Sample records for address current challenges

  1. EPA Leadership on Science, Innovation, and Decision Support Tools for Addressing Current and Future Challenges.

    PubMed

    Hecht, Alan D; Ferster, Aaron; Summers, Kevin

    2017-10-16

    When the U.S. Environmental Protection Agency (EPA) was established nearly 50 years ago, the nation faced serious threats to its air, land, and water, which in turn impacted human health. These threats were effectively addressed by the creation of EPA (in 1970) and many subsequent landmark environmental legislations which in turn significantly reduced threats to the Nation's environment and public health. A key element of historic legislation is research aimed at dealing with current and future problems. Today we face national and global challenges that go beyond classic media-specific (air, land, water) environmental legislation and require an integrated paradigm of action and engagement based on (1) innovation based on science and technology, (2) stakeholder engagement and collaboration, and (3) public education and support. This three-pronged approach recognizes that current environmental problems, include social as well as physical and environmental factors, are best addressed through collaborative problem solving, the application of innovation in science and technology, and multiple stakeholder engagement. To achieve that goal, EPA's Office of Research and Development (ORD) is working directly with states and local communities to develop and apply a suite of accessible decision support tools (DST) that aim to improve environmental conditions, protect human health, enhance economic opportunity, and advance a resilient and sustainability society. This paper showcases joint EPA and state actions to develop tools and approaches that not only meet current environmental and public health challenges, but do so in a way that advances sustainable, healthy, and resilient communities well into the future. EPA's future plans should build on current work but aim to effectively respond to growing external pressures. Growing pressures from megatrends are a major challenge for the new Administration and for cities and states across the country. The recent hurricanes hitting

  2. CIRM Alpha Stem Cell Clinics: Collaboratively Addressing Regenerative Medicine Challenges.

    PubMed

    Jamieson, Catriona H M; Millan, Maria T; Creasey, Abla A; Lomax, Geoff; Donohoe, Mary E; Walters, Mark C; Abedi, Mehrdad; Bota, Daniela A; Zaia, John A; Adams, John S

    2018-06-01

    The California Institute for Regenerative Medicine (CIRM) Alpha Stem Cell Clinic (ASCC) Network was launched in 2015 to address a compelling unmet medical need for rigorous, FDA-regulated, stem cell-related clinical trials for patients with challenging, incurable diseases. Here, we describe our multi-center experiences addressing current and future challenges. Copyright © 2018 Elsevier Inc. All rights reserved.

  3. Multiscale Modeling in Computational Biomechanics: Determining Computational Priorities and Addressing Current Challenges

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

    Tawhai, Merryn; Bischoff, Jeff; Einstein, Daniel R.

    2009-05-01

    Abstract In this article, we describe some current multiscale modeling issues in computational biomechanics from the perspective of the musculoskeletal and respiratory systems and mechanotransduction. First, we outline the necessity of multiscale simulations in these biological systems. Then we summarize challenges inherent to multiscale biomechanics modeling, regardless of the subdiscipline, followed by computational challenges that are system-specific. We discuss some of the current tools that have been utilized to aid research in multiscale mechanics simulations, and the priorities to further the field of multiscale biomechanics computation.

  4. Adequately Addressing Pediatric Obesity: Challenges Faced by Primary Care Providers.

    PubMed

    Shreve, Marilou; Scott, Allison; Vowell Johnson, Kelly

    2017-07-01

    To assess the challenges primary care providers encounter when providing counseling for pediatric patients identified as obese. A survey assessed the current challenges and barriers to the screening and treatment of pediatric obesity for providers in northwest Arkansas who provide care to families. The survey consisted of 15 Likert scale questions and 4 open-ended questions. Time, resources, comfort, and cultural issues were reported by providers as the biggest barriers in screening and the treatment of pediatric obesity. All providers reported lack of time as a barrier to providing the care needed for obese children. Cultural barriers of both the provider and client were identified as factors, which negatively affect the care and treatment of obese children. Primary care providers continue to experience challenges when addressing pediatric obesity. In this study, a lack of adequate time to address obesity was identified as the most significant current barrier and may likely be tied to physician resources. Although reimbursement for obesity is increasing, the level of reimbursement does not support the time or the resources needed to treat patients. Many providers reported their patients' cultural view of obesity influenced how they counsel their patients. Increasing providers' knowledge concerning differences in how weight is viewed or valued may assist them in the assessment and care of obese pediatric patients. The challenges identified in previous research continue to limit providers when addressing obesity. Although progress has been made regarding knowledge of guidelines, continuing effort is needed to tackle the remaining challenges. This will allow for earlier identification and intervention, resulting in improved outcomes in pediatric obesity.

  5. Applying evolutionary biology to address global challenges

    PubMed Central

    Carroll, Scott P.; Jørgensen, Peter Søgaard; Kinnison, Michael T.; Bergstrom, Carl T.; Denison, R. Ford; Gluckman, Peter; Smith, Thomas B.; Strauss, Sharon Y.; Tabashnik, Bruce E.

    2014-01-01

    Two categories of evolutionary challenges result from escalating human impacts on the planet. The first arises from cancers, pathogens and pests that evolve too quickly, and the second from the inability of many valued species to adapt quickly enough. Applied evolutionary biology provides a suite of strategies to address these global challenges that threaten human health, food security, and biodiversity. This review highlights both progress and gaps in genetic, developmental and environmental manipulations across the life sciences that either target the rate and direction of evolution, or reduce the mismatch between organisms and human-altered environments. Increased development and application of these underused tools will be vital in meeting current and future targets for sustainable development. PMID:25213376

  6. Challenges in Diabetes Care: Can Digital Health Help Address Them?

    PubMed Central

    Close, Kelly

    2016-01-01

    In Brief There is great enthusiasm for the potential of digital health solutions in medicine and diabetes to address key care challenges: patient and provider burden, lack of data to inform therapeutic decision-making, poor access to care, and costs. However, the field is still in its nascent days; many patients and providers do not currently engage with digital health tools, and for those who do, the burden is still often high. Over time, digital health has excellent potential to collect data more seamlessly, make collected data more useful, and drive better outcomes at lower costs in less time. But there is still much to prove. This review offers key background information on the current state of digital health in diabetes, six of the most promising digital health technologies and services, and the challenges that remain. PMID:27621530

  7. Addressing current and future challenges for the NHS: the role of good leadership.

    PubMed

    Elton, Lotte

    2016-10-03

    Purpose This paper aims to describe and analyse some of the ways in which good leadership can enable those working within the National Health Service (NHS) to weather the changes and difficulties likely to arise in the coming years, and takes the format of an essay written by the prize-winner of the Faculty of Medical Leadership and Management's Student Prize. The Faculty of Medical Leadership and Management ran its inaugural Student Prize in 2015-2016, which aimed at medical students with an interest in medical leadership. In running the Prize, the Faculty hoped to foster an enthusiasm for and understanding of the importance of leadership in medicine. Design/methodology/approach The Faculty asked entrants to discuss the role of good leadership in addressing the current and future challenges faced by the NHS, making reference to the Leadership and Management Standards for Medical Professionals published by the Faculty in 2015. These standards were intended to help guide current and future leaders and were grouped into three categories, namely, self, team and corporate responsibility. Findings This paper highlights the political nature of health care in the UK and the increasing impetus on medical professionals to navigate debates on austerity measures and health-care costs, particularly given the projected deficit in NHS funding. It stresses the importance of building organisational cultures prizing transparency to prevent future breaches in standards of care and the value of patient-centred approaches in improving satisfaction for both patients and staff. Identification of opportunities for collaboration and partnership is emphasised as crucial to assuage the burden that lack of appropriate social care places on clinical services. Originality/value This paper offers a novel perspective - that of a medical student - on the complex issues faced by the NHS over the coming years and utilises a well-regarded set of standards in conceptualising the role that health

  8. Current Challenges for HTCMC Aero-Propulsion Components

    NASA Technical Reports Server (NTRS)

    DiCarlo, James A.; Bansal, Narottam P.

    2007-01-01

    In comparison to the best metallic materials, HTCMC aero-propulsion engine components offer the opportunity of reduced weight and higher temperature operation, with corresponding improvements in engine cooling requirements, emissions, thrust, and specific fuel consumption. Although much progress has been made in the development of advanced HTCMC constituent materials and processes, major challenges still remain for their implementation into these components. The objectives of this presentation are to briefly review (1) potential HTCMC aero-propulsion components and their generic material performance requirements, (2) recent progress at NASA and elsewhere concerning advanced constituents and processes for meeting these requirements, (3) key HTCMC component implementation challenges that are currently being encountered, and (4) on-going activities within the new NASA Fundamental Aeronautics Program that are addressing these challenges.

  9. Unmanned Aerial Systems: Further Actions Needed to Fully Address Air Force and Army Pilot Workforce Challenges

    DTIC Science & Technology

    2016-03-16

    UNMANNED AERIAL SYSTEMS Further Actions Needed to Fully Address Air Force and Army Pilot Workforce Challenges...Armed Services, U.S. Senate March 16, 2016 UNMANNED AERIAL SYSTEMS Further Actions Needed to Fully Address Air Force and Army Pilot Workforce ...High-performing organizations use complete and current data to inform their strategic human capital planning and remain open to reevaluating workforce

  10. Addressing the Big-Earth-Data Variety Challenge with the Hierarchical Triangular Mesh

    NASA Technical Reports Server (NTRS)

    Rilee, Michael L.; Kuo, Kwo-Sen; Clune, Thomas; Oloso, Amidu; Brown, Paul G.; Yu, Honfeng

    2016-01-01

    We have implemented an updated Hierarchical Triangular Mesh (HTM) as the basis for a unified data model and an indexing scheme for geoscience data to address the variety challenge of Big Earth Data. We observe that, in the absence of variety, the volume challenge of Big Data is relatively easily addressable with parallel processing. The more important challenge in achieving optimal value with a Big Data solution for Earth Science (ES) data analysis, however, is being able to achieve good scalability with variety. With HTM unifying at least the three popular data models, i.e. Grid, Swath, and Point, used by current ES data products, data preparation time for integrative analysis of diverse datasets can be drastically reduced and better variety scaling can be achieved. In addition, since HTM is also an indexing scheme, when it is used to index all ES datasets, data placement alignment (or co-location) on the shared nothing architecture, which most Big Data systems are based on, is guaranteed and better performance is ensured. Moreover, our updated HTM encoding turns most geospatial set operations into integer interval operations, gaining further performance advantages.

  11. Current Challenges in Integrating Educational Technology into Elementary and Middle School Mathematics Education

    ERIC Educational Resources Information Center

    Okita, Sandra Y.; Jamalian, Azadeh

    2011-01-01

    Developing curriculum and instruction for mathematics education and designing technologically enhanced learning environments are often pursued separately, but may need to be addressed together to effectively link the strengths of technology to performance in mathematics and conceptual understanding. This paper addresses current challenges with…

  12. Addressing data access challenges in seismology

    NASA Astrophysics Data System (ADS)

    Trabant, C. M.; Ahern, T.; Weertman, B.; Benson, R. B.; Van Fossen, M.; Weekly, R. T.; Casey, R. E.; Suleiman, Y. Y.; Stults, M.

    2016-12-01

    The development of web services at the IRIS Data Management Center (DMC) over the last 6 years represents the most significant enhancement of data access ever introduced at the DMC. These web services have allowed the us to focus our internal operations around a single, consistent data access layer while facilitating development of a new generation of tools and methods for researchers to conduct their work. This effort led the DMC to propose standardized web service interfaces within the International Federation of Digital Seismograph Networks (FDSN), enabling other seismological data centers to offer data using compatible interfaces. With this new foundation, we now turn our attention to more advanced data access challenges. In particular, we will present the status of two developments intending to address 1) access to data of consistent quality for science and 2) discovery and access of data from multiple data centers. To address the challenge of requesting high or consistent quality data we will introduce our Research-Ready Data Sets (RRDS) initiative. The purpose of the RRDS project is to reduce the time a researcher spends culling and otherwise identifying data appropriate for given study. RRDS will provide users with additional criteria related to data quality that can be specified when requesting data. Leveraging the data quality measurements provided by our MUSTANG system, these criteria will include ambient noise, completeness, dead channel identification and more. To address the challenge of seismological data discovery and access, we have built and continue to improve the IRIS Federator. The Federator takes advantage of the FDSN-standard web services at various data centers to help a user locate specific channels, wherever they may be offered globally. The search interface provides results that are pre-formatted requests, ready for submission to each data center that serves that data. These two developments are aimed squarely at reducing the time

  13. Cultural neuroscience and global mental health: addressing grand challenges

    PubMed Central

    Chiao, Joan Y.; Li, Shu-Chen; Turner, Robert; Lee-Tauler, Su Yeon; Pringle, Beverly A.

    2016-01-01

    Mental, neurological and substance-use (MNS) disorders comprise approximately 13% of the global burden of disease. The Grand Challenges in Global Mental Health Initiative has recently identified research priorities for the next decade to address prevention and treatment of MNS disorders. One main research priority is to identify the root causes, risks and protective factors associated with global mental health. Recent advances in cultural neuroscience have identified theoretical, methodological, and empirical methods of identifying biomarkers associated with mental health disorders across nations. Here we review empirical research in cultural neuroscience that address meeting the grand challenges in global mental health. PMID:28642836

  14. ADDRESSING ENVIRONMENTAL ENGINEERING CHALLENGES WITH COMPUTATIONAL FLUID DYNAMICS

    EPA Science Inventory

    This paper discusses the status and application of Computational Fluid Dynamics )CFD) models to address environmental engineering challenges for more detailed understanding of air pollutant source emissions, atmospheric dispersion and resulting human exposure. CFD simulations ...

  15. 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

  16. 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.

  17. USGS Science: Addressing Our Nation's Challenges

    USGS Publications Warehouse

    Larson, Tania M.

    2009-01-01

    With 6.6 billion people already living on Earth, and that number increasing every day, human influence on our planet is ever more apparent. Changes to the natural world combined with increasing human demands threaten our health and safety, our national security, our economy, and our quality of life. As a planet and a Nation, we face unprecedented challenges: loss of critical and unique ecosystems, the effects of climate change, increasing demand for limited energy and mineral resources, increasing vulnerability to natural hazards, the effects of emerging diseases on wildlife and human health, and growing needs for clean water. The time to respond to these challenges is now, but policymakers and decisionmakers face difficult choices. With competing priorities to balance, and potentially serious - perhaps irreversible - consequences at stake, our leaders need reliable scientific information to guide their decisions. As the Nation's earth and natural science agency, the USGS monitors and conducts scientific research on natural hazards and resources and how these elements and human activities influence our environment. Because the challenges we face are complex, the science needed to better understand and deal with these challenges must reflect the complex interplay among natural and human systems. With world-class expertise in biology, geology, geography, hydrology, geospatial information, and remote sensing, the USGS is uniquely capable of conducting the comprehensive scientific research needed to better understand the interdependent interactions of Earth's systems. Every day, the USGS helps decisionmakers to minimize loss of life and property, manage our natural resources, and protect and enhance our quality of life. This brochure provides examples of the challenges we face and how USGS science helps decisionmakers to address these challenges.

  18. Addressing tomorrow's DMO technical challenges today

    NASA Astrophysics Data System (ADS)

    Milligan, James R.

    2009-05-01

    Distributed Mission Operations (DMO) is essentially a type of networked training that pulls in participants from all the armed services and, increasingly, allies to permit them to "game" and rehearse highly complex campaigns, using a mix of local, distant, and virtual players. The United States Air Force Research Laboratory (AFRL) is pursuing Science and Technology (S&T) solutions to address technical challenges associated with distributed communications and information management as DMO continues to progressively scale up the number, diversity, and geographic dispersal of participants in training and rehearsal exercises.

  19. NREL, SolarCity Addressing Challenges of High Penetrations of Distributed

    Science.gov Websites

    Companies NREL, SolarCity Addressing Challenges of High Penetrations of Distributed Photovoltaics NREL is , reliability, and stability challenges of interconnecting high penetrations of distributed photovoltaics (PV country that distributed solar is not a liability for reliability-and can even be an asset. Project Impact

  20. Addressing unwarranted clinical variation: A rapid review of current evidence.

    PubMed

    Harrison, Reema; Manias, Elizabeth; Mears, Stephen; Heslop, David; Hinchcliff, Reece; Hay, Liz

    2018-05-15

    Unwarranted clinical variation (UCV) can be described as variation that can only be explained by differences in health system performance. There is a lack of clarity regarding how to define and identify UCV and, once identified, to determine whether it is sufficiently problematic to warrant action. As such, the implementation of systemic approaches to reducing UCV is challenging. A review of approaches to understand, identify, and address UCV was undertaken to determine how conceptual and theoretical frameworks currently attempt to define UCV, the approaches used to identify UCV, and the evidence of their effectiveness. Rapid evidence assessment (REA) methodology was used. A range of text words, synonyms, and subject headings were developed for the major concepts of unwarranted clinical variation, standards (and deviation from these standards), and health care environment. Two electronic databases (Medline and Pubmed) were searched from January 2006 to April 2017, in addition to hand searching of relevant journals, reference lists, and grey literature. Results were merged using reference-management software (Endnote) and duplicates removed. Inclusion criteria were independently applied to potentially relevant articles by 3 reviewers. Findings were presented in a narrative synthesis to highlight key concepts addressed in the published literature. A total of 48 relevant publications were included in the review; 21 articles were identified as eligible from the database search, 4 from hand searching published work and 23 from the grey literature. The search process highlighted the voluminous literature reporting clinical variation internationally; yet, there is a dearth of evidence regarding systematic approaches to identifying or addressing UCV. Wennberg's classification framework is commonly cited in relation to classifying variation, but no single approach is agreed upon to systematically explore and address UCV. The instances of UCV that warrant investigation and

  1. Global challenges keynote address in memoriam to colleagues lost in the Malaysia airlines 17 crash

    PubMed Central

    Hankins, Catherine A.

    2016-01-01

    ABSTRACT Six colleagues working in the HIV field were killed when their flight en route to Kuala Lumpur was shot down over the Ukraine. This report is drawn from the in memoriam keynote opening address given at the 12th International AIDS Impact conference in Amsterdam in 2015. It highlights their tangible and valued roles in the HIV response and looks forward to the road ahead. It describes the ways in which we can build on their legacy to address current global challenges in HIV prevention and treatment and to mobilise the intensified, focused resources that are needed to turn the HIV epidemic on its head. PMID:26963879

  2. Global challenges keynote address in memoriam to colleagues lost in the Malaysia airlines 17 crash.

    PubMed

    Hankins, Catherine A

    2016-01-01

    Six colleagues working in the HIV field were killed when their flight en route to Kuala Lumpur was shot down over the Ukraine. This report is drawn from the in memoriam keynote opening address given at the 12th International AIDS Impact conference in Amsterdam in 2015. It highlights their tangible and valued roles in the HIV response and looks forward to the road ahead. It describes the ways in which we can build on their legacy to address current global challenges in HIV prevention and treatment and to mobilise the intensified, focused resources that are needed to turn the HIV epidemic on its head.

  3. Warren K. Sinclair Keynote Address: Current challenges in countering radiological terrorism.

    PubMed

    Poston, John W

    2005-11-01

    Terrorism, although perhaps known by other names, is not a new phenomenon. It dates back to Roman times and perhaps even further in world history. Caleb Carr says terrorism "is simply the contemporary name given to, and the modern permutation of, warfare deliberately waged against civilians with the purpose of destroying their will to support either their leaders or policies... " In modern times, in the United States, there have been isolated violent acts of citizens against each other, although these acts often were directed toward symbols of the federal government. In the Middle East and other parts of the world, acts of violence against U.S. citizens and military personnel date back into the early 1960's. Some of these acts seem to be almost random in nature. But these events occurred in distant lands of sometimes uncertain locations to the American public, who soon forgot them and their important message. Even though there had been at least one other attempt on the World Trade Center, it was not until 11 September 2001 that successful, large-scale acts of terrorism came to our shores. In 1998, the National Council on Radiation Protection and Measurements (NCRP) formed a Scientific Committee and charged the committee with the task of providing a report on the state of preparation and the potential use by terrorists of radiation and radioactivity. The draft report of the Committee was produced a year in advance of the events of 11 September 2001 and was published in its final form about a month after these terrible events. The report brought together, in one place, information that existed in a number of areas, not all of which were easily accessible. However, there were a number of gaps in the information and in the planning and preparation for such events. These were reflected in a series of recommendations for organization, planning, and training, as well as for research and development in a number of areas. This brief presentation will address a few selected

  4. Do textbooks address known learning challenges in area measurement? A comparative analysis

    NASA Astrophysics Data System (ADS)

    Hong, Dae S.; Choi, Kyong Mi; Runnalls, Cristina; Hwang, Jihyun

    2018-02-01

    This study compared area lessons from Korean textbooks and US standard-based textbooks to understand differences and similarities among these textbooks, as well as how these textbooks address known learning challenges in area measurement. Several well-known challenges have been identified in previous studies, such as covering, array structure, and linking array structure to area formula. We were interested in knowing if textbooks addressed these issues in their treatments of area measurement and, in doing so, provided students with opportunities to overcome or become familiar with known challenges. The results show that both countries' textbooks demonstrated similar limitations; only few area and area-related lessons are covered and three important learning challenges in area measurement are not covered well, which need to be informed to practicing teachers.

  5. Addressing the Grand Challenge of atmospheric carbon dioxide: geologic sequestration vs. biological recycling

    PubMed Central

    2011-01-01

    On February 15, 2008, the National Academy of Engineering unveiled their list of 14 Grand Challenges for Engineering. Building off of tremendous advancements in the past century, these challenges were selected for their role in assuring a sustainable existence for the rapidly increasing global community. It is no accident that the first five Challenges on the list involve the development of sustainable energy sources and management of environmental resources. While the focus of this review is to address the single Grand Challenge of "develop carbon sequestration methods", is will soon be clear that several other Challenges are intrinsically tied to it through the principles of sustainability. How does the realm of biological engineering play a role in addressing these Grand Challenges? PMID:22047501

  6. Cooperation of international Research Infrastructures to address environmental global challenges

    NASA Astrophysics Data System (ADS)

    Bonet García, Francisco J.; Suárez-Muñoz, María; Conchubhair, Diarmuid O.; Dohna, Tina; Lo Bue, Nadia

    2017-04-01

    Human impact on the planet is causing a set of global environmental problems that threaten the wellbeing of current and future generations. Examples of these environmental problems include climate change, decline of biodiversity, alteration of biogeochemical cycles, ocean acidification, etc. These environmental Global Challenges (GCs) are transnational and complex, combining elements of both natural and social factors. Providing solutions for these challenges can be significantly enhanced through the collaboration of various related institutions, governments and stakeholders. A deeper understanding of the causes and consequences of GCs, as well as the processes which control them is required. Environmental Research Infrastructures (DANUBIUS-RI) are key players in this learning process. Covering many fields of research, it is through RIs collaboration that GCs can be more fully addressed. However, the collaboration among environmental RIs is still limited nationally as well as internationally. Although contact is encouraged and interactions are common practice, there are few cases where RI managers initiate and foster transnational collaborations in order to address specific problems. The COOP+ project aims to explore and strengthen cooperation among global RIs by bringing various RIs together and working on the identification of requirements, strengths, knowledge gaps and other relevant items in regard to the selected GCs. For this purpose, 13 GCs have been selected: coral bleaching, marine debris, noise impact on marine fauna, Arctic sea ice melting, pollinators decline, threatened species, agriculture pollutants, nitrogen cycle, carbon and GHG, geohazards and extreme events, estuaries, global urbanization process, and ozone depletion. These GCs are being analysed and described by multidisciplinary teams of experts composed of scientists, RIs operators and other stakeholders. This assessment will derive a list of tasks and requirements to be fulfilled by the

  7. Aviation Security: Efforts to Measure Effectiveness and Address Challenges

    DTIC Science & Technology

    2003-11-05

    AND SUBTITLE AVIATION SECURITY Efforts to Meassure Effectiveness and Address Challenges 5a. CONTRACT NUMBER 5b. GRANT NUMBER 5c. PROGRAM ELEMENT...screeners in becoming more adept at detecting hard -to-spot threat objects. However, TIP was shut down immediately following the September 11

  8. Managing flood risks in the Mekong Delta: How to address emerging challenges under climate change and socioeconomic developments.

    PubMed

    Hoang, Long Phi; Biesbroek, Robbert; Tri, Van Pham Dang; Kummu, Matti; van Vliet, Michelle T H; Leemans, Rik; Kabat, Pavel; Ludwig, Fulco

    2018-02-24

    Climate change and accelerating socioeconomic developments increasingly challenge flood-risk management in the Vietnamese Mekong River Delta-a typical large, economically dynamic and highly vulnerable delta. This study identifies and addresses the emerging challenges for flood-risk management. Furthermore, we identify and analyse response solutions, focusing on meaningful configurations of the individual solutions and how they can be tailored to specific challenges using expert surveys, content analysis techniques and statistical inferences. Our findings show that the challenges for flood-risk management are diverse, but critical challenges predominantly arise from the current governance and institutional settings. The top-three challenges include weak collaboration, conflicting management objectives and low responsiveness to new issues. We identified 114 reported solutions and developed six flood management strategies that are tailored to specific challenges. We conclude that the current technology-centric flood management approach is insufficient given the rapid socioecological changes. This approach therefore should be adapted towards a more balanced management configuration where technical and infrastructural measures are combined with institutional and governance resolutions. Insights from this study contribute to the emerging repertoire of contemporary flood management solutions, especially through their configurations and tailoring to specific challenges.

  9. The Historical Context, Current Development, and Future Challenges of Distance Education in Indonesia

    ERIC Educational Resources Information Center

    Zuhairi, Aminudin; Wahyono, Effendi; Suratinah, Sharon

    2006-01-01

    This article addresses the historical context, current development, and future challenges of distance education in Indonesia. Conditions related to the geography, demography, socio-economic and cultural situations, as well as the availability of technology have encouraged the use of distance education as a valid choice in providing access to…

  10. Current Challenges in Geothermal Reservoir Simulation

    NASA Astrophysics Data System (ADS)

    Driesner, T.

    2016-12-01

    Geothermal reservoir simulation has long been introduced as a valuable tool for geothermal reservoir management and research. Yet, the current generation of simulation tools faces a number of severe challenges, in particular in the application for novel types of geothermal resources such as supercritical reservoirs or hydraulic stimulation. This contribution reviews a number of key problems: Representing the magmatic heat source of high enthalpy resources in simulations. Current practice is representing the deeper parts of a high enthalpy reservoir by a heat flux or temperature boundary condition. While this is sufficient for many reservoir management purposes it precludes exploring the chances of very high enthalpy resources in the deepest parts of such systems as well as the development of reliable conceptual models. Recent 2D simulations with the CSMP++ simulation platform demonstrate the potential of explicitly including the heat source, namely for understanding supercritical resources. Geometrically realistic incorporation of discrete fracture networks in simulation. A growing number of simulation tools can, in principle, handle flow and heat transport in discrete fracture networks. However, solving the governing equations and representing the physical properties are often biased by introducing strongly simplifying assumptions. Including proper fracture mechanics in complex fracture network simulations remains an open challenge. Improvements of the simulating chemical fluid-rock interaction in geothermal reservoirs. Major improvements have been made towards more stable and faster numerical solvers for multicomponent chemical fluid rock interaction. However, the underlying thermodynamic models and databases are unable to correctly address a number of important regions in temperature-pressure-composition parameter space. Namely, there is currently no thermodynamic formalism to describe relevant chemical reactions in supercritical reservoirs. Overcoming this

  11. Addressing strategy execution challenges to lead sustainable change.

    PubMed

    Shirey, Maria R

    2011-01-01

    This department highlights change management strategies that may be successful in strategically planning and executing organizational change initiatives. With the goal of presenting practical approaches helpful to nurse leaders advancing organizational change, content includes evidence-based projects, tools, and resources that mobilize and sustain organizational change initiatives. In this article, the author discusses strategy execution challenges that must be addressed to lead sustainable change.

  12. Challenges to using a business case for addressing health disparities.

    PubMed

    Lurie, Nicole; Somers, Stephen A; Fremont, Allen; Angeles, January; Murphy, Erin K; Hamblin, Allison

    2008-01-01

    The authors consider the challenges to quantifying both the business case and the social case for addressing disparities, which is central to achieving equity in the U.S. health care system. They describe the practical and methodological challenges faced by health plans exploring the business and social cases for undertaking disparity-reducing interventions. Despite these challenges, sound business and quality improvement principles can guide health care organizations seeking to reduce disparities. Place-based interventions may help focus resources and engage health care and community partners who can share in the costs of-and gains from-such efforts.

  13. Biological approaches for addressing the grand challenge of providing access to clean drinking water.

    PubMed

    Riley, Mark R; Gerba, Charles P; Elimelech, Menachem

    2011-03-31

    The U.S. National Academy of Engineering (NAE) recently published a document presenting "Grand Challenges for Engineering". This list was proposed by leading engineers and scientists from around the world at the request of the U.S. National Science Foundation (NSF). Fourteen topics were selected for these grand challenges, and at least seven can be addressed using the tools and methods of biological engineering. Here we describe how biological engineers can address the challenge of providing access to clean drinking water. This issue must be addressed in part by removing or inactivating microbial and chemical contaminants in order to properly deliver water safe for human consumption. Despite many advances in technologies this challenge is expanding due to increased pressure on fresh water supplies and to new opportunities for growth of potentially pathogenic organisms.

  14. Biological approaches for addressing the grand challenge of providing access to clean drinking water

    PubMed Central

    2011-01-01

    The U.S. National Academy of Engineering (NAE) recently published a document presenting "Grand Challenges for Engineering". This list was proposed by leading engineers and scientists from around the world at the request of the U.S. National Science Foundation (NSF). Fourteen topics were selected for these grand challenges, and at least seven can be addressed using the tools and methods of biological engineering. Here we describe how biological engineers can address the challenge of providing access to clean drinking water. This issue must be addressed in part by removing or inactivating microbial and chemical contaminants in order to properly deliver water safe for human consumption. Despite many advances in technologies this challenge is expanding due to increased pressure on fresh water supplies and to new opportunities for growth of potentially pathogenic organisms. PMID:21453515

  15. Addressing current challenges in cancer immunotherapy with mathematical and computational modelling.

    PubMed

    Konstorum, Anna; Vella, Anthony T; Adler, Adam J; Laubenbacher, Reinhard C

    2017-06-01

    The goal of cancer immunotherapy is to boost a patient's immune response to a tumour. Yet, the design of an effective immunotherapy is complicated by various factors, including a potentially immunosuppressive tumour microenvironment, immune-modulating effects of conventional treatments and therapy-related toxicities. These complexities can be incorporated into mathematical and computational models of cancer immunotherapy that can then be used to aid in rational therapy design. In this review, we survey modelling approaches under the umbrella of the major challenges facing immunotherapy development, which encompass tumour classification, optimal treatment scheduling and combination therapy design. Although overlapping, each challenge has presented unique opportunities for modellers to make contributions using analytical and numerical analysis of model outcomes, as well as optimization algorithms. We discuss several examples of models that have grown in complexity as more biological information has become available, showcasing how model development is a dynamic process interlinked with the rapid advances in tumour-immune biology. We conclude the review with recommendations for modellers both with respect to methodology and biological direction that might help keep modellers at the forefront of cancer immunotherapy development. © 2017 The Author(s).

  16. Towards addressing transient learning challenges in undergraduate physics: an example from electrostatics

    NASA Astrophysics Data System (ADS)

    Fredlund, T.; Linder, C.; Airey, J.

    2015-09-01

    In this article we characterize transient learning challenges as learning challenges that arise out of teaching situations rather than conflicts with prior knowledge. We propose that these learning challenges can be identified by paying careful attention to the representations that students produce. Once a transient learning challenge has been identified, teachers can create interventions to address it. By illustration, we argue that an appropriate way to design such interventions is to create variation around the disciplinary-relevant aspects associated with the transient learning challenge.

  17. Challenges faced by multidisplinary new investigators on addressing grand challenges in global health

    PubMed Central

    2014-01-01

    Background The grand challenges approach aims to spark innovative and transformative strategies to overcome barriers to significant global health issues. Grand Challenges Canada endorses an ‘Integrated Innovation™’ approach that focuses on the intersection of scientific/technological, social and business innovation. In this article we explore themes emerging from a dialogue between the authors, who are multidisciplinary recipients of the ‘Rising Stars in Global Health’ award from Grand Challenges Canada, regarding benefits of engaging in integrated innovation research, and recommendations for how this approach may develop in the future. Discussion Our dialogue followed a semi-structured interview format that addressed three topics: 1) reflections on applying an Integrated Innovation™ approach for global health; 2) thoughts on participation in the Grand Challenges 2012 meeting; and 3) authors’ visions of Grand Challenges Canada and the Grand Challenge movement towards 2020. The dialogue was transcribed verbatim and we used thematic analysis techniques to identify, analyze and report themes in the data. Benefits of working using the Grand Challenges approach centered on two themes: a) the potential for scientific breakthrough and b) building interdisciplinary collaborations and a community of scholars. Challenges and opportunities for Grand Challenges in moving forward included: a) capacity building, particularly regarding Integrated Innovation™ and scale-up planning; b) interdisciplinary and international mentorship for new investigators; and c) potential for future commercialization. Conclusions Our discussion highlighted that Integrated Innovation™ offers the opportunity to develop new theories, methods and approaches to global health while simultaneously fostering a collaborative spirit grounded in international, interdisciplinary collaborations. However, the arguable over-emphasis on corporatization poses a major challenge for new investigators

  18. Challenges faced by multidisplinary new investigators on addressing grand challenges in global health.

    PubMed

    Logie, Carmen; Dimaras, Helen; Fortin, Anny; Ramón-García, Santiago

    2014-04-15

    The grand challenges approach aims to spark innovative and transformative strategies to overcome barriers to significant global health issues. Grand Challenges Canada endorses an 'Integrated Innovation™' approach that focuses on the intersection of scientific/technological, social and business innovation. In this article we explore themes emerging from a dialogue between the authors, who are multidisciplinary recipients of the 'Rising Stars in Global Health' award from Grand Challenges Canada, regarding benefits of engaging in integrated innovation research, and recommendations for how this approach may develop in the future. Our dialogue followed a semi-structured interview format that addressed three topics: 1) reflections on applying an Integrated Innovation™ approach for global health; 2) thoughts on participation in the Grand Challenges 2012 meeting; and 3) authors' visions of Grand Challenges Canada and the Grand Challenge movement towards 2020. The dialogue was transcribed verbatim and we used thematic analysis techniques to identify, analyze and report themes in the data. Benefits of working using the Grand Challenges approach centered on two themes: a) the potential for scientific breakthrough and b) building interdisciplinary collaborations and a community of scholars. Challenges and opportunities for Grand Challenges in moving forward included: a) capacity building, particularly regarding Integrated Innovation™ and scale-up planning; b) interdisciplinary and international mentorship for new investigators; and c) potential for future commercialization. Our discussion highlighted that Integrated Innovation™ offers the opportunity to develop new theories, methods and approaches to global health while simultaneously fostering a collaborative spirit grounded in international, interdisciplinary collaborations. However, the arguable over-emphasis on corporatization poses a major challenge for new investigators. We propose a more balanced way forward

  19. Current issues and challenges in the management of bariatric patients.

    PubMed

    Bell, Sue Ellen

    2005-01-01

    Morbid obesity is an increasingly common healthcare problem, and providers and patients currently face numerous challenges in dealing with this problem effectively. Issues addressed in this article include the effect of stigma, the need for more evidence regarding effective management options, and the declining insurance coverage for bariatric surgery. The role of bariatric surgery in effective management of morbid obesity is discussed, along with the effect on and possible reasons for declining coverage. A comparison between benefits and coverage for bariatric surgery and angioplasty/stent placement is included.

  20. Consensus Statement on Electronic Health Predictive Analytics: A Guiding Framework to Address Challenges

    PubMed Central

    Amarasingham, Ruben; Audet, Anne-Marie J.; Bates, David W.; Glenn Cohen, I.; Entwistle, Martin; Escobar, G. J.; Liu, Vincent; Etheredge, Lynn; Lo, Bernard; Ohno-Machado, Lucila; Ram, Sudha; Saria, Suchi; Schilling, Lisa M.; Shahi, Anand; Stewart, Walter F.; Steyerberg, Ewout W.; Xie, Bin

    2016-01-01

    Context: The recent explosion in available electronic health record (EHR) data is motivating a rapid expansion of electronic health care predictive analytic (e-HPA) applications, defined as the use of electronic algorithms that forecast clinical events in real time with the intent to improve patient outcomes and reduce costs. There is an urgent need for a systematic framework to guide the development and application of e-HPA to ensure that the field develops in a scientifically sound, ethical, and efficient manner. Objectives: Building upon earlier frameworks of model development and utilization, we identify the emerging opportunities and challenges of e-HPA, propose a framework that enables us to realize these opportunities, address these challenges, and motivate e-HPA stakeholders to both adopt and continuously refine the framework as the applications of e-HPA emerge. Methods: To achieve these objectives, 17 experts with diverse expertise including methodology, ethics, legal, regulation, and health care delivery systems were assembled to identify emerging opportunities and challenges of e-HPA and to propose a framework to guide the development and application of e-HPA. Findings: The framework proposed by the panel includes three key domains where e-HPA differs qualitatively from earlier generations of models and algorithms (Data Barriers, Transparency, and Ethics) and areas where current frameworks are insufficient to address the emerging opportunities and challenges of e-HPA (Regulation and Certification; and Education and Training). The following list of recommendations summarizes the key points of the framework: Data Barriers: Establish mechanisms within the scientific community to support data sharing for predictive model development and testing.Transparency: Set standards around e-HPA validation based on principles of scientific transparency and reproducibility.Ethics: Develop both individual-centered and society-centered risk-benefit approaches to evaluate

  1. Consensus Statement on Electronic Health Predictive Analytics: A Guiding Framework to Address Challenges.

    PubMed

    Amarasingham, Ruben; Audet, Anne-Marie J; Bates, David W; Glenn Cohen, I; Entwistle, Martin; Escobar, G J; Liu, Vincent; Etheredge, Lynn; Lo, Bernard; Ohno-Machado, Lucila; Ram, Sudha; Saria, Suchi; Schilling, Lisa M; Shahi, Anand; Stewart, Walter F; Steyerberg, Ewout W; Xie, Bin

    2016-01-01

    The recent explosion in available electronic health record (EHR) data is motivating a rapid expansion of electronic health care predictive analytic (e-HPA) applications, defined as the use of electronic algorithms that forecast clinical events in real time with the intent to improve patient outcomes and reduce costs. There is an urgent need for a systematic framework to guide the development and application of e-HPA to ensure that the field develops in a scientifically sound, ethical, and efficient manner. Building upon earlier frameworks of model development and utilization, we identify the emerging opportunities and challenges of e-HPA, propose a framework that enables us to realize these opportunities, address these challenges, and motivate e-HPA stakeholders to both adopt and continuously refine the framework as the applications of e-HPA emerge. To achieve these objectives, 17 experts with diverse expertise including methodology, ethics, legal, regulation, and health care delivery systems were assembled to identify emerging opportunities and challenges of e-HPA and to propose a framework to guide the development and application of e-HPA. The framework proposed by the panel includes three key domains where e-HPA differs qualitatively from earlier generations of models and algorithms (Data Barriers, Transparency, and ETHICS) and areas where current frameworks are insufficient to address the emerging opportunities and challenges of e-HPA (Regulation and Certification; and Education and Training). The following list of recommendations summarizes the key points of the framework: Data Barriers: Establish mechanisms within the scientific community to support data sharing for predictive model development and testing.Transparency: Set standards around e-HPA validation based on principles of scientific transparency and reproducibility. Develop both individual-centered and society-centered risk-benefit approaches to evaluate e-HPA.Regulation and Certification: Construct a

  2. The next organizational challenge: finding and addressing diagnostic error.

    PubMed

    Graber, Mark L; Trowbridge, Robert; Myers, Jennifer S; Umscheid, Craig A; Strull, William; Kanter, Michael H

    2014-03-01

    Although health care organizations (HCOs) are intensely focused on improving the safety of health care, efforts to date have almost exclusively targeted treatment-related issues. The literature confirms that the approaches HCOs use to identify adverse medical events are not effective in finding diagnostic errors, so the initial challenge is to identify cases of diagnostic error. WHY HEALTH CARE ORGANIZATIONS NEED TO GET INVOLVED: HCOs are preoccupied with many quality- and safety-related operational and clinical issues, including performance measures. The case for paying attention to diagnostic errors, however, is based on the following four points: (1) diagnostic errors are common and harmful, (2) high-quality health care requires high-quality diagnosis, (3) diagnostic errors are costly, and (4) HCOs are well positioned to lead the way in reducing diagnostic error. FINDING DIAGNOSTIC ERRORS: Current approaches to identifying diagnostic errors, such as occurrence screens, incident reports, autopsy, and peer review, were not designed to detect diagnostic issues (or problems of omission in general) and/or rely on voluntary reporting. The realization that the existing tools are inadequate has spurred efforts to identify novel tools that could be used to discover diagnostic errors or breakdowns in the diagnostic process that are associated with errors. New approaches--Maine Medical Center's case-finding of diagnostic errors by facilitating direct reports from physicians and Kaiser Permanente's electronic health record--based reports that detect process breakdowns in the followup of abnormal findings--are described in case studies. By raising awareness and implementing targeted programs that address diagnostic error, HCOs may begin to play an important role in addressing the problem of diagnostic error.

  3. Scaling up to address data science challenges

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

    Wendelberger, Joanne R.

    Statistics and Data Science provide a variety of perspectives and technical approaches for exploring and understanding Big Data. Partnerships between scientists from different fields such as statistics, machine learning, computer science, and applied mathematics can lead to innovative approaches for addressing problems involving increasingly large amounts of data in a rigorous and effective manner that takes advantage of advances in computing. Here, this article will explore various challenges in Data Science and will highlight statistical approaches that can facilitate analysis of large-scale data including sampling and data reduction methods, techniques for effective analysis and visualization of large-scale simulations, and algorithmsmore » and procedures for efficient processing.« less

  4. Scaling up to address data science challenges

    DOE PAGES

    Wendelberger, Joanne R.

    2017-04-27

    Statistics and Data Science provide a variety of perspectives and technical approaches for exploring and understanding Big Data. Partnerships between scientists from different fields such as statistics, machine learning, computer science, and applied mathematics can lead to innovative approaches for addressing problems involving increasingly large amounts of data in a rigorous and effective manner that takes advantage of advances in computing. Here, this article will explore various challenges in Data Science and will highlight statistical approaches that can facilitate analysis of large-scale data including sampling and data reduction methods, techniques for effective analysis and visualization of large-scale simulations, and algorithmsmore » and procedures for efficient processing.« less

  5. Challenges created by data dissemination and access restrictions when attempting to address community concerns: individual privacy versus public wellbeing.

    PubMed

    Colquhoun, Amy; Aplin, Laura; Geary, Janis; Goodman, Karen J; Hatcher, Juanita

    2012-05-08

    Population health data are vital for the identification of public health problems and the development of public health strategies. Challenges arise when attempts are made to disseminate or access anonymised data that are deemed to be potentially identifiable. In these situations, there is debate about whether the protection of an individual's privacy outweighs potentially beneficial public health initiatives developed using potentially identifiable information. While these issues have an impact at planning and policy levels, they pose a particular dilemma when attempting to examine and address community concerns about a specific health problem. Research currently underway in northern Canadian communities on the frequency of Helicobacter pylori infection and associated diseases, such as stomach cancer, is used in this article to illustrate the challenges that data controls create on the ability of researchers and health officials to address community concerns. Barriers are faced by public health professionals and researchers when endeavouring to address community concerns; specifically, provincial cancer surveillance departments and community-driven participatory research groups face challenges related to data release or access that inhibit their ability to effectively address community enquiries. The resulting consequences include a limited ability to address misinformation or to alleviate concerns when dealing with health problems in small communities. The development of communication tools and building of trusting relationships are essential components of a successful investigation into community health concerns. It may also be important to consider that public wellbeing may outweigh the value of individual privacy in these situations. As such, a re-evaluation of data disclosure policies that are applicable in these circumstances should be considered.

  6. Strategies to Address Common Challenges When Teaching in an Active Learning Classroom

    ERIC Educational Resources Information Center

    Petersen, Christina I.; Gorman, Kristen S.

    2014-01-01

    This chapter provides practical strategies for addressing common challenges that arise for teachers in active learning classrooms. Our strategies come from instructors with experience teaching in these environments.

  7. MO-FG-BRB-01: Investing to Address the Global Cancer Challenge

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

    Atun, R.

    2015-06-15

    corresponding potential benefits of addressing this challenge. To describe what radiation therapy infrastructure, in terms of facilities, equipment and personnel, will be required to address this challenge. To describe models of addressing personnel and infrastructure mobilization and capacity building within regions where significant cancer treatment disparities exist.« less

  8. Energy-Intensive Processes Portfolio: Addressing Key Energy Challenges Across U.S. Industry

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

    None

    AMO is developing advanced technologies that cut energy use and carbon emissions in some of the most energy-intensive processes within U.S. manufacturing. The brochure describes the AMO R&D projects that address these challenges.

  9. Addressing educational challenges in veterinary medicine through the use of distance education.

    PubMed

    Murray, Amanda L; Sischo, William M

    2007-01-01

    The veterinary profession is currently facing many educational challenges, including an insufficient capacity to train and educate veterinarians for the multiple disciplines within the profession, a shortage of veterinarians in private and public practice, a shortage of faculty, a lack of human and professional diversity, and a rising cost of education resulting in extreme student debt loads. As a methodology for teaching, distance education (DE) has the potential to address many of these issues. By its very nature, DE can increase the capacity of current facilities and faculty. In addition, DE can allow students to acquire the necessary knowledge at less cost. This article describes a model for incorporating DE in the form of interactive Web-based courses, in conjunction with short, intensive residential programs, for the lecture portions of courses taught in the pre-veterinary, veterinary, and post-veterinary educational periods. In this model, the Web-based courses are used to convey the necessary core knowledge required at each step of the educational process. The residential portions are then used to apply the knowledge in such a way as to combine clinical applications with research in basic and applied sciences. Distance education can provide increased flexibility, high-quality educational experiences, and a less costly alternative for students while maximizing the reach of current faculty efforts and the capacity of existing physical structures.

  10. Challenges of implementing fibromyalgia treatment guidelines in current clinical practice.

    PubMed

    Arnold, Lesley M; Clauw, Daniel J

    2017-09-01

    The current diagnostic and treatment pathway for patients with fibromyalgia (FM) is lengthy, complex, and characterized by multiple physician visits with an average 2-year wait until diagnosis. It is clear that effective identification and appropriate treatment of FM remain a challenge in current clinical practice. Ideally, FM management involves a multidisciplinary approach with the preferable patient pathway originating in primary care but supported by a range of health care providers, including referral to specialist care when necessary. After the publication of individual clinical studies, high-quality reviews, and meta-analyses, recently published FM treatment guidelines have transitioned from an expert consensus to an evidence-based approach. Evidence-based guidelines provide a framework for ensuring early diagnosis and timely adoption of appropriate treatment. However, for successful outcomes, FM treatments must adopt a more holistic approach, which addresses more than just pain. Impact on the associated symptoms of fatigue and cognitive problems, sleep and mood disturbances, and lowered functional status are also important in judging the success of FM therapy. Recently published guidelines recommend the adoption of a symptom-based approach to guide pharmacologic treatment. Emerging treatment options for FM may be best differentiated on the basis of their effect on comorbid symptoms that are often associated with pain (e.g. sleep disturbance, mood, fatigue). The current review discusses the most recently published Canadian guidelines and the implications of the recent European League Against Rheumatism (EULAR) recommendations, with a focus on the challenges of implementing these guidelines in current clinical practice.

  11. Drugs in development for toxoplasmosis: advances, challenges, and current status.

    PubMed

    Alday, P Holland; Doggett, Joseph Stone

    2017-01-01

    Toxoplasma gondii causes fatal and debilitating brain and eye diseases. Medicines that are currently used to treat toxoplasmosis commonly have toxic side effects and require prolonged courses that range from weeks to more than a year. The need for long treatment durations and the risk of relapsing disease are in part due to the lack of efficacy against T. gondii tissue cysts. The challenges for developing a more effective treatment for toxoplasmosis include decreasing toxicity, achieving therapeutic concentrations in the brain and eye, shortening duration, eliminating tissue cysts from the host, safety in pregnancy, and creating a formulation that is inexpensive and practical for use in resource-poor areas of the world. Over the last decade, significant progress has been made in identifying and developing new compounds for the treatment of toxoplasmosis. Unlike clinically used medicines that were repurposed for toxoplasmosis, these compounds have been optimized for efficacy against toxoplasmosis during preclinical development. Medicines with enhanced efficacy as well as features that address the unique aspects of toxoplasmosis have the potential to greatly improve toxoplasmosis therapy. This review discusses the facets of toxoplasmosis that are pertinent to drug design and the advances, challenges, and current status of preclinical drug research for toxoplasmosis.

  12. Drugs in development for toxoplasmosis: advances, challenges, and current status

    PubMed Central

    Alday, P Holland; Doggett, Joseph Stone

    2017-01-01

    Toxoplasma gondii causes fatal and debilitating brain and eye diseases. Medicines that are currently used to treat toxoplasmosis commonly have toxic side effects and require prolonged courses that range from weeks to more than a year. The need for long treatment durations and the risk of relapsing disease are in part due to the lack of efficacy against T. gondii tissue cysts. The challenges for developing a more effective treatment for toxoplasmosis include decreasing toxicity, achieving therapeutic concentrations in the brain and eye, shortening duration, eliminating tissue cysts from the host, safety in pregnancy, and creating a formulation that is inexpensive and practical for use in resource-poor areas of the world. Over the last decade, significant progress has been made in identifying and developing new compounds for the treatment of toxoplasmosis. Unlike clinically used medicines that were repurposed for toxoplasmosis, these compounds have been optimized for efficacy against toxoplasmosis during preclinical development. Medicines with enhanced efficacy as well as features that address the unique aspects of toxoplasmosis have the potential to greatly improve toxoplasmosis therapy. This review discusses the facets of toxoplasmosis that are pertinent to drug design and the advances, challenges, and current status of preclinical drug research for toxoplasmosis. PMID:28182168

  13. Policy recommendations for addressing privacy challenges associated with cell-based research and interventions.

    PubMed

    Ogbogu, Ubaka; Burningham, Sarah; Ollenberger, Adam; Calder, Kathryn; Du, Li; El Emam, Khaled; Hyde-Lay, Robyn; Isasi, Rosario; Joly, Yann; Kerr, Ian; Malin, Bradley; McDonald, Michael; Penney, Steven; Piat, Gayle; Roy, Denis-Claude; Sugarman, Jeremy; Vercauteren, Suzanne; Verhenneman, Griet; West, Lori; Caulfield, Timothy

    2014-02-03

    The increased use of human biological material for cell-based research and clinical interventions poses risks to the privacy of patients and donors, including the possibility of re-identification of individuals from anonymized cell lines and associated genetic data. These risks will increase as technologies and databases used for re-identification become affordable and more sophisticated. Policies that require ongoing linkage of cell lines to donors' clinical information for research and regulatory purposes, and existing practices that limit research participants' ability to control what is done with their genetic data, amplify the privacy concerns. To date, the privacy issues associated with cell-based research and interventions have not received much attention in the academic and policymaking contexts. This paper, arising out of a multi-disciplinary workshop, aims to rectify this by outlining the issues, proposing novel governance strategies and policy recommendations, and identifying areas where further evidence is required to make sound policy decisions. The authors of this paper take the position that existing rules and norms can be reasonably extended to address privacy risks in this context without compromising emerging developments in the research environment, and that exceptions from such rules should be justified using a case-by-case approach. In developing new policies, the broader framework of regulations governing cell-based research and related areas must be taken into account, as well as the views of impacted groups, including scientists, research participants and the general public. This paper outlines deliberations at a policy development workshop focusing on privacy challenges associated with cell-based research and interventions. The paper provides an overview of these challenges, followed by a discussion of key themes and recommendations that emerged from discussions at the workshop. The paper concludes that privacy risks associated with cell

  14. Policy recommendations for addressing privacy challenges associated with cell-based research and interventions

    PubMed Central

    2014-01-01

    Background The increased use of human biological material for cell-based research and clinical interventions poses risks to the privacy of patients and donors, including the possibility of re-identification of individuals from anonymized cell lines and associated genetic data. These risks will increase as technologies and databases used for re-identification become affordable and more sophisticated. Policies that require ongoing linkage of cell lines to donors’ clinical information for research and regulatory purposes, and existing practices that limit research participants’ ability to control what is done with their genetic data, amplify the privacy concerns. Discussion To date, the privacy issues associated with cell-based research and interventions have not received much attention in the academic and policymaking contexts. This paper, arising out of a multi-disciplinary workshop, aims to rectify this by outlining the issues, proposing novel governance strategies and policy recommendations, and identifying areas where further evidence is required to make sound policy decisions. The authors of this paper take the position that existing rules and norms can be reasonably extended to address privacy risks in this context without compromising emerging developments in the research environment, and that exceptions from such rules should be justified using a case-by-case approach. In developing new policies, the broader framework of regulations governing cell-based research and related areas must be taken into account, as well as the views of impacted groups, including scientists, research participants and the general public. Summary This paper outlines deliberations at a policy development workshop focusing on privacy challenges associated with cell-based research and interventions. The paper provides an overview of these challenges, followed by a discussion of key themes and recommendations that emerged from discussions at the workshop. The paper concludes that

  15. Addressing the Analytic Challenges of Cross-Sectional Pediatric Pneumonia Etiology Data

    PubMed Central

    Feikin, Daniel R.; Scott, J. Anthony G.; Zeger, Scott L.; Murdoch, David R.; O’Brien, Katherine L.; Deloria Knoll, Maria

    2017-01-01

    Abstract Despite tremendous advances in diagnostic laboratory technology, identifying the pathogen(s) causing pneumonia remains challenging because the infected lung tissue cannot usually be sampled for testing. Consequently, to obtain information about pneumonia etiology, clinicians and researchers test specimens distant to the site of infection. These tests may lack sensitivity (eg, blood culture, which is only positive in a small proportion of children with pneumonia) and/or specificity (eg, detection of pathogens in upper respiratory tract specimens, which may indicate asymptomatic carriage or a less severe syndrome, such as upper respiratory infection). While highly sensitive nucleic acid detection methods and testing of multiple specimens improve sensitivity, multiple pathogens are often detected and this adds complexity to the interpretation as the etiologic significance of results may be unclear (ie, the pneumonia may be caused by none, one, some, or all of the pathogens detected). Some of these challenges can be addressed by adjusting positivity rates to account for poor sensitivity or incorporating test results from controls without pneumonia to account for poor specificity. However, no classical analytic methods can account for measurement error (ie, sensitivity and specificity) for multiple specimen types and integrate the results of measurements for multiple pathogens to produce an accurate understanding of etiology. We describe the major analytic challenges in determining pneumonia etiology and review how the common analytical approaches (eg, descriptive, case-control, attributable fraction, latent class analysis) address some but not all challenges. We demonstrate how these limitations necessitate a new, integrated analytical approach to pneumonia etiology data. PMID:28575372

  16. Tool for evaluating research implementation challenges: A sense-making protocol for addressing implementation challenges in complex research settings

    PubMed Central

    2013-01-01

    Background Many challenges arise in complex organizational interventions that threaten research integrity. This article describes a Tool for Evaluating Research Implementation Challenges (TECH), developed using a complexity science framework to assist research teams in assessing and managing these challenges. Methods During the implementation of a multi-site, randomized controlled trial (RCT) of organizational interventions to reduce resident falls in eight nursing homes, we inductively developed, and later codified the TECH. The TECH was developed through processes that emerged from interactions among research team members and nursing home staff participants, including a purposive use of complexity science principles. Results The TECH provided a structure to assess challenges systematically, consider their potential impact on intervention feasibility and fidelity, and determine actions to take. We codified the process into an algorithm that can be adopted or adapted for other research projects. We present selected examples of the use of the TECH that are relevant to many complex interventions. Conclusions Complexity theory provides a useful lens through which research procedures can be developed to address implementation challenges that emerge from complex organizations and research designs. Sense-making is a group process in which diverse members interpret challenges when available information is ambiguous; the groups’ interpretations provide cues for taking action. Sense-making facilitates the creation of safe environments for generating innovative solutions that balance research integrity and practical issues. The challenges encountered during implementation of complex interventions are often unpredictable; however, adoption of a systematic process will allow investigators to address them in a consistent yet flexible manner, protecting fidelity. Research integrity is also protected by allowing for appropriate adaptations to intervention protocols that

  17. Making Pedagogical Decisions to Address Challenges of Joint Jewish-Bedouin Environmental Projects in Israel

    ERIC Educational Resources Information Center

    Alkaher, Iris; Tal, Tali

    2016-01-01

    This interpretive study identifies challenges of working with Bedouin and Jewish Israeli youth in two multicultural projects: education for sustainability and place-conscious education. It also describes the ways the adult project leaders addressed these challenges and their views on the effectiveness of their decisions. Participants comprised 16…

  18. Addressing China's grand challenge of achieving food security while ensuring environmental sustainability.

    PubMed

    Lu, Yonglong; Jenkins, Alan; Ferrier, Robert C; Bailey, Mark; Gordon, Iain J; Song, Shuai; Huang, Jikun; Jia, Shaofeng; Zhang, Fusuo; Liu, Xuejun; Feng, Zhaozhong; Zhang, Zhibin

    2015-02-01

    China's increasingly urbanized and wealthy population is driving a growing and changing demand for food, which might not be met without significant increase in agricultural productivity and sustainable use of natural resources. Given the past relationship between lack of access to affordable food and political instability, food security has to be given a high priority on national political agendas in the context of globalization. The drive for increased food production has had a significant impact on the environment, and the deterioration in ecosystem quality due to historic and current levels of pollution will potentially compromise the food production system in China. We discuss the grand challenges of not only producing more food but also producing it sustainably and without environmental degradation. In addressing these challenges, food production should be considered as part of an environmental system (soil, air, water, and biodiversity) and not independent from it. It is imperative that new ways of meeting the demand for food are developed while safeguarding the natural resources upon which food production is based. We present a holistic approach to both science and policy to ensure future food security while embracing the ambition of achieving environmental sustainability in China. It is a unique opportunity for China to be a role model as a new global player, especially for other emerging economies.

  19. Addressing the Analytic Challenges of Cross-Sectional Pediatric Pneumonia Etiology Data.

    PubMed

    Hammitt, Laura L; Feikin, Daniel R; Scott, J Anthony G; Zeger, Scott L; Murdoch, David R; O'Brien, Katherine L; Deloria Knoll, Maria

    2017-06-15

    Despite tremendous advances in diagnostic laboratory technology, identifying the pathogen(s) causing pneumonia remains challenging because the infected lung tissue cannot usually be sampled for testing. Consequently, to obtain information about pneumonia etiology, clinicians and researchers test specimens distant to the site of infection. These tests may lack sensitivity (eg, blood culture, which is only positive in a small proportion of children with pneumonia) and/or specificity (eg, detection of pathogens in upper respiratory tract specimens, which may indicate asymptomatic carriage or a less severe syndrome, such as upper respiratory infection). While highly sensitive nucleic acid detection methods and testing of multiple specimens improve sensitivity, multiple pathogens are often detected and this adds complexity to the interpretation as the etiologic significance of results may be unclear (ie, the pneumonia may be caused by none, one, some, or all of the pathogens detected). Some of these challenges can be addressed by adjusting positivity rates to account for poor sensitivity or incorporating test results from controls without pneumonia to account for poor specificity. However, no classical analytic methods can account for measurement error (ie, sensitivity and specificity) for multiple specimen types and integrate the results of measurements for multiple pathogens to produce an accurate understanding of etiology. We describe the major analytic challenges in determining pneumonia etiology and review how the common analytical approaches (eg, descriptive, case-control, attributable fraction, latent class analysis) address some but not all challenges. We demonstrate how these limitations necessitate a new, integrated analytical approach to pneumonia etiology data. © The Author 2017. Published by Oxford University Press for the Infectious Diseases Society of America.

  20. Nonclinical safety testing of biopharmaceuticals--Addressing current challenges of these novel and emerging therapies.

    PubMed

    Brennan, Frank R; Baumann, Andreas; Blaich, Guenter; de Haan, Lolke; Fagg, Rajni; Kiessling, Andrea; Kronenberg, Sven; Locher, Mathias; Milton, Mark; Tibbitts, Jay; Ulrich, Peter; Weir, Lucinda

    2015-10-01

    Non-clinical safety testing of biopharmaceuticals can present significant challenges to human risk assessment with these often innovative and complex drugs. Hot Topics in this field were discussed recently at the 4th Annual European Biosafe General Membership meeting. In this feature article, the presentations and subsequent discussions from the main sessions are summarized. The topics covered include: (i) wanted versus unwanted immune activation, (ii) bi-specific protein scaffolds, (iii) use of Pharmacokinetic (PK)/Pharmacodynamic (PD) data to impact/optimize toxicology study design, (iv) cytokine release and challenges to human translation (v) safety testing of cell and gene therapies including chimeric antigen receptor T (CAR-T) cells and retroviral vectors and (vi) biopharmaceutical development strategies encompassing a range of diverse topics including optimizing entry of monoclonal antibodies (mAbs) into the brain, safety testing of therapeutic vaccines, non-clinical testing of biosimilars, infection in toxicology studies with immunomodulators and challenges to human risk assessment, maternal and infant anti-drug antibody (ADA) development and impact in non-human primate (NHP) developmental toxicity studies, and a summary of an NC3Rs workshop on the future vision for non-clinical safety assessment of biopharmaceuticals. Copyright © 2015 Elsevier Inc. All rights reserved.

  1. Addressing challenges for youths with mobility devices in winter conditions.

    PubMed

    Morales, Ernesto; Lindsay, Sally; Edwards, Geoffrey; Howell, Lori; Vincent, Claude; Yantzi, Nicole; Gauthier, Véronique

    2018-01-01

    Winter-related research about the experience of navigating in the urban context has mostly focused on the elderly population with physical disabilities. The aim of this project was to explore potential design solutions to enhance young people's mobility devices and the built environment to improve accessibility and participation in winter. A multi-method qualitative design process included the following steps: (1) in-depth interviews; (2) photo elicitation; (3) individual co-design sessions; and (4) group co-design sessions (i.e., focus group). The participants were 13 youths (nine males and four females), aged 12-21, who used a wheelchair (12 power chair users and one manual wheelchair), for some with their parents, others without their parents, according to the parents' willingness to participate or not in the study (n = 13). The first two authors conducted group co-design sessions with mechanical engineers and therapists/clinicians in two Canadian cities to discuss the feasibility of the designs. Results (findings): The youths and their parents reported different winter-related challenges and proposed specific design solutions to enhance their participation and inclusion in winter activities. Seven of these designs were presented at two group co-design sessions of therapists/clinicians and engineers. Two designs were found to be feasible: (1) a traction device for wheelchairs in snow and (2) a mat made of rollers to clean snow and dirt from tires. The results of this research highlight the frustrations and challenges youths who use wheelchairs encounter in winter and a need for new solutions to ensure greater accessibility in winter. Therapists/clinicians and designers should address winter-related accessibility problems in areas with abundant snow. Implications for Rehabilitation Several studies show that current urban contexts do not necessarily respond accurately to the needs of individuals with limited mobility. Winter-related research about the

  2. MO-FG-BRB-03: Addressing the Cancer Challenge: International Cancer Experts Corps

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

    Coleman, N.

    corresponding potential benefits of addressing this challenge. To describe what radiation therapy infrastructure, in terms of facilities, equipment and personnel, will be required to address this challenge. To describe models of addressing personnel and infrastructure mobilization and capacity building within regions where significant cancer treatment disparities exist.« less

  3. Exploiting Advanced Hydrogel Technologies to Address Key Challenges in Regenerative Medicine

    PubMed Central

    Gentleman, Eileen

    2018-01-01

    Regenerative medicine aims to tackle a panoply of challenges, from repairing focal damage to articular cartilage to preventing pathological tissue remodelling after myocardial infarction. Hydrogels are water-swollen networks formed from synthetic or naturally derived polymers, and are emerging as important tools to address these challenges. Recent advances in hydrogel chemistries are enabling researchers to create hydrogels that can act as 3D ex vivo tissue models, allowing them to explore fundamental questions in cell biology by replicating tissues’ dynamic and non-linear physical properties. Enabled by emerging techniques such as 3D bioprinting, cell-laden hydrogels are also being developed with highly controlled tissue-specific architectures, vasculature, and biological functions that together can direct tissue repair. Moreover, advanced in situ forming and acellular hydrogels are increasingly finding use as delivery vehicles for bioactive compounds and in mediating host cell response. Here, we review advances in the design and fabrication of hydrogels for regenerative medicine. We also address how controlled chemistries are allowing for precise engineering of spatial and time-dependent properties in hydrogels with a look to how these materials will eventually translate to clinical applications. PMID:29316363

  4. COOP+ project: Promoting the cooperation among international Research Infrastructures to address global environmental challenges.

    NASA Astrophysics Data System (ADS)

    Bonet-García, Francisco; Materia, Paola; Kutsch, Werner; de Lucas, Jesús Marco; Tjulin, Anders

    2016-04-01

    During the Anthropocene, mankind will face several global environmental challenges. One of the first and more successful responses provided by Science to these challenges is the collecting of long-term series of biophysical variables in order to improve our knowledge of natural systems. The huge amount of information gathered during the last decades by Research Infrastructures (RIs) has helped to understand the structure and functioning of natural systems at local and regional scales. But how can we address the global cross-scale and cross-disciplinary challenges posed by the global environment change? We believe that it will be necessary to observe, model better and understand the whole biosphere using long term data generated by international RIs. RIs play a key role on many of the last advances and discoveries in science, from the observation of the Higgs Boson at CERN to the exploration of the Universe by the telescopes of the European Southern Observatory in Chile. The scale of complexity, instrumentation, computing resources, technological advances, and also of the investments, and the size of research collaborations, do not have precedents in Science. RIs in environmental field are developing fast, but the corresponding communities need yet to further reflect the need for a wider global collaboration because the challenges to tackle are in essence of global nature. This contribution describes how COOP+ project (EU Horizon 2020 Coordination and Support Action) will promote the cooperation among RIs at a global scale to address global environmental challenges. Our project evolves from the experience of the sucessful FP7 COOPEUS project (see http://www.coopeus.eu), which explored the use and access to data from RIs in environmental research in Europe and USA. The general goal of COOP+ is to strengthen the links and coordination of the ESFRI RIs related to Marine Science (EMSO), Arctic and Atmospheric Research (EISCAT), Carbon Observation (ICOS) and Biodiversity

  5. Oral health in Libya: addressing the future challenges.

    PubMed

    Peeran, Syed Wali; Altaher, Omar Basheer; Peeran, Syed Ali; Alsaid, Fatma Mojtaba; Mugrabi, Marei Hamed; Ahmed, Aisha Mojtaba; Grain, Abdulgader

    2014-01-01

    Libya is a vast country situated in North Africa, having a relatively better functioning economy with a scanty population. This article is the first known attempt to review the current state of oral health care in Libya and to explore the present trends and future challenges. Libyan health system, oral health care, and human resources with the present status of dental education are reviewed comprehensively. A bibliographic study of oral health research and publications has been carried out. The results point toward a common indicator that oral health-related research is low. Strategies have to be developed to educate the medical and dental professionals, to update the current curriculum and enable the system to be competent in all aspects of oral health care management.

  6. Oral health in Libya: addressing the future challenges

    PubMed Central

    Peeran, Syed Wali; Altaher, Omar Basheer; Peeran, Syed Ali; Alsaid, Fatma Mojtaba; Mugrabi, Marei Hamed; Ahmed, Aisha Mojtaba; Grain, Abdulgader

    2014-01-01

    Libya is a vast country situated in North Africa, having a relatively better functioning economy with a scanty population. This article is the first known attempt to review the current state of oral health care in Libya and to explore the present trends and future challenges. Libyan health system, oral health care, and human resources with the present status of dental education are reviewed comprehensively. A bibliographic study of oral health research and publications has been carried out. The results point toward a common indicator that oral health–related research is low. Strategies have to be developed to educate the medical and dental professionals, to update the current curriculum and enable the system to be competent in all aspects of oral health care management. PMID:24666627

  7. Methods for Addressing Technology-induced Errors: The Current State.

    PubMed

    Borycki, E; Dexheimer, J W; Hullin Lucay Cossio, C; Gong, Y; Jensen, S; Kaipio, J; Kennebeck, S; Kirkendall, E; Kushniruk, A W; Kuziemsky, C; Marcilly, R; Röhrig, R; Saranto, K; Senathirajah, Y; Weber, J; Takeda, H

    2016-11-10

    The objectives of this paper are to review and discuss the methods that are being used internationally to report on, mitigate, and eliminate technology-induced errors. The IMIA Working Group for Health Informatics for Patient Safety worked together to review and synthesize some of the main methods and approaches associated with technology- induced error reporting, reduction, and mitigation. The work involved a review of the evidence-based literature as well as guideline publications specific to health informatics. The paper presents a rich overview of current approaches, issues, and methods associated with: (1) safe HIT design, (2) safe HIT implementation, (3) reporting on technology-induced errors, (4) technology-induced error analysis, and (5) health information technology (HIT) risk management. The work is based on research from around the world. Internationally, researchers have been developing methods that can be used to identify, report on, mitigate, and eliminate technology-induced errors. Although there remain issues and challenges associated with the methodologies, they have been shown to improve the quality and safety of HIT. Since the first publications documenting technology-induced errors in healthcare in 2005, we have seen in a short 10 years researchers develop ways of identifying and addressing these types of errors. We have also seen organizations begin to use these approaches. Knowledge has been translated into practice in a short ten years whereas the norm for other research areas is of 20 years.

  8. Methods for Addressing Technology-Induced Errors: The Current State

    PubMed Central

    Dexheimer, J. W.; Hullin Lucay Cossio, C.; Gong, Y.; Jensen, S.; Kaipio, J.; Kennebeck, S.; Kirkendall, E.; Kushniruk, A. W.; Kuziemsky, C.; Marcilly, R.; Röhrig, R.; Saranto, K.; Senathirajah, Y.; Weber, J.; Takeda, H.

    2016-01-01

    Summary Objectives The objectives of this paper are to review and discuss the methods that are being used internationally to report on, mitigate, and eliminate technology-induced errors. Methods The IMIA Working Group for Health Informatics for Patient Safety worked together to review and synthesize some of the main methods and approaches associated with technology-induced error reporting, reduction, and mitigation. The work involved a review of the evidence-based literature as well as guideline publications specific to health informatics. Results The paper presents a rich overview of current approaches, issues, and methods associated with: (1) safe HIT design, (2) safe HIT implementation, (3) reporting on technology-induced errors, (4) technology-induced error analysis, and (5) health information technology (HIT) risk management. The work is based on research from around the world. Conclusions Internationally, researchers have been developing methods that can be used to identify, report on, mitigate, and eliminate technology-induced errors. Although there remain issues and challenges associated with the methodologies, they have been shown to improve the quality and safety of HIT. Since the first publications documenting technology-induced errors in healthcare in 2005, we have seen in a short 10 years researchers develop ways of identifying and addressing these types of errors. We have also seen organizations begin to use these approaches. Knowledge has been translated into practice in a short ten years whereas the norm for other research areas is of 20 years. PMID:27830228

  9. Addressing challenges to MMPI-2-RF-based testimony: questions and answers.

    PubMed

    Ben-Porath, Yossef S

    2012-11-01

    Introduction of a new version of a psychological test brings with it challenges that can be accentuated by the adversarial nature of the legal process. In the case of the Minnesota Multiphasic Personality Inventory-2 Restructured Form (MMPI-2-RF), these challenges can be addressed by becoming familiar with the rationale for and the methods used in revising the inventory, the information contained in the test manuals, and the growing peer-reviewed literature on the test. Potential challenges to MMPI-2-RF-based testimony are identified in this article and discussed in question and answer format. The questions guiding this discussion are based on the Daubert factors, established in 1993 by the US Supreme Court as criteria for gauging the scientific validity of proffered expert testimony. The answers to these questions apply more broadly to testimony in depositions, pre-trial hearings, and at trial. Consideration of the MMPI-2-RF in light of the Daubert factors indicates that the instrument has been subjected to extensive empirical testing and that a substantial peer-reviewed literature is available to guide and support its use. Information about the known and potential rate of error associated with MMPI-2-RF scores is available, and standard procedures for administration, scoring, and interpretation of the inventory are detailed in the test administration manual. Indicators of MMPI-2-RF acceptance can be cited, and criticisms of the MMPI-2-RF can be addressed with information available in the test documents and an extensive, modern, and actively growing peer-reviewed literature.

  10. National health inequality monitoring: current challenges and opportunities.

    PubMed

    Hosseinpoor, Ahmad Reza; Bergen, Nicole; Schlotheuber, Anne; Boerma, Ties

    National health inequality monitoring needs considerably more investment to realize equity-oriented health improvements in countries, including advancement towards the Sustainable Development Goals. Following an overview of national health inequality monitoring and the associated resource requirements, we highlight challenges that countries may encounter when setting up, expanding or strengthening national health inequality monitoring systems, and discuss opportunities and key initiatives that aim to address these challenges. We provide specific proposals on what is needed to ensure that national health inequality monitoring systems are harnessed to guide the reduction of health inequalities.

  11. Addressing China’s grand challenge of achieving food security while ensuring environmental sustainability

    PubMed Central

    Lu, Yonglong; Jenkins, Alan; Ferrier, Robert C.; Bailey, Mark; Gordon, Iain J.; Song, Shuai; Huang, Jikun; Jia, Shaofeng; Zhang, Fusuo; Liu, Xuejun; Feng, Zhaozhong; Zhang, Zhibin

    2015-01-01

    China’s increasingly urbanized and wealthy population is driving a growing and changing demand for food, which might not be met without significant increase in agricultural productivity and sustainable use of natural resources. Given the past relationship between lack of access to affordable food and political instability, food security has to be given a high priority on national political agendas in the context of globalization. The drive for increased food production has had a significant impact on the environment, and the deterioration in ecosystem quality due to historic and current levels of pollution will potentially compromise the food production system in China. We discuss the grand challenges of not only producing more food but also producing it sustainably and without environmental degradation. In addressing these challenges, food production should be considered as part of an environmental system (soil, air, water, and biodiversity) and not independent from it. It is imperative that new ways of meeting the demand for food are developed while safeguarding the natural resources upon which food production is based. We present a holistic approach to both science and policy to ensure future food security while embracing the ambition of achieving environmental sustainability in China. It is a unique opportunity for China to be a role model as a new global player, especially for other emerging economies. PMID:26601127

  12. Challenges Addressing Unmet Need for Contraception: Voices of Family Planning Service Providers in Rural Tanzania.

    PubMed

    Baraka, Jitihada; Rusibamayila, Asinath; Kalolella, Admirabilis; Baynes, Colin

    2015-12-01

    Provider perspectives have been overlooked in efforts to address the challenges of unmet need for family planning (FP). This qualitative study was undertaken in Tanzania, using 22 key informant interviews and 4 focus group discussions. The research documents perceptions of healthcare managers and providers in a rural district on the barriers to meeting latent demand for contraception. Social-ecological theory is used to interpret the findings, illustrating how service capability is determined by the social, structural and organizational environment. Providers' efforts to address unmet need for FP services are constrained by unstable reproductive preferences, low educational attainment, and misconceptions about contraceptive side effects. Societal and organizational factors--such as gender dynamics, economic conditions, religious and cultural norms, and supply chain bottlenecks, respectively--also contribute to an adverse environment for meeting needs for care. Challenges that healthcare providers face interact and produce an effect which hinders efforts to address unmet need. Interventions to address this are not sufficient unless the supply of services is combined with systems strengthening and social engagement strategies in a way that reflects the multi-layered, social institutional problems.

  13. Megacities and Large Urban Complexes - WMO Role in Addressing Challenges and Opportunities

    NASA Astrophysics Data System (ADS)

    Terblanche, Deon; Jalkanen, Liisa

    2013-04-01

    Megacities and Large Urban Complexes - WMO Role in Addressing Challenges and Opportunities Deon E. Terblanche and Liisa Jalkanen dterblanche@wmo.int ljalkanen@wmo.int World Meteorological Organization, Geneva, Switzerland The 21st Century could amongst others, become known as the century in which our species has evolved from Homo sapiens to Homo urbanus. By now the urban population has surpassed the rural population and the rate of urbanization will continue at such a pace that by 2050 urban dwellers could outnumber their rural counterpart by more than two to one. Most of this growth in urban population will occur in developing countries and along coastal areas. Urbanization is to a large extent the outcome of humans seeking a better life through improved opportunities presented by high-density communities. Megacities and large urban complexes provide more job opportunities and social structures, better transport and communication links and a relative abundance of physical goods and services when compared to most rural areas. Unfortunately these urban complexes also present numerous social and environmental challenges. Urban areas differ from their surroundings by morphology, population density, and with high concentration of industrial activities, energy consumption and transport. They also pose unique challenges to atmospheric modelling and monitoring and create a multi-disciplinary spectrum of potential threats, including air pollution, which need to be addressed in an integrated way. These areas are also vulnerable to the changing climate and its implications to sea-level and extreme events, air quality and related health impacts. Many urban activities are significantly impacted by weather events that would not be considered to be of high impact in less densely populated areas. For instance, moderate precipitation events can cause flooding and landslides as modified urban catchments generally have higher run-off to rainfall ratios than their more pristine rural

  14. Research strategies for addressing uncertainties

    USGS Publications Warehouse

    Busch, David E.; Brekke, Levi D.; Averyt, Kristen; Jardine, Angela; Welling, Leigh; Garfin, Gregg; Jardine, Angela; Merideth, Robert; Black, Mary; LeRoy, Sarah

    2013-01-01

    Research Strategies for Addressing Uncertainties builds on descriptions of research needs presented elsewhere in the book; describes current research efforts and the challenges and opportunities to reduce the uncertainties of climate change; explores ways to improve the understanding of changes in climate and hydrology; and emphasizes the use of research to inform decision making.

  15. Addressing Earth Science Data Access Challenges through User Experience Research

    NASA Astrophysics Data System (ADS)

    Hemmings, S. N.; Banks, B.; Kendall, J.; Lee, C. M.; Irwin, D.; Toll, D. L.; Searby, N. D.

    2013-12-01

    The NASA Capacity Building Program (Earth Science Division, Applied Sciences Program) works to enhance end-user capabilities to employ Earth observation and Earth science (EO/ES) data in decision-making. Open data access and user-tailored data delivery strategies are critical elements towards this end. User Experience (UX) and User Interface (UI) research methods can offer important contributions towards addressing data access challenges, particularly at the interface of science application/product development and product transition to end-users. This presentation focuses on developing nation contexts and describes methods, results, and lessons learned from two recent UX/UI efforts conducted in collaboration with NASA: the SERVIRglobal.net redesign project and the U.S. Water Partnership (USWP) Portal development effort. SERVIR, a collaborative venture among NASA, USAID, and global partners, seeks to improve environmental management and climate change response by helping governments and other stakeholders integrate EO and geospatial technologies into decision-making. The USWP, a collaboration among U.S. public and private sectors, harnesses U.S.-based resources and expertise to address water challenges in developing nations. SERVIR's study, conducted from 2010-2012, assessed and tested user needs, preferences, and online experiences to generate a more user-friendly online data portal at SERVIRglobal.net. The portal provides a central access interface to data and products from SERVIR's network of hubs in East Africa, the Hindu Kush Himalayas, and Mesoamerica. The second study, conducted by the USWP Secretariat and funded by the U.S. Department of State, seeks to match U.S.-based water information resources with developing nation stakeholder needs. The USWP study utilizes a multi-pronged approach to identify key design requirements and to understand the existing water data portal landscape. Adopting UX methods allows data distributors to design customized UIs that

  16. Current Challenges in Cancer Treatment.

    PubMed

    Zugazagoitia, Jon; Guedes, Cristiano; Ponce, Santiago; Ferrer, Irene; Molina-Pinelo, Sonia; Paz-Ares, Luis

    2016-07-01

    In this review, we highlight the current concepts and discuss some of the current challenges and future prospects in cancer therapy. We frequently use the example of lung cancer. We conducted a nonsystematic PubMed search, selecting the most comprehensive and relevant research articles, clinical trials, translational papers, and review articles on precision oncology and immuno-oncology. Papers were prioritized and selected based on their originality and potential clinical applicability. Two major revolutions have changed cancer treatment paradigms in the past few years: targeting actionable alterations in oncogene-driven cancers and immuno-oncology. Important challenges are still ongoing in both fields of cancer therapy. On the one hand, druggable genomic alterations are diverse and represent only small subsets of patients in certain tumor types, which limits testing their clinical impact in biomarker-driven clinical trials. Next-generation sequencing technologies are increasingly being implemented for molecular prescreening in clinical research, but issues regarding clinical interpretation of large genomic data make their wide clinical use difficult. Further, dealing with tumor heterogeneity and acquired resistance is probably the main limitation for the success of precision oncology. On the other hand, long-term survival benefits with immune checkpoint inhibitors (anti-programmed death cell protein-1/programmed death cell ligand-1[PD-1/L1] and anti-cytotoxic T lymphocyte antigen-4 monoclonal antibodies) are restricted to a minority of patients, and no predictive markers are yet robustly validated that could help us recognize these subsets and optimize treatment delivery and selection. To achieve long-term survival benefits, drug combinations targeting several molecular alterations or cancer hallmarks might be needed. This will probably be one of the most challenging but promising precision cancer treatment strategies in the future. Targeting single molecular

  17. Resources and Recommendations for Using Transcriptomics to Address Grand Challenges in Comparative Biology

    PubMed Central

    Mykles, Donald L.; Burnett, Karen G.; Durica, David S.; Joyce, Blake L.; McCarthy, Fiona M.; Schmidt, Carl J.; Stillman, Jonathon H.

    2016-01-01

    High-throughput RNA sequencing (RNA-seq) technology has become an important tool for studying physiological responses of organisms to changes in their environment. De novo assembly of RNA-seq data has allowed researchers to create a comprehensive catalog of genes expressed in a tissue and to quantify their expression without a complete genome sequence. The contributions from the “Tapping the Power of Crustacean Transcriptomics to Address Grand Challenges in Comparative Biology” symposium in this issue show the successes and limitations of using RNA-seq in the study of crustaceans. In conjunction with the symposium, the Animal Genome to Phenome Research Coordination Network collated comments from participants at the meeting regarding the challenges encountered when using transcriptomics in their research. Input came from novices and experts ranging from graduate students to principal investigators. Many were unaware of the bioinformatics analysis resources currently available on the CyVerse platform. Our analysis of community responses led to three recommendations for advancing the field: (1) integration of genomic and RNA-seq sequence assemblies for crustacean gene annotation and comparative expression; (2) development of methodologies for the functional analysis of genes; and (3) information and training exchange among laboratories for transmission of best practices. The field lacks the methods for manipulating tissue-specific gene expression. The decapod crustacean research community should consider the cherry shrimp, Neocaridina denticulata, as a decapod model for the application of transgenic tools for functional genomics. This would require a multi-investigator effort. PMID:27639274

  18. Microwave Photonics: current challenges towards widespread application.

    PubMed

    Capmany, José; Li, Guifang; Lim, Christina; Yao, Jianping

    2013-09-23

    Microwave Photonics, a symbiotic field of research that brings together the worlds of optics and radio frequency is currently facing several challenges in its transition from a niche to a truly widespread technology essential to support the ever-increasing values for speed, bandwidth, processing capability and dynamic range that will be required in next generation hybrid access networks. We outline these challenges, which are the subject of the contributions to this focus issue.

  19. Current overview on challenges in regenerative endodontics

    PubMed Central

    Bansal, Ramta; Jain, Aditya; Mittal, Sunandan

    2015-01-01

    Introduction: Regenerative endodontics provides hope of converting the non-vital tooth into vital once again. It focuses on substituting traumatized and pathological pulp with functional pulp tissue. Current regenerative procedures successfully produce root development but still fail to re-establish real pulp tissue and give unpredictable results. There are several drawbacks that need to be addressed to improve the quality and efficiency of the treatment. Aim: The aim of this review article is to discuss major priorities that ought to be dealt before applications of regenerative endodontics flourish the clinical practice. Materials and Methods: A web-based research on MEDLINE was done using filter terms Review, published in the last 10 years and Dental journals. Keywords used for research were “regenerative endodontics,” “dental stem cells,” “growth factor regeneration,” “scaffolds,” and “challenges in regeneration.” This review article screened about 150 articles and then the relevant information was compiled. Results: Inspite of the impressive growth in regenerative endodontic field, there are certain loopholes in the existing treatment protocols that might sometimes result in undesired and unpredictable outcomes. Conclusion: Considerable research and development efforts are required to improve and update existing regenerative endodontic strategies to make it an effective, safe, and biological mode to save teeth. PMID:25657518

  20. EPA leadership on Science, Innovation, and Decision Support Tools for Addressing Current and Future Challenges

    EPA Science Inventory

    When the U.S. Environmental Protection Agency (EPA) was established nearly 50 years ago, the nation faced serious threats to its air, land, and water, which in turn impacted human health. These threats were effectively addressed by the creation of EPA (in 1970) and many subsequen...

  1. Advances in addressing technical challenges of point-of-care diagnostics in resource-limited settings

    PubMed Central

    Wang, ShuQi; Lifson, Mark A.; Inci, Fatih; Liang, Li-Guo; Sheng, Ye-Feng; Demirci, Utkan

    2016-01-01

    The striking prevalence of HIV, TB and malaria, as well as outbreaks of emerging infectious diseases, such as influenza A (H7N9), Ebola and MERS, poses great challenges for patient care in resource-limited settings (RLS). However, advanced diagnostic technologies cannot be implemented in RLS largely due to economic constraints. Simple and inexpensive point-of-care (POC) diagnostics, which rely less on environmental context and operator training, have thus been extensively studied to achieve early diagnosis and treatment monitoring in non-laboratory settings. Despite great input from material science, biomedical engineering and nanotechnology for developing POC diagnostics, significant technical challenges are yet to be overcome. Summarized here are the technical challenges associated with POC diagnostics from a RLS perspective and the latest advances in addressing these challenges are reviewed. PMID:26777725

  2. Interweaving Knowledge Resources to Address Complex Environmental Health Challenges

    PubMed Central

    Anderson, Beth Ellen; Suk, William A.

    2015-01-01

    Background Complex problems do not respect academic disciplinary boundaries. Environmental health research is complex and often moves beyond these boundaries, integrating diverse knowledge resources to solve such challenges. Here we describe an evolving paradigm for interweaving approaches that integrates widely diverse resources outside of traditional academic environments in full partnerships of mutual respect and understanding. We demonstrate that scientists, social scientists, and engineers can work with government agencies, industry, and communities to interweave their expertise into metaphorical knowledge fabrics to share understanding, resources, and enthusiasm. Objective Our goal is to acknowledge and validate how interweaving research approaches can contribute to research-driven, solution-oriented problem solving in environmental health, and to inspire more members of the environmental health community to consider this approach. Discussion The National Institutes of Health’s National Institute of Environmental Health Sciences Superfund Research Program (SRP), as mandated by Congress, has evolved to become a program that reaches across a wide range of knowledge resources. SRP fosters interweaving multiple knowledge resources to develop innovative multidirectional partnerships for research and training. Here we describe examples of how motivation, ideas, knowledge, and expertise from different people, institutions, and agencies can integrate to tackle challenges that can be as complex as the resources they bring to bear on it. Conclusions By providing structure for interweaving science with its stakeholders, we are better able to leverage resources, increase potential for innovation, and proactively ensure a more fully developed spectrum of beneficial outcomes of research investments. Citation Anderson BE, Naujokas MF, Suk WA. 2015. Interweaving knowledge resources to address complex environmental health challenges. Environ Health Perspect 123:1095–1099

  3. Interweaving Knowledge Resources to Address Complex Environmental Health Challenges.

    PubMed

    Anderson, Beth Ellen; Naujokas, Marisa F; Suk, William A

    2015-11-01

    Complex problems do not respect academic disciplinary boundaries. Environmental health research is complex and often moves beyond these boundaries, integrating diverse knowledge resources to solve such challenges. Here we describe an evolving paradigm for interweaving approaches that integrates widely diverse resources outside of traditional academic environments in full partnerships of mutual respect and understanding. We demonstrate that scientists, social scientists, and engineers can work with government agencies, industry, and communities to interweave their expertise into metaphorical knowledge fabrics to share understanding, resources, and enthusiasm. Our goal is to acknowledge and validate how interweaving research approaches can contribute to research-driven, solution-oriented problem solving in environmental health, and to inspire more members of the environmental health community to consider this approach. The National Institutes of Health's National Institute of Environmental Health Sciences Superfund Research Program (SRP), as mandated by Congress, has evolved to become a program that reaches across a wide range of knowledge resources. SRP fosters interweaving multiple knowledge resources to develop innovative multidirectional partnerships for research and training. Here we describe examples of how motivation, ideas, knowledge, and expertise from different people, institutions, and agencies can integrate to tackle challenges that can be as complex as the resources they bring to bear on it. By providing structure for interweaving science with its stakeholders, we are better able to leverage resources, increase potential for innovation, and proactively ensure a more fully developed spectrum of beneficial outcomes of research investments. Anderson BE, Naujokas MF, Suk WA. 2015. Interweaving knowledge resources to address complex environmental health challenges. Environ Health Perspect 123:1095-1099; http://dx.doi.org/10.1289/ehp.1409525.

  4. Getting People Involved: The Benefit of Intellectual Capital Management for Addressing HR Challenges

    ERIC Educational Resources Information Center

    Pook, Katja

    2011-01-01

    Purpose: This paper aims to explore the benefits of intellectual capital assessment for facing current challenges of human resources work and organizational development. Design/methodology/approach: The paper takes findings of studies on challenges in HR work and maps them with features of intellectual capital assessment methods. It is thus a…

  5. Screening for Cystic Fibrosis-Related Diabetes: Matching Pathophysiology and Addressing Current Challenges.

    PubMed

    Boudreau, Valérie; Reynaud, Quitterie; Dubois, Catherine Lehoux; Coriati, Adèle; Desjardins, Katherine; Durieu, Isabelle; Rabasa-Lhoret, Rémi

    2016-10-01

    Nearly 50% of adult patients with cystic fibrosis (CF) have diabetes. The occurrence of CF-related diabetes (CFRD) is preceded and is associated with deterioration of lung function and nutritional status. Microvascular complications can occur, but the main cause of death is respiratory failure rather than cardiovascular causes as in type 1 or type 2 diabetes. Because other methods such as glycated hemoglobin (A1C) levels are less sensitive in patients with CF, the recommended screening test is the oral glucose tolerance test (OGTT) with a 75 g glucose dose. However, OGTT is poorly suited for patients with CF, who are already facing a high disease-care burden, and appropriate CF-glucose cut-off for diagnosis and prognosis are also questioned. Thus, alternative screening methods are compared to the classical test (2-hour OGTT), including shorter OGTTs and continuous glucose monitoring. Moreover, many challenges complicate the screening for diabetes such as the complex medical care time for a patient, which is reflected by low adherence to screening tests. The best screening test should take into account the particularities of CFRD and the complexity of the CF medical care. Copyright © 2016 Canadian Diabetes Association. Published by Elsevier Inc. All rights reserved.

  6. Seafood traceability: current needs, available tools, and biotechnological challenges for origin certification.

    PubMed

    Leal, Miguel Costa; Pimentel, Tânia; Ricardo, Fernando; Rosa, Rui; Calado, Ricardo

    2015-06-01

    Market globalization and recurring food safety alerts have resulted in a growing consumer awareness of the need for food traceability. This is particularly relevant for seafood due to its perishable nature and importance as a key protein source for the population of the world. Here, we provide an overview of the current needs for seafood origin traceability, along with the limitations and challenges for its implementation. We focus on geochemical, biochemical, and molecular tools and how they should be optimized to be implemented globally and to address our societal needs. We suggest that seafood traceability is key to enforcing food safety regulations and fisheries control, combat fraud, and fulfill present and future expectations of conscientious producers, consumers, and authorities. Copyright © 2015 Elsevier Ltd. All rights reserved.

  7. Strategies to increase demand for maternal health services in resource-limited settings: challenges to be addressed.

    PubMed

    Elmusharaf, Khalifa; Byrne, Elaine; O'Donovan, Diarmuid

    2015-09-08

    Universal health access will not be achieved unless women are cared for in their own communities and are empowered to take decisions about their own health in a supportive environment. This will only be achieved by community-based demand side interventions for maternal health access. In this review article, we highlight three common strategies to increase demand-side barriers to maternal healthcare access and identify the main challenges that still need to be addressed for these strategies to be effective. Common demand side strategies can be grouped into three categories:(i) Financial incentives/subsidies; (ii) Enhancing patient transfer, and; (iii) Community involvement. The main challenges in assessing the effectiveness or efficacy of these interventions or strategies are the lack of quality evidence on their outcome and impact and interventions not integrated into existing health or community systems. However, what is highlighted in this review and overlooked in most of the published literature on this topic is the lack of knowledge about the context in which these strategies are to be implemented. We suggest three challenges that need to be addressed to create a supportive environment in which these demand-side strategies can effectively improve access to maternal health services. These include: addressing decision-making norms, engaging in intergenerational dialogue, and designing contextually appropriate communication strategies.

  8. The current challenges of teaching ESP

    NASA Astrophysics Data System (ADS)

    Fălăuş, A.

    2017-05-01

    Although the status of lingua franca can easily be claimed by English nowadays, there are always plenty of challenges involved in the process of teaching a foreign language. The simple mastering of the four skills (reading, writing, listening and speaking) and the acquisition of general grammar and vocabulary may not be enough in some circumstances. ESP focuses on the specific needs of the learners, concentrating more on language in context and on the students’ need to acquire a set of professional skills and particular job-related functions. This paper, consequently, focuses on identifying the current challenges that teachers and students may encounter in the process of teaching and learning English for Specific Purposes.

  9. The Challenges and Triumphs in Addressing Students' Intersectional Identities for Black Culture Centers

    ERIC Educational Resources Information Center

    Harris, Jessica C.; Patton, Lori D.

    2017-01-01

    This study examines how directors of Black culture centers (BCCs) address Black students' intersectional identities. We highlight the challenges that directors of BCCs face as they attempt to preserve a race salient agenda, while accounting for other critical facets of students' social identities. Findings explore how directors hold differing…

  10. Clinical Research with Transcranial Direct Current Stimulation (tDCS): Challenges and Future Directions

    PubMed Central

    Brunoni, Andre Russowsky; Nitsche, Michael A.; Bolognini, Nadia; Bikson, Marom; Wagner, Tim; Merabet, Lotfi; Edwards, Dylan J.; Valero-Cabre, Antoni; Rotenberg, Alexander; Pascual-Leone, Alvaro; Ferrucci, Roberta; Priori, Alberto; Boggio, Paulo; Fregni, Felipe

    2011-01-01

    Background Transcranial direct current stimulation (tDCS) is a neuromodulatory technique that delivers low-intensity, direct current to cortical areas facilitating or inhibiting spontaneous neuronal activity. In the past ten years, tDCS physiological mechanisms of action have been intensively investigated giving support for the investigation of its applications in clinical neuropsychiatry and rehabilitation. However, new methodological, ethical, and regulatory issues emerge when translating the findings of preclinical and phase I studies into phase II and III clinical studies. The aim of this comprehensive review is to discuss the key challenges of this process and possible methods to address them. Methods We convened a workgroup of researchers in the field to review, discuss and provide updates and key challenges of neuromodulation use for clinical research. Main Findings/Discussion We reviewed several basic and clinical studies in the field and identified potential limitations, taking into account the particularities of the technique. We review and discuss the findings into four topics: (i) mechanisms of action of tDCS, parameters of use and computer-based human brain modeling investigating electric current fields and magnitude induced by tDCS; (ii) methodological aspects related to the clinical research of tDCS as divided according to study phase (i.e., preclinical, phase I, phase II and phase III studies); (iii) ethical and regulatory concerns; (iv) future directions regarding novel approaches, novel devices, and future studies involving tDCS. Finally, we propose some alternative methods to facilitate clinical research on tDCS. PMID:22037126

  11. Bordetella pertussis pathogenesis: current and future challenges.

    PubMed

    Melvin, Jeffrey A; Scheller, Erich V; Miller, Jeff F; Cotter, Peggy A

    2014-04-01

    Pertussis, also known as whooping cough, has recently re-emerged as a major public health threat despite high levels of vaccination against the aetiological agent Bordetella pertussis. In this Review, we describe the pathogenesis of this disease, with a focus on recent mechanistic insights into B. pertussis virulence-factor function. We also discuss the changing epidemiology of pertussis and the challenges facing vaccine development. Despite decades of research, many aspects of B. pertussis physiology and pathogenesis remain poorly understood. We highlight knowledge gaps that must be addressed to develop improved vaccines and therapeutic strategies.

  12. Bordetella pertussis pathogenesis: current and future challenges

    PubMed Central

    Melvin, Jeffrey A.; Scheller, Erich V.; Miller, Jeff F.; Cotter, Peggy A.

    2014-01-01

    Pertussis, or whooping cough, has recently reemerged as a major public health threat despite high levels of vaccination against the etiological agent, Bordetella pertussis. In this Review, we describe the pathogenesis of this disease, with a focus on recent mechanistic insights into virulence factor function. We also discuss the changing epidemiology of pertussis and the challenges of vaccine development. Despite decades of research, many aspects of B. pertussis physiology and pathogenesis remain poorly understood. We highlight knowledge gaps that must be addressed to develop improved vaccines and therapeutic strategies. PMID:24608338

  13. Possibility and challenges of conversion of current virus species names to Linnaean binomials

    USGS Publications Warehouse

    Thomas, Postler; Clawson, Anna N.; Amarasinghe, Gaya K.; Basler, Christopher F.; Bavari, Sina; Benko, Maria; Blasdell, Kim R.; Briese, Thomas; Buchmeier, Michael J.; Bukreyev, Alexander; Calisher, Charles H.; Chandran, Kartik; Charrel, Remi; Clegg, Christopher S.; Collins, Peter L.; De la Torre, Juan Carlos; DeRisi, Joseph L.; Dietzgen, Ralf G.; Dolnik, Olga; Durrwald, Ralf; Dye, John M.; Easton, Andrew J.; Emonet, Sebastian; Formenty, Pierre; Fouchier, Ron A. M.; Ghedin, Elodie; Gonzalez, Jean-Paul; Harrach, Balazs; Hewson, Roger; Horie, Masayuki; Jiang, Daohong; Kobinger, Gary P.; Kondo, Hideki; Kropinski, Andrew; Krupovic, Mart; Kurath, Gael; Lamb, Robert A.; Leroy, Eric M.; Lukashevich, Igor S.; Maisner, Andrea; Mushegian, Arcady; Netesov, Sergey V.; Nowotny, Norbert; Patterson, Jean L.; Payne, Susan L.; Paweska, Janusz T.; Peters, C.J.; Radoshitzky, Sheli; Rima, Bertus K.; Romanowski, Victor; Rubbenstroth, Dennis; Sabanadzovic, Sead; Sanfacon, Helene; Salvato , Maria; Schwemmle, Martin; Smither, Sophie J.; Stenglein, Mark; Stone, D.M.; Takada , Ayato; Tesh, Robert B.; Tomonaga, Keizo; Tordo, N.; Towner, Jonathan S.; Vasilakis, Nikos; Volchkov, Victor E.; Jensen, Victoria; Walker, Peter J.; Wang, Lin-Fa; Varsani, Arvind; Whitfield , Anna E.; Zerbini, Francisco Murilo; Kuhn, Jens H.

    2017-01-01

    Botanical, mycological, zoological, and prokaryotic species names follow the Linnaean format, consisting of an italicized Latinized binomen with a capitalized genus name and a lower case species epithet (e.g., Homo sapiens). Virus species names, however, do not follow a uniform format, and, even when binomial, are not Linnaean in style. In this thought exercise, we attempted to convert all currently official names of species included in the virus family Arenaviridae and the virus order Mononegavirales to Linnaean binomials, and to identify and address associated challenges and concerns. Surprisingly, this endeavor was not as complicated or time-consuming as even the authors of this article expected when conceiving the experiment.

  14. Possibility and Challenges of Conversion of Current Virus Species Names to Linnaean Binomials

    PubMed Central

    Postler, Thomas S.; Clawson, Anna N.; Amarasinghe, Gaya K.; Basler, Christopher F.; Bavari, Sbina; Benkő, Mária; Blasdell, Kim R.; Briese, Thomas; Buchmeier, Michael J.; Bukreyev, Alexander; Calisher, Charles H.; Chandran, Kartik; Charrel, Rémi; Clegg, Christopher S.; Collins, Peter L.; Juan Carlos, De La Torre; Derisi, Joseph L.; Dietzgen, Ralf G.; Dolnik, Olga; Dürrwald, Ralf; Dye, John M.; Easton, Andrew J.; Emonet, Sébastian; Formenty, Pierre; Fouchier, Ron A. M.; Ghedin, Elodie; Gonzalez, Jean-Paul; Harrach, Balázs; Hewson, Roger; Horie, Masayuki; Jiāng, Dàohóng; Kobinger, Gary; Kondo, Hideki; Kropinski, Andrew M.; Krupovic, Mart; Kurath, Gael; Lamb, Robert A.; Leroy, Eric M.; Lukashevich, Igor S.; Maisner, Andrea; Mushegian, Arcady R.; Netesov, Sergey V.; Nowotny, Norbert; Patterson, Jean L.; Payne, Susan L.; PaWeska, Janusz T.; Peters, Clarence J.; Radoshitzky, Sheli R.; Rima, Bertus K.; Romanowski, Victor; Rubbenstroth, Dennis; Sabanadzovic, Sead; Sanfaçon, Hélène; Salvato, Maria S.; Schwemmle, Martin; Smither, Sophie J.; Stenglein, Mark D.; Stone, David M.; Takada, Ayato; Tesh, Robert B.; Tomonaga, Keizo; Tordo, Noël; Towner, Jonathan S.; Vasilakis, Nikos; Volchkov, Viktor E.; Wahl-Jensen, Victoria; Walker, Peter J.; Wang, Lin-Fa; Varsani, Arvind; Whitfield, Anna E.; Zerbini, F. Murilo; Kuhn, Jens H.

    2017-01-01

    Abstract Botanical, mycological, zoological, and prokaryotic species names follow the Linnaean format, consisting of an italicized Latinized binomen with a capitalized genus name and a lower case species epithet (e.g., Homo sapiens). Virus species names, however, do not follow a uniform format, and, even when binomial, are not Linnaean in style. In this thought exercise, we attempted to convert all currently official names of species included in the virus family Arenaviridae and the virus order Mononegavirales to Linnaean binomials, and to identify and address associated challenges and concerns. Surprisingly, this endeavor was not as complicated or time-consuming as even the authors of this article expected when conceiving the experiment. PMID:27798405

  15. Elections: DOD Needs More Comprehensive Planning to Address Military and Overseas Absentee Voting Challenges

    DTIC Science & Technology

    2016-04-01

    Acknowledgments Contact Acknowledgments Related GAO Products Page 75 GAO-16-378 DOD Overseas Absentee Voting U.S. Postal Service: Actions... Products Page 76 GAO-16-378 DOD Overseas Absentee Voting Election Reform: Nine States’ Experiences Implementing Federal Requirements for...ELECTIONS DOD Needs More Comprehensive Planning to Address Military and Overseas Absentee Voting Challenges

  16. 17 CFR 3.30 - Current address for purpose of delivery of communications from the Commission or the National...

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 17 Commodity and Securities Exchanges 1 2010-04-01 2010-04-01 false Current address for purpose of... Current address for purpose of delivery of communications from the Commission or the National Futures Association. (a) The address of each registrant, applicant for registration and principal, as submitted on the...

  17. Addressing global change challenges for Central Asian socio-ecosystems

    NASA Astrophysics Data System (ADS)

    Qi, Jiaguo; Bobushev, Temirbek S.; Kulmatov, Rashid; Groisman, Pavel; Gutman, Garik

    2012-06-01

    Central Asia is one of the most vulnerable regions on the planet earth to global climate change, depending on very fragile natural resources. The Soviet legacy has left the five countries (Kazakhstan, Tajikistan, Kyrgyzstan, Turkmenistan, and Uzbekistan) with a highly integrated system but they are facing great challenges with tensions that hinder regional coordination of food and water resources. With increasing climate variability and warming trend in the region, food and water security issues become even more crucial now and, if not addressed properly, could affect the regional stability. The long-term drivers of these two most critical elements, food and water, are climate change; the immediate and probably more drastic factors affecting the food and water security are land uses driven by institutional change and economic incentives. As a feedback, changes in land use and land cover have directly implications on water uses, food production, and lifestyles of the rural community in the region. Regional and international efforts have been made to holistically understand the cause, extent, rate and societal implications of land use changes in the region. Much of these have been understood, or under investigation by various projects, but solutions or research effort to develop solutions, to these urgent regional issues are lacking. This article, serves as an introduction to the special issue, provides a brief overview of the challenges facing the Central Asian countries and various international efforts in place that resulted in the publications of this special issue.

  18. Resources and Recommendations for Using Transcriptomics to Address Grand Challenges in Comparative Biology.

    PubMed

    Mykles, Donald L; Burnett, Karen G; Durica, David S; Joyce, Blake L; McCarthy, Fiona M; Schmidt, Carl J; Stillman, Jonathon H

    2016-12-01

    High-throughput RNA sequencing (RNA-seq) technology has become an important tool for studying physiological responses of organisms to changes in their environment. De novo assembly of RNA-seq data has allowed researchers to create a comprehensive catalog of genes expressed in a tissue and to quantify their expression without a complete genome sequence. The contributions from the "Tapping the Power of Crustacean Transcriptomics to Address Grand Challenges in Comparative Biology" symposium in this issue show the successes and limitations of using RNA-seq in the study of crustaceans. In conjunction with the symposium, the Animal Genome to Phenome Research Coordination Network collated comments from participants at the meeting regarding the challenges encountered when using transcriptomics in their research. Input came from novices and experts ranging from graduate students to principal investigators. Many were unaware of the bioinformatics analysis resources currently available on the CyVerse platform. Our analysis of community responses led to three recommendations for advancing the field: (1) integration of genomic and RNA-seq sequence assemblies for crustacean gene annotation and comparative expression; (2) development of methodologies for the functional analysis of genes; and (3) information and training exchange among laboratories for transmission of best practices. The field lacks the methods for manipulating tissue-specific gene expression. The decapod crustacean research community should consider the cherry shrimp, Neocaridina denticulata, as a decapod model for the application of transgenic tools for functional genomics. This would require a multi-investigator effort. © The Author 2016. Published by Oxford University Press on behalf of the Society for Integrative and Comparative Biology. All rights reserved. For permissions please email: journals.permissions@oup.com.

  19. Managing Human Resources. Greater OPM Leadership Needed To Address Critical Challenges. Report to the Congress.

    ERIC Educational Resources Information Center

    General Accounting Office, Washington, DC. General Government Div.

    The General Accounting Office examined the Office of Personnel Management's (OPM's) leadership role in addressing critical human resource problems and preparing the government to meet future challenges. Federal managers, OPM employees, and federal personnel officials were surveyed to study federal government problems in hiring, managing, and…

  20. Addressing the Challenge of Molecular Change: An Interim Report

    NASA Astrophysics Data System (ADS)

    Levine, Raphael D.

    2018-04-01

    Invited by the editorial committee of the Annual Review of Physical Chemistry to "contribute my autobiography," I present it here, as I understand the term. It is about my parents, my mentors, my coworkers, and my friends in learning and the scientific problems that we tried to address. Courtesy of the editorial assistance of Annual Reviews, some of the science is in the figure captions and sidebars. I am by no means done: I am currently trying to fuse the quantitative rigor of physical chemistry with systems biology while also dealing with a post-Born-Oppenheimer regime in electronic dynamics and am attempting to instruct molecules to perform advanced logic.

  1. Addressing the Challenge of Molecular Change: An Interim Report.

    PubMed

    Levine, Raphael D

    2018-04-20

    Invited by the editorial committee of the Annual Review of Physical Chemistry to "contribute my autobiography," I present it here, as I understand the term. It is about my parents, my mentors, my coworkers, and my friends in learning and the scientific problems that we tried to address. Courtesy of the editorial assistance of Annual Reviews, some of the science is in the figure captions and sidebars. I am by no means done: I am currently trying to fuse the quantitative rigor of physical chemistry with systems biology while also dealing with a post-Born-Oppenheimer regime in electronic dynamics and am attempting to instruct molecules to perform advanced logic.

  2. A Systematic Review of Wearable Patient Monitoring Systems - Current Challenges and Opportunities for Clinical Adoption.

    PubMed

    Baig, Mirza Mansoor; GholamHosseini, Hamid; Moqeem, Aasia A; Mirza, Farhaan; Lindén, Maria

    2017-07-01

    The aim of this review is to investigate barriers and challenges of wearable patient monitoring (WPM) solutions adopted by clinicians in acute, as well as in community, care settings. Currently, healthcare providers are coping with ever-growing healthcare challenges including an ageing population, chronic diseases, the cost of hospitalization, and the risk of medical errors. WPM systems are a potential solution for addressing some of these challenges by enabling advanced sensors, wearable technology, and secure and effective communication platforms between the clinicians and patients. A total of 791 articles were screened and 20 were selected for this review. The most common publication venue was conference proceedings (13, 54%). This review only considered recent studies published between 2015 and 2017. The identified studies involved chronic conditions (6, 30%), rehabilitation (7, 35%), cardiovascular diseases (4, 20%), falls (2, 10%) and mental health (1, 5%). Most studies focussed on the system aspects of WPM solutions including advanced sensors, wireless data collection, communication platform and clinical usability based on a specific area or disease. The current studies are progressing with localized sensor-software integration to solve a specific use-case/health area using non-scalable and 'silo' solutions. There is further work required regarding interoperability and clinical acceptance challenges. The advancement of wearable technology and possibilities of using machine learning and artificial intelligence in healthcare is a concept that has been investigated by many studies. We believe future patient monitoring and medical treatments will build upon efficient and affordable solutions of wearable technology.

  3. Addressing Open Water Data Challenges in the Bureau of Reclamation

    NASA Astrophysics Data System (ADS)

    Brekke, L. D.; Danner, A.; Nagode, J.; Rocha, J.; Poulton, S.; Anderson, A.

    2017-12-01

    The Bureau of Reclamation is largest wholesaler of water in the United States. Located in the 17 western states, Reclamation serves water to 31 million people, provides irrigated water to 20 percent of Western farmers, and is the second largest producer of hydroelectric power in the United States. Through these activities, Reclamation generates large amounts of water and water-related data, describing reservoirs and river system conditions, hydropower, environmental compliance activities, infrastructure assets, and other aspects of Reclamation's mission activities. Reclamation aims to make water and water-related data sets more easily found, accessed, and used in decision-making activities in order to benefit the public, private sector, and research communities. Historically, there has not been an integrated, bureau-wide system to store data in machine-readable formats; nor a system to permit centralized browsing, open access, and web-services. Reclamation began addressing these limitations by developing the Reclamation Water Information System (RWIS), released in Spring 2017 (https://water.usbr.gov/). A bureau-wide team contributed to RWIS development, including water data stewards, database administrators, and information technology (IT) specialists. The first RWIS release publishes reservoir time series data from Reclamation's five regions and includes a map interface for sites identification, a query interface for data discovery and access, and web-services for automated retrieval. As RWIS enhancement continues, the development team is developing a companion system - the Reclamation Information Sharing Environment (RISE) - to provide access to the other data subjects and types (geospatial, documents). While RWIS and RISE are promising starts, Reclamation continues to face challenges in addressing open water data goals: making data consolidation and open publishing a value-added activity for programs that publish data locally, going beyond providing open access

  4. Moving beyond regression techniques in cardiovascular risk prediction: applying machine learning to address analytic challenges

    PubMed Central

    Goldstein, Benjamin A.; Navar, Ann Marie; Carter, Rickey E.

    2017-01-01

    Abstract Risk prediction plays an important role in clinical cardiology research. Traditionally, most risk models have been based on regression models. While useful and robust, these statistical methods are limited to using a small number of predictors which operate in the same way on everyone, and uniformly throughout their range. The purpose of this review is to illustrate the use of machine-learning methods for development of risk prediction models. Typically presented as black box approaches, most machine-learning methods are aimed at solving particular challenges that arise in data analysis that are not well addressed by typical regression approaches. To illustrate these challenges, as well as how different methods can address them, we consider trying to predicting mortality after diagnosis of acute myocardial infarction. We use data derived from our institution's electronic health record and abstract data on 13 regularly measured laboratory markers. We walk through different challenges that arise in modelling these data and then introduce different machine-learning approaches. Finally, we discuss general issues in the application of machine-learning methods including tuning parameters, loss functions, variable importance, and missing data. Overall, this review serves as an introduction for those working on risk modelling to approach the diffuse field of machine learning. PMID:27436868

  5. Social Justice Leadership and Inclusion: Exploring Challenges in an Urban District Struggling to Address Inequities

    ERIC Educational Resources Information Center

    DeMatthews, David; Mawhinney, Hanne

    2014-01-01

    Research Approach: This cross case study describes the challenges that two principals working in one urban school district addressed while attempting to transform their school cultures to embrace an inclusion model. Analysis of interviews and observations in each school revealed the actions, values, and orientations of the individual leaders and…

  6. Addressing the Challenges and Needs of English-Speaking Caribbean Immigrant Students: Guidelines for School Counselors

    ERIC Educational Resources Information Center

    Morrison, Stephaney; Bryan, Julia

    2014-01-01

    Caribbean students are among the distinct immigrant groups in U.S. public schools with particular needs to be addressed by school counselors. This article discusses the challenges Caribbean immigrant students face that create obstacles to their academic and personal/social success. Guidelines for school counselors are outlined, which can be used…

  7. Challenges in the current antiangiogenic treatment paradigm for patients with non-small cell lung cancer.

    PubMed

    Wozniak, Antoinette

    2012-05-01

    Patients with non-small cell lung cancer (NSCLC) often present with advanced disease and cure rates are dismal with currently available treatment. Novel therapies including small molecule tyrosine kinase inhibitors and monoclonal antibodies are being developed to target angiogenesis, an essential step in tumorigenesis and metastasis. The only antiangiogenic agent currently approved for treatment of NSCLC is bevacizumab, although numerous other antiangiogenic inhibitors (e.g., sorafenib, sunitinib, cediranib, motesanib, BIBF 1120) are in clinical trials. Individualized treatment algorithms may improve patient outcomes and new evidence suggests that biomarkers may guide treatment decisions. We present an overview of the molecular pathways involved in angiogenesis, discuss clinical trials of bevacizumab and developmental antiangiogenic agents, and address the challenges of developing individualized treatment paradigms for NSCLC, particularly the use of biomarkers. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

  8. 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

  9. Addressing practical challenges in utility optimization of mobile wireless sensor networks

    NASA Astrophysics Data System (ADS)

    Eswaran, Sharanya; Misra, Archan; La Porta, Thomas; Leung, Kin

    2008-04-01

    This paper examines the practical challenges in the application of the distributed network utility maximization (NUM) framework to the problem of resource allocation and sensor device adaptation in a mission-centric wireless sensor network (WSN) environment. By providing rich (multi-modal), real-time information about a variety of (often inaccessible or hostile) operating environments, sensors such as video, acoustic and short-aperture radar enhance the situational awareness of many battlefield missions. Prior work on the applicability of the NUM framework to mission-centric WSNs has focused on tackling the challenges introduced by i) the definition of an individual mission's utility as a collective function of multiple sensor flows and ii) the dissemination of an individual sensor's data via a multicast tree to multiple consuming missions. However, the practical application and performance of this framework is influenced by several parameters internal to the framework and also by implementation-specific decisions. This is made further complex due to mobile nodes. In this paper, we use discrete-event simulations to study the effects of these parameters on the performance of the protocol in terms of speed of convergence, packet loss, and signaling overhead thereby addressing the challenges posed by wireless interference and node mobility in ad-hoc battlefield scenarios. This study provides better understanding of the issues involved in the practical adaptation of the NUM framework. It also helps identify potential avenues of improvement within the framework and protocol.

  10. Practical challenges in quantum key distribution

    DOE PAGES

    Diamanti, Eleni; Lo, Hoi -Kwong; Qi, Bing; ...

    2016-11-08

    Here, quantum key distribution (QKD) promises unconditional security in data communication and is currently being deployed in commercial applications. Nonetheless, before QKD can be widely adopted, it faces a number of important challenges such as secret key rate, distance, size, cost and practical security. Here, we survey those key challenges and the approaches that are currently being taken to address them.

  11. Practical challenges in quantum key distribution

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

    Diamanti, Eleni; Lo, Hoi -Kwong; Qi, Bing

    Here, quantum key distribution (QKD) promises unconditional security in data communication and is currently being deployed in commercial applications. Nonetheless, before QKD can be widely adopted, it faces a number of important challenges such as secret key rate, distance, size, cost and practical security. Here, we survey those key challenges and the approaches that are currently being taken to address them.

  12. Using a Sampling Strategy to Address Psychometric Challenges in Tutorial-Based Assessments

    ERIC Educational Resources Information Center

    Eva, Kevin W.; Solomon, Patty; Neville, Alan J.; Ladouceur, Michael; Kaufman, Karyn; Walsh, Allyn; Norman, Geoffrey R.

    2007-01-01

    Introduction: Tutorial-based assessment, despite providing a good match with the philosophy adopted by educational programmes that emphasize small group learning, remains one of the greatest challenges for educators working in this context. The current study was performed in an attempt to assess the psychometric characteristics of tutorial-based…

  13. Reading handprinted addresses on IRS tax forms

    NASA Astrophysics Data System (ADS)

    Ramanaprasad, Vemulapati; Shin, Yong-Chul; Srihari, Sargur N.

    1996-03-01

    The hand-printed address recognition system described in this paper is a part of the Name and Address Block Reader (NABR) system developed by the Center of Excellence for Document Analysis and Recognition (CEDAR). NABR is currently being used by the IRS to read address blocks (hand-print as well as machine-print) on fifteen different tax forms. Although machine- print address reading was relatively straightforward, hand-print address recognition has posed some special challenges due to demands on processing speed (with an expected throughput of 8450 forms/hour) and recognition accuracy. We discuss various subsystems involved in hand- printed address recognition, including word segmentation, word recognition, digit segmentation, and digit recognition. We also describe control strategies used to make effective use of these subsystems to maximize recognition accuracy. We present system performance on 931 address blocks in recognizing various fields, such as city, state, ZIP Code, street number and name, and personal names.

  14. Next-generation clinical trials: Novel strategies to address the challenge of tumor molecular heterogeneity.

    PubMed

    Catenacci, Daniel V T

    2015-05-01

    The promise of 'personalized cancer care' with therapies toward specific molecular aberrations has potential to improve outcomes. However, there is recognized heterogeneity within any given tumor-type from patient to patient (inter-patient heterogeneity), and within an individual (intra-patient heterogeneity) as demonstrated by molecular evolution through space (primary tumor to metastasis) and time (after therapy). These issues have become hurdles to advancing cancer treatment outcomes with novel molecularly targeted agents. Classic trial design paradigms are challenged by heterogeneity, as they are unable to test targeted therapeutics against low frequency genomic 'oncogenic driver' aberrations with adequate power. Usual accrual difficulties to clinical trials are exacerbated by low frequencies of any given molecular driver. To address these challenges, there is need for innovative clinical trial designs and strategies implementing novel diagnostic biomarker technologies to account for inter-patient molecular diversity and scarce tissue for analysis. Importantly, there is also need for pre-defined treatment priority algorithms given numerous aberrations commonly observed within any one individual sample. Access to multiple available therapeutic agents simultaneously is crucial. Finally intra-patient heterogeneity through time may be addressed by serial biomarker assessment at the time of tumor progression. This report discusses various 'next-generation' biomarker-driven trial designs and their potentials and limitations to tackle these recognized molecular heterogeneity challenges. Regulatory hurdles, with respect to drug and companion diagnostic development and approval, are considered. Focus is on the 'Expansion Platform Design Types I and II', the latter demonstrated with a first example, 'PANGEA: Personalized Anti-Neoplastics for Gastro-Esophageal Adenocarcinoma'. Applying integral medium-throughput genomic and proteomic assays along with a practical

  15. Possibility and Challenges of Conversion of Current Virus Species Names to Linnaean Binomials

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

    Postler, Thomas S.; Clawson, Anna N.; Amarasinghe, Gaya K.

    Botanical, mycological, zoological, and prokaryotic species names follow the Linnaean format, consisting of an italicized Latinized binomen with a capitalized genus name and a lower case species epithet (e.g., Homo sapiens). Virus species names, however, do not follow a uniform format, and, even when binomial, are not Linnaean in style. In this thought exercise, we attempted to convert all currently official names of species included in the virus family Arenaviridae and the virus order Mononegavirales to Linnaean binomials, and to identify and address associated challenges and concerns. Surprisingly, this endeavor was not as complicated or time-consuming as even the authorsmore » of this article expected when conceiving the experiment. [Arenaviridae; binomials; ICTV; International Committee on Taxonomy of Viruses; Mononegavirales; virus nomenclature; virus taxonomy.]« less

  16. Moving beyond regression techniques in cardiovascular risk prediction: applying machine learning to address analytic challenges.

    PubMed

    Goldstein, Benjamin A; Navar, Ann Marie; Carter, Rickey E

    2017-06-14

    Risk prediction plays an important role in clinical cardiology research. Traditionally, most risk models have been based on regression models. While useful and robust, these statistical methods are limited to using a small number of predictors which operate in the same way on everyone, and uniformly throughout their range. The purpose of this review is to illustrate the use of machine-learning methods for development of risk prediction models. Typically presented as black box approaches, most machine-learning methods are aimed at solving particular challenges that arise in data analysis that are not well addressed by typical regression approaches. To illustrate these challenges, as well as how different methods can address them, we consider trying to predicting mortality after diagnosis of acute myocardial infarction. We use data derived from our institution's electronic health record and abstract data on 13 regularly measured laboratory markers. We walk through different challenges that arise in modelling these data and then introduce different machine-learning approaches. Finally, we discuss general issues in the application of machine-learning methods including tuning parameters, loss functions, variable importance, and missing data. Overall, this review serves as an introduction for those working on risk modelling to approach the diffuse field of machine learning. © The Author 2016. Published by Oxford University Press on behalf of the European Society of Cardiology.

  17. Characteristics of Treatment Decisions to Address Challenging Behaviors in Children with Autism Spectrum Disorder.

    PubMed

    Anixt, Julia S; Meinzen-Derr, Jareen; Estridge, Halley; Smith, Laura; Brinkman, William B

    2018-05-01

    To describe the characteristics of treatment decisions to address challenging behaviors in children with autism spectrum disorder (ASD). Parents of children aged 4 to 15 years with ASD seen in a developmental behavioral pediatric (DBP) clinic completed validated measures to characterize their child's behaviors and their own level of stress. Parents reported their treatment priority before the visit. During the visit, we assessed shared decision making (SDM) using the Observing Patient Involvement (OPTION) scale and alignment of the clinician's treatment plan with the parent's priority. Before and after the visit, parents rated their uncertainty about the treatment plan using the Decisional Conflict Scale (DCS). We calculated descriptive statistics for the measures. Fifty-four families participated. Children were a mean (SD) age of 8.8 (3.3) years, and 87% were male. Children had a variety of behavioral challenges, and parents reported high levels of stress. Commonly reported parent treatment priorities were hyperactivity, tantrums, anxiety, and poor social skills. Levels of SDM were low, with a mean (SD) OPTION score of 24.5 (9.7). Parent priorities were addressed in 65% of treatment plans. Approximately 69% of parents had elevated DCS scores before the visit. Although levels of decisional conflict were lower after the visit compared with before the visit (p < 0.03), 46% of parents continued to report high scores on the DCS. Parents leave DBP visits with feelings of uncertainty about treatment decisions and with treatment plans that do not always address their priorities. SDM interventions hold promise to improve the quality of ASD treatment decisions.

  18. Smart wearable systems: current status and future challenges.

    PubMed

    Chan, Marie; Estève, Daniel; Fourniols, Jean-Yves; Escriba, Christophe; Campo, Eric

    2012-11-01

    Extensive efforts have been made in both academia and industry in the research and development of smart wearable systems (SWS) for health monitoring (HM). Primarily influenced by skyrocketing healthcare costs and supported by recent technological advances in micro- and nanotechnologies, miniaturisation of sensors, and smart fabrics, the continuous advances in SWS will progressively change the landscape of healthcare by allowing individual management and continuous monitoring of a patient's health status. Consisting of various components and devices, ranging from sensors and actuators to multimedia devices, these systems support complex healthcare applications and enable low-cost wearable, non-invasive alternatives for continuous 24-h monitoring of health, activity, mobility, and mental status, both indoors and outdoors. Our objective has been to examine the current research in wearable to serve as references for researchers and provide perspectives for future research. Herein, we review the current research and development of and the challenges facing SWS for HM, focusing on multi-parameter physiological sensor systems and activity and mobility measurement system designs that reliably measure mobility or vital signs and integrate real-time decision support processing for disease prevention, symptom detection, and diagnosis. For this literature review, we have chosen specific selection criteria to include papers in which wearable systems or devices are covered. We describe the state of the art in SWS and provide a survey of recent implementations of wearable health-care systems. We describe current issues, challenges, and prospects of SWS. We conclude by identifying the future challenges facing SWS for HM. Copyright © 2012 Elsevier B.V. All rights reserved.

  19. Current challenges in meeting global iodine requirements.

    PubMed

    Eastman, Creswell J; Jooste, Pieter

    2012-01-01

    Iodine deficiency is a global problem of immense magnitude afflicting 2 billion of the world's population. The adverse effects of iodine deficiency in humans, collectively termed iodine deficiency disorders, result from decreased thyroid hormone production and action, and vary in severity from thyroid enlargement (goiter) to severe, irreversible brain damage, termed endemic cretinism. Thyroid hormone is essential throughout life, but it is critical for normal brain development in the fetus and throughout childhood. During pregnancy, maternal thyroid hormone production must increase by 25-50% to meet maternal-fetal requirements. The principal sources of iodine in the diet include milk and dairy products, seafoods and foods with added iodized salt. Vegetables, fruits and cereals are generally poor sources of iodine because most of our soils and water supplies are deficient in iodine. The accepted solution to the problem is Universal Salt Iodization where all salt for human and animal consumption is iodized at a level of 20-40 µg/g. In principle, mandatory fortification represents the most effective public health strategy where safety and efficacy can be assured and there is a demonstrated need for the nutrient in the population. Voluntary fortification of salt and other foods has many limitations and few benefits. Iodine supplementation is a useful, but expensive, inefficient and unsustainable strategy for preventing iodine deficiency. The current worldwide push to decrease salt intake to prevent cardiovascular disease presents an entirely new challenge in addressing iodine deficiency in both developing and developed countries. Copyright © 2012 S. Karger AG, Basel.

  20. Addressing Complex Problems: Using Authentic Audiences and Challenges to Develop Adaptive Leadership and Socially Responsible Agency in Leadership Learners

    ERIC Educational Resources Information Center

    Andenoro, Anthony C.; Sowcik, Matthew J.; Balser, Teresa C.

    2017-01-01

    Complex and adaptive challenges threaten human well-being and sustainability. However, our leadership graduates often lack the capacity and or commitment to address these challenges in a meaningful way. This paper details a five-year study exploring the impact of an interdisciplinary undergraduate course on the development of global capacities,…

  1. Time for a change: addressing R&D and commercialization challenges for antibacterials

    PubMed Central

    Payne, David J.; Miller, Linda Federici; Findlay, David; Anderson, James; Marks, Lynn

    2015-01-01

    The antibacterial therapeutic area has been described as the perfect storm. Resistance is increasing to the point that our hospitals encounter patients infected with untreatable pathogens, the overall industry pipeline is described as dry and most multinational pharmaceutical companies have withdrawn from the area. Major contributing factors to the declining antibacterial industry pipeline include scientific challenges, clinical/regulatory hurdles and low return on investment. This paper examines these challenges and proposes approaches to address them. There is a need for a broader scientific agenda to explore new approaches to discover and develop antibacterial agents. Additionally, ideas of how industry and academia could be better integrated will be presented. While promising progress in the regulatory environment has been made, more streamlined regulatory paths are still required and the solutions will lie in global harmonization and clearly defined guidance. Creating the right incentives for antibacterial research and development is critical and a new commercial model for antibacterial agents will be proposed. One key solution to help resolve both the problem of antimicrobial resistance (AMR) and lack of new drug development are rapid, cost-effective, accurate point of care diagnostics that will transform antibacterial prescribing and enable more cost-effective and efficient antibacterial clinical trials. The challenges of AMR are too great for any one group to resolve and success will require leadership and partnerships among academia, industry and governments globally. PMID:25918443

  2. The mining sector of Liberia: current practices and environmental challenges.

    PubMed

    Wilson, Samuel T K; Wang, Hongtao; Kabenge, Martin; Qi, Xuejiao

    2017-08-01

    Liberia is endowed with an impressive stock of mineral reserves and has traditionally relied on mining, namely iron ore, gold, and diamonds, as a major source of income. The recent growth in the mining sector has the potential to contribute significantly to employment, income generation, and infrastructure development. However, the development of these mineral resources has significant environmental impacts that often go unnoticed. This paper presents an overview of the Liberian mining sector from historical, current development, and economic perspectives. The efforts made by government to address issues of environmental management and sustainable development expressed in national and international frameworks, as well as some of the environmental challenges in the mining sector are analyzed. A case study was conducted on one of the iron ore mines (China Union Bong Mines Investment) to analyze the effects of the water quality on the local water environment. The results show that the analyzed water sample concentrations were all above the WHO and Liberia water standard Class I guidelines for drinking water. Finally the paper examines the application of water footprint from a life cycle perspective in the Liberian mining sector and suggests some policy options for water resources management.

  3. 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

  4. Addressing neuropsychiatric disturbances during rehabilitation after traumatic brain injury: current and future methods

    PubMed Central

    Arciniegas, David B.

    2011-01-01

    Cognitive, emotional, behavioral, and sensorimotor disturbances are the principal clinical manifestations of traumatic brain injury (TBI) throughout the early postinjury period. These post-traumatic neuropsychiatric disturbances present substantial challenges to patients, their families, and clinicians providing their rehabilitative care, the optimal approaches to which remain incompletely developed. In this article, a neuropsychiairically informed, neurobiologically anchored approach to understanding and meeting challenges is described. The foundation for thai approach is laid, with a review of clinical case definitions of TBI and clarification of their intended referents. The differential diagnosis of event-related neuropsychiatric disturbances is considered next, after which the clinical and neurobiological heterogeneity within the diagnostic category of TBI are discussed. The clinical manifestations of biomechanical force-induced brain dysfunction are described as a state of post-traumatic encephalopathy (PTE) comprising several phenomenologically distinct stages, PTE is then used as a framework for understanding and clinically evaluating the neuropsychiatric sequelae of TBI encountered commonly during the early post-injury rehabilitation period, and for considering the types and timings of neurorehabilitative interventions. Finally, directions for future research that may address productively the challenges to TBI rehabilitation presented by neuropsychiatric disturbances are considered. PMID:22034400

  5. The Challenge of the Deanship.

    ERIC Educational Resources Information Center

    Montez, Joni; Wolverton, Mimi

    This paper addresses the evolution of the kinds of challenges that deans have met over time and examines perceptions of today's deans concerning their ability to deal effectively with current challenges. A sample of deans (n=695) in the colleges of education, business, liberal arts, and nursing at 360 public and private institutions was surveyed…

  6. Identifying and Addressing Themes of Job Dissatisfaction for Secondary Principals

    ERIC Educational Resources Information Center

    De Jong, David; Grundmeyer, Trent; Yankey, Julie

    2017-01-01

    Secondary principals serve in important roles that are complex, high-stress, and include demanding job responsibilities. Key stakeholders such as superintendents, school board members, and legislators must understand the challenges facing secondary principals in order to address the current themes of job dissatisfaction. Using new survey data…

  7. Principles of Positive Behaviour Supports: Using the FBA as a Problem-Solving Approach to Address Challenging Behaviours beyond Special Populations

    ERIC Educational Resources Information Center

    Moreno, Gerardo; Bullock, Lyndal M.

    2011-01-01

    The Functional Behavioural Assessment (FBA) is an investigative process that examines the context of challenging behaviours in the classroom. Information gleaned from the FBA process is used to develop a behaviour intervention plan to address the challenging behaviour and teach a socially acceptable replacement behaviour. However, the FBA has…

  8. Influenza Vaccines: Challenges and Solutions

    PubMed Central

    Houser, Katherine; Subbarao, Kanta

    2015-01-01

    Vaccination is the best method for the prevention and control of influenza. Vaccination can reduce illness and lessen severity of infection. This review focuses on how currently licensed influenza vaccines are generated in the U.S., why the biology of influenza poses vaccine challenges, and vaccine approaches on the horizon that address these challenges. PMID:25766291

  9. Arrhythmogenic KCNE gene variants: current knowledge and future challenges

    PubMed Central

    Crump, Shawn M.; Abbott, Geoffrey W.

    2014-01-01

    There are twenty-five known inherited cardiac arrhythmia susceptibility genes, all of which encode either ion channel pore-forming subunits or proteins that regulate aspects of ion channel biology such as function, trafficking, and localization. The human KCNE gene family comprises five potassium channel regulatory subunits, sequence variants in each of which are associated with cardiac arrhythmias. KCNE gene products exhibit promiscuous partnering and in some cases ubiquitous expression, hampering efforts to unequivocally correlate each gene to specific native potassium currents. Likewise, deducing the molecular etiology of cardiac arrhythmias in individuals harboring rare KCNE gene variants, or more common KCNE polymorphisms, can be challenging. In this review we provide an update on putative arrhythmia-causing KCNE gene variants, and discuss current thinking and future challenges in the study of molecular mechanisms of KCNE-associated cardiac rhythm disturbances. PMID:24478792

  10. Data integration in the era of omics: current and future challenges

    PubMed Central

    2014-01-01

    To integrate heterogeneous and large omics data constitutes not only a conceptual challenge but a practical hurdle in the daily analysis of omics data. With the rise of novel omics technologies and through large-scale consortia projects, biological systems are being further investigated at an unprecedented scale generating heterogeneous and often large data sets. These data-sets encourage researchers to develop novel data integration methodologies. In this introduction we review the definition and characterize current efforts on data integration in the life sciences. We have used a web-survey to assess current research projects on data-integration to tap into the views, needs and challenges as currently perceived by parts of the research community. PMID:25032990

  11. Time for a change: addressing R&D and commercialization challenges for antibacterials.

    PubMed

    Payne, David J; Miller, Linda Federici; Findlay, David; Anderson, James; Marks, Lynn

    2015-06-05

    The antibacterial therapeutic area has been described as the perfect storm. Resistance is increasing to the point that our hospitals encounter patients infected with untreatable pathogens, the overall industry pipeline is described as dry and most multinational pharmaceutical companies have withdrawn from the area. Major contributing factors to the declining antibacterial industry pipeline include scientific challenges, clinical/regulatory hurdles and low return on investment. This paper examines these challenges and proposes approaches to address them. There is a need for a broader scientific agenda to explore new approaches to discover and develop antibacterial agents. Additionally, ideas of how industry and academia could be better integrated will be presented. While promising progress in the regulatory environment has been made, more streamlined regulatory paths are still required and the solutions will lie in global harmonization and clearly defined guidance. Creating the right incentives for antibacterial research and development is critical and a new commercial model for antibacterial agents will be proposed. One key solution to help resolve both the problem of antimicrobial resistance (AMR) and lack of new drug development are rapid, cost-effective, accurate point of care diagnostics that will transform antibacterial prescribing and enable more cost-effective and efficient antibacterial clinical trials. The challenges of AMR are too great for any one group to resolve and success will require leadership and partnerships among academia, industry and governments globally. © 2015 The Author(s) Published by the Royal Society. All rights reserved.

  12. The importance of fungi and mycology for addressing major global challenges*.

    PubMed

    Lange, Lene

    2014-12-01

    In the new bioeconomy, fungi play a very important role in addressing major global challenges, being instrumental for improved resource efficiency, making renewable substitutes for products from fossil resources, upgrading waste streams to valuable food and feed ingredients, counteracting life-style diseases and antibiotic resistance through strengthening the gut biota, making crop plants more robust to survive climate change conditions, and functioning as host organisms for production of new biological drugs. This range of new uses of fungi all stand on the shoulders of the efforts of mycologists over generations: the scientific discipline mycology has built comprehensive understanding within fungal biodiversity, classification, evolution, genetics, physiology, ecology, pathogenesis, and nutrition. Applied mycology could not make progress without this platform. To unfold the full potentials of what fungi can do for both environment and man we need to strengthen the field of mycology on a global scale. The current mission statement gives an overview of where we are, what needs to be done, what obstacles to overcome, and which potentials are within reach. It further provides a vision for how mycology can be strengthened: The time is right to make the world aware of the immense importance of fungi and mycology for sustainable global development, where land, water and biological materials are used in a more efficient and more sustainable manner. This is an opportunity for profiling mycology by narrating the role played by fungi in the bioeconomy. Greater awareness and appreciation of the role of fungi can be used to build support for mycology around the world. Support will attract more talent to our field of study, empower mycologists around the world to generate more funds for necessary basic research, and strengthen the global mycology network. The use of fungi for unlocking the full potentials of the bioeconomy relies on such progress. The fungal kingdom can be an

  13. Current Computational Challenges for CMC Processes, Properties, and Structures

    NASA Technical Reports Server (NTRS)

    DiCarlo, James

    2008-01-01

    In comparison to current state-of-the-art metallic alloys, ceramic matrix composites (CMC) offer a variety of performance advantages, such as higher temperature capability (greater than the approx.2100 F capability for best metallic alloys), lower density (approx.30-50% metal density), and lower thermal expansion. In comparison to other competing high-temperature materials, CMC are also capable of providing significantly better static and dynamic toughness than un-reinforced monolithic ceramics and significantly better environmental resistance than carbon-fiber reinforced composites. Because of these advantages, NASA, the Air Force, and other U.S. government agencies and industries are currently seeking to implement these advanced materials into hot-section components of gas turbine engines for both propulsion and power generation. For applications such as these, CMC are expected to result in many important performance benefits, such as reduced component cooling air requirements, simpler component design, reduced weight, improved fuel efficiency, reduced emissions, higher blade frequencies, reduced blade clearances, and higher thrust. Although much progress has been made recently in the development of CMC constituent materials and fabrication processes, major challenges still remain for implementation of these advanced composite materials into viable engine components. The objective of this presentation is to briefly review some of those challenges that are generally related to the need to develop physics-based computational approaches to allow CMC fabricators and designers to model (1) CMC processes for fiber architecture formation and matrix infiltration, (2) CMC properties of high technical interest such as multidirectional creep, thermal conductivity, matrix cracking stress, damage accumulation, and degradation effects in aggressive environments, and (3) CMC component life times when all of these effects are interacting in a complex stress and service

  14. Teaching of leprosy: current challenges*

    PubMed Central

    Alves, Cynthia Rossetti Portela; Ribeiro, Maria Mônica Freitas; Melo, Elza Machado; Araújo, Marcelo Grossi

    2014-01-01

    In the context of declining leprosy endemicity worldwide, keeping the interest in knowledge and expertise in leprosy alive has been a matter of concern. Approaching the problem only in primary care, without the proper integration with other levels of care in the health system fails to account for the complexity of the disease. Training professionals to work at different levels of health care is a current challenge. The objective of this review was to look for experiences related to the teaching of leprosy both in undergraduate courses in the field of health sciences and in training programs for professionals who work in patient care. We highlight the role of the dermatologist in the management of control programs, diagnosis and treatment of the disease, as well as in the continuous education of other health professionals. PMID:24937820

  15. Rapid prototyping for biomedical engineering: current capabilities and challenges.

    PubMed

    Lantada, Andrés Díaz; Morgado, Pilar Lafont

    2012-01-01

    A new set of manufacturing technologies has emerged in the past decades to address market requirements in a customized way and to provide support for research tasks that require prototypes. These new techniques and technologies are usually referred to as rapid prototyping and manufacturing technologies, and they allow prototypes to be produced in a wide range of materials with remarkable precision in a couple of hours. Although they have been rapidly incorporated into product development methodologies, they are still under development, and their applications in bioengineering are continuously evolving. Rapid prototyping and manufacturing technologies can be of assistance in every stage of the development process of novel biodevices, to address various problems that can arise in the devices' interactions with biological systems and the fact that the design decisions must be tested carefully. This review focuses on the main fields of application for rapid prototyping in biomedical engineering and health sciences, as well as on the most remarkable challenges and research trends.

  16. Molecular ecology studies of species radiations: current research gaps, opportunities and challenges.

    PubMed

    de la Harpe, Marylaure; Paris, Margot; Karger, Dirk N; Rolland, Jonathan; Kessler, Michael; Salamin, Nicolas; Lexer, Christian

    2017-05-01

    Understanding the drivers and limits of species radiations is a crucial goal of evolutionary genetics and molecular ecology, yet research on this topic has been hampered by the notorious difficulty of connecting micro- and macroevolutionary approaches to studying the drivers of diversification. To chart the current research gaps, opportunities and challenges of molecular ecology approaches to studying radiations, we examine the literature in the journal Molecular Ecology and revisit recent high-profile examples of evolutionary genomic research on radiations. We find that available studies of radiations are highly unevenly distributed among taxa, with many ecologically important and species-rich organismal groups remaining severely understudied, including arthropods, plants and fungi. Most studies employed molecular methods suitable over either short or long evolutionary time scales, such as microsatellites or restriction site-associated DNA sequencing (RAD-seq) in the former case and conventional amplicon sequencing of organellar DNA in the latter. The potential of molecular ecology studies to address and resolve patterns and processes around the species level in radiating groups of taxa is currently limited primarily by sample size and a dearth of information on radiating nuclear genomes as opposed to organellar ones. Based on our literature survey and personal experience, we suggest possible ways forward in the coming years. We touch on the potential and current limitations of whole-genome sequencing (WGS) in studies of radiations. We suggest that WGS and targeted ('capture') resequencing emerge as the methods of choice for scaling up the sampling of populations, species and genomes, including currently understudied organismal groups and the genes or regulatory elements expected to matter most to species radiations. © 2017 John Wiley & Sons Ltd.

  17. Current Challenges in Health Economic Modeling of Cancer Therapies: A Research Inquiry

    PubMed Central

    Miller, Jeffrey D.; Foley, Kathleen A.; Russell, Mason W.

    2014-01-01

    Background The demand for economic models that evaluate cancer treatments is increasing, as healthcare decision makers struggle for ways to manage their budgets while providing the best care possible to patients with cancer. Yet, after nearly 2 decades of cultivating and refining techniques for modeling the cost-effectiveness and budget impact of cancer therapies, serious methodologic and policy challenges have emerged that question the adequacy of economic modeling as a sound decision-making tool in oncology. Objectives We sought to explore some of the contentious issues associated with the development and use of oncology economic models as informative tools in current healthcare decision-making. Our objective was to draw attention to these complex pharmacoeconomic concerns and to promote discussion within the oncology and health economics research communities. Methods Using our combined expertise in health economics research and economic modeling, we structured our inquiry around the following 4 questions: (1) Are economic models adequately addressing questions relevant to oncology decision makers; (2) What are the methodologic limitations of oncology economic models; (3) What guidelines are followed for developing oncology economic models; and (4) Is the evolution of oncology economic modeling keeping pace with treatment innovation? Within the context of each of these questions, we discuss issues related to the technical limitations of oncology modeling, the availability of adequate data for developing models, and the problems with how modeling analyses and results are presented and interpreted. Discussion There is general acceptance that economic models are good, essential tools for decision-making, but the practice of oncology and its rapidly evolving technologies present unique challenges that make assessing and demonstrating value especially complex. There is wide latitude for improvement in oncology modeling methodologies and how model results are presented

  18. Current challenges in health economic modeling of cancer therapies: a research inquiry.

    PubMed

    Miller, Jeffrey D; Foley, Kathleen A; Russell, Mason W

    2014-05-01

    The demand for economic models that evaluate cancer treatments is increasing, as healthcare decision makers struggle for ways to manage their budgets while providing the best care possible to patients with cancer. Yet, after nearly 2 decades of cultivating and refining techniques for modeling the cost-effectiveness and budget impact of cancer therapies, serious methodologic and policy challenges have emerged that question the adequacy of economic modeling as a sound decision-making tool in oncology. We sought to explore some of the contentious issues associated with the development and use of oncology economic models as informative tools in current healthcare decision-making. Our objective was to draw attention to these complex pharmacoeconomic concerns and to promote discussion within the oncology and health economics research communities. Using our combined expertise in health economics research and economic modeling, we structured our inquiry around the following 4 questions: (1) Are economic models adequately addressing questions relevant to oncology decision makers; (2) What are the methodologic limitations of oncology economic models; (3) What guidelines are followed for developing oncology economic models; and (4) Is the evolution of oncology economic modeling keeping pace with treatment innovation? Within the context of each of these questions, we discuss issues related to the technical limitations of oncology modeling, the availability of adequate data for developing models, and the problems with how modeling analyses and results are presented and interpreted. There is general acceptance that economic models are good, essential tools for decision-making, but the practice of oncology and its rapidly evolving technologies present unique challenges that make assessing and demonstrating value especially complex. There is wide latitude for improvement in oncology modeling methodologies and how model results are presented and interpreted. Complex technical and

  19. At the Crossroads of Nanotoxicology: Past Achievements and Current Challenges

    DTIC Science & Technology

    2015-01-01

    rates of ionic dissolution, improving in vitro to in vivo predictive efficiencies, and establishing safety exposure limits. This Review will discuss...Oberdörster et al., 2005a), which drove the focus of in vitro and in vivo model selection to accommodate these areas of higher NM exposure. Most...Accordingly, a current challenge is the design of simple, in vitro models that reliably predict in vivo effects following a NM challenge. In order

  20. Addressing challenges for future strategic-level emergency management: reframing, networking, and capacity-building.

    PubMed

    Bosomworth, Karyn; Owen, Christine; Curnin, Steven

    2017-04-01

    The mounting frequency and intensity of natural hazards, alongside growing interdependencies between social-technical and ecological systems, are placing increased pressure on emergency management. This is particularly true at the strategic level of emergency management, which involves planning for and managing non-routine, high-consequence events. Drawing on the literature, a survey, and interviews and workshops with Australia's senior emergency managers, this paper presents an analysis of five core challenges that these pressures are creating for strategic-level emergency management. It argues that emphasising 'emergency management' as a primary adaptation strategy is a retrograde step that ignores the importance of addressing socio-political drivers of vulnerabilities. Three key suggestions are presented that could assist the country's strategic-level emergency management in tackling these challenges: (i) reframe emergency management as a component of disaster risk reduction rather than them being one and the same; (ii) adopt a network governance approach; and (iii) further develop the capacities of strategic-level emergency managers. © 2017 The Author(s). Disasters © Overseas Development Institute, 2017.

  1. Developing Interdisciplinary Workforce to Meet Future Aerospace Challenges

    NASA Technical Reports Server (NTRS)

    Misra, Ajay

    2017-01-01

    The presentation will focus on the importance of interdisciplinary research for addressing future aerospace challenges. Examples of current research activities at NASA's Glenn Research Center will be provided to illustrate the importance of interdisciplinary research. Challenges with conducting interdisciplinary research will be discussed.

  2. Behavioral medicine and prevention of non-communicable diseases in China: current challenges and future directions.

    PubMed

    Ding, Ding; Zhong, Xuefeng; Lau, Joseph Tak-Fai; Oldenburg, Brian

    2014-08-01

    We describe the emergence of recent public health challenges in China, particularly those regarding lifestyle-related non-communicable diseases (NCDs). We also summarize some recent examples of behavioral medicine research and practice in relation to the prevention and control of NCDs in China. Finally, we describe recent changes in the public health system in China and how behavioral medicine research and practice can be incorporated into this system to address these public health challenges. We considered research and policy literature from both China and Western countries in order to evaluate the relevance of the field of behavioral medicine for addressing the rising NCDs in China. Rapid economic development and related social and environmental changes have brought about increasing wealth and lifestyle changes in China, along with new public health challenges related to the prevention and control of NCDs. The field of behavioral medicine has much to offer China in addressing these public health challenges. Although behavioral medicine research and practice are still at an early stage in China, there are encouraging signs of its development, particularly resulting from international collaborations with researchers from Western countries. The next stage of this field's development in China will involve increased integration of behavioral medicine into public health education, training, and the health system. However, this process of integration will need to build on China's traditional approaches to public health training, research, and practice. Although the field of behavioral medicine in public health is still in its infancy in China, we argue that the practice and principles of behavioral medicine are important for successfully addressing the substantial burden of NCDs now and in the future.

  3. Epigenetics of Addiction: Current Knowledge, Challenges, and Future Directions.

    PubMed

    Cecil, Charlotte A M; Walton, Esther; Viding, Essi

    2016-09-01

    Addiction to psychoactive substances is a debilitating condition underpinned by the interplay of genetic and environmental factors. At present, a key challenge for research is to delineate how, at a molecular level, these influences become "biologically embedded," contributing to the onset and persistence of addictive behaviors. Recently, epigenetic processes that regulate gene expression have emerged as a potential mechanism of interest. In this commentary, we discuss the relevance of epigenetics to addiction research, starting with the current state of knowledge, what challenges we have yet to overcome, and what the future may hold in terms of research methodology and translational potential.

  4. Possibility and Challenges of Conversion of Current Virus Species Names to Linnaean Binomials.

    PubMed

    Postler, Thomas S; Clawson, Anna N; Amarasinghe, Gaya K; Basler, Christopher F; Bavari, Sbina; Benko, Mária; Blasdell, Kim R; Briese, Thomas; Buchmeier, Michael J; Bukreyev, Alexander; Calisher, Charles H; Chandran, Kartik; Charrel, Rémi; Clegg, Christopher S; Collins, Peter L; Juan Carlos, De La Torre; Derisi, Joseph L; Dietzgen, Ralf G; Dolnik, Olga; Dürrwald, Ralf; Dye, John M; Easton, Andrew J; Emonet, Sébastian; Formenty, Pierre; Fouchier, Ron A M; Ghedin, Elodie; Gonzalez, Jean-Paul; Harrach, Balázs; Hewson, Roger; Horie, Masayuki; Jiang, Dàohóng; Kobinger, Gary; Kondo, Hideki; Kropinski, Andrew M; Krupovic, Mart; Kurath, Gael; Lamb, Robert A; Leroy, Eric M; Lukashevich, Igor S; Maisner, Andrea; Mushegian, Arcady R; Netesov, Sergey V; Nowotny, Norbert; Patterson, Jean L; Payne, Susan L; PaWeska, Janusz T; Peters, Clarence J; Radoshitzky, Sheli R; Rima, Bertus K; Romanowski, Victor; Rubbenstroth, Dennis; Sabanadzovic, Sead; Sanfaçon, Hélène; Salvato, Maria S; Schwemmle, Martin; Smither, Sophie J; Stenglein, Mark D; Stone, David M; Takada, Ayato; Tesh, Robert B; Tomonaga, Keizo; Tordo, Noël; Towner, Jonathan S; Vasilakis, Nikos; Volchkov, Viktor E; Wahl-Jensen, Victoria; Walker, Peter J; Wang, Lin-Fa; Varsani, Arvind; Whitfield, Anna E; Zerbini, F Murilo; Kuhn, Jens H

    2017-05-01

    Botanical, mycological, zoological, and prokaryotic species names follow the Linnaean format, consisting of an italicized Latinized binomen with a capitalized genus name and a lower case species epithet (e.g., Homo sapiens). Virus species names, however, do not follow a uniform format, and, even when binomial, are not Linnaean in style. In this thought exercise, we attempted to convert all currently official names of species included in the virus family Arenaviridae and the virus order Mononegavirales to Linnaean binomials, and to identify and address associated challenges and concerns. Surprisingly, this endeavor was not as complicated or time-consuming as even the authors of this article expected when conceiving the experiment. [Arenaviridae; binomials; ICTV; International Committee on Taxonomy of Viruses; Mononegavirales; virus nomenclature; virus taxonomy.]. Published by Oxford University Press on behalf of Society of Systematic Biologists 2016. This work is written by a US Government employee and is in the public domain in the US.

  5. Facilitators, challenges, and collaborative activities in faith and health partnerships to address health disparities.

    PubMed

    Kegler, Michelle C; Hall, Sarah M; Kiser, Mimi

    2010-10-01

    Interest in partnering with faith-based organizations (FBOs) to address health disparities has grown in recent years. Yet relatively little is known about these types of partnerships. As part of an evaluation of the Institute for Faith and Public Health Collaborations, representatives of 34 faith-health teams (n = 61) completed semi-structured interviews. Interviews were tape recorded, transcribed, and coded by two members of the evaluation team to identify themes. Major facilitators to faith-health collaborative work were passion and commitment, importance of FBOs in communities, favorable political climate, support from community and faith leaders, diversity of teams, and mutual trust and respect. Barriers unique to faith and health collaboration included discomfort with FBOs, distrust of either health agencies or FBOs, diversity within faith communities, different agendas, separation of church and state, and the lack of a common language. Findings suggest that faith-health partnerships face unique challenges but are capable of aligning resources to address health disparities.

  6. 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

  7. 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.

  8. Current challenges in autonomous vehicle development

    NASA Astrophysics Data System (ADS)

    Connelly, J.; Hong, W. S.; Mahoney, R. B., Jr.; Sparrow, D. A.

    2006-05-01

    The field of autonomous vehicles is a rapidly growing one, with significant interest from both government and industry sectors. Autonomous vehicles represent the intersection of artificial intelligence (AI) and robotics, combining decision-making with real-time control. Autonomous vehicles are desired for use in search and rescue, urban reconnaissance, mine detonation, supply convoys, and more. The general adage is to use robots for anything dull, dirty, dangerous or dumb. While a great deal of research has been done on autonomous systems, there are only a handful of fielded examples incorporating machine autonomy beyond the level of teleoperation, especially in outdoor/complex environments. In an attempt to assess and understand the current state of the art in autonomous vehicle development, a few areas where unsolved problems remain became clear. This paper outlines those areas and provides suggestions for the focus of science and technology research. The first step in evaluating the current state of autonomous vehicle development was to develop a definition of autonomy. A number of autonomy level classification systems were reviewed. The resulting working definitions and classification schemes used by the authors are summarized in the opening sections of the paper. The remainder of the report discusses current approaches and challenges in decision-making and real-time control for autonomous vehicles. Suggested research focus areas for near-, mid-, and long-term development are also presented.

  9. Online Learning: Addressing Challenges and Seizing Opportunities. Oregon

    ERIC Educational Resources Information Center

    Alliance for Excellent Education, 2010

    2010-01-01

    America's K-12 education system faces three significant challenges: (1) increased global demands for skilled workers, (2) significant financial shortfalls, and (3) a looming teacher shortage. Independently, these factors present significant challenges for U.S. schools. In combination, they create a national imperative for swift action to create a…

  10. Online Learning: Addressing Challenges and Seizing Opportunities. Minnesota

    ERIC Educational Resources Information Center

    Alliance for Excellent Education, 2010

    2010-01-01

    America's K-12 education system faces three significant challenges: (1) increased global demands for skilled workers, (2) significant financial shortfalls, and (3) a looming teacher shortage. Independently, these factors present significant challenges for U.S. schools. In combination, they create a national imperative for swift action to create a…

  11. Online Learning: Addressing Challenges and Seizing Opportunities. Hawaii

    ERIC Educational Resources Information Center

    Alliance for Excellent Education, 2010

    2010-01-01

    America's K-12 education system faces three significant challenges: (1) increased global demands for skilled workers, (2) significant financial shortfalls, and (3) a looming teacher shortage. Independently, these factors present significant challenges for U.S. schools. In combination, they create a national imperative for swift action to create a…

  12. Online Learning: Addressing Challenges and Seizing Opportunities. Idaho

    ERIC Educational Resources Information Center

    Alliance for Excellent Education, 2010

    2010-01-01

    America's K-12 education system faces three significant challenges: (1) increased global demands for skilled workers, (2) significant financial shortfalls, and (3) a looming teacher shortage. Independently, these factors present significant challenges for U.S. schools. In combination, they create a national imperative for swift action to create a…

  13. Online Learning: Addressing Challenges and Seizing Opportunities. Wisconsin

    ERIC Educational Resources Information Center

    Alliance for Excellent Education, 2010

    2010-01-01

    America's K-12 education system faces three significant challenges: (1) increased global demands for skilled workers, (2) significant financial shortfalls, and (3) a looming teacher shortage. Independently, these factors present significant challenges for U.S. schools. In combination, they create a national imperative for swift action to create a…

  14. Emerging Infections Program Efforts to Address Health Equity

    PubMed Central

    Vugia, Duc J.; Bennett, Nancy M.; Moore, Matthew R.

    2015-01-01

    The Emerging Infections Program (EIP), a collaboration between (currently) 10 state health departments, their academic center partners, and the Centers for Disease Control and Prevention, was established in 1995. The EIP performs active, population-based surveillance for important infectious diseases, addresses new problems as they arise, emphasizes projects that lead to prevention, and develops and evaluates public health practices. The EIP has increasingly addressed the health equity challenges posed by Healthy People 2020. These challenges include objectives to increase the proportion of Healthy People–specified conditions for which national data are available by race/ethnicity and socioeconomic status as a step toward first recognizing and subsequently eliminating health inequities. EIP has made substantial progress in moving from an initial focus on monitoring social determinants exclusively through collecting and analyzing data by race/ethnicity to identifying and piloting ways to conduct population-based surveillance by using area-based socioeconomic status measures. PMID:26291875

  15. Addressing the Challenges of Hepatitis C Virus Resistance and Treatment Failure.

    PubMed

    Colpitts, Che C; Baumert, Thomas F

    2016-08-16

    Chronic hepatitis C is a major cause of chronic liver disease, including liver cirrhosis and hepatocellular carcinoma. The development of direct-acting antivirals (DAAs) revolutionized hepatitis C virus (HCV) treatment by offering genuine prospects for the first comprehensive cure of a chronic viral infection in humans. While antiviral resistance is a significant limitation for interferon-based therapies, resistance and treatment failure still appear to be present in a small fraction of patients even in state-of-the-art DAA combination therapies. Therefore, treatment failure and resistance still remain a clinical challenge for the management of patients not responding to DAAs. In this special issue of Viruses on HCV drug resistance, mechanisms of antiviral resistance for different classes of antiviral drugs are described. Furthermore, the detection and monitoring of resistance in clinical practice, the clinical impact of resistance in different patient groups and strategies to prevent and address resistance and treatment failure using complementary antiviral strategies are reviewed.

  16. Hepatitis B Virus Infection in Tanzania: Current Status and Challenges

    PubMed Central

    Bakshi, Fatma A.; Jaka, Hyasinta

    2018-01-01

    Hepatitis B is one of the most common infectious diseases in the world with high prevalence in most of sub-Saharan Africa countries. The complexity in its diagnosis and treatment poses a significant management challenge in the resource-limited settings including Tanzania, where most of the tests and drugs are either unavailable or unaffordable. This mini review aims at demonstrating the current status of the disease in the country and discussing the concomitant challenges in diagnosis, treatment, and prevention. PMID:29666656

  17. Revisiting Antipsychotic-induced Akathisia: Current Issues and Prospective Challenges

    PubMed Central

    Salem, Haitham; Nagpal, Caesa; Pigott, Teresa; Teixeira, Antonio Lucio

    2017-01-01

    Background: Akathisia continues to be a significant challenge in current neurological and psychiatric practice. Prompt and accurate detection is often difficult and there is a lack of consensus concerning the neurobiological basis of akathisia. No definitive treatment has been established for akathisia despite numerous preclinical and clinical studies. Method: We reviewed antipsychotic-induced akathisia including its clinical presentation, proposed underlying pathophysiology, current and under investigation therapeutic strategies. Conclusion: Despite the initial promise that second generation antipsychotics would be devoid of akathisia effects, this has not been confirmed. Currently, there are limited therapeutic options for the clinical practice and the evidence supporting the most widely used treatments (beta blockers, anticholinergic drugs) is still absent or inconsistent. PMID:27928948

  18. Coach strategies for addressing psychosocial challenges during the return to sport from injury.

    PubMed

    Podlog, Leslie; Dionigi, Rylee

    2010-09-01

    The purpose of this study was to examine coach strategies for addressing athletes' psychosocial challenges in returning to sport following injury rehabilitation. Qualitative interviews with eight elite coaches from the Western Australian Institute of Sport (WAIS) in Perth, Australia revealed that coaches facilitated athletes' return to sport from injury through a variety of means, but did not typically provide systematic forms of assistance. Coaches commented that the idiosyncratic nature of the injury experience meant that they needed to apply strategies consistent with athletes' particular psychosocial needs. Such strategies included: (a) coordination of a "team approach" to rehabilitation; (b) fostering open communication with athletes and treatment team members; (c) social support; (d) positive thinking and goal setting; and (e) role models. Analysis of these strategies revealed that coaches attempted to address competence, autonomy, and relatedness needs in facilitating athletes' return from injury. These findings suggest that self-determination theory may be a valuable approach for examining coach forms of assistance regarding athletes' return to competition following injury. Findings are discussed in relation to injury literature and self-determination theory. Suggestions for future research are also presented.

  19. A Holistic Approach towards Information and Communication Technology (ICT) for Addressing Education Challenges in Asia and the Pacific

    ERIC Educational Resources Information Center

    Ra, Sungsup; Chin, Brian; Lim, Cher Ping

    2016-01-01

    Information and Communication Technology (ICT) offers opportunities for governments to address key education challenges of quality, equity, and efficiency. While governments and educational institutions in developed countries may have taken up these opportunities, many developing countries in Asia and the Pacific region have often missed them out.…

  20. Current challenges in autonomous driving

    NASA Astrophysics Data System (ADS)

    Barabás, I.; Todoruţ, A.; Cordoş, N.; Molea, A.

    2017-10-01

    Nowadays the automotive industry makes a quantum shift to a future, where the driver will have smaller and smaller role in driving his or her vehicle ending up being totally excluded. In this paper, we have investigated the different levels of driving automatization, the prospective effects of these new technologies on the environment and traffic safety, the importance of regulations and their current state, the moral aspects of introducing these technologies and the possible scenarios of deploying the autonomous vehicles. We have found that the self-driving technologies are facing many challenges: a) They must make decisions faster in very diverse conditions which can include many moral dilemmas as well; b) They have an important potential in reducing the environmental pollution by optimizing their routes, driving styles by communicating with other vehicles, infrastructures and their environment; c) There is a considerable gap between the self-drive technology level and the current regulations; fortunately, this gap shows a continuously decreasing trend; d) In case of many types of imminent accidents management there are many concerns about the ability of making the right decision. Considering that this field has an extraordinary speed of development, our study is up to date at the submission deadline. Self-driving technologies become increasingly sophisticated and technically accessible, and in some cases, they can be deployed for commercial vehicles as well. According to the current stage of research and development, it is still unclear how the self-driving technologies will be able to handle extreme and unexpected events including their moral aspects. Since most of the traffic accidents are caused by human error or omission, it is expected that the emergence of the autonomous technologies will reduce these accidents in their number and gravity, but the very few currently available test results have not been able to scientifically underpin this issue yet. The

  1. Current Challenges in Plant Eco-Metabolomics

    PubMed Central

    Peters, Kristian; Worrich, Anja; Alka, Oliver; Balcke, Gerd; Bruelheide, Helge; Dietz, Sophie; Dührkop, Kai; Heinig, Uwe; Kücklich, Marlen; Müller, Caroline; Poeschl, Yvonne; Pohnert, Georg; Ruttkies, Christoph; Schweiger, Rabea; Shahaf, Nir; Tortosa, Maria; Ueberschaar, Nico; Velasco, Pablo; Weiß, Brigitte M.; van Dam, Nicole M.

    2018-01-01

    The relatively new research discipline of Eco-Metabolomics is the application of metabolomics techniques to ecology with the aim to characterise biochemical interactions of organisms across different spatial and temporal scales. Metabolomics is an untargeted biochemical approach to measure many thousands of metabolites in different species, including plants and animals. Changes in metabolite concentrations can provide mechanistic evidence for biochemical processes that are relevant at ecological scales. These include physiological, phenotypic and morphological responses of plants and communities to environmental changes and also interactions with other organisms. Traditionally, research in biochemistry and ecology comes from two different directions and is performed at distinct spatiotemporal scales. Biochemical studies most often focus on intrinsic processes in individuals at physiological and cellular scales. Generally, they take a bottom-up approach scaling up cellular processes from spatiotemporally fine to coarser scales. Ecological studies usually focus on extrinsic processes acting upon organisms at population and community scales and typically study top-down and bottom-up processes in combination. Eco-Metabolomics is a transdisciplinary research discipline that links biochemistry and ecology and connects the distinct spatiotemporal scales. In this review, we focus on approaches to study chemical and biochemical interactions of plants at various ecological levels, mainly plant–organismal interactions, and discuss related examples from other domains. We present recent developments and highlight advancements in Eco-Metabolomics over the last decade from various angles. We further address the five key challenges: (1) complex experimental designs and large variation of metabolite profiles; (2) feature extraction; (3) metabolite identification; (4) statistical analyses; and (5) bioinformatics software tools and workflows. The presented solutions to these

  2. Exploring a Community of Practice Model for Professional Development to Address Challenges to Classroom Practices in Early Childhood

    ERIC Educational Resources Information Center

    Christ, Tanya; Wang, X. Christine

    2013-01-01

    This study explored whether or not, and how, an on-site and research-teacher community of practice model for professional development addressed the challenges to classroom practices in a Head Start program. Data sources included interviews with teachers, videos of planning and teaching sessions, and the researchers' fieldwork log and reflective…

  3. Defense Civil Support: DOD Needs to Identify National Guards Cyber Capabilities and Address Challenges in Its Exercises

    DTIC Science & Technology

    2016-09-01

    Congress. Consequently, as prepared now, this report does not help DOD leaders identify assets that could be used in a cyber crisis scenario...Guidance. GAO-13-128. Washington, D.C.: October 24, 2012. Defense Cyber Efforts: Management Improvements Needed to Enhance Programs Protecting the...DEFENSE CIVIL SUPPORT DOD Needs to Identify National Guard’s Cyber Capabilities and Address Challenges in Its

  4. Melanoma central nervous system metastases: current approaches, challenges, and opportunities

    PubMed Central

    Cohen, Justine V.; Tawbi, Hussain; Margolin, Kim A.; Amravadi, Ravi; Bosenberg, Marcus; Brastianos, Priscilla K.; Chiang, Veronica L.; de Groot, John; Glitza, Isabella C.; Herlyn, Meenhard; Holmen, Sheri L.; Jilaveanu, Lucia B.; Lassman, Andrew; Moschos, Stergios; Postow, Michael A.; Thomas, Reena; Tsiouris, John A.; Wen, Patrick; White, Richard M.; Turnham, Timothy; Davies, Michael A.; Kluger, Harriet M.

    2017-01-01

    Summary Melanoma central nervous system metastases are increasing, and the challenges presented by this patient population remain complex. In December 2015, the Melanoma Research Foundation and the Wistar Institute hosted the First Summit on Melanoma Central Nervous System (CNS) Metastases in Philadelphia, Pennsylvania. Here, we provide a review of the current status of the field of melanoma brain metastasis research; identify key challenges and opportunities for improving the outcomes in patients with melanoma brain metastases; and set a framework to optimize future research in this critical area. PMID:27615400

  5. Setting the Stage: Current State of Affairs and Major Challenges

    PubMed Central

    Reynolds, Steven J.; Quinn, Thomas C.

    2010-01-01

    The global human immunodeficiency virus (HIV) pandemic reached staggering proportions over the past 2 decades, particularly in areas of sub-Saharan Africa and other developing countries. Tremendous increases in donor resources over the past decade have allowed for a rapid scale-up of antiretroviral treatment and greater access to basic care and prevention programs in countries worst affected by HIV infection and AIDS. These programs have had a tremendous impact on the lives of millions of individuals and have also created optimism and hope where previously there was despair. Major challenges remain in combating the current HIV pandemic with regard to access to treatment; efficiency, quality, and sustainability of current programs; and the scale-up of evidence-based, effective prevention strategies. The global health community and political leaders will need to overcome these challenges if a long-term effective response to the HIV pandemic is to be achieved. PMID:20397959

  6. Cross-sector partnerships and public health: challenges and opportunities for addressing obesity and noncommunicable diseases through engagement with the private sector.

    PubMed

    Johnston, Lee M; Finegood, Diane T

    2015-03-18

    Over the past few decades, cross-sector partnerships with the private sector have become an increasingly accepted practice in public health, particularly in efforts to address infectious diseases in low- and middle-income countries. Now these partnerships are becoming a popular tool in efforts to reduce and prevent obesity and the epidemic of noncommunicable diseases. Partnering with businesses presents a means to acquire resources, as well as opportunities to influence the private sector toward more healthful practices. Yet even though collaboration is a core principle of public health practice, public-private or nonprofit-private partnerships present risks and challenges that warrant specific consideration. In this article, we review the role of public health partnerships with the private sector, with a focus on efforts to address obesity and noncommunicable diseases in high-income settings. We identify key challenges-including goal alignment and conflict of interest-and consider how changes to partnership practice might address these.

  7. Challenges facing European agriculture and possible biotechnological solutions.

    PubMed

    Ricroch, Agnès; Harwood, Wendy; Svobodová, Zdeňka; Sági, László; Hundleby, Penelope; Badea, Elena Marcela; Rosca, Ioan; Cruz, Gabriela; Salema Fevereiro, Manuel Pedro; Marfà Riera, Victoria; Jansson, Stefan; Morandini, Piero; Bojinov, Bojin; Cetiner, Selim; Custers, René; Schrader, Uwe; Jacobsen, Hans-Joerg; Martin-Laffon, Jacqueline; Boisron, Audrey; Kuntz, Marcel

    2016-10-01

    Agriculture faces many challenges to maximize yields while it is required to operate in an environmentally sustainable manner. In the present study, we analyze the major agricultural challenges identified by European farmers (primarily related to biotic stresses) in 13 countries, namely Belgium, Bulgaria, the Czech Republic, France, Germany, Hungary, Italy, Portugal, Romania, Spain, Sweden, UK and Turkey, for nine major crops (barley, beet, grapevine, maize, oilseed rape, olive, potato, sunflower and wheat). Most biotic stresses (BSs) are related to fungi or insects, but viral diseases, bacterial diseases and even parasitic plants have an important impact on yield and harvest quality. We examine how these challenges have been addressed by public and private research sectors, using either conventional breeding, marker-assisted selection, transgenesis, cisgenesis, RNAi technology or mutagenesis. Both national surveys and scientific literature analysis followed by text mining were employed to evaluate genetic engineering (GE) and non-GE approaches. This is the first report of text mining of the scientific literature on plant breeding and agricultural biotechnology research. For the nine major crops in Europe, 128 BS challenges were identified with 40% of these addressed neither in the scientific literature nor in recent European public research programs. We found evidence that the private sector was addressing only a few of these "neglected" challenges. Consequently, there are considerable gaps between farmer's needs and current breeding and biotechnology research. We also provide evidence that the current political situation in certain European countries is an impediment to GE research in order to address these agricultural challenges in the future. This study should also contribute to the decision-making process on future pertinent international consortia to fill the identified research gaps.

  8. Spiral counter-current chromatography: Design, development, application, and challenges.

    PubMed

    Huang, Xin-Yi; Sun, Xiao-Ming; Pei, Dong; Di, Duo-Long

    2017-01-01

    Depending on the rapid growth in the radial gradient of the centrifugal force, spiral counter-current chromatography can greatly improve the retention of stationary phase, especially for the aqueous two-phase systems with ultra-polar and high viscosity that are not well retained in the conventional multilayer coils counter-current chromatography. As a result, it is an attractive and alternative technology that is suited for separation of hydrophilic compounds and has led to many exciting progress in recent years. This review presents the recent advances and applications of spiral counter-current chromatography, including its major benefits and limitations, some novel methods to improve the separation efficiency and its applications in separation of real samples. In addition, the remaining challenges and future perspectives on development of spiral counter-current chromatography also are proposed in this article. © 2016 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

  9. Responsible authorship in engineering fields: an overview of current ethical challenges.

    PubMed

    Borenstein, Jason

    2011-06-01

    The primary aim of this article is to identify ethical challenges relating to authorship in engineering fields. Professional organizations and journals do provide crucial guidance in this realm, but this cannot replace the need for frequent and diligent discussions in engineering research communities about what constitutes appropriate authorship practice. Engineering researchers should seek to identify and address issues such as who is entitled to be an author and whether publishing their research could potentially harm the public.

  10. Informatics in clinical research in oncology: current state, challenges, and a future perspective.

    PubMed

    Chahal, Amar P S

    2011-01-01

    The informatics landscape of clinical trials in oncology has changed significantly in the last 10 years. The current state of the infrastructure for clinical trial management, execution, and data management is reviewed. The systems, their functionality, the users, and the standards available to researchers are discussed from the perspective of the oncologist-researcher. Challenges in complexity and in the processing of information are outlined. These challenges include the lack of communication and information-interchange between systems, the lack of simplified standards, and the lack of implementation and adherence to the standards that are available. The clinical toxicology criteria from the National Cancer Institute (CTCAE) are cited as a successful standard in oncology, and HTTP on the Internet is referenced for its simplicity. Differences in the management of information standards between industries are discussed. Possible future advances in oncology clinical research informatics are addressed. These advances include strategic policy review of standards and the implementation of actions to make standards free, ubiquitous, simple, and easily interpretable; the need to change from a local data-capture- or transaction-driven model to a large-scale data-interpretation model that provides higher value to the oncologist and the patient; and the need for information technology investment in a readily available digital educational model for clinical research in oncology that is customizable for individual studies. These new approaches, with changes in information delivery to mobile platforms, will set the stage for the next decade in clinical research informatics.

  11. Current Technical Approaches for the Early Detection of Foodborne Pathogens: Challenges and Opportunities.

    PubMed

    Cho, Il-Hoon; Ku, Seockmo

    2017-09-30

    The development of novel and high-tech solutions for rapid, accurate, and non-laborious microbial detection methods is imperative to improve the global food supply. Such solutions have begun to address the need for microbial detection that is faster and more sensitive than existing methodologies (e.g., classic culture enrichment methods). Multiple reviews report the technical functions and structures of conventional microbial detection tools. These tools, used to detect pathogens in food and food homogenates, were designed via qualitative analysis methods. The inherent disadvantage of these analytical methods is the necessity for specimen preparation, which is a time-consuming process. While some literature describes the challenges and opportunities to overcome the technical issues related to food industry legal guidelines, there is a lack of reviews of the current trials to overcome technological limitations related to sample preparation and microbial detection via nano and micro technologies. In this review, we primarily explore current analytical technologies, including metallic and magnetic nanomaterials, optics, electrochemistry, and spectroscopy. These techniques rely on the early detection of pathogens via enhanced analytical sensitivity and specificity. In order to introduce the potential combination and comparative analysis of various advanced methods, we also reference a novel sample preparation protocol that uses microbial concentration and recovery technologies. This technology has the potential to expedite the pre-enrichment step that precedes the detection process.

  12. Enabling a new Paradigm to Address Big Data and Open Science Challenges

    NASA Astrophysics Data System (ADS)

    Ramamurthy, Mohan; Fisher, Ward

    2017-04-01

    Data are not only the lifeblood of the geosciences but they have become the currency of the modern world in science and society. Rapid advances in computing, communi¬cations, and observational technologies — along with concomitant advances in high-resolution modeling, ensemble and coupled-systems predictions of the Earth system — are revolutionizing nearly every aspect of our field. Modern data volumes from high-resolution ensemble prediction/projection/simulation systems and next-generation remote-sensing systems like hyper-spectral satellite sensors and phased-array radars are staggering. For example, CMIP efforts alone will generate many petabytes of climate projection data for use in assessments of climate change. And NOAA's National Climatic Data Center projects that it will archive over 350 petabytes by 2030. For researchers and educators, this deluge and the increasing complexity of data brings challenges along with the opportunities for discovery and scientific breakthroughs. The potential for big data to transform the geosciences is enormous, but realizing the next frontier depends on effectively managing, analyzing, and exploiting these heterogeneous data sources, extracting knowledge and useful information from heterogeneous data sources in ways that were previously impossible, to enable discoveries and gain new insights. At the same time, there is a growing focus on the area of "Reproducibility or Replicability in Science" that has implications for Open Science. The advent of cloud computing has opened new avenues for not only addressing both big data and Open Science challenges to accelerate scientific discoveries. However, to successfully leverage the enormous potential of cloud technologies, it will require the data providers and the scientific communities to develop new paradigms to enable next-generation workflows and transform the conduct of science. Making data readily available is a necessary but not a sufficient condition. Data providers

  13. Challenges for a Local Service Agency to Address Domestic Violence –A Case Study From Rural Indonesia

    PubMed Central

    Hayati, Elli Nur; Emmelin, Maria; Eriksson, Malin

    2014-01-01

    Since the launch of a Zero Tolerance Policy in Indonesia, several policies to address domestic violence have been enacted. The obligation of local governments to establish service units for women survivors of domestic violence is one of them. Since domestic violence is a sensitive and complex issue in Indonesia it is important to understand how governmentally regulated services function in practice. This case study aimed to explore challenges faced by a local service agency in managing service provision for women survivors of domestic violence in rural Indonesia. Data from one focus group discussion (12 participants), four individual interviews, six short narratives, two days of participant observation, as well as archive reviews were collected. All data were analyzed using Grounded Theory Situational Analysis. The major challenge faced by the local agency was the low priority that was given them by the local authorities, mirrored also in low involvement by the assigned volunteers in the daily service. The study also identified a gap between the socio-cultural arena and the law & policy arena that needs to be bridged to avoid that the two arenas address domestic violence in a contradictory way. Budget allocation to support the sustainability of the daily routines of service agencies has to be given priority. There is also a need for careful considerations regarding the composition of personnel involved within daily management of service agencies addressing domestic violence. To bridge the gap between the legal systems and traditional cultural values, culturally adjusted alternative justice systems could be developed to increase women’s access to legal support. PMID:25363105

  14. Data monitoring committees: Promoting best practices to address emerging challenges.

    PubMed

    Fleming, Thomas R; DeMets, David L; Roe, Matthew T; Wittes, Janet; Calis, Karim A; Vora, Amit N; Meisel, Alan; Bain, Raymond P; Konstam, Marvin A; Pencina, Michael J; Gordon, David J; Mahaffey, Kenneth W; Hennekens, Charles H; Neaton, James D; Pearson, Gail D; Andersson, Tomas Lg; Pfeffer, Marc A; Ellenberg, Susan S

    2017-04-01

    Data monitoring committees are responsible for safeguarding the interests of study participants and assuring the integrity and credibility of clinical trials. The independence of data monitoring committees from sponsors and investigators is essential in achieving this mission. Creative approaches are needed to address ongoing and emerging challenges that potentially threaten data monitoring committees' independence and effectiveness. An expert panel of representatives from academia, industry and government sponsors, and regulatory agencies discussed these challenges and proposed best practices and operating principles for effective functioning of contemporary data monitoring committees. Prospective data monitoring committee members need better training. Options could include didactic instruction as well as apprenticeships to provide real-world experience. Data monitoring committee members should be protected against legal liability arising from their service. While avoiding breaches in confidentiality of interim data remains a high priority, data monitoring committees should have access to unblinded efficacy and safety data throughout the trial to enable informed judgments about risks and benefits. Because overly rigid procedures can compromise their independence, data monitoring committees should have the flexibility necessary to best fulfill their responsibilities. Data monitoring committee charters should articulate principles that guide the data monitoring committee process rather than list a rigid set of requirements. Data monitoring committees should develop their recommendations by consensus rather than through voting processes. The format for the meetings of the data monitoring committee should maintain the committee's independence and clearly establish the leadership of the data monitoring committee chair. The independent statistical group at the Statistical Data Analysis Center should have sufficient depth of knowledge about the study at hand and

  15. 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.

  16. Research and Technology Development Activities to Address the DOE-EM Environmental Mercury Challenge

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

    Pierce, Eric M; Peterson, Mark J

    Human activities have altered trace metal distributions globally. This is especially true for the trace metal mercury (Hg), a pervasive global pollutant that can be methylated to form highly toxic methylmercury (MeHg), which bioaccumulates in aquatic food webs, endangering humans and other biota. Currently there are more than 3,000 mercury-contaminated sites identified worldwide and the United Nations Environment Programme has recently highlighted the risk of this contamination to human health [1, 2]. The Oak Ridge Reservation (ORR) represents an example of one of these mercury-contaminated sites. Unlike other contaminants metals, radionuclides, and organic solvents that impact the Department of Energymore » Office of Environmental Management (DOE-EM) cleanup program at the ORR and other DOE sites, mercury has several unique characteristics that make environmental remediation of the Y-12 National Security Complex one of the most formidable challenges ever encountered. These distinctive physicochemical properties for mercury include the following: it is a liquid at ambient temperature and pressure; it is the only metal that biomagnifies; and it is the only contaminant transported as a cation, as a dissolved or gaseous elemental metal (similar to an organic solvent), or as both a cation and a dissolved or gaseous elemental metal under environmental conditions. Because of these complexities, implementing cost effective and sustainable solutions that reduce mercury flux from various primary and secondary contamination sources will require linking basic science understanding and applied research advancements into Oak Ridge Office of Environmental Management s (OREM) cleanup process. Currently, DOE is investing in mercury-related research through a variety of programs, including the Office of Science sponsored Critical Interfaces Science Focus Area, EM headquarters sponsored Applied Field Research Initiative, OREM-sponsored Lower East Fork Poplar Creek (LEFPC) Mercury

  17. Capacity Building for School Development: Current Problems and Future Challenges

    ERIC Educational Resources Information Center

    Ho, Dora; Lee, Moosung

    2016-01-01

    This article offers a theoretical discussion on the current problems and future challenges of school capacity building in early childhood education (ECE), aiming to highlight some key areas for future research. In recent years, there has been a notable policy shift from monitoring quality through inspection to improving quality through school…

  18. Addressing challenging behaviour in children with Down syndrome: the use of applied behaviour analysis for assessment and intervention.

    PubMed

    Feeley, Kathleen M; Jones, Emily A

    2006-09-01

    Children with Down syndrome are at an increased risk for engaging in challenging behaviour that may be part of a behavioural phenotype characteristic of Down syndrome. The methodology of applied behaviour analysis has been demonstrated effective with a wide range of challenging behaviours, across various disabilities. Applications to children with Down syndrome and the examination of behaviourally based strategies to specifically address the unique characteristics of children with Down syndrome are limited. However, there are several studies in which a subset of the participants did have Down syndrome. A handful of these studies are reviewed within the context of functional behaviour assessment and Positive Behavioural Supports. Drawing from these studies and the behavioural literature, as well as the authors' clinical experience and research, suggestions regarding early intervention for challenging behaviour with children with Down syndrome are provided.

  19. Current challenges in the management of breast cancer brain metastases.

    PubMed

    O'Sullivan, Ciara C; Davarpanah, Nicole N; Abraham, Jame; Bates, Susan E

    2017-04-01

    Approximately 50% of patients with advanced human epidermal growth factor 2 (HER2)-positive breast cancer and triple-negative breast cancer (TNBC) ultimately develop breast cancer brain metastases (BCBM), which are associated with significant morbidity and mortality. The advent of HER2-directed therapy resulted in greatly improved survival outcomes, but unfortunately at the price of an increased cumulative incidence of BCBM. We review challenges in the management of BCBM, and potential treatment strategies, including novel agents such as poly-adenosine diphosphate (ADP) ribose polymerase (PARP) inhibitors (olaparib, veliparib), cyclin-dependent kinase 4/6 (CDK4/6) inhibitors (palbociclib, abemaciclib), and taxane derivatives (eg, ANG1005 and TPI-287). The utility of human epidermal growth factor 2 (HER2)-directed therapies-lapatinib, ado-trastuzumab emtansine (T-DM1), neratinib and tucatinib-is also being studied in this setting. We address the need for improved imaging techniques and innovation in clinical trial design. For example, the current practice is to initially administer whole-brain radiotherapy (WBRT) as treatment for patients with multiple BCBM. However, in selected circumstances, first-line systemic treatment may be more appropriate in order to avoid neurocognitive toxicities, and potential options should be evaluated in window of opportunity trials. Other strategies that may aid development of more effective clinical trials and expedite the development of promising agents include the use of different clinical endpoints and different imaging tools. Copyright © 2017 Elsevier Inc. All rights reserved.

  20. Efficacy of a training program designed to help address challenges faced by health promotion volunteers.

    PubMed

    Taguchi, Atsuko; Murayama, Hiroshi; Arakawa, Mihoko; Terao, Atsushi

    2017-01-01

    Objective To evaluate the effectiveness of a training program designed to address the following three challenges facing health promotion volunteers: lack of new volunteers, short tenure of volunteering, and failure to build a collaborative relationship with other civic organizations.Methods Thirty-eight volunteer leaders representing 36 school districts (one from each district and two additional leaders) from southern parts of Shiga Prefecture participated in the training program. Four training sessions were conducted between July 2012 and January 2013. Each session lasted for 2 hours. The program included a lecture, group work, and role playing, all of which centered on the challenges experienced by the volunteers and possible solutions. Those who participated constituted the "training group," and other volunteers in the same area of Shiga, who did not take part in the program, made up the "non-training group." A third, control group consisted of health promotion volunteers based in City A, located outside the areas where the training occurred. To compare the three groups, we collected data before and after the training. The main evaluation index comprised the following three survey items: having confidence in recruiting new volunteers, having confidence in overcoming the difficulties or discouragement to continue to volunteer, and having confidence in explaining their activities to other local organizations to earn their cooperation. These questions were asked in a self-administered questionnaire using a 6-point Likert scale (1: strongly disagree, 6: strongly agree).Results The data were compared among the training group (28 out of the 38 participants completed the survey), non-training group (n=293), and control group (n=107). On the question about recruiting new volunteers, the training group's mean score increased from 2.9 (standard deviation (SD)=1.3) to 3.3 (SD=1.0) following the training, and the improvement relative to the other two groups was

  1. Recent trends for practical rehabilitation robotics, current challenges and the future.

    PubMed

    Yakub, Fitri; Md Khudzari, Ahmad Zahran; Mori, Yasuchika

    2014-03-01

    This paper presents and studies various selected literature primarily from conference proceedings, journals and clinical tests of the robotic, mechatronics, neurology and biomedical engineering of rehabilitation robotic systems. The present paper focuses of three main categories: types of rehabilitation robots, key technologies with current issues and future challenges. Literature on fundamental research with some examples from commercialized robots and new robot development projects related to rehabilitation are introduced. Most of the commercialized robots presented in this paper are well known especially to robotics engineers and scholars in the robotic field, but are less known to humanities scholars. The field of rehabilitation robot research is expanding; in light of this, some of the current issues and future challenges in rehabilitation robot engineering are recalled, examined and clarified with future directions. This paper is concluded with some recommendations with respect to rehabilitation robots.

  2. Re-thinking wastewater landscapes: combining innovative strategies to address tomorrow's urban wastewater treatment challenges.

    PubMed

    Smith, B R

    2009-01-01

    Most major cities worldwide face urban water management challenges relating to drinking supply, stormwater and wastewater treatment, and ecological preservation. In light of climate change and finite natural resources, addressing these challenges in sustainable ways will require innovative solutions arising from interdisciplinary collaboration. This article summarizes five major urban water management strategies that bridge the fields of engineering, ecology, landscape architecture, and urban planning. A conceptual implementation of these strategies is demonstrated through a design for a small constructed wetland treatment system in San Francisco, California. The proposed decentralized system described in this article consists of a detention basin, vegetated and open free water surface wetlands, and ultraviolet disinfection. In wet weather, the system would detain and treat combined sewer discharges (CSD), and in dry weather it would treat residential greywater for toilet flushing and irrigation in a nearby neighborhood. It is designed to adapt over time to changing climatic conditions and treatment demands. Importantly, this proposal demonstrates how constructed wetland engineers can incorporate multiple benefits into their systems, offering a vision of how wastewater infrastructure can be an attractive community, educational, recreational, and habitat amenity through the integration of engineering, ecology, and landscape design.

  3. Water management: Current and future challenges and research directions

    NASA Astrophysics Data System (ADS)

    Cosgrove, William J.; Loucks, Daniel P.

    2015-06-01

    Water distinguishes our planet compared to all the others we know about. While the global supply of available freshwater is more than adequate to meet all current and foreseeable water demands, its spatial and temporal distributions are not. There are many regions where our freshwater resources are inadequate to meet domestic, economic development and environmental needs. In such regions, the lack of adequate clean water to meet human drinking water and sanitation needs is indeed a constraint on human health and productivity and hence on economic development as well as on the maintenance of a clean environment and healthy ecosystems. All of us involved in research must find ways to remove these constraints. We face multiple challenges in doing that, especially given a changing and uncertain future climate, and a rapidly growing population that is driving increased social and economic development, globalization, and urbanization. How best to meet these challenges requires research in all aspects of water management. Since 1965, the journal Water Resources Research has played an important role in reporting and disseminating current research related to managing the quantity and quality and cost of this resource. This paper identifies the issues facing water managers today and future research needed to better inform those who strive to create a more sustainable and desirable future.

  4. Online Learning: Addressing Challenges and Seizing Opportunities. New Mexico

    ERIC Educational Resources Information Center

    Alliance for Excellent Education, 2010

    2010-01-01

    America's K-12 education system faces three significant challenges: (1) increased global demands for skilled workers, (2) significant financial shortfalls, and (3) a looming teacher shortage. Independently, these factors present significant challenges for U.S. schools. In combination, they create a national imperative for swift action to create a…

  5. Online Learning: Addressing Challenges and Seizing Opportunities. New Hampshire

    ERIC Educational Resources Information Center

    Alliance for Excellent Education, 2010

    2010-01-01

    America's K-12 education system faces three significant challenges: (1) increased global demands for skilled workers, (2) significant financial shortfalls, and (3) a looming teacher shortage. Independently, these factors present significant challenges for U.S. schools. In combination, they create a national imperative for swift action to create a…

  6. Building Connections: Strategies to Address Rurality and Accessibility Challenges

    ERIC Educational Resources Information Center

    Hartman, Sara; Hines-Bergmeier, Jennifer

    2015-01-01

    Operating a museum in a high poverty, underserved area creates many challenges related to accessibility, programming, and funding. Over the course of nearly a decade, the Ohio Valley Museum of Discovery (OVMoD) has identified several organizational practices that help mitigate these challenges. Located in the southeastern corner of Appalachian…

  7. New and improved proteomics technologies for understanding complex biological systems: Addressing a grand challenge in the life sciences

    PubMed Central

    Hood, Leroy E.; Omenn, Gilbert S.; Moritz, Robert L.; Aebersold, Ruedi; Yamamoto, Keith R.; Amos, Michael; Hunter-Cevera, Jennie; Locascio, Laurie

    2014-01-01

    This White Paper sets out a Life Sciences Grand Challenge for Proteomics Technologies to enhance our understanding of complex biological systems, link genomes with phenotypes, and bring broad benefits to the biosciences and the US economy. The paper is based on a workshop hosted by the National Institute of Standards and Technology (NIST) in Gaithersburg, MD, 14–15 February 2011, with participants from many federal R&D agencies and research communities, under the aegis of the US National Science and Technology Council (NSTC). Opportunities are identified for a coordinated R&D effort to achieve major technology-based goals and address societal challenges in health, agriculture, nutrition, energy, environment, national security, and economic development. PMID:22807061

  8. Addressing Challenges to Enhance the Bioactives of Withania somnifera through Organ, Tissue, and Cell Culture Based Approaches

    PubMed Central

    Singh, Pritika; Guleri, Rupam; Angurala, Amrita; Kaur, Kuldeep; Kaur, Kulwinder; Kaul, Sunil C.; Wadhwa, Renu

    2017-01-01

    Withania somnifera is a highly valued medicinal plant in traditional home medicine and is known for a wide range of bioactivities. Its commercial cultivation is adversely affected by poor seed viability and germination. Infestation by various pests and pathogens, survival under unfavourable environmental conditions, narrow genetic base, and meager information regarding biosynthesis of secondary metabolites are some of the other existing challenges in the crop. Biotechnological interventions through organ, tissue, and cell culture provide promising options for addressing some of these issues. In vitro propagation facilitates conservation and sustainable utilization of the existing germplasms and broadening the genetic base. It would also provide means for efficient and rapid mass propagation of elite chemotypes and generating uniform plant material round the year for experimentation and industrial applications. The potential of in vitro cell/organ cultures for the production of therapeutically valuable compounds and their large-scale production in bioreactors has received significant attention in recent years. In vitro culture system further provides distinct advantage for studying various cellular and molecular processes leading to secondary metabolite accumulation and their regulation. Engineering plants through genetic transformation and development of hairy root culture system are powerful strategies for modulation of secondary metabolites. The present review highlights the developments and sketches current scenario in this field. PMID:28299323

  9. Challenges of the English Teacher in the Engineering Faculty

    ERIC Educational Resources Information Center

    Astrid, Ramirez Valencia; Isabel, Borja-Alarcón; Alfonso, López-Vega

    2018-01-01

    Changes experienced in recent times focus their attention on new and multiple challenges that must be assumed by the English teacher, in the engineering context, which becomes a challenge against the demands by the current world from the English teacher in Colombia. This situation needs to be analyzed and studied. This article addresses the…

  10. Ability of institutions to address new challenges

    Treesearch

    B. Cashore; G. Galloway; F. Cubbage; D. Humphreys; P. Katila; K. Levin; A. Maryudi; C. McDermott; Kathleen McGinley

    2010-01-01

    What types of institutional configurations hold the most promise in fostering efforts for long-term amelioration of enduring environmental, social, and economic challenges facing the world’s forests? This chapter presents, and applies an analytical framework with which to review research findings and analyses that shed light on what appear to be the most promising...

  11. Usability and accessibility in consumer health informatics current trends and future challenges.

    PubMed

    Goldberg, Larry; Lide, Bettijoyce; Lowry, Svetlana; Massett, Holly A; O'Connell, Trisha; Preece, Jennifer; Quesenbery, Whitney; Shneiderman, Ben

    2011-05-01

    It is a truism that, for innovative eHealth systems to have true value and impact, they must first and foremost be usable and accessible by clinicians, consumers, and other stakeholders. In this paper, current trends and future challenges in the usability and accessibility of consumer health informatics will be described. Consumer expectations of their healthcare providers and healthcare records in this new era of consumer-directed care will be explored, and innovative visualizations, assistive technologies, and other ways that healthcare information is currently being provided and/or shared will be described. Challenges for ensuring the usability of current and future systems will also be discussed. An innovative model for conducting systematic, timely, user-centered research on consumer-facing websites at the National Cancer Institute (NCI) and the ongoing efforts at the National Institute of Standards and Technology (NIST) to promote health information technology (HIT) usability standards and evaluation criteria will also be presented. Copyright © 2011 American Journal of Preventive Medicine. All rights reserved.

  12. Carrington Mission and Beyond - What are the Challenges to be Scientifically and Operationally Addressed?

    NASA Astrophysics Data System (ADS)

    Gibbs, M.

    2016-12-01

    The proposed Carrington mission to L5 will bring many benefits of space weather forecasting, some of them glimpsed from the NASA STEREO Mission. How can any new data from L5 be used to maximum benefit? But what about other areas of potential space weather impacts. I'll address future needs and requirements from our Government Stakeholder view, protecting Critical National Infrastructure and key sectors. What are their needs and how can the global space weather enterprise (research & development and operations) begin to tackle these challenges. What new observations will we need (space borne or ground based), what models need developing and how will we use them to best effect? I will explore the key issues without delving deep into the science required.

  13. Traumatic brain injury and vestibulo-ocular function: current challenges and future prospects

    PubMed Central

    Wallace, Bridgett; Lifshitz, Jonathan

    2016-01-01

    Normal function of the vestibulo-ocular reflex (VOR) coordinates eye movement with head movement, in order to provide clear vision during motion and maintain balance. VOR is generated within the semicircular canals of the inner ear to elicit compensatory eye movements, which maintain stability of images on the fovea during brief, rapid head motion, otherwise known as gaze stability. Normal VOR function is necessary in carrying out activities of daily living (eg, walking and riding in a car) and is of particular importance in higher demand activities (eg, sports-related activities). Disruption or damage in the VOR can result in symptoms such as movement-related dizziness, blurry vision, difficulty maintaining balance with head movements, and even nausea. Dizziness is one of the most common symptoms following traumatic brain injury (TBI) and is considered a risk factor for a prolonged recovery. Assessment of the vestibular system is of particular importance following TBI, in conjunction with oculomotor control, due to the intrinsic neural circuitry that exists between the ocular and vestibular systems. The purpose of this article is to review the physiology of the VOR and the visual-vestibular symptoms associated with TBI and to discuss assessment and treatment guidelines for TBI. Current challenges and future prospects will also be addressed. PMID:28539811

  14. Comparison of current Shuttle and pre-Challenger flight suit reach capability during launch accelerations

    NASA Technical Reports Server (NTRS)

    Bagian, James P.; Schafer, Lauren E.

    1992-01-01

    The Challenger accident prompted the creation of a crew escape system which replaced the former Launch Entry Helmet (LEH) ensemble with the current Launch Entry Suit (LES). However, questions were raised regarding the impact of this change on crew reach capability. This study addressed the question of reach capability and its effects on realistic ground-based training for Space Shuttle missions. Eleven subjects performed reach sweeps in both the LEH and LES suits during 1 and 3 Gx acceleration trials in the Brooks AFB centrifuge. These reach sweeps were recorded on videotape and subsequently analyzed using a 3D motion analysis system. The ANOVA procedure of the Statistical Analysis System program was used to evaluate differences in forward and overhead reach. The results showed that the LES provided less reach capability than its predecessor, the LEH. This study also demonstrated that, since there was no substantial difference between 1 and 3 Gx reach sweeps in the LES, realistic Shuttle launch training may be accomplished in ground based simulators.

  15. 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.

  16. 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

  17. Strategies for Addressing the Challenges of Patient-Centered Medical Home Implementation: Lessons from Oregon.

    PubMed

    Gelmon, Sherril; Bouranis, Nicole; Sandberg, Billie; Petchel, Shauna

    2018-01-01

    Patient-centered medical homes (PCMHs) are at the forefront of the transformation of primary care as part of health systems reform. Despite robust literature describing implementation challenges, few studies describe strategies being used to overcome these challenges. This article addresses this gap through observations of exemplary PCMHs in Oregon, where the Oregon Health Authority supports and recognizes Patient-Centered Primary Care Homes (PCPCH). Twenty exemplary PCPCHs were selected using program scores, with considerations for diversity in clinic characteristics. Between 2015 and 2016, semistructured interviews and focus groups were completed with 85 key informants. Clinics reported similar challenges implementing the PCPCH model, including shifting patterns of care use, fidelity to the PCPCH model, and refining care processes. The following ten implementation strategies emerged: expanding access through care teams, preventing unnecessary emergency department visits through patient outreach, improved communication and referral tracking with outside providers, prioritization of selected program metrics, implementing patient-centered practices, developing continuous improvement capacity through committees and "champions," incorporating preventive services and chronic disease management, standardization of workflows, customizing electronic health records, and integration of mental health. Clinic leaders benefited from understanding the local context in which they were operating. Despite differences in size, ownership, geography, and population, all clinic leaders were observed to be proponents of strategies commonly associated with a "learning organization": systems thinking, personal mastery, mental models, shared vision, and team. Clinics can draw on their own characteristics, use state resources, and look to established PCMHs to build the evidence base for implementation in primary care. © Copyright 2018 by the American Board of Family Medicine.

  18. COOP+ project: Promoting the cooperation of international Research Infrastructures to address global environmental challenges.

    NASA Astrophysics Data System (ADS)

    Bonet-García, F.; Järvi, L.; Asmi, A.; Suárez-Muñoz, M.

    2016-12-01

    Humanity must face enormous environmental challenges including biodiversity decline, climate change, ocean acidification, sea level rise and overpopulation. The research infrastructures (RIs) created in the last decades worldwide cover a wide range of spatial and thematic scales and collect information about the functioning of Earth ecosystems. However, we need to go one step forward: understand and simulate the functioning of the Earth as a complex system in a global change scenario. Cooperation among international RIs as well as multidisciplinary work are mandatory to achieve this challenging objective. COOP+ (EU Horizon 2020 project) aims to strengthen the links and coordination of European environmental RIs with their international counterparts. COOP+ will create cooperation threads among international research infrastructures using environmental Global Challenges (GCs) as thematic guidelines. These GCs are polyhedral and sometimes wicked problems that threaten the sustainability of our modern societies from a social and environmental perspective. This contribution describes how COOP+ uses GCs as guidelines to foster cooperation among RIs. First we have created an open survey to collect ideas about GCs within the different scientific communities. We present the structure of this survey as well as the preliminary information that it contains. The survey will be accepting responses during the project life (September 2018). We also describe the structure of a template that will be used to collaboratively characterize some selected GCs under the point of view of RIs. The main idea is to assess how RIs can be useful to address global environmental problems. We encourage all scientists related to RIs communities to participate in this process.

  19. Chemical Education in India: Addressing Current Challenges and Optimizing Opportunities

    ERIC Educational Resources Information Center

    Krishnan, Mangala Sunder; Brakaspathy, R.; Arunan, E.

    2016-01-01

    This article gives a brief introduction to the structure of higher education programs in chemical and general sciences in India. The lack of high-quality chemical education in India in the past is traced back to the economic and social developments of the past. Remedial measures undertaken recently to improve the overall quality of chemical…

  20. Ethics in occupational health: deliberations of an international workgroup addressing challenges in an African context.

    PubMed

    London, Leslie; Tangwa, Godfrey; Matchaba-Hove, Reginald; Mkhize, Nhlanhla; Nwabueze, Remi; Nyika, Aceme; Westerholm, Peter

    2014-06-23

    International codes of ethics play an important role in guiding professional practice in developing countries. In the occupational health setting, codes developed by international agencies have substantial import on protecting working populations from harm. This is particularly so under globalisation which has transformed processes of production in fundamental ways across the globe. As part of the process of revising the Ethical Code of the International Commission on Occupational Health, an Africa Working Group addressed key challenges for the relevance and cogency of an ethical code in occupational health for an African context through an iterative consultative process. Firstly, even in the absence of strong legal systems of enforcement, and notwithstanding the value of legal institutionalisation of ethical codes, guidelines alone may offer advantageous routes to enhancing ethical practice in occupational health. Secondly, globalisation has particularly impacted on health and safety at workplaces in Africa, challenging occupational health professionals to be sensitive to, and actively redress imbalance of power. Thirdly, the different ways in which vulnerability is exemplified in the workplace in Africa often places the occupational health professional in invidious positions of Dual Loyalty. Fourth, the particular cultural emphasis in traditional African societies on collective responsibilities within the community impacts directly on how consent should be sought in occupational health practice, and how stigma should be dealt with, balancing individual autonomy with ideas of personhood that are more collective as in the African philosophy of ubuntu. To address stigma, practitioners need to be additionally sensitive to how power imbalances at the workplace intersect with traditional cultural norms related to solidarity. Lastly, particularly in the African context, the inseparability of workplace and community means that efforts to address workplace hazards demand

  1. Ethics in occupational health: deliberations of an international workgroup addressing challenges in an African context

    PubMed Central

    2014-01-01

    Background International codes of ethics play an important role in guiding professional practice in developing countries. In the occupational health setting, codes developed by international agencies have substantial import on protecting working populations from harm. This is particularly so under globalisation which has transformed processes of production in fundamental ways across the globe. As part of the process of revising the Ethical Code of the International Commission on Occupational Health, an Africa Working Group addressed key challenges for the relevance and cogency of an ethical code in occupational health for an African context through an iterative consultative process. Discussion Firstly, even in the absence of strong legal systems of enforcement, and notwithstanding the value of legal institutionalisation of ethical codes, guidelines alone may offer advantageous routes to enhancing ethical practice in occupational health. Secondly, globalisation has particularly impacted on health and safety at workplaces in Africa, challenging occupational health professionals to be sensitive to, and actively redress imbalance of power. Thirdly, the different ways in which vulnerability is exemplified in the workplace in Africa often places the occupational health professional in invidious positions of Dual Loyalty. Fourth, the particular cultural emphasis in traditional African societies on collective responsibilities within the community impacts directly on how consent should be sought in occupational health practice, and how stigma should be dealt with, balancing individual autonomy with ideas of personhood that are more collective as in the African philosophy of ubuntu. To address stigma, practitioners need to be additionally sensitive to how power imbalances at the workplace intersect with traditional cultural norms related to solidarity. Lastly, particularly in the African context, the inseparability of workplace and community means that efforts to address

  2. Current Status and Future Challenges in Risk-Based Radiation Engineering

    NASA Technical Reports Server (NTRS)

    Pellish, Jonathan A.

    2017-01-01

    This presentation covers the basis and challenges for radiation effects in electronic systems. The three main types of radiation effects in electronics are: 1) total ionizing dose (TID), 2) total non-ionizing dose (TNID) / displacement damage dose (DDD), and 3) single-event effect (SEE). Some content on relevant examples of effects, current concerns, and possible environmental model-driven solutions are also included.

  3. Current status and challenges in developing Ni phytomining: An agronomic perspective

    USDA-ARS?s Scientific Manuscript database

    This review examines the current status, progress and challenges in Ni phytomining agronomy undertaken since the first field trial two decades ago. To date, over 400 Ni hyperaccumulators have been documented (of which >30% are in Cuba) including approximately 50 species with potential for use in Ni ...

  4. Addressing the challenges of GRACE application in basins with hydraulic fracturing activity

    NASA Astrophysics Data System (ADS)

    Read, L.; Ruybal, C.; Hogue, T. S.; Hinojosa, M. P.

    2016-12-01

    Despite the growing number of studies that employ GRACE to quantify groundwater resources we have found no published studies on whether GRACE is also accounting for subsurface mass redistributions related to energy development activities from oil production, water production, and wastewater injection. Given the similar densities of water and crude oil (water is 1.0g/cc, crude oil is 0.8-0.9g/cc) and the fact that large volumes of oil and water are extracted on a monthly basis for hydraulic fracturing or reinjected as a means of waste disposal, it is important to determine whether GRACE is detecting mass redistributions from energy development to be able to correctly infer changes in water mass. The purpose of this study is to investigate whether GRACE measurements are impacted by energy development activities and offer a methodology for determining whether this activity should be considered when evaluating changes in terrestrial water storage, groundwater storage, or any other prediction involving quantification of groundwater. To address this question we compiled a dataset from the Bakken Play in North Dakota to use as a case study, where oil production was significant and increased exponentially from 2002-2015, and groundwater withdrawals for agriculture were relatively stable and limited. Preliminary results indicate that oil and gas production is of a similar scale and thus important to include when calculating groundwater changes. Broadly, this research addresses the challenges and uncertainties in applying GRACE to quantify groundwater or terrestrial water changes in energy-active basins, namely in accounting for oil reservoir changes, production, and injection rates, as well as the process of data collection in proprietary systems.

  5. A model for integrating clinical care and basic science research, and pitfalls of performing complex research projects for addressing a clinical challenge.

    PubMed

    Steck, R; Epari, D R; Schuetz, M A

    2010-07-01

    The collaboration of clinicians with basic science researchers is crucial for addressing clinically relevant research questions. In order to initiate such mutually beneficial relationships, we propose a model where early career clinicians spend a designated time embedded in established basic science research groups, in order to pursue a postgraduate qualification. During this time, clinicians become integral members of the research team, fostering long term relationships and opening up opportunities for continuing collaboration. However, for these collaborations to be successful there are pitfalls to be avoided. Limited time and funding can lead to attempts to answer clinical challenges with highly complex research projects characterised by a large number of "clinical" factors being introduced in the hope that the research outcomes will be more clinically relevant. As a result, the complexity of such studies and variability of its outcomes may lead to difficulties in drawing scientifically justified and clinically useful conclusions. Consequently, we stress that it is the basic science researcher and the clinician's obligation to be mindful of the limitations and challenges of such multi-factorial research projects. A systematic step-by-step approach to address clinical research questions with limited, but highly targeted and well defined research projects provides the solid foundation which may lead to the development of a longer term research program for addressing more challenging clinical problems. Ultimately, we believe that it is such models, encouraging the vital collaboration between clinicians and researchers for the work on targeted, well defined research projects, which will result in answers to the important clinical challenges of today. Copyright (c) 2010 Elsevier Ltd. All rights reserved.

  6. ADDRESSING ENVIRONMENTAL ENGINEERING CHALLENGES WITH COMPUTATIONAL FLUID DYNAMICS

    EPA Science Inventory

    In the field of environmental engineering, modeling tools are playing an ever larger role in addressing air quality issues, including source pollutant emissions, atmospheric dispersion and human exposure risks. More detailed modeling of environmental flows requires tools for c...

  7. Global occupational health: current challenges and the need for urgent action.

    PubMed

    Lucchini, Roberto G; London, Leslie

    2014-01-01

    Global occupational health and safety (OHS) is strictly linked to the dynamics of economic globalization. As the global market is increasing, the gap between developed and underdeveloped countries, occupational diseases, and injuries affect a vast number of workers worldwide. Global OHS issues also become local in developed countries due to many factors, including untrained migrant workers in the informal sector, construction, and agriculture. To identify the current status and challenges of global occupational health and safety and the needs for preventive action. Absence of OHS infrastructure amplifies the devastating consequences of infectious outbreaks like the Ebola pandemic and tuberculosis. Interventions in global OHS are urgently needed at various levels: 1. Increased governmental funding is needed for international organizations like the World Health Organization and the International Labor Organization to face the increasing demand for policies, guidance, and training. 2. Regulations to ban and control dangerous products are needed to avoid the transfer of hazardous production to developing countries. 3. The OHS community must address global OHS issues through advocacy, position papers, public statements, technical and ethical guidelines, and by encouraging access of OHS professionals from the developing countries to leadership positions in professional and academic societies. 4. Research, education, and training of OHS professionals, workers, unions and employers are needed to address global OHS issues and their local impact. 5. Consumers also can influence significantly the adoption of OHS practices by demanding the protection of workers who are producing he goods that are sold in the global market. Following the equation of maximized profits prompted by the inhibition of OHS is an old practice that has proven to cause significant costs to societies in the developed world. It is now an urgent priority to stop this process and promote a harmonized global

  8. New and improved proteomics technologies for understanding complex biological systems: addressing a grand challenge in the life sciences.

    PubMed

    Hood, Leroy E; Omenn, Gilbert S; Moritz, Robert L; Aebersold, Ruedi; Yamamoto, Keith R; Amos, Michael; Hunter-Cevera, Jennie; Locascio, Laurie

    2012-09-01

    This White Paper sets out a Life Sciences Grand Challenge for Proteomics Technologies to enhance our understanding of complex biological systems, link genomes with phenotypes, and bring broad benefits to the biosciences and the US economy. The paper is based on a workshop hosted by the National Institute of Standards and Technology (NIST) in Gaithersburg, MD, 14-15 February 2011, with participants from many federal R&D agencies and research communities, under the aegis of the US National Science and Technology Council (NSTC). Opportunities are identified for a coordinated R&D effort to achieve major technology-based goals and address societal challenges in health, agriculture, nutrition, energy, environment, national security, and economic development. © 2012 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

  9. Addressing Emerging Risks: Scientific and Regulatory Challenges Associated with Environmentally Persistent Free Radicals.

    PubMed

    Dugas, Tammy R; Lomnicki, Slawomir; Cormier, Stephania A; Dellinger, Barry; Reams, Margaret

    2016-06-08

    Airborne fine and ultrafine particulate matter (PM) are often generated through widely-used thermal processes such as the combustion of fuels or the thermal decomposition of waste. Residents near Superfund sites are exposed to PM through the inhalation of windblown dust, ingestion of soil and sediments, and inhalation of emissions from the on-site thermal treatment of contaminated soils. Epidemiological evidence supports a link between exposure to airborne PM and an increased risk of cardiovascular and pulmonary diseases. It is well-known that during combustion processes, incomplete combustion can lead to the production of organic pollutants that can adsorb to the surface of PM. Recent studies have demonstrated that their interaction with metal centers can lead to the generation of a surface stabilized metal-radical complex capable of redox cycling to produce ROS. Moreover, these free radicals can persist in the environment, hence their designation as Environmentally Persistent Free Radicals (EPFR). EPFR has been demonstrated in both ambient air PM2.5 (diameter < 2.5 µm) and in PM from a variety of combustion sources. Thus, low-temperature, thermal treatment of soils can potentially increase the concentration of EPFR in areas in and around Superfund sites. In this review, we will outline the evidence to date supporting EPFR formation and its environmental significance. Furthermore, we will address the lack of methodologies for specifically addressing its risk assessment and challenges associated with regulating this new, emerging contaminant.

  10. Addressing Emerging Risks: Scientific and Regulatory Challenges Associated with Environmentally Persistent Free Radicals

    PubMed Central

    Dugas, Tammy R.; Lomnicki, Slawomir; Cormier, Stephania A.; Dellinger, Barry; Reams, Margaret

    2016-01-01

    Airborne fine and ultrafine particulate matter (PM) are often generated through widely-used thermal processes such as the combustion of fuels or the thermal decomposition of waste. Residents near Superfund sites are exposed to PM through the inhalation of windblown dust, ingestion of soil and sediments, and inhalation of emissions from the on-site thermal treatment of contaminated soils. Epidemiological evidence supports a link between exposure to airborne PM and an increased risk of cardiovascular and pulmonary diseases. It is well-known that during combustion processes, incomplete combustion can lead to the production of organic pollutants that can adsorb to the surface of PM. Recent studies have demonstrated that their interaction with metal centers can lead to the generation of a surface stabilized metal-radical complex capable of redox cycling to produce ROS. Moreover, these free radicals can persist in the environment, hence their designation as Environmentally Persistent Free Radicals (EPFR). EPFR has been demonstrated in both ambient air PM2.5 (diameter < 2.5 µm) and in PM from a variety of combustion sources. Thus, low-temperature, thermal treatment of soils can potentially increase the concentration of EPFR in areas in and around Superfund sites. In this review, we will outline the evidence to date supporting EPFR formation and its environmental significance. Furthermore, we will address the lack of methodologies for specifically addressing its risk assessment and challenges associated with regulating this new, emerging contaminant. PMID:27338429

  11. Management of Dynamic Biomedical Terminologies: Current Status and Future Challenges

    PubMed Central

    Dos Reis, J. C.; Pruski, C.

    2015-01-01

    Summary Objectives Controlled terminologies and their dependent artefacts provide a consensual understanding of a domain while reducing ambiguities and enabling reasoning. However, the evolution of a domain’s knowledge directly impacts these terminologies and generates inconsistencies in the underlying biomedical information systems. In this article, we review existing work addressing the dynamic aspect of terminologies as well as their effects on mappings and semantic annotations. Methods We investigate approaches related to the identification, characterization and propagation of changes in terminologies, mappings and semantic annotations including techniques to update their content. Results and conclusion Based on the explored issues and existing methods, we outline open research challenges requiring investigation in the near future. PMID:26293859

  12. 17th Workshop on MHD Stability Control: addressing the disruption challenge for ITER

    NASA Astrophysics Data System (ADS)

    Buttery, Richard

    2013-08-01

    This annual workshop on magnetohydrodynamic stability control was held on 5-7 November 2012 at Columbia University in the city of New York, in the aftermath of a violent hydrodynamic instability event termed 'Hurricane Sandy'. Despite these challenging circumstances, Columbia University managed an excellent meeting, enabling the full participation of the community. This Workshop has been held since 1996 to help in the development of understanding and control of magnetohydrodynamic (MHD) instabilities for future fusion reactors. It covers a wide range of stability topics—from disruptions, to tearing modes, error fields, edge-localized modes (ELMs), resistive wall modes (RWMs) and ideal MHD—spanning many device types (tokamaks, stellarators and reversed field pinches) to identify commonalities in the physics and a means of control. The theme for 2012 was 'addressing the disruption challenge for ITER', and thus the first day had a heavy focus on both the avoidance and mitigation of disruptions in ITER. Key elements included understanding how to apply 3D fields to maintain stability, as well as managing the disruption process itself through mitigating loads in the thermal quench and handling so called 'runaway electrons'. This culminated in a panel discussion on the disruption mitigation strategy for ITER, which noted that heat load asymmetries during the thermal quench appear to be an artifact of MHD processes, and that runaway electron generation may be inevitable, suggesting research should focus on control and dissipation of the runaway beam. The workshop was combined this year with the annual US-Japan MHD Workshop, with a special section looking more deeply at 'Fundamentals of 3D Perturbed Equilibrium Control', with interesting sessions on 3D equilibrium reconstruction, RWM physics, novel control concepts such as non-magnetic sensing, adaptive control, q < 2 tokamak operation, and the effects of flow. The final day turned to tearing mode interactions

  13. An overview of current approaches and future challenges in physiological monitoring

    NASA Technical Reports Server (NTRS)

    Horst, Richard L.

    1988-01-01

    Sufficient evidence exists from laboratory studies to suggest that physiological measures can be useful as an adjunct to behavioral and subjective measures of human performance and capabilities. Thus it is reasonable to address the conceptual and engineering challenges that arise in applying this technology in operational settings. Issues reviewed include the advantages and disadvantages of constructs such as mental states, the need for physiological measures of performance, areas of application for physiological measures in operational settings, which measures appear to be most useful, problem areas that arise in the use of these measures in operational settings, and directions for future development.

  14. GEOSS: Addressing Big Data Challenges

    NASA Astrophysics Data System (ADS)

    Nativi, S.; Craglia, M.; Ochiai, O.

    2014-12-01

    In the sector of Earth Observation, the explosion of data is due to many factors including: new satellite constellations, the increased capabilities of sensor technologies, social media, crowdsourcing, and the need for multidisciplinary and collaborative research to face Global Changes. In this area, there are many expectations and concerns about Big Data. Vendors have attempted to use this term for their commercial purposes. It is necessary to understand whether Big Data is a radical shift or an incremental change for the existing digital infrastructures. This presentation tries to explore and discuss the impact of Big Data challenges and new capabilities on the Global Earth Observation System of Systems (GEOSS) and particularly on its common digital infrastructure called GCI. GEOSS is a global and flexible network of content providers allowing decision makers to access an extraordinary range of data and information at their desk. The impact of the Big Data dimensionalities (commonly known as 'V' axes: volume, variety, velocity, veracity, visualization) on GEOSS is discussed. The main solutions and experimentation developed by GEOSS along these axes are introduced and analyzed. GEOSS is a pioneering framework for global and multidisciplinary data sharing in the Earth Observation realm; its experience on Big Data is valuable for the many lessons learned.

  15. Current challenges and emerging drug delivery strategies for the treatment of psoriasis.

    PubMed

    Hoffman, Melissa B; Hill, Dane; Feldman, Steven R

    2016-10-01

    Psoriasis is a common skin disorder associated with physical, social, psychological and financial burden. Over the past two decades, advances in our understanding of pathogenesis and increased appreciation for the multifaceted burden of psoriasis has led to new treatment development and better patient outcomes. Yet, surveys demonstrate that many psoriasis patients are either undertreated or are dissatisfied with treatment. There are many barriers that need be overcome to optimize patient outcomes and satisfaction. This review covers the current challenges associated with each major psoriasis treatment strategy (topical, phototherapy, oral medications and biologics). It also reviews the challenges associated with the psychosocial aspects of the disease and how they affect treatment outcomes. Patient adherence, inconvenience, high costs, and drug toxicities are all discussed. Then, we review the emerging drug delivery strategies in topical, oral, and biologic therapy. By outlining current treatment challenges and emerging drug delivery strategies, we hope to highlight the deficits in psoriasis treatment and strategies for how to overcome them. Regardless of disease severity, clinicians should use a patient-centered approach. In all cases, we need to balance patients' psychosocial needs, treatment costs, convenience, and effectiveness with patients' preferences in order to optimize treatment outcomes.

  16. Single-stage-to-orbit: Meeting the challenge

    NASA Astrophysics Data System (ADS)

    Freeman, Delma C., Jr.; Talay, Theodore A.; Austin, Robert Eugene

    1995-10-01

    There has been and continues to be significant discussion about the viability of fully reusable, single-stage-to-orbit (SSTO) concepts for delivery of payloads to orbit. Often, these discussions have focused in detail on performance and technology requirements relating to the technical feasibility of the concept, with only broad generalizations on how the SSTO will achieve its economic goals of greatly reduced vehicle ground and flight operations costs. With the current industry and NASA Reusable Launch Vehicle Technology Program efforts underway to mature and demonstrate technologies leading to a viable commercial launch system that also satisfies national needs, achieving acceptable recurring costs becomes a significant challenge. This paper reviews the current status of the Reusable Launch Vehicle Technology Program including the DC-XA, X-33, and X-34 flight systems and associated technology programs. The paper also examines lessons learned from the recently completed DC-X reusable rocket demonstrator program. It examines how these technologies and flight systems address the technical and operability challenges of SSTO whose solutions are necessary to reduce costs. The paper also discusses the management and operational approaches that address the challenge of a new cost-effective, reusable launch vehicle system.

  17. Addressing recent docking challenges: A hybrid strategy to integrate template-based and free protein-protein docking.

    PubMed

    Yan, Yumeng; Wen, Zeyu; Wang, Xinxiang; Huang, Sheng-You

    2017-03-01

    Protein-protein docking is an important computational tool for predicting protein-protein interactions. With the rapid development of proteomics projects, more and more experimental binding information ranging from mutagenesis data to three-dimensional structures of protein complexes are becoming available. Therefore, how to appropriately incorporate the biological information into traditional ab initio docking has been an important issue and challenge in the field of protein-protein docking. To address these challenges, we have developed a Hybrid DOCKing protocol of template-based and template-free approaches, referred to as HDOCK. The basic procedure of HDOCK is to model the structures of individual components based on the template complex by a template-based method if a template is available; otherwise, the component structures will be modeled based on monomer proteins by regular homology modeling. Then, the complex structure of the component models is predicted by traditional protein-protein docking. With the HDOCK protocol, we have participated in the CPARI experiment for rounds 28-35. Out of the 25 CASP-CAPRI targets for oligomer modeling, our HDOCK protocol predicted correct models for 16 targets, ranking one of the top algorithms in this challenge. Our docking method also made correct predictions on other CAPRI challenges such as protein-peptide binding for 6 out of 8 targets and water predictions for 2 out of 2 targets. The advantage of our hybrid docking approach over pure template-based docking was further confirmed by a comparative evaluation on 20 CASP-CAPRI targets. Proteins 2017; 85:497-512. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

  18. HIV/AIDS Securitization: Outcomes and Current Challenges.

    PubMed

    Shadyab, Aladdin H; Hale, Braden R; Shaffer, Richard A

    2017-01-01

    The securitization (i.e., framing of a health issue as a security threat) of HIV/AIDS by the United Nations Security Council in 2000 changed the belief that HIV/AIDS is only a health issue. Although now accepted that HIV/AIDS represents a security threat, the consequences of securitization are still not widely established. The purpose of this paper was to present an evidence-based review of the outcomes and current challenges associated with HIV/AIDS securitization in the context of national security. We provided an overview of HIV/AIDS securitization, followed by a discussion of the impact of securitization on peacekeeping personnel and uniformed services. We also reviewed the United States Government's response to securitization and potential risks and benefits of securitization. Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.

  19. Challenges for Governance: A National Report.

    ERIC Educational Resources Information Center

    Tierney, William G.; Minor, James T.

    This report is designed to help policymakers, administrators, faculty, and researchers address the challenges of institutional governance by providing empirical data on the current role of faculty in institutional governance. It presents the results of a survey of more than 2,000 faculty and provosts across the United States (response rate of 53%)…

  20. Good practices and challenges in addressing poliomyelitis and measles in the European Union.

    PubMed

    Kinsman, John; Stöven, Svenja; Elgh, Fredrik; Murillo, Pilar; Sulzner, Michael

    2018-04-06

    All European Union (EU) and European Economic Area (EEA) Member States have pledged to ensure political commitment towards sustaining the region's poliomyelitis-free status and eliminating measles. However, there remain significant gaps between policy and practice in many countries. This article reports on an assessment conducted for the European Commission that aimed to support improvements in preparedness and response to poliomyelitis and measles in Europe. A documentary review was complemented by qualitative interviews with professionals working in International and EU agencies, and in at-risk or recently affected EU/EEA Member States (six each for poliomyelitis and measles). Twenty-six interviews were conducted on poliomyelitis and 24 on measles; the data were subjected to thematic analysis. Preliminary findings were then discussed at a Consensus Workshop with 22 of the interviewees and eight other experts. Generic or disease-specific plans exist in the participating countries and cross-border communications during outbreaks were generally reported as satisfactory. However, surveillance systems are of uneven quality, and clinical expertise for the two diseases is limited by a lack of experience. Serious breaches of protocol have recently been reported from companies producing poliomyelitis vaccines, and vaccine coverage rates for both diseases were also sub-optimal. A set of suggested good practices to address these and other challenges is presented. Poliomyelitis and measles should be brought fully onto the policy agendas of all EU/EEA Member States, and adequate resources provided to address them. Each country must abide by the relevant commitments that they have already made.

  1. Challenges in achieving patient participation: A review of how patient participation is addressed in empirical studies.

    PubMed

    Angel, Sanne; Frederiksen, Kirsten Norup

    2015-09-01

    For decades, it has been an ideal in western countries that individuals should participate in society as self-governing and autonomous subjects; however, this ideal does not always correspond to the actual experiences of individuals in their encounters with health professionals. This review identifies how empirical studies address challenges in achieving patient participation in clinical nursing. We conducted a literature search for studies of patient participation in PubMed, Cinahl, PsychInfo and Scopus. In a systematic review using Garrard's matrix method, we selected empirical studies that focused on patients' participation in health services. The empirical studies we investigated addressed the relationship between patient and nurse, knowledge, contact time with the patient, severity of illness and the effect of age on the degree of patient involvement. Every study thus investigated assessed patient participation as being achievable. None of the studies questioned the foundation for patient participation, which has been described in theoretical articles. The main explanation for difficulties in achieving patient participation was that expectations concerning the extent and quality of participation could be unrealistic and lead to dissatisfaction. Studies on patient participation identify challenges due to the nature of the relationship between laypersons and professionals, and the embedded difference in situation and knowledge. This difference may be reduced by time and a mutually positive attitude. But participation in its ideal form cannot be achieved because of this fundamental difference. Therefore, the optimal level of patient participation can only be achieved within a framework which provides both patients and health professionals with adequate time to build relationships and shared knowledge. Copyright © 2015 Elsevier Ltd. All rights reserved.

  2. A proposed reductionist solution to address the methodological challenges of inconsistent reflexology maps and poor experimental controls in reflexology research: a discussion paper.

    PubMed

    Jones, Jenny; Thomson, Patricia; Lauder, William; Leslie, Stephen J

    2013-03-01

    Reflexology is a complex massage intervention, based on the concept that specific areas of the feet (reflex points) correspond to individual internal organs within the body. Reflexologists trained in the popular Ingham reflexology method claim that massage to these points, using massage techniques unique to reflexology, stimulates an increase in blood supply to the corresponding organ. Reflexology researchers face two key methodological challenges that need to be addressed if a specific treatment-related hemodynamic effect is to be scientifically demonstrated. The first is the problem of inconsistent reflexology foot maps; the second is the issue of poor experimental controls. This article proposes a potential experimental solution that we believe can address both methodological challenges and in doing so, allow any specific hemodynamic treatment effect unique to reflexology to experimentally reveal itself.

  3. In Vivo Demonstration of Addressable Microstimulators Powered by Rectification of Epidermically Applied Currents for Miniaturized Neuroprostheses

    PubMed Central

    2015-01-01

    Electrical stimulation is used in order to restore nerve mediated functions in patients with neurological disorders, but its applicability is constrained by the invasiveness of the systems required to perform it. As an alternative to implantable systems consisting of central stimulation units wired to the stimulation electrodes, networks of wireless microstimulators have been devised for fine movement restoration. Miniaturization of these microstimulators is currently hampered by the available methods for powering them. Previously, we have proposed and demonstrated a heterodox electrical stimulation method based on electronic rectification of high frequency current bursts. These bursts can be delivered through textile electrodes on the skin. This approach has the potential to result in an unprecedented level of miniaturization as no bulky parts such as coils or batteries are included in the implant. We envision microstimulators designs based on application-specific integrated circuits (ASICs) that will be flexible, thread-like (diameters < 0.5 mm) and not only with controlled stimulation capabilities but also with sensing capabilities for artificial proprioception. We in vivo demonstrate that neuroprostheses composed of addressable microstimulators based on this electrical stimulation method are feasible and can perform controlled charge-balanced electrical stimulation of muscles. We developed miniature external circuit prototypes connected to two bipolar probes that were percutaneously implanted in agonist and antagonist muscles of the hindlimb of an anesthetized rabbit. The electronic implant architecture was able to decode commands that were amplitude modulated on the high frequency (1 MHz) auxiliary current bursts. The devices were capable of independently stimulating the target tissues, accomplishing controlled dorsiflexion and plantarflexion joint movements. In addition, we numerically show that the high frequency current bursts comply with safety standards

  4. In Vivo Demonstration of Addressable Microstimulators Powered by Rectification of Epidermically Applied Currents for Miniaturized Neuroprostheses.

    PubMed

    Becerra-Fajardo, Laura; Ivorra, Antoni

    2015-01-01

    Electrical stimulation is used in order to restore nerve mediated functions in patients with neurological disorders, but its applicability is constrained by the invasiveness of the systems required to perform it. As an alternative to implantable systems consisting of central stimulation units wired to the stimulation electrodes, networks of wireless microstimulators have been devised for fine movement restoration. Miniaturization of these microstimulators is currently hampered by the available methods for powering them. Previously, we have proposed and demonstrated a heterodox electrical stimulation method based on electronic rectification of high frequency current bursts. These bursts can be delivered through textile electrodes on the skin. This approach has the potential to result in an unprecedented level of miniaturization as no bulky parts such as coils or batteries are included in the implant. We envision microstimulators designs based on application-specific integrated circuits (ASICs) that will be flexible, thread-like (diameters < 0.5 mm) and not only with controlled stimulation capabilities but also with sensing capabilities for artificial proprioception. We in vivo demonstrate that neuroprostheses composed of addressable microstimulators based on this electrical stimulation method are feasible and can perform controlled charge-balanced electrical stimulation of muscles. We developed miniature external circuit prototypes connected to two bipolar probes that were percutaneously implanted in agonist and antagonist muscles of the hindlimb of an anesthetized rabbit. The electronic implant architecture was able to decode commands that were amplitude modulated on the high frequency (1 MHz) auxiliary current bursts. The devices were capable of independently stimulating the target tissues, accomplishing controlled dorsiflexion and plantarflexion joint movements. In addition, we numerically show that the high frequency current bursts comply with safety standards

  5. [Regulatory Program for Medical Devices in Cuba: experiences and current challenges].

    PubMed

    Pereira, Dulce María Martínez; Rodríguez, Yadira Álvarez; Valdés, Yamila Cedeño; Ribas, Silvia Delgado

    2016-05-01

    Regulatory control of medical devices in Cuba is conducted through a system based on the Regulatory Program for Medical Devices as a way to ensure the safety, efficacy, and effectiveness of these technologies, which are in use by the National Health System. This program was launched in 1992, when the Regulations for State Evaluation and Registration of Medical Devices were approved. Its successive stages and the merging of regulatory activities for drugs and medical equipment have meant progress toward stronger, more transparent strategies and greater control of industry and the National Health System. Throughout its course the Cuban program has met with challenges and difficulties that it has addressed by drawing on its own experiences. During the new period, the greatest challenges revolve around ensuring that regulatory systems incorporate scientific evaluation, risk levels, maximum rigor through the use of technical standards, and the implementation of international recommendations, together with the application of the ISO 13485 certification scheme, enhanced market monitoring, and classification of medical devices in accordance with their relevance to the country's national health policies. From the regional standpoint, the greatest challenge lies in working toward regulatory convergence. The Collaborating Centre for the Regulation of Health Technologies will support the proposed regulatory strategy and established regional priorities, in particular in connection with the implementation of actions involving medical devices.

  6. Health information exchange: persistent challenges and new strategies

    PubMed Central

    Gamm, Larry D

    2010-01-01

    Recent federal policies and actions support the adoption of health information exchange (HIE) in order to improve healthcare by addressing fragmented personal health information. However, concerted efforts at facilitating HIE have existed for over two decades in this country. The lessons of these experiences include a recurrence of barriers and challenges beyond those associated with technology. Without new strategies, the current support and methods of facilitating HIE may not address these barriers. PMID:20442146

  7. Large system change challenges: addressing complex critical issues in linked physical and social domains

    NASA Astrophysics Data System (ADS)

    Waddell, Steve; Cornell, Sarah; Hsueh, Joe; Ozer, Ceren; McLachlan, Milla; Birney, Anna

    2015-04-01

    Most action to address contemporary complex challenges, including the urgent issues of global sustainability, occurs piecemeal and without meaningful guidance from leading complex change knowledge and methods. The potential benefit of using such knowledge is greater efficacy of effort and investment. However, this knowledge and its associated tools and methods are under-utilized because understanding about them is low, fragmented between diverse knowledge traditions, and often requires shifts in mindsets and skills from expert-led to participant-based action. We have been engaged in diverse action-oriented research efforts in Large System Change for sustainability. For us, "large" systems can be characterized as large-scale systems - up to global - with many components, of many kinds (physical, biological, institutional, cultural/conceptual), operating at multiple levels, driven by multiple forces, and presenting major challenges for people involved. We see change of such systems as complex challenges, in contrast with simple or complicated problems, or chaotic situations. In other words, issues and sub-systems have unclear boundaries, interact with each other, and are often contradictory; dynamics are non-linear; issues are not "controllable", and "solutions" are "emergent" and often paradoxical. Since choices are opportunity-, power- and value-driven, these social, institutional and cultural factors need to be made explicit in any actionable theory of change. Our emerging network is sharing and building a knowledge base of experience, heuristics, and theories of change from multiple disciplines and practice domains. We will present our views on focal issues for the development of the field of large system change, which include processes of goal-setting and alignment; leverage of systemic transitions and transformation; and the role of choice in influencing critical change processes, when only some sub-systems or levels of the system behave in purposeful ways

  8. Addressing climate challenges in developing countries

    NASA Astrophysics Data System (ADS)

    Tilmes, Simone; Monaghan, Andrew; Done, James

    2012-04-01

    Advanced Study Program/Early Career Scientist Assembly Workshop on Regional Climate Issues in Developing Countries; Boulder, Colorado, 19-22 October 2011 The Early Career Scientist Assembly (ECSA) and the Advanced Study Program of the National Center for Atmospheric Research (NCAR) invited 35 early-career scientists from nearly 20 countries to attend a 3-day workshop at the NCAR Mesa Laboratory prior to the World Climate Research Programme (WCRP) Open Science Conference in October 2011. The goal of the workshop was to examine a range of regional climate challenges in developing countries. Topics included regional climate modeling, climate impacts, water resources, and air quality. The workshop fostered new ideas and collaborations between early-career scientists from around the world. The discussions underscored the importance of establishing partnerships with scientists located in typically underrepresented countries to understand and account for the local political, economic, and cultural factors on which climate change is superimposed.

  9. Freight transportation : strategies needed to address planning and financing limitations

    DOT National Transportation Integrated Search

    2003-12-01

    The General Accounting Office (GAO) was asked to address (1) the challenges to freight mobility, (2) the limitations key stakeholders have encountered in addressing these challenges, and (3) strategies that may aid decision makers in enhancing freigh...

  10. ILRS: Current Status and Future Challenges

    NASA Astrophysics Data System (ADS)

    Pearlman, M. R.; Bianco, G.; Merkowitz, S.; Noll, C. E.; Pavlis, E. C.; Shargorodsky, V.; Zhongping, Z.

    2016-12-01

    The International Laser Ranging Service (ILRS) is expanding its ground tracking capability with new stations and upgrades to current stations. Our Russian colleagues have installed new stations in Brasilia and South Africa, and have several other sites in process or in planning. The NASA Space Geodesy Program is preparing equipment for U.S. sites (McDonald and Haleakala) and with the Norwegian National Mapping Agency in Ny Ålesund; further deployments are planned. Upgrades continue at sites in China, and new sites are underway or planned in Europe and India. Stations are moving to higher repetition rates and more efficient detection to enhance satellite interleaving capability; some stations have already implemented automated processes that could lead to around-the-clock operation to increase temporal coverage and to make more efficient use of personnel. The ILRS roster of supported satellites continues to grow with the addition of the LARES satellite to augment tracking for the improvement of the ITRF. New GNSS constellations and geosynchronous satellites now bring the total roster to over 80 satellites - so much so, that new tracking strategies and time and location multiplexing are under consideration. There continues to be strong interest in Lunar Ranging. New applications of one-way and two-way laser ranging include ps-accurate time transfer, laser transponders for interplanetary ranging, and tracking of space debris. New laser ranging data products are being developed, including satellite orbit products, satellite orientation, gravity field products, and products to characterize the quality of data and station performance. This talk will give a brief summary of recent progress, current challenges and a view of the path ahead.

  11. Summoning compassion to address the challenges of conservation.

    PubMed

    Wallach, Arian D; Bekoff, Marc; Batavia, Chelsea; Nelson, Michael P; Ramp, Daniel

    2018-04-27

    Conservation practice is informed by science, but also reflects ethical beliefs about how we ought to value and interact with the Earth's biota. As human activities continue to drive extinctions and diminish critical life-sustaining ecosystem processes, achieving conservation goals becomes increasingly urgent. In our determination to react decisively, conservation challenges can be handled without due deliberation, particularly when wildlife individuals are sacrificed "for the greater good" of wildlife collectives (populations, species, ecosystems). With growing recognition of the widespread sentience and sapience of many nonhuman animals, standard conservation practices that categorically prioritize collectives without due consideration for the wellbeing of individuals are ethically untenable. Here we highlight three overarching ethical orientations characterizing current and historical practices in conservation that suppress compassion: instrumentalism, collectivism, and nativism. We illustrate how establishing a commitment to compassion could re-orient conservation in more ethically expansive directions, which incorporate recognition of the intrinsic value of wildlife, the sentience of nonhuman animals, and the values of novel ecosystems, introduced species and their members. A compassionate conservation approach allays practices that intentionally and unnecessarily harm wildlife individuals, while aligning with critical conservation goals. Although the urgency of achieving effective outcomes for solving major conservation problems may enhance the appeal of quick and harsh measures, the costs are too high. Continuing to justify moral indifference when causing the suffering of wildlife individuals, particularly those who possess sophisticated capacities for emotion, consciousness, and sociality, risks estranging conservation practice from prevailing, and appropriate, social values. As conservationists and compassionate beings, we must demonstrate concern for both

  12. Challenges in obesity research.

    PubMed

    Palou, Andreu; Bonet, M Luisa

    2013-09-01

    Obesity is the main nutritional problem and one of the most important health problems in developed societies. Central to the challenge of obesity prevention and management is a thoroughly understanding of its determinants. Multiple socio-cultural, socio-economic, behavioural and biological factors--often interrelated and many of them still unknown or poorly understood--can contribute to the establishment and perpetuation of obese phenotypes. Here, we address current research challenges regarding basic aspects of obesity and emerging science for its control, including brown adipose tissue thermogenesis and browning of white fat as possible therapeutic targets for obesity, the influence of the microbioma, and genetics, epigenetics, nutrigenomics and nutrigenetics of obesity. We also highlight hot topics in relation to food and lifestyle as determinants of obesity, including the brain mechanisms underlying environmental motivation to eat, the biological control of spontaneous physical activity, the possible role of concrete foods and food components, and the importance of early life nutrition and environment. Challenges regarding the connections of obesity with other alterations and pathologies are also briefly addressed, as well as social and economical challenges in relation to healthy food production and lifestyle for the prevention of obesity, and technological challenges in obesity research and management. The objective is to give a panoramic of advances accomplished and still ahead relevant to the different stakeholders engaged in understanding and combating obesity. Copyright © AULA MEDICA EDICIONES 2013. Published by AULA MEDICA. All rights reserved.

  13. Single-stage-to-orbit — Meeting the challenge

    NASA Astrophysics Data System (ADS)

    Freeman, Delma C.; Talay, Theodore A.; Austin, Robert Eugene

    1996-02-01

    There has been and continues to be significant discussion about the viability of fully reusable, single-stage-to-orbit (SSTO) concepts for delivery of payloads to orbit. Often, these discussions have focused in detail on performance and technology requirements relating to the technical feasibility of the concept, with only broad generalizations on how the SSTO will achieve its economic goals of greatly reduced vehicle ground and flight operations costs. With the current industry and NASA Reusable Launch Vehicle Technology Program efforts underway to mature and demonstrate technologies leading to a viable commercial launch system that also satisfies national needs, achieving acceptable recurring costs becomes a significant challenge. This paper reviews the current status of the Reusable Launch Vehicle Technology Program including the DC-XA, X-33, X-34 flight systems and associated technology programs. The paper also examines lessons learned from the recently completed DC-X reusable rocket demonstrator program. It examines how these technologies and flight systems address the technical and operability challenges of SSTO whose solutions are necessary to reduce costs. The paper also discusses the management and operational approaches that address the challenge of a new cost-effective, reusable launch vehicle system.

  14. Computational intelligence in gait research: a perspective on current applications and future challenges.

    PubMed

    Lai, Daniel T H; Begg, Rezaul K; Palaniswami, Marimuthu

    2009-09-01

    Our mobility is an important daily requirement so much so that any disruption to it severely degrades our perceived quality of life. Studies in gait and human movement sciences, therefore, play a significant role in maintaining the well-being of our mobility. Current gait analysis involves numerous interdependent gait parameters that are difficult to adequately interpret due to the large volume of recorded data and lengthy assessment times in gait laboratories. A proposed solution to these problems is computational intelligence (CI), which is an emerging paradigm in biomedical engineering most notably in pathology detection and prosthesis design. The integration of CI technology in gait systems facilitates studies in disorders caused by lower limb defects, cerebral disorders, and aging effects by learning data relationships through a combination of signal processing and machine learning techniques. Learning paradigms, such as supervised learning, unsupervised learning, and fuzzy and evolutionary algorithms, provide advanced modeling capabilities for biomechanical systems that in the past have relied heavily on statistical analysis. CI offers the ability to investigate nonlinear data relationships, enhance data interpretation, design more efficient diagnostic methods, and extrapolate model functionality. These are envisioned to result in more cost-effective, efficient, and easy-to-use systems, which would address global shortages in medical personnel and rising medical costs. This paper surveys current signal processing and CI methodologies followed by gait applications ranging from normal gait studies and disorder detection to artificial gait simulation. We review recent systems focusing on the existing challenges and issues involved in making them successful. We also examine new research in sensor technologies for gait that could be combined with these intelligent systems to develop more effective healthcare solutions.

  15. Aerospace Measurements: Challenges and Opportunities

    NASA Technical Reports Server (NTRS)

    Conway, Bruce A.

    1992-01-01

    New aerospace research initiatives offer both challenges and opportunities to rapidly-emerging electronics and electro-optics technology. Defining and implementing appropriate measurement technology development programs in response to the aeronautical ground facility research and testing needs of the new initiatives poses some particularly important problems. This paper discusses today's measurement challenges along with some of the technological opportunities which offer some hope for meeting the challenges, and describes measurement technology activities currently underway in the Langley Research Center's Instrument Research Division to address modern aerospace research and design engineering requirements. Projected and realized benefits and payoffs from the ongoing measurement and instrumentation efforts will be emphasized. A discussion of future trends in the aerospace measurement technology field will be included.

  16. Addressing Circuitous Currents MVDC Power Systems Protection

    DTIC Science & Technology

    2017-12-31

    load . The converter modules are current-controlled buck converters. They are being controlled to provide a no - load voltage of 155V at their outputs...PAGE Form Approved 0MB No . 0704-0188 The public reporting burden for this collection of information is estimated to average 1 hour per response...distribution is unlimited 13. SUPPLEMENTARY NOTES 14. ABSTRACT The work investigates Z-source breakers in multi-zone systems with current to the load through

  17. Ethical challenges in resuscitation.

    PubMed

    Mentzelopoulos, Spyros D; Slowther, Anne-Marie; Fritz, Zoe; Sandroni, Claudio; Xanthos, Theodoros; Callaway, Clifton; Perkins, Gavin D; Newgard, Craig; Ischaki, Eleni; Greif, Robert; Kompanje, Erwin; Bossaert, Leo

    2018-06-01

    A rapidly evolving resuscitation science provides more effective treatments to an aging population with multiple comorbidites. Concurrently, emergency care has become patient-centered. This review aims to describe challenges associated with the application of key principles of bioethics in resuscitation and post-resuscitation care; propose actions to address these challenges; and highlight the need for evidence-based ethics and consensus on ethical principles interpretation. Following agreement on the article's outline, subgroups of 2-3 authors provided narrative reviews of ethical issues concerning autonomy and honesty, beneficence/nonmaleficence and dignity, justice, specific practices/circumstances such as family presence during resuscitation, and emergency research. Proposals for addressing ethical challenges were also offered. Respect for patient autonomy can be realized through honest provision of information, shared decision-making, and advance directives/care planning. Essential prerequisites comprise public and specific healthcare professionals' education, appropriate regulatory provisions, and allocation of adequate resources. Regarding beneficence/nonmaleficence, resuscitation should benefit patients, while avoiding harm from futile interventions; pertinent practice should be based on neurological prognostication and patient/family-reported outcomes. Regarding dignity, aggressive life-sustaining treatments against patients preferences should be avoided. Contrary to the principle of justice, resuscitation quality may be affected by race/income status, age, ethnicity, comorbidity, and location (urban versus rural or country-specific/region-specific). Current evidence supports family presence during resuscitation. Regarding emergency research, autonomy should be respected without hindering scientific progress; furthermore, transparency of research conduct should be promoted and funding increased. Major ethical challenges in resuscitation science need to be

  18. Diagnosing cystic fibrosis-related diabetes: current methods and challenges.

    PubMed

    Prentice, Bernadette; Hameed, Shihab; Verge, Charles F; Ooi, Chee Y; Jaffe, Adam; Widger, John

    2016-07-01

    Cystic fibrosis-related diabetes (CFRD) is the end-point of a spectrum of glucose abnormalities in cystic fibrosis that begins with early insulin deficiency and ultimately results in accelerated nutritional decline and loss of lung function. Current diagnostic and management regimens are unable to entirely reverse this clinical decline. This review summarises the current understanding of the pathophysiology of CFRD, the issues associated with using oral glucose tolerance tests in CF and the challenges faced in making the diagnosis of CFRD. Medline database searches were conducted using search terms "Cystic Fibrosis Related Diabetes", "Cystic Fibrosis" AND "glucose", "Cystic Fibrosis" AND "insulin", "Cystic Fibrosis" AND "Diabetes". Additionally, reference lists were studied. Expert commentary: Increasing evidence points to early glucose abnormalities being clinically relevant in cystic fibrosis and as such novel diagnostic methods such as continuous glucose monitoring or 30 minute sampled oral glucose tolerance test (OGTT) may play a key role in the future in the screening and diagnosis of early glucose abnormalities in CF.

  19. Top 10 Ways To Improve Public Schools. Innovative Solutions To Help Address the Issues and Challenges Facing Most Public School Districts.

    ERIC Educational Resources Information Center

    Texas State Comptroller of Public Accounts, Austin.

    This report offers the top 10 challenges identified by public schools and the ways that the Texas School Performance Review (TSPR) suggests that these issues be addressed. The TSPR ensures that scarce education resources are spent in the classroom. For a TSPR review, the TSPR team is invited in for months of detailed study, during which it asks…

  20. Addressing the Challenges in Tonsillectomy Research to Inform Health Care Policy: A Review.

    PubMed

    Mandavia, Rishi; Schilder, Anne G M; Dimitriadis, Panagiotis A; Mossialos, Elias

    2017-09-01

    Eighty-five percent of investment in medical research has been wasted, with lack of effect on clinical practice and policy. There is increasing effort to improve the likelihood of research being used to influence clinical practice and policy. Tonsillectomy is one of the most common otorhinolaryngologic surgical procedures, and its frequency, cost, and morbidity create a clear need for evidence-based guidelines and policy. The first systematic review on tonsillectomy was conducted 40 years ago and highlighted the lack of definitive evidence for the procedure. Since that study, the body of evidence has still not been able to sufficiently inform policy. This review provides an overview of the key challenges in research to inform tonsillectomy policy and recommendations to help bridge the evidence-policy gap. The challenges in using research to inform policy can be summarized as 4 main themes: (1) non-policy-focused evidence and lack of available evidence, (2) quality of evidence, (3) communication of research findings, and (4) coordinating time frames. Researchers and decision makers should be aware of the limitations of research designs and conflicts of interest that can undermine policy decisions. Researchers must work with decision makers and patients throughout the research process to identify areas of unmet need and political priority, align research and policy time frames, and disseminate research findings. Incentives for researchers should be reorganized to promote dissemination of findings. It is important to consider why evidence gaps in tonsillectomy research have not been addressed during the past 40 years despite considerable investment in time and resources. These findings and recommendations will help produce research that is more responsive to policy gaps and more likely to result in policy changes.

  1. Current approaches to challenging scenarios in myeloproliferative neoplasms.

    PubMed

    Zimran, Eran; Hoffman, Ronald; Kremyanskaya, Marina

    2018-06-01

    The Philadelphia chromosome-negative myeloproliferative neoplasms (MPNs) including polycythemia vera, essential thrombocythemia and primary myelofibrosis are clonal hematological malignancies that originate at the level of the hematopoietic stem cell, and are characterized by excessive proliferation of cells belonging to one or more of the myeloid lineages. Central to the pathogenesis of the MPNs is constitutive activation of the JAK/STAT signaling pathway due to a family of driver mutations affecting JAK2, CALR or MPL. These disorders share common clinical and laboratory features, a significant burden of systemic symptoms, increased risk of developing arterial and venous thrombotic events, and the potential to progress to myelofibrosis and acute leukemia. Areas covered: We identified four clinical situations which represent challenging management dilemmas for patients with MPNs. Our conclusions and recommendations are based on a literature search using MEDLINE and recent meeting abstracts using the keywords, focusing on publications directly addressing these scenarios and on recent contributions to the field. Expert commentary: Multi-center efforts to study large cohorts of MPN patients have led to more uniform and evidence-based approaches to key aspects in MPN management. However, treatment strategies to deal with specific clinical scenarios are lacking.

  2. Restructuring Principal Preparation in Illinois: Perspectives on Implementation Successes, Challenges, and Future Outlook. IERC 2015-3

    ERIC Educational Resources Information Center

    Klostermann, Brenda K.; Pareja, Amber Stitziel; Hart, Holly; White, Bradford R.; Huynh, Michelle Hanh

    2015-01-01

    The goals of the current mixed methods study--the Illinois Principal Preparation Implementation Review Project (I-PREP)--are to describe how the new policy is being implemented, learning which aspects of the implementation have been challenging and why they present challenges, and how programs are addressing challenges and realizing improvements…

  3. Reaching Each Student: National Challenge and Organizational Commitment. Addresses to the College Board National Forum, October 31-November 2, 1990, Boston, Massachusetts.

    ERIC Educational Resources Information Center

    College Board, New York, NY.

    Four speakers addressed the College Board National Forum on "Reaching Each Student" in the Fall of 1990 in Boston, Massachusetts. John F. Akers, Chairman of the Board at International Business Machines in his speech "Reaching Each Student: A Business Perspective" challenged the College Board to work with American business to…

  4. Evaluation and comparison of current fetal ultrasound image segmentation methods for biometric measurements: a grand challenge.

    PubMed

    Rueda, Sylvia; Fathima, Sana; Knight, Caroline L; Yaqub, Mohammad; Papageorghiou, Aris T; Rahmatullah, Bahbibi; Foi, Alessandro; Maggioni, Matteo; Pepe, Antonietta; Tohka, Jussi; Stebbing, Richard V; McManigle, John E; Ciurte, Anca; Bresson, Xavier; Cuadra, Meritxell Bach; Sun, Changming; Ponomarev, Gennady V; Gelfand, Mikhail S; Kazanov, Marat D; Wang, Ching-Wei; Chen, Hsiang-Chou; Peng, Chun-Wei; Hung, Chu-Mei; Noble, J Alison

    2014-04-01

    This paper presents the evaluation results of the methods submitted to Challenge US: Biometric Measurements from Fetal Ultrasound Images, a segmentation challenge held at the IEEE International Symposium on Biomedical Imaging 2012. The challenge was set to compare and evaluate current fetal ultrasound image segmentation methods. It consisted of automatically segmenting fetal anatomical structures to measure standard obstetric biometric parameters, from 2D fetal ultrasound images taken on fetuses at different gestational ages (21 weeks, 28 weeks, and 33 weeks) and with varying image quality to reflect data encountered in real clinical environments. Four independent sub-challenges were proposed, according to the objects of interest measured in clinical practice: abdomen, head, femur, and whole fetus. Five teams participated in the head sub-challenge and two teams in the femur sub-challenge, including one team who tackled both. Nobody attempted the abdomen and whole fetus sub-challenges. The challenge goals were two-fold and the participants were asked to submit the segmentation results as well as the measurements derived from the segmented objects. Extensive quantitative (region-based, distance-based, and Bland-Altman measurements) and qualitative evaluation was performed to compare the results from a representative selection of current methods submitted to the challenge. Several experts (three for the head sub-challenge and two for the femur sub-challenge), with different degrees of expertise, manually delineated the objects of interest to define the ground truth used within the evaluation framework. For the head sub-challenge, several groups produced results that could be potentially used in clinical settings, with comparable performance to manual delineations. The femur sub-challenge had inferior performance to the head sub-challenge due to the fact that it is a harder segmentation problem and that the techniques presented relied more on the femur's appearance.

  5. Current status, future opportunities, and remaining challenges in landscape genetics [Chapter 14

    Treesearch

    Niko Balkenhol; Samuel A. Cushman; Lisette P. Waits; Andrew Storfer

    2016-01-01

    Landscape genetics has advanced the field of evolutionary ecology by providing a direct focus on relationships between landscape patterns and population processes, such as gene flow, selection, and genetic drift. This chapter discusses the current and emerging challenges and opportunities, which focus and facilitate future progress in the field. It presents ten...

  6. Applying Risk Prediction Models to Optimize Lung Cancer Screening: Current Knowledge, Challenges, and Future Directions.

    PubMed

    Sakoda, Lori C; Henderson, Louise M; Caverly, Tanner J; Wernli, Karen J; Katki, Hormuzd A

    2017-12-01

    Risk prediction models may be useful for facilitating effective and high-quality decision-making at critical steps in the lung cancer screening process. This review provides a current overview of published lung cancer risk prediction models and their applications to lung cancer screening and highlights both challenges and strategies for improving their predictive performance and use in clinical practice. Since the 2011 publication of the National Lung Screening Trial results, numerous prediction models have been proposed to estimate the probability of developing or dying from lung cancer or the probability that a pulmonary nodule is malignant. Respective models appear to exhibit high discriminatory accuracy in identifying individuals at highest risk of lung cancer or differentiating malignant from benign pulmonary nodules. However, validation and critical comparison of the performance of these models in independent populations are limited. Little is also known about the extent to which risk prediction models are being applied in clinical practice and influencing decision-making processes and outcomes related to lung cancer screening. Current evidence is insufficient to determine which lung cancer risk prediction models are most clinically useful and how to best implement their use to optimize screening effectiveness and quality. To address these knowledge gaps, future research should be directed toward validating and enhancing existing risk prediction models for lung cancer and evaluating the application of model-based risk calculators and its corresponding impact on screening processes and outcomes.

  7. In silico regenerative medicine: how computational tools allow regulatory and financial challenges to be addressed in a volatile market

    PubMed Central

    Geris, L.; Guyot, Y.; Schrooten, J.; Papantoniou, I.

    2016-01-01

    The cell therapy market is a highly volatile one, due to the use of disruptive technologies, the current economic situation and the small size of the market. In such a market, companies as well as academic research institutes are in need of tools to advance their understanding and, at the same time, reduce their R&D costs, increase product quality and productivity, and reduce the time to market. An additional difficulty is the regulatory path that needs to be followed, which is challenging in the case of cell-based therapeutic products and should rely on the implementation of quality by design (QbD) principles. In silico modelling is a tool that allows the above-mentioned challenges to be addressed in the field of regenerative medicine. This review discusses such in silico models and focuses more specifically on the bioprocess. Three (clusters of) examples related to this subject are discussed. The first example comes from the pharmaceutical engineering field where QbD principles and their implementation through the use of in silico models are both a regulatory and economic necessity. The second example is related to the production of red blood cells. The described in silico model is mainly used to investigate the manufacturing process of the cell-therapeutic product, and pays special attention to the economic viability of the process. Finally, we describe the set-up of a model capturing essential events in the development of a tissue-engineered combination product in the context of bone tissue engineering. For each of the examples, a short introduction to some economic aspects is given, followed by a description of the in silico tool or tools that have been developed to allow the implementation of QbD principles and optimal design. PMID:27051516

  8. In silico regenerative medicine: how computational tools allow regulatory and financial challenges to be addressed in a volatile market.

    PubMed

    Geris, L; Guyot, Y; Schrooten, J; Papantoniou, I

    2016-04-06

    The cell therapy market is a highly volatile one, due to the use of disruptive technologies, the current economic situation and the small size of the market. In such a market, companies as well as academic research institutes are in need of tools to advance their understanding and, at the same time, reduce their R&D costs, increase product quality and productivity, and reduce the time to market. An additional difficulty is the regulatory path that needs to be followed, which is challenging in the case of cell-based therapeutic products and should rely on the implementation of quality by design (QbD) principles. In silico modelling is a tool that allows the above-mentioned challenges to be addressed in the field of regenerative medicine. This review discusses such in silico models and focuses more specifically on the bioprocess. Three (clusters of) examples related to this subject are discussed. The first example comes from the pharmaceutical engineering field where QbD principles and their implementation through the use of in silico models are both a regulatory and economic necessity. The second example is related to the production of red blood cells. The described in silico model is mainly used to investigate the manufacturing process of the cell-therapeutic product, and pays special attention to the economic viability of the process. Finally, we describe the set-up of a model capturing essential events in the development of a tissue-engineered combination product in the context of bone tissue engineering. For each of the examples, a short introduction to some economic aspects is given, followed by a description of the in silico tool or tools that have been developed to allow the implementation of QbD principles and optimal design.

  9. Extensively Drug-resistant Tuberculosis (XDR-TB): A daunting challenge to the current End TB Strategy and policy recommendations.

    PubMed

    Rahman, Md Arifur; Sarkar, Atanu

    2017-07-01

    Extensively Drug-resistant Tuberculosis (XDR-TB) has emerged as one of the most formidable challenges to the End TB Strategy that has targeted a 95% reduction in TB deaths and 90% reduction in cases by 2035. Globally, there were an estimated 55,100 new XDR-TB cases in 2015 in 117 countries. However, only one in 30 XDR-TB cases had been reported so far. Drug susceptibility test (DST) is the mainstay for diagnosing XDR-TB, but the lack of laboratory facilities in the resource-limited endemic countries limit its uses. A few new drugs including bedaquiline and delamanid, have the potential to improve the efficiency of XDR-TB treatment, but the drugs have been included in 39 countries only. The costs of XDR-TB treatment are several folds higher than that of the MDR-TB. Despite the financing from the donors, there is an urgent need to fill the current funding gap of US$ 2 billion to ensure effective treatment and robust surveillance. In the review article we have addressed current update on XDR-TB, including surveillance, diagnosis and the interventions needed to treat and limit its spread, emphasis on extensive financial support for implementing of current recommendations to meet the goals of End TB Strategy. Copyright © 2017 Tuberculosis Association of India. Published by Elsevier B.V. All rights reserved.

  10. Strategies to address management challenges in larger intensive care units.

    PubMed

    Matlakala, M C; Bezuidenhout, M C; Botha, A D H

    2015-10-01

    To illustrate the need for and suggest strategies that will enhance sustainable management of a large intensive care unit (ICU). The challenges faced by intensive care nursing in South Africa are well documented. However, there appear to be no strategies available to assist nurses to manage large ICUs or for ICU managers to deal with problems as they arise. Data sources to illustrate the need for strategies were challenges described by ICU managers in the management of large ICUs. A purposive sample of managers was included in individual interviews during compilation of evidence regarding the challenges experienced in the management of large ICUs. The challenges were presented at the Critical Care Society of Southern Africa Congress held on 28 August to 2 September 2012 in Sun City North-West province, South Africa. Five strategies are suggested for the challenges identified: divide the units into sections; develop a highly skilled and effective nursing workforce to ensure delivery of quality nursing care; create a culture to retain an effective ICU nursing team; manage assets; and determine the needs of ICU nurses. ICUs need measures to drive the desired strategies into actions to continuously improve the management of the unit. Future research should be aimed at investigating the effectiveness of the strategies identified. This research highlights issues relating to large ICUs and the strategies will assist ICU managers to deal with problems related to large unit sizes, shortage of trained ICU nurses, use of agency nurses, shortage of equipment and supplies and stressors in the ICU. The article will make a contribution to the body of nursing literature on management of ICUs. © 2014 John Wiley & Sons Ltd.

  11. The role of business in addressing the long-term implications of the current food crisis.

    PubMed

    Yach, Derek

    2008-12-05

    Before the onset of the current food crisis, the evidence of a severely neglected nutrition crisis was starting to receive attention. Increased food prices are having severe impacts on the nutritional status of populations. Our current food system has evolved over decades in a largely unplanned manner and without consideration for the complexity and implications of linkages between health, nutrition, agricultural, economic, trade and security issues. The underlying causes for the nutrition crisis include the above, as well as decades of neglect with regard to nutrition, and agricultural science (especially in emerging markets); a failure of governance with respect to the major players involved in nutrition, a weak response by government donors and Foundations to invest in basic nutrition (in contrast to growing support for humanitarian aspects of food aid), and a reluctance to develop private-public partnerships. The emergence of new business models that tackle social problems while remaining profitable offers promise that the long term nutrition needs of people can be met. Businesses can have greater impact acting collectively than individually. Food, retail, food service, chemical and pharmaceutical companies have expertise, distribution systems and customers insights, if well harnessed, could leapfrog progress in addressing the food and nutrition crises. While business can do lots more, its combined impact will be minimal if a range of essential government actions and policies are not addressed. Governments need to create innovative and complementary opportunities that include incentives for businesses including: setting clear nutritional guidelines for fortification and for ready-to eat products; offering agreements to endorse approved products and support their distribution to clinics and schools; eliminating duties on imported vitamins and other micronutrients; and providing tax and other incentives for industry to invest with donors in essential nutrition

  12. The role of business in addressing the long-term implications of the current food crisis

    PubMed Central

    Yach, Derek

    2008-01-01

    Before the onset of the current food crisis, the evidence of a severely neglected nutrition crisis was starting to receive attention. Increased food prices are having severe impacts on the nutritional status of populations. Our current food system has evolved over decades in a largely unplanned manner and without consideration for the complexity and implications of linkages between health, nutrition, agricultural, economic, trade and security issues. The underlying causes for the nutrition crisis include the above, as well as decades of neglect with regard to nutrition, and agricultural science (especially in emerging markets); a failure of governance with respect to the major players involved in nutrition, a weak response by government donors and Foundations to invest in basic nutrition (in contrast to growing support for humanitarian aspects of food aid), and a reluctance to develop private-public partnerships. The emergence of new business models that tackle social problems while remaining profitable offers promise that the long term nutrition needs of people can be met. Businesses can have greater impact acting collectively than individually. Food, retail, food service, chemical and pharmaceutical companies have expertise, distribution systems and customers insights, if well harnessed, could leapfrog progress in addressing the food and nutrition crises. While business can do lots more, its combined impact will be minimal if a range of essential government actions and policies are not addressed. Governments need to create innovative and complementary opportunities that include incentives for businesses including: setting clear nutritional guidelines for fortification and for ready-to eat products; offering agreements to endorse approved products and support their distribution to clinics and schools; eliminating duties on imported vitamins and other micronutrients; and providing tax and other incentives for industry to invest with donors in essential nutrition

  13. National Institutes of Health addresses the science of diversity.

    PubMed

    Valantine, Hannah A; Collins, Francis S

    2015-10-06

    The US biomedical research workforce does not currently mirror the nation's population demographically, despite numerous attempts to increase diversity. This imbalance is limiting the promise of our biomedical enterprise for building knowledge and improving the nation's health. Beyond ensuring fairness in scientific workforce representation, recruiting and retaining a diverse set of minds and approaches is vital to harnessing the complete intellectual capital of the nation. The complexity inherent in diversifying the research workforce underscores the need for a rigorous scientific approach, consistent with the ways we address the challenges of science discovery and translation to human health. Herein, we identify four cross-cutting diversity challenges ripe for scientific exploration and opportunity: research evidence for diversity's impact on the quality and outputs of science; evidence-based approaches to recruitment and training; individual and institutional barriers to workforce diversity; and a national strategy for eliminating barriers to career transition, with scientifically based approaches for scaling and dissemination. Evidence-based data for each of these challenges should provide an integrated, stepwise approach to programs that enhance diversity rapidly within the biomedical research workforce.

  14. Addressing implementation challenges during guideline development - a case study of Swedish national guidelines for methods of preventing disease.

    PubMed

    Richter-Sundberg, Linda; Kardakis, Therese; Weinehall, Lars; Garvare, Rickard; Nyström, Monica E

    2015-01-22

    Many of the world's life threatening diseases (e.g. cancer, heart disease, stroke) could be prevented by eliminating life-style habits such as tobacco use, unhealthy diet, physical inactivity and excessive alcohol use. Incorporating evidence-based research on methods to change unhealthy lifestyle habits in clinical practice would be equally valuable. However gaps between guideline development and implementation are well documented, with implications for health care quality, safety and effectiveness. The development phase of guidelines has been shown to be important both for the quality in guideline content and for the success of implementation. There are, however, indications that guidelines related to general disease prevention methods encounter specific barriers compared to guidelines that are diagnosis-specific. In 2011 the Swedish National board for Health and Welfare launched guidelines with a preventive scope. The aim of this study was to investigate how implementation challenges were addressed during the development process of these disease preventive guidelines. Seven semi-structured interviews were conducted with members of the guideline development management group. Archival data detailing the guideline development process were also collected and used in the analysis. Qualitative data were analysed using content analysis as the analytical framework. The study identified several strategies and approaches that were used to address implementation challenges during guideline development. Four themes emerged from the analysis: broad agreements and consensus about scope and purpose; a formalized and structured development procedure; systematic and active involvement of stakeholders; and openness and transparency in the specific guideline development procedure. Additional factors concerning the scope of prevention and the work environment of guideline developers were perceived to influence the possibilities to address implementation issues. This case study

  15. Plant xylem hydraulics: What we understand, current research, and future challenges.

    PubMed

    Venturas, Martin D; Sperry, John S; Hacke, Uwe G

    2017-06-01

    Herein we review the current state-of-the-art of plant hydraulics in the context of plant physiology, ecology, and evolution, focusing on current and future research opportunities. We explain the physics of water transport in plants and the limits of this transport system, highlighting the relationships between xylem structure and function. We describe the great variety of techniques existing for evaluating xylem resistance to cavitation. We address several methodological issues and their connection with current debates on conduit refilling and exponentially shaped vulnerability curves. We analyze the trade-offs existing between water transport safety and efficiency. We also stress how little information is available on molecular biology of cavitation and the potential role of aquaporins in conduit refilling. Finally, we draw attention to how plant hydraulic traits can be used for modeling stomatal responses to environmental variables and climate change, including drought mortality. © 2017 Institute of Botany, Chinese Academy of Sciences.

  16. Determining the efficacy of national strategies aimed at addressing the challenges facing health personnel working in rural areas in KwaZulu-Natal, South Africa.

    PubMed

    Mburu, Grace; George, Gavin

    2017-07-31

    Shortages of Human Resources for Health (HRH) in rural areas are often driven by poor working and living conditions, inadequate salaries and benefits, lack of training and career development opportunities amongst others. The South African government has adopted a human resource strategy for the health sector in 2011 aimed at addressing these challenges. This study reviews the challenges faced by health personnel against government strategies aimed at attracting and retaining health personnel in these underserved areas. The study was conducted in six primary health care service sites in the Hlabisa sub-district of Umkhanyakude, located in northern KwaZulu-Natal, South Africa. The study population comprised 25 health workers including 11 professional nurses, 4 staff nurses and 10 doctors (4 medical doctors, 3 foreign medical doctors and 3 doctors undertaking community service). Qualitative data were collected from semi-structured interviews and analysed using thematic analysis. Government initiatives including the rural allowance, deployment of foreign medical doctors and the presence of health personnel undertaking their community service in rural areas are positively viewed by health personnel working in rural health facilities. However, poor living and working conditions, together with inadequate personal development opportunities, remain unresolved challenges. It is these challenges that will continue to dissuade experienced health personnel from remaining in these underserved areas. South Africa's HRH strategy for the Health Sector 2012/13-2015/16 had highlighted the key challenges raised by respondents and identified strategies aimed at addressing these challenges. Implementation of these strategies is key to improving both living and working conditions, and providing health personnel with opportunities for further development will require inter-ministerial collaboration if the HRH 2030 objectives are to be realised.

  17. Social media and pharmacovigilance: A review of the opportunities and challenges

    PubMed Central

    Sloane, Richard; Osanlou, Orod; Lewis, David; Bollegala, Danushka; Maskell, Simon; Pirmohamed, Munir

    2015-01-01

    Adverse drug reactions come at a considerable cost on society. Social media are a potentially invaluable reservoir of information for pharmacovigilance, yet their true value remains to be fully understood. In order to realize the benefits social media holds, a number of technical, regulatory and ethical challenges remain to be addressed. We outline these key challenges identifying relevant current research and present possible solutions. PMID:26147850

  18. Analysis of Factors Affecting System Performance in the ASpIRE Challenge

    DTIC Science & Technology

    2015-12-13

    performance in the ASpIRE (Automatic Speech recognition In Reverberant Environments) challenge. In particular, overall word error rate (WER) of the solver...systems is analyzed as a function of room, distance between talker and microphone, and microphone type. We also analyze speech activity detection...analysis will inform the design of future challenges and provide insight into the efficacy of current solutions addressing noisy reverberant speech

  19. Rhabdomyosarcoma: Current Challenges and Their Implications for Developing Therapies

    PubMed Central

    Hettmer, Simone; Li, Zhizhong; Billin, Andrew N.; Barr, Frederic G.; Cornelison, D.D.W.; Ehrlich, Alan R.; Guttridge, Denis C.; Hayes-Jordan, Andrea; Helman, Lee J.; Houghton, Peter J.; Khan, Javed; Langenau, David M.; Linardic, Corinne M.; Pal, Ranadip; Partridge, Terence A.; Pavlath, Grace K.; Rota, Rossella; Schäfer, Beat W.; Shipley, Janet; Stillman, Bruce; Wexler, Leonard H.; Wagers, Amy J.; Keller, Charles

    2014-01-01

    Rhabdomyosarcoma (RMS) represents a rare, heterogeneous group of mesodermal malignancies with skeletal muscle differentiation. One major subgroup of RMS tumors (so-called “fusion-positive” tumors) carries exclusive chromosomal translocations that join the DNA-binding domain of the PAX3 or PAX7 gene to the transactivation domain of the FOXO1 (previously known as FKHR) gene. Fusion-negative RMS represents a heterogeneous spectrum of tumors with frequent RAS pathway activation. Overtly metastatic disease at diagnosis is more frequently found in individuals with fusion-positive than in those with fusion-negative tumors. RMS is the most common pediatric soft-tissue sarcoma, and approximately 60% of all children and adolescents diagnosed with RMS are cured by currently available multimodal therapies. However, a curative outcome is achieved in <30% of high-risk individuals with RMS, including all those diagnosed as adults, those diagnosed with fusion-positive tumors during childhood (including metastatic and nonmetastatic tumors), and those diagnosed with metastatic disease during childhood (including fusion-positive and fusion-negative tumors). This white paper outlines current challenges in RMS research and their implications for developing more effective therapies. Urgent clinical problems include local control, systemic disease, need for improved risk stratification, and characterization of differences in disease course in children and adults. Biological challenges include definition of the cellular functions of PAX-FOXO1 fusion proteins, clarification of disease heterogeneity, elucidation of the cellular origins of RMS, delineation of the tumor microenvironment, and identification of means for rational selection and testing of new combination therapies. To streamline future therapeutic developments, it will be critical to improve access to fresh tumor tissue for research purposes, consider alternative trial designs to optimize early clinical testing of candidate

  20. HIV vaccines: current challenges and future directions.

    PubMed

    Avrett, Sam; Collins, Chris

    2002-07-01

    Volume seven of the Review will mark the tenth anniversary of the Canadian HIV/AIDS Legal Network with a series of articles that describe past developments and future directions in several areas of policy and law related to HIV/AIDS. The following article is the first of these, discussing current challenges and future directions in the development of and access to HIV vaccines. It argues that governments are under public health, ethical, and legal obligations to develop and provide access to HIV vaccines. It further explains what is required for governments to fulfill their obligations: additional commitment and resources for HIV vaccine development in the context of increased global research and development regarding diseases of the poor; increased support and advocacy for partnerships to develop HIV vaccines; enhanced regulatory capacity in every country to review, approve, and monitor HIV vaccines; and assurance of global supply of, procurement of, delivery of, and access to vaccines in the context of efforts to increase global access to public health measures and technologies.

  1. Anti-infective use in children and pregnancy: current deficiencies and future challenges

    PubMed Central

    Gwee, Amanda; Cranswick, Noel

    2015-01-01

    There are a number of challenges to using anti-infective agents in children and pregnant women. There is limited understanding of the altered pharmacokinetics of anti-infectives in these populations and as a result, optimized dosing regimens are yet to be established. The potential adverse effects of the drug on pregnancy outcome and the developing foetus is a major consideration, and the long term implications of drug side effects must be taken into account when drug exposure occurs early in life. These factors hinder research and licensing of new anti-infective drugs in these populations. We describe the current deficiencies and future challenges of anti-infective use in children and pregnant women, providing specific examples. PMID:24588467

  2. Intradermal delivery of vaccines: potential benefits and current challenges

    PubMed Central

    Hickling, JK; Jones, KR; Friede, M; Chen, D; Kristensen, D

    2011-01-01

    Abstract Delivery of vaccine antigens to the dermis and/or epidermis of human skin (i.e. intradermal delivery) might be more efficient than injection into the muscle or subcutaneous tissue, thereby reducing the volumes of antigen. This is known as dose-sparing and has been demonstrated in clinical trials with some, but not all, vaccines. Dose-sparing could be beneficial to immunization programmes by potentially reducing the costs of purchase, distribution and storage of vaccines; increasing vaccine availability and effectiveness. The data obtained with intradermal delivery of some vaccines are encouraging and warrant further study and development; however significant gaps in knowledge and operational challenges such as reformulation, optimizing vaccine presentation and development of novel devices to aid intradermal vaccine delivery need to be addressed. Modelling of the costs and potential savings resulting from intradermal delivery should be done to provide realistic expectations of the potential benefits and to support cases for investment. Implementation and uptake of intradermal vaccine delivery requires further research and development, which depends upon collaboration between multiple stakeholders in the field of vaccination. PMID:21379418

  3. Current challenges and pitfalls in the pharmacological treatment of depression

    PubMed Central

    Popa-Velea, O; Gheorghe, IR; Truţescu, CI; Purcărea, VL

    2015-01-01

    The multifactorial etiology of depression obliges needs an individual assessment, the psychopharmacological approach involving a biopsychosocial analysis for each individual case. The rebalancing of the depressive patient, seen as a return to a normal level of psychosocial functioning and reduced risk of relapse is achieved with a prompt and constant support of specialized teams. Treatment should include psychopharmacological and psychosocial approaches, the results being interrelated and contributing to the prognosis of the disorder. Progress in clinical and pharmacological research, vivid dynamics of socio-economic environment, the complexity of diagnostic evaluation and the need for an interdisciplinary approach may cause difficulties in addressing the depressive patient and the ethical controversies. The aim of this paper is to present a brief analysis of challenges encountered in the present psychiatric practice, starting from the heterogeneity of depressive manifestations and finishing with the prioritization of interventional forms. PMID:25866576

  4. Women in science: Current advances and challenges in Belarus

    NASA Astrophysics Data System (ADS)

    Tashlykova-Bushkevich, Iya I.

    2015-12-01

    Women constitute 49% of all natural scientists in Belarus. However, fewer than 18% of Belarusian natural scientists who hold a doctor of science degree are women. The proportion of women decreases with increasing rank at universities and institutes in Belarus. Gender imbalance at the level of full professor is striking at just 17.5% women, and illuminates the vertical segregation of women in the natural sciences. This report reviews the positions of women in science in Belarus to draw out current advances and challenges encountered by female scientists in the former socialist country. New statistical data are broken down by gender and aimed at advancing the general agenda for women in science.

  5. Addressing the Challenges of a Quarter Century of Giscience Education: A Flexible Higher Education Curriculum Framework

    NASA Astrophysics Data System (ADS)

    Veenendaal, B.

    2014-04-01

    A wide range of geographic information science (GIScience) educational programs currently exist, the oldest now over 25 years. Offerings vary from those specifically focussed on geographic information science, to those that utilise geographic information systems in various applications and disciplines. Over the past two decades, there have been a number of initiatives to design curricula for GIScience, including the NCGIA Core Curriculum, GIS&T Body of Knowledge and the Geospatial Technology Competency Model developments. The rapid developments in geospatial technology, applications and organisations have added to the challenges that higher educational institutions face in order to ensure that GIScience education is relevant and responsive to the changing needs of students and industry. This paper discusses some of the challenges being faced in higher education in general, and GIScience education in particular, and outlines a flexible higher education curriculum framework for GIScience.

  6. eHealth in Saudi Arabia: Current Trends, Challenges and Recommendations.

    PubMed

    Alsulame, Khaled; Khalifa, Mohamed; Househ, Mowafa

    2015-01-01

    The purpose of this study is to explore the current status of eHealth in Saudi Arabia from the perspective of health informatics professionals. We used a case study approach and analyzed participant data using thematic analysis. The study took place between July and August 2013. Data collection included interviews with nine senior health information professionals in Saudi Arabia. The findings describe participant views on current eHealth trends in Saudi Arabia and show differences among Saudi healthcare organizations in terms of eHealth adoption. Participants also describe the challenges relating to organizational and cultural issues, end user attitudes towards eHealth projects, and the lack of specialized human resources to implement eHealth systems. Two main recommendations made by the participants were to form a new national body for eHealth and to develop a unified plan for the implementation of Saudi eHealth initiatives.

  7. Geospatial Information and Geographic Information Systems (GIS): Current Issues and Future Challenges

    DTIC Science & Technology

    2009-06-08

    CRS Report for Congress Prepared for Members and Committees of Congress Geospatial Information and Geographic Information Systems (GIS...Geographic Information Systems (GIS): Current Issues and Future Challenges 5a. CONTRACT NUMBER 5b. GRANT NUMBER 5c. PROGRAM ELEMENT NUMBER 6...PAGE unclassified Standard Form 298 (Rev. 8-98) Prescribed by ANSI Std Z39-18 Geospatial Information and Geographic Information Systems (GIS

  8. Makerere University College of Health Sciences’ role in addressing challenges in health service provision at Mulago National Referral Hospital

    PubMed Central

    2011-01-01

    Background Mulago National Referral Hospital (MNRH), Uganda’s primary tertiary and teaching hospital, and Makerere University College of Health Sciences (MakCHS) have a close collaborative relationship. MakCHS students complete clinical rotations at MNRH, and MakCHS faculty partner with Mulago staff in clinical care and research. In 2009, as part of a strategic planning process, MakCHS undertook a qualitative study to examine care and service provision at MNRH, identify challenges, gaps, and solutions, and explore how MakCHS could contribute to improving care and service delivery at MNRH. Methods Key informant interviews (n=23) and focus group discussions (n=7) were conducted with nurses, doctors, administrators, clinical officers and other key stakeholders. Interviews and focus groups were tape recorded and transcribed verbatim, and findings were analyzed through collaborative thematic analysis. Results Challenges to care and service delivery at MNRH included resource constraints (staff, space, equipment, and supplies), staff inadequacies (knowledge, motivation, and professionalism), overcrowding, a poorly functioning referral system, limited quality assurance, and a cumbersome procurement system. There were also insufficiencies in the teaching of professionalism and communication skills to students, and patient care challenges that included lack of access to specialized services, risk of infections, and inappropriate medications. Suggestions for how MakCHS could contribute to addressing these challenges included strengthening referral systems and peripheral health center capacity, and establishing quality assurance mechanisms. The College could also strengthen the teaching of professionalism, communication and leadership skills to students, and monitor student training and develop courses that contribute to continuous professional development. Additionally, the College could provide in-service education for providers on professionalism, communication skills

  9. Nuclear Explosion Monitoring Advances and Challenges

    NASA Astrophysics Data System (ADS)

    Baker, G. E.

    2015-12-01

    We address the state-of-the-art in areas important to monitoring, current challenges, specific efforts that illustrate approaches addressing shortcomings in capabilities, and additional approaches that might be helpful. The exponential increase in the number of events that must be screened as magnitude thresholds decrease presents one of the greatest challenges. Ongoing efforts to exploit repeat seismic events using waveform correlation, subspace methods, and empirical matched field processing holds as much "game-changing" promise as anything being done, and further efforts to develop and apply such methods efficiently are critical. Greater accuracy of travel time, signal loss, and full waveform predictions are still needed to better locate and discriminate seismic events. Important developments include methods to model velocities using multiple types of data; to model attenuation with better separation of source, path, and site effects; and to model focusing and defocusing of surface waves. Current efforts to model higher frequency full waveforms are likely to improve source characterization while more effective estimation of attenuation from ambient noise holds promise for filling in gaps. Censoring in attenuation modeling is a critical problem to address. Quantifying uncertainty of discriminants is key to their operational use. Efforts to do so for moment tensor (MT) inversion are particularly important, and fundamental progress on the statistics of MT distributions is the most important advance needed in the near term in this area. Source physics is seeing great progress through theoretical, experimental, and simulation studies. The biggest need is to accurately predict the effects of source conditions on seismic generation. Uniqueness is the challenge here. Progress will depend on studies that probe what distinguishes mechanisms, rather than whether one of many possible mechanisms is consistent with some set of observations.

  10. Centennial Challenges Program Overview: How NASA Successfully Involves the General Public in the Solving of Current Technology Gaps

    NASA Technical Reports Server (NTRS)

    Roman, Monsi C.; Kim, Tony; Sudnik, Janet; Sivak, Amy; Porter, Molly; Cylar, Rosaling; Cavanaugh, Dominique; Krome, Kim

    2017-01-01

    The National Aeronautics and Space Administration (NASA) Centennial Challenges Program, part of the Space Technology Mission Directorate (STMD), addresses key technology needs of NASA and the nation, while facilitating new sources of innovation outside the traditional community. This is done by the direct engagement of the public at large, through the offering of Congressional authorized prize purses and associated challenges developed by NASA and the aerospace community and set up as a competition awarding the prize money for achieving the specified technology goal.

  11. Strategies to Address Challenging Behaviour in Young Children with Down Syndrome

    ERIC Educational Resources Information Center

    Feeley, Kathleen; Jones, Emily

    2008-01-01

    Children with Down syndrome are at an increased risk for engaging in challenging behaviour that may present problems within community, leisure, and educational settings, and, in many instances, precludes them from accessing these environments. Factors contributing to the occurrence of challenging behaviours include characteristics associated with…

  12. A strategy to address the nursing faculty shortage.

    PubMed

    Ganley, Barbara J; Sheets, Ingrid

    2009-07-01

    This article describes one university's experience in creating a master's geriatric clinical nurse specialist-nurse educator program to address the nursing faculty shortage and the need for geriatric clinical nurse specialists. The successes and challenges are outlined, and curricular ideas that may be beneficial to other nursing programs also are presented. This program has enhanced the university's pool of clinical instructors, increased its ability to provide services to older adults, and allowed faculty to instruct and focus undergraduates in the distinctions of geriatric nursing care. The biggest challenges faced were marketing and recruitment of nurses; these challenges were addressed, and possible solutions are offered. The most immediate benefit of this program was the generation of geriatric clinical nurse specialists.

  13. American Society of Clinical Oncology Summit on Addressing Obesity Through Multidisciplinary Provider Collaboration: Key Findings and Recommendations for Action.

    PubMed

    Ligibel, Jennifer A; Alfano, Catherine M; Hershman, Dawn L; Merrill, Janette K; Basen-Engquist, Karen; Bloomgarden, Zachary T; Demark-Wahnefried, Wendy; Dixon, Suzanne; Hassink, Sandra G; Jakicic, John M; Morton, John Magaña; Okwuosa, Tochi M; Powell-Wiley, Tiffany M; Rothberg, Amy E; Stephens, Mark; Streett, Sarah E; Wild, Robert A; Westman, Eric A; Williams, Ronald J; Wollins, Dana S; Hudis, Clifford A

    2017-11-01

    Given the increasing evidence that obesity increases the risk of developing and dying from malignancy, the American Society of Clinical Oncology (ASCO) launched an Obesity Initiative in 2013 that was designed to increase awareness among oncology providers and the general public of the relationship between obesity and cancer and to promote research in this area. Recognizing that the type of societal change required to impact the obesity epidemic will require a broad-based effort, ASCO hosted the "Summit on Addressing Obesity through Multidisciplinary Collaboration" in 2016. This meeting was held to review current challenges in addressing obesity within the respective health care provider communities and to identify priorities that would most benefit from a collective and cross-disciplinary approach. Efforts focused on four key areas: provider education and training; public education and activation; research; and policy and advocacy. Summit attendees discussed current challenges in addressing obesity within their provider communities and identified priorities that would most benefit from multidisciplinary collaboration. A synopsis of recommendations to facilitate future collaboration, as well as examples of ongoing cooperative efforts, provides a blueprint for multidisciplinary provider collaboration focused on obesity prevention and treatment. © 2017 The Obesity Society.

  14. Atherosclerotic renovascular disease – epidemiology, treatment and current challenges

    PubMed Central

    Vassallo, Diana

    2017-01-01

    The neutral results of recent large randomized controlled trials comparing renal revascularization with optimal medical therapy in patients with atherosclerotic renovascular disease (ARVD) have cast doubt on the role of revascularization in the management of unselected patients with this condition. However, these studies have strengthened the evidence base for the role of contemporary intensive medical vascular protection therapy and aggressive risk factor control in improving clinical outcomes in ARVD. Patients presenting with ‘high-risk’ clinical features such as uncontrolled hypertension, rapidly declining renal function or flash pulmonary oedema are underrepresented in these studies; hence these results may not be applicable to all patients with ARVD. In this ‘high-risk’ subgroup, conservative management may not be sufficient in preventing adverse events, and indeed, observational evidence suggests that this specific patient subgroup may gain benefit from timely renal revascularization. Current challenges include the development of novel diagnostic techniques to establish haemodynamic significance of a stenosis, patient risk stratification and prediction of post-revascularization outcomes to ultimately facilitate patient selection for revascularization. In this paper we describe the epidemiology of this condition and discuss treatment recommendations for this condition in light of the results of recent randomized controlled trials while highlighting important clinical unmet needs and challenges faced by clinicians managing this condition. PMID:29056991

  15. Current Trends and Challenges in Satellite Laser Ranging

    NASA Astrophysics Data System (ADS)

    Appleby, Graham M.; Bianco, Giuseppe; Noll, Carey E.; Pavlis, Erricos C.; Pearlman, Michael R.

    2016-12-01

    Satellite Laser Ranging (SLR) is used to measure accurately the distance from ground stations to retro-reflectors on satellites and on the Moon. SLR is one of the fundamental space-geodetic techniques that define the International Terrestrial Reference Frame (ITRF), which is the basis upon which many aspects of global change over space, time, and evolving technology are measured; with VLBI the two techniques define the scale of the ITRF; alone the SLR technique defines its origin (geocenter). The importance of the reference frame has recently been recognized at the inter-governmental level through the United Nations, which adopted in February 2015 the Resolution "Global Geodetic Reference Frame for Sustainable Development." Laser Ranging provides precision orbit determination and instrument calibration and validation for satellite-borne altimeters for the better understanding of sea level change, ocean dynamics, ice mass-balance, and terrestrial topography. It is also a tool to study the dynamics of the Moon and fundamental constants and theories. With the exception of the currently in-orbit GPS constellation, all GNSS satellites now carry retro-reflectors for improved orbit determination, harmonization of reference frames, and in-orbit co-location and system performance validation; the next generation of GPS satellites due for launch from 2019 onwards will also carry retro-reflectors. The ILRS delivers weekly realizations that are accumulated sequentially to extend the ITRF and the Earth Orientation Parameter series with a daily resolution. SLR technology continues to evolve towards the next-generation laser ranging systems and it is expected to successfully meet the challenges of the GGOS2020 program for a future Global Space Geodetic Network. Ranging precision is improving as higher repetition rate, narrower pulse lasers, and faster detectors are implemented within the network. Automation and pass interleaving at some stations is expanding temporal coverage and

  16. Restructuring Principal Preparation in Illinois: Perspectives on Implementation Successes, Challenges, and Future Outlook. Executive Summary. IERC 2015-3

    ERIC Educational Resources Information Center

    Klostermann, Brenda K.; Pareja, Amber Stitziel; Hart, Holly; White, Bradford R.; Huynh, Michelle Hanh

    2015-01-01

    The goals of the current mixed methods study--the Illinois Principal Preparation Implementation Review Project (I-PREP)--are to describe how the new policy is being implemented, learning which aspects of the implementation have been challenging and why they present challenges, and how programs are addressing challenges and realizing improvements…

  17. Review: New Vaccine Against Tuberculosis: Current Developments and Future Challenges

    NASA Astrophysics Data System (ADS)

    Liu, Jun

    2009-04-01

    Tuberculosis (TB) continues to be a global health threat. BCG was developed as an attenuated live vaccine for tuberculosis control nearly a century ago. Despite being the most widely used vaccine in human history, BCG is not an ideal vaccine and has two major limitations: its poor efficacy against adult pulmonary TB and its disconcerting safety in immunocompromised individuals. A safer and more effective TB vaccine is urgently needed. This review article discusses current strategies to develop the next generation of TB vaccines to replace BCG. While some progresses have been made in the past decade, significant challenges lie ahead.

  18. Determining the efficacy of national strategies aimed at addressing the challenges facing health personnel working in rural areas in KwaZulu-Natal, South Africa

    PubMed Central

    2017-01-01

    Background Shortages of Human Resources for Health (HRH) in rural areas are often driven by poor working and living conditions, inadequate salaries and benefits, lack of training and career development opportunities amongst others. The South African government has adopted a human resource strategy for the health sector in 2011 aimed at addressing these challenges. Aim This study reviews the challenges faced by health personnel against government strategies aimed at attracting and retaining health personnel in these underserved areas. Setting The study was conducted in six primary health care service sites in the Hlabisa sub-district of Umkhanyakude, located in northern KwaZulu-Natal, South Africa. Methods The study population comprised 25 health workers including 11 professional nurses, 4 staff nurses and 10 doctors (4 medical doctors, 3 foreign medical doctors and 3 doctors undertaking community service). Qualitative data were collected from semi-structured interviews and analysed using thematic analysis. Results Government initiatives including the rural allowance, deployment of foreign medical doctors and the presence of health personnel undertaking their community service in rural areas are positively viewed by health personnel working in rural health facilities. However, poor living and working conditions, together with inadequate personal development opportunities, remain unresolved challenges. It is these challenges that will continue to dissuade experienced health personnel from remaining in these underserved areas. Conclusion South Africa’s HRH strategy for the Health Sector 2012/13–2015/16 had highlighted the key challenges raised by respondents and identified strategies aimed at addressing these challenges. Implementation of these strategies is key to improving both living and working conditions, and providing health personnel with opportunities for further development will require inter-ministerial collaboration if the HRH 2030 objectives are to be

  19. Response assessment challenges in clinical trials of gliomas.

    PubMed

    Wen, Patrick Y; Norden, Andrew D; Drappatz, Jan; Quant, Eudocia

    2010-01-01

    Accurate, reproducible criteria for determining tumor response and progression after therapy are critical for optimal patient care and effective evaluation of novel therapeutic agents. Currently, the most widely used criteria for determining treatment response in gliomas is based on two-dimensional tumor measurements using neuroimaging studies (Macdonald criteria). In recent years, the limitation of these criteria, which only address the contrast-enhancing component of the tumor, have become increasingly apparent. This review discusses challenges that have emerged in assessing response in patients with gliomas and approaches being introduced to address them.

  20. Social media and pharmacovigilance: A review of the opportunities and challenges.

    PubMed

    Sloane, Richard; Osanlou, Orod; Lewis, David; Bollegala, Danushka; Maskell, Simon; Pirmohamed, Munir

    2015-10-01

    Adverse drug reactions come at a considerable cost on society. Social media are a potentially invaluable reservoir of information for pharmacovigilance, yet their true value remains to be fully understood. In order to realize the benefits social media holds, a number of technical, regulatory and ethical challenges remain to be addressed. We outline these key challenges identifying relevant current research and present possible solutions. © 2015 The British Pharmacological Society.

  1. Challenges in an Aging Society: Presidential Address to APPAM

    ERIC Educational Resources Information Center

    Swartz, Katherine

    2010-01-01

    The United States is at a critical crossroads in its history right now. The public policy problems that the people are facing are complex and interrelated, and the demographic changes that are about to significantly change their country are not well understood by large numbers of people. In this presidential address to the Association for Public…

  2. 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

  3. Challenges in Measuring External Currents Driven by the Solar Wind-Magnetosphere Interaction

    NASA Technical Reports Server (NTRS)

    Le, Guan; Slavin, James A.; Pfaff, Robert F.

    2014-01-01

    In studying the Earth's geomagnetism, it has always been a challenge to separate magnetic fields from external currents originating from the ionosphere and magnetosphere. While the internal magnetic field changes very slowly in time scales of years and more, the ionospheric and magnetospheric current systems driven by the solar wind -magnetosphere interaction are very dynamic. They are intimately controlled by the ionospheric electrodynamics and ionospheremagnetosphere coupling. Single spacecraft observations are not able to separate their spatial and temporal variations, and thus to accurately describe their configurations. To characterize and understand the external currents, satellite observations require both good spatial and temporal resolutions. This paper reviews our observations of the external currents from two recent LEO satellite missions: Space Technology 5 (ST-5), NASA's first three-satellite constellation mission in LEO polar orbit, and Communications/Navigation Outage Forecasting System (C/NOFS), an equatorial satellite developed by US Air Force Research Laboratory. We present recommendations for future geomagnetism missions based on these observations.

  4. Mental health care in Nepal: current situation and challenges for development of a district mental health care plan.

    PubMed

    Luitel, Nagendra P; Jordans, Mark Jd; Adhikari, Anup; Upadhaya, Nawaraj; Hanlon, Charlotte; Lund, Crick; Komproe, Ivan H

    2015-01-01

    Globally mental health problems are a serious public health concern. Currently four out of five people with severe mental illness in Low and Middle Income Countries (LMIC) receive no effective treatment. There is an urgent need to address this enormous treatment gap. Changing the focus of specialist mental health workers (psychiatrists and psychologists) from only service delivery to also designing and managing mental health services; building clinical capacity of the primary health care (PHC) workers, and providing supervision and quality assurance of mental health services may help in scaling up mental health services in LMICs. Little is known however, about the mental health policy and services context for these strategies in fragile-state settings, such as Nepal. A standard situation analysis tool was developed by the PRogramme for Improving Mental health carE (PRIME) consortium to systematically analyze and describe the current gaps in mental health care in Nepal, in order to inform the development of a district level mental health care plan (MHCP). It comprised six sections; general information (e.g. population, socio-economic conditions); mental health policies and plans; mental health treatment coverage; district health services; and community services. Data was obtained from secondary sources, including scientific publications, reports, project documents and hospital records. Mental health policy exists in Nepal, having been adopted in 1997, but implementation of the policy framework has yet to begin. In common with other LMICs, the budget allocated for mental health is minimal. Mental health services are concentrated in the big cities, with 0.22 psychiatrists and 0.06 psychologists per 100,000 population. The key challenges experienced in developing a district level MHCP included, overburdened health workers, lack of psychotropic medicines in the PHC, lack of mental health supervision in the existing system, and lack of a coordinating body in the Ministry

  5. The Practice of School Psychology in Quebec English Schools: Current Challenges and Opportunities

    ERIC Educational Resources Information Center

    Finn, Cindy A.

    2016-01-01

    In Quebec, school psychology is alive and well. This article outlines current challenges and opportunities related to the practice of psychology in Quebec English schools. Changes to the practice of psychology in Quebec over the last decade have had an impact on the delivery of psychological services in schools. Modifications of the admission…

  6. On Pliability and Progress: Challenging Current Conceptions of Eighteenth-Century French Educational Thought

    ERIC Educational Resources Information Center

    Gilead, Tal

    2009-01-01

    Examining the educational writings of three of the eighteenth-century's most innovative thinkers, the Abbe de Saint-Pierre, Morelly and Helvetius, this article challenges the currently accepted view that it was a belief in human pliability which gave rise to the contemporary groundbreaking faith in the power of education to improve society. The…

  7. Exploring Interoperability as a Multidimensional Challenge for Effective Emergency Response

    ERIC Educational Resources Information Center

    Santisteban, Hiram

    2010-01-01

    Purpose. The purpose of this research was to further an understanding of how the federal government is addressing the challenges of interoperability for emergency response or crisis management (FEMA, 2009) by informing the development of standards through the review of current congressional law, commissions, studies, executive orders, and…

  8. Addressing New Challenges for a Community Music Project in the Context of Higher Music Education: a Conceptual Framework

    ERIC Educational Resources Information Center

    Gande, Andrea; Kruse-Weber, Silke

    2017-01-01

    In response to Europe's societal challenges, such as current issues about migration, the Institute of Music Education at the University of Music and Performing Arts Graz established Meet4Music (M4M), a low-threshold community music project. M4M is open to individuals from all sociocultural and musical backgrounds and ages, and provides them with…

  9. Addressing value in surgical oncology: Why and how.

    PubMed

    Abbott, Daniel E

    2016-09-01

    Value, or outcome per cost, is increasingly emphasized in the current health care climate. With more sophisticated and expensive therapies available, treating a population with growing longevity, sustainability of current trends in health care spending is a significant challenge. And all too often, our devices and therapies are implemented without understanding the value that they offer; policy solutions for these issues are lagging. Certainly, cancer patients, in particular, are at the center of these value conundrums. A majority of patients with malignancy are elderly, with accumulated co-morbidities, and are disproportionately costly. To address these contemporary issues, we must first identify opportunities to maximize value through improved outcomes and/or decreased costs. Doing so in the setting of evolving delivery and payment models will provide providers, health systems and insurers an opportunity to flourish with demonstration of high quality, low cost care. J. Surg. Oncol. 2016;114:263-267. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

  10. 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.

  11. Internationalization of traditional Chinese medicine: current international market, internationalization challenges and prospective suggestions.

    PubMed

    Lin, Annie Xianghong; Chan, Ging; Hu, Yuanjia; Ouyang, Defang; Ung, Carolina Oi Lam; Shi, Luwen; Hu, Hao

    2018-01-01

    Through reviewing the current international market for traditional Chinese medicine (TCM), this paper identified the internationalization challenges for TCM, including unclear therapeutic material basis and mechanism, difficulty of quality control, low preparation level, registration/policy barriers, and shortage of intellectual property. To deal with these challenges, suggestions were given including: (1) product innovation of TCM (study the TCM by using the methods and means of western medicine; innovate the basic theory of TCM; develop TCM health product); (2) standard innovation of TCM; (3) building big data platform of Chinese medicine (big data platform of TCM preparation; big data platform on the quality of TCM).

  12. Experiences addressing health-related financial challenges with disease management among African American women with asthma.

    PubMed

    Patel, Minal R; Caldwell, Cleopatra H; Id-Deen, Effat; Clark, Noreen M

    2014-06-01

    Despite economic hardship, compliance with self-management regimens is still evident among individuals and families managing chronic disease. The purpose of this study was to describe how women with asthma address cost-related challenges to management of their condition. In 2012 and 2013, four focus groups were conducted in Southeast Michigan with 26 African American women with asthma, recruited based on maximum variation sampling procedures. A semi-structured interview protocol was employed by trained facilitators. Coded transcripts were analyzed for themes regarding means to reduce the impact of the cost of asthma management. Major themes identified were acceptance of the status quo; stockpiling and sharing medicines; utilizing community assistance programs; reaching out to healthcare providers and social networks for help; foregoing self-management; and utilizing urgent care. Awareness of strategies that are helpful to patients in reducing out-of-pocket costs may better equip service providers and others to develop interventions to make useful strategies more widely available.

  13. Experiences addressing health-related financial challenges with disease management among African American women with asthma

    PubMed Central

    Patel, Minal R.; Caldwell, Cleopatra H.; Id-Deen, Effat; Clark, Noreen M.

    2018-01-01

    Objective Despite economic hardship, compliance with self-management regimens is still evident among individuals and families managing chronic disease. The purpose of this study was to describe how women with asthma address cost-related challenges to management of their condition. Methods In 2012 and 2013, four focus groups were conducted in Southeast Michigan with 26 African American women with asthma, recruited based on maximum variation sampling procedures. A semi-structured interview protocol was employed by trained facilitators. Coded transcripts were analyzed for themes regarding means to reduce the impact of the cost of asthma management. Results Major themes identified were acceptance of the status quo; stockpiling and sharing medicines; utilizing community assistance programs; reaching out to healthcare providers and social networks for help; foregoing self-management; and utilizing urgent care. Conclusions Awareness of strategies that are helpful to patients in reducing out-of-pocket costs may better equip service providers and others to develop interventions to make useful strategies more widely available. PMID:24471517

  14. Changing panorama for surveillance of device-associated healthcare infections: Challenges faced in implementation of current guidelines.

    PubMed

    Gupta, Renu; Sharma, Sangeeta; Saxena, Sonal

    2018-01-01

    Healthcare-associated infections (HAI) are preventable in up to 30% of patients with evidence-based infection prevention and control (IPC) activities. IPC activities require effective surveillance to generate data for the HAI rates, defining priority areas, identifying processes amenable for improvement and institute interventions to improve patient's safety. However, uniform, accurate and standardised surveillance methodology using objective definitions can only generate meaningful data for effective execution of IPC activities. The highly exhaustive, complex and ever-evolving infection surveillance methodology pose a challenge for effective data capture, analysis and interpretation by ground level personnel. The present review addresses the gaps in knowledge and day-to-day challenges in surveillance faced by infection control team for effective implementation of IPC activities.

  15. Addressing the next challenges: A summary of the 22nd international symposium on hepatitis C virus and related viruses.

    PubMed

    Baumert, Thomas F; Schuster, Catherine; Cosset, François-Loïc; Dubuisson, Jean; Hofmann, Maike; Tautz, Norbert; Zeisel, Mirjam B; Thimme, Robert

    2016-04-01

    Following the discovery of the hepatitis C virus (HCV) more than 25 years ago the field has succeeded to develop methods that have changed the safety of blood products, understand the molecular virology, epidemiology and clinical disease of HCV, and identify specific targets for the development of direct-acting antivirals for HCV cure. Nevertheless, major clinical and scientific challenges remain: therapy is still only available to a fraction of infected patients worldwide and many patients remain undiagnosed and/or live in countries where therapy is unattainable. An urgently needed HCV vaccine to eradicate infection remains still elusive. Scientifically, major questions remain regarding the life cycle, pathogenesis and mechanisms of viral clearance and persistence. Addressing these challenges, this meeting report reviews key findings of the 22nd International Symposium on Hepatitis C Virus and Related Viruses in Strasbourg, France from October 9 to 13, 2015. Copyright © 2016 European Association for the Study of the Liver. Published by Elsevier B.V. All rights reserved.

  16. Network Function Virtualization (NFV) based architecture to address connectivity, interoperability and manageability challenges in Internet of Things (IoT)

    NASA Astrophysics Data System (ADS)

    Haseeb, Shariq; Hashim, Aisha Hassan A.; Khalifa, Othman O.; Faris Ismail, Ahmad

    2017-11-01

    IoT aims to interconnect sensors and actuators built into devices (also known as Things) in order for them to share data and control each other to improve existing processes for making people’s life better. IoT aims to connect between all physical devices like fridges, cars, utilities, buildings and cities so that they can take advantage of small pieces of information collected by each one of these devices and derive more complex decisions. However, these devices are heterogeneous in nature because of various vendor support, connectivity options and protocol suit. Heterogeneity of such devices makes it difficult for them to leverage on each other’s capabilities in the traditional IoT architecture. This paper highlights the effects of heterogeneity challenges on connectivity, interoperability, management in greater details. It also surveys some of the existing solutions adopted in the core network to solve the challenges of massive IoT deployments. Finally, the paper proposes a new architecture based on NFV to address the problems.

  17. The Current Often Implemented Fitness Tests in Physical Education Programs: Problems and Future Directions

    ERIC Educational Resources Information Center

    Keating, Xiaofen Deng

    2003-01-01

    This paper aims to examine current nationwide youth fitness test programs, address problems embedded in the programs, and possible solutions. The current Fitnessgram, President's Challenge, and YMCA youth fitness test programs were selected to represent nationwide youth fitness test programs. Sponsors of the nationwide youth fitness test programs…

  18. An International Perspective: The School as an Organization and Social Institution: Current Challenges

    ERIC Educational Resources Information Center

    Butler, Norman L.; Griffith, Kimberly Grantham; Kritsonis, William Allan

    2007-01-01

    This article is about the current challenges facing the school as an organization and social institution with respect to information technology. It is concluded that the school ought to educate broadly when preparing students for the workplace because we can not accurately predict what their needs will be due to rapid advances in technology.…

  19. National Institutes of Health addresses the science of diversity

    PubMed Central

    Valantine, Hannah A.; Collins, Francis S.

    2015-01-01

    The US biomedical research workforce does not currently mirror the nation’s population demographically, despite numerous attempts to increase diversity. This imbalance is limiting the promise of our biomedical enterprise for building knowledge and improving the nation’s health. Beyond ensuring fairness in scientific workforce representation, recruiting and retaining a diverse set of minds and approaches is vital to harnessing the complete intellectual capital of the nation. The complexity inherent in diversifying the research workforce underscores the need for a rigorous scientific approach, consistent with the ways we address the challenges of science discovery and translation to human health. Herein, we identify four cross-cutting diversity challenges ripe for scientific exploration and opportunity: research evidence for diversity’s impact on the quality and outputs of science; evidence-based approaches to recruitment and training; individual and institutional barriers to workforce diversity; and a national strategy for eliminating barriers to career transition, with scientifically based approaches for scaling and dissemination. Evidence-based data for each of these challenges should provide an integrated, stepwise approach to programs that enhance diversity rapidly within the biomedical research workforce. PMID:26392553

  20. Current challenges in quantifying preferential flow through the vadose zone

    NASA Astrophysics Data System (ADS)

    Koestel, John; Larsbo, Mats; Jarvis, Nick

    2017-04-01

    In this presentation, we give an overview of current challenges in quantifying preferential flow through the vadose zone. A review of the literature suggests that current generation models do not fully reflect the present state of process understanding and empirical knowledge of preferential flow. We believe that the development of improved models will be stimulated by the increasingly widespread application of novel imaging technologies as well as future advances in computational power and numerical techniques. One of the main challenges in this respect is to bridge the large gap between the scales at which preferential flow occurs (pore to Darcy scales) and the scale of interest for management (fields, catchments, regions). Studies at the pore scale are being supported by the development of 3-D non-invasive imaging and numerical simulation techniques. These studies are leading to a better understanding of how macropore network topology and initial/boundary conditions control key state variables like matric potential and thus the strength of preferential flow. Extrapolation of this knowledge to larger scales would require support from theoretical frameworks such as key concepts from percolation and network theory, since we lack measurement technologies to quantify macropore networks at these large scales. Linked hydro-geophysical measurement techniques that produce highly spatially and temporally resolved data enable investigation of the larger-scale heterogeneities that can generate preferential flow patterns at pedon, hillslope and field scales. At larger regional and global scales, improved methods of data-mining and analyses of large datasets (machine learning) may help in parameterizing models as well as lead to new insights into the relationships between soil susceptibility to preferential flow and site attributes (climate, land uses, soil types).

  1. Translational Challenges in Cardiovascular Tissue Engineering.

    PubMed

    Emmert, Maximilian Y; Fioretta, Emanuela S; Hoerstrup, Simon P

    2017-04-01

    Valvular heart disease and congenital heart defects represent a major cause of death around the globe. Although current therapy strategies have rapidly evolved over the decades and are nowadays safe, effective, and applicable to many affected patients, the currently used artificial prostheses are still suboptimal. They do not promote regeneration, physiological remodeling, or growth (particularly important aspects for children) as their native counterparts. This results in the continuous degeneration and subsequent failure of these prostheses which is often associated with an increased morbidity and mortality as well as the need for multiple re-interventions. To overcome this problem, the concept of tissue engineering (TE) has been repeatedly suggested as a potential technology to enable native-like cardiovascular replacements with regenerative and growth capacities, suitable for young adults and children. However, despite promising data from pre-clinical and first clinical pilot trials, the translation and clinical relevance of such TE technologies is still very limited. The reasons that currently limit broad clinical adoption are multifaceted and comprise of scientific, clinical, logistical, technical, and regulatory challenges which need to be overcome. The aim of this review is to provide an overview about the translational problems and challenges in current TE approaches. It further suggests directions and potential solutions on how these issues may be efficiently addressed in the future to accelerate clinical translation. In addition, a particular focus is put on the current regulatory guidelines and the associated challenges for these promising TE technologies.

  2. Technological challenges of addressing new and more complex migrating products from novel food packaging materials.

    PubMed

    Munro, Ian C; Haighton, Lois A; Lynch, Barry S; Tafazoli, Shahrzad

    2009-12-01

    The risk assessment of migration products resulting from packaging material has and continues to pose a difficult challenge. In most jurisdictions, there are regulatory requirements for the approval or notification of food contact substances that will be used in packaging. These processes generally require risk assessment to ensure safety concerns are addressed. The science of assessing food contact materials was instrumental in the development of the concept of Threshold of Regulation and the Threshold of Toxicological Concern procedures. While the risk assessment process is in place, the technology of food packaging continues to evolve to include new initiatives, such as the inclusion of antimicrobial substances or enzyme systems to prevent spoilage, use of plastic packaging intended to remain on foods as they are being cooked, to the introduction of more rigid, stable and reusable materials, and active packaging to extend the shelf-life of food. Each new technology brings with it the potential for exposure to new and possibly novel substances as a result of migration, interaction with other chemical packaging components, or, in the case of plastics now used in direct cooking of products, degradation products formed during heating. Furthermore, the presence of trace levels of certain chemicals from packaging that were once accepted as being of low risk based on traditional toxicology studies are being challenged on the basis of reports of adverse effects, particularly with respect to endocrine disruption, alleged to occur at very low doses. A recent example is the case of bisphenol A. The way forward to assess new packaging technologies and reports of very low dose effects in non-standard studies of food contact substances is likely to remain controversial. However, the risk assessment paradigm is sufficiently robust and flexible to be adapted to meet these challenges. The use of the Threshold of Regulation and the Threshold of Toxicological Concern concepts may

  3. Social power and social class: conceptualization, consequences, and current challenges.

    PubMed

    Rucker, Derek D; Galinsky, Adam D

    2017-12-01

    This article offers a primer on social power and social class with respect to their theoretical importance, conceptual distinction, and empirical relationship. We introduce and define the constructs of social power, social class, and one's psychological sense of power. We next explore the complex relationship between social power and social class. Because social class can produce a sense of power within an individual, studies on social power can inform theory and research on social class. We conclude with a discussion of the current challenges and future opportunities for the study of social power and social class. Copyright © 2017 Elsevier Ltd. All rights reserved.

  4. Challenging Assumptions: What Do We Need to Address in Our Disaster Risk Reduction Efforts?

    PubMed

    Codreanu, Tudor A; Ngo, Hanh; Robertson, Andrew; Celenza, Antonio

    2017-04-01

    Introduction Specific knowledge and skills are required, especially in the first 72 hours post-disaster, to bridge the time gap until essential services are restored and Emergency Medical Services (EMS) can focus on individuals' needs. This study explores disaster knowledge and preparedness in the first 72 hours as a function of the individual's engagement in discussions about disasters, and several other factors (both at personal and community/country level), as well as the entities/organizations perceived by the individual as being responsible for disaster risk reduction (DRR) education. A prospective, cross-sectional survey of 3,829 final-year high-school students was conducted in nine countries with different levels of disaster risk and economic development. Regression analyses examined the relationship between a 72-hour disaster preparedness composite outcome (ability to make water safe for drinking, knowledge of water potability, home evacuation skill, and improvising a safe room) and a series of independent predictors. Respondents from countries with lower economic development were significantly better prepared for the first 72 hours post-disaster than those from developed countries (OR=767.45; CI=13.75-48,822.94; P=.001). While several independent predictors showed a significant main effect, combined disaster risk education (DRE) efforts, as a partnership between school and local government, had the best predictive value (OR=3.52; CI=1.48-8.41; P=.005). Disaster preparedness in final-year high-school students is significantly better in developing countries. Further improvement requires a convergent effort in aligning the most effective educational policies and actions to best address the individual's and the community needs. Codreanu TA , Ngo H , Robertson A , Celenza A . Challenging assumptions: what do we need to address in our disaster risk reduction efforts? Prehosp Disaster Med. 2017;32(2):134-147.

  5. The Presidential Address to the Association for Career and Technical Education Research: Using Standards to Reform Teacher Preparation in Career and Technical Education--A Successful Reformation

    ERIC Educational Resources Information Center

    Whittington, M. Susie

    2005-01-01

    This article presents the presidential address at the annual conference of the Association for Career and Technical Education Research by M. Susie Whittington, ACTER President 2005. The purpose of the presidential address is to examine a current issue facing the profession, and pose challenges to the membership in the context of that issue. In her…

  6. Dengue vaccines: recent developments, ongoing challenges and current candidates

    PubMed Central

    McArthur, Monica A.; Sztein, Marcelo B.; Edelman, Robert

    2013-01-01

    Summary Dengue is among the most prevalent and important arbovirus diseases of humans. In order to effectively control this rapidly spreading disease, control of the vector mosquito and a safe and efficacious vaccine are critical. Despite considerable efforts, the development of a successful vaccine has remained elusive. Multiple factors have complicated the creation of a successful vaccine, not the least of which are the complex, immune-mediated responses against four antigenically distinct serotypes necessitating a tetravalent vaccine providing long lasting protective immunity. Despite the multiple impediments, there are currently many promising vaccine candidates in pre-clinical and clinical development. Here we review the recent advances in dengue virus vaccine development and briefly discuss the challenges associated with the use of these vaccines as a public health tool. PMID:23984962

  7. Technical challenges in designing post-marketing eCRFs to address clinical safety and pharmacovigilance needs.

    PubMed

    Lu, Zhengwu

    2010-01-01

    To identify key challenges and propose technical considerations in designing electronic case report form (eCRF) for post-marketing studies, the author undertakes a comprehensive literature review of peer reviewed and grey literature to assess the key aspects, processes, standards, recommendations, and best practices in designing eCRFs based on industry experience in designing and supporting electronic data capture (EDC) studies. Literature search using strings on MEDLINE and PUBMED returned few papers directly related to CRF design. Health informatics and general practice journals were searched and results reviewed. Many conference, government commission, health professional and special interests group websites provide relevant information from practical experience - summarization of this information is presented. Further, we presented a list of concrete technical considerations in dealing with EDC technology/system limitations based on literature assessment and industry implementation experience. It is recognized that cross-functional teams be involved in eCRF design process and decision making. To summarize the keys in designing eCRFs to address post-market study safety and pharmacovigilance needs, the first is to identify required data elements from the study protocol supporting data analyses and reporting requirements. Secondly, accepted best practices, CDASH & CDISC guidelines, and company internal or therapeutic unit standard should be considered and applied. Coding (MedDRA & WHODD) mapping should be managed and implemented as well when possible. Finally, we need to be on top of the EDC technologies, challenge the technologies, drive EDC improvement via working with vendors, and utilize the technologies to drive clinical effectiveness. Copyright (c) 2009 Elsevier Inc. All rights reserved.

  8. A Few Examples of Spacecraft Anomalies Attributed to Transient Voltages and Currents Issues

    NASA Technical Reports Server (NTRS)

    Perez, Ray

    2006-01-01

    It is easy to address voltage and current transient related issues when the hardware in question or similar type of hardware is always available to you and when such issues are deterministic in nature. Unexpected or unforeseen transient related problems are not always a challenge but become a severe concern when a unique piece of the hardware, which developed the problem, is in space; as it is with all satellites. This paper addresses in a qualitative manner, a few examples of voltage and current events of transient origin which disabled space hardware.

  9. IFE Chamber Technology - Status and Future Challenges

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

    Meier, W.R.; Raffray, A.R.; Abdel-Khalik, S.I.

    2003-07-15

    Significant progress has been made on addressing critical issues for inertial fusion energy (IFE) chambers for heavy-ion, laser and Z-pinch drivers. A variety of chamber concepts are being investigated including drywall (currently favored for laser IFE), wetted-wall (applicable to both laser and ion drivers), and thick-liquid-wall (favored by heavy ion and z-pinch drivers). Recent progress and remaining challenges in developing IFE chambers are reviewed.

  10. Natural Products in Caries Research: Current (Limited) Knowledge, Challenges and Future Perspective

    PubMed Central

    Jeon, J.-G; Rosalen, P.L.; Falsetta, M.L.; Koo, H.

    2011-01-01

    Dental caries is the most prevalent and costly oral infectious disease worldwide. Virulent biofilms firmly attached to tooth surfaces are prime biological factors associated with this disease. The formation of an exopolysaccharide-rich biofilm matrix, acidification of the milieu and persistent low pH at the tooth-biofilm interface are major controlling virulence factors that modulate dental caries pathogenesis. Each one offers a selective therapeutic target for prevention. Although fluoride, delivered in various modalities, remains the mainstay for the prevention of caries, additional approaches are required to enhance its effectiveness. Available antiplaque approaches are based on the use of broad-spectrum microbicidal agents, e.g. chlorhexidine. Natural products offer a rich source of structurally diverse substances with a wide range of biological activities, which could be useful for the development of alternative or adjunctive anticaries therapies. However, it is a challenging approach owing to complex chemistry and isolation procedures to derive active compounds from natural products. Furthermore, most of the studies have been focused on the general inhibitory effects on glucan synthesis as well as on bacterial metabolism and growth, often employing methods that do not address the pathophysiological aspects of the disease (e.g. bacteria in biofilms) and the length of exposure/retention in the mouth. Thus, the true value of natural products in caries prevention and/or their exact mechanisms of action remain largely unknown. Nevertheless, natural substances potentially active against virulent properties of cariogenic organisms have been identified. This review focuses on gaps in the current knowledge and presents a model for investigating the use of natural products in anticaries chemotherapy. PMID:21576957

  11. Women in physics in El Salvador: Historical perspectives and current challenges

    NASA Astrophysics Data System (ADS)

    Jiménez, Telma; Jiménez, Diana; Larios, Gloria

    2015-12-01

    Physics as a discipline in El Salvador's higher education system has struggled historically; however, since 1991, it has enjoyed a growth-friendly environment. While there are few female physicists in El Salvador, they are employed in various organizations and educational institutions, demonstrating that physics is a viable career path. El Salvador currently offers a range of opportunities for women in physics. With the support of the 5th IUPAP International Conference on Women in Physics, we will both meet the challenges and take advantage of the opportunities that face female physicists in El Salvador.

  12. The Vocational Education and Training System in Bulgaria. Current Situation, Challenges and Reform Needs.

    ERIC Educational Resources Information Center

    Pantaleev, Tzako; Kalandarova, Natalia; Dineva, Nedka; Panev, Georgi; Petrova, Iskra

    This report reviews the current situation of Bulgaria's vocational education and training (VET) system to identify challenges facing the system and areas needing reform. Section 1 explores the following five aspects of Bulgaria's political and socioeconomic situation: (1) demography; (2) economic developments (privatization of state enterprises,…

  13. 75 FR 37752 - Measuring Progress on Food Safety: Current Status and Future Directions; Public Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-06-30

    ... foodborne illness. FSIS, FDA, and CDC are collaborating to address the methodological and data challenges... regarding metrics and on current methods being used. Accordingly, the Agencies will hold two regional public...

  14. Nutritional issues for older adults: addressing degenerative ageing with long-term studies.

    PubMed

    de Groot, Lisette C P G M

    2016-05-01

    The ageing process is influenced by a variety of factors, including extrinsic, malleable lifestyle variables. The present paper deals with the epidemiological evidence for the role of dietary patterns and key nutritional concerns in relation to survival and ageing-related disorders that present themselves in later life. Healthful dietary patterns appear to be most relevant in old age. Specific nutritional concerns are related to vitamin D, vitamin B12 and protein malnutrition. An important challenge to further expand the knowledge base is currently addressed by the NuAge project, acknowledging the complexity of the ageing process and integrating different dimensions of research into human healthy ageing. In the meantime, reversing poor adherence to existing guidelines for a healthy diet remains a first challenge in public health nutritional practices.

  15. A Canadian Effort to Address Fractions Teaching and Learning Challenges

    ERIC Educational Resources Information Center

    Yearley, Shelley; Bruce, Catherine D.

    2014-01-01

    Teaching and learning fraction concepts provides challenges in primary schools all over the world. In this article, Shelley Yearley and Catherine Bruce describe a fractions-based research project conducted in Ontario, Canada.

  16. Current Challenges in Neurotoxicity Risk Assessment ...

    EPA Pesticide Factsheets

    Neurotoxicity risk assessment must continue to evolve in parallel with advances in basic research. Along with this evolution is an expansion in the scope of neurotoxicity assessments of environmental health risks. Examples of this expansion include an increasing emphasis on complex animal models that better replicate human behavior and a wider array of molecular and mechanistic data relevant to interpreting the underlying cause(s) of toxicity. However, modern neurotoxicology studies are often more nuanced and complicated than traditional studies, and they often vary considerably in evaluation methods from one study to the next, impeding comparisons. This can pose particular difficulties for risk assessors, especially given the recent demand for chemical risk assessments to be more systematic and transparent. This presentation will introduce and provide some examples of specific challenges in neurotoxicity assessments of environmental chemicals. Some of these challenges are relatively new to the field, such as the incorporation of data on neuron-supportive glial cells into hazard characterization, while other challenges have persisted for several decades, but only recently are studies being designed to evaluate them, including analyses of latent neurotoxicity. The examples provided illustrate some future research areas of interest for scientists and risk assessors examining human neurotoxicity risk. This abstract will be presented to internal U.S. Food and Drug A

  17. Cancer Core Europe: a consortium to address the cancer care-cancer research continuum challenge.

    PubMed

    Eggermont, Alexander M M; Caldas, Carlos; Ringborg, Ulrik; Medema, René; Tabernero, Josep; Wiestler, Otmar

    2014-11-01

    European cancer research for a transformative initiative by creating a consortium of six leading excellent comprehensive cancer centres that will work together to address the cancer care-cancer research continuum. Prerequisites for joint translational and clinical research programs are very demanding. These require the creation of a virtual single 'e-hospital' and a powerful translational platform, inter-compatible clinical molecular profiling laboratories with a robust underlying computational biology pipeline, standardised functional and molecular imaging, commonly agreed Standard Operating Procedures (SOPs) for liquid and tissue biopsy procurement, storage and processing, for molecular diagnostics, 'omics', functional genetics, immune-monitoring and other assessments. Importantly also it requires a culture of data collection and data storage that provides complete longitudinal data sets to allow for: effective data sharing and common database building, and to achieve a level of completeness of data that is required for conducting outcome research, taking into account our current understanding of cancers as communities of evolving clones. Cutting edge basic research and technology development serve as an important driving force for innovative translational and clinical studies. Given the excellent track records of the six participants in these areas, Cancer Core Europe will be able to support the full spectrum of research required to address the cancer research- cancer care continuum. Cancer Core Europe also constitutes a unique environment to train the next generation of talents in innovative translational and clinical oncology. Copyright © 2014. Published by Elsevier Ltd.

  18. A systematic review and checklist presenting the main challenges for health economic modeling in personalized medicine: towards implementing patient-level models.

    PubMed

    Degeling, Koen; Koffijberg, Hendrik; IJzerman, Maarten J

    2017-02-01

    The ongoing development of genomic medicine and the use of molecular and imaging markers in personalized medicine (PM) has arguably challenged the field of health economic modeling (HEM). This study aims to provide detailed insights into the current status of HEM in PM, in order to identify if and how modeling methods are used to address the challenges described in literature. Areas covered: A review was performed on studies that simulate health economic outcomes for personalized clinical pathways. Decision tree modeling and Markov modeling were the most observed methods. Not all identified challenges were frequently found, challenges regarding companion diagnostics, diagnostic performance, and evidence gaps were most often found. However, the extent to which challenges were addressed varied considerably between studies. Expert commentary: Challenges for HEM in PM are not yet routinely addressed which may indicate that either (1) their impact is less severe than expected, (2) they are hard to address and therefore not managed appropriately, or (3) HEM in PM is still in an early stage. As evidence on the impact of these challenges is still lacking, we believe that more concrete examples are needed to illustrate the identified challenges and to demonstrate methods to handle them.

  19. 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.

  20. Teaching Digital Natives: Promoting Information Literacy and Addressing Instructional Challenges

    ERIC Educational Resources Information Center

    Neumann, Crystal

    2016-01-01

    Technology must be used as a teaching and learning tool to help students succeed. However, educators must be proactive in identifying some of the pitfalls of technology, such as information illiteracy. The phenomenological study covers how English instructors from Indianapolis, who teach first year students, address information literacy and the…

  1. Youth-Onset Type 2 Diabetes Consensus Report: Current Status, Challenges, and Priorities

    PubMed Central

    Nadeau, Kristen J.; Anderson, Barbara J.; Berg, Erika G.; Chiang, Jane L.; Chou, Hubert; Copeland, Kenneth C.; Hannon, Tamara S.; Huang, Terry T.-K.; Lynch, Jane L.; Powell, Jeff; Sellers, Elizabeth; Tamborlane, William V.

    2016-01-01

    Type 2 diabetes is a significant and increasing burden in adolescents and young adults. Clear strategies for research, prevention, and treatment of the disease in these vulnerable patients are needed. Evidence suggests that type 2 diabetes in children is different not only from type 1 but also from type 2 diabetes in adults. Understanding the unique pathophysiology of type 2 diabetes in youth, as well as the risk of complications and the psychosocial impact, will enable industry, academia, funding agencies, advocacy groups, and regulators to collectively evaluate both current and future research, treatment, and prevention approaches. This Consensus Report characterizes type 2 diabetes in children, evaluates the fundamental differences between childhood and adult disease, describes the current therapeutic options, and discusses challenges to and approaches for developing new treatments. PMID:27486237

  2. Ebola crisis of 2014: are current strategies enough to meet the long-run challenges ahead?

    PubMed

    Gimm, Gilbert; Nichols, Len M

    2015-05-01

    The outbreak of the Ebola virus disease (EVD) in 2014 mobilized international efforts to contain a global health crisis. The emergence of the deadly virus in the United States and Europe among health care workers intensified fears of a worldwide epidemic. Market incentives for pharmaceutical firms to allocate their research and development resources toward Ebola treatments were weak because the limited number of EVD cases were previously confined to rural areas of West Africa. We discuss 3 policy recommendations to address the long-term challenges of EVD in an interconnected world.

  3. Stem cell technology for tendon regeneration: current status, challenges, and future research directions

    PubMed Central

    Lui, Pauline Po Yee

    2015-01-01

    Tendon injuries are a common cause of physical disability. They present a clinical challenge to orthopedic surgeons because injured tendons respond poorly to current treatments without tissue regeneration and the time required for rehabilitation is long. New treatment options are required. Stem cell-based therapies offer great potential to promote tendon regeneration due to their high proliferative, synthetic, and immunomodulatory activities as well as their potential to differentiate to the target cell types and undergo genetic modification. In this review, I first recapped the challenges of tendon repair by reviewing the anatomy of tendon. Next, I discussed the advantages and limitations of using different types of stem cells compared to terminally differentiated cells for tendon tissue engineering. The safety and efficacy of application of stem cells and their modified counterparts for tendon tissue engineering were then summarized after a systematic literature search in PubMed. The challenges and future research directions to enhance, optimize, and standardize stem cell-based therapies for augmenting tendon repair were then discussed. PMID:26715856

  4. Childhood Poverty in Colorado: A Closer Look at a Statewide Challenge

    ERIC Educational Resources Information Center

    Piscopo, Lisa

    2009-01-01

    The nation's recent economic problems underscore the urgency of addressing the challenges that low-income families face. The current economic downturn will exacerbate what already are troubling trends in Colorado--namely, that too many children in the state live in poverty and these numbers are growing rapidly. Until updated data are available, it…

  5. Promises and challenges in solid-state lighting

    NASA Astrophysics Data System (ADS)

    Schubert, Fred

    2010-03-01

    Lighting technologies based on semiconductor light-emitting diodes (LEDs) offer unprecedented promises that include three major benefits: (i) Gigantic energy savings enabled by efficient conversion of electrical energy to optical energy; (ii) Substantial positive contributions to sustainability through reduced emissions of global-warming gases, acid-rain gases, and toxic substances such as mercury; and (iii) The creation of new paradigms in lighting driven by the unique controllability of solid-state lighting sources. Due to the powerful nature of these benefits, the transition from conventional lighting sources to solid-state lighting is virtually assured. This presentation will illustrate the new world of lighting and illustrate the pervasive changes to be expected in lighting, displays, communications, and biotechnology. The presentation will also address the formidable challenges that must be addressed to continue the further advancement of solid-state lighting technology. These challenges offer opportunities for research and innovation. Specific challenges include light management, carrier transport, and optical design. We will present some innovative approaches in order to solve known technical challenges faced by solid-state lighting. These approaches include the demonstration and use of new optical thin-film materials with a continuously tunable refractive index. These approaches also include the use of polarization-matched structures that reduce the polarization fields in GaInN LEDs and the hotly debated efficiency droop, that is, the decreasing LED efficiency at high currents.

  6. Planetary Cartography - Activities and Current Challenges

    NASA Astrophysics Data System (ADS)

    Nass, Andrea; Di, Kaichang; Elgner, Stephan; van Gasselt, Stephan; Hare, Trent; Hargitai, Henrik; Karachevtseva, Irina; Kereszturi, Akos; Kersten, Elke; Kokhanov, Alexander; Manaud, Nicolas; Roatsch, Thomas; Rossi, Angelo Pio; Skinner, James, Jr.; Wählisch, Marita

    2018-05-01

    Maps are one of the most important tools for communicating geospatial information between producers and receivers. Geospatial data, tools, contributions in geospatial sciences, and the communication of information and transmission of knowledge are matter of ongoing cartographic research. This applies to all topics and objects located on Earth or on any other body in our Solar System. In planetary science, cartography and mapping have a history dating back to the roots of telescopic space exploration and are now facing new technological and organizational challenges with the rise of new missions, new global initiatives, organizations and opening research markets. The focus of this contribution is to introduce the community to the field of planetary cartography and its historic foundation, to highlight some of the organizations involved and to emphasize challenges that Planetary Cartography has to face today and in the near future.

  7. Recent advancements in bioremediation of dye: Current status and challenges.

    PubMed

    Vikrant, Kumar; Giri, Balendu Shekhar; Raza, Nadeem; Roy, Kangkan; Kim, Ki-Hyun; Rai, Birendra Nath; Singh, Ram Sharan

    2018-04-01

    The rampant industrialization and unchecked growth of modern textile production facilities coupled with the lack of proper treatment facilities have proliferated the discharge of effluents enriched with toxic, baleful, and carcinogenic pollutants including dyes, heavy metals, volatile organic compounds, odorants, and other hazardous materials. Therefore, the development of cost-effective and efficient control measures against such pollution is imperative to safeguard ecosystems and natural resources. In this regard, recent advances in biotechnology and microbiology have propelled bioremediation as a prospective alternative to traditional treatment methods. This review was organized to address bioremediation as a practical option for the treatment of dyes by evaluating its performance and typical attributes. It further highlights the current hurdles and future prospects for the abatement of dyes via biotechnology-based remediation techniques. Copyright © 2018 Elsevier Ltd. All rights reserved.

  8. Current Challenges in the First Principle Quantitative Modelling of the Lower Hybrid Current Drive in Tokamaks

    NASA Astrophysics Data System (ADS)

    Peysson, Y.; Bonoli, P. T.; Chen, J.; Garofalo, A.; Hillairet, J.; Li, M.; Qian, J.; Shiraiwa, S.; Decker, J.; Ding, B. J.; Ekedahl, A.; Goniche, M.; Zhai, X.

    2017-10-01

    The Lower Hybrid (LH) wave is widely used in existing tokamaks for tailoring current density profile or extending pulse duration to steady-state regimes. Its high efficiency makes it particularly attractive for a fusion reactor, leading to consider it for this purpose in ITER tokamak. Nevertheless, if basics of the LH wave in tokamak plasma are well known, quantitative modeling of experimental observations based on first principles remains a highly challenging exercise, despite considerable numerical efforts achieved so far. In this context, a rigorous methodology must be carried out in the simulations to identify the minimum number of physical mechanisms that must be considered to reproduce experimental shot to shot observations and also scalings (density, power spectrum). Based on recent simulations carried out for EAST, Alcator C-Mod and Tore Supra tokamaks, the state of the art in LH modeling is reviewed. The capability of fast electron bremsstrahlung, internal inductance li and LH driven current at zero loop voltage to constrain all together LH simulations is discussed, as well as the needs of further improvements (diagnostics, codes, LH model), for robust interpretative and predictive simulations.

  9. Nature-Based Solutions in the EU: Innovating with nature to address social, economic and environmental challenges.

    PubMed

    Faivre, Nicolas; Fritz, Marco; Freitas, Tiago; de Boissezon, Birgit; Vandewoestijne, Sofie

    2017-11-01

    Contemporary societies are facing a broad range of challenges, from pressures on human health and well-being to natural capital depletion, and the security of food, water and energy. These challenges are deeply intertwined with global processes, such as climate change and with local events such as natural disasters. The EU's research & innovation (R&I) policy is now seeking to address these challenges from a new perspective, with Nature-Based Solutions, and turn them into innovation opportunities that optimise the synergies between nature, society and the economy. Nature-Based Solutions can be an opportunity for innovation, and are here promoted by both policymakers and practitioners as a cost-effective way of creating a greener, more sustainable, and more competitive economy. Since 2013, the European Commission has devoted particular attention to Nature-Based Solutions through consultations and dialogues that sought to make the concept of these solutions more concrete and to define the concept's place within the spectrum of ecosystem-based approaches. In 2014, the Commission launched an expert group, which conducted further analysis, and made recommendations to help increase the use of Nature-Based Solutions and bring nature back into cities. In 2015, a survey was conducted on citizens' views and perceptions of 'Nature in Cities' to provide further insight for future work. Based on these elements and on results from running EU projects, the Commission has developed an R&I agenda for Nature-Based Solutions and has published targeted calls for proposals for large-scale demonstration projects in this field in 2016 and 2017. Additional R&I actions at EU level that promote systemic Nature-Based Solutions and their benefits to cities and territories are planned with the aim to improve the implementation capacity and evidence base for deploying Nature-Based Solutions and developing corresponding future markets. They are also expected to foster an interdisciplinary R

  10. Planetary Atmosphere and Surfaces Chamber (PASC): A Platform to Address Various Challenges in Astrobiology

    NASA Astrophysics Data System (ADS)

    Mateo-Marti, Eva

    2014-08-01

    stability and presence of certain minerals on planetary surfaces and the potential habitability of microorganisms under various planetary environmental conditions can be studied using our apparatus. Therefore, these simulation chambers can address multiple different challenging and multidisciplinary astrobiological studies.

  11. Addressing Reticence: The Challenge of Engaging Reluctant Adult ESL Students

    ERIC Educational Resources Information Center

    Carter, Steven J.; Henrichsen, Lynn E.

    2015-01-01

    Reticence frequently prevents adult ESL learners from learning as much as they otherwise might. The nature of second-language learning requires frequent performance that may challenge students' self-concepts, leading to reticence and self-consciousness. To reduce or prevent this problem, teachers must employ appropriate pedagogical and classroom…

  12. Addressing a Nation's Challenge: Graduate Programs in Gerontology in Israel

    ERIC Educational Resources Information Center

    Carmel, Sara; Lowenstein, Ariela

    2007-01-01

    Like other developed nations, Israel has rapidly aged. This demographic revolution has created new challenges for Israeli society. We describe the societal background, including the emerging societal needs, solutions, and problems, as well as the professional principles, which guided us in developing the first two Israeli academic programs in…

  13. Drugs for Neglected Diseases initiative model of drug development for neglected diseases: current status and future challenges.

    PubMed

    Ioset, Jean-Robert; Chang, Shing

    2011-09-01

    The Drugs for Neglected Diseases initiative (DNDi) is a patients' needs-driven organization committed to the development of new treatments for neglected diseases. Created in 2003, DNDi has delivered four improved treatments for malaria, sleeping sickness and visceral leishmaniasis. A main DNDi challenge is to build a solid R&D portfolio for neglected diseases and to deliver preclinical candidates in a timely manner using an original model based on partnership. To address this challenge DNDi has remodeled its discovery activities from a project-based academic-bound network to a fully integrated process-oriented platform in close collaboration with pharmaceutical companies. This discovery platform relies on dedicated screening capacity and lead-optimization consortia supported by a pragmatic, structured and pharmaceutical-focused compound sourcing strategy.

  14. Prenatal screening: current practice, new developments, ethical challenges.

    PubMed

    de Jong, Antina; Maya, Idit; van Lith, Jan M M

    2015-01-01

    Prenatal screening pathways, as nowadays offered in most Western countries consist of similar tests. First, a risk-assessment test for major aneuploides is offered to pregnant women. In case of an increased risk, invasive diagnostic tests, entailing a miscarriage risk, are offered. For decades, only conventional karyotyping was used for final diagnosis. Moreover, several foetal ultrasound scans are offered to detect major congenital anomalies, but the same scans also provide relevant information for optimal support of the pregnancy and the delivery. Recent developments in prenatal screening include the application of microarrays that allow for identifying a much broader range of abnomalities than karyotyping, and non-invasive prenatal testing (NIPT) that enables reducing the number of invasive tests for aneuploidies considerably. In the future, broad NIPT may become possible and affordable. This article will briefly address the ethical issues raised by these technological developments. First, a safe NIPT may lead to routinisation and as such challenge the central issue of informed consent and the aim of prenatal screening: to offer opportunity for autonomous reproductive choice. Widening the scope of prenatal screening also raises the question to what extent 'reproductive autonomy' is meant to expand. Finally, if the same test is used for two different aims, namely detection of foetal anomalies and pregnancy-related problems, non-directive counselling can no longer be taken as a standard. Our broad outline of the ethical issues is meant as an introduction into the more detailed ethical discussions about prenatal screening in the other articles of this special issue. © 2014 John Wiley & Sons Ltd.

  15. The GÉANT network: addressing current and future needs of the HEP community

    NASA Astrophysics Data System (ADS)

    Capone, Vincenzo; Usman, Mian

    2015-12-01

    coordinated the setup of the network infrastructure to perform the BELLE II Trans-Atlantic Data Challenge, and has been active on helping the BELLE II community to sort out their end-to-end performance issues. In this talk we will provide information about the current GÉANT network architecture and of the international connectivity, along with the upcoming upgrades and the planned and foreseeable improvements. We will also describe the implementation of the solutions provided to support the LHC and BELLE II experiments.

  16. 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.

  17. Current and New Approaches in GMO Detection: Challenges and Solutions

    PubMed Central

    Fraiture, Marie-Alice; Herman, Philippe; Taverniers, Isabel; Deforce, Dieter; Roosens, Nancy H.

    2015-01-01

    In many countries, genetically modified organisms (GMO) legislations have been established in order to guarantee the traceability of food/feed products on the market and to protect the consumer freedom of choice. Therefore, several GMO detection strategies, mainly based on DNA, have been developed to implement these legislations. Due to its numerous advantages, the quantitative PCR (qPCR) is the method of choice for the enforcement laboratories in GMO routine analysis. However, given the increasing number and diversity of GMO developed and put on the market around the world, some technical hurdles could be encountered with the qPCR technology, mainly owing to its inherent properties. To address these challenges, alternative GMO detection methods have been developed, allowing faster detections of single GM target (e.g., loop-mediated isothermal amplification), simultaneous detections of multiple GM targets (e.g., PCR capillary gel electrophoresis, microarray, and Luminex), more accurate quantification of GM targets (e.g., digital PCR), or characterization of partially known (e.g., DNA walking and Next Generation Sequencing (NGS)) or unknown (e.g., NGS) GMO. The benefits and drawbacks of these methods are discussed in this review. PMID:26550567

  18. Current and new approaches in GMO detection: challenges and solutions.

    PubMed

    Fraiture, Marie-Alice; Herman, Philippe; Taverniers, Isabel; De Loose, Marc; Deforce, Dieter; Roosens, Nancy H

    2015-01-01

    In many countries, genetically modified organisms (GMO) legislations have been established in order to guarantee the traceability of food/feed products on the market and to protect the consumer freedom of choice. Therefore, several GMO detection strategies, mainly based on DNA, have been developed to implement these legislations. Due to its numerous advantages, the quantitative PCR (qPCR) is the method of choice for the enforcement laboratories in GMO routine analysis. However, given the increasing number and diversity of GMO developed and put on the market around the world, some technical hurdles could be encountered with the qPCR technology, mainly owing to its inherent properties. To address these challenges, alternative GMO detection methods have been developed, allowing faster detections of single GM target (e.g., loop-mediated isothermal amplification), simultaneous detections of multiple GM targets (e.g., PCR capillary gel electrophoresis, microarray, and Luminex), more accurate quantification of GM targets (e.g., digital PCR), or characterization of partially known (e.g., DNA walking and Next Generation Sequencing (NGS)) or unknown (e.g., NGS) GMO. The benefits and drawbacks of these methods are discussed in this review.

  19. Addressing Physics Grand Challenges Using the Jefferson Lab FEL

    NASA Astrophysics Data System (ADS)

    Williams, Gwyn P.

    2006-11-01

    The Jefferson Lab Free Electron Laser[1] is the first of the so-called 4^th generation light sources to go operational. Capable of delivering extraordinarily bright, tunable light in ultrafast pulses from THz[2] through infrared to UV, the facility extends the experimental reach of accelerator-based light-sources by many orders of magnitude. This allows new opportunities to study many of the ``Grand Challenges'' recently defined by the Office of Science, Basic Energy Sciences Division, most of which are concerned with understandings of equilibrium and non-equilibrium behavior of materials in physics, chemistry and biology using precise pump and probe techniques. Specifically, in condensed matter physics, the JLab FEL permits new studies which go beyond earlier studies of reductionist behavior to those which examine emergent behavior. Thus, the understanding of high Tc superconductivity, colossal magneto-resistance, and observations of the breakdown of the Born-Oppenheimer approximation, are examples of collective behavior which is now treated theoretically via the concept of quasiparticles. In this presentation we will describe the dual pathways of light source development and physics challenges, and then show how they are combined in experiments that allow new insights to be developed to understand material function. We will illustrate this with details of the evolution of accelerator-based light sources, and with examples of work performed to date. References: [1] Neil et al. Phys. Rev.Letts 84, 662 (2000). [2] Carr, Martin, McKinney, Neil, Jordan & Williams, Nature 420, 153 (2002).

  20. Live attenuated vaccines: Historical successes and current challenges

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

    Minor, Philip D., E-mail: Philip.Minor@nibsc.org

    Live attenuated vaccines against human viral diseases have been amongst the most successful cost effective interventions in medical history. Smallpox was declared eradicated in 1980; poliomyelitis is nearing global eradication and measles has been controlled in most parts of the world. Vaccines function well for acute diseases such as these but chronic infections such as HIV are more challenging for reasons of both likely safety and probable efficacy. The derivation of the vaccines used has in general not been purely rational except in the sense that it has involved careful clinical trials of candidates and subsequent careful follow up inmore » clinical use; the identification of the candidates is reviewed. - Highlights: • Live vaccines against human diseases caused by viruses have been very successful. • They have been developed by empirical clinical studies and problems identified in later use. • It can be difficult to balance ability to cause disease and ability to immunise for a strain. • There is currently no reliable basis for predicting success from pure virological studies. • Vaccinia, which eradicated smallpox, is the paradigm for all successes and issues.« less

  1. 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.

  2. Water Utility Management Strategies in Turkey: The current situation and the challenges

    NASA Astrophysics Data System (ADS)

    Alp, E.; Aksoy, M. N.; Koçer, B.

    2013-12-01

    As the effects of climate change becomes more prominent, current challenges related to water and wastewater management is becoming more serious. Providing water that satisfies environmental and safety standards in terms of quantity and quality is needed to maintain human life without compromising the need of future generations. Besides providing safe and affordable water, necessary treatment should be achieved according to several important factors such as receiving body standards, discharge standards, water reuse options. Therefore, management of water becomes more crucial than ever that states have to provide accessibility of safe water with affordable cost to its citizens with the means of effective utility management, including water treatment facilities, wastewater treatment facilities, water supply facilities and water distribution systems. Water utilities encounter with several challenges related to cost, infrastructure, population, legislation, workforce and resource. This study aims to determine the current situation and the necessary strategies to improve utility management in Turkish municipalities in a sustainable manner. US Environment Protection Agency (EPA) has formed a tool on effective utility management that assists utilities to provide a solution for both current and future challenges. In this study, we used EPA's guidelines and developed a survey consists of 60 questions under 10 sub-topics (Product Quality, Employee & Leadership Development, Stakeholder Understanding & Support, Operational Optimization, Infrastructure Stability, Financial Viability, Community Sustainability, Customer Satisfaction, Operational Resiliency, and Water Resource Adequacy). This survey was sent to the managers of 25 metropolitan municipalities in Turkey to assess the current condition of municipalities. After the evaluation of the survey results for each topic, including the importance given by managers, facilities were rated according to their level of achievement

  3. The Evolution of Chemical High-Throughput Experimentation To Address Challenging Problems in Pharmaceutical Synthesis.

    PubMed

    Krska, Shane W; DiRocco, Daniel A; Dreher, Spencer D; Shevlin, Michael

    2017-12-19

    The structural complexity of pharmaceuticals presents a significant challenge to modern catalysis. Many published methods that work well on simple substrates often fail when attempts are made to apply them to complex drug intermediates. The use of high-throughput experimentation (HTE) techniques offers a means to overcome this fundamental challenge by facilitating the rational exploration of large arrays of catalysts and reaction conditions in a time- and material-efficient manner. Initial forays into the use of HTE in our laboratories for solving chemistry problems centered around screening of chiral precious-metal catalysts for homogeneous asymmetric hydrogenation. The success of these early efforts in developing efficient catalytic steps for late-stage development programs motivated the desire to increase the scope of this approach to encompass other high-value catalytic chemistries. Doing so, however, required significant advances in reactor and workflow design and automation to enable the effective assembly and agitation of arrays of heterogeneous reaction mixtures and retention of volatile solvents under a wide range of temperatures. Associated innovations in high-throughput analytical chemistry techniques greatly increased the efficiency and reliability of these methods. These evolved HTE techniques have been utilized extensively to develop highly innovative catalysis solutions to the most challenging problems in large-scale pharmaceutical synthesis. Starting with Pd- and Cu-catalyzed cross-coupling chemistry, subsequent efforts expanded to other valuable modern synthetic transformations such as chiral phase-transfer catalysis, photoredox catalysis, and C-H functionalization. As our experience and confidence in HTE techniques matured, we envisioned their application beyond problems in process chemistry to address the needs of medicinal chemists. Here the problem of reaction generality is felt most acutely, and HTE approaches should prove broadly enabling

  4. Preventing and Addressing Challenging Behavior: Common Questions and Practical Strategies

    ERIC Educational Resources Information Center

    Hemmeter, Mary Louise; Ostrosky, Michaelene M.; Corso, Robert M.

    2012-01-01

    The purpose of this article is to offer preschool teachers strategies for preventing challenging behavior and supporting the development of social skills and emotional competencies. This article is framed in a question and answer format using questions from teachers who the authors have worked with in the past. These questions and strategies are…

  5. Symposium: Animal welfare challenges for today and tomorrow.

    PubMed

    Vizzier Thaxton, Yvonne; Christensen, Karen D; Mench, Joy A; Rumley, Elizabeth R; Daugherty, Christine; Feinberg, Bruce; Parker, Molly; Siegel, Paul; Scanes, Colin G

    2016-09-01

    The increasing separation of the public from production agriculture means there is often a lack of knowledge among consumers about current production practices and a perception that increased productivity and economic efficiency are necessarily associated with a decline in animal welfare. A symposium was organized to present information about animal welfare issues and the challenges they pose for both scientists and the poultry and allied industries. Companion papers provide information about understanding public attitudes and physiological/immunological approaches to welfare assessment, while this paper outlines current and future challenges to egg and meat production and industry responses to those challenges. For broiler chickens, increases in growth rate result in corollary increases in metabolic heat generation and water consumption, leading to the need for continuing improvements in housing, ventilation, and litter management. Stocking densities, lighting programs, muscle myopathies, and use of antibiotics are also areas that require research attention. In the layer industry, the key challenge is housing, with the industry undergoing a shift from conventional cage housing to alternatives like enriched colonies or cage-free. While these alternative systems have hen welfare advantages, there are also welfare disadvantages that require the development of mitigation strategies, and it is also essential to address associated issues including economic, environmental, egg safety, and worker health impacts. Concerns on the horizon include euthanasia of surplus male chicks and spent hens as well as beak-trimming. The humaneness of slaughter methods is an important welfare and consumer confidence issue, and the current regulations for poultry slaughter in the USA are discussed and compared to those for livestock. The poultry and allied industries, including retailers, are responding to these concerns by consulting with experts, developing science-based animal care

  6. Health impact assessment in Mongolia: current situation, directions, and challenges.

    PubMed

    Spickett, Jeff; Batmunkh, Tsetsegsaikhan; Jones, Sarah

    2015-03-01

    Many developing countries have limited capacity to adequately assess and manage health impacts associated with environmental change. In Mongolia, methodologies to introduce health impact assessment (HIA) as part of the environmental impact assessment (EIA) process have been investigated, and a mechanism to incorporate HIA into the current EIA process is proposed. Some challenges to the implementation of HIA are discussed. The country is now in a position to incorporate HIA as part of the approvals process for development projects. Given the recent growth in population, industrial development, and urbanization together with the interest from international mining companies in the resources of the country, it is important for Mongolia to have such tools in place in order to take advantage of economic growth while improving health and well-being outcomes for the population. © 2012 APJPH.

  7. Identifying and Addressing Challenges to Research in University Laboratory Preschools

    ERIC Educational Resources Information Center

    File, Nancy

    2012-01-01

    Research Findings: This essay offers a review of challenges that university laboratory preschools face in providing a site for research that fits with other components of the program mission. An argument is made to consider paradigm shifts in research questions and methods that move away from traditions within the fields that study children's…

  8. Evaluating a School-Based Day Treatment Program for Students with Challenging Behaviors

    ERIC Educational Resources Information Center

    Hickman, Antoine Lewis

    2014-01-01

    Jade County Public Schools has provided school-based therapeutic day treatment in its public schools for more than 10 years. This program was adopted by the school system to provide an intervention in the school and classroom to address the challenging behaviors of students with emotional and behavioral disorders. Currently, three human services…

  9. The role and challenges of the food industry in addressing chronic disease

    PubMed Central

    2010-01-01

    Summary Increasingly, food companies play an important role in stemming the rising burden of nutrition-related chronic diseases. Concrete actions taken by these companies include global public commitments to address food reformulation, consumer information, responsible marketing, promotion of healthy lifestyles, and public-private partnerships. These actions are reviewed together with eleven specific PepsiCo goals and commitments that address products, the marketplace, and communities at large. Interim progress on these goals and commitments are discussed as well as constraints hampering faster progress. Further disease prevention depends on increasing implementation of private-public initiatives. PMID:20509876

  10. Biomanufacturing of Therapeutic Cells: State of the Art, Current Challenges, and Future Perspectives.

    PubMed

    Roh, Kyung-Ho; Nerem, Robert M; Roy, Krishnendu

    2016-06-07

    Stem cells and other functionally defined therapeutic cells (e.g., T cells) are promising to bring hope of a permanent cure for diseases and disorders that currently cannot be cured by conventional drugs or biological molecules. This paradigm shift in modern medicine of using cells as novel therapeutics can be realized only if suitable manufacturing technologies for large-scale, cost-effective, reproducible production of high-quality cells can be developed. Here we review the state of the art in therapeutic cell manufacturing, including cell purification and isolation, activation and differentiation, genetic modification, expansion, packaging, and preservation. We identify current challenges and discuss opportunities to overcome them such that cell therapies become highly effective, safe, and predictively reproducible while at the same time becoming affordable and widely available.

  11. Student service members/veterans on campus: Challenges for reintegration.

    PubMed

    Borsari, Brian; Yurasek, Ali; Miller, Mary Beth; Murphy, James G; McDevitt-Murphy, Meghan E; Martens, Matthew P; Darcy, Monica G; Carey, Kate B

    2017-01-01

    Many returning OIF/OEF/OND Veterans are seeking higher education in an effort to develop a meaningful career and financial stability. Evidence suggests that student service members/veterans (SSM/Vs) are experiencing less academic success than other students. The purpose of this review is to identify the unique challenges of SSM/Vs and evaluate current campus efforts to facilitate their retention and academic performance. With a focus on SSM/Vs attending colleges and universities, we obtained 57 peer-reviewed and 73 gray literature records published between 2001 and 2015. The current SSM/V literature contains an abundance of gray literature, and the empirical research tends to be limited by cross-sectional design and small sample sizes. SSM/Vs encounter significant personal and environmental challenges when transitioning from the military to college campuses. A variety of services have been developed to address the needs of the SSM/V population, but the efficacy of these services remains largely unknown. In conclusion, there is a clear need to provide education to faculty, students, and staff regarding the experiences of SSM/Vs. Efforts to enhance screening for, availability of, and SSM/V engagement in mental health services would also be beneficial, as would improved availability of and SSM/V access to academic support. All future programs designed to address the unique challenges of SSM/Vs in the academic environment should also be systematically implemented and evaluated. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

  12. Student Service Members/Veterans on Campus: Challenges for Reintegration

    PubMed Central

    Borsari, Brian; Yurasek, Ali; Miller, Mary Beth; Murphy, James G.; McDevitt-Murphy, Meghan E.; Martens, Matthew P.; Darcy, Monica G.; Carey, Kate B.

    2016-01-01

    Many returning OIF/OEF/OND Veterans are seeking higher education in an effort to develop a meaningful career and financial stability. Evidence suggests that student service members/Veterans (SSM/Vs) are experiencing less academic success than other students. The purpose of this review is to identify the unique challenges of SSM/Vs and evaluate current campus efforts to facilitate their retention and academic performance. With a focus on SSM/Vs attending colleges and universities, we obtained 57 peer-reviewed and 73 grey literature records published between 2001 and 2015. The current SSM/V literature contains an abundance of grey literature, and the empirical research tends to be limited by cross-sectional design and small sample sizes. SSM/Vs encounter significant personal and environmental challenges when transitioning from the military to college campuses. A variety of services have been developed to address the needs of the SSM/V population, but the efficacy of these services remains largely unknown. In conclusion, there is a clear need to provide education to faculty, students and staff regarding the experiences of SSM/Vs. Efforts to enhance screening for, availability of, and SSM/V engagement in mental health services would also be beneficial, as would improved availability of and SSM/V access to academic support. All future programs designed to address the unique challenges of SSM/Vs in the academic environment should also be systematically implemented and evaluated. PMID:28206804

  13. Women's business: the challenge of childbirth.

    PubMed

    Barclay, L; Andre, C A; Glover, P A

    1989-09-01

    This paper was delivered as the opening address at the First National Conference of Childbirth Educators held in Melbourne, Australia, November, 1988. It is published with permission and support from the organisers. This paper develops and links insights available from anthropology, sociology, feminism and economics to the challenge facing childbirth educators. This challenge needs illumination from a number of directions before it can be understood, explained and met. The challenge described in the paper is that of re-establishing the importance and value of 'women's business'. This phrase, developed further at the beginning of the work, is from Aboriginal culture. It conveys the uniqueness of matters belonging to women. Childbirth is currently big business. Its management, whilst masquerading as scientific or medical, is clearly socio-economic. Until this is understood big business will continue to dominate women's business. The paper sets out to develop and defend these assertions and establish a role and responsibility for childbirth educators in relation to them.

  14. Public health engineering education in India: current scenario, opportunities and challenges.

    PubMed

    Hussain, Mohammad Akhtar; Sharma, Kavya; Zodpey, Sanjay

    2011-01-01

    Public health engineering can play an important and significant role in solving environmental health issues. In order to confront public health challenges emerging out of environmental problems we need adequately trained public health engineers / environmental engineers. Considering the current burden of disease attributable to environmental factors and expansion in scope of applications of public health / environmental engineering science, it is essential to understand the present scenario of teaching, training and capacity building programs in these areas. Against this background the present research was carried out to know the current teaching and training programs in public health engineering and related disciplines in India and to understand the potential opportunities and challenges available. A systematic, predefined approach was used to collect and assemble the data related to various teaching and training programs in public health engineering / environmental engineering in India. Public health engineering / environmental engineering education and training in the country is mainly offered through engineering institutions, as pre-service and in-service training. Pre-service programs include diploma, degree (graduate) and post-graduate courses affiliated to various state technical boards, institutes and universities, whereas in-service training is mainly provided by Government of India recognized engineering and public health training institutes. Though trainees of these programs acquire skills related to engineering sciences, they significantly lack in public health skills. The teaching and training of public health engineering / environmental engineering is limited as a part of public health programs (MD Community Medicine, MPH, DPH) in India. There is need for developing teaching and training of public health engineering or environmental engineering as an interdisciplinary subject. Public health institutes can play an important and significant role in this

  15. Anti-Ebola therapies based on monoclonal antibodies: current state and challenges ahead.

    PubMed

    González-González, Everardo; Alvarez, Mario Moisés; Márquez-Ipiña, Alan Roberto; Trujillo-de Santiago, Grissel; Rodríguez-Martínez, Luis Mario; Annabi, Nasim; Khademhosseini, Ali

    2017-02-01

    The 2014 Ebola outbreak, the largest recorded, took us largely unprepared, with no available vaccine or specific treatment. In this context, the World Health Organization declared that the humanitarian use of experimental therapies against Ebola Virus (EBOV) is ethical. In particular, an experimental treatment consisting of a cocktail of three monoclonal antibodies (mAbs) produced in tobacco plants and specifically directed to the EBOV glycoprotein (GP) was tested in humans, apparently with good results. Several mAbs with high affinity to the GP have been described. This review discusses our current knowledge on this topic. Particular emphasis is devoted to those mAbs that have been assayed in animal models or humans as possible therapies against Ebola. Engineering aspects and challenges for the production of anti-Ebola mAbs are also briefly discussed; current platforms for the design and production of full-length mAbs are cumbersome and costly.

  16. A Systematic Review of Wearable Systems for Cancer Detection: Current State and Challenges.

    PubMed

    Ray, Partha Pratim; Dash, Dinesh; De, Debashis

    2017-10-02

    Rapid growth of sensor and computing platforms have introduced the wearable systems. In recent years, wearable systems have led to new applications across all medical fields. The aim of this review is to present current state-of-the-art approach in the field of wearable system based cancer detection and identify key challenges that resist it from clinical adoption. A total of 472 records were screened and 11 were finally included in this study. Two types of records were studied in this context that includes 45% research articles and 55% manufactured products. The review was performed per PRISMA guidelines where considerations was given to records that were published or reported between 2009 and 2017. The identified records included 4 cancer detecting wearable systems such as breast cancer (36.3%), skin cancer (36.3%), prostate cancer (18.1%), and multi-type cancer (9%). Most works involved sensor based smart systems comprising of microcontroller, Bluetooth module, and smart phone. Few demonstrated Ultra-Wide Band (i.e. UWB) antenna based wearable systems. Skin cancer detecting wearable systems were most comprehensible ones. The current works are gradually progressing with seamless integration of sensory units along with smart networking. However, they lack in cloud computing and long-range communication paradigms. Artificial intelligence and machine learning are key ports that need to be attached with current wearable systems. Further, clinical inertia, lack of awareness, and high cost are altogether pulling back the actual growth of such system. It is well comprehended that upon sincere orientation of all identified challenges, wearable systems would emerge as vital alternative to futuristic cancer detection.

  17. Addressing informatics challenges in Translational Research with workflow technology.

    PubMed

    Beaulah, Simon A; Correll, Mick A; Munro, Robin E J; Sheldon, Jonathan G

    2008-09-01

    Interest in Translational Research has been growing rapidly in recent years. In this collision of different data, technologies and cultures lie tremendous opportunities for the advancement of science and business for organisations that are able to integrate, analyse and deliver this information effectively to users. Workflow-based integration and analysis systems are becoming recognised as a fast and flexible way to build applications that are tailored to scientific areas, yet are built on a common platform. Workflow systems are allowing organisations to meet the key informatics challenges in Translational Research and improve disease understanding and patient care.

  18. Cultural Sensitivity and Challenges in Management of the Transgender Patient With ESRD in Transplantation.

    PubMed

    Hoch, Deborah Ann; Bulman, Maya; McMahon, Dorn W

    2016-03-01

    Transgender patients with end-stage renal disease (ESRD) present with specific challenges during the transplant evaluation, perioperative management, and postoperative phase of care. Demographic information, health-care records, chosen name, and gender identity along with documentation of specific health-care needs can become a challenge when gender assigned at birth is incongruent with the patients gender identity. Medical care involves addressing the end-organ disease as well as addressing those aspects of care specific to the transgender patient. This review article provides information on defining transgender, the impact of ESRD, and transgender in the transplant process and considerations in the throughout phases of care. Current recommendations for management of this unique population are provided. © 2016, NATCO.

  19. Rare cancers: Challenges & issues.

    PubMed

    Pillai, Raveendran K; Jayasree, K

    2017-01-01

    Rare cancers account for about 22 per cent of all cancers diagnosed worldwide, disproportionately affecting some demographic groups, with an occurrence of less than 6 per 100,000 individuals annually. Many rare cancers in adults, adolescents and children are not curable, and patients and care providers have little option to take therapeutic decisions. The epidemiology of rare cancers is a challenging area of study but is inadequately addressed. Despite efforts mainly in some European nations, a few improvements have been observed in the management of rare cancers. Reasons for this obvious stagnation are multifactorial and are mainly inherent to logistical difficulties in carrying out clinical trials in very small patient populations, hesitation of the pharmaceutical industry to spend in small markets and complexity in creating adequate information for the development of cost-effective drugs. Rare cancers also face specific challenges that include late and incorrect diagnosis, lack of clinical expertise and lack of research interest and development of new therapies. The utilization of nationally representative study findings for the patients' evaluation may possibly offer chances to find out pathogenesis and prevalence, and this will eventually lead to control and prevention. Currently, advancing targeted therapies offer a great opportunity for the better management of rare cancers. Conducting clinical trials with small patient population, innovative clinical trial approach, prevailing controlling obstacles for international cooperation and financial support for research are the present challenges for rare cancers. The International Rare Cancers Initiative functions as a main platform for achieving new international clinical trials in rare tumours. This review delineates the current challenges and issues in the interpretation, management and research scenarios of rare cancers.

  20. Rare cancers: Challenges & issues

    PubMed Central

    Pillai, Raveendran K.; Jayasree, K.

    2017-01-01

    Rare cancers account for about 22 per cent of all cancers diagnosed worldwide, disproportionately affecting some demographic groups, with an occurrence of less than 6 per 100,000 individuals annually. Many rare cancers in adults, adolescents and children are not curable, and patients and care providers have little option to take therapeutic decisions. The epidemiology of rare cancers is a challenging area of study but is inadequately addressed. Despite efforts mainly in some European nations, a few improvements have been observed in the management of rare cancers. Reasons for this obvious stagnation are multifactorial and are mainly inherent to logistical difficulties in carrying out clinical trials in very small patient populations, hesitation of the pharmaceutical industry to spend in small markets and complexity in creating adequate information for the development of cost-effective drugs. Rare cancers also face specific challenges that include late and incorrect diagnosis, lack of clinical expertise and lack of research interest and development of new therapies. The utilization of nationally representative study findings for the patients’ evaluation may possibly offer chances to find out pathogenesis and prevalence, and this will eventually lead to control and prevention. Currently, advancing targeted therapies offer a great opportunity for the better management of rare cancers. Conducting clinical trials with small patient population, innovative clinical trial approach, prevailing controlling obstacles for international cooperation and financial support for research are the present challenges for rare cancers. The International Rare Cancers Initiative functions as a main platform for achieving new international clinical trials in rare tumours. This review delineates the current challenges and issues in the interpretation, management and research scenarios of rare cancers. PMID:28574010

  1. Positron Emission Tomography: Current Challenges and Opportunities for Technological Advances in Clinical and Preclinical Imaging Systems.

    PubMed

    Vaquero, Juan José; Kinahan, Paul

    2015-01-01

    Positron emission tomography (PET) imaging is based on detecting two time-coincident high-energy photons from the emission of a positron-emitting radioisotope. The physics of the emission, and the detection of the coincident photons, give PET imaging unique capabilities for both very high sensitivity and accurate estimation of the in vivo concentration of the radiotracer. PET imaging has been widely adopted as an important clinical modality for oncological, cardiovascular, and neurological applications. PET imaging has also become an important tool in preclinical studies, particularly for investigating murine models of disease and other small-animal models. However, there are several challenges to using PET imaging systems. These include the fundamental trade-offs between resolution and noise, the quantitative accuracy of the measurements, and integration with X-ray computed tomography and magnetic resonance imaging. In this article, we review how researchers and industry are addressing these challenges.

  2. Positron Emission Tomography: Current Challenges and Opportunities for Technological Advances in Clinical and Preclinical Imaging Systems

    PubMed Central

    Vaquero, Juan José; Kinahan, Paul

    2017-01-01

    Positron emission tomography (PET) imaging is based on detecting two time-coincident high-energy photons from the emission of a positron-emitting radioisotope. The physics of the emission, and the detection of the coincident photons, give PET imaging unique capabilities for both very high sensitivity and accurate estimation of the in vivo concentration of the radiotracer. PET imaging has been widely adopted as an important clinical modality for oncological, cardiovascular, and neurological applications. PET imaging has also become an important tool in preclinical studies, particularly for investigating murine models of disease and other small-animal models. However, there are several challenges to using PET imaging systems. These include the fundamental trade-offs between resolution and noise, the quantitative accuracy of the measurements, and integration with X-ray computed tomography and magnetic resonance imaging. In this article, we review how researchers and industry are addressing these challenges. PMID:26643024

  3. Addressing multimorbidity to improve healthcare and economic sustainability

    PubMed Central

    Colombo, Francesca; García-Goñi, Manuel; Schwierz, Christoph

    2016-01-01

    Patients with multimorbidity are responsible for more than half of all healthcare utilization, challenging the healthcare budgets of all European nations. Although the European Union is showing signs of a fragile economic recovery, achieving sustainable growth will depend on delivering a combination of fiscal responsibility, structural reforms, and improved efficiency. Addressing the challenges of multimorbidity and providing more effective, affordable, and sustainable care, has climbed the political agenda at a global, European, and national level. Current healthcare systems are poorly adapted to cope with the challenges of patients with multimorbidity. Little is known about the epidemiology and natural history of multimorbidity; the evidence base is weak; clinical guidelines are not always relevant to this population; and financing and delivery systems have not evolved to adequately measure and reward quality and performance. Pockets of innovation are, however, beginning to emerge. In Spain, for example, the ongoing economic crisis has forced regional governments to deliver substantial efficiency savings and, with this in mind, integrated care programmes have been introduced across the country for people with chronic disease and multimorbidity. Early results suggest that formalized integrated care for patients with multimorbidity improves their perceptions of care coordination, reduces hospital and emergency admissions and readmissions, and reduces average costs per capita. Such innovations require meaningful investments at a national level – something that is now supported within the framework of the European Union’s Stability and Growth Pact. PMID:29090168

  4. Addressing multimorbidity to improve healthcare and economic sustainability.

    PubMed

    Colombo, Francesca; García-Goñi, Manuel; Schwierz, Christoph

    2016-01-01

    Patients with multimorbidity are responsible for more than half of all healthcare utilization, challenging the healthcare budgets of all European nations. Although the European Union is showing signs of a fragile economic recovery, achieving sustainable growth will depend on delivering a combination of fiscal responsibility, structural reforms, and improved efficiency. Addressing the challenges of multimorbidity and providing more effective, affordable, and sustainable care, has climbed the political agenda at a global, European, and national level. Current healthcare systems are poorly adapted to cope with the challenges of patients with multimorbidity. Little is known about the epidemiology and natural history of multimorbidity; the evidence base is weak; clinical guidelines are not always relevant to this population; and financing and delivery systems have not evolved to adequately measure and reward quality and performance. Pockets of innovation are, however, beginning to emerge. In Spain, for example, the ongoing economic crisis has forced regional governments to deliver substantial efficiency savings and, with this in mind, integrated care programmes have been introduced across the country for people with chronic disease and multimorbidity. Early results suggest that formalized integrated care for patients with multimorbidity improves their perceptions of care coordination, reduces hospital and emergency admissions and readmissions, and reduces average costs per capita. Such innovations require meaningful investments at a national level - something that is now supported within the framework of the European Union's Stability and Growth Pact.

  5. Issues and Challenges Facing Flexible Lithium-Ion Batteries for Practical Application.

    PubMed

    Cha, Hyungyeon; Kim, Junhyeok; Lee, Yoonji; Cho, Jaephil; Park, Minjoon

    2017-12-27

    With the advent of flexible electronics, lithium-ion batteries have become a key component of high performance energy storage systems. Thus, considerable effort is made to keep up with the development of flexible lithium-ion batteries. To date, many researchers have studied newly designed batteries with flexibility, however, there are several significant challenges that need to be overcome, such as degradation of electrodes under external load, poor battery performance, and complicated cell preparation procedures. In addition, an in-depth understanding of the current challenges for flexible batteries is rarely addressed in a systematical and practical way. Herein, recent progress and current issues of flexible lithium-ion batteries in terms of battery materials and cell designs are reviewed. A critical overview of important issues and challenges for the practical application of flexible lithium-ion batteries is also provided. Finally, the strategies are discussed to overcome current limitations of the practical use of flexible lithium-based batteries, providing a direction for future research. © 2017 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

  6. Current Challenges in the Management of Prolactinomas.

    PubMed

    Maiter, Dominique

    2015-04-01

    Although the diagnosis of prolactinoma is often straightforward and the treatment strategy has been well defined in recent guidelines, several challenging issues persist in their management. The differential diagnosis of a large pituitary tumour with moderately elevated prolactin (PRL) concentrations is sometimes difficult, and prolonged treatment with a dopamine agonist may be inappropriate when the diagnosis of a prolactinoma is not sufficiently well substantiated. Also, timely withdrawal of dopamine agonist treatment and the remaining indications of transsphenoidal surgery are still matters of debate. Last but not least, the management of resistant or aggressive prolactinomas remains a challenge for the clinician, especially when they occur in young patients.

  7. Current Challenges in the Management of Prolactinomas

    PubMed Central

    2015-01-01

    Summary Although the diagnosis of prolactinoma is often straightforward and the treatment strategy has been well defined in recent guidelines, several challenging issues persist in their management. The differential diagnosis of a large pituitary tumour with moderately elevated prolactin (PRL) concentrations is sometimes difficult, and prolonged treatment with a dopamine agonist may be inappropriate when the diagnosis of a prolactinoma is not sufficiently well substantiated. Also, timely withdrawal of dopamine agonist treatment and the remaining indications of transsphenoidal surgery are still matters of debate. Last but not least, the management of resistant or aggressive prolactinomas remains a challenge for the clinician, especially when they occur in young patients. PMID:29632566

  8. Differentiated Pedagogy to Address Learner Diversity in Secondary Physical Education

    ERIC Educational Resources Information Center

    Jarvis, Jane M.; Pill, Shane A.; Noble, Anna G.

    2017-01-01

    This article discusses the challenge of addressing student diversity in secondary physical education (PE) classes. Contemporary curriculum documents and teacher standards emphasize differentiated pedagogy in order to engage and challenge all learners. However, the reality of designing effective learning experiences for diverse students represents…

  9. Personal Genomic Information Management and Personalized Medicine: Challenges, Current Solutions, and Roles of HIM Professionals

    PubMed Central

    Alzu'bi, Amal; Zhou, Leming; Watzlaf, Valerie

    2014-01-01

    In recent years, the term personalized medicine has received more and more attention in the field of healthcare. The increasing use of this term is closely related to the astonishing advancement in DNA sequencing technologies and other high-throughput biotechnologies. A large amount of personal genomic data can be generated by these technologies in a short time. Consequently, the needs for managing, analyzing, and interpreting these personal genomic data to facilitate personalized care are escalated. In this article, we discuss the challenges for implementing genomics-based personalized medicine in healthcare, current solutions to these challenges, and the roles of health information management (HIM) professionals in genomics-based personalized medicine. PMID:24808804

  10. Verification Challenges at Low Numbers

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

    Benz, Jacob M.; Booker, Paul M.; McDonald, Benjamin S.

    2013-07-16

    This paper will explore the difficulties of deep reductions by examining the technical verification challenges. At each step on the road to low numbers, the verification required to ensure compliance of all parties will increase significantly. Looking post New START, the next step will likely include warhead limits in the neighborhood of 1000 (Pifer 2010). Further reductions will include stepping stones at 100’s of warheads, and then 10’s of warheads before final elimination could be considered of the last few remaining warheads and weapons. This paper will focus on these three threshold reduction levels, 1000, 100’s, 10’s. For each, themore » issues and challenges will be discussed, potential solutions will be identified, and the verification technologies and chain of custody measures that address these solutions will be surveyed. It is important to note that many of the issues that need to be addressed have no current solution. In these cases, the paper will explore new or novel technologies that could be applied. These technologies will draw from the research and development that is ongoing throughout the national lab complex, and will look at technologies utilized in other areas of industry for their application to arms control verification.« less

  11. Addressing Psychosocial Factors with Library Mentoring

    ERIC Educational Resources Information Center

    Farrell, Bridget; Alabi, Jaena; Whaley, Pambanisha; Jenda, Claudine

    2017-01-01

    The majority of articles on mentoring in the library and information science field address career development by emphasizing the orientation process for new librarians and building the requisite skills for a specific job. Few articles deal with the psychological and social challenges that many early-career and minority librarians face, which can…

  12. Addressing South Africa's Engineering Skills Gaps

    ERIC Educational Resources Information Center

    Hall, Jonathan; Sandelands, Eric

    2009-01-01

    Purpose: This paper aims to provide a case study of how engineering skills gaps are being addressed by Murray & Roberts in South Africa. Design/methodology/approach: The paper focuses on skills challenges in South Africa from a reflective practitioner perspective, exploring a case example from an industry leader. Findings: The paper explores…

  13. Addressing Sexual Violence as Student Affairs Work

    ERIC Educational Resources Information Center

    Landreman, Lisa M.; Williamsen, Kaaren M.

    2018-01-01

    In this chapter, we outline the challenges campuses face in addressing sexual violence and Title IX compliance. We argue that there are critical roles for student affairs professionals in Title IX work in developing effective campus sexual violence prevention and response strategies.

  14. New Methods to Address Old Challenges: The Use of Administrative Data for Longitudinal Replication Studies of Child Maltreatment

    PubMed Central

    Hurren, Emily; Stewart, Anna; Dennison, Susan

    2017-01-01

    Administrative data are crucial to the “big data” revolution of social science and have played an important role in the development of child maltreatment research. These data are also of value to administrators, policy makers, and clinicians. The focus of this paper is the use of administrative data to produce and replicate longitudinal studies of child maltreatment. Child protection administrative data have several advantages. They are often population-based, and allow longitudinal examination of child maltreatment and complex multi-level analyses. They also allow comparison across subgroups and minority groups, remove burden from individuals to disclose traumatic experiences, and can be less biased than retrospective recall. Finally, they can be linked to data from other agencies to explore comorbidity and outcomes, and are comparatively cost and time effective. The benefits and challenges associated with the use of administrative data for longitudinal child maltreatment research become magnified when these data are used to produce replications. Techniques to address challenges and support future replication efforts include developing a biographical understanding of the systems from which the data are drawn, using multiple data sources to contextualize the data and research results, recognizing and adopting various approaches to replication, and documenting all data coding and manipulation processes. These techniques are illustrated in this paper via a case study of previous replication work. PMID:28914775

  15. New Methods to Address Old Challenges: The Use of Administrative Data for Longitudinal Replication Studies of Child Maltreatment.

    PubMed

    Hurren, Emily; Stewart, Anna; Dennison, Susan

    2017-09-15

    Administrative data are crucial to the "big data" revolution of social science and have played an important role in the development of child maltreatment research. These data are also of value to administrators, policy makers, and clinicians. The focus of this paper is the use of administrative data to produce and replicate longitudinal studies of child maltreatment. Child protection administrative data have several advantages. They are often population-based, and allow longitudinal examination of child maltreatment and complex multi-level analyses. They also allow comparison across subgroups and minority groups, remove burden from individuals to disclose traumatic experiences, and can be less biased than retrospective recall. Finally, they can be linked to data from other agencies to explore comorbidity and outcomes, and are comparatively cost and time effective. The benefits and challenges associated with the use of administrative data for longitudinal child maltreatment research become magnified when these data are used to produce replications. Techniques to address challenges and support future replication efforts include developing a biographical understanding of the systems from which the data are drawn, using multiple data sources to contextualize the data and research results, recognizing and adopting various approaches to replication, and documenting all data coding and manipulation processes. These techniques are illustrated in this paper via a case study of previous replication work.

  16. Addressing the challenges of ECMO simulation.

    PubMed

    Alinier, Guillaume; Hassan, Ibrahim Fawzy; Alsalemi, Abdullah; Al Disi, Mohammed; Ait Hssain, Ali; Labib, Ahmed; Alhomsi, Yahya; Bensaali, Fayçal; Amira, Abbes; Ibrahim, Abdulsalam Saif

    2018-05-01

    The patient's condition and high-risk nature of extracorporeal membrane oxygenation (ECMO) therapy force clinical services to ensure clinicians are properly trained and always ready to deal effectively with critical situations. Simulation-based education (SBE), from the simplest approaches to the most immersive modalities, helps promote optimum individual and team performance. The risks of SBE are negative learning, inauthenticity in learning and over-reliance on the participants' suspension of disbelief. This is especially relevant to ECMO SBE as circuit/patient interactions are difficult to fully simulate without confusing circuit alterations. Our efforts concentrate on making ECMO simulation easier and more realistic in order to reduce the current gap there is between SBE and real ECMO patient care. Issues to be overcome include controlling the circuit pressures, system failures, patient issues, blood colour and cost factors. Key to our developments are the hospital-university collaboration and research funding. A prototype ECMO simulator has been developed that allows for realistic ECMO SBE. The system emulates the ECMO machine interface with remotely controllable pressure parameters, haemorrhaging, line chattering, air bubble noise and simulated blood colour change. The prototype simulator allows the simulation of common ECMO emergencies through innovative solutions that enhance the fidelity of ECMO SBE and reduce the requirement for suspension of disbelief from participants. Future developments will encompass the patient cannulation aspect.

  17. Addressing Challenges to Public Understanding of Science: Epistemic Cognition, Motivated Reasoning, and Conceptual Change

    ERIC Educational Resources Information Center

    Sinatra, Gale M.; Kienhues, Dorothe; Hofer, Barbara K.

    2014-01-01

    Science is of critical importance to daily life in a knowledge society and has a significant influence on many everyday decisions. As scientific problems increase in their number and complexity, so do the challenges facing the public in understanding these issues. Our objective is to focus on 3 of those challenges: the challenge of reasoning about…

  18. Anti-Ebola therapies based on monoclonal antibodies: Current state and challenges ahead

    PubMed Central

    González-González, E; Alvarez, MM; Márquez-Ipiña, AR; Santiago, G Trujillo-de; Rodríguez-Martínez, LM; Annabi, N; Khademhosseini, A

    2017-01-01

    The 2014 Ebola outbreak, the largest recorded, took us largely unprepared, with no available vaccine or specific treatment. In this context, the World Health Organization (WHO) declared that the humanitarian use of experimental therapies against Ebola Virus (EBOV) is ethical. In particular, an experimental treatment consisting of a cocktail of three monoclonal antibodies (mAbs) produced in tobacco plants and specifically directed to the Ebola virus glycoprotein (GP) was tested in humans, apparently with good results. Several mAbs with high affinity to the GP have been described. This review discusses our current knowledge on this topic. Particular emphasis is devoted to those mAbs that have been assayed in animal models or humans as possible therapies against Ebola. Engineering aspects and challenges for the production of anti-Ebola mAbs are also briefly discussed; current platforms for the design and production of full-length mAbs are cumbersome and costly. PMID:26611830

  19. 2010 Panel on the Biomaterials Grand Challenges

    PubMed Central

    Reichert, William “Monty”; Ratner, Buddy D.; Anderson, James; Coury, Art; Hoffman, Allan S.; Laurencin, Cato T.; Tirrell, David

    2014-01-01

    In 2009, the National Academy for Engineering issued the Grand Challenges for Engineering in the 21st Century comprised of 14 technical challenges that must be addressed to build a healthy, profitable, sustainable, and secure global community (http://www.engineeringchallenges.org). Although crucial, none of the NEA Grand Challenges adequately addressed the challenges that face the biomaterials community. In response to the NAE Grand Challenges, Monty Reichert of Duke University organized a panel entitled Grand Challenges in Biomaterials at the at the 2010 Society for Biomaterials Annual Meeting in Seattle. Six members of the National Academies—Buddy Ratner, James Anderson, Allan Hoffman, Art Coury, Cato Laurencin, and David Tirrell—were asked to propose a grand challenge to the audience that, if met, would significantly impact the future of biomaterials and medical devices. Successfully meeting these challenges will speed the 60-plus year transition from commodity, off-the-shelf biomaterials to bioengineered chemistries, and biomaterial devices that will significantly advance our ability to address patient needs and also to create new market opportunities. PMID:21171147

  20. Addressing risks to advance mental health research.

    PubMed

    Iltis, Ana S; Misra, Sahana; Dunn, Laura B; Brown, Gregory K; Campbell, Amy; Earll, Sarah A; Glowinski, Anne; Hadley, Whitney B; Pies, Ronald; Dubois, James M

    2013-12-01

    Risk communication and management are essential to the ethical conduct of research, yet addressing risks may be time consuming for investigators and institutional review boards may reject study designs that seem too risky. This can discourage needed research, particularly in higher-risk protocols or those enrolling potentially vulnerable individuals, such as those with some level of suicidality. Improved mechanisms for addressing research risks may facilitate much needed psychiatric research. To provide mental health researchers with practical approaches to (1) identify and define various intrinsic research risks, (2) communicate these risks to others (eg, potential participants, regulatory bodies, and society), (3) manage these risks during the course of a study, and (4) justify the risks. As part of a National Institute of Mental Health-funded scientific meeting series, a public conference and a closed-session expert panel meeting were held on managing and disclosing risks in mental health clinical trials. The expert panel reviewed the literature with a focus on empirical studies and developed recommendations for best practices and further research on managing and disclosing risks in mental health clinical trials. No institutional review board-review was required because there were no human subjects. Challenges, current data, practical strategies, and topics for future research are addressed for each of 4 key areas pertaining to management and disclosure of risks in clinical trials: identifying and defining risks, communicating risks, managing risks during studies, and justifying research risks. Empirical data on risk communication, managing risks, and the benefits of research can support the ethical conduct of mental health research and may help investigators better conceptualize and confront risks and to gain institutional review board-approval.

  1. Human epithelial hair follicle stem cells and their progeny: current state of knowledge, the widening gap in translational research and future challenges.

    PubMed

    Purba, Talveen S; Haslam, Iain S; Poblet, Enrique; Jiménez, Francisco; Gandarillas, Alberto; Izeta, Ander; Paus, Ralf

    2014-05-01

    Epithelial hair follicle stem cells (eHFSCs) are required to generate, maintain and renew the continuously cycling hair follicle (HF), supply cells that produce the keratinized hair shaft and aid in the reepithelialization of injured skin. Therefore, their study is biologically and clinically important, from alopecia to carcinogenesis and regenerative medicine. However, human eHFSCs remain ill defined compared to their murine counterparts, and it is unclear which murine eHFSC markers really apply to the human HF. We address this by reviewing current concepts on human eHFSC biology, their immediate progeny and their molecular markers, focusing on Keratin 15 and 19, CD200, CD34, PHLDA1, and EpCAM/Ber-EP4. After delineating how human eHFSCs may be selectively targeted experimentally, we close by defining as yet unmet key challenges in human eHFSC research. The ultimate goal is to transfer emerging concepts from murine epithelial stem cell biology to human HF physiology and pathology. © 2014 WILEY Periodicals, Inc.

  2. Cell therapy for heart failure: a comprehensive overview of experimental and clinical studies, current challenges, and future directions.

    PubMed

    Sanganalmath, Santosh K; Bolli, Roberto

    2013-08-30

    Despite significant therapeutic advances, the prognosis of patients with heart failure (HF) remains poor, and current therapeutic approaches are palliative in the sense that they do not address the underlying problem of the loss of cardiac tissue. Stem cell-based therapies have the potential to fundamentally transform the treatment of HF by achieving what would have been unthinkable only a few years ago-myocardial regeneration. For the first time since cardiac transplantation, a therapy is being developed to eliminate the underlying cause of HF, not just to achieve damage control. Since the initial report of cell therapy (skeletal myoblasts) in HF in 1998, research has proceeded at lightning speed, and numerous preclinical and clinical studies have been performed that support the ability of various stem cell populations to improve cardiac function and reduce infarct size in both ischemic and nonischemic cardiomyopathy. Nevertheless, we are still at the dawn of this therapeutic revolution. Many important issues (eg, mechanism(s) of action of stem cells, long-term engraftment, optimal cell type(s), and dose, route, and frequency of cell administration) remain to be resolved, and no cell therapy has been conclusively shown to be effective. The purpose of this article is to critically review the large body of work performed with respect to the use of stem/progenitor cells in HF, both at the experimental and clinical levels, and to discuss current controversies, unresolved issues, challenges, and future directions. The review focuses specifically on chronic HF; other settings (eg, acute myocardial infarction, refractory angina) are not discussed.

  3. Internet and mobile technologies: addressing the mental health of trauma survivors in less resourced communities.

    PubMed

    Ruzek, J I; Yeager, C M

    2017-01-01

    Internet and mobile technologies offer potentially critical ways of delivering mental health support in low-resource settings. Much evidence indicates an enormous negative impact of mental health problems in low- and middle-income countries (LMICs), and many of these problems are caused, or worsened, by exposure to wars, conflicts, natural and human-caused disasters, and other traumatic events. Though specific mental health treatments have been found to be efficacious and cost-effective for low-resource settings, most individuals living in these areas do not have access to them. Low-intensity task-sharing interventions will help, but there is a limit to the scalability and sustainability of human resources in these settings. To address the needs of trauma survivors, it will be important to develop and implement Internet and mobile technology resources to help reduce the scarcity, inequity, and inefficiency of current mental health services in LMICs. Mobile and Internet resources are experiencing a rapid growth in LMICs and can help address time, stigma, and cost barriers and connect those who have been socially isolated by traumatic events. This review discusses current research in technological interventions in low-resource settings and outlines key issues and future challenges and opportunities. Though formidable challenges exist for large-scale deployment of mobile and Internet mental health technologies, work to date indicates that these technologies are indeed feasible to develop, evaluate, and deliver to those in need of mental health services, and that they can be effective.

  4. Strategies for Helping Parents of Young Children Address Challenging Behaviors in the Home

    ERIC Educational Resources Information Center

    Chai, Zhen; Lieberman-Betz, Rebecca

    2016-01-01

    Challenging behavior can be defined as any repeated pattern of behavior, or perception of behavior, that interferes with or is at risk of interfering with optimal learning or engagement in prosocial interactions with peers and adults. It is generally accepted in young children that challenging behaviors serve some sort of communicative purpose--to…

  5. Development and regulation of biosimilars: current status and future challenges.

    PubMed

    Tsiftsoglou, Asterios S; Ruiz, Sol; Schneider, Christian K

    2013-06-01

    Biologic medicinal products developed via rDNA technology as recombinant protein-based medicines that have been in clinical use since the early 1980s as original biopharmaceuticals have greatly contributed to the therapy of severe metabolic and degenerative diseases. The recent expiration of the data protection or patents for most of them created opportunities for the development of copy versions of original biopharmaceuticals with similar biologic activity (termed biosimilars). Production of these new products is expected to meet worldwide demand, promote market competition, maintain the incentives for innovation, and sustain the healthcare systems. The licencing of these products, however, relies on the experience gained with the original biopharmaceuticals. Critical issues related to this class of medicinal products include their terminology (to avoid confusion with generics and non-innovator copy versions that have not been tested according to the biosimilar guidelines), manufacturing, and regulation. The European Union (EU) has been the first to establish a regulatory framework for marketing authorization application (MAA) and has named these products biosimilars, a term also recently adopted by the US FDA. Unlike the conventional, more common small molecular weight human medicines and chemical generics, protein-based medicines exhibit higher molecular weight, complexity in structure and function that can be affected by changes in the manufacturing process. Therefore, biosimilars represent a relatively heterogeneous class of medicinal products that make their regulation quite challenging. According to the current understanding in the EU, a biosimilar is a copy version of an already authorized biopharmaceutical (or reference product) with similar biologic activity, physicochemical characteristics, efficacy, and safety, based on a full comparability exercise at quality, preclinical and clinical level to ensure similar efficacy and safety. Guidance has been

  6. Current siRNA Targets in Atherosclerosis and Aortic Aneurysm

    PubMed Central

    Pradhan-Nabzdyk, Leena; Huang, Chenyu; Logerfo, Frank W.; Nabzdyk, Christoph S.

    2014-01-01

    Atherosclerosis (ATH) and aortic aneurysms (AA) remain challenging chronic diseases that confer high morbidity and mortality despite advances in medical, interventional, and surgical care. RNA interference represents a promising technology that may be utilized to silence genes contributing to ATH and AA. Despite positive results in preclinical and some clinical feasibility studies, challenges such as target/sequence validation, tissue specificity, transfection efficiency, and mitigation of unwanted off-target effects remain to be addressed. In this review the most current targets and some novel approaches in siRNA delivery are being discussed. Due to the plethora of investigated targets, only studies published between 2010 and 2014 were included. PMID:24882715

  7. Current Status of the Milky Stork Re-introduction Programme in Malaysia and Its Challenges

    PubMed Central

    Ismail, Ahmad; Rahman, Faid

    2016-01-01

    This review discussed the current status of the Milky Stork Re-introduction Programme in Malaysia and the challenges it faced. Although it has continued for almost seven years, more challenges appeared as time elapsed mainly due to the arising conflicts between the implementation of conservation policy versus the development projects in Kuala Gula. Hence, the released population is struggling to adapt mainly due to the reduction of suitable habitat for nesting and disturbed foraging areas by the continuous anthropogenic activities. Furthermore, the lack of appropriate training among captive storks prior to being released also slows the adaptation of the birds in their new habitat. The increasing pattern of pollution in the area is also highlighted. Several suggestions were given to help improve the current re-introduction programme. These include improvements to the captive training method, improvement of the existing enclosure’s condition and environment, protection of remaining mangrove forest, creation of a buffer zone to mitigate the increasing pollution level in the area, close monitoring of the released population, and maintaining continuous support and awareness among the public. Considering the ongoing anthropogenic activities that may impair the status of Kuala Gula as an important bird sanctuary, emphasis should be given to achieve sustainable development throughout the area. PMID:27688848

  8. Current status and challenge of Human Parasitology teaching in China

    PubMed Central

    Peng, Hong-Juan; Zhang, Chao; Wang, Chun-Mei; Chen, Xiao-Guang

    2012-01-01

    Parasitic infection profile in China has been changed greatly with the rapid economic development in China since the 1980s, such as the tremendous decreased infection rate of the soil-borne helminthiasis, the elimination of filariasis, the control of malaria, and the initiation to eradicate malaria in 2020. Some food-borne parasitic infections have increased such as Clonorchiasis, Cysticercosis, and Echinococcosis, probably because of the increased chances of eating out. This trend directly affected the status of Human Parasitology teaching in medical universities, such as the shorten length of this course, re-adjusted contents structure and teaching manners, even the change of the name of this course. In this paper, we analyzed the current status and challenges of Human Parasitology teaching in medical universities, and discussed the requisite contents and manners in course delivery and measures to improve the quality of Human Parasitology teaching in China. PMID:23265609

  9. Understanding Shale Gas: Recent Progress and Remaining Challenges

    DOE PAGES

    Striolo, Alberto; Cole, David R.

    2017-08-27

    Because of a number of technological advancements, unconventional hydrocarbons, and in particular shale gas, have transformed the US economy. Much is being learned, as demonstrated by the reduced cost of extracting shale gas in the US over the past five years. However, a number of challenges still need to be addressed. Many of these challenges represent grand scientific and technological tasks, overcoming which will have a number of positive impacts, ranging from the reduction of the environmental footprint of shale gas production to improvements and leaps forward in diverse sectors, including chemical manufacturing and catalytic transformations. This review addresses recentmore » advancements in computational and experimental approaches, which led to improved understanding of, in particular, structure and transport of fluids, including hydrocarbons, electrolytes, water, and CO 2 in heterogeneous subsurface rocks such as those typically found in shale formations. Finally, the narrative is concluded with a suggestion of a few research directions that, by synergistically combining computational and experimental advances, could allow us to overcome some of the hurdles that currently hinder the production of hydrocarbons from shale formations.« less

  10. Hematopoietic cell transplantation in Fanconi anemia: current evidence, challenges and recommendations.

    PubMed

    Ebens, Christen L; MacMillan, Margaret L; Wagner, John E

    2017-01-01

    Hematopoietic cell transplantation for Fanconi Anemia (FA) has improved dramatically over the past 40 years. With an enhanced understanding of the intrinsic DNA-repair defect and pathophysiology of hematopoietic failure and leukemogenesis, sequential changes to conditioning and graft engineering have significantly improved the expectation of survival after allogeneic hematopoietic cell transplantation (alloHCT) with incidence of graft failure decreased from 35% to <10% and acute graft-versus-host disease (GVHD) from >40% to <10%. Today, five-year overall survival exceeds 90% in younger FA patients with bone marrow failure but remains about 50% in those with hematologic malignancy. Areas covered: We review the evolution of alloHCT contributing to decreased rates of transplant related complications; highlight current challenges including poorer outcomes in cases of clonal hematologic disorders, alloHCT impact on endocrine function and intrinsic FA risk of epithelial malignancies; and describe investigational therapies for prevention and treatment of the hematologic manifestations of FA. Expert commentary: Current methods allow for excellent survival following alloHCT for FA associated BMF irrespective of donor hematopoietic cell source. Alternative curative approaches, such as gene therapy, are being explored to eliminate the risks of GVHD and minimize therapy-related adverse effects.

  11. 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

  12. 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.

  13. Assisted reproductive technologies are an integrated part of national strategies addressing demographic and reproductive challenges.

    PubMed

    Ziebe, Søren; Devroey, Paul

    2008-01-01

    The decline in the total fertility rate in the latter half of the 20th century in many European countries is becoming increasingly important in determining the demographic composition of Europe and its individual member states. This review focuses on discussion surrounding how assisted reproductive technology (ART) can impact declining fertility rates. This article summarizes key aspects of presentations given at the 'State of the ART 2007-ART and Society' meeting held in Lyon, France, in June 2007. For each topic, searches were conducted in MEDLINE and other databases and the results, alongside unpublished data and personal opinion, were presented to the Workshop Group. Individual subjects were discussed and any disagreements or omissions resolved. Although reduced fertility rates will have an impact on total population number, it is the change in the age structure of the population that is likely to be the most challenging factor faced by the European Union (EU). With evidence suggesting that an ageing population threatens future standards of living and social cohesion, managing demographic change through integrated policy response has become an important component of EU legislation. However, current measures fail to tackle the contribution that ART may play in alleviating falling fertility rates. Indeed, ART can have an important impact on economic and demographic factors, and should be incorporated into a population policy mix. Current barriers to ART include legislative restriction across different EU countries, limited availability to ART and current perception of ART in society. The inclusion of ART as part of a population policy mix in Europe is justified but must involve better communication among ART professionals, politicians and the general public.

  14. Early Childhood, High School, and College: Educational Challenges and MDRC's Research

    ERIC Educational Resources Information Center

    MDRC, 2014

    2014-01-01

    MDRC hosted a recent colloquium to celebrate their 40th anniversary and the contributions of former Board Chair Robert Solow. This paper summarizes a panel presentation featuring Frank Levy, Richard J. Murnane, Cecilia E. Rouse, and Ronald F. Ferguson, who discussed current challenges in education and how MDRC's research can help address them.

  15. Challenges and outlook for the UICC-Asian Regional Office.

    PubMed

    Akaza, Hideyuki

    2013-01-01

    At the United Nations High-level Meeting on Non-communicable Disease Prevention and Control in 2011 the link between health and socioeconomic issues was raised, becoming a global political issue. Health equity is one challenge that has hitherto not been addressed directly, although there is a growing shared recognition that cancer in Asia is an urgent social issue. At the UICC-ARO we are working to promote and widen networks of individuals and organizations in Asia and involve them in cooperation for this purpose. As part of our current activities, we are addressing the question of the "Economic burden of cancer in Asian countries: How should we face the current situation? " from a variety of angles and seeking to bring together a wealth of multidisciplinary knowledge about cancer in Asia and its related socioeconomic factors. It is essential to ensure that the real picture of cancer in Asia, which is currently not accurately understood, is conveyed clearly to all concerned, and also that the differences between cancer in Asia and in the West are highlighted.

  16. 75 FR 57006 - Addressing Policy and Logistical Challenges to Smart Grid Implementation

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-09-17

    ... electric vehicles, photovoltaic cells, wind turbines, or inflexible nuclear plants? What approaches make... generation and electric vehicles into the electric system; detect and address equipment problems and outages...

  17. Pharmaceutical policies in a crisis? Challenges and solutions identified at the PPRI Conference.

    PubMed

    Vogler, Sabine; Zimmermann, Nina; Ferrario, Alessandra; Wirtz, Veronika J; de Joncheere, Kees; Pedersen, Hanne Bak; Dedet, Guillaume; Paris, Valérie; Mantel-Teeuwisse, Aukje K; Babar, Zaheer-Ud-Din

    2016-01-01

    In October 2015, the third international Pharmaceutical Pricing and Reimbursement Information (PPRI) Conference was held in Vienna to foster discussion on challenges in pricing and reimbursement policies for medicines. The research presented highlighted that commonly used pharmaceutical pricing and reimbursement policies are not sufficiently effective to address current challenges. Conference participants called for fundamental reforms to ensure access to medicines, particularly to new and potentially more effective and/or safe medicines, while safeguarding the financial sustainability of health systems and working towards universal health coverage.

  18. Centennial Challenges

    NASA Image and Video Library

    2010-02-26

    Doug Comstock, NASA's Director, Innovative Partnership Office, speaks during a ceremony for winners and participants of NASA’s 2009 Centennial Challenges, Friday, Feb. 26, 2010, at NASA Headquarters in Washington. The year-long competition addresses a range of technical challenges that support NASA's missions in aeronautics and space with a goal of encouraging novel solutions from non-traditional sources. Photo Credit: (NASA/Paul E. Alers)

  19. Mind the Gap: Current Challenges and Future State of Heart Failure Care.

    PubMed

    McDonald, Michael A; Ashley, Euan A; Fedak, Paul W M; Hawkins, Nathaniel; Januzzi, James L; McMurray, John J V; Parikh, Victoria N; Rao, Vivek; Svystonyuk, Daniyil; Teerlink, John R; Virani, Sean

    2017-11-01

    The past decade has seen many advances in the management of heart failure (HF) that have improved survival and quality of life for patients living with this condition. A number of gaps remain in our understanding of the pathophysiology of HF, and the application of emerging treatment strategies is an exciting but daunting challenge. It is possible that advances in genetic evaluation of cardiomyopathy will provide a more refined approach to characterizing HF syndromes, whereas large-scale clinical trials on the horizon should further clarify the role of novel pharmacologic agents and invasive therapies. Cardiac repair and regeneration hold great promise, but a number of pragmatic issues will limit clinical application in the near term. Replacing cardiac function with ventricular assist devices represents significant progress in the management of advanced disease; however, unacceptable rates of complications and costs need to be addressed before broader use in the general HF population is feasible. The ability to personalize care is limited, and the optimal model of disease management in the Canadian context remains uncertain. The emergence of biomarker-guided management and remote monitoring technologies might facilitate a more personalized approach to care in an effort to maintain health and stability and to prevent worsening HF. Ultimately, a greater understanding of how and when to intervene in the setting of acute HF should translate into improved outcomes for the highest-risk subgroup of patients. This review highlights key challenges in the management of HF and highlights the progress toward an ideal future state. Copyright © 2017 Canadian Cardiovascular Society. Published by Elsevier Inc. All rights reserved.

  20. Practical Challenges of Current Video Rate OCT Elastography: Accounting for Dynamic and Static Tissue Properties

    PubMed Central

    Brezinski, Mark E

    2017-01-01

    Optical coherence tomography (OCT) elastography (OCTE) has the potential to be an important diagnostic tool for pathologies including coronary artery disease, osteoarthritis, malignancies, and even dental caries. Many groups have performed OCTE, including our own, using a wide range of approaches. However, we will demonstrate current OCTE approaches are not scalable to real-time, in vivo imaging. As will be discussed, among the most important reasons is current designs focus on the system and not the target. Specifically, tissue dynamic responses are not accounted, with examples being the tissue strain response time, preload variability, and conditioning variability. Tissue dynamic responses, and to a lesser degree static tissue properties, prevent accurate video rate modulus assessments for current embodiments. Accounting for them is the focus of this paper. A top-down approach will be presented to overcome these challenges to real time in vivo tissue characterization. Discussed first is an example clinical scenario where OTCE would be of substantial relevance, the prevention of acute myocardial infarction or heart attacks. Then the principles behind OCTE are examined. Next, constrains on in vivo application of current OCTE are evaluated, focusing on dynamic tissue responses. An example is the tissue strain response, where it takes about 20 msec after a stress is applied to reach plateau. This response delay is not an issue at slow acquisition rates, as most current OCTE approaches are preformed, but it is for video rate OCTE. Since at video rate each frame is only 30 msec, for essentially all current approaches this means the strain for a given stress is changing constantly during the B-scan. Therefore the modulus can’t be accurately assessed. This serious issue is an even greater problem for pulsed techniques as it means the strain/modulus for a given stress (at a location) is unpredictably changing over a B-scan. The paper concludes by introducing a novel

  1. Practical Challenges of Current Video Rate OCT Elastography: Accounting for Dynamic and Static Tissue Properties.

    PubMed

    Brezinski, Mark E

    2014-12-01

    Optical coherence tomography (OCT) elastography (OCTE) has the potential to be an important diagnostic tool for pathologies including coronary artery disease, osteoarthritis, malignancies, and even dental caries. Many groups have performed OCTE, including our own, using a wide range of approaches. However, we will demonstrate current OCTE approaches are not scalable to real-time, in vivo imaging. As will be discussed, among the most important reasons is current designs focus on the system and not the target. Specifically, tissue dynamic responses are not accounted, with examples being the tissue strain response time, preload variability, and conditioning variability. Tissue dynamic responses, and to a lesser degree static tissue properties, prevent accurate video rate modulus assessments for current embodiments. Accounting for them is the focus of this paper. A top-down approach will be presented to overcome these challenges to real time in vivo tissue characterization. Discussed first is an example clinical scenario where OTCE would be of substantial relevance, the prevention of acute myocardial infarction or heart attacks. Then the principles behind OCTE are examined. Next, constrains on in vivo application of current OCTE are evaluated, focusing on dynamic tissue responses. An example is the tissue strain response, where it takes about 20 msec after a stress is applied to reach plateau. This response delay is not an issue at slow acquisition rates, as most current OCTE approaches are preformed, but it is for video rate OCTE. Since at video rate each frame is only 30 msec, for essentially all current approaches this means the strain for a given stress is changing constantly during the B-scan. Therefore the modulus can't be accurately assessed. This serious issue is an even greater problem for pulsed techniques as it means the strain/modulus for a given stress (at a location) is unpredictably changing over a B-scan. The paper concludes by introducing a novel video

  2. Cryptography and the Internet: lessons and challenges

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

    McCurley, K.S.

    1996-12-31

    The popularization of the Internet has brought fundamental changes to the world, because it allows a universal method of communication between computers. This carries enormous benefits with it, but also raises many security considerations. Cryptography is a fundamental technology used to provide security of computer networks, and there is currently a widespread engineering effort to incorporate cryptography into various aspects of the Internet. The system-level engineering required to provide security services for the Internet carries some important lessons for researchers whose study is focused on narrowly defined problems. It also offers challenges to the cryptographic research community by raising newmore » questions not adequately addressed by the existing body of knowledge. This paper attempts to summarize some of these lessons and challenges for the cryptographic research community.« less

  3. Military genomics: a perspective on the successes and challenges of genomic medicine in the Armed Services.

    PubMed

    De Castro, Mauricio J; Turner, Clesson E

    2017-11-01

    We describe the impact genomics has on the health and readiness of the military service member, highlight several examples of the current and future plans for genomic medicine within the military, discuss challenges to implementation and provide recommendations to address some of those challenges. Published 2017. This article is a U.S. Government work and is in the public domain in the USA. Molecular Genetics & Genomic Medicine published by Wiley Periodicals, Inc.

  4. Addressing Theory and Performance Enhancements for the Independent Sustain and Address AC Plasma Display

    NASA Astrophysics Data System (ADS)

    Warren, Kevin Wilson

    The Independent Sustain and Address (ISA) AC plasma panel is a flat, flicker-free, gas discharge type of display device. This display technology promises to reduce both the cost of manufacturing and operation of AC plasma displays. The ISA technology uses a vastly different mechanism to change the state of the display pixels than the standard AC plasma technology. This addressing mechanism is an exploitation of some of the natural characteristics associated with the plasma that can form during strong gas discharges. This thesis presents detailed data from experiments that were designed to evaluate and test the effectiveness of this mechanism. Through these experiments, the theory that the addressing methodology is based upon is developed and evaluated. These experiments show that the address margin windows for this technology are very large, minimally two to three times larger than the address margins for the standard XY AC plasma addressing techniques. New capabilities are also described, such as global brightness control for the ISA technology and a technique for increasing the addressing rate. These advances were designed into working prototypes and transferred to industry where there are currently commercial products available based upon these advances. A technique for implementing gray scale using some of these advances is also proposed.

  5. Association for Academic Surgery presidential address: sticky floors and glass ceilings.

    PubMed

    Greenberg, Caprice C

    2017-11-01

    This 2017 Presidential Address for the Association for Academic Surgery was delivered on February 8, 2017. It addresses the difficult topic of gender disparities in surgery. Mixing empirical data with personal anecdotes, Dr. Caprice Greenberg provides an insightful overview of this difficult challenge facing the surgical discipline and practical advice on how we can begin to address it. Copyright © 2017 Elsevier Inc. All rights reserved.

  6. Opportunities to overcome the current limitations and challenges for efficient microbial production of optically pure lactic acid.

    PubMed

    Abdel-Rahman, Mohamed Ali; Sonomoto, Kenji

    2016-10-20

    There has been growing interest in the microbial production of optically pure lactic acid due to the increased demand for lactic acid-derived environmentally friendly products, for example biodegradable plastic (poly-lactic acid), as an alternative to petroleum-derived materials. To maximize the market uptake of these products, their cost should be competitive and this could be achieved by decreasing the production cost of the raw material, that is, lactic acid. It is of great importance to isolate and develop robust and highly efficient microbial lactic acid producers. Alongside the fermentative substrate and concentration, the yield and productivity of lactic acid are key parameters and major factors in determining the final production cost of lactic acid. In this review, we will discuss the current limitations and challenges for cost-efficient microbial production of optically pure lactic acid. The main obstacles to effective fermentation are the use of food resources, indirect utilization of polymeric sugars, sensitivity to inhibitory compounds released during biomass treatments, substrate inhibition, decreased lactic acid yield and productivity, inefficient utilization of mixed sugars, end product inhibition, increased use of neutralizing agents, contamination problems, and decreased optical purity of lactic acid. Furthermore, opportunities to address and overcome these limitations, either by fermentation technology or metabolic engineering approaches, will be introduced and discussed. Copyright © 2016 Elsevier B.V. All rights reserved.

  7. Computational challenges in atomic, molecular and optical physics.

    PubMed

    Taylor, Kenneth T

    2002-06-15

    Six challenges are discussed. These are the laser-driven helium atom; the laser-driven hydrogen molecule and hydrogen molecular ion; electron scattering (with ionization) from one-electron atoms; the vibrational and rotational structure of molecules such as H(3)(+) and water at their dissociation limits; laser-heated clusters; and quantum degeneracy and Bose-Einstein condensation. The first four concern fundamental few-body systems where use of high-performance computing (HPC) is currently making possible accurate modelling from first principles. This leads to reliable predictions and support for laboratory experiment as well as true understanding of the dynamics. Important aspects of these challenges addressable only via a terascale facility are set out. Such a facility makes the last two challenges in the above list meaningfully accessible for the first time, and the scientific interest together with the prospective role for HPC in these is emphasized.

  8. Academic Research Library as Broker in Addressing Interoperability Challenges for the Geosciences

    NASA Astrophysics Data System (ADS)

    Smith, P., II

    2015-12-01

    Data capture is an important process in the research lifecycle. Complete descriptive and representative information of the data or database is necessary during data collection whether in the field or in the research lab. The National Science Foundation's (NSF) Public Access Plan (2015) mandates the need for federally funded projects to make their research data more openly available. Developing, implementing, and integrating metadata workflows into to the research process of the data lifecycle facilitates improved data access while also addressing interoperability challenges for the geosciences such as data description and representation. Lack of metadata or data curation can contribute to (1) semantic, (2) ontology, and (3) data integration issues within and across disciplinary domains and projects. Some researchers of EarthCube funded projects have identified these issues as gaps. These gaps can contribute to interoperability data access, discovery, and integration issues between domain-specific and general data repositories. Academic Research Libraries have expertise in providing long-term discovery and access through the use of metadata standards and provision of access to research data, datasets, and publications via institutional repositories. Metadata crosswalks, open archival information systems (OAIS), trusted-repositories, data seal of approval, persistent URL, linking data, objects, resources, and publications in institutional repositories and digital content management systems are common components in the library discipline. These components contribute to a library perspective on data access and discovery that can benefit the geosciences. The USGS Community for Data Integration (CDI) has developed the Science Support Framework (SSF) for data management and integration within its community of practice for contribution to improved understanding of the Earth's physical and biological systems. The USGS CDI SSF can be used as a reference model to map to Earth

  9. [The Brazilian National Health Conference: challenges for the country].

    PubMed

    Gadelha, Paulo

    2015-10-01

    This article was published in the context of the upcoming 15th Brazilian National Health Conference and addresses the country's health challenges based on the history of previous conferences. The authors analyze the evolution of health as a public policy agenda, highlighting the role of such institutions as the Brazilian Center for Health Studies (CEBES), the Brazilian Association of Collective Health (Abrasco), and the National Health Council in advocating and establishing the Brazilian Unified National Health System (SUS). The article also focuses on expectations concerning the 15th National Health Conference within a political and economic scenario that raises questions and challenges both for the future of health policy, exemplified by SUS, and the current capacity to mobilize stakeholders.

  10. Engineering Ethics Education : Its Necessity, Objectives, Methods, Current State, and Challenges

    NASA Astrophysics Data System (ADS)

    Fudano, Jun

    The importance of engineering ethics education has become widely recognized in the industrialized countries including Japan. This paper examines the background against which engineering ethics education is required, and reviews its objectives, methods, and challenges, as well as its current state. In pointing out important issues associated with the apparent acceptance and quantitative development of ethics education, especially after the establishment of the Japan Accreditation Board for Engineering Education in 1999, the author stresses that the most serious problem is the lack of common understanding on the objectives of engineering ethics education. As a strategy to improve the situation, the so-called “Ethics-across-the-Curriculum” approach is introduced. The author also claims that business/organization ethics which is consistent with engineering ethics should be promoted in Japan.

  11. The Rise of International Relations Programs in the Brazilian Federal Universities: Curriculum Specificities and Current Challenges

    ERIC Educational Resources Information Center

    Ferreira, Marcos Alan S. V.

    2016-01-01

    The aim of this reflection is to study the new international relations (IR) programs introduced by Brazilian federal universities, looking comparatively at their curriculum specificities and current challenges. In recent years, Brazil has seen an increase of IR programs launched in several regions. Since 2003, the Ministry of Education is in the…

  12. Preclinical Mouse Cancer Models: A Maze of Opportunities and Challenges

    PubMed Central

    Day, Chi-Ping; Merlino, Glenn; Van Dyke, Terry

    2015-01-01

    Significant advances have been made in developing novel therapeutics for cancer treatment, and targeted therapies have revolutionized the treatment of some cancers. Despite the promise, only about five percent of new cancer drugs are approved, and most fail due to lack of efficacy. The indication is that current preclinical methods are limited in predicting successful outcomes. Such failure exacts enormous cost, both financial and in the quality of human life. This primer explores the current status, promise and challenges of preclinical evaluation in advanced mouse cancer models and briefly addresses emerging models for early-stage preclinical development. PMID:26406370

  13. Progress and challenges to the global waste management system.

    PubMed

    Singh, Jagdeep; Laurenti, Rafael; Sinha, Rajib; Frostell, Björn

    2014-09-01

    Rapid economic growth, urbanization and increasing population have caused (materially intensive) resource consumption to increase, and consequently the release of large amounts of waste to the environment. From a global perspective, current waste and resource management lacks a holistic approach covering the whole chain of product design, raw material extraction, production, consumption, recycling and waste management. In this article, progress and different sustainability challenges facing the global waste management system are presented and discussed. The study leads to the conclusion that the current, rather isolated efforts, in different systems for waste management, waste reduction and resource management are indeed not sufficient in a long term sustainability perspective. In the future, to manage resources and wastes sustainably, waste management requires a more systems-oriented approach that addresses the root causes for the problems. A specific issue to address is the development of improved feedback information (statistics) on how waste generation is linked to consumption. © The Author(s) 2014.

  14. Using the Electronic Health Record in Nursing Research: Challenges and Opportunities.

    PubMed

    Samuels, Joanne G; McGrath, Robert J; Fetzer, Susan J; Mittal, Prashant; Bourgoine, Derek

    2015-10-01

    Changes in the patient record from the paper to the electronic health record format present challenges and opportunities for the nurse researcher. Current use of data from the electronic health record is in a state of flux. Novel data analytic techniques and massive data sets provide new opportunities for nursing science. Realization of a strong electronic data output future relies on meeting challenges of system use and operability, data presentation, and privacy. Nurse researchers need to rethink aspects of proposal development. Joining ongoing national efforts aimed at creating usable data output is encouraged as a means to affect system design. Working to address challenges and embrace opportunities will help grow the science in a way that answers important patient care questions. © The Author(s) 2015.

  15. Interventions to address the stigma associated with leprosy: a perspective on the issues.

    PubMed

    Cross, Hugh

    2006-08-01

    This paper presents a perspective on stigma as an effect of leprosy. It identifies some of the strengths and weaknesses of current approaches to stigma reduction in leprosy and presents a rationale for considering alternative strategies. It is suggested that models used to explain health behavior in developed societies are inappropriate for explaining leprosy stigma or for developing strategies to address it. The author recommends due consideration of the alternative logic that characterizes cultural belief systems in countries where leprosy is a challenge. Criticism of the common practice of information dissemination as a strategy to address leprosy stigma is defended and the merits and limitations of an integrated health service in India is discussed. The author defends the suggestion that the principal objective of stigma interventions should be "normalization". An example of a Nepalese project based on empowerment theory is given to demonstrate how the transformation of identity from outcast to positive change agent, can effect "normalization".

  16. Narrative Research Addressing the Challenges of a Career in Professional Sports

    ERIC Educational Resources Information Center

    Frankl, Daniel

    2013-01-01

    The purpose of this article is to highlight the challenges that accomplished young athletes face as they aspire to become professional athletes. The data used in this study was derived from selected lived and told sport experiences of undergraduate and graduate kinesiology majors who were former competitive athletes. Additional data was derived…

  17. Current frontiers and future directions of telecoupling research

    NASA Astrophysics Data System (ADS)

    Liu, J.

    2016-12-01

    The world has been increasingly interconnected over long distances though processes such as international trade, migration, telecommunication, and disease spread. However, previous studies often focused on socioeconomic or environmental issues of distant processes. While these studies have generated useful information for individual disciplines, integrating socioeconomic and environmental information is essential for holistic understanding of complex global challenges and unbiased decision making to address the challenges. To advance integrated research, the framework of telecoupling (socioeconomic and environmental interactions over distances) has been developed to explicitly address both socioeconomic and environmental issues simultaneously. Although the framework is relatively new, it has already been applied to tackle a variety of globally important issues, such as food security, water resources, energy sustainability, land use, international trade (e.g., food, forest products, energy, wildlife, industrial products), species invasion, investment, ecosystem services, conservation, information dissemination, and tourism. These applications have identified many important research gaps (e.g. spillover systems) and hidden linkages (e.g. feedbacks) among distant areas of the world with profound implications for sustainable development, ecosystem health, and human well-being. While working with telecoupling presents more challenges than focusing only on disciplinary issues, support from funding agencies has helped accelerate research on telecoupling and more efforts are being aimed at framework quantification and operationalization. The presenter will provide an overview of the current frontiers, discuss future research directions, and highlight emerging opportunities and challenges in telecoupling research and governance.

  18. Current progress in patient-specific modeling

    PubMed Central

    2010-01-01

    We present a survey of recent advancements in the emerging field of patient-specific modeling (PSM). Researchers in this field are currently simulating a wide variety of tissue and organ dynamics to address challenges in various clinical domains. The majority of this research employs three-dimensional, image-based modeling techniques. Recent PSM publications mostly represent feasibility or preliminary validation studies on modeling technologies, and these systems will require further clinical validation and usability testing before they can become a standard of care. We anticipate that with further testing and research, PSM-derived technologies will eventually become valuable, versatile clinical tools. PMID:19955236

  19. A Survey of Challenges in Aerodynamic Exhaust Nozzle Technology for Aerospace Propulsion Applications

    NASA Technical Reports Server (NTRS)

    Shyne, Rickey J.

    2002-01-01

    The current paper discusses aerodynamic exhaust nozzle technology challenges for aircraft and space propulsion systems. Technology advances in computational and experimental methods have led to more accurate design and analysis tools, but many major challenges continue to exist in nozzle performance, jet noise and weight reduction. New generations of aircraft and space vehicle concepts dictate that exhaust nozzles have optimum performance, low weight and acceptable noise signatures. Numerous innovative nozzle concepts have been proposed for advanced subsonic, supersonic and hypersonic vehicle configurations such as ejector, mixer-ejector, plug, single expansion ramp, altitude compensating, lobed and chevron nozzles. This paper will discuss the technology barriers that exist for exhaust nozzles as well as current research efforts in place to address the barriers.

  20. Addressing sexual and relationship violence in the LGBT community using a bystander framework.

    PubMed

    Potter, Sharyn J; Fountain, Kim; Stapleton, Jane G

    2012-01-01

    Sexual and relationship violence are two major public health issues that affect an alarming number of undergraduate students. As a result, many colleges and universities have protocols to serve victims of these forms of violence. Despite federal legislation stating that all students should have equitable experiences, current protocols and programs focus primarily on heterosexual students. College student victims of sexual and relationship violence who identify as lesbian, gay, bisexual, or transgender can face particular challenges, including disclosure of their sexual and gender orientations, and revictimization when seeking services. In recent years an increasing number of campuses have adopted bystander prevention strategies to address sexual and relationship violence. These strategies seek to engage community members in the prevention of sexual and relationship violence by training them to identify and safely intervene in situations where sexual or relationship violence is about to occur, is occurring, or has occurred. In this article we review published bystander prevention strategies that focus on preventing sexual and relationship violence in the campus community, and discuss how bystander strategies are addressing or can address relationship and sexual violence in the LGBT community.

  1. Meeting report: Ocean 'omics science, technology and cyberinfrastructure: current challenges and future requirements (August 20-23, 2013).

    PubMed

    Gilbert, Jack A; Dick, Gregory J; Jenkins, Bethany; Heidelberg, John; Allen, Eric; Mackey, Katherine R M; DeLong, Edward F

    2014-06-15

    The National Science Foundation's EarthCube End User Workshop was held at USC Wrigley Marine Science Center on Catalina Island, California in August 2013. The workshop was designed to explore and characterize the needs and tools available to the community that is focusing on microbial and physical oceanography research with a particular emphasis on 'omic research. The assembled researchers outlined the existing concerns regarding the vast data resources that are being generated, and how we will deal with these resources as their volume and diversity increases. Particular attention was focused on the tools for handling and analyzing the existing data, on the need for the construction and curation of diverse federated databases, as well as development of shared, interoperable, "big-data capable" analytical tools. The key outputs from this workshop include (i) critical scientific challenges and cyber infrastructure constraints, (ii) the current and future ocean 'omics science grand challenges and questions, and (iii) data management, analytical and associated and cyber-infrastructure capabilities required to meet critical current and future scientific challenges. The main thrust of the meeting and the outcome of this report is a definition of the 'omics tools, technologies and infrastructures that facilitate continued advance in ocean science biology, marine biogeochemistry, and biological oceanography.

  2. Visual Analytics Tools for Sustainable Lifecycle Design: Current Status, Challenges, and Future Opportunities.

    PubMed

    Ramanujan, Devarajan; Bernstein, William Z; Chandrasegaran, Senthil K; Ramani, Karthik

    2017-01-01

    The rapid rise in technologies for data collection has created an unmatched opportunity to advance the use of data-rich tools for lifecycle decision-making. However, the usefulness of these technologies is limited by the ability to translate lifecycle data into actionable insights for human decision-makers. This is especially true in the case of sustainable lifecycle design (SLD), as the assessment of environmental impacts, and the feasibility of making corresponding design changes, often relies on human expertise and intuition. Supporting human sense-making in SLD requires the use of both data-driven and user-driven methods while exploring lifecycle data. A promising approach for combining the two is through the use of visual analytics (VA) tools. Such tools can leverage the ability of computer-based tools to gather, process, and summarize data along with the ability of human-experts to guide analyses through domain knowledge or data-driven insight. In this paper, we review previous research that has created VA tools in SLD. We also highlight existing challenges and future opportunities for such tools in different lifecycle stages-design, manufacturing, distribution & supply chain, use-phase, end-of-life, as well as life cycle assessment. Our review shows that while the number of VA tools in SLD is relatively small, researchers are increasingly focusing on the subject matter. Our review also suggests that VA tools can address existing challenges in SLD and that significant future opportunities exist.

  3. Addressing Challenges in Web Accessibility for the Blind and Visually Impaired

    ERIC Educational Resources Information Center

    Guercio, Angela; Stirbens, Kathleen A.; Williams, Joseph; Haiber, Charles

    2011-01-01

    Searching for relevant information on the web is an important aspect of distance learning. This activity is a challenge for visually impaired distance learners. While sighted people have the ability to filter information in a fast and non sequential way, blind persons rely on tools that process the information in a sequential way. Learning is…

  4. Alcohol portrayals in movies, music videos and soap operas and alcohol use of young people: current status and future challenges.

    PubMed

    Koordeman, Renske; Anschutz, Doeschka J; Engels, Rutger C M E

    2012-01-01

    To provide an overview of studies of the effects of alcohol portrayals in movies, music videos and soap operas on alcohol consumption among young people. Moreover, we highlight important issues that need to be addressed in future research. This paper reviews the current literature on alcohol portrayals on-screen and the associated gaps and challenges in alcohol media research. Thirteen longitudinal studies, 8 cross-sectional studies and 6 experimental studies examined the effects of alcohol portrayals on-screen on alcohol consumption among young people. They showed a relation between on-screen alcohol exposure and onset and progression of alcohol consumption. A distinction can be made between long-term effects and immediate effects on alcohol consumption. Only lately, more attention has been paid to processes underlying the effects of on-screen alcohol exposure. Replication of findings and development of new research designs is essential. On-screen alcohol exposure does not affect everyone. It is important to test individual differences in susceptibility to on-screen alcohol portrayals. Further, not all media alcohol portrayal might provoke similar effects. It is therefore essential to test the effect of different types of alcohol portrayals.

  5. Challenges to promoting health for amateur athletes through anti-doping policy.

    PubMed

    Henning, April

    2017-01-01

    Anti-doping regulations are intended, at least in part, to promote the health of athletes. While most anti-doping efforts target elite and professional competitors, there have been recent moves by sport governing bodies to expand anti-doping testing to include amateur athletes. Drawing on previous critiques of anti-doping policies and illustrating cases, this article outlines five of the challenges to health promotion of applying the current detect and ban model to the amateur level of sport. I argue that the current approach is not effective and, in some ways, may undermine the goal of health promotion at the amateur level. In order to address these challenges, I propose alternative, health-centred strategies that focus on athlete empowerment and choice through critical awareness of a variety of substances, associated risks and rewards, and the role of expertise in decision-making.

  6. Challenges to promoting health for amateur athletes through anti-doping policy

    PubMed Central

    Henning, April

    2017-01-01

    Anti-doping regulations are intended, at least in part, to promote the health of athletes. While most anti-doping efforts target elite and professional competitors, there have been recent moves by sport governing bodies to expand anti-doping testing to include amateur athletes. Drawing on previous critiques of anti-doping policies and illustrating cases, this article outlines five of the challenges to health promotion of applying the current detect and ban model to the amateur level of sport. I argue that the current approach is not effective and, in some ways, may undermine the goal of health promotion at the amateur level. In order to address these challenges, I propose alternative, health-centred strategies that focus on athlete empowerment and choice through critical awareness of a variety of substances, associated risks and rewards, and the role of expertise in decision-making. PMID:28736489

  7. Centennial Challenges

    NASA Image and Video Library

    2010-02-26

    NASA Administrator Charles Bolden, right, and Doug Comstock, left, stand with David Masten, of Masten Space Systems, during a ceremony for winners and participants of NASA’s 2009 Centennial Challenges, Friday, Feb. 26, 2010, at NASA Headquarters in Washington. The year-long competition addresses a range of technical challenges that support NASA's missions in aeronautics and space with a goal of encouraging novel solutions from non-traditional sources. Photo Credit: (NASA/Paul E. Alers)

  8. Challenges with Evidence-Based Management of Stable Ischemic Heart Disease.

    PubMed

    Patel, Amit V; Bangalore, Sripal

    2017-02-01

    Stable ischemic heart disease (SIHD) is a highly prevalent condition associated with increased costs, morbidity, and mortality. Management goals of SIHD can broadly be thought of in terms of improving prognosis and/or improving symptoms. Treatment options include medical therapy as well as revascularization, either with percutaneous coronary intervention or coronary artery bypass grafting. Herein, we will review the current evidence base for treatment of SIHD as well as its challenges and discuss ongoing studies to help address some of these knowledge gaps. There has been no consistent reduction in death or myocardial infarction (MI) with revascularization vs. medical therapy in patients with SIHD in contemporary trials. Angina and quality of life have been shown to be relieved more rapidly with revascularization vs. optimal medical therapy; however, the durability of these results is uncertain. There have been challenges and limitations in several of the trials addressing the optimal treatment strategy for SIHD due to potential selection bias (due to knowledge of coronary anatomy prior to randomization), patient crossover, and advances in medical therapy and revascularization strategies since trial completion. The challenges inherent to prior trials addressing the optimal management strategy for SIHD have impacted the generalizability of results to real-world cohorts. Until the results of additional ongoing trials are available, the decision for revascularization or medical therapy should be based on patients' symptoms, weighing the risks and benefits of each approach, and patient preference.

  9. Special Education in Arab Countries: Current Challenges

    ERIC Educational Resources Information Center

    Hadidi, Muna S.; Al Khateeb, Jamal M.

    2015-01-01

    Arab countries have undertaken various measures to develop special education programmes and services over the last three decades; nevertheless, major challenges remain regarding the expansion of these programmes and services and improving their quality. "This article provides an update on disability and special education in Arab…

  10. Mars outpost - System and operations challenges

    NASA Technical Reports Server (NTRS)

    Roberts, Barney; Guerra, Lisa

    1990-01-01

    The paper addresses the challenges inherent in establishing an outpost on the planet Mars. For background purposes, the unique, remote Martian environment and the developmental phases of a settlement in such an environment are discussed. Challenges are identified in terms of surface systems and operations. Due to its importance to habitability, the life support system (LSS) is highlighted with various options identified. Operations for the Mars outpost, earth-based and local, are characterized by a decentralized concept. The challenge of integrating logistics analysis early in system design and operations strategy is also addressed. In order to understand and reduce the system and operations challenges, the application of terrestrial and lunar testbeds is explained.

  11. The current status, challenges, and future developments of new tuberculosis vaccines.

    PubMed

    Gong, Wenping; Liang, Yan; Wu, Xueqiong

    2018-03-30

    Mycobacterium tuberculosis complex causes tuberculosis (TB), one of the top 10 causes of death worldwide. TB results in more fatalities than multi-drug resistant (MDR) HIV strain related coinfection. Vaccines play a key role in the prevention and control of infectious diseases. Unfortunately, the only licensed preventive vaccine against TB, bacilli Calmette-Guérin (BCG), is ineffective for prevention of pulmonary TB in adults. Therefore, it is very important to develop novel vaccines for TB prevention and control. This literature review provides an overview of the innate and adaptive immune response during M. tuberculosis infection, and presents current developments and challenges to novel TB vaccines. A comprehensive understanding of vaccines in preclinical and clinical studies provides extensive insight for the development of safer and more efficient vaccines, and may inspire new ideas for TB prevention and treatment.

  12. Challenges in Addressing Variability Of Lead in Domestic Plumbing

    EPA Science Inventory

    Current data indicate that lead exposure is of concern even at low concentrations. Corrosion is an important problem in drinking water because it can affect public health due to leaching of lead or other metals into the drinking water. For this reason, a corrosion control program...

  13. Standards, Assessment, and Readiness: Addressing Postsecondary Transition Issues across State Lines

    ERIC Educational Resources Information Center

    Michelau, Demarée K.

    2015-01-01

    This brief describes major challenges ahead for states, institutions, and most importantly, students as the standards and assessments from the Common Core Standards (CCSS) are implemented. It also offers recommendations to create a network structure that would assist K-12 and higher education leaders in addressing those challenges. To begin the…

  14. Addressing the Real-World Challenges in the Development of Propulsion IVHM Technology Experiment (PITEX)

    NASA Technical Reports Server (NTRS)

    Maul, William A.; Chicatelli, Amy; Fulton, Christopher E.; Balaban, Edward; Sweet, Adam; Hayden, Sandra Claire; Bajwa, Anupa

    2005-01-01

    The Propulsion IVHM Technology Experiment (PITEX) has been an on-going research effort conducted over several years. PITEX has developed and applied a model-based diagnostic system for the main propulsion system of the X-34 reusable launch vehicle, a space-launch technology demonstrator. The application was simulation-based using detailed models of the propulsion subsystem to generate nominal and failure scenarios during captive carry, which is the most safety-critical portion of the X-34 flight. Since no system-level testing of the X-34 Main Propulsion System (MPS) was performed, these simulated data were used to verify and validate the software system. Advanced diagnostic and signal processing algorithms were developed and tested in real-time on flight-like hardware. In an attempt to expose potential performance problems, these PITEX algorithms were subject to numerous real-world effects in the simulated data including noise, sensor resolution, command/valve talkback information, and nominal build variations. The current research has demonstrated the potential benefits of model-based diagnostics, defined the performance metrics required to evaluate the diagnostic system, and studied the impact of real-world challenges encountered when monitoring propulsion subsystems.

  15. Numerical simulation of turbulent combustion: Scientific challenges

    NASA Astrophysics Data System (ADS)

    Ren, ZhuYin; Lu, Zhen; Hou, LingYun; Lu, LiuYan

    2014-08-01

    Predictive simulation of engine combustion is key to understanding the underlying complicated physicochemical processes, improving engine performance, and reducing pollutant emissions. Critical issues as turbulence modeling, turbulence-chemistry interaction, and accommodation of detailed chemical kinetics in complex flows remain challenging and essential for high-fidelity combustion simulation. This paper reviews the current status of the state-of-the-art large eddy simulation (LES)/prob-ability density function (PDF)/detailed chemistry approach that can address the three challenging modelling issues. PDF as a subgrid model for LES is formulated and the hybrid mesh-particle method for LES/PDF simulations is described. Then the development need in micro-mixing models for the PDF simulations of turbulent premixed combustion is identified. Finally the different acceleration methods for detailed chemistry are reviewed and a combined strategy is proposed for further development.

  16. Adversarial reasoning: challenges and approaches

    NASA Astrophysics Data System (ADS)

    Kott, Alexander; Ownby, Michael

    2005-05-01

    This paper defines adversarial reasoning as computational approaches to inferring and anticipating an enemy's perceptions, intents and actions. It argues that adversarial reasoning transcends the boundaries of game theory and must also leverage such disciplines as cognitive modeling, control theory, AI planning and others. To illustrate the challenges of applying adversarial reasoning to real-world problems, the paper explores the lessons learned in the CADET -- a battle planning system that focuses on brigade-level ground operations and involves adversarial reasoning. From this example of current capabilities, the paper proceeds to describe RAID -- a DARPA program that aims to build capabilities in adversarial reasoning, and how such capabilities would address practical requirements in Defense and other application areas.

  17. Addressing Challenges to the Design & Test of Operational Lighting Environments for the International Space Station

    NASA Technical Reports Server (NTRS)

    Clark, Toni A.

    2014-01-01

    In our day to day lives, the availability of light, with which to see our environment, is often taken for granted. The designers of land based lighting systems use sunlight and artificial light as their toolset. The availability of power, quantity of light sources, and variety of design options are often unlimited. The accessibility of most land based lighting systems makes it easy for the architect and engineer to verify and validate their design ideas. Failures with an implementation, while sometimes costly, can easily be addressed by renovation. Consider now, an architectural facility orbiting in space, 260 miles above the surface of the earth. This human rated architectural facility, the International Space Station (ISS) must maintain operations every day, including life support and appropriate human comforts without fail. The facility must also handle logistics of regular shipments of cargo, including new passengers. The ISS requires accommodations necessary for human control of machine systems. Additionally, the ISS is a research facility and supports investigations performed inside and outside its livable volume. Finally, the facility must support remote operations and observations by ground controllers. All of these architectural needs require a functional, safe, and even an aesthetic lighting environment. At Johnson Space Center, our Habitability and Human Factors team assists our diverse customers with their lighting environment challenges, via physical test and computer based analysis. Because of the complexity of ISS operational environment, our team has learned and developed processes that help ISS operate safely. Because of the dynamic exterior lighting environment, uses computational modeling to predict the lighting environment. The ISS' orbit exposes it to a sunrise every 90 minutes, causing work surfaces to quickly change from direct sunlight to earthshine to total darkness. Proper planning of vehicle approaches, robotics operations, and crewed

  18. A Multi-Systemic School-Based Approach for Addressing Childhood Aggression

    ERIC Educational Resources Information Center

    Runions, Kevin

    2008-01-01

    School-based approaches to addressing aggression in the early grades have focused on explicit curriculum addressing social and emotional processes. The current study reviews research on the distinct modes of aggression, the status of current research on social and emotional processing relevant to problems of aggression amongst young children, as…

  19. In Situ Fabrication and Repair (ISFR) Technologies; New Challenges for Exploration

    NASA Technical Reports Server (NTRS)

    Bassler, Julie A.; Bodiford, Melanie P.; Hammond, Monica S.; King, Ron; Mclemore, Carole A.; Hall, Nancy R.; Fiske, Michael R.; Ray, Julie A.

    2006-01-01

    NASA's human exploration initiative poses great opportunity and great risk for manned missions to the Moon and Mars. Engineers and Scientists at the Marshall Space Flight Center (MSFC) are continuing to evaluate current technologies for in situ resource-based exploration fabrication and repair applications. Several technologies to be addressed in this paper have technology readiness levels (TRLs) that are currently mature enough to pursue for exploration purposes. However, while many technologies offer promising applications, these technologies must be pulled along by the demands and applications of this great initiative. The In Situ Fabrication and Repair (ISFR) Element will supply and push state of the art technologies for applications such as habitat structure development, in situ resource utilization for tool and part fabrication, and repair and non-destructive evaluation W E ) of common life support elements. As an overview of the ISFR Element, this paper will address rapid prototyping technologies, their applications, challenges, and near term advancements. This paper will also discuss the anticipated need to utilize in situ resources to produce replacement parts and fabricate repairs to vehicles, habitats, life support and quality of life elements. Overcoming the challenges of ISFR development will provide the Exploration initiative with state of the art technologies that reduce risk, and enhance supportability.

  20. Personalized medicine: challenges and opportunities for translational bioinformatics

    PubMed Central

    Overby, Casey Lynnette; Tarczy-Hornoch, Peter

    2013-01-01

    Personalized medicine can be defined broadly as a model of healthcare that is predictive, personalized, preventive and participatory. Two US President’s Council of Advisors on Science and Technology reports illustrate challenges in personalized medicine (in a 2008 report) and in use of health information technology (in a 2010 report). Translational bioinformatics is a field that can help address these challenges and is defined by the American Medical Informatics Association as “the development of storage, analytic and interpretive methods to optimize the transformation of increasing voluminous biomedical data into proactive, predictive, preventative and participatory health.” This article discusses barriers to implementing genomics applications and current progress toward overcoming barriers, describes lessons learned from early experiences of institutions engaged in personalized medicine and provides example areas for translational bioinformatics research inquiry. PMID:24039624

  1. Current limitations and recommendations to improve testing ...

    EPA Pesticide Factsheets

    In this paper existing regulatory frameworks and test systems for assessing potential endocrine-active chemicals are described, and associated challenges discussed, along with proposed approaches to address these challenges. Regulatory frameworks vary somewhat across organizations, but all basically evaluate whether a chemical possesses endocrine activity and whether this activity can result in adverse outcomes either to humans or the environment. Current test systems include in silico, in vitro and in vivo techniques focused on detecting potential endocrine activity, and in vivo tests that collect apical data to detect possible adverse effects. These test systems are currently designed to robustly assess endocrine activity and/or adverse effects in the estrogen, androgen, and thyroid hormonal pathways; however, there are some limitations of current test systems for evaluating endocrine hazard and risk. These limitations include a lack of certainty regarding: 1)adequately sensitive species and life-stages, 2) mechanistic endpoints that are diagnostic for endocrine pathways of concern, and 3) the linkage between mechanistic responses and apical, adverse outcomes. Furthermore, some existing test methods are resource intensive in regard to time, cost, and use of animals. However, based on recent experiences, there are opportunities to improve approaches to, and guidance for existing test methods, and to reduce uncertainty. For example, in vitro high throughput

  2. Communicative challenges in the home care of older persons - a qualitative exploration.

    PubMed

    Sundler, Annelie J; Eide, Hilde; van Dulmen, Sandra; Holmström, Inger K

    2016-10-01

    To explore communicative challenges in encounters between nurse assistants and older persons during home care visits. The older population is increasing worldwide. Currently, there is a shift in care for older people from institutional care to home care. Providing home care in a person's home involves several challenges, including the complexity of communication. A descriptive observational design with a qualitative approach was used. The data consisted of audio recordings of real-life encounters during home care visits between nurse assistants and older persons, collected in 2014. A hermeneutic phenomenological analysis was conducted. Communicative challenges were identified: (a) in situations where the older persons had a different view than the nurse assistants on the care task and its content; and (b) when unexpected actions or turns occurred in the communication. Challenges included older person's existential issues, fragility and worries and concerns, which often appeared to be only vaguely expressed and difficult to verbally detect and tackle. This engendered a risk of misinterpretation or ignorance of these challenges. The findings point to the importance of communication as the key to facilitate person-centred home care. Communication training should focus more on addressing needs and existential issues in older persons. Person-centred home care for older persons needs to be addressed at both an individual and an organizational level. © 2016 John Wiley & Sons Ltd.

  3. How Can eHealth Technology Address Challenges Related to Multimorbidity? Perspectives from Patients with Multiple Chronic Conditions.

    PubMed

    Zulman, Donna M; Jenchura, Emily C; Cohen, Danielle M; Lewis, Eleanor T; Houston, Thomas K; Asch, Steven M

    2015-08-01

    Patient eHealth technology offers potential support for disease self-management, but the value of existing applications for patients with multiple chronic conditions (MCCs) is unclear. To understand self-management and health care navigation challenges that patients face due to MCCs and to identify opportunities to support these patients through new and enhanced eHealth technology. After administering a screening survey, we conducted 10 focus groups of 3-8 patients grouped by age, sex, and common chronic conditions. Patients discussed challenges associated with having MCCs and their use of (and desires from) technology to support self-management. Three investigators used standard content analysis methods to code the focus group transcripts. Emergent themes were reviewed with all collaborators, and final themes and representative quotes were validated with a sample of participants. Fifty-three individuals with ≥3 chronic conditions and experience using technology for health-related purposes. Focus group participants had an average of five chronic conditions. Participants reported using technology most frequently to search for health information (96%), communicate with health care providers (92%), track medical information (83%), track medications (77%), and support decision-making about treatment (55%). Three themes emerged to guide eHealth technology development: (1) Patients with MCCs manage a high volume of information, visits, and self-care tasks; (2) they need to coordinate, synthesize, and reconcile health information from multiple providers and about different conditions; (3) their unique position at the hub of multiple health issues requires self-advocacy and expertise. Focus groups identified desirable eHealth resources and tools that reflect these themes. Although patients with multiple health issues use eHealth technology to support self-care for specific conditions, they also desire tools that transcend disease boundaries. By addressing the holistic

  4. Anion exchange membrane fuel cells: Current status and remaining challenges

    NASA Astrophysics Data System (ADS)

    Gottesfeld, Shimshon; Dekel, Dario R.; Page, Miles; Bae, Chulsung; Yan, Yushan; Zelenay, Piotr; Kim, Yu Seung

    2018-01-01

    The anion exchange membrane fuel cell (AEMFC) is an attractive alternative to acidic proton exchange membrane fuel cells, which to date have required platinum-based catalysts, as well as acid-tolerant stack hardware. The AEMFC could use non-platinum-group metal catalysts and less expensive metal hardware thanks to the high pH of the electrolyte. Over the last decade, substantial progress has been made in improving the performance and durability of the AEMFC through the development of new materials and the optimization of system design and operation conditions. In this perspective article, we describe the current status of AEMFCs as having reached beginning of life performance very close to that of PEMFCs when using ultra-low loadings of Pt, while advancing towards operation on non-platinum-group metal catalysts alone. In the latter sections, we identify the remaining technical challenges, which require further research and development, focusing on the materials and operational factors that critically impact AEMFC performance and/or durability. These perspectives may provide useful insights for the development of next-generation of AEMFCs.

  5. Anion exchange membrane fuel cells: Current status and remaining challenges

    DOE PAGES

    Gottesfeld, Shimshon; Dekel, Dario R.; Page, Miles; ...

    2017-09-01

    The anion exchange membrane fuel cell (AEMFC) is an attractive alternative to acidic proton exchange membrane fuel cells, which to date have required platinum-based catalysts, as well as acid-tolerant stack hardware. The AEMFC could use non-platinum-group metal catalysts and less expensive metal hardware thanks to the high pH of the electrolyte. Over the last decade, substantial progress has been made in improving the performance and durability of the AEMFC through the development of new materials and the optimization of system design and operation conditions. Here in this perspective article, we describe the current status of AEMFCs as having reached beginningmore » of life performance very close to that of PEMFCs when using ultra-low loadings of Pt, while advancing towards operation on non-platinum-group metal catalysts alone. In the latter sections, we identify the remaining technical challenges, which require further research and development, focusing on the materials and operational factors that critically impact AEMFC performance and/or durability. Finally, these perspectives may provide useful insights for the development of next-generation of AEMFCs.« less

  6. Current challenges in the recognition, prevention and treatment of perioperative pulmonary atelectasis.

    PubMed

    Restrepo, Ruben D; Braverman, Jane

    2015-02-01

    Innovations in surgery have significantly increased the number of procedures performed every year. While more individuals benefit from better surgical techniques and technology, a larger group of patients previously deemed ineligible for surgery now undergo high-complexity surgical procedures. Despite continuous improvements in the operating room and post-operative care, post-operative pulmonary complications (PPCs) continue to pose a serious threat to successful outcomes. PPCs are common, serious and costly. Growing awareness of the impact of PPCs has led to intensified efforts to understand the underlying causes. Current evidence demonstrates that a high proportion of PPCs are directly traceable to the pre-operative risk for and perioperative development of atelectasis. The substantial costs and losses associated with PPCs demand strategies to reduce their prevalence and impact. Effective interventions will almost certainly produce cost savings that significantly offset current economic and human resource expenditures. The purpose of this review is to describe the most common challenges encountered in the recognition, prevention and management of perioperative atelectasis. Expanding awareness and understanding of the role of atelectasis as a cause of PPCs can reduce their prevalence, impact important clinical outcomes and reduce the financial burden associated with treating these complications.

  7. Addressing Wife Abuse in Mexican Immigrant Couples: Challenges for Family Social Workers

    ERIC Educational Resources Information Center

    Hancock, Tina

    2006-01-01

    This article addresses wife abuse in undocumented Mexican immigrant couples and suggests an ecosystems treatment approach that takes into consideration the structural forces of oppression and discrimination on abusive behaviors in the home and combines individual, family and community level interventions to help immigrant men stop the abuse.…

  8. Addressing the hidden dimension in nursing education: promoting cultural competence.

    PubMed

    Carter, Kimberly F; Xu, Yu

    2007-01-01

    The authors describe a cultural competence quality enhancement process to address the retention challenge of students who speak English as second language and international students as part of a school of nursing's continuous program quality improvement to achieve excellence. The process, strategies, outcomes, and evaluation of the training program are detailed within the given geographical, institutional, and curriculum context. Lessons and continuing challenges are also specified.

  9. Plasma Physics Challenges of MM-to-THz and High Power Microwave Generation

    NASA Astrophysics Data System (ADS)

    Booske, John

    2007-11-01

    Homeland security and military defense technology considerations have stimulated intense interest in mobile, high power sources of millimeter-wave to terahertz regime electromagnetic radiation, from 0.1 to 10 THz. While sources at the low frequency end, i.e., the gyrotron, have been deployed or are being tested for diverse applications such as WARLOC radar and active denial systems, the challenges for higher frequency sources have yet to be completely met for applications including noninvasive sensing of concealed weapons and dangerous agents, high-data-rate communications, and high resolution spectroscopy and atmospheric sensing. The compact size requirements for many of these high frequency sources requires miniscule, micro-fabricated slow wave circuits with high rf ohmic losses. This necessitates electron beams with not only very small transverse dimensions but also very high current density for adequate gain. Thus, the emerging family of mm-to-THz e-beam-driven vacuum electronics devices share many of the same plasma physics challenges that currently confront ``classic'' high power microwave (HPM) generators [1] including bright electron sources, intense beam transport, energetic electron interaction with surfaces and rf air breakdown at output windows. Multidimensional theoretical and computational models are especially important for understanding and addressing these challenges. The contemporary plasma physics issues, recent achievements, as well as the opportunities and outlook on THz and HPM will be addressed. [1] R.J. Barker, J.H. Booske, N.C. Luhmann, and G.S. Nusinovich, Modern Microwave and Millimeter-Wave Power Electronics (IEEE/Wiley, 2005).

  10. Pretreatment of agricultural biomass for anaerobic digestion: Current state and challenges.

    PubMed

    Paudel, Shukra Raj; Banjara, Sushant Prasad; Choi, Oh Kyung; Park, Ki Young; Kim, Young Mo; Lee, Jae Woo

    2017-12-01

    The anaerobic digestion (AD) of agricultural biomass is an attractive second generation biofuel with potential environmental and economic benefits. Most agricultural biomass contains lignocellulose which requires pretreatment prior to AD. For optimization, the pretreatment methods need to be specific to the characteristics of the biomass feedstock. In this review, cereal residue, fruit and vegetable wastes, grasses and animal manure were selected as the agricultural biomass candidates, and the fundamentals and current state of various pretreatment methods used for AD of these feedstocks were investigated. Several nonconventional methods (electrical, ionic liquid-based chemicals, ruminant biological pretreatment) offer potential as targeted pretreatments of lignocellulosic biomass, but each comes with its own challenges. Pursuing an energy-intensive route, a combined bioethanol-biogas production could be a promising a second biofuel refinery option, further emphasizing the importance of pretreatment when lignocellulosic feedstock is used. Copyright © 2017 Elsevier Ltd. All rights reserved.

  11. Optically addressed ultra-wideband phased antenna array

    NASA Astrophysics Data System (ADS)

    Bai, Jian

    Demands for high data rate and multifunctional apertures from both civilian and military users have motivated development of ultra-wideband (UWB) electrically steered phased arrays. Meanwhile, the need for large contiguous frequency is pushing operation of radio systems into the millimeter-wave (mm-wave) range. Therefore, modern radio systems require UWB performance from VHF to mm-wave. However, traditional electronic systems suffer many challenges that make achieving these requirements difficult. Several examples includes: voltage controlled oscillators (VCO) cannot provide a tunable range of several octaves, distribution of wideband local oscillator signals undergo high loss and dispersion through RF transmission lines, and antennas have very limited bandwidth or bulky sizes. Recently, RF photonics technology has drawn considerable attention because of its advantages over traditional systems, with the capability of offering extreme power efficiency, information capacity, frequency agility, and spatial beam diversity. A hybrid RF photonic communication system utilizing optical links and an RF transducer at the antenna potentially provides ultra-wideband data transmission, i.e., over 100 GHz. A successful implementation of such an optically addressed phased array requires addressing several key challenges. Photonic generation of an RF source with over a seven-octave bandwidth has been demonstrated in the last few years. However, one challenge which still remains is how to convey phased optical signals to downconversion modules and antennas. Therefore, a feed network with phase sweeping capability and low excessive phase noise needs to be developed. Another key challenge is to develop an ultra-wideband array antenna. Modern frontends require antennas to be compact, planar, and low-profile in addition to possessing broad bandwidth, conforming to stringent space, weight, cost, and power constraints. To address these issues, I will study broadband and miniaturization

  12. Organization for rare diseases India (ORDI) - addressing the challenges and opportunities for the Indian rare diseases' community.

    PubMed

    Rajasimha, Harsha Karur; Shirol, Prasannakumar Basayya; Ramamoorthy, Preveen; Hegde, Madhuri; Barde, Sangeeta; Chandru, Vijay; Ravinandan, M E; Ramchandran, Ramani; Haldar, Kasturi; Lin, Jimmy C; Babar, Imran A; Girisha, Katta M; Srinivasan, Sudha; Navaneetham, Duraiswamy; Battu, Rajani; Devarakonda, Rajashree; Kini, Usha; Vijayachandra, Kinnimulki; Verma, Ishwar C

    2014-08-13

    In order to address the unmet needs and create opportunities that benefit patients with rare disease in India, a group of volunteers created a not-for-profit organization named Organization for Rare Diseases India (ORDI; www.ordindia.org). ORDI plans to represent the collective voice and advocate the needs of patients with rare diseases and other stakeholders in India. The ORDI team members come from diverse backgrounds such as genetics, molecular diagnostics, drug development, bioinformatics, communications, information technology, patient advocacy and public service. ORDI builds on the lessons learned from numerous similar organizations in the USA, European Union and disease-specific rare disease foundations in India. In this review, we provide a background on the landscape of rare diseases and the organizations that are active in this area globally and in India. We discuss the unique challenges in tackling rare diseases in India, and highlight the unmet needs of the key stakeholders of rare diseases. Finally, we define the vision, mission, goals and objectives of ORDI, identify the key developments in the health care context in India and welcome community feedback and comments on our approach.

  13. Addressing Methodological Challenges in Large Communication Datasets: Collecting and Coding Longitudinal Interactions in Home Hospice Cancer Care

    PubMed Central

    Reblin, Maija; Clayton, Margaret F; John, Kevin K; Ellington, Lee

    2015-01-01

    In this paper, we present strategies for collecting and coding a large longitudinal communication dataset collected across multiple sites, consisting of over 2000 hours of digital audio recordings from approximately 300 families. We describe our methods within the context of implementing a large-scale study of communication during cancer home hospice nurse visits, but this procedure could be adapted to communication datasets across a wide variety of settings. This research is the first study designed to capture home hospice nurse-caregiver communication, a highly understudied location and type of communication event. We present a detailed example protocol encompassing data collection in the home environment, large-scale, multi-site secure data management, the development of theoretically-based communication coding, and strategies for preventing coder drift and ensuring reliability of analyses. Although each of these challenges have the potential to undermine the utility of the data, reliability between coders is often the only issue consistently reported and addressed in the literature. Overall, our approach demonstrates rigor and provides a “how-to” example for managing large, digitally-recorded data sets from collection through analysis. These strategies can inform other large-scale health communication research. PMID:26580414

  14. The health and health system of South Africa: historical roots of current public health challenges.

    PubMed

    Coovadia, Hoosen; Jewkes, Rachel; Barron, Peter; Sanders, David; McIntyre, Diane

    2009-09-05

    The roots of a dysfunctional health system and the collision of the epidemics of communicable and non-communicable diseases in South Africa can be found in policies from periods of the country's history, from colonial subjugation, apartheid dispossession, to the post-apartheid period. Racial and gender discrimination, the migrant labour system, the destruction of family life, vast income inequalities, and extreme violence have all formed part of South Africa's troubled past, and all have inexorably affected health and health services. In 1994, when apartheid ended, the health system faced massive challenges, many of which still persist. Macroeconomic policies, fostering growth rather than redistribution, contributed to the persistence of economic disparities between races despite a large expansion in social grants. The public health system has been transformed into an integrated, comprehensive national service, but failures in leadership and stewardship and weak management have led to inadequate implementation of what are often good policies. Pivotal facets of primary health care are not in place and there is a substantial human resources crisis facing the health sector. The HIV epidemic has contributed to and accelerated these challenges. All of these factors need to be addressed by the new government if health is to be improved and the Millennium Development Goals achieved in South Africa.

  15. Teaching Islam in Contemporary America: Digital Ethnography and the Affective Challenges of Islamic Studies Pedagogy

    ERIC Educational Resources Information Center

    Dorroll, Courtney; Dorroll, Phil

    2017-01-01

    In this article we address the affective dimensions and challenges of teaching about Islam and Islamic studies in the current American political and cultural environment and make two related arguments. First, we explain how the impact of certain kinds of digital media in the past few years has heightened the association of Islam with violence in…

  16. The Importance of Exposure in Addressing Current and Emerging Air Quality Issues

    EPA Science Inventory

    The air quality issues that we face today and will face in the future are becoming increasingly more complex and require an improved understanding of human exposure to be effectively addressed. The objectives of this paper are (1) to discuss how concepts of human exposure and ex...

  17. Current Challenges in Commercially Producing Biofuels from Lignocellulosic Biomass

    PubMed Central

    Balan, Venkatesh

    2014-01-01

    Biofuels that are produced from biobased materials are a good alternative to petroleum based fuels. They offer several benefits to society and the environment. Producing second generation biofuels is even more challenging than producing first generation biofuels due the complexity of the biomass and issues related to producing, harvesting, and transporting less dense biomass to centralized biorefineries. In addition to this logistic challenge, other challenges with respect to processing steps in converting biomass to liquid transportation fuel like pretreatment, hydrolysis, microbial fermentation, and fuel separation still exist and are discussed in this review. The possible coproducts that could be produced in the biorefinery and their importance to reduce the processing cost of biofuel are discussed. About $1 billion was spent in the year 2012 by the government agencies in US to meet the mandate to replace 30% existing liquid transportation fuels by 2022 which is 36 billion gallons/year. Other countries in the world have set their own targets to replace petroleum fuel by biofuels. Because of the challenges listed in this review and lack of government policies to create the demand for biofuels, it may take more time for the lignocellulosic biofuels to hit the market place than previously projected. PMID:25937989

  18. Current Challenges in Commercially Producing Biofuels from Lignocellulosic Biomass

    DOE PAGES

    Balan, Venkatesh

    2014-01-01

    Biofuels that are produced from biobased materials are a good alternative to petroleum based fuels. They offer several benefits to society and the environment. Producing second generation biofuels is even more challenging than producing first generation biofuels due the complexity of the biomass and issues related to producing, harvesting, and transporting less dense biomass to centralized biorefineries. In addition to this logistic challenge, other challenges with respect to processing steps in converting biomass to liquid transportation fuel like pretreatment, hydrolysis, microbial fermentation, and fuel separation still exist and are discussed in this review. The possible coproducts that could be producedmore » in the biorefinery and their importance to reduce the processing cost of biofuel are discussed. About $1 billion was spent in the year 2012 by the government agencies in US to meet the mandate to replace 30% existing liquid transportation fuels by 2022 which is 36 billion gallons/year. Other countries in the world have set their own targets to replace petroleum fuel by biofuels. Because of the challenges listed in this review and lack of government policies to create the demand for biofuels, it may take more time for the lignocellulosic biofuels to hit the market place than previously projected.« less

  19. Addressing challenges of modulation transfer function measurement with fisheye lens cameras

    NASA Astrophysics Data System (ADS)

    Deegan, Brian M.; Denny, Patrick E.; Zlokolica, Vladimir; Dever, Barry; Russell, Laura

    2015-03-01

    Modulation transfer function (MTF) is a well defined and accepted method of measuring image sharpness. The slanted edge test, as defined in ISO12233 is a standard method of calculating MTF, and is widely used for lens alignment and auto-focus algorithm verification. However, there are a number of challenges which should be considered when measuring MTF in cameras with fisheye lenses. Due to trade-offs related Petzval curvature, planarity of the optical plane is difficult to achieve in fisheye lenses. It is therefore critical to have the ability to accurately measure sharpness throughout the entire image, particularly for lens alignment. One challenge for fisheye lenses is that, because of the radial distortion, the slanted edges will have different angles, depending on the location within the image and on the distortion profile of the lens. Previous work in the literature indicates that MTF measurements are robust for angles between 2 and 10 degrees. Outside of this range, MTF measurements become unreliable. Also, the slanted edge itself will be curved by the lens distortion, causing further measurement problems. This study summarises the difficulties in the use of MTF for sharpness measurement in fisheye lens cameras, and proposes mitigations and alternative methods.

  20. CURRENT SITUATION OF MEDICINE III AND CHALLENGES.

    PubMed

    Ferreira, Lydia Masako

    2015-01-01

    Describe the current situation of the area Medicine III of CAPES and detect challenges for the next four years of evaluation. The area's documents and reports of meetings were read from 2004 to 2013 Medicine III Capes as well as reports and evaluation form of each Postgraduate Program (PPG) of the area and the sub-page of the area from the Capes website. The data relating to the evaluation process, the assessment form and faculty, student and scientific production data of all of Post-Graduate Programs of Medicine III were computed and analyzed. From these data were detected the challenges of the area for the next four years (2013-2016). Among the 3,806 PPG, Medicine III had 41 PPG during last triennial evaluation and progressed from 18% to 43% of PPG very good or more concept (triennium 2001-2003 and 2010-2012). Most PPG were located in the South-East region (32), three in the South and two in the North-East. There was no PPG in North or Central-West regions. In 2013 and 2014 there were four approved Professional Master Degree Programs and one Master (M) and Doctorate (PhD). The average of permanent professors was 558 teachers with about three students/professor. The number of PhD graduates has increased as well as the reason PhD/MD. The proportion of in high impact periodicals (A1, A2, B1 and B2) jumped from 30% to 50% demonstrating positive community response to the policy area. The challenges identified were: decrease regional asymmetry, increase the number of masters and doctors of excellence, reassessment of Brazilian journals, stimulate and set internationalization indicators, including post-doctors and definition of its indicators, the PPG nucleation analysis, PPG 3x3, include primary and secondary education, professional master and indicators of technological scientific production and solidarity. Medicine III has been scientifically consolidated and their scientific researchers demonstrated maturity reaching a high level and matched to areas of greatest

  1. The Canadian general surgery resident: defining current challenges for surgical leadership.

    PubMed

    Tomlinson, Corey; Labossière, Joseph; Rommens, Kenton; Birch, Daniel W

    2012-08-01

    Surgery training programs in Canada and the United States have recognized the need to modify current models of training and education. The shifting demographic of surgery trainees, lifestyle issues and an increased trend toward subspecialization are the major influences. To guide these important educational initiatives, a contemporary profile of Canadian general surgery residents and their impressions of training in Canada is required. We developed and distributed a questionnaire to residents in each Canadian general surgery training program, and residents responded during dedicated teaching time. In all, 186 surveys were returned for analysis (62% response rate). The average age of Canadian general surgery residents is 30 years, 38% are women, 41% are married, 18% have dependants younger than 18 years and 41% plan to add to or start a family during residency. Most (87%) residents plan to pursue postgraduate education. On completion of training, 74% of residents plan to stay in Canada and 49% want to practice in an academic setting. Almost half (42%) of residents identify a poor balance between work and personal life during residency. Forty-seven percent of respondents have appropriate access to mentorship, whereas 37% describe suitable access to career guidance and 40% identify the availability of appropriate social supports. Just over half (54%) believe the stress level during residency is manageable. This survey provides a profile of contemporary Canadian general surgery residents. Important challenges within the residency system are identified. Program directors and chairs of surgery are encouraged to recognize these challenges and intervene where appropriate.

  2. Meeting report: Ocean ‘omics science, technology and cyberinfrastructure: current challenges and future requirements (August 20-23, 2013)

    PubMed Central

    Gilbert, Jack A; Dick, Gregory J.; Jenkins, Bethany; Heidelberg, John; Allen, Eric; Mackey, Katherine R. M.

    2014-01-01

    The National Science Foundation’s EarthCube End User Workshop was held at USC Wrigley Marine Science Center on Catalina Island, California in August 2013. The workshop was designed to explore and characterize the needs and tools available to the community that is focusing on microbial and physical oceanography research with a particular emphasis on ‘omic research. The assembled researchers outlined the existing concerns regarding the vast data resources that are being generated, and how we will deal with these resources as their volume and diversity increases. Particular attention was focused on the tools for handling and analyzing the existing data, on the need for the construction and curation of diverse federated databases, as well as development of shared, interoperable, “big-data capable” analytical tools. The key outputs from this workshop include (i) critical scientific challenges and cyber infrastructure constraints, (ii) the current and future ocean ‘omics science grand challenges and questions, and (iii) data management, analytical and associated and cyber-infrastructure capabilities required to meet critical current and future scientific challenges. The main thrust of the meeting and the outcome of this report is a definition of the ‘omics tools, technologies and infrastructures that facilitate continued advance in ocean science biology, marine biogeochemistry, and biological oceanography. PMID:25197495

  3. Virtual physiological human: training challenges.

    PubMed

    Lawford, Patricia V; Narracott, Andrew V; McCormack, Keith; Bisbal, Jesus; Martin, Carlos; Bijnens, Bart; Brook, Bindi; Zachariou, Margarita; Freixa, Jordi Villà I; Kohl, Peter; Fletcher, Katherine; Diaz-Zuccarini, Vanessa

    2010-06-28

    The virtual physiological human (VPH) initiative encompasses a wide range of activities, including structural and functional imaging, data mining, knowledge discovery tool and database development, biomedical modelling, simulation and visualization. The VPH community is developing from a multitude of relatively focused, but disparate, research endeavours into an integrated effort to bring together, develop and translate emerging technologies for application, from academia to industry and medicine. This process initially builds on the evolution of multi-disciplinary interactions and abilities, but addressing the challenges associated with the implementation of the VPH will require, in the very near future, a translation of quantitative changes into a new quality of highly trained multi-disciplinary personnel. Current strategies for undergraduate and on-the-job training may soon prove insufficient for this. The European Commission seventh framework VPH network of excellence is exploring this emerging need, and is developing a framework of novel training initiatives to address the predicted shortfall in suitably skilled VPH-aware professionals. This paper reports first steps in the implementation of a coherent VPH training portfolio.

  4. Culicoides Latreille (Diptera: Ceratopogonidae) taxonomy: Current challenges and future directions

    PubMed Central

    Harrup, L.E.; Bellis, G.A.; Balenghien, T.; Garros, C.

    2015-01-01

    Culicoides Latreille biting midges (Diptera: Ceratopogonidae) cause a significant biting nuisance to humans, livestock and equines, and are the biological vectors of a range of internationally important pathogens of both veterinary and medical importance. Despite their economic significance, the delimitation and identification of species and evolutionary relationships between species within this genus remains at best problematic. To date no phylogenetic study has attempted to validate the subgeneric classification of the genus and the monophyly of many of the subgenera remains doubtful. Many informal species groupings are also known to exist but few are adequately described, further complicating accurate identification. Recent contributions to Culicoides taxonomy at the species level have revealed a high correlation between morphological and molecular analyses although molecular analyses are revealing the existence of cryptic species. This review considers the methods for studying the systematics of Culicoides using both morphological and genetic techniques, with a view to understanding the factors limiting our current understanding of Culicoides biology and hence arbovirus epidemiology. In addition, we examine the global status of Culicoides identification, highlighting areas that are poorly addressed, including the potential implementation of emerging technologies. PMID:25535946

  5. HOM frequency control of SRF cavity in high current ERLs

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

    Xu, Chen; Ben-Zvi, Ilan

    The acceleration of high-current beam in Superconducting Radio Frequency (SRF) cavities is a challenging but essential for a variety of advanced accelerators. SRF cavities should be carefully designed to minimize the High Order Modes (HOM) power generated in the cavities by the beam current. The reduction of HOM power we demonstrate in a particular case can be quite large. This paper presents a method to systematically control the HOM resonance frequencies in the initial design phase to minimize the HOM power generation. This method is expected to be beneficial for the design of high SRF cavities addressing a variety ofmore » Energy Recovery Linac (ERL) applications.« less

  6. HOM frequency control of SRF cavity in high current ERLs

    DOE PAGES

    Xu, Chen; Ben-Zvi, Ilan

    2017-12-06

    The acceleration of high-current beam in Superconducting Radio Frequency (SRF) cavities is a challenging but essential for a variety of advanced accelerators. SRF cavities should be carefully designed to minimize the High Order Modes (HOM) power generated in the cavities by the beam current. The reduction of HOM power we demonstrate in a particular case can be quite large. This paper presents a method to systematically control the HOM resonance frequencies in the initial design phase to minimize the HOM power generation. This method is expected to be beneficial for the design of high SRF cavities addressing a variety ofmore » Energy Recovery Linac (ERL) applications.« less

  7. HOM frequency control of SRF cavity in high current ERLs

    NASA Astrophysics Data System (ADS)

    Xu, Chen; Ben-Zvi, Ilan

    2018-03-01

    The acceleration of high-current beam in Superconducting Radio Frequency (SRF) cavities is a challenging but essential for a variety of advanced accelerators. SRF cavities should be carefully designed to minimize the High Order Modes (HOM) power generated in the cavities by the beam current. The reduction of HOM power we demonstrate in a particular case can be quite large. This paper presents a method to systematically control the HOM resonance frequencies in the initial design phase to minimize the HOM power generation. This method is expected to be beneficial for the design of high SRF cavities addressing a variety of Energy Recovery Linac (ERL) applications.

  8. Current Status of Syphilis Vaccine Development: Need, Challenges, Prospects

    PubMed Central

    Cameron, Caroline E.; Lukehart, Sheila A.

    2013-01-01

    Syphilis is a multistage disease caused by the invasive spirochete Treponema pallidum subsp. pallidum. Despite inexpensive and effective antibiotic therapy, syphilis remains a prevalent disease in developing countries and has re-emerged as a public health threat in developed nations. In addition to the medical burden imparted by infectious syphilis, congenital syphilis is considered the most significant infectious disease affecting fetuses and newborns worldwide, and individuals afflicted with syphilis have an enhanced risk for HIV transmission and acquisition. The global disease burden of syphilis and failure of decades of public health efforts to stem the incidence of disease highlight the need for an effective syphilis vaccine. Although challenges associated with T. pallidum research have impeded understanding of this pathogen, the existence of a relevant animal model has enabled insight into the correlates of disease protection. Complete protection against infection has been achieved in the animal model using an extended immunization regimen of γ-irradiated T. pallidum, demonstrating the importance of treponemal surface components in generation of protective immunity and the feasibility of syphilis vaccine development. Syphilis is a prime candidate for development of a successful vaccine due to the (1) research community’s accumulated knowledge of immune correlates of protection; (2) existence of a relevant animal model that enables effective pre-clinical analyses; (3) universal penicillin susceptibility of T. pallidum which enhances the attractiveness of clinical vaccine trials; and (4) significant public health benefit a vaccine would have on reduction of infectious/congenital syphilis and HIV rates. Critical personnel, research and market gaps need to be addressed before the goal of a syphilis vaccine can be realized, including recruitment of additional researchers to the T. pallidum research field with a proportional increase in research funding

  9. The challenges of studying visual expertise in medical image diagnosis.

    PubMed

    Gegenfurtner, Andreas; Kok, Ellen; van Geel, Koos; de Bruin, Anique; Jarodzka, Halszka; Szulewski, Adam; van Merriënboer, Jeroen Jg

    2017-01-01

    Visual expertise is the superior visual skill shown when executing domain-specific visual tasks. Understanding visual expertise is important in order to understand how the interpretation of medical images may be best learned and taught. In the context of this article, we focus on the visual skill of medical image diagnosis and, more specifically, on the methodological set-ups routinely used in visual expertise research. We offer a critique of commonly used methods and propose three challenges for future research to open up new avenues for studying characteristics of visual expertise in medical image diagnosis. The first challenge addresses theory development. Novel prospects in modelling visual expertise can emerge when we reflect on cognitive and socio-cultural epistemologies in visual expertise research, when we engage in statistical validations of existing theoretical assumptions and when we include social and socio-cultural processes in expertise development. The second challenge addresses the recording and analysis of longitudinal data. If we assume that the development of expertise is a long-term phenomenon, then it follows that future research can engage in advanced statistical modelling of longitudinal expertise data that extends the routine use of cross-sectional material through, for example, animations and dynamic visualisations of developmental data. The third challenge addresses the combination of methods. Alternatives to current practices can integrate qualitative and quantitative approaches in mixed-method designs, embrace relevant yet underused data sources and understand the need for multidisciplinary research teams. Embracing alternative epistemological and methodological approaches for studying visual expertise can lead to a more balanced and robust future for understanding superior visual skills in medical image diagnosis as well as other medical fields. © 2016 John Wiley & Sons Ltd and The Association for the Study of Medical Education.

  10. A Promising Approach to Addressing America's Biggest Challenges. Needle-Moving Community Collaboratives

    ERIC Educational Resources Information Center

    Jolin, Michele; Schmitz, Paul; Seldon, Willa

    2012-01-01

    Communities face powerful challenges--a high-school dropout epidemic, youth unemployment, teen pregnancy--that require powerful solutions. In a climate of increasingly constrained resources, those solutions must help communities to achieve more with less. A new kind of community collaborative--an approach that aspires to significant,…

  11. The role of public-private partnerships in addressing the biomedical innovation challenge.

    PubMed

    Said, Maya; Zerhouni, Elias

    2014-11-01

    Without a step change in the productivity of pharmaceutical research and development, it will be difficult to tackle the public health challenges facing societies worldwide. Public–private partnerships could play a key role in achieving this step change, but they need to be well designed and led.

  12. Research of future network with multi-layer IP address

    NASA Astrophysics Data System (ADS)

    Li, Guoling; Long, Zhaohua; Wei, Ziqiang

    2018-04-01

    The shortage of IP addresses and the scalability of routing systems [1] are challenges for the Internet. The idea of dividing existing IP addresses between identities and locations is one of the important research directions. This paper proposed a new decimal network architecture based on IPv9 [11], and decimal network IP address from E.164 principle of traditional telecommunication network, the IP address level, which helps to achieve separation and identification and location of IP address, IP address form a multilayer network structure, routing scalability problem in remission at the same time, to solve the problem of IPv4 address depletion. On the basis of IPv9, a new decimal network architecture is proposed, and the IP address of the decimal network draws on the E.164 principle of the traditional telecommunication network, and the IP addresses are hierarchically divided, which helps to realize the identification and location separation of IP addresses, the formation of multi-layer IP address network structure, while easing the scalability of the routing system to find a way out of IPv4 address exhausted. In addition to modifying DNS [10] simply and adding the function of digital domain, a DDNS [12] is formed. At the same time, a gateway device is added, that is, IPV9 gateway. The original backbone network and user network are unchanged.

  13. The changing global landscape of health and disease: addressing challenges and opportunities for sustaining progress towards control and elimination of neglected tropical diseases (NTDs).

    PubMed

    Molyneux, David H; Dean, Laura; Adekeye, Oluwatosin; Stothard, J Russell; Theobald, Sally

    2018-03-16

    The drive to control neglected tropical diseases (NTDs) has had many successes but to reach defined targets new approaches are required. Over the last decade, NTD control programmes have benefitted from increased resources, and from effective partnerships and long-term pharmaceutical donations. Although the NTD agenda is broader than those diseases of parasitic aetiology there has been a massive up-scaling of the delivery of medicines to some billion people annually. Recipients are often the poorest, with the aspiration that NTD programmes are key to universal health coverage as reflected within the 2030 United Nations sustainable development goals (SDGs). To reach elimination targets, the community will need to adapt global events and changing policy environments to ensure programmes are responsive and can sustain progress towards NTD targets. Innovative thinking embedded within regional and national health systems is needed. Policy makers, managers and frontline health workers are the mediators between challenge and change at global and local levels. This paper attempts to address the challenges to end the chronic pandemic of NTDs and achieve the SDG targets. It concludes with a conceptual framework that illustrates the interactions between these key challenges and opportunities and emphasizes the health system as a critical mediator.

  14. Barriers, Challenges, and Decision-Making in the Letter Writing Process for Gender Transition.

    PubMed

    Budge, Stephanie L; Dickey, Lore M

    2017-03-01

    This article addresses the challenges that clinicians face in writing letters of support for transgender and gender-diverse clients. It addresses common but challenging clinical representations to help the reader understand the nuances associated with writing letters. Three cases are presented. The first addresses systemic challenges, the second addresses management of care, and the third addresses co-occurring mental health concerns. Recommendations for practice are provided based on the experiences included within the 3 case examples. Copyright © 2016 Elsevier Inc. All rights reserved.

  15. Challenges in image-guided therapy system design.

    PubMed

    Dimaio, Simon; Kapur, Tina; Cleary, Kevin; Aylward, Stephen; Kazanzides, Peter; Vosburgh, Kirby; Ellis, Randy; Duncan, James; Farahani, Keyvan; Lemke, Heinz; Peters, Terry; Lorensen, William Bill; Gobbi, David; Haller, John; Clarke, Laurence Larry; Pizer, Stephen; Taylor, Russell; Galloway, Robert; Fichtinger, Gabor; Hata, Nobuhiko; Lawson, Kimberly; Tempany, Clare; Kikinis, Ron; Jolesz, Ferenc

    2007-01-01

    System development for image-guided therapy (IGT), or image-guided interventions (IGI), continues to be an area of active interest across academic and industry groups. This is an emerging field that is growing rapidly: major academic institutions and medical device manufacturers have produced IGT technologies that are in routine clinical use, dozens of high-impact publications are published in well regarded journals each year, and several small companies have successfully commercialized sophisticated IGT systems. In meetings between IGT investigators over the last two years, a consensus has emerged that several key areas must be addressed collaboratively by the community to reach the next level of impact and efficiency in IGT research and development to improve patient care. These meetings culminated in a two-day workshop that brought together several academic and industrial leaders in the field today. The goals of the workshop were to identify gaps in the engineering infrastructure available to IGT researchers, develop the role of research funding agencies and the recently established US-based National Center for Image Guided Therapy (NCIGT), and ultimately to facilitate the transfer of technology among research centers that are sponsored by the National Institutes of Health (NIH). Workshop discussions spanned many of the current challenges in the development and deployment of new IGT systems. Key challenges were identified in a number of areas, including: validation standards; workflows, use-cases, and application requirements; component reusability; and device interface standards. This report elaborates on these key points and proposes research challenges that are to be addressed by a joint effort between academic, industry, and NIH participants.

  16. pH-Responsive carriers for oral drug delivery: challenges and opportunities of current platforms.

    PubMed

    Liu, Lin; Yao, WenDong; Rao, YueFeng; Lu, XiaoYang; Gao, JianQing

    2017-11-01

    Oral administration is a desirable alternative of parenteral administration due to the convenience and increased compliance to patients, especially for chronic diseases that require frequent administration. The oral drug delivery is a dynamic research field despite the numerous challenges limiting their effective delivery, such as enzyme degradation, hydrolysis and low permeability of intestinal epithelium in the gastrointestinal (GI) tract. pH-Responsive carriers offer excellent potential as oral therapeutic systems due to enhancing the stability of drug delivery in stomach and achieving controlled release in intestines. This review provides a wide perspective on current status of pH-responsive oral drug delivery systems prepared mainly with organic polymers or inorganic materials, including the strategies used to overcome GI barriers, the challenges in their development and future prospects, with focus on technology trends to improve the bioavailability of orally delivered drugs, the mechanisms of drug release from pH-responsive oral formulations, and their application for drug delivery, such as protein and peptide therapeutics, vaccination, inflammatory bowel disease (IBD) and bacterial infections.

  17. Cryopreservation of Human Mesenchymal Stem Cells for Clinical Applications: Current Methods and Challenges.

    PubMed

    Yong, Kar Wey; Wan Safwani, Wan Kamarul Zaman; Xu, Feng; Wan Abas, Wan Abu Bakar; Choi, Jane Ru; Pingguan-Murphy, Belinda

    2015-08-01

    Mesenchymal stem cells (MSCs) hold many advantages over embryonic stem cells (ESCs) and other somatic cells in clinical applications. MSCs are multipotent cells with strong immunosuppressive properties. They can be harvested from various locations in the human body (e.g., bone marrow and adipose tissues). Cryopreservation represents an efficient method for the preservation and pooling of MSCs, to obtain the cell counts required for clinical applications, such as cell-based therapies and regenerative medicine. Upon cryopreservation, it is important to preserve MSCs functional properties including immunomodulatory properties and multilineage differentiation ability. Further, a biosafety evaluation of cryopreserved MSCs is essential prior to their clinical applications. However, the existing cryopreservation methods for MSCs are associated with notable limitations, leading to a need for new or improved methods to be established for a more efficient application of cryopreserved MSCs in stem cell-based therapies. We review the important parameters for cryopreservation of MSCs and the existing cryopreservation methods for MSCs. Further, we also discuss the challenges to be addressed in order to preserve MSCs effectively for clinical applications.

  18. Intelligent Assistive Technology Applications to Dementia Care: Current Capabilities, Limitations, and Future Challenges

    PubMed Central

    Bharucha, Ashok J.; Anand, Vivek; Forlizzi, Jodi; Dew, Mary Amanda; Reynolds, Charles F.; Stevens, Scott; Wactlar, Howard

    2009-01-01

    The number of older Americans afflicted by Alzheimer disease and related dementias will triple to 13 million persons by 2050, thus greatly increasing healthcare needs. An approach to this emerging crisis is the development and deployment of intelligent assistive technologies that compensate for the specific physical and cognitive deficits of older adults with dementia, and thereby also reduce caregiver burden. The authors conducted an extensive search of the computer science, engineering, and medical databases to review intelligent cognitive devices, physiologic and environmental sensors, and advanced integrated sensor networks that may find future applications in dementia care. Review of the extant literature reveals an overwhelming focus on the physical disability of younger persons with typically nonprogressive anoxic and traumatic brain injuries, with few clinical studies specifically involving persons with dementia. A discussion of the specific capabilities, strengths, and limitations of each technology is followed by an overview of research methodological challenges that must be addressed to achieve measurable progress to meet the healthcare needs of an aging America. PMID:18849532

  19. Current Developments and Challenges in the Search for a Naturally Selected Diels-Alderase

    PubMed Central

    Kim, Hak Joong; Ruszczycky, Mark W.; Liu, Hung-wen

    2012-01-01

    Only a very few examples of enzymes known to catalyze pericyclic reactions have been reported, and presently no enzyme has been demonstrated unequivocally to catalyze a Diels-Alder reaction. Nevertheless, research into secondary metabolism has led to the discovery of numerous natural products exhibiting the structural hallmarks of [4+2] cycloadditions, prompting efforts to characterize the responsible enzymatic processes. These efforts have resulted in a growing collection of enzymes believed to catalyze pericyclic [4+2] cycloaddition reactions; however, in each case the complexity of the substrates and catalytic properties of these enzymes poses significant challenges in substantiating these hypotheses. Herein we consider the principles motivating these efforts and the enzymological systems currently under investigation. PMID:22260931

  20. NASA Space Rocket Logistics Challenges

    NASA Technical Reports Server (NTRS)

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

    2014-01-01

    The Space Launch System (SLS) is the new NASA heavy lift launch vehicle in development and is scheduled for its first mission in 2017. SLS has many of the same logistics challenges as any other large scale program. However, SLS also faces unique challenges. This presentation will address the SLS challenges, along with the analysis and decisions to mitigate the threats posed by each.

  1. 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.

  2. Medicinal mushroom science: Current perspectives, advances, evidences, and challenges.

    PubMed

    Wasser, Solomon P

    2014-01-01

    The main target of the present review is to draw attention to the current perspectives, advances, evidences, challenges, and future development of medicinal mushroom science in the 21 st century. Medicinal mushrooms and fungi are thought to possess approximately 130 medicinal functions, including antitumor, immunomodulating, antioxidant, radical scavenging, cardiovascular, anti-hypercholesterolemic, antiviral, antibacterial, anti-parasitic, antifungal, detoxification, hepatoprotective, and antidiabetic effects. Many, if not all, higher Basidiomycetes mushrooms contain biologically active compounds in fruit bodies, cultured mycelium, and cultured broth. Special attention is paid to mushroom polysaccharides. The data on mushroom polysaccharides and different secondary metabolites are summarized for approximately 700 species of higher hetero- and homobasidiomycetes. Numerous bioactive polysaccharides or polysaccharide-protein complexes from the medicinal mushrooms described appear to enhance innate and cell-mediated immune responses, and exhibit antitumor activities in animals and humans. Whilst the mechanism of their antitumor actions is still not completely understood, stimulation and modulation of key host immune responses by these mushroom compounds appear central. Polysaccharides and low-molecular-weight secondary metabolites are particularly important due to their antitumor and immunostimulating properties. Several of the mushroom compounds have been subjected to Phase I, II, and III clinical trials, and are used extensively and successfully in Asia to treat various cancers and other diseases. Special attention is given to many important unsolved problems in the study of medicinal mushrooms.

  3. Addressing disparities and achieving equity: cultural competence, ethics, and health-care transformation.

    PubMed

    Betancourt, Joseph R; Corbett, James; Bondaryk, Matthew R

    2014-01-01

    The passage of health-care reform and current efforts in payment reform signal the beginning of a significant transformation of the US health-care system. An entire new set of structures is being developed to facilitate increased access to care that is cost-effective and of high quality. As described in The Institute of Medicine report "Crossing the Quality Chasm," our nation is charting a path toward quality health care that aims to be safe, efficient, effective, timely, patient-centered, and equitable. As our health-care system rapidly undergoes dramatic transformation, several truths-and challenges-remain. First, racial and ethnic disparities in health care persist and are a clear sign of inequality in quality. Second, although the root causes for these disparities are complex, there exists a well-developed set of evidence-based approaches to address them; among these is improving the cultural competence of health-care providers and the health-care system. Third, as part of our care redesign, we must assure that we are prepared to meet the ethical challenges ahead and reassert the importance of equity, fairness, and caring as key building blocks of a new care delivery system. As we move ahead, it is critical to assure that our health-care system is culturally competent and has the capacity to deliver high-quality care for all, while eliminating disparities and assuring equity. Disparities are unjust, unethical, costly, and unacceptable-and integrating strategies to achieve equity as part of our health-care system's transformation will give us an incredible opportunity to comprehensively address them.

  4. Analysis of the mass media coverage of the Gates Foundation grand challenges in global health initiative.

    PubMed

    Verma, G

    2009-03-01

    The Grand Challenges were launched in 2003 by the Gates Foundation and other collaborators to address the health needs of developing countries. This paper outlines the current problem with health research and development in the context of inequality as conveyed by the 90/10 divide. The paper then looks at the focus and nature of press reporting of global health issues by analysing how press articles have portrayed the Grand Challenges in Global Health initiative. Analysis of the mass media illustrates that the focus of reporting on the Grand Challenges tends to be on utilitarian themes, leaving issues related to justice and equity comparatively under-reported.

  5. Ethical Challenges in the Teaching of Multicultural Course Work

    ERIC Educational Resources Information Center

    Fier, Elizabeth Boyer; Ramsey, MaryLou

    2005-01-01

    The authors explore the ethical issues and challenges frequently encountered by counselor educators of multicultural course work. Existing ethics codes are examined, and the need for greater specificity with regard to teaching courses of multicultural content is addressed. Options for revising existing codes to better address the challenges of…

  6. Transgender youth: current concepts

    PubMed Central

    2016-01-01

    In many countries throughout the world, increasing numbers of gender nonconforming/transgender youth are seeking medical services to enable the development of physical characteristics consistent with their experienced gender. Such medical services include use of agents to block endogenous puberty at Tanner stage II with subsequent use of cross-sex hormones, and are based on longitudinal studies demonstrating that those individuals who were first identified as gender dysphoric in early or middle childhood and continue to meet the mental health criteria for being transgender at early puberty are likely to be transgender as adults. This review addresses terms and definitions applicable to gender nonconforming youth, studies that shed light on the biologic determinants of gender identity, current clinical practice guidelines for transgender youth, challenges to optimal care, and priorities for research. PMID:28164070

  7. Survey of tuberculosis hospitals in China: current status and challenges.

    PubMed

    Du, Jian; Pang, Yu; Liu, Yuhong; Mi, Fengling; Xu, Shaofa; Li, Liang

    2014-01-01

    Hospitals will play an increasingly important role in delivering TB services in China, however little is known in terms of the current landscape of the hospital system that delivers TB care. In order to examine the status of TB hospitals we performed a study in which a total of 203 TB hospitals, with 30 beds or more, were enrolled from 31 provinces and Xinjiang Production and Construction Corps. Of the 203 hospitals, 93 (45.8%) were located in the eastern region of China, 84 (41.4%) in the central region, and 26 (12.8%) in the western region, while there were 34.6 million TB patients in western China, accounting for 34.6% of the TB burden nationwide. The total number of staff in these 203 hospitals was 83,011, of which 18,899 (22.8%) provided health services for TB patients, (physicians, nurses, lab technicians, etc). Although both the overall number of the health care workers and TB staff in the 203 hospitals increased from the year 1999 to 2009, the former increased by 52%, while the latter increased only by 34%, showing that the percentage of TB staff declined significantly (χ2 = 181.7, P<0.01). The total annual income of the 203 hospitals increased 5.5 fold from 1999 to 2009, while that from TB care increased 3.8 fold during the same period. TB care and control experienced a relatively slower development during this period as shown by the lower percentage of TB staff and the lesser increase in income from TB care in the hospitals. In conclusion, our findings demonstrated that hospital resources are scarcer in western China as compared with eastern China. In view of the current findings, policymakers are urged to address the uneven distribution of medical resources between the underdeveloped west and the more affluent eastern provinces.

  8. A Model Driven Framework to Address Challenges in a Mobile Learning Environment

    ERIC Educational Resources Information Center

    Khaddage, Ferial; Christensen, Rhonda; Lai, Wing; Knezek, Gerald; Norris, Cathie; Soloway, Elliot

    2015-01-01

    In this paper a review of the pedagogical, technological, policy and research challenges and concepts underlying mobile learning is presented, followed by a brief description of categories of implementations. A model Mobile learning framework and dynamic criteria for mobile learning implementations are proposed, along with a case study of one site…

  9. Student Leadership: Challenges and Possibilities

    ERIC Educational Resources Information Center

    Nel, Willy

    2016-01-01

    In my attempt to adhere to the request that I provide an interpretation of the theme for the session, "Critical Engagement, Innovation and Inclusivity", and cognisant of the primary audience, I weave student leadership responsibilities, challenges and possibilities into the address. Events since the plenary address have however…

  10. Health Information System Role-Based Access Control Current Security Trends and Challenges.

    PubMed

    de Carvalho Junior, Marcelo Antonio; Bandiera-Paiva, Paulo

    2018-01-01

    This article objective is to highlight implementation characteristics, concerns, or limitations over role-based access control (RBAC) use on health information system (HIS) using industry-focused literature review of current publishing for that purpose. Based on the findings, assessment for indication of RBAC is obsolete considering HIS authorization control needs. We have selected articles related to our investigation theme "RBAC trends and limitations" in 4 different sources related to health informatics or to the engineering technical field. To do so, we have applied the following search query string: "Role-Based Access Control" OR "RBAC" AND "Health information System" OR "EHR" AND "Trends" OR "Challenges" OR "Security" OR "Authorization" OR "Attacks" OR "Permission Assignment" OR "Permission Relation" OR "Permission Mapping" OR "Constraint". We followed PRISMA applicable flow and general methodology used on software engineering for systematic review. 20 articles were selected after applying inclusion and exclusion criteria resulting contributions from 10 different countries. 17 articles advocate RBAC adaptations. The main security trends and limitations mapped were related to emergency access, grant delegation, and interdomain access control. Several publishing proposed RBAC adaptations and enhancements in order to cope current HIS use characteristics. Most of the existent RBAC studies are not related to health informatics industry though. There is no clear indication of RBAC obsolescence for HIS use.

  11. The Growth of Neurosurgery in East Africa: Challenges.

    PubMed

    Santos, Maria M; Qureshi, Mubashir M; Budohoski, Karol P; Mangat, Halinder S; Ngerageza, Japhet G; Schöller, Karsten; Shabani, Hamisi K; Zubkov, Micaella R; Härtl, Roger

    2018-05-01

    As the second of 3 articles in this series, the aim of this article is to provide readers with an understanding of the development of neurosurgery in East Africa (foundations), the challenges that arise in providing neurosurgical care in developing countries (challenges), and an overview of traditional and novel approaches to overcoming these challenges and improving health care in the region (innovations). Recognizing the challenges that need to be addressed is the first step to implementing efficient and qualified surgery delivery systems in low- and middle-income countries. We reviewed the major challenges facing health care in East Africa and grouped them into 5 categories: 1) burden of surgical disease and workforce crisis; 2) global health view of surgery as "the neglected stepchild"; 3) need for recognizing the surgical system as an interdependent network and importance of organizational and equipment deficits; 4) lack of education in the community, failure of primary care systems, and net result of overwhelming tertiary care systems; 5) personal and professional burnout as well as brain drain of promising human resources from low- and middle-income countries in East Africa and similar regions across the world. Each major challenge was detailed and analyzed by authors who have worked or are currently working in the region, providing a personal perspective. Copyright © 2018. Published by Elsevier Inc.

  12. Addressing the challenges of standalone multi-core simulations in molecular dynamics

    NASA Astrophysics Data System (ADS)

    Ocaya, R. O.; Terblans, J. J.

    2017-07-01

    Computational modelling in material science involves mathematical abstractions of force fields between particles with the aim to postulate, develop and understand materials by simulation. The aggregated pairwise interactions of the material's particles lead to a deduction of its macroscopic behaviours. For practically meaningful macroscopic scales, a large amount of data are generated, leading to vast execution times. Simulation times of hours, days or weeks for moderately sized problems are not uncommon. The reduction of simulation times, improved result accuracy and the associated software and hardware engineering challenges are the main motivations for many of the ongoing researches in the computational sciences. This contribution is concerned mainly with simulations that can be done on a "standalone" computer based on Message Passing Interfaces (MPI), parallel code running on hardware platforms with wide specifications, such as single/multi- processor, multi-core machines with minimal reconfiguration for upward scaling of computational power. The widely available, documented and standardized MPI library provides this functionality through the MPI_Comm_size (), MPI_Comm_rank () and MPI_Reduce () functions. A survey of the literature shows that relatively little is written with respect to the efficient extraction of the inherent computational power in a cluster. In this work, we discuss the main avenues available to tap into this extra power without compromising computational accuracy. We also present methods to overcome the high inertia encountered in single-node-based computational molecular dynamics. We begin by surveying the current state of the art and discuss what it takes to achieve parallelism, efficiency and enhanced computational accuracy through program threads and message passing interfaces. Several code illustrations are given. The pros and cons of writing raw code as opposed to using heuristic, third-party code are also discussed. The growing trend

  13. Dynamics of the Earth's Inner Magnetosphere and its Connection to the Ionosphere: Current Understanding and Challenges

    NASA Technical Reports Server (NTRS)

    Zheng, Yihua

    2010-01-01

    The Earth's inner magnetosphere, a vast volume in space spanning from 1.5 Re (Earth radii) to 10 Re, is a host to a variety of plasma populations (with energy from 1 eV to few MeV) and physical processes where most of which involve plasma and field coupling. As a gigantic particle accelerator, the inner magnetosphere includes three overlapping regions: the plasmasphere, the ring current, and the Van Allen radiation belt. The complex structures and dynamics of these regions are externally driven by solar activities and internally modulated by intricate interactions and coupling. As a major constituent of Space Weather, the inner magnetosphere is both scientifically intriguing and practically important to our society. In this presentation, I will discuss our recent results from the Comprehensive Ring Current Model, in the context of our current understanding of the inner magnetosphere in general and challenges ahead in making further progresses.

  14. Dynamics of the Earth's Inner Magnetosphere and Its Connection to the Ionosphere: Current Understanding and Challenges

    NASA Technical Reports Server (NTRS)

    Zheng, Yihua

    2011-01-01

    The Earth's inner magnetosphere, a vast volume in space spanning from 1.5 Re (Earth radii) to 10 Re, is a host to a variety of plasma populations (with energy from 1 eV to few MeV) and physical processes where most of which involve plasma and field coupling. As a gigantic particle accelerator, the inner magnetosphere includes three overlapping regions: the plasmasphere, the ring current, and the Van Allen radiation belt. The complex structures and dynamics of these regions are externally driven by solar activities and internally modulated by intricate interactions and coupling. As a major constituent of Space Weather, the inner magnetosphere is both scientifically intriguing and practically important to our society. In this presentation, I will discuss our recent results from the Comprehensive Ring Current Model, in the context of our current understanding of the inner magnetosphere in general and challenges ahead in making further progresses.

  15. Terms of Address in the Chinese Business Enterprise

    ERIC Educational Resources Information Center

    Huang, Xiaoyan; Sultan, Robert

    2014-01-01

    This study examines terms of address currently used by employees of Chinese business enterprises. The authors find that a speaker's address selections are related significantly to the gender of the speaker, the location of the enterprise in Eastern or Western China, and the ownership type of the enterprise; that is, whether the enterprise is…

  16. "Permission to Speak": A Postcolonial View on Racialized Bodies and PE in the Current Context of Globalization

    ERIC Educational Resources Information Center

    Azzarito, Laura

    2016-01-01

    The current neoliberal context of schools presents difficult challenges in addressing persistent issues of social inequalities. In this article, first, I argue that because of today's market-driven education, the rise of fitness testing in school physical education (PE) can be seriously detrimental to young people in general and to ethnic-minority…

  17. Challenges in Fingertip Replantation

    PubMed Central

    Kim, Jin-Soo; Yang, Jae-Won; Lee, Dong-Chul; Ki, Sae-Hwi; Roh, Si-Young

    2013-01-01

    Fingertip amputation is a challenging injury to manage. Among various reconstructive procedures, replantation results in superior outcome, but is seldom considered in many institutions. From the identification of vessel ends to reanastomosis of the submillimeter vessels, fingertip's highly specialized anatomy requires technical excellence. By addressing these anatomic challenges, fingertip replantation can be a routine reconstructive option for microvascular surgeons. PMID:24872765

  18. Delivery of Therapeutic Proteins Using Electrospun Fibers-Recent Developments and Current Challenges.

    PubMed

    Seif, Salem; Planz, Viktoria; Windbergs, Maike

    2017-10-01

    Proteins play a vital role within the human body by regulating various functions and even serving as structural constituent of many body parts. In this context, protein-based therapeutics have attracted a lot of attention in the last few decades as potential treatment of different diseases. Due to the steadily increasing interest in protein-based therapeutics, different dosage forms were investigated for delivering such complex macromolecules to the human body. Here, electrospun fibers hold a great potential for embedding proteins without structural damage and for controlled release of the protein for therapeutic applications. This review provides a comprehensive overview of the current state of protein-based carrier systems using electrospun fibers, with special emphasis on discussing their potential and key challenges in developing such therapeutic strategies, along with a prospective view of anticipated future directions. © 2017 Deutsche Pharmazeutische Gesellschaft.

  19. Strengthening health information systems to address health equity challenges.

    PubMed Central

    Nolen, Lexi Bambas; Braveman, Paula; Dachs, J. Norberto W.; Delgado, Iris; Gakidou, Emmanuela; Moser, Kath; Rolfe, Liz; Vega, Jeanette; Zarowsky, Christina

    2005-01-01

    Special studies and isolated initiatives over the past several decades in low-, middle- and high-income countries have consistently shown inequalities in health among socioeconomic groups and by gender, race or ethnicity, geographical area and other measures associated with social advantage. Significant health inequalities linked to social (dis)advantage rather than to inherent biological differences are generally considered unfair or inequitable. Such health inequities are the main object of health development efforts, including global targets such as the Millennium Development Goals, which require monitoring to evaluate progress. However, most national health information systems (HIS) lack key information needed to assess and address health inequities, namely, reliable, longitudinal and representative data linking measures of health with measures of social status or advantage at the individual or small-area level. Without empirical documentation and monitoring of such inequities, as well as country-level capacity to use this information for effective planning and monitoring of progress in response to interventions, movement towards equity is unlikely to occur. This paper reviews core information requirements and potential databases and proposes short-term and longer term strategies for strengthening the capabilities of HIS for the analysis of health equity and discusses HIS-related entry points for supporting a culture of equity-oriented decision-making and policy development. PMID:16184279

  20. The challenge of Propionibacterium acnes and revision shoulder arthroplasty: a review of current diagnostic options.

    PubMed

    Shields, Margaret V; Abdullah, Leath; Namdari, Surena

    2016-06-01

    Propionibacterium acnes is the most common cause of infection after shoulder arthroplasty. Whereas there are several methods that can aid in the diagnosis of P. acnes infection, there is not a single "gold standard" because of the difficulties inherent in identifying this bacterium. We present an evidence-based discussion of the demographic, clinical, and radiographic predictors of P. acnes infection and review the current options for diagnosis. This review was written after a comprehensive analysis of the current literature related to shoulder periprosthetic joint infection and P. acnes identification. Of the techniques reviewed, α-defensin had the highest sensitivity in detecting P. acnes infection (63%). C-reactive protein level and erythrocyte sedimentation rate were often normal in cases of infection. Whereas P. acnes can be challenging to successfully diagnose, there are several options that are considered preferable because of their higher sensitivities and specificities. The current gold standard is intraoperative culture, but major advances in molecular techniques may provide future improvements in diagnostic accuracy. Copyright © 2016 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Elsevier Inc. All rights reserved.