Astronomia para/com crianças carentes em Limeira

NASA Astrophysics Data System (ADS)

Bretones, P. S.; Oliveira, V. C.

2003-08-01

Em 2001, o Instituto Superior de Ciências Aplicadas (ISCA Faculdades de Limeira) iniciou um projeto pelo qual o Observatório do Morro Azul empreendeu uma parceria com o Centro de Promoção Social Municipal (CEPROSOM), instituição mantida pela Prefeitura Municipal de Limeira para atender crianças e adolescentes carentes. O CEPROSOM contava com dois projetos: Projeto Centro de Convivência Infantil (CCI) e Programa Criança e Adolescente (PCA), que atendiam crianças e adolescentes em Centros Comunitários de diversas áreas da cidade. Esses projetos têm como prioridades estabelecer atividades prazerosas para as crianças no sentido de retirá-las das ruas. Assim sendo, as crianças passaram a ter mais um tipo de atividade - as visitas ao observatório. Este painel descreve as várias fases do projeto, que envolveu: reuniões de planejamento, curso de Astronomia para as orientadoras dos CCIs e PCAs, atividades relacionadas a visitas das crianças ao Observatório, proposta de construção de gnômons e relógios de Sol nos diversos Centros Comunitários de Limeira e divulgação do projeto na imprensa. O painel inclui discussões sobre a aprendizagem de crianças carentes, relatos que mostram a postura das orientadoras sobre a pertinência do ensino de Astronomia, relatos do monitor que fez o atendimento no Observatório e o que o número de crianças atendidas representou para as atividades da instituição desde o início de suas atividades e, em particular, em 2001. Os resultados são baseados na análise de relatos das orientadoras e do monitor do Observatório, registros de visitas e matérias da imprensa local. Conclui com uma avaliação do que tal projeto representou para as Instituições participantes. Para o Observatório, em particular, foi feita uma análise com relação às outras modalidades de atendimentos que envolvem alunos de escolas e público em geral. Também é abordada a questão do compromisso social do Observatório na educação do

Standardized terminology and nomenclature for pancreatobiliary cytology: The Papanicolaou Society of Cytopathology Guidelines.

PubMed

Pitman, Martha B; Centeno, Barbara A; Ali, Syed Z; Genevay, Muriel; Stelow, Ed; Mino-Kenudson, Mari; Castillo, Carlos Fernandez-Del; Schmidt, C Max; Brugge, William R; Layfield, Lester J

2014-01-01

The Papanicolaou Society of Cytopathology has developed a set of guidelines for pancreatobiliary cytology including indications for endoscopic ultrasound (EUS) guided fine-needle aspiration (FNA) biopsy, techniques of EUS-FNA, terminology and nomenclature of pancreatobiliary disease, ancillary testing and post-biopsy treatment and management. All documents are based on the expertise of the authors, a review of the literature, discussion of the draft document at several national and international meetings over an 18 month period and synthesis of online comments of the draft document on the Papanicolaou Society of Cytopathology web site [www.papsociety.org]. This document selectively presents the results of these discussions and focuses on a proposed standardized terminology scheme for pancreatobiliary specimens that correlate cytological diagnosis with biological behavior and increasingly conservative patient management of surveillance only. The proposed terminology scheme recommends a six-tiered system: Non-diagnostic, negative, atypical, neoplastic [benign or other], suspicious and positive. Unique to this scheme is the "neoplastic" category separated into "benign" (serous cystadenoma) or "other" (premalignant mucinous cysts, neuroendocrine tumors and solid-pseudopapillary neoplasms (SPNs)). The positive or malignant category is reserved for high-grade, aggressive malignancies including ductal adenocarcinoma, acinar cell carcinoma, poorly differentiated neuroendocrine carcinomas, pancreatoblastoma, lymphoma and metastases. Interpretation categories do not have to be used. Some pathology laboratory information systems require an interpretation category, which places the cytological diagnosis into a general category. This proposed scheme provides terminology that standardizes the category of the various diseases of the pancreas, some of which are difficult to diagnose specifically by cytology. In addition, this terminology scheme attempts to provide maximum

Standardized terminology and nomenclature for pancreatobiliary cytology: the Papanicolaou Society of Cytopathology guidelines.

PubMed

Pitman, Martha B; Centeno, Barbara A; Ali, Syed Z; Genevay, Muriel; Stelow, Ed; Mino-Kenudson, Mari; Fernandez-del Castillo, Carlos; Max Schmidt, C; Brugge, William; Layfield, Lester

2014-04-01

The Papanicolaou Society of Cytopathology has developed a set of guidelines for pancreatobiliary cytology including indications for endoscopic ultrasound (EUS)-guided fine needle aspiration (FNA) biopsy, techniques of EUS-FNA, terminology and nomenclature of pancreatobiliary disease, ancillary testing, and postbiopsy treatment and management. All documents are based on the expertise of the authors, a review of the literature, discussions of the draft document at several national and international meetings over an 18-month period and synthesis of online comments of the draft document on the Papanicolaou Society of Cytopathology web site (www.papsociety.org). This document selectively presents the results of these discussions and focuses on a proposed standardized terminology scheme for pancreatobiliary specimens that correlate cytological diagnosis with biological behavior and increasingly conservative patient management of surveillance only. The proposed terminology scheme recommends a six-tiered system: Nondiagnostic, Negative, Atypical, Neoplastic (benign or other), Suspicious and Positive. Unique to this scheme is the "Neoplastic" category separated into "benign" (serous cystadenoma), or "Other" (premalignant mucinous cysts, neuroendocrine tumors, and solid-pseudopapillary neoplasms). The positive or malignant category is reserved for high-grade, aggressive malignancies including ductal adenocarcinoma, acinar cell carcinoma, poorly differentiated neuroendocrine carcinomas, pancreatoblastoma, lymphoma, and metastases. Interpretation categories do not have to be used. Some pathology laboratory information systems require an interpretation category, which places the cytological diagnosis into a general category. This proposed scheme provides terminology that standardizes the category of the various diseases of the pancreas, some of which are difficult to diagnose specifically by cytology. In addition, this terminology scheme attempts to provide maximum flexibility

Santé sexuelle et reproductive des adolescentes de Bobo Dioulasso, Burkina Faso: place de la communication parents-adolescentes pour la réduction des risques

PubMed Central

Some, Donmozoun Télesphore; Some, Der Adolphe; Hien, Hervé; Diallo, Ramata; Zingue, Dézémon; Diallo, Ibrahim; Diagbouga, Serge; Dao, Blami

2012-01-01

Introduction Les adolescentes sont très vulnérables face aux Infections Sexuellement Transmissibles (IST) et au VIH/SIDA. Notre étude a pour objectifs d’explorer la qualité de la communication entre les adolescentes et leurs parents sur les IST/VIH/SIDA et de recueillir leurs suggestions pour l’amélioration de cette communication. Méthodes L’étude était transversale qualitative sur 2 mois. La population de l’étude était composée par des adolescentes de 13 à 17 ans et leurs parents habitant la ville de Bobo Dioulasso. Vingt (20) adolescentes scolarisées ont été tirés au sort dans trois établissements secondaires et 20 autres non scolarisées choisies de façon accidentelle dans la ville. Les informations ont été collectées à l’aide de 8 focus groups. Les discussions ont été enregistrées sur cassettes, retranscrites en verbatim, et analysées à l’aide du logiciel QSR NVIVO 2.0. Résultats Les adolescentes et leurs parents communiquent très peu ou pas sur les questions des IST/VIH/SIDA; l’auto-information par les paires ou les médias est la première source d’information. Pour les parents, l’information existe et est accessible aux adolescentes alors que pour ces dernières, leurs connaissances de ces maladies sont parfois erronées. L’abstinence, la fidélité et le dépistage volontaire comme moyen de prévention sont très peu évoqués par les adolescentes de même que par leurs parents. Conclusion La communication parents-adolescentes est insuffisante voire absente dans certains milieux. Il est urgent de conduire des actions auprès des adolescentes et leurs parents pour mieux les informer sur les IST/VIH/SIDA et améliorer la communication sur ces maladies. PMID:22655099

Screening with Papanicolaou tests in Alberta

PubMed Central

Symonds, Christopher J.; Chen, Wenxin; Rose, Marianne Sarah; Cooke, Lara J.

2018-01-01

Abstract Objective To describe the prevalence and geographic distribution of cervical cancer screening, as well as the age groups of those undergoing screening, in Alberta, and to determine if screening practices conform to current guidelines and follow Choosing Wisely Canada recommendations. Design Descriptive study using data from the Alberta Ministry of Health Analytics and Performance Reporting Branch. Setting Alberta. Participants Women who had 1 or more Papanicolaou tests between 2011 and 2013. Main outcome measures Number of women aged 15 to 20 and those aged 70 and older who had 1 or more Pap tests in a 3-year period; year-to-year trends in screening rates for women in these 2 age groups; trends in screening rates in various geographic regions (ie, cities and zones) in Alberta; and the discipline of clinicians who ordered the Pap tests. Results Between 2011 and 2013, 805 632 women in the province of Alberta had 1 or more Pap tests for cervical cancer screening. Overall, 25 511 (17.5%) women aged 15 to 20 and 16 818 (10.3%) aged 70 and older were screened contrary to most existing guidelines. Screening rates varied markedly in different geographic regions of the province. Most Pap tests were ordered by family physicians or general practitioners. Conclusion Within the geographic regions of Alberta, provincial, national, and international guidelines for screening with Pap tests are inconsistently followed. This strongly echoes the need for clinicians and patients to consider the Choosing Wisely Canada recommendations and current guidelines for cervical cancer screening. PMID:29358254

Comparative Assessment of Conventional Papanicolaou and Modified Ultrafast Papanicolaou Stains in Fine Needle Aspiration Samples and Body Fluids.

PubMed

Arul, P; Eniya, S; Pushparaj, Magesh; Masilamani, Suresh; Kanmani, P; Lingasamy, C

2018-01-01

Conventional Papanicolaou (Pap) stain has undergone many modifications; of these, ultrafast Pap stain is the most popular as it shortens the turnaround time of reporting. Application of modified ultrafast Pap (MUFP) stain in the evaluation of fine needle aspiration (FNA) samples and body fluids are scanty. To evaluate the utility of MUFP stain in various FNA samples and body fluids and compare the findings with those of conventional Pap stain. In this cross-sectional study, two wet-fixed and two airdried smears from each sample [301 samples (255 FNA samples and 46 body fluids)] were prepared and stained by the conventional Pap and MUFP stains, respectively. Concordant and discordant rate was calculated. Quality index (QI) of MUFP stain was assessed by background, overall staining, cell morphology, and nuclear characteristics. MUFP-stained smears were also categorized into excellent, good, and fair. The concordance rate for MUFP stain was 100%. QI of MUFP stain for breast, thyroid, lymph node, soft tissue, salivary gland, and body fluids was 0.9, 0.93, 0.95, 1, 0.94, and 1, respectively. Excellent quality of stain was noted in 53.2% and good in 24.6% of the cases allowing easy diagnosis. In 22.2% of fair cases, diagnosis was possible with some difficulties. Our study concluded that MUFP stain could be considered as a rapid and reliable diagnostic tool and can be applied on a regular basis in FNA samples and body fluids to offer immediate diagnosis. However, caution should be taken while reporting certain MUFP-stained smears to avoid over/under diagnosis.

A brief chronicle of cytology: from Janssen to Papanicolaou and beyond.

PubMed

Diamantis, Aristides; Beloukas, Apostolos I; Kalogeraki, Alexandra M; Magiorkinis, Emmanouil

2013-06-01

The aim of our study was to outline and present the major hallmarks in the history of clinical cytology. For this purpose, an extensive research in modern literature and the PubMed database was undertaken. Furthermore, we studied original papers and books of the pioneers in cytopathology. The development of the first microscope by Hans and Sacharias Janssen is a hallmark in biological sciences, since the study of microcosmos was made feasible. From the discovery of single cells by Robert Hooke and the cell theory by Schleiden and Schwann till the establishment of exfoliative cytology by George Papanicolaou and the invention of fine-needle aspiration biopsy technique by Martin and Ellis, there is a three-century continuum of important discoveries and research. Today, flow cytometry and the introduction of molecular techniques have revolutionized medicine and are expected to change the face of cytology in the near future. Copyright © 2012 Wiley Periodicals, Inc.

Lessons learned from successful Papanicolaou cytology cervical cancer prevention in the Socialist Republic of Vietnam.

PubMed

Suba, Eric J; Raab, Stephen S

2012-04-01

In 1996, we documented that the burden of cervical cancer in Vietnam was associated with troop movements during the Vietnam War. Subsequently, establishment of Papanicolaou screening in southern Vietnam was associated with reductions in cervical cancer incidence from 29.2/100,000 in 1998 to 16/100,000 in 2003. This is one of the first English-language reports of a real-world cervical cancer prevention effort associated with a decisive impact on health outcomes in a contemporary developing country. if our ideological commitment is to improve health outcomes as rapidly as possible among as many people as possible, then Papanicolaou screening (with or without HPV or visual screening) must be implemented without further delay in any setting where cervical screening is appropriate but unavailable; consideration must be given to HPV vaccination after, rather than before, full coverage of target demographic groups by screening services has been achieved and/or the possibility has been excluded that HPV vaccination may be ineffective for cancer prevention. Competing ideological commitments engender imprudent yet commercially useful alternative strategies prone to decelerate global reductions in mortality by suppressing the more-rapid uptake of less-expensive open-source technology in favor of the less-rapid uptake of more-expensive proprietary technologies with uncertain real-world advantages and unfavorable real-world operational limitations. Global cervical cancer prevention efforts will become more effective if global health leaders, including the Bill & Melinda Gates Foundation, embrace an ideological commitment to improving health outcomes as rapidly as possible among as many people as possible and assimilate the policy implications of that commitment. Copyright © 2011 Wiley-Liss, Inc.

Effectiveness of rapid prescreening and 10% rescreening in liquid-based Papanicolaou testing.

PubMed

Currens, Heather S; Nejkauf, Katharine; Wagner, Lynn; Raab, Stephen S

2012-01-01

Although rapid prescreening (RPS) has been shown to be an effective quality control procedure for detecting false-negative conventional Papanicolaou (Pap) tests, RPS has not been widely implemented in the United States. In our laboratory, cytotechnologists performed RPS in 3,567 liquid-based Pap tests: 1,911 SurePath (BD Diagnostics-TriPath, Burlington, NC) preparations that were manually screened and 1,656 ThinPrep Pap tests (Hologic, Bedford, MA) that were imaged using the ThinPrep Imaging System (Hologic). We compared the sensitivity of RPS, 10% rescreening (R-10%), and routine screening (RS). In contrast with previously published findings, we found that RS + RPS did not improve screening sensitivity compared with RS + R-10%. These results support the following hypotheses: (1) Higher baseline RS sensitivity as a result of Pap test diagnoses standardization implemented for quality improvement purposes decreases the performance impact of RPS. (2) R-10% and RPS quality assurance methods detect diagnostic failures caused by different types of cognitive errors.

ACTITUDES HACIA LA COMUNICACIÓN SEXUAL ENTRE PADRES/MADRES Y ADOLESCENTES EN PUERTO RICO*

PubMed Central

Fernández, Ana Michelle; McFarlane, Melvin Negrón; González, Ricardo; Díaz, Leslie; Betancourt-Díaz, Elba; Cintrón-Bou, Francheska; Varas-Díaz, Nelson; Villarruel, Antonia

2017-01-01

RESUMEN La comunicación sobre sexualidad entre padres/madres y adolescentes enfrenta dificultades particulares producto de factores socioculturales. Este estudio tuvo como objetivo documentar las actitudes de padres/madres y adolescentes hacia la comunicación sobre temas de sexualidad. Los resultados emanan de la medición inicial del Proyecto Cuídalos. Los datos de este estudio forman parte de un estudio amplio que evaluó un módulo interactivo basado en la web para mejorar comunicación sobre temas de salud entre padres/madres y adolescentes entre 13–17 años. En este artículo, reportamos datos basales que contestaron los/as participantes sobre comodidad al hablar sobre temas de salud sexual. La muestra, de los datos aquí expuestos, estuvo compuesta por 458 diadas de madres/padres y sus hijos/as adolescentes (n=916). Se realizó análisis de frecuencias y medidas de tendencia central con los datos obtenidos inicialmente. La edad promedio de los adolescentes fue de 15 años, de los que un 15% se encontraban activos sexualmente. Los/as adolescentes tienen mejor disposición que los/as padres/madres para hablar sobre sexualidad. Sin embargo, los/as padres/madres entienden que comparten suficiente información sobre temas relacionados a la sexualidad. Los/as padres/madres y adolescentes reportaron algún grado de dificultad e incomodidad al hablar sobre métodos específicos de prevención. Los resultados destacan la necesidad de incorporar a los/as padres/madres en intervenciones con adolescentes sobre temas de salud sexual. En Puerto Rico es necesario desarrollar programas dirigidos a minimizar las conductas sexuales de alto riesgo en jóvenes. PMID:28736599

Evaluation of Papanicolaou stain for studying micronuclei in buccal cells under field conditions.

PubMed

Ayyad, Sohair B A; Israel, Ebenezer; El-Setouhy, Maged; Nasr, Ghada Radwan; Mohamed, Mostafa K; Loffredo, Christopher A

2006-01-01

To compare Papanicolaou (Pap) and May-Grünwald Giemsa (MGG) stain as 2 techniques for staining for buccal mucosal cells to detect micronuclei (MN) infield studies. Eighty cytologic smears (2 per individual) were taken from the buccal mucosa of 40 cigarette smokers recruited at a rural village in Egypt. Forty smears were stained with Pap stain and 40 with MGG stain. All were assessed for cellularity and scored for MN. Pap stain was faster and easier to process and transport in the field study than was MGG stain. Regarding MGG smears, bacteria and cell debris masked the MN as compared to Pap smears, in which the fixative destroyed the bacteria and made the cell boundaries clearly demarcated. Using Pap stain, MN were seen easily in transparent cytoplasm. Pap stain is the preferred method infield studies for scoring and detecting MN in cells of buccal mucosa.

ESTIGMA Y VIH/SIDA ENTRE PADRES/MADRES Y ADOLESCENTES PUERTORRIQUEÑOS/AS

PubMed Central

Pérez, Grace Rosado; Reyes, Glendalys Rivera; Villanueva, Victoria Larrieux; Torres, Gilliam J. Torres; Díaz, Elba Betancourt; Varas-Díaz, Nelson; Villaruel, Antonia

2016-01-01

La comunicación entre padres/madres y adolescentes sobre el tema de la sexualidad es importante para el desarrollo de la salud de personas jóvenes. Dicha comunicación puede verse negativamente impactada por actitudes estigmatizantes hacia el tema del VIH/SIDA. El objetivo de este estudio fue identificar actitudes estigmatizantes hacia el VIH/SIDA entre padres/madres y adolescentes puertorriqueños/as. Este esfuerzo es parte del Proyecto Cuídalos, dirigido a probar una intervención en formato electrónico que busca aumentar la comunicación sobre sexualidad y salud entre padres/madres y adolescentes mediante un diseño experimental con 458 diadas de padres/madres y adolescentes de 13 a 17 años. Para propósitos de este artículo reportamos estadísticas descriptivas sobre estigma hacia el VIH/SIDA con la información recopilada en la medición basal. Tanto adultos/as como adolescentes mostraron actitudes estigmatizantes hacia el VIH/SIDA. A la luz de los resultados es necesario continuar desarrollando intervenciones para la reducción de estigma en esta población. Los/as padres/madres pueden ser un recurso invaluable para reducir el estigma en los/as jóvenes, y prevenir conductas sexuales de riesgo e infecciones. PMID:27099649

Clinical Implications of the Cervical Papanicolaou Test Results in the Management of Anal Warts in HIV-Infected Women

PubMed Central

Luu, Hung N.; Amirian, E. Susan; Piller, Linda; Chan, Wenyaw; Scheurer, Michael E.

2013-01-01

The Papanicolaou test (or Pap test) has long been used as a screening tool to detect cervical precancerous/cancerous lesions. However, studies on the use of this test to predict both the presence and change in size of genital warts are limited. We examined whether cervical Papanicolaou test results are associated with the size of the largest anal wart over time in HIV-infected women in an on-going cohort study in the US. A sample of 976 HIV-infected women included in a public dataset obtained from the Women’s Interagency HIV Study (WIHS) was selected for analysis. A linear mixed model was performed to determine the relationship between the size of anal warts and cervical Pap test results. About 32% of participants had abnormal cervical Pap test results at baseline. In the adjusted model, a woman with a result of Atypia Squamous Cell Undetermined Significance/Low-grade Squamous Intraepithelial Lesion (ASCUS/LSIL) had an anal wart, on average, 12.81 mm2 larger than a woman with normal cervical cytology. The growth rate of the largest anal wart after each visit in a woman with ASCUS/LSIL was 1.56 mm2 slower than that of a woman with normal cervical results. However, they were not significant (P = 0.54 and P = 0.82, respectively). This is the first study to examine the relationship between cervical Pap test results and anal wart development in HIV-infected women. Even though no association between the size of anal wart and cervical Pap test results was found, a screening program using anal cytology testing in HIV-infected women should be considered. Further studies in cost-effectiveness and efficacy of an anal cytology test screening program are warranted. PMID:24312348

Quality assessment and improvement of "Unsatisfactory" liquid-based cervicovaginal papanicolaou smears.

PubMed

Mirzamani, Neda; Chau, Karen; Rafael, Oana; Shergill, Uday; Sajjan, Sujata; Sumskaya, Irina; Gimenez, Cecilia; Klein, Melissa; Das, Kasturi

2017-10-01

The quality of cervicovaginal smears determines the success of cytology in screening programs for cervical cancer. Bethesda 2014 revisited the adequacy criteria for atrophic smears and redefined the squamous cell count in the "unsatisfactory" category. In this study, we evaluated the smear quality of Thinprep liquid-based cervicovaginal Papanicolaou cytology slides (TPS) that were previously deemed unsatisfactory, to determine reasons for such categorization. In addition, we attempted to establish the impact of the new adequacy criteria on the rate and management of unsatisfactory diagnosis. About 234 unsatisfactory TPS were examined. The reasons for unsatisfactory were noted. The number of squamous cells was recounted, as per the new Bethesda criteria, in borderline adequacy cases that showed an atrophic pattern. The leading cause for unsatisfactory TPS was lubricating gel, followed by blood, as observed in older and younger age groups, respectively (Figure 1). Eleven borderline cases were reclassified as "satisfactory" using the new Bethesda cell count, with 27% above 60 years of age. About 82% of these borderline cases were negative for intraepithelial lesion or malignancy on repeat testing. There was no difference of management or change in rate of unsatisfactory when patients above 60 were reclassified into the satisfactory category using the new Bethesda count. However, a larger study is needed to evaluate whether the new recommendation for minimum cellularity can be implemented in patients above a certain age cut-off. The study highlights the need for improvement in collection practices and education of practitioners. © 2017 Wiley Periodicals, Inc.

Influence of hormonal contraceptive use and health beliefs on sexual orientation disparities in Papanicolaou test use.

PubMed

Charlton, Brittany M; Corliss, Heather L; Missmer, Stacey A; Frazier, A Lindsay; Rosario, Margaret; Kahn, Jessica A; Austin, S Bryn

2014-02-01

Reproductive health screenings are a necessary part of quality health care. However, sexual minorities underutilize Papanicolaou (Pap) tests more than heterosexuals do, and the reasons are not known. Our objective was to examine if less hormonal contraceptive use or less positive health beliefs about Pap tests explain sexual orientation disparities in Pap test intention and utilization. We used multivariable regression with prospective data gathered from 3821 females aged 18 to 25 years in the Growing Up Today Study (GUTS). Among lesbians, less hormonal contraceptive use explained 8.6% of the disparities in Pap test intention and 36.1% of the disparities in Pap test utilization. Less positive health beliefs associated with Pap testing explained 19.1% of the disparities in Pap test intention. Together, less hormonal contraceptive use and less positive health beliefs explained 29.3% of the disparities in Pap test intention and 42.2% of the disparities in Pap test utilization. Hormonal contraceptive use and health beliefs, to a lesser extent, help to explain sexual orientation disparities in intention and receipt of a Pap test, especially among lesbians.

Predictors of Iranian women's intention to first papanicolaou test practice: An application of protection motivation theory.

PubMed

Dehdari, T; Hassani, L; Shojaeizadeh, D; Hajizadeh, E; Nedjat, S; Abedini, M

2016-01-01

Given the importance of papanicolaou (Pap) test in the early detection and timely treatment of cervical cancer, present study was designed to determine predictors of a sample of Iranian women's intention to first Pap test practice based on the protection motivation theory (PMT) variables. In this cross-sectional study, a total of 240 women referral to the 30 primary health care clinics were selected. They completed a developed scale based on PMT variables including intention, perceived vulnerability and severity, fear, response costs, response efficacy and self-efficacy. Path analysis was used to determine the association between predictive factors and intention. The results showed that PMT had goodness of fit with a χ2/df = 2.37, df = 28, P= 0.001 and RMSEA = 0.076. PMT explained 42% of the variance in women's intention to get first Pap smear test. Self-efficacy (b = 0.55, P< 0.001) and response efficacy (b = 0.19, P< 0.001) were found to be the predictors of intention. These findings may be used to develop tailored, theory-based educational interventions associated with Pap testing among women.

Influence of Hormonal Contraceptive Use and Health Beliefs on Sexual Orientation Disparities in Papanicolaou Test Use

PubMed Central

Corliss, Heather L.; Missmer, Stacey A.; Frazier, A. Lindsay; Rosario, Margaret; Kahn, Jessica A.; Austin, S. Bryn

2014-01-01

Objectives. Reproductive health screenings are a necessary part of quality health care. However, sexual minorities underutilize Papanicolaou (Pap) tests more than heterosexuals do, and the reasons are not known. Our objective was to examine if less hormonal contraceptive use or less positive health beliefs about Pap tests explain sexual orientation disparities in Pap test intention and utilization. Methods. We used multivariable regression with prospective data gathered from 3821 females aged 18 to 25 years in the Growing Up Today Study (GUTS). Results. Among lesbians, less hormonal contraceptive use explained 8.6% of the disparities in Pap test intention and 36.1% of the disparities in Pap test utilization. Less positive health beliefs associated with Pap testing explained 19.1% of the disparities in Pap test intention. Together, less hormonal contraceptive use and less positive health beliefs explained 29.3% of the disparities in Pap test intention and 42.2% of the disparities in Pap test utilization. Conclusions. Hormonal contraceptive use and health beliefs, to a lesser extent, help to explain sexual orientation disparities in intention and receipt of a Pap test, especially among lesbians. PMID:23763393

p16/ki-67 dual-stain cytology in the triage of ASCUS and LSIL papanicolaou cytology: results from the European equivocal or mildly abnormal Papanicolaou cytology study.

PubMed

Schmidt, Dietmar; Bergeron, Christine; Denton, Karin J; Ridder, Ruediger

2011-06-25

The objective of this study was to analyze the diagnostic performance of a newly established immunocytochemical dual-stain protocol, which simultaneously detects p16(INK4a) and Ki-67 expression in cervical cytology samples, for identifying high-grade cervical intraepithelial neoplasia (CIN2+) in women with Papanicolaou (Pap) cytology results categorized as atypical squamous cells of undetermined significance (ASCUS) or low-grade squamous intraepithelial lesions (LSIL). Residual liquid-based cytology material from 776 retrospectively collected ASCUS/LSIL cases that were available from a recent study evaluating p16 cytology and HPV testing were subjected to p16/Ki-67 dual staining. The presence of 1 or more double-immunoreactive cell(s) was regarded as a positive test outcome, irrespective of morphology. Test results were correlated to histology follow-up. Sensitivity of p16/Ki-67 dual-stain cytology for biopsy-confirmed CIN2+ was 92.2% (ASCUS) and 94.2% (LSIL), while specificity rates were 80.6% (ASCUS) and 68.0% (LSIL), respectively. Similar sensitivity/specificity profiles were found for both age groups of women aged <30 years versus women aged ≥30 years. Dual-stain cytology showed comparable sensitivity, but significantly higher specificity, when compared with human papillomavirus (HPV) testing. The results of this study show that p16/Ki-67 dual-stain cytology provided a high sensitivity for the detection of underlying CIN2+ in women with ASCUS or LSIL Pap cytology results, comparable to the rates previously reported for HPV testing and p16 single-stain cytology. However, the specificity of this morphology-independent interpretation of p16/Ki-67 dual-stain cytology testing was further improved compared with the earlier p16 single-stain cytology approach, which required morphology interpretation, and it is significantly higher when compared with HPV testing. Copyright © 2011 American Cancer Society.

Barriers to Follow-Up for Abnormal Papanicolaou Smears among Female Sex Workers in Lima, Peru.

PubMed

Aharon, Devora; Calderon, Martha; Solari, Vicky; Alarcon, Patricia; Zunt, Joseph

2017-01-01

Cervical cancer is the most prevalent cancer among Peruvian women. Female sex workers (FSW) in Peru are at elevated risk for HPV infection, and receive annual Papanicolaou screening. The objective of this study was to identify barriers to follow-up for abnormal Pap smears among FSW in Peru. 97 FSW attending the Alberto Barton Health Center in Lima were surveyed regarding their STI screening history. 17 women with a history of an abnormal Pap smear were interviewed about their experiences regarding follow-up care. Of the 27 HPV-positive women, only 8 (30%) received follow-up treatment. Of the 19 women who did not receive follow-up, 7 (37%) had not been informed of their abnormal result. Qualitative interviews revealed that the major barrier to follow-up was lack of knowledge about HPV and potential health consequences of an abnormal Pap smear. HPV infection is highly prevalent in Peruvian FSW, yet only 30% of FSW with abnormal Pap smears receive follow-up care. The predominant barriers to follow-up were lack of standardization in recording and communicating results and insufficient FSW knowledge regarding health consequences of HPV infection. Standardization of record-keeping and distribution of educational pamphlets have been implemented to improve follow-up for HPV.

Uso Del Condón en Adolescentes Nahuas, un Modelo Explicativo.

PubMed

Tirado, María de Los Ángeles Meneses; Benavides-Torres, Raquel A; Navarro, Sergio Meneses; de la Colina, Juan Antonio Doncel; Rodríguez, Dora Julia Onofre; Hernández, Francisco Javier Baéz

2018-03-01

En México, la población indígena supera los siete millones de habitantes, en Puebla el grupo más representativo es el Náhuatl. Sin embargo, las condiciones de vida, salud, educación y transporte son precarias para esta población. En los adolescentes, las responsabilidades como el matrimonio, la familia y los compromisos ante la comunidad, favorecen conductas de riesgo sexual que dificultan su desarrollo económico, social y reproductivo. El objetivo fue proponer un modelo explicativo del uso del condón en adolescentes nahuas. Método. Bajo el marco de la teoría social cognitiva, el concepto de valores culturales de Leininger y el proceso de la sustracción teórica, se desarrolló este artículo. Se muestran las relaciones del modelo con las proposiciones y los factores que influyen en el uso del condón para este grupo específico. Finalmente, el modelo explica las variables de interés, los niveles de abstracción y las relaciones entre sí en el contexto náhuatl. El siguiente paso será implementar los indicadores empíricos para conocer el grado de influencia de los factores personales y ambientales hacia el uso del condón en adolescentes nahuas. Resultados que aportarán información para el desarrollo del conocimiento en enfermería y la reducción de riesgo sexual de esta población.

Experience in managing a large-scale rescreening of Papanicolaou smears and the pros and cons of measuring proficiency with visual and written examinations.

PubMed

Rube, I F

1989-01-01

Experiences in a large-scale interlaboratory rescreening of Papanicolaou smears are detailed, and the pros and cons of measuring proficiency in cytology are discussed. Despite the additional work of the rescreening project and some psychological and technical problems, it proved to be a useful measure of the laboratory's performance as a whole. One problem to be avoided in future similar studies is the creation of too many diagnostic categories. Individual testing and certification have been shown to be accurate predictors of proficiency. For cytology, such tests require a strong visual component to test interpretation and judgment skills, such as by the use of glass slides or photomicrographs. The potential of interactive videodisc technology for facilitating cytopathologic teaching and assessment is discussed.

Cytomorphology of cervicovaginal melanoma: ThinPrep versus conventional Papanicolaou tests.

PubMed

Setia, Namrata; Goulart, Robert A; Leiman, Gladywn; Otis, Christopher N; Modem, Rukmini; Pantanowtiz, Liron

2010-12-31

Primary cervicovaginal melanoma is a rare malignancy associated with a high risk of recurrence. Prior studies discussing the cytomorphology of cervicovaginal melanoma have been based primarily on review of conventional Papanicolaou (Pap) smears. The aim of this study was to evaluate cervicovaginal melanomas identified in liquid-based Pap tests, in comparison with features seen on conventional Pap smear preparation. Cases of cervicovaginal melanoma identified on Pap tests with concurrent or subsequent histopathologic confirmation were collected from the Baystate Medical Center cytopathology files and personal archives of the authors over a total period of 34 years. All cytopathology (n = 6) and the available histology slides (n = 5) were reviewed. Cases were analyzed regarding clinical, histopathologic and cytomorphological findings. A total of six cases with invasive cervicovaginal melanoma diagnosed on Pap tests were identified. Most patients were postmenopausal with contact bleeding, correlating with surface ulceration (identified in biopsy/excision material in 5/5 cases). Most cases had deeply invasive tumors (5/5: modified Breslow's thickness > 5 mm and Chung's level of invasion IV/V). Pap tests included four ThinPrep and two conventional smears. Overall, ThinPrep Pap tests exhibited a higher ratio of tumor cells to background squamous cells. While all Pap tests were bloodstained, tumor diathesis was prominent only within conventional smears. Melanoma cells were present both as clusters and scattered single cells in each Pap test type. Both the preparations contained epithelioid tumor cells, whereas spindled tumor cells were seen in only two ThinPrep cases. Prominent nucleoli and binucleation of tumor cells were seen in both the preparations. Melanin pigment was identified in only ThinPrep (3/4) cases and nuclear pseudo-inclusions in one conventional Pap smear. Cell blocks were made in three ThinPrep cases and immunocytochemistry (S-100, HMB45, Melan

Human papillomavirus infections in women seeking cervical Papanicolaou cytology of Durango, Mexico: prevalence and genotypes

PubMed Central

Sánchez-Anguiano, Luis Francisco; Alvarado-Esquivel, Cosme; Reyes-Romero, Miguel Arturo; Carrera-Rodríguez, Margarita

2006-01-01

Background HPV infection in women from developing countries is an important public health problem. Therefore, we sought to determine the prevalences of HPV infection and HPV genotypes in a female population of Durango City, Mexico. Also to determine whether any socio-demographic characteristic from the women associated with HPV infection exists. Methods Four hundred and ninety eight women seeking cervical Papanicolaou examination in three public Health Centers were examined for HPV infection. All women were tested for HPV DNA PCR by using HPV universal primers. In addition, all positive HPV DNA PCR samples were further analyzed for genotyping of HPV genotype 16, 18 and 33. Socio-demographic characteristics from each participant were also obtained. Results Twenty-four out of four hundred and ninety-eight (4.8%) women were found infected by HPV. HPV genotype 16 was found in 18 out of the 24 (75%) infected women. Two of them were also coinfected by HPV genotype 18 (8.3%). In the rest 6 PCR positive women, genotyping for HPV genotypes 16, 18 and 33 were negative. Conclusion The prevalence of HPV in women of Durango City is low; however, most infected women have high risk HPV genotype. The women who were studied showed low frequency of risk factors for HPV infection and this may explain the low prevalence of HPV infection. The high frequency of high risk HPV genotypes observed might explain the high rate of mortality for cervical cancer in our region. PMID:16504014

Human papillomavirus infections in women seeking cervical Papanicolaou cytology of Durango, Mexico: prevalence and genotypes.

PubMed

Sánchez-Anguiano, Luis Francisco; Alvarado-Esquivel, Cosme; Reyes-Romero, Miguel Arturo; Carrera-Rodríguez, Margarita

2006-02-20

HPV infection in women from developing countries is an important public health problem. Therefore, we sought to determine the prevalences of HPV infection and HPV genotypes in a female population of Durango City, Mexico. Also to determine whether any socio-demographic characteristic from the women associated with HPV infection exists. Four hundred and ninety eight women seeking cervical Papanicolaou examination in three public Health Centers were examined for HPV infection. All women were tested for HPV DNA PCR by using HPV universal primers. In addition, all positive HPV DNA PCR samples were further analyzed for genotyping of HPV genotype 16, 18 and 33. Socio-demographic characteristics from each participant were also obtained. Twenty-four out of four hundred and ninety-eight (4.8%) women were found infected by HPV. HPV genotype 16 was found in 18 out of the 24 (75%) infected women. Two of them were also coinfected by HPV genotype 18 (8.3%). In the rest 6 PCR positive women, genotyping for HPV genotypes 16, 18 and 33 were negative. The prevalence of HPV in women of Durango City is low; however, most infected women have high risk HPV genotype. The women who were studied showed low frequency of risk factors for HPV infection and this may explain the low prevalence of HPV infection. The high frequency of high risk HPV genotypes observed might explain the high rate of mortality for cervical cancer in our region.

Prevalence of Abnormal Papanicolaou Test Results and Related Factors among Women Living in Zanjan, Iran.

PubMed

Maleki, Azam; Ahmadnia, Elahe; Avazeh, Azar; Mazloomzadeh, Saeideh; Molaei, Behnaz; Jalilvand, Ahmad

2015-01-01

Currently, a comprehensive program for screening and early detection of cervical cancer does not exist in Iran. This study aimed to determine the prevalence of abnormal Papanicolaou (Pap) smears and some related factors among women living in Zanjan, Iran. This cross-sectional study was conducted in 2012 in Zanjan on 4274 married women aged 20-65 years. The study participants were selected through two-stage cluster sampling. After obtaining written consent, demographic and fertility questionnaires were completed. Samples from cervix were obtained through a standard method using the Rover Cervex- Brush. Evaluation and interpretation of the samples were reported using the Bethesda 2001 method. Data were statistically analyzed using chi-square and logistic regression models. Most inflammatory changes in the samples were mild (37.4%). Abnormal atypical changes in the epithelial cells were found in 4.04%. The highest percentage of abnormal changes in the epithelial cells was atypical squamous cells of undetermined significance (ASCUS) (1.9%). Abnormal results of Pap smear was significantly and independently associated with age, papillomavirus infection, and lack of awareness about Pap smear tests. Given the high prevalence of inflammatory and precancerous changes in this study, compared to other studies in Iran and other Muslim countries, and the effect of demographic variables and individual factors on abnormal results, increasing the awareness of women and their families regarding the risk factors for cervical cancer, preventive measures such as screening, and timely treatment seem necessary.

Clinicopathological importance of Papanicolaou smears for the diagnosis of premalignant and malignant lesions of the cervix.

PubMed

Bukhari, Mulazim Hussain; Saba, Kanwal; Qamar, Samina; Majeed, Muhammad Muddasar; Niazi, Shahida; Naeem, Samina

2012-01-01

Premalignant and malignant lesions are not uncommon in Pakistani women, especially in the older age-groups This study was conducted to determine the clinicopathological importance of conventional Papanicolaou (Pap) smears for the diagnosis of premalignant and malignant lesions of the cervix. Pap smears of 1000 women were examined from January 2007 to June 2009. Only cases with neoplastic cytology were included. The overall frequency of normal, inadequate, neoplastic, and infective smears was 50%, 1.8%, 10.2%, and 38.3%, respectively. Most of the patients (67%) were in the postmenopausal age-group, with the mean age being 44.7±15.63 years. The commonest clinical signs/symptoms seen among the 102 patients with neoplastic gynecological lesions were vaginal discharge and abnormal bleeding (93/102;(91.2% and 62/102;60.7%). Of the 102 cases with neoplastic lesions 46 patients (45%) had low-grade squamous cell intraepithelial lesions (LSILs), 22 (21.5%) had high-grade squamous cell intraepithelial lesions (HSILs), 14 (13.7%) had squamous cell carcinoma, and 6 (5.8%) showed features of adenocarcinoma. Ten (9.8%) cases showed cytology of atypical squamous cells of undetermined significance (ASCUS) and four (3.9%) cases had atypical glandular cells of undetermined significance (AGUS). We conclude that cervical smear examination is well suited for diagnosing neoplastic disease. It is clear that cervical neoplastic lesions are becoming a problem in Pakistan.

[Waiting time for the first colposcopic examination in women with abnormal Papanicolaou test].

PubMed

Nascimento, Maria Isabel do; Rabelo, Irene Machado Moraes Alvarenga; Cardoso, Fabrício Seabra Polidoro; Musse, Ricardo Neif Vieira

2015-08-01

To evaluate the waiting times before obtaining the first colposcopic examination for women with abnormal Papanicolaou smears. Retrospective cohort study conducted on patients who required a colposcopic examination to clarify an abnormal pap test, between 2002 January and 2008 August, in a metropolitan region of Brazil. The waiting times were defined as: Total Waiting Time (interval between the date of the pap test result and the date of the first colposcopic examination); Partial A Waiting Time (interval between the date of the pap test result and the date of referral); Partial B Waiting Time (interval between the date of referral and the date of the first colposcopic examination). Means, medians, relative and absolute frequencies were calculated. The Kruskal-Wallis test and Pearson's chi-square test were used to determine statistical significance. A total of 1,544 women with mean of age of 34 years (SD=12.6 years) were analyzed. Most of them had access to colposcopic examination within 30 days (65.8%) or 60 days (92.8%) from referral. Mean Total Waiting Time, Partial A Waiting Time, and Partial B Waiting Time were 94.5 days (SD=96.8 days), 67.8 days (SD=95.3 days) and 29.2 days (SD=35.1 days), respectively. A large part of the women studied had access to colposcopic examination within 60 days after referral, but Total waiting time was long. Measures to reduce the waiting time for obtaining the first colposcopic examination can help to improve the quality of care in the context of cervical cancer control in the region, and ought to be addressed at the phase between the date of the pap test results and the date of referral to the teaching hospital.

Cytomorphology of cervicovaginal melanoma: ThinPrep versus conventional Papanicolaou tests

PubMed Central

Setia, Namrata; Goulart, Robert A; Leiman, Gladywn; Otis, Christopher N; Modem, Rukmini; Pantanowtiz, Liron

2010-01-01

Background: Primary cervicovaginal melanoma is a rare malignancy associated with a high risk of recurrence. Prior studies discussing the cytomorphology of cervicovaginal melanoma have been based primarily on review of conventional Papanicolaou (Pap) smears. The aim of this study was to evaluate cervicovaginal melanomas identified in liquid-based Pap tests, in comparison with features seen on conventional Pap smear preparation. Materials and Methods: Cases of cervicovaginal melanoma identified on Pap tests with concurrent or subsequent histopathologic confirmation were collected from the Baystate Medical Center cytopathology files and personal archives of the authors over a total period of 34 years. All cytopathology (n = 6) and the available histology slides (n = 5) were reviewed. Cases were analyzed regarding clinical, histopathologic and cytomorphological findings. Results: A total of six cases with invasive cervicovaginal melanoma diagnosed on Pap tests were identified. Most patients were postmenopausal with contact bleeding, correlating with surface ulceration (identified in biopsy/excision material in 5/5 cases). Most cases had deeply invasive tumors (5/5: modified Breslow's thickness > 5 mm and Chung's level of invasion IV/V). Pap tests included four ThinPrep and two conventional smears. Overall, ThinPrep Pap tests exhibited a higher ratio of tumor cells to background squamous cells. While all Pap tests were bloodstained, tumor diathesis was prominent only within conventional smears. Melanoma cells were present both as clusters and scattered single cells in each Pap test type. Both the preparations contained epithelioid tumor cells, whereas spindled tumor cells were seen in only two ThinPrep cases. Prominent nucleoli and binucleation of tumor cells were seen in both the preparations. Melanin pigment was identified in only ThinPrep (3/4) cases and nuclear pseudo-inclusions in one conventional Pap smear. Cell blocks were made in three ThinPrep cases and

Management of ASCUS findings in Papanicolaou smears. A retrospective study.

PubMed

Iavazzo, C; Boutas, I; Grigoriadis, C; Vrachnis, N; Salakos, N

2012-01-01

Atypical squamous cells of undetermined significance (ASCUS) are a cervical cytologic finding category suggestive but not definitive of squamous intraepithelial lesions. ASCUS remains an incompletely described entity and accounts for even 5%-10% of reported Papanicolaou (Pap) smears. The management of women with such cytologic findings remains controversial. The aim of this study was to evaluate the cytology laboratory findings with regards to ASCUS diagnosis, using cervical Pap smears, and colposcopic biopsies, as well as their management. This is a retrospective study of patients with ASCUS Pap smears taken during the period January 2010 - December 2010 in the Second Department of Obstetrics and Gynecology, Aretaieion Hospital. During the study period, 657 Pap smears were examined at the Aretaieion Hospital; moreover, seven patients, whose Pap smears were cytologically diagnosed with ASCUS, were referred from other clinics, providing a total of 42 cases with a descriptive diagnosis of ASCUS for review. Of the 42 cases, eight were not studied because they were either lost in follow-up or they did not have available data. The remaining 34/42 patients were evaluated by colposcopic examination and directed biopsies where necessary. The ratio of ASCUS to low-grade squamous intraepithelial lesion (LGSIL), high-grade squamous cell intraepithelial lesion (HGSIL) or squamous cell carcinoma (SCC) was 5/34, 1/34, and 0/34, respectively. In the 34 ASCUS cases evaluated by colposcopy, the age distribution varied from 22 to 54 years. Eight of 34 cases did not have a child, 7/34 were primigravida, 18/34 were secondi-gravida, and 1/34 had four children. Four out of 34 cases were postmenopausal, 3/34 referred no history of abnormal bleeding, 21/34 were smokers, 6/34 used oral contraceptives, 2/34 used intrauterine devices, 1/34 took replacement of hormones, 4/34 had prior abnormal Pap smears human papillomavirus (HPV), or 1/34 had previous cancer (breast cancer). Colposcopy was

Factor Structure of the "Escala de Autoeficacia para la Depresion en Adolescentes" (EADA)

ERIC Educational Resources Information Center

Diaz-Santos, Mirella; Cumba-Aviles, Eduardo; Bernal, Guillermo; Rivera-Medina, Carmen

2011-01-01

The current concept and measures of self-efficacy for depression in adolescents do not consider developmental and cultural aspects essential to understand and assess this construct in Latino youth. We examined the factor structure of the "Escala de Autoeficacia para la Depresion en Adolescentes" (EADA), a Spanish instrument designed to…

Clinicopathological importance of Papanicolaou smears for the diagnosis of premalignant and malignant lesions of the cervix

PubMed Central

Bukhari, Mulazim Hussain; Saba, Kanwal; Qamar, Samina; Majeed, Muhammad Muddasar; Niazi, Shahida; Naeem, Samina

2012-01-01

Background: Premalignant and malignant lesions are not uncommon in Pakistani women, especially in the older age-groups Aim: This study was conducted to determine the clinicopathological importance of conventional Papanicolaou (Pap) smears for the diagnosis of premalignant and malignant lesions of the cervix. Materials and Methods: Pap smears of 1000 women were examined from January 2007 to June 2009. Only cases with neoplastic cytology were included. Results: The overall frequency of normal, inadequate, neoplastic, and infective smears was 50%, 1.8%, 10.2%, and 38.3%, respectively. Most of the patients (67%) were in the postmenopausal age-group, with the mean age being 44.7±15.63 years. The commonest clinical signs/symptoms seen among the 102 patients with neoplastic gynecological lesions were vaginal discharge and abnormal bleeding (93/102;(91.2% and 62/102;60.7%). Of the 102 cases with neoplastic lesions 46 patients (45%) had low-grade squamous cell intraepithelial lesions (LSILs), 22 (21.5%) had high-grade squamous cell intraepithelial lesions (HSILs), 14 (13.7%) had squamous cell carcinoma, and 6 (5.8%) showed features of adenocarcinoma. Ten (9.8%) cases showed cytology of atypical squamous cells of undetermined significance (ASCUS) and four (3.9%) cases had atypical glandular cells of undetermined significance (AGUS). Conclusion: We conclude that cervical smear examination is well suited for diagnosing neoplastic disease. It is clear that cervical neoplastic lesions are becoming a problem in Pakistan. PMID:22438612

Violence Victimization, Social Support, and Papanicolaou Smear Outcomes: A Longitudinal Study from Adolescence to Young Adulthood.

PubMed

Hsieh, Hsing-Fang; Heinze, Justin E; Lang, Ian; Mistry, Ritesh; Buu, Anne; Zimmerman, Marc A

2017-12-01

African American youth are among those at greatest risk for experiencing violence victimization. Notably, the mortality rate of cervical cancer for African American women is also twice that of white women. To date, we know of no literature using longitudinal data to examine how violence victimization relates to Papanicolaou (Pap) smear results or cervical cancer in this population. Our study examines how violence victimization during adolescence (age 15 to 18) influences psychological distress, perceived social support, heavy substance abuse, and sexual risk behaviors during emerging adulthood (age 20 to 23), and subsequent Pap smear outcomes during young adulthood (age 29 to 32). This study is based on 12 waves of data collected in a longitudinal study of 360 African American women from mid-adolescence (ninth grade, mean age = 14.8 years) to young adulthood (mean age = 32.0 years). We used structural equation modeling analysis to examine the hypothesized model. Violence victimization during adolescence had a direct effect on decreased social support, increased psychological distress, and increased heavy cigarette use during emerging adulthood. Better social support was also associated with fewer sexual partners during emerging adulthood and lower odds of abnormal Pap smear results during young adulthood. The effect of violence victimization on abnormal Pap smear was mediated by social support. Our results show that violence victimization during adolescence has long-term negative effects through multiple pathways that persist into adulthood. Our findings also suggest that social support may help to compensate against other risk factors. Interventions designed to address the perceived support may help victims cope with their experience.

Preventive Care for Women in Prison: A Qualitative Community Health Assessment of the Papanicolaou Test and Follow-Up Treatment at a California State Women’s Prison

PubMed Central

Magee, Catherine G.; Hult, Jen R.; Turalba, Ruby; McMillan, Shelby

2005-01-01

Growing evidence indicates that women in prison are particularly vulnerable to many negative health outcomes, including cervical cancer. The Papanicolaou (Pap) test is an effective tool to screen for this disease. To determine what is and is not working with the Pap test and follow-up treatment, we performed qualitative interviews with women prisoners and key informants at a California state women’s prison. Our assessment revealed that the process of administering Pap tests at this institution was not meeting the health care needs of the women interviewed. Women reported having negative experiences during the test and with their health care providers. Additionally the prison’s culture and infrastructure create obstacles that hinder prisoners from receiving quality care and providers from delivering that care. In response, women prisoners use self-and community advocacy to meet their health care needs and cope with these challenges. PMID:16186450

Papanicolaou Society of Cytopathology new guidelines have a greater ability of risk stratification for pancreatic endoscopic ultrasound-guided fine-needle aspiration specimens

PubMed Central

Chen, Bo; Zhao, Yu; Gu, Jiangang; Wu, Huanwen; Liang, Zhiyong; Meng, Zhilan

2017-01-01

The Papanicolaou Society of Cytopathology has recently proposed a standardized terminology and nomenclature guidelines for pancreatic cytology. However the risk of malignancy associated with the new guidelines has been scarcely studied. In this study, a series of pancreatic cytology cases obtained by endoscopic ultrasound-guided fine-needle aspiration from 294 Chinese patients were retrospectively re-categorized into six categories according the new guidelines. The risks of malignancy were 18.1% for “negative,” 20.0% for “neoplastic,” 57.1% for “nondiagnostic,” 69.2% for “atypical,” 87.5% for “suspicious,” and 100.0% for “positive” respectively. The area under the receiver operating characteristic curve was 0.93 (95% Confidence Interval, 0.90-0.96), which was significantly higher than that associated with old classification system (0.82; 95% Confidence Interval, 0.77-0.87) conventionally used in China. Our investigation demonstrated that the new guidelines have a greater ability of risk stratification than the old classification system conventionally used in China. This may be helpful in giving better predictions of malignancy, thus leading to more personalized treatment strategies. PMID:28042957

Incidence of High Grade Squamous Intraepithelial Lesions in Patients with Atypical Squamous Cells of Undetermined Significance Papanicolaou Smears at Naresuan University Hospital.

PubMed

Heng, Suttichai; Sirichaisutdhikorn, Daranee

2016-01-01

To determine the incidence of high-grade cervical intraepithelial neoplasia (CIN2-3) among patients with atypical squamous cells of undetermined significance (ASC-US) Papanicolaou (Pap) smears. One-hundred and eighty-seven patients with ASC-US Pap smears who underwent colposcopy with histological study were enrolled between September 2007 and August 2015. Patient factors (including age, parity, current pills used, HIV status, age at first sexual intercourse and number of sexual partners) were obtained. Logistic regression analysis was used to evaluate clinical factors associated with CIN2-3. CIN was diagnosed in 92 of 187 women (49.2%). Sixty-one of these (32.6%) had CIN1 and 31 (16.6%) had CIN2-3. There was no woman who had invasive cancer. There was no correlation of high-grade CIN with factors in this study including age, parity, current pills used, HIV status, age at first sexual intercourse and number of sexual partners. Data from this study showed no invasive cervical cancer was found in patients with ASC-US. There was no patient factor associated with high grade intraepithelial neoplasia in patients with ASC-US Pap smears.

Compliance with Papanicolaou smear screening following tubal ligation in women with cervical cancer.

PubMed

Winkler, H A; Anderson, P S; Fields, A L; Runowicz, C D; DeVictoria, C; Goldberg, G L

1999-01-01

To evaluate patient compliance with Papanicolaou (Pap) smear screening after tubal ligation compared with other methods of birth control in patients who develop cervical cancer, a retrospective review of 262 women with cervical cancer diagnosed at age < or = 70 years was undertaken at the Albert Einstein College of Medicine from January 1987 to December 1995. Demographic data, stage of the disease, histologic type, history of smoking, history of sexually transmitted disease (STD), and birth control use were recorded. The Pap screening history was obtained from all the patients. Women who had a bilateral tubal ligation (BTL) were compared with those who did not have this form of birth control. The date and result of their last Pap test prior to their diagnosis of cervical cancer was noted. Two hundred fourteen women with cervical cancer were evaluable. The clinical stage, mean age, history of smoking, and history of STD were similar for both groups. Gravidity among the BTL group was higher than in the non-BTL group (p < 0.01). Forty-eight (22.4%) women had a previous BTL. Twenty-seven of these 48 patients (56.3%) did not have a Pap smear within 3 years prior to the diagnosis of cervical cancer. Of the 166 patients, 61 (36.7%) did not have a Pap test within 3 years (p < 0.05). Fourteen women (29.2%) in the tubal ligation group never returned for a Pap test following the BTL. An average of 6.2+/-5.9 years elapsed since the last Pap test in the BTL group, with 4.0+/-5.1 years in the nontubal ligation group (p < 0.05). There was a correlation between the number of years since BTL (14.2+/-7.7) to the number of years since the last Pap test (6.2+/-5.9) (p < 0.05). Women who have had a BTL should be considered high risk because of poor screening compliance. A Pap test every 3 years is not adequate in this high-risk population group. We advocate improved counseling regarding the importance of continued annual Pap screening for women who are considering tubal ligation.

Characteristic findings of cervical Papanicolaou tests from transgender patients on androgen therapy: Challenges in detecting dysplasia.

PubMed

Adkins, B D; Barlow, A B; Jack, A; Schultenover, S J; Desouki, M M; Coogan, A C; Weiss, V L

2018-02-28

The characteristic features of Papanicolaou (Pap) tests collected from female-to-male (FTM) transgender patients on androgen therapy have not been well defined in the literature. FTM transgender patients require cervical cancer screening with the same recommended frequency as cis-gender females. Dysplasia remains challenging to differentiate from atrophy. Without pertinent history, the atrophic findings in younger transgender patients can be misinterpreted as high-grade dysplasia. A review of all cervical Pap tests of transgender patients receiving androgen therapy (2010-2017) was performed. Bethesda diagnosis, cytomorphological features, HPV testing and cervical biopsy results were reviewed. Eleven transgender patients receiving androgen therapy were identified with 23 cervical Pap tests, 11 HPV tests and five cervical biopsies performed. A review of the Pap tests demonstrated: 57% negative for intraepithelial lesion; 13% unsatisfactory; 13% atypical squamous cells of undetermined significance; 13% atypical squamous cells - cannot exclude high-grade squamous intraepithelial lesion; and 4% high-grade squamous intraepithelial lesion. The rates of abnormal tests were higher than our age-matched cis-gender atrophic cohort rates of unsatisfactory (0.5%), atypical squamous cells of undetermined significance (7%), atypical squamous cells-cannot exclude high-grade squamous intraepithelial lesion (0%) and high-grade squamous intraepithelial lesion (0.5%). The cytological findings from liquid-based preparations included dispersed and clustered parabasal-type cells, scattered degenerated cells, smooth evenly dispersed chromatin, and occasional mild nuclear enlargement and irregularity. Dysplastic cells had larger nuclei, hyperchromatic clumped chromatin, and more irregular nuclear contours. The evaluation of dysplasia can be challenging on Pap tests from transgender patients on androgen therapy. The cohort evaluated had higher rates of unsatisfactory and abnormal Pap tests

Comparison of conventional Papanicolaou cytology samples with liquid-based cervical cytology samples from women in Pernambuco, Brazil

PubMed Central

Costa, M.O.L.P.; Heráclio, S.A.; Coelho, A.V.C.; Acioly, V.L.; Souza, P.R.E.; Correia, M.T.S.

2015-01-01

In the present study, we compared the performance of a ThinPrep cytological method with the conventional Papanicolaou test for diagnosis of cytopathological changes, with regard to unsatisfactory results achieved at the Central Public Health Laboratory of the State of Pernambuco. A population-based, cross-sectional study was performed with women aged 18 to 65 years, who spontaneously sought gynecological services in Public Health Units in the State of Pernambuco, Northeast Brazil, between April and November 2011. All patients in the study were given a standardized questionnaire on sociodemographics, sexual characteristics, reproductive practices, and habits. A total of 525 patients were assessed by the two methods (11.05% were under the age of 25 years, 30.86% were single, 4.4% had had more than 5 sexual partners, 44% were not using contraception, 38.85% were users of alcohol, 24.38% were smokers, 3.24% had consumed drugs previously, 42.01% had gynecological complaints, and 12.19% had an early history of sexually transmitted diseases). The two methods showed poor correlation (k=0.19; 95%CI=0.11–0.26; P<0.001). The ThinPrep method reduced the rate of unsatisfactory results from 4.38% to 1.71% (χ2=5.28; P=0.02), and the number of cytopathological changes diagnosed increased from 2.47% to 3.04%. This study confirmed that adopting the ThinPrep method for diagnosis of cervical cytological samples was an improvement over the conventional method. Furthermore, this method may reduce possible losses from cytological resampling and reduce obstacles to patient follow-up, improving the quality of the public health system in the State of Pernambuco, Northeast Brazil. PMID:26247400

De novo establishment and cost-effectiveness of Papanicolaou cytology screening services in the Socialist Republic of Vietnam.

PubMed

Suba, E J; Nguyen, C H; Nguyen, B D; Raab, S S

2001-03-01

Cervical carcinoma is the leading cause of cancer-related death among women in the developing world. The absence of cervical screening in Vietnam and other developing countries is due in large part to the perceived expense of implementing Papanicolaou cytology screening services, although, to the authors' knowledge, the cost-effectiveness of establishing such services has never been studied in a developing country. Using decision analytic methods, the authors assessed cost-effectiveness of Pap screening from a societal perspective in Vietnam, the world's 9th most populous developing country (estimated 1999 population, 79 million). Outcomes measured included life expectancy, cervical carcinoma incidence, cost per woman, and cost-effectiveness. Total costs to establish a nationwide 5-year interval Pap screening program in Vietnam will average less than $148,400 annually during the 10-year time period assumed necessary to develop the program and may be considerably lower if only high risk geographic areas are targeted. Maintenance costs will average less than $0.092 annually per woman in the target screening population. Assuming 70% program participation, cervical carcinoma incidence will decrease from 26 in 100,000 to 14.8 in 100,000, and cost-effectiveness will be $725 per discounted life-year. Several assumptions used in this analysis constitute biases against the effectiveness of Pap screening, which in reality may be significantly more cost-effective than reported here. Contrary to widespread belief, Pap screening in developing countries such as Vietnam is extraordinarily inexpensive and appears to be cost-effective. Because prospects are uncertain regarding useful alternatives to the Pap test, the evidence-based argument for establishing conventional Pap screening services in developing countries such as Vietnam is compelling. Population-based conventional Pap screening services have been established de novo in Vietnam and are now operational. Copyright 2001

Acceptability of reminder letters for Papanicolaou tests: a survey of women from 23 Family Health Networks in Ontario.

PubMed

Karwalajtys, Tina; Kaczorowski, Janusz; Lohfeld, Lynne; Laryea, Stephanie; Anderson, Kelly; Roder, Stefanie; Sebaldt, Rolf J

2007-10-01

To explore women's perspectives on the acceptability and content of reminder letters from the family physician for Papanicolaou (Pap) test screening and the effect of reminder letters on compliance with screening recommendations. A population-based survey was conducted in 23 Family Health Networks and Primary Care Networks participating in a demonstration project to increase the delivery of preventive services in Ontario. Questionnaires were mailed to randomly selected women aged 35 to 69 years who had received a reminder letter for a Pap test from their family physician within the previous six months. Two focus groups were conducted with a volunteer sample of respondents. The usable response rate was 54.3% (406/748). Two-thirds (65.8%, 267/406) of women who completed the survey recalled receiving the reminder letter. Overall, 52.3% (212/405) reported having a Pap test in the past six months. Among women who recalled the reminder letter and scheduled or had a Pap test, 71.4% (125/175) reported that the letter influenced their decision to be screened. The majority of respondents (80.8%, 328/406) wanted to continue to receive reminder letters for Pap tests from their physician, and 34.5% (140/406) wanted to receive additional information about cervical screening. Focus group interviews indicated that women who have had a Pap test may still be unsure about screening recommendations, what the test detects, and the rationale for follow-up procedures. Reminder letters in family practice were viewed as useful and influenced women's decisions to undergo Pap test screening. Women who have had a Pap test may still need additional information about the test.

Decreasing cervical cancer mortality in Mexico: effect of Papanicolaou coverage, birthrate, and the importance of diagnostic validity of cytology.

PubMed

Lazcano-Ponce, Eduardo; Palacio-Mejia, Lina Sofía; Allen-Leigh, Betania; Yunes-Diaz, Elsa; Alonso, Patricia; Schiavon, Raffaela; Hernandez-Avila, Mauricio

2008-10-01

The reduction in cervical cancer mortality in developed countries has been attributed to well-organized, population-based prevention and control programs that incorporate screening with the Papanicolaou (Pap) smear. In Mexico, there has been a decrease in cervical cancer mortality, but it is unclear what factors have prompted this reduction. Using data from national indicators, we determined the correlation between cervical cancer mortality rates and Pap coverage, birthrate, and gross national product, using a linear regression model. We determined relative risk of dying of cervical cancer according to place of residence (rural/urban, region) using a Poisson model. We also estimated Pap smear coverage using national survey data and evaluated the validity and reproducibility of Pap smear diagnosis. An increase in Pap coverage (beta= -0.069) and a decrease in birthrate (beta=0.054) correlate with decreasing cervical cancer mortality in Mexico. Self-reported Pap smear rates in the last 12 months vary from 27.4% to 48.1%. Women who live in the central (relative risk, 1.04) and especially the southern (relative risk, 1.47) parts of Mexico have a greater relative risk of dying of cervical cancer than those who live in the north. There is a high incidence of false negatives in cervical cytology laboratories in Mexico; the percentage of false negatives varies from 3.33% to 53.13%. The decrease in cervical cancer mortality observed in Mexico is proportional to increasing Pap coverage and decreasing birthrate. Accreditation of cervical cytology laboratories is needed to improve diagnostic precision.

Impact of Patient Reminders on Papanicolaou Test Completion for High-Risk Patients Identified by a Clinical Decision Support System.

PubMed

MacLaughlin, Kathy L; Kessler, Maya E; Komandur Elayavilli, Ravikumar; Hickey, Branden C; Scheitel, Marianne R; Wagholikar, Kavishwar B; Liu, Hongfang; Kremers, Walter K; Chaudhry, Rajeev

2018-05-01

A clinical decision support system (CDSS) for cervical cancer screening identifies patients due for routine cervical cancer screening. Yet, high-risk patients who require more frequent screening or earlier follow-up to address past abnormal results are not identified. We aimed to assess the effect of a complex CDSS, incorporating national guidelines for high-risk patient screening and abnormal result management, its implementation to identify patients overdue for testing, and the outcome of sending a targeted recommendation for follow-up. At three primary care clinics affiliated with an academic medical center, a reminder recommending an appointment for Papanicolaou (Pap) testing or Pap and human papillomavirus cotesting was sent to high-risk women aged 18 through 65 years (intervention group) identified by CDSS as overdue for testing. Historical control patients, who did not receive a reminder, were identified by CDSS 1 year before the date when reminders were sent to the intervention group. Test completion rates were compared between the intervention and control groups through a generalized estimating equation extension. Across the three sites, the average completion rate of recommended follow-up testing was significantly higher in the intervention group at 23.7% (61/257) than the completion rate at 3.3% (17/516) in the control group (p < 0.001). A CDSS with enhanced capabilities to identify high-risk women due for cervical cancer testing beyond routine screening intervals, with subsequent patient notification, has the potential to decrease cervical precancer and cancer by improving adherence to guideline-compliant follow-up and needed treatment.

La mortalidad en adolescentes con cáncer: características clinicoepidemiológicas de muerte y aspectos éticos emergentes.

PubMed

Cicero-Oneto, Carlo Egysto; Mata-Valderrama, Guadalupe; Valdez-Martínez, Edith

Describir los aspectos epidemiológicos, clínicos y éticos de la mortalidad de los adolescentes con cáncer en -México. Se revisaron 63 expedientes clínicos de adolescentes (de 14 a 18 años de edad) con cáncer, fallecidos entre 2011 y 2014, para obtener información clínica y epidemiológica de su muerte. Los sitios de estudio fueron tres hospitales de concentración en la Ciudad de México. De los 40 adolescentes con criterios de fase terminal, 16 (40%) continuaron recibiendo tratamiento con fines curativos. De los 51 cuyo lugar de muerte era conocido, 45 (88%) murieron en hospital. De los 41 que murieron dentro de los 30 días de su última hospitalización, las muertes fueron principalmente debidas a complicaciones (51%), a progresión de la enfermedad (41%) o bien fueron muertes en tratamiento paliativo (7%, 3/41). La práctica oncológica descansa en lo que es conocido como modelo biomédico. Los resultados del estudio sugieren y apoyan la urgente necesidad de implementar verdaderos servicios de cuidados paliativos, pero más importante que eso, está el ímpetu de poner la ética de la práctica clínica en acción, y de ese modo reforzar la buena práctica de la medicina. Copyright: © 2018 SecretarÍa de Salud

A Case-Control Study of Oral Epithelial Proliferative Markers among Sudanese Toombak Dippers Using Micronuclei Assay, Argyrophilic Nucleolar Organizer Region, Papanicolaou and Crystal Violet Methods

PubMed Central

Anass, M. Abbas; G. Ahmed, Hussain

2013-01-01

The use of Toombak has been reported to play a major role in the etiology of oral cancer in Sudan. The cellular proliferative activity on the oral epithelium of 210 Toombak dippers was assessed by applying the micronuclei frequency, mean argyrophilic nucleolar organizer region (AgNOR) counts, Papanicolaou method, and 1% crystal violet stain. Participants were divided into 3 groups: 200 were apparently healthy individuals, 100 were Toombak users (cases), 100 were non-tobacco users (control) and 10 were patients with oral squamous cell carcinomas. Cytological atypia was identified among 4 (4%). Toombak users and was not found among the control group (P<0.04). The micronuclei frequencies were higher in Toombak users (1.026) than in the control group (0.356) (P<0.0001). The mean AgNOR counts in Toombak users (2.423) were higher than control group (1.303) (P<0.0001). Neither Toombak users nor control group showed mitotic figures in 1% crystal violet method. The results of this research showed that Toombak dipping is a high risk factor for increase in the cellular proliferation in the oral mucosa. The cytological proliferative marker methods used are useful for screening Toombak users. PMID:24179643

Papanicolaou smear findings in solid-organ transplant recipients compared with normal subjects according to the Bethesda 2001 system.

PubMed

Ok Atılgan, Alev; Tepeoğlu, Merih; Haberal, A Nihan; Durukan, Elif; Kuşcu, Esra; Haberal, Mehmet

2015-04-01

Solid-organ transplant recipients are at increased risk of developing cancer including cervical cancer compared with woman in the general population, mostly due to long-term immunosuppressive therapy. The Papanicolaou smear remains the primary method of screening cervical pathology including preinvasive and invasive lesions. The objective of this study was to evaluate Pap smear findings in solid-organ transplant recipients, determine the prevalence of abnormal smears, and compare these patients with the general population. We retrospectively examined 111 women patients who received liver or kidney transplant between January 1990 to December 2012 at Başkent University Ankara Hospital. Pap smear findings were compared with normal control patients matched for same age and technical procedure of cervical cytology. To selection of control patients, propensity score matching program was performed. All Pap smears were re-examined according to Bethesda 2001 criteria. In 111 transplant patients, 2 patients (1.8%) had atypical squamous cells of undetermined significance, 8 patients (7.2%) had low-grade squamous intraepithelial lesion, 15 patients (13.5%) had Candida infection, 2 patients (1.8%) had Trichomonas vaginalis, 1 patient (0.9%) had herpes simplex infection, 13 patients (11.7%) had bacterial vaginosis, 15 patients (13.5%) had reactive changes due to inflammation, and 18 patients (16.2%) had atrophy. When we compared our results with the control group, there were statistically significant differences (P ≤ .05) between the 2 groups in epithelial cell abnormalities (low-grade squamous intraepithelial lesion), Candida infection, bacterial vaginosis, and atrophy. Pap smear screening potentially may help recognize cervical preinvasive and invasive lesions. The risk of developing cervical intraepithelial neoplasia is greater in transplant recipients because of immunosuppressive therapy. The incidence of low-grade squamous intraepithelial lesion was significantly greater

Differential uptake of recent Papanicolaou testing by HPV vaccination status among young women in the United States, 2008-2013.

PubMed

Sauer, Ann Goding; Jemal, Ahmedin; Simard, Edgar P; Fedewa, Stacey A

2015-08-01

A positive association between recent Papanicolaou (Pap) test uptake and initiation of HPV vaccination among U.S. women has been reported. However, it is unknown whether recent Pap testing by HPV vaccination status varies by race/ethnicity. Discerning racial/ethnic variations is important given the higher prevalence of HPV types other than 16 and 18 in some racial/ethnic groups. We assessed whether uptake of recent Pap testing differed among women aged 21-30 years who had not initiated the HPV vaccination series versus those who had and whether this pattern differed by sociodemographic factors. 2008, 2010, and 2013 National Health Interview Survey data were used to generate weighted prevalence estimates and 95% confidence intervals (CIs) (n=7095). Adjusted predicted marginal models were used to generate adjusted prevalence ratios (aPRs) to assess the relationship between recent Pap test uptake and HPV vaccination series initiation by race/ethnicity. The uptake of recent Pap testing among those who had not initiated the HPV vaccination series was significantly lower (81.0%) compared to those who had initiated vaccination (90.5%) (aPR=0.93, 95% CI: 0.90-0.96). This finding was consistent across most sociodemographic factors, though not statistically significant for Blacks, Hispanics, those with lower levels of education, or those with higher levels of income. Young women who had not initiated HPV vaccination were less likely to have had a recent Pap test compared to women who had initiated vaccination. Concerted efforts are needed to increase uptake of recommended cervical cancer screening and HPV vaccination among young women. Copyright © 2015 Elsevier Ltd. All rights reserved.

Los “puntos débiles o sensibles” de los Ensayos Clínicos en niñas/os y adolescentes

PubMed Central

Melamed, Irene N.

2017-01-01

Resumen La revisión ética de un Ensayo Clínico1 que incluye a niñas/os y adolescentes en calidad de participantes, debe centrar su mirada en aspectos relacionados con la vulnerabilidad inherente a esa etapa de la vida, condición que se nutre de elementos biológicos, emocionales, de justicia y de equidad, entre otros. Sin embargo, la visión sugerida en este caso y sin desoír las características mencionadas, es la que busca profundizar en uno de los actores del proceso de investigación: el Ensayo Clínico. El objetivo es poder determinar la presencia o no de “zonas frágiles o de puntos débiles” en su interior, los que al ser individualizados y especialmente considerados, contribuyan a mejorar la calidad de la revisión ética de las investigaciones que son llevadas a cabo en niñas/os y adolescentes. PMID:28757905

Cytological diagnosis of basal cell carcinoma and actinic keratosis, using Papanicolaou and May-Grünwald-Giemsa stained cutaneous tissue smear.

PubMed

Christensen, E; Bofin, A; Gudmundsdóttir, I; Skogvoll, E

2008-10-01

Cytology may become the diagnostic method of choice with the advent of new non-invasive treatments for non-melanoma skin cancer, as the sampling technique for cytology entails little tissue disfiguration. The aim of this study was to compare and evaluate the diagnostic performance of scrape cytology using two different cytological staining techniques, and to evaluate additional touch imprint cytology, with that of histopathology of basal cell carcinoma (BCC) and actinic keratosis (AK). We investigated 50 BCC and 28 AK histologically verified lesions, from 41 and 25 patients, respectively. Two separate skin scrape samples and one touch imprint sample were taken from each lesion. The smears were stained with Papanicolaou (Pap) or May-Grünwald-Giemsa (MGG) stains. All cytological specimens were examined in random order by pathologists without knowledge of the histology. Cytodiagnostic results were compared with the histopathological report. Scrape cytodiagnosis agreed with histopathology in 48 (Pap) and 47 (MGG) of the 50 BCC cases, and in 26 of 28 (Pap) and 21 of 26 (MGG) AK cases, yielding sensitivities of 96%, 94%, 93% and 81%, respectively. No significant difference in sensitivity between the two staining methods was found but a trend towards higher Pap sensitivity for AK was noted (P = 0.10). Touch imprint cytology confirmed histopathology in 38 of the 77 cases of BCC and AK. Cytological diagnosis with either Pap or MGG stain for BCC and AK is reliable, and differentiates well between BCC and AK. Imprint cytology proved to be non-diagnostic in half of the examined cases.

The Cellient automated cell block system is useful in the differential diagnosis of atypical glandular cells in Papanicolaou tests.

PubMed

Xing, Wei; Hou, April Y; Fischer, Andrew; Owens, Christopher L; Jiang, Zhong

2014-01-01

Atypical glandular cells (AGC) is a very important diagnosis in gynecological cytology. In the current study, the authors investigated the usefulness of Cellient cell blocks (CB) for characterizing AGC on Papanicolaou (Pap) tests. A total of 148 patients with an AGC diagnosis based on Pap tests by cytotechnologists and referred to cytopathologists were studied. Among these patients, there were 68 patients with CB preparations and 80 patients with Pap tests only (TP-AGC group). Follow-up results by Pap tests or biopsies were obtained in 117 of 148 patients. The median follow-up was 13 months (range, 1 month-36 months). Of the 68 patients with CBs, 31 (46%) were reclassified as negative for dysplasia or low-grade intraepithelial lesion; 30 patients (44%) retained a diagnosis of AGC (CB-AGC group); and 7 patients (10%) were given specific diagnoses of high-grade intraepithelial lesion (3 patients), endocervical adenocarcinoma in situ (1 patient), and invasive adenocarcinoma (3 patients). On follow-up, the CB-AGC group was found to have a significantly lower rate of negative/low-grade squamous intraepithelial lesion diagnoses compared with the TP-AGC group (55% vs 85%; P= .006). The CB-AGC group had a significantly higher rate of endocervical or endometrial adenocarcinoma compared with the TP-AGC group (36% vs 8%; P= .003) at the time of follow-up. The rates of high-grade squamous intraepithelial lesion were not found to be statistically different between these 2 groups (9% vs 7%; P= .66). The Cellient CB is a useful technique to further categorize a diagnosis of AGC on Pap tests. Using the Cellient CB system, the pathologist has the ability to improve the diagnostic accuracy of AGC so that unnecessary colposcopic evaluation or biopsies can be avoided. © 2013 American Cancer Society.

Etude du pronostic maternel et périnatal au cours de l’accouchement chez l’adolescente à Lubumbashi, République Démocratique du Congo

PubMed Central

Luhete, Prosper Kakudji; Mukuku, Olivier; Tambwe, Albert Mwembo; Kayamba, Prosper Kalenga Muenze

2017-01-01

Introduction L’objectif de cette étude était de déterminer la fréquence et d’évaluer le pronostic maternel et périnatal lors de l’accouchement chez les adolescentes dans la ville de Lubumbashi. Méthodes C’était une étude cas-témoin des accouchées d’une grossesse monofoetale de Décembre 2013 à Mai 2014 dans 10 maternités de référence à Lubumbashi (RD Congo). Les adolescentes (< 20 ans) ont été comparées aux femmes âgées de 20-34 ans. Les paramètres sociodémographiques maternels, la morbi-mortalité maternelle et périnatale ont été analysées. Les statistiques usuelles et la régression logistique ont été utilisées pour analyser les résultats. Le seuil de signification a été fixé à une valeur de p<0,05. Résultats La fréquence d’accouchement chez les adolescentes était de 7,7%. Nous avons observé que la césarienne (ORa=1,9 (1,1-3,1)), l’épisiotomie (ORa=4,2 (2,9-5,9)), la délivrance pathologique (ORa= 2,7 (1,1-6,5)), l’éclampsie (ORa= 4,4 (1,3-14,5)) et le faible poids de naissance (ORa=2,0 (1,3-3,0)) ont été significativement plus élevés chez les adolescentes que chez les adultes. Conclusion L’accouchement chez les adolescentes, comparativement à celui de femmes âgées de 20-34 ans, reste associé à un mauvais pronostic. D’où l’organisation des séances de sensibilisation pour une meilleure fréquentation des services consultations prénatales, une optimisation du dépistage, de la surveillance et de la prévention des pathologies de la grossesse chez les adolescentes s’avère importante et urgente. Introduction This study aimed to determine the frequency and to assess maternal and perinatal prognosis for vaginal delivery in adolescent girls in the city of Lubumbashi. Methods We conducted a case-control study of vaginal deliveries in singleton pregnancy in 10 referral hospitals in Lubumbashi (DR Congo) from December 2013 to May 2014. Adolescent girls (< 20 years) were compared to older women

[Validity and reproducibility of Escala de Evaluación da Insatisfación Corporal para Adolescentes].

PubMed

Conti, Maria Aparecida; Slater, Betzabeth; Latorre, Maria do Rosário Dias de Oliveira

2009-06-01

To validate a body dissatisfaction scale for adolescents. The study included 386 female and male adolescents aged 10 to 17 years enrolled in a private elementary and middle school in the city of São Bernardo do Campo, southeastern Brazil, in 2006. 'Escala de Evaluación da Insatisfación Corporal para Adolescentes' (body dissatisfaction scale for adolescents) was translated and culturally adapted. The Portuguese instrument was evaluated for internal consistency using Cronbach's alpha, factor analysis with Varimax rotation, discriminant validity by comparing score means according to nutritional status (low weight, normal weight, and at risk of overweight and obesity) using the Kruskal-Wallis test. Concurrent validity was assessed using Spearman's rank correlation coefficient between scores and body mass index, waist-hip ratio and waist circumference. Reproducibility was evaluated using Wilcoxon test, and intraclass correlation coefficient. The translated and back-translated scale showed good agreement with the original one. The translated scale had good internal consistency in all subgroups studied (males and females in early and intermediate adolescence) and was able to discriminate adolescents according to their nutritional status. In the concurrent analysis, all three measures were correlated, except for males in early adolescence. Its reproducibility was ascertained. The 'Escala de Evaluación da Insatisfación Corporal para Adolescentes' was successfully translated into Portuguese and adapted to the Brazilian background and showed good results. It is recommended for the evaluation of the attitudinal component of body image in adolescents.

EM Diffusion for a Time-Domain Airborne EM System

NASA Astrophysics Data System (ADS)

Yin, C.; Qiu, C.; Liu, Y.; Cai, J.

2014-12-01

Visualization of EM diffusion for an airborne EM (AEM) system is important for understanding the transient procedure of EM diffusion. The current distribution and diffusion features also provide effective means to evaluate EM footprint, depth of exploration and further help AEM system design and data interpretation. Most previous studies on EM diffusion (or "smoke ring" effect) are based on the static presentation of EM field, where the dynamic features of EM diffusion were not visible. For visualizing the dynamic feature of EM diffusion, we first calculate in this paper the frequency-domain EM field by downward continuation of the EM field at the EM receiver to the deep earth. After that, we transform the results to time-domain via a Fourier transform. We take a homogeneous half-space and a two-layered earth induced by a step pulse to calculate the EM fields and display the EM diffusion in the earth as 3D animated vectors or time-varying contours. The "smoke ring" effect of EM diffusion, dominated by the resistivity distribution of the earth, is clearly observed. The numerical results for an HCP (vertical magnetic dipole) and a VCX (horizontal magnetic dipole) transmitting coil above a homogeneous half-space of 100 ohm-m are shown in Fig.1. We display as example only the distribution of EM field inside the earth for the diffusion time of 0.05ms. The detailed EM diffusion will be shown in our future presentation. From the numerical experiments for different models, we find that 1) the current for either an HCP or a VCX transmitting dipole propagates downward and outward with time, becoming wider and more diffuse, forming a "smoke ring"; 2) for a VCX transmitter, the underground current forms two ellipses, corresponding to the two polarities of the magnetic flux of a horizontal magnetic dipole, injecting into or ejected from the earth; 3) for a HCP transmitter, however, the underground current forms only one circle, corresponding to the polarity of the magnetic flux

Community-randomised controlled trial embedded in the Anishinaabek Cervical Cancer Screening Study: human papillomavirus self-sampling versus Papanicolaou cytology

PubMed Central

Zehbe, Ingeborg; Jackson, Robert; Wood, Brianne; Weaver, Bruce; Escott, Nicholas; Severini, Alberto; Krajden, Mel; Bishop, Lisa; Morrisseau, Kyla; Ogilvie, Gina; Burchell, Ann N; Little, Julian

2016-01-01

Objectives The incidence of cervical cancer is up to 20-fold higher among First Nations women in Canada than the general population, probably due to lower participation in screening. Offering human papillomavirus (HPV) self-sampling in place of Papanicolaou (Pap) testing may eventually increase screening participation and reduce cervical cancer rates in this population. Design A community-randomised controlled screening trial. Setting First Nations communities in Northwest Ontario, Canada. Participants Women aged between 25 and 69, living in Robinson Superior Treaty First Nations. The community was the unit of randomisation. Interventions Women were asked to complete a questionnaire and have screening by HPV self-sampling (arm A) or Pap testing (arm B). Primary outcome measures The number of women who participated in cervical screening. Randomisation Community clusters were randomised to include approximately equivalent numbers of women in each arm. Results 6 communities were randomised to arm A and 5 to arm B. One community withdrew, leaving 5 communities in each group (834 eligible women). Participation was <25%. Using clustered intention-to-treat (ITT) analysis, initial and cumulative averaged uptakes in arm A were 1.4-fold (20% vs 14.3%, p=0.628) and 1.3-fold (20.6% vs 16%, p=0.694) higher compared to arm B, respectively. Corresponding per protocol (PP) analysis indicates 2.2-fold (22.9% vs 10.6%, p=0.305) and 1.6-fold (22.9% vs 14.1%, p=0.448) higher uptakes in arm A compared to arm B. Screening uptake varied between communities (range 0–62.1%). Among women who completed a questionnaire (18.3% in arm A, 21.7% in arm B), the screening uptake was 1.8-fold (ITT; p=0.1132) or 3-fold (PP; p<0.01) higher in arm A versus arm B. Conclusions Pap and HPV self-sampling were compared in a marginalised, Canadian population. Results indicated a preference for self-sampling. More research on how to reach underscreened Indigenous women is necessary. Trial registration

Significance of a diagnosis of atypical squamous cells of undetermined significance for Papanicolaou smears in perimenopausal and postmenopausal women.

PubMed

Keating, J T; Wang, H H

2001-04-25

The current study was conducted to determine the significance of a diagnosis of atypical squamous cells of undetermined significance (ASCUS) in perimenopausal and postmenopausal women. The reports for all Papanicolaou (Pap) smears viewed in the study institution's cytology laboratory over a 6-month period were reviewed. Women were divided into premenopausal (age < or = 45 years), perimenopausal (ages 46-54 years), and postmenopausal (age > or = 55 years) categories. Slide review and 2-year follow-up were obtained for selected cases diagnosed as ASCUS. ASCUS cases among the perimenopausal women were compared with an age-matched control group. The total number of abnormal Pap smears in the premenopausal, perimenopausal, and postmenopausal categories were 770 (6.8%), 104 (4.3%), and 67 (2.9%), with 482, 83, and 41 diagnoses of ASCUS, respectively. The ratio of ASCUS to squamous intraepithelial lesions (SIL) was 2.2 overall and 1.9, 7.5, and 4.1, respectively, for each group (P < 0.001). The positive predictive value for a diagnosis of SIL on subsequent Pap smears or biopsies was 22%, 12.2%, and 29.7%, respectively. Slide review showed that the premenopausal ASCUS cases appeared to have a higher percentage of nuclear-cytoplasmic ratio increase and nuclear membrane irregularities compared with the other categories (P = 0.03 and P = 0.02, respectively) and the perimenopausal group was found to have more ASCUS in metaplastic cells (P = 0.03). In perimenopausal women, slides diagnosed as ASCUS demonstrated more air-drying artifact than the control group (P = 0.004) but had less obvious atrophy (P = 0.01). Despite a decreased abnormality rate with increasing age, the results of the current study show that the perimenopausal and postmenopausal groups appear to have elevated ASCUS-to-SIL ratios. ASCUS appears to have a particularly low positive predictive value for SIL in perimenopausal women, and therefore most likely is overcalled in this age group. This may be attributable

Age-specific performance of careHPV versus Papanicolaou and visual inspection of cervix with acetic acid testing in a primary cervical cancer screening.

PubMed

Labani, Satyanarayana; Asthana, Smita

2016-01-01

Human papillomavirus (HPV) is recommended as a primary screening tool for cervical screening. Assessment of age-specific performance of newer HPV careHPV DNA testing is important as risk of cervical intraepithelial neoplasia (CIN) varies at different ages. We aim to evaluate careHPV in comparison to Papanicolaou (Pap) test and visual inspection of the cervix with acetic acid (VIA) cervical screening tests for the detection of high-grade CIN. The cross sectional study was conducted in a rural population of North India. Ever-married women 30-59 years of age were invited for screening by careHPV (self-collected vaginal and physician-collected cervical samples), Pap test and VIA. Associations for trend in age for detecting histological-confirmed CINII+ and CINIII+ for each screening test were evaluated. Age-specific association with each screening test was evaluated. Of a total of 7761 women invited, 5032 were screened and analysis was performed on 4658 with all screen test results. No significant (p>0.05) association of age for any screening test in the detection of CINII+ or CINIII+ was observed. For the older age group, cervical HPV (CHPV) showed high sensitivity and specificity for CINII+ detection. Specificity of CHPV or vaginal HPV (VHPV) was equal or higher than Pap in all age groups. Cervical screening options of CHPV or VHPV, or Pap, performed equally in the younger age group while CHPV might be an option for all ages in the detection of high-grade CIN. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Busca de estruturas em grandes escalas em altos redshifts

NASA Astrophysics Data System (ADS)

Boris, N. V.; Sodré, L., Jr.; Cypriano, E.

2003-08-01

A busca por estruturas em grandes escalas (aglomerados de galáxias, por exemplo) é um ativo tópico de pesquisas hoje em dia, pois a detecção de um único aglomerado em altos redshifts pode por vínculos fortes sobre os modelos cosmológicos. Neste projeto estamos fazendo uma busca de estruturas distantes em campos contendo pares de quasares próximos entre si em z Â3 0.9. Os pares de quasares foram extraídos do catálogo de Véron-Cetty & Véron (2001) e estão sendo observados com os telescópios: 2,2m da University of Hawaii (UH), 2,5m do Observatório de Las Campanas e com o GEMINI. Apresentamos aqui a análise preliminar de um par de quasares observado nos filtros i'(7800 Å) e z'(9500 Å) com o GEMINI. A cor (i'-z') mostrou-se útil para detectar objetos "early-type" em redshifts menores que 1.1. No estudo do par 131046+0006/J131055+0008, com redshift ~ 0.9, o uso deste método possibilitou a detecção de sete objetos candidatos a galáxias "early-type". Num mapa da distribuição projetada dos objetos para 22 < i' < 25 observou-se que estas galáxias estão localizadas próximas a um dos quasares e há indícios de que estejam aglomeradas dentro de um área de ~ 6 arcmin2. Se esse for o caso, estes objetos seriam membros de uma estrutura em grande escala. Um outro argumento em favor dessa hipótese é que eles obedecem uma relação do tipo Kormendy (raio equivalente X brilho superficial dentro desse raio), como a apresentada pelas galáxias elípticas em z = 0.

RETOS EN LA INTERVENCIÓN CON ADOLESCENTES PUERTORRIQUEÑOS/AS QUE MANIFIESTAN COMPORTAMIENTO SUICIDA*

PubMed Central

Vélez, Yovanska Duarté; Dávila, Paloma Torres; Hernández, Samariz Laboy

2015-01-01

Presentamos un estudio de caso de una adolescente puertorriqueña con comportamiento suicida. Esta comenzó una Terapia Socio Cognitivo-Conductual para el Comportamiento Suicida (TSCC-CS) de tipo ambulatorio luego de una hospitalización por intento suicida. La TSCC-CS incorpora una perspectiva ecológica y de desarrollo a la terapia cognitivo-conductual. Inicialmente mostró baja autoestima y severos síntomas depresivos y de ansiedad. Al finalizar el tratamiento, manifestó un cambio significativo en su sintomatología clínica y evidenció una mejoría en sus destrezas de manejo. No presentó ideas suicidas durante meses previos, ni durante el seguimiento. El análisis de este caso permitió realizar cambios en el protocolo de tratamiento, particularmente en las sesiones de familia y de comunicación con el fin de aumentar la viabilidad del tratamiento. PMID:26702337

Human papillomavirus DNA testing as an adjunct to cytology in cervical screening programs.

PubMed

Lörincz, Attila T; Richart, Ralph M

2003-08-01

Our objective was to review current large studies of human papillomavirus (HPV) DNA testing as an adjunct to the Papanicolaou test for cervical cancer screening programs. We analyzed 10 large screening studies that used the Hybrid Capture 2 test and 3 studies that used the polymerase chain reaction test in a manner that enabled reliable estimates of accuracy for detecting or predicting high-grade cervical intraepithelial neoplasia (CIN). Most studies allowed comparison of HPV DNA and Papanicolaou testing and estimates of the performance of Papanicolaou and HPV DNA as combined tests. The studies were selected on the basis of a sufficient number of cases of high-grade CIN and cancer to provide meaningful statistical values. Investigators had to demonstrate the ability to generate reasonably reliable Hybrid Capture 2 or polymerase chain reaction data that were either minimally biased by nature of study design or that permitted analytical techniques for addressing issues of study bias to be applied. Studies had to provide data for the calculation of test sensitivity, specificity, predictive values, odds ratios, relative risks, confidence intervals, and other relevant measures. Final data were abstracted directly from published articles or estimated from descriptive statistics presented in the articles. In some studies, new analyses were performed from raw data supplied by the principal investigators. We concluded that HPV DNA testing was a more sensitive indicator for prevalent high-grade CIN than either conventional or liquid cytology. A combination of HPV DNA and Papanicolaou testing had almost 100% sensitivity and negative predictive value. The specificity of the combined tests was slightly lower than the specificity of the Papanicolaou test alone, but this decrease could potentially be offset by greater protection from neoplastic progression and cost savings available from extended screening intervals. One "double-negative" HPV DNA and Papanicolaou test indicated

Fertility rates and perinatal outcomes of adolescent pregnancies: a retrospective population-based study.

PubMed

Souza, Maria de Lourdes de; Lynn, Fiona Ann; Johnston, Linda; Tavares, Eduardo Cardoso Teixeira; Brüggemann, Odaléa Maria; Botelho, Lúcio José

2017-04-06

analyze trends in fertility rates and associations with perinatal outcomes for adolescents in Santa Catarina, Brazil. a population-based study covering 2006 to 2013 was carried out to evaluate associations between perinatal outcomes and age groups, using odds ratios, and Chi-squared tests. differences in the fertility rate among female adolescents across regions and time period were observed, ranging from 40.9 to 72.0 per 1,000 in mothers aged 15-19 years. Adolescents had fewer prenatal care appointments than mothers ≥20 years, and a higher proportion had no partner. Mothers aged 15-19 years were more likely to experience preterm birth (OR:1.1; CI:1.08-1.13; p<0.001), have an infant with low birthweight (OR:1.1; CI:1.10-1.15; p<0.001) and low Apgar score at 5 minutes (OR:1.4; CI:1.34-1.45; p<0.001) than mothers ≥20 years, with the odds for adverse outcomes greater for those aged 10-14 years. this study provides evidence of fertility rates among adolescents remaining higher in regions of social and economic deprivation. Adolescent mothers and their infants more likely to experience adverse perinatal outcomes. Nurses, public health practitioners, health and social care professionals and educators need to work collaboratively to better target strategies for adolescents at greater risk; to help reduce fertility rates and improve outcomes. analizar as tendências das taxas de fertilidade e associações com desfechos perinatais entre adolescentes em Santa Catarina, Brasil. estudo populacional conduzido de 2016 à 2013. Associações entre desfechos perinatais e grupos por faixa etária foram investigadas usando odds Ratio e teste Chi-quadrado. as diferenças encontradas nas taxas de fertilidade entre mães adolescentes nas regiões e período observado variaram de 40,9-72,0 por 1.000 entre mães de 15 a 19 anos de idade. As adolescentes atenderam menos consultas pré-natais, quando comparadas às mães com 20 anos ou mais, e a maioria não tinha parceiro. M�

Correlation of the NBME advanced clinical examination in EM and the national EM M4 exams.

PubMed

Hiller, Katherine; Miller, Emily S; Lawson, Luan; Wald, David; Beeson, Michael; Heitz, Corey; Morrissey, Thomas; House, Joseph; Poznanski, Stacey

2015-01-01

Since 2011 two online, validated exams for fourth-year emergency medicine (EM) students have been available (National EM M4 Exams). In 2013 the National Board of Medical Examiners offered the Advanced Clinical Examination in Emergency Medicine (EM-ACE). All of these exams are now in widespread use; however, there are no data on how they correlate. This study evaluated the correlation between the EM-ACE exam and the National EM M4 Exams. From May 2013 to April 2014 the EM-ACE and one version of the EM M4 exam were administered sequentially to fourth-year EM students at five U.S. medical schools. Data collected included institution, gross and scaled scores and version of the EM M4 exam. We performed Pearson's correlation and random effects linear regression. 305 students took the EM-ACE and versions 1 (V1) or 2 (V2) of the EM M4 exams (281 and 24, respectively) [corrected].The mean percent correct for the exams were as follows: EM-ACE 74.9 (SD-9.82), V1 83.0 (SD-6.39), V2 78.5 (SD-7.70) [corrected]. Pearson's correlation coefficient for the V1/EM-ACE was 0.53 (0.43 scaled) and for the V2/EM-ACE was 0.58 (0.41 scaled) [corrected]. The coefficient of determination for V1/ EM-ACE was 0.73 and for V2/EM-ACE 0.71 (0.65 and .49 for scaled scores) [ERRATUM]. The R-squared values were 0.28 and 0.30 (0.18 and 0.13 scaled), respectively [corrected]. There was significant cluster effect by institution. There was moderate positive correlation of student scores on the EM-ACE exam and the National EM M4 Exams.

EMS provider determinations of necessity for transport and reimbursement for EMS response, medical care, and transport: combined resource document for the National Association of EMS Physicians position statements.

PubMed

Millin, Michael G; Brown, Lawrence H; Schwartz, Brian

2011-01-01

With increasing demands for emergency medical services (EMS), many EMS jurisdictions are utilizing EMS provider-initiated nontransport policies as a method to offload potentially nonemergent patients from the EMS system. EMS provider determination of medical necessity, resulting in nontransport of patients, has the potential to avert unnecessary emergency department visits. However, EMS systems that utilize these policies must have additional education for the providers, a quality improvement process, and active physician oversight. In addition, EMS provider determination of nontransport for a specific situation should be supported by evidence in the peer-reviewed literature that the practice is safe. Further, EMS systems that do not utilize these programs should not be financially penalized. Payment for EMS services should be based on the prudent layperson standard. EMS systems that do utilize nontransport policies should be appropriately reimbursed, as this represents potential cost savings to the health care system.

Hypertriglyceridemic Waist Phenotype and Changes in the Fasting Glycemia and Blood Pressure in Children and Adolescents Over One-Year Follow-Up Period.

PubMed

Costa, Priscila Ribas de Farias; Assis, Ana Marlúcia Oliveira; Cunha, Carla de Magalhães; Pereira, Emile Miranda; Jesus, Gabriela Dos Santos de; Silva, Lais Eloy Machado da; Alves, Wilanne Pinheiro de Oliveira

2017-07-01

The hypertriglyceridemic waist (HTW) phenotype is defined as the simultaneous presence of increased waist circumference (WC) and serum triglycerides (TG) levels and it has been associated with cardiometabolic risk in children and adolescents. The objective was to evaluate the influence of HTW phenotype in the fasting glycemia and blood pressure in children and adolescents over one-year follow-up period. It is a cohort study involving 492 children and adolescents from 7 to 15 years old, both genders, who were submitted to anthropometric, biochemical and clinical evaluation at the baseline, and also after 6 and 12 months of follow-up. Generalized Estimating Equation (GEE) models were calculated to evaluate the longitudinal influence of the HTW phenotype in the glycemia and blood pressure over one-year. It was observed a prevalence of 10.6% (n = 52) of HTW phenotype in the students. The GEE models identified that students with HTW phenotype had an increase of 3.87 mg/dl in the fasting glycemia mean (CI: 1.68-6.05) and of 3.67mmHg in the systolic blood pressure (SBP) mean (CI: 1.55-6.08) over one-year follow-up, after adjusting for confounding variables. The results of this study suggest that HTW phenotype is a risk factor for longitudinal changes in glycemia and SBP in children and adolescents over one-year follow-up period. O fenótipo de cintura hipertrigliceridêmica (CHT) é definido como a presença simultânea de circunferência de cintura (CC) e níveis séricos de triglicérides (TG) aumentados e tem sido associado com risco cardiometabólico em crianças e adolescentes. Avaliar a influência do fenótipo CHT na glicemia de jejum e na pressão arterial em crianças e adolescentes em um período de acompanhamento de um ano. Trata-se de um estudo de coorte envolvendo 492 crianças e adolescentes de 7 a 15 anos de ambos os sexos, que foram submetidos à avaliação antropométrica, bioquímica e clínica no início e também após 6 e 12 meses de seguimento. Os

Factor Structure of the Escala de Autoeficacia para la Depresión en Adolescentes (EADA)

PubMed Central

Díaz-Santos, Mirella; Cumba-Avilés, Eduardo; Bernal, Guillermo; Rivera-Medina, Carmen

2018-01-01

The current concept and measures of self-efficacy for depression in adolescents do not consider developmental and cultural aspects essential to understand and assess this construct in Latino youth. We examined the factor structure of the Escala de Autoeficacia para la Depresión en Adolescentes (EADA): a Spanish instrument designed to assess this construct as experienced by this population. Participants were 116 Puerto Rican adolescents aged 13 to 17 years who completed the EADA and two other self-report measures. An exploratory factor analysis yielded a two-factor solution (Personal Self-Efficacy for Depression and Interpersonal Self-Efficacy for Depression) accounting for 37.57% of the total variance. Results revealed that EADA factors have excellent internal consistency as well as concurrent and construct validity, supporting its adequacy to assess Latino adolescents’ self-efficacy for depression. The conceptual meaning of the factors was consistent with the distinction between aspects of this construct hypothesized to be important among Latino youth.

Autonomous Microstructure EM-APEX Floats

DTIC Science & Technology

2016-01-01

Autonomous Microstructure_EM-APEX_Float 4/8/16 at 3:21 PM 1 Title: Autonomous Microstructure EM-APEX Floats Authors: Ren-Chieh Lien1,2...Street Seattle, WA 98105 rcl@uw.edu Abstract: Fast responding FP-07 thermistors have been incorporated on profiling EM-APEX floats to measure...storage board. The raw and processed temperature observations are stored on a microSD card. Results from eight microstructure EM-APEX floats

Professionals and interfamily violence against children and adolescents: in between legal and conceptual precepts.

PubMed

Schek, Gabriele; Silva, Mara Regina Santos da; Lacharité, Carl; Bueno, Maria Emilia Nunes

2016-01-01

To identify the conceptions of professionals regarding interfamily violence against children and adolescents. A qualitative study conducted with 15 professionals who had taken children and adolescents under their care as a result of interfamily violence. Data were collected between November, 2013, and March, 2015, through semi-structured interviews. Data were organized and analyzed using the Textual Discourse Analysis technique. The professional discourse highlighted that some legal aspects regarding the handling of interfamily violence against children and adolescents are neglected; an omission supported by the justification of professionals to preserve the family. We highlight the confrontation between the concept of family as a caregiver and the family that commits violence against children, in addition to the positioning of professionals, which does not include the family or the aggressor in the intervention process in facing situations of interfamily violence attended to by the services. Acting against interfamily violence requires professionals to do away with some pre-established concepts in ordee to put the actual needs of victims and families into evidence. Identificar, com base no discurso dos profissionais, suas concepções a respeito da violência intrafamiliar contra crianças e adolescentes. Estudo qualitativo, realizado com 15 profissionais, que tiveram sob seus cuidados crianças e adolescentes atendidas em decorrência da violência intrafamiliar. Os dados foram coletados entre novembro de 2013 e março de 2015, por meio de entrevistas semiestruturadas. Os dados foram organizados e analisados utilizando a técnica de Análise Textual Discursiva. O discurso dos profissionais colocou em evidência que alguns aspectos legais em relação ao manejo da violência intrafamiliar contra crianças e adolescentes são negligenciados, omissão respaldada pela justificativa dos profissionais de preservar a família. Destaca-se o confronto entre a concep

Diagnostic performance of HPV E6/E7 mRNA assay for detection of cervical high-grade intraepithelial neoplasia and cancer among women with ASCUS Papanicolaou smears.

PubMed

Ren, Chenchen; Zhu, Yuanhang; Yang, Li; Zhang, Xiaoan; Liu, Ling; Ren, Chunying

2018-02-01

The aim of this study was to investigate the clinical performance of high risk (HR) HPV E6/E7 mRNA assay in detecting cervical high-grade intraepithelial neoplasia and cancer among women with atypical squamous cells of undetermined significance (ASCUS) Papanicolaou (Pap) smears. A total of 160 patients with ASCUS who underwent HR-HPV DNA assay, HR-HPV E6/E7 mRNA assay and colposcopy biopsy at Third Affiliated Hospital of Zhengzhou University, China, from December 2015 to March 2017, were enrolled. Logistic regression analysis was used to evaluate the relationship between pathological results with clinical biologic factors. Univariate analysis showed that the qualitative results of HR-HPV DNA, qualitative results of HR-HPV E6/E7 mRNA and expression levels of HR-HPV E6/E7 mRNA were risk factors of high-grade cervical intraepithelial neoplasia (CIN) and cervical cancer (all P < 0.05). Multivariable analysis found that only the expression levels of HR-HPV E6/E7 mRNA was associated with high-grade CIN and cervical cancer (OR = 8.971, 95% CI = 2.572-31.289, P = 0.001). An optimal cut-off value of ≥ 558.26 copies/ml was determined using receiver operating characteristic curve, and specificity of cut-off value were higher than E6/E7 mRNA qualitative assay and DNA qualitative assay. HPV E6/E7 mRNA quantitative assay may be a valuable tool in triage of ASCUS pap smears. A high specificity of E6/E7 mRNA quantitative assay as a triage test in women with ASCUS can be translated into a low referral for colposcopy.

Knowledge, attitude and practice of the smear test and its relation with female age.

PubMed

Silveira, Nara Sibério Pinho; Vasconcelos, Camila Teixeira Moreira; Nicolau, Ana Izabel Oliveira; Oriá, Mônica Oliveira Batista; Pinheiro, Patricia Neyva da Costa; Pinheiro, Ana Karina Bezerra

2016-06-14

to verify the association among the knowledge attitude and practice of women in relation to the smear test and the age range. a cross-sectional research was undertaken, associated with the knowledge, attitude and practice survey at a Primary Health Care service. The sample consisted of 775 women, distributed in three age ranges: adolescent, young and elderly. although high rates of inappropriate knowledge were found in all age ranges, it was significantly higher among the adolescents (p=0.000). A similar trend was found in the attitude component, with percentages of inappropriateness in adolescence that drop as age advances (p=0.000). Nevertheless, no statistical difference among the groups was found in terms of practice (p=0.852). the study demonstrated a relation between the age range and knowledge, attitude and practice of the smear test. verificar a associação entre o conhecimento, atitude e prática de mulheres em relação ao exame colpocitológico e a faixa etária. trata-se de pesquisa de corte transversal associada ao inquérito conhecimento, atitude e prática, em uma Unidade de Atenção Primária à Saúde. A amostra foi composta por 775 mulheres, distribuídas em três faixas etárias: adolescentes, jovens e idosas. embora o conhecimento inadequado tenha tido altas taxas em todas as faixas etárias, foi significativamente superior entre as adolescentes (p=0,000). Tendência semelhante no componente atitude por apresentar percentuais de inadequabilidade na adolescência e decair com o avançar da idade (p=0,000). Todavia, não houve diferença estatística entre os grupos quanto à prática (p=0,852). o estudo demonstrou relação entre a faixa etária e o conhecimento, a atitude e a prática do exame colpocitológico. verificar la asociación entre el conocimiento, la actitud y práctica de mujeres con relación a la prueba colpocitológica y el rango de edad. se trata de investigación trasversal asociada a la encuesta conocimiento, actitud y pr

EMS Provider Perceptions on Termination of Resuscitation in a Large, Urban EMS System.

PubMed

Tataris, Katie L; Richards, Christopher T; Stein-Spencer, Leslee; Ryan, Stephanie; Lazzara, Pete; Weber, Joseph M

2017-01-01

Despite the value of out-of-hospital Termination of Resuscitation (TOR) and the scientific evidence in favor of this practice, TOR has not been uniformly adopted or consistently practiced in EMS systems. Previous focus group studies have identified multiple barriers to implementation of out of hospital TOR but existing literature on EMS provider perceptions is limited. We sought to identify EMS providers' perceived barriers to performing out-of-hospital TOR in a large urban EMS system. The Chicago EMS System is a regional collaborative of EMS physicians, nurses and provider agencies, including the Chicago Fire Department (CFD), which provides exclusive emergency response for 9-1-1 calls in Chicago. CFD is an urban, fire-based EMS agency with a tiered response, with fire-fighter EMTs and paramedics providing initial care, and single role paramedics providing supplemental care and transport. A 2-page written survey was distributed to understand providers' experiences with managing OHCA and perceived barriers to TOR to inform subsequent improvements in protocol development and education. Of 3500 EMS providers that received the survey, 2309 were completed (66%). Survey respondent demographics were fire-fighter/EMTB (69%), fire-fighter/paramedic (14%), and single role paramedic (17%). The most frequent barrier to field TOR was scene safety (86%). The most common safety issue identified was family reaction to TOR (68%) and many providers felt threatened by family when trying to perform TOR (38%). Providers with a higher career numbers of OHCA were more likely to have felt threatened by the family (OR 6.70, 95% CI 2.99-15.00) and single role paramedics were more likely than FF/EMTBs to have felt threatened (OR 3.34, 95% CI 2.65-4.22). Barriers to delivering a death notification after TOR, include being uncomfortable or threatened with possible family reaction (52%) and family asking to continue the resuscitation (45%). There was lack of formal prior death notification

Nursing interventions in monitoring the adolescent with Cystic Fibrosis: a literature review.

PubMed

Reisinho, Maria da Conceição Marinho Sousa Ribeiro Oliveira; Gomes, Bárbara Pereira

2016-12-08

to search for nursing interventions focused on the improvement of quality of life and promotion of self-care of adolescents suffering from the Cystic Fibrosis. literature review. The inclusion criteria were: primary studies and studies with interventions developed by nurses in the adolescent population with Cystic Fibrosis, using Portuguese, Spanish, French and English with no time limit, and supported by the databases Scopus, Web of Science and CINAHL. The search expressions were: nursing AND care AND adolescent AND "Cystic Fibrosis" AND ("quality of life" OR "self-care"). a total of 59 articles was retrieved; 8 matched the criteria chosen. Nursing interventions targeted at adolescents with Cystic Fibrosis and their family members were identified. These interventions were organized according to the nurses' role, namely caregiver, coordinator, counsellor, researcher, trainer and care partner. nursing interventions targeted at following up the adolescent during the entire therapeutic process, involving the presence of parents/significant others, since both the adolescent and family have to be responsible for self-care. Healthcare professionals should be capable of identifying the specific needs of patients with chronic disease and their family, permitting a better understanding and adaptation to the health-disease transition process. buscar intervenções de enfermagem que enfoquem a melhoria da qualidade de vida e a promoção do autocuidado em adolescentes que sofrem de fibrose cística. revisão de literatura. Os critérios de inclusão foram: estudos primários e estudos com intervenções desenvolvidas por enfermeiros na população adolescente com fibrose cística, em português, espanhol, francês e inglês, sem delimitação temporal, nas bases de dados Scopus, Web of Science e CINAHL. Os termos utilizados na busca foram: enfermagem AND cuidado AND adolescente AND "Fibrose Cística" AND ("qualidade de vida" OR "autocuidado"). ao total, 59 artigos foram

Gulf War Women’s Health Cohort

DTIC Science & Technology

2017-10-01

suggested excess rates of woman’s health problems, e.g., breast cysts, abnormal Papanicolaou (Pap) smears, yeast infections, and bladder infections...e.g., breast cysts, abnormal Papanicolaou (Pap) smears, yeast infections, and bladder infections (4-6). However, in the 25 years since the war...lumps or cysts in the breasts, abnormal Pap tests) compared to women deployed elsewhere. In a further follow-up survey of this cohort of USAF

Cosmic muon induced EM showers in NO$$\

DOE PAGES

Yadav, Nitin; Duyang, Hongyue; Shanahan, Peter; ...

2016-11-15

Here, the NuMI Off-Axis v e Appearance (NOvA) experiment is a ne appearance neutrino oscillation experiment at Fermilab. It identifies the ne signal from the electromagnetic (EM) showers induced by the electrons in the final state of neutrino interactions. Cosmic muon induced EM showers, dominated by bremsstrahlung, are abundant in NOvA far detector. We use the Cosmic Muon- Removal technique to get pure EM shower sample from bremsstrahlung muons in data. We also use Cosmic muon decay in flight EM showers which are highly pure EM showers.The large Cosmic-EM sample can be used, as data driven method, to characterize themore » EM shower signature and provides valuable checks of the simulation, reconstruction, particle identification algorithm, and calibration across the NOvA detector.« less

Cosmic muon induced EM showers in NO$$\

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

Yadav, Nitin; Duyang, Hongyue; Shanahan, Peter

Here, the NuMI Off-Axis v e Appearance (NOvA) experiment is a ne appearance neutrino oscillation experiment at Fermilab. It identifies the ne signal from the electromagnetic (EM) showers induced by the electrons in the final state of neutrino interactions. Cosmic muon induced EM showers, dominated by bremsstrahlung, are abundant in NOvA far detector. We use the Cosmic Muon- Removal technique to get pure EM shower sample from bremsstrahlung muons in data. We also use Cosmic muon decay in flight EM showers which are highly pure EM showers.The large Cosmic-EM sample can be used, as data driven method, to characterize themore » EM shower signature and provides valuable checks of the simulation, reconstruction, particle identification algorithm, and calibration across the NOvA detector.« less

HPV testing with cytology triage for cervical cancer screening in routine practice.

PubMed

Louvanto, Karolina; Chevarie-Davis, Myriam; Ramanakumar, Agnihotram Venkata; Franco, Eduardo Luis; Ferenczy, Alex

2014-05-01

The purpose of this study was to evaluate the feasibility and effectiveness of Viral Testing Alone with Pap (Papanicolaou) Triage for Screening Cervical Cancer in Routine Practice (VASCAR) in a publicly funded university-affiliated hospital in Montreal, Canada. Women who are 30-65 years old are screened with the Hybrid Capture-2 assay. Women with negative results are retested at 3-year intervals; women with positive results are triaged with conventional cytologic methods. Women with Papanicolaou positive test results (≥atypical squamous cells of undetermined significance) are referred to colposcopy; women with Papanicolaou negative test results are retested with Hybrid Capture-2 assay and a Papanicolaou test in 1 year. Results were compared with a historic era (annual cytology with ≥atypical squamous cells of undetermined significance threshold for colposcopy referral) in the 3 years before VASCAR. VASCAR included 23,739 eligible women, among whom 1646 women (6.9%) tested positive for the human papillomavirus (HPV). Because of the need for subsequent sampling for cytologic testing, follow-up evaluation for cytologic triage was relatively poor; only 46% and 24% of HPV-positive women were Papanicolaou-triaged and underwent biopsy, respectively. Protocol violations occurred mainly in the early phases of implementation (12%). Detection of high-grade cervical intraepithelial neoplasia increased nearly 3-fold (rate ratio, 2.78; 95% confidence interval [CI], 2.1-3.7) during VASCAR, mostly because of a doubling in the rate of high-grade cervical intraepithelial neoplasia (34.0%; 95% CI, 21.2-48.8) compared with the historic cytology-only era (16.3%; 95% CI, 13.2-19.8). VASCAR reduced the median time to colposcopy from a positive screen from 11 months (95% CI, 10.48-11.50) to 3 months (95% CI, 2.64-3.80). VASCAR is feasible; however, it requires cosampling for HPV and cytology and for continuous education of healthcare providers of the HPV-Papanicolaou triage protocol

The effectiveness of a mail reminder system for depot medroxyprogesterone injections.

PubMed

Madlon-Kay, D J

1996-04-01

To determine if a mail reminder system leads to an increase in the percentage of depot medroxyprogesterone acetate (Depo-Provera) injections administered on time, the charts of 184 women were reviewed. The reminder postcard included the due dates of both the next medroxyprogesterone injection and the next Papanicolaou test. Timeliness of injections improved with the reminder system from 64% administered on time to 76% (P < .02). Injections given late despite the reminders were late a mean of 8 days. Injections given late before the reminder system began were late a mean of 20 days (P < .05). If injections given during the injection's 14-day "grace" period are included, the on-time rate improved from 87% to 96% with the reminder system (P < .005). The reminder system was not effective in ensuring annual Papanicolaou testing. Vigilance is needed to ensure that women receiving medroxyprogesterone injections also receive timely Papanicolaou testing.

A emissão em 8mm e as bandas de Merrill-Sanford em estrelas carbonadas

NASA Astrophysics Data System (ADS)

de Mello, A. B.; Lorenz-Martins, S.

2003-08-01

Estrelas carbonadas possuem bandas moleculares em absorção no visível e, no infravermelho (IR) as principais características espectrais se devem a emissão de grãos. Recentemente foi detectada a presença de bandas de SiC2 (Merrill-Sanford, MS) em emissão sendo atribuída à presença de um disco rico em poeira. Neste trabalho analisamos uma amostra de 14 estrelas carbonadas, observadas no telescópio de 1.52 m do ESO em 4 regiões espectrais diferentes, a fim de detectar as bandas de MS em emissão. Nossa amostra é composta de estrelas que apresentam além da emissão em 11.3 mm, outra em 8 mm. Esta última emissão, não usual nestes objetos, tem sido atribuída ou a moléculas de C2H2, ou a um composto sólido ainda indefinido. A detecção de emissões de MS e aquelas no IR, simultaneamente, revelaria um cenário mais complexo que o habitualmente esperado para os ventos destes objetos. No entanto como primeiro resultado, verificamos que as bandas de Merrill-Sanford encontram-se em absorção, não revelando nenhuma conexão com a emissão a 8 mm. Assim, temos duas hipóteses: (a) a emissão a 8 mm se deve à molécula C2H2 ou (b) essa emissão é resultado da emissão térmica de grãos. Testamos a segunda hipótese modelando a amostra com grãos não-homogêneos de SiC e quartzo, o qual emite em aproximadamente 8mm. Este grão seria produzido em uma fase evolutiva anterior a das carbonadas (estrelas S) e por terem uma estrutura cristalina são destruídos apenas na presença de campos de radiação ultravioleta muito intensos. Os modelos para os envoltórios utilizam o método de Monte Carlo para descrever o problema do transporte da radiação. As conclusões deste trabalho são: (1) as bandas de Merrill-Sanford se encontram em absorção, sugerindo um cenário usual para os ventos das estrelas da amostra; (2) neste cenário, a emissão em 8 mm seria resultado de grãos de quartzo com mantos de SiC, indicando que o quartzo poderia sobreviver a fase

The Orthogonally Partitioned EM Algorithm: Extending the EM Algorithm for Algorithmic Stability and Bias Correction Due to Imperfect Data.

PubMed

Regier, Michael D; Moodie, Erica E M

2016-05-01

We propose an extension of the EM algorithm that exploits the common assumption of unique parameterization, corrects for biases due to missing data and measurement error, converges for the specified model when standard implementation of the EM algorithm has a low probability of convergence, and reduces a potentially complex algorithm into a sequence of smaller, simpler, self-contained EM algorithms. We use the theory surrounding the EM algorithm to derive the theoretical results of our proposal, showing that an optimal solution over the parameter space is obtained. A simulation study is used to explore the finite sample properties of the proposed extension when there is missing data and measurement error. We observe that partitioning the EM algorithm into simpler steps may provide better bias reduction in the estimation of model parameters. The ability to breakdown a complicated problem in to a series of simpler, more accessible problems will permit a broader implementation of the EM algorithm, permit the use of software packages that now implement and/or automate the EM algorithm, and make the EM algorithm more accessible to a wider and more general audience.

Pain from the life cycle perspective: Evaluation and Measurement through psychophysical methods of category estimation and magnitude estimation.

PubMed

Sousa, Fátima Aparecida Emm Faleiros; Silva, Talita de Cássia Raminelli da; Siqueira, Hilze Benigno de Oliveira Moura; Saltareli, Simone; Gomez, Rodrigo Ramon Falconi; Hortense, Priscilla

2016-08-18

to describe acute and chronic pain from the perspective of the life cycle. participants: 861 people in pain. The Multidimensional Pain Evaluation Scale (MPES) was used. in the category estimation method the highest descriptors of chronic pain for children/ adolescents were "Annoying" and for adults "Uncomfortable". The highest descriptors of acute pain for children/adolescents was "Complicated"; and for adults was "Unbearable". In magnitude estimation method, the highest descriptors of chronic pain was "Desperate" and for descriptors of acute pain was "Terrible". the MPES is a reliable scale it can be applied during different stages of development. descrever a dor aguda e a crônica na perspectiva do ciclo vital. Métodos: participaram 861 pessoas com dor. Foi utilizada a Escala Multidimensional de Avaliação da Dor (EMADOR). Resultados: no método da estimação de categoria o descritor da dor crônica de maior atribuição para crianças e adolescentes foi "Chata" e para adultos foi "Desconfortável". Os descritores de maior atribuição para dor aguda em crianças e adolescentes foram "Complicada" e em adultos "Insuportável". No método de estimação de magnitude, o descritor de maior atribuição na dor crônica foi "Atormentadora" e na dor aguda foi "Terrível". a EMADOR é uma escala confiável e pode ser utilizada nas diferentes etapas do desenvolvimento humano. la descripción del dolor agudo y crónico desde las perspectiva del ciclo de vida. participaron 861 personas con dolor. Se utilizó la Escala Multidimensional de Evaluación del Dolor (EMEDOR). en el método de estimación de categoría el descriptor de dolor crónico más alto para niños y adolescentes fue de Molesto y para adultos fue Incómodo. Los descriptores mayores de dolor agudo para niños y adolescentes fueron Complejo y para adultos Insoportable. En el método de estimación de magnitud, el mayor descriptor de dolor crónico fueron Atormentador y el mayor de dolor agudo fue Terrible

Relationship between Resting Heart Rate, Blood Pressure and Pulse Pressure in Adolescents.

PubMed

Christofaro, Diego Giulliano Destro; Casonatto, Juliano; Vanderlei, Luiz Carlos Marques; Cucato, Gabriel Grizzo; Dias, Raphael Mendes Ritti

2017-05-01

High resting heart rate is considered an important factor for increasing mortality chance in adults. However, it remains unclear whether the observed associations would remain after adjustment for confounders in adolescents. To analyze the relationship between resting heart rate, blood pressure and pulse pressure in adolescents of both sexes. A cross-sectional study with 1231 adolescents (716 girls and 515 boys) aged 14-17 years. Heart rate, blood pressure and pulse pressure were evaluated using an oscillometric blood pressure device, validated for this population. Weight and height were measured with an electronic scale and a stadiometer, respectively, and waist circumference with a non-elastic tape. Multivariate analysis using linear regression investigated the relationship between resting heart rate and blood pressure and pulse pressure in boys and girls, controlling for general and abdominal obesity. Higher resting heart rate values were observed in girls (80.1 ± 11.0 beats/min) compared to boys (75.9 ± 12.7 beats/min) (p ≤ 0.001). Resting heart rate was associated with systolic blood pressure in boys (Beta = 0.15 [0.04; 0.26]) and girls (Beta = 0.24 [0.16; 0.33]), with diastolic blood pressure in boys (Beta = 0.50 [0.37; 0.64]) and girls (Beta = 0.41 [0.30; 0.53]), and with pulse pressure in boys (Beta = -0.16 [-0.27; -0.04]). This study demonstrated a relationship between elevated resting heart rate and increased systolic and diastolic blood pressure in both sexes and pulse pressure in boys even after controlling for potential confounders, such as general and abdominal obesity. A frequência cardíaca de repouso é considerada um importante fator de aumento de mortalidade em adultos. Entretanto, ainda é incerto se as associações observadas permanecem após ajuste para fatores de confusão em adolescentes. Analisar a relação entre frequência cardíaca de repouso, pressão arterial e pressão de pulso em adolescentes dos dois sexos. Estudo transversal

EMS Agenda for the Future

DOT National Transportation Integrated Search

1996-09-01

The National Highway Traffic Safety Administration (NHTSA) and the Health Resources and Services Administration, Maternal and Child Health Bureau sponsored The EMS Agenda for the Future. This document focuses on aspects of EMS related to emergency ca...

The low risk of precancer after a screening result of human papillomavirus-negative/atypical squamous cells of undetermined significance papanicolaou and implications for clinical management.

PubMed

Gage, Julia C; Katki, Hormuzd A; Schiffman, Mark; Castle, Philip E; Fetterman, Barbara; Poitras, Nancy E; Lorey, Thomas; Cheung, Li C; Behrens, Catherine; Sharma, Abha; Zhao, Fang-Hui; Cuzick, Jack; Yang, Zi Hua; Kinney, Walter K

2014-11-01

Different US practice guidelines have conflicting recommendations for when women should return after a screening result of human papillomavirus (HPV)-negative with an equivocal Papanicolaou (Pap) result of atypical squamous cells of undetermined significance (ASC-US) (ie, return in either 3 or 5 years). One way to determine management is to compare the risk of precancer/cancer after an HPV-negative/ASC-US result with the risks after other negative screening results. For example, if the risk after an HPV-negative/ASC-US result was similar to the risk after a negative Pap test, a 3-year return would be preferred because guidelines agree that women with negative Pap test results should return in 3 years. Alternatively, if the risk after an HPV-negative/ASC-US result is similar to that after a cotest-negative result (HPV negative/Pap test negative), a 5-year return would be preferred because guidelines agree that women testing cotest negative should return in 5 years. The authors compared risks of cervical intraepithelial neoplasia of grade 3 or higher (CIN3+) and cervical cancer among women aged 30 years to 64 years at Kaiser Permanente Northern California with the following test results from 2003 through 2012: 17,191 women testing HPV negative/ASC-US; 980,268 women testing Pap test negative (regardless of HPV result); and 892,882 women testing cotest negative. The 5-year CIN3+ and cancer risks after an HPV-negative/ASC-US result were closer to the risks after a negative Pap test result (CIN3+: 0.48% vs 0.31% [P =.0019]; and cancer: 0.043% vs 0.031% [P =.4]) than after a negative cotest (CIN3+: 0.48% vs 0.11% [P<.0001]; and cancer: 0.043% vs 0.014% [P =.016]). Women testing HPV negative/ASC-US were found to have precancer/cancer risks that were more closely aligned with women with negative Pap test results, suggesting that women testing HPV negative/ASC-US should be managed similarly to women testing negative on Pap tests with a 3-year return for screening. © 2014

Determination of oestrous cycle of the rats by direct examination: how reliable?

PubMed

Yener, T; Turkkani Tunc, A; Aslan, H; Aytan, H; Cantug Caliskan, A

2007-02-01

For determination of the oestrous cycle in rats classical Papanicolaou technique has long been used successfully. Instead of using many stains in Papanicolaou, staining the vaginal secretions with only methylene blue has also been defined. Recently a new technique in which vaginal samples are directly examined under light microscope has been introduced. The aim of this study was to assess the reliability of this new technique by comparing it with the classical staining techniques. From 20 Wistar rats 60 vaginal samples were collected with a micropipette, three from each. Briefly, the vagina was flushed two to three times then the fluid was placed onto a glass slide. The fluid was equally distributed onto three glass slides. The glass slides were coded. Two samples were stained with Papanicolaou and methylene blue while the other one was examined directly. Determination of the phases of the oestrous cycle was made by the same histologist who was blinded to the groups and coding system. After determination of the oestrous phase in all samples, the results were compared and it was found that the results were matching. In conclusion, the same results can be obtained with the direct examination technique and this technique is reliable, so there is no need to use relatively time-consuming, less practical and more expensive techniques such as Papanicolaou or methylene blue.

Topical Treatment With an Agent Disruptive to <em>P. acnesem> Biofilm Provides Positive Therapeutic Response: Results of a Randomized Clinical Trial.

PubMed

Bernhardt, Michael J; Myntti, Matthew F

2016-06-01

The traditional disease model of acne has been one of follicular plugging due to 'sticky epithelial cells' associated with increased sebum production with deep follicular anaerobic conditions favoring <em>P. acnesem>- generated inflammation. <em>P. acnesem> biofilms have been found more frequently in patients with acne than controls. Biofilms are genetically coded to create adhesion to the pilosebaceous unit followed by production of a mucopolysaccharide coating capable of binding to lipid surfaces. Traditional therapies for acne have involved mixtures of oral and topical antibiotics admixed with topical keratolytics and retinoids, which are aimed at traditional bacterial reduction as well as downregulating the inflammatory cascade. These approaches are limited by side effect and compliance/tolerability issues. As the <em>P. acnesem> biofilm may, in fact, be the instigator of this process, we studied the use of a topical agent designed to reduce the <em>P. acnesem> biofilm to see if reducing the biofilm would be therapeutically efficacious. We present data of a proprietary topical non-prescription agent with a novel pharmaco mechanism designed to attack the biofilm produced by <em>P. acnesem>. Our data shows a decrease of inflammatory lesions by 44% and non-inflammatory lesions by 32% after 12 weeks and also provided for a meaningful improvement in the quality of life of the patients in the study. These improvements were achieved with a product that was not associated with burning, chafing, irritation, or erythema, which can be seen with topical treatments. It is apparent from this study that by addressing the biofilm which protects the <em>P. acnesem> bacteria through the use of the Acne Gel, the incidence of acne symptoms can be greatly reduced, while having no negative impacts on the patients' skin (ClinicalTrials.gov registry number NCT02404285).

<em>J Drugs Dermatol. em>2016;15(6):677-683.

Estudo em microondas do aprisionamento e precipitação de elétrons em explosões solares

NASA Astrophysics Data System (ADS)

Rosal, A. C.; Costa, J. E. R.

2003-08-01

Uma explosão solar é uma variação rápida e intensa do brilho que ocorre nas chamadas regiões ativas da atmosfera, constituídas por um plasma magnetizado com intensa indução magnética. Os modelos de explosões solares atuais, discutidos na literatura, apresentam características de aprisionamento e precipitação de elétrons em ambientes magnéticos simplificados. Neste trabalho, nos propusemos a separar a emissão dos elétrons aprisionados da emissão dos elétrons em precipitação apenas a partir da emissão em microondas, melhorando portanto o controle sobre o conjunto de parâmetros inferidos. A emissão em microondas da população em precipitação é bastante fraca e portanto da nossa base de dados de 130 explosões observadas pelo Rádio Polarímetro de Nobeyama, em sete freqüências, apenas para 32 foi possível separar as duas componentes de emissão com uma boa razão sinal/ruído. A partir de estudos das escalas de tempo das emissões devidas à variação gradual da emissão no aprisionamento e da variação rápida da emissão dos elétrons em precipitação foi possível obter a separação utilizando um filtro temporal nas emissões resultantes. Em nossa análise destas explosões estudamos os espectros girossincrotrônicos da emissão gradual, a qual associamos provir do topo dos arcos magnéticos e da emissão de variação rápida associada aos elétrons em precipitação. Estes espectros foram calculados e dos quais inferimos que a indução magnética efetiva do topo e dos pés foi em média, Btopo = 236 G e Bpés = 577 G, inferidas das freqüências de pico dos espectros em ntopo = 11,8 GHz e npés = 14,6 GHz com leve anisotropia (pequeno alargamento espectral). O índice espectral da distribuição não-térmica de elétrons d, inferido do índice espectral de fótons da emissão em regime opticamente fino, foi de dtopo = 3,3 e dpés = 3,9. Estes parâmetros são típicos da maioria das análises realizadas em ambiente único de

Retrospectively exploring the importance of items in the decision to leave the emergency medical services (EMS) profession and their relationships to life satisfaction after leaving EMS and likelihood of returning to EMS.

PubMed

Blau, Gary; Chapman, Susan

2011-01-01

An exit survey was returned by a sample of 127 respondents in fully compensated positions who left the EMS profession, most within 12 months prior to filling out the exit survey. A very high percentage continued to work after leaving EMS. Respondents were asked to rate the importance of each of 17 items in affecting their decision to leave EMS. A higher than anticipated response to a "not applicable" response choice affected the usability of 8 of these items. Nine of the 17 items had at least 65 useable responses and were used for further analysis. Within these 9, stress/burnout and lack of job challenges had the highest importance in affecting the decision to leave EMS, while desire for better pay and benefits had the lowest importance. Desire for career change was positively related to life satisfaction after leaving EMS and negatively related to likelihood of returning to EMS. Stress/burnout was positively related to life satisfaction after leaving EMS. Study limitations and future research issues are briefly discussed.

Injuries to emergency medicine residents on EMS rotations.

PubMed

Cone, D C; McNamara, R M

1998-01-01

To study the incidence and nature of injuries sustained by emergency medicine (EM) residents during EMS rotations, and steps taken at EM residency programs to increase resident safety during field activities. An eight-question survey form was mailed to all 114 U.S. EM residency directors, with a second mailing to nonresponders eight weeks after the initial mailing. A total of 105 surveys were returned (92%). Six surveys were from new programs whose residents have not yet rotated on EMS. These were excluded from further analysis, leaving 99 programs. Of these, 91 (92%) reported no injuries. One EM resident died in a helicopter crash in 1985. Seven other injury events were reported: 1) facial lacerations, rib fractures, and a shoulder injury in an ambulance accident; 2) an open finger fracture (crushed by a backboard); 3) contusions and a concussion when an ambulance was struck by a fire engine; 4) a groin pull sustained while entering a helicopter; 5) bilateral metatarsal fractures in a fall; 6) rib fractures, a pneumothorax, and a concussion in an ambulance accident; and 7) "minor injuries" sustained in a crash while responding to a scene in a program-owned response vehicle. Actions taken at residency programs to reduce the risk of injury include the use of ballistic vests (four programs), requiring helmets on flights (five programs), and changing flight experience from mandatory to optional (two programs). Ten programs (10%) reported using ground scene safety lectures, and nine programs (15% of those offering flights) reported various types of flight safety instruction. Sixty-nine programs (70%) reported no formal field safety training or other active steps to increase resident safety on EMS rotations. Injuries sustained by EM residents during EMS rotations are uncommon but nontrivial, with several serious injuries and one fatality reported. The majority of EM residency programs have no formal safety training programs for EMS rotations.

Navigating 3D electron microscopy maps with EM-SURFER.

PubMed

Esquivel-Rodríguez, Juan; Xiong, Yi; Han, Xusi; Guang, Shuomeng; Christoffer, Charles; Kihara, Daisuke

2015-05-30

The Electron Microscopy DataBank (EMDB) is growing rapidly, accumulating biological structural data obtained mainly by electron microscopy and tomography, which are emerging techniques for determining large biomolecular complex and subcellular structures. Together with the Protein Data Bank (PDB), EMDB is becoming a fundamental resource of the tertiary structures of biological macromolecules. To take full advantage of this indispensable resource, the ability to search the database by structural similarity is essential. However, unlike high-resolution structures stored in PDB, methods for comparing low-resolution electron microscopy (EM) density maps in EMDB are not well established. We developed a computational method for efficiently searching low-resolution EM maps. The method uses a compact fingerprint representation of EM maps based on the 3D Zernike descriptor, which is derived from a mathematical series expansion for EM maps that are considered as 3D functions. The method is implemented in a web server named EM-SURFER, which allows users to search against the entire EMDB in real-time. EM-SURFER compares the global shapes of EM maps. Examples of search results from different types of query structures are discussed. We developed EM-SURFER, which retrieves structurally relevant matches for query EM maps from EMDB within seconds. The unique capability of EM-SURFER to detect 3D shape similarity of low-resolution EM maps should prove invaluable in structural biology.

Pulmonary function in children and adolescents with sickle cell disease: have we paid proper attention to this problem?

PubMed

Vieira, Ana Karine; Alvim, Cristina Gonçalves; Carneiro, Maria Cristina Marquez; Ibiapina, Cássio da Cunha

2016-01-01

To evaluate pulmonary function and functional capacity in children and adolescents with sickle cell disease. This was a cross-sectional study involving 70 children and adolescents (8-15 years of age) with sickle cell disease who underwent pulmonary function tests (spirometry) and functional capacity testing (six-minute walk test). The results of the pulmonary function tests were compared with variables related to the severity of sickle cell disease and history of asthma and of acute chest syndrome. Of the 64 patients who underwent spirometry, 15 (23.4%) showed abnormal results: restrictive lung disease, in 8 (12.5%); and obstructive lung disease, in 7 (10.9%). Of the 69 patients who underwent the six-minute walk test, 18 (26.1%) showed abnormal results regarding the six-minute walk distance as a percentage of the predicted value for age, and there was a ≥ 3% decrease in SpO2 in 36 patients (52.2%). Abnormal pulmonary function was not significantly associated with any of the other variables studied, except for hypoxemia and restrictive lung disease. In this sample of children and adolescents with sickle cell disease, there was a significant prevalence of abnormal pulmonary function. The high prevalence of respiratory disorders suggests the need for a closer look at the lung function of this population, in childhood and thereafter. Avaliar a função pulmonar e a capacidade funcional em crianças e adolescentes com doença falciforme. Estudo transversal com 70 crianças e adolescentes com doença falciforme (8-15 anos), submetidos a testes de função respiratória (espirometria) e de capacidade funcional (teste de caminhada de seis minutos). Os resultados da avaliação da função pulmonar foram comparados com variáveis relacionadas à gravidade da doença falciforme e à presença de história de asma e de síndrome torácica aguda. Dos 64 pacientes submetidos à espirometria, 15 (23,4%) apresentaram resultados alterados: distúrbio ventilatório restritivo, em

Where There is No EMS: Lay Providers in Emergency Medical Services Care - EMS as a Public Health Priority.

PubMed

Debenham, Sierra; Fuller, Matthew; Stewart, Matthew; Price, Raymond R

2017-12-01

By 2030, road traffic accidents are projected to be the fifth leading cause of death worldwide, with 90% of these deaths occurring in low- and middle-income countries (LMICs). While high-quality, prehospital trauma care is crucial to reduce the number of trauma-related deaths, effective Emergency Medical Systems (EMS) are limited or absent in many LMICs. Although lay providers have long been recognized as the front lines of informal trauma care in countries without formal EMS, few efforts have been made to capitalize on these networks. We suggest that lay providers can become a strong foundation for nascent EMS through a four-fold approach: strengthening and expanding existing lay provider training programs; incentivizing lay providers; strengthening locally available first aid supply chains; and using technology to link lay provider networks. Debenham S , Fuller M , Stewart M , Price RR . Where there is no EMS: lay providers in Emergency Medical Services care - EMS as a public health priority. Prehosp Disaster Med. 2017;32(6):593-595.

Overweight effect on spirometric parameters in adolescents undergoing exercise.

PubMed

Costa, Rayana de Oliveira; Silva, Juliana Pereira; Lacerda, Eliana Mattos; Dias, Rodrigo; Pezolato, Vitor Alexandre; Silva, Carlos Alberto da; Krinski, Kleverton; Correia, Marco Aurélio de Valois; Cieslak, Fabrício

2016-01-01

To evaluate effects of overweight on spirometric parameters in adolescents who underwent bronchial provocation test for exercise. We included 71 male adolescents. The diagnosis of asthma was done based on participants' clinical history and on the International Study Questionnaire Asthma and Allergies in Childhood, and the diagnosis of obesity was based on body mass index above 95th percentile. The bronchospasm induced by exercise was assessed using the run-walk test on a treadmill for eight minutes. The decrease in forced expiratory volume in one second > or equal to 10% before exercise was considered positive, and to calculate the intensity in exercise-induced bronchospasm we measured the maximum percentage of forced expiratory volume in one second and above the curve area. Data analysis was carried out using the Mann-Whitney U test and Friedman test (ANOVA), followed by Wilcoxon test (p<0.05). In addition, we used Fisher's exact test to analyze the exercise-induced bronchospasm frequency. Significant differences were observed among obese adolescents in exercise-induced bronchospasm frequency (p=0,013) and in relation to time required for recovery after exercise (p=0,007). Overweight can influence the increase in the exercise-induced bronchospasm frequency in non-asthmatic adolescents compared with eutrophic adolescents. Avaliar o efeito do excesso de peso sobre parâmetros espirométricos em adolescentes submetidos ao teste de broncoprovocação por exercício. Participaram do estudo 71 adolescentes do sexo masculino. O diagnóstico de asma foi obtido por meio de histórico clínico e do questionário International Study of Asthma and Allergies in Childhood, e o de obesidade, pelo índice de massa corporal acima do percentil 95. Para avaliar o broncoespasmo induzido pelo exercício, utilizou-se o teste correr/caminhar em esteira ergométrica, com duração de 8 minutos, considerando positivo se diminuição do volume expiratório forçado no primeiro segundo >10

An Analysis of EMS and ED Detection of Stroke.

PubMed

Medoro, Ian; Cone, David C

2017-01-01

Studies have shown a reduction in time-to-CT and improved process measures when EMS personnel notify the ED of a "stroke alert" from the field. However, there are few data on the accuracy of these EMS stroke alerts. The goal of this study was to examine diagnostic test performance of EMS and ED stroke alerts and related process measures. The EMS and ED records of all stroke alerts in a large tertiary ED from August 2013-January 2014 were examined and data abstracted by one trained investigator, with data accuracy confirmed by a second investigator for 15% of cases. Stroke alerts called by EMS prior to ED arrival were compared to stroke alerts called by ED physicians and nurses (for walk-in patients, and patients transported by EMS without EMS stroke alerts). Means ± SD, medians, unpaired t-tests (for continuous data), and two-tailed Fisher's exact tests (for categorical data) were used. Of 260 consecutive stroke alerts, 129 were EMS stroke alerts, and 131 were ED stroke alerts (70 called by physicians, 61 by nurses). The mean NIH Stroke Scale was higher in the EMS group (8.1 ± 7.6 vs. 3.0 ± 5.0, p < 0.0001). The positive predictive value of EMS stroke alerts was 0.60 (78/129), alerts by ED nurses was 0.25 (15/61), and alerts by ED physicians was 0.31 (22/70). The PPV for EMS was better than for nurses or physicians (both p < 0.001), and more patients in the EMS group had final diagnoses of stroke (62/129 vs. 24/131, p < 0.001). The positive likelihood ratio was 1.53 for EMS personnel, 0.45 for physicians, and 0.77 for nurses. The mean time to order the CT (8.5 ± 7.1 min vs. 23.1 ± 18.2 min, p < 0.0001) and the mean ED length of stay (248 ± 116 min vs. 283 ± 128 min, p = 0.022) were shorter for the EMS stroke alert group. More EMS stroke alert patients received tPA (16/129 vs. 6/131, p = 0.027). EMS stroke alerts have better diagnostic test performance than stroke alerts by ED staff, likely due to higher NIH Stroke Scale scores (more obvious

An economic toolkit for identifying the cost of emergency medical services (EMS) systems: detailed methodology of the EMS Cost Analysis Project (EMSCAP).

PubMed

Lerner, E Brooke; Garrison, Herbert G; Nichol, Graham; Maio, Ronald F; Lookman, Hunaid A; Sheahan, William D; Franz, Timothy R; Austad, James D; Ginster, Aaron M; Spaite, Daniel W

2012-02-01

Calculating the cost of an emergency medical services (EMS) system using a standardized method is important for determining the value of EMS. This article describes the development of a methodology for calculating the cost of an EMS system to its community. This includes a tool for calculating the cost of EMS (the "cost workbook") and detailed directions for determining cost (the "cost guide"). The 12-step process that was developed is consistent with current theories of health economics, applicable to prehospital care, flexible enough to be used in varying sizes and types of EMS systems, and comprehensive enough to provide meaningful conclusions. It was developed by an expert panel (the EMS Cost Analysis Project [EMSCAP] investigator team) in an iterative process that included pilot testing the process in three diverse communities. The iterative process allowed ongoing modification of the toolkit during the development phase, based upon direct, practical, ongoing interaction with the EMS systems that were using the toolkit. The resulting methodology estimates EMS system costs within a user-defined community, allowing either the number of patients treated or the estimated number of lives saved by EMS to be assessed in light of the cost of those efforts. Much controversy exists about the cost of EMS and whether the resources spent for this purpose are justified. However, the existence of a validated toolkit that provides a standardized process will allow meaningful assessments and comparisons to be made and will supply objective information to inform EMS and community officials who are tasked with determining the utilization of scarce societal resources. © 2012 by the Society for Academic Emergency Medicine.

The association between EMS workplace safety culture and safety outcomes.

PubMed

Weaver, Matthew D; Wang, Henry E; Fairbanks, Rollin J; Patterson, Daniel

2012-01-01

Prior studies have highlighted wide variation in emergency medical services (EMS) workplace safety culture across agencies. To determine the association between EMS workplace safety culture scores and patient or provider safety outcomes. We administered a cross-sectional survey to EMS workers affiliated with a convenience sample of agencies. We recruited these agencies from a national EMS management organization. We used the EMS Safety Attitudes Questionnaire (EMS-SAQ) to measure workplace safety culture and the EMS Safety Inventory (EMS-SI), a tool developed to capture self-reported safety outcomes from EMS workers. The EMS-SAQ provides reliable and valid measures of six domains: safety climate, teamwork climate, perceptions of management, working conditions, stress recognition, and job satisfaction. A panel of medical directors, emergency medical technicians and paramedics, and occupational epidemiologists developed the EMS-SI to measure self-reported injury, medical errors and adverse events, and safety-compromising behaviors. We used hierarchical linear models to evaluate the association between EMS-SAQ scores and EMS-SI safety outcome measures. Sixteen percent of all respondents reported experiencing an injury in the past three months, four of every 10 respondents reported an error or adverse event (AE), and 89% reported safety-compromising behaviors. Respondents reporting injury scored lower on five of the six domains of safety culture. Respondents reporting an error or AE scored lower for four of the six domains, while respondents reporting safety-compromising behavior had lower safety culture scores for five of the six domains. Individual EMS worker perceptions of workplace safety culture are associated with composite measures of patient and provider safety outcomes. This study is preliminary evidence of the association between safety culture and patient or provider safety outcomes.

A new Em-like protein from Lactuca sativa, LsEm1, enhances drought and salt stress tolerance in Escherichia coli and rice.

PubMed

Xiang, Dian-Jun; Man, Li-Li; Zhang, Chun-Lan; Peng-Liu; Li, Zhi-Gang; Zheng, Gen-Chang

2018-02-07

Late embryogenesis abundant (LEA) proteins are closely related to abiotic stress tolerance of plants. In the present study, we identified a novel Em-like gene from lettuce, termed LsEm1, which could be classified into group 1 LEA proteins, and shared high homology with Cynara cardunculus Em protein. The LsEm1 protein contained three different 20-mer conserved elements (C-element, N-element, and M-element) in the C-termini, N-termini, and middle-region, respectively. The LsEm1 mRNAs were accumulated in all examined tissues during the flowering and mature stages, with a little accumulation in the roots and leaves during the seedling stage. Furthermore, the LsEm1 gene was also expressed in response to salt, dehydration, abscisic acid (ABA), and cold stresses in young seedlings. The LsEm1 protein could effectively reduce damage to the lactate dehydrogenase (LDH) and protect LDH activity under desiccation and salt treatments. The Escherichia coli cells overexpressing the LsEm1 gene showed a growth advantage over the control under drought and salt stresses. Moreover, LsEm1-overexpressing rice seeds were relatively sensitive to exogenously applied ABA, suggesting that the LsEm1 gene might depend on an ABA signaling pathway in response to environmental stresses. The transgenic rice plants overexpressing the LsEm1 gene showed higher tolerance to drought and salt stresses than did wild-type (WT) plants on the basis of the germination performances, higher survival rates, higher chlorophyll content, more accumulation of soluble sugar, lower relative electrolyte leakage, and higher superoxide dismutase activity under stress conditions. The LsEm1-overexpressing rice lines also showed less yield loss compared with WT rice under stress conditions. Furthermore, the LsEm1 gene had a positive effect on the expression of the OsCDPK9, OsCDPK13, OsCDPK15, OsCDPK25, and rab21 (rab16a) genes in transgenic rice under drought and salt stress conditions, implying that overexpression of these

7 CFR 1945.35 - Special EM loan training.

Code of Federal Regulations, 2010 CFR

2010-01-01

...) PROGRAM REGULATIONS (CONTINUED) EMERGENCY Disaster Assistance-General § 1945.35 Special EM loan training... workshop and a test. (c) Objective. The basic objective of this training program is to keep State and... employees in administering the EM loan program. (d) Comprehensive EM loan training package. A comprehensive...

The association between EMS workplace safety culture and safety outcomes

PubMed Central

Weaver, Matthew D.; Wang, Henry E.; Fairbanks, Rollin J.; Patterson, Daniel

2012-01-01

Objective Prior studies have highlighted wide variation in EMS workplace safety culture across agencies. We sought to determine the association between EMS workplace safety culture scores and patient or provider safety outcomes. Methods We administered a cross-sectional survey to EMS workers affiliated with a convenience sample of agencies. We recruited these agencies from a national EMS management organization. We used the EMS Safety Attitudes Questionnaire (EMS-SAQ) to measure workplace safety culture and the EMS Safety Inventory (EMS-SI), a tool developed to capture self-reported safety outcomes from EMS workers. The EMS-SAQ provides reliable and valid measures of six domains: safety climate, teamwork climate, perceptions of management, perceptions of working conditions, stress recognition, and job satisfaction. A panel of medical directors, paramedics, and occupational epidemiologists developed the EMS-SI to measure self-reported injury, medical errors and adverse events, and safety-compromising behaviors. We used hierarchical linear models to evaluate the association between EMS-SAQ scores and EMS-SI safety outcome measures. Results Sixteen percent of all respondents reported experiencing an injury in the past 3 months, four of every 10 respondents reported an error or adverse event (AE), and 90% reported safety-compromising behaviors. Respondents reporting injury scored lower on 5 of the 6 domains of safety culture. Respondents reporting an error or AE scored lower for 4 of the 6 domains, while respondents reporting safety-compromising behavior had lower safety culture scores for 5 of 6 domains. Conclusions Individual EMS worker perceptions of workplace safety culture are associated with composite measures of patient and provider safety outcomes. This study is preliminary evidence of the association between safety culture and patient or provider safety outcomes. PMID:21950463

Association between EMS Question Bank Completion and Passing Rates on the EMS Certification Examination.

PubMed

Clemency, Brian; Martin-Gill, Christian; Rall, Nicole; May, Paul; Lubin, Jeffrey; Cooley, Craig; Van Dillen, Christine; Silvestri, Salvatore; Portela, Roberto; Cooney, Derek; Knutsen, Christian; March, Juan

2017-01-01

A board review question bank was created to assist candidates in their preparation for the 2015 EMS certification examination. We aimed to describe the development of this question bank and evaluate its successes in preparing candidates to obtain EMS subspecialty board certification. An online question bank was developed by 13 subject matter experts who participated as item writers, representing eight different EMS fellowship programs. The online question bank consisted of four practice tests, with each of the tests comprised of 100 questions. The number of candidates who participated in and completed the question bank was calculated. The passing rate among candidates who completed the question bank was calculated and compared to the publicly reported statistics for all candidates. The relationship between candidates' performance on the question bank and subspecialty exam pass rates was determined. A total of 252 candidates took at least one practice test and, of those, 225 candidates completed all four 100-question practice tests. The pass rate on the 2015 EMS certification exam was 79% (95%CI 74-85%) among candidates who completed the question bank, which is 12% higher than the overall pass rate (p = 0.003). Candidates' performance on the question bank was positively associated with overall success on the exam (X 2 = 75.8, p < 0.0001). Achieving a score of ≥ 70% on the question bank was associated with a higher likelihood of passing the exam (OR = 17.8; 95% CI: 8.0-39.6). Completing the question bank program was associated with improved pass rates on the EMS certification exam. Strong performance on the question bank correlated with success on the exam.

Estimation of multiple sound sources with data and model uncertainties using the EM and evidential EM algorithms

NASA Astrophysics Data System (ADS)

Wang, Xun; Quost, Benjamin; Chazot, Jean-Daniel; Antoni, Jérôme

2016-01-01

This paper considers the problem of identifying multiple sound sources from acoustical measurements obtained by an array of microphones. The problem is solved via maximum likelihood. In particular, an expectation-maximization (EM) approach is used to estimate the sound source locations and strengths, the pressure measured by a microphone being interpreted as a mixture of latent signals emitted by the sources. This work also considers two kinds of uncertainties pervading the sound propagation and measurement process: uncertain microphone locations and uncertain wavenumber. These uncertainties are transposed to the data in the belief functions framework. Then, the source locations and strengths can be estimated using a variant of the EM algorithm, known as the Evidential EM (E2M) algorithm. Eventually, both simulation and real experiments are shown to illustrate the advantage of using the EM in the case without uncertainty and the E2M in the case of uncertain measurement.

Peat soils stabilization using Effective Microorganisms (EM)

NASA Astrophysics Data System (ADS)

Yusof, N. Z.; Samsuddin, N. S.; Hanif, M. F.; Syed Osman, S. B.

2018-04-01

Peat soil is known as geotechnical problematic soil since it is the softest soil having highly organic and moisture content which led to high compressibility, low shear strength and long-term settlement. The aim of this study was to obtain the stabilized peat soils using the Effective Microorganisms (EM). The volume of EM added and mixed with peat soils varied with 2%, 4%, 6%, 8% and 10% and then were cured for 7, 14 and 21 days. The experiment was done for uncontrolled and controlled moisture content. Prior conducting the main experiments, the physical properties such as moisture content, liquid limit, specific gravity, and plastic limit etc. were measure for raw peat samples. The Unconfined Compressive Strength (UCS) test was performed followed by regression analysis to check the effect of EM on the soil strength. Obtained results have shown that the mix design for controlled moisture contents showed the promising improvement in their compressive strength. The peat soil samples with 10% of EM shows the highest increment in UCS value and the percentage of increments are in the range of 44% to 65% after curing for 21 days. The regression analysis of the EM with the soil compressive strength showed that in controlled moisture conditions, EM significantly improved the soil stability as the value of R2 ranged between 0.97 – 0.78. The results have indicated that the addition of EM in peat soils provides significant improving in the strength of the soil as well as the other engineering properties.

Phenotypes of asthma in low-income children and adolescents: cluster analysis.

PubMed

Cabral, Anna Lucia Barros; Sousa, Andrey Wirgues; Mendes, Felipe Augusto Rodrigues; Carvalho, Celso Ricardo Fernandes de

2017-01-01

Studies characterizing asthma phenotypes have predominantly included adults or have involved children and adolescents in developed countries. Therefore, their applicability in other populations, such as those of developing countries, remains indeterminate. Our objective was to determine how low-income children and adolescents with asthma in Brazil are distributed across a cluster analysis. We included 306 children and adolescents (6-18 years of age) with a clinical diagnosis of asthma and under medical treatment for at least one year of follow-up. At enrollment, all the patients were clinically stable. For the cluster analysis, we selected 20 variables commonly measured in clinical practice and considered important in defining asthma phenotypes. Variables with high multicollinearity were excluded. A cluster analysis was applied using a twostep agglomerative test and log-likelihood distance measure. Three clusters were defined for our population. Cluster 1 (n = 94) included subjects with normal pulmonary function, mild eosinophil inflammation, few exacerbations, later age at asthma onset, and mild atopy. Cluster 2 (n = 87) included those with normal pulmonary function, a moderate number of exacerbations, early age at asthma onset, more severe eosinophil inflammation, and moderate atopy. Cluster 3 (n = 108) included those with poor pulmonary function, frequent exacerbations, severe eosinophil inflammation, and severe atopy. Asthma was characterized by the presence of atopy, number of exacerbations, and lung function in low-income children and adolescents in Brazil. The many similarities with previous cluster analyses of phenotypes indicate that this approach shows good generalizability. Estudos que caracterizam fenótipos de asma predominantemente incluem adultos ou foram realizados em crianças e adolescentes de países desenvolvidos; portanto, sua aplicabilidade em outras populações, tais como as de países em desenvolvimento, permanece indeterminada. Nosso

Inventory of File sref_em.t03z.pgrb212.ctl.grib2

Science.gov Websites

UGRD analysis U-Component of <em>Wind> [m/s] 006 10 m above ground VGRD analysis V-Component of <em>Wind> [m/s of <em>Wind> [m/s] 018 250 mb VGRD analysis V-Component of <em>Wind> [m/s] 019 500 mb HGT analysis Geopotential Height [gpm] 020 500 mb UGRD analysis U-Component of <em>Wind> [m/s] 021 500 mb VGRD analysis V-Component of

Inventory of File sref_em.t03z.pgrb132.ctl.grib2

Science.gov Websites

UGRD analysis U-Component of <em>Wind> [m/s] 006 10 m above ground VGRD analysis V-Component of <em>Wind> [m/s of <em>Wind> [m/s] 018 250 mb VGRD analysis V-Component of <em>Wind> [m/s] 019 500 mb HGT analysis Geopotential Height [gpm] 020 500 mb UGRD analysis U-Component of <em>Wind> [m/s] 021 500 mb VGRD analysis V-Component of

Inventory of File sref_em.t03z.pgrb243.ctl.grib2

Science.gov Websites

UGRD analysis U-Component of <em>Wind> [m/s] 006 10 m above ground VGRD analysis V-Component of <em>Wind> [m/s of <em>Wind> [m/s] 018 250 mb VGRD analysis V-Component of <em>Wind> [m/s] 019 500 mb HGT analysis Geopotential Height [gpm] 020 500 mb UGRD analysis U-Component of <em>Wind> [m/s] 021 500 mb VGRD analysis V-Component of

Inventory of File sref_em.t03z.pgrb221.ctl.grib2

Science.gov Websites

UGRD analysis U-Component of <em>Wind> [m/s] 006 10 m above ground VGRD analysis V-Component of <em>Wind> [m/s of <em>Wind> [m/s] 018 250 mb VGRD analysis V-Component of <em>Wind> [m/s] 019 500 mb HGT analysis Geopotential Height [gpm] 020 500 mb UGRD analysis U-Component of <em>Wind> [m/s] 021 500 mb VGRD analysis V-Component of

Inventory of File sref_em.t03z.pgrb216.ctl.grib2

Science.gov Websites

UGRD analysis U-Component of <em>Wind> [m/s] 006 10 m above ground VGRD analysis V-Component of <em>Wind> [m/s of <em>Wind> [m/s] 018 250 mb VGRD analysis V-Component of <em>Wind> [m/s] 019 500 mb HGT analysis Geopotential Height [gpm] 020 500 mb UGRD analysis U-Component of <em>Wind> [m/s] 021 500 mb VGRD analysis V-Component of

Emergency Medical Services Utilization in EMS Priority Conditions in Beirut, Lebanon.

PubMed

El Sayed, Mazen; Tamim, Hani; Chehadeh, Ahel Al-Hajj; Kazzi, Amin A

2016-12-01

Early activation and use of Emergency Medical Services (EMS) are associated with improved patient outcomes in EMS priority conditions in developed EMS systems. This study describes patterns of EMS use and identifies predictors of EMS utilization in EMS priority conditions in Lebanon METHODS: This was a cross-sectional study of a random sample of adult patients presenting to the emergency department (ED) of a tertiary care center in Beirut with the following EMS priority conditions: chest pain, major trauma, respiratory distress, cardiac arrest, respiratory arrest, and airway obstruction. Patient/proxy survey (20 questions) and chart review were completed. The responses to survey questions were "disagree," "neutral," or "agree" and were scored as one, two, or three with three corresponding to higher likelihood of EMS use. A total scale score ranging from 20 to 60 was created and transformed from 0% to 100%. Data were analyzed based on mode of presentation (EMS vs other). Among the 481 patients enrolled, only 112 (23.3%) used EMS. Mean age for study population was 63.7 years (SD=18.8 years) with 56.5% males. Mean clinical severity score (Emergency Severity Index [ESI]) was 2.5 (SD=0.7) and mean pain score was 3.1 (SD=3.5) at ED presentation. Over one-half (58.8%) needed admission to hospital with 21.8% to an intensive care unit care level and with a mortality rate of 7.3%. Significant associations were found between EMS use and the following variables: severity of illness, degree of pain, familiarity with EMS activation, previous EMS use, perceived EMS benefit, availability of EMS services, trust in EMS response times and treatment, advice from family, and unavailability of immediate private mode of transport (P≤.05). Functional screening, or requiring full assistance (OR=4.77; 95% CI, 1.85-12.29); acute symptoms onset ≤ one hour (OR=2.14; 95% CI, 1.08-4.26); and higher scale scores (OR=2.99; 95% CI, 2.20-4.07) were significant predictors of EMS use. Patients

School Budget Hold'em Facilitator's Guide

ERIC Educational Resources Information Center

Education Resource Strategies, 2012

2012-01-01

"School Budget Hold'em" is a game designed to help school districts rethink their budgeting process. It evolved out of Education Resource Strategies' (ERS) experience working with large urban districts around the country. "School Budget Hold'em" offers a completely new approach--one that can turn the budgeting process into a long-term visioning…

Environmental Education and Development Division (EM-522). Annual report, Fiscal year 1993

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

Not Available

1993-12-31

The Environmental Education and Development Division (EM-522) is one of three divisions within the Office of Technology Integration and Environmental Education and Development (EM-52) in Environmental Restoration and Waste Management`s (EM`s) Office of Technology Development (EM-50). The primary design criterion for EM-522 education activities is directly related to meeting EM`s goal of environmental compliance on an accelerated basis and cleanup of the 1989 inventory of inactive sites and facilities by the year 2019. Therefore, EM-522`s efforts are directed specifically toward stimulating knowledge and capabilities to achieve the goals of EM while contributing to DOE`s overall goal of increasing scientific, mathematical,more » and technical literacy and competency. This report discusses fiscal year 1993 activities.« less

Assessment of Carotid Intima-Media Thickness as an Early Marker Of Vascular Damage In Hypertensive Children.

PubMed

Baroncini, Liz Andréa Villela; Sylvestre, Lucimary de Castro; Baroncini, Camila Varotto; Pecoits, Roberto

2017-05-01

The increased carotid intima-media thickness (CIMT) correlates with the presence of atherosclerosis in adults and describes vascular abnormalities in both hypertensive children and adolescents. To assess CIMT as an early marker of atherosclerosis and vascular damage in hypertensive children and adolescents compared with non-hypertensive controls and to evaluate the influence of gender, age, and body mass index (BMI) on CIMT on each group. Observational cohort study. A total of 133 hypertensive subjects (male, n = 69; mean age, 10.5 ± 4 years) underwent carotid ultrasound exam for assessment of CIMT. One hundred and twenty-one non-hypertensive subjects (male, n = 64; mean age, 9.8 ± 4.1 years) were selected as controls for gender, age (± 1 year), and BMI (± 10%). There were no significant difference regarding gender (p = 0.954) and age (p = 0.067) between groups. Hypertensive subjects had higher BMI when compared to control group (p = 0.004), although within the established range of 10%. Subjects in the hypertensive group had higher CIMT values when compared to control group (0.46 ± 0.05 versus 0.42 ± 0.05 mm, respectively, p < 0.001; one-way ANOVA). Carotid IMT values were not significantly influenced by gender, age, and BMI when analyzed in both groups separately (Student's t-test for independent samples). According to the adjusted determination coefficient (R²) only 11.7% of CIMT variations were accounted for by group variations, including age, gender, and BMI. Carotid intima-media thickness was higher in hypertensive children and adolescents when compared to the control group. The presence of hypertension increased CIMT regardless of age, gender, and BMI. O aumento da espessura médio-intimal carotídea (EMIC) correlaciona-se com a presença de aterosclerose em adultos e descreve anormalidades vasculares em crianças e adolescentes hipertensos. Avaliar a EMIC como marcador precoce de aterosclerose e dano vascular em crianças e adolescentes hipertensos em

Fatigue in children and adolescents with cancer from the perspective of health professionals.

PubMed

Silva, Michele Cristina Miyauti da; Lopes, Luís Carlos; Nascimento, Lucila Castanheira; Lima, Regina Aparecida Garcia de

2016-08-29

to investigate health professionals' knowledge about the concept, assessment and intervention in fatigue in children and adolescents with cancer. exploratory study with qualitative approach, with 53 health professionals (10 nurses, 33 assistant nurses, 3 physicians, 3 nutritionists, 2 psychologists and 2 physical therapists). Semi structured interviews were held, which were recorded and analyzed by means of inductive thematic content analysis. the data were organized around three themes: knowledge of health professionals about fatigue; identification of fatigue and interventions to relieve fatigue. the results indicate the health professionals' limited knowledge about fatigue, as well as the lack of investment in their training and continuing education. Most of all, the lack of research on the theme in the Brazilian context remains a barrier to support improvements in care for this symptom in children and adolescents with cancer. investigar quais conhecimentos os profissionais de saúde têm acerca do conhecimento, avaliação e intervenção sobre a fadiga em crianças e adolescentes com câncer. estudo exploratório com abordagem qualitativa, realizado com 53 profissionais de saúde (10 enfermeiros, 33 auxiliares de enfermagem, 3 médicos, 3 nutricionistas, 2 psicólogos e 2 fisioterapeutas). Foram conduzidas entrevistas semiestruturadas as quais foram gravadas e analisadas por meio do modelo de análise de conteúdo do tipo temática indutiva. os dados foram organizados ao redor de três temas: conhecimento dos profissionais da saúde sobre fadiga; identificação da fadiga e intervenções para o alívio da fadiga. os achados apontam para o conhecimento limitado dos profissionais de saúde sobre fadiga, bem como para o pouco investimento em educação continuada e permanente. Sobretudo, a escassez de estudos sobre o assunto no cenário brasileiro ainda é uma barreira para oferecer subsídios para melhoria deste sintoma em crianças e adolescentes com c

The EM Earthquake Precursor

NASA Astrophysics Data System (ADS)

Jones, K. B., II; Saxton, P. T.

2013-12-01

Many attempts have been made to determine a sound forecasting method regarding earthquakes and warn the public in turn. Presently, the animal kingdom leads the precursor list alluding to a transmission related source. By applying the animal-based model to an electromagnetic (EM) wave model, various hypotheses were formed, but the most interesting one required the use of a magnetometer with a differing design and geometry. To date, numerous, high-end magnetometers have been in use in close proximity to fault zones for potential earthquake forecasting; however, something is still amiss. The problem still resides with what exactly is forecastable and the investigating direction of EM. After the 1989 Loma Prieta Earthquake, American earthquake investigators predetermined magnetometer use and a minimum earthquake magnitude necessary for EM detection. This action was set in motion, due to the extensive damage incurred and public outrage concerning earthquake forecasting; however, the magnetometers employed, grounded or buried, are completely subject to static and electric fields and have yet to correlate to an identifiable precursor. Secondly, there is neither a networked array for finding any epicentral locations, nor have there been any attempts to find even one. This methodology needs dismissal, because it is overly complicated, subject to continuous change, and provides no response time. As for the minimum magnitude threshold, which was set at M5, this is simply higher than what modern technological advances have gained. Detection can now be achieved at approximately M1, which greatly improves forecasting chances. A propagating precursor has now been detected in both the field and laboratory. Field antenna testing conducted outside the NE Texas town of Timpson in February, 2013, detected three strong EM sources along with numerous weaker signals. The antenna had mobility, and observations were noted for recurrence, duration, and frequency response. Next, two

Diagnostic value of JC/BK virus antibody immunohistochemistry staining in urine samples from posttransplant immunosuppressed patients in relation to polyomavirus reactivation.

PubMed

Yuste, Rosario Sanchez; Frías, Carolina; López, Ana; Vallejo, Carlos; Martín, Paloma; Bellas, Carmen

2008-01-01

To compare the diagnostic value of cytology and immunohistochemistry staining (IHS) of urine samples for polyomavirus reactivation diagnosis. Sixty-eight urine samples collected from 18 immunosuppressed patients were analyzed by Papanicolaou and IHS with a JC/BK virus-specific monoclonal antibody. Overall, polyomavirus BK (BKV) was positive in 11 of 18 patients (61.1%) (3 of whom developed hemorrhagic cystitis) and in 23 of 68 urine samples (28%). Of 23 samples, 4 (17%) were positive by 1 of the 2 techniques, only. Of 23 samples, 19 (83%) were positive by both methods. In matching urine samples from the same patient, the number of BKV-infected positive cells detected by IHS in urine slides was higher than those detected by Papanicolaou staining (71.3%). The main advantage of LHS is that it allowed confirmation of BKV infection diagnosis in urine samples. IHS detected more BKV-infected cells in samples with few positive urothelial cells, which would have gone undetected if only Papanicolaou staining had been used as the BKV screening method. Urine samples testing for BKV by both techniques will improve diagnosis in asymptomatic patients, allowing early therapeutic intervention and a better clinical outcome.

E/M coding problems plague physicians, coders.

PubMed

King, Mitchell S; Lipsky, Martin S; Sharp, Lisa

2002-01-01

As the government turns its high beams on fraudulent billing, physician E/M coding is raising questions. With several studies spotlighting the difficulty physicians have in applying CPT E/M codes, the authors wanted to know if credentialed coders had the same problem. Here's what they found.

Application of the EM algorithm to radiographic images.

PubMed

Brailean, J C; Little, D; Giger, M L; Chen, C T; Sullivan, B J

1992-01-01

The expectation maximization (EM) algorithm has received considerable attention in the area of positron emitted tomography (PET) as a restoration and reconstruction technique. In this paper, the restoration capabilities of the EM algorithm when applied to radiographic images is investigated. This application does not involve reconstruction. The performance of the EM algorithm is quantitatively evaluated using a "perceived" signal-to-noise ratio (SNR) as the image quality metric. This perceived SNR is based on statistical decision theory and includes both the observer's visual response function and a noise component internal to the eye-brain system. For a variety of processing parameters, the relative SNR (ratio of the processed SNR to the original SNR) is calculated and used as a metric to compare quantitatively the effects of the EM algorithm with two other image enhancement techniques: global contrast enhancement (windowing) and unsharp mask filtering. The results suggest that the EM algorithm's performance is superior when compared to unsharp mask filtering and global contrast enhancement for radiographic images which contain objects smaller than 4 mm.

Feasibility for an EMS workforce safety and health surveillance system

DOT National Transportation Integrated Search

2007-05-01

Emergency Medical Services (EMS) personnel treat an estimated 22 million patients a year in the United States. Estimates have placed the EMS workforce at around 900,000 workers, but the precise number is unknown because EMS workers include career and...

EMS providers do not use FOAM for education.

PubMed

Bucher, Joshua; Donovan, Colleen; McCoy, Jonathan

2018-05-24

Free open access to medical education (FOAM, #FOAM) is the free availability of educational materials on various medicine topics. We hope to evaluate the use of social media and FOAM by emergency medical services (EMS) providers. We designed an online survey distributed to EMS providers with questions about demographics and social media/FOAM use by providers. The survey was sent to the American College of Emergency Physicians (ACEP) EMS Listserv of medical directors and was asked to be distributed to their respective agencies. The survey was designed to inquire about the providers' knowledge of FOAM and social media and their use of the above for EMS education. There were 169 respondents out of a total of 523 providers yielding a response rate of 32.3%. Fifty-three percent of respondents are paramedics, 37% are EMT-Basic trained, and the remainder (16%) were "other." The minority (20%) of respondents had heard of FOAM. However, 54% of respondents had heard of "free medical education online" regarding pertinent topics. Of the total respondents who used social media for education, 31% used Facebook and 23% used blogs and podcasts as resources for online education. Only 4% of respondents stated they produced FOAM content. Seventy-six percent of respondents said they were "interested" or "very interested" in using FOAM for medical education. If FOAM provided continuing medical education (CME), 83% of respondents would be interested in using it. Social media is not used frequently by EMS providers for the purposes of FOAM. There is interest within EMS providers to use FOAM for education, even if CME was not provided. FOAM can provide a novel area of education for EMS.

Emergency medical service (EMS): A unique flight environment

NASA Technical Reports Server (NTRS)

Shively, R. Jay

1993-01-01

The EMS flight environment is unique in today's aviation. The pilots must respond quickly to emergency events and often fly to landing zones where they have never been before . The time from initially receiving a call to being airborne can be as little as two to three minutes. Often the EMS pilot is the only aviation professional on site, they have no operations people or other pilots to aid them in making decisons. Further, since they are often flying to accident scenes, not airports, there is often complete weather and condition information. Therefore, the initial decision that the pilot must make, accepting or declining a flight, can become very difficult. The accident rate of EMS helicopters has been relatively high over the past years. NASA-Ames research center has taken several steps in an attempt to aid EMS pilots in their decision making and situational awareness. A preflight risk assessment system (SAFE) was developed to aid pilots in their decision making, and was tested at an EMS service. The resutls of the study were promising and a second version incorporating the lessons learned is under development. A second line of research was the development of a low cost electronic chart display (ECD). This is a digital map display to help pilots maintain geographical orientation. Another thrust was undertaken in conjunction with the Aviation Safety Reporting System (ASRS). This involved publicizing the ASRS to EMS pilots and personnel, and calling each of the reporters back to gather additional information. This paper will discuss these efforts and how they may positively impact the safety of EMS operations.

Recent developments in the CCP-EM software suite.

PubMed

Burnley, Tom; Palmer, Colin M; Winn, Martyn

2017-06-01

As part of its remit to provide computational support to the cryo-EM community, the Collaborative Computational Project for Electron cryo-Microscopy (CCP-EM) has produced a software framework which enables easy access to a range of programs and utilities. The resulting software suite incorporates contributions from different collaborators by encapsulating them in Python task wrappers, which are then made accessible via a user-friendly graphical user interface as well as a command-line interface suitable for scripting. The framework includes tools for project and data management. An overview of the design of the framework is given, together with a survey of the functionality at different levels. The current CCP-EM suite has particular strength in the building and refinement of atomic models into cryo-EM reconstructions, which is described in detail.

Recent developments in the CCP-EM software suite

PubMed Central

Burnley, Tom

2017-01-01

As part of its remit to provide computational support to the cryo-EM community, the Collaborative Computational Project for Electron cryo-Microscopy (CCP-EM) has produced a software framework which enables easy access to a range of programs and utilities. The resulting software suite incorporates contributions from different collaborators by encapsulating them in Python task wrappers, which are then made accessible via a user-friendly graphical user interface as well as a command-line interface suitable for scripting. The framework includes tools for project and data management. An overview of the design of the framework is given, together with a survey of the functionality at different levels. The current CCP-EM suite has particular strength in the building and refinement of atomic models into cryo-EM reconstructions, which is described in detail. PMID:28580908

How good can cryo-EM become?

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

Glaeser, Robert M.

The suddenness with which single-particle cryo-electron microscopy (cryo-EM) has emerged as a method for determining high-resolution structures of biological macromolecules invites the questions, how much better can this technology get, and how fast is that likely to happen? While we can rightly celebrate the maturation of cryo-EM as a high-resolution structure-determination tool, I believe there still are many developments to look forward to.

Short version of the Depression Anxiety Stress Scale-21: is it valid for Brazilian adolescents?

PubMed

Silva, Hítalo Andrade da; Passos, Muana Hiandra Pereira Dos; Oliveira, Valéria Mayaly Alves de; Palmeira, Aline Cabral; Pitangui, Ana Carolina Rodarti; Araújo, Rodrigo Cappato de

2016-01-01

To evaluate the interday reproducibility, agreement and validity of the construct of short version of the Depression Anxiety Stress Scale-21 applied to adolescents. The sample consisted of adolescents of both sexes, aged between 10 and 19 years, who were recruited from schools and sports centers. The validity of the construct was performed by exploratory factor analysis, and reliability was calculated for each construct using the intraclass correlation coefficient, standard error of measurement and the minimum detectable change. The factor analysis combining the items corresponding to anxiety and stress in a single factor, and depression in a second factor, showed a better match of all 21 items, with higher factor loadings in their respective constructs. The reproducibility values for depression were intraclass correlation coefficient with 0.86, standard error of measurement with 0.80, and minimum detectable change with 2.22; and, for anxiety/stress: intraclass correlation coefficient with 0.82, standard error of measurement with 1.80, and minimum detectable change with 4.99. The short version of the Depression Anxiety Stress Scale-21 showed excellent values of reliability, and strong internal consistency. The two-factor model with condensation of the constructs anxiety and stress in a single factor was the most acceptable for the adolescent population. Avaliar a reprodutibilidade interdias, a concordância e a validade do construto da versão reduzida da Depression Anxiety Stress Scale-21 aplicada a adolescentes. A amostra foi composta por adolescentes de ambos os sexos, com idades entre 10 e 19 anos, recrutados de escolas e centros esportivos. A validade de construto foi realizada por análise fatorial exploratória, e a confiabilidade foi calculada para cada construto, por meio de coeficiente de correlação intraclasse, erro padrão de medida e mudança mínima detectável. A análise fatorial combinando os itens correspondentes a ansiedade e estresse em um

Big data in cryoEM: automated collection, processing and accessibility of EM data.

PubMed

Baldwin, Philip R; Tan, Yong Zi; Eng, Edward T; Rice, William J; Noble, Alex J; Negro, Carl J; Cianfrocco, Michael A; Potter, Clinton S; Carragher, Bridget

2018-06-01

The scope and complexity of cryogenic electron microscopy (cryoEM) data has greatly increased, and will continue to do so, due to recent and ongoing technical breakthroughs that have led to much improved resolutions for macromolecular structures solved using this method. This big data explosion includes single particle data as well as tomographic tilt series, both generally acquired as direct detector movies of ∼10-100 frames per image or per tilt-series. We provide a brief survey of the developments leading to the current status, and describe existing cryoEM pipelines, with an emphasis on the scope of data acquisition, methods for automation, and use of cloud storage and computing. Copyright © 2017 Elsevier Ltd. All rights reserved.

ALiEM Blog and Podcast Watch: Toxicology.

PubMed

Zaver, Fareen; Craddick, Michael; Sanford, Audrey; Sefa, Nana; Hughes, George; Lin, Michelle

2017-10-01

The WestJEM Blog and Podcast Watch presents high-quality open-access educational blogs and podcasts in emergency medicine based on the ongoing Academic Life in Emergency Medicine (ALiEM) Approved Instructional Resources (AIR) and AIR-Professional (Pro) series. Both series critically appraise open-access educational blogs and podcasts in EM using an objective scoring instrument. This installment of the blog and podcast watch series curated and scored relevant posts in the specific topic of toxicology emergencies from the AIR-Pro Series. The AIR-Pro Series is a continuously building curriculum covering a new subject area every two months. For each area, eight EM chief residents identify 3-5 advanced clinical questions. Using FOAMsearch.net and FOAMSearcher to search blogs and podcasts, relevant posts are scored by eight reviewers from the AIR-Pro editorial board, which is comprised of EM faculty and chief residents at various institutions across North America. The scoring instrument contains five measurement outcomes based on seven-point Likert scales: recency, accuracy, educational utility, evidence based, and references. The AIR-Pro label is awarded to posts with a score of ≥28 (out of 35) points. An "honorable mention" label is awarded if board members collectively felt that the blogs were valuable and the scores were > 25. A total of 31 blog posts and podcasts were included. Key educational pearls from the six high-quality AIR-Pro posts and four honorable mentions are summarized. The WestJEM ALiEM Blog and Podcast Watch series is based on the AIR and AIR-Pro Series, which attempts to identify high-quality educational content on open-access blogs and podcasts. This series provides an expert-based, crowdsourced approach towards critically appraising educational social media content for EM clinicians. This installment focuses on toxicology emergencies.

ALiEM Blog and Podcast Watch: Toxicology

PubMed Central

Zaver, Fareen; Craddick, Michael; Sanford, Audrey; Sefa, Nana; Hughes, George; Lin, Michelle

2017-01-01

Introduction The WestJEM Blog and Podcast Watch presents high-quality open-access educational blogs and podcasts in emergency medicine based on the ongoing Academic Life in Emergency Medicine (ALiEM) Approved Instructional Resources (AIR) and AIR-Professional (Pro) series. Both series critically appraise open-access educational blogs and podcasts in EM using an objective scoring instrument. This installment of the blog and podcast watch series curated and scored relevant posts in the specific topic of toxicology emergencies from the AIR-Pro Series. Methods The AIR-Pro Series is a continuously building curriculum covering a new subject area every two months. For each area, eight EM chief residents identify 3–5 advanced clinical questions. Using FOAMsearch.net and FOAMSearcher to search blogs and podcasts, relevant posts are scored by eight reviewers from the AIR-Pro editorial board, which is comprised of EM faculty and chief residents at various institutions across North America. The scoring instrument contains five measurement outcomes based on seven-point Likert scales: recency, accuracy, educational utility, evidence based, and references. The AIR-Pro label is awarded to posts with a score of ≥28 (out of 35) points. An “honorable mention” label is awarded if board members collectively felt that the blogs were valuable and the scores were > 25. Results A total of 31 blog posts and podcasts were included. Key educational pearls from the six high-quality AIR-Pro posts and four honorable mentions are summarized. Conclusion The WestJEM ALiEM Blog and Podcast Watch series is based on the AIR and AIR-Pro Series, which attempts to identify high-quality educational content on open-access blogs and podcasts. This series provides an expert-based, crowdsourced approach towards critically appraising educational social media content for EM clinicians. This installment focuses on toxicology emergencies. PMID:29085545

EMS versus civilian transportation of severely injured patients

DOT National Transportation Integrated Search

1999-08-26

A previous report of 5782 trauma patients demonstrated higher mortality among those transported by EMS than among their non-EMS transported counterparts. This study was performed to test the hypothesis that the two groups differed in the injury-to-ho...

Trombo flutuante em veia femoral

PubMed Central

Bertanha, Matheus; Pimenta, Rafael Elias Farres; Brandão, Gustavo Muçouçah Sampaio; Sobreira, Marcone Lima; Moura, Regina; Jaldin, Rodrigo Gibin; de Camargo, Paula Angeleli Bueno; Yoshida, Winston Bonetti

2017-01-01

Resumo O trombo venoso flutuante em veia femoral é um tipo de trombo com alto potencial de embolização pulmonar. Entretanto, ainda é controversa a conduta mais apropriada nesses casos. Tratamentos clínicos com anticoagulantes ou fibrinolíticos e trombectomias abertas ou por meio de dispositivos endovasculares vêm sendo empregados ainda sem um critério de indicação bem definido. Apresentamos três casos clínicos de trombos flutuantes em veia femoral, de etiologias distintas, cujos tratamentos e respectivas evoluções serão discutidos. PMID:29930666

Inventory of File sref_em.t09z.pgrb212.ctl.grib2

Science.gov Websites

Temperature [K] 002 10 m above ground UGRD 3 hour fcst U-Component of <em>Wind> [m/s] 003 10 m above ground VGRD 3 hour fcst V-Component of <em>Wind> [m/s] 004 mean sea level PRMSL 3 hour fcst Pressure Reduced to MSL [Pa mb HGT 3 hour fcst Geopotential Height [gpm] 012 250 mb UGRD 3 hour fcst U-Component of <em>Wind> [m/s

Structural Composites With Tuned EM Chirality

DTIC Science & Technology

2014-12-23

photonic   crystals .   Tammuz  Dubnov  (7/14  –  9/14)  –  Laboratory  Assistant  -­‐  assisted in the testing...AFRL-OSR-VA-TR-2015-0018 STRUCTURAL COMPOSITES WITH TUNED EM CHIRALITY Siavouche Nemat Nasser UNIVERSITY OF CALIFORNIA SAN DIEGO Final Report 12/23...REPORT Grant/Contract  Title:        STRUCTURAL  COMPOSITES  WITH  TUNED  EM   CHIRALITY     Grant  No.:

Processing of Cryo-EM Movie Data.

PubMed

Ripstein, Z A; Rubinstein, J L

2016-01-01

Direct detector device (DDD) cameras dramatically enhance the capabilities of electron cryomicroscopy (cryo-EM) due to their improved detective quantum efficiency (DQE) relative to other detectors. DDDs use semiconductor technology that allows micrographs to be recorded as movies rather than integrated individual exposures. Movies from DDDs improve cryo-EM in another, more surprising, way. DDD movies revealed beam-induced specimen movement as a major source of image degradation and provide a way to partially correct the problem by aligning frames or regions of frames to account for this specimen movement. In this chapter, we use a self-consistent mathematical notation to explain, compare, and contrast several of the most popular existing algorithms for computationally correcting specimen movement in DDD movies. We conclude by discussing future developments in algorithms for processing DDD movies that would extend the capabilities of cryo-EM even further. © 2016 Elsevier Inc. All rights reserved.

Characterizing local EMS systems.

DOT National Transportation Integrated Search

2013-08-01

Emergency medical services (EMS) systems are configured differently depending on several factors, including the size, demographics, geography, and politics of the local communities they serve. Although some information exists about the organization, ...

Cervical and Breast Cancer Screening Among Mexican Migrant Women, 2013

PubMed Central

Guerrero, Natalie; Zhang, Xiao; Rangel, Gudelia; Gonzalez-Fagoaga, J. Eduardo

2016-01-01

Introduction Information on cervical and breast cancer screening among Latinas in the United States is limited. Even less information is available on screening practices of migrant women who engage in circular migration. We examined rates of cervical and breast cancer screening and the extent to which sociodemographics and other characteristics explain screening practices of Mexican migrant women who return to Mexico from the United States. Methods We used data from a cross-sectional probability survey of Mexico-born migrant women who returned, through Tijuana, to Mexico from the United States in 2013. The sample consisted of women who returned involuntarily (via deportation) or voluntarily; 177 reported authorized documentation status, and 36 reported unauthorized documentation status in the previous 12 months. Descriptive statistics were calculated and logistic regressions were estimated. Results Of 36 undocumented migrant women, 8 (22.2%) had a Papanicolaou test and 11 (30.6%) had a mammogram in the previous year; of 177 documented migrants, 83 (46.9%) had a Papanicolaou test and 68 (38.4%) had a mammogram. Undocumented migrants were less likely than documented migrants to receive a Papanicolaou test (odds ratio [OR] = 0.29; 95% confidence interval [CI], 0.12–0.67); the likelihood was similar after adjustment for sociodemographic, migration, and acculturation factors (adjusted OR = 0.33; 95% CI, 0.12–0.90). Having health insurance (adjusted OR = 4.17; 95% CI, 1.80–9.65) and a regular source of health care (adjusted OR = 2.83; 95% CI, 1.05–7.65) were significant predictors of receiving a mammogram but not a Papanicolaou test. Conclusion Public health programs are needed to improve access to cervical and breast cancer screenings for Latina migrant women in general and undocumented circular migrants in particular. PMID:27513995

Utilisation of cancer screening services by disabled women in Chile

PubMed Central

Rotarou, Elena S.

2017-01-01

Background Research has shown that women with disabilities face additional challenges in accessing and using healthcare services compared to non-disabled women. However, relatively little is known about the utilisation of cancer screening services for women with disabilities. This study addresses this gap by examining the utilisation of the Papanicolaou test and mammography for disabled women in Chile. Methods We used cross-sectional data, taken from a 2015 nationally-representative survey. Initially, we employed logistic regressions to test for differences in utilisation rates for the Papanicolaou test (66,281 observations) and the mammogram (35,294 observations) between disabled and non-disabled women. Next, logistic regressions were used to investigate the demographic, socioeconomic, and health-related factors affecting utilisation rates for cancer screening services for disabled women (sample sizes: 5,823 observations for the Papanicolaou test and 5,731 observations for the mammogram). Results Disabled women were less likely to undergo screening tests than non-disabled women. For the Papanicolaou test and mammography, the multivariable regression models showed that living in rural areas, having higher education, being affiliated with a private health insurance company, giving a good health self-assessment score, and being under medical treatment for other illnesses were associated with higher utilisation rates. On the other hand, being single, inactive with regard to employment, and having a better income were linked with lower utilisation. While utilisation rates for both disabled and non-disabled women have increased since 2006, the utilisation disparity has slightly increased. Conclusions This study shows the influence of various factors in the utilisation rates of preventive cancer screening services for disabled women. To develop effective initiatives targeting inequalities in the utilisation of cancer screening tests, it is important to move beyond an

Utilisation of cancer screening services by disabled women in Chile.

PubMed

Sakellariou, Dikaios; Rotarou, Elena S

2017-01-01

Research has shown that women with disabilities face additional challenges in accessing and using healthcare services compared to non-disabled women. However, relatively little is known about the utilisation of cancer screening services for women with disabilities. This study addresses this gap by examining the utilisation of the Papanicolaou test and mammography for disabled women in Chile. We used cross-sectional data, taken from a 2015 nationally-representative survey. Initially, we employed logistic regressions to test for differences in utilisation rates for the Papanicolaou test (66,281 observations) and the mammogram (35,294 observations) between disabled and non-disabled women. Next, logistic regressions were used to investigate the demographic, socioeconomic, and health-related factors affecting utilisation rates for cancer screening services for disabled women (sample sizes: 5,823 observations for the Papanicolaou test and 5,731 observations for the mammogram). Disabled women were less likely to undergo screening tests than non-disabled women. For the Papanicolaou test and mammography, the multivariable regression models showed that living in rural areas, having higher education, being affiliated with a private health insurance company, giving a good health self-assessment score, and being under medical treatment for other illnesses were associated with higher utilisation rates. On the other hand, being single, inactive with regard to employment, and having a better income were linked with lower utilisation. While utilisation rates for both disabled and non-disabled women have increased since 2006, the utilisation disparity has slightly increased. This study shows the influence of various factors in the utilisation rates of preventive cancer screening services for disabled women. To develop effective initiatives targeting inequalities in the utilisation of cancer screening tests, it is important to move beyond an exclusively single-disease approach and

Cervical and Breast Cancer Screening Among Mexican Migrant Women, 2013.

PubMed

Guerrero, Natalie; Zhang, Xiao; Rangel, Gudelia; Gonzalez-Fagoaga, J Eduardo; Martinez-Donate, Ana

2016-08-11

Information on cervical and breast cancer screening among Latinas in the United States is limited. Even less information is available on screening practices of migrant women who engage in circular migration. We examined rates of cervical and breast cancer screening and the extent to which sociodemographics and other characteristics explain screening practices of Mexican migrant women who return to Mexico from the United States. We used data from a cross-sectional probability survey of Mexico-born migrant women who returned, through Tijuana, to Mexico from the United States in 2013. The sample consisted of women who returned involuntarily (via deportation) or voluntarily; 177 reported authorized documentation status, and 36 reported unauthorized documentation status in the previous 12 months. Descriptive statistics were calculated and logistic regressions were estimated. Of 36 undocumented migrant women, 8 (22.2%) had a Papanicolaou test and 11 (30.6%) had a mammogram in the previous year; of 177 documented migrants, 83 (46.9%) had a Papanicolaou test and 68 (38.4%) had a mammogram. Undocumented migrants were less likely than documented migrants to receive a Papanicolaou test (odds ratio [OR] = 0.29; 95% confidence interval [CI], 0.12-0.67); the likelihood was similar after adjustment for sociodemographic, migration, and acculturation factors (adjusted OR = 0.33; 95% CI, 0.12-0.90). Having health insurance (adjusted OR = 4.17; 95% CI, 1.80-9.65) and a regular source of health care (adjusted OR = 2.83; 95% CI, 1.05-7.65) were significant predictors of receiving a mammogram but not a Papanicolaou test. Public health programs are needed to improve access to cervical and breast cancer screenings for Latina migrant women in general and undocumented circular migrants in particular.

Medical Oversight, Educational Core Content, and Proposed Scopes of Practice of Wilderness EMS Providers: A Joint Project Developed by Wilderness EMS Educators, Medical Directors, and Regulators Using a Delphi Approach.

PubMed

Millin, Michael G; Johnson, David E; Schimelpfenig, Tod; Conover, Keith; Sholl, Matthew; Busko, Jonnathan; Alter, Rachael; Smith, Will; Symonds, Jennifer; Taillac, Peter; Hawkins, Seth C

2017-01-01

A disparity exists between the skills needed to manage patients in wilderness EMS environments and the scopes of practice that are traditionally approved by state EMS regulators. In response, the National Association of EMS Physicians Wilderness EMS Committee led a project to define the educational core content supporting scopes of practice of wilderness EMS providers and the conditions when wilderness EMS providers should be required to have medical oversight. Using a Delphi process, a group of experts in wilderness EMS, representing educators, medical directors, and regulators, developed model educational core content. This core content is a foundation for wilderness EMS provider scopes of practice and builds on both the National EMS Education Standards and the National EMS Scope of Practice Model. These experts also identified the conditions when oversight is needed for wilderness EMS providers. By consensus, this group of experts identified the educational core content for four unique levels of wilderness EMS providers: Wilderness Emergency Medical Responder (WEMR), Wilderness Emergency Medical Technician (WEMT), Wilderness Advanced Emergency Medical Technician (WAEMT), and Wilderness Paramedic (WParamedic). These levels include specialized skills and techniques pertinent to the operational environment. The skills and techniques increase in complexity with more advanced certification levels, and address the unique circumstances of providing care to patients in the wilderness environment. Furthermore, this group identified that providers having a defined duty to act should be functioning with medical oversight. This group of experts defined the educational core content supporting the specific scopes of practice that each certification level of wilderness EMS provider should have when providing patient care in the wilderness setting. Wilderness EMS providers are, indeed, providing health care and should thus function within defined scopes of practice and with

Model-based local density sharpening of cryo-EM maps

PubMed Central

Jakobi, Arjen J; Wilmanns, Matthias

2017-01-01

Atomic models based on high-resolution density maps are the ultimate result of the cryo-EM structure determination process. Here, we introduce a general procedure for local sharpening of cryo-EM density maps based on prior knowledge of an atomic reference structure. The procedure optimizes contrast of cryo-EM densities by amplitude scaling against the radially averaged local falloff estimated from a windowed reference model. By testing the procedure using six cryo-EM structures of TRPV1, β-galactosidase, γ-secretase, ribosome-EF-Tu complex, 20S proteasome and RNA polymerase III, we illustrate how local sharpening can increase interpretability of density maps in particular in cases of resolution variation and facilitates model building and atomic model refinement. PMID:29058676

High school allied health students and their exposure to the profession of EMS.

PubMed

Holloman, Joshua B; Hubble, Michael W

2012-06-01

Ensuring a stable Emergency Medical Services (EMS) workforce is a growing concern, and effective recruiting strategies are needed to expose young adults to the EMS profession. The objective of this study was to assess the exposure of high school allied health students to EMS as a career option, as well as measure their attitudes and beliefs about the EMS profession. Hypothesis Few high school allied health students are exposed to EMS educational and career opportunities. A convenience sample of allied health students in a rural high school system was surveyed about exposure to EMS, career intentions, factors impacting career decisions, and attitudes and beliefs about EMS. Descriptive statistics were calculated, and intention to pursue an EMS career was modeled using logistic regression. Of 171 students enrolled in allied health courses across six high schools, 135 (78.9%) agreed to participate; 85.2% were female. Almost all (92.6%) respondents intended to pursue a health career, but only 43.0% reported that their allied health course exposed them to EMS as a profession. Few participants (37.7%) were knowledgeable about EMS associate degree or baccalaureate degree (27.4%) programs. Only 20.7% of the respondents intended to pursue EMS as a career, although 46.0% wanted to learn more about the profession. Most (68.2%) students expressed interest in an emergency medical technician (EMT) course if one were offered, and 80.0% were interested in a ride-along program. Independent predictors of pursuing an EMS career included exposure to EMS outside of high school (OR = 7.4, 95% CI = 1.7-30.4); media influence on career choice (OR = 9.6, 95% CI = 1.8-50.1); and the belief that EMS was mentally challenging (OR = 15.9, 95% CI = 1.1-216.6). Negative predictors included the beliefs that an EMS career was stimulating (OR = 0.05, 95% CI = 0.00-0.53) and physically challenging (OR = 0.06, 95% CI = 0.00-0.63); as well as prior exposure to an EMS job advertisement (OR = 0.14, 0

The HOME Team: Evaluating the Effect of an EMS-based Outreach Team to Decrease the Frequency of 911 Use Among High Utilizers of EMS.

PubMed

Tangherlini, Niels; Villar, Julian; Brown, John; Rodriguez, Robert M; Yeh, Clement; Friedman, Benjamin T; Wada, Paul

2016-12-01

The San Francisco Fire Department's (SFFD; San Francisco, California USA) Homeless Outreach and Medical Emergency (HOME) Team is the United States' first Emergency Medical Services (EMS)-based outreach effort using a specially trained paramedic to redirect frequent users of EMS to other types of services. The effectiveness of this program at reducing repeat use of emergency services during the first seven months of the team's existence was examined. A retrospective analysis of EMS use frequency and demographic characteristics of frequent users was conducted. Clients that used emergency services at least four times per month from March 2004 through May 2005 were contacted for intervention. Patterns for each frequent user before and after intervention were analyzed. Changes in EMS use during the 15-month study interval was the primary outcome measurement. A total of 59 clients were included. The target population had a median age of 55.1 years and was 68% male. Additionally, 38.0% of the target population was homeless, 43.4% had no primary care, 88.9% had a substance abuse disorder at time of contact, and 83.0% had a history of psychiatric disorder. The HOME Team undertook 320 distinct contacts with 65 frequent users during the study period. The average EMS use prior to HOME Team contact was 18.72 responses per month (SD=19.40), and after the first contact with the HOME Team, use dropped to 8.61 (SD=10.84), P<.001. Frequent users of EMS suffer from disproportionate comorbidities, particularly substance abuse and psychiatric disorders. This population responds well to the intervention of a specially trained paramedic as measured by EMS usage. Tangherlini N , Villar J , Brown J , Rodriguez RM , Yeh C , Friedman BT , Wada P . The HOME Team: evaluating the effect of an EMS-based outreach team to decrease the frequency of 911 use among high utilizers of EMS. Prehosp Disaster Med. 2016;31(6):603-607.

EMS technology assessment template

DOT National Transportation Integrated Search

2008-01-01

This technology assessment template is designed to evaluate information technology and EMS devices that provide data about patients, evaluation-oriented clinical patient information, or decision support tools. The template may also be used by consume...

A HF EM installation allowing simultaneous whole body and deep local EM hyperthermia.

PubMed

Mazokhin, V N; Kolmakov, D N; Lucheyov, N A; Gelvich, E A; Troshin, I I

1999-01-01

The structure and main features of a HF EM installation based upon a new approach for creating electromagnetic fields destined for whole body (WBH) and deep local (DLH) hyperthermia are discussed. The HF EM field, at a frequency of 13.56 MHz, is created by a coplanar capacity type applicator positioned under a distilled water filled bolus that the patient is lying on. The EM energy being released directly in the deep tissues ensures effective whole body heating to required therapeutic temperatures of up to 43.5 degrees C, whereas the skin temperature can be maintained as low as 39-40.5 degrees C. For DLH, the installation is equipped with additional applicators and a generator operating at a frequency of 40.68 MHz. High efficiency of the WBH applicator makes it possible to carry out the WBH procedure without any air-conditioning cabin. Due to this, a free access to the patient's body during the WBH treatment is provided and a simultaneous WBH/DLH or WBH/LH procedure by means of additional applicators is possible. Controllable power output in the range of 100-800 W at a frequency of 13.56 MHz and 50-350 W at a frequency of 40.68 MHz allows accurate temperature control during WBH, DLH and WBH/DLH procedures. SAR patterns created by the WBH and DLH applicators in a liquid muscle phantom and measured by means of a non-perturbing E-dipole are investigated. The scattered EM field strength measured in the vicinity of the operating installation during the WBH, DLH and WBH/DLH procedures does not exceed security standards. Examples of temperature versus time graphs in the course of WBH, DLH and WBH/DLH procedures in clinics are presented. The installation is successfully used in leading oncological institutions of Russia and Belarus, though combined WBH/DLH procedures are evidently more complicated and demand thorough planning and temperature measurements to avoid overheating.

What variables affect public perceptions for EMS meeting general community needs?

PubMed

Blau, Gary; Hochner, Arthur; Portwood, James

2012-01-01

In the fall, 2010, a phone survey of 928 respondents examined two research questions: does the general public perceive Emergency Medical Services (EMS) as meeting their community needs? And what factors or correlates help to explain EMS meeting community needs? To maximize geographical representation across the contiguous United States, a clustered stratified sampling strategy was used based upon zip codes across the 48 states. Results showed strong support by the sample for perceiving that EMS was meeting their general community needs. 17 percent of the variance in EMS meeting community needs was collectively explained by the demographic and perceptual variables in the regression model. Of the correlates tested, the strongest relationship was found between greater admiration for EMS professionals and higher perception of EMS meeting community needs. Study limitations included sampling households with only landline (no cell) phones, using a simulated emergency situation, and not collecting gender data.

Correlates of suicidality in firefighter/EMS personnel.

PubMed

Martin, Colleen E; Tran, Jana K; Buser, Sam J

2017-01-15

Firefighter and Emergency Medical Services (EMS) personnel experience higher rates of lifetime suicidal ideation and attempts than the general population and other protective service professions. Several correlates of suicidality (alcohol use, depression, posttraumatic stress) have been identified in the literature as applicable to firefighter/EMS populations; however, few studies to date have examined the specific correlates of suicidality (lifetime suicidal ideation and/or attempts) in a firefighter/EMS sample. Participants (N=3036) from a large, urban fire department completed demographic and self-report measures of alcohol dependence, depression, posttraumatic stress disorder (PTSD) symptom severity, and lifetime suicidal ideation and attempts. Participants in this sample performed both firefighter and EMS duties, were predominately male (97%), White (61.6%), and 25-34 years old (32.1%). Through hierarchical linear regressions, depression (β=.22, p<.05) and PTSD symptom severity (β=.21, p<.05) were significantly associated with lifetime suicidal ideation (R 2 =17.5). Depression (β=.15, p<.001), and PTSD symptom severity (β=.07, p<.01) were significantly associated with lifetime suicide attempts (R 2 =5.1). Several limitations are addressed in the current study. The survey was a self-report pre-existing dataset and lifetime suicidal ideation and attempts were measured using sum scores. Additionally, the disproportionately large sample of males and large, urban setting, may not generalize to female firefighters and members of rural community fire departments. The current study highlights the importance of targeting depression and PTSD symptom severity in efforts to reduce suicidality in firefighter/EMS personnel. Published by Elsevier B.V.

Integrating Green Purchasing Into Your Environmental Management System (EMS)

EPA Pesticide Factsheets

The goal of this report is to help Federal facilities integrate green purchasing into their EMS. The intended audience includes those tasked with implementing an EMS, reducing environmental impacts, meeting green purchasing requirements.

Cervical screening and general physical examination behaviors of women exposed in utero to diethylstilbestrol.

PubMed

Camp, Elizabeth A; Coker, Ann L; Troisi, Rebecca; Robboy, Stanley J; Noller, Kenneth L; Goodman, Karen J; Titus-Ernstoff, Linda T; Hatch, Elizabeth E; Herbst, Arthur L; Kaufman, Raymond H; Adam, Ervin

2008-04-01

To estimate whether women exposed in utero to diethylstilbestrol (DES) report receiving more cervical and general physical examinations compared to unexposed women. 1994 Diethylstilbestrol Adenosis cohort data are used to assess the degree of recommended compliance of cervical screenings found in 3,140 DES-exposed and 826 unexposed women. Participants were enrolled at 4 sites: Houston, Boston, Rochester, and Los Angeles. Logistic regression modeling was used to analyze mailed questionnaire data, which included reported frequency over the preceding 5 years (1990-1994) of Papanicolaou smears and general physical examinations. Diethylstilbestrol-exposed women exceeded the recommended frequency of Papanicolaou smear screenings [adjusted odds ratio (aOR) = 2.15, 95% CI (confidence interval) = 1.60-2.88] compared to the unexposed. This association held among those without a history of cervical intraepithelial neoplasia (aOR = 1.88, 95% CI = 1.35-2.62). Diethylstilbestrol-exposed women exceeded annual recommendations for physical examinations (aOR = 2.27, 95% CI = 1.16-4.43) among women without a history of chronic disease when compared to unexposed women. Most DES-exposed women are receiving cervical cancer screening at least at recommended intervals, but one third of the women are not receiving annual Papanicolaou smear examinations.

7 CFR 1945.35 - Special EM loan training.

Code of Federal Regulations, 2012 CFR

2012-01-01

... workshop and a test. (c) Objective. The basic objective of this training program is to keep State and... 7 Agriculture 13 2012-01-01 2012-01-01 false Special EM loan training. 1945.35 Section 1945.35...) PROGRAM REGULATIONS (CONTINUED) EMERGENCY Disaster Assistance-General § 1945.35 Special EM loan training...

7 CFR 1945.35 - Special EM loan training.

Code of Federal Regulations, 2011 CFR

2011-01-01

... workshop and a test. (c) Objective. The basic objective of this training program is to keep State and... 7 Agriculture 13 2011-01-01 2009-01-01 true Special EM loan training. 1945.35 Section 1945.35...) PROGRAM REGULATIONS (CONTINUED) EMERGENCY Disaster Assistance-General § 1945.35 Special EM loan training...

Alternatives to Traditional EMS Dispatch and Transport: A Scoping Review of Reported Outcomes.

PubMed

Jensen, Jan L; Carter, Alix J E; Rose, Jennifer; Visintini, Sarah; Bourdon, Emmanuelle; Brown, Ryan; McVey, Jennifer; Travers, Andrew H

2015-09-01

Emergency medical services (EMS) programs, which provide an alternative to traditional EMS dispatch or transport to the emergency department (ED), are becoming widely implemented. This scoping review identified and catalogued all outcomes used to measure such alternative EMS programs. Data Source Broad systematized bibliographic and grey literature searches were conducted. Study Selection Inclusion criteria were 911 callers/EMS patients, reported on alternatives to traditional EMS dispatch OR traditional EMS transport to the ED, and reported an outcome measure. Data Extraction The reports were categorized as either alternative to dispatch or to EMS transport, and outcome measures were categorized and described. Data Synthesis The bibliographic search retrieved 13,215 records, of which 34 articles met the inclusion criteria, with an additional 10 added from reference list hand-searching (n=44 included). In the grey literature search, 31 websites were identified, from which four met criteria and were retrieved (n=4 included). Fifteen reports (16 studies) described alternatives to EMS dispatch, and 33 reports described alternatives to EMS transport. The most common outcomes reported in the alternatives to EMS dispatch reports were service utilization and decision accuracy. Twenty-four different specific outcomes were reported. The most common outcomes reported in the alternatives to EMS transport reports were service utilization and safety, and 50 different specific outcomes were reported. Numerous outcome measures were identified in reports of alternative EMS programs, which were catalogued and described. Researchers and program leaders should achieve consensus on uniform outcome measures, to allow benchmarking and improve comparison across programs.

International Space Station (ISS) Emergency Mask (EM) Development

NASA Technical Reports Server (NTRS)

Toon, Katherine P.; Hahn, Jeffrey; Fowler, Michael; Young, Kevin

2011-01-01

The Emergency Mask (EM) is considered a secondary response emergency Personal Protective Equipment (PPE) designed to provide respiratory protection to the International Space Station (ISS) crewmembers in response to a post-fire event or ammonia leak. The EM is planned to be delivered to ISS in 2012 to replace the current air purifying respirator (APR) onboard ISS called the Ammonia Respirator (AR). The EM is a one ]size ]fits ]all model designed to fit any size crewmember, unlike the APR on ISS, and uses either two Fire Cartridges (FCs) or two Commercial Off-the-Shelf (COTS) 3M(Trademark). Ammonia Cartridges (ACs) to provide the crew with a minimum of 8 hours of respiratory protection with appropriate cartridge swap ]out. The EM is designed for a single exposure event, for either post ]fire or ammonia, and is a passive device that cannot help crewmembers who cannot breathe on their own. The EM fs primary and only seal is around the wearer fs neck to prevent a crewmember from inhaling contaminants. During the development of the ISS Emergency Mask, several design challenges were faced that focused around manufacturing a leak free mask. The description of those challenges are broadly discussed but focuses on one key design challenge area: bonding EPDM gasket material to Gore(Registered Trademark) fabric hood.

Two fluorescent wavelengths, 440(ex)/520(em) nm and 370(ex)/440(em) nm, reflect advanced glycation and oxidation end products in human skin without diabetes.

PubMed

Beisswenger, Paul J; Howell, Scott; Mackenzie, Todd; Corstjens, Hugo; Muizzuddin, Neelam; Matsui, Mary S

2012-03-01

Advanced glycation end products (AGEs) and oxidation products (OPs) play an important role in diabetes complications, aging, and damage from sun exposure. Measurement of skin autofluorescence (SAF) has been promoted as a noninvasive technique to measure skin AGEs, but the actual products quantified are uncertain. We have compared specific SAF measurements with analytically determined AGEs and oxidative biomarkers in skin collagen and determined if these measurements can be correlated with chronological aging and actinic exposure. SAF at four excitation (ex)/emission (em) intensities was measured on the upper inner arm ("sun protected") and dorsal forearm ("sun exposed") in 40 subjects without diabetes 20-60 years old. Skin collagen from the same sites was analyzed by liquid chromatography-tandem mass spectrometry for three AGEs-pentosidine, carboxymethyllysine (CML), and carboxyethyllysine (CEL)-and the OP methionine sulfoxide (MetSO). There was poor correlation of AGE-associated fluorescence spectra with AGEs and OP in collagen, with only pentosidine correlating with fluorescence at 370(ex)/440(em) nm. A little-studied SAF (440(ex)/520(em) nm), possibly reflecting elastin cross-links, correlated with all AGEs and OPs. Levels of CML, pentosidine, and MetSO, but not SAF, were significantly higher in sun-exposed skin. These AGEs and OPs, as well as SAF at 370(ex)/440(em) nm and 440(ex)/520(em) nm, increased with chronological aging. SAF measurements at 370(ex)/440(em) nm and 335(ex)/385(em) nm, except for pentosidine, which correlated with fluorescence at 370(ex)/440(em), correlate poorly with glycated and oxidatively modified protein in human skin and do not reflect actinic modification. A new fluorescence measurement (440(ex)/520(em) nm) appears to reflect AGEs and OPs in skin.

Organization of professional practices against intrafamily violence against children and adolescents in the institutional context.

PubMed

Schek, Gabriele; Silva, Mara Regina Santos da; Lacharité, Carl; Bueno, Maria Emília Nunes

2017-06-05

to analyze based on the practitioners' discourse, the way they organize their practices confronting situations of intra-family violence against children and adolescents. qualitative research carried out with 15 professionals who work in social and health services located in the southernmost of Brazil. Data were collected through semi-structured interviews, performed at the participants' workplace. We used a theoretical matrix to analyze the data, based on Institutional Ethnography and the technique of discursive textual analysis. the practitioners' practices developed in situations of intra-family violence against children and adolescents are organized on the basis of: power relations that take place in services that respond to violence situations; routines instituted to meet the demands of care in services; and the interplay between the conception of violence as a public health problem and the conception of violence as a social problem. the way these practices are organized is reflected in actions that are not protective against situations of intra-family violence against children and adolescents. analisar, com base no discurso dos profissionais, como ocorre a organização de suas práticas frente às situações de violência intrafamiliar contra crianças e adolescentes. pesquisa qualitativa, realizada com 15 profissionais que atuam em serviços sociais e de saúde localizados no extremo sul do Brasil. Os dados foram coletados por meio de entrevistas semiestruturadas, realizadas no próprio local de trabalho dos participantes. Para a análise dos dados foi construída uma matriz teórica com base na Etnografia Institucional e utilizada a técnica de análise textual discursiva. as práticas profissionais desenvolvidas nas situações de violência intrafamiliar contra crianças e adolescentes se organizam a partir de: relações de poder que se desenrolam nos serviços que atendem às situações de violência; rotinas instituídas para suprir as demandas de

Degradation of benzodiazepines after 120 days of EMS deployment.

PubMed

McMullan, Jason T; Jones, Elizabeth; Barnhart, Bruce; Denninghoff, Kurt; Spaite, Daniel; Zaleski, Erin; Silbergleit, Robert

2014-01-01

EMS treatment of status epilepticus improves outcomes, but the benzodiazepine best suited for EMS use is unclear, given potential high environmental temperature exposures. To describe the degradation of diazepam, lorazepam, and midazolam as a function of temperature exposure and time over 120 days of storage on active EMS units. Study boxes containing vials of diazepam, lorazepam, and midazolam were distributed to 4 active EMS units in each of 2 EMS systems in the southwestern United States during May-August 2011. The boxes logged temperature every minute and were stored in EMS units per local agency policy. Two vials of each drug were removed from each box at 30-day intervals and underwent high-performance liquid chromatography to determine drug concentration. Concentration was analyzed as mean (and 95%CI) percent of initial labeled concentration as a function of time and mean kinetic temperature (MKT). 192 samples were collected (2 samples of each drug from each of 4 units per city at 4 time-points). After 120 days, the mean relative concentration (95%CI) of diazepam was 97.0% (95.7-98.2%) and of midazolam was 99.0% (97.7-100.2%). Lorazepam experienced modest degradation by 60 days (95.6% [91.6-99.5%]) and substantial degradation at 90 days (90.3% [85.2-95.4%]) and 120 days (86.5% [80.7-92.3%]). Mean MKT was 31.6°C (95%CI 27.1-36.1). Increasing MKT was associated with greater degradation of lorazepam, but not midazolam or diazepam. Midazolam and diazepam experienced minimal degradation throughout 120 days of EMS deployment in high-heat environments. Lorazepam experienced significant degradation over 120 days and appeared especially sensitive to higher MKT exposure.

10 CFR Appendixes E-M to Part 52 - [Reserved

Code of Federal Regulations, 2010 CFR

2010-01-01

... 10 Energy 2 2010-01-01 2010-01-01 false [Reserved] E Appendixes E-M to Part 52 Energy NUCLEAR REGULATORY COMMISSION (CONTINUED) LICENSES, CERTIFICATIONS, AND APPROVALS FOR NUCLEAR POWER PLANTS Appendixes E-M to Part 52 [Reserved] ...

10 CFR Appendixes E-M to Part 52 - [Reserved

Code of Federal Regulations, 2011 CFR

2011-01-01

... 10 Energy 2 2011-01-01 2011-01-01 false [Reserved] E Appendixes E-M to Part 52 Energy NUCLEAR REGULATORY COMMISSION (CONTINUED) LICENSES, CERTIFICATIONS, AND APPROVALS FOR NUCLEAR POWER PLANTS Appendixes E-M to Part 52 [Reserved] ...

Analysis of the electrochemistry of hemes with Ems spanning 800 mV

PubMed Central

Zheng, Zhong; Gunner, M. R.

2009-01-01

The free energy of heme reduction in different proteins is found to vary over more than 18 kcal/mol. It is a challenge to determine how proteins manage to achieve this enormous range of Ems with a single type of redox cofactor. Proteins containing 141 unique hemes of a-, b-, and c-type, with bis-His, His-Met, and aquo-His ligation were calculated using Multi-Conformation Continuum Electrostatics (MCCE). The experimental Ems range over 800 mV from −350 mV in cytochrome c3 to 450 mV in cytochrome c peroxidase (vs. SHE). The quantitative analysis of the factors that modulate heme electrochemistry includes the interactions of the heme with its ligands, the solvent, the protein backbone, and sidechains. MCCE calculated Ems are in good agreement with measured values. Using no free parameters the slope of the line comparing calculated and experimental Ems is 0.73 (R2 = 0.90), showing the method accounts for 73% of the observed Em range. Adding a +160 mV correction to the His-Met c-type hemes yields a slope of 0.97 (R2 = 0.93). With the correction 65% of the hemes have an absolute error smaller than 60 mV and 92% are within 120 mV. The overview of heme proteins with known structures and Ems shows both the lowest and highest potential hemes are c-type, whereas the b-type hemes are found in the middle Em range. In solution, bis-His ligation lowers the Em by ≈205 mV relative to hemes with His-Met ligands. The bis-His, aquo-His, and His-Met ligated b-type hemes all cluster about Ems which are ≈200 mV more positive in protein than in water. In contrast, the low potential bis-His c-type hemes are shifted little from in solution, whereas the high potential His-Met c-type hemes are raised by ≈300 mV from solution. The analysis shows that no single type of interaction can be identified as the most important in setting heme electrochemistry in proteins. For example, the loss of solvation (reaction field) energy, which raises the Em, has been suggested to be a major factor in

Inventory of File sref_em.t03z.pgrb132.p1.f06.grib2

Science.gov Websites

6 hour fcst <em>Soil> Temperature Validation to deprecate [K] 402 0-0.1 m below ground SOILW 6 hour fcst Volumetric <em>Soil> Moisture Content [Fraction] 403 0.1-0.4 m below ground TSOIL 6 hour fcst <em>Soil> Temperature Validation to deprecate [K] 404 0.1-0.4 m below ground SOILW 6 hour fcst Volumetric <em>Soil> Moisture Content

Time of Day and Day of Week Trends in EMS Demand.

PubMed

Cantwell, Kate; Morgans, Amee; Smith, Karen; Livingston, Michael; Spelman, Tim; Dietze, Paul

2015-01-01

We examined temporal variations in overall Emergency Medical Services (EMS) demand, as well as medical and trauma cases separately. We analyzed cases according to time of day and day of week to determine whether population level demand demonstrates temporal patterns that will increase baseline knowledge for EMS planning. We conducted a secondary analysis of data from the Ambulance Victoria data warehouse covering the period 2008-2011. We included all cases of EMS attendance which resulted in 1,203,803 cases for review. Data elements comprised age, gender, date and time of call to the EMS emergency number along with the clinical condition of the patient. We employed Poisson regression to analyze case numbers and trigonometric regression to quantify distribution patterns. EMS demand exhibited a bimodal distribution with the highest peak at 10:00 and a second smaller peak at 19:00. The highest number of cases occurred on Fridays, and the lowest on Tuesdays and Wednesdays. However, the distribution of cases throughout the day differed by day of week. Distribution patterns on Fridays, Saturdays and Sundays differed significantly from the rest of the week (p < 0.001). When categorized into medical or trauma cases, medical cases were more frequent during working hours and involved patients of higher mean age (57 years vs. 49 years for trauma, p < 0.001). Trauma cases peaked on Friday and Saturday nights around midnight. Day of week EMS demand distribution patterns reveal differences that can be masked in aggregate data. Day of week EMS demand distribution patterns showed not only which days have differences in demand but the times of day at which the demand changes. Patterns differed by case type as well. These differences in distribution are important for EMS demand planning. Increased understanding of EMS demand patterns is imperative in a climate of ever-increasing demand and fiscal constraints. Further research is needed into the effect of age and case type on EMS

Inventory of File sref_em.t03z.pgrb212.p1.f00.grib2

Science.gov Websites

Relative Humidity [%] 014.1 10 m above ground UGRD analysis U-Component of <em>Wind> [m/s] 014.2 10 m above ground VGRD analysis V-Component of <em>Wind> [m/s] 015 surface WEASD analysis Water Equivalent of Accumulated <em>Wind> [m/s] 032.2 30-0 mb above ground VGRD analysis V-Component of <em>Wind> [m/s] 033 30-0 mb above ground

Inventory of File sref_em.t03z.pgrb221.p1.f00.grib2

Science.gov Websites

Relative Humidity [%] 014.1 10 m above ground UGRD analysis U-Component of <em>Wind> [m/s] 014.2 10 m above ground VGRD analysis V-Component of <em>Wind> [m/s] 015 surface WEASD analysis Water Equivalent of Accumulated <em>Wind> [m/s] 032.2 30-0 mb above ground VGRD analysis V-Component of <em>Wind> [m/s] 033 30-0 mb above ground

Cryo-EM visualization of the protein machine that replicates the chromosome

NASA Astrophysics Data System (ADS)

Li, Huilin

Structural knowledge is key to understanding biological functions. Cryo-EM is a physical method that uses transmission electron microscopy to visualize biological molecules that are frozen in vitreous ice. Due to recent advances in direct electron detector and image processing algorithm, cryo-EM has become a high-resolution technique. Cryo-EM field is undergoing a rapid expansion and vast majority research institutions and research universities around the world are setting up cryo-EM research. Indeed, the method is revolutionizing structural and molecular biology. We have been using cryo-EM to study the structure and mechanism of eukaryotic chromosome replication. Despite an abundance of cartoon drawings found in review articles and biology textbooks, the structure of the eukaryotic helicase that unwinds the double stranded DNA has been unknown. It has also been unknown how the helicase works with DNA polymerases to accomplish the feat of duplicating the genome. In my presentation, I will show how we have used cryo-EM to derive at structures of the eukaryotic chromosome replication machinery and describe mechanistic insights we have gleaned from the structures.

Urban versus rural lifestyle in adolescents: associations between environment, physical activity levels and sedentary behavior.

PubMed

Regis, Manuela Ferreira; Oliveira, Luciano Machado Ferreira Tenório de; Santos, Ana Raquel Mendes Dos; Leonidio, Ameliane da Conceição Reubens; Diniz, Paula Rejane Beserra; Freitas, Clara Maria Silvestre Monteiro de

2016-01-01

To analyze the levels of physical activity and sedentary behavior in adolescents living in urban and rural areas. An epidemiological, cross-section study with quantitative design, carried out at the regional level. The sample comprised 6,234 students aged 14 to 19 years, selected using random cluster sampling. The χ2 test and binary logistic regression were used in the analysis. A total of 74.5% of adolescents lived in urban areas. After adjustment, rural residents spent less time watching television (odds ratio - OR: 0.45; 95% confidence interval - 95%CI: 0.39-0.52), using a computer and/or playing video games (OR: 0.30; 95%CI: 0.22-0.42), or sitting down (OR: 0.66; 95%CI: 0.54-0.80); chose passive leisure less often (OR: 0.83; 95%IC: 0.72-0.95) and were less likely to be classified as insufficiently active (OR: 0.88; 95%IC: 0.78-0.99) when compared to urban residents, regardless of sex or age. The fact that adolescents living in rural areas who did not work were more likely to be classified as insufficiently active (OR: 2.59; 95%CI: 2.07-3.24) emphasized the significant role of occupation in physical activity levels in this group. Adolescents living in rural areas were less exposed to the sedentary behaviors, chose more active leisure, and had higher levels of physical activity. Place of residence and occupation may play a major role in youth lifestyle. Analisar os níveis de atividade física e o comportamento sedentário em adolescentes das áreas urbanas e rurais. Estudo epidemiológico, transversal, com abordagem quantitativa e abrangência estadual, cuja amostra foi constituída por 6.234 estudantes (14 a 19 anos), selecionados por meio de uma estratégia de amostragem aleatória de conglomerados. As análises foram realizadas por meio do teste χ2 e da regressão logística binária. Na amostra, 74,5% dos adolescentes eram residentes em área urbana. Após o ajuste, constatou-se que os adolescentes oriundos da área rural usavam menos televisão (odds

PEG Enhancement for EM1 and EM2+ Missions

NASA Technical Reports Server (NTRS)

Von der Porten, Paul; Ahmad, Naeem; Hawkins, Matt

2018-01-01

NASA is currently building the Space Launch System (SLS) Block-1 launch vehicle for the Exploration Mission 1 (EM-1) test flight. The next evolution of SLS, the Block-1B Exploration Mission 2 (EM-2), is currently being designed. The Block-1 and Block-1B vehicles will use the Powered Explicit Guidance (PEG) algorithm. Due to the relatively low thrust-to-weight ratio of the Exploration Upper Stage (EUS), certain enhancements to the Block-1 PEG algorithm are needed to perform Block-1B missions. In order to accommodate mission design for EM-2 and beyond, PEG has been significantly improved since its use on the Space Shuttle program. The current version of PEG has the ability to switch to different targets during Core Stage (CS) or EUS flight, and can automatically reconfigure for a single Engine Out (EO) scenario, loss of communication with the Launch Abort System (LAS), and Inertial Navigation System (INS) failure. The Thrust Factor (TF) algorithm uses measured state information in addition to a priori parameters, providing PEG with an improved estimate of propulsion information. This provides robustness against unknown or undetected engine failures. A loft parameter input allows LAS jettison while maximizing payload mass. The current PEG algorithm is now able to handle various classes of missions with burn arcs much longer than were seen in the shuttle program. These missions include targeting a circular LEO orbit with a low-thrust, long-burn-duration upper stage, targeting a highly eccentric Trans-Lunar Injection (TLI) orbit, targeting a disposal orbit using the low-thrust Reaction Control System (RCS), and targeting a hyperbolic orbit. This paper will describe the design and implementation of the TF algorithm, the strategy to handle EO in various flight regimes, algorithms to cover off-nominal conditions, and other enhancements to the Block-1 PEG algorithm. This paper illustrates challenges posed by the Block-1B vehicle, and results show that the improved PEG

SubspaceEM: A Fast Maximum-a-posteriori Algorithm for Cryo-EM Single Particle Reconstruction

PubMed Central

Dvornek, Nicha C.; Sigworth, Fred J.; Tagare, Hemant D.

2015-01-01

Single particle reconstruction methods based on the maximum-likelihood principle and the expectation-maximization (E–M) algorithm are popular because of their ability to produce high resolution structures. However, these algorithms are computationally very expensive, requiring a network of computational servers. To overcome this computational bottleneck, we propose a new mathematical framework for accelerating maximum-likelihood reconstructions. The speedup is by orders of magnitude and the proposed algorithm produces similar quality reconstructions compared to the standard maximum-likelihood formulation. Our approach uses subspace approximations of the cryo-electron microscopy (cryo-EM) data and projection images, greatly reducing the number of image transformations and comparisons that are computed. Experiments using simulated and actual cryo-EM data show that speedup in overall execution time compared to traditional maximum-likelihood reconstruction reaches factors of over 300. PMID:25839831

Teenage pregnancies in Mozambique: the experience of "Servicios Amigos dos Adolescentes" clinics in Beira.

PubMed

Pizzol, Damiano; Di Gennaro, Francesco; Boscardin, Chiara; Putoto, Giovanni; Cuppini, Elena; Pita, Graciana; George, Alexandra; Monno, Laura; Saracino, Annalisa; Da Dalt, Liviana; De Palma, Angela

2018-03-01

The purpose of this article is to provide insights into the demand for pregnancy-related health services by adolescent girls and young women in Mozambique. We analysed the patient registers for the first year of operation (2014) of the Servicios Amigos dos Adolescentes (SAAJ) [Friendly Services for Adolescents] clinics in Beira, Mozambique. These registers provide details of the service demands of, and services provided to the 8 290 adolescent girls and young women who accessed the 6 SAAJ clinics in 2014. Analysis of that record, with disaggregation of the patients according to age (9 years or less; 10-14; 15-19; 20-24; 25 and older), show that 3 021 (36%) were pregnant or had previously been pregnant; most being girls in the 15-19 age band (59%). Being pregnant or having been pregnant previously was associated with dropping out of school. Of all the girls and women, 60% agreed to HIV testing and counselling; the HIV prevalence rate amongst this group was 4-5% amongst adolescents and 25% amongst women 25 years and older. A minority of the girls and women who were pregnant or had been pregnant previously agreed to HIV testing and counselling. Notwithstanding the limitations for analysis, the results were alarming: substantially high HIV prevalence rates were indicated (2% amongst 10-14 year old girls; 8% amongst 15-19 year olds; 10% amongst 20-24 year olds; and 28% amongst >24 year olds). The data from the SAAJ clinics and results pertain only to conditions in Beira. However, as the first empirical assessment of pregnancy-related service demand amongst adolescent girls and young women in the country and involving a relatively large sample, we contend that this study affirms the need for expansion of sexual and reproductive health (SRH) services, including HIV services, for adolescent girls and young women in Mozambique.

Pre-flight risk assessment in Emergency Medical Service (EMS) helicopters

NASA Technical Reports Server (NTRS)

Shively, R. J.

1992-01-01

The Emergency Medical Service (EMS) industry has been the subject of several television and newspaper articles (Harvey and Jensen, 1987) which emphasized the negative aspects, (e.g., fatalities and high accident rates), rather than the life saving services performed. Until recently, the accident rate of the EMS industry has been five times as high as that of other civil helicopters. This high accident rate has been coupled with the dramatic rise in the number of programs. The industry has built from a single service at its inception in 1972, to over 180 in 1987 (Spray, 1987), to the point that 93 percent of the contiguous U.S. is now covered by some type of EMS service. These factors prompted the National Transportation Safety Board (NTSB) to study the accidents that occurred between May 11, 1978 and December 3, 1986 (NTSB, 1988). The NTSB report concluded that 'Sound pilot judgment is central to safe flight operations.' They further stated that '... factors unique to EMS helicopter operations--such as the influence of the mission itself, program competition, and EMS program management perspectives--can drastically influence pilot judgment during the EMS mission.' One of the most difficult decisions that a pilot must make is whether to accept or decline a mission. A pre-flight risk assessment system (SAFE) was developed at NASA-Ames Research Center for civil EMS operations to aid pilots in making this decision objectively. The ability of the SAFE system to predict mission risk profiles was tested at an EMS facility. The results of this field study demonstrated that the usefulness of SAFE was highly dependent on the type of mission flown. SAFE is now being modified so that it can 'learn' with each mission flown. For example, after flying a mission to a particular site, an EMS pilot would input information about this mission into the system, such as new buildings, wires, or approach procedures. Then, the next time a pilot flew a similar mission or one to the same

EMS Provider Assessment of Vehicle Damage Compared to a Professional Crash Reconstructionist

PubMed Central

Lerner, E. Brooke; Cushman, Jeremy T.; Blatt, Alan; Lawrence, Richard; Shah, Manish N.; Swor, Robert; Brasel, Karen; Jurkovich, Gregory J.

2011-01-01

Objective To determine the accuracy of EMS provider assessments of motor vehicle damage, when compared to measurements made by a professional crash reconstructionist. Methods EMS providers caring for adult patients injured during a motor vehicle crash and transported to the regional trauma center in a midsized community were interviewed upon ED arrival. The interview collected provider estimates of crash mechanism of injury. For crashes that met a preset severity threshold, the vehicle’s owner was asked to consent to having a crash reconstructionist assess their vehicle. The assessment included measuring intrusion and external auto deformity. Vehicle damage was used to calculate change in velocity. Paired t-test and correlation were used to compare EMS estimates and investigator derived values. Results 91 vehicles were enrolled; of these 58 were inspected and 33 were excluded because the vehicle was not accessible. 6 vehicles had multiple patients. Therefore, a total of 68 EMS estimates were compared to the inspection findings. Patients were 46% male, 28% admitted to hospital, and 1% died. Mean EMS estimated deformity was 18” and mean measured was 14”. Mean EMS estimated intrusion was 5” and mean measured was 4”. EMS providers and the reconstructionist had 67% agreement for determination of external auto deformity (kappa 0.26), and 88% agreement for determination of intrusion (kappa 0.27) when the 1999 Field Triage Decision Scheme Criteria were applied. Mean EMS estimated speed prior to the crash was 48 mph±13 and mean reconstructionist estimated change in velocity was 18 mph±12 (correlation -0.45). EMS determined that 19 vehicles had rolled over while the investigator identified 18 (kappa 0.96). In 55 cases EMS and the investigator agreed on seatbelt use, for the remaining 13 cases there was disagreement (5) or the investigator was unable to make a determination (8) (kappa 0.40). Conclusions This study found that EMS providers are good at estimating

Comments on theoretical foundation of "EM Drive"

NASA Astrophysics Data System (ADS)

Wu, C.-W.

2018-03-01

The concept of EM Drive has attracted much attention and groups of work have been conducted to prove or verify it, of which the published experimental outcome is criticized in great details while the theoretical foundation has not been discussed. The present essay investigates on the theoretical derivations of the net thrust in the "EM drive" and reveals the self-contradiction arising at the very start, when the law of conservation of momentum was utilized and opposed simultaneously.

Image segmentation by EM-based adaptive pulse coupled neural networks in brain magnetic resonance imaging.

PubMed

Fu, J C; Chen, C C; Chai, J W; Wong, S T C; Li, I C

2010-06-01

We propose an automatic hybrid image segmentation model that integrates the statistical expectation maximization (EM) model and the spatial pulse coupled neural network (PCNN) for brain magnetic resonance imaging (MRI) segmentation. In addition, an adaptive mechanism is developed to fine tune the PCNN parameters. The EM model serves two functions: evaluation of the PCNN image segmentation and adaptive adjustment of the PCNN parameters for optimal segmentation. To evaluate the performance of the adaptive EM-PCNN, we use it to segment MR brain image into gray matter (GM), white matter (WM) and cerebrospinal fluid (CSF). The performance of the adaptive EM-PCNN is compared with that of the non-adaptive EM-PCNN, EM, and Bias Corrected Fuzzy C-Means (BCFCM) algorithms. The result is four sets of boundaries for the GM and the brain parenchyma (GM+WM), the two regions of most interest in medical research and clinical applications. Each set of boundaries is compared with the golden standard to evaluate the segmentation performance. The adaptive EM-PCNN significantly outperforms the non-adaptive EM-PCNN, EM, and BCFCM algorithms in gray mater segmentation. In brain parenchyma segmentation, the adaptive EM-PCNN significantly outperforms the BCFCM only. However, the adaptive EM-PCNN is better than the non-adaptive EM-PCNN and EM on average. We conclude that of the three approaches, the adaptive EM-PCNN yields the best results for gray matter and brain parenchyma segmentation. Copyright 2009 Elsevier Ltd. All rights reserved.

EMS Providers and Exception From Informed Consent Research: Benefits, Ethics, and Community Consultation

PubMed Central

Ripley, Elizabeth; Ramsey, Cornelia; Prorock-Ernest, Amy; Foco, Rebecca; Luckett, Solomon; Ornato, Joseph P.

2013-01-01

As attention to, and motivation for, EMS-related research continues to grow, particularly exception from informed consent (EFIC) research, it is important to understand the thoughts, beliefs, and experiences of EMS providers who are actively engaged in the research. Study Objective We explored the attitudes, beliefs, and experiences of EMS providers regarding their involvement in prehospital emergency research, particularly EFIC research. Method Using a qualitative design, 24 participants were interviewed including Nationally Registered Paramedics and Virginia certified Emergency Medical Technicians employed at Richmond Ambulance Authority, the participating EMS agency. At the time of our interviews, the EMS agency was involved in an exception from informed consent trial. Transcribed interview data were coded and analyzed for themes. Findings were presented back to the EMS agency for validation. Results Overall, there appeared to be support for prehospital emergency research. Participants viewed research as necessary for the advancement of the field of EMS. Improvement in patient care was identified as one of the most important benefits. A number of ethical considerations were identified: individual risk versus public good and consent. EMS providers in our study were open to working with EMS researchers throughout the community consultation and public disclosure process. Conclusions EMS providers in our study value research and are willing to participate in studies. Support for research was balanced with concerns and challenges regarding the role of providers in the research process. PMID:22823963

Knowledge of adolescents regarding sexually transmitted infections and pregnancy.

PubMed

Almeida, Rebeca Aranha Arrais Santos; Corrêa, Rita da Graça Carvalhal Frazão; Rolim, Isaura Letícia Tavares Palmeira; Hora, Jessica Marques da; Linard, Andrea Gomes; Coutinho, Nair Portela Silva; Oliveira, Priscila da Silva

2017-01-01

To investigate the knowledge of adolescents related to sexually transmitted infections (STIs), AIDS, and pregnancy, and understand the role of school in sex education. A qualitative descriptive study, developed through a semi-structured interview and a form for participant characterization, with 22 high school students from a public school aged 16 to 19 years. Data were submitted to content analysis. After analysis, four thematic categories were developed: sexuality and sex education; understanding of risk behaviors; knowledge of STI/AIDS; and knowledge of and practices for prevention. This study showed the need for preventive educational actions for adolescents, because the lack of information contributes to their vulnerability. The adolescents recognize the importance of sex education; therefore it is important to implement strategies to promote and protect health in the school environment to encourage and strengthen self-care in health. investigar o conhecimento de adolescentes relacionado às Infecções Sexualmente Transmissíveis (IST), AIDS e gravidez, além de conhecer a compreensão sobre o papel da escola na educação sexual. estudo qualitativo, descritivo, desenvolvido por meio de entrevista semiestruturada e formulário para caracterização dos participantes, com 22 adolescentes entre 16 e 19 anos de idade, estudantes do Ensino Médio em uma escola pública. Os dados foram submetidos à análise de conteúdo. da análise emergiram quatro categorias temáticas: Sexualidade e educação sexual; Compreensão de comportamentos de risco; Conhecimento de IST/AIDS; Conhecimento e práticas de prevenção. revelou-se a necessidade de ações educativas de prevenção para os adolescentes, pois a falta de informações contribui para a sua vulnerabilidade. Os adolescentes reconhecem a importância da educação sexual; consequentemente, é importante a implementação de estratégias de promoção e de proteção à saúde no ambiente escolar para contribuir e

Composting of rice straw with effective microorganisms (EM) and its influence on compost quality

PubMed Central

2013-01-01

This study aims to assess the effect of EM application on the composting process of rice straw with goat manure and green waste and to evaluate the quality of both compost treatments. There are two treatment piles in this study, in which one pile was applied with EM and another pile without EM. Each treatment was replicated three times with 90 days of composting duration. The parameters for the temperature, pH, TOC and C/N ratio, show that decomposition of organic matter occurs during the 90-day period. The t-test conducted shows that there is a significant difference between compost with EM and compost without EM. The application of EM in compost increases the macro and micronutrient content. The following parameters support this conclusion: compost applied with EM has more N, P and K content (P < 0.05) compared to compost without EM. Although the Fe in compost with EM is much higher (P < 0.05) than in the compost without EM, for Zn and Cu, there is no significant difference between treatments. This study suggests that the application of EM is suitable to increase the mineralization in the composting process. The final resultant compost indicated that it was in the range of the matured level and can be used without any restriction. PMID:23390930

Composting of rice straw with effective microorganisms (EM) and its influence on compost quality.

PubMed

Jusoh, Mohd Lokman Che; Manaf, Latifah Abd; Latiff, Puziah Abdul

2013-02-07

This study aims to assess the effect of EM application on the composting process of rice straw with goat manure and green waste and to evaluate the quality of both compost treatments. There are two treatment piles in this study, in which one pile was applied with EM and another pile without EM. Each treatment was replicated three times with 90 days of composting duration. The parameters for the temperature, pH, TOC and C/N ratio, show that decomposition of organic matter occurs during the 90-day period. The t-test conducted shows that there is a significant difference between compost with EM and compost without EM. The application of EM in compost increases the macro and micronutrient content. The following parameters support this conclusion: compost applied with EM has more N, P and K content (P < 0.05) compared to compost without EM. Although the Fe in compost with EM is much higher (P < 0.05) than in the compost without EM, for Zn and Cu, there is no significant difference between treatments. This study suggests that the application of EM is suitable to increase the mineralization in the composting process. The final resultant compost indicated that it was in the range of the matured level and can be used without any restriction.

Multifunction waveform generator for EM receiver testing

NASA Astrophysics Data System (ADS)

Chen, Kai; Jin, Sheng; Deng, Ming

2018-01-01

In many electromagnetic (EM) methods - such as magnetotelluric, spectral-induced polarization (SIP), time-domain-induced polarization (TDIP), and controlled-source audio magnetotelluric (CSAMT) methods - it is important to evaluate and test the EM receivers during their development stage. To assess the performance of the developed EM receivers, controlled synthetic data that simulate the observed signals in different modes are required. In CSAMT and SIP mode testing, the waveform generator should use the GPS time as the reference for repeating schedule. Based on our testing, the frequency range, frequency precision, and time synchronization of the currently available function waveform generators on the market are deficient. This paper presents a multifunction waveform generator with three waveforms: (1) a wideband, low-noise electromagnetic field signal to be used for magnetotelluric, audio-magnetotelluric, and long-period magnetotelluric studies; (2) a repeating frequency sweep square waveform for CSAMT and SIP studies; and (3) a positive-zero-negative-zero signal that contains primary and secondary fields for TDIP studies. In this paper, we provide the principles of the above three waveforms along with a hardware design for the generator. Furthermore, testing of the EM receiver was conducted with the waveform generator, and the results of the experiment were compared with those calculated from the simulation and theory in the frequency band of interest.

2-D modelling and simulation of EM brake for liquid steel

NASA Astrophysics Data System (ADS)

Aslan, Necdet; Senturk, Kenan; Tessarotto, Massimo

2003-11-01

The problem of EM control of bottom tapping in steelmaking metallurgy is an old and well known challenge not only from the technological viewpoint but also, potentially, an interesting and still open theoretical problem, from the viewpoint of the investigation of the detailed MHD phenomena occurring in EM braking devices [1]. Purpose of the present work is the formulation of a 2-D MHD model for a DC EM braking device, which includes the consistent modelization of inductive EM fields produced by the conductive fluid, large scale turbulence, boundary conditions for the EM fields and thermal effects. The mathematical model has been implemented in a new 2-D MHD code developed for this purpose [2], based on the so-called fluctuation splitting and dual-time stepping methods, respectively, to advance in time the fluid fields and satisfy the relevant incompressibility-solenoidality conditions for the fluid mass velocity and the magnetic field. Main goal of the investigation is the analysis of the nonlinear phenomena occurring in the process of slowing down of a column of liquid steel under the action of the EM brake, and in particular the detailed description of the effects of large scale turbulence produced by the action of Lorentz force on the fluid, their influence on the magnitude of the inductive EM fields and the performance of the EM brake itself. REFERENCES [1] A.Codutti, A.Martinis, M.Pavlicevic, M.Tessarotto and D.Batic, Proc. 3rd International Symposium on EMP (Nagoya, Japan, April 2000), p.530 (2000). [2] N.Aslan, K.Senturk and M.Tessarotto, Efficient 2-D solver for incompressible magnefluids, communication at this Conference (2003).

Functionalized anatomical models for EM-neuron Interaction modeling

NASA Astrophysics Data System (ADS)

Neufeld, Esra; Cassará, Antonino Mario; Montanaro, Hazael; Kuster, Niels; Kainz, Wolfgang

2016-06-01

The understanding of interactions between electromagnetic (EM) fields and nerves are crucial in contexts ranging from therapeutic neurostimulation to low frequency EM exposure safety. To properly consider the impact of in vivo induced field inhomogeneity on non-linear neuronal dynamics, coupled EM-neuronal dynamics modeling is required. For that purpose, novel functionalized computable human phantoms have been developed. Their implementation and the systematic verification of the integrated anisotropic quasi-static EM solver and neuronal dynamics modeling functionality, based on the method of manufactured solutions and numerical reference data, is described. Electric and magnetic stimulation of the ulnar and sciatic nerve were modeled to help understanding a range of controversial issues related to the magnitude and optimal determination of strength-duration (SD) time constants. The results indicate the importance of considering the stimulation-specific inhomogeneous field distributions (especially at tissue interfaces), realistic models of non-linear neuronal dynamics, very short pulses, and suitable SD extrapolation models. These results and the functionalized computable phantom will influence and support the development of safe and effective neuroprosthetic devices and novel electroceuticals. Furthermore they will assist the evaluation of existing low frequency exposure standards for the entire population under all exposure conditions.

Improving rural emergency medical services (EMS) through transportation system enhancements.

DOT National Transportation Integrated Search

2014-05-01

Improved emergency medical services (EMS) will impact traffic safety and public health in rural : communities. Better planned, designed, and operated roadway networks that connect hospitals with : communities in need will enhance EMS performance. To ...

A Generalized Fast Frequency Sweep Algorithm for Coupled Circuit-EM Simulations

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

Rockway, J D; Champagne, N J; Sharpe, R M

2004-01-14

Frequency domain techniques are popular for analyzing electromagnetics (EM) and coupled circuit-EM problems. These techniques, such as the method of moments (MoM) and the finite element method (FEM), are used to determine the response of the EM portion of the problem at a single frequency. Since only one frequency is solved at a time, it may take a long time to calculate the parameters for wideband devices. In this paper, a fast frequency sweep based on the Asymptotic Wave Expansion (AWE) method is developed and applied to generalized mixed circuit-EM problems. The AWE method, which was originally developed for lumped-loadmore » circuit simulations, has recently been shown to be effective at quasi-static and low frequency full-wave simulations. Here it is applied to a full-wave MoM solver, capable of solving for metals, dielectrics, and coupled circuit-EM problems.« less

Comparative Analysis of Fusion Center Outreach to Fire and EMS Agencies

DTIC Science & Technology

2015-12-01

ANALYSIS OF FUSION CENTER OUTREACH TO FIRE AND EMS AGENCIES by Scott E. Goldstein December 2015 Thesis Advisor: Fathali Moghaddam Second...REPORT TYPE AND DATES COVERED Master’s thesis 4. TITLE AND SUBTITLE COMPARATIVE ANALYSIS OF FUSION CENTER OUTREACH TO FIRE AND EMS AGENCIES 5...public release; distribution is unlimited 12b. DISTRIBUTION CODE A 13. ABSTRACT (maximum 200 words) Fire and EMS responders have had little

Man-Portable Simultaneous Magnetometer and EM System (MSEMS)

DTIC Science & Technology

2008-12-01

expensive fluxgate magnetometers . This is because the interleaving hardware is expecting a Larmor signal as input; it performs period counting of the...Larmor signal between EM61 pulses to convert the frequency-based Larmor signal into nanotesla. A fluxgate magnetometer does not employ the resonance...FINAL REPORT Man-Portable Simultaneous Magnetometer and EM System (MSEMS) ESTCP Project MM-0414 December 2008 Robert Siegel Science

Methodology for the development of a Canadian national EMS research agenda

PubMed Central

2011-01-01

Background Many health care disciplines use evidence-based decision making to improve patient care and system performance. While the amount and quality of emergency medical services (EMS) research in Canada has increased over the past two decades, there has not been a unified national plan to enable research, ensure efficient use of research resources, guide funding decisions and build capacity in EMS research. Other countries have used research agendas to identify barriers and opportunities in EMS research and define national research priorities. The objective of this project is to develop a national EMS research agenda for Canada that will: 1) explore what barriers to EMS research currently exist, 2) identify current strengths and opportunities that may be of benefit to advancing EMS research, 3) make recommendations to overcome barriers and capitalize on opportunities, and 4) identify national EMS research priorities. Methods/Design Paramedics, educators, EMS managers, medical directors, researchers and other key stakeholders from across Canada will be purposefully recruited to participate in this mixed methods study, which consists of three phases: 1) qualitative interviews with a selection of the study participants, who will be asked about their experience and opinions about the four study objectives, 2) a facilitated roundtable discussion, in which all participants will explore and discuss the study objectives, and 3) an online Delphi consensus survey, in which all participants will be asked to score the importance of each topic discovered during the interviews and roundtable as they relate to the study objectives. Results will be analyzed to determine the level of consensus achieved for each topic. Discussion A mixed methods approach will be used to address the four study objectives. We anticipate that the keys to success will be: 1) ensuring a representative sample of EMS stakeholders, 2) fostering an open and collaborative roundtable discussion, and 3

Prevalência de tromboembolismo pulmonar incidental em pacientes oncológicos: análise retrospectiva em grande centro

PubMed Central

Carneiro, Renata Mota; van Bellen, Bonno; Santana, Pablo Rydz Pinheiro; Gomes, Antônio Carlos Portugal

2017-01-01

Resumo Contexto Devido à maior aplicação de exames de imagem rotineiros, especialmente nos pacientes com neoplasia para controle da doença, vem aumentando o diagnóstico de tromboembolismo pulmonar (TEP) incidental, importante fator de morbimortalidade associado. Objetivo Identificar os casos de TEP incidental em pacientes oncológicos submetidos a tomografia computadorizada (TC) de tórax, correlacionando aspectos clínicos e fatores de risco associados. Métodos Estudo retrospectivo de todos os episódios de TEP ocorridos de janeiro de 2013 a junho de 2016, com seleção dos pacientes oncológicos e divisão deles em dois grupos: com suspeita clínica e sem suspeita clínica (incidentais) de embolia pulmonar. Resultados Foram avaliados 468 pacientes com TEP no período citado. Destes, 23,1% eram oncológicos, entre os quais 44,4% apresentaram achado incidental de embolia pulmonar na TC de tórax. Não houve diferença estatística entre os grupos para sexo, idade e tabagismo. Quanto à procedência, 58,3% dos pacientes sem suspeita clínica eram de origem ambulatorial e 41,7% com suspeita de TEP vinham do pronto-socorro (p < 0,001). As neoplasias mais prevalentes foram de pulmão (17,6%), intestino (15,7%) e mama (13,0%). Aqueles com achado incidental apresentaram significativamente mais metástases, sem diferença entre os grupos para realização de quimioterapia, radioterapia ou cirurgia recente. Quanto aos sintomas apresentados, 41,9% daqueles sem suspeita clínica tinham queixas sugestivas de TEP quando realizaram o exame. Conclusão TEP incidental é frequente em pacientes oncológicos, especialmente naqueles provenientes de seguimento ambulatorial e em estágios avançados da doença. Sintomas sugestivos de TEP estavam presentes em pacientes sem suspeita clínica ao realizarem a TC de tórax. PMID:29930652

The US DOE EM international program

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

Elmetti, Rosa R.; Han, Ana M.; Roach, Jay A.

2013-07-01

The U.S. Department of Energy (DOE) Office of Environmental Management (EM) conducts international collaboration activities in support of U.S. policies and objectives regarding the accelerated risk reduction and remediation of environmental legacy of the nations' nuclear weapons program and government sponsored nuclear energy research. The EM International Program supported out of the EM Office of the Associate Principal Deputy Assistant Secretary pursues collaborations with foreign government organizations, educational institutions and private industry to assist in identifying technologies and promote international collaborations that leverage resources and link international experience and expertise. In fiscal year (FY) 2012, the International Program awarded eightmore » international collaborative projects for work scope spanning waste processing, groundwater and soil remediation, deactivation and decommissioning (D and D) and nuclear materials disposition initiatives to seven foreign organizations. Additionally, the International Program's scope and collaboration opportunities were expanded to include technical as well as non-technical areas. This paper will present an overview of the on-going tasks awarded in FY 2012 and an update of upcoming international activities and opportunities for expansion into the remainder of FY 2013 and beyond. (authors)« less

EMS workforce for the 21st century : a national assessment

DOT National Transportation Integrated Search

2008-06-01

Emergency medical technicians (EMTs) and paramedics are a critical component of any communitys Emergency Medical Services (EMS) system. Assuring the continued viability of the prehospital EMS workforce is a key concern for many local, State, Feder...

7 CFR 759.6 - EM to be made available.

Code of Federal Regulations, 2014 CFR

2014-01-01

... natural disaster has occurred in a county, resulting in severe physical losses. If the FSA Administrator determines that such a natural disaster has occurred, then EM can be made available to eligible farmers for... AGRICULTURE SPECIAL PROGRAMS DISASTER DESIGNATIONS AND NOTIFICATIONS § 759.6 EM to be made available. (a) For...

7 CFR 759.6 - EM to be made available.

Code of Federal Regulations, 2013 CFR

2013-01-01

... natural disaster has occurred in a county, resulting in severe physical losses. If the FSA Administrator determines that such a natural disaster has occurred, then EM can be made available to eligible farmers for... AGRICULTURE SPECIAL PROGRAMS DISASTER DESIGNATIONS AND NOTIFICATIONS § 759.6 EM to be made available. (a) For...

Economic evaluation of DNA ploidy analysis vs liquid-based cytology for cervical screening.

PubMed

Nghiem, V T; Davies, K R; Beck, J R; Follen, M; MacAulay, C; Guillaud, M; Cantor, S B

2015-06-09

DNA ploidy analysis involves automated quantification of chromosomal aneuploidy, a potential marker of progression toward cervical carcinoma. We evaluated the cost-effectiveness of this method for cervical screening, comparing five ploidy strategies (using different numbers of aneuploid cells as cut points) with liquid-based Papanicolaou smear and no screening. A state-transition Markov model simulated the natural history of HPV infection and possible progression into cervical neoplasia in a cohort of 12-year-old females. The analysis evaluated cost in 2012 US$ and effectiveness in quality-adjusted life-years (QALYs) from a health-system perspective throughout a lifetime horizon in the US setting. We calculated incremental cost-effectiveness ratios (ICERs) to determine the best strategy. The robustness of optimal choices was examined in deterministic and probabilistic sensitivity analyses. In the base-case analysis, the ploidy 4 cell strategy was cost-effective, yielding an increase of 0.032 QALY and an ICER of $18 264/QALY compared to no screening. For most scenarios in the deterministic sensitivity analysis, the ploidy 4 cell strategy was the only cost-effective strategy. Cost-effectiveness acceptability curves showed that this strategy was more likely to be cost-effective than the Papanicolaou smear. Compared to the liquid-based Papanicolaou smear, screening with a DNA ploidy strategy appeared less costly and comparably effective.

Identification of AgNORs and cytopathological changes in oral lichen planus lesions.

PubMed

Ferreira, Stefânia Jeronimo; Machado, Maria Ângela Naval; de Lima, Antônio Adilson Soares; Johann, Aline Cristina Batista Rodrigues; Grégio, Ana Maria Trindade; Azevedo-Alanis, Luciana Reis

2017-01-01

To evaluate cytopathological changes in epithelial cells of the oral mucosa of patients with oral lichen planus (OLP) compared with patients without OLP. Swabs were collected from the oral mucosa of 20 patients with OLP (case group) and 20 patients without OLP (control group) using liquid-based cytology. After Papanicolaou staining, the smears were characterized based on Papanicolaou classification and degree of maturation. Nuclear area (NA) measurements, cytoplasmic area (CA) measurements, and the NA/CA ratio were determined from 50 epithelial cells per slide. For quantification of argyrophilic nucleolar organizer regions (AgNORs), the smears were stained with silver nitrate, and the number of AgNORs was counted in 100 cells. In both groups, there was a predominance of Papanicolaou Class I nucleated cells in the superficial layer. The average values of NA (p>0.05) and CA (p=0.000) were greater in the case group (NA=521.6, CA=22,750.3) compared with the control group (NA=518.9, CA=18,348.0). The NA/CA ratio was 0.025 for the case group and 0.031 for the control group (p=0.004). There was no significant difference between the mean AgNORs values of both groups (p>0.05). The oral mucosa of patients with OLP exhibited significant cytomorphometric changes. However, there was no evidence of malignancy. Copyright © 2016 Elsevier GmbH. All rights reserved.

Association of Burnout with Workforce-Reducing Factors among EMS Professionals.

PubMed

Crowe, Remle P; Bower, Julie K; Cash, Rebecca E; Panchal, Ashish R; Rodriguez, Severo A; Olivo-Marston, Susan E

2018-01-01

Emergency medical services (EMS) professionals often work long hours at multiple jobs and endure frequent exposure to traumatic events. The stressors inherent to the prehospital setting may increase the likelihood of experiencing burnout and lead providers to exit the profession, representing a serious workforce and public health concern. Our objectives were to estimate the prevalence of burnout, identify characteristics associated with experiencing burnout, and quantify its relationship with factors that negatively impact EMS workforce stability, namely sickness absence and turnover intentions. A random sample of 10,620 emergency medical technicians (EMTs) and 10,540 paramedics was selected from the National EMS Certification database to receive an electronic questionnaire between October, 2015 and November, 2015. Using the validated Copenhagen Burnout Inventory (CBI), we assessed burnout across three dimensions: personal, work-related, and patient-related. We used multivariable logistic regression modeling to identify burnout predictors and quantify the association between burnout and our workforce-related outcomes: reporting ten or more days of work absence due to personal illness in the past 12 months, and intending to leave an EMS job or the profession within the next 12 months. Burnout was more prevalent among paramedics than EMTs (personal: 38.3% vs. 24.9%, work-related: 30.1% vs. 19.1%, and patient-related: 14.4% vs. 5.5%). Variables associated with increased burnout in all dimensions included certification at the paramedic level, having between five and 15 years of EMS experience, and increased weekly call volume. After adjustment, burnout was associated with over a two-fold increase in odds of reporting ten or more days of sickness absence in the past year. Burnout was associated with greater odds of intending to leave an EMS job (personal OR:2.45, 95% CI:1.95-3.06, work-related OR:3.37, 95% CI:2.67-4.26, patient-related OR: 2.38, 95% CI:1.74-3.26) or

Inventory of File sref_em.t03z.pgrb221.p1.f06.grib2

Science.gov Websites

surface WEASD 6 hour fcst Water <em>Equivalent> of Accumulated Snow Depth [kg/m^2] 016 surface APCP 0-6 hour surface WEASD 0-6 hour acc Water <em>Equivalent> of Accumulated Snow Depth [kg/m^2] 019 surface CSNOW 6 hour hour fcst Specific Humidity [kg/kg] 401 surface NCPCP 0-6 hour acc Large-Scale Precipitation (<em>non>

Inventory of File sref_em.t03z.pgrb132.p1.f00.grib2

Science.gov Websites

0-0.1 m below ground TSOIL analysis <em>Soil> Temperature Validation to deprecate [K] 402 0-0.1 m below ground SOILW analysis Volumetric <em>Soil> Moisture Content [Fraction] 403 0.1-0.4 m below ground TSOIL analysis <em>Soil> Temperature Validation to deprecate [K] 404 0.1-0.4 m below ground SOILW analysis Volumetric

Traffic safety facts : feasibility for an EMS workforce safety and health surveillance system

DOT National Transportation Integrated Search

2007-05-01

Emergency Medical Services (EMS) personnel treat an estimated : 22 million patients a year (Maguire and Walz, 2004). : While on duty, EMS workers frequently encounter two : work-related risks: injury and illness. Current research on : EMS workforce i...

Compositions of HIMU, EM1, and EM2 from Global Trends between Radiogenic Isotopes and Major Elements in Ocean Island Basalts

NASA Astrophysics Data System (ADS)

Jackson, M. G.; Dasgupta, R.

2008-12-01

Sr and Pb isotopes exhibit global trends with the concentrations of major elements (SiO2, TiO2, FeO, Al2O3 and K2O) and major elements ratios (CaO/Al2O3 and K2O/TiO2) in the shield-stage lavas from 18 oceanic hotspots (including Hawaii, Iceland, Galapagos, Cook-Australs, St. Helena, Cape Verde, Cameroon, Canary, Madeira, Comoros, Azores, Samoa, Society, Marquesas, Mascarene, Kerguelen, Pitcairn, and Selvagen). Based on the relationships between major elements and isotopes in ocean island basalts (OIBs), we find that the lavas derived from the mantle end members, HIMU (or high 'ì' = 238U/204Pb), EM1 (enriched mantle 1), EM2 (enriched mantle 2), and DMM (depleted MORB [mid-ocean ridge basalt] mantle) exhibit distinct major element characteristics: When compared to oceanic hotspots globally, the hotspots with a HIMU (radiogenic Pb-isotopes and low 87Sr/86Sr) component, such as St. Helena and Cook-Australs, exhibit high CaO/Al2O3, FeOT, and TiO2 and low SiO2 and Al2O3. EM1 (enriched mantle 1; intermediate 87Sr/86Sr and low 206Pb/204Pb; sampled by hotspots like Pitcairn and Kerguelen) and EM2 (enriched mantle 2; high 87Sr/86Sr and intermediate 206Pb/204Pb; sampled by hotspots like Samoa and Societies) exhibit higher K2O concentrations and K2O/TiO2 weight ratios than HIMU lavas. EM1 lavas exhibit the lowest CaO/Al2O3 in the OIB dataset, and this sets EM1 apart from EM2. A plot of CaO/Al2O3 vs K2O/TiO2 perfectly resolves the four mantle end member lavas. Melting processes (pressure, temperature and degree of melting) fail to provide an explanation for the full spectrum of major element concentrations in OIBs. Such processes also fail to explain the correlations between major elements and radiogenic isotopes. Instead, a long, time integrated history of various parent- daughter elements appears to be coupled to major element and/or volatile heterogeneity in the mantle source. End member lava compositions are compared with experimental partial melt compositions to place

Compositions of HIMU, EM1, and EM2 from global trends between radiogenic isotopes and major elements in ocean island basalts

NASA Astrophysics Data System (ADS)

Jackson, Matthew G.; Dasgupta, Rajdeep

2008-11-01

Sr and Pb isotopes exhibit global trends with the concentrations of major elements (SiO 2, TiO 2, FeO, Al 2O 3 and K 2O) and major elements ratios (CaO/Al 2O 3 and K 2O/TiO 2) in the shield-stage lavas from 18 oceanic hotspots (including Hawaii, Iceland, Galapagos, Cook-Australs, St. Helena, Cape Verde, Cameroon, Canary, Madeira, Comoros, Azores, Samoa, Society, Marquesas, Mascarene, Kerguelen, Pitcairn, and Selvagen). Based on the relationships between major elements and isotopes in ocean island basalts (OIBs), we find that the lavas derived from the mantle end members, HIMU (or high 'μ' = 238U/ 204Pb), EM1 (enriched mantle 1), EM2 (enriched mantle 2), and DMM (depleted MORB [mid-ocean ridge basalt] mantle) exhibit distinct major element characteristics: When compared to oceanic hotspots globally, the hotspots with a HIMU (radiogenic Pb-isotopes and low 87Sr/ 86Sr) component, such as St. Helena and Cook-Australs, exhibit high CaO/Al 2O 3, FeO T, and TiO 2 and low SiO 2 and Al 2O 3. EM1 (enriched mantle 1; intermediate 87Sr/ 86Sr and low 206Pb/ 204Pb; sampled by hotspots like Pitcairn and Kerguelen) and EM2 (enriched mantle 2; high 87Sr/ 86Sr and intermediate 206Pb/ 204Pb; sampled by hotspots like Samoa and Societies) exhibit higher K 2O concentrations and K 2O/TiO 2 weight ratios than HIMU lavas. EM1 lavas exhibit the lowest CaO/Al 2O 3 in the OIB dataset, and this sets EM1 apart from EM2. A plot of CaO/Al 2O 3 vs K 2O/TiO 2 perfectly resolves the four mantle end member lavas. Melting processes (pressure, temperature and degree of melting) fail to provide an explanation for the full spectrum of major element concentrations in OIBs. Such processes also fail to explain the correlations between major elements and radiogenic isotopes. Instead, a long, time integrated history of various parent-daughter elements appears to be coupled to major element and/or volatile heterogeneity in the mantle source. End member lava compositions are compared with experimental partial

Consensus Reached in the Role of EMS in Injury Prevention

DOT National Transportation Integrated Search

1996-06-01

The intent of this statement is to represent the consensus of the EMS community on essential and desirable activities for EMS in primary injury prevention. After reviewing the literature, the project steering committee drafted the statement. Then the...

Inventory of File sref_em.t03z.pgrb212.p1.f06.grib2

Science.gov Websites

surface WEASD 6 hour fcst Water <em>Equivalent> of Accumulated Snow Depth [kg/m^2] 016 surface APCP 0-6 hour surface WEASD 0-6 hour acc Water <em>Equivalent> of Accumulated Snow Depth [kg/m^2] 019 surface CSNOW 6 hour -6 hour acc Large-Scale Precipitation (<em>non>-convective) [kg/m^2] 415 surface SNOM 0-6 hour acc Snow

Operation Protective Edge - A Unique Challenge for a Civilian EMS Agency.

PubMed

Jaffe, Eli; Strugo, Refael; Wacht, Oren

2015-10-01

During July through August 2014, Operation Protective Edge, a military conflict between Israel and the Hamas regime in Gaza, dramatically affected both populations. Magen David Adom (MDA), the Israeli national Emergency Medical Service (EMS) and a member of the Red Cross, faced a unique challenge during the conflict: to continue providing crucial service to the entire civilian population of Israel, which was under constant missile threat. This challenge included not only providing immediate care for routine EMS calls under missile threat, but also preparing and delivering immediate care to civilians injured in attacks on major cities, as well as small communities, in Israel. This task is a challenge for a civilian EMS agency that normally operates in a non-military environment, yet, in an instant, must enhance its capability to respond to a considerable threat to its population. During Operation Protective Edge, MDA provided care for 842 wounded civilians and utilized a significant amount of its resources. Providing EMS services for a civilian population in a mixed civilian/military scenario is a challenging task on a national level for an EMS system, especially when the threat lasts for weeks. This report describes MDA's preparedness and operations during Operation Protective Edge, and the unique EMS challenges and dilemmas the agency faced.

Aquisição de Estreptococos Mutans e Desenvolvimento de Cárie Dental em Primogênitos

PubMed Central

NOCE, Erica; RUBIRA, Cassia Maria Fischer; da Silva ROSA, Odila Pereira; da SILVA, Salete Moura Bonifácio; BRETZ, Walter Antonio

2011-01-01

Objetivo Avaliar o momento de aquisição de estreptococos mutans (EM), desenvolvimento de cárie dental e as variáveis a eles associadas no decorrer de 23 meses, em primogênitos de famílias de baixo nível socioeconômico, desde os sete meses de idade. Método A amostra foi selecionada com base em mães densamente colonizadas por EM, incluindo todos os membros de 14 famílias que conviviam na mesma casa. Foram envolvidos no estudo 14 mães, pais e primogênitos e 8 parentes, na maioria avós. Exames clínicos e radiográficos iniciais determinaram os índices de cárie e condição periodontal dos adultos. Contagens de EM foram feitas em todos os adultos nas duas primeiras visitas. Nas crianças foram avaliados os níveis de EM, o número de dentes e de cáries, em quatro visitas. Resultados A prevalência de EM nos adultos foi alta, estando ausente em apenas um dos pais. EM foram detectados em 1, 2, 3 e 10 crianças, respectivamente nas visitas #1, 2, 3 e 4. A cárie dental foi detectada em apenas três crianças na última visita (aos 30 meses de idade), as quais apresentaram escores de EM significantemente maiores que as crianças sem cárie, na mesma visita. Conclusão Exclusivamente a condição social de baixa renda e mães densamente colonizadas por EM não são sinônimo de colonização precoce e alta atividade de cárie em crianças cuidadas em casa. O desenvolvimento de cárie está significantemente associado a escores elevados de EM nas crianças. PMID:22022218

Cryo-EM in drug discovery: achievements, limitations and prospects.

PubMed

Renaud, Jean-Paul; Chari, Ashwin; Ciferri, Claudio; Liu, Wen-Ti; Rémigy, Hervé-William; Stark, Holger; Wiesmann, Christian

2018-06-08

Cryo-electron microscopy (cryo-EM) of non-crystalline single particles is a biophysical technique that can be used to determine the structure of biological macromolecules and assemblies. Historically, its potential for application in drug discovery has been heavily limited by two issues: the minimum size of the structures it can be used to study and the resolution of the images. However, recent technological advances - including the development of direct electron detectors and more effective computational image analysis techniques - are revolutionizing the utility of cryo-EM, leading to a burst of high-resolution structures of large macromolecular assemblies. These advances have raised hopes that single-particle cryo-EM might soon become an important tool for drug discovery, particularly if they could enable structural determination for 'intractable' targets that are still not accessible to X-ray crystallographic analysis. This article describes the recent advances in the field and critically assesses their relevance for drug discovery as well as discussing at what stages of the drug discovery pipeline cryo-EM can be useful today and what to expect in the near future.

EPA LABORATORIES IMPLEMENT EMS PROGRAM

EPA Science Inventory

This paper highlights the breadth and magnitude of carrying out an effective Environmental Management System (EMS) program at the U.S. EPA's research and development laboratories. Federal research laboratories have unique operating challenges compared to more centralized industr...

The multispectral instrument of the Sentinel2 EM program results

NASA Astrophysics Data System (ADS)

Chorvalli, Vincent; Espuche, Stéphane; Delbru, Francis; Martimort, Philippe; Fernandez, Valerie; Kirchner, Volker

2017-11-01

The MSI EM campaign has been conducted before releasing the flight model integration and test. This paper presents the MSI EM configuration and the various tests results. Experience gained through this extensive test program allowed securing the MSI PFM integration and test activities.

NASA EM Followup of LIGO-Virgo Candidate Events

NASA Technical Reports Server (NTRS)

Blackburn, Lindy L.

2011-01-01

We present a strategy for a follow-up of LIGO-Virgo candidate events using offline survey data from several NASA high-energy photon instruments aboard RXTE, Swift, and Fermi. Time and sky-location information provided by the GW trigger allows for a targeted search for prompt and afterglow EM signals. In doing so, we expect to be sensitive to signals which are too weak to be publicly reported as astrophysical EM events.

Sobre o uso das séries de Puiseux em mecanica celeste

NASA Astrophysics Data System (ADS)

Miloni, O. I.

2003-08-01

Neste trabalho é apresentada uma demonstração do uso dos diferentes desenvolvimentos em séries para as equações de perturbação em Mecânica Celeste no marco Hamiltoniano. Em trabalhos clássicos como os de Poincaré (Poincaré, 1893) por exemplo, já esta planteado o uso de potências não inteiras no pequeno parâmetro, o que evidencia a não analiticidade das funções quando uma ressonância ocorre. Nestes trabalhos os desenvolvimentos são na raíz quadrada da massa de Júpiter (o pequeno parâmetro). Mais recentemente (Ferraz-Mello, 1985) outros tipos de desenvolvimentos foram aplicados modificando substancialmente as ordens de grandeza e a velocidade de convergência das séries. Com esta abordagem, os desenvolvimentos foram expressados em termos da raíz cúbica do pequeno parâmetro. Neste trabalho apresentamos um enfoque geral, onde os diferentes tipos de desenvolvimentos em séries de Puiseux (Valiron, 1950) são obtidos a partir da aplicação de Teorema de Preparação de Weierstrass (Goursat, 1916) considerando a equação de Hamilton-Jacobi como uma equação algébrica. Os resultados são aplicados ao problema restrito dos três corpos em ressonância de primeira ordem e, dependendo da grandeza da excentricidade do asteróide em relação à de Júpiter, obtemos os diferentes desenvolvimentos, em raíz quadrada ou raíz cúbica da massa de Júpiter.

A novel storage system for cryoEM samples.

PubMed

Scapin, Giovanna; Prosise, Winifred W; Wismer, Michael K; Strickland, Corey

2017-07-01

We present here a new CryoEM grid boxes storage system designed to simplify sample labeling, tracking and retrieval. The system is based on the crystal pucks widely used by the X-ray crystallographic community for storage and shipping of crystals. This system is suitable for any cryoEM laboratory, but especially for large facilities that will need accurate tracking of large numbers of samples coming from different sources. Copyright © 2017. Published by Elsevier Inc.

EM calibration based on Post OPC layout analysis

NASA Astrophysics Data System (ADS)

Sreedhar, Aswin; Kundu, Sandip

2010-03-01

Design for Manufacturability (DFM) involves changes to the design and CAD tools to help increase pattern printability and improve process control. Design for Reliability (DFR) performs the same to improve reliability of devices from failures such as Electromigration (EM), gate-oxide break down, hot carrier injection (HCI), Negative Bias Temperature Insatiability (NBTI) and mechanical stress effects. Electromigration (EM) occurs due to migration or displacement of atoms as a result of the movement of electrons through a conducting medium. The rate of migration determines the Mean Time to Failure (MTTF) which is modeled as a function of temperature and current density. The model itself is calibrated through failure analysis (FA) of parts that are deemed to have failed due to EM against design parameters such as linewidth. Reliability Verification (RV) of a design involves verifying that every conducting line in a design meets certain MTTF threshold. In order to perform RV, current density for each wire must be computed. Current itself is a function of the parasitics that are determined through RC extraction. The standard practice is to perform the RC extraction and current density calculation on drawn, pre-OPC layouts. If a wire fails to meet threshold for MTTF, it may be resized. Subsequently, mask preparation steps such as OPC and PSM introduce extra features such as SRAFs, jogs,hammerheads and serifs that change their resistance, capacitance and current density values. Hence, calibrating EM model based on pre-OPC layouts will lead to different results compared to post-OPC layouts. In this work, we compare EM model calibration and reliability check based on drawn layout versus predicted layout, where the drawn layout is pre-OPC layout and predicted layout is based on litho simulation of post-OPC layout. Results show significant divergence between these two approaches, making a case for methodology based on predicted layout.

The EM SSAB Annual Work Plan Process: Focusing Board Efforts and Resources - 13667

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

Young, Ralph

One of the most daunting tasks for any new member of a local board of the Environmental Management Site Specific Advisory Board (EM SSAB) is to try to understand the scope of the clean-up activities going on at the site. In most cases, there are at least two or three major cleanup activities in progress as well as monitoring of past projects. When planning for future projects is added to the mix, the list of projects can be long. With the clean-up activities involving all major environmental media - air, water, soils, and groundwater, new EM SSAB members can findmore » themselves totally overwhelmed and ineffective. Helping new members get over this initial hurdle is a major objective of EM and all local boards of the EM SSAB. Even as members start to understand the size and scope of the projects at a site, they can still be frustrated at the length of time it takes to see results and get projects completed. Many project and clean-up timelines for most of the sites go beyond 10 years, so it's not unusual for an EM SSAB member to see the completion of only 1 or 2 projects over the course of their 6-year term on the board. This paper explores the annual work planning process of the EM SSAB local boards, one tool that can be used to educate EM SSAB members into seeing the broader picture for the site. EM SSAB local work plans divide the site into projects focused on a specific environmental issue or media such as groundwater and/or waste disposal options. Projects are further broken down into smaller segments by highlighting major milestones. Using these metrics, local boards of the EM SSAB can start to quantify the effectiveness of the project in achieving the ultimate goal of site clean-up. These metrics can also trigger board advice and recommendations for EM. At the beginning of each fiscal year, the EM SSAB work plan provides a road map with quantifiable checkpoints for activities throughout the year. When the work plans are integrated with site

Cervical Cancer Screening (PDQ®)—Patient Version

Cancer.gov

Cervical cancer screening tests (e.g., the Papanicolaou (Pap) Test, HPV DNA, Thin-prep) find cervical changes before cancer develops. Learn more about the potential benefits and harms of these tests in this expert-reviewed summary.

Improving Rural Emergency Medical Services (EMS) through transportation system enhancements Phase II : project brief.

DOT National Transportation Integrated Search

2015-12-01

This study used the National EMS Information System (NEMSIS) South Dakota data to develop datadriven performance metrics for EMS. Researchers used the data for three tasks: geospatial analysis of EMS events, optimization of station locations, and ser...

A User's Guide to the ALiEM Emergency Medicine Match Advice Web Series.

PubMed

Gisondi, Michael A; Fant, Abra; Shakeri, Nahzinine; Schnapp, Benjamin H; Lin, Michelle

2017-06-01

ALiEM EM Match Advice is a web series hosted on the Academic Life in Emergency Medicine website. The intended audience includes senior medical students seeking a residency in emergency medicine (EM) and the faculty members who advise them. Each episode features a panel of three EM program directors who discuss a critical step in the residency application process. This article serves as a user's guide to the series, including a timeline for viewing each episode, brief summaries of the panel discussions, and reflection questions for discussion between students and their faculty advisors.

High-resolution cryo-EM proteasome structures in drug development

PubMed Central

da Fonseca, Paula C. A.

2017-01-01

With the recent advances in biological structural electron microscopy (EM), protein structures can now be obtained by cryo-EM and single-particle analysis at resolutions that used to be achievable only by crystallographic or NMR methods. We have explored their application to study protein–ligand inter­actions using the human 20S proteasome, a well established target for cancer therapy that is also being investigated as a target for an increasing range of other medical conditions. The map of a ligand-bound human 20S proteasome served as a proof of principle that cryo-EM is emerging as a realistic approach for more general structural studies of protein–ligand interactions, with the potential benefits of extending such studies to complexes that are unfavourable to other methods and allowing structure determination under conditions that are closer to physiological, preserving ligand specificity towards closely related binding sites. Subsequently, the cryo-EM structure of the Plasmodium falciparum 20S proteasome, with a new prototype specific inhibitor bound, revealed the molecular basis for the ligand specificity towards the parasite complex, which provides a framework to guide the development of highly needed new-generation antimalarials. Here, the cryo-EM analysis of the ligand-bound human and P. falciparum 20S proteasomes is reviewed, and a complete description of the methods used for structure determination is provided, including the strategy to overcome the bias orientation of the human 20S proteasome on electron-microscope grids and details of the icr3d software used for three-dimensional reconstruction. PMID:28580914

Design of a prosumer EMS for energy trading

NASA Astrophysics Data System (ADS)

Hwang, T.; Yoo, Y.; Kang, S.; Lee, I.

2018-03-01

We design a DER management system for energy trading based on OASIS EI and EMIX. With the spread of DERs, there is a growing need of a system for integrated management of DERs and customer loads. In this paper, we give a brief overview of a DER EMS for prosumer energy saving and trading. Based on the OASIS standards, we design a functional architecture of a DER EMS for energy trading. After showing communication protocols and operation sequences, we summarize our works.

Community surveillance of falls among the elderly using computerized EMS transport data.

PubMed

Wofford, J L; Heuser, M D; Moran, W P; Schwartz, E; Mittelmark, M B

1994-07-01

Because falls are common among the elderly and are associated with high morbidity and mortality, community surveillance has been recommended. The purpose of this study was to characterize the impact of falls among the elderly on emergency medical transport services (EMS) and to explore the potential for community surveillance of falls through the use of computerized EMS data. Computerized EMS data and United States census data for 1990 for persons aged > or = 65 in Forsyth County, NC, were used to produce EMS transport rates for falls and to make comparisons by age, gender, race, and residence (nursing home vs community). A fall was reported as the cause for EMS summons in 15.1% (613 of 4,058) of cases. Transport rates in 1990 for falls were 7.8 per 1,000, 25.4 per 1,000, and 58.5 per 1,000 for the age groups of 65 to 74 years, 75 to 84 years, and 85 years and older. Rates were higher for females than for males (17.1 per 1,000 v 8.1 per 1,000) and higher for whites than for African-Americans (14.3 per 1,000 v 10.3 per 1,000). Rates for nursing home residents were four times that of community residents (70.6 per 1,000 v 16.0 per 1,000). Over 50% of nursing home fallers were transported between midnight and 0400 compared with 25% of community dwellers. EMS summons for older adults reporting a fall accounts for a significant portion (15%) of all transports in this county. Computerized EMS data demonstrated patterns of falls among the elderly that are consistent with known demographic factors. The potential for using computerized EMS data as a practical means of community surveillance should be further explored.

Ambiente e formação estelar em galáxias

NASA Astrophysics Data System (ADS)

Mateus, A., Jr.; Sodré, L., Jr.

2003-08-01

Estudamos o ambiente de galáxias com formação estelar inicialmente a partir de uma amostra limitada em volume proveniente do 2dF Galaxy Redshift Survey. Discriminamos as galáxias com formação estelar com base em distintas classes espectrais, utilizando para esta classificação as larguras equivalentes das linhas [OII]l3727 e Hd. O ambiente é caracterizado pela densidade espacial local de galáxias. Mostramos que a fração de galáxias com formação estelar é bastante reduzida em ambientes densos, enquanto a de galáxias passivas aumenta nestas regiões. Por outro lado, quando analisamos a fração de galáxias que apresentam um surto recente de formação estelar, notamos que ela independe do ambiente, sendo que em regiões mais densas alguns destes objetos apresentam distorções em sua morfologia. Estes resultados são confrontados com a análise da dependência ambiental da taxa de formação estelar, estimada pela emissão em Ha, de uma amostra extraída do Sloan Digital Sky Survey. Um declínio gradual da formação estelar também é observado nesta análise, sugerindo que as interações por efeitos de maré sejam responsáveis pela redução da formação estelar em ambientes densos através da remoção do reservatório de gás das galáxias. No entanto, estas interações também podem induzir surtos de formação estelar nas galáxias, além de peculiaridades morfológicas observadas nos objetos que habitam regiões mais densas.

Robust w-Estimators for Cryo-EM Class Means.

PubMed

Huang, Chenxi; Tagare, Hemant D

2016-02-01

A critical step in cryogenic electron microscopy (cryo-EM) image analysis is to calculate the average of all images aligned to a projection direction. This average, called the class mean, improves the signal-to-noise ratio in single-particle reconstruction. The averaging step is often compromised because of the outlier images of ice, contaminants, and particle fragments. Outlier detection and rejection in the majority of current cryo-EM methods are done using cross-correlation with a manually determined threshold. Empirical assessment shows that the performance of these methods is very sensitive to the threshold. This paper proposes an alternative: a w-estimator of the average image, which is robust to outliers and which does not use a threshold. Various properties of the estimator, such as consistency and influence function are investigated. An extension of the estimator to images with different contrast transfer functions is also provided. Experiments with simulated and real cryo-EM images show that the proposed estimator performs quite well in the presence of outliers.

Identified EM Earthquake Precursors

NASA Astrophysics Data System (ADS)

Jones, Kenneth, II; Saxton, Patrick

2014-05-01

Many attempts have been made to determine a sound forecasting method regarding earthquakes and warn the public in turn. Presently, the animal kingdom leads the precursor list alluding to a transmission related source. By applying the animal-based model to an electromagnetic (EM) wave model, various hypotheses were formed, but the most interesting one required the use of a magnetometer with a differing design and geometry. To date, numerous, high-end magnetometers have been in use in close proximity to fault zones for potential earthquake forecasting; however, something is still amiss. The problem still resides with what exactly is forecastable and the investigating direction of EM. After a number of custom rock experiments, two hypotheses were formed which could answer the EM wave model. The first hypothesis concerned a sufficient and continuous electron movement either by surface or penetrative flow, and the second regarded a novel approach to radio transmission. Electron flow along fracture surfaces was determined to be inadequate in creating strong EM fields, because rock has a very high electrical resistance making it a high quality insulator. Penetrative flow could not be corroborated as well, because it was discovered that rock was absorbing and confining electrons to a very thin skin depth. Radio wave transmission and detection worked with every single test administered. This hypothesis was reviewed for propagating, long-wave generation with sufficient amplitude, and the capability of penetrating solid rock. Additionally, fracture spaces, either air or ion-filled, can facilitate this concept from great depths and allow for surficial detection. A few propagating precursor signals have been detected in the field occurring with associated phases using custom-built loop antennae. Field testing was conducted in Southern California from 2006-2011, and outside the NE Texas town of Timpson in February, 2013. The antennae have mobility and observations were noted for

EMS Provider assessment of vehicle damage compared with assessment by a professional crash reconstructionist.

PubMed

Lerner, E Brooke; Cushman, Jeremy T; Blatt, Alan; Lawrence, Richard D; Shah, Manish N; Swor, Robert A; Brasel, Karen; Jurkovich, Gregory J

2011-01-01

To determine the accuracy of emergency medical services (EMS) provider assessments of motor vehicle damage when compared with measurements made by a professional crash reconstructionist. EMS providers caring for adult patients injured during a motor vehicle crash and transported to the regional trauma center in a midsized community were interviewed upon emergency department arrival. The interview collected provider estimates of crash mechanism of injury. For crashes that met a preset severity threshold, the vehicle's owner was asked to consent to having a crash reconstructionist assess the vehicle. The assessment included measuring intrusion and external automobile deformity. Vehicle damage was used to calculate change in velocity. Paired t-test, correlation, and kappa were used to compare EMS estimates and investigator-derived values. Ninety-one vehicles were enrolled; of these, 58 were inspected and 33 were excluded because the vehicle was not accessible. Six vehicles had multiple patients. Therefore, a total of 68 EMS estimates were compared with the inspection findings. Patients were 46% male, 28% were admitted to hospital, and 1% died. The mean EMS-estimated deformity was 18 inches and the mean measured deformity was 14 inches. The mean EMS-estimated intrusion was 5 inches and the mean measured intrusion was 4 inches. The EMS providers and the reconstructionist had 68% agreement for determination of external automobile deformity (kappa 0.26) and 88% agreement for determination of intrusion (kappa 0.27) when the 1999 American College of Surgeons Field Triage Decision Scheme criteria were applied. The mean (± standard deviation) EMS-estimated speed prior to the crash was 48 ± 13 mph and the mean reconstructionist-estimated change in velocity was 18 ± 12 mph (correlation -0.45). The EMS providers determined that 19 vehicles had rolled over, whereas the investigator identified 18 (kappa 0.96). In 55 cases, EMS and the investigator agreed on seat belt use; for

TandEM: Titan and Enceladus mission

USGS Publications Warehouse

Coustenis, A.; Atreya, S.K.; Balint, T.; Brown, R.H.; Dougherty, M.K.; Ferri, F.; Fulchignoni, M.; Gautier, D.; Gowen, R.A.; Griffith, C.A.; Gurvits, L.I.; Jaumann, R.; Langevin, Y.; Leese, M.R.; Lunine, J.I.; McKay, C.P.; Moussas, X.; Muller-Wodarg, I.; Neubauer, F.; Owen, T.C.; Raulin, F.; Sittler, E.C.; Sohl, F.; Sotin, Christophe; Tobie, G.; Tokano, T.; Turtle, E.P.; Wahlund, J.-E.; Waite, J.H.; Baines, K.H.; Blamont, J.; Coates, A.J.; Dandouras, I.; Krimigis, T.; Lellouch, E.; Lorenz, R.D.; Morse, A.; Porco, C.C.; Hirtzig, M.; Saur, J.; Spilker, T.; Zarnecki, J.C.; Choi, E.; Achilleos, N.; Amils, R.; Annan, P.; Atkinson, D.H.; Benilan, Y.; Bertucci, C.; Bezard, B.; Bjoraker, G.L.; Blanc, M.; Boireau, L.; Bouman, J.; Cabane, M.; Capria, M.T.; Chassefiere, E.; Coll, P.; Combes, M.; Cooper, J.F.; Coradini, A.; Crary, F.; Cravens, T.; Daglis, I.A.; de Angelis, E.; De Bergh, C.; de Pater, I.; Dunford, C.; Durry, G.; Dutuit, O.; Fairbrother, D.; Flasar, F.M.; Fortes, A.D.; Frampton, R.; Fujimoto, M.; Galand, M.; Grasset, O.; Grott, M.; Haltigin, T.; Herique, A.; Hersant, F.; Hussmann, H.; Ip, W.; Johnson, R.; Kallio, E.; Kempf, S.; Knapmeyer, M.; Kofman, W.; Koop, R.; Kostiuk, T.; Krupp, N.; Kuppers, M.; Lammer, H.; Lara, L.-M.; Lavvas, P.; Le, Mouelic S.; Lebonnois, S.; Ledvina, S.; Li, Ji; Livengood, T.A.; Lopes, R.M.; Lopez-Moreno, J. -J.; Luz, D.; Mahaffy, P.R.; Mall, U.; Martinez-Frias, J.; Marty, B.; McCord, T.; Salvan, C.M.; Milillo, A.; Mitchell, D.G.; Modolo, R.; Mousis, O.; Nakamura, M.; Neish, Catherine D.; Nixon, C.A.; Mvondo, D.N.; Orton, G.; Paetzold, M.; Pitman, J.; Pogrebenko, S.; Pollard, W.; Prieto-Ballesteros, O.; Rannou, P.; Reh, K.; Richter, L.; Robb, F.T.; Rodrigo, R.; Rodriguez, S.; Romani, P.; Bermejo, M.R.; Sarris, E.T.; Schenk, P.; Schmitt, B.; Schmitz, N.; Schulze-Makuch, D.; Schwingenschuh, K.; Selig, A.; Sicardy, B.; Soderblom, L.; Spilker, L.J.; Stam, D.; Steele, A.; Stephan, K.; Strobel, D.F.; Szego, K.; Szopa,

2009-01-01

TandEM was proposed as an L-class (large) mission in response to ESA’s Cosmic Vision 2015–2025 Call, and accepted for further studies, with the goal of exploring Titan and Enceladus. The mission concept is to perform in situ investigations of two worlds tied together by location and properties, whose remarkable natures have been partly revealed by the ongoing Cassini–Huygens mission. These bodies still hold mysteries requiring a complete exploration using a variety of vehicles and instruments. TandEM is an ambitious mission because its targets are two of the most exciting and challenging bodies in the Solar System. It is designed to build on but exceed the scientific and technological accomplishments of the Cassini–Huygens mission, exploring Titan and Enceladus in ways that are not currently possible (full close-up and in situ coverage over long periods of time). In the current mission architecture, TandEM proposes to deliver two medium-sized spacecraft to the Saturnian system. One spacecraft would be an orbiter with a large host of instruments which would perform several Enceladus flybys and deliver penetrators to its surface before going into a dedicated orbit around Titan alone, while the other spacecraft would carry the Titan in situ investigation components, i.e. a hot-air balloon (Montgolfière) and possibly several landing probes to be delivered through the atmosphere.

TandEM: Titan and Enceladus mission

NASA Astrophysics Data System (ADS)

Coustenis, A.; Atreya, S. K.; Balint, T.; Brown, R. H.; Dougherty, M. K.; Ferri, F.; Fulchignoni, M.; Gautier, D.; Gowen, R. A.; Griffith, C. A.; Gurvits, L. I.; Jaumann, R.; Langevin, Y.; Leese, M. R.; Lunine, J. I.; McKay, C. P.; Moussas, X.; Müller-Wodarg, I.; Neubauer, F.; Owen, T. C.; Raulin, F.; Sittler, E. C.; Sohl, F.; Sotin, C.; Tobie, G.; Tokano, T.; Turtle, E. P.; Wahlund, J.-E.; Waite, J. H.; Baines, K. H.; Blamont, J.; Coates, A. J.; Dandouras, I.; Krimigis, T.; Lellouch, E.; Lorenz, R. D.; Morse, A.; Porco, C. C.; Hirtzig, M.; Saur, J.; Spilker, T.; Zarnecki, J. C.; Choi, E.; Achilleos, N.; Amils, R.; Annan, P.; Atkinson, D. H.; Bénilan, Y.; Bertucci, C.; Bézard, B.; Bjoraker, G. L.; Blanc, M.; Boireau, L.; Bouman, J.; Cabane, M.; Capria, M. T.; Chassefière, E.; Coll, P.; Combes, M.; Cooper, J. F.; Coradini, A.; Crary, F.; Cravens, T.; Daglis, I. A.; de Angelis, E.; de Bergh, C.; de Pater, I.; Dunford, C.; Durry, G.; Dutuit, O.; Fairbrother, D.; Flasar, F. M.; Fortes, A. D.; Frampton, R.; Fujimoto, M.; Galand, M.; Grasset, O.; Grott, M.; Haltigin, T.; Herique, A.; Hersant, F.; Hussmann, H.; Ip, W.; Johnson, R.; Kallio, E.; Kempf, S.; Knapmeyer, M.; Kofman, W.; Koop, R.; Kostiuk, T.; Krupp, N.; Küppers, M.; Lammer, H.; Lara, L.-M.; Lavvas, P.; Le Mouélic, S.; Lebonnois, S.; Ledvina, S.; Li, J.; Livengood, T. A.; Lopes, R. M.; Lopez-Moreno, J.-J.; Luz, D.; Mahaffy, P. R.; Mall, U.; Martinez-Frias, J.; Marty, B.; McCord, T.; Menor Salvan, C.; Milillo, A.; Mitchell, D. G.; Modolo, R.; Mousis, O.; Nakamura, M.; Neish, C. D.; Nixon, C. A.; Nna Mvondo, D.; Orton, G.; Paetzold, M.; Pitman, J.; Pogrebenko, S.; Pollard, W.; Prieto-Ballesteros, O.; Rannou, P.; Reh, K.; Richter, L.; Robb, F. T.; Rodrigo, R.; Rodriguez, S.; Romani, P.; Ruiz Bermejo, M.; Sarris, E. T.; Schenk, P.; Schmitt, B.; Schmitz, N.; Schulze-Makuch, D.; Schwingenschuh, K.; Selig, A.; Sicardy, B.; Soderblom, L.; Spilker, L. J.; Stam, D.; Steele, A.; Stephan, K.; Strobel, D. F.; Szego, K.; Szopa, C.; Thissen, R.; Tomasko, M. G.; Toublanc, D.; Vali, H.; Vardavas, I.; Vuitton, V.; West, R. A.; Yelle, R.; Young, E. F.

2009-03-01

TandEM was proposed as an L-class (large) mission in response to ESA’s Cosmic Vision 2015-2025 Call, and accepted for further studies, with the goal of exploring Titan and Enceladus. The mission concept is to perform in situ investigations of two worlds tied together by location and properties, whose remarkable natures have been partly revealed by the ongoing Cassini-Huygens mission. These bodies still hold mysteries requiring a complete exploration using a variety of vehicles and instruments. TandEM is an ambitious mission because its targets are two of the most exciting and challenging bodies in the Solar System. It is designed to build on but exceed the scientific and technological accomplishments of the Cassini-Huygens mission, exploring Titan and Enceladus in ways that are not currently possible (full close-up and in situ coverage over long periods of time). In the current mission architecture, TandEM proposes to deliver two medium-sized spacecraft to the Saturnian system. One spacecraft would be an orbiter with a large host of instruments which would perform several Enceladus flybys and deliver penetrators to its surface before going into a dedicated orbit around Titan alone, while the other spacecraft would carry the Titan in situ investigation components, i.e. a hot-air balloon (Montgolfière) and possibly several landing probes to be delivered through the atmosphere.

The US DOE-EM International Program - 13004

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

Elmetti, Rosa R.; Han, Ana M.; Williams, Alice C.

2013-07-01

The U.S. Department of Energy (DOE) Office of Environmental Management (EM) conducts international collaboration activities in support of U.S. policies and objectives regarding the accelerated risk reduction and remediation of environmental legacy of the nations' nuclear weapons program and government sponsored nuclear energy research. The EM International Program supported out of the EM Office of the Associate Principal Deputy Assistant Secretary pursues collaborations with foreign government organizations, educational institutions and private industry to assist in identifying technologies and promote international collaborations that leverage resources and link international experience and expertise. In fiscal year (FY) 2012, the International Program awarded eightmore » international collaborative projects for work scope spanning waste processing, groundwater and soil remediation, deactivation and decommissioning (D and D) and nuclear materials disposition initiatives to seven foreign organizations. Additionally, the International Program's scope and collaboration opportunities were expanded to include technical as well as non-technical areas. This paper will present an overview of the on-going tasks awarded in FY 2012 and an update of upcoming international activities and opportunities for expansion into FY 2013 and beyond. (authors)« less

Helicopter EMS: Research Endpoints and Potential Benefits

PubMed Central

Thomas, Stephen H.; Arthur, Annette O.

2012-01-01

Patients, EMS systems, and healthcare regions benefit from Helicopter EMS (HEMS) utilization. This article discusses these benefits in terms of specific endpoints utilized in research projects. The endpoint of interest, be it primary, secondary, or surrogate, is important to understand in the deployment of HEMS resources or in planning further HEMS outcomes research. The most important outcomes are those which show potential benefits to the patients, such as functional survival, pain relief, and earlier ALS care. Case reports are also important “outcomes” publications. The benefits of HEMS in the rural setting is the ability to provide timely access to Level I or Level II trauma centers and in nontrauma, interfacility transport of cardiac, stroke, and even sepsis patients. Many HEMS crews have pharmacologic and procedural capabilities that bring a different level of care to a trauma scene or small referring hospital, especially in the rural setting. Regional healthcare and EMS system's benefit from HEMS by their capability to extend the advanced level of care throughout a region, provide a “backup” for areas with limited ALS coverage, minimize transport times, make available direct transport to specialized centers, and offer flexibility of transport in overloaded hospital systems. PMID:22203905

Protective immunity against Eimeria maxima induced by vaccines of Em14-3-3 antigen.

PubMed

Liu, Tingqi; Huang, Jingwei; Ehsan, Muhammad; Wang, Shuai; Fei, Hong; Zhou, Zhouyang; Song, Xiaokai; Yan, Ruofeng; Xu, Lixin; Li, Xiangrui

2018-04-15

Eimeria maxima 14-3-3 (Em14-3-3) open reading frame (ORF) which consisted of 861 bp encoding a protein of 286 amino acids was successfully amplified and sequenced. Subsequently, the Em14-3-3 ORF was subcloned into pET-32a (+) and pVAX1, respectively. RT-PCR and immunoblot analyses confirmed that the target gene was successfully transcribed and expressed in vivo. Immunofluorescence analysis showed that Em14-3-3 was expressed in both the sporozoites and merozoites. The animal experiments demonstrated that both rEm14-3-3 and pVAX1-14-3-3 could clearly alleviate jejunum lesions and body weight loss. The Em14-3-3 vaccines could increase oocyst decrease ratio, as well as produce an anticoccidial index of more than 165. The percentages of CD4 + in both the Em14-3-3 immunized groups were much higher, when compared with those of PBS, pET32a (+), and pVAX1 controls (P < 0.05). Similarly, the anti-Em14-3-3 antibody titers of both rEm14-3-3 and pVAX1-14-3-3 immunized groups showed higher levels compared with those of PBS, pET32a (+), and pVAX1 controls (P < 0.05). The IFN-γ and tumor growth factor-β (TGF-β) levels showed significant increments in the rEm14-3-3 and pVAX1-14-3-3 immunized groups, when compared with those in the negative controls (P < 0.05). These results demonstrated that Em14-3-3 could be used as a promising antigen candidate for developing vaccines against E. maxima. Copyright © 2018 Elsevier B.V. All rights reserved.

X-rays in the Cryo-EM Era: Structural Biology’s Dynamic Future

PubMed Central

Shoemaker, Susannah C.; Ando, Nozomi

2018-01-01

Over the past several years, single-particle cryo-electron microscopy (cryo-EM) has emerged as a leading method for elucidating macromolecular structures at near-atomic resolution, rivaling even the established technique of X-ray crystallography. Cryo-EM is now able to probe proteins as small as hemoglobin (64 kDa), while avoiding the crystallization bottleneck entirely. The remarkable success of cryo-EM has called into question the continuing relevance of X-ray methods, particularly crystallography. To say that the future of structural biology is either cryo-EM or crystallography, however, would be misguided. Crystallography remains better suited to yield precise atomic coordinates of macromolecules under a few hundred kDa in size, while the ability to probe larger, potentially more disordered assemblies is a distinct advantage of cryo-EM. Likewise, crystallography is better equipped to provide high-resolution dynamic information as a function of time, temperature, pressure, and other perturbations, whereas cryo-EM offers increasing insight into conformational and energy landscapes, particularly as algorithms to deconvolute conformational heterogeneity become more advanced. Ultimately, the future of both techniques depends on how their individual strengths are utilized to tackle questions on the frontiers of structural biology. Structure determination is just one piece of a much larger puzzle: a central challenge of modern structural biology is to relate structural information to biological function. In this perspective, we share insight from several leaders in the field and examine the unique and complementary ways in which X-ray methods and cryo-EM can shape the future of structural biology. PMID:29227642

The positive impact of simultaneous implementation of the BD FocalPoint GS Imaging System and lean principles on the operation of gynecologic cytology.

PubMed

Wong, Rebecca; Levi, Angelique W; Harigopal, Malini; Schofield, Kevin; Chhieng, David C

2012-02-01

Our cytology laboratory, like many others, is under pressure to improve quality and provide test results faster while decreasing costs. We sought to address these issues by introducing new technology and lean principles. To determine the combined impact of the FocalPoint Guided Screener (GS) Imaging System (BD Diagnostics-TriPath, Burlington, North Carolina) and lean manufacturing principles on the turnaround time (TAT) and productivity of the gynecologic cytology operation. We established a baseline measure of the TAT for Papanicolaou tests. We then compared that to the performance after implementing the FocalPoint GS Imaging System and lean principles. The latter included value-stream mapping, workflow modification, and a first in-first out policy. The mean (SD) TAT for Papanicolaou tests before and after the implementation of FocalPoint GS Imaging System and lean principles was 4.38 (1.28) days and 3.20 (1.32) days, respectively. This represented a 27% improvement in the average TAT, which was statistically significant (P < .001). In addition, the productivity of staff improved 17%, as evidenced by the increase in slides screened from 8.85/h to 10.38/h. The false-negative fraction decreased from 1.4% to 0.9%, representing a 36% improvement. In our laboratory, the implementation of FocalPoint GS Imaging System in conjunction with lean principles resulted in a significant decrease in the average TAT for Papanicolaou tests and a substantial increase in the productivity of cytotechnologists while maintaining the diagnostic quality of gynecologic cytology.

The effective molarity (EM)--a computational approach.

PubMed

Karaman, Rafik

2010-08-01

The effective molarity (EM) for 12 intramolecular S(N)2 processes involving the formation of substituted aziridines and substituted epoxides were computed using ab initio and DFT calculation methods. Strong correlation was found between the calculated effective molarity and the experimentally determined values. This result could open a door for obtaining EM values for intramolecular processes that are difficult to be experimentally provided. Furthermore, the calculation results reveal that the driving forces for ring-closing reactions in the two different systems are proximity orientation of the nucleophile to the electrophile and the ground strain energies of the products and the reactants. Copyright 2010 Elsevier Inc. All rights reserved.

Learning when to Hold'em and When to Fold'em: ERS's Budget Hold'em Game Facilitates the Budget Development Process in Memphis

ERIC Educational Resources Information Center

Education Resource Strategies, 2010

2010-01-01

If your school district is facing a budget issue, it might surprise you to learn that the solution might very well lie in a game of cards. That certainly was the case earlier this year for the city schools of Memphis, Tennessee. The game is called Budget Hold'em, and it was developed by Education Resource Strategies (ERS) of Watertown,…

An Evaluation of DOE-EM Public Participation Programs

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

Bradbury, Judith A.; Branch, Kristi M.; Malone, Elizabeth L.

This report evaluates the scope and effectiveness of the public participation pr ograms, including Site-Specific Advisory Boards (SSABs), at seven U.S. Departmen t of Energy (DOE) sites: Fernald, Hanford, Los Alamos, Nevada, Oak Ridge, Paduc ah, and Savannah River. The primary purpose of the study is to assist both DOE Field and Headquarters managers in reviewing and understanding lessons learned o ver the past decade concerning public participation programs administered by the DOE Office of Environmental Management (EM). The evaluation provides a snapsh ot of selected EM public participation programs at a particular point of time. It is based onmore » interviews and site visits conducted between January and June 200 2- a time of change within the program. The study focuses on public participati on programs that incorporate a variety of activities and address a wide range of individual site activities and decisions. It uses the Acceptability Diamond as an evaluative framework to answer questions about stakeholders' experiences wit h, and assessment of, DOE-EM's public participation programs. The Acceptability Diamond, which was developed by researchers from the Pacific Northwest National Laboratory in previous research, identifies four program dimensions - substanti ve issues, decision-making process, relationships, and accountability - that det ermine the effectiveness of an agency's interactions with local communities. Es sentially, a public participation program may be deemed effective to the extent that it provides for open disclosure and addresses all four acceptability dimens ions in ways that are appropriate and effective for a particular community and s ituation. This framework provides a guide for agencies to 1) set objectives, 2) design public participation and oversight programs, and 3) set criteria for eva luating program effectiveness. In the current study, where the framework is use d as a means of assessing program effectiveness, the focus is on

Ondas de choque em jatos de quasares e objetos BL Lacertae

NASA Astrophysics Data System (ADS)

Melo, F. E.; Botti, L. C. L.

2003-08-01

Este trabalho é parte de um projeto que vem sendo realizado há dois anos no CRAAM, cujos objetivos principais são analisar e aplicar um modelo generalizado de ondas de choque em jatos relativísticos de plasma, presentes em quasares e objetos BL Lacertae, para explicar a variabilidade observada nestes objetos. O método consiste em uma decomposição de curvas de luz em séries de explosões similares, em várias freqüências, baseando-se em uma evolução espectro-temporal média das explosões. A partir da evolução média, um ajuste de cada explosão é feito com base em equações empíricas, modificando-se apenas parâmetros específicos de cada explosão. Inicialmente o modelo foi aplicado ajustando-se as curvas de luz a explosões delineadas por uma evolução do choque em três estágios, segundo a predominância do processo de emissão: síncrotron, Compton e adiabático. Entretanto, nesta nova fase de projeto, visando uma parametrização mais concisa, uma otimização do algoritmo de ajuste e uma convergência mais rápida, a formulação para cada evento foi assumida com uma evolução em apenas dois estágios: subida e descida. Isto possibilitou uma ótima delineação das curvas de luz das fontes OV236, OJ287, 3C273 e BL Lac, entre 1980 e 2000, nas freqüências 4.8, 8.0, 14.5 e 22 GHz, utilizando-se dados do Observatório da Universidade de Michigan, do Observatório do Itapetinga (Atibaia SP) e do Observatório Metsähovi. Como conclusões importantes, verificou-se que: os parâmetros ajustados descrevem o comportamento do jato; os valores do índice que descreve a expansão do jato sugerem que o mesmo se expande de uma forma não-cônica; o campo magnético é turbulento atrás da frente de choque; e as peculiaridades das explosões são devidas à influência de grandezas tais como o coeficiente da distribuição espectral de energia dos elétrons, a intensidade de campo magnético e o fator de feixe Doppler, no início do choque.

Unsupervised Cryo-EM Data Clustering through Adaptively Constrained K-Means Algorithm.

PubMed

Xu, Yaofang; Wu, Jiayi; Yin, Chang-Cheng; Mao, Youdong

2016-01-01

In single-particle cryo-electron microscopy (cryo-EM), K-means clustering algorithm is widely used in unsupervised 2D classification of projection images of biological macromolecules. 3D ab initio reconstruction requires accurate unsupervised classification in order to separate molecular projections of distinct orientations. Due to background noise in single-particle images and uncertainty of molecular orientations, traditional K-means clustering algorithm may classify images into wrong classes and produce classes with a large variation in membership. Overcoming these limitations requires further development on clustering algorithms for cryo-EM data analysis. We propose a novel unsupervised data clustering method building upon the traditional K-means algorithm. By introducing an adaptive constraint term in the objective function, our algorithm not only avoids a large variation in class sizes but also produces more accurate data clustering. Applications of this approach to both simulated and experimental cryo-EM data demonstrate that our algorithm is a significantly improved alterative to the traditional K-means algorithm in single-particle cryo-EM analysis.

Cervical Cancer Screening (PDQ®)—Health Professional Version

Cancer.gov

Cervical cancer screening tests (e.g., the Papanicolaou (Pap) Test, HPV DNA, Thin-prep) reduce mortality from cervical cancer. Get detailed information about the evidence behind, and the potential benefits and harms of cervical cancer screening in this summary for clinicians.

Robust w-Estimators for Cryo-EM Class Means

PubMed Central

Huang, Chenxi; Tagare, Hemant D.

2016-01-01

A critical step in cryogenic electron microscopy (cryo-EM) image analysis is to calculate the average of all images aligned to a projection direction. This average, called the “class mean”, improves the signal-to-noise ratio in single particle reconstruction (SPR). The averaging step is often compromised because of outlier images of ice, contaminants, and particle fragments. Outlier detection and rejection in the majority of current cryo-EM methods is done using cross-correlation with a manually determined threshold. Empirical assessment shows that the performance of these methods is very sensitive to the threshold. This paper proposes an alternative: a “w-estimator” of the average image, which is robust to outliers and which does not use a threshold. Various properties of the estimator, such as consistency and influence function are investigated. An extension of the estimator to images with different contrast transfer functions (CTFs) is also provided. Experiments with simulated and real cryo-EM images show that the proposed estimator performs quite well in the presence of outliers. PMID:26841397

Orion EM-1 Booster Preps - Aft Skirt Preps/Painting

NASA Image and Video Library

2016-10-31

The right hand aft skirt for NASA's Space Launch System (SLS) rocket has been refurbished and painted and is in a drying cell in a support building at the Hangar AF facility at Cape Canaveral Air Force Station in Florida. The space shuttle-era aft skirt will be used on the right hand booster of the SLS for Exploration Mission 1 (EM-1). NASA is preparing for EM-1, deep space missions, and the Journey to Mars.

Orion EM-1 Booster Preps - Aft Skirt Preps/Painting

NASA Image and Video Library

2016-10-29

The right hand aft skirt for NASA's Space Launch System (SLS) rocket has been painted and is in a drying cell in a support building at the Hangar AF facility at Cape Canaveral Air Force Station in Florida. The space shuttle-era aft skirt will be used on the right hand booster of NASA's Space Launch System rocket for Exploration Mission 1 (EM-1). NASA is preparing for EM-1, deep space missions, and the Journey to Mars.

The European Mobile System (EMS)

NASA Technical Reports Server (NTRS)

Jongejans, A.; Rogard, R.; Mistretta, I.; Ananasso, F.

1993-01-01

The European Space Agency is presently procuring an L band payload in order to promote a regional European L band system coping with the specific needs of the European market. The payload, and the two communications systems to be supported, are described below. The potential market for EMS in Europe is discussed.

Cryo-EM of dynamic protein complexes in eukaryotic DNA replication.

PubMed

Sun, Jingchuan; Yuan, Zuanning; Bai, Lin; Li, Huilin

2017-01-01

DNA replication in Eukaryotes is a highly dynamic process that involves several dozens of proteins. Some of these proteins form stable complexes that are amenable to high-resolution structure determination by cryo-EM, thanks to the recent advent of the direct electron detector and powerful image analysis algorithm. But many of these proteins associate only transiently and flexibly, precluding traditional biochemical purification. We found that direct mixing of the component proteins followed by 2D and 3D image sorting can capture some very weakly interacting complexes. Even at 2D average level and at low resolution, EM images of these flexible complexes can provide important biological insights. It is often necessary to positively identify the feature-of-interest in a low resolution EM structure. We found that systematically fusing or inserting maltose binding protein (MBP) to selected proteins is highly effective in these situations. In this chapter, we describe the EM studies of several protein complexes involved in the eukaryotic DNA replication over the past decade or so. We suggest that some of the approaches used in these studies may be applicable to structural analysis of other biological systems. © 2016 The Protein Society.

Robust estimation for class averaging in cryo-EM Single Particle Reconstruction.

PubMed

Huang, Chenxi; Tagare, Hemant D

2014-01-01

Single Particle Reconstruction (SPR) for Cryogenic Electron Microscopy (cryo-EM) aligns and averages the images extracted from micrographs to improve the Signal-to-Noise ratio (SNR). Outliers compromise the fidelity of the averaging. We propose a robust cross-correlation-like w-estimator for combating the effect of outliers on the average images in cryo-EM. The estimator accounts for the natural variation of signal contrast among the images and eliminates the need for a threshold for outlier rejection. We show that the influence function of our estimator is asymptotically bounded. Evaluations of the estimator on simulated and real cryo-EM images show good performance in the presence of outliers.

New Developments in the Technology Readiness Assessment Process in US DOE-EM - 13247

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

Krahn, Steven; Sutter, Herbert; Johnson, Hoyt

2013-07-01

A Technology Readiness Assessment (TRA) is a systematic, metric-based process and accompanying report that evaluates the maturity of the technologies used in systems; it is designed to measure technology maturity using the Technology Readiness Level (TRL) scale pioneered by the National Aeronautics and Space Administration (NASA) in the 1980's. More recently, DoD has adopted and provided systematic guidance for performing TRAs and determining TRLs. In 2007 the GAO recommended that the DOE adopt the NASA/DoD methodology for evaluating technology maturity. Earlier, in 2006-2007, DOE-EM had conducted pilot TRAs on a number of projects at Hanford and Savannah River. In Marchmore » 2008, DOE-EM issued a process guide, which established TRAs as an integral part of DOE-EM's Project Management Critical Decision Process. Since the development of its detailed TRA guidance in 2008, DOE-EM has continued to accumulate experience in the conduct of TRAs and the process for evaluating technology maturity. DOE has developed guidance on TRAs applicable department-wide. DOE-EM's experience with the TRA process, the evaluations that led to recently developed proposed revisions to the DOE-EM TRA/TMP Guide; the content of the proposed changes that incorporate the above lessons learned and insights are described. (authors)« less

Improving Rural Emergency Medical Services (EMS) through transportation system enhancements Phase II.

DOT National Transportation Integrated Search

2015-12-01

Providing acute medical care outside of the hospital, Emergency Medical Services (EMS) is crucial in rural environments where hospitals are not close by and are difficult to access. Establishing EMS performance measures is critical in improving a rur...

Scalable and Interactive Segmentation and Visualization of Neural Processes in EM Datasets

PubMed Central

Jeong, Won-Ki; Beyer, Johanna; Hadwiger, Markus; Vazquez, Amelio; Pfister, Hanspeter; Whitaker, Ross T.

2011-01-01

Recent advances in scanning technology provide high resolution EM (Electron Microscopy) datasets that allow neuroscientists to reconstruct complex neural connections in a nervous system. However, due to the enormous size and complexity of the resulting data, segmentation and visualization of neural processes in EM data is usually a difficult and very time-consuming task. In this paper, we present NeuroTrace, a novel EM volume segmentation and visualization system that consists of two parts: a semi-automatic multiphase level set segmentation with 3D tracking for reconstruction of neural processes, and a specialized volume rendering approach for visualization of EM volumes. It employs view-dependent on-demand filtering and evaluation of a local histogram edge metric, as well as on-the-fly interpolation and ray-casting of implicit surfaces for segmented neural structures. Both methods are implemented on the GPU for interactive performance. NeuroTrace is designed to be scalable to large datasets and data-parallel hardware architectures. A comparison of NeuroTrace with a commonly used manual EM segmentation tool shows that our interactive workflow is faster and easier to use for the reconstruction of complex neural processes. PMID:19834227

Is the algorithm used to process heart rate variability data clinically relevant? Analysis in male adolescents.

PubMed

Soares, Antonio Henrique Germano; Farah, Breno Quintella; Cucato, Gabriel Grizzo; Bastos-Filho, Carmelo José Albanez; Christofaro, Diego Giulliano Destro; Vanderlei, Luiz Carlos Marques; Lima, Aluísio Henrique Rodrigues de Andrade; Ritti-Dias, Raphael Mendes

2016-01-01

cardiovascular adolescentes do gênero masculino. Estudo transversal, que incluiu 1.152 adolescentes do gênero masculino (14 a 19 anos). Componentes de baixa e alta frequência (absolutos e unidades normalizadas), razão componente de baixa frequência/componente de alta frequência e poder total da variabilidade da frequência cardíaca foram obtidos em repouso, na posição supina, usando os métodos transformada rápida de Fourier e autorregressivo. Todos os parâmetros da variabilidade da frequência cardíaca para ambos os métodos foram diferentes (p<0,05). Entretanto, um pequeno tamanho do efeito (<0,1) foi observado para todos os parâmetros. Os coeficientes de correlação intraclasse entre os métodos variaram de 0,96 a 0,99, enquanto os coeficientes de variação foram de 7,4 a 14,8%. A circunferência abdominal foi negativamente associada com o componente de alta frequência, e positivamente associada com o componente de baixa frequência e o balanço simpatovagal (p<0,001 para a transformada rápida de Fourier e o autorregressivo em todas as associações). A pressão arterial sistólica foi negativamente associada com o poder total e o componente de alta frequência, enquanto foi positivamente associada com o componente de baixa frequência e o balanço simpatovagal (p<0,001 para a transformada rápida de Fourier e o autorregressivo em todas as associações). O índice de massa corporal foi negativamente associado com o componente de alta frequência, enquanto foi positivamente associado com o componente de baixa frequência e o balanço simpatovagal (valores de p variando de <0,001 a 0,007). Houve diferenças significantes nos parâmetros da variabilidade da frequência cardíaca obtidos com os métodos transformada rápida de Fourier e autorregressivo em adolescentes masculinos, mas essas diferenças não foram clinicamente significativas.

Pre-flight risk assessment in emergency medical service (EMS) helicopters

NASA Technical Reports Server (NTRS)

Shively, Robert J.

1990-01-01

A preflight risk assessment system (SAFE) was developed at NASA-Ames Research Center for civil EMS operations to assist pilots in making a decision objectively to accept or decline a mission. The ability of the SAFE system to predict risk profiles was examined at an EMS operator. Results of this field study showed that the usefulness of SAFE was largely dependent on the type of mission flown.

A User’s Guide to the ALiEM Emergency Medicine Match Advice Web Series

PubMed Central

Gisondi, Michael A.; Fant, Abra; Shakeri, Nahzinine; Schnapp, Benjamin H.; Lin, Michelle

2017-01-01

ALiEM EM Match Advice is a web series hosted on the Academic Life in Emergency Medicine website. The intended audience includes senior medical students seeking a residency in emergency medicine (EM) and the faculty members who advise them. Each episode features a panel of three EM program directors who discuss a critical step in the residency application process. This article serves as a user’s guide to the series, including a timeline for viewing each episode, brief summaries of the panel discussions, and reflection questions for discussion between students and their faculty advisors. PMID:28611891

Orion EM-1 Booster Preps - Aft Skirt Preps/Painting

NASA Image and Video Library

2016-10-28

A technician with Orbital ATK, prime contractor for the Space Launch System (SLS) Booster, preps a section of the right hand aft skirt for primer and paint in a support building at the Hangar AF facility at Cape Canaveral Air Force Station in Florida. The space shuttle-era aft skirt will be used on the right hand booster of NASA's SLS rocket for Exploration Mission 1 (EM-1). NASA is preparing for EM-1, deep space missions, and the Journey to Mars.

EMS Systems in Lower-Middle Income Countries: A Literature Review.

PubMed

Suryanto; Plummer, Virginia; Boyle, Malcolm

2017-02-01

Introduction Prehospital care is one of the many issues that require addressing by lower-middle income countries (LMICs) where approximately 90% of global injuries occur. This may arise from more traffic in LMICs, poor road conditions, lack of public awareness of the importance of road safety, and the lack of ability to provide first aid to the victims. However, prehospital care in LMICs remains underdeveloped. Problem There is insufficient evidence regarding the development of prehospital care among LMICs. Thus, the objective of this study was to investigate the status of Emergency Medical Services (EMS) systems in these countries. A review of medical-related electronic databases was designed to identify the development of EMS systems in LMICs. A search of the literature was undertaken using three electronic databases, CINAHL, Ovid Medline, and EMBASE via Ovid, from their commencement date until the end of July 2015. The grey literature was searched using Google Scholar. Articles were included if they reported on the establishment and current status of an EMS system and were excluded if they were letters to the editor, articles focusing on disaster management, a combination of more than one country if the other country was not a LMIC, written in a language other than English or Bahasa Indonesia, and/or focusing only on in-hospital care. There were 337 articles identified in CINAHL, 731 in Ovid Medline, 891 in EMBASE via Ovid, and 41 in Google Scholar. Based on the title and abstract, 31 articles from CINAHL, 40 from Ovid Medline, 43 from EMBASE, and 11 from Google Scholar were retrieved for further review. There were 92 articles that met the inclusion criteria with 35 articles removed, as they were duplicated, leaving 57 articles to be reviewed. From those 48 countries categorized as LMICs, there were 16 (33.3%) countries that had information about an EMS system, including injury types, patient demographic, prehospital transport, and the obstacles in implementing

XTEN Nationwide EMS Proposal.

DTIC Science & Technology

1979-01-01

revenue producers.20 It is the co on carriers position to sell as much service as possible to users of the network while DCS is designed to provide...escalating costs in the United States Postal Service ( USPS ) (due to its labor intensive nature) and declining costs in the EMS industries (due to...Carrier Assoc. for Tele- communications (CCAT), GTE Service Corporation (GTE), Litton Micro- wave Cooking Products , Inc., Microband Corporation of American

The longitudinal study of turnover and the cost of turnover in EMS

PubMed Central

Patterson, P. Daniel; Jones, Cheryl B.; Hubble, Michael W.; Carr, Matthew; Weaver, Matthew D.; Engberg, John; Castle, Nicholas

2010-01-01

Purpose Few studies have examined employee turnover and associated costs in emergency medical services (EMS). The purpose of this study was to quantify the mean annual rate of turnover, total median cost of turnover, and median cost per termination in a diverse sample of EMS agencies. Methods A convenience sample of 40 EMS agencies was followed over a 6 month period. Internet, telephone, and on-site data collection methods were used to document terminations, new hires, open positions, and costs associated with turnover. The cost associated with turnover was calculated based on a modified version of the Nursing Turnover Cost Calculation Methodology (NTCCM). The NTCCM identified direct and indirect costs through a series of questions that agency administrators answered monthly during the study period. A previously tested measure of turnover to calculate the mean annual rate of turnover was used. All calculations were weighted by the size of the EMS agency roster. The mean annual rate of turnover, total median cost of turnover, and median cost per termination were determined for 3 categories of agency staff mix: all paid staff, mix of paid and volunteer (mixed), and all-volunteer. Results The overall weighted mean annual rate of turnover was 10.7%. This rate varied slightly across agency staffing mix: (all-paid=10.2%, mixed=12.3%, all-volunteer=12.4%). Among agencies that experienced turnover (n=25), the weighted median cost of turnover was $71,613.75, which varied across agency staffing mix: (all-paid=$86,452.05, mixed=$9,766.65, and all-volunteer=$0). The weighted median cost per termination was $6,871.51 and varied across agency staffing mix: (all-paid=$7,161.38, mixed=$1,409.64, and all-volunteer=$0). Conclusions Annual rates of turnover and costs associated with turnover vary widely across types of EMS agencies. The study’s mean annual rate of turnover was lower than expected based on information appearing in the news media and EMS trade magazines. Findings

Disability and Preventive Cancer Screening: Results from the 2001 California Health Interview Survey

PubMed Central

Ramirez, Anthony; Farmer, Gail C.; Grant, David; Papachristou, Theodora

2005-01-01

Objective. We sought to evaluate preventive cancer screening compliance among adults with disability in California. Methods. We used data from the 2001 California Health Interview Survey to compare disabled and nondisabled adults for differences in preventive cancer screening behaviors. Compliance rates for cancer screening tests (mammography, Papanicolaou test, prostate-specific antigen, sigmoidoscopy/colonoscopy, and fecal occult blood test) between the 2 subpopulations were evaluated. Results. Women with disabilities were 17% (Papanicolaou tests) and 13% (mammograms) more likely than women without disabilities to report noncompliance with cancer screening guidelines. Interactions between disability and reports of a doctor recommendation on cervical cancer screening were significant; women with disabilities had a lower likelihood of receiving a recommendation. Men with disabilities were 19% less likely than men without disabilities to report a prostate-specific antigen test within the last 3 years. Conclusions.secondary to structural and/or clinical factors underpinning the differences found. PMID:16195509

Detection of CIN by naked eye visualization after application of acetic acid.

PubMed

Londhe, M; George, S S; Seshadri, L

1997-06-01

A prospective study was undertaken to determine the sensitivity and specificity of acetic application to the cervix followed by naked eye visualization as a screening test for detection of cervical intraepithelial neoplasia. Three hundred and seventy two sexually active woman in the reproductive age group were studied. All the women underwent Papanicolaou test, acetic acid test and colposcopy. One hundred and seventy five woman were acetic acid test negative, 197 women were acetic acid test positive. The sensitivity of acetic acid test was 72.4%, specificity 54% and false negative rate 15.2%, as compared to papanicolaou test which had a sensitivity of 13.2%, specificity of 96.3% and false negative rate of 24.4%. The advantage of the acetic acid test lies in its easy technique, low cost and high sensitivity which are important factors for determining the efficacy of any screening programme in developing countries.

Techniques for cytologic sampling of pancreatic and bile duct lesions.

PubMed

Brugge, William; Dewitt, John; Klapman, Jason B; Ashfaq, Raheela; Shidham, Vinod; Chhieng, David; Kwon, Richard; Baloch, Zubair; Zarka, Matthew; Staerkel, Gregg

2014-04-01

The Papanicolaou Society of Cytopathology has developed a set of guidelines for pancreatobiliary cytology including indications for endoscopic ultrasound guided fine-needle aspiration biopsy, techniques of the endoscopic retrograde cholangiopancreatography, terminology and nomenclature of pancreatobiliary disease, ancillary testing, and postbiopsy management. All documents are based on the expertise of the authors, a review of the literature, discussions of the draft document at several national and international meetings over an 18-month period and synthesis of online comments of the draft document on the Papanicolaou Society of Cytopathology website [www.papsociety.org]. This document presents the results of these discussions regarding the use of ancillary testing in the cytological diagnosis of biliary and pancreatic lesions. This document summarizes the current state of the art for techniques in acquiring cytology specimens from the biliary tree as well as solid and cystic lesions of the pancreas. Copyright © 2014 Wiley Periodicals, Inc.

Unsupervised Cryo-EM Data Clustering through Adaptively Constrained K-Means Algorithm

PubMed Central

Xu, Yaofang; Wu, Jiayi; Yin, Chang-Cheng; Mao, Youdong

2016-01-01

In single-particle cryo-electron microscopy (cryo-EM), K-means clustering algorithm is widely used in unsupervised 2D classification of projection images of biological macromolecules. 3D ab initio reconstruction requires accurate unsupervised classification in order to separate molecular projections of distinct orientations. Due to background noise in single-particle images and uncertainty of molecular orientations, traditional K-means clustering algorithm may classify images into wrong classes and produce classes with a large variation in membership. Overcoming these limitations requires further development on clustering algorithms for cryo-EM data analysis. We propose a novel unsupervised data clustering method building upon the traditional K-means algorithm. By introducing an adaptive constraint term in the objective function, our algorithm not only avoids a large variation in class sizes but also produces more accurate data clustering. Applications of this approach to both simulated and experimental cryo-EM data demonstrate that our algorithm is a significantly improved alterative to the traditional K-means algorithm in single-particle cryo-EM analysis. PMID:27959895

Factors that Influence the Formation and Stability of Thin, Cryo-EM Specimens

DOE PAGES

Glaeser, Robert M.; Han, Bong-Gyoon; Csencsits, Roseann; ...

2015-09-17

Poor consistency of the ice thickness from one area of a cryo-electron microscope (cryo-EM) specimen grid to another, from one grid to the next, and from one type of specimen to another, motivates a reconsideration of how to best prepare suitably thin specimens. We first review the three related topics of wetting, thinning, and stability against dewetting of aqueous films spread over a hydrophilic substrate. Furthermore, we then suggest that the importance of there being a surfactant monolayer at the air-water interface of thin, cryo-EM specimens has been largely underappreciated. In fact, a surfactant layer (of uncontrolled composition and surfacemore » pressure) can hardly be avoided during standard cryo-EM specimen preparation. Thus it is suggested that better control over the composition and properties of the surfactant layer may result in more reliable production of cryo-EM specimens with the desired thickness.« less

Factors that Influence the Formation and Stability of Thin, Cryo-EM Specimens

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

Glaeser, Robert M.; Han, Bong-Gyoon; Csencsits, Roseann

Poor consistency of the ice thickness from one area of a cryo-electron microscope (cryo-EM) specimen grid to another, from one grid to the next, and from one type of specimen to another, motivates a reconsideration of how to best prepare suitably thin specimens. We first review the three related topics of wetting, thinning, and stability against dewetting of aqueous films spread over a hydrophilic substrate. Furthermore, we then suggest that the importance of there being a surfactant monolayer at the air-water interface of thin, cryo-EM specimens has been largely underappreciated. In fact, a surfactant layer (of uncontrolled composition and surfacemore » pressure) can hardly be avoided during standard cryo-EM specimen preparation. Thus it is suggested that better control over the composition and properties of the surfactant layer may result in more reliable production of cryo-EM specimens with the desired thickness.« less

Configurations of EMS systems : a pilot study

DOT National Transportation Integrated Search

2008-03-01

Emergency medical services (EMS) systems are configured differently depending on several factors, including the size, demographics, geography, and politics of the local communities they serve. Although some information exists about the organization, ...

Method for evaluating compatibility of commercial electromagnetic (EM) microsensor tracking systems with surgical and imaging tables

NASA Astrophysics Data System (ADS)

Nafis, Christopher; Jensen, Vern; von Jako, Ron

2008-03-01

Electromagnetic (EM) tracking systems have been successfully used for Surgical Navigation in ENT, cranial, and spine applications for several years. Catheter sized micro EM sensors have also been used in tightly controlled cardiac mapping and pulmonary applications. EM systems have the benefit over optical navigation systems of not requiring a line-of-sight between devices. Ferrous metals or conductive materials that are transient within the EM working volume may impact tracking performance. Effective methods for detecting and reporting EM field distortions are generally well known. Distortion compensation can be achieved for objects that have a static spatial relationship to a tracking sensor. New commercially available micro EM tracking systems offer opportunities for expanded image-guided navigation procedures. It is important to know and understand how well these systems perform with different surgical tables and ancillary equipment. By their design and intended use, micro EM sensors will be located at the distal tip of tracked devices and therefore be in closer proximity to the tables. Our goal was to define a simple and portable process that could be used to estimate the EM tracker accuracy, and to vet a large number of popular general surgery and imaging tables that are used in the United States and abroad.

Compassionate Options for Pediatric EMS (COPE): Addressing Communication Skills.

PubMed

Calhoun, Aaron W; Sutton, Erica R H; Barbee, Anita P; McClure, Beth; Bohnert, Carrie; Forest, Richard; Taillac, Peter; Fallat, Mary E

2017-01-01

Each year, 16,000 children suffer cardiopulmonary arrest, and in one urban study, 2% of pediatric EMS calls were attributed to pediatric arrests. This indicates a need for enhanced educational options for prehospital providers that address how to communicate to families in these difficult situations. In response, our team developed a cellular phone digital application (app) designed to assist EMS providers in self-debriefing these events, thereby improving their communication skills. The goal of this study was to pilot the app using a simulation-based investigative methodology. Video and didactic app content was generated using themes developed from a series of EMS focus groups and evaluated using volunteer EMS providers assessed during two identical nonaccidental trauma simulations. Intervention groups interacted with the app as a team between assessments, and control groups debriefed during that period as they normally would. Communication performance and gap analyses were measured using the Gap-Kalamazoo Consensus Statement Assessment Form. A total of 148 subjects divided into 38 subject groups (18 intervention groups and 20 control groups) were assessed. Comparison of initial intervention group and control group scores showed no statistically significant difference in performance (2.9/5 vs. 3.0/5; p = 0.33). Comparisons made during the second assessment revealed a statistically significant improvement in the intervention group scores, with a moderate to large effect size (3.1/5 control vs. 4.0/5 intervention; p < 0.001, r = 0.69, absolute value). Gap analysis data showed a similar pattern, with gaps of -0.6 and -0.5 (values suggesting team self-over-appraisal of communication abilities) present in both control and intervention groups (p = 0.515) at the initial assessment. This gap persisted in the control group at the time of the second assessment (-0.8), but was significantly reduced (0.04) in the intervention group (p = 0.013, r = 0.41, absolute value

The Impact of Education About Cervical Cancer and Human Papillomavirus on Women's Healthy Lifestyle Behaviors and Beliefs: Using the PRECEDE Educational Model.

PubMed

Koç, Zeliha; Özdeş, Emel Kurtoğlu; Topatan, Serap; Çinarli, Tuğba; Şener, Asuman; Danaci, Esra; Palazoğlu, Cansu Atmaca

2018-02-14

Early detection of cervical cancer improves the chances of successful treatment. The aim of this study was to determine the effect of education about cervical cancer and human papillomavirus on the healthy lifestyle, behavior, and beliefs of Turkish women who were without cancer, using the PRECEDE education model. This qualitative and quantitative study was conducted as a prospective, randomized, 2-group (intervention and control) trial at a community training center in north Turkey. A total of 156 Turkish women who were without cancer participated in this study. The semistructured interview form, the SF-36 Health Status Questionnaire, the Health Belief Model Scale for Cervical Cancer and Pap Smear Test, and the Healthy Lifestyle Behavior Scale II were used. The subdimension scores of the Health Belief Model Scale for Cervical Cancer and Pap Smear Test were found to be higher among women in the study group (cervical cancer seriousness, P = .001; health motivation, P = .001) as compared with the control group after the education program. The SF-36 Health Status Questionnaire domain scores for physical role limitations, mental role limitations, and general health perceptions increased in the study group after the intervention. The posteducation health motivation of women in the study group was improved, the women's perceptions of obstacles to Papanicolaou testing decreased, and through increased knowledge and awareness, the rate of Papanicolaou testing increased. Educational programs aimed at motivating women to increase their awareness of cervical cancer, preventing cervical cancer, and having Papanicolaou testing are necessary and beneficial in this sample.

Disparity in the Persistence of High-Risk Human Papillomavirus Genotypes Between African American and European American Women of College Age

PubMed Central

Banister, Carolyn E.; Messersmith, Amy R.; Cai, Bo; Spiryda, Lisa B.; Glover, Saundra H.; Pirisi, Lucia; Creek, Kim E.

2015-01-01

Background. Cervical cancer incidence and mortality rates are higher in African Americans than in European Americans (white, non-Hispanic of European ancestry). The reasons for this disparity are not known. Methods. We recruited a population-based longitudinal cohort of 326 European American and 113 African American female college freshmen in Columbia, South Carolina, to compare clearance of high-risk human papillomavirus (HR-HPV) infection between ethnicities. HPV testing and typing from samples obtained for Papanicolaou testing occurred every 6 months. Results. African American participants had an increased risk of testing positive for HR-HPV, compared with European American participants, but the frequency of incident HPV infection was the same in African American and European American women. Thus, exposure to HPV could not explain the higher rate of HPV positivity among African American women. The time required for 50% of participants to clear HR-HPV infection was 601 days for African American women (n = 63) and 316 days for European American women (n = 178; odds ratio [OR], 1.61; 95% confidence interval [CI], 1.08–2.53). African American women were more likely than European American women to have an abnormal result of a Papanicolaou test (OR, 1.58; 95% CI, 1.05–2.39). Conclusions. We propose that the longer time to clearance of HR-HPV among African American women leads to increased rates of abnormal results of Papanicolaou tests and contributes to the increased rates of cervical cancer observed in African American women. PMID:25028692

[Human papillomavirus testing in cervical cancer screening at a public health service of Santiago, Chile].

PubMed

Terrazas, Solana; Ibáñez, Carolina; Lagos, Marcela; Poggi, Helena; Brañes, Jorge; Barriga, María Isabel; Cartagena, Jaime; Núñez, Felipe; González, Francisca; Cook, Paz; Van De Wyngard, Vanessa; Ferreccio, Catterina

2015-01-01

Molecular techniques for human papillomavirus (HPV) detection have a good performance as screening tests and could be included in cervical cancer early detection programs. We conducted a population-based trial comparing HPV detection and Papanicolaou as primary screening tests, in a public health service in Santiago, Chile. To describe the experience of implementing this new molecular test and present the main results of the study. Women aged 25 to 64 enrolled in three public health centers were invited to participate. In all women, samples were collected for Papanicolaou and HPV DNA testing, and naked-eye visual inspection of the cervix with acetic acid was performed. Women with any positive screening test were referred to the local area hospital for diagnostic confirmation with colposcopy and biopsy of suspicious lesions. Screening results were obtained for 8265 women, of whom 931 (11.3%) were positive to any test. The prevalence of cervical intraepithelial neoplasia grade 2 or worse (CIN2+) was 1.1%; nine women had invasive cervical cancer. Sensitivities for the detection of CIN2+ were 22.1% (95% confidence interval (CI) 16.4-29.2) for Papanicolaou and 92.7% (95% CI 84.4-96.8) for HPV testing; specificities were 98.9% (95% CI 98.7-99.0) and 92.0% (95% CI 91.4-92.6) respectively. This experience showed that the implementation of a molecular test for cervical cancer screening is not a major challenge in Chile: it was well accepted by both the health team and the participants, and it may improve the effectiveness of the screening program.

Cystatin E/M Suppresses Tumor Cell Growth through Cytoplasmic Retention of NF-κB

PubMed Central

Soh, Hendrick; Venkatesan, Natarajan; Veena, Mysore S.; Ravichandran, Sandhiya; Zinabadi, Alborz; Basak, Saroj K.; Parvatiyar, Kislay; Srivastava, Meera; Liang, Li-Jung; Gjertson, David W.; Torres, Jorge Z.; Moatamed, Neda A.

2016-01-01

We and others have shown that the cystatin E/M gene is inactivated in primary human tumors, pointing to its role as a tumor suppressor gene. However, the molecular mechanism of tumor suppression is not yet understood. Using plasmid-directed cystatin E/M gene overexpression, a lentivirus-mediated tetracycline-inducible vector system, and human papillomavirus 16 (HPV 16) E6 and E7 gene-immortalized normal human epidermal keratinocytes, we demonstrated intracellular and non-cell-autonomous apoptotic growth inhibition of tumor cell lines and that growth inhibition is associated with cytoplasmic retention of NF-κB. We further demonstrated decreased phosphorylation of IκB kinase (IKKβ) and IκBα in the presence of tumor necrosis factor alpha (TNF-α), confirming the role of cystatin E/M in the regulation of the NF-κB signaling pathway. Growth suppression of nude mouse xenograft tumors carrying a tetracycline-inducible vector system was observed with the addition of doxycycline in drinking water, confirming that the cystatin E/M gene is a tumor suppressor gene. Finally, immunohistochemical analyses of cervical carcinoma in situ and primary tumors have shown a statistically significant inverse relationship between the expression of cystatin E/M and cathepsin L and a direct relationship between the loss of cystatin E/M expression and nuclear expression of NF-κB. We therefore propose that the cystatin E/M suppressor gene plays an important role in the regulation of NF-κB. PMID:27090639

Orion EM-1 Booster Preps - Aft Skirt Preps/Painting

NASA Image and Video Library

2016-10-28

Technicians with Orbital ATK, prime contractor for the Space Launch System (SLS) Booster, prepare the right hand aft skirt for NASA’s SLS rocket for primer and painting inside a support building at the Hangar AF facility at Cape Canaveral Air Force Station in Florida. The space shuttle-era aft skirt, was inspected and resurfaced and will be primed and painted for use on the right hand booster of the SLS rocket for Exploration Mission 1 (EM-1). NASA is preparing for EM-1, deep-space missions, and the journey to Mars.

Orion EM-1 Booster Preps - Aft Skirt Preps/Painting

NASA Image and Video Library

2016-10-28

Technicians with Orbital ATK, prime contractor for the Space Launch System (SLS) Booster, prepare a paint mixture for the right hand aft skirt for NASA’s SLS in a support building at the Hangar AF facility at Cape Canaveral Air Force Station in Florida. The space shuttle-era aft skirt, was inspected and resurfaced, and will be primed and painted for use on the right hand booster of the SLS rocket for Exploration Mission 1 (EM-1). NASA is preparing for EM-1, deep-space missions, and the Journey to Mars.

Automated structure refinement of macromolecular assemblies from cryo-EM maps using Rosetta.

PubMed

Wang, Ray Yu-Ruei; Song, Yifan; Barad, Benjamin A; Cheng, Yifan; Fraser, James S; DiMaio, Frank

2016-09-26

Cryo-EM has revealed the structures of many challenging yet exciting macromolecular assemblies at near-atomic resolution (3-4.5Å), providing biological phenomena with molecular descriptions. However, at these resolutions, accurately positioning individual atoms remains challenging and error-prone. Manually refining thousands of amino acids - typical in a macromolecular assembly - is tedious and time-consuming. We present an automated method that can improve the atomic details in models that are manually built in near-atomic-resolution cryo-EM maps. Applying the method to three systems recently solved by cryo-EM, we are able to improve model geometry while maintaining the fit-to-density. Backbone placement errors are automatically detected and corrected, and the refinement shows a large radius of convergence. The results demonstrate that the method is amenable to structures with symmetry, of very large size, and containing RNA as well as covalently bound ligands. The method should streamline the cryo-EM structure determination process, providing accurate and unbiased atomic structure interpretation of such maps.

Estudo comparativo entre estrelas centrais de nebulosas planetárias deficientes em hidrogênio

NASA Astrophysics Data System (ADS)

Marcolino, W. L. F.; de Araújo, F. X.

2003-08-01

Apresentamos neste trabalho o resultado de um estudo das principais características espectrais das estrelas centrais de nebulosas planetárias (ECNP) deficientes em hidrogênio. A origem e a evolução dessas estrelas ainda constitui um problema em aberto na evolução estelar. Geralmente esses objetos são divididos em [WCE], [WCL] e [WELS]. Os tipos [WCE] e [WCL] apresentam um espectro típico de uma estrela Wolf-Rayet carbonada de população I e as [WELS] apresentam linhas fracas de carbono e oxigênio em emissão. Existem evidências que apontam a seguinte sequência evolutiva : [WCL] = > [WCE] = > [WELS] = > PG 1159 (pré anã-branca). No entanto, tal cenário apresenta falhas como por exemplo a falta de ECNP entre os tipos [WCL] e [WCE]. Baseados em uma amostra de 24 objetos obtida no telescópio de 1.52m em La Silla, Chile (acordo ESO/ON), ao longo do ano 2000, apresentamos os resultados da comparação das larguras equivalentes de diversas linhas relevantes entre os tipos [WCL], [WCE] e [WELS]. Verificamos que nossos dados estão de acordo com a sequência evolutiva. Baseado nas linhas de C IV, conseguimos dividir pela primeira vez as [WELS] em dois grupos principais. Além disso, os dados reforçam a afirmação de que as [WCE] são as estrelas que possuem a maior temperatura entre as ECNP deficientes em hidrogênio. Discutimos ainda, a escassez de dados disponíveis na literatura e a necessidade da obtenção de parametros físicos para estes objetos.

Does EMS Perceived Anatomic Injury Predict Trauma Center Need?

PubMed Central

Lerner, E. Brooke; Roberts, Jennifer; Guse, Clare E.; Shah, Manish N.; Swor, Robert; Cushman, Jeremy T.; Blatt, Alan; Jurkovich, Gregory J.; Brasel, Karen

2013-01-01

Objective Our objective was to determine the predictive value of the anatomic step of the 2011 Field Triage Decision Scheme for identifying trauma center need. Methods EMS providers caring for injured adults transported to regional trauma centers in 3 midsized communities were interviewed over two years. Patients were included, regardless of injury severity, if they were at least 18 years old and were transported by EMS with a mechanism of injury that was an assault, motor vehicle or motorcycle crash, fall, or pedestrian or bicyclist struck. The interview was conducted upon ED arrival and collected physiologic condition and anatomic injury data. Patients who met the physiologic criteria were excluded. Trauma center need was defined as non-orthopedic surgery within 24 hours, intensive care unit admission, or death prior to hospital discharge. Data were analyzed by calculating descriptive statistics including positive likelihood ratios (+LR) with 95% confidence intervals. Results 11,892 interviews were conducted. One was excluded because of missing outcome data and 1,274 were excluded because they met the physiologic step. EMS providers identified 1,167 cases that met the anatomic criteria, of which 307 (26%) needed the resources of a trauma center (38% sensitivity, 91% specificity, +LR 4.4; CI: 3.9 - 4.9). Criteria with a +LR ≥5 were flail chest (9.0; CI: 4.1 - 19.4), paralysis (6.8; CI: 4.2 - 11.2), two or more long bone fractures (6.3; CI: 4.5 - 8.9), and amputation (6.1; CI: 1.5 - 24.4). Criteria with a +LR >2 and <5 were penetrating injury (4.8; CI: 4.2 - 5.6), and skull fracture (4.8; CI: 3.0 - 7.7). Only pelvic fracture (1.9; CI: 1.3 - 2.9) had a +LR less than 2. Conclusions The anatomic step of the Field Triage Guidelines as determined by EMS providers is a reasonable tool for determining trauma center need. Use of EMS perceived pelvic fracture as an indicator for trauma center need should be re-evaluated. PMID:23627418

RURALSIM: the design and implementation of a rural EMS simulator.

PubMed

Shuman, L J; Wolfe, H; Gunter, M J

1992-01-01

Why were these applications of simulation technology unsuccessful? Parochialism, the volunteer nature of EMS planning, and limited regional commitment to resolve such complex problems at the local level all combined to present significant barriers to implementation. Political factors which posed the most significant barriers included: conservative attitudes concerning the funding and regulation of EMS activities by local governments; general opposition to governmental intervention in the private sector; strong resistance to mandatory standards for EMS; jurisdictional disputes between EMS-related agencies; lack of cooperation between the local governments; competition between prehospital-care providers and between hospitals; overemphasis on local jurisdictional boundaries in the planning and delivery of services; and the allocation of EMS resources, such as ambulances, according to political priorities, rather than more objective criteria. Based upon the results of the four field tests, the following observations are relevant: 1. RURALSIM is a very complex simulator. While every effort was made to assure generalizability, for any given situation, it required extensive modification and tailoring. The result was a model capable of handling a rather diverse set of situations, but one that could not be turned over to the general public for use. To implement RURALSIM required the participation of the University of Pittsburgh research team. The newer simulation languages now available alleviate this problem somewhat. 2. RURALSIM's complexity was needed to examine the different alternatives proposed by local planners. It was particularly needed in order to simulate each region's existing system. Such "base-line" simulations were required in order to achieve face validity and provide a basis for comparing alternatives. 3. With hindsight, a major weakness was the limited amount of face-to-face interaction between local planners and decision makers and the University of

Assessing the environmental performance of construction materials testing using EMS: An Australian study.

PubMed

Dejkovski, Nick

2016-10-01

This paper reports the audit findings of the waste management practices at 30 construction materials testing (CMT) laboratories (constituting 4.6% of total accredited CMT laboratories at the time of the audit) that operate in four Australian jurisdictions and assesses the organisation's Environmental Management System (EMS) for indicators of progress towards sustainable development (SD). In Australia, waste indicators are 'priority indicators' of environmental performance yet the quality and availability of waste data is poor. National construction and demolition waste (CDW) data estimates are not fully disaggregated and the contribution of CMT waste (classified as CDW) to the national total CDW landfill burden is difficult to quantify. The environmental and human impacts of anthropogenic release of hazardous substances contained in CMT waste into the ecosphere can be measured by construing waste indicators from the EMS. An analytical framework for evaluating the EMS is developed to elucidate CMT waste indicators and assess these indicators against the principle of proportionality. Assessing against this principle allows for: objective evaluations of whether the environmental measures prescribed in the EMS are 'proportionate' to the 'desired' (subjective) level of protection chosen by decision-makers; and benchmarking CMT waste indicators against aspirational CDW targets set by each Australian jurisdiction included in the audit. Construed together, the EMS derived waste indicators and benchmark data provide a composite indicator of environmental performance and progress towards SD. The key audit findings indicate: CMT laboratories have a 'poor' environmental performance (and overall progress towards SD) when EMS waste data are converted into indicator scores and assessed against the principle of proportionality; CMT waste recycling targets are lower when benchmarked against jurisdictional CDW waste recovery targets; and no significant difference in the average

Cryo-EM Data Are Superior to Contact and Interface Information in Integrative Modeling.

PubMed

de Vries, Sjoerd J; Chauvot de Beauchêne, Isaure; Schindler, Christina E M; Zacharias, Martin

2016-02-23

Protein-protein interactions carry out a large variety of essential cellular processes. Cryo-electron microscopy (cryo-EM) is a powerful technique for the modeling of protein-protein interactions at a wide range of resolutions, and recent developments have caused a revolution in the field. At low resolution, cryo-EM maps can drive integrative modeling of the interaction, assembling existing structures into the map. Other experimental techniques can provide information on the interface or on the contacts between the monomers in the complex. This inevitably raises the question regarding which type of data is best suited to drive integrative modeling approaches. Systematic comparison of the prediction accuracy and specificity of the different integrative modeling paradigms is unavailable to date. Here, we compare EM-driven, interface-driven, and contact-driven integrative modeling paradigms. Models were generated for the protein docking benchmark using the ATTRACT docking engine and evaluated using the CAPRI two-star criterion. At 20 Å resolution, EM-driven modeling achieved a success rate of 100%, outperforming the other paradigms even with perfect interface and contact information. Therefore, even very low resolution cryo-EM data is superior in predicting heterodimeric and heterotrimeric protein assemblies. Our study demonstrates that a force field is not necessary, cryo-EM data alone is sufficient to accurately guide the monomers into place. The resulting rigid models successfully identify regions of conformational change, opening up perspectives for targeted flexible remodeling. Copyright © 2016 Biophysical Society. Published by Elsevier Inc. All rights reserved.

Cryo-EM Data Are Superior to Contact and Interface Information in Integrative Modeling

PubMed Central

de Vries, Sjoerd J.; Chauvot de Beauchêne, Isaure; Schindler, Christina E.M.; Zacharias, Martin

2016-01-01

Protein-protein interactions carry out a large variety of essential cellular processes. Cryo-electron microscopy (cryo-EM) is a powerful technique for the modeling of protein-protein interactions at a wide range of resolutions, and recent developments have caused a revolution in the field. At low resolution, cryo-EM maps can drive integrative modeling of the interaction, assembling existing structures into the map. Other experimental techniques can provide information on the interface or on the contacts between the monomers in the complex. This inevitably raises the question regarding which type of data is best suited to drive integrative modeling approaches. Systematic comparison of the prediction accuracy and specificity of the different integrative modeling paradigms is unavailable to date. Here, we compare EM-driven, interface-driven, and contact-driven integrative modeling paradigms. Models were generated for the protein docking benchmark using the ATTRACT docking engine and evaluated using the CAPRI two-star criterion. At 20 Å resolution, EM-driven modeling achieved a success rate of 100%, outperforming the other paradigms even with perfect interface and contact information. Therefore, even very low resolution cryo-EM data is superior in predicting heterodimeric and heterotrimeric protein assemblies. Our study demonstrates that a force field is not necessary, cryo-EM data alone is sufficient to accurately guide the monomers into place. The resulting rigid models successfully identify regions of conformational change, opening up perspectives for targeted flexible remodeling. PMID:26846888

EM Cep: The Be Star

NASA Astrophysics Data System (ADS)

Kochiashvili, N.; Kochiashvili, I.; Natsvlishvili, R.; Vardosanidze, M.; Beradze, S.

2017-07-01

On the basis of UBVR photometric data, obtained in the Abastumani Observatory during 1991-1999, very interesting and unusual flare of EM Cep has been revealed. Duration of the flare was over two hours. We estimated the percentage of brightness increase during the flare and brightness decrease of the corresponding anti- flare and the minimum amount of the lost mass during this event. We have solved the light curves of the star using the Wilson-Devinney code. But the resulting fraction of calculated brightness of the companion star was not in accordance with spectral data. Then we decided to check the idea of a pulsating single star using new spectral data. Together with our Buyrakan colleagues we obtained and analyzed spectra of the star. We could not find spectral lines of a companion star or any traces of the radial velocities using this data. Hence, we concluded that we need the higher resolution spectra for final resolution of the matter. On the basis of the latest spectral data of Bulgarian astronomers they concluded that EM Cep is a single star. This makes it possible to suggest, that the question of stellar pulsation could be solved using additional photometric observations.

Humoral and cell-mediated immune responses to influenza vaccination in equine metabolic syndrome (EMS) horses.

PubMed

Elzinga, Sarah; Reedy, Stephanie; Barker, Virginia D; Chambers, Thomas M; Adams, Amanda A

2018-05-01

Obesity is an increasing problem in the equine population with recent reports indicating that the percentage of overweight horses may range anywhere from 20.6-51%. Obesity in horses has been linked to more serious health concerns such as equine metabolic syndrome (EMS). EMS is a serious problem in the equine industry given its defining characteristics of insulin dysregualtion and obesity, as well as the involvement of laminitis. Little research however has been conducted to determine the effects of EMS on routine healthcare of these horses, in particular how they respond to vaccination. It has been shown that obese humans and mice have decreased immune responses to vaccination. EMS may have similar effects on vaccine responses in horses. If this is the case, these animals may be more susceptible to disease, acting as unknown disease reservoirs. Therefore, we investigated the effects of EMS on immune responses to routine influenza vaccination. Twenty-five adult horses of mixed-sex and mixed-breed (8-21 years old) horses; 13 EMS and 12 non-EMS were selected. Within each group, 4 horses served as non-vaccinate saline controls and the remaining horses were vaccinated with a commercially available equine influenza vaccine. Vaccination (influenza or saline) was administered on weeks 0 and 3, and peripheral blood samples taken on week 0 prior to vaccination and on weeks 1, 2, 3, 4, and 5 post vaccination. Blood samples were used to measure hemagglutination inhibition (HI) titers and equine influenza specific IgGa, IgGb, and IgGT levels. Blood samples were also used to isolate peripheral blood mononuclear cells (PBMCs) for analysis of cell mediated immune (CMI) responses via real-time polymerase chain reaction (RT-PCR). All horses receiving influenza vaccination responded with significant increases (P < 0.05) in HI titers, and IgGa and IgGb equine influenza specific antibodies following vaccination compared to saline controls. EMS did not significantly affect (P�

The PX-EM algorithm for fast stable fitting of Henderson's mixed model

PubMed Central

Foulley, Jean-Louis; Van Dyk, David A

2000-01-01

This paper presents procedures for implementing the PX-EM algorithm of Liu, Rubin and Wu to compute REML estimates of variance covariance components in Henderson's linear mixed models. The class of models considered encompasses several correlated random factors having the same vector length e.g., as in random regression models for longitudinal data analysis and in sire-maternal grandsire models for genetic evaluation. Numerical examples are presented to illustrate the procedures. Much better results in terms of convergence characteristics (number of iterations and time required for convergence) are obtained for PX-EM relative to the basic EM algorithm in the random regression. PMID:14736399

Orion EM-1 Crew Module Structural Test Article loaded onto Guppy

NASA Image and Video Library

2017-04-25

The Orion Exploration Mission-1 (EM-1) structural test article, inside its transport container, is secured in NASA's Super Guppy aircraft at the Shuttle Landing Facility at NASA's Kennedy Space Center in Florida. The test article will be transported to Lockheed Martin's Denver facility for testing. The Orion spacecraft will launch atop NASA’s Space Launch System rocket on EM-1, its first deep space mission.

Orion EM-1 Crew Module Structural Test Article loaded onto Guppy

NASA Image and Video Library

2017-04-25

The Orion Exploration Mission-1 (EM-1) structural test article, secured inside its transport container, is loaded into NASA's Super Guppy aircraft at the Shuttle Landing Facility at NASA's Kennedy Space Center in Florida. The test article will be transported to Lockheed Martin's Denver facility for testing. The Orion spacecraft will launch atop NASA’s Space Launch System rocket on EM-1, its first deep space mission.

The 2017 Nobel Prize in Chemistry: cryo-EM comes of age.

PubMed

Shen, Peter S

2018-03-01

The 2017 Nobel Prize in Chemistry was awarded to Jacques Dubochet, Joachim Frank, and Richard Henderson for "developing cryo-electron microscopy (cryo-EM) for the high-resolution structure determination of biomolecules in solution." This feature article summarizes some of the major achievements leading to the development of cryo-EM and recent technological breakthroughs that have transformed the method into a mainstream tool for structure determination.

Leukocyte Recognition Using EM-Algorithm

NASA Astrophysics Data System (ADS)

Colunga, Mario Chirinos; Siordia, Oscar Sánchez; Maybank, Stephen J.

This document describes a method for classifying images of blood cells. Three different classes of cells are used: Band Neutrophils, Eosinophils and Lymphocytes. The image pattern is projected down to a lower dimensional sub space using PCA; the probability density function for each class is modeled with a Gaussian mixture using the EM-Algorithm. A new cell image is classified using the maximum a posteriori decision rule.

BSSDATA - um programa otimizado para filtragem de dados em radioastronomia solar

NASA Astrophysics Data System (ADS)

Martinon, A. R. F.; Sawant, H. S.; Fernandes, F. C. R.; Stephany, S.; Preto, A. J.; Dobrowolski, K. M.

2003-08-01

A partir de 1998, entrou em operação regular no INPE, em São José dos Campos, o Brazilian Solar Spectroscope (BSS). O BSS é dedicado às observações de explosões solares decimétricas com alta resolução temporal e espectral, com a principal finalidade de investigar fenômenos associados com a liberação de energia dos "flares" solares. Entre os anos de 1999 e 2002, foram catalogadas, aproximadamente 340 explosões solares classificadas em 8 tipos distintos, de acordo com suas características morfológicas. Na análise detalhada de cada tipo, ou grupo, de explosões solares deve-se considerar a variação do fluxo do sol calmo ("background"), em função da freqüência e a variação temporal, além da complexidade das explosões e estruturas finas registradas superpostas ao fundo variável. Com o intuito de realizar tal análise foi desenvolvido o programa BSSData. Este programa, desenvolvido em linguagem C++, é constituído de várias ferramentas que auxiliam no tratamento e análise dos dados registrados pelo BSS. Neste trabalho iremos abordar as ferramentas referentes à filtragem do ruído de fundo. As rotinas do BSSData para filtragem de ruído foram testadas nos diversos grupos de explosões solares ("dots", "fibra", "lace", "patch", "spikes", "tipo III" e "zebra") alcançando um bom resultado na diminuição do ruído de fundo e obtendo, em conseqüência, dados onde o sinal torna-se mais homogêneo ressaltando as áreas onde existem explosões solares e tornando mais precisas as determinações dos parâmetros observacionais de cada explosão. Estes resultados serão apresentados e discutidos.

78 FR 18983 - Proposed Data Collections Submitted for Public Comment and Recommendations

Federal Register 2010, 2011, 2012, 2013, 2014

2013-03-28

... maximum limit of 100 slides in no less than an 8-hour day. On August 29, 2011 the American Society of...: American Society for Clinical Pathology, American Society for Cytotechnology, American Society of Cytopathology, and Papanicolaou Society of Cytopathology. The College of American Pathologists also acknowledged...

Orion EM-1 Booster Preps - Aft Skirt Preps/Painting

NASA Image and Video Library

2016-10-28

A paint technician with Orbital ATK, prime contractor for the Space Launch System (SLS) Booster, uses an air gun to apply paint to the right hand aft skirt for NASA’s SLS rocket inside a support building at the Hangar AF facility at Cape Canaveral Air Force Station. The space shuttle-era aft skirt, was inspected and resurfaced to prepare it for primer and paint. The aft skirt will be used on the right hand booster of the SLS rocket for Exploration Mission 1 (EM-1). NASA is preparing for EM-1, deep-space missions, and the journey to Mars.

Biospecimen repositories and cytopathology.

PubMed

Krishnamurthy, Savitri

2015-03-01

Biospecimen repositories are important for the advancement of biomedical research. Literature on the potential for biobanking of fine-needle aspiration, gynecologic, and nongynecologic cytology specimens is very limited. The potential for biobanking of these specimens as valuable additional resources to surgically excised tissues appears to be excellent. The cervicovaginal specimens that can be used for biobanking include Papanicolaou-stained monolayer preparations and residual material from liquid-based cytology preparations. Different types of specimen preparations of fine-needle aspiration and nongynecologic specimens, including Papanicolaou-stained and Diff-Quik-stained smears, cell blocks. and dedicated passes/residual material from fine-needle aspiration stored frozen in a variety of solutions, can be used for biobanking. Because of several gaps in knowledge regarding the standard of operative procedures for the procurement, storage, and quality assessment of cytology specimens, further studies as well as national conferences and workshops are needed not only to create awareness but also to facilitate the use of cytopathology specimens for biobanking. © 2014 American Cancer Society.

DOE-EM Science of Safety Robotics Challenge

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

Rimando, Rodrigo; Watts, Alex; Bobbitt, John

During the week of August 22nd, 2016, over 150 technologists, stakeholders, and Department of Energy, Office of Environmental Management workers, met at DOE’s Portsmouth Gaseous Diffusion Plant in Ohio, for the EM Science of Safety Robotics Challenge.

[In Process Citation].

PubMed

Guzmán-Mercado, Elizabeth; Vásquez-Garibay, Edgar M; Troyo-Sanroman, Rogelio; Romero-Velarde, Enrique

2016-03-25

Objetivo: identificar los hábitos alimentarios de adolescentes embarazadas en cuatro estados civiles diferentes: casada, cohabita con una pareja, soltera sin pareja y soltera con una pareja. Métodos: en estudio transversal, se incluyeron 321 adolescentes embarazadas de 13-19 años que acudieron al Hospital Civil de Guadalajara Dr. Juan I Menchaca, Guadalajara (Jalisco, México). Se encontraban sanas, en cualquier trimestre del embarazo y pertenecían a un nivel socioe-conómico bajo o medio-bajo. El estado civil se estratificó en: casadas; en unión libre; soltera con una pareja y soltera sin pareja. Se incluyeron datos socio-demográficos, económicos y de hábitos de alimentación. Se utilizaron pruebas de ANOVA, pruebas post-hoc para Chi 2 , razón de momios y modelos de regresión logística. Resultados: la frecuencia de las adolescentes casadas fue de 9,3%, 59,8% en unión libre, 15,3% eran solteras sin pareja y 15,6% solteras con pareja. La baja escolaridad (RM 2,6 [1,5-4,4]) y la ocupación en el hogar (RM 4,47 [1,99-10,0]) predominaron entre las adolescentes en unión libre; la ocupación en el hogar (RM 0,28 [0,127-0,61]) y cenar sin compañía (RM 4,12 [1,62-10,8]) fueron significativamente más frecuentes en adolescentes sin pareja. El consumo de verduras fue menor en las adolescentes casadas y en quienes cohabitaban con pareja; el consumo de frijoles y pan dulce fue menor en adolescentes embarazadas casadas. Conclusión: debido a que ciertas variables y hábitos de alimentación mostraron diferencias entre los grupos es pertinente analizar las adolescentes embarazadas de acuerdo a su estado civil.

Análise da medição do raio solar em ultravioleta

NASA Astrophysics Data System (ADS)

Saraiva, A. C. V.; Giménez de Castro, C. G.; Costa, J. E. R.; Selhorst, C. L.; Simões, P. J. A.

2003-08-01

A medição acurada do raio solar em qualquer banda do espectro eletromagnético é de relevância na formulação e calibração de modelos da estrutura e atmosfera solar. Esses modelos atribuem emissão do contínuo do Sol calmo em microondas à mesma região da linha Ha do Hell. Apresentamos a medição do raio solar em UV com imagens do EIT (Extreme Ultraviolet Image Telescope) entre 1996 e 2002, no comprimento de onda 30,9 nm (Ha do Hell), que se forma na região de transição/cromosfera solar. A técnica utilizada para o cálculo do raio UV foi baseada na transformada Wavelet B3spline. Fizemos um banco de dados com 1 imagem por dia durante o período citado. Obtivemos como resultado o raio médio da ordem de 975.61" e uma diminuição do mesmo para o período citado variando em média -0,45" /ano. Comparamos estes dados com os valores obtidos pelo ROI (Radio Observatório de Itapetinga) em 22/48 GHz e Nobeyama Radio Heliograph em 17 GHz mostrando que os raios médios são muito próximos o que indica que a região de formação nessas freqüências é a mesma conforme os modelos. Comparamos os resultados também com outros índices de atividade solar.

Orion EM-1 Crew Module Structural Test Article loaded onto Guppy

NASA Image and Video Library

2017-04-25

On the tarmac at the Shuttle Landing Facility at NASA's Kennedy Space Center in Florida, the Orion Exploration Mission-1 (EM-1) structural test article, secured in its transport container, is loaded into the agency's Super Guppy aircraft. The test article will be transported to Lockheed Martin's Denver facility for testing. The Orion spacecraft will launch atop NASA’s Space Launch System rocket on EM-1, its first deep space mission.

Orion EM-1 Crew Module Structural Test Article loaded onto Guppy

NASA Image and Video Library

2017-04-25

NASA's Super Guppy aircraft has been closed and secured at the Shuttle Landing Facility at NASA's Kennedy Space Center in Florida. The Orion Exploration Mission-1 (EM-1) structural test article is secured inside the Super Guppy and will be transported to Lockheed Martin's Denver facility for testing. The Orion spacecraft will launch atop NASA’s Space Launch System rocket on EM-1, its first deep space mission.

DOE-EM Science of Safety Robotics Challenge

ScienceCinema

Rimando, Rodrigo; Watts, Alex; Bobbitt, John; McLaughlin, Doug; Quigley, Morgan; Gladwell, Scott; McLoughlin, Mike; Kinnamon, Tony; Garcia, Joe; Ansari, Alex; Voyles, Richard; Chambers, David; Pryor, Mitch; Workman, Theresa; Mehling, Joshua; Browning, Kimberly; Deuel, Jake; Profitt, Bryan; Reibold, Marty

2018-06-12

During the week of August 22nd, 2016, over 150 technologists, stakeholders, and Department of Energy, Office of Environmental Management workers, met at DOE’s Portsmouth Gaseous Diffusion Plant in Ohio, for the EM Science of Safety Robotics Challenge.

Availability of emergency obstetric care (EmOC) among public and private health facilities in rural northwest Bangladesh.

PubMed

Sikder, Shegufta S; Labrique, Alain B; Ali, Hasmot; Hanif, Abu A M; Klemm, Rolf D W; Mehra, Sucheta; West, Keith P; Christian, Parul

2015-01-31

Although safe motherhood strategies recommend that women seek timely care from health facilities for obstetric complications, few studies have described facility availability of emergency obstetric care (EmOC). We sought to describe and compare availability and readiness to provide EmOC among public and private health facilities commonly visited for pregnancy-related complications in two districts of northwest Bangladesh. We also described aspects of financial and geographic access to healthcare and key constraints to EmOC provision. Using data from a large population-based community trial, we identified and surveyed the 14 health facilities (7 public, 7 private) most frequently visited for obstetric complications and near misses as reported by women. Availability of EmOC was based on provision of medical services, assessed through clinician interviews and record review. Levels of EmOC availability were defined as basic or comprehensive. Readiness for EmOC provision was based on scores in four categories: staffing, equipment, laboratory capacity, and medicines. Readiness scores were calculated using unweighted averages. Costs of C-section procedures and geographic locations of facilities were described. Textual analysis was used to identify key constraints. The seven surveyed private facilities offered comprehensive EmOC compared to four of the seven public facilities. With 100% representing full readiness, mean EmOC readiness was 81% (range: 63%-91%) among surveyed private facilities compared to 67% (range: 48%-91%) in public facilities (p = 0.040). Surveyed public clinics had low scores on staffing and laboratory capacity (69%; 50%). The mean cost of the C-section procedure in private clinics was $77 (standard deviation: $16) and free in public facilities. The public sub-district facilities were the only facilities located in rural areas, with none providing comprehensive EmOC. Shortages in specialized staff were listed as the main barrier to EmOC provision in

Demographics and Fellowship Training of Residency Leadership in EM: A Descriptive Analysis.

PubMed

Greenstein, Josh; Hardy, Ross; Chacko, Jerel; Husain, Abbas

2017-01-01

Emergency medicine (EM) fellowships are becoming increasingly numerous, and there is a growing trend among EM residents to pursue postgraduate fellowship training. Scant data have been published on the prevalence of postgraduate training among emergency physicians. We aimed to describe the prevalence and regional variation of fellowships among EM residency leadership. We conducted an online anonymous survey that was sent to the Council of EM Residency Directors (CORD) membership in October 2014. The survey was a brief questionnaire, which inquired about fellowship, secondary board certification, gender, and length in a leadership position of each member of its residency leadership. We separated the responses to the survey into four different geographic regions. The geographic regions were defined by the same classification used by the National Resident Matching Program (NRMP). We defined residency leadership as program director (PD), associate PD and assistant PD. Residencies that did not complete the survey were then individually contacted to encourage completion. The survey was initially piloted for ease of use and understanding of the questions with a select few EM PDs. We obtained responses from 145 of the 164 Accrediting Council for Graduate Medical Education-accredited EM residencies (88%). The fellowship prevalence among PDs, associate PDs, and assistant PDs was 21.4%, 20.3%, and 24.9% respectively. The most common fellowship completed was a fellowship in toxicology. Secondary board certification among PDs, associate PDs, and assistant PDs was 9.7%, 4.8%, and 2.9% respectively. Eighty-two percent of PDs have at least five years in residency leadership. Seventy-six percent of PDs were male, and there was a near-even split of gender among associate PDs and assistant PDs. The Western region had the highest percentage of fellowship and or secondary board certification among all levels of residency leadership. There is a low prevalence of fellowship training and

Syndrome surveillance of fentanyl-laced heroin outbreaks: Utilization of EMS, Medical Examiner and Poison Center databases.

PubMed

Moore, P Quincy; Weber, Joseph; Cina, Steven; Aks, Steven

2017-11-01

Describe surveillance data from three existing surveillance systems during an unexpected fentanyl outbreak in a large metropolitan area. We performed a retrospective analysis of three data sets: Chicago Fire Department EMS, Cook County Medical Examiner, and Illinois Poison Center. Each included data from January 1, 2015 through December 31, 2015. EMS data included all EMS responses in Chicago, Illinois, for suspected opioid overdose in which naloxone was administered and EMS personnel documented other criteria indicative of opioid overdose. Medical Examiner data included all deaths in Cook County, Illinois, related to heroin, fentanyl or both. Illinois Poison Center data included all calls in Chicago, Illinois, related to fentanyl, heroin, and other prescription opioids. Descriptive statistics using Microsoft Excel® were used to analyze the data and create figures. We identified a spike in opioid-related EMS responses during an 11-day period from September 30-October 10, 2015. Medical Examiner data showed an increase in both fentanyl and mixed fentanyl/heroin related deaths during the months of September and October, 2015 (375% and 550% above the median, respectively.) Illinois Poison Center data showed no significant increase in heroin, fentanyl, or other opioid-related calls during September and October 2015. Our data suggests that EMS data is an effective real-time surveillance mechanism for changes in the rate of opioid overdoses. Medical Examiner's data was found to be valuable for confirmation of EMS surveillance data and identification of specific intoxicants. Poison Center data did not correlate with EMS or Medical Examiner data. Copyright © 2017 Elsevier Inc. All rights reserved.

Orion EM-1 Crew Module Structural Test Article loaded onto Guppy

NASA Image and Video Library

2017-04-25

A view from inside NASA's Super Guppy aircraft at the Shuttle Landing Facility at NASA's Kennedy Space Center in Florida, as the Orion Exploration Mission-1 (EM-1) structural test article, secured inside its transport container, is loaded into the aircraft. The test article will be transported to Lockheed Martin's Denver facility for testing. The Orion spacecraft will launch atop NASA’s Space Launch System rocket on EM-1, its first deep space mission.

Orion EM-1 Crew Module Structural Test Article loaded onto Guppy

NASA Image and Video Library

2017-04-25

On the tarmac at the Shuttle Landing Facility at NASA's Kennedy Space Center in Florida, the agency's Super Guppy aircraft closes after the Orion Exploration Mission-1 (EM-1) structural test article, in its transport container, is secured inside. The test article will be transported to Lockheed Martin's Denver facility for testing. The Orion spacecraft will launch atop NASA’s Space Launch System rocket on EM-1, its first deep space mission.

Orion EM-1 Crew Module Structural Test Article loaded onto Guppy

NASA Image and Video Library

2017-04-25

The Orion Exploration Mission-1 (EM-1) structural test article, secured inside its transport container, arrives at the Shuttle Landing Facility at NASA's Kennedy Space Center in Florida. The test article will be loaded into NASA's Super Guppy aircraft, in view at left, and transported to Lockheed Martin's Denver facility for testing. The Orion spacecraft will launch atop NASA’s Space Launch System rocket on EM-1, its first deep space mission.

Orion EM-1 Forward Skirt Move from Hangar AF to BFF

NASA Image and Video Library

2017-08-30

The Exploration Mission-1 (EM-1) left-hand forward skirt for NASA's Space Launch System (SLS) solid rocket boosters arrives inside the high bay at the Booster Fabrication Facility (BFF) at NASA's Kennedy Space Center in Florida. In the BFF, the forward skirt will be inspected and prepared for use on the left-hand solid rocket booster for EM-1. NASA's Orion spacecraft will fly atop the SLS rocket on its first uncrewed flight test.

National Energy Efficiency Evaluation, Measurement and Verification (EM&V) Standard: Scoping Study of Issues and Implementation Requirements

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

Schiller Consulting, Inc.; Schiller, Steven R.; Goldman, Charles A.

2011-02-04

This report is a scoping study that identifies issues associated with developing a national evaluation, measurement and verification (EM&V) standard for end-use, non-transportation, energy efficiency activities. The objectives of this study are to identify the scope of such a standard and define EM&V requirements and issues that will need to be addressed in a standard. To explore these issues, we provide and discuss: (1) a set of definitions applicable to an EM&V standard; (2) a literature review of existing guidelines, standards, and 'initiatives' relating to EM&V standards as well as a review of 'bottom-up' versus 'top-down' evaluation approaches; (3) amore » summary of EM&V related provisions of two recent federal legislative proposals (Congressman Waxman's and Markey's American Clean Energy and Security Act of 2009 and Senator Bingaman's American Clean Energy Leadership Act of 2009) that include national efficiency resource requirements; (4) an annotated list of issues that that are likely to be central to, and need to be considered when, developing a national EM&V standard; and (5) a discussion of the implications of such issues. There are three primary reasons for developing a national efficiency EM&V standard. First, some policy makers, regulators and practitioners believe that a national standard would streamline EM&V implementation, reduce costs and complexity, and improve comparability of results across jurisdictions; although there are benefits associated with each jurisdiction setting its own EM&V requirements based on their specific portfolio and evaluation budgets and objectives. Secondly, if energy efficiency is determined by the US Environmental Protection Agency to be a Best Available Control Technology (BACT) for avoiding criteria pollutant and/or greenhouse gas emissions, then a standard can be required for documenting the emission reductions resulting from efficiency actions. The third reason for a national EM&V standard is that such a

EM&V for Energy Efficiency Policies and Initiatives

EPA Pesticide Factsheets

Learn how representatives of jurisdictions, companies, and other entities can use evaluation, measurement, and verification (EM&V) in demand-side energy efficiency (EE) investments to achieve intended environmental, energy, and economic goals.

Uma grade de perfis teóricos para estrelas massivas em transição

NASA Astrophysics Data System (ADS)

Nascimento, C. M. P.; Machado, M. A.

2003-08-01

Na XXVIII Reunião Anual da Sociedade Astronômica Brasileira (2002) apresentamos uma grade de perfis calculados de acordo com os pontos da trajetória evolutiva de metalicidade solar, Z = 0.02 e taxa de perda de massa () padrão, para estrelas com massa inicial de 25, 40, 60, 85 e 120 massas solares. Estes perfis foram calculados com o auxílio de um código numérico adequado para descrever os ventos de objetos massivos, supondo simetria esférica, estacionaridade e homogeneidade. No presente trabalho, apresentamos a complementação da grade com os perfis teóricos relativos às trajetórias de Z = 0.02 com taxa de perda de massa dobrada em relação a padrão (2´), e de metalicidade Z = 0.008. Para cada ponto das três trajetórias obtemos os perfis teóricos de Ha, Hb, Hg e Hd, e como esperado eles se apresentam em pura emissão, pura absorção ou em P-Cygni. Para valores de taxa de perda de massa muito baixos (~10-7) não há formação de linhas, o que é visto nos primeiros pontos em todas as trajetórias. Em geral, para um mesmo ponto a componente de emissão diminui e a absorção aumenta de Ha para Hd. É verificado que as trajetórias com Z = 0.02 e padrão possuem menos circuitos (loops) do que as com metalicidade Z = 0.02 e 2´ padrão, e seus perfis são, em geral, menos intensos. Em relação a trajetória de Z = 0.008, verifica-se menos circuitos e maior variação em luminosidade, e seus perfis mostram-se em, algumas trajetórias, mais intensos. Verificamos também que, pontos distintos em uma mesma trajetória, apresentam perfis diferentes para valores similares de luminosidade e temperatura efetiva. Sendo assim, uma grade de perfis teóricos parece ser útil para fornecer uma informação preliminar sobre o estágio evolutivo de uma estrela massiva.

Disparity in the persistence of high-risk human papillomavirus genotypes between African American and European American women of college age.

PubMed

Banister, Carolyn E; Messersmith, Amy R; Cai, Bo; Spiryda, Lisa B; Glover, Saundra H; Pirisi, Lucia; Creek, Kim E

2015-01-01

Cervical cancer incidence and mortality rates are higher in African Americans than in European Americans (white, non-Hispanic of European ancestry). The reasons for this disparity are not known. We recruited a population-based longitudinal cohort of 326 European American and 113 African American female college freshmen in Columbia, South Carolina, to compare clearance of high-risk human papillomavirus (HR-HPV) infection between ethnicities. HPV testing and typing from samples obtained for Papanicolaou testing occurred every 6 months. African American participants had an increased risk of testing positive for HR-HPV, compared with European American participants, but the frequency of incident HPV infection was the same in African American and European American women. Thus, exposure to HPV could not explain the higher rate of HPV positivity among African American women. The time required for 50% of participants to clear HR-HPV infection was 601 days for African American women (n = 63) and 316 days for European American women (n = 178; odds ratio [OR], 1.61; 95% confidence interval [CI], 1.08-2.53). African American women were more likely than European American women to have an abnormal result of a Papanicolaou test (OR, 1.58; 95% CI, 1.05-2.39). We propose that the longer time to clearance of HR-HPV among African American women leads to increased rates of abnormal results of Papanicolaou tests and contributes to the increased rates of cervical cancer observed in African American women. © The Author 2014. Published by Oxford University Press on behalf of the Infectious Diseases Society of America. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

Prescribe for health. Improving cancer screening in physician practices serving low-income and minority populations.

PubMed

Manfredi, C; Czaja, R; Freels, S; Trubitt, M; Warnecke, R; Lacey, L

1998-01-01

To evaluate a health maintenance organization (HMO)-sponsored intervention to improve cancer screening in private physician practices serving low-income, minority populations. A randomized controlled trial with preintervention and postintervention measurements. Measurements were obtained by abstracting information from independent random samples of medical charts (N = 2316 at preintervention and 2238 at postintervention). Forty-seven primary care physician practices located in low-income and minority urban neighborhoods in Chicago, Ill. Practices were encouraged to adopt an office chart reminder system and to use a patient health maintenance card. Activities to facilitate the adoption of these items and for compliance with cancer screening guidelines included on-site training and start-up assistance visits, a physician continuing medical education seminar, and quality assurance visits with feedback to physicians. The proportions of patients with a chart-documented mammogram, clinical breast examination, Papanicolaou smear, or fecal occult blood slide test in the 2 years before preintervention and postintervention chart abstractions. Between baseline and postintervention, there was a net increase in the proportion of HMO members in the intervention, compared with the control practices, who received in the preceding 2 years a Papanicolaou smear (11.9%) and a fecal occult blood slide test (14.1%). There was a net increase in the proportion of non-HMO patients in the intervention compared with the control practices who received a clinical breast examination (15.3%) and a fecal occult blood slide test (20.2%). Implementation of an HMO-mediated, multicomponent intervention to improve cancer screening was feasible and effective for the Papanicolaou smear, fecal occult blood slide test, and the clinical breast examination, but not for mammography.

Orion EM-1 Crew Module Adapter Move to Clean Room

NASA Image and Video Library

2016-11-29

Inside the Neil Armstrong Operations and Checkout Building high bay at NASA’s Kennedy Space Center in Florida, the Orion crew module adapter (CMA) for Exploration Mission 1 (EM-1) is being moved to a clean room. The CMA will undergo propellant and environmental control and life support system tube installation and welding. The adapter will connect the Orion crew module to the European Space Agency-provided service module. The Orion spacecraft will launch atop NASA’s Space Launch System rocket on EM-1, its first deep space mission, in late 2018.

Orion EM-1 Crew Module Adapter Move to Clean Room

NASA Image and Video Library

2016-11-29

Inside the Neil Armstrong Operations and Checkout Building high bay at NASA’s Kennedy Space Center in Florida, Lockheed Martin technicians move the Orion crew module adapter (CMA) for Exploration Mission 1 (EM-1) into a clean room. The CMA will undergo propellant and environmental control and life support system tube installation and welding. The adapter will connect the Orion crew module to the European Space Agency-provided service module. The Orion spacecraft will launch atop NASA’s Space Launch System rocket on EM-1, its first deep space mission, in late 2018.

Orion EM-1 Crew Module Adapter Move to Clean Room

NASA Image and Video Library

2016-11-29

Inside the Neil Armstrong Operations and Checkout Building high bay at NASA’s Kennedy Space Center in Florida, Lockheed Martin technicians begin to move the Orion crew module adapter (CMA) for Exploration Mission 1 (EM-1) to a clean room. The CMA will undergo propellant and environmental control and life support system tube installation and welding. The adapter will connect the Orion crew module to the European Space Agency-provided service module. The Orion spacecraft will launch atop NASA’s Space Launch System rocket on EM-1, its first deep space mission, in late 2018.

Orion EM-1 Crew Module Adapter Move to Clean Room

NASA Image and Video Library

2016-11-29

Inside the Neil Armstrong Operations and Checkout Building high bay at NASA’s Kennedy Space Center in Florida, Lockheed Martin technicians move the Orion crew module adapter (CMA) for Exploration Mission 1 (EM-1) toward a clean room. The CMA will undergo propellant and environmental control and life support system tube installation and welding. The adapter will connect the Orion crew module to the European Space Agency-provided service module. The Orion spacecraft will launch atop NASA’s Space Launch System rocket on EM-1, its first deep space mission, in late 2018.

Immune protection of microneme 7 (EmMIC7) against Eimeria maxima challenge in chickens.

PubMed

Huang, Jingwei; Zhang, Zhenchao; Li, Menghui; Song, Xiaokai; Yan, Ruofeng; Xu, Lixin; Li, Xiangrui

2015-10-01

In the present study, the immune protective effects of recombinant microneme protein 7 of Eimeria maxima (rEmMIC7) and a DNA vaccine encoding this antigen (pVAX1-EmMIC7) on experimental challenge were evaluated. Two-week-old chickens were randomly divided into five groups. Experimental groups of chickens were immunized with 100 μg DNA vaccine pVAX1-MIC7 or 200 μg rEmMIC7, while control groups of chickens were injected with pVAX1 plasmid or sterile phosphate buffered saline (PBS). The results showed that the anti-EmMIC7 antibody titres in chickens of both rEmMIC7 and pVAX1-MIC7 groups were significantly higher as compared to PBS and pVAX1 control (P < .05). The splenocytes from both vaccinated groups of chickens displayed significantly greater proliferation response compared with the controls (P < .05). Serum from chickens immunized with pVAX1-MIC7 and rEmMIC7 displayed significantly high levels of interleukin-2, interferon-γ, IL-10, IL-17, tumour growth factor-β and IL-4 (P < .05) compared to those of negative controls. The challenge experiment results showed that both the recombinant antigen and the DNA vaccine could obviously alleviate jejunum lesions, body weight loss and enhance oocyst decrease ratio. The anti-coccidial index (ACI) of the pVAX1-MIC7 group was 167.84, higher than that of the recombinant MIC7 protein group, 167.10. Our data suggested that immunization with EmMIC7 was effective in imparting partial protection against E. maxima challenge in chickens and it could be an effective antigen candidate for the development of new vaccines against E. maxima.

Recidivism Among Licensed-Released Prisoners Who Participated in the EM Program in Israel.

PubMed

Shoham, Efrat; Yehosha-Stern, Shirley; Efodi, Rotem

2015-08-01

Toward the end of 2006, a pilot program was launched in Israel wherein licensed-released prisoners were put under electronic monitoring (EM). In addition to EM, the pilot program, operated by the Prisoners' Rehabilitation Authority, provides programs of occupational supervision and personal therapy and is designed to allow for early release of those prisoners who, without increased supervision, would have been found unsuitable for early release. The aim of this study was to ascertain whether participation in the EM program among licensed-released prisoners in Israel might bring about lessened recidivism. For that matter, rates of arrests and incarceration were examined during a follow-up period of up to 4 years, among the entirety of licensed-released prisoners participating in the EM program between the years 2007 and 2009 (n = 155). To compare recidivism rates, a control group was assembled from among the entirety of released prisoners who were found unsuitable for early release in judicial conditions, and had therefore served the full term of their incarceration, to be released between the years 2005 and 2006 (a period of time during which an EM program was not yet operated among licensed-released prisoners in Israel). Study findings clearly show that while among the control group, 42% of released prisoners were re-incarcerated, at the end of a 4-year follow-up period, only 15% among the study group had returned to prison. These findings can be explained by combining the Social Control theory and the Self-Control theory which consider the period of time under EM program and the occupational and familial integration tools for reducing criminal connections and enhancing pro-social behavior. © The Author(s) 2014.

Emergency Medical Service (EMS) Utilization by Syrian Refugees Residing in Ankara, Turkey.

PubMed

Altıner, Ali Osman; Yeşil, Sıdıka Tekeli

2018-04-01

Introduction Many Syrians have left their country and migrated to other countries since March 2011, due to the civil war. As of March 2016, a total of 2,747,946 Syrian refugees had immigrated to Turkey. Some Syrian refugees have been living in camps, while 2,475,134 have been living in metropolitan areas, such as Ankara. Study Objective This study investigated Emergency Medical Service (EMS) utilization among Syrian refugees residing in Ankara. This study was a descriptive, cross-sectional database analysis using data obtained from the Department of EMS of the Ankara Provincial Health Directorate. Five stations in the Altındağ region of Ankara responded to 42% of all calls from Syrian refugees. Prehospital EMS in Ankara have been used mostly by Syrian refugees younger than 18-years-old. Study findings also suggest that medical staff in regions where Syrian refugees are likely to be treated should be supported and provided with the ability to overcome language barriers and cultural differences. Altıner AO , Tekeli Yeşil S . Emergency Medical Service (EMS) utilization by Syrian refugees residing in Ankara, Turkey. Prehosp Disaster Med. 2018;33(2):160-164.

Measurement and Analysis of L-Band (1535-1660 MHz) Electromagnetic (EM) Noise on Ships

DOT National Transportation Integrated Search

1974-12-01

A program of L-band (1535-1660 MHz) electromagnetic (EM) noise measurements conducted on ships is described. The magnitude and duration of EM noise on ships is of particular significance in terms of potential radio frequency interference (RFI) to fut...

Disaster Relief and Emergency Medical Services Project (DREAMS TM): Digital EMS

DTIC Science & Technology

2000-10-01

exchanges between the hospital and the EMS vehicle. By creating the virtual presence of a physician at or near the emergency scene, more lives will be saved ...address, cross street, zip code etc. The map can be saved to the clipboard or to an EMF graphics file for use by other applications in the system. 29...section can be found in Appendix B. The EMS personnel on board the ambulance can benefit greatly from technology integration. Several time- saving

Orion EM-1 Crew Module Structural Test Article loaded onto Guppy

NASA Image and Video Library

2017-04-25

On the tarmac at the Shuttle Landing Facility at NASA's Kennedy Space Center in Florida, NASA and contractor workers review procedures before beginning loading of the Orion Exploration Mission-1 (EM-1) structural test article in its transport container into NASA's Super Guppy aircraft. The test article will be transported to Lockheed Martin's Denver facility for testing. The Orion spacecraft will launch atop NASA’s Space Launch System rocket on EM-1, its first deep space mission.

Orion EM-1 Forward Skirt Move from Hangar AF to BFF

NASA Image and Video Library

2017-08-30

The Exploration Mission-1 (EM-1) left-hand forward skirt for NASA's Space Launch System (SLS) solid rocket boosters arrives at the entrance to the high bay at the Booster Fabrication Facility (BFF) at NASA's Kennedy Space Center in Florida. In the BFF, the forward skirt will be inspected and prepared for use on the left-hand solid rocket booster for EM-1. NASA's Orion spacecraft will fly atop the SLS rocket on its first uncrewed flight test.

Measuring Turbulence Mixing in Indonesian Seas Using Microstructure EM-APEX Floats

DTIC Science & Technology

2016-04-18

14 . ABSTRACT With the help of my graduate student at Columbia Univers ity (Asmi Napitu who is from Indonesia ) I have arranged a plan for the...and Fisheries of Republic of Indonesia (KKP), Bali BPPL lab on their Baruna Jaya 8 cruise in August 2016. Arrangement to sh ip the EM APEX float to... Indonesia in the spring 2016 are being arranged. 15. SUBJECT TERMS mixing within the Banda; EM APEX fl oats; upper ocean processes; mixed layer

An EM System with Dynamic Multi-Axis Transmitter and Tensor Gradiometer Receiver

DTIC Science & Technology

2011-06-01

main difference between the spatial behavior of target anomalies measured with a magnetometer and those we measured with an EM system is in the nature...environmental and UXO applications, current efforts include the development of tensor magnetic gradiometers based on triaxial fluxgate technology by the USGS...Superconducting gradiometer/ Magnetometer Arrays and a Novel Signal Processing Technique. IEEE Trans. on Magnetics, MAG-11(2), 701-707. EM Tensor

An EM System With Dramatic Multi-Axis Transmitter and Tensor Gradiometer Receiver

DTIC Science & Technology

2011-06-01

Thus, the main difference between the spatial behavior of target anomalies measured with a magnetometer and those we measured with an EM system is in...current efforts include the development of tensor magnetic gradiometers based on triaxial fluxgate technology by the USGS (Snyder & Bracken, Development...Superconducting gradiometer/ Magnetometer Arrays and a Novel Signal Processing Technique. IEEE Trans. on Magnetics, MAG-11(2), 701-707. EM Tensor Gradiometer

Observações no infravermelho médio de objetos estelares jovens em NGC 3576

NASA Astrophysics Data System (ADS)

Barbosa, C.; Damineli, A.; Blum, R.; Conti, P.

2003-08-01

Apresentamos os resultados de observações no infravermelho médio de candidatos a objetos estelares jovens e massivos em NGC 3576. As imagens de alta resolução foram obtidas no observatório Gemini Sul com o uso dos filtros em 10,8, 7,9, 9,8, 12,5 e 18,2 mm. Nossas imagens mostram a fonte IRS 1 resolvida em 4 objetos pela primeira vez em 10 mm. Para cada objeto obtivemos a distribuição espectral de energia de 1.2 até 18 mm, bem como a temperatura de cor, a distribuição espacial e a profundidade óptica em 9,8 mm da poeira circunstelar. Apresentamos uma estimativa das massas dos objetos estudados, baseados na luminosidade emitida no infravermelho médio, bem como um modelo para explicar as diferentes características observadas de cada objeto. Finalmente discutimos a possível localização da(s) fonte(s) de ionização de NGC 3576.

Segmentation of nuclear images in automated cervical cancer screening

NASA Astrophysics Data System (ADS)

Dadeshidze, Vladimir; Olsson, Lars J.; Domanik, Richard A.

1995-08-01

This paper describes an efficient method of segmenting cell nuclei from complex scenes based upon the use of adaptive region growing in conjuction with nucleus-specific filters. Results of segmenting potentially abnormal (cancer or neoplastic) cell nuclei in Papanicolaou smears from 0.8 square micrometers resolution images are also presented.

Directly reconstructing principal components of heterogeneous particles from cryo-EM images.

PubMed

Tagare, Hemant D; Kucukelbir, Alp; Sigworth, Fred J; Wang, Hongwei; Rao, Murali

2015-08-01

Structural heterogeneity of particles can be investigated by their three-dimensional principal components. This paper addresses the question of whether, and with what algorithm, the three-dimensional principal components can be directly recovered from cryo-EM images. The first part of the paper extends the Fourier slice theorem to covariance functions showing that the three-dimensional covariance, and hence the principal components, of a heterogeneous particle can indeed be recovered from two-dimensional cryo-EM images. The second part of the paper proposes a practical algorithm for reconstructing the principal components directly from cryo-EM images without the intermediate step of calculating covariances. This algorithm is based on maximizing the posterior likelihood using the Expectation-Maximization algorithm. The last part of the paper applies this algorithm to simulated data and to two real cryo-EM data sets: a data set of the 70S ribosome with and without Elongation Factor-G (EF-G), and a data set of the influenza virus RNA dependent RNA Polymerase (RdRP). The first principal component of the 70S ribosome data set reveals the expected conformational changes of the ribosome as the EF-G binds and unbinds. The first principal component of the RdRP data set reveals a conformational change in the two dimers of the RdRP. Copyright © 2015 Elsevier Inc. All rights reserved.

Directly Reconstructing Principal Components of Heterogeneous Particles from Cryo-EM Images

PubMed Central

Tagare, Hemant D.; Kucukelbir, Alp; Sigworth, Fred J.; Wang, Hongwei; Rao, Murali

2015-01-01

Structural heterogeneity of particles can be investigated by their three-dimensional principal components. This paper addresses the question of whether, and with what algorithm, the three-dimensional principal components can be directly recovered from cryo-EM images. The first part of the paper extends the Fourier slice theorem to covariance functions showing that the three-dimensional covariance, and hence the principal components, of a heterogeneous particle can indeed be recovered from two-dimensional cryo-EM images. The second part of the paper proposes a practical algorithm for reconstructing the principal components directly from cryo-EM images without the intermediate step of calculating covariances. This algorithm is based on maximizing the (posterior) likelihood using the Expectation-Maximization algorithm. The last part of the paper applies this algorithm to simulated data and to two real cryo-EM data sets: a data set of the 70S ribosome with and without Elongation Factor-G (EF-G), and a data set of the inluenza virus RNA dependent RNA Polymerase (RdRP). The first principal component of the 70S ribosome data set reveals the expected conformational changes of the ribosome as the EF-G binds and unbinds. The first principal component of the RdRP data set reveals a conformational change in the two dimers of the RdRP. PMID:26049077

Detecção inesperada de efeitos de lentes fracas em grupos de galáxias pouco luminosos em raios-X

NASA Astrophysics Data System (ADS)

Carrasco, R.; Mendes de Oliveira, C.; Sodré, L., Jr.; Lima Neto, G. B.; Cypriano, E. S.; Lengruber, L. L.; Cuevas, H.; Ramirez, A.

2003-08-01

Obtivemos, como parte do programa de verificação científica do GMOS Sul, imagens profundas de três grupos de galáxias: G97 e G102 (z~0,4) e G124 (z = 0,17). Esses alvos foram selecionados a partir do catálogo de fontes extensas de Vikhlinin (1998), por terem luminosidades em raios X menores que 3´1043 ergs s-1, valor cerca de uma ou duas ordens de grandeza inferior ao de aglomerados de galáxias. O objetivo primário dessas observações é o estudo da evolução de galáxias em grupos. Grupos são ambientes menos densos que aglomerados, contêm a grande maioria das galáxias do Universo mas que, até o momento, foram estudados detalhadamente apenas no Universo local (z~0). Com esses dados efetuamos uma análise estatística da distorção na forma das galáxias de fundo (lentes gravitacionais fracas) como forma de inferir o conteúdo e a distribuição de massa nesses grupos apesar de que, em princípio, esse efeito não deveria ser detectado uma vez que os critérios de seleção adotados previlegiam sistemas de baixa massa. De fato, para G124 obtivemos apenas um limite superior para sua massa que é compatível com sua luminosidade em raios X. De modo contrário e surpreendente, os objetos G102 e G097, aparentam ter massas que resultariam em dispersões de velocidade maiores que 1000 km s-1, muito maiores do que se espera para grupos de galáxias. Com efeito, para G097 obtivemos, a partir de dados do satélite XMM, uma estimativa para a temperatura do gás intragrupo de kT = 2,6 keV, que é tipica de sistemas com dispersões de velocidade de ~ 600 km s-1, bem característica de grupos. Essas contradições aparentes entre lentes fracas e raios X podem ser explicadas de dois modos: i) a massa obtida por lentes estaria sobreestimada devido à superposição de estruturas massivas ao longo da linha de visada ou ii) a temperatura do gás do meio intra-grupo reflete o potencial gravitacional de estruturas menores que estariam se fundindo para formar uma

Areas of Potential Impact of the Patient Protection and Affordable Care Act on EMS: A Synthesis of the Literature.

PubMed

Ostermayer, Daniel G; Brown, Charles A; Fernandez, William G; Couvillon, Emily

2017-04-01

This comprehensive review synthesizes the existing literature on the Patient Protection and Affordable Care Act (ACA) as it relates to emergency medical services (EMS) in order to provide guidance for navigating current and future healthcare changes. We conducted a comprehensive review to identify all existing literature related to the ACA and EMS and all sections within the federal law pertaining to EMS. Many changes enacted by the ACA directly affect emergency care with potential indirect effects on EMS systems. New Medicaid enrollees and changes to existing coverage plans may alter EMS transport volumes. Reimbursement changes such as adjustments to the ambulance inflation factor (AIF) alter the yearly increases in EMS reimbursement by incorporating the multifactor productivity value into yearly reimbursement adjustments. New initiatives, funded by the Center for Medicare & Medicaid Innovation are exploring novel and cost-effective prehospital care delivery opportunities while EMS agencies individually explore partnerships with healthcare systems. EMS systems should be aware of the direct and indirect impact of ACA on prehospital care due to the potential for changes in financial reimbursement, acuity and volume changes, and ongoing new care delivery initiatives.

Areas of Potential Impact of the Patient Protection and Affordable Care Act on EMS: A Synthesis of the Literature

PubMed Central

Ostermayer, Daniel G.; Brown, Charles A.; Fernandez, William G.; Couvillon, Emily

2017-01-01

Introduction This comprehensive review synthesizes the existing literature on the Patient Protection and Affordable Care Act (ACA) as it relates to emergency medical services (EMS) in order to provide guidance for navigating current and future healthcare changes. Methods We conducted a comprehensive review to identify all existing literature related to the ACA and EMS and all sections within the federal law pertaining to EMS. Results Many changes enacted by the ACA directly affect emergency care with potential indirect effects on EMS systems. New Medicaid enrollees and changes to existing coverage plans may alter EMS transport volumes. Reimbursement changes such as adjustments to the ambulance inflation factor (AIF) alter the yearly increases in EMS reimbursement by incorporating the multifactor productivity value into yearly reimbursement adjustments. New initiatives, funded by the Center for Medicare & Medicaid Innovation are exploring novel and cost-effective prehospital care delivery opportunities while EMS agencies individually explore partnerships with healthcare systems. Conclusion EMS systems should be aware of the direct and indirect impact of ACA on prehospital care due to the potential for changes in financial reimbursement, acuity and volume changes, and ongoing new care delivery initiatives. PMID:28435495

ALiEM Blog and Podcast Watch: Procedures in Emergency Medicine.

PubMed

Joshi, Nikita; Morley, Eric J; Taira, Taku; Branzetti, Jeremy; Grock, Andrew

2017-10-01

The WestJEM Blog and Podcast Watch presents high-quality, open-access educational blogs and podcasts in emergency medicine (EM) based on the ongoing Academic Life in EM (ALiEM) Approved Instructional Resources (AIR) and AIR-Professional series. Both series critically appraise resources using an objective scoring rubric. This installment of the Blog and Podcast Watch highlights the topic of procedure emergencies from the AIR Series. The AIR Series is a continuously building curriculum that follows the Council of Emergency Medicine Residency Directors' (CORD) annual testing schedule. For each module, relevant content is collected from the top 50 Social Media Index sites published within the previous 12 months, and scored by eight AIR board members using five equally weighted measurement outcomes: Best Evidence in Emergency Medicine (BEEM) score, accuracy, educational utility, evidence based, and references. Resources scoring ≥30 out of 35 available points receive an AIR label. Resources scoring 27-29 receive an "honorable mention" label if the executive board agrees that the post is accurate and educationally valuable. A total of 85 blog posts and podcasts were evaluated in June 2016. This report summarizes key educational pearls from the three AIR posts and the 10 Honorable Mentions. The WestJEM Blog and Podcast Watch series is based on the AIR and AIR-Pro series, which attempts to identify high-quality educational content on open-access blogs and podcasts. This series provides an expert-based, post-publication curation of educational social media content for EM clinicians, with this installment focusing on procedure emergencies within the AIR series.

What do EMS personnel think about domestic violence? An exploration of attitudes and experiences after participation in training.

PubMed

Donnelly, Elizabeth A; Oehme, Karen; Melvin, Rebecca

2016-02-01

In 2012, the American College of Emergency Physicians (ACEP) reaffirmed that domestic violence is a serious public health hazard that emergency medical services (EMS) personnel will encounter. Many victims of domestic violence may refuse transport to the hospital, making EMS prehospital field personnel --EMTs and paramedics-- their only contact with healthcare providers. Despite these facts, the interaction of field EMS personnel and victims of domestic violence remains largely unexamined. Given the importance of the interaction of field EMS personnel have with victims of domestic violence, the goal of this study is to explore attitudes about and experiences of EMS personnel on the issue of domestic violence after completing a training on domestic violence. Participants were recruited by researchers contacting multiple EMS agencies. Data were gathered using a survey attached to an online domestic violence training for field EMS personnel (EMTs and paramedics) circulated in a large southern state. Participants were able to obtain continuing education credits for completing the online modules. A total of 403 respondents completed the survey. 71% of respondents indicated that they frequently encounter patients who disclose domestic violence; 45% believe that if a victim does not disclose abuse, there is little they can do to help; and from 32% to 43% reported assumptions and attitudes that indicate beliefs that victims are responsible for the abuse. Implications of the data are discussed suggesting that EMS providers are aware that they frequently assist victims of domestic violence, yet many continue to endorse common myths and negative attitudes about victims. Core components of training that can educate EMS personnel about the dynamics of domestic violence are described, and a new free online training for medical professionals on domestic violence is offered for use as part of ongoing education to enhance the EMS response to victims. Copyright © 2015 Elsevier Ltd

The National Clinical Assessment Tool for Medical Students in the Emergency Department (NCAT-EM)

PubMed Central

Jung, Julianna; Franzen, Douglas; Lawson, Luan; Manthey, David; Tews, Matthew; Dubosh, Nicole; Fisher, Jonathan; Haughey, Marianne; House, Joseph B.; Trainor, Arleigh; Wald, David A.; Hiller, Katherine

2018-01-01

Introduction Clinical assessment of medical students in emergency medicine (EM) clerkships is a highly variable process that presents unique challenges and opportunities. Currently, clerkship directors use institution-specific tools with unproven validity and reliability that may or may not address competencies valued most highly in the EM setting. Standardization of assessment practices and development of a common, valid, specialty-specific tool would benefit EM educators and students. Methods A two-day national consensus conference was held in March 2016 in the Clerkship Directors in Emergency Medicine (CDEM) track at the Council of Residency Directors in Emergency Medicine (CORD) Academic Assembly in Nashville, TN. The goal of this conference was to standardize assessment practices and to create a national clinical assessment tool for use in EM clerkships across the country. Conference leaders synthesized the literature, articulated major themes and questions pertinent to clinical assessment of students in EM, clarified the issues, and outlined the consensus-building process prior to consensus-building activities. Results The first day of the conference was dedicated to developing consensus on these key themes in clinical assessment. The second day of the conference was dedicated to discussing and voting on proposed domains to be included in the national clinical assessment tool. A modified Delphi process was initiated after the conference to reconcile questions and items that did not reach an a priori level of consensus. Conclusion The final tool, the National Clinical Assessment Tool for Medical Students in Emergency Medicine (NCAT-EM) is presented here. PMID:29383058

Perfil das alterações vasculares periféricas em dependentes de crack acompanhados em Centro de Atenção Psicossocial para Álcool e Drogas (CAPS-AD)

PubMed Central

da Costa, Antônio Fagundes; Baldaçara, Leonardo Rodrigo; da Silva, Sílvio Alves; Tavares, Ana Célia de Freitas Ramos; Orsolin, Ederson de Freitas; Prehl, Vinícius Barros; Gondo, Fernando Hirohito Beltran; Santana, Hernani Lopes

2016-01-01

Resumo Contexto O consumo de crack é um dos grandes desafios em saúde pública, e o uso dessa droga tem efeitos diretos na saúde de seus usuários. Objetivos Avaliar o perfil das alterações vasculares em pacientes com dependência de crack em Centro de Atenção Psicossocial para Álcool e Drogas (CAPS-AD) e observar os possíveis efeitos vasculares periféricos. Métodos Trata-se de um estudo observacional, descritivo, de corte transversal. Os pacientes da amostra foram submetidos a um questionário objetivo para avaliar questões demográficas, padrão de uso da droga, coexistência de diabetes melito, hipertensão arterial ou tabagismo, exame físico e ecográfico. Os dados foram sumarizados e analisados estatisticamente com teste qui-quadrado ou teste exato de Fisher. Resultados A média de idade da amostra foi de 33,29 (±7,15) anos, e 74% eram do gênero masculino. A média de idade de início de uso da droga foi de 23,4 (±7,78) anos, com tempo médio de uso de 9,58 (±5,64) anos. O consumo médio diário de pedras de crack foi de 21,45 (±8,32) pedras. A alteração de pulsos em membros inferiores foi mais frequente em mulheres. A prevalência do espessamento da parede arterial nos membros inferiores foi de 94,8%. O tempo de uso da droga apresentou associação estatística (p = 0,0096) com alteração do padrão de curva espectral das artérias dos membros inferiores. Conclusões Há alterações vasculares periféricas em usuários de crack. O tempo de uso da droga exerceu um maior impacto nesse sistema, o que sugere associação entre o uso do crack e a diminuição de fluxo arterial.

Orion EM-1 Crew Module Structural Test Article loaded onto Guppy

NASA Image and Video Library

2017-04-25

The Orion Exploration Mission-1 (EM-1) structural test article, secured inside its transport container, is lifted up by crane from its transport vehicle at the Shuttle Landing Facility at NASA's Kennedy Space Center in Florida. The test article will be loaded into NASA's Super Guppy aircraft, in view at left, and transported to Lockheed Martin's Denver facility for testing. The Orion spacecraft will launch atop NASA’s Space Launch System rocket on EM-1, its first deep space mission.

Orion EM-1 Forward Skirt Transport from Hangar AF to BFF

NASA Image and Video Library

2017-08-30

The Exploration Mission-1 (EM-1) left-hand forward skirt for NASA's Space Launch System (SLS) solid rocket boosters is transported by truck to the Booster Fabrication Facility (BFF) at NASA's Kennedy Space Center in Florida from Hangar AE at Cape Canaveral Air Force Station. In the BFF, the forward skirt will be inspected and prepared for use on the left-hand solid rocket booster for EM-1. NASA's Orion spacecraft will fly atop the SLS rocket on its first uncrewed flight test.

Orion EM-1 Forward Skirt Move from Hangar AF to BFF

NASA Image and Video Library

2017-08-30

The Exploration Mission-1 (EM-1) left-hand forward skirt for NASA's Space Launch System (SLS) solid rocket boosters arrives at the Booster Fabrication Facility (BFF) at NASA's Kennedy Space Center in Florida from Hangar AE at Cape Canaveral Air Force Station. In the BFF, the forward skirt will be inspected and prepared for use on the left-hand solid rocket booster for EM-1. NASA's Orion spacecraft will fly atop the SLS rocket on its first uncrewed flight test.

A Goal Programming Model for the Siting of Multilevel EMS Systems.

DTIC Science & Technology

1980-03-01

Management," unpublished Ph.D. thesis, University of Texas, Austin, Texas, 1971. -23- (11) Daskin , M. and E. Stern, " A Multiobjective Set Covering...GOAL PROGRAM4MING MODEL FOR THE SITING OF MULTILEVEL EMS SYSTE-ETC(U) UNM1AR 80 A CHARNES, J E STORBECK N000iA-75-C-569 WICLASSIFIED CCS-366 N...366 A GOAL PROGRAMMING MODEL FOR THE SITING OF MULTILEVEL EMS SYSTEMS by A . Charnes J. Storbeck March 1980 This project was partially supported by

EM-1 Booster Prep, Right Aft Skirt Work-In-Progress

NASA Image and Video Library

2016-10-30

The right hand aft skirt for NASA's Space Launch System (SLS) rocket has been refurbished and painted and is ready for the assembly process in the Booster Fabrication Facility at the agency's Kennedy Space Center in Florida. The aft skirt was refurbished and painted in support facilities at the Hangar AF facility at Cape Canaveral Air Force Station in Florida. The space shuttle-era aft skirt will be used on the right hand booster of the SLS for Exploration Mission 1 (EM-1). NASA is preparing for EM-1, deep space missions, and the Journey to Mars.

Orion EM-1 Crew Module Adapter Move to Clean Room

NASA Image and Video Library

2016-11-29

Inside the Neil Armstrong Operations and Checkout Building high bay at NASA's Kennedy Space Center in Florida, Lockheed Martin technicians secure a protective cover around the Orion crew module adapter (CMA) for Exploration Mission 1 (EM-1) for its move to a clean room. The CMA will undergo propellant and environmental control and life support system tube installation and welding. The adapter will connect the Orion crew module to the European Space Agency-provided service module. The Orion spacecraft will launch atop NASA’s Space Launch System rocket on EM-1, its first deep space mission, in late 2018.

Orion EM-1 Crew Module Adapter Move to Clean Room

NASA Image and Video Library

2016-11-29

Inside the Neil Armstrong Operations and Checkout Building high bay at NASA’s Kennedy Space Center in Florida, a Lockheed Martin technician secures a protective cover around the Orion crew module adapter (CMA) for Exploration Mission 1 (EM-1) for its move to a clean room The CMA will undergo propellant and environmental control and life support system tube installation and welding. The adapter will connect the Orion crew module to the European Space Agency-provided service module. The Orion spacecraft will launch atop NASA’s Space Launch System rocket on EM-1, its first deep space mission, in late 2018.

Orion EM-1 Crew Module Adapter Move to Clean Room

NASA Image and Video Library

2016-11-29

Inside the Neil Armstrong Operations and Checkout Building high bay at NASA’s Kennedy Space Center in Florida, Lockheed Martin technicians secure a protective cover around the Orion crew module adapter (CMA) for Exploration Mission 1 (EM-1) for its move to a clean room. The CMA will undergo propellant and environmental control and life support system tube installation and welding. The adapter will connect the Orion crew module to the European Space Agency-provided service module. The Orion spacecraft will launch atop NASA’s Space Launch System rocket on EM-1, its first deep space mission, in late 2018.

Orion EM-1 Crew Module Adapter Move to Clean Room

NASA Image and Video Library

2016-11-29

Inside the Neil Armstrong Operations and Checkout Building high bay at NASA’s Kennedy Space Center in Florida, a protective cover is installed around the Orion crew module adapter (CMA) for Exploration Mission 1 (EM-1) for its move to a clean room. The CMA will undergo propellant and environmental control and life support system tube installation and welding. The adapter will connect the Orion crew module to the European Space Agency-provided service module. The Orion spacecraft will launch atop NASA’s Space Launch System rocket on EM-1, its first deep space mission, in late 2018.

Orion EM-1 Crew Module Adapter Move to Clean Room

NASA Image and Video Library

2016-11-29

Inside the Neil Armstrong Operations and Checkout Building high bay at NASA’s Kennedy Space Center in Florida, Lockheed Martin technicians are preparing the Orion crew module adapter (CMA) for Exploration Mission 1 (EM-1) for the move into a clean room. The CMA will undergo propellant and environmental control and life support system tube installation and welding. The adapter will connect the Orion crew module to the European Space Agency-provided service module. The Orion spacecraft will launch atop NASA’s Space Launch System rocket on EM-1, its first deep space mission, in late 2018.

Orion EM-1 Crew Module Adapter Move to Clean Room

NASA Image and Video Library

2016-11-29

Inside the Neil Armstrong Operations and Checkout Building high bay at NASA's Kennedy Space Center in Florida, Lockheed Martin technicians secure a protective cover around the Orion crew module adapter (CMA) for Exploration Mission 1 (EM-1) for its move to a clean. The CMA will undergo propellant and environmental control and life support system tube installation and welding. The adapter will connect the Orion crew module to the European Space Agency-provided service module. The Orion spacecraft will launch atop NASA’s Space Launch System rocket on EM-1, its first deep space mission, in late 2018.

Orion EM-1 Crew Module Adapter Move to Clean Room

NASA Image and Video Library

2016-11-29

Inside the Neil Armstrong Operations and Checkout Building high bay at NASA’s Kennedy Space Center in Florida, the Orion crew module adapter (CMA) for Exploration Mission 1 (EM-1) is in a clean room with protective walls secured around it. The adapter will undergo propellant and environmental control and life support system tube installation and welding. The adapter will connect the Orion crew module to the European Space Agency-provided service module. The Orion spacecraft will launch atop NASA’s Space Launch System rocket on EM-1, its first deep space mission, in late 2018.

Classification of ASASSN-17em/AT2017cts

NASA Astrophysics Data System (ADS)

Bersier, David

2017-04-01

We obtained a spectrum of the candidate supernova ASASSN-17em/AT2017cts (ATEL #10241), using the SPRAT spectrograph mounted on the robotic 2m Liverpool Telescope at the Roque de los Muchachos observatory (La Palma).

Evolução química em galáxias compactas azuis (BCGs)

NASA Astrophysics Data System (ADS)

Lanfranchi, G. A.; Matteucci, F.

2003-08-01

Neste trabalho, a formação estelar e evolução quí mica em galáxias Compactas Azuis (Blue Compact Galaxies - BCGs) foram estudadas através da comparação de previsões de modelos de evolução quí mica a várias razões de abundância quí mica observadas nestas galáxias. Modelos detalhados com recentes dados de nucleossí ntese e que levam em consideração o papel desempenahdo por supernovas de ambos os tipos (II e Ia) na evolução galáctica foram desenvolvidos para as BCGs permitindo seguir a evolução de vários elementos quí micos (H, D, He, C, N, O, Mg, Si, S, Ca, e Fe). O modelo é caracterizado pelas prescrições adotadas para a formação estelar, a qual ocorre em vários surtos de atividade separados por longos perí odos quiescentes. Após ajustar os melhores modelos aos dados observacionais, as previsões destes modelos foram comparadas também a razões de abundância observadas em sistemas Damped Lyman alpha (DLAs) e a origem do N (primária ou secundária) foi discutida. Alguns dos resultados obtidos são: i) as razões de abundância observadas nas BCGs são reproduzidas por modelos com 2 a 7 surtos de formação estelar com eficiência entre n = 0.2-0.9 Gano-1; ii) os baixos valores de N/O observados nestas galáxias são um resultado natural de uma formação estelar em surtos; iii) os modelos para BCGs podem reproduzir os dados dos DLAs, iv) uma quantidade "baixa" de N primário produzido em estrelas de alta massa pode ser uma explicação para os baixos valores de [N/a] observados em DLAs.

Orion EM-1 Crew Module Structural Test Article Prepped for Trans

NASA Image and Video Library

2017-04-24

Inside the Neil Armstrong Operations and Checkout Building high bay at NASA's Kennedy Space Center in Florida, technicians secure the transport container with the Orion Exploration Mission-1 (EM-1) structural test article onto a transport vehicle for the move to the Shuttle Landing Facility. The test article will be loaded in NASA's Super Guppy airplane and transported to Lockheed Martin's Denver facility for testing. The Orion spacecraft will launch atop NASA’s Space Launch System rocket on EM-1, its first deep space mission.

Orion EM-1 Crew Module Structural Test Article Prepped for Trans

NASA Image and Video Library

2017-04-24

Inside the Neil Armstrong Operations and Checkout Building high bay at NASA's Kennedy Space Center in Florida, the Orion Exploration Mission-1 (EM-1) structural test article inside its transport container, is secured onto a transport vehicle for the move to the Shuttle Landing Facility. The test article will be loaded in NASA's Super Guppy airplane and transported to Lockheed Martin's Denver facility for testing. The Orion spacecraft will launch atop NASA’s Space Launch System rocket on EM-1, its first deep space mission.

Orion EM-1 Crew Module Structural Test Article Prepped for Trans

NASA Image and Video Library

2017-04-24

Inside the Neil Armstrong Operations and Checkout Building high bay at NASA's Kennedy Space Center in Florida, technicians secure the Orion Exploration Mission-1 (EM-1) structural test article in its transport container onto a transport vehicle for the move to the Shuttle Landing Facility. The test article will be loaded in NASA's Super Guppy airplane and transported to Lockheed Martin's Denver facility for testing. The Orion spacecraft will launch atop NASA’s Space Launch System rocket on EM-1, its first deep space mission.

Orion EM-1 Crew Module Structural Test Article Prepped for Trans

NASA Image and Video Library

2017-04-24

Inside the Neil Armstrong Operations and Checkout Building high bay at NASA's Kennedy Space Center in Florida, the Orion Exploration Mission-1 (EM-1) structural test article, secured inside its transport container, is lowered onto a transport vehicle for the move to the Shuttle Landing Facility. The test article will be loaded in NASA's Super Guppy airplane and transported to Lockheed Martin's Denver facility for testing. The Orion spacecraft will launch atop NASA’s Space Launch System rocket on EM-1, its first deep space mission.

3D time-domain airborne EM modeling for an arbitrarily anisotropic earth

NASA Astrophysics Data System (ADS)

Yin, Changchun; Qi, Yanfu; Liu, Yunhe

2016-08-01

Time-domain airborne EM data is currently interpreted based on an isotropic model. Sometimes, it can be problematic when working in the region with distinct dipping stratifications. In this paper, we simulate the 3D time-domain airborne EM responses over an arbitrarily anisotropic earth with topography by edge-based finite-element method. Tetrahedral meshes are used to describe the abnormal bodies with complicated shapes. We further adopt the Backward Euler scheme to discretize the time-domain diffusion equation for electric field, obtaining an unconditionally stable linear equations system. We verify the accuracy of our 3D algorithm by comparing with 1D solutions for an anisotropic half-space. Then, we switch attentions to effects of anisotropic media on the strengths and the diffusion patterns of time-domain airborne EM responses. For numerical experiments, we adopt three typical anisotropic models: 1) an anisotropic anomalous body embedded in an isotropic half-space; 2) an isotropic anomalous body embedded in an anisotropic half-space; 3) an anisotropic half-space with topography. The modeling results show that the electric anisotropy of the subsurface media has big effects on both the strengths and the distribution patterns of time-domain airborne EM responses; this effect needs to be taken into account when interpreting ATEM data in areas with distinct anisotropy.

Global Convergence of the EM Algorithm for Unconstrained Latent Variable Models with Categorical Indicators

ERIC Educational Resources Information Center

Weissman, Alexander

2013-01-01

Convergence of the expectation-maximization (EM) algorithm to a global optimum of the marginal log likelihood function for unconstrained latent variable models with categorical indicators is presented. The sufficient conditions under which global convergence of the EM algorithm is attainable are provided in an information-theoretic context by…

Time series modelling to forecast prehospital EMS demand for diabetic emergencies.

PubMed

Villani, Melanie; Earnest, Arul; Nanayakkara, Natalie; Smith, Karen; de Courten, Barbora; Zoungas, Sophia

2017-05-05

Acute diabetic emergencies are often managed by prehospital Emergency Medical Services (EMS). The projected growth in prevalence of diabetes is likely to result in rising demand for prehospital EMS that are already under pressure. The aims of this study were to model the temporal trends and provide forecasts of prehospital attendances for diabetic emergencies. A time series analysis on monthly cases of hypoglycemia and hyperglycemia was conducted using data from the Ambulance Victoria (AV) electronic database between 2009 and 2015. Using the seasonal autoregressive integrated moving average (SARIMA) modelling process, different models were evaluated. The most parsimonious model with the highest accuracy was selected. Forty-one thousand four hundred fifty-four prehospital diabetic emergencies were attended over a seven-year period with an increase in the annual median monthly caseload between 2009 (484.5) and 2015 (549.5). Hypoglycemia (70%) and people with type 1 diabetes (48%) accounted for most attendances. The SARIMA (0,1,0,12) model provided the best fit, with a MAPE of 4.2% and predicts a monthly caseload of approximately 740 by the end of 2017. Prehospital EMS demand for diabetic emergencies is increasing. SARIMA time series models are a valuable tool to allow forecasting of future caseload with high accuracy and predict increasing cases of prehospital diabetic emergencies into the future. The model generated by this study may be used by service providers to allow appropriate planning and resource allocation of EMS for diabetic emergencies.

Hybrid polymer composite membrane for an electromagnetic (EM) valveless micropump

NASA Astrophysics Data System (ADS)

Said, Muzalifah Mohd; Yunas, Jumril; Bais, Badariah; Azlan Hamzah, Azrul; Yeop Majlis, Burhanuddin

2017-07-01

In this paper, we report on a hybrid membrane used as an actuator in an electromagnetically driven valveless micropump developed using MEMS processes. The membrane structure consists of the combination of a magnetic polymer composite membrane and an attached bulk permanent magnet which is expected to have a compact structure and a strong magnetic force with maintained membrane flexibility. A soft polymeric material made of polydimethylsiloxane (PDMS) is initially mixed with neodymium magnetic particles (NdFeB) to form a magnetic polymer composite membrane. The membrane is then bonded with the PDMS based microfluidic part, developed using soft lithography process. The developed micropump was tested in terms of the actuator membrane deflection capability and the fluidic flow of the injected fluid sample through the microfluidic channel. The experimental results show that the magnetic composite actuator membrane with an attached bulk permanent magnet is capable of producing a maximum membrane deflection of up to 106 µm. The functionality test of the electromagnetic (EM) actuator for fluid pumping purposes was done by supplying an AC voltage with various amplitudes, signal waves and frequencies. A wide range of sample injection rates from a few µl min-1 to tens of nl min-1 was achieved with a maximum flow rate of 6.6 µl min-1. The injection flow rate of the EM micropump can be controlled by adjusting the voltage amplitude and frequency supplied to the EM coil, to control the membrane deflection in the pump chamber. The designed valveless EM micropump has a very high potential to enhance the drug delivery system capability in biomedical applications.

ALiEM Blog and Podcast Watch: Procedures in Emergency Medicine

PubMed Central

Joshi, Nikita; Morley, Eric J.; Taira, Taku; Branzetti, Jeremy; Grock, Andrew

2017-01-01

Introduction The WestJEM Blog and Podcast Watch presents high-quality, open-access educational blogs and podcasts in emergency medicine (EM) based on the ongoing Academic Life in EM (ALiEM) Approved Instructional Resources (AIR) and AIR-Professional series. Both series critically appraise resources using an objective scoring rubric. This installment of the Blog and Podcast Watch highlights the topic of procedure emergencies from the AIR Series. Methods The AIR Series is a continuously building curriculum that follows the Council of Emergency Medicine Residency Directors’ (CORD) annual testing schedule. For each module, relevant content is collected from the top 50 Social Media Index sites published within the previous 12 months, and scored by eight AIR board members using five equally weighted measurement outcomes: Best Evidence in Emergency Medicine (BEEM) score, accuracy, educational utility, evidence based, and references. Resources scoring ≥30 out of 35 available points receive an AIR label. Resources scoring 27–29 receive an “honorable mention” label if the executive board agrees that the post is accurate and educationally valuable. Results A total of 85 blog posts and podcasts were evaluated in June 2016. This report summarizes key educational pearls from the three AIR posts and the 10 Honorable Mentions. Conclusion The WestJEM Blog and Podcast Watch series is based on the AIR and AIR-Pro series, which attempts to identify high-quality educational content on open-access blogs and podcasts. This series provides an expert-based, post-publication curation of educational social media content for EM clinicians, with this installment focusing on procedure emergencies within the AIR series. PMID:29085547

Discos de acresção em sistemas Be-X

NASA Astrophysics Data System (ADS)

Lopes de Oliveira, R.; Janot-Pacheco, E.

2003-08-01

Alguns fenômenos de outbursts em Be-X sugerem a existência, mesmo que temporária, de um disco de acresção quando da passagem do objeto compacto pelo periastro orbital. Neste trabalho avaliamos a possibilidade de formação do disco de acresção em sistemas Be+estrela de neutrons e Be+anã branca, e a influência da excentricidade orbital na ocorrência deste fenômeno. Utilizamos a expressão analítica para o momento angular específico da matéria constituinte de um meio em expansão lenta, como é o caso do disco circunstelar das estrelas Be, proposta por Wang(1981), sob a condição básica de que o raio de circularização deva ser maior do que o raio de Alfvén. Concluímos que existe um limite para o período orbital do sistema acima do qual não é possível a formação do disco de acresção, e que este valor aumenta para sistemas com excentricidade orbital maior.

Adherence to dietary recommendations for preschoolers: clinical trial with teenage mothers.

PubMed

Soldateli, Betina; Vigo, Alvaro; Giugliani, Elsa Regina Justo

2016-12-22

To assess the effect of educational dietary intervention offered in the child's first year of life, as well as teenage mothers and grandmothers in carrying out the dietary recommendations at four to seven years. Randomized clinical trial initiated in 2006, in Porto Alegre, RS, involving 323 teenage mothers and grandmothers who cohabited. The intervention consisted of six counseling sessions on breastfeeding and healthy complementary feeding. The first session occurred in the maternity ward and the other ones in the households of mothers at seven, 15, 30, 60, and 120 days of the child's life. The information about the child's diet were obtained on a monthly basis in the first six months, every two months in the second half-year, and at four to seven years, using a food frequency questionnaire. To assess the adequacy of food consumption to the recommendations from the Ministry of Health, we elaborated a score system that would reflect the compliance with the Ten Steps for Healthy Toddlers from 2 to 10 Years. The average scores of intervention and control groups were compared using the t-test. Low adherence to recommendations on child nutrition was found in the study population, with no difference in implementation the steps between the groups. The score on the compliance with the steps was similar in both groups (9.6 [SD = 1.63] and 9.3 [SD = 1.60] in the intervention and control groups, respectively) and no influence of the cohabitation with the grandmother was found. Educational dietary intervention in the first four months of the child's life for teenage mothers and grandmothers had no effect on the compliance with the recommendations at four to seven years of the child's life. Avaliar o efeito de intervenção alimentar educativa oferecida, no primeiro ano de vida da criança, a mães adolescentes e avós maternas, no cumprimento das recomendações alimentares aos quatro a sete anos. Ensaio clínico randomizado iniciado em 2006, em Porto Alegre, RS, envolvendo

Orion EM-1 Crew Module Structural Test Article Prepped for Trans

NASA Image and Video Library

2017-04-24

Inside the Neil Armstrong Operations and Checkout Building high bay at NASA's Kennedy Space Center in Florida, the Orion Exploration Mission-1 (EM-1) structural test article is secured inside its transport container. A crane is used to move the container toward a transport vehicle for the move to the Shuttle Landing Facility. The test article will be loaded in NASA's Super Guppy airplane and transported to Lockheed Martin's Denver facility for testing. The Orion spacecraft will launch atop NASA’s Space Launch System rocket on EM-1, its first deep space mission.

Papanicolaou Testing by Physicians in Manitoba: Who Does Them?

PubMed Central

Cohen, Marsha M.; Hammarstrand, Karen M.

1989-01-01

Pap testing is one of the few effective preventive health practices available to primary care physicians. Yet we know little about how well this procedure is being done. Using data from the province of Manitoba's universal health insurance plan for the years 1976, 1978 and 1982, we determined the proportion of all Pap tests of women over 25 years of age performed by the various physician specialties; the percentage of physicians in each specialty who performed tests; and the mean number of tests per specialty group. We also determined the mean number of tests by age and training of the physician. The number of physicians performing Pap tests increased from 749 in 1976 to 780 in 1982. About 2% of Pap tests performed in the province were done by internists, 5% by general surgeons, about 33% by obstetrician/gynecologists, 40% by urban general practitioners, and 22% by rural general practitioners. Other physicians accounted for less than 0.2% of all tests. The mean number of Pap tests performed increased with increasing physician age up to age 60 and declined thereafter. Manitoba-trained physicians performed the highest rate of Pap testing, and this pattern was maintained over time. In 1982, only 22% of internists, 29% of general surgeons, and 78% of family physicians/general practitioners were performing tests. These results raise the question of why a significant number of physicians are not carrying out this effective preventive health practice. PMID:21248879

Investigation of contrast-enhanced subtracted breast CT images with MAP-EM based on projection-based weighting imaging.

PubMed

Zhou, Zhengdong; Guan, Shaolin; Xin, Runchao; Li, Jianbo

2018-06-01

Contrast-enhanced subtracted breast computer tomography (CESBCT) images acquired using energy-resolved photon counting detector can be helpful to enhance the visibility of breast tumors. In such technology, one challenge is the limited number of photons in each energy bin, thereby possibly leading to high noise in separate images from each energy bin, the projection-based weighted image, and the subtracted image. In conventional low-dose CT imaging, iterative image reconstruction provides a superior signal-to-noise compared with the filtered back projection (FBP) algorithm. In this paper, maximum a posteriori expectation maximization (MAP-EM) based on projection-based weighting imaging for reconstruction of CESBCT images acquired using an energy-resolving photon counting detector is proposed, and its performance was investigated in terms of contrast-to-noise ratio (CNR). The simulation study shows that MAP-EM based on projection-based weighting imaging can improve the CNR in CESBCT images by 117.7%-121.2% compared with FBP based on projection-based weighting imaging method. When compared with the energy-integrating imaging that uses the MAP-EM algorithm, projection-based weighting imaging that uses the MAP-EM algorithm can improve the CNR of CESBCT images by 10.5%-13.3%. In conclusion, MAP-EM based on projection-based weighting imaging shows significant improvement the CNR of the CESBCT image compared with FBP based on projection-based weighting imaging, and MAP-EM based on projection-based weighting imaging outperforms MAP-EM based on energy-integrating imaging for CESBCT imaging.

Self-assembled monolayers improve protein distribution on holey carbon cryo-EM supports

PubMed Central

Meyerson, Joel R.; Rao, Prashant; Kumar, Janesh; Chittori, Sagar; Banerjee, Soojay; Pierson, Jason; Mayer, Mark L.; Subramaniam, Sriram

2014-01-01

Poor partitioning of macromolecules into the holes of holey carbon support grids frequently limits structural determination by single particle cryo-electron microscopy (cryo-EM). Here, we present a method to deposit, on gold-coated carbon grids, a self-assembled monolayer whose surface properties can be controlled by chemical modification. We demonstrate the utility of this approach to drive partitioning of ionotropic glutamate receptors into the holes, thereby enabling 3D structural analysis using cryo-EM methods. PMID:25403871

Volta phase plate data collection facilitates image processing and cryo-EM structure determination.

PubMed

von Loeffelholz, Ottilie; Papai, Gabor; Danev, Radostin; Myasnikov, Alexander G; Natchiar, S Kundhavai; Hazemann, Isabelle; Ménétret, Jean-François; Klaholz, Bruno P

2018-06-01

A current bottleneck in structure determination of macromolecular complexes by cryo electron microscopy (cryo-EM) is the large amount of data needed to obtain high-resolution 3D reconstructions, including through sorting into different conformations and compositions with advanced image processing. Additionally, it may be difficult to visualize small ligands that bind in sub-stoichiometric levels. Volta phase plates (VPP) introduce a phase shift in the contrast transfer and drastically increase the contrast of the recorded low-dose cryo-EM images while preserving high frequency information. Here we present a comparative study to address the behavior of different data sets during image processing and quantify important parameters during structure refinement. The automated data collection was done from the same human ribosome sample either as a conventional defocus range dataset or with a Volta phase plate close to focus (cfVPP) or with a small defocus (dfVPP). The analysis of image processing parameters shows that dfVPP data behave more robustly during cryo-EM structure refinement because particle alignments, Euler angle assignments and 2D & 3D classifications behave more stably and converge faster. In particular, less particle images are required to reach the same resolution in the 3D reconstructions. Finally, we find that defocus range data collection is also applicable to VPP. This study shows that data processing and cryo-EM map interpretation, including atomic model refinement, are facilitated significantly by performing VPP cryo-EM, which will have an important impact on structural biology. Copyright © 2018 Elsevier Inc. All rights reserved.

Preventing EMS workplace violence: A mixed-methods analysis of insights from assaulted medics.

PubMed

Maguire, Brian J; O'Neill, Barbara J; O'Meara, Peter; Browne, Matthew; Dealy, Michael T

2018-05-31

To describe measures that assaulted EMS personnel believe will help prevent violence against EMS personnel. This mixed- methods study includes a thematic analysis and directed content analysis of one survey question that asked the victims of workplace violence how the incident might have been prevented. Of 1778 survey respondents, 633 reported being assaulted in the previous 12 months; 203 of them believed the incident could have been prevented and 193 of them (95%) answered this question. Six themes were identified using Haddon's Matrix as a framework. The themes included: Human factors, including specialized training related to specific populations and de-escalation techniques as well as improved situational awareness; Equipment factors, such as restraint equipment and resources; and, Operational and environment factors, including advanced warning systems. Persons who could have prevented the violence were identified as police, self, other professionals, partners and dispatchers. Restraints and training were suggested as violence-prevention tools and methods CONCLUSIONS: This is the first international study from the perspective of victimized EMS personnel, to report on ways that violence could be prevented. Ambulance agencies should consider these suggestions and work with researchers to evaluate risks at the agency level and to develop, implement and test interventions to reduce the risks of violence against EMS personnel. These teams should work together to both form an evidence-base for prevention and to publish findings so that EMS medical directors, administrators and professionals around the world can learn from each experience. Copyright © 2018 Elsevier Ltd. All rights reserved.

Fluorescence spectroscopy for diagnosis of squamous intraepithelial lesions of the cervix.

PubMed

Mitchell, M F; Cantor, S B; Ramanujam, N; Tortolero-Luna, G; Richards-Kortum, R

1999-03-01

To calculate receiver operating characteristic (ROC) curves for fluorescence spectroscopy in order to measure its performance in the diagnosis of squamous intraepithelial lesions (SILs) and to compare these curves with those for other diagnostic methods: colposcopy, cervicography, speculoscopy, Papanicolaou smear screening, and human papillomavirus (HPV) testing. Data from our previous clinical study were used to calculate ROC curves for fluorescence spectroscopy. Curves for other techniques were calculated from other investigators' reports. To identify these, a MEDLINE search for articles published from 1966 to 1996 was carried out, using the search terms "colposcopy," "cervicoscopy," "cervicography," "speculoscopy," "Papanicolaou smear," "HPV testing," "fluorescence spectroscopy," and "polar probe" in conjunction with the terms "diagnosis," "positive predictive value," "negative predictive value," and "receiver operating characteristic curve." We found 270 articles, from which articles were selected if they reported results of studies involving high-disease-prevalence populations, reported findings of studies in which colposcopically directed biopsy was the criterion standard, and included sufficient data for recalculation of the reported sensitivities and specificities. We calculated ROC curves for fluorescence spectroscopy using Bayesian and neural net algorithms. A meta-analytic approach was used to calculate ROC curves for the other techniques. Areas under the curves were calculated. Fluorescence spectroscopy using the neural net algorithm had the highest area under the ROC curve, followed by fluorescence spectroscopy using the Bayesian algorithm, followed by colposcopy, the standard diagnostic technique. Cervicography, Papanicolaou smear screening, and HPV testing performed comparably with each other but not as well as fluorescence spectroscopy and colposcopy. Fluorescence spectroscopy performs better than colposcopy and other techniques in the diagnosis of

Increased mortality associated with EMS transport of gunshot wound victims when compared to private vehicle transport.

PubMed

Zafar, Syed Nabeel; Haider, Adil H; Stevens, Kent A; Ray-Mazumder, Nik; Kisat, Mehreen T; Schneider, Eric B; Chi, Albert; Galvagno, Samuel M; Cornwell, Edward E; Efron, David T; Haut, Elliott R

2014-09-01

Recent studies suggest that mode of transport affects survival in penetrating trauma patients. We hypothesised that there is wide variation in transport mode for patients with gunshot wounds (GSW) and there may be a mortality difference for GSW patients transported by emergency medical services (EMS) vs. private vehicle (PV). We studied adult (≥16 years) GSW patients in the National Trauma Data Bank (2007-2010). Level 1 and 2 trauma centres (TC) receiving ≥50 GSW patients per year were included. Proportions of patients arriving by each transport mode for each TC were examined. In-hospital mortality was compared between the two groups, PV and EMS, using multivariable regression analyses. Models were adjusted for patient demographics, injury severity, and were adjusted for clustering by facility. 74,187 GSW patients were treated at 182 TCs. The majority (76%) were transported by EMS while 12.6% were transported by PV. By individual TC, the proportion of patients transported by each category varied widely: EMS (median 78%, interquartile range (IQR) 66-85%), PV (median 11%, IQR 7-17%), or others (median 7%, IQR 2-18%). Unadjusted mortality was significantly different between PV and EMS (2.1% vs. 9.7%, p<0.001). Multivariable analysis demonstrated that EMS transported patients had a greater than twofold odds of dying when compared to PV (OR=2.0, 95% CI 1.73-2.35). Wide variation exists in transport mode for GSW patients across the United States. Mortality may be higher for GSW patients transported by EMS when compared to private vehicle transport. Further studies should be performed to examine this question. Copyright © 2014 Elsevier Ltd. All rights reserved.

Marine EM: The Past, The Present, and The Future

NASA Astrophysics Data System (ADS)

Constable, S.

2016-12-01

The high cost of deepwater exploration motivated the development of commercial marine magnetotelluric (MT) exploration in 1995, but it wasn't until marine controlled-source electromagnetic (CSEM) methods burst upon the industry scene with the formation of three new contractors in 2002 that things got really exciting. Now the bubble has burst and the excitement has diminished, but marine EM remains an important tool for offshore exploration. Early mistakes were made as a result of poor instrumentation and a lack of good interpretation tools - unlike seismics, EM relies heavily on inversion to produce useful results - but both equipment and inversion codes have improved significantly. Still, there are mistakes that can be made. Rock anisotropy and seawater conductivity have to be handled appropriately. A strong galvanic response means that there is a resistivity/thickness ambiguity when imaging reservoirs, but the inductive nature of the data means that multi-frequency inversions are very much better than using single frequencies. Resolution will never be as good as for seismic methods, but is much better than for potential field methods and conductivity may often be a more diagnostic property than acoustic impedance. EM images resistivity, not hydrocarbon content, and false positives occasionally occur, but false negatives are rare. That is, without a CSEM signature there is little chance of discovering economical hydrocarbons. This should bode well for the future of the method.

The Canadian National EMS Research Agenda: Impact and Feasibility of Implementation of Previously Generated Recommendations.

PubMed

Jensen, J L; Blanchard, I E; Bigham, B L; Carter, Aje; Brown, R; Socha, D; Brown, L H; Travers, A H; Craig, A M; Morrison, L J

2015-09-01

A recent mixed-methods study on the state of emergency medical services (EMS) research in Canada led to the generation of nineteen actionable recommendations. As part of the dissemination plan, a survey was distributed to EMS stakeholders to determine the anticipated impact and feasibility of implementing these recommendations in Canadian systems. An online survey explored both the implementation impact and feasibility for each recommendation using a five-point scale. The sample consisted of participants from the Canadian National EMS Research Agenda study (published in 2013) and additional EMS research stakeholders identified through snowball sampling. Responses were analysed descriptively using median and plotted on a matrix. Participants reported any planned or ongoing initiatives related to the recommendations, and required or anticipated resources. Free text responses were analysed with simple content analysis, collated by recommendation. The survey was sent to 131 people, 94 (71.8%) of whom responded: 30 EMS managers/regulators (31.9%), 22 researchers (23.4%), 15 physicians (16.0%), 13 educators (13.8%), and 5 EMS providers (5.3%). Two recommendations (11%) had a median impact score of 4 (of 5) and feasibility score of 4 (of 5). Eight recommendations (42%) had an impact score of 5, with a feasibility score of 3. Nine recommendations (47%) had an impact score of 4 and a feasibility score of 3. For most recommendations, participants scored the anticipated impact higher than the feasibility to implement. Ongoing or planned initiatives exist pertaining to all recommendations except one. All of the recommendations will require additional resources to implement.

Evaluation of staining methods for cytologic diagnosis of oral lesions.

PubMed

Almeida, Janete Dias; Lima, Celina Faig; Brandão, Adriana Aigotti Haberbeck; Cabral, Luiz Antonio Guimarães

2008-01-01

To compare the efficacy ofPapanicolaou, hematoxylin-eosin (H-E), Leishman and periodic acid-Schiff (PAS) staining for cytologic diagnosis of oral lesions. Patients from the Discipline of Stomatology, São José dos Campos Dental School, from the wards of Hosapital Heliópolis and from the dentistry outpatient clinic of the University Hospital, University of São Paulo Medical School, with the following diseases, were selected: erythematous candidiasis (n=9), pseudomembranous candidiasis (n=10), squamous cell carcinoma (n=19), herpes simplex (n=8), paracoccidioidomycosis (n=8) and pemphigus vulgaris (n=1). The different staining methods were compared regarding the quality of definition of cytoplasmic and nuclear morphologic characteristics and the identification of bacteria, fungi, inflammatory cells and secretions. Papanicolaou and H-E staining were considered better methods. In cases of fungal infections, PAS staining is useful and should be applied as a complementary method. Within the limitations of this study, it can be concluded that the cytologic diagnosis of oral lesions along with different staining methods is a useful tool for oral diagnosis.

A protocol for bladder cancer screening and medical surveillance among high-risk groups: The Drake Health Registry experience

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

Marsh, G.M.; Callahan, C.; Pavlock, D.

In 1986, the Drake Health Registry Study initiated bladder cancer screening for 366 persons at high risk because of occupational exposure to beta-naphthylamine. The Drake Health Registry Study screening protocol consists of urinalysis, Papanicolaou cytology, and quantitative fluorescence image analysis. A positive screening test qualifies participants for a full diagnostic evaluation. The screening protocol has been modified during the first 3 years of the program's existence to address unexpected patterns of test results and to incorporate advances in screening technology. The current protocol, which has a two-tiered screening schedule, has been utilized successfully for 15 months. Of the 26 positivemore » results to date most have been based on abnormal Papanicolaou cytology and/or quantitative fluorescence image analysis. Bladder abnormalities were cited among most of the 18 study members who underwent diagnostic evaluation, including chronic cystitis, inflammation, hyperplasia, and dysplasia. We conclude that the screening program is detecting very early changes in a relatively young cohort and that these persons must be monitored over a number of years to ensure adequate medical surveillance.« less

TRICARE: changes included in the National Defense Authorization Act for Fiscal Year 2007; improvements to descriptions of cancer screening for women. Final rule.

PubMed

2010-08-06

The Department is publishing this final rule to implement section 703 of the National Defense Authorization Act (NDAA) for Fiscal Year 2007 (FY07), Public Law 109-364. Specifically, that legislation authorizes breast cancer screening and cervical cancer screening for female beneficiaries of the Military Health System, instead of constraining such testing to mammograms and Papanicolaou smears. The rule allows coverage for "breast cancer screening" and "cervical cancer screening" for female beneficiaries of the Military Health System, instead of constraining such testing to mammograms and Papanicolaou tests. This rule ensures new breast and cervical cancer screening procedures can be added to the TRICARE benefit as such procedures are proven to be a safe, effective, and nationally accepted medical practice. This amends the cancer specific recommendations for breast and cervical cancer screenings to be brought in line with the processes for updating other cancer screening recommendations. In response to public comment on the proposed rule, this final rule includes a clarification that the benefit encompasses screening based on Health and Human Services guidelines.

Accurate model annotation of a near-atomic resolution cryo-EM map.

PubMed

Hryc, Corey F; Chen, Dong-Hua; Afonine, Pavel V; Jakana, Joanita; Wang, Zhao; Haase-Pettingell, Cameron; Jiang, Wen; Adams, Paul D; King, Jonathan A; Schmid, Michael F; Chiu, Wah

2017-03-21

Electron cryomicroscopy (cryo-EM) has been used to determine the atomic coordinates (models) from density maps of biological assemblies. These models can be assessed by their overall fit to the experimental data and stereochemical information. However, these models do not annotate the actual density values of the atoms nor their positional uncertainty. Here, we introduce a computational procedure to derive an atomic model from a cryo-EM map with annotated metadata. The accuracy of such a model is validated by a faithful replication of the experimental cryo-EM map computed using the coordinates and associated metadata. The functional interpretation of any structural features in the model and its utilization for future studies can be made in the context of its measure of uncertainty. We applied this protocol to the 3.3-Å map of the mature P22 bacteriophage capsid, a large and complex macromolecular assembly. With this protocol, we identify and annotate previously undescribed molecular interactions between capsid subunits that are crucial to maintain stability in the absence of cementing proteins or cross-linking, as occur in other bacteriophages.

Accurate model annotation of a near-atomic resolution cryo-EM map

PubMed Central

Hryc, Corey F.; Chen, Dong-Hua; Afonine, Pavel V.; Jakana, Joanita; Wang, Zhao; Haase-Pettingell, Cameron; Jiang, Wen; Adams, Paul D.; King, Jonathan A.; Schmid, Michael F.; Chiu, Wah

2017-01-01

Electron cryomicroscopy (cryo-EM) has been used to determine the atomic coordinates (models) from density maps of biological assemblies. These models can be assessed by their overall fit to the experimental data and stereochemical information. However, these models do not annotate the actual density values of the atoms nor their positional uncertainty. Here, we introduce a computational procedure to derive an atomic model from a cryo-EM map with annotated metadata. The accuracy of such a model is validated by a faithful replication of the experimental cryo-EM map computed using the coordinates and associated metadata. The functional interpretation of any structural features in the model and its utilization for future studies can be made in the context of its measure of uncertainty. We applied this protocol to the 3.3-Å map of the mature P22 bacteriophage capsid, a large and complex macromolecular assembly. With this protocol, we identify and annotate previously undescribed molecular interactions between capsid subunits that are crucial to maintain stability in the absence of cementing proteins or cross-linking, as occur in other bacteriophages. PMID:28270620

Queda dos homicídios em São Paulo, Brasil: uma análise descritiva

PubMed Central

Peres, Maria Fernanda Tourinho; Vicentin, Diego; Nery, Marcelo Batista; de Lima, Renato Sérgio; de Souza, Edinilsa Ramos; Cerda, Magdalena; Cardia, Nancy; Adorno, e Sérgio

2012-01-01

Objetivo Descrever a evolução da mortalidade por homicídios no Município de São Paulo segundo tipo de arma, sexo, raça ou cor, idade e áreas de exclusão/inclusão social entre 1996 e 2008. Métodos Estudo ecológico de série temporal. Os dados sobre óbitos ocorridos no Município foram coletados da base de dados do Programa de Aprimoramento das Informações sobre Mortalidade, seguindo a Classificação Internacional de Doenças, Décima Revisão (CID-10). Foram calculadas as taxas de mortalidade por homicídio (TMH) para a população total, por sexo, raça ou cor, faixa etária, tipo de arma e área de exclusão/inclusão social. As TMH foram padronizadas por idade pelo método direto. Foram calculados os percentuais de variação no período estudado. Para as áreas de exclusão/inclusão social foram calculados os riscos relativos de morte por homicídio. Resultados As TMH apresentaram queda de 73,7% entre 2001 e 2008. Foi observada redução da TMH em todos os grupos analisados, mais pronunciada em homens (−74,5%), jovens de 15 a 24 anos (−78,0%) e moradores de áreas de exclusão social extrema (−79,3%). A redução ocorreu, sobretudo, nos homicídios cometidos com armas de fogo (−74,1%). O risco relativo de morte por homicídio nas áreas de exclusão extrema (tendo como referência áreas com algum grau de exclusão social) foi de 2,77 em 1996, 3,9 em 2001 e 2,13 em 2008. Nas áreas de alta exclusão social, o risco relativo foi de 2,07 em 1996 e 1,96 em 2008. Conclusões Para compreender a redução dos homicídios no Município, é importante considerar macrodeterminantes que atingem todo o Município e todos os subgrupos populacionais e microdeterminantes que atuam localmente, influenciando de forma diferenciada os homicídios com armas de fogo e os homicídios na população jovem, no sexo masculino e em residentes em áreas de alta exclusão social. PMID:21390415

Superconducting Electromagnetic Suspension (EMS) system for Grumman Maglev concept

NASA Technical Reports Server (NTRS)

Kalsi, Swarn S.

1994-01-01

The Grumman developed Electromagnetic Suspension (EMS) Maglev system has the following key characteristics: a large operating airgap--40 mm; levitation at all speeds; both high speed and low speed applications; no deleterious effects on SC coils at low vehicle speeds; low magnetic field at the SC coil--less than 0.35 T; no need to use non-magnetic/non-metallic rebar in the guideway structure; low magnetic field in passenger cabin--approximately 1 G; low forces on the SC coil; employs state-of-the-art NbTi wire; no need for an active magnet quench protection system; and lower weight than a magnet system with copper coils. The EMS Maglev described in this paper does not require development of any new technologies. The system could be built with the existing SC magnet technology.

[Spontaneous and induced sterility by ethyl methanesulfonate (EMS) in Nigella damascena L].

PubMed

Gilot-Delhalle, J

1976-01-01

EMS-induced sterility could be very partially due to chromosomal aberrations appearing during male and female meiosis or even to mechanical abnormalities of the double fertilization. The sterility could be also related to diplontic origin (lethal factors or small deficiencies appearing in homozygous state on account of self-pollinization). Owing to our histological and genetical data, a female gametophytic origin could be mainly ascribed to EMS induced sterility. It could arise from a damage of the feeding function of the nucellus.

A head-to-head hands-on comparison of ERCP mechanical simulator (EMS) and Ex-vivo Porcine Stomach Model (PSM)

PubMed Central

Leung, Joseph W; Wang, Dong; Hu, Bing; Lim, Brian

2011-01-01

Background ERCP mechanical simulator (EMS) and ex-vivo porcine stomach model (PSM) have been described. No direct comparison was reported on endoscopists' perception regarding their efficacy for ERCP training Objective Comparative assessment of EMS and PSM. Design Questionnaire survey before and after practice. Setting Hands-on practice workshops. Subjects 22 endoscopists with prior experience in 111±225 (mean±SD) ERCP. Interventions Participants performed scope insertion, selective bile duct cannulation with guide wire and insertion of a single biliary stent. Simulated fluoroscopy with external pin-hole camera (EMS), or with additional transillumination (PSM) was used to monitor exchange of accessories. Main outcome measure Participants rated their understanding and confidence before and after hands-on practice, and credibility of each simulator for ERCP training. Comparative efficacy of EMS and PSM for ERCP education was scored (1=not, 10=very) based on pre and post practice surveys: realism (tissue pliability, papilla anatomy, visual/cannulation realism, wire manipulation, simulated fluoroscopy, overall experience); usefulness (assessment of results, supplementing clinical experience, easy for trainees to learn new skills) and application (overall ease of use, prepare trainees to use real instrument and ease of incorporation into training). Results Before hands-on practice, both EMS and PSM received high scores. After practice, there was a significantly greater increase in confidence score for EMS than PSM (p<0.003). Participants found EMS more useful for training (p=0.017). Limitations: Subjective scores. Conclusions Based on head-to-head hands-on comparison, endoscopists considered both EMS and PSM credible options for improving understanding and supplementing clinical ERCP training. EMS is more useful for basic learning. PMID:22163080

Back strength and flexibility of EMS providers in practicing prehospital providers.

PubMed

Crill, Matthew T; Hostler, David

2005-06-01

In the execution of prehospital care duties, an EMS provider may be required to carry equipment and patients over long distances or over multiple flights of stairs at any time of the day. At a minimum, a prehospital provider must have sufficient lower back strength and hamstring flexibility to prevent musculoskeletal injury while lifting. This study administered fitness assessments related to the occupational activities of the prehospital provider with the purpose of describing the incidence of occupational back injury and percentage of providers with known risk factors for back injury. Ninety subjects were tested during a regional EMS conference. Men were significantly taller and heavier than women and had significantly less hamstring flexibility. Body Mass Index was 30.7 +/- 7.2 in men and 28 +/- 5.7 in women. However, no significant differences were noted in an extension test of back strength. When surveyed, 47.8% of subjects reported a back injury in the previous 6 months but only 39.1% of these injuries were sustained while performing EMS duties. While only 13% of these injuries resulted in missed work, 52.2% reported their injury interfered with their daily activities. In spite of the physical nature of the profession, EMS providers in our sample were significantly overweight according to their Body Mass Index and may lack sufficient back strength and flexibilityfor safe execution of their duties. This group of professionals may be at risk for occupational injury and should be targeted for interventions to improve strength and flexibility.

Genomic characterization of EmsB microsatellite loci in Echinococcus multilocularis.

PubMed

Valot, Benoît; Knapp, Jenny; Umhang, Gérald; Grenouillet, Frédéric; Millon, Laurence

2015-06-01

EmsB is a molecular marker applied to Echinococcus multilocularis genotyping studies. This marker has largely been used to investigate the epidemiology of the parasite in different endemic foci. The present study has lifted the veil on the genetic structure of this microsatellite. By in silico analysis on the E. multilocularis genome the microsatellite was described in about 40 copies on the chromosome 5 of the parasite. Similar structure was found in the relative parasite Echinococcus granulosus, where the microsatellite was firstly described. The present study completes the first investigations made on the EmsB microsatellite origins and confirms the reliability of this highly discriminant molecular marker. Copyright © 2015 Elsevier B.V. All rights reserved.

EM-1 Booster Prep, Left Aft Skirt Work-In-Progress

NASA Image and Video Library

2016-10-30

Inside the Booster Fabrication Facility at NASA's Kennedy Space Center in Florida, the left hand aft skirt for the agency's Space Launch System (SLS) rocket is ready for the assembly process. From left, are Chad Goetz, quality technician with Orbital ATK, and Robbie Blaue, quality assurance specialist with the Defense Contract Management Agency. The aft skirt was refurbished and painted in support facilities at the Hangar AF facility at Cape Canaveral Air Force Station in Florida. The space shuttle-era aft skirt will be used on the left hand booster of the SLS for Exploration Mission 1 (EM-1). NASA is preparing for EM-1, deep space missions, and the Journey to Mars.

Orion EM-1 Crew Module Structural Test Article Prepped for Trans

NASA Image and Video Library

2017-04-24

Inside the Neil Armstrong Operations and Checkout Building high bay at NASA's Kennedy Space Center in Florida, the Orion Exploration Mission-1 (EM-1) structural test article is secured inside its transport container. Technicians monitor the progress as a crane is used to move the container toward a transport vehicle for the move to the Shuttle Landing Facility. The test article will be loaded in NASA's Super Guppy airplane and transported to Lockheed Martin's Denver facility for testing. The Orion spacecraft will launch atop NASA’s Space Launch System rocket on EM-1, its first deep space mission.

Genomic selection and complex trait prediction using a fast EM algorithm applied to genome-wide markers

PubMed Central

2010-01-01

Background The information provided by dense genome-wide markers using high throughput technology is of considerable potential in human disease studies and livestock breeding programs. Genome-wide association studies relate individual single nucleotide polymorphisms (SNP) from dense SNP panels to individual measurements of complex traits, with the underlying assumption being that any association is caused by linkage disequilibrium (LD) between SNP and quantitative trait loci (QTL) affecting the trait. Often SNP are in genomic regions of no trait variation. Whole genome Bayesian models are an effective way of incorporating this and other important prior information into modelling. However a full Bayesian analysis is often not feasible due to the large computational time involved. Results This article proposes an expectation-maximization (EM) algorithm called emBayesB which allows only a proportion of SNP to be in LD with QTL and incorporates prior information about the distribution of SNP effects. The posterior probability of being in LD with at least one QTL is calculated for each SNP along with estimates of the hyperparameters for the mixture prior. A simulated example of genomic selection from an international workshop is used to demonstrate the features of the EM algorithm. The accuracy of prediction is comparable to a full Bayesian analysis but the EM algorithm is considerably faster. The EM algorithm was accurate in locating QTL which explained more than 1% of the total genetic variation. A computational algorithm for very large SNP panels is described. Conclusions emBayesB is a fast and accurate EM algorithm for implementing genomic selection and predicting complex traits by mapping QTL in genome-wide dense SNP marker data. Its accuracy is similar to Bayesian methods but it takes only a fraction of the time. PMID:20969788

Atomic Resolution Cryo-EM Structure of β-Galactosidase.

PubMed

Bartesaghi, Alberto; Aguerrebere, Cecilia; Falconieri, Veronica; Banerjee, Soojay; Earl, Lesley A; Zhu, Xing; Grigorieff, Nikolaus; Milne, Jacqueline L S; Sapiro, Guillermo; Wu, Xiongwu; Subramaniam, Sriram

2018-05-10

The advent of direct electron detectors has enabled the routine use of single-particle cryo-electron microscopy (EM) approaches to determine structures of a variety of protein complexes at near-atomic resolution. Here, we report the development of methods to account for local variations in defocus and beam-induced drift, and the implementation of a data-driven dose compensation scheme that significantly improves the extraction of high-resolution information recorded during exposure of the specimen to the electron beam. These advances enable determination of a cryo-EM density map for β-galactosidase bound to the inhibitor phenylethyl β-D-thiogalactopyranoside where the ordered regions are resolved at a level of detail seen in X-ray maps at ∼ 1.5 Å resolution. Using this density map in conjunction with constrained molecular dynamics simulations provides a measure of the local flexibility of the non-covalently bound inhibitor and offers further opportunities for structure-guided inhibitor design. Published by Elsevier Ltd.

Instantaneous polarization statistic property of EM waves incident on time-varying reentry plasma

NASA Astrophysics Data System (ADS)

Bai, Bowen; Liu, Yanming; Li, Xiaoping; Yao, Bo; Shi, Lei

2018-06-01

An analytical method is proposed in this paper to study the effect of time-varying reentry plasma sheath on the instantaneous polarization statistic property of electromagnetic (EM) waves. Based on the disturbance property of the hypersonic fluid, the spatial-temporal model of the time-varying reentry plasma sheath is established. An analytical technique referred to as transmission line analogy is developed to calculate the instantaneous transmission coefficient of EM wave propagation in time-varying plasma. Then, the instantaneous polarization statistic theory of EM wave propagation in the time-varying plasma sheath is developed. Taking the S-band telemetry right hand circularly polarized wave as an example, effects of incident angle and plasma parameters, including the electron density and the collision frequency on the EM wave's polarization statistic property are studied systematically. Statistical results indicate that the lower the collision frequency and the larger the electron density and incident angle is, the worse the deterioration of the polarization property is. Meanwhile, in conditions of critical parameters of certain electron density, collision frequency, and incident angle, the transmitted waves have both the right and left hand polarization mode, and the polarization mode will reverse. The calculation results could provide useful information for adaptive polarization receiving of the spacecraft's reentry communication.

Influence of motivations for seeking ISO 14001 certification on perceptions of EMS effectiveness in China.

PubMed

Fryxell, Gerald E; Lo, Carlos Wing-Hung; Chung, Shan Shan

2004-02-01

This study examines the motivations of mainland Chinese facilities in seeking ISO 14001 certification and examines the linkages between these motivations and self-reports of the effectiveness of major environmental management system (EMS) components. In a sample of 128 facilities in Beijing, Shanghai, and Guangzhou, the main drivers for certification were reported to be to ensure regulatory compliance, to enhance the firm's reputation, and to improve environmental performance, in that order. Although motivation to achieve cost reductions were least emphasized, a broad range of motivations appears to be considered in the decision to seek certification to ISO 14001. Regression models linking these motivations to the EMS components suggests that internal motivations have an influence on most EMS components. One interesting exception to this, however, is that no significant relationship was observed between internal motivations and the promulgation of environmental objectives and targets. The relationships associated with external motivations for certification (i.e., those in response to customer and other stakeholder pressures) and EMS components, on the other hand, are weaker and tend to occur earlier in the process cycle. No significant relationships were found between motivations to reduce costs and perceptions of the effectiveness of EMS components. Overall, these findings suggest that ISO 14001, as currently being implemented in mainland China, may have a modestly useful role when used in combination with other policy mechanisms to move the Chinese economy toward more sustainable practices. It is asserted that the ISO standard could provide even greater benefits if Chinese registrars were more proactive in developing EMS in conjunction with even more rigorous third-party audits.

2. HI PAR (ACQUISITION RADAR) TOWER AND ENLISTED MEN (EM) ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

2. HI PAR (ACQUISITION RADAR) TOWER AND ENLISTED MEN (EM) BARRACKS WITH RADAR ATTACHED. - Nike Hercules Missile Battery Summit Site, Battery Control Administration & Barracks Building, Anchorage, Anchorage, AK

Physics-based simulation of EM and SM in TSV-based 3D IC structures

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

Kteyan, Armen; Sukharev, Valeriy; Zschech, Ehrenfried

2014-06-19

Evolution of stresses in through-silicon-vias (TSVs) and in the TSV landing pad due to the stress migration (SM) and electromigration (EM) phenomena are considered. It is shown that an initial stress distribution existing in a TSV depends on its architecture and copper fill technology. We demonstrate that in the case of proper copper annealing the SM-induced redistribution of atoms results in uniform distributions of the hydrostatic stress and concentration of vacancies along each segment. In this case, applied EM stressing generates atom migration that is characterized by kinetics depending on the preexisting equilibrium concentration of vacancies. Stress-induced voiding in TSVmore » is considered. EM induced voiding in TSV landing pad is analyzed in details.« less

Covariance Structure Model Fit Testing under Missing Data: An Application of the Supplemented EM Algorithm

ERIC Educational Resources Information Center

Cai, Li; Lee, Taehun

2009-01-01

We apply the Supplemented EM algorithm (Meng & Rubin, 1991) to address a chronic problem with the "two-stage" fitting of covariance structure models in the presence of ignorable missing data: the lack of an asymptotically chi-square distributed goodness-of-fit statistic. We show that the Supplemented EM algorithm provides a…

Perda de massa em ventos empoeirados de estrelas supergigantes

NASA Astrophysics Data System (ADS)

Vidotto, A. A.; Jatenco-Pereira, V.

2003-08-01

Em praticamente todas as regiões do diagrama HR, as estrelas apresentam evidências observacionais de perda de massa. Na literatura, pode-se encontrar trabalhos que tratam tanto do diagnóstico da perda de massa como da construção de modelos que visam explicá-la. O amortecimento de ondas Alfvén tem sido utilizado como mecanismo de aceleração de ventos homogêneos. Entretanto, sabe-se que os envelopes de estrelas frias contêm grãos sólidos e moléculas. Com o intuito de estudar a interação entre as ondas Alfvén e a poeira e a sua conseqüência na aceleração do vento estelar, Falceta-Gonçalves & Jatenco-Pereira (2002) desenvolveram um modelo de perda de massa para estrelas supergigantes. Neste trabalho, apresentamos um estudo do modelo acima proposto para avaliar a dependência da taxa de perda de massa com alguns parâmetros iniciais como, por exemplo, a densidade r0, o campo magnético B0, o comprimento de amortecimento da onda L0, seu fluxo f0, entre outros. Sendo assim, aumentando f0 de 10% a partir de valores de referência, vimos que aumenta consideravelmente, enquanto que um aumento de mesmo valor em r0, B0 e L0 acarreta uma diminuição em .

Insights from the draft genome into the pathogenicity of a clinical isolate of Elizabethkingia meningoseptica Em3.

PubMed

Chen, Shicheng; Soehnlen, Marty; Downes, Frances P; Walker, Edward D

2017-01-01

Elizabethkingia meningoseptica is an emerging, healthcare-associated pathogen causing a high mortality rate in immunocompromised patients. We report the draft genome sequence of E. meningoseptica Em3, isolated from sputum from a patient with multiple underlying diseases. The genome has a length of 4,037,922 bp, a GC-content 36.4%, and 3673 predicted protein-coding sequences. Average nucleotide identity analysis (>95%) assigned the bacterium to the species E. meningoseptica. Genome analysis showed presence of the curli formation and assembly operon and a gene encoding hemagglutinins, indicating ability to form biofilm. In vitro biofilm assays demonstrated that E. meningoseptica Em3 formed more biofilm than E. anophelis Ag1 and E. miricola Emi3, both lacking the curli operon. A gene encoding thiol-activated cholesterol-dependent cytolysin in E. meningoseptica Em3 (potentially involved in lysing host immune cells) was also absent in E. anophelis Ag1 and E. miricola Emi3. Strain Em3 showed α-hemolysin activity on blood agar medium, congruent with presence of hemolysin and cytolysin genes. Furthermore, presence of heme uptake and utilization genes demonstrated adaptations for bloodstream infections. Strain Em3 contained 12 genes conferring resistance to β-lactams, including β-lactamases class A, class B, and metallo-β-lactamases. Results of comparative genomic analysis here provide insights into the evolution of E. meningoseptica Em3 as a pathogen.

DeepPicker: A deep learning approach for fully automated particle picking in cryo-EM.

PubMed

Wang, Feng; Gong, Huichao; Liu, Gaochao; Li, Meijing; Yan, Chuangye; Xia, Tian; Li, Xueming; Zeng, Jianyang

2016-09-01

Particle picking is a time-consuming step in single-particle analysis and often requires significant interventions from users, which has become a bottleneck for future automated electron cryo-microscopy (cryo-EM). Here we report a deep learning framework, called DeepPicker, to address this problem and fill the current gaps toward a fully automated cryo-EM pipeline. DeepPicker employs a novel cross-molecule training strategy to capture common features of particles from previously-analyzed micrographs, and thus does not require any human intervention during particle picking. Tests on the recently-published cryo-EM data of three complexes have demonstrated that our deep learning based scheme can successfully accomplish the human-level particle picking process and identify a sufficient number of particles that are comparable to those picked manually by human experts. These results indicate that DeepPicker can provide a practically useful tool to significantly reduce the time and manual effort spent in single-particle analysis and thus greatly facilitate high-resolution cryo-EM structure determination. DeepPicker is released as an open-source program, which can be downloaded from https://github.com/nejyeah/DeepPicker-python. Copyright © 2016 Elsevier Inc. All rights reserved.

The Rhode Island Life Saving Score (RILSS)--a proposed life-saving definition for EMS and emergency medicine.

PubMed

Williams, Kenneth A; Sullivan, Francis M

2013-12-03

Emergency Medical Services (EMS) and Emergency Medicine staff are often described as life-saving providers, but there is no generally accepted objective definition of a life saved by these providers. Therefore, a proposed definition is described. Development of this definition began with conceptual rules, followed by a survey of physician EMS medical directors, and then by the development of a tool to implement the definition, and measure its validity and reliability through a review of 100 critical care transport EMS patient charts.

FragFit: a web-application for interactive modeling of protein segments into cryo-EM density maps.

PubMed

Tiemann, Johanna K S; Rose, Alexander S; Ismer, Jochen; Darvish, Mitra D; Hilal, Tarek; Spahn, Christian M T; Hildebrand, Peter W

2018-05-21

Cryo-electron microscopy (cryo-EM) is a standard method to determine the three-dimensional structures of molecular complexes. However, easy to use tools for modeling of protein segments into cryo-EM maps are sparse. Here, we present the FragFit web-application, a web server for interactive modeling of segments of up to 35 amino acids length into cryo-EM density maps. The fragments are provided by a regularly updated database containing at the moment about 1 billion entries extracted from PDB structures and can be readily integrated into a protein structure. Fragments are selected based on geometric criteria, sequence similarity and fit into a given cryo-EM density map. Web-based molecular visualization with the NGL Viewer allows interactive selection of fragments. The FragFit web-application, accessible at http://proteinformatics.de/FragFit, is free and open to all users, without any login requirements.

Accurate model annotation of a near-atomic resolution cryo-EM map

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

Hryc, Corey F.; Chen, Dong-Hua; Afonine, Pavel V.

Electron cryomicroscopy (cryo-EM) has been used to determine the atomic coordinates (models) from density maps of biological assemblies. These models can be assessed by their overall fit to the experimental data and stereochemical information. However, these models do not annotate the actual density values of the atoms nor their positional uncertainty. Here, we introduce a computational procedure to derive an atomic model from a cryo- EM map with annotated metadata. The accuracy of such a model is validated by a faithful replication of the experimental cryo-EM map computed using the coordinates and associated metadata. The functional interpretation of any structuralmore » features in the model and its utilization for future studies can be made in the context of its measure of uncertainty. We applied this protocol to the 3.3-Å map of the mature P22 bacteriophage capsid, a large and complex macromolecular assembly. With this protocol, we identify and annotate previously undescribed molecular interactions between capsid subunits that are crucial to maintain stability in the absence of cementing proteins or cross-linking, as occur in other bacteriophages.« less

Accurate model annotation of a near-atomic resolution cryo-EM map

DOE PAGES

Hryc, Corey F.; Chen, Dong-Hua; Afonine, Pavel V.; ...

2017-03-07

Electron cryomicroscopy (cryo-EM) has been used to determine the atomic coordinates (models) from density maps of biological assemblies. These models can be assessed by their overall fit to the experimental data and stereochemical information. However, these models do not annotate the actual density values of the atoms nor their positional uncertainty. Here, we introduce a computational procedure to derive an atomic model from a cryo- EM map with annotated metadata. The accuracy of such a model is validated by a faithful replication of the experimental cryo-EM map computed using the coordinates and associated metadata. The functional interpretation of any structuralmore » features in the model and its utilization for future studies can be made in the context of its measure of uncertainty. We applied this protocol to the 3.3-Å map of the mature P22 bacteriophage capsid, a large and complex macromolecular assembly. With this protocol, we identify and annotate previously undescribed molecular interactions between capsid subunits that are crucial to maintain stability in the absence of cementing proteins or cross-linking, as occur in other bacteriophages.« less

EM algorithm applied for estimating non-stationary region boundaries using electrical impedance tomography

NASA Astrophysics Data System (ADS)

Khambampati, A. K.; Rashid, A.; Kim, B. S.; Liu, Dong; Kim, S.; Kim, K. Y.

2010-04-01

EIT has been used for the dynamic estimation of organ boundaries. One specific application in this context is the estimation of lung boundaries during pulmonary circulation. This would help track the size and shape of lungs of the patients suffering from diseases like pulmonary edema and acute respiratory failure (ARF). The dynamic boundary estimation of the lungs can also be utilized to set and control the air volume and pressure delivered to the patients during artificial ventilation. In this paper, the expectation-maximization (EM) algorithm is used as an inverse algorithm to estimate the non-stationary lung boundary. The uncertainties caused in Kalman-type filters due to inaccurate selection of model parameters are overcome using EM algorithm. Numerical experiments using chest shaped geometry are carried out with proposed method and the performance is compared with extended Kalman filter (EKF). Results show superior performance of EM in estimation of the lung boundary.

População estelar jovem em galáxias irregulares próximas

NASA Astrophysics Data System (ADS)

Guimarães, T. A.; Telles, E.

2003-08-01

A análise do conteúdo estelar de galáxias próximas através da fotometria das suas estrelas resolvidas nos fornece informações importantes sobre a história de formação estelar e os processos de formação estelar em galáxias, que estão diretamente ligados ao estudo de evolução de galáxias. Quando nenhuma estrela puder ser resolvida o método mais poderoso consiste na análise do conteúdo estelar integrado das galáxias através das suas cores integradas em conjunto com informação espectroscópica que combinados com modelos de síntese evolutiva podem restringir simultaneamente a função de massa inicial (IMF) e a taxa de formação estelar (SFR). Nesse contexto, galáxias do tipo tardio, em particular, irregulares, são relevantes por várias razões: elas são objetos relativamente simples, com alta atividade de formação estelar e são objetos relativamente jovens (geralmente apresentam baixas abundâncias de elementos pesados e grande quantidade de gás). Apresentamos uma análise fotométrica de uma amostra de 7 galáxias do tipo tardio do universo local (NGC 2366, NGC 4395, NGC 4656, NGC 4214, NGC 4236, HOII, IC2574) que foram observadas com uma boa resolução espacial nas bandas B, V e R no telescópio Isaac Newton de 2.5m de Roque de los Muchachos nas Ilhas Canárias, Espanha. A distribuição espacial da população estelar jovem dessas galáxias é discutida sobre os pontos de vista dos íindices de cor integrados e dos seus diagramas cor magnitude, que comparados com isócronas teóricas, nos fornecem informações sobre os eventos de formação estelar, como por exemplo, indicações sobre a idade dos mesmos. As principais conclusões do trabalho podem ser resumidas em: (i) As galáxias irregulares possuem formação estelar recente (FE) espalhada ocorrendo nos últimos 50 Manos; (ii) A formação estelar em galáxias irregulares não é auto-propagante em escalas globais ( > 100 pc) ; (iii) A FE pode ser auto-regulável em escalas

cryoem-cloud-tools: A software platform to deploy and manage cryo-EM jobs in the cloud.

PubMed

Cianfrocco, Michael A; Lahiri, Indrajit; DiMaio, Frank; Leschziner, Andres E

2018-06-01

Access to streamlined computational resources remains a significant bottleneck for new users of cryo-electron microscopy (cryo-EM). To address this, we have developed tools that will submit cryo-EM analysis routines and atomic model building jobs directly to Amazon Web Services (AWS) from a local computer or laptop. These new software tools ("cryoem-cloud-tools") have incorporated optimal data movement, security, and cost-saving strategies, giving novice users access to complex cryo-EM data processing pipelines. Integrating these tools into the RELION processing pipeline and graphical user interface we determined a 2.2 Å structure of ß-galactosidase in ∼55 hours on AWS. We implemented a similar strategy to submit Rosetta atomic model building and refinement to AWS. These software tools dramatically reduce the barrier for entry of new users to cloud computing for cryo-EM and are freely available at cryoem-tools.cloud. Copyright © 2018. Published by Elsevier Inc.

Asynchronous data acquisition and on-the-fly analysis of dose fractionated cryoEM images by UCSFImage

PubMed Central

Li, Xueming; Zheng, Shawn; Agard, David A.; Cheng, Yifan

2015-01-01

Newly developed direct electron detection cameras have a high image output frame rate that enables recording dose fractionated image stacks of frozen hydrated biological samples by electron cryomicroscopy (cryoEM). Such novel image acquisition schemes provide opportunities to analyze cryoEM data in ways that were previously impossible. The file size of a dose fractionated image stack is 20 ~ 60 times larger than that of a single image. Thus, efficient data acquisition and on-the-fly analysis of a large number of dose-fractionated image stacks become a serious challenge to any cryoEM data acquisition system. We have developed a computer-assisted system, named UCSFImage4, for semi-automated cryo-EM image acquisition that implements an asynchronous data acquisition scheme. This facilitates efficient acquisition, on-the-fly motion correction, and CTF analysis of dose fractionated image stacks with a total time of ~60 seconds/exposure. Here we report the technical details and configuration of this system. PMID:26370395

EWET: Data collection and interface for the genetic analysis of Echinococcus multilocularis based on EmsB microsatellite.

PubMed

Knapp, Jenny; Damy, Sylvie; Brillaud, Jonathan; Tissot, Jean-Daniel; Navion, Jérémy; Mélior, Raphael; Afonso, Eve; Hormaz, Vanessa; Gottstein, Bruno; Umhang, Gérald; Casulli, Adriano; Dadeau, Frédéric; Millon, Laurence; Raoul, Francis

2017-01-01

Evolution and dispersion history on Earth of organisms can best be studied through biological markers in molecular epidemiological studies. The biological diversity of the cestode Echinococcus multilocularis was investigated in different cladistic approaches. First the morphological aspects were explored in connection with its ecology. More recently, molecular aspects were investigated to better understand the nature of the variations observed among isolates. The study of the tandemly repeated multilocus microsatellite EmsB allowed us to attain a high genetic diversity level where other classic markers have failed. Since 2006, EmsB data have been collected on specimens from various endemic foci of the parasite in Europe (in historic and newly endemic areas), Asia (China, Japan and Kyrgyzstan), and North America (Canada and Alaska). Biological data on the isolates and metadata were also recorded (e.g. host, geographical location, EmsB analysis, citation in the literature). In order to make available the data set of 1,166 isolates from classic and aberrant domestic and wild animal hosts (larval lesions and adult worms) and from human origin, an open web access interface, developed in PHP, and connected to a PostgreSQL database, was developed in the EmsB Website for the Echinococcus Typing (EWET) project. It allows researchers to access data collection, perform genetic analyses online (e.g. defining the genetic distance between their own samples and the samples in the database), consult distribution maps of EmsB profiles, and record and share their new EmsB genotyping data. In order to standardize the EmsB analyses performed in the different laboratories throughout the world, a calibrator was developed. The final aim of this project was to gather and arrange available data to permit to better understand the dispersion and transmission patterns of the parasite among definitive and intermediate hosts, in order to organize control strategies on the ground.

EWET: Data collection and interface for the genetic analysis of Echinococcus multilocularis based on EmsB microsatellite

PubMed Central

Damy, Sylvie; Brillaud, Jonathan; Tissot, Jean-Daniel; Navion, Jérémy; Mélior, Raphael; Afonso, Eve; Hormaz, Vanessa; Gottstein, Bruno; Umhang, Gérald; Casulli, Adriano; Dadeau, Frédéric; Millon, Laurence; Raoul, Francis

2017-01-01

Evolution and dispersion history on Earth of organisms can best be studied through biological markers in molecular epidemiological studies. The biological diversity of the cestode Echinococcus multilocularis was investigated in different cladistic approaches. First the morphological aspects were explored in connection with its ecology. More recently, molecular aspects were investigated to better understand the nature of the variations observed among isolates. The study of the tandemly repeated multilocus microsatellite EmsB allowed us to attain a high genetic diversity level where other classic markers have failed. Since 2006, EmsB data have been collected on specimens from various endemic foci of the parasite in Europe (in historic and newly endemic areas), Asia (China, Japan and Kyrgyzstan), and North America (Canada and Alaska). Biological data on the isolates and metadata were also recorded (e.g. host, geographical location, EmsB analysis, citation in the literature). In order to make available the data set of 1,166 isolates from classic and aberrant domestic and wild animal hosts (larval lesions and adult worms) and from human origin, an open web access interface, developed in PHP, and connected to a PostgreSQL database, was developed in the EmsB Website for the Echinococcus Typing (EWET) project. It allows researchers to access data collection, perform genetic analyses online (e.g. defining the genetic distance between their own samples and the samples in the database), consult distribution maps of EmsB profiles, and record and share their new EmsB genotyping data. In order to standardize the EmsB analyses performed in the different laboratories throughout the world, a calibrator was developed. The final aim of this project was to gather and arrange available data to permit to better understand the dispersion and transmission patterns of the parasite among definitive and intermediate hosts, in order to organize control strategies on the ground. PMID:28972978

The Soils and Groundwater – EM-20 S&T Roadmap Quality Assurance Project Plan

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

Fix, N. J.

The Soils and Groundwater – EM-20 Science and Technology Roadmap Project is a U.S. Department of Energy, Office of Environmental Management-funded initiative designed to develop new methods, strategies and technology for characterizing, modeling, remediating, and monitoring soils and groundwater contaminated with metals, radionuclides, and chlorinated organics. This Quality Assurance Project Plan provides the quality assurance requirements and processes that will be followed by EM-20 Roadmap Project staff.

EM-21 Retrieval Knowledge Center: Waste Retrieval Challenges

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

Fellinger, Andrew P.; Rinker, Michael W.; Berglin, Eric J.

EM-21 is the Waste Processing Division of the Office of Engineering and Technology, within the U.S. Department of Energy’s (DOE) Office of Environmental Management (EM). In August of 2008, EM-21 began an initiative to develop a Retrieval Knowledge Center (RKC) to provide the DOE, high level waste retrieval operators, and technology developers with centralized and focused location to share knowledge and expertise that will be used to address retrieval challenges across the DOE complex. The RKC is also designed to facilitate information sharing across the DOE Waste Site Complex through workshops, and a searchable database of waste retrieval technology information.more » The database may be used to research effective technology approaches for specific retrieval tasks and to take advantage of the lessons learned from previous operations. It is also expected to be effective for remaining current with state-of-the-art of retrieval technologies and ongoing development within the DOE Complex. To encourage collaboration of DOE sites with waste retrieval issues, the RKC team is co-led by the Savannah River National Laboratory (SRNL) and the Pacific Northwest National Laboratory (PNNL). Two RKC workshops were held in the Fall of 2008. The purpose of these workshops was to define top level waste retrieval functional areas, exchange lessons learned, and develop a path forward to support a strategic business plan focused on technology needs for retrieval. The primary participants involved in these workshops included retrieval personnel and laboratory staff that are associated with Hanford and Savannah River Sites since the majority of remaining DOE waste tanks are located at these sites. This report summarizes and documents the results of the initial RKC workshops. Technology challenges identified from these workshops and presented here are expected to be a key component to defining future RKC-directed tasks designed to facilitate tank waste retrieval solutions.« less

[Not Available].

PubMed

Grao-Cruces, Alberto; Loureiro, Nuno; Fernández-Martínez, Antonio; Mota, Jorge

2016-07-19

Introducción y objetivos: examinar la asociación del apoyo de los padres y de los amigos con diferentes intensidades de actividad física durante el tiempo libre de adolescentes españoles de ambos sexos.Métodos: un total 352 adolescentes españoles (51.70% chicos; 12-16 años) cumplimentaron el International Physical Activity Questionnarie for Adolescents y un cuestionario validado sobre apoyo social. Se realizaron análisis de regresión linear ajustados por edad.Resultados: el apoyo social de padres y amigos influyó positivamente sobre los niveles de actividad física vigorosa que los adolescentes españoles realizan durante su tiempo libre (β=.226 y β=.285 en chicos y β=.167 y β=.181 en chicas, para el apoyo de padres y amigos respectivamente) y sobre los de intensidad moderada en el caso de las chicas (β=.195 y β=.200, respectivamente).Conclusiones: el apoyo de padres y amigos contribuye a los niveles de actividad física moderada o vigorosa en adolescentes españoles.

3D reconstruction of synapses with deep learning based on EM Images

NASA Astrophysics Data System (ADS)

Xiao, Chi; Rao, Qiang; Zhang, Dandan; Chen, Xi; Han, Hua; Xie, Qiwei

2017-03-01

Recently, due to the rapid development of electron microscope (EM) with its high resolution, stacks delivered by EM can be used to analyze a variety of components that are critical to understand brain function. Since synaptic study is essential in neurobiology and can be analyzed by EM stacks, the automated routines for reconstruction of synapses based on EM Images can become a very useful tool for analyzing large volumes of brain tissue and providing the ability to understand the mechanism of brain. In this article, we propose a novel automated method to realize 3D reconstruction of synapses for Automated Tapecollecting Ultra Microtome Scanning Electron Microscopy (ATUM-SEM) with deep learning. Being different from other reconstruction algorithms, which employ classifier to segment synaptic clefts directly. We utilize deep learning method and segmentation algorithm to obtain synaptic clefts as well as promote the accuracy of reconstruction. The proposed method contains five parts: (1) using modified Moving Least Square (MLS) deformation algorithm and Scale Invariant Feature Transform (SIFT) features to register adjacent sections, (2) adopting Faster Region Convolutional Neural Networks (Faster R-CNN) algorithm to detect synapses, (3) utilizing screening method which takes context cues of synapses into consideration to reduce the false positive rate, (4) combining a practical morphology algorithm with a suitable fitting function to segment synaptic clefts and optimize the shape of them, (5) applying the plugin in FIJI to show the final 3D visualization of synapses. Experimental results on ATUM-SEM images demonstrate the effectiveness of our proposed method.

System concept definition of the Grumman superconducting Electromagnetic Suspension (EMS) Maglev design

NASA Technical Reports Server (NTRS)

Proise, M.

1994-01-01

Grumman, under contract to the Army Corps of Engineers, completed a System Concept Definition (SCD) study to design a high-speed 134 m/s (300 m.p.h.) magnetically levitated (Maglev) transportation system. The primary development goals were to design a Maglev that is safe, reliable, environmentally acceptable, and low-cost. The cost issue was a predominant one, since previous studies have shown that an economically viable Maglev system (one that is attractive to investors for future models of passenger and/or freight transportation) requires a cost that is about $12.4 M/km ($20 Million per mile). The design is based on the electromagnetic suspension (EMS) system using superconducting iron-core magnets mounted along both sides of the vehicle. The EMS system has several advantages compared to the electrodynamic suspension (EDS) Maglev systems such as low stray magnetic fields in the passenger cabin and the surrounding areas, uniform load distribution along the full length of the vehicle, and small pole pitch for smoother propulsion and ride comfort. It is also levitated at all speeds and incorporates a wrap-around design of safer operation. The Grumman design has all the advantages of an EMS system identified above, while eliminating (or significantly improving) drawbacks associated with normal magnet powered EMS systems. Improvements include larger gap clearance, lighter weight, lower number of control servos, and higher off line switching speeds. The design also incorporates vehicle tilt (plus or minus 9 deg) for higher coordinated turn and turn out speed capability.

Giving EMS flexibility in transporting low-acuity patients could generate substantial Medicare savings.

PubMed

Alpert, Abby; Morganti, Kristy G; Margolis, Gregg S; Wasserman, Jeffrey; Kellermann, Arthur L

2013-12-01

Some Medicare beneficiaries who place 911 calls to request an ambulance might safely be cared for in settings other than the emergency department (ED) at lower cost. Using 2005-09 Medicare claims data and a validated algorithm, we estimated that 12.9-16.2 percent of Medicare-covered 911 emergency medical services (EMS) transports involved conditions that were probably nonemergent or primary care treatable. Among beneficiaries not admitted to the hospital, about 34.5 percent had a low-acuity diagnosis that might have been managed outside the ED. Annual Medicare EMS and ED payments for these patients were approximately $1 billion per year. If Medicare had the flexibility to reimburse EMS for managing selected 911 calls in ways other than transport to an ED, we estimate that the federal government could save $283-$560 million or more per year, while improving the continuity of patient care. If private insurance companies followed suit, overall societal savings could be twice as large.

Implementation of the universal BLS termination of resuscitation rule in a rural EMS system.

PubMed

Jordan, Matthew R; O'Keefe, Michael F; Weiss, David; Cubberley, C Wes; MacLean, Charles D; Wolfson, Daniel L

2017-09-01

Emergency Medical Services (EMS) are often the first medical providers to begin resuscitation of out-of-hospital cardiac arrest (OHCA) victims. The universal Basic Life Support Termination of Resuscitation (BLS-TOR) rule is a validated clinical prediction tool used to identify patients in which continued resuscitation efforts are futile. The primary aim is to compare the rate of transport of OHCA cases before and after the implementation of a BLS-TOR protocol and to determine the compliance rate of EMS personnel with the new protocol in a largely volunteer, rural system. A retrospective cohort study was conducted using the statewide EMS electronic patient care report system. Cases were identified by searching for any incident that had a primary impression of "cardiac arrest" or a primary symptom of "cardiorespiratory arrest" or "death." Data were collected from the two years prior to and following implementation of the BLS-TOR rule from January 1, 2012 through March 31, 2016. There were 702 OHCA cases were identified, with 329 cases meeting inclusion criteria. The transport rate was 91.1% in the pre-intervention group compared with 69.4% in the post-intervention group (χ2=24.8; p<0.001). EMS compliance rate with the BLS-TOR rule was 66.7%. Of the 265 patients transported during the study, 87 patients met (post-intervention group; n=22) or retrospectively met (pre-intervention group; n=65) the BLS-TOR requirements for field termination of resuscitation. None of these patients survived to hospital discharge. Rural EMS systems may benefit from implementation and utilization of the universal BLS-TOR rule. Published by Elsevier B.V.

Label-free visualization of ultrastructural features of artificial synapses via cryo-EM.

PubMed

Gopalakrishnan, Gopakumar; Yam, Patricia T; Madwar, Carolin; Bostina, Mihnea; Rouiller, Isabelle; Colman, David R; Lennox, R Bruce

2011-12-21

The ultrastructural details of presynapses formed between artificial substrates of submicrometer silica beads and hippocampal neurons are visualized via cryo-electron microscopy (cryo-EM). The silica beads are derivatized by poly-d-lysine or lipid bilayers. Molecular features known to exist at presynapses are clearly present at these artificial synapses, as visualized by cryo-EM. Key synaptic features such as the membrane contact area at synaptic junctions, the presynaptic bouton containing presynaptic vesicles, as well as microtubular structures can be identified. This is the first report of the direct, label-free observation of ultrastructural details of artificial synapses.

Unwelcome visitors: is EMS ready for fire ants and killer bees.

PubMed

Bledsoe, Bryan E

2007-08-01

Fire ants and AHBs are aggressive social insects that readily attack when they perceive a threat. Rarely, each can cause fatal allergic reactions. However, AHBs can overwhelm and kill even healthy, nonallergic people. Such encounters are relatively rare, yet increasing in frequency. As a rule, fire ants can't overwhelm a healthy, mobile person, and even hundreds of stings are rarely fatal. AHBs, however, pose a greater threat to EMS and fire personnel when encountered. Every EMS agency in areas where AHBs are located (or predicted to migrate) should develop protocols for AHB attacks. Such a response should assure adequate personnel and, above all, rescuer safety. The protocol should be periodically practiced and reviewed.

A Descriptive Analysis of Care Provided by Law Enforcement Prior to EMS Arrival in the United States.

PubMed

Klassen, Aaron B; Core, S Brent; Lohse, Christine M; Sztajnkrycer, Matthew D

2018-04-01

Study Objectives Law enforcement is increasingly viewed as a key component in the out-of-hospital chain of survival, with expanded roles in cardiac arrest, narcotic overdose, and traumatic bleeding. Little is known about the nature of care provided by law enforcement prior to the arrival of Emergency Medical Services (EMS) assets. The purpose of the current study was to perform a descriptive analysis of events reported to a national EMS database. This study was a descriptive analysis of the 2014 National Emergency Medical Services Information System (NEMSIS) public release research data set, containing EMS emergency response data from 41 states. Code E09_02 1200 specifically identifies care provided by law enforcement prior to EMS arrival. A total of 25,835,729 unique events were reported. Of events in which pre-arrival care was documented, 2.0% received prior aid by law enforcement. Patients receiving law enforcement care prior to EMS arrival were more likely to be younger (52.8 [SD=23.3] years versus 58.7 [SD=23.3] years), male (54.8% versus 46.7%), and white (80.3% versus 77.5%). Basic Life Support (BLS) EMS response was twice as likely in patients receiving prior aid by law enforcement. Multiple-casualty incidents were five times more likely with prior aid by law enforcement. Compared with prior aid by other services, law enforcement pre-arrival care was more likely with motor vehicle accidents, firearm assaults, knife assaults, blunt assaults, and drug overdoses, and less likely at falls and childbirths. Cardiac arrest was significantly more common in patients receiving prior aid by law enforcement (16.5% versus 2.6%). Tourniquet application and naloxone administration were more common in the law enforcement prior aid group. Where noted, law enforcement pre-arrival care occurs in 2.0% of EMS patient encounters. The majority of cases involve cardiac arrest, motor vehicle accidents, and assaults. Better understanding of the nature of law enforcement care is

Texas Hold 'em Online Poker: A Further Examination

ERIC Educational Resources Information Center

Hopley, Anthony A. B.; Dempsey, Kevin; Nicki, Richard

2012-01-01

Playing Texas Hold 'em Online Poker (THOP) is on the rise. However, there is relatively little research examining factors that contribute to problem gambling in poker players. The aim of this study was to extend the research findings of Hopley and Nicki (2010). The negative mood states of depression, anxiety and stress were found to be linked to…

Shifting baselines in the Ems Dollard estuary: A comparison across three decades reveals changing benthic communities

NASA Astrophysics Data System (ADS)

Compton, Tanya J.; Holthuijsen, Sander; Mulder, Maarten; van Arkel, Maarten; Schaars, Loran Kleine; Koolhaas, Anita; Dekinga, Anne; ten Horn, Job; Luttikhuizen, Pieternella C.; van der Meer, Jaap; Piersma, Theunis; van der Veer, Henk W.

2017-09-01

At a time when there is a growing discussion about the natural state of estuaries, a comparison of macrozoobenthos communities from two surveys conducted 30 years apart in the Ems Dollard estuary, in the eastern Wadden Sea, The Netherlands, provides a unique opportunity to compare changes over time. As expected, our comparison revealed a gradient in species composition from land (the Dollard) to sea (the Outer Ems) at both points in time, with brackish species in the Dollard and more marine species in the Outer Ems (Wadden Sea). Total richness increased over time; however, this mainly reflected the immigration of new species and sampling differences. In the Dollard, total biomass declined over time, most likely reflecting de-eutrophication in this area. Strikingly, at the meeting point between the sea and the brackish Dollard, i.e. the Inner Ems, the community composition changed from one dominated by bivalves (1970s) to one dominated by worms (since 2009). This change involved a reduction in total biomass, mainly of Mya arenaria, and immigration of polychaete worms (Marenzellaria viridis and Alitta succinea). In the Outer Ems, an increase in total biomass was observed, associated with the recent successful recruitment of Cerastoderma edule. This comparison highlights that historical data provides useful insights at large spatial scales. However, a full understanding of the complex dynamics of estuaries requires an analysis of continuous long-term monitoring series.

Mathematical Model for Collision-Coalescence Among Inclusions in the Bloom Continuous Caster with M-EMS

NASA Astrophysics Data System (ADS)

Lei, Hong; Jiang, Jimin; Yang, Bin; Zhao, Yan; Zhang, Hongwei; Wang, Weixian; Dong, Guiwen

2018-04-01

Mathematical simulation is an effective tool to analyze the fluid flow and the inclusion behavior in the bloom continuous caster with mold electromagnetic stirring (M-EMS). The mathematical model is applied to the modeling of magnetic field, flow field, and inclusion field. Due to the introduction of Archimedes force, the collision mechanism and inclusion's slipping velocity should be modified in the inclusion mass and population conservation model. Numerically predicted magnetic field, flow field, and the inclusion spatial distribution conform to the experimental results in the existing literature. Lorentz force plays an important role in the fluid flow, and Archimedes force plays an important role in the inclusion distribution in the continuous caster. Due to Brownian collision, Stokes collision, Archimedes collision, and turbulent collision, the coalescence among inclusions occurs in the bloom continuous caster with M-EMS. Among the four types of collisions, turbulent collision occurs most frequently, followed by Archimedes collision and Stokes collision. The frequency of Brownian collision is several orders of magnitudes smaller and is therefore negligible. The inclusion volume concentration, number density, and characteristic radius exhibit a U-shape in the continuous caster without M-EMS. However, with M-EMS, they exhibit an inverted U-shape.

EM in high-dimensional spaces.

PubMed

Draper, Bruce A; Elliott, Daniel L; Hayes, Jeremy; Baek, Kyungim

2005-06-01

This paper considers fitting a mixture of Gaussians model to high-dimensional data in scenarios where there are fewer data samples than feature dimensions. Issues that arise when using principal component analysis (PCA) to represent Gaussian distributions inside Expectation-Maximization (EM) are addressed, and a practical algorithm results. Unlike other algorithms that have been proposed, this algorithm does not try to compress the data to fit low-dimensional models. Instead, it models Gaussian distributions in the (N - 1)-dimensional space spanned by the N data samples. We are able to show that this algorithm converges on data sets where low-dimensional techniques do not.

Design and Implementation of a postgraduate curriculum to support Ethiopia's first emergency medicine residency training program: the Toronto Addis Ababa Academic Collaboration in Emergency Medicine (TAAAC-EM).

PubMed

Meshkat, Nazanin; Teklu, Sisay; Hunchak, Cheryl

2018-04-06

To design and implement an emergency medicine (EM) postgraduate training curriculum to support the establishment of the first EM residency program at Addis Ababa University (AAU). In response to the Ethiopian Federal Ministry of Health mandate to develop EM services in Ethiopia, University of Toronto EM faculty were invited to develop and deliver EM content and expertise for the first EM postgraduate residency training program at AAU. The Toronto Addis Ababa Academic Collaboration-EM (TAAAC-EM) used five steps of a six-step approach to guide curriculum development and implementation: 1. Problem identification and general needs assessment, 2. Targeted needs assessment using indirect methods (interviews and site visits of the learners and learning environment), 3. Defining goals and objectives, 4. Choosing educational strategies and curriculum map development and 5. The needs assessment identified a learning environment with appropriate, though limited, resources for the implementation of an EM residency program. A lack of educational activities geared towards EM practice was identified, specifically of active learning techniques (ALTs) such as bedside teaching, simulation and procedural teaching. A curriculum map was devised to supplement the AAU EM residency program curriculum. The TAAAC-EM curriculum was divided into three distinct streams: clinical, clinical epidemiology and EM administration. The clinical sessions were divided into didactic and ALTs including practical/procedural and simulation sessions, and bedside teaching was given a strong emphasis. Implementation is currently in its seventh year, with continuous monitoring and revisions of the curriculum to meet evolving needs. We have outlined the design and implementation of the TAAAC-EM curriculum; an evaluation of this curriculum is currently underway. As EM spreads as a specialty throughout Africa and other resource-limited regions, this model can serve as a working guide for similar bi

Single-particle cryo-EM using alignment by classification (ABC): the structure of Lumbricus terrestris haemoglobin.

PubMed

Afanasyev, Pavel; Seer-Linnemayr, Charlotte; Ravelli, Raimond B G; Matadeen, Rishi; De Carlo, Sacha; Alewijnse, Bart; Portugal, Rodrigo V; Pannu, Navraj S; Schatz, Michael; van Heel, Marin

2017-09-01

Single-particle cryogenic electron microscopy (cryo-EM) can now yield near-atomic resolution structures of biological complexes. However, the reference-based alignment algorithms commonly used in cryo-EM suffer from reference bias, limiting their applicability (also known as the 'Einstein from random noise' problem). Low-dose cryo-EM therefore requires robust and objective approaches to reveal the structural information contained in the extremely noisy data, especially when dealing with small structures. A reference-free pipeline is presented for obtaining near-atomic resolution three-dimensional reconstructions from heterogeneous ('four-dimensional') cryo-EM data sets. The methodologies integrated in this pipeline include a posteriori camera correction, movie-based full-data-set contrast transfer function determination, movie-alignment algorithms, (Fourier-space) multivariate statistical data compression and unsupervised classification, 'random-startup' three-dimensional reconstructions, four-dimensional structural refinements and Fourier shell correlation criteria for evaluating anisotropic resolution. The procedures exclusively use information emerging from the data set itself, without external 'starting models'. Euler-angle assignments are performed by angular reconstitution rather than by the inherently slower projection-matching approaches. The comprehensive 'ABC-4D' pipeline is based on the two-dimensional reference-free 'alignment by classification' (ABC) approach, where similar images in similar orientations are grouped by unsupervised classification. Some fundamental differences between X-ray crystallography versus single-particle cryo-EM data collection and data processing are discussed. The structure of the giant haemoglobin from Lumbricus terrestris at a global resolution of ∼3.8 Å is presented as an example of the use of the ABC-4D procedure.

DustEM: Dust extinction and emission modelling

NASA Astrophysics Data System (ADS)

Compiègne, M.; Verstraete, L.; Jones, A.; Bernard, J.-P.; Boulanger, F.; Flagey, N.; Le Bourlot, J.; Paradis, D.; Ysard, N.

2013-07-01

DustEM computes the extinction and the emission of interstellar dust grains heated by photons. It is written in Fortran 95 and is jointly developed by IAS and CESR. The dust emission is calculated in the optically thin limit (no radiative transfer) and the default spectral range is 40 to 108 nm. The code is designed so dust properties can easily be changed and mixed and to allow for the inclusion of new grain physics.

Effect of Body-Worn Cameras on EMS Documentation Accuracy: A Pilot Study.

PubMed

Ho, Jeffrey D; Dawes, Donald M; McKay, Evan M; Taliercio, Jeremy J; White, Scott D; Woodbury, Blair J; Sandefur, Mark A; Miner, James R

2017-01-01

Current Emergency Medical Services (EMS) documentation practices usually occur from memory after an event is over. While this practice is fairly standard, it is unclear if it can introduce significant error. Modern technology has seen the increased use of recorded video by society to more objectively document notable events. Stationary mounted cameras, cell-phone cameras, and law enforcement officer Body-Worn Cameras (BWCs) are increasingly used by society for this purpose. Video used in this way can often clarify or contradict recall from memory. BWCs are currently not widely used by EMS. The hypothesis is that current EMS documentation practices are inaccurate and that BWCs will have a positive effect on documentation accuracy. This prospective, observational study used a convenience sample of paramedics in a simulation lab. The Paramedics wore a BWC and responded to a simulated call of "One Down" (unresponsive from heroin abuse) involving Role Players (RPs). The paramedics received standardized cues from the RPs during the simulation to keep it on track.  The simulation contained many factors of concern (e.g., weapons and drugs in plain view, unattended minors, etc.) and intentional stressors (e.g., distraught family member, uncooperative patient, etc.). Upon completion of the scenario, paramedic documentation occurred from memory on an electronic template.  After initial documentation, paramedics viewed their BWC recording and were allowed to make tabulated changes. Changes were categorized by a priori criteria as minor, moderate, or major.  Ten paramedics participated with an average age of 33.3 years (range 22-43), 8 males and 2 females. The average length of paramedic career experience was 7.7 years (range 2 months to 20 years). There were 71 total documentation changes (7 minor, 51 moderate, 13 major) made after video review. Linear regression (ANCOVA) indicated changes made indirectly correlated with years of experience (coefficient 8.27, 4

EMS providers' perceptions of safety climate and adherence to safe work practices.

PubMed

Eliseo, Laura J; Murray, Kate A; White, Laura F; Dyer, Sophia; Mitchell, Patricia A; Fernandez, William G

2012-01-01

Occupational injuries are an important source of morbidity for emergency medical services (EMS) providers. Previous work has shown that employee perceptions of an organization's commitment to safety (i.e., safety climate) correlate with adherence to safe practices. To assess the association between perceived safety climate and compliance with safety procedures in an urban EMS system with >100,000 calls/year. EMS providers were issued a self-administered survey that included questions on demographics, years of experience, perceived safety climate, and adherence to safety procedures. Safety climate was assessed with a 20-item validated instrument. Adherence to safety procedures was assessed with a nine-item list of safety behaviors. Strict adherence to safety procedures was defined as endorsing "agree" or "strongly agree" on 80% of items. The effect of safety climate on compliance with safe practices was estimated using multiple logistic regression. One hundred ninety-six of 221 providers (89%) completed surveys; 74% were male; the median age was 36-40 years; and the median amount of experience was 8 years. One hundred twenty-seven of 196 respondents (65%) reported strict adherence to safe work practice. Factor analysis confirmed the original six-factor grouping of questions; frequent safety-related feedback/training was significantly associated with safe practices (odds ratio [OR] = 2.14, 95% confidence interval [CI] = 1.01-4.51). EMS workers perceiving a high degree of perceived safety climate was associated with twofold greater odds of self-reported level of strict adherence to safe work practices. Frequent safety-related feedback/training was the one dimension of safety climate that had the strongest association with adherence to safe workplace behaviors.

Lack of integration of automated external defibrillators with EMS response may reduce lifesaving potential of public-access defibrillation.

PubMed

Myers, J Brent; French, David; Webb, William

2005-01-01

Automated external defibrillators (AEDs) used for public-access defibrillation (PAD) allow for rapid defibrillation, particularly if the AEDs are incorporated into an organized response plan. This project was undertaken to determine how many PAD AEDs were in North Carolina, how many were properly registered, and how many were integrated into the emergency medical services (EMS) response. Data were collected for this prospective, descriptive study via phone survey, e-mail survey, and/or direct personal interview. Four sources were utilized: 1) state office of EMS AED registration database, 2) AED sales representatives, 3) county EMS agency representatives, and 4) American Heart Association (AHA) training center instructors and regional faculty. The primary endpoint was determining the proportion of AEDs placed in unregistered locations. The state EMS office provided the state registry of AED locations. One-hundred percent of state-recognized AED vendors and county EMS agencies provided data. Twelve of 55 (22%) AHA personnel provided data. Eight hundred eighty-one unique locations were identified. Although AED sales are required by law to be registered, the office of EMS database contained only 99 of the 552 (18%) unique PAD locations identified by the study. A large number of unregistered AEDs are being placed in communities. AEDs placed as part of an organized PAD program improve the rates of survival from sudden cardiac death. In the absence of registration, it is difficult to determine the extent to which these AEDs are part of an organized PAD program.

PRISM-EM: template interface-based modelling of multi-protein complexes guided by cryo-electron microscopy density maps.

PubMed

Kuzu, Guray; Keskin, Ozlem; Nussinov, Ruth; Gursoy, Attila

2016-10-01

The structures of protein assemblies are important for elucidating cellular processes at the molecular level. Three-dimensional electron microscopy (3DEM) is a powerful method to identify the structures of assemblies, especially those that are challenging to study by crystallography. Here, a new approach, PRISM-EM, is reported to computationally generate plausible structural models using a procedure that combines crystallographic structures and density maps obtained from 3DEM. The predictions are validated against seven available structurally different crystallographic complexes. The models display mean deviations in the backbone of <5 Å. PRISM-EM was further tested on different benchmark sets; the accuracy was evaluated with respect to the structure of the complex, and the correlation with EM density maps and interface predictions were evaluated and compared with those obtained using other methods. PRISM-EM was then used to predict the structure of the ternary complex of the HIV-1 envelope glycoprotein trimer, the ligand CD4 and the neutralizing protein m36.

The role of calling EMS versus using private transportation in improving the management of stroke in France.

PubMed

Gache, Kristel; Couralet, Melanie; Nitenberg, Gérard; Leleu, Henri; Minvielle, Etienne

2013-01-01

To compare the time from symptom onset to brain imaging between patients calling emergency medical services (EMS) and those using private means for transportation. We focused on symptom onset-to-brain imaging times of ≤2 hours and ≤3 hours 30 minutes, assuming a one-hour interval between imaging and thrombolysis. Other variables were the patient's age, gender, stroke type, National Institutes of Health Stroke Scale (NIHSS) score, presence of an on-site stroke unit, and period of symptom onset. Univariate analyses and a hierarchical linear regression model were used, as appropriate, and adjusted for these variables. A total of 1,105 stroke patients (28%) were included in the analyses, 40.6% of them transported by EMS. Patients using EMS were significantly older (72.8 vs. 70.5 years; p = 0.008), they had a higher NIHSS score (8 vs. 6.1; p = 0.0001), fewer were ischemic (85.1% vs. 90.6%; p = 0.005), and more of them reached hospitals with an on-site stroke unit (81.3% vs. 72.9%; p = 0.002). For the EMS-call patients, the median symptom onset-to-brain imaging time was significantly shorter (3 hours 21 minutes vs. 5 hours 57 minutes), and after adjustment, maximum delays of 2 hours and 3 hours 30 minutes were independently associated with EMS call: 28% vs. 18% (p = 0.015) and 66% vs. 45% (p < 0.0001) of patients, respectively, leading to an adjusted odds ratio of 2.77 (95% confidence interval, 2.007-3.828; p < 0.0001) for the threshold of 3 hours 30 minutes. The symptom onset-to-brain imaging time was significantly shorter in case of EMS transportation, but most patients did not reach the hospital in time to be eligible for thrombolysis. Efforts are still needed to reduce delays, especially public education and EMS activation. These efforts should be combined with new approaches for the quality management of stroke patients.

EM61 MK2 Cart Data Collection and Analysis

DTIC Science & Technology

2011-06-01

number. 1. REPORT DATE JUN 2011 2 . REPORT TYPE N/A 3. DATES COVERED - 4. TITLE AND SUBTITLE EM61 MK2 Cart Data Collection and Analysis... 2   1.3  REGULATORY DRIVERS... 2   1.3.1  OBJECTIVE OF THE ADVISORY GROUP .......................................................... 2   2.0  TECHNOLOGY

General 4-week toxicity study with EMS in the rat.

PubMed

Pfister, Thomas; Eichinger-Chapelon, Anne

2009-11-12

In this subacute toxicity study, ethyl methanesulfonate (EMS) was administered daily by oral gavage to SPF-bred Wistar rats of both sexes at dose levels of 20, 60 and 180/120 mg/kg body weight (bw)/day for a period of 28 days (for 19 days in the high-dose group). A control group was treated similarly with the vehicle, bidistilled water, only. The groups comprised 10 animals per sex, which were sacrificed after 28 days, respectively 19 days in the high-dose group, of treatment. Additional five rats per sex and group were treated accordingly and then allowed a 14 days treatment-free recovery period. Additional six rats per sex and group (three rats per sex in the control group) were treated accordingly and used for hemoglobin adduct analysis after EMS exposure. All animals survived until their scheduled necropsy. Treatment with EMS had a direct dose-dependent effect on food consumption and consequently on body weight at doses > or =20mg/kgbw/day in male rats and at > or =60 mg/kgbw/day in females rats. Hence, treatment with the high dose of 180 mg/kgbw/day had to be interrupted for 9 days after which, the animals were re-dosed at 120 mg/kgbw/day. This dose was also poorly tolerated over the remaining two treatment weeks causing again a marked reduction in food consumption and body weight. A dose of 60 mg/kgbw/day was moderately tolerated over 4 weeks treatment with mean daily food consumption and body weight distinctly lower than in controls. Primary targets of systemic toxicity were the hematopoietic system, thymolymphatic system and sexual organs. Characteristic changes in hematology parameters were decreased red blood cell counts, hematocrit, and hemoglobin concentration. White blood cell counts were also decreased due to reduced lymphocyte and granulocyte populations of each fraction. The corresponding histopathology findings were fatty atrophy of bone marrow and minimal hypocellularity of the white pulp of the spleen. Similarly, treatment with EMS caused an

Police transport versus ground EMS: A trauma system-level evaluation of prehospital care policies and their effect on clinical outcomes.

PubMed

Wandling, Michael W; Nathens, Avery B; Shapiro, Michael B; Haut, Elliott R

2016-11-01

Rapid transport to definitive care ("scoop and run") versus field stabilization in trauma remains a topic of debate and has resulted in variability in prehospital policy. We aimed to identify trauma systems frequently using a true "scoop and run" police transport approach and to compare mortality rates between police and ground emergency medical services (EMS) transport. Using the National Trauma Databank (NTDB), we identified adult gunshot and stab wound patients presenting to Level 1 or 2 trauma centers from 2010 to 2012. Hospitals were grouped into their respective cities and regional trauma systems. Patients directly transported by police or ground EMS to trauma centers in the 100 most populous US trauma systems were included. Frequency of police transport was evaluated, identifying trauma systems with high utilization. Mortality rates and risk-adjusted odds ratio for mortality for police versus EMS transport were derived. Of 88,564 total patients, 86,097 (97.2%) were transported by EMS and 2,467 (2.8%) by police. Unadjusted mortality was 17.7% for police transport and 11.6% for ground EMS. After risk adjustment, patients transported by police were no more likely to die than those transported by EMS (OR = 1.00, 95% CI: 0.69-1.45). Among all police transports, 87.8% occurred in three locations (Philadelphia, Sacramento, and Detroit). Within these trauma systems, unadjusted mortality was 19.9% for police transport and 13.5% for ground EMS. Risk-adjusted mortality was no different (OR = 1.01, 95% CI: 0.68-1.50). Using trauma system-level analyses, patients with penetrating injuries in urban trauma systems were found to have similar mortality for police and EMS transport. The majority of prehospital police transport in penetrating trauma occurs in three trauma systems. These cities represent ideal sites for additional system-level evaluation of prehospital transport policies. Prognostic/epidemiologic study, level III.

Comparison of an Atomic Model and Its Cryo-EM Image at the Central Axis of a Helix

PubMed Central

He, Jing; Zeil, Stephanie; Hallak, Hussam; McKaig, Kele; Kovacs, Julio; Wriggers, Willy

2016-01-01

Cryo-electron microscopy (cryo-EM) is an important biophysical technique that produces three-dimensional (3D) density maps at different resolutions. Because more and more models are being produced from cryo-EM density maps, validation of the models is becoming important. We propose a method for measuring local agreement between a model and the density map using the central axis of the helix. This method was tested using 19 helices from cryo-EM density maps between 5.5 Å and 7.2 Å resolution and 94 helices from simulated density maps. This method distinguished most of the well-fitting helices, although challenges exist for shorter helices. PMID:27280059

Single-particle cryo-EM using alignment by classification (ABC): the structure of Lumbricus terrestris haemoglobin

PubMed Central

Seer-Linnemayr, Charlotte; Ravelli, Raimond B. G.; Matadeen, Rishi; De Carlo, Sacha; Alewijnse, Bart; Portugal, Rodrigo V.; Pannu, Navraj S.; Schatz, Michael; van Heel, Marin

2017-01-01

Single-particle cryogenic electron microscopy (cryo-EM) can now yield near-atomic resolution structures of biological complexes. However, the reference-based alignment algorithms commonly used in cryo-EM suffer from reference bias, limiting their applicability (also known as the ‘Einstein from random noise’ problem). Low-dose cryo-EM therefore requires robust and objective approaches to reveal the structural information contained in the extremely noisy data, especially when dealing with small structures. A reference-free pipeline is presented for obtaining near-atomic resolution three-dimensional reconstructions from heterogeneous (‘four-dimensional’) cryo-EM data sets. The methodologies integrated in this pipeline include a posteriori camera correction, movie-based full-data-set contrast transfer function determination, movie-alignment algorithms, (Fourier-space) multivariate statistical data compression and unsupervised classification, ‘random-startup’ three-dimensional reconstructions, four-dimensional structural refinements and Fourier shell correlation criteria for evaluating anisotropic resolution. The procedures exclusively use information emerging from the data set itself, without external ‘starting models’. Euler-angle assignments are performed by angular reconstitution rather than by the inherently slower projection-matching approaches. The comprehensive ‘ABC-4D’ pipeline is based on the two-dimensional reference-free ‘alignment by classification’ (ABC) approach, where similar images in similar orientations are grouped by unsupervised classification. Some fundamental differences between X-ray crystallography versus single-particle cryo-EM data collection and data processing are discussed. The structure of the giant haemoglobin from Lumbricus terrestris at a global resolution of ∼3.8 Å is presented as an example of the use of the ABC-4D procedure. PMID:28989723

How well do General EMS 911 dispatch protocols predict ED resource utilization for pediatric patients?

PubMed

Fessler, Stephanie J; Simon, Harold K; Yancey, Arthur H; Colman, Michael; Hirsh, Daniel A

2014-03-01

The use of Emergency Medical Services (EMS) for low-acuity pediatric problems is well documented. Attempts have been made to curb potentially unnecessary transports, including using EMS dispatch protocols, shown to predict acuity and needs of adults. However, there are limited data about this in children. The primary objective of this study is to determine the pediatric emergency department (PED) resource utilization (surrogate of acuity level) for pediatric patients categorized as "low-acuity" by initial EMS protocols. Records of all pediatric patients classified as "low acuity" and transported to a PED in winter and summer of 2010 were reviewed. Details of the PED visit were recorded. Patients were categorized and compared based on chief complaint group. Resource utilization was defined as requiring any prescription medications, labs, procedures, consults, admission or transfer. "Under-triage" was defined as a "low-acuity" EMS transport subsequently requiring emergent interventions. Of the 876 eligible cases, 801 were included; 392/801 had no resource utilization while 409 of 801 had resource utilization. Most (737/801) were discharged to home; however, 64/801 were admitted, including 1 of 801 requiring emergent intervention (under-triage rate 0.12%). Gastroenterology and trauma groups had a significant increase in resource utilization, while infectious disease and ear-nose-throat groups had decreased resource utilization. While this EMS system did not well predict overall resource utilization, it safely identified most low-acuity patients, with a low under-triage rate. This study identifies subgroups of patients that could be managed without emergent transport and can be used to further refine current protocols or establish secondary triage systems. © 2013.

Evaluation of Cervicography Screening for Cervical Cancer in a High Risk Population

DTIC Science & Technology

2000-02-16

Higher sensitivity was associated with younger age , premenopausal status, the presence of metaplasia. the absence of cervicovaginal atrophy, and improved...recommended for postmenopausal women and/or women ages 50 and older. iv EVALUATION OF CERVICOGRAPHY SCREENING FOR CERVICAL CANCER IN A HIGH-RISK POPULATION...Institute. The Guanacaste site was selected because of its consistently high age -adjusted rates of cervical cancer despite existing Papanicolaou

Quantifying Golgi structure using EM: combining volume-SEM and stereology for higher throughput.

PubMed

Ferguson, Sophie; Steyer, Anna M; Mayhew, Terry M; Schwab, Yannick; Lucocq, John Milton

2017-06-01

Investigating organelles such as the Golgi complex depends increasingly on high-throughput quantitative morphological analyses from multiple experimental or genetic conditions. Light microscopy (LM) has been an effective tool for screening but fails to reveal fine details of Golgi structures such as vesicles, tubules and cisternae. Electron microscopy (EM) has sufficient resolution but traditional transmission EM (TEM) methods are slow and inefficient. Newer volume scanning EM (volume-SEM) methods now have the potential to speed up 3D analysis by automated sectioning and imaging. However, they produce large arrays of sections and/or images, which require labour-intensive 3D reconstruction for quantitation on limited cell numbers. Here, we show that the information storage, digital waste and workload involved in using volume-SEM can be reduced substantially using sampling-based stereology. Using the Golgi as an example, we describe how Golgi populations can be sensed quantitatively using single random slices and how accurate quantitative structural data on Golgi organelles of individual cells can be obtained using only 5-10 sections/images taken from a volume-SEM series (thereby sensing population parameters and cell-cell variability). The approach will be useful in techniques such as correlative LM and EM (CLEM) where small samples of cells are treated and where there may be variable responses. For Golgi study, we outline a series of stereological estimators that are suited to these analyses and suggest workflows, which have the potential to enhance the speed and relevance of data acquisition in volume-SEM.

Man-Portable Simultaneous Magnetometer and EM System (MSEMS)

DTIC Science & Technology

2008-12-01

limited to cesium vapor magnetometers outputting a Larmor signal. It cannot, as presently configured, be used with less expensive fluxgate magnetometers ...pulses to convert the frequency-based Larmor signal into nT. A fluxgate magnetometer does not employ the resonance mechanism of an alkali vapor...Simultaneous Magnetometer and EM System (MSEMS) December 2008 Report Documentation Page Form ApprovedOMB No. 0704-0188 Public reporting burden for the

The effect of a curfew on pediatric out-of-hospital EMS responses.

PubMed

Weiss, S J; Couk, J; Nobile, M; Ernst, A A; Johnson, W

1998-01-01

The purpose of a curfew is to decrease the amount of crime inflicted on minors during the late hours of the night. On June 1, 1994, a city curfew was instituted in New Orleans, requiring all persons 17 years of age or younger to be off the streets from 9 PM to 6 AM Sunday through Thursday, and from 11 PM to 6 AM on Friday and Saturday. This study evaluated the effect of the curfew on emergency medical services (EMS) transports for patients who were 17 years old or younger (pediatric). Data from all pediatric transports were included from the months before (5/94) and after (6/94) the institution of the curfew, and from the same two months one year earlier (5/93 and 6/93). A chi-square test was used to evaluate comparisons. The city EMS transports 48,000 patients per year in a one-tiered system (paramedic only) that acts as the sole provider of emergency EMS transport in the city. Approximately 10% of all transports are pediatric, and 40% of the pediatric transports are for trauma. A total of 1,642 transports were found that fit the inclusion criteria. In May 1993, there were 415 total pediatric transports; 234 were pediatric trauma. In June 1993, there were 406 total pediatric transports; 250 were pediatric trauma. In May 1994, there were 447 total pediatric runs; 243 were pediatric trauma. During the postcurfew month, June 1994, there were a significant decrease in pediatric transports to 370 (p < 0.01) and a significant decrease in pediatric trauma transport to 189 (p < 0.01). The institution of a curfew may lead to a drop in pediatric EMS runs during curfew hours. Another value of the curfew may be in the secondary effects of the curfew in preventing childhood injury during noncurfew hours.

Profilaxia da trombose venosa profunda em cirurgia bariátrica: estudo comparativo com doses diferentes de heparina de baixo peso molecular

PubMed Central

Goslan, Carlos José; Baretta, Giórgio Alfredo Pedroso; de Souza, Hemuara Grasiela Pestana; Orsi, Bruna Zanin; Zanoni, Esdras Camargo A.; Lopes, Marco Antonio Gimenez; Engelhorn, Carlos Alberto

2018-01-01

Resumo Contexto A cirurgia bariátrica é considerada a melhor opção para o tratamento da obesidade, cujos pacientes são considerados de alto risco para fenômenos tromboembólicos. Objetivos Comparar o uso de doses diferentes de heparina de baixo peso molecular (HBPM) na profilaxia da trombose venosa profunda (TVP) em pacientes candidatos à cirurgia bariátrica em relação ao risco de TVP, alteração na dosagem do fator anti-Xa e sangramento pré ou pós-operatório. Métodos Estudo comparativo transversal em pacientes submetidos à cirurgia bariátrica distribuídos em dois grupos, que receberam doses de HBPM de 40 mg (grupo controle, GC) e 80 mg (grupo de estudo, GE). Foram avaliados por ultrassonografia vascular e dosagem de KPTT, TAP, plaquetas e fator anti-Xa. Resultados Foram avaliados 60 pacientes, sendo 34 no GC e 26 no GE. Foi observada diferença significativa somente no peso (p = 0,003) e índice de massa corporal (p = 0,018) no GE em relação ao GC. Não houve diferença na dosagem de KPTT, TAP, plaquetas e fator anti-Xa entre os grupos. Não foram detectados TVP ou sangramentos significativos em ambos os grupos. Conclusões Não houve diferença estatisticamente significativa na utilização de doses maiores de HBPM na profilaxia da TVP em pacientes candidatos à cirurgia bariátrica em relação ao risco de TVP, dosagem do fator anti-Xa e sangramento pré ou pós-operatório.

Covariance Matrix Estimation for the Cryo-EM Heterogeneity Problem*

PubMed Central

Katsevich, E.; Katsevich, A.; Singer, A.

2015-01-01

In cryo-electron microscopy (cryo-EM), a microscope generates a top view of a sample of randomly oriented copies of a molecule. The problem of single particle reconstruction (SPR) from cryo-EM is to use the resulting set of noisy two-dimensional projection images taken at unknown directions to reconstruct the three-dimensional (3D) structure of the molecule. In some situations, the molecule under examination exhibits structural variability, which poses a fundamental challenge in SPR. The heterogeneity problem is the task of mapping the space of conformational states of a molecule. It has been previously suggested that the leading eigenvectors of the covariance matrix of the 3D molecules can be used to solve the heterogeneity problem. Estimating the covariance matrix is challenging, since only projections of the molecules are observed, but not the molecules themselves. In this paper, we formulate a general problem of covariance estimation from noisy projections of samples. This problem has intimate connections with matrix completion problems and high-dimensional principal component analysis. We propose an estimator and prove its consistency. When there are finitely many heterogeneity classes, the spectrum of the estimated covariance matrix reveals the number of classes. The estimator can be found as the solution to a certain linear system. In the cryo-EM case, the linear operator to be inverted, which we term the projection covariance transform, is an important object in covariance estimation for tomographic problems involving structural variation. Inverting it involves applying a filter akin to the ramp filter in tomography. We design a basis in which this linear operator is sparse and thus can be tractably inverted despite its large size. We demonstrate via numerical experiments on synthetic datasets the robustness of our algorithm to high levels of noise. PMID:25699132

Border Injuries: An Analysis of Prehospital Demographics, Mechanisms, and Patterns of Injuries Encountered by USBP EMS Agents in the El Paso (Texas USA) Sector.

PubMed

Baker, Russell A

2017-08-01

Study Objective The aim of this study was to evaluate Emergency Medical Services (EMS), use, injury mechanisms, prehospital assessments, and injuries among those receiving aid from the United States Border Patrol (USBP) in the El Paso (Texas USA) Sector. This is a time-series, retrospective analysis of all prehospital data for injuries among patients receiving care from USBP EMS on the US Mexico border in the El Paso sector from February 6, 2014 to February 6, 2016. A total of 473 documented EMS encounters occurred in this two-year period and demonstrated a male gender predominance (male 63%; female 37%) with the most prominent ages between 22-40 years old. The most prevalent EMS call types were medical (55%) and trauma (42%). The most common chief complaints were an injured or painful extremity (35%) and rash (13%). The most common USBP EMS provider primary impression was traumatic injury (34%), followed by fever/infection (17%) and extremity injury (7%); however, the most common secondary impression was also extremity injury (20%). The most common mechanism of injury was fall (26%) and motor vehicle accident (MVA; 22%). The USBP EMS was the first provider on scene in 96% of the MVAs. The author reports on injury patterns, mechanisms, chief complaints, EMS impressions, as well as demographics of patients reporting to USBP EMS. A knowledge of these injury patterns will be useful to EMS administrators and physicians along the US Mexico border. Baker RA . Border injuries: an analysis of prehospital demographics, mechanisms, and patterns of injuries encountered by USBP EMS agents in the El Paso (Texas USA) Sector. Prehosp Disaster Med. 2017;32(4):431-436.

In-hospital airway management training for non-anesthesiologist EMS physicians: a descriptive quality control study.

PubMed

Trimmel, Helmut; Beywinkler, Christoph; Hornung, Sonja; Kreutziger, Janett; Voelckel, Wolfgang G

2017-04-26

Pre-hospital airway management is a major challenge for emergency medical service (EMS) personnel. Despite convincing evidence that the rescuer's qualifications determine efficacy of tracheal intubation, in-hospital airway management training is not mandatory in Austria, and often neglected. Thus we sought to prove that airway management competence of EMS physicians can be established and maintained by a tailored training program. In this descriptive quality control study we retrospectively evaluated all in- and pre-hospital airway cases managed by EMS physicians who underwent a structured in-hospital training program in anesthesia at General Hospital Wiener Neustadt. Data was obtained from electronic anesthesia and EMS documentation systems. From 2006 to 2016, 32 EMS physicians with 3-year post-graduate education, but without any prior experience in anesthesia were trained. Airway management proficiency was imparted in three steps: initial training, followed by an ongoing practice schedule in the operating room (OR). Median and interquartile range of number of in-hospital tracheal intubations (TIs) vs. use of supra-glottic airway devices (SGA) were 33.5 (27.5-42.5) vs. 19.0 (15.0-27.0) during initial training; 62.0 (41.8-86.5) vs. 33.5 (18.0-54.5) during the first, and 64.0 (34.5-93.8) vs. 27 (12.5-56.0) during the second year. Pre-hospitaly, every physician performed 9.0 (5.0-14.8) TIs vs. 0.0 (0.0-0.0) SGA cases during the first, and 9.0 (7.0-13.8) TIs vs. 0.0 (0.0-0.3) SGA during the second year. Use of an SGA was mandatory when TI failed after the second attempt, thus accounting for a total of 33 cases. In 8 cases, both TI and SGA failed, but bag mask ventilation was successfully performed. No critical events related to airway management were noted and overall success rate for TI with a max of 2 attempts was 95.3%. Number of TIs per EMS physician is low in the pre-hospital setting. A training concept that assures an additional 60+ TIs per year appears to

Populações estelares em galáxias HII

NASA Astrophysics Data System (ADS)

Westera, P.; Cuisinier, F.; Telles, E.; Kehrig, C.

2003-08-01

Analisamos o conteúdo estelar de 74 galáxias HII a partir do contínuo observado nos espectros ópticos dessas galáxias, utilizando métodos de síntese de população estelar. Descobrimos que todas as galáxias para as quais encontramos soluções contêm uma população estelar velha que domina a massa estelar, e numa maioria dessas também encontramos evidência de uma população de idade intermediaria além da geração jovem que está se formando agora. Concluímos que a formação estelar dessas galáxias se realiza em surtos individuais, Esses surtos são interrompidos por longos períodos de inatividade, com os primeiros consumindo a maior parte do gás. Sugerimos, portanto, que as galáxias HII sejam galáxias anãs normais flagradas em um período de surto.

Draft Genome Sequence of Elizabethkingia anophelis Strain EM361-97 Isolated from the Blood of a Cancer Patient

PubMed Central

Lin, Jiun-Nong; Yang, Chih-Hui; Lai, Chung-Hsu; Huang, Yi-Han

2016-01-01

Elizabethkingia anophelis EM361-97 was isolated from the blood of a patient with nasopharyngeal carcinoma and lung cancer. We report the draft genome sequence of EM361-97, which contains a G+C content of 35.7% and 3,611 candidate protein-encoding genes. PMID:27789647

Estudo espectral em raios-X duros de fontes do tipo Z com o HEXTE/RXTE

NASA Astrophysics Data System (ADS)

D'Amico, F.; Heindl, W. A.; Rothschild, R. E.

2003-08-01

Apresentam-se os resultados de um estudo espectral em raios-X de fontes do tipo Z. As fontes do tipo Z são binárias de raios-X de baixa massa (BXBM) com campo magnético intermediário (B~109G). Esta classe de fontes é composta por apenas 6 fontes Galácticas (a saber: ScoX-1, 9, 7, CygX-2, 5 e 0). A nossa análise se concentra na faixa de raios-X duros (E ~ 20keV), até cerca de 200keV, faixa ótima de operação do telescópio "High Energy X-ray Timing Experiment" (HEXTE), um dos três telescópios de raios-X à bordo do Rossi X-ray Timing Explorer (RXTE). Nossa motivação para tal estudo, uma busca de caudas em raios-X duros em fontes do tipo Z, foi o pouco conhecimento sobre a emissão nesta faixa de energia das referidas fontes quando comparadas, por exemplo, as fontes do tipo atoll (também BXBM). Apresentam-se a análise/redução de dados e explicita-se a maneira como o HEXTE mede o ru1do de fundo. Especial atenção é direcionada a este item devido a localização das fontes do tipo Z e também ao problema de contaminação por fontes próximas. Com exceção de ScoX-1, nenhuma cauda em raios-X duros foi encontrada para as outras fontes, a despeito de resultados de detecção dessas caudas em algumas fontes pelo satélite BeppoSAX. As interpretações deste resultado serão apresentadas. Do ponto de vista deste estudo, nós deduzimos que a produção de caudas de raios-X duros em fontes do tipo Z é um processo disparado quando, pelo menos, uma condição é satisfeita: o brilho da componente térmica do espectro precisa estar acima de um certo valor limiar de ~4´1036ergs-1.

Evidence-Based Guidelines for Fatigue Risk Management in EMS: Formulating Research Questions and Selecting Outcomes.

PubMed

Patterson, P Daniel; Higgins, J Stephen; Lang, Eddy S; Runyon, Michael S; Barger, Laura K; Studnek, Jonathan R; Moore, Charity G; Robinson, Kathy; Gainor, Dia; Infinger, Allison; Weiss, Patricia M; Sequeira, Denisse J; Martin-Gill, Christian

2017-01-01

Greater than half of Emergency Medical Services (EMS) personnel report work-related fatigue, yet there are no guidelines for the management of fatigue in EMS. A novel process has been established for evidence-based guideline (EBG) development germane to clinical EMS questions. This process has not yet been applied to operational EMS questions like fatigue risk management. The objective of this study was to develop content valid research questions in the Population, Intervention, Comparison, and Outcome (PICO) framework, and select outcomes to guide systematic reviews and development of EBGs for EMS fatigue risk management. We adopted the National Prehospital EBG Model Process and Grading of Recommendations Assessment, Development, and Evaluation (GRADE) framework for developing, implementing, and evaluating EBGs in the prehospital care setting. In accordance with steps one and two of the Model Process, we searched for existing EBGs, developed a multi-disciplinary expert panel and received external input. Panelists completed an iterative process to formulate research questions. We used the Content Validity Index (CVI) to score relevance and clarity of candidate PICO questions. The panel completed multiple rounds of question editing and used a CVI benchmark of ≥0.78 to indicate acceptable levels of clarity and relevance. Outcomes for each PICO question were rated from 1 = less important to 9 = critical. Panelists formulated 13 candidate PICO questions, of which 6 were eliminated or merged with other questions. Panelists reached consensus on seven PICO questions (n = 1 diagnosis and n = 6 intervention). Final CVI scores of relevance ranged from 0.81 to 1.00. Final CVI scores of clarity ranged from 0.88 to 1.00. The mean number of outcomes rated as critical, important, and less important by PICO question was 0.7 (SD 0.7), 5.4 (SD 1.4), and 3.6 (SD 1.9), respectively. Patient and personnel safety were rated as critical for most PICO questions. PICO questions and

Estudo de soluções locais e cosmológicas em teorias do tipo tensor-escalar

NASA Astrophysics Data System (ADS)

Silva E Costa, S.

2003-08-01

Teorias do tipo tensor-escalar são a mais simples extensão possí vel da Relatividade Geral. Nessas teorias, cujo modelo padrão é a teoria de Brans-Dicke, a curvatura do espaço-tempo, descrita por componentes tensoriais, aparece acoplada a um campo escalar que, de certo modo, representa uma variação na constante de acoplamento da gravitação. Tais teorias apresentam soluções locais e cosmológicas que, em determinados limites, recaem nas apresentadas pela Relatividade Geral, mas que em outros limites trazem novidades, tais como conseqüências observacionais da evolução de flutuações primordiais distintas daquelas previstas pela Relatividade Geral (ver, por ex., Nagata et al., PRD 66, p. 103510 (2002)). Graças a esta possibilidade de trazer à luz novidades em relação à gravitação, teorias do tipo tensor-escalar podem ser vistas como um interessante campo alternativo de pesquisas para soluções dos problemas de massa faltante (ou escura) e/ou energia escura. Seguindo tal linha, este trabalho, ainda em sua fase inicial, apresenta soluções gerais de teorias do tipo tensor-escalar para diversas situações, verificando-se em que consiste a divergência dessas soluções dos casos tradicionais possí veis na Relatividade Geral. Como exemplos das soluções aqui apresentadas pode-se destacar uma expressão geral para diferentes soluções cosmológicas englobando diferentes tipos de matéria (representados por diferentes equações de estado), e a expressão para uma solução local representando um buraco negro com rotação, similar à solução de Kerr da Relatividade Geral. Por fim, é importante ressaltar que, embora aqui apresentem-se poucos resultados novos, na literatura sobre o assunto a maior parte das soluções apresentadas limita-se a uns poucos casos especí ficos, tal como soluções cosmológicas apenas com curvatura nula, e que mesmo as soluções disponí veis são, em geral, pouco divulgadas e, portanto, pouco conhecidas, e �

Development and implementation of a geographical area categorisation method with targeted performance indicators for nationwide EMS in Finland.

PubMed

Pappinen, Jukka; Laukkanen-Nevala, Päivi; Mäntyselkä, Pekka; Kurola, Jouni

2018-05-15

In Finland, hospital districts (HD) are required by law to determine the level and availability of Emergency Medical Services (EMS) for each 1-km 2 sized area (cell) within their administrative area. The cells are currently categorised into five risk categories based on the predicted number of missions. Methodological defects and insufficient instructions have led to incomparability between EMS services. The aim of this study was to describe a new, nationwide method for categorising the cells, analyse EMS response time data and describe possible differences in mission profiles between the new risk category areas. National databases of EMS missions, population and buildings were combined with an existing nationwide 1-km 2 hexagon-shaped cell grid. The cells were categorised into four groups, based on the Finnish Environment Institute's (FEI) national definition of urban and rural areas, population and historical EMS mission density within each cell. The EMS mission profiles of the cell categories were compared using risk ratios with confidence intervals in 12 mission groups. In total, 87.3% of the population lives and 87.5% of missions took place in core or other urban areas, which covered only 4.7% of the HDs' surface area. Trauma mission incidence per 1000 inhabitants was higher in core urban areas (42.2) than in other urban (24.2) or dispersed settlement areas (24.6). The results were similar for non-trauma missions (134.8, 93.2 and 92.2, respectively). Each cell category had a characteristic mission profile. High-energy trauma missions and cardiac problems were more common in rural and uninhabited cells, while violence, intoxication and non-specific problems dominated in urban areas. The proposed area categories and grid-based data collection appear to be a useful method for evaluating EMS demand and availability in different parts of the country for statistical purposes. Due to a similar rural/urban area definition, the method might also be usable for

Characteristics of the pediatric patients treated by the Pediatric Emergency Care Applied Research Network's affiliated EMS agencies.

PubMed

Lerner, E Brooke; Dayan, Peter S; Brown, Kathleen; Fuchs, Susan; Leonard, Julie; Borgialli, Dominic; Babcock, Lynn; Hoyle, John D; Kwok, Maria; Lillis, Kathleen; Nigrovic, Lise E; Mahajan, Prashant; Rogers, Alexander; Schwartz, Hamilton; Soprano, Joyce; Tsarouhas, Nicholas; Turnipseed, Samuel; Funai, Tomohiko; Foltin, George

2014-01-01

To describe pediatric patients transported by the Pediatric Emergency Care Applied Research Network's (PECARN's) affiliated emergency medical service (EMS) agencies and the process of submitting and aggregating data from diverse agencies. We conducted a retrospective analysis of electronic patient care data from PECARN's partner EMS agencies. Data were collected on all EMS runs for patients less than 19 years old treated between 2004 and 2006. We conducted analyses only for variables with usable data submitted by a majority of participating agencies. The investigators aggregated data between study sites by recoding it into categories and then summarized it using descriptive statistics. Sixteen EMS agencies agreed to participate. Fourteen agencies (88%) across 11 states were able to submit patient data. Two of these agencies were helicopter agencies (HEMS). Mean time to data submission was 378 days (SD 175). For the 12 ground EMS agencies that submitted data, there were 514,880 transports, with a mean patient age of 9.6 years (SD 6.4); 53% were male, and 48% were treated by advanced life support (ALS) providers. Twenty-two variables were aggregated and analyzed, but not all agencies were able to submit all analyzed variables and for most variables there were missing data. Based on the available data, median response time was 6 minutes (IQR: 4-9), scene time 15 minutes (IQR: 11-21), and transport time 9 minutes (IQR: 6-13). The most common chief complaints were traumatic injury (28%), general illness (10%), and respiratory distress (9%). Vascular access was obtained for 14% of patients, 3% received asthma medication, <1% pain medication, <1% assisted ventilation, <1% seizure medication, <1% an advanced airway, and <1% CPR. Respiratory rate, pulse, systolic blood pressure, and GCS were categorized by age and the majority of children were in the normal range except for systolic blood pressure in those under one year old. Despite advances in data definitions and

EMS-physicians' self reported airway management training and expertise; a descriptive study from the Central Region of Denmark

PubMed Central

2011-01-01

Background Prehospital advanced airway management, including prehospital endotracheal intubation is challenging and recent papers have addressed the need for proper training, skill maintenance and quality control for emergency medical service personnel. The aim of this study was to provide data regarding airway management-training and expertise from the regional physician-staffed emergency medical service (EMS). Methods The EMS in this part of The Central Region of Denmark is a two tiered system. The second tier comprises physician staffed Mobile Emergency Care Units. The medical directors of the programs supplied system data. A questionnaire addressing airway management experience, training and knowledge was sent to the EMS-physicians. Results There are no specific guidelines, standard operating procedures or standardised program for obtaining and maintaining skills regarding prehospital advanced airway management in the schemes covered by this study. 53/67 physicians responded; 98,1% were specialists in anesthesiology, with an average of 17,6 years of experience in anesthesiology, and 7,2 years experience as EMS-physicians. 84,9% reported having attended life support course(s), 64,2% an advanced airway management course. 24,5% fulfilled the curriculum suggested for Danish EMS physicians. 47,2% had encountered a difficult or impossible PHETI, most commonly in a patient in cardiac arrest or a trauma patient. Only 20,8% of the physicians were completely familiar with what back-up devices were available for airway management. Conclusions In this, the first Danish study of prehospital advanced airway management, we found a high degree of experience, education and training among the EMS-physicians, but their equipment awareness was limited. Check-outs, guidelines, standard operating procedures and other quality control measures may be needed. PMID:21303510

Prevalence of inter-hemispheric asymetry in children and adolescents with interdisciplinary diagnosis of non-verbal learning disorder.

PubMed

Wajnsztejn, Alessandra Bernardes Caturani; Bianco, Bianca; Barbosa, Caio Parente

2016-01-01

To describe clinical and epidemiological features of children and adolescents with interdisciplinary diagnosis of non-verbal learning disorder and to investigate the prevalence of inter-hemispheric asymmetry in this population group. Cross-sectional study including children and adolescents referred for interdisciplinary assessment with learning difficulty complaints, who were given an interdisciplinary diagnosis of non-verbal learning disorder. The following variables were included in the analysis: sex-related prevalence, educational system, initial presumptive diagnoses and respective prevalence, overall non-verbal learning disorder prevalence, prevalence according to school year, age range at the time of assessment, major family complaints, presence of inter-hemispheric asymmetry, arithmetic deficits, visuoconstruction impairments and major signs and symptoms of non-verbal learning disorder. Out of 810 medical records analyzed, 14 were from individuals who met the diagnostic criteria for non-verbal learning disorder, including the presence of inter-hemispheric asymmetry. Of these 14 patients, 8 were male. The high prevalence of inter-hemispheric asymmetry suggests this parameter can be used to predict or support the diagnosis of non-verbal learning disorder. Descrever as características clínicas e epidemiológicas de crianças e adolescentes com transtorno de aprendizagem não verbal, e investigar a prevalência de assimetria inter-hemisférica neste grupo populacional. Estudo transversal que incluiu crianças e adolescentes encaminhados para uma avaliação interdisciplinar, com queixas de dificuldades de aprendizagem e que receberam diagnóstico interdisciplinar de transtorno de aprendizagem não verbal. As variáveis avaliadas foram prevalência por sexo, sistema de ensino, hipóteses diagnósticas iniciais e respectivas prevalências, prevalência de condições em relação à amostra total, prevalência geral do transtorno de aprendizagem não verbal

Validation of cryo-EM structure of IP₃R1 channel.

PubMed

Murray, Stephen C; Flanagan, John; Popova, Olga B; Chiu, Wah; Ludtke, Steven J; Serysheva, Irina I

2013-06-04

About a decade ago, three electron cryomicroscopy (cryo-EM) single-particle reconstructions of IP3R1 were reported at low resolution. It was disturbing that these structures bore little similarity to one another, even at the level of quaternary structure. Recently, we published an improved structure of IP3R1 at ∼1 nm resolution. However, this structure did not bear any resemblance to any of the three previously published structures, leading to the question of why the structure should be considered more reliable than the original three. Here, we apply several methods, including class-average/map comparisons, tilt-pair validation, and use of multiple refinement software packages, to give strong evidence for the reliability of our recent structure. The map resolution and feature resolvability are assessed with the gold standard criterion. This approach is generally applicable to assessing the validity of cryo-EM maps of other molecular machines. Copyright © 2013 Elsevier Ltd. All rights reserved.

Beam-induced motion correction for sub-megadalton cryo-EM particles.

PubMed

Scheres, Sjors Hw

2014-08-13

In electron cryo-microscopy (cryo-EM), the electron beam that is used for imaging also causes the sample to move. This motion blurs the images and limits the resolution attainable by single-particle analysis. In a previous Research article (Bai et al., 2013) we showed that correcting for this motion by processing movies from fast direct-electron detectors allowed structure determination to near-atomic resolution from 35,000 ribosome particles. In this Research advance article, we show that an improved movie processing algorithm is applicable to a much wider range of specimens. The new algorithm estimates straight movement tracks by considering multiple particles that are close to each other in the field of view, and models the fall-off of high-resolution information content by radiation damage in a dose-dependent manner. Application of the new algorithm to four data sets illustrates its potential for significantly improving cryo-EM structures, even for particles that are smaller than 200 kDa. Copyright © 2014, Scheres.

Injury risks of EMS responders: evidence from the National Fire Fighter Near-Miss Reporting System

PubMed Central

Taylor, Jennifer A; Davis, Andrea L; Barnes, Brittany; Lacovara, Alicia V; Patel, Reema

2015-01-01

Objectives We analysed near-miss and injury events reported to the National Fire Fighter Near-Miss Reporting System (NFFNMRS) to investigate the workplace hazards and safety concerns of Emergency Medical Services (EMS) responders in the USA. Methods We reviewed 769 ‘non-fire emergency event’ reports from the NFFNMRS using a mixed methods approach. We identified 185 emergency medical calls and analysed their narrative text fields. We assigned Mechanism of Near-Miss/Injury and Nature of Injury codes and then tabulated frequencies (quantitative). We coded major themes regarding work hazards and safety concerns reported by the EMS responders (qualitative). Results Of the 185 emergency medical calls, the most commonly identified Mechanisms of Near-Miss/Injury to EMS responders was Assaults, followed by Struck-by Motor Vehicle, and Motor Vehicle Collision. The most commonly identified weapon used in an assault was a firearm. We identified 5 major domains of workplace hazards and safety concerns: Assaults by Patients, Risks from Motor Vehicles, Personal Protective Equipment, Relationships between Emergency Responders, and Policies, Procedures and Practices. Conclusions Narrative text from the NFFNMRS is a rich source of data that can be analysed quantitatively and qualitatively to provide insight into near-misses and injuries sustained by EMS responders. Near-miss reporting systems are critical components for occupational hazard surveillance. PMID:26068510

Telescópio de patrulhamento solar em 12 GHz

NASA Astrophysics Data System (ADS)

Utsumi, F.; Costa, J. E. R.

2003-08-01

O telescópio de patrulhamento solar é um instrumento dedicado à observação de explosões solares com início de suas operações em janeiro de 2002, trabalhando próximo ao pico de emissão do espectro girossincrotrônico (12 GHz). Trata-se de um arranjo de três antenas concebido para a detecção de explosões e determinação em tempo real da localização da região emissora. Porém, desde sua implementação em uma montagem equatorial movimentada por um sistema de rotação constante (15 graus/hora) o rastreio apresentou pequenas variações de velocidade e folgas nas caixas de engrenagens. Assim, tornou-se necessária a construção de um sistema de correção automática do apontamento que era de fundamental importância para os objetivos do projeto. No segundo semestre de 2002 empreendemos uma série de tarefas com o objetivo de automatizar completamente o rastreio, a calibração, a aquisição de dados, controle de ganhos, offsets e transferência dos dados pela internet através de um projeto custeado pela FAPESP. O rastreio automático é realizado através de um inversor que controla a freqüência da rede de alimentação do motor de rastreio podendo fazer micro-correções na direção leste-oeste conforme os radiômetros desta direção detectem uma variação relativa do sinal. Foi adicionado também um motor na direção da declinação para correção automática da variação da direção norte-sul. Após a implementação deste sistema a precisão do rastreio melhorou para um desvio máximo de 30 segundos de arco, o que está muito bom para este projeto. O Telescópio se encontra em funcionamento automático desde março de 2003 e já conta com várias explosões observadas após a conclusão desta fase de automação. Estamos apresentando as explosões mais intensas do período e com as suas respectivas posições no disco solar.

Complete Genome Sequence of Elizabethkingia miricola Strain EM798-26 Isolated from the Blood of a Cancer Patient

PubMed Central

Lai, Chung-Hsu; Yang, Chih-Hui; Huang, Yi-Han; Lin, Hsi-Hsun

2018-01-01

ABSTRACT Elizabethkingia miricola EM798-26 was isolated from the blood of a patient with diffuse large B-cell lymphoma in Taiwan. We report here the complete genome sequence of EM798-26, which contains a G+C content of 35.7% and 3,877 candidate protein-coding genes. PMID:29301886

<em>An Amphibious Magnetotelluric Investigation of the Cascadian Seismogenic and ETS zones.em>

NASA Astrophysics Data System (ADS)

Parris, B. A.; Livelybrooks, D.; Bedrosian, P.; Egbert, G. D.; Key, K.; Schultz, A.; Cook, A.; Kant, M.; Wogan, N.; Zeryck, A.

2015-12-01

The amphibious Magnetotelluric Observations of Cascadia using a Huge Array (MOCHA) experiment seeks to address unresolved questions about the seismogenic locked zone and down-dip transition zone where episodic tremor and slip (ETS) originates. The presence of free fluids is thought to be one of the primary controls on ETS behavior within the Cascadia margin. Since the bulk electrical conductivity in the crust and mantle can be greatly increased by fluids, magnetotelluric(MT) observations can offer unique insights on the fluid distribution and its relation to observed ETS behavior. Here we present preliminary results from the 146 MT stations collected for the MOCHA project. MOCHA is unique in that it is the first amphibious array of MT stations occupied to provide for 3-D interpretation of conductivity structure of a subduction zone. The MOCHA data set comprises 75 onshore stations and 71 offshore stations, accumulated over a two-year period, and located on an approximate 25km grid, spanning from the trench to the Eastern Willamette Valley, and from central Oregon into middle Washington. We present the results of a series of east-west (cross-strike) oriented, two-dimensional inversions created using the MARE2DEM software that provide an initial picture of the conductivity structure of the locked and ETS zones and its along strike variations. Our models can be used to identify correlations between ETS occurrence rates and inferred fluid concentrations. Our modeling explores the impact of various parameterizations on 2-D inversion results, including inclusion of a smoothness penalty reduction along the inferred slab interface. This series of 2-D inversions can then be used collectively to help make and guide an a priori 3-D inversion. In addition we will present a preliminary 3-D inversion of the onshore stations created using the ModEM software. We are currently working on modifying ModEM to support inversion of offshore data. The more computationally intensive 3-D

Connections between EM2-containing terminals and GABA/μ-opioid receptor co-expressing neurons in the rat spinal trigeminal caudal nucleus

PubMed Central

Li, Meng-Ying; Wu, Zhen-Yu; Lu, Ya-Cheng; Yin, Jun-Bin; Wang, Jian; Zhang, Ting; Dong, Yu-Lin; Wang, Feng

2014-01-01

Endomorphin-2 (EM2) demonstrates a potent antinociceptive effect via the μ-opioid receptor (MOR). To provide morphological evidence for the pain control effect of EM2, the synaptic connections between EM2-immunoreactive (IR) axonal terminals and γ-amino butyric acid (GABA)/MOR co-expressing neurons in lamina II of the spinal trigeminal caudal nucleus (Vc) were investigated in the rat. Dense EM2-, MOR- and GABA-IR fibers and terminals were mainly observed in lamina II of the Vc. Within lamina II, GABA- and MOR-neuronal cell bodies were also encountered. The results of immunofluorescent histochemical triple-staining showed that approximately 14.2 or 18.9% of GABA-IR or MOR-IR neurons also showed MOR- or GABA-immunopositive staining in lamina II; approximately 45.2 and 36.1% of the GABA-IR and MOR-IR neurons, respectively, expressed FOS protein in their nuclei induced by injecting formalin into the left lower lip of the mouth. Most of the GABA/MOR, GABA/FOS, and MOR/FOS double-labeled neurons made close contacts with EM2-IR fibers and terminals. Immuno-electron microscopy confirmed that the EM2-IR terminals formed synapses with GABA-IR or MOR-IR dendritic processes and neuronal cell bodies in lamina II of the Vc. These results suggest that EM2 might participate in pain transmission and modulation by binding to MOR-IR and GABAergic inhibitory interneuron in lamina II of the Vc to exert inhibitory effect on the excitatory interneuron in lamina II and projection neurons in laminae I and III. PMID:25386121

FOLD-EM: automated fold recognition in medium- and low-resolution (4-15 Å) electron density maps.

PubMed

Saha, Mitul; Morais, Marc C

2012-12-15

Owing to the size and complexity of large multi-component biological assemblies, the most tractable approach to determining their atomic structure is often to fit high-resolution radiographic or nuclear magnetic resonance structures of isolated components into lower resolution electron density maps of the larger assembly obtained using cryo-electron microscopy (cryo-EM). This hybrid approach to structure determination requires that an atomic resolution structure of each component, or a suitable homolog, is available. If neither is available, then the amount of structural information regarding that component is limited by the resolution of the cryo-EM map. However, even if a suitable homolog cannot be identified using sequence analysis, a search for structural homologs should still be performed because structural homology often persists throughout evolution even when sequence homology is undetectable, As macromolecules can often be described as a collection of independently folded domains, one way of searching for structural homologs would be to systematically fit representative domain structures from a protein domain database into the medium/low resolution cryo-EM map and return the best fits. Taken together, the best fitting non-overlapping structures would constitute a 'mosaic' backbone model of the assembly that could aid map interpretation and illuminate biological function. Using the computational principles of the Scale-Invariant Feature Transform (SIFT), we have developed FOLD-EM-a computational tool that can identify folded macromolecular domains in medium to low resolution (4-15 Å) electron density maps and return a model of the constituent polypeptides in a fully automated fashion. As a by-product, FOLD-EM can also do flexible multi-domain fitting that may provide insight into conformational changes that occur in macromolecular assemblies.

Gradientes de abundâncias em galáxias espirais

NASA Astrophysics Data System (ADS)

Dors, O. L.., Jr.; Copetti, M. V. F.

2003-08-01

Gradientes de abundâncias obtidos através de observações de regiões H II têm um papel importante no estudo de formação e evolução de galáxias espirais. Determinações diretas de abundâncias somente são obtidas quando linhas de emissão sensíveis à temperatura eletrônica (e.g., [O III]l4363) são detectadas. Infelizmente estas linhas são fracas ou não observadas em regiões H II de baixa excitação. Nestes casos métodos empíricos são utilizados para estimar as abundâncias químicas. Entretanto, diferentes métodos têm produzido diferentes estimativas de gradientes de abundâncias. Neste trabalho, nós construímos modelos de fotoionização com o objetivo de descrever diagramas de diagnósticos construídos com dados publicados de algumas galáxias espirais normais e barradas. Comparações entre nossas estimativas de abundâncias e de outros métodos mostram que quando não há acordo entre eles, nossos modelos superestimam as abundâncias de O/H e N/H por um fator de 0.3 dex em relação a estimativas diretas de abundâncias, e por fator de 0.2 dex em relação a outros métodos empíricos. A origem da produção de nitrogênio nas galáxias estudadas é discutida.

Factor Analysis with EM Algorithm Never Gives Improper Solutions when Sample Covariance and Initial Parameter Matrices Are Proper

ERIC Educational Resources Information Center

Adachi, Kohei

2013-01-01

Rubin and Thayer ("Psychometrika," 47:69-76, 1982) proposed the EM algorithm for exploratory and confirmatory maximum likelihood factor analysis. In this paper, we prove the following fact: the EM algorithm always gives a proper solution with positive unique variances and factor correlations with absolute values that do not exceed one,…

Challenges and opportunities in the high-resolution cryo-EM visualization of microtubules and their binding partners.

PubMed

Nogales, Eva; Kellogg, Elizabeth H

2017-10-01

As non-crystallizable polymers, microtubules have been the target of cryo-electron microscopy (cryo-EM) studies since the technique was first established. Over the years, image processing strategies have been developed that take care of the unique, pseudo-helical symmetry of the microtubule. With recent progress in data quality and data processing, cryo-EM reconstructions are now reaching resolutions that allow the generation of atomic models of microtubules and the factors that bind them. These include cellular partners that contribute to microtubule cellular functions, or small ligands that interfere with those functions in the treatment of cancer. The stage is set to generate a family portrait for all identified microtubule interacting proteins and to use cryo-EM as a drug development tool in the targeting of tubulin. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

Potential Association of Posttraumatic Stress Disorder and Decreased Bone Mineral Density in Repatriated Prisoners of War

DTIC Science & Technology

2011-03-01

and target tissue- related causes . Int J Obesity 2000 ; 24 (Suppl 2) : S50 – S55 . 31. Papanicolaou DA , Wilder RL , Manolagas SC...the US. All rights reserved. MILITARY MEDICINE, 176, 3:270, 2011 270 MILITARY MEDICINE, Vol. 176, March 2011 INTRODUCTION Osteoporosis is defi ned...and susceptibility to fracture. 1 Male osteoporosis is a less well- recognized and studied condition compared to osteoporosis in women. It is known

Optimisation of nutritional requirements for dopamine synthesis by calcium alginate-entrapped mutant strain of Aspergillus oryzae EMS-6.

PubMed

Ali, Sikander; Nawaz, Wajeeha

2017-02-01

The optimisation of nutritional requirements for dopamine (DA) synthesis by calcium alginate-entrapped mutant variant of Aspergillus oryzae EMS-6 using submerged fermentation technique was investigated. A total of 13 strains were isolated from soil. Isolate I-2 was selected as a better producer of DA and improved by exposing with ethyl methylsulphonate (EMS). EMS-6 was selected as it exhibited 43 μg/mL DA activity. The mutant variable was further treated with low levels of l-cysteine HCl to make it resistant against diversion and environmental stress. The conidiospores of mutant variant were entrapped in calcium alginate beads for stable product formation. EMS-6 gave maximum DA activity (124 μg/mL) when supplemented with 0.1% peptone and 0.2% sucrose, under optimised parameters viz. pH 3, temperature of 55 °C and incubation time of 70 min. The study involves the high profile of DA activity and is needed, as DA is capable to control numerous neurogenic disorders.

MOM3D/EM-ANIMATE - MOM3D WITH ANIMATION CODE

NASA Technical Reports Server (NTRS)

Shaeffer, J. F.

1994-01-01

MOM3D (LAR-15074) is a FORTRAN method-of-moments electromagnetic analysis algorithm for open or closed 3-D perfectly conducting or resistive surfaces. Radar cross section with plane wave illumination is the prime analysis emphasis; however, provision is also included for local port excitation for computing antenna gain patterns and input impedances. The Electric Field Integral Equation form of Maxwell's equations is solved using local triangle couple basis and testing functions with a resultant system impedance matrix. The analysis emphasis is not only for routine RCS pattern predictions, but also for phenomenological diagnostics: bistatic imaging, currents, and near scattered/total electric fields. The images, currents, and near fields are output in form suitable for animation. MOM3D computes the full backscatter and bistatic radar cross section polarization scattering matrix (amplitude and phase), body currents and near scattered and total fields for plane wave illumination. MOM3D also incorporates a new bistatic k space imaging algorithm for computing down range and down/cross range diagnostic images using only one matrix inversion. MOM3D has been made memory and cpu time efficient by using symmetric matrices, symmetric geometry, and partitioned fixed and variable geometries suitable for design iteration studies. MOM3D may be run interactively or in batch mode on 486 IBM PCs and compatibles, UNIX workstations or larger computers. A 486 PC with 16 megabytes of memory has the potential to solve a 30 square wavelength (containing 3000 unknowns) symmetric configuration. Geometries are described using a triangular mesh input in the form of a list of spatial vertex points and a triangle join connection list. The EM-ANIMATE (LAR-15075) program is a specialized visualization program that displays and animates the near-field and surface-current solutions obtained from an electromagnetics program, in particular, that from MOM3D. The EM-ANIMATE program is windows based and

Evolução temporal de discos circunstelares em estrelas Be

NASA Astrophysics Data System (ADS)

Fernandes, M. V. M.; Leister, N. V.; Levenhagen, R. S.

2003-08-01

A pesquisa do mecanismo que leva uma estrela do tipo Be a perder massa e formar um envelope circunstelar, nomeado como fenômeno Be, é uma questão em aberto, intrigante, e que adquire contornos interessantes em face às informações espectroscópicas de alta resolução. Nesta última década, consolida-se a idéia de que a forma destes envelopes é de tipo discóide, obedecendo a uma lei Kepleriana de velocidades, e mais ainda, recentemente há evidências de que a distribuição de matéria nestes discos pode assumir um caráter de anel. Medidas de algumas dimensões de discos circunstelares puderam ser obtidas pela análise de espectros de alta resolução e alta relação sinal-ruído para as estrelas Be: alpha Eri (HD 10144, B3Vpe), omicron And (HD 217675, B6IIIpe), e eta Cen (HD el972, B1.5Vne), no período dos anos de 1991 a 2001. Alguns modelos clássicos de envelope predizem uma distribuição de massa que decresce suavemente a partir da superfície estelar. Entretanto, considerando que a separação de picos de emissão em perfis de linhas do HeI e H-alpha, alargados por efeitos cinemáticos, é função do raio estelar e da velocidade rotacional projetada (vsini); nossos resultados sugerem a presença de um anel de matéria circunstelar, que aparece logo após a ejeção do material fotosférico, imediatamente acima da superfície estelar, e que se expande para raios maiores ao longo do tempo, eventualmente desconectando-se da superfície por uma região de densidade de matéria mínima. Tais interpretações revivem a idéia de que anéis de matéria circunstelar podem ser os responsáveis por algumas variabilidades em perfis de linhas de emissão, como as variações V/R.

Military Emergency Medical Service System Assessment: Application of the National Park Service Needs Assessment and Program Audit to Objectively Evaluate the Military EMS System of Okinawa, Japan.

PubMed

Ross, Elliot M; Harper, Stephen A; Cunningham, Cord; Walrath, Benjamin D; DeMers, Gerard; Kharod, Chetan U

2017-03-01

As part of a Military Emergency Medical Services (EMS) system process improvement initiative, the authors sought to objectively evaluate the U.S. military EMS system for the island of Okinawa. They applied a program evaluation tool currently utilized by the U.S. National Park Service (NPS). A comprehensive needs assessment was conducted to evaluate the current Military EMS system in Okinawa, Japan. The NPS EMS Program Audit Worksheet was used to get an overall "score" of our assessment. After all the data had been collected, a joint committee of Military EMS physicians reviewed the findings and made formal recommendations. From 2011 to 2014, U.S. military EMS on Okinawa averaged 1,345 ± 137 patient transports annually. An advanced life support (ALS) provider would have been dispatched on 558 EMS runs (38%) based on chief complaint in 2014 had they been available. Over 36,000 man-hours were expended during this period to provide National Registry Emergency Medical Technician (EMT)-accredited instruction to certify 141 Navy Corpsman as EMT Basics. The NPS EMS Program Audit Worksheet was used and the program scored a total of 31, suggesting the program is well planned and operating within standards. This evaluation of the Military EMS system on Okinawa using the NPS program assessment and audit worksheet demonstrates the NPS evaluation instruments may offer a useful assessment tool for the evaluation of Military EMS systems. Reprint & Copyright © 2017 Association of Military Surgeons of the U.S.

[Not Available].

PubMed

Latorre-Román, Pedro Ángel; Martínez-López, Emilio José; Ruiz-Ariza, Alberto; Izquierdo-Rus, Tomás; Salas-Sánchez, Jesús; García-Pinillos, Felipe

2016-06-30

Objetivo: el objetivo de este estudio es evaluar las propiedades psicométricas del cuestionario de disfrute por el ejercicio físico (PACES) en adolescentes con sobrepeso y obesidad.Métodos: participaron 139 adolescentes con sobrepeso y obesidad: 91 niñas (edad = 13,85 ± 1,92 años; índice de masa corporal [IMC] = 26,83 ± 3,16 kg/m2) y 48 niños (edad = 14,29 ± 1,62 años; IMC = 28,31 ± 3,74 kg/m2). Para analizar el disfrute por la actividad física se empleó el cuestionario Physical Activity Enjoyment Scale (PACES).Resultados: los resultados del análisis factorial exploratorio y confirmatorio han mostrado una estructura de dos factores; a su vez el PACES presenta una consistencia interna muy alta (alfa de Cronbach = 0,908). La fiabilidad test-retest indica una buena concordancia temporal (Spearman rho = 0,815, p < 0,001). Por último, el PACES en adolescentes con sobrepeso y obesidad manifiesta una validez convergente adecuada con la intencionalidad de ser activo (MIFA), la atracción por la actividad física (CAPA), la resistencia cardiorrespiratoria y los pliegues suprailiacoy subescapular.Conclusión: los resultados confirman que el PACES es una medida válida y fiable del disfrute por la actividad física en adolescentes con sobrepeso y obesidad. El disfrute por la actividad física puede ser relevante en la participación de los adolescentes con sobrepeso y obesidad en estas actividades.

Robust EM Continual Reassessment Method in Oncology Dose Finding

PubMed Central

Yuan, Ying; Yin, Guosheng

2012-01-01

The continual reassessment method (CRM) is a commonly used dose-finding design for phase I clinical trials. Practical applications of this method have been restricted by two limitations: (1) the requirement that the toxicity outcome needs to be observed shortly after the initiation of the treatment; and (2) the potential sensitivity to the prespecified toxicity probability at each dose. To overcome these limitations, we naturally treat the unobserved toxicity outcomes as missing data, and use the expectation-maximization (EM) algorithm to estimate the dose toxicity probabilities based on the incomplete data to direct dose assignment. To enhance the robustness of the design, we propose prespecifying multiple sets of toxicity probabilities, each set corresponding to an individual CRM model. We carry out these multiple CRMs in parallel, across which model selection and model averaging procedures are used to make more robust inference. We evaluate the operating characteristics of the proposed robust EM-CRM designs through simulation studies and show that the proposed methods satisfactorily resolve both limitations of the CRM. Besides improving the MTD selection percentage, the new designs dramatically shorten the duration of the trial, and are robust to the prespecification of the toxicity probabilities. PMID:22375092

Varying-energy CT imaging method based on EM-TV

NASA Astrophysics Data System (ADS)

Chen, Ping; Han, Yan

2016-11-01

For complicated structural components with wide x-ray attenuation ranges, conventional fixed-energy computed tomography (CT) imaging cannot obtain all the structural information. This limitation results in a shortage of CT information because the effective thickness of the components along the direction of x-ray penetration exceeds the limit of the dynamic range of the x-ray imaging system. To address this problem, a varying-energy x-ray CT imaging method is proposed. In this new method, the tube voltage is adjusted several times with the fixed lesser interval. Next, the fusion of grey consistency and logarithm demodulation are applied to obtain full and lower noise projection with a high dynamic range (HDR). In addition, for the noise suppression problem of the analytical method, EM-TV (expectation maximization-total Jvariation) iteration reconstruction is used. In the process of iteration, the reconstruction result obtained at one x-ray energy is used as the initial condition of the next iteration. An accompanying experiment demonstrates that this EM-TV reconstruction can also extend the dynamic range of x-ray imaging systems and provide a higher reconstruction quality relative to the fusion reconstruction method.

An Introduction to Emergency Medical Services (EMS). Pre-Hospital Phase. Emergency Medical Services Orientation, Lesson Plan No. 9.

ERIC Educational Resources Information Center

Young, Derrick P.

Designed for use with interested students at high schools, community colleges, and four-year colleges, this lesson plan was developed to provide an introduction to the pre-hospital phase of Emergency Medical Services (EMS) and to serve as a recruitment tool for the EMS Program at Kapiolani Community College (KCC) in Hawaii. The objectives of the…

Cateteres venosos centrais de inserção periférica: alternativa ou primeira escolha em acesso vascular?

PubMed Central

Di Santo, Marcelo Kalil; Takemoto, Diogo; Nascimento, Robert Guimarães; Nascimento, Ariele Milano; Siqueira, Érika; Duarte, Caio Túlio; Jovino, Marco Antônio Caldas; Kalil, Jorge Agle

2017-01-01

Resumo Contexto Os cateteres venosos centrais de inserção periférica (PICC) são dispositivos intravenosos, introduzidos através de uma veia superficial ou profunda da extremidade superior ou inferior até o terço distal da veia cava superior ou proximal da veia cava inferior. Apresentam maior segurança para infusão de soluções vesicantes/irritantes e hiperosmolares, antibioticoterapia, nutrição parenteral prolongada (NPT) e uso de quimioterápicos; demonstram reduzido risco de infecção em comparação a outros cateteres vasculares e maior relação custo/benefício se comparados ao cateter venoso de inserção central (CVCIC). Objetivos Apresentar os resultados de implantes de PICCs ecoguiados e posicionados por fluoroscopia realizados no Hospital e Maternidade São Luiz (HMSL) Itaim, Rede D’or, Brasil. Métodos Estudo prospectivo, não randomizado, realizado entre fevereiro de 2015 e novembro de 2016. Utilizou-se protocolo pré-estabelecido pela instituição em casos de solicitação de acesso vascular. Foram analisadas indicações, doenças prevalentes, tipo do cateter implantado, sucesso técnico, complicações relacionadas ao cateter, e estabelecidos critérios de inclusão e exclusão. Resultados Solicitados 256 acessos vasculares, sendo implantados 236 PICCs (92,1%) e 20 CVCICs (7,9%). Principais indicações: antibioticoterapia prolongada (52,0%), NPT (19,3%) e acesso venoso difícil (16,0%). Houve sucesso técnico em 246 cateteres implantados (96,1%). A veia basílica direita foi a principal veia puncionada em 192 pacientes (75,0%), seguida da braquial direita em 28 pacientes (10,9%). Conclusões O implante dos PICCs ecoguiados e posicionados por fluoroscopia demonstrou baixa incidência de complicações, reduzidos índices de infecção e é seguro e eficaz em casos de acessos vasculares difíceis, sendo esses cateteres considerados dispositivos de escolha em acesso vascular central.

Automatic CT Brain Image Segmentation Using Two Level Multiresolution Mixture Model of EM

NASA Astrophysics Data System (ADS)

Jiji, G. Wiselin; Dehmeshki, Jamshid

2014-04-01

Tissue classification in computed tomography (CT) brain images is an important issue in the analysis of several brain dementias. A combination of different approaches for the segmentation of brain images is presented in this paper. A multi resolution algorithm is proposed along with scaled versions using Gaussian filter and wavelet analysis that extends expectation maximization (EM) algorithm. It is found that it is less sensitive to noise and got more accurate image segmentation than traditional EM. Moreover the algorithm has been applied on 20 sets of CT of the human brain and compared with other works. The segmentation results show the advantages of the proposed work have achieved more promising results and the results have been tested with Doctors.

Using high-order polynomial basis in 3-D EM forward modeling based on volume integral equation method

NASA Astrophysics Data System (ADS)

Kruglyakov, Mikhail; Kuvshinov, Alexey

2018-05-01

3-D interpretation of electromagnetic (EM) data of different origin and scale becomes a common practice worldwide. However, 3-D EM numerical simulations (modeling)—a key part of any 3-D EM data analysis—with realistic levels of complexity, accuracy and spatial detail still remains challenging from the computational point of view. We present a novel, efficient 3-D numerical solver based on a volume integral equation (IE) method. The efficiency is achieved by using a high-order polynomial (HOP) basis instead of the zero-order (piecewise constant) basis that is invoked in all routinely used IE-based solvers. We demonstrate that usage of the HOP basis allows us to decrease substantially the number of unknowns (preserving the same accuracy), with corresponding speed increase and memory saving.

Computational Prediction of Atomic Structures of Helical Membrane Proteins Aided by EM Maps

PubMed Central

Kovacs, Julio A.; Yeager, Mark; Abagyan, Ruben

2007-01-01

Integral membrane proteins pose a major challenge for protein-structure prediction because only ≈100 high-resolution structures are available currently, thereby impeding the development of rules or empirical potentials to predict the packing of transmembrane α-helices. However, when an intermediate-resolution electron microscopy (EM) map is available, it can be used to provide restraints which, in combination with a suitable computational protocol, make structure prediction feasible. In this work we present such a protocol, which proceeds in three stages: 1), generation of an ensemble of α-helices by flexible fitting into each of the density rods in the low-resolution EM map, spanning a range of rotational angles around the main helical axes and translational shifts along the density rods; 2), fast optimization of side chains and scoring of the resulting conformations; and 3), refinement of the lowest-scoring conformations with internal coordinate mechanics, by optimizing the van der Waals, electrostatics, hydrogen bonding, torsional, and solvation energy contributions. In addition, our method implements a penalty term through a so-called tethering map, derived from the EM map, which restrains the positions of the α-helices. The protocol was validated on three test cases: GpA, KcsA, and MscL. PMID:17496035

Causal mechanisms of seismo-EM phenomena during the 1965-1967 Matsushiro earthquake swarm.

PubMed

Enomoto, Yuji; Yamabe, Tsuneaki; Okumura, Nobuo

2017-03-21

The 1965-1967 Matsushiro earthquake swarm in central Japan exhibited two unique characteristics. The first was a hydro-mechanical crust rupture resulting from degassing, volume expansion of CO 2 /water, and a crack opening within the critically stressed crust under a strike-slip stress. The other was, despite the lower total seismic energy, the occurrence of complexed seismo-electromagnetic (seismo-EM) phenomena of the geomagnetic intensity increase, unusual earthquake lights (EQLs) and atmospheric electric field (AEF) variations. Although the basic rupture process of this swarm of earthquakes is reasonably understood in terms of hydro-mechanical crust rupture, the associated seismo-EM processes remain largely unexplained. Here, we describe a series of seismo-EM mechanisms involved in the hydro-mechanical rupture process, as observed by coupling the electric interaction of rock rupture with CO 2 gas and the dielectric-barrier discharge of the modelled fields in laboratory experiments. We found that CO 2 gases passing through the newly created fracture surface of the rock were electrified to generate pressure-impressed current/electric dipoles, which could induce a magnetic field following Biot-Savart's law, decrease the atmospheric electric field and generate dielectric-barrier discharge lightning affected by the coupling effect between the seismic and meteorological activities.

Computational prediction of atomic structures of helical membrane proteins aided by EM maps.

PubMed

Kovacs, Julio A; Yeager, Mark; Abagyan, Ruben

2007-09-15

Integral membrane proteins pose a major challenge for protein-structure prediction because only approximately 100 high-resolution structures are available currently, thereby impeding the development of rules or empirical potentials to predict the packing of transmembrane alpha-helices. However, when an intermediate-resolution electron microscopy (EM) map is available, it can be used to provide restraints which, in combination with a suitable computational protocol, make structure prediction feasible. In this work we present such a protocol, which proceeds in three stages: 1), generation of an ensemble of alpha-helices by flexible fitting into each of the density rods in the low-resolution EM map, spanning a range of rotational angles around the main helical axes and translational shifts along the density rods; 2), fast optimization of side chains and scoring of the resulting conformations; and 3), refinement of the lowest-scoring conformations with internal coordinate mechanics, by optimizing the van der Waals, electrostatics, hydrogen bonding, torsional, and solvation energy contributions. In addition, our method implements a penalty term through a so-called tethering map, derived from the EM map, which restrains the positions of the alpha-helices. The protocol was validated on three test cases: GpA, KcsA, and MscL.

Causal mechanisms of seismo-EM phenomena during the 1965-1967 Matsushiro earthquake swarm

NASA Astrophysics Data System (ADS)

Enomoto, Yuji; Yamabe, Tsuneaki; Okumura, Nobuo

2017-03-01

The 1965-1967 Matsushiro earthquake swarm in central Japan exhibited two unique characteristics. The first was a hydro-mechanical crust rupture resulting from degassing, volume expansion of CO2/water, and a crack opening within the critically stressed crust under a strike-slip stress. The other was, despite the lower total seismic energy, the occurrence of complexed seismo-electromagnetic (seismo-EM) phenomena of the geomagnetic intensity increase, unusual earthquake lights (EQLs) and atmospheric electric field (AEF) variations. Although the basic rupture process of this swarm of earthquakes is reasonably understood in terms of hydro-mechanical crust rupture, the associated seismo-EM processes remain largely unexplained. Here, we describe a series of seismo-EM mechanisms involved in the hydro-mechanical rupture process, as observed by coupling the electric interaction of rock rupture with CO2 gas and the dielectric-barrier discharge of the modelled fields in laboratory experiments. We found that CO2 gases passing through the newly created fracture surface of the rock were electrified to generate pressure-impressed current/electric dipoles, which could induce a magnetic field following Biot-Savart’s law, decrease the atmospheric electric field and generate dielectric-barrier discharge lightning affected by the coupling effect between the seismic and meteorological activities.

Paediatric Virology as a new educational initiative: An interview with Nobelist Professor of Virology Harald zur Hausen.

PubMed

Mammas, Ioannis N; Spandidos, Demetrios A

2017-10-01

Born in Gelsenkirchen-Buer in Germany on March 11th, 1936, Professor Harald zur Hausen, Emeritus Professor of Virology at the University of Freiburg and 2008 Nobel Prize Laureate in Physiology or Medicine for his discovery of human papillomavirus (HPV), which causes cervical cancer, believes that good knowledge of virological methods and diagnostic possibilities are an asset for all young paediatricians. Professor zur Hausen considers that the creation of an educational platform on Paediatric Virology is definitely very beneficial for young paediatricians, as this will greatly enhance their knowledge in the field of Virology. He very actively advocates the vaccination of boys for the eradication of HPV infection and emphasises that male HPV vaccination should be included into the current vaccination programmes. He would have certainly considered Dr George N. Papanicolaou (Kyme, Island of Euboea, Greece, 1883 - Miami, Florida, USA, 1962) as an excellent candidate for the Nobel Prize, stating that the contribution of Dr Papanicolaou did not find sufficient recognition in the past. In the context of the 3rd Workshop on Paediatric Virology, which will be held in Athens, Greece, on October 7th, 2017, Professor zur Hausen will give his plenary lecture on 'Paediatric Virology and Oncology: Virus persistence and the important first years of life'.

Paediatric Virology as a new educational initiative: An interview with Nobelist Professor of Virology Harald zur Hausen

PubMed Central

Mammas, Ioannis N.; Spandidos, Demetrios A.

2017-01-01

Born in Gelsenkirchen-Buer in Germany on March 11th, 1936, Professor Harald zur Hausen, Emeritus Professor of Virology at the University of Freiburg and 2008 Nobel Prize Laureate in Physiology or Medicine for his discovery of human papillomavirus (HPV), which causes cervical cancer, believes that good knowledge of virological methods and diagnostic possibilities are an asset for all young paediatricians. Professor zur Hausen considers that the creation of an educational platform on Paediatric Virology is definitely very beneficial for young paediatricians, as this will greatly enhance their knowledge in the field of Virology. He very actively advocates the vaccination of boys for the eradication of HPV infection and emphasises that male HPV vaccination should be included into the current vaccination programmes. He would have certainly considered Dr George N. Papanicolaou (Kyme, Island of Euboea, Greece, 1883 - Miami, Florida, USA, 1962) as an excellent candidate for the Nobel Prize, stating that the contribution of Dr Papanicolaou did not find sufficient recognition in the past. In the context of the 3rd Workshop on Paediatric Virology, which will be held in Athens, Greece, on October 7th, 2017, Professor zur Hausen will give his plenary lecture on ‘Paediatric Virology and Oncology: Virus persistence and the important first years of life’. PMID:29042913

New technologies in cervical cancer precursor detection.

PubMed

Soler, M E; Blumenthal, P D

2000-09-01

The current literature reflects three routes toward improving cervical cancer screening. The first is to improve the test qualities of cytology-based screening. The use of liquid-based cytology and computerized analysis of Papanicolaou tests are examples of attempts at this approach. Secondly, through various combinations of parallel or sequential tests, either the sensitivity or the specificity of a given test could be improved depending on the tests chosen and the order in which they were performed (eg, Papanicolaou test followed by human papillomavirus [HPV] or vice versa). Several excellent studies have been published this year on the use of HPV DNA testing as a primary screening modality and as an adjunct to the triage of mildly abnormal cytologic findings. The recent literature also reflects increasing interest in visual inspection of the cervix and self-collected samples for HPV testing as an equally effective and viable alternative to cytology in low-resource settings. A third possibility is to make use of advances in digital and spectroscopic techniques. In these cost-conscious times, a significant number of articles address the cost-effectiveness of these technologies and the real value of cervical cancer screening. This article reviews the current literature concerning both the advent of new cervical cancer screening technologies and the rediscovery of old ones.

Cultural Psychology of Differences and EMS; a New Theoretical Framework for Understanding and Reconstructing Culture.

PubMed

Yamamoto, Toshiya

2017-09-01

In this paper I introduce the outlines of our new type of theoretical framework named 'Cultural psychology of Differences' for understanding cultural others and dialogically reconstructing interactions among cultural others. In order to understand cultural others, it is necessary for us to reconstruct a new concept which enables us to analyze dynamic generation processes of culture. We propose the concept of Expanded Mediational Structure, EMS, as an elementary unit for understanding human social interactions. EMS is composed of subjects who interacts each other using objects of some kind as mediators, and a normative mediator, NM, which mediates their interactions. It is necessary to generate, share and adjust a NM to keep social interactions stable, and culture will appear when interaction malfunction is attributed to a gaps of NMs. The concept of EMS helps us to understand how culture is functionally substantialized in the plane of collective (or communal) intersubjectivity and how cultural conflicts develop and intensify. Focusing on the generation process of culture through interactions provides us with another option to understand cultural others through dialogical interactions with them.

2.2 Å resolution cryo-EM structure of β-galactosidase in complex with a cell-permeant inhibitor.

PubMed

Bartesaghi, Alberto; Merk, Alan; Banerjee, Soojay; Matthies, Doreen; Wu, Xiongwu; Milne, Jacqueline L S; Subramaniam, Sriram

2015-06-05

Cryo-electron microscopy (cryo-EM) is rapidly emerging as a powerful tool for protein structure determination at high resolution. Here we report the structure of a complex between Escherichia coli β-galactosidase and the cell-permeant inhibitor phenylethyl β-D-thiogalactopyranoside (PETG), determined by cryo-EM at an average resolution of ~2.2 angstroms (Å). Besides the PETG ligand, we identified densities in the map for ~800 water molecules and for magnesium and sodium ions. Although it is likely that continued advances in detector technology may further enhance resolution, our findings demonstrate that preparation of specimens of adequate quality and intrinsic protein flexibility, rather than imaging or image-processing technologies, now represent the major bottlenecks to routinely achieving resolutions close to 2 Å using single-particle cryo-EM. Copyright © 2015, American Association for the Advancement of Science.

EmPOWERing Children with Learning Disabilities: A Practitioner-Based Reflection

ERIC Educational Resources Information Center

Cass, Richard J.

2011-01-01

Recent reports indicate that the expressive writing needs of students who struggle have become a critical and life-influencing problem. This article provides an overview of current research on the writing needs of students with LD and a practitioner-based reflection on the Singer and Bashir EmPOWER approach, a resource that can help teachers meet…

Structure of the 30 kDa HIV-1 RNA Dimerization Signal by a Hybrid Cryo-EM, NMR, and Molecular Dynamics Approach.

PubMed

Zhang, Kaiming; Keane, Sarah C; Su, Zhaoming; Irobalieva, Rossitza N; Chen, Muyuan; Van, Verna; Sciandra, Carly A; Marchant, Jan; Heng, Xiao; Schmid, Michael F; Case, David A; Ludtke, Steven J; Summers, Michael F; Chiu, Wah

2018-03-06

Cryoelectron microscopy (cryo-EM) and nuclear magnetic resonance (NMR) spectroscopy are routinely used to determine structures of macromolecules with molecular weights over 65 and under 25 kDa, respectively. We combined these techniques to study a 30 kDa HIV-1 dimer initiation site RNA ([DIS] 2 ; 47 nt/strand). A 9 Å cryo-EM map clearly shows major groove features of the double helix and a right-handed superhelical twist. Simulated cryo-EM maps generated from time-averaged molecular dynamics trajectories (10 ns) exhibited levels of detail similar to those in the experimental maps, suggesting internal structural flexibility limits the cryo-EM resolution. Simultaneous inclusion of the cryo-EM map and 2 H-edited NMR-derived distance restraints during structure refinement generates a structure consistent with both datasets and supporting a flipped-out base within a conserved purine-rich bulge. Our findings demonstrate the power of combining global and local structural information from these techniques for structure determination of modest-sized RNAs. Copyright © 2018 Elsevier Ltd. All rights reserved.

Routine single particle CryoEM sample and grid characterization by tomography

PubMed Central

Noble, Alex J; Brasch, Julia; Chase, Jillian; Acharya, Priyamvada; Tan, Yong Zi; Zhang, Zhening; Kim, Laura Y; Scapin, Giovanna; Rapp, Micah; Eng, Edward T; Rice, William J; Cheng, Anchi; Negro, Carl J; Shapiro, Lawrence; Kwong, Peter D; Jeruzalmi, David; des Georges, Amedee; Potter, Clinton S

2018-01-01

Single particle cryo-electron microscopy (cryoEM) is often performed under the assumption that particles are not adsorbed to the air-water interfaces and in thin, vitreous ice. In this study, we performed fiducial-less tomography on over 50 different cryoEM grid/sample preparations to determine the particle distribution within the ice and the overall geometry of the ice in grid holes. Surprisingly, by studying particles in holes in 3D from over 1000 tomograms, we have determined that the vast majority of particles (approximately 90%) are adsorbed to an air-water interface. The implications of this observation are wide-ranging, with potential ramifications regarding protein denaturation, conformational change, and preferred orientation. We also show that fiducial-less cryo-electron tomography on single particle grids may be used to determine ice thickness, optimal single particle collection areas and strategies, particle heterogeneity, and de novo models for template picking and single particle alignment. PMID:29809143

Código para imageamento indireto de estrelas em sistemas binarios: simulação de variações elipsoidais e do perfil das linhas

NASA Astrophysics Data System (ADS)

Souza, T. R.; Baptista, R.

2003-08-01

As estrelas secundárias em variáveis cataclí smicas (VCs) e binárias-x de baixa massa (BXBMs) são cruciais para o entendimento da origem, evolução e comportamento destas binárias interagentes. Elas são estrelas magneticamente ativas submetidas a condições ambientais extremas [e.g., estão muito próximas de uma fonte quente e irradiante; têm rotação extremamente rápida e forma distorcida; estão perdendo massa a taxas de 10-8-10-10 M¤/ano] que contribuem para que suas propriedades sejam distintas das de estrelas de mesma massa na seqüência principal. Por outro lado, o padrão de irradiação na face da secundária fornece informação sobre a geometria das estruturas de acréscimo em torno da estrela primária. Assim, a obtenção de imagens da superfície destas estrelas é de grande interesse astrofísico. A Tomografia Roche usa as variações no perfil das linhas de emissão/absorção da estrela secundária em função da fase orbital para mapear a distribuição de brilho em sua superfície. Neste trabalho apresentamos os resultados iniciais do desenvolvimento de um programa para o mapeamento da distribuição de brilho na superfí cie das estrelas secundárias em VCs e BXBMs com técnicas de astro-tomografia. Presentemente temos em operação um código que simula as variações no perfil das linhas em conseqüência de efeito Doppler resultante da combinação de rotação e translação de uma estrela em forma de lobo de Roche em torno do centro de massa da binária, em função da distribuição de brilho na superfície desta estrela. O código igualmente produz a curva de luz resultante das variações de aspecto da estrela em função da fase orbital (variações elipsoidais).

Cervical cancer screening and updated Pap guidelines.

PubMed

Warren, Johanna B; Gullett, Heidi; King, Valerie J

2009-03-01

Cervical cancer and its dysplasia precursors account for significant morbidity and mortality in women worldwide. Human papillomavirus infection is common, preventable, and now widely accepted as the causative agent with oncogenic potential in the development of cervical cancer. Screening via Papanicolaou testing is critical, and interpretation of test results with knowledge of patient risk factors is imperative. Many evidence-based guidelines for screening, interpretation, and management have been developed and are widely available for use.

Incident Diagnoses of Cancers and Cancer-related Deaths, Active Component, U.S. Armed Forces, 2000-2011

DTIC Science & Technology

2012-06-01

diagnosis was older age. For example, for all cancer sites except the cervix and tes- ticle, the highest rates of diagnoses were among those older than... cancer screening exami- nations such as mammography, prostate specifi c antigen (PSA) testing, cytological examination of the cervix (Papanicolaou...M S M R Vol. 19 No. 6 June 2012Page 18 Incident Diagnoses of Cancers and Cancer -related Deaths, Active Component, U.S. Armed Forces, 2000-2011

The effect of feed supplementation with effective microorganisms (EM) on pro- and anti-inflammatory cytokine concentrations in pigs.

PubMed

Laskowska, Ewa; Jarosz, Łukasz; Grądzki, Zbigniew

2017-12-01

Effective microorganisms (EM) are used in numerous fields associated with agriculture. The beneficial effects of EM on the general health of pigs and on production parameters are also determined by the influence of these microbes on immunity. The aim of the study was to assess the effect of feed supplementation with EM on the concentration of pro- and anti-inflammatory cytokines in the serum and in a culture of PBMCs with and without ConA stimulation in pigs. ELISA kits were used to determine the cytokine levels in the porcine serum and the PBMC culture supernatants. Evaluation of the serum concentration of cytokines revealed statistically significantly higher concentrations of IL-2, IL-4, IL-10, IFN-γ and TNF-α in the pigs receiving EM Bokashi. The highest concentration of TGF-β in the experimental group was noted on the final test day. Evaluation of cytokine concentrations in the PBMC cultures revealed statistically significantly higher concentrations of IL-2, IL-4 and IL-10 from the third day of the experiment. Statistically significantly higher concentrations of TNF-α were obtained in the unstimulated PBMC culture on the second test day and in the culture treated with ConA on the second and the third test days. The results of our study indicate that supplementation of pig feed with EM Bokashi activates the cell-mediated and humoral immune response, ensuring that Th1/Th2 balance is maintained and enhancing immune processes protecting the body against infection. Copyright © 2017. Published by Elsevier Ltd.

Método numérico das diferenças finitas no domínio do tempo aplicado a ondas Alfvén em plasma astrofísico

NASA Astrophysics Data System (ADS)

Dos Santos, L. C.; Kintopp, J. A.; Jatenco-Pereira, V.; Opher, R.

2003-08-01

Ondas Alfvén em plasma astrofísico têm sido objeto de intenso estudo nas últimas décadas pelo fato de apresentarem papel importante em muitas áreas de pesquisa na astrofísica. Particularmente são importantes no mecanismo de aquecimento da coroa solar; em ventos estelares; em jatos galácticos e extragalácticos; em discos protoestelares, etc. A formulação para diferenças finitas no domínio do tempo (FDTD), aplicada a plasma magnetizado é desenvolvida para estudo das propriedades de ondas Alfvén em três dimensões (3D-FDTD). O método é aplicado inicialmente a um plasma homogêneo e isotérmico imerso em uma região com campo magnético externo B0, que sofre uma pequena perturbação. Uma vez gerada a onda, esta perturbação é retirada e, então analisamos a evolução temporal das ondas, bem como a forma de seu amortecimento.

Assessment of peak skin dose in interventional cardiology: A comparison between Gafchromic film and dosimetric software em.dose.

PubMed

Greffier, J; Van Ngoc Ty, C; Bonniaud, G; Moliner, G; Ledermann, B; Schmutz, L; Cornillet, L; Cayla, G; Beregi, J P; Pereira, F

2017-06-01

To compare the use of a dose mapping software to Gafchromic film measurement for a simplified peak skin dose (PSD) estimation in interventional cardiology procedure. The study was conducted on a total of 40 cardiac procedures (20 complex coronary angioplasty of chronic total occlusion (CTO) and 20 coronary angiography and coronary angioplasty (CA-PTCA)) conducted between January 2014 to December 2015. PSD measurement (PSD Film ) was obtained by placing XR-RV3 Gafchromic under the patient's back for each procedure. PSD (PSD em.dose ) was computed with the software em.dose©. The calculation was performed on the dose metrics collected from the private dose report of each procedure. Two calculation methods (method A: fluoroscopic kerma equally spread on cine acquisition and B: fluoroscopic kerma is added to one air Kerma cine acquisition that contributes to the PSD) were used to calculate the fluoroscopic dose contribution as fluoroscopic data were not recorded in our interventional room. Statistical analyses were carried out to compare PSD Film and PSD em.dose . The PSD Film median (1st quartile; 3rd quartile) was 0.251(0.190;0.336)Gy for CA-PTCA and 1.453(0.767;2.011)Gy for CTO. For method-A, the PSD em.dose was 0.248(0.182;0.369)Gy for CA-PTCA and 1.601(0.892;2.178)Gy for CTO, and 0.267(0.223;0.446)Gy and 1.75 (0.912;2.584)Gy for method-B, respectively. For the two methods, the correlation between PSD Film and PSD em.dose was strong. For all cardiology procedures investigated, the mean deviation between PSD Film and PSD em.dose was 3.4±21.1% for method-A and 17.3%±23.9% for method-B. The dose mapping software is convenient to calculate peak skin dose in interventional cardiology. Copyright © 2017 Associazione Italiana di Fisica Medica. Published by Elsevier Ltd. All rights reserved.

Estudo de propriedades estruturais e opticas de multicamadas epitaxiais emissoras de luz baseadas em InGaN/GaN

NASA Astrophysics Data System (ADS)

Pereira, Sergio Manuel de Sousa

Esta tese apresenta os resultados de uma investigacao experimental em filmes epitaxiais emissores de luz baseados em InxGa1-xN. O InxGa1-xN e uma liga semicondutora ternaria do grupo III-N muito utilizada como camada activa numa gama de dispositivos optoelectronicos em desenvolvimento, incluindo diodos emissores de luz (LEDs) e diodos laser (LDs), para operacao na regiao do visivel e ultravioleta do espectro electromagnetico. Neste estudo, caracterizam-se as propriedade opticas e estruturais de camadas simples e pocos quânticos multiplos (Multiple Quantum Wells, MQWs) de InxGa1-xN/GaN, com enfase nas suas propriedades fisicas fundamentais. O objectivo central do trabalho prende-se com a compreensao mais profunda dos processos fisicos que estao por tras das suas propriedades opticas, preenchendo o fosso existente entre aplicacoes tecnologicas e o conhecimento cientifico. Nomeadamente, a tese aborda os problemas da medicao da fraccao de InN (x) em multicamadas ultrafinas sujeitas a tensoes, a influencia da composicao e das tensoes microscopicas nas propriedades opticas e estruturais. A questao relativa a segregacao de fases em multicamadas de InxGa1-xN/GaN e tambem discutida a luz dos resultados obtidos. A metodologia seguida assenta na integracao de resultados obtidos por tecnicas complementares atraves de uma analise sistematica e multidisciplinar. Esta abordagem passa pela combinacao de: 1) Crescimento de amostras por deposicao epitaxial em fase de vapor organometalico (MOVPE) com caracteristicas especificas de forma a tentar isolar parâmetros estruturais, tais como espessura e composicao; 2) Caracterizacao nanoestrutural por microscopia de forca atomica (AFM), microscopica electronica de varrimento (SEM), difraccao de raios-X e retro-dispersao de Rutherford (RBS); 3) Caracterizacao optica a escalas complementares por: espectroscopia de absorcao optica (OA), fotoluminescencia (PL), catodoluminescencia (CL) e microscopia confocal (CM) com analise espectral. Com

A Fast and Effective Microfluidic Spraying-Plunging Method for High-Resolution Single-Particle Cryo-EM.

PubMed

Feng, Xiangsong; Fu, Ziao; Kaledhonkar, Sandip; Jia, Yuan; Shah, Binita; Jin, Amy; Liu, Zheng; Sun, Ming; Chen, Bo; Grassucci, Robert A; Ren, Yukun; Jiang, Hongyuan; Frank, Joachim; Lin, Qiao

2017-04-04

We describe a spraying-plunging method for preparing cryoelectron microscopy (cryo-EM) grids with vitreous ice of controllable, highly consistent thickness using a microfluidic device. The new polydimethylsiloxane (PDMS)-based sprayer was tested with apoferritin. We demonstrate that the structure can be solved to high resolution with this method of sample preparation. Besides replacing the conventional pipetting-blotting-plunging method, one of many potential applications of the new sprayer is in time-resolved cryo-EM, as part of a PDMS-based microfluidic reaction channel to study short-lived intermediates on the timescale of 10-1,000 ms. Published by Elsevier Ltd.

Yeast Inner-Subunit PA-NZ-1 Labeling Strategy for Accurate Subunit Identification in a Macromolecular Complex through Cryo-EM Analysis.

PubMed

Wang, Huping; Han, Wenyu; Takagi, Junichi; Cong, Yao

2018-05-11

Cryo-electron microscopy (cryo-EM) has been established as one of the central tools in the structural study of macromolecular complexes. Although intermediate- or low-resolution structural information through negative staining or cryo-EM analysis remains highly valuable, we lack general and efficient ways to achieve unambiguous subunit identification in these applications. Here, we took advantage of the extremely high affinity between a dodecapeptide "PA" tag and the NZ-1 antibody Fab fragment to develop an efficient "yeast inner-subunit PA-NZ-1 labeling" strategy that when combined with cryo-EM could precisely identify subunits in macromolecular complexes. Using this strategy combined with cryo-EM 3D reconstruction, we were able to visualize the characteristic NZ-1 Fab density attached to the PA tag inserted into a surface-exposed loop in the middle of the sequence of CCT6 subunit present in the Saccharomyces cerevisiae group II chaperonin TRiC/CCT. This procedure facilitated the unambiguous localization of CCT6 in the TRiC complex. The PA tag was designed to contain only 12 amino acids and a tight turn configuration; when inserted into a loop, it usually has a high chance of maintaining the epitope structure and low likelihood of perturbing the native structure and function of the target protein compared to other tagging systems. We also found that the association between PA and NZ-1 can sustain the cryo freezing conditions, resulting in very high occupancy of the Fab in the final cryo-EM images. Our study demonstrated the robustness of this strategy combined with cryo-EM in efficient and accurate subunit identification in challenging multi-component complexes. Copyright © 2018 Elsevier Ltd. All rights reserved.

EMS Activations for School-Aged Children From Public Buildings, Places of Recreation or Sport, and Health Care Facilities in Pennsylvania.

PubMed

Catherine, Andrew T; Olympia, Robert P

2016-06-01

To determine the etiology of emergency medical services (EMS) activations in 2011 to public buildings, places of recreation or sport, and health care facilities involving children aged 5 to 18 years in Pennsylvania. Electronic records documenting 2011 EMS activations as provided by the Pennsylvania Department of Health's Bureau of EMS were reviewed. Data elements (demographics, dispatch complaint, mechanism of injury, primary assessment) from patients aged 5 to 18 years involved in an EMS response call originating from either a public building, a place of recreation and sport, or health care facility were analyzed. A total of 12,289 records were available for analysis. The most common primary assessments from public buildings were traumatic injury, behavioral/psychiatric disorder, syncope/fainting, seizure, and poisoning. The most common primary assessments from places of recreation or sport were traumatic injury, syncope/fainting, altered level of consciousness, respiratory distress, and abdominal pain. The most common primary assessments from health care facilities were behavioral/psychiatric disorder, traumatic injury, abdominal pain, respiratory distress, and syncope/fainting. When examining the mechanism of injury for trauma-related primary assessments, falls were the most common mechanism at all 3 locations, followed by being struck by an object. Of the 1335 serious-incident calls (11% of the total EMS activations meeting inclusion criteria), 61.2% were from public buildings, 14.1% from places of recreation or sport, and 24.7% from health care facilities. Our identification of common EMS dispatch complaints, mechanisms of injury, and primary assessments can be used in the education of staff and preparation of facilities for medical emergencies and injuries where children spend time.

Tritium contamination at EG&G/EM in North Las Vegas, Nevada

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

Sowell, C.V.; Arent, L.J.

1996-06-01

The tritium contamination discovered at the EG&G Energy Measurements (EG&G/EM) facility in North Las Vegas, Nevada, on 20 April 1995, could have been averted by good health physics practices and/or adequate management oversight. Scandium tritide (ScT{sub 3}) targets were installed for use in sealed tube neutron generators at EG&G/EM. In addition, EG&G/EM was also storing zirconium tritide (ZrT{sub 3}) and titanium tritide (TiT{sub 3}) foils. Since the targets were classified as sealed sources, the appropriate administrative and engineering control measures such as relocating targets/sources, air monitoring, bioassay, waste stream management, labeling/posting and training were not implemented. In all there weremore » six unreported incidents of tritium contamination from March 1994 to July 1995. Swipe surveys revealed areas exceeding the action level of 10,000 dpm/100 cm{sup 2} by up to three orders of magnitude. After reclassifying the targets as unsealed sources, a bioassay program was instituted, and the results were higher than expected for three employees. The doses assigned to the three individuals working in the contaminated area were 35, 58, and 61 mrem committed effective dose equivalent. Though the doses were low, the decontamination costs were in excess of $350,000.00. An investigation, was initiated by the U.S. Department of Energy Nevada Operations Office to analyze the events that led to the tritium contamination and recommend actions to prevent recurrence. Event and causal factor charting, Project Evaluation Tree (PET) analysis techniques, and root cause analysis, were used to evaluate management systems, causal sequences, and systems factors contributing to the tritium release.« less

The EmX Franklin Corridor BRT project evaluation : final report, April 2009.

DOT National Transportation Integrated Search

2009-04-01

Lane Transit District began BRT service on its Franklin Corridor EmX in January 14, 2007. The four mile long route connects downtown Eugene and downtown Springfield, the two main hubs for LTDs system. The corridor, which has the greatest ridership...

The importance of mantle wedge heterogeneity to subduction zone magmatism and the origin of EM1

NASA Astrophysics Data System (ADS)

Turner, Stephen J.; Langmuir, Charles H.; Dungan, Michael A.; Escrig, Stephane

2017-08-01

The composition of the convecting asthenospheric mantle that feeds the mantle wedge can be investigated via rear-arc lavas that have minimal slab influence. This "ambient mantle wedge" composition (the composition of the wedge prior to the addition of a slab component) varies substantially both worldwide and within individual arcs. 143Nd/144Nd measurements of rear-arc samples that have minimal slab influence are similar to 143Nd/144Nd in the stratovolcanoes of the adjacent volcanic fronts, suggesting that 143Nd/144Nd of arc-front volcanics are largely inherited from the ambient mantle composition. 143Nd/144Nd correlates with ratios such as Th/U, Zr/Nb, and La/Sm, indicating that these ratios also are strongly influenced by ambient wedge heterogeneity. The same phenomenon is observed among individual volcanoes from the Chilean Southern Volcanic Zone (SVZ), where along-strike variability of the volcanic front tracks that of rear-arc monogenetic volcanics. Depleted mantle wedges are more strongly influenced by slab-derived components than are enriched wedges. This leads to surprising trace element correlations in the global dataset, such as between Pb/Nb and Zr/Nb, which are not explicable by variable compositions or fluxes of slab components. Depleted ambient mantle is present beneath arcs with back-arc spreading; relatively enriched mantle is present adjacent to continents. Ambient mantle wedge heterogeneity both globally and regionally forms isotope mixing trajectories for Sr, Nd and Hf between depleted mantle and EM1-type enriched compositions as represented by Gough Island basalts. Making use of this relationship permits a quantitative match with the SVZ data. It has been suggested that EM1-type mantle reservoirs are the result of recycled lower continental crust, though such models do not account for certain trace element ratios such as Ce/Pb and Nb/U or the surprisingly homogeneous trace element compositions of EM1 volcanics. A model in which the EM1 end

Preliminary Results from an Integrated Airborne EM and Aeromagnetic Survey in Yellowstone National Park

NASA Astrophysics Data System (ADS)

Dickey, K.; Holbrook, W. S.; Finn, C.; Auken, E.; Carr, B.; Sims, K. W. W.; Bedrosian, P.; Lowenstern, J. B.; Hurwitz, S.; Pedersen, J. B. B.

2017-12-01

Yellowstone National Park hosts over 10,000 thermal features (e.g. geysers, fumaroles, mud pots, and hot springs), yet little is known about the circulation depth of meteoric water feeding these features, nor the lithological and structural bounds on the pathways that guide deep, hot fluids to the surface. Previous near-surface geophysical studies have been effective in imaging shallow hydrothermal pathways in some areas of the park, but these methods are difficult to conduct over the large areas needed to characterize entire hydrothermal systems. Transient electromagnetic (TEM) soundings and 2D direct current (DC) resistivity profiles show that hydrothermal fluids at active sites have a higher electrical conductivity than the surrounding hydrothermally inactive areas. For that reason, airborne TEM is an effective method to characterize large areas and identify hydrothermally active and inactive zones using electrical conductivity. Aeromagnetic data have been useful in mapping faults that localize hot springs, making the integration of aeromagnetic and EM data effective for structurally characterizing fluid pathways. Here we present the preliminary results from an airborne transient electromagnetic (TEM) and magnetic survey acquired jointly by the U.S. Geological Survey (USGS) and the University of Wyoming (UW) in November 2016. We integrate the EM and magnetic data for the purpose of edge detection of rhyolite flow boundaries as well as source depth of hydrothermal features. The maximum horizontal gradient technique applied on magnetic data is a useful tool that used to estimate source depth as well as indicate faults and fractures. The integration of EM with magnetics allows us to distinguish hydrothermally altered fault systems that guide fluids in the subsurface. We have used preliminary 2D inversions of EM from Aarhus Workbench to delineate rhyolite flow edges in the upper 300-600 meters and cross-checked those boundaries with the aeromagnetic map.