Weber, Jochen; Mischel, Walter; Casey, B J; Ochsner, Kevin N

    2017-07-01

    Emotion regulation is a critical life skill that develops throughout childhood and adolescence. Despite this development in emotional processes, little is known about how the underlying brain systems develop with age. This study examined emotion regulation in 112 individuals (aged 6-23 years) as they viewed aversive and neutral images using a reappraisal task. On "reappraisal" trials, participants were instructed to view the images as distant, a strategy that has been previously shown to reduce negative affect. On "reactivity" trials, participants were instructed to view the images without regulating emotions to assess baseline emotional responding. During reappraisal, age predicted less negative affect, reduced amygdala responses and inverse coupling between the ventromedial prefrontal cortex (vmPFC) and amygdala. Moreover, left ventrolateral prefrontal (vlPFC) recruitment mediated the relationship between increasing age and diminishing amygdala responses. This negative vlPFC-amygdala association was stronger for individuals with inverse coupling between the amygdala and vmPFC. These data provide evidence that vmPFC-amygdala connectivity facilitates vlPFC-related amygdala modulation across development. © The Author 2016. Published by Oxford University Press. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

  8. Metal Surface Decontamination by the PFC Solution

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

    Hui-Jun Won; Gye-Nam Kim; Wang-Kyu Choi

    2006-07-01

    PFC (per-fluorocarbon) spray decontamination equipment was fabricated and its decontamination behavior was investigated. Europium oxide powder was mixed with the isotope solution which contains Co-60 and Cs-137. The different shape of metal specimens artificially contaminated with europium oxide powder was used as the surrogate contaminants. Before and after the application of the PFC spray decontamination method, the radioactivity of the metal specimens was measured by MCA. The decontamination factors were in the range from 9.6 to 62.4. The spent PFC solution was recycled by distillation. Before and after distillation, the turbidity of PFC solution was also measured. From the testmore » results, it was found that more than 98% of the PFC solution could be recycled by a distillation. (authors)« less

  9. Schema representation in patients with ventromedial PFC lesions.

    PubMed

    Ghosh, Vanessa E; Moscovitch, Morris; Melo Colella, Brenda; Gilboa, Asaf

    2014-09-03

    Human neuroimaging and animal studies have recently implicated the ventromedial prefrontal cortex (vmPFC) in memory schema, particularly in facilitating new encoding by existing schemas. In humans, the most conspicuous memory disorder following vmPFC damage is confabulation; strategic retrieval models suggest that aberrant schema activation or reinstatement plays a role in confabulation. This raises the possibility that beyond its role in schema-supported memory encoding, the vmPFC is also implicated in schema reinstatement itself. If that is the case, vmPFC lesions should lead to impaired schema-based operations, even on tasks that do not involve memory acquisition. To test this prediction, ten patients with vmPFC damage, four with present or prior confabulation, and a group of twelve matched healthy controls made speeded yes/no decisions as to whether words were closely related to a schema (a visit to the doctor). Ten minutes later, they repeated the task for a new schema (going to bed) with some words related to the first schema included as lures. Last, they rated the degree to which stimuli were related to the second schema. All four vmPFC patients with present or prior confabulation were impaired in rejecting lures and in classifying stimulus belongingness to the schema, even when they were not lures. Nonconfabulating patients performed comparably to healthy adults with high accuracy, comparable reaction times, and similar ratings. These results show for the first time that damage to the human vmPFC, when associated with confabulation, leads to deficient schema reinstatement, which is likely a prerequisite for schema-mediated memory integration. Copyright © 2014 the authors 0270-6474/14/3412057-14$15.00/0.

  10. Distinguishing the roles of dorsolateral and anterior PFC in visual metacognition.

    PubMed

    Shekhar, Medha; Rahnev, Dobromir

    2018-05-02

    postulated specific functions for DLPFC and aPFC in metacognitive computation and corroborated them using a computational model that reproduced our results. Our causal results reveal the existence of a specialized modular organization in PFC for confidence generation. Copyright © 2018 the authors.

  11. 14 CFR 158.49 - Handling of PFC's.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 14 Aeronautics and Space 3 2013-01-01 2013-01-01 false Handling of PFC's. 158.49 Section 158.49... PASSENGER FACILITY CHARGES (PFC'S) Collection, Handling, and Remittance of PFC's § 158.49 Handling of PFC's... amount of PFC revenue in the covered air carrier's account at the time the bankruptcy petition is filed...

  12. 14 CFR 158.49 - Handling of PFC's.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 14 Aeronautics and Space 3 2014-01-01 2014-01-01 false Handling of PFC's. 158.49 Section 158.49... PASSENGER FACILITY CHARGES (PFC'S) Collection, Handling, and Remittance of PFC's § 158.49 Handling of PFC's... amount of PFC revenue in the covered air carrier's account at the time the bankruptcy petition is filed...

  13. 14 CFR 158.49 - Handling of PFC's.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 14 Aeronautics and Space 3 2011-01-01 2011-01-01 false Handling of PFC's. 158.49 Section 158.49... PASSENGER FACILITY CHARGES (PFC'S) Collection, Handling, and Remittance of PFC's § 158.49 Handling of PFC's... amount of PFC revenue in the covered air carrier's account at the time the bankruptcy petition is filed...

  14. 14 CFR 158.49 - Handling of PFC's.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 14 Aeronautics and Space 3 2010-01-01 2010-01-01 false Handling of PFC's. 158.49 Section 158.49... PASSENGER FACILITY CHARGES (PFC'S) Collection, Handling, and Remittance of PFC's § 158.49 Handling of PFC's... amount of PFC revenue in the covered air carrier's account at the time the bankruptcy petition is filed...

  15. 14 CFR 158.49 - Handling of PFC's.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 14 Aeronautics and Space 3 2012-01-01 2012-01-01 false Handling of PFC's. 158.49 Section 158.49... PASSENGER FACILITY CHARGES (PFC'S) Collection, Handling, and Remittance of PFC's § 158.49 Handling of PFC's... amount of PFC revenue in the covered air carrier's account at the time the bankruptcy petition is filed...

  16. Neuroanatomy of the vmPFC and dlPFC predicts individual differences in cognitive regulation during dietary self-control across regulation strategies.

    PubMed

    Schmidt, Liane; Tusche, Anita; Manoharan, Nicolas; Hutcherson, Cendri; Hare, Todd; Plassmann, Hilke

    2018-06-04

    self-regulation, suggesting that neuroanatomical differences in the vmPFC and dlPFC may represent a general marker for self-control abilities. These results identify candidate neuroanatomical markers for dieting success and failure, and suggest potential targets for therapies aimed at preventing or treating obesity and related eating disorders. Copyright © 2018 the authors.

  17. 14 CFR 158.51 - Remittance of PFC's.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 14 Aeronautics and Space 3 2013-01-01 2013-01-01 false Remittance of PFC's. 158.51 Section 158.51... PASSENGER FACILITY CHARGES (PFC'S) Collection, Handling, and Remittance of PFC's § 158.51 Remittance of PFC's. Passenger facility charges collected by carriers shall be remitted to the public agency on a...

  18. 14 CFR 158.51 - Remittance of PFC's.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 14 Aeronautics and Space 3 2014-01-01 2014-01-01 false Remittance of PFC's. 158.51 Section 158.51... PASSENGER FACILITY CHARGES (PFC'S) Collection, Handling, and Remittance of PFC's § 158.51 Remittance of PFC's. Passenger facility charges collected by carriers shall be remitted to the public agency on a...

  19. 14 CFR 158.51 - Remittance of PFC's.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 14 Aeronautics and Space 3 2012-01-01 2012-01-01 false Remittance of PFC's. 158.51 Section 158.51... PASSENGER FACILITY CHARGES (PFC'S) Collection, Handling, and Remittance of PFC's § 158.51 Remittance of PFC's. Passenger facility charges collected by carriers shall be remitted to the public agency on a...

  20. 14 CFR 158.51 - Remittance of PFC's.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 14 Aeronautics and Space 3 2010-01-01 2010-01-01 false Remittance of PFC's. 158.51 Section 158.51... PASSENGER FACILITY CHARGES (PFC'S) Collection, Handling, and Remittance of PFC's § 158.51 Remittance of PFC's. Passenger facility charges collected by carriers shall be remitted to the public agency on a...

  1. 14 CFR 158.51 - Remittance of PFC's.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 14 Aeronautics and Space 3 2011-01-01 2011-01-01 false Remittance of PFC's. 158.51 Section 158.51... PASSENGER FACILITY CHARGES (PFC'S) Collection, Handling, and Remittance of PFC's § 158.51 Remittance of PFC's. Passenger facility charges collected by carriers shall be remitted to the public agency on a...

  2. 14 CFR 158.13 - Use of PFC revenue.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... PASSENGER FACILITY CHARGES (PFC'S) General § 158.13 Use of PFC revenue. PFC revenue, including any interest... 14 Aeronautics and Space 3 2012-01-01 2012-01-01 false Use of PFC revenue. 158.13 Section 158.13... costs of approved projects at any airport the public agency controls. (a) Total cost. PFC revenue may be...

  3. 14 CFR 158.13 - Use of PFC revenue.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... PASSENGER FACILITY CHARGES (PFC'S) General § 158.13 Use of PFC revenue. PFC revenue, including any interest... 14 Aeronautics and Space 3 2013-01-01 2013-01-01 false Use of PFC revenue. 158.13 Section 158.13... costs of approved projects at any airport the public agency controls. (a) Total cost. PFC revenue may be...

  4. 14 CFR 158.13 - Use of PFC revenue.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... PASSENGER FACILITY CHARGES (PFC'S) General § 158.13 Use of PFC revenue. PFC revenue, including any interest... 14 Aeronautics and Space 3 2014-01-01 2014-01-01 false Use of PFC revenue. 158.13 Section 158.13... costs of approved projects at any airport the public agency controls. (a) Total cost. PFC revenue may be...

  5. 14 CFR 158.18 - Use of PFC revenue to pay for debt service for non-eligible projects.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ..., DEPARTMENT OF TRANSPORTATION (CONTINUED) AIRPORTS PASSENGER FACILITY CHARGES (PFC'S) General § 158.18 Use of PFC revenue to pay for debt service for non-eligible projects. (a) The FAA may authorize a public... 14 Aeronautics and Space 3 2011-01-01 2011-01-01 false Use of PFC revenue to pay for debt service...

  6. 14 CFR 158.18 - Use of PFC revenue to pay for debt service for non-eligible projects.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ..., DEPARTMENT OF TRANSPORTATION (CONTINUED) AIRPORTS PASSENGER FACILITY CHARGES (PFC'S) General § 158.18 Use of PFC revenue to pay for debt service for non-eligible projects. (a) The FAA may authorize a public... 14 Aeronautics and Space 3 2013-01-01 2013-01-01 false Use of PFC revenue to pay for debt service...

  7. 14 CFR 158.18 - Use of PFC revenue to pay for debt service for non-eligible projects.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ..., DEPARTMENT OF TRANSPORTATION (CONTINUED) AIRPORTS PASSENGER FACILITY CHARGES (PFC'S) General § 158.18 Use of PFC revenue to pay for debt service for non-eligible projects. (a) The FAA may authorize a public... 14 Aeronautics and Space 3 2010-01-01 2010-01-01 false Use of PFC revenue to pay for debt service...

  8. 14 CFR 158.18 - Use of PFC revenue to pay for debt service for non-eligible projects.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ..., DEPARTMENT OF TRANSPORTATION (CONTINUED) AIRPORTS PASSENGER FACILITY CHARGES (PFC'S) General § 158.18 Use of PFC revenue to pay for debt service for non-eligible projects. (a) The FAA may authorize a public... 14 Aeronautics and Space 3 2014-01-01 2014-01-01 false Use of PFC revenue to pay for debt service...

  9. 14 CFR 158.18 - Use of PFC revenue to pay for debt service for non-eligible projects.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ..., DEPARTMENT OF TRANSPORTATION (CONTINUED) AIRPORTS PASSENGER FACILITY CHARGES (PFC'S) General § 158.18 Use of PFC revenue to pay for debt service for non-eligible projects. (a) The FAA may authorize a public... 14 Aeronautics and Space 3 2012-01-01 2012-01-01 false Use of PFC revenue to pay for debt service...

  10. 14 CFR 158.37 - Amendment of approved PFC.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ...) AIRPORTS PASSENGER FACILITY CHARGES (PFC'S) Application and Approval § 158.37 Amendment of approved PFC. (a)(1) A public agency may amend the FAA's decision with respect to an approved PFC to: (i) Increase or... approved. (2) A public agency may not amend the FAA's decision with respect to an approved PFC to add...

  11. 14 CFR 158.37 - Amendment of approved PFC.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ...) AIRPORTS PASSENGER FACILITY CHARGES (PFC'S) Application and Approval § 158.37 Amendment of approved PFC. (a)(1) A public agency may amend the FAA's decision with respect to an approved PFC to: (i) Increase or... approved. (2) A public agency may not amend the FAA's decision with respect to an approved PFC to add...

  12. 14 CFR 158.37 - Amendment of approved PFC.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ...) AIRPORTS PASSENGER FACILITY CHARGES (PFC'S) Application and Approval § 158.37 Amendment of approved PFC. (a)(1) A public agency may amend the FAA's decision with respect to an approved PFC to: (i) Increase or... approved. (2) A public agency may not amend the FAA's decision with respect to an approved PFC to add...

  13. 14 CFR 158.37 - Amendment of approved PFC.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ...) AIRPORTS PASSENGER FACILITY CHARGES (PFC'S) Application and Approval § 158.37 Amendment of approved PFC. (a)(1) A public agency may amend the FAA's decision with respect to an approved PFC to: (i) Increase or... approved. (2) A public agency may not amend the FAA's decision with respect to an approved PFC to add...

  14. 14 CFR 158.37 - Amendment of approved PFC.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ...) AIRPORTS PASSENGER FACILITY CHARGES (PFC'S) Application and Approval § 158.37 Amendment of approved PFC. (a)(1) A public agency may amend the FAA's decision with respect to an approved PFC to: (i) Increase or... approved. (2) A public agency may not amend the FAA's decision with respect to an approved PFC to add...

  15. Developing PFC representations using reinforcement learning

    PubMed Central

    Reynolds, Jeremy R.; O'Reilly, Randall C.

    2009-01-01

    From both functional and biological considerations, it is widely believed that action production, planning, and goal-oriented behaviors supported by the frontal cortex are organized hierarchically (Fuster, 1990, Koechlin, Ody, & Kouneiher, 2003, & Miller, Galanter, & Pribram, 1960) However, the nature of the different levels of the hierarchy remains unclear, and little attention has been paid to the origins of such a hierarchy. We address these issues through biologically-inspired computational models that develop representations through reinforcement learning. We explore several different factors in these models that might plausibly give rise to a hierarchical organization of representations within the PFC, including an initial connectivity hierarchy within PFC, a hierarchical set of connections between PFC and subcortical structures controlling it, and differential synaptic plasticity schedules. Simulation results indicate that architectural constraints contribute to the segregation of different types of representations, and that this segregation facilitates learning. These findings are consistent with the idea that there is a functional hierarchy in PFC, as captured in our earlier computational models of PFC function and a growing body of empirical data. PMID:19591977

  16. 14 CFR 158.7 - Exclusivity of authority.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ...) AIRPORTS PASSENGER FACILITY CHARGES (PFC'S) General § 158.7 Exclusivity of authority. (a) A State... imposition or collection of a PFC or the use of PFC revenue. (b) No contract or agreement between an air... impose a PFC or use the PFC revenue in accordance with this part. [Doc. No. 26385, 56 FR 24278, May 29...

  17. 14 CFR 158.7 - Exclusivity of authority.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ...) AIRPORTS PASSENGER FACILITY CHARGES (PFC'S) General § 158.7 Exclusivity of authority. (a) A State... imposition or collection of a PFC or the use of PFC revenue. (b) No contract or agreement between an air... impose a PFC or use the PFC revenue in accordance with this part. [Doc. No. 26385, 56 FR 24278, May 29...

  18. 14 CFR 158.7 - Exclusivity of authority.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ...) AIRPORTS PASSENGER FACILITY CHARGES (PFC'S) General § 158.7 Exclusivity of authority. (a) A State... imposition or collection of a PFC or the use of PFC revenue. (b) No contract or agreement between an air... impose a PFC or use the PFC revenue in accordance with this part. [Doc. No. 26385, 56 FR 24278, May 29...

  19. 14 CFR 158.7 - Exclusivity of authority.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ...) AIRPORTS PASSENGER FACILITY CHARGES (PFC'S) General § 158.7 Exclusivity of authority. (a) A State... imposition or collection of a PFC or the use of PFC revenue. (b) No contract or agreement between an air... impose a PFC or use the PFC revenue in accordance with this part. [Doc. No. 26385, 56 FR 24278, May 29...

  20. 14 CFR 158.7 - Exclusivity of authority.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ...) AIRPORTS PASSENGER FACILITY CHARGES (PFC'S) General § 158.7 Exclusivity of authority. (a) A State... imposition or collection of a PFC or the use of PFC revenue. (b) No contract or agreement between an air... impose a PFC or use the PFC revenue in accordance with this part. [Doc. No. 26385, 56 FR 24278, May 29...

  1. 14 CFR 158.39 - Use of excess PFC revenue.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ...) AIRPORTS PASSENGER FACILITY CHARGES (PFC'S) Application and Approval § 158.39 Use of excess PFC revenue. (a) If the PFC revenue remitted to the public agency, plus interest earned thereon, exceeds the allowable... 14 Aeronautics and Space 3 2014-01-01 2014-01-01 false Use of excess PFC revenue. 158.39 Section...

  2. 14 CFR 158.39 - Use of excess PFC revenue.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ...) AIRPORTS PASSENGER FACILITY CHARGES (PFC'S) Application and Approval § 158.39 Use of excess PFC revenue. (a) If the PFC revenue remitted to the public agency, plus interest earned thereon, exceeds the allowable... 14 Aeronautics and Space 3 2010-01-01 2010-01-01 false Use of excess PFC revenue. 158.39 Section...

  3. 14 CFR 158.39 - Use of excess PFC revenue.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ...) AIRPORTS PASSENGER FACILITY CHARGES (PFC'S) Application and Approval § 158.39 Use of excess PFC revenue. (a) If the PFC revenue remitted to the public agency, plus interest earned thereon, exceeds the allowable... 14 Aeronautics and Space 3 2011-01-01 2011-01-01 false Use of excess PFC revenue. 158.39 Section...

  4. 14 CFR 158.39 - Use of excess PFC revenue.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ...) AIRPORTS PASSENGER FACILITY CHARGES (PFC'S) Application and Approval § 158.39 Use of excess PFC revenue. (a) If the PFC revenue remitted to the public agency, plus interest earned thereon, exceeds the allowable... 14 Aeronautics and Space 3 2013-01-01 2013-01-01 false Use of excess PFC revenue. 158.39 Section...

  5. 14 CFR 158.39 - Use of excess PFC revenue.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ...) AIRPORTS PASSENGER FACILITY CHARGES (PFC'S) Application and Approval § 158.39 Use of excess PFC revenue. (a) If the PFC revenue remitted to the public agency, plus interest earned thereon, exceeds the allowable... 14 Aeronautics and Space 3 2012-01-01 2012-01-01 false Use of excess PFC revenue. 158.39 Section...

  6. Developing PFC representations using reinforcement learning.

    PubMed

    Reynolds, Jeremy R; O'Reilly, Randall C

    2009-12-01

    From both functional and biological considerations, it is widely believed that action production, planning, and goal-oriented behaviors supported by the frontal cortex are organized hierarchically [Fuster (1991); Koechlin, E., Ody, C., & Kouneiher, F. (2003). Neuroscience: The architecture of cognitive control in the human prefrontal cortex. Science, 424, 1181-1184; Miller, G. A., Galanter, E., & Pribram, K. H. (1960). Plans and the structure of behavior. New York: Holt]. However, the nature of the different levels of the hierarchy remains unclear, and little attention has been paid to the origins of such a hierarchy. We address these issues through biologically-inspired computational models that develop representations through reinforcement learning. We explore several different factors in these models that might plausibly give rise to a hierarchical organization of representations within the PFC, including an initial connectivity hierarchy within PFC, a hierarchical set of connections between PFC and subcortical structures controlling it, and differential synaptic plasticity schedules. Simulation results indicate that architectural constraints contribute to the segregation of different types of representations, and that this segregation facilitates learning. These findings are consistent with the idea that there is a functional hierarchy in PFC, as captured in our earlier computational models of PFC function and a growing body of empirical data.

  7. 14 CFR 158.13 - Use of PFC revenue.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... costs of approved projects at any airport the public agency controls. (a) Total cost. PFC revenue may be... costs. Public agencies may use PFC revenue to pay for allowable administrative support costs. Public... debt service and financing costs. (1) Public agencies may use PFC revenue to pay debt service and...

  8. Medial PFC Damage Abolishes the Self-reference Effect

    PubMed Central

    Philippi, Carissa L.; Duff, Melissa C.; Denburg, Natalie L.; Tranel, Daniel; Rudrauf, David

    2012-01-01

    Functional neuroimaging studies suggest that the medial PFC (mPFC) is a key component of a large-scale neural system supporting a variety of self-related processes. However, it remains unknown whether the mPFC is critical for such processes. In this study, we used a human lesion approach to examine this question. We administered a standard trait judgment paradigm [Kelley, W. M., Macrae, C. N., Wyland, C. L., Caglar, S., Inati, S., & Heatherton, T. F. Finding the self? An event-related fMRI study. Journal of Cognitive Neuroscience, 14, 785–794, 2002] to patients with focal brain damage to the mPFC. The self-reference effect (SRE), a memory advantage conferred by self-related processing, served as a measure of intact self-processing ability. We found that damage to the mPFC abolished the SRE. The results demonstrate that the mPFC is necessary for the SRE and suggest that this structure is important for self-referential processing and the neural representation of self. PMID:21942762

  9. 14 CFR 158.43 - Public agency notification to collect PFC's.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 14 Aeronautics and Space 3 2011-01-01 2011-01-01 false Public agency notification to collect PFC's... TRANSPORTATION (CONTINUED) AIRPORTS PASSENGER FACILITY CHARGES (PFC'S) Collection, Handling, and Remittance of PFC's § 158.43 Public agency notification to collect PFC's. (a) Following approval of an application...

  10. 14 CFR 158.43 - Public agency notification to collect PFC's.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 14 Aeronautics and Space 3 2014-01-01 2014-01-01 false Public agency notification to collect PFC's... TRANSPORTATION (CONTINUED) AIRPORTS PASSENGER FACILITY CHARGES (PFC'S) Collection, Handling, and Remittance of PFC's § 158.43 Public agency notification to collect PFC's. (a) Following approval of an application...

  11. 14 CFR 158.43 - Public agency notification to collect PFC's.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 14 Aeronautics and Space 3 2013-01-01 2013-01-01 false Public agency notification to collect PFC's... TRANSPORTATION (CONTINUED) AIRPORTS PASSENGER FACILITY CHARGES (PFC'S) Collection, Handling, and Remittance of PFC's § 158.43 Public agency notification to collect PFC's. (a) Following approval of an application...

  12. 14 CFR 158.43 - Public agency notification to collect PFC's.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 14 Aeronautics and Space 3 2010-01-01 2010-01-01 false Public agency notification to collect PFC's... TRANSPORTATION (CONTINUED) AIRPORTS PASSENGER FACILITY CHARGES (PFC'S) Collection, Handling, and Remittance of PFC's § 158.43 Public agency notification to collect PFC's. (a) Following approval of an application...

  13. 14 CFR 158.43 - Public agency notification to collect PFC's.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 14 Aeronautics and Space 3 2012-01-01 2012-01-01 false Public agency notification to collect PFC's... TRANSPORTATION (CONTINUED) AIRPORTS PASSENGER FACILITY CHARGES (PFC'S) Collection, Handling, and Remittance of PFC's § 158.43 Public agency notification to collect PFC's. (a) Following approval of an application...

  14. Childhood cancer survivor care: development of the Passport for Care.

    PubMed

    Poplack, David G; Fordis, Michael; Landier, Wendy; Bhatia, Smita; Hudson, Melissa M; Horowitz, Marc E

    2014-12-01

    Survivors of childhood cancer are at risk of long-term adverse effects and late effects of the disease and/or its treatment. In response to national recommendations to improve evidence-based follow-up care, a web-based support system for clinical decision making, the Passport for Care (PFC), was developed for use at the point of care to produce screening recommendations individualized to the survivor. To date, the PFC has been implemented in over half of the nearly 200 clinics affiliated with the Children's Oncology Group across the USA. Most clinician users report that the PFC has been integrated into clinic workflows, and that it fosters improved conversations with survivors about the potential late effects a survivor might experience and about the screening and/or behavioural interventions recommended to improve health status. Furthermore, clinicians using the PFC have indicated that they adhered more closely to follow-up care guidelines. Perspectives on the challenges encountered and lessons learned during the development and deployment of the PFC are reviewed and contrasted with other nationwide approaches to the provision of guidance on survivor follow-up care; furthermore, the implications for the care of childhood cancer survivors are discussed.

  15. Childhood cancer survivor care: development of the Passport for Care

    PubMed Central

    Poplack, David G.; Fordis, Michael; Landier, Wendy; Bhatia, Smita; Hudson, Melissa M.; Horowitz, Marc E.

    2016-01-01

    Survivors of childhood cancer are at risk of long-term adverse effects and late effects of the disease and/or its treatment. In response to national recommendations to improve evidence-based follow-up care, a web-based support system for clinical decision making, the Passport for Care (PFC), was developed for use at the point of care to produce screening recommendations individualized to the survivor. To date, the PFC has been implemented in over half of the nearly 200 clinics affiliated with the Children's Oncology Group across the USA. Most clinician users report that the PFC has been integrated into clinic workflows, and that it fosters improved conversations with survivors about the potential late effects a survivor might experience and about the screening and/or behavioural interventions recommended to improve health status. Furthermore, clinicians using the PFC have indicated that they adhered more closely to follow-up care guidelines. Perspectives on the challenges encountered and lessons learned during the development and deployment of the PFC are reviewed and contrasted with other nationwide approaches to the provision of guidance on survivor follow-up care; furthermore, the implications for the care of childhood cancer survivors are discussed. PMID:25348788

  16. G proteins in rat prefrontal cortex (PFC) are differentially activated as a function of oxygen status and PFC region.

    PubMed

    Hambrecht, V S; Vlisides, P E; Row, B W; Gozal, D; Baghdoyan, H A; Lydic, R

    2009-03-01

    This study tested the hypothesis that activation of guanine nucleotide binding (G) proteins in rat prefrontal cortex (PFC) is altered by hypoxia. G protein activation by the cholinergic agonist carbachol and the opioid agonist DAMGO was quantified using [(35)S]GTPgammaS autoradiography. G protein activation was expressed as nCi/g tissue in the PFC of 18 rats exposed for 14 consecutive days to sustained hypoxia (10% O(2)), intermittent hypoxia (10% and 21% O(2) alternating every 90 s), or room air (21% O(2)). Relative to basal levels of G protein activation, carbachol and DAMGO increased G protein activation by approximately 70% across all oxygen concentrations. Compared to the room air condition, sustained hypoxia caused a significant increase in G protein activation in frontal association (FrA) region of the PFC. Region-specific comparisons revealed that intermittent and sustained hypoxia caused greater DAMGO-stimulated G protein activation in the FrA than in the pre-limbic (PrL). The data show for the first time that hypoxia increased G protein activation in PFC. The results suggest the potential for hypoxia-induced enhancements in G protein activation to alter PFC function.

  17. Cyclo-octafluorobutane (PFC-318) in the global atmosphere

    NASA Astrophysics Data System (ADS)

    Muhle, J.; Vollmer, M. K.; Fraser, P. J.; Rhee, T. S.; Ivy, D. J.; Arnold, T.; Harth, C. M.; Salameh, P.; O'Doherty, S.; Young, D.; Steele, P.; Krummel, P. B.; Leist, M.; Schmidbauer, N.; Lunder, C.; Kim, J.; Kim, K.; Reimann, S.; Simmonds, P.; Prinn, R. G.; Weiss, R. F.

    2010-12-01

    PFC-318 (c-C4F8, cyclo-octafluorobutane) is a long-lived (3200 years) perfluorocarbon (PFC) greenhouse gas with a high 100-year Global Warming Potential (GWP100 = 10,300) and a wide range of industrial uses. We extend previous atmospheric measurements of PFC-318 in the Cape Grim Air Archive (Oram, 1999) with our new in situ measurements from remote and urban AGAGE (Advanced Global Atmospheric Gases Experiment) and affiliated stations. Our longest in situ record is from the Jungfraujoch observatory in the Swiss Alps, and our data set is augmented by measurements of flasks from the King Sejong and Troll coastal Antarctic stations and several locations in the Northern Hemisphere. In mid-2009 we find ˜1.25 ppt (parts-per-trillion, dry mol fraction) in the Northern Hemisphere and ˜1.20 ppt in the Southern Hemisphere, with rise rates of ˜0.03 ppt/yr and an interhemispheric ratio of ˜1.04. We obtain PFC-318 emissions for 2008-2010 of ˜1 Gg/yr using a simple box model, and preliminary measurements of older archived air at SIO indicate similar emissions since at the least the late 1990s. In contrast, the EDGAR v4 emissions database estimates much lower PFC-318 emissions of 0.02 Gg/yr for 2005. Using GWP100 we calculate ˜10 million tons of CO2-equivalent PFC-318 emissions/yr for 2008-2010, about double the CO2-equivalent PFC-218 annual emissions, or 0.4 times the CO2-equivalent PFC-116 annual emissions, reported for 2008-2009 by Mühle et al. (2010). Thus PFC-318 is the third most important PFC in terms of CO2-equivalent emissions. We find mostly baseline conditions at remote AGAGE stations and urban sites in the USA, Europe, and Australia, in contrast to frequent above baseline conditions at Gosan station, Jeju Island, South Korea, indicating significant emission sources in East Asia as found by Saito et al. (2010). Oram, D.E., Trends of long-lived anthropogenic halocarbons in the Southern Hemisphere and model calculation of global emissions, Ph.D. thesis, University

  18. Past makes future: role of pFC in prediction.

    PubMed

    Fuster, Joaquín M; Bressler, Steven L

    2015-04-01

    The pFC enables the essential human capacities for predicting future events and preadapting to them. These capacities rest on both the structure and dynamics of the human pFC. Structurally, pFC, together with posterior association cortex, is at the highest hierarchical level of cortical organization, harboring neural networks that represent complex goal-directed actions. Dynamically, pFC is at the highest level of the perception-action cycle, the circular processing loop through the cortex that interfaces the organism with the environment in the pursuit of goals. In its predictive and preadaptive roles, pFC supports cognitive functions that are critical for the temporal organization of future behavior, including planning, attentional set, working memory, decision-making, and error monitoring. These functions have a common future perspective and are dynamically intertwined in goal-directed action. They all utilize the same neural infrastructure: a vast array of widely distributed, overlapping, and interactive cortical networks of personal memory and semantic knowledge, named cognits, which are formed by synaptic reinforcement in learning and memory acquisition. From this cortex-wide reservoir of memory and knowledge, pFC generates purposeful, goal-directed actions that are preadapted to predicted future events.

  19. Language learning without control: the role of the PFC.

    PubMed

    Friederici, Angela D; Mueller, Jutta L; Sehm, Bernhard; Ragert, Patrick

    2013-05-01

    Learning takes place throughout lifetime but differs in infants and adults because of the development of the PFC, a brain region responsible for cognitive control. To test this hypothesis, adults were investigated in a language learning paradigm under inhibitory, cathodal transcranial direct current stimulation over PFC. The experiment included a learning session interspersed with test phases and a test-only session. The stimulus material required the learning of grammatical dependencies between two elements in a novel language. In a parallel design, cathodal transcranial direct current stimulation over the left PFC, right PFC, or sham stimulation was applied during the learning session but not during the test-only session. Event-related brain potentials (ERPs) were recorded during both sessions. Whereas no ERP learning effects were observed during the learning session, different ERP learning effects as a function of prior stimulation type were found during the test-only session, although behavioral learning success was equal across conditions. With sham stimulation, the ERP learning effect was reflected in a centro-parietal N400-like negativity indicating lexical processes. Inhibitory stimulation over the left PFC, but not over the right PFC, led to a late positivity similar to that previously observed in prelinguistic infants indicating associative learning. The present data demonstrate that adults can learn with and without cognitive control using different learning mechanisms. In the presence of cognitive control, adult language learning is lexically guided, whereas it appears to be associative in nature when PFC control is downregulated.

  20. Bridgeless SEPIC PFC Converter for Multistring LED Driver

    NASA Astrophysics Data System (ADS)

    Jha, Aman; Singh, Bhim

    2018-05-01

    This paper deals with Power Factor Correction (PFC) in Low Voltage High Current (LVHC) multi-string light emitting diode (LED) using a bridgeless (BL) single ended primary inductance converter (SEPIC). This application is designed for large area LED lighting with illumination control. A multi-mode LED dimming technique is used for the lighting control. The BL-SEPIC PFC converter is used as a load emulator for high power factor. The regulated low voltage from flyback converter is a source power to the synchronous buck converters for multi-string LED driver and forced cooling system for LED junction. The BL-SEPIC PFC converter inductor design is based on Discontinuous Inductor Current Modes (DICM) which provides good PFC at low cost. Test results are found quite satisfactory for universal input AC (90-265 V). There is significant improvement in the power factor and input current Total Harmonic Distortion (THD) with good margin of harmonic limits for lighting IEC 61000-3-2 Class C.

  1. Architecture of PFC supports analogy, but PFC is not an analogy machine.

    PubMed

    Speed, Ann

    2010-06-01

    In the preceding discussion paper, I proposed a theory of prefrontal cortical organization that was fundamentally intended to address the question: How does prefrontal cortex (PFC) support the various functions for which it seems to be selectively recruited? In so doing, I chose to focus on a particular function, analogy, that seems to have been largely ignored in the theoretical treatments of PFC, but that does underlie many other cognitive functions (Hofstadter, 2001 ; Holyoak & Thagard, 1997 ). At its core, this paper was intended to use analogy as a foundation for exploring one possibility for prefrontal function in general, although it is easy to see how the analogy-specific interpretation arises (as in the comment by Ibáñez). In an attempt to address this more foundational question, this response will step away from analogy as a focus, and will address first the various comments from the perspective of the initial motivation for developing this theory, and then specific issues raised by the commentators.

  2. PFC knee replacement: osteolytic failures from extreme polyethylene degradation.

    PubMed

    Casey, David; Cottrell, Jocelyn; DiCarlo, Edward; Windsor, Russell; Wright, Timothy

    2007-11-01

    Despite the long-term success of press-fit condylar (PFC) knee prostheses, premature failures caused by aggressive rapid osteolysis have been reported. To investigate why patients experience such failures, we reviewed 48 retrieved implants and surrounding tissues together with demographic and radiographic data. Polyethylene degradation was determined from density profiles taken through the retrieved inserts. We compared the histology of tissues around PFC implants with that from around failed implants of similar designs from patients matched to length of implantation, body mass index, and age. The pathologic response in PFC patients showed more widespread, dense, sheet-like cellular infiltrate, whereas in the matched patients, the infiltrate was generally scattered discontinuously. The dominant wear mode of the PFC inserts was severe delamination on the articular surfaces. Wear damage was worse with increased length of implantation and was correlated with oxidative degradation and osteolysis. Degradation and osteolysis were more severe with inserts stored longer and sterilized by gamma radiation in air. These results underscore that degradation and increased shelf life lead to osteolysis and loosening. However, they raise questions concerning the cellular reaction to the debris from PFC implants that could lead to a better general understanding of osteolysis.

  3. PFC neurons reflect categorical decisions about ambiguous stimuli.

    PubMed

    Roy, Jefferson E; Buschman, Timothy J; Miller, Earl K

    2014-06-01

    We examined whether PFC neuron activity reflects categorical decisions in monkeys categorizing ambiguous stimuli. A morphing system was used to systematically vary stimulus shape and precisely define category boundaries. Ambiguous stimuli were centered on a category boundary, that is, they were a mix of 50% of two prototypes and therefore had no category information, so monkeys guessed at their category membership. We found that the monkeys' trial-by-trial decision about the category membership of an ambiguous image was reflected in PFC activity. Activity to the same ambiguous image differed significantly, depending on which category the monkey had assigned it to. This effect only occurred when that scheme was behaviorally relevant. These indicate that PFC activity reflects categorical decisions.

  4. Overcoming the barriers to implementing patient-focused care.

    PubMed

    McQueen, J

    1993-01-01

    Potential barriers to implementing PFC sometimes seem enormous. Instead of orienting toward problems associated with implementing PFC, we can eliminate some of the barriers simply by focusing on and pursuing the ideal, "the seamless patient care experience." Fundamentally improving our health care delivery systems is not really a strategic option. It is our responsibility. We must do things better, faster, with more compassion, and at less cost. What evidence will demonstrate that your organization is becoming more patient-focused? Patients will not be inconvenienced because of "how the system works." They will consider your organization "best in class." They will know that the hospital's medical care and services will meet or exceed their expectations. Physicians and staff will feel more highly valued by the organization. Management empowers them by improving the systems they must use, providing ongoing training, and decentralizing the authority they need to deliver excellent medical care and satisfy patients' personal needs. Communication improves vertically and horizontally throughout the organization. The hospital becomes increasingly attractive to employers and HMOs. Reengineered processes result in increases in productivity. Better patient outcomes, at less cost, can be demonstrated. Occupancy rates stabilize or grow, utilization is carefully managed, and improvements in the bottom line strengthen the organization. How do we make these visions a reality? By committing to PFC and getting started right away. Just as "quality" is multidimensional, so must be our operating strategy. Patient-focused care is the model that will redefine the future of health care.

  5. The feasibility study of hot cell decontamination by the PFC spray method

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

    Hui-Jun Won; Chong-Hun Jung; Jei-Kwon Moon

    2008-01-15

    The characteristics of per-fluorocarbon compounds (PFC) are colorless, non-toxic, easily vaporized and nonflammable. Also, some of them are liquids of a high density, low surface tension, low latent heat and low specific heat. These particular chemical and physical properties of fluoro-organic compounds permit their use in very different fields such as electronics, medicine, tribology, nuclear and material science. The Sonatol process was developed under a contract with the DOE. The Sonatol process uses an ultrasonic agitation in a PFC solution that contains a fluorinated surfactant to remove radioactive particles from surfaces. Filtering the suspended particles allows the solutions to bemore » reused indefinitely. They applied the Sonatol process to the decontamination of a heterogeneous legacy Pu-238 waste that exhibited an excessive hydrogen gas generation, which prevents a transportation of such a waste to a Waste Isolation Pilot Plant. Korea Atomic Energy Research Institute (KAERI) is developing dry decontamination technologies applicable to a decontamination of a highly radioactive area loosely contaminated with radioactive particles. This contamination has occurred as a result of an examination of a post-irradiated material or the development of the DUPIC process. The dry decontamination technologies developed are the carbon dioxide pellet spray method and the PFC spray method. As a part of the project, PFC ultrasonic decontamination technology was developed in 2004. The PFC spray decontamination method which is based on the test results of the PFC ultrasonic method has been under development since 2005. The developed PFC spray decontamination equipment consists of four modules (spray, collection, filtration and distillation). Vacuum cup of the collection module gathers the contaminated PFC solution, then the solution is moved to the filtration module and it is recycled. After a multiple recycling of the spent PFC solution, it is purified in the

  6. 77 FR 44307 - Notice of Passenger Facility Charge (PFC) Approvals and Disapprovals

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-07-27

    ... Required to Collect PFC's: Air taxi/ commercial operators filing FAA Form 1800-31. Determination: Approved... Air Carriers Not Required to Collect PFC's: Nonscheduled/ on-demand air carriers filing FAA Form 1800... Carriers Not Required to Collect PFC's: None. Brief Description of Projects Approved for Collection and Use...

  7. Investigation of stormwater quality improvements utilizing permeable friction course (PFC).

    DOT National Transportation Integrated Search

    2010-09-01

    This report describes research into the water quality and hydraulics of the Permeable Friction Course (PFC). : Water quality monitoring of 3 locations in the Austin area indicates up to a 90 percent reduction in pollutant : discharges from PFC compar...

  8. 14 CFR 158.47 - Collection of PFC's on tickets issued outside the U.S.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 14 Aeronautics and Space 3 2013-01-01 2013-01-01 false Collection of PFC's on tickets issued... OF TRANSPORTATION (CONTINUED) AIRPORTS PASSENGER FACILITY CHARGES (PFC'S) Collection, Handling, and Remittance of PFC's § 158.47 Collection of PFC's on tickets issued outside the U.S. (a) For tickets issued...

  9. 14 CFR 158.47 - Collection of PFC's on tickets issued outside the U.S.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 14 Aeronautics and Space 3 2012-01-01 2012-01-01 false Collection of PFC's on tickets issued... OF TRANSPORTATION (CONTINUED) AIRPORTS PASSENGER FACILITY CHARGES (PFC'S) Collection, Handling, and Remittance of PFC's § 158.47 Collection of PFC's on tickets issued outside the U.S. (a) For tickets issued...

  10. 14 CFR 158.47 - Collection of PFC's on tickets issued outside the U.S.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 14 Aeronautics and Space 3 2014-01-01 2014-01-01 false Collection of PFC's on tickets issued... OF TRANSPORTATION (CONTINUED) AIRPORTS PASSENGER FACILITY CHARGES (PFC'S) Collection, Handling, and Remittance of PFC's § 158.47 Collection of PFC's on tickets issued outside the U.S. (a) For tickets issued...

  11. 14 CFR 158.47 - Collection of PFC's on tickets issued outside the U.S.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 14 Aeronautics and Space 3 2011-01-01 2011-01-01 false Collection of PFC's on tickets issued... OF TRANSPORTATION (CONTINUED) AIRPORTS PASSENGER FACILITY CHARGES (PFC'S) Collection, Handling, and Remittance of PFC's § 158.47 Collection of PFC's on tickets issued outside the U.S. (a) For tickets issued...

  12. 14 CFR 158.45 - Collection of PFC's on tickets issued in the U.S.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 14 Aeronautics and Space 3 2010-01-01 2010-01-01 false Collection of PFC's on tickets issued in... TRANSPORTATION (CONTINUED) AIRPORTS PASSENGER FACILITY CHARGES (PFC'S) Collection, Handling, and Remittance of PFC's § 158.45 Collection of PFC's on tickets issued in the U.S. (a) On and after the charge effective...

  13. 14 CFR 158.45 - Collection of PFC's on tickets issued in the U.S.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 14 Aeronautics and Space 3 2012-01-01 2012-01-01 false Collection of PFC's on tickets issued in... TRANSPORTATION (CONTINUED) AIRPORTS PASSENGER FACILITY CHARGES (PFC'S) Collection, Handling, and Remittance of PFC's § 158.45 Collection of PFC's on tickets issued in the U.S. (a) On and after the charge effective...

  14. 14 CFR 158.45 - Collection of PFC's on tickets issued in the U.S.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 14 Aeronautics and Space 3 2014-01-01 2014-01-01 false Collection of PFC's on tickets issued in... TRANSPORTATION (CONTINUED) AIRPORTS PASSENGER FACILITY CHARGES (PFC'S) Collection, Handling, and Remittance of PFC's § 158.45 Collection of PFC's on tickets issued in the U.S. (a) On and after the charge effective...

  15. 14 CFR 158.45 - Collection of PFC's on tickets issued in the U.S.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 14 Aeronautics and Space 3 2011-01-01 2011-01-01 false Collection of PFC's on tickets issued in... TRANSPORTATION (CONTINUED) AIRPORTS PASSENGER FACILITY CHARGES (PFC'S) Collection, Handling, and Remittance of PFC's § 158.45 Collection of PFC's on tickets issued in the U.S. (a) On and after the charge effective...

  16. 14 CFR 158.45 - Collection of PFC's on tickets issued in the U.S.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 14 Aeronautics and Space 3 2013-01-01 2013-01-01 false Collection of PFC's on tickets issued in... TRANSPORTATION (CONTINUED) AIRPORTS PASSENGER FACILITY CHARGES (PFC'S) Collection, Handling, and Remittance of PFC's § 158.45 Collection of PFC's on tickets issued in the U.S. (a) On and after the charge effective...

  17. 14 CFR 158.17 - Project eligibility at PFC levels of $4 or $4.50.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... TRANSPORTATION (CONTINUED) AIRPORTS PASSENGER FACILITY CHARGES (PFC'S) General § 158.17 Project eligibility at PFC levels of $4 or $4.50. (a) A project for any airport is eligible for PFC funding at levels of $4... 14 Aeronautics and Space 3 2013-01-01 2013-01-01 false Project eligibility at PFC levels of $4 or...

  18. 14 CFR 158.17 - Project eligibility at PFC levels of $4 or $4.50.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... TRANSPORTATION (CONTINUED) AIRPORTS PASSENGER FACILITY CHARGES (PFC'S) General § 158.17 Project eligibility at PFC levels of $4 or $4.50. (a) A project for any airport is eligible for PFC funding at levels of $4... 14 Aeronautics and Space 3 2014-01-01 2014-01-01 false Project eligibility at PFC levels of $4 or...

  19. 14 CFR 158.17 - Project eligibility at PFC levels of $4 or $4.50.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... TRANSPORTATION (CONTINUED) AIRPORTS PASSENGER FACILITY CHARGES (PFC'S) General § 158.17 Project eligibility at PFC levels of $4 or $4.50. (a) A project for any airport is eligible for PFC funding at levels of $4... 14 Aeronautics and Space 3 2011-01-01 2011-01-01 false Project eligibility at PFC levels of $4 or...

  20. 14 CFR 158.17 - Project eligibility at PFC levels of $4 or $4.50.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... TRANSPORTATION (CONTINUED) AIRPORTS PASSENGER FACILITY CHARGES (PFC'S) General § 158.17 Project eligibility at PFC levels of $4 or $4.50. (a) A project for any airport is eligible for PFC funding at levels of $4... 14 Aeronautics and Space 3 2012-01-01 2012-01-01 false Project eligibility at PFC levels of $4 or...

  1. 14 CFR 158.17 - Project eligibility at PFC levels of $4 or $4.50.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... TRANSPORTATION (CONTINUED) AIRPORTS PASSENGER FACILITY CHARGES (PFC'S) General § 158.17 Project eligibility at PFC levels of $4 or $4.50. (a) A project for any airport is eligible for PFC funding at levels of $4... 14 Aeronautics and Space 3 2010-01-01 2010-01-01 false Project eligibility at PFC levels of $4 or...

  2. PFOS and PFC releases and associated pollution from a PFC production plant in Minnesota (USA).

    PubMed

    Oliaei, Fardin; Kriens, Don; Weber, Roland; Watson, Alan

    2013-04-01

    Perfluorooctane sulfonate (PFOS) and PFOS-related substances have been listed as persistent organic pollutants in the Stockholm Convention. From August 2012, Parties to the Convention needed to address the use, storage, and disposal of PFOS-including production sites and sites where PFOS wastes have been deposited-in their national implementation plans. The paper describes the pollution in Minnesota (USA) caused by the 3M Company at one of the largest per/polyfluorinated chemical (PFC) production facilities. From early 1950s until the end of 2002, when 3M terminated PFOS and perfluorooctanoic acid (PFOA) production, PFOS, PFOA, and other PFC production wastes were disposed around the plant and in local disposal sites. Discharges from the site and releases from deposits caused widespread contamination of ground and surface waters including local drinking water wells. Fish in the river downstream were contaminated with PFOS to levels that led to fish consumption advisories. Human exposures resulted from ingesting contaminated drinking water, requiring installation of water treatment facilities and alternate water supplies. The critical evaluation of the assessments done revealed a range of gaps in particular of human exposure where relevant exposure pathways including the entire exposure via food have not been taken into consideration. Currently, the exposure assessment of vulnerable groups such as children or Hmong minorities is inadequate and needs to be improved/validated by epidemiological studies. The assessment methodology described for this site may serve-with highlighted improvements-as a model for assessment of other PFOS/PFC production sites in the Stockholm Convention implementation.

  3. Altered Excitability and Local Connectivity of mPFC-PAG Neurons in a Mouse Model of Neuropathic Pain.

    PubMed

    Cheriyan, John; Sheets, Patrick L

    2018-05-16

    inputs and can modulate endogenous analgesia via direct projections to the periaqueductal gray (PAG). However, the mechanisms by which chronic pain alters intracortical circuitry of mPFC-PAG neurons are unknown. Here, we report specific changes to local circuits of mPFC-PAG neurons in mice displaying chronic pain behavior after nerve injury. These findings provide evidence for a neural mechanism by which chronic pain disrupts the descending analgesic system via functional changes to cortical circuits. Copyright © 2018 the authors 0270-6474/18/384829-11$15.00/0.

  4. Optogenetic stimulation of infralimbic PFC reproduces ketamine's rapid and sustained antidepressant actions.

    PubMed

    Fuchikami, Manabu; Thomas, Alexandra; Liu, Rongjian; Wohleb, Eric S; Land, Benjamin B; DiLeone, Ralph J; Aghajanian, George K; Duman, Ronald S

    2015-06-30

    Ketamine produces rapid and sustained antidepressant actions in depressed patients, but the precise cellular mechanisms underlying these effects have not been identified. Here we determined if modulation of neuronal activity in the infralimbic prefrontal cortex (IL-PFC) underlies the antidepressant and anxiolytic actions of ketamine. We found that neuronal inactivation of the IL-PFC completely blocked the antidepressant and anxiolytic effects of systemic ketamine in rodent models and that ketamine microinfusion into IL-PFC reproduced these behavioral actions of systemic ketamine. We also found that optogenetic stimulation of the IL-PFC produced rapid and long-lasting antidepressant and anxiolytic effects and that these effects are associated with increased number and function of spine synapses of layer V pyramidal neurons. The results demonstrate that ketamine infusions or optogenetic stimulation of IL-PFC are sufficient to produce long-lasting antidepressant behavioral and synaptic responses similar to the effects of systemic ketamine administration.

  5. Complexity of VTA DA neural activities in response to PFC transection in nicotine treated rats.

    PubMed

    Chen, Ting Y; Zhang, Die; Dragomir, Andrei; Akay, Yasemin M; Akay, Metin

    2011-02-27

    The dopaminergic (DA) neurons in the ventral tegmental area (VTA) are widely implicated in the addiction and natural reward circuitry of the brain. These neurons project to several areas of the brain, including prefrontal cortex (PFC), nucleus accubens (NAc) and amygdala. The functional coupling between PFC and VTA has been demonstrated, but little is known about how PFC mediates nicotinic modulation in VTA DA neurons. The objectives of this study were to investigate the effect of acute nicotine exposure on the VTA DA neuronal firing and to understand how the disruption of communication from PFC affects the firing patterns of VTA DA neurons. Extracellular single-unit recordings were performed on Sprague-Dawley rats and nicotine was administered after stable recording was established as baseline. In order to test how input from PFC affects the VTA DA neuronal firing, bilateral transections were made immediate caudal to PFC to mechanically delete the interaction between VTA and PFC. The complexity of the recorded neural firing was subsequently assessed using a method based on the Lempel-Ziv estimator. The results were compared with those obtained when computing the entropy of neural firing. Exposure to nicotine triggered a significant increase in VTA DA neurons firing complexity when communication between PFC and VTA was present, while transection obliterated the effect of nicotine. Similar results were obtained when entropy values were estimated. Our findings suggest that PFC plays a vital role in mediating VTA activity. We speculate that increased firing complexity with acute nicotine administration in PFC intact subjects is due to the close functional coupling between PFC and VTA. This hypothesis is supported by the fact that deletion of PFC results in minor alterations of VTA DA neural firing when nicotine is acutely administered.

  6. Association of diabetic foot care and amputation rates in Germany.

    PubMed

    Kröger, Knut; Moysidis, Theodoros; Feghaly, Michel; Schäfer, Erika; Bufe, Alexander

    2016-10-01

    Podologists are nurses who care for the diabetic foot (orthotics, offloading devices, blisters, calluses, treatment of fungus infection and patient education). In contrast to podiatrists, they are not qualified to perform any surgical treatment or wound care. We analysed whether there is an association between the decrease in major amputations and the number of podologic foot care (PFC) visits prescribed in Germany. Detailed list of all major lower limb amputations (OPS 5-864) performed from 2007 to 2011 was provided by the Federal Statistical Office. Data were separated for the 16 federal states in Germany. Detailed lists of the number of PFC treatments for each of the 5 years were derived from the federal report of the statutory health insurance. The total numbers of hospitalised cases per year having diabetes mellitus documented as an additional diagnosis were used to adjust for the different rates of people with diabetes in each federal state. Within a 5-year time period, population-based major amputations per 100 000 people dropped from 21·7 in 2007 to 17·5 in 2011 (-18·5%); whereas the number of PFC treatments per 1000 insured increased from 22 in 2007 to 60 in 2011 (+172·7%). The total number of major amputations divided by the total number of hospitalised cases with the additional diagnosis of diabetes mellitus (DM) shows an inverse correlation with the number of PFC treatments per 1000 insured (Pearson's correlation factor is -0·52049). The five countries with the highest increase in PFC compared with the five countries with the lowest increase (35·6 versus 15·4 per 1000 insured) will have only small differences in the decrease in major amputation rates in this period (-5·1 versus -3·4 per 100.000). There is a strong association between increasing utilisation PFC and decreasing major amputations in Germany. Further study is required to document the cost-effectiveness of this service. © 2014 The Authors. International Wound Journal © 2014

  7. 14 CFR 158.35 - Extension of time to submit application to use PFC revenue.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... use PFC revenue. 158.35 Section 158.35 Aeronautics and Space FEDERAL AVIATION ADMINISTRATION, DEPARTMENT OF TRANSPORTATION (CONTINUED) AIRPORTS PASSENGER FACILITY CHARGES (PFC'S) Application and Approval § 158.35 Extension of time to submit application to use PFC revenue. (a) A public agency may request an...

  8. 14 CFR 158.35 - Extension of time to submit application to use PFC revenue.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... use PFC revenue. 158.35 Section 158.35 Aeronautics and Space FEDERAL AVIATION ADMINISTRATION, DEPARTMENT OF TRANSPORTATION (CONTINUED) AIRPORTS PASSENGER FACILITY CHARGES (PFC'S) Application and Approval § 158.35 Extension of time to submit application to use PFC revenue. (a) A public agency may request an...

  9. 14 CFR 158.35 - Extension of time to submit application to use PFC revenue.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... use PFC revenue. 158.35 Section 158.35 Aeronautics and Space FEDERAL AVIATION ADMINISTRATION, DEPARTMENT OF TRANSPORTATION (CONTINUED) AIRPORTS PASSENGER FACILITY CHARGES (PFC'S) Application and Approval § 158.35 Extension of time to submit application to use PFC revenue. (a) A public agency may request an...

  10. 14 CFR 158.35 - Extension of time to submit application to use PFC revenue.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... use PFC revenue. 158.35 Section 158.35 Aeronautics and Space FEDERAL AVIATION ADMINISTRATION, DEPARTMENT OF TRANSPORTATION (CONTINUED) AIRPORTS PASSENGER FACILITY CHARGES (PFC'S) Application and Approval § 158.35 Extension of time to submit application to use PFC revenue. (a) A public agency may request an...

  11. 14 CFR 158.35 - Extension of time to submit application to use PFC revenue.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... use PFC revenue. 158.35 Section 158.35 Aeronautics and Space FEDERAL AVIATION ADMINISTRATION, DEPARTMENT OF TRANSPORTATION (CONTINUED) AIRPORTS PASSENGER FACILITY CHARGES (PFC'S) Application and Approval § 158.35 Extension of time to submit application to use PFC revenue. (a) A public agency may request an...

  12. A fully Bayesian before-after analysis of permeable friction course (PFC) pavement wet weather safety.

    PubMed

    Buddhavarapu, Prasad; Smit, Andre F; Prozzi, Jorge A

    2015-07-01

    Permeable friction course (PFC), a porous hot-mix asphalt, is typically applied to improve wet weather safety on high-speed roadways in Texas. In order to warrant expensive PFC construction, a statistical evaluation of its safety benefits is essential. Generally, the literature on the effectiveness of porous mixes in reducing wet-weather crashes is limited and often inconclusive. In this study, the safety effectiveness of PFC was evaluated using a fully Bayesian before-after safety analysis. First, two groups of road segments overlaid with PFC and non-PFC material were identified across Texas; the non-PFC or reference road segments selected were similar to their PFC counterparts in terms of site specific features. Second, a negative binomial data generating process was assumed to model the underlying distribution of crash counts of PFC and reference road segments to perform Bayesian inference on the safety effectiveness. A data-augmentation based computationally efficient algorithm was employed for a fully Bayesian estimation. The statistical analysis shows that PFC is not effective in reducing wet weather crashes. It should be noted that the findings of this study are in agreement with the existing literature, although these studies were not based on a fully Bayesian statistical analysis. Our study suggests that the safety effectiveness of PFC road surfaces, or any other safety infrastructure, largely relies on its interrelationship with the road user. The results suggest that the safety infrastructure must be properly used to reap the benefits of the substantial investments. Copyright © 2015 Elsevier Ltd. All rights reserved.

  13. Effect of Threat on Right dlPFC Activity during Behavioral Pattern Separation

    PubMed Central

    Hsiung, Abigail; Ernst, Monique; Grillon, Christian

    2017-01-01

    It has long been established that individuals with anxiety disorders tend to overgeneralize attributes of fearful stimuli to nonfearful stimuli, but there is little mechanistic understanding of the neural system that supports overgeneralization. To address this gap in our knowledge, this study examined effect of experimentally induced anxiety in humans on generalization using the behavioral pattern separation (BPS) paradigm. Healthy subjects of both sexes encoded and retrieved novel objects during periods of safety and threat of unpredictable shocks while we recorded brain activity with fMRI. During retrieval, subjects were instructed to differentiate among new, old, and altered images. We hypothesized that the hippocampus and dorsolateral prefrontal cortex (dlPFC) would play a key role in the effect of anxiety on BPS. The dlPFC, but not the hippocampus, showed increased activity for altered images compared with old images when retrieval occurred during periods of threat compared with safety. In addition, accuracy for altered items retrieved during threat was correlated with dlPFC activity. Together, these results suggest that overgeneralization in anxiety patients may be mediated by an inability to recruit the dlPFC, which mediates the cognitive control needed to overcome anxiety and differentiate between old and altered items during periods of threat. SIGNIFICANCE STATEMENT Anxiety and posttraumatic stress disorder patients generalize fear to nonfearful fear stimuli, making it difficult to regulate anxiety. Understanding how anxiety affects generalization is key to understanding the overgeneralization experienced by these patients. We examined this relationship in healthy subjects by studying how threat of shock affects neural responses to previously encountered stimuli. Although previous studies point to hippocampal involvement, we found that threat affected activity in the dorsolateral prefrontal cortex (dlPFC), rather than the hippocampus, when subjects

  14. Columnar processing in primate pFC: evidence for executive control microcircuits.

    PubMed

    Opris, Ioan; Hampson, Robert E; Gerhardt, Greg A; Berger, Theodore W; Deadwyler, Sam A

    2012-12-01

    A common denominator for many cognitive disorders of human brain is the disruption of neural activity within pFC, whose structural basis is primarily interlaminar (columnar) microcircuits or "minicolumns." The importance of this brain region for executive decision-making has been well documented; however, because of technological constraints, the minicolumnar basis is not well understood. Here, via implementation of a unique conformal multielectrode recording array, the role of interlaminar pFC minicolumns in the executive control of task-related target selection is demonstrated in nonhuman primates performing a visuomotor DMS task. The results reveal target-specific, interlaminar correlated firing during the decision phase of the trial between multielectrode recording array-isolated minicolumnar pairs of neurons located in parallel in layers 2/3 and layer 5 of pFC. The functional significance of individual pFC minicolumns (separated by 40 μm) was shown by reduced correlated firing between cell pairs within single minicolumns on error trials with inappropriate target selection. To further demonstrate dependence on performance, a task-disrupting drug (cocaine) was administered in the middle of the session, which also reduced interlaminar firing in minicolumns that fired appropriately in the early (nondrug) portion of the session. The results provide a direct demonstration of task-specific, real-time columnar processing in pFC indicating the role of this type of microcircuit in executive control of decision-making in primate brain.

  15. 77 FR 15841 - Notice of Passenger Facility Charge (PFC) Approvals and Disapprovals

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-03-16

    ... PFC approvals and disapprovals under the provisions of the Aviation Safety and Capacity Expansion Act... DEPARTMENT OF TRANSPORTATION Federal Aviation Administration Notice of Passenger Facility Charge (PFC) Approvals and Disapprovals AGENCY: Federal Aviation Administration (FAA), DOT. ACTION: Monthly...

  16. Cost Analysis and Policy Implications of a Pediatric Palliative Care Program.

    PubMed

    Gans, Daphna; Hadler, Max W; Chen, Xiao; Wu, Shang-Hua; Dimand, Robert; Abramson, Jill M; Ferrell, Betty; Diamant, Allison L; Kominski, Gerald F

    2016-09-01

    In 2010, California launched Partners for Children (PFC), a pediatric palliative care pilot program offering hospice-like services for children eligible for full-scope Medicaid delivered concurrently with curative care, regardless of the child's life expectancy. We assessed the change from before PFC enrollment to the enrolled period in 1) health care costs per enrollee per month (PEPM), 2) costs by service type and diagnosis category, and 3) health care utilization (days of inpatient care and length of hospital stay). A pre-post analysis compared enrollees' health care costs and utilization up to 24 months before enrollment with their costs during participation in the pilot, from January 2010 through December 2012. Analyses were conducted using paid Medicaid claims and program enrollment data. The average PEPM health care costs of program enrollees decreased by $3331 from before their participation in PFC to the enrolled period, driven by a reduction in inpatient costs of $4897 PEPM. PFC enrollees experienced a nearly 50% reduction in the average number of inpatient days per month, from 4.2 to 2.3. Average length of stay per hospitalization dropped from an average of 16.7 days before enrollment to 6.5 days while in the program. Through the provision of home-based therapeutic services, 24/7 access to medical advice, and enhanced, personally tailored care coordination, PFC demonstrated an effective way to reduce costs for children with life-limiting conditions by moving from costly inpatient care to more coordinated and less expensive outpatient care. PFC's home-based care strategy is a cost-effective model for pediatric palliative care elsewhere. Copyright © 2016 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.

  17. 32 CFR 732.14 - Authorized care.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... Defense Department of Defense (Continued) DEPARTMENT OF THE NAVY PERSONNEL NONNAVAL MEDICAL AND DENTAL CARE Medical and Dental Care From Nonnaval Sources § 732.14 Authorized care. (a) Medical. (1... part of the medical expenses incurred. (c) Dental. (1) With prior approval, the following may be...

  18. 32 CFR 732.14 - Authorized care.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... Defense Department of Defense (Continued) DEPARTMENT OF THE NAVY PERSONNEL NONNAVAL MEDICAL AND DENTAL CARE Medical and Dental Care From Nonnaval Sources § 732.14 Authorized care. (a) Medical. (1... part of the medical expenses incurred. (c) Dental. (1) With prior approval, the following may be...

  19. 32 CFR 732.14 - Authorized care.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... Defense Department of Defense (Continued) DEPARTMENT OF THE NAVY PERSONNEL NONNAVAL MEDICAL AND DENTAL CARE Medical and Dental Care From Nonnaval Sources § 732.14 Authorized care. (a) Medical. (1... part of the medical expenses incurred. (c) Dental. (1) With prior approval, the following may be...

  20. 32 CFR 732.14 - Authorized care.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... Defense Department of Defense (Continued) DEPARTMENT OF THE NAVY PERSONNEL NONNAVAL MEDICAL AND DENTAL CARE Medical and Dental Care From Nonnaval Sources § 732.14 Authorized care. (a) Medical. (1... part of the medical expenses incurred. (c) Dental. (1) With prior approval, the following may be...

  1. 32 CFR 732.14 - Authorized care.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... Defense Department of Defense (Continued) DEPARTMENT OF THE NAVY PERSONNEL NONNAVAL MEDICAL AND DENTAL CARE Medical and Dental Care From Nonnaval Sources § 732.14 Authorized care. (a) Medical. (1... part of the medical expenses incurred. (c) Dental. (1) With prior approval, the following may be...

  2. 76 FR 12405 - Notice of Passenger Facility Charge (PFC) Approvals and Disapprovals

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-03-07

    .... Mandatory pavement markings. Airport signage. Runway guard lights. Wildlife study. PFC application.... Runway 18/36 pavement maintenance. Runway 13/31 pavement maintenance. PFC administration fees. Brief... Use: Tractor with snow blower and snow plow. Airport security and access control upgrades--design...

  3. Differential Processing of Isolated Object and Multi-item Pop-Out Displays in LIP and PFC.

    PubMed

    Meyers, Ethan M; Liang, Andy; Katsuki, Fumi; Constantinidis, Christos

    2017-10-11

    Objects that are highly distinct from their surroundings appear to visually "pop-out." This effect is present for displays in which: (1) a single cue object is shown on a blank background, and (2) a single cue object is highly distinct from surrounding objects; it is generally assumed that these 2 display types are processed in the same way. To directly examine this, we applied a decoding analysis to neural activity recorded from the lateral intraparietal (LIP) area and the dorsolateral prefrontal cortex (dlPFC). Our analyses showed that for the single-object displays, cue location information appeared earlier in LIP than in dlPFC. However, for the display with distractors, location information was substantially delayed in both brain regions, and information first appeared in dlPFC. Additionally, we see that pattern of neural activity is similar for both types of displays and across different color transformations of the stimuli, indicating that location information is being coded in the same way regardless of display type. These results lead us to hypothesize that 2 different pathways are involved processing these 2 types of pop-out displays. © The Author 2017. Published by Oxford University Press. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

  4. Stunted PFC activity during neuromuscular control under stress with obesity.

    PubMed

    Mehta, Ranjana K

    2016-02-01

    Obesity is an established risk factor for impaired cognition, which is primarily regulated by the prefrontal cortex (PFC). However, very little is known about the neural pathways that underlie obesity-related declines in neuromuscular control, particularly under stress. The purpose of this study was to determine the role of the PFC on neuromuscular control during handgrip exertions under stress with obesity. Twenty non-obese and obese young adults performed submaximal handgrip exertions in the absence and presence of a concurrent stressful task. Primary dependent measures included oxygenated hemoglobin (HbO2: a measure of PFC activity) and force fluctuations (an indicator of neuromuscular control). Higher HbO2 levels in the PFC were observed in the non-obese compared to the obese group (P = 0.009). In addition, higher HbO2 levels were observed in the stress compared to the control condition in the non-obese group; however, this trend was reversed in the obese group (P = 0.043). In general, force fluctuations increased by 26% in the stress when compared to the control condition (P = 0.001) and obesity was associated with 39% greater force fluctuation (P = 0.024). Finally, while not significant, obesity-related decrements in force fluctuations were magnified under stress (P = 0.063). The current study provides the first evidence that neuromuscular decrements with obesity were associated with impaired PFC activity and this relationship was augmented in stress conditions. These findings are important because they provide new information on obesity-specific changes in brain function associated with neuromuscular control since the knowledge previously focused largely on obesity-specific changes in peripheral muscle capacity.

  5. Fractal analysis of polyferric chloride-humic acid (PFC-HA) flocs in different topological spaces.

    PubMed

    Wang, Yili; Lu, Jia; Baiyu, Du; Shi, Baoyou; Wang, Dongsheng

    2009-01-01

    The fractal dimensions in different topological spaces of polyferric chloride-humic acid (PFC-HA) flocs, formed in flocculating different kinds of humic acids (HA) water at different initial pH (9.0, 7.0, 5.0) and PFC dosages, were calculated by effective density-maximum diameter, image analysis, and N2 absorption-desorption methods, respectively. The mass fractal dimensions (Df) of PFC-HA flocs were calculated by bi-logarithm relation of effective density with maximum diameter and Logan empirical equation. The Df value was more than 2.0 at initial pH of 7.0, which was 11% and 13% higher than those at pH 9.0 and 5.0, respectively, indicating the most compact flocs formed in flocculated HA water at initial pH of 7.0. The image analysis for those flocs indicates that after flocculating the HA water at initial pH greater than 7.0 with PFC flocculant, the fractal dimensions of D2 (logA vs. logdL) and D3 (logVsphere VS. logdL) of PFC-HA flocs decreased with the increase of PFC dosages, and PFC-HA flocs showed a gradually looser structure. At the optimum dosage of PFC, the D2 (logA vs. logdL) values of the flocs show 14%-43% difference with their corresponding Df, and they even had different tendency with the change of initial pH values. However, the D2 values of the flocs formed at three different initial pH in HA solution had a same tendency with the corresponding Dr. Based on fractal Frenkel-Halsey-Hill (FHH) adsorption and desorption equations, the pore surface fractal dimensions (Ds) for dried powders of PFC-HA flocs formed in HA water with initial pH 9.0 and 7.0 were all close to 2.9421, and the Ds values of flocs formed at initial pH 5.0 were less than 2.3746. It indicated that the pore surface fractal dimensions of PFC-HA flocs dried powder mainly show the irregularity from the mesopore-size distribution and marcopore-size distribution.

  6. Mid-term Results of Total Knee Arthroplasty Using PFC Sigma RP-F.

    PubMed

    Kim, Jun-Young; Cheon, Sang-Ho; Kyung, Hee-Soo

    2012-12-01

    We compared the mid-term results after total knee arthroplasty (TKA) using PFC Sigma RP-F mobile model with PFC Sigma PS fixed model. We analyzed 45 knees that underwent TKA with PFC Sigma RP-Fn (study group) and 45 knees with PFC Sigma PS (control group). The mean follow-up period was 65 months (range, 60-69 months). The evaluation system of the American knee society was used for clinical and radiological assessment. Also, the maximal knee flexion angle was assessed. The mean maximum flexion angle in the study group (135°) was greater than that in the control group (125°) at the early post-operation & final follow-up period (p=0.033). The range of motion (ROM) in the study group was recovered earlier at the postoperative 6 months, and ROM gain was improved to a greater extent at the final follow-up period (p=0.039). The knee score and function score and radiographic evaluation were no difference between the two groups (p>0.05) at the final follow-up. The two cases of radiolucency in posterior condyle and medial tibial plateau and one case of patellar elongation were seen in the study group. The PFC Sigma RP-F mobile system appears to facilitate greater maximum flexion angle and ROM gain with two cases of radiolucent line.

  7. Common and unique representations in pFC for face and place attractiveness.

    PubMed

    Pegors, Teresa K; Kable, Joseph W; Chatterjee, Anjan; Epstein, Russell A

    2015-05-01

    Although previous neuroimaging research has identified overlapping correlates of subjective value across different reward types in the ventromedial pFC (vmPFC), it is not clear whether this "common currency" evaluative signal extends to the aesthetic domain. To examine this issue, we scanned human participants with fMRI while they made attractiveness judgments of faces and places-two stimulus categories that are associated with different underlying rewards, have very different visual properties, and are rarely compared with each other. We found overlapping signals for face and place attractiveness in the vmPFC, consistent with the idea that this region codes a signal for value that applies across disparate reward types and across both economic and aesthetic judgments. However, we also identified a subregion of vmPFC within which activity patterns for face and place attractiveness were distinguishable, suggesting that some category-specific attractiveness information is retained in this region. Finally, we observed two separate functional regions in lateral OFC: one region that exhibited a category-unique response to face attractiveness and another region that responded strongly to faces but was insensitive to their value. Our results suggest that vmPFC supports a common mechanism for reward evaluation while also retaining a degree of category-specific information, whereas lateral OFC may be involved in basic reward processing that is specific to only some stimulus categories.

  8. Features in simulation of crystal growth using the hyperbolic PFC equation and the dependence of the numerical solution on the parameters of the computational grid

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

    Starodumov, Ilya; Kropotin, Nikolai

    2016-08-10

    We investigate the three-dimensional mathematical model of crystal growth called PFC (Phase Field Crystal) in a hyperbolic modification. This model is also called the modified model PFC (originally PFC model is formulated in parabolic form) and allows to describe both slow and rapid crystallization processes on atomic length scales and on diffusive time scales. Modified PFC model is described by the differential equation in partial derivatives of the sixth order in space and second order in time. The solution of this equation is possible only by numerical methods. Previously, authors created the software package for the solution of the Phasemore » Field Crystal problem, based on the method of isogeometric analysis (IGA) and PetIGA program library. During further investigation it was found that the quality of the solution can strongly depends on the discretization parameters of a numerical method. In this report, we show the features that should be taken into account during constructing the computational grid for the numerical simulation.« less

  9. 76 FR 3143 - Office of Child Care; Delegation of Authority

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-01-19

    ... Care; Delegation of Authority Notice is hereby given that I have delegated to the Director, Office of Child Care, Administration for Children and Families, the authorities vested in me by the Secretary of... assigned to the Office of Child Care. (a) Authorities Delegated 1. Authority to administer the provisions...

  10. A comparative analysis between fixed bearing total knee arthroplasty (PFC Sigma) and rotating platform total knee arthroplasty (PFC-RP) with minimum 3-year follow-up.

    PubMed

    Jawed, Akram; Kumar, Vijay; Malhotra, R; Yadav, C S; Bhan, S

    2012-06-01

    Since the introduction of mobile bearing total knee designs nearly 30 years back, many studies have been done to evaluate its long-term result. Comparison with fixed bearing designs has been done in the past, but the studies were confounded by variables such as disease, surgeon, bone quality, pain tolerance, etc. We attempt to eliminate these variables in this study. A total of 50 patients who had bilateral arthritis of the knee with similar deformity and pre-operative range of motion on both sides agreed to have one knee replaced with mobile bearing total knee design (PFC-RP) and the other with a fixed bearing design (PFC Sigma) were prospectively evaluated. Comparative analysis of both the designs was done at a mean follow-up of 40 months, minimizing patient, surgeon and observer related bias. Clinical and radiographic outcome, survival and complication rates were compared. At a mean follow-up of 40 months (range 36-47 months), no benefit of mobile bearing (PFC-RP) over fixed bearing design (PFC Sigma) could be demonstrated with respect to Knee Society scores, pain scores, range of flexion, subject preference or patello-femoral complication rates. Radiographs showed no difference in prosthetic alignment. No patient required a revision surgery till last follow-up. Our study demonstrated no advantage of the mobile-bearing arthroplasty over fixed bearing arthroplasty with regard to clinical results at short-term follow-up. However, longer follow-up is necessary to confirm whether these results are sustained.

  11. Differential Functional Connectivity Alterations of Two Subdivisions within the Right dlPFC in Parkinson's Disease

    PubMed Central

    Caspers, Julian; Mathys, Christian; Hoffstaedter, Felix; Südmeyer, Martin; Cieslik, Edna C.; Rubbert, Christian; Hartmann, Christian J.; Eickhoff, Claudia R.; Reetz, Kathrin; Grefkes, Christian; Michely, Jochen; Turowski, Bernd; Schnitzler, Alfons; Eickhoff, Simon B.

    2017-01-01

    Patients suffering from Parkinson's disease (PD) often show impairments in executive function (EF) like decision-making and action control. The right dorsolateral prefrontal cortex (dlPFC) has been strongly implicated in EF in healthy subjects and has repeatedly been reported to show alterations related to EF impairment in PD. Recently, two key regions for cognitive action control have been identified within the right dlPFC by co-activation based parcellation. While the posterior region is engaged in rather basal EF like stimulus integration and working memory, the anterior region has a more abstract, supervisory function. To investigate whether these functionally distinct subdivisions of right dlPFC are differentially affected in PD, we analyzed resting-state functional connectivity (FC) in 39 PD patients and 44 age- and gender-matched healthy controls. Patients were examined both after at least 12 h withdrawal of dopaminergic drugs (OFF) and under their regular dopaminergic medication (ON). We found that only the posterior right dlPFC subdivision shows FC alterations in PD, while the anterior part remains unaffected. PD-related decreased FC with posterior right dlPFC was found in the bilateral medial posterior parietal cortex (mPPC) and left dorsal premotor region (PMd) in the OFF state. In the medical ON, FC with left PMd normalized, while decoupling with bilateral mPPC remained. Furthermore, we observed increased FC between posterior right dlPFC and the bilateral dorsomedial prefrontal cortex (dmPFC) in PD in the ON state. Our findings point to differential disturbances of right dlPFC connectivity in PD, which relate to its hierarchical organization of EF processing by stronger affecting the functionally basal posterior aspect than the hierarchically higher anterior part. PMID:28611616

  12. History of winning remodels thalamo-PFC circuit to reinforce social dominance.

    PubMed

    Zhou, Tingting; Zhu, Hong; Fan, Zhengxiao; Wang, Fei; Chen, Yang; Liang, Hexing; Yang, Zhongfei; Zhang, Lu; Lin, Longnian; Zhan, Yang; Wang, Zheng; Hu, Hailan

    2017-07-14

    Mental strength and history of winning play an important role in the determination of social dominance. However, the neural circuits mediating these intrinsic and extrinsic factors have remained unclear. Working in mice, we identified a dorsomedial prefrontal cortex (dmPFC) neural population showing "effort"-related firing during moment-to-moment competition in the dominance tube test. Activation or inhibition of the dmPFC induces instant winning or losing, respectively. In vivo optogenetic-based long-term potentiation and depression experiments establish that the mediodorsal thalamic input to the dmPFC mediates long-lasting changes in the social dominance status that are affected by history of winning. The same neural circuit also underlies transfer of dominance between different social contests. These results provide a framework for understanding the circuit basis of adaptive and pathological social behaviors. Copyright © 2017, American Association for the Advancement of Science.

  13. Endoscopic treatment of large pancreatic fluid collections (PFC) using self-expanding metallic stents (SEMS) - a two-center experience.

    PubMed

    Chaves, Dalton Marques; Mönkemüller, Klaus; Carneiro, Fred; Medrado, Bruno; Dos Santos, Marcos; Wodak, Stephanie; Reimão, Sílvia; Sakai, Paulo; de Moura, Eduardo

    2014-12-01

    Background/study aim: During the last several years, endoscopic ultrasound (EUS)-guided pancreatic fluid collections' (PFC) drainage has evolved into the preferred drainage technique. Recently, self-expanding metallic stents (SEMS) have been used as an alternative to double pigtail stents, with the advantage of providing a larger diameter fistula, thereby decreasing the risk of early obstruction and also allowing for direct endoscopic exploration of the cavity. The aim of this study was to evaluate the technical and clinical success, safety, and outcome of patients undergoing EUS-guided drainage of complex PFC using SEMS. The study was conducted at two tertiary hospitals from January 2010 to January 2013. All patients with PFC referred for endoscopic drainage were enrolled in a prospective database. The inclusion criteria were: (1) patients with pseudocysts or walled-off necrosis based on the revised Atlanta classification; (2) symptomatic patients with thick PFC; (3) PFC that persisted more than 6 weeks; and (4) large PFC diameter (≥ 9 cm). The exclusion criteria consisted of coagulation disorders, PFC bleeding or infection, and failure-to-inform written consent. A total of 16 patients (9 females, 7 males; mean age 52.6, range 20 - 82) underwent EUS drainage with SEMS. There were 14 cases of pseudocysts and 2 cases of walled-off necrosis. The etiologies of the PFC were mainly gallstones (8 of 16 patients, 50 %) and alcohol (5 of 16 patients, 31 %). Technical success was achieved in 100 % of the cases. All patients had a complete resolution of the PFC. Transmural EUS-guided drainage of complex PFC using SEMS is feasible, appears safe, and is efficacious. However, the exchange of the UC (uncovered)-SEMS for plastic stents is mandatory within 1 week. Future prospective studies, preferably multicenter studies, comparing SEMS versus traditional plastic stents for the drainage of PFC are warranted.

  14. Person-specific theory of mind in medial pFC.

    PubMed

    Welborn, B Locke; Lieberman, Matthew D

    2015-01-01

    Although research on theory of mind has strongly implicated the dorsomedial pFC (incuding medial BA 8 and BA 9), the unique contributions of medial pFC (MPFC; corresponding to medial BA 10) to mentalizing remain uncertain. The extant literature has considered the possibility that these regions may be specialized for self-related cognition or for reasoning about close others, but evidence for both accounts has been inconclusive. We propose a novel theoretical framework: MPFC selectively implements "person-specific theories of mind" (ToMp) representing the unique, idiosyncratic traits or attributes of well-known individuals. To test this hypothesis, we used fMRI to assess MPFC responses in Democratic and Republican participants as they evaluated more or less subjectively well-known political figures. Consistent with the ToMp account, MPFC showed greater activity to subjectively well-known targets, irrespective of participants' reported feelings of closeness or similarity. MPFC also demonstrated greater activity on trials in which targets (whether politicians or oneself) were judged to be relatively idiosyncratic, making a generic theory of mind inapplicable. These results suggest that MPFC may supplement the generic theory of mind process, with which dorsomedial pFC has been associated, by contributing mentalizing capacities tuned to individuated representations of specific well-known others.

  15. Repeated microinjections into the medial prefrontal cortex (mPFC) impair extinction of conditioned place preference in mice.

    PubMed

    Groblewski, Peter A; Cunningham, Christopher L

    2012-04-21

    The medial prefrontal cortex (mPFC) is important for extinction of many behaviors including conditioned place preference (CPP). We examined the effects of intra-mPFC inactivation (with bupivacaine) on extinction of ethanol-induced CPP in mice. Injections of both bupivacaine and vehicle impaired extinction whereas no-surgery control mice extinguished normally. Consistent with recently reported effects of mPFC lesions, these data suggest that extinction was impaired by excessive mPFC damage induced by repeated intracranial infusions. Copyright © 2012 Elsevier B.V. All rights reserved.

  16. 77 FR 33805 - Notice of Passenger Facility Charge (PFC) Approvals and Disapprovals

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-06-07

    ... EFFECTIVE DATE: July 1, 2018. ESTIMATED CHARGE EXPIRATION DATE: October 1, 2021. CLASS OF AIR CARRIERS NOT... charge approved date PFC revenue PFC revenue expiration expiration date date 05-05-C-07-EWR 04/06/12 $556,442,435 $566,136,035 07/1/11 09/1/11 Newark, NJ 10-08-C-01-SAV 05/03/12 4,066,265 6,669,248 04/1/16 12...

  17. Reward acts on the pFC to enhance distractor resistance of working memory representations.

    PubMed

    Fallon, Sean James; Cools, Roshan

    2014-12-01

    Working memory and reward processing are often thought to be separate, unrelated processes. However, most daily activities involve integrating these two types of information, and the two processes rarely, if ever, occur in isolation. Here, we show that working memory and reward interact in a task-dependent manner and that this task-dependent interaction involves modulation of the pFC by the ventral striatum. Specifically, BOLD signal during gains relative to losses in the ventral striatum and pFC was associated not only with enhanced distractor resistance but also with impairment in the ability to update working memory representations. Furthermore, the effect of reward on working memory was accompanied by differential coupling between the ventral striatum and ignore-related regions in the pFC. Together, these data demonstrate that reward-related signals modulate the balance between cognitive stability and cognitive flexibility by altering functional coupling between the ventral striatum and the pFC.

  18. A clinical and radiostereometric study of the cemented PFC-sigma prosthesis: a 5-year study of 29 cases with a fixed bearing.

    PubMed

    von Schewelov, Thord; Besjakov, Jack; Sanzén, Lennart; Carlsson, Ake

    2009-07-01

    The press-fit condylar (PFC) cruciate-retaining total knee prosthesis is well documented in the literature. In 1997, a modification of the femoral component was introduced, and the prosthesis was renamed PFC-Sigma. The alteration may influence the migratory and rotational pattern of the tibial component and thus long-time survival rate. In this radiostereometric analysis, we found that the micromotion of the PFC-Sigma prosthesis differs slightly from the original PFC design, an advantage of the PFC-Sigma prosthesis. The median maximum total point motion at 5 years was 0.64 mm for the PFC-Sigma design and 0.79 mm for the previous version of PFC (P = .9). However, the PFC-Sigma rotated less around the transverse (x) axis than did the PFC (medians, 0.22 mm and 0.48 mm, respectively; P = .04). From the radiostereometric, radiographic, and clinical data, we conclude that the PFC-Sigma knee prosthesis can be used with confidence.

  19. 76 FR 56001 - Notice of Passenger Facility Charge (PFC) Approvals and Disapprovals

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-09-09

    ... revenue PFC revenue date date 07-10-C-03-DSM Des Moines, IA... 06/29/11 $9,175,000 $9,547,773 08/01/17 08/01/17 01-04-C-01-MBS Freeland, MI..... 07/11/11 1,999,052 566,875 07/01/06 07/01/06 06-09-C-02-JAX... had previously been approved for collection of PFC revenue in decision 06- 08-C-00-DBQ and for use of...

  20. Serum concentrations of perfluorinated compounds (PFC) ...

    EPA Pesticide Factsheets

    Perfluorinated compounds (PFCs) have been widely used in industrial applications and consumer products. Their persistent nature and potential health impacts are of concern. Given the high cost of collecting serum samples, this study is to understand whether we can quantify PFC serum concentrations using factors extracted from questionnaire responses and indirect measurements, and whether a single serum measurement can be used to classify an individual′s exposure over a one-year period. The study population included three demographic groups: young children (2–8 years old) (N=67), parents of young children (55 years old) (N=59). PFC serum concentrations, house dust concentrations, and questionnaires were collected. The geometric mean of perfluorooctane sulfonic acid (PFOS) was highest for the older adults. In contrast, the geometric mean of perfluorooctanoic acid (PFOA) was highest for children. Serum concentrations of the parent and the child from the same family were moderately correlated (Spearman correlation (r)=0.26–0.79, p<0.05), indicating common sources within a family. For adults, age, having occupational exposure or having used fire extinguisher, frequencies of consuming butter/margarine, pork, canned meat entrées, tuna and white fish, freshwater fish, and whether they ate microwave popcorn were significantly positively associated with serum concentrations of individual PFCs. For children, residential dust

  1. Remote control system for high-perfomance computer simulation of crystal growth by the PFC method

    NASA Astrophysics Data System (ADS)

    Pavlyuk, Evgeny; Starodumov, Ilya; Osipov, Sergei

    2017-04-01

    Modeling of crystallization process by the phase field crystal method (PFC) - one of the important directions of modern computational materials science. In this paper, the practical side of the computer simulation of the crystallization process by the PFC method is investigated. To solve problems using this method, it is necessary to use high-performance computing clusters, data storage systems and other often expensive complex computer systems. Access to such resources is often limited, unstable and accompanied by various administrative problems. In addition, the variety of software and settings of different computing clusters sometimes does not allow researchers to use unified program code. There is a need to adapt the program code for each configuration of the computer complex. The practical experience of the authors has shown that the creation of a special control system for computing with the possibility of remote use can greatly simplify the implementation of simulations and increase the performance of scientific research. In current paper we show the principal idea of such a system and justify its efficiency.

  2. Cholinergic and ghrelinergic receptors and KCNQ channels in the medial PFC regulate the expression of palatability.

    PubMed

    Parent, Marc A; Amarante, Linda M; Swanson, Kyra; Laubach, Mark

    2015-01-01

    The medial prefrontal cortex (mPFC) is a key brain region for the control of consummatory behavior. Neuronal activity in this area is modulated when rats initiate consummatory licking and reversible inactivations eliminate reward contrast effects and reduce a measure of palatability, the duration of licking bouts. Together, these data suggest the hypothesis that rhythmic neuronal activity in the mPFC is crucial for the control of consummatory behavior. The muscarinic cholinergic system is known to regulate membrane excitability and control low-frequency rhythmic activity in the mPFC. Muscarinic receptors (mAChRs) act through KCNQ (Kv7) potassium channels, which have recently been linked to the orexigenic peptide ghrelin. To understand if drugs that act on KCNQ channels within the mPFC have effects on consummatory behavior, we made infusions of several muscarinic drugs (scopolamine, oxotremorine, physostigmine), the KCNQ channel blocker XE-991, and ghrelin into the mPFC and evaluated their effects on consummatory behavior. A consistent finding across all drugs was an effect on the duration of licking bouts when animals consume solutions with a relatively high concentration of sucrose. The muscarinic antagonist scopolamine reduced bout durations, both systemically and intra-cortically. By contrast, the muscarinic agonist oxotremorine, the cholinesterase inhibitor physostigmine, the KCNQ channel blocker XE-991, and ghrelin all increased the durations of licking bouts when infused into the mPFC. Our findings suggest that cholinergic and ghrelinergic signaling in the mPFC, acting through KCNQ channels, regulates the expression of palatability.

  3. On temporal connectivity of PFC via Gauss-Markov modeling of fNIRS signals.

    PubMed

    Aydöre, Sergül; Mihçak, M Kivanç; Ciftçi, Koray; Akin, Ata

    2010-03-01

    Functional near-infrared spectroscopy (fNIRS) is an optical imaging method, which monitors the brain activation by measuring the successive changes in the concentration of oxy- and deoxyhemoglobin in real time. In this study, we present a method to investigate the functional connectivity of prefrontal cortex (PFC) Sby applying a Gauss-Markov model to fNIRS signals. The hemodynamic changes on PFC during the performance of cognitive paradigm are measured by fNIRS for 17 healthy adults. The color-word matching Stroop task is performed to activate 16 different regions of PFC. There are three different types of stimuli in this task, which can be listed as incongruent stimulus (IS), congruent stimulus (CS), and neutral stimulus (NS), respectively. We introduce a new measure, called "information transfer metric" (ITM) for each time sample. The behavior of ITMs during IS are significantly different from the ITMs during CS and NS, which is consistent with the outcome of the previous research, which concentrated on fNIRS signal analysis via color-word matching Stroop task. Our analysis shows that the functional connectivity of PFC is highly relevant with the cognitive load, i.e., functional connectivity increases with the increasing cognitive load.

  4. Detecting representations of recent and remote autobiographical memories in vmPFC and hippocampus

    PubMed Central

    Bonnici, Heidi M.; Chadwick, Martin J.; Lutti, Antoine; Hassabis, Demis; Weiskopf, Nikolaus; Maguire, Eleanor A.

    2012-01-01

    How autobiographical memories are represented in the human brain and whether this changes with time are questions central to memory neuroscience. Two regions in particular have been consistently implicated, the ventromedial prefrontal cortex (vmPFC) and the hippocampus, although their precise contributions are still contested. The key question in this debate, when reduced to its simplest form, concerns where information about specific autobiographical memories is located. Here we availed ourselves of the opportunity afforded by multi-voxel pattern analysis (MVPA) to provide an alternative to conventional neuropsychological and fMRI approaches, by detecting representations of individual autobiographical memories in patterns of fMRI activity. We examined whether information about specific recent (two weeks old) and remote (ten years old) autobiographical memories was represented in vmPFC and hippocampus, and other medial temporal and neocortical regions. vmPFC contained information about recent and remote autobiographical memories, although remote memories were more readily detected there, indicating that consolidation or a change of some kind had occurred. Information about both types of memory was also present in the hippocampus, suggesting it plays a role in the retrieval of vivid autobiographical memories regardless of remoteness. Interestingly, we also found that while recent and remote memories were both represented within anterior and posterior hippocampus, the latter nevertheless contained more information about remote memories. Thus, like vmPFC, the hippocampus too respected the distinction between recent and remote memories. Overall, these findings clarify and extend our view of vmPFC and hippocampus while also informing systems-level consolidation and providing clear targets for future studies. PMID:23175849

  5. Oxytocin in the medial prefrontal cortex regulates maternal care, maternal aggression and anxiety during the postpartum period

    PubMed Central

    Sabihi, Sara; Dong, Shirley M.; Durosko, Nicole E.; Leuner, Benedetta

    2014-01-01

    The neuropeptide oxytocin (OT) acts on a widespread network of brain regions to regulate numerous behavioral adaptations during the postpartum period including maternal care, maternal aggression, and anxiety. In the present study, we examined whether this network also includes the medial prefrontal cortex (mPFC). We found that bilateral infusion of a highly specific oxytocin receptor antagonist (OTR-A) into the prelimbic (PL) region of the mPFC increased anxiety-like behavior in postpartum, but not virgin, females. In addition, OTR blockade in the postpartum mPFC impaired maternal care behaviors and enhanced maternal aggression. Overall, these results suggest that OT in the mPFC modulates maternal care and aggression, as well as anxiety-like behavior, during the postpartum period. Although the relationship among these behaviors is complicated and further investigation is required to refine our understanding of OT actions in the maternal mPFC, these data nonetheless provide new insights into neural circuitry of OT-mediated postpartum behaviors. PMID:25147513

  6. Traces of pFc' in IVIG interact with human IgG Fc domains and counteract aggregation.

    PubMed

    Rispens, Theo; Himly, Martin; Ooievaar-De Heer, Pleuni; den Bleker, Tamara H; Aalberse, Rob C

    2010-04-16

    To prevent multimer formation, intravenous immunoglobulin (IVIG) is often treated with traces of pepsin. So far, the mechanism behind this treatment has been unclear. Recently, we reported that human IgG4 binds other IgG molecules via Fc-Fc interactions. Here we show that IVIG treated with traces of pepsin (Nanogam) inhibits these interactions. We found that--besides IgG4--peptides corresponding to IgG1 and IgG2 pFc' (products of limited pepsin digestion) are responsible for the inhibitory action. Using radiolabeled pFc', it was found that pFc' binds directly to IgG1. Furthermore, recombinant CH3 fragments were found to also possess binding activity, and potencies of inhibition varied over 3 orders of magnitude amongst the subclasses, IgG4 being most potent. We propose that pFc' formation explains how limited pepsin digestion diminishes adverse effects of IVIG. In particular, the presence of this fragment can enhance the stability of IgG products including IVIG and therapeutical monoclonal antibodies. Indeed, using a model system it was found that acid-induced aggregation of IgG is reduced in the presence of pFc', suggesting a 'chaperone-like' activity of this fragment. Thus, pFc' can modulate Fc interactions and may therefore reduce adverse effects of IVIG, in particular by preventing oligomerization. 2010 Elsevier B.V. All rights reserved.

  7. Descending glutamatergic pathways of PFC are involved in acute and chronic action of Methylphenidate

    PubMed Central

    Wanchoo, S.J.; Swann, A.C.; Dafny, N.

    2012-01-01

    Progressive augmentation of behavioral response following repeated psychostimulant administrations is known as behavioral sensitization, and is an indicator of a drug’s liability for abuse. It is known that methylphenidate (MPD) (also known as Ritalin), a drug used to treat Attention-Deficit Hyperactivity Disorder (ADHD), induces sensitization in animals following repeated injections. It was recently reported that bilateral electric (non-specific) lesion of prefrontal cortex (PFC) prevented MPD elicited behavioral sensitization. Since PFC sends glutamatergic afferents to both ventral tegmental area (VTA) and nucleus accumbens (NAc), sites that are involved in induction and expression of behavioral sensitization respectively and glutamate from PFC is known to modulate dopamine cell activity in VTA and NAc, this study investigated the role of descending glutamate from PFC in MPD elicited behavioral sensitization. Locomotor activity of three groups of rats- control, sham operated and group with specific chemical lesion of glutamate neurons of PFC- was recorded using an open-field assay. On experimental day (ED) 1, the locomotor activity was recorded post a saline injection. The sham and lesion groups underwent respective surgeries on ED 2, and were allowed to recover for five days (from ED 3 to ED 7). The post-surgery baseline was recorded on ED 8 following a saline injection. On ED’s 9 through 14, 2.5 mg/kg MPD was given, followed by a four day washout period (ED 15 –18). All three groups received a rechallenge injection of 2.5 mg/kg on ED 19 and their locomotor activity on various days was analyzed. It was found that ibotenic acid lesion modulated the acute and chronic effects of MPD and hence suggests that PFC glutamatergic afferents are involved in the acute effect of MPD as well as in its chronic effects such as behavioral sensitization to MPD. PMID:19747456

  8. Descending glutamatergic pathways of PFC are involved in acute and chronic action of methylphenidate.

    PubMed

    Wanchoo, S J; Swann, A C; Dafny, N

    2009-12-08

    Progressive augmentation of behavioral response following repeated psychostimulant administrations is known as behavioral sensitization, and is an indicator of a drug's liability for abuse. It is known that methylphenidate (MPD) (also known as Ritalin), a drug used to treat attention-deficit hyperactivity disorder (ADHD), induces sensitization in animals following repeated injections. It was recently reported that bilateral electric (non-specific) lesion of prefrontal cortex (PFC) prevented MPD elicited behavioral sensitization. Since PFC sends glutamatergic afferents to both ventral tegmental area (VTA) and nucleus accumbens (NAc), sites that are involved in induction and expression of behavioral sensitization respectively and glutamate from PFC is known to modulate dopamine cell activity in VTA and NAc, this study investigated the role of descending glutamate from PFC in MPD elicited behavioral sensitization. Locomotor activity of three groups of rats-control, sham operated and group with specific chemical lesion of glutamate neurons of PFC-was recorded using an open-field assay. On experimental day (ED) 1, the locomotor activity was recorded post a saline injection. The sham and lesion groups underwent respective surgeries on ED 2, and were allowed to recover for 5 days (from ED 3 to ED 7). The post-surgery baseline was recorded on ED 8 following a saline injection. On ED's 9 through 14, 2.5 mg/kg MPD was given, followed by a 4-day washout period (ED 15 -18). All three groups received a rechallenge injection of 2.5 mg/kg on ED 19 and their locomotor activity on various days was analyzed. It was found that ibotenic acid lesion modulated the acute and chronic effects of MPD and hence suggests that PFC glutamatergic afferents are involved in the acute effect of MPD as well as in its chronic effects such as behavioral sensitization to MPD.

  9. PFC Emissions from Detected Versus Nondetected Anode Effects in the Aluminum Industry

    NASA Astrophysics Data System (ADS)

    Wong, David S.; Fraser, Paul; Lavoie, Pascal; Kim, Jooil

    2015-02-01

    Perfluorinated carbon compounds (PFCs) CF4 and C2F6 are potent greenhouse gases that are generated in aluminum reduction cells during events known as anode effects (AEs). Since the 1990s, the aluminum industry has made considerable progress in reducing PFCs from conventionally defined and detected AEs. However in recent years, the industry has noted the presence of unaccounted PFCs that are generated outside the conventional AE definition. Two additional AE categories have been proposed, namely low-voltage, propagating AEs (LVP-AEs) and nonpropagating AEs (NP-AEs) that relate to continuous, background levels of PFC emissions. These unaccounted PFC phenomena may help explain the recent discrepancy between industry accounting and atmospheric measurements of global PFC emissions. Estimates from AGAGE, a global network of atmospheric observatories, suggest as much as 50% underaccounting of PFCs by the aluminum industry in the 2006-2010 period. The following work reviews this discrepancy and the potential role played by LVP-AEs and NP-AEs.

  10. 78 FR 41184 - Notice of Intent To Rule on Passenger Facility Charge (PFC) Application 11-05-C-00-SFO to Impose...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-07-09

    ... Facility Charge (PFC) Application 11-05-C-00-SFO to Impose and Use PFC Revenue at San Francisco... the application to impose and use PFC revenue at San Francisco International Airport (SFO), under the... FAA proposes to rule and invites public comment on the application to impose and use PFC revenue at...

  11. Induction and modulation of persistent activity in a layer V PFC microcircuit model

    PubMed Central

    Papoutsi, Athanasia; Sidiropoulou, Kyriaki; Cutsuridis, Vassilis; Poirazi, Panayiota

    2013-01-01

    Working memory refers to the temporary storage of information and is strongly associated with the prefrontal cortex (PFC). Persistent activity of cortical neurons, namely the activity that persists beyond the stimulus presentation, is considered the cellular correlate of working memory. Although past studies suggested that this type of activity is characteristic of large scale networks, recent experimental evidence imply that small, tightly interconnected clusters of neurons in the cortex may support similar functionalities. However, very little is known about the biophysical mechanisms giving rise to persistent activity in small-sized microcircuits in the PFC. Here, we present a detailed biophysically—yet morphologically simplified—microcircuit model of layer V PFC neurons that incorporates connectivity constraints and is validated against a multitude of experimental data. We show that (a) a small-sized network can exhibit persistent activity under realistic stimulus conditions. (b) Its emergence depends strongly on the interplay of dADP, NMDA, and GABAB currents. (c) Although increases in stimulus duration increase the probability of persistent activity induction, variability in the stimulus firing frequency does not consistently influence it. (d) Modulation of ionic conductances (Ih, ID, IsAHP, IcaL, IcaN, IcaR) differentially controls persistent activity properties in a location dependent manner. These findings suggest that modulation of the microcircuit's firing characteristics is achieved primarily through changes in its intrinsic mechanism makeup, supporting the hypothesis of multiple bi-stable units in the PFC. Overall, the model generates a number of experimentally testable predictions that may lead to a better understanding of the biophysical mechanisms of persistent activity induction and modulation in the PFC. PMID:24130519

  12. Induction and modulation of persistent activity in a layer V PFC microcircuit model.

    PubMed

    Papoutsi, Athanasia; Sidiropoulou, Kyriaki; Cutsuridis, Vassilis; Poirazi, Panayiota

    2013-01-01

    Working memory refers to the temporary storage of information and is strongly associated with the prefrontal cortex (PFC). Persistent activity of cortical neurons, namely the activity that persists beyond the stimulus presentation, is considered the cellular correlate of working memory. Although past studies suggested that this type of activity is characteristic of large scale networks, recent experimental evidence imply that small, tightly interconnected clusters of neurons in the cortex may support similar functionalities. However, very little is known about the biophysical mechanisms giving rise to persistent activity in small-sized microcircuits in the PFC. Here, we present a detailed biophysically-yet morphologically simplified-microcircuit model of layer V PFC neurons that incorporates connectivity constraints and is validated against a multitude of experimental data. We show that (a) a small-sized network can exhibit persistent activity under realistic stimulus conditions. (b) Its emergence depends strongly on the interplay of dADP, NMDA, and GABAB currents. (c) Although increases in stimulus duration increase the probability of persistent activity induction, variability in the stimulus firing frequency does not consistently influence it. (d) Modulation of ionic conductances (I h , I D , I sAHP, I caL, I caN, I caR) differentially controls persistent activity properties in a location dependent manner. These findings suggest that modulation of the microcircuit's firing characteristics is achieved primarily through changes in its intrinsic mechanism makeup, supporting the hypothesis of multiple bi-stable units in the PFC. Overall, the model generates a number of experimentally testable predictions that may lead to a better understanding of the biophysical mechanisms of persistent activity induction and modulation in the PFC.

  13. Discrete Element Method (DEM) Simulations using PFC3D

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

    Matt Evans

    Contains input scripts, background information, reduced data, and results associated with the discrete element method (DEM) simulations of interface shear tests, plate anchor pullout tests, and torpedo anchor installation and pullout tests, using the software PFC3D (v4.0).

  14. 14 CFR 158.13 - Use of PFC revenue.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... the purchase price of a new low emission vehicle and the purchase price of a standard emission vehicle... the financial need of the airport. (f) Combination of PFC revenue and Federal grant funds. A public... are subject to the record keeping and auditing requirements of this part, as well as the reporting...

  15. Early outcome of TKA with a medial pivot fixed-bearing prosthesis is worse than with a PFC mobile-bearing prosthesis.

    PubMed

    Kim, Young-Hoo; Yoon, Sung-Hwan; Kim, Jun-Shik

    2009-02-01

    Although the design features of the Medial Pivot fixed-bearing prosthesis reportedly improve kinematics compared with TKAs using fixed-bearings, clinical improvements have not been reported. We asked whether the clinical and radiographic outcomes, ranges of motion of the knee, patient satisfaction, and complication rates would be better in knees with a Medial Pivot fixed-bearing prosthesis than in those with a PFC Sigma mobile-bearing prosthesis. We compared the results of 92 patients who had a Medial Pivot fixed-bearing prosthesis implanted in one knee and a PFC Sigma mobile-bearing prosthesis implanted in the other. There were 85 women and seven men with a mean age of 69.5 years (range, 55-81 years). The minimum followup was 2 years (mean, 2.6 years; range, 2-3 years). The patients were assessed clinically and radiographically using the rating systems of the Hospital for Special Surgery and the Knee Society at 3 months, 1 year, and annually thereafter. Contrary to expectations, we found worse early clinical outcomes, smaller ranges of knee motion, less patient satisfaction, and a higher complication rate for the Medial Pivot fixed-bearing prosthesis than for the PFC Sigma mobile-bearing prosthesis. Level I, therapeutic study. See the Guidelines for Authors for a complete description of levels of evidence.

  16. Uncertainty-Dependent Extinction of Fear Memory in an Amygdala-mPFC Neural Circuit Model

    PubMed Central

    Li, Yuzhe; Nakae, Ken; Ishii, Shin; Naoki, Honda

    2016-01-01

    Uncertainty of fear conditioning is crucial for the acquisition and extinction of fear memory. Fear memory acquired through partial pairings of a conditioned stimulus (CS) and an unconditioned stimulus (US) is more resistant to extinction than that acquired through full pairings; this effect is known as the partial reinforcement extinction effect (PREE). Although the PREE has been explained by psychological theories, the neural mechanisms underlying the PREE remain largely unclear. Here, we developed a neural circuit model based on three distinct types of neurons (fear, persistent and extinction neurons) in the amygdala and medial prefrontal cortex (mPFC). In the model, the fear, persistent and extinction neurons encode predictions of net severity, of unconditioned stimulus (US) intensity, and of net safety, respectively. Our simulation successfully reproduces the PREE. We revealed that unpredictability of the US during extinction was represented by the combined responses of the three types of neurons, which are critical for the PREE. In addition, we extended the model to include amygdala subregions and the mPFC to address a recent finding that the ventral mPFC (vmPFC) is required for consolidating extinction memory but not for memory retrieval. Furthermore, model simulations led us to propose a novel procedure to enhance extinction learning through re-conditioning with a stronger US; strengthened fear memory up-regulates the extinction neuron, which, in turn, further inhibits the fear neuron during re-extinction. Thus, our models increased the understanding of the functional roles of the amygdala and vmPFC in the processing of uncertainty in fear conditioning and extinction. PMID:27617747

  17. Uncertainty-Dependent Extinction of Fear Memory in an Amygdala-mPFC Neural Circuit Model.

    PubMed

    Li, Yuzhe; Nakae, Ken; Ishii, Shin; Naoki, Honda

    2016-09-01

    Uncertainty of fear conditioning is crucial for the acquisition and extinction of fear memory. Fear memory acquired through partial pairings of a conditioned stimulus (CS) and an unconditioned stimulus (US) is more resistant to extinction than that acquired through full pairings; this effect is known as the partial reinforcement extinction effect (PREE). Although the PREE has been explained by psychological theories, the neural mechanisms underlying the PREE remain largely unclear. Here, we developed a neural circuit model based on three distinct types of neurons (fear, persistent and extinction neurons) in the amygdala and medial prefrontal cortex (mPFC). In the model, the fear, persistent and extinction neurons encode predictions of net severity, of unconditioned stimulus (US) intensity, and of net safety, respectively. Our simulation successfully reproduces the PREE. We revealed that unpredictability of the US during extinction was represented by the combined responses of the three types of neurons, which are critical for the PREE. In addition, we extended the model to include amygdala subregions and the mPFC to address a recent finding that the ventral mPFC (vmPFC) is required for consolidating extinction memory but not for memory retrieval. Furthermore, model simulations led us to propose a novel procedure to enhance extinction learning through re-conditioning with a stronger US; strengthened fear memory up-regulates the extinction neuron, which, in turn, further inhibits the fear neuron during re-extinction. Thus, our models increased the understanding of the functional roles of the amygdala and vmPFC in the processing of uncertainty in fear conditioning and extinction.

  18. PFC Activity Pattern During Verbal WM Task in Healthy Male and Female Subjects: A NIRS Study.

    PubMed

    Gao, Chenyang; Zhang, Lei; Luo, Dewu; Liu, Dan; Gong, Hui

    2016-01-01

    Near-infrared spectroscopy (NIRS), as a non-invasive optical imaging method, has been widely used in psychology research. Working memory (WM) is an extensively researched psychological concept related to the temporary storage and processing of information. Many neuropsychological studies demonstrate that several brain areas of prefrontal cortex (PFC) are engaged during verbal WM tasks. The gender-based differences in WM remains under dispute. To better understand the active module and gender differences in PFC activity patterns during verbal WM tasks, we investigated the blood oxygenation changes of the PFC in 15 healthy subjects using a homemade multichannel continuous-wave NIRS instrument, while performing a verbal n-back task. We employed traditional activation and novel connectivity analyses simultaneously. Males had a higher level of oxygenation activity and connectivity in PFC than females. Only the results of females revealed a leftward lateralization in the 2-back task.

  19. Planning and Decision Making for Care Transitions

    PubMed Central

    Sörensen, Silvia; Mak, Wingyun; Pinquart, Martin

    2015-01-01

    The need to plan for future health care and residential adjustments increases with age, growing frailty, and restrictions in coverage of long-term care and will continue to grow with population aging. Older adults’ lack of financial preparation for health care costs, insufficient knowledge about available options, and inadequate communication about care-related values has become an increasing public health challenge. This chapter describes a model of Preparation for Future Care (PFC), which encompasses different levels and domains of planning. Research about the extent to which planning is helpful in navigating care transitions is reviewed, and barriers and facilitators of planning including individual, familial, cultural, and national long-term care policy factors are discussed. Planning in the context of dementia and practical approaches that can be taken to enhance PFC is addressed, as well as recommendations for future research in the area of planning and decision making in the context of care transitions. PMID:26207079

  20. 5-HT2a receptor in mPFC influences context-guided reconsolidation of object memory in perirhinal cortex.

    PubMed

    Morici, Juan Facundo; Miranda, Magdalena; Gallo, Francisco Tomás; Zanoni, Belén; Bekinschtein, Pedro; Weisstaub, Noelia V

    2018-05-02

    Context-dependent memories may guide adaptive behavior relaying in previous experience while updating stored information through reconsolidation. Retrieval can be triggered by partial and shared cues. When the cue is presented, the most relevant memory should be updated. In a contextual version of the object recognition task, we examined the effect of medial PFC (mPFC) serotonin 2a receptor (5-HT2aR) blockade during retrieval in reconsolidation of competing objects memories. We found that mPFC 5-HT2aR controls retrieval and reconsolidation of object memories in the perirhinal cortex (PRH), but not in the dorsal hippocampus in rats. Also, reconsolidation of objects memories in PRH required a functional interaction between the ventral hippocampus and the mPFC. Our results indicate that in the presence of conflicting information at retrieval, mPFC 5-HT2aR may facilitate top-down context-guided control over PRH to control the behavioral response and object memory reconsolidation. © 2018, Morici et al.

  1. 5-HT2a receptor in mPFC influences context-guided reconsolidation of object memory in perirhinal cortex

    PubMed Central

    Morici, Juan Facundo; Miranda, Magdalena; Gallo, Francisco Tomás; Zanoni, Belén; Bekinschtein, Pedro

    2018-01-01

    Context-dependent memories may guide adaptive behavior relaying in previous experience while updating stored information through reconsolidation. Retrieval can be triggered by partial and shared cues. When the cue is presented, the most relevant memory should be updated. In a contextual version of the object recognition task, we examined the effect of medial PFC (mPFC) serotonin 2a receptor (5-HT2aR) blockade during retrieval in reconsolidation of competing objects memories. We found that mPFC 5-HT2aR controls retrieval and reconsolidation of object memories in the perirhinal cortex (PRH), but not in the dorsal hippocampus in rats. Also, reconsolidation of objects memories in PRH required a functional interaction between the ventral hippocampus and the mPFC. Our results indicate that in the presence of conflicting information at retrieval, mPFC 5-HT2aR may facilitate top-down context-guided control over PRH to control the behavioral response and object memory reconsolidation. PMID:29717980

  2. Performance and cost effectiveness of permeable friction course (PFC) pavements.

    DOT National Transportation Integrated Search

    2013-02-01

    In this project, the research team evaluated the performance of Permeable Friction Courses (PFC) over time and compared it against other types of wearing surface pavement layers. Several pavement sections including Asphalt Rubber (AR) PFCs, Performan...

  3. Cyclo-octafluorobutane (PFC-318, c-C4F8) in the global atmosphere

    NASA Astrophysics Data System (ADS)

    Muhle, J.; Vollmer, M. K.; Ivy, D. J.; Fraser, P.; Arnold, T.; Harth, C. M.; Salameh, P.; O'Doherty, S.; Young, D.; Steele, P.; Krummel, P. B.; Leist, M.; Rhee, T. S.; Schmidbauer, N.; Lunder, C.; Kim, J.; Kim, K.; Reimann, S.; Simmonds, P.; Prinn, R. G.; Weiss, R. F.

    2011-12-01

    The perfluorocarbon (PFC) cyclo-octafluorobutane (PFC-318, c-C4F8) is a very long-lived (up to 3,200 years) and potent greenhouse gas (100-year global warming potential up to 10,300) with a wide range of industrial uses. We present an update of our PFC-318 archived air and in situ measurements from remote and urban AGAGE (Advanced Global Atmospheric Gases Experiment) sites and affiliated stations in both hemispheres. Most importantly, we have significantly improved our Southern Hemisphere (SH) data density by measuring the Cape Grim Air Archive (1970s-2010). Combined with our previously presented measurements of archived Northern Hemisphere (NH) flasks (1973-2009), we provide thirty year spanning records for both hemispheres. We have also further extended our in situ records by continuing our measurements at all remote stations, with the longest hemispheric records starting in November 2007 at Jungfraujoch (NH) and in June 2010 at Cape Grim (SH). We compare our data with those of Oram (1999) and Oram et al. (2011), who focus on SH data alone, and with other previous data sets. From our measurements, we derive emission estimates using a chemical transport model and inverse method, and compare our results to previous measurement based emission estimates (top-down) and to the EDGAR emission database (bottom-up). As stated previously (Mühle et al., 2010), we find emissions of ~1 Gg/yr in recent years while EDGAR estimates only 0.02 Gg/yr for 2005, similar to what Oram et al. (2011) find. We conclude that PFC-318 is the third most important PFC in terms of abundance and CO2-equivalent emissions. We continue to observe mostly baseline concentrations at remote AGAGE stations and urban sites in the USA, Europe, and Australia, in contrast to frequent pollution episodes measured at sites in East Asia, indicating significant regional emissions in East Asia, as found by Saito et al. (2010). EDGAR, Emission Database for Global Atmospheric Research, release version 4.1. http

  4. Perfluorochemical (PFC) exposure in children: associations with impaired response inhibition.

    PubMed

    Gump, Brooks B; Wu, Qian; Dumas, Amy K; Kannan, Kurunthachalam

    2011-10-01

    Perfluorinated chemicals (PFCs) have been used widely in consumer products since the 1950s and are currently found at detectable levels in the blood of humans and animals across the globe. In stark contrast to this widespread exposure to PFCs, there is relatively little research on potential adverse health effects of exposure to these chemicals. We performed this cross-sectional study to determine if specific blood PFC levels are associated with impaired response inhibition in children. Blood levels of 11 PFCs were measured in children (N = 83) and 6 PFCs: perfluorooctane sulfonate (PFOS), perfluorohexane sulfate (PFHxS), perfluorooctanoic acid (PFOA), perfluorononanoic acid (PFNA), perfluorooctanesulfonamide (PFOSA), and perfluorodecanoic acid (PFDA) - were found at detectable levels in most children (87.5% or greater had detectable levels). These levels were analyzed in relation to the differential reinforcement of low rates of responding (DRL) task. This task rewards delays between responses (i.e., longer inter-response times; IRTs) and therefore constitutes a measure of response inhibition. Higher levels of blood PFOS, PFNA, PFDA, PFHxS, and PFOSA were associated with significantly shorter IRTs during the DRL task. The magnitude of these associations was such that IRTs during the task decreased by 29-34% for every 1 SD increase in the corresponding blood PFC. This study suggests an association between PFC exposure and children's impulsivity. Although intriguing, there is a need for further investigation and replication with a larger sample of children.

  5. Perfluorochemical (PFC) Exposure in Children: Associations with Impaired Response Inhibition

    PubMed Central

    Gump, Brooks B.; Wu, Qian; Dumas, Amy K.; Kannan, Kurunthachalam

    2011-01-01

    Background Perfluorinated chemicals (PFCs) have been used widely in consumer products since the 1950s and are currently found at detectable levels in the blood of humans and animals across the globe. In stark contrast to this widespread exposure to PFCs, there is relatively little research on potential adverse health effects of exposure to these chemicals. Objectives We performed this cross-sectional study to determine if specific blood PFC levels are associated with impaired response inhibition in children. Methods Blood levels of 11 PFCs were measured in children (N = 83) and 6 PFCs: perfluorooctane sulfonate (PFOS), perfluorohexane sulfate (PFHxS), perfluorooctanoic acid (PFOA), perfluorononanoic acid (PFNA), perfluorooctanesulfonamide (PFOSA), and perfluorodecanoic acid (PFDA) – were found at detectable levels in most children (87.5% or greater had detectable levels). These levels were analyzed in relation to the differential reinforcement of low rates of responding (DRL) task. This task rewards delays between responses (i.e., longer inter-response times; IRTs) and therefore constitutes a measure of response inhibition. Results Higher levels of blood PFOS, PFNA, PFDA, PFHxS, and PFOSA were associated with significantly shorter IRTs during the DRL task. The magnitude of these associations was such that IRTs during the task decreased by 29–34% for every 1 SD increase in the corresponding blood PFC. Conclusions This study suggests an association between PFC exposure and children’s impulsivity. Although intriguing, there is a need for further investigation and replication with a larger sample of children. PMID:21682250

  6. Perfluorochemical (PFC) liquid enhances recombinant adenovirus vector-mediated viral interleukin-10 (AdvIL-10) expression in rodent lung.

    PubMed

    Li, John T; Bonneau, Laura A; Zimmerman, Jerry J; Weiss, Daniel J

    2007-05-01

    Adenovirus and cationic liposome mediated transfer of Interleukin-10 (IL-10), a potent anti-inflammatory cytokine, has been shown to decrease pro-inflammatory cytokine levels and overall lung inflammation in models of lung transplantation and injury. Limitations to current approaches of IL-10 gene therapy include poor vector delivery methods and pro-inflammatory properties of human IL-10 under certain conditions. We hypothesize that using perfluorochemical (PFC) liquid to deliver the highly homologous viral IL-10 (vIL-10), which is predominantly anti-inflammatory with minimal pro-inflammatory activities, can potentially be a more effective strategy to combat inflammatory lung diseases. In this study, we compare the use of PFC liquid versus aerosolized method to deliver adenovirus encoding the vIL-10 gene (AdvIL-10) in C57Bl6 mice. Detectable vIL-10 levels were measured from bronchoalveolar lavage fluid and lung homogenates at one, four, ten and thirty days after AdvIL-10. Furthermore, we determined if use of PFC liquid could allow for the use of a lower dose of AdvIL-10 by comparing the levels of detectable vIL-10 at different doses of AdvIL-10 delivered +/- PFC liquid. Results showed that PFC liquid enhanced detectable vIL-10 by up to ten fold and that PFC liquid allowed the use of ten-fold less vector. PFC liquid increased detectable vIL-10 in lung homogenates at all time points; however, the increase in detectable vIL-10 in BAL fluid peaked at four days and was no longer evident by thirty days after intratracheal instillation. In summary, this is the first report utilizing PFC liquid to enhance the delivery of a potentially therapeutic molecule, vIL-10. We believe this strategy can be used to perform future studies on the use of the predominantly anti-inflammatory vIL-10 to treat inflammatory lung diseases.

  7. High-power piezo drive amplifier for large stack and PFC applications

    NASA Astrophysics Data System (ADS)

    Clingman, Dan J.; Gamble, Mike

    2001-08-01

    This paper describes the continuing development of Boeing High Power Piezo Drive Amplifiers. Described is the development and testing of a 1500 Vpp, 8 amp switching amplifier. This amplifier is used to drive a piezo stack driven rotor blade trailing edge flap on a full size helicopter. Also discuss is a switching amplifier designed to drive a Piezo Fiber Composite (PFC) active twist rotor blade. This amplifier was designed to drive the PFC material at 2000 Vpp and 0.5 amps. These amplifiers recycle reactive energy, allowing for a power and weight efficient amplifier design. This work was done in conjunction with the DARPA sponsored Phase II Smart Rotor Blade program and the NASA Langley Research Center sponsored Active Twist Rotor (ATR) blade program.

  8. Perinatal fluoxetine prevents the effect of pre-gestational maternal stress on 5-HT in the PFC, but maternal stress has enduring effects on mPFC synaptic structure in offspring.

    PubMed

    Gemmel, Mary; Kokras, Nikolaos; Dalla, Christina; Pawluski, Jodi L

    2018-01-01

    Maternal affective disorders are frequently treated with selective serotonin reuptake inhibitor medications (SSRIs); with up to 10% of women being prescribed these medications during pregnancy. Infant development depends on the early serotonergic environment, which is altered by perinatal SSRIs, raising concern about how these medications affect neural outcomes. While clinical and preclinical research suggests an impact of SSRIs on the developing brain, more research is needed to determine the effects on neuroplasticity, the serotonergic system, and the hypothalamic-pituitary-adrenal axis in neural regions mediating behavior. The current work investigated the effects of the SSRI, fluoxetine, on the serotonergic system in the prefrontal cortex (PFC) during pre-adolescence, and changes to synaptic markers and glucocorticoid receptor density in the cingulate cortex (medial PFC) of pre-adolescent and adult Sprague-Dawley male and female rats. To model aspects of Perinatal Depression and maternal anxiety, pre-gestational maternal stress was used resulting in male and female offspring from 4 groups: 1) control, 2) perinatal fluoxetine exposed, 3) pre-gestational maternal stress exposed, and 4) pre-gestational maternal stress + fluoxetine. Perinatal fluoxetine prevented the effects of maternal stress on 5-HT levels and 5-HT turnover ratio in the PFC of pre-adolescent offspring, particularly in females. However, pre-gestational stress reduced synaptophysin and PSD-95 densities in the cingulate cortex, effects that were more pronounced in males. Interestingly, perinatal fluoxetine exposure reduced GR density in adult males in this same brain area. Together, results show differential effects of perinatal SSRIs and pre-gestational maternal stress on neurodevelopment in the PFC of males and females. Copyright © 2017 Elsevier Ltd. All rights reserved.

  9. Bilateral six-hydroxydopamine administration to PFC prevents the expression of behavioral sensitization to methylphenidate.

    PubMed

    Wanchoo, S J; Lee, M J; Swann, A C; Dafny, N

    2010-02-02

    Psychostimulants like amphetamine and methylphenidate (MPD) are used to treat attention deficit hyperactivity disorder (ADHD), which is marked by developmentally inappropriate inattention, hyperactivity, and impulsivity. Neuropsychological analyses indicate that ADHD patients are impaired on tasks of behavioral inhibition, reward reversal, and working memory, which are functions of the prefrontal cortex (PFC) and are modulated by the mesocortical dopamine (DA) system. Non-specific electrical lesioning of PFC eliminated the expression of behavioral sensitization elicited by chronic MPD administration. Behavioral sensitization is the progressive augmentation of locomotor activity as a result of repetitive (chronic) exposure to the drug. It is believed that the sensitization to chronic drug treatment is caused due to an increase in DA in the mesocorticolimbic DA system, which includes the PFC. Therefore, this study investigated the role of PFC DA in mediating the behavioral sensitization to repeated administration of MPD in adult male Sprague-Dawley rats. On experimental day (ED) 1, the behavior was recorded post-saline injection. On ED 2, the rats were divided into three groups--control, sham and bilateral 6-OHDA treated group; and the sham and 6-OHDA treated groups underwent respective surgeries. After 5 days of rest following surgery, the post-surgery baseline was recorded on ED 8 following a saline injection. All three groups received 2.5 mg/kg MPD for 6 days (from ED 9 to ED 14), followed by a 3-day washout period (ED 15 to ED 18). On ED 19, a rechallenge injection of 2.5 mg/kg MPD was given and locomotor activity was recorded. It was found that the 6-OHDA lesion group failed to exhibit behavioral sensitization to MPD. The involvement of the dopaminergic afferents of PFC in behavioral sensitization to MPD is discussed. (c) 2009 Elsevier B.V. All rights reserved.

  10. PFC2D simulation of thermally induced cracks in concrete specimens

    NASA Astrophysics Data System (ADS)

    Liu, Xinghong; Chang, Xiaolin; Zhou, Wei; Li, Shuirong

    2013-06-01

    The appearance of cracks exposed to severe environmental conditions can be critical for concrete structures. The research is to validate Particle Flow Code(PFC2D) method in the context of concrete thermally-induced cracking simulations. First, concrete was discreted as meso-level units of aggregate, cement mortar and the interfaces between them. Parallel bonded-particle model in PFC2D was adapted to describe the constitutive relation of the cementing material. Then, the concrete mechanics meso-parameters were obtained through several groups of biaxial tests, in order to make the numerical results comply with the law of the indoor test. The concrete thermal meso-parameters were determined by compared with the parameters in the empirical formula through the simulations imposing a constant heat flow to the left margin of concrete specimens. At last, a case of 1000mm×500mm concrete specimen model was analyzed. It simulated the formation and development process of the thermally-induced cracks under the cold waves of different durations and temperature decline. Good agreements in fracture morphology and process were observed between the simulations, previous studies and laboratory data. The temperature decline limits during cold waves were obtained when its tensile strength was given as 3MPa. And it showed the feasibility of using PFC2D to simulate concrete thermally-induced cracking.

  11. Nurse practitioners and controlled substances prescriptive authority: improving access to care.

    PubMed

    Ambrose, Michelle A; Tarlier, Denise S

    2013-03-01

    In 2007, Health Canada proposed a new framework to regulate prescriptive authority for controlled substances, titled New Classes of Practitioners Regulations (NCPR). The new regulatory framework was passed in November 2012; it gives nurse practitioners (NPs), midwives and podiatrists the authority to prescribe controlled medications under the Controlled Drugs and Substances Act. It is expected that authorizing NPs to write prescriptions for certain controlled substances commonly used in primary care will enhance flexibility and timeliness in primary care service delivery. Studies from the United States have shown positive outcomes in primary care access, decreased healthcare costs and the evolution and advancement of the NP role when prescriptive authority was expanded to include controlled substances. The purpose of this paper is to examine how NPs' prescriptive authority for controlled substances affects access to primary care and NP role development. Three key issues identified from the experience of one group of NPs in the United States (access to care, professional autonomy and prescriber knowledge) offer insight into the practice changes that may be anticipated for NPs in Canada now that they have acquired prescriptive authority for controlled substances. Recommendations are offered to assist nurse leaders and educators to best support NPs as they take on this new and important role responsibility.

  12. 14 CFR 158.11 - Public agency request not to require collection of PFC's by a class of air carriers or foreign...

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... collection of PFC's by a class of air carriers or foreign air carriers or for service to isolated communities... TRANSPORTATION (CONTINUED) AIRPORTS PASSENGER FACILITY CHARGES (PFC'S) General § 158.11 Public agency request not to require collection of PFC's by a class of air carriers or foreign air carriers or for service to...

  13. 14 CFR 158.11 - Public agency request not to require collection of PFC's by a class of air carriers or foreign...

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... collection of PFC's by a class of air carriers or foreign air carriers or for service to isolated communities... TRANSPORTATION (CONTINUED) AIRPORTS PASSENGER FACILITY CHARGES (PFC'S) General § 158.11 Public agency request not to require collection of PFC's by a class of air carriers or foreign air carriers or for service to...

  14. 14 CFR 158.11 - Public agency request not to require collection of PFC's by a class of air carriers or foreign...

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... collection of PFC's by a class of air carriers or foreign air carriers or for service to isolated communities... TRANSPORTATION (CONTINUED) AIRPORTS PASSENGER FACILITY CHARGES (PFC'S) General § 158.11 Public agency request not to require collection of PFC's by a class of air carriers or foreign air carriers or for service to...

  15. 14 CFR 158.11 - Public agency request not to require collection of PFC's by a class of air carriers or foreign...

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... collection of PFC's by a class of air carriers or foreign air carriers or for service to isolated communities... TRANSPORTATION (CONTINUED) AIRPORTS PASSENGER FACILITY CHARGES (PFC'S) General § 158.11 Public agency request not to require collection of PFC's by a class of air carriers or foreign air carriers or for service to...

  16. 14 CFR 158.11 - Public agency request not to require collection of PFC's by a class of air carriers or foreign...

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... collection of PFC's by a class of air carriers or foreign air carriers or for service to isolated communities... TRANSPORTATION (CONTINUED) AIRPORTS PASSENGER FACILITY CHARGES (PFC'S) General § 158.11 Public agency request not to require collection of PFC's by a class of air carriers or foreign air carriers or for service to...

  17. Ex vivo dissection of optogenetically activated mPFC and hippocampal inputs to neurons in the basolateral amygdala: implications for fear and emotional memory

    PubMed Central

    Hübner, Cora; Bosch, Daniel; Gall, Andrea; Lüthi, Andreas; Ehrlich, Ingrid

    2014-01-01

    Many lines of evidence suggest that a reciprocally interconnected network comprising the amygdala, ventral hippocampus (vHC), and medial prefrontal cortex (mPFC) participates in different aspects of the acquisition and extinction of conditioned fear responses and fear behavior. This could at least in part be mediated by direct connections from mPFC or vHC to amygdala to control amygdala activity and output. However, currently the interactions between mPFC and vHC afferents and their specific targets in the amygdala are still poorly understood. Here, we use an ex-vivo optogenetic approach to dissect synaptic properties of inputs from mPFC and vHC to defined neuronal populations in the basal amygdala (BA), the area that we identify as a major target of these projections. We find that BA principal neurons (PNs) and local BA interneurons (INs) receive monosynaptic excitatory inputs from mPFC and vHC. In addition, both these inputs also recruit GABAergic feedforward inhibition in a substantial fraction of PNs, in some neurons this also comprises a slow GABAB-component. Amongst the innervated PNs we identify neurons that project back to subregions of the mPFC, indicating a loop between neurons in mPFC and BA, and a pathway from vHC to mPFC via BA. Interestingly, mPFC inputs also recruit feedforward inhibition in a fraction of INs, suggesting that these inputs can activate dis-inhibitory circuits in the BA. A general feature of both mPFC and vHC inputs to local INs is that excitatory inputs display faster rise and decay kinetics than in PNs, which would enable temporally precise signaling. However, mPFC and vHC inputs to both PNs and INs differ in their presynaptic release properties, in that vHC inputs are more depressing. In summary, our data describe novel wiring, and features of synaptic connections from mPFC and vHC to amygdala that could help to interpret functions of these interconnected brain areas at the network level. PMID:24634648

  18. The effects of nicotine exposure and PFC transection on the time-frequency distribution of VTA DA neurons' firing activities.

    PubMed

    Chen, Ting Y; Zhang, Die; Dragomir, Andrei; Akay, Yasemin; Akay, Metin

    2011-05-01

    We investigated the influence of nicotine exposure and prefrontal cortex (PFC) transections on ventral tegmental areas (VTA) dopamine (DA) neurons' firing activities using a time-frequency method based on the continuous wavelet transform (CWT). Extracellular single-unit neural activity was recorded from DA neurons in the VTA area of rats. One group had their PFC inputs to the VTA intact, while the other group had the inputs to VTA bilaterally transected immediate caudal to the PFC. We hypothesized that the systemic nicotine exposure will significantly change the energy distribution in the recorded neural activity. Additionally, we investigated whether the loss of inputs to the VTA caused by the PFC transection resulted in the cancellation of the nicotine' effect on the neurons' firing patterns. The time-frequency representations of VTA DA neurons firing activity were estimated from the reconstructed firing rate histogram. The energy contents were estimated from three frequency bands, which are known to encompass the significant modes of operation of DA neurons. Our results show that systemic nicotine exposure disrupts the energy distribution in PFC-intact rats. Particularly, there is a significant increase in energy contents of the 1-1.5 Hz frequency band. This corresponds to an observed increase in the firing rate of VTA DA neurons following nicotine exposure. Additionally, our results from PFC-transected rats show that there is no change in the energy distribution of the recordings after systemic nicotine exposure. These results indicate that the PFC plays an important role in affecting the activities of VTA DA neurons and that the CWT is a useful method for monitoring the changes in neural activity patterns in both time and frequency domains.

  19. The Emulsified PFC Oxycyte® Improved Oxygen Content and Lung Injury Score in a Swine Model of Oleic Acid Lung Injury (OALI).

    PubMed

    Haque, Ashraful; Scultetus, Anke H; Arnaud, Francoise; Dickson, Leonora J; Chun, Steve; McNamee, George; Auker, Charles R; McCarron, Richard M; Mahon, Richard T

    2016-12-01

    Perfluorocarbons (PFCs) can transport 50 times more oxygen than human plasma. Their properties may be advantageous in preservation of tissue viability in oxygen-deprived states, such as in acute lung injury. We hypothesized that an intravenous dose of the PFC emulsion Oxycyte ® would improve tissue oxygenation and thereby mitigate the effects of acute lung injury. Intravenous oleic acid (OA) was used to induce lung injury in anesthetized and instrumented Yorkshire swine assigned to three experimental groups: (1) PFC post-OA received Oxycyte ® (5 ml/kg) 45 min after oleic acid-induced lung injury (OALI); (2) PFC pre-OA received Oxycyte ® 45 min before OALI; and (3) Controls which received equivalent dose of normal saline. Animals were observed for 3 h after OALI began, and then euthanized. The median survival times for PFC post-OA, PFC pre-OA, and control were 240, 87.5, and 240 min, respectively (p = 0.001). Mean arterial pressure and mean pulmonary arterial pressure were both higher in the PFC post-OA (p < 0.001 for both parameters). Oxygen content was significantly different between PFC post-OA and the control (p = 0.001). Histopathological grading of lung injury indicated that edema and congestion was significantly less severe in the PFC post-OA compared to control (p = 0.001). The intravenous PFC Oxycyte ® improves blood oxygen content and lung histology when used as a treatment after OALI, while Oxycyte ® used prior to OALI was associated with increased mortality. Further exploration in other injury models is indicated.

  20. Does the PFC model of analogy account for decision making, problem solving, reasoning, flexibility, adaptability, and even creativity?

    PubMed

    Barutta, Joaquin; Guex, Raphael; Ibáñez, Agustín

    2010-06-01

    Abstract From everyday cognition to scientific discovery, analogical processes play an important role: bringing connection, integration, and interrelation of information. Recently, a PFC model of analogy has been proposed to explain many cognitive processes and integrate general functional properties of PFC. We argue here that analogical processes do not suffice to explain the cognitive processes and functions of PFC. Moreover the model does not satisfactorily integrate specific explanatory mechanisms required for the different processes involved. Its relevance would be improved if fewer cognitive phenomena were considered and more specific predictions and explanations about those processes were stated.

  1. Optimization and application of TiO₂/Ti-Pt photo fuel cell (PFC) to effectively generate electricity and degrade organic pollutants simultaneously.

    PubMed

    Li, Kan; Zhang, Hongbo; Tang, Tiantian; Xu, Yunlan; Ying, Diwen; Wang, Yalin; Jia, Jinping

    2014-10-01

    A TiO2/Ti-Pt photo fuel cell (PFC) was established to generate electricity and degrade organic pollutants simultaneously. The electricity generation was optimized through investigation the influences of photoanode calcination temperature and dissolve oxygen on the resistances existing in PFC. TiO2 light quantum yield was also improved in PFC which resulted in a higher PC degradation efficiency. Two kinds of real textile wastewaters were also employed in this PFC system, 62.4% and 50.0% Coulombic efficiency were obtained for 8 h treatment. These refractory wastewaters with high salinity may become good fuels in PFC because a) TiO2 has no selectivity and can degrade nearly any organic substance, b) no more electrolyte is needed due to the high salinity, c) the energy in wastes can be recovered to generate electricity. The electricity generated by the PFC was further applied on a TiO2/Ti rotating disk photoelectrocatalytic reactor. A bias voltage between 0.6 and 0.75 V could be applied and the PC degradation efficiency was significantly improved. This result was similar with that obtained by a 0.7 V DC power. Copyright © 2014 Elsevier Ltd. All rights reserved.

  2. Pharmacological and therapeutic directions in ADHD: Specificity in the PFC.

    PubMed

    Levy, Florence

    2008-02-28

    Recent directions in the treatment of ADHD have involved both a broadening of pharmacological perspectives to include nor-adrenergic as well as dopaminergic agents. A review of animal and human studies of pharmacological and therapeutic directions in ADHD suggests that the D1 receptor is a specific site for dopaminergic regulation of the PFC, but optimal levels of dopamine (DA) are required for beneficial effects on working memory. Animal and human studies indicate that the alpha-2A receptor is also important for prefrontal regulation, leaving open the question of the relative importance of these receptor sites. The therapeutic effects of ADHD medications in the prefrontal cortex have focused attention on the development of working memory capacity in ADHD. The actions of dopaminergic vs noradrenergic agents, currently available for the treatment of ADHD have overlapping, but different actions in the prefrontal cortex (PFC) and subcortical centers. While stimulants act on D1 receptors in the dorsolateral prefrontal cortex, they also have effects on D2 receptors in the corpus striatum and may also have serotonergic effects at orbitofrontal areas. At therapeutic levels, dopamine (DA) stimulation (through DAT transporter inhibition) decreases noise level acting on subcortical D2 receptors, while NE stimulation (through alpha-2A agonists) increases signal by acting preferentially in the PFC possibly on DAD1 receptors. On the other hand, alpha-2A noradrenergic transmission is more limited to the prefrontal cortex (PFC), and thus less likely to have motor or stereotypic side effects, while alpha-2B and alpha-2C agonists may have wider cortical effects. The data suggest a possible hierarchy of specificity in the current medications used in the treatment of ADHD, with guanfacine likely to be most specific for the treatment of prefrontal attentional and working memory deficits. Stimulants may have broader effects on both vigilance and motor impulsivity, depending on dose

  3. PFC Blood Oxygenation Changes in Four Different Cognitive Tasks.

    PubMed

    Takeda, Tomotaka; Kawakami, Yoshiaki; Konno, Michiyo; Matsuda, Yoshiaki; Nishino, Masayasu; Suzuki, Yoshihiro; Kawano, Yoshiaki; Nakajima, Kazunori; Ozawa, Toshimitsu; Kondo, Yoshihiro; Sakatani, Kaoru

    2017-01-01

    Aging often results in a decline in cognitive function, related to alterations in the prefrontal cortex (PFC) activation. Maintenance of this function in an aging society is an important issue. Some practices/drills, moderate exercise, mastication, and a cognitive task itself could enhance cognitive function. In this validation study, before evaluating the effects of some drills on the elderly, we examined the neural substrate of blood oxygenation changes by the use of four cognitive tasks and fNIRS. Seven healthy volunteers (mean age 25.3 years) participated in this study. Each task session was designed in a block manner; 4 periods of rests (30 s) and 3 blocks of four tasks (30 s). The tasks used were: a computerized Stroop test, a Wisconsin Card Sorting Test, a Sternberg working memory paradigm, and a semantic verbal fluency task. The findings of the study are that all four tasks activated PFC to some extent, without laterality except for the verbal fluency task. The results confirm that NIRS is suitable for measurement of blood oxygenation changes in frontal brain areas that are associated with all four cognitive tasks.

  4. Validity aspects of the patient feedback questionnaire on consultation skills (PFC), a promising learning instrument in medical education.

    PubMed

    Reinders, Marcel E; Blankenstein, Annette H; Knol, Dirk L; de Vet, Henrica C W; van Marwijk, Harm W J

    2009-08-01

    A focus on the communicator competency is considered to be an important requirement to help physicians to acquire consultation skills. A feedback questionnaire, in which patients assess consultation skills might be a useful learning tool. An existing questionnaire on patient perception of patient-centeredness (PPPC) was adapted to cover the 'communicator' items in the competency profile. We assessed the face and content validity, the construct validity and the internal consistency of this new patient feedback on consultation skills (PFC) questionnaire. We assessed the face validity of the PFC by interviewing patients and general practice trainees (GPTs) during the developmental process. The content validity was determined by experts (n=10). First-year GPTs (23) collected 222 PFCs, from which the data were used to assess the construct validity (factor analysis), internal consistency, response rates and ceiling effects. The PFC adequately covers the corresponding 'communicator' competency (face and content validity). Factor analysis showed a one-dimensional construct. The internal consistency was high (Cronbach's alpha 0.89). For the single items, the response rate varied from 89.2% to 100%; the maximum score (ceiling effect) varied from 45.5% to 89.2%. The PFC appears to be a valid, internally consistent instrument. The PFC may be a valuable learning tool with which GPTs, other physicians and medical students can acquire feedback from patients regarding their consultation skills.

  5. A solar light driven dual photoelectrode photocatalytic fuel cell (PFC) for simultaneous wastewater treatment and electricity generation.

    PubMed

    Bai, Jing; Wang, Rui; Li, Yunpo; Tang, Yuanyuan; Zeng, Qingyi; Xia, Ligang; Li, Xuejin; Li, Jinhua; Li, Caolong; Zhou, Baoxue

    2016-07-05

    In this paper, a novel dual heterojunction Photocatalytic Fuel Cell (PFC) system based on BiVO4/TiO2 nanotubes/FTO photoanode and ZnO/CuO nanowires/FTO photocathode has been designed. Compared with the electrodes in PFCs reported in earlier literatures, the proposed heterojunction not only enhances the visible light absorption but also offers a higher photoconversion efficiency. In addition, the nanostructured heterojunction owns a large surface area that ensures a large amount of active sites for organics degradation. The performance of the PFC base on the dual photoelectrodes was also studied herein. The results indicated that the PFC in ths paper exhibits a superior performance and its JV(max) reached 0.116 mw cm(-2), which is higher than that in most of reported PFCs with a Pt-free photocathode. When hazardous organic compounds such as methyl orange, Congo red and methylene blue were decomposed, the degradation rates obtained is to be 76%, 83%, and 90% respectively after 80 mins reaction. The proposed heterojunction photoelectrodes provided great potential for cost-effective and high-efficiency organic pollutants degradation and electricity generation in a PFC system. Copyright © 2016 Elsevier B.V. All rights reserved.

  6. 76 FR 2944 - Notice of Passenger Facility Charge (PFC) Approvals and Disapprovals

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-01-18

    ... equipment. Rehabilitate airfield guidance signs. Rehabilitate runway 16/34 (design only). Rehabilitate parallel and connecting taxiways (design only). Rehabilitate terminal building. Conduct wildlife hazard assessment. Terminal building expansion (design only). PFC administrative costs. Reconstruct west aircraft...

  7. Investigating the influence of PFC transection and nicotine on dynamics of AMPA and NMDA receptors of VTA dopaminergic neurons.

    PubMed

    Chen, Ting; Zhang, Die; Dragomir, Andrei; Kobayashi, Kunikazu; Akay, Yasemin; Akay, Metin

    2011-10-21

    All drugs of abuse, including nicotine, activate the mesocorticolimbic system that plays critical roles in nicotine reward and reinforcement development and triggers glutamatergic synaptic plasticity on the dopamine (DA) neurons in the ventral tegmental area (VTA). The addictive behavior and firing pattern of the VTA DA neurons are thought to be controlled by the glutamatergic synaptic input from prefrontal cortex (PFC). Interrupted functional input from PFC to VTA was shown to decrease the effects of the drug on the addiction process. Nicotine treatment could enhance the AMPA/NMDA ratio in VTA DA neurons, which is thought as a common addiction mechanism. In this study, we investigate whether or not the lack of glutamate transmission from PFC to VTA could make any change in the effects of nicotine. We used the traditional AMPA/NMDA peak ratio, AMPA/NMDA area ratio, and KL (Kullback-Leibler) divergence analysis method for the present study. Our results using AMPA/NMDA peak ratio showed insignificant difference between PFC intact and transected and treated with saline. However, using AMPA/NMDA area ratio and KL divergence method, we observed a significant difference when PFC is interrupted with saline treatment. One possible reason for the significant effect that the PFC transection has on the synaptic responses (as indicated by the AMPA/NMDA area ratio and KL divergence) may be the loss of glutamatergic inputs. The glutamatergic input is one of the most important factors that contribute to the peak ratio level. Our results suggested that even within one hour after a single nicotine injection, the peak ratio of AMPA/NMDA on VTA DA neurons could be enhanced.

  8. Valence-specific conflict moderation in the dorso-medial PFC and the caudate head in emotional speech.

    PubMed

    Kotz, Sonja A; Dengler, Reinhard; Wittfoth, Matthias

    2015-02-01

    Emotional speech comprises of complex multimodal verbal and non-verbal information that allows deducting others' emotional states or thoughts in social interactions. While the neural correlates of verbal and non-verbal aspects and their interaction in emotional speech have been identified, there is very little evidence on how we perceive and resolve incongruity in emotional speech, and whether such incongruity extends to current concepts of task-specific prediction errors as a consequence of unexpected action outcomes ('negative surprise'). Here, we explored this possibility while participants listened to congruent and incongruent angry, happy or neutral utterances and categorized the expressed emotions by their verbal (semantic) content. Results reveal valence-specific incongruity effects: negative verbal content expressed in a happy tone of voice increased activation in the dorso-medial prefrontal cortex (dmPFC) extending its role from conflict moderation to appraisal of valence-specific conflict in emotional speech. Conversely, the caudate head bilaterally responded selectively to positive verbal content expressed in an angry tone of voice broadening previous accounts of the caudate head in linguistic control to moderating valence-specific control in emotional speech. Together, these results suggest that control structures of the human brain (dmPFC and subcompartments of the basal ganglia) impact emotional speech differentially when conflict arises. © The Author (2014). Published by Oxford University Press. For Permissions, please email: journals.permissions@oup.com.

  9. Simple adaptive control system design for a quadrotor with an internal PFC

    NASA Astrophysics Data System (ADS)

    Mizumoto, Ikuro; Nakamura, Takuto; Kumon, Makoto; Takagi, Taro

    2014-12-01

    The paper deals with an adaptive control system design problem for a four rotor helicopter or quadrotor. A simple adaptive control design scheme with a parallel feedforward compensator (PFC) in the internal loop of the considered quadrotor will be proposed based on the backstepping strategy. As is well known, the backstepping control strategy is one of the advanced control strategy for nonlinear systems. However, the control algorithm will become complex if the system has higher order relative degrees. We will show that one can skip some design steps of the backstepping method by introducing a PFC in the inner loop of the considered quadrotor, so that the structure of the obtained controller will be simplified and a high gain based adaptive feedback control system will be designed. The effectiveness of the proposed method will be confirmed through numerical simulations.

  10. The differential contributions of pFC and temporo-parietal cortex to multimodal semantic control: exploring refractory effects in semantic aphasia.

    PubMed

    Gardner, Hannah E; Lambon Ralph, Matthew A; Dodds, Naomi; Jones, Theresa; Ehsan, Sheeba; Jefferies, Elizabeth

    2012-04-01

    Aphasic patients with multimodal semantic impairment following pFC or temporo-parietal (TP) cortex damage (semantic aphasia [SA]) have deficits characterized by poor control of semantic activation/retrieval, as opposed to loss of semantic knowledge per se. In line with this, SA patients show "refractory effects"; that is, declining accuracy in cyclical word-picture matching tasks when semantically related sets are presented rapidly and repeatedly. This is argued to follow a build-up of competition between targets and distractors. However, the link between poor semantic control and refractory effects is still controversial for two reasons. (1) Some theories propose that refractory effects are specific to verbal or auditory tasks, yet SA patients show poor control over semantic processing in both word and picture semantic tasks. (2) SA can result from lesions to either the left pFC or TP cortex, yet previous work suggests that refractory effects are specifically linked to the left inferior frontal cortex. For the first time, verbal, visual, and nonverbal auditory refractory effects were explored in nine SA patients who had pFC (pFC+) or TP cortex (TP-only) lesions. In all modalities, patient accuracy declined significantly over repetitions. This refractory effect at the group level was driven by pFC+ patients and was not shown by individuals with TP-only lesions. These findings support the theory that SA patients have reduced control over multimodal semantic retrieval and, additionally, suggest there may be functional specialization within the posterior versus pFC elements of the semantic control network.

  11. 78 FR 57211 - Notice of Passenger Facility Charge (PFC) Approvals and Disapprovals

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-09-17

    ... Aviation Safety and Capacity Expansion Act of 1990 (Title IX of the Omnibus Budget Reconciliation Act of... DEPARTMENT OF TRANSPORTATION Federal Aviation Administration Notice of Passenger Facility Charge (PFC) Approvals and Disapprovals AGENCY: Federal Aviation Administration (FAA), DOT. ACTION: Monthly...

  12. 78 FR 76382 - Notice of Passenger Facility Charge (PFC) Approvals and Disapprovals

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-12-17

    ... Aviation Safety and Capacity Expansion Act of 1990 (Title IX of the Omnibus Budget Reconciliation Act of... DEPARTMENT OF TRANSPORTATION Federal Aviation Administration Notice of Passenger Facility Charge (PFC) Approvals and Disapprovals AGENCY: Federal Aviation Administration (FAA), DOT. ACTION: Monthly...

  13. 75 FR 33376 - Notice of Passenger Facility Charge (PFC) Approvals and Disapprovals

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-06-11

    ... Aviation Safety and Capacity Expansion Act of 1990 (Title IX of the Omnibus Budget Reconciliation Act of... DEPARTMENT OF TRANSPORTATION Federal Aviation Administration Notice of Passenger Facility Charge (PFC) Approvals and Disapprovals AGENCY: Federal Aviation Administration (FAA), DOT. ACTION: Monthly...

  14. 75 FR 56654 - Notice of Passenger Facility Charge (PFC) Approvals and Disapprovals

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-09-16

    ... under the provisions of the Aviation Safety and Capacity Expansion Act of 1990 (Title IX of the Omnibus... DEPARTMENT OF TRANSPORTATION Federal Aviation Administration Notice of Passenger Facility Charge (PFC) Approvals and Disapprovals AGENCY: Federal Aviation Administration (FAA), DOT. ACTION: Monthly...

  15. 75 FR 69155 - Notice of Passenger Facility Charge (PFC) Approvals and Disapprovals

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-11-10

    ... disapprovals under the provisions of the Aviation Safety and Capacity Expansion Act of 1990 (Title IX of the... DEPARTMENT OF TRANSPORTATION Federal Aviation Administration Notice of Passenger Facility Charge (PFC) Approvals and Disapprovals AGENCY: Federal Aviation Administration (FAA), DOT. ACTION: Monthly...

  16. 78 FR 57205 - Notice of Passenger Facility Charge (PFC) Approvals and Disapprovals

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-09-17

    ... Aviation Safety and Capacity Expansion Act of 1990 (Title IX of the Omnibus Budget Reconciliation Act of... DEPARTMENT OF TRANSPORTATION Federal Aviation Administration Notice of Passenger Facility Charge (PFC) Approvals and Disapprovals AGENCY: Federal Aviation Administration (FAA), DOT. ACTION: Monthly...

  17. Multiple effects of β-amyloid on single excitatory synaptic connections in the PFC.

    PubMed

    Wang, Yun; Zhou, Thomas H; Zhi, Zhina; Barakat, Amey; Hlatky, Lynn; Querfurth, Henry

    2013-01-01

    Prefrontal cortex (PFC) is recognized as an AD-vulnerable region responsible for defects in cognitive functioning. Pyramidal cell (PC) connections are typically facilitating (F) or depressing (D) in PFC. Excitatory post-synaptic potentials (EPSPs) were recorded using patch-clamp from single connections in PFC slices of rats and ferrets in the presence of β-amyloid (Aβ). Synaptic transmission was significantly enhanced or reduced depending on their intrinsic type (facilitating or depressing), Aβ species (Aβ 40 or Aβ 42) and concentration (1-200 nM vs. 0.3-1 μ M). Nanomolar Aβ 40 and Aβ 42 had opposite effects on F-connections, resulting in fewer or increased EPSP failure rates, strengthening or weakening EPSPs and enhancing or inhibiting short-term potentiation [STP: synaptic augmentation (SA) and post-tetanic potentiation (PTP)], respectively. High Aβ 40 concentrations induced inhibition regardless of synaptic type. D-connections were inhibited regardless of Aβ species or concentration. The inhibition induced with bath application was hard to recover by washout, but a complete recovery was obtained with brief local application and prompt washout. Our data suggests that Aβ 40 acts on the prefrontal neuronal network by modulating facilitating and depressing synapses. At higher levels, both Aβ 40 and Aβ 42 inhibit synaptic activity and cause irreversible toxicity once diffusely accumulated in the synaptic environment.

  18. Multiple effects of β-amyloid on single excitatory synaptic connections in the PFC

    PubMed Central

    Wang, Yun; Zhou, Thomas H.; Zhi, Zhina; Barakat, Amey; Hlatky, Lynn; Querfurth, Henry

    2013-01-01

    Prefrontal cortex (PFC) is recognized as an AD-vulnerable region responsible for defects in cognitive functioning. Pyramidal cell (PC) connections are typically facilitating (F) or depressing (D) in PFC. Excitatory post-synaptic potentials (EPSPs) were recorded using patch-clamp from single connections in PFC slices of rats and ferrets in the presence of β-amyloid (Aβ). Synaptic transmission was significantly enhanced or reduced depending on their intrinsic type (facilitating or depressing), Aβ species (Aβ 40 or Aβ 42) and concentration (1–200 nM vs. 0.3–1 μ M). Nanomolar Aβ 40 and Aβ 42 had opposite effects on F-connections, resulting in fewer or increased EPSP failure rates, strengthening or weakening EPSPs and enhancing or inhibiting short-term potentiation [STP: synaptic augmentation (SA) and post-tetanic potentiation (PTP)], respectively. High Aβ 40 concentrations induced inhibition regardless of synaptic type. D-connections were inhibited regardless of Aβ species or concentration. The inhibition induced with bath application was hard to recover by washout, but a complete recovery was obtained with brief local application and prompt washout. Our data suggests that Aβ 40 acts on the prefrontal neuronal network by modulating facilitating and depressing synapses. At higher levels, both Aβ 40 and Aβ 42 inhibit synaptic activity and cause irreversible toxicity once diffusely accumulated in the synaptic environment. PMID:24027495

  19. 75 FR 13337 - Notice of Passenger Facility Charge (PFC) Approvals and Disapprovals

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-03-19

    ....00 PFC Level: North terminal complex conceptual design. Cargo service road. Decision Date: December 1... and II). Aircraft rescue and firefighting building (design). Runway 24 runway safety area improvements (design). Runway 24 runway safety area improvements (grading/drainage). Runway 6 localizer (design...

  20. 75 FR 65551 - Notice of Passenger Facility Charge (PFC) Approvals and Disapprovals

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-10-25

    ... at a $3.00 PFC Level: New terminal development schematic preliminary engineering study and design... for Collection and Use: Air carrier apron. Pavement condition inventory. New terminal building... construction. De-icing treatment plant. Domestic water service. CTX design and installation. Landside planning...

  1. Simple adaptive control system design for a quadrotor with an internal PFC

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

    Mizumoto, Ikuro; Nakamura, Takuto; Kumon, Makoto

    2014-12-10

    The paper deals with an adaptive control system design problem for a four rotor helicopter or quadrotor. A simple adaptive control design scheme with a parallel feedforward compensator (PFC) in the internal loop of the considered quadrotor will be proposed based on the backstepping strategy. As is well known, the backstepping control strategy is one of the advanced control strategy for nonlinear systems. However, the control algorithm will become complex if the system has higher order relative degrees. We will show that one can skip some design steps of the backstepping method by introducing a PFC in the inner loopmore » of the considered quadrotor, so that the structure of the obtained controller will be simplified and a high gain based adaptive feedback control system will be designed. The effectiveness of the proposed method will be confirmed through numerical simulations.« less

  2. Resuscitation of severe but brief haemorrhagic shock with PFC in rabbits restores skeletal muscle oxygen delivery and does not alter skeletal muscle metabolism.

    PubMed

    Audonnet-Blaise, Sandra; Krafft, Marie-Pierre; Smani, Younes; Mertes, Paul-Michel; Marie, Pierre-Yves; Labrude, Pierre; Longrois, Dan; Menu, Patrick

    2006-07-01

    Studies have demonstrated that perfluorocarbon (PFC) emulsions associated with hyperoxia improved whole body oxygen delivery during resuscitation of acute haemorrhagic shock (HS). Nevertheless the microcirculatory effects of PFC and the potential deleterious effects of hyperoxic reperfusion are still of concern. We investigated (i) the ability of a newly formulated, small sized and highly stable PFC emulsion to increase skeletal muscle oxygen delivery and (ii) the effect of hyperoxic reperfusion on skeletal muscle metabolism after a brief period of ischaemia using an original, microdialysis-based method that allowed simultaneous measurement tissue oxygen pressure (PtiO2) and interstitial lactate and pyruvate. These measurements were carried out in anaesthetised and ventilated (FiO2 = 1) rabbits subjected to acute HS (50% of blood volume withdrawal) and either resuscitated with a PFC emulsion diluted with a 5% albumin solution (16.2 g PFC per kg body weight) (n = 10) or with a modified fluid gelatin solution (Gelofusine) (n = 10). We found no difference between the two groups for the haemodynamic and haematological variables (except for the venous oxygen partial pressure). However, a significant difference was observed in the slope of the regression linear relationship exhibited between the mean arterial pressure (MAP) and the PtiO2, PFC group showing a much steeper slope than Gelofusine group. In addition, PtiO2 values increased linearly with decreasing haematocrit (Hct) values in PFC-resuscitated animals and decreased linearly with decreasing Hct values in Gelofusine-resuscitated animals. There were no differences between the two groups concerning the blood and interstitial lactate/pyruvate ratios suggesting no deleterious effect of hyperoxic resuscitation in skeletal muscle. In conclusion these results suggest that resuscitation of severe, but brief, HS with PFC increased skeletal muscle oxygen delivery without measurable deleterious effects.

  3. Concomitant behavioral and PFC neuronal activity recorded following dose-response protocol of MPD in adult male rats.

    PubMed

    Venkataraman, Sidish S; Claussen, Catherine; Joseph, Michael; Dafny, Nachum

    2017-04-01

    The use of methylphenidate (MPD), a commonly prescribed drug to treat attention-deficit hyperactivity disorder (ADHD), has steadily increased over the past 25 years. This trend has been accompanied by more MPD abuse by ordinary individuals for its cognitive enhancing effects. Therefore, understanding the effects of MPD on the prefrontal cortex (PFC), a brain area involved in higher cortical processing such as executive function, language, planning, and attention regulation, is of particular importance. The goal of this study is to investigate the effects of acute and chronic dose-response characteristics following MPD exposure on both the PFC neuronal population and behavioral activity in freely behaving animals implanted previously with permanent electrodes within the PFC. Four groups of animals were used: saline (control), 0.6, 2.5, and 10.0mg/kg MPD. It was observed that the same dose of either 0.6, 2.5, or 10.0mg/kg repetitive (chronic) MPD exposure elicited behavioral sensitization in some animals and behavioral tolerance in others, and that the majority of PFC units recorded from animals expressing behavioral sensitization to chronic MPD exposure responded to MPD by increasing their neuronal firing rate, whereas the majority of PFC neurons recorded from animals expressing behavioral tolerance in response to chronic MPD responded by decreasing their neuronal firing rate. This data suggests that in animals that display behavioral sensitization, chronic MPD exposure causes an increase in the number of post-synaptic D1 dopamine receptors leading to an increase in behavioral and neuronal firing rate, while in animals that display behavioral tolerance, chronic MPD exposure causes an increase in the number of post-synaptic D2 dopamine receptors leading to a decrease in behavioral and neuronal firing rate. This dichotomy needs to be further investigated. Copyright © 2017 Elsevier Inc. All rights reserved.

  4. Evaluating Use of Sub-Grade Drains with PFC for Stormwater Drainage : final report.

    DOT National Transportation Integrated Search

    2017-08-01

    The overarching objective of this project is to evaluate the effectiveness of incorporated subgrade drain (usually called underdrain) in the permeable friction course (PFC) pavement to facilitate drainage of stormwater within and on the pavemen...

  5. 76 FR 28123 - Notice of Passenger Facility Charge (PFC) Approvals and Disapprovals

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-05-13

    ... for Collection and Use: Design/construct passenger terminal and land/airside. PFC application... Level: Runway 16L/34R pavement rehabilitation. Concourse B--additional boarding bridges. North cargo... 16R134L. Joint seal runway 16R/34L--taxiways A and B. [[Page 28124

  6. Power-Quality Improvement in PFC Bridgeless SEPIC-Fed BLDC Motor Drive

    NASA Astrophysics Data System (ADS)

    Singh, Bhim; Bist, Vashist

    2013-06-01

    This article presents a design of a power factor correction (PFC)-based brushless DC (BLDC) motor drive. The speed control of BLDC motor is achieved by controlling the DC link voltage of the voltage source inverter (VSI) feeding BLDC motor using a single voltage sensor. A front-end bridgeless single-ended primary inductance converter (SEPIC) is used for DC link voltage control and PFC operation. A bridgeless SEPIC is designed to operate in discontinuous inductor current mode (DICM) thus utilizing a simple control scheme of voltage follower. An electronic commutation of BLDC motor is used for VSI to operate in a low-frequency operation for reduced switching losses in the VSI. Moreover, a bridgeless topology offers less conduction losses due to absence of diode bridge rectifier for further increasing the efficiency. The proposed BLDC motor drive is designed to operate over a wide range of speed control with an improved power-quality at the AC mains under the recommended international power-quality standards such as IEC 61000-3-2.

  7. Optimism and Planning for Future Care Needs among Older Adults

    PubMed Central

    Sörensen, Silvia; Hirsch, Jameson K.; Lyness, Jeffrey M.

    2015-01-01

    Aging is associated with an increase in need for assistance. Preparation for future care (PFC) is related to improved coping ability as well as better mental and physical health outcomes among older adults. We examined the association of optimism with components of PFC among older adults. We also explored race differences in the relationship between optimism and PFC. In Study 1, multiple regression showed that optimism was positively related to concrete planning. In Study 2, optimism was related to gathering information. An exploratory analysis combining the samples yielded a race interaction: For Whites higher optimism, but for Blacks lower optimism was associated with more planning. High optimism may be a barrier to future planning in certain social and cultural contexts. PMID:26045699

  8. 78 FR 57208 - Notice of Passenger Facility Charge (PFC) Approvals and Disapprovals

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-09-17

    ... LEVEL: End of runway deicing program--phase 1, runway 34R. Taxiway S pavement reconstruction. Replace carousel 9 and oversized bag belt TU3. Terminal redevelopment program--design and associated technical... APPROVED FOR COLLECTION AND USE: PFC program administration. Design taxiways A, L and B. BRIEF DESCRIPTION...

  9. 20 CFR 10.300 - What are the basic rules for authorizing emergency medical care?

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... rules for authorizing emergency medical care? (a) When an employee sustains a work-related traumatic injury that requires medical examination, medical treatment, or both, the employer shall authorize such...-16 within four hours of the claimed injury. If the employer gives verbal authorization for such care...

  10. 20 CFR 10.300 - What are the basic rules for authorizing emergency medical care?

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... rules for authorizing emergency medical care? (a) When an employee sustains a work-related traumatic injury that requires medical examination, medical treatment, or both, the employer shall authorize such...-16 within four hours of the claimed injury. If the employer gives verbal authorization for such care...

  11. 20 CFR 10.300 - What are the basic rules for authorizing emergency medical care?

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... rules for authorizing emergency medical care? (a) When an employee sustains a work-related traumatic injury that requires medical examination, medical treatment, or both, the employer shall authorize such...-16 within four hours of the claimed injury. If the employer gives verbal authorization for such care...

  12. 20 CFR 10.300 - What are the basic rules for authorizing emergency medical care?

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... rules for authorizing emergency medical care? (a) When an employee sustains a work-related traumatic injury that requires medical examination, medical treatment, or both, the employer shall authorize such...-16 within four hours of the claimed injury. If the employer gives verbal authorization for such care...

  13. 20 CFR 10.300 - What are the basic rules for authorizing emergency medical care?

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... rules for authorizing emergency medical care? (a) When an employee sustains a work-related traumatic injury that requires medical examination, medical treatment, or both, the employer shall authorize such...-16 within four hours of the claimed injury. If the employer gives verbal authorization for such care...

  14. 76 FR 34124 - Notice of Passenger Facility Charge (PFC) Approvals and Disapprovals

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-06-10

    ... International Airport. Brief Description Of Projects Approved for Collection and Use at a $4.50 PFC Level...- demand air operations that enplane less than 2,500 passengers per year at Portland International Airport... less than 1 percent of the total annual enplanements at Los Angeles International Airport. Brief...

  15. Engagement of the PFC in Consolidation and Recall of Recent Spatial Memory

    ERIC Educational Resources Information Center

    Leon, Wanda C.; Bruno, Martin A.; Allard, Simon; Nader, Karim; Cuello, A. Claudio

    2010-01-01

    The standard model of system consolidation proposes that memories are initially hippocampus dependent and become hippocampus independent over time. Previous studies have demonstrated the involvement of the medial prefrontal cortex (mPFC) in the retrieval of remote memories. The transformations required to make a memory undergo system's…

  16. 78 FR 76383 - Notice of Passenger Facility Charge (PFC) Approvals and Disapprovals

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-12-17

    ...: LGA runways 4 and 31 runway safety area planning, environmental, and engineering. Brief Description of... Collection at EWR and Use at JFK at a $3.00 PFC Level: JFK taxiway P rehabilitation planning and engineering... delay reduction phase II--planning and engineering. Brief Description of Project Approved for Collection...

  17. 75 FR 79077 - Notice of Passenger Facility Charge (PFC) Approvals and Disapprovals

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-12-17

    ... rehabilitation, phase I Airfield sweeper Airfield pavement markings Airport operations area security improvements... Collection and Use at a $3.00 PFC Level: Permanent in-line baggage system design Terminal 3 security... the FAA to design and construct the South Air Traffic Control Tower. In addition, due to the complex...

  18. Assessment and management of the first German case of a contamination with perfluorinated compounds (PFC) in the Region Sauerland, North Rhine-Westphalia.

    PubMed

    Wilhelm, Michael; Kraft, Martin; Rauchfuss, Knut; Hölzer, Jürgen

    2008-01-01

    In May 2006 the first serious German perfluorinated compounds (PFC) case of contamination became evident. Industrial waste with high concentrations of PFC was manufactured into a soil improver by a recycling company and spread by farmers on agricultural land of the rural area Sauerland, and led to substantial environmental pollution. In parts of the affected area, perfluorooctanoic acid (PFOA) concentrations in drinking water were > 0.5 microg/L. The German Drinking Water Commission assessed PFC in drinking water and set a health-based guidance value for safe lifelong exposure of all population groups at 0.3 microg/L (sum of perfluorooctane sulfonate [PFOS] and PFOA). The Ministry of Environment together with regional institutions initiated monitoring measurements and actions to minimize further contamination. A human biomonitoring study with mother-child pairs and men revealed that increased PFOA exposure via drinking water led to about four- to eightfold higher PFOA levels in plasma compared to nonexposed groups. Analysis of PFC in breast milk showed comparatively low levels, which seemed not to pose a risk for lactating infants. Due to high levels of PFOS in fish from contaminated lakes and rivers, recommendations for anglers to reduce fish consumption were initiated. Remediation of the affected area is ongoing and PFC levels in various matrices are still above background levels.

  19. Perinatal n-3 fatty acid deficiency selectively reduces myo-inositol levels in the adult rat PFC: an in vivo (1)H-MRS study.

    PubMed

    McNamara, Robert K; Able, Jessica; Jandacek, Ronald; Rider, Therese; Tso, Patrick; Lindquist, Diana M

    2009-03-01

    To investigate the effects of omega-3 fatty acid deficiency on phosphatidylinositol signaling in brain, myo-inositol (mI) concentrations were determined in the prefrontal cortex (PFC) of omega-3 fatty acid deficient rats by in vivo proton magnetic resonance spectroscopy ((1)H-MRS). To generate graded deficits in PFC docosahexaenoic acid (22:6n-3) (DHA) composition, perinatal and postweaning alpha-linolenic acid (18:3n-3) (ALA) deficiency models were used. Adult male rats were scanned in a 7T Bruker Biospec system and a (1)H-MRS spectrum acquired from the bilateral medial PFC. Rats were then challenged with SKF83959, a selective agonist at phosphoinositide (PI)-coupled dopamine D(1) receptors. Postmortem PFC fatty acid composition was determined by gas chromatography. Relative to controls, PFC DHA composition was significantly reduced in adult postweaning (-27%) and perinatal (-65%) ALA-deficiency groups. Basal PFC mI concentrations were significantly reduced in the perinatal deficiency group (-21%, P = 0.001), but not in the postweaning deficiency group (-1%, P = 0.86). Among all rats, DHA composition was positively correlated with mI concentrations and the mI/creatine (Cr) ratio. SKF83959 challenge significantly increased mI concentrations only in the perinatal deficiency group (+16%, P = 0.02). These data demonstrate that perinatal deficits in cortical DHA accrual significantly and selectively reduce mI concentrations and augment receptor-generated mI synthesis.

  20. A gateway system in rostral PFC? Evidence from biasing attention to perceptual information and internal representations.

    PubMed

    Henseler, Ilona; Krüger, Sebastian; Dechent, Peter; Gruber, Oliver

    2011-06-01

    Some situations require us to be highly sensitive to information in the environment, whereas in other situations, our attention is mainly focused on internally represented information. It has been hypothesized that a control system located in the rostral prefrontal cortex (PFC) acts as gateway between these two forms of attention. Here, we examined the neural underpinnings of this 'gateway system' using fMRI and functional connectivity analysis. We designed different tasks, in which the demands for attending to external or internal information were manipulated, and tested 1) whether there is a functional specialization within the rostral PFC along a medial-lateral dimension, and 2) whether these subregions can influence attentional weighting processes by specifically interacting with other parts of the brain. Our results show that lateral aspects of the rostral PFC are preferentially activated when attention is directed to internal representations, whereas anterior medial aspects are activated when attention is directed to sensory events. Furthermore, the rostrolateral subregion was preferentially connected to regions in the prefrontal and parietal cortex during internal attending, whereas the rostromedial subregion was connected to the basal ganglia, thalamus, and sensory association cortices during external attending. Finally, both subregions interacted with another important prefrontal region involved in cognitive control, the inferior frontal junction, in a task-specific manner, depending on the current attentional demands. These findings suggest that the rostrolateral and rostromedial part of the anterior PFC have dissociable roles in attentional control, and that they might, as part of larger networks, be involved in dynamically adjusting the contribution of internal and external information to current cognition. Copyright © 2011 Elsevier Inc. All rights reserved.

  1. PLGA/PFC particles loaded with gold nanoparticles as dual contrast agents for photoacoustic and ultrasound imaging

    NASA Astrophysics Data System (ADS)

    Wang, Yan J.; Strohm, Eric M.; Sun, Yang; Niu, Chengcheng; Zheng, Yuanyi; Wang, Zhigang; Kolios, Michael C.

    2014-03-01

    Phase-change contrast agents consisting of a perfluorocarbon (PFC) liquid core stabilized by a lipid, protein, or polymer shell have been proposed for a variety of clinical applications. Previous work has demonstrated that vaporization can be induced by laser irradiation through optical absorbers incorporated inside the droplet. In this study, Poly-lactide-coglycolic acid (PLGA) particles loaded with PFC liquid and silica-coated gold nanoparticles (GNPs) were developed and characterized using photoacoustic (PA) methods. Microsized PLGA particles were loaded with PFC liquid and GNPs (14, 35, 55nm each with a 20nm silica shell) using a double emulsion method. The PA signal intensity and optical vaporization threshold were investigated using a 375 MHz transducer and a focused 532-nm laser (up to 450-nJ per pulse). The laser-induced vaporization threshold energy decreased with increasing GNP size. The vaporization threshold was 850, 690 and 420 mJ/cm2 for 5μm-sized PLGA particles loaded with 14, 35 and 55 nm GNPs, respectively. The PA signal intensity increased as the laser fluence increased prior to the vaporization event. This trend was observed for all particles sizes. PLGA particles were then incubated with MDA-MB-231 breast cancer cells for 6 hours to investigate passive targeting, and the vaporization of the PLGA particles that were internalized within cells. The PLGA particles passively internalized by MDA cells were visualized via confocal fluorescence imaging. Upon PLGA particle vaporization, bubbles formed inside the cells resulting in cell destruction. This work demonstrates that GNPs-loaded PLGA/PFC particles have potential as PA theranostic agents in PA imaging and optically-triggered drug delivery systems.

  2. Aggression and increased glutamate in the mPFC during withdrawal from intermittent alcohol in outbred mice.

    PubMed

    Hwa, Lara S; Nathanson, Anna J; Shimamoto, Akiko; Tayeh, Jillian K; Wilens, Allison R; Holly, Elizabeth N; Newman, Emily L; DeBold, Joseph F; Miczek, Klaus A

    2015-08-01

    Disrupted social behavior, including occasional aggressive outbursts, is characteristic of withdrawal from long-term alcohol (EtOH) use. Heavy EtOH use and exaggerated responses during withdrawal may be treated using glutamatergic N-methyl-D-aspartate receptor (NMDAR) antagonists. The current experiments explore aggression and medial prefrontal cortex (mPFC) glutamate as consequences of withdrawal from intermittent access to EtOH and changes in aggression and mPFC glutamate caused by NMDAR antagonists memantine and ketamine. Swiss male mice underwent withdrawal following 1-8 weeks of intermittent access to 20 % EtOH. Aggressive and nonaggressive behaviors with a conspecific were measured 6-8 h into EtOH withdrawal after memantine or ketamine (0-30 mg/kg, i.p.) administration. In separate mice, extracellular mPFC glutamate after memantine was measured during withdrawal using in vivo microdialysis. At 6-8 h withdrawal from EtOH, mice exhibited more convulsions and aggression and decreased social contact compared to age-matched water controls. Memantine, but not ketamine, increased withdrawal aggression at the 5-mg/kg dose in mice with a history of 8 weeks of EtOH but not 1 or 4 weeks of EtOH or in water drinkers. Tonic mPFC glutamate was higher during withdrawal after 8 weeks of EtOH compared to 1 week of EtOH or 8 weeks of water. Five milligrams per kilogram of memantine increased glutamate in 8-week EtOH mice, but also in 1-week EtOH and water drinkers. These studies reveal aggressive behavior as a novel symptom of EtOH withdrawal in outbred mice and confirm a role of NMDARs during withdrawal aggression and for disrupted social behavior.

  3. Aggression and increased glutamate in the mPFC during withdrawal from intermittent alcohol in outbred mice

    PubMed Central

    Hwa, Lara S.; Nathanson, Anna J.; Shimamoto, Akiko; Tayeh, Jillian K.; Wilens, Allison R.; Holly, Elizabeth N.; Newman, Emily L.; DeBold, Joseph F.; Miczek, Klaus A.

    2015-01-01

    Rationale Disrupted social behavior, including occasional aggressive outbursts, is characteristic of withdrawal from long-term alcohol (EtOH) use. Heavy EtOH use and exaggerated responses during withdrawal may be treated using glutamatergic N-methyl-D-aspartate receptor (NMDAR) antagonists. Objectives The current experiments explore aggression and medial prefrontal cortex (mPFC) glutamate as consequences of withdrawal from intermittent access to EtOH, and changes in aggression and mPFC glutamate caused by NMDAR antagonists memantine and ketamine. Methods Swiss male mice underwent withdrawal following 1-8 weeks of intermittent access to 20% EtOH. Aggressive and non-aggressive behaviors with a conspecific were measured 6-8 h into EtOH withdrawal after memantine or ketamine (0-30 mg/kg, i.p.) administration. In separate mice, extracellular mPFC glutamate after memantine was measured during withdrawal using in vivo microdialysis. Results At 6-8 h withdrawal from EtOH, mice exhibited more convulsions and aggression, and decreased social contact compared to age-matched water controls. Memantine, but not ketamine, increased withdrawal aggression at the 5 mg/kg dose in mice with a history of 8 weeks EtOH but not 1 or 4 weeks of EtOH or in water drinkers. Tonic mPFC glutamate was higher during withdrawal after 8 weeks EtOH compared to 1 week EtOH or 8 weeks water. Five mg/kg memantine increased glutamate in 8 week EtOH mice, but also in 1 week EtOH and water drinkers. Conclusions These studies reveal aggressive behavior as a novel symptom of EtOH withdrawal in outbred mice and confirm a role of NMDARs during withdrawal aggression and for disrupted social behavior. PMID:25899790

  4. Full practice authority--effecting change and improving access to care: the Nevada journey.

    PubMed

    VanBeuge, Susan S; Walker, Tomas

    2014-06-01

    In 2013, Nevada shifted from a collaborative practice model to full practice authority. Given the challenges many states still face, this article provides an outline of the evolution of the "nurse practitioner" (NP) in Nevada. Reviewing the path Nevada took toward full practice authority, we hope to provide insight including lessons learned and opposition encountered to assist other states working toward full practice authority. Literature searches were conducted on PubMed and MEDLINE. Search terms included "autonomous practice," "nurse practitioner," and "full practice authority." Healthcare reform will require nurse practitioners committed to legislative change. Nurse practitioners have the knowledge and ability to affect the legislative process and improve patients' access to care. With careful planning, full engagement, and team building, making a statute change is possible and should be seriously considered in states still struggling with collaborative relationships. Nurse practitioners are well situated to provide primary care in the United States. Removing barriers to practice through statute change will empower NPs to effect positive change in our struggling healthcare system. ©2014 The Author(s) ©2014 American Association of Nurse Practitioners.

  5. tDCS Stimulation of the dlPFC Selectively Moderates the Detrimental Impact of Emotion on Analytical Reasoning.

    PubMed

    Trémolière, Bastien; Maheux-Caron, Véronique; Lepage, Jean-François; Blanchette, Isabelle

    2018-01-01

    There is evidence of a detrimental effect of emotion on reasoning. Recent studies suggest that this relationship is mediated by working memory, a function closely associated with the dorsolateral prefrontal cortex (dlPFC). Relying on transcranial direct current stimulation (tDCS), the present research explores the possibility that anodal stimulation of the dlPFC has the potential to prevent the effect of emotion on analytical reasoning. Thirty-four participants took part in a lab experiment and were tested twice: one session using offline anodal stimulation (with a 2 mA current stimulation applied to the left dlPFC for 20 min), one session using a control (sham) stimulation. In each session, participants solved syllogistic reasoning problems featuring neutral and emotionally negative contents. Results showed that anodal stimulation diminished the deleterious effect of emotion on syllogistic reasoning, but only for a subclass of problems: problems where the conclusion was logically valid. We discuss our results in the light of the reasoning literature as well as the apparent variability of tDCS effects.

  6. Progesterone modifies the responsivity of the amygdala-mPFC connection in male but not female Wistar rats.

    PubMed

    Contreras, Carlos M; Gutiérrez-García, Ana G

    2017-05-10

    Amygdala-medial prefrontal cortex (mPFC) connections partially regulate fear, anxiety, and the acquisition of conditioned fear. Progesterone exerts some effects on anxiety and fear. Currently unknown, however, are the actions of progesterone on the responsivity of amygdala-mPFC connections and possible sex differences. We performed single-unit extracellular recordings from the prelimbic (PL) and infralimbic (IL) cortices of the mPFC during stimulation of the basal amygdala (BA) in anesthetized male and diestrus female rats. Basal amygdala stimulation produced an initial excitatory paucisynaptic response that was similar between sexes and unaffected by progesterone. A long-lasting inhibitory response followed the initial brief excitatory response, which was more pronounced in the PL region in males. The unit activity ratio analysis indicated that progesterone negated the sex difference in the PL region response to BA stimulation. The results suggest that progesterone decreases the responsivity to amygdala stimulation, particularly in males compared with diestrus females, which may be related to sex differences in the strategies to cope with threatening situations. Copyright © 2017 Elsevier B.V. All rights reserved.

  7. Ventral medial prefrontal cortex (vmPFC) as a target of the dorsolateral prefrontal modulation by transcranial direct current stimulation (tDCS) in drug addiction.

    PubMed

    Nakamura-Palacios, Ester Miyuki; Lopes, Isabela Bittencourt Coutinho; Souza, Rodolpho Albuquerque; Klauss, Jaisa; Batista, Edson Kruger; Conti, Catarine Lima; Moscon, Janine Andrade; de Souza, Rodrigo Stênio Moll

    2016-10-01

    Here, we report some electrophysiologic and imaging effects of the transcranial direct current stimulation (tDCS) over the dorsolateral prefrontal cortex (dlPFC) in drug addiction, notably in alcohol and crack-cocaine dependence. The low resolution electromagnetic tomography (LORETA) analysis obtained through event-related potentials (ERPs) under drug-related cues, more specifically in its P3 segment (300-500 ms) in both, alcoholics and crack-cocaine users, showed that the ventral medial prefrontal cortex (vmPFC) was the brain area with the largest change towards increasing activation under drug-related cues in those subjects that kept abstinence during and after the treatment with bilateral tDCS (2 mA, 35 cm(2), cathodal left and anodal right) over dlPFC, applied repetitively (five daily sessions). In an additional study in crack-cocaine, which showed craving decreases after repetitive bilateral tDCS, we examined data originating from diffusion tensor imaging (DTI), and we found increased DTI parameters in the left connection between vmPFC and nucleus accumbens (NAcc), such as the number of voxels, fractional anisotropy (FA) and apparent diffusion coefficient (ADC), in tDCS-treated crack-cocaine users when compared to the sham-tDCS group. This increasing of DTI parameters was significantly correlated with craving decreasing after the repetitive tDCS. The vmPFC relates to the control of drug seeking, possibly by extinguishing this behavior. In our studies, the bilateral dlPFC tDCS reduced relapses and craving to the drug use, and increased the vmPFC activation under drug cues, which may be of a great importance in the control of drug use in drug addiction.

  8. 40 CFR Table F-1 to Subpart F of... - Slope and Overvoltage Coefficients for the Calculation of PFC Emissions From Aluminum Production

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 40 Protection of Environment 22 2013-07-01 2013-07-01 false Slope and Overvoltage Coefficients for the Calculation of PFC Emissions From Aluminum Production F Table F-1 to Subpart F of Part 98...—Slope and Overvoltage Coefficients for the Calculation of PFC Emissions From Aluminum Production...

  9. 40 CFR Table F-1 to Subpart F of... - Slope and Overvoltage Coefficients for the Calculation of PFC Emissions From Aluminum Production

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 40 Protection of Environment 21 2014-07-01 2014-07-01 false Slope and Overvoltage Coefficients for the Calculation of PFC Emissions From Aluminum Production F Table F-1 to Subpart F of Part 98...—Slope and Overvoltage Coefficients for the Calculation of PFC Emissions From Aluminum Production...

  10. 40 CFR Table F-1 to Subpart F of... - Slope and Overvoltage Coefficients for the Calculation of PFC Emissions From Aluminum Production

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 40 Protection of Environment 21 2011-07-01 2011-07-01 false Slope and Overvoltage Coefficients for the Calculation of PFC Emissions From Aluminum Production F Table F-1 to Subpart F of Part 98...—Slope and Overvoltage Coefficients for the Calculation of PFC Emissions From Aluminum Production...

  11. 40 CFR Table F-1 to Subpart F of... - Slope and Overvoltage Coefficients for the Calculation of PFC Emissions From Aluminum Production

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 40 Protection of Environment 22 2012-07-01 2012-07-01 false Slope and Overvoltage Coefficients for the Calculation of PFC Emissions From Aluminum Production F Table F-1 to Subpart F of Part 98...—Slope and Overvoltage Coefficients for the Calculation of PFC Emissions From Aluminum Production...

  12. Transfer of classical eyeblink conditioning with electrical stimulation of mPFC or tone as conditioned stimulus in guinea pigs.

    PubMed

    Yao, Juan; Wu, Guang-Yan; Liu, Guo-Long; Liu, Shu-Lei; Yang, Yi; Wu, Bing; Li, Xuan; Feng, Hua; Sui, Jian-Feng

    2014-11-01

    Learning with a stimulus from one sensory modality can facilitate subsequent learning with a new stimulus from a different sensory modality. To date, the characteristics and mechanism of this phenomenon named transfer effect still remain ambiguous. Our previous work showed that electrical stimulation of medial prefrontal cortex (mPFC) as a conditioned stimulus (CS) could successfully establish classical eyeblink conditioning (EBC). The present study aimed to (1) observe whether transfer of EBC learning would occur when CSs shift between central (mPFC electrical stimulation as a CS, mPFC-CS) and peripheral (tone as a CS, tone CS); (2) compare the difference in transfer effect between the two paradigms, delay EBC (DEBC) and trace EBC (TEBC). A total of 8 groups of guinea pigs were tested in the study, including 4 experimental groups and 4 control groups. Firstly, the experimental groups accepted central (or peripheral) CS paired with corneal airpuff unconditioned stimulus (US); then, CS shifted to the peripheral (or central) and paired with US. The control groups accepted corresponding central (or peripheral) CS and pseudo-paired with US, and then shifted CS from central (or peripheral) to peripheral (or central) and paired with US. The results showed that the acquisition rates of EBC were higher in experimental groups than in control groups after CS switching from central to peripheral or vice versa, and the CR acquisition rate was remarkably higher in DEBC than in TEBC in both transfer ways. The results indicate that EBC transfer can occur between learning established with mPFC-CS and tone CS. Memory of CS-US association for delay paradigm was less disturbed by the sudden switch of CS than for trace paradigm. This study provides new insight into neural mechanisms underlying conditioned reflex as well as the role of mPFC. Copyright © 2014 Elsevier B.V. All rights reserved.

  13. Individual differences in the balance of GABA to glutamate in pFC predict the ability to select among competing options.

    PubMed

    de la Vega, Alejandro; Brown, Mark S; Snyder, Hannah R; Singel, Debra; Munakata, Yuko; Banich, Marie T

    2014-11-01

    Individuals vary greatly in their ability to select one item or response when presented with a multitude of options. Here we investigate the neural underpinnings of these individual differences. Using magnetic resonance spectroscopy, we found that the balance of inhibitory versus excitatory neurotransmitters in pFC predicts the ability to select among task-relevant options in two language production tasks. The greater an individual's concentration of GABA relative to glutamate in the lateral pFC, the more quickly he or she could select a relevant word from among competing options. This outcome is consistent with our computational modeling of this task [Snyder, H. R., Hutchison, N., Nyhus, E., Curran, T., Banich, M. T., O'Reilly, R. C., et al. Neural inhibition enables selection during language processing. Proceedings of the National Academy of Sciences, U.S.A., 107, 16483-16488, 2010], which predicts that greater net inhibition in pFC increases the efficiency of resolving competition among task-relevant options. Moreover, the association with the GABA/glutamate ratio was specific to selection and was not observed for executive function ability in general. These findings are the first to link the balance of excitatory and inhibitory neural transmission in pFC to specific aspects of executive function.

  14. Clinical and Radiographic Results of Attune and PFC Sigma Knee Designs at 2-Year Follow-Up: A Prospective Matched-Pair Analysis.

    PubMed

    Ranawat, Chitranjan S; White, Peter B; West, Sarah; Ranawat, Amar S

    2017-02-01

    Anterior knee pain (AKP) and/or crepitation are important causes of dissatisfaction after total knee arthroplasty (TKA). Aim of this prospective, matched-pair study was to compare 2 different designs of patellofemoral (ie, trochlear groove) TKA. The Attune knee has an anatomic trochlear groove with a medialized dome patellar component vs the PFC Sigma with a single radius trochlear groove with a domed shaped patella. Between January 2010 and December 2014, 100 consecutive Attune TKAs were matched to 100 PFC Sigma TKAs based on age, gender, side, and body mass index. All surgeries were performed via medial parapatellar approach and used cemented, posterior-stabilized implants with patellar resurfacing. Clinical evaluations were assessed using Knee Society Scores (KSS) and a patient-administered questionnaire at 2-year follow-up (range, 1.5-3 years). Based on the KSS clinical rating system, excellent clinical results were achieved in 89.4% and 90.7% of Attune and PFC Sigma TKAs, respectively. There were no significant differences in the KS pain or function scores. The overall incidence of AKP was significantly lower with the Attune knee compared to that of the PFC Sigma (12.5% vs 25.8%; P = .02). The incidence of hearing or feeling noise was also less with the Attune knee (17.7% vs 30.9%; P = .02). The incidence of painful crepitation was low in both groups (1.0% vs 4.1%) with no significant difference between groups (P = .37). Both groups had similar high satisfaction scores of 8.6 and 8.4 for the Attune and PFC groups, respectively (P = .09). At 2-year follow-up, there were no differences between the PFC Sigma and Attune knees in KSS or satisfaction. However, the Attune group had a lesser incidence of AKP and crepitation. Further studies should focus on AKP and noise in cruciate-retaining knees. Copyright © 2016 Elsevier Inc. All rights reserved.

  15. Transcranial Direct Current Stimulation over the Medial Prefrontal Cortex and Left Primary Motor Cortex (mPFC-lPMC) Affects Subjective Beauty but Not Ugliness

    PubMed Central

    Nakamura, Koyo; Kawabata, Hideaki

    2015-01-01

    Neuroaesthetics has been searching for the neural bases of the subjective experience of beauty. It has been demonstrated that neural activities in the medial prefrontal cortex (mPFC) and the left primary motor cortex (lPMC) correlate with the subjective experience of beauty. Although beauty and ugliness seem to be semantically and conceptually opposite, it is still unknown whether these two evaluations represent extreme opposites in unitary or bivariate dimensions. In this study, we applied transcranial direct current stimulation (tDCS) to examine whether non-invasive brain stimulation modulates two types of esthetic evaluation; evaluating beauty and ugliness. Participants rated the subjective beauty and ugliness of abstract paintings before and after the application of tDCS. Application of cathodal tDCS over the mPFC with anode electrode over the lPMC, which induced temporal inhibition of neural excitability of the mPFC, led to a decrease in beauty ratings but not ugliness ratings. There were no changes in ratings of both beauty and ugliness when applying anodal tDCS or sham stimulation over the mPFC. Results from our experiment indicate that the mPFC and the lPMC have a causal role in generating the subjective experience of beauty, with beauty and ugliness evaluations constituting two distinct dimensions. PMID:26696865

  16. The effect of future time perspective on delay discounting is mediated by the gray matter volume of vmPFC.

    PubMed

    Guo, Yiqun; Chen, Zhiyi; Feng, Tingyong

    2017-07-28

    Although several previous studies have shown that individuals' attitude towards time could affect their intertemporal preference, little is known about the neural basis of the relation between time perspective (TP) and delay discounting. In the present study, we quantified the gray matter (GM) cortical volume using voxel-based morphometry (VBM) methods to investigate the effect of TP on delay discounting (DD) across two independent samples. For group 1 (102 healthy college students; 46 male; 20.40 ± 1.87 years), behavioral results showed that only Future TP was a significant predictor of DD, and higher scores on Future TP were related to lower discounting rates. Whole-brain analysis revealed that steeper discounting correlated with greater GM volume in the ventromedial prefrontal cortex (vmPFC) and ventral part of posterior cingulate cortex (vPCC). Also, GM volume of a cluster in the vmPFC was correlated with Future TP. Interestingly, there was an overlapping region in vmPFC that was correlated with both DD and Future TP. Region-of-interest analysis further indicated that the overlapping region of vmPFC played a partially mediating role in the relation between Future TP and DD in the other independent dataset (Group 2, 36 healthy college students; 14 male; 20.18±1.80 years). Taken together, our results provide a new perspective from neural basis for explaining the relation between DD and future TP. Copyright © 2017 Elsevier Ltd. All rights reserved.

  17. The relationship between dlPFC activity during unpredictable threat and CO2-induced panic symptoms.

    PubMed

    Balderston, Nicholas L; Liu, Jeffrey; Roberson-Nay, Roxann; Ernst, Monique; Grillon, Christian

    2017-11-30

    Panic disorder is characterized by sudden, repeated, and unexpected attacks of intense fear and overwhelming anxiety about when another attack may strike. Patients with panic disorder and healthy individuals with a history of panic attacks show a hypersensitivity to unpredictable threats, suggesting a possible link between panic and sustained anxiety. The purpose of this study was to determine the degree to which induced symptoms of panic relate to fear and anxiety, as well as activity in the neural systems that mediate and regulate these affective states. Psychological and physiological symptoms of panic were assessed during an 8-min 7.5% CO 2 challenge task. Psychological, physiological, and neural symptoms of fear and anxiety were measured during two sessions (one psychophysiology and one functional magnetic resonance imaging where subjects experienced several blocks of no threat (N), predictable shock (P), and unpredictable shock (U; NPU threat task). We used a principle component analysis to characterize panic susceptibility (PS), and found that PS significantly predicted dorsolateral prefrontal cortex (dlPFC) activity to the unpredictable cue during the NPU threat task. When examining the weighted beta coefficients from this analysis, we observed that self-reported fear/anxiety during the CO 2 challenge negatively loaded onto dlPFC activity during the NPU task. Consistent with this observation, dlPFC activity during the unpredictable cue was also negatively correlated with anxiety during the NPU sessions. Together, these results suggest that panic symptoms and anxiety are regulated by the same prefrontal cognitive control system.

  18. An isolated bridgeless AC-DC PFC converter using a LC resonant voltage doubler rectifier

    NASA Astrophysics Data System (ADS)

    Lee, Sin-woo; Do, Hyun-Lark

    2016-12-01

    This paper proposed an isolated bridgeless AC-DC power factor correction (PFC) converter using a LC resonant voltage doubler rectifier. The proposed converter is based on isolated conventional single-ended primary inductance converter (SEPIC) PFC converter. The conduction loss of rectification is reduced than a conventional one because the proposed converter is designed to eliminate a full-bridge rectifier at an input stage. Moreover, for zero-current switching (ZCS) operation and low voltage stresses of output diodes, the secondary of the proposed converter is designed as voltage doubler with a LC resonant tank. Additionally, an input-output electrical isolation is provided for safety standard. In conclusion, high power factor is achieved and efficiency is improved. The operational principles, steady-state analysis and design equations of the proposed converter are described in detail. Experimental results from a 60 W prototype at a constant switching frequency 100 kHz are presented to verify the performance of the proposed converter.

  19. Leaching of PFC from soils contaminated with PFC of different origin

    NASA Astrophysics Data System (ADS)

    Kalbe, Ute; Piechotta, Christian; Rothe, Robert

    2017-04-01

    Leaching tests are fundamental tools for the assessment of groundwater impact by contaminated soils concerning the soil-groundwater pathway. Such procedures are supposed to serve as the basis for a reliable leachate prognosis. They can be applied to determine the short and long term leaching behaviour as well as the source term of contaminated soils. For this purpose two types of leaching procedures have been validated in Germany for the examination of the leaching behaviour of frequently occurring organic substances (DIN 19528 - column test and DIN 19529 - batch test). A liquid-to-solid ratio (L/S) of 2 L/kg and 10 L/kg) is the basis for the risk assessment which is implemented in different German regulations. The equivalence of test results for both tests for the same material under investigation has been investigated for a variety of pollutants in order to assess their reliability in compliance testing. However, for emerging pollutants there is hardly data available on this issue. Leaching tests on soils contaminated with emerging pollutants such as PFC (Perfluorinated Surfactants) are currently coming more into consideration due to the increasing detection of contaminated sites. Therefore, two soils were investigated in this study from different contamination source (paper sludge containing compost and fire distinguishing foam) using both leaching tests and both liquid-to-solid ratios. The leachability of the various perfluorinated compounds in relation to their content in solid matter was considered. Furthermore the eluate pre-treatment prior analysis (in particular liquid/solid separation step needed for batch tests) has been taken into account. The comparability of the results from batch and column is dependent on the solubility of the various compounds, on the L/S and on the turbidity in the eluates.

  20. The impact of competition among health care financing authorities on market yields and issuer interest expenses.

    PubMed

    Bernet, Patrick M; Carpenter, Caryl E; Saunders, Warren

    2011-01-01

    The main source of capital for non-for-profit health care organizations is tax-exempt municipal bonds. The tax-exempt nature of this debt requires that they be issued through financing authorities, which are run by, or affiliated with, state or local government agencies. In some states, all tax-exempt health care bonds must be issued through a single financing authority, but in other states the issuing health care organization has a choice of multiple authorities. Using a Herfindahl index of issuer concentration, prior research has found that greater competition among authorities results in lower interest costs to the issuing health care organization. We pick up where this earlier study left off, examining the links between authority competition, the interest expenses to the issuer, and the yield to the market investor. Although our analysis of all hospital bonds issued between 1994 and 2002 corroborates earlier findings with regard to interest expenses to the issuing health care organization, we also find market yield is lower for statewide authorities where issuer concentration is lower. Thus, authority competition is good from the issuers' point of view, but holds no favor in the investors' eyes. On the other hand, the lower market yield associated with statewide authorities does not make its way down to the issuer in the form of lower interest costs. To help sort through this paradox, we explore our findings through interviews of executives in state issuing authorities.

  1. Serum concentrations of perfluorinated compounds (PFC) among selected populations of children and Adults in California

    EPA Science Inventory

    Perfluorinated compounds (PFCs) have been widely used in industrial applications and consumer products. Their persistent nature and potential health impacts are of concern. Given the high cost of collecting serum samples, this study is to understand whether we can quantify PFC se...

  2. Prevention of alcohol-heightened aggression by CRF-R1 antagonists in mice: critical role for DRN-PFC serotonin pathway.

    PubMed

    Quadros, Isabel M; Hwa, Lara S; Shimamoto, Akiko; Carlson, Julia; DeBold, Joseph F; Miczek, Klaus A

    2014-11-01

    Alcohol can escalate aggressive behavior in a significant subgroup of rodents, humans, and nonhuman primates. The present study investigated whether blockade of corticotropin-releasing factor receptor type 1 (CRF-R1) could prevent the emergence of alcohol-heightened aggression in mice. The serotonin (5-HT) pathway from the dorsal raphe nucleus (DRN) to the medial prefrontal cortex (mPFC) by CRF-R1 was investigated as a possible target for the prevention of alcohol-heightened aggressive behavior. Male CFW mice that reliably exhibited aggressive behaviors after consuming 1 g/kg of alcohol received systemic or intra-DRN administration of CRF-R1 antagonists, CP-154,526 or MTIP, before a confrontation with a male conspecific. Blockade of DRN CRF-R1 receptors with both antagonists significantly reduced only alcohol-heightened aggression, whereas systemic administration reduced both alcohol-heightened and species-typical aggression. Next, a 5-HT1A agonist, 8-OH-DPAT, was coadministered with CP-154,526 into the DRN to temporarily disrupt 5-HT activity. This manipulation abolished the antiaggressive effects of intra-DRN CP-154,526. In the mPFC, in vivo microdialysis revealed that extracellular 5-HT levels were increased in mice that consumed alcohol and were then injected with CP-154,526, both systemically or intra-DRN. Neither alcohol nor CP-154,526 alone affected 5-HT release in the mPFC. The present results suggest the DRN as a critical site for CRF-R1 to modulate alcohol-heightened aggression via action on the serotonergic DRN-PFC pathway.

  3. vmPFC activation during a stressor predicts positive emotions during stress recovery

    PubMed Central

    Yang, Xi; Garcia, Katelyn M; Jung, Youngkyoo; Whitlow, Christopher T; McRae, Kateri; Waugh, Christian E

    2018-01-01

    Abstract Despite accruing evidence showing that positive emotions facilitate stress recovery, the neural basis for this effect remains unclear. To identify the underlying mechanism, we compared stress recovery for people reflecting on a stressor while in a positive emotional context with that for people in a neutral context. While blood–oxygen-level dependent data were being collected, participants (N = 43) performed a stressful anagram task, which was followed by a recovery period during which they reflected on the stressor while watching a positive or neutral video. Participants also reported positive and negative emotions throughout the task as well as retrospective thoughts about the task. Although there was no effect of experimental context on emotional recovery, we found that ventromedial prefrontal cortex (vmPFC) activation during the stressor predicted more positive emotions during recovery, which in turn predicted less negative emotions during recovery. In addition, the relationship between vmPFC activation and positive emotions during recovery was mediated by decentering—the meta-cognitive detachment of oneself from one’s feelings. In sum, successful recovery from a stressor seems to be due to activation of positive emotion-related regions during the stressor itself as well as to their downstream effects on certain cognitive forms of emotion regulation. PMID:29462404

  4. Adolescent social isolation affects schizophrenia-like behavior and astrocyte biomarkers in the PFC of adult rats.

    PubMed

    Sun, Lan; Min, Li; Zhou, Hao; Li, Man; Shao, Feng; Wang, Weiwen

    2017-08-30

    Social isolation is regarded as a cause of schizophrenia spectrum disorders. Animal models of schizophrenia are constructed by repeated early environment deprivation as an important paradigm to reveal its pathological mechanism. Male Sprague Dawley rats were assigned to either social-rearing (SR) or isolated-rearing (IR) groups during postnatal days (PNDs) 21-34. On PND 56, all rats underwent behavioral testing including locomotor activity, anxiety-related behaviors in an open field and prepulse inhibition (PPI). Then, the rats were sacrificed and prefrontal cortex (PFC) tissues were separated for high-throughput proteomics analysis and Western blot validation. Rats of the IR group showed increased spontaneous locomotion, increased anxiety-like behavior and disrupted PPI compared with rats of the SR group. Based on proteomics analysis, a total of 124 PFC proteins were found to be significantly differentially expressed between the SR group and the IR group, the most remarkable of which were glial fibrillary acidic protein (GFAP), Annexin A2 (ANXA2) and vimentin (VIM), three astrocyte biomarkers. Further Western blot measurement confirmed that the levels of GFAP, ANXA2 and VIM were increased significantly in IR rats. Adolescent social isolation induced schizophrenia-like behaviors and significantly different expression of 124 PFC proteins in adult rats, especially GFAP, ANXA2 and VIM, which suggests that astrocyte development might be involved in the neural mechanism of schizophrenia. Copyright © 2017. Published by Elsevier B.V.

  5. 14 CFR 158.47 - Collection of PFC's on tickets issued outside the U.S.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... required to collect a PFC on air travel tickets issued on its own ticket stock unless it serves a point or... this section, unless the itinerary is for travel wholly within the U.S. Air carriers and foreign air carriers must comply with § 158.45 where the itinerary is for travel wholly within the U.S. regardless of...

  6. 77 FR 16537 - Grant of Authority for Subzone Status Piramal Critical Care, Inc., (Inhalation Anesthetics...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-03-21

    ... Status Piramal Critical Care, Inc., (Inhalation Anesthetics), Bethlehem, PA Pursuant to its authority... anesthetic manufacturing and distribution facilities of Piramal Critical Care, Inc., located in Bethlehem... inhalation anesthetics at the facilities of Piramal Critical Care, Inc., located in Bethlehem, Pennsylvania...

  7. Serum concentrations of perfluorinated compounds (PFC) among selected populations of children and adults in California.

    PubMed

    Wu, Xiangmei May; Bennett, Deborah H; Calafat, Antonia M; Kato, Kayoko; Strynar, Mark; Andersen, Erik; Moran, Rebecca E; Tancredi, Daniel J; Tulve, Nicolle S; Hertz-Picciotto, Irva

    2015-01-01

    Perfluorinated compounds (PFCs) have been widely used in industrial applications and consumer products. Their persistent nature and potential health impacts are of concern. Given the high cost of collecting serum samples, this study is to understand whether we can quantify PFC serum concentrations using factors extracted from questionnaire responses and indirect measurements, and whether a single serum measurement can be used to classify an individual's exposure over a one-year period. The study population included three demographic groups: young children (2-8 years old) (N=67), parents of young children (<55 years old) (N=90), and older adults (>55 years old) (N=59). PFC serum concentrations, house dust concentrations, and questionnaires were collected. The geometric mean of perfluorooctane sulfonic acid (PFOS) was highest for the older adults. In contrast, the geometric mean of perfluorooctanoic acid (PFOA) was highest for children. Serum concentrations of the parent and the child from the same family were moderately correlated (Spearman correlation (r)=0.26-0.79, p<0.05), indicating common sources within a family. For adults, age, having occupational exposure or having used fire extinguisher, frequencies of consuming butter/margarine, pork, canned meat entrées, tuna and white fish, freshwater fish, and whether they ate microwave popcorn were significantly positively associated with serum concentrations of individual PFCs. For children, residential dust concentrations, frequency of wearing waterproof clothes, frequency of having canned fish, hotdogs, chicken nuggets, French fries, and chips, and whether they ate microwave popcorn were significant positive predictors of individual PFC serum concentrations. In addition, the serum concentrations collected in a subset of young children (N=20) and the parents (N=42) one year later were strongly correlated (r=0.68-0.98, p<0.001) with the levels measured at the first visits, but showed a decreasing trend. Children had

  8. Serum concentrations of perfluorinated compounds (PFC) among selected populations of children and Adults in California

    PubMed Central

    Wu, Xiangmei (May); Bennett, Deborah H.; Calafat, Antonia M.; Kato, Kayoko; Strynar, Mark; Andersen, Erik; Moran, Rebecca E.; Tancredi, Daniel J.; Tulve, Nicolle S.; Hertz-Picciotto, Irva

    2016-01-01

    Perfluorinated compounds (PFCs) have been widely used in industrial applications and consumer products. Their persistent nature and potential health impacts are of concern. Given the high cost of collecting serum samples, this study is to understand whether we can quantify PFC serum concentrations using factors extracted from questionnaire responses and indirect measurements, and whether a single serum measurement can be used to classify an individual’s exposure over a one-year period. The study population included three demographic groups: young children (2–8 years old) (N=67), parents of young children (<55 years old) (N=90), and older adults (>55 years old) (N=59). PFC serum concentrations, house dust concentrations, and questionnaires were collected. The geometric mean of perfluorooctane sulfonic acid (PFOS) was highest for the older adults. In contrast, the geometric mean of perfluorooctanoic acid (PFOA) was highest for children. Serum concentrations of the parent and the child from the same family were moderately correlated (Spearman correlation (r)=0.26–0.79, p<0.05), indicating common sources within a family. For adults, age, having occupational exposure or having used fire extinguisher, frequencies of consuming butter/margarine, pork, canned meat entrées, tuna and white fish, freshwater fish, and whether they ate microwave popcorn were significantly positively associated with serum concentrations of individual PFCs. For children, residential dust concentrations, frequency of wearing waterproof clothes, frequency of having canned fish, hotdogs, chicken nuggets, French fries, and chips, and whether they ate microwave popcorn were significant positive predictors of individual PFC serum concentrations. In addition, the serum concentrations collected in a subset of young children (N=20) and the parents (N=42) one year later were strongly correlated (r=0.68–0.98, p<0.001) with the levels measured at the first visits, but showed a decreasing trend

  9. Alter spontaneous activity in amygdala and vmPFC during fear consolidation following 24 h sleep deprivation.

    PubMed

    Feng, Pan; Becker, Benjamin; Feng, Tingyong; Zheng, Yong

    2018-05-15

    Sleep deprivation (SD) has been associated with cognitive and emotional disruptions, however its impact on the acquisition of fear and subsequent fear memory consolidation remain unknown. To address this question, we measured human brain activity before and after fear acquisition under conditions of 24 h sleep deprivation versus normal sleep using resting-state functional magnetic resonance imaging (rs-fMRI). Additionally, we explored whether the fear acquisition-induced change of brain activity during the fear memory consolidation window can be predicted by subjective fear ratings and autonomic fear response, assessed by skin conductance responses (SCR) during acquisition. Behaviorally, the SD group demonstrated increased subjective and autonomic fear responses compared to controls at the stage of fear acquisition. During the stage of fear consolidation, the SD group displayed decreased ventromedial prefrontal cortex (vmPFC) activity and concomitantly increased amygdala activity. Moreover, in the SD group fear acquisition-induced brain activity changes in amygdala were positively correlated with both, subjective and autonomic fear indices during acquisition, whereas in controls changes vmPFC activity were positively correlated with fear indices during acquisition. Together, the present findings suggested that SD may weaken the top-down ability of the vmPFC to regulate amygdala activity during fear memory consolidation. Moreover, subjective and objective fear at fear acquisition stage can predict the change of brain activity in amygdala in fear memory consolidation following SD. Copyright © 2018 Elsevier Inc. All rights reserved.

  10. Li experiments at the tokamak T-11 M in field of steady state PFC investigations

    NASA Astrophysics Data System (ADS)

    Mirnov, S. V.; Lazarev, V. B.

    2011-08-01

    The renewable plasma facing components (PFCs) of steady state tokamak-reactor can be created in framework of Lithium emitter-collector concept, which suggests Li-loop development close the Li-PFC and plasma periphery. It should ensure: Li-emission from PFC into the plasma, plasma periphery cooling by non-coronal Li radiation, Li ions collection before their loss on the wall and Li return into emitter. The subjects of the last T-11 M investigations were the Lithium collection by limiters and Lithium removal from the wall during tokamak conditioning. The Lithium behavior was studied with witness samples and mobile graphite probe. It was shown that Li-deposit on the sides of rail Li-limiter (collector) is proportional to the Li-emission from the Li-limiter (emitter). Lithium deposit on the ion-drift side of Li-limiter is up to 2-3 times more than on the electron-side. The efficiency of Li-collection by T-11 M limiters can be 60 ± 20% of total Lithium emission from Li-limiter during plasma discharges.

  11. Authorities and Mechanisms for Purchased Care at the Department of Veterans Affairs

    PubMed Central

    Greenberg, Michael D.; Batka, Caroline; Buttorff, Christine; Dunigan, Molly; Lovejoy, Susan L.; McGovern, Geoffrey; Pace, Nicholas M.; Pillemer, Francesca; Williams, Kayla M.; Apaydin, Eric; Aranibar, Clara; Buenaventura, Maya; Carter, Phillip; Cherney, Samantha; Davis, Lynn E.; Donohue, Amy Grace; Geyer, Lily; Hemler, Joslyn; Roshan, Parisa; Skrabala, Lauren; Simmons, Stephen; Thompson, Joseph; Welch, Jonathan; Hosek, Susan D.; Farmer, Carrie M.

    2016-01-01

    Abstract The Veterans Access, Choice, and Accountability Act of 2014 addressed the need for access to timely, high-quality health care for veterans. Section 201 of the legislation called for an independent assessment of various aspects of veterans' health care. The RAND Corporation was tasked with an assessment of the authorities and mechanisms by which the Department of Veterans Affairs (VA) pays for health care services from non-VA providers. Purchased care accounted for 10 percent, or around $5.6 billion, of VA's health care budget in fiscal year 2014, and the amount of care purchased from outside VA is growing rapidly. VA purchases non-VA care through an array of programs, each with different payment processes and eligibility requirements for veterans and outside providers. A review and analysis of statutes, regulations, legislation, and literature on VA purchased care, along with interviews with expert stakeholders, a survey of VA medical facilities, and an evaluation of local-level policy documents revealed that VA's purchased care system is complex and decentralized. Inconsistencies in procedures, unclear goals, and a lack of cohesive strategy for purchased care could have ramifications for veterans' access to care. Adding to the complexity of VA's purchased care system is a lack of systematic data collection on access to and quality of care provided through VA's purchased care programs. The analysis also explored concepts of “episodes of care” and their implications for purchased care by VA. PMID:28083425

  12. The response of L5 pyramidal neurons of the PFC to magnetic stimulation from a micro-coil.

    PubMed

    Lee, Seung Woo; Fried, Shelley I

    2014-01-01

    Magnetic stimulation of the nervous system, e.g. transcranial magnetic stimulation (TMS), has been used both to unravel basic structure and function of the nervous system as well as to treat neurological diseases, i.e. clinical depression. Despite progress in both areas, ongoing advancements have been limited by a lack of understanding of the mechanism by which magnetic stimulation alters neural activity. Here, we report responses of cortical neurons to magnetic stimulation arising from a sub-millimeter coil. Cell attached patch clamp was used to record neural activity of layer 5/6 pyramidal neurons of the prefrontal cortex (PFC) in the in vitro mouse brain slice preparation. The fields arising from the small coil were quite different from those arising during clinical TMS but nevertheless allowed the responses of cortical neurons to magnetic stimulation to be probed. For example, the focal nature of induced fields allowed the sensitivity of different regions within targeted pyramidal neurons, e.g. apical dendrite, soma and axon hillock, to be compared. We found that PFC pyramidal neurons were not sensitive to single pulses of stimulation regardless of coil location. However, regions of the apical dendrite and proximal axon were both sensitive to repetitive stimulation as long as the orientation of the induced electric field was aligned with the long axis of the neuron. These results suggest that neurons of the PFC are sensitive to weak magnetic fields and further, that this type of approach may be useful for unraveling some of the mechanisms underlying TMS.

  13. Investigation of lithium PFC surface characteristics and low recycling at LTX/LTX-Beta

    NASA Astrophysics Data System (ADS)

    Maan, Anurag; Kaita, Robert; Elliott, Drew; Boyle, Dennis; Majeski, Richard; Donovan, David; Buzi, Luxherta; Koel, Bruce E.; Biewer, Theodore M.

    2017-10-01

    Lithium coatings on high-Z PFCs at LTX have led to improved plasma performance. The initial hypothesis was that lithium retains hydrogen by forming lithium hydride and thereby enabling low recycling in LTX. However, recent in-vacuo measurements indicate the presence of lithium oxide in deposited lithium coatings. Improved plasma performance continued to be observed in the presence of lithium oxide. These observations raise questions like what is the nature of the lithium oxide surface, whether the PFC is an amorphous mixture of lithium and lithium oxide or something more ordered like a lithium oxide layer growing on top of lithium, and whether lithium oxide is responsible for any retention of hydrogen from the plasma. To investigate the mechanism by which the LTX PFC might be responsible for low recycling, we discuss the results of deuterium retention measurements using NRA/RBS and sample characterization using high resolution XPS (HR-XPS) in bulk lithium samples. Baseline HR-XPS scans indicate the presence of Lithium Oxide on sputtered lithium samples. Status of related planned experiments at LTX- β will also be discussed. This work was supported by the US. D.O.E. contract DE-AC05-00OR22725 and DE-AC02-09CH11466. BEK acknowledges support of this work by the U.S. DOE, Office of Science/FES under Award Number DE-SC0012890.

  14. Patients’ mobility as an indicator for (in)efficiency:a panel data analysis on Italian health care authorities

    PubMed Central

    2013-01-01

    Abstract This paper investigates the influence of internal managerial patterns of heath care authorities on the decision of patients to migrate towards different health care organizations to avail treatments. The efficiency and productivity issues are analyzed, considering the (passive) migration as a proxy for the (in)efficient service availed. We follow the “vote by feet” theorization by Tiebout , assuming that citizens can choose to avail a health treatment in a public service provider different from their resident one. The choice for a center that is far from home implies a negative judgment to the alternative health care supplier that is closer to the patient. Testing Fixed Effects Panel Model on a sample of Italian health care authorities, a strong correlation is found among variables in our model and some relevant dependence is tested between patients’ mobility behavior and their resident authorities’ efficiency in allocating resources on the proper operating cost. Spending in the proper way on health care could bring about an enhancement of performances. Instead, wasting resources is immediately perceived by the patient, who consequently seems to move to a different health care authority. JEL code M48 PMID:23422329

  15. Age-related changes in overcoming proactive interference in associative memory: The role of PFC-mediated executive control processes at retrieval.

    PubMed

    Dulas, Michael R; Duarte, Audrey

    2016-05-15

    Behavioral evidence has shown age-related impairments in overcoming proactive interference in memory, but it is unclear what underlies this deficit. Imaging studies in the young suggest overcoming interference may require several executive control processes supported by the ventrolateral prefrontal cortex (VLPFC) and dorsolateral PFC (DLPFC). The present functional magnetic resonance imaging (fMRI) study investigated whether age-related changes in dissociable executive control processes underlie deficits in overcoming proactive interference in associative memory during retrieval. Participants were tasked with remembering which associate (face or scene) objects were paired with most recently during study, under conditions of high or low proactive interference. Behavioral results demonstrated that, as interference increased, memory performance decreased similarly across groups, with slight associative memory deficits in older adults. Imaging results demonstrated that, across groups, left mid-VLPFC showed increasing activity with increasing interference, though activity did not distinguish correct from incorrect associative memory responses, suggesting this region may not directly serve in successful resolution of proactive interference, per se. Under conditions of high interference, older adults showed reduced associative memory accuracy effects in the DLPFC and anterior PFC. These results suggest that age-related PFC dysfunction may not be ubiquitous. Executive processes supported by ventral regions that detect mnemonic interference may be less affected than processes supported by dorsal and anterior regions that directly resolve interference. Copyright © 2016 Elsevier Inc. All rights reserved.

  16. [Mathematical simulation of stem/cement/bone mechanical interactions for Poldi-Cech, CF-30, MS-30 and PFC femoral components].

    PubMed

    Kovanda, M; Havlícek, V; Hudec, J

    2009-04-01

    PURPOSE OF THE STUDY The mid-term longevity of femoral components varies considerably, with some showing failure due to early aseptic loosening. Since the hip joint is subject to heavy mechanical loads, it can be assumed that the mechanical interaction of the implant, bone cement and femur will play a key role in the resultant reliability of an arthroplasty. This study was designed to examine this mechanical interaction in four femoral components different in construction (Poldi-Cech, CF-30, MS-30 and PFC) using mathematical simulation. MATERIAL AND METHODS Four stem/cement/femur 3-D mathematical models, comparable in quality, infolving the Poldi-Cech, CF-30, MS-30 and PFC stems, respectively, were constructed. A 3-D model for each stem was created according to its real, middle-size femoral component. Each 3-D model of the cement mantle corresponded in shape to the mantle of the appropriate real stem, with its thickness based on the recommended values of 4-7 mm in the proximal and 1-3 mm in the distal part, and with the cement mantle reaching as far as 10 mm distal to the femoral stem tip. For simplicitys sake the outer surface of the cement mantle was simulated as smooth. A 3-D model involving the proximal epiphysis and the metaphysis of a femur was reconstructed, based on a series of CT cross-sections obtained periodically at 10.5-mm and 2.5-mm distances. The sten/cement/femur model with the MS-30 stem also included a centraliser. The mechanical interaction of the stem, bone cement and bone tissue was examined by means of mathematical stimulation using ANSYS 5.7 software based on finite element analysis. RESULTS For the sake of simplicity, only two key parameters are presented, namely, contact stress at the stem-cement interface and equivalent deformation in the stem/cement/femur system. The least satisfactory stress loading was in the CF-30 stem whose sharp edges showed the values of contact stress about six-times higher than on the mid-medial portion of the

  17. Reducing health care costs--potential and limitations of local authority health services.

    PubMed

    Ijsselmuiden, C B; De Beer, C

    1990-08-04

    Local authorities (LAs) currently provide preventive and promotive services. It is argued that, by extending the role of the LA to the provision of comprehensive services, including ambulatory and hospital curative care, both the quality and the cost-effectiveness of health care would be improved. Making health care the responsibility of the LA would minimise fragmentation, allow for the provision of a number of services that currently are neglected because they fall through the gap that exists between preventive and curative services, and result in the more effective use of personnel currently restricted to providing preventive care only. LAs offer an appropriate structure for effective community control over the health services, and are more likely to be sensitive to local needs and demands. In addition, their administrative proximity to other LA departments responsible for housing, town planning and parks and recreation allows for an effective multisectoral approach to health. The positive aspects of LA care can only be achieved in the context of racially integrated services provided by an LA elected by universal adult franchise. Smaller LAs may need to be grouped together in larger units for the purpose of achieving satisfactory economies of scale in the provision of health care.

  18. A comparison of clinical- and patient-reported outcomes of the cemented ATTUNE and PFC sigma fixed bearing cruciate sacrificing knee systems in patients who underwent total knee replacement with both prostheses in opposite knees.

    PubMed

    Carey, Brian W; Harty, James

    2018-03-15

    The ATTUNE Knee by DePuy Synthes was introduced in 2013. It is designed to provide better range of motion and address patient-reported instability. The PFC Sigma Knee, an earlier prosthesis by DePuy Synthes, is a common knee replacement with a strong clinical track record. Our aim is to compare the outcomes after primary total knee replacement for end-stage knee osteoarthritis of the PFC and ATTUNE knee systems in 21 patients who each have prosthesis in opposite knees using WOMAC, Oxford Knee and SF-12 scores and evaluation of range of motion. A review was carried out on 21 patients who underwent primary total knee replacement with both the ATTUNE and PFC knee systems. These were staged operations performed in the same institution and by the same surgeon. All cases were followed up for a minimum of 6 months. WOMAC, Oxford Knee and SF-12 scores, as well as knee range of motion were recorded preoperatively and at 6 months postoperatively. There was a significant difference in pre- to 6-month post-operative outcomes in PFC and ATTUNE groups with regard to improvement in range of motion (10° ± 8 and 13° ± 11, respectively). There was also a significant improvement in WOMAC scores (PFC group) and Oxford Knee Scores (ATTUNE group) (8.9 ± 7.7 and 12.1 ± 8.4, respectively). There was a significant improvement in SF-12 Score in both groups (10.1 ± 9.3 for PFC and 15.8 ± 13.3 for ATTUNE). The minimum clinically important difference (MCID) in scoring systems at 6 months was reached by 6 patients in the PFC group and 12 in the ATTUNE group. A significant difference was demonstrated in clinical outcome at 6 months postoperatively between PFC and ATTUNE knee systems in patients who underwent total knee arthroplasty with both prostheses. Superior results were recorded for the ATTUNE knee system.

  19. Chronic LSD alters gene expression profiles in the mPFC relevant to schizophrenia.

    PubMed

    Martin, David A; Marona-Lewicka, Danuta; Nichols, David E; Nichols, Charles D

    2014-08-01

    Chronic administration of lysergic acid diethylamide (LSD) every other day to rats results in a variety of abnormal behaviors. These build over the 90 day course of treatment and can persist at full strength for at least several months after cessation of treatment. The behaviors are consistent with those observed in animal models of schizophrenia and include hyperactivity, reduced sucrose-preference, and decreased social interaction. In order to elucidate molecular changes that underlie these aberrant behaviors, we chronically treated rats with LSD and performed RNA-sequencing on the medial prefrontal cortex (mPFC), an area highly associated with both the actions of LSD and the pathophysiology of schizophrenia and other psychiatric illnesses. We observed widespread changes in the neurogenetic state of treated animals four weeks after cessation of LSD treatment. QPCR was used to validate a subset of gene expression changes observed with RNA-Seq, and confirmed a significant correlation between the two methods. Functional clustering analysis indicates differentially expressed genes are enriched in pathways involving neurotransmission (Drd2, Gabrb1), synaptic plasticity (Nr2a, Krox20), energy metabolism (Atp5d, Ndufa1) and neuropeptide signaling (Npy, Bdnf), among others. Many processes identified as altered by chronic LSD are also implicated in the pathogenesis of schizophrenia, and genes affected by LSD are enriched with putative schizophrenia genes. Our results provide a relatively comprehensive analysis of mPFC transcriptional regulation in response to chronic LSD, and indicate that the long-term effects of LSD may bear relevance to psychiatric illnesses, including schizophrenia. Copyright © 2014 Elsevier Ltd. All rights reserved.

  20. Chronic LSD alters gene expression profiles in the mPFC relevant to schizophrenia

    PubMed Central

    Martin, David A.; Marona-Lewicka, Danuta; Nichols, David E.; Nichols, Charles D.

    2014-01-01

    Chronic administration of lysergic acid diethylamide (LSD) every other day to rats results in a variety of abnormal behaviors. These build over the 90 day course of treatment and can persist at full strength for at least several months after cessation of treatment. The behaviors are consistent with those observed in animal models of schizophrenia and include hyperactivity, reduced sucrose-preference, and decreased social interaction. In order to elucidate molecular changes that underlie these aberrant behaviors, we chronically treated rats with LSD and performed RNA-Sequencing on the medial prefrontal cortex (mPFC), an area highly associated with both the actions of LSD and the pathophysiology of schizophrenia and other psychiatric illnesses. We observed widespread changes in the neurogenetic state of treated animals four weeks after cessation of LSD treatment. QPCR was used to validate a subset of gene expression changes observed with RNA-Seq, and confirmed a significant correlation between the two methods. Functional clustering analysis indicates differentially expressed genes are enriched in pathways involving neurotransmission (Drd2, Gabrb1), synaptic plasticity (Nr2a, Krox20), energy metabolism (Atp5d, Ndufa1) and neuropeptide signaling (Npy, Bdnf), among others. Many processes identified as altered by chronic LSD are also implicated in the pathogenesis of schizophrenia, and genes affected by LSD are enriched with putative schizophrenia genes. Our results provide a relatively comprehensive analysis of mPFC transcriptional regulation in response to chronic LSD, and indicate that the long-term effects of LSD may bear relevance to psychiatric illnesses, including schizophrenia. PMID:24704148

  1. The Single Logon Application: an enabler for access to disparate systems in a patient-focused care environment.

    PubMed Central

    SooHoo, S. L.; Aabedi, F.; Wagenet, R. C.; Dorst, M.; Stempson, M.

    1995-01-01

    The presence of separate, independent systems for patient results is a common problem in many institutions. The Single Logon Application (SLA) was developed to mitigate the problems presented by these disparate systems, and its use was a key component in a Patient-Focused Care (PFC) implementation. PMID:8563263

  2. Preliminary Design of a Digital Holography PFC Erosion Diagnostic for MPEX

    NASA Astrophysics Data System (ADS)

    Thomas, C. E. (Tommy), Jr.; Biewer, T. M.; Shaw, G. C.; Baylor, L. R.; Combs, S. K.; Meitner, S. J.; Rapp, J.; Hillis, D. L.; Granstedt, E. M.; Majeski, R.; Kaita, R.

    2015-11-01

    Preliminary design of a Digital Holography (DH) in-situ Plasma Facing Component (PFC) erosion diagnostic to be used on the proto-MPEX/MPEX experiment is presented. Design trade-offs are discussed including the selection of CO2 laser frequencies and whether/where to use reflective or refractive optical components. The costs and benefits of using a high-speed (expensive) infrared (IR) camera or a lower speed (inexpensive) IR camera, and whether to use simultaneous or sequential acquisition of DH exposures for the dual wavelength system are also described. Expected layout, resolution, and noise figures will be discussed, along with resolution and noise data from previous work at ORNL and PPPL. Partial Support from USDOE Contract DE-AC02-09CH11466 and USDOE Grant DE-FG02-07ER84724 for previous Digital Holography work done at ORNL and PPPL is gratefully acknowledged.

  3. Agomelatine (S20098) modulates the expression of cytoskeletal microtubular proteins, synaptic markers and BDNF in the rat hippocampus, amygdala and PFC.

    PubMed

    Ladurelle, Nataly; Gabriel, Cecilia; Viggiano, Adela; Mocaër, Elisabeth; Baulieu, Etienne E; Bianchi, Massimiliano

    2012-06-01

    Agomelatine is described as a novel and clinical effective antidepressant drug with melatonergic (MT(1)/MT(2)) agonist and 5-HT(2C) receptor antagonist properties. Previous studies suggest that modulation of neuronal plasticity and microtubule dynamics may be involved in the treatment of depression. The present study investigated the effects of agomelatine on microtubular, synaptic and brain-derived neurotrophic factor (BDNF) proteins in selected rat brain regions. Adult male rats received agomelatine (40 mg/kg i.p.) once a day for 22 days. The pro-cognitive effect of agomelatine was tested in the novel object recognition task and antidepressant activity in the forced swimming test. Microtubule dynamics markers, microtubule-associated protein type 2 (MAP-2), phosphorylated MAP-2, synaptic markers [synaptophysin, postsynaptic density-95 (PSD-95) and spinophilin] and BDNF were measured by Western blot in the hippocampus, amygdala and prefrontal cortex (PFC). Agomelatine exerted pro-cognitive and antidepressant activity and induced molecular changes in the brain areas examined. Agomelatine enhanced microtubule dynamics in the hippocampus and to a higher magnitude in the amygdala. By contrast, in the PFC, a decrease in microtubule dynamics was observed. Spinophilin (dendritic spines marker) was decreased, and BDNF increased in the hippocampus. Synaptophysin (presynaptic) and spinophilin were increased in the PFC and amygdala, while PSD-95 (postsynaptic marker) was increased in the amygdala, consistent with the phenomena of synaptic remodelling. Agomelatine modulates cytoskeletal microtubule dynamics and synaptic markers. This may play a role in its pharmacological behavioural effects and may result from the melatonergic agonist and 5-HT(2C) antagonist properties of the compound.

  4. Design of a digital holography system for PFC erosion measurements on Proto-MPEX

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

    ThomasJr., C. E.; Biewer, Theodore M; Baylor, Larry R

    2016-01-01

    A project has been started at ORNL to develop a dual-wavelength digital holography system for plasma facing component (PFC) erosion measurements on Proto-MPEX. Such a system will allow in-situ real-time measurements of component erosion. Initially the system will be developed with one laser, and first experimental laboratory measurements will be made with the single laser system. In the second year of development a second CO2 laser will be added and measurements with the dual wavelength system will begin. Adding the second wavelength allows measurements at a much longer synthetic wavelength equal to the average of the two wavelengths times themore » average divided by the difference of the two wavelengths.« less

  5. PFC and Triglyme for Li-Air Batteries: A Molecular Dynamics Study.

    PubMed

    Kuritz, Natalia; Murat, Michael; Balaish, Moran; Ein-Eli, Yair; Natan, Amir

    2016-04-07

    In this work, we present an all-atom molecular dynamics (MD) study of triglyme and perfluorinated carbons (PFCs) using classical atomistic force fields. Triglyme is a typical solvent used in nonaqueous Li-air battery cells. PFCs were recently reported to increase oxygen availability in such cells. We show that O2 diffusion in two specific PFC molecules (C6F14 and C8F18) is significantly faster than in triglyme. Furthermore, by starting with two very different initial configurations for our MD simulation, we demonstrate that C8F18 and triglyme do not mix. The mutual solubility of these molecules is evaluated both theoretically and experimentally, and a qualitative agreement is found. Finally, we show that the solubility of O2 in C8F18 is considerably higher than in triglyme. The significance of these results to Li-air batteries is discussed.

  6. Can tokamaks PFC survive a single event of any plasma instabilities?

    NASA Astrophysics Data System (ADS)

    Hassanein, A.; Sizyuk, V.; Miloshevsky, G.; Sizyuk, T.

    2013-07-01

    Plasma instability events such as disruptions, edge-localized modes (ELMs), runaway electrons (REs), and vertical displacement events (VDEs) are continued to be serious events and most limiting factors for successful tokamak reactor concept. The plasma-facing components (PFCs), e.g., wall, divertor, and limited surfaces of a tokamak as well as coolant structure materials are subjected to intense particle and heat loads and must maintain a clean and stable surface environment among them and the core/edge plasma. Typical ITER transient events parameters are used for assessing the damage from these four different instability events. HEIGHTS simulation showed that a single event of a disruption, giant ELM, VDE, or RE can cause significant surface erosion (melting and vaporization) damage to PFC, nearby components, and/or structural materials (VDE, RE) melting and possible burnout of coolant tubes that could result in shut down of reactor for extended repair time.

  7. Long-term tropospheric trend of octafluorocyclobutane (c-C4F8 or PFC-318)

    NASA Astrophysics Data System (ADS)

    Oram, D. E.; Mani, F. S.; Laube, J. C.; Newland, M. J.; Reeves, C. E.; Sturges, W. T.; Penkett, S. A.; Brenninkmeijer, C. A. M.; Röckmann, T.; Fraser, P. J.

    2011-07-01

    Air samples collected at Cape Grim, Tasmania between 1978 and 2008 and during a series of more recent aircraft sampling programmes have been analysed to determine the atmospheric abundance and trend of octafluorocyclobutane (-C4F8 or PFC-318). c-C4F8 has an atmospheric lifetime in excess of 3000 yr and a global warming potential (GWP) of 10 300 (100 yr time horizon), making it one of the most potent greenhouse gases detected in the atmosphere to date. The abundance of c-C4F8 in the Southern Hemisphere has risen from 0.35 ppt in 1978 to 1.2 ppt in 2010, and is currently increasing at a rate of around 0.03 ppt yr-1. It is the third most abundant perfluorocarbon (PFC) in the present day atmosphere, behind CF4 (~75 ppt) and C2F6 (~4 ppt). The origin of c-C4F8 is unclear. Using a 2-D global model to derive top-down global emissions based on the Cape Grim measurements yields a recent (2007) emission rate of around 1.1 Gg yr-1 and a cumulative emission up to and including 2007 of 38.1 Gg. Emissions reported on the EDGAR emissions database for the period 1986-2005 represent less than 1 % of the top-down emissions for the same period, which suggests there is a large unaccounted for source of this compound. It is also apparent that the magnitude of this source has varied considerably over the past 30 yr, declining sharply in the late 1980s before increasing again in the mid-1990s.

  8. The Small GTPase Rac1 Contributes to Extinction of Aversive Memories of Drug Withdrawal by Facilitating GABAA Receptor Endocytosis in the vmPFC.

    PubMed

    Wang, Weisheng; Ju, Yun-Yue; Zhou, Qi-Xin; Tang, Jian-Xin; Li, Meng; Zhang, Lei; Kang, Shuo; Chen, Zhong-Guo; Wang, Yu-Jun; Ji, Hui; Ding, Yu-Qiang; Xu, Lin; Liu, Jing-Gen

    2017-07-26

    Extinction of aversive memories has been a major concern in neuropsychiatric disorders, such as anxiety disorders and drug addiction. However, the mechanisms underlying extinction of aversive memories are not fully understood. Here, we report that extinction of conditioned place aversion (CPA) to naloxone-precipitated opiate withdrawal in male rats activates Rho GTPase Rac1 in the ventromedial prefrontal cortex (vmPFC) in a BDNF-dependent manner, which determines GABA A receptor (GABA A R) endocytosis via triggering synaptic translocation of activity-regulated cytoskeleton-associated protein (Arc) through facilitating actin polymerization. Active Rac1 is essential and sufficient for GABA A R endocytosis and CPA extinction. Knockdown of Rac1 expression within the vmPFC of rats using Rac1-shRNA suppressed GABA A R endocytosis and CPA extinction, whereas expression of a constitutively active form of Rac1 accelerated GABA A R endocytosis and CPA extinction. The crucial role of GABA A R endocytosis in the LTP induction and CPA extinction is evinced by the findings that blockade of GABA A R endocytosis by a dynamin function-blocking peptide (Myr-P4) abolishes LTP induction and CPA extinction. Thus, the present study provides first evidence that Rac1-dependent GABA A R endocytosis plays a crucial role in extinction of aversive memories and reveals the sequence of molecular events that contribute to learning experience modulation of synaptic GABA A R endocytosis. SIGNIFICANCE STATEMENT This study reveals that Rac1-dependent GABA A R endocytosis plays a crucial role in extinction of aversive memories associated with drug withdrawal and identifies Arc as a downstream effector of Rac1 regulations of synaptic plasticity as well as learning and memory, thereby suggesting therapeutic targets to promote extinction of the unwanted memories. Copyright © 2017 the authors 0270-6474/17/377096-15$15.00/0.

  9. Kinetic properties and adrenergic control of TREK-2-like channels in rat medial prefrontal cortex (mPFC) pyramidal neurons.

    PubMed

    Ładno, W; Gawlak, M; Szulczyk, P; Nurowska, E

    2017-06-15

    TREK-2-like channels were identified on the basis of electrophysiological and pharmacological tests performed on freshly isolated and enzymatically/mechanically dispersed pyramidal neurons of the rat medial prefrontal cortex (mPFC). Single-channel currents were recorded in cell-attached configuration and the impact of adrenergic receptors (α 1 , α 2 , β) stimulation on spontaneously appearing TREK-2-like channel activity was tested. The obtained results indicate that noradrenaline decreases the mean open probability of TREK-2-like channel currents by activation of β 1 but not of α 1 - and α 2 -adrenergic receptors. Mean open time and channel conductance were not affected. The system of intracellular signaling pathways depends on the activation of protein kinase A. We also show that adrenergic control of TREK-2-like channel currents by adrenergic receptors was similar in pyramidal neurons isolated from young, adolescent, and adult rats. Immunofluorescent confocal scans of mPFC slices confirmed the presence of the TREK-2 protein, which was abundant in layer V pyramidal neurons. The role of TREK-2-like channel control by adrenergic receptors is discussed. Copyright © 2017 Elsevier B.V. All rights reserved.

  10. Dose-response characteristics of methylphenidate on locomotor behavior and on sensory evoked potentials recorded from the VTA, NAc, and PFC in freely behaving rats.

    PubMed

    Yang, Pamela B; Swann, Alan C; Dafny, Nachum

    2006-01-17

    Methylphenidate (MPD) is a psychostimulant commonly prescribed for attention deficit/hyperactivity disorder. The mode of action of the brain circuitry responsible for initiating the animals' behavior in response to psychostimulants is not well understood. There is some evidence that psychostimulants activate the ventral tegmental area (VTA), nucleus accumbens (NAc), and prefrontal cortex (PFC). The present study was designed to investigate the acute dose-response of MPD (0.6, 2.5, and 10.0 mg/kg) on locomotor behavior and sensory evoked potentials recorded from the VTA, NAc, and PFC in freely behaving rats previously implanted with permanent electrodes. For locomotor behavior, adult male Wistar-Kyoto (WKY; n = 39) rats were given saline on experimental day 1 and either saline or an acute injection of MPD (0.6, 2.5, or 10.0 mg/kg, i.p.) on experimental day 2. Locomotor activity was recorded for 2-h post injection on both days using an automated, computerized activity monitoring system. Electrophysiological recordings were also performed in the adult male WKY rats (n = 10). Five to seven days after the rats had recovered from the implantation of electrodes, each rat was placed in a sound-insulated, electrophysiological test chamber where its sensory evoked field potentials were recorded before and after saline and 0.6, 2.5, and 10.0 mg/kg MPD injection. Time interval between injections was 90 min. Results showed an increase in locomotion with dose-response characteristics, while a dose-response decrease in amplitude of the components of sensory evoked field responses of the VTA, NAc, and PFC neurons. For example, the P3 component of the sensory evoked field response of the VTA decreased by 19.8% +/- 7.4% from baseline after treatment of 0.6 mg/kg MPD, 37.8% +/- 5.9% after 2.5 mg/kg MPD, and 56.5% +/- 3.9% after 10 mg/kg MPD. Greater attenuation from baseline was observed in the NAc and PFC. Differences in the intensity of MPD-induced attenuation were also found among

  11. Trajectories of Preparation for Future Care among First-Degree Relatives of Alzheimer's Disease Patients: An Ancillary Study of ADAPT

    ERIC Educational Resources Information Center

    Mak, Wingyun; Sorensen, Silvia

    2012-01-01

    Purpose: This study examines the longitudinal patterns of Preparation for Future Care (PFC), defined as Awareness, Avoidance, Gathering Information, Decision Making, and Concrete Plans, in first-degree relatives of people with Alzheimer's disease (AD). Design and Methods: Eight time points across 6.5 years from a subsample of adults aged 70 years…

  12. Long-term tropospheric trend of octafluorocyclobutane (c-C4F8 or PFC-318)

    NASA Astrophysics Data System (ADS)

    Oram, D. E.; Mani, F. S.; Laube, J. C.; Newland, M. J.; Reeves, C. E.; Sturges, W. T.; Penkett, S. A.; Brenninkmeijer, C. A. M.; Röckmann, T.; Fraser, P. J.

    2012-01-01

    Air samples collected at Cape Grim, Tasmania between 1978 and 2008 and during a series of more recent aircraft sampling programmes have been analysed to determine the atmospheric abundance and trend of octafluorocyclobutane (c-C4F8 or PFC-318). c-C4F8 has an atmospheric lifetime in excess of 3000 yr and a global warming potential (GWP) of 10 300 (100 yr time horizon), making it one of the most potent greenhouse gases detected in the atmosphere to date. The abundance of c-C4F8 in the Southern Hemisphere has risen from 0.35 ppt in 1978 to 1.2 ppt in 2010, and is currently increasing at a rate of around 0.03 ppt yr-1. It is the third most abundant perfluorocarbon (PFC) in the present day atmosphere, behind CF4 (~75 ppt) and C2F6 (~4 ppt). Although a number of potential sources of c-C4F8 have been reported, including the electronics and semi-conductor industries, there remains a large discrepancy in the atmospheric budget. Using a 2-D global model to derive top-down global emissions based on the Cape Grim measurements yields a recent (2007) emission rate of around 1.1 Gg yr-1 and a cumulative emission up to and including 2007 of 38.1 Gg. Emissions reported on the EDGAR emissions database for the period 1986-2005 represent less than 1% of the top-down emissions for the same period, which suggests there is a large unaccounted for source of this compound. It is also apparent that the magnitude of this source has varied considerably over the past 30 yr, declining sharply in the late 1980s before increasing again in the mid-1990s.

  13. The effect of statutory limitations on the authority of substitute decision makers on the care of patients in the intensive care unit: case examples and review of state laws affecting withdrawing or withholding life-sustaining treatment.

    PubMed

    Venkat, Arvind; Becker, Julianna

    2014-01-01

    While the ethics and critical care literature is replete with discussion of medical futility and the ethics of end-of-life care decisions in the intensive care unit, little attention is paid to the effect of statutory limitations on the authority of substitute decision makers during the course of treatment of patients in the critical care setting. In many jurisdictions, a clear distinction is made between the authority of a health care power of attorney, who is legally designated by a competent adult to make decisions regarding withholding or withdrawing life-sustaining treatment, and of next-of-kin, who are limited in this regard. However, next-of-kin are often relied upon to consent to necessary procedures to advance a patient's medical care. When conflicts arise between critical care physicians and family members regarding projected patient outcome and functional status, these statutory limitations on decision-making authority by next of kin can cause paralysis in the medical care of severely ill patients, leading to practical and ethical impasses. In this article, we will provide case examples of how statutory limitations on substitute decision making authority for next of kin can impede the care of patients. We will also review the varying jurisdictional limitations on the authority of substitute decision makers and explore their implications for patient care in the critical care setting. Finally, we will review possible ethical and legal solutions to resolve these impasses.

  14. Previous Institutionalization Is Followed by Broader Amygdala-Hippocampal-PFC Network Connectivity during Aversive Learning in Human Development.

    PubMed

    Silvers, Jennifer A; Lumian, Daniel S; Gabard-Durnam, Laurel; Gee, Dylan G; Goff, Bonnie; Fareri, Dominic S; Caldera, Christina; Flannery, Jessica; Telzer, Eva H; Humphreys, Kathryn L; Tottenham, Nim

    2016-06-15

    Early institutional care can be profoundly stressful for the human infant, and, as such, can lead to significant alterations in brain development. In animal models, similar variants of early adversity have been shown to modify amygdala-hippocampal-prefrontal cortex development and associated aversive learning. The current study examined this rearing aberration in human development. Eighty-nine children and adolescents who were either previously institutionalized (PI youth; N = 46; 33 females and 13 males; age range, 7-16 years) or were raised by their biological parents from birth (N = 43; 22 females and 21 males; age range, 7-16 years) completed an aversive-learning paradigm while undergoing functional neuroimaging, wherein visual cues were paired with either an aversive sound (CS+) or no sound (CS-). For the PI youth, better aversive learning was associated with higher concurrent trait anxiety. Both groups showed robust learning and amygdala activation for CS+ versus CS- trials. However, PI youth also exhibited broader recruitment of several regions and increased hippocampal connectivity with prefrontal cortex. Stronger connectivity between the hippocampus and ventromedial PFC predicted significant improvements in future anxiety (measured 2 years later), and this was particularly true within the PI group. These results suggest that for humans as well as for other species, early adversity alters the neurobiology of aversive learning by engaging a broader prefrontal-subcortical circuit than same-aged peers. These differences are interpreted as ontogenetic adaptations and potential sources of resilience. Prior institutionalization is a significant form of early adversity. While nonhuman animal research suggests that early adversity alters aversive learning and associated neurocircuitry, no prior work has examined this in humans. Here, we show that youth who experienced prior institutionalization, but not comparison youth, recruit the hippocampus during aversive

  15. 14 CFR 158.25 - Applications.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... PASSENGER FACILITY CHARGES (PFC'S) Application and Approval § 158.25 Applications. (a) General. This section specifies the information the public agency must file when applying for authority to impose a PFC and for authority to use PFC revenue on a project. A public agency may apply for such authority at any commercial...

  16. 14 CFR 158.25 - Applications.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... PASSENGER FACILITY CHARGES (PFC'S) Application and Approval § 158.25 Applications. (a) General. This section specifies the information the public agency must file when applying for authority to impose a PFC and for authority to use PFC revenue on a project. A public agency may apply for such authority at any commercial...

  17. 14 CFR 158.25 - Applications.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... PASSENGER FACILITY CHARGES (PFC'S) Application and Approval § 158.25 Applications. (a) General. This section specifies the information the public agency must file when applying for authority to impose a PFC and for authority to use PFC revenue on a project. A public agency may apply for such authority at any commercial...

  18. 14 CFR 158.25 - Applications.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... PASSENGER FACILITY CHARGES (PFC'S) Application and Approval § 158.25 Applications. (a) General. This section specifies the information the public agency must file when applying for authority to impose a PFC and for authority to use PFC revenue on a project. A public agency may apply for such authority at any commercial...

  19. Patient perceptions in New Mexico about doctors of chiropractic functioning as primary care providers with limited prescriptive authority

    PubMed Central

    Lehman, James J.; Suozzi, Paul J.; Simmons, George R.; Jegtvig, Shereen K.

    2011-01-01

    Objectives The purpose of this study was to determine chiropractic patients' perceptions of chiropractors serving as primary care providers and having a limited prescriptive authority. Methods Four doctors of chiropractic in Albuquerque and Santa Fe, NM, participated in surveying their patients during the summer of 2008. The chiropractors distributed the questionnaires consecutively to chiropractic patients. Patients answered questions regarding their perceptions of their chiropractors, use of chiropractic care, and medications for pain. The participating chiropractors collected the completed patient questionnaires and mailed them to the primary investigator. Results The chiropractic providers collected 275 chiropractic patient questionnaires. The number of patient questionnaires collected by each of the 4 participating chiropractors ranged from 35 to 100. The patients primarily sought care for the management and treatment of pain (98.5%), and 57.5% considered that their chiropractors were “primary care providers.” Eighty-five percent preferred that their chiropractor be qualified to prescribe medications and provide hands-on treatment, whereas 97.5% perceived their chiropractors to be chiropractic physicians. Conclusions This small group of chiropractic patients from 4 offices in New Mexico perceived that their doctors of chiropractic were physicians and primary care providers, and 85% preferred that their chiropractor treat patients with limited prescriptive authority when appropriately trained. PMID:22027203

  20. Dissociable roles of medial and lateral PFC in rule learning.

    PubMed

    Cao, Bihua; Li, Wei; Li, Fuhong; Li, Hong

    2016-11-01

    Although the neural basis of rule learning is of great interest to cognitive neuroscientists, the pattern of transient brain activation during rule discovery remains to be investigated. In this study, we measured event-related functional magnetic resonance imaging (fMRI) during distinct phases of rule learning. Twenty-one healthy human volunteers were presented with a series of cards, each containing a clock-like display of 12 circles numbered sequentially. Participants were instructed that a fictitious animal would move from one circle to another either in a regular pattern (according to a rule hidden in consecutive trials) or randomly. Participants were then asked to judge whether a given step followed a rule. While the rule-search phase evoked more activation in the posterior lateral prefrontal cortex (LPFC), the rule-following phase caused stronger activation in the anterior medial prefrontal cortex (MPFC). Importantly, the intermediate phase, the rule-discovery phase evoked more activations in MPFC and dorsal anterior cingulate cortex (dACC) than rule search, and more activations in LPFC than rule following. Therefore, we can conclude that the medial and lateral PFC have dissociable contributions in rule learning.

  1. A view from Riggs: treatment resistance and patient authority--VIII. Standards of care and patient autonomy.

    PubMed

    Charles, Marilyn

    2008-01-01

    The therapeutic community at the Austen Riggs Center relies on patient authority to preserve the open setting. Patients' willingness to take on the challenges and responsibilities of citizenship makes it possible to work without bars or locks. Most patients arrive having been labeled "treatment resistant," a label that can connote noncompliance but can also mark the complexity of the trouble and a resistance to being objectified in ways that are dehumanizing. Respect for this complexity can at times counter standards of care that define and prescribe ways of viewing patients and attending to their distress that may be simplistic and undermine development. This paper will explore how current ideas about standards of care may insufficiently take into account the importance of the patient's authority--and the therapist's standards--in helping an individual to make sense of life and experience, and how facing this dilemma head on can reduce resistance.

  2. A PFC3D-based numerical simulation of cutting load for lunar rock simulant and experimental validation

    NASA Astrophysics Data System (ADS)

    Li, Peng; Jiang, Shengyuan; Tang, Dewei; Xu, Bo

    2017-05-01

    For sake of striking a balance between the need of drilling efficiency and the constrains of power budget on the moon, the penetrations per revolution of drill bit are generally limited in the range around 0.1 mm, and besides the geometric angle of the cutting blade need to be well designed. This paper introduces a simulation approach based on PFC3D (particle flow code 3 dimensions) for analyzing the cutting load feature on lunar rock simulant, which is derived from different geometric-angle blades with a small cutting depth. The mean values of the cutting force of five blades in the survey region (four on the boundary points and one on the center point) are selected as the macroscopic responses of model. The method of experimental design which includes Plackett-Burman (PB) design and central composite design (CCD) method is adopted in the matching procedure of microparameters in PFC model. Using the optimization method of enumeration, the optimum set of microparameters is acquired. Then, the experimental validation is implemented by using other twenty-five blades with different geometric angles, and the results from both simulations and laboratory tests give fair agreements. Additionally, the rock breaking process cut by different blades are quantified from simulation analysis. This research provides the theoretical support for the refinement of the rock cutting load prediction and the geometric design of cutting blade on the drill bit.

  3. The case for full practice authority.

    PubMed

    Holmes, Olivia; Kinsey-Weathers, Shanieka

    2016-03-01

    The Institute of Medicine (IOM) recommended in its 2010 report on the future of nursing that advanced practice registered nurses (APRNs) should factor prominently in providing care to the millions of Americans who access healthcare services under the Affordable Care Act (ACA). The IOM also recommended that APRNs practice to the full extent of their education and training.However, many states have laws in place that limit full practice authority for APRNs, specifically NPs, in providing basic health services such as primary care. These laws place restrictions on independent practice and Medicaid and Medicare reimbursement, which prevent nurses from “responding effectively to rapidly changing health care settings and an evolving health care system.” Less than half of the United States has adopted full practice authority licensure and practice laws (see APRN practice authority at a glance). This article discusses how the primary care needs of millions of Americans can be met by granting full practice authority to APRNs nationwide and provides evidence to support the high level of care these practitioners can provide independently.

  4. Combustion Control System Design of Diesel Engine via ASPR based Output Feedback Control Strategy with a PFC

    NASA Astrophysics Data System (ADS)

    Mizumoto, Ikuro; Tsunematsu, Junpei; Fujii, Seiya

    2016-09-01

    In this paper, a design method of an output feedback control system with a simple feedforward input for a combustion model of diesel engine will be proposed based on the almost strictly positive real-ness (ASPR-ness) of the controlled system for a combustion control of diesel engines. A parallel feedforward compensator (PFC) design scheme which renders the resulting augmented controlled system ASPR will also be proposed in order to design a stable output feedback control system for the considered combustion model. The effectiveness of our proposed method will be confirmed through numerical simulations.

  5. Unity Power Factor Operated PFC Converter Based Power Supply for Computers

    NASA Astrophysics Data System (ADS)

    Singh, Shikha; Singh, Bhim; Bhuvaneswari, G.; Bist, Vashist

    2017-11-01

    Power Supplies (PSs) employed in personal computers pollute the single phase ac mains by drawing distorted current at a substandard Power Factor (PF). The harmonic distortion of the supply current in these personal computers are observed 75% to 90% with the Crest Factor (CF) being very high which escalates losses in the distribution system. To find a tangible solution to these issues, a non-isolated PFC converter is employed at the input of isolated converter that is capable of improving the input power quality apart from regulating the dc voltage at its output. This is given to the isolated stage that yields completely isolated and stiffly regulated multiple output voltages which is the prime requirement of computer PS. The operation of the proposed PS is evaluated under various operating conditions and the results show improved performance depicting nearly unity PF and low input current harmonics. The prototype of this PS is developed in laboratory environment and test results are recorded which corroborate the power quality improvement observed in simulation results under various operating conditions.

  6. TRICARE; Changes included in the John Warner National Defense Authorization Act for Fiscal Year 2007; authorization of anesthesia and other costs for dental care for children and certain other patients. Final rule.

    PubMed

    2007-09-25

    This final rule implements section 702 of the John Warner National Defense Authorization Act for Fiscal Year 2007, Public Law 109-364. The rule provides coverage of contracted medical care with respect to dental care beyond that care required as a necessary adjunct to medical or surgical treatment. The entitlement of institutional and anesthesia services is authorized in conjunction with non-covered dental treatment for patients with developmental, mental, or physical disabilities or for pediatric patients age 5 or under. This final rule does not eliminate any contracted medical care that is currently covered for spouses and children. The entitlement of anesthesia services includes general anesthesia services only. Institutional services include institutional benefits associated with both hospital and in-out surgery settings. Patients with developmental, mental, or physical disabilities are those patients with conditions that prohibit dental treatment in a safe and effective manner. Therefore, it is medically or psychologically necessary for these patients to require general anesthesia for dental treatment.

  7. Overall behaviour of PFC integrated SST-1 vacuum system

    NASA Astrophysics Data System (ADS)

    Khan, Ziauddin; Raval, Dilip C.; Paravasu, Yuvakiran; Semwal, Pratibha; Dhanani, Kalpeshkumar R.; George, Siju; Shoaib, Mohammad; Prakash, Arun; Babu, Gattu R.; Thankey, Prashant; Pathan, Firozkhan S.; Pradhan, Subrata

    2017-04-01

    As a part of phase-I up-gradation of Steady-state Superconducting Tokamak (SST-1), Graphite Plasma Facing Components (PFCs) have been integrated inside SST-1 vacuum vessel as a first wall (FW) during Nov 14 and May 2015. The SST-1 FW has a total surface area of the installed PFCs exposed to plasma is ∼ 40 m2 which is nearly 50% of the total surface area of stainless steel vacuum chamber (∼75 m2). The volume of the vessel within the PFCs is ∼ 16 m3. After the integration of PFCs, the entire vessel as well as the PFC cooling/baking circuits has been qualified with an integrated helium leak tightness of < 1.0 x 10-8 mbar 1/s. The pumping system of the SST-1 vacuum vessel comprises of one number of Roots’ pump, four numbers of turbomolecular pumps and a cryopump. After the initial pump down, the PFCs were baked at 250 °C for nearly 20 hours employing hot nitrogen gas to remove the absorbed water vapours. Thereafter, Helium glow discharges cleaning were carried out towards the removal of surface impurities. The pump down characteristics of SST-1 vacuum chamber and the changes in the residual gaseous impurities after the installation of the PFCs will be discussed in this paper.

  8. What can local authorities do to improve the social care-related quality of life of older adults living at home? Evidence from the Adult Social Care Survey.

    PubMed

    van Leeuwen, K M; Malley, J; Bosmans, J E; Jansen, A P D; Ostelo, R W; van der Horst, H E; Netten, A

    2014-09-01

    Local authorities spend considerable resources on social care at home for older adults. Given the expected growth in the population of older adults and budget cuts on local government, it is important to find efficient ways of maintaining and improving the quality of life of older adults. The ageing in place literature suggests that policies in other functions of local authorities may have a significant role to play. This study aims to examine the associations between social care-related quality of life (SCRQoL) in older adults and three potential policy targets for local authorities: (i) accessibility of information and advice, (ii) design of the home and (iii) accessibility of the local area. We used cross-sectional data from the English national Adult Social Care Survey (ASCS) 2010/2011 on service users aged 65 years and older and living at home (N=29,935). To examine the association between SCRQoL, as measured by the ASCOT, and three single-item questions about accessibility of information, design of the home and accessibility of the local area, we estimate linear and quantile regression models. After adjusting for physical and mental health factors and other confounders our findings indicate that SCRQoL is significantly lower for older adults who find it more difficult to find information and advice, for those who report that their home design is inappropriate for their needs and for those who find it more difficult to get around their local area. In addition, these three variables are as strongly associated with SCRQoL as physical and mental health factors. We conclude that in seeking to find ways to maintain and improve the quality of life of social care users living at home, local authorities could look more broadly across their responsibilities. Further research is required to explore the cost-effectiveness of these options compared to standard social care services. Copyright © 2014 Elsevier Ltd. All rights reserved.

  9. Intermittent Ethanol during Adolescence Leads to Lasting Behavioral Changes in Adulthood and Alters Gene Expression and Histone Methylation in the PFC.

    PubMed

    Wolstenholme, Jennifer T; Mahmood, Tariq; Harris, Guy M; Abbas, Shahroze; Miles, Michael F

    2017-01-01

    Adolescents primarily consume alcohol in binges, which can be particularly harmful to the developing frontal cortex and increase risk for an adult alcohol use disorder. We conducted a study investigating immediate and long lasting changes to the prefrontal cortex (PFC) transcriptome to determine the molecular mechanisms underlying adult ethanol behavioral sensitivity following binge ethanol in adolescence. DBA/2J mice were orally dosed with 4 g/kg ethanol intermittently from day 29 to 42. Adolescent mice were tested for anxiety-like behavior and ethanol sensitivity using the loss of righting reflex task. As adults, mice were tested for cognitive changes using the novel object recognition task, ethanol-induced anxiolysis and ethanol sensitivity. Adolescent binge ethanol altered ethanol sensitivity in young mice and led to lasting memory deficits in the object recognition test and greater ethanol sensitivity in adulthood. Using genomic profiling of transcripts in the PFC, we found that binge ethanol reduced myelin-related gene expression and altered chromatin modifying genes involved in histone demethylation at H3K9 and H3K36. We hypothesize that ethanol's actions on histone methylation may be a switch for future transcriptional changes that underlie the behavioral changes lasting into adulthood.

  10. A PFC2D model of the interactions between the tire and the aggregate filled arrester bed on escape ramp

    NASA Astrophysics Data System (ADS)

    Qin, Pin-pin; Chen, Chui-ce; Pei, Shi-kang; Li, Xin

    2017-06-01

    The stopping distance of a runaway vehicle is determined by the entry speed, the design of aggregate-filled arrester bed and the longitudinal grade of escape ramp. Although numerous previous studies have been carried out on the influence of speed and grade on stopping distance, taking into account aggregate properties is rare. Firstly, this paper analyzes the interactions between the tire and the aggregate. The tire and the aggregate are abstracted into a big particle unit and a particle combination unit consisting of lots of aggregates, respectively. Secondly this paper proposes an assumption that this interaction is a kind of particle flow. Later, this paper uses some particle properties to describe the tire-particle unit and aggregate-particle unit respectively, then puts forward several simplified steps of modeling by particle flow code in 2 dimensions (PFC2D). Therefore, a PFC2D micro-simulation model of the interactions between the tire and the aggregate is proposed. The parameters of particle properties are then calibrated by three groups of numerical tests. The calibrated model is verified by eight full-scale arrester bed testing data to demonstrate its feasibility and accuracy. This model provides escape ramp designers a feasible simulation method not only for predicting the stopping distance but also considering the aggregate properties.

  11. Predicting Motivation: Computational Models of PFC Can Explain Neural Coding of Motivation and Effort-based Decision-making in Health and Disease.

    PubMed

    Vassena, Eliana; Deraeve, James; Alexander, William H

    2017-10-01

    Human behavior is strongly driven by the pursuit of rewards. In daily life, however, benefits mostly come at a cost, often requiring that effort be exerted to obtain potential benefits. Medial PFC (MPFC) and dorsolateral PFC (DLPFC) are frequently implicated in the expectation of effortful control, showing increased activity as a function of predicted task difficulty. Such activity partially overlaps with expectation of reward and has been observed both during decision-making and during task preparation. Recently, novel computational frameworks have been developed to explain activity in these regions during cognitive control, based on the principle of prediction and prediction error (predicted response-outcome [PRO] model [Alexander, W. H., & Brown, J. W. Medial prefrontal cortex as an action-outcome predictor. Nature Neuroscience, 14, 1338-1344, 2011], hierarchical error representation [HER] model [Alexander, W. H., & Brown, J. W. Hierarchical error representation: A computational model of anterior cingulate and dorsolateral prefrontal cortex. Neural Computation, 27, 2354-2410, 2015]). Despite the broad explanatory power of these models, it is not clear whether they can also accommodate effects related to the expectation of effort observed in MPFC and DLPFC. Here, we propose a translation of these computational frameworks to the domain of effort-based behavior. First, we discuss how the PRO model, based on prediction error, can explain effort-related activity in MPFC, by reframing effort-based behavior in a predictive context. We propose that MPFC activity reflects monitoring of motivationally relevant variables (such as effort and reward), by coding expectations and discrepancies from such expectations. Moreover, we derive behavioral and neural model-based predictions for healthy controls and clinical populations with impairments of motivation. Second, we illustrate the possible translation to effort-based behavior of the HER model, an extended version of PRO

  12. Arcing and its role in PFC erosion and dust production in DIII-D

    NASA Astrophysics Data System (ADS)

    Rudakov, D. L.; Chrobak, C. P.; Doerner, R. P.; Krasheninnikov, S. I.; Moyer, R. A.; Umstadter, K. R.; Wampler, W. R.; Wong, C. P. C.

    2013-07-01

    Two types of arc tracks are observed on the plasma-facing components (PFCs) in DIII-D. "Unmagnetized" random walk tracks are produced during glow discharges; they are rare and have no importance for PFC erosion but may degrade diagnostic mirrors. "Magnetized" scratch-like type II tracks are produced by unipolar arcs during plasma operations; they are formed by "retrograde BxJ" motion of the cathode spot and are roughly perpendicular to the local magnetic field. Type II arcs cause measurable erosion of graphite, but based on the evidence available they are relatively small contributors to the total erosion of carbon in DIII-D compared to other mechanisms such as physical and chemical sputtering and ablation from leading edges. Erosion by arcing of tungsten films deposited on graphite samples was observed in Divertor Material Evaluation System (DiMES) experiments. New DiMES experiments aimed at time-resolved arc measurements are proposed.

  13. Academic Underachievement and Exclusion of People Who Have Been Looked after in Local Authority Care

    ERIC Educational Resources Information Center

    Mallon, James

    2005-01-01

    Although higher education for 50% of all school leavers by 2010 is the stated aim of the United Kingdom government, it is clear that initiatives aimed at widening access do not reach those most in need. This is nowhere more true than in the case of people who have spent all or part of their childhood in the care of local authorities, and who…

  14. Baclofen ameliorates spatial working memory impairments induced by chronic cerebral hypoperfusion via up-regulation of HCN2 expression in the PFC in rats.

    PubMed

    Luo, Pan; Chen, Cheng; Lu, Yun; Fu, TianLi; Lu, Qing; Xu, Xulin; Li, Changjun; He, Zhi; Guo, Lianjun

    2016-07-15

    Chronic cerebral hypoperfusion (CCH) causes memory deficits and increases the risk of vascular dementia (VD) through several biologically plausible pathways. However, whether CCH causes prefrontal cortex (PFC)-dependent spatial working memory impairments and Baclofen, a GABAB receptor agonist, could ameliorate the impairments is still not clear especially the mechanisms underlying the process. In this study, rats were subjected to permanent bilateral occlusion of the common carotid arteries (two-vessel occlusion, 2VO) to induce CCH. Two weeks later, rats were treated with 25mg/kg Baclofen (intraperitioneal injection, i.p.) for 3 weeks. Spatial working memory was evaluated in a Morris water maze using a modified delayed matching-to-place (DMP) procedure. Western blotting and immunohistochemistry were used to quantify the protein levels and protein localization. Our results showed that 2VO caused striking spatial working memory impairments, accompanied with a decreased HCN2 expression in PFC, but the protein levels of protein gene product 9.5 (PGP9.5, a neuron specific protein), glial fibrillary acidic protein (GFAP), synaptophysin (SYP), brain-derived neurotrophic factor (BDNF), parvalbumin (PV) and HCN1 were not distinguishably changed as compared with sham-operated rats. Baclofen treatment significantly improved the spatial working memory impairments caused by 2VO, accompanied with a reversion of 2VO-induced down-regulation of HCN2. Furthermore, there was a co-localization of HCN2 subunits and parvalbumin-positive neurons in PFC. Therefore, HCN2 may target inhibitory interneurons that is implicated in working memory processes, which may be a possible mechanism of the up-regulation of HCN2 by Baclofen treatment that reliefs spatial working memory deficits in rats with CCH. Copyright © 2016 Elsevier B.V. All rights reserved.

  15. Photocatalytic fuel cell (PFC) and dye self-photosensitization photocatalytic fuel cell (DSPFC) with BiOCl/Ti photoanode under UV and visible light irradiation.

    PubMed

    Li, Kan; Xu, Yunlan; He, Yi; Yang, Chen; Wang, Yalin; Jia, Jinping

    2013-04-02

    A fuel cell that functioned as a photo fuel cell (PFC) when irradiated with UV light and as a dye self-photosensitization photo fuel cell (DSPFC) when irradiated with visible light was proposed and investigated in this study. The system included a BiOCl/Ti plate photoanode and a Pt cathode, and dye solutions were employed as fuel. Electricity was generated at the same time as the dyes were degraded. 26.2% and 24.4% Coulombic efficiency were obtained when 20 mL of 10 mg · L(-1) Rhodamine B solution was treated with UV for 2 h and visible light for 3 h, respectively. Irradiation with natural and artificial sunlight was also evaluated. UV and visible light could be utilized at the same time and the photogenerated current was observed. The mechanism of electricity generation in BiOCl/Ti PFC and DSPFC was studied through degradation of the colorless salicylic acid solution. Factors that affect the electricity generation and dye degradation performance, such as solution pH and cathode material, were also investigated and optimized.

  16. Transformation management of primary health care services in two selected local authorities in Gauteng.

    PubMed

    Sibaya, W; Muller, M

    2000-12-01

    The transformation of health services in South Africa today is governed by the political, policy and legislative frameworks. This article focuses on the transformation of a primary health care service within a local authority in Gauteng. The purpose with this article is to explore and describe the perceptions (expectations and fears) of selected managers employed in this primary health care service. The results are utilised to compile a strategy (framework) for transformation management and leadership within the primary health care service. A qualitative research design was utilised and the data was collected by means of individual interviews with selected managers in the service, followed by a content analysis. The expectations and fears of managers focus mainly on personnel matters, community participation/satisfaction, salaries and parity, inadequate stocks/supplies and medication, the deterioration of quality service delivery and the need for training and empowerment. These results are divided into structure, process and outcome dimensions and are embodied in the conceptual framework for the transformation and leadership strategy. It is recommended that standards for transformation management be formulated and that the quality of transformation management be evaluated accordingly.

  17. The theta burst transcranial magnetic stimulation over the right PFC affects electroencephalogram oscillation during emotional processing.

    PubMed

    Cao, Dan; Li, Yingjie; Niznikiewicz, Margaret A; Tang, Yingying; Wang, Jijun

    2018-03-02

    Prefrontal cortex (PFC) plays an important role in emotional processing and therefore is one of the most frequently targeted regions for non-invasive brain stimulation such as repetitive transcranial magnetic stimulation (rTMS) in clinical trials, especially in the treatment of emotional disorders. As an approach to enhance the effectiveness of rTMS, continuous theta burst stimulation (cTBS) has been demonstrated to be efficient and safe. However, it is unclear how cTBS affects brain processes related to emotion. In particular, psychophysiological studies on the underlying neural mechanisms are sparse. In the current study, we investigated how the cTBS influences emotional processing when applied over the right PFC. Participants performed an emotion recognition Go/NoGo task, which asked them to select a GO response to either happy or fearful faces after the cTBS or after sham stimulation, while 64-channel electroencephalogram (EEG) was recorded. EEG oscillation was examined using event-related spectral perturbation (ERSP) in a time-interval between 170 and 310ms after face stimuli onset. In the sham group, we found a significant difference in the alpha band between response to happy and fearful stimuli but that effect did not exist in the cTBS group. The alpha band activity at the scalp was reduced suggesting the excitatory effect at the brain level. The beta and gamma band activity was not sensitive to cTBS intervention. The results of the current study demonstrate that cTBS does affect emotion processing and the effect is reflected in changes in EEG oscillations in the alpha band specifically. The results confirm the role of prefrontal cortex in emotion processing. We also suggest that this pattern of cTBS results elucidates mechanisms by which mood improvement in depressive disorders is achieved using cTBS intervention. Copyright © 2017 Elsevier Inc. All rights reserved.

  18. Transiently increased glutamate cycling in rat PFC is associated with rapid onset of antidepressant-like effects.

    PubMed

    Chowdhury, G M I; Zhang, J; Thomas, M; Banasr, M; Ma, X; Pittman, B; Bristow, L; Schaeffer, E; Duman, R S; Rothman, D L; Behar, K L; Sanacora, G

    2017-01-01

    Several drugs have recently been reported to induce rapid antidepressant effects in clinical trials and rodent models. Although the cellular mechanisms involved remain unclear, reports suggest that increased glutamate transmission contributes to these effects. Here, we demonstrate that the antidepressant-like efficacy of three unique drugs, with reported rapid onset antidepressant properties, is coupled with a rapid transient rise in glutamate cycling in the medial prefronal cortex (mPFC) of awake rats as measured by ex vivo 1 H-[ 13 C]-nuclear magnetic resonance spectroscopy. Rats were acutely pretreated by intraperitoneal injection with a single dose of ketamine (1, 3, 10, 30 and 80 mg kg -1 ), Ro 25-6981 (1, 3 and 10 mg kg -1 ), scopolamine (5, 25 and 100 μg kg -1 ) or vehicle (controls). At fixed times after drug injection, animals received an intravenous infusion of [1,6- 13 C 2 ]glucose for 8 min to enrich the amino-acid pools of the brain with 13 C, followed by rapid euthanasia. The mPFC was dissected, extracted with ethanol and metabolite 13 C enrichments were measured. We found a clear dose-dependent effect of ketamine and Ro 25-6981 on behavior and the percentage of 13 C enrichment of glutamate, glutamine and GABA (γ-aminobutyric acid). Further, we also found an effect of scopolamine on both cycling and behavior. These studies demonstrate that three pharmacologically distinct classes of drugs, clinically related through their reported rapid antidepressant actions, share the common ability to rapidly stimulate glutamate cycling at doses pertinent for their antidepressant-like efficacy. We conclude that increased cycling precedes the antidepressant action at behaviorally effective doses and suggest that the rapid change in cycling could be used to predict efficacy of novel agents or identify doses with antidepressant activity.

  19. Control of high-Z PFC erosion by local gas injection in DIII-D

    NASA Astrophysics Data System (ADS)

    Rudakov, D. L.; Stangeby, P. C.; Wong, C. P. C.; McLean, A. G.; Wampler, W. R.; Watkins, J. G.; Boedo, J. A.; Briesemeister, A.; Buchenauer, D. A.; Chrobak, C. P.; Elder, J. D.; Fenstermacher, M. E.; Guo, H. Y.; Lasnier, C. J.; Leonard, A. W.; Maingi, R.; Moyer, R. A.

    2015-08-01

    Reduced erosion of a high-Z PFC divertor surface was observed in DIII-D with local injection of methane and deuterium gases. Molybdenum-coated silicon samples were exposed in the lower divertor of DIII-D using DiMES under plasma conditions previously shown to cause significant net erosion of Mo. Three exposures with 13CH4 and one exposure with D2 gas injection about 12 cm upstream of the samples located within 1-2 cm of the attached strike point were performed. Reduction of Mo erosion was evidenced in-situ by the suppression of MoI line radiation at 386.4 nm once the gas injection started. Post-mortem ion beam analysis demonstrated that the net erosion of molybdenum near the center of the samples exposed with 13CH4 injection was below the measurement resolution of 0.5 nm, corresponding to a rate of ⩽0.04 nm/s. Compared to the previously measured erosion rates, this constitutes a reduction by a factor of >10.

  20. Intermittent Ethanol during Adolescence Leads to Lasting Behavioral Changes in Adulthood and Alters Gene Expression and Histone Methylation in the PFC

    PubMed Central

    Wolstenholme, Jennifer T.; Mahmood, Tariq; Harris, Guy M.; Abbas, Shahroze; Miles, Michael F.

    2017-01-01

    Adolescents primarily consume alcohol in binges, which can be particularly harmful to the developing frontal cortex and increase risk for an adult alcohol use disorder. We conducted a study investigating immediate and long lasting changes to the prefrontal cortex (PFC) transcriptome to determine the molecular mechanisms underlying adult ethanol behavioral sensitivity following binge ethanol in adolescence. DBA/2J mice were orally dosed with 4 g/kg ethanol intermittently from day 29 to 42. Adolescent mice were tested for anxiety-like behavior and ethanol sensitivity using the loss of righting reflex task. As adults, mice were tested for cognitive changes using the novel object recognition task, ethanol-induced anxiolysis and ethanol sensitivity. Adolescent binge ethanol altered ethanol sensitivity in young mice and led to lasting memory deficits in the object recognition test and greater ethanol sensitivity in adulthood. Using genomic profiling of transcripts in the PFC, we found that binge ethanol reduced myelin-related gene expression and altered chromatin modifying genes involved in histone demethylation at H3K9 and H3K36. We hypothesize that ethanol’s actions on histone methylation may be a switch for future transcriptional changes that underlie the behavioral changes lasting into adulthood. PMID:29018328

  1. Caring Science or Science of Caring.

    PubMed

    Turkel, Marian C; Watson, Jean; Giovannoni, Joseph

    2018-01-01

    The concepts caring science and science of caring have different meanings; however, they are often used interchangeably. The purpose of this paper is to present an overview of the synthesis of the scholarly literature on the definitions of the science of caring and caring science and to affirm the authors' perspective relating to the language of caring science. Caring science advances the epistemology and ontology of caring. Ideas related to caring science inquiry are presented, and the authors acknowledge the future of caring science as unitary caring science.

  2. Effects of adolescent social stress and antidepressant treatment on cognitive inflexibility and Bdnf epigenetic modifications in the mPFC of adult mice.

    PubMed

    Xu, Hang; Wang, Jiesi; Zhang, Ke; Zhao, Mei; Ellenbroek, Bart; Shao, Feng; Wang, Weiwen

    2018-02-01

    Adolescent social stress (ASS) can increase susceptibility to depression in adulthood. However, the underlying psychological and neural mechanisms remain unclear. Cortically mediated cognitive dysfunctions are increasingly recognized as an independent and important risk factor of depression. Using social defeat stress, a classical animal model of depression, our previous studies found that mice subjected to this form of stress during early adolescence displayed cognitive inflexibility (CI) in adulthood. This change was accompanied by a down-regulation of Bdnf gene expression in the medial prefrontal cortex (mPFC); this gene encodes a key molecule involved in depression and antidepressant action. In the present paper, we identified epigenetic modification of Bdnf as a possible mechanism underlying the behavioral and molecular changes. ASS induced a set of depressive phenotypes, including increased social avoidance and CI, as well as reduced levels of total Bdnf and isoform IV but not isoform I or VI transcripts in the mPFC. In parallel with changes in Bdnf gene expression, previously stressed adult mice showed increased levels of dimethylation of histone H3 at lysine K9 (H3K9me2) immediately downstream of the Bdnf IV promoter. On the other hand, no differences were found in trimethylation of histone H3 at lysine K4 (H3K4me3) or in acetylation of histone H3 at lysine K9 (H3K9ac) or at K4 (H3K4ac) in the Bdnf IV promoter. Likewise, no alterations were found in DNA methylation of the Bdnf IV promoter. Additionally, treatment with the chronic antidepressant tranylcypromine reversed Bdnf epigenetic changes and related gene transcription while also reversing CI, but not social avoidance, in previously stressed adult mice. These results suggest that epigenetic changes to the Bdnf gene in the mPFC after adolescent social adversity may be involved in the regulation of cognitive dysfunction in depression and antidepressant action in adulthood. Copyright © 2017 Elsevier Ltd

  3. Particularism in health care: challenging the authority of the aggregate.

    PubMed

    Tanenbaum, Sandra J

    2014-12-01

    In health care, particularism asserts the primacy of the individual case. Moral particularists, such as Jonsen and Toulmin, reject deduction from universal moral principles and instead seek warrants for action from the multiple sources unique to a given patient. Another kind of health care particularism, here referred to as the knowledge of particulars, is offered as a corrective to evidence-based medicine (EBM), its influence on health care practice and policy, and specifically to EBM's reliance on the aggregate. This paper describes the knowledge of particulars and identifies strategies for its legitimation in health care policy and practice. First, the paper documents the ascendancy of the aggregate through EBM's definition of 'what works' in health care. Second, it delineates the limits of health care knowledge based on the analysis of aggregates, not only for the care of individual patients but for the formulation of policies about patient care. Third, the paper analyses prominent rejections of the particular in contemporary health policy discourse and relates them to larger political purposes. Finally, it depicts the knowledge of particulars as the basis for clinical prudence and offers three potential strategies for promoting particularism as essential to high-quality care. © 2014 John Wiley & Sons, Ltd.

  4. Chronic Gestational Stress Leads to Depressive-Like Behavior and Compromises Medial Prefrontal Cortex Structure and Function during the Postpartum Period

    PubMed Central

    Leuner, Benedetta; Fredericks, Peter J.; Nealer, Connor; Albin-Brooks, Christopher

    2014-01-01

    Postpartum depression, which affects approximately 15% of new mothers, is associated with impaired mother-infant interactions and deficits in cognitive function. Exposure to stress during pregnancy is a major risk factor for postpartum depression. However, little is known about the neural consequences of gestational stress. The medial prefrontal cortex (mPFC) is a brain region that has been linked to stress, cognition, maternal care, and mood disorders including postpartum depression. Here we examined the effects of chronic gestational stress on mPFC function and whether these effects might be linked to structural modifications in the mPFC. We found that in postpartum rats, chronic gestational stress resulted in maternal care deficits, increased depressive-like behavior, and impaired performance on an attentional set shifting task that relies on the mPFC. Furthermore, exposure to chronic stress during pregnancy reduced dendritic spine density on mPFC pyramidal neurons and altered spine morphology. Taken together, these findings suggest that pregnancy stress may contribute to postpartum mental illness and its associated symptoms by compromising structural plasticity in the mPFC. PMID:24594708

  5. 75 FR 36099 - Legislative Changes to Primary Care Loan Program Authorized Under Title VII of the Public Health...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-06-24

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES Health Resources and Services Administration Legislative Changes to Primary Care Loan Program Authorized Under Title VII of the Public Health Service Act AGENCY... changes Section 723 of the Public Health Service Act (PHSA) regarding administration of the PCL program...

  6. 32 CFR 564.38 - For whom authorized.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... REGULATIONS Medical Attendance and Burial § 564.38 For whom authorized. (a) In line of duty. Medical care is... of an injury incurred in line of duty. (4) Medical care is not authorized at Army expense for members... is determined to be not in line of duty, may not be furnished medical care at Army expense. (32 U.S.C...

  7. Physicians' Perspectives on Caring for Cognitively Impaired Elders.(author Abstract)

    ERIC Educational Resources Information Center

    Adams, Wendy L.; McIlvain, Helen E.; Geske, Jenenne A.; Porter, Judy L.

    2005-01-01

    Purpose: This study aims to develop ah in-depth understanding of the issues important to primary care physicians in providing care to cognitively impaired elders. Design and Methods: In-depth interviews were conducted with 20 primary care physicians. Text coded as "cognitive impairment" was retrieved and analyzed by use of grounded theory analysis…

  8. Dendritic nonlinearities reduce network size requirements and mediate ON and OFF states of persistent activity in a PFC microcircuit model.

    PubMed

    Papoutsi, Athanasia; Sidiropoulou, Kyriaki; Poirazi, Panayiota

    2014-07-01

    Technological advances have unraveled the existence of small clusters of co-active neurons in the neocortex. The functional implications of these microcircuits are in large part unexplored. Using a heavily constrained biophysical model of a L5 PFC microcircuit, we recently showed that these structures act as tunable modules of persistent activity, the cellular correlate of working memory. Here, we investigate the mechanisms that underlie persistent activity emergence (ON) and termination (OFF) and search for the minimum network size required for expressing these states within physiological regimes. We show that (a) NMDA-mediated dendritic spikes gate the induction of persistent firing in the microcircuit. (b) The minimum network size required for persistent activity induction is inversely proportional to the synaptic drive of each excitatory neuron. (c) Relaxation of connectivity and synaptic delay constraints eliminates the gating effect of NMDA spikes, albeit at a cost of much larger networks. (d) Persistent activity termination by increased inhibition depends on the strength of the synaptic input and is negatively modulated by dADP. (e) Slow synaptic mechanisms and network activity contain predictive information regarding the ability of a given stimulus to turn ON and/or OFF persistent firing in the microcircuit model. Overall, this study zooms out from dendrites to cell assemblies and suggests a tight interaction between dendritic non-linearities and network properties (size/connectivity) that may facilitate the short-memory function of the PFC.

  9. A novel escapable social interaction test reveals that social behavior and mPFC activation during an escapable social encounter are altered by post-weaning social isolation and are dependent on the aggressiveness of the stimulus rat

    PubMed Central

    Goodell, Dayton J.; Ahern, Megan A.; Baynard, Jessica; Wall, Vanessa L.; Bland, Sondra T.

    2016-01-01

    Post-weaning social isolation (PSI) has been shown to increase aggressive behavior and alter medial prefrontal cortex (mPFC) function in social species such as rats. Here we developed a novel escapable social interaction test (ESIT) allowing for the quantification of escape and social behaviors in addition to mPFC activation in response to an aggressive or nonaggressive stimulus rat. Male rats were exposed to 3 weeks of PSI (ISO) or group (GRP) housing, and exposed to 3 trials, with either no trial, all trials, or the last trial only with a stimulus rat. Analysis of social behaviors indicated that ISO rats spent less time in the escape chamber and more time engaged in social interaction, aggressive grooming, and boxing than did GRP rats. Interestingly, during the third trial all rats engaged in more of the quantified social behaviors and spent less time escaping in response to aggressive but not nonaggressive stimulus rats. Rats exposed to nonaggressive stimulus rats on the third trial had greater c-fos and ARC immunoreactivity in the mPFC than those exposed to an aggressive stimulus rat. Conversely, a social encounter produced an increase in large PSD-95 punctae in the mPFC independently of trial number, but only in ISO rats exposed to an aggressive stimulus rat. The results presented here demonstrate that PSI increases interaction time and aggressive behaviors during escapable social interaction, and that the aggressiveness of the stimulus rat in a social encounter is an important component of behavioral and neural outcomes for both isolation and group-reared rats. PMID:27633556

  10. Blonanserin ameliorates phencyclidine-induced visual-recognition memory deficits: the complex mechanism of blonanserin action involving D₃-5-HT₂A and D₁-NMDA receptors in the mPFC.

    PubMed

    Hida, Hirotake; Mouri, Akihiro; Mori, Kentaro; Matsumoto, Yurie; Seki, Takeshi; Taniguchi, Masayuki; Yamada, Kiyofumi; Iwamoto, Kunihiro; Ozaki, Norio; Nabeshima, Toshitaka; Noda, Yukihiro

    2015-02-01

    Blonanserin differs from currently used serotonin 5-HT₂A/dopamine-D₂ receptor antagonists in that it exhibits higher affinity for dopamine-D₂/₃ receptors than for serotonin 5-HT₂A receptors. We investigated the involvement of dopamine-D₃ receptors in the effects of blonanserin on cognitive impairment in an animal model of schizophrenia. We also sought to elucidate the molecular mechanism underlying this involvement. Blonanserin, as well as olanzapine, significantly ameliorated phencyclidine (PCP)-induced impairment of visual-recognition memory, as demonstrated by the novel-object recognition test (NORT) and increased extracellular dopamine levels in the medial prefrontal cortex (mPFC). With blonanserin, both of these effects were antagonized by DOI (a serotonin 5-HT₂A receptor agonist) and 7-OH-DPAT (a dopamine-D₃ receptor agonist), whereas the effects of olanzapine were antagonized by DOI but not by 7-OH-DPAT. The ameliorating effect was also antagonized by SCH23390 (a dopamine-D₁ receptor antagonist) and H-89 (a protein kinase A (PKA) inhibitor). Blonanserin significantly remediated the decrease in phosphorylation levels of PKA at Thr(197) and of NR1 (an essential subunit of N-methyl-D-aspartate (NMDA) receptors) at Ser(897) by PKA in the mPFC after a NORT training session in the PCP-administered mice. There were no differences in the levels of NR1 phosphorylated at Ser(896) by PKC in any group. These results suggest that the ameliorating effect of blonanserin on PCP-induced cognitive impairment is associated with indirect functional stimulation of the dopamine-D₁-PKA-NMDA receptor pathway following augmentation of dopaminergic neurotransmission due to inhibition of both dopamine-D₃ and serotonin 5-HT₂A receptors in the mPFC.

  11. 75 FR 3954 - Agency Information Collection Activity Seeking OMB Approval

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-01-25

    ... (PFC). DATES: Please submit comments by February 24, 2010. FOR FURTHER INFORMATION CONTACT: Carla...: Passenger Facility Charge (PFC) Application. Type of Request: Extension without change of a currently...: 49 U.S.C. 40117 authorizes airports to impose passenger facility charges (PFC). This program requires...

  12. 78 FR 48541 - Agency Information Collection Activities: Requests for Comments; Clearance of Renewed Approval of...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-08-08

    ... Facility Charge (PFC) Application. Form Numbers: FAA Form 5500-1. Type of Review: Renewal of an information collection. Background: 49 U.S.C. 40117 authorizes airports to impose passenger facility charges (PFC). The... Facility Charge (PFC) Application AGENCY: Federal Aviation Administration (FAA), DOT. ACTION: Notice and...

  13. 78 FR 29425 - Agency Information Collection Activities: Requests for Comments; Clearance of Renewed Approval of...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-05-20

    ... Facility Charge (PFC) Application. Form Numbers: FAA Form 5500-1. Type of Review: Renewal of an information collection. Background: 49 U.S.C. 40117 authorizes airports to impose passenger facility charges (PFC). The... Facility Charge (PFC) Application AGENCY: Federal Aviation Administration (FAA), DOT. ACTION: Notice and...

  14. 32 CFR 732.20 - Adjudication authorities.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... DENTAL CARE Medical and Dental Care From Nonnaval Sources § 732.20 Adjudication authorities. (a) General...” (OMA) and for dental care, “offices of dental affairs” (ODA). NAVMEDCOMINST 6010.3 delineates...) Responsibility for dental matters for States in the Northeast Region is vested in: Commander, Naval Medical...

  15. 32 CFR 732.20 - Adjudication authorities.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... DENTAL CARE Medical and Dental Care From Nonnaval Sources § 732.20 Adjudication authorities. (a) General...” (OMA) and for dental care, “offices of dental affairs” (ODA). NAVMEDCOMINST 6010.3 delineates...) Responsibility for dental matters for States in the Northeast Region is vested in: Commander, Naval Medical...

  16. 32 CFR 732.20 - Adjudication authorities.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... DENTAL CARE Medical and Dental Care From Nonnaval Sources § 732.20 Adjudication authorities. (a) General...” (OMA) and for dental care, “offices of dental affairs” (ODA). NAVMEDCOMINST 6010.3 delineates...) Responsibility for dental matters for States in the Northeast Region is vested in: Commander, Naval Medical...

  17. 32 CFR 732.20 - Adjudication authorities.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... DENTAL CARE Medical and Dental Care From Nonnaval Sources § 732.20 Adjudication authorities. (a) General...” (OMA) and for dental care, “offices of dental affairs” (ODA). NAVMEDCOMINST 6010.3 delineates...) Responsibility for dental matters for States in the Northeast Region is vested in: Commander, Naval Medical...

  18. 32 CFR 732.20 - Adjudication authorities.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... DENTAL CARE Medical and Dental Care From Nonnaval Sources § 732.20 Adjudication authorities. (a) General...” (OMA) and for dental care, “offices of dental affairs” (ODA). NAVMEDCOMINST 6010.3 delineates...) Responsibility for dental matters for States in the Northeast Region is vested in: Commander, Naval Medical...

  19. A novel escapable social interaction test reveals that social behavior and mPFC activation during an escapable social encounter are altered by post-weaning social isolation and are dependent on the aggressiveness of the stimulus rat.

    PubMed

    Goodell, Dayton J; Ahern, Megan A; Baynard, Jessica; Wall, Vanessa L; Bland, Sondra T

    2017-01-15

    Post-weaning social isolation (PSI) has been shown to increase aggressive behavior and alter medial prefrontal cortex (mPFC) function in social species such as rats. Here we developed a novel escapable social interaction test (ESIT) allowing for the quantification of escape and social behaviors in addition to mPFC activation in response to an aggressive or nonaggressive stimulus rat. Male rats were exposed to 3 weeks of PSI (ISO) or group (GRP) housing, and exposed to 3 trials, with either no trial, all trials, or the last trial only with a stimulus rat. Analysis of social behaviors indicated that ISO rats spent less time in the escape chamber and more time engaged in social interaction, aggressive grooming, and boxing than did GRP rats. Interestingly, during the third trial all rats engaged in more of the quantified social behaviors and spent less time escaping in response to aggressive but not nonaggressive stimulus rats. Rats exposed to nonaggressive stimulus rats on the third trial had greater c-fos and ARC immunoreactivity in the mPFC than those exposed to an aggressive stimulus rat. Conversely, a social encounter produced an increase in large PSD-95 punctae in the mPFC independently of trial number, but only in ISO rats exposed to an aggressive stimulus rat. The results presented here demonstrate that PSI increases interaction time and aggressive behaviors during escapable social interaction, and that the aggressiveness of the stimulus rat in a social encounter is an important component of behavioral and neural outcomes for both isolation and group-reared rats. Copyright © 2016 Elsevier B.V. All rights reserved.

  20. 14 CFR 158.19 - Requirement for competition plans.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... (CONTINUED) AIRPORTS PASSENGER FACILITY CHARGES (PFC'S) General § 158.19 Requirement for competition plans. (a) Beginning in fiscal year 2001, no public agency may impose a PFC with respect to a covered... to PFC authority approved prior to April 5, 2000. (b) The Administrator will review any plan...

  1. 14 CFR 158.19 - Requirement for competition plans.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... (CONTINUED) AIRPORTS PASSENGER FACILITY CHARGES (PFC'S) General § 158.19 Requirement for competition plans. (a) Beginning in fiscal year 2001, no public agency may impose a PFC with respect to a covered... to PFC authority approved prior to April 5, 2000. (b) The Administrator will review any plan...

  2. 14 CFR 158.19 - Requirement for competition plans.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... (CONTINUED) AIRPORTS PASSENGER FACILITY CHARGES (PFC'S) General § 158.19 Requirement for competition plans. (a) Beginning in fiscal year 2001, no public agency may impose a PFC with respect to a covered... to PFC authority approved prior to April 5, 2000. (b) The Administrator will review any plan...

  3. 14 CFR 158.19 - Requirement for competition plans.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... (CONTINUED) AIRPORTS PASSENGER FACILITY CHARGES (PFC'S) General § 158.19 Requirement for competition plans. (a) Beginning in fiscal year 2001, no public agency may impose a PFC with respect to a covered... to PFC authority approved prior to April 5, 2000. (b) The Administrator will review any plan...

  4. 14 CFR 158.19 - Requirement for competition plans.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... (CONTINUED) AIRPORTS PASSENGER FACILITY CHARGES (PFC'S) General § 158.19 Requirement for competition plans. (a) Beginning in fiscal year 2001, no public agency may impose a PFC with respect to a covered... to PFC authority approved prior to April 5, 2000. (b) The Administrator will review any plan...

  5. Caring to Care: Applying Noddings' Philosophy to Medical Education.

    PubMed

    Balmer, Dorene F; Hirsh, David A; Monie, Daphne; Weil, Henry; Richards, Boyd F

    2016-12-01

    The authors argue that Nel Noddings' philosophy, "an ethic of caring," may illuminate how students learn to be caring physicians from their experience of being in a caring, reciprocal relationship with teaching faculty. In her philosophy, Noddings acknowledges two important contextual continuities: duration and space, which the authors speculate exist within longitudinal integrated clerkships. In this Perspective, the authors highlight core features of Noddings' philosophy and explore its applicability to medical education. They apply Noddings' philosophy to a subset of data from a previously published longitudinal case study to explore its "goodness of fit" with the experience of eight students in the 2012 cohort of the Columbia-Bassett longitudinal integrated clerkship. In line with Noddings' philosophy, the authors' supplementary analysis suggests that students (1) recognized caring when they talked about "being known" by teaching faculty who "cared for" and "trusted" them; (2) responded to caring by demonstrating enthusiasm, action, and responsibility toward patients; and (3) acknowledged that duration and space facilitated caring relations with teaching faculty. The authors discuss how Noddings' philosophy provides a useful conceptual framework to apply to medical education design and to future research on caring-oriented clinical training, such as longitudinal integrated clerkships.

  6. Representational similarity of social and valence information in the medial pFC.

    PubMed

    Chavez, Robert S; Heatherton, Todd F

    2015-01-01

    The human brain is remarkably adept at integrating complex information to form unified psychological representations of agents, objects, and events in the environment. Two domains in which this ability is particularly salient are the processing of social and valence information and are supported by common cortical areas in the medial pFC (MPFC). Because social information is often embedded within valenced emotional contexts, it is possible that activation patterns within the MPFC may represent both of these types of cognitive processes when presented simultaneously. The current study tested this possibility by employing a large-scale automated meta-analysis tool, together with multivoxel pattern analysis to investigate the representational similarity of social and valence information in the MPFC during fMRI. Using a representational similarity analysis, we found a high degree of representational similarity both within social dimensions and within valence dimensions, but not across them (e.g., positive social information was highly dissimilar to negative nonsocial information), in a ventral portion of the MPFC. These results were significantly correlated with a behaviorally measured similarity structure of the same stimuli, suggesting that a psychologically meaningful representation of social and valence information is reflected by multivoxel activation patterns in the ventral MPFC.

  7. Nucleus Accumbens Shell and mPFC but Not Insula Orexin-1 Receptors Promote Excessive Alcohol Drinking

    PubMed Central

    Lei, Kelly; Wegner, Scott A.; Yu, Ji Hwan; Mototake, Arisa; Hu, Bing; Hopf, Frederic W.

    2016-01-01

    Addiction to alcohol remains a major social and economic problem, in part because of the high motivation for alcohol that humans exhibit and the hazardous binge intake this promotes. Orexin-1-type receptors (OX1Rs) promote reward intake under conditions of strong drives for reward, including excessive alcohol intake. While systemic modulation of OX1Rs can alter alcohol drinking, the brain regions that mediate this OX1R enhancement of excessive drinking remain unknown. Given the importance of the nucleus accumbens (NAc) and anterior insular cortex (aINS) in driving many addictive behaviors, including OX1Rs within these regions, we examined the importance of OX1Rs in these regions on excessive alcohol drinking in C57BL/6 mice during limited-access alcohol drinking in the dark cycle. Inhibition of OX1Rs with the widely used SB-334867 within the medial NAc Shell (mNAsh) significantly reduced drinking of alcohol, with no effect on saccharin intake, and no effect on alcohol consumption when infused above the mNAsh. In contrast, intra-mNAsh infusion of the orexin-2 receptor TCS-OX2-29 had no impact on alcohol drinking. In addition, OX1R inhibition within the aINS had no effect on excessive drinking, which was surprising given the importance of aINS-NAc circuits in promoting alcohol consumption and the role for aINS OX1Rs in driving nicotine intake. However, OX1R inhibition within the mPFC did reduce alcohol drinking, indicating cortical OXR involvement in promoting intake. Also, in support of the critical role for mNAsh OX1Rs, SB within the mNAsh also significantly reduced operant alcohol self-administration in rats. Finally, orexin ex vivo enhanced firing in mNAsh neurons from alcohol-drinking mice, with no effect on evoked EPSCs or input resistance; a similar orexin increase in firing without a change in input resistance was observed in alcohol-naïve mice. Taken together, our results suggest that OX1Rs within the mNAsh and mPFC, but not the aINS, play a central role in

  8. 42 CFR 1002.2 - General authority.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 5 2010-10-01 2010-10-01 false General authority. 1002.2 Section 1002.2 Public Health OFFICE OF INSPECTOR GENERAL-HEALTH CARE, DEPARTMENT OF HEALTH AND HUMAN SERVICES OIG AUTHORITIES PROGRAM INTEGRITY-STATE-INITIATED EXCLUSIONS FROM MEDICAID General Provisions § 1002.2 General authority...

  9. A Common Polymorphism in SCN2A Predicts General Cognitive Ability through Effects on PFC Physiology.

    PubMed

    Scult, Matthew A; Trampush, Joey W; Zheng, Fengyu; Conley, Emily Drabant; Lencz, Todd; Malhotra, Anil K; Dickinson, Dwight; Weinberger, Daniel R; Hariri, Ahmad R

    2015-09-01

    Here we provide novel convergent evidence across three independent cohorts of healthy adults (n = 531), demonstrating that a common polymorphism in the gene encoding the α2 subunit of neuronal voltage-gated type II sodium channels (SCN2A) predicts human general cognitive ability or "g." Using meta-analysis, we demonstrate that the minor T allele of a common polymorphism (rs10174400) in SCN2A is associated with significantly higher "g" independent of gender and age. We further demonstrate using resting-state fMRI data from our discovery cohort (n = 236) that this genetic advantage may be mediated by increased capacity for information processing between the dorsolateral PFC and dorsal ACC, which support higher cognitive functions. Collectively, these findings fill a gap in our understanding of the genetics of general cognitive ability and highlight a specific neural mechanism through which a common polymorphism shapes interindividual variation in "g."

  10. Comparing and Contrasting the Cognitive Effects of Hippocampal and Ventromedial Prefrontal Cortex Damage: A Review of Human Lesion Studies.

    PubMed

    McCormick, Cornelia; Ciaramelli, Elisa; De Luca, Flavia; Maguire, Eleanor A

    2018-03-15

    The hippocampus and ventromedial prefrontal cortex (vmPFC) are closely connected brain regions whose functions are still debated. In order to offer a fresh perspective on understanding the contributions of these two brain regions to cognition, in this review we considered cognitive tasks that usually elicit deficits in hippocampal-damaged patients (e.g., autobiographical memory retrieval), and examined the performance of vmPFC-lesioned patients on these tasks. We then took cognitive tasks where performance is typically compromised following vmPFC damage (e.g., decision making), and looked at how these are affected by hippocampal lesions. Three salient motifs emerged. First, there are surprising gaps in our knowledge about how hippocampal and vmPFC patients perform on tasks typically associated with the other group. Second, while hippocampal or vmPFC damage seems to adversely affect performance on so-called hippocampal tasks, the performance of hippocampal and vmPFC patients clearly diverges on classic vmPFC tasks. Third, although performance appears analogous on hippocampal tasks, on closer inspection, there are significant disparities between hippocampal and vmPFC patients. Based on these findings, we suggest a tentative hierarchical model to explain the functions of the hippocampus and vmPFC. We propose that the vmPFC initiates the construction of mental scenes by coordinating the curation of relevant elements from neocortical areas, which are then funneled into the hippocampus to build a scene. The vmPFC then engages in iterative re-initiation via feedback loops with neocortex and hippocampus to facilitate the flow and integration of the multiple scenes that comprise the coherent unfolding of an extended mental event. Copyright © 2017 The Author(s). Published by Elsevier Ltd.. All rights reserved.

  11. Serotonin 1B Receptors Regulate Prefrontal Function by Gating Callosal and Hippocampal Inputs.

    PubMed

    Kjaerby, Celia; Athilingam, Jegath; Robinson, Sarah E; Iafrati, Jillian; Sohal, Vikaas S

    2016-12-13

    Both medial prefrontal cortex (mPFC) and serotonin play key roles in anxiety; however, specific mechanisms through which serotonin might act on the mPFC to modulate anxiety-related behavior remain unknown. Here, we use a combination of optogenetics and synaptic physiology to show that serotonin acts presynaptically via 5-HT1B receptors to selectively suppress inputs from the contralateral mPFC and ventral hippocampus (vHPC), while sparing those from mediodorsal thalamus. To elucidate how these actions could potentially regulate prefrontal circuit function, we infused a 5-HT1B agonist into the mPFC of freely behaving mice. Consistent with previous studies that have optogenetically inhibited vHPC-mPFC projections, activating prefrontal 5-HT1B receptors suppressed theta-frequency mPFC activity (4-12 Hz), and reduced avoidance of anxiogenic regions in the elevated plus maze. These findings suggest a potential mechanism, linking specific receptors, synapses, patterns of circuit activity, and behavior, through which serotonin may regulate prefrontal circuit function, including anxiety-related behaviors. Copyright © 2016 The Author(s). Published by Elsevier Inc. All rights reserved.

  12. P.F.C Sigma® cruciate retaining fixed-bearing versus mobile-bearing knee arthroplasty: a prospective comparative study with minimum 10-year follow-up.

    PubMed

    Riaz, O; Aqil, A; Sisodia, G; Chakrabarty, G

    2017-12-01

    To prospectively compare long-term clinical and radiological outcomes following a cruciate retaining fixed-bearing (FB) and a mobile-bearing (MB) primary total knee replacement (TKR). We prospectively reviewed 113 TKRs in 99 patients (14 bilateral) with a PFC sigma cruciate retaining rotating platform system, at an average follow-up of 11.1 years (range 10-12). Results were contrasted with those from 89 TKRs in 72 patients (17 bilateral) with a PFC sigma cruciate fixed-bearing prosthesis, at an average follow-up of 12.1 years (range 10-14.1). Outcomes collected included pre- and post-operative range of motion, Oxford Knee Scores, complications encountered, as well as radiographical assessments of polyethylene wear. In the MB group, mean Oxford Knee Scores improved from 16 pre-operatively to 42 at final follow-up. The mean range of motion was 115° (75-130). In the FB group, mean Oxford Knee Scores improved from 16.2 pre-operatively to 42.5 at final follow-up. The mean range of motion was 111.2 (80-135) degrees at final follow-up. We failed to elicit an objectively demonstrable clinical difference between the MB- and FB-implanted knees. Similarly, radiological benefits of the MB implants with regard to polyethylene wear were not evident at a minimum 10-year follow-up.

  13. Comparison the performance of carbon plate and Pt-loaded carbon in photocatalytic fuel cell (PFC) process

    NASA Astrophysics Data System (ADS)

    Khalik, Wan Fadhilah; Ong, Soon-An; Ho, Li-Ngee; Voon, Chun-Hong; Wong, Yee-Shian; Yusoff, Nik Athirah; Lee, Sin-Li

    2017-04-01

    The objective of this study is to compare the performance of cathode electrode in photocatalytic fuel cell (PFC) system under UV light irradiation. The initial concentration 10 mg/L of Reactive Black 5 (RB5) with carbon plate (CP) and Pt-loaded carbon (Pt/C) as cathode reduced to 2.052 and 0.549 mg/L, respectively, after 24 h irradiated by UV light. The value for open circuit voltage, Voc, short-circuit current density, Jsc and maximum power density, Pmax for CP was 0.825 V, 0.00035 mA/cm2 and 0.000063 mW/cm2, respectively, meanwhile Voc, Jsc and Pmax for Pt/C was 1.15 V, 0.0015 mA/cm2 and 0.000286 mW/cm2, respectively, by varying external resistor value from 300 kΩ to 10 Ω. The degradation of RB5 and generation of electricity with Pt/C as cathode showed greater performance than CP.

  14. A Halifax Case Study that Offers an Alternative History of Care Provided by Local Authorities under the 1913 Mental Deficiency Act

    ERIC Educational Resources Information Center

    Dale, Pamela

    2014-01-01

    Institutions, and their problems, have traditionally dominated learning disability histories. We know far more about what happened in areas where councils established and/or enthusiastically used local institutions than other places. Local authorities less committed to institutional care must have relied more on family and other carers. This may…

  15. Blonanserin Ameliorates Phencyclidine-Induced Visual-Recognition Memory Deficits: the Complex Mechanism of Blonanserin Action Involving D3-5-HT2A and D1-NMDA Receptors in the mPFC

    PubMed Central

    Hida, Hirotake; Mouri, Akihiro; Mori, Kentaro; Matsumoto, Yurie; Seki, Takeshi; Taniguchi, Masayuki; Yamada, Kiyofumi; Iwamoto, Kunihiro; Ozaki, Norio; Nabeshima, Toshitaka; Noda, Yukihiro

    2015-01-01

    Blonanserin differs from currently used serotonin 5-HT2A/dopamine-D2 receptor antagonists in that it exhibits higher affinity for dopamine-D2/3 receptors than for serotonin 5-HT2A receptors. We investigated the involvement of dopamine-D3 receptors in the effects of blonanserin on cognitive impairment in an animal model of schizophrenia. We also sought to elucidate the molecular mechanism underlying this involvement. Blonanserin, as well as olanzapine, significantly ameliorated phencyclidine (PCP)-induced impairment of visual-recognition memory, as demonstrated by the novel-object recognition test (NORT) and increased extracellular dopamine levels in the medial prefrontal cortex (mPFC). With blonanserin, both of these effects were antagonized by DOI (a serotonin 5-HT2A receptor agonist) and 7-OH-DPAT (a dopamine-D3 receptor agonist), whereas the effects of olanzapine were antagonized by DOI but not by 7-OH-DPAT. The ameliorating effect was also antagonized by SCH23390 (a dopamine-D1 receptor antagonist) and H-89 (a protein kinase A (PKA) inhibitor). Blonanserin significantly remediated the decrease in phosphorylation levels of PKA at Thr197 and of NR1 (an essential subunit of N-methyl-D-aspartate (NMDA) receptors) at Ser897 by PKA in the mPFC after a NORT training session in the PCP-administered mice. There were no differences in the levels of NR1 phosphorylated at Ser896 by PKC in any group. These results suggest that the ameliorating effect of blonanserin on PCP-induced cognitive impairment is associated with indirect functional stimulation of the dopamine-D1-PKA-NMDA receptor pathway following augmentation of dopaminergic neurotransmission due to inhibition of both dopamine-D3 and serotonin 5-HT2A receptors in the mPFC. PMID:25120077

  16. Who Cares for Care Leavers?

    ERIC Educational Resources Information Center

    Askew, Julie; Rodgers, Paul; West, Andrew

    2016-01-01

    This chapter describes a programme of learning and development at the University of Sheffield, United Kingdom, to support looked-after children and care leavers (youth previously provided care outside or beyond family) throughout the student lifecycle. In this context, looked-after children are those cared for by a town/city authority where…

  17. Attitudes toward expanding nurses' authority.

    PubMed

    Kerzman, Hana; Van Dijk, Dina; Eizenberg, Limor; Khaikin, Rut; Phridman, Shoshi; Siman-Tov, Maya; Goldberg, Shoshi

    2015-01-01

    In recent years, an increasing number of care procedures previously under the physician's authority have been placed in the hands of registered nurses. The purpose of this study was to examine the attitudes of nurses towards expanding nurses' authority and the relationships between these attitudes and job satisfaction facets, professional characteristics, and demographics. A cross-sectional study was conducted between 2010 and 2011 in three major medical centers in Israel. Participants included 833 nurses working in 89 departments. Attitudes toward the expansion of nurses' authority were assessed by self-report questionnaire, as well as job satisfaction facets including perception of professional autonomy, nurse-physician working relations, workload and burnout, perceptions of quality of care, and nursing staff satisfaction at work. Nurses reported positive attitudes toward the expansion of nurses' authority and moderate attitudes for interpretation of diagnostic tests in selected situations. The results of multivariate regression analyses demonstrate that the nurses' satisfaction from professional autonomy and work relations were the most influential factors in explaining their attitudes toward the expansion of nurses' authority. In addition, professionally young nurses tend to be more positive regarding changes in nurses' authority. In the Israeli reality of a nurse's shortage, we are witnessing professional transitions toward expansion of the scope of nurses' accountability and decision-making authority. The current research contributes to our understanding of attitudes toward the expansion of nurses' authority among the nursing staffs. The findings indicate the necessity of redefining the scope of nursing practice within the current professional context.

  18. Higher Rate of Revision in PFC Sigma Primary Total Knee Arthroplasty With Mismatch of Femoro-Tibial Component Sizes.

    PubMed

    Young, Simon W; Clarke, Henry D; Graves, Stephen E; Liu, Yen-Liang; de Steiger, Richard N

    2015-05-01

    Total knee arthroplasty (TKA) systems permit a degree of femoro-tibial component size mismatch. The effect of mismatched components on revision rates has not been evaluated in a large study. We reviewed 21,906 fixed-bearing PFC Sigma primary TKAs using the Australian Orthopaedic Association National Joint Replacement Registry, dividing patients into three groups: no femoro-tibial size mismatch, tibial component size > femoral component size, and femoral component > tibial component. Revision rates were higher when the femoral size was greater than the tibia, compared to both equal size (HR = 1.20 (1.00, 1.45), P = 0.047) and to tibial size greater than femoral (HR = 1.60 (1.08, 2.37), P = 0.019). Potential mechanisms to explain these findings include edge loading of polyethylene and increased tibial component stresses. Copyright © 2014 Elsevier Inc. All rights reserved.

  19. 77 FR 70967 - Authorization for Non-VA Medical Services

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-11-28

    ... expand the delivery of healthcare to veterans, VA is, like the rest of the healthcare industry...(a)(2)(B) to expand VA's authority to provide non-VA medical services under the non- VA care... furnished hospital care, nursing home care, domiciliary care, or medical services and who requires medical...

  20. Altruism and mature care: some rival moral considerations in care ethics.

    PubMed

    Hem, Marit Helene; Halvorsen, Kristin; Nortvedt, Per

    2014-11-01

    We discuss Carol Gilligan's original concept of mature care in the light of the altruistic approach to caring and good clinical judgment. In particular, we highlight how the concept of mature care can capture important challenges in today's nursing. Further, we illuminate how mature care might differ normatively from an altruistic approach to caring and the traditional prudential virtues in nursing. We also discuss similarities between mature care and virtue ethics. For nursing and nurses' identity, in today's health care system that is increasingly pressured to 'produce' health, we believe it is important to both developing further theories on mature care and having normative discussions about care. © The Author(s) 2014.

  1. 45 CFR 150.325 - Settlement authority.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 45 Public Welfare 1 2010-10-01 2010-10-01 false Settlement authority. 150.325 Section 150.325 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES REQUIREMENTS RELATING TO HEALTH CARE ACCESS CMS... Governmental Plans-Civil Money Penalties § 150.325 Settlement authority. Nothing in §§ 150.315 through 150.323...

  2. Simulating tokamak PFC performance using simultaneous dual beam particle loading with pulsed heat loading

    NASA Astrophysics Data System (ADS)

    Sinclair, Gregory; Gonderman, Sean; Tripathi, Jitendra; Ray, Tyler; Hassanein, Ahmed

    2017-10-01

    The performance of plasma facing components (PFCs) in a fusion device are expected to change due to high flux particle loading during operation. Tungsten (W) is a promising PFC candidate material, due to its high melting point, high thermal conductivity, and low tritium retention. However, ion irradiation of D and He have each shown to diminish the thermal strength of W. This work investigates the synergistic effect between ion species, using dual beam irradiation, on the thermal response of W during ELM-like pulsed heat loading. Experiments studied three different loading conditions: laser, laser + He+, and laser + He+ + D+. 100 eV He+ and D+ exposures used a flux of 3.0-3.5 x 1020 m-2 s-1. ELM-like loading was applied using a pulsed Nd:YAG laser at an energy density of 0.38-1.51 MJ m-2 (3600 1 ms pulses at 1 Hz). SEM imaging revealed that laser + He+ loading at 0.76 MJ m-2 caused surface melting, inhibiting fuzz formation. Increasing the laser fluence decreased grain size and increased surface pore density. Thermally-enhanced migration of trapped gases appear to reflect resultant molten morphology. This work was supported by the National Science Foundation PIRE project.

  3. Health care employee perceptions of patient-centered care.

    PubMed

    Balbale, Salva Najib; Turcios, Stephanie; LaVela, Sherri L

    2015-03-01

    Given the importance of health care employees in the delivery of patient-centered care, understanding their unique perspectives is essential for quality improvement. The purpose of this study was to use photovoice to evaluate perceptions and experiences around patient-centered care among U.S. Veterans Affairs (VA) health care employees. We asked participants to take photographs of salient features in their environment related to patient-centered care. We used the photographs to facilitate dialogue during follow-up interviews. Twelve VA health care employees across two VA sites participated in the project. Although most participants felt satisfied with their work environment and experiences at the VA, they identified several areas for improvement. These included a need for more employee health and wellness initiatives and a need for enhanced opportunities for training and professional growth. Application of photovoice enabled us to learn about employees' unique perspectives around patient-centered care while engaging them in an evaluation of care delivery. © The Author(s) 2014.

  4. The Authorizer and Charter School Closures: Exercising Adaptive Leadership to Protect the Public Interest. Authorizer Issue Brief. Number 8

    ERIC Educational Resources Information Center

    Geyer, Veronica

    2005-01-01

    Part and parcel of a charter school authorizer's oversight responsibility is the unenviable task of closing a school that fails to pass muster. As with most challenges that authorizers face, closing a charter school can be a complex task; executing a closure decision can entail a web of issues that the prudent authorizer must unravel carefully.…

  5. The manufacture of blood plasma products in Scotland: a brief history.

    PubMed

    Foster, Peter R

    2016-02-01

    A number of essential clinical products are derived from human blood plasma, including immunoglobulin products for the treatment of infections and disorders of immunity; albumin for protein and fluid replacement and coagulation factors for the treatment of haemophilia and other disorders of haemostasis. For many years, these protein pharmaceuticals were manufactured by the Scottish National Blood Transfusion Service (SNBTS) at its Scottish Protein Fractionation Centre (PFC) in Edinburgh, a contribution which ended with the closure of the PFC in 2008. The origins and development of plasma fractionation in Scotland are summarised in this article, as well as issues which contributed to the closure of the PFC. © The Author(s) 2015.

  6. Bidirectional Frontoparietal Oscillatory Systems Support Working Memory.

    PubMed

    Johnson, Elizabeth L; Dewar, Callum D; Solbakk, Anne-Kristin; Endestad, Tor; Meling, Torstein R; Knight, Robert T

    2017-06-19

    The ability to represent and select information in working memory provides the neurobiological infrastructure for human cognition. For 80 years, dominant views of working memory have focused on the key role of prefrontal cortex (PFC) [1-8]. However, more recent work has implicated posterior cortical regions [9-12], suggesting that PFC engagement during working memory is dependent on the degree of executive demand. We provide evidence from neurological patients with discrete PFC damage that challenges the dominant models attributing working memory to PFC-dependent systems. We show that neural oscillations, which provide a mechanism for PFC to communicate with posterior cortical regions [13], independently subserve communications both to and from PFC-uncovering parallel oscillatory mechanisms for working memory. Fourteen PFC patients and 20 healthy, age-matched controls performed a working memory task where they encoded, maintained, and actively processed information about pairs of common shapes. In controls, the electroencephalogram (EEG) exhibited oscillatory activity in the low-theta range over PFC and directional connectivity from PFC to parieto-occipital regions commensurate with executive processing demands. Concurrent alpha-beta oscillations were observed over parieto-occipital regions, with directional connectivity from parieto-occipital regions to PFC, regardless of processing demands. Accuracy, PFC low-theta activity, and PFC → parieto-occipital connectivity were attenuated in patients, revealing a PFC-independent, alpha-beta system. The PFC patients still demonstrated task proficiency, which indicates that the posterior alpha-beta system provides sufficient resources for working memory. Taken together, our findings reveal neurologically dissociable PFC and parieto-occipital systems and suggest that parallel, bidirectional oscillatory systems form the basis of working memory. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

  7. Two-year follow-up biomonitoring pilot study of residents' and controls' PFC plasma levels after PFOA reduction in public water system in Arnsberg, Germany.

    PubMed

    Brede, Edna; Wilhelm, Michael; Göen, Thomas; Müller, Johannes; Rauchfuss, Knut; Kraft, Martin; Hölzer, Jürgen

    2010-06-01

    Residents in Arnsberg, Germany, had been supplied by drinking water contaminated with perfluorooctanoate (PFOA). Biomonitoring data from 2006 evidenced that plasma PFOA concentrations of residents from Arnsberg were 4.5-8.3 times higher than those in reference groups. The introduction of charcoal filtration in July 2006 distinctly reduced PFOA concentrations in drinking water. Our one-year follow-up study showed a 10-20% reduction of PFOA plasma levels in residents from Arnsberg. Here we report the first results of the two-year follow-up study Arnsberg 2008. Additionally, the results of the two-year follow-up examination of the reference group are included. Paired plasma samples of 138 study participants (45 children, 46 mothers and 47 men) collected in 2006 and 2008 were considered in the statistical analyses. Within the two years plasma concentrations of PFOA, perfluorooctanesulfonate (PFOS) and perfluorohexanesulfonate (PFHxS) decreased in residents from Arnsberg and in control groups. The geometric means of PFOA plasma levels declined by 39% (children and mothers) and 26% (men) in Arnsberg and by 13-15% in the corresponding subgroups from the reference areas. For the population from Arnsberg a geometric mean plasma PFOA half-life of 3.26 years (range 1.03-14.67 years) was calculated. Our results confirm an ongoing reduction of the PFOA load in residents from Arnsberg. The decline of PFC levels in plasma of participants from the reference areas reflects the general decrease of human PFC exposure during the very recent years. Copyright 2010 Elsevier GmbH. All rights reserved.

  8. Dental care utilization and expenditures in children with special health care needs.

    PubMed

    Beil, Heather; Mayer, Michelle; Rozier, R Gary

    2009-09-01

    The authors compared children with special health care needs (CSHCN) and children without special health care needs (SHCN) with respect to the odds, amount and determinants of having any dental care and dental care expenditures. The authors assessed data from the 2004 Medical Expenditures Panel Survey, Agency for Healthcare Research and Quality, to identify a sample of 8,518 children aged 2 to 17 years. The authors used logistic regression to determine the effect of having SHCN on the probability of having any dental care expenditure, for total dental care expenditures and procedure-specific expenditures. They tested the modifying effect between CSHCN and other variables on the probability of having any dental care expenditure. Compared with children without SHCN, CSHCN did not differ in the probability (odds ratio = 0.91, 95 percent confidence interval [CI] = 0.76 to 1.09) or amount (beta = 30.17, 95 percent CI = -162.93 to 223.27) of total dental care expenditures. Likewise, CSHCN did not differ in their likelihood of having undergone a preventive, restorative, diagnostic or other procedure. Known determinants of dental care utilization did not modify the relationships between having SCHN and any dental care expenditure. Despite the reported difficulty in CSHCN's accessing dental care, the authors found that CSHCN had dental care utilization and expenditures that were comparable with those of children without SHCN. Furthermore, the association of CSHCN status and any dental care expenditure was not modified by known determinants of dental care utilization. Future research should focus on characterizing risk for dental disease among CSHCN more accurately and identifying factors that affect dental care utilization in CSHCN, including provider and parent characteristics. The study results highlight low rates of dental care utilization among all young children, including CSHCN. Efforts to increase dental care utilization among children are warranted and need to

  9. Sex differences in the functional lateralization of emotion and decision-making in the human brain

    PubMed Central

    Reber, Justin; Tranel, Daniel

    2016-01-01

    Dating back to the case of Phineas Gage, decades of neuropsychological research have shown that the ventromedial prefrontal cortex (vmPFC) is crucial to both real-world social functioning and abstract decision-making in the laboratory (e.g., Bechara et al., 1994; Damasio et al., 1994; Stuss et al., 1983). Previous research has found that the relationship between the laterality of individuals’ vmPFC lesions and neuropsychological performance is moderated by their sex, whereby there are more severe social, emotional, and decision-making impairments in men with right-sided vmPFC lesions and in women with left-sided vmPFC lesions (Tranel et al., 2005; Sutterer et al., 2015). We conducted a selective review of studies examining the effect of vmPFC lesions on emotion and decision-making, and found further evidence of sex-related differences in the lateralization of function not only in the vmPFC, but also in other neurological structures associated with decision-making and emotion. Our review suggests that both sex and laterality effects warrant more careful consideration in the scientific literature. PMID:27870462

  10. 42 CFR 35.21 - Authorization of transfer.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 1 2010-10-01 2010-10-01 false Authorization of transfer. 35.21 Section 35.21 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICAL CARE AND EXAMINATIONS HOSPITAL AND STATION MANAGEMENT Transfer of Patients § 35.21 Authorization of transfer. Except as...

  11. 42 CFR 35.21 - Authorization of transfer.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 42 Public Health 1 2014-10-01 2014-10-01 false Authorization of transfer. 35.21 Section 35.21 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICAL CARE AND EXAMINATIONS HOSPITAL AND STATION MANAGEMENT Transfer of Patients § 35.21 Authorization of transfer. Except as...

  12. 42 CFR 35.21 - Authorization of transfer.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 1 2011-10-01 2011-10-01 false Authorization of transfer. 35.21 Section 35.21 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICAL CARE AND EXAMINATIONS HOSPITAL AND STATION MANAGEMENT Transfer of Patients § 35.21 Authorization of transfer. Except as...

  13. 42 CFR 35.21 - Authorization of transfer.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 42 Public Health 1 2013-10-01 2013-10-01 false Authorization of transfer. 35.21 Section 35.21 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICAL CARE AND EXAMINATIONS HOSPITAL AND STATION MANAGEMENT Transfer of Patients § 35.21 Authorization of transfer. Except as...

  14. 42 CFR 35.21 - Authorization of transfer.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 42 Public Health 1 2012-10-01 2012-10-01 false Authorization of transfer. 35.21 Section 35.21 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICAL CARE AND EXAMINATIONS HOSPITAL AND STATION MANAGEMENT Transfer of Patients § 35.21 Authorization of transfer. Except as...

  15. The neural bases for devaluing radical political statements revealed by penetrating traumatic brain injury.

    PubMed

    Cristofori, Irene; Viola, Vanda; Chau, Aileen; Zhong, Wanting; Krueger, Frank; Zamboni, Giovanna; Grafman, Jordan

    2015-08-01

    Given the determinant role of ventromedial prefrontal cortex (vmPFC) in valuation, we examined whether vmPFC lesions also modulate how people scale political beliefs. Patients with penetrating traumatic brain injury (pTBI; N = 102) and healthy controls (HCs; N = 31) were tested on the political belief task, where they rated 75 statements expressing political opinions concerned with welfare, economy, political involvement, civil rights, war and security. Each statement was rated for level of agreement and scaled along three dimensions: radicalism, individualism and conservatism. Voxel-based lesion-symptom mapping (VLSM) analysis showed that diminished scores for the radicalism dimension (i.e. statements were rated as less radical than the norms) were associated with lesions in bilateral vmPFC. After dividing the pTBI patients into three groups, according to lesion location (i.e. vmPFC, dorsolateral prefrontal cortex [dlPFC] and parietal cortex), we found that the vmPFC, but not the dlPFC, group had reduced radicalism scores compared with parietal and HC groups. These findings highlight the crucial role of the vmPFC in appropriately valuing political behaviors and may explain certain inappropriate social judgments observed in patients with vmPFC lesions. © The Author (2015). Published by Oxford University Press. For Permissions, please email: journals.permissions@oup.com.

  16. Early-course unmedicated schizophrenia patients exhibit elevated prefrontal connectivity associated with longitudinal change.

    PubMed

    Anticevic, Alan; Hu, Xinyu; Xiao, Yuan; Hu, Junmei; Li, Fei; Bi, Feng; Cole, Michael W; Savic, Aleksandar; Yang, Genevieve J; Repovs, Grega; Murray, John D; Wang, Xiao-Jing; Huang, Xiaoqi; Lui, Su; Krystal, John H; Gong, Qiyong

    2015-01-07

    Strong evidence implicates prefrontal cortex (PFC) as a major source of functional impairment in severe mental illness such as schizophrenia. Numerous schizophrenia studies report deficits in PFC structure, activation, and functional connectivity in patients with chronic illness, suggesting that deficient PFC functional connectivity occurs in this disorder. However, the PFC functional connectivity patterns during illness onset and its longitudinal progression remain uncharacterized. Emerging evidence suggests that early-course schizophrenia involves increased PFC glutamate, which might elevate PFC functional connectivity. To test this hypothesis, we examined 129 non-medicated, human subjects diagnosed with early-course schizophrenia and 106 matched healthy human subjects using both whole-brain data-driven and hypothesis-driven PFC analyses of resting-state fMRI. We identified increased PFC connectivity in early-course patients, predictive of symptoms and diagnostic classification, but less evidence for "hypoconnectivity." At the whole-brain level, we observed "hyperconnectivity" around areas centered on the default system, with modest overlap with PFC-specific effects. The PFC hyperconnectivity normalized for a subset of the sample followed longitudinally (n = 25), which also predicted immediate symptom improvement. Biologically informed computational modeling implicates altered overall connection strength in schizophrenia. The initial hyperconnectivity, which may decrease longitudinally, could have prognostic and therapeutic implications. Copyright © 2015 the authors 0270-6474/15/350267-20$15.00/0.

  17. Pilot Study of Behavioral Treatment in Dementia Care Units.(practice Concepts)(author Abstract)

    ERIC Educational Resources Information Center

    Lichtenberg, Peter A.; Kemp-Havican, Julie; MacNeill, Susan E.; Johnson, Amanda Schafer

    2005-01-01

    Purpose: This article reports on the development and use of behavioral treatment as a well-being intervention for individuals with dementia residing at special care units in a nursing home. Design and Methods: The project took place upon the construction and opening of two new homelike units for dementia care in a rural community-care center.…

  18. Postnatal Day 2 to 11 Constitutes a 5-HT-Sensitive Period Impacting Adult mPFC Function

    PubMed Central

    Rebello, Tahilia J.; Yu, Qinghui; Goodfellow, Nathalie M.; Caffrey Cagliostro, Martha K.; Teissier, Anne; Morelli, Emanuela; Demireva, Elena Y.; Chemiakine, Alexei; Rosoklija, Gorazd B.; Dwork, Andrew J.; Lambe, Evelyn K.; Ansorge, Mark S.

    2014-01-01

    Early-life serotonin [5-hydroxytryptamine (5-HT)] signaling modulates brain development, which impacts adult behavior, but 5-HT-sensitive periods, neural substrates, and behavioral consequences remain poorly understood. Here we identify the period ranging from postnatal day 2 (P2) to P11 as 5-HT sensitive, with 5-HT transporter (5-HTT) blockade increasing anxiety- and depression-like behavior, and impairing fear extinction learning and memory in adult mice. Concomitantly, P2–P11 5-HTT blockade causes dendritic hypotrophy and reduced excitability of infralimbic (IL) cortex pyramidal neurons that normally promote fear extinction. By contrast, the neighboring prelimbic (PL) pyramidal neurons, which normally inhibit fear extinction, become more excitable. Excitotoxic IL but not PL lesions in adult control mice reproduce the anxiety-related phenotypes. These findings suggest that increased 5-HT signaling during P2–P11 alters adult mPFC function to increase anxiety and impair fear extinction, and imply a differential role for IL and PL neurons in regulating affective behaviors. Together, our results support a developmental mechanism for the etiology and pathophysiology of affective disorders and fear-related behaviors. PMID:25209278

  19. 75 FR 60471 - Statement of Organization, Functions, and Delegations of Authority

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-09-30

    ... support for working families and improving the quality of child care to promote healthy development... child care programs authorized under the Child Care and Development Block Grant (CCDBG) Act and section...; identifies and implements operational planning objectives and initiatives related to child care; provides...

  20. Rostro-caudal and dorso-ventral gradients in medial and lateral prefrontal cortex during cognitive control of affective and cognitive interference.

    PubMed

    Rahm, Christoffer; Liberg, Benny; Wiberg-Kristoffersen, Maria; Aspelin, Peter; Msghina, Mussie

    2013-04-01

    Characterizing the anatomical substrates of major brain functions such as cognition and emotion is of utmost importance to the ongoing efforts of understanding the nature of psychiatric ailments and their potential treatment. The aim of our study was to investigate how the brain handles affective and cognitive interferences on cognitive processes. Functional magnetic resonance imaging investigation was performed on healthy individuals, comparing the brain oxygenation level dependent activation patterns during affective and cognitive counting Stroop tasks. The affective Stroop task activated rostral parts of medial prefrontal cortex (PFC) and rostral and ventral parts of lateral PFC, while cognitive Stroop activated caudal parts of medial PFC and caudal and dorsal parts of lateral PFC. Our findings suggest that the brain may handle affective and cognitive interference on cognitive processes differentially, with affective interference preferentially activating rostral and ventral PFC networks and cognitive interference activating caudal and dorsal PFC networks. © 2013 The Authors. Scandinavian Journal of Psychology © 2013 The Scandinavian Psychological Associations.

  1. The uses and gratifications of online care pages: a study of CaringBridge.

    PubMed

    Anderson, Isolde K

    2011-09-01

    This study investigated how online care pages help people connect with others and gain social support during a health care event. It reports the results of a survey of 1035 CaringBridge authors who set up personalized web pages because of hospitalization, serious illness, or other reasons, regarding the uses and gratifications obtained from their sites. Four primary benefits were found to be important to all authors of CaringBridge sites: providing information, receiving encouragement from messages, convenience, and psychological support. Hierarchical multiple regression revealed significant effects for six demographic and health-related variables: gender, age, religiosity, Internet usage, the purpose for which the site was set up, and sufficiency of information received from health care providers. Support was obtained for the perspective that online care pages provide new media gratifications for authors, and that health-related antecedents of media use may affect media selection and gratifications. The implications of this study for communication researchers and support services like CaringBridge are also discussed.

  2. 42 CFR 1002.210 - Permissive exclusions; general authority.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 5 2010-10-01 2010-10-01 false Permissive exclusions; general authority. 1002.210 Section 1002.210 Public Health OFFICE OF INSPECTOR GENERAL-HEALTH CARE, DEPARTMENT OF HEALTH AND HUMAN... § 1002.210 Permissive exclusions; general authority. The State agency must have administrative procedures...

  3. Sex differences in the functional lateralization of emotion and decision making in the human brain.

    PubMed

    Reber, Justin; Tranel, Daniel

    2017-01-02

    Dating back to the case of Phineas Gage, decades of neuropsychological research have shown that the ventromedial prefrontal cortex (vmPFC) is crucial to both real-world social functioning and abstract decision making in the laboratory (see, e.g., Stuss et al., ; Bechara et al., 1994; Damasio et al., ). Previous research has shown that the relationship between the laterality of individuals' vmPFC lesions and neuropsychological performance is moderated by their sex, whereby there are more severe social, emotional, and decision-making impairments in men with right-side vmPFC lesions and in women with left-side vmPFC lesions (Tranel et al., 2005; Sutterer et al., 2015). We conducted a selective review of studies examining the effect of vmPFC lesions on emotion and decision making and found further evidence of sex-related differences in the lateralization of function not only in the vmPFC but also in other neurological structures associated with decision making and emotion. This Mini-Review suggests that both sex and laterality effects warrant more careful consideration in the scientific literature. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

  4. Home care outsourcing strategy.

    PubMed

    Drake, Paul R; Davies, Bethan M

    2006-01-01

    This paper aims to help public sector managers that are formulating strategies for outsourcing home care from the independent sector. A review was performed of relevant literature on the outsourcing of home care and its political drivers in the U.K. This indicates that the future of home care services, taking into consideration outsourcing and how Best Value will be achieved, has not been researched widely. Therefore, an exploratory approach to research was adopted here using in-depth analysis of a small number of particularly informative local authorities and private providers selected by purposive/judgemental (extreme and critical case) sampling. Personal contact was deemed necessary in order to perform an intensive investigation to pursue in-depth information. The British Government's Best Value regime is driving local authorities towards increasing levels of outsourcing in the provision of home care. A local authority may choose to outsource all of its home care or maintain some in-house provision based on capacity or capabilities that are complementary to those provided by the independent sector. The 100 per cent outsourcing strategy places enabling demands on the local authority, whereas the alternative strategy requires decisions to be made on what should be outsourced. Across the authorities surveyed, six strategies for creating a mixed economy of care have been identified, with the mix being based on complementary capacity and/or capabilities. With Best Value driving authorities to consider lower-cost options, the outcome may be a reduction in the amount of complementary capacity provided in-house, in favour of strategies involving complementary capabilities that deliver the Best Value possible. Re-enablement is emerging as a common, complementary or core capability that is remaining in-house. Outsourcing also requires decisions to be made on the number of independent providers to be used and the type of contracts to be employed. This paper considers the

  5. Integration Strategies of Pharmacists in Primary Care-Based Accountable Care Organizations: A Report from the Accountable Care Organization Research Network, Services, and Education.

    PubMed

    Joseph, Tina; Hale, Genevieve M; Eltaki, Sara M; Prados, Yesenia; Jones, Renee; Seamon, Matthew J; Moreau, Cynthia; Gernant, Stephanie A

    2017-05-01

    benefits and overcome barriers to the integration of pharmacists into patient care, programs involve pharmacists will become an increasingly common approach to improve outcomes and reduce the total cost of care and will improve the financial viability of primary care-based ACOs. No outside funding supported this research. The authors report no conflicts of interest related to this manuscript. Study concept and design were contributed by Joseph, Hale, and Eltaki, with assistance from the other authors. Prados and Jones took the lead in data collection and data interpretation and analysis, with assistance from the other authors. The manuscript was written primarily by Joseph and Hale, along with the other authors, and revised primarily by Seamon and Gernant, along with the other authors.

  6. 45 CFR 99.21 - Authority of presiding officer.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 45 Public Welfare 1 2010-10-01 2010-10-01 false Authority of presiding officer. 99.21 Section 99.21 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL ADMINISTRATION PROCEDURE FOR HEARINGS FOR THE CHILD CARE AND DEVELOPMENT FUND Hearing Procedures § 99.21 Authority of presiding officer...

  7. Liberalism, authority, and bioethics commissions.

    PubMed

    MacDougall, D Robert

    2013-12-01

    Bioethicists working on national ethics commissions frequently think of themselves as advisors to the government, but distance themselves from any claims to actual authority. Governments however may find it beneficial to appear to defer to the authority of these commissions when designing laws and policies, and might appoint such commissions for exactly this reason. Where does the authority for setting laws and policies come from? This question is best answered from within a normative political philosophy. This paper explains the locus of moral authority as understood within one family of normative political theories--liberal political theories--and argues that most major "liberal" commentators have understood both the source and scope of ethics commissions' authority in a manner at odds with liberalism, rightly interpreted. The author argues that reexamining the implications of liberalism for bioethics commissions would mean changing what are considered valid criticisms of such commissions and also changing the content of national bioethics commission mandates. The author concludes that bioethicists who participate in such commissions ought to carefully examine their own views about the normative limits of governmental authority because such limits have important implications for the contribution that bioethicists can legitimately make to government commissions.

  8. Care pathways as boundary objects between primary and secondary care: Experiences from Norwegian home care services.

    PubMed

    Håland, Erna; Røsstad, Tove; Osmundsen, Tonje C

    2015-11-01

    The need for integration of healthcare services and collaboration across organisational boundaries is highlighted as a major challenge within healthcare in many countries. Care pathways are often presented as a solution to this challenge. In this article, we study a project of developing, introducing and using a care pathway across healthcare levels focusing on older home-dwelling patients in need of home care services after hospital discharge. In so doing, we use the concept of boundary object, as described by Star and Griesemer, to explore how care pathways can act as tools for translation between specialist healthcare services and home care services. Based on interviews with participants in the project, we find that response to existing needs, local tailoring, involvement and commitment are all crucial for the care pathway to function as a boundary object in this setting. Furthermore, the care pathway, as we argue, can be used to push boundaries just as much as it can be used as a tool for bridging across them, thus potentially contributing to a more equal relationship between specialist healthcare services and home care services. © The Author(s) 2015.

  9. 14 CFR 158.29 - The Administrator's decision.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 14 Aeronautics and Space 3 2010-01-01 2010-01-01 false The Administrator's decision. 158.29... decision. (a) Authority to impose a PFC. (1) An application to impose a PFC will be approved in whole or in...) The Administrator notifies the public agency in writing of the decision on the application. The...

  10. Li Experiments at the Tokamak T-11M Toward PFC Concept of Steady State Tokamak-Reactor

    NASA Astrophysics Data System (ADS)

    Mirnov, S. V.

    2009-11-01

    As practical method of using a liquid lithium as a renewable plasma-facing component (PCF) for steady state tokamak-reactor the concept of lithium emitter-collector is considered [1]. It is based on lithium filled capillary porous system proposed by V.A. Evtikhin et al. (1996). The lithium circulation process consists of four steps: (1) Li emission from the PFC emitter into the plasma; (2) plasma boundary cooling by non-coronal Li radiation; (3) Li ion capture by the collector (before they are lost to the tokamak chamber wall); (4) Li return from the collector to the emitter. T-11M tokamak experiments have used three local rail limiters made from lithium, molybdenum and graphite as lithium collectors. The lithium behavior was studied by analysis of the witness samples, and by a mobile graphite probe. The key findings are: (1) lithium collection on the ion side of the lithium limiter is 2-3 times larger than on the electron side; (2) total efficiency of Li collection integrated over all three rail limiters can reach 50-70% of the lithium emission during the discharge pulse, while the theoretical limit is about 90%. [1] S.V. Mirnov, J. Nucl. Mat., 390-391, 876 (2009).

  11. [Dutch Health Care Inspectorate (IGZ) abuses its inspection authority in patient files].

    PubMed

    van Lessen Kloeke, Koosje

    2014-01-01

    For its investigation regarding the transfer of data after discharge of vulnerable elderly patients from hospital to nursing homes, care homes or home care, the Dutch Health Care Inspectorate (IGZ) demands access to patients' files, without their explicit consent. Doctors who do not cooperate run the risk of penalty payments. Since it concerns a limited number of patients per practice, it would not be unreasonably onerous for the Inspectorate to allow doctors to ask their patients' consent. Other reasons mentioned by the Inspectorate, such as possible "inappropriate correction" of data and the capability of vulnerable elderly patients to give their consent seem improper grounds to breach patients' right to privacy and to demand that doctors breach professional confidentiality. The legality of the Inspectorate's actions could be addressed in a test case and should be discussed more widely in light of the Inspectorate's work plan for 2014.

  12. Allocation of authority in European health policy.

    PubMed

    Adolph, Christopher; Greer, Scott L; Massard da Fonseca, Elize

    2012-11-01

    Although many study the effects of different allocations of health policy authority, few ask why countries assign responsibility over different policies as they do. We test two broad theories: fiscal federalism, which predicts rational governments will concentrate information-intensive operations at lower levels, and redistributive and regulatory functions at higher levels; and "politicized federalism", which suggests a combination of systematic and historically idiosyncratic political variables interfere with efficient allocation of authority. Drawing on the WHO Health in Transition country profiles, we present new data on the allocation of responsibility for key health care policy tasks (implementation, provision, finance, regulation, and framework legislation) and policy areas (primary, secondary and tertiary care, public health and pharmaceuticals) in the 27 EU member states and Switzerland. We use a Bayesian multinomial mixed logit model to analyze how different countries arrive at different allocations of authority over each task and area of health policy, and find the allocation of powers broadly follows fiscal federalism. Responsibility for pharmaceuticals, framework legislation, and most finance lodges at the highest levels of government, acute and primary care in the regions, and provision at the local and regional levels. Where allocation does not follow fiscal federalism, it appears to reflect ethnic divisions, the population of states and regions, the presence of mountainous terrain, and the timing of region creation. Copyright © 2012 Elsevier Ltd. All rights reserved.

  13. Health Care Delivery.

    ERIC Educational Resources Information Center

    Starfield, Barbara

    1987-01-01

    The article reviews emerging health care delivery options for handicapped children. Cost structures, quality of care, and future prospects are considered for Health Maintenance Organizations, Preferred Provider Organizations, Tax Supported Direct Service Programs, Hospital-Based Services, and Ambulatory Care Organizations. (Author/DB)

  14. Using key performance indicators as knowledge-management tools at a regional health-care authority level.

    PubMed

    Berler, Alexander; Pavlopoulos, Sotiris; Koutsouris, Dimitris

    2005-06-01

    The advantages of the introduction of information and communication technologies in the complex health-care sector are already well-known and well-stated in the past. It is, nevertheless, paradoxical that although the medical community has embraced with satisfaction most of the technological discoveries allowing the improvement in patient care, this has not happened when talking about health-care informatics. Taking the above issue of concern, our work proposes an information model for knowledge management (KM) based upon the use of key performance indicators (KPIs) in health-care systems. Based upon the use of the balanced scorecard (BSC) framework (Kaplan/Norton) and quality assurance techniques in health care (Donabedian), this paper is proposing a patient journey centered approach that drives information flow at all levels of the day-to-day process of delivering effective and managed care, toward information assessment and knowledge discovery. In order to persuade health-care decision-makers to assess the added value of KM tools, those should be used to propose new performance measurement and performance management techniques at all levels of a health-care system. The proposed KPIs are forming a complete set of metrics that enable the performance management of a regional health-care system. In addition, the performance framework established is technically applied by the use of state-of-the-art KM tools such as data warehouses and business intelligence information systems. In that sense, the proposed infrastructure is, technologically speaking, an important KM tool that enables knowledge sharing amongst various health-care stakeholders and between different health-care groups. The use of BSC is an enabling framework toward a KM strategy in health care.

  15. 78 FR 18594 - Delegation of Authorities

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-03-27

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES Delegation of Authorities Notice is hereby given that I... Health Insurance Portability and Accountability Act of 1996 (HIPAA) insofar as such provisions pertain to..., Affordable Health Care for All Americans Subtitle B--Immediate Actions to Preserve and Expand Coverage...

  16. 77 FR 70893 - Authorization for Non-VA Medical Services

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-11-28

    ... professions, Health records, Homeless, Mental health programs, Nursing homes, Reporting and recordkeeping... restrictive modes of healthcare delivery. Although VA has made great strides to expand the delivery of... expand VA's authority to provide non-VA medical services under the non- VA care authority. As amended...

  17. Ethics, Politics, and Religion in Public Health Care: A Manifesto for Health Care Chaplains in Canada.

    PubMed

    Lasair, Simon

    2016-03-01

    Health care chaplaincy positions in Canada are significantly threatened due to widespread health care cutbacks. Yet the current time also presents a significant opportunity for spiritual care providers. This article argues that religion and spirituality in Canada are undergoing significant changes. The question for Canadian health care chaplains is, then: how well equipped are they to understand these changes in health care settings and to engage them? This article attempts to go part way toward an answer. © The Author(s) 2016.

  18. Integrated care: theory to practice.

    PubMed

    Stokes, Jonathan; Checkland, Kath; Kristensen, Søren Rud

    2016-10-01

    'Integrated care' is pitched as the solution to current health system challenges. In the literature, what integrated care actually involves is complex and contested. Multi-disciplinary team case management is frequently the primary focus of integrated care when implemented internationally. We examine the practical application of integrated care in the NHS in England to exemplify the prevalence of the case management focus. We look at the evidence for effectiveness of multi-disciplinary team case management, for the focus on high-risk groups and for integrated care more generally. We suggest realistic expectations of what integration of care alone can achieve and additional research questions. © The Author(s) 2016.

  19. How Limited Systematicity Emerges: A Computational Cognitive Neuroscience Approach (Author’s Manuscript)

    DTIC Science & Technology

    2014-09-01

    not losing track of the original facts of the situation. However, hippocampal episodic memory also has limitations – it operates one memory at a...ability to strategically control the use of episodic memory . Specific areas of PFC are implicated as these episodic control structures, including...certainly start by encoding the problem into hippocampal episodic memory , so they can retrieve it when interference overtakes the system and they

  20. Prehospital Medicine and the Future Will ECMO Ever Play a Role?

    PubMed

    Macku, David; Hedvicak, Pavel; Quinn, John; Bencko, Vladimir

    Due to the hybrid warfare currently experienced by multiple NATO coalition and NATO partner nations, the tactical combat casualty care (TCCC) paradigm is greatly challenged. One of the major challenges to TCCC is the ad hoc extension phase in resource-poor environments, referred to as prolonged field care (PFC) and forward resuscitative care (FRC). The nuanced clinical skills with limited resources required by warfighters and auxiliary health care professionals to mitigate death on the battlefield and prevent morbidity and mortality in the PFC phase represent a balance that is still under review. The aim of our article is to describe the connection between extracorporeal membrane oxygenation (ECMO) or the extracorporeal life support (ECLS) treatment and its possible improvement in prehospital trauma care, at a Role 1 or 2 facility and, more provocatively, in the PFC phase of care in the future through innovative technology and how it connects with FRC. We report and describe here the primary components of ECMO/ECLS and present the main concept of a human extracorporeal circulation cocoon as a transitional living form for the cardiopulmonary stabilization of wounded combatants on the battlefield and their transportation to higher echelons of care and treatment facilities (to include damage control resuscitation [DCR] and damage control surgery [DCS]). As clinical governance, these matters would fall within the remit of the Committee on Surgical Combat Casualty Care (CoSCCC) and the Committee on Enroute Combat Casualty Care (CoERCCC), and it is within this framework that we propose this concept piece of ECMO in the prehospital space. We caution that this report is a proposed innovation to TCCC but also serves to push the envelope of the PFC and FRC paradigm. What we propose will not change the practice this year, but as ECMO technology progresses, it may change our practice within the next decade. We conclude with proposed novel future research to save life on the

  1. Association of TMEM18 variants with BMI and waist circumference in children and correlation of mRNA expression in the PFC with body weight in rats.

    PubMed

    Rask-Andersen, Mathias; Jacobsson, Josefin A; Moschonis, George; Chavan, Rohit A; Sikder, Md Abu Noman; Allzén, Elin; Alsiö, Johan; Chrousos, George P; Manios, Yannis; Fredriksson, Robert; Schiöth, Helgi B

    2012-02-01

    Genome-wide association studies have shown a strong association of single-nucleotide polymorphisms (SNPs) in the near vicinity of the TMEM18 gene. The effects of the TMEM18-associated variants are more readily observed in children. TMEM18 encodes a 3TM protein, which locates to the nuclear membrane. The functional context of TMEM18 and the effects of its associated variants are as of yet undetermined. To further explore the effects of near-TMEM18 variants, we have genotyped two TMEM18-associated SNPs, rs6548238 and rs4854344, in a cohort of 2352 Greek children (Healthy Growth Study). Included in this study are data on anthropomorphic traits body weight, BMI z-score and waist circumference. Also included are dietary energy and macronutrient intake as measured via 24-h recall interviews. Major alleles of rs6548238 and rs4854344 were significantly associated with an increased risk of obesity (odds ratio = 1.489 (1.161-1.910) and 1.494 (1.165-1.917), respectively), and positively correlated to body weight (P = 0.017, P = 0.010) and waist circumference (P = 0.003, P = 0.003). An association to energy and macronutrient intake was not observed in this cohort. We also correlated food intake and body weight in a food choice model in rats to Tmem18 expression in central regions involved in feeding behavior. We observed a strong positive correlation between TMEM18 expression and body weight in the prefrontal cortex (PFC) (r = 0.5694, P = 0.0003) indicating a potential role for TMEM18 in higher functions related to feeding involving the PFC.

  2. Anodal transcranial direct current stimulation over right dorsolateral prefrontal cortex alters decision making during approach-avoidance conflict.

    PubMed

    Chrysikou, Evangelia G; Gorey, Claire; Aupperle, Robin L

    2017-03-01

    Approach-avoidance conflict (AAC) refers to situations associated with both rewarding and threatening outcomes. The AAC task was developed to measure AAC decision-making. Approach behavior during this task has been linked to self-reported anxiety sensitivity and has elicited anterior cingulate, insula, caudate and right dorsolateral prefrontal cortex (dlPFC) activity, with right lateral PFC tracking the extent of approach behavior. Guided by these results, we used excitatory transcranial direct current stimulation (tDCS) to demonstrate the causal involvement of right dlPFC in AAC decision-making. Participants received anodal tDCS at 1.5mA over either left or right dlPFC or sham stimulation, while performing the AAC task and a control short-term memory task. Analyses of variance (ANOVA) revealed that for individuals with high anxiety sensitivity excitatory right (but not left or sham) dlPFC stimulation elicited measurable decreases in approach behavior during conflict. Excitatory left (but not right or sham) dlPFC simulation improved performance on the control task. These results support a possible asymmetry between the contributions of right and left dlPFC to AAC resolution during emotional decision-making. Increased activity in right dlPFC may contribute to anxiety-related symptoms and, as such, serve as a neurobehavioral target of anxiolytic treatments aiming to decrease avoidance behavior. © The Author (2016). Published by Oxford University Press.

  3. Depression of excitatory synapses onto parvalbumin interneurons in the medial prefrontal cortex in susceptibility to stress.

    PubMed

    Perova, Zinaida; Delevich, Kristen; Li, Bo

    2015-02-18

    In response to extreme stress, individuals either show resilience or succumb to despair. The prefrontal cortex (PFC) is required for coping with stress, and PFC dysfunction has been implicated in stress-related mental disorders, including depression. Nevertheless, the mechanisms by which the PFC participates in stress responses remain unclear. Here, we investigate the role of parvalbumin (PV) interneurons in the medial PFC (mPFC) in shaping behavioral responses to stress induced by the learned helplessness procedure, in which animals are subjected to an unpredictable and inescapable stressor. PV interneurons in the mPFC were probed and manipulated in knock-in mice expressing the Cre recombinase under the endogenous parvalbumin promoter. Notably, we found that excitatory synaptic transmission onto these neurons was decreased in mice showing helplessness, a behavioral state that is thought to resemble features of human depression. Furthermore, selective suppression of PV interneurons in the mPFC using hM4Di, a DREADD (designer receptor exclusively activated by designer drug), promoted helplessness, indicating that activation of these neurons during stress promotes the establishment of resilient behavior. Our results reveal a cellular mechanism of mPFC dysfunction that may contribute to the emergence of maladaptive behavioral responses in the face of adverse life events. Copyright © 2015 the authors 0270-6474/15/353201-06$15.00/0.

  4. Digital health care--the convergence of health care and the Internet.

    PubMed

    Frank, S R

    2000-04-01

    The author believes that interactive media (the Internet and the World Wide Web) and associated applications used to access those media (portals, browsers, specialized Web-based applications) will result in a substantial, positive, and measurable impact on medical care faster than any previous information technology or communications tool. Acknowledging the dynamic environment, the author classifies "pure" digital health care companies into three business service areas: content, connectivity, and commerce. Companies offering these services are attempting to tap into a host of different markets within the health care industry including providers, payers, pharmaceutical and medical products companies, employers, distributors, and consumers. As the fastest growing medium in history, and given the unique nature of health care information and the tremendous demand for content among industry professionals and consumers, the Internet offers a more robust and targeted direct marketing opportunity than traditional media. From the medical consumer's standpoint (i.e., the patient) the author sees the Internet as performing five critical functions: (1) Disseminate information, (2) Aid informed decision making, (3) Promote health, (4) Provide a means for information exchange and support--the community concept, and (5) Increase self-care and manage demand for health services, lowering direct medical costs. The author firmly submits the Web will provide overall benefits to the health care economy as health information consumers manage their own health problems that might not directly benefit from an encounter with a health professional. Marrying the Internet to other interactive technologies, including voice recognition systems and telephone-based triage lines among others, holds the promise of reducing unnecessary medical services.

  5. Can the Accountable Care Organization model facilitate integrated care in England?

    PubMed

    Ahmed, Faheem; Mays, Nicholas; Ahmed, Naeem; Bisognano, Maureen; Gottlieb, Gary

    2015-10-01

    Following the global economic recession, health care systems have experienced intense political pressure to contain costs without compromising quality. One response is to focus on improving the continuity and coordination of care, which is seen as beneficial for both patients and providers. However, cultural and structural barriers have proved difficult to overcome in the quest to provide integrated care for entire populations. By holding groups of providers responsible for the health outcomes of a designated population, in the United States, Accountable Care Organizations are regarded as having the potential to foster collaboration across the continuum of care. They could have a similar role in England's National Health Service. However, it is important to consider the difference in context before implementing a similar model, adapted to suit the system's strengths. Working together, general practice federations and the Academic Health Science Networks could form the basis of accountable care in England. © The Author(s) 2015.

  6. Ventromedial prefrontal damage reduces mind-wandering and biases its temporal focus.

    PubMed

    Bertossi, Elena; Ciaramelli, Elisa

    2016-11-01

    Mind-wandering, an ubiquitous expression of humans' mental life, reflects a drift of attention away from the current task towards self-generated thoughts, and has been associated with activity in the brain default network. To date, however, little is understood about the contribution of individual nodes of this network to mind-wandering. Here, we investigated whether the ventromedial prefrontal cortex (vmPFC) is critically involved in mind-wandering, by studying the propensity to mind-wander in patients with lesion to the vmPFC (vmPFC patients), control patients with lesions not involving the vmPFC, and healthy individuals. Participants performed three tasks varying in cognitive demands while their thoughts were periodically sampled, and a self-report scale of daydreaming in daily life. vmPFC patients exhibited reduced mind-wandering rates across tasks, and claimed less frequent daydreaming, than both healthy and brain-damaged controls. vmPFC damage reduced off-task thoughts related to the future, while it promoted those about the present. These results indicate that vmPFC critically supports mind-wandering, possibly by helping to construct future-related scenarios and thoughts that have the potential to draw attention inward, away from the ongoing tasks. © The Author (2016). Published by Oxford University Press. For Permissions, please email: journals.permissions@oup.com.

  7. The interaction of process and domain in prefrontal cortex during inductive reasoning.

    PubMed

    Babcock, Laura; Vallesi, Antonino

    2015-01-01

    Inductive reasoning is an everyday process that allows us to make sense of the world by creating rules from a series of instances. Consistent with accounts of process-based fractionations of the prefrontal cortex (PFC) along the left-right axis, inductive reasoning has been reliably localized to left PFC. However, these results may be confounded by the task domain, which is typically verbal. Indeed, some studies show that right PFC activation is seen with spatial tasks. This study used fMRI to examine the effects of process and domain on the brain regions recruited during a novel pattern discovery task. Twenty healthy young adult participants were asked to discover the rule underlying the presentation of a series of letters in varied spatial locations. The rules were either verbal (pertaining to a single semantic category) or spatial (geometric figures). Bilateral ventrolateral PFC activations were seen for the spatial domain, while the verbal domain showed only left ventrolateral PFC. A conjunction analysis revealed that the two domains recruited a common region of left ventrolateral PFC. The data support a central role of left PFC in inductive reasoning. Importantly, they also suggest that both process and domain shape the localization of reasoning in the brain. Copyright © 2014 The Authors. Published by Elsevier Ltd.. All rights reserved.

  8. A nonlinear control scheme based on dynamic evolution path theory for improved dynamic performance of boost PFC converter working on nonlinear features.

    PubMed

    Mohanty, Pratap Ranjan; Panda, Anup Kumar

    2016-11-01

    This paper is concerned to performance improvement of boost PFC converter under large random load fluctuation, ensuring unity power factor (UPF) at source end and regulated voltage at load side. To obtain such performance, a nonlinear controller based on dynamic evolution path theory is designed and its robustness is examined under both heavy and light loading condition. In this paper, %THD and zero-cross-over dead-zone of input current is significantly reduced. Also, very less response time of input current and output voltage to that of load and reference variation is remarked. A simulation model of proposed system is designed and it is realized using dSPACE 1104 signal processor for a 390V DC , 500W prototype. The relevant experimental and simulation waveforms are presented. Copyright © 2016 ISA. Published by Elsevier Ltd. All rights reserved.

  9. Comparison of the clinical outcomes after total knee arthroplasty with the LCS rotating platform mobile bearing knee system and the PFC Sigma RP-F mobile bearing knee system.

    PubMed

    Kwak, Ju-Yeong; Jeong, Jae-Heon; Lee, Sang-Hak; Jung, Ho-Joong; Jung, Young-Bok

    2012-12-01

    We compared clinical outcomes after total knee arthroplasty with the Low Contact Stress (LCS) rotating platform mobile bearing knee system and the Press Fit Condylar Sigma rotating platform high flexion (PFC Sigma RP-F) mobile bearing knee system. Fifty cases of total knee arthroplasty were performed with the PFC Sigma RP-F mobile bearing knee system and sixty-one cases were performed with the LCS mobile bearing total knee arthroplasty. The average duration of follow-up was 2.9 years. The mean Hospital for Special Surgery (HSS) knee score was 62.1 (range, 52 to 75) in the LCS group and 61.9 (range, 50 to 74) in the Sigma RP-F group preoperatively, and 90.1 (range, 84 to 100) in the LCS group and 89.8 (range, 83 to 100) in the Sigma RP-F group at the final follow-up. The mean preoperative flexion contracture was 6.7° (range, 0° to 10°) in the LCS group and 9.3° (range, 0° to 15°) in the Sigma RP-F group preoperatively. The mean range of motion was 124.6° (range, 105° to 150°) in the LCS group and 126.1° (range, 104° to 145°) in the Sigma RP-F group at the final follow-up. After a minimum duration of follow-up of two years, we found no significant differences between the two groups with regard to the range of knee motion or the clinical or radiographic results.

  10. 75 FR 18138 - Health Care Eligibility Under the Secretarial Designee Program and Related Special Authorities

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-04-09

    ... 0790-AI52] Health Care Eligibility Under the Secretarial Designee Program and Related Special... establish policies and assign responsibilities for health care eligibility under the Secretarial Designee... inpatient health care provided in the United States to foreign military or diplomatic personnel or their...

  11. 75 FR 72682 - Health Care Eligibility Under the Secretarial Designee Program and Related Special Authorities

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-11-26

    ... 0790-AI52 Health Care Eligibility Under the Secretarial Designee Program and Related Special... assigns responsibilities for health care eligibility under the Secretarial Designee Program. It also implements the requirement that the United States receive reimbursement for inpatient health care provided in...

  12. Long term care needs and personal care services under Medicaid: a survey of administrators.

    PubMed

    Palley, H A; Oktay, J S

    1991-01-01

    Home and community based care services constitute a public initiative in the development of a long term care service network. One such home based initiative is the personal care service program of Medicaid. The authors conducted a national survey of administrators of this program. They received a response from 16 administrators of such programs in 1987-1988. The responses raise significant issues regarding training, access to and equity of services, quality of services, administrative oversight and the coordination of home-based care in a network of available services. Based on administrator responses, the authors draw several conclusions.

  13. Increased prefrontal cortex neurogranin enhances plasticity and extinction learning.

    PubMed

    Zhong, Ling; Brown, Joshua; Kramer, Audra; Kaleka, Kanwardeep; Petersen, Amber; Krueger, Jamie N; Florence, Matthew; Muelbl, Matthew J; Battle, Michelle; Murphy, Geoffrey G; Olsen, Christopher M; Gerges, Nashaat Z

    2015-05-13

    Increasing plasticity in neurons of the prefrontal cortex (PFC) has been proposed as a possible therapeutic tool to enhance extinction, a process that is impaired in post-traumatic stress disorder, schizophrenia, and addiction. To test this hypothesis, we generated transgenic mice that overexpress neurogranin (a calmodulin-binding protein that facilitates long-term potentiation) in the PFC. Neurogranin overexpression in the PFC enhanced long-term potentiation and increased the rates of extinction learning of both fear conditioning and sucrose self-administration. Our results indicate that elevated neurogranin function within the PFC can enhance local plasticity and increase the rate of extinction learning across different behavioral tasks. Thus, neurogranin can provide a molecular link between enhanced plasticity and enhanced extinction. Copyright © 2015 the authors 0270-6474/15/357503-06$15.00/0.

  14. Women's authority during childbirth and Safe Motherhood in Yemen.

    PubMed

    Kempe, Annica; Noor-Aldin Alwazer, Fatoom A; Theorell, Töres

    2010-11-01

    In the effort to increase utilization of professional care during childbirth in low-income countries, few studies have taken a holistic approach to investigating women's perspective of safety and the link to perceived own authority at birth. The aim of the study was to examine women's authority at birth with reference to the intrapartum factors, the level of training of staff and the social and demographic background of women. A multistage (stratified-purposive-random) sampling process was used. We interviewed 220 women with childbirth experience in urban/rural Yemen. We performed bivariate chi-square tests and multiple logistic regression analysis. Women who had their questions answered and requests met during childbirth had 83% higher probability (95% CI 1.66-2.02) to perceive own authority. Women who reported skin-to-skin contact/newborn in arms had 28% higher (95% CI 1.03-1.59) and those who had more distant contact 15% lower (95% CI 0.75-0.95) probability. A graded negative association was found between the perceived authority of the woman in childbirth and the level of biomedical training of staff (p<.0001). Women's social and demographic background played no role for their perceived own authority at birth. This paper argues that supporting Yemeni women to exercise their own authority during childbirth would significantly facilitate their ability to give birth successfully and with personal satisfaction. In a country where women are routinely disempowered, their personal empowerment at birth is very important to them. Skilled birth assistants often, in women's perceptions, work against their personal power and authority, most especially MDs but also midwives. This failure results in women failing to seek medical care when needed. Supporting women to experience their own authority at birth would facilitate the accomplishment of both the Millennium Development Goals and those of the Safe Motherhood Initiative. We call for increased cooperation between modern

  15. Research on the deformation and failure evolution of sandstone under triaxial compression based on PFC2D

    NASA Astrophysics Data System (ADS)

    Yang, X. B.; Han, X. X.; Zhou, T. B.; Liu, E. L.

    2017-04-01

    Through the comparative analysis of the results of the triaxial compression experiments of sandstone and the numerical simulation results of particle flow code PFC2D under the same conditions, the typical simulation curve and the corresponding simulation process were selected to analyze the evolution characteristics of the surface deformation field, the evolution characteristics of the velocity field and displacement field of the deformation localization bands of sandstone under triaxial compression. Research results show that the changes of the velocities and displacements of deformation localization bands corresponds to the change of stress during compression; In the same deformation localization band, the dislocation velocities are always in the same direction, but in the direction vertical to the localization band, the localization band sometimes squeezes and sometimes stretches; At different positions of the same deformation localization band, the dislocation velocities and extrusion velocities are both different at the same time; In the post-peak stage of loading, along the same deformation localization band, the dislocation displacements close to both loaded ends are generally greater than the ones near to the middle position of the specimen, the stretching displacements close to both loaded ends are generally smaller than the ones near to the middle position of the specimen.

  16. Implementation of additional prescribing authorization among oncology pharmacists in Alberta.

    PubMed

    Au, Bianca; Dersch-Mills, Deonne; Ghosh, Sunita; Jupp, Jennifer; Chambers, Carole; Cusano, Frances; Danilak, Melanie

    2018-01-01

    Purpose To describe the practice settings and prescribing practices of oncology pharmacists with additional prescribing authorization. Methods A descriptive, cross-sectional survey of all oncology pharmacists in Alberta was conducted using a web-based questionnaire over four weeks between March and April 2016. Pharmacists were identified from the Cancer Services Pharmacy Directory and leadership staff in Alberta Health Services. Descriptive statistics were used to describe the practice setting, prescribing practices, motivators to apply for additional prescribing authorization, and the facilitators and barriers of prescribing. Logistic regression was used to explore factors associated with having additional prescribing authorization. Results The overall response rate was 41% (71 of 175 pharmacists). Oncology pharmacists with additional prescribing authorization made up 38% of respondents. They primarily worked in urban, tertiary cancer centers, and practiced in ambulatory care. The top 3 clinical activities they participated in were medication reconciliation, medication counseling/education, and ambulatory patient assessment. Respondents thought additional prescribing authorization was most useful for ambulatory patient assessment and follow-up. Antiemetics were prescribed the most often. The median number of prescriptions written in an average week of clinical work was 5. Competence, self-confidence, and the potential impact on patient care/perceived impact on work environment were the strongest facilitators of prescribing. The strongest motivators to apply for additional prescribing authorization were relevancy to practice, the potential for increased efficiency, and advancing the profession. Conclusion The current majority of oncology pharmacist prescribing in Alberta occurs in ambulatory care with a large focus on antiemetic prescribing. Pharmacists found additional prescribing authorization most useful for ambulatory patient assessment and follow-up.

  17. Steadying the Three-Legged Stool: Authorizers, Charter Schools, and Education Service Providers. Authorizing Matters. Issue Brief

    ERIC Educational Resources Information Center

    Lowe, Adam; Lin, Margaret

    2006-01-01

    A three-legged stool is always stable, regardless of its placement on an uneven surface. Keeping the top parallel to the floor and comfortable to sit on, however, requires careful steps to achieve balance among each of the three legs. In carrying out their work, authorizers typically work to achieve steadiness in a two-party accountability…

  18. Bioethics and caring.

    PubMed Central

    van Hooft, S

    1996-01-01

    The author agrees with the critiques of moral theory offered by such writers as Bernard Williams and Alasdair MacIntyre, and uses ideas from Heidegger and Levinas to argue that caring is an ontological structure of human existence which takes two forms: caring about on self (which he calls our "self-project") and caring-about-others. This dual form of caring is expressed on four Aristotelian levels of human living which the author describes and illustrates with reference to the phenomenon of pain. It is concluded from this analysis that traditional notions of morality as imposing obligations should give way to an understanding of ethics as the social forms given to our caring for ourselves and for others. A number of implications for ethical theory are sketched out with the conclusion that virtue theory should be preferred and that the model could be worked out more fully to show that virtue theory can be internalist, particularist, pluralist, personalist and objectivist. PMID:8731533

  19. Bioethics and caring.

    PubMed

    van Hooft, S

    1996-04-01

    The author agrees with the critiques of moral theory offered by such writers as Bernard Williams and Alasdair MacIntyre, and uses ideas from Heidegger and Levinas to argue that caring is an ontological structure of human existence which takes two forms: caring about on self (which he calls our "self-project") and caring-about-others. This dual form of caring is expressed on four Aristotelian levels of human living which the author describes and illustrates with reference to the phenomenon of pain. It is concluded from this analysis that traditional notions of morality as imposing obligations should give way to an understanding of ethics as the social forms given to our caring for ourselves and for others. A number of implications for ethical theory are sketched out with the conclusion that virtue theory should be preferred and that the model could be worked out more fully to show that virtue theory can be internalist, particularist, pluralist, personalist and objectivist.

  20. Strategies for Development of Palliative Care From the Perspectives of General Population and Health Care Professionals: A Japanese Outreach Palliative Care Trial of Integrated Regional Model Study.

    PubMed

    Yoshida, Saran; Miyashita, Mitsunori; Morita, Tatsuya; Akizuki, Nobuya; Akiyama, Miki; Shirahige, Yutaka; Ichikawa, Takayuki; Eguchi, Kenji

    2015-09-01

    This study primarily aimed to identify future actions required to promote palliative care in Japan. The future actions regarded as effective by the general population were "improve physicians' skill in palliative care" (61%), "create a counseling center for cancer" (61%), and "improve nurses' skill in palliative care" (60%). In contrast, future actions regarded as effective by the health care professionals were "set up a Web site that provides information about cancer" (72%), "promote consultation with specialists in palliative care" (71%), and "open an outpatient department specializing in palliative care" (70%). The results suggest (1) development and maintenance of settings; (2) enhancement of palliative care education and training programs for health care providers; and (3) improvement in distributing information about cancer and regional palliative care resources to the general population. © The Author(s) 2014.

  1. Let Care Shine Through

    ERIC Educational Resources Information Center

    Bondy, Elizabeth; Hambacher, Elyse

    2016-01-01

    Care is in the eyes of the receiver; it doesn't exist unless those being cared for experience it. The authors describe culturally relevant critical teacher care, an approach that considers the effects of students' cultural and socioeconomic conditions and that helps teachers find ways to show care to every learner--especially those from oppressed…

  2. Social Isolation During the Critical Period Reduces Synaptic and Intrinsic Excitability of a Subtype of Pyramidal Cell in Mouse Prefrontal Cortex.

    PubMed

    Yamamuro, Kazuhiko; Yoshino, Hiroki; Ogawa, Yoichi; Makinodan, Manabu; Toritsuka, Michihiro; Yamashita, Masayuki; Corfas, Gabriel; Kishimoto, Toshifumi

    2018-03-01

    Juvenile social experience is crucial for the functional development of forebrain regions, especially the prefrontal cortex (PFC). We previously reported that social isolation for 2 weeks after weaning induces prefrontal cortex dysfunction and hypomyelination. However, the effect of social isolation on physiological properties of PFC neuronal circuit remained unknown. Since hypomyelination due to isolation is prominent in deep-layer of medial PFC (mPFC), we focused on 2 types of Layer-5 pyramidal cells in the mPFC: prominent h-current (PH) cells and nonprominent h-current (non-PH) cells. We found that a 2-week social isolation after weaning leads to a specific deterioration in action potential properties and reduction in excitatory synaptic inputs in PH cells. The effects of social isolation on PH cells, which involve reduction in functional glutamatergic synapses and α-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid/N-methyl-d-aspartate charge ratio, are specific to the 2 weeks after weaning and to the mPFC. We conclude that juvenile social experience plays crucial roles in the functional development in a subtype of Layer-5 pyramidal cells in the mPFC. Since these neurons project to subcortical structures, a deficit in social experience during the critical period may result in immature neural circuitry between mPFC and subcortical targets. © The Author 2017. Published by Oxford University Press. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

  3. Network structure underlying resolution of conflicting non-verbal and verbal social information.

    PubMed

    Watanabe, Takamitsu; Yahata, Noriaki; Kawakubo, Yuki; Inoue, Hideyuki; Takano, Yosuke; Iwashiro, Norichika; Natsubori, Tatsunobu; Takao, Hidemasa; Sasaki, Hiroki; Gonoi, Wataru; Murakami, Mizuho; Katsura, Masaki; Kunimatsu, Akira; Abe, Osamu; Kasai, Kiyoto; Yamasue, Hidenori

    2014-06-01

    Social judgments often require resolution of incongruity in communication contents. Although previous studies revealed that such conflict resolution recruits brain regions including the medial prefrontal cortex (mPFC) and posterior inferior frontal gyrus (pIFG), functional relationships and networks among these regions remain unclear. In this functional magnetic resonance imaging study, we investigated the functional dissociation and networks by measuring human brain activity during resolving incongruity between verbal and non-verbal emotional contents. First, we found that the conflict resolutions biased by the non-verbal contents activated the posterior dorsal mPFC (post-dmPFC), bilateral anterior insula (AI) and right dorsal pIFG, whereas the resolutions biased by the verbal contents activated the bilateral ventral pIFG. In contrast, the anterior dmPFC (ant-dmPFC), bilateral superior temporal sulcus and fusiform gyrus were commonly involved in both of the resolutions. Second, we found that the post-dmPFC and right ventral pIFG were hub regions in networks underlying the non-verbal- and verbal-content-biased resolutions, respectively. Finally, we revealed that these resolution-type-specific networks were bridged by the ant-dmPFC, which was recruited for the conflict resolutions earlier than the two hub regions. These findings suggest that, in social conflict resolutions, the ant-dmPFC selectively recruits one of the resolution-type-specific networks through its interaction with resolution-type-specific hub regions. © The Author (2013). Published by Oxford University Press. For Permissions, please email: journals.permissions@oup.com.

  4. Palliative Care in Iran: Moving Toward the Development of Palliative Care for Cancer.

    PubMed

    Rassouli, Maryam; Sajjadi, Moosa

    2016-04-01

    Cancer is the third leading cause of death in Iran and its incidence has been increasing in recent years. Patients' quality of life is altered rather enormously due to cancer, which doubles the importance of and the need for providing palliative care in Iran. Although many steps have been taken toward the development and providing of palliative care in Iran, there is still a large gap between the status quo and the desirable state. This study presents the current state of palliative care for cancer patients and discusses the barriers, challenges and outlook of palliative care in Iran. If infrastructural projects that have recently been launched prove successful, proper advancement toward the providing of palliative care services in Iran will then not far on the horizon. © The Author(s) 2014.

  5. Oregon's experiment in health care delivery and payment reform: coordinated care organizations replacing managed care.

    PubMed

    Howard, Steven W; Bernell, Stephanie L; Yoon, Jangho; Luck, Jeff; Ranit, Claire M

    2015-02-01

    To control Medicaid costs, improve quality, and drive community engagement, the Oregon Health Authority introduced a new system of coordinated care organizations (CCOs). While CCOs resemble traditional Medicaid managed care, they have differences that have been deliberately designed to improve care coordination, increase accountability, and incorporate greater community governance. Reforms include global budgets integrating medical, behavioral, and oral health care and public health functions; risk-adjusted payments rewarding outcomes and evidence-based practice; increased transparency; and greater community engagement. The CCO model faces several implementation challenges. If successful, it will provide improved health care delivery, better health outcomes, and overall savings. Copyright © 2015 by Duke University Press.

  6. What is the health care product?

    PubMed

    France, K R; Grover, R

    1992-06-01

    Because of the current competitive environment, health care providers (hospitals, HMOs, physicians, and others) are constantly searching for better products and better means for delivering them. The health care product is often loosely defined as a service. The authors develop a more precise definition of the health care product, product line, and product mix. A bundle-of-elements concept is presented for the health care product. These conceptualizations help to address how health care providers can segment their market and position, promote, and price their products. Though the authors focus on hospitals, the concepts and procedures developed are applicable to other health care organizations.

  7. Unfinished nursing care, missed care, and implicitly rationed care: State of the science review.

    PubMed

    Jones, Terry L; Hamilton, Patti; Murry, Nicole

    2015-06-01

    The purposes of this review of unfinished care were to: (1) compare conceptual definitions and frameworks associated with unfinished care and related synonyms (i.e. missed care, implicitly rationed care; and care left undone); (2) compare and contrast approaches to instrumentation; (3) describe prevalence and patterns; (4) identify antecedents and outcomes; and (5) describe mitigating interventions. A literature search in CINAHL and MEDLINE identified 1828 articles; 54 met inclusion criteria. Search terms included: implicit ration*, miss* care, ration* care, task* undone, and unfinish*care. Analysis was performed in three phases: initial screening and sorting, comprehensive review for data extraction (first author), and confirmatory review to validate groupings, major themes, and interpretations (second author). Reviewed literature included 42 quantitative reports; 7 qualitative reports; 1 mixed method report; and 4 scientific reviews. With one exception, quantitative studies involved observational cross-sectional survey designs. A total of 22 primary samples were identified; 5 involved systematic sampling. The response rate was >60% in over half of the samples. Unfinished care was measured with 14 self-report instruments. Most nursing personnel (55-98%) reported leaving at least 1 task undone. Estimates increased with survey length, recall period, scope of response referent, and scope of resource scarcity considered. Patterns of unfinished care were consistent with the subordination of teaching and emotional support activities to those related to physiologic needs and organizational audits. Predictors of unfinished care included perceived team interactions, adequacy of resources, safety climate, and nurse staffing. Unfinished care is a predictor of: decreased nurse-reported care quality, decreased patient satisfaction; increased adverse events; increased turnover; decreased job and occupational satisfaction; and increased intent to leave. Unfinished care is a

  8. Serotonin Signaling through Prefrontal Cortex 5-HT1A Receptors during Adolescence Can Determine Baseline Mood-Related Behaviors.

    PubMed

    Garcia-Garcia, Alvaro L; Meng, Qingyuan; Canetta, Sarah; Gardier, Alain M; Guiard, Bruno P; Kellendonk, Christoph; Dranovsky, Alex; Leonardo, E David

    2017-01-31

    Lifelong homeostatic setpoints for mood-related behaviors emerge during adolescence. Serotonin (5-HT) plays an important role in refining the formation of brain circuits during sensitive developmental periods. In rodents, the role of 5-HT 1A receptors in general and autoreceptors in particular has been characterized in anxiety. However, less is known about the role of 5-HT 1A receptors in depression-related behavior. Here, we show that whole-life suppression of heteroreceptor expression results in a broad depression-like behavioral phenotype accompanied by physiological and cellular changes within medial prefrontal cortex-dorsal raphe proper (mPFC-DRN) circuitry. These changes include increased basal 5-HT in a mPFC that is hyporesponsive to stress and decreased basal 5-HT levels and firing rates in a DRN hyperactivated by the same stressor. Remarkably, loss of heteroreceptors in the PFC at adolescence is sufficient to recapitulate this depression-like behavioral syndrome. Our results suggest that targeting mPFC 5-HT 1A heteroreceptors during adolescence in humans may have lifelong ramifications for depression and its treatment. Copyright © 2017 The Author(s). Published by Elsevier Inc. All rights reserved.

  9. How to Manage Hospital-Based Palliative Care Teams Without Full-Time Palliative Care Physicians in Designated Cancer Care Hospitals: A Qualitative Study.

    PubMed

    Sakashita, Akihiro; Kishino, Megumi; Nakazawa, Yoko; Yotani, Nobuyuki; Yamaguchi, Takashi; Kizawa, Yoshiyuki

    2016-07-01

    To clarify how highly active hospital palliative care teams can provide efficient and effective care regardless of the lack of full-time palliative care physicians. Semistructured focus group interviews were conducted, and content analysis was performed. A total of 7 physicians and 6 nurses participated. We extracted 209 codes from the transcripts and organized them into 3 themes and 21 categories, which were classified as follows: (1) tips for managing palliative care teams efficiently and effectively (7 categories); (2) ways of acquiring specialist palliative care expertise (9 categories); and (3) ways of treating symptoms that are difficult to alleviate (5 categories). The findings of this study can be used as a nautical chart of hospital-based palliative care team (HPCT) without full-time PC physician. Full-time nurses who have high management and coordination abilities play a central role in resource-limited HPCTs. © The Author(s) 2015.

  10. Insensitive parenting may accelerate the development of the amygdala-medial prefrontal cortex circuit.

    PubMed

    Thijssen, Sandra; Muetzel, Ryan L; Bakermans-Kranenburg, Marian J; Jaddoe, Vincent W V; Tiemeier, Henning; Verhulst, Frank C; White, Tonya; Van Ijzendoorn, Marinus H

    2017-05-01

    This study examined whether the association between age and amygdala-medial prefrontal cortex (mPFC) connectivity in typically developing 6- to 10-year-old children is correlated with parental care. Resting-state functional magnetic resonance imaging scans were acquired from 124 children of the Generation R Study who at 4 years old had been observed interacting with their parents to assess maternal and paternal sensitivity. Amygdala functional connectivity was assessed using a general linear model with the amygdalae time series as explanatory variables. Higher level analyses assessing Sensitivity × Age as well as exploratory Sensitivity × Age × Gender interaction effects were performed restricted to voxels in the mPFC. We found significant Sensitivity × Age interaction effects on amygdala-mPFC connectivity. Age was related to stronger amygdala-mPFC connectivity in children with a lower combined parental sensitivity score (b = 0.11, p = .004, b = 0.06, p = .06, right and left amygdala, respectively), but not in children with a higher parental sensitivity score, (b = -0.07, p = .12, b = -0.06, p = .12, right and left amygdala, respectively). A similar effect was found for maternal sensitivity, with stronger amygdala-mPFC connectivity in children with less sensitive mothers. Exploratory (parental, maternal, paternal) Sensitivity × Age × Gender interaction analyses suggested that this effect was especially pronounced in girls. Amygdala-mPFC resting-state functional connectivity has been shown to increase from age 10.5 years onward, implying that the positive association between age and amygdala-mPFC connectivity in 6- to 10-year-old children of less sensitive parents represents accelerated development of the amygdala-mPFC circuit.

  11. Continuing Care Retirement Communities: An Analysis of Financial Viability and Health Care Coverage.

    ERIC Educational Resources Information Center

    Ruchlin, Hirsch S.

    1988-01-01

    Calculated financial ratios for 109 Continuing Care Retirement Communities (CCRCs). Noted problems with regard to asset productivity, profitability, and equity levels. Found that a risk-spreading charge structure for financing health care needs appeared to exist among CCRCs providing a full-care contract. (Author/ABL)

  12. Integration of Palliative Care Principles into the Ongoing Care of Children with Cancer: Individualized Care Planning and Coordination

    PubMed Central

    Baker, Justin N; Hinds, Pamela S; Spunt, Sheri L; Barfield, Raymond C; Allen, Caitlin; Powell, Brent C; Anderson, Lisa H; Kane, Javier R

    2008-01-01

    Synopsis The Individualized Care Planning and Coordination Model is designed to integrate palliative care principles and practices into the ongoing care of children with cancer. Application of the model helps clinicians to generate a comprehensive individualized care plan that is implemented through Individualized Care Coordination processes as detailed here. Clinicians’ strong desire to provide compassionate, competent and sensitive care to the seriously ill child and the child’s family can be effectively translated into clinical practice through these processes. “To cure sometimes, to relieve often, to comfort always -- this is our work.” Author Unknown PMID:18242323

  13. 78 FR 76064 - Authorization for Non-VA Medical Services; Withdrawal

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-12-16

    ... DEPARTMENT OF VETERANS AFFAIRS 38 CFR Part 17 RIN 2900-AO47 Authorization for Non-VA Medical... November 28, 2012, that would have amended its regulations regarding payment by VA for medical services under VA's statutory authority to provide non-VA medical care. VA sought to remove an outdated...

  14. Regulating payment for home care companionship services: legal authority and public policy.

    PubMed

    Kapp, Marshall B

    2008-01-01

    On June 11, 2007, the U.S. Supreme Court issued a ruling in the case of Long Island Care at Home Ltd. v. Coke that upheld a federal regulation exempting employees of third-party agencies who provide home-based "companionship services" to disabled persons from the protections of the minimum wage and overtime pay provisions of the Fair Labor Standards Act. This article discusses the legal issues argued in the case and the legal rationales for the court's decision. The article then identifies the important public policy questions involving the maintenance of a sufficient, competent home care workforce that were left unanswered by the legal ruling and outlines some of the pragmatic implications of potential responses to these public policy questions.

  15. Impact of cannabis use on prefrontal and parietal cortex gyrification and surface area in adolescents and emerging adults.

    PubMed

    Shollenbarger, Skyler G; Price, Jenessa; Wieser, Jon; Lisdahl, Krista

    2015-12-01

    Regions undergoing maturation with CB1 receptors may be at increased risk for cannabis-induced alterations. Here, we examine the relationships between cannabis use and prefrontal (PFC) and inferior parietal gyrification and surface area (SA) in youth. Participants included 33 cannabis users and 35 controls (ages 18-25). Exclusions included co-morbid psychiatric/neurologic disorders and heavy other drug use. Multiple regressions and Pearson r correlations examined the effects of cannabis use on gyrification, SA and cognition. Cannabis use was associated with decreased gyrification in: ventral-medial PFC (RH: [FDR corrected p=.02], LH: [FDR corrected p=.02]); medial PFC (RH: [FDR corrected p=.02], LH: [FDR corrected p=.02]); and frontal poles (RH: [FDR corrected p=.02], LH: [FDR corrected p=.02]). No differences were observed in bilateral hemispheres, PFC, dorsolateral, ventrolateral, or inferior parietal ROIs. Cannabis use was associated with marginally decreased SA in left: medial PFC [FDR corrected p=.09], and ventral lateral PFC: [FDR corrected p=.09]. In cannabis users, increased gyrification was associated with improved working-memory performance in right medial (p=.003), ventral-medial (p=.03), and frontal pole ROIs (p=.007). Cannabis use was associated with reduced gyrification in PFC regions implicated in self-referential thought and social cognition. Results suggest that these gyrification characteristics may have cognitive implications. Copyright © 2015 The Authors. Published by Elsevier Ltd.. All rights reserved.

  16. Susceptibility to social pressure following ventromedial prefrontal cortex damage.

    PubMed

    Chen, Kuan-Hua; Rusch, Michelle L; Dawson, Jeffrey D; Rizzo, Matthew; Anderson, Steven W

    2015-11-01

    Social pressure influences human behavior including risk taking, but the psychological and neural underpinnings of this process are not well understood. We used the human lesion method to probe the role of ventromedial prefrontal cortex (vmPFC) in resisting adverse social pressure in the presence of risk. Thirty-seven participants (11 with vmPFC damage, 12 with brain damage outside the vmPFC and 14 without brain damage) were tested in driving simulator scenarios requiring left-turn decisions across oncoming traffic with varying time gaps between the oncoming vehicles. Social pressure was applied by a virtual driver who honked aggressively from behind. Participants with vmPFC damage were more likely to select smaller and potentially unsafe gaps under social pressure, while gap selection by the comparison groups did not change under social pressure. Participants with vmPFC damage also showed prolonged elevated skin conductance responses (SCR) under social pressure. Comparison groups showed similar initial elevated SCR, which then declined prior to making left-turn decisions. The findings suggest that the vmPFC plays an important role in resisting explicit and immediately present social pressure with potentially negative consequences. The vmPFC appears to contribute to the regulation of emotional responses and the modulation of decision making to optimize long-term outcomes. © The Author (2015). Published by Oxford University Press. For Permissions, please email: journals.permissions@oup.com.

  17. Do neonatologists limit parental decision-making authority? A Canadian perspective.

    PubMed

    Albersheim, Susan G; Lavoie, Pascal M; Keidar, Yaron D

    2010-12-01

    According to the principles of family-centered care, fully informed parents and health care professionals are partners in the care of sick neonates. The aim of this study was to assess the attitudes of Canadian neonatologists towards the authority of parents to make life-and-death decisions for their babies. We interviewed 121 (74%) of the 164 practicing neonatologists in Canada (June 2004-March 2005), using scripted open-ended questions and common clinical scenarios. Data analysis employed interpretive description methodology. The main outcome measure was the intention of neonatologists to limit parental life-and-death decision-making authority, when they disagree with parental decisions. Neonatologists' self-rated respect for parental decision-making authority was 8/10. Most neonatologists thought that parents should be either primary decision-makers or part of the decision-making team. Fifty-six percent of neonatologists would limit parental decision-making authority if the parents' decision is not in the baby's "best interest". In response to common neonatal severe illness scenarios, up to 18% of neonatologists said they would limit parental decision-making, even if the chance of intact survival is very poor. For clinical scenarios with equally poor long-term outcomes, neonatologists were more likely to comply with parental wishes early in the life of a baby, particularly with documented brain injury. Canadian neonatologists espouse high regard for parental decision-making authority, but are prepared to limit parental authority if the parents' decision is not thought to be in the baby's best interest. Although neonatologists advise parents that treatment can be started at birth, and stopped later, this was only for early severe brain injury. Copyright © 2010 Elsevier Ltd. All rights reserved.

  18. 32 CFR 728.31 - Eligible beneficiaries and health benefits authorized.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... PERSONNEL MEDICAL AND DENTAL CARE FOR ELIGIBLE PERSONS AT NAVY MEDICAL DEPARTMENT FACILITIES Retired Members... authorized the same medical and dental benefits as active duty members subject to the availability of space... requirements of § 728.31(b)(7)(i) or (ii) may be provided medical and dental care as a dependent when the...

  19. The Politics of Native American Health Care and the Affordable Care Act.

    PubMed

    Skinner, Daniel

    2016-02-01

    This article examines an important but largely overlooked dimension of the Patient Protection and Affordable Care Act (ACA), namely, its significance for Native American health care. The author maintains that reading the ACA against the politics of Native American health care policy shows that, depending on their regional needs and particular contexts, many Native Americans are well-placed to benefit from recent Obama-era reforms. At the same time, the kinds of options made available by the ACA constitute a departure from the service-based (as opposed to insurance-based) Indian Health Service (IHS). Accordingly, the author argues that ACA reforms--private marketplaces, Medicaid expansion, and accommodations for Native Americans--are best read as potential "supplements" to an underfunded IHS. Whether or not Native Americans opt to explore options under the ACA will depend in the long run on the quality of the IHS in the post-ACA era. Beyond understanding the ACA in relation to IHS funding, the author explores how Native American politics interacts with the key tenets of Obama-era health care reform--especially "affordability"--which is critical for understanding what is required from and appropriate to future Native American health care policy making. Copyright © 2016 by Duke University Press.

  20. Interhemispheric Connectivity and Executive Functioning in Adults With Tourette Syndrome

    PubMed Central

    Margolis, Amy; Donkervoort, Mireille; Kinsbourne, Marcel; Peterson, Bradley S.

    2008-01-01

    The prefrontal cortex (PFC) is relatively smaller, and the corpus callosum (CC) larger, in adults with Tourette syndrome (TS). The authors explored the possible roles of the PFC and the CC in mediating interhemispheric interference and coordination in TS adults. They measured performance on M. Kinsbourne and J. Cook's (1971) verbal–manual interference task and on the bimanual Purdue Pegboard in 38 adults with TS and 34 healthy adults. Compared with controls, TS subjects were impaired on the bimanual Purdue Pegboard. On the dual task, right-hand performance did not differ between groups, but the normally expected left-hand advantage (opposite hemisphere condition) was absent in TS subjects. In the control group only, better left-hand performance accompanied larger PFC volumes but not CC cross-sectional area. PFC dysfunction might have precluded executive control of interference in the TS group. PMID:16460223

  1. Health care reform and care at the behavioral health--primary care interface.

    PubMed

    Druss, Benjamin G; Mauer, Barbara J

    2010-11-01

    The historic passage of the Patient Protection and Affordable Care Act in March 2010 offers the potential to address long-standing deficits in quality and integration of services at the interface between behavioral health and primary care. Many of the efforts to reform the care delivery system will come in the form of demonstration projects, which, if successful, will become models for the broader health system. This article reviews two of the programs that might have a particular impact on care on the two sides of that interface: Medicaid and Medicare patient-centered medical home demonstration projects and expansion of a Substance Abuse and Mental Health Services Administration program that colocates primary care services in community mental health settings. The authors provide an overview of key supporting factors, including new financing mechanisms, quality assessment metrics, information technology infrastructure, and technical support, that will be important for ensuring that initiatives achieve their potential for improving care.

  2. Together but apart: Caring for a spouse with dementia resident in a care facility.

    PubMed

    Hemingway, Dawn; MacCourt, Penny; Pierce, Joanna; Strudsholm, Tina

    2016-07-01

    This longitudinal, exploratory study was designed to better understand the lived experience of spousal caregivers age 60 and older providing care to partners with Alzheimer's disease and related dementias resident in a care facility. Twenty eight spousal caregivers were interviewed up to three times over a period of 2 years, and long-term care facility staff from four locations across British Columbia (BC), Canada participated in four focus groups. Thematic analysis of interview and focus group transcripts revealed a central, unifying theme 'together but apart'. The results identify key targets for policy makers and service providers to support positive health and well-being outcomes for spousal caregivers providing care to their partners diagnosed with Alzheimer's disease and related dementia and living in care facilities. © The Author(s) 2014.

  3. Improving Palliative Care Team Meetings: Structure, Inclusion, and "Team Care".

    PubMed

    Brennan, Caitlin W; Kelly, Brittany; Skarf, Lara Michal; Tellem, Rotem; Dunn, Kathleen M; Poswolsky, Sheila

    2016-07-01

    Increasing demands on palliative care teams point to the need for continuous improvement to ensure teams are working collaboratively and efficiently. This quality improvement initiative focused on improving interprofessional team meeting efficiency and subsequently patient care. Meeting start and end times improved from a mean of approximately 9 and 6 minutes late in the baseline period, respectively, to a mean of 4.4 minutes late (start time) and ending early in our sustainability phase. Mean team satisfaction improved from 2.4 to 4.5 on a 5-point Likert-type scale. The improvement initiative clarified communication about patients' plans of care, thus positively impacting team members' ability to articulate goals to other professionals, patients, and families. We propose several recommendations in the form of a team meeting "toolkit." © The Author(s) 2015.

  4. Advance Care Planning in palliative care: a qualitative investigation into the perspective of Paediatric Intensive Care Unit staff.

    PubMed

    Mitchell, Sarah; Dale, Jeremy

    2015-04-01

    The majority of children and young people who die in the United Kingdom have pre-existing life-limiting illness. Currently, most such deaths occur in hospital, most frequently within the intensive care environment. To explore the experiences of senior medical and nursing staff regarding the challenges associated with Advance Care Planning in relation to children and young people with life-limiting illnesses in the Paediatric Intensive Care Unit environment and opportunities for improvement. Qualitative one-to-one, semi-structured interviews were conducted with Paediatric Intensive Care Unit consultants and senior nurses, to gain rich, contextual data. Thematic content analysis was carried out. UK tertiary referral centre Paediatric Intensive Care Unit. Eight Paediatric Intensive Care Unit consultants and six senior nurses participated. Four main themes emerged: recognition of an illness as 'life-limiting'; Advance Care Planning as a multi-disciplinary, structured process; the value of Advance Care Planning and adverse consequences of inadequate Advance Care Planning. Potential benefits of Advance Care Planning include providing the opportunity to make decisions regarding end-of-life care in a timely fashion and in partnership with patients, where possible, and their families. Barriers to the process include the recognition of the life-limiting nature of an illness and gaining consensus of medical opinion. Organisational improvements towards earlier recognition of life-limiting illness and subsequent Advance Care Planning were recommended, including education and training, as well as the need for wider societal debate. Advance Care Planning for children and young people with life-limiting conditions has the potential to improve care for patients and their families, providing the opportunity to make decisions based on clear information at an appropriate time, and avoid potentially harmful intensive clinical interventions at the end of life. © The Author(s) 2015.

  5. Devolution to democratic health authorities in Saskatchewan: an interim report

    PubMed Central

    Lewis, Steven J.; Kouri, Denise; Estabrooks, Carole A.; Dickinson, Harley; Dutchak, Jacqueline J.; Williams, J. Ivan; Mustard, Cameron; Hurley, Jeremiah

    2001-01-01

    Background In 1995 Saskatchewan adopted a district health board structure in which two-thirds of members are elected and the rest are appointed. This study examines the opinions of board members about health care reform and devolution of authority from the province to the health districts. Methods All 357 members of Saskatchewan district health boards were surveyed in 1997; 275 (77%) responded. Analyses included comparisons between elected and appointed members and between members with experience as health care providers and those without such experience, as well as comparisons with hypotheses about how devolution would develop, which were advanced in a 1997 report by another group. Results Most respondents felt that devolution had resulted in increased local control and better quality of decisions. Ninety-two percent of respondents believed extensive reforms were necessary and 83% that changes made in the previous 5 years had been for the best. However, 56% agreed that there was no clear vision of the reformed system. A small majority (59%) perceived health care reform as having been designed to improve health rather than reduce spending, contrary to a previous hypothesis. Many respondents (76%) thought that boards were legally responsible for things over which they had insufficient control, and 63% perceived that they were too restricted by rules laid down by the provincial government, findings that confirm the expectation of tensions surrounding the division of authority. Respondents with current or former experience as health care providers were less likely than nonprovider respondents to believe that nonphysician health care providers support decisions made by the regional health boards (45% v. 63%, p = 0.02), a result that confirmed the contention that the role of health care providers on the boards would be a source of tension. Interpretation Members of Saskatchewan district health boards supported the general goals of health care reform and believed that

  6. Devolution to democratic health authorities in Saskatchewan: an interim report.

    PubMed

    Lewis, S J; Kouri, D; Estabrooks, C A; Dickinson, H; Dutchak, J J; Williams, J I; Mustard, C; Hurley, J

    2001-02-06

    In 1995 Saskatchewan adopted a district health board structure in which two-thirds of members are elected and the rest are appointed. This study examines the opinions of board members about health care reform and devolution of authority from the province to the health districts. All 357 members of Saskatchewan district health boards were surveyed in 1997; 275 (77%) responded. Analyses included comparisons between elected and appointed members and between members with experience as health care providers and those without such experience, as well as comparisons with hypotheses about how devolution would develop, which were advanced in a 1997 report by another group. Most respondents felt that devolution had resulted in increased local control and better quality of decisions. Ninety-two percent of respondents believed extensive reforms were necessary and 83% that changes made in the previous 5 years had been for the best. However, 56% agreed that there was no clear vision of the reformed system. A small majority (59%) perceived health care reform as having been designed to improve health rather than reduce spending, contrary to a previous hypothesis. Many respondents (76%) thought that boards were legally responsible for things over which they had insufficient control, and 63% perceived that they were too restricted by rules laid down by the provincial government, findings that confirm the expectation of tensions surrounding the division of authority. Respondents with current or former experience as health care providers were less likely than nonprovider respondents to believe that nonphysician health care providers support decisions made by the regional health boards (45% v. 63%, p = 0.02), a result that confirmed the contention that the role of health care providers on the boards would be a source of tension. Members of Saskatchewan district health boards supported the general goals of health care reform and believed that changes already undertaken had been positive

  7. Organization of Hospital Nursing, Provision of Nursing Care, and Patient Experiences With Care in Europe.

    PubMed

    Bruyneel, Luk; Li, Baoyue; Ausserhofer, Dietmar; Lesaffre, Emmanuel; Dumitrescu, Irina; Smith, Herbert L; Sloane, Douglas M; Aiken, Linda H; Sermeus, Walter

    2015-12-01

    This study integrates previously isolated findings of nursing outcomes research into an explanatory framework in which care left undone and nurse education levels are of key importance. A moderated mediation analysis of survey data from 11,549 patients and 10,733 nurses in 217 hospitals in eight European countries shows that patient care experience is better in hospitals with better nurse staffing and a more favorable work environment in which less clinical care is left undone. Clinical care left undone is a mediator in this relationship. Clinical care is left undone less frequently in hospitals with better nurse staffing and more favorable nurse work environments, and in which nurses work less overtime and are more experienced. Higher proportions of nurses with a bachelor's degree reduce the effect of worse nurse staffing on more clinical care left undone. © The Author(s) 2015.

  8. Mental Health in Long Term Care Settings.

    ERIC Educational Resources Information Center

    Shore, Herbert

    1978-01-01

    There are many ways in which long-term care facilities attempt to cope with the mental health problems of the elderly. The author reviews five factors crucial to effective care for the aged in these facilities. (Author/RK)

  9. Child Care in Canada

    ERIC Educational Resources Information Center

    Graham, Kathy

    2005-01-01

    In this article, the author describes early learning and care arrangements in Canada and how the country faced the challenges in the development of a National Child Care System. While the provincial/territorial governments are responsible for early learning and care, the federal government has formed health and social programs including some child…

  10. Prescriptive authority for advanced practice nurses: current and future perspectives.

    PubMed

    McDermott, K C

    1995-09-01

    To present an overview of the issues related to prescriptive authority and advanced practice nurses (APNs) in oncology. Professional journals and books, print media, and professional and government releases. Discussion of issues related to complex political, educational, economic, and healthcare environmental factors. Strategies to achieve increased recognition for APN prescriptive authority include increasing APNs' knowledge about the effects of the political process on prescriptive authority, educating legislators and consumers, promoting standardization of pharmacology curricula, and encouraging formation of coalitions. Failure to pass a national healthcare plan, escalating managed-care markets, and the reform efforts of individual states to forge their own healthcare initiatives will challenge the APN's ability to practice and prescribe. The subject of prescriptive authority highlights the controversies and debates that APNs encounter in a dynamic healthcare environment. These include the complexity of state-to-state regulations, non-nursing professions making key decisions regarding scope of practice and prescriptive authority, and the challenge for APNs to carve out new roles while overcoming state regulatory inconsistencies and market-reform barriers. If not resolved, these issues will continue to prevent qualified APNs from providing appropriate and comprehensive care to patients with cancer.

  11. Japanese Bereaved Family Members' Perspectives of Palliative Care Units and Palliative Care: J-HOPE Study Results.

    PubMed

    Kinoshita, Satomi; Miyashita, Mitsunori; Morita, Tatsuya; Sato, Kazuki; Shoji, Ayaka; Chiba, Yurika; Miyazaki, Tamana; Tsuneto, Satoru; Shima, Yasuo

    2016-06-01

    The study purpose was to understand the perspectives of bereaved family members regarding palliative care unit (PCU) and palliative care and to compare perceptions of PCU before admission and after bereavement. A cross-sectional questionnaire survey was conducted, and the perceptions of 454 and 424 bereaved family members were obtained regarding PCU and palliative care, respectively. Family members were significantly more likely to have positive perceptions after bereavement (ranging from 73% to 80%) compared to before admission (ranging from 62% to 71%). Bereaved family members who were satisfied with medical care in the PCU had a positive perception of the PCU and palliative care after bereavement. Respondents younger than 65 years of age were significantly more likely to have negative perceptions of PCU and palliative care. © The Author(s) 2015.

  12. In Search of Models of Care

    ERIC Educational Resources Information Center

    Davidson, Glen W.

    1978-01-01

    Without careful definition of "spiritual," hospice care will be little different in quality from that offered in acute and chronic care centers. Also discussed is the challenge to hospice care staff to defy trends in recent health care allowing staff rather than patients to determine what dignity means. (Author)

  13. Federal Aviation Administration (FAA) Reauthorization: An Overview of Legislative Action in the 111th Congress

    DTIC Science & Technology

    2010-03-22

    airports would be encouraged to assess their energy requirements, including heating and cooling , base load, back- up power, and power for on-road...available under the AIP or PFC programs. The trial program is to encourage compatible land uses with the airport and generate economic benefits to both...prevents the Metropolitan Washington Airports Authority from applying for AIP or PFC grants after October 1, 2008. . FAA Reauthorization: An Overview of

  14. Effects of valence and divided attention on cognitive reappraisal processes.

    PubMed

    Morris, John A; Leclerc, Christina M; Kensinger, Elizabeth A

    2014-12-01

    Numerous studies have investigated the neural substrates supporting cognitive reappraisal, identifying the importance of cognitive control processes implemented by prefrontal cortex (PFC). This study examined how valence and attention affect the processes used for cognitive reappraisal by asking participants to passively view or to cognitively reappraise positive and negative images with full or divided attention. When participants simply viewed these images, results revealed few effects of valence or attention. However, when participants engaged in reappraisal, there was a robust effect of valence, with the reappraisal of negative relative to positive images associated with more widespread activation, including within regions of medial and lateral PFC. There also was an effect of attention, with more lateral PFC recruitment when regulating with full attention and more medial PFC recruitment when regulating with divided attention. Within two regions of medial PFC and one region of ventrolateral PFC, there was an interaction between valence and attention: in these regions, divided attention reduced activity during reappraisal of positive but not negative images. Critically, participants continued to report reappraisal success even during the Divided Attention condition. These results suggest multiple routes to successful cognitive reappraisal, depending upon image valence and the availability of attentional resources. © The Author (2014). Published by Oxford University Press. For Permissions, please email: journals.permissions@oup.com.

  15. Anxiety Evokes Hypofrontality and Disrupts Rule-Relevant Encoding by Dorsomedial Prefrontal Cortex Neurons.

    PubMed

    Park, Junchol; Wood, Jesse; Bondi, Corina; Del Arco, Alberto; Moghaddam, Bita

    2016-03-16

    anxiety affects PFC encoding of cognitive events is of great clinical and evolutionary significance. Using a clinically valid experimental model, we find that, under anxiety, decision making may be skewed by salient and conflicting environmental stimuli at the expense of flexible top-down guided choices. We also find that anxiety suppresses spontaneous activity of PFC neurons, and weakens encoding of task rules by dorsomedial PFC neurons. These data provide a neuronal encoding scheme for how anxiety disengages PFC during decision making. Copyright © 2016 the authors 0270-6474/16/363322-14$15.00/0.

  16. Numerical Simulations of Slow Stick Slip Events with PFC, a DEM Based Code

    NASA Astrophysics Data System (ADS)

    Ye, S. H.; Young, R. P.

    2017-12-01

    Nonvolcanic tremors around subduction zone have become a fascinating subject in seismology in recent years. Previous studies have shown that the nonvolcanic tremor beneath western Shikoku is composed of low frequency seismic waves overlapping each other. This finding provides direct link between tremor and slow earthquakes. Slow stick slip events are considered to be laboratory scaled slow earthquakes. Slow stick slip events are traditionally studied with direct shear or double direct shear experiment setup, in which the sliding velocity can be controlled to model a range of fast and slow stick slips. In this study, a PFC* model based on double direct shear is presented, with a central block clamped by two side blocks. The gauge layers between the central and side blocks are modelled as discrete fracture networks with smooth joint bonds between pairs of discrete elements. In addition, a second model is presented in this study. This model consists of a cylindrical sample subjected to triaxial stress. Similar to the previous model, a weak gauge layer at a 45 degrees is added into the sample, on which shear slipping is allowed. Several different simulations are conducted on this sample. While the confining stress is maintained at the same level in different simulations, the axial loading rate (displacement rate) varies. By varying the displacement rate, a range of slipping behaviour, from stick slip to slow stick slip are observed based on the stress-strain relationship. Currently, the stick slip and slow stick slip events are strictly observed based on the stress-strain relationship. In the future, we hope to monitor the displacement and velocity of the balls surrounding the gauge layer as a function of time, so as to generate a synthetic seismogram. This will allow us to extract seismic waveforms and potentially simulate the tremor-like waves found around subduction zones. *Particle flow code, a discrete element method based numerical simulation code developed by

  17. Communication and Culture in the Surgical Intensive Care Unit: Boundary Production and the Improvement of Patient Care.

    PubMed

    Conn, Lesley Gotlib; Haas, Barbara; Cuthbertson, Brian H; Amaral, Andre C; Coburn, Natalie; Nathens, Avery B

    2016-06-01

    This ethnography explores communication around critically ill surgical patients in three surgical intensive care units (ICUs) in Canada. A boundary framework is used to articulate how surgeons', intensivists', and nurses' communication practices shape and are shaped by their respective disciplinary perspectives and experiences. Through 50 hours of observations and 43 interviews, these health care providers are found to engage in seven communication behaviors that either mitigate or magnify three contested symbolic boundaries: expertise, patient ownership, and decisional authority. Where these boundaries are successfully mitigated, experiences of collaborative, high-quality patient care are produced; by contrast, boundary magnification produces conflict and perceptions of unsafe patient care. Findings reveal that high quality and safe patient care are produced through complex social and cultural interactions among surgeons, intensivists, and nurses that are also expressions of knowledge and power. This enhances our understanding of why current quality improvement efforts targeting communication may be ineffective. © The Author(s) 2015.

  18. Nursing: caring or codependent?

    PubMed

    Caffrey, R A; Caffrey, P A

    1994-01-01

    Can nurses practice caring within a healthcare system that promotes codependency? Caring promotes mutual empowerment of all participants while codependent caring disempowers. Nurses are expected to practice caring with clients, The authors contend, however, that nursing, as historically and currently practiced within bureaucratic/patriarchal organizations, is founded on a value system that fosters codependency. Until nursing is practiced within the context of caring organizations and a caring healthcare system, nurses will continue to be powerless to shape their own practice as carers and burnout will continue to be a problem.

  19. Derivation of a needs based capitation formula for allocating prescribing budgets to health authorities and primary care groups in England: regression analysis

    PubMed Central

    Rice, Nigel; Dixon, Paul; Lloyd, David C E F; Roberts, David

    2000-01-01

    Objective To develop a weighted capitation formula for setting target allocations for prescribing expenditures for health authorities and primary care groups in England. Design Regression analysis relating prescribing costs to the demographic, morbidity, and mortality composition of practice lists. Setting 8500 general practices in England. Subjects Data from the 1991 census were attributed to practice lists on the basis of the place of residence of the practice population. Main outcome measures Variation in age, sex, and temporary resident originated prescribing units (ASTRO(97)-PUs) adjusted net ingredient cost of general practices in England for 1997-8 modelled for the impact of health and social needs after controlling for differences in supply. Results A needs gradient based on the four variables: permanent sickness, percentage of dependants in no carer households, percentage of students, and percentage of births on practice lists. These, together with supply characteristics, explained 41% of variation in prescribing costs per ASTRO(97)-PU adjusted capita across practices. The latter alone explained about 35% of variation in total costs per head across practices. Conclusions The model has good statistical specification and contains intuitively plausible needs drivers of prescribing expenditure. Together with adjustments made for differences in ASTRO(97)-PUs the model is capable of explaining 62% (35%+0.65% (41%)) of variation in prescribing expenditure at practice level. The results of the study have formed the basis for setting target budgets for 1999-2000 allocations for prescribing expenditure for health authorities and primary care groups. PMID:10650026

  20. Care Aides' Relational Practices and Caring Contributions.

    PubMed

    Andersen, Elizabeth A; Spiers, Jude

    2016-11-01

    residents. 2. Describe how nursing home managers can empower care aides to provide care. DISCLOSURE STATEMENT Neither the planners nor the author have any conflicts of interest to disclose. The current study was a qualitative focused ethnography aimed at exploring the complexities of care; working environments; and knowledge, skills, and efforts of care aides who work in nursing homes. Over the past decade, dramatic shifts in staffing patterns in Canadian nursing homes have transformed care aides' assistive and caring roles. Care aides are now the central and most accessible service providers to nursing home residents. In the current article, the authors (a) conceptualize care aide work as caring rather than caring activities, (b) explore relational care as a foundational and significant component of care aide work, (c) interpret care aides' relational care practices through the lens of Swanson's Middle Range Theory of Caring, and (d) describe how nursing home managers can empower care aides to do this work. [Journal of Gerontological Nursing, 42(11), 24-30.]. Copyright 2016, SLACK Incorporated.

  1. Blueprint for an Undergraduate Primary Care Curriculum.

    PubMed

    Fazio, Sara B; Demasi, Monica; Farren, Erin; Frankl, Susan; Gottlieb, Barbara; Hoy, Jessica; Johnson, Amanda; Kasper, Jill; Lee, Patrick; McCarthy, Claire; Miller, Kathe; Morris, Juliana; O'Hare, Kitty; Rosales, Rachael; Simmons, Leigh; Smith, Benjamin; Treadway, Katherine; Goodell, Kristen; Ogur, Barbara

    2016-12-01

    In light of the increasing demand for primary care services and the changing scope of health care, it is important to consider how the principles of primary care are taught in medical school. While the majority of schools have increased students' exposure to primary care, they have not developed a standardized primary care curriculum for undergraduate medical education. In 2013, the authors convened a group of educators from primary care internal medicine, pediatrics, family medicine, and medicine-pediatrics, as well as five medical students to create a blueprint for a primary care curriculum that could be integrated into a longitudinal primary care experience spanning undergraduate medical education and delivered to all students regardless of their eventual career choice.The authors organized this blueprint into three domains: care management, specific areas of content expertise, and understanding the role of primary care in the health care system. Within each domain, they described specific curriculum content, including longitudinality, generalism, central responsibility for managing care, therapeutic alliance/communication, approach to acute and chronic care, wellness and prevention, mental and behavioral health, systems improvement, interprofessional training, and population health, as well as competencies that all medical students should attain by graduation.The proposed curriculum incorporates important core features of doctoring, which are often affirmed by all disciplines but owned by none. The authors argue that primary care educators are natural stewards of this curriculum content and can ensure that it complements and strengthens all aspects of undergraduate medical education.

  2. Blunted neural response to implicit negative facial affect in anorexia nervosa.

    PubMed

    Leppanen, Jenni; Cardi, Valentina; Paloyelis, Yannis; Simmons, Andy; Tchanturia, Kate; Treasure, Janet

    2017-09-01

    People with anorexia nervosa (AN) have difficulties in a wide range of social-emotional processes. Previous work suggests atypical involvement of the prefrontal cortex (PFC), amygdala, insula, and fusiform gyri during social-emotional processing in AN. Twenty women with AN and twenty healthy comparison (HC) women were presented with happy, fearful, and neutral faces during a functional magnetic resonance imaging study. Group differences were investigated in the following regions of interest: lateral PFC, amygdala, insula, and fusiform gyri. The HC participants showed significantly increased recruitment of the ventrolateral PFC and amygdala in the fearful > neutral contrast relative to the AN participants. The AN participants showed a significantly increased recruitment of a small cluster in the right posterior insula in the happy > neutral contrast. These findings are in line with the hypothesis that people with AN have a blunted response to negative and atypical exaggerated response to positive emotionally provoking stimuli. Copyright © 2017 The Author(s). Published by Elsevier B.V. All rights reserved.

  3. Trends in Family Child Care

    ERIC Educational Resources Information Center

    Neugebauer, Roger

    2011-01-01

    The author presents insights from various readers of "ExchangeEveryDay" regarding trends in the world of family child care. Kathleen Reticker of Acre Family Child Care in Lowell, Massachusetts thinks an increasing trend in Family Child Care is the pressure to emulate a Center, instead of seeing family child care as a different model. Over the…

  4. Innovation in Pediatric Cardiac Intensive Care: An Exponential Convergence Toward Transformation of Care.

    PubMed

    Maher, Kevin O; Chang, Anthony C; Shin, Andrew; Hunt, Juliette; Wong, Hector R

    2015-10-01

    The word innovation is derived from the Latin noun innovatus, meaning renewal or change. Although companies such as Google and Apple are nearly synonymous with innovation, virtually all sectors in our current lives are imbued with yearn for innovation. This has led to organizational focus on innovative strategies as well as recruitment of chief innovation officers and teams in a myriad of organizations. At times, however, the word innovation seems like an overused cliché, as there are now more than 5,000 books in print with the word "innovation" in the title. More recently, innovation has garnered significant attention in health care. The future of health care is expected to innovate on a large scale in order to deliver sustained value for an overall transformative care. To date, there are no published reports on the state of the art in innovation in pediatric health care and in particular, pediatric cardiac intensive care. This report will address the issue of innovation in pediatric medicine with relevance to cardiac intensive care and delineate possible future directions and strategies in pediatric cardiac intensive care. © The Author(s) 2015.

  5. Chemogenetic Activation of an Extinction Neural Circuit Reduces Cue-Induced Reinstatement of Cocaine Seeking.

    PubMed

    Augur, Isabel F; Wyckoff, Andrew R; Aston-Jones, Gary; Kalivas, Peter W; Peters, Jamie

    2016-09-28

    The ventromedial prefrontal cortex (vmPFC) has been shown to negatively regulate cocaine-seeking behavior, but the precise conditions by which vmPFC activity can be exploited to reduce cocaine relapse are currently unknown. We used viral-mediated gene transfer of designer receptors (DREADDs) to activate vmPFC neurons and examine the consequences on cocaine seeking in a rat self-administration model of relapse. Activation of vmPFC neurons with the Gq-DREADD reduced reinstatement of cocaine seeking elicited by cocaine-associated cues, but not by cocaine itself. We used a retro-DREADD approach to confine the Gq-DREADD to vmPFC neurons that project to the medial nucleus accumbens shell, confirming that these neurons are responsible for the decreased cue-induced reinstatement of cocaine seeking. The effects of vmPFC activation on cue-induced reinstatement depended on prior extinction training, consistent with the reported role of this structure in extinction memory. These data help define the conditions under which chemogenetic activation of extinction neural circuits can be exploited to reduce relapse triggered by reminder cues. The ventromedial prefrontal cortex (vmPFC) projection to the nucleus accumbens shell is important for extinction of cocaine seeking, but its anatomical proximity to the relapse-promoting projection from the dorsomedial prefrontal cortex to the nucleus accumbens core makes it difficult to selectively enhance neuronal activity in one pathway or the other using traditional pharmacotherapy (e.g., systemically administered drugs). Viral-mediated gene delivery of an activating Gq-DREADD to vmPFC and/or vmPFC projections to the nucleus accumbens shell allows the chemogenetic exploitation of this extinction neural circuit to reduce cocaine seeking and was particularly effective against relapse triggered by cocaine reminder cues. Copyright © 2016 the authors 0270-6474/16/3610174-07$15.00/0.

  6. The Nucleus Reuniens Controls Long-Range Hippocampo-Prefrontal Gamma Synchronization during Slow Oscillations.

    PubMed

    Ferraris, Maëva; Ghestem, Antoine; Vicente, Ana F; Nallet-Khosrofian, Lauriane; Bernard, Christophe; Quilichini, Pascale P

    2018-03-21

    Gamma oscillations are involved in long-range coupling of distant regions that support various cognitive operations. Here we show in adult male rats that synchronized bursts of gamma oscillations bind the hippocampus (HPC) and prefrontal cortex (mPFC) during slow oscillations and slow-wave sleep, a brain state that is central for consolidation of memory traces. These gamma bursts entrained the firing of the local HPC and mPFC neuronal populations. Neurons of the nucleus reuniens (NR), which is a structural and functional hub between HPC and mPFC, demonstrated a specific increase in their firing before gamma burst onset, suggesting their involvement in HPC-mPFC binding. Chemical inactivation of NR disrupted the temporal pattern of gamma bursts and their synchronization, as well as mPFC neuronal firing. We propose that the NR drives long-range hippocampo-prefrontal coupling via gamma bursts providing temporal windows for information exchange between the HPC and mPFC during slow-wave sleep. SIGNIFICANCE STATEMENT Long-range coupling between hippocampus (HPC) and prefrontal cortex (mPFC) is believed to support numerous cognitive functions, including memory consolidation occurring during sleep. Gamma-band synchronization is a fundamental process in many neuronal operations and is instrumental in long-range coupling. Recent evidence highlights the role of nucleus reuniens (NR) in consolidation; however, how it influences hippocampo-prefrontal coupling is unknown. In this study, we show that HPC and mPFC are synchronized by gamma bursts during slow oscillations in anesthesia and natural sleep. By manipulating and recording the NR-HPC-mPFC network, we provide evidence that the NR actively promotes this long-range gamma coupling. This coupling provides the hippocampo-prefrontal circuit with a novel mechanism to exchange information during slow-wave sleep. Copyright © 2018 the authors 0270-6474/18/383026-13$15.00/0.

  7. Optogenetic Examination of Prefrontal-Amygdala Synaptic Development.

    PubMed

    Arruda-Carvalho, Maithe; Wu, Wan-Chen; Cummings, Kirstie A; Clem, Roger L

    2017-03-15

    A brain network comprising the medial prefrontal cortex (mPFC) and amygdala plays important roles in developmentally regulated cognitive and emotional processes. However, very little is known about the maturation of mPFC-amygdala circuitry. We conducted anatomical tracing of mPFC projections and optogenetic interrogation of their synaptic connections with neurons in the basolateral amygdala (BLA) at neonatal to adult developmental stages in mice. Results indicate that mPFC-BLA projections exhibit delayed emergence relative to other mPFC pathways and establish synaptic transmission with BLA excitatory and inhibitory neurons in late infancy, events that coincide with a massive increase in overall synaptic drive. During subsequent adolescence, mPFC-BLA circuits are further modified by excitatory synaptic strengthening as well as a transient surge in feedforward inhibition. The latter was correlated with increased spontaneous inhibitory currents in excitatory neurons, suggesting that mPFC-BLA circuit maturation culminates in a period of exuberant GABAergic transmission. These findings establish a time course for the onset and refinement of mPFC-BLA transmission and point to potential sensitive periods in the development of this critical network. SIGNIFICANCE STATEMENT Human mPFC-amygdala functional connectivity is developmentally regulated and figures prominently in numerous psychiatric disorders with a high incidence of adolescent onset. However, it remains unclear when synaptic connections between these structures emerge or how their properties change with age. Our work establishes developmental windows and cellular substrates for synapse maturation in this pathway involving both excitatory and inhibitory circuits. The engagement of these substrates by early life experience may support the ontogeny of fundamental behaviors but could also lead to inappropriate circuit refinement and psychopathology in adverse situations. Copyright © 2017 the authors 0270-6474/17/372976-10$15.00/0.

  8. An office or a bedroom? Challenges for family-centered care in the pediatric intensive care unit.

    PubMed

    Macdonald, Mary Ellen; Liben, Stephen; Carnevale, Franco A; Cohen, S Robin

    2012-09-01

    Although the modern pediatric intensive care unit (PICU) has followed general pediatrics and adopted the family-centered care model, little is known about how families prospectively experience PICU care. The authors' goal was to better understand the experiences of families whose child was hospitalized in a PICU. They conducted a 12-month prospective ethnographic study in a PICU in a tertiary care hospital in a large North American urban center. Data were obtained via participant-observation and formal and informal interviews with 18 families and staff key informants. Findings revealed a disconnect between the espoused model of family-centered care and quotidian professional practices. This divergence emerged in the authors' analysis as a heuristic that contrasts a professional "office" to a sick child's "bedroom." PICU practices and protocols transformed the child into a patient and parents into visitors; issues such as noise, visitation, turf, and privacy could favor staff comfort and convenience over that of the child and family. The authors' discussion highlights suggestions to overcome this divergence in order to truly make the PICU family centered.

  9. Developmental fluoxetine and prenatal stress effects on serotonin, dopamine, and synaptophysin density in the PFC and hippocampus of offspring at weaning.

    PubMed

    Gemmel, Mary; Rayen, Ine; Lotus, Tiffany; van Donkelaar, Eva; Steinbusch, Harry W; De Lacalle, Sonsoles; Kokras, Nikolaos; Dalla, Christina; Pawluski, Jodi L

    2016-04-01

    Selective serotonin reuptake inhibitor medication exposure during the perinatal period can have a long term impact in adult offspring on neuroplasticity and the serotonergic system, but the impact of these medications during early development is poorly understood. The aim of this study was to determine the effects of developmental exposure to the SSRI, fluoxetine, on the serotonergic system, dopaminergic system, and synaptophysin density in the prefrontal cortex and hippocampus, as well as number of immature neurons in the dentate gyrus, in juvenile rat offspring at weaning. To model aspects of maternal depression, prenatal restraint stress was used. Sprague-Dawley rat offspring were exposed to either prenatal stress and/or fluoxetine. Main findings show that developmental fluoxetine exposure to prenatally stressed offspring decreased 5-HT and 5-HIAA levels and altered the dopaminergic system in the hippocampus. Prenatal stress, regardless of fluoxetine, increased synaptophysin density in the PFC. This work indicates that early exposure to maternal stress and SSRI medication can alter brain monoamine levels and synaptophysin density in offspring at weaning. © 2015 Wiley Periodicals, Inc.

  10. Predicting planning performance from structural connectivity between left and right mid-dorsolateral prefrontal cortex: moderating effects of age during postadolescence and midadulthood.

    PubMed

    Kaller, Christoph P; Reisert, Marco; Katzev, Michael; Umarova, Roza; Mader, Irina; Hennig, Jürgen; Weiller, Cornelius; Köstering, Lena

    2015-04-01

    Complex cognitive abilities such as planning are known to critically rely on activity of bilateral mid-dorsolateral prefrontal cortex (mid-dlPFC). However, the functional relevance of the structural connectivity between left and right mid-dlPFC is yet unknown. Here, we applied global tractography to derive streamline counts as estimates of the structural connectivity between mid-dlPFC homologs and related it to planning performance in the Tower of London task across early to midadulthood, assuming a moderating effect of age. Multiple regression analyses with interaction effects revealed that streamline counts between left and right mid-dlPFC were negatively associated with planning performance specifically in early postadolescence. From the fourth life decade on, there was a trend for a reversed, positive association. These differential findings were corroborated by converging results from fractional anisotropy and white-matter density estimates in the genu of the corpus callosum where fibers connecting mid-dlPFC homologs traversed. Moreover, the results for streamline counts were regionally specific, marking the strength of mid-dlPFC connectivity as critical in predicting interindividual differences in planning performance across different stages of adulthood. Taken together, present findings provide first evidence for nonadditive effects of age on the relation between complex cognitive abilities and the structural connectivity of mid-dlPFC homologs. © The Author 2013. Published by Oxford University Press. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

  11. The increase in medial prefrontal glutamate/glutamine concentration during memory encoding is associated with better memory performance and stronger functional connectivity in the human medial prefrontal-thalamus-hippocampus network.

    PubMed

    Thielen, Jan-Willem; Hong, Donghyun; Rohani Rankouhi, Seyedmorteza; Wiltfang, Jens; Fernández, Guillén; Norris, David G; Tendolkar, Indira

    2018-06-01

    The classical model of the declarative memory system describes the hippocampus and its interactions with representational brain areas in posterior neocortex as being essential for the formation of long-term episodic memories. However, new evidence suggests an extension of this classical model by assigning the medial prefrontal cortex (mPFC) a specific, yet not fully defined role in episodic memory. In this study, we utilized 1H magnetic resonance spectroscopy (MRS) and psychophysiological interaction (PPI) analysis to lend further support for the idea of a mnemonic role of the mPFC in humans. By using MRS, we measured mPFC γ-aminobutyric acid (GABA) and glutamate/glutamine (GLx) concentrations before and after volunteers memorized face-name association. We demonstrate that mPFC GLx but not GABA levels increased during the memory task, which appeared to be related to memory performance. Regarding functional connectivity, we used the subsequent memory paradigm and found that the GLx increase was associated with stronger mPFC connectivity to thalamus and hippocampus for associations subsequently recognized with high confidence as opposed to subsequently recognized with low confidence/forgotten. Taken together, we provide new evidence for an mPFC involvement in episodic memory by showing a memory-related increase in mPFC excitatory neurotransmitter levels that was associated with better memory and stronger memory-related functional connectivity in a medial prefrontal-thalamus-hippocampus network. © 2018 The Authors Human Brain Mapping Published by Wiley Periodicals, Inc.

  12. Moving survivorship care plans forward: focus on care coordination.

    PubMed

    Salz, Talya; Baxi, Shrujal

    2016-07-01

    After completing treatment for cancer, the coordination of oncology and primary care presents a challenge for cancer survivors. Many survivors need continued oncology follow-up, and all survivors require primary care. Coordinating the shared care of a cancer survivor, or facilitating an informed handoff from oncology to primary care, is essential for cancer survivors. Survivorship care plans are personalized documents that summarize cancer treatment and outline a plan of recommended ongoing care, with the goal of facilitating the coordination of post-treatment care. Despite their face validity, five trials have failed to demonstrate the effectiveness of survivorship care plans. We posit that these existing trials have critical shortcomings and do not adequately address whether survivorship care plans improve care coordination. Moving forward, we propose four criteria for future trials of survivorship care plans: focusing on high-needs survivor populations, tailoring the survivorship care plan to the care setting, facilitating implementation of the survivorship care plan in clinical practice, and selecting appropriate trial outcomes to assess care coordination. When trials meet these criteria, we can finally assess whether survivorship care plans help cancer survivors receive optimal oncology and primary care. © 2016 The Authors. Cancer Medicine published by John Wiley & Sons Ltd.

  13. Dementia care mapping to support staff in the care of people with intellectual disability and dementia: a feasibility study.

    PubMed

    Schaap, Feija D; Fokkens, Andrea S; Dijkstra, Geke J; Reijneveld, Sijmen A; Finnema, Evelyn J

    2018-04-24

    The number of people with intellectual disability and dementia increases; this combination causes behavioural changes. Dementia Care Mapping (DCM) supports staff in dementia care in nursing homes and may be useful in intellectual disability-care. This qualitative study examines the feasibility of DCM for older people with intellectual disability and dementia. The present authors obtained data in focus groups and interviews with professional users and analysed using a framework for feasibility studies. With experts in dementia and intellectual disability researches, the present authors determined the overall feasibility. DCM was found to be feasible in intellectual disability-care, regarding five domains of feasibility. Staff reported DCM to be useful and valuable and addresses to their demand for skills and knowledge. All professional users found DCM feasible in intellectual disability-care, which was confirmed by experts. DCM is feasible in intellectual disability-care. When fully tailored to intellectual disability-care, DCM is useful and provides opportunities to assess its effectiveness. © 2018 The Authors. Journal of Applied Research in Intellectual Disabilities Published by John Wiley & Sons Ltd.

  14. Friendship Repertoires and Care Arrangement: A Praxeological Approach.

    PubMed

    Hahmann, Julia

    2017-01-01

    Friends are important companions and serve as sources for diverse dimensions of social support, including elderly care. Rather than researching populations that have already established care arrangements including friends, the author seeks to understand relationship systems with a focus on the inner logic friendship to consequently describe and understand involved care arrangements, be it with family members or friends. To illustrate the diversity of friendship repertoires, qualitative interviews with older adult Germans are analyzed regarding cognitive concepts of friendships in contrast to familiar ties as well as social practices around relationship systems. While some repertoires successfully include chosen ties in their care arrangements, others not only focus on family, they do not wish to receive care from friends. The article's praxeological approach highlights the need to reflect habitual differences when thinking about elderly informal care arrangements. © The Author(s) 2016.

  15. Therapeutic Effect of Intravenous Infusion of Perfluorocarbon Emulsion on LPS-Induced Acute Lung Injury in Rats

    PubMed Central

    Lv, Qi; Yin, Xiaofeng; Song, Jianqi; Landén, Ning Xu; Fan, Haojun

    2014-01-01

    Acute lung injury (ALI) and its more severe form, acute respiratory distress syndrome (ARDS) are the leading causes of death in critical care. Despite extensive efforts in research and clinical medicine, mortality remains high in these diseases. Perfluorocarbon (PFC), a chemical compound known as liquid ventilation medium, is capable of dissolving large amounts of physiologically important gases (mainly oxygen and carbon dioxide). In this study we aimed to investigate the effect of intravenous infusion of PFC emulsion on lipopolysaccharide (LPS) induced ALI in rats and elucidate its mechanism of action. Forty two Wistar rats were randomly divided into three groups: 6 rats were treated with saline solution by intratracheal instillation (control group), 18 rats were treated with LPS by intratracheal instillation (LPS group) and the other 18 rats received PFC through femoral vein prior to LPS instillation (LPS+PFC group). The rats in the control group were sacrificed 6 hours later after saline instillation. At 2, 4 and 6 hours of exposure to LPS, 6 rats in the LPS group and 6 rats in LPS+PFC group were sacrificed at each time point. By analyzing pulmonary pathology, partial pressure of oxygen in the blood (PaO2) and lung wet-dry weight ratio (W/D) of each rat, we found that intravenous infusion of PFC significantly alleviated acute lung injury induced by LPS. Moreover, we showed that the expression of pulmonary myeloperoxidase (MPO), intercellular adhesion molecule-1 (ICAM-1) of endothelial cells and CD11b of polymorphonuclear neutrophils (PMN) induced by LPS were significantly decreased by PFC treatment in vivo. Our results indicate that intravenous infusion of PFC inhibits the infiltration of PMNs into lung tissue, which has been shown as the core pathogenesis of ALI/ARDS. Thus, our study provides a theoretical foundation for using intravenous infusion of PFC to prevent and treat ALI/ARDS in clinical practice. PMID:24489970

  16. Meaning of caring in pediatric intensive care unit from the perspective of parents: A qualitative study.

    PubMed

    Mattsson, Janet Yvonne; Arman, Maria; Castren, Maaret; Forsner, Maria

    2014-12-01

    When children are critically ill, parents still strive to be present and participate in the care of their child. Pediatric intensive care differs from other realms of pediatric care as the nature of care is technically advanced and rather obstructing than encouraging parental involvement or closeness, either physically or emotionally, with the critically ill child. The aim of this study was to elucidate the meaning of caring in the pediatric intensive care unit from the perspective of parents. The design of this study followed Benner's interpretive phenomenological method. Eleven parents of seven children participated in observations and interviews. The following aspects of caring were illustrated in the themes arising from the findings: being a bridge to the child on the edge, building a sheltered atmosphere, meeting the child's needs, and adapting the environment for family life. The overall impression is that the phenomenon of caring is experienced exclusively when it is directed toward the exposed child. The conclusion drawn is that caring is present when providing expert physical care combined with fulfilling emotional needs and supporting continuing daily parental care for the child in an inviting environment. © The Author(s) 2013.

  17. Monitoring of Childcare Fees: Prices Surveillance Authority Monitoring Report No. 13.

    ERIC Educational Resources Information Center

    Prices Surveillance Authority, Melbourne (Australia).

    This report documents a survey conducted to determine if Australian parents have benefited from an increase in child care assistance subsidies authorized in April 1993. A total of 281 day care centers across Australia responded to surveys mailed in July 1992, February 1993, and May 1993. Data was also collected about profit margins, quality of…

  18. Controlling inpatient psychiatric utilization through managed care.

    PubMed

    Wickizer, T M; Lessler, D; Travis, K M

    1996-03-01

    There is little current understanding of how managed care strategies affect hospital inpatient psychiatric care for mentally ill patients. This study examined one prominent form of managed care, utilization management, which reviews requests for psychiatric care and authorizes provision of care deemed appropriate and clinically necessary. The authors analyzed data on 2,265 utilization management reviews conducted during 1989-1992 for patients insured by a single large commercial insurance company. Three utilization management procedures were examined: preadmission review, continued-stay review, and case management. The performance indicators analyzed included percent of admission requests granted, number of days requested and approved, and number of treatment extensions granted. Utilization management initially approved inpatient psychiatric treatment for nearly all (98.8%) of the patients but authorized, on average, only one-third of the days requested (6.9 versus 19.0). On average, 23.5 (total) days of care were requested and 16.8 days were approved. Care for patients with alcohol or drug dependence diagnoses was more restricted than was care for other patients. These data suggest that managed care does restrict inpatient psychiatric care, primarily by managing length of stay. The fact that almost all patients were approved for the same initial length of stay implies adherence to strict treatment protocols that do not distinguish among different clinical or patient factors. There is a need for careful study of the effects of managed care on outcomes and quality of psychiatric care.

  19. Who Cares about Caring in Early Childhood Teacher Education Programs?

    ERIC Educational Resources Information Center

    McNamee, Abigail; Mercurio, Mia; Peloso, Jeanne M.

    2007-01-01

    The ability to care for oneself, near and distant others, animals, plants, human-made objects, and even ideas is an antidote for violence in its many forms as experienced in childhood as well as adulthood. This article makes a case for facilitating the development of the ability to care as children develop. The authors emphasize the importance of…

  20. Clinician styles of care: transforming patient care at the intersection of leadership and medicine.

    PubMed

    Huynh, Ho P; Sweeny, Kate

    2014-11-01

    A key role of clinicians is to motivate their patients to initiate and maintain beneficial health behaviors. This article integrates research on transformational leadership, clinician-patient communication, and health behavior to introduce a novel approach to understanding and improving clinicians' effectiveness as motivators. We describe three dominant clinician styles or patterned approaches to patient care that derive from leadership theory (in order of least to most effective): laissez-faire, transactional, and transformational. Additionally, we suggest potential mediators and effects of the transformational style of care. Finally, we discuss future research directions for the study of clinician styles of care. © The Author(s) 2013.

  1. The Future of Home Health Care

    PubMed Central

    Landers, Steven; Madigan, Elizabeth; Leff, Bruce; Rosati, Robert J.; McCann, Barbara A.; Hornbake, Rodney; MacMillan, Richard; Jones, Kate; Bowles, Kathryn; Dowding, Dawn; Lee, Teresa; Moorhead, Tracey; Rodriguez, Sally; Breese, Erica

    2016-01-01

    The Future of Home Health project sought to support transformation of home health and home-based care to meet the needs of patients in the evolving U.S. health care system. Interviews with key thought leaders and stakeholders resulted in key themes about the future of home health care. By synthesizing this qualitative research, a literature review, case studies, and the themes from a 2014 Institute of Medicine and National Research Council workshop on “The Future of Home Health Care,” the authors articulate a vision for home-based care and recommend a bold framework for the Medicare-certified home health agency of the future. The authors also identify challenges and recommendations for achievement of this framework. PMID:27746670

  2. 45 CFR 99.21 - Authority of presiding officer.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... HEARINGS FOR THE CHILD CARE AND DEVELOPMENT FUND Hearing Procedures § 99.21 Authority of presiding officer... therein; (7) Examine witnesses; (8) Receive, rule on, exclude or limit evidence or discovery; (9) Fix the... to compel by subpoena the production of witnesses, papers, or other evidence. ...

  3. 45 CFR 99.21 - Authority of presiding officer.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... HEARINGS FOR THE CHILD CARE AND DEVELOPMENT FUND Hearing Procedures § 99.21 Authority of presiding officer... therein; (7) Examine witnesses; (8) Receive, rule on, exclude or limit evidence or discovery; (9) Fix the... to compel by subpoena the production of witnesses, papers, or other evidence. ...

  4. 45 CFR 99.21 - Authority of presiding officer.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... HEARINGS FOR THE CHILD CARE AND DEVELOPMENT FUND Hearing Procedures § 99.21 Authority of presiding officer... therein; (7) Examine witnesses; (8) Receive, rule on, exclude or limit evidence or discovery; (9) Fix the... to compel by subpoena the production of witnesses, papers, or other evidence. ...

  5. 45 CFR 99.21 - Authority of presiding officer.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... HEARINGS FOR THE CHILD CARE AND DEVELOPMENT FUND Hearing Procedures § 99.21 Authority of presiding officer... therein; (7) Examine witnesses; (8) Receive, rule on, exclude or limit evidence or discovery; (9) Fix the... to compel by subpoena the production of witnesses, papers, or other evidence. ...

  6. An archaeology of caring knowledge.

    PubMed

    Paley, J

    2001-10-01

    There have been repeated attempts, especially during the last 20 years, to say precisely what caring in nursing is. Authors who undertake this task usually begin with the observation that the concept of caring is complex and elusive, and suggest that their contribution will help to clarify this most confused of notions. However, they are always followed by other authors, who do exactly the same thing. We seem to be no closer, now, to a clarification of caring than we have ever been. The paper offers a diagnosis of this situation, and explains why the project of retrieving caring from its elusiveness is an impossible one. I will suggest that this has nothing to do with the concept of caring, as such. Rather, the impossibility of the task follows from what these authors take to be knowledge of caring. I present an analysis of some presuppositions about what knowledge is. These presuppositions pervade the literature on caring, and can be summarized as follows: knowledge of caring is an aggregate of things said about it, derived from a potentially endless series of associations, grouped into attributes on the basis of resemblances, and conceived as a holistic description of the phenomenon. Further, I suggest that this analysis is akin to the one which Foucault offers of sixteenth century knowledge. The analysis suggests that this way of knowing is approximately 350 years out of date, and explains why the task of arriving at knowledge (in this sense) is impossible. Moreover, Foucault's claim that sixteenth century knowledge is "plethoric yet absolutely poverty-stricken" applies, with equal force, to nursing's knowledge of caring.

  7. Fear Memory Recall Potentiates Opiate Reward Sensitivity through Dissociable Dopamine D1 versus D4 Receptor-Dependent Memory Mechanisms in the Prefrontal Cortex.

    PubMed

    Jing Li, Jing; Szkudlarek, Hanna; Renard, Justine; Hudson, Roger; Rushlow, Walter; Laviolette, Steven R

    2018-05-09

    control acquisition or recall of fear memories and how these mechanisms might regulate sensitivity to the rewarding effects of opioids. We demonstrate that PFC D4 activation not only controls the salience of fear memory acquisition, but potentiates the rewarding effects of opioids. In contrast, PFC D1 receptor activation blocks recall of fear memories and prevents potentiation of opioid reward effects. Together, these findings demonstrate novel PFC mechanisms that may account for how emotional memory disturbances might increase the addictive liability of opioid-class drugs. Copyright © 2018 the authors 0270-6474/18/384543-13$15.00/0.

  8. Adaptive Encoding of Outcome Prediction by Prefrontal Cortex Ensembles Supports Behavioral Flexibility.

    PubMed

    Del Arco, Alberto; Park, Junchol; Wood, Jesse; Kim, Yunbok; Moghaddam, Bita

    2017-08-30

    The prefrontal cortex (PFC) is thought to play a critical role in behavioral flexibility by monitoring action-outcome contingencies. How PFC ensembles represent shifts in behavior in response to changes in these contingencies remains unclear. We recorded single-unit activity and local field potentials in the dorsomedial PFC (dmPFC) of male rats during a set-shifting task that required them to update their behavior, among competing options, in response to changes in action-outcome contingencies. As behavior was updated, a subset of PFC ensembles encoded the current trial outcome before the outcome was presented. This novel outcome-prediction encoding was absent in a control task, in which actions were rewarded pseudorandomly, indicating that PFC neurons are not merely providing an expectancy signal. In both control and set-shifting tasks, dmPFC neurons displayed postoutcome discrimination activity, indicating that these neurons also monitor whether a behavior is successful in generating rewards. Gamma-power oscillatory activity increased before the outcome in both tasks but did not differentiate between expected outcomes, suggesting that this measure is not related to set-shifting behavior but reflects expectation of an outcome after action execution. These results demonstrate that PFC neurons support flexible rule-based action selection by predicting outcomes that follow a particular action. SIGNIFICANCE STATEMENT Tracking action-outcome contingencies and modifying behavior when those contingencies change is critical to behavioral flexibility. We find that ensembles of dorsomedial prefrontal cortex neurons differentiate between expected outcomes when action-outcome contingencies change. This predictive mode of signaling may be used to promote a new response strategy at the service of behavioral flexibility. Copyright © 2017 the authors 0270-6474/17/378363-11$15.00/0.

  9. Quality care as ethical care: a poststructural analysis of palliative and supportive district nursing care.

    PubMed

    Nagington, Maurice; Walshe, Catherine; Luker, Karen A

    2016-03-01

    Quality of care is a prominent discourse in modern health-care and has previously been conceptualised in terms of ethics. In addition, the role of knowledge has been suggested as being particularly influential with regard to the nurse-patient-carer relationship. However, to date, no analyses have examined how knowledge (as an ethical concept) impinges on quality of care. Qualitative semi-structured interviews were conducted with 26 patients with palliative and supportive care needs receiving district nursing care and thirteen of their lay carers. Poststructural discourse analysis techniques were utilised to take an ethical perspective on the current way in which quality of care is assessed and produced in health-care. It is argued that if quality of care is to be achieved, patients and carers need to be able to redistribute and redevelop the knowledge of their services in a collaborative way that goes beyond the current ways of working. Theoretical works and extant research are then used to produce tentative suggestions about how this may be achieved. © 2015 The Authors Nursing Inquiry Published by John Wiley & Sons Ltd.

  10. Identifying Inconsistencies and Reporting Deficits in Therapeutic Massage and Bodywork (TMB) Case Reports Authored by TMB Practitioners: a TMB-Adapted CAse REport (CARE) Guidelines Audit Through 2014.

    PubMed

    Munk, Niki; Shue, Sarah; Freeland, Emilee; Ralston, Rick; Boulanger, Karen T

    2016-09-01

    Case reports are a fundamental tool through which therapeutic massage and bodywork (TMB) practitioners can inform research and impact their field by detailing the presentation, treatment, and follow-up of a single individual encountered in practice. Inconsistencies in case reporting limit their impact as fundamental sources of clinical evidence. Using the TMB-adapted CAse REport (CARE) guidelines, the current study sought to provide a rich description regarding the reporting quality of TMB practitioner authored TMB case reports in the literature. 1) Systematic identification of published, peer-reviewed TMB case reports authored by TMB practitioners following PRISMA recommendations; 2) audit development based on TMB-adapted CARE guidelines; 3) audit implementation; and 4) descriptive analysis of audit scores. Our search identified 977 articles and 35 met study inclusion criteria. On average, TMB case reports included approximately 58% of the total items identified as necessary by the TMB-adapted CARE guidelines. Introduction sections of case reports had the best item reporting (80% on average), while Case Presentation (54%) and Results (52%) sections scored moderately overall, with only 20% of necessary Practitioner Description items included on average. Audit scores revealed inconsistent abstract reporting and few audited case reports including client race (20%), perspective (26%), and occupation/activities (40%); practitioner practice setting (12%), training (12%), scope-of-practice (29%), and credentialing (20%); adverse events or lack thereof (17%); and some aspect of informed consent (34%). Treatment descriptor item reporting varied from high to low. Various implications of concern are discussed. The current audit and descriptive analysis highlight several reporting inconsistencies in TMB case reports prior to 2015. Reporting guidelines for case reports are important if standards for, and impact of, TMB case reports are desired. Adherence to reporting

  11. Health care professionals' perspectives of the experiences of family caregivers during in-patient cancer care.

    PubMed

    Ekstedt, Mirjam; Stenberg, Una; Olsson, Mariann; Ruland, Cornelia M

    2014-11-01

    Being a family member of a patient who is being treated in an acute care setting for cancer often involves a number of challenges. Our study describes Norwegian cancer care health professionals' perceptions of family members who served as family caregivers (FCs) and their need for support during the in-hospital cancer treatment of their ill family member. Focus group discussions were conducted with a multidisciplinary team of 24 experienced social workers, physicians, and nurses who were closely involved in the patients' in-hospital cancer treatment and care. Drawing on qualitative hermeneutic analysis, four main themes describe health professionals' perceptions of FCs during the patient's in-hospital cancer care: an asset and additional burden, infinitely strong and struggling with helplessness, being an outsider in the center of care, and being in different temporalities. We conclude that it is a challenge for health care professionals to support the family and create room for FC's needs in acute cancer care. System changes are needed in health care, so that the patient/FC dyad is viewed as a unit of care in a dual process of caregiving, which would enable FCs to be given space and inclusion in care, with their own needs simultaneously considered alongside those of the patient. © The Author(s) 2014.

  12. Author fees for online publication

    NASA Astrophysics Data System (ADS)

    Like the journals themselves, AGU publication fees have been restructured to accommodate the new online, publish-as-ready approach. The new fee structure is based on authors' providing electronic files of their text and art in acceptable formats (Word, WordPerfect, and LaTeX for text, and .eps or .tif for digital art). However, if you are unable to supply electronic files, you can opt for a higher-charge, full-service route in which AGU will create electronic files from hard copy. All authors for AGU journals are expected to support the journal archive through fees based on number as well as size of article files. The revenue from these fees is set aside for the "Perpetual Care Trust Fund," which will support the migration of the journal archive to new formats or media as technology changes. For several journals, excess length fees remain in place to encourage submission of concisely written articles. During this first transition year, most author fees are based on the number of print page equivalents (pdf) in an article; in the future, however, charges are expected to be associated with file size. The specific fees for each journal are posted on AGU's Web site under Publications-Tools for Authors.

  13. An evaluation of routine specialist palliative care for patients on the Liverpool Care Pathway.

    PubMed

    Thompson, Jo; Brown, Jayne; Davies, Andrew

    2014-01-01

    This report describes a service evaluation of the 'added value' of routine specialist palliative care team (SPCT) involvement with patients on the Liverpool Care Pathway for the Dying Patient (LCP). In the authors' hospital, patients that are commenced on the LCP are routinely referred to the SPCT. They are reviewed on the day of referral and then at least every other day, depending on the clinical situation. The data for this report was obtained by reviewing the SPCT's clinical database and the patients' LCP proformas. The SPCT intervened in the care of 80% of 158 newly referred patients, e.g. for alteration of continuous subcutaneous infusion (23%) or alteration of use of non-pharmacological interventions (21%). Furthermore, 11% of patients were taken off the LCP, around one quarter of whom were later put back on. The authors' model of care could overcome many of the issues relating to the LCP and would ameliorate the developing vacuum of care for patients at the end of life.

  14. Baccalaureate vs Associate Degree Nurses: The Care-Cure Dichotomy

    ERIC Educational Resources Information Center

    Bullough, Bonnie; Sparks, Colleen

    1975-01-01

    The authors discuss the care-cure dichotomy (baccaulaureate students were found to be care-oriented; the associate degree students were cure-oriented) and the problems these attitudes present. (Author/BP)

  15. Executive Summary of the Health Care Productivity Report.

    PubMed

    2001-04-01

    Governments and health care organizations are increasingly interested in ways to rethink and reform their health care systems. To help provide a foundation for future reform, the authors examined the health care systems in the United States, Germany, and the United Kingdom. The authors assessed productivity in the treatment of four diseases during the late 1980s: diabetes, cholelithiasis (gallstones), breast cancer, and lung cancer. The authors looked at the different day-to-day actions of doctors and hospitals and tried to connect these actions to differences in longevity and the quality of life.

  16. The Physician Assistant in Geriatric Long-Term Care

    ERIC Educational Resources Information Center

    Becker, Robert G.

    1976-01-01

    The Physician Assistant (PA) is a new health-care professional who is trained to function as a "physician extender." The author's experience with 71 PA students and graduate PA's at the Jewish Institute for Geriatric Care is described. (Author)

  17. Managed care contracting: a systematic approach.

    PubMed

    Flores, K

    1987-12-01

    Managed care is sweeping the health care industry and has produced some special challenges for providers. Success in contracting depends on preparation. In this article, the author defines managed care and outlines who should be involved in the contracting for these services. Special attention is given to how to develop the appropriate internal support. The author contends that a provider should not embrace all contracting offers and suggests criteria for selection of the best offers. Finally, the prevailing pricing schemes are reviewed and caveats given on their interpretation and use.

  18. Stress-altered synaptic plasticity and DAMP signaling in the hippocampus-PFC axis; elucidating the significance of IGF-1/IGF-1R/CaMKIIα expression in neural changes associated with a prolonged exposure therapy.

    PubMed

    Ogundele, Olalekan M; Ebenezer, Philip J; Lee, Charles C; Francis, Joseph

    2017-06-14

    Traumatic stress patients showed significant improvement in behavior after a prolonged exposure to an unrelated stimulus. This treatment method attempts to promote extinction of the fear memory associated with the initial traumatic experience. However, the subsequent prolonged exposure to such stimulus creates an additional layer of neural stress. Although the mechanism remains unclear, prolonged exposure therapy (PET) likely involves changes in synaptic plasticity, neurotransmitter function and inflammation; especially in parts of the brain concerned with the formation and retrieval of fear memory (Hippocampus and Prefrontal Cortex: PFC). Since certain synaptic proteins are also involved in danger-associated molecular pattern signaling (DAMP), we identified the significance of IGF-1/IGF-1R/CaMKIIα expression as a potential link between the concurrent progression of synaptic and inflammatory changes in stress. Thus, a comparison between IGF-1/IGF-1R/CaMKIIα, synaptic and DAMP proteins in stress and PET may highlight the significance of PET on synaptic morphology and neuronal inflammatory response. In behaviorally characterized Sprague-Dawley rats, there was a significant decline in neural IGF-1 (p<0.001), hippocampal (p<0.001) and cortical (p<0.05) IGF-1R expression. These animals showed a significant loss of presynaptic markers (synaptophysin; p<0.001), and changes in neurotransmitters (VGLUT2, Tyrosine hydroxylase, GABA, ChAT). Furthermore, naïve stressed rats recorded a significant decrease in post-synaptic marker (PSD-95; p<0.01) and synaptic regulator (CaMKIIα; p<0.001). As part of the synaptic response to a decrease in brain CaMKIIα, small ion conductance channel (KCa2.2) was upregulated in the brain of naïve stressed rats (p<0.01). After a PET, an increase in IGF-1 (p<0.05) and IGF-1R was recorded in the Stress-PET group (p<0.001). As such, hippocampal (p<0.001), but not cortical (ns) synaptophysin expression increased in Stress-PET. Although PSD-95

  19. Cost Sharing, Health Care Expenditures, and Utilization: An International Comparison.

    PubMed

    Perkowski, Patryk; Rodberg, Leonard

    2016-01-01

    Health systems implement cost sharing to help reduce health care expenditure and utilization by discouraging the use of unnecessary health care services. We examine cost sharing in 28 countries in the Organisation for Economic Co-operation and Development from 1999 through 2009 in the areas of medical care, hospital care, and pharmaceuticals. We investigate associations between cost sharing, health care expenditures, and health care utilization and find no significant association between cost sharing and health care expenditures or utilization in these countries. © The Author(s) 2015.

  20. Primary care ... where?

    PubMed

    Adcock, G B

    1999-07-01

    Corporate-based nurse managed centers are not the national norm. More prevalent is the use of an occupational health or physician-directed medical model of care. The author describes how a 14-year-old primary care center at a North Carolina computer software company is just "business as usual" when viewed in the context of the company's philosophy, goals, and culture. Included are considerations for nurse practitioners interested in the successful transplantation of this primary care model to other settings.

  1. The neural signature of self-concept development in adolescence: The role of domain and valence distinctions.

    PubMed

    van der Cruijsen, R; Peters, S; van der Aar, L P E; Crone, E A

    2017-11-22

    Neuroimaging studies in adults showed that cortical midline regions including medial prefrontal cortex (mPFC) and posterior parietal cortex (PPC) are important in self-evaluations. The goals of this study were to investigate the contribution of these regions to self-evaluations in late childhood, adolescence, and early adulthood, and to examine whether these differed per domain (academic, physical and prosocial) and valence (positive versus negative). Also, we tested whether this activation changes across adolescence. For this purpose, participants between ages 11-21-years (N = 150) evaluated themselves on trait sentences in an fMRI session. Behaviorally, adolescents rated their academic traits less positively than children and young adults. The neural analyses showed that evaluating self-traits versus a control condition was associated with increased activity in mPFC (domain-general effect), and positive traits were associated with increased activity in ventral mPFC (valence effect). Self-related mPFC activation increased linearly with age, but only for evaluating physical traits. Furthermore, an adolescent-specific decrease in striatum activation for positive self traits was found. Finally, we found domain-specific neural activity for evaluating traits in physical (dorsolateral PFC, dorsal mPFC) and academic (PPC) domains. Together, these results highlight the importance of domain distinctions when studying self-concept development in late childhood, adolescence, and early adulthood. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

  2. Age- and Sex-Dependent Impact of Repeated Social Stress on Intrinsic and Synaptic Excitability of the Rat Prefrontal Cortex.

    PubMed

    Urban, Kimberly R; Valentino, Rita J

    2017-01-01

    Stress is implicated in psychiatric illnesses that are characterized by impairments in cognitive functions that are mediated by the medial prefrontal cortex (mPFC). Because sex and age determine stress vulnerability, the effects of repeated social stress occurring during early adolescence, mid-adolescence, or adulthood on the cellular properties of male and female rat mPFC Layer V neurons in vitro were examined. Repeated resident-intruder stress produced age- and sex-specific effects on mPFC intrinsic and synaptic excitability. Mid-adolescents were particularly vulnerable to effects on intrinsic excitability. The maximum number of action potentials (APs) evoked by increasing current intensity was robustly decreased in stressed male and female mid-adolescent rats compared with age-matched controls. These effects were associated with stress-induced changes in AP half-width, amplitude, threshold, and input resistance. Social stress at all ages generally decreased synaptic excitability by decreasing the amplitude of spontaneous excitatory postsynaptic potentials. The results suggest that whereas social stress throughout life can diminish the influence of afferents driving the mPFC, social stress during mid-adolescence additionally affects intrinsic characteristics of mPFC neurons that determine excitability. The depressant effects of social stress on intrinsic and synaptic mPFC neurons may underlie its ability to affect executive functions and emotional responses, particularly during adolescence. © The Author 2016. Published by Oxford University Press.

  3. A partial solution: a local mental health authority for the UK.

    PubMed

    Hadley, Trevor R.; Goldman, Howard H.

    1998-07-01

    BACKGROUND: the structural problems of the mental health system in the UK have been analyzed by a number of authors over the past several years as the "reforms" of the health and social service systems have continued (Kavanagh and Knapp, 1995; Mechanic, 1995). In a recent article, Hadley and Goldman (1995) suggest that one possible solution to some of these issues may be the creation of a local mental health authority. Such an authority would consolidate the funding, authority and responsibility in a single entity. We believe this model, which is typical of many local public mental health systems in the US, is at least part of the solution to the current problem of financial and service fragmentation of the current system in the UK. The numerous "reforms" of the health and social service systems (which include the Community Care Act, the development of the Internal Market, GP fundholding and the purchaser-provider split) were not designed for the care of the mentally ill (Han, 1996). These policy changes in the design of health and social services have created a complicated and difficult context in which services must be delivered. Too many agencies play a significant role in the delivery and management of mental health services. Health authorities, social service agencies and GP fundholders are direct and indirect funders of the system while community care trusts, social service agencies and GPs are service providers (Hadley, 1996a). RESULTS AND A PROPOSAL: We believe that the development of local mental health authorities may be part of the solution to the structural and economic problems of the current system in the UK. It is not the answer to limited resources or limited skills, but can create a new structure, which will permit and encourage the cooperation and innovation that is now possible only with unusual effort. Local mental health authorities have a number of crucial characteristics, but, most importantly, they refocus the system on the provision of care

  4. A systematic review of contemporary models of shared HIV care and HIV in primary care in high-income settings.

    PubMed

    Mapp, Fiona; Hutchinson, Jane; Estcourt, Claudia

    2015-12-01

    HIV shared care is uncommon in the UK although shared care could be a beneficial model of care. We review the literature on HIV shared care to determine current practice and clinical, economic and patient satisfaction outcomes. We searched MEDLINE, EMBASE, NICE Evidence, Cochrane collaboration, Google and websites of the British HIV Association, Aidsmap, Public Health England, World Health Organization and Terrence Higgins Trust using relevant search terms in August 2014. Studies published after 2000, from healthcare settings comparable to the UK that described links between primary care and specialised HIV services were included and compared using principles of the Critical Appraisal Skills Programme and Authority, Accuracy, Coverage, Objectivity, Date, Significance frameworks. Three of the nine included models reported clinical or patient satisfaction outcomes but data collection and analyses were inadequate. None reported economic outcomes although some provided financial costings. Facilitators of shared care included robust clinical protocols, training and timely communication. Few published examples of HIV shared care exist and quality of evidence is poor. There is no consistent association with improved clinical outcomes, cost effectiveness or acceptability. Models are context specific, driven by local need, although some generalisable features could inform novel service delivery. Further evaluative research is needed to determine optimal components of shared HIV care. © The Author(s) 2015.

  5. What makes migrant live-in home care workers in elder care be satisfied with their job?

    PubMed

    Iecovich, Esther

    2011-10-01

    The study aims to examine job satisfaction of migrant live-in home care workers who provide care to frail older adults and to examine the extent to which quality of relationships between the care provider and care recipient and workplace characteristics is associated with job satisfaction.  A convenience sample that included 335 dyads of Philippine workers and their frail care recipients were recruited through 2 national home care agencies and snowballing. Multiple regression analyses examined the extent to which workplace characteristics, quality of relationships, care recipient characteristics, and care worker characteristics explain job satisfaction. Scores for job satisfaction, quality of relationships, and workplace characteristics were strongly positive. Overall and intrinsic job satisfactions were explained by workers' qualifications, workplace characteristics, and quality of relationships from the perspective of care recipients, whereas satisfaction with benefits was affected by workplace characteristics and quality of relationships from the perspective of the care workers. Findings suggest that workers who were better qualified in terms of more years of formal education and more years as care workers and who reported improved workplace characteristics, in particular more job decision authority and variety, reported increased job satisfaction. Therefore, enabling migrant live-in care workers more job decision authority and variety may increase their job satisfaction. More research is needed to deepen our understanding of additional job-related characteristics that explain job satisfaction among this group of care workers.

  6. Care management redesign: increasing care manager time with patients and providers while improving metrics.

    PubMed

    Kowinsky, Amy; Greenhouse, Pamela K; Zombek, Victoria L; Rader, Sandra L; Reidy, Margaret E

    2009-09-01

    In many hospitals, addressing increasing financial and regulatory requirements has resulted in a decline in care managers' time spent communicating directly with patients, families, and healthcare providers. The authors discuss the redesign of a hospital care management model that increased the time care managers spend with patients, families, and other care professionals, while patient satisfaction increased, labor cost remained neutral, length of stay decreased, and the payment denial rate remained among the country's lowest.

  7. 45 CFR 150.403 - Scope of ALJ's authority.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 45 Public Welfare 1 2010-10-01 2010-10-01 false Scope of ALJ's authority. 150.403 Section 150.403 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES REQUIREMENTS RELATING TO HEALTH CARE ACCESS CMS ENFORCEMENT IN GROUP AND INDIVIDUAL INSURANCE MARKETS Administrative Hearings § 150.403 Scope of ALJ's...

  8. 45 CFR 150.403 - Scope of ALJ's authority.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 45 Public Welfare 1 2011-10-01 2011-10-01 false Scope of ALJ's authority. 150.403 Section 150.403 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES REQUIREMENTS RELATING TO HEALTH CARE ACCESS CMS ENFORCEMENT IN GROUP AND INDIVIDUAL INSURANCE MARKETS Administrative Hearings § 150.403 Scope of ALJ's...

  9. Who contracts for primary care?

    PubMed

    Lewis, R; Gillam, S; Gosden, T; Sheaff, R

    1999-12-01

    The implications of the 1997 NHS (Primary Care) Act have been largely overlooked in the rush to establish Primary Care Groups. Allowing health authorities to develop local contracts for primary care has far-reaching implications and is an important departure from the national system of negotiation that has characterized general practice to date. This paper describes a content analysis of a sample of Personal Medical Services (PMS) pilot contracts. In the first year little attention has been given to achieving cost savings or greater efficiency and few contracts promote clinical guidelines. The difficulties of specifying services sensitive to local health needs are highlighted and the national Statement of Fees and Allowances (the 'Red Book') may not be swiftly supplanted. However, the pilots have introduced innovations such as salaried general practitioners, nurse-led services and NHS trust-managed care. The development of local contracts provides a valuable learning experience for general practitioners and health authorities in advance of the establishment of Primary Care Trusts.

  10. Cultivating the Role of Nurse Practitioners in Providing Primary Care to Vulnerable Populations in an Era of Health-Care Reform.

    PubMed

    Xue, Ying; Intrator, Orna

    2016-02-01

    The evolving role of nurse practitioners (NPs) as primary care providers, especially for vulnerable populations, is central to the debate regarding strategies to address the growing need for primary care services. The current article provides policy recommendations for leveraging and expanding the historic role of NPs in caring for vulnerable populations, by focusing on three key policy levers: NP scope-of-practice regulation, distribution of the NP workforce, and NP education. These policy levers must go hand in hand to build a sufficient and equitably distributed NP workforce, to help meet the escalating need for primary care in an era of health-care reform. © The Author(s) 2016.

  11. [Nursing care according to Virginia Henderson in the at home care field].

    PubMed

    Coll, Margarita; Besora, Inma; Icart, Teresa; Vall, Asunción Ferré; Manito, Isabel; Ondiviela, Angeles; Pulpon, Anna

    2007-03-01

    The authors determine if applying the nurse process, by adopting Virginia Henderson's conceptual model, is more effective and provides any added value in terms of quality care and security or professional satisfaction in comparison to the application of other methods which do not adopt Henderson's model in the field of at home care.

  12. Influence of computational domain size on the pattern formation of the phase field crystals

    NASA Astrophysics Data System (ADS)

    Starodumov, Ilya; Galenko, Peter; Alexandrov, Dmitri; Kropotin, Nikolai

    2017-04-01

    Modeling of crystallization process by the phase field crystal method (PFC) represents one of the important directions of modern computational materials science. This method makes it possible to research the formation of stable or metastable crystal structures. In this paper, we study the effect of computational domain size on the crystal pattern formation obtained as a result of computer simulation by the PFC method. In the current report, we show that if the size of a computational domain is changed, the result of modeling may be a structure in metastable phase instead of pure stable state. The authors present a possible theoretical justification for the observed effect and provide explanations on the possible modification of the PFC method to account for this phenomenon.

  13. The health care system: factoring in the ethnicity, cultural and health care needs of women and children of color.

    PubMed

    Griffin, F N

    1994-01-01

    The author reviews the literature on factors which influence the health of African Americans. The concept of poverty as a health problem is discussed as well as the feminization of poverty. The author implores health care workers, to begin to implement the concepts of ethnicity and culture when giving care to clients of color.

  14. Health Care Reform, Care Coordination, and Transformational Leadership.

    PubMed

    Steaban, Robin Lea

    2016-01-01

    This article is meant to spur debate on the role of the professional nurse in care coordination as well as the role of nursing leaders for defining and leading to a future state. This work highlights the opportunity and benefits associated with transformation of professional nursing practice in response to the mandates of the Affordable Care Act of 2010. An understanding of core concepts and the work of care coordination are used to propose a model of care coordination based on the population health pyramid. This maximizes the roles of nurses across the continuum as transformational leaders in the patient/family and nursing relationship. The author explores the role of the nurse in a transactional versus transformational relationship with patients, leading to actualization of the nurse in care coordination. Focusing on the role of the nurse leader, the challenges and necessary actions for optimization of the professional nurse role are explored, using principles of transformational leadership.

  15. Evaluating Industry Payments Among Dermatology Clinical Practice Guidelines Authors.

    PubMed

    Checketts, Jake X; Sims, Matthew Thomas; Vassar, Matt

    2017-12-01

    It is well documented that financial conflicts of interest influence medical research and clinical practice. Prior to the Open Payments provisions of the Affordable Care Act, financial ties became apparent only through self-disclosure. The nature of financial interests has not been studied among physicians who develop dermatology clinical practice guidelines. To evaluate payments received by physicians who author dermatology clinical practice guidelines, compare disclosure statements for accuracy, determine whether pharmaceutical companies from which the authors received payments manufactured products related to the guidelines, and examine the extent to which the American Academy of Dermatology enforced their Administrative Regulations for guideline development. Three American Academy of Dermatology guidelines published from 2013 to 2016 were retrieved. Double data extraction was used to record financial payments received by 49 guideline authors using the Open Payments database. Payments received by the authors from the date of the initial literature search to the date of publication were used to evaluate disclosure statement accuracy, detail the companies providing payments, and evaluate Administrative Regulations enforcement. This study is applicable to clinical practice guideline panels drafting recommendations, physicians using clinical practice guidelines to inform patient care, and those establishing policies for guideline development. Our main outcomes are the monetary values and types of payments received by physicians who author dermatology guidelines and the accuracy of disclosure statements. Data were collected from the Open Payments database and analyzed descriptively. Of the 49 authors evaluated, 40 received at least 1 reported industry payment, 31 accepted more than $1000, 25 accepted more than $10 000, and 18 accepted more than $50 000. Financial payments amounted to a mean of $157 177 per author. The total reimbursement among the 49 authors

  16. False recall is reduced by damage to the ventromedial prefrontal cortex: implications for understanding the neural correlates of schematic memory.

    PubMed

    Warren, David E; Jones, Samuel H; Duff, Melissa C; Tranel, Daniel

    2014-05-28

    Schematic memory, or contextual knowledge derived from experience (Bartlett, 1932), benefits memory function by enhancing retention and speeding learning of related information (Bransford and Johnson, 1972; Tse et al., 2007). However, schematic memory can also promote memory errors, producing false memories. One demonstration is the "false memory effect" of the Deese-Roediger-McDermott (DRM) paradigm (Roediger and McDermott, 1995): studying words that fit a common schema (e.g., cold, blizzard, winter) often produces memory for a nonstudied word (e.g., snow). We propose that frontal lobe regions that contribute to complex decision-making processes by weighting various alternatives, such as ventromedial prefrontal cortex (vmPFC), may also contribute to memory processes by weighting the influence of schematic knowledge. We investigated the role of human vmPFC in false memory by combining a neuropsychological approach with the DRM task. Patients with vmPFC lesions (n = 7) and healthy comparison participants (n = 14) studied word lists that excluded a common associate (the critical item). Recall and recognition tests revealed expected high levels of false recall and recognition of critical items by healthy participants. In contrast, vmPFC patients showed consistently reduced false recall, with significantly fewer intrusions of critical items. False recognition was also marginally reduced among vmPFC patients. Our findings suggest that vmPFC increases the influence of schematically congruent memories, a contribution that may be related to the role of the vmPFC in decision making. These novel neuropsychological results highlight a role for the vmPFC as part of a memory network including the medial temporal lobes and hippocampus (Andrews-Hanna et al., 2010). Copyright © 2014 the authors 0270-6474/14/347677-06$15.00/0.

  17. 77 FR 19290 - Medicare and Medicaid Programs; Renewal of Deeming Authority of the Accreditation Association for...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-03-30

    ... Ambulatory Health Care, Inc. for Medicare Advantage Health Maintenance Organizations and Local Preferred... Accreditation Association for Ambulatory Health Care, Inc. (AAAHC) for Health Maintenance Organizations and....165(b). AOs that apply for MA deeming authority are generally recognized by the health care industry...

  18. 78 FR 43055 - Accelerating Improvements in HIV Prevention and Care in the United States Through the HIV Care...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-07-18

    ... Improvements in HIV Prevention and Care in the United States Through the HIV Care Continuum Initiative #0; #0... 13649 of July 15, 2013 Accelerating Improvements in HIV Prevention and Care in the United States Through the HIV Care Continuum Initiative By the authority vested in me as President by the Constitution and...

  19. The Future of Health Care in the Kurdistan Region - Iraq: Toward an Effective, High-Quality System with an Emphasis on Primary Care.

    PubMed

    Moore, Melinda; Anthony, C Ross; Lim, Yee-Wei; Jones, Spencer S; Overton, Adrian; Yoong, Joanne K

    2014-01-01

    At the request of the Kurdistan Regional Government (KRG), RAND researchers undertook a yearlong analysis of the health care system in the Kurdistan Region of Iraq, with a focus on primary care. RAND staff reviewed available literature on the Kurdistan Region and information relevant to primary care; interviewed a wide range of policy leaders, health practitioners, patients, and government officials to gather information and understand their priorities; collected and studied all available data related to health resources, services, and conditions; and projected future supply and demand for health services in the Kurdistan Region; and laid out the health financing challenges and questions. In this volume, the authors describe the strengths of the health care system in the Kurdistan Region as well as the challenges it faces. The authors suggest that a primary care-oriented health care system could help the KRG address many of these challenges. The authors discuss how such a system might be implemented and financed, and they make recommendations for better utilizing resources to improve the quality, access, effectiveness, and efficiency of primary care.

  20. Home care in Austria: the interplay of family orientation, cash-for-care and migrant care.

    PubMed

    Österle, August; Bauer, Gudrun

    2012-05-01

    This article discusses the development of the home care sector in Austria. It analyses what impacts the interplay of the traditional family orientation to care, a universal cash-for-care scheme (reaching about 5% of the population) and a growing migrant care sector have on formal home care in Austria. The article is based on an analysis of research papers, policy documents and statistical data covering the period from the introduction of the cash-for-care scheme in 1993 up to 2011. Some authors have argued that generous cash benefits with no direct link to service use - as in the case of Austria - limit the development of home care, particularly in countries with a traditionally strong family orientation towards long-term care. Additionally, a tradition of family care and an emphasis on cash benefits may be conducive to the employment of migrant carers in private households, as a potential substitute for both family care and formal care. Despite this context, Austria has seen a substantial increase in formal home care over the past two decades. This has been driven by clients using their increased purchasing power and by policy priorities emphasising the extension of home care. Migrant care work was regularised in 2007, and the analysis suggests that while migrant care has usually worked as a substitute for other care arrangements, migrant care can also become a more integral element of care schemes. The article concludes that family orientation, unconditional cash benefits and the use of migrant carers do not necessarily preclude the development of a strong social service sector. However, there is a risk that budgetary limitations will primarily affect social service development. © 2011 Blackwell Publishing Ltd.

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