ESL Reading Textbooks vs. University Textbooks: Are We Giving Our Students the Input They May Need?

ERIC Educational Resources Information Center

Miller, Don

2011-01-01

Developing reading skills in a second language presents learners with many challenges, including lexico-grammatical decoding. An additional challenge is posed by the different registers of written text and the associated lexico-grammatical features with which learners must contend. Questioning the efficacy of using non-academic reading texts in…

Diploma R.N.'s: A New Challenge for Career Planning and Placement

ERIC Educational Resources Information Center

Bostaph, Charles; Moore, Marti

1978-01-01

Need for additional college education or career change is becoming common for registered nurses who are graduates of hospital diploma programs. This creates challenges for career planning and placement professionals, including counseling of R.N.s with a variety of majors and needs who wish to enter fields other than hospital nursing. (Author)

Near Real Time Integration of Satellite and Radar Data for Probabilistic Nearcasting of Severe Weather

NASA Astrophysics Data System (ADS)

Pilone, D.; Quinn, P.; Mitchell, A. E.; Baynes, K.; Shum, D.

2014-12-01

This talk introduces the audience to some of the very real challenges associated with visualizing data from disparate data sources as encountered during the development of real world applications. In addition to the fundamental challenges of dealing with the data and imagery, this talk discusses usability problems encountered while trying to provide interactive and user-friendly visualization tools. At the end of this talk the audience will be aware of some of the pitfalls of data visualization along with tools and techniques to help mitigate them. There are many sources of variable resolution visualizations of science data available to application developers including NASA's Global Imagery Browse Services (GIBS), however integrating and leveraging visualizations in modern applications faces a number of challenges, including: - Varying visualized Earth "tile sizes" resulting in challenges merging disparate sources - Multiple visualization frameworks and toolkits with varying strengths and weaknesses - Global composite imagery vs. imagery matching EOSDIS granule distribution - Challenges visualizing geographically overlapping data with different temporal bounds - User interaction with overlapping or collocated data - Complex data boundaries and shapes combined with multi-orbit data and polar projections - Discovering the availability of visualizations and the specific parameters, color palettes, and configurations used to produce them In addition to discussing the challenges and approaches involved in visualizing disparate data, we will discuss solutions and components we'll be making available as open source to encourage reuse and accelerate application development.

Collaboration challenges in systematic reviews: a survey of health sciences librarians

PubMed Central

Nicholson, Joey; McCrillis, Aileen; Williams, Jeff D.

2017-01-01

Objective: While many librarians have been asked to participate in systematic reviews with researchers, often these researchers are not familiar with the systematic review process or the appropriate role for librarians. The purpose of this study was to identify the challenges and barriers that librarians face when collaborating on systematic reviews. To take a wider view of the whole process of collaborating on systematic reviews, the authors deliberately focused on interpersonal and methodological issues other than searching itself. Methods: To characterize the biggest challenges that librarians face while collaborating on systematic review projects, we used a web-based survey. The thirteen-item survey included seventeen challenges grouped into two categories: methodological and interpersonal. Participants were required to indicate the frequency and difficulty of the challenges listed. Open-ended questions allowed survey participants to describe challenges not listed in the survey and to describe strategies used to overcome challenges. Results: Of the 17 challenges listed in the survey, 8 were reported as common by over 40% of respondents. These included methodological issues around having too broad or narrow research questions, lacking eligibility criteria, having unclear research questions, and not following established methods. The remaining challenges were interpersonal, including issues around student-led projects and the size of the research team. Of the top 8 most frequent challenges, 5 were also ranked as most difficult to handle. Open-ended responses underscored many of the challenges included in the survey and revealed several additional challenges. Conclusions: These results suggest that the most frequent and challenging issues relate to development of the research question and general communication with team members. Clear protocols for collaboration on systematic reviews, as well as a culture of mentorship, can help librarians prevent and address these challenges. PMID:28983202

Collaboration challenges in systematic reviews: a survey of health sciences librarians.

PubMed

Nicholson, Joey; McCrillis, Aileen; Williams, Jeff D

2017-10-01

While many librarians have been asked to participate in systematic reviews with researchers, often these researchers are not familiar with the systematic review process or the appropriate role for librarians. The purpose of this study was to identify the challenges and barriers that librarians face when collaborating on systematic reviews. To take a wider view of the whole process of collaborating on systematic reviews, the authors deliberately focused on interpersonal and methodological issues other than searching itself. To characterize the biggest challenges that librarians face while collaborating on systematic review projects, we used a web-based survey. The thirteen-item survey included seventeen challenges grouped into two categories: methodological and interpersonal. Participants were required to indicate the frequency and difficulty of the challenges listed. Open-ended questions allowed survey participants to describe challenges not listed in the survey and to describe strategies used to overcome challenges. Of the 17 challenges listed in the survey, 8 were reported as common by over 40% of respondents. These included methodological issues around having too broad or narrow research questions, lacking eligibility criteria, having unclear research questions, and not following established methods. The remaining challenges were interpersonal, including issues around student-led projects and the size of the research team. Of the top 8 most frequent challenges, 5 were also ranked as most difficult to handle. Open-ended responses underscored many of the challenges included in the survey and revealed several additional challenges. These results suggest that the most frequent and challenging issues relate to development of the research question and general communication with team members. Clear protocols for collaboration on systematic reviews, as well as a culture of mentorship, can help librarians prevent and address these challenges.

Meeting the Challenge of Interpretation: Hearing the Voices of People with Intellectual and Developmental Disability through I-Poems

ERIC Educational Resources Information Center

Corby, Deirdre; Taggart, Laurence; Cousins, Wendy

2018-01-01

Including the inner perspectives of people who have intellectual disability can pose methodological challenges to qualitative researchers. This article explains how the Listening Guide was applied as an additional step in the analysis during a study which used hermeneutic interviews with people with intellectual disability as the sole method of…

A Comparison Study of the Use of Paper versus Digital Textbooks by Undergraduate Students

ERIC Educational Resources Information Center

Johnson, James W.

2013-01-01

Today's undergraduate student faces many challenges. The challenges include paying for tuition and textbooks and finding a job upon graduation. These students are tech-savvy and seeking better ways to learn and retain material they learn in their classes. In addition, the textbook market is trying to evolve by serving this tech-generation through…

Material Challenges and Opportunities for Commercial Electric Aircraft

NASA Technical Reports Server (NTRS)

Misra, Ajay

2014-01-01

Significant reduction in carbon dioxide emission for future air transportation system will require adoption of electric propulsion system and more electric architectures. Various options for aircraft electric propulsion include hybrid electric, turboelectric, and full electric system. Realization of electric propulsion system for commercial aircraft applications will require significant increases in power density of electric motors and energy density of energy storage system, such as the batteries and fuel cells. In addition, transmission of MW of power in the aircraft will require high voltage power transmission system to reduce the weight of the power transmission system. Finally, there will be significant thermal management challenges. Significant advances in material technologies will be required to meet these challenges. Technologies of interest include materials with higher electrical conductivity than Cu, high thermal conductivity materials, and lightweight electrically insulating materials with high breakdown voltage, high temperature magnets, advanced battery and fuel cell materials, and multifunctional materials. The presentation will include various challenges for commercial electric aircraft and provide an overview of material improvements that will be required to meet these challenges.

International and cross-cultural issues: six key challenges for our professions.

PubMed

Marshall, Julie

2003-01-01

This paper discusses a number of key challenges facing professionals who work with people who have communication disabilities. The challenges are related to working internationally and in a cross-culturally competent way. Each challenge is discussed, drawing on material from a range of sources, including the papers in the final 2003 edition of FOLIA PHONIATRICA ET LOGOPAEDICA ('International and Cross-Cultural Issues'). The challenges discussed cover how experiences from majority world countries can be used to benefit services elsewhere, 'mainstreaming' commitment to cross-cultural competence, learning from relationships with other professionals, influencing research practice, responding to requests to work internationally and finally, dealing with cultural differences that challenge working practices. Some solutions are suggested and additional questions posed. Copyright 2003 S. Karger AG, Basel

Certification of lightning protection for a full-authority digital engine control

NASA Technical Reports Server (NTRS)

Dargi, M.; Rupke, E.; Wiles, K.

1991-01-01

FADEC systems present many challenges to the lightning protection engineer. Verification of the protection-design adequacy for certification purposes presents additional challenges. The basic requirements of the certification plan of a FADEC is to demonstrate compliance with Federal Airworthiness Regulations (FAR) 25.1309 and 25.581. These FARs are intended for transport aircraft, but there are equivalent sections for general aviation aircraft, normal and transport rotorcraft. Military aircraft may have additional requirements. The criteria for demonstration of adequate lightning protection for a FADEC systems include the procedures outlined in FAA Advisory Circular (AC) 20-136, Protection of aircraft electrical/electronic systems against the indirect effects of lightning. As FADEC systems, including the interconnecting wiring, are generally not susceptible to direct attachment of lightning currents, the verification of protection against indirect effects is primarily described.

Does Cultural Adaptation Have a Role in Substance Abuse Treatment?

PubMed Central

Burlew, A. Kathleen; Copeland, Valire Carr; Ahuama-Jonas, Chizara; Calsyn, Donald A.

2013-01-01

The changing ethnic composition of the nation and increasing requirements to use evidence-based treatments (EBTs) challenge mental health professionals to adapt treatments and interventions to be appropriate for their clients. This article applies the available information on cultural adaptation to substance abuse. The authors’ review suggests that the most common approaches for adapting substance use interventions include some combination of either community involvement in the adaptation, existing research and literature, and/or consultation from experts to adapt EBTs. The challenges facing the development of culturally adapted interventions include the need for additional research to determine which specific EBTs warrant adaptation, the responsibility of maintaining the balance between fidelity and adaptation, and the challenge of intragroup diversity. PMID:23731430

Use of measles supplemental immunization activities (SIAs) as a delivery platform for other maternal and child health interventions: opportunities and challenges.

PubMed

Johri, Mira; Sharma, Jitendar K; Jit, Mark; Verguet, Stéphane

2013-02-18

Measles supplementary immunization activities (SIAs) offer children in countries with weaker immunization delivery systems like India a second opportunity for measles vaccination. They could also provide a platform to deliver additional interventions, but the feasibility and acceptability of including add-ons is uncertain. We surveyed Indian programme officers involved in the current (2010-2012) measles SIAs concerning opportunities and challenges of using SIAs as a delivery platform for other maternal and child health interventions. Respondents felt that an expanded SIA strategy including add-ons could be of great value in improving access and efficiency. They viewed management challenges, logistics, and safety as the most important potential barriers. They proposed that additional interventions be selected using several criteria, of which importance of the health problem, safety, and contribution to health equity figured most prominently. For children, they recommended inclusion of basic interventions to address nutritional deficiencies, diarrhoea and parasites over vaccines. For mothers, micronutrient interventions were highest ranked. Copyright © 2012 Elsevier Ltd. All rights reserved.

What are the challenges in developing effective health policies for obesity?

PubMed

Binks, M; Chin, S-H

2017-06-01

Identifying and implementing thoughtful, evidence-based (or at least evidence-informed) public health approaches to influencing obesity is a complex issue fraught with multiple challenges. These challenges begin with determining whether obesity policy approaches should be implemented. This is considered within the broader context of how common public health policy approaches may be relevant and applied to obesity. Additional challenges discussed include inconsistencies in clearly identifying obesity policy targets (for example, prevention versus treatment), selection of appropriate intervention targets and the identification and measurement of meaningful outcomes. Current policy initiatives are drawn upon to illustrate these challenges in the context of promoting solution-focused dialog aimed toward improving current initiatives and informing the development of new programs.

Tourette syndrome in children and adolescents: special considerations.

PubMed

Eapen, Valsamma; Crncec, Rudi

2009-12-01

Tourette syndrome (TS) affects people of all ages, with onset in early childhood and continuing through the different stages of the life cycle into adolescence and adults. This review focuses on barriers to diagnosis and challenges in the management of young patients with TS. Barriers to identification occur at multiple levels, including detection in the community setting (including schools), parents' help-seeking behavior, and cultural influences on such behavior, as well as diagnosis by the medical provider. Challenges to management include unfamiliarity of primary care providers, inconsistencies in the diagnosis and management plan, and failure to recognize comorbid conditions, as well as inadequate knowledge and lack of resources to effectively deal with comorbidities. In addition to the complexities posed by pharmacological interactions, there are unique psychosocial challenges experienced by young people with TS and their families. Effective communication and collaboration between families, health care providers, and school personnel, as well as supportive communities, are essential components of comprehensive management.

Changing therapeutic paradigms in CMV retinitis in AIDS.

PubMed

Piper, H; Ciulla, T A; Danis, R P; Pratt, L M

2000-12-01

Cytomegalovirus (CMV) retinitis is a common ocular complication of immunosuppression. The management of CMV retinitis has been continuously evolving over the last decade. The mainstay of therapy remains ganciclovir and foscarnet. However, increasing resistance and ongoing toxicities to these agents remain a challenge. Additional frequently utilised agents include cidofovir and fomivirsen. The advent of highly active antiretroviral therapy (HAART) has allowed the restoration of immunocompetency to many patients previously challenged by CMV infection. In some circumstances, HAART has even eliminated the need for ongoing antiviral therapy. This paper reviews the current treatment modalities, including their toxicities and dosing recommendations.

Using the Visual and Performing Arts to Complement Young Adolescents' "Close Reading" of Texts

ERIC Educational Resources Information Center

McDermott, Peter; Falk-Ross, Francine; Medow, Sharon

2017-01-01

The educational needs of young adolescents require that curricula include a more expanded set of multiple integrative approaches, including new literacies, and that it be "challenging, exploratory, integrative, and relevant" (National Middle School Association, 2010). Although educators are now focusing on the addition of digital formats…

A reflective teaching challenge to motivate educational innovation.

PubMed

Edwards, Roger A; Kirwin, Jennifer; Gonyeau, Michael; Matthews, S James; Lancaster, Jason; DiVall, Margarita

2014-06-17

To describe a teaching challenge intended to increase faculty use of evidence-based and student-centered instructional strategies in the demanding school of pharmacy context with technology-savvy students. A teaching challenge was created that required faculty members to incorporate a "new-to-you" innovative teaching method in a class, course, or experiential activity. The method was linked to at least 1 of 7 evidence-based principles for effective teaching. Faculty members were exposed to colleagues' teaching strategies via brief voluntary presentations at department meetings. A post-challenge survey provided assessment data about the challenge. Responses to a baseline survey provided additional information about what faculty members were already doing (52% response rate). Eighty-one percent of faculty respondents completed the challenge. A wide array of new strategies (13 categories such as flipped classrooms and social media) was implemented and 75% included the use of technology. Nearly all respondents (96%) thought that participation in the challenge was worth the effort and planned to participate again the following year. All faculty members intended to continue using their new strategy and 56% planned additional modifications with future implementations. The challenge demonstrated how multiple goals of curricular improvement, faculty development, and student-centered instruction could be achieved together. The teaching challenge motivated most of the faculty members to try something new to them. Links between evidence-based principles and day-to-day activities were strengthened. The new-to-you design placed the challenge within reach of faculty members regardless of their background, subject, or experience.

A study of a museum-school partnership

NASA Astrophysics Data System (ADS)

Wojton, Mary Ann

Partnerships between museums and schools never have been more important than they are today. Schools, especially urban schools, are facing challenges, including low student achievement and difficulty obtaining funding. Partners can help schools overcome these challenges by sharing educational and financial resources. Nearly 11,000 American museums spend more than $1 billion annually to provide over 18 million instructional hours for k-12 educational programs such as professional development for teachers, guided field trips, and staff visits to schools. Museums would seem like natural partners for challenged urban schools. Yet museums and schools struggle to establish and maintain effective partnerships. This study examined a partnership between a science center and an urban elementary school to provide additional knowledge and resources for those in the field to overcome these challenges in order to create relationships that help students. Using qualitative methods with interpretive descriptive purposes (Erickson, 1986; Glesne, 1999; Lincoln & Guba, 2000), the research design is based on several methods of data collection, including face-to-face, semi-structured interviews; observations; written text; and field notes. Participants in this study included students, parents, teachers, school administrators and museum educators. In addition, adult representatives of community organizations were interviewed to determine the impact of the partnership on the community. The study found that an effective partnership will have four basic elements: mutual goals, communication plan, key leader support, planning and research, and four interpersonal elements: personal responsibility, honesty, communication at the intimate level, and trust. Partners may have difficulty developing these to their fullest extent due to time limitations. No partnership is perfect. By creating strong interpersonal relationships, partners can mitigate challenges caused by limited basic elements and increase the likelihood that their partnership will be effective.

A Socially Inclusive Teaching Strategy for Transforming the Teaching of English First Additional Language

ERIC Educational Resources Information Center

Malebese, M. L.

2017-01-01

This paper explores ways of including indigenous knowledge systems in the teaching of English First Additional Language (EFAL). The aim is to use a socially inclusive teaching strategy in such a manner that the imbalances that past oppressive regimes brought into the teaching and learning of a second language, EFAL in this case, is challenged and…

Assessment of nurse retention challenges and strategies in Lebanese hospitals: the perspective of nursing directors.

PubMed

El-Jardali, Fadi; Merhi, Mirvat; Jamal, Diana; Dumit, Nuhad; Mouro, Gladys

2009-05-01

Assess nurse retention challenges and strategies as perceived by nursing directors in Lebanese hospitals. The Kampala Health Workforce Declaration stressed the importance of retaining an effective, responsive and equitably distributed health workforce, particularly nurses. Little is known about nurse retention challenges and strategies in Lebanon. Nursing directors of 76 hospitals participated and were sent a two-page survey on perceived retention challenges and hospital-based retention strategies. Retention challenges included unsatisfactory salary, unsuitable shifts and working hours, as well as better opportunities in other areas within or outside Lebanon. Retention strategies included implementing financial rewards and benefits, a salary scale, staff development, praise and improving work environment. Nursing directors did not address all perceived challenges in their strategies. To better manage the nursing workforce, nursing directors should regularly measure and monitor nurse turnover rates and also their causes and predictors. Nursing directors should develop, implement and evaluate retention strategies. More information is needed on the management and leadership capacities of nursing directors in addition to their span of control. Nursing directors are facing challenges in retaining their nurses. If these problems are not addressed, Lebanon will continue to lose competent and skilled nurses.

The Shigella human challenge model.

PubMed

Porter, C K; Thura, N; Ranallo, R T; Riddle, M S

2013-02-01

Shigella is an important bacterial cause of infectious diarrhoea globally. The Shigella human challenge model has been used since 1946 for a variety of objectives including understanding disease pathogenesis, human immune responses and allowing for an early assessment of vaccine efficacy. A systematic review of the literature regarding experimental shigellosis in human subjects was conducted. Summative estimates were calculated by strain and dose. While a total of 19 studies evaluating nine strains at doses ranging from 10 to 1 × 1010 colony-forming units were identified, most studies utilized the S. sonnei strain 53G and the S. flexneri strain 2457T. Inoculum solution and pre-inoculation buffering has varied over time although diarrhoea attack rates do not appear to increase above 75-80%, and dysentery rates remain fairly constant, highlighting the need for additional dose-ranging studies. Expansion of the model to include additional strains from different serotypes will elucidate serotype and strain-specific outcome variability.

Planning as an Iterative Process

NASA Technical Reports Server (NTRS)

Smith, David E.

2012-01-01

Activity planning for missions such as the Mars Exploration Rover mission presents many technical challenges, including oversubscription, consideration of time, concurrency, resources, preferences, and uncertainty. These challenges have all been addressed by the research community to varying degrees, but significant technical hurdles still remain. In addition, the integration of these capabilities into a single planning engine remains largely unaddressed. However, I argue that there is a deeper set of issues that needs to be considered namely the integration of planning into an iterative process that begins before the goals, objectives, and preferences are fully defined. This introduces a number of technical challenges for planning, including the ability to more naturally specify and utilize constraints on the planning process, the ability to generate multiple qualitatively different plans, and the ability to provide deep explanation of plans.

Soft Encapsulation of Flexible Electrical Stimulation Implant: Challenges and Innovations

PubMed Central

Debelle, Adrien; Hermans, Laura; Bosquet, Maxime; Dehaeck, Sam; Lonys, Laurent; Scheid, Benoit; Nonclercq, Antoine; Vanhoestenberghe, Anne

2016-01-01

In this document we discuss the main challenges encountered when producing flexible electrical stimulation implants, and present our approach to solving them for prototype production. We include a study of the optimization of the flexible PCB design, the selection of additive manufacturing materials for the mold, and the chemical compatibility of the different materials. Our approach was tested on a flexible gastro-stimulator as part of the ENDOGES research program. PMID:28078073

A standardised challenge model with an enterotoxigenic F4+ Escherichia coli strain in piglets assessing clinical traits and faecal shedding of fae and est-II toxin genes.

PubMed

Spitzer, Franz; Vahjen, Wilfried; Pieper, Robert; Martinez-Vallespin, Beatriz; Zentek, Jürgen

2014-12-01

This study evaluated the effect of five feed additives on post weaning diarrhoea (PWD) in piglets challenged 3 d after weaning with an enterotoxigenic Escherichia coli strain (ETEC). In three experimental runs, a total of 84 piglets was weaned at 21 days of age and randomly assigned to seven treatments. As dietary treatment, piglets were fed a basal diet or diets with addition of bovine colostrum (0.2%), pineapple stem extract containing bromelain (0.2%), an autolysed yeast preparation (Saccharomyces cerevisiae) (0.1%), a combination of organic acids (0.7%) and a phytogenic product with thyme essential oil (0.015%). A porcine ETEC, serotype O149:K91:K88ac was given twice via oral infection on day 3 after weaning at 10(10) colony forming units/animal. One group of piglets was fed the basal diet without ETEC challenge. Traits included clinical sores, body temperature, faecal scoring and determination of faecal dry matter and the shedding of fae and est-II ETEC toxin genes. After weaning, non-challenged control piglets did not show signs of diarrhoea or impaired health, while the majority of infected piglets had a drop in body temperature, signs of diarrhoea and impaired general health. Mortality, the decrease of faecal dry matter and shedding of the toxin genes fae and est-II were not affected by the different additives. In conclusion, the ETEC challenge model induced distinct clinical signs of PWD in piglets, but the tested feed additives had no preventive effect under these conditions.

Addressing Challenges in Studies of Behavioral Responses of Whales to Noise.

PubMed

Cato, Douglas H; Dunlop, Rebecca A; Noad, Michael J; McCauley, Robert D; Kniest, Eric; Paton, David; Kavanagh, Ailbhe S

2016-01-01

Studying the behavioral response of whales to noise presents numerous challenges. In addition to the characteristics of the noise exposure, many factors may affect the response and these must be measured and accounted for in the analysis. An adequate sample size that includes matching controls is crucial if meaningful results are to be obtained. Field work is thus complicated, logistically difficult, and expensive. This paper discusses some of the challenges and how they are being met in a large-scale multiplatform project in which humpback whales are exposed to the noise of seismic air guns.

A review of design issues specific to hypersonic flight vehicles

NASA Astrophysics Data System (ADS)

Sziroczak, D.; Smith, H.

2016-07-01

This paper provides an overview of the current technical issues and challenges associated with the design of hypersonic vehicles. Two distinct classes of vehicles are reviewed; Hypersonic Transports and Space Launchers, their common features and differences are examined. After a brief historical overview, the paper takes a multi-disciplinary approach to these vehicles, discusses various design aspects, and technical challenges. Operational issues are explored, including mission profiles, current and predicted markets, in addition to environmental effects and human factors. Technological issues are also reviewed, focusing on the three major challenge areas associated with these vehicles: aerothermodynamics, propulsion, and structures. In addition, matters of reliability and maintainability are also presented. The paper also reviews the certification and flight testing of these vehicles from a global perspective. Finally the current stakeholders in the field of hypersonic flight are presented, summarizing the active programs and promising concepts.

Mars Design Reference Architecture 5.0 Study: Executive Summary

NASA Technical Reports Server (NTRS)

Drake, Bret G.

2008-01-01

The NASA Mars Design Reference Architecture 5.0 Study seeks to update its long term goals and objective for human exploration missions; flight and surface systems for human missions and supporting infrastructure; operational concept for human and robotic exploration of Mars; key challenges including risk and cost drivers; and, its development schedule options. It additionally seeks to assess strategic linkages between lunar and Mars strategies and develop and understanding of methods for reducing the cost/risk of human Mars missions through investment in research, technology development, and synergy with other exploration plans. Recommendations are made regarding conjunction class (long-stay) missions which are seen as providing the best balance of cost, risk, and performance. Additionally, this study reviews entry, descent, and landing challenges; in-space transportation systems; launch vehicle and Orion assessments; risk and risk mitigation; key driving requirements and challenges; and, lunar linkages.

CASL Verification and Validation Plan

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

Mousseau, Vincent Andrew; Dinh, Nam

2016-06-30

This report documents the Consortium for Advanced Simulation of LWRs (CASL) verification and validation plan. The document builds upon input from CASL subject matter experts, most notably the CASL Challenge Problem Product Integrators, CASL Focus Area leaders, and CASL code development and assessment teams. This document will be a living document that will track progress on CASL to do verification and validation for both the CASL codes (including MPACT, CTF, BISON, MAMBA) and for the CASL challenge problems (CIPS, PCI, DNB). The CASL codes and the CASL challenge problems are at differing levels of maturity with respect to validation andmore » verification. The gap analysis will summarize additional work that needs to be done. Additional VVUQ work will be done as resources permit. This report is prepared for the Department of Energy’s (DOE’s) CASL program in support of milestone CASL.P13.02.« less

Text Savvy

ERIC Educational Resources Information Center

Guilford, Jacquelyn; Bustamante, Annette; Mackura, Kelly; Hirsch, Susan; Lyon, Edward; Estrada, Kelly

2017-01-01

Learning science is language intensive. Students might have to interpret the meaning of models, support claims with evidence, communicate arguments, and discuss phenomena and scientific principles. For English Language Learners (ELLs), engaging in scientific and engineering practices includes additional challenges. This article describes a series…

Implications and challenges for implementation of the FDA’s final deeming rule for waterpipe tobacco

PubMed Central

Sutfin, Erin L; Soule, Eric K; McKelvey, Karma; Jenson, Desmond

2017-01-01

For the first time, the Food and Drug Administration’s (FDAs) Center for Tobacco Products now has regulatory authority over all tobacco products, including waterpipe tobacco. In the rule expanding its authority to cover all tobacco products, the FDA uses largely a one-size-fits-all approach. However, several aspects of waterpipe tobacco smoking make it unique from other tobacco products, which may require more specific, tailored rules. This paper describes the distinct features of waterpipe tobacco products and accessories, and identifies unique challenges to the current regulation posed by this form of tobacco use. Additionally, we highlight the need for further research-generated evidence to support additional rulemaking. PMID:28667092

Inhalation delivery of protein therapeutics.

PubMed

Kane, Colleen; O'Neil, Karyn; Conk, Michelle; Picha, Kristen

2013-04-01

Inhaled therapeutics are used routinely to treat a variety of pulmonary diseases including asthma, COPD and cystic fibrosis. In addition, biological therapies represent the fastest growing segment of approved pharmaceuticals. However, despite the increased availability of biological therapies, nearly all inhaled therapeutics are small molecule drugs with only a single inhaled protein therapeutic approved. There remains a significant unmet need for therapeutics in pulmonary diseases, and biological therapies with potential to alter disease progression represent a significant opportunity to treat these challenging diseases. This review provides a background into efforts to develop inhaled biological therapies and highlights some of the associated challenges. In addition, we speculate on the ideal properties of a biologic therapy for inhaled delivery.

Effects of Dietary Additives and Early Feeding on Performance, Gut Development and Immune Status of Broiler Chickens Challenged with Clostridium perfringens

PubMed Central

Ao, Z.; Kocher, A.; Choct, M.

2012-01-01

The effects of dietary additives and holding time on resistance and resilience of broiler chickens to Clostridium perfringens challenge were investigated by offering four dietary treatments. These were a negative control (basal), a positive control (Zn-bacitracin) and two dietary additives, mannanoligosaccharides (MOS), and acidifier. Two holding times included (a) immediate access to feed and water post hatch (FED) and (b) access to both feed and water 48 h post hatch (HELD). Chicks fed Zn-bacitracin had no intestinal lesions attributed to necrotic enteritis (NE), whereas chicks fed both MOS or acidifier showed signs of NE related lesions. All dietary treatments were effective in reducing the numbers of C. perfringens in the ileum post challenge. The FED chicks had heavier body weight and numerically lower mortality. The FED chicks also showed stronger immune responses to NE challenge, showing enhanced (p<0.05) proliferation of T-cells. Early feeding of the MOS supplemented diet increased (p<0.05) IL-6 production. The relative bursa weight of the FED chicks was heavier at d 21 (p<0.05). All the additives increased the relative spleen weight of the HELD chicks at d 14 (p<0.05). The FED chicks had increased villus height and reduced crypt depth, and hence an increased villus/crypt ratio, especially in the jejunum at d 14 (p<0.05). The same was true for the HELD chicks given dietary additives (p<0.05). It may be concluded that the chicks with early access to dietary additives showed enhanced immune response and gut development, under C. perfringens challenge. The findings of this study shed light on managerial and nutritional strategies that could be used to prevent NE in the broiler industry without the use of in-feed antibiotics. PMID:25049595

Manufacturing and Security Challenges in 3D Printing

NASA Astrophysics Data System (ADS)

Zeltmann, Steven Eric; Gupta, Nikhil; Tsoutsos, Nektarios Georgios; Maniatakos, Michail; Rajendran, Jeyavijayan; Karri, Ramesh

2016-07-01

As the manufacturing time, quality, and cost associated with additive manufacturing (AM) continue to improve, more and more businesses and consumers are adopting this technology. Some of the key benefits of AM include customizing products, localizing production and reducing logistics. Due to these and numerous other benefits, AM is enabling a globally distributed manufacturing process and supply chain spanning multiple parties, and hence raises concerns about the reliability of the manufactured product. In this work, we first present a brief overview of the potential risks that exist in the cyber-physical environment of additive manufacturing. We then evaluate the risks posed by two different classes of modifications to the AM process which are representative of the challenges that are unique to AM. The risks posed are examined through mechanical testing of objects with altered printing orientation and fine internal defects. Finite element analysis and ultrasonic inspection are also used to demonstrate the potential for decreased performance and for evading detection. The results highlight several scenarios, intentional or unintentional, that can affect the product quality and pose security challenges for the additive manufacturing supply chain.

Ethically sustainable governance in the biobanking of eggs and embryos for research.

PubMed

Stroud, Karla; O'Doherty, Kieran C

2015-12-01

Biobanking of human tissues is associated with a range of ethical, legal, and social (ELS) challenges. These include difficulties in operationalising informed consent protocols, protecting donors' privacy, managing the return of incidental findings, conceptualising ownership of tissues, and benefit sharing. Though largely unresolved, these challenges are well documented and debated in academic literature. One common response to the ELS challenges of biobanks is a call for strong and independent governance of biobanks. Theorists who argue along these lines suggest that since fully informed consent to a single research project is often not feasible, research participants should be given the additional protection of being allowed to consent to the governance framework of the biobank. Such governance therefore needs to be transparent and ethically sustainable. In this paper we review the governance challenges of establishing and maintaining human tissue biobanks. We then discuss how the creation of a biobank for eggs and embryos, in particular, may introduce additional or unique challenges beyond those presented by the biobanking of other human tissues. Following previous work on biobank governance, we argue that ethically sustainable governance needs to be participatory, adaptive, and trustworthy.

Could Wind or Solar Energy Replace Diesel Generators for Aviation Ground Maintenance Operations?

DTIC Science & Technology

2013-04-17

power. Both of these systems depend on the sun to produce energy. Wind turbines depend on wind which results from the uneven heating of the earth...inefficient. In addition to these limitations, both systems are costly and their installation brings a number of challenges. For the wind turbines ...these challenges include: the obstruction created by the height of the turbines near airfields, the amount of land necessary for a 7 turbines wind farm

Challenges and Opportunities for Tribal Waters: Addressing Disparities in Safe Public Drinking Water on the Crow Reservation in Montana, USA.

PubMed

Doyle, John T; Kindness, Larry; Realbird, James; Eggers, Margaret J; Camper, Anne K

2018-03-21

Disparities in access to safe public drinking water are increasingly being recognized as contributing to health disparities and environmental injustice for vulnerable communities in the United States. As the Co-Directors of the Apsaálooke Water and Wastewater Authority (AWWWA) for the Crow Tribe, with our academic partners, we present here the multiple and complex challenges we have addressed in improving and maintaining tribal water and wastewater infrastructure, including the identification of diverse funding sources for infrastructure construction, the need for many kinds of specialized expertise and long-term stability of project personnel, ratepayer difficulty in paying for services, an ongoing legacy of inadequate infrastructure planning, and lack of water quality research capacity. As a tribal entity, the AWWWA faces additional challenges, including the complex jurisdictional issues affecting all phases of our work, lack of authority to create water districts, and additional legal and regulatory gaps-especially with regards to environmental protection. Despite these obstacles, the AWWWA and Crow Tribe have successfully upgraded much of the local water and wastewater infrastructure. We find that ensuring safe public drinking water for tribal and other disadvantaged U.S. communities will require comprehensive, community-engaged approaches across a broad range of stakeholders to successfully address these complex legal, regulatory, policy, community capacity, and financial challenges.

Challenges and Opportunities for Tribal Waters: Addressing Disparities in Safe Public Drinking Water on the Crow Reservation in Montana, USA

PubMed Central

Doyle, John T.; Kindness, Larry; Realbird, James; Camper, Anne K.

2018-01-01

Disparities in access to safe public drinking water are increasingly being recognized as contributing to health disparities and environmental injustice for vulnerable communities in the United States. As the Co-Directors of the Apsaálooke Water and Wastewater Authority (AWWWA) for the Crow Tribe, with our academic partners, we present here the multiple and complex challenges we have addressed in improving and maintaining tribal water and wastewater infrastructure, including the identification of diverse funding sources for infrastructure construction, the need for many kinds of specialized expertise and long-term stability of project personnel, ratepayer difficulty in paying for services, an ongoing legacy of inadequate infrastructure planning, and lack of water quality research capacity. As a tribal entity, the AWWWA faces additional challenges, including the complex jurisdictional issues affecting all phases of our work, lack of authority to create water districts, and additional legal and regulatory gaps—especially with regards to environmental protection. Despite these obstacles, the AWWWA and Crow Tribe have successfully upgraded much of the local water and wastewater infrastructure. We find that ensuring safe public drinking water for tribal and other disadvantaged U.S. communities will require comprehensive, community-engaged approaches across a broad range of stakeholders to successfully address these complex legal, regulatory, policy, community capacity, and financial challenges. PMID:29561815

Psychological stress during exercise: cardiorespiratory and hormonal responses.

PubMed

Webb, Heather E; Weldy, Michael L; Fabianke-Kadue, Emily C; Orndorff, G R; Kamimori, Gary H; Acevedo, Edmund O

2008-12-01

The purpose of this study was to examine the cardiorespiratory (CR) and stress hormone responses to a combined physical and mental stress. Eight participants (VO2(max) = 41.24 +/- 6.20 ml kg(-1) min(-1)) completed two experimental conditions, a treatment condition including a 37 min ride at 60% of VO2(max) with participants responding to a computerized mental challenge dual stress condition (DSC) and a control condition of the same duration and intensity without the mental challenge exercise alone condition (EAC). Significant interactions across time were found for CR responses, with heart rate, ventilation, and respiration rate demonstrating higher increases in the DSC. Additionally, norepinephrine was significantly greater in the DSC at the end of the combined challenge. Furthermore, cortisol area-under-the-curve (AUC) was also significantly elevated during the DSC. These results demonstrate that a mental challenge during exercise can exacerbate the stress response, including the release of hormones that have been linked to negative health consequences (cardiovascular, metabolic, autoimmune illnesses).

Smart nanoparticles as targeting platforms for HIV infections

NASA Astrophysics Data System (ADS)

Adhikary, Rishi Rajat; More, Prachi; Banerjee, Rinti

2015-04-01

While Human Immunodeficiency Virus (HIV) infections are reducing in incidence with the advent of Highly Active Anti-retroviral Therapy (HAART), there remain a number of challenges including the existence of reservoirs, drug resistance and anatomical barriers to antiretroviral therapy. To overcome these, smart nanoparticles with stimuli responsive release are proposed for delivery of anti-retroviral agents. The paper highlights the strategic similarities between the design of smart antiretroviral nanocarriers and those optimized for cancer chemotherapy. This includes the development of nanoparticles capable of passive and active targeting as well as those that are responsive to various internal and external triggers. For antiretroviral therapy, the relevant triggers for stimuli responsive release of drugs include semen, enzymes, endosomal escape, temperature and magnetic field. Deriving from the experience of cancer chemotherapy, additional potential triggers are light and ultrasound which remain hitherto unexplored in HIV therapy. In addition, the roles of nanomicrobicides (nanogels) and virus mimetic nanoparticles are discussed from the point of view of prevention of HIV transmission. The challenges associated with translation of smart nanoparticles for HIV infections to realize the Millennium Development Goal of combating HIV infections are discussed.

Smart nanoparticles as targeting platforms for HIV infections.

PubMed

Adhikary, Rishi Rajat; More, Prachi; Banerjee, Rinti

2015-05-07

While Human Immunodeficiency Virus (HIV) infections are reducing in incidence with the advent of Highly Active Anti-retroviral Therapy (HAART), there remain a number of challenges including the existence of reservoirs, drug resistance and anatomical barriers to antiretroviral therapy. To overcome these, smart nanoparticles with stimuli responsive release are proposed for delivery of anti-retroviral agents. The paper highlights the strategic similarities between the design of smart antiretroviral nanocarriers and those optimized for cancer chemotherapy. This includes the development of nanoparticles capable of passive and active targeting as well as those that are responsive to various internal and external triggers. For antiretroviral therapy, the relevant triggers for stimuli responsive release of drugs include semen, enzymes, endosomal escape, temperature and magnetic field. Deriving from the experience of cancer chemotherapy, additional potential triggers are light and ultrasound which remain hitherto unexplored in HIV therapy. In addition, the roles of nanomicrobicides (nanogels) and virus mimetic nanoparticles are discussed from the point of view of prevention of HIV transmission. The challenges associated with translation of smart nanoparticles for HIV infections to realize the Millennium Development Goal of combating HIV infections are discussed.

Challenges for Electronics in the Vision for Space Exploration

NASA Technical Reports Server (NTRS)

LaBel, Kenneth A.

2005-01-01

This presentation has been a brief snapshot discussing electronics and Exploration-related challenges. The vision for Space Exploration creates a new paradigm for NASA missions. This includes transport (Crew Exploration Vehicle-CEV), and lunar and Mars Exploration and human presence. If one considers the additional hazards faced by these concepts versus more traditional NASA missions, multiple challenges surface for reliable utilization of electronic parts. The true challenge is to provide a risk as low as reasonably achievable (ALARA-a traditional biological radiation exposure term), while still providing cost effective solutions. This presentation also discusses the hazard for electronic parts and exploration, the types of electronic parts for exploration, and the critical juncture for space usage of commercial changes in the electronics world.

Barriers to weight-related health behaviours: a qualitative comparison of the socioecological conditions between pregnant and post-partum low-income women

PubMed Central

Uesugi, Keriann; Olson, Christine

2015-01-01

The association between socio-ecological factors and poor health outcomes for low-income women and their children has been the focus of disparities research for several decades. This research compares the socio-ecological conditions among low-income women from pregnancy to postpartum and highlights the factors that make weight management increasingly difficult after delivery. As part of the formative research for an online health intervention, group and individual interviews were conducted with low-income pregnant and postpartum women. Five pregnancy group interviews (n=15 women), five postpartum group interviews (n=23 women) and seven individual interviews with a total of 45 participants were conducted in Rochester, NY. All interviews were audio-recorded. The constant comparative method was used to code interview notes and identify emergent themes. Subjects faced many challenges that affected their attitudes, beliefs and their ability to maintain or improve healthy-weight behaviors. These included unemployment, relationship issues, minimal social support, lack of education, limited healthcare access, pre-existing medical conditions and neighborhood disadvantage. Compared to pregnant women, postpartum women faced additional difficulties, such as child illnesses and custody issues. The most striking differences between pregnancy and postpartum related to the family’s medical problems and greater environmental constraints. Many factors detracted from women’s capacity to engage in healthy-weight behaviors postpartum, including challenges present prior to delivery, challenges present prior to delivery that worsen after delivery, and new challenges that begin after delivery. These additional postpartum challenges need to be considered in designing programs, policies and interventions that promote healthy weight. PMID:25040706

Modernizing the Opposed-Piston Engine for More Efficient Military Ground Vehicle Applications

DTIC Science & Technology

2012-08-01

stroke (OP2S) engines and their use in military applications. It also highlights the engine’s fundamental architectural advantages. In addition, the...rejection. Furthermore, the paper includes an overview of the fundamental challenges of OP2S engines, along with a discussion of how Achates Power...It also highlights the engine’s fundamental architectural advantages. In addition, the paper introduces the Achates Power opposed-piston engine

An Overview on Additive Manufacturing of Polymers

NASA Astrophysics Data System (ADS)

Jasiuk, Iwona; Abueidda, Diab W.; Kozuch, Christopher; Pang, Siyuan; Su, Frances Y.; McKittrick, Joanna

2018-03-01

We present an overview on additive manufacturing (AM), also called three-dimensional printing, with a focus on polymers. First, we introduce the AM concept. Next, we outline several AM processes, including their advantages and limitations, and list common polymers that are used in commercial printers. Then, we state various AM applications and present two examples. We conclude with a global view of the AM field, its challenges, and future directions.

Substance misuse prevention and economic analysis: challenges and opportunities regarding international utility.

PubMed

Guyll, Max; Spoth, Richard; Cornish, Marilyn A

2012-01-01

Economic analyses of substance misuse prevention assess the intervention cost necessary to achieve a particular outcome, and thereby provide an additional dimension for evaluating prevention programming. This article reviews several types of economic analysis, considers how they can be applied to substance misuse prevention, and discusses challenges to enhancing their international relevance, particularly their usefulness for informing policy decisions. Important first steps taken to address these challenges are presented, including the disease burden concept and the development of generalized cost-effectiveness, advances that facilitate international policy discussions by providing a common framework for evaluating health care needs and program effects.

Design and high-volume manufacture of low-cost molded IR aspheres for personal thermal imaging devices

NASA Astrophysics Data System (ADS)

Zelazny, A. L.; Walsh, K. F.; Deegan, J. P.; Bundschuh, B.; Patton, E. K.

2015-05-01

The demand for infrared optical elements, particularly those made of chalcogenide materials, is rapidly increasing as thermal imaging becomes affordable to the consumer. The use of these materials in conjunction with established lens manufacturing techniques presents unique challenges relative to the cost sensitive nature of this new market. We explore the process from design to manufacture, and discuss the technical challenges involved. Additionally, facets of the development process including manufacturing logistics, packaging, supply chain management, and qualification are discussed.

Challenges in pediatric ambulatory anesthesia: kids are different.

PubMed

Collins, Corey E; Everett, Lucinda L

2010-06-01

The care of the child having ambulatory surgery presents a specific set of challenges to the anesthesia provider. This review focuses on areas of clinical distinction that support the additional attention children often require, and on clinical controversies that require providers to have up-to-date information to guide practice and address parental concerns. These include perioperative risk; obstructive sleep apnea; obesity; postoperative nausea and vomiting; neurocognitive outcomes; and specific concerns regarding common ear, nose, and throat procedures. Copyright (c) 2010 Elsevier Inc. All rights reserved.

Report on July 2015 Additional Protocol Coordinators Best Practices Workshop

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

Gitau, Ernest T.N.; Burbank, Roberta L.; Finch, Valerie A.

After 10 years of implementation experience, the Office of Nonproliferation and Arms Control (NPAC) within the Department of Energy/National Nuclear Security Administration (DOE/NNSA) conducted the Additional Protocol (AP) Coordinators Best Practices Workshop at Oak Ridge National Laboratory from July 29-30, 2015. The goal of this workshop was to identify implementation best practices, lessons learned, and compliance challenges from the various Additional Protocol Coordinators (APCs) at each laboratory in the DOE/NNSA complex and associated sites. The workshop provided the opportunity for participants to share their insights and establish networks that APCs can utilize to continue to discuss challenges (new and old),more » identify best practices, and enhance communication and coordination for reporting multi-lab research projects during review activities. Workshop participants included DOE/NNSA HQ, laboratory and site APCs, seasoned experts, members of the original implementation outreach team, and Field Element and site security representatives.« less

The dilemma of allergy to food additives.

PubMed

Bahna, Sami L; Burkhardt, Joshua G

2018-01-01

To provide a brief summary on food additives and to outline a practical approach for evaluating subjects suspected of having reactions to food additives. Information was derived from selected reviews and original articles published in peer-reviewed journals, supplemented by the clinical experience of the authors. Priority was given to studies that used blinded, placebo controlled, oral challenges to confirm adverse reactions to food additives. In addition, selected, appropriately evaluated case reports were included. A large number of food additives are widely used in the food industry. Allergic reactions to additives seem to be rare but are very likely underdiagnosed, primarily due to a low index of suspicion. A wide variety of symptoms to food additives have been reported, but a cause-and-effect relationship has not been well documented in the majority of cases. Reactions to food additives should be suspected in patients who report symptoms related to multiple foods or to a certain food when commercially prepared but not when home made. It is also prudent to investigate food additives in subjects considered to have "idiopathic" reactions. Except for a limited number of natural additives, there is a small role for skin tests or in vitro testing. Oral challenge, in stages, with commonly used additives is the definitive procedure for detecting the offending agent. Once the specific additive is identified, management is strict avoidance, which can be difficult.

Improving feed efficiency in dairy production systems – challenges and possibilities

USDA-ARS?s Scientific Manuscript database

Improving production efficiency has always been a goal of animal agriculture to ensure an abundant food and fiber supply, and to maintain producer profitability. In recent decades, the concept of sustainable agriculture emerged, which includes the additional goals of safeguarding natural resources, ...

Tier-2 Optimisation for Computational Density/Diversity and Big Data

NASA Astrophysics Data System (ADS)

Fay, R. B.; Bland, J.

2014-06-01

As the number of cores on chip continues to trend upwards and new CPU architectures emerge, increasing CPU density and diversity presents multiple challenges to site administrators. These include scheduling for massively multi-core systems (potentially including Graphical Processing Units (GPU), integrated and dedicated) and Many Integrated Core (MIC)) to ensure a balanced throughput of jobs while preserving overall cluster throughput, as well as the increasing complexity of developing for these heterogeneous platforms, and the challenge in managing this more complex mix of resources. In addition, meeting data demands as both dataset sizes increase and as the rate of demand scales with increased computational power requires additional performance from the associated storage elements. In this report, we evaluate one emerging technology, Solid State Drive (SSD) caching for RAID controllers, with consideration to its potential to assist in meeting evolving demand. We also briefly consider the broader developing trends outlined above in order to identify issues that may develop and assess what actions should be taken in the immediate term to address those.

Current Status and Challenges of Atmospheric Data Assimilation

NASA Astrophysics Data System (ADS)

Atlas, R. M.; Gelaro, R.

2016-12-01

The issues of modern atmospheric data assimilation are fairly simple to comprehend but difficult to address, involving the combination of literally billions of model variables and tens of millions of observations daily. In addition to traditional meteorological variables such as wind, temperature pressure and humidity, model state vectors are being expanded to include explicit representation of precipitation, clouds, aerosols and atmospheric trace gases. At the same time, model resolutions are approaching single-kilometer scales globally and new observation types have error characteristics that are increasingly non-Gaussian. This talk describes the current status and challenges of atmospheric data assimilation, including an overview of current methodologies, the difficulty of estimating error statistics, and progress toward coupled earth system analyses.

Report on New Methods for Representing and Interacting with Qualitative Geographic Information, Stage 2: Task Group 1 Core Re-engineering and Place-based Use Case

DTIC Science & Technology

2013-06-30

Void, Behind you, Quantum Leaping, The space between spaces  when a geographic reference is provided, we identified several categories of challenges to... consciously opt-in to include geolocation in times of crisis. In addition, 10% of tweets in our sample included place references in the text and that

Regional Seminars to Address Current Nuclear Export Control Issues

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

Killinger, Mark H.

2002-07-01

The control of nuclear-related exports, a critical component of the nonproliferation regime, is facing several opportunities and challenges. As countries sign and ratify the International Atomic Energy Agency's (IAEA) safeguards Additional Protocol (AP), they will begin to report far more export information, including exports of a list of items similar to the Nuclear Supplier Group's Trigger List that existed when the AP was developed in the mid-1990s. This positive development contrasts with challenges such as globalization, transshipments, and tracking of end-uses. Pacific Northwest National Laboratory is proposing that the US Department of Energy (DOE) develop regional seminars that address thesemore » types of issues related to export/import controls. The DOE seminars would be designed to supplement regional seminars sponsored by the IAEA and member states on topics related to the Additional Protocol (referred to as "IAEA seminars"). The topic of nuclear export/import controls is not thoroughly addressed in the IAEA seminars. The proposed DOE seminars would therefore have two objectives: familiarizing countries with the export/import provisions of the Additional Protocol, and addressing challenges such as those noted above. The seminars would be directed particularly at countries that have not ratified the AP, and at regions where export-related problems are particularly prevalent. The intent is to encourage governments to implement more effective nuclear export control systems that meet the challenges of the 21st century.« less

State-Building Challenges in a Post-Revolution Libya

DTIC Science & Technology

2012-10-01

for the Army, the Department of De - fense, and the larger national security community. In addition to its studies, SSI publishes special reports on...addition, his publications include com- mentaries and research papers for the Centro de Es- tudios y Documentacion Internacionales de Barcelona (CIDOB...and the Centre d’Études Internationales de Rabat, as well as various newspaper articles in and about the region. He is a frequent commentator in the

Additive Manufacturing of Nickel Superalloys: Opportunities for Innovation and Challenges Related to Qualification

NASA Astrophysics Data System (ADS)

Babu, S. S.; Raghavan, N.; Raplee, J.; Foster, S. J.; Frederick, C.; Haines, M.; Dinwiddie, R.; Kirka, M. K.; Plotkowski, A.; Lee, Y.; Dehoff, R. R.

2018-06-01

Innovative designs for turbines can be achieved by advances in nickel-based superalloys and manufacturing methods, including the adoption of additive manufacturing. In this regard, selective electron beam melting (SEBM) and selective laser melting (SLM) of nickel-based superalloys do provide distinct advantages. Furthermore, the direct energy deposition (DED) processes can be used for repair and reclamation of nickel alloy components. The current paper explores opportunities for innovation and qualification challenges with respect to deployment of AM as a disruptive manufacturing technology. In the first part of the paper, fundamental correlations of processing parameters to defect tendency and microstructure evolution will be explored using DED process. In the second part of the paper, opportunities for innovation in terms of site-specific control of microstructure during processing will be discussed. In the third part of the paper, challenges in qualification of AM parts for service will be discussed and potential methods to alleviate these issues through in situ process monitoring, and big data analytics are proposed.

Materials and structures technology insertion into spacecraft systems: Successes and challenges

NASA Astrophysics Data System (ADS)

Rawal, Suraj

2018-05-01

Over the last 30 years, significant advancements have led to the use of multifunctional materials and structures technologies in spacecraft systems. This includes the integration of adaptive structures, advanced composites, nanotechnology, and additive manufacturing technologies. Development of multifunctional structures has been directly influenced by the implementation of processes and tools for adaptive structures pioneered by Prof. Paolo Santini. Multifunctional materials and structures incorporating non-structural engineering functions such as thermal, electrical, radiation shielding, power, and sensors have been investigated. The result has been an integrated structure that offers reduced mass, packaging volume, and ease of integration for spacecraft systems. Current technology development efforts are being conducted to develop innovative multifunctional materials and structures designs incorporating advanced composites, nanotechnology, and additive manufacturing. However, these efforts offer significant challenges in the qualification and acceptance into spacecraft systems. This paper presents a brief overview of the technology development and successful insertion of advanced material technologies into spacecraft structures. Finally, opportunities and challenges to develop and mature next generation advanced materials and structures are presented.

Ongoing ostomy self-care challenges of long-term rectal cancer survivors.

PubMed

Bulkley, Joanna E; McMullen, Carmit K; Grant, Marcia; Wendel, Christopher; Hornbrook, Mark C; Krouse, Robert S

2018-05-29

Surgical treatment for rectal cancer (RC) can result in an intestinal ostomy that requires lifelong adaptation and investment of physical, cognitive, and financial resources. However, little is known about the extent of ongoing challenges related to ostomy self-care among long-term RC survivors. We analyzed the prevalence of self-reported ostomy self-care challenges and the physical and environmental factors that can support or undermine ostomy self-care. We mailed surveys to long-term (≥ 5 years post-diagnosis) RC survivors, including 177 adults with ostomies who were members of integrated health systems in northern California, Oregon, and Washington State. Potential participants were identified through tumor registries. Data were also extracted from electronic health records. The response rate was 65%. The majority of respondents were male (67%), and the mean age was 75 years. Sixty-three percent of respondents reported at least one ostomy self-care challenge. The most common challenges were leakage or skin problems around the ostomy and needing to change the pouching system too frequently. Twenty-two percent reported difficulty caring for their ostomy. Younger age and higher BMI were consistently related to ostomy self-care challenges. The majority of RC survivors reported ostomy-related self-care challenges, and 31% experienced problems across multiple domains of ostomy self-care. In addition, most survivors reported significant physical challenges that could lead to ostomy-related disability. Although the participants surveyed had access to ostomy care nurses, the care gaps we found suggest that additional work is needed to understand barriers to ostomy care, reduce unmet needs, and improve well-being among this group.

Toward global prevention of sexually transmitted infections (STIs): the need for STI vaccines.

PubMed

Gottlieb, Sami L; Low, Nicola; Newman, Lori M; Bolan, Gail; Kamb, Mary; Broutet, Nathalie

2014-03-20

An estimated 499 million curable sexually transmitted infections (STIs; gonorrhea, chlamydia, syphilis, and trichomoniasis) occurred globally in 2008. In addition, well over 500 million people are estimated to have a viral STI such as herpes simplex virus type 2 (HSV-2) or human papillomavirus (HPV) at any point in time. STIs result in a large global burden of sexual, reproductive, and maternal-child health consequences, including genital symptoms, pregnancy complications, cancer, infertility, and enhanced HIV transmission, as well as important psychosocial consequences and financial costs. STI control strategies based primarily on behavioral primary prevention and STI case management have had clear successes, but gains have not been universal. Current STI control is hampered or threatened by several behavioral, biological, and implementation challenges, including a large proportion of asymptomatic infections, lack of feasible diagnostic tests globally, antimicrobial resistance, repeat infections, and barriers to intervention access, availability, and scale-up. Vaccines against HPV and hepatitis B virus offer a new paradigm for STI control. Challenges to existing STI prevention efforts provide important reasons for working toward additional STI vaccines. We summarize the global epidemiology of STIs and STI-associated complications, examine challenges to existing STI prevention efforts, and discuss the need for new STI vaccines for future prevention efforts. Copyright © 2014 Elsevier Ltd. All rights reserved.

The challenge of scientific activities in wilderness

Treesearch

David J. Parsons

2000-01-01

Science is an appropriate and necessary use of wilderness. The long-term protection of wilderness, including decisions related to the planning and management of wilderness resources, use and values, requires an understanding often available only through scientific investigation. In addition, wilderness provides opportunities for scientific understanding not available...

Maintaining Continuity of Knowledge of Spent Fuel Pools: Tool Survey

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

Benz, Jacob M.; Smartt, Heidi A.; Tanner, Jennifer E.

This report examines supplemental tools that can be used in addition to optical surveillance cameras to maintain CoK in low-to-no light conditions, and increase the efficiency and effectiveness of spent fuel CoK, including item counting and ID verification, in challenging conditions.

Teachers for Children with Emotional/Behavioral Disorders: Education's Greatest Challenge?

ERIC Educational Resources Information Center

Lauritzen, Paul; Friedman, Stephen J.

1991-01-01

This article describes children having emotional/behavioral disorders, presents data demonstrating the critical shortage of teachers for this population, discusses factors that contribute to this problem, and offers recommendations including giving teachers of these children an additional salary stipend and providing them the option of…

Financial sustainability of academic health centers: identifying challenges and strategic responses.

PubMed

Stimpson, Jim P; Li, Tao; Shiyanbola, Oyewale O; Jacobson, Janelle J

2014-06-01

Academic health centers (AHCs) play a vital role in the health care system. The training of health care personnel and delivery of health care services, especially to the most complex and financially challenged patients, has been a responsibility increasingly shouldered by AHCs over the years. Additionally, AHCs play a significant role in researching and developing new treatment protocols, including discovering and validating new health technologies. However, AHCs face unique financial challenges in fulfilling their social mission in the health care system. Reforms being implemented under the Affordable Care Act and shifting economic patterns are threatening the financial sustainability of AHCs.The authors review challenges facing AHCs, including training new health care professionals with fewer funding resources, disproportionate clinical care of complex and costly patients, charity care to uninsured and underinsured, and reduced research funding opportunities. Then, they provide a review of some potential solutions to these challenges, including new reimbursement methods, improvements in operational efficiency, price regulation, subsidization of education, improved decision making and communication, utilization of industrial management tools, and increasing internal and external cooperation. Devising solutions to the evolving problems of AHCs is crucial to improving health care delivery in the United States. Most likely, a combination of market, government, and system reforms will be needed to improve the viability of AHCs and assist them in fulfilling their social and organizational missions.

Introduction and Overview of the Industrial Interactive Panel Session

NASA Astrophysics Data System (ADS)

Seiler, David

2014-03-01

A unique industrial panel covering the challenges and needs of various industries and how being innovative is important. The session involves two invited industry speakers (24 minutes each) who will set the stage for the interactive round table panel session. The Panel, led by moderator Mark Bernius (Morgan Advanced Materials), consists of the two invited speakers plus an additional five industry panelists. The first thirty minutes of the panel session has the five additional panelists introducing themselves and their work/company. These introductions could include what they or their company does, sharing one or two technical highlights, listing some challenges or needs for physicists, and what innovation breakthroughs are needed in their industries. The final hour of the session will be highly interactive with questions to the panel coming from the moderator, the audience, and the panelists themselves. Questions that might be addressed include: how physicists are or could be critical in advancing innovation; how can AIP/APS/FIAP help industry get the physics help they need to be innovative (knowledge, the right staff, etc.); what role can students and post docs play in advancing industry's mission; etc. We invite you to participate in this interactive session and ask our industry experts your own interesting and challenging questions. The invited speakers are George Thompson, Intel, and Rick Watkins, Nike. The panel members also include Jason Cleveland, Asylum Research; Robert Doering, Texas Instruments; William Gallagher, IBM T.J. Watson Research Center; James Hollenhorst, Agilent Technologies; and Martin Poitzsch, Schlumberger-Doll Research.

Dealing with aggressive behavior within the health care team: a leadership challenge.

PubMed

Hynes, Patricia; Kissoon, Niranjan; Hamielec, Cindy M; Greene, Anne Marie; Simone, Carmine

2006-06-01

During an interdisciplinary Canadian leadership forum [ (click on the Conferences icon)], participants were challenged to develop an approach to a difficult leadership/management situation. In a scenario involving aggressive behavior among health care providers, participants identified that, before responding, an appropriate leader should collect additional information to identify the core problem(s) causing such behavior. Possibilities include stress; lack of clear roles, responsibilities, and standard operating procedures; and, finally, lack of training on important leadership/management skills. As a result of these core problems, several potential solutions are possible, all with potential obstacles to implementation. Additional education around communication and team interaction was felt to be a priority. In summary, clinical leaders probably have a great deal to gain from augmenting their leadership/management skills.

Patient level costing in Ireland: process, challenges and opportunities.

PubMed

Murphy, A; McElroy, B

2015-03-01

In 2013, the Department of Health released their policy paper on hospital financing entitled Money Follows the Patient. A fundamental building block for the proposed financing model is patient level costing. This paper outlines the patient level costing process, identifies the opportunities and considers the challenges associated with the process in the Irish hospital setting. Methods involved a review of the existing literature which was complemented with an interview with health service staff. There are considerable challenges associated with implementing patient level costing including deficits in information and communication technologies and financial expertise as well as timeliness of coding. In addition, greater clinical input into the costing process is needed compared to traditional costing processes. However, there are long-term benefits associated with patient level costing; these include empowerment of clinical staff, improved transparency and price setting and greater fairness, especially in the treatment of outliers. These can help to achieve the Government's Health Strategy. The benefits of patient level costing need to be promoted and a commitment to investment in overcoming the challenges is required.

Implementing Multisector Nutrition Programs in Ethiopia and Nepal: Challenges and Opportunities From a Stakeholder Perspective.

PubMed

Kennedy, Eileen; Fekadu, Habtamu; Ghosh, Shibani; Baral, Kedar; Davis, Dale; Sapkota, Diplav; Webb, Patrick

2016-12-01

Effective governance is essential for effective nutrition program implementation. There are additional challenges in launching multisector plans to enhance nutritional status. The present study compares the challenges and opportunities in Ethiopia and Nepal in designing and implementing a multisector plan for nutrition. A semi-quantitative questionnaire with open-ended questions was used to solicit information from senior national-level policy officials and other key stakeholders. The nature of the major nutrition problems in each country was similar; these include malnutrition (particularly stunting), food insecurity, and micronutrient malnutrition. The main challenges identified included the need for more specificity in the roles of agencies/individuals in program implementation, more effective mechanisms for linking national to subnational officials, methods for creating awareness of the plans, and a dedicated line item in the budgets of each agency. The level of enthusiasm was high in both countries. Respondents in both countries highlighted the need to identify a "champion" at the highest level who would keep the momentum for the respective plans alive. © The Author(s) 2016.

Factors Influencing the Research Participation of Adults with Autism Spectrum Disorders

ERIC Educational Resources Information Center

Haas, Kaaren; Costley, Debra; Falkmer, Marita; Richdale, Amanda; Sofronoff, Kate; Falkmer, Torbjörn

2016-01-01

Recruiting adults with autism spectrum disorders (ASD) into research poses particular difficulties; longitudinal studies face additional challenges. This paper reports on a mixed methods study to identify factors influencing the participation in longitudinal autism research of adults with ASD, including those with an intellectual disability, and…

The Student Writing Toolkit: Enhancing Undergraduate Teaching of Scientific Writing in the Biological Sciences

ERIC Educational Resources Information Center

Dirrigl, Frank J., Jr.; Noe, Mark

2014-01-01

Teaching scientific writing in biology classes is challenging for both students and instructors. This article offers and reviews several useful "toolkit" items that improve student writing. These include sentence and paper-length templates, funnelling and compartmentalisation, and preparing compendiums of corrections. In addition,…

The Electronic School Library Resource Center: Facilities Planning for the New Information Technologies.

ERIC Educational Resources Information Center

Blodgett, Teresa; Repman, Judi

1995-01-01

Addresses the necessity of incorporating new computer technologies into school library resource centers and notes some administrative challenges. An extensive checklist is provided for assessing equipment and furniture needs, physical facilities, and rewiring needs. A glossary of 20 terms and 11 additional resources is included. (AEF)

Controlled laboratory challenge demonstrates substantial additive genetic variation in resistance to Streptococcus iniae in Nile tilapia

USDA-ARS?s Scientific Manuscript database

Streptococcus iniae is an etiologic agent of streptococcal disease in tilapia and is one of several Streptococcus spp. that negatively impact worldwide tilapia production. Methods for the prevention and control of S. iniae include vaccines, management strategies, and antibiotics. An alternative and ...

Online Schooling in the United States: A Response to Saultz and Fusarelli

ERIC Educational Resources Information Center

Beck, Dennis; LaFrance, Jason

2017-01-01

In this paper, we discuss some concerns and recommendations of Saultz and Fusarelli (2017), offering nuanced and detailed views of online schooling from a different perspective. This includes addressing challenges regarding online learning such as fluctuating enrollments, financial concerns, quality assurance, and accountability. In addition, we…

Immersion and Identity: Experiences of an African American Preschool Child

ERIC Educational Resources Information Center

McCullough, Ruanda Garth; Reyes, Sharon Adelman

2010-01-01

This article explores the benefits and challenges of a Spanish language immersion preschool from the perspective of a non-Spanish speaking African American family. Data explored include the decision to enroll, reactions from peers and family, home-school communication issues, language development, and family involvement. In addition,…

The Challenge of Catholicity.

ERIC Educational Resources Information Center

Gallin, Alice, Ed.

1988-01-01

The character and mission of Catholic institutions of higher education are discussed in nine articles. Questions that are posed include: what issues of the Catholic tradition need to be further examined; what additional reading of the Vatican II texts are appropriate; how is one to understand the American context within which the Catolic mission…

Evaluation of an Educational Program for Adolescents with Asthma

ERIC Educational Resources Information Center

Berg, Jill; Tichacek, Mary J.; Theodorakis, Renee

2004-01-01

In addition to challenges of adolescence itself, teens with asthma face demands of asthma management and risks of asthma sequelae, including fatalities. Few asthma educational programs specifically address their needs. In response to school nurse concern, this pilot study evaluated an adolescent asthma education program, the "Power Breathing[TM]…

Dietary Management of Attention Deficit Disorder.

ERIC Educational Resources Information Center

Dengate, Sue

1997-01-01

Claims early studies of diet and ADHD focused irrelevantly on sugar, failing to sufficiently eliminate problem-causing foods, include parental observations, and adequately rate common symptoms. Asserts that recent studies show additive-free diets alone are of little benefit, that a low-chemical elimination diet followed by challenges can identify…

First-line treatment: a critical appraisal of cognitive behavioral therapy developments and alternatives.

PubMed

Arch, Joanna J; Craske, Michelle G

2009-09-01

In this article, the authors assess the successes, remaining challenges, and new developments in cognitive behavioral therapy (CBT) for anxiety disorders. They define CBT, examine treatment components, review treatment efficacy, and discuss the challenges of attrition, long-term follow-up, co-occurring/comorbid disorders, limited treatment comparisons, treatment mediators, and broader implementation. In addition, they present recent developments in cognitive behavioral therapy for anxiety disorders, including linking exposure therapy to basic science, mindfulness and acceptance-based treatments, and unified or transdiagnostic treatment protocols.

DoD And VA Health Care: Federal Recovery Coordination Program Continues to Expand But Faces Significant Challenges

DTIC Science & Technology

2011-03-01

FRCP) Enrollees, September 2010 Diagnoses Percentage of enrollees Traumatic brain injury 54 Psychological diagnosis 43 Orthopedic injury 25...analysis of FRCP data. Note: These diagnoses may not represent each enrollee’s primary medical diagnosis . Additionally, approximately 70 percent of...FRCP enrollees have more than one diagnosis . a“Medical diagnosis ” includes diagnoses such as stroke, heart attack, and cancer. b“Other” includes

Meeting the needs of the postpartum woman with epilepsy.

PubMed

Rousseau, Jennifer B

2008-01-01

Although pregnancy and postpartum are times of emotional and physical change for all women, women with epilepsy have additional concerns and face special challenges. This article describes the nursing care for this special population to help the clinical nurse provide for the safety of these women and their infants. A multidisciplinary approach is essential, and families need to be included in the care planning. Special considerations for medication management, additional rest, seizure precautions, and discharge instructions are described.

Integrated Data Modeling and Simulation on the Joint Polar Satellite System Program

NASA Technical Reports Server (NTRS)

Roberts, Christopher J.; Boyce, Leslye; Smith, Gary; Li, Angela; Barrett, Larry

2012-01-01

The Joint Polar Satellite System is a modern, large-scale, complex, multi-mission aerospace program, and presents a variety of design, testing and operational challenges due to: (1) System Scope: multi-mission coordination, role, responsibility and accountability challenges stemming from porous/ill-defined system and organizational boundaries (including foreign policy interactions) (2) Degree of Concurrency: design, implementation, integration, verification and operation occurring simultaneously, at multiple scales in the system hierarchy (3) Multi-Decadal Lifecycle: technical obsolesce, reliability and sustainment concerns, including those related to organizational and industrial base. Additionally, these systems tend to become embedded in the broader societal infrastructure, resulting in new system stakeholders with perhaps different preferences (4) Barriers to Effective Communications: process and cultural issues that emerge due to geographic dispersion and as one spans boundaries including gov./contractor, NASA/Other USG, and international relationships.

Medicolegal Issues in Traumatic Brain Injury.

PubMed

Zasler, Nathan D; Bigler, Erin

2017-05-01

The role of the physiatrist in provision of medicolegal expert testimony in cases involving traumatic brain injury is challenging and complex. This article provides an overview of how such work should be conducted from a practical perspective including discussion of ethical, legal, medical, and business aspects of such activities. Additionally, pointers are provided with regards to how information including preinjury, injury, and postinjury (including neuroimaging and neuropsychological data) should be considered and integrated into medicolegal opinions and testimony. Copyright © 2016 Elsevier Inc. All rights reserved.

Challenges in detecting drowsiness based on driver’s behavior

NASA Astrophysics Data System (ADS)

Triyanti, V.; Iridiastadi, H.

2017-12-01

Drowsiness while driving has been a critical issue within the context of transportation safety. A number of approaches have been developed to reduce the risks of drowsy drivers. The mechanisms in detecting fatigue and sleepiness while driving has been categorized into three broad approaches, including vehicle-based, physiological-based, and behavior-based approaches. This paper will discuss recent studies in recognizing drowsy drivers based on their behaviors, particularly changes in eyes and facial characteristics. This paper will also address challenges in capturing aspects of natural expressions, driver responses, behavior, and task environment associated with sleepiness. Additionally, a number of technical aspects should be seriously considered, including correctly capturing face and eye characteristics from unwanted movements, unsuitable task environments, technological limitations, and individual differences.

Overcoming the Challenges of Co-creation

NASA Astrophysics Data System (ADS)

Pandya, R.; Udu-gama, N.; Goodwin, M.; Otellini, P.

2016-12-01

There is growing interest in co-creation, especially for community-related issues like climate change, resilience, pollution, and environmental justice. Nevertheless, co-creation is still not mainstream practice in either geosciences or the world of decision-makers. This presents many challenges. On the science side, challenges include a paucity of training opportunities, lack of funding for co-creation, difficulty publishing or otherwise getting credit for the effort, and a perceived lack of prestige compared to theoretical research. On the community side, parallel challenges include a lack of experience working with scientists or thinking about geoscience's relevance to community issues, tight budgets and competing priorities, the need for outputs beyond publications, and the difficulty including science among a range of factors. Additionally, scientists and community leaders often work across public and private sectors and must navigate different approaches to data, privacy, and accountability. We'll use this session to explore opportunities to overcome the challenges of co-creation. Systems thinking suggests a range of approaches: enabling individuals, reducing specific challenges, changing the relationship between the elements of the systems, and changing the goals or mindsets of the systems - each more powerful than the last. For example, mentoring and coaching enables individuals, and pro-bono work eases the challenge of getting professional credit. New modes of output, like plain language abstracts, change the relationship between publications and other outputs. We can work on changing mindsets by publicizing and celebrating individual successes. With more effort and impact, we can build collaborations in the collective impact model, where we bring scientific and community organizations together around a common agenda and shared measurement. Building on these examples, we will use this session to collect strategies and opportunities from all participants.

School Administrator Perceptions of Cyberbullying Facilitators and Barriers to Preventive Action: A Qualitative Study.

PubMed

Young, Rachel; Tully, Melissa; Ramirez, Marizen

2017-06-01

Schools are often held responsible for preventing or addressing cyberbullying, yet little is known about school administrator perceptions of cyberbullying and the challenges they face in addressing this public health issue. The goal of this study is to examine school administrators' perceptions of the facilitators of cyberbullying and barriers to primary and secondary prevention strategies. Public school administrators ( N = 36) participated in in-depth interviews about bullying and discussed their experiences with cyberbullying and their perceptions of cyberbullying facilitators and barriers to prevention. Three main themes arose from the analysis: (1) cyberbullying as a major challenge; (2) facilitators of cyberbullying and barriers to preventive action, including parents and technology; and (3) prevention efforts, including unclear jurisdiction for action, primary versus secondary prevention efforts, and technology attributes that facilitate school response to bullying. Although administrators perceive cyberbullying as a major challenge facing their schools, they are often unsure about appropriate primary and secondary prevention efforts. Relationships with parents and police complicate response and prevention as schools attempt to navigate unclear jurisdiction. Additionally, technology presents a challenge to schools because it is seen as an enabler of cyberbullying, a facilitator of prevention, and a necessary part of education efforts. Lack of research on prevention strategies, parents' knowledge and attitudes, and confusion about responsibility for addressing cyberbullying are barriers to action. Findings suggest administrators could benefit from additional clarity on which strategies are most effective for primary prevention of cyberbullying, and that prevention strategies should proactively involve parents to promote effective collaboration with schools.

Thermal Injuries in Veterinary Forensic Pathology.

PubMed

Wohlsein, P; Peters, M; Schulze, C; Baumgärtner, W

2016-09-01

Localized thermal injuries in animals may be caused by exposure to fire and radiant heat, contact with hot items including hot liquids or steam, inhalation of hot air, and exposure to cold temperatures. In addition, animal fire victims may have intoxications caused by smoke gas. This article reviews the causes, pathogenetic aspects, morphological findings, additional investigations, differential diagnoses, and causes of death in various forms of thermal injuries. Since these cases do not occur frequently in diagnostic pathology, they represent a challenging task in general but also with respect to forensic or criminal aspects, such as whether a lesion represents an accidental or nonaccidental effect. Besides detailed information about the circumstances at the location, thermal injuries in animals require a thorough morphological evaluation, including additional investigations in conjunction with a profound knowledge about the possible lesion spectrum and suitable additional investigations. © The Author(s) 2016.

Participatory Democracy, Community Organizing and the Community Assessment of Freeway Exposure and Health (CAFEH) Partnership

PubMed Central

Sprague Martinez, Linda; Reisner, Ellin; Campbell, Maria; Brugge, Doug

2017-01-01

Background: Conflicting interests, power imbalance and relationships characterized by distrust are just a few of the many challenges community–academic research partnerships face. In addition, the time it takes to build relationships is often overlooked, which further complicates matters and can leave well-intentioned individuals re-creating oppressive conditions through inauthentic partnerships. This paper presents a novel approach of using meeting minutes to explore partnership dynamics. The Community Assessment of Freeway Exposure and Health (CAFEH) partnership is used as an illustrative case study to identify how community academic partnerships overcome the challenges associated with community-based participatory research (CBPR). CAFEH is a study of ultrafine particle exposure (UFP) near highways in the Boston, MA area. Methods: Qualitative analysis was applied to meeting minutes and process evaluation reports from the first three years of the CAFEH study (n = 73 files). In addition, a group meeting was held with project partners in order to contextualize the findings from the document analysis. Results: The three most commonly referenced challenges included language barriers, the overall project structure and budgetary constraints. Meanwhile, a heavy emphasis on process and an approach steeped in participatory democracy facilitated CAFEH’s ability to overcome these challenges, as well as sustain and augment strong partnership ties. Conclusions: This experience suggests that leadership that incorporates an organizing approach and a transformational style facilitates CBPR processes and helps teams surmount challenges. PMID:28165418

Participatory Democracy, Community Organizing and the Community Assessment of Freeway Exposure and Health (CAFEH) Partnership.

PubMed

Sprague Martinez, Linda; Reisner, Ellin; Campbell, Maria; Brugge, Doug

2017-02-04

Background: Conflicting interests, power imbalance and relationships characterized by distrust are just a few of the many challenges community-academic research partnerships face. In addition, the time it takes to build relationships is often overlooked, which further complicates matters and can leave well-intentioned individuals re-creating oppressive conditions through inauthentic partnerships. This paper presents a novel approach of using meeting minutes to explore partnership dynamics. The Community Assessment of Freeway Exposure and Health (CAFEH) partnership is used as an illustrative case study to identify how community academic partnerships overcome the challenges associated with community-based participatory research (CBPR). CAFEH is a study of ultrafine particle exposure (UFP) near highways in the Boston, MA area. Methods: Qualitative analysis was applied to meeting minutes and process evaluation reports from the first three years of the CAFEH study ( n = 73 files). In addition, a group meeting was held with project partners in order to contextualize the findings from the document analysis. Results: The three most commonly referenced challenges included language barriers, the overall project structure and budgetary constraints. Meanwhile, a heavy emphasis on process and an approach steeped in participatory democracy facilitated CAFEH's ability to overcome these challenges, as well as sustain and augment strong partnership ties. Conclusions: This experience suggests that leadership that incorporates an organizing approach and a transformational style facilitates CBPR processes and helps teams surmount challenges.

The lung mycobiome in the next-generation sequencing era

PubMed Central

Tipton, Laura; Ghedin, Elodie; Morris, Alison

2017-01-01

ABSTRACT The fungi that reside in the human lungs represent an understudied, but medically relevant comm-unity. From the few studies published on the lung mycobiome, we find that there are fungi in both the healthy and diseased respiratory tract, that these fungi vary widely between individuals, and that there is a trend toward lower fungal diversity among individuals with disease. This review discusses the few studies of the lung mycobiome and details the challenges that accompany lung mycobiome studies. These challenges include sample collection and processing, sequence amplification and processing, and a history of multiple names for species. Some challenges may never be solved, but others can be solved with more data and additional studies of the lung mycobiome. PMID:27687858

Human experimental challenge with enterotoxigenic Escherichia coli elicits immune responses to canonical and novel antigens relevant to vaccine development.

PubMed

Chakraborty, Subhra; Randall, Arlo; Vickers, Tim J; Molina, Doug; Harro, Clayton D; DeNearing, Barbara; Brubaker, Jessica; Sack, David A; Bourgeois, A Louis; Felgner, Philip L; Liang, Xiaowu; Mani, Sachin; Wenzel, Heather; Townsend, R Reid; Gilmore, Petra E; Darsley, Michael J; Rasko, David A; Fleckenstein, James M

2018-05-24

Enterotoxigenic Escherichia coli (ETEC) is a major cause of diarrheal illness in the developing world. ETEC vaccinology has been challenged by genetic diversity and heterogeneity of canonical antigens. Examination of the antigenic breadth of immune responses associated with protective immunity could afford new avenues for vaccine development. Antibody lymphocyte supernatants (ALS) and sera from 20 naïve human volunteers challenged with ETEC strain H10407 and from 10 volunteers re-challenged 4-6 weeks later with the same strain (9 of whom were completely protected on re-challenge) were tested against ETEC proteome microarrays containing 957 antigens. ETEC challenge stimulated robust serum and mucosal (ALS) responses to canonical vaccine antigens (CFA/I, and the B subunit of LT) as well as a small number of antigens not presently targeted in ETEC vaccines. These included pathovar-specific secreted proteins (EtpA, EatA) as well as highly conserved E. coli antigens including YghJ, flagellin (FliC), and pertactin-like autotransporter proteins, all of which have previously afforded protection against ETEC infection in preclinical studies. Collectively, studies reported here suggest that immune responses following ETEC infection involve traditional vaccine targets as well as a select number of more recently identified protein antigens that could offer additional avenues for vaccine development for these pathogens.

Dose addition models based on biologically-relevant reductions in fetal testosterone accurately predict postnatal reproductive tract alterations by a phthalate mixture in rats

EPA Science Inventory

Challenges in cumulative risk assessment of anti-androgenic phthalate mixtures include a lack of data on all the individual phthalates and difficulty determining the biological relevance of reduction in fetal testosterone (T) on postnatal development. The objectives of the curren...

Controlled challenge experiment demonstrates substantial additive genetic variation in resistance of Nile tilapia (Oreochromis niloticus) to Streptococcus iniae

USDA-ARS?s Scientific Manuscript database

Streptococcus iniae is an etiologic agent of streptococcal disease in tilapia and is one of several Streptococcus spp. that negatively impact worldwide tilapia production. Methods for the prevention and control of S. iniae include vaccines, management strategies, and antibiotics. A complimentary pre...

The Assessment Journey: Defining and Refining Instrument Dilemmas

ERIC Educational Resources Information Center

Gallo, Ann Marie; Carr, Michael T.; Gallo, Joseph A.

2010-01-01

Designing and implementing assessment instruments are ongoing challenges for physical educators. The initial design phase includes asking the question, "What do I want the students to know and/or be able to do?" Seemingly, the question is direct and should lead to a concrete answer. In addition to designing assessment instruments, one of the most…

East-West Encounters: The Challenges of Directing a Program in Jordan.

ERIC Educational Resources Information Center

Sawaie, Mohammed

1995-01-01

The director of a University of Virginia Arabic language program in Jordan discusses issues, sometimes unfamiliar, with which the administrator must deal. In addition to logistical and administrative tasks, in this context these include the role of women in the Arab university and students' questions about the universality of social values. (MSE)

Life Skills at a Tribal College: A Culturally Relevant Educational Intervention

ERIC Educational Resources Information Center

Keith, Jill F.; Stastny, Sherri N.; Agnew, Wanda; Brunt, Ardith; Aune, Pat

2017-01-01

American Indians, Alaska Natives, and Native Hawaiians (AI/AN/NH) experience the lowest rates of college retention and significant barriers to graduation. In addition, AI/AN/NH individuals face health challenges that include higher rates of obesity, overweight, and type 2 diabetes. We designed a culturally relevant life skills curriculum based on…

Supporting Young Children in Combat-Injured Families: Call to Action

ERIC Educational Resources Information Center

Arata-Maiers, Teresa L.; Stafford, Elisabeth M.

2010-01-01

Military families are currently facing the longest period of combat in the history of the nation, along with the attendant challenges of prolonged or repeated deployment. With the return of 36,000-plus service members wounded in action, including nearly 11,000 requiring medical evacuation and those with additional "invisible injuries," there are…

Reluctantly Recognizing Resistance: An Analysis of Representations of Critical Literacy in "English Journal"

ERIC Educational Resources Information Center

Petrone, Robert; Bullard, Lisa

2012-01-01

In addition to the successes the author (Robert) experienced as a high school English teacher, he faced many challenges and frustrations, including student motivation and attendance, "helicopter parents," finding time and energy to grade papers, and limited resources. However, as an educator committed to teaching English to help students develop…

USA: German in the Changing Landscape of Postsecondary Education

ERIC Educational Resources Information Center

Tatlock, Lynne

2010-01-01

This article identifies recent indicators of the state of German Studies in the United States with special attention to postsecondary enrollments in German. It additionally reviews challenges to the postsecondary teaching of German as they manifest themselves both locally and nationally, including the positioning of German Studies in the life of…

Peer Education in Student Leadership Programs: Responding to Co-Curricular Challenges

ERIC Educational Resources Information Center

Haber, Paige

2011-01-01

Leadership development is an outcome of colleges and universities today stressed both in and out of the classroom. Additionally, leadership is often included in institutional missions, with emphasis on students developing as responsible citizens or leaders. The use of peer educators is standard in many student leadership development programs. In…

Valuing Little Steps toward Inquiry

ERIC Educational Resources Information Center

Grueber, David; Whitin, Phyllis

2012-01-01

In a climate of high-stakes testing that emphasizes content, it can be challenging to teach science from an inquiry perspective. In addition there is a widespread call for a new approach to science education that includes science practices, crosscutting concepts, and core ideas (NRC 2011). However, it is not imperative for teachers to implement…

Beyond the Four Walls: Examining the Use of Authentic Learning Modules

ERIC Educational Resources Information Center

Jagielski, Donna Marie

2016-01-01

While attempting to provide real world experiences in STEM, educators face numerous challenges including adhering to curriculum requirements and working with potentially limited resources. The purpose of this action research study was to examine how the addition of authentic learning modules to the existing University of Arizona Middle School…

Water Bottle Designs and Measures

ERIC Educational Resources Information Center

Carmody, Heather Gramberg

2010-01-01

The increase in the diversity of students and the complexity of their needs can be a rich addition to a mathematics classroom. The challenge for teachers is to find a way to include students' interests and creativity in a way that allows for rigorous mathematics. One method of incorporating the diversity is the development of "open-ended…

Tertiary-Tier PBIS in Alternative, Residential and Correctional School Settings: Considering Intensity in the Delivery of Evidence-Based Practice

ERIC Educational Resources Information Center

Scott, Terrance M.; Cooper, Justin

2013-01-01

Students in alternative, residential, and correctional settings present challenges in the classroom and facility due to the complexity and intensity of their behaviors. In addition, the factors typically associated with these settings including crowding, inconsistency, and conflicting staff perspectives on education and discipline present…

Supreme Court Term in Review

ERIC Educational Resources Information Center

Hawke, Catherine

2012-01-01

One can't have a meaningful discussion about the 2011-2012 U.S. Supreme Court term without mentioning the historic health care challenge. However, even without that headliner, the term was jam-packed with interesting twists and turns. In addition to health care, the Court confronted a number of hot-button issues, including: immigration, the rights…

Stamps, Sarcophagi, and Songs: Teaching World History with Online Resources

ERIC Educational Resources Information Center

Schrum, Kelly

2012-01-01

Teaching world history is challenging. In addition to covering the history of the world geographically and chronologically, it is difficult to find high quality, translated materials ready for classroom use. The Roy Rosenzweig Center for History and New Media at George Mason University offers free, online materials, including primary sources,…

Teleglaucoma: improving access and efficiency for glaucoma care.

PubMed

Kassam, Faazil; Yogesan, Kanagasingam; Sogbesan, Enitan; Pasquale, Louis R; Damji, Karim F

2013-01-01

Teleglaucoma is the application of telemedicine for glaucoma. We review and present the current literature on teleglaucoma; present our experience with teleglaucoma programs in Alberta, Canada and Western Australia; and discuss the challenges and opportunities in this emerging field. Teleglaucoma is a novel area that was first explored a little over a decade ago and early studies highlighted the technical challenges of delivering glaucoma care remotely. Advanced technologies have since emerged that show great promise in providing access to underserviced populations. Additionally, these technologies can improve the efficiency of healthcare systems burdened with an increasing number of patients with glaucoma, and a limited supply of ophthalmologists. Additional benefits of teleglaucoma systems include e-learning and e-research. Further work is needed to fully validate and study the cost and comparative effectiveness of this approach relative to traditional models of healthcare.

Teleglaucoma: Improving Access and Efficiency for Glaucoma Care

PubMed Central

Kassam, Faazil; Yogesan, Kanagasingam; Sogbesan, Enitan; Pasquale, Louis R.; Damji, Karim F.

2013-01-01

Teleglaucoma is the application of telemedicine for glaucoma. We review and present the current literature on teleglaucoma; present our experience with teleglaucoma programs in Alberta, Canada and Western Australia; and discuss the challenges and opportunities in this emerging field. Teleglaucoma is a novel area that was first explored a little over a decade ago and early studies highlighted the technical challenges of delivering glaucoma care remotely. Advanced technologies have since emerged that show great promise in providing access to underserviced populations. Additionally, these technologies can improve the efficiency of healthcare systems burdened with an increasing number of patients with glaucoma, and a limited supply of ophthalmologists. Additional benefits of teleglaucoma systems include e-learning and e-research. Further work is needed to fully validate and study the cost and comparative effectiveness of this approach relative to traditional models of healthcare. PMID:23741133

Toward a Digital Thread and Data Package for Metals-Additive Manufacturing.

PubMed

Kim, D B; Witherell, P; Lu, Y; Feng, S

2017-01-01

Additive manufacturing (AM) has been envisioned by many as a driving factor of the next industrial revolution. Potential benefits of AM adoption include the production of low-volume, customized, complicated parts/products, supply chain efficiencies, shortened time-to-market, and environmental sustainability. Work remains, however, for AM to reach the status of a full production-ready technology. Whereas the ability to create unique 3D geometries has been generally proven, production challenges remain, including lack of (1) data manageability through information management systems, (2) traceability to promote product producibility, process repeatability, and part-to-part reproducibility, and (3) accountability through mature certification and qualification methodologies. To address these challenges in part, this paper discusses the building of data models to support the development of validation and conformance methodologies in AM. We present an AM information map that leverages informatics to facilitate part producibility, process repeatability, and part-to-part reproducibility in an AM process. We present three separate case studies to demonstrate the importance of establishing baseline data structures and part provenance through an AM digital thread.

Toward a Digital Thread and Data Package for Metals-Additive Manufacturing

PubMed Central

Kim, D. B.; Witherell, P.; Lu, Y.; Feng, S.

2017-01-01

Additive manufacturing (AM) has been envisioned by many as a driving factor of the next industrial revolution. Potential benefits of AM adoption include the production of low-volume, customized, complicated parts/products, supply chain efficiencies, shortened time-to-market, and environmental sustainability. Work remains, however, for AM to reach the status of a full production-ready technology. Whereas the ability to create unique 3D geometries has been generally proven, production challenges remain, including lack of (1) data manageability through information management systems, (2) traceability to promote product producibility, process repeatability, and part-to-part reproducibility, and (3) accountability through mature certification and qualification methodologies. To address these challenges in part, this paper discusses the building of data models to support the development of validation and conformance methodologies in AM. We present an AM information map that leverages informatics to facilitate part producibility, process repeatability, and part-to-part reproducibility in an AM process. We present three separate case studies to demonstrate the importance of establishing baseline data structures and part provenance through an AM digital thread. PMID:28691115

Human Performance Considerations for Remotely Piloted Aircraft Systems (RPAS)

NASA Technical Reports Server (NTRS)

Shively, R. Jay; Hobbs, Alan; Lyall, Beth; Rorie, Conrad

2015-01-01

Successful integration of Remotely Piloted Aircraft Systems (RPAS) into civil airspace will not only require solutions to technical challenges, but will also require that the design and operation of RPAS take into account human limitations and capabilities. Human factors can affect overall system performance whenever the system relies on people to interact with another element of the system. Four types of broad interactions can be described. These are (1) interactions between people and hardware, such as controls and displays; (2) human use of procedures and documentation; (3) impact of the task environment, including lighting, noise and monotony; and lastly, (4) interactions between operational personnel, including communication and coordination. In addition to the human factors that have been identified for conventional aviation, RPAS operations introduce a set of unique human challenges. The purpose of document is to raise human factors issues for consideration by workgroups of the ICAO RPAS panel as they work to develop guidance material and additions to ICAO annexes. It is anticipated that the content of this document will be revised and updated as the work of the panel progresses.

Recommendations for provoked challenge urine testing.

PubMed

Ruha, Anne-Michelle

2013-12-01

"Urine mobilization test," "challenge test," and "provoked urine test" are all terms used to describe the administration of a chelating agent to a person prior to collection of their urine to test for metals. There is no standard, validated challenge test. Despite recommendations by professional and government organizations against the use of provoked urine testing, the tests are still commonly used and recommended by some practitioners. Challenge testing utilizes a variety of chelating agents, including dimercaptosuccinic acid (DMSA), dimercaptopropanesulfonate (DMPS), and ethylenediaminetetraacetic acid (EDTA). The agents are given by a variety of routes of administration, doses used are inconsistent, and urine collection procedures vary. Additional problems with challenge tests include comparison of results to inappropriate reference ranges and creatinine correction of urine obtained within hours of chelator administration. Human volunteer studies demonstrate that mercury is detected in the urine of most people even in the absence of known exposure or chelator administration, and that urinary mercury excretion rises after administration of a chelator, regardless of exposure history and in an unpredictable fashion. Studies also demonstrate that challenge testing fails to reveal a "body burden" of mercury due to remote exposure. Chelating agents have been associated with adverse reactions. Current evidence does not support the use of DMPS, DMSA, or other chelation challenge tests for the diagnosis of metal toxicity. Since there are no established reference ranges for provoked urine samples in healthy subjects, no reliable evidence to support a diagnostic value for the tests, and potential harm, these tests should not be utilized.

Challenges to Health During Deep Space Exploration Missions

NASA Technical Reports Server (NTRS)

Watkins, S.; Leveton, L.; Norsk, P.; Huff, J.; Shah, R.

2014-01-01

Long duration missions outside of low Earth orbit will present unique challenges to the maintenance of human health. Stressors with physiologic and psychological impacts are inherent in exploration missions, including reduced gravity, increased radiation, isolation, limited habitable volume, circadian disruptions, and cabin atmospheric changes. Operational stressors such as mission timeline and extravehicular activities must also be considered, and these varied stressors may act in additive or synergistic fashions. Should changes to physiology or behavior manifest as a health condition, the rendering of care in an exploration environment must also be considered. Factors such as the clinical background of the crew, inability to evacuate to Earth in a timely manner, communication delay, and limitations in available medical resources will have an impact on the assessment and treatment of these conditions. The presentations associated with this panel will address these unique challenges from the perspective of several elements of the NASA Human Research Program, including Behavioral Health and Performance, Human Health Countermeasures, Space Radiation, and Exploration Medical Capability.

The Benefits of Physician Training Programs for Rural Communities: Lessons Learned from the Teaching Health Center Graduate Medical Education Program.

PubMed

Lee, Marshala; Newton, Helen; Smith, Tracey; Crawford, Malena; Kepley, Hayden; Regenstein, Marsha; Chen, Candice

2016-01-01

Rural communities disproportionately face preventable chronic diseases and death from treatable conditions. Health workforce shortages contribute to limited health care access and health disparities. Efforts to address workforce shortages have included establishing graduate medical education programs with the goal of recruiting and retaining physicians in the communities in which they train. However, rural communities face a number of challenges in developing and maintaining successful residency programs, including concerns over financial sustainability and the integration of resident trainees into existing clinical practices. Despite these challenges, rural communities are increasingly interested in investing in residency programs; those that are successful see additional benefits in workforce recruitment, access, and quality of care that have immediate and direct impact on the health of rural communities. This commentary examines the challenges and benefits of rural residency programs, drawing from lessons learned from the Health Resources and Services Administration's Teaching Health Center Graduate Medical Education program.

Fundamental Aeronautics Program: Overview of Propulsion Work in the Supersonic Cruise Efficiency Technical Challenge

NASA Technical Reports Server (NTRS)

Castner, Ray

2012-01-01

The Supersonics Project, part of NASA's Fundamental Aeronautics Program, contains a number of technical challenge areas which include sonic boom community response, airport noise, high altitude emissions, cruise efficiency, light weight durable engines/airframes, and integrated multi-discipline system design. This presentation provides an overview of the current (2012) activities in the supersonic cruise efficiency technical challenge, and is focused specifically on propulsion technologies. The intent is to develop and validate high-performance supersonic inlet and nozzle technologies. Additional work is planned for design and analysis tools for highly-integrated low-noise, low-boom applications. If successful, the payoffs include improved technologies and tools for optimized propulsion systems, propulsion technologies for a minimized sonic boom signature, and a balanced approach to meeting efficiency and community noise goals. In this propulsion area, the work is divided into advanced supersonic inlet concepts, advanced supersonic nozzle concepts, low fidelity computational tool development, high fidelity computational tools, and improved sensors and measurement capability. The current work in each area is summarized.

Caring for a major government official: challenges and lessons learned.

PubMed

Weiss, Yoram G; Mor-Yosef, Shlomo; Sprung, Charles L; Weissman, Charles; Weiss, Yuval

2007-07-01

Analysis of the medical, organizational, and administrative issues surrounding the care of a dignitary in an intensive care unit. On January 4, 2006, Ariel Sharon, the Israeli Prime Minister was emergently admitted to the Hadassah-Hebrew University Medical Center in Jerusalem owing to a severe intracranial hemorrhage. Immediately following his admission, he underwent an extensive neurosurgical procedure to control the bleeding. Thereafter, he required intensive care for 5 months and underwent additional procedures. This admission presented organizational and administrative challenges. The major challenge was to provide the Prime Minister with the best medical care while avoiding the "very important person syndrome" and simultaneously continuing routine hospital activities. To coordinate his complicated medical management, a consultation forum was established composed of all the physicians directly involved in Mr. Sharon's care. Additionally, a senior intensivist was chosen to coordinate the medical care and, along with a physician from the hospital administration, assist with administrative issues. Among the issues that the coordinating team addressed, with the help of many other hospital services, included patient confidentiality vs. public information, security of the patient's medical chart (including laboratory data and imaging), and coordination with security personnel. The acute care of a major governmental official requires the medical staff to address many administrative issues, while providing the "very important person" patient with appropriate intensive medical care. This article presents a strategy for addressing these issues.

Progress and challenges of disaster health management in China: a scoping review.

PubMed

Zhong, Shuang; Clark, Michele; Hou, Xiang-Yu; Zang, Yuli; FitzGerald, Gerard

2014-01-01

Despite the importance of an effective health system response to various disasters, relevant research is still in its infancy, especially in middle- and low-income countries. This paper provides an overview of the status of disaster health management in China, with its aim to promote the effectiveness of the health response for reducing disaster-related mortality and morbidity. A scoping review method was used to address the recent progress of and challenges to disaster health management in China. Major health electronic databases were searched to identify English and Chinese literature that were relevant to the research aims. The review found that since 2003 considerable progress has been achieved in the health disaster response system in China. However, there remain challenges that hinder effective health disaster responses, including low standards of disaster-resistant infrastructure safety, the lack of specific disaster plans, poor emergency coordination between hospitals, lack of portable diagnostic equipment and underdeveloped triage skills, surge capacity, and psychological interventions. Additional challenges include the fragmentation of the emergency health service system, a lack of specific legislation for emergencies, disparities in the distribution of funding, and inadequate cost-effective considerations for disaster rescue. One solution identified to address these challenges appears to be through corresponding policy strategies at multiple levels (e.g. community, hospital, and healthcare system level).

Emerging Water Contaminants: Technical, Legal and Policy Challenges

NASA Astrophysics Data System (ADS)

Deeb, R. A.; Kresic, N.; Laugier, M. C.; Kavanaugh, M. C.

2002-12-01

Approximately 120 new chemicals are created each year due to ever-improving industry and technology markets. Releases of new contaminants into the environment can occur during production, use and disposal of these chemicals thereby leading to potential contamination of water supply sources. Very few emerging contaminants are regulated. In addition, knowledge gaps regarding emerging contaminants include lack health effects, occurrence (either because these compounds are not measured or because concentrations are below detection limits of readily available analytical techniques) and fate and transport in the environment especially with regards to mobility and persistence. The sources of these compounds are numerous. One source is treated wastewater, which is re-injected into groundwater aquifers for indirect potable reuse purposes. Emerging compounds of concern can be classified in various classes. This presentation will focus on contaminants, which have emerged in the last 10 years including pharmaceuticals (antibiotics/drugs), personal care products (polycyclic musks), pesticides/herbicides, industrial solvents (1,4-dioxane), gasoline additives (MTBE), disinfection byproducts such as NDMA (N-nitrosodimethylamine), and inorganic compounds such as perchlorate and arsenic. This presentation will present technical, legal and legislative challenges posed by the presence of these contaminants in water. Background information including chemical's history of use, sources in the environments, nationwide occurrence, physical and chemical properties, behavior in the environment and technologies for removal from soil and water will be presented. In addition, case studies on MTBE, pharmaceuticals and personal care products, 1,4-dioxane, arsenic and NDMA will be discussed.

Trust in Vaccines: Why It Takes More than Good Faith.

PubMed

Begg, Norman

2013-08-12

This Vaccines issue on "Confidence in Vaccines" provides sound evidence through multiple perspectives of life-saving impacts when vaccination programs are effectively implemented in a population. Yet there remain challenges to achieving this impact, including scientific, medical, manufacturing, policy-related and logistical issues. Additionally, socio-cultural, religious and political agendas can come into play, taking public health hostage and sometimes allowing the circulation of myths regarding vaccination. All of these challenges play a role in public confidence in vaccines and vaccination. What we trust, we embrace. What we do not trust, we do not embrace.

Cassini Solstice Mission Maneuver Experience: Year One

NASA Technical Reports Server (NTRS)

Wagner, Sean V.; Arrieta, Juan; Ballard, Christopher G.; Hahn, Yungsun; Stumpf, Paul W.; Valerino, Powtawche N.

2011-01-01

The Cassini-Huygens spacecraft began its four-year Prime Mission to study Saturn's system in July 2004. Two tour extensions followed: a two-year Equinox Mission beginning in July 2008 and a seven-year Solstice Mission starting in September 2010. This paper highlights Cassini maneuver activities from June 2010 through June 2011, covering the transition from the Equinox to Solstice Mission. This interval included 38 scheduled maneuvers, nine targeted Titan flybys, three targeted Enceladus flybys, and one close Rhea flyby. In addition, beyond the demanding nominal navigation schedule, numerous unforeseen challenges further complicated maneuver operations. These challenges will be discussed in detail.

Assessment of human resources management practices in Lebanese hospitals.

PubMed

El-Jardali, Fadi; Tchaghchagian, Victoria; Jamal, Diana

2010-01-01

Sound human resources (HR) management practices are essential for retaining effective professionals in hospitals. Given the recruitment and retention reality of health workers in the twenty-first century, the role of HR managers in hospitals and those who combine the role of HR managers with other responsibilities should not be underestimated. The objective of this study is to assess the perception of HR managers about the challenges they face and the current strategies being adopted. The study also aims at assessing enabling factors including role, education, experience and HR training. A cross-sectional survey design of HR managers (and those who combine their role as HR manager with other duties) in Lebanese hospitals was utilized. The survey included a combination of open- and close-ended questions. Questions included educational background, work experience, and demographics, in addition to questions about perceived challenges and key strategies being used. Quantitative data analysis included uni-variate analysis, whereas thematic analysis was used for open-ended questions. A total of 96 respondents from 61 hospitals responded. Respondents had varying levels of expertise in the realm of HR management. Thematic analysis revealed that challenges varied across respondents and participating hospitals. The most frequently reported challenge was poor employee retention (56.7%), lack of qualified personnel (35.1%), and lack of a system for performance evaluation (28.9%). Some of the strategies used to mitigate the above challenges included offering continuing education and training for employees (19.6%), improving salaries (14.4%), and developing retention strategies (10.3%). Mismatch between reported challenges and strategies were observed. To enable hospitals to deliver good quality, safe healthcare, improving HR management is critical. There is a need for a cadre of competent HR managers who can fully assume these responsibilities and who can continuously improve the status of employees at their organizations. The upcoming accreditation survey of Lebanese hospitals (2010-2011) presents an opportunity to strengthen HR management and enhance competencies of existing HR managers. Recognizing HR challenges and the importance of effective HR strategies should become a priority to policy-makers and top managers alike. Study findings may extend to other countries in the Eastern Mediterranean region.

Assessment of human resources management practices in Lebanese hospitals.

PubMed

El-Jardali, Fadi; Tchaghchagian, Victoria; Jamal, Diana

2009-11-12

Sound human resources (HR) management practices are essential for retaining effective professionals in hospitals. Given the recruitment and retention reality of health workers in the twenty-first century, the role of HR managers in hospitals and those who combine the role of HR managers with other responsibilities should not be underestimated. The objective of this study is to assess the perception of HR managers about the challenges they face and the current strategies being adopted. The study also aims at assessing enabling factors including role, education, experience and HR training. A cross-sectional survey design of HR managers (and those who combine their role as HR manager with other duties) in Lebanese hospitals was utilized. The survey included a combination of open- and close-ended questions. Questions included educational background, work experience, and demographics, in addition to questions about perceived challenges and key strategies being used. Quantitative data analysis included uni-variate analysis, whereas thematic analysis was used for open-ended questions. A total of 96 respondents from 61 hospitals responded. Respondents had varying levels of expertise in the realm of HR management. Thematic analysis revealed that challenges varied across respondents and participating hospitals. The most frequently reported challenge was poor employee retention (56.7%), lack of qualified personnel (35.1%), and lack of a system for performance evaluation (28.9%). Some of the strategies used to mitigate the above challenges included offering continuing education and training for employees (19.6%), improving salaries (14.4%), and developing retention strategies (10.3%). Mismatch between reported challenges and strategies were observed. To enable hospitals to deliver good quality, safe healthcare, improving HR management is critical. There is a need for a cadre of competent HR managers who can fully assume these responsibilities and who can continuously improve the status of employees at their organizations. The upcoming accreditation survey of Lebanese hospitals (2010-2011) presents an opportunity to strengthen HR management and enhance competencies of existing HR managers. Recognizing HR challenges and the importance of effective HR strategies should become a priority to policy makers and top managers alike. Study findings may extend to other countries in the Eastern Mediterranean region.

Assessment of human resources management practices in Lebanese hospitals

PubMed Central

2009-01-01

Background Sound human resources (HR) management practices are essential for retaining effective professionals in hospitals. Given the recruitment and retention reality of health workers in the twenty-first century, the role of HR managers in hospitals and those who combine the role of HR managers with other responsibilities should not be underestimated. The objective of this study is to assess the perception of HR managers about the challenges they face and the current strategies being adopted. The study also aims at assessing enabling factors including role, education, experience and HR training. Methods A cross-sectional survey design of HR managers (and those who combine their role as HR manager with other duties) in Lebanese hospitals was utilized. The survey included a combination of open- and close-ended questions. Questions included educational background, work experience, and demographics, in addition to questions about perceived challenges and key strategies being used. Quantitative data analysis included uni-variate analysis, whereas thematic analysis was used for open-ended questions. Results A total of 96 respondents from 61 hospitals responded. Respondents had varying levels of expertise in the realm of HR management. Thematic analysis revealed that challenges varied across respondents and participating hospitals. The most frequently reported challenge was poor employee retention (56.7%), lack of qualified personnel (35.1%), and lack of a system for performance evaluation (28.9%). Some of the strategies used to mitigate the above challenges included offering continuing education and training for employees (19.6%), improving salaries (14.4%), and developing retention strategies (10.3%). Mismatch between reported challenges and strategies were observed. Conclusion To enable hospitals to deliver good quality, safe healthcare, improving HR management is critical. There is a need for a cadre of competent HR managers who can fully assume these responsibilities and who can continuously improve the status of employees at their organizations. The upcoming accreditation survey of Lebanese hospitals (2010-2011) presents an opportunity to strengthen HR management and enhance competencies of existing HR managers. Recognizing HR challenges and the importance of effective HR strategies should become a priority to policy makers and top managers alike. Study findings may extend to other countries in the Eastern Mediterranean region. PMID:19909527

Single-Cell Microgels: Technology, Challenges, and Applications.

PubMed

Kamperman, Tom; Karperien, Marcel; Le Gac, Séverine; Leijten, Jeroen

2018-04-12

Single-cell-laden microgels effectively act as the engineered counterpart of the smallest living building block of life: a cell within its pericellular matrix. Recent breakthroughs have enabled the encapsulation of single cells in sub-100-μm microgels to provide physiologically relevant microniches with minimal mass transport limitations and favorable pharmacokinetic properties. Single-cell-laden microgels offer additional unprecedented advantages, including facile manipulation, culture, and analysis of individual cell within 3D microenvironments. Therefore, single-cell microgel technology is expected to be instrumental in many life science applications, including pharmacological screenings, regenerative medicine, and fundamental biological research. In this review, we discuss the latest trends, technical challenges, and breakthroughs, and present our vision of the future of single-cell microgel technology and its applications. Copyright © 2018 Elsevier Ltd. All rights reserved.

Large datasets, logistics, sharing and workflow in screening.

PubMed

Cook, Tessa S

2018-03-29

Cancer screening initiatives exist around the world for different malignancies, most frequently breast, colorectal, and cervical cancer. A number of cancer registries exist to collect relevant data, but while these data may include imaging findings, they rarely, if ever, include actual images. Additionally, the data submitted to the registry are usually correlated with eventual cancer diagnoses and patient outcomes, rather than used with the individual's future screenings. Developing screening programs that allow for images to be submitted to a central location in addition to patient meta data and used for comparison to future screening exams would be very valuable in increasing access to care and ensuring that individuals are effectively screened at appropriate intervals. It would also change the way imaging results and additional patient data are correlated to eventual outcomes. However, it introduces logistical challenges surrounding secure storage and transmission of data to subsequent screening sites. In addition, in the absence of standardized protocols for screening, comparing current and prior imaging, especially from different equipment, can be challenging. Implementing a large-scale screening program with an image-enriched screening registry-effectively, an image-enriched electronic screening record-also requires that incentives exist for screening sites, physicians, and patients to participate; to maximize coverage, participation may have to be supported by government agencies. Workflows will also have to be adjusted to support registry participation for all screening patients in an effort to create a large, robust data set that can be used for future screening efforts as well as research initiatives.center.

Challenges of the NGSS for Future Geoscience Education

NASA Astrophysics Data System (ADS)

Wysession, M. E.; Colson, M.; Duschl, R. A.; Lopez, R. E.; Messina, P.; Speranza, P.

2013-12-01

The new Next Generation Science Standards (NGSS), which spell out a set of K-12 performance expectations for life science, physical science, and Earth and space science (ESS), pose a variety of opportunities and challenges for geoscience education. Among the changes recommended by the NGSS include establishing ESS on an equal footing with both life science and physical sciences, at the full K-12 level. This represents a departure from the traditional high school curriculum in most states. In addition, ESS is presented as a complex, integrated, interdisciplinary, quantitative Earth Systems-oriented set of sciences that includes complex and politically controversial topics such as climate change and human impacts. The geoscience communities will need to mobilize in order to assist and aid in the full implementation of ESS aspects of the NGSS in as many states as possible. In this context, the NGSS highlight Earth and space science to an unprecedented degree. If the NGSS are implemented in an optimal manner, a year of ESS will be taught in both middle and high school. In addition, because of the complexity and interconnectedness of the ESS content (with material such as climate change and human sustainability), it is recommended (Appendix K of the NGSS release) that much of it be taught following physics, chemistry, and biology. However, there are considerable challenges to a full adoption of the NGSS. A sufficient work force of high school geoscientists qualified in modern Earth Systems Science does not exist and will need to be trained. Many colleges do not credit high school geoscience as a lab science with respect to college admission. The NGSS demand curricular practices that include analyzing and interpreting real geoscience data, and these curricular modules do not yet exist. However, a concerted effort on the part of geoscience research and education organizations can help resolve these challenges.

Innovation in Data-Driven Decision Making within SWPBIS Systems: Welcome to the Gallery Walk

ERIC Educational Resources Information Center

Kennedy, Michael J.; Mimmack, Jody; Flannery, K. Brigid

2012-01-01

Schools implementing school-wide positive behavioral interventions and supports (SWPBIS) at the high school level face the same challenges as elementary and middle schools, but also encounter an additional set of barriers all their own. To name but a few, these barriers include the need to focus on dropout prevention, postsecondary outcomes,…

The Globally Great Moral Challenge: Ecocentric Democracy, Values, Morals and Meaning

ERIC Educational Resources Information Center

Payne, Phillip G.

2010-01-01

This response article written from "outside" the Swedish-Danish contexts of this special issue considers how we might highlight and make additional ecocentric meaning of some of the terms most frequently used in this collection. In the first instance my focus is on "meaning" but this is expanded to include other terms such as…

47 CFR 1.1911 - Demand for payment.

Code of Federal Regulations, 2010 CFR

2010-10-01

... additional period within to challenge the existence of, or amount of the non-tax debt if such time period has... cooperate to resolve the debt. The specific content, timing, and number of demand letters depend upon the type and amount of the debt, including, e.g., any notes and the terms of agreements of the parties, and...

Implementing a High-Assurance Smart-Card OS

NASA Astrophysics Data System (ADS)

Karger, Paul A.; Toll, David C.; Palmer, Elaine R.; McIntosh, Suzanne K.; Weber, Samuel; Edwards, Jonathan W.

Building a high-assurance, secure operating system for memory constrained systems, such as smart cards, introduces many challenges. The increasing power of smart cards has made their use feasible in applications such as electronic passports, military and public sector identification cards, and cell-phone based financial and entertainment applications. Such applications require a secure environment, which can only be provided with sufficient hardware and a secure operating system. We argue that smart cards pose additional security challenges when compared to traditional computer platforms. We discuss our design for a secure smart card operating system, named Caernarvon, and show that it addresses these challenges, which include secure application download, protection of cryptographic functions from malicious applications, resolution of covert channels, and assurance of both security and data integrity in the face of arbitrary power losses.

Challenges and Strategies in Thermal Processing of Amorphous Solid Dispersions: A Review.

PubMed

LaFountaine, Justin S; McGinity, James W; Williams, Robert O

2016-02-01

Thermal processing of amorphous solid dispersions continues to gain interest in the pharmaceutical industry, as evident by several recently approved commercial products. Still, a number of pharmaceutical polymer carriers exhibit thermal or viscoelastic limitations in thermal processing, especially at smaller scales. Additionally, active pharmaceutical ingredients with high melting points and/or that are thermally labile present their own specific challenges. This review will outline a number of formulation and process-driven strategies to enable thermal processing of challenging compositions. These include the use of traditional plasticizers and surfactants, temporary plasticizers utilizing sub- or supercritical carbon dioxide, designer polymers tailored for hot-melt extrusion processing, and KinetiSol® Dispersing technology. Recent case studies of each strategy will be described along with potential benefits and limitations.

Additive Manufacturing and 3D Printing in NASA: An Overview of Current Projects and Future Initiatives for Space Exploration

NASA Technical Reports Server (NTRS)

Clinton, R. G., Jr.

2014-01-01

NASA, including each Mission Directorate, is investing in, experimenting with, and/or utilizing AM across a broad spectrum of applications and projects; Centers have created and are continuing to create partnerships with industry, other Government Agencies, other Centers, and Universities; In-house additive manufacturing capability enables rapid iteration of the entire design, development and testing process, increasing innovation and reducing risk and cost to projects; For deep space exploration, AM offers significant reduction to logistics costs and risk by providing ability to create on demand; There are challenges: Overwhelming message from recent JANNAF AM for Propulsion Applications TIM was "certification."; NASA will continue to work with our partners to address this and other challenges to advance the state of the art in AM and incorporate these capabilities into an array of applications from aerospace to science missions to deep space exploration.

Implementation Challenges for Sintered Silicon Carbide Fiber Bonded Ceramic Materials for High Temperature Applications

NASA Technical Reports Server (NTRS)

Singh, M.

2011-01-01

During the last decades, a number of fiber reinforced ceramic composites have been developed and tested for various aerospace and ground based applications. However, a number of challenges still remain slowing the wide scale implementation of these materials. In addition to continuous fiber reinforced composites, other innovative materials have been developed including the fibrous monoliths and sintered fiber bonded ceramics. The sintered silicon carbide fiber bonded ceramics have been fabricated by the hot pressing and sintering of silicon carbide fibers. However, in this system reliable property database as well as various issues related to thermomechanical performance, integration, and fabrication of large and complex shape components has yet to be addressed. In this presentation, thermomechanical properties of sintered silicon carbide fiber bonded ceramics (as fabricated and joined) will be presented. In addition, critical need for manufacturing and integration technologies in successful implementation of these materials will be discussed.

Using the "Seven A's" assessment tool for developing competency in case management.

PubMed

Gallagher, Louise P; Truglio-Londrigan, Marie

2004-01-01

In the latter part of the 20th century, healthcare reform sparked a transition in the nursing curriculum from acute care to primary and secondary care. Faculty responded to this challenge by redesigning curricula in creative ways. The transitional curriculum introduced community clinical experiences designed to challenge students to practice in diverse, nontraditional sites and in more independent ways. Such practice requires the nurse to function as designer, coordinator, and manager of patient care in addition to the traditional provider role. Additionally, the transitional curricula emphasized the roles of communicator, educator, facilitator, listener, and advocate to a greater degree. For students to achieve competence in the above roles, the curriculum must include learning activities that allow them to practice as case managers in the community. This paper presents the "Seven A's" as a framework for students to gain an understanding of and engage in the role and process of case management in the community.

Challenges of Hospital Response to the Twin Earthquakes of August 21, 2012, in East Azerbaijan, Iran.

PubMed

Pouraghaei, Mahboub; Jannati, Ali; Moharamzadeh, Peyman; Ghaffarzad, Amir; Far, Moharram Heshmati; Babaie, Javad

2017-08-01

As the cornerstone of any health system, hospitals have a crucial role in response to disasters. Because hospital experiences in disaster response can be instructive, this study examined the challenges of hospital response to the twin earthquakes of 2012 in East Azerbaijan, Iran. In this qualitative study, the challenges of hospital response in the East Azerbaijan earthquakes were examined through focus group discussions. Participants were selected purposefully, and focus group discussions continued until data saturation. The data were manually analyzed by using Strauss and Corbin's recommended method. Hospitals were faced with 6 major challenges: lack of preparedness, lack of coordination, logistic deficiencies, patient/injured management, communication management, and other smaller challenges that were categorized in the "other challenges" category. The main theme was the lack of preparedness for disasters. Although hospital preparedness is emphasized in credible references, this study showed that lack of preparedness is a major challenge for hospitals during disasters. Thus, it seems that hospital officials' disaster risk perception and hospital preparedness should be improved. In addition, hospital preparedness assessment indexes should be included in the hospital accreditation process. (Disaster Med Public Health Preparedness. 2017;11:422-430).

Illness, normality and identity: the experience of heart transplant as a young adult.

PubMed

Waldron, Rebecca; Malpus, Zoey; Shearing, Vanessa; Sanchez, Melissa; Murray, Craig D

2017-09-01

End stage heart failure and transplant present great opportunities and challenges for patients of all ages. However, young adulthood may present additional specific challenges associated with the development of identity, career and romantic relationships. Despite recognition of greater mortality rates in young adults, consideration of the experience of transplant during this life stage has been largely overlooked in the literature. The aim of this study was to explore the experience of heart transplant in young adults. Interviews were conducted with nine participants across three transplant services in the United Kingdom and the data subject to interpretative phenomenological analysis. Analysis identified three themes. "Separating from illness" and "working toward normality" involved limiting the influence of illness on identity, as well as reengaging with typical functioning in young adulthood. "Integrating transplant into identity" involved acknowledging the influence of living with a shortened life expectancy. The need for support that recognizes specific challenges of transplant as a young adult is discussed (e.g. the development of age specific end of life pathways, improved communication between transplant recipients, their families and teams), including consideration of the impact of societal discourses (e.g. gift of life) which provided additional challenges for patients. IMPLICATIONS FOR REHABILITATION Heart transplant presents specific challenges according to the recipient's life stage. The needs of young adult recipients should be considered. Transplant professionals should consider providing opportunities for peer support and addressing the identities and values of young adult transplant recipients during rehabilitation.

Listening Effort: How the Cognitive Consequences of Acoustic Challenge Are Reflected in Brain and Behavior

PubMed Central

2018-01-01

Everyday conversation frequently includes challenges to the clarity of the acoustic speech signal, including hearing impairment, background noise, and foreign accents. Although an obvious problem is the increased risk of making word identification errors, extracting meaning from a degraded acoustic signal is also cognitively demanding, which contributes to increased listening effort. The concepts of cognitive demand and listening effort are critical in understanding the challenges listeners face in comprehension, which are not fully predicted by audiometric measures. In this article, the authors review converging behavioral, pupillometric, and neuroimaging evidence that understanding acoustically degraded speech requires additional cognitive support and that this cognitive load can interfere with other operations such as language processing and memory for what has been heard. Behaviorally, acoustic challenge is associated with increased errors in speech understanding, poorer performance on concurrent secondary tasks, more difficulty processing linguistically complex sentences, and reduced memory for verbal material. Measures of pupil dilation support the challenge associated with processing a degraded acoustic signal, indirectly reflecting an increase in neural activity. Finally, functional brain imaging reveals that the neural resources required to understand degraded speech extend beyond traditional perisylvian language networks, most commonly including regions of prefrontal cortex, premotor cortex, and the cingulo-opercular network. Far from being exclusively an auditory problem, acoustic degradation presents listeners with a systems-level challenge that requires the allocation of executive cognitive resources. An important point is that a number of dissociable processes can be engaged to understand degraded speech, including verbal working memory and attention-based performance monitoring. The specific resources required likely differ as a function of the acoustic, linguistic, and cognitive demands of the task, as well as individual differences in listeners’ abilities. A greater appreciation of cognitive contributions to processing degraded speech is critical in understanding individual differences in comprehension ability, variability in the efficacy of assistive devices, and guiding rehabilitation approaches to reducing listening effort and facilitating communication. PMID:28938250

Listening Effort: How the Cognitive Consequences of Acoustic Challenge Are Reflected in Brain and Behavior.

PubMed

Peelle, Jonathan E

Everyday conversation frequently includes challenges to the clarity of the acoustic speech signal, including hearing impairment, background noise, and foreign accents. Although an obvious problem is the increased risk of making word identification errors, extracting meaning from a degraded acoustic signal is also cognitively demanding, which contributes to increased listening effort. The concepts of cognitive demand and listening effort are critical in understanding the challenges listeners face in comprehension, which are not fully predicted by audiometric measures. In this article, the authors review converging behavioral, pupillometric, and neuroimaging evidence that understanding acoustically degraded speech requires additional cognitive support and that this cognitive load can interfere with other operations such as language processing and memory for what has been heard. Behaviorally, acoustic challenge is associated with increased errors in speech understanding, poorer performance on concurrent secondary tasks, more difficulty processing linguistically complex sentences, and reduced memory for verbal material. Measures of pupil dilation support the challenge associated with processing a degraded acoustic signal, indirectly reflecting an increase in neural activity. Finally, functional brain imaging reveals that the neural resources required to understand degraded speech extend beyond traditional perisylvian language networks, most commonly including regions of prefrontal cortex, premotor cortex, and the cingulo-opercular network. Far from being exclusively an auditory problem, acoustic degradation presents listeners with a systems-level challenge that requires the allocation of executive cognitive resources. An important point is that a number of dissociable processes can be engaged to understand degraded speech, including verbal working memory and attention-based performance monitoring. The specific resources required likely differ as a function of the acoustic, linguistic, and cognitive demands of the task, as well as individual differences in listeners' abilities. A greater appreciation of cognitive contributions to processing degraded speech is critical in understanding individual differences in comprehension ability, variability in the efficacy of assistive devices, and guiding rehabilitation approaches to reducing listening effort and facilitating communication.

Medical Operational Challenges in the Expedition 16 Landing and Recovery

NASA Technical Reports Server (NTRS)

Moynihan, S.; Johnston, S. L.; Ilcus, L. S.; Shevchenko, V.

2009-01-01

On April 19, 2008 the crew of Expedition 16 left the International Space Station and returned to earth via their Soyuz TMA-11 capsule after 192 days on orbit. Their capsule experienced the second consecutive and third ballistic reentry in the last 10 TMA recoveries and landed approximately 260 miles (420 km) from the prime landing site. Issues: The purpose of this presentation will be to describe, not only the typical medical operational challenges faced by Flight Surgeons recovering a long duration crew from space, but also address the unique challenges that existed with the Expedition 16 landing and crew recovery. Nominal Soyuz recovery challenges include remote recovery sites with crew exposures to sleep shifting and fatigue, dehydration, hypothermia and hyperthermia, and rotational, sustained, and impact g-forces. These environmental factors coupled with the patho-physiologic neuro-vestibular and orthostatic intolerance changes that occur secondary to the crews reintroduction into the earth s gravity field will be detailed. Additional challenges that were unique to this expedition included a ballistic reentry with higher g-loads, the presence of fire outside of the capsule on landing, a contingency medical event of a ground support personnel, and loss of communications with the crew just prior to landing and during recovery operations. Conclusions: In spite of these unique challenges the Russian Search and Rescue Forces and Medical Support personnel along with U.S. Medical Support performed well together. Possible improvements in training and coordination will be discussed.

DSLR Double Star Astrometry Using an Alt-Az Telescope

NASA Astrophysics Data System (ADS)

Frey, Thomas; Haworth, David

2014-07-01

The goal of this project was to determine if the double star's angular separation and position angle measurements could be successfully measured with a motor driven, alt-azimuth Dobsonian-mounted Newtonian telescope (without a field rotator), and a digital single-lens reflex (DSLR) camera. Additionally, the project was constrained by using as much existing equipment as much as possible, including an Apple MacBook Pro laptop and a Canon T2i camera. This project was additionally challenging because the first author had no experience with astrophotography.

Imaging of thymic disorders

PubMed Central

Bogot, Naama R; Quint, Leslie E

2005-01-01

Evaluation of the thymus poses a challenge to the radiologist. In addition to age-related changes in thymic size, shape, and tissue composition, there is considerable variability in the normal adult thymic appearance within any age group. Many different types of disorders may affect the thymus, including hyperplasia, cysts, and benign and malignant neoplasms, both primary and secondary; clinical and imaging findings typical for each disease process are described in this article. Whereas computed tomography is the mainstay for imaging the thymus, other imaging modalities may occasionally provide additional structural or functional information. PMID:16361143

Challenge from Without: Analysis of the Recommendations Advanced by Five National Education Task Forces and Their Policy Implications for Precollege and Higher Education. The Nelson A. Rockefeller Institute of Government Special Report Series Number 4.

ERIC Educational Resources Information Center

Kemmerer, Frances; And Others

This report includes expanded versions of two papers by Frances Kemmerer and Alan P. Wagner which were first presented at a 1983 working seminar on the recommendations of five national educational task forces and their implications for New York State educational policy. Included also is a major additional paper contributed by W. Paul Vogt. The…

Flight Dynamics and Controls Discipline Overview

NASA Technical Reports Server (NTRS)

Theodore, Colin R.

2012-01-01

This presentation will touch topics, including but not limited to, the objectives and challenges of flight dynamics and controls that deal with the pilot and the cockpit's technology, the flight dynamics and controls discipline tasks, and the full envelope of flight dynamics modeling. In addition, the LCTR 7x10-ft wind tunnel test will also be included along with the optimal trajectories for noise abatement and its investigations on handling quality. Furthermore, previous experiments and their complying results will also be discussed.

The practices, challenges and recommendations of South African audiologists regarding managing children with auditory processing disorders

PubMed Central

Govender, Samantha; Khan, Nasim

2016-01-01

Audiologists managing children with auditory processing disorders (APD) encounter challenges that include conflicting definitions, several classification profiles, problems with differential diagnosis and a lack of standardised guidelines. The heterogeneity of the disorder and its concomitant childhood disorders makes diagnosis difficult. Linguistic and cultural issues are additional challenges faced by South African audiologists. The study aimed to describe the practices, challenges and recommendations of South African audiologists managing children with APD. A quantitative, non-experimental descriptive survey was used to obtain data from 156 audiologists registered with the Health Professions of South Africa. Findings revealed that 67% screened for APD, 42% assessed while 43% provided intervention. A variety of screening and assessment procedures were being administered, with no standard test battery identified. A range of intervention strategies being used are discussed. When the relationship between the number of years of experience and the audiologists’ level of preparedness to practice in the field of APD was compared, a statistically significant difference (p = 0.049) was seen in that participants with more than 10 years of experience were more prepared to practice in this area. Those participants having qualified as speech-language therapists and audiologists were significantly more prepared (p = 0.03) to practice than the audiologists who comprised the sample. Challenges experienced by the participants included the lack of linguistically and culturally appropriate screening and assessment tools and limited normative data. Recommendations included reviewing the undergraduate audiology training programmes, reinstituting the South African APD Taskforce, developing linguistically and culturally appropriate normative data, creating awareness among educators and involving them in the multidisciplinary team. PMID:27380913

Progress and challenges of disaster health management in China: a scoping review

PubMed Central

Zhong, Shuang; Clark, Michele; Hou, Xiang-Yu; Zang, Yuli; FitzGerald, Gerard

2014-01-01

Background Despite the importance of an effective health system response to various disasters, relevant research is still in its infancy, especially in middle- and low-income countries. Objective This paper provides an overview of the status of disaster health management in China, with its aim to promote the effectiveness of the health response for reducing disaster-related mortality and morbidity. Design A scoping review method was used to address the recent progress of and challenges to disaster health management in China. Major health electronic databases were searched to identify English and Chinese literature that were relevant to the research aims. Results The review found that since 2003 considerable progress has been achieved in the health disaster response system in China. However, there remain challenges that hinder effective health disaster responses, including low standards of disaster-resistant infrastructure safety, the lack of specific disaster plans, poor emergency coordination between hospitals, lack of portable diagnostic equipment and underdeveloped triage skills, surge capacity, and psychological interventions. Additional challenges include the fragmentation of the emergency health service system, a lack of specific legislation for emergencies, disparities in the distribution of funding, and inadequate cost-effective considerations for disaster rescue. Conclusions One solution identified to address these challenges appears to be through corresponding policy strategies at multiple levels (e.g. community, hospital, and healthcare system level). PMID:25215910

Epigallocatechin-3-gallate protects Kuruma shrimp Marsupeneaus japonicus from white spot syndrome virus and Vibrio alginolyticus.

PubMed

Wang, Zhi; Sun, Baozhen; Zhu, Fei

2018-07-01

Epigallocatechin-3-gallate (EGCG) is the most abundant catechin in green tea and exhibits potential antibacterial and anticancer activities. In this study, EGCG was used in pathogen-challenge experiments in shrimp to discover its effect on the innate immune system of an invertebrate. Kuruma shrimp Marsupeneaus japonicus was used as an experimental model and challenged with white spot syndrome virus (WSSV) and the Gram-negative bacterium Vibrio alginolyticus. Pathogen-challenge experiments showed that EGCG pretreatment significantly delayed and reduced mortality upon WSSV and V. alginolyticus infection, with VP-28 copies of WSSV also reduced. Quantitative reverse transcription polymerase chain reaction revealed the positive influence of EGCG on several innate immune-related genes, including IMD, proPO, QM, myosin, Rho, Rab7, p53, TNF-alpha, MAPK, and NOS, and we observed positive influences on three immune parameters, including total hemocyte count and phenoloxidase and superoxide dismutase activities, by EGCG treatment. Additionally, results showed that EGCG treatment significantly reduced apoptosis upon V. alginolyticus challenge. These results indicated the positive role of EGCG in the shrimp innate immune system as an enhancer of immune parameters and an inhibitor of apoptosis, thereby delaying and reducing mortality upon pathogen challenge. Our findings provide insight into potential therapeutic or preventive functions associated with EGCG to enhance shrimp immunity and protect shrimp from pathogen infection. Copyright © 2018 Elsevier Ltd. All rights reserved.

Long-term protective effects of methamphetamine preconditioning against single-day methamphetamine toxic challenges.

PubMed

Hodges, A B; Ladenheim, B; McCoy, M T; Beauvais, G; Cai, N; Krasnova, I N; Cadet, J L

2011-03-01

Methamphetamine (METH) use is associated with neurotoxic effects which include decreased levels of dopamine (DA), serotonin (5-HT) and their metabolites in the brain. We have shown that escalating METH dosing can protect against METH induced neurotoxicity in rats sacrificed within 24 hours after a toxic METH challenge. The purpose of the current study was to investigate if the protective effects of METH persisted for a long period of time. We also tested if a second challenge with a toxic dose of METH would cause further damage to monoaminergic terminals. Saline-pretreated rats showed significant METH-induced decreases in striatal DA and 5-HT levels in rats sacrificed 2 weeks after the challenge. Rats that received two METH challenges showed no further decreases in striatal DA or 5-HT levels in comparison to the single METH challenge. In contrast, METH-pretreated rats showed significant protection against METH-induced striatal DA and 5-HT depletion. In addition, the METH challenge causes substantial decreases in cortical 5-HT levels which were not further potentiated by a second drug challenge. METH preconditioning provided almost complete protection against METH -induced 5-HT depletion. These results are consistent with the idea that METH pretreatment renders the brain refractory to METH-induced degeneration of brain monoaminergic systems.

Pediatric cardiovascular safety: challenges in drug and device development and clinical application.

PubMed

Bates, Katherine E; Vetter, Victoria L; Li, Jennifer S; Cummins, Susan; Aguel, Fernando; Almond, Christopher; Dubin, Anne M; Elia, Josephine; Finkle, John; Hausner, Elizabeth A; Joseph, Francesca; Karkowsky, Abraham M; Killeen, Matthew; Lemacks, Jodi; Mathis, Lisa; McMahon, Ann W; Pinnow, Ellen; Rodriguez, Ignacio; Stockbridge, Norman L; Stockwell, Margaret; Tassinari, Melissa; Krucoff, Mitchell W

2012-10-01

Development of pediatric medications and devices is complicated by differences in pediatric physiology and pathophysiology (both compared with adults and within the pediatric age range), small patient populations, and practical and ethical challenges to designing clinical trials. This article summarizes the discussions that occurred at a Cardiac Safety Research Consortium-sponsored Think Tank convened on December 10, 2010, where members from academia, industry, and regulatory agencies discussed important issues regarding pediatric cardiovascular safety of medications and cardiovascular devices. Pediatric drug and device development may use adult data but often requires additional preclinical and clinical testing to characterize effects on cardiac function and development. Challenges in preclinical trials include identifying appropriate animal models, clinically relevant efficacy end points, and methods to monitor cardiovascular safety. Pediatric clinical trials have different ethical concerns from adult trials, including consideration of the subjects' families. Clinical trial design in pediatrics should assess risks and benefits as well as incorporate input from families. Postmarketing surveillance, mandated by federal law, plays an important role in both drug and device safety assessment and becomes crucial in the pediatric population because of the limitations of premarketing pediatric studies. Solutions for this wide array of issues will require collaboration between academia, industry, and government as well as creativity in pediatric study design. Formation of various epidemiologic tools including registries to describe outcomes of pediatric cardiac disease and its treatment as well as cardiac effects of noncardiovascular medications, should inform preclinical and clinical development and improve benefit-risk assessments for the patients. The discussions in this article summarize areas of emerging consensus and other areas in which consensus remains elusive and provide suggestions for additional research to further our knowledge and understanding of this topic. Copyright © 2012 Mosby, Inc. All rights reserved.

Dst Index in the 2008 GEM Modeling Challenge - Model Performance for Moderate and Strong Magnetic Storms

NASA Technical Reports Server (NTRS)

Rastaetter, Lutz; Kuznetsova, Maria; Hesse, Michael; Chulaki, Anna; Pulkkinen, Antti; Ridley, Aaron J.; Gombosi, Tamas; Vapirev, Alexander; Raeder, Joachim; Wiltberger, Michael James;

NASA Game Changing Development Program Manufacturing Innovation Project

NASA Technical Reports Server (NTRS)

Tolbert, Carol; Vickers, John

2011-01-01

This presentation examines the new NASA Manufacturing Innovation Project. The project is a part of the Game Changing Development Program which is one element of the Space Technology Programs Managed by Office of the Chief Technologist. The project includes innovative technologies in model-based manufacturing, digital additive manufacturing, and other next generation manufacturing tools. The project is also coupled with the larger federal initiatives in this area including the National Digital Engineering and Manufacturing Initiative and the Advanced Manufacturing Partnership. In addition to NASA, other interagency partners include the Department of Defense, Department of Commerce, NIST, Department of Energy, and the National Science Foundation. The development of game-changing manufacturing technologies are critical for NASA s mission of exploration, strengthening America s manufacturing competitiveness, and are highly related to current challenges in defense manufacturing activities. There is strong consensus across industry, academia, and government that the future competitiveness of U.S. industry will be determined, in large part, by a technologically advanced manufacturing sector. This presentation highlights the prospectus of next generation manufacturing technologies to the challenges faced NASA and by the Department of Defense. The project focuses on maturing innovative/high payoff model-based manufacturing technologies that may lead to entirely new approaches for a broad array of future NASA missions and solutions to significant national needs. Digital manufacturing and computer-integrated manufacturing "virtually" guarantee advantages in quality, speed, and cost and offer many long-term benefits across the entire product lifecycle. This paper addresses key enablers and emerging strategies in areas such as: Current government initiatives, Model-based manufacturing, and Additive manufacturing.

Considerations for incorporating eicosapentaenoic and docosahexaenoic omega-3 fatty acids into the military food supply chain.

PubMed

Ismail, Adam; Rice, Harry B

2014-11-01

The U.S. military may consider exploring the inclusion of the long-chain omega-3 fatty acids, eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), in the diets of active duty military personnel. To be successful, certain challenges must be overcome including determining appropriate dosage, ensuring cost efficiency, and optimizing stability. To increase EPA and DHA intake, the military should consider using one of three strategies, including mandates or recommendations on omega-3 supplement usage, contracts to purchase commercially available foods for distribution in the food supply chain, or direct addition of EPA and DHA into currently consumed foods. This review presents the challenges and strategies and provides potential suggestions to the military to increase the likelihood of success. Reprint & Copyright © 2014 Association of Military Surgeons of the U.S.

Current state and challenges in developing oral vaccines.

PubMed

Vela Ramirez, Julia E; Sharpe, Lindsey A; Peppas, Nicholas A

2017-05-15

While vaccination remains the most cost effective strategy for disease prevention, communicable diseases persist as the second leading cause of death worldwide. There is a need to design safe, novel vaccine delivery methods to protect against unaddressed and emerging diseases. Development of vaccines administered orally is preferable to traditional injection-based formulations for numerous reasons including improved safety and compliance, and easier manufacturing and administration. Additionally, the oral route enables stimulation of humoral and cellular immune responses at both systemic and mucosal sites to establish broader and long-lasting protection. However, oral delivery is challenging, requiring formulations to overcome the harsh gastrointestinal (GI) environment and avoid tolerance induction to achieve effective protection. Here we address the rationale for oral vaccines, including key biological and physicochemical considerations for next-generation oral vaccine design. Copyright © 2017 Elsevier B.V. All rights reserved.

Prevalence of sensitivity to food and drug additives in patients with chronic idiopathic urticaria.

PubMed

Rajan, Jessica P; Simon, Ronald A; Bosso, John V

2014-01-01

Chronic idiopathic urticaria (CIU) is defined as the presence of urticaria most days of the week for a period of 6 weeks or longer. There have been reports of food additive sensitivity in CIU previously, but the prevalence has not been precisely determined. To determine the prevalence of reactions to food and drug additives in patients with CIU. We challenged 100 patients in our allergy/immunology division with CIU to the 11 additives most commonly associated with reactions: tartrazine (FD&C Yellow 5), potassium metabisulfite, monosodium glutamate, aspartame, sodium benzoate, methyl paraben, butylated hydroxy anisole, butylated hydroxy toluene, FD&C Yellow 6, sodium nitrate, sodium nitrite. All of the patients had a history of CIU for longer than 6 weeks, and 43 reported possible history of food or drug additive sensitivity. Single-blind challenges to all of the additives were performed in the clinic and skin scores were recorded. Subjects with positive challenge tests underwent double-blind placebo controlled challenges. Of 100 subjects, only 2 had a positive urticarial response on single-blind challenge. Neither of these patients had a positive urticarial response on double-blind placebo-controlled challenge. There were no gastrointestinal, respiratory, or other symptom, and no patients reported late reactions. We were able to conclude, with 95% confidence intervals that sensitivity to any of the 11 food and drug additives occurs in fewer than 1% of patients with CIU. Food and drug additives appear to be a rare cause of CIU, and avoidance is not recommended. Copyright © 2013 American Academy of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

Transsphenoidal surgery in patients with acromegaly: operative strategies for overcoming technically challenging anatomical variations.

PubMed

Zada, Gabriel; Cavallo, Luigi M; Esposito, Felice; Fernandez-Jimenez, Julio Cesar; Tasiou, Anastasia; De Angelis, Michelangelo; Cafiero, Tullio; Cappabianca, Paolo; Laws, Edward R

2010-10-01

In addition to difficulties with anesthetic and medical management, transsphenoidal operations in patients with longstanding acromegaly are associated with inherent intraoperative challenges because of anatomical variations that occur frequently in these patients. The object of this study was to review the overall safety profile and anatomical/technical challenges associated with transsphenoidal surgery in patients with acromegaly. The authors performed a retrospective analysis of 169 patients who underwent endoscopic transsphenoidal operations for growth hormone-secreting adenomas to assess the incidence of surgical complications. A review of frequently occurring anatomical challenges and operative strategies employed during each phase of the operation to address these particular issues was performed. Of 169 cases reviewed, there was no perioperative mortality. Internal carotid artery injury occurred in 1 patient (0.6%) with complex sinus anatomy, who remained neurologically intact following endovascular unilateral carotid artery occlusion. Other complications included: significant postoperative epistaxis (5 patients [3%]), transient diabetes insipidus (5 patients [3%]), delayed symptomatic hyponatremia (4 patients [2%]), CSF leak (2 patients [1%]), and pancreatitis (1 patient [0.6%]). Preoperative considerations in patients with acromegaly should include a cardiopulmonary evaluation and planning regarding intubation and other aspects of the anesthetic technique. During the nasal phase of the transsphenoidal operation, primary challenges include maintaining adequate visualization and hemostasis, which is frequently compromised by redundant, edematous nasal mucosa and bony hypertrophy of the septum and the nasal turbinates. During the sphenoid phase, adequate bony removal, optimization of working space, and correlation of imaging studies to intraoperative anatomy are major priorities. The sellar phase is frequently challenged by increased sellar floor thickness, distinct patterns of tumor extension and bony invasion, and anatomical variations in the caliber and course of the internal carotid artery. Specific operative techniques for addressing each of these intraoperative challenges are discussed. Transsphenoidal surgery in patients with longstanding acromegaly frequently poses greater challenges than operations for other types of sellar lesions, yet these challenges may be safely and effectively overcome with the anticipation of specific issues and implementation of various intraoperative techniques.

Education of senior house officers: current challenges

PubMed Central

Carr, S

2003-01-01

Over recent years several factors have impacted upon the education of doctors in training in medicine and other specialties. These factors include the European Working Time Directive and shift patterns of working, increasing service demands, changes in the examination and assessment processes, and clinical governance issues. In addition, over the next few years further changes will take place with the implementation of "Modernising Medical Careers" document and the establishment of the new Postgraduate Medical Education and Training Board. This article attempts to review the effects of these changes on education of junior doctors and to suggest some possible ways to address these challenges. PMID:14654571

Challenges Encountered by Vietnamese Nurses When Caring for Patients With Cancer.

PubMed

Thuy Nguyen, Ly; Clemenceau Annoussamy, Lourdes; LeBaron, Virginia T

2017-03-01

Providing holistic care is acknowledged as central to providing quality care for patients with cancer, but providing competent nursing care consistent with these approaches remains a challenge for nurses in Vietnam. Obstacles for Vietnamese oncology nurses include their low status, the limited scope of nursing practice, work overload in a hierarchical system, and cultural beliefs that view death and dying as taboo. Additional research to support oncology nurses in Vietnam must acknowledge the merits of improving nursing education as an important strategy for enhancing nursing autonomy, quality of care, and outcomes for the increasing number of patients with cancer in low- and middle-income countries.

Advances in Antibody Design

PubMed Central

Tiller, Kathryn E.; Tessier, Peter M.

2017-01-01

The use of monoclonal antibodies as therapeutics requires optimizing several of their key attributes. These include binding affinity and specificity, folding stability, solubility, pharmacokinetics, effector functions, and compatibility with the attachment of additional antibody domains (bispecific antibodies) and cytotoxic drugs (antibody–drug conjugates). Addressing these and other challenges requires the use of systematic design methods that complement powerful immunization and in vitro screening methods. We review advances in designing the binding loops, scaffolds, domain interfaces, constant regions, post-translational and chemical modifications, and bispecific architectures of antibodies and fragments thereof to improve their bioactivity. We also highlight unmet challenges in antibody design that must be overcome to generate potent antibody therapeutics. PMID:26274600

Overcoming Challenges to Childhood Immunizations Status.

PubMed

Sabnis, Svapna S; Conway, James H

2015-10-01

Vaccines are one of the greatest public health achievements, preventing both mortality and morbidity. However, overall immunization rates are still below the 90% target for Healthy People 2020. There remain significant disparities in immunization rates between children of different racial/ethnic groups, as well as among economically disadvantaged populations. There are systemic issues and challenges in providing access to immunization opportunities. In addition, vaccine hesitancy contributes to underimmunization. Multiple strategies are needed to improve immunization rates, including improving access to vaccines and minimizing financial barriers to families. Vaccine status should be assessed and vaccines given at all possible opportunities. Copyright © 2015 Elsevier Inc. All rights reserved.

Management of an asymptomatic patient with the apical variant of hypertrophic cardiomyopathy.

PubMed

Trojan, Meghan K Borden; Biederman, Robert W

2017-07-01

Healthcare professionals are faced with challenging decisions regarding patient evaluation and management on a daily basis. Once a diagnosis is made, additional challenges include how to proceed with the management. Here, we present an eighty-two-year-old female who was incidentally diagnosed with the apical variant of hypertrophic cardiomyopathy on a transthoracic echocardiogram. She was found to have newly diagnosed atrial fibrillation, but was otherwise asymptomatic from a cardiomyopathy standpoint. No specific guidelines exist for this patient population. Therefore, how does one proceed with the management of an asymptomatic patient with the apical variant of hypertrophic cardiomyopathy? © 2017, Wiley Periodicals, Inc.

Factors Influencing the Uptake of a Mechatronics Curriculum Initiative in Five Australian Secondary Schools

ERIC Educational Resources Information Center

Nicholas, Howard; Ng, Wan

2012-01-01

While the ready-made Lego[TM] Robotics kits are popular in schools and are used by students at both primary and secondary year levels, using the Picaxe microcontroller (chip) to create simple electronic devices, including robotic devices is less popular. The latter imposes an additional challenge as a result of the need to construct the universal…

Funding alternatives in EHR adoption: beyond HITECH incentives and traditional approaches.

PubMed

Wang, Tiankai; Wang, Yangmei; Biedermann, Sue

2013-05-01

The meaningful use incentives under HITECH may be inadequate to address the financial challenges many hospitals face in implementing electronic health records (EHRs). Hospitals can fill the capital gap between EHR costs and available funds by exploring other potential funding sources. These sources include additional grants, funding permissible under EHR regulations, vendor financing, and tax benefits under IRS Section 179.

HARNESSING THE CHEMISTRY OF CO{sub 2}

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

Louie, Janis

2012-11-30

Our research presents several strategies for addressing the challenges of activating CO2. In addition, our cycloaddition chemistry addresses several fundamental issues pertaining to catalysis as it applies to energy conservation. Topics addressed include: DEVELOPMENT OF A CYCLOADDITION CATALYST; INCREASING THE UTILITY OF THE NI CYCLOADDITION CATALYST; UNDERSTANDING THE MECHANISM OF NI-CATALYZED CYCLOADDITION; and METAL-FREE CO{sub 2} ACTIVATION.

Adaptive trials for tuberculosis: early reflections on theory and practice.

PubMed

Montgomery, C M

2016-08-01

Adaptive designs (ADs) have been proposed for anti-tuberculosis treatment trials. This call for innovation occurs against the backdrop of fundamental changes in the acceptable evidence base in anti-tuberculosis treatment. To contextualise ADs for tuberculosis (TB) and explore early responses from those working in the field. In this qualitative study investigating processes of theoretical and practical change in randomised controlled trials, 24 interviews were conducted with professionals involved in AD trials, half of whom worked in the TB field. Clinical trialists working on AD trials in TB are positive about the efficiency these designs offer, but remain cautious about their suitability. In addition to technical concerns, informants discussed the challenges of implementing AD in developing countries, including limited regulatory capacity to evaluate proposals, investments needed in infrastructure and site capacity, and challenges regarding informed consent. Respondents identified funding, interdisciplinary communication and regulatory and policy responses as additional concerns potentially affecting the success of AD for TB. Empirical research is needed into patient experiences of AD, including informed consent. Further consideration of the contexts of innovation in trial design is needed. These are fundamental to the successful translation of theory into practice.

Mental health challenges among adolescents living with HIV.

PubMed

Vreeman, Rachel C; McCoy, Brittany M; Lee, Sonia

2017-05-16

Mental health is a critical and neglected global health challenge for adolescents infected with HIV. The prevalence of mental and behavioural health issues among HIV-infected adolescents may not be well understood or addressed as the world scales up HIV prevention and treatment for adolescents. The objective of this narrative review is to assess the current literature related to mental health challenges faced by adolescents living with HIV, including access to mental health services, the role of mental health challenges during transition from paediatric to adult care services and responsibilities, and the impact of mental health interventions. For each of the topics included in this review, individual searches were run using Medline and PubMed, accompanied by scans of bibliographies of relevant articles. The topics on which searches were conducted for HIV-infected adolescents include depression and anxiety, transition from paediatric to adult HIV care and its impact on adherence and mental health, HIV-related, mental health services and interventions, and the measurement of mental health problems. Articles were included if the focus was consistent with one of the identified topics, involved HIV-infected adolescents, and was published in English. Mental and behavioural health challenges are prevalent in HIV-infected adolescents, including in resource-limited settings where most of them live, and they impact all aspects of HIV prevention and treatment. Too little has been done to measure the impact of mental health challenges for adolescents living with HIV, to evaluate interventions to best sustain or improve the mental health of this population, or to create healthcare systems with personnel or resources to promote mental health. Mental health issues should be addressed proactively during adolescence for all HIV-infected youth. In addition, care systems need to pay greater attention to how mental health support is integrated into the care management for HIV, particularly throughout lifespan changes from childhood to adolescence to adulthood. The lack of research and support for mental health needs in resource-limited settings presents an enormous burden for which cost-effective solutions are urgently needed.

Mental health challenges among adolescents living with HIV

PubMed Central

Vreeman, Rachel C.; McCoy, Brittany M.; Lee, Sonia

2017-01-01

Abstract Introduction: Mental health is a critical and neglected global health challenge for adolescents infected with HIV. The prevalence of mental and behavioural health issues among HIV-infected adolescents may not be well understood or addressed as the world scales up HIV prevention and treatment for adolescents. The objective of this narrative review is to assess the current literature related to mental health challenges faced by adolescents living with HIV, including access to mental health services, the role of mental health challenges during transition from paediatric to adult care services and responsibilities, and the impact of mental health interventions. Methods: For each of the topics included in this review, individual searches were run using Medline and PubMed, accompanied by scans of bibliographies of relevant articles. The topics on which searches were conducted for HIV-infected adolescents include depression and anxiety, transition from paediatric to adult HIV care and its impact on adherence and mental health, HIV-related, mental health services and interventions, and the measurement of mental health problems. Articles were included if the focus was consistent with one of the identified topics, involved HIV-infected adolescents, and was published in English. Results and Discussion: Mental and behavioural health challenges are prevalent in HIV-infected adolescents, including in resource-limited settings where most of them live, and they impact all aspects of HIV prevention and treatment. Too little has been done to measure the impact of mental health challenges for adolescents living with HIV, to evaluate interventions to best sustain or improve the mental health of this population, or to create healthcare systems with personnel or resources to promote mental health. Conclusions: Mental health issues should be addressed proactively during adolescence for all HIV-infected youth. In addition, care systems need to pay greater attention to how mental health support is integrated into the care management for HIV, particularly throughout lifespan changes from childhood to adolescence to adulthood. The lack of research and support for mental health needs in resource-limited settings presents an enormous burden for which cost-effective solutions are urgently needed. PMID:28530045

Ethical Issues and Practical Challenges in Suicide Research.

PubMed

Hom, Melanie A; Podlogar, Matthew C; Stanley, Ian H; Joiner, Thomas E

2017-03-01

Research with human subjects represents a critical avenue for suicide prevention efforts; however, such research is not without its ethical and practical challenges. Specifically, given the nature of research with individuals at elevated risk for suicide (e.g., increased concerns regarding participant safety, adverse events, liability, difficulties often arise during the institutional review board (IRB) evaluation and approval process. This paper aims to discuss IRB-related issues associated with suicide prevention research, including researcher and IRB panel member responsibilities, suicide risk assessment and management ethics and procedures, informed consent considerations, preparation of study protocols, and education and training. Points to consider and components to potentially include in an IRB application for suicide-related research are additionally provided. Literature relevant to ethics in suicide research and suicide risk assessment and management was reviewed and synthesized. Suicide research can be conducted in accordance with ethical principles while also furthering the science of suicide prevention. Despite the challenging nature of suicide prevention research, empirically informed solutions exist to address difficulties that may emerge in interfacing with IRBs. There remain areas for improvement in the IRB approval process that warrant further investigation and work.

Assessing Species Diversity Using Metavirome Data: Methods and Challenges.

PubMed

Herath, Damayanthi; Jayasundara, Duleepa; Ackland, David; Saeed, Isaam; Tang, Sen-Lin; Halgamuge, Saman

2017-01-01

Assessing biodiversity is an important step in the study of microbial ecology associated with a given environment. Multiple indices have been used to quantify species diversity, which is a key biodiversity measure. Measuring species diversity of viruses in different environments remains a challenge relative to measuring the diversity of other microbial communities. Metagenomics has played an important role in elucidating viral diversity by conducting metavirome studies; however, metavirome data are of high complexity requiring robust data preprocessing and analysis methods. In this review, existing bioinformatics methods for measuring species diversity using metavirome data are categorised broadly as either sequence similarity-dependent methods or sequence similarity-independent methods. The former includes a comparison of DNA fragments or assemblies generated in the experiment against reference databases for quantifying species diversity, whereas estimates from the latter are independent of the knowledge of existing sequence data. Current methods and tools are discussed in detail, including their applications and limitations. Drawbacks of the state-of-the-art method are demonstrated through results from a simulation. In addition, alternative approaches are proposed to overcome the challenges in estimating species diversity measures using metavirome data.

Challenges and Recent Developments in Hearing Aids: Part I. Speech Understanding in Noise, Microphone Technologies and Noise Reduction Algorithms

PubMed Central

Chung, King

2004-01-01

This review discusses the challenges in hearing aid design and fitting and the recent developments in advanced signal processing technologies to meet these challenges. The first part of the review discusses the basic concepts and the building blocks of digital signal processing algorithms, namely, the signal detection and analysis unit, the decision rules, and the time constants involved in the execution of the decision. In addition, mechanisms and the differences in the implementation of various strategies used to reduce the negative effects of noise are discussed. These technologies include the microphone technologies that take advantage of the spatial differences between speech and noise and the noise reduction algorithms that take advantage of the spectral difference and temporal separation between speech and noise. The specific technologies discussed in this paper include first-order directional microphones, adaptive directional microphones, second-order directional microphones, microphone matching algorithms, array microphones, multichannel adaptive noise reduction algorithms, and synchrony detection noise reduction algorithms. Verification data for these technologies, if available, are also summarized. PMID:15678225

Update on infection control challenges in special pediatric populations.

PubMed

Balkhy, Hanan H; Zingg, Walter

2014-08-01

Compared with adults, neonatal and pediatric populations are especially vulnerable patients who have specific diagnostic and therapeutic differences; therefore, the standard infection control practices designed for adults are sometimes not effective or need modifications to work. This review focuses on the recent literature addressing the challenges and successes in preventing healthcare-associated infections (HAIs) in children. Improving the implementation of pediatric versions of preventive bundles focusing on proper catheter insertion and maintenance, mainly as a part of a larger multimodal strategy, is effective in reducing the central-line-associated bloodstream infections in neonatal and pediatric populations including oncology patients. Appropriate feeding, antimicrobial stewardship, and infection control measures should be combined in reducing necrotizing enterocolitis in preterm neonates. Implementing a multimodal bundle strategy adapted for pediatric population is successful in preventing ventilator-associated pneumonia. Appropriate use of antimicrobial prophylaxis remains the cornerstone for preventing surgical-site infections irrespective of age, with few additional effective adjuvant preventive practices in specific pediatric patients. Several evidence-based practices are effective in reducing the incidence and the impact of HAIs in children; however, proper implementation remains a challenge. Additionally, several adult preventive practices are still unestablished in children and need further thorough examination.

Towards co-packaging of photonics and microelectronics in existing manufacturing facilities

NASA Astrophysics Data System (ADS)

Janta-Polczynski, Alexander; Cyr, Elaine; Bougie, Jerome; Drouin, Alain; Langlois, Richard; Childers, Darrell; Takenobu, Shotaro; Taira, Yoichi; Lichoulas, Ted W.; Kamlapurkar, Swetha; Engelmann, Sebastian; Fortier, Paul; Boyer, Nicolas; Barwicz, Tymon

2018-02-01

The impact of integrated photonics on optical interconnects is currently muted by challenges in photonic packaging and in the dense integration of photonic modules with microelectronic components on printed circuit boards. Single mode optics requires tight alignment tolerance for optical coupling and maintaining this alignment in a cost-efficient package can be challenging during thermal excursions arising from downstream microelectronic assembly processes. In addition, the form factor of typical fiber connectors is incompatible with the dense module integration expected on printed circuit boards. We have implemented novel approaches to interfacing photonic chips to standard optical fibers. These leverage standard high throughput microelectronic assembly tooling and self-alignment techniques resulting in photonic packaging that is scalable in manufacturing volume and in the number of optical IOs per chip. In addition, using dense optical fiber connectors with space-efficient latching of fiber patch cables results in compact module size and efficient board integration, bringing the optics closer to the logic chip to alleviate bandwidth bottlenecks. This packaging direction is also well suited for embedding optics in multi-chip modules, including both photonic and microelectronic chips. We discuss the challenges and rewards in this type of configuration such as thermal management and signal integrity.

Mapping Geology and Vegetation using Hyperspectral Data in Antarctica: Current Challenges, New Solutions and Looking to the Future

NASA Astrophysics Data System (ADS)

Black, M.; Riley, T. R.; Fleming, A. H.; Ferrier, G.; Fretwell, P.; Casanovas, P.

2015-12-01

Antarctica is a unique and geographically remote environment. Traditional field campaigns investigating geology and vegetation in the region encounter numerous challenges including the harsh polar climate, the invasive nature of the work, steep topography and high infrastructure costs. Additionally, such field campaigns are often limited in terms of spatial and temporal resolution, and particularly, the topographical challenges presented in the Antarctic mean that many areas remain inaccessible. Remote Sensing, particularly hyperspectral imaging, may provide a solution to overcome the difficulties associated with field based mapping in the Antarctic. Planned satellite launches, such as EnMAP and HyspIRI, if successful, will yield large-scale, repeated hyperspectral imagery of Antarctica. Hyperspectral imagery has proven mapping capabilities and can yield greater information than can be attained using multispectral data. As a precursor to future satellite imagery, we utilise hyperspectral imagery from the first known airborne hyperspectral survey carried out in the Antarctic by the British Antarctic Survey and partners in 2011. Multiple imaging spectrometers were simultaneously deployed covering the visible, shortwave and thermal infrared regions of the electromagnetic spectrum. Additional data was generated during a field campaign deploying multiple ground spectrometers covering the same wavelengths as the airborne imagers. We utilise this imagery to assess the current challenges and propose some new solutions for mapping vegetation and geology, which may be directly applicable to future satellite hyperspectral imagery in the Antarctic.

Working and caring for a child with chronic illness: A review of current literature.

PubMed

Kish, A M; Newcombe, P A; Haslam, D M

2018-05-01

Advances in medical knowledge have contributed to the increase in the number of children living with some form of long-term chronic illness or condition. As a consequence of these advancements, treatments that are more accessible and easier to administer, usually within a child's home, have been developed. However, this may mean that parents take on greater treatment responsibility and require extra time and energy to meet these tasks, additional to other responsibilities. This review paper aims to summarize and critique existing literature on working parents of children with a chronic condition, by focusing on patterns of parent work, the challenges experienced, and the flow-on consequences to well-being. Employing a narrative, meta-synthesis of the current literature, this review identified 3 key themes related to working parents of children with chronic illness. The paper first identifies that although employment is less common, these parents are not necessarily nonworking. Second, these parents experience numerous challenges including balancing work and family, time constraints, stress, and feelings of "doing it all." And third, the above challenges lead to additional impacts on parental quality of life. This review summarizes what is currently known about work patterns, challenges, and consequences in parents of children with chronic conditions. Employment is clearly impacted for these parents. Although workplace challenges have been extensively researched, other challenges (eg, personal and family) and impacts on their well-being have not. This review discusses the present standing of this research. It outlines the strengths and limitations of the current literature, makes recommendations for future research, and suggests theoretical and practical implications of the further findings. © 2018 John Wiley & Sons Ltd.

New Mass Properties Engineers Aerospace Ballasting Challenge Facilitated by the SAWE Community

NASA Technical Reports Server (NTRS)

Cutright, Amanda; Shaughnessy, Brendan

2010-01-01

The discipline of Mass Properties Engineering tends to find the engineers; not typically vice versa. In this case, two engineers quickly found their new responsibilities deep in many aspects of mass properties engineering and required to meet technical challenges in a fast paced environment. As part of NASA's Constellation Program, a series of flight tests will be conducted to evaluate components of the new spacecraft launch vehicles. One of these tests is the Pad Abort 1 (PA-1) flight test which will test the Launch Abort System (LAS), a system designed to provide escape for astronauts in the event of an emergency. The Flight Test Articles (FTA) used in this flight test are required to match mass properties corresponding to the operational vehicle, which has a continually evolving design. Additionally, since the structure and subsystems for the Orion Crew Module (CM) FTA are simplified versions of the final product, thousands of pounds of ballast are necessary to achieve the desired mass properties. These new mass properties engineers are responsible for many mass properties aspects in support of the flight test, including meeting the ballasting challenge for the CM Boilerplate FTA. SAWE expert and experienced mass properties engineers, both those that are directly on the team and many that supported via a variety of Society venues, significantly contributed to facilitating the success of addressing this particular mass properties ballasting challenge, in addition to many other challenges along the way. This paper discusses the details regarding the technical aspects of this particular mass properties challenge, as well as identifies recommendations for new mass properties engineers that were learned from the SAWE community along the way.

An Overview of Science Challenges Pertaining to our Understanding of Extreme Geomagnetically Induced Currents. Chapter 8

NASA Technical Reports Server (NTRS)

Ngwira, Chigomezyo M.; Pulkkinen, Antti A.

2018-01-01

Vulnerability of man-made infrastructure to Earth-directed space weather events is a serious concern for today's technology-dependent society. Space weather-driven geomagnetically induced currents (GICs) can disrupt operation of extended electrically conducting technological systems. The threat of adverse impacts on critical technological infrastructure, like power grids, oil and gas pipelines, and communication networks, has sparked renewed interest in extreme space weather. Because extreme space weather events have low occurrence rate but potentially high impact, this presents a major challenge for our understanding of extreme GIC activity. In this chapter, we discuss some of the key science challenges pertaining to our understanding of extreme events. In addition, we present an overview of GICs including highlights of severe impacts over the last 80 years and recent U.S. Federal actions relevant to this community.

Barriers to Employment for Transition-age Youth with Developmental and Psychiatric Disabilities.

PubMed

Noel, Valerie A; Oulvey, Eugene; Drake, Robert E; Bond, Gary R

2017-05-01

Youth with developmental and psychiatric disabilities encounter significant vocational challenges, even when they receive supported employment services. We examined the barriers to employment for 280 transition-age youth with disabilities enrolled in supported employment in eight community rehabilitation centers. Employment team members identified each youth's top three barriers to employment using a 21-item checklist. Lack of work experience, transportation problems, and program engagement issues represented common barriers for both youth with developmental disabilities (53, 36, and 25%) and youth with psychiatric disabilities (20, 33, and 26%). Additional common barriers among youth with developmental disabilities included cognitive problems (32%) and lack of social skills (23%) and among youth with psychiatric disabilities included poor control of psychiatric symptoms (23%). Despite receiving evidence-based employment services, youth with disabilities encounter many barriers to employment. Awareness of typical barriers for transition-age youth, including those specific to different disability groups, may help employment programs anticipate challenges and develop strategies that avoid these barriers and their effects on employment opportunities.

Economic Evaluation alongside Multinational Studies: A Systematic Review of Empirical Studies

PubMed Central

Oppong, Raymond; Jowett, Sue; Roberts, Tracy E.

2015-01-01

Purpose of the study This study seeks to explore methods for conducting economic evaluations alongside multinational trials by conducting a systematic review of the methods used in practice and the challenges that are typically faced by the researchers who conducted the economic evaluations. Methods A review was conducted for the period 2002 to 2012, with potentially relevant articles identified by searching the Medline, Embase and NHS EED databases. Studies were included if they were full economic evaluations conducted alongside a multinational trial. Results A total of 44 studies out of a possible 2667 met the inclusion criteria. Methods used for the analyses varied between studies, indicating a lack of consensus on how economic evaluation alongside multinational studies should be carried out. The most common challenge appeared to be related to addressing differences between countries, which potentially hinders the generalisability and transferability of results. Other challenges reported included inadequate sample sizes and choosing cost-effectiveness thresholds. Conclusions It is recommended that additional guidelines be developed to aid researchers in this area and that these be based on an understanding of the challenges associated with multinational trials and the strengths and limitations of alternative approaches. Guidelines should focus on ensuring that results will aid decision makers in their individual countries. PMID:26121465

Tuberculosis control in prisons: current situation and research gaps.

PubMed

Dara, Masoud; Acosta, Colleen D; Melchers, Natalie V S Vinkeles; Al-Darraji, Haider A A; Chorgoliani, Dato; Reyes, Hernan; Centis, Rosella; Sotgiu, Giovanni; D'Ambrosio, Lia; Chadha, Sarabjit S; Migliori, Giovanni Battista

2015-03-01

Tuberculosis (TB) in penitentiary services (prisons) is a major challenge to TB control. This review article describes the challenges that prison systems encounter in TB control and provides solutions for the more efficient use of limited resources based on the three pillars of the post-2015 End TB Strategy. This paper also proposes research priorities for TB control in prisons based on current challenges. Articles (published up to 2011) included in a recent systematic review on TB control in prisons were further reviewed. In addition, relevant articles in English (published 1990 to May 2014) were identified by searching keywords in PubMed and Google Scholar. Article bibliographies and conference abstracts were also hand-searched. Despite being a serious cause of morbidity and mortality among incarcerated populations, many prison systems encounter a variety of challenges that hinder TB control. These include, but are not limited to, insufficient laboratory capacity and diagnostic tools, interrupted supply of medicines, weak integration between civilian and prison TB services, inadequate infection control measures, and low policy priority for prison healthcare. Governmental commitment, partnerships, and sustained financing are needed in order to facilitate improvements in TB control in prisons, which will translate to the wider community. Copyright © 2015 World Health Organization. Published by Elsevier Ltd.. All rights reserved.

Paving the Path for Human Space Exploration: The Challenges and Opportunities

NASA Technical Reports Server (NTRS)

Hansen, Lauri

2016-01-01

Lauri Hansen, Director of Engineering at NASA Johnson Space Center will discuss the challenges of human space exploration. The future of human exploration begins with our current earth reliant missions in low earth orbit. These missions utilize the International Space Station to learn how to safely execute deep space missions. In addition to serving as an exploration test bed and enabling world class research, the International Space Station enables NASA to build international and commercial partnerships. NASA's next steps will be to enable the commercialization of low earth orbit while concentrating on developing the spacecraft and infrastructure necessary for deep space exploration and long duration missions. The Orion multi-purpose crew vehicle and the Space Launch System rocket are critical building blocks in this next phase of exploration. There are many challenges in designing spacecraft to perform these missions including safety, complex vehicle design, and mass challenges. Orion development is proceeding well, and includes a significant partnership with the European Space Agency (ESA) to develop and build the Service Module portion of the spacecraft. Together, NASA and ESA will provide the capability to take humans further than we have ever been before - 70,000 km past the moon. This will be the next big step in expanding the frontiers of human exploration, eventually leading to human footprints on Mars.

Bronchial reactions to exposure to welding fumes.

PubMed Central

Contreras, G R; Chan-Yeung, M

1997-01-01

OBJECTIVES: To study the airway response and its mechanism to welding fumes in six welders with respiratory symptoms. METHODS: Methacholine and welding challenge tests were carried out. The concentration of welding fumes during the exposure test was measured. On two subjects who developed bronchoconstricition to welding challenge, additional tests were carried out including prick, patch, and inhalation challenges with metal salt solutions. RESULTS: Three subjects developed immediate bronchial reaction to exposure to welding fume; one to mild steel and stainless steel welding, another to mild steel and galvanised welding, and one only to galvanised welding. They all had a moderate to pronounced degree of non-specific bronchial hyperresponsiveness. The concentration of fumes during welding tests, particularly to galvanised welding, was high. An inhalation challenge test with zinc chloride salt solution in two subjects who reacted to galvanised welding was negative. Prick and patch tests with zinc chloride were also negative. CONCLUSION: The airway response to welding in these subjects is non-specific and is due to irritation rather than to sensitisation. PMID:9538358

Bronchial reactions to exposure to welding fumes.

PubMed

Contreras, G R; Chan-Yeung, M

1997-11-01

To study the airway response and its mechanism to welding fumes in six welders with respiratory symptoms. Methacholine and welding challenge tests were carried out. The concentration of welding fumes during the exposure test was measured. On two subjects who developed bronchoconstricition to welding challenge, additional tests were carried out including prick, patch, and inhalation challenges with metal salt solutions. Three subjects developed immediate bronchial reaction to exposure to welding fume; one to mild steel and stainless steel welding, another to mild steel and galvanised welding, and one only to galvanised welding. They all had a moderate to pronounced degree of non-specific bronchial hyperresponsiveness. The concentration of fumes during welding tests, particularly to galvanised welding, was high. An inhalation challenge test with zinc chloride salt solution in two subjects who reacted to galvanised welding was negative. Prick and patch tests with zinc chloride were also negative. The airway response to welding in these subjects is non-specific and is due to irritation rather than to sensitisation.

Aeroelasticity Benchmark Assessment: Subsonic Fixed Wing Program

NASA Technical Reports Server (NTRS)

Florance, Jennifer P.; Chwalowski, Pawel; Wieseman, Carol D.

2010-01-01

The fundamental technical challenge in computational aeroelasticity is the accurate prediction of unsteady aerodynamic phenomena and the effect on the aeroelastic response of a vehicle. Currently, a benchmarking standard for use in validating the accuracy of computational aeroelasticity codes does not exist. Many aeroelastic data sets have been obtained in wind-tunnel and flight testing throughout the world; however, none have been globally presented or accepted as an ideal data set. There are numerous reasons for this. One reason is that often, such aeroelastic data sets focus on the aeroelastic phenomena alone (flutter, for example) and do not contain associated information such as unsteady pressures and time-correlated structural dynamic deflections. Other available data sets focus solely on the unsteady pressures and do not address the aeroelastic phenomena. Other discrepancies can include omission of relevant data, such as flutter frequency and / or the acquisition of only qualitative deflection data. In addition to these content deficiencies, all of the available data sets present both experimental and computational technical challenges. Experimental issues include facility influences, nonlinearities beyond those being modeled, and data processing. From the computational perspective, technical challenges include modeling geometric complexities, coupling between the flow and the structure, grid issues, and boundary conditions. The Aeroelasticity Benchmark Assessment task seeks to examine the existing potential experimental data sets and ultimately choose the one that is viewed as the most suitable for computational benchmarking. An initial computational evaluation of that configuration will then be performed using the Langley-developed computational fluid dynamics (CFD) software FUN3D1 as part of its code validation process. In addition to the benchmarking activity, this task also includes an examination of future research directions. Researchers within the Aeroelasticity Branch will examine other experimental efforts within the Subsonic Fixed Wing (SFW) program (such as testing of the NASA Common Research Model (CRM)) and other NASA programs and assess aeroelasticity issues and research topics.

Patients’ Online Access to Their Primary Care Electronic Health Records and Linked Online Services: Implications for Research and Practice

PubMed Central

Mold, Freda; de Lusignan, Simon

2015-01-01

Online access to medical records and linked services, including requesting repeat prescriptions and booking appointments, enables patients to personalize their access to care. However, online access creates opportunities and challenges for both health professionals and their patients, in practices and in research. The challenges for practice are the impact of online services on workload and the quality and safety of health care. Health professionals are concerned about the impact on workload, especially from email or other online enquiry systems, as well as risks to privacy. Patients report how online access provides a convenient means through which to access their health provider and may offer greater satisfaction if they get a timely response from a clinician. Online access and services may also result in unforeseen consequences and may change the nature of the patient-clinician interaction. Research challenges include: (1) Ensuring privacy, including how to control inappropriate carer and guardian access to medical records; (2) Whether online access to records improves patient safety and health outcomes; (3) Whether record access increases disparities across social classes and between genders; and (4) Improving efficiency. The challenges for practice are: (1) How to incorporate online access into clinical workflow; (2) The need for a business model to fund the additional time taken. Creating a sustainable business model for a safe, private, informative, more equitable online service is needed if online access to records is to be provided outside of pay-for-service systems. PMID:26690225

Patients' Online Access to Their Primary Care Electronic Health Records and Linked Online Services: Implications for Research and Practice.

PubMed

Mold, Freda; de Lusignan, Simon

2015-12-04

Online access to medical records and linked services, including requesting repeat prescriptions and booking appointments, enables patients to personalize their access to care. However, online access creates opportunities and challenges for both health professionals and their patients, in practices and in research. The challenges for practice are the impact of online services on workload and the quality and safety of health care. Health professionals are concerned about the impact on workload, especially from email or other online enquiry systems, as well as risks to privacy. Patients report how online access provides a convenient means through which to access their health provider and may offer greater satisfaction if they get a timely response from a clinician. Online access and services may also result in unforeseen consequences and may change the nature of the patient-clinician interaction. Research challenges include: (1) Ensuring privacy, including how to control inappropriate carer and guardian access to medical records; (2) Whether online access to records improves patient safety and health outcomes; (3) Whether record access increases disparities across social classes and between genders; and (4) Improving efficiency. The challenges for practice are: (1) How to incorporate online access into clinical workflow; (2) The need for a business model to fund the additional time taken. Creating a sustainable business model for a safe, private, informative, more equitable online service is needed if online access to records is to be provided outside of pay-for-service systems.

Qualitative analysis of round-table discussions on the business case and procurement challenges for hospital electronic prescribing systems.

PubMed

Cresswell, Kathrin M; Slee, Ann; Coleman, Jamie; Williams, Robin; Bates, David W; Sheikh, Aziz

2013-01-01

There is a pressing need to understand the challenges surrounding procurement of and business case development for hospital electronic prescribing systems, and to identify possible strategies to enhance the efficiency of these processes in order to assist strategic decision making. We organized eight multi-disciplinary round-table discussions in the United Kingdom. Participants included policy makers, representatives from hospitals, system developers, academics, and patients. Each discussion was digitally audio-recorded, transcribed verbatim and, together with accompanying field notes, analyzed thematically with NVivo9. We drew on data from 17 participants (approximately eight per roundtable), six hours of discussion, and 15 pages of field notes. Key challenges included silo planning with systems not being considered as part of an integrated organizational information technology strategy, lack of opportunity for interactions between customers and potential suppliers, lack of support for hospitals in choosing appropriate systems, difficulty of balancing structured planning with flexibility, and the on-going challenge of distinguishing "wants" and aspirations from organizational "needs". Development of business cases for major investments in information technology does not take place in an organizational vacuum. Building on previously identified potentially transferable dimensions to the development and execution of business cases surrounding measurements of costs/benefits and risk management, we have identified additional components relevant to ePrescribing systems. These include: considerations surrounding strategic context, case for change and objectives, future service requirements and options appraisal, capital and revenue implications, timescale and deliverability, and risk analysis and management.

Microstructural Development and Technical Challenges in Laser Additive Manufacturing: Case Study with a 316L Industrial Part

NASA Astrophysics Data System (ADS)

Marya, Manuel; Singh, Virendra; Marya, Surendar; Hascoet, Jean Yves

2015-08-01

Additive manufacturing (AM) brings disruptive changes to the ways parts, and products are designed, fabricated, tested, qualified, inspected, marketed, and sold. These changes introduce novel technical challenges and concerns arising from the maturity and diversity of today's AM processes, feedstock materials, and process parameter interactions. AM bears a resemblance with laser and electron beam welding in the so-called conduction mode, which involves a multitude of dynamic physical events between the projected feedstock and a moving heat source that eventually influence AM part properties. For this paper, an air vent was selected for its thin-walled, hollow, and variable cross section, and limited size. The studied air vents, randomly selected from a qualification batch, were fabricated out of 316L stainless steel using a 4 kW fiber laser powder-fed AM system, referred to as construction laser additive direct (CLAD). These were systematically characterized by microhardness indentation, visual examination, optical and scanning electron microscopy, and electron-back-scattering diffraction in order to determine AM part suitability for service and also broadly discuss metallurgical phenomena. The paper then briefly expands the discussion to include additional engineering alloys and further analyze relationships between AM process parameters and AM part properties, consistently utilizing past experience with the same powder-fed CLAD 3D printer, the well-established science and technology of welding and joining, and recent publications on additive manufacturing.

The psychosocial needs of lesbian, gay, bisexual, or transgender patients with cancer.

PubMed

Margolies, Liz

2014-08-01

Because of discrimination and secrecy, lesbian, gay, bisexual, and transgender (LGBT) people have poorer health outcomes, which include an increased risk for certain cancers and additional challenges in cancer treatment and survivorship. The oncology nurse also should be aware of issues of LGBT sexuality and the impact that oncology treatment may have on the LGBT patient's immediate and long-term sexual functioning.

Managing the Services Supply Chain in the Department of Defense: Opportunities and Challenges

DTIC Science & Technology

2006-04-30

and Russell (1990), Heskett, Sasser and Hart (1990), Lovelock (1992b), Fitzsimmons and Fitzsimmons (2006), and in casebooks including Sasser, Hart...managers of service businesses. Lovelock (1983) proposes five schemes for classifying services that offer insight for marketing and operations...managers in different service businesses. Additional suggestions for managing service business are given by Lovelock (1992a), Schmenner (1986), and Quinn

Identifying and overcoming implementation challenges: Experience of 59 noninstitutional long-term services and support pilot programs in the Veterans Health Administration

PubMed Central

Sullivan, Jennifer L.; Adjognon, Omonyêlé L.; Engle, Ryann L.; Shin, Marlena H.; Afable, Melissa K.; Rudin, Whitney; White, Bert; Shay, Kenneth; Lukas, Carol VanDeusen

2018-01-01

Background: From 2010 to 2013, the Department of Veterans Affairs (VA) funded a large pilot initiative to implement noninstitutional long-term services and supports (LTSS) programs to support aging Veterans. Our team evaluated implementation of 59 VA noninstitutional LTSS programs. Purpose: The specific objectives of this study are to (a) examine the challenges influencing program implementation comparing active sites that remained open and inactive sites that closed during the funding period and (b) identify ways that active sites overcame the challenges they experienced. Methodology: Key informant semistructured interviews occurred between 2011 and 2013. We conducted 217 telephone interviews over four time points. Content analysis was used to identify emergent themes. The study team met regularly to define each challenge, review all codes, and discuss discrepancies. For each follow-up interview with the sites, the list of established challenges was used as a priori themes. Emergent data were also coded. Results: The challenges affecting implementation included human resources and staffing issues, infrastructure, resources allocation and geography, referrals and marketing, leadership support, and team dynamics and processes. Programs were able to overcome challenges by communicating with team members and other areas in the organization, utilizing information technology solutions, creative use of staff and flexible schedules, and obtaining additional resources. Discussion: This study highlights several common challenges programs can address during the program implementation. The most often mentioned strategy was effective communication. Strategies also targeted several components of the organization including organizational functions and processes (e.g., importance of coordination within a team and across disciplines to provide good care), infrastructure (e.g., information technology and human resources), and program fit with priorities in the organization (e.g., leadership support). Implications: Anticipating potential pitfalls of program implementation for future noninstitutional LTSS programs can improve implementation efficiency and program sustainability. Staff at multiple levels in the organization must fully support noninstitutional LTSS programs to address these challenges. PMID:28125459

Identifying and overcoming implementation challenges: Experience of 59 noninstitutional long-term services and support pilot programs in the Veterans Health Administration.

PubMed

Sullivan, Jennifer L; Adjognon, Omonyêlé L; Engle, Ryann L; Shin, Marlena H; Afable, Melissa K; Rudin, Whitney; White, Bert; Shay, Kenneth; Lukas, Carol VanDeusen

From 2010 to 2013, the Department of Veterans Affairs (VA) funded a large pilot initiative to implement noninstitutional long-term services and supports (LTSS) programs to support aging Veterans. Our team evaluated implementation of 59 VA noninstitutional LTSS programs. The specific objectives of this study are to (a) examine the challenges influencing program implementation comparing active sites that remained open and inactive sites that closed during the funding period and (b) identify ways that active sites overcame the challenges they experienced. Key informant semistructured interviews occurred between 2011 and 2013. We conducted 217 telephone interviews over four time points. Content analysis was used to identify emergent themes. The study team met regularly to define each challenge, review all codes, and discuss discrepancies. For each follow-up interview with the sites, the list of established challenges was used as a priori themes. Emergent data were also coded. The challenges affecting implementation included human resources and staffing issues, infrastructure, resources allocation and geography, referrals and marketing, leadership support, and team dynamics and processes. Programs were able to overcome challenges by communicating with team members and other areas in the organization, utilizing information technology solutions, creative use of staff and flexible schedules, and obtaining additional resources. This study highlights several common challenges programs can address during the program implementation. The most often mentioned strategy was effective communication. Strategies also targeted several components of the organization including organizational functions and processes (e.g., importance of coordination within a team and across disciplines to provide good care), infrastructure (e.g., information technology and human resources), and program fit with priorities in the organization (e.g., leadership support). Anticipating potential pitfalls of program implementation for future noninstitutional LTSS programs can improve implementation efficiency and program sustainability. Staff at multiple levels in the organization must fully support noninstitutional LTSS programs to address these challenges.

Automatically augmenting lifelog events using pervasively generated content from millions of people.

PubMed

Doherty, Aiden R; Smeaton, Alan F

2010-01-01

In sensor research we take advantage of additional contextual sensor information to disambiguate potentially erroneous sensor readings or to make better informed decisions on a single sensor's output. This use of additional information reinforces, validates, semantically enriches, and augments sensed data. Lifelog data is challenging to augment, as it tracks one's life with many images including the places they go, making it non-trivial to find associated sources of information. We investigate realising the goal of pervasive user-generated content based on sensors, by augmenting passive visual lifelogs with "Web 2.0" content collected by millions of other individuals.

Terra Mission Operations: Launch to the Present (and Beyond)

NASA Technical Reports Server (NTRS)

Kelly, Angelita; Moyer, Eric; Mantziaras, Dimitrios; Case, Warren

2014-01-01

The Terra satellite, flagship of NASA's long-term Earth Observing System (EOS) Program, continues to provide useful earth science observations well past its 5-year design lifetime. This paper describes the evolution of Terra operations, including challenges and successes and the steps taken to preserve science requirements and prolong spacecraft life. Working cooperatively with the Terra science and instrument teams, including NASA's international partners, the mission operations team has successfully kept the Terra operating continuously, resolving challenges and adjusting operations as needed. Terra retains all of its observing capabilities (except Short Wave Infrared) despite its age. The paper also describes concepts for future operations. This paper will review the Terra spacecraft mission successes and unique spacecraft component designs that provided significant benefits extending mission life and science. In addition, it discusses special activities as well as anomalies and corresponding recovery efforts. Lastly, it discusses future plans for continued operations.

Challenges in systematic reviews: synthesis of topics related to the delivery, organization, and financing of health care.

PubMed

Bravata, Dena M; McDonald, Kathryn M; Shojania, Kaveh G; Sundaram, Vandana; Owens, Douglas K

2005-06-21

Some important health policy topics, such as those related to the delivery, organization, and financing of health care, present substantial challenges to established methods for evidence synthesis. For example, such reviews may ask: What is the effect of for-profit versus not-for-profit delivery of care on patient outcomes? Or, which strategies are the most effective for promoting preventive care? This paper describes innovative methods for synthesizing evidence related to the delivery, organization, and financing of health care. We found 13 systematic reviews on these topics that described novel methodologic approaches. Several of these syntheses used 3 approaches: conceptual frameworks to inform problem formulation, systematic searches that included nontraditional literature sources, and hybrid synthesis methods that included simulations to address key gaps in the literature. As the primary literature on these topics expands, so will opportunities to develop additional novel methods for performing high-quality comprehensive syntheses.

Dementia in the Oldest Old

PubMed Central

Bullain, Szófia S.; Corrada, María M.

2013-01-01

Purpose of Review: This article discusses some of the unique features of dementia in the oldest old, including some of the most common diagnostic challenges, and potential strategies to overcome them. Recent Findings: Advances include new insight into the role of common risk factors and the effects of multiple underlying neuropathologic features for dementia in the oldest old. In addition, this article contains the latest age-specific normative data for commonly used neuropsychological tests for the oldest old. Summary: The oldest old—people aged 90 years and older—are the fastest-growing segment of society and have the highest rates of dementia in the population. The risk factors, diagnostic challenges, and underlying neuropathologic features of dementia are strikingly different in the 90-years-and-older population compared to younger elderly. Special consideration of these unique features of dementia is necessary when evaluating oldest-old subjects with cognitive impairment. PMID:23558489

Gazing into the crystal ball: future considerations for ensuring sustained growth of the functional food and nutraceutical marketplace.

PubMed

Marinangeli, Christopher P F; Jones, Peter J H

2013-06-01

Over the last decade the concept of functional foods and nutraceuticals (FFN) has gained support from various stakeholders including the food industry, scientific and academic community, government institutions or regulators, producers and consumers. However, as one begins to evaluate the global FFN industry, several issues emerge including (i) a lack of consensus across jurisdictions for acknowledging safe and efficacious FFN, (ii) challenges regarding the classification of novel food-derived bioactives as FFN or drugs, and (iii) a disconnect between nutrient requirements and dosages of FFN required to facilitate health benefits. The objectives of the present review are to discuss the role of existing stakeholders within the FFN marketplace and identify performance indicators for growth within the FFN sector. In addition, the following report provides feasible resolutions to present and future challenges facing the global FFN industry to ensure sustained long-term growth.

Multidisciplinary investigation of the fate, transport, and remediation of chlorinated solvents in fractured rocks at the former Naval Air Warfare Center (NAWC): Scientific and management challenges, and strategies for a successful research program

NASA Astrophysics Data System (ADS)

Tiedeman, C. R.; Goode, D. J.; Shapiro, A. M.; Lacombe, P. J.; Chapelle, F. H.; Bradley, P. M.; Imbrigiotta, T. E.; Williams, J. H.; Curtis, G. P.; Hsieh, P. A.

2008-12-01

At the former Naval Air Warfare Center (NAWC) in West Trenton NJ, the U.S. Geological Survey, in cooperation with the U.S. Navy and under support from the Strategic Environmental Research and Development Program (SERDP), is investigating the fate, transport, and remediation of trichloroethylene (TCE) and its daughter products in dipping, fractured mudstones underlying the site. TCE concentrations in ground water are as high as ~100 mg/L. Objectives of multidisciplinary research at the NAWC include (1) understanding the physical, chemical, and microbiological processes and properties affecting the fate, transport, and removal of chlorinated solvents in fractured rocks, (2) assessing the efficiency of different remediation methods (pump and treat, natural and enhanced biodegradation), and (3) transferring the results to help remediate other contaminated fractured rock aquifers. There are numerous scientific and technical challenges to meeting these goals, including the extreme spatial variability of flow and transport properties at the NAWC and the complex distribution of contaminants, geochemical constituents, and microorganisms in fractures and the rock matrix. In addition, there are management challenges that are equally important to address in order to achieve a successful research program. These include balancing the requirements of the many parties involved at the site, including researchers, the site owner, and regulatory agencies; and ensuring that limited research funds are directed towards work that addresses the most important scientific questions as well as stakeholder concerns. Strategies for the scientific challenges at NAWC include developing a carefully planned program to characterize spatial variability in rock properties and groundwater constituents so that the data obtained are applicable to solving research questions focused on remediation. Strategies for the management challenges include fostering open lines of communication among all parties and conferring with the U.S. Environmental Protection Agency to ensure that our research is relevant to remediation at Superfund and other hazardous waste sites with chlorinated solvent contamination of fractured rocks.

Urinary metabolites of histamine and leukotrienes before and after placebo-controlled challenge with ASA and food additives in chronic urticaria patients.

PubMed

Di Lorenzo, G; Pacor, M L; Vignola, A M; Profita, M; Esposito-Pellitteri, M; Biasi, D; Corrocher, R; Caruso, C

2002-12-01

The recovery of mediator metabolites from urine has the potential to provide a rapid, safe, and easily available index of release of mediators. We aimed to determine urinary metabolites of both histamine and leukotrienes (LTs) in patients affected by chronic urticaria (CU). Twenty patients with CU were studied. They were selected on the basis of double-blind placebo-controlled challenge (DBPC) with acetyl salicylic acid (ASA) and food additives. Ten patients (group B) were negative to both challenges. Ten patients (group C) presented urticaria and/or the appearance of angioedema during or 24 h after challenge, with reactions to ASA (five patients) or food additives (five patients). We recruited 15 healthy volunteers as controls (group A). During a second challenge, groups B and C were challenged double-blind with a single dose of ASA, or a specific food additive, or placebo. The healthy group was challenged only with a placebo (talc capsule). Patients in groups B and C were challenged twice: with placebo (as groups B1 and C1) and with ASA (groups B2 and C2) or food additives (C2). Four samples of urine were collected; one during the night before the specific or sham challenge (baseline), and three at 2, 6 and 24 h after the challenge. Urinary methylhistamine (N-MH) and LTE4 were analyzed and normalized for urinary creatinine. For urinary N-MH at baseline, there was a significant difference only between group A and groups B1, B2, C1 and C2 (A vs. B1, P < 0.0001; A vs. B2, P < 0.0001; A vs. C1, P < 0.0001; A vs. C2, P < 0.0001). We detected a significant variation in urinary methylhistamine excretion only in group C2 after 2 h, 6 h and 24 h (P < 0.0001). However, no variations were observed in N-MH excretion rate in the other groups (A, B1, C1) after challenge with placebo, and in B2 after challenge with ASA 20 mg. For urinary LTE4 at baseline no differences were found between the mean values for the different groups. After specific challenge, only C2 patients showed significantly increased excretion rates of urinary LTE4 compared with the other groups challenged with placebo (A, B1, C1), or ASA (B2) (P < 0.0001). No significant correlation was seen between urinary LTE4 and methylhistamine excretion rate in any patients. Our results show that urinary excretion of N-MH and LTE4 is different for CU patients without ASA or food hypersensitivity, compared to those with CU with ASA or food additive hypersensitivity after specific challenge.

Numerical and Experimental Study of Ti6Al4V Components Manufactured Using Powder Bed Fusion Additive Manufacturing

NASA Astrophysics Data System (ADS)

Zielinski, Jonas; Mindt, Hans-Wilfried; Düchting, Jan; Schleifenbaum, Johannes Henrich; Megahed, Mustafa

2017-12-01

Powder bed fusion additive manufacturing of titanium alloys is an interesting manufacturing route for many applications requiring high material strength combined with geometric complexity. Managing powder bed fusion challenges, including porosity, surface finish, distortions and residual stresses of as-built material, is the key to bringing the advantages of this process to production main stream. This paper discusses the application of experimental and numerical analysis towards optimizing the manufacturing process of a demonstration component. Powder characterization including assessment of the reusability, assessment of material consolidation and process window optimization is pursued prior to applying the identified optima to study the distortion and residual stresses of the demonstrator. Comparisons of numerical predictions with measurements show good correlations along the complete numerical chain.

Pressing needs of biomedical text mining in biocuration and beyond: opportunities and challenges

PubMed Central

Singhal, Ayush; Leaman, Robert; Catlett, Natalie; Lemberger, Thomas; McEntyre, Johanna; Polson, Shawn; Xenarios, Ioannis; Arighi, Cecilia; Lu, Zhiyong

2016-01-01

Text mining in the biomedical sciences is rapidly transitioning from small-scale evaluation to large-scale application. In this article, we argue that text-mining technologies have become essential tools in real-world biomedical research. We describe four large scale applications of text mining, as showcased during a recent panel discussion at the BioCreative V Challenge Workshop. We draw on these applications as case studies to characterize common requirements for successfully applying text-mining techniques to practical biocuration needs. We note that system ‘accuracy’ remains a challenge and identify several additional common difficulties and potential research directions including (i) the ‘scalability’ issue due to the increasing need of mining information from millions of full-text articles, (ii) the ‘interoperability’ issue of integrating various text-mining systems into existing curation workflows and (iii) the ‘reusability’ issue on the difficulty of applying trained systems to text genres that are not seen previously during development. We then describe related efforts within the text-mining community, with a special focus on the BioCreative series of challenge workshops. We believe that focusing on the near-term challenges identified in this work will amplify the opportunities afforded by the continued adoption of text-mining tools. Finally, in order to sustain the curation ecosystem and have text-mining systems adopted for practical benefits, we call for increased collaboration between text-mining researchers and various stakeholders, including researchers, publishers and biocurators. PMID:28025348

Pressing needs of biomedical text mining in biocuration and beyond: opportunities and challenges

DOE PAGES

Singhal, Ayush; Leaman, Robert; Catlett, Natalie; ...

2016-12-26

Text mining in the biomedical sciences is rapidly transitioning from small-scale evaluation to large-scale application. In this article, we argue that text-mining technologies have become essential tools in real-world biomedical research. We describe four large scale applications of text mining, as showcased during a recent panel discussion at the BioCreative V Challenge Workshop. We draw on these applications as case studies to characterize common requirements for successfully applying text-mining techniques to practical biocuration needs. We note that system ‘accuracy’ remains a challenge and identify several additional common difficulties and potential research directions including (i) the ‘scalability’ issue due to themore » increasing need of mining information from millions of full-text articles, (ii) the ‘interoperability’ issue of integrating various text-mining systems into existing curation workflows and (iii) the ‘reusability’ issue on the difficulty of applying trained systems to text genres that are not seen previously during development. We then describe related efforts within the text-mining community, with a special focus on the BioCreative series of challenge workshops. We believe that focusing on the near-term challenges identified in this work will amplify the opportunities afforded by the continued adoption of text-mining tools. In conclusion, in order to sustain the curation ecosystem and have text-mining systems adopted for practical benefits, we call for increased collaboration between text-mining researchers and various stakeholders, including researchers, publishers and biocurators.« less

Pressing needs of biomedical text mining in biocuration and beyond: opportunities and challenges

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

Singhal, Ayush; Leaman, Robert; Catlett, Natalie

Text mining in the biomedical sciences is rapidly transitioning from small-scale evaluation to large-scale application. In this article, we argue that text-mining technologies have become essential tools in real-world biomedical research. We describe four large scale applications of text mining, as showcased during a recent panel discussion at the BioCreative V Challenge Workshop. We draw on these applications as case studies to characterize common requirements for successfully applying text-mining techniques to practical biocuration needs. We note that system ‘accuracy’ remains a challenge and identify several additional common difficulties and potential research directions including (i) the ‘scalability’ issue due to themore » increasing need of mining information from millions of full-text articles, (ii) the ‘interoperability’ issue of integrating various text-mining systems into existing curation workflows and (iii) the ‘reusability’ issue on the difficulty of applying trained systems to text genres that are not seen previously during development. We then describe related efforts within the text-mining community, with a special focus on the BioCreative series of challenge workshops. We believe that focusing on the near-term challenges identified in this work will amplify the opportunities afforded by the continued adoption of text-mining tools. In conclusion, in order to sustain the curation ecosystem and have text-mining systems adopted for practical benefits, we call for increased collaboration between text-mining researchers and various stakeholders, including researchers, publishers and biocurators.« less

Chemical modifications of antisense morpholino oligomers enhance their efficacy against Ebola virus infection.

PubMed

Swenson, Dana L; Warfield, Kelly L; Warren, Travis K; Lovejoy, Candace; Hassinger, Jed N; Ruthel, Gordon; Blouch, Robert E; Moulton, Hong M; Weller, Dwight D; Iversen, Patrick L; Bavari, Sina

2009-05-01

Phosphorodiamidate morpholino oligomers (PMOs) are uncharged nucleic acid-like molecules designed to inactivate the expression of specific genes via the antisense-based steric hindrance of mRNA translation. PMOs have been successful at knocking out viral gene expression and replication in the case of acute viral infections in animal models and have been well tolerated in human clinical trials. We propose that antisense PMOs represent a promising class of therapeutic agents that may be useful for combating filoviral infections. We have previously shown that mice treated with a PMO whose sequence is complementary to a region spanning the start codon of VP24 mRNA were protected against lethal Ebola virus challenge. In the present study, we report on the abilities of two additional VP24-specific PMOs to reduce the cell-free translation of a VP24 reporter, to inhibit the in vitro replication of Ebola virus, and to protect mice against lethal challenge when the PMOs are delivered prior to infection. Additionally, structure-activity relationship evaluations were conducted to assess the enhancement of antiviral efficacy associated with PMO chemical modifications that included conjugation with peptides of various lengths and compositions, positioning of conjugated peptides to either the 5' or the 3' terminus, and the conferring of charge modifications by the addition of piperazine moieties. Conjugation with arginine-rich peptides greatly enhanced the antiviral efficacy of VP24-specific PMOs in infected cells and mice during lethal Ebola virus challenge.

Therapeutic Advances in HCV Genotype 1 Infection: Insights from the Society of Infectious Diseases Pharmacists.

PubMed

Deming, Paulina; Martin, Michelle T; Chan, Juliana; Dilworth, Thomas J; El-Lababidi, Rania; Love, Bryan L; Mohammad, Rima A; Nguyen, Amy; Spooner, Linda M; Wortman, Suzanne B

2016-02-01

Hepatitis C virus (HCV) is the most common blood-borne infection in the United States. The high morbidity and mortality due to untreated infection have prompted updated screening recommendations that now include one-time HCV screening for all patients born between 1945 and 1965, in addition to risk factor-based screening. Current guidelines recommend treatment for all patients with chronic HCV. Treatment for HCV genotype 1 has evolved dramatically since the approval of the direct-acting antivirals. The approval of ledipasvir-sofosbuvir, ombitasvir-paritaprevir-ritonavir and dasabuvir, and simeprevir with sofosbuvir has dramatically altered the treatment landscape. High sustained virologic response (SVR) rates favor treatment, yet access to care poses a challenge for patients and providers. Current and emerging data with new therapies indicate high SVR rates in treatment-naïve and treatment-experienced patients, including patients with cirrhosis and in other special populations. Additional data suggest the addition of ribavirin can decrease treatment duration without compromising SVR rates. Resistance is an increasing area of interest in HCV, with baseline mutations identified and the potential for the development of resistance-associate variants in patients undergoing treatment. Due to the rapid evolution of HCV treatment, pharmacists should address challenges and play an integral role in agent selection, dosing, drug interaction screening, adverse effect monitoring, and the coordination of treatment. Clinical application of the latest information will reduce patient risk and improve outcomes. © 2016 Pharmacotherapy Publications, Inc.

The need and challenges for development of an Epstein-Barr virus vaccine

PubMed Central

Cohen, Jeffrey I.; Mocarski, Edward S.; Raab-Traub, Nancy; Corey, Lawrence; Nabel, Gary J.

2012-01-01

Epstein-Barr virus (EBV) is the major cause of infectious mononucleosis and is associated with several malignancies including nasopharyngeal carcinoma, gastric carcinoma, Hodgkin lymphoma, Burkitt lymphoma, and lymphoma after organ or stem cell transplant. A candidate vaccine containing soluble EBV glycoprotein gp350 protected cottontop tamarins from EBV lymphoma after challenge with EBV. In the only phase 2 trial of an EBV vaccine in humans, soluble gp350 in alum and monophosphoryl lipid A adjuvant reduced the rate of infectious mononucleosis in EBV seronegative adults, but did not affect the rate of EBV infection. A peptide vaccine corresponding to EBV latency proteins has been tested in a small number of adults to prevent infectious mononucleosis. Some of the barriers to development of an EBV vaccine include (a) whether additional viral proteins in addition to gp350 would be more effective for preventing mononucleosis or EBV malignancies, (b) the difficulty of performing clinical trials to prevent EBV associated malignancies in the absence of good surrogate markers for tumor development, and the long period of time between primary EBV infection and development of many EBV tumors, (c) the lack of knowledge of immune correlates for protection against EBV infection and disease, (d) the limitations in animal models to study protection against EBV infection and disease, and (e) the need for additional information on the economic and societal burden of infectious mononucleosis to assess the cost-benefit of a prophylactic vaccine. PMID:23598481

Outcome Measures for Clinical Trials in Down Syndrome

PubMed Central

Esbensen, Anna J.; Hooper, Stephen R.; Fidler, Deborah; Hartley, Sigan; Edgin, Jamie; d’Ardhuy, Xavier Liogier; Capone, George; Conners, Frances; Mervis, Carolyn B.; Abbeduto, Leonard; Rafii, Michael; Krinsky-McHale, Sharon J.; Urv, Tiina

2017-01-01

Increasingly individuals with intellectual and developmental disabilities, including Down syndrome, are being targeted for clinical trials. However, a challenge exists in effectively evaluating the outcomes of these new pharmacological interventions. Few empirically evaluated, psychometrically sound outcome measures appropriate for use in clinical trials with individuals with Down syndrome have been identified. To address this challenge, the NIH assembled leading clinicians and scientists to review existing measures and identify those that currently are appropriate for trials; those that may be appropriate after expansion of age range addition of easier items, and/or downward extension of psychometric norms; and areas where new measures need to be developed. This paper focuses on measures in the areas of cognition and behavior. PMID:28452584

Meeting the challenge of interpretation: Hearing the voices of people with intellectual and developmental disability through I-Poems.

PubMed

Corby, Deirdre; Taggart, Laurence; Cousins, Wendy

2018-06-01

Including the inner perspectives of people who have intellectual disability can pose methodological challenges to qualitative researchers. This article explains how the Listening Guide was applied as an additional step in the analysis during a study which used hermeneutic interviews with people with intellectual disability as the sole method of data collection. An argument is made for the systematic application of the guide with a focus on the use of I-Poems. This article advances qualitative methodological approaches and concludes that this method of drawing attention to the participants' own voices provides a unique basis for interpreting interviews and tasks researchers to examine the use of the Listening Guide.

Lesbian, Gay, Bisexual, and Transgender (LGBT) Survivorship.

PubMed

Kamen, Charles

2018-02-01

To discuss lesbian, gay, bisexual, and transgender (LGBT)-specific survivorship issues including: integrating sexual and gender minority identities with cancer survivor identities; coordinating medical care and disclosing identities to health care providers; dealing with late effects of treatment; and addressing LGBT family and relationship issues. Published articles, quotes from an online survey of 311 LGBT survivors. The transition from active cancer treatment to survivorship presents challenges, and LGBT cancer survivors may face additional challenges as they enter the survivorship phase. Oncology nurses can improve the quality of survivorship care delivered to LGBT survivors and their caregivers by addressing the disparities and gaps in health care. Copyright © 2017 Elsevier Inc. All rights reserved.

Moving the Journey Towards Independence: Adolescents Transitioning to Successful Diabetes Self-Management.

PubMed

Babler, Elizabeth; Strickland, Carolyn June

2015-01-01

To gain a greater understanding of adolescent's experiences living with Type 1 diabetes mellitus (T1DM) and create a theoretical paradigm. Grounded theory as described by Glaser was used. Fifteen in-depth interviews were conducted with adolescent's ages 11-15 with T1DM. Symbolic interactionism is the theoretical framework for grounded theory. Data were collected; transcribed, coded, and analyzed simultaneously using constant comparative analysis and findings were grounded in the words of participants. A theoretical model was created with the concept of "normalizing". Normalizing was defined as the ability to integrate diabetes into one's daily life to make diabetes 'part of me'. Phase four of the model, and the focus of this manuscript was "Moving the Journey towards Independence" and included: 1) taking over care, 2) experiencing conflict with parents, and 3) realizing diabetes is hard. The major task for adolescents in this phase was separating from parents to independently manage diabetes. The normalizing task for this phase was: "taking on the burden of care". Adolescents described challenges with independent care and increased parental conflict including: fearing needles, forgetting insulin, feeling embarrassed and believing that diabetes was a burden in their life. Additionally, juggling the multiple responsibilities of home, school and work along with managing a chronic illness during adolescence is challenging. Transitioning to diabetes self-management is a challenge for adolescents. This model advances understanding of the moving processes in adolescents transitioning; additionally, hypotheses are presented that may be used for developing interventions to promote success in self-management. Copyright © 2015 Elsevier Inc. All rights reserved.

Moving the journey towards independence: Adolescents transitioning to successful diabetes self-management

PubMed Central

Strickland, C. June

2016-01-01

Purpose To gain a greater understanding of adolescent’s experiences living with Type 1 diabetes mellitus (T1DM) and create a theoretical paradigm. Methods Grounded theory as described by Glaser was used. Fifteen in-depth interviews were conducted with adolescent’s ages 11 to 15 with T1DM. Symbolic interactionism is the theoretical framework for grounded theory. Data were collected; transcribed, coded, and analyzed simultaneously using constant comparative analysis and findings were grounded in the words of participants. Results A theoretical model was created with the concept of “normalizing”. Normalizing was defined as the ability to integrate diabetes into one’s daily life to make diabetes ‘part of me’. Phase four of the model, and the focus of this manuscript was “Moving the Journey towards Independence” and included: 1) taking over care, 2) experiencing conflict with parents, and 3) realizing diabetes is hard. The major task for adolescents in this phase was separating from parents to independently manage diabetes. The normalizing task for this phase was: “taking on the burden of care”. Adolescents described challenges with independent care and increased parental conflict including: fearing needles, forgetting insulin, feeling embarrassed and believing that diabetes was a burden in their life. Additionally, juggling the multiple responsibilities of home, school and work along with managing a chronic illness during adolescence is challenging. Conclusions Transitioning to diabetes self-management is a challenge for adolescents. This model advances understanding of the moving processes in adolescents transitioning; additionally, hypotheses are presented that may be used for developing interventions to promote success in self-management. PMID:26190456

Closing the gap between knowledge and clinical application: challenges for genomic translation.

PubMed

Burke, Wylie; Korngiebel, Diane M

2015-01-01

Despite early predictions and rapid progress in research, the introduction of personal genomics into clinical practice has been slow. Several factors contribute to this translational gap between knowledge and clinical application. The evidence available to support genetic test use is often limited, and implementation of new testing programs can be challenging. In addition, the heterogeneity of genomic risk information points to the need for strategies to select and deliver the information most appropriate for particular clinical needs. Accomplishing these tasks also requires recognition that some expectations for personal genomics are unrealistic, notably expectations concerning the clinical utility of genomic risk assessment for common complex diseases. Efforts are needed to improve the body of evidence addressing clinical outcomes for genomics, apply implementation science to personal genomics, and develop realistic goals for genomic risk assessment. In addition, translational research should emphasize the broader benefits of genomic knowledge, including applications of genomic research that provide clinical benefit outside the context of personal genomic risk.

Comprehensive strategies for the prevention and control of diabetes and cardiovascular diseases in Africa: future directions.

PubMed

Muna, Walinjom F T

2013-01-01

The countries of the Sub Saharan African region have insufficient resources and healthcare systems that are poorly adapted to cope with the longstanding burden associated with communicable diseases and the ongoing HIV/AIDS pandemic. In addition, the rising burden of non-communicable diseases, including diabetes, cardiovascular diseases, and their risk factors, poses additional challenges. These countries need to urgently develop strategies to address these challenges of disease prevention and control. These strategies will require a new vision and more relevant and 'suitable' vocabulary in dealing with healthcare design, planning and implementation (using a cross-sectorial approach). Lessons learnt from the past (e.g. primary health care) in sub-Saharan Africa and other regions of the world may equally prove useful in developing strategies for the prevention and control of non-communicable diseases. Any potential strategy must emphasize the crucial role of economic, social, and environmental health determinants as well as the use of appropriate health technology. © 2013.

Laser Ultrasound Spectroscopy Scanning for 3D Printed Parts

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

Brennan, Guendalyn Kendra

One of the challenges of additive manufacturing is quality control due to the possibility of unseen flaws in the final product. The current methods of inspection are lacking in detail, too slow for practical use, or unable to validate internal structure. This report examines the use of laser ultrasound spectroscopy in layer by layer scans of 3D printed parts as they are created. The result is fast and detailed quality control. An additional advantage of this method is the ability to cancel a print as soon as a defect is detected, therefore saving materials and time. This technique, though simplemore » in concept, has been a challenge to implement. I discuss tweaking the 3D printer configuration, and finding the optimal settings for laser scanning small parts made of ABS plastic, as well as the limits of how small of a detail the laser can detect. These settings include the frequency of the ultrasonic transducer, the speed of the laser, and the distance from the laser to the part.« less

Non-dairy probiotic food products: An emerging group of functional foods.

PubMed

Min, Min; Bunt, Craig R; Mason, Susan L; Hussain, Malik A

2018-04-09

The functional food sector has shown tremendous growth in recent years with the application of probiotic bacteria as "food additives". The utilization of probiotic bacteria in food presents many challenges related to their growth, survival, viability, stability and functionality in food processing, storage and consumption as well as changes of sensory characteristics of probiotic foods. Although dairy foods are currently the most common food carrier to deliver probiotics, an increasing number of non-dairy food matrices exhibit potential for delivery of probiotics. This review provides more recent insight into the emergence of non-dairy probiotics products, the interactions between probiotics and different food matrices and the challenges in developing such products. Some of the technical issues are also reviewed and discussed. These issues include the efficacy of probiotic bacteria in non-chilled, low pH or high water activity foods; the potential loss of bacterial viability, additionally unwanted fermentation and changes of the sensory characteristics of food products which may result in poor microbiological quality and low acceptability to consumers.

Possibility of Exosome-Based Therapeutics and Challenges in Production of Exosomes Eligible for Therapeutic Application.

PubMed

Yamashita, Takuma; Takahashi, Yuki; Takakura, Yoshinobu

2018-01-01

Exosomes are cell-derived vesicles with a diameter 30-120 nm. Exosomes contain endogenous proteins and nucleic acids; delivery of these molecules to exosome-recipient cells causes biological effects. Exosomes derived from some types of cells such as mesenchymal stem cells and dendritic cells have therapeutic potential and may be biocompatible and efficient agents against various disorders such as organ injury. However, there are many challenges for the development of exosome-based therapeutics. In particular, producing exosomal formulations is the major barrier for therapeutic application because of their heterogeneity and low productivity. Development and optimization of producing methods, including methods for isolation and storage of exosome formulations, are required for realizing exosome-based therapeutics. In addition, improvement of therapeutic potential and delivery efficiency of exosomes are important for their therapeutic application. In this review, we summarize current knowledge about therapeutic application of exosomes and discuss some challenges in their successful use.

Towards successful Dissemination of Psychological First Aid: a study of provider training preferences.

PubMed

Hambrick, Erin P; Rubens, Sonia L; Vernberg, Eric M; Jacobs, Anne K; Kanine, Rebecca M

2014-04-01

Dissemination of Psychological First Aid (PFA) is challenging considering the complex nature of disaster response and the various disaster mental health (DMH) trainings available. To understand challenges to dissemination in community mental health centers (CMHCs), interviews were conducted with nine DMH providers associated with CMHCs. Consensual qualitative analysis was used to analyze data. Interviews were targeted toward understanding organizational infrastructure, DMH training requirements, and training needs. Results clarified challenges to DMH training in CMHCs and factors that may promote buy-in for trainings. For example, resources are limited and thus allocated for state and federal training requirements. Therefore, including PFA in these requirements could promote adoption. Additionally, a variety of training approaches that differ in content, style, and length would be useful. To conclude, a conceptual model for ways to promote buy-in for the PFA Guide is proposed.

Factors influencing community nursing roles and health service provision in rural areas: a review of literature.

PubMed

Barrett, Annette; Terry, Daniel R; Lê, Quynh; Hoang, Ha

2016-02-01

This review sought to better understand the issues and challenges experienced by community nurses working in rural areas and how these factors shape their role. Databases were searched to identify relevant studies, published between 1990 and 2015, that focussed on issues and challenges experienced by rural community nurses. Generic and grey literature relating to the subject was also searched. The search was systematically conducted multiple times to assure accuracy. A total of 14 articles met the inclusion criteria. This critical review identified common issues impacting community nursing and included role definition, organisational change, human resource, workplace and geographic challenges. Community nurses are flexible, autonomous, able to adapt care to the service delivery setting, and have a diversity of knowledge and skills. Considerably more research is essential to identify factors that impact rural community nursing practice. In addition, greater advocacy is required to develop the role.

MFIX simulation of NETL/PSRI challenge problem of circulating fluidized bed

DOE PAGES

Li, Tingwen; Dietiker, Jean-François; Shahnam, Mehrdad

2012-12-01

In this paper, numerical simulations of NETL/PSRI challenge problem of circulating fluidized bed (CFB) using the open-source code Multiphase Flow with Interphase eXchange (MFIX) are reported. Two rounds of simulation results are reported including the first-round blind test and the second-round modeling refinement. Three-dimensional high fidelity simulations are conducted to model a 12-inch diameter pilot-scale CFB riser. Detailed comparisons between numerical results and experimental data are made with respect to axial pressure gradient profile, radial profiles of solids velocity and solids mass flux along different radial directions at various elevations for operating conditions covering different fluidization regimes. Overall, the numericalmore » results show that CFD can predict the complex gas–solids flow behavior in the CFB riser reasonably well. In addition, lessons learnt from modeling this challenge problem are presented.« less

Challenges and opportunities in clinical translation of biomedical optical spectroscopy and imaging

NASA Astrophysics Data System (ADS)

Wilson, Brian C.; Jermyn, Michael; Leblond, Frederic

2018-03-01

Medical devices face many hurdles before they enter routine clinical practice to address unmet clinical needs. This is also the case for biomedical optical spectroscopy and imaging systems that are used here to illustrate the opportunities and challenges involved. Following initial concept, stages in clinical translation include instrument development, preclinical testing, clinical prototyping, clinical trials, prototype-to-product conversion, regulatory approval, commercialization, and finally clinical adoption and dissemination, all in the face of potentially competing technologies. Optical technologies face additional challenges from their being extremely diverse, often targeting entirely different diseases and having orders-of-magnitude differences in resolution and tissue penetration. However, these technologies can potentially address a wide variety of unmet clinical needs since they provide rich intrinsic biochemical and structural information, have high sensitivity and specificity for disease detection and localization, and are practical, safe (minimally invasive, nonionizing), and relatively affordable.

Challenges to the rapid identification of children who have been trafficked for commercial sexual exploitation.

PubMed

Rafferty, Yvonne

2016-02-01

Child trafficking for commercial sexual exploitation (CSE) is a complex phenomenon, requiring multifaceted programs and policies by various stakeholders. A number of publications have focused on preventing this heinous crime. Less attention, however, has been paid to the recovery and rehabilitation of children who have been traumatized as a result of being trafficked for CSE. This article focuses on the first step in the protection and recovery process, which is to ensure that procedures are in place for their identification, so that they might access timely and appropriate assistance. It highlights three situational and two child-related challenges to identification. In addition, it describes the additional victimization experienced by children who are wrongly arrested for crimes associated with prostitution or illegal border crossings, rather than being identified as victims. An extensive literature review was conducted, and included academic publications, as well as governmental and non-governmental reports. In addition, field-based qualitative research was undertaken in South and Southeast Asia, and involved interviews with representatives from United Nations and governmental agencies, non-governmental organizations (NGOs), and aftercare recovery programs. Copyright © 2015 Elsevier Ltd. All rights reserved.

Orion EFT-1 Cavity Heating Tile Experiments and Environment Reconstruction

NASA Technical Reports Server (NTRS)

Salazar, Giovanni; Amar, Adam; Oliver, Brandon; Hyatt, Andrew; Rezin, Marc

2016-01-01

Developing aerothermodynamic environments for deep cavities, such as those produced by micrometeoroids and orbital debris impacts, poses a great challenge for engineers. In order to assess existing cavity heating models, two one-inch diameter cavities were flown on the Orion Multi-Purpose Crew Vehicle during Exploration Flight Test 1 (EFT1). These cavities were manufactured with depths of 1.0 in and 1.4 in, and they were both instrumented. Instrumentation included surface thermocouples upstream, downstream and within the cavities, and additional thermocouples at the TPS-structure interface. This paper will present the data obtained, and comparisons with computational predictions will be shown. Additionally, the development of a 3D material thermal model will be described, which will be used to account for the three-dimensionality of the problem when interpreting the data. Furthermore, using a multi-dimensional inverse heat conduction approach, a reconstruction of a time- and space-dependent flight heating distribution during EFT1 will be presented. Additional discussions will focus on instrumentation challenges and calibration techniques specific to these experiments. The analysis shown will highlight the accuracies and/or deficiencies of current computational techniques to model cavity flows during hypersonic re-entry.

A {3,2}-Order Bending Theory for Laminated Composite and Sandwich Beams

NASA Technical Reports Server (NTRS)

Cook, Geoffrey M.; Tessler, Alexander

1998-01-01

A higher-order bending theory is derived for laminated composite and sandwich beams thus extending the recent {1,2}-order theory to include third-order axial effect without introducing additional kinematic variables. The present theory is of order {3,2} and includes both transverse shear and transverse normal deformations. A closed-form solution to the cylindrical bending problem is derived and compared with the corresponding exact elasticity solution. The numerical comparisons are focused on the most challenging material systems and beam aspect ratios which include moderate-to-thick unsymmetric composite and sandwich laminates. Advantages and limitations of the theory are discussed.

Economic evaluations of alcohol prevention interventions: Is the evidence sufficient? A review of methodological challenges.

PubMed

Hill, Sarah R; Vale, Luke; Hunter, David; Henderson, Emily; Oluboyede, Yemi

2017-12-01

Public health interventions have unique characteristics compared to health technologies, which present additional challenges for economic evaluation (EE). High quality EEs that are able to address the particular methodological challenges are important for public health decision-makers. In England, they are even more pertinent given the transition of public health responsibilities in 2013 from the National Health Service to local government authorities where new agents are shaping policy decisions. Addressing alcohol misuse is a globally prioritised public health issue. This article provides a systematic review of EE and priority-setting studies for interventions to prevent and reduce alcohol misuse published internationally over the past decade (2006-2016). This review appraises the EE and priority-setting evidence to establish whether it is sufficient to meet the informational needs of public health decision-makers. 619 studies were identified via database searches. 7 additional studies were identified via hand searching journals, grey literature and reference lists. 27 met inclusion criteria. Methods identified included cost-utility analysis (18), cost-effectiveness analysis (6), cost-benefit analysis (CBA) (1), cost-consequence analysis (CCA) (1) and return-on-investment (1). The review identified a lack of consideration of methodological challenges associated with evaluating public health interventions and limited use of methods such as CBA and CCA which have been recommended as potentially useful for EE in public health. No studies using other specific priority-setting tools were identified. Copyright © 2017 The Authors. Published by Elsevier B.V. All rights reserved.

Physiological and transcriptional responses and cross protection of Lactobacillus plantarum ZDY2013 under acid stress.

PubMed

Huang, Renhui; Pan, Mingfang; Wan, Cuixiang; Shah, Nagendra P; Tao, Xueying; Wei, Hua

2016-02-01

Acid tolerance responses (ATR) in Lactobacillus plantarum ZDY2013 were investigated at physiological and molecular levels. A comparison of composition of cell membrane fatty acids (CMFA) between acid-challenged and unchallenged cells showed that acid adaptation evoked a significantly higher percentage of saturated fatty acids and cyclopropane fatty acids in acid-challenged than in unchallenged cells. In addition, reverse transcription-quantitative PCR analysis in acid-adapted cells at different pH values (ranging from 3.0 to 4.0) indicated that several genes were differently regulated, including those related to proton pumps, amino acid metabolism, sugar metabolism, and class I and class III stress response pathways. Expression of genes involved in fatty acid synthesis and production of alkali was significantly upregulated. Upon exposure to pH 4.5 for 2 h, a higher survival rate (higher viable cell count) of Lactobacillus plantarum ZDY2013 was achieved following an additional challenge to 40 mM hydrogen peroxide for 60 min, but no difference in survival rate of cells was found with further challenge to heat, ethanol, or salt. Therefore, we concluded that the physiological and metabolic changes of acid-treated cells of Lactobacillus plantarum ZDY2013 help the cells resist damage caused by acid, and further initiated global response signals to bring the whole cell into a state of defense to other stress factors, especially hydrogen peroxide. Copyright © 2016 American Dairy Science Association. Published by Elsevier Inc. All rights reserved.

What guidance is available for researchers conducting overviews of reviews of healthcare interventions? A scoping review and qualitative metasummary.

PubMed

Pollock, Michelle; Fernandes, Ricardo M; Becker, Lorne A; Featherstone, Robin; Hartling, Lisa

2016-11-14

Overviews of reviews (overviews) compile data from multiple systematic reviews to provide a single synthesis of relevant evidence for decision-making. Despite their increasing popularity, there is limited methodological guidance available for researchers wishing to conduct overviews. The objective of this scoping review is to identify and collate all published and unpublished documents containing guidance for conducting overviews examining the efficacy, effectiveness, and/or safety of healthcare interventions. Our aims were to provide a map of existing guidance documents; identify similarities, differences, and gaps in the guidance contained within these documents; and identify common challenges involved in conducting overviews. We conducted an iterative and extensive search to ensure breadth and comprehensiveness of coverage. The search involved reference tracking, database and web searches (MEDLINE, EMBASE, DARE, Scopus, Cochrane Methods Studies Database, Google Scholar), handsearching of websites and conference proceedings, and contacting overview producers. Relevant guidance statements and challenges encountered were extracted, edited, grouped, abstracted, and presented using a qualitative metasummary approach. We identified 52 guidance documents produced by 19 research groups. Relatively consistent guidance was available for the first stages of the overview process (deciding when and why to conduct an overview, specifying the scope, and searching for and including systematic reviews). In contrast, there was limited or conflicting guidance for the latter stages of the overview process (quality assessment of systematic reviews and their primary studies, collecting and analyzing data, and assessing quality of evidence), and many of the challenges identified were also related to these stages. An additional, overarching challenge identified was that overviews are limited by the methods, reporting, and coverage of their included systematic reviews. This compilation of methodological guidance for conducting overviews of healthcare interventions will facilitate the production of future overviews and can help authors address key challenges they are likely to encounter. The results of this project have been used to identify areas where future methodological research is required to generate empirical evidence for overview methods. Additionally, these results have been used to update the chapter on overviews in the next edition of the Cochrane Handbook for Systematic Reviews of Interventions.

U.S. Army Medical Materiel Development Activity 1990 Annual Report

DTIC Science & Technology

1990-01-31

volunteers and protected most of them against a diarrheal challenge; the study will be expanded. Shigella immune milk fed to volunteers provided enough...evidence of protection against diarrhea that the study will be repeated with a more potent immune milk preparation. A pharmacokinetic study of intravenously...additional lot of inactivated RVF Vaccine will be prepared. Clinical trials at Johns Hopkins University will include Phase 1 evaluation of Tularemia, Q

Invisible Wounds of War. Psychological and Cognitive Injuries, Their Consequences, and Services to Assist Recovery

DTIC Science & Technology

2008-01-01

Education. Comper et al. (2005) reviewed seven studies in which patients were given an information intervention. The interventions included reassurance...information on the recovery process, or strategies for managing mild-TBI symptoms. Comper and associates found sufficient evidence to conclude that...numbers and heterogeneity of brain-injured patients pose additional challenges (Turner-Stokes and Wade, 2004). Pharmacotherapy. Comper and colleagues (2005

Electric power restructuring in iran: achievements and challenges

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

Khosroshahi, Kaveh Aflaki; Jadid, Shahram; Shahidehpour, Mohammad

2009-03-15

Although the power market in Iran is not fully constructed, several key steps have been taken to meet privatization and restructuring objectives. The addition of a power exchange sector has placed the power market on par with that in other countries. Operational concerns that still need to be addressed include technical and non-technical losses, enhancing new investment, and providing incentives for introducing energy efficiency and promoting green power generation. (author)

Low Vision Aids in Glaucoma

PubMed Central

Khanna, Anjani

2012-01-01

A large number of glaucoma patients suffer from vision impairments that qualify as low vision. Additional difficulties associated with low vision include problems with glare, lighting, and contrast, which can make daily activities extremely challenging. This article elaborates on how low vision aids can help with various tasks that visually impaired glaucoma patients need to do each day, to take care of themselves and to lead an independent life. PMID:27990068

Influenza Vaccine: Federal Investments in Alternative Technologies and Challenges to Development and Licensure

DTIC Science & Technology

2011-06-01

chicken flocks to infectious diseases, the federal government has funded the development of alternative technologies that can be used to produce new...American Society for Microbiology and the Infectious Disease Society of America. Other experts we interviewed included those from provider groups...emergencies, per the 2006 Pandemic and All- Hazards Preparedness Act.16 Additionally, as the principal department for protecting the public’s health, HHS is

Conflict coaching training for nurse managers: a case study of a two-hospital health system.

PubMed

Brinkert, Ross

2011-01-01

This study evaluated the application of the Comprehensive Conflict Coaching model in a hospital environment. Conflict coaching involves a coach working with a client to improve the client's conflict understanding, interaction strategies and/or interaction skills. The training of nurse managers as conflict coaches is an innovative continuing education programme that partially addresses conflict-related concerns in nursing. Twenty nurse managers trained as conflict coaches and each coached a supervisee. Qualitative data were gathered from nurse managers, supervisees and senior nursing leaders over an 8-month period and organized using standard programme evaluation themes. Benefits included supervisor conflict coaching competency and enhanced conflict communication competency for nurse managers and supervisees facing specific conflict situations. Challenges included the management of programme tensions. Additional benefits and challenges are discussed, along with study limitations. Conflict coaching was a practical and effective means of developing the conflict communication competencies of nurse managers and supervisees. Additional research is needed. Conflict is common in nursing. Conflict coaching is a new conflict communication and supervision intervention that demonstrates initial promise. Conflict coaching seems to work best when supported by a positive conflict culture and integrated with other conflict intervention processes. © 2010 The Author. Journal compilation © 2010 Blackwell Publishing Ltd.

Hydrogen sulfide deactivates common nitrobenzofurazan-based fluorescent thiol labeling reagents.

PubMed

Montoya, Leticia A; Pluth, Michael D

2014-06-17

Sulfhydryl-containing compounds, including thiols and hydrogen sulfide (H2S), play important but differential roles in biological structure and function. One major challenge in separating the biological roles of thiols and H2S is developing tools to effectively separate the reactivity of these sulfhydryl-containing compounds. To address this challenge, we report the differential responses of common electrophilic fluorescent thiol labeling reagents, including nitrobenzofurazan-based scaffolds, maleimides, alkylating agents, and electrophilic aldehydes, toward cysteine and H2S. Although H2S reacted with all of the investigated scaffolds, the photophysical response to each scaffold was significantly different. Maleimide-based, alkylating, and aldehydic thiol labeling reagents provided a diminished fluorescence response when treated with H2S. By contrast, nitrobenzofurazan-based labeling reagents were deactivated by H2S addition. Furthermore, the addition of H2S to thiol-activated nitrobenzofurazan-based reagents reduced the fluorescence signal, thus establishing the incompatibility of nitrobenzofurazan-based thiol labeling reagents in the presence of H2S. Taken together, these studies highlight the differential reactivity of thiols and H2S toward common thiol-labeling reagents and suggest that sufficient care must be taken when labeling or measuring thiols in cellular environments that produce H2S due to the potential for both false-positive and eroded responses.

The Case for the Application of Worldwide Marine Radioactivity Studies In the Search for Undeclared Facilities and Activities

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

Mark Schanfein

2013-06-01

Undeclared nuclear facilities unequivocally remain the most difficult safeguards challenge facing the International Atomic Energy Agency (IAEA). Recent cases of undeclared facilities revealed in Iran and Syria, which are NPT signatory States, show both the difficulty and the seriousness of this threat to nonproliferation. In the case of undeclared nuclear facilities, the most effective deterrent against proliferation is the application of Wide-Area Environmental Sampling (WAES); however, WAES is currently cost-prohibitive. As with any threat, the most effective countering strategy is a multifaceted approach. Some of the approaches applied by the IAEA include: open source analysis, satellite imagery, on-site environmental sampling,more » complementary access under the Additional Protocol (where in force), traditional safeguards inspections, and information provided by member States. These approaches, naturally, are focused on specific States. Are there other opportunities not currently within the IAEA purview to assess States that may provide another opportunity to detect clandestine facilities? In this paper, the author will make the case that the IAEA Department of Safeguards should explore the area of worldwide marine radioactivity studies as one possible opportunity. One such study was released by the IAEA Marine Environment Laboratory in January 2005. This technical document focused on 90Sr, 137Cs, and 239/240Pu. It is clearly a challenging area because of the many sources of anthropogenic radionuclides in the world’s oceans and seas including: nuclear weapons testing, reprocessing, accidents, waste dumping, and industrial and medical radioisotopes, whose distributions change based on oceanographic, geochemical, and biological processes, and their sources. It is additionally challenging where multiple States share oceans, seas, and rivers. But with the application of modern science, historical sampling to establish baselines, and a focus on the most relevant radionuclides, the potential is there to support this challenging IAEA safeguards mission.« less

Asthma control in patients on fixed dose combination evaluated with mannitol challenge test.

PubMed

Romberg, Kerstin A M; Berggren, Anna-Carin; Bjermer, Leif

2014-02-01

Asthma is often difficult to control and it is likely that not all patients are optimally treated. This study aimed to explore asthma control in adults receiving fixed dose combination (FDC) therapy. Control of asthma was assessed using the mannitol challenge test as a monitoring tool to see if this would give additional information compared to the asthma control test (ACT). The study was an open-label, prospective study on 98 adults prescribed with FDC therapies for at least three months. 74 patients considered that their asthma was well controlled. However, 60 patients had a positive mannitol challenge test (PD15 < 635 mg), and when those with a positive response to the short-acting β2-agonist (≥15%) after the mannitol challenge test were included, this increased to 64 patients (65%). Exploratory analysis determined that the spirometry parameters; FEV1/FVC and FEV1% of predicted, were statistically significant predictors of a positive mannitol challenge test. Co-morbid conditions such as concomitant upper airway involvement or eczema did not predict mannitol reactivity. Although most patients rated their asthma as well controlled, many provided a positive mannitol challenge test, suggesting the presence of underlying inflammation, despite treatment with fixed dose combination therapy. Copyright © 2013 The Authors. Published by Elsevier Ltd.. All rights reserved.

Training direct care staff to increase positive interactions with individuals with developmental disabilities.

PubMed

Zoder-Martell, Kimberly A; Dufrene, Brad A; Tingstrom, Daniel H; Olmi, D Joe; Jordan, Sara S; Biskie, Erika M; Sherman, Julie C

2014-09-01

This study tested the effects of direct training on direct care staff's initiation of positive interactions with individuals with developmental disabilities who resided in an intermediate care facility. Participants included four direct care staff and their residents. Direct training included real-time prompts delivered via a one-way radio, and data were collected for immediate and sustained increases in rates of direct care staff's positive interactions. Additionally, this study evaluated the link between increased rates of positive interactions and concomitant decreases in residents' challenging behaviors. A multiple baseline design across participants was used and results indicated that all direct care staff increased their rates of positive interactions during direct training. Moreover, all but one participant continued to engage residents in positive interactions at levels above the criterion during the maintenance phase and follow-up phases. The direct care staff member who did not initially meet the criterion improved to adequate levels following one brief performance feedback session. With regard to residents' challenging behaviors, across phases, residents engaged in low levels of challenging behaviors making those results difficult to evaluate. However, improvements in residents' rate of positive interactions were noted. Copyright © 2014 Elsevier Ltd. All rights reserved.

Ethical considerations in pediatric neurology.

PubMed

Ronen, Gabriel M; Dan, Bernard

2013-01-01

The practice of pediatric neurology demands a high level of responsibility at multiple levels. These include listening carefully to people's stories in order to assess each situation, planning and implementing investigations and therapies, individual and family counseling, longitudinal follow-up from fetal life throughout childhood and adolescence, organization of transition to adult care, and societal advocacy. In the 21st century these activities must be carried out in the context of major societal and technological changes which have brought about many new challenges for pediatric neurologists. In this chapter, we address ethical and moral issues that may help guide pediatric neurologists with regard to a number of specific challenges. These include physician-patient relationships that are based on benign paternalism with respect for autonomy and promoting quality of life, practicing evidence-based medicine, and the technological imperative. In addition we discuss the tension between clinical practice and research, relationships between physicians and industry, and the public role of pediatric neurologists to advocate for children with neurological and developmental conditions. We also illustrate some challenges in selected situations such as prenatal counseling (fetal neurology), neonatal encephalopathy, and persistent vegetative state. Copyright © 2013 Elsevier B.V. All rights reserved.

Accountability Studies on Air Pollution and Health: the HEI Experience.

PubMed

Boogaard, Hanna; van Erp, Annemoon M; Walker, Katherine D; Shaikh, Rashid

2017-12-01

Assessing health effects of air quality interventions is of ever-increasing interest. Given the prominent role Health Effects Institute (HEI) has played in accountability research, this review focuses on HEI's recent experiences, the challenges it has encountered, and provides possible directions for future research. Most accountability studies to date have focused on effects of relatively short-term, local-scale, and sometimes temporary interventions. Only a few recent accountability studies have sought to investigate large-scale, multiyear regulatory programs. Common challenges encountered include lack of statistical power, how to account appropriately for background trends in air quality and health, and difficulties in direct attribution of changes in air pollution and health to a single intervention among many regulatory actions. New methods have been developed for accountability research that has shown promise addressing some of those challenges, including use of causal inference methods. These and other approaches that would enhance the attribution of changes in air quality and health directly to an intervention should continue to be further explored. In addition, integration of social and behavioral sciences in accountability research is warranted, and climate related co-benefits and dis-benefits may be considered.

Identifying Challenges to the Integration of Computer-Based Surveillance Information Systems in a Large City Health Department: A Case Study.

PubMed

Jennings, Jacky M; Stover, Jeffrey A; Bair-Merritt, Megan H; Fichtenberg, Caroline; Munoz, Mary Grace; Maziad, Rafiq; Ketemepi, Sherry Johnson; Zenilman, Jonathan

2009-01-01

Integrated infectious disease surveillance information systems have the potential to provide important new surveillance capacities and business efficiencies for local health departments. We conducted a case study at a large city health department of the primary computer-based infectious disease surveillance information systems during a 10-year period to identify the major challenges for information integration across the systems. The assessment included key informant interviews and evaluations of the computer-based surveillance information systems used for acute communicable diseases, human immunodeficiency virus/acquired immunodeficiency syndrome, sexually transmitted diseases, and tuberculosis. Assessments were conducted in 1998 with a follow-up in 2008. Assessments specifically identified and described the primary computer-based surveillance information system, any duplicative information systems, and selected variables collected. Persistent challenges to information integration across the information systems included the existence of duplicative data systems, differences in the variables used to collect similar information, and differences in basic architecture. The assessments identified a number of challenges for information integration across the infectious disease surveillance information systems at this city health department. The results suggest that local disease control programs use computer-based surveillance information systems that were not designed for data integration. To the extent that integration provides important new surveillance capacities and business efficiencies, we recommend that patient-centric information systems be designed that provide all the epidemiologic, clinical, and research needs in one system. In addition, the systems should include a standard system of elements and fields across similar surveillance systems.

Qualitative Analysis of Round-Table Discussions on the Business Case and Procurement Challenges for Hospital Electronic Prescribing Systems

PubMed Central

Cresswell, Kathrin M.; Slee, Ann; Coleman, Jamie; Williams, Robin; Bates, David W.; Sheikh, Aziz

2013-01-01

Objectives There is a pressing need to understand the challenges surrounding procurement of and business case development for hospital electronic prescribing systems, and to identify possible strategies to enhance the efficiency of these processes in order to assist strategic decision making. Materials and Methods We organized eight multi-disciplinary round-table discussions in the United Kingdom. Participants included policy makers, representatives from hospitals, system developers, academics, and patients. Each discussion was digitally audio-recorded, transcribed verbatim and, together with accompanying field notes, analyzed thematically with NVivo9. Results We drew on data from 17 participants (approximately eight per roundtable), six hours of discussion, and 15 pages of field notes. Key challenges included silo planning with systems not being considered as part of an integrated organizational information technology strategy, lack of opportunity for interactions between customers and potential suppliers, lack of support for hospitals in choosing appropriate systems, difficulty of balancing structured planning with flexibility, and the on-going challenge of distinguishing “wants” and aspirations from organizational “needs”. Discussion and conclusions Development of business cases for major investments in information technology does not take place in an organizational vacuum. Building on previously identified potentially transferable dimensions to the development and execution of business cases surrounding measurements of costs/benefits and risk management, we have identified additional components relevant to ePrescribing systems. These include: considerations surrounding strategic context, case for change and objectives, future service requirements and options appraisal, capital and revenue implications, timescale and deliverability, and risk analysis and management. PMID:24260213

Real-Time Operation of the International Space Station

NASA Astrophysics Data System (ADS)

Suffredini, M. T.

2002-01-01

The International Space Station is on orbit and real-time operations are well underway. Along with the assembly challenges of building and operating the International Space Station , scientific activities are also underway. Flight control teams in three countries are working together as a team to plan, coordinate and command the systems on the International Space Station.Preparations are being made to add the additional International Partner elements including their operations teams and facilities. By October 2002, six Expedition crews will have lived on the International Space Station. Management of real-time operations has been key to these achievements. This includes the activities of ground teams in control centers around the world as well as the crew on orbit. Real-time planning is constantly challenged with balancing the requirements and setting the priorities for the assembly, maintenance, science and crew health functions on the International Space Station. It requires integrating the Shuttle, Soyuz and Progress requirements with the Station. It is also necessary to be able to respond in case of on-orbit anomalies and to set plans and commands in place to ensure the continues safe operation of the Station. Bringing together the International Partner operations teams has been challenging and intensely rewarding. Utilization of the assets of each partner has resulted in efficient solutions to problems. This paper will describe the management of the major real-time operations processes, significant achievements, and future challenges.

STEM Beyond The Classroom: Creating Authentic Outreach Programs That Build Bridges Between The Classroom And Real World Challenges

NASA Astrophysics Data System (ADS)

Ibarra, D. L.; Forder, S. E.; Pritchard, M.

2014-12-01

The ISF Academy was founded by Charles Kao, a Nobel Prize laureate. In 2011, the Shuyuan programs were established at The ISF Academy to operate both as a "school within a school" and as a "school outside the classroom." The Shuyuan programs work together with the IBO Science and Technology subject areas to develop comprehensive and challenging opportunities that address the 14 Grand Engineering Challenges. The goal is to establish co-curricular programs that go beyond the taught curriculum and support STEM curricula. Several programs outside of the classroom include an onsite robotics researcher, underwater and land based robotics programs, field trips, whole school food waste composting and the implementation of an energy tracking system. Relationships with several local universities allow students to work closely with professors in research settings and, annually, a leading researcher gives a keynote speech to our students. Other signature Shuyuan programs have developed international strategic relationships with the NRI at Cambridge University, where students spend several weeks studying science and civilization in China using primary source materials. Additionally, Shuyuan has supported extension opportunities for classroom teachers with institutional partnerships that include the British Council, governmental organizations, local universities, corporations, and NGOs. In conclusion, the overall goal of the Shuyuan Programs is to provide experiential learning opportunities that challenge conventional curriculum design in a manner that is supportive and innovative!

Targeting of non-dominant antigens as a vaccine strategy to broaden T-cell responses during chronic viral infection.

PubMed

Holst, Peter J; Jensen, Benjamin A H; Ragonnaud, Emeline; Thomsen, Allan R; Christensen, Jan P

2015-01-01

In this study, we compared adenoviral vaccine vectors with the capacity to induce equally potent immune responses against non-dominant and immunodominant epitopes of murine lymphocytic choriomeningitis virus (LCMV). Our results demonstrate that vaccination targeting non-dominant epitopes facilitates potent virus-induced T-cell responses against immunodominant epitopes during subsequent challenge with highly invasive virus. In contrast, when an immunodominant epitope was included in the vaccine, the T-cell response associated with viral challenge remained focussed on that epitope. Early after challenge with live virus, the CD8+ T cells specific for vaccine-encoded epitopes, displayed a phenotype typically associated with prolonged/persistent antigenic stimulation marked by high levels of KLRG-1, as compared to T cells reacting to epitopes not included in the vaccine. Notably, this association was lost over time in T cells specific for the dominant T cell epitopes, and these cells were fully capable of expanding in response to a new viral challenge. Overall, our data suggests a potential for broadening of the antiviral CD8+ T-cell response by selecting non-dominant antigens to be targeted by vaccination. In addition, our findings suggest that prior adenoviral vaccination is not likely to negatively impact the long-term and protective immune response induced and maintained by a vaccine-attenuated chronic viral infection.

Police on the Front Line of Community Geriatric Healthcare: Challenges and Opportunities

PubMed Central

Brown, Rebecca T.; Ahalt, Cyrus; Steinman, Michael A.; Kruger, Kelly; Williams, Brie A.

2015-01-01

As the population ages, police increasingly serve as first responders to incidents involving older adults in which aging-related health plays a critical role. The goals of this study were to assess police officers’ knowledge of aging-related health; to identify challenges police experience in their encounters with older adults; and to describe their recommendations for how to address those challenges. This was a mixed methods study of 141 San Francisco police officers recruited from mandatory police trainings between 2011 and 2013. Descriptive statistics were used to analyze 141 self-administered questionnaires and principles of grounded theory were used to analyze open-ended questionnaire responses and 11 additional qualitative interviews. Nearly all officers (89%) reported interacting with older adults at least monthly. Although 84% of police reported prior training in working with older adults, only 32% rated themselves knowledgeable about aging-related health. Participants described themselves as first-responders to medical and social emergencies involving older adults and identified several challenges including identifying and responding to aging-related conditions and ensuring appropriate medical and social service hand-offs. To address these challenges, officers recommended developing trainings focused on recognizing and responding to aging-related conditions and improving police knowledge of community resources for older adults. They also called for enhanced communication and collaboration between police and clinicians. These findings suggest that despite playing a front-line role in responding to older adults with complex medical and social needs, many police may benefit from additional knowledge about aging-related health and community resources. Collaboration between police and healthcare providers presents an important opportunity to develop geriatrics training and interprofessional systems of care to support police work with a rapidly aging population. PMID:25378267

Police on the front line of community geriatric health care: challenges and opportunities.

PubMed

Brown, Rebecca T; Ahalt, Cyrus; Steinman, Michael A; Kruger, Kelly; Williams, Brie A

2014-11-01

As the population ages, police increasingly serve as first responders to incidents involving older adults in which aging-related health plays a critical role. The goals of this study were to assess police officers' knowledge of aging-related health, to identify challenges police experience in their encounters with older adults, and to describe their recommendations for how to address those challenges. This was a mixed-methods study of 141 San Francisco police officers recruited from mandatory police trainings between 2011 and 2013. Descriptive statistics were used to analyze 141 self-administered questionnaires, and principles of grounded theory were used to analyze open-ended questionnaire responses and 11 additional qualitative interviews. Eighty-nine percent of officers reported interacting with older adults at least monthly. Although 84% of police reported prior training in working with older adults, only 32% rated themselves as knowledgeable about aging-related health. Participants described themselves as first responders to medical and social emergencies involving older adults and identified several challenges, including identifying and responding to aging-related conditions and ensuring appropriate medical and social service handoffs. To address these challenges, officers recommended developing trainings focused on recognizing and responding to aging-related conditions and improving police knowledge of community resources for older adults. They also called for enhanced communication and collaboration between police and clinicians. These findings suggest that, because they assume a front-line role in responding to older adults with complex medical and social needs, many police may benefit from additional knowledge about aging-related health and community resources. Collaboration between police and healthcare providers presents an important opportunity to develop geriatrics training and interprofessional systems of care to support police work with a rapidly aging population. © 2014, Copyright the Authors Journal compilation © 2014, The American Geriatrics Society.

Development of an Aotus nancymaae Model for Shigella Vaccine Immunogenicity and Efficacy Studies

PubMed Central

Gregory, Michael; Lugo-Roman, Luis A.; Galvez Carrillo, Hugo; Tilley, Drake Hamilton; Baldeviano, Christian; Simons, Mark P.; Reynolds, Nathanael D.; Ranallo, Ryan T.; Suvarnapunya, Akamol E.; Venkatesan, Malabi M.; Oaks, Edwin V.

2014-01-01

Several animal models exist to evaluate the immunogenicity and protective efficacy of candidate Shigella vaccines. The two most widely used nonprimate models for vaccine development include a murine pulmonary challenge model and a guinea pig keratoconjunctivitis model. Nonhuman primate models exhibit clinical features and gross and microscopic colonic lesions that mimic those induced in human shigellosis. Challenge models for enterotoxigenic Escherichia coli (ETEC) and Campylobacter spp. have been successfully developed with Aotus nancymaae, and the addition of a Shigella-Aotus challenge model would facilitate the testing of combination vaccines. A series of experiments were designed to identify the dose of Shigella flexneri 2a strain 2457T that induces an attack rate of 75% in the Aotus monkey. After primary challenge, the dose required to induce an attack rate of 75% was calculated to be 1 × 1011 CFU. Shigella-specific immune responses were low after primary challenge and subsequently boosted upon rechallenge. However, preexisting immunity derived from the primary challenge was insufficient to protect against the homologous Shigella serotype. A successive study in A. nancymaae evaluated the ability of multiple oral immunizations with live-attenuated Shigella vaccine strain SC602 to protect against challenge. After three oral immunizations, animals were challenged with S. flexneri 2a 2457T. A 70% attack rate was demonstrated in control animals, whereas animals immunized with vaccine strain SC602 were protected from challenge (efficacy of 80%; P = 0.05). The overall study results indicate that the Shigella-Aotus nancymaae challenge model may be a valuable tool for evaluating vaccine efficacy and investigating immune correlates of protection. PMID:24595138

Work participation and arthritis: a systematic overview of challenges, adaptations and opportunities for interventions.

PubMed

Hoving, Jan L; van Zwieten, Myra C B; van der Meer, Marrit; Sluiter, Judith K; Frings-Dresen, Monique H W

2013-07-01

Understanding the factors that play a role in maintaining people with inflammatory arthritis in the workforce may aid the design of interventions to support work participation. The objective of this systematic overview is to summarize qualitative studies that explore experiences of patients with inflammatory arthritis to remain employed or return to work. Bibliographic databases including MEDLINE, EMBASE and PsycInfo were searched until December 2011 to identify any qualitative studies that focused on experiences, challenges or adaptations of patients with inflammatory arthritis to remain employed. Thematic analyses were used to identify any first or higher order themes for which all data were entered into MAXQDA software. In addition, methodological quality was assessed using an eight-item checklist. Of 6338 citations, 10 studies were included. RA was the condition in eight studies. Individual interviews (six studies) were used more frequently than group interviews (four studies). Methodological quality varied from 2 to 8 points and had no effect on the number of themes identified. Thematic analyses showed seven key concepts important to patients, including disease symptoms, management of the disease, socioeconomic issues, work conditions and adaptations, emotional challenges, interpersonal issues affecting work and family life and meaning of work. By including studies from different countries and settings, we show a comprehensive overview of themes considered important by patients and strengthen our belief that these factors should be considered in interventions that aim to improve work participation for patients with inflammatory arthritis.

An 8-week web-based weight loss challenge with celebrity endorsement and enhanced social support: observational study.

PubMed

Hutchesson, Melinda J; Collins, Clare E; Morgan, Philip J; Callister, Robin

2013-07-04

Initial engagement and weight loss within Web-based weight loss programs may predict long-term success. The integration of persuasive Web-based features may boost engagement and therefore weight loss. To determine whether an 8-week challenge within a commercial Web-based weight loss program influenced weight loss, website use, and attrition in the short term, when compared to the standard program. De-identified data for participants (mean age 36.7±10.3 years; 86% female) who enrolled in the Biggest Loser Club (BLC) (n=952) and the BLC's Shannan Ponton Fast Track Challenge (SC) for 8 weeks (n=381) were compared. The BLC program used standard evidence-based website features, with individualized calorie and exercise targets to facilitate a weight loss of 0.5-1 kg per week (-500kcal/day less than estimated energy expenditure). SC used the same website features but in addition promoted greater initial weight loss using a 1200 kcal/day energy intake target and physical activity energy expenditure of 600 kcal/day. SC used persuasive features to facilitate greater user engagement, including offering additional opportunities for social support (eg, webinar meetings with a celebrity personal trainer and social networking) endorsed by a celebrity personal trainer. Self-reported weekly weight records were used to determine weight change after 8 weeks. A primary analysis was undertaken using a generalized linear mixed model (GLMM) with all available weight records for all participants included. Dropout (participants who cancelled their subscription) and nonusage (participants who stopped using the Web-based features) attrition rates at 8 weeks were calculated. The number of participants who accessed each website feature and the total number of days each feature was used were calculated. The difference between attrition rates and website use for the two programs were tested using chi-square and Wilcoxon Rank Sum tests, respectively. Using GLMM, including weight data for all participants, there was significantly greater (P=.03) 8-week weight loss in SC (-5.1 kg [-5.5 to -4.6 kg] or -6.0%) compared to BLC participants (-4.5 kg [-4.8, -4.2] or -5.0%). Dropout rates were low and consistent across groups (BLC: 17 (1.8%) vs SC: 2 (0.5%), P=.08) and 48.7% (456/936) of BLC and 51.2% (184/379) of SC participants accessed the website at 8 weeks, with no difference between programs (P=.48). SC participants accessed the discussion forums, menu plans, exercise plans, and educational materials significantly more than BLC participants (P<.05). Using a short-term challenge with persuasive features, including online social support with endorsement by a celebrity personal trainer, as well as a greater energy balance deficit, within a commercial Web-based weight loss program may facilitate greater initial weight loss and engagement with some program components. The results support the need for a more rigorous and prospective evaluation of Web-based weight loss programs that incorporate additional strategies to enhance initial weight loss and engagement, such as a short-term challenge.

An 8-Week Web-Based Weight Loss Challenge With Celebrity Endorsement and Enhanced Social Support: Observational Study

PubMed Central

Collins, Clare E; Morgan, Philip J; Callister, Robin

2013-01-01

Background Initial engagement and weight loss within Web-based weight loss programs may predict long-term success. The integration of persuasive Web-based features may boost engagement and therefore weight loss. Objective To determine whether an 8-week challenge within a commercial Web-based weight loss program influenced weight loss, website use, and attrition in the short term, when compared to the standard program. Methods De-identified data for participants (mean age 36.7±10.3 years; 86% female) who enrolled in the Biggest Loser Club (BLC) (n=952) and the BLC’s Shannan Ponton Fast Track Challenge (SC) for 8 weeks (n=381) were compared. The BLC program used standard evidence-based website features, with individualized calorie and exercise targets to facilitate a weight loss of 0.5-1 kg per week (–500kcal/day less than estimated energy expenditure). SC used the same website features but in addition promoted greater initial weight loss using a 1200 kcal/day energy intake target and physical activity energy expenditure of 600 kcal/day. SC used persuasive features to facilitate greater user engagement, including offering additional opportunities for social support (eg, webinar meetings with a celebrity personal trainer and social networking) endorsed by a celebrity personal trainer. Self-reported weekly weight records were used to determine weight change after 8 weeks. A primary analysis was undertaken using a generalized linear mixed model (GLMM) with all available weight records for all participants included. Dropout (participants who cancelled their subscription) and nonusage (participants who stopped using the Web-based features) attrition rates at 8 weeks were calculated. The number of participants who accessed each website feature and the total number of days each feature was used were calculated. The difference between attrition rates and website use for the two programs were tested using chi-square and Wilcoxon Rank Sum tests, respectively. Results Using GLMM, including weight data for all participants, there was significantly greater (P=.03) 8-week weight loss in SC (–5.1 kg [–5.5 to –4.6 kg] or –6.0%) compared to BLC participants (–4.5 kg [–4.8, –4.2] or –5.0%). Dropout rates were low and consistent across groups (BLC: 17 (1.8%) vs SC: 2 (0.5%), P=.08) and 48.7% (456/936) of BLC and 51.2% (184/379) of SC participants accessed the website at 8 weeks, with no difference between programs (P=.48). SC participants accessed the discussion forums, menu plans, exercise plans, and educational materials significantly more than BLC participants (P<.05). Conclusions Using a short-term challenge with persuasive features, including online social support with endorsement by a celebrity personal trainer, as well as a greater energy balance deficit, within a commercial Web-based weight loss program may facilitate greater initial weight loss and engagement with some program components. The results support the need for a more rigorous and prospective evaluation of Web-based weight loss programs that incorporate additional strategies to enhance initial weight loss and engagement, such as a short-term challenge. PMID:23827796

Fuselage mounted anti-collision lights utilizing high power LEDs

NASA Astrophysics Data System (ADS)

Lundberg, John; Machi, Nicolo; Mangum, Scott; Singer, Jeffrey

2005-09-01

As LEDs continue to improve in efficacy and total light output, they are increasingly finding their way in to new applications in the aviation industry as well as adjacent markets. One function that is particularly challenging and may reap substantial benefits from this new technology is the fuselage mounted anti-collision light. Anti-collision lights provide conspicuity for the aircraft by periodically emitting bright flashes of light. The color, light distribution and intensity levels for these lights are all closely regulated through Federal Aviation Regulation (FAR) documents. These lighting requirements, along with thermal, environmental and aerodynamic requirements, drive the overall design. In this paper, we will discuss the existing technologies used in anti-collision lights and the advantages and challenges associated with an LED solution. Particular attention will be given to the optical, thermal, electrical and aerodynamic aspects associated with an LED approach. A specific case study will be presented along with some of the challenges that have arisen during the design process. These challenges include the addition of an integrated covert anti-collision lighting.

Fat-Soluble Vitamins: Clinical Indications and Current Challenges for Chromatographic Measurement

PubMed Central

Albahrani, Ali A.; Greaves, Ronda F.

2016-01-01

Fat-soluble vitamins, including vitamins A, D and E, are required for a wide variety of physiological functions. Over the past two decades, deficiencies of these vitamins have been associated with increased risk of cancer, type II diabetes mellitus and a number of immune system disorders. In addition, there is increasing evidence of interactions between these vitamins, especially between vitamins A and D. As a result of this enhanced clinical association with disease, translational clinical research and laboratory requests for vitamin measurements have significantly increased. These laboratory requests include measurement of 25-OHD (vitamin D), retinol (vitamin A) and α-tocopherol (vitamin E); the most accepted blood indicators for the assessment of body fat-soluble vitamin (FSV) status. There are significant obstacles to precise FSV measurement in blood. These obstacles include their physical and chemical properties, incomplete standardisation of measurement and limitations in the techniques that are currently used for quantification. The aim of this review is to briefly outline the metabolism and interactions of FSV as a prelude to identifying the current challenges for the quantification of blood vitamins A, D and E. PMID:27057076

Fat-Soluble Vitamins: Clinical Indications and Current Challenges for Chromatographic Measurement.

PubMed

Albahrani, Ali A; Greaves, Ronda F

2016-02-01

Fat-soluble vitamins, including vitamins A, D and E, are required for a wide variety of physiological functions. Over the past two decades, deficiencies of these vitamins have been associated with increased risk of cancer, type II diabetes mellitus and a number of immune system disorders. In addition, there is increasing evidence of interactions between these vitamins, especially between vitamins A and D. As a result of this enhanced clinical association with disease, translational clinical research and laboratory requests for vitamin measurements have significantly increased. These laboratory requests include measurement of 25-OHD (vitamin D), retinol (vitamin A) and α-tocopherol (vitamin E); the most accepted blood indicators for the assessment of body fat-soluble vitamin (FSV) status. There are significant obstacles to precise FSV measurement in blood. These obstacles include their physical and chemical properties, incomplete standardisation of measurement and limitations in the techniques that are currently used for quantification. The aim of this review is to briefly outline the metabolism and interactions of FSV as a prelude to identifying the current challenges for the quantification of blood vitamins A, D and E.

Data Processing and Text Mining Technologies on Electronic Medical Records: A Review

PubMed Central

Sun, Wencheng; Li, Yangyang; Liu, Fang; Fang, Shengqun; Wang, Guoyan

2018-01-01

Currently, medical institutes generally use EMR to record patient's condition, including diagnostic information, procedures performed, and treatment results. EMR has been recognized as a valuable resource for large-scale analysis. However, EMR has the characteristics of diversity, incompleteness, redundancy, and privacy, which make it difficult to carry out data mining and analysis directly. Therefore, it is necessary to preprocess the source data in order to improve data quality and improve the data mining results. Different types of data require different processing technologies. Most structured data commonly needs classic preprocessing technologies, including data cleansing, data integration, data transformation, and data reduction. For semistructured or unstructured data, such as medical text, containing more health information, it requires more complex and challenging processing methods. The task of information extraction for medical texts mainly includes NER (named-entity recognition) and RE (relation extraction). This paper focuses on the process of EMR processing and emphatically analyzes the key techniques. In addition, we make an in-depth study on the applications developed based on text mining together with the open challenges and research issues for future work. PMID:29849998

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

Keyes, D.; McInnes, L. C.; Woodward, C.

This report is an outcome of the workshop Multiphysics Simulations: Challenges and Opportunities, sponsored by the Institute of Computing in Science (ICiS). Additional information about the workshop, including relevant reading and presentations on multiphysics issues in applications, algorithms, and software, is available via https://sites.google.com/site/icismultiphysics2011/. We consider multiphysics applications from algorithmic and architectural perspectives, where 'algorithmic' includes both mathematical analysis and computational complexity and 'architectural' includes both software and hardware environments. Many diverse multiphysics applications can be reduced, en route to their computational simulation, to a common algebraic coupling paradigm. Mathematical analysis of multiphysics coupling in this form is not alwaysmore » practical for realistic applications, but model problems representative of applications discussed herein can provide insight. A variety of software frameworks for multiphysics applications have been constructed and refined within disciplinary communities and executed on leading-edge computer systems. We examine several of these, expose some commonalities among them, and attempt to extrapolate best practices to future systems. From our study, we summarize challenges and forecast opportunities. We also initiate a modest suite of test problems encompassing features present in many applications.« less

Regulatory T-cells in autoimmune diseases: challenges, controversies and--yet--unanswered questions.

PubMed

Grant, Charlotte R; Liberal, Rodrigo; Mieli-Vergani, Giorgina; Vergani, Diego; Longhi, Maria Serena

2015-02-01

Regulatory T cells (Tregs) are central to the maintenance of self-tolerance and tissue homeostasis. Markers commonly used to define human Tregs in the research setting include high expression of CD25, FOXP3 positivity and low expression/negativity for CD127. Many other markers have been proposed, but none unequivocally identifies bona fide Tregs. Tregs are equipped with an array of mechanisms of suppression, including the modulation of antigen presenting cell maturation and function, the killing of target cells, the disruption of metabolic pathways and the production of anti-inflammatory cytokines. Treg impairment has been reported in a number of human autoimmune conditions and includes Treg numerical and functional defects and conversion into effector cells in response to inflammation. In addition to intrinsic Treg impairment, resistance of effector T cells to Treg control has been described. Discrepancies in the literature are common, reflecting differences in the choice of study participants and the technical challenges associated with investigating this cell population. Studies differ in terms of the methodology used to define and isolate putative regulatory cells and to assess their suppressive function. In this review we outline studies describing Treg frequency and suppressive function in systemic and organ specific autoimmune diseases, with a specific focus on the challenges faced when investigating Tregs in these conditions. Copyright © 2014 Elsevier B.V. All rights reserved.

Cost-Effective Additive Manufacturing in Space: HELIOS Technology Challenge Guide

NASA Technical Reports Server (NTRS)

DeVieneni, Alayna; Velez, Carlos Andres; Benjamin, David; Hollenbeck, Jay

2012-01-01

Welcome to the HELIOS Technology Challenge Guide. This document is intended to serve as a general road map for participants of the HELIOS Technology Challenge [HTC] Program and the associated inaugural challenge: HTC-01: Cost-Effective Additive Manufacturing in Space. Please note that this guide is not a rule book and is not meant to hinder the development of innovative ideas. Its primary goal is to highlight the objectives of the HTC-01 Challenge and to describe possible solution routes and pitfalls that such technology may encounter in space. Please also note that participants wishing to demonstrate any hardware developed under this program during any future HELIOS Technology Challenge showcase event(s) may be subject to event regulations to be published separately at a later date.

Chronic illness burden and quality of life in an aging HIV population

PubMed Central

Balderson, Benjamin H.; Grothaus, Lou; Harrison, Robert G.; McCoy, Katryna; Mahoney, Christine; Catz, Sheryl

2012-01-01

The population of persons living with HIV (PLWH) is growing older and more prone to developing other chronic health conditions. Disease progression has been shown to be related to quality of life (QoL). However, descriptions of chronic comorbid illnesses and the unique QoL challenges of older adults living with HIV are not well understood and have not been examined in multiple geographic locations. About 452 PLWH aged 50 years or older were recruited from AIDS Service Organizations in nine states. Participants completed a telephone survey that included measures of other chronic health conditions, perceived stress, depression, and health-related quality of life. As much as 94% of the sample reported a chronic health condition in addition to HIV (mode = 2). The highest reported conditions were hypertension, chronic pain, hepatitis, and arthritis. Despite relatively high rates of depression, overall QoL was moderately high for the sample. Physical functioning was most impacted by the addition of other chronic health problems. Social functioning, mental health functioning, stress, and depression were also strongly associated with chronic disease burden. Additional chronic health problems are the norm for PLWH aged 50 years and older. QoL is significantly related to the addition of chronic health problems. As increasing numbers of PLWH reach older age, this raises challenges for providing comprehensive healthcare to older PLWH with multiple chronic conditions. PMID:22894702

The future of HIV prevention: prospects for an effective anti-HIV microbicide.

PubMed

Nuttall, Jeremy; Romano, Joseph; Douville, Karen; Galbreath, Caroline; Nel, Annaléne; Heyward, William; Mitchnick, Mark; Walker, Saul; Rosenberg, Zeda

2007-03-01

Topical microbicides are self-administered products for prevention of HIV transmission, and they present one of the most promising strategies for combating the HIV-AIDS epidemic. The development of microbicides is a long and complicated process, with many hurdles that are unique to this class of product, including challenges in product design, in the conduct and design of clinical trials, and in obtaining licensure of a new class of products intended for use almost exclusively in developing countries. Once they have been registered, there are additional challenges to the marketing and distribution of microbicides. An overview of the types of microbicide currently in development, and a summary of the issues and the approaches being taken to address them, are provided.

Dendrimers in Medicine: Therapeutic Concepts and Pharmaceutical Challenges.

PubMed

Wu, Lin-Ping; Ficker, Mario; Christensen, Jørn B; Trohopoulos, Panagiotis N; Moghimi, Seyed Moein

2015-07-15

Dendrimers are three-dimensional macromolecular structures originating from a central core molecule and surrounded by successive addition of branching layers (generation). These structures exhibit a high degree of molecular uniformity, narrow molecular weight distribution, tunable size and shape characteristics, as well as multivalency. Collectively, these physicochemical characteristics together with advancements in design of biodegradable backbones have conferred many applications to dendrimers in formulation science and nanopharmaceutical developments. These have included the use of dendrimers as pro-drugs and vehicles for solubilization, encapsulation, complexation, delivery, and site-specific targeting of small-molecule drugs, biopharmaceuticals, and contrast agents. We briefly review these advances, paying particular attention to attributes that make dendrimers versatile for drug formulation as well as challenging issues surrounding the future development of dendrimer-based medicines.

Outcome Measures for Clinical Trials in Down Syndrome.

PubMed

Esbensen, Anna J; Hooper, Stephen R; Fidler, Deborah; Hartley, Sigan L; Edgin, Jamie; d'Ardhuy, Xavier Liogier; Capone, George; Conners, Frances A; Mervis, Carolyn B; Abbeduto, Leonard; Rafii, Michael; Krinsky-McHale, Sharon J; Urv, Tiina

2017-05-01

Increasingly individuals with intellectual and developmental disabilities, including Down syndrome, are being targeted for clinical trials. However, a challenge exists in effectively evaluating the outcomes of these new pharmacological interventions. Few empirically evaluated, psychometrically sound outcome measures appropriate for use in clinical trials with individuals with Down syndrome have been identified. To address this challenge, the National Institutes of Health (NIH) assembled leading clinicians and scientists to review existing measures and identify those that currently are appropriate for trials; those that may be appropriate after expansion of age range addition of easier items, and/or downward extension of psychometric norms; and areas where new measures need to be developed. This article focuses on measures in the areas of cognition and behavior.

Use of Genetic Testing for Primary Immunodeficiency Patients.

PubMed

Heimall, Jennifer R; Hagin, David; Hajjar, Joud; Henrickson, Sarah E; Hernandez-Trujillo, Hillary S; Tan, Yuval; Kobrynski, Lisa; Paris, Kenneth; Torgerson, Troy R; Verbsky, James W; Wasserman, Richard L; Hsieh, Elena W Y; Blessing, Jack J; Chou, Janet S; Lawrence, Monica G; Marsh, Rebecca A; Rosenzweig, Sergio D; Orange, Jordan S; Abraham, Roshini S

2018-04-01

Genetic testing plays a critical role in diagnosis for many primary immunodeficiency diseases. The goals of this report are to outline some of the challenges that clinical immunologists face routinely in the use of genetic testing for patient care. In addition, we provide a review of the types of genetic testing used in the diagnosis of PID, including their strengths and limitations. We describe the strengths and limitations of different genetic testing approaches for specific clinical contexts that raise concern for specific PID disorders in light of the challenges reported by the clinical immunologist members of the CIS in a recent membership survey. Finally, we delineate the CIS's recommendations for the use of genetic testing in light of these issues.

Venture Capital Investment in the Life Sciences in Switzerland.

PubMed

Hosang, Markus

2014-12-01

Innovation is one of the main driving factors for continuous and healthy economic growth and welfare. Switzerland as a resource-poor country is particularly dependent on innovation, and the life sciences, which comprise biotechnologies, (bio)pharmaceuticals, medical technologies and diagnostics, are one of the key areas of innovative strength of Switzerland. Venture capital financing and venture capitalists (frequently called 'VCs') and investors in public equities have played and still play a pivotal role in financing the Swiss biotechnology industry. In the following some general features of venture capital investment in life sciences as well as some opportunities and challenges which venture capital investors in Switzerland are facing are highlighted. In addition certain means to counteract these challenges including the 'Zukunftsfonds Schweiz' are discussed.

Pressing needs of biomedical text mining in biocuration and beyond: opportunities and challenges.

PubMed

Singhal, Ayush; Leaman, Robert; Catlett, Natalie; Lemberger, Thomas; McEntyre, Johanna; Polson, Shawn; Xenarios, Ioannis; Arighi, Cecilia; Lu, Zhiyong

2016-01-01

Text mining in the biomedical sciences is rapidly transitioning from small-scale evaluation to large-scale application. In this article, we argue that text-mining technologies have become essential tools in real-world biomedical research. We describe four large scale applications of text mining, as showcased during a recent panel discussion at the BioCreative V Challenge Workshop. We draw on these applications as case studies to characterize common requirements for successfully applying text-mining techniques to practical biocuration needs. We note that system 'accuracy' remains a challenge and identify several additional common difficulties and potential research directions including (i) the 'scalability' issue due to the increasing need of mining information from millions of full-text articles, (ii) the 'interoperability' issue of integrating various text-mining systems into existing curation workflows and (iii) the 'reusability' issue on the difficulty of applying trained systems to text genres that are not seen previously during development. We then describe related efforts within the text-mining community, with a special focus on the BioCreative series of challenge workshops. We believe that focusing on the near-term challenges identified in this work will amplify the opportunities afforded by the continued adoption of text-mining tools. Finally, in order to sustain the curation ecosystem and have text-mining systems adopted for practical benefits, we call for increased collaboration between text-mining researchers and various stakeholders, including researchers, publishers and biocurators. Published by Oxford University Press 2016. This work is written by US Government employees and is in the public domain in the US.

Enantioselective Synthesis of Medium-Sized Lactams via Chiral α,β-Unsaturated Acylammonium Salts.

PubMed

Kang, Guowei; Yamagami, Masaki; Vellalath, Sreekumar; Romo, Daniel

2018-04-06

Medium-sized lactams are important structural motifs found in a variety of bioactive compounds and natural products but are challenging to prepare, especially in optically active form. A Michael addition/proton transfer/lactamization organocascade process is described that delivers medium-sized lactams, including azepanones, benzazepinones, azocanones, and benzazocinones, in high enantiopurity through the intermediacy of chiral α,β-unsaturated acylammonium salts. An unexpected indoline synthesis was also uncovered, and the benzazocinone skeleton was transformed into other complex heterocyclic derivatives, including spiroglutarimides, isoquinolinones, and δ-lactones. © 2018 Wiley-VCH Verlag GmbH & Co. KGaA, Weinheim.

Cognitive Remediation Strategies

PubMed Central

WEINSTEIN, CHERYL S.

1994-01-01

Evidence continues to emerge that childhood symptoms of attention-deficit hyperactivity disorder (ADHD) persist into adulthood. These symptoms include motoric hyperactivity, restlessness, attention deficits, poor organizational skills, impulsivity, and memory impairment. Poor academic and work performance, frustration, humiliation, and shame are also components of adult ADHD. Psychotherapists are challenged to understand the meaning of the disorder and its ramifications in all aspects of life. An active multimodal approach, including somatic treatment and psychotherapy, is needed. In addition, cognitive remediation strategies to enhance attention, organization, memory, and problem-solving skills are an important adjunct to treatment. These strategies serve as psychological tools to circumvent deficits. PMID:22700173

Chronic Pancreatitis: Current Status and Challenges for Prevention and Treatment.

PubMed

Lew, Daniel; Afghani, Elham; Pandol, Stephen

2017-07-01

This paper reviews the current status of our understanding of the epidemiology, diagnosis, and management of the continuum of pancreatic diseases from acute and recurrent acute pancreatitis to chronic pancreatitis and the diseases that are often linked with pancreatitis including diabetes mellitus and pancreatic cancer. In addition to reviewing the current state of the field, we identify gaps in knowledge that are necessary to address to improve patient outcomes in these conditions.

Challenges of the Global Century: Report of the Project on Globalization and National Security

DTIC Science & Technology

2001-01-01

military and civilian leaders for service at the highest levels of national defense and security. The major components of NDU include the Industrial ...academic programs. In addition, it produces Joint Force Quarterly, a professional military journal published for the Chairman of the Joint Chiefs of...shocks become contagious. In these circumstances, it can both arouse anger at industrial democracies and facili- tate the growth of international crime

Revisiting the Concept of Targeting Only Bacillus anthracis Toxins as a Treatment for Anthrax.

PubMed

Glinert, Itai; Bar-David, Elad; Sittner, Assa; Weiss, Shay; Schlomovitz, Josef; Ben-Shmuel, Amir; Mechaly, Adva; Altboum, Zeev; Kobiler, David; Levy, Haim

2016-08-01

Protective antigen (PA)-based vaccines are effective in preventing the development of fatal anthrax disease both in humans and in relevant animal models. The Bacillus anthracis toxins lethal toxin (lethal factor [LF] plus PA) and edema toxin (edema factor [EF] plus PA) are essential for the establishment of the infection, as inactivation of these toxins results in attenuation of the pathogen. Since the toxins reach high toxemia levels at the bacteremic stages of the disease, the CDC's recommendations include combining antibiotic treatment with antitoxin (anti-PA) immunotherapy. We demonstrate here that while treatment with a highly potent neutralizing monoclonal antibody was highly efficient as postexposure prophylaxis treatment, it failed to protect rabbits with any detectable bacteremia (≥10 CFU/ml). In addition, we show that while PA vaccination was effective against a subcutaneous spore challenge, it failed to protect rabbits against systemic challenges (intravenous injection of vegetative bacteria) with the wild-type Vollum strain or a toxin-deficient mutant. To test the possibility that additional proteins, which are secreted by the bacteria under pathogenicity-stimulating conditions in vitro, may contribute to the vaccine's potency, we immunized rabbits with a secreted protein fraction from a toxin-null mutant. The antiserum raised against the secreted fraction reacts with the bacteria in an immunofluorescence assay. Immunization with the secreted protein fraction did not protect the rabbits against a systemic challenge with the fully pathogenic bacteria. Full protection was obtained only by a combined vaccination with PA and the secreted protein fraction. Therefore, these results indicate that an effective antiserum treatment in advanced stages of anthrax must include toxin-neutralizing antibodies in combination with antibodies against bacterial cell targets. Copyright © 2016, American Society for Microbiology. All Rights Reserved.

Genome-editing Technologies for Gene and Cell Therapy.

PubMed

Maeder, Morgan L; Gersbach, Charles A

2016-03-01

Gene therapy has historically been defined as the addition of new genes to human cells. However, the recent advent of genome-editing technologies has enabled a new paradigm in which the sequence of the human genome can be precisely manipulated to achieve a therapeutic effect. This includes the correction of mutations that cause disease, the addition of therapeutic genes to specific sites in the genome, and the removal of deleterious genes or genome sequences. This review presents the mechanisms of different genome-editing strategies and describes each of the common nuclease-based platforms, including zinc finger nucleases, transcription activator-like effector nucleases (TALENs), meganucleases, and the CRISPR/Cas9 system. We then summarize the progress made in applying genome editing to various areas of gene and cell therapy, including antiviral strategies, immunotherapies, and the treatment of monogenic hereditary disorders. The current challenges and future prospects for genome editing as a transformative technology for gene and cell therapy are also discussed.

Genome-editing Technologies for Gene and Cell Therapy

PubMed Central

Maeder, Morgan L; Gersbach, Charles A

2016-01-01

Gene therapy has historically been defined as the addition of new genes to human cells. However, the recent advent of genome-editing technologies has enabled a new paradigm in which the sequence of the human genome can be precisely manipulated to achieve a therapeutic effect. This includes the correction of mutations that cause disease, the addition of therapeutic genes to specific sites in the genome, and the removal of deleterious genes or genome sequences. This review presents the mechanisms of different genome-editing strategies and describes each of the common nuclease-based platforms, including zinc finger nucleases, transcription activator-like effector nucleases (TALENs), meganucleases, and the CRISPR/Cas9 system. We then summarize the progress made in applying genome editing to various areas of gene and cell therapy, including antiviral strategies, immunotherapies, and the treatment of monogenic hereditary disorders. The current challenges and future prospects for genome editing as a transformative technology for gene and cell therapy are also discussed. PMID:26755333

Investment in Open Innovation Service Providers: NASA's Innovative Strategy for Solving Space Exploration Challenges

NASA Technical Reports Server (NTRS)

Fogarty, Jennifer A.; Rando, Cynthia; Baumann, David; Richard, Elizabeth; Davis, Jeffrey

2010-01-01

In an effort to expand routes for open communication and create additional opportunities for public involvement with NASA, Open Innovation Service Provider (OISP) methodologies have been incorporated as a tool in NASA's problem solving strategy. NASA engaged the services of two OISP providers, InnoCentive and Yet2.com, to test this novel approach and its feasibility in solving NASA s space flight challenges. The OISPs were chosen based on multiple factors including: network size and knowledge area span, established process, methodology, experience base, and cost. InnoCentive and Yet2.com each met the desired criteria; however each company s approach to Open Innovation is distinctly different. InnoCentive focuses on posting individual challenges to an established web-based network of approximately 200,000 solvers; viable solutions are sought and granted a financial award if found. Based on a specific technological need, Yet2.com acts as a talent scout providing a broad external network of experts as potential collaborators to NASA. A relationship can be established with these contacts to develop technologies and/or maintained as an established network of future collaborators. The results from the first phase of the pilot study have shown great promise for long term efficacy of utilizing the OISP methodologies. Solution proposals have been received for the challenges posted on InnoCentive and are currently under review for final disposition. In addition, Yet2.com has identified new external partners for NASA and we are in the process of understanding and acting upon these new opportunities. Compared to NASA's traditional routes for external problem solving, the OISP methodologies offered NASA a substantial savings in terms of time and resources invested. In addition, these strategies will help NASA extend beyond its current borders to build an ever expanding network of experts and global solvers.

Challenges in Reproducibility, Replicability, and Comparability of Computational Models and Tools for Neuronal and Glial Networks, Cells, and Subcellular Structures.

PubMed

Manninen, Tiina; Aćimović, Jugoslava; Havela, Riikka; Teppola, Heidi; Linne, Marja-Leena

2018-01-01

The possibility to replicate and reproduce published research results is one of the biggest challenges in all areas of science. In computational neuroscience, there are thousands of models available. However, it is rarely possible to reimplement the models based on the information in the original publication, let alone rerun the models just because the model implementations have not been made publicly available. We evaluate and discuss the comparability of a versatile choice of simulation tools: tools for biochemical reactions and spiking neuronal networks, and relatively new tools for growth in cell cultures. The replicability and reproducibility issues are considered for computational models that are equally diverse, including the models for intracellular signal transduction of neurons and glial cells, in addition to single glial cells, neuron-glia interactions, and selected examples of spiking neuronal networks. We also address the comparability of the simulation results with one another to comprehend if the studied models can be used to answer similar research questions. In addition to presenting the challenges in reproducibility and replicability of published results in computational neuroscience, we highlight the need for developing recommendations and good practices for publishing simulation tools and computational models. Model validation and flexible model description must be an integral part of the tool used to simulate and develop computational models. Constant improvement on experimental techniques and recording protocols leads to increasing knowledge about the biophysical mechanisms in neural systems. This poses new challenges for computational neuroscience: extended or completely new computational methods and models may be required. Careful evaluation and categorization of the existing models and tools provide a foundation for these future needs, for constructing multiscale models or extending the models to incorporate additional or more detailed biophysical mechanisms. Improving the quality of publications in computational neuroscience, enabling progressive building of advanced computational models and tools, can be achieved only through adopting publishing standards which underline replicability and reproducibility of research results.

Challenges in Reproducibility, Replicability, and Comparability of Computational Models and Tools for Neuronal and Glial Networks, Cells, and Subcellular Structures

PubMed Central

Manninen, Tiina; Aćimović, Jugoslava; Havela, Riikka; Teppola, Heidi; Linne, Marja-Leena

2018-01-01

The possibility to replicate and reproduce published research results is one of the biggest challenges in all areas of science. In computational neuroscience, there are thousands of models available. However, it is rarely possible to reimplement the models based on the information in the original publication, let alone rerun the models just because the model implementations have not been made publicly available. We evaluate and discuss the comparability of a versatile choice of simulation tools: tools for biochemical reactions and spiking neuronal networks, and relatively new tools for growth in cell cultures. The replicability and reproducibility issues are considered for computational models that are equally diverse, including the models for intracellular signal transduction of neurons and glial cells, in addition to single glial cells, neuron-glia interactions, and selected examples of spiking neuronal networks. We also address the comparability of the simulation results with one another to comprehend if the studied models can be used to answer similar research questions. In addition to presenting the challenges in reproducibility and replicability of published results in computational neuroscience, we highlight the need for developing recommendations and good practices for publishing simulation tools and computational models. Model validation and flexible model description must be an integral part of the tool used to simulate and develop computational models. Constant improvement on experimental techniques and recording protocols leads to increasing knowledge about the biophysical mechanisms in neural systems. This poses new challenges for computational neuroscience: extended or completely new computational methods and models may be required. Careful evaluation and categorization of the existing models and tools provide a foundation for these future needs, for constructing multiscale models or extending the models to incorporate additional or more detailed biophysical mechanisms. Improving the quality of publications in computational neuroscience, enabling progressive building of advanced computational models and tools, can be achieved only through adopting publishing standards which underline replicability and reproducibility of research results. PMID:29765315

Composites

NASA Astrophysics Data System (ADS)

Taylor, John G.

The Composites market is arguably the most challenging and profitable market for phenolic resins aside from electronics. The variety of products and processes encountered creates the challenges, and the demand for high performance in critical operations brings value. Phenolic composite materials are rendered into a wide range of components to supply a diverse and fragmented commercial base that includes customers in aerospace (Space Shuttle), aircraft (interiors and brakes), mass transit (interiors), defense (blast protection), marine, mine ducting, off-shore (ducts and grating) and infrastructure (architectural) to name a few. For example, phenolic resin is a critical adhesive in the manufacture of honeycomb sandwich panels. Various solvent and water based resins are described along with resin characteristics and the role of metal ions for enhanced thermal stability of the resin used to coat the honeycomb. Featured new developments include pultrusion of phenolic grating, success in RTM/VARTM fabricated parts, new ballistic developments for military vehicles and high char yield carbon-carbon composites along with many others. Additionally, global regional market resin volumes and sales are presented and compared with other thermosetting resin systems.

Fundamental Aeronautics Program: Overview of Project Work in Supersonic Cruise Efficiency

NASA Technical Reports Server (NTRS)

Castner, Raymond

2011-01-01

The Supersonics Project, part of NASA?s Fundamental Aeronautics Program, contains a number of technical challenge areas which include sonic boom community response, airport noise, high altitude emissions, cruise efficiency, light weight durable engines/airframes, and integrated multi-discipline system design. This presentation provides an overview of the current (2011) activities in the supersonic cruise efficiency technical challenge, and is focused specifically on propulsion technologies. The intent is to develop and validate high-performance supersonic inlet and nozzle technologies. Additional work is planned for design and analysis tools for highly-integrated low-noise, low-boom applications. If successful, the payoffs include improved technologies and tools for optimized propulsion systems, propulsion technologies for a minimized sonic boom signature, and a balanced approach to meeting efficiency and community noise goals. In this propulsion area, the work is divided into advanced supersonic inlet concepts, advanced supersonic nozzle concepts, low fidelity computational tool development, high fidelity computational tools, and improved sensors and measurement capability. The current work in each area is summarized.

Assessing new developments in the pre-market regulatory process of medical devices in the People's Republic of China.

PubMed

Zhang, Shixuan; Kriza, Christine; Kolominsky-Rabas, Peter L

2014-09-01

The objective of this paper is to provide a systematic overview of the Chinese medical device registration processes, identify challenges and suggest how these can be addressed. In addition, the paper will outline the impact of new policies and regulations since the restructuring of the China FDA. A systematic review was performed for journal articles between the year of 2009 and 2013 in the following databases: PubMed, ScienceDirect and Zhongguozhiwang. The review has identified 184 papers which were potentially relevant. Seventeen articles were included in the review, which highlights the challenges and opportunities related to the medical device registration process. In order to understand the actual impact of the regulation environment and its policies including the lack of regulatory guidance regular assessment updates are crucial. The results of this paper are aimed at informing regulatory bodies, health policy decision makers, national and international Health Technology Assessment networks as well as medical devices manufacturers.

Diverticular Disease: Traditional and Evolving Paradigms.

PubMed

Lamanna, Lenore; Moran, Patricia E

Diverticular disease includes diverticulosis, which are sac protrusions of the intestinal mucosa, and diverticulitis, inflammation of the diverticula. Diverticular disease is listed as one of the top 10 leading physician diagnoses for gastrointestinal disorders in outpatient clinic visits in the United States. There are several classifications of diverticular disease ranging from asymptomatic diverticulosis to diverticulitis with complications. Several theories are linked to the development of diverticula which includes the physiology of the colon itself, collagen cross-linking, and recently challenged, low-fiber intake. The differential diagnoses of lower abdominal pain in addition to diverticular disease have overlapping signs and symptoms, which can make a diagnosis challenging. Identification of the distinct signs and symptoms of each classification will assist the practitioner in making the correct diagnosis and lead to appropriate management. The findings from recent studies have changed the paradigm of diverticular disease. The purpose of this article is to discuss traditional dogma and evolving concepts in the pathophysiology, prevention, and management of diverticular disease. Practitioners must be knowledgeable about diverticular disease for improved outcomes.

Dogs in the Workplace: A Review of the Benefits and Potential Challenges.

PubMed

Foreman, Anne M; Glenn, Margaret K; Meade, B Jean; Wirth, Oliver

2017-05-08

Pet dogs, therapy dogs, and service dogs can be seen in workplaces with increasing frequency. Although dogs may provide many benefits to employees and employers, their presence may introduce additional hazards and concerns to the work environment. Therefore, decisions to accept dogs in the workplace may include many considerations including the health, safety, and well-being of employees, legal and cultural sensitivities, and animal welfare. The present paper serves to introduce the issue of dogs in the workplace and outline the potential benefits and challenges to their presence. The legal accommodations afforded to certain types of dogs in workplace settings are discussed, and the research findings pertaining to the potential benefits of dogs on human health and well-being are summarized. The paper concludes with considerations for human resource management personnel in the areas of diversity, employee relations, ethics and corporate responsibility, organizational and employee development, safety and security, and legal considerations, as well as suggested topics for future research.

Enhancement of microalgal growth and biocomponent-based transformations for improved biofuel recovery: A review.

PubMed

Salama, El-Sayed; Hwang, Jae-Hoon; El-Dalatony, Marwa M; Kurade, Mayur B; Kabra, Akhil N; Abou-Shanab, Reda A I; Kim, Ki-Hyun; Yang, Il-Seung; Govindwar, Sanjay P; Kim, Sunjoon; Jeon, Byong-Hun

2018-06-01

Microalgal biomass has received much attention as feedstock for biofuel production due to its capacity to accumulate a substantial amount of biocomponents (including lipid, carbohydrate, and protein), high growth rate, and environmental benefit. However, commercial realization of microalgal biofuel is a challenge due to its low biomass production and insufficient technology for complete utilization of biomass. Recently, advanced strategies have been explored to overcome the challenges of conventional approaches and to achieve maximum possible outcomes in terms of growth. These strategies include a combination of stress factors; co-culturing with other microorganisms; and addition of salts, flue gases, and phytohormones. This review summarizes the recent progress in the application of single and combined abiotic stress conditions to stimulate microalgal growth and its biocomponents. An innovative schematic model is presented of the biomass-energy conversion pathway that proposes the transformation of all potential biocomponents of microalgae into biofuels. Copyright © 2018 Elsevier Ltd. All rights reserved.

Dogs in the Workplace: A Review of the Benefits and Potential Challenges

PubMed Central

Foreman, Anne M.; Glenn, Margaret K.; Meade, B. Jean; Wirth, Oliver

2017-01-01

Pet dogs, therapy dogs, and service dogs can be seen in workplaces with increasing frequency. Although dogs may provide many benefits to employees and employers, their presence may introduce additional hazards and concerns to the work environment. Therefore, decisions to accept dogs in the workplace may include many considerations including the health, safety, and well-being of employees, legal and cultural sensitivities, and animal welfare. The present paper serves to introduce the issue of dogs in the workplace and outline the potential benefits and challenges to their presence. The legal accommodations afforded to certain types of dogs in workplace settings are discussed, and the research findings pertaining to the potential benefits of dogs on human health and well-being are summarized. The paper concludes with considerations for human resource management personnel in the areas of diversity, employee relations, ethics and corporate responsibility, organizational and employee development, safety and security, and legal considerations, as well as suggested topics for future research. PMID:28481317

Promoting Social and Emotional Growth of Students with Disabilities

ERIC Educational Resources Information Center

Darrow, Alice-Ann

2014-01-01

Students with disabilities are often faced with numerous challenges as they progress through their school years. In addition to disability-related challenges, they may encounter additional difficulties such as bullying in school and lack of social acceptance by their peers. It is important that students with disabilities develop competence in…

The future of PanDA in ATLAS distributed computing

NASA Astrophysics Data System (ADS)

De, K.; Klimentov, A.; Maeno, T.; Nilsson, P.; Oleynik, D.; Panitkin, S.; Petrosyan, A.; Schovancova, J.; Vaniachine, A.; Wenaus, T.

2015-12-01

Experiments at the Large Hadron Collider (LHC) face unprecedented computing challenges. Heterogeneous resources are distributed worldwide at hundreds of sites, thousands of physicists analyse the data remotely, the volume of processed data is beyond the exabyte scale, while data processing requires more than a few billion hours of computing usage per year. The PanDA (Production and Distributed Analysis) system was developed to meet the scale and complexity of LHC distributed computing for the ATLAS experiment. In the process, the old batch job paradigm of locally managed computing in HEP was discarded in favour of a far more automated, flexible and scalable model. The success of PanDA in ATLAS is leading to widespread adoption and testing by other experiments. PanDA is the first exascale workload management system in HEP, already operating at more than a million computing jobs per day, and processing over an exabyte of data in 2013. There are many new challenges that PanDA will face in the near future, in addition to new challenges of scale, heterogeneity and increasing user base. PanDA will need to handle rapidly changing computing infrastructure, will require factorization of code for easier deployment, will need to incorporate additional information sources including network metrics in decision making, be able to control network circuits, handle dynamically sized workload processing, provide improved visualization, and face many other challenges. In this talk we will focus on the new features, planned or recently implemented, that are relevant to the next decade of distributed computing workload management using PanDA.

Dietary arginine supplementation alleviates intestinal mucosal disruption induced by Escherichia coli lipopolysaccharide in weaned pigs.

PubMed

Liu, Yulan; Huang, Jingjing; Hou, Yongqing; Zhu, Huiling; Zhao, Shengjun; Ding, Binying; Yin, Yulong; Yi, Ganfeng; Shi, Junxia; Fan, Wei

2008-09-01

This study evaluated whether arginine (Arg) supplementation could attenuate gut injury induced by Escherichia coli lipopolysaccharide (LPS) challenge through an anti-inflammatory role in weaned pigs. Pigs were allotted to four treatments including: (1) non-challenged control; (2) LPS-challenged control; (3) LPS+0.5 % Arg; (4) LPS+1.0 % Arg. On day 16, pigs were injected with LPS or sterile saline. At 6 h post-injection, pigs were killed for evaluation of small intestinal morphology and intestinal gene expression. Within 48 h of challenge, 0.5 % Arg alleviated the weight loss induced by LPS challenge (P = 0.025). In all three intestinal segments, 0.5 or 1.0 % Arg mitigated intestinal morphology impairment (e.g. lower villus height and higher crypt depth) induced by LPS challenge (P < 0.05), and alleviated the decrease of crypt cell proliferation and the increase of villus cell apoptosis after LPS challenge (P < 0.01). The 0.5 % Arg prevented the elevation of jejunal IL-6 mRNA abundance (P = 0.082), and jejunal (P = 0.030) and ileal (P = 0.039) TNF-alpha mRNA abundance induced by LPS challenge. The 1.0 % Arg alleviated the elevation of jejunal IL-6 mRNA abundance (P = 0.053) and jejunal TNF-alpha mRNA abundance (P = 0.003) induced by LPS challenge. The 0.5 % Arg increased PPARgamma mRNA abundance in all three intestinal segments (P < 0.10), and 1.0 % Arg increased duodenal PPARgamma mRNA abundance (P = 0.094). These results indicate that Arg supplementation has beneficial effects in alleviating gut mucosal injury induced by LPS challenge. Additionally, it is possible that the protective effects of Arg on the intestine are associated with decreasing the expression of intestinal pro-inflammatory cytokines through activating PPARgamma expression.

Benefits and challenges of international clinical education from a US-based physiotherapist faculty perspective.

PubMed

Pechak, Celia; Black, Jill D

2013-12-01

The influence of internationalization on physiotherapist education in at least North American-based programmes has become more apparent. Faculty and students have been involved in various international activities. One category of activities includes international clinical education (ICE), where students earn clinical education credit for their learning activities at international sites. Although this educational strategy appears to be increasingly used in at least the United States and Canada, the related literature is limited in scope. The purpose of this portion of the present study was to investigate the benefits and challenges of ICE for US-based students, US-based physiotherapy programmes and international partners from the perspective of US-based faculty sending students for clinical education internationally. Content analysis was used for this qualitative study. Fifteen US-based faculty members who had experience in sending physiotherapist students for ICE were recruited. The primary researcher conducted semi-structured phone interviews, averaging approximately 60 minutes in length. The primary and secondary researchers completed data analysis using NVivo 8 software (QSR International Inc., Cambridge, MA). Benefits of ICE to the students included exposure to alternate health systems, broadening of student perspectives and clinical competence. Challenges consisted of funding and possible language barrier. Increased visibility, expanded global perspective and faculty collaborations were benefits to the programme. Ensuring a quality learning experience was the greatest programme challenge. Benefits to the international site included education and faculty collaborations/exchanges; challenges were language, student clinical preparation and unfamiliarity with the student evaluation tool. Because the sample was limited to 15 US-based faculty members, the results may not be relevant to all programmes inside or outside of the United States. Additionally, the study lacked perspectives from the students or international sites. The present study is an early step in the important examination of the impact of this emerging educational trend on physiotherapy education and practice. Copyright © 2013 John Wiley & Sons, Ltd.

The National Astronomy Consortium: Lessons learned from a program to support underrepresented students in pursuing STEM careers

NASA Astrophysics Data System (ADS)

Mills, Elisabeth A.; Sheth, Kartik; Giles, Faye; Strolger, Louis-Gregory; Brisbin, Drew; Boyd, Patricia T.; Benjamin, Robert A.; NAC Consortium

2016-01-01

The National Astronomy Consortium (NAC) is a program partnering physics and astronomy departments in majority and minority-serving institutions across the country. The primary aim of this program is to support traditionally underrepresented students interested in pursuing a career in STEM through a 9-10 week summer astronomy research project and a year of additional mentoring after they return to their home institution. Students are also given an opportunity to apply for a second year in this program, often at a different site. In addition to providing research and professional experience, the NAC also seeks to strengthen ties between the majority and minority-serving institutions in order to better serve these students throughout their careers. I will report on lessons learned from the second year of hosting a cohort at the National Radio Astronomy Observatory in Socorro, NM. I will discuss the program structure during and after the summer, mentoring challenges, and ways that these challenges were addressed, including organizing a series of guest speakers and connecting students with a broader community of remote mentors.

Structural technology challenges for evolutionary growth of Space Station Freedom

NASA Technical Reports Server (NTRS)

Doiron, Harold H.

1990-01-01

A proposed evolutionary growth scenario for Space Station Freedom was defined recently by a NASA task force created to study requirements for a Human Exploration Initiative. The study was an initial response to President Bush's July 20, 1989 proposal to begin a long range program of human exploration of space including a permanently manned lunar base and a manned mission to Mars. This growth scenario evolves Freedom into a critical transportation node to support lunar and Mars missions. The growth scenario begins with the Assembly Complete configuration and adds structure, power, and facilities to support a Lunar Transfer Vehicle (LTV) verification flight. Evolutionary growth continues to support expendable, then reusable LTV operations, and finally, LTV and Mars Transfer Vehicle (MTV) operations. The significant structural growth and additional operations creating new loading conditions will present new technological and structural design challenges in addition to the considerable technology requirements of the baseline Space Station Freedom program. Several structural design and technology issues of the baseline program are reviewed and related technology development required by the growth scenario is identified.

A Software Developer’s Guide to Informal Evaluation of Visual Analytics Environments Using VAST Challenge Information

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

Cook, Kristin A.; Scholtz, Jean; Whiting, Mark A.

The VAST Challenge has been a popular venue for academic and industry participants for over ten years. Many participants comment that the majority of their time in preparing VAST Challenge entries is discovering elements in their software environments that need to be redesigned in order to solve the given task. Fortunately, there is no need to wait until the VAST Challenge is announced to test out software systems. The Visual Analytics Benchmark Repository contains all past VAST Challenge tasks, data, solutions and submissions. This paper details the various types of evaluations that may be conducted using the Repository information. Inmore » this paper we describe how developers can do informal evaluations of various aspects of their visual analytics environments using VAST Challenge information. Aspects that can be evaluated include the appropriateness of the software for various tasks, the various data types and formats that can be accommodated, the effectiveness and efficiency of the process supported by the software, and the intuitiveness of the visualizations and interactions. Researchers can compare their visualizations and interactions to those submitted to determine novelty. In addition, the paper provides pointers to various guidelines that software teams can use to evaluate the usability of their software. While these evaluations are not a replacement for formal evaluation methods, this information can be extremely useful during the development of visual analytics environments.« less

Finding the Words: Medical Students' Reflections on Communication Challenges in Clinic.

PubMed

Braverman, Genna; Bereknyei Merrell, Sylvia; Bruce, Janine S; Makoul, Gregory; Schillinger, Erika

2016-11-01

Interpersonal communication is essential to providing excellent patient care and requires ongoing development. Although aspects of medical student interpersonal communication may degrade throughout career progression, it is unknown what specific elements pose challenges. We aimed to characterize clerkship students' perspectives on communication challenges in the outpatient setting to help inform curricular development. Third-year medical students in a required family medicine clerkship were asked to describe a communication challenge they encountered. Open-ended written responses were collected through a mandatory post-clerkship survey. Responses were qualitatively coded using an a priori framework for teaching and assessing communication skills (The SEGUE Framework for Teaching and Assessing Communication Skills) with data-derived additions to the framework, followed by a team-based thematic analysis. We collected 799 reflections written by 518 students from 2007-2014. Three dominant themes emerged from the analysis: challenges with (1) effectively exchanging information with patients, (2) managing emotional aspects of the patient encounter, and (3) negotiating terms of the encounter. Communication curricula focus on content and process of the medical interview, but insufficient time and energy are devoted to psychosocial factors, including aspects of the encounter that are emotionally charged or conflicting. While gaps in students' communication skillsets may be anticipated or observed by educators, this study offers an analysis of students' own perceptions of the challenges they face.

Solar Sail Roadmap Mission GN and C Challenges

NASA Technical Reports Server (NTRS)

Heaton, Andrew F.

2005-01-01

The NASA In-Space Propulsion program is funding development work for solar sails to enhance future scientific opportunities. Key to this effort are scientific solar sail roadmap missions identified by peer review. The two near-term missions of interest are L1 Diamond and Solar Polar Imager. Additionally, the New Millennium Program is sponsoring the Space Technology 9 (ST9) demonstration mission. Solar sails are one of five technologies competing for the ST9 flight demonstration. Two candidate solar sail missions have been identified for a potential ST9 flight. All the roadmap missions and candidate flight demonstration missions face various GN&C challenges. A variety of efforts are underway to address these challenges. These include control actuator design and testing, low thrust optimization studies, attitude control system design and modeling, control-structure interaction studies, trajectory control design, and solar radiation pressure model development. Here we survey the various efforts underway and identify a few of specific recent interest and focus.

Using virtual machine monitors to overcome the challenges of monitoring and managing virtualized cloud infrastructures

NASA Astrophysics Data System (ADS)

Bamiah, Mervat Adib; Brohi, Sarfraz Nawaz; Chuprat, Suriayati

2012-01-01

Virtualization is one of the hottest research topics nowadays. Several academic researchers and developers from IT industry are designing approaches for solving security and manageability issues of Virtual Machines (VMs) residing on virtualized cloud infrastructures. Moving the application from a physical to a virtual platform increases the efficiency, flexibility and reduces management cost as well as effort. Cloud computing is adopting the paradigm of virtualization, using this technique, memory, CPU and computational power is provided to clients' VMs by utilizing the underlying physical hardware. Beside these advantages there are few challenges faced by adopting virtualization such as management of VMs and network traffic, unexpected additional cost and resource allocation. Virtual Machine Monitor (VMM) or hypervisor is the tool used by cloud providers to manage the VMs on cloud. There are several heterogeneous hypervisors provided by various vendors that include VMware, Hyper-V, Xen and Kernel Virtual Machine (KVM). Considering the challenge of VM management, this paper describes several techniques to monitor and manage virtualized cloud infrastructures.

Regulatory Decisions on Endocrine Disrupting Chemicals Should be Based on the Principles of Endocrinology

PubMed Central

Vandenberg, Laura N.; Colborn, Theo; Hayes, Tyrone B.; Heindel, Jerrold J.; Jacobs, David R.; Lee, Duk-Hee; Myers, John Peterson; Shioda, Toshi; Soto, Ana M.; vom Saal, Frederick S.; Welshons, Wade V.; Zoeller, R. Thomas

2013-01-01

For years, scientists from various disciplines have studied the effects of endocrine disrupting chemicals (EDCs) on the health and wellbeing of humans and wildlife. Some studies have specifically focused on the effects of low doses, i.e. those in the range that are thought to be safe for humans and/or animals. Others have focused on the existence of non-monotonic dose-response curves. These concepts challenge the way that chemical risk assessment is performed for EDCs. Continued discussions have clarified exactly what controversies and challenges remain. We address several of these issues, including why the study and regulation of EDCs should incorporate endocrine principles; what level of consensus there is for low dose effects; challenges to our understanding of non-monotonicity; and whether EDCs have been demonstrated to produce adverse effects. This discussion should result in a better understanding of these issues, and allow for additional dialogue on their impact on risk assessment. PMID:23411111

Food hypersensitivity in 20 dogs with skin and gastrointestinal signs.

PubMed

Paterson, S

1995-12-01

Canine food allergy can be defined as a nonseasonal, pruritic skin disorder of dogs that is associated with the ingestion of a substance found in the dog's diet. This study records the use of a proprietary dried fish, corn and soya-based diet for the investigation and maintenance of food allergic dogs when fed initially as a restricted allergen diet and then as a maintenance diet after challenge. All the dogs showed evidence of pruritic skin disease and in addition demonstrated gastrointestinal signs. These included the presence of faecal mucus and blood, tenesmus and increased faecal frequency; all the signs associated with colitis. Both cutaneous and gastrointestinal signs resolved when an elimination diet was fed and could be reproduced when the animal was appropriately challenged. Ten dogs were trialled on a home cooked diet of fish and potato and 10 dogs on the proprietary complete food. All the dogs were challenged to identify their food allergies. Nineteen of the dogs have subsequently been successfully maintained on the proprietary food.

Stock assessment in inland fisheries: a foundation for sustainable use and conservation

USGS Publications Warehouse

Lorenzen, Kai; Cowx, Ian G.; Entsua-Mensah, R. E. M.; Lester, Nigel P.; Koehn, J.D.; Randall, R.G.; So, N.; Bonar, Scott A.; Bunnell, David B.; Venturelli, Paul A.; Bower, Shannon D.; Cooke, Steven J.

2016-01-01

Fisheries stock assessments are essential for science-based fisheries management. Inland fisheries pose challenges, but also provide opportunities for biological assessments that differ from those encountered in large marine fisheries for which many of our assessment methods have been developed. These include the number and diversity of fisheries, high levels of ecological and environmental variation, and relative lack of institutional capacity for assessment. In addition, anthropogenic impacts on habitats, widespread presence of non-native species and the frequent use of enhancement and restoration measures such as stocking affect stock dynamics. This paper outlines various stock assessment and data collection approaches that can be adapted to a wide range of different inland fisheries and management challenges. Although this paper identifies challenges in assessment, it focuses on solutions that are practical, scalable and transferrable. A path forward is suggested in which biological assessment generates some of the critical information needed by fisheries managers to make effective decisions that benefit the resource and stakeholders.

Does making meaning make it better? Narrative meaning-making and well-being in at-risk African-American adolescent females

PubMed Central

Sales, Jessica M.; Merrill, Natalie A.; Fivush, Robyn

2012-01-01

It has been argued that, for certain people, attempts at making meaning about past life events, especially challenging events, might be detrimental to well-being. In this study we explored the association between narrative indicators of meaning-making and psychological well-being, while also considering the role of individual level factors such as life history, personality characteristics and locus of control, among an at-risk sample of low socioeconomic status inner-city African-American adolescent females with challenging lives. We found that having a more external locus of control and including more cognitive processing language in narratives about a highly negative past experience were associated with increased depressive symptoms. Our findings suggest that certain types of narrative meaning-making language may reflect ongoing and unsuccessful efforts after meaning, and, may be more similar to rumination than to resolution. Additionally, they support claims that for certain individuals from challenging backgrounds, efforts after meaning might not be psychologically healthy. PMID:22897108

Community Cloud Computing

NASA Astrophysics Data System (ADS)

Marinos, Alexandros; Briscoe, Gerard

Cloud Computing is rising fast, with its data centres growing at an unprecedented rate. However, this has come with concerns over privacy, efficiency at the expense of resilience, and environmental sustainability, because of the dependence on Cloud vendors such as Google, Amazon and Microsoft. Our response is an alternative model for the Cloud conceptualisation, providing a paradigm for Clouds in the community, utilising networked personal computers for liberation from the centralised vendor model. Community Cloud Computing (C3) offers an alternative architecture, created by combing the Cloud with paradigms from Grid Computing, principles from Digital Ecosystems, and sustainability from Green Computing, while remaining true to the original vision of the Internet. It is more technically challenging than Cloud Computing, having to deal with distributed computing issues, including heterogeneous nodes, varying quality of service, and additional security constraints. However, these are not insurmountable challenges, and with the need to retain control over our digital lives and the potential environmental consequences, it is a challenge we must pursue.

Brain Metastasis: Unique Challenges and Open Opportunities

PubMed Central

Lowery, Frank J.; Yu, Dihua

2016-01-01

The metastasis of cancer to the central nervous system (CNS) remains a devastating clinical reality, carrying an estimated survival time of less than one year in spite of recent therapeutic breakthroughs for other disease contexts. Advances in brain metastasis research are hindered by a number of reasons, including its complicated nature and the difficulty of modeling metastatic cancer growth in the unique brain microenvironment. In this review, we will discuss the clinical challenge, and compare the values and limitations of the available models for brain metastasis research. Additionally, we will specifically address current knowledge on how brain metastases take advantage of the unique brain environment to benefit their own growth. Finally, we will explore the distinctive metabolic and nutrient characteristics of the brain; how these paradoxically represent barriers to establishment of brain metastasis, but also provide ample supplies for metastatic cells’ growth in the brain. We envision that multi-disciplinary innovative approaches will open opportunities for the field to make breakthroughs in tackling unique challenges of brain metastasis. PMID:27939792

Applications of Single-Cell Sequencing for Multiomics.

PubMed

Xu, Yungang; Zhou, Xiaobo

2018-01-01

Single-cell sequencing interrogates the sequence or chromatin information from individual cells with advanced next-generation sequencing technologies. It provides a higher resolution of cellular differences and a better understanding of the underlying genetic and epigenetic mechanisms of an individual cell in the context of its survival and adaptation to microenvironment. However, it is more challenging to perform single-cell sequencing and downstream data analysis, owing to the minimal amount of starting materials, sample loss, and contamination. In addition, due to the picogram level of the amount of nucleic acids used, heavy amplification is often needed during sample preparation of single-cell sequencing, resulting in the uneven coverage, noise, and inaccurate quantification of sequencing data. All these unique properties raise challenges in and thus high demands for computational methods that specifically fit single-cell sequencing data. We here comprehensively survey the current strategies and challenges for multiple single-cell sequencing, including single-cell transcriptome, genome, and epigenome, beginning with a brief introduction to multiple sequencing techniques for single cells.

Microbiome Therapeutics – Advances and Challenges

PubMed Central

Mimee, Mark; Citorik, Robert J.; Lu, Timothy K.

2016-01-01

The microbial community that lives on and in the human body exerts a major impact on human health, from metabolism to immunity. In order to leverage the close associations between microbes and their host, development of therapeutics targeting the microbiota has surged in recent years. Here, we discuss current additive and subtractive strategies to manipulate the microbiota, focusing on bacteria engineered to produce therapeutic payloads, consortia of natural organisms and selective antimicrobials. Further, we present challenges faced by the community in the development of microbiome therapeutics, including designing microbial therapies that are adapted for specific geographies in the body, stable colonization with microbial therapies, discovery of clinically relevant biosensors, robustness of engineered synthetic gene circuits and addressing safety and biocontainment concerns. Moving forward, collaboration between basic and applied researchers and clinicians to address these challenges will poise the field to herald an age of next-generation, cellular therapies that draw on novel findings in basic research to inform directed augmentation of the human microbiota. PMID:27158095

Microbiome therapeutics - Advances and challenges.

PubMed

Mimee, Mark; Citorik, Robert J; Lu, Timothy K

2016-10-01

The microbial community that lives on and in the human body exerts a major impact on human health, from metabolism to immunity. In order to leverage the close associations between microbes and their host, development of therapeutics targeting the microbiota has surged in recent years. Here, we discuss current additive and subtractive strategies to manipulate the microbiota, focusing on bacteria engineered to produce therapeutic payloads, consortia of natural organisms and selective antimicrobials. Further, we present challenges faced by the community in the development of microbiome therapeutics, including designing microbial therapies that are adapted for specific geographies in the body, stable colonization with microbial therapies, discovery of clinically relevant biosensors, robustness of engineered synthetic gene circuits and addressing safety and biocontainment concerns. Moving forward, collaboration between basic and applied researchers and clinicians to address these challenges will poise the field to herald an age of next-generation, cellular therapies that draw on novel findings in basic research to inform directed augmentation of the human microbiota. Copyright © 2016. Published by Elsevier B.V.

Small is challenging; distal femur fracture management in an elderly lady with achondroplastic dwarfism.

PubMed

Murphy, Colin G; Chrea, Bopha; Molloy, Alan P; Nicholson, Paul

2013-03-20

Achondroplasia is an autosomal dominant dwarfing condition that represents the most common form of skeletal dysplasia. The disease is caused by a mutation in the gene encoding fibroblast growth factor receptor 3 (FGFR3) found at the p16.3 locus on chromosome 4 which results in severe inhibition of subchondral bone growth. Anatomic variations, including articular and periarticular deformities classically seen with this condition, amplify the complexity of fracture fixation. Blood volume loss, age-related bone fragility, component selection and positioning pose serious orthopaedic challenges. Concomitant cardiovascular, respiratory and neurological comorbidities pose additional high-risk perioperative considerations. Despite an estimated prevalence of 1:25 000 in the general population, there is little literature concerning the operative and postoperative treatment challenges faced by orthopaedic surgeons dealing with fracture management on a patient with this condition. We present a case of an intercondylar femoral fracture in an elderly achondroplastic lady successfully treated with percutaneous screw fixation.

Challenges of Using Methadone in the Indian Pain and Palliative Care Practice.

PubMed

Viswanath, Vidya; Palat, Gayatri; Chary, Srini; Broderick, Ann

2018-01-01

Palliative care providers across India lobbied to gain access to methadone for pain relief and this has finally been achieved. Palliative care activists will count on the numerous strengths for introducing methadone in India, including the various national and state government initiatives that have been introduced recognizing the importance of palliative care as a specialty in addition to improving opioid accessibility and training. Adding to the support are the Non-Governmental Organizations (NGOs), the medical fraternity and the international interactive and innovative programs such as the Project Extension for Community Health Outcome. As compelling as the need for methadone is, many challenges await. This article outlines the challenges of procuring methadone and also discusses the challenges specific to methadone. Balancing the availability and diversion in a setting of opioid phobia, implementing the amended laws to improve availability and accessibility in a country with diverse health-care practices are the major challenges in implementing methadone for relief of pain. The unique pharmacology of the drug requires meticulous patient selection, vigilant monitoring, and excellent communication and collaboration with a multidisciplinary team and caregivers. The psychological acceptance of the patient, the professional training of the team and the place where care is provided are also challenges which need to be overcome. These challenges could well be the catalyst for a more diligent and vigilant approach to opioid prescribing practices. Start low, go slow could well be the way forward with caregiver education to prescribe methadone safely in the Indian palliative care setting.

Bridging the Chasm: Challenges, Opportunities, and Resources for Integrating a Dissemination and Implementation Science Curriculum into Medical Education.

PubMed

Ginossar, Tamar; Heckman, Carolyn J; Cragun, Deborah; Quintiliani, Lisa M; Proctor, Enola K; Chambers, David A; Skolarus, Ted; Brownson, Ross C

2018-01-01

Physicians are charged with implementing evidence-based medicine, yet few are trained in the science of Dissemination and Implementation (D&I). In view of the potential of evidence-based training in D&I to help close the gap between research and practice, the goal of this review is to examine the importance of D&I training in medical education, describe challenges to implementing such training, and provide strategies and resources for building D&I capacity. We conducted (1) a systematic review to identify US-based D&I training efforts and (2) a critical review of additional literature to inform our evaluation of the challenges and opportunities of integrating D&I training in medical education. Out of 269 unique articles reviewed, 11 described US-based D&I training. Although vibrant and diverse training opportunities exist, their capacity is limited, and they are not designed to meet physicians' needs. Synthesis of relevant literature using a critical review approach identified challenges inherent to changing medical education, as well as challenges related to D&I science. Finally, selected strategies and resources are available for facilitating incorporation of D&I training into medical education and overcoming existing challenges. Integrating D&I training in the medical education curriculum, and particularly in residency and fellowship training, holds promise for bridging the chasm between scientific discoveries and improved patient care and outcomes. However, unique challenges should be addressed, including the need for greater evidence.

A social-cognitive framework of multidisciplinary team innovation.

PubMed

Paletz, Susannah B F; Schunn, Christian D

2010-01-01

The psychology of science typically lacks integration between cognitive and social variables. We present a new framework of team innovation in multidisciplinary science and engineering groups that ties factors from both literatures together. We focus on the effects of a particularly challenging social factor, knowledge diversity, which has a history of mixed effects on creativity, most likely because those effects are mediated and moderated by cognitive and additional social variables. In addition, we highlight the distinction between team innovative processes that are primarily divergent versus convergent; we propose that the social and cognitive implications are different for each, providing a possible explanation for knowledge diversity's mixed results on team outcomes. Social variables mapped out include formal roles, communication norms, sufficient participation and information sharing, and task conflict; cognitive variables include analogy, information search, and evaluation. This framework provides a roadmap for research that aims to harness the power of multidisciplinary teams. Copyright © 2009 Cognitive Science Society, Inc.

Chronic Pancreatitis: Current Status and Challenges for Prevention and Treatment

PubMed Central

Lew, Daniel; Afghani, Elham

2017-01-01

This paper reviews the current status of our understanding of the epidemiology, diagnosis, and management of the continuum of pancreatic diseases from acute and recurrent acute pancreatitis to chronic pancreatitis and the diseases that are often linked with pancreatitis including diabetes mellitus and pancreatic cancer. In addition to reviewing the current state of the field, we identify gaps in knowledge that are necessary to address to improve patient outcomes in these conditions. PMID:28501969

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

Bunch, Kyle J.; Williams, Laura S.; Jones, Anthony M.

The 2010 ratification of the New START Treaty has been widely regarded as a noteworthy national security achievement for both the Obama administration and the Medvedev-Putin regime, but deeper cuts are envisioned under future arms control regimes. Future verification needs will include monitoring the storage of warhead components and fissile materials and verifying dismantlement of warheads, pits, secondaries, and other materials. From both the diplomatic and technical perspectives, verification under future arms control regimes will pose new challenges. Since acceptable verification technology must protect sensitive design information and attributes, non-nuclear non-sensitive signatures may provide a significant verification tool without themore » use of additional information barriers. The use of electromagnetic signatures to monitor nuclear material storage containers is a promising technology with the potential to fulfill these challenging requirements. Research performed at Pacific Northwest National Laboratory (PNNL) has demonstrated that low frequency electromagnetic signatures of sealed metallic containers can be used to confirm the presence of specific components on a “yes/no” basis without revealing classified information. Arms control inspectors might use this technique to verify the presence or absence of monitored items, including both nuclear and non-nuclear materials. Although additional research is needed to study signature aspects such as uniqueness and investigate container-specific scenarios, the technique potentially offers a rapid and cost-effective tool to verify reduction and dismantlement of U.S. and Russian nuclear weapons.« less

Evaluation of anti-allergic properties of caffeic acid phenethyl ester in a murine model of systemic anaphylaxis

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

Park, Sae-Gwang; Lee, Da-Young; Seo, Su-Kil

Caffeic acid phenethyl ester (CAPE) is an active component of honeybee propolis extracts. It has several positive effects, including anti-inflammatory, anti-oxidation, anti-cancer, anti-bacterial, anti-viral, anti-fungal, and immunomodulatory effects. In particular, the suppressive effect of NF-{kappa}B may disrupt a component of allergic induction. The principal objective of this experimental study was to evaluate the effects of CAPE on the active systemic anaphylaxis induced by ovalbumin (OVA) challenge in mice. Mice were intraperitoneally sensitized and intravenously challenged with OVA. Histopathological analysis, nuclear factor (NF)-{kappa}B activation, and the plasma levels of histamine and total IgE after allergen challenge were evaluated. After challenges, allmore » of the sham-treated mice developed anaphylactic symptoms, increased plasma levels of histamine and OVA-specific IgE, marked vascular leakage, NF-{kappa}B activation, platelet-activating factor (PAF) production, and histological changes including pulmonary edema and hemorrhage in the renal medullae within 20 min. By way of contrast, a reduction in the plasma levels of histamine and OVA-specific IgE and an inhibition of NF-{kappa}B activation and PAF release were observed in the CAPE-treated mice. In addition, a significant prevention of hemoconcentration and OVA-induced pathological changes were noted. These results indicate that CAPE demonstrates an anti-allergic effect, which may be the result of its protective effects against IgE-mediated allergy.« less

Progress and challenges in viral vector manufacturing

PubMed Central

van der Loo, Johannes C.M.; Wright, J. Fraser

2016-01-01

Promising results in several clinical studies have emphasized the potential of gene therapy to address important medical needs and initiated a surge of investments in drug development and commercialization. This enthusiasm is driven by positive data in clinical trials including gene replacement for Hemophilia B, X-linked Severe Combined Immunodeficiency, Leber's Congenital Amaurosis Type 2 and in cancer immunotherapy trials for hematological malignancies using chimeric antigen receptor T cells. These results build on the recent licensure of the European gene therapy product Glybera for the treatment of lipoprotein lipase deficiency. The progress from clinical development towards product licensure of several programs presents challenges to gene therapy product manufacturing. These include challenges in viral vector-manufacturing capacity, where an estimated 1–2 orders of magnitude increase will likely be needed to support eventual commercial supply requirements for many of the promising disease indications. In addition, the expanding potential commercial product pipeline and the continuously advancing development of recombinant viral vectors for gene therapy require that products are well characterized and consistently manufactured to rigorous tolerances of purity, potency and safety. Finally, there is an increase in regulatory scrutiny that affects manufacturers of investigational drugs for early-phase clinical trials engaged in industry partnerships. Along with the recent increase in biopharmaceutical funding in gene therapy, industry partners are requiring their academic counterparts to meet higher levels of GMP compliance at earlier stages of clinical development. This chapter provides a brief overview of current progress in the field and discusses challenges in vector manufacturing. PMID:26519140

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

Cook, Kris A.; Scholtz, Jean; Whiting, Mark A.

The VAST Challenge has been a popular venue for academic and industry participants for over ten years. Many participants comment that the majority of their time in preparing VAST Challenge entries is discovering elements in their software environments that need to be redesigned in order to solve the given task. Fortunately, there is no need to wait until the VAST Challenge is announced to test out software systems. The Visual Analytics Benchmark Repository contains all past VAST Challenge tasks, data, solutions and submissions. This paper details the various types of evaluations that may be conducted using the Repository information. Inmore » this paper we describe how developers can do informal evaluations of various aspects of their visual analytics environments using VAST Challenge information. Aspects that can be evaluated include the appropriateness of the software for various tasks, the various data types and formats that can be accommodated, the effectiveness and efficiency of the process supported by the software, and the intuitiveness of the visualizations and interactions. Researchers can compare their visualizations and interactions to those submitted to determine novelty. In addition, the paper provides pointers to various guidelines that software teams can use to evaluate the usability of their software. While these evaluations are not a replacement for formal evaluation methods, this information can be extremely useful during the development of visual analytics environments.« less

NASA Space Rocket Logistics Challenges

NASA Technical Reports Server (NTRS)

Neeley, James R.; Jones, James V.; Watson, Michael D.; Bramon, Christopher J.; Inman, Sharon K.; Tuttle, Loraine

2014-01-01

The Space Launch System (SLS) is the new NASA heavy lift launch vehicle and is scheduled for its first mission in 2017. The goal of the first mission, which will be uncrewed, is to demonstrate the integrated system performance of the SLS rocket and spacecraft before a crewed flight in 2021. SLS has many of the same logistics challenges as any other large scale program. Common logistics concerns for SLS include integration of discreet programs geographically separated, multiple prime contractors with distinct and different goals, schedule pressures and funding constraints. However, SLS also faces unique challenges. The new program is a confluence of new hardware and heritage, with heritage hardware constituting seventy-five percent of the program. This unique approach to design makes logistics concerns such as commonality especially problematic. Additionally, a very low manifest rate of one flight every four years makes logistics comparatively expensive. That, along with the SLS architecture being developed using a block upgrade evolutionary approach, exacerbates long-range planning for supportability considerations. These common and unique logistics challenges must be clearly identified and tackled to allow SLS to have a successful program. This paper will address the common and unique challenges facing the SLS programs, along with the analysis and decisions the NASA Logistics engineers are making to mitigate the threats posed by each.

Meta-ethnography 25 years on: challenges and insights for synthesising a large number of qualitative studies.

PubMed

Toye, Francine; Seers, Kate; Allcock, Nick; Briggs, Michelle; Carr, Eloise; Barker, Karen

2014-06-21

Studies that systematically search for and synthesise qualitative research are becoming more evident in health care, and they can make an important contribution to patient care. Our team was funded to complete a meta-ethnography of patients' experience of chronic musculoskeletal pain. It has been 25 years since Noblit and Hare published their core text on meta-ethnography, and the current health research environment brings additional challenges to researchers aiming to synthesise qualitative research. Noblit and Hare propose seven stages of meta-ethnography which take the researcher from formulating a research idea to expressing the findings. These stages are not discrete but form part of an iterative research process. We aimed to build on the methods of Noblit and Hare and explore the challenges of including a large number of qualitative studies into a qualitative systematic review. These challenges hinge upon epistemological and practical issues to be considered alongside expectations about what determines high quality research. This paper describes our method and explores these challenges. Central to our method was the process of collaborative interpretation of concepts and the decision to exclude original material where we could not decipher a concept. We use excerpts from our research team's reflexive statements to illustrate the development of our methods.

Meta-ethnography 25 years on: challenges and insights for synthesising a large number of qualitative studies

PubMed Central

2014-01-01

Studies that systematically search for and synthesise qualitative research are becoming more evident in health care, and they can make an important contribution to patient care. Our team was funded to complete a meta-ethnography of patients’ experience of chronic musculoskeletal pain. It has been 25 years since Noblit and Hare published their core text on meta-ethnography, and the current health research environment brings additional challenges to researchers aiming to synthesise qualitative research. Noblit and Hare propose seven stages of meta-ethnography which take the researcher from formulating a research idea to expressing the findings. These stages are not discrete but form part of an iterative research process. We aimed to build on the methods of Noblit and Hare and explore the challenges of including a large number of qualitative studies into a qualitative systematic review. These challenges hinge upon epistemological and practical issues to be considered alongside expectations about what determines high quality research. This paper describes our method and explores these challenges. Central to our method was the process of collaborative interpretation of concepts and the decision to exclude original material where we could not decipher a concept. We use excerpts from our research team’s reflexive statements to illustrate the development of our methods. PMID:24951054

Implementing interprofessional education and practice: Lessons from a resource-constrained university.

PubMed

Frantz, J M; Rhoda, A J

2017-03-01

Interprofessional education is seen as a vehicle to facilitate collaborative practice and, therefore, address the complex health needs of populations. A number of concerns have, however, been raised with the implementation of interprofessional education. The three core concerns raised in the literature and addressed in the article include the lack of an explicit framework, challenges operationalising interprofessional education and practice, and the lack of critical mass in terms of human resources to drive activities related to interprofessional education and practice. This article aims to present lessons learnt when attempting to overcome the main challenges and implementing interprofessional education activities in a resource-constrained higher education setting in South Africa. Boyer's model of scholarship, which incorporates research, teaching integration, and application, was used to address the challenge of a lack of a framework in which to conceptualise the activities of interprofressional education. In addition, a scaffolding approach to teaching activities within a curriculum was used to operationalise interprofessional education and practice. Faculty development initiatives were additionally used to develop a critical mass that focused on driving interprofessional education. Lessons learnt highlighted that if a conceptual model is agreed upon by all, it allows for a more focused approach, and both human and financial resources may be channelled towards a common goal which may assist resource-constrained institutions in successfully implementing interprofessional activities.

Economic evaluation of health promotion interventions for older people: do applied economic studies meet the methodological challenges?

PubMed

Huter, Kai; Dubas-Jakóbczyk, Katarzyna; Kocot, Ewa; Kissimova-Skarbek, Katarzyna; Rothgang, Heinz

2018-01-01

In the light of demographic developments health promotion interventions for older people are gaining importance. In addition to methodological challenges arising from the economic evaluation of health promotion interventions in general, there are specific methodological problems for the particular target group of older people. There are especially four main methodological challenges that are discussed in the literature. They concern measurement and valuation of informal caregiving, accounting for productivity costs, effects of unrelated cost in added life years and the inclusion of 'beyond-health' benefits. This paper focuses on the question whether and to what extent specific methodological requirements are actually met in applied health economic evaluations. Following a systematic review of pertinent health economic evaluations, the included studies are analysed on the basis of four assessment criteria that are derived from methodological debates on the economic evaluation of health promotion interventions in general and economic evaluations targeting older people in particular. Of the 37 studies included in the systematic review, only very few include cost and outcome categories discussed as being of specific relevance to the assessment of health promotion interventions for older people. The few studies that consider these aspects use very heterogeneous methods, thus there is no common methodological standard. There is a strong need for the development of guidelines to achieve better comparability and to include cost categories and outcomes that are relevant for older people. Disregarding these methodological obstacles could implicitly lead to discrimination against the elderly in terms of health promotion and disease prevention and, hence, an age-based rationing of public health care.

An open access database for the evaluation of heart sound algorithms.

PubMed

Liu, Chengyu; Springer, David; Li, Qiao; Moody, Benjamin; Juan, Ricardo Abad; Chorro, Francisco J; Castells, Francisco; Roig, José Millet; Silva, Ikaro; Johnson, Alistair E W; Syed, Zeeshan; Schmidt, Samuel E; Papadaniil, Chrysa D; Hadjileontiadis, Leontios; Naseri, Hosein; Moukadem, Ali; Dieterlen, Alain; Brandt, Christian; Tang, Hong; Samieinasab, Maryam; Samieinasab, Mohammad Reza; Sameni, Reza; Mark, Roger G; Clifford, Gari D

2016-12-01

In the past few decades, analysis of heart sound signals (i.e. the phonocardiogram or PCG), especially for automated heart sound segmentation and classification, has been widely studied and has been reported to have the potential value to detect pathology accurately in clinical applications. However, comparative analyses of algorithms in the literature have been hindered by the lack of high-quality, rigorously validated, and standardized open databases of heart sound recordings. This paper describes a public heart sound database, assembled for an international competition, the PhysioNet/Computing in Cardiology (CinC) Challenge 2016. The archive comprises nine different heart sound databases sourced from multiple research groups around the world. It includes 2435 heart sound recordings in total collected from 1297 healthy subjects and patients with a variety of conditions, including heart valve disease and coronary artery disease. The recordings were collected from a variety of clinical or nonclinical (such as in-home visits) environments and equipment. The length of recording varied from several seconds to several minutes. This article reports detailed information about the subjects/patients including demographics (number, age, gender), recordings (number, location, state and time length), associated synchronously recorded signals, sampling frequency and sensor type used. We also provide a brief summary of the commonly used heart sound segmentation and classification methods, including open source code provided concurrently for the Challenge. A description of the PhysioNet/CinC Challenge 2016, including the main aims, the training and test sets, the hand corrected annotations for different heart sound states, the scoring mechanism, and associated open source code are provided. In addition, several potential benefits from the public heart sound database are discussed.

Additive Manufacturing: Unlocking the Evolution of Energy Materials

PubMed Central

Zhakeyev, Adilet; Wang, Panfeng; Shu, Wenmiao; Wang, Huizhi

2017-01-01

Abstract The global energy infrastructure is undergoing a drastic transformation towards renewable energy, posing huge challenges on the energy materials research, development and manufacturing. Additive manufacturing has shown its promise to change the way how future energy system can be designed and delivered. It offers capability in manufacturing complex 3D structures, with near‐complete design freedom and high sustainability due to minimal use of materials and toxic chemicals. Recent literatures have reported that additive manufacturing could unlock the evolution of energy materials and chemistries with unprecedented performance in the way that could never be achieved by conventional manufacturing techniques. This comprehensive review will fill the gap in communicating on recent breakthroughs in additive manufacturing for energy material and device applications. It will underpin the discoveries on what 3D functional energy structures can be created without design constraints, which bespoke energy materials could be additively manufactured with customised solutions, and how the additively manufactured devices could be integrated into energy systems. This review will also highlight emerging and important applications in energy additive manufacturing, including fuel cells, batteries, hydrogen, solar cell as well as carbon capture and storage. PMID:29051861

Additive Manufacturing: Unlocking the Evolution of Energy Materials.

PubMed

Zhakeyev, Adilet; Wang, Panfeng; Zhang, Li; Shu, Wenmiao; Wang, Huizhi; Xuan, Jin

2017-10-01

The global energy infrastructure is undergoing a drastic transformation towards renewable energy, posing huge challenges on the energy materials research, development and manufacturing. Additive manufacturing has shown its promise to change the way how future energy system can be designed and delivered. It offers capability in manufacturing complex 3D structures, with near-complete design freedom and high sustainability due to minimal use of materials and toxic chemicals. Recent literatures have reported that additive manufacturing could unlock the evolution of energy materials and chemistries with unprecedented performance in the way that could never be achieved by conventional manufacturing techniques. This comprehensive review will fill the gap in communicating on recent breakthroughs in additive manufacturing for energy material and device applications. It will underpin the discoveries on what 3D functional energy structures can be created without design constraints, which bespoke energy materials could be additively manufactured with customised solutions, and how the additively manufactured devices could be integrated into energy systems. This review will also highlight emerging and important applications in energy additive manufacturing, including fuel cells, batteries, hydrogen, solar cell as well as carbon capture and storage.

The Challenge of Efflux-Mediated Antibiotic Resistance in Gram-Negative Bacteria

PubMed Central

Plésiat, Patrick

2015-01-01

SUMMARY The global emergence of multidrug-resistant Gram-negative bacteria is a growing threat to antibiotic therapy. The chromosomally encoded drug efflux mechanisms that are ubiquitous in these bacteria greatly contribute to antibiotic resistance and present a major challenge for antibiotic development. Multidrug pumps, particularly those represented by the clinically relevant AcrAB-TolC and Mex pumps of the resistance-nodulation-division (RND) superfamily, not only mediate intrinsic and acquired multidrug resistance (MDR) but also are involved in other functions, including the bacterial stress response and pathogenicity. Additionally, efflux pumps interact synergistically with other resistance mechanisms (e.g., with the outer membrane permeability barrier) to increase resistance levels. Since the discovery of RND pumps in the early 1990s, remarkable scientific and technological advances have allowed for an in-depth understanding of the structural and biochemical basis, substrate profiles, molecular regulation, and inhibition of MDR pumps. However, the development of clinically useful efflux pump inhibitors and/or new antibiotics that can bypass pump effects continues to be a challenge. Plasmid-borne efflux pump genes (including those for RND pumps) have increasingly been identified. This article highlights the recent progress obtained for organisms of clinical significance, together with methodological considerations for the characterization of MDR pumps. PMID:25788514

The challenge of ubiquitous computing in health care: technology, concepts and solutions. Findings from the IMIA Yearbook of Medical Informatics 2005.

PubMed

Bott, O J; Ammenwerth, E; Brigl, B; Knaup, P; Lang, E; Pilgram, R; Pfeifer, B; Ruderich, F; Wolff, A C; Haux, R; Kulikowski, C

2005-01-01

To review recent research efforts in the field of ubiquitous computing in health care. To identify current research trends and further challenges for medical informatics. Analysis of the contents of the Yearbook on Medical Informatics 2005 of the International Medical Informatics Association (IMIA). The Yearbook of Medical Informatics 2005 includes 34 original papers selected from 22 peer-reviewed scientific journals related to several distinct research areas: health and clinical management, patient records, health information systems, medical signal processing and biomedical imaging, decision support, knowledge representation and management, education and consumer informatics as well as bioinformatics. A special section on ubiquitous health care systems is devoted to recent developments in the application of ubiquitous computing in health care. Besides additional synoptical reviews of each of the sections the Yearbook includes invited reviews concerning E-Health strategies, primary care informatics and wearable healthcare. Several publications demonstrate the potential of ubiquitous computing to enhance effectiveness of health services delivery and organization. But ubiquitous computing is also a societal challenge, caused by the surrounding but unobtrusive character of this technology. Contributions from nearly all of the established sub-disciplines of medical informatics are demanded to turn the visions of this promising new research field into reality.

Ethical Challenges of Randomized Violence Intervention Trials: Examining the SHARE intervention in Rakai, Uganda

PubMed Central

Wagman, Jennifer A.; Paul, Amy; Namatovu, Fredinah; Ssekubugu, Robert; Nalugoda, Fred

2016-01-01

Objective We identify complexities encountered, including unanticipated crossover between trial arms and inadequate ‘standard of care’ violence services, during a cluster randomized trial (CRT) of a community-level intimate partner violence (IPV) and HIV prevention intervention in Uganda. Methods Concepts in public health ethics - beneficence, social value of research, fairness, standard of care, and researcher responsibilities for post-trial benefits - are used to critically reflect on lessons learned and guide discussion on practical and ethical challenges of violence intervention CRTs. Results Existing ethical guidelines provide incomplete guidance for responding to unexpected crossover in CRTs providing IPV services. We struggled to balance duty of care with upholding trial integrity, and identifying and providing appropriate standard of care. While we ultimately offered short-term IPV services to controls, we faced additional challenges related to sustaining services beyond the ‘short-term’ and post-trial. Conclusion Studies evaluating community-level violence interventions, including those combined with HIV reduction strategies, are limited yet critical for developing evidence-based approaches for effectively preventing IPV. Although CRTs are a promising design, further guidance is needed to implement trials that avoid introducing tensions between validity of findings, researchers’ responsibilities to protect participants, and equitable distribution of CRT benefits. PMID:27453794

Emerging issues, challenges, and changing epidemiology of fungal disease outbreaks.

PubMed

Benedict, Kaitlin; Richardson, Malcolm; Vallabhaneni, Snigdha; Jackson, Brendan R; Chiller, Tom

2017-12-01

Several high-profile outbreaks have drawn attention to invasive fungal infections (IFIs) as an increasingly important public health problem. IFI outbreaks are caused by many different fungal pathogens and are associated with numerous settings and sources. In the community, IFI outbreaks often occur among people without predisposing medical conditions and are frequently precipitated by environmental disruption. Health-care-associated IFI outbreaks have been linked to suboptimal hospital environmental conditions, transmission via health-care workers' hands, contaminated medical products, and transplantation of infected organs. Outbreak investigations provide important insights into the epidemiology of IFIs, uncover risk factors for infection, and identify opportunities for preventing similar events in the future. Well recognised challenges with IFI outbreak recognition, response, and prevention include the need for improved rapid diagnostic methods, the absence of routine surveillance for most IFIs, adherence to infection control practices, and health-care provider awareness. Additionally, IFI outbreak investigations have revealed several emerging issues, including new populations at risk because of travel or relocation, occupation, or immunosuppression; fungal pathogens appearing in geographical areas in which they have not been previously recognised; and contaminated compounded medications. This report highlights notable IFI outbreaks in the past decade, with an emphasis on these emerging challenges in the USA. Copyright © 2017 Elsevier Ltd. All rights reserved.

[Evaluative designs in public health: methodological considerations].

PubMed

López, Ma José; Marí-Dell'Olmo, Marc; Pérez-Giménez, Anna; Nebot, Manel

2011-06-01

Evaluation of public health interventions poses numerous methodological challenges. Randomization of individuals is not always feasible and interventions are usually composed of multiple factors. To face these challenges, certain elements, such as the selection of the most appropriate design and the use of a statistical analysis that includes potential confounders, are essential. The objective of this article was to describe the most frequently used designs in the evaluation of public health interventions (policies, programs or campaigns). The characteristics, strengths and weaknesses of each of these evaluative designs are described. Additionally, a brief explanation of the most commonly used statistical analysis in each of these designs is provided. Copyright © 2011 Sociedad Española de Salud Pública y Administración Sanitaria. Published by Elsevier Espana. All rights reserved.

The storybook method: research feedback with young participants.

PubMed

Anderson, Kate; Balandin, Susan

2011-12-01

Children are valuable informants for social research; however, their participation presents additional ethical and practical challenges. Of these challenges, feedback to verify the researchers' interpretations drawn from children's data, and the dissemination of project findings to young participants, have proven difficult to overcome. In this paper, we outline the Storybook method, an approach to feedback in research with young children. In the example study, illustrations, interactive pop-ups, and third-person disclosure were used to aid children aged 7-9 years to overcome the power imbalance in interviews with adults. The Storybook method facilitated active participation in the validation process. Potential modifications of the method for use with older populations, including adults with intellectual disabilities, complex communication needs, and those requiring alternate access to written texts, are also explored.

Modern Approaches for Asymmetric Construction of Carbon-Fluorine Quaternary Stereogenic Centers: Synthetic Challenges and Pharmaceutical Needs.

PubMed

Zhu, Yi; Han, Jianlin; Wang, Jiandong; Shibata, Norio; Sodeoka, Mikiko; Soloshonok, Vadim A; Coelho, Jaime A S; Toste, F Dean

2018-04-11

New methods for preparation of tailor-made fluorine-containing compounds are in extremely high demand in nearly every sector of chemical industry. The asymmetric construction of quaternary C-F stereogenic centers is the most synthetically challenging and, consequently, the least developed area of research. As a reflection of this apparent methodological deficit, pharmaceutical drugs featuring C-F stereogenic centers constitute less than 1% of all fluorine-containing medicines currently on the market or in clinical development. Here we provide a comprehensive review of current research activity in this area, including such general directions as asymmetric electrophilic fluorination via organocatalytic and transition-metal catalyzed reactions, asymmetric elaboration of fluorine-containing substrates via alkylations, Mannich, Michael, and aldol additions, cross-coupling reactions, and biocatalytic approaches.

Activating human genes with zinc finger proteins, transcription activator-like effectors and CRISPR/Cas9 for gene therapy and regenerative medicine.

PubMed

Gersbach, Charles A; Perez-Pinera, Pablo

2014-08-01

New technologies have recently been developed to control the expression of human genes in their native genomic context by engineering synthetic transcription factors that can be targeted to any DNA sequence. The ability to precisely regulate any gene as it occurs naturally in the genome provides a means to address a variety of diseases and disorders. This approach also circumvents some of the traditional challenges of gene therapy. In this editorial, we review the technologies that have enabled targeted human gene activation, including the engineering of transcription factors based on zinc finger proteins, transcription activator-like effectors and the CRISPR/Cas9 system. Additionally, we highlight examples in which these methods have been developed for therapeutic applications and discuss challenges and opportunities.

Accurately Diagnosing and Treating Borderline Personality Disorder

PubMed Central

Gentile, Julie P.; Correll, Terry L.

2010-01-01

The high prevalence of comorbid bipolar and borderline personality disorders and some diagnostic criteria similar to both conditions present both diagnostic and therapeutic challenges. This article delineates certain symptoms which, by careful history taking, may be attributed more closely to one of these two disorders. Making the correct primary diagnosis along with comorbid psychiatric conditions and choosing the appropriate type of psychotherapy and pharmacotherapy are critical steps to a patient's recovery. In this article, we will use a case example to illustrate some of the challenges the psychiatrist may face in diagnosing and treating borderline personality disorder. In addition, we will explore treatment strategies, including various types of therapy modalities and medication classes, which may prove effective in stabilizing or reducing a broad range of symptomotology associated with borderline personality disorder. PMID:20508805

Access and Costs: Recommendations for Title IV. Hearing on Examining Proposals Authorizing Funds for Title IV Student Aid Programs and Issues Relating to Access to Costs of Postsecondary Education of the Higher Education Act, Including S. 1036, To Revise Section 435 of the Higher Education Act To Allow for the Young Americans Bank and Similar Small, Nonprofit Organizations to Provide Additional Funds for Educational Programming, of the Committee on Labor and Human Resources. United States Senate, One Hundred Fifth Congress, First Session.

ERIC Educational Resources Information Center

Congress of the U.S., Washington, DC. Senate Committee on Labor and Human Resources.

This 10th and final hearing in a series related to the reauthorization of the Higher Education Act, focused on three specific areas: (1) the challenges posed by demographic changes in the college student population--nearly half of all students attend community colleges where the average age of students is 29; (2) the challenges and opportunities…

Systems biology solutions for biochemical production challenges.

PubMed

Hansen, Anne Sofie Lærke; Lennen, Rebecca M; Sonnenschein, Nikolaus; Herrgård, Markus J

2017-06-01

There is an urgent need to significantly accelerate the development of microbial cell factories to produce fuels and chemicals from renewable feedstocks in order to facilitate the transition to a biobased society. Methods commonly used within the field of systems biology including omics characterization, genome-scale metabolic modeling, and adaptive laboratory evolution can be readily deployed in metabolic engineering projects. However, high performance strains usually carry tens of genetic modifications and need to operate in challenging environmental conditions. This additional complexity compared to basic science research requires pushing systems biology strategies to their limits and often spurs innovative developments that benefit fields outside metabolic engineering. Here we survey recent advanced applications of systems biology methods in engineering microbial production strains for biofuels and -chemicals. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

Socio-economic and cultural vulnerabilities to cervical cancer and challenges faced by patients attending care at Tikur Anbessa Hospital: a cross sectional and qualitative study.

PubMed

Tadesse, Sara Kebede

2015-09-16

Cervical cancer is a leading cause of death among women in Ethiopia, affecting them at a time of their life when they are critical to social and economic stability. This study was mainly focused on assessing different socioeconomic and cultural related factors that make women vulnerable to cervical cancer and challenges women face in the process of diagnosis and treatment. To achieve the objective of the study both qualitative and quantitative methods were utilized.198 participants were enrolled in a cross- sectional survey and 10 in-depth interviews were conducted with patients in Tikur Anbessa Hospital. A consecutive sampling method was used to select participants in the survey while purposive sampling was employed to select participants in the qualitative design. For the population covered in the study, poverty along with other socio-cultural practices such as early marriage, high parity and to certain extent polygamy were identified as factors that increased the vulnerability of women to cervical cancer. In addition, the study has uncovered several challenges faced by cervical cancer patients in the diagnosis and treatment process. Three types of challenges that include, health care based, psychological and economic were identified. System and practitioner delay were found as the main hurdles within the variable of health care related challenges. What's more, the psychological challenges identified included, fear of recurrence, negative social attitude and distress associated with the side effects from treatments such as fecal & urinary leakage. Furthermore, inability of bearing costs related to treatment and accommodation were cited as the main economic challenges. The study showed various socio-economic and cultural vulnerabilities that expose women to cervical cancer and the challenges encountered by cervical cancer patients after their diagnosis. Addressing this issue largely lies in strengthening primary and secondary preventive mechanisms, providing public education about safer sex practices, family planning and eliminating cultural practices such as early marriage and polygamy in connection to cervical cancer. Furthermore, improving the diagnostic and treatment procedures and facilities is also a crucial component that needs due emphasis in the fight against cervical cancer.

Vancomycin Dosing in Obese Patients: Special Considerations and Novel Dosing Strategies.

PubMed

Durand, Cheryl; Bylo, Mary; Howard, Brian; Belliveau, Paul

2018-06-01

To review the literature regarding vancomycin pharmacokinetics in obese patients and strategies used to improve dosing in this population. PubMed, EMBASE (1974 to November 2017), and Google Scholar searches were conducted using the search terms vancomycin, obese, obesity, pharmacokinetics, strategy, and dosing. Additional articles were selected from reference lists of selected studies. Included articles were those published in English with a primary focus on vancomycin pharmacokinetic parameters in obese patients and practical vancomycin dosing strategies, clinical experiences, or challenges of dosing vancomycin in this population. Volume of distribution and clearance are the pharmacokinetic parameters that most often affect vancomycin dosing in obese patients; both are increased in this population. Challenges with dosing in obese patients include inconsistent and inadequate dosing, observations that the obese population may not be homogeneous, and reports of an increased likelihood of supratherapeutic trough concentrations. Investigators have revised and developed dosing and monitoring protocols to address these challenges. These approaches improved target trough attainment to varying degrees. Some of the vancomycin dosing approaches provided promising results in obese patients, but there were notable differences in methods used to develop these approaches, and sample sizes were small. Although some approaches can be considered for validation in individual institutions, further research is warranted. This may include validating approaches in larger populations with narrower obesity severity ranges, investigating target attainment in indication-specific target ranges, and evaluating the impact of different dosing weights and methods of creatinine clearance calculation.

The South African Experience of Conservation and Social Forestry Outreach Nurseries

NASA Astrophysics Data System (ADS)

Botha, Jenny; Witkowski, Ed T. F.; Cock, Jacklyn

2006-11-01

Outreach nurseries are favored conservation and social forestry tools globally, but, as with many integrated conservation and development programs (ICDPs), they do not always produce anticipated results. A synopsis of the experience of South African practitioners is provided in this study of 65 outreach nurseries. South African outreach nurseries frequently include financial objectives, creating additional challenges in simultaneously attaining conservation and socioeconomic goals. Progress was hindered by biophysical problems (e.g., lack of water, poor soils, etc.) as well as the harsh socioeconomic conditions facing most communities in which nurseries had been established. Attaining financial viability was challenging. Business management skills were often restricted, and few viability studies included adequate market research. Costs to community participants were usually high, and benefits were limited. Conservation objectives were frequently lost in the struggle to attain financial viability. The management of social processes also proved challenging. Although small scale and relatively straightforward compared with many ICDPs, nurseries usually require substantial institutional support, including a range of technical, business, and development services. Project time frames need to be reconsidered, as practitioners estimate that it takes 5-10 years for nurseries to start meeting objectives, and donors and implementing agencies often operate on 2-3-year project cycles. Detailed viability studies are essential, incorporating a social probe and an assessment of potential impacts of projects on community participants. Progress needs to be continuously evaluated to enable institutions and community participants to adapt to changing conditions as well as ensure that the spectrum of objectives are being achieved.

The South African experience of conservation and social forestry outreach nurseries.

PubMed

Botha, Jenny; Witkowski, Ed T F; Cock, Jacklyn

2006-11-01

Outreach nurseries are favored conservation and social forestry tools globally, but, as with many integrated conservation and development programs (ICDPs), they do not always produce anticipated results. A synopsis of the experience of South African practitioners is provided in this study of 65 outreach nurseries. South African outreach nurseries frequently include financial objectives, creating additional challenges in simultaneously attaining conservation and socioeconomic goals. Progress was hindered by biophysical problems (e.g., lack of water, poor soils, etc.) as well as the harsh socioeconomic conditions facing most communities in which nurseries had been established. Attaining financial viability was challenging. Business management skills were often restricted, and few viability studies included adequate market research. Costs to community participants were usually high, and benefits were limited. Conservation objectives were frequently lost in the struggle to attain financial viability. The management of social processes also proved challenging. Although small scale and relatively straightforward compared with many ICDPs, nurseries usually require substantial institutional support, including a range of technical, business, and development services. Project time frames need to be reconsidered, as practitioners estimate that it takes 5-10 years for nurseries to start meeting objectives, and donors and implementing agencies often operate on 2-3-year project cycles. Detailed viability studies are essential, incorporating a social probe and an assessment of potential impacts of projects on community participants. Progress needs to be continuously evaluated to enable institutions and community participants to adapt to changing conditions as well as ensure that the spectrum of objectives are being achieved.

Collaborative Orthopaedic Research Between and Within Institutions.

PubMed

Wolf, Brian R; Verma, Nikhil N; Spindler, Kurt P; Wright, Rick W

2017-02-15

Collaborative research is common in many medical disciplines; however, the field of orthopaedics has been relatively slow to adopt this type of research approach. Collaborative research efforts can occur between multiple institutions and, in some instances, may benefit from subspecialty society sponsorship. Collaborative research efforts between several research spheres within a single institution also can be advantageous. Collaborative research has many benefits, including a larger number of patients in studies, more power in the research, and better generalizability. In addition, collaborative research efforts allow resources to be pooled within and between institutions. The challenges of collaborative research include data management, funding, and the publication of manuscripts that have many authors.

Advancements in ocular drug delivery.

PubMed

Weiner, Alan L; Gilger, Brian C

2010-11-01

This review covers both noninvasive and invasive ophthalmic drug delivery systems that can have application to therapy of veterinary ophthalmic diseases. Noninvasive approaches include gel technologies, permeation enhancement via pro-drug development, solubilization agents and nanoparticle technologies, iontophoresis, microneedles, drug-eluting contact lenses and eye misters, and microdroplets. More invasive systems include both eroding implants and noneroding technologies that encompass diffusion based systems, active pumps, intraocular lenses, suprachoroidal drug delivery, and episcleral reservoirs. In addition to addressing the physiologic challenges of achieving the necessary duration of delivery, tissue targeting and patient compliance, the commercial development factors of biocompatibility, sterilization, manufacturability and long-term stability will be discussed. © 2010 American College of Veterinary Ophthalmologists.

Mindfulness-based cognitive therapy for depression: trends and developments.

PubMed

MacKenzie, Meagan B; Kocovski, Nancy L

2016-01-01

Mindfulness-based cognitive therapy (MBCT) was developed as a psychological intervention for individuals at risk of depressive relapse. Possible mechanisms of change for this intervention are in line with its theoretical underpinnings, and include increases in mindfulness and/or decreases in negative repetitive thoughts. This review provides an overview of current trends in MBCT research, including efficacy and questions regarding the specific effects of MBCT in light of recent comparisons with structurally equivalent control conditions, mechanisms of change, and moderators of treatment outcome. In addition, future directions are discussed, such as challenges with training an adequate number of therapists and disseminating this therapy.

Overview of the Altair Lunar Lander Thermal Control System Design

NASA Technical Reports Server (NTRS)

Stephan, Ryan A.

2010-01-01

NASA's Constellation Program has been developed to successfully return humans to the Lunar surface by 2020. The Constellation Program includes several different project offices including Altair, which is the next generation Lunar Lander. The planned Altair missions are very different than the Lunar missions accomplished during the Apollo era. These differences have resulted in a significantly different thermal control system architecture. The current paper will summarize the Altair mission architecture and the various operational phases. In addition, the derived thermal requirements will be presented. The paper will conclude with a brief description of the thermal control system designed to meet these unique and challenging thermal requirements.

Microencapsulated sorbic acid and pure botanicals affect Salmonella Typhimurium shedding in pigs: a close-up look from weaning to slaughter in controlled and field conditions.

PubMed

Grilli, Ester; Foresti, Fabio; Tugnoli, Benedetta; Fustini, Mattia; Zanoni, Maria G; Pasquali, Paolo; Callaway, Todd R; Piva, Andrea; Alborali, Giovanni L

2015-10-01

The aim of this study was to assess the efficacy of a combination of sorbic acid, thymol, and carvacrol in reducing the prevalence and shedding level of Salmonella Typhimurium in pigs either in a controlled challenge environment or in a production setting. In the first study, 24 weaned piglets were separated in 4 isolation units (6 piglets/isolation unit). Each unit received either a basal diet (no treatment) or a microencapsulated mixture of sorbic acid, thymol, and carvacrol at 1, 2, or 5 g/kg of feed. After 21 d, pigs were orally challenged with 6 log10 colony-forming units of Salmonella Typhimurium. Blood samples and feces from rectal ampullae were collected every week. On d56 of the study, pigs were euthanized and necropsied to collect intestinal contents (jejunum through colon) and ileocecal lymph nodes. Samples were analyzed for Salmonella Typhimurium and serological analysis was also conducted. In the second study, an all-in-all-out multisite pig farm that was positive for monophasic Salmonella Typhimurium was followed throughout a production cycle from weaning to slaughter. Pigs received either a basal diet or the basal diet including 5 g/kg of the microencapsulated additive. Environmental, fecal, and blood samples were collected monthly, and cecal contents and ileocecal lymph nodes were collected at slaughter to isolate and enumerate Salmonella. The results indicate that the additive at 5 g/kg tended to reduce Salmonella fecal prevalence in both a controlled challenge (p=0.07) and in production conditions (p=0.03). Nevertheless, the additive did not reduce the number of pigs seropositive for Salmonella, nor it reduced the Salmonella prevalence at slaughter. The data indicate that these additives are not effective alone but must be used in conjunction with appropriate containment measures at lairage in order to prevent reinfection in pigs and to reduce the number of pigs carrying Salmonella entering the food chain.

Multiple-level stakeholder engagement in malaria clinical trials: addressing the challenges of conducting clinical research in resource-limited settings.

PubMed

Mtove, George; Kimani, Joshua; Kisinza, William; Makenga, Geofrey; Mangesho, Peter; Duparc, Stephan; Nakalembe, Miriam; Phiri, Kamija S; Orrico, Russell; Rojo, Ricardo; Vandenbroucke, Pol

2018-03-22

Multinational clinical trials are logistically complex and require close coordination between various stakeholders. They must comply with global clinical standards and are accountable to multiple regulatory and ethical bodies. In resource-limited settings, it is challenging to understand how to apply global clinical standards to international, national, and local factors in clinical trials, making multiple-level stakeholder engagement an important element in the successful conduct of these clinical trials. During the planning and implementation of a large multinational clinical trial for intermittent preventive treatment of malaria in pregnancy in resource-limited areas of sub-Saharan Africa, we encountered numerous challenges, which required implementation of a range of engagement measures to ensure compliance with global clinical and regulatory standards. These challenges included coordination with ongoing global malaria efforts, heterogeneity in national regulatory structures, sub-optimal healthcare infrastructure, local practices and beliefs, and perspectives that view healthcare providers with undue trust or suspicion. In addition to engagement with international bodies, such as the World Health Organization, the Malaria in Pregnancy Consortium, the Steve Biko Centre for Bioethics, and the London School of Hygiene and Tropical Medicine, in order to address the challenges just described, Pfizer Inc. and Medicines for Malaria Venture (the "Sponsoring Entities" for these studies) and investigators liaised with national- and district-level stakeholders such as health ministers and regional/local community health workers. Community engagement measures undertaken by investigators included local meetings with community leaders to explain the research aims and answer questions and concerns voiced by the community. The investigators also engaged with family members of prospective trial participants in order to be sensitive to local practices and beliefs. Engagement with key stakeholders at international and national levels enabled the Sponsoring Entities to address challenges by aligning the study design with the requirements of health and regulatory agencies and to understand and address healthcare infrastructure needs prior to trial initiation. Local stakeholder engagement, including community members, study participants, and family enabled the investigators to address challenges by ensuring that study design and conduct were adapted to local considerations and ensuring accurate information about the study aims was shared with the public. ClinicalTrials.gov, ID: NCT01103063 . Registered on 7 April 2010.

Viscoelasticity of biofilms and their recalcitrance to mechanical and chemical challenges

PubMed Central

Peterson, Brandon W.; He, Yan; Ren, Yijin; Zerdoum, Aidan; Libera, Matthew R.; Sharma, Prashant K.; van Winkelhoff, Arie-Jan; Neut, Danielle; Stoodley, Paul; van der Mei, Henny C.; Busscher, Henk J.

2015-01-01

We summarize different studies describing mechanisms through which bacteria in a biofilm mode of growth resist mechanical and chemical challenges. Acknowledging previous microscopic work describing voids and channels in biofilms that govern a biofilms response to such challenges, we advocate a more quantitative approach that builds on the relation between structure and composition of materials with their viscoelastic properties. Biofilms possess features of both viscoelastic solids and liquids, like skin or blood, and stress relaxation of biofilms has been found to be a corollary of their structure and composition, including the EPS matrix and bacterial interactions. Review of the literature on viscoelastic properties of biofilms in ancient and modern environments as well as of infectious biofilms reveals that the viscoelastic properties of a biofilm relate with antimicrobial penetration in a biofilm. In addition, also the removal of biofilm from surfaces appears governed by the viscoelasticity of a biofilm. Herewith, it is established that the viscoelasticity of biofilms, as a corollary of structure and composition, performs a role in their protection against mechanical and chemical challenges. Pathways are discussed to make biofilms more susceptible to antimicrobials by intervening with their viscoelasticity, as a quantifiable expression of their structure and composition. PMID:25725015

Additive and Interactive Effects of Stimulus Degradation: No Challenge for CDP+

ERIC Educational Resources Information Center

Ziegler, Johannes C.; Perry, Conrad; Zorzi, Marco

2009-01-01

S. O'Malley and D. Besner (2008) showed that additive effects of stimulus degradation and word frequency in reading aloud occur in the presence of nonwords but not in pure word lists. They argued that this dissociation presents a major challenge to interactive computational models of reading aloud and claimed that no currently implemented model is…

Space Acquisitions: Some Programs Have Overcome Past Problems, but Challenges and Uncertainty Remain for the Future

DTIC Science & Technology

2015-04-29

are being conducted for the SpaceX Falcon 9 v1.1 launch system. In addition, in its fiscal year 2016 President’s Budget request, DOD requested funding...DOD expects SpaceX to be certified by June 2015. Additionally, the department has faced unexpected complications, such as challenges to its

Efficient Exploration of Membrane-Associated Phenomena at Atomic Resolution.

PubMed

Vermaas, Josh V; Baylon, Javier L; Arcario, Mark J; Muller, Melanie P; Wu, Zhe; Pogorelov, Taras V; Tajkhorshid, Emad

2015-06-01

Biological membranes constitute a critical component in all living cells. In addition to providing a conducive environment to a wide range of cellular processes, including transport and signaling, mounting evidence has established active participation of specific lipids in modulating membrane protein function through various mechanisms. Understanding lipid-protein interactions underlying these mechanisms at a sufficiently high resolution has proven extremely challenging, partly due to the semi-fluid nature of the membrane. In order to address this challenge computationally, multiple methods have been developed, including an alternative membrane representation termed highly mobile membrane mimetic (HMMM) in which lateral lipid diffusion has been significantly enhanced without compromising atomic details. The model allows for efficient sampling of lipid-protein interactions at atomic resolution, thereby significantly enhancing the effectiveness of molecular dynamics simulations in capturing membrane-associated phenomena. In this review, after providing an overview of HMMM model development, we will describe briefly successful application of the model to study a variety of membrane processes, including lipid-dependent binding and insertion of peripheral proteins, the mechanism of phospholipid insertion into lipid bilayers, and characterization of optimal tilt angle of transmembrane helices. We conclude with practical recommendations for proper usage of the model in simulation studies of membrane processes.

Sex offender registration and community notification: emerging legal and research issues.

PubMed

Logan, Wayne A

2003-06-01

Sex offender registration and community notification laws, now in effect nationwide, have inspired considerable controversy. This article examines the variety of legal challenges brought against the laws since the mid-1990s and surveys issues likely to receive judicial attention in the immediate future. The article also provides an overview of the limited empirical work done to date on registration and notification, and the major areas that warrant additional research, including, most notably, inquiry into efficacy, costs, and consequences.

Vaccines for Pseudomonas aeruginosa: a long and winding road.

PubMed

Priebe, Gregory P; Goldberg, Joanna B

2014-04-01

Despite the recognition of Pseudomonas aeruginosa as an opportunistic pathogen, no vaccine against this bacteria has come to market. This review describes the current state-of-the-art in vaccinology for this bacterium. This includes a discussion of those at risk for infection, the types of vaccines and the approaches for empirical and targeted antigen selection under development, as well as a perspective on where the field should go. In addition, the challenges in developing a vaccine for those individuals at risk are discussed.

Tinea cruris in children.

PubMed

Patel, Gopal A; Wiederkehr, Michael; Schwartz, Robert A

2009-09-01

Tinea cruris is an intensely pruritic fungal infection of the groin and adjacent skin. Also known as crotch rot and jock itch, it can be a troubling important entity that at times is a clinical, diagnostic, and therapeutic challenge. Predisposing factors include heat, humidity, and hyperhidrosis, common accompaniments of high school-aged athletes. Furthermore, obesity and diabetes mellitus, additional risk factors for tinea cruris, are reaching unprecedented levels in adolescents. Treatment options range from improving hygiene to topical antifungal agents and systemic antifungal agents, the latter with potentially dangerous side effects.

Challenges Surrounding the Injection and Arrival of Targets at LIFE Fusion Chamber Center

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

Miles, R; Spaeth, M; Manes, K

2010-12-01

IFE target designers must consider several engineering requirements in addition to the physics requirements for successful target implosion. These considerations include low target cost, high manufacturing throughput, the ability of the target to survive the injection into the fusion chamber and arrive in a condition and physical position consistent with proper laser-target interaction and ease of post-implosion debris removal. This article briefly describes these considerations for the Laser Inertial Fusion-based Energy (LIFE) targets currently being designed.

Linguistic and Cultural Challenges in Communication and Translation in US-Sponsored HIV Prevention Research in Emerging Economies

PubMed Central

2015-01-01

Linguistic and cultural differences can impede comprehension among potential research participants during the informed consent process, but how researchers and IRBs respond to these challenges in practice is unclear. We conducted in-depth interviews with 15 researchers, research ethics committee (REC) chairs and members from 8 different countries with emerging economies, involved in HIV-related research sponsored by HIV Prevention Trials Network (HPTN), regarding the ethical and regulatory challenges they face in this regard. In the interviews, problems with translating study materials often arose as major concerns. Four sets of challenges were identified concerning linguistic and cultural translations of informed consent documents and other study materials, related to the: (1) context, (2) process, (3) content and (4) translation of these documents. Host country contextual issues included low literacy rates, education (e.g., documents may need to be written below 5th grade reading level), and experiences with research, and different views of written documentation. Certain terms and concepts may not exist in other languages, or have additional connotations that back translations do not always reveal. Challenges arise because of not only the content of word-for-word, literal translation, but the linguistic form of the language, such as tone (e.g., appropriate forms of politeness vs. legalese, seen as harsh), syntax, manner of questions posed, and the concept of the consent); and the contexts of use affect meaning. Problems also emerged in bilateral communications – US IRBs may misunderstand local practices, or communicate insufficiently the reasons for their decisions to foreign RECs. In sum, these data highlight several challenges that have received little, if any, attention in past literature on translation of informed consent and study materials, and have crucial implications for improving practice, education, research and policy, suggesting several strategies, including needs for broader open-source multilingual lexicons, and more awareness of the complexities involved. PMID:26225759

Linguistic and Cultural Challenges in Communication and Translation in US-Sponsored HIV Prevention Research in Emerging Economies.

PubMed

Hanrahan, Donna; Sexton, Patrina; Hui, Katrina; Teitcher, Jennifer; Sugarman, Jeremy; London, Alex John; Barnes, Mark; Purpura, James; Klitzman, Robert

2015-01-01

Linguistic and cultural differences can impede comprehension among potential research participants during the informed consent process, but how researchers and IRBs respond to these challenges in practice is unclear. We conducted in-depth interviews with 15 researchers, research ethics committee (REC) chairs and members from 8 different countries with emerging economies, involved in HIV-related research sponsored by HIV Prevention Trials Network (HPTN), regarding the ethical and regulatory challenges they face in this regard. In the interviews, problems with translating study materials often arose as major concerns. Four sets of challenges were identified concerning linguistic and cultural translations of informed consent documents and other study materials, related to the: (1) context, (2) process, (3) content and (4) translation of these documents. Host country contextual issues included low literacy rates, education (e.g., documents may need to be written below 5th grade reading level), and experiences with research, and different views of written documentation. Certain terms and concepts may not exist in other languages, or have additional connotations that back translations do not always reveal. Challenges arise because of not only the content of word-for-word, literal translation, but the linguistic form of the language, such as tone (e.g., appropriate forms of politeness vs. legalese, seen as harsh), syntax, manner of questions posed, and the concept of the consent); and the contexts of use affect meaning. Problems also emerged in bilateral communications--US IRBs may misunderstand local practices, or communicate insufficiently the reasons for their decisions to foreign RECs. In sum, these data highlight several challenges that have received little, if any, attention in past literature on translation of informed consent and study materials, and have crucial implications for improving practice, education, research and policy, suggesting several strategies, including needs for broader open-source multilingual lexicons, and more awareness of the complexities involved.

Emerging Challenges and Opportunities for Education and Research in Weed Science

PubMed Central

Chauhan, Bhagirath S.; Matloob, Amar; Mahajan, Gulshan; Aslam, Farhena; Florentine, Singarayer K.; Jha, Prashant

2017-01-01

In modern agriculture, with more emphasis on high input systems, weed problems are likely to increase and become more complex. With heightened awareness of adverse effects of herbicide residues on human health and environment and the evolution of herbicide-resistant weed biotypes, a significant focus within weed science has now shifted to the development of eco-friendly technologies with reduced reliance on herbicides. Further, with the large-scale adoption of herbicide-resistant crops, and uncertain climatic optima under climate change, the problems for weed science have become multi-faceted. To handle these complex weed problems, a holistic line of action with multi-disciplinary approaches is required, including adjustments to technology, management practices, and legislation. Improved knowledge of weed ecology, biology, genetics, and molecular biology is essential for developing sustainable weed control practices. Additionally, judicious use of advanced technologies, such as site-specific weed management systems and decision support modeling, will play a significant role in reducing costs associated with weed control. Further, effective linkages between farmers and weed researchers will be necessary to facilitate the adoption of technological developments. To meet these challenges, priorities in research need to be determined and the education system for weed science needs to be reoriented. In respect of the latter imperative, closer collaboration between weed scientists and other disciplines can help in defining and solving the complex weed management challenges of the 21st century. This consensus will provide more versatile and diverse approaches to innovative teaching and training practices, which will be needed to prepare future weed science graduates who are capable of handling the anticipated challenges of weed science facing in contemporary agriculture. To build this capacity, mobilizing additional funding for both weed research and weed management education is essential. PMID:28928765

Emerging Challenges and Opportunities for Education and Research in Weed Science.

PubMed

Chauhan, Bhagirath S; Matloob, Amar; Mahajan, Gulshan; Aslam, Farhena; Florentine, Singarayer K; Jha, Prashant

2017-01-01

In modern agriculture, with more emphasis on high input systems, weed problems are likely to increase and become more complex. With heightened awareness of adverse effects of herbicide residues on human health and environment and the evolution of herbicide-resistant weed biotypes, a significant focus within weed science has now shifted to the development of eco-friendly technologies with reduced reliance on herbicides. Further, with the large-scale adoption of herbicide-resistant crops, and uncertain climatic optima under climate change, the problems for weed science have become multi-faceted. To handle these complex weed problems, a holistic line of action with multi-disciplinary approaches is required, including adjustments to technology, management practices, and legislation. Improved knowledge of weed ecology, biology, genetics, and molecular biology is essential for developing sustainable weed control practices. Additionally, judicious use of advanced technologies, such as site-specific weed management systems and decision support modeling, will play a significant role in reducing costs associated with weed control. Further, effective linkages between farmers and weed researchers will be necessary to facilitate the adoption of technological developments. To meet these challenges, priorities in research need to be determined and the education system for weed science needs to be reoriented. In respect of the latter imperative, closer collaboration between weed scientists and other disciplines can help in defining and solving the complex weed management challenges of the 21st century. This consensus will provide more versatile and diverse approaches to innovative teaching and training practices, which will be needed to prepare future weed science graduates who are capable of handling the anticipated challenges of weed science facing in contemporary agriculture. To build this capacity, mobilizing additional funding for both weed research and weed management education is essential.

Construction of a nontoxigenic Clostridium botulinum strain for food challenge studies.

PubMed

Bradshaw, Marite; Marshall, Kristin M; Heap, John T; Tepp, William H; Minton, Nigel P; Johnson, Eric A

2010-01-01

Clostridium botulinum produces the most poisonous natural toxin known and is a perennial concern to the food industry and to regulatory agencies due to the potential threat of food-borne botulism. To ensure the botulinal safety of foods, rigorous food challenge testing to validate food-processing conditions and food formulations has been routinely performed. Detection of the botulinum neurotoxin is performed by using a mouse bioassay and/or in vitro assays. There has been considerable interest by the food industry and regulatory agencies in minimizing or even replacing the use of animals in these challenge studies. In addition, due to stringent select-agent regulations, the testing of various foods using toxigenic C. botulinum strains requires facilities and personnel that are certified for work with this organism. For this purpose we propose to generate sets of nontoxigenic C. botulinum strains from proteolytic and nonproteolytic groups that differ from the wild-type strains only by their inability to produce botulinum neurotoxin. In this initial study we describe the generation of a nontoxigenic mutant of C. botulinum strain 62A using the ClosTron mutagenesis system by inserting a group II intron into the botulinum neurotoxin type A gene (bont/A). The mutant clones were nontoxigenic as determined by Western blots and mouse bioassays but showed physiological characteristics, including growth properties and sporulation, that were similar to those of the parent strain in laboratory media. Additional studies will be required to evaluate comparable characteristics in various food matrices. The availability of suitable nontoxigenic C. botulinum strains for food challenge studies will be beneficial for enhancing the botulinal safety of foods as well as increasing the biosafety of workers and may eliminate the use of laboratory animals.

Experiences of registered nurses who supervise international nursing students in the clinical and classroom setting: an integrative literature review.

PubMed

Newton, Louise; Pront, Leeanne; Giles, Tracey M

2016-06-01

To examine the literature reporting the experiences and perceptions of registered nurses who supervise international nursing students in the clinical and classroom setting. Nursing education relies on clinical experts to supervise students during classroom and clinical education, and the quality of that supervision has a significant impact on student development and learning. Global migration and internationalisation of nursing education have led to increasing numbers of registered nurses supervising international nursing students. However, a paucity of relevant literature limits our understanding of these experiences. An integrative literature review. Comprehensive database searches of CINAHL, Informit, PubMed, Journals@Ovid, Findit@flinders and Medline were undertaken. Screening of 179 articles resulted in 10 included for review. Appraisal and analysis using Whittemore and Knafl's (Journal of Advanced Nursing, 52, 2005, 546) five stage integrative review recommendations was undertaken. This review highlighted some unique challenges for registered nurses supervising international nursing students. Identified issues were, a heightened sense of responsibility, additional pastoral care challenges, considerable time investments, communication challenges and cultural differences between teaching and learning styles. It is possible that these unique challenges could be minimised by implementing role preparation programmes specific to international nursing student supervision. Further research is needed to provide an in-depth exploration of current levels of preparation and support to make recommendations for future practice, education and policy development. An awareness of the specific cultural learning needs of international nursing students is an important first step to the provision of culturally competent supervision for this cohort of students. There is an urgent need for education and role preparation for all registered nurses supervising international nursing students, along with adequate recognition of the additional time required to effectively supervise these students. © 2016 John Wiley & Sons Ltd.

Center for Electrocatalysis, Transport Phenomena, and Materials (CETM) for Innovative Energy Storage - Final Report

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

Soloveichik, Grigorii

2015-11-30

EFRC vision. The direct use of organic hydrides in fuel cells as virtual hydrogen carriers that generate stable organic molecules, protons, and electrons upon electro-oxidation and can be electrochemically charged by re-hydrogenating the oxidized carrier was the major focus of the Center for Electrocatalysis, Transport Phenomena and Materials for Innovative Energy Storage (EFRC-ETM). Compared to a hydrogen-on-demand design that includes thermal decomposition of organic hydrides in a catalytic reactor, the proposed approach is much simpler and does not require additional dehydrogenation catalysts or heat exchangers. Further, this approach utilizes the advantages of a flow battery (i.e., separation of power andmore » energy, ease of transport and storage of liquid fuels) with fuels that have system energy densities similar to current hydrogen PEM fuel cells. EFRC challenges. Two major EFRC challenges were electrocatalysis and transport phenomena. The electrocatalysis challenge addresses fundamental processes which occur at a single molecular catalyst (microscopic level) and involve electron and proton transfer between the hydrogen rich and hydrogen depleted forms of organic liquid fuel and the catalyst. To form stable, non-radical dehydrogenation products from the organic liquid fuel, it is necessary to ensure fast transport of at least two electrons and two protons (per double bond formation). The same is true for the reverse hydrogenation reaction. The transport phenomena challenge addresses transport of electrons to/from the electrocatalyst and the current collector as well as protons across the polymer membrane. Additionally it addresses prevention of organic liquid fuel, water and oxygen transport through the PEM. In this challenge, the transport of protons or molecules involves multiple sites or a continuum (macroscopic level) and water serves as a proton conducting medium for the majority of known sulfonic acid based PEMs. Proton transfer in the presence of prospective organic liquid fuels was studied. During EFRC program various types of electrocatalysts, classes of fuels, and membranes have been investigated.« less

2013 mask industry survey

NASA Astrophysics Data System (ADS)

Malloy, Matt

2013-09-01

A comprehensive survey was sent to merchant and captive mask shops to gather information about the mask industry as an objective assessment of its overall condition. 2013 marks the 12th consecutive year for this process. Historical topics including general mask profile, mask processing, data and write time, yield and yield loss, delivery times, maintenance, and returns were included and new topics were added. Within each category are multiple questions that result in a detailed profile of both the business and technical status of the mask industry. While each year's survey includes minor updates based on feedback from past years and the need to collect additional data on key topics, the bulk of the survey and reporting structure have remained relatively constant. A series of improvements is being phased in beginning in 2013 to add value to a wider audience, while at the same time retaining the historical content required for trend analyses of the traditional metrics. Additions in 2013 include topics such as top challenges, future concerns, and additional details in key aspects of mask masking, such as the number of masks per mask set per ground rule, minimum mask resolution shipped, and yield by ground rule. These expansions beyond the historical topics are aimed at identifying common issues, gaps, and needs. They will also provide a better understanding of real-life mask requirements and capabilities for comparison to the International Technology Roadmap for Semiconductors (ITRS).

Deep brain stimulation and ethics: perspectives from a multisite qualitative study of Canadian neurosurgical centers.

PubMed

Bell, Emily; Maxwell, Bruce; McAndrews, Mary Pat; Sadikot, Abbas; Racine, Eric

2011-12-01

Deep brain stimulation (DBS) is an approved neurosurgical intervention for motor disorders such as Parkinson disease. The emergence of psychiatric uses for DBS combined with the fact that it is an invasive and expensive procedure creates important ethical and social challenges in the delivery of care that need further examination. We endeavored to examine health care provider perspectives on ethical and social challenges encountered in DBS. Health care providers working in Canadian DBS surgery programs participated in a semistructured interview to identify and characterize ethical and social challenges of DBS. A content analysis of the interviews was conducted. Several key ethical issues, such as patient screening and resource allocation, were identified by members of neurosurgical teams. Providers described challenges in selecting patients for DBS on the basis of unclear evidence-based guidance regarding behavioral issues or cognitive criteria. Varied contexts of resource allocation, including some very challenging schemas, were also reported. In addition, the management of patients in the community was highlighted as a source of ethical and clinical complexity, given the need for coordinated long-term care. This study provides insights into the complexity of ethical challenges that providers face in the use of DBS across different neurosurgical centers. We propose actions for health care providers for the long-term care and postoperative monitoring of patients with DBS. More data on patient perspectives in DBS would complement the understanding of key challenges, as well as contribute to best practices, for patient selection, management, and resource allocation. Copyright © 2011 Elsevier Inc. All rights reserved.

Dissociation between history and challenge in patients with physical urticaria.

PubMed

Komarow, Hirsh D; Arceo, Sarah; Young, Michael; Nelson, Celeste; Metcalfe, Dean D

2014-01-01

Physical urticaria is a subtype of chronic urticaria induced by a physical stimulus. To evaluate the consistency between a history of physical urticaria and results of challenge testing. Seventy-six subjects, ages 3 to 77 years old, were referred with the diagnosis of a physical urticaria and were evaluated by using challenge testing directed toward the presenting diagnosis, yet included other stimuli based on history. The majority of subjects were tested to 3 or more stimuli, thus 294 provocation tests were performed. Fifty-seven subjects were surveyed for the status of their physical urticaria at least 1 year after initial evaluation. Of the 76 subjects with a positive history of a physical urticaria, 38% (n = 29) were challenge negative to the presenting diagnosis. Eight subjects within the challenge negative group reacted positively to additional testing, thus 28% (n = 21) remained negative to all challenge testing, which allowed discontinuation of medications and avoidance behavior. A negative challenge result was less likely with subjects who presented with cold-induced urticaria (25%), delayed pressure urticaria (25%), and dermatographism (29%), yet more common with cholinergic (65%) and solar urticaria (67%). A 1-year follow-up survey of 57 subjects was consistent with initial results. Nineteen of this subgroup were rechallenged for the presenting diagnosis, and the outcome was unchanged in 17 subjects and, in 2 subjects the urticaria had resolved. The diagnosis by history of a physical urticaria should be verified by testing whenever possible and particularly if the condition is judged as severe and thus requires both significant life-style changes and pharmacologic intervention. Published by Elsevier Inc.

Challenges to quantitative applications of Landsat observations for the urban thermal environment.

PubMed

Chen, Feng; Yang, Song; Yin, Kai; Chan, Paul

2017-09-01

Since the launch of its first satellite in 1972, the Landsat program has operated continuously for more than forty years. A large data archive collected by the Landsat program significantly benefits both the academic community and society. Thermal imagery from Landsat sensors, provided with relatively high spatial resolution, is suitable for monitoring urban thermal environment. Growing use of Landsat data in monitoring urban thermal environment is demonstrated by increasing publications on this subject, especially over the last decade. Urban thermal environment is usually delineated by land surface temperature (LST). However, the quantitative and accurate estimation of LST from Landsat data is still a challenge, especially for urban areas. This paper will discuss the main challenges for urban LST retrieval, including urban surface emissivity, atmospheric correction, radiometric calibration, and validation. In addition, we will discuss general challenges confronting the continuity of quantitative applications of Landsat observations. These challenges arise mainly from the scan line corrector failure of the Landsat 7 ETM+ and channel differences among sensors. Based on these investigations, the concerns are to: (1) show general users the limitation and possible uncertainty of the retrieved urban LST from the single thermal channel of Landsat sensors; (2) emphasize efforts which should be done for the quantitative applications of Landsat data; and (3) understand the potential challenges for the continuity of Landsat observation (i.e., thermal infrared) for global change monitoring, while several climate data record programs being in progress. Copyright © 2017. Published by Elsevier B.V.

Diplomatic Solutions to Additive Challenges

DTIC Science & Technology

Additive manufacturing (AM) technology, colloquially known as 3D printing , will bring significant benefits to society, but also poses great risks...regimes, are not sufficient to address the challenges presented by 3D printing technology. The DOS should evaluate and promote unconventional strategies...from printed weapons proliferation. Working with other nations to resolve the appropriate balance between development and security, and to promote norms

5 CFR 919.735 - Under what conditions do I get an additional opportunity to challenge the facts on which the...

Code of Federal Regulations, 2010 CFR

2010-01-01

... 5 Administrative Personnel 2 2010-01-01 2010-01-01 false Under what conditions do I get an additional opportunity to challenge the facts on which the suspension is based? 919.735 Section 919.735 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT (CONTINUED) CIVIL SERVICE REGULATIONS (CONTINUED) GOVERNMENTWIDE DEBARMENT AND SUSPENSION ...

5 CFR 919.830 - Under what conditions do I get an additional opportunity to challenge the facts on which a...

Code of Federal Regulations, 2010 CFR

2010-01-01

... 5 Administrative Personnel 2 2010-01-01 2010-01-01 false Under what conditions do I get an additional opportunity to challenge the facts on which a proposed debarment is based? 919.830 Section 919.830 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT (CONTINUED) CIVIL SERVICE REGULATIONS (CONTINUED) GOVERNMENTWIDE DEBARMENT AND SUSPENSION ...

Cultural Dimensions of Feedback at an Australian University: A Study of International Students with English as an Additional Language

ERIC Educational Resources Information Center

Warner, Richard; Miller, Julia

2015-01-01

International students with English as an additional language face transitional challenges when entering a new academic culture. One such challenge involves optimising feedback to help foster their academic development, bearing in mind that feedback is not a culturally neutral entity (Nazif, A., Biswas, D., & Hilbig, R. (2004-2005). Towards an…

Challenges associated with the implementation of the nursing process: A systematic review.

PubMed

Zamanzadeh, Vahid; Valizadeh, Leila; Tabrizi, Faranak Jabbarzadeh; Behshid, Mojghan; Lotfi, Mojghan

2015-01-01

Nursing process is a scientific approach in the provision of qualified nursing cares. However, in practice, the implementation of this process is faced with numerous challenges. With the knowledge of the challenges associated with the implementation of the nursing process, the nursing processes can be developed appropriately. Due to the lack of comprehensive information on this subject, the current study was carried out to assess the key challenges associated with the implementation of the nursing process. To achieve and review related studies on this field, databases of Iran medix, SID, Magiran, PUBMED, Google scholar, and Proquest were assessed using the main keywords of nursing process and nursing process systematic review. The articles were retrieved in three steps including searching by keywords, review of the proceedings based on inclusion criteria, and final retrieval and assessment of available full texts. Systematic assessment of the articles showed different challenges in implementation of the nursing process. Intangible understanding of the concept of nursing process, different views of the process, lack of knowledge and awareness among nurses related to the execution of process, supports of managing systems, and problems related to recording the nursing process were the main challenges that were extracted from review of literature. On systematically reviewing the literature, intangible understanding of the concept of nursing process has been identified as the main challenge in nursing process. To achieve the best strategy to minimize the challenge, in addition to preparing facilitators for implementation of nursing process, intangible understanding of the concept of nursing process, different views of the process, and forming teams of experts in nursing education are recommended for internalizing the nursing process among nurses.

Benefit of the basophil activation test in deciding when to reintroduce cow's milk in allergic children.

PubMed

Rubio, A; Vivinus-Nébot, M; Bourrier, T; Saggio, B; Albertini, M; Bernard, A

2011-01-01

Oral challenges are required to establish the persistence or resolution of IgE-mediated cow's milk allergy (CMA). Determining the appropriate timing for challenging is the main difficulty. The benefit of the basophil activation test (BAT) in predicting a child's reaction to the oral challenge was evaluated and compared to the specific IgE and skin prick tests' (SPT) results. One hundred and twelve consecutive children with CMA admitted for an oral challenge to reassess their allergy were included. Allergen-induced basophil activation was detected as a CD63-upregulation by flow cytometry. Thirty-six children (32%) had a positive oral challenge. The percentage of activated basophils in patients with a positive challenge (mean = 20.9; SD = 18.8) was significantly higher than that of patients with a negative challenge (mean = 3.9; SD = 9.8, P < 0.0001), and was well correlated with the eliciting dose of cow's milk (P < 0.0001). The BAT had an efficiency of 90%, a sensitivity of 91%, a specificity of 90%, and positive and negative predictive values of 81% and 96% in detecting persistently allergic patients. The area under the ROC curve was 0.866. These scores were higher than those obtained with SPT and IgE values, whichever positivity cut-point was chosen. Referring to a decisional algorithm combining BAT, specific IgE and SPT allowed the correct identification of 94% of patients as tolerant or persistently allergic to cow's milk proteins (CMP) in our cohort. The BAT could be a valuable tool in the management of paediatric CMA in addition to specific IgE quantification and SPT, by contributing in determining whether an oral challenge can safely be undertaken. © 2010 John Wiley & Sons A/S.

Challenges associated with the implementation of the nursing process: A systematic review

PubMed Central

Zamanzadeh, Vahid; Valizadeh, Leila; Tabrizi, Faranak Jabbarzadeh; Behshid, Mojghan; Lotfi, Mojghan

2015-01-01

Background: Nursing process is a scientific approach in the provision of qualified nursing cares. However, in practice, the implementation of this process is faced with numerous challenges. With the knowledge of the challenges associated with the implementation of the nursing process, the nursing processes can be developed appropriately. Due to the lack of comprehensive information on this subject, the current study was carried out to assess the key challenges associated with the implementation of the nursing process. Materials and Methods: To achieve and review related studies on this field, databases of Iran medix, SID, Magiran, PUBMED, Google scholar, and Proquest were assessed using the main keywords of nursing process and nursing process systematic review. The articles were retrieved in three steps including searching by keywords, review of the proceedings based on inclusion criteria, and final retrieval and assessment of available full texts. Results: Systematic assessment of the articles showed different challenges in implementation of the nursing process. Intangible understanding of the concept of nursing process, different views of the process, lack of knowledge and awareness among nurses related to the execution of process, supports of managing systems, and problems related to recording the nursing process were the main challenges that were extracted from review of literature. Conclusions: On systematically reviewing the literature, intangible understanding of the concept of nursing process has been identified as the main challenge in nursing process. To achieve the best strategy to minimize the challenge, in addition to preparing facilitators for implementation of nursing process, intangible understanding of the concept of nursing process, different views of the process, and forming teams of experts in nursing education are recommended for internalizing the nursing process among nurses. PMID:26257793

Introduction to the Special Issue: Interventions to Reduce Challenging Behavior Among Individuals With Autism Spectrum Disorder.

PubMed

Davis, Tonya N; Rispoli, Mandy

2018-05-01

The prevalence of autism spectrum disorder (ASD) is on the rise. In addition to the social communication skill deficits and restrictive repetitive behaviors and interests, many individuals with ASD engage in challenging behavior. Challenging behavior is associated with a multitude of negative outcomes. Challenging behavior may cause harm to the individual with ASD as well as limit opportunities for educational, vocational, and social participation and development. In addition, caregivers experience high stress and low quality of mental health. As a result, challenging behavior warrants intervention that is specifically tailored to the unique characteristics of individuals with ASD. The purpose of this Special Issue is to showcase recent research in the treatment of challenging behavior for individuals with ASD. This two-part Special Issue contains 12 studies that range from systematic and quality reviews of the intervention literature, to innovative treatment approaches, to studies that develop and evaluate treatments for restrictive and repetitive behaviors and interests.

The process of developing audiovisual patient information: challenges and opportunities.

PubMed

Hutchison, Catherine; McCreaddie, May

2007-11-01

The aim of this project was to produce audiovisual patient information, which was user friendly and fit for purpose. The purpose of the audiovisual patient information is to inform patients about randomized controlled trials, as a supplement to their trial-specific written information sheet. Audiovisual patient information is known to be an effective way of informing patients about treatment. User involvement is also recognized as being important in the development of service provision. The aim of this paper is (i) to describe and discuss the process of developing the audiovisual patient information and (ii) to highlight the challenges and opportunities, thereby identifying implications for practice. A future study will test the effectiveness of the audiovisual patient information in the cancer clinical trial setting. An advisory group was set up to oversee the project and provide guidance in relation to information content, level and delivery. An expert panel of two patients provided additional guidance and a dedicated operational team dealt with the logistics of the project including: ethics; finance; scriptwriting; filming; editing and intellectual property rights. Challenges included the limitations of filming in a busy clinical environment, restricted technical and financial resources, ethical needs and issues around copyright. There were, however, substantial opportunities that included utilizing creative skills, meaningfully involving patients, teamworking and mutual appreciation of clinical, multidisciplinary and technical expertise. Developing audiovisual patient information is an important area for nurses to be involved with. However, this must be performed within the context of the multiprofessional team. Teamworking, including patient involvement, is crucial as a wide variety of expertise is required. Many aspects of the process are transferable and will provide information and guidance for nurses, regardless of specialty, considering developing this format of patient information.

The benefits and challenges of using computer-assisted symptom assessments in oncology clinics: results of a qualitative assessment.

PubMed

Mark, Tami L; Johnson, Gina; Fortner, Barry; Ryan, Katheryn

2008-10-01

Developed for clinical use in oncology settings, the Patient Assessment, Care & Education (PACE) System is a computer technology tool designed to address the under-identification and treatment of chemotherapy-related symptoms. This system includes general core questions together with the Patient Care Monitor (PCM), a validated questionnaire that assesses patient-reported problems, six symptom burden indices, and one global quality of life index. The system automatically scores the PCM and generates a written report. The objective of this study was to assess the manner in which clinicians use this system and identify the benefits and challenges that oncology clinics may face when adopting this system. The study was part of a larger evaluation of the system that included standardized surveys and chart review. Sixteen providers (physicians, nurses, and physician assistants) at 13 community oncology clinics participated in a 30-minute interview. Responses were coded according to common phrases or concepts. Clinicians indicated that they use the system mainly for symptom assessment or review of systems. The most common benefits identified included the improved ability to identify under-reported symptoms, enhanced communication with patients; increased efficiency; and its ability to highlight patients' most bothersome symptoms. Challenges included patient burden from the frequent need to answer the questionnaires, issues with the wording and formatting of the screening questionnaire, and technical difficulties. In sum, these interviews suggest that electronic symptom assessments offer potential advantages in terms improving the integration of routine assessment of patients' symptoms and health-related quality of life into the daily flow of an oncology clinic. The approach should receive additional research and development attention.

Powder bed binder jet 3D printing of Inconel 718: Densification, microstructural evolution and challenges

DOE PAGES

Nandwana, Peeyush; Elliott, Amy M.; Siddel, Derek; ...

2017-01-03

Traditional manufacturing of Inconel 718 components from castings and thermomechanical processing routes involve extensive post processing and machining to attain the desired geometry. Additive manufacturing (AM) technologies including direct energy deposition (DED), selective laser melting (SLM), electron beam melting (EBM) and binder jet 3D printing (BJ3DP) can minimize scrap generation and reduce lead times. While there is extensive literature on the use of melting and solidification based AM technologies, there has been limited research on the use of binder jet 3D printing. In this paper, a brief review on binder jet additive manufacturing of Inconel 718 is presented. In addition,more » existing knowledge on sintering of Inconel 718 has been extended to binder jet 3D printing. We found that supersolidus liquid phase sintering (SLPS) is necessary to achieve full densification of Inconel 718. SLPS is sensitive to the feedstock chemistry that has a strong influence on the liquid volume fraction at the processing temperature. Based on these results, we discuss an empirical framework to determine the role of powder particle size and liquid volume fraction on sintering kinetics. In conclusion, the role of powder packing factor and binder saturation on microstructural evolution is discussed. The current challenges in the use of BJ3DP for fabrication of Inconel 718, as well as, extension to other metal systems, are presented.« less

Synthetic biology in space: considering the broad societal and ethical implications

NASA Astrophysics Data System (ADS)

Race, Margaret S.; Moses, Jacob; McKay, Christopher; Venkateswaran, Kasthuri J.

2012-02-01

Although the field of synthetic biology is still in its infancy, there are expectations for great advances in the coming decades, both on Earth and potentially in space. Promising applications for long duration space missions include a variety of biologically engineered products and biologically aided processes and technologies, which will undoubtedly be scrutinized for risks and benefits in the broad context of ethical, legal and social realms. By comparing and contrasting features of Earth-based and space-applied synthetic biology, it is possible to identify the likely similarities and differences, and to identify possible challenges ahead for space applications that will require additional research, both in the short and long terms. Using an analytical framework associated with synthetic biology and new technologies on Earth, this paper analyses the kinds of issues and concerns ahead, and identifies those areas where space applications may require additional examination. In general, while Earth- and space-based synthetic biology share many commonalities, space applications have additional challenges such as those raised by space microbiology and environmental factors, legal complications, planetary protection, lack of decision-making infrastructure(s), long duration human missions, terraforming and the possible discovery of extraterrestrial (ET) life. For synthetic biology, the way forward offers many exciting opportunities, but is not without legitimate concerns - for life, environments and society, both on Earth and beyond.

Disorders Related to Use of Psychoactive Substances in DSM-5: Changes and Challenges.

PubMed

Bhad, Roshan; Lal, Rakesh; Balhara, Yatan Pal Singh

2015-01-01

In the most recent edition of Diagnostic and Statistical Manual (DSM) that is DSM-5 many modifications have been made in substance use disorder section. These include changes in terminology; sections and categories; diagnostic criteria; threshold for diagnosis; severity; and specifier. Additionally, there have been certain additions and omissions from the earlier version. Critical evaluation of the changes made to the section on disorders related to use of psychoactive substances in India context has not been published so far. The current paper presents a critique of the changes made to the substance use disorder section in DSM-5. The rationale for these changes put forth by DSM-5 work group on substance related disorders have been discussed. Additionally, attempt has been made to highlight the possible future challenges consequent to the current nosological revision for substance use disorder category. Overall DSM-5 seems to be promising in fulfilling its goal of DSM-ICD harmonisation and movement towards an internationally compatible and practical diagnostic system for mental health disorders. It has increased the scope of addiction by inclusion of behavioural addiction. It has also tried to balance the categorical and dimensional approach to diagnosis. However, the real test of this newer edition of one of the most commonly used nosological systems will be during clinical care and research. This will help address the debatable issues regarding the changes that DSM-5 brings with it.

Economic evaluation of factorial randomised controlled trials: challenges, methods and recommendations

PubMed Central

Gray, Alastair

2017-01-01

Increasing numbers of economic evaluations are conducted alongside randomised controlled trials. Such studies include factorial trials, which randomise patients to different levels of two or more factors and can therefore evaluate the effect of multiple treatments alone and in combination. Factorial trials can provide increased statistical power or assess interactions between treatments, but raise additional challenges for trial‐based economic evaluations: interactions may occur more commonly for costs and quality‐adjusted life‐years (QALYs) than for clinical endpoints; economic endpoints raise challenges for transformation and regression analysis; and both factors must be considered simultaneously to assess which treatment combination represents best value for money. This article aims to examine issues associated with factorial trials that include assessment of costs and/or cost‐effectiveness, describe the methods that can be used to analyse such studies and make recommendations for health economists, statisticians and trialists. A hypothetical worked example is used to illustrate the challenges and demonstrate ways in which economic evaluations of factorial trials may be conducted, and how these methods affect the results and conclusions. Ignoring interactions introduces bias that could result in adopting a treatment that does not make best use of healthcare resources, while considering all interactions avoids bias but reduces statistical power. We also introduce the concept of the opportunity cost of ignoring interactions as a measure of the bias introduced by not taking account of all interactions. We conclude by offering recommendations for planning, analysing and reporting economic evaluations based on factorial trials, taking increased analysis costs into account. © 2017 The Authors. Statistics in Medicine published by John Wiley & Sons Ltd. PMID:28470760

Psychological stress during exercise: immunoendocrine and oxidative responses.

PubMed

Huang, Chun-Jung; Webb, Heather E; Evans, Ronald K; McCleod, Kelly A; Tangsilsat, Supatchara E; Kamimori, Gary H; Acevedo, Edmund O

2010-12-01

The purpose of this study was to examine the changes in catecholamines (epinephrine [EPI] and norepinephrine [NE]), interleukin-2 (IL-2) and a biomarker of oxidative stress (8-isoprostane) in healthy individuals who were exposed to a dual challenge (physical and psychological stress). Furthermore, this study also examined the possible relationships between catecholamines (NE and EPI) and 8-isoprostane and between IL-2 and 8-isoprostane following a combined physical and psychological challenge. Seven healthy male subjects completed two experimental conditions. The exercise-alone condition (EAC) consisted of cycling at 60% VO(2max) for 37 min, while the dual-stress condition (DSC) included 20 min of a mental challenge while cycling. DSC showed greater EPI and 8-isoprostane levels (significant condition by time interaction). NE and IL-2 revealed significant change across time in both conditions. In addition, following dual stress, EPI area-under-the-curve (AUC) demonstrated a positive correlation with NE AUC and IL-2 AUC. NE AUC was positively correlated with IL-2 AUC and peak 8-isoprostane, and peak IL-2 was positively correlated with peak 8-isoprostane in response to a dual stress. The potential explanation for elevated oxidative stress during dual stress may be through the effects of the release of catecholamines and IL-2. These findings may further provide the potential explanation that dual stress alters physiological homeostasis in many occupations including firefighting, military operations and law enforcement. A greater understanding of these responses to stress can assist in finding strategies (e.g. exercise training) to overcome the inherent psychobiological challenges associated with physically and mentally demanding professions.

Challenges of deploying nuclear energy for power generation in Malaysia

NASA Astrophysics Data System (ADS)

Jaafar, Mohd Zamzam; Nazaruddin, Nurul Huda; Lye, Jonathan Tan Thiam

2017-01-01

Under the 10th Malaysia Plan (2010-2015) and the Economic Transformation Programme (ETP), nuclear energy was identified as a potential long-term option to be explored for electricity generation in Peninsular Malaysia. The energy sector in Malaysia currently faces several concerns including depleting domestic gas supply which will affect security and reliability of supply as well as overdependance on fossil fuels - mainly gas and imported coal, and nuclear energy may offer a possible solution to these issues as well as global climate change concern. Pursuing the nuclear option, Malaysia Nuclear Power Corporation (MNPC) is undertaking a series of comprehensive studies to facilitate an informed Government decision on the matter. This paper aims to discuss the many challenges towards the peaceful use of nuclear energy for electricity generation in the context of the New Energy Policy 2010 to achieve a balanced and sustainable energy mix. This effort will continue in the 11th Malaysia Plan (2016-2020) with emphasis on implementing a comprehensive communications plan and public awareness programme for the potential use of nuclear energy in the future. In analysing the challenges for the development of nuclear energy in Malaysia, the traditional triple bottom line (TBL) framework for sustainability, encompassing economic, social and environmental objectives is utilized. An additional factor, technical, is also included in the analysis to provide a more holistic view. It is opined that the main challenges of developing nuclear energy for electricity generation in a newcomer country like Malaysia can be attributed primarily to domestic non-technical factors compared to the technical factor.

An update on pharmaceutical film coating for drug delivery.

PubMed

Felton, Linda A; Porter, Stuart C

2013-04-01

Pharmaceutical coating processes have generally been transformed from what was essentially an art form in the mid-twentieth century to a much more technology-driven process. This review article provides a basic overview of current film coating processes, including a discussion on polymer selection, coating formulation additives and processing equipment. Substrate considerations for pharmaceutical coating processes are also presented. While polymeric coating operations are commonplace in the pharmaceutical industry, film coating processes are still not fully understood, which presents serious challenges with current regulatory requirements. Novel analytical technologies and various modeling techniques that are being used to better understand film coating processes are discussed. This review article also examines the challenges of implementing process analytical technologies in coating operations, active pharmaceutical ingredients in polymer film coatings, the use of high-solids coating systems and continuous coating and other novel coating application methods.

An overview of LLNL high-energy short-pulse technology for advanced radiography of laser fusion experiments

NASA Astrophysics Data System (ADS)

Barty, C. P. J.; Key, M.; Britten, J.; Beach, R.; Beer, G.; Brown, C.; Bryan, S.; Caird, J.; Carlson, T.; Crane, J.; Dawson, J.; Erlandson, A. C.; Fittinghoff, D.; Hermann, M.; Hoaglan, C.; Iyer, A.; Jones, L., II; Jovanovic, I.; Komashko, A.; Landen, O.; Liao, Z.; Molander, W.; Mitchell, S.; Moses, E.; Nielsen, N.; Nguyen, H.-H.; Nissen, J.; Payne, S.; Pennington, D.; Risinger, L.; Rushford, M.; Skulina, K.; Spaeth, M.; Stuart, B.; Tietbohl, G.; Wattellier, B.

2004-12-01

The technical challenges and motivations for high-energy, short-pulse generation with NIF and possibly other large-scale Nd : glass lasers are reviewed. High-energy short-pulse generation (multi-kilojoule, picosecond pulses) will be possible via the adaptation of chirped pulse amplification laser techniques on NIF. Development of metre-scale, high-efficiency, high-damage-threshold final optics is a key technical challenge. In addition, deployment of high energy petawatt (HEPW) pulses on NIF is constrained by existing laser infrastructure and requires new, compact compressor designs and short-pulse, fibre-based, seed-laser systems. The key motivations for HEPW pulses on NIF is briefly outlined and includes high-energy, x-ray radiography, proton beam radiography, proton isochoric heating and tests of the fast ignitor concept for inertial confinement fusion.

Building a Road from Light to Energy

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

Li, Anton; Bilby, David; Barito, Adam

Representing the Center for Solar and Thermal Energy Conversion (CSTEC), this document is one of the entries in the Ten Hundred and One Word Challenge. As part of the challenge, the 46 Energy Frontier Research Centers were invited to represent their science in images, cartoons, photos, words and original paintings, but any descriptions or words could only use the 1000 most commonly used words in the English language, with the addition of one word important to each of the EFRCs and the mission of DOE energy. The mission of the Center for Solar and Thermal Energy Conversion (CSTEC) is tomore » design and to synthesize new materials for high efficiency photovoltaic (PV) and thermoelectric (TE) devices, predicated on new fundamental insights into equilibrium and non-equilibrium processes, including quantum phenomena, that occur in materials over various spatial and temporal scales.« less

Privacy preserving processing of genomic data: A survey.

PubMed

Akgün, Mete; Bayrak, A Osman; Ozer, Bugra; Sağıroğlu, M Şamil

2015-08-01

Recently, the rapid advance in genome sequencing technology has led to production of huge amount of sensitive genomic data. However, a serious privacy challenge is confronted with increasing number of genetic tests as genomic data is the ultimate source of identity for humans. Lately, privacy threats and possible solutions regarding the undesired access to genomic data are discussed, however it is challenging to apply proposed solutions to real life problems due to the complex nature of security definitions. In this review, we have categorized pre-existing problems and corresponding solutions in more understandable and convenient way. Additionally, we have also included open privacy problems coming with each genomic data processing procedure. We believe our classification of genome associated privacy problems will pave the way for linking of real-life problems with previously proposed methods. Copyright © 2015 Elsevier Inc. All rights reserved.

Cleaner Energy for Cars

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

Cropley, Cecelia

Representing the Center for Catalytic Hydrocarbon Functionalization (CCHF), this document is one of the entries in the Ten Hundred and One Word Challenge. As part of the challenge, the 46 Energy Frontier Research Centers were invited to represent their science in images, cartoons, photos, words and original paintings, but any descriptions or words could only use the 1000 most commonly used words in the English language, with the addition of one word important to each of the EFRCs and the mission of DOE: energy. The mission of CCHF is to develop, validate, and optimize new methods to rearrange the bondsmore » of hydrocarbons, implement enzymatic strategies into synthetic systems, and design optimal environments for catalysts that can be used to reversibly functionalize hydrocarbons, especially for more efficient use of natural gas including low temperature conversion to liquid fuels.« less

Vision-related research priorities and how to finance them.

PubMed

McCarty, Catherine A

2012-01-01

A number of organizations have employed a consultative process with the vision community to engage relevant parties in identifying needs and opportunities for vision research. The National Eye Institute in the US and the European Commission are currently undergoing consultation to develop priorities for vision research. Once these priorities have been established, the challenge will be to identify the resources to advance these research agendas. Success rates for Federal funding for research have decreased recently in the USA, UK, and Australia. Researchers should consider various potential funding sources for their research. The universal consideration for funding is that the reason for funding should align with the mission of the funding organization. In addition to Federal research organizations that fund investigator-initiated research, other potential funding sources include nongovernmental organizations, for-profit companies, individual philanthropy, and service organizations. In addition to aligning with organizational funding priorities, researchers need to consider turn-around time and total funds available including whether an organization will cover institutional indirect costs. Websites are useful tools to find information about organizations that fund research, including grant deadlines. Collaboration is encouraged.

Vision-related research priorities and how to finance them

PubMed Central

McCarty, Catherine A

2012-01-01

A number of organizations have employed a consultative process with the vision community to engage relevant parties in identifying needs and opportunities for vision research. The National Eye Institute in the US and the European Commission are currently undergoing consultation to develop priorities for vision research. Once these priorities have been established, the challenge will be to identify the resources to advance these research agendas. Success rates for Federal funding for research have decreased recently in the USA, UK, and Australia. Researchers should consider various potential funding sources for their research. The universal consideration for funding is that the reason for funding should align with the mission of the funding organization. In addition to Federal research organizations that fund investigator-initiated research, other potential funding sources include nongovernmental organizations, for-profit companies, individual philanthropy, and service organizations. In addition to aligning with organizational funding priorities, researchers need to consider turn-around time and total funds available including whether an organization will cover institutional indirect costs. Websites are useful tools to find information about organizations that fund research, including grant deadlines. Collaboration is encouraged. PMID:22944760

Do systematic reviews on pediatric topics need special methodological considerations?

PubMed

Farid-Kapadia, Mufiza; Askie, Lisa; Hartling, Lisa; Contopoulos-Ioannidis, Despina; Bhutta, Zulfiqar A; Soll, Roger; Moher, David; Offringa, Martin

2017-03-06

Systematic reviews are key tools to enable decision making by healthcare providers and policymakers. Despite the availability of the evidence based Preferred Reporting Items for Systematic reviews and Meta-Analysis (PRISMA-2009 and PRISMA-P 2015) statements that were developed to improve the transparency and quality of reporting of systematic reviews, uncertainty on how to deal with pediatric-specific methodological challenges of systematic reviews impairs decision-making in child health. In this paper, we identify methodological challenges specific to the design, conduct and reporting of pediatric systematic reviews, and propose a process to address these challenges. One fundamental decision at the outset of a systematic review is whether to focus on a pediatric population only, or to include both adult and pediatric populations. Both from the policy and patient care point of view, the appropriateness of interventions and comparators administered to pre-defined pediatric age subgroup is critical. Decisions need to be based on the biological plausibility of differences in treatment effects across the developmental trajectory in children. Synthesis of evidence from different trials is often impaired by the use of outcomes and measurement instruments that differ between trials and are neither relevant nor validated in the pediatric population. Other issues specific to pediatric systematic reviews include lack of pediatric-sensitive search strategies and inconsistent choices of pediatric age subgroups in meta-analyses. In addition to these methodological issues generic to all pediatric systematic reviews, special considerations are required for reviews of health care interventions' safety and efficacy in neonatology, global health, comparative effectiveness interventions and individual participant data meta-analyses. To date, there is no standard approach available to overcome this problem. We propose to develop a consensus-based checklist of essential items which researchers should consider when they are planning (PRISMA-PC-Protocol for Children) or reporting (PRISMA-C-reporting for Children) a pediatric systematic review. Available guidelines including PRISMA do not cover the complexity associated with the conduct and reporting of systematic reviews in the pediatric population; they require additional and modified standards for reporting items. Such guidance will facilitate the translation of knowledge from the literature to bedside care and policy, thereby enhancing delivery of care and improving child health outcomes.

The SEIS Experiment for the InSight mission: status and performance expectations

NASA Astrophysics Data System (ADS)

Mimoun, David; Lognonne, Philippe; Banerdt, W. Bruce; Laudet, Philippe; De Raucourt, Sébastien; IJpelaan, Frans; Kerjean, Laurent; Perez, Rene; Pont, Gabriel; Sylvestre-Baron, Annick; verdier, Nicolas; Denise, Robert; Feldman, Jason; Hurst, Ken; Klein, Kerry; Giardini, Domenico; Zweifel, Peter; Pike, W. Tom; Calcutt, Simon; Bramanti, Christina

2015-04-01

The Insight NASA Discovery mission, led by the Jet Propulsion Laboratory, will deploy in September 2016 a very broadband seismometer on the Mars surface, SEIS (Seismic Experiment for Interior Structure). It is a hybrid 3-axes instrument, which encloses 3 very broadband oblique sensors and 3 short period sensors. The sensor assembly and its wind and thermal shield will by deployed on the Mars surface from the Phoenix-like spacecraft by a robotic arm (IDS). The acquisition system will be hosted in the spacecraft warm electronics box, and connected to the deployed sensor assembly by a tether. The SEIS experiment is provided by CNES, the French Space Agency that makes the coordination of a wide consortium including IPGP of Paris (SEIS PI Institution), Imperial College of London, Oxford University, MPS of Göttingen, ETH of Zürich, ISAE from Toulouse and the Jet Propulsion Laboratory of Pasadena. In addition to the seismometer, the Insight payload will also include a suite of instruments complementary to the seismometer, such as a precision temperature sensor, a micro-barometer, a magnetometer and a wind sensor, making it the first geophysical multi-parameter station on another planet. A heat flow sensor and geodetic measurements will provide additional science measurements, in order to constrain the internal structure of Mars. Several challenges have been overcome to design and realize the planetary seismometer, which will exhibit a noise of about 10-9 m/s2/sqrt(Hz) in its seismic bandwidth bandwidth (0.01-1 Hz) for the very broadband component. These challenges include a very efficient insulation from the external temperature variations, and a finely crafted mechanical design to keep the extreme sensitivity of the seismometer, while allowing enough robustness for the harsh mechanical environment encountered during the launch and landing sequences. Also, specific attention has been paid to understanding the various environment contributions to the noise figure. A discussion will be presented, on how to understand the seismometer performance figure in a changing environment, and how to secure the mission science goals in the challenging environment of the Mars surface.

Coping and resilience among ethnoracial individuals experiencing homelessness and mental illness.

PubMed

Paul, Sayani; Corneau, Simon; Boozary, Tanya; Stergiopoulos, Vicky

2018-03-01

The multiple challenges that ethnoracial homeless individuals experiencing mental illness face are well documented. However, little is known about how this homeless subpopulation copes with the compounding stressors of racial discrimination, homelessness and mental illness. This study is an in-depth investigation of the personal perceived strengths, attitudes and coping behaviors of homeless adults of diverse ethnoracial backgrounds experiencing homelessness and mental illness in Toronto, Canada. Using qualitative methods, 36 in-depth semi-structured interviews were conducted to capture the perspectives of ethnoracial homeless participants with mental illness on coping and resilience. Transcripts were analyzed using thematic analysis. Similar to prior findings in the general homeless population, study participants recognized personal strengths and attitudes as great sources of coping and resilience, describing hope and optimism, self-esteem and confidence, insight into their challenges and spirituality as instrumental to overcoming current challenges. In addition, participants described several coping strategies, including seeking support from family, friends and professionals; socializing with peers; engaging in meaningful activities; distancing from overwhelming challenges; and finding an anchor. Findings suggest that homeless adults with mental illness from ethnoracial groups use similar coping strategies and sources of resilience with the general homeless population and highlight the need for existing services to foster hope, recognize and support individual coping strategies and sources of resilience of homeless individuals experiencing complex challenges.

Social determinants of health in selected slum areas in Jordan: challenges and policy directions.

PubMed

Ajlouni, Musa T

2016-01-01

The unplanned urbanization in Jordan has over time created many informal settlements "slums" around big cities as Amman, Zerka and Aqaba. The purpose of this study was to highlight the most common challenges related to social determinants of health in two selected slum areas in Amman and Aqaba and suggest policy directions and interventions to meet these challenges. In addition to a prestructured interview with all household heads living in the two slum sites, focus group meetings with a purposefully selected sample of 12 slum dwellers in each site were used to assess the structural and intermediary determinants of health as perceived by slum residents in the two study locations. The study found that slum residents in the two locations suffer from many challenges as severe poverty; unemployment; illiteracy and low education attainments; gender discrimination; insufficient and poor diet; social and official exclusion; unhealthy environment; lack of water supply, electricity and basic sanitation facilities; high prevalence of diseases; and insufficient and inappropriate health services. Specific policy directions to meet these challenges were recommended and grouped into three main clusters: social protection, social inclusion and empowerment. New plans and tools should be developed by local authorities in Jordan to understand, protect, include and empower those vulnerable people who are forced to live in these unhealthy and inhuman environments. Copyright © 2014 John Wiley & Sons, Ltd.

An Evaluation of ChalleNGe Graduates DOD Employability

DTIC Science & Technology

2018-01-22

initial reading and applied math TABE scores are more likely to complete ChalleNGe. In addition, those graduates who begin ChalleNGe with higher TABE...students arrive at ChalleNGe at low levels of reading comprehension, writing, and basic math ; they simply are not ready to acquire a second language...positive, long-term impacts for ChalleNGe graduates. Our previous work has shown that cadets with higher initial reading and applied math TABE scores are

Wholesome Nutrition: an example for a sustainable diet.

PubMed

von Koerber, Karl; Bader, Nadine; Leitzmann, Claus

2017-02-01

'Wholesome Nutrition' is a concept of sustainable nutrition that was developed at the University of Giessen in the 1980s. In this concept, health and the ecologic, economic, social and cultural dimensions of nutrition are equally important. In 1992 at the UN-Conference on Environment and Development in Rio de Janeiro the definition of 'Sustainable Development' comprised the dimensions environment, economy and society. Additionally to these three 'classical' dimensions of sustainability, we included 'health' as the fourth dimension because nutrition has far reaching effects on human health. The fifth dimension, 'culture', became part of the sustainability dialogue since many years; the respective cultural background influences food habits. Presently, mankind has to cope with huge global challenges such as poverty and food insecurity in low-income countries as well as climate change. Therefore the objective is to identify prospects for actions to respond to these global challenges. The concept of 'Sustainable Nutrition' analyses the food supply chain at all stages from input-production and primary production to processing, distribution, preparation, consumption and waste disposal. The present analysis leads to the following seven principles: preference of plant-based foods, organic foods, regional and seasonal products, preference of minimally processed foods, Fair Trade products, resource-saving housekeeping and enjoyable eating culture. This concept is based on holistic thinking and has the potential to reduce the global challenges in the field of nutrition. Scientists, stakeholders, multipliers and consumers are asked to consider environmental, economic, social and cultural aspects in addition to the biological (health) aspects.

Successes and challenges in a novel doctoral program in systems agriculture: a case example.

PubMed

Lust, D; Topliff, D; Deotte, R

2010-01-01

A doctoral program in Systems Agriculture was initiated at West Texas A&M University, Canyon, TX, in September, 2003. The stated objective of the program was "..to prepare leaders for the agricultural industry that are trained in a multidisciplinary, research-based curriculum that emphasizes a systems approach to problem solving". The program offers a single doctoral degree in Agriculture and accepts qualified students with a master's or professional degree in agricultural or related disciplines. Courses related to systems methodologies, leadership, agricultural economics, plant and soil science, and animal science are required. Additional program requirements include a systems research project and dissertation, leadership training, and written and oral exams. The program has exceeded enrollment and graduation targets, suggesting interest in this approach to a doctoral degree. Students have entered the program with M.S. backgrounds in education, traditional agricultural disciplines, veterinary medicine, business, and physics. Graduates have gained employment in industry, university teaching and research, government research/administration, and extension. Doctoral student projects in systems agriculture contributed to curriculum changes and to the conceptual framework adopted by a multi-state research group. Designing and teaching courses for students with diverse backgrounds has been challenging. Development of a common understanding of systems agriculture was identified by a third-party program review as an issue for faculty. Development and maintenance of program standards and administrative procedures posed additional challenges. Leadership, administrative support, and timely and continuing program assessment are suggested as necessary components for a nontraditional doctoral program.

Digitalizing historical high resolution water level data: Challenges and opportunities

NASA Astrophysics Data System (ADS)

Holinde, Lars; Hein, Hartmut; Barjenbruch, Ulrich

2017-04-01

Historical tide-gauge data offer the opportunities for determining variations in key characteristics for water level data and the analyses of past extreme events (storm surges). These information are important for calculating future trends and scenarios. But there are challenges involved due to the extensive effort needed to digitalize gauge sheets and quality control the resulting historical data. Based on these conditions, two main sources for inaccuracies in historical time series can be identified. First are several challenges due to the digitalization of the historical data, e.g. general quality of the sheets, multiple crossing lines of the observed water levels and additional comments on the sheet describing problems or additional information during the measurements. Second are problems during the measurements themselves. These can include the incorrect positioning of the sheets, trouble with the tide-gauge and maintenance. Errors resulting from these problems can be e.g. flat lines, discontinuities and outlier. Especially, the characterization of outliers has to be conducted carefully, to distinguish between real outliers and the appearance of extreme events. Methods for the quality control process involve the use of statistics, machine learning and neural networks. These will be described and applied to three different time series from tide gauge stations at the cost of Lower Saxony, Germany. Resulting difficulties and outcomes of the quality control process will be presented and explained. Furthermore, we will present a first glance at analyses for these time series.

Food safety systems in a small dairy factory: implementation, major challenges, and assessment of systems' performances.

PubMed

Cusato, Sueli; Gameiro, Augusto H; Corassin, Carlos H; Sant'ana, Anderson S; Cruz, Adriano G; Faria, José de Assis F; de Oliveira, Carlos Augusto F

2013-01-01

The present study describes the implementation of a food safety system in a dairy processing plant located in the State of São Paulo, Brazil, and the challenges found during the process. In addition, microbiological indicators have been used to assess system's implementation performance. The steps involved in the implementation of a food safety system included a diagnosis of the prerequisites, implementation of the good manufacturing practices (GMPs), sanitation standard operating procedures (SSOPs), training of the food handlers, and hazard analysis and critical control point (HACCP). In the initial diagnosis, conformity with 70.7% (n=106) of the items analyzed was observed. A total of 12 critical control points (CCPs) were identified: (1) reception of the raw milk, (2) storage of the raw milk, (3 and 4) reception of the ingredients and packaging, (5) milk pasteurization, (6 and 7) fermentation and cooling, (8) addition of ingredients, (9) filling, (10) storage of the finished product, (11) dispatching of the product, and (12) sanitization of the equipment. After implementation of the food safety system, a significant reduction in the yeast and mold count was observed (p<0.05). The main difficulties encountered for the implementation of food safety system were related to the implementation of actions established in the flow chart and to the need for constant training/adherence of the workers to the system. Despite this, the implementation of the food safety system was shown to be challenging, but feasible to be reached by small-scale food industries.

Potential drug delivery approaches for XFS-associated and XFS-associated glaucoma.

PubMed

Kulkarni, Shreya S; Kompella, Uday B

2014-01-01

Key tissue targets in treating exfoliation syndrome (XFS) and the associated glaucoma include lens, iris, and ciliary body, which produce the exfoliative material, and the trabecular meshwork, which may be impaired by the exfoliative material. In addition to antiglaucoma drug therapy, strategies for treating the disease include approaches for preventing formation of exfoliative material as well as those aimed at digesting exfoliative material. A variety of drug molecules including small molecules, protein drugs, and nucleic acids are potential candidates for treating XFS. Potential drug classes include antioxidants, lysyl oxidase-like 1 enhancers, antifibrotics, anti-inflammatory agents, proteases, and chaperones. However, the delivery of these agents to the target tissues in the anterior segment is hindered by protective static and dynamic barriers of the eye. Thus, unique drug delivery approaches are needed for each drug type (small molecules, proteins, and nucleic acids). In addition, there is a need for sustaining drug therapy for treating XFS, which can potentially be addressed by using nanoparticles, microparticles, implants, and contact lens delivery systems. This article provides an overview of drug delivery challenges and opportunities in treating XFS with the focus being on nanomedicines.

Rural Asthma: Current Understanding of Prevalence, Patterns, and Interventions for Children and Adolescents.

PubMed

Estrada, Robin Dawson; Ownby, Dennis R

2017-06-01

Asthma is the most common chronic illness of children and adolescents in the USA. While asthma has been understood to disproportionately affect urban dwellers, recent investigations have revealed rural pediatric asthma prevalence to be very similar to urban and to be more closely correlated with socioeconomic and environmental factors than geographic location or population density. Rural children experience factors unique to location that impact asthma development and outcomes, including housing quality, cigarette smoke exposure, and small/large-scale farming. Additionally, there are challenging barriers to appropriate asthma care that frequently are more severe for those living in rural areas, including insurance status, lack of primary care providers and pulmonary specialists, knowledge deficits (both patient and provider), and a lack of culturally tailored asthma interventions. Interventions designed to address rural pediatric asthma disparities are more likely to be successful when targeted to specific challenges, such as the use of school-based services or telemedicine to mitigate asthma care access issues. Continued research on understanding the complex interaction of specific rural environmental factors with host factors can inform future interventions designed to mitigate asthma disparities.

Mental health literacy as theory: current challenges and future directions.

PubMed

Spiker, Douglas A; Hammer, Joseph H

2018-02-13

Mental health literacy (MHL) is one increasingly researched factor thought to influence mental health behaviors. Researchers have argued for expanding the definition of MHL to include additional constructs, but no consensus has yet been reached on what constructs should be included as part of MHL. The purpose of this paper is to (i) elucidate how the expansion of the MHL construct has impeded the growth of MHL research and (ii) through the lens of construct and theory development, highlight how these challenges might be remedied. An inclusive search of the literature was undertaken to identify MHL studies. The principles of construct and theory development guided a critical analysis of MHL. The review of the literature found that MHL violates many principles of what constitutes an acceptable construct definition. To address these concerns, we proposed conceptualizing MHL as a theory and recommended principles of theory development that should be taken into consideration. A theory of MHL can guide future researchers to clearly delineate important constructs and their interrelationships. For practitioners, a theory of MHL can help inform how to improve MHL at both the individual and community level.

The 10th Annual Bioassays and Bioanalytical Method Development Conference.

PubMed

Ma, Mark; Tudan, Christopher; Koltchev, Dolly

2015-01-01

The 10th Annual Bioassays and Bioanalytical Method Development Conference was hosted in Boston, MA, USA on 20-22 October 2014. This meeting brought together scientists from the biopharmaceutical and life sciences industries, the regulatory agency and academia to share and discuss current trends in cell-based assays and bioanalysis, challenges and ideas for the future of the bioassays and bioanalytical method development. The experiences associated with new and innovative technologies were evaluated as well as their impact on the current bioassays methodologies and bioanalysis workflow, including quality, feasibility, outsourcing strategies and challenges, productivity and compliance. Several presentations were also provided by members of the US FDA, sharing both scientific and regulatory paradigms including a most recent update on the position of the FDA with specific aspects of the draft Bioanalytical Method Validation guidance following its review of the industry's responses. The meeting was jointly coincided with the 15th Annual Immunogenicity for Biotherapeutics meeting, allowing for attendees to also familiarize themselves with new and emerging approaches to overcome the effect of immunogenicity, in addition to investigative strategies.

Robotic cardiac surgery: an anaesthetic challenge.

PubMed

Wang, Gang; Gao, Changqing

2014-08-01

Robotic cardiac surgery with the da Vinci robotic surgical system offers the benefits of a minimally invasive procedure, including a smaller incision and scar, reduced risk of infection, less pain and trauma, less bleeding and blood transfusion requirements, shorter hospital stay and decreased recovery time. Robotic cardiac surgery includes extracardiac and intracardiac procedures. Extracardiac procedures are often performed on a beating heart. Intracardiac procedures require the aid of peripheral cardiopulmonary bypass via a minithoracotomy. Robotic cardiac surgery, however, poses challenges to the anaesthetist, as the obligatory one-lung ventilation (OLV) and CO2 insufflation may reduce cardiac output and increase pulmonary vascular resistance, potentially resulting in hypoxaemia and haemodynamic compromise. In addition, surgery requires appropriate positioning of specialised cannulae such as an endopulmonary vent, endocoronary sinus catheter, and endoaortic clamp catheter under the guidance of transoesophageal echocardiography. Therefore, cardiac anaesthetists should have a working knowledge of these systems, OLV and haemodynamic support. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Veterinary professional associates: does the profession's foresight include a mid-tier professional similar to physician assistants?

PubMed

Kogan, Lori R; Stewart, Sherry M

2009-01-01

The projected shortage of veterinarians has created a need to explore alternatives designed to meet society's future demands. A veterinary professional health care provider, similar to the human medical profession's physician assistant (PA), is one such alternative. To explore this option, this paper provides background information on the development of PAs, including the motivations behind the initiative and the history of the role's development. Rather than aiming for a persuasive appeal, the authors have written this article with the intent of fostering discussion. It is suggested that perhaps veterinary professional associates, modeled after PAs, could be employed to handle routine veterinary care and thereby allow veterinarians additional time to focus on the more demanding and challenging aspects of veterinary medicine. Perhaps a team approach, similar to the physician/PA team, could help the field of veterinary medicine to better serve both clients and patients. As veterinary medicine directs its attention toward the new challenges on the horizon, creative solutions will be needed. Perhaps some variation of a veterinary professional associate is worthy of future discussion.

Tiered analytics for purity assessment of macrocyclic peptides in drug discovery: Analytical consideration and method development.

PubMed

Qian Cutrone, Jingfang Jenny; Huang, Xiaohua Stella; Kozlowski, Edward S; Bao, Ye; Wang, Yingzi; Poronsky, Christopher S; Drexler, Dieter M; Tymiak, Adrienne A

2017-05-10

Synthetic macrocyclic peptides with natural and unnatural amino acids have gained considerable attention from a number of pharmaceutical/biopharmaceutical companies in recent years as a promising approach to drug discovery, particularly for targets involving protein-protein or protein-peptide interactions. Analytical scientists charged with characterizing these leads face multiple challenges including dealing with a class of complex molecules with the potential for multiple isomers and variable charge states and no established standards for acceptable analytical characterization of materials used in drug discovery. In addition, due to the lack of intermediate purification during solid phase peptide synthesis, the final products usually contain a complex profile of impurities. In this paper, practical analytical strategies and methodologies were developed to address these challenges, including a tiered approach to assessing the purity of macrocyclic peptides at different stages of drug discovery. Our results also showed that successful progression and characterization of a new drug discovery modality benefited from active analytical engagement, focusing on fit-for-purpose analyses and leveraging a broad palette of analytical technologies and resources. Copyright © 2017. Published by Elsevier B.V.

Researchers’ Perceptions of the Ethical Implications of Pharmacogenomics Research with Children

PubMed Central

Avard, D.; Silverstein, T.; Sillon, G.; Joly, Y.

2009-01-01

Background This paper presents the results of an exploratory qualitative study that assesses Canadian pediatric researchers’ perceptions of a pre-selected group of ethical issues raised by pharmacogenomics research with children. Methods As a pilot study, we conducted semi-structured telephone interviews with Canadian pediatric pharmacogenomic researchers. The interviews were guided by the following themes: (1) benefits and risks of inclusion, (2) the consent/assent process, and (3) the return of research results. Results Issues about assent, consent, risks and benefits, as well as the communication of results were addressed by the respondents. Some issues, such as the unique vulnerability of children, the long term privacy concerns associated with biobanking, additional core elements that need to be discussed and included in the consent/assent forms, as well as the challenges of communicating research results in a pediatric research were not explicitly identified by the respondents. Conclusion Further consideration should be given to address the ethical challenges of including children in pharmacogenomics research. This exploratory study indicates that further guidance is needed if children are to be protected and yet benefit from such research. PMID:19204423

Five-way smoking status classification using text hot-spot identification and error-correcting output codes.

PubMed

Cohen, Aaron M

2008-01-01

We participated in the i2b2 smoking status classification challenge task. The purpose of this task was to evaluate the ability of systems to automatically identify patient smoking status from discharge summaries. Our submission included several techniques that we compared and studied, including hot-spot identification, zero-vector filtering, inverse class frequency weighting, error-correcting output codes, and post-processing rules. We evaluated our approaches using the same methods as the i2b2 task organizers, using micro- and macro-averaged F1 as the primary performance metric. Our best performing system achieved a micro-F1 of 0.9000 on the test collection, equivalent to the best performing system submitted to the i2b2 challenge. Hot-spot identification, zero-vector filtering, classifier weighting, and error correcting output coding contributed additively to increased performance, with hot-spot identification having by far the largest positive effect. High performance on automatic identification of patient smoking status from discharge summaries is achievable with the efficient and straightforward machine learning techniques studied here.

Rural patients' experiences of the open disclosure of adverse events.

PubMed

Piper, Donella; Iedema, Rick; Bower, Kate

2014-08-01

To analyse rural patients' and their families' experiences of open disclosure and offer recommendations to improve disclosure in rural areas. Retrospective qualitative study based on a subset of 13 semistructured, in-depth interviews with rural patients from a larger dataset. The larger data set form a nationwide, multisite, retrospective-qualitative study that included 100 semistructured, in-depth interviews with 119 patients and family members who were involved in high-severity health care incidents and incident disclosure. The larger study is known as the '100 Patient Stories' study. Interviews were transcribed verbatim and analysed by one analyst (D.P.) for recurrent experiences and concerns. Acute care. A sub-set of 13 of the 100 participants from the '100 Patient Stories' study who identified as experiencing an adverse incident in a rural or regional area. Patients' and family members' perceptions and experiences of health care incident disclosure, as expressed in interviews. Rural patients and clinicians experience additional challenges to metropolitan patients and clinicians in their experiences of health care incidents. These additional barriers include: a lack of resources at small hospitals; delays in diagnosis and transfer; distance between services; and a lack of communication between providers. These challenges impact not only upon how patients and their families experience incidents, but also how open disclosure is implemented. This analysis of 13 of the 100 Patient Stories interviews provides guidance to rural health services on how to conduct open disclosure. © 2014 National Rural Health Alliance Inc.

Family-based treatment of eating disorders in adolescents: current insights

PubMed Central

Rienecke, Renee D

2017-01-01

Eating disorders are serious illnesses associated with significant morbidity and mortality. Family-based treatment (FBT) has emerged as an effective intervention for adolescents with anorexia nervosa, and preliminary evidence suggests that it may be efficacious in the treatment of adolescents with bulimia nervosa. Multifamily therapy for anorexia nervosa provides a more intensive experience for families needing additional support. This review outlines the three phases of treatment, key tenets of family-based treatment, and empirical support for FBT. In addition, FBT in higher levels of care is described, as well as challenges in the implementation of FBT and recent adaptations to FBT, including offering additional support to eating-disorder caregivers. Future research is needed to identify families for whom FBT does not work, determine adaptations to FBT that may increase its efficacy, develop ways to improve treatment adherence among clinicians, and find ways to support caregivers better during treatment. PMID:28615982

Family-based treatment of eating disorders in adolescents: current insights.

PubMed

Rienecke, Renee D

2017-01-01

Eating disorders are serious illnesses associated with significant morbidity and mortality. Family-based treatment (FBT) has emerged as an effective intervention for adolescents with anorexia nervosa, and preliminary evidence suggests that it may be efficacious in the treatment of adolescents with bulimia nervosa. Multifamily therapy for anorexia nervosa provides a more intensive experience for families needing additional support. This review outlines the three phases of treatment, key tenets of family-based treatment, and empirical support for FBT. In addition, FBT in higher levels of care is described, as well as challenges in the implementation of FBT and recent adaptations to FBT, including offering additional support to eating-disorder caregivers. Future research is needed to identify families for whom FBT does not work, determine adaptations to FBT that may increase its efficacy, develop ways to improve treatment adherence among clinicians, and find ways to support caregivers better during treatment.

Challenges with the implementation of an Integrated Disease Surveillance and Response (IDSR) system: systematic review of the lessons learned.

PubMed

Phalkey, Revati K; Yamamoto, Shelby; Awate, Pradip; Marx, Michael

2015-02-01

Despite a realistic strategy and availability of resources, multiple challenges still overwhelm countries grappling with the challenges of communicable disease surveillance. The Integrated Disease Surveillance and Response (IDSR) strategy is by far the most pragmatic strategy in resource-poor settings. The objective of this study was to systematically review and document the lessons learned and the challenges identified with the implementation of the IDSR in low- and middle-income countries and to identify the main barriers that contribute to its sub-optimal functioning. A systematic review of literature published in English using Web of Knowledge, PubMed, and databases of the World Health Organization (WHO) and the Centers for Disease Control (CDC) between 1998 and 2012 was undertaken. Additionally, manual reference and grey literature searches were conducted. Citations describing core and support functions or the quality attributes of the IDSR as described by WHO and CDC were included in the review. Thirty-three assessment studies met the inclusion criteria. IDSR strategy has been best adopted and implemented in the WHO-AFRO region. Although significant progress is made in overcoming the challenges identified with vertical disease surveillance strategies, gaps still exist. Mixed challenges with core and support IDSR functions were observed across countries. Main issues identified include non-sustainable financial resources, lack of co-ordination, inadequate training and turnover of peripheral staff, erratic feedback, inadequate supervision from the next level, weak laboratory capacities coupled with unavailability of job aids (case definitions/reporting formats), and poor availability of communication and transport systems particularly at the periphery. Best outcomes in core functions and system attributes were reported when support surveillance functions performed optimally. Apart from technical and technological issues, human resources and the health care system structures that receive the IDSR determine its output. The challenges identified with IDSR implementation are largely 'systemic'. IDSR will best benefit from skill-based training of personnel and strengthening of the support surveillance functions alongside health care infrastructures at the district level. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine © The Author 2013; all rights reserved.

Challenges Involved in the Development and Delivery of Abuse-deterrent Formulations of Opioid Analgesics.

PubMed

Cohen, Joshua P; Mendoza, Mario; Roland, Carl

2018-02-01

This commentary examines the development, regulatory, and reimbursement challenges facing abuse-deterrent formulation (ADF) products. In January 2017, the Tufts Center for the Study of Drug Development convened a roundtable to explore clinical development, regulatory, and reimbursement challenges with respect to ADFs of opioid analgesics. Roundtable participants, who included a range of pharmaceutical industry and other experts, discussed multiple challenges. First, several key clinical development challenges were identified and discussed. These challenges pertain to prodrug development and development of deterrents against oral abuse. Second, experts suggested that more clarity is needed from regulatory authorities regarding standards for proving ADF labeling claims and for being rewarded with 3-year data exclusivity. Similarly, given the substantial burdens associated with the development of postapproval evidence generation, experts raised the need for a consistent regulatory policy related to postapproval evidence generation for all ADFs (branded and generic). Third, despite the public health benefits of certain ADF products, current coverage and access policies impede patient access. Payer justification for restrictive policies appears to be based more on budget impact considerations than cost-effectiveness. Fourth, there remains a need to further expand the evidence base regarding clinical and cost-effectiveness as well as abuse deterrence in a real-world setting for all ADF products. Clinical development challenges need to be overcome with respect to novel ADF technologies, such as prodrugs and deterrents against oral abuse. More clarity is needed from regulatory authorities on labeling claims and data exclusivity eligibility with respect to ADFs. Ensuring prescriber training and awareness of various options for treating pain, including ADF products, is an important step, as is educating payers about the public health benefits of ADFs in appropriate subpopulations of pain patients. In addition, physicians may need to incorporate appropriate risk stratification methods. Finally, it is important to establish a level playing field between coverage of ADF and non-ADF products so that non-ADF products are not given preferred formulary placement. Copyright © 2018 Elsevier HS Journals, Inc. All rights reserved.

The physiological and production effects of increased dietary intake of vitamins E and C in feedlot cattle challenged with bovine herpesvirus 1.

PubMed

Cusack, P M V; McMeniman, N P; Lean, I J

2005-10-01

The physiological and production effects of feeding additional vitamin E and ruminally protected vitamin C were examined in cattle challenged with bovine herpesvirus 1 (BHV 1). Forty-eight individually penned 6-mo-old Angus and Angus crossbred heifer calves with a mean BW of 151 kg were allocated randomly to four diets in a 2 x 2 factorial arrangement of treatments. Pelleted diets provided either 15 or 185 IU/kg of DM of vitamin E, with or without 3.7 g of ruminally protected vitamin C/kg of DM. Blood samples were taken at start of the experiment and at wk 4, 5, and 6. At the start of wk 5, half of each of the dietary groups was challenged with BHV 1. Feeding additional vitamin E was associated with greater (P < 0.001) mean plasma alpha-tocopherol. In contrast, feeding ruminally protected vitamin C was not associated with greater (P = 0.59) mean plasma ascorbate concentration; however, feeding ruminally protected vitamin C was associated with lower (P = 0.03) mean blood total superoxide dismutase (Cu/Zn SOD and Mn SOD) concentration. Calves fed additional vitamin E had greater (P = 0.05) mean plasma beta-carotene concentrations. There were interactions between dietary intake of vitamins E and C with respect to serum ceruloplasmin concentration (P = 0.01) and G:F (P = 0.05). Bovine herpesvirus 1 challenge was associated with lower white cell count (P = 0.007), lymphocyte count (P < 0.001), and DMI (P = 0.03). Feeding additional vitamin E to calves challenged with BHV 1 was associated with a lower (P = 0.03) serum ceruloplasmin concentration. There was a non-significant trend towards an interaction (P = 0.06) between the feeding of vitamins E and C, with virus-challenged calves fed additional vitamin E alone having greater plasma retinol concentrations. The feeding of vitamins E and/or C in calves challenged with BHV 1 was associated with alterations in the concentrations of other antioxidants. More severe disease may have translated these cellular effects to changes in health and performance.

ProteinTracker: an application for managing protein production and purification

PubMed Central

2012-01-01

Background Laboratories that produce protein reagents for research and development face the challenge of deciding whether to track batch-related data using simple file based storage mechanisms (e.g. spreadsheets and notebooks), or commit the time and effort to install, configure and maintain a more complex laboratory information management system (LIMS). Managing reagent data stored in files is challenging because files are often copied, moved, and reformatted. Furthermore, there is no simple way to query the data if/when questions arise. Commercial LIMS often include additional modules that may be paid for but not actually used, and often require software expertise to truly customize them for a given environment. Findings This web-application allows small to medium-sized protein production groups to track data related to plasmid DNA, conditioned media samples (supes), cell lines used for expression, and purified protein information, including method of purification and quality control results. In addition, a request system was added that includes a means of prioritizing requests to help manage the high demand of protein production resources at most organizations. ProteinTracker makes extensive use of existing open-source libraries and is designed to track essential data related to the production and purification of proteins. Conclusions ProteinTracker is an open-source web-based application that provides organizations with the ability to track key data involved in the production and purification of proteins and may be modified to meet the specific needs of an organization. The source code and database setup script can be downloaded from http://sourceforge.net/projects/proteintracker. This site also contains installation instructions and a user guide. A demonstration version of the application can be viewed at http://www.proteintracker.org. PMID:22574679

Selecting optimal second-generation antihistamines for allergic rhinitis and urticaria in Asia.

PubMed

Recto, Marysia Tiongco; Gabriel, Ma Teresita; Kulthanan, Kanokvalai; Tantilipikorn, Pongsakorn; Aw, Derrick Chen-Wee; Lee, Tak Hong; Chwen, Ch'ng Chin; Mutusamy, Somasundran; Hao, Nguyen Trong; Quang, Vo Thanh; Canonica, Giorgio Walter

2017-01-01

Allergic diseases are on the rise in many parts of the world, including the Asia-Pacific (APAC) region. Second-generation antihistamines are the first-line treatment option in the management of allergic rhinitis and urticaria. International guidelines describe the management of these conditions; however, clinicians perceive the additional need to tailor treatment according to patient profiles. This study serves as a consensus of experts from several countries in APAC (Hong Kong, Malaysia, the Philippines, Singapore, Thailand, Vietnam), which aims to describe the unmet needs, practical considerations, challenges, and key decision factors when determining optimal second-generation antihistamines for patients with allergic rhinitis and/or urticaria. Specialists from allergology, dermatology, and otorhinolaryngology were surveyed on practical considerations and key decision points when treating patients with allergic rhinitis and/or urticaria. Clinicians felt the need for additional tools for diagnosis of these diseases and a single drug with all preferred features of an antihistamine. Challenges in treatment include lack of clinician and patient awareness and compliance, financial constraints, and treatment for special patient populations such as those with concomitant disease. Selection of optimal second-generation antihistamines depends on many factors, particularly drug safety and efficacy, impact on psychomotor abilities, and sedation. Country-specific considerations include drug availability and cost-effectiveness. Survey results reveal bilastine as a preferred choice due to its high efficacy and safety, suitability for special patient populations, and the lack of sedative effects. Compliance to the international guidelines is present among allergists, dermatologists and otorhinolaryngologists; however, this is lower amongst general practitioners (GPs). To increase awareness, allergy education programs targeted at GPs and patients may be beneficial. Updates to the existing international guidelines are suggested in APAC to reflect appropriate management for different patient profiles and varying symptoms of allergic rhinitis and urticaria.

Intravenous hemostats: challenges in translation to patients

NASA Astrophysics Data System (ADS)

Lashof-Sullivan, Margaret; Shoffstall, Andrew; Lavik, Erin

2013-10-01

Excessive bleeding and the resulting complications are a leading killer of young people globally. There are many successful methods to halt bleeding in the extremities, including compression, tourniquets, and dressings. However, current treatments for internal hemorrhage (including from head or truncal injuries), termed non-compressible bleeding, are inadequate. For these non-compressible injuries, blood transfusions are the current treatment standard. However, they must be refrigerated, may potentially transfer disease, and are of limited supply. In addition, time is of the essence for halting hemorrhage, since more than a third of civilian deaths due to hemorrhage from trauma occur before the patient even reaches the hospital. As a result, particles that can cross-link activated platelets through the glycoprotein IIb/IIIa receptor expressed on activated platelets are being investigated as an alternative treatment for non-compressible bleeding. Ideally, these particles would interact specifically with platelets to stabilize the platelet plug. Initial designs used biologically derived microparticles with red blood cell fragment or albumin cores decorated with RGD or fibrinogen, which bind to GPIIb/IIIa. More recently there has been research into the use of fully synthetic nanoparticles with liposomal or polymer cores that crosslink platelets through a targeting peptide bound to the surface. Some of the challenges for the development of these particles include appropriate sizing to prevent blocking the capillaries of the lungs, immune system evasion to prevent strong reactions and increase circulation time, and storage and resuspension so that first responders can easily use the particles. In addition, the effectiveness of the variety of animal bleeding models in predicting outcomes must be examined before test results can be fully understood. Progress has been made in the development of particles to combat hemorrhage, but issues of immune sensitivity and storage must be resolved before these types of particles can be translated for human use.

Implementing new care models: learning from the Greater Manchester demonstrator pilot experience.

PubMed

Elvey, Rebecca; Bailey, Simon; Checkland, Kath; McBride, Anne; Parkin, Stephen; Rothwell, Katy; Hodgson, Damian

2018-06-19

Current health policy focuses on improving accessibility, increasing integration and shifting resources from hospitals to community and primary care. Initiatives aimed at achieving these policy aims have supported the implementation of various 'new models of care', including general practice offering 'additional availability' appointments during evenings and at weekends. In Greater Manchester, six 'demonstrator sites' were funded: four sites delivered additional availability appointments, other services included case management and rapid response. The aim of this paper is to explore the factors influencing the implementation of services within a programme designed to improve access to primary care. The paper consists of a qualitative process evaluation undertaken within provider organisations, including general practices, hospitals and care homes. Semi-structured interviews, with the data subjected to thematic analysis. Ninety-one people participated in interviews. Six key factors were identified as important for the establishment and running of the demonstrators: information technology; information governance; workforce and organisational development; communications and engagement; supporting infrastructure; federations and alliances. These factors brought to light challenges in the attempt to provide new or modify existing services. Underpinning all factors was the issue of trust; there was consensus amongst our participants that trusting relationships, particularly between general practices, were vital for collaboration. It was also crucial that general practices trusted in the integrity of anyone external who was to work with the practice, particularly if they were to access data on the practice computer system. A dialogical approach was required, which enabled staff to see themselves as active rather than passive participants. The research highlights various challenges presented by the context within which extended access is implemented. Trust was the fundamental underlying issue; there was consensus amongst participants that trusting relationships were vital for effective collaboration in primary care.

Clinical evaluation incorporating a personal genome

PubMed Central

Ashley, Euan A.; Butte, Atul J.; Wheeler, Matthew T.; Chen, Rong; Klein, Teri E.; Dewey, Frederick E.; Dudley, Joel T.; Ormond, Kelly E.; Pavlovic, Aleksandra; Hudgins, Louanne; Gong, Li; Hodges, Laura M.; Berlin, Dorit S.; Thorn, Caroline F.; Sangkuhl, Katrin; Hebert, Joan M.; Woon, Mark; Sagreiya, Hersh; Whaley, Ryan; Morgan, Alexander A.; Pushkarev, Dmitry; Neff, Norma F; Knowles, Joshua W.; Chou, Mike; Thakuria, Joseph; Rosenbaum, Abraham; Zaranek, Alexander Wait; Church, George; Greely, Henry T.; Quake, Stephen R.; Altman, Russ B.

2010-01-01

Background The cost of genomic information has fallen steeply but the path to clinical translation of risk estimates for common variants found in genome wide association studies remains unclear. Since the speed and cost of sequencing complete genomes is rapidly declining, more comprehensive means of analyzing these data in concert with rare variants for genetic risk assessment and individualisation of therapy are required. Here, we present the first integrated analysis of a complete human genome in a clinical context. Methods An individual with a family history of vascular disease and early sudden death was evaluated. Clinical assessment included risk prediction for coronary artery disease, screening for causes of sudden cardiac death, and genetic counselling. Genetic analysis included the development of novel methods for the integration of whole genome sequence data including 2.6 million single nucleotide polymorphisms and 752 copy number variations. The algorithm focused on predicting genetic risk of genes associated with known Mendelian disease, recognised drug responses, and pathogenicity for novel variants. In addition, since integration of risk ratios derived from case control studies is challenging, we estimated posterior probabilities from age and sex appropriate prior probability and likelihood ratios derived for each genotype. In addition, we developed a visualisation approach to account for gene-environment interactions and conditionally dependent risks. Findings We found increased genetic risk for myocardial infarction, type II diabetes and certain cancers. Rare variants in LPA are consistent with the family history of coronary artery disease. Pharmacogenomic analysis suggested a positive response to lipid lowering therapy, likely clopidogrel resistance, and a low initial dosing requirement for warfarin. Many variants of uncertain significance were reported. Interpretation Although challenges remain, our results suggest that whole genome sequencing can yield useful and clinically relevant information for individual patients, especially for those with a strong family history of significant disease. PMID:20435227

Magnetic resonance imaging of the fetal brain.

PubMed

Tee, L Mf; Kan, E Yl; Cheung, J Cy; Leung, W C

2016-06-01

This review covers the recent literature on fetal brain magnetic resonance imaging, with emphasis on techniques, advances, common indications, and safety. We conducted a search of MEDLINE for articles published after 2010. The search terms used were "(fetal OR foetal OR fetus OR foetus) AND (MR OR MRI OR [magnetic resonance]) AND (brain OR cerebral)". Consensus statements from major authorities were also included. As a result, 44 relevant articles were included and formed the basis of this review. One major challenge is fetal motion that is largely overcome by ultra-fast sequences. Currently, single-shot fast spin-echo T2-weighted imaging remains the mainstay for motion resistance and anatomical delineation. Recently, a snap-shot inversion recovery sequence has enabled robust T1-weighted images to be obtained, which is previously a challenge for standard gradient-echo acquisitions. Fetal diffusion-weighted imaging, diffusion tensor imaging, and magnetic resonance spectroscopy are also being developed. With multiplanar capabilities, superior contrast resolution and field of view, magnetic resonance imaging does not have the limitations of sonography, and can provide additional important information. Common indications include ventriculomegaly, callosum and posterior fossa abnormalities, and twin complications. There are safety concerns about magnetic resonance-induced heating and acoustic damage but current literature showed no conclusive evidence of deleterious fetal effects. The American College of Radiology guideline states that pregnant patients can be accepted to undergo magnetic resonance imaging at any stage of pregnancy if risk-benefit ratio to patients warrants that the study be performed. Magnetic resonance imaging of the fetal brain is a safe and powerful adjunct to sonography in prenatal diagnosis. It can provide additional information that aids clinical management, prognostication, and counselling.

Access and acceptability of community-based services for older Greek migrants in Australia: user and provider perspectives.

PubMed

Hurley, Catherine; Panagiotopoulos, Georgia; Tsianikas, Michael; Newman, Lareen; Walker, Ruth

2013-03-01

In most developed nations, ageing migrants represent a growing proportion of the older population. Policies that emphasise care in the community depend on older migrants having access to formal services along with informal support, yet little is known about how older migrants experience community-based formal services. By examining the views of both Greek elders in Australia and those of formal service providers, this research fills an important gap in the literature around access to and acceptability of formal community-based services for older migrants. A research team including two Greek background researchers used existing social groups and a snowball sampling method to conduct face-to-face interviews and focus groups with seventy older Greeks in Adelaide, Australia. In addition, 22 community-based service providers were interviewed over the telephone. Results from users and providers showed that while many older Greeks experience service access issues, they also relied heavily on family for support and assistance at home. Reliance on family was both in preference to formal services or where formal services were used, to locate, negotiate and monitor such services. Common barriers identified by both groups included cost, transport and availability, but additional challenges were posed by language, literacy and cultural attitudes. Demographic changes including greater employment mobility and female workforce participation among adult children will have implications for both formal and informal care providers. Formal service providers need to ensure that services are promoted and delivered to take account of the important role of family in informal support while also addressing the access challenges posed by language and literacy. Research conducted by researchers from the same cultural background in the respondent's native language can further advance knowledge in this area. © 2012 Blackwell Publishing Ltd.

Recommendations for Laboratory Containment and Management of Gene Drive Systems in Arthropods.

PubMed

Benedict, Mark Q; Burt, Austin; Capurro, Margareth L; De Barro, Paul; Handler, Alfred M; Hayes, Keith R; Marshall, John M; Tabachnick, Walter J; Adelman, Zach N

2018-01-01

Versatile molecular tools for creating driving transgenes and other invasive genetic factors present regulatory, ethical, and environmental challenges that should be addressed to ensure their safe use. In this article, we discuss driving transgenes and invasive genetic factors that can potentially spread after their introduction into a small proportion of individuals in a population. The potential of invasive genetic factors to increase their number in natural populations presents challenges that require additional safety measures not provided by previous recommendations regarding accidental release of arthropods. In addition to providing physical containment, invasive genetic factors require greater attention to strain management, including their distribution and identity confirmation. In this study, we focus on insects containing such factors with recommendations for investigators who are creating them, institutional biosafety committees charged with ensuring safety, funding agencies providing support, those managing insectaries handling these materials who are responsible for containment, and other persons who will be receiving insects-transgenic or not-from these facilities. We give specific examples of efforts to modify mosquitoes for mosquito-borne disease control, but similar considerations are relevant to other arthropods that are important to human health, the environment, and agriculture.

Improving homology modeling of G-protein coupled receptors through multiple-template derived conserved inter-residue interactions

NASA Astrophysics Data System (ADS)

Chaudhari, Rajan; Heim, Andrew J.; Li, Zhijun

2015-05-01

Evidenced by the three-rounds of G-protein coupled receptors (GPCR) Dock competitions, improving homology modeling methods of helical transmembrane proteins including the GPCRs, based on templates of low sequence identity, remains an eminent challenge. Current approaches addressing this challenge adopt the philosophy of "modeling first, refinement next". In the present work, we developed an alternative modeling approach through the novel application of available multiple templates. First, conserved inter-residue interactions are derived from each additional template through conservation analysis of each template-target pairwise alignment. Then, these interactions are converted into distance restraints and incorporated in the homology modeling process. This approach was applied to modeling of the human β2 adrenergic receptor using the bovin rhodopsin and the human protease-activated receptor 1 as templates and improved model quality was demonstrated compared to the homology model generated by standard single-template and multiple-template methods. This method of "refined restraints first, modeling next", provides a fast and complementary way to the current modeling approaches. It allows rational identification and implementation of additional conserved distance restraints extracted from multiple templates and/or experimental data, and has the potential to be applicable to modeling of all helical transmembrane proteins.

The development of partnership after hypertensive diseases in pregnancy.

PubMed

Leeners, Brigitte; Rath, Werner; Kuse, Sabine; Tschudin, Sibil

2015-04-01

Hypertensive diseases in pregnancy (HDP) occur in 5-8% of all pregnancies and represent one of the most important causes of maternal and fetal morbidity. Even after a normal pregnancy/delivery adaptation to parenthood is a major challenge. However, a successful adjustment is important for future family health. As pregnancy complications may put additional strain on early parenthood, the current study investigated satisfaction with partnership including factors which determine (dis)satisfaction as well as separation rates after pregnancies complicated by HDP. A total of 737 women after HDP and 624 matched-control women completed a self-administered questionnaire on psycho-social factors in the development of HDP. Free-text answers on satisfaction with partnership were analyzed by conceptual analysis. Women with HDP were significantly less often satisfied with their partnership than control women (76%/81.1%; p < 0.05). Women with preeclampsia were at higher risk for an unsatisfactory relationship than those with other manifestations of HDP. Common interests and aims could be identified as the most important reasons for a satisfying marital relationship in women with and without a diagnosis of HDP. HDP represent an additional challenge in family adjustment. Adapted perinatal psycho-social support may help to facilitate the start into family life.

NREL Smart Grid Projects

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

Hambrick, J.

2012-01-01

Although implementing Smart Grid projects at the distribution level provides many advantages and opportunities for advanced operation and control, a number of significant challenges must be overcome to maintain the high level of safety and reliability that the modern grid must provide. For example, while distributed generation (DG) promises to provide opportunities to increase reliability and efficiency and may provide grid support services such as volt/var control, the presence of DG can impact distribution operation and protection schemes. Additionally, the intermittent nature of many DG energy sources such as photovoltaics (PV) can present a number of challenges to voltage regulation,more » etc. This presentation provides an overview a number of Smart Grid projects being performed by the National Renewable Energy Laboratory (NREL) along with utility, industry, and academic partners. These projects include modeling and analysis of high penetration PV scenarios (with and without energy storage), development and testing of interconnection and microgrid equipment, as well as the development and implementation of advanced instrumentation and data acquisition used to analyze the impacts of intermittent renewable resources. Additionally, standards development associated with DG interconnection and analysis as well as Smart Grid interoperability will be discussed.« less

Recommendations for Laboratory Containment and Management of Gene Drive Systems in Arthropods

PubMed Central

Burt, Austin; Capurro, Margareth L.; De Barro, Paul; Handler, Alfred M.; Hayes, Keith R.; Marshall, John M.; Tabachnick, Walter J.; Adelman, Zach N.

2018-01-01

Abstract Versatile molecular tools for creating driving transgenes and other invasive genetic factors present regulatory, ethical, and environmental challenges that should be addressed to ensure their safe use. In this article, we discuss driving transgenes and invasive genetic factors that can potentially spread after their introduction into a small proportion of individuals in a population. The potential of invasive genetic factors to increase their number in natural populations presents challenges that require additional safety measures not provided by previous recommendations regarding accidental release of arthropods. In addition to providing physical containment, invasive genetic factors require greater attention to strain management, including their distribution and identity confirmation. In this study, we focus on insects containing such factors with recommendations for investigators who are creating them, institutional biosafety committees charged with ensuring safety, funding agencies providing support, those managing insectaries handling these materials who are responsible for containment, and other persons who will be receiving insects—transgenic or not—from these facilities. We give specific examples of efforts to modify mosquitoes for mosquito-borne disease control, but similar considerations are relevant to other arthropods that are important to human health, the environment, and agriculture. PMID:29040058

Parcel Delivery in AN Urban Environment Using Unmanned Aerial Systems: a Vision Paper

NASA Astrophysics Data System (ADS)

Anbaroğlu, B.

2017-11-01

This vision paper addresses the challenges and explores the avenue of solutions regarding the use of Unmanned Aerial Systems (UAS) for transporting parcels in urban areas. We have already witnessed companies' delivering parcels using UAS in rural areas, but the challenge of utilizing them for an urban environment is eminent. Nevertheless, the increasing research on the various aspects of UAS, including their battery life, resistance to harsh weather conditions and sensing its environment foresee their common usage in the logistics industry, especially in an urban environment. In addition, the increasing trend on 3D city modelling offer new directions regarding realistic as well as light 3D city models that are easy to modify and distribute. Utilizing UAS for transporting parcels in an urban environment would be a disruptive technological achievement as our roads will be less congested which would lead to less air pollution as well as wasted money and time. In addition, parcels could potentially be delivered much faster. This paper argues, with the support of the state-of-the-art research, that UASs will be used for transporting parcels in an urban environment in the coming decades.

Near-infrared laser-induced fluorescence detection in capillary electrophoresis.

PubMed

McWhorter, S; Soper, S A

2000-04-01

As capillary electrophoresis continues to focus on miniaturization, either through reducing column dimensions or situating entire electrophoresis systems on planar chips, advances in detection become necessary to meet the challenges posed by these electrophoresis platforms. The challenges result from the fact that miniaturization requires smaller load volumes, demanding highly sensitive detection. In addition, many times multiple targets must be analyzed simultaneously (multiplexed applications), further complicating detection. Near-infrared (NIR) fluorescence offers an attractive alternative to visible fluorescence for critical applications in capillary electrophoresis due to the impressive limits of detection that can be generated, in part resulting from the low background levels that are observed in the NIR. Advances in instrumentation and fluorogenic labels appropriate for NIR monitoring have led to a growing number of examples of the use of NIR fluorescence in capillary electrophoresis. In this review, we will cover instrumental components used to construct ultrasensitive NIR fluorescence detectors, including light sources and photon transducers. In addition, we will discuss various types of labeling dyes appropriate for NIR fluorescence and finally, we will present several applications that have used NIR fluorescence in capillary electrophoresis, especially for DNA sequencing and fragment analysis.

Space Biosensor Systems: Implications for Technology Transfer

NASA Technical Reports Server (NTRS)

Hines, J. W.; Somps, C. J.; Madou, M.; Imprescia, Clifford C. (Technical Monitor)

1997-01-01

To meet the need for continuous, automated monitoring of animal subjects, including; humans, during space flight, NASA is developing advanced physiologic sensor and biotelemetry system technologies. The ability to continuously track basic physiological parameters, such as heart rate, blood pH, and body temperature, in untethered subjects in space is a challenging task. At NASA's Ames Research Center, where a key focus is gravitational biology research, engineers have teamed with life scientists to develop wireless sensor systems for automated physiologic monitoring of animal models as small as the rat. This technology is also being adapted, in collaboration with medical professionals, to meet human clinical monitoring needs both in space and on the ground. Thus, these advanced monitoring technologies have important dual-use functions; they meet space flight data collection requirements and constraints, while concurrently addressing a number of monitoring and data acquisition challenges on the ground in areas of clinical monitoring and biomedical research. Additional applications for these and related technologies are being sought and additional partnerships established that enhance development efforts, reduce costs and facilitate technology infusion between the public and private sectors. This paper describes technology transfer and co-development projects that have evolved out of NASA's miniaturized, implantable chemical sensor development efforts.

22 CFR 208.830 - Under what conditions do I get an additional opportunity to challenge the facts on which the...

Code of Federal Regulations, 2010 CFR

2010-04-01

... 22 Foreign Relations 1 2010-04-01 2010-04-01 false Under what conditions do I get an additional opportunity to challenge the facts on which the proposed debarment is based? 208.830 Section 208.830 Foreign Relations AGENCY FOR INTERNATIONAL DEVELOPMENT GOVERNMENTWIDE DEBARMENT AND SUSPENSION (NONPROCUREMENT) Debarment § 208.830 Under what...

REFLECTION IN HOME VISITING: THE WHAT, WHY, AND A BEGINNING STEP TOWARD HOW.

PubMed

Tomlin, Angela M; Hines, Elesia; Sturm, Lynne

2016-11-01

The work of home visitors in early childhood fields may include addressing many challenges to achieving curricular outcomes, including issues such as maintaining boundaries and managing one's own reactions to children, parents, and overall family situations. Increasingly, reflective supervision and consultation are recognized as a way for workers in home-visiting early intervention and early care fields to address these personal and professional challenges and build competence (Watson, Gatti, Cox, Harrison, & Hennes, ). The features of home visiting that make reflective supervision/consultation essential are discussed. Next, results of a pilot project in which a sample of Part C early intervention providers respond to a vignette portraying a challenging parent-child interaction are briefly presented and discussed. Despite often stating the importance of relationships, participants did not identify concrete methods of supporting relationship or demonstrate recognition of parallel process. In addition, providers seldom endorsed the use of reflective skills such as observing, listening, wondering, or reflecting (Weatherston, ), and no providers discussed a need for reflective supervision/consultation. We suggest that these findings illustrate some of the areas in which early intervention home visitors could benefit from participation in reflective supervision/consultation to move from identifying reflective skills as important to actually being able to use such skills in their work with families. © 2016 Michigan Association for Infant Mental Health.

Responding to the Language Challenge: Kaiser Permanente's Approach

PubMed Central

Meyers, Kate; Tang, Gayle; Fernandez, Alicia

2009-01-01

Objective: To inform current debates on improving health care quality for patients with limited English proficiency by identifying the drivers and processes for one large health care delivery system's implementation of particular models, key success factors, and remaining challenges for the field. Study Design: A qualitative case study of the Kaiser Permanente (KP) San Francisco Medical Center's approach to developing linguistic access services and subsequent organizationwide initiatives. Methods: We conducted semistructured interviews with eight current and former clinical and administrative leaders from the KP San Francisco Medical Center and national headquarters. Interviews were analyzed for key themes. Results: KP San Francisco Medical Center developed linguistic and cultural services in response to a confluence of external and internal factors, including changing demographics, care quality challenges, and patient and clinician satisfaction issues. Early strategies included development of language-specific care modules focused on Chinese- and Spanish-speaking members while meeting broader linguistic access and cultural-competency needs through a centralized Multicultural Services Center. Additional approaches across KP regions have focused on improving interpreter services, optimizing use of bilingual staff, and creating a translation infrastructure to improve quality and reduce redundancy in written translation efforts. Conclusions: KP's experiences developing linguistic and cultural care and services since the 1990s provide lessons about decision-making processes and approaches that may guide other health systems, insurers, and policy makers striving to improve care quality and safety for patients with limited English proficiency. PMID:20740094

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

Stokes, David

This program seeks to demonstrate a solution to enhance existing biomass cookstove performance through the use of RTI’s Thermoelectric Enhanced Cookstove Add-on (TECA) device. The self-powered TECA device captures a portion of heat from the stove and converts it to electricity through a thermoelectric (TE) device to power a blower. Colorado State University and Envirofit International are partners to support the air injection design and commercialization to enhance combustion in the stove and reduce emissions. Relevance: By demonstrating a proof of concept of the approach with the Envirofit M-5000 stove and TECA device, we hope to apply this technology tomore » existing stoves that are already in use and reduce emissions for stoves that have already found user acceptance to provide a true health benefit. Challenges: The technical challenges include achieving Tier 4 emissions from a biomass stove and for such a stove to operate reliably in the harsh field environment. Additional challenges include the fact that it is difficult to develop a cost effective solution and insure adoption and proper use in the field. Outcomes: In this program we have demonstrated PM emissions at 82 mg/MJd, a 70% reduction as compared to baseline stove operation. We have also developed a stove optimization approach that reduces the number of costly experiments. We have evaluated component-level reliability and will be testing the stove prototype in the field for performance and reliability.« less

Energy Management Challenges and Opportunities with Increased Intermittent Renewable Generation on the California Electrical Grid

NASA Astrophysics Data System (ADS)

Eichman, Joshua David

Renewable resources including wind, solar, geothermal, biomass, hydroelectric, wave and tidal, represent an opportunity for environmentally preferred generation of electricity that also increases energy security and independence. California is very proactive in encouraging the implementation of renewable energy in part through legislation like Assembly Bill 32 and the development and execution of Renewable Portfolio Standards (RPS); however renewable technologies are not without challenges. All renewable resources have some resource limitations, be that from location, capacity, cost or availability. Technologies like wind and solar are intermittent in nature but represent one of the most abundant resources for generating renewable electricity. If RPS goals are to be achieved high levels of intermittent renewables must be considered. This work explores the effects of high penetration of renewables on a grid system, with respect to resource availability and identifies the key challenges from the perspective of the grid to introducing these resources. The HiGRID tool was developed for this analysis because no other tool could explore grid operation, while maintaining system reliability, with a diverse set of renewable resources and a wide array of complementary technologies including: energy efficiency, demand response, energy storage technologies and electric transportation. This tool resolves the hourly operation of conventional generation resources (nuclear, coal, geothermal, natural gas and hydro). The resulting behavior from introducing additional renewable resources and the lifetime costs for each technology is analyzed.

Social challenges faced by queer Latino college men: Navigating negative responses to coming out in a double minority sample of emerging adults.

PubMed

Eaton, Asia A; Rios, Desdamona

2017-10-01

In this paper, we qualitatively examine the social challenges experienced by queer, Latino college men in the coming out process. Using an intersectional perspective informed by the double jeopardy hypothesis, intersectional invisibility, and Latino/a cultural norms, we asked 22 queer Latino college men to describe the major challenges they experienced with their sexual identities. To examine the subjective experiences of participants' multiple minority identities, we conducted semistructured interviews. Our sample consisted of 22 college student men who identified as Latino, queer, and cisgender. Participant ages ranged from 18 to 29 (M = 21.50, SD = 3.70). For race/ethnicity, all participants identified with the broad category Latino. For sexual orientation, 18 participants self-identified as gay or homosexual, 3 identified as "other," and 1 identified as bisexual. Sixty-eight percent of participants (15/22) described encountering negative social responses to their sexual identity disclosure, including Loss of Relationships, Aggression, Pathologizing, and Self-Serving Responses. Additionally, 55% spontaneously reinterpreted or Cognitively Reframed their negative experiences (12/22), including the subthemes of It's never happened to me, Minimizing, and Victim Blame. We relate each subtheme to potentially influential social and cultural norms among queer, Latino college men, such as collectivistic values and familismo. Suggestions for research and practice with individuals at this identity intersection are described. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

Current challenges and future directions for bacterial self-healing concrete.

PubMed

Lee, Yun Suk; Park, Woojun

2018-04-01

Microbially induced calcium carbonate precipitation (MICP) has been widely explored and applied in the field of environmental engineering over the last decade. Calcium carbonate is naturally precipitated as a byproduct of various microbial metabolic activities. This biological process was brought into practical use to restore construction materials, strengthen and remediate soil, and sequester carbon. MICP has also been extensively examined for applications in self-healing concrete. Biogenic crack repair helps mitigate the high maintenance costs of concrete in an eco-friendly manner. In this process, calcium carbonate precipitation (CCP)-capable bacteria and nutrients are embedded inside the concrete. These bacteria are expected to increase the durability of the concrete by precipitating calcium carbonate in situ to heal cracks that develop in the concrete. However, several challenges exist with respect to embedding such bacteria; harsh conditions in concrete matrices are unsuitable for bacterial life, including high alkalinity (pH up to 13), high temperatures during manufacturing processes, and limited oxygen supply. Additionally, many biological factors, including the optimum conditions for MICP, the molecular mechanisms involved in MICP, the specific microorganisms suitable for application in concrete, the survival characteristics of the microorganisms embedded in concrete, and the amount of MICP in concrete, remain unclear. In this paper, metabolic pathways that result in conditions favorable for calcium carbonate precipitation, current and potential applications in concrete, and the remaining biological challenges are reviewed.

Sequential Design of Experiments to Maximize Learning from Carbon Capture Pilot Plant Testing

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

Soepyan, Frits B.; Morgan, Joshua C.; Omell, Benjamin P.

Pilot plant test campaigns can be expensive and time-consuming. Therefore, it is of interest to maximize the amount of learning and the efficiency of the test campaign given the limited number of experiments that can be conducted. This work investigates the use of sequential design of experiments (SDOE) to overcome these challenges by demonstrating its usefulness for a recent solvent-based CO2 capture plant test campaign. Unlike traditional design of experiments methods, SDOE regularly uses information from ongoing experiments to determine the optimum locations in the design space for subsequent runs within the same experiment. However, there are challenges that needmore » to be addressed, including reducing the high computational burden to efficiently update the model, and the need to incorporate the methodology into a computational tool. We address these challenges by applying SDOE in combination with a software tool, the Framework for Optimization, Quantification of Uncertainty and Surrogates (FOQUS) (Miller et al., 2014a, 2016, 2017). The results of applying SDOE on a pilot plant test campaign for CO2 capture suggests that relative to traditional design of experiments methods, SDOE can more effectively reduce the uncertainty of the model, thus decreasing technical risk. Future work includes integrating SDOE into FOQUS and using SDOE to support additional large-scale pilot plant test campaigns.« less

Challenges in the Management and Stewardship of Airborne Observational Data at the National Center for Atmospheric Research (NCAR) Earth Observing Laboratory (EOL)

NASA Astrophysics Data System (ADS)

Aquino, J.; Daniels, M. D.

2015-12-01

The National Science Foundation (NSF) provides the National Center for Atmospheric Research (NCAR) Earth Observing Laboratory (EOL) funding for the operation, maintenance and upgrade of two research aircraft: the NSF/NCAR High-performance Instrumented Airborne Platform for Environmental Research (HIAPER) Gulfstream V and the NSF/NCAR Hercules C-130. A suite of in-situ and remote sensing airborne instruments housed at the EOL Research Aviation Facility (RAF) provide a basic set of measurements that are typically deployed on most airborne field campaigns. In addition, instruments to address more specific research requirements are provided by collaborating participants from universities, industry, NASA, NOAA or other agencies (referred to as Principal Investigator, or PI, instruments). At the 2014 AGU Fall Meeting, a poster (IN13B-3639) was presented outlining the components of Airborne Data Management included field phase data collection, formats, data archival and documentation, version control, storage practices, stewardship and obsolete data formats, and public data access. This talk will cover lessons learned, challenges associated with the above components, and current developments to address these challenges, including: tracking data workflows for aircraft instrumentation to facilitate identification, and correction, of gaps in these workflows; implementation of dataset versioning guidelines; and assignment of Digital Object Identifiers (DOIs) to data and instrumentation to facilitate tracking data and facility use in publications.

STS-114: Engine Cut-Off Sensors Are a No-Go: Teaching Notes for NASA Case Study

NASA Technical Reports Server (NTRS)

Ransom, Khadijah S.; Johnson, Grace K.

2013-01-01

This case study format is intended to simulate the experience of facing the same difficult challenges and making the same critical decisions as managers, engineers, and scientists in the Space Shuttle Program. It has been designed for use in the classroom setting to help students develop skills related to decision-making. Students will read about the engine cut-off sensor anomaly which created challenges during the STS-114 mission and have the opportunity to make decisions as lead NASA engineers and Mission Management Team members. Included within this document are three case study presentation options - class discussion, group activity, and open-ended research. Please read the full case prior to in-class presentation to allow ample time for students' analysis and reflection, as well as to prepare additional questions. activities or exercises, material selection, etc. Depending upon the setting of your presentation and the number of participants, please choose at least one presentation format beforehand and plan accordingly. You may expect the following learning objectives by using the proposed formats. Learning Objectives: To enable students to experience the responsibilities of NASA management, engineers, and analysis; to discover possible procedures for investigating system anomalies; to become familiar with the liquid hydrogen low level engine cut-off sensor, including its function, connecting components, and location within the Space Shuttle; and to encourage critical analysis and stimulating discussion of Space Shuttle mission challenges.

Development and implementation of sepsis alert systems

PubMed Central

Harrison, Andrew M.; Gajic, Ognjen; Pickering, Brian W.; Herasevich, Vitaly

2016-01-01

Synopsis/Summary Development and implementation of sepsis alert systems is challenging, particularly outside the monitored intensive care unit (ICU) setting. Important barriers to wider use of sepsis alerts include evolving clinical definitions of sepsis, information overload & alert fatigue, due to suboptimal alert performance. Outside the ICU, additional barriers include differences in health care delivery models, charting behaviors, and availability of electronic data. Currently available evidence does not support routine use of sepsis alert systems in clinical practice. However, continuous improvement in both the afferent (data availability and accuracy of detection algorithms) and efferent (evidence-based decision support and smoother integration into clinical workflow) limbs of sepsis alert systems will help translate theoretical advantages into measurable patient benefit. PMID:27229639

IEEE 1547 Standards Advancing Grid Modernization

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

Basso, Thomas; Chakraborty, Sudipta; Hoke, Andy

Technology advances including development of advanced distributed energy resources (DER) and grid-integrated operations and controls functionalities have surpassed the requirements in current standards and codes for DER interconnection with the distribution grid. The full revision of IEEE Standards 1547 (requirements for DER-grid interconnection and interoperability) and 1547.1 (test procedures for conformance to 1547) are establishing requirements and best practices for state-of-the-art DER including variable renewable energy sources. The revised standards will also address challenges associated with interoperability and transmission-level effects, in addition to strictly addressing the distribution grid needs. This paper provides the status and future direction of the ongoingmore » development focus for the 1547 standards.« less

Treatments for common psychiatric conditions among adults during acute, rehabilitation, and reintegration phases.

PubMed

Difede, Joann; Cukor, Judith; Lee, Francis; Yurt, Roger

2009-12-01

Common and pernicious adult psychiatric disorders consequent to burn injury include post-traumatic stress disorder (PTSD), major depressive disorder (MDD), and new-onset substance abuse disorder. Diagnosing and treating these disorders is complicated by the complex psychosocial issues associated with burns including grief, pain, role impairment, disfigurement, dysfunction, stigma, as well as financial and legal issues. Additionally, pre-morbid psychiatric and neurological illnesses are risk factors for burns, adding to the challenge of diagnosis and treatment. This article will focus on the diagnosis and treatment of PTSD and MDD consequent to burn trauma, as these are the major psychiatric outcomes, addressing the attendant psychosocial problems as threads in this post-trauma tapestry.

Preanesthetic Assessment of the Jehovah's Witness Patient

PubMed Central

Lin, Eric S.; Kaye, Alan D.; Baluch, Amir R.

2012-01-01

The Jehovah's Witnesses, a religious group of 7 million people in more than 200 countries, teaches its followers to not accept blood, resulting in potentially challenging and ethical dilemmas for anesthesiologists. In recent years, Jehovah's Witnesses changed certain elements of their approach to blood transfusion practice, including accepting autologous transfusions in certain circumstances. We examine mechanisms to resolve ethical conflicts, such as additional medical consultations with other involved physicians, surgeons, and anesthesiologists; short-term counseling or psychiatric consultation for patient and family; case management conferences; consultation with individuals trained in clinical ethics or a hospital-based ethics committee; and discussions with hospital administration. We also discuss treatment options, including certain blood products, anesthetic techniques, and pharmacological interventions. PMID:22438784

Group Health Coaching: Strengths, Challenges, and Next Steps

PubMed Central

Wolever, Ruth Q.; Manning, Linda; Elam, Roy; Moore, Margaret; Frates, Elizabeth Pegg; Duskey, Heidi; Anderson, Chelsea; Curtis, Rebecca L.; Masemer, Susan; Lawson, Karen

2013-01-01

There is great need for cost effective approaches to increase patient engagement and improve health and well-being. Health and wellness coaching has recently demonstrated great promise, but the majority of studies to date have focused on individual coaching (ie, one coach with one client). Newer initiatives are bringing a group coaching model from corporate leadership development and educational settings into the healthcare arena. A group approach potentially increases cost-effective access to a larger number of clients and brings the possible additional benefit of group support. This article highlights some of the group coaching approaches currently being conducted across the United States. The group coaching interventions included in this overview are offered by a variety of academic and private sector institutions, use both telephonic and in-person coaching, and are facilitated by professionally trained health and wellness coaches as well as trained peer coaches. Strengths and challenges experienced in these efforts are summarized, as are recommendations to address those challenges. A working definition of “Group Health and Wellness Coaching” is proposed, and important next steps for research and for the training of group coaches are presented. PMID:24416678

Navigation Challenges of the Mars Phoenix Lander Mission

NASA Technical Reports Server (NTRS)

Portock, Brian M.; Kruizinga, Gerhard; Bonfiglio, Eugene; Raofi, Behzad; Ryne, Mark

2008-01-01

The Mars Phoenix Lander mission was launched on August 4th, 2007. To land safely at the desired landing location on the Mars surface, the spacecraft trajectory had to be controlled to a set of stringent atmospheric entry and landing conditions. The landing location needed to be controlled to an elliptical area with dimensions of 100km by 20km. The two corresponding critical components of the atmospheric entry conditions are the entry flight path angle (target: -13.0 deg +/-0.21 deg) and the entry time (within +/-30 seconds). The purpose of this paper is to describe the navigation strategies used to overcome the challenges posed during spacecraft operations, which included an attitude control thruster calibration campaign, a trajectory control strategy, and a trajectory reconstruction strategy. Overcoming the navigation challenges resulted in final Mars atmospheric entry conditions just 0.007 deg off in entry flight path angle and 14.9 sec early in entry time. These entry dispersions in addition to the entry, descent, and landing trajectory dispersion through the atmosphere, lead to a final landing location just 7 km away from the desired landing target.

SAMPL4 & DOCK3.7: lessons for automated docking procedures

NASA Astrophysics Data System (ADS)

Coleman, Ryan G.; Sterling, Teague; Weiss, Dahlia R.

2014-03-01

The SAMPL4 challenges were used to test current automated methods for solvation energy, virtual screening, pose and affinity prediction of the molecular docking pipeline DOCK 3.7. Additionally, first-order models of binding affinity were proposed as milestones for any method predicting binding affinity. Several important discoveries about the molecular docking software were made during the challenge: (1) Solvation energies of ligands were five-fold worse than any other method used in SAMPL4, including methods that were similarly fast, (2) HIV Integrase is a challenging target, but automated docking on the correct allosteric site performed well in terms of virtual screening and pose prediction (compared to other methods) but affinity prediction, as expected, was very poor, (3) Molecular docking grid sizes can be very important, serious errors were discovered with default settings that have been adjusted for all future work. Overall, lessons from SAMPL4 suggest many changes to molecular docking tools, not just DOCK 3.7, that could improve the state of the art. Future difficulties and projects will be discussed.

Diagnostic challenges of childhood asthma.

PubMed

Bakirtas, Arzu

2017-01-01

Diagnosis of asthma in childhood is challenging. Both underdiagnosis and overdiagnosis of asthma are important issues. The present review gives information about challenging factors for an accurate diagnosis of childhood asthma. Although underdiagnosis of asthma in childhood has always been the most important diagnostic problem, overdiagnosis of asthma has also been increasingly recognized. This is probably due to diagnosis of asthma based on symptoms and signs alone. Demonstration of variable airflow obstruction by lung function tests is the most common asthma diagnostic tests used in practice and is therefore strongly recommended in children who can cooperate. Recently, an asthma guideline combining the clinical and economic evidences with sensitivity and specificity of diagnostic procedures was developed to improve accuracy of diagnosis and to avoid overdiagnosis. This guideline provided an algorithmic clinical and cost-effective approach and included fractional exhaled nitric oxide measurement as one of the diagnostic tests in addition to lung function. Diagnosis of asthma in children should be made by combining relevant history with at least two confirmatory diagnostic tests whenever possible. Diagnosis based on short-period treatment trials should be limited to young children who are unable to cooperate with these tests.

Design, demonstration and testing of low F-number LWIR panoramic imaging relay optics

NASA Astrophysics Data System (ADS)

Furxhi, Orges; Frascati, Joe; Driggers, Ronald

2018-04-01

Panoramic imaging is inherently wide field of view. High sensitivity uncooled Long Wave Infrared (LWIR) imaging requires low F-number optics. These two requirements result in short back working distance designs that, in addition to being costly, are challenging to integrate with commercially available uncooled LWIR cameras and cores. Common challenges include the relocation of the shutter flag, custom calibration of the camera dynamic range and NUC tables, focusing, and athermalization. Solutions to these challenges add to the system cost and make panoramic uncooled LWIR cameras commercially unattractive. In this paper, we present the design of Panoramic Imaging Relay Optics (PIRO) and show imagery and test results with one of the first prototypes. PIRO designs use several reflective surfaces (generally two) to relay a panoramic scene onto a real, donut-shaped image. The PIRO donut is imaged on the focal plane of the camera using a commercially-off-the-shelf (COTS) low F-number lens. This approach results in low component cost and effortless integration with pre-calibrated commercially available cameras and lenses.

The challenges of amblyopia treatment.

PubMed

Maconachie, Gail D E; Gottlob, Irene

2015-12-01

The treatment of amblyopia, particularly anisometropic (difference in refractive correction) and/or strabismic (turn of one eye) amblyopia has long been a challenge for many clinicians. Achieving optimum outcomes, where the amblyopic eye reaches a visual acuity similar to the fellow eye, is often impossible in many patients. Part of this challenge has resulted from a previous lack of scientific evidence for amblyopia treatment that was highlight by a systematic review by Snowdon et al. in 1998. Since this review, a number of publications have revealed new findings in the treatment of amblyopia. This includes the finding that less intensive occlusion treatments can be successful in treating amblyopia. A relationship between adherence to treatment and visual acuity has also been established and has been shown to be influenced by the use of intervention material. In addition, there is growing evidence of that a period of glasses wearing only can significantly improve visual acuity alone without any other modes of treatment. This review article reports findings since the Snowdon's report. Copyright © 2016 Chang Gung University. Published by Elsevier B.V. All rights reserved.

Veterinary parasitology teaching in China in the 21st century - Challenges, opportunities and perspectives.

PubMed

Liu, Guo-Hua; Zhang, Long-Xian; Zou, Feng-Cai; Yuan, Zi-Guo; Zhao, Guang-Hui; Hu, Min; Suo, Xun; Zhu, Xing-Quan

2018-03-15

China has made significant achievements in social-economic development in the last three decades, and the numbers of livestock and companion animals are rapidly increasing. Some advances have been made in the control and prevention of animal parasitic diseases, but there are still some significant challenges, particularly in relation to foodborne parasitic zoonoses and vector-borne diseases. In addition, new molecular (e.g., genomic and transcriptomic) technologies have been developed and are gradually being introduced into the veterinary parasitology field. Therefore, teaching of veterinary parasitology in Chinese universities has undergone significant changes over the years, in terms of topics, depth and breadth, and also in the ways in which courses are delivered. In this article, we describe the current status of veterinary parasitology teaching at the undergraduate and postgraduate levels in Chinese universities, summarise changes and improvement in veterinary parasitology teaching, and discuss the challenges and opportunities for veterinary parasitology teaching in the 21st century, including the use of new teaching technologies and the integration of the "One Health" concept into veterinary parasitology courses. Copyright © 2018 Elsevier B.V. All rights reserved.

Group health coaching: strengths, challenges, and next steps.

PubMed

Armstrong, Colin; Wolever, Ruth Q; Manning, Linda; Elam, Roy; Moore, Margaret; Frates, Elizabeth Pegg; Duskey, Heidi; Anderson, Chelsea; Curtis, Rebecca L; Masemer, Susan; Lawson, Karen

2013-05-01

There is great need for cost effective approaches to increase patient engagement and improve health and well-being. Health and wellness coaching has recently demonstrated great promise, but the majority of studies to date have focused on individual coaching (ie, one coach with one client). Newer initiatives are bringing a group coaching model from corporate leadership development and educational settings into the healthcare arena. A group approach potentially increases cost-effective access to a larger number of clients and brings the possible additional benefit of group support. This article highlights some of the group coaching approaches currently being conducted across the United States. The group coaching interventions included in this overview are offered by a variety of academic and private sector institutions, use both telephonic and in-person coaching, and are facilitated by professionally trained health and wellness coaches as well as trained peer coaches. Strengths and challenges experienced in these efforts are summarized, as are recommendations to address those challenges. A working definition of "Group Health and Wellness Coaching" is proposed, and important next steps for research and for the training of group coaches are presented.

The legal and ethical concerns that arise from using complex predictive analytics in health care.

PubMed

Cohen, I Glenn; Amarasingham, Ruben; Shah, Anand; Xie, Bin; Lo, Bernard

2014-07-01

Predictive analytics, or the use of electronic algorithms to forecast future events in real time, makes it possible to harness the power of big data to improve the health of patients and lower the cost of health care. However, this opportunity raises policy, ethical, and legal challenges. In this article we analyze the major challenges to implementing predictive analytics in health care settings and make broad recommendations for overcoming challenges raised in the four phases of the life cycle of a predictive analytics model: acquiring data to build the model, building and validating it, testing it in real-world settings, and disseminating and using it more broadly. For instance, we recommend that model developers implement governance structures that include patients and other stakeholders starting in the earliest phases of development. In addition, developers should be allowed to use already collected patient data without explicit consent, provided that they comply with federal regulations regarding research on human subjects and the privacy of health information. Project HOPE—The People-to-People Health Foundation, Inc.

Application of advanced diffraction based optical metrology overlay capabilities for high-volume manufacturing

NASA Astrophysics Data System (ADS)

Chen, Kai-Hsiung; Huang, Guo-Tsai; Hsieh, Hung-Chih; Ni, Wei-Feng; Chuang, S. M.; Chuang, T. K.; Ke, Chih-Ming; Huang, Jacky; Rao, Shiuan-An; Cumurcu Gysen, Aysegul; d'Alfonso, Maxime; Yueh, Jenny; Izikson, Pavel; Soco, Aileen; Wu, Jon; Nooitgedagt, Tjitte; Ottens, Jeroen; Kim, Yong Ho; Ebert, Martin

2017-03-01

On-product overlay requirements are becoming more challenging with every next technology node due to the continued decrease of the device dimensions and process tolerances. Therefore, current and future technology nodes require demanding metrology capabilities such as target designs that are robust towards process variations and high overlay measurement density (e.g. for higher order process corrections) to enable advanced process control solutions. The impact of advanced control solutions based on YieldStar overlay data is being presented in this paper. Multi patterning techniques are applied for critical layers and leading to additional overlay measurement demands. The use of 1D process steps results in the need of overlay measurements relative to more than one layer. Dealing with the increased number of overlay measurements while keeping the high measurement density and metrology accuracy at the same time presents a challenge for high volume manufacturing (HVM). These challenges are addressed by the capability to measure multi-layer targets with the recently introduced YieldStar metrology tool, YS350. On-product overlay results of such multi-layers and standard targets are presented including measurement stability performance.

Playing with LISEM: Experiences from Norway

NASA Astrophysics Data System (ADS)

Greipsland, Inga; Krzeminska, Dominika

2017-04-01

Reducing soil loss from agricultural land is an important environmental challenge that is of relevance for both the European Soil Thematic Strategy (EC 2002) and the Water Framework Directive (EC 2000). Agricultural land in Norway is scarce, covering only around 3% of the total land area (The World Bank, 2015), which puts stress on preserving soil quality for food production. Additionally, reducing sediment loss is a national priority because of associated transport of pollutants such as phosphorous, which can cause eutrophication in nearby waterbodies. It is necessary to find tools that can estimate the effect of different scenarios on erosion processes on agricultural areas. We would like to present the challenges experienced and the results obtained by using LISEM (Limburg Soil Erosion Model) on the plot- subcatchment- and catchment scale in southeastern Norway. The agricultural catchment has been the subject of long-term monitoring of water quality. Challenges included spatial upscaling of local calibration, calibration on areas with very low soil loss rates and equifinality. In this poster, we want to facilitate a discussion about the possibilities of and limitations to the model for predicting hydrological and soil erosion processes at different scales.

Continuing challenges in influenza

PubMed Central

Webster, Robert G.; Govorkova, Elena A.

2014-01-01

Influenza is an acute respiratory disease in mammals and domestic poultry that emerges from zoonotic reservoirs in aquatic birds and bats. Although influenza viruses are among the most intensively studied pathogens, existing control options require further improvement. Influenza vaccines must be regularly updated because of continuous antigenic drift and sporadic antigenic shifts in the viral surface glycoproteins. Currently, influenza therapeutics are limited to neuraminidase inhibitors; novel drugs and vaccine approaches are therefore urgently needed. Advances in vaccinology and structural analysis have revealed common antigenic epitopes on hemagglutinins across all influenza viruses and suggest that a universal influenza vaccine is possible. In addition, various immunomodulatory agents and signaling pathway inhibitors are undergoing preclinical development. Continuing challenges in influenza include the emergence of pandemic H1N1 influenza in 2009, human infections with avian H7N9 influenza in 2013, and sporadic human cases of highly pathogenic avian H5N1 influenza. Here, we review the challenges facing influenza scientists and veterinary and human public health officials; we also discuss the exciting possibility of achieving the ultimate goal of controlling influenza’s ability to change its antigenicity. PMID:24891213

Generation SMH (shaking my head): Work-Life Balance and Generational Realities

NASA Astrophysics Data System (ADS)

Jones, M. B.

2012-12-01

Many Federal Agencies have 'workforce development' programs that focus on preparing the next generation of scientists and engineers at the graduate and undergraduate level. Several of the science Agencies (e.g., NASA, NOAA, EPA, etc.), have programs that support students in many of the diverse disciplines that are unique to those Agency missions. While financial support certainly is critical to assist students in the STEM and other fields, professional development is just as important to equip students with a balanced arsenal of tactics to be successful professionals in the STEM workforce of today. Finding life balance as one moves through a STEM career path poses unique challenges that require a certain skill set that is not always intuitive. Some of those challenges include: selecting grad or post doc positions (negotiating to a family's advantage); balancing work and family commitments; and dealing with employer/advisor perceptions and expectations. For current and future generations in STEM, many of the above mentioned challenges require additional skill in negotiating interactions with individuals from other generations. Understanding perceptions and managing expectations are learnable skills that do not necessarily come with project funding.

Nanofluidics: A New Arena for Materials Science.

PubMed

Xu, Yan

2018-01-01

A significant growth of research in nanofluidics is achieved over the past decade, but the field is still facing considerable challenges toward the transition from the current physics-centered stage to the next application-oriented stage. Many of these challenges are associated with materials science, so the field of nanofluidics offers great opportunities for materials scientists to exploit. In addition, the use of unusual effects and ultrasmall confined spaces of well-defined nanofluidic environments would offer new mechanisms and technologies to manipulate nanoscale objects as well as to synthesize novel nanomaterials in the liquid phase. Therefore, nanofluidics will be a new arena for materials science. In the past few years, burgeoning progress has been made toward this trend, as overviewed in this article, including materials and methods for fabricating nanofluidic devices, nanofluidics with functionalized surfaces and functional material components, as well as nanofluidics for manipulating nanoscale materials and fabricating new nanomaterials. Many critical challenges as well as fantastic opportunities in this arena lie ahead. Some of those, which are of particular interest, are also discussed. © 2017 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

Towards first principle medical diagnostics: on the importance of disease-disease and sign-sign interactions

NASA Astrophysics Data System (ADS)

Ramezanpour, Abolfazl; Mashaghi, Alireza

2017-07-01

A fundamental problem in medicine and biology is to assign states, e.g. healthy or diseased, to cells, organs or individuals. State assignment or making a diagnosis is often a nontrivial and challenging process and, with the advent of omics technologies, the diagnostic challenge is becoming more and more serious. The challenge lies not only in the increasing number of measured properties and dynamics of the system (e.g. cell or human body) but also in the co-evolution of multiple states and overlapping properties, and degeneracy of states. We develop, from first principles, a generic rational framework for state assignment in cell biology and medicine, and demonstrate its applicability with a few simple theoretical case studies from medical diagnostics. We show how disease-related statistical information can be used to build a comprehensive model that includes the relevant dependencies between clinical and laboratory findings (signs) and diseases. In particular, we include disease-disease and sign-sign interactions and study how one can infer the probability of a disease in a patient with given signs. We perform comparative analysis with simple benchmark models to check the performances of our models. We find that including interactions can significantly change the statistical importance of the signs and diseases. This first principles approach, as we show, facilitates the early diagnosis of disease by taking interactions into accounts, and enables the construction of consensus diagnostic flow charts. Additionally, we envision that our approach will find applications in systems biology, and in particular, in characterizing the phenome via the metabolome, the proteome, the transcriptome, and the genome.

SMAP Instrument Mechanical System Engineering

NASA Technical Reports Server (NTRS)

Slimko, Eric; French, Richard; Riggs, Benjamin

2013-01-01

The Soil Moisture Active Passive (SMAP) mission, scheduled for launch by the end of 2014, is being developed to measure the soil moisture and soil freeze/thaw state on a global scale over a three-year period. The accuracy, resolution, and global coverage of SMAP measurements are invaluable across many science and applications disciplines including hydrology, climate, carbon cycle, and the meteorological, environment, and ecology applications communities. The SMAP observatory is composed of a despun bus and a spinning instrument platform that includes both a deployable 6 meter aperture low structural frequency Astromesh reflector and a spin control system. The instrument section has engendered challenging mechanical system issues associated with the antenna deployment, flexible antenna pointing in the context of a multitude of disturbances, spun section mass properties, spin control system development, and overall integration with the flight system on both mechanical and control system levels. Moreover, the multitude of organizations involved, including two major vendors providing the spin subsystem and reflector boom assembly plus the flight system mechanical and guidance, navigation, and control teams, has led to several unique system engineering challenges. Capturing the key physics associated with the function of the flight system has been challenging due to the many different domains that are applicable. Key interfaces and operational concepts have led to complex negotiations because of the large number of organizations that integrate with the instrument mechanical system. Additionally, the verification and validation concerns associated with the mechanical system have had required far-reaching involvement from both the flight system and other subsystems. The SMAP instrument mechanical systems engineering issues and their solutions are described in this paper.

School Building Designs: Principles and Challenges of the 21st Century.

ERIC Educational Resources Information Center

Chan, T. C.

2002-01-01

Reviews school-facility challenges and design principles described in 2000 U.S. Department of Education report on school planning and design. Describes additional school-facility design challenges and planning principles. Describes five critical facility-planning issues for the 21st Century. (Contains 14 references.) (PKP)

The Relationship between Psychiatric Symptomatology and Motivation of Challenging Behaviour: A Preliminary Study

ERIC Educational Resources Information Center

Holden, Borge; Gitlesen, Jens Petter

2008-01-01

In addition to explaining challenging behaviour by way of behaviour analytic, functional analyses, challenging behaviour is increasingly explained by way of psychiatric symptomatology. According to some researchers, the two approaches complement each other, as psychiatric symptomatology may form a motivational basis for the individual's response…

Campus Challenge - Part 2: Benefits and Challenges of BACnet

DOE PAGES

Masica, Ken

2016-01-15

Additional challenges of implementing a BACnet network in a large campus environment are explored in this article: providing BACnet campus connectivity, protecting BACnet network traffic, and controlling the resulting broadcast traffic. An example of BACnet implementation is also presented, unifying concepts presented in this and Part One of the article.

Challenges to the successful implementation of 3-D sound

NASA Astrophysics Data System (ADS)

Begault, Durand R.

1991-11-01

The major challenges for the successful implementation of 3-D audio systems involve minimizing reversals, intracranially heard sound, and localization error for listeners. Designers of 3-D audio systems are faced with additional challenges in data reduction and low-frequency response characteristics. The relationship of the head-related transfer function (HRTF) to these challenges is shown, along with some preliminary psychoacoustic results gathered at NASA-Ames.

Underage drinking: does the minimum age drinking law offer enough protection?

PubMed

Green, Rivka; Jason, Hannah; Ganz, Debora

2015-05-01

Underage drinking is a significant problem in the US. It is responsible for several thousand mortalities and fatalities each year, both among minors and other members of society. Additionally, underage alcohol consumption produces a severe economic burden in the US. Introduction to alcohol in youth poses serious long-term risks for adolescents, including occupational, educational, and psychosocial impairments, and increases the risk for developing alcohol abuse disorders in adulthood. In order to address and mitigate this problem, the US has set a minimum age drinking law of 21 in all 50 states, and has implemented several supplementary laws limiting the possession and consumption of alcohol. Though these laws have successfully reduced underage drinking, several additional strategies are noteworthy, including preventative and intervention efforts incorporating environmental, individual, communal, and parental factors. The following literature review describes these concepts as they relate to underage drinking laws in the US. Directions for future research, interventions, and ongoing challenges related to the minimum drinking age in the US are also discussed.

3D bioprinting of tissues and organs.

PubMed

Murphy, Sean V; Atala, Anthony

2014-08-01

Additive manufacturing, otherwise known as three-dimensional (3D) printing, is driving major innovations in many areas, such as engineering, manufacturing, art, education and medicine. Recent advances have enabled 3D printing of biocompatible materials, cells and supporting components into complex 3D functional living tissues. 3D bioprinting is being applied to regenerative medicine to address the need for tissues and organs suitable for transplantation. Compared with non-biological printing, 3D bioprinting involves additional complexities, such as the choice of materials, cell types, growth and differentiation factors, and technical challenges related to the sensitivities of living cells and the construction of tissues. Addressing these complexities requires the integration of technologies from the fields of engineering, biomaterials science, cell biology, physics and medicine. 3D bioprinting has already been used for the generation and transplantation of several tissues, including multilayered skin, bone, vascular grafts, tracheal splints, heart tissue and cartilaginous structures. Other applications include developing high-throughput 3D-bioprinted tissue models for research, drug discovery and toxicology.

International Students in Western Developed Countries: History, Challenges, and Prospects

ERIC Educational Resources Information Center

Akanwa, Emmanuel E.

2015-01-01

Many scholars have described the various challenges international students face in Western developed countries including the United States, the United Kingdom, and Australia. Some of the challenges include differences in culture, language barriers, adjustment problems, medical concerns, pedagogical challenges, housing issues, lack of support…

The male beard hair and facial skin - challenges for shaving.

PubMed

Maurer, M; Rietzler, M; Burghardt, R; Siebenhaar, F

2016-06-01

The challenge of shaving is to cut the beard hair as closely as possible to the skin without unwanted effects on the skin. To achieve this requires the understanding of beard hair and male facial skin biology as both, the beard hair and the male facial skin, contribute to the difficulties in obtaining an effective shave without shaving-induced skin irritation. Little information is available on the biology of beard hairs and beard hair follicles. We know that, in beard hairs, the density, thickness, stiffness, as well as the rates of elliptical shape and low emerging angle, are high and highly heterogeneous. All of this makes it challenging to cut it, and shaving techniques commonly employed to overcome these challenges include shaving with increased pressure and multiple stroke shaving, which increase the probability and extent of shaving-induced skin irritation. Several features of male facial skin pose problems to a perfect shave. The male facial skin is heterogeneous in morphology and roughness, and male skin has a tendency to heal slower and to develop hyperinflammatory pigmentation. In addition, many males exhibit sensitive skin, with the face most often affected. Finally, the hair follicle is a sensory organ, and the perifollicular skin is highly responsive to external signals including mechanical and thermal stimulation. Perifollicular skin is rich in vasculature, innervation and cells of the innate and adaptive immune system. This makes perifollicular skin a highly responsive and inflammatory system, especially in individuals with sensitive skin. Activation of this system, by shaving, can result in shaving-induced skin irritation. Techniques commonly employed to avoid shaving-induced skin irritation include shaving with less pressure, pre- and post-shave skin treatment and to stop shaving altogether. Recent advances in shaving technology have addressed some but not all of these issues. A better understanding of beard hairs, beard hair follicles and male facial skin is needed to develop novel and better approaches to overcome the challenge of shaving. This article covers what is known about the physical properties of beard hairs and skin and why those present a challenge for blade and electric shaving, respectively. © 2016 Society of Cosmetic Scientists and the Société Française de Cosmétologie.

Use of empirically supported interventions for psychopathology: can the participatory approach move us beyond the research-to-practice gap?

PubMed

Becker, Carolyn Black; Stice, Eric; Shaw, Heather; Woda, Susan

2009-04-01

Dissemination, or distribution, of empirically supported interventions (ESIs) for psychopathology remains a significant challenge. This paper reviews the principles of community-partnership research (CPR) and explores why CPR might improve distribution of psychological ESIs. Benefits of CPR include building trust, pooling resources and knowledge, and better serving a community by directly involving its members in the design and implementation of research. In addition, after establishing a community's trust using CPR, researchers are likely to be better positioned to partner with communities in the further distribution of ESIs via community networks. This paper reviews the case of dissonance-based eating disorder prevention interventions to provide an example of how CPR can facilitate the adoption and distribution of an ESI by a community, in this case, sororities. CPR also presents a number of challenges, however, because it is time consuming and does not always align with funding mechanisms and research designs used in randomized controlled trials. Further, CPR does not necessarily solve the challenge of training providers, though it may help with problem solving. Ultimately, we suggest that the benefits of CPR far outweigh the challenges, and hope that more researchers will adopt these practices so that more individuals can benefit from empirically supported psychological interventions.

Attachment status and salivary cortisol in a normal day and during simulated interpersonal stress in young men.

PubMed

Rifkin-Graboi, Anne

2008-05-01

Attachment insecurity, as assessed via the adult attachment interview (AAI), may be expected to relate to basal hypothalamic-pituitary-adrenal (HPA) activity because it is retrodictive of stressful early experiences, which may influence HPA development. In addition, because AAI insecurity may reflect limitations on concurrent cognitive, emotional, and behavioral strategies for managing interpersonal distress, insecurity may also relate to cortisol reactivity specifically during inter-personal challenges. Nevertheless, only two studies have examined associations between AAI insecurity and cortisol, and in total only eight non-clinical men were included. To expand upon past research, the current study focused on college aged men and examined relations between attachment status (via categories and continuous scores) and cortisol levels during daily life and during interpersonal laboratory challenges, wherein subjects were asked to visualize and respond to hypothetical situations concerning loss, separation, and abandonment. Unlike prior research, salivary cortisol was measured during cognitive challenges (e.g. non-autobiographical memory tests), so as to inform questions concerning the specificity of effects. Contrary to expectations, only limited evidence suggested a relation between insecurity and basal HPA functioning. However, in keeping with expectations, associations between insecurity, and in particular dismissing idealization, and comparatively higher cortisol values following interpersonal challenges were observed.

Additive Effect of Diesel Exhaust Particulates and Ozone on Airway Hyperresponsiveness and Inflammation in a Mouse Model of Asthma

PubMed Central

Choi, Inseon-S; Takizawa, Hajime; Rhim, TaiYoun; Lee, June-Hyuk; Park, Sung-Woo; Park, Choon-Sik

2005-01-01

Allergic airway diseases are related to exposure to atmospheric pollutants, which have been suggested to be one factor in the increasing prevalence of asthma. Little is known about the effect of ozone and diesel exhaust particulates (DEP) on the development or aggravation of asthma. We have used a mouse asthma model to determine the effect of ozone and DEP on airway hyperresponsiveness and inflammation. Methacholine enhanced pause (Penh) was measured. Levels of IL-4 and IFN-γ were quantified in bronchoalveolar lavage fluids by enzyme immunoassays. The OVA-sensitized-challenged and ozone and DEP exposure group had higher Penh than the OVA-sensitized-challenged group and the OVA-sensitized-challenged and DEP exposure group, and the OVA-sensitized-challenged and ozone exposure group. Levels of IFN-γ were decreased in the OVA-sensitized-challenged and DEP exposure group and the OVA-sensitized-challenged and ozone and DEP exposure group compared to the OVA-sensitized-challenged and ozone exposure group. Levels of IL-4 were increased in the OVA-sensitized-challenged and ozone exposure group and the OVA-sensitized-challenged and DEP exposure group, and the OVA-sensitized-challenged and ozone and DEP exposure group compared to OVA-sensitized-challenged group. Co-exposure of ozone and DEP has additive effect on airway hyperresponsiveness by modulation of IL-4 and IFN-γ suggesting that DEP amplify Th2 immune response. PMID:16224148

The journal of undergraduate neuroscience education: history, challenges, and future developments.

PubMed

Dunbar, Gary L; Lom, Barbara; Grisham, William; Ramirez, Julio J

2009-01-01

The 'JUNE and You' sessions presented at the July 2008 Undergraduate Neuroscience Education workshop, sponsored jointly by Faculty for Undergraduate Neuroscience (FUN) and Project Kaleidoscope (PKAL), featured background information about the history and mission of the Journal of Undergraduate Neuroscience Education (JUNE), followed by an informative discussion about the challenges facing JUNE, including new ideas for future developments. This article will highlight some of the information and ideas generated and shared at this conference. Critical discussion points included the need to keep members of FUN actively engaged in submitting and reviewing articles for JUNE. Ways in which authors, reviewers, and interested faculty members could best help in promoting the mission and vision of JUNE were discussed. Concerns about recent hackings into the JUNE website were also raised, and possible solutions and measures that can be taken to minimize this in the future were discussed. In addition, ideas for expanding the role of JUNE to provide a forum to evaluate new and emerging website information that is pertinent to undergraduate neuroscience education was discussed. Ideas for future developments of JUNE included revolving postings of articles as they are accepted, providing links to several related websites, and allowing updates for articles that have been previously published in JUNE. Finally, ideas for maintaining and expanding JUNE's stature as the resource for undergraduate neuroscience education included ensuring that JUNE is listed on important search vehicles, such as PubMed.

Implementing Innovation: The Creation of an iUnit and the Role of Nursing.

PubMed

Tiase, Victoria L; Ventura, Rosemary; Sorbello, Daniel; Robinson, Kenya

2016-01-01

NewYork-Presbyterian Hospital took on the challenge of thinking about innovation differently with the implementation of an innovation unit or iUnit to create the patient care unit of the future. Goals were to understand more about the innovation process and to test new service models, technology platforms, devices, and deployment models. Key findings from the focus groups included the need for additional training and technical support. In general, the initiative was felt to improve overall communication and represents a starting point for further innovation programs.

Observations, Ideas, and Opinions: Systems Engineering and Integration for Return to Flight

NASA Technical Reports Server (NTRS)

Gafka, George K.

2006-01-01

This presentation addresses project management and systems engineering and integration challenges for return to flight, focusing on the Thermal Protection System Tile Repair Project (TRP). The program documentation philosophy, communication with program requirements flow and philosophy and planned deliverables and documentation are outlined. The development of TRP 'use-as-is' analytical tools is also highlighted and emphasis is placed on the use flight history to assess pre-flight and real-time risk. Additionally, an overview is provided of the repair procedure, including an outline of the logistics deployment chart.

Mucinous Cystadenocarcinoma of the Breast: Report of 2 Cases Including One With Long-Term Local Recurrence.

PubMed

Nayak, Anupma; Bleiweiss, Ira J; Dumoff, Kimberly; Bhuiya, Tawfiqul A

2018-05-01

Primary mucinous cystadenocarcinoma (MCA) of breast is an exceedingly rare tumor with histologic resemblance to MCA arising in ovary, pancreas, and gastrointestinal tract. In this article, we present 2 additional cases of MCA of breast, one highlighting the diagnostic challenges of a rare entity that may potentially lead to unnecessary chemotherapy and the second case presenting with recurrence after 8 years of primary surgical excision defying the indolent behavior reported in the literature. To our knowledge, this is the first reported instance of such behavior.

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

Bogucz, Edward A.

Healthy buildings provide high indoor environmental quality for occupants while simultaneously reducing energy consumption. This project advanced the development and marketability of envisioned healthy, energy-efficient buildings through studies that evaluated the use of emerging technologies in commercial and residential buildings. The project also provided resources required for homebuilders to participate in DOE’s Builders Challenge, concomitant with the goal to reduce energy consumption in homes by at least 30% as a first step toward achieving envisioned widespread availability of net-zero energy homes by 2030. In addition, the project included outreach and education concerning energy efficiency in buildings.

Wastewater treatment by nanofiltration membranes

NASA Astrophysics Data System (ADS)

Mulyanti, R.; Susanto, H.

2018-03-01

Lower energy consumption compared to reverse osmosis (RO) and higher rejection compared to ultrafiltration make nanofiltration (NF) membrane get more and more attention for wastewater treatment. NF has become a promising technology not only for treating wastewater but also for reusing water from wastewater. This paper presents various application of NF for wastewater treatments. The factors affecting the performance of NF membranes including operating conditions, feed characteristics and membrane characteristics were discussed. In addition, fouling as a severe problem during NF application is also presented. Further, future prospects and challenges of NF for wastewater treatments are explained.

Regulatory and quality considerations for continuous manufacturing. May 20-21, 2014 Continuous Manufacturing Symposium.

PubMed

Allison, Gretchen; Cain, Yanxi Tan; Cooney, Charles; Garcia, Tom; Bizjak, Tara Gooen; Holte, Oyvind; Jagota, Nirdosh; Komas, Bekki; Korakianiti, Evdokia; Kourti, Dora; Madurawe, Rapti; Morefield, Elaine; Montgomery, Frank; Nasr, Moheb; Randolph, William; Robert, Jean-Louis; Rudd, Dave; Zezza, Diane

2015-03-01

This paper assesses the current regulatory environment, relevant regulations and guidelines, and their impact on continuous manufacturing. It summarizes current regulatory experience and learning from both review and inspection perspectives. It outlines key regulatory aspects, including continuous manufacturing process description and control strategy in regulatory files, process validation, and key Good Manufacturing Practice (GMP) requirements. In addition, the paper identifies regulatory gaps and challenges and proposes a way forward to facilitate implementation. © 2014 Wiley Periodicals, Inc. and the American Pharmacists Association.

Structurally Integrated Photoluminescent Chemical and Biological Sensors: An Organic Light-Emitting Diode-Based Platform

NASA Astrophysics Data System (ADS)

Shinar, J.; Shinar, R.

The chapter describes the development, advantages, challenges, and potential of an emerging, compact photoluminescence-based sensing platform for chemical and biological analytes, including multiple analytes. In this platform, the excitation source is an array of organic light-emitting device (OLED) pixels that is structurally integrated with the sensing component. Steps towards advanced integration with additionally a thin-film-based photodetector are also described. The performance of the OLED-based sensing platform is examined for gas-phase and dissolved oxygen, glucose, lactate, ethanol, hydrazine, and anthrax lethal factor.

Bilateral vocal cord paralysis in children.

PubMed

Chen, Eunice Y; Inglis, Andrew F

2008-10-01

Bilateral vocal cord paralysis in children with its many causes presents a challenging problem to the pediatric otolaryngologist. Traditionally, management of bilateral vocal cord paralysis includes securing the airway with a tracheotomy and waiting for spontaneous recovery. Surgeons have tried a variety of surgical procedures in lieu of or in addition to tracheotomy, but none are perfect solutions to the problem. This article reviews the current surgical procedures for bilateral vocal cord paralysis in the pediatric population with a particular focus on the senior author's experience with the endoscopic posterior costal cartilage grafting procedure.

Splenic injuries in athletes: a review.

PubMed

Gannon, Elizabeth H; Howard, Thomas

2010-01-01

Splenic injuries can be challenging to the sports medicine physician. While these injuries are not common among athletes, they can have serious, potentially fatal consequences if not properly diagnosed and managed in a prompt and timely fashion. Currently, there are no evidence-based guidelines on returning athletes to previous levels of activity after sustaining a splenic injury. In addition, there is no consensus on follow-up imaging after injury. This article discusses the evaluation of athletes with blunt abdominal trauma for splenic injury, including the imaging, management, and current return-to-play guidelines.

Mission X: Train Like an Astronaut Challenge

NASA Technical Reports Server (NTRS)

Lloyd, Charles W.

2016-01-01

The Mission X: Train Like an Astronaut Challenge was developed in 2011 to encourage proper exercise and nutrition at an early age by teaching young people to live and eat like space explorers. The strong correlation between an unhealthy childhood diet and adolescent fitness, and the onset of chronic diseases as an adult is the catalyst for Mission X. Mission X is dedicated to assisting people on a global scale to live healthier lifestyles and learn about human space exploration. The Mission X: Train Like an Astronaut 2015 (MX15) International Challenge hosted almost 40,000 children on 800 teams, 28 countries affiliated with 12 space agencies. The MX15 website included 17 languages. MX15, the fifth annual international fitness challenges sponsored by the NASA Human Research Program worked with the European Space Agency and other space agencies from around the world. In comparison to MX14, MX15 expanded to include four additional new countries, increased the number of students by approximately 68% and the number of teams by 29%. Chile' and South Korea participated in the new fall Astro Charlie Walk Around the Earth Challenge. Pre-challenge training materials were made more readily available from the website. South Korea completed a prospective assessment of the usability of the MX content for improving health and fitness in 212 preschool children and their families. Mission X is fortunate to have the support of the NASA, ESA and JAXA astronaut corps. In MX15, they participated in the opening and closing events as well as while on-board the International Space Station. Italian Astronaut Samantha Cristoretti participated as the MX15 Astronaut Ambassador for health and fitness providing the opening video and other videos from ISS. United Kingdom Astronaut Tim Peake and US Astronaut Kate Rubins have agreed to be the MX Ambassadors for 2016 and 2017 respectively. The MX15 International Working Group Face-to-Face meeting and Closing Event were held at the Agenzia Spaziale Italiana (ASI) in Rome, Italy. A record number of twenty-eight countries participated. Austria and Norway have offered to host the 2016 and 2017 working group meetings. MX16 planning began with the working group meetings and areas of improvement will include another second early challenge to accommodate countries in the Southern Hemisphere, recommended changes to the MX website, development of a more defined approach to metrics, a change to the format of future MX International Working Group meetings, and proposed new activities to be developed by the MX International Educator Working Group. We look forward to welcoming many new participants in 2016!

Detection of infectious bronchitis virus with the use of real-time quantitative reverse transcriptase-PCR and correlation with virus detection in embryonated eggs.

PubMed

Roh, Ha-Jung; Hilt, Deborah A; Jackwood, Mark W

2014-09-01

Real-time quantitative reverse transcriptase-polymerase chain reaction (qRT-PCR) assays have been used to detect the presence of challenge virus when the efficacy of infectious bronchitis virus (IBV) vaccine against field viruses is being experimentally evaluated. However, federal guidelines for licensing IBV vaccines indicate that challenge-virus detection following vaccination is to be conducted in embryonated eggs. In this study, we examined qRT-PCR data with the use of universal and type-specific primers and probe sets for IBV detection and compared those data with challenge-virus detection in embryonated eggs to determine if the two methods of evaluating vaccine efficacy are comparable. In addition, we tested the qRT-PCR assays on thermocyclers from two different manufacturers. We found the universal IBV primers and probe set to be comparable to challenge-virus detection in embryonated eggs. However, for some IBV types (Mass41 and Conn on the SmartCycler II and Ark, Mass41, Conn, and GA98 on the ABI 7500) the qRT-PCR assay was more sensitive than virus detection in embryonated eggs. This may simply be due to the universal IBV qRT-PCR assay being more sensitive than virus detection in eggs or to the assay detecting nucleic acid from nonviable virus. This finding is important and needs to be considered when evaluating challenge-virus detection for vaccination and challenge studies, because qRT-PCR could potentially identify positive birds that would otherwise be negative by virus detection in embryonated eggs; thus it could lead to a more stringent measure of vaccine efficacy. We also found that the IBV type-specific primers and probe sets designed in this study were in general less sensitive than the universal IBV primers and probe set. Only the Ark-DPI-spedcific assay on the SmartCycler II and the Ark-DPI-, Mass41-, and DE072/GA98- (for detection of GA98 virus only) specific assays on the ABI 7500 were comparable in sensitivity to virus detection in eggs. We found that a number of variables, including the virus type examined, primers and probe efficiency and stability, and assay conditions, including thermocycler platform, can affect the data obtained from qRT-PCR assays. These results indicate that qRT-PCR assays can be used to detect IBV challenge virus, but each assay, including the assay conditions and thermocycler, should be individually evaluated if those data are expected to be comparable to virus detection in embryonated eggs.

Chlorogenic Acid Decreases Intestinal Permeability and Increases Expression of Intestinal Tight Junction Proteins in Weaned Rats Challenged with LPS

PubMed Central

Ruan, Zheng; Liu, Shiqiang; Zhou, Yan; Mi, Shumei; Liu, Gang; Wu, Xin; Yao, Kang; Assaad, Houssein; Deng, Zeyuan; Hou, Yongqing; Wu, Guoyao; Yin, Yulong

2014-01-01

Chlorogenic acid, a natural phenolic acid present in fruits and plants, provides beneficial effects for human health. The objectives of this study were to investigate whether chlorogenic acid (CHA) could improve the intestinal barrier integrity for weaned rats with lipopolysaccharide (LPS) challenge. Thirty-two weaned male Sprague Dawley rats (21±1 d of age; 62.26±2.73 g) were selected and randomly allotted to four treatments, including weaned rat control, LPS-challenged and chlorogenic acid (CHA) supplemented group (orally 20 mg/kg and 50 mg/kg body). Dietary supplementation with CHA decreased (P<0.05) the concentrations of urea and albumin in the serum, compared to the LPS-challenged group. The levels of IFN-γ and TNF-α were lower (P<0.05) in the jejunal and colon of weaned rats receiving CHA supplementation, in comparison with the control group. CHA supplementation increased (P<0.05) villus height and the ratio of villus height to crypt depth in the jejunal and ileal mucosae under condictions of LPS challenge. CHA supplementation decreased (P<0.05) intestinal permeability, which was indicated by the ratio of lactulose to mannitol and serum DAO activity, when compared to weaned rats with LPS challenge. Immunohistochemical analysis of tight junction proteins revealed that ZO-1 and occludin protein abundances in the jejunum and colon were increased (P<0.05) by CHA supplementation. Additionally, results of immunoblot analysis revealed that the amount of occludin in the colon was also increased (P<0.05) in CHA-supplemented rats. In conclusion, CHA decreases intestinal permeability and increases intestinal expression of tight junction proteins in weaned rats challenged with LPS. PMID:24887396

Challenges contributing to disrupted transition from paediatric to adult diabetes care in young adults with Type 1 diabetes

PubMed Central

Pyatak, E. A.; Sequeira, P. A.; Whittemore, R.; Vigen, C. P.; Peters, A. L.; Weigensberg, M. J.

2014-01-01

Aim To examine challenges contributing to disruptions in care during the transition from paediatric to adult care among young adults with Type 1 diabetes who are primarily in ethnic minority groups and have low socio-economic status. Methods Participants (n = 20) were newly enrolled patients in a transition clinic for young adults with Type 1 diabetes with a history of loss to medical follow-up. Participants completed qualitative semi-structured interviews detailing their transition experiences in addition to demographic, HbA1c and psychosocial measures. Descriptive statistics were completed for quantitative data, and narrative thematic analysis of interviews was used to identify common themes. A mixed-method analysis was used to identify the associations between stressors identified in interviews and clinical and psychosocial variables. Results Three categories of challenges contributing to loss to follow-up were identified: psychosocial challenges, health provider and health system challenges and developmental challenges. Participants experienced a high degree of stressful life circumstances which were associated with higher HbA1c (r = 0.60, P = 0.005), longer duration of loss to follow-up (r = 0.51, P = 0.02), greater emergency department utilization (r = 0.45, P = 0.05), and lower life satisfaction (r = −0.62, P = 0.003). Conclusions A confluence of challenges, including stressful life circumstances, healthcare system barriers and the developmental trajectory of young adulthood, contributes to a high risk of loss to follow-up and poor health in this population of young adults with Type 1 diabetes. An integrated approach to transition addressing medical and psychosocial needs may facilitate improved follow-up and health outcomes in clinical settings. PMID:24798586

Protein Biomarkers for Early Detection of Pancreatic Ductal Adenocarcinoma: Progress and Challenges.

PubMed

Root, Alex; Allen, Peter; Tempst, Paul; Yu, Kenneth

2018-03-07

Approximately 75% of patients with pancreatic ductal adenocarcinoma are diagnosed with advanced cancer, which cannot be safely resected. The most commonly used biomarker CA19-9 has inadequate sensitivity and specificity for early detection, which we define as Stage I/II cancers. Therefore, progress in next-generation biomarkers is greatly needed. Recent reports have validated a number of biomarkers, including combination assays of proteins and DNA mutations; however, the history of translating promising biomarkers to clinical utility suggests that several major hurdles require careful consideration by the medical community. The first set of challenges involves nominating and verifying biomarkers. Candidate biomarkers need to discriminate disease from benign controls with high sensitivity and specificity for an intended use, which we describe as a two-tiered strategy of identifying and screening high-risk patients. Community-wide efforts to share samples, data, and analysis methods have been beneficial and progress meeting this challenge has been achieved. The second set of challenges is assay optimization and validating biomarkers. After initial candidate validation, assays need to be refined into accurate, cost-effective, highly reproducible, and multiplexed targeted panels and then validated in large cohorts. To move the most promising candidates forward, ideally, biomarker panels, head-to-head comparisons, meta-analysis, and assessment in independent data sets might mitigate risk of failure. Much more investment is needed to overcome these challenges. The third challenge is achieving clinical translation. To moonshot an early detection test to the clinic requires a large clinical trial and organizational, regulatory, and entrepreneurial know-how. Additional factors, such as imaging technologies, will likely need to improve concomitant with molecular biomarker development. The magnitude of the clinical translational challenge is uncertain, but interdisciplinary cooperation within the PDAC community is poised to confront it.

Multi-parameter comparison of a standardized mixed meal tolerance test in healthy and type 2 diabetic subjects: the PhenFlex challenge.

PubMed

Wopereis, Suzan; Stroeve, Johanna H M; Stafleu, Annette; Bakker, Gertruud C M; Burggraaf, Jacobus; van Erk, Marjan J; Pellis, Linette; Boessen, Ruud; Kardinaal, Alwine A F; van Ommen, Ben

2017-01-01

A key feature of metabolic health is the ability to adapt upon dietary perturbations. Recently, it was shown that metabolic challenge tests in combination with the new generation biomarkers allow the simultaneous quantification of major metabolic health processes. Currently, applied challenge tests are largely non-standardized. A systematic review defined an optimal nutritional challenge test, the "PhenFlex test" (PFT). This study aimed to prove that PFT modulates all relevant processes governing metabolic health thereby allowing to distinguish subjects with different metabolic health status. Therefore, 20 healthy and 20 type 2 diabetic (T2D) male subjects were challenged both by PFT and oral glucose tolerance test (OGTT). During the 8-h response time course, 132 parameters were quantified that report on 26 metabolic processes distributed over 7 organs (gut, liver, adipose, pancreas, vasculature, muscle, kidney) and systemic stress. In healthy subjects, 110 of the 132 parameters showed a time course response. Patients with T2D showed 18 parameters to be significantly different after overnight fasting compared to healthy subjects, while 58 parameters were different in the post-challenge time course after the PFT. This demonstrates the added value of PFT in distinguishing subjects with different health status. The OGTT and PFT response was highly comparable for glucose metabolism as identical amounts of glucose were present in both challenge tests. Yet the PFT reports on additional processes, including vasculature, systemic stress, and metabolic flexibility. The PFT enables the quantification of all relevant metabolic processes involved in maintaining or regaining homeostasis of metabolic health. Studying both healthy subjects and subjects with impaired metabolic health showed that the PFT revealed new processes laying underneath health. This study provides the first evidence towards adopting the PFT as gold standard in nutrition research.

Challenges and Opportunities for Testing Students Who Are Deaf or Hard of Hearing: Information for Educators on Creating Test Equity. Test Equity Considerations: Schools

ERIC Educational Resources Information Center

PEPNet-West, 2010

2010-01-01

For most students, test taking is a challenge. For students who are deaf or hard of hearing, classroom quizzes, tests, and exams are even more challenging. Standardized tests--The SAT, ACT, state proficiency tests, No Child Left Behind annual tests, and psychoeducational evaluations--present additional challenges for students who are deaf or hard…

Vocational and Technical Education in Lebanon: Strategic Issues and Challenges

ERIC Educational Resources Information Center

Karam, Gebran

2006-01-01

The current status of the Lebanese vocational and technical education (VTE) system is assessed and the strategic issues and challenges facing it are identified. In addition to the economic and social challenges that are common to many developing countries, the Lebanese system suffers from idiosyncratic problems, which may require innovative and…

The placenta: a multifaceted, transient organ

PubMed Central

Burton, Graham J.; Fowden, Abigail L.

2015-01-01

The placenta is arguably the most important organ of the body, but paradoxically the most poorly understood. During its transient existence, it performs actions that are later taken on by diverse separate organs, including the lungs, liver, gut, kidneys and endocrine glands. Its principal function is to supply the fetus, and in particular, the fetal brain, with oxygen and nutrients. The placenta is structurally adapted to achieve this, possessing a large surface area for exchange and a thin interhaemal membrane separating the maternal and fetal circulations. In addition, it adopts other strategies that are key to facilitating transfer, including remodelling of the maternal uterine arteries that supply the placenta to ensure optimal perfusion. Furthermore, placental hormones have profound effects on maternal metabolism, initially building up her energy reserves and then releasing these to support fetal growth in later pregnancy and lactation post-natally. Bipedalism has posed unique haemodynamic challenges to the placental circulation, as pressure applied to the vena cava by the pregnant uterus may compromise venous return to the heart. These challenges, along with the immune interactions involved in maternal arterial remodelling, may explain complications of pregnancy that are almost unique to the human, including pre-eclampsia. Such complications may represent a trade-off against the provision for a large fetal brain. PMID:25602070

Progress in development of an integrated dietary supplement ingredient database at the NIH Office of Dietary Supplements

PubMed Central

Dwyer, Johanna T.; Picciano, Mary Frances; Betz, Joseph M.; Fisher, Kenneth D.; Saldanha, Leila G.; Yetley, Elizabeth A.; Coates, Paul M.; Radimer, Kathy; Bindewald, Bernadette; Sharpless, Katherine E.; Holden, Joanne; Andrews, Karen; Zhao, Cuiwei; Harnly, James; Wolf, Wayne R.; Perry, Charles R.

2013-01-01

Several activities of the Office of Dietary Supplements (ODS) at the National Institutes of Health involve enhancement of dietary supplement databases. These include an initiative with US Department of Agriculture to develop an analytically substantiated dietary supplement ingredient database (DSID) and collaboration with the National Center for Health Statistics to enhance the dietary supplement label database in the National Health and Nutrition Examination Survey (NHANES). The many challenges that must be dealt with in developing an analytically supported DSID include categorizing product types in the database, identifying nutrients, and other components of public health interest in these products and prioritizing which will be entered in the database first. Additional tasks include developing methods and reference materials for quantifying the constituents, finding qualified laboratories to measure the constituents, developing appropriate sample handling procedures, and finally developing representative sampling plans. Developing the NHANES dietary supplement label database has other challenges such as collecting information on dietary supplement use from NHANES respondents, constant updating and refining of information obtained, developing default values that can be used if the respondent cannot supply the exact supplement or strength that was consumed, and developing a publicly available label database. Federal partners and the research community are assisting in making an analytically supported dietary supplement database a reality. PMID:25309034

Current methods for the isolation of extracellular vesicles.

PubMed

Momen-Heravi, Fatemeh; Balaj, Leonora; Alian, Sara; Mantel, Pierre-Yves; Halleck, Allison E; Trachtenberg, Alexander J; Soria, Cesar E; Oquin, Shanice; Bonebreak, Christina M; Saracoglu, Elif; Skog, Johan; Kuo, Winston Patrick

2013-10-01

Extracellular vesicles (EVs), including microvesicles and exosomes, are nano- to micron-sized vesicles, which may deliver bioactive cargos that include lipids, growth factors and their receptors, proteases, signaling molecules, as well as mRNA and non-coding RNA, released from the cell of origin, to target cells. EVs are released by all cell types and likely induced by mechanisms involved in oncogenic transformation, environmental stimulation, cellular activation, oxidative stress, or death. Ongoing studies investigate the molecular mechanisms and mediators of EVs-based intercellular communication at physiological and oncogenic conditions with the hope of using this information as a possible source for explaining physiological processes in addition to using them as therapeutic targets and disease biomarkers in a variety of diseases. A major limitation in this evolving discipline is the hardship and the lack of standardization for already challenging techniques to isolate EVs. Technical advances have been accomplished in the field of isolation with improving knowledge and emerging novel technologies, including ultracentrifugation, microfluidics, magnetic beads and filtration-based isolation methods. In this review, we will discuss the latest advances in methods of isolation methods and production of clinical grade EVs as well as their advantages and disadvantages, and the justification for their support and the challenges that they encounter.

Anaerobic digestion of food waste - Challenges and opportunities.

PubMed

Xu, Fuqing; Li, Yangyang; Ge, Xumeng; Yang, Liangcheng; Li, Yebo

2018-01-01

The disposal of large amounts of food waste has caused significant environmental pollution and financial costs globally. Compared with traditional disposal methods (i.e., landfilling, incineration, and composting), anaerobic digestion (AD) is a promising technology for food waste management, but has not yet been fully applied due to a few technical and social challenges. This paper summarizes the quantity, composition, and methane potential of various types of food waste. Recent research on different strategies to enhance AD of food waste, including co-digestion, addition of micronutrients, control of foaming, and process design, is discussed. It is envisaged that AD of food waste could be combined with an existing AD facility or be integrated with the production of value-added products to reduce costs and increase revenue. Further understanding of the fundamental biological and physicochemical processes in AD is required to improve the technology. Copyright © 2017 Elsevier Ltd. All rights reserved.

AMT (3-(2-aminopropyl)indole) and 5-IT (5-(2-aminopropyl)indole): an analytical challenge and implications for forensic analysis.

PubMed

Elliott, Simon P; Brandt, Simon D; Freeman, Sally; Archer, Roland P

2013-03-01

5-(2-Aminopropyl)indole (5-IT) and 3-(2-aminopropyl)indole (α-methyltryptamine, AMT) are isomeric substances and their differentiation can be a challenge under routine analytical conditions, especially when reference material is unavailable. 5-IT represents a very recent addition to the battery of new psychoactive substances that are commercially available from online retailers. This report illustrates how subtle differences observed under mass spectral and UV conditions can help to facilitate the differentiation between the two isomers. Analyses included (1)  H and (13) C NMR, GC-EI/CI ion trap MS, applications of several U/HPLC-DAD and HPLC-MS methods. Investigations currently underway also highlight the confirmation that AMT was detected in a number of fatal intoxications. These findings also demonstrate that there is a potential risk of misidentification when dealing with both substances. Copyright © 2012 John Wiley & Sons, Ltd.

A multi target approach to control chemical reactions in their inhomogeneous solvent environment

NASA Astrophysics Data System (ADS)

Keefer, Daniel; Thallmair, Sebastian; Zauleck, Julius P. P.; de Vivie-Riedle, Regina

2015-12-01

Shaped laser pulses offer a powerful tool to manipulate molecular quantum systems. Their application to chemical reactions in solution is a promising concept to redesign chemical synthesis. Along this road, theoretical developments to include the solvent surrounding are necessary. An appropriate theoretical treatment is helpful to understand the underlying mechanisms. In our approach we simulate the solvent by randomly selected snapshots from molecular dynamics trajectories. We use multi target optimal control theory to optimize pulses for the various arrangements of explicit solvent molecules simultaneously. This constitutes a major challenge for the control algorithm, as the solvent configurations introduce a large inhomogeneity to the potential surfaces. We investigate how the algorithm handles the new challenges and how well the controllability of the system is preserved with increasing complexity. Additionally, we introduce a way to statistically estimate the efficiency of the optimized laser pulses in the complete thermodynamical ensemble.

Bloodstream infections in haematology: risks and new challenges for prevention.

PubMed

Worth, Leon J; Slavin, Monica A

2009-05-01

Bloodstream infections are an important cause of morbidity and mortality in the haematology population, and may contribute to delayed administration of chemotherapy, increased length of hospitalisation, and increased healthcare expenditure. For gram-positive, gram-negative, anaerobic and fungal infections, specific risk factors are recognised. Unique host and environmental factors contributing to pathogenesis are acknowledged in this population. Trends in spectrum and antimicrobial susceptibility of pathogens are examined, and potential contributing factors are discussed. These include the widespread use of empiric antimicrobial therapy, increasingly intensive chemotherapeutic regimens, frequent use of central venous catheters, and local infection control practices. In addition, the risks and benefits of prophylaxis, and spectrum of endemic flora are identified as relevant factors within individual centres. Finally, challenges are presented regarding prevention, early detection, surveillance and prophylaxis. To reduce the rate and impact of bloodstream infections multifaceted and customised strategies are required within individual haematology units.

Potential of Continuous Manufacturing for Liposomal Drug Products.

PubMed

Worsham, Robert D; Thomas, Vaughan; Farid, Suzanne S

2018-05-21

Over the last several years, continuous manufacturing of pharmaceuticals has evolved from bulk APIs and solid oral dosages into the more complex realm of biologics. The development of continuous downstream processing techniques has allowed biologics manufacturing to realize the benefits (e.g. improved economics, more consistent quality) that come with continuous processing. If relevant processing techniques and principles are selected, the opportunity arises to develop continuous manufacturing designs for additional pharmaceutical products including liposomal drug formulations. Liposome manufacturing has some inherent aspects that make it favorable for a continuous process. Other aspects such as formulation refinement, materials of construction, and aseptic processing need development, but present an achievable challenge. This paper reviews the current state of continuous manufacturing technology applicable to liposomal drug product manufacturing and an assessment of the challenges and potential of this application. This article is protected by copyright. All rights reserved.