20 CFR 670.610 - When are students authorized to take leaves of absence from their Job Corps centers?

Code of Federal Regulations, 2010 CFR

2010-04-01

... 20 Employees' Benefits 3 2010-04-01 2010-04-01 false When are students authorized to take leaves... Student Support § 670.610 When are students authorized to take leaves of absence from their Job Corps centers? Job Corps students are eligible for annual leaves, emergency leaves and other types of leaves of...

Factors Affecting Sexual History Taking in a Health Center Serving Homeless Persons.

PubMed

Sowicz, Timothy Joseph; Bradway, Christine K

2018-03-01

Low rates of documentation of sexual histories have been reported and research on sexual history taking (SHT) has focused on the content of, barriers to collecting, and interventions to improve documentation of sexual histories. Absent from this literature is an understanding of the contextual factors affecting SHT. To address this gap, a focused ethnography of one health center was conducted. Data were collected through observations of health care encounters and interviews with health care providers (HCPs). No SHT was observed and this was likely influenced by patients' characteristics, communication between patients and HCPs, the prioritization of patients' basic needs, and time constraints imposed upon encounters. Given that the health center studied serves patients experiencing homelessness, behavioral health concerns, and opioid use disorder, findings illuminate areas for future inquiry into a patient population affected by social as well as physiologic determinants of health and potentially at high risk for adverse sexual health outcomes.

An evaluation of composite propulsion for single-stage-to-orbit vehicles designed for horizontal take-off

NASA Technical Reports Server (NTRS)

Martin, J. A.

1977-01-01

Composite propulsion was analyzed for single-stage-to-orbit vehicles designed for horizontal take-off. Trajectory, geometric, and mass analyses were performed to establish the orbital payload capability of six engines. The results indicated that none of the engines performed adequately to deliver payloads to orbit as analyzed. The single-stage turbine and oxidizer-rich gas generator resulted in a low engine specific impulse, and the performance increment of the ejector subsystem was less than that of a separate rocket system with a high combustion pressure. There was a benefit from incorporating a fan into the engine, and removal of the fan from the airstream during the ramjet mode increased the orbital payload capability.

Obama Kennedy Space Center Visit

NASA Image and Video Library

2010-04-14

President Barack Obama takes the stage after being introduced by NASA Administrator Charles Bolden, right, and US Senator Bill Nelson (D-FL) during an event where Obama outlined a bold new course the administration is charting to maintain U.S. leadership in human space flight at the NASA Kennedy Space Center in Cape Canaveral, Fla. on Thursday, April 15, 2010. Photo Credit: (NASA/Bill Ingalls)

Nurses take center stage in private duty home care.

PubMed

Brackett, Nicole

2013-06-01

The Affordable Care Act gives America's largest group of health care providers--nurses--a unique chance to lead in improving outcomes, increasing patient satisfaction, and lowering costs. Nurses' roles continue to grow in settings from hospitals and long-term care facilities to home health and hospice agencies. Nurses are also key players in private duty home care, where they serve as care coordinators for clients. Working directly with doctors, therapists, in-home caregivers, and families, nurses are critical in delivering quality, seamless in-home care.

User-friendly chemistry takes center stage at ACS meeting

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

Pool, R.

1992-09-11

These days it seems that what chemistry needs more than anything else is a good p.r. agent. If you ask John or Joan Q. Public about the accomplishments of the chemical industry, chances are they'll mention Love Canal, CFCs destroying the ozone layer, or carcinogens in food. However, if the national meeting of the American Chemical Society in Washington, D.C., 2 weeks ago is any indication, chemists are working hard to fix the image problem. Nearly all of the two dozen press conferences held during the meeting focused on food, health topics, environment-friendly technology, or some other subject close tomore » consumers' hearts. And the scientific talks themselves reflected the same interests, with sessions such as Environmental Successes in the Chemical Industry', Food Phytochemicals for Cancer Prevention', Chemistry of Electrophilic Metal Complexes', New Advances in Polyolefin Polymers', Zapping acid rain with microwaves.'« less

Taking centre stage...

NASA Astrophysics Data System (ADS)

1998-11-01

HAMLET (Highly Automated Multimedia Light Enhanced Theatre) was the star performance at the recent finals of the `Young Engineer for Britain' competition, held at the Commonwealth Institute in London. This state-of-the-art computer-controlled theatre lighting system won the title `Young Engineers for Britain 1998' for David Kelnar, Jonathan Scott, Ramsay Waller and John Wyllie (all aged 16) from Merchiston Castle School, Edinburgh. HAMLET replaces conventional manually-operated controls with a special computer program, and should find use in the thousands of small theatres, schools and amateur drama productions that operate with limited resources and without specialist expertise. The four students received a £2500 prize between them, along with £2500 for their school, and in addition they were invited to spend a special day with the Royal Engineers. A project designed to improve car locking systems enabled Ian Robinson of Durham University to take the `Working in industry award' worth £1000. He was also given the opportunity of a day at sea with the Royal Navy. Other prizewinners with their projects included: Jun Baba of Bloxham School, Banbury (a cardboard armchair which converts into a desk and chair); Kobika Sritharan and Gemma Hancock, Bancroft's School, Essex (a rain warning system for a washing line); and Alistair Clarke, Sam James and Ruth Jenkins, Bishop of Llandaff High School, Cardiff (a mechanism to open and close the retractable roof of the Millennium Stadium in Cardiff). The two principal national sponsors of the competition, which is organized by the Engineering Council, are Lloyd's Register and GEC. Industrial companies, professional engineering institutions and educational bodies also provided national and regional prizes and support. During this year's finals, various additional activities took place, allowing the students to surf the Internet and navigate individual engineering websites on a network of computers. They also visited the

Take a Bow

ERIC Educational Resources Information Center

Spitzer, Greg; Ogurek, Douglas J.

2009-01-01

Performing-arts centers can provide benefits at the high school and collegiate levels, and administrators can take steps now to get the show started. When a new performing-arts center comes to town, local businesses profit. Events and performances draw visitors to the community. Ideally, a performing-arts center will play many roles: entertainment…

Thrust vector control of upper stage with a gimbaled thruster during orbit transfer

NASA Astrophysics Data System (ADS)

Wang, Zhaohui; Jia, Yinghong; Jin, Lei; Duan, Jiajia

2016-10-01

In launching Multi-Satellite with One-Vehicle, the main thruster provided by the upper stage is mounted on a two-axis gimbal. During orbit transfer, the thrust vector of this gimbaled thruster (GT) should theoretically pass through the mass center of the upper stage and align with the command direction to provide orbit transfer impetus. However, it is hard to be implemented from the viewpoint of the engineering mission. The deviations of the thrust vector from the command direction would result in large velocity errors. Moreover, the deviations of the thrust vector from the upper stage mass center would produce large disturbance torques. This paper discusses the thrust vector control (TVC) of the upper stage during its orbit transfer. Firstly, the accurate nonlinear coupled kinematic and dynamic equations of the upper stage body, the two-axis gimbal and the GT are derived by taking the upper stage as a multi-body system. Then, a thrust vector control system consisting of the special attitude control of the upper stage and the gimbal rotation of the gimbaled thruster is proposed. The special attitude control defined by the desired attitude that draws the thrust vector to align with the command direction when the gimbal control makes the thrust vector passes through the upper stage mass center. Finally, the validity of the proposed method is verified through numerical simulations.

Do school-based health centers improve adolescents' access to health care, health status, and risk-taking behavior?

PubMed

Kisker, E E; Brown, R S

1996-05-01

The purpose of this investigation was to assess the School-Based Adolescent Health Care Program, which provided comprehensive health-related services in 24 school-based health centers. The outcomes evaluation compared a cohort of students attending 19 participating schools and a national sample of urban youths, using logit models to control for observed differences between the two groups of youths. Outcome measures included self-reports concerning health center utilization, use of other health care providers, knowledge of key health facts, substance use, sexual activity, contraceptive use, pregnancies and births, and health status. The health centers increased students' access to health care and improved their health knowledge. However, the estimated impacts on health status and risky behaviors were inconsistent, and most were small and not statistically significant. School-based health centers can increase students' health knowledge and access to health-related services, but more intensive or different services are needed if they are to significantly reduce risk-taking behaviors.

Putting equity center stage: challenging evidence-free reforms.

PubMed

Whitehead, Margaret; Dahlgren, Göran; McIntyre, Di

2007-01-01

Do we have an "evidence-free zone" around the health sector reforms that have taken place over the past few decades? Certainly, many of the policy prescriptions have been based on ideology and assumptions about the likely impact of policies, rather than evidence-based. The provision of health care is increasingly treated as a commodity that can be subjected to the same prescription as other goods: privatization, competition, deregulation, decentralization. Evidence has slowly emerged over the 1990s and early 2000s on the adverse effects of these policy prescriptions on equity, particularly in low- and middle-income countries, but a shift in policy is barely perceptible. There is a need for a fresh approach that puts equity center stage. A gap that must be filled is on the "demand" or "need" side: in particular, the impact of policy changes on families and communities. This article is the first in a series of eight articles that present the findings of studies that attempt to fill this gap, helping to develop a more evidence-based approach to equity and health sector policy from the users'/potential patients' perspective.

Altus I aircraft taking off from lakebed runway

NASA Technical Reports Server (NTRS)

1997-01-01

The remotely-piloted Altus I aircraft takes off from Rogers Dry Lake adjacent to NASA's Dryden Flight Research Center, Edwards, Calif. The short series of test flights sponsored by the Naval Postgraduate School in early August, 1997, were designed to demonstrate the ability of the experimental craft to cruise at altitudes above 40,000 feet for sustained durations. On its final flight Aug. 15, the Altus I reached an altitude of 43,500 feet. The Altus I and its sister ship, the Altus II, are variants of the Predator surveillance drone built by General Atomics/Aeronautical Systems, Inc. They are designed for high-altitude, long-duration scientific sampling missions, and are powered by turbocharged piston engines. The Altus I incorporates a single-stage turbocharger, while the Altus II, built for NASA's Environmental Research Aircraft and Sensor Technology program, sports a two-stage turbocharger to enable the craft to fly at altitudes above 55,000 feet.

A comparison of center-based vs. home-based daily hemodialysis for patients with end-stage renal disease.

PubMed

Kraus, Michael; Burkart, John; Hegeman, Rebecca; Solomon, Richard; Coplon, Norman; Moran, John

2007-10-01

Home hemodialysis has been a therapeutic option for almost 4 decades. The complexity of dialysis equipment has been a factor-limiting adoption of this modality. We performed a feasibility study to demonstrate the safety of center-based vs. home-based daily hemodialysis with the NxStage System One portable hemodialysis device. We also performed a retrospective analysis to determine if clinical effects previously associated with short-daily dialysis were also seen using this novel device. We conducted a prospective, 2-treatment, 2-period, open-label, crossover study of in-center hemodialysis vs. home hemodialysis in 32 patients treated at 6 U.S. centers. The 8-week In-Center Phase (6 days/week) was followed by a 2-week transition period and then followed by the 8-week Home Phase (6 days/week). We retrospectively collected data on hemodialysis treatment parameters immediately preceding the study in a subset of patients. Twenty-six out of 32 patients (81%) successfully completed the study. Successful delivery of at least 90% of prescribed fluid volume (primary endpoint) was achieved in 98.5% of treatments in-center and 97.3% at home. Total effluent volume as a percentage of prescribed volume was between 94% and 100% for all study weeks. The composite rate of intradialytic and interdialytic adverse events per 100 treatments was significantly higher for the In-Center Phase (5.30) compared with the Home Phase (2.10; p=0.007). Compared with the period immediately preceding the study, there were reductions in blood pressure, antihypertensive medications, and interdialytic weight gain. Daily home hemodialysis with a small, easy-to-use hemodialysis device is a viable dialysis option for end-stage renal disease patients capable of self/partner-administered dialysis.

76 FR 77578 - In the Matter of: Brendan Technologies, Inc., CenterStaging Corp., PGMI, Inc., Thermal Energy...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-12-13

... SECURITIES AND EXCHANGE COMMISSION [File No. 500-1] In the Matter of: Brendan Technologies, Inc., CenterStaging Corp., PGMI, Inc., Thermal Energy Storage, Inc., and Trinity3 Corporation; Order of... there is a lack of current and accurate information concerning the securities of Thermal Energy Storage...

Cluster II quartet take the stage together

NASA Astrophysics Data System (ADS)

1999-11-01

This is the only occasion on which all four of ESA's Cluster II spacecraft will be on display together in Europe. Four Spacecraft, One Mission The unique event takes place near the end of the lengthy assembly and test programme, during which each individual spacecraft is being assembled in sequence, one after the other. Two have already completed their assembly and systems testing and are about to be stored in special containers at IABG prior to shipment to the Baikonur launch site in Kazakhstan next spring. In the case of the other two, flight models 5 and 8, installation of the science payloads has finished, but their exhaustive series of environmental tests at IABG have yet to begin. Following delivery to the launch site next April, the satellites will be launched in pairs in June and July 2000. Two Soyuz rockets, each with a newly designed Fregat upper stage, are being provided by the Russian-French Starsem company. This will be the first time ESA satellites have been launched from the former Soviet Union. Cluster II is a replacement for the original Cluster mission, which was lost during the maiden launch of Ariane 5 in June 1996. ESA, given the mission's importance in its overall strategy in the area of the Sun-Earth connection, decided to rebuild this unique project. ESA member states supported that proposal. On 3 April 1997, the Agency's Science Programme Committee agreed. Cluster II was born. European Teamwork Scientific institutions and industrial enterprises in almost all the 14 ESA member states and the United States are taking part in the Cluster II project. Construction of the eight Cluster / Cluster II spacecraft has been a major undertaking for European industry. Built into each 1200 kg satellite are six propellant tanks, two pressure tanks, eight thrusters, 80 metres of pipework, about 5 km of wiring, 380 connectors and more than 14 000 electrical contacts. All the spacecraft were assembled in the giant clean room at the Friedrichshafen plant of

TDRS-M Atlas V Booster and Centaur Stages Arrival, Offload, and Transport (Booster) to ASOC

NASA Image and Video Library

2017-06-26

The United Launch Alliance (ULA) Mariner arrives at Port Canaveral in Florida carrying an Atlas V rocket booster and centaur upper stage bounded for Cape Canaveral Air Force Station. The centaur upper stage is transported from the company's Mariner ship to the Delta Operations Center. The booster stage is transported to the Atlas Spaceflight Operations Center. The rocket is scheduled to launch the Tracking and Data Relay Satellite, TDRS-M. It will be the latest spacecraft destined for the agency's constellation of communications satellites that allows nearly continuous contact with orbiting spacecraft ranging from the International Space Station and Hubble Space Telescope to the array of scientific observatories. Liftoff atop the ULA Atlas V rocket is scheduled to take place from Cape Canaveral's Space Launch Complex 41 on Aug. 3, 2017 at 9:02 a.m. EDT.

OA-7 Atlas Booster and Centaur Stages Arrival

NASA Image and Video Library

2017-02-06

The Mariner cargo ship arrives at the Army Outpost wharf at Port Canaveral, Florida, near the Kennedy Space Center. Aboard is the United Launch Alliance (ULA) Atlas V booster and centaur stages for the Orbital ATK CRS-7 commercial resupply mission to the International Space Station. After the rocket is offloaded, a transport truck takes the Atlas V vehicle hardware to the hangar at the Atlas Spaceflight Operations Center (ASOC), located south of Space Launch Complex 41 at Cape Canaveral Air Force Station. Scheduled to launch a Cygnus spacecraft on March 19, 2017, the Orbital ATK CRS-7 mission will deliver thousands of pounds of supplies, equipment and scientific research materials that improve life on Earth and drive progress toward future space exploration.

Collaboration Takes Center Stage: Interactive Teaching through a Schoolwide Focus on the Performing Arts Leads to Dramatic Improvements in Learning

ERIC Educational Resources Information Center

Williamson, Jeff; Zimmerman, Diane

2009-01-01

In the Old Adobe Union School District in Petaluma, California, the school staff's goal is to assure that all teachers make the fundamental shift from teacher-centric to learner-centric thinking. For them, this is what distinguishes great teachers from good teachers. They believe this level of expertise takes years to develop and that schools play…

The Agendas of Distance Teaching Universities: Moving from the Margins to the Center Stage of Higher Education.

ERIC Educational Resources Information Center

Guri-Rosenblit, Sarah

1999-01-01

Examined from a comparative perspective the extent to which the agendas of distance teaching universities have moved from the margins to the center stage of higher education. Demonstrates that the boundaries between distance and campus universities are blurring and converging, and that future relations between them will be marked by competition…

Shared decision-making in end-stage renal disease: a protocol for a multi-center study of a communication intervention to improve end-of-life care for dialysis patients.

PubMed

Eneanya, Nwamaka D; Goff, Sarah L; Martinez, Talaya; Gutierrez, Natalie; Klingensmith, Jamie; Griffith, John L; Garvey, Casey; Kitsen, Jenny; Germain, Michael J; Marr, Lisa; Berzoff, Joan; Unruh, Mark; Cohen, Lewis M

2015-06-12

End-stage renal disease carries a prognosis similar to cancer yet only 20 % of end-stage renal disease patients are referred to hospice. Furthermore, conversations between dialysis team members and patients about end-of-life planning are uncommon. Lack of provider training about how to communicate prognostic data may contribute to the limited number of end-of-life care discussions that take place with this chronically ill population. In this study, we will test the Shared Decision-Making Renal Supportive Care communication intervention to systematically elicit patient and caretaker preferences for end-of-life care so that care concordant with patients' goals can be provided. This multi-center study will deploy an intervention to improve end-of-life communication for hemodialysis patients who are at high risk of death in the ensuing six months. The intervention will be carried out as a prospective cohort with a retrospective cohort serving as the comparison group. Patients will be recruited from 16 dialysis units associated with two large academic centers in Springfield, Massachusetts and Albuquerque, New Mexico. Critical input from patient advisory boards, a stakeholder panel, and initial qualitative analysis of patient and caretaker experiences with advance care planning have informed the communication intervention. Rigorous communication training for hemodialysis social workers and providers will ensure that standardized study procedures are performed at each dialysis unit. Nephrologists and social workers will communicate prognosis and provide advance care planning in face-to-face encounters with patients and families using a social work-centered algorithm. Study outcomes including frequency and timing of hospice referrals, patient and caretaker satisfaction, quality of end-of-life discussions, and quality of death will be assessed over an 18 month period. The Shared Decision-Making Renal Supportive Care Communication intervention intends to improve discussions

Attending an activity center: positive experiences of a group of home-dwelling persons with early-stage dementia.

PubMed

Söderhamn, Ulrika; Aasgaard, Live; Landmark, Bjørg

2014-01-01

In Norway, there is a focus on home-dwelling people with dementia receiving the opportunity to participate in organized meaningful activities. The aim of this study was to elucidate the experiences of home-dwelling persons with early-stage dementia who attend an activity center and participate in adapted physical and social activities delivered by nurses and volunteers. The study adopted a qualitative approach, with individual interviews conducted among eight people diagnosed with early-stage dementia. The interview texts were analyzed using manifest and latent content analysis. Four categories, ie, "appreciated activities", "praised nurses and volunteers", "being more active", and "being included in a fellowship", as well as the overall theme "participation in appreciated activities and a sense of feeling included in a fellowship may have a positive influence on health and well-being" emerged in the analysis. The informants appreciated the adapted physical and social activities and expressed their enjoyment and gratitude. They found the physical activities useful, and they felt themselves to be included in a fellowship through cheerful nurses and volunteers. The nurses were able to create a good atmosphere and spread joy in the center together with the volunteers. The informants felt themselves valued as the persons they were. These findings indicated that such activities may have had a positive influence on the informants' health and well-being. In order to succeed with this kind of activity center, it is decisive that the nurses are able to tailor meaningful activities and create an environment where the persons with dementia can feel that they are respected and valued. The municipality health care service should implement such activity centers with specialist nurses in dementia care together with volunteers.

Things Are Falling Apart: Can the Center Find a Solution that Will Hold?

ERIC Educational Resources Information Center

Finn, Chester E., Jr.

2006-01-01

The year 2005 began with high schools taking center stage in Washington's continuing drama concerning education reform. President George W. Bush started things off in January, when he delivered a ringing address at a suburban District of Columbia high school about the urgency of reforming American high schools and offered a bold $1.5 billion plan…

Precision adjustable stage

DOEpatents

Cutburth, Ronald W.; Silva, Leonard L.

1988-01-01

An improved mounting stage of the type used for the detection of laser beams is disclosed. A stage center block is mounted on each of two opposite sides by a pair of spaced ball bearing tracks which provide stability as well as simplicity. The use of the spaced ball bearing pairs in conjunction with an adjustment screw which also provides support eliminates extraneous stabilization components and permits maximization of the area of the center block laser transmission hole.

Calcium in the pathomechanism of amyotrophic lateral sclerosis - Taking center stage?

PubMed

Patai, Roland; Nógrádi, Bernát; Engelhardt, József I; Siklós, László

2017-02-19

Amyotrophic lateral sclerosis is an incurable, relentlessly progressive disease primarily affecting motor neurons. The cause of the disease, except for the mutations identified in a small fraction of patients, is unknown. The major mechanisms contributing to the degeneration of motor neurons have already been disclosed and characterized, including excitotoxicity, oxidative stress, mitochondrial dysfunction, and immune/inflammatory processes. During the progression of the disease these toxic processes are not discrete, but each facilitates the deleterious effect of the other. However, due to their common reciprocal calcium dependence, calcium ions may act as a common denominator and through a positive feedback loop may combine the individual pathological processes into a unified escalating mechanism of neuronal destruction. This mini-review provides an overview of the mutual calcium dependence of the major toxic mechanisms associated with amyotrophic lateral sclerosis. Copyright © 2016 Elsevier Inc. All rights reserved.

Assessing the uniqueness of language: Animal grammatical abilities take center stage.

PubMed

Ten Cate, Carel

2017-02-01

Questions related to the uniqueness of language can only be addressed properly by referring to sound knowledge of the relevant cognitive abilities of nonhuman animals. A key question concerns the nature and extent of animal rule-learning abilities. I discuss two approaches used to assess these abilities. One is comparing the structures of animal vocalizations to linguistic ones, and another is addressing the grammatical rule- and pattern-learning abilities of animals through experiments using artificial grammars. Neither of these approaches has so far provided unambiguous evidence of advanced animal abilities. However, when we consider how animal vocalizations are analyzed, the types of stimuli and tasks that are used in artificial grammar learning experiments, the limited number of species examined, and the groups to which these belong, I argue that the currently available evidence is insufficient to arrive at firm conclusions concerning the limitations of animal grammatical abilities. As a consequence, the gap between human linguistic rule-learning abilities and those of nonhuman animals may be smaller and less clear than is currently assumed. This means that it is still an open question whether a difference in the rule-learning and rule abstraction abilities between animals and humans played the key role in the evolution of language.

Taking Over a Broken Program

ERIC Educational Resources Information Center

Grabowski, Carl

2008-01-01

Taking over a broken program can be one of the hardest tasks to take on. However, working towards a vision and a common goal--and eventually getting there--makes it all worth it in the end. In this article, the author shares the lessons she learned as the new director for the Bright Horizons Center in Ashburn, Virginia. She suggests that new…

Fundal pressure during the second stage of labor in a tertiary obstetric center: a prospective analysis.

PubMed

Moiety, Fady M Shawky; Azzam, Amal Z

2014-04-01

To ascertain whether uterine fundal pressure should have a role in the management of the second stage of labor and to determine its prevalence, benefits and adverse maternal-fetal outcomes. This was a prospective observational study set in a tertiary teaching and research obstetric hospital. A total of 8097 women in labor between 37 and 42 gestational weeks with a singleton cephalic presentation were enrolled. Subjects were subdivided into two groups: fundal pressure group (n=1974 women) and control group (n=6123 women). The primary outcome measure was the duration of the second stage. The secondary outcome measures were maternal outcomes (immediate or delayed) and neonatal outcomes. The prevalence of fundal pressure in our center was 24.38%. Fundal pressure maneuver significantly shortened the duration of the second stage among primiparous women, increased the risk of severe perineal laceration and admission to neonatal intensive care unit in comparison to the non-fundal group. Delayed maternal outcomes showed significant increase in dyspareunia and de novo stress urinary incontinence in the fundal pressure group. Although fundal pressure maneuver shortens the duration of the second stage of labor among primiparous women, it should not be used except when indicated, and under strict guidelines owing to its adverse maternal and fetal outcomes. © 2014 The Authors. Journal of Obstetrics and Gynaecology Research © 2014 Japan Society of Obstetrics and Gynecology.

Guests line the stage at a women's forum at the Apollo/Saturn V Center

NASA Technical Reports Server (NTRS)

1999-01-01

At a women's forum about 'Past, Present and Future of Space,' held in the Apollo/Saturn V Center, guests line the stage. From left, they are Marta Bohn-Meyer, the first woman to pilot an SR- 71; astronauts Ellen Ochoa, Ken Cockrell, Joan Higginbotham, and Yvonne Cagle; former astronaut Sally Ride, the first American woman to fly in space; and Jennifer Harris, the Mars 2001 Operations System Development Manager at the Jet Propulsion Laboratory. The forum included a welcome by Center Director Roy Bridges and remarks by Donna Shalala, secretary of Department of Health and Human Services. The attendees are planning to view the launch of STS-93 at the Banana Creek viewing site. Much attention has been generated over the launch due to Commander Eileen M. Collins, the first woman to serve as commander of a Shuttle mission. The primary payload of the five-day mission is the Chandra X-ray Observatory, which will allow scientists from around the world to study some of the most distant, powerful and dynamic objects in the universe. Liftoff is scheduled for July 20 at 12:36 a.m. EDT.

The effect of group counseling based on self-awareness skill on sexual risk-taking among girl students in Gorgan, Iran: a randomized trial.

PubMed

Kabiri, Golnoosh; Ziaei, Tayebe; Aval, Masumeh Rezaei; Vakili, Mohammad Ali

2017-09-15

Background Sexual puberty in adolescents occurs before their mental and emotional maturity and exposes them to high-risk sexual behaviors. Because sexual risk-taking occurs before adolescents become involved in a sexual relationship, this study was conducted to identify the effect of group counseling based on self-awareness skill on sexual risk-taking among female high school students in Gorgan in order to suggest some preventative measures. Methods The present parallel study is a randomized field trial conducted on 96 girl students who were studying in grades 10, 11 and 12 of high school with an age range of 14-18 years old. Sampling was done based on a multi-stage process. In the first stage, through the randomized clustering approach, four centers among six health centers were selected. In the second stage, 96 samples were collected through consecutive sampling. Finally, the samples were divided into two intervention and control groups (each one having 48 subjects) through the simple randomized approach. It has to be noted that no blinding was done in the present study. The data were collected using a demographic specifications form and the Iranian Adolescents Risk-Taking Scale (IARS). The consultation sessions based on self-awareness skill were explained to an intervention group through 60-min sessions over 7 weeks. The pretest was conducted for both groups and the posttest was completed 1 week and 1 month after the intervention by the intervention and control groups. Finally, after the loss of follow-up/drop out, a total of 80 subjects remained in the study; 42 subjects in the intervention group and 38 subjects in the control group. Data analyses were done using SPSS v.16 along with the Freidman non-parametric test and the Mann-Whitney and Wilcoxon tests. Results The results showed that the sexual risk-taking mean scores in the intervention group (10.54 ± 15.64) were reduced by applying 1-week (8.03 ± 12.82) and 1-month (4.91 ± 10.10) follow-ups after the

NASA's Space Launch System Takes Shape

NASA Technical Reports Server (NTRS)

Askins, Bruce R.; Robinson, Kimberly F.

2017-01-01

Significant hardware and software for NASA's Space Launch System (SLS) began rolling off assembly lines in 2016, setting the stage for critical testing in 2017 and the launch of new capability for deep-space human exploration. (Figure 1) At NASA's Michoud Assembly Facility (MAF) near New Orleans, LA, full-scale test articles are being joined by flight hardware. Structural test stands are nearing completion at NASA's Marshall Space Flight Center (MSFC), Huntsville, AL. An SLS booster solid rocket motor underwent test firing, while flight motor segments were cast. An RS-25 and Engine Control Unit (ECU) for early SLS flights were tested at NASA's Stennis Space Center (SSC). The upper stage for the first flight was completed, and NASA completed Preliminary Design Review (PDR) for a new, powerful upper stage. The pace of production and testing is expected to increase in 2017. This paper will discuss the technical and programmatic highlights and challenges of 2016 and look ahead to plans for 2017.

The results of studies to determine the impact of far-aft center-of-gravity locations on the design of a single-stage-to-orbit vehicle system

NASA Technical Reports Server (NTRS)

Freeman, D. C., Jr.; Powell, R. W.

1979-01-01

Aft center-of-gravity locations dictated by the large number of rocket engines required has been a continuing problem of single-stage-to-orbit vehicles. Recent work at Langley has demonstrated that these aft center-of-gravity problems become more pronounced for the proposed heavy-lift mission, creating some unique design problems for both the SSTO and staged vehicle systems. During the course of this study, an effort was made to bring together automated vehicle design, wind-tunnel tests, and flight control analyses to assess the impact of longitudinal and lateral-directional instability, and control philosophy on entry vehicle design technology.

50 CFR 218.181 - Permissible methods of taking.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 50 Wildlife and Fisheries 10 2013-10-01 2013-10-01 false Permissible methods of taking. 218.181... Center Panama City Division § 218.181 Permissible methods of taking. (a) Under Letters of Authorization... activities identified in § 218.180(c) is limited to the following species, by the indicated method of take...

Revising Lecture Notes: How Revision, Pauses, and Partners Affect Note Taking and Achievement

ERIC Educational Resources Information Center

Luo, Linlin; Kiewra, Kenneth A.; Samuelson, Lydia

2016-01-01

Note taking has been categorized as a two-stage process: the recording of notes and the review of notes. We contend that note taking might best involve a three-stage process where the missing stage is revision. This study investigated the benefits of revising lecture notes and addressed two questions: First, is revision more effective than…

Lung epithelial stem cells and their niches: Fgf10 takes center stage.

PubMed

Volckaert, Thomas; De Langhe, Stijn

2014-01-01

Throughout life adult animals crucially depend on stem cell populations to maintain and repair their tissues to ensure life-long organ function. Stem cells are characterized by their capacity to extensively self-renew and give rise to one or more differentiated cell types. These powerful stem cell properties are key to meet the changing demand for tissue replacement during normal lung homeostasis and regeneration after lung injury. Great strides have been made over the last few years to identify and characterize lung epithelial stem cells as well as their lineage relationships. Unfortunately, knowledge on what regulates the behavior and fate specification of lung epithelial stem cells is still limited, but involves communication with their microenvironment or niche, a local tissue environment that hosts and influences the behaviors or characteristics of stem cells and that comprises other cell types and extracellular matrix. As such, an intimate and dynamic epithelial-mesenchymal cross-talk, which is also essential during lung development, is required for normal homeostasis and to mount an appropriate regenerative response after lung injury. Fibroblast growth factor 10 (Fgf10) signaling in particular seems to be a well-conserved signaling pathway governing epithelial-mesenchymal interactions during lung development as well as between different adult lung epithelial stem cells and their niches. On the other hand, disruption of these reciprocal interactions leads to a dysfunctional epithelial stem cell-niche unit, which may culminate in chronic lung diseases such as chronic obstructive pulmonary disease (COPD), chronic asthma and idiopathic pulmonary fibrosis (IPF).

2011 Take Our Children to Work Day

NASA Image and Video Library

2011-07-26

During the 2011 Take Our Children to Work Day at Stennis Space Center, participants engaged in hands-on activities, including viewing the sun through a solar telescope (right photo). Children also visited the StenniSphere museum and had an opportunity to take photos at the astronaut suit exhibit.

Psychometric properties of the Brazilian-adapted version of the Ages and Stages Questionnaire in public child daycare centers.

PubMed

Filgueiras, Alberto; Pires, Pedro; Maissonette, Silvia; Landeira-Fernandez, J

2013-08-01

Well-designed screening assessment instruments that can evaluate child development in public daycare centers represent an important resource to help improve the quality of these programs, as an early detection method for early developmental delay. The Ages and Stages Questionnaire, 3rd edition (ASQ-3), comprises a series of 21 questionnaires designed to screen developmental performance in the domains of communication, gross motor skills, fine motor skills, problem solving, and personal-social ability in children aged 2 to 66 months. The purpose of the present work was to translate and adapt all of the ASQ-3 questionnaires for use in Brazilian public child daycare centers and to explore their psychometric characteristics with both Classical Test Theory and Rating Scale analyses from the Rasch model family. A total of 18 Ages & Stages Questionnaires - Brazilian translation (ASQ-BR) questionnaires administered at intervals from 6 to 60 months of age were analyzed based on primary caregiver evaluations of 45,640 children distributed in 468 public daycare centers in the city of Rio de Janeiro. The results indicated that most of the ASQ-BR questionnaires had adequate internal consistency. Exploratory factor analyses yielded a one-factor solution for each domain of all of the ASQ-BR questionnaires. The only exception was the personal-social domain in some of the questionnaires. Item Response Theory based on Rating Scale analysis (infit and outfit mean squares statistics) indicated that only 44 of 540 items showed misfit problems. In summary, the ASQ-BR questionnaires are psychometrically sound developmental screening instruments that can be easily administered by primary caregivers. Copyright © 2013 Elsevier Ltd. All rights reserved.

The Iowa Flood Center's River Stage Sensors—Technical Details

NASA Astrophysics Data System (ADS)

Niemeier, J. J.; Kruger, A.; Ceynar, D.; Fahim Rezaei, H.

2012-12-01

The Iowa Flood Center (IFC), along with support from the Iowa Department of Transportation (DOT) and the Iowa Department of Natural Resources (DNR) have developed a bridge-mounted river stage sensor. Each sensor consists of an ultrasonic distance measuring module, cellular modem, a GPS unit that provides accurate time and an embedded controller that orchestrates the sensors' operation. A sensor is powered by a battery and solar panel along with a solar charge controller. All the components are housed in/on a sturdy metal box that is then mounted on the side of a bridge. Additionally, each sensor incorporates a water-intrusion sensor and an internal temperature sensor. In operation, the microcontroller wakes, and turns on the electronics every 15 minutes and then measures the distance between the ultrasonic sensor and the water surface. Several measurements are averaged and transmitted along with system health information (battery voltage, state of water intrusion sensor, and internal temperature) via cellular modem to remote servers on the internet. The microcontroller then powers the electronics down and enters a sleep/power savings mode. The sensor's firmware allows the remote server to adjust the measurement rate to 5, 15, and 60 minutes. Further, sensors maintain a 24-day buffer of previous measurements. If a sensor could not successfully transmit its data because of cellular network connection problems, it will transmit the backlog on subsequent transmissions. We paid meticulous attention to all engineering aspects and sensors are very robust and have operated essentially continuously through two Iowa winters and summers, including the 2012 record-breaking warm summer.

Contrary melanoma-associated antigen-A expression at the tumor front and center: A comparative analysis of stage I and IV head and neck squamous cell carcinoma

PubMed Central

Hartmann, Stefan; Brisam, Muna; Rauthe, Stephan; Driemel, Oliver; Brands, Roman C.; Rosenwald, Andreas; Kübler, Alexander C.; Müller-Richter, Urs D. A.

2016-01-01

There is a growing body of evidence indicating that several melanoma-associated antigen-A (MAGE-A) subgroups contribute to the malignancy of head and neck cancer. The present study retrospectively analyzed the expression of all known MAGE-A subgroups in the tumor front and center of 38 head and neck cancer patients (Union for International Cancer Control stage I or IV) by immunohistochemistry. MAGE-A1, -A6, -A8, -A9 and -A11 were expressed at significantly higher levels at the tumor front of stage IV specimens compared with the tumor front of stage I specimens. In stage I cancer, the tumor center and front ratio (C/F ratio) for each subgroup was >1.0. In stage IV cancer, the C/F ratio was <1.0 in 9/11 subgroups. The most significant change in the expression pattern was observed for MAGE-A11. These results indicated that there is a marked alteration and shift to the invasive front of almost all MAGE-A subgroups, but particularly MAGE-A11, during the progression of head and neck squamous cell carcinoma. PMID:27703530

When perspective taking increases taking: reactive egoism in social interaction.

PubMed

Epley, Nicholas; Caruso, Eugene; Bazerman, Max H

2006-11-01

Group members often reason egocentrically, believing that they deserve more than their fair share of group resources. Leading people to consider other members' thoughts and perspectives can reduce these egocentric (self-centered) judgments such that people claim that it is fair for them to take less; however, the consideration of others' thoughts and perspectives actually increases egoistic (selfish) behavior such that people actually take more of available resources. A series of experiments demonstrates this pattern in competitive contexts in which considering others' perspectives activates egoistic theories of their likely behavior, leading people to counter by behaving more egoistically themselves. This reactive egoism is attenuated in cooperative contexts. Discussion focuses on the implications of reactive egoism in social interaction and on strategies for alleviating its potentially deleterious effects.

Variable volume combustor with center hub fuel staging

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

Ostebee, Heath Michael; McConnaughhay, Johnie Franklin; Stewart, Jason Thurman

The present application and the resultant patent provide a combustor for use with a gas turbine engine. The combustor may include a number of micro-mixer fuel nozzles and a fuel injection system for providing a flow of fuel to the micro-mixer fuel nozzles. The fuel injection system may include a center hub for providing the flow of fuel therethrough. The center hub may include a first supply circuit for a first micro-mixer fuel nozzle and a second supply circuit for a second micro-mixer fuel nozzle.

Orion Stage Adapter Arrival

NASA Image and Video Library

2018-04-03

NASA's Super Guppy aircraft touches down at the Shuttle Landing Facility at the agency's Kennedy Space Center in Florida. The Super Guppy is carrying the Orion Stage Adapter (OSA), the second flight-hardware section of NASA's Space Launch System (SLS) rocket that has arrived at Kennedy. The OSA will connect the Orion spacecraft to the upper part of the SLS rocket, the interim cryogenic propulsion stage (ICPS). Both the OSA and ICPS are being stored for processing in the center's Space Station Processing Facility in preparation for Exploration Mission-1, the first uncrewed, integrated launch of the SLS rocket and Orion spacecraft.

Towards cheaper control centers

NASA Technical Reports Server (NTRS)

Baize, Lionel

1994-01-01

Today, any approach to the design of new space systems must take into consideration an important constraint, namely costs. This approach is our guideline for new missions and also applies to the ground segment, and particularly to the control center. CNES has carried out a study on a recent control center for application satellites in order to take advantage of the experience gained. This analysis, the purpose of which is to determine, a posteriori, the costs of architecture needs and choices, takes hardware and software costs into account and makes a number of recommendations.

RELATIONSHIP OF ASSESS SELF-ESTEEM AND LOCUS OF CONTROL WITH QUALITY OF LIFE DURING TREATMENT STAGES IN PATIENTS REFERRING TO DRUG ADDICTION REHABILITATION CENTERS

PubMed Central

Heidari, Mohammad; Ghodusi, Mansureh

2016-01-01

Objective: Thus, the present research was carried out aimed at determining the relationship between self-esteem and locus of control and quality of life during treatment stages in the patients referring to drug addiction rehabilitation centers of Borujen city, Iran. Methods: The current study was a sectional research of descriptive correlation type. The research sample was 150 individuals of patients referring to addiction rehabilitation centers of Borujen city. For data gathering, Rosenberg Self-esteem Scale, Rotter’s Locus of Control Scale, and SF36 Quality of Life Questionnaire were used. Following collection of questionnaires, the data were analyzed using SPSS/16 software. Results: According to the results, in the 12th day of treatment, 96 patients exhibited moderate self-esteem, 102 patients had internal locus of control, and the score of their overall quality of life was 40.43±12.71. Furthermore, Pearson’s correlation coefficient indicated that a significant and positive relationship was observed between locus of control and quality of life during different treatment stages. Conclusion: It seems that quality of life improves during addiction treatment stages due to improvement of personality traits including locus of control and self-esteem. Therefore, consultation methods as a very crucial priority in addiction rehabilitation centers shall be taken into account by the health sector authorities and managers and can play an essential role in enhancing quality of life. PMID:27698598

Center variation in the use of nonstandardized model for end-stage liver disease exception points.

PubMed

Goldberg, David S; Makar, George; Bittermann, Therese; French, Benjamin

2013-12-01

The Model for End-Stage Liver Disease (MELD) score is an imperfect prognosticator of waitlist dropout, so transplant centers may apply for exception points to increase a waitlist candidate's priority on the waitlist. Exception applications are categorized as recognized exceptional diagnoses (REDs; eg, hepatocellular carcinoma) and non-REDs (eg, cholangitis). Although prior work has demonstrated regional variation in the use of exceptions, no work has examined the between-center variability. We analyzed all new waitlist candidates from February 27, 2002 to June 3, 2011 to explore variations in the use of non-REDs, for which no strict exception criteria exist. There were 58,641 new waitlist candidates, and 4356 (7.4%) applied for a non-RED exception. The number of applications increased steadily over time, as did the approval rates for such applications: from <50% in 2002 to nearly 75% in 2010. When we adjusted for patient factors, there was significant variability (P < 0.001) in the use of non-RED exceptions in 8 of 11 United Network for Organ Sharing (UNOS) regions and in the approval of these exceptions in 6 of 11 UNOS regions. The variability in the use and approval of non-REDs was clinically significant: waitlist candidates with approved exceptions were significantly more likely to undergo transplantation (68.3% versus 53.4%, P < 0.001) and were less likely to be removed for death or clinical deterioration (10.4% versus 16.2%, P < 0.001). Increased median MELD score at transplantation within a donor service area was the only center factor associated with increased odds of applying for exceptions, while no center factors were associated with having non-RED exceptions approved. Further work is needed to identify other sources of variation to ensure the appropriate and equitable use of non-RED exceptions. © 2013 American Association for the Study of Liver Diseases.

Survival Advantage Associated with Decrease in Stage at Detection from Stage IIIC to Stage IIIA Epithelial Ovarian Cancer

PubMed Central

Lefringhouse, Jason; Pavlik, Edward; Miller, Rachel; DeSimone, Christopher; Ueland, Frederick; Kryscio, Richard; van Nagell, J. R.

2014-01-01

Objective. The aim of this study was to document the survival advantage of lowering stage at detection from Stage IIIC to Stage IIIA epithelial ovarian cancer. Methods. Treatment outcomes and survival were evaluated in patients with Stage IIIA and Stage IIIC epithelial ovarian cancer treated from 2000 to 2009 at the University of Kentucky Markey Cancer Center (UKMCC) and SEER institutions. Results. Cytoreduction to no visible disease (P < 0.0001) and complete response to platinum-based chemotherapy (P < 0.025) occurred more frequently in Stage IIIA than in Stage IIIC cases. Time to progression was shorter in patients with Stage IIIC ovarian cancer (17 ± 1 months) than in those with Stage II1A disease (36 ± 8 months). Five-year overall survival (OS) improved from 41% in Stage IIIC patients to 60% in Stage IIIA patients treated at UKMCC and from 37% to 56% in patients treated at SEER institutions for a survival advantage of 19% in both data sets. 53% of Stage IIIA and 14% of Stage IIIC patients had NED at last followup. Conclusions. Decreasing stage at detection from Stage IIIC to stage IIIA epithelial ovarian cancer is associated with a 5-year survival advantage of nearly 20% in patients treated by surgical tumor cytoreduction and platinum-based chemotherapy. PMID:25254047

Human-Centered Design Capability

NASA Technical Reports Server (NTRS)

Fitts, David J.; Howard, Robert

2009-01-01

For NASA, human-centered design (HCD) seeks opportunities to mitigate the challenges of living and working in space in order to enhance human productivity and well-being. Direct design participation during the development stage is difficult, however, during project formulation, a HCD approach can lead to better more cost-effective products. HCD can also help a program enter the development stage with a clear vision for product acquisition. HCD tools for clarifying design intent are listed. To infuse HCD into the spaceflight lifecycle the Space and Life Sciences Directorate developed the Habitability Design Center. The Center has collaborated successfully with program and project design teams and with JSC's Engineering Directorate. This presentation discusses HCD capabilities and depicts the Center's design examples and capabilities.

Youth Risk Taking Behavior: The Role of Schools. A Center Policy & Practice Analysis Brief

ERIC Educational Resources Information Center

Center for Mental Health in Schools at UCLA, 2007

2007-01-01

Risk taking is natural. As the bumper stickers says: "Risk taking happens!" Risk taking behavior may be beneficial or harmful. Some risk taking is unintentional. But a considerable amount stems from proactive or reactive motivation. For schools, some forms of student risk taking behavior are a necessity, and some forms are a problem. With respect…

A cross-sectional survey of policies guiding second stage labor in urban Japanese hospitals, clinics and midwifery birth centers.

PubMed

Baba, Kaori; Kataoka, Yaeko; Nakayama, Kaori; Yaju, Yukari; Horiuchi, Shigeko; Eto, Hiromi

2016-02-24

The Japan Academy of Midwifery developed and disseminated the '2012 Evidence-based Guidelines for Midwifery Care (Guidelines for Midwives)' for low-risk births to achieve a more uniform standard of care during childbirth in Japan. The objective of this study was to cross-sectional survey policy implementation regarding care during the second stage of labor at Japanese hospitals, clinics, and midwifery birth centers, and to compare those policies with the recommendations in Guidelines for Midwives. This study was conducted in the four major urbanized areas (e.g. Tokyo) of the Kanto region of Japan. Respondents were chiefs of the institutions (obstetricians/midwives), nurse administrators (including midwives) of the obstetrical departments, or other nurse/midwives who were well versed in the routine care of the targeted institutions. The Guidelines implementation questionnaire comprised 12 items. Data was collected from October 2010 to July 2011. The overall response was 255 of the 684 institutions (37%). Of the total responses 46% were hospitals, 26% were clinics and 28% were midwifery birth centers. Few institutions reported perineal massage education for 'almost all cases'. Using 'active birth' were all midwifery birth centers, 56% hospitals and 32% clinics. Few institutions used water births. The majority of hospitals (73%) and clinics (80%) but a minority (39%) of midwifery birth centers reported 'not implemented' about applying warm compress to the perineum. Few midwifery birth centers (10%) and more hospitals (38%) and clinics (50%) had a policy for valsalva as routine care. Many hospitals (90%) and clinics (88%) and fewer midwifery birth centers (54%) offered hands-on technique to provide perineal support during birth. A majority of institutions used antiseptic solution for perineal disinfection. Few institutions routinely used episiotomies for multiparas, however routine use for primiparas was slightly more in hospitals (21%) and clinics (25%). All

Orion Stage Adapter Arrival

NASA Image and Video Library

2018-04-03

NASA's Super Guppy aircraft taxies onto the tarmac after touching down at the Shuttle Landing Facility at the agency's Kennedy Space Center in Florida. The Super Guppy is carrying the Orion Stage Adapter (OSA), the second flight-hardware section of NASA's Space Launch System (SLS) rocket that has arrived at Kennedy. The OSA will connect the Orion spacecraft to the upper part of the SLS rocket, the interim cryogenic propulsion stage (ICPS). Both the OSA and ICPS are being stored for processing in the center's Space Station Processing Facility in preparation for Exploration Mission-1, the first uncrewed, integrated launch of the SLS rocket and Orion spacecraft.

Orion Stage Adapter Arrival

NASA Image and Video Library

2018-04-03

NASA's Super Guppy aircraft glides to a stop at the Shuttle Landing Facility at the agency's Kennedy Space Center in Florida. The Super Guppy is carrying the Orion Stage Adapter (OSA), the second flight-hardware section of NASA's Space Launch System (SLS) rocket that has arrived at Kennedy. The OSA will connect the Orion spacecraft to the upper part of the SLS rocket, the interim cryogenic propulsion stage (ICPS). Both the OSA and ICPS are being stored for processing in the center's Space Station Processing Facility in preparation for Exploration Mission-1, the first uncrewed, integrated launch of the SLS rocket and Orion spacecraft.

Orion Stage Adapter Arrival

NASA Image and Video Library

2018-04-03

NASA's Super Guppy aircraft prepares to touch down at the Shuttle Landing Facility at the agency's Kennedy Space Center in Florida. The Super Guppy is carrying the Orion Stage Adapter (OSA), the second flight-hardware section of NASA's Space Launch System (SLS) rocket that has arrived at Kennedy. The OSA will connect the Orion spacecraft to the upper part of the SLS rocket, the interim cryogenic propulsion stage (ICPS). Both the OSA and ICPS are being stored for processing in the center's Space Station Processing Facility in preparation for Exploration Mission-1, the first uncrewed, integrated launch of the SLS rocket and Orion spacecraft.

Launch Vehicle Stage Adapter from Start to Stack

NASA Image and Video Library

2016-10-16

See how a test version of the launch vehicle stage adapter (LVSA) for NASA's new rocket, the Space Launch System, is designed, built and stacked in a test stand at the agency's Marshall Space Flight Center in Huntsville, Alabama. The LVSA was moved to a 65-foot-tall test stand Oct. 12 at Marshall. The test version LVSA will be stacked with other test pieces of the upper part of the SLS rocket and pushed, pulled and twisted as part of an upcoming test series to ensure each structure can withstand the incredible stresses of launch. The LVSA joins the core stage simulator, which was loaded into the test stand Sept. 21. The other three qualification articles and the Orion simulator will complete the stack later this fall. Testing is scheduled to begin in early 2017. SLS will be the world’s most powerful rocket, and with the Orion spacecraft, take astronauts to deep-space destinations, including the Journey to Mars. More information on the upcoming test series can be found here: http://go.nasa.gov/2dS8yXB

Financial viability of perinatal centers in the longer term, taking legislative requirements into account. An examination of the cost-revenue structure of a Level I perinatal center.

PubMed

Lux, Michael P; Kraml, Florian; Wagner, Stefanie; Hack, Carolin C; Schulze, Christine; Faschingbauer, Florian; Winkler, Mathias; Fasching, Peter A; Beckmann, Matthias W; Hildebrandt, Thomas

2013-01-01

Debate is currently taking place over minimum case numbers for the care of premature infants and neonates in Germany. As a result of the Federal Joint Committee (Gemeinsamer Bundesauschuss, G-BA) guidelines for the quality of structures, processes, and results, requiring high levels of staffing resources, Level I perinatal centers are increasingly becoming the focus for health-economics questions, specifically, debating whether Level I structures are financially viable. Using a multistep contribution margin analysis, the operating results for the Obstetrics Section at the University Perinatal Center of Franconia (Universitäts-Perinatalzentrum Franken) were calculated for the year 2009. Costs arising per diagnosis-related group (DRG) (separated into variable costs and fixed costs) and the corresponding revenue generated were compared for 4,194 in-patients and neonates, as well as for 3,126 patients in the outpatient ultrasound and pregnancy clinics. With a positive operating result of € 374,874.81, a Level I perinatal center on the whole initially appears to be financially viable, from the obstetrics point of view (excluding neonatology), with a high bed occupancy rate and a profitable case mix. By contrast, the costs of prenatal diagnostics, with a negative contribution margin II of € 50,313, cannot be covered. A total of 79.4% of DRG case numbers were distributed to five DRGs, all of which were associated with pregnancies and neonates with the lowest risk profiles. A Level I perinatal center is currently capable of covering its costs. However, the cost-revenue ratio is fragile due to the high requirements for staffing resources and numerous economic, social, and regional influencing factors.

Development of a Rotating Rake Array for Boundary-Layer-Ingesting Fan-Stage Measurements

NASA Technical Reports Server (NTRS)

Wolter, John D.; Arend, David J.; Hirt, Stefanie M.; Gazzaniga, John A.

2017-01-01

The recent Boundary-Layer-Ingesting Inlet/Distortion Tolerant Fan wind tunnel experiment at NASA Glenn Research Center's 8- by 6-foot Supersonic Wind Tunnel (SWT) examined the performance of a novel inlet and fan stage that was designed to ingest the vehicle boundary layer in order to take advantage of a predicted overall propulsive efficiency benefit. A key piece of the experiment's instrumentation was a pair of rotating rake arrays located upstream and downstream of the fan stage. This paper examines the development of these rake arrays. Pre-test numerical solutions were sampled to determine placement and spacing for rake pressure and temperature probes. The effects of probe spacing and survey density on the repeatability of survey measurements was examined. These data were then used to estimate measurement uncertainty for the adiabatic efficiency.

Development of a Rotating Rake Array for Boundary-Layer-Ingesting Fan-Stage Measurements

NASA Technical Reports Server (NTRS)

Wolter, John D.; Arend, David J.; Hirt, Stefanie M.; Gazzaniga, John A.

2017-01-01

The recent Boundary-Layer-Ingesting Inlet/Distortion Tolerant Fan wind tunnel experiment at NASA Glenn Research Center's 8-foot by 6-foot supersonic wind tunnel examined the performance of a novel inlet and fan stage that was designed to ingest the vehicle boundary layer in order to take advantage of a predicted overall propulsive efficiency benefit. A key piece of the experiment's instrumentation was a pair of rotating rake arrays located upstream and downstream of the fan stage. This paper examines the development of these rake arrays. Pre-test numerical solutions were sampled to determine placement and spacing for rake pressure and temperature probes. The effects of probe spacing and survey density on the repeatability of survey measurements was examined. These data were then used to estimate measurement uncertainty for the adiabatic efficiency.

Radiotherapy and Nuclear Medicine Project for an Integral Oncology Center at the Oaxaca High Specialization Regional Hospital

NASA Astrophysics Data System (ADS)

De Jesús, M.; Trujillo-Zamudio, F. E.

2010-12-01

A building project of Radiotherapy & Nuclear Medicine services (diagnostic and therapy), within an Integral Oncology Center (IOC), requires interdisciplinary participation of architects, biomedical engineers, radiation oncologists and medical physicists. This report focus on the medical physicist role in designing, building and commissioning stages, for the final clinical use of an IOC at the Oaxaca High Specialization Regional Hospital (HRAEO). As a first step, during design stage, the medical physicist participates in discussions about radiation safety and regulatory requirements for the National Regulatory Agency (called CNSNS in Mexico). Medical physicists propose solutions to clinical needs and take decisions about installing medical equipment, in order to fulfill technical and medical requirements. As a second step, during the construction stage, medical physicists keep an eye on building materials and structural specifications. Meanwhile, regulatory documentation must be sent to CNSNS. This documentation compiles information about medical equipment, radioactivity facility, radiation workers and nuclear material data, in order to obtain the license for the linear accelerator, brachytherapy and nuclear medicine facilities. As a final step, after equipment installation, the commissioning stage takes place. As the conclusion, we show that medical physicists are essentials in order to fulfill with Mexican regulatory requirements in medical facilities.

Exit Stage Left (And Right): Getting Your Chorus on and off the Stage

ERIC Educational Resources Information Center

Van Hoven, Scott

2004-01-01

A key element of a well-received performance is the efficient flow of performers on and off the stage. This important detail is often neglected until the last minute, with results that are, to say the least, unpredictable. While moving a large number of students on and off the stage will always take time, slow movement and ragged appearance while…

Center Variation and Outcomes Associated with Delayed Sternal Closure Following Stage 1 Palliation for Hypoplastic Left Heart Syndrome

PubMed Central

Johnson, Jason N.; Jaggers, James; Li, Shuang; O’Brien, Sean M.; Li, Jennifer S.; Jacobs, Jeffrey P.; Jacobs, Marshall L.; Welke, Karl F.; Peterson, Eric D.; Pasquali, Sara K.

2009-01-01

Objectives There is debate whether primary or delayed sternal closure (DSC) is the best strategy following Stage 1 palliation (S1P) for hypoplastic left heart syndrome (HLHS). We describe center variation in DSC following S1P and associated outcomes. Methods Society of Thoracic Surgeons Congenital Database participants performing S1P for HLHS from 2000–2007 were included. We examined center variation in DSC, and compared in-hospital mortality, prolonged length of stay (LOS >6wks), and postoperative infection in centers with low (≤25% of cases), middle (26%–74% of cases), and high (≥75% of cases) DSC utilization, adjusting for patient and center factors. Results There were 1283 patients (45 centers) included. Median age and weight at surgery were 6d (IQR4-9d) and 3.2 kg (IQR2.8–3.5kg); 59% were male. DSC was used in 74% (range 3–100% of cases/center). In centers with high (n=23) and middle (n=17) vs. low (n=5) DSC utilization, there was a greater proportion of patients with prolonged LOS and infection, and a trend toward increased in-hospital mortality in unadjusted analysis. In multivariable analysis, there was no difference in mortality. Centers with high and middle DSC utilization had prolonged LOS [OR (95%CI): 2.83(1.46–5.47) p=0.002 and 2.23(1.17–4.26) p=0.02] and more infection [2.34(1.20–4.57) p=0.01 and 2.37(1.36–4.16) p=0.003]. Conclusions Utilization of DSC following S1P varies widely. These observational data suggest more frequent use of DSC is associated with longer LOS and higher postoperative infection rates. Further evaluation of the risks and benefits of DSC in the management of these complex infants is necessary. PMID:20167337

NASA's Space Launch System Takes Shape

NASA Technical Reports Server (NTRS)

Askins, Bruce; Robinson, Kimberly F.

2017-01-01

Major hardware and software for NASA's Space Launch System (SLS) began rolling off assembly lines in 2016, setting the stage for critical testing in 2017 and the launch of a major new capability for deep space human exploration. SLS continues to pursue a 2018 first launch of Exploration Mission 1 (EM-1). At NASA's Michoud Assembly Facility near New Orleans, LA, Boeing completed welding of structural test and flight liquid hydrogen tanks, and engine sections. Test stands for core stage structural tests at NASA's Marshall Space Flight Center, Huntsville, AL. neared completion. The B2 test stand at NASA's Stennis Space Center, MS, completed major structural renovation to support core stage green run testing in 2018. Orbital ATK successfully test fired its second qualification solid rocket motor in the Utah desert and began casting the motor segments for EM-1. Aerojet Rocketdyne completed its series of test firings to adapt the heritage RS-25 engine to SLS performance requirements. Production is under way on the first five new engine controllers. NASA also signed a contract with Aerojet Rocketdyne for propulsion of the RL10 engines for the Exploration Upper Stage. United Launch Alliance delivered the structural test article for the Interim Cryogenic Propulsion Stage to MSFC for tests and construction was under way on the flight stage. Flight software testing at MSFC, including power quality and command and data handling, was completed. Substantial progress is planned for 2017. Liquid oxygen tank production will be completed at Michoud. Structural testing at Marshall will get under way. RS-25 hotfire testing will verify the new engine controllers. Core stage horizontal integration will begin. The core stage pathfinder mockup will arrive at the B2 test stand for fit checks and tests. EUS will complete preliminary design review. This paper will discuss the technical and programmatic successes and challenges of 2016 and look ahead to plans for 2017.

Down with Walls, Up with Malls: Taking Classes to the Shopping Centers.

ERIC Educational Resources Information Center

Duerden, Noel H.

1980-01-01

Learn and Shop, a concept of offering university credit courses by university faculty in shopping centers which was developed by Indiana University-Purdue University in Indianapolis, is described. The Learn and Shop curriculum permits individuals to earn a two-year associate degree in liberal arts entirely at shopping centers. (MLW)

2012 Take Our Children to Work Day

NASA Image and Video Library

2012-07-31

More than 250 children of employees at 15 Stennis Space Center resident agencies and organizations visited the facility July 31 to participate in annual Take Our Children to Work Day activities. Participants enjoyed various presentations and demonstrations on topics such as cryogenics and information security. They also had an opportunity to visit site facilities to learn about various work performed at the NASA center.

Dilemmas in Lung Cancer Staging.

PubMed

Vlahos, Ioannis

2018-05-01

The advent of the 8th edition of the lung cancer staging system reflects a further meticulous evidence-based advance in the stratification of the survival of patients with lung cancer. Although addressing many limitations of earlier staging systems, several limitations in staging remain. This article reviews from a radiological perspective the limitations of the current staging system, highlighting the process of TNM restructuring, the residual issues with regards to the assignment of T, N, M descriptors, and their associated stage groupings and how these dilemmas impact guidance of multidisciplinary teams taking care of patients with lung cancer. Crown Copyright © 2018. Published by Elsevier Inc. All rights reserved.

Taking Part One GNVQ Forward.

ERIC Educational Resources Information Center

Frankland, Gillian; Ebrahim, Nazir

This document is intended to assist practitioners involved in the delivery of Part One General National Vocational Qualifications (GNVQs), which are GNVQs designed for students in the United Kingdom who are at Key Stage 4 and the post-16 level. Section 1 examines the following topics of interest to centers that are contemplating introducing Part…

Simulation and Analyses of Stage Separation Two-Stage Reusable Launch Vehicles

NASA Technical Reports Server (NTRS)

Pamadi, Bandu N.; Neirynck, Thomas A.; Hotchko, Nathaniel J.; Tartabini, Paul V.; Scallion, William I.; Murphy, Kelly J.; Covell, Peter F.

2005-01-01

NASA has initiated the development of methodologies, techniques and tools needed for analysis and simulation of stage separation of next generation reusable launch vehicles. As a part of this activity, ConSep simulation tool is being developed which is a MATLAB-based front-and-back-end to the commercially available ADAMS(registered Trademark) solver, an industry standard package for solving multi-body dynamic problems. This paper discusses the application of ConSep to the simulation and analysis of staging maneuvers of two-stage-to-orbit (TSTO) Bimese reusable launch vehicles, one staging at Mach 3 and the other at Mach 6. The proximity and isolated aerodynamic database were assembled using the data from wind tunnel tests conducted at NASA Langley Research Center. The effects of parametric variations in mass, inertia, flight path angle, altitude from their nominal values at staging were evaluated. Monte Carlo runs were performed for Mach 3 staging to evaluate the sensitivity to uncertainties in aerodynamic coefficients.

RSF Data Center Tour

ScienceCinema

Powers, Chuck

2017-12-11

The Data Center in the Research Support Facility on the campus of the U.S. Department of Energy's National Renewable Energy Laboratory (NREL) marks a significant accomplishment in its ultra-efficiency. Data centers by nature are very energy intensive. The RSF Data Center was designed to use 80% less energy than NREL's old data center, which had been in use for the last 30 years. This tour takes you through the data center highlighting its energy saving techniques.

Beyond Buses, Boilers, and Books: Instructional Support Takes Center Stage for Principal Supervisors

ERIC Educational Resources Information Center

Syed, Sarosh

2014-01-01

Denver Public Schools, one of 14 districts that receive funding from The Wallace Foundation to improve principal effectiveness, is also one of a number of districts around the country emphasizing the development of principals' managers in the central office. The principal's job has changed over the last decade, going from a role that revolved…

Orion Stage Adapter (OSA) Offload

NASA Image and Video Library

2018-04-04

NASA Kennedy Space Center security officers prepare to escort the Orion Stage Adapter (OSA), secured on a flatbed transporter, along State Road 3 to the Space Station Processing Facility (SSPF) at NASA's Kennedy Space Center in Florida. The OSA is the second flight-hardware section of the agency's Space Launch System (SLS) rocket to arrive at Kennedy. The OSA will connect the Orion spacecraft to the upper part of the SLS, the interim cryogenic propulsion stage (ICPS). Both the OSA and ICPS are being stored for processing in the SSPF in preparation for Exploration Mission-1, the first uncrewed, integrated launch of the SLS rocket and Orion spacecraft.

Accuracy of recorded tumor, node, and metastasis stage in a comprehensive cancer center.

PubMed

Brierley, James D; Catton, Pamela A; O'Sullivan, Brian; Dancey, Janet E; Dowling, Anthony J; Irish, Jonathan C; McGowan, Thomas S; Sturgeon, Jeremy F G; Swallow, Carol J; Rodrigues, George B; Panzarella, Tony

2002-01-15

The benefits of recording the tumor, node, and metastasis (TNM) stages of cancer patients are well accepted, but little is known about how accurately this is performed. An audit was performed to determine the accuracy of recorded stage and to act as a baseline before the implementation of an education program. All new patient referrals to Princess Margaret Hospital between July 1 and August 31, 1997, were reviewed. An audit panel composed of five health record technicians (HRTs) and 10 doctors was assembled. Each auditor reviewed 10% of the health record. If there was a discrepancy between the stage in the health record and the auditor stage, then the final stage was determined by the audit committee. Analysis of the agreement between the health record, the physician auditor, the HRT auditor, and the final stage was performed. A total of 855 patients were referred with a new diagnosis of a malignancy for which there was a TNM stage system; 833 patients (97.4%) had a stage assigned. There was agreement between the health record stage and final stage in 80% (95% confidence interval [CI], 77% to 82%) of cases for clinical stage, compared with 90% (95% CI, 87% to 92%) for pathologic stage. Of the major site groups, lung was the least accurately recorded. The most common major discrepancies were due to the recording of X when a definite category could be assigned. This audit demonstrates the importance of staging and provides impetus to develop staging guidelines and education programs.

Take Our Children to Work Day

NASA Technical Reports Server (NTRS)

2008-01-01

Hundreds of children participated in the annual Take Our Children to Work Day at Stennis Space Center on July 29. During the day, children of Stennis employees received a tour of facilities and took part in various activities, including demonstrations in cryogenics and robotics.

Take Our Children to Work Day

NASA Image and Video Library

2008-07-16

Hundreds of children participated in the annual Take Our Children to Work Day at Stennis Space Center on July 29. During the day, children of Stennis employees received a tour of facilities and took part in various activities, including demonstrations in cryogenics and robotics.

The Life Cycle of the Child Care Center -- Understanding Center Growth and Development.

ERIC Educational Resources Information Center

Bess, Gary; Ratekin, Cindy

2001-01-01

Identifies the seven stages of the life cycle for child care centers: entrepreneurial; development; formalization; maturity; stagnation; death; and renewal. Suggests that critical transition points exist for organizational development, and that, if they are aware of and understand each stage of development, administrators may intervene at those…

Simulation and Analyses of Stage Separation of Two-Stage Reusable Launch Vehicles

NASA Technical Reports Server (NTRS)

Pamadi, Bandu N.; Neirynck, Thomas A.; Hotchko, Nathaniel J.; Tartabini, Paul V.; Scallion, William I.; Murphy, K. J.; Covell, Peter F.

2007-01-01

NASA has initiated the development of methodologies, techniques and tools needed for analysis and simulation of stage separation of next generation reusable launch vehicles. As a part of this activity, ConSep simulation tool is being developed which is a MATLAB-based front-and-back-end to the commercially available ADAMS(Registerd TradeMark) solver, an industry standard package for solving multi-body dynamic problems. This paper discusses the application of ConSep to the simulation and analysis of staging maneuvers of two-stage-to-orbit (TSTO) Bimese reusable launch vehicles, one staging at Mach 3 and the other at Mach 6. The proximity and isolated aerodynamic database were assembled using the data from wind tunnel tests conducted at NASA Langley Research Center. The effects of parametric variations in mass, inertia, flight path angle, altitude from their nominal values at staging were evaluated. Monte Carlo runs were performed for Mach 3 staging to evaluate the sensitivity to uncertainties in aerodynamic coefficients.

First Stage Acceptance Test

NASA Technical Reports Server (NTRS)

1960-01-01

This photograph shows the intense smoke and fire created by the five F-1 engines from a test firing of the Saturn V first stage (S-1C) in the S-1C test stand at the Marshall Space Flight Center. The towering 363-foot Saturn V was a multi-stage, multi-engine launch vehicle standing taller than the Statue of Liberty. Altogether, the Saturn V engines produced as much power as 85 Hoover Dams.

KENNEDY SPACE CENTER, FLA. - In the Orbiter Processing Facility, STS-114 Mission Specialist Wendy Lawrence takes a close look at the some of the tiles underneath Atlantis. Lawrence is a new addition to the mission crew. The STS-114 crew is at KSC to take part in crew equipment and orbiter familiarization.

NASA Image and Video Library

2003-10-30

KENNEDY SPACE CENTER, FLA. - In the Orbiter Processing Facility, STS-114 Mission Specialist Wendy Lawrence takes a close look at the some of the tiles underneath Atlantis. Lawrence is a new addition to the mission crew. The STS-114 crew is at KSC to take part in crew equipment and orbiter familiarization.

KENNEDY SPACE CENTER, FLA. - In the Orbiter Processing Facility, STS-114 Mission Specialist Andy Thomas takes a close look at the some of the tiles underneath Atlantis. Thomas is a new addition to the mission crew. The STS-114 crew is at KSC to take part in crew equipment and orbiter familiarization.

NASA Image and Video Library

2003-10-30

KENNEDY SPACE CENTER, FLA. - In the Orbiter Processing Facility, STS-114 Mission Specialist Andy Thomas takes a close look at the some of the tiles underneath Atlantis. Thomas is a new addition to the mission crew. The STS-114 crew is at KSC to take part in crew equipment and orbiter familiarization.

2011 Take Our Children to Work Day

NASA Image and Video Library

2011-07-26

Some 230 children of Stennis Space Center employees visited the facility July 26 to participate in annual Take Our Children to Work Day activities. Participants enjoyed various presentations and demonstrations on topics such as cryogenics, underwater robotics and geocaching.

Launch Vehicle Stage Adapter Move

NASA Image and Video Library

2017-08-24

A NASA KAMAG transporter moves the Space Launch System’s launch vehicle stage adapter (LVSA) to an area where spray-on foam insulation will be applied. The LVSA recently completed manufacturing on a 30 foot welding tool at NASA’s Marshall Space Flight Center in Huntsville, Al. The LVSA will be coated with insulation that will protect it during it’s trip to space. The LVSA provides structural support and connects the core stage and the interim cryogenic propulsion stage during the first integrated flight of SLS and Orion.

Validation of the CPS+EG and Neo-Bioscore staging systems after preoperative systemic therapy for breast cancer in a single center in China.

PubMed

Xu, Ling; Duan, Xuening; Zhou, Bin; Liu, Yinhua; Ye, Jingming; Liu, Zhaorui; Ma, Chao; Zhang, Hong; Zhang, Shuang; Zhang, Lanbo; Zhao, Jianxin; Cheng, Yuanjia

2018-04-17

Prognostic assessment after preoperative systemic therapy (PST) plays a vital role in determining treatment in breast cancer patients. Many researchers have sought to develop a system to quantitate residual tumor and its correlation with prognosis after PST. This retrospective study validated the CPS + EG staging system and Neo-Bioscore in a single center in China. Data from patients with non-metastatic primary breast cancer who were treated with PST and surgery from Jan. 2008 to Dec. 2014 at the Breast Disease Center of Peking University First Hospital, China, were reviewed. DFS, DSS and OS were calculated using the K-M curve and AUC. Multivariate analysis was used for a Cox proportional hazards model. All calculations were performed with SAS 9.4. A total of 403 patients were enrolled in this study. The median follow-up period was 45 (range 11-107) months. The five-year DFS, DSS and OS rates were 86.4%, 91.2% and 90.5%, respectively. The CS, PS, CPS + EG staging system and Neo-Bioscore stratified patients according to DFS, DSS, and OS after PST, with all P values < 0.0001. The CPS + EG staging system and Neo-Bioscore stratified prognosis after PST better than CS. HER2-positive patients without trastuzumab treatment had obviously worse DFS and OS than other subgroups with different HER2 statuses that scored a 3 in the Neo-Bioscore system. The CPS + EG staging system and Neo-Bioscore can improve prognostic prediction in non-pCR breast cancer patients after PST and, provided unfavorable prognostic factors such as insufficient treatment are incorporated, will have broader clinical applicability. Copyright © 2018 Elsevier Ltd. All rights reserved.

Second Stage (S-II) Arrives at Marshall Space Flight Center For Testing

NASA Technical Reports Server (NTRS)

2004-01-01

The business end of a Second Stage (S-II) slowly emerges from the shipping container as workers prepare to transport the Saturn V component to the testing facility at MSFC. The Second Stage (S-II) underwent vibration and engine firing tests. The towering 363-foot Saturn V was a multi-stage, multi-engine launch vehicle standing taller than the Statue of Liberty. Altogether, the Saturn V engines produced as much power as 85 Hoover Dams.

KENNEDY SPACE CENTER, FLA. - STS-114 Mission Commander Eileen Collins looks over flight equipment in the Orbiter Processing Facility, along with Glenda Laws, EVA Task Leader, with United Space Alliance at Johnson Space Center. The STS-114 crew is at KSC to take part in crew equipment and orbiter familiarization.

NASA Image and Video Library

2003-10-30

KENNEDY SPACE CENTER, FLA. - STS-114 Mission Commander Eileen Collins looks over flight equipment in the Orbiter Processing Facility, along with Glenda Laws, EVA Task Leader, with United Space Alliance at Johnson Space Center. The STS-114 crew is at KSC to take part in crew equipment and orbiter familiarization.

KENNEDY SPACE CENTER, FLA. - In the Orbiter Processing Facility, STS-114 Pilot James Kelly (center) and Mission Specialist Wendy Lawrence, who was recently added to the mission crew, look at the nose cap recently removed from Atlantis. The STS-114 crew is at KSC to take part in equipment familiarization.

NASA Image and Video Library

2003-10-30

KENNEDY SPACE CENTER, FLA. - In the Orbiter Processing Facility, STS-114 Pilot James Kelly (center) and Mission Specialist Wendy Lawrence, who was recently added to the mission crew, look at the nose cap recently removed from Atlantis. The STS-114 crew is at KSC to take part in equipment familiarization.

Family-Centered Care in Juvenile Justice Institutions: A Mixed Methods Study Protocol.

PubMed

Simons, Inge; Mulder, Eva; Rigter, Henk; Breuk, René; van der Vaart, Wander; Vermeiren, Robert

2016-09-12

Treatment and rehabilitation interventions in juvenile justice institutions aim to prevent criminal reoffending by adolescents and to enhance their prospects of successful social reintegration. There is evidence that these goals are best achieved when the institution adopts a family-centered approach, involving the parents of the adolescents. The Academic Workplace Forensic Care for Youth has developed two programs for family-centered care for youth detained in groups for short-term and long-term stay, respectively. The overall aim of our study is to evaluate the family-centered care program in the first two years after the first steps of its implementation in short-term stay groups of two juvenile justice institutions in the Netherlands. The current paper discusses our study design. Based on a quantitative pilot study, we opted for a study with an explanatory sequential mixed methods design. This pilot is considered the first stage of our study. The second stage of our study includes concurrent quantitative and qualitative approaches. The quantitative part of our study is a pre-post quasi-experimental comparison of family-centered care with usual care in short-term stay groups. The qualitative part of our study involves in-depth interviews with adolescents, parents, and group workers to elaborate on the preceding quantitative pilot study and to help interpret the outcomes of the quasi-experimental quantitative part of the study. We believe that our study will result in the following findings. In the quantitative comparison of usual care with family-centered care, we assume that in the latter group, parents will be more involved with their child and with the institution, and that parents and adolescents will be more motivated to take part in therapy. In addition, we expect family-centered care to improve family interactions, to decrease parenting stress, and to reduce problem behavior among the adolescents. Finally, we assume that adolescents, parents, and the

Developmental Stages in School Computer Use: Neither Marx Nor Piaget.

ERIC Educational Resources Information Center

Lengel, James G.

Karl Marx's theory of stages can be applied to computer use in the schools. The first stage, the P Stage, comprises the entry of the computer into the school. Computer use at this stage is personal and tends to center around one personality. Social studies teachers are seldom among this select few. The second stage of computer use, the D Stage, is…

Mars Science Laboratory Descent Stage

NASA Image and Video Library

2011-11-10

The descent stage of NASA Mars Science Laboratory spacecraft is being lifted during assembly of the spacecraft in this photograph taken inside the Payload Hazardous Servicing Facility at NASA Kennedy Space Center, Fla.

KENNEDY SPACE CENTER, FLA. - Children enjoy displays of security equipment during Take Our Children to Work Day. Employees were invited to share their work experience with their children on this annual event.

NASA Image and Video Library

2003-07-24

KENNEDY SPACE CENTER, FLA. - Children enjoy displays of security equipment during Take Our Children to Work Day. Employees were invited to share their work experience with their children on this annual event.

KENNEDY SPACE CENTER, FLA. - Children enjoy displays of fire equipment during Take Our Children to Work Day. Employees were invited to share their work experience with their children on this annual event.

NASA Image and Video Library

2003-07-24

KENNEDY SPACE CENTER, FLA. - Children enjoy displays of fire equipment during Take Our Children to Work Day. Employees were invited to share their work experience with their children on this annual event.

An estimation of water origins in the vicinity of a tropical cyclone's center and associated dynamic processes

NASA Astrophysics Data System (ADS)

Takakura, Toshinari; Kawamura, Ryuichi; Kawano, Tetsuya; Ichiyanagi, Kimpei; Tanoue, Masahiro; Yoshimura, Kei

2018-01-01

To clarify the time evolution of water origins in the vicinity of a tropical cyclone (TC)'s center, we have simulated Typhoon Man-yi (July 2007) in our case study, using an isotopic regional spectral model. The model results confirm that the replacement of water origins occurs successively as the TC develops and migrates northward over the western North Pacific. It is confirmed that, in this case, a significant proportion of total precipitable water around the cyclone center comes from external regions rather than the underlying ocean during the mature stage of a TC. Similar features can also be seen in the proportion of each oceanic origin to total condensation. Indian Ocean, South China Sea, and Maritime Continent water vapors begin to increase gradually at the developing stage and reach their peak at the decay stage when the TC approaches southwestern Japan. These remote ocean vapors are transported to the east of the cyclone via the moisture conveyor belt, a zone characterized by distinct low-level moisture flux that stretches from the Indian Ocean to the TC, and are further supplied into the inner region of the TC by inflow within the boundary layer associated with its secondary circulation. Since it takes time to undergo these two dynamic processes, the delayed influence of remote ocean vapors on the TC appears to become evident during the mature stage.

Mars Science Laboratory Cruise Stage

NASA Image and Video Library

2011-11-10

The cruise stage of NASA Mars Science Laboratory spacecraft is being prepared for final stacking of the spacecraft in this photograph from inside the Payload Hazardous Servicing Facility at NASA Kennedy Space Center, Fla.

TAKE OUR CHILDREN TO WORK DAY

NASA Image and Video Library

2016-06-23

NASA’S MARSHALL SPACE FLIGHT CENTER KICKS OFF ITS ANNUAL "TAKE OUR CHILDREN TO WORK DAY" EVENTS JUNE 23 WITH OPENING REMARKS FROM LOUCIOUS HIRES, DIRECTOR OF MARSHALL’S OFFICE OF DIVERSITY AND EQUAL OPPORTUNITY. AN ESTIMATED 500 POTENTIAL FUTURE SPACEFARERS, SCIENTISTS AND ENGINEERS IN GRADES 3-12 TOOK PART IN THE DAY’S ACTIVITIES, TOURS AND PRESENTATIONS.

International neuroblastoma staging system stage 1 neuroblastoma: a prospective study and literature review.

PubMed

Kushner, B H; Cheung, N K; LaQuaglia, M P; Ambros, P F; Ambros, I M; Bonilla, M A; Ladanyi, M; Gerald, W L

1996-07-01

To gain insight into the management of non-metastatic neuroblastoma by examining clinical and biologic features of International Neuroblastoma Staging System (INSS) stage 1 tumors. Patients were staged by both the INSS and the Evans staging system and were evaluated for biologic prognostic factors. Patients with INSS stage 1 received no cytotoxic therapy. The literature was reviewed for clinical and biologic data about INSS stage 1. We evaluated 10 consecutive patients (median age, 17.5 months) with INSS stage 1; all remain disease-free (median follow-up duration, > 5 years). Tumors were in the abdomen (n = 6), chest (n = 3), or pelvis (n = 1). Neuroblastoma involved margins of resection in six tumors. Poor-prognostic biologic findings included tumor-cell diploidy (n = 2) and unfavorable Shimada histopathology (n = 2). Two patients were to receive chemotherapy for, respectively, a tumor deemed unresectable and a tumor classified as Evans stage III; second opinions resulted in surgical management alone in each case. Published reports confirm that some INSS stage 1 patients (1) are at risk for overtreatment, and (2) have poor-prognostic biologic findings yet do well. Surgery alone suffices for INSS stage 1 neuroblastoma, even if biologic prognostic factors are unfavorable, microscopic disease remains after surgery, and tumor size is suggestive of "advanced-stage" status in other staging systems. Attempts to resect regionally confined neuroblastomas should take precedence over immediate use of cytotoxic therapy; otherwise, some patients may receive chemotherapy or radiotherapy unnecessarily.

Helping Students Take Control: A Model of Advising. Student Success Center.

ERIC Educational Resources Information Center

Moon, Brenda G.; Boland, Reginald

This handbook presents Rowan-Cabarrus Community College's (North Carolina) model of academic advising as embodied by its Student Success Center. Divided into seven parts, this handbook contains the following sections: a mission statement, Early Alert forms, evaluation tool, forms section, organizational chart of pre-college program, brochure, and…

Particle-Laden Leidenfrost Droplets: Final-Stage Observations

NASA Astrophysics Data System (ADS)

Fang, Zecong; Xu, Jie

2015-03-01

Little interest has been paid to the final stage of a Leidenfrost droplet until a recent study by Celestini et al [Phys. Rev. Lett. 109, 034501 (2012)] reporting an unexpected take-off phenomenon of micrometer sized pure liquid droplets (Rl < R take-off radius, and Ri is the critical radius above which droplets start to lose sphericity). In our study, we first report an unexpected observation on millimeter sized water Leidenfrost droplets (R >Ri), which behave quite differently from the previous study. While an originally micrometer sized Leidenfrost droplet takes off due to breakdown of lubrication regime, and hovers above its vapor layer until disappearing in the final stage of evaporation, an originally millimetric Leidenfrost drop is observed to hover and oscillate, taking off and falling back consecutively. We further report another interesting observation on water droplets containing micrometric glass beads. These droplets spontaneously organize and buckle together during evaporation. In addition to oscillation just like pure droplets, these particle-laden drops create an unexpected explosive shoot-up at the end of evaporation.

COMPASS Final Report: Enceladus Solar Electric Propulsion Stage

NASA Technical Reports Server (NTRS)

Oleson, Steven R.; McGuire, Melissa L.

2011-01-01

The results of the NASA Glenn Research Center (GRC) COllaborative Modeling and Parametric Assessment of Space Systems (COMPASS) internal Solar Electric Propulsion (SEP) stage design are documented in this report (Figure 1.1). The SEP Stage was designed to deliver a science probe to Saturn (the probe design was performed separately by the NASA Goddard Space Flight Center s (GSFC) Integrated Mission Design Center (IMDC)). The SEP Stage delivers the 2444 kg probe on a Saturn trajectory with a hyperbolic arrival velocity of 5.4 km/s. The design carried 30 percent mass, 10 percent power, and 6 percent propellant margins. The SEP Stage relies on the probe for substantial guidance, navigation and control (GN&C), command and data handling (C&DH), and Communications functions. The stage is configured to carry the probe and to minimize the packaging interference between the probe and the stage. The propulsion system consisted of a 1+1 (one active, one spare) configuration of gimbaled 7 kW NASA Evolutionary Xenon Thruster (NEXT) ion propulsion thrusters with a throughput of 309 kg Xe propellant. Two 9350 W GaAs triple junction (at 1 Astronomical Unit (AU), includes 10 percent margin) ultra-flex solar arrays provided power to the stage, with Li-ion batteries for launch and contingency operations power. The base structure was an Al-Li hexagonal skin-stringer frame built to withstand launch loads. A passive thermal control system consisted of heat pipes to north and south radiator panels, multilayer insulation (MLI) and heaters for the Xe tank. All systems except tanks and solar arrays were designed to be single fault tolerant.

The Second Stage of a Saturn V Ready For Test

NASA Technical Reports Server (NTRS)

1970-01-01

This Saturn V S-II (second) stage is being lifted into position for a test at the Vehicle Assembly Building at the Kennedy Space Center. When the Saturn V booster stage (S-IC) burned out and dropped away, power for the Saturn was provided by the 82-foot-long and 33-foot-diameter S-II stage. Developed by the Space Division of North American Aviation under the direction of the Marshall Space Flight Center, the stage utilized five J-2 engines, each producing 200,000 pounds of thrust. The engines used liquid oxygen and liquid hydrogen as propellants. The towering 363-foot Saturn V was a multi-stage, multi-engine launch vehicle standing taller than the Statue of Liberty. Altogether, the Saturn V engines produced as much power as 85 Hoover Dams.

Electric Field Control of Magnetism Using BiFeO3-Based Heterostructures

DTIC Science & Technology

2014-04-22

dissipation in the form of heat has become a center stage issue for the microelectronics industry. By taking advantage of the strong correlations...speed and storage density, significant energy dissipation in the form of heat has become a center stage issue for the microelectronics industry. By...and storage density, significant energy dissipation in the form of heat has become a center stage issue for the microelectronics industry. By taking

A 3-stage model of patient-centered communication for addressing cancer patients' emotional distress.

PubMed

Dean, Marleah; Street, Richard L

2014-02-01

To describe pathways through which clinicians can more effectively respond to patients' emotions in ways that contribute to betterment of the patient's health and well-being. A representative review of literature on managing emotions in clinical consultations was conducted. A three-stage, conceptual model for assisting clinicians to more effectively address the challenges of recognizing, exploring, and managing cancer patients' emotional distress in the clinical encounter was developed. To enhance and enact recognition of patients' emotions, clinicians can engage in mindfulness, self-situational awareness, active listening, and facilitative communication. To enact exploration, clinicians can acknowledge and validate emotions and provide empathy. Finally, clinicians can provide information empathetically, identify therapeutic resources, and give referrals and interventions as needed to help lessen patients' emotional distress. This model serves as a framework for future research examining pathways that link clinicians' emotional cue recognition to patient-centered responses exploring a patient's emotional distress to therapeutic actions that contribute to improved psychological and emotional health. Specific communicative and cognitive strategies are presented that can help clinicians better recognize a patient's emotional distress and respond in ways that have therapeutic value. Published by Elsevier Ireland Ltd.

Two stage to orbit design

NASA Technical Reports Server (NTRS)

1991-01-01

A preliminary design of a two-stage to orbit vehicle was conducted with the requirements to carry a 10,000 pound payload into a 300 mile low-earth orbit using an airbreathing first stage, and to take off and land unassisted on a 15,000 foot runway. The goal of the design analysis was to produce the most efficient vehicle in size and weight which could accomplish the mission requirements. Initial parametric analysis indicated that the weight of the orbiter and the transonic performance of the system were the two parameters that had the largest impact on the design. The resulting system uses a turbofan ramjet powered first stage to propel a scramjet and rocket powered orbiter to the stage point of Mach 6 to 6.5 at an altitude of 90,000 ft.

Rationale and design of a patient-centered medical home intervention for patients with end-stage renal disease on hemodialysis.

PubMed

Porter, Anna C; Fitzgibbon, Marian L; Fischer, Michael J; Gallardo, Rani; Berbaum, Michael L; Lash, James P; Castillo, Sheila; Schiffer, Linda; Sharp, Lisa K; Tulley, John; Arruda, Jose A; Hynes, Denise M

2015-05-01

In the U.S., more than 400,000 individuals with end-stage renal disease (ESRD) require hemodialysis (HD) for renal replacement therapy. ESRD patients experience a high burden of morbidity, mortality, resource utilization, and poor quality of life (QOL). Under current care models, ESRD patients receive fragmented care from multiple providers at multiple locations. The Patient-Centered Medical Home (PCMH) is a team approach, providing coordinated care across the healthcare continuum. While this model has shown some early benefits for complex chronic diseases such as diabetes, it has not been applied to HD patients. This study is a non-randomized quasi-experimental intervention trial implementing a Patient-Centered Medical Home for Kidney Disease (PCMH-KD). The PCMH-KD extends the existing dialysis care team (comprised of a nephrologist, dialysis nurse, dialysis technician, social worker, and dietitian) by adding a general internist, pharmacist, nurse coordinator, and a community health worker, all of whom will see the patients together, and separately, as needed. The primary goal is to implement a comprehensive, multidisciplinary care team to improve care coordination, quality of life, and healthcare use for HD patients. Approximately 240 patients will be recruited from two sites; a non-profit university-affiliated dialysis center and an independent for-profit dialysis center. Outcomes include (i) patient-reported outcomes, including QOL and satisfaction; (ii) clinical outcomes, including blood pressure and diet; (iii) healthcare use, including emergency room visits and hospitalizations; and (iv) staff perceptions. Given the significant burden that patients with ESRD on HD experience, enhanced care coordination provides an opportunity to reduce this burden and improve QOL. Copyright © 2015 Elsevier Inc. All rights reserved.

Stage III nasopharyngeal angiofibroma: Improving results with endoscopic-assisted midfacial degloving and modification to the Fisch staging system.

PubMed

Shah, Saurin R; Keshri, Amit; Patadia, Simple; Sahu, Rabi Narayan; Srivastava, Arun Kumar; Behari, Sanjay

2015-10-01

To study outcomes with endoscopic-assisted midfacial degloving for Fisch stage III nasopharyngeal angiofibroma and propose a new staging system. Retrospective study of patients with Fisch stage III juvenile nasopharyngeal angiofibroma (JNA) including preoperative angiography, intraoperative blood loss and residue/recurrence following surgery. Tertiary care superspecialty referral center. Fifteen consecutive patients with Fisch stage III JNA undergoing operations over a period of 18 months. Preoperative angiography details, intraoperative blood loss, residue/recurrence, complications of surgery. Transarterial embolization with particulate agents followed by endoscopic-assisted midfacial degloving provides excellent outcomes with Fisch stage III JNAs. The modified Fisch staging system proposed would allow better preoperative evaluation and comparison of outcomes with different treatment options for stage III JNAs. Copyright © 2015 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

Differential associations between impulsivity and risk-taking and brain activations underlying working memory in adolescents.

PubMed

Panwar, Karni; Rutherford, Helena J V; Mencl, W Einar; Lacadie, Cheryl M; Potenza, Marc N; Mayes, Linda C

2014-11-01

Increased impulsivity and risk-taking are common during adolescence and relate importantly to addictive behaviors. However, the extent to which impulsivity and risk-taking relate to brain activations that mediate cognitive processing is not well understood. Here we examined the relationships between impulsivity and risk-taking and the neural correlates of working memory. Neural activity was measured in 18 adolescents (13-18 years) while they engaged in a working memory task that included verbal and visuospatial components that each involved encoding, rehearsal and recognition stages. Risk-taking and impulsivity were assessed using the Balloon Analogue Risk Task (BART) and the adolescent version of the Barratt Impulsiveness Scale-11 (BIS-11A), respectively. We found overlapping as well as distinct regions subserving the different stages of verbal and visuospatial working memory. In terms of risk-taking, we found a positive correlation between BART scores and activity in subcortical regions (e.g., thalamus, dorsal striatum) recruited during verbal rehearsal, and an inverse correlation between BART scores and cortical regions (e.g., parietal and temporal regions) recruited during visuospatial rehearsal. The BIS-11A evidenced that motor impulsivity was associated with activity in regions recruited during all stages of working memory, while attention and non-planning impulsivity was only associated with activity in regions recruited during recognition. In considering working memory, impulsivity and risk-taking together, both impulsivity and risk-taking were associated with activity in regions recruited during rehearsal; however, during verbal rehearsal, differential correlations were found. Specifically, positive correlations were found between: (1) risk-taking and activity in subcortical regions, including the thalamus and dorsal striatum; and, (2) motor impulsivity and activity in the left inferior frontal gyrus, insula, and dorsolateral prefrontal cortex. Therefore

Differential associations between impulsivity and risk-taking and brain activations underlying working memory in adolescents

PubMed Central

Panwar, Karni; Rutherford, Helena J.V.; Mencl, W. Einar; Lacadie, Cheryl M.; Potenza, Marc N.; Mayes, Linda C.

2014-01-01

Increased impulsivity and risk-taking are common during adolescence and relate importantly to addictive behaviors. However, the extent to which impulsivity and risk-taking relate to brain activations that mediate cognitive processing is not well understood. Here we examined the relationships between impulsivity and risk-taking and the neural correlates of working memory. Neural activity was measured in 18 adolescents (13–18 years) while they engaged in a working memory task that included verbal and visuospatial components that each involved encoding, rehearsal and recognition stages. Risk-taking and impulsivity were assessed using the Balloon Analogue Risk Task (BART) and the adolescent version of the Barratt Impulsiveness Scale -11 (BIS-11A), respectively. We found overlapping as well as distinct regions subserving the different stages of verbal and visuospatial working memory. In terms of risk-taking, we found a positive correlation between BART scores and activity in subcortical regions (e.g., thalamus, dorsal striatum) recruited during verbal rehearsal, and an inverse correlation between BART scores and cortical regions (e.g., parietal and temporal regions) recruited during visuospatial rehearsal. The BIS-11A evidenced that motor impulsivity was associated with activity in regions recruited during all stages of working memory, while attention and non-planning impulsivity was only associated with activity in regions recruited during recognition. In considering working memory, impulsivity and risk-taking together, both impulsivity and risk-taking were associated with activity in regions recruited during rehearsal; however, during verbal rehearsal, differential correlations were found. Specifically, positive correlations were found between: (1) risk-taking and activity in subcortical regions, including the thalamus and dorsal striatum; and, (2) motor impulsivity and activity in the left inferior frontal gyrus, insula, dorsolateral and ventrolateral prefrontal

Kohlberg and Piaget on Stages and Moral Reasoning.

ERIC Educational Resources Information Center

Carpendale, Jeremy I. M.

2000-01-01

Maintains that although Kohlberg emphasized the importance of perspective taking in moral reasoning, his view of developmental stages is inconsistent with this position. Argues that a modification of Kohlberg's conception of stages drawing on Piagetian theory would result in a view of moral reasoning as a process of coordinating all perspectives…

Interim Cryogenic Propulsion Stage (ICPS) Transport from DOC to

NASA Image and Video Library

2017-07-26

The Interim Cryogenic Propulsion Stage (ICPS) for NASA's Space Launch System (SLS) rocket, packed inside a canister, exits the United Launch Alliance (ULA) Delta Operations Center near Space Launch Complex 37 at Cape Canaveral Air Force Station for its move to the Space Station Processing Facility at NASA's Kennedy Space Center in Florida. The ICPS is the first integrated piece of flight hardware to arrive for the SLS. It is the in-space stage that is located toward the top of the rocket, between the Launch Vehicle Stage Adapter and the Orion Spacecraft Adapter. It will provide some of the in-space propulsion during Orion's first flight test atop the SLS on Exploration Mission-1.

Interim Cryogenic Propulsion Stage (ICPS) Prep for Transport fro

NASA Image and Video Library

2017-07-25

The Interim Cryogenic Propulsion Stage (ICPS) for NASA's Space Launch System (SLS) rocket is packed inside a canister and ready to be moved from the United Launch Alliance (ULA) Delta Operations Center near Space Launch Complex 37 at Cape Canaveral Air Force Station to the Space Station Processing Facility at NASA's Kennedy Space Center in Florida. The ICPS is the first integrated piece of flight hardware to arrive for the SLS. It is the in-space stage that is located toward the top of the rocket, between the Launch Vehicle Stage Adapter and the Orion Spacecraft Adapter. It will provide some of the in-space propulsion during Orion's first flight test atop the SLS on Exploration Mission-1.

Interim Cryogenic Propulsion Stage (ICPS) Transport from DOC to

NASA Image and Video Library

2017-07-26

The Interim Cryogenic Propulsion Stage (ICPS) for NASA's Space Launch System (SLS) rocket is packed inside a canister and ready to exit the United Launch Alliance (ULA) Delta Operations Center near Space Launch Complex 37 at Cape Canaveral Air Force Station for its move to the Space Station Processing Facility at NASA's Kennedy Space Center in Florida. The ICPS is the first integrated piece of flight hardware to arrive for the SLS. It is the in-space stage that is located toward the top of the rocket, between the Launch Vehicle Stage Adapter and the Orion Spacecraft Adapter. It will provide some of the in-space propulsion during Orion's first flight test atop the SLS on Exploration Mission-1.

Interim Cryogenic Propulsion Stage (ICPS) Transport from DOC to

NASA Image and Video Library

2017-07-26

The Interim Cryogenic Propulsion Stage (ICPS) for NASA's Space Launch System (SLS) rocket, packed inside a canister, is transported from the United Launch Alliance (ULA) Delta Operations Center near Space Launch Complex 37 at Cape Canaveral Air Force Station along the route to the Space Station Processing Facility at NASA's Kennedy Space Center in Florida. The ICPS is the first integrated piece of flight hardware to arrive for the SLS. It is the in-space stage that is located toward the top of the rocket, between the Launch Vehicle Stage Adapter and the Orion Spacecraft Adapter. It will provide some of the in-space propulsion during Orion's first flight test atop the SLS on Exploration Mission-1.

Market-stage analysis enhances strategic planning.

PubMed

McDonald, R B

1998-07-01

Changing market conditions are challenging healthcare organizations to determine how to allocate resources and make operational planning decisions to prepare for future changes. A vital part of meeting these challenges is understanding the impact of market stages, and using that knowledge to build effective business strategies. Financial modeling that includes market-stage information provides insight into market opportunities and presents a clearer picture of the organizational changes that will need to be implemented at each stage. Effective strategic action should take into account critical success factors in market responsiveness, organizational responsiveness, operational effectiveness, and financial strength.

Upper-Stage Flight Experiment

NASA Technical Reports Server (NTRS)

Anderson, W. E.; Boxwell, R.; Crockett, D. V.; Ross, R.; Lewis, T.; McNeal, C.; Verdarame, K.

1999-01-01

For propulsion applications that require that the propellants are storable for long periods, have a high density impulse, and are environmentally clean and non-toxic, the best choice is a combination of high-concentration hydrogen peroxide (High Test Peroxide, or HTP) and a liquid hydrocarbon (LHC) fuel. The HTP/LHC combination is suitable for low-cost launch vehicles, space taxi and space maneuvering vehicles, and kick stages. Orbital Sciences Corporation is under contract with the NASA Marshall Space Flight Center in cooperation with the Air Force Research Lab to design, develop and demonstrate a new low-cost liquid upper stage based on HTP and JP-8. The Upper Stage Flight Experiment (USFE) focuses on key technologies necessary to demonstrate the operation of an inherently simple propulsion system with an innovative, state-of-the-art structure. Two key low-cost vehicle elements will be demonstrated - a 10,000 lbf thrust engine and an integrated composite tank structure. The suborbital flight test of the USFE is scheduled for 2001. Preceding the flight tests are two major series of ground tests at NASA Stennis Space Center and a subscale tank development program to identify compatible composite materials and to verify their compatibility over long periods of time. The ground tests include a thrust chamber development test series and an integrated stage test. This paper summarizes the results from the first phase of the thrust chamber development tests and the results to date from the tank material compatibility tests. Engine and tank configurations that meet the goals of the program are described.

Patient-centered communication to assess and enhance patient adherence to glaucoma medication.

PubMed

Hahn, Steven R

2009-11-01

Using an understanding of a patient's difficulty in revealing nonadherence and patient-centered communication skills to identify and address barriers to adherence to glaucoma medication regimens. In addition to cost and logistical difficulties with obtaining and administering medicine, a patient's adherence to medication is influenced by the balance between the perceived need for medication and concerns about taking medication. This article is based on both the author's clinical experience and peer-reviewed research on effective doctor-patient communication and assessment and management of nonadherence. Three strategies have been identified that help physicians to detect and address problems with adherence: (1) a 4-step adherence assessment interview designed to detect nonadherence that decreases patient resistance to revealing nonadherence by applying a shared decision-making process and mitigating social undesirability; (2) asking open-ended questions in ask-tell-ask sequences; and (3) tailoring interventions to the patient's stage of readiness for change. Patients conceal nonadherence because they want to be thought of by their physicians as good patients. They are driven to nonadherence by an imbalance between their perceived need for medication and their concerns about taking it. Patient-centered communication techniques can engage the patient in shared decision making about medication, thereby redefining the good patient as someone who works with his or her health care provider to address adherence barriers. Those barriers can be explored with open-ended questions designed to elicit the patient's understanding and concerns, to provide information, and to assess change in the patient's understanding and attitudes. Communication will be more effective if it is based on the patient's stage of readiness to adopt adherent self-management practices. Proprietary or commercial disclosure may be found after the references.

Laparoscopic staging for apparent stage I epithelial ovarian cancer.

PubMed

Melamed, Alexander; Keating, Nancy L; Clemmer, Joel T; Bregar, Amy J; Wright, Jason D; Boruta, David M; Schorge, John O; Del Carmen, Marcela G; Rauh-Hain, J Alejandro

2017-01-01

Whereas advances in minimally invasive surgery have made laparoscopic staging technically feasible in stage I epithelial ovarian cancer, the practice remains controversial because of an absence of randomized trials and lack of high-quality observational studies demonstrating equivalent outcomes. This study seeks to evaluate the association of laparoscopic staging with survival among women with clinical stage I epithelial ovarian cancer. We used the National Cancer Data Base to identify all women who underwent surgical staging for clinical stage I epithelial ovarian cancer diagnosed from 2010 through 2012. The exposure of interest was planned surgical approach (laparoscopy vs laparotomy), and the primary outcome was overall survival. The primary analysis was based on an intention to treat: all women whose procedures were initiated laparoscopically were categorized as having had a planned laparoscopic procedure, regardless of subsequent conversion to laparotomy. We used propensity methods to match patients who underwent planned laparoscopic staging with similar patients who underwent planned laparotomy based on observed characteristics. We compared survival among the matched cohorts using the Kaplan-Meier method and Cox regression. We compared the extent of lymphadenectomy using the Wilcoxon rank-sum test. Among 4798 eligible patients, 1112 (23.2%) underwent procedures that were initiated laparoscopically, of which 190 (17%) were converted to laparotomy. Women who underwent planned laparoscopy were more frequently white, privately insured, from wealthier ZIP codes, received care in community cancer centers, and had smaller tumors that were more frequently of serous and less often of mucinous histology than those who underwent staging via planned laparotomy. After propensity score matching, time to death did not differ between patients undergoing planned laparoscopic vs open staging (hazard ratio, 0.77, 95% confidence interval, 0.54-1.09; P = .13). Planned

Hydrothermal mineralization at seafloor spreading centers

NASA Astrophysics Data System (ADS)

Rona, Peter A.

1984-01-01

zones of active extension) common to all spreading centers, regional tectonic setting determined by stage (early, advanced), and rate (slow, intermediate-to-fast) of opening of an ocean basin about a spreading center, and local tectonic sub-setting that incorporates anomalous structural and thermal conditions conducive to mineral concentration (thermal gradient, permeability, system geometry, leaky versus tight hydrothermal systems). Temporal frames of reference comprise the relation between mineral concentration and timing of regional plutonic, volcanic and tectonic cycles and of episodic local physical and chemical events (transient stress, fluctuating heat transfer, intrusion-extrusion, fracturing, sealing, etc.). Types of hydrothermal deposits are not uniquely associated with specific tectonic settings and subsettings. Similar types of hydrothermal deposits may occur in different tectonic settings as a consequence of convergence of physical and chemical processes of concentration. Local tectonic sub-settings with conditions conducive to hydrothermal mineralization at slow-spreading centers (half rate ≤ 2cm y -1; length c. 28,000 km), characterized by an estimated average convective heat transfer of 15.1·10 8 cal. cm -2, deep-level ( > 3 km), relative narrow (< 5 km wide at base) magma chambers, and high topographic relief (1-5 km) are: (1) basins along linear sections of the axial zone of volcanic extrusion near transform faults at an early stage of opening, represented by a large stratiform sulfide deposit (estimated 32.5·10 6 metric tons) of the Atlantis II Deep of the Red Sea; (2) the wall along linear sections of the rift valley in the marginal zone of active extension at an advanced stage of opening, represented by encrustations and layered deposits of manganese and iron oxides, hydroxides and silicates inferred to be underlain by stockwork sulfides at the TAG Hydrothermal Field at latitude 26°C on the Mid-Atlantic Ridge; (3) transform faults, especially

Assessment of Stage 35 With APNASA

NASA Technical Reports Server (NTRS)

Celestina, Mark L.; Mulac, Richard

2009-01-01

An assessment of APNASA was conducted at NASA Glenn Research Center under the Fundamental Aeronautics Program to determine their predictive capabilities. The geometry selected for this study was Stage 35 which is a single stage transonic compressor. A speedline at 100% speed was generated and compared to experimental data at 100% speed for two turbulence models. Performance of the stage at 100% speed and profiles of several key aerodynamic parameters are compared to the survey data downstream of the stator in this report. In addition, hub leakage was modeled and compared to solutions without leakage and the available experimental data.

Single-stage-to-orbit performance enhancement from take-off thrust augmentation

NASA Astrophysics Data System (ADS)

Galati, Terence; Elkins, Travis

1997-01-01

Thrust augmentation offers the Single Stage to Orbit (SSTO) space launch vehicle improved payload capability while reducing vehicle weight and cost. Optimization of vehicle configuration and flight profile are studied. Using a 612,000 kg Gross Lift Off Weight (GLOW) SSTO with three Castor® strap-on motors, payloads in excess of 18,000 kg to Low Earth Orbit (LEO) are achievable. Emphasis is placed on finding vehicle optimums in the 9,000 kg payload range to capture over 80% of commercial payloads. Strap-on boosters allow a small SSTO vehicle to fly with a mass fraction of only 0.88 and LOX/H2 engines operating at 445 sec vacuum specific impulse. Payload sensitivity due to variations of mass fraction, Isp and pitch rate are quantified.

Reliability of center of pressure measures for assessing the development of sitting postural control through the stages of sitting.

PubMed

Wickstrom, Jordan; Stergiou, Nick; Kyvelidou, Anastasia

2017-07-01

Cerebral palsy (CP) impairs an individual's ability to move and control one's posture. Unfortunately, the signs and symptoms of CP may not be apparent before age two. Evaluating sitting posture is a potential way to assess the developing mechanisms that contribute to CP. The purpose of this project was to determine the reliability of linear and nonlinear measures, including inter- and intrastage reliability, when used to analyze the center of pressure (COP) time series during the stages of sitting development in children with typical development (TD) and with/at-risk for cerebral palsy (CP). We hypothesized that nonlinear tools would be more reliable than linear tools in assessing childrens' sitting development, and reliability would increase with development. COP data was recorded for three trials at eight sessions. Linear parameters used were root mean square, range of sway for the anterior-posterior (AP) and medial-lateral (ML) directions, and sway path. Nonlinear parameters used were Approximate Entropy, the largest Lyapunov Exponent, and Correlation Dimension for the AP and ML direction. Participants consisted of 33 children with TD and 26 children with/at-risk for CP. Our results determined that COP is a moderately reliable method for assessing the development of sitting postural control in stages in both groups. Thus, clinicians may be able to use measures from COP data across stages to assess the efficacy of therapeutic interventions that are intended to improve sitting postural abilities in children with/at-risk for CP. Copyright © 2017 Elsevier B.V. All rights reserved.

Community Centers and Student Unions.

ERIC Educational Resources Information Center

Sternberg, Eugene D.; Sternberg, Barbara E.

An overview of the social and planning concepts which serve as a foundation for the location, programming, and operation of various types of community centers and student unions is offered in this book. Pointing up the vital role of these institutions in meeting current community needs, it takes a look at community centers and student unions from…

Prelaunch - Apollo VII (Erection of First Stage) - KSC

NASA Image and Video Library

1968-04-15

S68-29781 (22 April 1968) --- Low angle view at the Kennedy Space Center's Pad 34 showing the erection of the first stage of the Saturn 205 launch vehicle. The two-stage Saturn IB will be the launch vehicle for the first unmanned Apollo space mission, Apollo 7 (Spacecraft 101/Saturn 205).

Center removal amount control of magnetorheological finishing process by spiral polishing way

NASA Astrophysics Data System (ADS)

Wang, Yajun; He, Jianguo; Ji, Fang; Huang, Wen; Xiao, Hong; Luo, Qing; Zheng, Yongcheng

2010-10-01

Spiral polishing is a traditional process of computer-controlled optical surfacing. However, the additional polishing amount is great and the center polishing amount is difficult to control. At first, a simplified mathematics model is presented for magnetorheological finishing, which indicates that the center polishing amount and additional polishing amount are proportional to the length and peak value of magnetorheological finishing influence function, and are inversely proportional to pitch and rotation rate of spiral track, and the center polishing amount is much bigger than average polishing amount. Secondly, the relationships of "tool feed way and center polishing amount", "spiral pitch and calculation accuracy of influence matrix for dwell time function solution", "spiral pitch and center polishing amount" and "peak removal rate, dimensions of removal function and center removal amount" are studied by numerical computation by Archimedes spiral path. It shows that the center polishing amount is much bigger in feed stage than that in backhaul stage when the head of influence function is towards workpiece edge in feeding; and the bigger pitch, the bigger calculation error of influence matrix elements; and the bigger pitch, the smaller center polishing amount, and the smaller peak removal rate and dimensions of removal function, the smaller center removal amount. At last, the polishing results are given, which indicates that the center polishing amount is acceptable with a suitable polishing amount rate of feed stage and backhaul stage, and with a suitable spiral pitch during magnetorheological finishing procedure by spiral motion way.

Shakespeare Page to Stage: An Active Approach to "Othello."

ERIC Educational Resources Information Center

Thomas, Peter

1994-01-01

Presents an account of how one English teacher taught William Shakespeare's "Othello" through dramatics in a challenging way. Considers how teachers of drama might discuss props, stage directions, and the proper handling of Desdemona's handkerchief. Explains how teachers should try to take the plays from "page to stage." (HB)

Plugging Into GEOSS - A Data Center Takes the Leap

NASA Astrophysics Data System (ADS)

Khalsa, S. S.; Weaver, R. L.; Duerr, R. E.; Shaw, A.

2008-12-01

The data sets managed and distributed by the National Snow and Ice Data Center in Boulder, Colorado are accessible through a variety of interfaces: custom web services, WIST, which is the NASA EOS Data System interface, and by simple FTP. The Global Earth Observation System of Systems, GEOSS, offers the potential to make our data visible and accessible in the context of a much larger and more widely available system. But what does a data center have to do to tie into this larger system? What are the optimal data formats and protocols that should be maintained? What metadata standards and services should we sustain in order to maximize the visibility of our data? How will our holdings in existing catalogs be harvested by GEOSS? We address these questions through a pilot study that we report on in this paper. On June 2, 2008 the Group on Earth Observation, GEO, announced that the GEOSS Common Infrastructure (GCI) was "open for business," and that this Initial Operating Capability (IOC) was beginning a 1-year testing and evaluation period. The purpose of the IOC is two-fold: first, to encourage Earth observation providers to populate GEOSS by registering their data sets, services, and other components; and 2) to allow the global community to use, evaluate and thereby improve the GCI. NSIDC is contributing to both objectives. The GEOSS 10-Year Implementation Plan specifies, at a very high level, recommended standards for connectivity for services, data and metadata. GEO has also published Tactical and Strategic Guidance Documents to help data providers like NSIDC decide how it should proceed to become an active participant in the GEOSS. GEOSS and NSIDC are both adopting many of the OGC standards as their respective systems evolve. But how well do the OGC implementations of each of these entities mesh? What are the gaps, what are the currently less well developed yet critical path standards that require work? We describe our experiences in registering several data sets

Career Development through Life-Centered Education.

ERIC Educational Resources Information Center

Wernick, Walter

Schooling can be a terrible social disease, if it generates grasping, self-centered individuals seeking freedom from responsibility rather than life-centered human beings seeking freedom for responsibility. Career education can focus on individuals, but help them see themselves as characters in a larger play on the world's stage. Others may have…

Helping Leaders Take Effective Action: A Program Evaluation.

ERIC Educational Resources Information Center

Young, Dianne P.; Dixon, Nancy M.

In 1991 the Center for Creative Leadership (CCL) launched its LeaderLab program, with the goal of helping executives take more effective action in their leadership situations. This publication presents findings of a program evaluation that explored whether program participants took more effective action in their leadership situations. Data were…

Two-Stage Centrifugal Fan

NASA Technical Reports Server (NTRS)

Converse, David

2011-01-01

Fan designs are often constrained by envelope, rotational speed, weight, and power. Aerodynamic performance and motor electrical performance are heavily influenced by rotational speed. The fan used in this work is at a practical limit for rotational speed due to motor performance characteristics, and there is no more space available in the packaging for a larger fan. The pressure rise requirements keep growing. The way to ordinarily accommodate a higher DP is to spin faster or grow the fan rotor diameter. The invention is to put two radially oriented stages on a single disk. Flow enters the first stage from the center; energy is imparted to the flow in the first stage blades, the flow is redirected some amount opposite to the direction of rotation in the fixed stators, and more energy is imparted to the flow in the second- stage blades. Without increasing either rotational speed or disk diameter, it is believed that as much as 50 percent more DP can be achieved with this design than with an ordinary, single-stage centrifugal design. This invention is useful primarily for fans having relatively low flow rates with relatively high pressure rise requirements.

Two-stage fixed-bed gasifier with selectable middle gas off-take point

DOEpatents

Strickland, Larry D.; Bissett, Larry A.

1992-01-01

A two-stage fixed bed coal gasifier wherein an annular region is in registry with a gasification zone underlying a devolatilization zone for extracting a side stream of high temperature substantially tar-free gas from the gasifier. A vertically displaceable skirt means is positioned within the gasifier to define the lower portion of the annular region so that vertical displacement of the skirt means positions the inlet into the annular region in a selected location within or in close proximity to the gasification zone for providing a positive control over the composition of the side stream gas.

Is Your Center Burglar/Vandal Proofed? Guidelines for Protecting Your Center.

ERIC Educational Resources Information Center

Adams, Shawn

1998-01-01

Identifies specific steps that child care centers can take to reduce the chances of burglary and vandalism. Differentiates loss prevention, loss control, and risk financing. Includes discussion of layering defenses, perimeter protection, security lighting, building surface security, locks, and alarm systems. Discusses the importance of reducing…

KENNEDY SPACE CENTER, FLA. - Children enjoy a hands-on display of security equipment during Take Our Children to Work Day. Employees were invited to share their work experience with their children on this annual event.

NASA Image and Video Library

2003-07-24

KENNEDY SPACE CENTER, FLA. - Children enjoy a hands-on display of security equipment during Take Our Children to Work Day. Employees were invited to share their work experience with their children on this annual event.

KENNEDY SPACE CENTER, FLA. - Children enjoy a hands-on display of fire equipment behind KSC NASA Headquarters. Employees were invited to share their work experience with their children for Take Our Children to Work Day.

NASA Image and Video Library

2003-07-24

KENNEDY SPACE CENTER, FLA. - Children enjoy a hands-on display of fire equipment behind KSC NASA Headquarters. Employees were invited to share their work experience with their children for Take Our Children to Work Day.

Primary centers and secondary concentrations of tectonic activity through time in the western hemisphere of Mars

USGS Publications Warehouse

Anderson, R.C.; Dohm, J.M.; Golombek, M.P.; Haldemann, A.F.C.; Franklin, B.J.; Tanaka, K.L.; Lias, J.; Peer, B.

2001-01-01

Five main stages of radial and concentric structures formed around Tharsis from the Noachian through the Amazonian as determined by geologic mapping of 24,452 structures within the stratigraphic framework of Mars and by testing their radial and concentric orientations. Tectonic activity peaked in the Noachian (stage 1) around the largest center, Claritas, an elongate center extending more than 20?? in latitude and defined by about half of the total grabens which are concentrated in the Syria Planum, Thaumasia, and Tempe Terra regions. During the Late Noachian and Early Hesperian (stage 2), extensional structures formed along the length of present-day Valles Marineris and in Thaumasia (with a secondary concentration near Warrego Vallis) radial to a region just to the south of the central margin of Valles Marineris. Early Hesperian (stage 3) radial grabens in Pavonis, Syria, Ulysses, and Tempe Terra and somewhat concentric wrinkle ridges in Lunae and Solis Plana and in Thaumasia, Sirenum, Memnonia, and Amazonis are centered northwest of Syria with secondary centers at Thaumasia, Tempe Terra, Ulysses Fossae, and western Valles Marineris. Late Hesperian/Early Amazonian (stage 4) structures around Alba Patera, the northeast trending alignment of Tharsis Montes, and Olympus Mons appears centered on Alba Patera. Stage 5 structures (Middle-Late Amazonian) represent the last pulse of Tharsis-related activity and are found around the large shield volcanoes and are centered near Pavonis Mons. Tectonic activity around Tharsis began in the Noachian and generally decreased through geologic time to the Amazonian. Statistically significant radial distributions of structures formed during each stage, centered at different locations within the higher elevations of Tharsis. Secondary centers of radial structures during many of the stages appear related to previously identified local magmatic centers that formed at different times and locations throughout Tharsis. Copyright 2001 by

Career Development and Promotion in an Academic Health Center.

PubMed

Christophersen, Edward R

2017-03-01

This paper examines the successive stages of the career path for psychologists who commit to spending their professional lives working in academic health centers. Key factors for success at each stage are described, as are the steps required for progressing to subsequent stages of professional development. The paper breaks new ground by including consideration of a post-retirement stage, "Professor Emeritus status."

Radiation Therapy With Durvalumab or Cetuximab in Treating Patients With Stage III-IVB Head and Neck Cancer Who Cannot Take Cisplatin

ClinicalTrials.gov

2018-06-15

Head and Neck Squamous Cell Carcinoma; Stage III Hypopharyngeal Squamous Cell Carcinoma AJCC v7; Stage III Laryngeal Squamous Cell Carcinoma AJCC v6 and v7; Stage III Oral Cavity Squamous Cell Carcinoma AJCC v6 and v7; Stage III Oropharyngeal Squamous Cell Carcinoma AJCC v7; Stage IVA Hypopharyngeal Squamous Cell Carcinoma AJCC v7; Stage IVA Laryngeal Squamous Cell Carcinoma AJCC v7; Stage IVA Oral Cavity Squamous Cell Carcinoma AJCC v6 and v7; Stage IVA Oropharyngeal Squamous Cell Carcinoma AJCC v7; Stage IVB Hypopharyngeal Squamous Cell Carcinoma AJCC v7; Stage IVB Laryngeal Squamous Cell Carcinoma AJCC v7; Stage IVB Oral Cavity Squamous Cell Carcinoma AJCC v6 and v7; Stage IVB Oropharyngeal Squamous Cell Carcinoma AJCC v7

Center for Advanced Space Propulsion

NASA Technical Reports Server (NTRS)

1995-01-01

The Center for Advanced Space Propulsion (CASP) is part of the University of Tennessee-Calspan Center for Aerospace Research (CAR). It was formed in 1985 to take advantage of the extensive research faculty and staff of the University of Tennessee and Calspan Corporation. It is also one of sixteen NASA sponsored Centers established to facilitate the Commercial Development of Space. Based on investigators' qualifications in propulsion system development, and matching industries' strong intent, the Center focused its efforts in the following technical areas: advanced chemical propulsion, electric propulsion, AI/Expert systems, fluids management in microgravity, and propulsion materials processing. This annual report focuses its discussion in these technical areas.

Astronaut Kevin Chilton takes a break during bailout training

NASA Image and Video Library

1993-12-22

S93-50720 (22 Dec 1993) --- Astronaut Kevin P. Chilton, pilot, takes a break during emergency bailout training at the Johnson Space Center's (JSC) Weightless Environment Training Facility (WET-F). Chilton and five other NASA astronauts are scheduled to fly aboard the Space Shuttle Endeavour next year.

Five Stage Missile Research Rocket, Wallops Island , 1957

NASA Image and Video Library

1957-11-19

**Note also copied and numbered as L90-3749. -- L57-4827 caption: Take off of a five-stage missile research rocket from Wallops Island in 1957. The first two stages propelled the model to about 100,000 feet the last three stages were fired on a descending path to simulate the reentry conditions of ballistic missiles. -- Photograph published in Winds of Change, 75th Anniversary NASA publication (page 72), by James Schultz. -- Photograph also published in Engineer in Charge: A History of the Langley Aeronautical Laboratory, 1917-1958 by James R. Hansen (page 380).

A shadowgraph study of the National Launch System's 1 1/2 stage vehicle configuration and Heavy Lift Launch Vehicle configuration. [Using the Marshall Space Flight Center's 14-Inch Trisonic Wind Tunnel

NASA Technical Reports Server (NTRS)

Pokora, Darlene C.; Springer, Anthony M.

1994-01-01

A shadowgraph study of the National Launch System's (NLS's) 1 1/2 stage and heavy lift launch vehicle (HLLV) configurations is presented. Shadowgraphs are shown for the range of Mach numbers from Mach 0.6 to 5.0 at various angles-of-attack and roll angles. Since the 1 1/2 stage configuration is generally symmetric, no shadowgraphs of any roll angle are shown for this configuration. The major flow field phenomena over the NLS 1 1/2 stage and HLLV configurations are shown in the shadowgraphs. These shadowgraphs are used in the aerothermodynamic analysis of the external flow conditions the launch vehicle would encounter during the ascent stage of flight. The shadowgraphs presented in this study were obtained from configurations tested in the Marshall Space Flight Center's 14-Inch Trisonic Wind Tunnel during 1992.

Ares I Crew Launch Vehicle Upper Stage Element Overview

NASA Technical Reports Server (NTRS)

McArthur, J. Craig

2008-01-01

This viewgraph presentation gives an overview of NASA's Ares I Crew Launch Vehicle Upper Stage Element. The topics include: 1) What is NASA s Mission?; 2) NASA s Exploration Roadmap What is our time line?; 3) Building on a Foundation of Proven Technologies Launch Vehicle Comparisons; 4) Ares I Upper Stage; 5) Upper Stage Primary Products; 6) Ares I Upper Stage Development Approach; 7) What progress have we made?; 8) Upper Stage Subsystem Highlights; 9) Structural Testing; 10) Common Bulkhead Processing; 11) Stage Installation at Stennis Space Center; 12) Boeing Producibility Team; 13) Upper Stage Low Cost Strategy; 14) Ares I and V Production at Michoud Assembly Facility (MAF); 15) Merged Manufacturing Flow; and 16) Manufacturing and Assembly Weld Tools.

Interim Cryogenic Propulsion Stage (ICPS) Handover Signing

NASA Image and Video Library

2017-10-26

Meeting in the Launch Control Center of NASA's Kennedy Space Center in Florida, officials of the agency's Spacecraft/Payload Integration and Evolution (SPIE) organization formally turn over processing of the Space Launch System (SLS) rocket's Interim Cryogenic Propulsion Stage (ICPS) to the center's Ground Systems Development and Operations (GSDO) directorate. The ICPS is the first integrated piece of flight hardware to arrive in preparation for the uncrewed Exploration Mission-1. With the Orion attached, the ICPS sits atop the SLS rocket and will provide the spacecraft with the additional thrust needed to travel tens of thousands of miles beyond the Moon.

Investigating Research Gaps of Pharmaceutical take back Events: An Analysis of take back Program Participants' Socioeconomic, Demographic, and Geographic Characteristics and the Public Health Benefits of take back Programs

NASA Astrophysics Data System (ADS)

Stoddard, K. I.; Hodge, V.; Maxey, G.; Tiwari, C.; Cready, C.; Huggett, D. B.

2017-06-01

Research continues to show that pharmaceutical environmental contamination causes adverse effects to aquatic life. There are also public health risks associated with pharmaceuticals because in-home reserves of medications provide opportunities for accidental poisoning and intentional medication abuse. Pharmaceutical take back programs have been seen as a potential remedy for these issues; however, a thorough review of past programs indicates limited research has been conducted on take back programs. Furthermore, there are significant gaps in take back program research. To address these gaps and ultimately determine if take back programs could improve public health, research was conducted in conjunction with the take back program Denton drug disposal days held in Denton, Texas. Socioeconomic, demographic, and geographic characteristics of Denton drug disposal days participants were investigated using surveys and Geographic Information Systems. Potential impacts of the Denton drug disposal days program on public health were determined by comparing data from Denton drug disposal days events with data supplied by the North Texas Poison Center. Results suggest that Denton drug disposal days events may have prevented accidental poisonings or intentional abuse, however only qualitative comparisons support this statement and there was insufficient empirical evidence to support the conclusion that Denton drug disposal days events were exclusively responsible for public health improvements. An interesting finding was that there was a definitive travel threshold that influenced participation in Denton drug disposal days events. Overall, this study fills some geographic, socioeconomic, and demographic data gaps of take back programs and proposes methods to analyze and improve participation in future take back programs. These methods could also be applied to improve participation in other local environmentally-focused programs such as household hazardous collection events.

Investigating Research Gaps of Pharmaceutical take back Events: An Analysis of take back Program Participants' Socioeconomic, Demographic, and Geographic Characteristics and the Public Health Benefits of take back Programs.

PubMed

Stoddard, K I; Hodge, V; Maxey, G; Tiwari, C; Cready, C; Huggett, D B

2017-06-01

Research continues to show that pharmaceutical environmental contamination causes adverse effects to aquatic life. There are also public health risks associated with pharmaceuticals because in-home reserves of medications provide opportunities for accidental poisoning and intentional medication abuse. Pharmaceutical take back programs have been seen as a potential remedy for these issues; however, a thorough review of past programs indicates limited research has been conducted on take back programs. Furthermore, there are significant gaps in take back program research. To address these gaps and ultimately determine if take back programs could improve public health, research was conducted in conjunction with the take back program Denton drug disposal days held in Denton, Texas. Socioeconomic, demographic, and geographic characteristics of Denton drug disposal days participants were investigated using surveys and Geographic Information Systems. Potential impacts of the Denton drug disposal days program on public health were determined by comparing data from Denton drug disposal days events with data supplied by the North Texas Poison Center. Results suggest that Denton drug disposal days events may have prevented accidental poisonings or intentional abuse, however only qualitative comparisons support this statement and there was insufficient empirical evidence to support the conclusion that Denton drug disposal days events were exclusively responsible for public health improvements. An interesting finding was that there was a definitive travel threshold that influenced participation in Denton drug disposal days events. Overall, this study fills some geographic, socioeconomic, and demographic data gaps of take back programs and proposes methods to analyze and improve participation in future take back programs. These methods could also be applied to improve participation in other local environmentally-focused programs such as household hazardous collection events.

KENNEDY SPACE CENTER, FLA. - Pamella J. Dana, Ph.D., director, Office of Tourism, Trade, and Economic Development in Florida, takes part in the proposal for locating NASA’s new Shared Services Center in the Central Florida Research Park, near Orlando. The presentation was given to NASA Administrator Sean O’Keefe and other officials. The center would centralize NASA’s payroll, accounting, human resources, facilities and procurement offices that are now handled at each field center. The consolidation is part of the One NASA focus. Six sites around the U.S. are under consideration by NASA.

NASA Image and Video Library

2004-02-19

KENNEDY SPACE CENTER, FLA. - Pamella J. Dana, Ph.D., director, Office of Tourism, Trade, and Economic Development in Florida, takes part in the proposal for locating NASA’s new Shared Services Center in the Central Florida Research Park, near Orlando. The presentation was given to NASA Administrator Sean O’Keefe and other officials. The center would centralize NASA’s payroll, accounting, human resources, facilities and procurement offices that are now handled at each field center. The consolidation is part of the One NASA focus. Six sites around the U.S. are under consideration by NASA.

Effectiveness of an existing estuarine no-take fish sanctuary within the Kennedy Space Center, Florida

USGS Publications Warehouse

Johnson, D.R.; Funicelli, N.A.; Bohnsack, James A.

1999-01-01

Approximately 22% of the waters of the Merritt Island National Wildlife Refuge, which encompasses the Kennedy Space Center, Florida, have been closed to public access and fishing since 1962. These closed areas offer an opportunity to test the effectiveness of 'no-take' sanctuaries by analyzing two replicated estuarine areas. Areas open and closed to fishing were sampled from November 1986 to January 1990 with 653 random trammel-net sets, each enclosing 3,721 m2. Samples from no-fishing areas had significantly (P < 0.05) greater abundance and larger fishes than fished areas. Relative abundance (standardized catch per unit effort, CPUE) in protected areas (6.4 fish/set) was 2.6 times greater than in the fished areas (2.4 fish/set) for total game fish, 2.4 times greater for spotted seatrout Cynoscion nebulosus, 6.3 times greater for red drum Sciaenops ocellatus, 12.8 times greater for black drum Pogonias cromis, 5.3 times greater for common snook Centropomus undecimalis, and 2.6 times greater for striped mullet Mugil cephalus. Fishing had the primary effect on CPUE, independent of habitat and other environmental factors. Salinity and depth were important secondary factors affecting CPUE, followed by season or month, and temperature. The importance of specific factors varied with each species. Median and maximum size of red drum, spotted seatrout, black drum, and striped mullet were also significantly greater in the unfished areas. More and larger fish of spawning age were observed in the unfished areas for red drum, spotted seatrout, and black drum. Tagging studies documented export of important sport fish from protected areas to fished areas.

Saturn V S-IC (First) Stage

NASA Technical Reports Server (NTRS)

2004-01-01

This cutaway illustration shows the Saturn V S-IC (first) stage with detailed callouts of the components. The S-IC Stage is 138 feet long and 33 feet in diameter, producing 7,500,000 pounds of thrust through five F-1 engines that are powered by liquid oxygen and kerosene. Four of the engines are mounted on an outer ring and gimbal for control purposes. The fifth engine is rigidly mounted in the center. When ignited, the roar produced by the five engines equals the sound of 8,000,000 hi-fi sets.

STS-5 crewmembers take part in countdown demonstration test (CDDT)

NASA Technical Reports Server (NTRS)

1982-01-01

STS-5 crewmembers take part in countdown demonstration test (CDDT) at the launch pad 39, Kennedy Space Center. They are, left to right, Vance D. Brand, commander; William B. Lenoir, mission specialist; Robert F. Overmyer, pilot; and Joseph P. Allen, mission specialist.

Surgical outcomes of robotic-assisted surgical staging for endometrial cancer are equivalent to traditional laparoscopic staging at a minimally invasive surgical center

PubMed Central

Cardenas-Goicoechea, Joel; Adams, Sarah; Bhat, Suneel B.; Randall, Thomas C.

2010-01-01

Objective To compare peri- and post-operative complications and outcomes of robotic-assisted surgical staging with traditional laparoscopic surgical staging for women with endometrial cancer. Methods A retrospective chart review of cases of women undergoing minimally invasive total hysterectomy and pelvic and para-aortic lymphadenectomy by a robotic-assisted approach or traditional laparoscopic approach was conducted. Major intraoperative complications, including vascular injury, enterotomy, cystotomy, or conversion to laparotomy, were measured. Secondary outcomes including operative time, blood loss, transfusion rate, number of lymph nodes retrieved, and the length of hospitalization were also measured. Results 275 cases were identified–102 patients with robotic-assisted staging and 173 patients with traditional laparoscopic staging. There was no significant difference in the rate of major complications between groups (p=0.13). The mean operative time was longer in cases of robotic-assisted staging (237 min vs. 178 min, p<0.0001); however, blood loss was significantly lower (109 ml vs. 187 ml, p<0.0001). The mean number of lymph nodes retrieved were similar between groups (p=0.32). There were no significant differences in the time to discharge, re-admission, or re-operation rates between the two groups. Conclusion Robotic-assisted surgery is an acceptable alternative to laparoscopy for minimally invasive staging of endometrial cancer. In addition to the improved ease of operation, visualization, and range of motion of the robotic instruments, robotic surgery results in a lower mean blood loss, although longer operative time. More data are needed to determine if the rates of urinary tract injuries and other surgical complications can be reduced with the use of robotic surgery. PMID:20144471

Designing oligo libraries taking alternative splicing into account

NASA Astrophysics Data System (ADS)

Shoshan, Avi; Grebinskiy, Vladimir; Magen, Avner; Scolnicov, Ariel; Fink, Eyal; Lehavi, David; Wasserman, Alon

2001-06-01

We have designed sequences for DNA microarrays and oligo libraries, taking alternative splicing into account. Alternative splicing is a common phenomenon, occurring in more than 25% of the human genes. In many cases, different splice variants have different functions, are expressed in different tissues or may indicate different stages of disease. When designing sequences for DNA microarrays or oligo libraries, it is very important to take into account the sequence information of all the mRNA transcripts. Therefore, when a gene has more than one transcript (as a result of alternative splicing, alternative promoter sites or alternative poly-adenylation sites), it is very important to take all of them into account in the design. We have used the LEADS transcriptome prediction system to cluster and assemble the human sequences in GenBank and design optimal oligonucleotides for all the human genes with a known mRNA sequence based on the LEADS predictions.

Moral Reasoning: Its Relation to Logical Thinking and Role-Taking.

ERIC Educational Resources Information Center

Smith, Marion E.

1978-01-01

In a sample of 100 children, aged 8-14, there was a clear association between consolidated concrete operational thinking and Kohlberg's Stage 2 moral reasoning, and some evidence that, in order of development, logical thinking precedes role-taking, which precedes moral reasoning, at corresponding levels of conceptual complexity. (Author/SJL)

Ares I Upper Stage Pressure Tests in Wind Tunnel

NASA Technical Reports Server (NTRS)

2007-01-01

Under the goals of the Vision for Space Exploration, Ares I is a chief component of the cost-effective space transportation infrastructure being developed by NASA's Constellation Program. This transportation system will safely and reliably carry human explorers back to the moon, and then onward to Mars and other destinations in the solar system. The Ares I effort includes multiple project element teams at NASA centers and contract organizations around the nation, and is managed by the Exploration Launch Projects Office at NASA's Marshall Space Flight Center (MFSC). ATK Launch Systems near Brigham City, Utah, is the prime contractor for the first stage booster. ATK's subcontractor, United Space Alliance of Houston, is designing, developing and testing the parachutes at its facilities at NASA's Kennedy Space Center in Florida. NASA's Johnson Space Center in Houston hosts the Constellation Program and Orion Crew Capsule Project Office and provides test instrumentation and support personnel. Together, these teams are developing vehicle hardware, evolving proven technologies, and testing components and systems. Their work builds on powerful, reliable space shuttle propulsion elements and nearly a half-century of NASA space flight experience and technological advances. Ares I is an inline, two-stage rocket configuration topped by the Crew Exploration Vehicle, its service module, and a launch abort system. In this HD video image, the first stage reentry 1/2% model is undergoing pressure measurements inside the wind tunnel testing facility at MSFC. (Highest resolution available)

Lucinda Huffaker and the Hospitality of the Wabash Center

ERIC Educational Resources Information Center

Placher, William C.

2007-01-01

As associate director and then director of the Wabash Center for Teaching and Learning in Theology and Religion, Lucinda Huffaker has been a key factor in the Center's reputation for hospitality. The Center's work presupposes that reflection on teaching improves teaching and learning, and good reflection on one's teaching requires taking risks and…

Orion Stage Adapter move to Redstone Airfield

NASA Image and Video Library

2018-04-03

NASA's Super Guppy aircraft arrives to the U.S. Army’s Redstone Airfield in Huntsville, Alabama, April 2, to pick up flight hardware for NASA’s Space Launch System – its new, deep-space rocket that will enable astronauts to begin their journey to explore destinations far into the solar system. The Guppy will depart on Tuesday, April 3 to deliver the Orion stage adapter to NASA’s Kennedy Space Center in Florida for flight preparations. On Exploration Mission-1, the first integrated flight of the SLS and the Orion spacecraft, the adapter will connect Orion to the rocket and carry 13 CubeSats as secondary payloads. Rumaasha Maasha stands in front of the Orion stage adapter in the cargo hold of NASA's Super Guppy aircraft. The Orion stage adapter, the top of the rocket that connects the Space Lauch System to Orion, will carry 13 CubeSats as secondary payloads on Exploration Mission-1, the first integrated flight of SLS and the Orion spacecraft. Guppy transported the adapter to Kennedy Space Center April 3.

Space Launch System Launch Vehicle Stage Adapter Hardware Completes Manufacturing

NASA Image and Video Library

2017-08-28

The Launch Vehicle Stage Adapter for the first flight of the Space Launch System, NASA’s new deeps space rocket, recently completed manufacturing at NASA’s Marshal Space Flight Center in Huntsville, Alabama. The LVSA, the largest piece of the rocket welded together in Marshall’s Huntsville manufacturing area, will connect two major sections of SLS – the 27.6-foot diameter core stage and the 16.4-foot interim cryogenic propulsion stage – for the first integrated flight of SLS and the Orion spacecraft. Teledyne Brown Engineering of Huntsville, the prime contractor for the adapter, has completed manufacturing, and engineers are preparing to apply thermal insulation. It will be the largest piece of hardware that Marshall. The LVSA was moved from the NASA welding area to NASA’s Center for Advanced Manufacturing where the thermal protection system will be applied.

CTEPP STANDARD OPERATING PROCEDURE FOR DAY CARE CENTER SAMPLE SUBJECTS RECRUITMENT (SOP-1.11)

EPA Science Inventory

The CTEPP subject recruitment procedures for the daycare center component are described in the SOP. There are two stages in this phase of CTEPP subject recruitment. The objective of the first stage is to enroll daycare centers for the study. Six target counties in each state ar...

Unifying Human Centered Design and Systems Engineering for Human Systems Integration

NASA Technical Reports Server (NTRS)

Boy, Guy A.; McGovernNarkevicius, Jennifer

2013-01-01

Despite the holistic approach of systems engineering (SE), systems still fail, and sometimes spectacularly. Requirements, solutions and the world constantly evolve and are very difficult to keep current. SE requires more flexibility and new approaches to SE have to be developed to include creativity as an integral part and where the functions of people and technology are appropriately allocated within our highly interconnected complex organizations. Instead of disregarding complexity because it is too difficult to handle, we should take advantage of it, discovering behavioral attractors and the emerging properties that it generates. Human-centered design (HCD) provides the creativity factor that SE lacks. It promotes modeling and simulation from the early stages of design and throughout the life cycle of a product. Unifying HCD and SE will shape appropriate human-systems integration (HSI) and produce successful systems.

The End-Stage Renal Disease Adherence Questionnaire (ESRD-AQ): testing the psychometric properties in patients receiving in-center hemodialysis.

PubMed

Kim, Youngmee; Evangelista, Lorraine S; Phillips, Linda R; Pavlish, Carol; Kopple, Joel D

2010-01-01

Reported treatment adherence rates of patients with end stage renal disease (ESRD) have been extremely varied due to lack of reliable and valid measurement tools. This study was conducted to develop and test an instrument to measure treatment adherence to hemodialysis (HD) attendance, medications, fluid restrictions, and diet prescription among patients with ESRD. This article describes the methodological approach used to develop and test the psychometric properties (such as reliability and validity) of the 46-item ESRD-Adherence Questionnaire (ESRD-AQ) in a cohort of patients receiving maintenance HD at dialysis centers in Los Angeles County. The ESRD-AQ is the first self-report instrument to address all components of adherence behaviors of patients with ESRD. The findings support that the instrument is reliable and valid and is easy to administer. Future studies are needed in a larger sample to determine whether additional modifications are needed.

CLOSEUP VIEW OF THE FIRST STAGE OF THE SATURN I ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

CLOSE-UP VIEW OF THE FIRST STAGE OF THE SATURN I ROCKET, SHOWING A DETAIL VIEW OF THE ENGINE CLUSTER. THE SATURN I ROCKET WAS THE FIRST UNITED STATES ROCKET TO HAVE MULTIPLE ENGINES ON A SINGLE STAGE. - Marshall Space Flight Center, Saturn Propulsion & Structural Test Facility, East Test Area, Huntsville, Madison County, AL

42 CFR 482.104 - Condition of participation: Additional requirements for kidney transplant centers.

Code of Federal Regulations, 2011 CFR

2011-10-01

... for kidney transplant centers. 482.104 Section 482.104 Public Health CENTERS FOR MEDICARE & MEDICAID....104 Condition of participation: Additional requirements for kidney transplant centers. (a) Standard: End stage renal disease (ESRD) services. Kidney transplant centers must directly furnish...

42 CFR 482.104 - Condition of participation: Additional requirements for kidney transplant centers.

Code of Federal Regulations, 2010 CFR

2010-10-01

... for kidney transplant centers. 482.104 Section 482.104 Public Health CENTERS FOR MEDICARE & MEDICAID....104 Condition of participation: Additional requirements for kidney transplant centers. (a) Standard: End stage renal disease (ESRD) services. Kidney transplant centers must directly furnish...

STS-5 crewmembers take part in countdown demonstration test (CDDT)

NASA Technical Reports Server (NTRS)

1982-01-01

STS-5 crewmembers take part in countdown demonstration test (CDDT) at the launch pad. Astronaut Vance D. Brand, commander, is at center, flanked by Mission Specialists William B. Lenoir, left, and Joseph P. ALlen. Mission Specialist/Astronaut Kathryn B. Sullivan, Far left, is in training for future mission.

Creating Effective Video to Promote Student-Centered Teaching

ERIC Educational Resources Information Center

Gainsburg, Julie

2009-01-01

Training and investing teachers at all career levels in student-centered practices is widely recognized as a significant challenge. Various studies document the failure of student-centered teaching practices to take hold in K-12 mathematics classrooms in significant ways, including collaborative work; problems that are cognitively demanding or…

Comparison of Alaskan Flood Stages: Annual Exceedance Probability vs. Impact Based Stages and Recommendations for the Future

NASA Astrophysics Data System (ADS)

Anderson, B. J.

2016-12-01

The Alaska River Forecasting Center (APRFC) issues water level forecasts that are used in conjunction with established flood stages to provide flood warning and advisory information to the public. The APRFC typically establishes flood stages based on observed impacts but Alaska has sparse empirical data (e.g., few impact surveys). Thus service hydrologists in Alaska use flood frequency analysis (LP3 distribution) to estimate flood stages from annual exceedance probabilities (AEPs) (Curran et al, 2016). Previously, the APRFC has maintained that bankfull stage corresponds to the 50% AEP, minor to 10-20% AEP, moderate to 2.5-7% AEP, and major to 1-2% AEP, but we now need to statistically verify this relationship. Our objective is therefore to validate the relationship between flood stages and stage associated with the 50, 20, 10, 4, 2, 1, 0.2, and 0.5 AEPs to provide recommendations for improved flood forecasting. We studied the relationship between AEP and flood stage for all gages (56) used by the APRFC that had rating curves not older than 3 years, flood stages based on observed impacts, and at least 10 years of peak annual stage data. The analysis found relatively strong relationships for all flood stages, except for bankfull stage, but with some differences when compared to the traditionally referenced relationship. Major flood stage appears to be most similar to the 1-.2% AEP (100-500 year RI) while moderate flood stage best fits the 2-4% AEP (25-50 year interval). Gages showing a difference in stage of 2 ft or greater exhibited this difference across all flood stages, which we link to site specific qualities such as susceptibility to ice-jam flooding. We present this method as a possible application to Alaskan Rivers as a general flood stage guideline.

Disease staging as a measure of disease severity.

PubMed

Kohyama, Jun; Fujitani, Shigeki; Umesato, Yoshimasa; Kataoka, Hitomi

2015-06-24

Disease staging, first developed in 1970, has been used to assess the levels of biological severity, defined as the risk of organ failure or death, of specific medical diseases. Because few studies to date have evaluated disease staging in Japan, a small pilot study was designed to determine whether disease staging is available and useful in actual medical practice in Japan. The relationships between disease staging and length of stay, medical costs and age were retrospectively evaluated in patients admitted to Japan Association for Development of Community Medicine - Tokyo Bay Urayasu Ichikawa Medical Center for appendicitis, type 2 diabetes mellitus, and cerebrovascular diseases from April 2012 to March 2013. Patients were easily staged based on information at the time of hospital discharge. Disease stages were found to be affected significantly by length of hospital stay and medical costs. Age also affected disease stages in patients with appendicitis. These findings indicate that disease staging was available in Japan and was affected by hospital resources, including length of hospital stay and medical costs.

Interim Cryogenic Propulsion Stage (ICPS) Transport from DOC to

NASA Image and Video Library

2017-07-26

Packed inside its canister, the Interim Cryogenic Propulsion Stage (ICPS) for NASA's Space Launch System (SLS) rocket is being transported to the Space Station Processing Facility at NASA's Kennedy Space Center in Florida. The ICPS is the first integrated piece of flight hardware to arrive for the SLS. It is the in-space stage that is located toward the top of the rocket, between the Launch Vehicle Stage Adapter and the Orion Spacecraft Adapter. It will provide some of the in-space propulsion during Orion's first flight test atop the SLS on Exploration Mission-1.

History of the FIGO cancer staging system.

PubMed

Odicino, Franco; Pecorelli, Sergio; Zigliani, Lucia; Creasman, William T

2008-05-01

The main objectives of any good staging system - essential to an evidence-based approach to cancer - are: to aid the clinician in planning treatment; to provide indication of prognosis; to assist the physician in evaluating the results of treatment; to facilitate the exchange of information between treatment centers, thus disseminating knowledge; and to contribute to continuing investigations into human malignancies. A good staging system must have 3 basic characteristics: it must be valid, reliable, and practical. The first staging system for gynecological cancers appeared around the turn of the 20th century and applied to the carcinoma of the cervix uteri-the most common cancer affecting women in high income countries at that time. The classification and staging of the other gynecological malignancies was not put forward until the 1950s. Over the years, these staging classifications - with the exception of cervical cancer and gestational trophoblastic neoplasia - have shifted from a clinical to a surgical-pathological basis. This paper reviews the history of the International Federation of Gynecology and Obstetrics (FIGO) cancer staging system, how it was developed, and why.

75 FR 2106 - Endangered and Threatened Species; Take of Anadromous Fish

Federal Register 2010, 2011, 2012, 2013, 2014

2010-01-14

... and Threatened Species; Take of Anadromous Fish AGENCY: National Marine Fisheries Service (NMFS... NMFS regulations (50 CFR parts 222-226) governing listed fish and wildlife permits. Species Covered in... steelhead not to exceed 2 percent of the total number of fish captured for each life stage and species...

Reliability Centered Maintenance - Methodologies

NASA Technical Reports Server (NTRS)

Kammerer, Catherine C.

2009-01-01

Journal article about Reliability Centered Maintenance (RCM) methodologies used by United Space Alliance, LLC (USA) in support of the Space Shuttle Program at Kennedy Space Center. The USA Reliability Centered Maintenance program differs from traditional RCM programs because various methodologies are utilized to take advantage of their respective strengths for each application. Based on operational experience, USA has customized the traditional RCM methodology into a streamlined lean logic path and has implemented the use of statistical tools to drive the process. USA RCM has integrated many of the L6S tools into both RCM methodologies. The tools utilized in the Measure, Analyze, and Improve phases of a Lean Six Sigma project lend themselves to application in the RCM process. All USA RCM methodologies meet the requirements defined in SAE JA 1011, Evaluation Criteria for Reliability-Centered Maintenance (RCM) Processes. The proposed article explores these methodologies.

Staged Reading of the Play: Delicate Particle Logic

NASA Astrophysics Data System (ADS)

2016-03-01

The play explores the relationship between science and art through the story of the discovery of nuclear fission. Under the harshly male-dominated science elite of the time, Lise Meitner broke through to become the leader of a major scientific institute, and the first woman to have the title of ``Professor'' in all of Germany. Along with her long-time partner, chemist Otto Hahn, she began a series of experiments that led to the discovery of nuclear fission. The play presents a meeting between Dr. Meitner and Hahn's wife, Edith, who was a painter. The complicated swirl of their intertwined lives, two women and one man, mixes with the violent upheavals in the world, as the Nazis take over Germany and everything changes. The playwright is Jennifer Blackmer who is a faculty member in theatre at Ball State University http://www.jenniferblackmer.com/ and the staged reading is performed by the Pioneer Theatre Company, http://www.pioneertheatre.org/ of Salt Lake City. After the performance, the director and the actors will be available for a talk-back audience discussion. Produced by Brian Schwartz, Brooklyn College and the Graduate Center of the City University of New York.

The staging of testicular tumors.

PubMed

Sandeman, T F; Matthews, J P

1979-06-01

Sufficient information was recorded in the majority of a series of 531 germinal malignancies of the testis, to stage them retrospectively according to the T.N.M. staging system recommended by the U.I.C.C. and compare this with a locally devised scheme. By separately analyzing the commonest pathological types (differentiated seminoma, malignant teratoma intermediate and undifferentiated malignant teratoma) the histological influence on prognosis was minimized in this comparison. The predictive ability and greater simplicity of the Peter MacCallum Hospital system appears to be superior and it is put forward as an advance in staging for consideration when this comes up for review. It is pointed out that reporting results according to a more rigorous staging system can give the impression that survival figures are better than those obtained at another center using less stringent criteria, when in fact the overall results are the same and nothing has been done for the individual patient. This must be allowed for when considering different methods of treatment. Because of the importance of biochemical markers their inclusion in any staging system is essential; however, they are difficult if not impossible to incorporate under the anatomical sections. A separate category is proposed.

Walt Disney visited Marshall Space Flight Center (MSFC)

NASA Technical Reports Server (NTRS)

1965-01-01

Walt Disney toured the West Test Area during his visit to the Marshall Space Flight Center on April 13, 1965. The three in center foreground are Karl Heimburg, Director, Test Division; Dr. von Braun, Director, MSFC; and Walt Disney. The Dynamic Test Stand with the S-1C stage being installed is in the background.

The Development of the Hawaii State Senior Center.

ERIC Educational Resources Information Center

Amor, Charles W.

A multi-purpose senior center within a community college setting is the focus of this presentation. The following points are discussed: (1) the historical development of the Hawaii State Senior Center with respect to national and local programs on aging; (2) the financial means of expanding and supporting the various stages of development; (3) the…

A Multi-Stage Reverse Logistics Network Problem by Using Hybrid Priority-Based Genetic Algorithm

NASA Astrophysics Data System (ADS)

Lee, Jeong-Eun; Gen, Mitsuo; Rhee, Kyong-Gu

Today remanufacturing problem is one of the most important problems regarding to the environmental aspects of the recovery of used products and materials. Therefore, the reverse logistics is gaining become power and great potential for winning consumers in a more competitive context in the future. This paper considers the multi-stage reverse Logistics Network Problem (m-rLNP) while minimizing the total cost, which involves reverse logistics shipping cost and fixed cost of opening the disassembly centers and processing centers. In this study, we first formulate the m-rLNP model as a three-stage logistics network model. Following for solving this problem, we propose a Genetic Algorithm pri (GA) with priority-based encoding method consisting of two stages, and introduce a new crossover operator called Weight Mapping Crossover (WMX). Additionally also a heuristic approach is applied in the 3rd stage to ship of materials from processing center to manufacturer. Finally numerical experiments with various scales of the m-rLNP models demonstrate the effectiveness and efficiency of our approach by comparing with the recent researches.

Aft View of Saturn V Third Stage (S-IVB)

NASA Technical Reports Server (NTRS)

1960-01-01

The powerful J-2 engine is prominent in this photograph of a Saturn V Third Stage (S-IVB) resting on a transporter in the Manufacturing Facility at Marshall Space Flight Center in Huntsville, Alabama. The towering 363-foot Saturn V was a multi-stage, multi-engine launch vehicle standing taller than the Statue of Liberty. Altogether, the Saturn V engines produced as much power as 85 Hoover Dams.

[Interpretation of update on The AJCC Esophageal Cancer Staging System, Eighth Edition].

PubMed

Yuan, Y; Chen, L Q

2017-02-01

The recently published AJCC Esophageal Cancer Staging System, 8(th) Edition will be implemented on Januray 1, 2018, which was developed by Worldwide Esophageal Cancer Collaboration based on 22 654 esophageal cancer patients from 33 worldwide centers. The definition of T, N, M, G stage and regional lymph nodes were optimized in the 8(th) edition. And the new "2 cm" principle has simplified the definition for the cancer of esophagogastric junction. In addition to pathologic staging, the 8(th) edition also provided clinical staging and pathologic staging after neoadjuvant therapy, making the new esophageal cancer staging system more practicable and reasonable.

Preoperative Prolapse Stage as Predictor of Failure of Sacrocolpopexy.

PubMed

Aslam, Muhammad F; Osmundsen, Blake; Edwards, Sharon R; Matthews, Catherine; Gregory, William T

2016-01-01

Our aim was to determine if there was a correlation between the preoperative prolapse stage and postoperative recurrence of prolapse 1 year after sacrocolpopexy. Our null hypothesis is that the preoperative stage of prolapse does not increase the risk of recurrence. This is a multicenter cohort study from 3 centers. We included subjects who underwent robotic-assisted sacrocolpopexy and completed a standardized 1-year follow-up from 2009-2014. All subjects underwent a complete preoperative evaluation and completed 12 months of follow-up with the pelvic organ prolapse quantification examination. We compared those subjects who met the definition of recurrence with those who did not, analyzing the following covariates: stage of prolapse using International Continence Society (ICS) definitions, individual pelvic organ prolapse quantification points, age, body mass index, race, exogenous estrogen use, menopause, smoking, vaginal parity, cesarean section, and performance of concomitant procedures. We defined recurrence as any prolapse beyond the hymen. We had 125 women from 3 centers who met our criteria, with 23.2% of them having recurrence at 1 year. We found that recurrence increased as the preoperative ICS stage of prolapse increased (P = <0.001 in the univariate model). In the multivariate model, using logistic regression, we found that the risk of recurrence of pelvic organ prolapse increased as the presurgery clinical stage increased with an odds ratio of 3.8 (95% confidence interval, 1.5-9) when controlling for age, menopausal status, and genital hiatus (P = 0.004). Much like a higher stage of disease in oncology, we found that increasing stage of prolapse preoperatively increased the risk of recurrence at 1 year after sacrocolpopexy.

Students Taking Charge: Inside the Learner-Active, Technology-Infused Classroom

ERIC Educational Resources Information Center

Sulla, Nancy

2011-01-01

Teachers and administrators who recognize the needs of today's society and students, and their impact on teaching and learning, can use this book to create student-centered classrooms that make technology a vital part of their lessons. Filled with practical examples and step-by-step guidelines, "Students Taking Charge" will help educators design…

Understanding wellness center loyalty through lifestyle analysis.

PubMed

Suresh, Satya; Ravichandran, Swathi; P, Ganesan

2011-01-01

Many changes taking place at a macro-level in Indian society along with the popularity of services that are native to India, such as Yoga and Ayurveda, have generated significant interest in wellness services. To assist wellness centers in gaining loyal clients, the goal of this study was to understand the influence of customer lifestyle factors on wellness center loyalty. The activities, interests, and opinions model was used to understand the lifestyles of wellness center clients. Data were collected from clients of five wellness centers. Regression results indicate that overworked individuals and those seeking a balance between work and family life would be the most loyal to wellness centers. Managerial implications of results are discussed.

Planning for the Automation of School Library Media Centers.

ERIC Educational Resources Information Center

Caffarella, Edward P.

1996-01-01

Geared for school library media specialists whose centers are in the early stages of automation or conversion to a new system, this article focuses on major components of media center automation: circulation control; online public access catalogs; machine readable cataloging; retrospective conversion of print catalog cards; and computer networks…

Treatment of localized-stage follicular lymphoma.

PubMed

Sorigue, Marc; Tuset, Victòria; Sancho, Juan-Manuel

2018-05-12

Follicular lymphoma (FL) is the most common indolent lymphoma and it most frequently presents in an advanced-stage. Therapeutic considerations for advanced-stage are different from those of localized-stage FL, in which radiotherapy (RT) is generally recommended. However, the available evidence suffers from shortcomings that are relatively specific to this clinical entity due to its rarity and long survival with all available treatment modalities, including that most of the existing evidence originated at a time when diagnostic classifications, staging procedures and radiotherapeutic standards were different from those available today and when anti-CD20 monoclonal antibodies were not available. Available treatment modalities include observation, systemic therapy only, RT only and RT in combination with systemic therapy. We review the evidence available with each of them and the data from present day clinical practice studies as well as briefly discuss what diagnostic and therapeutic developments may take place in the next few years. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

Two-stage acceleration of protons from relativistic laser-solid interaction

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

Liu Jinlu; Sheng, Z. M.; Zheng, J.

2012-12-21

A two-stage proton acceleration scheme using present-day intense lasers and a unique target design is proposed. The target system consists of a hollow cylinder, inside which is a hollow cone, which is followed by the main target with a flat front and dish-like flared rear surface. At the center of the latter is a tapered proton layer, which is surrounded by outer proton layers at an angle to it. In the first acceleration stage, protons in both layers are accelerated by target normal sheath acceleration. The center-layer protons are accelerated forward along the axis and the side protons are acceleratedmore » and focused towards them. As a result, the side-layer protons radially compress as well as axially further accelerate the front part of the accelerating center-layer protons in the second stage, which are also radially confined and guided by the field of the fast electrons surrounding them. Two-dimensional particle-incell simulation shows that a 79fs 8.5 Multiplication-Sign 10{sup 20} W/cm{sup 2} laser pulse can produce a proton bunch with {approx} 267MeV maximum energy and {approx} 9.5% energy spread, which may find many applications, including cancer therapy.« less

Interim Cryogenic Propulsion Stage (ICPS) Transport from DOC to

NASA Image and Video Library

2017-07-26

Packed inside its canister, the Interim Cryogenic Propulsion Stage (ICPS) for NASA's Space Launch System (SLS) rocket arrives at the low bay entrance of the Space Station Processing Facility at NASA's Kennedy Space Center in Florida. The ICPS is the first integrated piece of flight hardware to arrive for the SLS. It is the in-space stage that is located toward the top of the rocket, between the Launch Vehicle Stage Adapter and the Orion Spacecraft Adapter. It will provide some of the in-space propulsion during Orion's first flight test atop the SLS on Exploration Mission-1.

Interim Cryogenic Propulsion Stage (ICPS) Transport from DOC to

NASA Image and Video Library

2017-07-26

Packed inside its canister, the Interim Cryogenic Propulsion Stage (ICPS) for NASA's Space Launch System (SLS) rocket is moved into the low bay entrance of the Space Station Processing Facility at NASA's Kennedy Space Center in Florida. The ICPS is the first integrated piece of flight hardware to arrive for the SLS. It is the in-space stage that is located toward the top of the rocket, between the Launch Vehicle Stage Adapter and the Orion Spacecraft Adapter. It will provide some of the in-space propulsion during Orion's first flight test atop the SLS on Exploration Mission-1.

Saturn V First Stage (S-1C) At MSFC

NASA Technical Reports Server (NTRS)

1960-01-01

This small group of unidentified officials is dwarfed by the gigantic size of the Saturn V first stage (S-1C) at the shipping area of the Manufacturing Engineering Laboratory at Marshall Space Flight Center in Huntsville, Alabama. The towering 363-foot Saturn V was a multi-stage, multi-engine launch vehicle standing taller than the Statue of Liberty. Altogether, the Saturn V engines produced as much power as 85 Hoover Dams.

Student Services/One Stop Centers: A Qualitative Examination of Implementation at Three Post-Secondary Institutions

ERIC Educational Resources Information Center

Becker, Janine M.

2012-01-01

This research investigates Student Services/One Stop Centers at three post-secondary institutions, looking at the origination of the centers and success through the lens of behavioral theories. Comparing the 3-stage Group Dynamics Theory of Lewin (1947), Social Learning Theory of Bandura (1977), and the 8-stage Change Management Model of Kotter…

Tool for evaluating the evolution Space Weather Regional Warning Centers under the innovation point of view: the Case Study of the Embrace Space Weather Program Early Stages

NASA Astrophysics Data System (ADS)

Denardini, Clezio Marcos

2016-07-01

We have developed a tool for measuring the evolutional stage of the space weather regional warning centers using the approach of the innovative evolution starting from the perspective presented by Figueiredo (2009, Innovation Management: Concepts, metrics and experiences of companies in Brazil. Publisher LTC, Rio de Janeiro - RJ). It is based on measuring the stock of technological skills needed to perform a certain task that is (or should) be part of the scope of a space weather center. It also addresses the technological capacity for innovation considering the accumulation of technological and learning capabilities, instead of the usual international indices like number of registered patents. Based on this definition, we have developed a model for measuring the capabilities of the Brazilian Study and Monitoring Program Space Weather (Embrace), a program of the National Institute for Space Research (INPE), which has gone through three national stages of development and an international validation step. This program was created in 2007 encompassing competence from five divisions of INPE in order to carry out the data collection and maintenance of the observing system in space weather; to model processes of the Sun-Earth system; to provide real-time information and to forecast space weather; and provide diagnostic their effects on different technological systems. In the present work, we considered the issues related to the innovation of micro-processes inherent to the nature of the Embrace program, not the macro-economic processes, despite recognizing the importance of these. During the development phase, the model was submitted to five scientists/managers from five different countries member of the International Space Environment Service (ISES) who presented their evaluations, concerns and suggestions. It was applied to the Embrace program through an interview form developed to be answered by professional members of regional warning centers. Based on the returning

Aerodynamics of a beetle in take-off flights

NASA Astrophysics Data System (ADS)

Lee, Boogeon; Park, Hyungmin; Kim, Sun-Tae

2015-11-01

In the present study, we investigate the aerodynamics of a beetle in its take-off flights based on the three-dimensional kinematics of inner (hindwing) and outer (elytron) wings, and body postures, which are measured with three high-speed cameras at 2000 fps. To track the highly deformable wing motions, we distribute 21 morphological markers and use the modified direct linear transform algorithm for the reconstruction of measured wing motions. To realize different take-off conditions, we consider two types of take-off flights; that is, one is the take-off from a flat ground and the other is from a vertical rod mimicking a branch of a tree. It is first found that the elytron which is flapped passively due to the motion of hindwing also has non-negligible wing-kinematic parameters. With the ground, the flapping amplitude of elytron is reduced and the hindwing changes its flapping angular velocity during up and downstrokes. On the other hand, the angle of attack on the elytron and hindwing increases and decreases, respectively, due to the ground. These changes in the wing motion are critically related to the aerodynamic force generation, which will be discussed in detail. Supported by the grant to Bio-Mimetic Robot Research Center funded by Defense Acquisition Program Administration (UD130070ID).

2017 Solar Eclipse, Ames Research Center

NASA Image and Video Library

2017-08-21

Taking a break from their duties at the Ames Vertical Gun Range to look up at the eclipse over Ames Research Center in Mountain View are from left to right are Alfredo "Freddie" Perez, Chuck Cornelison, Don Bowling, Adam Parish

Efficiency of photochemical stages of photosynthesis in purple bacteria (a critical survey).

PubMed

Borisov, A Yu

2014-03-01

Based on currently available data, the energy transfer efficiency in the successive photophysical and photochemical stages has been analyzed for purple bacteria. This analysis covers the stages starting from migration of the light-induced electronic excitations from the bulk antenna pigments to the reaction centers up to irreversible stage of the electron transport along the transmembrane chain of cofactors-carriers. Some natural factors are revealed that significantly increase the rates of efficient processes in these stages. The influence on their efficiency by the "bottleneck" in the energy migration chain is established. The overall quantum yield of photosynthesis in these stages is determined.

Efficacy and safety of febuxostat in 73 gouty patients with stage 4/5 chronic kidney disease: A retrospective study of 10 centers.

PubMed

Juge, Pierre-Antoine; Truchetet, Marie-Elise; Pillebout, Evangeline; Ottaviani, Sébastien; Vigneau, Cécile; Loustau, Clotilde; Cornec, Divi; Pascart, Tristan; Snanoudj, Renaud; Bailly, Florian; Cornec-Le Gall, Emilie; Schaeverbeke, Thierry; Saraux, Alain; Dieudé, Philippe; Flipo, René-Marc; Richette, Pascal; Lioté, Frédéric; Bardin, Thomas; Chalès, Gérard; Ea, Hang-Korng

2017-10-01

The allopurinol dose is limited in chronic kidney disease, particularly stage 4/5 chronic kidney disease. Febuxostat has a hepatic metabolism and has been approved without dose adaptation in gouty patients with stage 1-3 chronic kidney disease. We aimed to study the safety and efficacy of febuxostat for stage 4/5 chronic kidney disease. In this retrospective study, we included patients with (1) a diagnosis of gout, (2) febuxostat treatment, (3) estimated glomerular filtration rate≤30mL/min/1.73m 2 (Modification of Diet in Renal Disease formula) at febuxostat initiation and (4) follow-up for at least 3 months after febuxostat initiation. Efficacy, safety and variation in estimated glomerular filtration rate were analyzed. We included 73 patients (mean age 70.2±11.8, 61 men, 31 with vascular chronic kidney disease and 18 renal transplantation) with gout (baseline serum uric acid level=9.86±2.85mg/dL, mean gout duration 6.2±7.0 years) from 10 academic centers. Comorbidities included cardiac failure (17.8%), hypertension (98.6%), diabetes mellitus (30.1%), dyslipidemia (64.8%) and history of cardiovascular events (38.4%). At the last visit (mean follow-up 68.5±64.8 weeks), the daily dose of febuxostat was 40mg for 7 patients (10.5%), 80mg for 50 (74.6%) and 120mg for 10 (14.9%). Serum uric acid level was<6mg/dL for 49 patients (67%). Renal function improved for 18 patients, was unchanged for 24 and worsened for 31; 19 patients experienced flares and 1 patient, limb edema. Febuxostat seemed efficient in gouty patients with stage 4/5 chronic kidney disease. However, safety data were not clear regarding renal function. Larger studies are needed to assess safety. Copyright © 2016 Société française de rhumatologie. Published by Elsevier SAS. All rights reserved.

Regression analysis on the variation in efficiency frontiers for prevention stage of HIV/AIDS.

PubMed

Kamae, Maki S; Kamae, Isao; Cohen, Joshua T; Neumann, Peter J

2011-01-01

To investigate how the cost effectiveness of preventing HIV/AIDS varies across possible efficiency frontiers (EFs) by taking into account potentially relevant external factors, such as prevention stage, and how the EFs can be characterized using regression analysis given uncertainty of the QALY-cost estimates. We reviewed cost-effectiveness estimates for the prevention and treatment of HIV/AIDS published from 2002-2007 and catalogued in the Tufts Medical Center Cost-Effectiveness Analysis (CEA) Registry. We constructed efficiency frontier (EF) curves by plotting QALYs against costs, using methods used by the Institute for Quality and Efficiency in Health Care (IQWiG) in Germany. We stratified the QALY-cost ratios by prevention stage, country of study, and payer perspective, and estimated EF equations using log and square-root models. A total of 53 QALY-cost ratios were identified for HIV/AIDS in the Tufts CEA Registry. Plotted ratios stratified by prevention stage were visually grouped into a cluster consisting of primary/secondary prevention measures and a cluster consisting of tertiary measures. Correlation coefficients for each cluster were statistically significant. For each cluster, we derived two EF equations - one based on the log model, and one based on the square-root model. Our findings indicate that stratification of HIV/AIDS interventions by prevention stage can yield distinct EFs, and that the correlation and regression analyses are useful for parametrically characterizing EF equations. Our study has certain limitations, such as the small number of included articles and the potential for study populations to be non-representative of countries of interest. Nonetheless, our approach could help develop a deeper appreciation of cost effectiveness beyond the deterministic approach developed by IQWiG.

KENNEDY SPACE CENTER, FLA. - In the Orbiter Processing Facility, STS-114 crew members look at the tiles underneath Atlantis. From center, left to right (in uniform), are Pilot James Kelly, Mission Specialist Soichi Noguchi, Mission Specialists Wendy Lawrence and Stephen Robinson. Accompanying them at left Glenda Laws, EVA Task Leader, with United Space Alliance at Johnson Space Center. Noguchi is with the Japan Aerospace Exploration Agency, JAXA. The STS-114 crew is at KSC to take part in crew equipment and orbiter familiarization.

NASA Image and Video Library

2003-10-30

KENNEDY SPACE CENTER, FLA. - In the Orbiter Processing Facility, STS-114 crew members look at the tiles underneath Atlantis. From center, left to right (in uniform), are Pilot James Kelly, Mission Specialist Soichi Noguchi, Mission Specialists Wendy Lawrence and Stephen Robinson. Accompanying them at left Glenda Laws, EVA Task Leader, with United Space Alliance at Johnson Space Center. Noguchi is with the Japan Aerospace Exploration Agency, JAXA. The STS-114 crew is at KSC to take part in crew equipment and orbiter familiarization.

Taking the Headaches out of Anesthetizing "Drosophila": A Cheap & Easy Method of Constructing Carbon Dioxide Staging

ERIC Educational Resources Information Center

Artiss, Thomas; Hughes, Bobby

2007-01-01

Carbon dioxide is an excellent alternative to conventional methods of anesthetizing fruit flies as it is non-flammable and odorless. We have devised a method of constructing carbon dioxide stages used to keep "Drosophila" immobilized cheaply and easily using empty micropipette tip containers. (Contains 6 figures.)

Orion Stage Adapter move to Redstone Airfield

NASA Image and Video Library

2018-04-03

NASA's Super Guppy aircraft arrives to the U.S. Army’s Redstone Airfield in Huntsville, Alabama, April 2, to pick up flight hardware for NASA’s Space Launch System – its new, deep-space rocket that will enable astronauts to begin their journey to explore destinations far into the solar system. The Guppy will depart on Tuesday, April 3 to deliver the Orion stage adapter to NASA’s Kennedy Space Center in Florida for flight preparations. On Exploration Mission-1, the first integrated flight of the SLS and the Orion spacecraft, the adapter will connect Orion to the rocket and carry 13 CubeSats as secondary payloads. Rumaasha Maasha, an aerospace engineer in Marshall's Spacecraft & Vehicle Systems Department, tours the cockpit of NASA's Super Guppy aircraft April 3 when it landed at Marshall to pick up the Orion stage adapter for transportation to NASA's Kennedy Space Center. Maasha holds a master's degree in aerospace engineering, is a certified aviation maintenance tech and pilot and previously worked as a 747 loadmaster and airline refueler.

42 CFR 488.60 - Special procedures for approving end stage renal disease facilities.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 42 Public Health 5 2011-10-01 2011-10-01 false Special procedures for approving end stage renal disease facilities. 488.60 Section 488.60 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES... ENFORCEMENT PROCEDURES Special Requirements § 488.60 Special procedures for approving end stage renal disease...

42 CFR 488.60 - Special procedures for approving end stage renal disease facilities.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 42 Public Health 5 2010-10-01 2010-10-01 false Special procedures for approving end stage renal disease facilities. 488.60 Section 488.60 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES... ENFORCEMENT PROCEDURES Special Requirements § 488.60 Special procedures for approving end stage renal disease...

42 CFR 488.60 - Special procedures for approving end stage renal disease facilities.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 42 Public Health 5 2013-10-01 2013-10-01 false Special procedures for approving end stage renal disease facilities. 488.60 Section 488.60 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES... ENFORCEMENT PROCEDURES Special Requirements § 488.60 Special procedures for approving end stage renal disease...

42 CFR 488.60 - Special procedures for approving end stage renal disease facilities.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 42 Public Health 5 2014-10-01 2014-10-01 false Special procedures for approving end stage renal disease facilities. 488.60 Section 488.60 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES... ENFORCEMENT PROCEDURES Special Requirements § 488.60 Special procedures for approving end stage renal disease...

42 CFR 488.60 - Special procedures for approving end stage renal disease facilities.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 42 Public Health 5 2012-10-01 2012-10-01 false Special procedures for approving end stage renal disease facilities. 488.60 Section 488.60 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES... ENFORCEMENT PROCEDURES Special Requirements § 488.60 Special procedures for approving end stage renal disease...

Overall survival after resection of retroperitoneal sarcoma at academic cancer centers versus community cancer centers: An analysis of the National Cancer Data Base.

PubMed

Berger, Nicholas G; Silva, Jack P; Mogal, Harveshp; Clarke, Callisia N; Bedi, Manpreet; Charlson, John; Christians, Kathleen K; Tsai, Susan; Gamblin, T Clark

2018-02-01

Operative resection remains the definitive curative therapy for retroperitoneal sarcoma. Data published recently show a correlation between improved outcomes for complex oncologic operations and treatment at academic centers. For large retroperitoneal sarcomas, operative resection can be complex and require multidisciplinary care. We hypothesized that survival rates vary between type of treating center for patients undergoing resection for retroperitoneal sarcoma. Patients with stage I to III nonmetastatic retroperitoneal sarcomas who underwent operative resection were identified from the National Cancer Database during the years 2004-2013. Treating centers were categorized as academic cancer centers or community cancer centers. Overall survival was analyzed by log-rank test and graphed using Kaplan-Meier method. A total of 2,762 patients were identified. A majority of patients (59.4%, n = 1,642) underwent resection at an academic cancer centers. Median age at diagnosis was 63 years old. Neoadjuvant radiotherapy was more common at academic cancer centers, while adjuvant radiotherapy was more common at community cancer centers. Improved overall survival was seen at academic cancer centers across all stages compared with community cancer centers (P = .014) but, after multivariable Cox regression analysis, was not a significant independent predictor of survival (hazard ratio = 0.91, 95% confidence interval, 0.79-1.04, P = .171). Academic cancer centers exhibited a greater rate of R0 resection (55.9% vs 47.0%, P < .001) and a lesser odds of positive margins (odds ratio 0.83, 95% confidence interval, 0.69-0.99, P = .044) after multivariable logistic regression. Resection for retroperitoneal sarcoma performed at academic cancer centers was an independent predictor of margin-negative resection but was not a statistically significant factor for survival. This observation suggests that site of care may contribute to some aspect of improved oncologic resection

A dual-stage sodium thermal electrochemical converter (Na-TEC)

NASA Astrophysics Data System (ADS)

Limia, Alexander; Ha, Jong Min; Kottke, Peter; Gunawan, Andrey; Fedorov, Andrei G.; Lee, Seung Woo; Yee, Shannon K.

2017-12-01

The sodium thermal electrochemical converter (Na-TEC) is a heat engine that generates electricity through the isothermal expansion of sodium ions. The Na-TEC is a closed system that can theoretically achieve conversion efficiencies above 45% when operating between thermal reservoirs at 1150 K and 550 K. However, thermal designs have confined previous single-stage devices to thermal efficiencies below 20%. To mitigate some of these limitations, we consider dividing the isothermal expansion into two stages; one at the evaporator temperature (1150 K) and another at an intermediate temperature (650 K-1050 K). This dual-stage Na-TEC takes advantage of regeneration and reheating, and could be amenable to better thermal management. Herein, we demonstrate how the dual-stage device can improve the efficiency by up to 8% points over the best performing single-stage device. We also establish an application regime map for the single- and dual-stage Na-TEC in terms of the power density and the total thermal parasitic loss. Generally, a single-stage Na-TEC should be used for applications requiring high power densities, whereas a dual-stage Na-TEC should be used for applications requiring high efficiency.

Using a Pattern-Centered Approach to Assess Sexual Risk-Taking in Study Abroad Students

ERIC Educational Resources Information Center

Marcantonio, Tiffany; Angelone, D. J.; Sledjeski, Eve

2016-01-01

Objectives: The purpose of this study was to examine the impact of several potential factors related to sexually risky behaviors in study abroad students. The authors utilized a pattern-centered analysis to identify specific groups that can be targeted for intervention. Participants: The sample consisted of 173 students who studied abroad in a…

Origin of Marshall Space Flight Center (MSFC)

NASA Image and Video Library

1960-09-08

President Dwight D. Eisenhower and Mrs. George C. Marshall unveil the bronze bust of General George C. Marshall during the dedication of the Marshall Space Flight Center. Eisenhower signed an Executive Order on October 21, 1959 directing the transfer of persornel from the Redstone Arsenal's Army Ballistic Missile Agency Development Operations Division to NASA. On March 15, 1960, another Executive Order announced that the space complex formed within the boundaries of Redstone Arsenal would become the George C. Marshall Space Flight Center. The Center was activated on July 1, 1960, with dedication ceremonies taking place September 8, 1960.

Developmental changes and individual differences in risk and perspective taking in adolescence.

PubMed

Crone, Eveline A; Bullens, L; van der Plas, E A A; Kijkuit, E J; Zelazo, P D

2008-01-01

Despite the assumed prevalence of risk-taking behavior in adolescence, the laboratory evidence of risk taking remains scarce, and the individual variation poorly understood. Drawing from neuroscience studies, we tested whether risk and reward orientation are influenced by the perspective that adolescents take when making risky decisions. Perspective taking was manipulated by cuing participants prior to each choice whether the decision was made for "self," or from the perspective of an "other" (the experimenter in Experiment 1; a hypothetical peer in Experiment 2). In Experiment 1, we show a developmental decrease in risk-taking behavior across different stages of adolescence. In addition, all age groups made fewer risky choices for the experimenter, but the difference between self and other was larger in early adolescence. In Experiment 2, we show that high sensation-seeking (SS) adolescents make more risky choices than low SS adolescents, but both groups make a similar differentiation for other individuals (low risk-taking or high risk-taking peers). Together, the results show that younger adolescents and high SS adolescents make more risky choices for themselves, but can appreciate that others may make fewer risky choices. The developmental change toward more rational decisions versus emotional, impulsive decisions may reflect, in part, more efficient integration of others' perspectives into one's decision making. These developmental results are discussed regarding brain systems important for risk taking and perspective taking.

Computational Plume Modeling of COnceptual ARES Vehicle Stage Tests

NASA Technical Reports Server (NTRS)

Allgood, Daniel C.; Ahuja, Vineet

2007-01-01

The plume-induced environment of a conceptual ARES V vehicle stage test at the NASA Stennis Space Center (NASA-SSC) was modeled using computational fluid dynamics (CFD). A full-scale multi-element grid was generated for the NASA-SSC B-2 test stand with the ARES V stage being located in a proposed off-center forward position. The plume produced by the ARES V main power plant (cluster of five RS-68 LOX/LH2 engines) was simulated using a multi-element flow solver - CRUNCH. The primary objective of this work was to obtain a fundamental understanding of the ARES V plume and its impingement characteristics on the B-2 flame-deflector. The location, size and shape of the impingement region were quantified along with the un-cooled deflector wall pressures, temperatures and incident heating rates. Issues with the proposed tests were identified and several of these addressed using the CFD methodology. The final results of this modeling effort will provide useful data and boundary conditions in upcoming engineering studies that are directed towards determining the required facility modifications for ensuring safe and reliable stage testing in support of the Constellation Program.

Flexible spatial perspective-taking: conversational partners weigh multiple cues in collaborative tasks.

PubMed

Galati, Alexia; Avraamides, Marios N

2013-01-01

Research on spatial perspective-taking often focuses on the cognitive processes of isolated individuals as they adopt or maintain imagined perspectives. Collaborative studies of spatial perspective-taking typically examine speakers' linguistic choices, while overlooking their underlying processes and representations. We review evidence from two collaborative experiments that examine the contribution of social and representational cues to spatial perspective choices in both language and the organization of spatial memory. Across experiments, speakers organized their memory representations according to the convergence of various cues. When layouts were randomly configured and did not afford intrinsic cues, speakers encoded their partner's viewpoint in memory, if available, but did not use it as an organizing direction. On the other hand, when the layout afforded an intrinsic structure, speakers organized their spatial memories according to the person-centered perspective reinforced by the layout's structure. Similarly, in descriptions, speakers considered multiple cues whether available a priori or at the interaction. They used partner-centered expressions more frequently (e.g., "to your right") when the partner's viewpoint was misaligned by a small offset or coincided with the layout's structure. Conversely, they used egocentric expressions more frequently when their own viewpoint coincided with the intrinsic structure or when the partner was misaligned by a computationally difficult, oblique offset. Based on these findings we advocate for a framework for flexible perspective-taking: people weigh multiple cues (including social ones) to make attributions about the relative difficulty of perspective-taking for each partner, and adapt behavior to minimize their collective effort. This framework is not specialized for spatial reasoning but instead emerges from the same principles and memory-depended processes that govern perspective-taking in non-spatial tasks.

Applicability of the BCLC staging system to patients with hepatocellular carcinoma in Korea: analysis at a single center with a liver transplant center.

PubMed

Kim, Sung Eun; Lee, Han Chu; Kim, Kang Mo; Lim, Young-Suk; Chung, Young-Hwa; Lee, Yung Sang; Suh, Dong Jin

2011-06-01

The Barcelona Clinic Liver Cancer (BCLC) staging system is logical for the staging and treatment of hepatocellular carcinoma (HCC) because it was based on survival data. This study evaluated the applicability of the BCLC staging system and reasons for divergence from BCLC-recommended treatments in Korean HCC patients. One hundred and sixty consecutive HCC patients were prospectively enrolled. Treatments were generally recommended according to the guideline of the American Association for the Study of Liver Diseases, but patients were also informed about alternative treatments. The final decision was made with patient agreement, and was based on the doctor's preferences when a patient was unable to reach a decision. There were 2 (1%), 101 (64%), 20 (12.5%), 34 (21.5%), and 3 (1%) patients with very early-, early-, intermediate-, advanced-, and terminal-stage disease, respectively. Only 64 patients (40%) were treated according to BCLC recommendations. The treatment deviated from BCLC recommendations in 68% (69/101) and 79% (27/34) of patients with early and advanced stage, respectively. The main causes of deviation were refusal to undergo surgery, the presence of an indeterminate malignancy nodule, the absence of a suitable donor, or financial problems. Donor shortage, financial problems, the relatively limited efficacy of molecular targeting agents, and the presence of an indeterminate nodule were the main causes of deviation from BCLC recommendations. Even after excluding cases in which decisions were made by patient preference, only 66% of the HCC patients were treated according to BCLC recommendations. Treatment guidelines that reflect the Korean situation are mandatory for HCC patients.

Kennedy Center Salute To Apollo

NASA Image and Video Library

2009-07-17

Apollo 11 astronaut Buzz Aldrin, left, meets with Gene Kranz, retired NASA Flight Director and manager, back stage after the "Salute to Apollo" ceremony at the Kennedy Center for the Performing Arts, Saturday, July 18, 2009 in Washington. The event was part of NASA's week long celebration of the Apollo 40th Anniversary. Photo Credit: (NASA/Bill Ingalls)

Force balance in the take-off of a pierid butterfly: relative importance and timing of leg impulsion and aerodynamic forces.

PubMed

Bimbard, Gaëlle; Kolomenskiy, Dmitry; Bouteleux, Olivier; Casas, Jérôme; Godoy-Diana, Ramiro

2013-09-15

Up to now, the take-off stage has remained an elusive phase of insect flight that was relatively poorly explored compared with other maneuvers. An overall assessment of the different mechanisms involved in force production during take-off has never been explored. Focusing on the first downstroke, we have addressed this problem from a force balance perspective in butterflies taking off from the ground. In order to determine whether the sole aerodynamic wing force could explain the observed motion of the insect, we have firstly compared a simple analytical model of the wing force with the acceleration of the insect's center of mass estimated from video tracking of the wing and body motions. Secondly, wing kinematics were also used for numerical simulations of the aerodynamic flow field. Similar wing aerodynamic forces were obtained by the two methods. However, neither are sufficient, nor is the inclusion of the ground effect, to predict faithfully the body acceleration. We have to resort to the leg forces to obtain a model that best fits the data. We show that the median and hind legs display an active extension responsible for the initiation of the upward motion of the insect's body, occurring before the onset of the wing downstroke. We estimate that legs generate, at various times, an upward force that can be much larger than all other forces applied to the insect's body. The relative timing of leg and wing forces explains the large variability of trajectories observed during the maneuvers.

Src Kinase: A Novel Target of Early-Stage ER-Negative Breast Cancer

DTIC Science & Technology

2012-03-01

patients with early stage ErbB2-overexpressing biopsies and ER- atypia . 13 REFERENCES: 1. Jordan VC. Tamoxifen for breast cancer prevention. Proc Soc...Summary01-03-2012 Src Kinase: A Novel Target of Early-Stage ER-Negative Breast Cancer Shalini Jain University of Texas M.D. Anderson Cancer Center Houston...SUBTITLE “Src Kinase: A Novel Target of Early-Stage ER-Negative Breast Cancer” 5a. CONTRACT NUMBER W81XWH-11-1-0004 5b. GRANT NUMBER

Stir Friction Welding Used in Ares I Upper Stage Fabrication

NASA Technical Reports Server (NTRS)

2007-01-01

Under the goals of the Vision for Space Exploration, Ares I is a chief component of the cost-effective space transportation infrastructure being developed by NASA's Constellation Program. This transportation system will safely and reliably carry human explorers back to the moon, and then onward to Mars and other destinations in the solar system. The Ares I effort includes multiple project element teams at NASA centers and contract organizations around the nation, and is managed by the Exploration Launch Projects Office at NASA's Marshall Space Flight Center (MFSC). ATK Launch Systems near Brigham City, Utah, is the prime contractor for the first stage booster. ATK's subcontractor, United Space Alliance of Houston, is designing, developing and testing the parachutes at its facilities at NASA's Kennedy Space Center in Florida. NASA's Johnson Space Center in Houston hosts the Constellation Program and Orion Crew Capsule Project Office and provides test instrumentation and support personnel. Together, these teams are developing vehicle hardware, evolving proven technologies, and testing components and systems. Their work builds on powerful, reliable space shuttle propulsion elements and nearly a half-century of NASA space flight experience and technological advances. Ares I is an inline, two-stage rocket configuration topped by the Crew Exploration Vehicle, its service module, and a launch abort system. This HD video image depicts friction stir welding used in manufacturing aluminum panels that will fabricate the Ares I upper stage barrel. The panels are subjected to confidence tests in which the bent aluminum is stressed to breaking point and thoroughly examined. The panels are manufactured by AMRO Manufacturing located in El Monte, California. (Highest resolution available)

Stir Friction Welding Used in Ares I Upper Stage Fabrication

NASA Technical Reports Server (NTRS)

2007-01-01

Under the goals of the Vision for Space Exploration, Ares I is a chief component of the cost-effective space transportation infrastructure being developed by NASA's Constellation Program. This transportation system will safely and reliably carry human explorers back to the moon, and then onward to Mars and other destinations in the solar system. The Ares I effort includes multiple project element teams at NASA centers and contract organizations around the nation, and is managed by the Exploration Launch Projects Office at NASA's Marshall Space Flight Center (MFSC). ATK Launch Systems near Brigham City, Utah, is the prime contractor for the first stage booster. ATK's subcontractor, United Space Alliance of Houston, is designing, developing and testing the parachutes at its facilities at NASA's Kennedy Space Center in Florida. NASA's Johnson Space Center in Houston hosts the Constellation Program and Orion Crew Capsule Project Office and provides test instrumentation and support personnel. Together, these teams are developing vehicle hardware, evolving proven technologies, and testing components and systems. Their work builds on powerful, reliable space shuttle propulsion elements and nearly a half-century of NASA space flight experience and technological advances. Ares I is an inline, two-stage rocket configuration topped by the Crew Exploration Vehicle, its service module, and a launch abort system. This HD video image depicts friction stir welding used in manufacturing aluminum panels that will fabricate the Ares I upper stage barrel. The aluminum panels are subjected to confidence panel tests during which the bent aluminum is stressed to breaking point and thoroughly examined. The panels are manufactured by AMRO Manufacturing located in El Monte, California. (Highest resolution available)

Seven Steps You Can Take to Improve Your Objectives. Third Edition.

ERIC Educational Resources Information Center

Alvir, Claire Gelinas

This document gives examples of seven steps a classroom teacher can take to improve both instructional and learning objectives. This improvement is to be measured by increased student learning. The seven steps are as follows: a) write a simple behavioral objective, b) edit, c) revise objective to make it learner centered, d) clarify, e) evaluate…

Implications of inaccurate clinical nodal staging in pancreatic adenocarcinoma.

PubMed

Swords, Douglas S; Firpo, Matthew A; Johnson, Kirsten M; Boucher, Kenneth M; Scaife, Courtney L; Mulvihill, Sean J

2017-07-01

Many patients with stage I-II pancreatic adenocarcinoma do not undergo resection. We hypothesized that (1) clinical staging underestimates nodal involvement, causing stage IIB to have a greater percent of resected patients and (2) this stage-shift causes discrepancies in observed survival. The Surveillance, Epidemiology, and End Results (SEER) research database was used to evaluate cause-specific survival in patients with pancreatic adenocarcinoma from 2004-2012. Survival was compared using the log-rank test. Single-center data on 105 patients who underwent resection of pancreatic adenocarcinoma without neoadjuvant treatment were used to compare clinical and pathologic nodal staging. In SEER data, medium-term survival in stage IIB was superior to IB and IIA, with median cause-specific survival of 14, 9, and 11 months, respectively (P < .001). Seventy-two percent of stage IIB patients underwent resection vs 28% in IB and 36% in IIA (P < .001). In our institutional data, 12.4% of patients had clinical evidence of nodal involvement vs 69.5% by pathologic staging (P < .001). Among clinical stage IA-IIA patients, 71.6% had nodal involvement by pathologic staging. Both SEER and institutional data support substantial underestimation of nodal involvement by clinical staging. This finding has implications in decisions regarding neoadjuvant therapy and analysis of outcomes in the absence of pathologic staging. Copyright © 2017 Elsevier Inc. All rights reserved.

Crew Launch Vehicle (CLV) Upper Stage Configuration Selection Process

NASA Technical Reports Server (NTRS)

Davis, Daniel J.; Coook, Jerry R.

2006-01-01

The Crew Launch Vehicle (CLV), a key component of NASA's blueprint for the next generation of spacecraft to take humans back to the moon, is being designed and built by engineers at NASA s Marshall Space Flight Center (MSFC). The vehicle s design is based on the results of NASA's 2005 Exploration Systems Architecture Study (ESAS), which called for development of a crew-launch system to reduce the gap between Shuttle retirement and Crew Exploration Vehicle (CEV) Initial Operating Capability, identification of key technologies required to enable and significantly enhance these reference exploration systems, and a reprioritization of near- and far-term technology investments. The Upper Stage Element (USE) of the CLV is a clean-sheet approach that is being designed and developed in-house, with element management at MSFC. The USE concept is a self-supporting cylindrical structure, approximately 115' long and 216" in diameter, consisting of the following subsystems: Primary Structures (LOX Tank, LH2 Tank, Intertank, Thrust Structure, Spacecraft Payload Adaptor, Interstage, Forward and Aft Skirts), Secondary Structures (Systems Tunnel), Avionics and Software, Main Propulsion System, Reaction Control System, Thrust Vector Control, Auxiliary Power Unit, and Hydraulic Systems. The ESAS originally recommended a CEV to be launched atop a four-segment Space Shuttle Main Engine (SSME) CLV, utilizing an RS-25 engine-powered upper stage. However, Agency decisions to utilize fewer CLV development steps to lunar missions, reduce the overall risk for the lunar program, and provide a more balanced engine production rate requirement prompted engineers to switch to a five-segment design with a single Saturn-derived J-2X engine. This approach provides for single upper stage engine development for the CLV and an Earth Departure Stage, single Reusable Solid Rocket Booster (RSRB) development for the CLV and a Cargo Launch Vehicle, and single core SSME development. While the RSRB design has

The Effects of Binge Drinking on College Students’ Next-Day Academic Test-Taking Performance and Mood State

PubMed Central

Howland, Jonathan; Rohsenow, Damaris J; Greece, Jacey A; Littlefield, Caroline A; Almeida, Alissa; Heeren, Timothy; Winter, Michael; Bliss, Caleb A.; Hunt, Sarah; Hermos, John

2010-01-01

Aim To assess the effects of binge drinking on students’ next-day academic test-taking performance. Design A placebo-controlled cross-over design with randomly assigned order of conditions. Participants were randomized to either alcoholic beverage (mean =.12 g% breath alcohol concentration [BrAC]) or placebo on the first night and then received the other beverage a week later. The next day, participants were assessed on test-taking, neurocognitive performance and mood state. Participants 193 college students (≥ 21 years) recruited from greater Boston. Setting The trial was conducted at the General Clinical Research Center at the Boston Medical Center. Measurements The Graduate Record Exams © (GREs) and a quiz on a lecture presented the previous day measured test-taking performance; the Neurobehavioral Evaluation System (NES3) and the Psychomotor Vigilance Test (PVT) measured neurocognitive performance; and, the Profile of Mood States (POMS) measured mood. Findings Test-taking performance was not affected the morning after alcohol administration, but mood state and attention/reaction time were. Conclusion Drinking to a level of .12 g% BrAC does not affect next-day test-taking performance, but does affect some neurocognitive measures and mood state. PMID:20403018

Core Stage Inter-Tank Umbilical (CSITU) Lift at ML

NASA Image and Video Library

2017-10-11

A heavy-lift crane and rigging are used to lift the Core Stage Inter-tank Umbilical (CSITU) up to about the 140-foot level of the mobile launcher (ML) tower at NASA's Kennedy Space Center in Florida. The CSITU is moved into place for a fit check of the attachment hardware. The umbilical will then be lowered down and installed permanently on the ML at a later date. The CSITU is a swing-arm umbilical that will connect to the Space Launch System core stage inter-tank. It will provide conditioned air, pressurized gases and power and data connection to the core stage. The Ground Systems Development and Operations Program is overseeing installation of the umbilicals.

Taking the Pulse of the University of Tennessee Medical Center's Health Literacy Knowledge.

PubMed

Grabeel, Kelsey Leonard; Beeler, Cynthia J

2018-01-01

Low health literacy is well documented in East Tennessee. Before addressing the issue, librarians at the Preston Medical Library, University of Tennessee Medical Center in Knoxville, Tennessee, conducted a needs assessment of hospital staff to determine their knowledge of health literacy and the need for training. As a follow-up, library staff conducted training sessions for nurses through classes, small group meetings, and staff huddles. The result is an increased dialogue of health literacy at the hospital, along with new research projects, a forum, and a summit meeting.

INTERIM CRYOGENIC PROPULSION STAGE TEST ARTICLE UNLOADED PRIOR T

NASA Image and Video Library

2016-06-20

TWO CRANES LIFT THE APPROXIMATELY 8,000-POUND INTERIM CRYOGENIC PROPULSION STAGE TEST ARTICLE OUT OF ITS CRATE AT MARSHALL. THE TEST ARTICLE ARRIVED AT MARSHALL SPACE FLIGHT CENTER VIA BARGE ON THE TENNESSEE RIVER AND WAS TRANSPORTED TO BUILDING 4649 WHERE TESTING WILL BEGIN.

NASA Completes Webb Telescope Center of Curvature Pre-test

NASA Image and Video Library

2017-12-08

Engineers and technicians working on the James Webb Space Telescope successfully completed the first important optical measurement of Webb’s fully assembled primary mirror, called a Center of Curvature test. Taking a “before” optical measurement of the telescope’s deployed mirror is crucial before the telescope goes into several stages of rigorous mechanical testing. These tests will simulate the violent sound and vibration environments the telescope will experience inside its rocket on its way out into space. This environment is one of the most stressful structurally and could alter the shape and alignment of Webb’s primary mirror, which could degrade or, in the worst case, ruin its performance. Webb has been designed and constructed to withstand its launch environment, but it must be tested to verify that it will indeed survive and not change in any unexpected way. Making the same optical measurements both before and after simulated launch environment testing and comparing the results is fundamental to Webb’s development, assuring that it will work in space. Credit: NASA/Goddard/Chris Gunn Read more: go.nasa.gov/2enIgwP NASA image use policy. NASA Goddard Space Flight Center enables NASA’s mission through four scientific endeavors: Earth Science, Heliophysics, Solar System Exploration, and Astrophysics. Goddard plays a leading role in NASA’s accomplishments by contributing compelling scientific knowledge to advance the Agency’s mission. Follow us on Twitter Like us on Facebook Find us on Instagram

Society for Vascular Surgery Wound, Ischemia, foot Infection (WIfI) score correlates with the intensity of multimodal limb treatment and patient-centered outcomes in patients with threatened limbs managed in a limb preservation center.

PubMed

Robinson, William P; Loretz, Lorraine; Hanesian, Colleen; Flahive, Julie; Bostrom, John; Lunig, Nicholas; Schanzer, Andres; Messina, Louis

2017-08-01

The Society for Vascular Surgery Wound, Ischemia, foot Infection (WIfI) system aims to stratify threatened limbs according to their anticipated natural history and estimate the likelihood of benefit from revascularization, but whether it accurately stratifies outcomes in limbs undergoing aggressive treatment for limb salvage is unknown. We investigated whether the WIfI stage correlated with the intensity of limb treatment required and patient-centered outcomes. We stratified limbs from a prospectively maintained database of consecutive patients referred to a limb preservation center according to WIfI stage (October 2013-May 2015). Comorbidities, multimodal limb treatment, including foot operations and revascularization, and patient-centered outcomes (wound healing, limb salvage, amputation-free survival, maintenance of ambulatory and independent living status, and mortality) were compared among WIfI stages. Multivariate analysis was performed to identify predictors of wound healing and limb salvage. We identified 280 threatened limbs encompassing all WIfI stages in 257 consecutive patients: stage 1, 48 (17%); stage 2, 67 (24%); stage 3, 64 (23%); stage 4, 83 (30%); and stage 5 (unsalvageable), 18 (6%). Operative foot débridement, minor amputation, and use of revascularization increased with increasing WIfI stage (P ≤ .04). Revascularization was performed in 106 limbs (39%), with equal use of open and endovascular procedures. Over a median follow-up of 209 days (interquartile range, 95, 340) days, 1-year Kaplan-Meier wound healing cumulative incidence was 71%, and the proportion with complete wound healing decreased with increasing WIfI stage. Major amputation was required in 26 stage 1 to 4 limbs (10%). Increasing WIfI stage was associated with decreased 1-year Kaplan-Meier limb salvage (stage 1: 96%, stage 2: 84%, stage 3: 90%, and stage 4: 78%; P = .003) and amputation-free survival (P = .006). Stage 4 WIfI independently predicted amputation (hazard ratio

Kennedy Center Salute To Apollo

NASA Image and Video Library

2009-07-17

National Symphony Orchestra Conductor Emil de Cou, left, meets with Gene Kranz, retired NASA Flight Director and manager, back stage after the "Salute to Apollo" ceremony at the Kennedy Center for the Performing Arts, Saturday, July 18, 2009 in Washington. The event was part of NASA's week long celebration of the Apollo 40th Anniversary. Photo Credit: (NASA/Bill Ingalls)

KENNEDY SPACE CENTER, FLA. - KSC Director Jim Kennedy and Glenn Research Center Director Dr. Julian Earls share the stage during the rollout of the One NASA initiative at KSC. Earls gave a motivational speech during the luncheon held at the Visitor Complex Debus Conference Center. The event was held at the IMAX Theater® where NASA leaders discussed One NASA with selected employees. Explaining how their respective centers contribute to One NASA, along with Kennedy and Earls, were James Jennings, NASA’s associate deputy administrator for institutions and asset management; Ed Weiler, associate administrator for Space Science; Kevin Peterson, Dryden Flight Research Center director; incoming KSC Deputy Director Woodrow Whitlow; and implementation team lead Johnny Stevenson.

NASA Image and Video Library

2003-08-20

KENNEDY SPACE CENTER, FLA. - KSC Director Jim Kennedy and Glenn Research Center Director Dr. Julian Earls share the stage during the rollout of the One NASA initiative at KSC. Earls gave a motivational speech during the luncheon held at the Visitor Complex Debus Conference Center. The event was held at the IMAX Theater® where NASA leaders discussed One NASA with selected employees. Explaining how their respective centers contribute to One NASA, along with Kennedy and Earls, were James Jennings, NASA’s associate deputy administrator for institutions and asset management; Ed Weiler, associate administrator for Space Science; Kevin Peterson, Dryden Flight Research Center director; incoming KSC Deputy Director Woodrow Whitlow; and implementation team lead Johnny Stevenson.

SRTR center-specific reporting tools: Posttransplant outcomes.

PubMed

Dickinson, D M; Shearon, T H; O'Keefe, J; Wong, H-H; Berg, C L; Rosendale, J D; Delmonico, F L; Webb, R L; Wolfe, R A

2006-01-01

Measuring and monitoring performance--be it waiting list and posttransplant outcomes by a transplant center, or organ donation success by an organ procurement organization and its partnering hospitals--is an important component of ensuring good care for people with end-stage organ failure. Many parties have an interest in examining these outcomes, from patients and their families to payers such as insurance companies or the Centers for Medicare and Medicaid Services; from primary caregivers providing patient counseling to government agencies charged with protecting patients. The Scientific Registry of Transplant Recipients produces regular, public reports on the performance of transplant centers and organ procurement organizations. This article explains the statistical tools used to prepare these reports, with a focus on graft survival and patient survival rates of transplant centers--especially the methods used to fairly and usefully compare outcomes of centers that serve different populations. The article concludes with a practical application of these statistics--their use in screening transplant center performance to identify centers that may need remedial action by the OPTN/UNOS Membership and Professional Standards Committee.

Special Aspects of Flight Dynamics of a Reusable Cryogenic Booster Stage

NASA Astrophysics Data System (ADS)

Klevanski, J.; Sippel, M.

2005-02-01

The semi-reusable Space Transportation System (STS) investigated in the German ASTRA research program consists of two reusable winged liquid fly-back booster stages called LFBB attached to the expendable Ariane 5 core at an upgraded technology level. The focus of the presented study is the in-depth research of the special aspects of flight dynamics of a LFBB in all flight phases and especially the investigation of the trimmablity, stability and controllability. The LFBB-layout is developed under consideration of tight structural and geometrical constraints of using European cryogenic rocket engine technology [1]. These design conditions result in the special LFBB layout features, such as its large diameter fuselage and a forward position of the air-breathing engines. The great variation in the location of the center of pressure for different Mach numbers caused by large diameter fuselage and a wide range of center of gravity position demand canards for trim and control purposes. The aerodynamic investigation loop performed by the DLR Institute of Aerodynamics and Flow Technology in Braunschweig [2],[3] and in the DLR Wind Tunnel in Cologne [6] allowed optimizing the key features of the aerodynamical layout, such as the canards shape and the wing profile. The main task of this study is the investigation of the longitudinal flight dynamics of the LFBB using the obtained aerodynamic data within a closed loop simulation taking into account rigid body equations of motion, control law and actuators by realistic assumption. This paper discusses the controllability of the whole STS during the ascent phase until separation including wind gust influence, guaranteeing of the structural constraints during re-entry phase and the trimmablity and controllability of the LFBB during the cruise return flight. The flight dynamics behavior of the LFBB is investigated for different center of gravity positions with reasonable margins.

Flexible spatial perspective-taking: conversational partners weigh multiple cues in collaborative tasks

PubMed Central

Galati, Alexia; Avraamides, Marios N.

2013-01-01

Research on spatial perspective-taking often focuses on the cognitive processes of isolated individuals as they adopt or maintain imagined perspectives. Collaborative studies of spatial perspective-taking typically examine speakers' linguistic choices, while overlooking their underlying processes and representations. We review evidence from two collaborative experiments that examine the contribution of social and representational cues to spatial perspective choices in both language and the organization of spatial memory. Across experiments, speakers organized their memory representations according to the convergence of various cues. When layouts were randomly configured and did not afford intrinsic cues, speakers encoded their partner's viewpoint in memory, if available, but did not use it as an organizing direction. On the other hand, when the layout afforded an intrinsic structure, speakers organized their spatial memories according to the person-centered perspective reinforced by the layout's structure. Similarly, in descriptions, speakers considered multiple cues whether available a priori or at the interaction. They used partner-centered expressions more frequently (e.g., “to your right”) when the partner's viewpoint was misaligned by a small offset or coincided with the layout's structure. Conversely, they used egocentric expressions more frequently when their own viewpoint coincided with the intrinsic structure or when the partner was misaligned by a computationally difficult, oblique offset. Based on these findings we advocate for a framework for flexible perspective-taking: people weigh multiple cues (including social ones) to make attributions about the relative difficulty of perspective-taking for each partner, and adapt behavior to minimize their collective effort. This framework is not specialized for spatial reasoning but instead emerges from the same principles and memory-depended processes that govern perspective-taking in non-spatial tasks

Structure of first- and second-stage mineralized elements in teeth of the sea urchin Lytechinus variegatus.

PubMed

Robach, J S; Stock, S R; Veis, A

2009-12-01

Microstructure of the teeth of the sea urchin Lytechinus variegatus was investigated using optical microscopy, SEM (scanning electron microscopy) and SIMS (secondary ion mass spectroscopy). The study focused on the internal structure of the first-stage mineral structures of high Mg calcite (primary, secondary and carinar process plates, prisms) and on morphology of the columns of second-stage mineral (very high Mg calcite) that cement the first-stage material together. Optical micrographs under polarized light revealed contrast in the centers (midlines) of carinar process plates and in prisms in polished sections; staining of primary and carinar process plates revealed significant dye uptake at the plate centers. Demineralization with and without fixation revealed that the midlines of primary and carinar process plates (but not secondary plates) and the centers of prisms differed from the rest of the plate or prism, and SIMS showed proteins concentrated in these plate centers. SEM was used to study the morphology of columns, the fracture surfaces of mature teeth and the 3D morphology of prisms. These observations of internal structures in plates and prisms offer new insight into the mineralization process and suggest an important role for protein inclusions within the first-stage mineral. Some of the 3D structures not reported previously, such as twisted prisms and stacks of carinar process plates with nested wrinkles, may represent structural strengthening strategies.

Structure of first- and second-stage mineralized elements in teeth of the sea urchin Lytechinus variegatus

PubMed Central

Robach, J. S.; Stock, S. R.; Veis, A.

2009-01-01

Microstructure of the teeth of the sea urchin Lytechinus variegatus was investigated using optical microscopy, SEM (scanning electron microscopy) and SIMS (secondary ion mass spectroscopy). The study focused on the internal structure of the first-stage mineral structures of high Mg calcite (primary, secondary and carinar process plates; prisms) and on morphology of the columns of second-stage mineral (very high Mg calcite) that cement the first-stage material together. Optical micrographs under polarized light revealed contrast in the centers (midlines) of carinar process plates and in prisms in polished sections; staining of primary and carinar process plates revealed significant dye uptake at the plate centers. Demineralization with and without fixation revealed that the midlines of primary and carinar process plates (but not secondary plates) and the centers of prisms differed from the rest of the plate or prism, and SIMS showed proteins concentrated in these plate centers. SEM was used to study the morphology of columns, the fracture surfaces of mature teeth and the 3D morphology of prisms. These observations of internal structures in plates and prisms offer new insight into the mineralization process and suggest an important role for protein inclusions within the first-stage mineral. Some of the 3D structures not reported previously, such as twisted prisms and stacks of carinar process plates with nested wrinkles, may represent structural strengthening strategies. PMID:19616101

Early development of turn-taking with parents shapes vocal acoustics in infant marmoset monkeys

PubMed Central

Takahashi, Daniel Y.; Fenley, Alicia R.; Ghazanfar, Asif A.

2016-01-01

In humans, vocal turn-taking is a ubiquitous form of social interaction. It is a communication system that exhibits the properties of a dynamical system: two individuals become coupled to each other via acoustic exchanges and mutually affect each other. Human turn-taking develops during the first year of life. We investigated the development of vocal turn-taking in infant marmoset monkeys, a New World species whose adult vocal behaviour exhibits the same universal features of human turn-taking. We find that marmoset infants undergo the same trajectory of change for vocal turn-taking as humans, and do so during the same life-history stage. Our data show that turn-taking by marmoset infants depends on the development of self-monitoring, and that contingent parental calls elicit more mature-sounding calls from infants. As in humans, there was no evidence that parental feedback affects the rate of turn-taking maturation. We conclude that vocal turn-taking by marmoset monkeys and humans is an instance of convergent evolution, possibly as a result of pressures on both species to adopt a cooperative breeding strategy and increase volubility. PMID:27069047

Interim Cryogenic Propulsion Stage (ICPS) for EM-1 Transport fro

NASA Image and Video Library

2017-04-11

The Interim Cryogenic Propulsion Stage (ICPS) for NASA's Space Launch System rocket is moved inside the Delta Operations Center at Cape Canaveral Air Force Station in Florida. The ICPS was moved from the United Launch Alliance (ULA) Horizontal Integration Facility near Space Launch Complex 37 at the Cape. The ICPS is the first integrated piece of flight hardware to arrive for the SLS. It is the in-space stage that is located toward the top of the rocket, between the Launch Vehicle Stage Adapter and the Orion Spacecraft Adapter. It will provide some of the in-space propulsion during Orion's first flight test atop the SLS on Exploration Mission-1.

Interim Cryogenic Propulsion Stage (ICPS) for EM-1 Transport fro

NASA Image and Video Library

2017-04-11

The Interim Cryogenic Propulsion Stage (ICPS) for NASA's Space Launch System rocket arrives at the Delta Operations Center at Cape Canaveral Air Force Station in Florida. The ICPS was moved from the United Launch Alliance (ULA) Horizontal Integration Facility near Space Launch Complex 37 at the Cape. The ICPS is the first integrated piece of flight hardware to arrive for the SLS. It is the in-space stage that is located toward the top of the rocket, between the Launch Vehicle Stage Adapter and the Orion Spacecraft Adapter. It will provide some of the in-space propulsion during Orion's first flight test atop the SLS on Exploration Mission-1.

Changes in the quality of care during progress from stage 1 to stage 2 of Meaningful Use.

PubMed

Levine, David M; Healey, Michael J; Wright, Adam; Bates, David W; Linder, Jeffrey A; Samal, Lipika

2017-03-01

The Centers for Medicare and Medicaid Services (CMS) canceled Meaningful Use (MU), replacing it with Advancing Care Information, which preserves many MU elements. Therefore, transitioning from MU stage 1 to MU stage 2 has important implications for the new policy, yet the quality of care provided by physicians transitioning from MU1 to MU2 is unknown. Retrospective longitudinal evaluation of the quality of care delivered by outpatient physicians at an academic medical center in the transition between MU1 and MU2. Between MU1 and MU2, 4 measures improved: hypertension control (35% vs 40%), influenza immunization (63% vs 68%), tobacco use assessment/counseling (86% vs 96%), and diabetes control (93% vs 96%; P all <.01). One worsened: senior weight screening/follow-up (54% vs 49%; P  < .01). Two were unchanged: chlamydia screening and adult weight screening/follow-up. In this single-site study, when clinicians progressed from MU1 to MU2, 4 quality measures improved, 2 were unchanged, and 1 worsened. Analysis of national data should guide policy decisions about the content of MU's successor. © The Author 2016. Published by Oxford University Press on behalf of the American Medical Informatics Association. All rights reserved. For Permissions, please email: journals.permissions@oup.com

77 FR 62499 - Leaf River Energy Center LLC; Notice of Application

Federal Register 2010, 2011, 2012, 2013, 2014

2012-10-15

... DEPARTMENT OF ENERGY Federal Energy Regulatory Commission [Docket No. CP12-526-000] Leaf River Energy Center LLC; Notice of Application Take notice that on September 24, 2012, Leaf River Energy Center LLC (Leaf River), 53 Riverside Avenue, Westport, Connecticut, 06880, filed an application in Docket No...

Saturn V First Stage S-1C LOX Fuel Tanks

NASA Technical Reports Server (NTRS)

1960-01-01

This photograph shows the Saturn V assembled LOX (Liquid Oxygen) and fuel tanks ready for transport from the Manufacturing Engineering Laboratory at Marshall Space Flight Center in Huntsville, Alabama. The tanks were then shipped to the launch site at Kennedy Space Center for a flight. The towering 363-foot Saturn V was a multi-stage, multi-engine launch vehicle standing taller than the Statue of Liberty. Altogether, the Saturn V engines produced as much power as 85 Hoover Dams.

Stir Friction Welding Used in Ares I Upper Stage Fabrication

NASA Technical Reports Server (NTRS)

2007-01-01

Under the goals of the Vision for Space Exploration, Ares I is a chief component of the cost-effective space transportation infrastructure being developed by NASA's Constellation Program. This transportation system will safely and reliably carry human explorers back to the moon, and then onward to Mars and other destinations in the solar system. The Ares I effort includes multiple project element teams at NASA centers and contract organizations around the nation, and is managed by the Exploration Launch Projects Office at NASA's Marshall Space Flight Center (MFSC). ATK Launch Systems near Brigham City, Utah, is the prime contractor for the first stage booster. ATK's subcontractor, United Space Alliance of Houston, is designing, developing and testing the parachutes at its facilities at NASA's Kennedy Space Center in Florida. NASA's Johnson Space Center in Houston hosts the Constellation Program and Orion Crew Capsule Project Office and provides test instrumentation and support personnel. Together, these teams are developing vehicle hardware, evolving proven technologies, and testing components and systems. Their work builds on powerful, reliable space shuttle propulsion elements and nearly a half-century of NASA space flight experience and technological advances. Ares I is an inline, two-stage rocket configuration topped by the Crew Exploration Vehicle, its service module, and a launch abort system. This HD video image depicts the preparation and placement of a confidence ring for friction stir welding used in manufacturing aluminum panels that will fabricate the Ares I upper stage barrel. The aluminum panels are manufactured and subjected to confidence tests during which the bent aluminum is stressed to breaking point and thoroughly examined. The panels are manufactured by AMRO Manufacturing located in El Monte, California. (Highest resolution available)

Taking the Plunge: Next Steps in Engaged Learning

PubMed Central

Frederick, Jennifer

2010-01-01

College and university science educators from across Connecticut gathered at Yale’s West Campus in April 2010 for a Project Kaleidoscope (PKAL) program entitled “Taking the Plunge: Next Steps in Engaged Learning.” Funded by the National Science Foundation (NSF) and co-sponsored by the Connecticut Conference of Independent Colleges (CCIC) and Yale’s McDougal Graduate Teaching Center, the event was the latest in a PKAL series of one-day conferences aimed at equipping science, technology, engineering, and math (STEM) instructors with effective approaches to engaging students and training future scientists. PMID:20885897

2017 Solar Eclipse, Ames Research Center

NASA Image and Video Library

2017-08-21

Taking a break from his duties at the Ames Vertical Gun Range to look up at the eclipse over Ames Research Center in Mountain View Adam Parrish not only views but wears, on his forehead, the image of the 2017 Solar eclipse at 09:20:56 on August 21, 2017.

South Carolina Center for Teacher Recruitment: 93-94 Annual Report.

ERIC Educational Resources Information Center

South Carolina Center for Teacher Recruitment, Rock Hill.

This report outlines and evaluates the 1993-94 accomplishments of the South Carolina Center for Teacher Recruitment and addresses future directions the Center and its programs will be taking. The main body of the document reports on the following programs: (1) Minority Teacher Recruitment; (2) ProTeam Program (to make minority students and young…

Standard operating procedures for taking a sexual history.

PubMed

Althof, Stanley E; Rosen, Raymond C; Perelman, Michael A; Rubio-Aurioles, Eusebio

2013-01-01

While there is evidence of increased professional and public awareness of sexual problems, both male and female sexual dysfunctions remain underdiagnosed and undertreated by health care professionals around the world. Health care professionals (HCPs) are typically reluctant, disinterested, or unskilled in sexual problem management and regrettably are often disinclined to inquire about sexual issues. HCPs in all countries receive variable, nonstandardized, or inadequate training in sexual history taking and its treatment. This article presents a standard operating procedure (SOP) for taking a sexual history from men or women with sexual problems or performance concerns. Review of relevant evidence-based literature identified through a PubMed search, integrated with expert opinion. Guidelines for taking a sexual history are presented along with the relevant domains, opening and follow-up questions. The SOP presented in this article offers HCPs a brief, structured, and uniform method for obtaining a sexual history from men or women seeking health care services. Sexual history taking should be based on three basic principles, which serve as the foundation for managing sexual problems in men and women. These include the following: (i) a patient-centered approach; (ii) evidenced-based diagnostic and treatment recommendations; and (iii) use of a unified management approach for men and women. Sexual history taking should always be conducted in a culturally sensitive manner, taking account of the individual's background and lifestyle, status of the partner relationship, and the clinician's comfort and experience with the topic. Sexual inquiry should be incorporated into all new patient encounters, when possible, if only to ask one or two broad questions such as the following: "Are you sexually active? Do you have any sexual concerns or problems you would like to discuss?" Sexual history taking is a cornerstone of sexual medicine clinical practice. All patients should be

Melanoma Staging: Evidence-Based Changes in the American Joint Committee on Cancer Eighth Edition Cancer Staging Manual

PubMed Central

Gershenwald, Jeffrey E.; Scolyer, Richard A.; Hess, Kenneth R.; Sondak, Vernon K.; Long, Georgina V.; Ross, Merrick I.; Lazar, Alexander J.; Faries, Mark B.; Kirkwood, John M.; McArthur, Grant A.; Haydu, Lauren E.; Eggermont, Alexander M. M.; Flaherty, Keith T.; Balch, Charles M.; Thompson, John F.

2018-01-01

To update the melanoma staging system of the American Joint Committee on Cancer (AJCC) a large database was assembled comprising >46,000 patients from 10 centers worldwide with stages I, II, and III melanoma diagnosed since 1998. Based on analyses of this new database, the existing seventh edition AJCC stage IV database, and contemporary clinical trial data, the AJCC Melanoma Expert Panel introduced several important changes to the Tumor, Nodes, Metastasis (TNM) classification and stage grouping criteria. Key changes in the eighth edition AJCC Cancer Staging Manual include: 1) tumor thickness measurements to be recorded to the nearest 0.1 mm, not 0.01 mm; 2) definitions of T1a and T1b are revised (T1a, <0.8 mm without ulceration; T1b, 0.8–1.0 mm with or without ulceration or <0.8 mm with ulceration), with mitotic rate no longer a T category criterion; 3) pathological (but not clinical) stage IA is revised to include T1b N0 M0 (formerly pathologic stage IB); 4) the N category descriptors “microscopic” and “macroscopic” for regional node metastasis are redefined as “clinically occult” and “clinically apparent”; 5) prognostic stage III groupings are based on N category criteria and T category criteria (ie, primary tumor thickness and ulceration) and increased from 3 to 4 subgroups (stages IIIA–IIID); 6) definitions of N subcategories are revised, with the presence of microsatellites, satellites, or in-transit metastases now categorized as N1c, N2c, or N3c based on the number of tumor-involved regional lymph nodes, if any; 7) descriptors are added to each M1 subcategory designation for lactate dehydrogenase (LDH) level (LDH elevation no longer upstages to M1c); and 8) a new M1d designation is added for central nervous system metastases. This evidence-based revision of the AJCC melanoma staging system will guide patient treatment, provide better prognostic estimates, and refine stratification of patients entering clinical trials. PMID:29028110

Pathway Linking Patient-Centered Communication to Emotional Well-Being: Taking into Account Patient Satisfaction and Emotion Management.

PubMed

Jiang, Shaohai

2017-03-01

In the United States, levels of emotional well-being remain low, with 40% of American adults reporting the experience of daily stress and excessive anxiety. The doctor-patient communication during medical encounters may play a significant role in improving people's emotional well-being. Based on Street and his colleagues' (2009) pathway mediation model linking communication to health outcomes, this paper illustrates a mechanism that underlies how patient-centered communication improves emotional well-being. The results showed that patient-centered communication had direct effects on emotional well-being. In addition to the direct effects, patient-centered communication also indirectly influenced emotional well-being, mediated by patient satisfaction and emotion management, supporting the partial mediation. The findings provide additional empirical evidence to the pathways from communication to health outcomes, one of the least developed areas of communication research, and also offer significant implications for the design of interventions to improve patients' emotional well-being.

Progress on Ares First Stage Propulsion

NASA Technical Reports Server (NTRS)

Priskos, Alex S.; Tiller, Bruce

2008-01-01

The mission of the National Aeronautics and Space Administration (NASA) is not simply to maintain its current position with the International Space Station and other space exploration endeavors, but to build a permanent outpost on the Moon and then travel on to explore ever more distant terrains. The Constellation Program will oversee the development of the crew capsule, launch vehicles, and other systems needed to achieve this mission. From this initiative will come two new launch vehicles: the Ares I and Ares V. The Ares I will be a human-rated vehicle, which will be used for crew transport; the Ares V, a cargo transport vehicle, will be the largest launch vehicle ever built. The Ares Projects team at Marshall Space Flight Center (MSFC) in Huntsville, Alabama is assigned with developing these two new vehicles. The Ares I vehicle will have an in-line, two-stage rocket configuration. The first stage will provide the thrust or propulsion component for the Ares rocket systems through the first two minutes of the mission. The First Stage Team is tasked with developing the propulsion system necessary to liftoff from the Earth and loft the entire Ares vehicle stack toward low-Earth orbit. Building on the legacy of the Space Shuttle and other NASA space exploration initiatives, the propulsion for the Ares I First Stage will be a Shuttle-derived reusable solid rocket motor. Progress to date by the First Stage Team has been robust and on schedule. This paper provides an update on the design and development of the Ares First Stage Propulsion system.

[RABIN MEDICAL CENTER - A TERTIARY CENTER OF EXCELLENCE IN SERVICE, TEACHING AND RESEARCH].

PubMed

Niv, Yaron; Halpern, Eyran

2017-04-01

Rabin Medical Center (RMC) belongs to Clalit Health Services and is a tertiary, academic medical center with all the facilities of modern and advanced medicine. Annually in the RMC, 650,000 patients are treated in the outpatient clinics, and 100,000 patients are hospitalized in the hospital departments. All these patients are treated by 4500 devoted staff members, including 1000 physicians and 2000 nurses. RMC is one of the largest, centrally located medical centers for medical and nursing students' education in Israel, taking place in clinical departments, as well as in basic sciences courses. We also have a nursing school attached to the hospital. Our vision supports excellence in research. We have a special Research Department that supports RMC researchers, with research coordinators, and all the relevant facilities to assist in clinical and basic science studies. We also promote collaboration efforts with many academic centers in Israel and abroad. The scope of RMC research is broad, including 700 new studies every year and 1500 active studies currently. This issue of Harefuah is dedicated to the clinical and basic science research conducted at RMC with original papers presenting research performed by our departments and laboratories.

Is take-over time all that matters? The impact of visual-cognitive load on driver take-over quality after conditionally automated driving.

PubMed

Zeeb, Kathrin; Buchner, Axel; Schrauf, Michael

2016-07-01

Currently, development of conditionally automated driving systems which control both lateral and longitudinal vehicle guidance is attracting a great deal of attention. The driver no longer needs to constantly monitor the roadway, but must still be able to resume vehicle control if necessary. The relaxed attention requirement might encourage engagement in non-driving related secondary tasks, and the resulting effect on driver take-over is unclear. The aim of this study was to examine how engagement in three different naturalistic secondary tasks (writing an email, reading a news text, watching a video clip) impacted take-over performance. A driving simulator study was conducted and data from a total of 79 participants (mean age 40 years, 35 females) were used to examine response times and take-over quality. Drivers had to resume vehicle control in four different non-critical scenarios while engaging in secondary tasks. A control group did not perform any secondary tasks. There was no influence of the drivers' engagement in secondary tasks on the time required to return their hands to the steering wheel, and there seemed to be only little if any influence on the time the drivers needed to intervene in vehicle control. Take-over quality, however, deteriorated for distracted drivers, with drivers reading a news text and drivers watching a video deviating on average approximately 8-9cm more from the lane center. These findings seem to indicate that establishing motor readiness may be carried out almost reflexively, but cognitive processing of the situation is impaired by driver distraction. This, in turn, appears to determine take-over quality. The present findings emphasize the importance to consider both response times and take-over quality for a comprehensive understanding of factors that influence driver take-over. Furthermore, a training effect in response times was found to be moderated by the drivers' prior experience with driver assistance systems. This shows

Saturn V First Stage (S-1C) Ready for Assembly AT KSC

NASA Technical Reports Server (NTRS)

1968-01-01

This photograph shows the Saturn V first stage (S-1C) in the Vehicle Assembly Building at Kennedy Space Center ready to be mated with the second and third stages to complete the assembly of a Saturn V launch vehicle. This particular Saturn V was used for Apollo 6, which was a systems test flight. The towering 363-foot Saturn V was a multi-stage, multi-engine launch vehicle standing taller than the Statue of Liberty. Altogether, the Saturn V engines produced as much power as 85 Hoover Dams.

Ultra-precise micro-motion stage for optical scanning test

NASA Astrophysics Data System (ADS)

Chen, Wen; Zhang, Jianhuan; Jiang, Nan

2009-05-01

This study aims at the application of optical sensing technology in a 2D flexible hinge test stage. Optical fiber sensor which is manufactured taking advantage of the various unique properties of optical fiber, such as good electric insulation properties, resistance of electromagnetic disturbance, sparkless property and availability in flammable and explosive environment, has lots of good properties, such as high accuracy and wide dynamic range, repeatable, etc. and is applied in 2D flexible hinge stage driven by PZT. Several micro-bending structures are designed utilizing the characteristics of the flexible hinge stage. And through experiments, the optimal micro-bending tooth structure and the scope of displacement sensor trip under this optimal micro-bending tooth structure are derived. These experiments demonstrate that the application of optical fiber displacement sensor in 2D flexible hinge stage driven by PZT substantially broadens the dynamic testing range and improves the sensitivity of this apparatus. Driving accuracy and positioning stability are enhanced as well. [1,2

KENNEDY SPACE CENTER, FLA. - Former astronaut Story Musgrave talks to employees and their children during a welcome ceremony in the IMAX Theatre, KSC Visitor Complex. Employees were invited to share their work experience with their children for Take Our Children to Work Day.

NASA Image and Video Library

2003-07-24

KENNEDY SPACE CENTER, FLA. - Former astronaut Story Musgrave talks to employees and their children during a welcome ceremony in the IMAX Theatre, KSC Visitor Complex. Employees were invited to share their work experience with their children for Take Our Children to Work Day.

Initial Assessment of the Ares I-X Launch Vehicle Upper Stage to Vibroacoustic Flight Environments

NASA Technical Reports Server (NTRS)

Larko, Jeffrey M.; Hughes, William O.

2008-01-01

The Ares I launch vehicle will be NASA s first new launch vehicle since 1981. Currently in design, it will replace the Space Shuttle in taking astronauts to the International Space Station, and will eventually play a major role in humankind s return to the Moon and eventually to Mars. Prior to any manned flight of this vehicle, unmanned test readiness flights will be flown. The first of these readiness flights, named Ares I-X, is scheduled to be launched in April 2009. The NASA Glenn Research Center is responsible for the design, manufacture, test and analysis of the Ares I-X upper stage simulator (USS) element. As part of the design effort, the structural dynamic response of the Ares I-X launch vehicle to its vibroacoustic flight environments must be analyzed. The launch vehicle will be exposed to extremely high acoustic pressures during its lift-off and aerodynamic stages of flight. This in turn will cause high levels of random vibration on the vehicle's outer surface that will be transmitted to its interior. Critical flight equipment, such as its avionics and flight guidance components are susceptible to damage from this excitation. This study addresses the modelling, analysis and predictions from examining the structural dynamic response of the Ares I-X upper stage to its vibroacoustic excitations. A statistical energy analysis (SEA) model was used to predict the high frequency response of the vehicle at locations of interest. Key to this study was the definition of the excitation fields corresponding to lift off acoustics and the unsteady aerodynamic pressure fluctuations during flight. The predicted results will be used by the Ares I-X Project to verify the flight qualification status of the Ares I-X upper stage components.

Propagation of stage measurement uncertainties to streamflow time series

NASA Astrophysics Data System (ADS)

Horner, Ivan; Le Coz, Jérôme; Renard, Benjamin; Branger, Flora; McMillan, Hilary

2016-04-01

Streamflow uncertainties due to stage measurements errors are generally overlooked in the promising probabilistic approaches that have emerged in the last decade. We introduce an original error model for propagating stage uncertainties through a stage-discharge rating curve within a Bayesian probabilistic framework. The method takes into account both rating curve (parametric errors and structural errors) and stage uncertainty (systematic and non-systematic errors). Practical ways to estimate the different types of stage errors are also presented: (1) non-systematic errors due to instrument resolution and precision and non-stationary waves and (2) systematic errors due to gauge calibration against the staff gauge. The method is illustrated at a site where the rating-curve-derived streamflow can be compared with an accurate streamflow reference. The agreement between the two time series is overall satisfying. Moreover, the quantification of uncertainty is also satisfying since the streamflow reference is compatible with the streamflow uncertainty intervals derived from the rating curve and the stage uncertainties. Illustrations from other sites are also presented. Results are much contrasted depending on the site features. In some cases, streamflow uncertainty is mainly due to stage measurement errors. The results also show the importance of discriminating systematic and non-systematic stage errors, especially for long term flow averages. Perspectives for improving and validating the streamflow uncertainty estimates are eventually discussed.

An analysis of risk-taking behavior among adolescent blunt trauma patients.

PubMed

Foley, David S; Draus, John M; Santos, Ariel P; Franklin, Glen A

2009-05-01

The impact of risk-taking behavior among adolescent blunt trauma patients is not fully appreciated. This study examined the relationship between adolescent risk-taking behaviors, the resultant injury severity, and outcome for blunt trauma. Between January 2000 and December 2005, data were collected on adolescent blunt trauma patients (12-18 years) admitted to either a Level I adult trauma center or large urban pediatric hospital. Five groups of risk-taking behavior were examined: ATV riders, drug and alcohol users, unhelmeted motorcyclists, unhelmeted extreme sports participants and unrestrained motor vehicle occupants. Demographic data, mechanism of injury, injury severity, hospital course and outcomes were evaluated for each group. A total of 2030 adolescents were admitted following blunt trauma; 723 adolescents (36%) were engaged in risk-taking behavior at the time of their injury. Most patients were male (68%). Unrestrained MVA occupants were the most frequently encountered risk takers (37%); among this subset, most were unrestrained passengers (74%). Head injuries were frequent (22%) among risk takers. When compared to non-risk-takers, there were no significant age, race, gender, or ISS differences. However, a significantly higher number of positive head CT scans were found among risk-taking adolescents (22%, p < 0.05). Mortality was low (3%). Risk-taking behavior is prevalent among adolescent blunt trauma patients. Improved injury prevention strategies are needed to discourage these behaviors during adolescence.

Core Stage Forward Skirt Umbilical Installation onto Mobile Laun

NASA Image and Video Library

2017-06-30

Just north of the Vehicle Assembly Building at NASA's Kennedy Space Center in Florida, the core stage forward skirt umbilical is installed on the mobile launcher. The mobile launcher is designed to support the assembly, testing and check-out of the agency's Space Launch System (SLS) rocket and the Orion spacecraft.

Core Stage Forward Skirt Umbilical Installation onto Mobile Laun

NASA Image and Video Library

2017-06-30

Just north of the Vehicle Assembly Building at NASA's Kennedy Space Center in Florida, technicians install the core stage forward skirt umbilical on the mobile launcher. The mobile launcher is designed to support the assembly, testing and check-out of the agency's Space Launch System (SLS) rocket and the Orion spacecraft.

Big6 Stage 3 - Location and Access Treasure Hunting

ERIC Educational Resources Information Center

Darrow, Rob

2005-01-01

Locating sources and accessing the information they contain is part of the Big6 approach to information problem solving. In this stage of knowing where to look and how to find the required source, library media specialists train students in the use of the card catalog in the library media center.

Core Stage Forward Skirt Umbilical Installation onto Mobile Launcher

NASA Image and Video Library

2017-06-29

Just north of the Vehicle Assembly Building at NASA's Kennedy Space Center in Florida, the core stage forward skirt umbilical is installed on the mobile launcher. The mobile launcher is designed to support the assembly, testing and check-out of the agency's Space Launch System (SLS) rocket and the Orion spacecraft.

Interim Cryogenic Propulsion Stage (ICPS) for EM-1 Transport fro

NASA Image and Video Library

2017-04-11

The Interim Cryogenic Propulsion Stage (ICPS) for NASA's Space Launch System (SLS) rocket has been moved on its transport stand by truck out of the United Launch Alliance (ULA) Horizontal Integration Facility near Space Launch Complex 37 at Cape Canaveral Air Force Station in Florida. The ICPS will be transported to the Delta Operations Center. The ICPS is the first integrated piece of flight hardware to arrive for the SLS. It is the in-space stage that is located toward the top of the rocket, between the Launch Vehicle Stage Adapter and the Orion Spacecraft Adapter. It will provide some of the in-space propulsion during Orion's first flight test atop the SLS on Exploration Mission-1.

Interim Cryogenic Propulsion Stage (ICPS) for EM-1 Transport fro

NASA Image and Video Library

2017-04-11

The Interim Cryogenic Propulsion Stage (ICPS) for NASA's Space Launch System (SLS) rocket is moved on its transport stand by truck out of the United Launch Alliance (ULA) Horizontal Integration Facility near Space Launch Complex 37 at Cape Canaveral Air Force Station in Florida. The ICPS will be transported to the Delta Operations Center. The ICPS is the first integrated piece of flight hardware to arrive for the SLS. It is the in-space stage that is located toward the top of the rocket, between the Launch Vehicle Stage Adapter and the Orion Spacecraft Adapter. It will provide some of the in-space propulsion during Orion's first flight test atop the SLS on Exploration Mission-1.

Interim Cryogenic Propulsion Stage (ICPS) for EM-1 Transport fro

NASA Image and Video Library

2017-04-11

The Interim Cryogenic Propulsion Stage (ICPS) for NASA's Space Launch System (SLS) rocket has been moved on its transport stand by truck out of the United Launch Alliance (ULA) Horizontal Integration Facility near Space Launch Complex 37 at Cape Canaveral Air Force Station in Florida, on its way to the Delta Operations Center. The ICPS is the first integrated piece of flight hardware to arrive for the SLS. It is the in-space stage that is located toward the top of the rocket, between the Launch Vehicle Stage Adapter and the Orion Spacecraft Adapter. It will provide some of the in-space propulsion during Orion's first flight test atop the SLS on Exploration Mission-1.

Interim Cryogenic Propulsion Stage (ICPS) for EM-1 Transport fro

NASA Image and Video Library

2017-04-11

The Interim Cryogenic Propulsion Stage (ICPS) for NASA's Space Launch System (SLS) rocket has been moved on its transport stand by truck out of the United Launch Alliance (ULA) Horizontal Integration Facility near Space Launch Complex 37 at Cape Canaveral Air Force Station in Florida, and is on its way to the Delta Operations Center. The ICPS is the first integrated piece of flight hardware to arrive for the SLS. It is the in-space stage that is located toward the top of the rocket, between the Launch Vehicle Stage Adapter and the Orion Spacecraft Adapter. It will provide some of the in-space propulsion during Orion's first flight test atop the SLS on Exploration Mission 1.

Teachers' Evaluation of Student-Centered Learning Environments

ERIC Educational Resources Information Center

Cubukcu, Zuhal

2012-01-01

Problem Statement: The student-centered teaching is the arrangement of the teaching experience focusing on the students' responsibilities and activities in the learning process which takes into consideration the students' interests, demands and needs. According to this approach, while teaching experiences are planned, different learning strategies…

A Lymph Node Staging System for Gastric Cancer: A Hybrid Type Based on Topographic and Numeric Systems.

PubMed

Choi, Yoon Young; An, Ji Yeong; Katai, Hitoshi; Seto, Yasuyuki; Fukagawa, Takeo; Okumura, Yasuhiro; Kim, Dong Wook; Kim, Hyoung-Il; Cheong, Jae-Ho; Hyung, Woo Jin; Noh, Sung Hoon

2016-01-01

Although changing a lymph node staging system from an anatomically based system to a numerically based system in gastric cancer offers better prognostic performance, several problems can arise: it does not offer information on the anatomical extent of disease and cannot represent the extent of lymph node dissection. The purpose of this study was to discover an alternative lymph node staging system for gastric cancer. Data from 6025 patients who underwent gastrectomy for primary gastric cancer between January 2000 and December 2010 were reviewed. The lymph node groups were reclassified into lesser-curvature, greater-curvature, and extra-perigastric groups. Presence of any metastatic lymph node in one group was considered positive. Lymph node groups were further stratified into four (new N0-new N3) according to the number of positive lymph node groups. Survival outcomes with this new N staging were compared with those of the current TNM system. For validation, two centers in Japan (large center, n = 3443; medium center, n = 560) were invited. Even among the same pN stages, the more advanced new N stage showed worse prognosis, indicating that the anatomical extent of metastatic lymph nodes is important. The prognostic performance of the new staging system was as good as that of the current TNM system for overall advanced gastric cancer as well as lymph node-positive gastric cancer (Harrell C-index was 0.799, 0.726, and 0.703 in current TNM and 0.799, 0.727, and 0.703 in new TNM stage). Validation sets supported these outcomes. The new N staging system demonstrated prognostic performance equal to that of the current TNM system and could thus be used as an alternative.

Expendable second stage reusable space shuttle booster. Volume 4: Detail mass properties data

NASA Technical Reports Server (NTRS)

1971-01-01

Mass properties data are presented to describe the characteristics of an expendable second stage with a reusable space shuttle booster. The final mass characteristics of the vehicle configurations for three specified payloads are presented in terms of weight, center of gravity, and mass moments of inertia. Three basic subjects are the integrated vehicle system, the expendable second stage, and the booster modifications.

Information on center characteristics as costs' determinants in multicenter clinical trials: is modeling center effect worth the effort?

PubMed

Petrinco, Michele; Pagano, Eva; Desideri, Alessandro; Bigi, Riccardo; Ghidina, Marco; Ferrando, Alberto; Cortigiani, Lauro; Merletti, Franco; Gregori, Dario

2009-01-01

Several methodological problems arise when health outcomes and resource utilization are collected at different sites. To avoid misleading conclusions in multi-center economic evaluations the center effect needs to be taken into adequate consideration. The aim of this article is to compare several models, which make use of a different amount of information about the enrolling center. To model the association of total medical costs with the levels of two sets of covariates, one at patient and one at center level, we considered four statistical models, based on the Gamma model in the class of the Generalized Linear Models with a log link, which use different amount of information on the enrolling centers. Models were applied to Cost of Strategies after Myocardial Infarction data, an international randomized trial on costs of uncomplicated acute myocardial infarction (AMI). The simple center effect adjustment based on a single random effect results in a more conservative estimation of the parameters as compared with approaches which make use of deeper information on the centers characteristics. This study shows, with reference to a real multicenter trial, that center information cannot be neglected and should be collected and inserted in the analysis, better in combination with one or more random effect, taking into account in this way also the heterogeneity among centers because of unobserved centers characteristics.

Saturn V First Stage Lowered to the Ground After Static Test

NASA Technical Reports Server (NTRS)

1966-01-01

This vintage photograph shows the 138-foot long first stage of the Saturn V being lowered to the ground following a successful static test firing at Marshall Space flight Center's S-1C test stand. The firing provided NASA engineers information on the booster's systems. The towering 363-foot Saturn V was a multi-stage, multi-engine launch vehicle standing taller than the Statue of Liberty. Altogether, the Saturn V engines produced as much power as 85 Hoover Dams.

Why Crisis Pregnancy Centers Are Legal but Unethical.

PubMed

Bryant, Amy G; Swartz, Jonas J

2018-03-01

Crisis pregnancy centers are organizations that seek to intercept women with unintended pregnancies who might be considering abortion. Their mission is to prevent abortions by persuading women that adoption or parenting is a better option. They strive to give the impression that they are clinical centers, offering legitimate medical services and advice, yet they are exempt from regulatory, licensure, and credentialing oversight that apply to health care facilities. Because the religious ideology of these centers' owners and employees takes priority over the health and well-being of the women seeking care at these centers, women do not receive comprehensive, accurate, evidence-based clinical information about all available options. Although crisis pregnancy centers enjoy First Amendment rights protections, their propagation of misinformation should be regarded as an ethical violation that undermines women's health. © 2018 American Medical Association. All Rights Reserved.

A staging table for the embryonic development of the brownbanded bamboo shark (Chiloscyllium punctatum)

PubMed Central

Onimaru, Koh; Motone, Fumio; Kiyatake, Itsuki; Nishida, Kiyonori

2018-01-01

Background: Studying cartilaginous fishes (chondrichthyans) has helped us understand vertebrate evolution and diversity. However, resources such as genome sequences, embryos, and detailed staging tables are limited for species within this clade. To overcome these limitations, we have focused on a species, the brownbanded bamboo shark (Chiloscyllium punctatum), which is a relatively common aquarium species that lays eggs continuously throughout the year. In addition, because of its relatively small genome size, this species is promising for molecular studies. Results: To enhance biological studies of cartilaginous fishes, we establish a normal staging table for the embryonic development of the brownbanded bamboo shark. Bamboo shark embryos take around 118 days to reach the hatching period at 25°C, which is approximately 1.5 times as fast as the small‐spotted catshark (Scyliorhinus canicula) takes. Our staging table divides the embryonic period into 38 stages. Furthermore, we found culture conditions that allow early embryos to grow in partially opened egg cases. Conclusions: In addition to the embryonic staging table, we show that bamboo shark embryos exhibit relatively fast embryonic growth and are amenable to culture, key characteristics that enhance their experimental utility. Therefore, the present study is a foundation for cartilaginous fish research. Developmental Dynamics 247:712–723, 2018. © 2017 Wiley Periodicals, Inc. PMID:29396887

SLI Artist's Concept-Stage Separation

NASA Technical Reports Server (NTRS)

2002-01-01

NASA's Marshall Space Flight Center in Huntsville, Alabama, manages the Space Launch Initiative (SLI), NASA's priority developmental program focused on empowering America's leadership in space. SLI includes commercial, higher education and defense partnerships and contracts to offer widespread participation in both the risk and success of developing our nation's next-generation reusable launch vehicle. This photo depicts an artist's concept of a future second-generation launch vehicle during separation of stages. For SLI, architecture definition includes all components of the next-generation reusable launch system: Earth-to-orbit vehicles (the Space Shuttle is the first-generation earth-to-orbit vehicle), crew transfer vehicles, transfer stages, ground processing systems, flight operations systems, and development of business case strategies. Three contractor teams have each been funded to develop potential second generation reusable launch system architectures: The Boeing Company of Seal Beach, California; Lockheed Martin Corporation of Denver, Colorado; a team including Northrop Grumman of El Segundo, California; and Orbital Sciences Corporation of Dulles, Virginia.

The retrospective analysis of patients with uterine sarcomas: A single-center experience.

PubMed

Terek, Mustafa Cosan; Akman, Levent; Hursitoglu, Behiye Seda; Sanli, Ulus Ali; Ozsaran, Zeynep; Tekindal, Mustafa Agah; Dikmen, Yilmaz; Zekioglu, Osman; Ozsaran, Ahmet Aydin

2016-01-01

Uterine sarcomas are rare, malignant, gynecological tumors and show diverse histopathological features. Therefore, there is no consensus on risk factors for poor outcome and optimal treatment. The aim of this retrospective analysis is to report the clinical outcome of patients with uterine sarcoma treated at a single center. The data was obtained regarding the patient's demographic characteristics, pathological results, treatments given, survival, and complications of all uterine sarcoma patients treated in a single center between the years 2000 and 2012. The 80.month overall survival. (OS) was determined with respect to prognostic factors including age, stage of disease, histopathological type, and adjuvant treatment. A total of 57 case records are retrieved for this retrospective analysis. The mean age of the patients is 62.5 ± 11.2 years. International Federation of Gynecology and Obstetrics (FIGO) stage distribution is stage I: 29; stage II: 13; stage III: 9; stage IV: 6. Fifty-seven patients underwent surgery, 33 received postoperative radiotherapy (PORT), and 32 received chemotherapy. Median follow-up period was 25 months (range 2-85 months). The 80-month OS for the entire group of patients was 36.7%. The significant prognostic factors for survival are age under 50 years, stage of disease, and adjuvant chemotherapy. Although limited by small sample size and retrospective nature, age under 50 years, stage of disease, and adjuvant chemotherapy are significant prognostic factors for survival for uterine sarcomas.

Technical Committee on Aricultural Chemical Safety (ACSA) Life Stages Task Force

EPA Science Inventory

This document takes a life stages approach to the assessment of risk attributable to crop protection products, and well-known experts in the field are contributing authors. The paper presents an in-depth justification for proposed changes in current protocols for toxicity testing...

Prognostic relevance of biological subtype overrides that of TNM staging in breast cancer: discordance between stage and biology.

PubMed

Jung, Hyun Ae; Park, Yeon Hee; Kim, Moonjin; Kim, Sungmin; Chang, Won Jin; Choi, Moon Ki; Hong, Jung Yong; Kim, Seok Won; Kil, Won Ho; Lee, Jeong Eon; Nam, Seok Jin; Ahn, Jin Seok; Im, Young-Hyuck

2015-02-01

Recently, we faced difficult treatment decisions regarding appropriate adjuvant systemic treatment, especially for patients who show discordance between stage and tumor biology. The aim of this study was to compare the prognostic relevance of the TNM staging system with that of intrinsic subtype in breast cancer. We retrospectively identified women patients who received curative surgery for stage I-III breast cancer with available data on immunohistochemistry profiles including hormone receptor (HR) status, human epidermal growth factor receptor 2 (HER2) status, and Ki 67 staining at the Samsung Medical Center from January 2004 to September 2008. Primary outcomes were recurrence-free survival (RFS) and overall survival (OS). A total of 1145 patients were diagnosed with breast cancer and received curative surgery. Of these, 463 (40.4%) patients were stage I, and 682 (59.6%) were stage II or III. In addition, 701 (61.2%) patients were HR positive, 239 (20.9%) were HER2 positive, and 205 (20.9%) had triple-negative breast cancer. The 5-year RFS for the patients who were HR positive and HER2 negative with a low Ki 67 staining score (0-25%) was 99%. The 5-year RFS for patients who were HER2-positive or had triple-negative breast cancer were 89 and 83%, respectively (P value = <0.001). In multivariate analysis, advanced stage (II/III) and unfavorable biology (HER2 positive or triple negative) retained their statistical significance as predictors of decreased RFS and OS. Patients with advanced-stage disease (II or III) but favorable tumor biology (HR positive and HER2 negative and low Ki 67) had better clinical outcomes than those with stage I disease and unfavorable tumor biology in terms of RFS (99 versus 92%, P value = 0.011) and OS (99 versus 96%, P value = 0.03) at 5 years. The current results showed that intrinsic subtype has a greater prognostic impact in predicting clinical outcomes in subpopulations of patients with stage I-III breast cancer who show

Hinterbrand Lodge Outdoor Education Center. Program Information.

ERIC Educational Resources Information Center

Dependents Schools (DOD), Washington, DC. European Area.

Describing Department of Defense Dependents Schools Europe (DODDSEUR) use of Hinterbrand Lodge Outdoor Education Center, this document is directed to sponsors wishing to take groups to Hinterbrand for one or more of the five program options (outdoor education week, teacher weekend, school-designed outdoor education program, administrative faculty…

[Automatic Sleep Stage Classification Based on an Improved K-means Clustering Algorithm].

PubMed

Xiao, Shuyuan; Wang, Bei; Zhang, Jian; Zhang, Qunfeng; Zou, Junzhong

2016-10-01

Sleep stage scoring is a hotspot in the field of medicine and neuroscience.Visual inspection of sleep is laborious and the results may be subjective to different clinicians.Automatic sleep stage classification algorithm can be used to reduce the manual workload.However,there are still limitations when it encounters complicated and changeable clinical cases.The purpose of this paper is to develop an automatic sleep staging algorithm based on the characteristics of actual sleep data.In the proposed improved K-means clustering algorithm,points were selected as the initial centers by using a concept of density to avoid the randomness of the original K-means algorithm.Meanwhile,the cluster centers were updated according to the‘Three-Sigma Rule’during the iteration to abate the influence of the outliers.The proposed method was tested and analyzed on the overnight sleep data of the healthy persons and patients with sleep disorders after continuous positive airway pressure(CPAP)treatment.The automatic sleep stage classification results were compared with the visual inspection by qualified clinicians and the averaged accuracy reached 76%.With the analysis of morphological diversity of sleep data,it was proved that the proposed improved K-means algorithm was feasible and valid for clinical practice.

You're a "What"? Rodeo Clown

ERIC Educational Resources Information Center

Liming, Drew

2012-01-01

Rodeo clowns entertain crowds during and between rodeo events, such as bull riding and steer roping. While these events take place in the center of the arena, rodeo clowns walk along the outskirts and provide comic narrative. Between events, rodeo clowns take center stage and perform brief sketches to keep the crowd entertained. Rodeo clowns…

Abdomen/pelvis computed tomography in staging of pediatric Hodgkin Lymphoma: is it always necessary?

PubMed

Farruggia, Piero; Puccio, Giuseppe; Sala, Alessandra; Todesco, Alessandra; Terenziani, Monica; Mura, Rosamaria; D'Amico, Salvatore; Casini, Tommaso; Mosa, Clara; Pillon, Marta; Boaro, Maria Paola; Bottigliero, Gaetano; Burnelli, Roberta; Consarino, Caterina; Fedeli, Fausto; Mascarin, Maurizio; Perruccio, Katia; Schiavello, Elisabetta; Trizzino, Angela; Ficola, Umberto; Garaventa, Alberto; Rossello, Mario

2016-09-01

The purpose of the study was to determine if abdomen/pelvis computed tomography (CT) can be safety omitted in the initial staging of a subgroup of children affected by Hodgkin Lymphoma (HL). Every participating center of A.I.E.O.P (Associazione Italiana di Ematologia ed Oncologia Pediatrica) sent local staging reports of 18F-fluorodeoxyglucose positron emission tomography (PET) and abdominal ultrasound (US) along with digital images of staging abdomen/pelvis CT to the investigation center where the CT scans were evaluated by an experienced pediatric radiologist. The local radiologist who performed the US was unaware of local CT and PET reports (both carried out after US), and the reviewer radiologist examining the CT images was unaware of local US, PET and CT reports. A new abdominal staging of 123 patients performed on the basis of local US report, local PET report, and centralized CT report was then compared to a simpler staging based on local US and PET. No additional lesion was discovered by CT in patients with abdomen/pelvis negativity in both US and PET or isolated spleen positivity in US (or US and PET), and so it seems that in the initial staging, abdomen/pelvis CT can be safety omitted in about 1/2 to 2/3 of children diagnosed with HL. © 2016 The Authors. Cancer Medicine published by John Wiley & Sons Ltd.

Core Stage Forward Skirt Umbilical Installation onto Mobile Laun

NASA Image and Video Library

2017-06-30

Just north of the Vehicle Assembly Building at NASA's Kennedy Space Center in Florida, a crane lifts the core stage forward skirt umbilical for installation onto the mobile launcher. The mobile launcher is designed to support the assembly, testing and check-out of the agency's Space Launch System (SLS) rocket and the Orion spacecraft.

Control centers design for ergonomics and safety.

PubMed

Quintana, Leonardo; Lizarazo, Cesar; Bernal, Oscar; Cordoba, Jorge; Arias, Claudia; Monroy, Magda; Cotrino, Carlos; Montoya, Olga

2012-01-01

This paper shows the general design conditions about ergonomics and safety for control centers in the petrochemical process industry. Some of the topics include guidelines for the optimized workstation design, control room layout, building layout, and lighting, acoustical and environmental design. Also takes into account the safety parameters in the control rooms and centers design. The conditions and parameters shown in this paper come from the standards and global advances on this topic on the most recent publications. And also the work was supplemented by field visits of our team to the control center operations in a petrochemical company, and technical literature search efforts. This guideline will be useful to increase the productivity and improve the working conditions at the control rooms.

The Learner-Centered Curriculum: Design and Implementation

ERIC Educational Resources Information Center

Cullen, Roxanne; Harris, Michael; Hill, Reinhold R.

2012-01-01

Most of the scholarship on learner-centeredness is focused on individual classroom pedagogy, but this book takes learner-centeredness beyond the classroom and asks academic leaders to consider the broader implications of making their institutions fully learner-centered. Systemic change is needed, and curriculum is at the heart of what higher…

A young star takes centre stage

NASA Image and Video Library

2015-03-02

With its helical appearance resembling a snail’s shell, this reflection nebula seems to spiral out from a luminous central star in this new NASA/ESA Hubble Space Telescope image. The star in the centre, known as V1331 Cyg and located in the dark cloud LDN 981 — or, more commonly, Lynds 981 — had previously been defined as a T Tauri star. A T Tauri is a young star — or Young Stellar Object — that is starting to contract to become a main sequence star similar to the Sun. What makes V1331Cyg special is the fact that we look almost exactly at one of its poles. Usually, the view of a young star is obscured by the dust from the circumstellar disc and the envelope that surround it. However, with V1331Cyg we are actually looking in the exact direction of a jet driven by the star that is clearing the dust and giving us this magnificent view. This view provides an almost undisturbed view of the star and its immediate surroundings allowing astronomers to study it in greater detail and look for features that might suggest the formation of a verylow-mass object in the outer circumstellar disc.

Melanoma staging: Evidence-based changes in the American Joint Committee on Cancer eighth edition cancer staging manual.

PubMed

Gershenwald, Jeffrey E; Scolyer, Richard A; Hess, Kenneth R; Sondak, Vernon K; Long, Georgina V; Ross, Merrick I; Lazar, Alexander J; Faries, Mark B; Kirkwood, John M; McArthur, Grant A; Haydu, Lauren E; Eggermont, Alexander M M; Flaherty, Keith T; Balch, Charles M; Thompson, John F

2017-11-01

Answer questions and earn CME/CNE To update the melanoma staging system of the American Joint Committee on Cancer (AJCC) a large database was assembled comprising >46,000 patients from 10 centers worldwide with stages I, II, and III melanoma diagnosed since 1998. Based on analyses of this new database, the existing seventh edition AJCC stage IV database, and contemporary clinical trial data, the AJCC Melanoma Expert Panel introduced several important changes to the Tumor, Nodes, Metastasis (TNM) classification and stage grouping criteria. Key changes in the eighth edition AJCC Cancer Staging Manual include: 1) tumor thickness measurements to be recorded to the nearest 0.1 mm, not 0.01 mm; 2) definitions of T1a and T1b are revised (T1a, <0.8 mm without ulceration; T1b, 0.8-1.0 mm with or without ulceration or <0.8 mm with ulceration), with mitotic rate no longer a T category criterion; 3) pathological (but not clinical) stage IA is revised to include T1b N0 M0 (formerly pathologic stage IB); 4) the N category descriptors "microscopic" and "macroscopic" for regional node metastasis are redefined as "clinically occult" and "clinically apparent"; 5) prognostic stage III groupings are based on N category criteria and T category criteria (ie, primary tumor thickness and ulceration) and increased from 3 to 4 subgroups (stages IIIA-IIID); 6) definitions of N subcategories are revised, with the presence of microsatellites, satellites, or in-transit metastases now categorized as N1c, N2c, or N3c based on the number of tumor-involved regional lymph nodes, if any; 7) descriptors are added to each M1 subcategory designation for lactate dehydrogenase (LDH) level (LDH elevation no longer upstages to M1c); and 8) a new M1d designation is added for central nervous system metastases. This evidence-based revision of the AJCC melanoma staging system will guide patient treatment, provide better prognostic estimates, and refine stratification of patients entering clinical trials. CA

[Primary, single-stage arterial switch operations at a newly-established, comprehensive congenital cardiac center performed in the neonatal age and beyond].

PubMed

Király, László; Tamás, Csaba

2015-06-21

Outcome of arterial switch operation for transposition of the great arteries with/without ventricular septal defect is a service key-performance-indicator. The aim of the authors was to assess patient characteristics and parameters in the perioperative course. In the setting of a newly-established, comprehensive tertiary-care center, primary complete repair was performed including associated anomalies, e.g. transverse arch repairs. Patients with d-transposition were grouped according to coexistence of ventricular septal defect. 118 arterial switch operations were performed between 2007 and 2014 with 96.62% survival (114/118). Ventricular septal defect and repair of associated anomalies did not yield worse outcome. Left ventricular re-training with late presentation necessitated mechanical circulatory support for 4.5±1.5 days. D-transposition is suitable for standardization of clinical algorithm and surgical technique. Quality standards contribute to excellent outcomes, minimize complications, and serve as blueprint for other neonatal open-heart procedures. Availability of mechanical circulatory support is key for single-stage left ventricular re-training beyond the neonatal period.

SLJ's Technology Survey 2006: New Technologies--Like Blogs and Wikis--Are Taking Their Place in the School Media Center

ERIC Educational Resources Information Center

Brewer, Sally; Milam, Peggy

2006-01-01

This article presents findings from the School Library Journal's 2006 national technology survey that investigated the trend in today's library media centers. As this study demonstrates, technology continues to be a significant aspect of K-12 media centers. Despite restricted funding and schedules stretched to the limit, media specialists have…

An Accidental Scientist: Chance, Failure, Risk-Taking, and Mentoring.

PubMed

McGrath, Patrick J

2018-04-06

I never intended to become a scientist. My career developed on the basis of chance happenings, repeated failure, the willingness to take risks and the acceptance and provision of mentoring. My career has included periods of difficulty and shifted back and forth between academic health centers and universities in Canada. Although I have been amply recognized for my successes, my greatest learning has come from my failures. My greatest satisfaction has been in the development, evaluation and dissemination of interventions. The combination of intellectual stimulation and emotional gratification has meant a rewarding career.

First stage of Saturn launch vehicle in KSC Vehicle Assembly Building

NASA Technical Reports Server (NTRS)

1968-01-01

The first (S-1C) stage of the Saturn 505 launch vehicle being prepared for erection in the high bay area of the Kennedy Space Center's (KSC) Vehicle Assembly Building (VAB). Saturn 505 is the launch vehicle for the Apollo 10 mission.

Introduction to the JPA special issue: Can the Psychodynamic Diagnostic Manual put the complex person back at the center-stage of personality assessment?

PubMed

Huprich, Steven K; Meyer, Gregory J

2011-03-01

We briefly introduce this special issue, which focuses both on the Psychodynamic Diagnostic Manual (PDM) and the practice of idiographic, depth-oriented personality assessment. The 7 articles in this issue are diverse in scope but all address these 2 important topics. To set the stage, the special issue opens with a description of the history behind, the purposes of, and the steps taken to develop the PDM, and the next article provides a compelling illustration of depth-oriented personality assessment in the context of a long-term course of psychodynamic treatment. The third and fourth articles describe how the PDM model fosters attention to dynamic processes, not just overt symptoms, and they articulate the challenges and benefits of integrating this model into both the revitalized practice of assessment and diagnosis and the research avenues that will evaluate its validity and utility. The fifth article provides a broad overview of interesting experimental research on implicit processes from personality, social, and cognitive psychology, with implications for understanding and assessing dynamic processes. The sixth article illustrates how a PDM-based assessment of an adolescent boy helpfully contributed to his psychodynamic therapy. Finally, the issue closes with an illuminating article describing a PDM-based training model for the graduated development of assessment and diagnosis skills in a doctoral program. Overall, this special issue helps show how the PDM can invigorate multimethod personality assessment by placing the complex idiographic understanding of a person at the center-stage in the assessment process.

Note Taking on Trial: A Legal Application of Note-Taking Research

ERIC Educational Resources Information Center

Kiewra, Kenneth A.

2016-01-01

This article is about note taking, but it is not an exhaustive review of note-taking literature. Instead, it portrays the application of note-taking research to an unusual and important area of practice--the law. I was hired to serve as an expert witness on note taking in a legal case that hinged, in part, on the completeness and accuracy of…

Accuracy of magnetic resonance imaging in the pre-operative staging of rectal adenocarcinoma: Experience from a regional Australian cancer center.

PubMed

White, Rohen; Ung, Kim Ann; Mathlum, Maitham

2013-12-01

Selection of the optimal treatment pathway in patients with rectal adenocarcinoma relies on accurate locoregional staging. This study aims to assess the accuracy of staging with magnetic resonance imaging (MRI) and in particular, its accuracy in differentiating patients with early stage disease from those with more advanced disease who benefit from a different treatment approach. Patients who were staged with MRI and received surgery as the first line of treatment for biopsy-proven adenocarcinoma of the rectum were identified. Comparison was made between the clinical stage on MRI and the pathological stage of the surgical specimen. The sensitivity, specificity and overall accuracy of MRI was assessed. In all, 58 eligible patients were identified. In 31% of patients, the extent of disease was underrepresented on preoperative MRI. Sensitivity, specificity and overall accuracy of anorectal MRI in detecting stage II/III disease status in this cohort was 59, 71 and 62%, respectively. MRI underestimated the pathological stage in many patients in this series who may have benefited from the addition of neoadjuvant radiotherapy to their management. This study supports further refinement of preoperative staging and demonstrates that impressive results from highly controlled settings may be difficult to reproduce in community practice. © 2012 Wiley Publishing Asia Pty Ltd.

Fostering person-centered care among nursing students: creative pedagogical approaches to developing personal knowing.

PubMed

Schwind, Jasna K; Beanlands, Heather; Lapum, Jennifer; Romaniuk, Daria; Fredericks, Suzanne; LeGrow, Karen; Edwards, Susanna; McCay, Elizabeth; Crosby, Jamie

2014-06-01

Person-centered care (PCC) is grounded in principles of respect, autonomy, and empowerment and requires the development of interpersonal relationships. For nursing students to engage in PCC, they need to intentionally develop personal knowing, which is an essential attribute of therapeutic relationships. Developing personal knowing, as well as professional knowledge, positions students to enact PCC in their practice. Faculty members play a vital role in fostering the development of personal knowing by creating opportunities for students in which genuine and respectful dialogue, reflection, self-awareness, and critical thinking can take place. This article explores several creative approaches faculty have used to actualize these qualities in their teaching-learning encounters with nursing students at various stages of their students' professional development. These approaches offer experiential teaching-learning opportunities that foster the development of personal knowing, as well as constructive and respectful relationships between faculty and students, therefore laying the groundwork for PCC in practice settings. Copyright 2014, SLACK Incorporated.

Core Stage Forward Skirt Umbilical Installation onto Mobile Laun

NASA Image and Video Library

2017-05-25

Construction workers assist as a crane lifts the Core Stage Forward Skirt Umbilical up for installation on the mobile launcher tower at NASA's Kennedy Space Center in Florida. The mobile launcher tower will be equipped with a number of lines, called umbilicals that will connect to the Space Launch System (SLS) rocket and Orion spacecraft for Exploration Mission-1 (EM-1). The CSFSU will be located at about the 180-foot level on the tower, above the liquid oxygen tank. The CSFSU is an umbilical that will swing into position to provide connections to the core stage forward skirt of the SLS rocket, and then swing away before launch. Its main purpose is to provide conditioned air/GN2 to the SLS core stage forward skirt cavity. The Ground Systems Development and Operations Program is overseeing installation of the umbilicals.

Core Stage Forward Skirt Umbilical Installation onto Mobile Laun

NASA Image and Video Library

2017-05-25

A crane has been attached to the Core Stage Forward Skirt Umbilical (CSFSU) to lift it up for installation on the mobile launcher tower at NASA's Kennedy Space Center in Florida. The mobile launcher tower will be equipped with a number of lines, called umbilicals that will connect to the Space Launch System (SLS) rocket and Orion spacecraft for Exploration Mission-1 (EM-1). The CSFSU will be located at about the 180-foot level on the tower, above the liquid oxygen tank. The CSFSU is an umbilical that will swing into position to provide connections to the core stage forward skirt of the SLS rocket, and then swing away before launch. Its main purpose is to provide conditioned air/GN2 to the SLS core stage forward skirt cavity. The Ground Systems Development and Operations Program is overseeing installation of the umbilicals.

Core Stage Forward Skirt Umbilical Installation onto Mobile Laun

NASA Image and Video Library

2017-05-25

Cranes and rigging are being used to lift up the Core Stage Forward Skirt Umbilical (CSFSU) for installation on the mobile launcher tower at NASA's Kennedy Space Center in Florida. The mobile launcher tower will be equipped with a number of lines, called umbilicals that will connect to the Space Launch System (SLS) rocket and Orion spacecraft for Exploration Mission-1 (EM-1). The CSFSU will be located at about the 180-foot level on the tower, above the liquid oxygen tank. The CSFSU is an umbilical that will swing into position to provide connections to the core stage forward skirt of the SLS rocket, and then swing away before launch. Its main purpose is to provide conditioned air/GN2 to the SLS core stage forward skirt cavity. The Ground Systems Development and Operations Program is overseeing installation of the umbilicals.

Core Stage Forward Skirt Umbilical Installation onto Mobile Laun

NASA Image and Video Library

2017-05-25

Cranes and rigging are being used to lift the Core Stage Forward Skirt Umbilical (CSFSU) into position for installation on the mobile launcher tower at NASA's Kennedy Space Center in Florida. The mobile launcher tower will be equipped with a number of lines, called umbilicals that will connect to the Space Launch System (SLS) rocket and Orion spacecraft for Exploration Mission-1 (EM-1). The CSFSU will be located at about the 180-foot level on the tower, above the liquid oxygen tank. The CSFSU is an umbilical that will swing into position to provide connections to the core stage forward skirt of the SLS rocket, and then swing away before launch. Its main purpose is to provide conditioned air/GN2 to the SLS core stage forward skirt cavity. The Ground Systems Development and Operations Program is overseeing installation of the umbilicals.

Core Stage Forward Skirt Umbilical Installation onto Mobile Laun

NASA Image and Video Library

2017-05-25

A construction worker welds a metal part during installation of the Core Stage Forward Skirt Umbilical on the mobile launcher tower at NASA's Kennedy Space Center in Florida. The mobile launcher tower will be equipped with a number of lines, called umbilicals that will connect to the Space Launch System (SLS) rocket and Orion spacecraft for Exploration Mission-1 (EM-1). The CSFSU will be located at about the 180-foot level on the tower, above the liquid oxygen tank. The CSFSU is an umbilical that will swing into position to provide connections to the core stage forward skirt of the SLS rocket, and then swing away before launch. Its main purpose is to provide conditioned air/GN2 to the SLS core stage forward skirt cavity. The Ground Systems Development and Operations Program is overseeing installation of the umbilicals.

Core Stage Forward Skirt Umbilical Installation onto Mobile Laun

NASA Image and Video Library

2017-05-25

Construction workers assist as a crane lifts the Core Stage Forward Skirt Umbilical into position for installation on the mobile launcher tower at NASA's Kennedy Space Center in Florida. The mobile launcher tower will be equipped with a number of lines, called umbilicals that will connect to the Space Launch System (SLS) rocket and Orion spacecraft for Exploration Mission-1 (EM-1). The CSFSU will be located at about the 180-foot level on the tower, above the liquid oxygen tank. The CSFSU is an umbilical that will swing into position to provide connections to the core stage forward skirt of the SLS rocket, and then swing away before launch. Its main purpose is to provide conditioned air/GN2 to the SLS core stage forward skirt cavity. The Ground Systems Development and Operations Program is overseeing installation of the umbilicals.

Core Stage Forward Skirt Umbilical Installation onto Mobile Laun

NASA Image and Video Library

2017-05-25

Seeming to hang in midair, the Core Stage Forward Skirt Umbilical (CSFSU) is lifted high up by crane for installation on the mobile launcher tower at NASA's Kennedy Space Center in Florida. The mobile launcher tower will be equipped with a number of lines, called umbilicals that will connect to the Space Launch System rocket and Orion spacecraft for Exploration Mission-1 (EM-1). The CSFSU will be located at about the 180-foot level on the tower, above the liquid oxygen tank. The CSFSU is an umbilical that will swing into position to provide connections to the core stage forward skirt of the SLS rocket, and then swing away before launch. Its main purpose is to provide conditioned air/GN2 to the SLS core stage forward skirt cavity. The Ground Systems Development and Operations Program is overseeing installation of the umbilicals.

New control center for EPM in Medellin, Columbia

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

Gomez, H.C.; Zadeh, K.N.; Meyer, R.C.

1989-07-01

The municipal electric utility of Empresas Publicas de Medellin (EPM) in Medellin, Colombia, has completed the installation and testing of their new control center. These facilities, which include all the functions expected from a modern control center, were implemented through carefully monitored and executed project stages, which are described in this article. EPM generates and transmits 1400 MW of exclusively hydroelectric energy to their service territory of the city of Medellin and nine neighboring cities and 77 smaller cities. The EPM system load ranges from 400 MW to 1200 MW.

Aero-Assisted Pre-Stage for Ballistic and Aero-Assisted Launch Vehicles

NASA Technical Reports Server (NTRS)

Ustinov, Eugene A.

2012-01-01

A concept of an aero-assisted pre-stage is proposed, which enables launch of both ballistic and aero-assisted launch vehicles from conventional runways. The pre-stage can be implemented as a delta-wing with a suitable undercarriage, which is mated with the launch vehicle, so that their flight directions are coaligned. The ample wing area of the pre-stage combined with the thrust of the launch vehicle ensure prompt roll-out and take-off of the stack at airspeeds typical for a conventional jet airliner. The launch vehicle is separated from the pre-stage as soon as safe altitude is achieved, and the desired ascent trajectory is reached. Nominally, the pre-stage is non-powered. As an option, to save the propellant of the launch vehicle, the pre-stage may have its own short-burn propulsion system, whereas the propulsion system of the launch vehicle is activated at the separation point. A general non-dimensional analysis of performance of the pre-stage from roll-out to separation is carried out and applications to existing ballistic launch vehicle and hypothetical aero-assisted vehicles (spaceplanes) are considered.

42 CFR 413.210 - Conditions for payment under the end-stage renal disease (ESRD) prospective payment system.

Code of Federal Regulations, 2011 CFR

2011-10-01

... disease (ESRD) prospective payment system. 413.210 Section 413.210 Public Health CENTERS FOR MEDICARE... REIMBURSEMENT; PAYMENT FOR END-STAGE RENAL DISEASE SERVICES; OPTIONAL PROSPECTIVELY DETERMINED PAYMENT RATES FOR SKILLED NURSING FACILITIES Payment for End-Stage Renal Disease (ESRD) Services and Organ Procurement Costs...

42 CFR 413.210 - Conditions for payment under the end-stage renal disease (ESRD) prospective payment system.

Code of Federal Regulations, 2010 CFR

2010-10-01

... disease (ESRD) prospective payment system. 413.210 Section 413.210 Public Health CENTERS FOR MEDICARE... REIMBURSEMENT; PAYMENT FOR END-STAGE RENAL DISEASE SERVICES; OPTIONAL PROSPECTIVELY DETERMINED PAYMENT RATES FOR SKILLED NURSING FACILITIES Payment for End-Stage Renal Disease (ESRD) Services and Organ Procurement Costs...

42 CFR 413.210 - Conditions for payment under the end-stage renal disease (ESRD) prospective payment system.

Code of Federal Regulations, 2012 CFR

2012-10-01

... disease (ESRD) prospective payment system. 413.210 Section 413.210 Public Health CENTERS FOR MEDICARE... REIMBURSEMENT; PAYMENT FOR END-STAGE RENAL DISEASE SERVICES; OPTIONAL PROSPECTIVELY DETERMINED PAYMENT RATES FOR SKILLED NURSING FACILITIES Payment for End-Stage Renal Disease (ESRD) Services and Organ Procurement Costs...

42 CFR 413.210 - Conditions for payment under the end-stage renal disease (ESRD) prospective payment system.

Code of Federal Regulations, 2013 CFR

2013-10-01

... disease (ESRD) prospective payment system. 413.210 Section 413.210 Public Health CENTERS FOR MEDICARE... REIMBURSEMENT; PAYMENT FOR END-STAGE RENAL DISEASE SERVICES; OPTIONAL PROSPECTIVELY DETERMINED PAYMENT RATES FOR SKILLED NURSING FACILITIES Payment for End-Stage Renal Disease (ESRD) Services and Organ Procurement Costs...

42 CFR 413.210 - Conditions for payment under the end-stage renal disease (ESRD) prospective payment system.

Code of Federal Regulations, 2014 CFR

2014-10-01

... disease (ESRD) prospective payment system. 413.210 Section 413.210 Public Health CENTERS FOR MEDICARE... REIMBURSEMENT; PAYMENT FOR END-STAGE RENAL DISEASE SERVICES; OPTIONAL PROSPECTIVELY DETERMINED PAYMENT RATES FOR SKILLED NURSING FACILITIES Payment for End-Stage Renal Disease (ESRD) Services and Organ Procurement Costs...

[Four stages in the history of the Centro Médico Nacional Siglo XXI of the IMSS].

PubMed

Fajardo-Ortiz, Guillermo

2015-01-01

This document presents four stages in the history of the Centro Médico Nacional Siglo XXI (Centro Médico Nacional XXI Century) of the Instituto Mexicano del Seguro Social. The first stage started at the end of the third decade of the twentieth century and ended in 1961, it corresponded to the conception, planning and construction of what was to be the Centro Médico del Distrito Federal (Centro Médico of the Distrito Federal) belonging to the Secretaría de Salubridad y Asistencia (Ministry of Health and Assistance). The second stage began when the Center was acquired by the Institute, then was known like Centro Médico Nacional (Centro Médico Nacional ), being put into full operation in 1963, more than twenty-two years later, in 1985, an earthquake virtually ended it, immediately began its reconstruction, finishing the second stage. In 1989 began the third stage, different and new buildings complemented or replaced the structures damaged or destroyed by the earthquake which formed the now Centro Médico Nacional Siglo XXI (Centro Médico Nacional XXI Century). In 2004 the fourth stage opened when the four hospitals of the Center were categorized like Unidades Médicas de Alta Especialidad (High Specialized Medical Units).

KENNEDY SPACE CENTER, FLA. - STS-114 Mission Specialist Wendy Lawrence autographs the sign presented to workers in the Orbiter Processing Facility. Lawrence is a new addition to the crew. The STS-114 crew is at KSC to take part in crew equipment and orbiter familiarization.

NASA Image and Video Library

2003-10-30

KENNEDY SPACE CENTER, FLA. - STS-114 Mission Specialist Wendy Lawrence autographs the sign presented to workers in the Orbiter Processing Facility. Lawrence is a new addition to the crew. The STS-114 crew is at KSC to take part in crew equipment and orbiter familiarization.

KENNEDY SPACE CENTER, FLA. - Former astronaut Story Musgrave signs autographs for employees’ children after his presentation during a welcome ceremony in the IMAX Theatre, KSC Visitor Complex. Employees were invited to share their work experience with their children for Take Our Children to Work Day.

NASA Image and Video Library

2003-07-24

KENNEDY SPACE CENTER, FLA. - Former astronaut Story Musgrave signs autographs for employees’ children after his presentation during a welcome ceremony in the IMAX Theatre, KSC Visitor Complex. Employees were invited to share their work experience with their children for Take Our Children to Work Day.

Behavioral Stage of Change and Dialysis Decision-Making

PubMed Central

McGrail, Anna; Lewis, Steven A.; Schold, Jesse; Lawless, Mary Ellen; Sehgal, Ashwini R.; Perzynski, Adam T.

2015-01-01

Background and objectives Behavioral stage of change (SoC) algorithms classify patients’ readiness for medical treatment decision-making. In the precontemplation stage, patients have no intention to take action within 6 months. In the contemplation stage, action is intended within 6 months. In the preparation stage, patients intend to take action within 30 days. In the action stage, the change has been made. This study examines the influence of SoC on dialysis modality decision-making. Design, setting, participants, & measurements SoC and relevant covariates were measured, and associations with dialysis decision-making were determined. In-depth interviews were conducted with 16 patients on dialysis to elicit experiences. Qualitative interview data informed the survey design. Surveys were administered to adults with CKD (eGFR≤25 ml/min/1.73 m2) from August, 2012 to June, 2013. Multivariable logistic regression modeled dialysis decision-making with predictors: SoC, provider connection, and dialysis knowledge score. Results Fifty-five patients completed the survey (71% women, 39% white, and 59% black), and median annual income was $17,500. In total, 65% of patients were in the precontemplation/contemplation (thinking) and 35% of patients were in the preparation/maintenance (acting) SoC; 62% of patients had made dialysis modality decisions. Doctors explaining modality options, higher dialysis knowledge scores, and fewer lifestyle barriers were associated with acting versus thinking SoC (all P<0.02). Patients making modality decisions had doctors who explained dialysis options (76% versus 43%), were in the acting versus the thinking SoC (50% versus 10%), had higher dialysis knowledge scores (1.4 versus 0.5), and had lower eGFR (13.9 versus 16.8 ml/min/1.73 m2; all P<0.05). In adjusted analyses, dialysis knowledge was significantly associated with decision-making (odds ratio, 4.2; 95% confidence interval, 1.4 to 12.9; P=0.01), and SoC was of borderline significance

Interactive, Learner-Centered Methods of Teaching Mathematics

ERIC Educational Resources Information Center

Alsardary, Salar; Blumberg, Phyllis

2009-01-01

We describe a learner-centered upper-level mathematics course where the students present the material to the class instead of the instructor, and the students make presentations on applied topics at the regional MAA meeting. After take-home examinations the students can discuss their answers one-on-one with the instructor. The students liked the…

Weekend Study Buddies: Using Portable Learning Centers.

ERIC Educational Resources Information Center

Stephens, Harristina; Jairrels, Veda

2003-01-01

This article discusses how one teacher uses a weekend study buddy as a portable learning center for students (ages 5-9) with mild disabilities. The study buddy is a colorful cloth or paper bag that the students take home over the weekend. It can also be individualized to target particular needs. (Contains 8 references.) (CR)

Implementing the patient-centered medical home in complex adaptive systems: Becoming a relationship-centered patient-centered medical home.

PubMed

Flieger, Signe Peterson

This study explores the implementation experience of nine primary care practices becoming patient-centered medical homes (PCMH) as part of the New Hampshire Citizens Health Initiative Multi-Stakeholder Medical Home Pilot. The purpose of this study is to apply complex adaptive systems theory and relationship-centered organizations theory to explore how nine diverse primary care practices in New Hampshire implemented the PCMH model and to offer insights for how primary care practices can move from a structural PCMH to a relationship-centered PCMH. Eighty-three interviews were conducted with administrative and clinical staff at the nine pilot practices, payers, and conveners of the pilot between November and December 2011. The interviews were transcribed, coded, and analyzed using both a priori and emergent themes. Although there is value in the structural components of the PCMH (e.g., disease registries), these structures are not enough. Becoming a relationship-centered PCMH requires attention to reflection, sensemaking, learning, and collaboration. This can be facilitated by settings aside time for communication and relationship building through structured meetings about PCMH components as well as the implementation process itself. Moreover, team-based care offers a robust opportunity to move beyond the structures to focus on relationships and collaboration. (a) Recognize that PCMH implementation is not a linear process. (b) Implementing the PCMH from a structural perspective is not enough. Although the National Committee for Quality Assurance or other guidelines can offer guidance on the structural components of PCMH implementation, this should serve only as a starting point. (c) During implementation, set aside structured time for reflection and sensemaking. (d) Use team-based care as a cornerstone of transformation. Reflect on team structures and also interactions of the team members. Taking the time to reflect will facilitate greater sensemaking and learning and

Implementing the patient-centered medical home in complex adaptive systems: Becoming a relationship-centered patient-centered medical home

PubMed Central

Flieger, Signe Peterson

2017-01-01

Background This study explores the implementation experience of nine primary care practices becoming patient-centered medical homes (PCMH) as part of the New Hampshire Citizens Health Initiative Multi-Stakeholder Medical Home Pilot. Purpose The purpose of this study is to apply complex adaptive systems theory and relationship-centered organizations theory to explore how nine diverse primary care practices in New Hampshire implemented the PCMH model and to offer insights for how primary care practices can move from a structural PCMH to a relationship-centered PCMH. Methodology/Approach Eighty-three interviews were conducted with administrative and clinical staff at the nine pilot practices, payers, and conveners of the pilot between November and December 2011. The interviews were transcribed, coded, and analyzed using both a priori and emergent themes. Findings Although there is value in the structural components of the PCMH (e.g., disease registries), these structures are not enough. Becoming a relationship-centered PCMH requires attention to reflection, sensemaking, learning, and collaboration. This can be facilitated by settings aside time for communication and relationship building through structured meetings about PCMH components as well as the implementation process itself. Moreover, team-based care offers a robust opportunity to move beyond the structures to focus on relationships and collaboration. Practice Implications (a) Recognize that PCMH implementation is not a linear process. (b) Implementing the PCMH from a structural perspective is not enough. Although the National Committee for Quality Assurance or other guidelines can offer guidance on the structural components of PCMH implementation, this should serve only as a starting point. (c) During implementation, set aside structured time for reflection and sensemaking. (d) Use team-based care as a cornerstone of transformation. Reflect on team structures and also interactions of the team members. Taking

High-Tech Playground: Cultural Center Journey Expands Student Horizons of Faith and Culture.

ERIC Educational Resources Information Center

Andersen, Colleen Curry

2003-01-01

Discusses how the John Paul II Cultural Center is an example of how Catholic educators have begun taking advantage of new teaching resources to help students understand their personal faith. Center contains hands-on and interactive journey to learning about Catholicism and the faiths of other people. (MZ)

Cetuximab, Cisplatin, and Radiation Therapy in Treating Patients With Stage IB, Stage II, Stage III, or Stage IVA Cervical Cancer

ClinicalTrials.gov

2014-12-29

Cervical Adenocarcinoma; Cervical Adenosquamous Carcinoma; Cervical Small Cell Carcinoma; Cervical Squamous Cell Carcinoma; Stage IB Cervical Cancer; Stage IIA Cervical Cancer; Stage IIB Cervical Cancer; Stage III Cervical Cancer; Stage IVA Cervical Cancer

Crowder College MARET Center Facility Final Scientific/Technical Report

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

Rand, Amy

This project was a research facility construction project and did not include actual research. The new facility will benefit the public by providing training opportunities for students, as well as incubator and laboratory space for entrepreneurs in the areas of alternative and renewable energies. The 9,216 -square-foot Missouri Alternative and Renewable Energy Technology (MARET) Center was completed in late 2011. Classes in the MARET Center began in the spring 2012 semester. Crowder College takes pride in the MARET Center, a focal point of the campus, as the cutting edge in education, applied research and commercial development in the growing fieldmore » of green technology.« less

Two-stage Raman compression of laser pulses with controllable phase fronts

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

Balakin, A. A.; Fraiman, G. M.; State University of Nizhny Novgorod, Nizhny Novgorod

2015-05-15

The phase front of an ultrashort laser pulse undergoing Raman amplification and compression in inhomogeneous plasma can be controlled such that it is unaffected by density gradients and thus remains focusable. This is achieved by performing the Raman backscattering in two stages. At the first stage, the standard nonlinear Raman compression of a seed wave takes place and produces a short ultraintense pulse, which yet may be poorly focusable. At the second stage, this amplified pulse is scattered again, now serving as a pump, off a second copy of the initial seed. This stage, which utilizes a denser and shortermore » plasma, is intended not for compression but rather for passing a significant fraction of the energy to the second seed quickly. Then, the output pulse that is produced is not just short and ultraintense, but also has the smooth phase front of the original seed.« less

Developmental Stages in Receptive Grammar Acquisition: A Processability Theory Account

ERIC Educational Resources Information Center

Buyl, Aafke; Housen, Alex

2015-01-01

This study takes a new look at the topic of developmental stages in the second language (L2) acquisition of morphosyntax by analysing receptive learner data, a language mode that has hitherto received very little attention within this strand of research (for a recent and rare study, see Spinner, 2013). Looking at both the receptive and productive…

Reusable aerospace system with horizontal take-off

NASA Astrophysics Data System (ADS)

Lozino-Lozinskii, G. E.; Shkadov, L. M.; Plokhikh, V. P.

1990-10-01

An aerospace system (ASS) concept aiming at cost reductions for launching facilities, reduction of ground preparations for start and launch phases, flexibility of use, international inspection of space systems, and emergency rescue operations is presented. The concept suggests the utilization of an AN-225 subsonic carrier aircraft capable of carrying up to 250 ton of the external load, external fuel tank, and orbital spacecraft. It includes a horizontal take-off, full reusable or single-use system, orbital aircraft with hypersonic characteristics, the use of an air-breathing jet engine on the first stage of launch, and the utilization of advanced structural materials. Among possible applications for ASS are satellite launches into low supporting orbits, suborbital cargo and passenger flights, scientific and economic missions, and the technical servicing of orbital vehicles and stations.

NASA Ares I Crew Launch Vehicle Upper Stage Overview

NASA Technical Reports Server (NTRS)

Davusm Daniel J.; McArthur, J. Craig

2008-01-01

By incorporating rigorous engineering practices, innovative manufacturing processes and test techniques, a unique multi-center government/contractor partnership, and a clean-sheet design developed around the primary requirements for the International Space Station (ISS) and Lunar missions, the Upper Stage Element of NASA's Crew Launch Vehicle (CLV), the "Ares I," is a vital part of the Constellation Program's transportation system.

Teaching Geology on Weekends and at Shopping Centers.

ERIC Educational Resources Information Center

Mirsky, Arthur; East, James R.

1981-01-01

The success of an outreach education program held by Indiana University-Purdue University at Indianapolis is described. The college offers regular credit courses on Saturday and Sunday for people who could not take regularly scheduled courses. A Learn and Shop program held at shopping centers is also described. (JT)

75 FR 68607 - CenterPoint Energy-Illinois Gas Transmission Company; Notice of Baseline Filing

Federal Register 2010, 2011, 2012, 2013, 2014

2010-11-08

... DEPARTMENT OF ENERGY Federal Energy Regulatory Commission [Docket No. PR10-80-001] CenterPoint Energy--Illinois Gas Transmission Company; Notice of Baseline Filing November 1, 2010. Take notice that on October 28, 2010, CenterPoint Energy--Illinois Gas Transmission Company submitted a revised...

Effect of learner-centered teaching on motivation and learning strategies in a third-year pharmacotherapy course.

PubMed

Cheang, Kai I

2009-05-27

To develop, implement, and assess a learner-centered approach to teaching a third-year pharmacotherapy course in a doctor of pharmacy (PharmD) program. The pharmacotherapy course was restructured according to the learner-centered approach. The Motivated Strategies for Learning Questionnaire (MSLQ) was administered to students before and after taking the course, and changes in MSLQ subscales from baseline were evaluated. Students' response to the learner-centered approach and characteristics associated with MSLQ scores were also evaluated. Compared to baseline, students' intrinsic goal orientation control of learning beliefs, self-efficacy, critical thinking, and metacognitive self-regulation improved after taking the course. Students responded positively to the learner-centered approach. Additionally, students with a clinical practice career orientation or who prepared frequently for classes scored higher on several MSLQ domains. The learner-centered approach was effective in promoting several domains of motivation and learning strategies in a third-year pharmacotherapy course.

Is complete resection of high-risk stage IV neuroblastoma associated with better survival?

PubMed

Yeung, Fanny; Chung, Patrick Ho Yu; Tam, Paul Kwong Hang; Wong, Kenneth Kak Yuen

2015-12-01

The role of surgery in the management of stage IV neuroblastoma is controversial. In this study, we attempted to study if complete tumor resection had any impact on event-free survival (EFS) and overall survival (OS). A retrospective analysis of patients with stage IV neuroblastoma between November 2000 and July 2014 in a tertiary referral center was performed. Demographics data, extent of surgical resection, and outcomes were analyzed. A total of 34 patients with stage IV neuroblastoma according to International Neuroblastoma Staging System (INSS) were identified. The median age at diagnosis and operation was 3.5 (±1.9) years and 3.8 (±2.0) years, respectively. Complete gross tumor resection (CTR) was achieved in twenty-four patients (70.1%), in which one of the patients had nephrectomy and another had distal pancreatectomy. Gross total resection (GTR) with removal of >95% of tumor was performed in six patients (17.6%) and subtotal tumor resection (STR) with removal of >50%, but <95% of tumor was performed in four patients (11.8%). There was no statistical significance in terms of 5-year EFS and OS among the 3 groups. There was no surgery-related mortality or morbidity. From our center's experience, as there was no substantial survival benefit in stage IV neuroblastoma patients undergoing complete tumor resection, organ preservation and minimalization of morbidity should also be taken into consideration. Copyright © 2015. Published by Elsevier Inc.

Bugs, Planes, and Ferris Wheels: A Problem-Centered Curriculum

ERIC Educational Resources Information Center

Campbell, William E.; Kemp, Joyce C.; Zia, Joan H.

2006-01-01

This article describes a problem-centered curriculum for grades 9-12, using problem sets developed by a mathematics department and designed to take the place of textbooks. The students discover mathematical concepts in the context of the problems and activities in the materials.

Child Care Center Design & the Potential of Architecture.

ERIC Educational Resources Information Center

Abbott, Carl; Abbott, Cooper

This paper discusses the impact of layout and design of child care centers on the education of young children. It asserts that child care facilities must be designed to support and stimulate children's natural developmental processes, providing both direct and indirect educational opportunities. The paper discusses the stages of the design process…

Serum Ionized Calcium Quantification for Staging Canine Periodontal Disease: A Preliminary Study.

PubMed

Miguel Carreira, L; Daniela, Dias; Pedro, Azevedo

2015-06-01

Periodontal diseases (PD) are infectious, inflammatory, progressive diseases of the oral cavity affecting people and dogs. PD takes 2 forms: gingivitis and periodontitis. Diagnosing or staging PD can be achieved only with dental x-rays and periodontal probing, both of which require the use of general anesthesia in dogs. This study aimed to determine whether serum ionized calcium ([iCa(2+)]) levels can be useful in preliminary PD staging in dogs. A sample of 40 dogs (n = 40) was divided into 4 groups (n = 10 each) based on the following PD stages: G1 (gingivitis), G2 (initial periodontitis), G3 (moderate periodontitis), and G4 (severe periodontitis). The groups were then subjected to [iCa(2+)] quantification. Statistically significant differences were observed between PD stages and [iCa(2+)] for all stages except G3 and G4. Therefore, this parameter can be used as an additional tool to establish and monitor preliminary PD status. Copyright © 2015 Elsevier Inc. All rights reserved.

Hydrodynamic instability of elastic-plastic solid plates at the early stage of acceleration.

PubMed

Piriz, A R; Sun, Y B; Tahir, N A

2015-03-01

A model is presented for the linear Rayleigh-Taylor instability taking place at the early stage of acceleration of an elastic-plastic solid, when the shock wave is still running into the solid and is driven by a time varying pressure on the interface. When the the shock is formed sufficiently close to the interface, this stage is considered to follow a previous initial phase controlled by the Ritchmyer-Meshkov instability that settles new initial conditions. The model reproduces the behavior of the instability observed in former numerical simulation results and provides a relatively simpler physical picture than the currently existing one for this stage of the instability evolution.

Overwintering Stages of Meloidogyne incognita in Vitis vinifera.

PubMed

Melakeberhan, H; Ferris, H; McKenry, M V; Gaspard, J T

1989-01-01

The overwintering of Meloidogyne incognita in and around Vitis vinifera cv. French Colombard roots was studied in a naturally infested vineyard at the Kearney Agricultural Center, in a growth chamber, in inoculated vines in microplots at the University of California, Davis, and in a greenhouse. Infected roots were sampled at intervals from onset of vine dormancy until plants accumulated about 800 degree days (DD - base 10 C). Embryogenesis within eggs, classified as less than or more than 16 cells and fully differentiated, and numbers of juveniles (second to fourth stage) and preovipositional and mature (egg-laying) adult stages in roots were determined. All stages were present at the onset of dormancy. Juveniles and immature females were not recovered during the dormant period. Mature females and eggs were always present in roots, although the number of mature females generally decreased with time after onset of dormancy. In contrast, in a greenhouse experiment that accumulated comparable DD without the host plant going through dormancy, the number of mature females increased. After bud break, the number of eggs per female increased and all nematode stages were found in host roots. Eggs in all stages of embryogenesis were observed at all times of sampling, indicating that females overwinter and are capable of laying eggs when conditions improve in the spring and need to be considered in nematode management decisions.

Early Phase in the Development of Cannabidiol as a Treatment for Addiction: Opioid Relapse Takes Initial Center Stage.

PubMed

Hurd, Yasmin L; Yoon, Michelle; Manini, Alex F; Hernandez, Stephanie; Olmedo, Ruben; Ostman, Maria; Jutras-Aswad, Didier

2015-10-01

Multiple cannabinoids derived from the marijuana plant have potential therapeutic benefits but most have not been well investigated, despite the widespread legalization of medical marijuana in the USA and other countries. Therapeutic indications will depend on determinations as to which of the multiple cannabinoids, and other biologically active chemicals that are present in the marijuana plant, can be developed to treat specific symptoms and/or diseases. Such insights are particularly critical for addiction disorders, where different phytocannabinoids appear to induce opposing actions that can confound the development of treatment interventions. Whereas Δ(9)-tetracannabinol has been well documented to be rewarding and to enhance sensitivity to other drugs, cannabidiol (CBD), in contrast, appears to have low reinforcing properties with limited abuse potential and to inhibit drug-seeking behavior. Other considerations such as CBD's anxiolytic properties and minimal adverse side effects also support its potential viability as a treatment option for a variety of symptoms associated with drug addiction. However, significant research is still needed as CBD investigations published to date primarily relate to its effects on opioid drugs, and CBD's efficacy at different phases of the abuse cycle for different classes of addictive substances remain largely understudied. Our paper provides an overview of preclinical animal and human clinical investigations, and presents preliminary clinical data that collectively sets a strong foundation in support of the further exploration of CBD as a therapeutic intervention against opioid relapse. As the legal landscape for medical marijuana unfolds, it is important to distinguish it from "medical CBD" and other specific cannabinoids, that can more appropriately be used to maximize the medicinal potential of the marijuana plant.

Utilizing Education and Perspective Taking to Remediate the Stigma of Taking Antidepressants.

PubMed

Martinez, Larry R; Xu, Shi; Hebl, Michelle

2018-05-01

The incidence of depression has been increasing. One of the best interventions for depression is taking antidepressant medications. However, the stigma of taking antidepressants has been shown to be a barrier not only to seeking an antidepressant regimen but also adhering to it. This may have negative consequences for people who suffer from depression. Thus, in two studies, we investigate the incidence of felt stigma of taking antidepressants among clinically depressed individuals who take antidepressants and the effectiveness of two possible interventions to reduce this stigma among others. Study 1 revealed that stigma toward individuals who take antidepressants is a reality, either because people were not educated about depression and antidepressants, or because they did not show empathy or did not take on perspectives from the victim's point-of-view. Based on these results, we used an experimental design in Study 2 to investigate the effects of education and perspective-taking interventions in diminishing the stigma of taking antidepressants. These results suggest that participant gender played a moderating role in the effectiveness of education and perspective taking, such that a combination of the two interventions resulted in lower stigma for men but not for women. These results suggest that people can be trained (using a simple, low-fidelity intervention) to be more accepting of antidepressant use among their friends, family members, and colleagues, resulting in better outcomes for those who benefit from taking antidepressants.

MK2206 in Treating Patients With Stage I, Stage II, or Stage III Breast Cancer

ClinicalTrials.gov

2017-08-01

Estrogen Receptor Negative; Estrogen Receptor Positive; HER2/Neu Negative; HER2/Neu Positive; Progesterone Receptor Negative; Progesterone Receptor Positive; Stage IA Breast Cancer; Stage IB Breast Cancer; Stage IIA Breast Cancer; Stage IIB Breast Cancer; Stage IIIA Breast Cancer; Stage IIIB Breast Cancer; Stage IIIC Breast Cancer; Triple-Negative Breast Carcinoma

First stage of Saturn launch vehicle in KSC Vehicle Assembly Building

NASA Image and Video Library

1968-12-03

S68-55034 (3 Dec. 1968) --- The first (S-1C) stage of the Saturn 505 launch vehicle being prepared for erection in the high bay area of the Kennedy Space Center's (KSC) Vehicle Assembly Building (VAB). Saturn 505 is the launch vehicle for the Apollo 10 mission.

The Next Stage: Moving from Isolated Digital Collections to Interoperable Digital Libraries.

ERIC Educational Resources Information Center

Besser, Howard

2002-01-01

Presents a conceptual framework for digital library development and discusses how to move from isolated digital collections to interoperable digital libraries. Topics include a history of digital libraries; user-centered architecture; stages of technological development; standards, including metadata; and best practices. (Author/LRW)

Clinical Phenotype Predicts Early Staged Bilateral Deep Brain Stimulation in Parkinson’s Disease

PubMed Central

Sung, Victor W.; Watts, Ray L.; Schrandt, Christian J.; Guthrie, Stephanie; Wang, Deli; Amara, Amy W.; Guthrie, Barton L.; Walker, Harrison C.

2014-01-01

Object While many centers place bilateral DBS systems simultaneously, unilateral STN DBS followed by a staged contralateral procedure has emerged as a treatment option for many patients. However little is known about whether the preoperative phenotype predicts when staged placement of a DBS electrode in the opposite subthalamic nucleus will be required. We aimed to determine whether preoperative clinical phenotype predicts early staged placement of a second subthalamic deep brain stimulation (DBS) electrode in patients who undergo unilateral subthalamic DBS for Parkinson's disease (PD). Methods Eighty-two consecutive patients with advanced PD underwent unilateral subthalamic DBS contralateral to the most affected hemibody and had at least 2 years of follow-up. Multivariate logistic regression determined preoperative characteristics that predicted staged placement of a second electrode in the opposite subthalamic nucleus. Preoperative measurements included aspects of the Unified Parkinson Disease Rating Scale (UPDRS), motor asymmetry index, and body weight. Results At 2 years follow-up, 28 of the 82 patients (34%) had undergone staged placement of a contralateral electrode while the remainder chose to continue with unilateral stimulation. Statistically significant improvements in UPDRS total and part 3 scores were retained at the end of the 2 year follow-up period in both subsets of patients. Multivariate logistic regression showed that the most important predictors for early staged placement of a second subthalamic stimulator were low asymmetry index (odds ratio 13.4; 95% confidence interval 2.8, 64.9), high tremor subscore (OR 7.2; CI 1.5, 35.0), and low body weight (OR 5.5; CI 1.4, 22.3). Conclusions This single center study provides evidence that elements of the preoperative PD phenotype predict whether patients will require early staged bilateral subthalamic DBS. These data may aid in the management of patients with advanced PD who undergo subthalamic DBS. PMID

77 FR 41391 - Final Priority; Rehabilitation Research and Training Center on Vocational Rehabilitation and...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-07-13

... Research and Training Center (RRTCs) on Vocational Rehabilitation (VR) and Developing Strategies to Meet... Projects and Centers Program administered by NIDRR. Specifically, this priority is for an RRTC on VR and... effective VR practices that take into account economic conditions, labor market trends, and employer needs...

Investigating the predictive of risk-taking attitudes and behaviors among Iranian drivers

PubMed Central

Habibi, Ehsanollah; Haghi, Azam; Maracy, Mohammad Reza

2014-01-01

Background: World Health Organization findings shows that up to year 2020 the number of fatality due to driving accidents will increases up to 65%, which is 80% is in developing countries. Iran has one of the highest rates of road traffic accident mortality rate in the world. Materials and Methods: The cross-sectional study was carried out in the center and west of Iran upon 540 ordinary and taxi drivers who were driving regularly from bus terminals and the travel agencies to other cities. Data collection tool is a questionnaire that measuring driving risk taking by two items of risky driving behaviors and risk taking attitudes. Findings: The results of this study showed that the averages of risk driving behaviors scores were higher than the average of risk taking attitudes scores. The results of logistic regression test showed that the risky driving behaviors can be a predictor of driving accidents due to individuals’ risk taking (P = 0.014). Among all these variables, attitude toward rule violations and speeding, aggressive driving and violation of the road laws respectively are important predictive of drivers’ risk taking (P < 0.0010). Discussion and Conclusion: Although attitude toward risk taking has been located at a low level by different ways, a desired result was not obtained from the reduction of those high risky behaviors; in fact, high-rate of accidents and traffic incidence in Iran indicates this matter well. PMID:24741659

Aerodynamic Characteristics at a Mach Number of 3.10 of Several Fourth-Stage Shapes of the Scout Research Vehicle

NASA Technical Reports Server (NTRS)

Jaquet, Byron M.

1961-01-01

A wind-tunnel investigation was made at a Mach number of 3.10 (Reynolds number per foot of 16.3 x 10(exp 6) to 16.9 x 10(exp 6)) to determine the aerodynamic characteristics of various modifications of the payload section of the fourth stage of the Scout research vehicle. It was found that, for the combination of stages 3 and 4, increasing the size of the nose of the basic Scout to provide a cylindrical section of the same diameter as the third stage increased the normal-force slope by about 30 percent, the axial force by about 39 percent, and moved the center of pressure forward by about one fourth-stage base diameter. By reducing the diameter of the cylinder, at about one nose length behind the base of the enlarged nose frustum, to that of the basic Scout and thereafter retaining the shape of the basic Scout, the center of pressure was moved rearward by about one-half fourth-stage base diameter at the expense of an additional 19-percent increase in axial force. A spike-hemisphere configuration had the largest forces and moments and the most forward center-of-pressure location of the configurations considered. Except for the axial force and pitching-moment slope, the experimental trends or magnitudes could not be estimated with the desired accuracy by Newtonian or-slender body theory.

The Functional Status of Patients with AIDS Attending Antiretroviral Treatment Center

PubMed Central

Thejus, TJ; Jeeja, MC; Jayakrishnan, T

2009-01-01

Aims: To assess the functional status of patients with Acquired immunodeficiency syndrome (AIDS) registered in the Anti-Retroviral Treatment (ART) center. Materials and Methods: Design: Descriptive study. Study setting: ART center in Calicut Medical College, Kerala, India. Subjects: Cohorts of AIDS patients attending the ART center during the year 2007. Data collection: Done prospectively from the secondary data available from the center. Outcome measures: The demographic, morbidity, functional status and laboratory parameters were collected. Data processing was done using Excel datasheet and analysis were done using Epi info 2003. Results: One hundred and ninety-five patients received care during this period; 69% were males. The mean age was 38±9 years; 80% of them were married and in 50% of their spouses also tested positive for HIV. The mean CD4 count was 127 cells/microliter. The majority (90%) were categorized as WHO Stage 3 or 4 of HIV. Only 52% of them were able to perform their usual work in or outside their house; the rest were not able to lead an economically productive life. Thirty-six per cent were only able to perform activities of daily living; 12% were bedridden. The functional status of the patients positively correlated with WHO disease stage (P = < 0-0001), and CD4 count and hemoglobin levels negatively correlated with staging (P = <0.001). 62% are having any of the opportunistic infections. Conclusion: Fifty per cent of the AIDS patients are disabled and need support and care. As AIDS is a growing problem, community-based palliative care for AIDS patients should be strengthened in India. PMID:20606857

Rethinking exploitation: a process-centered account.

PubMed

Jansen, Lynn A; Wall, Steven

2013-12-01

Exploitation has become an important topic in recent discussions of biomedical and research ethics. This is due in no small measure to the influence of Alan Wertheimer's path-breaking work on the subject. This paper presents some objections to Wertheimer's account of the concept. The objections attempt to show that his account places too much emphasis on outcome-based considerations and too little on process-based considerations. Building on these objections, the paper develops an alternative process-centered account of the concept. This alternative account of exploitation takes as its point of departure the broadly Kantian notion that it is wrong to use another as an instrument for the advancement of one's own ends. It sharpens this slippery notion and adds a number of refinements to it. The paper concludes by arguing that process-centered accounts of exploitation better illuminate the ethical challenges posed by research on human subjects than outcome-centered accounts.

Two-stage urethroplasty is a better choice for proximal hypospadias with severe chordee after urethral plate transection: a single-center experience.

PubMed

Zheng, Da-Chao; Yao, Hai-Jun; Cai, Zhi-Kang; Da, Jun; Chen, Qi; Chen, Yan-Bo; Zhang, Ke; Xu, Ming-Xi; Lu, Mu-Jun; Wang, Zhong

2015-01-01

It is still debatable whether single- or two-stage urethroplasty is a more suitable technique for treating hypospadias with severe chordee after urethral plate transection. This retrospective study evaluated these two techniques. A total of 66 patients of proximal hypospadias with severe chordee were divided into two groups according to the techniques they underwent: 32 and 34 patients underwent single-stage (Duckett) or two-stage urethroplasty, respectively. Median ages at presentation were 7.5 years and 11.0 years in single-stage and two-stage repair groups, respectively. Median follow-ups were 28.5 months (20-60 months) and 35 months (18-60 months) in the single-stage and two-stage groups, respectively. The meatus of the neourethra was located at the top of the glans in all patients. No recurrence of chordee was found during follow-up, and all patients or parents were satisfied with the penile length and appearance. Complications were encountered in eight patients in both groups, with no statistically significant differences between the two techniques. The late complication rate of stricture was higher after the single-stage procedure (18.75% vs 0%). The complication rate after single-stage repairs was significantly lower in the prepubescent subgroup (10.52%) than in the postpubescent cohort (46.15%). These results indicate that the urethral plate transection effectively corrects severe chordee associated with proximal hypospadias during the intermediate follow-up period. Considering the higher rate of stricture after single-stage urethroplasty, two-stage urethroplasty is recommended for proximal hypospadias with severe chordee after urethral plate transection.

Liver disease stage determines whether the immune response stifles or stimulates tumor growth | Center for Cancer Research

Cancer.gov

Researchers at the Center for Cancer Research and colleagues from three cancer research centers in Germany have discovered a mechanism whereby precancerous liver cells, found in individuals with chronic liver disease, can prevent neighboring cells from becoming cancerous but can also speed the growth of cells that have already become cancerous.  Learn more...

Communication patterns in audiologic rehabilitation history-taking: audiologists, patients, and their companions.

PubMed

Grenness, Caitlin; Hickson, Louise; Laplante-Lévesque, Ariane; Meyer, Carly; Davidson, Bronwyn

2015-01-01

The nature of communication between patient and practitioner influences patient outcomes. Specifically, the history-taking phase of a consultation plays a role in the development of a relationship and in the success of subsequent shared decision making. There is limited research investigating patient-centered communication in audiology, and this study may be the first to investigate verbal communication in an adult audiologic rehabilitation context. This research aimed, first, to describe the nature of verbal communication involving audiologists, patients, and companions in the history-taking phase of initial audiology consultations and, second, to determine factors associated with communication dynamics. Sixty-three initial audiology consultations involving patients over the age of 55, their companions when present, and audiologists were audio-video recorded. Consultations were coded using the Roter Interaction Analysis System and divided into three consultation phases: history, examination, and counseling. This study analyzed only the history-taking phase in terms of opening structure, communication profiles of each speaker, and communication dynamics. Associations between communication dynamics (verbal dominance, content balance, and communication control) and 11 variables were evaluated using Linear Mixed Model methods. The mean length of the history-taking phase was 8.8 min (range 1.7 to 22.6). A companion was present in 27% of consultations. Results were grouped into three areas of communication: opening structure, information exchange, and relationship building. Examination of the history opening structure revealed audiologists' tendency to control the agenda by initiating consultations with a closed-ended question 62% of the time, followed by interruption of patient talk after 21.3 sec, on average. The aforementioned behaviors were associated with increased verbal dominance throughout the history and increased control over the content of questions. For the

A continuum of sociotechnical requirements for patient-centered problem lists.

PubMed

Collins, Sarah; Tsivkin, Kira; Hongsermeier, Tonya; Dubois, David; Nandigam, Hari Krishna; Rocha, Roberto A

2013-01-01

Specific requirements for patient-centered health information technology remain ill-defined. To create operational definitions of patient-centered problem lists, we propose a continuum of sociotechnical requirements with five stages: 1) Intradisciplinary Care Planning: Viewing and searching for problems by discipline; 2) Multi-disciplinary Care Planning: Categorizing problem states to meet discipline-specific needs; 3) Interdisciplinary Care Planning: Sharing and linking problems between disciplines; 4) Integrated and Coordinated Care Planning: Associating problems with assessments, tasks, interventions and outcomes across disciplines for coordination, knowledge development, and reporting; and 5) Patient-Centered Care Planning: Engaging patients in identification of problems and maintenance of their problem list.

Patients' and family caregivers' understanding of the cancer stage, treatment goal, and chance of cure: A study with patient-caregiver-physician triad.

PubMed

Shin, Dong Wook; Cho, Juhee; Kim, So Young; Yang, Hyung Kook; Park, Keeho; Kweon, Sun-Seog; Koh, Dai Ha; Nam, Hae-Sung; Park, Jong-Hyock

2018-01-01

Accurate understanding of the extent of disease, treatment goal, and prognosis is a prerequisite for patients with cancer and their caregivers to make informed decision. We sought to evaluate patients' and family caregivers' understanding of the cancer stage, treatment goal, and chance of cure taking their own physician's evaluation as reference. A national survey was performed with 750 patient-caregiver dyads (75.5% participation rate) recruited by 134 oncologists in 13 cancer centers (93% participation rate) in South Korea. Both patients and caregivers were asked to report their knowledge of patient's cancer stage, treatment goal, and chance of cure. Concordance was evaluated with percentage agreement and weighted κ, and predictors of discordance of patient and caregiver's response with that of physician's were explored by multivariate regression analyses with mixed effect model. The agreement rates between patient-physician and caregiver-physician were 63.0% and 65.9% for disease stage, 69.0% and 70.0% for treatment goal, and 41.4% and 45.1% for chance of cure. When discordance occurs, patients and caregivers often had an optimistic view. Distant stage, older age, female sex, and absence of depression were associated with optimistic view of patients, and there was significant between-physician variance for all 3 outcomes. The discordance revealed that our study suggests the need for better communication between physician and patients, as well as the caregivers. Research is needed to develop a comprehensive strategy to improve the understanding of the patients and family so that treatment decisions are made based on realistic estimation. Copyright © 2017 John Wiley & Sons, Ltd.

Final priority; National Institute on Disability and Rehabilitation Research--Disability and Rehabilitation Projects and Centers Program--Rehabilitation Engineering Research Centers. Final priority.

PubMed

2013-06-19

The Assistant Secretary for Special Education and Rehabilitative Services announces a priority for a Rehabilitation Engineering Research Center (RERC) on Technologies to Support Successful Aging with Disability under the Disability and Rehabilitation Research Projects and Centers Program administered by the National Institute on Disability and Rehabilitation Research (NIDRR). The Assistant Secretary may use this priority for a competition in fiscal year (FY) 2013 and later years. We take this action to focus research attention on areas of national need. We intend to use this priority to improve outcomes for individuals with disabilities.

Contact centers, pervasive computing and telemedicine: a quality health care triangle.

PubMed

Maglaveras, Nicos

2004-01-01

The Citizen Health System (CHS) is a European Commission (CEC) funded project in the field of IST for Health. Its main goal is to develop a generic contact center which in its pilot stage can be used in the monitoring, treatment and management of chronically ill patients at home in Greece, Spain, and Germany. Such contact centers, using any type of communication technology, and providing timely and preventive prompting to the patients are envisaged in the future to evolve into well-being contact centers providing services to all citizens. In this paper, we present the structure of such a generic contact center and present its major achievements, and their impact to the quality of health delivery.

Stage I-IIA Non-Bulky Hodgkin's Lymphoma. Is Further Distinction Based on Prognostic Factors Useful? The Stanford Experience

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

Advani, Ranjana H., E-mail: radvani@stanford.edu; Hoppe, Richard T.; Maeda, Lauren S.

2011-12-01

Purpose: In the United States, early-stage Hodgkin's lymphoma (HL) is defined as asymptomatic stage I/II non-bulky disease. European groups stratify patients to more intense treatment by considering additional unfavorable factors, such as age, number of nodal sites, sedimentation rate, extranodal disease, and elements of the international prognostic score for advanced HL. We sought to determine the prognostic significance of these factors in patients with early-stage disease treated at Stanford University Medical Center. Methods and Materials: This study was a retrospective analysis of 101 patients treated with abbreviated Stanford V chemotherapy (8 weeks) and 30-Gy (n = 84 patients) or 20-Gymore » (n = 17 patients) radiotherapy to involved sites. Outcomes were assessed after applying European risk factors. Results: At a median follow-up of 8.5 years, freedom from progression (FFP) and overall survival (OS) rates were 94% and 97%, respectively. From 33% to 60% of our patients were unfavorable per European criteria (i.e., German Hodgkin Study Group [GHSG], n = 55%; European Organization for Research and Treatment of Cancer, n = 33%; and Groupe d'Etudes des Lymphomes de l'Adulte, n = 61%). Differences in FFP rates between favorable and unfavorable patients were significant only for GHSG criteria (p = 0.02) with there were no differences in OS rates for any criteria. Five of 6 patients who relapsed were successfully salvaged. Conclusions: The majority of our patients deemed unfavorable had an excellent outcome despite undergoing a significantly abbreviated regimen. Application of factors used by the GHSG defined a less favorable subset for FFP but with no impact on OS. As therapy for early-stage disease moves to further reductions in therapy, these factors take on added importance in the interpretation of current trial results and design of future studies.« less

Effect of Learner-Centered Teaching on Motivation and Learning Strategies in a Third-Year Pharmacotherapy Course

PubMed Central

Cheang, Kai I.

2009-01-01

Objectives To develop, implement, and assess a learner-centered approach to teaching a third-year pharmacotherapy course in a doctor of pharmacy (PharmD) program. Methods The pharmacotherapy course was restructured according to the learner-centered approach. The Motivated Strategies for Learning Questionnaire (MSLQ) was administered to students before and after taking the course, and changes in MSLQ subscales from baseline were evaluated. Students’ response to the learner-centered approach and characteristics associated with MSLQ scores were also evaluated. Results Compared to baseline, students’ intrinsic goal orientation control of learning beliefs, self-efficacy, critical thinking, and metacognitive self-regulation improved after taking the course. Students responded positively to the learner-centered approach. Additionally, students with a clinical practice career orientation or who prepared frequently for classes scored higher on several MSLQ domains. Conclusions The learner-centered approach was effective in promoting several domains of motivation and learning strategies in a third-year pharmacotherapy course. PMID:19564985

The thesis of stages fourteen years later

NASA Astrophysics Data System (ADS)

Beeby, C. E.

1980-12-01

The author indicates the changes and additions he would make to his book ` The Quality of Education in Developing Countries' (1966) if he were re-writing it in 1980. He would make clearer that his primary interest is in a continuum of change, the process of growth of a school system, and that the `stages' are only a convenient non-mathematical artifact to make the thesis more useful to administrators and planners. In the light of more recent developments and experiences, he now gives new stress to the pluralism of objectives at the stage of Meaning, and discusses the political, social, cultural and financial reasons why a country may choose not to take the difficult step from stage III to stage IV. Recent forms of alternative education, particularly those embodying plans for lifelong education, offer some hope of bypassing his thesis of stages. More consideration is given to constraints other than that of teacher qualification, though the difficulty of changing the skills, habits, attitudes and purposes in the teaching profession remain the chief obstacle to qualitative growth. Particular attention is paid to `crash' programmes where processes that are, by their very nature, successive are compressed into simultaneous or almost simultaneous ones. Some implications of the thesis of stages for teacher training are briefly dealt with. Regarding the application of the thesis to secondary education, he maintains that a better model of growth would be one based on the capacity of secondary education to respond to the changing economic and social demands of the community. Finally, he suggests three methods of testing his hypotheses and pleads that more consideration be given to building up a body of educational, theory based on the experience of developing countries over the past three decades.

Local condensate depletion at trap center under strong interactions

NASA Astrophysics Data System (ADS)

Yukalov, V. I.; Yukalova, E. P.

2018-04-01

Cold trapped Bose-condensed atoms, interacting via hard-sphere repulsive potentials are considered. Simple mean-field approximations show that the condensate distribution inside a harmonic trap always has the shape of a hump with the maximum condensate density occurring at the trap center. However, Monte Carlo simulations at high density and strong interactions display the condensate depletion at the trap center. The explanation of this effect of local condensate depletion at trap center is suggested in the frame of self-consistent theory of Bose-condensed systems. The depletion is shown to be due to the existence of the anomalous average that takes into account pair correlations and appears in systems with broken gauge symmetry.

Designing the Ares I Crew Launch Vehicle Upper Stage Element and Integrating the Stack at NASA's Marshall Space Flight Center

NASA Technical Reports Server (NTRS)

Otte, Neil E.; Lyles, Garry; Reuter, James L.; Davis, Daniel J.

2008-01-01

Fielding an integrated launch vehicle system entails many challenges, not the least of which is the fact that it has been over 30 years since the United States has developed a human-rated vehicle - the venerable Space Shuttle. Over time, whole generations of rocket scientists have passed through the aerospace community without the opportunity to perform such exacting, demanding, and rewarding work. However, with almost 50 years of experience leading the design, development, and end-to-end systems engineering and integration of complex launch vehicles, the National Aeronautics and Space Administration's (NASA's) Marshall Space Flight Center offers the in-house talent - both junior- and senior-level personnel - to shape a new national asset to meet the requirements for safe, reliable, and affordable space exploration solutions. The technical personnel are housed primarily in Marshall's Engineering Directorate and are matrixed into the programs and projects that reside at the rocket center. Fortunately, many Apollo-era and Shuttle engineers, as well as those who gained valuable hands-on experience in the 1990s by conducting technology demonstrator projects such as the Delta-Clipper Experimental Advanced, X-33, X-34, and X-37, as well as the short-lived Orbital Space Plane, work closely with industry partners to advance the nation's strategic capability for human access to space. The Ares Projects Office, resident at Marshall, is managing the design and development of America's new space fleet, including the Ares I, which will loft the Orion crew capsule for its first test flight in the 2013 timeframe, as well as the heavy-lift Ares V, which will round out the capability to leave low-Earth orbit once again, when it delivers the Altair lunar lander to orbit late next decade. This paper provides information about the approach to integrating the Ares I stack and designing the upper stage in house, using unique facilities and an expert workforce to revitalize the nation

[Obesity associated risk using Edmonton staging in bariatric surgery].

PubMed

de Cos, Ana Isabel; Cardenas, Jersy J; Pelegrina, Beatriz; Roldan, M Concepción; Calvo, Isabel; Vázquez, Clotilde; Pallardo, Luis Felipe

2014-09-20

With a prevalence of Morbid Obesity of 1,2% of the Spanish population, the current criteria for Bariatric Surgery do not classify patients taking into consideration co-morbidities or functional status. We need new staging systems useful in predicting mortality and able to support prioritizing treatments. Applying Edmonton staging system to patients awaiting Bariatric Surgery. Data collected from 81 patients from 2011- 2013 after pre-surgery protocol. Weight, height, waist, BMI, biochemical parameters and blood pressure are registered. Also taken down are hepatic, renal, osteoarticular diseases, sleep-apnea syndrome and/or gastro-oesophageal reflux, if present. Edmonton staging of ten variables is applied to each patient. 81 patients: 67% women, average age 47y, 18% below 30y. Average BMI of 47, 90% of patients have a BMI >40. 34% of patients show sleep-apnea syndrome and 25% gastro-oesophageal reflux. 9% of the patients have a BMI >45, diabetes mellitus and sleep-apnea syndrome. Applying the Edmonton Staging, nine patients (11%) are in the highest risk range (stage 3), 70% are in the high-risk range (stage 2) and 15 patients (18%) are included in the low-risk range. No patient was found to be in stage 0 without obesity risk factors. The Edmonton staging system provides us with information on presence or extent of co-morbidities that guide decision making in individuals. The mortality- predictive ability of Edmonton proposal could help to assist in determining the urgency of Bariatric Surgery and establish better criteria to prioritize these group of patients. Copyright AULA MEDICA EDICIONES 2014. Published by AULA MEDICA. All rights reserved.

Changes in blood flow during one stage lengthening of bone: an experimental study in rats.

PubMed

Kwon, S T; Chung, C Y

2000-06-01

Distraction osteogenesis is a well-accepted method of bone lengthening. Its disadvantages, however, are that it requires an external fixator and takes a long time. One-stage lengthening therefore offers certain advantages. A first point of reference for the safe limits of this procedure might be the changes of blood flow, and this is also the crucial factor in deciding on the appropriate method of lengthening, particularly where the hand or foot is involved. Using a laser Doppler flowmeter we measured blood flow in the dorsum of the foot after using bilateral minimonofixators to lengthen the tibias of 15 Sprague-Dawley rats. They were lengthened in four stages: stage 0 (before lengthening); stage I--12.5%; stage II--25%; and stage III--31.25% of lengthening. The blood flow during stage I decreased to 79% compared to that of stage 0; 16% during stage II; and 1% during stage III. This study suggests that the maximal permissible extent of lengthening might be less than a quarter according to the blood flow as suggested by this animal model.

The design of two-stage-to-orbit vehicles

NASA Technical Reports Server (NTRS)

1991-01-01

Two separate student design groups developed conceptual designs for a two-stage-to-orbit vehicle, with each design group consisting of a carrier team and an orbiter team. A two-stage-to-orbit system is considered in the event that single-stage-to-orbit is deemed not feasible in the foreseeable future; the two-stage system would also be used as a complement to an already existing heavy lift vehicle. The design specifications given are to lift a 10,000-lb payload 27 ft long by 10 ft diameter, to low Earth orbit (300 n.m.) using an air breathing carrier configuration that will take off horizontally within 15,000 ft. The staging Mach number and altitude were to be determined by the design groups. One group designed a delta wing/body carrier with the orbiter nested within the fuselage of the carrier, and the other group produced a blended cranked-delta wing/body carrier with the orbiter in the more conventional piggyback configuration. Each carrier used liquid hydrogen-fueled turbofanramjet engines, with data provided by General Electric Aircraft Engine Group. While one orbiter used a full-scale Space Shuttle Main Engine (SSME), the other orbiter employed a half-scale SSME coupled with scramjet engines, with data again provided by General Electric. The two groups conceptual designs, along with the technical trade-offs, difficulties, and details that surfaced during the design process are presented.

Taking a Concept to Commercialization: Designing Relevant Tests to Address Safety.

PubMed

Ferrara, Lisa A

2016-04-01

Taking a product from concept to commercialization requires careful navigation of the regulatory pathway through a series of steps: (A) moving the idea through proof of concept and beyond; (B) evaluating new technologies that may provide added value to the idea; (C) designing appropriate test strategies and protocols; and (D) evaluating and mitigating risks. Moving an idea from the napkin stage of development to the final product requires a team effort. When finished, the product rarely resembles the original design, but careful steps throughout the product life cycle ensure that the product meets the vision.

Viewer-centered and body-centered frames of reference in direct visuomotor transformations.

PubMed

Carrozzo, M; McIntyre, J; Zago, M; Lacquaniti, F

1999-11-01

It has been hypothesized that the end-point position of reaching may be specified in an egocentric frame of reference. In most previous studies, however, reaching was toward a memorized target, rather than an actual target. Thus, the role played by sensorimotor transformation could not be disassociated from the role played by storage in short-term memory. In the present study the direct process of sensorimotor transformation was investigated in reaching toward continuously visible targets that need not be stored in memory. A virtual reality system was used to present visual targets in different three-dimensional (3D) locations in two different tasks, one with visual feedback of the hand and arm position (Seen Hand) and the other without such feedback (Unseen Hand). In the Seen Hand task, the axes of maximum variability and of maximum contraction converge toward the mid-point between the eyes. In the Unseen Hand task only the maximum contraction correlates with the sight-line and the axes of maximum variability are not viewer-centered but rotate anti-clockwise around the body and the effector arm during the move from the right to the left workspace. The bulk of findings from these and previous experiments support the hypothesis of a two-stage process, with a gradual transformation from viewer-centered to body-centered and arm-centered coordinates. Retinal, extra-retinal and arm-related signals appear to be progressively combined in superior and inferior parietal areas, giving rise to egocentric representations of the end-point position of reaching.

Immature Stages of Development in the Parasitoid Wasp, Diachasmimorpha longicaudata

PubMed Central

Paladino, Leonela Zusel Carabajal; Papeschi, Alba Graciela; Cladera, Jorge Luis

2010-01-01

The morphological changes experienced during the immature stages of the solitary parasitoid Diachasmimorpha longicaudata (Ashmead) (Hymenoptera: Braconidae: Opiinae) were studied. This natural enemy of several species of tephritid fruit flies is widely used in biological control strategies. Immature stages are poorly understood in endoparasitoids because they exist within the host. In the present work, developmental processes are described for this species, reared in Ceratitis capitata (Wiedemann) (Diptera: Tephritidae) larvae under controlled environmental conditions. At 25° C, 85% RH, and with an 18:6 L:D photoperiod, preimaginal development takes about 16 days. Five preimaginal stages can be described: egg, three larval instars, prepupa, pupa, and pharate adult. Superparasitism was found in 20% of the host pupae, and the number of oviposition scars was positively correlated with the number of parasitoid larvae per host puparium. The results are compared and discussed with previous studies on related species. PMID:20569133

Bevacizumab, Cisplatin, Radiation Therapy, and Fluorouracil in Treating Patients With Stage IIB, Stage III, Stage IVA, or Stage IVB Nasopharyngeal Cancer

ClinicalTrials.gov

2018-01-04

Stage II Nasopharyngeal Keratinizing Squamous Cell Carcinoma AJCC v7; Stage III Nasopharyngeal Keratinizing Squamous Cell Carcinoma AJCC v7; Stage III Nasopharyngeal Undifferentiated Carcinoma AJCC v7; Stage IV Nasopharyngeal Keratinizing Squamous Cell Carcinoma AJCC v7; Stage IV Nasopharyngeal Undifferentiated Carcinoma AJCC v7

Orion EM-1 Interim Cryogenic Propulsion Stage (ICPS) move from HIF to DOC

NASA Image and Video Library

2017-04-12

The Orion EM-1 Interim Cryogenic Propulsion Stage is moved from the Horizontal Integration Facility (HIF) to the Delta Operations Center (DOC) at Cape Canaveral Air Force Station to continue processing for it's future mission on the Space Launch System rocket.

Five-year Results of Whole Breast Intensity Modulated Radiation Therapy for the Treatment of Early Stage Breast Cancer: The Fox Chase Cancer Center Experience

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

Keller, Lanea M.M., E-mail: Lanea.Keller@fccc.edu; Sopka, Dennis M.; Li Tianyu

Purpose: To report the 5-year outcomes using whole-breast intensity-modulated radiation therapy (IMRT) for the treatment of early-stage-breast cancer at the Fox Chase Cancer Center. Methods and Materials: A total of 946 women with early-stage breast cancer (stage 0, I, or II) were treated with IMRT after surgery with or without systemic therapy from 2003-2010. Whole-breast radiation was delivered via an IMRT technique with a median whole-breast radiation dose of 46 Gy and median tumor bed boost of 14 Gy. Endpoints included local-regional recurrence, cosmesis, and late complications. Results: With a median follow-up of 31 months (range, 1-97 months), there weremore » 12 ipsilateral breast tumor recurrences (IBTR) and one locoregional recurrence. The 5-year actuarial IBTR and locoregional recurrence rates were 2.0% and 2.4%. Physician-reported cosmestic outcomes were available for 645 patients: 63% were considered 'excellent', 33% 'good', and <1.5% 'fair/poor'. For physician-reported cosmesis, boost doses {>=}16 Gy, breast size >900 cc, or boost volumes >34 cc were significantly associated with a 'fair/poor' cosmetic outcome. Fibrosis, edema, erythema, and telangectasia were also associated with 'fair/poor' physician-reported cosmesis; erythema and telangectasia remained significant on multivariate analysis. Patient-reported cosmesis was available for 548 patients, and 33%, 50%, and 17% of patients reported 'excellent', 'good', and 'fair/poor' cosmesis, respectively. The use of a boost and increased boost volume: breast volume ratio were significantly associated with 'fair/poor' outcomes. No parameter for patient-reported cosmesis was significant on multivariate analysis. The chances of experiencing a treatment related effect was significantly associated with a boost dose {>=}16 Gy, receipt of chemotherapy and endocrine therapy, large breast size, and electron boost energy. Conclusions: Whole-breast IMRT is associated with very low rates of local recurrence at 5

Esophageal Resection for End-Stage Achalasia.

PubMed

Aiolfi, Alberto; Asti, Emanuele; Bonitta, Gianluca; Siboni, Stefano; Bonavina, Luigi

2018-04-01

Achalasia is a rare disease characterized by impaired lower esophageal sphincter relaxation loss and of peristalsis in the esophageal body. Endoscopic balloon dilation and laparoscopic surgical myotomy have been established as initial treatment modalities. Indications and outcomes of esophagectomy in the management of end-stage achalasia are less defined. A literature search was conducted to identify all reports on esophagectomy for end-stage achalasia between 1987 and 2017. MEDLINE, Embase, and Cochrane databases were consulted matching the terms "achalasia," "end-stage achalasia," "esophagectomy," and "esophageal resection." Seventeen articles met the inclusion criteria and 1422 patients were included in this narrative review. Most of the patients had previous multiple endoscopic and/or surgical treatments. Esophagectomy was performed through a transthoracic (74%) or a transhiatal (26%) approach. A thoracoscopic approach was used in a minority of patients and seemed to be safe and effective. In 95 per cent of patients, the stomach was used as an esophageal substitute. The mean postoperative morbidity rate was 27.1 per cent and the mortality rate 2.1 per cent. Symptom resolution was reported in 75 to 100 per cent of patients over a mean follow-up of 43 months. Only five series including 195 patients assessed the long-term follow-up (>5 years) after reconstruction with gastric or colon conduits, and the results seem similar. Esophagectomy for end-stage achalasia is safe and effective in tertiary referral centers. A thoracoscopic approach is a feasible and safe alternative to thoracotomy and may replace the transhiatal route in the future.

Centers Made Simple: A Management and Activity Guide

ERIC Educational Resources Information Center

Reynolds, Laureen

2005-01-01

Drawing from her own experiences, teacher and author Laureen Reynolds shares management strategies, helpful suggestions, and quick tips to take the mystery out of setting up centers and demonstrates how to make the most of valuable classroom time. The activities outlined in this book are designed to appeal to students of all abilities, and range…

Design of Center-TRACON Automation System

NASA Technical Reports Server (NTRS)

Erzberger, Heinz; Davis, Thomas J.; Green, Steven

1993-01-01

A system for the automated management and control of terminal area traffic, referred to as the Center-TRACON Automation System (CTAS), is being developed at NASA Ames Research Center. In a cooperative program, NASA and FAA have efforts underway to install and evaluate the system at the Denver area and Dallas/Ft. Worth area air traffic control facilities. This paper will review CTAS architecture, and automation functions as well as the integration of CTAS into the existing operational system. CTAS consists of three types of integrated tools that provide computer-generated advisories for both en-route and terminal area controllers to guide them in managing and controlling arrival traffic efficiently. One tool, the Traffic Management Advisor (TMA), generates runway assignments, landing sequences and landing times for all arriving aircraft, including those originating from nearby feeder airports. TMA also assists in runway configuration control and flow management. Another tool, the Descent Advisor (DA), generates clearances for the en-route controllers handling arrival flows to metering gates. The DA's clearances ensure fuel-efficient and conflict free descents to the metering gates at specified crossing times. In the terminal area, the Final Approach Spacing Tool (FAST) provides heading and speed advisories that help controllers produce an accurately spaced flow of aircraft on the final approach course. Data bases consisting of several hundred aircraft performance models, airline preferred operational procedures, and a three dimensional wind model support the operation of CTAS. The first component of CTAS, the Traffic Management Advisor, is being evaluated at the Denver TRACON and the Denver Air Route Traffic Control Center. The second component, the Final Approach Spacing Tool, will be evaluated in several stages at the Dallas/Fort Worth Airport beginning in October 1993. An initial stage of the Descent Advisor tool is being prepared for testing at the Denver Center

The SLS Stages Intertank Structural Test Assembly (STA) arrives at MSFC

NASA Image and Video Library

2018-03-08

The SLS Stages Intertank Structural Test Assembly (STA) is rolling off the NASA Pegasus Barge at the MSFC Dock enroute to the MSFC 4619 Load Test Annex test facility for qualification testing via MSFC West Test Area. STA enters West Test Area from intersection of Dodd and Saturn roads. Onlookers take photos with Historic Dynamic Test Stand in background.

Designing the Ares I Crew Launch Vehicle Upper Stage Element and Integrating the Stack at NASA's Marshall Space Flight Center

NASA Technical Reports Server (NTRS)

Lyles, Garry; Otte, Neil E.

2008-01-01

transportation system for missions to the International Space Station in the next decade and to explore the Moon and establish an outpost around the 2020 timeframe.4 Based on this extensive study, NASA selected the Ares I crew launch vehicle configuration and the heavy-lift Ares V cargo launch vehicle (fig 1). This paper will give an overview of NASA's approach to integrating the Ares I vehicle stack using capabilities and assets that are resident in Marshall's Engineering Directorate, working in partnership with other NASA Centers and the U.S. aerospace industry. It also will provide top-level details on the progress of the in-house design of the Ares I vehicle's upper stage element.

Using a pattern-centered approach to assess sexual risk-taking in study abroad students.

PubMed

Marcantonio, Tiffany; Angelone, D J; Sledjeski, Eve

2016-01-01

The purpose of this study was to examine the impact of several potential factors related to sexually risky behaviors in study abroad students. The authors utilized a pattern-centered analysis to identify specific groups that can be targeted for intervention. The sample consisted of 173 students who studied abroad in a variety of international locations for an average of 4 months. Participants completed questionnaires informed by the Triandis Theory of Interpersonal Behavior that have been predictive of risky sex in traditional traveling environments. The analyses revealed 3 different pathways for risky sexual behavior: Environmental involvement, historical condom use, and intentions to engage in risky sex. These findings can be used for identification of specific high-risk groups of students who can be targeted for predeparture prevention programs.

Health care employee perceptions of patient-centered care.

PubMed

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

2015-03-01

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

Overview of Transonic to Hypersonic Stage Separation Tool Development for Multi-Stage-to-Orbit Concepts

NASA Technical Reports Server (NTRS)

Murphy, Kelly J.; Bunning, Pieter G.; Pamadi, Bandu N.; Scallion, William I.; Jones, Kenneth M.

2004-01-01

An overview of research efforts at NASA in support of the stage separation and ascent aerothermodynamics research program is presented. The objective of this work is to develop a synergistic suite of experimental, computational, and engineering tools and methods to apply to vehicle separation across the transonic to hypersonic speed regimes. Proximity testing of a generic bimese wing-body configuration is on-going in the transonic (Mach numbers 0.6, 1.05, and 1.1), supersonic (Mach numbers 2.3, 3.0, and 4.5) and hypersonic (Mach numbers 6 and 10) speed regimes in four wind tunnel facilities at the NASA Langley Research Center. An overset grid, Navier-Stokes flow solver has been enhanced and demonstrated on a matrix of proximity cases and on a dynamic separation simulation of the bimese configuration. Steady-state predictions with this solver were in excellent agreement with wind tunnel data at Mach 3 as were predictions via a Cartesian-grid Euler solver. Experimental and computational data have been used to evaluate multi-body enhancements to the widely-used Aerodynamic Preliminary Analysis System, an engineering methodology, and to develop a new software package, SepSim, for the simulation and visualization of vehicle motions in a stage separation scenario. Web-based software will be used for archiving information generated from this research program into a database accessible to the user community. Thus, a framework has been established to study stage separation problems using coordinated experimental, computational, and engineering tools.

Advanced Hepatocellular Carcinoma: Which Staging Systems Best Predict Prognosis?

PubMed Central

Huitzil-Melendez, Fidel-David; Capanu, Marinela; O'Reilly, Eileen M.; Duffy, Austin; Gansukh, Bolorsukh; Saltz, Leonard L.; Abou-Alfa, Ghassan K.

2010-01-01

Purpose The purpose of cancer staging systems is to accurately predict patient prognosis. The outcome of advanced hepatocellular carcinoma (HCC) depends on both the cancer stage and the extent of liver dysfunction. Many staging systems that include both aspects have been developed. It remains unknown, however, which of these systems is optimal for predicting patient survival. Patients and Methods Patients with advanced HCC treated over a 5-year period at Memorial Sloan-Kettering Cancer Center were identified from an electronic medical record database. Patients with sufficient data for utilization in all staging systems were included. TNM sixth edition, Okuda, Barcelona Clinic Liver Cancer (BCLC), Cancer of the Liver Italian Program (CLIP), Chinese University Prognostic Index (CUPI), Japan Integrated Staging (JIS), and Groupe d'Etude et de Traitement du Carcinome Hepatocellulaire (GETCH) systems were ranked on the basis of their accuracy at predicting survival by using concordance index (c-index). Other independent prognostic variables were also identified. Results Overall, 187 eligible patients were identified and were staged by using the seven staging systems. CLIP, CUPI, and GETCH were the three top-ranking staging systems. BCLC and TNM sixth edition lacked any meaningful prognostic discrimination. Performance status, AST, abdominal pain, and esophageal varices improved the discriminatory ability of CLIP. Conclusion In our selected patient population, CLIP, CUPI, and GETCH were the most informative staging systems in predicting survival in patients with advanced HCC. Prospective validation is required to determine if they can be accurately used to stratify patients in clinical trials and to direct the appropriate need for systemic therapy versus best supportive care. BCLC and TNM sixth edition were not helpful in predicting survival outcome, and their use is not supported by our data. PMID:20458042

Final priority; National Institute on Disability and Rehabilitation Research--Disability and Rehabilitation Research Projects and Centers Program--Rehabilitation Engineering Research Centers. Final priority.

PubMed

2013-06-14

The Assistant Secretary for Special Education and Rehabilitative Services announces a priority for a Rehabilitation Engineering Research Center (RERC) on Universal Interfaces and Information Technology Access under the Disability and Rehabilitation Research Projects and Centers Program administered by the National Institute on Disability and Rehabilitation Research (NIDRR). The Assistant Secretary may use this priority for a competition in fiscal year (FY) 2013 and later years. We take this action to focus research attention on areas of national need. We intend to use this priority to improve outcomes for individuals with disabilities.

Frederick National Lab Collaborates with Moffitt Cancer Center on HPV and Oral Cancer | FNLCR Staging

Cancer.gov

The Frederick National Lab and Moffitt Cancer Center have established a collaboration to research antibody responses against the human papillomavirus (HPV) in males following administration of the Gardasil vaccine. The vaccine prevents HPV infections

Kinetics of the electronic center annealing in Al2O3 crystals

NASA Astrophysics Data System (ADS)

Kuzovkov, V. N.; Kotomin, E. A.; Popov, A. I.

2018-04-01

The experimental annealing kinetics of the primary electronic F, F+ centers and dimer F2 centers observed in Al2O3 produced under neutron irradiation were carefully analyzed. The developed theory takes into account the interstitial ion diffusion and recombination with immobile F-type and F2-centers, as well as mutual sequential transformation with temperature of three types of experimentally observed dimer centers which differ by net charges (0, +1, +2) with respect to the host crystalline sites. The relative initial concentrations of three types of F2 electronic defects before annealing are obtained, along with energy barriers between their ground states as well as the relaxation energies.

Wooden Spaceships: Human-Centered Vehicle Design for Space

NASA Technical Reports Server (NTRS)

Twyford, Evan

2009-01-01

Presentation will focus on creative human centered design solutions in relation to manned space vehicle design and development in the NASA culture. We will talk about design process, iterative prototyping, mockup building and user testing and evaluation. We will take an inside look at how new space vehicle concepts are developed and designed for real life exploration scenarios.

Nurses' experiences using a nursing information system: early stage of technology implementation.

PubMed

Lee, Ting-Ting

2007-01-01

Adoption of information technology in nursing practice has become a trend in healthcare. The impact of this technology on users has been widely studied, but little attention has been given to its influence at the beginning stage of implementation. Knowing the barriers to adopting technology could shorten this transition stage and minimize its negative influences. The purpose of this study was to explore nurses' experiences in the early stage of implementing a nursing information system. Focus groups were used to collect data at a medical center in Taiwan. The results showed that nurses had problems with the system's content design, had insufficient training, were concerned about data security, were stressed by added work, and experienced poor interdisciplinary cooperation. To smooth this beginning stage, the author recommends involving nurses early in the system design, providing sufficient training in keyboard entry skills, redesigning workflow, and improving interdisciplinary communication.

Neoadjuvant Systemic Therapy Use for Younger Patients with Breast Cancer Treated in Different Types of Cancer Centers Across the United States.

PubMed

Mohiuddin, Jahan J; Deal, Allison M; Carey, Lisa A; Lund, Jennifer L; Baker, Brock R; Zagar, Timothy M; Jones, Ellen L; Marks, Lawrence B; Chen, Ronald C

2016-11-01

Multiple clinical trials have shown that neoadjuvant systemic therapy has a benefit in women who are borderline lumpectomy candidates and in those with locally advanced breast cancers by reducing the mastectomy rate and making inoperable tumors operable. The study aim was to examine the patterns of neoadjuvant chemotherapy and endocrine therapy use among younger women in the United States treated at different types of cancer centers. Data from the National Cancer Data Base for 118,086 women younger than 65 years with clinical stage IIA (T2N0 only) to IIIC breast cancer. Following the National Comprehensive Cancer Network guideline categorization, patients were grouped into those who were borderline lumpectomy candidates (clinical stage IIA [T2N0 only], IIB, or IIIA [T3N1 only]) or those with locally advanced disease (clinical stage IIIA [T0-3N2 only], IIIB, or IIIC). The main outcome was the proportion of women who received neoadjuvant systemic therapy. Use of neoadjuvant chemotherapy ranged from 17% (stage IIA) to 79% (stage IIIB). Across almost all stage and receptor subtypes, the use was lower in community vs academic centers. On multivariable analysis, use of neoadjuvant chemotherapy was decreased in community vs academic centers (borderline lumpectomy candidates: adjusted risk ratio = 0.73; 95% CI, 0.69-0.77; locally advanced disease: adjusted risk ratio = 0.78; 95% CI, 0.74-0.83). Use of guideline-concordant neoadjuvant chemotherapy is significantly higher among women treated at academic vs community centers in young and healthy women who do not commonly have contraindications to this treatment. Our study identified a potential disparity in cancer care by type of center where patients receive treatment. Copyright © 2016 American College of Surgeons. Published by Elsevier Inc. All rights reserved.

TBCC Fan Stage Operability and Performance

NASA Technical Reports Server (NTRS)

Suder, Kenneth L.

2007-01-01

NASA s Fundamental Aeronautics Program is investigating turbine-based propulsion systems for access to space because it provides the potential for aircraft-like, space-launch operations that may significantly reduce launch costs and improve safety. Studies performed under NASA s NGLT and the NASP High Speed Propulsion Assessment (HiSPA) program indicated a variable cycle turbofan/ramjet was the best configuration to satisfy access-to-space mission requirements because this configuration maximizes the engine thrust-to-weight ratio while minimizing frontal area. To this end, NASA and GE teamed to design a Mach 4 variable cycle turbofan/ramjet engine for access to space. To enable the wide operating range of a Mach 4+ variable cycle turbofan ramjet required the development of a unique fan stage design capable of multi-point operation to accommodate variations in bypass ratio (10X), fan speed (7X), inlet mass flow (3.5X), inlet pressure (8X), and inlet temperature (3X). The primary goal of the fan stage was to provide a high pressure ratio level with good efficiency at takeoff through the mid range of engine operation, while avoiding stall and losses at the higher flight Mach numbers, without the use of variable inlet guide vanes. Overall fan performance and operability therefore requires major consideration, as competing goals at different operating points and aeromechanical issues become major drivers in the design. To mitigate risk of meeting the unique design requirements for the fan stage, NASA and GE teamed to design and build a 57% engine scaled fan stage to be tested in NASA s transonic compressor facility. The objectives of this test are to assess the aerodynamic and aero mechanic performance and operability characteristics of the fan stage over the entire range of engine operation including: 1) sea level static take-off, 2) transition over large swings in fan bypass ratio, 3) transition from turbofan to ramjet, and 4) fan windmilling operation at high Mach

Maximally efficient two-stage screening: Determining intellectual disability in Taiwanese military conscripts.

PubMed

Chien, Chia-Chang; Huang, Shu-Fen; Lung, For-Wey

2009-01-27

The purpose of this study was to apply a two-stage screening method for the large-scale intelligence screening of military conscripts. We collected 99 conscripted soldiers whose educational levels were senior high school level or lower to be the participants. Every participant was required to take the Wisconsin Card Sorting Test (WCST) and the Wechsler Adult Intelligence Scale-Revised (WAIS-R) assessments. Logistic regression analysis showed the conceptual level responses (CLR) index of the WCST was the most significant index for determining intellectual disability (ID; FIQ ≤ 84). We used the receiver operating characteristic curve to determine the optimum cut-off point of CLR. The optimum one cut-off point of CLR was 66; the two cut-off points were 49 and 66. Comparing the two-stage window screening with the two-stage positive screening, the area under the curve and the positive predictive value increased. Moreover, the cost of the two-stage window screening decreased by 59%. The two-stage window screening is more accurate and economical than the two-stage positive screening. Our results provide an example for the use of two-stage screening and the possibility of the WCST to replace WAIS-R in large-scale screenings for ID in the future.

Maximally efficient two-stage screening: Determining intellectual disability in Taiwanese military conscripts

PubMed Central

Chien, Chia-Chang; Huang, Shu-Fen; Lung, For-Wey

2009-01-01

Objective: The purpose of this study was to apply a two-stage screening method for the large-scale intelligence screening of military conscripts. Methods: We collected 99 conscripted soldiers whose educational levels were senior high school level or lower to be the participants. Every participant was required to take the Wisconsin Card Sorting Test (WCST) and the Wechsler Adult Intelligence Scale-Revised (WAIS-R) assessments. Results: Logistic regression analysis showed the conceptual level responses (CLR) index of the WCST was the most significant index for determining intellectual disability (ID; FIQ ≤ 84). We used the receiver operating characteristic curve to determine the optimum cut-off point of CLR. The optimum one cut-off point of CLR was 66; the two cut-off points were 49 and 66. Comparing the two-stage window screening with the two-stage positive screening, the area under the curve and the positive predictive value increased. Moreover, the cost of the two-stage window screening decreased by 59%. Conclusion: The two-stage window screening is more accurate and economical than the two-stage positive screening. Our results provide an example for the use of two-stage screening and the possibility of the WCST to replace WAIS-R in large-scale screenings for ID in the future. PMID:21197345

No Value for Routine Chest Radiography in the Work-Up of Early Stage Cervical Cancer Patients

PubMed Central

Hoogendam, Jacob P.; Zweemer, Ronald P.; Verkooijen, Helena M.; de Jong, Pim A.; van den Bosch, Maurice A. A. J.; Verheijen, René H. M.; Veldhuis, Wouter B.

2015-01-01

Aim Evidence supporting the recommendation to include chest radiography in the work-up of all cervical cancer patients is limited. We investigated the diagnostic value of routine chest radiography in cervical cancer staging. Methods All consecutive cervical cancer patients who presented at our tertiary referral center in the Netherlands (January 2006 – September 2013), and for whom ≥6 months follow-up was available, were included. As part of the staging procedure, patients underwent a routine two-directional digital chest radiograph. Findings were compared to a composite reference standard consisting of all imaging studies and histology obtained during the 6 months following radiography. Results Of the 402 women who presented with cervical cancer, 288 (71.6%) underwent chest radiography and had ≥6 months follow-up. Early clinical stage (I/II) cervical cancer was present in 244/288 (84.7%) women, while 44 (15.3%) presented with advanced disease (stage III/IV). The chest radiograph of 1 woman – with advanced pre-radiograph stage (IVA) disease – showed findings consistent with pulmonary metastases. Radiographs of 7 other women – 4 early, 3 advanced stage disease – were suspicious for pulmonary metastases which was confirmed by additional imaging in only 1 woman (with pre-radiograph advanced stage (IIIB) disease) and excluded in 6 cases, including all women with early stage disease. In none of the 288 women were thoracic skeletal metastases identified on imaging or during 6 months follow up. Radiography was unremarkable in 76.4% of the study population, and showed findings unrelated to the cervical carcinoma in 21.2%. Conclusion Routine chest radiography was of no value for any of the early stage cervical cancer patients presenting at our tertiary center over a period of 7.7 years. PMID:26135733

No Value for Routine Chest Radiography in the Work-Up of Early Stage Cervical Cancer Patients.

PubMed

Hoogendam, Jacob P; Zweemer, Ronald P; Verkooijen, Helena M; de Jong, Pim A; van den Bosch, Maurice A A J; Verheijen, René H M; Veldhuis, Wouter B

2015-01-01

Evidence supporting the recommendation to include chest radiography in the work-up of all cervical cancer patients is limited. We investigated the diagnostic value of routine chest radiography in cervical cancer staging. All consecutive cervical cancer patients who presented at our tertiary referral center in the Netherlands (January 2006 - September 2013), and for whom ≥6 months follow-up was available, were included. As part of the staging procedure, patients underwent a routine two-directional digital chest radiograph. Findings were compared to a composite reference standard consisting of all imaging studies and histology obtained during the 6 months following radiography. Of the 402 women who presented with cervical cancer, 288 (71.6%) underwent chest radiography and had ≥6 months follow-up. Early clinical stage (I/II) cervical cancer was present in 244/288 (84.7%) women, while 44 (15.3%) presented with advanced disease (stage III/IV). The chest radiograph of 1 woman - with advanced pre-radiograph stage (IVA) disease - showed findings consistent with pulmonary metastases. Radiographs of 7 other women - 4 early, 3 advanced stage disease - were suspicious for pulmonary metastases which was confirmed by additional imaging in only 1 woman (with pre-radiograph advanced stage (IIIB) disease) and excluded in 6 cases, including all women with early stage disease. In none of the 288 women were thoracic skeletal metastases identified on imaging or during 6 months follow up. Radiography was unremarkable in 76.4% of the study population, and showed findings unrelated to the cervical carcinoma in 21.2%. Routine chest radiography was of no value for any of the early stage cervical cancer patients presenting at our tertiary center over a period of 7.7 years.

STS-98 crew members take part in CEIT

NASA Technical Reports Server (NTRS)

2000-01-01

STS-98 Mission Specialist Robert Curbeam (right) raises his arms as he checks out equipment inside the U.S. Lab, Destiny. At left of center is Mission Specialist Marsha Ivins. Curbeam and Ivins, along with other crew members, are taking part in Crew Equipment Interface Test activities becoming familiar with equipment they will be handling during the mission. Others in the crew are Commander Ken Cockrell, Pilot Mark Polansky and Mission Specialist Thomas Jones. The mission will be transporting the Lab to the International Space Station with five system racks already installed inside of the module. With delivery of electronics in the lab, electrically powered attitude control for Control Moment Gyroscopes will be activated. The STS-98 launch is scheduled for Jan. 18, 2001.

Efficacy and safety of Apatinib in stage IV sarcomas: experience of a major sarcoma center in China.

PubMed

Li, Feng; Liao, Zhichao; Zhao, Jun; Zhao, Gang; Li, Xubin; Du, Xiaoling; Yang, Yun; Yang, Jilong

2017-09-08

This study was conducted to review the efficacy and safety of Apatinib in stage IV sarcoma patients who failed previous chemotherapy. The clinical information on 16 patients with stage IV sarcomas who failed in prior chemotherapy and subsequently received Apatinib treatment was collected. Apatinib was given 500mg/daily and 4 weeks as a cycle. All patients had at least one measurable extracranial tumor according to Response Evaluation Criteria In Solid Tumors 1.0 criteria. Progression free survival (PFS), overall survival (OS), objective response rate (ORR), disease control rate (DCR) and treatment-related adverse effects (AEs) were reviewed and evaluated. Patients was administered Apatinib for 0 to 9 cycles with the median of 3.2 cycles. Median follow-up time was 8.4 months (1 to 12 months). Ten of 16 patients received at least 1 complete cycle of Apatinib treatment were eligible for the efficacy analysis. The median PFS was 8.84 months. Two patients achieved partial response (PR) and 6 patients achieved stable disease (SD). Two patients were evaluated as progression disease (PD) and one patient died of disease progression. The ORR was 20.0% (2/10) and the DCR was 80.0% (8/10). The most common grade 3/4 treatment-related AEs were hypertension (18.7%), hand-foot syndrome (12.5%) and proteinuria (6.3%). No drug-related severe AEs occurred. CApatinib treatment in this exploratory study exhibited objective efficacy and manageable toxicity in stage IV sarcoma patients who failed in chemotherapy. This result supports future random controlled trial to further define Apatinib activity in stage IV sarcomas.

[DRG-based cost analysis of inpatient conservative treatment of stage III/IV peripheral arterial occlusive disease].

PubMed

Heidrich, H; Rogatti, W; Altmann, E; Bauersachs, R; Diehm, C; Fahrig, C; Lawall, H; Ranft, J; Schenker, M; Schweizer, H J; Stiegler, H; Wilke, M

2003-11-01

DRG-based cost analysis of inpatient conservative treatment of PAD stage III/IV BACKGROUND: In a prospective study carried out by the German Society of Angiology and the DRG Competence Center, Munich, the question was investigated whether the costs of conservative treatment of patients with PAOD stage III/IV (DRG F65) are adequately represented within the current G-DRG system. METHODS UND PATIENTS: Between September 1 and December 16, 2002, a total of 704 patients with DRG F65 (peripheral vascular diseases) were evaluated at 8 angiologic centers in Germany. Apart from the length of hospital stay, the total costs (cost equivalents) were calculated using a method developed by the DRG Research Group at the University of Münster. Moreover, the study population was compared with a German calculation sample for the DRGs F65A/B, as published by InEK. As it turned out, conservatively treated patients with PAOD stage III or IV (DRGs F65A/B) cause significantly (p < 0.001) higher costs and have significantly (p < 0.001) greater lengths of hospital stay than patients who were also assigned to DRG F65 because of other vascular diseases. At the same time it became clear that angiologic centers treat twice as many patients with critical limb ischemia in comparison with the German average. The reimbursement hitherto estimated by InEK covers not even half the cost actually produced by conservative treatment of PAD stage III/IV. To ensure a performance-related reimbursement, a new basis DRG for patients with PAD stage III/IV has to be created, as has ben proposed by the German Society of Angiology. Otherwise, adequate conservative therapy in accordance with existing guidelines, of patients who cannot be treated surgically or interventionally will not be possible any more in the future.

VLBA Detects Earth's Motion Around the Milky Way's Center

NASA Astrophysics Data System (ADS)

1999-06-01

It takes our Solar System more than 200 million years to orbit the center of the Milky Way Galaxy, 26,000 light-years away. Despite that tremendously long time span, astronomers using the National Science Foundation's (NSF) powerful Very Long Baseline Array (VLBA) radio telescope have shown they can detect this orbital motion in ten days! In addition, they have made a new and more accurate determination of just how long it takes us to circle our Galaxy -- 226 million years. "Not only is this a tremendous technical achievement, but it also has allowed us to greatly strengthen the scientific case for a supermassive black hole at the Galaxy's center -- definitely ruling out a multiple-star system," said Mark Reid of the Harvard-Smithsonian Center for Astrophysics. Reid, along with Anthony Readhead and Rene Vermuelen of Caltech and Robert Treuhaft of the Jet Propulsion Laboratory, announced their discovery at the American Astronomical Society's meeting in Chicago. The scientists used the continent-wide VLBA, part of the NSF's National Radio Astronomy Observatory (NRAO), to observe a radio-wave-emitting object called Sagittarius A* (pronounced "A-star"), that has been thought to mark the exact center of the Milky Way since its discovery more than two decades ago. They were able to measure its position on the sky within nearly one ten-thousandth of a second of arc -- a precision 600,000 times greater than that of the human eye and more than 500 times greater than that of the Hubble Space Telescope. With this precision, the astronomers were able to detect the slight apparent shift in position of Sagittarius A* compared to the positions of much more-distant quasars behind it. That apparent shift was caused by the motion of the Solar System around the Galaxy's center. "From these measurements, we estimate that we are moving at about 135 miles per second in our orbit around the center of the Milky Way," Reid said. "Even though it takes more than 200 million years for us to

Changes in Brain Function in Patients With Stage I, Stage II, Stage III, or Stage IV Ovarian, Primary Peritoneal, or Fallopian Tube Cancer Who Are Receiving Chemotherapy

ClinicalTrials.gov

2018-04-11

Cognitive Side Effects of Cancer Therapy; Malignant Ovarian Epithelial Tumor; Ovarian Brenner Tumor; Ovarian Carcinosarcoma; Ovarian Choriocarcinoma; Ovarian Clear Cell Cystadenocarcinoma; Ovarian Dysgerminoma; Ovarian Embryonal Carcinoma; Ovarian Endometrioid Adenocarcinoma; Ovarian Mixed Germ Cell Tumor; Ovarian Mucinous Cystadenocarcinoma; Ovarian Polyembryoma; Ovarian Sarcoma; Ovarian Seromucinous Carcinoma; Ovarian Serous Cystadenocarcinoma; Ovarian Teratoma; Ovarian Yolk Sac Tumor; Stage I Ovarian Cancer; Stage IA Fallopian Tube Cancer; Stage IA Ovarian Cancer; Stage IA Ovarian Germ Cell Tumor; Stage IB Fallopian Tube Cancer; Stage IB Ovarian Cancer; Stage IB Ovarian Germ Cell Tumor; Stage IC Fallopian Tube Cancer; Stage IC Ovarian Cancer; Stage IC Ovarian Germ Cell Tumor; Stage II Ovarian Cancer; Stage IIA Fallopian Tube Cancer; Stage IIA Ovarian Cancer; Stage IIA Ovarian Germ Cell Tumor; Stage IIB Fallopian Tube Cancer; Stage IIB Ovarian Cancer; Stage IIB Ovarian Germ Cell Tumor; Stage IIC Fallopian Tube Cancer; Stage IIC Ovarian Cancer; Stage IIC Ovarian Germ Cell Tumor; Stage IIIA Fallopian Tube Cancer; Stage IIIA Ovarian Cancer; Stage IIIA Ovarian Germ Cell Tumor; Stage IIIA Primary Peritoneal Cancer; Stage IIIB Fallopian Tube Cancer; Stage IIIB Ovarian Cancer; Stage IIIB Ovarian Germ Cell Tumor; Stage IIIB Primary Peritoneal Cancer; Stage IIIC Fallopian Tube Cancer; Stage IIIC Ovarian Cancer; Stage IIIC Ovarian Germ Cell Tumor; Stage IIIC Primary Peritoneal Cancer; Stage IV Fallopian Tube Cancer; Stage IV Ovarian Cancer; Stage IV Ovarian Germ Cell Tumor; Stage IV Primary Peritoneal Cancer; Undifferentiated Ovarian Carcinoma

Analysis of the lettuce data from the variable pressure growth chamber at NASA Johnson Space Center: A three-stage nested design model

NASA Technical Reports Server (NTRS)

Lee, Tze-San

1992-01-01

A model of three-stage nested experimental design was applied to analyze the lettuce data obtained from the variable pressure growth chamber test bed at NASA-Johnson Space Center. From the results of an application of the analysis of variance and covariance on the data set, it was noted that all of the (uncontrollable) factors, Side, Zone, Height and (controllable) PAR (photosynthetically active radiation), had nonhomogeneous effects on the dry weight of the edible biomass of lettuce per pot. Incidentally, the variations accountable to the (uncontrollable) factorial heterogeneities are merely 9 percent and 17 percent of the total variation for both the first and second crop test, respectively. After adjusting for the PAR as a covariate in the no-intercept model, the accountable variations to all the four factors are 94 percent and 92 percent for the first and the second crop test, respectively. With the use of a no-intercept simple linear regression model, the accountable variations to the factor PAR are 92 percent and 90 percent for the first and the second crop test, respectively. Evidently, the (controllable) factor PAR is the dominating one.

The SLS Stages Intertank Structural Test Assembly (STA) arrives at MSFC

NASA Image and Video Library

2018-03-08

The SLS Stages Intertank Structural Test Assembly (STA) is rolling off the NASA Pegasus Barge at the MSFC Dock enroute to the MSFC 4619 Load Test Annex test facility for qualification testing via MSFC West Test Area. Historic Saturn 1-C test stand on far left, blockhouse 4670 on far right, SLS LH2 test stand, 4693, in center.

Stereotactic Body Radiotherapy for Early-stage Non-small-cell Lung Cancer in Patients 80 Years and Older: A Multi-center Analysis.

PubMed

Cassidy, Richard J; Patel, Pretesh R; Zhang, Xinyan; Press, Robert H; Switchenko, Jeffrey M; Pillai, Rathi N; Owonikoko, Taofeek K; Ramalingam, Suresh S; Fernandez, Felix G; Force, Seth D; Curran, Walter J; Higgins, Kristin A

2017-09-01

Stereotactic body radiotherapy (SBRT) is the standard of care for medically inoperable early-stage non-small-cell lung cancer. Despite the limited number of octogenarians and nonagenarians on trials of SBRT, its use is increasingly being offered in these patients, given the aging cancer population, medical fragility, or patient preference. Our purpose was to investigate the efficacy, safety, and survival of patients ≥ 80 years old treated with definitive lung SBRT. Patients who underwent SBRT were reviewed from 2009 to 2015 at 4 academic centers. Patients diagnosed at ≥ 80 years old were included. Kaplan-Meier and multivariate logistic regression and Cox proportional hazard regression analyses were performed. Recursive partitioning analysis was done to determine a subgroup of patients most likely to benefit from therapy. A total of 58 patients were included, with a median age of 84.9 years (range, 80.1-95.2 years), a median follow-up time of 19.9 months (range, 6.9-64.9 months), a median fraction size of 10.0 Gy (range, 7.0-20.0 Gy), and a median number of fractions of 5.0 (range, 3.0-8.0 fractions). On multivariate analysis, higher Karnofsky performance status (KPS) was associated with higher local recurrence-free survival (hazard ratio [HR], 0.92; P < .01), regional recurrence-free survival (HR, 0.94; P < .01), and overall survival (HR, 0.91; P < .01). On recursive partitioning analysis, patients with KPS ≥ 75 had improved 3-year cancer-specific and overall survival (99.4% and 91.9%, respectively) compared with patients with KPS < 75 (47.8% and 23.6%, respectively; P < .01). Definitive lung SBRT for early-stage non-small-cell lung cancer was efficacious and safe in patients ≥ 80 years old. Patients with a KPS of ≥ 75 derived the most benefit from therapy. Copyright © 2017 Elsevier Inc. All rights reserved.

Designing and implementing a parenting resource center for pregnant teens.

PubMed

Broussard, Anne B; Broussard, Brenda S

2009-01-01

The Resource Center for Young Parents-To-Be is a longstanding and successful grant-funded project that was initiated as a response to an identified community need. Senior-level baccalaureate nursing students and their maternity-nursing instructors are responsible for staffing the resource center's weekly sessions, which take place at a public school site for pregnant adolescents. Childbirth educators interested in working with this population could assist in replicating this exemplary clinical project in order to provide prenatal education to this vulnerable and hard-to-reach group.

Harmonizing the MSSM with the Galactic Center excess

NASA Astrophysics Data System (ADS)

Butter, Anja; Murgia, Simona; Plehn, Tilman; Tait, Tim M. P.

2017-08-01

The minimal supersymmetric setup offers a comprehensive framework to interpret the Fermi-LAT Galactic Center excess. Taking into account experimental, theoretical, and astrophysical uncertainties we can identify valid parameter regions linked to different annihilation channels. They extend to dark matter masses above 250 GeV. There exists a very mild tension between the observed relic density and the annihilation rate in the center of our Galaxy for specific channels. The strongest additional constraints come from the new generation of direct detection experiments, ruling out much of the light and intermediate dark matter mass regime and giving preference to heavier dark matter annihilating into a pair of top quarks.

Cluster analysis for determining distribution center location

NASA Astrophysics Data System (ADS)

Lestari Widaningrum, Dyah; Andika, Aditya; Murphiyanto, Richard Dimas Julian

2017-12-01

Determination of distribution facilities is highly important to survive in the high level of competition in today’s business world. Companies can operate multiple distribution centers to mitigate supply chain risk. Thus, new problems arise, namely how many and where the facilities should be provided. This study examines a fast-food restaurant brand, which located in the Greater Jakarta. This brand is included in the category of top 5 fast food restaurant chain based on retail sales. There were three stages in this study, compiling spatial data, cluster analysis, and network analysis. Cluster analysis results are used to consider the location of the additional distribution center. Network analysis results show a more efficient process referring to a shorter distance to the distribution process.

Ares I and Ares I-X Stage Separation Aerodynamic Testing

NASA Technical Reports Server (NTRS)

Pinier, Jeremy T.; Niskey, Charles J.

2011-01-01

The aerodynamics of the Ares I crew launch vehicle (CLV) and Ares I-X flight test vehicle (FTV) during stage separation was characterized by testing 1%-scale models at the Arnold Engineering Development Center s (AEDC) von Karman Gas Dynamics Facility (VKF) Tunnel A at Mach numbers of 4.5 and 5.5. To fill a large matrix of data points in an efficient manner, an injection system supported the upper stage and a captive trajectory system (CTS) was utilized as a support system for the first stage located downstream of the upper stage. In an overall extremely successful test, this complex experimental setup associated with advanced postprocessing of the wind tunnel data has enabled the construction of a multi-dimensional aerodynamic database for the analysis and simulation of the critical phase of stage separation at high supersonic Mach numbers. Additionally, an extensive set of data from repeated wind tunnel runs was gathered purposefully to ensure that the experimental uncertainty would be accurately quantified in this type of flow where few historical data is available for comparison on this type of vehicle and where Reynolds-averaged Navier-Stokes (RANS) computational simulations remain far from being a reliable source of static aerodynamic data.

A Retrospective Survival Analysis of Anatomic and Prognostic Stage Group Based on the American Joint Committee on Cancer 8th Edition Cancer Staging Manual in Luminal B Human Epidermal Growth Factor Receptor 2-negative Breast Cancer.

PubMed

Xu, Ling; Li, Jiang-Hong; Ye, Jing-Ming; Duan, Xue-Ning; Cheng, Yuan-Jia; Xin, Ling; Liu, Qian; Zhou, Bin; Liu, Yin-Hua

2017-08-20

Current understanding of tumor biology suggests that breast cancer is a group of diseases with different intrinsic molecular subtypes. Anatomic staging system alone is insufficient to provide future outcome information. The American Joint Committee on Cancer (AJCC) expert panel updated the 8th edition of the staging manual with prognostic stage groups by incorporating biomarkers into the anatomic stage groups. In this study, we retrospectively analyzed the data from our center in China using the anatomic and prognostic staging system based on the AJCC 8th edition staging manual. We reviewed the data from January 2008 to December 2014 for cases with Luminal B Human Epidermal Growth Factor Receptor 2 (HER2)-negative breast cancer in our center. All cases were restaged using the AJCC 8th edition anatomic and prognostic staging system. The Kaplan-Meier method and log-rank test were used to compare the survival differences between different subgroups. SPSS software version 19.0 (IBM Corp., Armonk, NY, USA) was used for the statistical analyses. This study consisted of 796 patients with Luminal B HER-negative breast cancer. The 5-year disease-free survival (DFS) of 769 Stage I-III patients was 89.7%, and the 5-year overall survival (OS) of all 796 patients was 91.7%. Both 5-year DFS and 5-year OS were significantly different in the different anatomic and prognostic stage groups. There were 372 cases (46.7%) assigned to a different group. The prognostic Stage II and III patients restaged from anatomic Stage III had significant differences in 5-year DFS (χ2 = 11.319, P= 0.001) and 5-year OS (χ2 = 5.225, P= 0.022). In addition, cases restaged as prognostic Stage I, II, or III from the anatomic Stage II group had statistically significant differences in 5-year DFS (χ2 = 6.510, P= 0.039) but no significant differences in 5-year OS (χ2 = 5.087, P= 0.079). However, the restaged prognostic Stage I and II cases from anatomic Stage I had no statistically significant

Validation: A Family-Centered Communication Skill.

PubMed

Harvey, Pat; Ahmann, Elizabeth

2016-01-01

Family-centered care can seem challenging when family member behavior, choices, attitudes, or emotions are "difficult" or "challenging" to deal with. Yet nurses can develop skills to effectively interact with families in a wide variety of circumstances and then become able to practice family-centered care in any situation that might arise. One particularly useful skill is "validation," which means accepting what the family member says or does as a valid expression of thoughts and feelings in that particular circumstance at that particular time. Validation does not mean there is agreement or acceptance of unsafe behaviors, only that the nurse acknowledges that the family member's concerns and feelings are important and should be listened to and taken seriously, even in the presence of disagreement. Validation, which should be individualized, can take many forms, ranging from providing complete attention to reflection of statements, identification of possible unexpressed emotions, normalization, and finally, a full and genuine sense of connection. Understanding and practicing validation can empower nurses and family members, as well as support effectivefamily-centered communication and problem solving even in challenging circumstances.

Validation: a family-centered communication skill.

PubMed

Harvey, Pat; Ahmann, Elizabeth

2014-01-01

Family-centered care can seem challenging when family member behavior, choices, attitudes, or emotions are "difficult" or "challenging" to deal with. Yet nurses can develop skills to effectively interact with families in a wide variety of circumstances and then become able to practice family-centered care in any situation that might arise. One particularly useful skill is "validation," which means accepting what the family member says or does as a valid expression of thoughts and feelings in that particular circumstance at that particular time. Validation does not mean there is agreement or acceptance of unsafe behaviors, only that the nurse acknowledges that the family member's concerns and feelings are important and should be listened to and taken seriously, even in the presence of disagreement. Validation, which should be individualized, can take many forms, ranging from providing complete attention to reflection of statements, identification of possible unexpressed emotions, normalization, and finally, a full and genuine sense of connection. Understanding and practicing validation can empower nurses and family members, as well as support effective family-centered communication and problem solving, even in challenging circumstances.

[Patient-centered medicine for tuberculosis medical services].

PubMed

Fujita, Akira; Narita, Tomoyo

2012-12-01

necessary patient information among the relevant parties. The regional care pathway was developed by the Tobu Public Health Center. It is currently being used by several other public health centers in Hiroshima. Utilization of these two pathways has resulted in improved adherence, treatment being offered at local clinics, shorter hospitalization and better treatment outcomes. 2. Patient-centered DOTS in Funabashi-city: Akiko UOZUMI (Funabashi-city Public Health Center) In Funabashi-city, all TB patients, including those with LTBI, are treated under DOTS which recognizes and tries to accommodate the various different needs of each individual patient. For example, various types of DOTS are offered, such as pharmacy-based DOTS and DOTS supported by caregivers of nursing homes. This enables public health nurses to take into consideration both the results of risk assessment and convenience for the patient, and choose DOTS which most effectively support the patient. Furthermore, DOTS in principle is offered face-to-face, so that DOTS providers may not only build relationship of trust with the patient, but also to collect and analyze the necessary information regarding the patient and respond timely when problems arise. Such effort has directly contributed to improved default and treatment rate. 3. Hospital DOTS and clinical path for the treatment of tuberculosis: Kentaro SAKASHITA, Akira FUJITA (Tokyo Metropolitan Tama Medical Center) We introduced a version of hospital DOTS at Tama Medical Center (formerly Fuchu Hospital) in 2004. As part of this three-stage version, patients are allowed to progress to the next stage if they meet the step-up criteria. Following the introduction of this hospital DOTS, the occurrence of drug administration-related incidents decreased and support for patient adherence became easier for health care workers than before. In 2006, we developed a clinical path based on this hospital DOTS with consistent eligibility criteria for patients. This clinical

Astronauts Henricks and Kregel take a break during training at WETF

NASA Image and Video Library

1995-02-16

S95-03470 (16 FEB 1995) --- Attired in blue training versions of the orange Shuttle launch and entry garments, astronauts Terence T. (Tom) Henricks, right, and Kevin R. Kregel take a break during a bailout training session at the Johnson Space Center's (JSC) Weightless Environment Training Facility (WET-F). Assigned as commander and pilot, respectively, for the STS-70 mission, the two later joined their crew mates in making use of a nearby 25-feet deep pool to practice parachute landings in water and subsequent deployment of life rafts.

Combustion Dynamics and Stability Modeling of a Liquid Oxygen/RP-2 Oxygen-Rich Staged Combustion Preburner and Thrust Chamber Assembly with Gas-Centered Swirl Coaxial Injector Elements

NASA Technical Reports Server (NTRS)

Casiano, M. J.; Kenny, R. J.; Protz, C. S.; Garcia, C. P.; Simpson, S. P.; Elmore, J. L.; Fischbach, S. R.; Giacomoni, C. B.; Hulka, J. R.

2016-01-01

The Combustion Stability Tool Development (CSTD) project, funded by the Air Force Space and Missile Systems Center, began in March 2015 supporting a renewed interest in the development of a liquid oxygen/hydrocarbon, oxygen-rich combustion engine. The project encompasses the design, assembly, and hot-fire testing of the NASA Marshall Space Flight Center 40-klbf Integrated Test Rig (MITR). The test rig models a staged-combustion configuration by combining an oxygen-rich preburner (ORPB), to generate hot gas, with a thrust chamber assembly (TCA) using gas-centered swirl coaxial injector elements. There are five separately designed interchangeable injectors in the TCA that each contain 19- or 27- injector elements. A companion paper in this JANNAF conference describes the design characteristics, rationale, and fabrication issues for all the injectors. The data acquired from a heavily instrumented rig encompasses several injectors, several operating points, and stability bomb tests. Another companion paper in this JANNAF conference describes this test program in detail. In this paper, dynamic data from the hot-fire testing is characterized and used to identify the responses in the ORPB and TCA. A brief review of damping metrics are discussed and applied as a measure of stability margin for damped acoustic modes. Chug and longitudinal combustion stability models and predictions are described which includes new dynamic models for compressible flow through an orifice and a modification to incorporate a third feed line for inclusion of the fuel-film coolant. Flow-acoustics finite element modeling is used to investigate the anticipated TCA acoustics, the effects of injector element length on stability margin, and the potential use of an ORPB orifice trip ring for improving longitudinal stability margin.

Carboplatin and Paclitaxel With or Without Cisplatin and Radiation Therapy in Treating Patients With Stage I, Stage II, Stage III, or Stage IVA Endometrial Cancer

ClinicalTrials.gov

2018-01-09

Endometrial Clear Cell Adenocarcinoma; Endometrial Serous Adenocarcinoma; Stage IA Uterine Corpus Cancer; Stage IB Uterine Corpus Cancer; Stage II Uterine Corpus Cancer; Stage IIIA Uterine Corpus Cancer; Stage IIIB Uterine Corpus Cancer; Stage IIIC Uterine Corpus Cancer; Stage IVA Uterine Corpus Cancer

Small Launch Vehicle Concept Development for Affordable Multi-Stage Inline Configurations

NASA Technical Reports Server (NTRS)

Beers, Benjamin R.; Waters, Eric D.; Philips, Alan D.; Threet, Grady E., Jr.

2014-01-01

The Advanced Concepts Office at NASA's George C. Marshall Space Flight Center conducted a study of two configurations of a three stage, inline, liquid propellant small launch vehicle concept developed on the premise of maximizing affordability by targeting a specific payload capability range based on current industry demand. The initial configuration, NESC-1, employed liquid oxygen as the oxidizer and rocket propellant grade kerosene as the fuel in all three stages. The second and more heavily studied configuration, NESC-4, employed liquid oxygen and rocket propellant grade kerosene on the first and second stages and liquid oxygen and liquid methane fuel on the third stage. On both vehicles, sensitivity studies were first conducted on specific impulse and stage propellant mass fraction in order to baseline gear ratios and drive the focus of concept development. Subsequent sensitivity and trade studies on the NESC-4 configuration investigated potential impacts to affordability due to changes in gross liftoff weight and/or vehicle complexity. Results are discussed at a high level to understand the severity of certain sensitivities and how those trade studies conducted can either affect cost, performance or both.

Small Launch Vehicle Concept Development for Affordable Multi-Stage Inline Configurations

NASA Technical Reports Server (NTRS)

Beers, Benjamin R.; Waters, Eric D.; Philips, Alan D.; Threet, Grady E. Jr.

2013-01-01

The Advanced Concepts Office at NASA's George C. Marshall Space Flight Center conducted a study of two configurations of a three-stage, inline, liquid propellant small launch vehicle concept developed on the premise of maximizing affordability by targeting a specific payload capability range based on current industry demand. The initial configuration, NESC-1, employed liquid oxygen as the oxidizer and rocket propellant grade kerosene as the fuel in all three stages. The second and more heavily studied configuration, NESC-4, employed liquid oxygen and RP-1 on the first and second stages and liquid oxygen and liquid methane fuel on the third stage. On both vehicles, sensitivity studies were first conducted on specific impulse and stage propellant mass fraction in order to baseline gear ratios and drive the focus of concept development. Subsequent sensitivity and trade studies on the NESC-4 concept investigated potential impacts to affordability due to changes in gross liftoff weight and/or vehicle complexity. Results are discussed at a high level to understand the impact severity of certain sensitivities and how those trade studies conducted can either affect cost, performance, or both.

Small Launch Vehicle Concept Development for Affordable Multi-Stage Inline Configurations

NASA Technical Reports Server (NTRS)

Beers, Benjamin R.; Waters, Eric D.; Philips, Alan D.; Threet, Grady E., Jr.

2014-01-01

The Advanced Concepts Office at NASA's George C. Marshall Space Flight Center conducted a study of two configurations of a three-stage, inline, liquid propellant small launch vehicle concept developed on the premise of maximizing affordability by targeting a specific payload capability range based on current and future industry demand. The initial configuration, NESC-1, employed liquid oxygen as the oxidizer and rocket propellant grade kerosene as the fuel in all three stages. The second and more heavily studied configuration, NESC-4, employed liquid oxygen and rocket propellant grade kerosene on the first and second stages and liquid oxygen and liquid methane fuel on the third stage. On both vehicles, sensitivity studies were first conducted on specific impulse and stage propellant mass fraction in order to baseline gear ratios and drive the focus of concept development. Subsequent sensitivity and trade studies on the NESC-4 concept investigated potential impacts to affordability due to changes in gross liftoff mass and/or vehicle complexity. Results are discussed at a high level to understand the impact severity of certain sensitivities and how those trade studies conducted can either affect cost, performance, or both.

Oregon School-Based Health Centers 1996-1997 Services Report.

ERIC Educational Resources Information Center

Alexander, Tammis; Nystrom, Robert J.; Spitz, Lauren

School based health centers (SBHC) are effective providers of health services and education because they are easy for students to access, they take an integrated and developmentally appropriate approach to meeting health needs, and they are prevention-oriented. This report describes the 1996-1997 services provided in 15 of 19 state-supported…

"Take-home" box trainers are an effective alternative to virtual reality simulators.

PubMed

Yiasemidou, Marina; de Siqueira, Jonathan; Tomlinson, James; Glassman, Daniel; Stock, Simon; Gough, Michael

2017-06-01

Practice on virtual reality simulators (VRSs) has been shown to improve surgical performance. However, VRSs are expensive and usually housed in surgical skills centers that may be inaccessible at times convenient for surgical trainees to practice. Conversely, box trainers (BT) are inexpensive and can be used anywhere at anytime. This study assesses "take-home" BTs as an alternative to VRS. After baseline assessments (two simulated laparoscopic cholecystectomies, one on a VRS and one on a BT), 25 surgical trainees were randomized to two groups. Trainees were asked to practice three basic laparoscopic tasks for 6 wk (BT group using a "take-home" box trainer; VR group using VRS in clinical skills centers). After the practice period, all performed two laparoscopic cholecystectomy, one on a VRS and one on a BT; (i.e., posttraining assessment). VRS provided metrics (total time [TT], number of movements instrument tip path length), and expert video assessment of cholecystectomy in a BT (Global Operative Assessment of Laparoscopic Skills [GOALS] score) were recorded. Performance during pretraining and posttraining assessment was compared. The BT group showed a significant improvement for all VRS metrics (P = 0.008) and the efficiency category of GOALS score (P = 0.03). Only TT improved in the VRS group, and none of the GOALS categories demonstrated a statistically significant improvement after training. Finally, the improvement in VRS metrics in the BT group was significantly greater than in the VR group (TT P = 0.005, number of movements P = 0.042, path length P = 0.031), although there were no differences in the GOALS scores between the groups. This study suggests that a basic "take-home" BT is a suitable alternative to VRS. Copyright © 2017 Elsevier Inc. All rights reserved.

Free-Flight Test Results of Scale Models Simulating Viking Parachute/Lander Staging

NASA Technical Reports Server (NTRS)

Polutchko, Robert J.

1973-01-01

This report presents the results of Viking Aerothermodynamics Test D4-34.0. Motion picture coverage of a number of Scale model drop tests provides the data from which time-position characteristics as well as canopy shape and model system attitudes are measured. These data are processed to obtain the instantaneous drag during staging of a model simulating the Viking decelerator system during parachute staging at Mars. Through scaling laws derived prior to test (Appendix A and B) these results are used to predict such performance of the Viking decelerator parachute during staging at Mars. The tests were performed at the NASA/Kennedy Space Center (KSC) Vertical Assembly Building (VAB). Model assemblies were dropped 300 feet to a platform in High Bay No. 3. The data consist of an edited master film (negative) which is on permanent file in the NASA/LRC Library. Principal results of this investigation indicate that for Viking parachute staging at Mars: 1. Parachute staging separation distance is always positive and continuously increasing generally along the descent path. 2. At staging, the parachute drag coefficient is at least 55% of its prestage equilibrium value. One quarter minute later, it has recovered to its pre-stage value.

Mars Observer/Transfer Orbit Stage (TOS)

NASA Technical Reports Server (NTRS)

1992-01-01

In the Payload Hazardous Servicing Facility, the integrated Mars Observer/Transfer Orbit Stage (TOS) payload is ready for encapsulation in the Titan III nose fairing. The TOS booster maiden flight was dedicated to Thomas O. Paine, a former NASA administrator who strongly supported interplanetary exploration and was an early backer of the TOS program. Launched September 25, 1992 from the Kennedy Space Flight Center aboard a Titan III rocket and the TOS, the Mars Observer spacecraft was to be the first U.S. spacecraft to study Mars since the Viking missions 18 years prior. Unfortunately, the Mars Observer spacecraft fell silent just 3 days prior to entering orbit around Mars.

Taking Care of Your Diabetes Means Taking Care of Your Heart (Tip Sheet)

MedlinePlus

... Diabetes Means Taking Care of Your Heart Taking Care of Your Diabetes Means Taking Care of Your Heart Diabetes and Heart Disease For ... What you can do now Ask your health care team these questions: What can I do to ...

Life stage, not climate change, explains observed tree range shifts.

PubMed

Máliš, František; Kopecký, Martin; Petřík, Petr; Vladovič, Jozef; Merganič, Ján; Vida, Tomáš

2016-05-01

Ongoing climate change is expected to shift tree species distribution and therefore affect forest biodiversity and ecosystem services. To assess and project tree distributional shifts, researchers may compare the distribution of juvenile and adult trees under the assumption that differences between tree life stages reflect distributional shifts triggered by climate change. However, the distribution of tree life stages could differ within the lifespan of trees, therefore, we hypothesize that currently observed distributional differences could represent shifts over ontogeny as opposed to climatically driven changes. Here, we test this hypothesis with data from 1435 plots resurveyed after more than three decades across the Western Carpathians. We compared seedling, sapling and adult distribution of 12 tree species along elevation, temperature and precipitation gradients. We analyzed (i) temporal shifts between the surveys and (ii) distributional differences between tree life stages within both surveys. Despite climate warming, tree species distribution of any life stage did not shift directionally upward along elevation between the surveys. Temporal elevational shifts were species specific and an order of magnitude lower than differences among tree life stages within the surveys. Our results show that the observed range shifts among tree life stages are more consistent with ontogenetic differences in the species' environmental requirements than with responses to recent climate change. The distribution of seedlings substantially differed from saplings and adults, while the distribution of saplings did not differ from adults, indicating a critical transition between seedling and sapling tree life stages. Future research has to take ontogenetic differences among life stages into account as we found that distributional differences recently observed worldwide may not reflect climate change but rather the different environmental requirements of tree life stages. © 2016

Life-stage, not climate change, explains observed tree range shifts

PubMed Central

Máliš, František; Kopecký, Martin; Petřík, Petr; Vladovič, Jozef; Merganič, Ján; Vida, Tomáš

2017-01-01

Ongoing climate change is expected to shift tree species distribution and therefore affect forest biodiversity and ecosystem services. To assess and project tree distributional shifts, researchers may compare the distribution of juvenile and adult trees under the assumption that differences between tree life-stages reflect distributional shifts triggered by climate change. However, the distribution of tree life-stages could differ within the lifespan of trees, therefore we hypothesize that currently observed distributional differences could represent shifts over ontogeny as opposed to climatically driven changes. Here we test this hypothesis with data from 1435 plots resurveyed after more than three decades across the Western Carpathians. We compared seedling, sapling and adult distribution of 12 tree species along elevation, temperature and precipitation gradients. We analyzed i) temporal shifts between the surveys and ii) distributional differences between tree life-stages within both surveys. Despite climate warming, tree species distribution of any life-stage did not shift directionally upward along elevation between the surveys. Temporal elevational shifts were species-specific and an order of magnitude lower than differences among tree life-stages within the surveys. Our results show that the observed range shifts among tree life-stages are more consistent with ontogenetic differences in the species’ environmental requirements than with responses to recent climate change. The distribution of seedlings substantially differed from saplings and adults, while the distribution of saplings did not differ from adults, indicating a critical transition between seedling and sapling tree life-stages. Future research has to take ontogenetic differences among life-stages into account as we found that distributional differences recently observed worldwide may not reflect climate change but rather the different environmental requirements of tree life-stages. PMID:26725258

NHEXAS PHASE I ARIZONA STUDY--STANDARD OPERATING PROCEDURE FOR FIRST STAGE OF CLEANING ELECTRONIC DATA (HAND ENTRY) (UA-D-16.0)

EPA Science Inventory

The purpose of this SOP is to provide a standard method for the "first stage" of cleaning data. The first cleaning stage takes place after data verification and before master database appendage. This procedure applies to (1) post-keypunch data collected by the NHEXAS Arizona st...

The Door: A Model Youth Center. Treatment Program Monograph Series.

ERIC Educational Resources Information Center

National Inst. on Drug Abuse (DHHS/PHS), Rockville, MD.

This report provides basic facts about The Door, a multifaceted youth center in New York City, which serves 300-400 young people each day. The origins, early stages, guiding philosophy, activities, and organizational structure are described. Recommendations for initiating and operating multiservice youth projects based on the experience of The…

Family caregivers’ role implementation at different stages of dementia

PubMed Central

Huang, Huei-Ling; Shyu, Yea-Ing L; Chen, Min-Chi; Huang, Chin-Chang; Kuo, Hung-Chou; Chen, Sien-Tsong; Hsu, Wen-Chuin

2015-01-01

Purpose The purpose of this study was to explore family caregivers’ role-implementation experiences at different stages of dementia. Patients and methods For this cross-sectional, exploratory study, 176 dyads of family caregivers and their community-dwelling elderly relatives with dementia were recruited from the neurological clinics of a medical center in Taiwan. The Family Caregiving Inventory was used to assess family caregivers for caregiving activities, role strain, role preparation, and help from others at different stages of care receivers’ dementia. Results Family caregivers’ caregiving activities were related to patients’ stages of dementia. For patients with mild dementia, caregivers provided more assistance in transportation and housekeeping. In addition to these two activities, family caregivers of patients with moderate dementia provided more assistance with mobility and protection. For patients with severe dementia, family caregivers provided more assistance with personal care, mobility and protection, transportation, and housekeeping. Overall, family caregivers reported having some preparation to provide care; the most difficult caregiving activity was identified as managing behavioral problems. Conclusion This study’s results provide a knowledge base for designing dementia stage-specific interventions in clinical practice and developing community-based, long-term care systems for families of patients with dementia. PMID:25584022

Influence of the duration of the second stage of labor on the likelihood of obstetric anal sphincter injury.

PubMed

Aiken, Catherine E; Aiken, Abigail R; Prentice, Andrew

2015-03-01

Duration of the second stage of labor has been suggested as an independent risk factor for clinically detectable obstetric anal sphincter injury in low-risk nulliparous women. A retrospective 5-year cohort study was conducted in a UK obstetrics center which included a high-risk delivery unit and a low-risk birthing center. The study included 4,831 nulliparous women with vertex-presenting, single, live-born infants at term, stratified according to spontaneous or instrumental delivery. Binary logistic regression models were used to examine the association between duration of second stage and sphincter injury. Three-hundred twenty-five of 4,831 women (6.7%) sustained sphincter injuries. In spontaneously delivering women, no association between duration of the second stage and the likelihood of sphincter injury was recorded. Factors associated with increased likelihood of sphincter injury included older maternal age, higher birthweight, and Southeast Asian ethnicity. In contrast, for women undergoing instrumental delivery, a longer second stage was associated with an increased sphincter injury risk of 6 percent per 15 minutes in the second stage of labor before delivery. For spontaneous vaginal deliveries, duration of the second stage of labor was not an independent risk factor for obstetric anal sphincter injury. The association between prolonged second stage and sphincter injury for instrumental deliveries is likely explained by the risk posed by the use of the instruments themselves or by delay in initiating instrumental assistance. Attempts to modify the duration of the second stage for prevention of sphincter injuries are unlikely to be beneficial and may be detrimental. © 2014 Wiley Periodicals, Inc.

Influence of the duration of the second stage of labor on the likelihood of obstetric anal sphincter injury

PubMed Central

AIKEN, Catherine E.; AIKEN, Abigail R.; PRENTICE, Andrew

2014-01-01

Background Duration of the second stage of labor has been suggested as an independent risk factor for clinically detectable obstetric anal sphincter injury in low-risk nulliparous women. Methods A retrospective 5-year cohort study in a UK obstetrics center including high-risk delivery unit and low-risk birthing center. 4831 nulliparous women with vertex-presenting, single, live-born infants at term were included. The cohort was stratified according to spontaneous or instrumental delivery. Binary logistic regression models were used to examine the association between duration of second stage and sphincter injury. Results 325 of 4831 women (6.7%) sustained sphincter injuries. In spontaneously delivering women, there was no association between duration of the second stage and the likelihood of sustaining sphincter injuries. Factors associated with increased likelihood of sustaining sphincter injury included older maternal age, higher birthweight and Southeast Asian ethnicity. By contrast, for women undergoing instrumental delivery, a longer second stage was associated with an increased sphincter injury risk of 6% per 15 minutes in the second stage of labor prior to delivery. Conclusions For spontaneous vaginal deliveries, duration of the second stage of labor is not an independent risk factor for obstetric anal sphincter injuries. The association between prolonged second stage and sphincter injury for instrumental deliveries is likely explained by the risk posed by the use of the instruments themselves or by delay in initiating instrumental assistance. Attempts to modify the duration of the second stage for prevention of sphincter injuries are unlikely to be beneficial and may be detrimental. PMID:25439012

Chemotherapy Toxicity On Quality of Life in Older Patients With Stage I, Stage II, Stage III, or Stage IV Ovarian Epithelial, Primary Peritoneal Cavity, or Fallopian Tube Cancer

ClinicalTrials.gov

2017-05-03

Stage I Ovarian Cancer; Stage IA Fallopian Tube Cancer; Stage IB Fallopian Tube Cancer; Stage IC Fallopian Tube Cancer; Stage II Ovarian Cancer; Stage IIA Fallopian Tube Cancer; Stage IIB Fallopian Tube Cancer; Stage IIC Fallopian Tube Cancer; Stage III Ovarian Cancer; Stage III Primary Peritoneal Cancer; Stage IIIA Fallopian Tube Cancer; Stage IIIB Fallopian Tube Cancer; Stage IIIC Fallopian Tube Cancer; Stage IV Fallopian Tube Cancer; Stage IV Ovarian Cancer; Stage IV Primary Peritoneal Cancer

Two-Stage Modeling of Formaldehyde-Induced Tumor Incidence in the Rat—analysis of Uncertainties

EPA Science Inventory

This works extends the 2-stage cancer modeling of tumor incidence in formaldehyde-exposed rats carried out at the CIIT Centers for Health Research. We modify key assumptions, evaluate the effect of selected uncertainties, and develop confidence bounds on parameter estimates. Th...

Effects of 8th Grade Algebra on High School Course-Taking and Math Achievement: Evidence from Changing Practices in a Large Urban District

ERIC Educational Resources Information Center

Rickles, Jordan; Phillips, Meredith; Yamashiro, Kyo

2014-01-01

Between 1990 and 2012, the percentage of 13-year-olds (most of whom are 8th graders) taking algebra more than doubled, from 15% to 34% (National Center for Education Statistics, 2013). Yet recent education policy changes suggest that this movement to encourage algebra-taking in 8th grade has begun to reverse course. Existing research suggests that…

Planning and Marketing: Two Keys to a Recreation Center's Success.

ERIC Educational Resources Information Center

Downs, Joseph P.

1983-01-01

Indoor recreational facilities in Fairfax County, Virginia, owe their success to (1) development of comprehensive plans, which take into account site location, community needs, area trends, and financing possibilities, and (2) use of continuous marketing strategies. The centers are self-supporting. Each offers a variety of recreation/sports…

The Importance of Take-Out Food Packaging Attributes: Conjoint Analysis and Quality Function Deployment Approach

NASA Astrophysics Data System (ADS)

Lestari Widaningrum, Dyah

2014-03-01

This research aims to investigate the importance of take-out food packaging attributes, using conjoint analysis and QFD approach among consumers of take-out food products in Jakarta, Indonesia. The conjoint results indicate that perception about packaging material (such as paper, plastic, and polystyrene foam) plays the most important role overall in consumer perception. The clustering results that there is strong segmentation in which take-out food packaging material consumer consider most important. Some consumers are mostly oriented toward the colour of packaging, while another segment of customers concerns on packaging shape and packaging information. Segmentation variables based on packaging response can provide very useful information to maximize image of products through the package's impact. The results of House of Quality development described that Conjoint Analysis - QFD is a useful combination of the two methodologies in product development, market segmentation, and the trade off between customers' requirements in the early stages of HOQ process

Three Drug Combinations for Late-Stage Trypanosoma brucei gambiense Sleeping Sickness: A Randomized Clinical Trial in Uganda

PubMed Central

Priotto, Gerardo; Fogg, Carole; Balasegaram, Manica; Erphas, Olema; Louga, Albino; Checchi, Francesco; Ghabri, Salah; Piola, Patrice

2006-01-01

Objectives: Our objective was to compare the efficacy and safety of three drug combinations for the treatment of late-stage human African trypanosomiasis caused by Trypanosoma brucei gambiense. Design: This trial was a randomized, open-label, active control, parallel clinical trial comparing three arms. Setting: The study took place at the Sleeping Sickness Treatment Center run by Médecins Sans Frontières at Omugo, Arua District, Uganda Participants: Stage 2 patients diagnosed in Northern Uganda were screened for inclusion and a total of 54 selected. Interventions: Three drug combinations were given to randomly assigned patients: melarsoprol-nifurtimox (M+N), melarsoprol-eflornithine (M+E), and nifurtimox-eflornithine (N+E). Dosages were uniform: intravenous (IV) melarsoprol 1.8 mg/kg/d, daily for 10 d; IV eflornithine 400 mg/kg/d, every 6 h for 7 d; oral nifurtimox 15 (adults) or 20 (children <15 y) mg/kg/d, every 8 h for 10 d. Patients were followed up for 24 mo. Outcome Measures: Outcomes were cure rates and adverse events attributable to treatment. Results: Randomization was performed on 54 patients before enrollment was suspended due to unacceptable toxicity in one of the three arms. Cure rates obtained with the intention to treat analysis were M+N 44.4%, M+E 78.9%, and N+E 94.1%, and were significantly higher with N+E (p = 0.003) and M+E (p = 0.045) than with M+N. Adverse events were less frequent and less severe with N+E, resulting in fewer treatment interruptions and no fatalities. Four patients died who were taking melarsoprol-nifurtimox and one who was taking melarsoprol-eflornithine. Conclusions: The N+E combination appears to be a promising first-line therapy that may improve treatment of sleeping sickness, although the results from this interrupted study do not permit conclusive interpretations. Larger studies are needed to continue the evaluation of this drug combination in the treatment of T. b. gambiense sleeping sickness. PMID:17160135

A Concept of Two-Stage-To-Orbit Reusable Launch Vehicle

NASA Astrophysics Data System (ADS)

Yang, Yong; Wang, Xiaojun; Tang, Yihua

2002-01-01

Reusable Launch Vehicle (RLV) has a capability of delivering a wide rang of payload to earth orbit with greater reliability, lower cost, more flexibility and operability than any of today's launch vehicles. It is the goal of future space transportation systems. Past experience on single stage to orbit (SSTO) RLVs, such as NASA's NASP project, which aims at developing an rocket-based combined-cycle (RBCC) airplane and X-33, which aims at developing a rocket RLV, indicates that SSTO RLV can not be realized in the next few years based on the state-of-the-art technologies. This paper presents a concept of all rocket two-stage-to-orbit (TSTO) reusable launch vehicle. The TSTO RLV comprises an orbiter and a booster stage. The orbiter is mounted on the top of the booster stage. The TSTO RLV takes off vertically. At the altitude about 50km the booster stage is separated from the orbiter, returns and lands by parachutes and airbags, or lands horizontally by means of its own propulsion system. The orbiter continues its ascent flight and delivers the payload into LEO orbit. After completing orbit mission, the orbiter will reenter into the atmosphere, automatically fly to the ground base and finally horizontally land on the runway. TSTO RLV has less technology difficulties and risk than SSTO, and maybe the practical approach to the RLV in the near future.

When the Girls Still Wore Headscarves: Integration and Belonging in an After-School Center in Berlin

ERIC Educational Resources Information Center

Burnside, Bruce S.

2015-01-01

This study is centered on a youth center in Berlin, Germany, that serves migrant females. It draws on the anthropology of performance and the concept of "friction" to argue for an understanding of performances of belonging, where migrant girls stage acts of inclusion through creative encounters with the forces of integration to negotiate…

Rituximab and Oblimersen in Treating Patients With Stage II, Stage III, or Stage IV Follicular Non-Hodgkin's Lymphoma

ClinicalTrials.gov

2013-01-04

Stage III Grade 1 Follicular Lymphoma; Stage III Grade 2 Follicular Lymphoma; Stage III Grade 3 Follicular Lymphoma; Stage IV Grade 1 Follicular Lymphoma; Stage IV Grade 2 Follicular Lymphoma; Stage IV Grade 3 Follicular Lymphoma

KENNEDY SPACE CENTER, FLA. - In the Space Station Processing Facility, STS-114 Mission Specialist Wendy Lawrence manipulates part of a Multi-Purpose Logistics Module. Lawrence is a new addition to the mission crew. The STS-114 crew is at KSC to take part in crew equipment and orbiter familiarization.

NASA Image and Video Library

2003-10-30

KENNEDY SPACE CENTER, FLA. - In the Space Station Processing Facility, STS-114 Mission Specialist Wendy Lawrence manipulates part of a Multi-Purpose Logistics Module. Lawrence is a new addition to the mission crew. The STS-114 crew is at KSC to take part in crew equipment and orbiter familiarization.

Using the stages of change model to counsel victims of intimate partner violence.

PubMed

Frasier, P Y; Slatt, L; Kowlowitz, V; Glowa, P T

2001-05-01

Medical expenses from intimate partner violence (IPV) total between $3 and $5 billion annually. Many abuse victims are exposed to serious injuries, and are likely to see their physicians more frequently than other patients. Practitioners must have a reliable and realistic approach to counseling patients who are victims of IPV. This paper presents the stages of change model as a practical guide for counseling victims. Through patients' responses to a series of questions, the practitioner can identify which of five stages of change (precontemplation, preparation, contemplation, action, maintenance) the patient is in. The practitioner can then employ stage-specific strategies for counseling the patient. Using this model shifts the definition of successful outcome from the traditional focus of trying to 'fix the problem' to a patient-centered focus, working with the patient to explore the most effective strategies given his/her stage of change.

Using Evidence-Centered Design to Create a Special Educator Observation System

ERIC Educational Resources Information Center

Johnson, Evelyn S.; Crawford, Angela R.; Moylan, Laura A.; Zheng, Yuzhu

2018-01-01

The Evidence-Centered Design (ECD) framework was used to create a special education teacher observation system, Recognizing Effective Special Education Teachers (RESET). Extensive reviews of research informed the domain analysis and modeling stages, and led to the conceptual framework in which effective special education teaching is…

Assessing the Impact of New Student Campus Recreation Centers

ERIC Educational Resources Information Center

Zizzi, Samuel; Ayers, Suzan F.; Watson II, Jack C.; Keeler, Linda A.

2004-01-01

The student recreation center (SRC) at many colleges and universities has evolved from being a place to lift weights and take aerobics classes to becoming a high-powered recruitment tool (Colleges use recreation, 2002). The present study included the development of an instrument to assess the use and impact of SRCs. Students (N = 655; users = 537,…

Is the increase of hypomanic stages during adolescence related to gender and developmental tasks?

PubMed

Brand, Serge; Angst, Jules; Holsboer-Trachsler, Edith

2010-04-01

To detach themselves from their family of origin, adolescents need to develop proactive behaviour which includes increased risk-taking and novelty seeking. These behaviours may be attributable both to developmental issues and to hypomanic-like stages. Since there is a lack of research focusing on hypomania in adolescents, the aim of the study was to compare hypomania scores of adolescents with those of adult outpatients suffering from bipolar II disorders, and to investigate possible gender-related differences. One hundred and seven adolescents (mean age: 18 years) took part in the study; 60 of them indicated that they experienced intense romantic love; 47 were controls. Participants completed the Hypomania Check List, and data were compared with those of adult outpatients suffering from bipolar II disorders. Scores of adolescents in early-stage intense romantic love differed from those of adolescent controls, but not from those of outpatients suffering from a bipolar II disorder. Factor analyses revealed that both groups of adolescents displayed higher scores for the factor "irritable/risk-taking" hypomania. A gender-related pattern was found, with increased scores for female adolescents. Adolescents' developmental tasks surrounding experiences in social, psychosexual and substance use-related engagement may lead to temporary and gender-related hypomanic-like stages.

Mission Control Center (MCC): Apollo XV - MSC

NASA Image and Video Library

1971-08-02

S71-41759 (2 Aug. 1971) --- A partial view of activity in the Mission Operations Control Room in the Mission Control Center during the liftoff of the Apollo 15 Lunar Module "Falcon" ascent stage from the lunar surface. An RCA color television camera mounted on the Lunar Roving Vehicle made it possible for people on Earth to watch the LM's spectacular launch from the moon. The LM liftoff was at 171:37 ground elapsed time. The LRV was parked about 300 feet east of the LM. The TV camera was remotely controlled from a console in the MOCR. Seated in the right foreground is astronaut Edgar D. Mitchell, a spacecraft communicator. Mitchell was lunar module pilot of the Apollo 14 lunar landing mission. Note liftoff on the television monitor in the center background.

Personality in the cockroach Diploptera punctata: Evidence for stability across developmental stages despite age effects on boldness.

PubMed

Stanley, Christina R; Mettke-Hofmann, Claudia; Preziosi, Richard F

2017-01-01

Despite a recent surge in the popularity of animal personality studies and their wide-ranging associations with various aspects of behavioural ecology, our understanding of the development of personality over ontogeny remains poorly understood. Stability over time is a central tenet of personality; ecological pressures experienced by an individual at different life stages may, however, vary considerably, which may have a significant effect on behavioural traits. Invertebrates often go through numerous discrete developmental stages and therefore provide a useful model for such research. Here we test for both differential consistency and age effects upon behavioural traits in the gregarious cockroach Diploptera punctata by testing the same behavioural traits in both juveniles and adults. In our sample, we find consistency in boldness, exploration and sociality within adults whilst only boldness was consistent in juveniles. Both boldness and exploration measures, representative of risk-taking behaviour, show significant consistency across discrete juvenile and adult stages. Age effects are, however, apparent in our data; juveniles are significantly bolder than adults, most likely due to differences in the ecological requirements of these life stages. Size also affects risk-taking behaviour since smaller adults are both bolder and more highly explorative. Whilst a behavioural syndrome linking boldness and exploration is evident in nymphs, this disappears by the adult stage, where links between other behavioural traits become apparent. Our results therefore indicate that differential consistency in personality can be maintained across life stages despite age effects on its magnitude, with links between some personality traits changing over ontogeny, demonstrating plasticity in behavioural syndromes.

Personality in the cockroach Diploptera punctata: Evidence for stability across developmental stages despite age effects on boldness

PubMed Central

Mettke-Hofmann, Claudia; Preziosi, Richard F.

2017-01-01

Despite a recent surge in the popularity of animal personality studies and their wide-ranging associations with various aspects of behavioural ecology, our understanding of the development of personality over ontogeny remains poorly understood. Stability over time is a central tenet of personality; ecological pressures experienced by an individual at different life stages may, however, vary considerably, which may have a significant effect on behavioural traits. Invertebrates often go through numerous discrete developmental stages and therefore provide a useful model for such research. Here we test for both differential consistency and age effects upon behavioural traits in the gregarious cockroach Diploptera punctata by testing the same behavioural traits in both juveniles and adults. In our sample, we find consistency in boldness, exploration and sociality within adults whilst only boldness was consistent in juveniles. Both boldness and exploration measures, representative of risk-taking behaviour, show significant consistency across discrete juvenile and adult stages. Age effects are, however, apparent in our data; juveniles are significantly bolder than adults, most likely due to differences in the ecological requirements of these life stages. Size also affects risk-taking behaviour since smaller adults are both bolder and more highly explorative. Whilst a behavioural syndrome linking boldness and exploration is evident in nymphs, this disappears by the adult stage, where links between other behavioural traits become apparent. Our results therefore indicate that differential consistency in personality can be maintained across life stages despite age effects on its magnitude, with links between some personality traits changing over ontogeny, demonstrating plasticity in behavioural syndromes. PMID:28489864

A Bayesian predictive two-stage design for phase II clinical trials.

PubMed

Sambucini, Valeria

2008-04-15

In this paper, we propose a Bayesian two-stage design for phase II clinical trials, which represents a predictive version of the single threshold design (STD) recently introduced by Tan and Machin. The STD two-stage sample sizes are determined specifying a minimum threshold for the posterior probability that the true response rate exceeds a pre-specified target value and assuming that the observed response rate is slightly higher than the target. Unlike the STD, we do not refer to a fixed experimental outcome, but take into account the uncertainty about future data. In both stages, the design aims to control the probability of getting a large posterior probability that the true response rate exceeds the target value. Such a probability is expressed in terms of prior predictive distributions of the data. The performance of the design is based on the distinction between analysis and design priors, recently introduced in the literature. The properties of the method are studied when all the design parameters vary.

Oblimersen Sodium and Combination Chemotherapy in Treating Patients With Newly Diagnosed Stage I, Stage II, Stage III, or Stage IV Diffuse Large B-Cell Lymphoma

ClinicalTrials.gov

2012-10-11

Contiguous Stage II Adult Diffuse Large Cell Lymphoma; Noncontiguous Stage II Adult Diffuse Large Cell Lymphoma; Stage I Adult Diffuse Large Cell Lymphoma; Stage III Adult Diffuse Large Cell Lymphoma; Stage IV Adult Diffuse Large Cell Lymphoma

The Mark Coventry, MD, Award: Oral Antibiotics Reduce Reinfection After Two-Stage Exchange: A Multicenter, Randomized Controlled Trial.

PubMed

Frank, Jonathan M; Kayupov, Erdan; Moric, Mario; Segreti, John; Hansen, Erik; Hartman, Curtis; Okroj, Kamil; Belden, Katherine; Roslund, Brian; Silibovsky, Randi; Parvizi, Javad; Della Valle, Craig J

2017-01-01

Many patients develop recurrent periprosthetic joint infection after two-stage exchange arthroplasty of the hip or knee. One potential but insufficiently tested strategy to decrease the risk of persistent or recurrent infection is to administer additional antibiotics after the second-stage reimplantation. (1) Does a 3-month course of oral antibiotics decrease the risk of failure secondary to infection after a two-stage exchange? (2) Are there any complications related to the administration of oral antibiotics after a two-stage exchange? (3) In those patients who develop a reinfection, is the infecting organism different from the initial infection? Patients at seven centers randomized to receive 3 months of oral antibiotics or no further antibiotic treatment after operative cultures after the second-stage reimplantation were negative. Adult patients undergoing two-stage hip or knee revision arthroplasty for a periprosthetic infection who met Musculoskeletal Infection Society (MSIS) criteria for infection at the first stage were included. Oral antibiotic therapy was tailored to the original infecting organism(s) in consultation with an infectious disease specialist. MSIS criteria as used by the treating surgeon defined failure. Surveillance of patients for complications, including reinfection, occurred at 3 weeks, 6 weeks, 3 months, 12 months, and 24 months. If an organism demonstrated the same antibiotic sensitivities as the original organism, it was considered the same organism; no DNA subtyping was performed. Analysis was performed as intent to treat with all randomized patients included in the groups to which they were randomized. A log-rank survival curve was used to analyze the primary outcome of reinfection. At planned interim analysis (enrollment is ongoing), 59 patients were successfully randomized to the antibiotic group and 48 patients to the control group. Fifty-seven patients had an infection after TKA and 50 after a THA. There was no minimum followup

Measurements of the center-of-mass energies at BESIII via the di-muon process

DOE PAGES

Ablikim, M.; Achasov, M. N.; Ai, X. C.; ...

2016-06-01

From 2011 to 2014, the BESIII experiment collected about 5 fb -1 data at center-of-mass energies around 4 GeV for the studies of the charmonium-like and higher excited charmonium states. By analyzing the di-muon process e +e - → γ ISR/FSRμ +μ -, the center-of-mass energies of the data samples are measured with a precision of 0.8 MeV. The center-of-mass energy is found to be stable for most of the time during data taking.

Generations of spreading basins and stages of breakdown of Wegener's Pangea in the geodynamic evolution of the Arctic Ocean

NASA Astrophysics Data System (ADS)

Shipilov, E. V.

2008-03-01

system of the Canada Basin that finished its evolution in the Late Cretaceous and the North Atlantic system of the Makarov and Eurasia basins that came to take the place of the Paleopacific system. In contrast to traditional views, it has been suggested that asymmetry of the northern Norwegian-Greenland Basin is explained by two-stage development of this Atlantic segment with formation of primary and secondary spreading centers. The secondary spreading center of the Knipovich Ridge started to evolve approximately at the Oligocene-Miocene transition. This process resulted in the breaking off of the Hovgard continental block from the Barents Sea margin. Thus, the breakdown of Wegener’s Pangea and its Laurasian fragments with the formation of young spreading basins was a staged process that developed nearly from opposite sides. Before the Late Cretaceous (the first stage), the Pangea broke down from the side of Paleopacific to form the Canada Basin, an element of the Amerasia Basin (first phase of ocean formation). Since the Late Cretaceous, destructive pulses came from the side of the North Atlantic and resulted in the separation of Greenland from North America and the development of the Labrador-Baffin-Makarov spreading system (second phase of ocean formation). The Cenozoic was marked by the development of the second spreading branch and the formation of the Norwegian-Greenland and Eurasia oceanic basins (third phase of ocean formation). Spreading centers of this branch are functioning currently but at an extremely low rate.

Family-centered care to promote successful community reintegration after war: it takes a nation.

PubMed

Glynn, Shirley M

2013-12-01

The papers in this section focus on public health responses and implementation considerations in addressing the challenges military families confront when parents go to war. While many military families show resilience, the challenges resulting from a decade of war with multiple deployments are detailed, as are innovative military and civilian programs designed to help service members and their families reintegrate successfully into the community. As more and more service members leave active duty, the burden of meeting military families' psychological needs will transition from the Department of Defense (DoD) and into the Veterans Administration (VA) and civilian arenas. While many strategies to support successful readjustment are offered, in this time of dwindling mental health resources and competing needs, it is unclear what priority the broader society places on meeting the needs of returning service members and their families. A growing emphasis on family-centered care in the Veterans Administration may help meet this gap.

Conceptual design of two-stage-to-orbit hybrid launch vehicle

NASA Technical Reports Server (NTRS)

1991-01-01

The object of this design class was to design an earth-to orbit vehicle to replace the present NASA space shuttle. The major motivations for designing a new vehicle were to reduce the cost of putting payloads into orbit and to design a vehicle that could better service the space station with a faster turn-around time. Another factor considered in the design was that near-term technology was to be used. Materials, engines and other important technologies were to be realized in the next 10 to 15 years. The first concept put forth by NASA to meet these objectives was the National Aerospace Plane (NASP). The NASP is a single-stage earth-to-orbit air-breathing vehicle. This concept ran into problems with the air-breathing engine providing enough thrust in the upper atmosphere, among other things. The solution of this design class is a two-stage-to-orbit vehicle. The first stage is air-breathing and the second stage is rocket-powered, similar to the space shuttle. The second stage is mounted on the top of the first stage in a piggy-back style. The vehicle takes off horizontally using only air-breathing engines, flies to Mach six at 100,000 feet, and launches the second stage towards its orbital path. The first stage, or booster, will weigh approximately 800,000 pounds and the second stage, or orbiter will weigh approximately 300,000 pounds. The major advantage of this design is the full recoverability of the first stage compared with the present solid rocket booster that are only partially recoverable and used only a few times. This reduces the cost as well as providing a more reliable and more readily available design for servicing the space station. The booster can fly an orbiter up, turn around, land, refuel, and be ready to launch another orbiter in a matter of hours.

Design and construction of the X-2 two-stage free piston driven expansion tube

NASA Technical Reports Server (NTRS)

Doolan, Con

1995-01-01

This report outlines the design and construction of the X-2 two-stage free piston driven expansion tube. The project has completed its construction phase and the facility has been installed in the new impulsive research laboratory where commissioning is about to take place. The X-2 uses a unique, two-stage driver design which allows a more compact and lower overall cost free piston compressor. The new facility has been constructed in order to examine the performance envelope of the two-stage driver and how well it couple to sub-orbital and super-orbital expansion tubes. Data obtained from these experiments will be used for the design of a much larger facility, X-3, utilizing the same free piston driver concept.

76 FR 73600 - Taking and Importing Marine Mammals; Taking Marine Mammals Incidental to Missile Launch...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-11-29

... years if NMFS finds, after notification and opportunity for public comment, that the taking will have a... taking. Regulations governing the taking of northern elephant seals (Mirounga angustirostris), Pacific... a period not to exceed 1 year, take of pinnipeds, by harassment, incidental to missile launch...

Wide angle view of Mission Control Center during Apollo 14 transmission

NASA Image and Video Library

1971-01-31

S71-17122 (31 Jan. 1971) --- A wide angle overall view of the Mission Operations Control Room (MOCR) in the Mission Control Center at the Manned spacecraft Center. This view was photographed during the first color television transmission from the Apollo 14 Command Module. Projected on the large screen at the right front of the MOCR is a view of the Apollo 14 Lunar Module, still attached to the Saturn IVB stage. The Command and Service Modules were approaching the LM/S-IVB during transposition and docking maneuvers.

A new magnetic bearing using Halbach magnet arrays for a magnetic levitation stage.

PubMed

Choi, Young-Man; Lee, Moon G; Gweon, Dae-Gab; Jeong, Jaehwa

2009-04-01

Next-generation lithography requires a high precision stage, which is compatible with a high vacuum condition. A magnetic levitation stage with six degrees-of-freedom is considered state-of-the-art technology for a high vacuum condition. The noncontact characteristic of magnetic levitation enables high precision positioning as well as no particle generation. To position the stage against gravity, z-directional electromagnetic levitation mechanisms are widely used. However, if electromagnetic actuators for levitation are used, heat is inevitably generated, which deforms the structures and degrades accuracy of the stage. Thus, a gravity compensator is required. In this paper, we propose a new magnetic bearing using Halbach magnet arrays for a magnetic levitation stage. The novel Halbach magnetic bearing exerts a force four times larger than a conventional magnetic bearing with the same volume. We also discuss the complementary characteristics of the two magnetic bearings. By modifying the height of the center magnet in a Halbach magnetic bearing, a performance compromise between levitating force density and force uniformity is obtained. The Halbach linear active magnetic bearing can be a good solution for magnetic levitation stages because of its large and uniform levitation force.

Health Self-Efficacy Among Populations with Multiple Chronic Conditions: the Value of Patient-Centered Communication.

PubMed

Finney Rutten, Lila J; Hesse, Bradford W; St Sauver, Jennifer L; Wilson, Patrick; Chawla, Neetu; Hartigan, Danielle B; Moser, Richard P; Taplin, Stephen; Glasgow, Russell; Arora, Neeraj K

2016-08-01

Using cross-sectional survey data, we assessed the association between chronic illness burden and health-related self-efficacy, evaluating whether patient-centered communication is associated with self-efficacy and if that relationship varies by chronic illness burden. Data were from the Health Information National Trends Survey, a cross-sectional survey of the US adult population collected in 2012-2013 (n = 3630). Health-related self-efficacy was measured with the item: "Overall, how confident are you about your ability to take good care of your health?" and the prevalence of six chronic conditions and depression/anxiety was assessed. Patient-centered communication was measured as the frequency with which respondents perceived their healthcare providers allowed them to ask questions, gave attention to their emotions, involved them in decisions, made sure they understood how to take care of their health, helped them to deal with uncertainty, and if they felt they could rely on their healthcare providers to take care of their healthcare needs. Health-related self-efficacy was significantly lower among individuals with greater illness burden. In adjusted analysis, individuals who experienced more positive patient-centered communication reported higher levels of self-efficacy (β = 0.26, P < 0.0001); this association was strongest among those with greater illness burden. Higher levels of self-efficacy were observed among patients reporting more positive patient-centered communication; the observed association was stronger among those with greater chronic illness burden.

Novel clinical staging for patients with end-stage gastrointestinal carcinoma.

PubMed

Yasuda, Naokuni; Nakashima, Osamu; Ohnaka, Toru; Kamisaka, Koji; Tsunoda, Akira; Kusano, Mitsuo

2006-01-01

We created a new clinical staging system for end-stage gastrointestinal (GI) carcinoma to clarify the therapeutic goals for these patients. Data were obtained from a retrospective review of medical charts. Based on daily clinical observation of 144 patients with end-stage GI carcinoma, we classified the terminal stages as A, B, C, and D. The mean durations of terminal stages A, B, C, and D were 19, 16.6, 6.6, and 1.8 days, respectively, in patients with end-stage gastric cancer and 28.5, 9.1, 5.4, and 1.9 days, respectively, in patients with colorectal cancer. Moreover, 88.0% of patients with gastric carcinoma and 82.6% of patients with colorectal carcinoma passed through terminal stages A, B, C, and D sequentially. The patients in terminal stage B experienced temporary relief of symptoms, but those in terminal stage C did not (P < 0.05). These terminal stages can easily be judged by clinical observation and may be an effective new tool with which to manage patients with end-stage GI carcinoma and their families.

Estimation of legal age using calcification stages of third molars in living individuals.

PubMed

Streckbein, Philipp; Reichert, Isabelle; Verhoff, Marcel A; Bödeker, Rolf-Hasso; Kähling, Christopher; Wilbrand, Jan-Falco; Schaaf, Heidrun; Howaldt, Hans-Peter; May, Andreas

2014-12-01

The increased number of adolescents and young adults with unknown or inaccurately given date of birth is a current issue in justice and legal medicine. The objective of this study was to determine the extent to which third molar calcification stages assessed on panoramic X-rays could be useful as additional criteria for forensic age estimation in living individuals, focusing on the legally important ages 17 and 18. In a retrospective multi-center study, the developmental stage of each individual's third molar was analyzed using Demirjian's scale in 2360 cases. Additionally, sex, age and ancestry were assessed. Individuals with the lowest calcification stage of all present molars in stage H were ≥18 years with a likelihood of ≥99.05% in the female (n=388), and ≥99.24% in the male (n=482) population. The lowest calcification stage of all present third molars proved to be useful as an additional reliable criterion for the determination of an age ≥18 years. Copyright © 2014 Forensic Science Society. Published by Elsevier Ireland Ltd. All rights reserved.

Quality Improvement Initiative in School-Based Health Centers across New Mexico

ERIC Educational Resources Information Center

Booker, John M.; Schluter, Janette A.; Carrillo, Kris; McGrath, Jane

2011-01-01

Background: Quality improvement principles have been applied extensively to health care organizations, but implementation of quality improvement methods in school-based health centers (SBHCs) remains in a developmental stage with demonstration projects under way in individual states and nationally. Rural areas, such as New Mexico, benefit from the…

A stage is a stage is a stage: a direct comparison of two scoring systems.

PubMed

Dawson, Theo L

2003-09-01

L. Kohlberg (1969) argued that his moral stages captured a developmental sequence specific to the moral domain. To explore that contention, the author compared stage assignments obtained with the Standard Issue Scoring System (A. Colby & L. Kohlberg, 1987a, 1987b) and those obtained with a generalized content-independent stage-scoring system called the Hierarchical Complexity Scoring System (T. L. Dawson, 2002a), on 637 moral judgment interviews (participants' ages ranged from 5 to 86 years). The correlation between stage scores produced with the 2 systems was .88. Although standard issue scoring and hierarchical complexity scoring often awarded different scores up to Kohlberg's Moral Stage 2/3, from his Moral Stage 3 onward, scores awarded with the two systems predominantly agreed. The author explores the implications for developmental research.

Single stage queueing/manufacturing system model that involves emission variable

NASA Astrophysics Data System (ADS)

Murdapa, P. S.; Pujawan, I. N.; Karningsih, P. D.; Nasution, A. H.

2018-04-01

Queueing is commonly occured at every industry. The basic model of queueing theory gives a foundation for modeling a manufacturing system. Nowadays, carbon emission is an important and inevitable issue due to its huge impact to our environment. However, existing model of queuing applied for analysis of single stage manufacturing system has not taken Carbon emissions into consideration. If it is applied to manufacturing context, it may lead to improper decisisions. By taking into account of emission variables into queuing models, not only the model become more comprehensive but also it creates awareness on the issue to many parties that involves in the system. This paper discusses the single stage M/M/1 queueing model that involves emission variable. Hopefully it could be a starting point for the next more complex models. It has a main objective for determining how carbon emissions could fit into the basic queueing theory. It turned out that the involvement of emission variables into the model has modified the traditional model of a single stage queue to a calculation model of production lot quantity allowed per period.

Methods for Surgical Targeting of the STN in Early-Stage Parkinson’s Disease

PubMed Central

Camalier, Corrie R.; Konrad, Peter E.; Gill, Chandler E.; Kao, Chris; Remple, Michael R.; Nasr, Hana M.; Davis, Thomas L.; Hedera, Peter; Phibbs, Fenna T.; Molinari, Anna L.; Neimat, Joseph S.; Charles, David

2013-01-01

Patients with Parkinson’s disease (PD) experience progressive neurological decline, and future interventional therapies are thought to show most promise in early stages of the disease. There is much interest in therapies that target the subthalamic nucleus (STN) with surgical access. While locating STN in advanced disease patients (Hoehn–Yahr Stage III or IV) is well understood and routinely performed at many centers in the context of deep brain stimulation surgery, the ability to identify this nucleus in early-stage patients has not previously been explored in a sizeable cohort. We report surgical methods used to target the STN in 15 patients with early PD (Hoehn–Yahr Stage II), using a combination of image guided surgery, microelectrode recordings, and clinical responses to macrostimulation of the region surrounding the STN. Measures of electrophysiology (firing rates and root mean squared activity) have previously been found to be lower than in later-stage patients, however, the patterns of electrophysiology seen and dopamimetic macrostimulation effects are qualitatively similar to those seen in advanced stages. Our experience with surgical implantation of Parkinson’s patients with minimal motor symptoms suggest that it remains possible to accurately target the STN in early-stage PD using traditional methods. PMID:24678307

National Agricultural-Based Lubricants (NABL) Center

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

Honary, Lou

2013-09-30

This project, while defined as a one year project from September 30, 2012 – September 30, 2013, was a continuation of a number of tasks that were defined in previous years. Those tasks were performed and were finalized in this period. The UNI-NABL Center, which has been in operation in various forms since 1991, has closed its facilities since September 2013 and will be phasing out in June 2014. This report covers the individual tasks that were identified in the previous reports and provides closure to each task in its final stage.

Optimal management for surgically Stage 1 serous cancer of the uterus.

PubMed

Elit, L; Kwon, J; Bentley, J; Trim, K; Ackerman, I; Carey, M

2004-01-01

To describe the outcomes of patients who have undergone well-conducted surgery and found to have Stage 1 serous uterine cancer. This retrospective cohort study includes women who have been treated for Stage 1 serous cancer of the uterus from 1985 to 2001. Cases were included from the regional cancer centers in Hamilton, London, Sunnybrook Toronto and Cancer Care Manitoba. Forty-three women met the inclusion criteria: Complete surgical staging (n = 27), surgery followed by pelvic radiation therapy (n = 4), surgery followed by whole abdominal radiation therapy (n = 6), surgery followed by adjuvant chemotherapy (n = 6). Patient age or depth of invasion did not influence survival. Progression free interval was 22 months (SD = 14.29). Recurrence rate was highest for adjuvant chemotherapy (66%). Survival was assessed by treatment modality and a statistically significant poorer survival was seen in the adjuvant chemotherapy group (OR 17.5; 95% CI 1.3-227.6). No comment can be made on a superior treatment regimen given the small numbers in each treatment strata. This study supports the findings of others in the literature. In a group of patients where surgical staging shows limited disease (i.e., surgically Stage 1 disease), then surgery alone appears to be adequate treatment.

ARES I Upper Stage Subsystems Design and Development

NASA Technical Reports Server (NTRS)

Frate, David T.; Senick, Paul F.; Tolbert, Carol M.

2011-01-01

From 2005 through early 2011, NASA conducted concept definition, design, and development of the Ares I launch vehicle. The Ares I was conceived to serve as a crew launch vehicle for beyond-low-Earth-orbit human space exploration missions as part of the Constellation Program Architecture. The vehicle was configured with a single shuttle-derived solid rocket booster first stage and a new liquid oxygen/liquid hydrogen upper stage, propelled by a single, newly developed J-2X engine. The Orion Crew Exploration Vehicle was to be mated to the forward end of the Ares I upper stage through an interface with fairings and a payload adapter. The vehicle design passed a Preliminary Design Review in August 2008, and was nearing the Critical Design Review when efforts were concluded as a result of the Constellation Program s cancellation. At NASA Glenn Research Center, four subsystems were developed for the Ares I upper stage. These were thrust vector control (TVC) for the J-2X, electrical power system (EPS), purge and hazardous gas (P&HG), and development flight instrumentation (DFI). The teams working each of these subsystems achieved 80 percent or greater design completion and extensive development testing. These efforts were extremely successful representing state-of-the-art technology and hardware advances necessary to achieve Ares I reliability, safety, availability, and performance requirements. This paper documents the designs, development test activity, and results.

It takes chutzpah: oncology nurse leaders.