Battery Cell Voltage Sensing and Balancing Using Addressable Transformers

NASA Technical Reports Server (NTRS)

Davies, Francis

2009-01-01

A document discusses the use of saturating transformers in a matrix arrangement to address individual cells in a high voltage battery. This arrangement is able to monitor and charge individual cells while limiting the complexity of circuitry in the battery. The arrangement has inherent galvanic isolation, low cell leakage currents, and allows a single bad cell in a battery of several hundred cells to be easily spotted.

Title TBA: Revising the Abstract Submission Process.

PubMed

Tibon, Roni; Open Science Committee, Cbu; Henson, Richard

2018-04-01

Academic conferences are among the most prolific scientific activities, yet the current abstract submission and review process has serious limitations. We propose a revised process that would address these limitations, achieve some of the aims of Open Science, and stimulate discussion throughout the entire lifecycle of the scientific work. Copyright © 2018 The Authors. Published by Elsevier Ltd.. All rights reserved.

A four-diode full-wave ionic current rectifier based on bipolar membranes: overcoming the limit of electrode capacity.

PubMed

Gabrielsson, Erik O; Janson, Per; Tybrandt, Klas; Simon, Daniel T; Berggren, Magnus

2014-08-13

Full-wave rectification of ionic currents is obtained by constructing the typical four-diode bridge out of ion conducting bipolar membranes. Together with conjugated polymer electrodes addressed with alternating current, the bridge allows for generation of a controlled ionic direct current for extended periods of time without the production of toxic species or gas typically arising from electrode side-reactions. © 2014 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

Session on coupled atmospheric/chemistry coupled models

NASA Technical Reports Server (NTRS)

Thompson, Anne

1993-01-01

The session on coupled atmospheric/chemistry coupled models is reviewed. Current model limitations, current issues and critical unknowns, and modeling activity are addressed. Specific recommendations and experimental strategies on the following are given: multiscale surface layer - planetary boundary layer - chemical flux measurements; Eulerian budget study; and Langrangian experiment. Nonprecipitating cloud studies, organized convective systems, and aerosols - heterogenous chemistry are also discussed.

Increasing the Extracted Beam Current Density in Ion Thrusters

NASA Astrophysics Data System (ADS)

Arthur, Neil Anderson

Ion thrusters have seen application on space science missions and numerous satellite missions. Ion engines offer higher electrical efficiency and specific impulse capability coupled with longer demonstrated lifetime as compared to other space propulsion technologies. However, ion engines are considered to have low thrust. This work aims to address the low thrust conception; whereby improving ion thruster performance and thrust density will lead to expanded mission capabilities for ion thruster technology. This goal poses a challenge because the mechanism for accelerating ions, the ion optics, is space charge limited according to the Child-Langmuir law-there is a finite number of ions that can be extracted through the grids for a given voltage. Currently, ion thrusters operate at only 40% of this limit, suggesting there is another limit artificially constraining beam current. Experimental evidence suggests the beam current can become source limited-the ion density within the plasma is not large enough to sustain high beam currents. Increasing the discharge current will increase ion density, but ring cusp ion engines become anode area limited at high discharge currents. The ring cusp magnetic field increases ionization efficiency but limits the anode area available for electron collection. Above a threshold current, the plasma becomes unstable. Increasing the engine size is one approach to increasing the operational discharge current, ion density, and thus the beam current, but this presents engineering challenges. The ion optics are a pair of closely spaced grids. As the engine diameter increases, it becomes difficult to maintain a constant grid gap. Span-to-gap considerations for high perveance optics limit ion engines to 50 cm in diameter. NASA designed the annular ion engine to address the anode area limit and scale-up problems by changing the discharge chamber geometry. The annular engine provides a central mounting structure for the optics, allowing the beam area to increase while maintaining a fixed span-to-gap. The central stalk also provides additional surface area for electron collection. Circumventing the anode area limitation, the annular ion engine can operate closer to the Child-Langmuir limit as compared to a conventional cylindrical ion thruster. Preliminary discharge characterization of a 65 cm annular ion engine shows >90% uniformity and validates the scalability of the technology. Operating beyond the Child-Langmuir limit would allow for even larger performance gains. This classic law does not consider the ion injection velocity into the grid sheath. The Child-Langmuir limit shifts towards higher current as the ion velocity increases. Ion drift velocity can be created by enhancing the axially-directed electric field. One method for creating this field is to modify the plasma potential distribution. This can be accomplished by biasing individual magnetic cusps, through isolated, conformal electrodes placed on each magnet ring. Experiments on a 15 cm ion thruster have shown that plasma potential in the bulk can be modified by as much as 5 V and establish ion drift towards the grid plane. Increases in ion current density at the grid by up to 20% are demonstrated. Performance implications are also considered, and increases in simulated beam current of 15% and decreases in discharge losses of 5% are observed. Electron density measurements within the magnetic cusps revealed, surprisingly, as cusp current draw increases, the leak width does not change. This suggests that instead of increasing the electron collection area, cusp bias enhances electron mobility along field lines.

Challenges in personalised management of chronic diseases-heart failure as prominent example to advance the care process.

PubMed

Brunner-La Rocca, Hans-Peter; Fleischhacker, Lutz; Golubnitschaja, Olga; Heemskerk, Frank; Helms, Thomas; Hoedemakers, Thom; Allianses, Sandra Huygen; Jaarsma, Tiny; Kinkorova, Judita; Ramaekers, Jan; Ruff, Peter; Schnur, Ivana; Vanoli, Emilio; Verdu, Jose; Zippel-Schultz, Bettina

2015-01-01

Chronic diseases are the leading causes of morbidity and mortality in Europe, accounting for more than 2/3 of all death causes and 75 % of the healthcare costs. Heart failure is one of the most prominent, prevalent and complex chronic conditions and is accompanied with multiple other chronic diseases. The current approach to care has important shortcomings with respect to diagnosis, treatment and care processes. A critical aspect of this situation is that interaction between stakeholders is limited and chronic diseases are usually addressed in isolation. Health care in Western countries requires an innovative approach to address chronic diseases to provide sustainability of care and to limit the excessive costs that may threaten the current systems. The increasing prevalence of chronic diseases combined with their enormous economic impact and the increasing shortage of healthcare providers are among the most critical threats. Attempts to solve these problems have failed, and future limitations in financial resources will result in much lower quality of care. Thus, changing the approach to care for chronic diseases is of utmost social importance.

Novel optical strategies for biodetection

NASA Astrophysics Data System (ADS)

Sakamuri, Rama M.; Wolfenden, Mark S.; Anderson, Aaron S.; Swanson, Basil I.; Schmidt, Jurgen S.; Mukundan, Harshini

2013-09-01

Although bio-detection strategies have significantly evolved in the past decade, they still suffer from many disadvantages. For one, current approaches still require confirmation of pathogen viability by culture, which is the `gold-standard' method, and can take several days to result. Second, current methods typically target protein and nucleic acid signatures and cannot be applied to other biochemical categories of biomarkers (e.g.; lipidated sugars). Lipidated sugars (e.g.; lipopolysaccharide, lipoarabinomannan) are bacterial virulence factors that are significant to pathogenicity. Herein, we present two different optical strategies for biodetection to address these two limitations. We have exploited bacterial iron sequestration mechanisms to develop a simple, specific assay for the selective detection of viable bacteria, without the need for culture. We are currently working on the use of this technology for the differential detection of two different bacteria, using siderophores. Second, we have developed a novel strategy termed `membrane insertion' for the detection of amphiphilic biomarkers (e.g. lipidated glycans) that cannot be detected by conventional approaches. We have extended this technology to the detection of small molecule amphiphilic virulence factors, such as phenolic glycolipid-1 from leprosy, which could not be directly detected before. Together, these strategies address two critical limitations in current biodetection approaches. We are currently working on the optimization of these methods, and their extension to real-world clinical samples.

Drug Prohibition in the United States: Costs, Consequences, and Alternatives

NASA Astrophysics Data System (ADS)

Nadelmann, Ethan A.

1989-09-01

``Drug legalization'' increasingly merits serious consideration as both an analytical model and a policy option for addressing the ``drug problem.'' Criminal justice approaches to the drug problem have proven limited in their capacity to curtail drug abuse. They also have proven increasingly costly and counterproductive. Drug legalization policies that are wisely implemented can minimize the risks of legalization, dramatically reduce the costs of current policies, and directly address the problems of drug abuse.

Corridor-wide Safety Data Analysis and Identification of Existing Successful Safety Programs

DOT National Transportation Integrated Search

2010-06-01

Many diverse factors contribute to motor vehicle crashes. States have multiple competing priorities and limited resources to address these priorities, so there is a need, particularly in our current economic climate, to prioritize interventions and s...

Direct Determination of Nonmetals in Solution with Atomic Spectrometry.

ERIC Educational Resources Information Center

McGregor, David A.; And Others

1988-01-01

Addresses solution nonmetal determinations on a fundamental level. Characterizes research in this area of chemical instrumentation. Discusses the fundamental limitations of nonmetal atomic spectrometry, the status of nonmetals and atomic spectroscopic techniques, and current directions in solution nonmetal determinations. (CW)

Achieving development goals for HIV, tuberculosis and malaria in sub-Saharan Africa through integrated antenatal care: barriers and challenges.

PubMed

Fowkes, Freya J I; Draper, Bridget L; Hellard, Margaret; Stoové, Mark

2016-12-12

The global health community is currently transitioning from the Millennium Development Goals (MDGs) to the Sustainable Development Goals (SDGs). Unfortunately, progress towards maternal, newborn and infant health MDGs has lagged significantly behind other key health goals, demanding a renewed global effort in this key health area. The World Health Organization and other institutions heralded integrated antenatal care (ANC) as the best way to address the inter-related health issues of HIV, tuberculosis (TB) and malaria in the high risk groups of pregnant women and infants; integrated ANC services also offer a mechanism to address slow progress towards improved maternal health. There is remarkably limited evidence on best practice approaches of program implementation, acceptability and effectiveness for integrated ANC models targeting multiple diseases. Here, we discuss current integrated ANC global guidelines and the limited literature describing integrated ANC implementation and evidence for their role in addressing HIV, malaria and TB during pregnancy in sub-Saharan Africa. We highlight the paucity of data on the effectiveness of integrated ANC models and identify significant structural barriers in the health system (funding, infrastructure, distribution, human resources), the adoption system (limited buy-in from implementers, leadership, governance) and, in the broader context, patient-centred barriers (fear, stigma, personal burdens) and barriers in funding structures. We highlight recommendations for action and discuss avenues for the global health community to develop systems to integrate multiple disease programs into ANC models of care that better address these three priority infectious diseases. With the current transition to the SDGs and concerns regarding the failure to meet maternal health MDGs, the global health community, researchers, implementers and funding bodies must work together to ensure the establishment of quality operational and implementation research to inform integrated ANC models. It is imperative that the global health community engages in a timely discussion about such implementation innovations and instigates appropriate actions to ensure advances in maternal health are sufficient to meet applicable SDGs.

University Students' Engagement in At Risk Behaviors: A Study of Past Parenting and Current Personality.

ERIC Educational Resources Information Center

Steward, Robbie J.; Conner, John; Conner, Nicole; Neil, Doug; Rampersad, Dara; Fischer, Angie; Gaertner, Amy; Inkala, Laurel; Tsai, Cindy

The initial intent for this study was to tease out the sources of the most critical contributor to individuals' engagement in dangerous behaviors and to add to the literature addressing these at-risk behaviors by attending to the limitations of the current body of literature. White university students (N=60) completed three measures for the study:…

Current limitations and recommendations to improve testing for the environmental assessment of endocrine active substances

EPA Science Inventory

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 organizatio...

Pilot-Induced Oscillation Research: Status at the End of the Century. Volume 2

NASA Technical Reports Server (NTRS)

Shafer, Mary F. (Compiler); Steinmetz, Paul (Compiler)

2001-01-01

The workshop "Pilot-Induced Oscillation Research: The Status at the End of the Century," was held at NASA Dryden Flight Research Center on 6-8 April 1999. The presentations at this conference addressed the most current information available, addressing regulatory issues, flight test, safety, modeling, prediction, simulation, mitigation or prevention, and areas that require further research. All presentations were approved for publication as unclassified documents with no limits on their distribution. This proceedings includes the viewgraphs (some with author's notes) used for thirty presentations that were actually given and two presentations that were not given because of time limitations. Four technical papers on this subject are also included.

Pilot-Induced Oscillation Research: Status at the End of the Century. Volume 3

NASA Technical Reports Server (NTRS)

Shafer, Mary F. (Compiler); Steinmetz, Paul (Compiler)

2001-01-01

The workshop "Pilot-Induced Oscillation Research: The Status at the End of the Century," was held at NASA Dryden Flight Research Center on 6-8 April 1999. The presentations at this conference addressed the most current information available, addressing regulatory issues, flight test, safety, modeling, prediction, simulation, mitigation or prevention, and areas that require further research. All presentations were approved for publication as unclassified documents with no limits on their distribution. This proceedings includes the viewgraphs (some with author's notes) used for thirty presentations that were actually given and two presentations that were not given because of time limitations. Four technical papers on this subject are also included.

Pilot-Induced Oscillation Research: The Status at the End of the Century. Volume 1

NASA Technical Reports Server (NTRS)

Shafer, Mary F. (Compiler); Steinmetz, Paul (Compiler)

2001-01-01

The workshop "Pilot-Induced Oscillation Research: The Status at the End of the Century," was held at NASA Dryden Flight Research Center on 6-8 April 1999. The presentations at this conference addressed the most current information available, addressing regulatory issues, flight test, safety, modeling, prediction, simulation, mitigation or prevention, and areas that require further research. All presentations were approved for publication as unclassified documents with no limits on their distribution. This proceedings includes the viewgraphs (some with author's notes) used for thirty presentations that were actually given and two presentations that were not given because of time limitations. Four technical papers on this subject are also included.

Modeling of Photoionized Plasmas

NASA Technical Reports Server (NTRS)

Kallman, Timothy R.

2010-01-01

In this paper I review the motivation and current status of modeling of plasmas exposed to strong radiation fields, as it applies to the study of cosmic X-ray sources. This includes some of the astrophysical issues which can be addressed, the ingredients for the models, the current computational tools, the limitations imposed by currently available atomic data, and the validity of some of the standard assumptions. I will also discuss ideas for the future: challenges associated with future missions, opportunities presented by improved computers, and goals for atomic data collection.

Fines classification based on sensitivity to pore-fluid chemistry

USGS Publications Warehouse

Jang, Junbong; Santamarina, J. Carlos

2016-01-01

The 75-μm particle size is used to discriminate between fine and coarse grains. Further analysis of fine grains is typically based on the plasticity chart. Whereas pore-fluid-chemistry-dependent soil response is a salient and distinguishing characteristic of fine grains, pore-fluid chemistry is not addressed in current classification systems. Liquid limits obtained with electrically contrasting pore fluids (deionized water, 2-M NaCl brine, and kerosene) are combined to define the soil “electrical sensitivity.” Liquid limit and electrical sensitivity can be effectively used to classify fine grains according to their fluid-soil response into no-, low-, intermediate-, or high-plasticity fine grains of low, intermediate, or high electrical sensitivity. The proposed methodology benefits from the accumulated experience with liquid limit in the field and addresses the needs of a broader range of geotechnical engineering problems.

Toxicity Bioassays for Ecological Risk Assessment in Arid and Semiarid Ecosystems. Reviews Environmental Contamination and Toxicology 168:43-98.

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

Markwiese, J.T.; Ryti, R.T.; Hooten, M.M.

2001-02-01

This paper discusses current limitations for performing ecological risk assessments in dry environments (i.e., ecosystems that are characteristic of many DOE Facilities) and presents novel approaches to addressing ecological risk in such systems.

The future role of next-generation DNA sequencing and metagenetics in aquatic biology monitoring programs

EPA Science Inventory

The development of current biological monitoring and bioassessment programs was a drastic improvement over previous programs created for monitoring a limited number of specific chemical pollutants. Although these assessment programs are better designed to address the transient an...

Solid-State Fault Current Limiter Development : Design and Testing Update of a 15kV SSCL Power Stack

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

Dr. Ram Adapa; Mr. Dante Piccone

2012-04-30

ABSTRACT The Solid-State Fault Current Limiter (SSCL) is a promising technology that can be applied to utility power delivery systems to address the problem of increasing fault currents associated with load growth. As demand continues to grow, more power is added to utility system either by increasing generator capacity or by adding distributed generators, resulting in higher available fault currents, often beyond the capabilities of the present infrastructure. The SSCL is power-electronics based equipment designed to work with the present utility system to address this problem. The SSCL monitors the line current and dynamically inserts additional impedance into the linemore » in the event of a fault being detected. The SSCL is based on a modular design and can be configured for 5kV through 69kV systems at nominal current ratings of 1000A to 4000A. Results and Findings This report provides the final test results on the development of 15kV class SSCL single phase power stack. The scope of work included the design of the modular standard building block sub-assemblies, the design and manufacture of the power stack and the testing of the power stack for the key functional tests of continuous current capability and fault current limiting action. Challenges and Objectives Solid-State Current Limiter technology impacts a wide spectrum of utility engineering and operating personnel. It addresses the problems associated with load growth both at Transmission and Distribution class networks. The design concept is pioneering in terms of developing the most efficient and compact power electronics equipment for utility use. The initial test results of the standard building blocks are promising. The independent laboratory tests of the power stack are promising. However the complete 3 phase system needs rigorous testing for performance and reliability. Applications, Values, and Use The SSCL is an intelligent power-electronics device which is modular in design and can provide current limiting or current interrupting capabilities. It can be applied to variety of applications from distribution class to transmission class power delivery grids and networks. It can also be applied to single major commercial and industrial loads and distributed generator supplies. The active switching of devices can be further utilized for protection of substation transformers. The stress on the system can be reduced substantially improving the life of the power system. It minimizes the voltage sag by speedy elimination of heavy fault currents and promises to be an important element of the utility power system. DOE Perspective This development effort is now focused on a 15kV system. This project will help mitigate the challenges of increasing available fault current. DOE has made a major contribution in providing a cost effective SSCL designed to integrate seamlessly into the Transmission and Distribution networks of today and the future. Approach SSCL development program for a 69kV SSCL was initiated which included the use of the Super GTO advanced semiconductor device which won the 2007 R&D100 Award. In the beginning, steps were identified to accomplish the economically viable design of a 69kV class Solid State Current Limiter that is extremely reliable, cost effective, and compact enough to be applied in urban transmission. The prime thrust in design and development was to encompass the 1000A and the 3000A ratings and provide a modular design to cover the wide range of applications. The focus of the project was then shifted to a 15kV class SSCL. The specifications for the 15kV power stack are reviewed. The design changes integrated into the 15kV power stack are discussed. In this Technical Update the complete project is summarized followed by a detailed test report. The power stack independent high voltage laboratory test requirements and results are presented. Keywords Solid State Current Limiter, SSCL, Fault Current Limiter, Fault Current Controller, Power electronics controller, Intelligent power-electronics Device, IED« less

Optimizing administrative datasets to examine acute kidney injury in the era of big data: workgroup statement from the 15(th) ADQI Consensus Conference.

PubMed

Siew, Edward D; Basu, Rajit K; Wunsch, Hannah; Shaw, Andrew D; Goldstein, Stuart L; Ronco, Claudio; Kellum, John A; Bagshaw, Sean M

2016-01-01

The purpose of this review is to report how administrative data have been used to study AKI, identify current limitations, and suggest how these data sources might be enhanced to address knowledge gaps in the field. 1) To review the existing evidence-base on how AKI is coded across administrative datasets, 2) To identify limitations, gaps in knowledge, and major barriers to scientific progress in AKI related to coding in administrative data, 3) To discuss how administrative data for AKI might be enhanced to enable "communication" and "translation" within and across administrative jurisdictions, and 4) To suggest how administrative databases might be configured to inform 'registry-based' pragmatic studies. Literature review of English language articles through PubMed search for relevant AKI literature focusing on the validation of AKI in administrative data or used administrative data to describe the epidemiology of AKI. Acute Dialysis Quality Initiative (ADQI) Consensus Conference September 6-7(th), 2015, Banff, Canada. Hospitalized patients with AKI. The coding structure for AKI in many administrative datasets limits understanding of true disease burden (especially less severe AKI), its temporal trends, and clinical phenotyping. Important opportunities exist to improve the quality and coding of AKI data to better address critical knowledge gaps in AKI and improve care. A modified Delphi consensus building process consisting of review of the literature and summary statements were developed through a series of alternating breakout and plenary sessions. Administrative codes for AKI are limited by poor sensitivity, lack of standardization to classify severity, and poor contextual phenotyping. These limitations are further hampered by reduced awareness of AKI among providers and the subjective nature of reporting. While an idealized definition of AKI may be difficult to implement, improving standardization of reporting by using laboratory-based definitions and providing complementary information on the context in which AKI occurs are possible. Administrative databases may also help enhance the conduct of and inform clinical or registry-based pragmatic studies. Data sources largely restricted to North American and Europe. Administrative data are rapidly growing and evolving, and represent an unprecedented opportunity to address knowledge gaps in AKI. Progress will require continued efforts to improve awareness of the impact of AKI on public health, engage key stakeholders, and develop tangible strategies to reconfigure infrastructure to improve the reporting and phenotyping of AKI. WHY IS THIS REVIEW IMPORTANT?: Rapid growth in the size and availability of administrative data has enhanced the clinical study of acute kidney injury (AKI). However, significant limitations exist in coding that hinder our ability to better understand its epidemiology and address knowledge gaps. The following consensus-based review discusses how administrative data have been used to study AKI, identify current limitations, and suggest how these data sources might be enhanced to improve the future study of this disease. WHAT ARE THE KEY MESSAGES?: The current coding structure of administrative data is hindered by a lack of sensitivity, standardization to properly classify severity, and limited clinical phenotyping. These limitations combined with reduced awareness of AKI and the subjective nature of reporting limit understanding of disease burden across settings and time periods. As administrative data become more sophisticated and complex, important opportunities to employ more objective criteria to diagnose and stage AKI as well as improve contextual phenotyping exist that can help address knowledge gaps and improve care.

Recent advances in tuberculosis diagnostics in resource-limited settings.

PubMed

Seki, Mitsuko; Kim, Chang-Ki; Hayakawa, Satoshi; Mitarai, Satoshi

2018-04-19

Smear-negative and drug-resistant cases of tuberculosis (TB) disease necessitate the development of new diagnostic methods, especially in resource-limited settings. To improve the current TB situations, sensitive and specific TB point-of-care tests (POCTs) should be developed. This review addresses the current status of TB, novel diagnostic methodologies for TB, and the impact of those new diagnostics on TB control in such situations. Moreover, the perspective of TB management based on laboratory examinations is described. Smear microscopy with sputum samples is the only laboratory examination available in many resource-limited settings and is still used globally. Several nucleic acid amplification tests (NATs) have been developed. The World Health Organization (WHO) endorsed novel diagnostics based on NATs and updated their definition of a bacteriologically confirmed case requiring the biological specimen to be positive by smear microscopy, culture, or the WHO-recommended rapid diagnostic protocols. The use of new diagnostics increased the number of bacteriologically confirmed TB cases. Novel diagnostics are now available, but their sensitivity is still lower than that of conventional liquid culture method. To address the increasing incidence of TB, more resources including novel diagnostics as POCTs with higher sensitivity must be allocated to healthcare systems.

If I had a magic wand....Wish list of a dermatologist (Conference Presentation)

NASA Astrophysics Data System (ADS)

Kelly, Kristen M.

2016-02-01

Challenges in dermatology that can be addressed by photonics research will be explored. Non-invasive, real-time diagnosis of skin lesions would eliminate biopsy risks, minimize patient anxiety by providing more rapid answers and allow diagnosis and treatment in a single visit. Multiple approaches have been tried, but significant limitations of current technologies make them impractical for routine clinic implementation. Photonics can also be used for treatment assessment to determine if intervention is adequate or if further treatment is needed. Ideal feedback should be non-invasive, rapid and accurate. Monitoring for potential adverse effects can greatly improve treatment safety, allowing clinicians to push the limits of therapy while preventing serious complications. Light based therapies can also be improved by increasing photon penetration and selectivity for targeted cells or skin structures. Current light based treatments are in many cases limited by photon penetration. In addition, we often seek to damage a specific chromophore but are not able to distinguish between targeted disease and non-targeted normal structures such as the cells of a melanoma and normal melanocytes and port wine stain versus normal vasculature. Scientist and clinician collaboration can address these and other issues and greatly improve patient care.

Methodological issues associated with preclinical drug development and increased placebo effects in schizophrenia clinical trials.

PubMed

Brown, Matt A; Bishnoi, Ram J; Dholakia, Sara; Velligan, Dawn I

2016-01-20

Recent failures to detect efficacy in clinical trials investigating pharmacological treatments for schizophrenia raise concerns regarding the potential contribution of methodological shortcomings to this research. This review provides an examination of two key methodological issues currently suspected of playing a role in hampering schizophrenia drug development; 1) limitations on the translational utility of preclinical development models, and 2) methodological challenges posed by increased placebo effects. Recommendations for strategies to address these methodological issues are addressed.

Antiseptics and Antibiotics for Surgical Wounds Healing by Secondary Intention: Summary of a Cochrane Review.

PubMed

Norman, Gill; Dumville, Jo C; Crosbie, Emma J

2016-11-01

Do antiseptics and antibiotics benefit surgical wounds healing by secondary intention (SWHSI)? No high-quality randomized clinical trials have addressed this question. Current evidence is limited and insufficient; it is uncertain whether treating SWHSI with antiseptics or antibiotics is beneficial.

An Examination of New Counselor Mentor Programs

ERIC Educational Resources Information Center

Bass, Erin; Gardner, Lauren; Onwukaeme, Chika; Revere, Dawn; Shepherd, Denise; Parrish, Mark S.

2013-01-01

An analysis of current new counselor mentor programs reveals the need for such programs, but information regarding established programs is limited. A review of the literature addresses program characteristics and data obtained from existing mentor program participants. An overview of four programs explaining the framework outlined for mentoring…

Phenomenological Study: How Organizational Structures and Change Processes Influence Student Learning

ERIC Educational Resources Information Center

Johnson, Charlotte Clay

2013-01-01

Educational institutions create organizational structures for younger students with limited work experience. New generations of adult students require different organizational structures to improve success. The current phenomenological qualitative study addressed the lack of consensus of what types of organizational structures in higher education…

Sharing Expository Texts with Preschool Children in Special Education

ERIC Educational Resources Information Center

Breit-Smith, Allison; Busch, Jamie; Guo, Ying

2015-01-01

Although a general limited availability of expository texts currently exists in preschool special education classrooms, expository tests offer speech-language pathologists (SLPs) a rich context for addressing the language goals of preschool children with language impairment on their caseloads. Thus, this article highlights the differences between…

Addressing Trauma in Substance Abuse Treatment

ERIC Educational Resources Information Center

Giordano, Amanda L.; Prosek, Elizabeth A.; Stamman, Julia; Callahan, Molly M.; Loseu, Sahar; Bevly, Cynthia M.; Cross, Kaitlin; Woehler, Elliott S.; Calzada, Richard-Michael R.; Chadwell, Katie

2016-01-01

Trauma is prevalent among clients with substance abuse issues, yet addictions counselors' training in trauma approaches is limited. The purpose of the current article is to provide pertinent information regarding trauma treatment including the use of assessments, empirically supported clinical approaches, self-help groups and the risk of vicarious…

Artificial Ligaments: Promise or Panacea?

ERIC Educational Resources Information Center

Lubell, Adele

1987-01-01

The Food and Drug Administration has approved a prosthetic ligament for limited use in persons with damaged anterior cruciate ligaments (ACL). This article addresses ligament repair, ACL tears, current treatment, development of the Gore-Tex artificial ligament, other artificial ligaments in process, and arguments for and against their use.…

Relevance and Retrieval Evaluation: Perspectives from Medicine.

ERIC Educational Resources Information Center

Hersh, William

1994-01-01

Discusses topical relevance and situational relevance, which takes into account the impact of the retrieval system on the user, in the context of medicine. Topics addressed include scientific validity; limitations of current evaluation methodology, including recall and precision; and a framework for future retrieval research based on an…

A Critique of Sociocultural Values in PBIS.

PubMed

Wilson, Alyssa N

2015-05-01

Horner and Sugai provide lessons learned from their work with disseminating the Positive Behavioral Interventions and Support (PBIS) model. While PBIS represents an empirical school-wide approach for maladaptive student behaviors, the model appears to have limitations regarding sociocultural values and behavioral data collection practices. The current paper provides an overview of three identified areas for improvement and outlines how administrators using PBIS can incorporate acceptance and mindfulness-based intervention procedures to address the discussed limitations.

Modern Instrumental Methods in Forensic Toxicology*

PubMed Central

Smith, Michael L.; Vorce, Shawn P.; Holler, Justin M.; Shimomura, Eric; Magluilo, Joe; Jacobs, Aaron J.; Huestis, Marilyn A.

2009-01-01

This article reviews modern analytical instrumentation in forensic toxicology for identification and quantification of drugs and toxins in biological fluids and tissues. A brief description of the theory and inherent strengths and limitations of each methodology is included. The focus is on new technologies that address current analytical limitations. A goal of this review is to encourage innovations to improve our technological capabilities and to encourage use of these analytical techniques in forensic toxicology practice. PMID:17579968

Current limitations and recommendations to improve testing for the environmental assessment of endocrine active substances

USGS Publications Warehouse

Coady, Katherine K.; Biever, Ronald C.; Denslow, Nancy D.; Gross, Melanie; Guiney, Patrick D.; Holbech, Henrik; Karouna-Renier, Natalie K.; Katsiadaki, Ioanna; Krueger, Hank; Levine, Steven L.; Maack, Gerd; Williams, Mike; Wolf, Jeffrey C.; Ankley, Gerald T.

2017-01-01

In the present study, existing regulatory frameworks and test systems for assessing potential endocrine active chemicals are described, and associated challenges are discussed, along with proposed approaches to address these challenges. Regulatory frameworks vary somewhat across geographies, but all basically evaluate whether a chemical possesses endocrine activity and whether this activity can result in adverse outcomes either to humans or to 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 hormone signaling 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 with 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 screening could be used to prioritize chemicals for testing and provide insights as to the most appropriate assays for characterizing hazard and risk. Other recommendations include adding endpoints for elucidating connections between mechanistic effects and adverse outcomes, identifying potentially sensitive taxa for which test methods currently do not exist, and addressing key endocrine pathways of possible concern in addition to those associated with estrogen, androgen, and thyroid signaling. 

Training cognition in ADHD: current findings, borrowed concepts, and future directions.

PubMed

Rutledge, Kyle J; van den Bos, Wouter; McClure, Samuel M; Schweitzer, Julie B

2012-07-01

With both its high prevalence and myriad of negative outcomes, Attention-Deficit/Hyperactivity Disorder (ADHD) demands a careful consideration of the efficacy of its treatment options. Although the benefits of medication have a robust empirical background, nonpharmaceutical interventions evoke particular interest, as they are often viewed more favorably by parents. This review pays special attention to the use of working memory and recent cognitive training attempts in ADHD, describing its cognitive, behavioral, and biological effects in relation to current neurological theory of the disorder. While these treatments have demonstrated positive effects on some measures, there are limitations, as studies have failed to demonstrate generalization to critical measures, such as teacher-rated classroom behaviors, and have provided limited but growing evidence of functionally significant improvements in behavior. There is also a clear lack of research on the effects of training on reward systems and self-control. These limitations may be addressed by broadening the scope and procedures of the training and incorporating research concepts from other fields of study. First, it is important to consider the developmental trajectories of brain regions in individuals with the disorder, as they may relate to the effectiveness of cognitive training. Notions from behavioral economics, including delay discounting and framing (i.e., context) manipulations that influence present orientation, also have applications in the study of cognitive training in ADHD. In considering these other domains, we may find new ways to conceptualize and enhance cognitive training in ADHD and, in turn, address current limitations of interventions that fall in this category.

Understanding ocean acidification impacts on organismal to ecological scales

USGS Publications Warehouse

Andersson, Andreas J; Kline, David I; Edmunds, Peter J; Archer, Stephen D; Bednaršek, Nina; Carpenter, Robert C; Chadsey, Meg; Goldstein, Philip; Grottoli, Andrea G.; Hurst, Thomas P; King, Andrew L; Kübler, Janet E.; Kuffner, Ilsa B.; Mackey, Katherine R M; Menge, Bruce A.; Paytan, Adina; Riebesell, Ulf; Schnetzer, Astrid; Warner, Mark E; Zimmerman, Richard C

2015-01-01

Ocean acidification (OA) research seeks to understand how marine ecosystems and global elemental cycles will respond to changes in seawater carbonate chemistry in combination with other environmental perturbations such as warming, eutrophication, and deoxygenation. Here, we discuss the effectiveness and limitations of current research approaches used to address this goal. A diverse combination of approaches is essential to decipher the consequences of OA to marine organisms, communities, and ecosystems. Consequently, the benefits and limitations of each approach must be considered carefully. Major research challenges involve experimentally addressing the effects of OA in the context of large natural variability in seawater carbonate system parameters and other interactive variables, integrating the results from different research approaches, and scaling results across different temporal and spatial scales.

Simulation in Training--The Current Imperative.

DTIC Science & Technology

1980-05-16

Carlisle Barracks, PA 17013 - I1. CONTROLLING OFFICE NAME AND ADDRESS 12 . REPORT DATE I. NUMBER OF PAGES 24 14. MONITORING AGENCY NAME & ADDRESSQIf different...growth in components, spare parts, fuel and lubricants, as well as limited space in which to train, the Army must adapt a strategy of field train- ing...I________________________ k AUTHOR(S): Richard P. Diehl, LTC, INF TITLE: Simulation in Training--The Current Imperative FORMAT: Individual Study Project DATE: 16

Current Status of Legislative Proposals on Greenhouse Gas Emissions and Alternative Energy in the U.S. Congress

NASA Astrophysics Data System (ADS)

Richardson, L. J.

2007-12-01

The 110th Congress is now beginning to grapple with the issue of human-induced climate change and what, if anything, to do about it. A number of bills are currently being considered that would limit greenhouse gas emissions using various policy mechanisms and over various time frames. With a commitment by the current Congressional leadership to pass legislation addressing global warming, and significant hurdles remaining, it promises to be an eventful fall session. I will review the current status of these legislative proposals and their prospects of becoming law.

Detection of proteolytic activity by covalent tethering of fluorogenic substrates in zymogram gels.

PubMed

Deshmukh, Ameya A; Weist, Jessica L; Leight, Jennifer L

2018-05-01

Current zymographic techniques detect only a subset of known proteases due to the limited number of native proteins that have been optimized for incorporation into polyacrylamide gels. To address this limitation, we have developed a technique to covalently incorporate fluorescently labeled, protease-sensitive peptides using an azido-PEG3-maleimide crosslinker. Peptides incorporated into gels enabled measurement of MMP-2, -9, -14, and bacterial collagenase. Sensitivity analysis demonstrated that use of peptide functionalized gels could surpass detection limits of current techniques. Finally, electrophoresis of conditioned media from cultured cells resulted in the appearance of several proteolytic bands, some of which were undetectable by gelatin zymography. Taken together, these results demonstrate that covalent incorporation of fluorescent substrates can greatly expand the library of detectable proteases using zymographic techniques.

38 CFR 1.710 - Homeless claimants: Delivery of benefit payments and correspondence.

Code of Federal Regulations, 2010 CFR

2010-07-01

... filing their claims shall be counseled as to the importance of providing his or her current mailing... limited to shelters, kitchens and private outreach facilities, information encouraging such organizations to counsel individuals on the importance of providing mailing addresses to the Department of Veterans...

Beyond Word Processing: Rhetorical Invention with Computers.

ERIC Educational Resources Information Center

Strickland, James

In the area of composition, computer assisted instruction (CAI) must move beyond the limited concerns of the current-traditional rhetoric to address the larger issues of writing, become process-centered, and involve active writing rather than answering multiple-choice questions. Researchers cite four major types of interactive CAI, the last of…

The Experiences of the Younger Supervisor: Implications for Organizations

ERIC Educational Resources Information Center

Hanson, Lea

2012-01-01

With four generations in today's workforce, roles are being redefined to include a growing number of younger supervisor/older subordinate relationships, referred to as the intergenerational dyad. What current and limited literature exists about the intergenerational dyad exclusively addresses the issues of generational workplace differences…

Geriatrics Educational Outreach: A Tale of Three GRECCs

ERIC Educational Resources Information Center

Clark, Elizabeth; Fitzgerald, James T.; Griffith, Jennifer; Weir, Charlene

2011-01-01

Current geriatrics workforce projections indicate that clinicians who care for adults will need basic geriatrics knowledge and skills to address the geriatric syndromes and issues that limit functional independence and complicate medical management. This is most evident for the clinicians caring for veterans in the Department of Veterans Affairs…

Virtual Road Safety Audits: Recommended Procedures for Using Driving Simulation and Technology to Expand Existing Practices

DOT National Transportation Integrated Search

2018-02-02

One approach that has been proposed to address the limitations of the current reactive safetymonitoring approaches is the use of road safety audits (RSAs). As part of an RSA, the existing or expected characteristics and traffic conditions of a locati...

THE VALUE OF STEEP, GREEN ROOF TECHNOLOGY TO SUSTAINABLE COLD CLIMATE COMMUNITIES

EPA Science Inventory

With the knowledge gained from this preliminary study, we plan to built a modified extensive green roof product that addresses both the opportunities and limitations of current extensive manufactured green roof products. The results of our tests will be shared with building c...

Semantic Search of Web Services

ERIC Educational Resources Information Center

Hao, Ke

2013-01-01

This dissertation addresses semantic search of Web services using natural language processing. We first survey various existing approaches, focusing on the fact that the expensive costs of current semantic annotation frameworks result in limited use of semantic search for large scale applications. We then propose a vector space model based service…

DATA COLLECTED IN THE EPA'S NATIONAL EXPOSURE RESEARCH LABORATORY'S FIELD MEASUREMENT STUDIES TO EVALUATE AGGREGATE EXPOSURE

EPA Science Inventory

The Food Quality Protection Act of 1996 requires children's risk assessments to be conducted using high quality and high quantity data. Currently, data on children's exposures and exposure factors are limited and insufficient to address risk assessments that do not rely heavil...

IMPROVING PARTICULATE MATTER SOURCE APPORTIONMENT FOR HEALTH STUDIES: A TRAINED RECEPTOR MODELING APPROACH WITH SENSITIVITY, UNCERTAINTY AND SPATIAL ANALYSES

EPA Science Inventory

An approach for conducting PM source apportionment will be developed, tested, and applied that directly addresses limitations in current SA methods, in particular variability, biases, and intensive resource requirements. Uncertainties in SA results and sensitivities to SA inpu...

The effect of environmental factors on the implementation of the Mechanistic-empirical pavement design guide (MEPDG).

DOT National Transportation Integrated Search

2011-07-01

Current pavement design based on the AASHTO Design Guide uses an empirical approach from the results of the AASHO Road Test conducted in 1958. To address some of the limitations of the original design guide, AASHTO developed a new guide: Mechanistic ...

Economic and phosphorus-related effects of precision feeding and forage management at a farm scale

USDA-ARS?s Scientific Manuscript database

A system-level redesign of farm management is needed to maintain economic viability of the farm while addressing phosphorous imbalance problems caused by many current practices. One innovative strategy, precision feed management (PFM), reduces soil-phosphorus build-up by limiting feed and fertilizer...

Reducing State Communication Anxiety for Public Speakers: An Energy Psychology Pilot Study

ERIC Educational Resources Information Center

Fitch, John, III; Schmuldt, Laura; Rudick, Karen L.

2011-01-01

This mixed-method pilot study investigates the efficacy of implementing primordial energy activation and transcendence to address public speaking anxiety. Speech anxiety was significantly reduced from pretest to posttest, as measured by the Communication Anxiety Inventory State. Suggestions for future research, limitations of the current study,…

Culture and Self in Career Development: Working with American Indians

ERIC Educational Resources Information Center

Juntunen, Cindy L.; Cline, Kara

2010-01-01

The career development concerns of American Indians continue to receive limited attention in the vocational or career literature. To address this deficit, the current article will apply the cultural formulation approach to career counseling with American Indians. This article presents information on factors related to cultural and self-identity…

40 CFR 450.21 - Effluent limitations reflecting the best practicable technology currently available (BPT).

Code of Federal Regulations, 2012 CFR

2012-07-01

.... Design, install and maintain effective erosion controls and sediment controls to minimize the discharge of pollutants. At a minimum, such controls must be designed, installed and maintained to: (1) Control... design, installation and maintenance of erosion and sediment controls must address factors such as the...

40 CFR 450.21 - Effluent limitations reflecting the best practicable technology currently available (BPT).

Code of Federal Regulations, 2013 CFR

2013-07-01

.... Design, install and maintain effective erosion controls and sediment controls to minimize the discharge of pollutants. At a minimum, such controls must be designed, installed and maintained to: (1) Control... design, installation and maintenance of erosion and sediment controls must address factors such as the...

Lessons Learned from Citizen Science in the Classroom

ERIC Educational Resources Information Center

Gray, Steven A.; Nicosia, Kristina; Jordan, Rebecca C.

2012-01-01

Mueller, Tippins, and Bryan's contrast of the current limitations of science education with the potential virtues of citizen science provides an important theoretical perspective about the future of democratized science and K-12 education. However, the authors fail to adequately address the existing barriers and constraints to moving…

Adolescent Male-to-Female Transgender Voice and Communication Therapy

ERIC Educational Resources Information Center

Hancock, Adrienne; Helenius, Lauren

2012-01-01

Current research to describe and evaluate effectiveness of voice and communication therapy for male-to-female transgender people is limited to adults. This paper provides rationale, procedures, and outcomes from voice and communication therapy for a male-to-female transgender adolescent 15 years of age. Treatment addressed vocal hygiene, breath…

Parenting Latino Toddlers and Preschoolers: Clinical and Nonclinical Samples

ERIC Educational Resources Information Center

Perez, Maria E.; Fox, Robert A.

2008-01-01

Parenting practices contribute significantly to the social-emotional development of young children. There is limited literature that addresses the role of culture in parenting, particularly among Latino families who have very young children with significant behavior problems. The current study compared the parenting practices of 30 low-income…

AFEII Analog Front End Board Design Specifications

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

Rubinov, Paul; /Fermilab

2005-04-01

This document describes the design of the 2nd iteration of the Analog Front End Board (AFEII), which has the function of receiving charge signals from the Central Fiber Tracker (CFT) and providing digital hit pattern and charge amplitude information from those charge signals. This second iteration is intended to address limitations of the current AFE (referred to as AFEI in this document). These limitations become increasingly deleterious to the performance of the Central Fiber Tracker as instantaneous luminosity increases. The limitations are inherent in the design of the key front end chips on the AFEI board (the SVXIIe and themore » SIFT) and the architecture of the board itself. The key limitations of the AFEI are: (1) SVX saturation; (2) Discriminator to analog readout cross talk; (3) Tick to tick pedestal variation; and (4) Channel to channel pedestal variation. The new version of the AFE board, AFEII, addresses these limitations by use of a new chip, the TriP-t and by architectural changes, while retaining the well understood and desirable features of the AFEI board.« less

GLIDE: a grid-based light-weight infrastructure for data-intensive environments

NASA Technical Reports Server (NTRS)

Mattmann, Chris A.; Malek, Sam; Beckman, Nels; Mikic-Rakic, Marija; Medvidovic, Nenad; Chrichton, Daniel J.

2005-01-01

The promise of the grid is that it will enable public access and sharing of immense amounts of computational and data resources among dynamic coalitions of individuals and institutions. However, the current grid solutions make several limiting assumptions that curtail their widespread adoption. To address these limitations, we present GLIDE, a prototype light-weight, data-intensive middleware infrastructure that enables access to the robust data and computational power of the grid on DREAM platforms.

Home visitation programs: An untapped opportunity for the delivery of early childhood obesity prevention

PubMed Central

Salvy, Sarah-Jeanne; de la Haye, Kayla; Galama, Titus; Goran, Michael I.

2016-01-01

Background Extant obesity efforts have had limited impact among low-income underserved children, in part because of limitations inherent to existing programs: 1) short duration and low intensity; 2) late timing of implementation, when children are already overweight or obese; 3) intervention delivery limiting their accessibility and sustainability; and 4) failure to address barriers such as a lack of culturally competent services, poverty and housing instability, which interfere with healthy lifestyle changes. Objective This concept paper proposes an innovative model of obesity prevention implemented in infancy and sustained throughout early childhood to address the limitations of current obesity prevention efforts. Specifically, we propose to integrate sustained, weekly, in-home obesity prevention as part of the services already delivered by ongoing Home Visitation Programs, which currently do not target obesity prevention. Conclusion The home visiting structure represents an ideal model for impactful obesity prevention as home visitation programs: (1) already provide comprehensive services to diverse low-income infants and families who are most at risk for obesity and poor health due to socio-economic and structural conditions; (2) services are initiated in infancy and sustained throughout critical developmental periods for the formation of healthy/unhealthy behaviors; and (3) have been in place for more than 40 years, with a widespread presence across the United States and nationwide, which is critical for the scalability and sustainability of obesity prevention. PMID:27911984

Home visitation programs: an untapped opportunity for the delivery of early childhood obesity prevention.

PubMed

Salvy, S-J; de la Haye, K; Galama, T; Goran, M I

2017-02-01

Extant obesity efforts have had limited impact among low-income underserved children, in part because of limitations inherent to existing programs: (i) short duration and low intensity; (ii) late timing of implementation, when children are already overweight or obese; (iii) intervention delivery limiting their accessibility and sustainability; and (iv) failure to address barriers such as a lack of culturally competent services, poverty and housing instability, which interfere with healthy lifestyle changes. This concept paper proposes an innovative model of obesity prevention implemented in infancy and sustained throughout early childhood to address the limitations of current obesity prevention efforts. Specifically, we propose to integrate sustained, weekly, in-home obesity prevention as part of the services already delivered by ongoing Home Visitation Programs, which currently do not target obesity prevention. The home visiting structure represents an ideal model for impactful obesity prevention as home visitation programs: (i) already provide comprehensive services to diverse low-income infants and families who are most at risk for obesity and poor health because of socio-economic and structural conditions; (ii) services are initiated in infancy and sustained throughout critical developmental periods for the formation of healthy/unhealthy behaviors; and (iii) have been in place for more than 40 years, with a widespread presence across the United States and nationwide, which is critical for the scalability and sustainability of obesity prevention. © 2016 World Obesity Federation.

A Review of Contraception and Abortion Content in Family Medicine Textbooks.

PubMed

Schubert, Finn D; Akse, Sarp; Bennett, Ariana H; Glassman, Nancy R; Gold, Marji

2015-01-01

Family physicians are critical providers of reproductive health care in the United States, and family physicians and trainees refer to textbooks as a source of clinical information. This study evaluates the coverage of reproductive health topics in current family medicine textbooks. We identified 12 common family medicine textbooks through a computerized literature search and through the recommendations of a local family medicine clerkship and evaluated 24 areas of reproductive health content (comprising contraceptive care, management of early pregnancy loss, and provision of induced abortion) for accuracy and thoroughness using criteria that we created based on the latest guidelines. All contraceptive methods evaluated were addressed in more than half of the textbooks, though discrepancies existed by method, with intrauterine devices (IUDs), external (male) condoms, and diaphragms addressed most frequently (10/12 texts) and male and female sterilization addressed least frequently (8/12 texts). While most contraceptive methods, when addressed, were usually addressed accurately, IUDs were often addressed inaccurately. Coverage of early pregnancy loss management was limited to 7/12 texts, and coverage of early abortion methods was even more limited, with only 4/12 texts addressing the topic. Family medicine textbooks do not uniformly provide correct and thorough information on reproductive health topics relevant to family medicine, and attention is needed to ensure that family physicians are receiving appropriate information and training to meet the reproductive health needs of US women.

Comparison of the quench and fault current limiting characteristics of the flux-coupling type SFCL with single and three-phase transformer

NASA Astrophysics Data System (ADS)

Jung, Byung Ik; Cho, Yong Sun; Park, Hyoung Min; Chung, Dong Chul; Choi, Hyo Sang

2013-01-01

The South Korean power grid has a network structure for the flexible operation of the system. The continuously increasing power demand necessitated the increase of power facilities, which decreased the impedance in the power system. As a result, the size of the fault current in the event of a system fault increased. As this increased fault current size is threatening the breaking capacity of the circuit breaker, the main protective device, a solution to this problem is needed. The superconducting fault current limiter (SFCL) has been designed to address this problem. SFCL supports the stable operation of the circuit breaker through its excellent fault-current-limiting operation [1-5]. In this paper, the quench and fault current limiting characteristics of the flux-coupling-type SFCL with one three-phase transformer were compared with those of the same SFCL type but with three single-phase transformers. In the case of the three-phase transformers, both the superconducting elements of the fault and sound phases were quenched, whereas in the case of the single-phase transformer, only that of the fault phase was quenched. For the fault current limiting rate, both cases showed similar rates for the single line-to-ground fault, but for the three-wire earth fault, the fault current limiting rate of the single-phase transformer was over 90% whereas that of the three-phase transformer was about 60%. It appears that when the three-phase transformer was used, the limiting rate decreased because the fluxes by the fault current of each phase were linked in one core. When the power loads of the superconducting elements were compared by fault type, the initial (half-cycle) load was great when the single-phase transformer was applied, whereas for the three-phase transformer, its power load was slightly lower at the initial stage but became greater after the half fault cycle.

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.

Corruption of pharmaceutical markets: addressing the misalignment of financial incentives and public health.

PubMed

Gagnon, Marc-André

2013-01-01

This paper explains how the current architecture of the pharmaceutical markets has created a misalignment of financial incentives and public health that is a central cause of harmful practices. It explores three possible solutions to address that misalignment: taxes, increased financial penalties, and drug pricing based on value. Each proposal could help to partly realign financial incentives and public health. However, because of the limits of each proposal, there is no easy solution to fixing the problem of financial incentives. © 2013 American Society of Law, Medicine & Ethics, Inc.

Recent advances in hypersonic technology

NASA Technical Reports Server (NTRS)

Dwoyer, Douglas L.

1990-01-01

This paper will focus on recent advances in hypersonic aerodynamic prediction techniques. Current capabilities of existing numerical methods for predicting high Mach number flows will be discussed and shortcomings will be identified. Physical models available for inclusion into modern codes for predicting the effects of transition and turbulence will also be outlined and their limitations identified. Chemical reaction models appropriate to high-speed flows will be addressed, and the impact of their inclusion in computational fluid dynamics codes will be discussed. Finally, the problem of validating predictive techniques for high Mach number flows will be addressed.

A Sequential Analysis of Parent-Child Interactions in Anxious and Nonanxious Families

ERIC Educational Resources Information Center

Williams, Sarah R.; Kertz, Sarah J.; Schrock, Matthew D.; Woodruff-Borden, Janet

2012-01-01

Although theoretical work has suggested that reciprocal behavior patterns between parent and child may be important in the development of childhood anxiety, most empirical work has failed to consider the bidirectional nature of interactions. The current study sought to address this limitation by utilizing a sequential approach to exploring…

Educational contracts in family medicine residency training.

PubMed Central

Mahood, S.; Rojas, R.; Andres, D.; Zagozeski, C.; White, G.; Bradel, T.

1994-01-01

An educational contract for family medicine residency training and evaluation addresses many of the difficulties and challenges of current postgraduate medical education. This article identifies important principles for developing a contractual approach; describes the contract used in one program and its implementation; and discusses its theory, advantages, and limitations. Images p550-a PMID:8199512

Theoretical Orientation and Personality of the Therapist: A Graduate Student Sample

ERIC Educational Resources Information Center

Ivanovic, Mirka

2011-01-01

The current study adds to the literature--and addresses several identified limitations--about the relationship between therapist trainees' personality traits and their preference for a particular theoretical orientation(s). Therapist trainees (N = 197) in a Clinical Psy.D program at The Chicago School of Professional Psychology completed a paper…

Rural Vocational and Transition Assessment Practices for Students with Intellectual Disabilities: What Do Educators Really Know?

ERIC Educational Resources Information Center

Brendle, Janna; Tucker, Kathryn J.; Lock, Robin H.

2018-01-01

Transition planning requires quality vocational and transition assessment tailored to the student's needs, strengths, preferences and interests. Limited research is currently available that addresses assessment types and use of results that rural practitioners utilize to aid in transition planning for students with intellectual disabilities (ID).…

Substance Abuse among Youth with Disabilities. Prevention Research Update, Number Seven/Summer 1990.

ERIC Educational Resources Information Center

Prendergast, Michael; And Others

This literature review focuses on the state of current knowledge concerning alcohol and other drug (AOD) abuse among people with developmental, learning, hearing, visual, and mobility impairments. The review is divided into four main sections. The first section addresses the limits of the available research-based information. The second section…

Surveying Immigrant Communities: Policy Imperatives and Technical Challenges.

ERIC Educational Resources Information Center

DaVanzo, Julie; And Others

While national debates focus on rising immigration and its impact, current data on immigrants and how they affect the national life are limited. To determine the feasibility of conducting a national survey of immigrants, a pilot project surveyed Salvadorans and Filipinos in Los Angeles in 1991. This report addresses key methodological issues in…

Arizona | Midmarket Solar Policies in the United States | Solar Research |

Science.gov Websites

standard. Arizona has a net-metering program with no size limit but is specific to the customer's load % of customer's total connected load Aggregate cap: Not addressed Credit: Net excess generation is are exempt from Arizona Corporation Commission regulation. Community Solar There are currently no

Using a Sequence Homology-Based Predictive Strategy to Address Current Demands for Focused Toxicity Testing in Ecological Risk Assessment

EPA Science Inventory

The lack of resources available for comprehensive toxicity testing, international interest in limiting the quantity of animals used in testing, and a mounting list of anthropogenic chemicals produced world-wide have led to the exploration of innovative means for identifying chemi...

Assessing Faculty Beliefs about the Importance of Various Marketing Job Skills

ERIC Educational Resources Information Center

Hyman, Michael R.; Hu, Jing

2005-01-01

The need to improve the professional skills of those with marketing degrees has spurred surveys of current students, alumni, practitioners, and faculty about the importance of various professional skills; however, previous surveys of marketing faculty have focused only on computer skills. To address this limitation, the goals of this study were…

Cultural Competence and Social Work Education: Moving toward Assessment of Practice Behaviors

ERIC Educational Resources Information Center

Jani, Jayshree S.; Osteen, Philip; Shipe, Stacy

2016-01-01

Social work educators are responsible for ensuring that future practitioners are culturally competent and have the ability to work effectively with people from different backgrounds. The purpose of this article is to address the current limitations in measuring cultural competence and to report the results of a qualitative study examining…

Graduate Students' Research Interest in Business Ethics: A Study of Dissertations

ERIC Educational Resources Information Center

Piotrowski, Chris; Guyette, Roger W.

2014-01-01

Research on the nature of business ethics education during graduate-level training is somewhat limited. One approach in determining advanced students' research interest in the area is to examine the selection of "business ethics" topics for dissertation research. The current study addressed this issue by conducting a topical…

Enhancing Beginners' Second Language Learning through an Informal Online Environment

ERIC Educational Resources Information Center

Chakowa, Jessica

2018-01-01

Web 2.0 tools are used increasingly to support second language learning, but there have been limited studies involving beginner learners, multiple technologies, and informal settings. This current study addresses this gap and investigates the factors affecting students' interest in a nongraded online learning environment and what kinds of tools,…

77 FR 54887 - Proposed Information Collection; Comment Request; 2013 Census Test

Federal Register 2010, 2011, 2012, 2013, 2014

2012-09-06

... Test will inform Census Bureau planners who are guiding the design of additional 2020 Decennial Census.... Current plans do not target Tribal sites and group quarters addresses for this test due to limitations of... Test AGENCY: U.S. Census Bureau, Commerce. ACTION: Notice. SUMMARY: The Department of Commerce, as part...

Improving Access to Accommodations: Reducing Political and Institutional Barriers for Canadian Postsecondary Students with Visual Impairments

ERIC Educational Resources Information Center

Ostrowski, Christopher P.

2016-01-01

Challenges to obtaining quality academic accommodations for students with visual impairments in postsecondary education hinder accessibility and the success of such students. The limitations of current policies and practices intended to address the needs of students in Canada are examined and potential solutions are discussed. Further systemic…

Scaling Up Decision Theoretic Planning to Planetary Rover Problems

NASA Technical Reports Server (NTRS)

Meuleau, Nicolas; Dearden, Richard; Washington, Rich

2004-01-01

Because of communication limits, planetary rovers must operate autonomously during consequent durations. The ability to plan under uncertainty is one of the main components of autonomy. Previous approaches to planning under uncertainty in NASA applications are not able to address the challenges of future missions, because of several apparent limits. On another side, decision theory provides a solid principle framework for reasoning about uncertainty and rewards. Unfortunately, there are several obstacles to a direct application of decision-theoretic techniques to the rover domain. This paper focuses on the issues of structure and concurrency, and continuous state variables. We describes two techniques currently under development that address specifically these issues and allow scaling-up decision theoretic solution techniques to planetary rover planning problems involving a small number of goals.

Developing sustainable global health technologies: insight from an initiative to address neonatal hypothermia.

PubMed

Gupta, Rajesh; Patel, Rajan; Murty, Naganand; Panicker, Rahul; Chen, Jane

2015-02-01

Relative to drugs, diagnostics, and vaccines, efforts to develop other global health technologies, such as medical devices, are limited and often focus on the short-term goal of prototype development instead of the long-term goal of a sustainable business model. To develop a medical device to address neonatal hypothermia for use in resource-limited settings, we turned to principles of design theory: (1) define the problem with consideration of appropriate integration into relevant health policies, (2) identify the users of the technology and the scenarios in which the technology would be used, and (3) use a highly iterative product design and development process that incorporates the perspective of the user of the technology at the outset and addresses scalability. In contrast to our initial idea, to create a single device, the process guided us to create two separate devices, both strikingly different from current solutions. We offer insights from our initial experience that may be helpful to others engaging in global health technology development.

Current investigations into the genotoxicity of zinc oxide and silica nanoparticles in mammalian models in vitro and in vivo: carcinogenic/genotoxic potential, relevant mechanisms and biomarkers, artifacts, and limitations

PubMed Central

Kwon, Jee Young; Koedrith, Preeyaporn; Seo, Young Rok

2014-01-01

Engineered nanoparticles (NPs) are widely used in many sectors, such as food, medicine, military, and sport, but their unique characteristics may cause deleterious health effects. Close attention is being paid to metal NP genotoxicity; however, NP genotoxic/carcinogenic effects and the underlying mechanisms remain to be elucidated. In this review, we address some metal and metal oxide NPs of interest and current genotoxicity tests in vitro and in vivo. Metal NPs can cause DNA damage such as chromosomal aberrations, DNA strand breaks, oxidative DNA damage, and mutations. We also discuss several parameters that may affect genotoxic response, including physicochemical properties, widely used assays/end point tests, and experimental conditions. Although potential biomarkers of nanogenotoxicity or carcinogenicity are suggested, inconsistent findings in the literature render results inconclusive due to a variety of factors. Advantages and limitations related to different methods for investigating genotoxicity are described, and future directions and recommendations for better understanding genotoxic potential are addressed. PMID:25565845

Sea ice motions in the Central Arctic pack ice as inferred from AVHRR imagery

NASA Technical Reports Server (NTRS)

Emery, William; Maslanik, James; Fowler, Charles

1995-01-01

Synoptic observations of ice motion in the Arctic Basin are currently limited to those acquired by drifting buoys and, more recently, radar data from ERS-1. Buoys are not uniformly distributed throughout the Arctic, and SAR coverage is currently limited regionally and temporally due to the data volume, swath width, processing requirements, and power needs of the SAR. Additional ice-motion observations that can map ice responses simultaneously over large portions of the Arctic on daily to weekly time intervals are thus needed to augment the SAR and buoys data and to provide an intermediate-scale measure of ice drift suitable for climatological analyses and ice modeling. Principal objectives of this project were to: (1) demonstrate whether sufficient ice features and ice motion existed within the consolidated ice pack to permit motion tracking using AVHRR imagery; (2) determine the limits imposed on AVHRR mapping by cloud cover; and (3) test the applicability of AVHRR-derived motions in studies of ice-atmosphere interactions. Each of these main objectives was addressed. We conclude that AVHRR data, particularly when blended with other available observations, provide a valuable data set for studying sea ice processes. In a follow-on project, we are now extending this work to cover larger areas and to address science questions in more detail.

Physical therapy and occupational therapy in Parkinson's disease.

PubMed

Radder, Danique L M; Sturkenboom, Ingrid H; van Nimwegen, Marlies; Keus, Samyra H; Bloem, Bastiaan R; de Vries, Nienke M

2017-10-01

Current medical management is only partially effective in controlling the symptoms of Parkinson's disease. As part of comprehensive multidisciplinary care, physical therapy and occupational therapy aim to support people with Parkinson's disease in dealing with the consequences of their disease in daily activities. In this narrative review, we address the limitations that people with Parkinson's disease may encounter despite optimal medical management, and we clarify both the unique and shared approaches that physical therapists and occupational therapists can apply in treating these limitations.

Passive detection of copy-move forgery in digital images: state-of-the-art.

PubMed

Al-Qershi, Osamah M; Khoo, Bee Ee

2013-09-10

Currently, digital images and videos have high importance because they have become the main carriers of information. However, the relative ease of tampering with images and videos makes their authenticity untrustful. Digital image forensics addresses the problem of the authentication of images or their origins. One main branch of image forensics is passive image forgery detection. Images could be forged using different techniques, and the most common forgery is the copy-move, in which a region of an image is duplicated and placed elsewhere in the same image. Active techniques, such as watermarking, have been proposed to solve the image authenticity problem, but those techniques have limitations because they require human intervention or specially equipped cameras. To overcome these limitations, several passive authentication methods have been proposed. In contrast to active methods, passive methods do not require any previous information about the image, and they take advantage of specific detectable changes that forgeries can bring into the image. In this paper, we describe the current state-of-the-art of passive copy-move forgery detection methods. The key current issues in developing a robust copy-move forgery detector are then identified, and the trends of tackling those issues are addressed. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

Molecularly imprinted polymers for the detection of illegal drugs and additives: a review.

PubMed

Xiao, Deli; Jiang, Yue; Bi, Yanping

2018-04-04

This review (with 154 refs.) describes the current status of using molecularly imprinted polymers in the extraction and quantitation of illicit drugs and additives. The review starts with an introduction into some synthesis methods (lump MIPs, spherical MIPs, surface imprinting) of MIPs using illicit drugs and additives as templates. The next section covers applications, with subsections on the detection of illegal additives in food, of doping in sports, and of illicit addictive drugs. A particular focus is directed towards current limitations and challenges, on the optimization of methods for preparation of MIPs, their applicability to aqueous samples, the leakage of template molecules, and the identification of the best balance between adsorption capacity and selectivity factor. At last, the need for convincing characterization methods, the lack of uniform parameters for defining selectivity, and the merits and demerits of MIPs prepared using nanomaterials are addressed. Strategies are suggested to solve existing problems, and future developments are discussed with respect to a more widespread use in relevant fields. Graphical abstract This review gives a comprehensive overview of the advances made in molecularly imprinting of polymers for use in the extraction and quantitation of illicit drugs and additives. Methods for syntheses, highlighted applications, limitations and current challenges are specifically addressed.

Policy Options for Addressing Health System and Human Resources for Health Crisis in Liberia Post-Ebola Epidemic.

PubMed

Budy, Fidel C T

2015-01-01

Qualified healthcare workers within an effective health system are critical in promoting and achieving greater health outcomes such as those espoused in the Millennium Development Goals. Liberia is currently struggling with the effects of a brutal 14-year long civil war that devastated health infrastructures and caused most qualified health workers to flee and settle in foreign countries. The current output of locally trained health workers is not adequate for the tasks at hand. The recent Ebola Virus Disease (EVD) exposed the failings of the Liberian healthcare system. There is limited evidence of policies that could be replicated in Liberia to encourage qualified diaspora Liberian health workers to return and contribute to managing the phenomenon. This paper reviews the historical context for the human resources for health crisis in Liberia; it critically examines two context-specific health policy options to address the crisis, and recommends reverse brain drain as a policy option to address the immediate and critical crisis facing the health care sector in Liberia.

Sensor Technology for Integrated Vehicle Health Management of Aerospace Vehicles

NASA Technical Reports Server (NTRS)

Prosser, W. H.; Brown, T. L.; Woodard, S. E.; Fleming, G. A.; Cooper, E. G.

2002-01-01

NASA is focusing considerable efforts on technology development for Integrated Vehicle Health Management systems. The research in this area is targeted toward increasing aerospace vehicle safety and reliability, while reducing vehicle operating and maintenance costs. Onboard, real-time sensing technologies that can provide detailed information on structural integrity are central to such a health management system. This paper describes a number of sensor technologies currently under development for integrated vehicle health management. The capabilities, current limitations, and future research needs of these technologies are addressed.

Virtual reality and neuropsychology: upgrading the current tools.

PubMed

Schultheis, Maria T; Himelstein, Jessica; Rizzo, Albert A

2002-10-01

Virtual reality (VR) is an evolving technology that has been applied in various aspects of medicine, including the treatment of phobia disorders, pain distraction interventions, surgical training, and medical education. These applications have served to demonstrate the various assets offered through the use of VR. To provide a background and rationale for the application of VR to neuropsychological assessment. A brief introduction to VR technology and a review of current ongoing neuropsychological research that integrates the use of this technology. VR offers numerous assets that may enhance current neuropsychological assessment protocols and address many of the limitations faced by our traditional methods.

Current Limitations of Surgical Robotics in Reconstructive Plastic Microsurgery.

PubMed

Tan, Youri P A; Liverneaux, Philippe; Wong, Jason K F

2018-01-01

Surgical robots have the potential to provide surgeons with increased capabilities, such as removing physiologic tremor, scaling motion and increasing manual dexterity. Several surgical specialties have subsequently integrated robotic surgery into common clinical practice. Plastic and reconstructive microsurgical procedures have not yet  benefitted significantly from technical developments observed over the last two decades. Several studies have successfully demonstrated the feasibility of utilising surgical robots in plastic surgery procedures, yet limited work has been done to identify and analyse current barriers that have prevented wide-scale adaptation of surgical robots for microsurgery. Therefore, a systematic review using PubMed, MEDLINE, Embase and Web of Science databases was performed, in order to evaluate current state of surgical robotics within the field of reconstructive microsurgery and their limitations. Despite the theoretical potential of surgical robots, current commercially available robotic systems are suboptimal for plastic or reconstructive microsurgery. Absence of bespoke microsurgical instruments, increases in operating time, and high costs associated with robotic-assisted provide a barrier to using such systems effectively for reconstructive microsurgery. Consequently, surgical robots provide currently little overall advantage over conventional microsurgery. Nevertheless, if current barriers can be addressed and systems are specifically designed for microsurgery, surgical robots may have the potential of meaningful impact on clinical outcomes within  this surgical subspeciality.

Current Limitations of Surgical Robotics in Reconstructive Plastic Microsurgery

PubMed Central

Tan, Youri P. A.; Liverneaux, Philippe; Wong, Jason K. F.

2018-01-01

Surgical robots have the potential to provide surgeons with increased capabilities, such as removing physiologic tremor, scaling motion and increasing manual dexterity. Several surgical specialties have subsequently integrated robotic surgery into common clinical practice. Plastic and reconstructive microsurgical procedures have not yet  benefitted significantly from technical developments observed over the last two decades. Several studies have successfully demonstrated the feasibility of utilising surgical robots in plastic surgery procedures, yet limited work has been done to identify and analyse current barriers that have prevented wide-scale adaptation of surgical robots for microsurgery. Therefore, a systematic review using PubMed, MEDLINE, Embase and Web of Science databases was performed, in order to evaluate current state of surgical robotics within the field of reconstructive microsurgery and their limitations. Despite the theoretical potential of surgical robots, current commercially available robotic systems are suboptimal for plastic or reconstructive microsurgery. Absence of bespoke microsurgical instruments, increases in operating time, and high costs associated with robotic-assisted provide a barrier to using such systems effectively for reconstructive microsurgery. Consequently, surgical robots provide currently little overall advantage over conventional microsurgery. Nevertheless, if current barriers can be addressed and systems are specifically designed for microsurgery, surgical robots may have the potential of meaningful impact on clinical outcomes within  this surgical subspeciality. PMID:29740585

Menstrual hygiene management among adolescent schoolgirls in low- and middle-income countries: research priorities

PubMed Central

Phillips-Howard, Penelope A.; Caruso, Bethany; Torondel, Belen; Zulaika, Garazi; Sahin, Murat; Sommer, Marni

2016-01-01

Background A lack of adequate guidance on menstrual management; water, disposal, and private changing facilities; and sanitary hygiene materials in low- and middle-income countries leaves schoolgirls with limited options for healthy personal hygiene during monthly menses. While a plethora of observational studies have described how menstrual hygiene management (MHM) barriers in school impact girls’ dignity, well-being, and engagement in school activities, studies have yet to confirm if inadequate information and facilities for MHM significantly affects quantifiable school and health outcomes influencing girls’ life chances. Evidence on these hard outcomes will take time to accrue; however, a current lack of standardized methods, tools, and research funding is hampering progress and must be addressed. Objectives Compile research priorities for MHM and types of research methods that can be used. Results In this article, we highlight the current knowledge gaps in school-aged girls’ MHM research, and identify opportunities for addressing the dearth of hard evidence limiting the ability of governments, donors, and other agencies to appropriately target resources. We outline a series of research priorities and methodologies that were drawn from an expert panel to address global priorities for MHM in schools for the next 10 years. Conclusions A strong evidence base for different settings, standardized definitions regarding MHM outcomes, improved study designs and methodologies, and the creation of an MHM research consortia to focus attention on this neglected global issue. PMID:27938648

How are coastal households responding to climate change?

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

Elrick-Barr, Carmen E.; Smith, Timothy F.; Preston, Benjamin L.

In Australia, shared responsibility is a concept advocated to promote collective climate change adaptation by multiple actors and institutions. However, a shared response is often promoted in the absence of information regarding actions currently taken; in particular, there is limited knowledge regarding action occurring at the household scale. To address this gap, we examine household actions taken to address climate change and associated hazards in two Australian coastal communities. Mixed methods research is conducted to answer three questions: (1) what actions are currently taken (mitigation, actions to lobby for change or adaptation to climate impacts)? (2) why are these actionsmore » taken (e.g. are they consistent with capacity, experience, perceptions of risk); and (3) what are the implications for adaptation? We find that households are predominantly mitigating greenhouse gas emissions and that impact orientated adaptive actions are limited. Coping strategies are considered sufficient to mange climate risks, proving a disincentive for additional adaptive action. Influencing factors differ, but generally, risk perception and climate change belief are associated with action. Furthermore, the likelihood of more action is a function of homeownership and a tendency to plan ahead. Addressing factors that support or constrain household adaptive decision-making and action, from the physical (e.g. homeownership) to the social (e.g. skills in planning and a culture of adapting to change) will be critical in increasing household participation in adaptation.« less

How are coastal households responding to climate change?

DOE PAGES

Elrick-Barr, Carmen E.; Smith, Timothy F.; Preston, Benjamin L.; ...

2016-06-13

In Australia, shared responsibility is a concept advocated to promote collective climate change adaptation by multiple actors and institutions. However, a shared response is often promoted in the absence of information regarding actions currently taken; in particular, there is limited knowledge regarding action occurring at the household scale. To address this gap, we examine household actions taken to address climate change and associated hazards in two Australian coastal communities. Mixed methods research is conducted to answer three questions: (1) what actions are currently taken (mitigation, actions to lobby for change or adaptation to climate impacts)? (2) why are these actionsmore » taken (e.g. are they consistent with capacity, experience, perceptions of risk); and (3) what are the implications for adaptation? We find that households are predominantly mitigating greenhouse gas emissions and that impact orientated adaptive actions are limited. Coping strategies are considered sufficient to mange climate risks, proving a disincentive for additional adaptive action. Influencing factors differ, but generally, risk perception and climate change belief are associated with action. Furthermore, the likelihood of more action is a function of homeownership and a tendency to plan ahead. Addressing factors that support or constrain household adaptive decision-making and action, from the physical (e.g. homeownership) to the social (e.g. skills in planning and a culture of adapting to change) will be critical in increasing household participation in adaptation.« less

Menstrual hygiene management among adolescent schoolgirls in low- and middle-income countries: research priorities.

PubMed

Phillips-Howard, Penelope A; Caruso, Bethany; Torondel, Belen; Zulaika, Garazi; Sahin, Murat; Sommer, Marni

2016-01-01

A lack of adequate guidance on menstrual management; water, disposal, and private changing facilities; and sanitary hygiene materials in low- and middle-income countries leaves schoolgirls with limited options for healthy personal hygiene during monthly menses. While a plethora of observational studies have described how menstrual hygiene management (MHM) barriers in school impact girls' dignity, well-being, and engagement in school activities, studies have yet to confirm if inadequate information and facilities for MHM significantly affects quantifiable school and health outcomes influencing girls' life chances. Evidence on these hard outcomes will take time to accrue; however, a current lack of standardized methods, tools, and research funding is hampering progress and must be addressed. Compile research priorities for MHM and types of research methods that can be used. In this article, we highlight the current knowledge gaps in school-aged girls' MHM research, and identify opportunities for addressing the dearth of hard evidence limiting the ability of governments, donors, and other agencies to appropriately target resources. We outline a series of research priorities and methodologies that were drawn from an expert panel to address global priorities for MHM in schools for the next 10 years. A strong evidence base for different settings, standardized definitions regarding MHM outcomes, improved study designs and methodologies, and the creation of an MHM research consortia to focus attention on this neglected global issue.

Current Guidelines Have Limited Applicability to Patients with Comorbid Conditions: A Systematic Analysis of Evidence-Based Guidelines

PubMed Central

Lugtenberg, Marjolein; Burgers, Jako S.; Clancy, Carolyn; Westert, Gert P.; Schneider, Eric C.

2011-01-01

Background Guidelines traditionally focus on the diagnosis and treatment of single diseases. As almost half of the patients with a chronic disease have more than one disease, the applicability of guidelines may be limited. The aim of this study was to assess the extent that guidelines address comorbidity and to assess the supporting evidence of recommendations related to comorbidity. Methodology/Principal Findings We conducted a systematic analysis of evidence-based guidelines focusing on four highly prevalent chronic conditions with a high impact on quality of life: chronic obstructive pulmonary disease, depressive disorder, diabetes mellitus type 2, and osteoarthritis. Data were abstracted from each guideline on the extent that comorbidity was addressed (general comments, specific recommendations), the type of comorbidity discussed (concordant, discordant), and the supporting evidence of the comorbidity-related recommendations (level of evidence, translation of evidence). Of the 20 guidelines, 17 (85%) addressed the issue of comorbidity and 14 (70%) provided specific recommendations on comorbidity. In general, the guidelines included few recommendations on patients with comorbidity (mean 3 recommendations per guideline, range 0 to 26). Of the 59 comorbidity-related recommendations provided, 46 (78%) addressed concordant comorbidities, 8 (14%) discordant comorbidities, and for 5 (8%) the type of comorbidity was not specified. The strength of the supporting evidence was moderate for 25% (15/59) and low for 37% (22/59) of the recommendations. In addition, for 73% (43/59) of the recommendations the evidence was not adequately translated into the guidelines. Conclusions/Significance Our study showed that the applicability of current evidence-based guidelines to patients with comorbid conditions is limited. Most guidelines do not provide explicit guidance on treatment of patients with comorbidity, particularly for discordant combinations. Guidelines should be more explicit about the applicability of their recommendations to patients with comorbidity. Future clinical trials should also include patients with the most prevalent combinations of chronic conditions. PMID:22028802

Transmembrane transport of peptide type compounds: prospects for oral delivery

NASA Technical Reports Server (NTRS)

Lipka, E.; Crison, J.; Amidon, G. L.

1996-01-01

Synthesis and delivery of potential therapeutic peptides and peptidomimetic compounds has been the focus of intense research over the last 10 years. While it is widely recognized that numerous limitations apply to oral delivery of peptides, some of the limiting factors have been addressed and their mechanisms elucidated, which has lead to promising strategies. This article will briefly summarize the challenges, results and current approaches of oral peptide delivery and give some insight on future strategies. The barriers determining peptide bioavailability after oral administration are intestinal membrane permability, size limitations, intestinal and hepatic metabolism and in some cases solubility limitations. Poor membrane permeabilities of hydrophilic peptides might be overcome by structurally modifying the compounds, thus increasing their membrane partition characteristics and/or their affinity to carrier proteins. Another approach is the site-specific delivery of the peptide to the most permeable parts of the intestine. The current view on size limitation for oral drug delivery has neglected partition considerations. Recent studies suggest that compounds with a molecular weight up to 4000 might be significantly absorbed, assuming appropriate partition behavior and stability. Metabolism, probably the most significant factor in the absorption fate of peptides, might be controlled by coadministration of competitive enzyme inhibitors, structural modifications and administration of the compound as a well absorbed prodrug that is converted into the therapeutically active agent after its absorption. For some peptides poor solubility might present a limitation to oral absorption, an issue that has been addressed by mechanistically defining and therefore improving formulation parameters. Effective oral peptide delivery requires further development in understanding these complex mechanisms in order to maximize the therapeutic potential of this class of compounds.

Toward best practice in Human Machine Interface design for older drivers: A review of current design guidelines.

PubMed

Young, K L; Koppel, S; Charlton, J L

2017-09-01

Older adults are the fastest growing segment of the driving population. While there is a strong emphasis for older people to maintain their mobility, the safety of older drivers is a serious community concern. Frailty and declines in a range of age-related sensory, cognitive, and physical impairments can place older drivers at an increased risk of crash-related injuries and death. A number of studies have indicated that in-vehicle technologies such as Advanced Driver Assistance Systems (ADAS) and In-Vehicle Information Systems (IVIS) may provide assistance to older drivers. However, these technologies will only benefit older drivers if their design is congruent with the complex needs and diverse abilities of this driving cohort. The design of ADAS and IVIS is largely informed by automotive Human Machine Interface (HMI) guidelines. However, it is unclear to what extent the declining sensory, cognitive and physical capabilities of older drivers are addressed in the current guidelines. This paper provides a review of key current design guidelines for IVIS and ADAS with respect to the extent they address age-related changes in functional capacities. The review revealed that most of the HMI guidelines do not address design issues related to older driver impairments. In fact, in many guidelines driver age and sensory cognitive and physical impairments are not mentioned at all and where reference is made, it is typically very broad. Prescriptive advice on how to actually design a system so that it addresses the needs and limitations of older drivers is not provided. In order for older drivers to reap the full benefits that in-vehicle technology can afford, it is critical that further work establish how older driver limitations and capabilities can be supported by the system design process, including their inclusion into HMI design guidelines. Copyright © 2016 Elsevier Ltd. All rights reserved.

Robust Networking Architecture and Secure Communication Scheme for Heterogeneous Wireless Sensor Networks

ERIC Educational Resources Information Center

McNeal, McKenzie, III.

2012-01-01

Current networking architectures and communication protocols used for Wireless Sensor Networks (WSNs) have been designed to be energy efficient, low latency, and long network lifetime. One major issue that must be addressed is the security in data communication. Due to the limited capabilities of low cost and small sized sensor nodes, designing…

The Wechsler ACS Social Perception Subtest: A Preliminary Comparison with Other Measures of Social Cognition

ERIC Educational Resources Information Center

Kandalaft, Michelle R.; Didehbani, Nyaz; Cullum, C. Munro; Krawczyk, Daniel C.; Allen, Tandra T.; Tamminga, Carol A.; Chapman, Sandra B.

2012-01-01

Relative to other cognitive areas, there are few clinical measures currently available to assess social perception. A new standardized measure, the Wechsler Advanced Clinical Solutions (ACS) Social Perception subtest, addresses some limitations of existing measures; however, little is known about this new test. The first goal of this investigation…

Interactive Display of High-Resolution Images on the World Wide Web.

ERIC Educational Resources Information Center

Clyde, Stephen W.; Hirschi, Gregory W.

Viewing high-resolution images on the World Wide Web at a level of detail necessary for collaborative research is still a problem today, given the Internet's current bandwidth limitations and its ever increasing network traffic. ImageEyes is an interactive display tool being developed at Utah State University that addresses this problem by…

Free Community College: An Approach to Increase Adult Student Success in Postsecondary Education. Special Report

ERIC Educational Resources Information Center

Pingel, Sarah; Parker, Emily; Sisneros, Lauren

2016-01-01

This policy report discusses the growing interest in free community college policies across state legislatures, addresses the limited potential of current policies to help states reach their completion and attainment goals and offers a new, inclusive framework for including adult students in free community college policies. The following is…

Technology and Sexuality--What's the Connection? Addressing Youth Sexualities in Efforts to Increase Girls' Participation in Computing

ERIC Educational Resources Information Center

Ashcraft, Catherine

2015-01-01

To date, girls and women are significantly underrepresented in computer science and technology. Concerns about this underrepresentation have sparked a wealth of educational efforts to promote girls' participation in computing, but these programs have demonstrated limited impact on reversing current trends. This paper argues that this is, in part,…

Redesigning Teacher Evaluation: Lessons Learned from a Pilot Implementation in New Hampshire

ERIC Educational Resources Information Center

Riordan, Julie; Lacireno-Paquet, Natalie; Shakman, Karen; Bocala, Candice

2016-01-01

Many studies have called attention to the limitations of current teacher evaluation systems and the need for reform nationwide. This study addresses three research questions: (1) What are the features of the new teacher evaluation systems in New Hampshire's districts with SIG schools?; (2) To what extent did schools implement the evaluation system…

Bionic Manufacturing: Towards Cyborg Cells and Sentient Microbots.

PubMed

Srivastava, Sarvesh Kumar; Yadav, Vikramaditya G

2018-05-01

Bio-inspired engineering applies biological design principles towards developing engineering solutions but is not practical as a manufacturing paradigm. We advocate 'bionic manufacturing', a synergistic fusion of biotic and abiotic components, to transition away from bio-inspiration toward bio-augmentation to address current limitations in bio-inspired manufacturing. Copyright © 2017 Elsevier Ltd. All rights reserved.

78 FR 15753 - Maintenance, Testing, and Replacement of Vented Lead-Acid Storage Batteries for Nuclear Power Plants

Federal Register 2010, 2011, 2012, 2013, 2014

2013-03-12

.... Although a time limit is given, comments and suggestions in connection with items for inclusion in guides currently being developed or improvements in all published guides are encouraged at any time. ADDRESSES: You...: 301-251-7455, or by email: [email protected] . Both of the Office of Nuclear Regulatory Research...

Lessons Learned from Citizen Science in the Classroom. A Response to "The Future of Citizen Science."

ERIC Educational Resources Information Center

Gray, Steven A.; Nicosia, Kristina; Jordan, Rebecca C.

2012-01-01

Mueller, Tippins, and Bryan's contrast of the current limitations of science education with the potential virtues of citizen science provides an important theoretical perspective about the future of democratized science and K-12 education. However, the authors fail to adequately address the existing barriers and constraints to moving…

Implementing "Big Ideas" to Advance the Teaching and Learning of Science, Technology, Engineering, and Mathematics (STEM)

ERIC Educational Resources Information Center

Chalmers, Christina; Carter, Merilyn; Cooper, Tom; Nason, Rod

2017-01-01

Although education experts are increasingly advocating the incorporation of integrated Science, Technology, Engineering, and Mathematics (STEM) curriculum units to address limitations in much current STEM teaching and learning, a review of the literature reveals that more often than not such curriculum units are not mediating the construction of…

Confidentiality Protection of User Data and Adaptive Resource Allocation for Managing Multiple Workflow Performance in Service-Based Systems

ERIC Educational Resources Information Center

An, Ho

2012-01-01

In this dissertation, two interrelated problems of service-based systems (SBS) are addressed: protecting users' data confidentiality from service providers, and managing performance of multiple workflows in SBS. Current SBSs pose serious limitations to protecting users' data confidentiality. Since users' sensitive data is sent in…

What Works for the Children? What We Know and Don't Know about Bilingual Education.

ERIC Educational Resources Information Center

Ma, Jacinta

Currently, there is no overall strategy for comprehensively addressing the academic needs of English Language Learners (ELLs). Their right to equal opportunities to participate and learn has been recognized by federal law. There is limited evidence regarding bilingual education and effective strategies for educating ELLs. Research indicates that 1…

Clinician-Focused Overview of Bionic Exoskeleton Use After Spinal Cord Injury.

PubMed

Palermo, Anne E; Maher, Jennifer L; Baunsgaard, Carsten Bach; Nash, Mark S

2017-01-01

Spinal cord injury (SCI) resulting in paralysis of lower limbs and trunk restricts daily upright activity, work capacity, and ambulation ability, putting persons with an injury at greater risk of developing a myriad of secondary medical issues. Time spent in the upright posture has been shown to decrease the risk of these complications in SCI. Unfortunately, the majority of ambulation assistive technologies are limited by inefficiencies such as high energy demand, lengthy donning and doffing time, and poor gait pattern precluding widespread use. These limitations spurred the development of bionic exoskeletons. These devices are currently being used in rehabilitation settings for gait retraining, and some have been approved for home use. This overview will address the current state of available devices and their utility.

Do therapists address gender and power in infidelity? A feminist analysis of the treatment literature.

PubMed

Williams, Kirstee; Knudson-Martin, Carmen

2013-07-01

Sociocontextual factors such as gender and power play an important role in the etiology of affairs and in recovery from them, yet it is unclear how current treatment models address these issues. Drawing on feminist epistemology, this study utilized a grounded theory analysis of 29 scholarly articles and books on infidelity treatment published between 2000 and 2010 to identify the circumstances under which gender and power issues were or were not part of treatment. We found five conditions that limit attention to gender and power: (a) speaking (or assuming) as though partners are equal, (b) reframing infidelity as a relationship problem, (c) limiting discussion of societal context to background, (d) not considering how societal gender and power patterns impact relationship dynamics, and (e) limiting discussion of ethics on how to position around infidelity. Analysis explored how each occurred across three phases of couple therapy. The findings provide a useful foundation for a sociocontextual framework for infidelity treatment. © 2012 American Association for Marriage and Family Therapy.

The Need for Comprehensive Health Care Quality Measures for Older Adults.

PubMed

MacLeod, Stephanie; Schwebke, Kay; Hawkins, Kevin; Ruiz, Joann; Hoo, Emma; Yeh, Charlotte S

2017-10-24

Research indicates that older adults receive only about half of their recommended care, with varying quality and limited attention to social issues impacting their health through the most commonly used quality measures. Additionally, many existing measures neglect to address nonclinical social determinants of health. Evidence of the need for more comprehensive measures for seniors is growing. The primary purpose of this article, which is supported by a limited review of literature, is to describe gaps among current quality measures in addressing certain nonclinical needs of older adults, including key social determinants of health. In doing so, the authors describe their position on the need for expanded measures to incorporate these factors to improve care and quality of life. The authors conducted a limited review of the literature to inform this article, focusing specifically on selected measures for older adults rather than a broader systematic review of all measures. Most research identified was related to clinical practice guidelines rather than quality measures of care as applied to older adults. Furthermore, the literature reviewed reflected limited evidence of efforts to tailor quality measures for the unique social needs of older adults, confirming a potential gap in this area. A growing need exists for improved quality measures specifically designed to help providers address the unique social needs of older adults. Filling this gap will improve overall understanding of seniors and help them to achieve optimal health and successful aging.

Modeling mania in preclinical settings: a comprehensive review

PubMed Central

Sharma, Ajaykumar N.; Fries, Gabriel R.; Galvez, Juan F.; Valvassori, Samira S.; Soares, Jair C.; Carvalho, André F.; Quevedo, Joao

2015-01-01

The current pathophysiological understanding of mechanisms leading to onset and progression of bipolar manic episodes remains limited. At the same time, available animal models for mania have limited face, construct, and predictive validities. Additionally, these models fail to encompass recent pathophysiological frameworks of bipolar disorder (BD), e.g. neuroprogression. Therefore, there is a need to search for novel preclinical models for mania that could comprehensively address these limitations. Herein we review the history, validity, and caveats of currently available animal models for mania. We also review new genetic models for mania, namely knockout mice for genes involved in neurotransmission, synapse formation, and intracellular signaling pathways. Furthermore, we review recent trends in preclinical models for mania that may aid in the comprehension of mechanisms underlying the neuroprogressive and recurring nature of BD. In conclusion, the validity of animal models for mania remains limited. Nevertheless, novel (e.g. genetic) animal models as well as adaptation of existing paradigms hold promise. PMID:26545487

Family and medical leave act: unresolved issues.

PubMed

Pyle, Jean L; Pelletier, Marianne S

2003-01-01

The United States' Family and Medical Leave Act (FMLA) of 1993 was an effort to provide national support for families attempting to balance the demands of the workplace and the need to care for a new child, one's own health, or an ill child, spouse, or parent. It is seriously limited, however, in terms of its accessibility for many workers. We briefly compare the FMLA to the substantially broader policies of Western European countries. We highlight its reported benefits to workers but document disparities in employees' use of the FMLA by gender, race, and income level. We evaluate whether employers' fears of higher costs were justified. We point out current challenges that may limit the FMLA further. We close by examining the range of alternative policies in effect at the state level and proposals that would address the current limitations of the FMLA and broaden its coverage.

Binary optics: Trends and limitations

NASA Technical Reports Server (NTRS)

Farn, Michael W.; Veldkamp, Wilfrid B.

1993-01-01

We describe the current state of binary optics, addressing both the technology and the industry (i.e., marketplace). With respect to the technology, the two dominant aspects are optical design methods and fabrication capabilities, with the optical design problem being limited by human innovation in the search for new applications and the fabrication issue being limited by the availability of resources required to improve fabrication capabilities. With respect to the industry, the current marketplace does not favor binary optics as a separate product line and so we expect that companies whose primary purpose is the production of binary optics will not represent the bulk of binary optics production. Rather, binary optics' more natural role is as an enabling technology - a technology which will directly result in a competitive advantage in a company's other business areas - and so we expect that the majority of binary optics will be produced for internal use.

List based prefetch

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

Boyle, Peter; Christ, Norman; Gara, Alan

A list prefetch engine improves a performance of a parallel computing system. The list prefetch engine receives a current cache miss address. The list prefetch engine evaluates whether the current cache miss address is valid. If the current cache miss address is valid, the list prefetch engine compares the current cache miss address and a list address. A list address represents an address in a list. A list describes an arbitrary sequence of prior cache miss addresses. The prefetch engine prefetches data according to the list, if there is a match between the current cache miss address and the listmore » address.« less

List based prefetch

DOEpatents

Boyle, Peter [Edinburgh, GB; Christ, Norman [Irvington, NY; Gara, Alan [Yorktown Heights, NY; Kim,; Changhoan, [San Jose, CA; Mawhinney, Robert [New York, NY; Ohmacht, Martin [Yorktown Heights, NY; Sugavanam, Krishnan [Yorktown Heights, NY

2012-08-28

A list prefetch engine improves a performance of a parallel computing system. The list prefetch engine receives a current cache miss address. The list prefetch engine evaluates whether the current cache miss address is valid. If the current cache miss address is valid, the list prefetch engine compares the current cache miss address and a list address. A list address represents an address in a list. A list describes an arbitrary sequence of prior cache miss addresses. The prefetch engine prefetches data according to the list, if there is a match between the current cache miss address and the list address.

Noninvasive Brain Stimulation in Pediatric Attention-Deficit Hyperactivity Disorder (ADHD): A Review.

PubMed

Rubio, Belen; Boes, Aaron D; Laganiere, Simon; Rotenberg, Alexander; Jeurissen, Danique; Pascual-Leone, Alvaro

2016-05-01

Attention-deficit hyperactivity disorder (ADHD) is one of the most prevalent neurodevelopmental disorders in the pediatric population. The clinical management of ADHD is currently limited by a lack of reliable diagnostic biomarkers and inadequate therapy for a minority of patients who do not respond to standard pharmacotherapy. There is optimism that noninvasive brain stimulation may help to address these limitations. Transcranial magnetic stimulation and transcranial direct current stimulation are 2 methods of noninvasive brain stimulation that modulate cortical excitability and brain network activity. Transcranial magnetic stimulation can be used diagnostically to probe cortical neurophysiology, whereas daily use of repetitive transcranial magnetic stimulation or transcranial direct current stimulation can induce long-lasting and potentially therapeutic changes in targeted networks. In this review, we highlight research showing the potential diagnostic and therapeutic applications of transcranial magnetic stimulation and transcranial direct current stimulation in pediatric ADHD. We also discuss the safety and ethics of using these tools in the pediatric population. © The Author(s) 2015.

A paradigm shift on beta-thalassaemia treatment: How will we manage this old disease with new therapies?

PubMed

Cappellini, Maria Domenica; Porter, John B; Viprakasit, Vip; Taher, Ali T

2018-07-01

Beta-thalassaemia causes defective haemoglobin synthesis leading to ineffective erythropoiesis, chronic haemolytic anaemia, and subsequent clinical complications. Blood transfusion and iron chelation allow long-term disease control, and haematopoietic stem cell transplantation offers a potential cure for some patients. Nonetheless, there are still many challenges in the management of beta-thalassaemia. The main treatment option for most patients is supportive care; furthermore, the long-term efficacy and safety of current therapeutic strategies are limited and adherence is suboptimal. An increasing understanding of the underlying molecular and cellular disease mechanisms plus an awareness of limitations of current management strategies are driving research into novel therapeutic options. Here we provide an overview of the current pathophysiology, clinical manifestations, and global burden of beta-thalassaemia. We reflect on what has been achieved to date, describe the challenges associated with currently available therapy, and discuss how these issues might be addressed by novel therapeutic approaches in development. Copyright © 2018 The Authors. Published by Elsevier Ltd.. All rights reserved.

Current Status and Research into Overcoming Limitations of Capsule Endoscopy

PubMed Central

Kwack, Won Gun; Lim, Yun Jeong

2016-01-01

Endoscopic investigation has a critical role in the diagnosis and treatment of gastrointestinal (GI) diseases. Since 2001, capsule endoscopy (CE) has been available for small-bowel exploration and is under continuous development. During the past decade, CE has achieved impressive improvements in areas such as miniaturization, resolution, and battery life. As a result, CE is currently a first-line tool for the investigation of the small bowel in obscure gastrointestinal bleeding and is a useful alternative to wired enteroscopy. Nevertheless, CE still has several limitations, such as incomplete examination and limited diagnostic and therapeutic capabilities. To resolve these problems, many groups have suggested several models (e.g., controlled CO2 insufflation system, magnetic navigation system, mobile robotic platform, tagging and biopsy equipment, and targeted drug-delivery system), which are in development. In the near future, new technological advances will improve the capabilities of CE and broaden its spectrum of applications not only for the small bowel but also for the colon, stomach, and esophagus. The purpose of this review is to introduce the current status of CE and to review the ongoing development of solutions to address its limitations. PMID:26855917

Modeling approaches for characterizing and evaluating environmental exposure to engineered nanomaterials in support of risk-based decision making.

PubMed

Hendren, Christine Ogilvie; Lowry, Michael; Grieger, Khara D; Money, Eric S; Johnston, John M; Wiesner, Mark R; Beaulieu, Stephen M

2013-02-05

As the use of engineered nanomaterials becomes more prevalent, the likelihood of unintended exposure to these materials also increases. Given the current scarcity of experimental data regarding fate, transport, and bioavailability, determining potential environmental exposure to these materials requires an in depth analysis of modeling techniques that can be used in both the near- and long-term. Here, we provide a critical review of traditional and emerging exposure modeling approaches to highlight the challenges that scientists and decision-makers face when developing environmental exposure and risk assessments for nanomaterials. We find that accounting for nanospecific properties, overcoming data gaps, realizing model limitations, and handling uncertainty are key to developing informative and reliable environmental exposure and risk assessments for engineered nanomaterials. We find methods suited to recognizing and addressing significant uncertainty to be most appropriate for near-term environmental exposure modeling, given the current state of information and the current insufficiency of established deterministic models to address environmental exposure to engineered nanomaterials.

Spheromak Formation and Current Sustainment Using a Repetitively Pulsed Source

NASA Astrophysics Data System (ADS)

Woodruff, S.; Macnab, A. I. D.; Ziemba, T. M.; Miller, K. E.

2009-06-01

By repeated injection of magnetic helicity ( K = 2φψ) on time-scales short compared with the dissipation time (τinj << τ K ), it is possible to produce toroidal currents relevant to POP-level experiments. Here we discuss an effective injection rate, due to the expansion of a series of current sheets and their subsequent reconnection to form spheromaks and compression into a copper flux-conserving chamber. The benefits of repeated injection are that the usual limits to current amplification can be exceeded, and an efficient quasi-steady sustainment scenario is possible (within minimum impact on confinement). A new experiment designed to address the physics of pulsed formation and sustainment is described.

Dilemmas in Lung Cancer Staging.

PubMed

Vlahos, Ioannis

2018-05-01

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

The effect of incomplete fuel-air mixing on the lean blowout limit, lean stability limit and NO(x) emissions in lean premixed gas turbine combustors

NASA Technical Reports Server (NTRS)

Shih, W.-P.; Lee, J. G.; Santavicca, D. A.

1994-01-01

Gas turbine engines for both land-based and aircraft propulsion applications are facing regulations on NOx emissions which cannot be met with current combustor technology. A number of alternative combustor strategies are being investigated which have the potential capability of achieving ultra-low NOx emissions, including lean premixed combustors, direct injection combustors, rich burn-quick quench-lean burn combustors and catalytic combustors. The research reported in this paper addresses the effect of incomplete fuel-air mixing on the lean limit performance and the NOx emissions characteristics of lean premixed combustors.

NASA/Goddard Thermal Technology Overview 2014

NASA Technical Reports Server (NTRS)

Butler, Daniel; Swanson, Theodore D.

2014-01-01

This presentation summarizes the current plans and efforts at NASA Goddard to develop new thermal control technology for anticipated future missions. It will also address some of the programmatic developments currently underway at NASA, especially with respect to the Technology Development Program at NASA. While funding for basic technology development is still scarce, significant efforts are being made in direct support of flight programs. New technology development continues to be driven by the needs of future missions, and applications of these technologies to current Goddard programs will be addressed. Many of these technologies also have broad applicability to DOD, DOE, and commercial programs. Partnerships have been developed with the Air Force, Navy, and various universities to promote technology development. In addition, technology development activities supported by internal research and development (IRAD) program, the Small Business Innovative Research (SBIR) program, and the NASA Engineering and Safety Center (NESC), are reviewed in this presentation. Specific technologies addressed include; two-phase systems applications and issues on NASA missions, latest developments of electro-hydrodynamically pumped systems, development of high electrical conductivity coatings, and various other research activities. New Technology program underway at NASA, although funding is limited center dot NASA/GSFC's primary mission of science satellite development is healthy and vibrant, although new missions are scarce - now have people on overhead working new missions and proposals center dot Future mission applications promise to be thermally challenging center dot Direct technology funding is still very restricted - Projects are the best source for direct application of technology - SBIR thermal subtopic resurrected in FY 14 - Limited Technology development underway via IRAD, NESC, other sources - Administrator pushing to revive technology and educational programs at NASA - new HQ directorate established

Optimization of electrode characteristics for the Br₂/H₂ redox flow cell

DOE PAGES

Tucker, Michael C.; Cho, Kyu Taek; Weber, Adam Z.; ...

2014-10-17

The Br₂/H₂ redox flow cell shows promise as a high-power, low-cost energy storage device. The effect of various aspects of material selection, processing, and assembly of electrodes on the operation, performance, and efficiency of the system is determined. In particular, (+) electrode thickness, cell compression, hydrogen pressure, and (–) electrode architecture are investigated. Increasing hydrogen pressure and depositing the (–) catalyst layer on the membrane instead of on the carbon-paper backing layers have a large positive impact on performance, enabling a limiting current density above 2 A cm -2 and a peak power density of 1.4 W cm -2. Maximummore » energy efficiency of 79% is achieved. In addition, the root cause of limiting-current behavior in this system is elucidated, where it is found that Br - reversibly adsorbs at the Pt (–) electrode for potentials exceeding a critical value, and the extent of Br - coverage is potential-dependent. This phenomenon limits maximum cell current density and must be addressed in system modeling and design. These findings are expected to lower system cost and enable higher efficiency.« less

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

Heeter, J.; Bird, L.; Gelman, R.

Several states are addressing the issue of net metering program caps, which limit the total amount of net metered generating capacity that can be installed in a state or utility service territory. In this analysis, we examine net metering caps to gain perspective on how long net metering will be available in various jurisdictions under current policies. We also surveyed state practices and experience to understand important policy design considerations.

Negative Affect and HIV Risk in Alcohol and Other Drug (AOD) Abusing Adolescent Offenders

ERIC Educational Resources Information Center

Lucenko, Barbara A.; Malow, Robert M.; Sanchez-Martinez, Mario; Jennings, Terri; Devieux, Jessy G.

2003-01-01

Various depressive symptoms have been linked to elevated levels of HIV risk across diverse adult populations in multiple studies. However, this link has been examined in a much more limited manner among adolescents, despite an exceedingly heightened risk of both HIV and negative affect in this age group. To address the current lack of clinically…

Examining Off-Campus Students' Sense of Belonging and Behaviors in a Town-Gown Context

ERIC Educational Resources Information Center

Carter, Erin Hundley

2017-01-01

The current study emerged from the need to address student behavior issues in town-gown communities and the practical need to know more about off-campus students as central actors in these behaviors. Off-campus students have long been labeled as commuter students because of limited recognition of the known diversity within the commuter population…

77 FR 40843 - Federal Motor Vehicle Safety Standard No. 108; Lamp, Reflective Devices, and Associated Equipment

Federal Register 2010, 2011, 2012, 2013, 2014

2012-07-11

... limiting the impacts of glare. Our current standard primarily treats a headlamp as a separate piece of...) at any time by going to http://www.regulations.gov . Follow the online instructions for accessing the dockets. You may also read the materials at the Docket Management Facility by going to the street address...

Mapping the Margins and Searching for Higher Ground: Examining the Marginalisation of Black Female Graduate Students at PWIs

ERIC Educational Resources Information Center

Green, Dari; Pulley, Tifanie; Jackson, Melinda; Martin, Lori Latrice; Fasching-Varner, Kenneth J.

2018-01-01

The number of Black females enrolled in colleges and universities has grown in recent years, particularly at predominately white institutions (PWIs). Currently, research on the rise of Black females at PWIs is limited and fails to adequately address the emotional, social, and mental well-being of these students. Recent studies also largely ignore…

Commercial sexual exploitation and sex trafficking of adolescents.

PubMed

Chung, Richard J; English, Abigail

2015-08-01

This review describes the current state of commercial sexual exploitation and sex trafficking of adolescents in the United States and globally, the legal and health implications of this severe form of abuse, and the roles that pediatric and adolescent healthcare providers can play in addressing this issue. Although this form of exploitation and abuse is shrouded in secrecy, pediatric and adolescent healthcare providers are well positioned to respond when it arises. However, awareness and understanding of the issue are generally lacking among healthcare professionals, currently limiting their effectiveness in combating this problem. Although the empirical evidence base available to guide clinical care of victims of trafficking remains limited given the secretive nature of the abuse, important contributions to the multidisciplinary literature on this issue have been made in recent years, including the Institute of Medicine's landmark report in the United States. Commercial sexual exploitation and sex trafficking of adolescents represent a human rights tragedy that remains inadequately addressed. As preeminent advocates for the health and well-being of adolescents, pediatric and adolescent healthcare providers can play a crucial role in advancing efforts not only to intervene but also to prevent further victimization of vulnerable youth.

KINETIC-J: A computational kernel for solving the linearized Vlasov equation applied to calculations of the kinetic, configuration space plasma current for time harmonic wave electric fields

NASA Astrophysics Data System (ADS)

Green, David L.; Berry, Lee A.; Simpson, Adam B.; Younkin, Timothy R.

2018-04-01

We present the KINETIC-J code, a computational kernel for evaluating the linearized Vlasov equation with application to calculating the kinetic plasma response (current) to an applied time harmonic wave electric field. This code addresses the need for a configuration space evaluation of the plasma current to enable kinetic full-wave solvers for waves in hot plasmas to move beyond the limitations of the traditional Fourier spectral methods. We benchmark the kernel via comparison with the standard k →-space forms of the hot plasma conductivity tensor.

Equatorial oceanography. [review of research

NASA Technical Reports Server (NTRS)

Cane, M. A.; Sarachik, E. S.

1983-01-01

United States progress in equatorial oceanography is reviewed, focusing on the low frequency response of upper equatorial oceans to forcing by the wind. Variations of thermocline depth, midocean currents, and boundary currents are discussed. The factors which determine sea surface temperature (SST) variability in equatorial oceans are reviewed, and the status of understanding of the most spectacular manifestation of SST variability, the El Nino-Southern Oscillation phenomenon, is discussed. The problem of observing surface winds, regarded as a fundamental factor limiting understanding of the equatorial oceans, is addressed. Finally, an attempt is made to identify those current trends which are expected to bear fruit in the near and distant future.

The Role of Food Banks in Addressing Food Insecurity: A Systematic Review.

PubMed

Bazerghi, Chantelle; McKay, Fiona H; Dunn, Matthew

2016-08-01

Food banks play a major role in the food aid sector by distributing donated and purchased groceries directly to food insecure families. The public health implications of food insecurity are significant, particularly as food insecurity has a higher prevalence among certain population groups. This review consolidates current knowledge about the function and efficacy of food banks to address food insecurity. A systematic review was conducted. Thirty-five publications were reviewed, of which 14 examined food security status, 13 analysed nutritional quality of food provided, and 24 considered clients' needs in relation to food bank use. This review found that while food banks have an important role to play in providing immediate solutions to severe food deprivation, they are limited in their capacity to improve overall food security outcomes due to the limited provision of nutrient-dense foods in insufficient amounts, especially from dairy, vegetables and fruits. Food banks have the potential to improve food security outcomes when operational resources are adequate, provisions of perishable food groups are available, and client needs are identified and addressed.

A potentiostat featuring an integrator transimpedance amplifier for the measurement of very low currents--Proof-of-principle application in microfluidic separations and voltammetry.

PubMed

Koutilellis, G D; Economou, A; Efstathiou, C E

2016-03-01

This work reports the design and construction of a novel potentiostat which features an integrator transimpedance amplifier as a current-monitoring unit. The integration approach addresses the limitations of the feedback resistor approach used for current monitoring in conventional potentiostat designs. In the present design, measurement of the current is performed by a precision switched integrator transimpedance amplifier operated in the dual sampling mode which enables sub-pA resolution. The potentiostat is suitable for measuring very low currents (typical dynamic range: 5 pA-4.7 μA) with a 16 bit resolution, and it can support 2-, 3- and 4-electrode cell configurations. Its operation was assessed by using it as a detection module in a home-made capillary electrophoresis system for the separation and amperometric detection of paracetamol and p-aminophenol at a 3-electrode microfluidic chip. The potential and limitations of the proposed potentiostat to implement fast potential-scan voltammetric techniques were demonstrated for the case of cyclic voltammetry.

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

Mendez Cruz, Carmen Margarita; Rochau, Gary E.; Middleton, Bobby

Sandia National Laboratories and General Atomics are pleased to respond to the Advanced Research Projects Agency-Energy (ARPA-e)’s request for information on innovative developments that may overcome various current reactor-technology limitations. The RFI is particularly interested in innovations that enable ultra-safe and secure modular nuclear energy systems. Our response addresses the specific features for reactor designs called out in the RFI, including a brief assessment of the current state of the technologies that would enable each feature and the methods by which they could be best incorporated into a reactor design.

From office tools to community supports: The need for infrastructure to address the social determinants of health in paediatric practice.

PubMed

Fazalullasha, Fatima; Taras, Jillian; Morinis, Julia; Levin, Leo; Karmali, Karima; Neilson, Barbara; Muskat, Barbara; Bloch, Gary; Chan, Kevin; McDonald, Maureen; Makin, Sue; Ford-Jones, E Lee

2014-04-01

Previous research has highlighted the importance of addressing the social determinants of health to improve child health outcomes. However, significant barriers exist that limit the paediatrician's ability to properly address these issues. Barriers include a lack of clinical time, resources, training and education with regard to the social determinants of health; awareness of community resources; and case-management capacity. General practice recommendations to help the health care provider link patients to the community are insufficient. The objective of the current article was to present options for improving the link between the office and the community, using screening questions incorporating physician-based tools that link community resources. Simple interventions, such as routine referral to early-year centres and selected referral to public health home-visiting programs, may help to address populations with the greatest needs.

From office tools to community supports: The need for infrastructure to address the social determinants of health in paediatric practice

PubMed Central

Fazalullasha, Fatima; Taras, Jillian; Morinis, Julia; Levin, Leo; Karmali, Karima; Neilson, Barbara; Muskat, Barbara; Bloch, Gary; Chan, Kevin; McDonald, Maureen; Makin, Sue; Ford-Jones, E Lee

2014-01-01

Previous research has highlighted the importance of addressing the social determinants of health to improve child health outcomes. However, significant barriers exist that limit the paediatrician’s ability to properly address these issues. Barriers include a lack of clinical time, resources, training and education with regard to the social determinants of health; awareness of community resources; and case-management capacity. General practice recommendations to help the health care provider link patients to the community are insufficient. The objective of the current article was to present options for improving the link between the office and the community, using screening questions incorporating physician-based tools that link community resources. Simple interventions, such as routine referral to early-year centres and selected referral to public health home-visiting programs, may help to address populations with the greatest needs. PMID:24855416

The management of patients with limited-stage classical Hodgkin lymphoma.

PubMed

Gospodarowicz, Mary K; Meyer, Ralph M

2006-01-01

The term limited-stage Hodgkin lymphoma refers to those patients with stage I-II disease and an absence of bulky disease. Among those patients with classical Hodgkin lymphoma, approximately one-third of patients will fall into this category. As long-term disease control can now be anticipated in more than 90% of these patients, management strategies must increasingly address the need to reduce the long-term treatment-related risks. Current treatment options include use of combined modality therapy that includes an abbreviated course of chemotherapy and involved-field radiation or treatment with chemotherapy, currently consisting of ABVD, as a single modality. The choice of treatment between these two options involves specific trade-offs that must balance issues of disease control against long-term risk of late effects.

A Single-Vector Force Calibration Method Featuring the Modern Design of Experiments

NASA Technical Reports Server (NTRS)

Parker, P. A.; Morton, M.; Draper, N.; Line, W.

2001-01-01

This paper proposes a new concept in force balance calibration. An overview of the state-of-the-art in force balance calibration is provided with emphasis on both the load application system and the experimental design philosophy. Limitations of current systems are detailed in the areas of data quality and productivity. A unique calibration loading system integrated with formal experimental design techniques has been developed and designated as the Single-Vector Balance Calibration System (SVS). This new concept addresses the limitations of current systems. The development of a quadratic and cubic calibration design is presented. Results from experimental testing are compared and contrasted with conventional calibration systems. Analyses of data are provided that demonstrate the feasibility of this concept and provide new insights into balance calibration.

An Integrated Assessment Approach to Address Artisanal and Small-Scale Gold Mining in Ghana.

PubMed

Basu, Niladri; Renne, Elisha P; Long, Rachel N

2015-09-17

Artisanal and small-scale gold mining (ASGM) is growing in many regions of the world including Ghana. The problems in these communities are complex and multi-faceted. To help increase understanding of such problems, and to enable consensus-building and effective translation of scientific findings to stakeholders, help inform policies, and ultimately improve decision making, we utilized an Integrated Assessment approach to study artisanal and small-scale gold mining activities in Ghana. Though Integrated Assessments have been used in the fields of environmental science and sustainable development, their use in addressing specific matter in public health, and in particular, environmental and occupational health is quite limited despite their many benefits. The aim of the current paper was to describe specific activities undertaken and how they were organized, and the outputs and outcomes of our activity. In brief, three disciplinary workgroups (Natural Sciences, Human Health, Social Sciences and Economics) were formed, with 26 researchers from a range of Ghanaian institutions plus international experts. The workgroups conducted activities in order to address the following question: What are the causes, consequences and correctives of small-scale gold mining in Ghana? More specifically: What alternatives are available in resource-limited settings in Ghana that allow for gold-mining to occur in a manner that maintains ecological health and human health without hindering near- and long-term economic prosperity? Several response options were identified and evaluated, and are currently being disseminated to various stakeholders within Ghana and internationally.

Alternatives to current HIV/AIDS policies and practices in South African prisons.

PubMed

Goyer, K C; Gow, Jeff

2002-01-01

Prisoners in South Africa face problems of overcrowding, violence and poor nutrition. Added to this burden in recent times is the increased threat from HIV. The HIV epidemic has been relatively late in coming to South Africa but infection rates are now 20% in the adult population. However, there is no data available on the level of HIV infection in the prison population. Overseas studies suggest that the characteristics of prisoners place them at much greater risk of HIV infection. Factors which contribute to increased levels of HIV infection include poor health care facilities, lack of condoms and lack of disinfectants. Current policies and practices on HIV in prison attempt to balance the constraints of limited resources with the need to preserve prisoner human rights. The outcomes include: mass testing not freely available, HIV education is limited, and early release of prisoners with advanced AIDS is not allowed. Constraints on the implementation of effective HIV prevention strategies include: bureaucratic inefficiency, lack of resources, and a reluctance by prison authorities to address the issue of HIV in prison. These problems can possibly be overcome by addressing the issue from both management and prisoner perspectives. On the management side, increased resources, increased training of prison officials, and increased political commitment to address the issue are required. Outside partnerships are probably required for an effective response. Prisoners require better nutrition, better living conditions, better health care, freely available condoms and disinfectants.

An Integrated Assessment Approach to Address Artisanal and Small-Scale Gold Mining in Ghana

PubMed Central

Basu, Niladri; Renne, Elisha P.; Long, Rachel N.

2015-01-01

Artisanal and small-scale gold mining (ASGM) is growing in many regions of the world including Ghana. The problems in these communities are complex and multi-faceted. To help increase understanding of such problems, and to enable consensus-building and effective translation of scientific findings to stakeholders, help inform policies, and ultimately improve decision making, we utilized an Integrated Assessment approach to study artisanal and small-scale gold mining activities in Ghana. Though Integrated Assessments have been used in the fields of environmental science and sustainable development, their use in addressing specific matter in public health, and in particular, environmental and occupational health is quite limited despite their many benefits. The aim of the current paper was to describe specific activities undertaken and how they were organized, and the outputs and outcomes of our activity. In brief, three disciplinary workgroups (Natural Sciences, Human Health, Social Sciences and Economics) were formed, with 26 researchers from a range of Ghanaian institutions plus international experts. The workgroups conducted activities in order to address the following question: What are the causes, consequences and correctives of small-scale gold mining in Ghana? More specifically: What alternatives are available in resource-limited settings in Ghana that allow for gold-mining to occur in a manner that maintains ecological health and human health without hindering near- and long-term economic prosperity? Several response options were identified and evaluated, and are currently being disseminated to various stakeholders within Ghana and internationally. PMID:26393627

Staying Connected: Sustaining Collaborative Care Models with Limited Funding.

PubMed

Johnston, Brenda J; Peppard, Lora; Newton, Marian

2015-08-01

Providing psychiatric services in the primary care setting is challenging. The multidisciplinary, coordinated approach of collaborative care models (CCMs) addresses these challenges. The purpose of the current article is to discuss the implementation of a CCM at a free medical clinic (FMC) where volunteer staff provide the majority of services. Essential components of CCMs include (a) comprehensive screening and assessment, (b) shared development and communication of care plans among providers and the patient, and (c) care coordination and management. Challenges to implementing and sustaining a CCM at a FMC in Virginia attempting to meet the medical and psychiatric needs of the underserved are addressed. Although the CCM produced favorable outcomes, sustaining the model long-term presented many challenges. Strategies for addressing these challenges are discussed. Copyright 2015, SLACK Incorporated.

Update on cellular encapsulation.

PubMed

Smith, Kate E; Johnson, Robert C; Papas, Klearchos K

2018-05-06

There is currently a significant disparity between the number of patients who need lifesaving transplants and the number of donated human organs. Xenotransplantation is a way to address this disparity and attempts to enable the use of xenogeneic tissues have persisted for centuries. While immunologic incompatibilities have presented a persistent impediment to their use, encapsulation may represent a way forward for the use of cell-based xenogeneic therapeutics without the need for immunosuppression. In conjunction with modern innovations such as the use of bioprinting, incorporation of immune modulating molecules into capsule membranes, and genetic engineering, the application of xenogeneic cells to treat disorders ranging from pain to liver failure is becoming increasingly realistic. The present review discusses encapsulation in the context of xenotransplantation, focusing on the current status of clinical trials, persistent issues such as antigen shedding, oxygen availability, and donor selection, and recent developments that may address these limitations. © 2018 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Environmental Radiation Effects: A Need to Question Old Paradigms

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

Hinton, T.G.; Bedford, J.; Ulsh, B.

2003-03-27

A historical perspective is given of the current paradigm that does not explicitly protect the environment from radiation, but instead, relies on the concept that if dose limits are set to protect humans then the environment is automatically protected as well. We summarize recent international questioning of this paradigm and briefly present three different frameworks for protecting biota that are being considered by the U.S. DOE, the Canadian government and the International Commission on Radiological Protection. We emphasize that an enhanced collaboration is required between what has traditionally been separated disciplines of radiation biology and radiation ecology if we aremore » going to properly address the current environmental radiation problems. We then summarize results generated from an EMSP grant that allowed us to develop a Low Dose Irradiation Facility that specifically addresses effects of low-level, chronic irradiation on multiple levels of biological organization.« less

Burns education: The emerging role of simulation for training healthcare professionals.

PubMed

Sadideen, Hazim; Goutos, Ioannis; Kneebone, Roger

2017-02-01

Burns education appears to be under-represented in UK undergraduate curricula. However current postgraduate courses in burns education provide formal training in resuscitation and management. Simulation has proven to be a powerful modality to advance surgical training in both technical and non-technical skills. We present a literature review that summarises the format of current burns education, and provides detailed insight into historic, current and novel advances in burns simulation for both technical and non-technical skills, that can be used to augment surgical training. Addressing the economic and practical limitations of current immersive surgical simulation is important, and this review proposes future directions for integration of innovative simulation strategies into training curricula. Copyright © 2016 Elsevier Ltd and ISBI. All rights reserved.

Suicide and Suicide Risk in Lesbian, Gay, Bisexual, and Transgender Populations: Review and Recommendations

PubMed Central

Haas, Ann P.; Eliason, Mickey; Mays, Vickie M.; Mathy, Robin M.; Cochran, Susan D.; D'Augelli, Anthony R.; Silverman, Morton M.; Fisher, Prudence W.; Hughes, Tonda; Rosario, Margaret; Russell, Stephen T.; Malley, Effie; Reed, Jerry; Litts, David A.; Haller, Ellen; Sell, Randall L.; Remafedi, Gary; Bradford, Judith; Beautrais, Annette L.; Brown, Gregory K.; Diamond, Gary M.; Friedman, Mark S.; Garofalo, Robert; Turner, Mason S.; Hollibaugh, Amber; Clayton, Paula J.

2011-01-01

Despite strong indications of elevated risk of suicidal behavior in lesbian, gay, bisexual, and transgender people, limited attention has been given to research, interventions or suicide prevention programs targeting these populations. This article is a culmination of a three-year effort by an expert panel to address the need for better understanding of suicidal behavior and suicide risk in sexual minority populations, and stimulate the development of needed prevention strategies, interventions and policy changes. This article summarizes existing research findings, and makes recommendations for addressing knowledge gaps and applying current knowledge to relevant areas of suicide prevention practice. PMID:21213174

Probabilistic Approaches to Examining Linguistic Features of Test Items and Their Effect on the Performance of English Language Learners

ERIC Educational Resources Information Center

Solano-Flores, Guillermo

2014-01-01

This article addresses validity and fairness in the testing of English language learners (ELLs)--students in the United States who are developing English as a second language. It discusses limitations of current approaches to examining the linguistic features of items and their effect on the performance of ELL students. The article submits that…

Remote sensing of spring phenology in northeastern forests: A comparison of methods, field metrics and sources of uncertainty

Treesearch

Katharine White; Jennifer Pontius; Paul Schaberg

2014-01-01

Current remote sensing studies of phenology have been limited to coarse spatial or temporal resolution and often lack a direct link to field measurements. To address this gap, we compared remote sensing methodologies using Landsat Thematic Mapper (TM) imagery to extensive field measurements in a mixed northern hardwood forest. Five vegetation indices, five mathematical...

Comments on "The necessary and sufficient conditions of therapeutic personality change.".

PubMed

Silberschatz, George

2007-09-01

This commentary describes the impact of Carl Rogers' classic article (see record 2007-14630-002) on the field of psychotherapy in general and on control-mastery theory and research in particular. The relevance of Rogers' model in the current psychotherapy literature and debates is addressed as are some of the limitations of the model. (PsycINFO Database Record (c) 2010 APA, all rights reserved).

Nutrient Limitation of Microbial Mediated Decomposition and Arctic Soil Chronology

NASA Astrophysics Data System (ADS)

Melle, C. J.; Darrouzet-Nardi, A.; Wallenstein, M. D.

2012-12-01

Soils of northern permafrost regions currently contain twice as much carbon as the entire Earth's atmosphere. Traditionally, environmental constraints have limited microbial activity resulting in restricted decomposition of soil organic matter in these systems and accumulation of massive amounts of soil organic carbon (SOC), however climate change is reducing the constraints of decomposition in arctic permafrost regions. Carbon cycling in nutrient poor, arctic ecosystems is tightly coupled to other biogeochemical cycles. Several studies have suggested strong nitrogen limitations of primary productivity and potentially warm-season microbial activity in these nutrient deficient soils. Nitrogen is required for microbial extracellular enzyme production which drives the decomposition of soil organic matter (SOM). Nitrogen limited arctic soils may also experience limitation via labile carbon availability despite the SOM rich environment due to low extracellular enzyme production. Few studies have directly addressed nutrient induced microbial limitation in SOC rich arctic tundra soils, and even less is known about the potential for nutrient co-limitation. Additionally, through the process of becoming deglaciated, sites within close proximity to one another may have experienced drastic differences in their effective soil ages due to the varied length of their active histories. Many soil properties and nutrient deficiencies are directly related to soil age, however this chronology has not previously been a focus of research on nutrient limitation of arctic soil microbial activity. Understanding of nutrient limitations, as well as potential co-limitation, on arctic soil microbial activity has important implications for carbon cycling and the ultimate fate of the current arctic SOC reservoir. Analyses of nutrient limitation on soils of a single site are not adequate for fully understanding the controls on soil microbial activity across a vast land mass with large variation in effective soil age. My research is focused on addressing the questions of the extent of microbial N limitation in arctic tundra soils, the potential for co-limitation of labile C despite a high SOC environment, and the dependence, if any, nutrient limitation may have on the effective age of the soil. I have addressed these questions by conducting a laboratory soil incubation of factorial design with treatments of amended glucose, amended ammonium nitrate, and a control consisting of an addition of an equivalent volume of deionized water. Moist acid tundra soils possessing similar soil properties from two arctic sites of close proximity yet with varying deglaciation chronologies were utilized in my study. Soil properties of C-mineralization via respiration, microbial biomass, and nitrogen content in the forms of ammonium, nitrate, and total free amino acids and microbial extra-cellular enzyme production were assayed to determine the microbial response to the experimental treatments. Through the results of this work, I hope to better our understanding of biogeochemical cycling within arctic tundra ecosystems and the response to climate change by contributing to existing knowledge of nutrient limitation on microbial mediated decomposition of SOC in the arctic and how this may differ in soils of varying effective age.

'Muscle-sparing' statins: preclinical profiles and future clinical use.

PubMed

Pfefferkorn, Jeffrey A

2009-03-01

Coronary heart disease (CHD) is a leading cause of death in the US, and hypercholesterolemia is a key risk factor for this disease. The current standard of care for treating hypercholesterolemia is the use of HMG-CoA reductase inhibitors, also known as statins, which block the rate-limiting step of cholesterol biosynthesis. In widespread clinical use, statins have proven safe and effective for both primary prevention of CHD and secondary prevention of coronary events. Results from several recent clinical trials have demonstrated that increasingly aggressive cholesterol-lowering therapy might offer additional protection against CHD compared with less aggressive treatment standards. While higher doses of current statin therapies are capable of achieving these more aggressive treatment goals, in certain cases statin-induced myalgia, the muscle pain or weakness that sometimes accompanies high-dose statin therapy, limits patient compliance with a treatment regimen. To address this limitation, efforts have been undertaken to develop highly hepatoselective statins that are capable of delivering best-in-class efficacy with minimized risk of dose-limiting myalgia. In this review, the preclinical and early clinical data for these next generation statins are discussed.

Access to inpatient dermatology care in Pennsylvania hospitals.

PubMed

Messenger, Elizabeth; Kovarik, Carrie L; Lipoff, Jules B

2016-01-01

Access to care is a known issue in dermatology, and many patients may experience long waiting periods to see a physician. In this study, an anonymous online survey was sent to all 274 Pennsylvania hospitals licensed by the US Department of Health in order to evaluate current levels of access to inpatient dermatology services. Although the response rate to this survey was limited, the data suggest that access to inpatient dermatology services is limited and may be problematic in hospitals across the United States. Innovation efforts and further studies are needed to address this gap in access to care.

The American Science Pipeline: Sustaining Innovation in a Time of Economic Crisis

PubMed Central

Hue, Gillian; Sales, Jessica; Comeau, Dawn; Lynn, David G.

2010-01-01

Significant limitations have emerged in America's science training pipeline, including inaccessibility, inflexibility, financial limitations, and lack of diversity. We present three effective programs that collectively address these challenges. The programs are grounded in rigorous science and integrate through diverse disciplines across undergraduate, graduate, and postdoctoral students, and resonate with the broader community. We discuss these models in the context of current economic constraints on higher education and the urgent need for our institutions to recruit and retain diverse student populations and sustain the successful American record in scientific education and innovation. PMID:21123689

Incoherent Scatterer in a Luttinger Liquid: A New Paradigmatic Limit

NASA Astrophysics Data System (ADS)

Altland, Alexander; Gefen, Yuval; Rosenow, Bernd

2012-03-01

We address the problem of a Luttinger liquid with a scatterer that allows for both coherent and incoherent scattering channels. The asymptotic behavior at zero temperature is governed by a new stable fixed point: A Goldstone mode dominates the low energy dynamics, leading to universal behavior. This limit is marked by equal probabilities for forward and backward scattering. Notwithstanding this nontrivial scattering pattern, we find that the shot noise as well as cross-current correlations vanish. We thus present a paradigmatic picture of an impurity in the Luttinger model, alternative to the Kane-Fisher picture.

Supermarket sales data: feasibility and applicability in population food and nutrition monitoring.

PubMed

Tin, Sandar Tin; Mhurchu, Cliona Ni; Bullen, Chris

2007-01-01

Population food and nutrition monitoring plays a critical role in understanding suboptimal nutrition at the population level, yet current monitoring methods such as national surveys are not practical to undertake on a continuous basis. Supermarket sales data potentially address this gap by providing detailed, timely, and inexpensive monitoring data for informing policies and anticipating trends. This paper reviews 22 studies that used supermarket sales data to examine food purchasing patterns. Despite some methodological limitations, feasibility studies showed promising results. The potential and limitations of using supermarket sales data to supplement food and nutrition monitoring methods are discussed.

Nonequilibrium optical conductivity: General theory and application to transient phases

NASA Astrophysics Data System (ADS)

Kennes, D. M.; Wilner, E. Y.; Reichman, D. R.; Millis, A. J.

2017-08-01

A nonequilibrium theory of optical conductivity of dirty-limit superconductors and commensurate charge density wave is presented. We discuss the current response to different experimentally relevant light-field probe pulses and show that a single frequency definition of the optical conductivity σ (ω )≡j (ω )/E (ω ) is difficult to interpret out of the adiabatic limit. We identify characteristic time-domain signatures distinguishing between superconducting, normal-metal, and charge density wave states. We also suggest a route to directly address the instantaneous superfluid stiffness of a superconductor by shaping the probe light field.

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

Requirements for a next generation global flood inundation models

NASA Astrophysics Data System (ADS)

Bates, P. D.; Neal, J. C.; Smith, A.; Sampson, C. C.

2016-12-01

In this paper we review the current status of global hydrodynamic models for flood inundation prediction and highlight recent successes and current limitations. Building on this analysis we then go on to consider what is required to develop the next generation of such schemes and show that to achieve this a number of fundamental science problems will need to be overcome. New data sets and new types of analysis will be required, and we show that these will only partially be met by currently planned satellite missions and data collection initiatives. A particular example is the quality of available global Digital Elevation data. The current best data set for flood modelling, SRTM, is only available at a relatively modest 30m resolution, contains pixel-to-pixel noise of 6m and is corrupted by surface artefacts. Creative processing techniques have sought to address these issues with some success, but fundamentally the quality of the available global terrain data limits flood modelling and needs to be overcome. Similar arguments can be made for many other elements of global hydrodynamic models including their bathymetry data, boundary conditions, flood defence information and model validation data. We therefore systematically review each component of global flood models and document whether planned new technology will solve current limitations and, if not, what exactly will be required to do so.

Mechanical Computing Redux: Limitations at the Nanoscale

NASA Astrophysics Data System (ADS)

Liu, Tsu-Jae King

2014-03-01

Technology solutions for overcoming the energy efficiency limits of nanoscale complementary metal oxide semiconductor (CMOS) technology ultimately will be needed in order to address the growing issue of integrated-circuit chip power density. Off-state leakage current sets a fundamental lower limit in energy per operation for any voltage-level-based digital logic implemented with transistors (CMOS and beyond), which leads to practical limits for device density (i.e. cost) and operating frequency (i.e. system performance). Mechanical switches have zero off-state leakag and hence can overcome this fundamental limit. Contact adhesive force sets a lower limit for the switching energy of a mechanical switch, however, and also directly impacts its performance. This paper will review recent progress toward the development of nano-electro-mechanical relay technology and discuss remaining challenges for realizing the promise of mechanical computing for ultra-low-power computing. Supported by the Center for Energy Efficient Electronics Science (NSF Award 0939514).

Techno-economic, location, and carbon emission analysis of thermochemical biomass to transportation fuels

NASA Astrophysics Data System (ADS)

Wright, Mark Mba

There are significant technological and systemic challenges faced by today's advanced biofuel industry. These challenges stem from the current state-of-technology and from the system (consumer market, infrastructure, environment...) in which this emerging industry is being developed. The state-of-technology will improve with continued efforts in technology development, but novel approaches are required to investigate the systemic challenges that limit the adoption of advanced biofuels. The motivation of this dissertation is to address the question of how to find cost-effective, sustainable, and environmentally responsible pathways for the production of biofuels. Economic competitiveness, long-term viability, and benign environmental impact are key for biofuels to be embraced by industry, government, and consumers. Techno-economic, location, and carbon emission analysis are research methodologies that help address each of these issues. The research approach presented in this dissertation is to combine these three methodologies into a holistic study of advanced biofuel technologies. The value of techno-economic, location, and carbon emission analysis is limited when conducted in isolation because of current public perception towards energy technologies. Energy technologies are evaluated based on multiple criteria with a significant emphasis on the three areas investigated in this study. There are important aspects within each of these fields that could significantly limit the value of advances in other fields of study. Therefore, it is necessary that future research in advanced biofuels always consider the systemic challenges faced by novel developments.

A potentiostat featuring an integrator transimpedance amplifier for the measurement of very low currents—Proof-of-principle application in microfluidic separations and voltammetry

NASA Astrophysics Data System (ADS)

Koutilellis, G. D.; Economou, A.; Efstathiou, C. E.

2016-03-01

This work reports the design and construction of a novel potentiostat which features an integrator transimpedance amplifier as a current-monitoring unit. The integration approach addresses the limitations of the feedback resistor approach used for current monitoring in conventional potentiostat designs. In the present design, measurement of the current is performed by a precision switched integrator transimpedance amplifier operated in the dual sampling mode which enables sub-pA resolution. The potentiostat is suitable for measuring very low currents (typical dynamic range: 5 pA-4.7 μA) with a 16 bit resolution, and it can support 2-, 3- and 4-electrode cell configurations. Its operation was assessed by using it as a detection module in a home-made capillary electrophoresis system for the separation and amperometric detection of paracetamol and p-aminophenol at a 3-electrode microfluidic chip. The potential and limitations of the proposed potentiostat to implement fast potential-scan voltammetric techniques were demonstrated for the case of cyclic voltammetry.

Machine Learning Approaches for Clinical Psychology and Psychiatry.

PubMed

Dwyer, Dominic B; Falkai, Peter; Koutsouleris, Nikolaos

2018-05-07

Machine learning approaches for clinical psychology and psychiatry explicitly focus on learning statistical functions from multidimensional data sets to make generalizable predictions about individuals. The goal of this review is to provide an accessible understanding of why this approach is important for future practice given its potential to augment decisions associated with the diagnosis, prognosis, and treatment of people suffering from mental illness using clinical and biological data. To this end, the limitations of current statistical paradigms in mental health research are critiqued, and an introduction is provided to critical machine learning methods used in clinical studies. A selective literature review is then presented aiming to reinforce the usefulness of machine learning methods and provide evidence of their potential. In the context of promising initial results, the current limitations of machine learning approaches are addressed, and considerations for future clinical translation are outlined.

Current Opinion on the Role of Neurogenesis in the Therapeutic Strategies for Alzheimer Disease, Parkinson Disease, and Ischemic Stroke; Considering Neuronal Voiding Function

PubMed Central

Lee, Eun-Hye

2016-01-01

Neurological diseases such as Alzheimer, Parkinson, and ischemic stroke have increased in occurrence and become important health issues throughout the world. There is currently no effective therapeutic strategy for addressing neurological deficits after the development of these major neurological disorders. In recent years, it has become accepted that adult neural stem cells located in the subventricular and subgranular zones have the ability to proliferate and differentiate in order to replace lost or damaged neural cells. There have been many limitations in the clinical application of both endogenous and exogenous neurogenesis for neurological disorders. However, many studies have investigated novel mechanisms in neurogenesis and have shown that these limitations can potentially be overcome with appropriate stimulation and various approaches. We will review concepts related to possible therapeutic strategies focused on the perspective of neurogenesis for the treatment of patients diagnosed with Alzheimer disease, Parkinson disease, and ischemic stroke based on current reports. PMID:28043116

Working session 2: Tubing inspection

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

Guerra, J.; Tapping, R.L.

1997-02-01

This session was attended by delegates from 10 countries, and four papers were presented. A wide range of issues was tabled for discussion. Realizing that there was limited time available for more detailed discussion, three topics were chosen for the more detailed discussion: circumferential cracking, performance demonstration (to focus on POD and sizing), and limits of methods. Two other subsessions were organized: one dealt with some challenges related to the robustness of current inspection methods, especially with respect to leaving cracked tubes in service, and the other with developing a chart of current NDE technology with recommendations for future development.more » These three areas are summarized in turn, along with conclusions and/or recommendations. During the discussions there were four presentations. There were two (Canada, Japan) on eddy current probe developments, both of which addressed multiarray probes that would detect a range of flaws, one (Spain) on circumferential crack detection, and one (JRC, Petten) on the recent PISC III results.« less

Non-invasive Renal Denervation: Update on External Ultrasound Approaches.

PubMed

Schmieder, Roland E; Ott, Christian; Bramlage, Peter

2016-06-01

In the last decade, intravenous renal denervation (RDN) has emerged as an alternative to pharmacological treatment in patients with resistant hypertension, but currently involves an invasive and technically challenging procedure. The Surround Sound™ system utilises externally delivered ultrasound to achieve RDN using a completely non-invasive, automated real-time tracking system coupled with a therapeutic delivery module thereby addressing these limitations. A brief history, technical overview and summary of preclinical and clinical studies of the KonaMedical Surround Sound™ system are presented. A literature search using the terms "renal denervation", "resistant hypertension" and "external ultrasound" was performed using PubMed, and references retrieved were selected based on relevancy and year of publication (date range 1991-2015). The Surround Sound™ system appears to be a promising approach to RDN which eliminates several of the factors currently limiting the intravenous approach. So far, it has demonstrated efficacy for reducing blood pressure in resistant hypertension patients with minimal adverse effects. Several double-blind, sham-controlled clinical trials are currently underway to confirm the validity of these findings.

Neuronavigation in the surgical management of brain tumors: current and future trends

PubMed Central

Orringer, Daniel A; Golby, Alexandra; Jolesz, Ferenc

2013-01-01

Neuronavigation has become an ubiquitous tool in the surgical management of brain tumors. This review describes the use and limitations of current neuronavigational systems for brain tumor biopsy and resection. Methods for integrating intraoperative imaging into neuronavigational datasets developed to address the diminishing accuracy of positional information that occurs over the course of brain tumor resection are discussed. In addition, the process of integration of functional MRI and tractography into navigational models is reviewed. Finally, emerging concepts and future challenges relating to the development and implementation of experimental imaging technologies in the navigational environment are explored. PMID:23116076

Piloted aircraft simulation concepts and overview

NASA Technical Reports Server (NTRS)

Sinacori, J. B.

1978-01-01

An overview of piloted aircraft simulation is presented that reflects the viewpoint of an aeronautical technologist. The intent is to acquaint potential users with some of the basic concepts and issues that characterize piloted simulation. Application to the development of aircraft are highlighted, but some aspects of training simulators are covered. A historical review is given together with a description of some current simulators. Simulator usages, advantages, and limitations are discussed and human perception qualities important to simulation are related. An assessment of current simulation is presented that addresses validity, fidelity, and deficiencies. Future prospects are discussed and technology projections are made.

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

Boosting the oxidase mimicking activity of nanoceria by fluoride capping: rivaling protein enzymes and ultrasensitive F- detection

NASA Astrophysics Data System (ADS)

Liu, Biwu; Huang, Zhicheng; Liu, Juewen

2016-07-01

Nanomaterial-based enzyme mimics (nanozymes) are currently a new forefront of chemical research. However, the application of nanozymes is limited by their low catalytic activity and low turnover numbers. Cerium dioxide nanoparticles (nanoceria) are among the few with oxidase activity. Herein, we report an interesting finding addressing their limitations. The oxidase activity of nanoceria is improved by over 100-fold by fluoride capping, making it more close to real oxidases. The turnover number reached 700 in 15 min, drastically improved from ~15 turnovers for the naked particles. The mechanism is attributed to surface charge modulation and facilitated electron transfer by F- capping based on ζ-potential and free radical measurements. Ultrasensitive sensing of fluoride was achieved with a detection limit of 0.64 μM F- in water and in toothpastes, while no other tested anions can achieve the activity enhancement.Nanomaterial-based enzyme mimics (nanozymes) are currently a new forefront of chemical research. However, the application of nanozymes is limited by their low catalytic activity and low turnover numbers. Cerium dioxide nanoparticles (nanoceria) are among the few with oxidase activity. Herein, we report an interesting finding addressing their limitations. The oxidase activity of nanoceria is improved by over 100-fold by fluoride capping, making it more close to real oxidases. The turnover number reached 700 in 15 min, drastically improved from ~15 turnovers for the naked particles. The mechanism is attributed to surface charge modulation and facilitated electron transfer by F- capping based on ζ-potential and free radical measurements. Ultrasensitive sensing of fluoride was achieved with a detection limit of 0.64 μM F- in water and in toothpastes, while no other tested anions can achieve the activity enhancement. Electronic supplementary information (ESI) available: Methods, TMB oxidation kinetics and control experiments. See DOI: 10.1039/c6nr02730j

Addressing Prediabetes in Childhood Obesity Treatment Programs: Support from Research and Current Practice

PubMed Central

Grow, H. Mollie; Fernandez, Cristina; Lukasiewicz, Gloria J.; Rhodes, Erinn T.; Shaffer, Laura A.; Sweeney, Brooke; Woolford, Susan J.; Estrada, Elizabeth

2014-01-01

Abstract Background: Type 2 diabetes mellitus (T2DM) and prediabetes have increased in prevalence among overweight and obese children, with significant implications for long-term health. There is little published evidence on the best approaches to care of prediabetes among overweight youth or the current practices used across pediatric weight management programs. Methods: This article reviews the literature and summarizes current practices for screening, diagnosis, and treatment of prediabetes at childhood obesity treatment centers. Findings regarding current practice were based on responses to an online survey from 28 pediatric weight management programs at 25 children's hospitals in 2012. Based on the literature reviewed, and empiric data, consensus support statements on prediabetes care and T2DM prevention were developed among representatives of these 25 children's hospitals' obesity clinics. Results: The evidence reviewed demonstrates that current T2DM and prediabetes diagnostic parameters are derived from adult-based studies with little understanding of clinical outcomes among youth. Very limited evidence exists on preventing progression of prediabetes. Some evidence suggests that a significant proportion of obese youth with prediabetes will revert to normoglycemia without pharmacological management. Evidence supports lifestyle modification for children with prediabetes, but further study of specific lifestyle changes and pharmacological treatments is needed. Conclusion: Evidence to guide management of prediabetes in children is limited. Current practice patterns of pediatric weight management programs show areas of variability in practice, reflecting the limited evidence base. More research is needed to guide clinical care for overweight youth with prediabetes. PMID:25055134

The Full Scope of Family Physicians' Work Is Not Reflected by Current Procedural Terminology Codes.

PubMed

Young, Richard A; Burge, Sandy; Kumar, Kaparaboyna Ashok; Wilson, Jocelyn

2017-01-01

The purpose of this study was to characterize the content of family physician (FP) clinic encounters, and to count the number of visits in which the FPs addressed issues not explicitly reportable by 99211 to 99215 and 99354 Current Procedural Terminology (CPT) codes with current reimbursement methods and based on examples provided in the CPT manual. The data collection instrument was modeled on the National Ambulatory Medical Care Survey. Trained assistants directly observed every other FP-patient encounter and recorded every patient concern, issue addressed by the physician (including care barriers related to health care systems and social determinants), and treatment ordered in clinics affiliated with 10 residencies of the Residency Research Network of Texas. A visit was deemed to include physician work that was not explicitly reportable if the number or nature of issues addressed exceeded the definitions or examples for 99205/99215 or 99214 + 99354 or a preventive service code, included the physician addressing health care system or social determinant issues, or included the care of a family member. In 982 physician-patient encounters, patients raised 517 different reasons for visit (total, 5278; mean, 5.4 per visit; range, 1 to 16) and the FPs addressed 509 different issues (total issues, 3587; mean, 3.7 per visit; range, 1 to 10). FPs managed 425 different medications, 18 supplements, and 11 devices. A mean of 3.9 chronic medications were continued per visit (range, 0 to 21) and 4.6 total medications were managed (range, 0 to 22). In 592 (60.3%) of the visits the FPs did work that was not explicitly reportable with available CPT codes: 582 (59.3%) addressed more numerous issues than explicitly reportable, 64 (6.5%) addressed system barriers, and 13 (1.3%) addressed concerns for other family members. FPs perform cognitive work in a majority of their patient encounters that are not explicitly reportable, either by being higher than the CPT example number of diagnoses per code or the type of problems addressed, which has implications for the care of complex multi-morbid patients and the growth of the primary care workforce. To address these limitations, either the CPT codes and their associated rules should be updated to reflect the realities of family physicians' practices or new billing and coding approaches should be developed. © Copyright 2017 by the American Board of Family Medicine.

Dual-Energy CT: New Horizon in Medical Imaging

PubMed Central

Goo, Jin Mo

2017-01-01

Dual-energy CT has remained underutilized over the past decade probably due to a cumbersome workflow issue and current technical limitations. Clinical radiologists should be made aware of the potential clinical benefits of dual-energy CT over single-energy CT. To accomplish this aim, the basic principle, current acquisition methods with advantages and disadvantages, and various material-specific imaging methods as clinical applications of dual-energy CT should be addressed in detail. Current dual-energy CT acquisition methods include dual tubes with or without beam filtration, rapid voltage switching, dual-layer detector, split filter technique, and sequential scanning. Dual-energy material-specific imaging methods include virtual monoenergetic or monochromatic imaging, effective atomic number map, virtual non-contrast or unenhanced imaging, virtual non-calcium imaging, iodine map, inhaled xenon map, uric acid imaging, automatic bone removal, and lung vessels analysis. In this review, we focus on dual-energy CT imaging including related issues of radiation exposure to patients, scanning and post-processing options, and potential clinical benefits mainly to improve the understanding of clinical radiologists and thus, expand the clinical use of dual-energy CT; in addition, we briefly describe the current technical limitations of dual-energy CT and the current developments of photon-counting detector. PMID:28670151

Russia and the Current State of Arms Control

DTIC Science & Technology

2012-09-01

Suite 1204, Arlington VA 22202-4302. Respondents should be aware that notwithstanding any other provision of law , no person shall be subject to a...for the Further Reduction and Limitation of Strategic Offensive Arms (START III) addressed well-covered ground from past arms control efforts and...composed of political, military, business , faith, and civic leaders in late 2008. That group mount- ed an international campaign for the elimination of

Novel Approaches for Retinal Drug and Gene Delivery

PubMed Central

Kim, Stephen J.

2014-01-01

The ARVO 2014 minisymposium on “Novel Approaches for Retinal Drug and Gene Delivery” was held on May 6, 2014 in Orlando, FL. The main intent of the symposium was to review recent advances in retinal drug and gene delivery with specific emphasis on novel approaches that address current limitations and have the potential to translate into clinical practice. The symposium was sponsored by Translational Vision Science and Technology. PMID:25346872

Artificial Intelligence: A Revolution Waiting to Happen

DTIC Science & Technology

2017-06-09

REPORT DOCUMENTATION PAGE Form Approved OMB No. 0704-0188 Public reporting burden for this collection of information is estimated to average 1...currently valid OMB control number. PLEASE DO NOT RETURN YOUR FORM TO THE ABOVE ADDRESS. 1. REPORT DATE (DD-MM-YYYY) 9-06-2017 2. REPORT TYPE...important RMAs, limited by innovative concepts and organizational desire to change. General AI, on the other hand, looms in theoretical form as a

Biohydrogen from Microalgae

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

Dubini, Alexandra; Gonzalez-Ballester, David

2016-03-01

This chapter provides an overview of the current state of knowledge of the mechanisms involved in biohydrogen production from microalgae. The known limitations linked to photohydrogen productivity are addressed. Particular attention is given to physiological and molecular strategies to sustain and improve hydrogen production. The impact of different nutrient stresses and the effect of carbon supply on hydrogen production are discussed. The genetic and metabolic engineering approaches for increasing hydrogen production are outlined.

Electronics: Mott Transistor: Fundamental Studies and Device Operation Mechanisms

DTIC Science & Technology

2016-03-21

display a currently valid OMB control number. PLEASE DO NOT RETURN YOUR FORM TO THE ABOVE ADDRESS. Harvard University Office for Sponsored Programs...including journal references , in the following categories: (b) Papers published in non-peer-reviewed journals (N/A for none) 03/21/2016 03/21/2016 03...limited kinetics of electron doping in correlated oxides, Applied Physics Letters (07 2015) TOTAL: 1 Books Number of Manuscripts: Patents Submitted

Generation of Particles and Seeding

NASA Technical Reports Server (NTRS)

Meyers, James F.

1991-01-01

One of the most important elements in laser velocimetry, yet the most neglected, is the small particle embedded in the flow field that scatters the light necessary to make velocity measurements. An attempt to remove the confusion in choosing a seeding method by assessing many of the techniques currently used is presented. Their characteristics and typical limitations imposed by various applications are outlined. The ramifications of these methods on measurement accuracy are addressed.

High Mobility Conjugated Polymers

DTIC Science & Technology

2007-10-20

will act as a trap for opposite charge carriers; the electron affinities were 4.0 eV (BBL) and 2.7 eV (PTHQx) and ionization potentials were 6.0 eV...transistors (OFETs), photovoltaic cells, and photodetectors, is limited primarily by the low charge carrier mobilities of current materials. To address this...showing a maximum mobility with hexyl. Fundamental insights into the structural factors that govern high mobility charge transport and recombination in

Renal denervation in the management of resistant hypertension: current evidence and perspectives.

PubMed

Jin, Yu; Persu, Alexandre; Staessen, Jan A

2013-09-01

Catheter-based renal denervation has emerged as a novel treatment modality for resistant hypertension. This review summarizes the current evidence on this procedure in treatment of resistant hypertension, limitations of available evidence and questions to be answered. The SYMPLICITY studies showed that renal denervation is feasible in treating resistant hypertension, but failed to provide conclusive evidence on the size and durability of the antihypertensive, renal and sympatholytic effects, as well as the long-term safety. The definition of resistant hypertension was loose in the SYMPLICITY studies and the management of resistant hypertension was suboptimal. Future studies should have a randomized design and enroll truly resistant hypertension patients by excluding secondary hypertension, white-coat hypertension and nonadherent patients. Questions to be addressed by the ongoing and future trials include the long-term efficacy and safety of this procedure, identification of responders and uncovering of the underlying mechanisms. Only well-designed, randomized clinical trials addressing the limitations of the SYMPLICITY studies will be able to demonstrate whether renal denervation is an efficacious treatment modality in resistant hypertension and in which patients. For now, renal denervation remains an experimental procedure and should only be offered to truly resistant hypertensive patients in a research context after careful selection.

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

PubMed

Ten Cate, Carel

2017-02-01

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

One-dimensional conduction through supporting electrolytes: two-scale cathodic Debye layer.

PubMed

Almog, Yaniv; Yariv, Ehud

2011-10-01

Supporting-electrolyte solutions comprise chemically inert cations and anions, produced by salt dissolution, together with a reactive ionic species that may be consumed and generated on bounding ion-selective surfaces (e.g., electrodes or membranes). Upon application of an external voltage, a Faraday current is thereby established. It is natural to analyze this ternary-system process through a one-dimensional transport problem, employing the thin Debye-layer limit. Using a simple model of ideal ion-selective membranes, we have recently addressed this problem for moderate voltages [Yariv and Almog, Phys. Rev. Lett. 105, 176101 (2010)], predicting currents that scale as a fractional power of Debye thickness. We address herein the complementary problem of moderate currents. We employ matched asymptotic expansions, separately analyzing the two inner thin Debye layers adjacent to the ion-selective surfaces and the outer electroneutral region outside them. A straightforward calculation following comparable singular-perturbation analyses of binary systems is frustrated by the prediction of negative ionic concentrations near the cathode. Accompanying numerical simulations, performed for small values of Debye thickness, indicate a number unconventional features occurring at that region, such as inert-cation concentration amplification and electric-field intensification. The current-voltage correlation data of the electrochemical cell, obtained from compilation of these simulations, does not approach a limit as the Debye thickness vanishes. Resolution of these puzzles reveals a transformation of the asymptotic structure of the cathodic Debye layer. This reflects the emergence of an internal boundary layer, adjacent to the cathode, wherein field and concentration scaling differs from those of the Gouy-Chapman theory. The two-scale feature of the cathodic Debye layer is manifested through a logarithmic voltage scaling with Debye thickness. Accounting for this scaling, the complied current-voltage data collapses upon a single curve. This curve practically coincides with an asymptotically calculated universal current-voltage relation.

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Federal Register 2010, 2011, 2012, 2013, 2014

2011-04-13

... date on which a limit up/limit down mechanism to address extraordinary market volatility, if adopted... down mechanism to address extraordinary market volatility, if adopted, applies [April 11, 2011]. If the... which a limit up/limit down mechanism to address extraordinary market volatility, if adopted, applies...

76 FR 20732 - Self-Regulatory Organizations; NASDAQ OMX BX, Inc.; Notice of Filing and Immediate Effectiveness...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-04-13

... which a limit up/limit down mechanism to address extraordinary market volatility, if adopted, applies... mechanism to address extraordinary market volatility, if adopted, applies [April 11, 2011]. If the pilot is... limit up/limit down mechanism to address extraordinary market volatility, if adopted, applies [April 11...

Corneal Tissue Engineering: Recent Advances and Future Perspectives

PubMed Central

Ghezzi, Chiara E.; Rnjak-Kovacina, Jelena

2015-01-01

To address the growing need for corneal transplants two main approaches are being pursued: allogenic and synthetic materials. Allogenic tissue from human donors is currently the preferred choice; however, there is a worldwide shortage in donated corneal tissue. In addition, tissue rejection often limits the long-term success of this approach. Alternatively, synthetic homologs to donor corneal grafts are primarily considered temporary replacements until suitable donor tissue becomes available, as they result in a high incidence of graft failure. Tissue engineered cornea analogs would provide effective cornea tissue substitutes and alternatives to address the need to reduce animal testing of commercial products. Recent progress toward these needs is reviewed here, along with future perspectives. PMID:25434371

Competency-based education: a new model for teaching orthopaedics.

PubMed

Alman, Benjamin A; Ferguson, Peter; Kraemer, William; Nousiainen, Markku T; Reznick, Richard K

2013-01-01

The current methods used to train residents to become orthopaedic surgeons are based on tradition, not evidence-based models. Educators have only a limited ability to assess trainees for competency using validated tests in various domains. The reduction in resident work hours limits the time available for clinical training, which has resulted in some calls for lengthening the training process. Another approach to address limited training hours is to focus training in a program that allows residents to graduate from a rotation based on demonstrated competency rather than on time on a service. A pilot orthopaedic residency curriculum, which uses a competency-based framework of resident training and maximizes the use of available training hours, has been designed and is being implemented.

Fatigue and fatigability in neurologic illnesses

PubMed Central

Krupp, Lauren B.; Enoka, Roger M.

2013-01-01

Fatigue is commonly reported in many neurologic illnesses, including multiple sclerosis, Parkinson disease, myasthenia gravis, traumatic brain injury, and stroke. Fatigue contributes substantially to decrements in quality of life and disability in these illnesses. Despite the clear impact of fatigue as a disabling symptom, our understanding of fatigue pathophysiology is limited and current treatment options rarely lead to meaningful improvements in fatigue. Progress continues to be hampered by issues related to terminology and assessment. In this article, we propose a unified taxonomy and a novel assessment approach to addressing distinct aspects of fatigue and fatigability in clinical and research settings. This taxonomy is based on our current knowledge of the pathophysiology and phenomenology of fatigue and fatigability. Application of our approach indicates that the assessment and reporting of fatigue can be clarified and improved by utilizing this taxonomy and creating measures to address distinct aspects of fatigue and fatigability. We review the strengths and weaknesses of several common measures of fatigue and suggest, based on our model, that many research questions may be better addressed by using multiple measures. We also provide examples of how to apply and validate the taxonomy and suggest directions for future research. PMID:23339207

Geocoding rural addresses in a community contaminated by PFOA: a comparison of methods.

PubMed

Vieira, Verónica M; Howard, Gregory J; Gallagher, Lisa G; Fletcher, Tony

2010-04-21

Location is often an important component of exposure assessment, and positional errors in geocoding may result in exposure misclassification. In rural areas, successful geocoding to a street address is limited by rural route boxes. Communities have assigned physical street addresses to rural route boxes as part of E911 readdressing projects for improved emergency response. Our study compared automated and E911 methods for recovering and geocoding valid street addresses and assessed the impact of positional errors on exposure classification. The current study is a secondary analysis of existing data that included 135 addresses self-reported by participants of a rural community study who were exposed via public drinking water to perfluorooctanoate (PFOA) released from a DuPont facility in Parkersburg, West Virginia. We converted pre-E911 to post-E911 addresses using two methods: automated ZP4 address-correction software with the U.S. Postal Service LACS database and E911 data provided by Wood County, West Virginia. Addresses were geocoded using TeleAtlas, an online commercial service, and ArcView with StreetMap Premium North America NAVTEQ 2008 enhanced street dataset. We calculated positional errors using GPS measurements collected at each address and assessed exposure based on geocoded location in relation to public water pipes. The county E911 data converted 89% of the eligible addresses compared to 35% by ZP4 LACS. ArcView/NAVTEQ geocoded more addresses (n = 130) and with smaller median distance between geocodes and GPS coordinates (39 meters) than TeleAtlas (n = 85, 188 meters). Without E911 address conversion, 25% of the geocodes would have been more than 1000 meters from the true location. Positional errors in TeleAtlas geocoding resulted in exposure misclassification of seven addresses whereas ArcView/NAVTEQ methods did not misclassify any addresses. Although the study was limited by small numbers, our results suggest that the use of county E911 data in rural areas increases the rate of successful geocoding. Furthermore, positional accuracy of rural addresses in the study area appears to vary by geocoding method. In a large epidemiological study investigating the health effects of PFOA-contaminated public drinking water, this could potentially result in exposure misclassification if addresses are incorrectly geocoded to a street segment not serviced by public water.

Pre-anthropocene mercury residues in North American freshwater fish.

PubMed

Hope, Bruce K; Louch, Jeff

2014-04-01

Mercury (Hg) has been entering the environment from both natural and anthropogenic sources for millennia, and humans have been influencing its environmental transport and fate from well before the Industrial Revolution. Exposure to Hg (as neurotoxic monomethylmercury [MeHg]) occurs primarily through consumption of finfish, shellfish, and marine mammals, and regulatory limits for MeHg concentrations in fish tissue have steadily decreased as information on its health impacts has become available. These facts prompted us to consider 2 questions: 1) What might the MeHg levels in fish tissue have been in the pre-Anthropocene, before significant human impacts on the environment? and 2) How would these pre-Anthropocene levels have compared with current regulatory criteria for MeHg residues in fish tissue? We addressed the first question by estimating pre-Anthropocene concentrations of MeHg in the tissues of prey and predatory fish with an integrated Hg speciation, transport, fate, and food web model (SERAFM), using estimated Hg concentrations in soil, sediment, and atmospheric deposition before the onset of significant human activity (i.e., ≤2000 BCE). Model results show MeHg residues in fish varying depending on the characteristics of the modeled water body, which suggests that Hg in fish tissue is best considered at the scale of individual watersheds or water bodies. We addressed the second question by comparing these model estimates with current regulatory criteria and found that MeHg residues in predatory (but not prey) fish could have approached or exceeded these criteria in some water bodies during the pre-Anthropocene. This suggests that the possibility of naturally occurring levels of Hg in fish below which it is not possible to descend, regardless of where those levels stand with respect to current regulatory limits. Risk management decisions made under these circumstances have the potential to be ineffectual, frustrating, and costly for decision makers and stakeholders alike, suggesting the need for regulatory flexibility when addressing the issue of Hg in fish. © 2013 SETAC.

Training Space Surgeons for Missions to the Moon and Mars

NASA Technical Reports Server (NTRS)

Pool, S. L.; McSwain, N.

2004-01-01

Over a period of 4 years, several working groups reviewed the provisions for medical care in low earth orbit and for future flights such as to the Moon and Mars. More than 60 medical experts representing a wide variety of clinical backgrounds participated in the working groups. They concluded that NASA medical training for long-duration missions, while critical to success, is currently aimed at short-term skill retention. They noted that several studies have shown that skills and knowledge deteriorate rapidly in the absence of adequate sustainment training. American Heart Association studies have shown that typically less than twenty-five percent of learned skills remain after 6 to 8 months. In addition to identifying the current training deficiencies, the working groups identified additional skill and knowledge sets required for missions to the Moon and Mars and curricula were developed to address inadequacies. Space medicine care providers may be categorized into 4 types based on health care responsibilities and level of education required. The first 2 types are currently recognized positions within the flight crew: crew medical officers and astronaut-physician. The crew medical officer (CMO), a non-medically trained astronaut crewmember, is given limited emergency medical technician-like training to provide medical care on orbit. Many of hidher duties are carried out under the direction of a ground-based flight surgeon in mission control. Second is the astronaut- physician whose primary focus is on mission specialist duties and training, and who has very limited ability to maintain medical proficiency. Two new categories are recommended to complete the 4 types of care providers primarily to address the needs of those who will travel to the Moon and Mars. Physician astronaut - a physician, who in addition to being a mission specialist, will be required to maintain and enhance hidher medical proficiency while serving as an astronaut. Space surgeon - a physician astronaut given special training to address the unique health care requirements envisioned for expeditions such as those to Mars.

Science, precaution, and the politics of technological risk: converging implications in evolutionary and social scientific perspectives.

PubMed

Stirling, Andy

2008-04-01

This paper examines apparent tensions between "science-based," "precautionary," and "participatory" approaches to decision making on risk. Partly by reference to insights currently emerging in evolutionary studies, the present paper looks for ways to reconcile some of the contradictions. First, I argue that technological evolution is a much more plural and open-ended process than is conventionally supposed. Risk politics is thus implicitly as much about social choice of technological pathways as narrow issues of safety. Second, it is shown how conventional "science-based" risk assessment techniques address only limited aspects of incomplete knowledge in complex, dynamic, evolutionary processes. Together, these understandings open the door to more sophisticated, comprehensive, rational, and robust decision-making processes. Despite their own limitations, it is found that precautionary and participatory approaches help to address these needs. A concrete framework is outlined through which the synergies can be more effectively harnessed. By this means, we can hope simultaneously to improve scientific rigor and democratic legitimacy in risk governance.

Intracranial Pressure Monitoring—Review and Avenues for Development

PubMed Central

Dolmans, Rianne G. F.

2018-01-01

Intracranial pressure (ICP) monitoring is a staple of neurocritical care. The most commonly used current methods of monitoring in the acute setting include fluid-based systems, implantable transducers and Doppler ultrasonography. It is well established that management of elevated ICP is critical for clinical outcomes. However, numerous studies show that current methods of ICP monitoring cannot reliably define the limit of the brain’s intrinsic compensatory capacity to manage increases in pressure, which would allow for proactive ICP management. Current work in the field hopes to address this gap by harnessing live-streaming ICP pressure-wave data and a multimodal integration with other physiologic measures. Additionally, there is continued development of non-invasive ICP monitoring methods for use in specific clinical scenarios. PMID:29401746

Microbial Production of l-Serine from Renewable Feedstocks.

PubMed

Zhang, Xiaomei; Xu, Guoqiang; Shi, Jinsong; Koffas, Mattheos A G; Xu, Zhenghong

2018-07-01

l-Serine is a non-essential amino acid that has wide and expanding applications in industry with a fast-growing market demand. Currently, extraction and enzymatic catalysis are the main processes for l-serine production. However, such approaches limit the industrial-scale applications of this important amino acid. Therefore, shifting to the direct fermentative production of l-serine from renewable feedstocks has attracted increasing attention. This review details the current status of microbial production of l-serine from renewable feedstocks. We also summarize the current trends in metabolic engineering strategies and techniques for the typical industrial organisms Corynebacterium glutamicum and Escherichia coli that have been developed to address and overcome major challenges in the l-serine production process. Copyright © 2018 Elsevier Ltd. All rights reserved.

Estimated Muscle Loads During Squat Exercise in Microgravity Conditions

NASA Technical Reports Server (NTRS)

Fregly, Christopher D.; Kim, Brandon T.; Li, Zhao; DeWitt, John K.; Fregly, Benjamin J.

2012-01-01

Loss of muscle mass in microgravity is one of the primary factors limiting long-term space flight. NASA researchers have developed a number of exercise devices to address this problem. The most recent is the Advanced Resistive Exercise Device (ARED), which is currently used by astronauts on the International Space Station (ISS) to emulate typical free-weight exercises in microgravity. ARED exercise on the ISS is intended to reproduce Earth-level muscle loads, but the actual muscle loads produced remain unknown as they cannot currently be measured directly. In this study we estimated muscle loads experienced during squat exercise on ARED in microgravity conditions representative of Mars, the moon, and the ISS. The estimates were generated using a subject-specific musculoskeletal computer model and ARED exercise data collected on Earth. The results provide insight into the capabilities and limitations of the ARED machine.

Incorporating uncertainty in watershed management decision-making: A mercury TMDL case study

USGS Publications Warehouse

Labiosa, W.; Leckie, J.; Shachter, R.; Freyberg, D.; Rytuba, J.; ,

2005-01-01

Water quality impairment due to high mercury fish tissue concentrations and high mercury aqueous concentrations is a widespread problem in several sub-watersheds that are major sources of mercury to the San Francisco Bay. Several mercury Total Maximum Daily Load regulations are currently being developed to address this problem. Decisions about control strategies are being made despite very large uncertainties about current mercury loading behavior, relationships between total mercury loading and methyl mercury formation, and relationships between potential controls and mercury fish tissue levels. To deal with the issues of very large uncertainties, data limitations, knowledge gaps, and very limited State agency resources, this work proposes a decision analytical alternative for mercury TMDL decision support. The proposed probabilistic decision model is Bayesian in nature and is fully compatible with a "learning while doing" adaptive management approach. Strategy evaluation, sensitivity analysis, and information collection prioritization are examples of analyses that can be performed using this approach.

Noninvasive Brain Stimulation in Pediatric ADHD: A Review

PubMed Central

Rubio, Belen; Boes, Aaron D.; Laganiere, Simon; Rotenberg, Alexander; Jeurissen, Danique; Pascual-Leone, Alvaro

2015-01-01

Attention-deficit hyperactivity disorder (ADHD) is one of the most prevalent neurodevelopmental disorders in the pediatric population. The clinical management of ADHD is currently limited by a lack of reliable diagnostic biomarkers and inadequate therapy for a minority of patients that do not respond to standard pharmacotherapy. There is optimism that noninvasive brain stimulation may help to address these limitations. Transcranial magnetic stimulation (TMS) and transcranial direct current stimulation (tDCS) are two methods of noninvasive brain stimulation that modulate cortical excitability and brain network activity. TMS can be used diagnostically to probe cortical neurophysiology, while daily use of repetitive TMS or tDCS can induce long-lasting and potentially therapeutic changes in targeted networks. In this review we highlight research showing the potential diagnostic and therapeutic applications of TMS and tDCS in pediatric ADHD. We also discuss the safety and ethics of using these tools in the pediatric population. PMID:26661481

Overcoming limitations of model-based diagnostic reasoning systems

NASA Technical Reports Server (NTRS)

Holtzblatt, Lester J.; Marcotte, Richard A.; Piazza, Richard L.

1989-01-01

The development of a model-based diagnostic system to overcome the limitations of model-based reasoning systems is discussed. It is noted that model-based reasoning techniques can be used to analyze the failure behavior and diagnosability of system and circuit designs as part of the system process itself. One goal of current research is the development of a diagnostic algorithm which can reason efficiently about large numbers of diagnostic suspects and can handle both combinational and sequential circuits. A second goal is to address the model-creation problem by developing an approach for using design models to construct the GMODS model in an automated fashion.

Feasibility of producing a range of food products from a limited range of undifferenitiated major food components

NASA Technical Reports Server (NTRS)

Karel, M.; Kamarei, A. R.

1984-01-01

This report reviews current knowledge associated with producing safe, nutritious, and acceptable foods from a limited number of source independent macronutrients. The advantages, and disadvantages, of such an approach for use by space crews are discussed. The production of macronutrients from a variety of sources is covered in detail. The sources analyzed are: wheat, soybeans, algae (3 genera), glycerol, and digested cellulose. Fabrication of food from the above macronutrient sources is discussed and particular attention is addressed to nutrition, acceptability and reliability. The processes and concepts involved in food fabrication and macronutrient production are also considered for utilization in a space environment.

Advances in instrumentation at the W. M. Keck Observatory

NASA Astrophysics Data System (ADS)

Adkins, Sean M.; Armandroff, Taft; Lewis, Hilton; Martin, Chris; McLean, Ian S.; Rockosi, Constance; Wizinowich, Peter

2010-07-01

In this paper we describe both recently completed instrumentation projects and our current development efforts in the context of the Observatory's science driven strategic plan which seeks to address key questions in observational astronomy for extra-galactic, Galactic, and planetary science with both seeing limited capabilities and high angular resolution adaptive optics capabilities. This paper will review recently completed projects as well as new instruments in development including MOSFIRE, a near IR multi-object spectrograph nearing completion, a new seeing limited integral field spectrograph for the visible wavelength range called the Keck Cosmic Web Imager, and the Keck Next Generation Adaptive Optics facility and its first light science instrument DAVINCI.

The use of coupled atmospheric and hydrological models for water-resources management in headwater basins

USGS Publications Warehouse

Leavesley, G.; Hay, L.

1998-01-01

Coupled atmospheric and hydrological models provide an opportunity for the improved management of water resources in headwater basins. Issues currently limiting full implementation of coupled-model methodologies include (a) the degree of uncertainty in the accuracy of precipitation and other meteorological variables simulated by atmospheric models, and (b) the problem of discordant scales between atmospheric and bydrological models. Alternative methodologies being developed to address these issues are reviewed.

Status of Net Metering: Assessing the Potential to Reach Program Caps

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

Heeter, J.; Gelman, R.; Bird, L.

2014-09-01

Several states are addressing the issue of net metering program caps, which limit the total amount of net metered generating capacity that can be installed in a state or utility service territory. In this analysis, we examine net metering caps to gain perspective on how long net metering will be available in various jurisdictions under current policies. We also surveyed state practices and experience to understand important policy design considerations.

Emergence of Fundamental Limits in Spatially Distributed Dynamical Networks and Their Tradeoffs

DTIC Science & Technology

2017-05-01

It is shown that the resulting non -convex optimization problem can be equivalently reformulated into a rank-constrained problem. We then...display a current ly valid OMB control number. PLEASE DO NOT RETURN YOUR FORM TO THE ABOVE ADDRESS. 1. REPORT DATE (DD-MM- YYYY) ,2. REPORT TYPE 3...robustness in distributed control and dynamical systems. Our research re- sults are highly relevant for analysis and synthesis of engineered and natural

A Practical Guide to the Open Standards for Unattended Sensors (OSUS)

DTIC Science & Technology

2018-01-01

collection of information if it does not display a currently valid OMB control number. PLEASE DO NOT RETURN YOUR FORM TO THE ABOVE ADDRESS. 1. REPORT DATE...in OSUS development and some of the benefits of implementing an OSUS controller as the central processing platform in a smart sensing device. The... controller 16. SECURITY CLASSIFICATION OF: 17. LIMITATION OF ABSTRACT UU 18. NUMBER OF PAGES 91 19a. NAME OF

Prediction of the Hydrogen Peroxide-Induced Methionine Oxidation Propensity in Monoclonal Antibodies.

PubMed

Agrawal, Neeraj J; Dykstra, Andrew; Yang, Jane; Yue, Hai; Nguyen, Xichdao; Kolvenbach, Carl; Angell, Nicolas

2018-05-01

Methionine oxidation in therapeutic antibodies can impact the product's stability, clinical efficacy, and safety and hence it is desirable to address the methionine oxidation liability during antibody discovery and development phase. Although the current experimental approaches can identify the oxidation-labile methionine residues, their application is limited mostly to the development phase. We demonstrate an in silico method that can be used to predict oxidation-labile residues based solely on the antibody sequence and structure information. Since antibody sequence information is available in the discovery phase, the in silico method can be applied very early on to identify the oxidation-labile methionine residues and subsequently address the oxidation liability. We believe that the in silico method for methionine oxidation liability assessment can aid in antibody discovery and development phase to address the liability in a more rational way. Copyright © 2018 American Pharmacists Association®. Published by Elsevier Inc. All rights reserved.

Multi-terminal Two-color ZnCdSe/ZnCdMgSe Based Quantum-well Infrared Photodetector

NASA Astrophysics Data System (ADS)

Kaya, Yasin; Ravikumar, Arvind; Chen, Guopeng; Tamargo, Maria C.; Shen, Aidong; Gmachl, Claire

Target recognition and identification applications benefits from two-color infrared (IR) detectors in the mid and long-wavelength IR regions. Currently, InGaAs/AlGaAs and GaAs/AlGaAs multiple quantum wells (QWs) grown on GaAs substrate are the most commonly used two-color QW IR photodetectors (QWIPs). However, the lattice-mismatch and the buildup of strain limit the number of QWs that can be grown, in turn increasing the dark current noise, and limiting the device detectivity.In this work, we report on two-color QWIPs based on the large conduction band offset (~1.12ev) ZnCdSe/ZnCdMgSe material system lattice matched to InP. QWIPs were designed based on a bound to quasi-bound transition, centered at 4 μm and 7 μm and each QW is repeated 50 times to eliminate the high dark current and a contact layer is inserted between the two stacks of QWs for independent electrical contacts. Wafers are processed into two step rectangular mesas by lithography and wet etching. Experiments showed absorption spectra centered at 4.9 μm and 7.6 μm at 80 K and the full width at half maximums were Δλ / λ = 21 % and Δλ / λ = 23 % , respectively. Current work studies the Johnson and the background noise limited detectivities of these QWIPs. Current address: School of Earth, Energy and Environmental Sciences, Stanford, CA 94305, USA.

Total Pancreatectomy With Islet Autotransplantation

PubMed Central

Bellin, Melena D.; Gelrud, Andres; Arreaza-Rubin, Guillermo; Dunn, Ty B.; Humar, Abhinav; Morgan, Katherine A.; Naziruddin, Bashoo; Rastellini, Cristiana; Rickels, Michael R.; Schwarzenberg, Sarah J.; Andersen, Dana K.

2015-01-01

A workshop sponsored by the National Institute of Diabetes and Digestive and Kidney Diseases focused on research gaps and opportunities in total pancreatectomy with islet autotransplantation (TPIAT) for the management of chronic pancreatitis. The session was held on July 23, 2014 and structured into 5 sessions: (1) patient selection, indications, and timing; (2) technical aspects of TPIAT; (3) improving success of islet autotransplantation; (4) improving outcomes after total pancreatectomy; and (5) registry considerations for TPIAT. The current state of knowledge was reviewed; knowledge gaps and research needs were specifically highlighted. Common themes included the need to identify which patients best benefit from and when to intervene with TPIAT, current limitations of the surgical procedure, diabetes remission and the potential for improvement, opportunities to better address pain remission, GI complications in this population, and unique features of children with chronic pancreatitis considered for TPIAT. The need for a multicenter patient registry that specifically addresses the complexities of chronic pancreatitis and total pancreatectomy outcomes and postsurgical diabetes outcomes was repeatedly emphasized. PMID:25599324

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.

Building systemic capacity for nutrition: training towards a professionalised workforce for Africa.

PubMed

Ellahi, Basma; Annan, Reginald; Sarkar, Swrajit; Amuna, Paul; Jackson, Alan A

2015-11-01

The fundamental role played by good nutrition in enabling personal, social and economic development is now widely recognised as presenting a fundamental global challenge that has to be addressed if major national and international problems are to be resolved in the coming decades. The recent focus provided by the Millennium Development Goals and the Scaling-Up-Nutrition (SUN) movement has been towards reducing the extent of nutrition-related malnutrition in high-burden countries. This has served to emphasise that there is a problem of inadequate professional capacity in nutrition that is sufficiently widespread to severely limit all attempts at the effective delivery and sustainability of nutrition-related and nutrition-enabling interventions that have impact at scale. Many high-burden countries are in sub-Saharan Africa where there is a high dependency on external technical support to address nutrition-related problems. We have sought to explore the nature and magnitude of the capacity needs with a particular focus on achieving levels of competency within standardised professional pre-service training which is fit-for-purpose to meet the objectives within the SUN movement in Africa. We review our experience of engaging with stakeholders through workshops, a gap analysis of the extent of the problem to be addressed, and a review of current efforts in Africa to move the agenda forward. We conclude that there are high aspirations but severely limited human resource and capacity for training that is fit-for-purpose at all skill levels in nutrition-related subjects in Africa. There are no structured or collaborative plans within professional groups to address the wide gap between what is currently available, the ongoing needs and the future expectations for meeting local technical and professional capability. Programmatic initiatives encouraged by agencies and other external players, will need to be matched by improved local capabilities to address the serious efforts required to meet the needs for sustained improvements related to SUN in high-burden countries. Importantly, there are pockets of effort which need to be encouraged within a context in which experience can be shared and mutual support provided.

Methodological issues associated with clinical trials in epilepsy.

PubMed

Ferlazzo, Edoardo; Sueri, Chiara; Gasparini, Sara; Russo, Emilio; Cianci, Vittoria; Ascoli, Michele; De Sarro, Giovambattista; Aguglia, Umberto

2017-10-01

despite methodological advances in epilepsy clinical trials, the proportion of patients reaching seizure-freedom has not substantially changed over the years. We review the main methodological limitations of current trials, the possible strategies to overcome these limits, and the issues that need to be addressed in next future. Area covered: references were identified by PubMed search until March 2017 and unpublished literature was searched on ClinicalTrials.gov. Add-on trials mainly involve refractory epilepsy subjects, reducing overall response to the investigational drug. The inclusion of subjects with earlier disease from less developed countries has partially allowed overcoming this limitation, but has introduced more random variability of results. Monotherapy trials rise methodological, economical, and ethical concerns with different regulatory requirements in European Union and in the United States of America. Newer trial designs, such as futility trials or 'time-to-event' design, have been implemented. Moreover, both add-on and monotherapy trials results might be affected by patient's ability to recognize and record seizures, and by randomness of seizures occurrence over time. Possible strategies to achieve more reliable outcomes are detailed. Expert commentary: clinical trial methodology needs to be optimized to better address regulatory agencies requirements and to encounter both patients' and clinicians' needs.

Principles of treatment for vaccine-associated sarcomas.

PubMed

Novosad, C Andrew

2003-05-01

In the last decade, there has been a great deal of information surrounding the etiology, diagnosis, and treatment of feline vaccine-associated sarcomas. The presence of a mass in areas used for subcutaneous or intramuscular injections should alert the clinician to the possibility of a vaccine-associated sarcoma. Early detection and subsequent treatment is paramount to limit local invasion and distant metastasis. The current data are suggesting that a team approach with multi-modality therapy is the appropriate way to address this disease. In the following article, we will discuss the history/incidence, pathology, diagnosis, and current treatment options, which include a combination of surgery, radiation, and chemotherapy for vaccine-associated sarcomas.

Debris in the geostationary orbit ring, the endless shooting gallery: The necessity for a disposal policy

NASA Technical Reports Server (NTRS)

Suddeth, D. H.

1985-01-01

NASA is considering establishing a policy for the limitation of the physical crowding of the geostationary orbit. The proposed policy is intended to address the following issues: (1) deal only with geostationary altitudes; (2) illustrate the unique value and usefulness of the geostationary orbit ring; (3) describe the orbital dynamics as simply as possible; (4) describe the current spacecraft and debris situation; (5) briefly review current industry and agency policies; (6) project future trends of physical crowding with the present nonpolicy; (7) propose solutions that can be implemented in the near future; and (8) use previous work as much as desirable.

Development of a handheld smart dental instrument for root canal imaging

NASA Astrophysics Data System (ADS)

Okoro, Chukwuemeka; Vartanian, Albert; Toussaint, , Kimani C., Jr.

2016-11-01

Ergonomics and ease of visualization play a major role in the effectiveness of endodontic therapy. Using only commercial off-the-shelf components, we present the pulpascope-a prototype of a compact, handheld, wireless dental instrument for pulp cavity imaging. This instrument addresses the current limitations of occupational injuries, size, and cost that exist with current endodontic microscopes used for root canal procedures. Utilizing a 15,000 coherent, imaging fiber bundle along with an integrated illumination source and wireless CMOS sensor, we demonstrate images of various teeth with resolution of ˜48 μm and angular field-of-view of 70 deg.

Editorial introduction.

PubMed

Gelso, Charles J

2007-09-01

Introduces the special section in the current issue of Psychotherapy: Theory, Research, Practice, Training. This section contains a reprint of Carl R. Rogers' (1957) seminal paper on the necessary and sufficient conditions for constructive personality change, as well as 11 reaction papers from some of the best psychotherapy theoreticians and researchers of our time. The reaction papers address the impact of Rogers' paper on the field of psychotherapy in general and therapy of the commenter's persuasion in particular, limitations of Rogers' viewpoints, the most important and enduring aspects of Rogers' theoretical statement, and how Rogers' ideas may exhibit themselves directly and indirectly in the current psychotherapy scene. (PsycINFO Database Record (c) 2010 APA, all rights reserved).

Can informed consent to research be adapted to risk?

PubMed

Bromwich, Danielle; Rid, Annette

2015-07-01

The current ethical and regulatory framework for research is often charged with burdening investigators and impeding socially valuable research. To address these concerns, a growing number of research ethicists argue that informed consent should be adapted to the risks of research participation. This would require less rigorous consent standards in low-risk research than in high-risk research. However, the current discussion is restricted to cases of research in which the risks of research participation are outweighed by the potential clinical benefits for the individual research participant. Furthermore, current proposals do not address the concern that risk-adapted informed consent may result in enrolling participants into research without their autonomous authorisation. In this paper, we show how the standard view of informed consent--consent as autonomous authorisation--can be adapted to risk even when the research does not have a favourable risk-benefit profile for the participant. Our argument has two important implications: first, it implies that current and proposed consent standards are not adequately calibrated to risk and, second, that consent standards also need to be adapted to factors other than risk. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Quantification of human motion: gait analysis-benefits and limitations to its application to clinical problems.

PubMed

Simon, Sheldon R

2004-12-01

The technology supporting the analysis of human motion has advanced dramatically. Past decades of locomotion research have provided us with significant knowledge about the accuracy of tests performed, the understanding of the process of human locomotion, and how clinical testing can be used to evaluate medical disorders and affect their treatment. Gait analysis is now recognized as clinically useful and financially reimbursable for some medical conditions. Yet, the routine clinical use of gait analysis has seen very limited growth. The issue of its clinical value is related to many factors, including the applicability of existing technology to addressing clinical problems; the limited use of such tests to address a wide variety of medical disorders; the manner in which gait laboratories are organized, tests are performed, and reports generated; and the clinical understanding and expectations of laboratory results. Clinical use is most hampered by the length of time and costs required for performing a study and interpreting it. A "gait" report is lengthy, its data are not well understood, and it includes a clinical interpretation, all of which do not occur with other clinical tests. Current biotechnology research is seeking to address these problems by creating techniques to capture data rapidly, accurately, and efficiently, and to interpret such data by an assortment of modeling, statistical, wave interpretation, and artificial intelligence methodologies. The success of such efforts rests on both our technical abilities and communication between engineers and clinicians.

Characterization of Hollow Cathode Performance and Thermal Behavior

NASA Technical Reports Server (NTRS)

Polk, James E.; Goebel, Dan M.; Watkins, Ron; Jameson, Kristina; Yoneshige, Lance; Przybylowski, JoHanna; Cho, Lauren

2006-01-01

Hollow cathodes are one of the main life-limiting components in ion engines and Hall thrusters. Although state-of-the-art hollow cathodes have demonstrated up to 30,352 hours of operation in ground tests with careful handling, future missions are likely to require longer life, more margin and greater resistance to reactive contaminant gases. Three alternate hollow cathode technologies that exploit different emitter materials or geometries to address some of the limitations of state-of-the-art cathodes are being investigated. Performance measurements of impregnated tungsten-iridium dispenser cathodes at discharge currents of 4 to 15 A demonstrated that they have the same operating range and ion production efficiency as conventional tungsten dispenser cathodes. Temperature measurements indicated that tungsten-iridium cathodes also operate at the same emitter temperatures. They did not exhibit the expected reduction in work function at the current densities tested. Hollow cathodes with lanthanum hexaboride emitters operated over a wide current range, but suffered from lower ion production efficiency at currents below about 12.4 A because of higher insert heating requirements. Differences in operating voltages and ion production rates are explained with a simple model of the effect of cathode parameters on discharge behavior.

Current practice of microsurgery by members of the American Society for Surgery of the Hand.

PubMed

Payatakes, Alexander H; Zagoreos, Nikolaos P; Fedorcik, Gregory G; Ruch, David S; Levin, L Scott

2007-04-01

First, to determine the percentage of members of the American Society for Surgery of the Hand (ASSH) that use microsurgical techniques as part of their surgery practice, and second, to identify factors limiting their use of these techniques. A 34-item, anonymous, Web-based survey was sent to all active ASSH members. Twelve items concerned demographics and 22 items addressed prior microsurgical training, current use of these techniques, factors currently limiting their use of these techniques, and potential methods to address these limiting factors. Responses were received from 561 of 1,238 of the ASSH members contacted (45% response rate). Most had residency training in orthopedics (N=460, 82%) or plastic surgery (N=79, 14%), followed by a hand fellowship in an orthopedic (N=363, 62%) or combined program (N=170, 30%). More than 54% (N=304) practiced privately, 33% (N=184) practiced in tertiary institutions, and the remainder practiced at regional centers. Of those responding, 505 (90%) stated that hand surgery constituted more than 50% of their practice, whereas for 527 (94%) respondents microsurgery comprised less than 25%. Most members (N=398, 71%) accepted emergency patients, of which 223 (56%) at a referral center. Three hundred sixteen respondents (56%) performed replantations, of whom 196 (62%) performed fewer than 5 per year. Four hundred fifteen respondents (74%) observed a decrease in replantation attempts over the past decade. This was attributed to refinement of indications (N=17, 83%), fewer patients with amputations (N=116, 28%), and declining reimbursement (N=344, 4%). Reasons for not personally performing replantations included busy elective schedules (N=125, 51%), inadequate confidence in performing replantations (N=96, 39%), and disappointment in results (N=56, 23%). Thirty percent (N=74) stated they would reconsider performing replantations if reimbursement was greater. Practice rates of examined microsurgical procedures ranged from 22% to 57%, although most had received microsurgical training. Despite rating their fellowship as excellent (N=393, 70%) or good (N=135, 24%), only 315 (56%) considered their present microsurgical skills to be above average. Many respondents believed that they would benefit from continuous training through continuing education courses. Educational, economic, and practical factors discourage the clinical application of microsurgical technique by hand surgeons. This unfavorable environment should be addressed by policy-making organizations and continuous surgical training. Other/Survey.

Ultra-processed foods and the limits of product reformulation.

PubMed

Scrinis, Gyorgy; Monteiro, Carlos Augusto

2018-01-01

The nutritional reformulation of processed food and beverage products has been promoted as an important means of addressing the nutritional imbalances in contemporary dietary patterns. The focus of most reformulation policies is the reduction in quantities of nutrients-to-limit - Na, free sugars, SFA, trans-fatty acids and total energy. The present commentary examines the limitations of what we refer to as 'nutrients-to-limit reformulation' policies and practices, particularly when applied to ultra-processed foods and drink products. Beyond these nutrients-to-limit, there are a range of other potentially harmful processed and industrially produced ingredients used in the production of ultra-processed products that are not usually removed during reformulation. The sources of nutrients-to-limit in these products may be replaced with other highly processed ingredients and additives, rather than with whole or minimally processed foods. Reformulation policies may also legitimise current levels of consumption of ultra-processed products in high-income countries and increased levels of consumption in emerging markets in the global South.

A 0.2 V Micro-Electromechanical Switch Enabled by a Phase Transition.

PubMed

Dong, Kaichen; Choe, Hwan Sung; Wang, Xi; Liu, Huili; Saha, Bivas; Ko, Changhyun; Deng, Yang; Tom, Kyle B; Lou, Shuai; Wang, Letian; Grigoropoulos, Costas P; You, Zheng; Yao, Jie; Wu, Junqiao

2018-04-01

Micro-electromechanical (MEM) switches, with advantages such as quasi-zero leakage current, emerge as attractive candidates for overcoming the physical limits of complementary metal-oxide semiconductor (CMOS) devices. To practically integrate MEM switches into CMOS circuits, two major challenges must be addressed: sub 1 V operating voltage to match the voltage levels in current circuit systems and being able to deliver at least millions of operating cycles. However, existing sub 1 V mechanical switches are mostly subject to significant body bias and/or limited lifetimes, thus failing to meet both limitations simultaneously. Here 0.2 V MEM switching devices with ≳10 6 safe operating cycles in ambient air are reported, which achieve the lowest operating voltage in mechanical switches without body bias reported to date. The ultralow operating voltage is mainly enabled by the abrupt phase transition of nanolayered vanadium dioxide (VO 2 ) slightly above room temperature. The phase-transition MEM switches open possibilities for sub 1 V hybrid integrated devices/circuits/systems, as well as ultralow power consumption sensors for Internet of Things applications. © 2018 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

GlobTherm, a global database on thermal tolerances for aquatic and terrestrial organisms.

PubMed

Bennett, Joanne M; Calosi, Piero; Clusella-Trullas, Susana; Martínez, Brezo; Sunday, Jennifer; Algar, Adam C; Araújo, Miguel B; Hawkins, Bradford A; Keith, Sally; Kühn, Ingolf; Rahbek, Carsten; Rodríguez, Laura; Singer, Alexander; Villalobos, Fabricio; Ángel Olalla-Tárraga, Miguel; Morales-Castilla, Ignacio

2018-03-13

How climate affects species distributions is a longstanding question receiving renewed interest owing to the need to predict the impacts of global warming on biodiversity. Is climate change forcing species to live near their critical thermal limits? Are these limits likely to change through natural selection? These and other important questions can be addressed with models relating geographical distributions of species with climate data, but inferences made with these models are highly contingent on non-climatic factors such as biotic interactions. Improved understanding of climate change effects on species will require extensive analysis of thermal physiological traits, but such data are both scarce and scattered. To overcome current limitations, we created the GlobTherm database. The database contains experimentally derived species' thermal tolerance data currently comprising over 2,000 species of terrestrial, freshwater, intertidal and marine multicellular algae, plants, fungi, and animals. The GlobTherm database will be maintained and curated by iDiv with the aim to keep expanding it, and enable further investigations on the effects of climate on the distribution of life on Earth.

Effect of hysteretic and non-hysteretic negative capacitance on tunnel FETs DC performance

NASA Astrophysics Data System (ADS)

Saeidi, Ali; Jazaeri, Farzan; Stolichnov, Igor; Luong, Gia V.; Zhao, Qing-Tai; Mantl, Siegfried; Ionescu, Adrian M.

2018-03-01

This work experimentally demonstrates that the negative capacitance effect can be used to significantly improve the key figures of merit of tunnel field effect transistor (FET) switches. In the proposed approach, a matching condition is fulfilled between a trained-polycrystalline PZT capacitor and the tunnel FET (TFET) gate capacitance fabricated on a strained silicon-nanowire technology. We report a non-hysteretic switch configuration by combining a homojunction TFET and a negative capacitance effect booster, suitable for logic applications, for which the on-current is increased by a factor of 100, the transconductance by 2 orders of magnitude, and the low swing region is extended. The operation of a hysteretic negative capacitance TFET, when the matching condition for the negative capacitance is fulfilled only in a limited region of operation, is also reported and discussed. In this late case, a limited improvement in the device performance is observed. Overall, the paper demonstrates the main beneficial effects of negative capacitance on TFETs are the overdrive and transconductance amplification, which exactly address the most limiting performances of current TFETs.

Mesenchymal stem cell therapy for acute radiation syndrome: innovative medical approaches in military medicine.

PubMed

Eaton, Erik B; Varney, Timothy R

2015-01-01

After a radiological or nuclear event, acute radiation syndrome (ARS) will present complex medical challenges that could involve the treatment of hundreds to thousands of patients. Current medical doctrine is based on limited clinical data and remains inadequate. Efforts to develop medical innovations that address ARS complications are unlikely to be generated by industry because of market uncertainties specific to this type of injury. A prospective strategy could be the integration of cellular therapy to meet the medical demands of ARS. The most clinically advanced cellular therapy to date is the administration of mesenchymal stem cells (MSCs). Results of currently published investigations describing MSC safety and efficacy in a variety of injury and disease models demonstrate the unique qualities of this reparative cell population in adapting to the specific requirements of the damaged tissue in which the cells integrate. This report puts forward a rationale for the further evaluation of MSC therapy to address the current unmet medical needs of ARS. We propose that the exploration of this novel therapy for the treatment of the multivariate complications of ARS could be of invaluable benefit to military medicine.

Current knowledge and trends in age-related macular degeneration: today's and future treatments.

PubMed

Velez-Montoya, Raul; Oliver, Scott C N; Olson, Jeffrey L; Fine, Stuart L; Mandava, Naresh; Quiroz-Mercado, Hugo

2013-09-01

To address the most dynamic and current issues concerning today's treatment options and promising research efforts regarding treatment for age-related macular degeneration. This review is aimed to serve as a practical reference for more in-depth reviews on the subject. An online review of the database PubMed and Ovid were performed, searching for the key words age-related macular degeneration, AMD, VEGF, treatment, PDT, steroids, bevacizumab, ranibizumab, VEGF-trap, radiation, combined therapy, as well as their compound phrases. The search was limited to articles published since 1985. All returned articles were carefully screened, and their references were manually reviewed for additional relevant data. The web page www.clinicaltrials.gov was also accessed in search of relevant research trials. A total of 363 articles were reviewed, including 64 additional articles extracted from the references. At the end, only 160 references were included in this review. Treatment for age-related macular degeneration is a very dynamic research field. While current treatments are mainly aimed at blocking vascular endothelial growth factor, future treatments seek to prevent vision loss because of scarring. Promising efforts have been made to address the dry form of the disease, which has lacked effective treatment.

Current Priorities for Public Health Practice in Addressing the Role of Human Genomics in Improving Population Health

PubMed Central

Khoury, Muin J.; Bowen, Michael S.; Burke, Wylie; Coates, Ralph J.; Dowling, Nicole F.; Evans, James P.; Reyes, Michele; St. Pierre, Jeannette

2017-01-01

In spite of accelerating human genome discoveries in a wide variety of diseases of public health significance, the promise of personalized health care and disease prevention based on genomics has lagged behind. In a time of limited resources, public health agencies must continue to focus on implementing programs that can improve health and prevent disease now. Nevertheless, public health has an important and assertive leadership role in addressing the promise and pitfalls of human genomics for population health. Such efforts are needed not only to implement what is known in genomics to improve health but also to reduce potential harm and create the infrastructure needed to derive health benefits in the future. PMID:21406285

Could virtual reality be effective in treating children with phobias?

PubMed

Bouchard, Stéphane

2011-02-01

The use of virtual reality to treat anxiety disorders in adults is gaining popularity and its efficacy is supported by numerous outcome studies. Similar research for children is lagging behind. The outcome studies on the use of virtual reality to treat anxiety disorders in children currently address only specific phobias, and all of the available trials are reviewed in this article. Despite the limited number of studies, results are very encouraging for the treatment of school and spider phobias. A study with adolescents suggests that, at least for social anxiety, exposure stimuli would be more effective if they were developed specifically for younger populations. Virtual reality may not increase children's motivation towards therapy unless their fearful apprehension is addressed before initiating the treatment.

Reservoir Stimulation Optimization with Operational Monitoring for Creation of EGS

DOE Data Explorer

Fernandez, Carlos A.

2013-09-25

EGS field projects have not sustained production at rates greater than ½ of what is needed for economic viability. The primary limitation that makes commercial EGS infeasible is our current inability to cost-effectively create high-permeability reservoirs from impermeable, igneous rock within the 3,000-10,000 ft depth range. Our goal is to develop a novel fracturing fluid technology that maximizes reservoir permeability while reducing stimulation cost and environmental impact. Laboratory equipment development to advance laboratory characterization/monitoring is also a priority of this project to study and optimize the physicochemical properties of these fracturing fluids in a range of reservoir conditions. Barrier G is the primarily intended GTO barrier to be addressed as well as support addressing barriers D, E and I.

Reservoir Stimulation Optimization with Operational Monitoring for Creation of EGS

DOE Data Explorer

Carlos A. Fernandez

2014-09-15

EGS field projects have not sustained production at rates greater than ½ of what is needed for economic viability. The primary limitation that makes commercial EGS infeasible is our current inability to cost-effectively create high-permeability reservoirs from impermeable, igneous rock within the 3,000-10,000 ft depth range. Our goal is to develop a novel fracturing fluid technology that maximizes reservoir permeability while reducing stimulation cost and environmental impact. Laboratory equipment development to advance laboratory characterization/monitoring is also a priority of this project to study and optimize the physicochemical properties of these fracturing fluids in a range of reservoir conditions. Barrier G is the primarily intended GTO barrier to be addressed as well as support addressing barriers D, E and I.

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...

Model for Predicting Passage of Invasive Fish Species Through Culverts

NASA Astrophysics Data System (ADS)

Neary, V.

2010-12-01

Conservation efforts to promote or inhibit fish passage include the application of simple fish passage models to determine whether an open channel flow allows passage of a given fish species. Derivations of simple fish passage models for uniform and nonuniform flow conditions are presented. For uniform flow conditions, a model equation is developed that predicts the mean-current velocity threshold in a fishway, or velocity barrier, which causes exhaustion at a given maximum distance of ascent. The derivation of a simple expression for this exhaustion-threshold (ET) passage model is presented using kinematic principles coupled with fatigue curves for threatened and endangered fish species. Mean current velocities at or above the threshold predict failure to pass. Mean current velocities below the threshold predict successful passage. The model is therefore intuitive and easily applied to predict passage or exclusion. The ET model’s simplicity comes with limitations, however, including its application only to uniform flow, which is rarely found in the field. This limitation is addressed by deriving a model that accounts for nonuniform conditions, including backwater profiles and drawdown curves. Comparison of these models with experimental data from volitional swimming studies of fish indicates reasonable performance, but limitations are still present due to the difficulty in predicting fish behavior and passage strategies that can vary among individuals and different fish species.

Limited antigenic variation in the Trypanosoma cruzi candidate vaccine antigen TSA-1.

PubMed

Knight, J M; Zingales, B; Bottazzi, M E; Hotez, P; Zhan, B

2014-12-01

Chagas disease (American trypanosomiasis caused by Trypanosoma cruzi) is one of the most important neglected tropical diseases in the Western Hemisphere. The toxicities and limited efficacies of current antitrypanosomal drugs have prompted a search for alternative technologies such as a therapeutic vaccine comprised of T. cruzi antigens, including a recombinant antigen encoding the N-terminal 65 kDa portion of Trypomastigote surface antigen-1 (TSA-1). With at least six known genetically distinct T. cruzi lineages, variability between the different lineages poses a unique challenge for the development of broadly effective therapeutic vaccine. The variability across the major lineages in the current vaccine candidate antigen TSA-1 has not previously been addressed. To assess the variation in TSA-1, we cloned and sequenced TSA-1 from several different T. cruzi strains representing three of the most clinically relevant lineages. Analysis of the different alleles showed limited variation in TSA-1 across the different strains and fit with the current theory for the evolution of the different lineages. Additionally, minimal variation in known antigenic epitopes for the HLA-A 02 allele suggests that interlineage variation in TSA-1 would not impair the range and efficacy of a vaccine containing TSA-1. © 2014 John Wiley & Sons Ltd.

Military Service, Deployments, and Exposures in Relation to Amyotrophic Lateral Sclerosis Etiology and Survival

PubMed Central

Beard, John D.; Kamel, Freya

2015-01-01

Rates of amyotrophic lateral sclerosis (ALS) have been reported to be higher among US military veterans, who currently number more than 21 million, but the causal factor(s) has not been identified. We conducted a review to examine the weight of evidence for associations between military service, deployments, and exposures and ALS etiology and survival. Thirty articles or abstracts published through 2013 were reviewed. Although the current evidence suggests a positive association with ALS etiology, it is too limited to draw firm conclusions regarding associations between military service and ALS etiology or survival. Some evidence suggests that deployment to the 1990–1991 Persian Gulf War may be associated with ALS etiology, but there is currently no strong evidence that any particular military exposure is associated with ALS etiology. Future studies should address the limitations of previous ones, such as reliance on mortality as a surrogate for incidence, a dearth of survival analyses, lack of clinical data, low statistical power, and limited exposure assessment. The Genes and Environmental Exposures in Veterans with Amyotrophic Lateral Sclerosis (GENEVA) Study is one such study, but additional research is needed to determine whether military-related factors are associated with ALS and to assess potential prevention strategies. PMID:25365170

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 action are largely determined at a systems level currently, and stakeholder engagement in this process is limited. Lack of consensus on an evidence-based definition for UCV remains a substantial barrier to progress in this field. © 2018 John Wiley & Sons, Ltd.

MFC Communications Infrastructure Study

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

Michael Cannon; Terry Barney; Gary Cook

2012-01-01

Unprecedented growth of required telecommunications services and telecommunications applications change the way the INL does business today. High speed connectivity compiled with a high demand for telephony and network services requires a robust communications infrastructure.   The current state of the MFC communication infrastructure limits growth opportunities of current and future communication infrastructure services. This limitation is largely due to equipment capacity issues, aging cabling infrastructure (external/internal fiber and copper cable) and inadequate space for telecommunication equipment. While some communication infrastructure improvements have been implemented over time projects, it has been completed without a clear overall plan and technology standard.more »   This document identifies critical deficiencies with the current state of the communication infrastructure in operation at the MFC facilities and provides an analysis to identify needs and deficiencies to be addressed in order to achieve target architectural standards as defined in STD-170. The intent of STD-170 is to provide a robust, flexible, long-term solution to make communications capabilities align with the INL mission and fit the various programmatic growth and expansion needs.« less

Programmable Logic Controllers for Research on the Cyber Security of Industrial Power Plants

DTIC Science & Technology

2017-02-12

group . 15. SUBJECT TERMS Industrial control systems, cyber security 16. SECURITY CLASSIFICATION OF: 17. LIMITATION OF a. REPORT b. ABSTRACT c. THIS...currently valid OMB control number. PLEASE DO NOT RETURN YOUR FORM TO THE ABOVE ADDRESS. 1. REPORT DATE (00-MM-YYYY) ,2. REPORT TYPE 3. DATES COVERED...From- To) 12/02/2017 Final 15 August 2015 - 12 February 2017 4. TITLE AND SUBTITLE Sa. CONTRACT NUMBER Programmable Logic Controllers for Research

School Holiday Food Provision in the UK: A Qualitative Investigation of Needs, Benefits, and Potential for Development

PubMed Central

Graham, Pamela Louise; Crilley, Eilish; Stretesky, Paul B.; Long, Michael A.; Palmer, Katie Jane; Steinbock, Eileen; Defeyter, Margaret Anne

2016-01-01

Access to an adequate supply of nutritious food has been recognized as a basic human right. However, many families across the UK face food insecurity, which is thought to be exacerbated during school holidays. To address this issue, some schools and community groups have chosen to roll out holiday clubs, though research into the effectiveness of such interventions is limited and no studies to date have evaluated holiday clubs being organized through schools. In an effort to address some of the limitations in the research literature, the current qualitative investigation utilized semi-structured interviews with staff involved in holiday clubs in school and community venues with the aim of gaging their views on the need for and benefits of holiday food provision in addition to potential areas for development. The investigation revealed that staff perceived many families to be facing food insecurity and isolation during the school holidays, which may be alleviated through holiday club provision. Holiday clubs were viewed as a valuable source of support for children and adults, providing food, activities, and learning experiences. Staff were keen to see them implemented on a wider scale in future but suggested some areas that require attention in any future development of such provision. Findings are discussed in relation to current research, policy, and practice surrounding the health and wellbeing of children and families. PMID:27597938

Sexual and reproductive health and rights and mHealth in policy and practice in South Africa.

PubMed

Waldman, Linda; Stevens, Marion

2015-05-01

Information and Communications Technology (ICT) offers enormous opportunity and innovation to improve public health and health systems.This paper explores the intersections between mHealth and sexual and reproductive health and rights in both policy and practice. It is a qualitative study, informed by policy review and key informant interviews. Three case studies provide evidence of what is happening on the ground in relation to ICTs and reproductive health and rights. We argue that in terms of policy, there is little overlap between health rights and communication technology. In the area of practice, however, significant interventions address aspects of reproductive health. At present, the extent to which mHealth addresses the full range of reproductive justice and sexual and reproductive health and rights is limited, particularly in terms of government initiatives. The paper argues that mHealth projects tend to avoid contentious aspects of sexual health, while addressing favourable topics such as pregnancy and motherhood. The ways in which information is framed in mHealth mirrors current gaps within sexual and reproductive health and rights, where a limited and conservative lens predominates, and which may result in narrow programming and implementation of services. Copyright © 2015. Published by Elsevier Ltd.

A limited-angle CT reconstruction method based on anisotropic TV minimization.

PubMed

Chen, Zhiqiang; Jin, Xin; Li, Liang; Wang, Ge

2013-04-07

This paper presents a compressed sensing (CS)-inspired reconstruction method for limited-angle computed tomography (CT). Currently, CS-inspired CT reconstructions are often performed by minimizing the total variation (TV) of a CT image subject to data consistency. A key to obtaining high image quality is to optimize the balance between TV-based smoothing and data fidelity. In the case of the limited-angle CT problem, the strength of data consistency is angularly varying. For example, given a parallel beam of x-rays, information extracted in the Fourier domain is mostly orthogonal to the direction of x-rays, while little is probed otherwise. However, the TV minimization process is isotropic, suggesting that it is unfit for limited-angle CT. Here we introduce an anisotropic TV minimization method to address this challenge. The advantage of our approach is demonstrated in numerical simulation with both phantom and real CT images, relative to the TV-based reconstruction.

Energy Harvesting for Structural Health Monitoring Sensor Networks

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

Park, G.; Farrar, C. R.; Todd, M. D.

2007-02-26

This report has been developed based on information exchanges at a 2.5-day workshop on energy harvesting for embedded structural health monitoring (SHM) sensing systems that was held June 28-30, 2005, at Los Alamos National Laboratory. The workshop was hosted by the LANL/UCSD Engineering Institute (EI). This Institute is an education- and research-focused collaboration between Los Alamos National Laboratory (LANL) and the University of California, San Diego (UCSD), Jacobs School of Engineering. A Statistical Pattern Recognition paradigm for SHM is first presented and the concept of energy harvesting for embedded sensing systems is addressed with respect to the data acquisition portionmore » of this paradigm. Next, various existing and emerging sensing modalities used for SHM and their respective power requirements are summarized, followed by a discussion of SHM sensor network paradigms, power requirements for these networks and power optimization strategies. Various approaches to energy harvesting and energy storage are discussed and limitations associated with the current technology are addressed. This discussion also addresses current energy harvesting applications and system integration issues. The report concludes by defining some future research directions and possible technology demonstrations that are aimed at transitioning the concept of energy harvesting for embedded SHM sensing systems from laboratory research to field-deployed engineering prototypes.« less

Neighborhood Disparities in Access to Healthy Foods and Their Effects on Environmental Justice

PubMed Central

Dave, Jayna

2012-01-01

Environmental justice is concerned with an equitable distribution of environmental burdens. These burdens comprise immediate health hazards as well as subtle inequities, such as limited access to healthy foods. We reviewed the literature on neighborhood disparities in access to fast-food outlets and convenience stores. Low-income neighborhoods offered greater access to food sources that promote unhealthy eating. The distribution of fast-food outlets and convenience stores differed by the racial/ethnic characteristics of the neighborhood. Further research is needed to address the limitations of current studies, identify effective policy actions to achieve environmental justice, and evaluate intervention strategies to promote lifelong healthy eating habits, optimum health, and vibrant communities. PMID:22813465

New developments for the detection and treatment of cardiac vasculopathy.

PubMed

Clerkin, Kevin J; Ali, Ziad A; Mancini, Donna M

2017-02-15

Cardiac allograft vasculopathy (CAV) is a major limitation to long-term survival after heart transplantation. Innovative new techniques to diagnose CAV have been applied to detect disease. This review will examine the current diagnostic and treatment options available to clinicians for CAV. Diagnostic modalities addressing the pathophysiology underlying CAV (arterial wall thickening and decreased coronary blood flow) improve diagnostic sensitivity when compared to traditional (angiography and dobutamine stress echocardiography) techniques. Limited options are available to prevent and treat CAV; however, progress has been made in making an earlier and more accurate diagnosis. Future research is needed to identify the optimal time to modify immunosuppression and investigate novel treatments for CAV.

Interdisciplinary Postdoctoral Training in Global Health Through a Novel Joint Project for Trainees from Diverse Disciplines: Benefits, Risks, and Observations.

PubMed

Oberhelman, Richard A; Huaynate, Cynthia Anticona; Correa, Malena; Malpartida, Holger Mayta; Pajuelo, Monica; Paz-Soldan, Valerie A; Gilman, Robert H; Zimic, Mirko; Murphy, Laura; Belizan, Jose

2017-03-01

Postdoctoral training programs are usually highly individualized arrangements between trainees and a limited number of senior mentors in their field, an approach that contrasts with current trends in public health education that promote interdisciplinary training to spur innovation. Herein, we describe an alternative model for postdoctoral training for a group of fellows from distinct disciplines. Fellows work with mentors from diverse fields to create a joint research project or a group of complementary projects, with the goal of developing a new device, intervention, or innovation to address a global health problem. The perceived benefits, challenges, and limitations of this team approach to interdisciplinary postdoctoral training are presented.

Management of uncommon disorders in pregnancy: Von Hippel-Lindau disease, Gitelman syndrome, and Nutcracker syndrome.

PubMed

Merhi, Basma; Miller, Margaret; Lanis, Aviya; Katz, Brittany; Hsu, Tiffany; Tong, Iris

2017-09-01

Uncommon renal disorders in pregnancy can be challenging to manage given limited evidence in the literature to guide management. We present a series of three uncommon renal disorders in pregnancy: Von Hippel-Lindau disease, Gitelman syndrome, and Nutcracker syndrome. Previously published case reports with differing outcomes offer some guidance to the management of these disorders in pregnancy. In this case series, we address the management of these syndromes during pregnancy and discuss the maternal and fetal outcomes. All three of our patients had good maternal and fetal outcomes, which will contribute to current data on maternal and fetal outcomes in these rare diseases, which is limited.

Inductive-capacitive resonant circuit sensors for structural health and environmental monitoring

NASA Astrophysics Data System (ADS)

DeRouin, Andrew J.

Inductive-capacitive (LC) sensors are low-cost, wireless, durable, simple to fabricate and battery-less. Consequently, they are well suited to sensing applications in harsh environments or where large numbers of sensors are needed. Due to their many advantages, LC sensors have been used for sensing a variety of parameters including humidity, temperature, chemical concentrations, pH, stress/pressure, strain, food quality and even biological growth. However, current versions of the LC sensor technology are limited to sensing only one parameter. This work focuses on the development and characterization of two new sensor designs that address this limitation in addition to significantly reducing the overall sensor footprint and thus the sensor unit cost.

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

Duro, Francisco Rodrigo; Blas, Javier Garcia; Isaila, Florin

The increasing volume of scientific data and the limited scalability and performance of storage systems are currently presenting a significant limitation for the productivity of the scientific workflows running on both high-performance computing (HPC) and cloud platforms. Clearly needed is better integration of storage systems and workflow engines to address this problem. This paper presents and evaluates a novel solution that leverages codesign principles for integrating Hercules—an in-memory data store—with a workflow management system. We consider four main aspects: workflow representation, task scheduling, task placement, and task termination. As a result, the experimental evaluation on both cloud and HPC systemsmore » demonstrates significant performance and scalability improvements over existing state-of-the-art approaches.« less

Digital Social Media, Youth, and Nonmedical Use of Prescription Drugs: The Need for Reform

PubMed Central

Liang, Bryan A; Strathdee, Steffanie A

2013-01-01

The tragic death of 18-year-old Ryan Haight highlighted the ethical, public health, and youth patient safety concerns posed by illicit online nonmedical use of prescription drugs (NUPM) sourcing, leading to a federal law in an effort to address this concern. Yet despite the tragedy and resulting law, the NUPM epidemic in the United States has continued to escalate and represents a dangerous and growing trend among youth and adolescents. A critical point of access associated with youth NUPM is the Internet. Internet use among this vulnerable patient group is ubiquitous and includes new, emerging, and rapidly developing technologies—particularly social media networking (eg, Facebook and Twitter). These unregulated technologies may pose a potential risk for enabling youth NUPM behavior. In order to address limitations of current regulations and promote online safety, we advocate for legislative reform to specifically address NUPM promotion via social media and other new online platforms. Using more comprehensive and modernized federal legislation that anticipates future online developments is critical in substantively addressing youth NUPM behavior occurring through the Internet. PMID:23892156

Perceptions and Practices of Mass Bat Exposure Events in the Setting of Rabies Among U.S. Public Health Agencies

PubMed Central

Hsu, C. H.; Brown, C. M.; Murphy, J. M.; Haskell, M. G.; Williams, C.; Feldman, K.; Mitchell, K.; Blanton, J. D.; Petersen, B. W.; Wallace, R. M.

2017-01-01

Summary Current guidelines in the setting of exposures to potentially rabid bats established by the Advisory Committee on Immunization Practices (ACIP) address post-exposure prophylaxis (PEP) administration in situations where a person may not be aware that a bite or direct contact has occurred and the bat is not available for diagnostic testing. These include instances when a bat is discovered in a room where a person awakens from sleep, is a child without an adult witness, has a mental disability or is intoxicated. The current ACIP guidelines, however, do not address PEP in the setting of multiple persons exposed to a bat or a bat colony, otherwise known as mass bat exposure (MBE) events. Due to a dearth of recommendations for response to these events, the reported reactions by public health agencies have varied widely. To address this perceived limitation, a survey of 45 state public health agencies was conducted to characterize prior experiences with MBE and practices to mitigate the public health risks. In general, most states (69% of the respondents) felt current ACIP guidelines were unclear in MBE scenarios. Thirty-three of the 45 states reported prior experience with MBE, receiving an average of 16.9 MBE calls per year and an investment of 106.7 person-hours annually on MBE investigations. PEP criteria, investigation methods and the experts recruited in MBE investigations varied between states. These dissimilarities could reflect differences in experience, scenario and resources. The lack of consistency in state responses to potential mass exposures to a highly fatal disease along with the large contingent of states dissatisfied with current ACIP guidance warrants the development of national guidelines in MBE settings. PMID:27389926

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.

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...

Group 1: Scenario design and development issues

NASA Technical Reports Server (NTRS)

Sherwin, P.

1981-01-01

All LOFT scenarios and flight segments should be designed on the basis of a detailed statement of specific objectives. These objectives must state what kind of situation is to be addressed and why. The origin, routing, and destination of a particular scenario should be dictated by the specific objectives for that scenario or leg. Other factors to be considered are the desired weather, climate, etc. Simulator visual system, as well as other capabilities and limitations must be considered at a very early stage of scenario design. The simulator navigation area must be apropriate and must coincide with current Jeppeson charts. Much of the realism of LOFT is destroyed if the crew is unable to use current manuals and other materials.

Resveratrol and Alzheimer's Disease: Mechanistic Insights.

PubMed

Ahmed, Touqeer; Javed, Sehrish; Javed, Sana; Tariq, Ameema; Šamec, Dunja; Tejada, Silvia; Nabavi, Seyed Fazel; Braidy, Nady; Nabavi, Seyed Mohammad

2017-05-01

Alzheimer's disease (AD) is the leading cause of dementia in the elderly and is characterized by progressive cognitive and memory deficits. The pathological hallmarks of AD include extracellular senile plaques and intracellular neurofibrillary tangles. Although several mechanisms have been used to explain the underlying pathogenesis of AD, current treatment regimens remain inadequate. The neuroprotective effects of the polyphenolic stilbene resveratrol (3,5,4'-trihydroxy-trans-stilbene) have been investigated in several in vitro and in vivo models of AD. The current review discusses the multiple potential mechanisms of action of resveratrol on the pathobiology of AD. Moreover, due to the limited pharmacokinetic parameters of resveratrol, multiple strategies aimed at increasing the bioavailability of resveratrol have also been addressed.

Supporting the information domains of fall-risk management in home care via health information technology.

PubMed

Alhuwail, Dari; Koru, Güneş; Mills, Mary Etta

2016-01-01

In the United States, home care clinicians often start the episode of care devoid of relevant fall-risk information. By collecting and analyzing qualitative data from 30 clinicians in one home health agency, this case study aimed to understand how the currently adopted information technology solutions supported the clinicians' fall-risk management (FRM) information domains, and explored opportunities to adopt other solutions to better support FRM. The currently adopted electronic health record system and fall-reporting application served only some information domains with a limited capacity. Substantial improvement in addressing the FRM information domains is possible by effectively modifying the existing solutions and purposefully adopting new solutions.

Evidence-Based Strategies for Preserving Mobility for Elderly and Aging Manual Wheelchair Users

PubMed Central

Requejo, Philip S.; Furumasu, Jan; Mulroy, Sara J.

2015-01-01

Elderly and aging manual wheelchair (MWC) users have increased risk for accelerated loss of function and mobility that greatly limits independence and affects quality of life. This review paper addresses important issues for preserving function and mobility for elderly and aging individuals who use a MWC by presenting the current available evidence and recommendations. These include recommendations for maximizing function, by decreasing pain, improving the ability to self-propel, and prolonging mobility and endurance through ergonomics, individualized wheelchair selection and configuration, and adaptations for increasing the capacity to handle the daily mobility demands through training, strengthening, and exercise. Each recommendation is supported by current research in each relevant area. PMID:26366040

Adjuvant treatment of stage IB NSCLC: the problem of stage subset heterogeneity.

PubMed

Calhoun, Royce; Jablons, David; Lau, Derick; Gandara, David R

2008-04-30

While 5-year survival rates in patients with stage IB non-small-cell lung cancer (NSCLC) are historically modest (40% to 67%), adjuvant chemotherapy trials including this subgroup have shown little evidence of chemotherapeutic benefit. This article reviews the available data regarding adjuvant chemotherapy following surgically resected stage IB NSCLC, framed within the context of present and future proposed definitions of this diagnosis. The discussion addresses limitations of the current staging system and how this contributes to the mixed results seen with adjuvant treatment. In addition, the authors consider current treatment options for stage IB NSCLC and review planned clinical trials for stage I disease designed to exploit new pharmacogenomic findings.

100 years of the physics of diodes

NASA Astrophysics Data System (ADS)

Zhang, Peng; Valfells, Ágúst; Ang, L. K.; Luginsland, J. W.; Lau, Y. Y.

2017-03-01

The Child-Langmuir Law (CL), discovered a century ago, gives the maximum current that can be transported across a planar diode in the steady state. As a quintessential example of the impact of space charge shielding near a charged surface, it is central to the studies of high current diodes, such as high power microwave sources, vacuum microelectronics, electron and ion sources, and high current drivers used in high energy density physics experiments. CL remains a touchstone of fundamental sheath physics, including contemporary studies of nanoscale quantum diodes and nano gap based plasmonic devices. Its solid state analog is the Mott-Gurney law, governing the maximum charge injection in solids, such as organic materials and other dielectrics, which is important to energy devices, such as solar cells and light emitting diodes. This paper reviews the important advances in the physics of diodes since the discovery of CL, including virtual cathode formation and extension of CL to multiple dimensions, to the quantum regime, and to ultrafast processes. We review the influence of magnetic fields, multiple species in bipolar flow, electromagnetic and time dependent effects in both short pulse and high frequency THz limits, and single electron regimes. Transitions from various emission mechanisms (thermionic-, field-, and photoemission) to the space charge limited state (CL) will be addressed, especially highlighting the important simulation and experimental developments in selected contemporary areas of study. We stress the fundamental physical links between the physics of beams to limiting currents in other areas, such as low temperature plasmas, laser plasmas, and space propulsion.

[The quality of epidemiological research on pediatric refractive error and amblyopia in China needs to be improved].

PubMed

He, M G

2017-01-11

Over the past decade, great progress has been made in the clinical and epidemiological studies on refractive error and amblyopia in children with research findings published in international peer reviewed journals. This article reviews some of the essential publications so that the research findings could be learnt extensively, understood critically and objectively, and applied effectively to clinical practice. We aim to address the current limitations and shed light on clinical practice. (Chin J Ophthalmol, 2017, 53: 3-6) .

Reforming of JP-8 in Microplasmas for Compact SOFC Power 500 W

DTIC Science & Technology

2012-11-30

Ouyang X, Bednarova L, Besser RS, Ho P. Preferential oxidation (PrOx) in a thin-film catalytic microreactor : Advantages and limitations. Vol. 51, 2005...Chemistry, Allyn and Bacon. Inc. Boston 1973:21. [23] Dietz D , Ghezel-Ayagh H, Hunt J, Belkind A , Becker K, Nickens A . Plasma treatment of a heated... a collection of information if it does not display a currently valid OMB control number. PLEASE DO NOT RETURN YOUR FORM TO THE ABOVE ADDRESS. a

Dynamical Quantum Correlations of Ising Models on an Arbitrary Lattice and Their Resilience to Decoherence

DTIC Science & Technology

2013-01-01

of information if it does not display a currently valid OMB control number . PLEASE DO NOT RETURN YOUR FORM TO THE ABOVE ADDRESS. a...Boulder The Regents of the University of Colorado Office of Contracts and Grants Boulder, CO 80309 -0572 REPORT DOCUMENTATION PAGE b. ABSTRACT UU c...THIS PAGE UU 2. REPORT TYPE New Reprint 17. LIMITATION OF ABSTRACT UU 15. NUMBER OF PAGES 5d. PROJECT NUMBER 5e. TASK NUMBER 5f. WORK UNIT

Handheld computing in pathology

PubMed Central

Park, Seung; Parwani, Anil; Satyanarayanan, Mahadev; Pantanowitz, Liron

2012-01-01

Handheld computing has had many applications in medicine, but relatively few in pathology. Most reported uses of handhelds in pathology have been limited to experimental endeavors in telemedicine or education. With recent advances in handheld hardware and software, along with concurrent advances in whole-slide imaging (WSI), new opportunities and challenges have presented themselves. This review addresses the current state of handheld hardware and software, provides a history of handheld devices in medicine focusing on pathology, and presents future use cases for such handhelds in pathology. PMID:22616027

Peptide Functionalized Gold Nanorods for the Sensitive Detection of a Cardiac Biomarker Using Plasmonic Paper Devices (Postprint)

DTIC Science & Technology

2015-11-10

currently valid OMB control number. PLEASE DO NOT RETURN YOUR FORM TO THE ABOVE ADDRESS. 1. REPORT DATE (DD-MM-YY) 2. REPORT TYPE 3 . DATES COVERED...refractive index difference on the order of 3 × 10−4 refractive index units (RIU)), probe the conformational changes of individual biomacromolecules...natural antibodies and short peptides, as BREs. We demonstrate that pep - tides provide a significantly higher sensitivity and lower limit of detection

Invocation oriented architecture for agile code and agile data

NASA Astrophysics Data System (ADS)

Verma, Dinesh; Chan, Kevin; Leung, Kin; Gkelias, Athanasios

2017-05-01

In order to address the unique requirements of sensor information fusion in a tactical coalition environment, we are proposing a new architecture - one based on the concept of invocations. An invocation is a combination of a software code and a piece of data, both managed using techniques from Information Centric networking. This paper will discuss limitations of current approaches, present the architecture for an invocation oriented architecture, illustrate how it works with an example scenario, and provide reasons for its suitability in a coalition environment.

Next Gen One Portal Usability Evaluation

NASA Technical Reports Server (NTRS)

Cross, E. V., III; Perera, J. S.; Hanson, A. M.; English, K.; Vu, L.; Amonette, W.

2018-01-01

Each exercise device on the International Space Station (ISS) has a unique, customized software system interface with unique layouts / hierarchy, and operational principles that require significant crew training. Furthermore, the software programs are not adaptable and provide no real-time feedback or motivation to enhance the exercise experience and/or prevent injuries. Additionally, the graphical user interfaces (GUI) of these systems present information through multiple layers resulting in difficulty navigating to the desired screens and functions. These limitations of current exercise device GUI's lead to increased crew time spent on initiating, loading, performing exercises, logging data and exiting the system. To address these limitations a Next Generation One Portal (NextGen One Portal) Crew Countermeasure System (CMS) was developed, which utilizes the latest industry guidelines in GUI designs to provide an intuitive ease of use approach (i.e., 80% of the functionality gained within 5-10 minutes of initial use without/limited formal training required). This is accomplished by providing a consistent interface using common software to reduce crew training, increase efficiency & user satisfaction while also reducing development & maintenance costs. Results from the usability evaluations showed the NextGen One Portal UI having greater efficiency, learnability, memorability, usability and overall user experience than the current Advanced Resistive Exercise Device (ARED) UI used by astronauts on ISS. Specifically, the design of the One-Portal UI as an app interface similar to those found on the Apple and Google's App Store, assisted many of the participants in grasping the concepts of the interface with minimum training. Although the NextGen One-Portal UI was shown to be an overall better interface, observations by the test facilitators noted specific exercise tasks appeared to have a significant impact on the NextGen One-Portal UI efficiency. Future updates to the NextGen One Portal UI will address these inefficiencies.

Geriatrics in family practice residency education: an unmet challenge.

PubMed

Gazewood, John D; Vanderhoff, Bruce; Ackermann, Richard; Cefalu, Charles

2003-01-01

The aging of the US population poses one of the greatest future challenges for family practice residency graduates. At a time when our discipline should be strengthening geriatric education to address the needs of our aging population, the Group on Geriatric Education of the Society of Teachers of Family Medicine believes that recent guidelines from important family medicine organizations suggest that our discipline's interest in geriatric education may be waning. Barriers to improving geriatric education in family practice residencies include limited geriatric faculty, changes in geriatric fellowship training, competing curricular demands, and limited diversity of geriatric training sites. Improving geriatric education in family practice residencies will require greater emphasis on faculty development and integration of geriatric principles throughout family practice residency education. The Residency Review Committee for Family Practice should review the Program Requirements for Residency Education to ensure that geriatric training requirements are consistent with current educational needs. The leadership of family medicine organizations should collaboratively address the need for continued improvement in training our residents to care for older patients and the chronically ill.

Display integration for ground combat vehicles

NASA Astrophysics Data System (ADS)

Busse, David J.

1998-09-01

The United States Army's requirement to employ high resolution target acquisition sensors and information warfare to increase its dominance over enemy forces has led to the need to integrate advanced display devices into ground combat vehicle crew stations. The Army's force structure require the integration of advanced displays on both existing and emerging ground combat vehicle systems. The fielding of second generation target acquisition sensors, color digital terrain maps and high volume digital command and control information networks on these platforms define display performance requirements. The greatest challenge facing the system integrator is the development and integration of advanced displays that meet operational, vehicle and human computer interface performance requirements for the ground combat vehicle fleet. The subject of this paper is to address those challenges: operational and vehicle performance, non-soldier centric crew station configurations, display performance limitations related to human computer interfaces and vehicle physical environments, display technology limitations and the Department of Defense (DOD) acquisition reform initiatives. How the ground combat vehicle Program Manager and system integrator are addressing these challenges are discussed through the integration of displays on fielded, current and future close combat vehicle applications.

Computer Simulation and Digital Resources for Plastic Surgery Psychomotor Education.

PubMed

Diaz-Siso, J Rodrigo; Plana, Natalie M; Stranix, John T; Cutting, Court B; McCarthy, Joseph G; Flores, Roberto L

2016-10-01

Contemporary plastic surgery residents are increasingly challenged to learn a greater number of complex surgical techniques within a limited period. Surgical simulation and digital education resources have the potential to address some limitations of the traditional training model, and have been shown to accelerate knowledge and skills acquisition. Although animal, cadaver, and bench models are widely used for skills and procedure-specific training, digital simulation has not been fully embraced within plastic surgery. Digital educational resources may play a future role in a multistage strategy for skills and procedures training. The authors present two virtual surgical simulators addressing procedural cognition for cleft repair and craniofacial surgery. Furthermore, the authors describe how partnerships among surgical educators, industry, and philanthropy can be a successful strategy for the development and maintenance of digital simulators and educational resources relevant to plastic surgery training. It is our responsibility as surgical educators not only to create these resources, but to demonstrate their utility for enhanced trainee knowledge and technical skills development. Currently available digital resources should be evaluated in partnership with plastic surgery educational societies to guide trainees and practitioners toward effective digital content.

An ounce of prevention ... what are the returns? Second edition, 1999.

PubMed

Messonnier, M L; Corso, P S; Teutsch, S M; Haddix, A C; Harris, J R

1999-04-01

Because human and financial resources are limited, health efforts must focus on prevention strategies that yield the most benefit for the investment. Many current strategies identified in the literature offer opportunities to promote health at a reasonable cost. To present a literature-based review of evidence demonstrating that prevention can be an effective and wise use of resources through CDC's An Ounce of Prevention ... What Are the Returns? Second Edition. Systematic review of cost-effectiveness literature for a selected group of prevention strategies. Prevention strategies relevant to the U.S. population. Data indicate that the health conditions considered can be addressed through prevention strategies that are either cost effective or cost saving. An Ounce of Prevention ... What Are the Returns? Second Edition can be used to conveniently access information on prevention strategies, the diseases and injuries they address, and their cost effectiveness. It also complements other comprehensive prevention guides. However, limitations of the available cost-effectiveness studies indicate that standardized procedures should be followed for studies of all recommended prevention strategies. Researchers must standardize review procedures to improve both the quality and comparability of studies.

Cell therapy, 3D culture systems and tissue engineering for cardiac regeneration.

PubMed

Emmert, Maximilian Y; Hitchcock, Robert W; Hoerstrup, Simon P

2014-04-01

Ischemic Heart Disease (IHD) still represents the "Number One Killer" worldwide accounting for the death of numerous patients. However the capacity for self-regeneration of the adult heart is very limited and the loss of cardiomyocytes in the infarcted heart leads to continuous adverse cardiac-remodeling which often leads to heart-failure (HF). The concept of regenerative medicine comprising cell-based therapies, bio-engineering technologies and hybrid solutions has been proposed as a promising next-generation approach to address IHD and HF. Numerous strategies are under investigation evaluating the potential of regenerative medicine on the failing myocardium including classical cell-therapy concepts, three-dimensional culture techniques and tissue-engineering approaches. While most of these regenerative strategies have shown great potential in experimental studies, the translation into a clinical setting has either been limited or too rapid leaving many key questions unanswered. This review summarizes the current state-of-the-art, important challenges and future research directions as to regenerative approaches addressing IHD and resulting HF. Copyright © 2014 Elsevier B.V. All rights reserved.

Earth-Abundant Oxygen Evolution Catalysts Coupled onto ZnO Nanowire Arrays for Efficient Photoelectrochemical Water Cleavage

PubMed Central

Jiang, Chaoran; Moniz, Savio J A; Khraisheh, Majeda; Tang, Junwang

2014-01-01

ZnO has long been considered as a model UV-driven photoanode for photoelectrochemical water splitting, but its performance has been limited by fast charge-carrier recombination, extremely poor stability in aqueous solution, and slow kinetics of water oxidation. These issues were addressed by applying a strategy of optimization and passivation of hydrothermally grown 1D ZnO nanowire arrays. The length and diameter of bare ZnO nanowires were optimized by varying the growth time and precursor concentration to achieve optimal photoelectrochemical performance. The addition of earth-abundant cobalt phosphate (Co-Pi) and nickel borate (Ni-B) oxygen evolution catalysts onto ZnO nanowires resulted in substantial cathodic shifts in onset potential to as low as about 0.3 V versus the reversible hydrogen electrode (RHE) for Ni-B/ZnO, for which a maximum photocurrent density of 1.1 mA cm−2 at 0.9 V (vs. RHE) with applied bias photon-to-current efficiency of 0.4 % and an unprecedented near-unity incident photon-to-current efficiency at 370 nm. In addition the potential required for saturated photocurrent was dramatically reduced from 1.6 to 0.9 V versus RHE. Furthermore, the stability of these ZnO nanowires was significantly enhanced by using Ni-B compared to Co-Pi due to its superior chemical robustness, and it thus has additional functionality as a stable protecting layer on the ZnO surface. These remarkable enhancements in both photocatalytic activity and stability directly address the current severe limitations in the use of ZnO-based photoelectrodes for water-splitting applications, and can be applied to other photoanodes for efficient solar-driven fuel synthesis. PMID:25156820

Using Agent-Based Models to Develop Public Policy about Food Behaviours: Future Directions and Recommendations.

PubMed

Giabbanelli, Philippe J; Crutzen, Rik

2017-01-01

Most adults are overweight or obese in many western countries. Several population-level interventions on the physical, economical, political, or sociocultural environment have thus attempted to achieve a healthier weight. These interventions have involved different weight-related behaviours, such as food behaviours. Agent-based models (ABMs) have the potential to help policymakers evaluate food behaviour interventions from a systems perspective. However, fully realizing this potential involves a complex procedure starting with obtaining and analyzing data to populate the model and eventually identifying more efficient cross-sectoral policies. Current procedures for ABMs of food behaviours are mostly rooted in one technique, often ignore the food environment beyond home and work, and underutilize rich datasets. In this paper, we address some of these limitations to better support policymakers through two contributions. First, via a scoping review, we highlight readily available datasets and techniques to deal with these limitations independently. Second, we propose a three steps' process to tackle all limitations together and discuss its use to develop future models for food behaviours. We acknowledge that this integrated process is a leap forward in ABMs. However, this long-term objective is well-worth addressing as it can generate robust findings to effectively inform the design of food behaviour interventions.

Fetal brain volumetry through MRI volumetric reconstruction and segmentation

PubMed Central

Estroff, Judy A.; Barnewolt, Carol E.; Connolly, Susan A.; Warfield, Simon K.

2013-01-01

Purpose Fetal MRI volumetry is a useful technique but it is limited by a dependency upon motion-free scans, tedious manual segmentation, and spatial inaccuracy due to thick-slice scans. An image processing pipeline that addresses these limitations was developed and tested. Materials and methods The principal sequences acquired in fetal MRI clinical practice are multiple orthogonal single-shot fast spin echo scans. State-of-the-art image processing techniques were used for inter-slice motion correction and super-resolution reconstruction of high-resolution volumetric images from these scans. The reconstructed volume images were processed with intensity non-uniformity correction and the fetal brain extracted by using supervised automated segmentation. Results Reconstruction, segmentation and volumetry of the fetal brains for a cohort of twenty-five clinically acquired fetal MRI scans was done. Performance metrics for volume reconstruction, segmentation and volumetry were determined by comparing to manual tracings in five randomly chosen cases. Finally, analysis of the fetal brain and parenchymal volumes was performed based on the gestational age of the fetuses. Conclusion The image processing pipeline developed in this study enables volume rendering and accurate fetal brain volumetry by addressing the limitations of current volumetry techniques, which include dependency on motion-free scans, manual segmentation, and inaccurate thick-slice interpolation. PMID:20625848

The QuEST for multi-sensor big data ISR situation understanding

NASA Astrophysics Data System (ADS)

Rogers, Steven; Culbertson, Jared; Oxley, Mark; Clouse, H. Scott; Abayowa, Bernard; Patrick, James; Blasch, Erik; Trumpfheller, John

2016-05-01

The challenges for providing war fighters with the best possible actionable information from diverse sensing modalities using advances in big-data and machine learning are addressed in this paper. We start by presenting intelligence, surveillance, and reconnaissance (ISR) related big-data challenges associated with the Third Offset Strategy. Current approaches to big-data are shown to be limited with respect to reasoning/understanding. We present a discussion of what meaning making and understanding require. We posit that for human-machine collaborative solutions to address the requirements for the strategy a new approach, Qualia Exploitation of Sensor Technology (QuEST), will be required. The requirements for developing a QuEST theory of knowledge are discussed and finally, an engineering approach for achieving situation understanding is presented.

Use of necrophagous insects as evidence of cadaver relocation: myth or reality?

PubMed Central

Gosselin, Matthias; Hedouin, Valéry

2017-01-01

The use of insects as indicators of post-mortem displacement is discussed in many texts, courses and TV shows, and several studies addressing this issue have been published. Although the concept is widely cited, it is poorly understood, and only a few forensic cases have successfully applied such a method. The use of necrophagous insects as evidence of cadaver relocation actually involves a wide range of biological aspects. Distribution, microhabitat, phenology, behavioral ecology, and molecular analysis are among the research areas associated with this topic. This article provides the first review of the current knowledge and addresses the potential and limitations of different methods to evaluate their applicability. This work reveals numerous weaknesses and erroneous beliefs as well as many possibilities and research opportunities. PMID:28785513

WhatsApp in Stroke Systems: Current Use and Regulatory Concerns.

PubMed

Calleja-Castillo, Juan M; Gonzalez-Calderon, Gina

2018-01-01

Smartphone use is extremely common. Applications such as WhatsApp have billions of users and physicians are no exception. Stroke Medicine is a field where instant communication among fairly large groups is essential. In developing countries, economic limitations preclude the possibility of acquiring proper communication platforms. Thus, WhatsApp has been used as an organizational tool, for sharing clinical data, and for real time guidance of clinical care decisions. It has evolved into a cheap, accessible tool for telemedicine. Nevertheless, regulatory and privacy issues must be addressed. Some countries have implemented legislation to address this issue, while others lag behind. In this article, we present an overview on the different roles WhatsApp has acquired as a clinical tool in stroke systems and the potential privacy concerns of its use.

WhatsApp in Stroke Systems: Current Use and Regulatory Concerns

PubMed Central

Calleja-Castillo, Juan M.; Gonzalez-Calderon, Gina

2018-01-01

Smartphone use is extremely common. Applications such as WhatsApp have billions of users and physicians are no exception. Stroke Medicine is a field where instant communication among fairly large groups is essential. In developing countries, economic limitations preclude the possibility of acquiring proper communication platforms. Thus, WhatsApp has been used as an organizational tool, for sharing clinical data, and for real time guidance of clinical care decisions. It has evolved into a cheap, accessible tool for telemedicine. Nevertheless, regulatory and privacy issues must be addressed. Some countries have implemented legislation to address this issue, while others lag behind. In this article, we present an overview on the different roles WhatsApp has acquired as a clinical tool in stroke systems and the potential privacy concerns of its use. PMID:29904369

Motivating and Assisting Adult, Online Chemistry Students: A Review of the Literature

NASA Astrophysics Data System (ADS)

Bannier, Betsy J.

2010-06-01

While comprehensive texts, articles, and literature reviews presenting research in the singular arenas of motivation, help-seeking, and online science learning are relatively easy to find, syntheses and interactions between these constructs are lacking. Part I of this review addresses this knowledge gap by drawing together key research from the domains of educational psychology and adult education, addressing the constructs of motivation, self-efficacy, adult learning, and help-seeking. Part II of this review extends and applies the motivation and help-seeking discussion to the emerging and exciting field of online chemistry education. The result is a comprehensive synthesis of the strengths and limitations of the currently existing body of knowledge related to the motivation and help-seeking behaviors of adult, online chemistry students.

Medical curricula and preventing childhood obesity: pooling the resources of medical students and primary care to inform curricula.

PubMed

Wylie, Ann; Furmedge, Daniel S; Appleton, Amber; Toop, Helen; Coats, Tom

2009-03-01

The study aimed to firstly provide a small self-selecting group of medical students with the opportunity to explore current approaches and opportunities addressing the prevention of childhood obesity and, secondly, to consider what aspects could be part of the taught curriculum. Medical students in their third and fourth year were invited to self-design special study modules (SSMs) exploring interventions and processes addressing the growing concern about childhood obesity. One student looked at the role of the primary care teams, two looked at community-based opportunities to improve physical activity in urban areas where there is significant deprivation and one student explored the complex role of the media as a social determinant of dietary patterns and sedentary behaviour. Primary care health professionals questioned their role in regard to raising the topic of obesity in the consultation and had limited awareness of current NICE guidelines and local interventions for referral. Local authority physical activity programmes have an important role in preventing and tackling obesity and although the media are regulated, there is limited impact on reducing obesity. Conversely, the influence of the media is complex and enables medical students and teachers to be aware of some of the social determinants influencing health-related behaviour. About a third of UK GP practices have some role in medical undergraduate education. It will therefore be inevitable that students will encounter GPs working with prevention and management of childhood obesity, however limited, and this will increasingly be part of the teaching agenda, whether formal and planned or opportunistic. Curricula could include being familiar with the evidence that informs NICE guidelines, observing these guidelines being implemented and their limitations, awareness of local schemes for referral to prevent or treat obesity and the influence of wider determinants on diet and physical activity behaviour, including the media.

Bimanual coordination: A missing piece of arm rehabilitation after stroke.

PubMed

Kantak, Shailesh; Jax, Steven; Wittenberg, George

2017-01-01

Inability to use the arm in daily actions significantly lowers quality of life after stroke. Most contemporary post-stroke arm rehabilitation strategies that aspire to re-engage the weaker arm in functional activities have been greatly limited in their effectiveness. Most actions of daily life engage the two arms in a highly coordinated manner. In contrast, most rehabilitation approaches predominantly focus on restitution of the impairments and unilateral practice of the weaker hand alone. We present a perspective that this misalignment between real world requirements and intervention strategies may limit the transfer of unimanual capability to spontaneous arm use and functional recovery. We propose that if improving spontaneous engagement and use of the weaker arm in real life is the goal, arm rehabilitation research and treatment need to address the coordinated interaction between arms in targeted theory-guided interventions. Current narrow focus on unimanual deficits alone, difficulty in quantifying bimanual coordination in real-world actions and limited theory-guided focus on control and remediation of different coordination modes are some of the biggest obstacles to successful implementation of effective interventions to improve bimanual coordination in the real world. We present a theory-guided taxonomy of bimanual actions that will facilitate quantification of coordination for different real-world tasks and provide treatment targets for addressing coordination deficits. We then present evidence in the literature that points to bimanual coordination deficits in stroke survivors and demonstrate how current rehabilitation approaches are limited in their impact on bimanual coordination. Importantly, we suggest theory-based areas of future investigation that may assist quantification, identification of neural mechanisms and scientifically-based training/remediation approaches for bimanual coordination deficits post-stroke. Advancing the science and practice of arm rehabilitation to incorporate bimanual coordination will lead to a more complete functional recovery of the weaker arm, thus improving the effectiveness of rehabilitation interventions and augmenting quality of life after stroke.

Can CO2 Turbulent Flux Be Measured by Lidar? A Preliminary Study

NASA Technical Reports Server (NTRS)

Gilbert, Fabien; Koch, Grady; Beyon, Jeffrey Y.; Hilton, Timothy W.; Davis, Kenneth J.; Andrews, Arlyn; Flamant, Pierre H.; Singh, Upendra N.

2011-01-01

The vertical profiling ofCO2 turbulent fluxes in the atmospheric boundary layer (ABL) is investigated using a coherent differential absorption lidar (CDIAL) operated nearby a tall tower in Wisconsin during June 2007. A CDIAL can perform simultaneous range-resolved CO2 DIAL and velocity measurements. The lidar eddy covariance technique is presented. The aims of the study are (i) an assessment of performance and current limitation of available CDIAL for CO2 turbulent fluxes and (ii) the derivation of instrument specifications to build a future CDIAL to perform accurate range-resolved CO2 fluxes. Experimental lidar CO2 mixing ratio and vertical velocity profiles are successfully compared with in situ sensors measurements. Time and space integral scales of turbulence in the ABL are addressed that result in limitation for time averaging and range accumulation. A first attempt to infer CO2 fluxes using an eddy covariance technique with currently available 2-mm CDIAL dataset is reported.

On-chip cooling by superlattice-based thin-film thermoelectrics.

PubMed

Chowdhury, Ihtesham; Prasher, Ravi; Lofgreen, Kelly; Chrysler, Gregory; Narasimhan, Sridhar; Mahajan, Ravi; Koester, David; Alley, Randall; Venkatasubramanian, Rama

2009-04-01

There is a significant need for site-specific and on-demand cooling in electronic, optoelectronic and bioanalytical devices, where cooling is currently achieved by the use of bulky and/or over-designed system-level solutions. Thermoelectric devices can address these limitations while also enabling energy-efficient solutions, and significant progress has been made in the development of nanostructured thermoelectric materials with enhanced figures-of-merit. However, fully functional practical thermoelectric coolers have not been made from these nanomaterials due to the enormous difficulties in integrating nanoscale materials into microscale devices and packaged macroscale systems. Here, we show the integration of thermoelectric coolers fabricated from nanostructured Bi2Te3-based thin-film superlattices into state-of-the-art electronic packages. We report cooling of as much as 15 degrees C at the targeted region on a silicon chip with a high ( approximately 1,300 W cm-2) heat flux. This is the first demonstration of viable chip-scale refrigeration technology and has the potential to enable a wide range of currently thermally limited applications.

Mass Storage and Retrieval at Rome Laboratory

NASA Technical Reports Server (NTRS)

Kann, Joshua L.; Canfield, Brady W.; Jamberdino, Albert A.; Clarke, Bernard J.; Daniszewski, Ed; Sunada, Gary

1996-01-01

As the speed and power of modern digital computers continues to advance, the demands on secondary mass storage systems grow. In many cases, the limitations of existing mass storage reduce the overall effectiveness of the computing system. Image storage and retrieval is one important area where improved storage technologies are required. Three dimensional optical memories offer the advantage of large data density, on the order of 1 Tb/cm(exp 3), and faster transfer rates because of the parallel nature of optical recording. Such a system allows for the storage of multiple-Gbit sized images, which can be recorded and accessed at reasonable rates. Rome Laboratory is currently investigating several techniques to perform three-dimensional optical storage including holographic recording, two-photon recording, persistent spectral-hole burning, multi-wavelength DNA recording, and the use of bacteriorhodopsin as a recording material. In this paper, the current status of each of these on-going efforts is discussed. In particular, the potential payoffs as well as possible limitations are addressed.

Review of pharmacological therapies in fibromyalgia syndrome

PubMed Central

2014-01-01

This review addresses the current status of drug therapy for the management of fibromyalgia syndrome (FMS) and is based on interdisciplinary FMS management guidelines, meta-analyses of drug trial data, and observational studies. In the absence of a single gold-standard medication, patients are treated with a variety of drugs from different categories, often with limited evidence. Drug therapy is not mandatory for the management of FMS. Pregabalin, duloxetine, milnacipran, and amitriptyline are the current first-line prescribed agents but have had a mostly modest effect. With only a minority of patients expected to experience substantial benefit, most will discontinue therapy because of either a lack of efficacy or tolerability problems. Many drug treatments have undergone limited study and have had negative results. It is unlikely that these failed pilot trials will undergo future study. However, medications, though imperfect, will continue to be a component of treatment strategy for these patients. Both the potential for medication therapy to relieve symptoms and the potential to cause harm should be carefully considered in their administration. PMID:24433463

Modeling of Steady-state Scenarios for the Fusion Nuclear Science Facility, Advanced Tokamak Approach

NASA Astrophysics Data System (ADS)

Garofalo, A. M.; Chan, V. S.; Prater, R.; Smith, S. P.; St. John, H. E.; Meneghini, O.

2013-10-01

A Fusion National Science Facility (FNSF) would complement ITER in addressing the community identified science and technology gaps to a commercially attractive DEMO, including breeding tritium and completing the fuel cycle, qualifying nuclear materials for high fluence, developing suitable materials for the plasma-boundary interface, and demonstrating power extraction. Steady-state plasma operation is highly desirable to address the requirements for fusion nuclear technology testing [1]. The Advanced Tokamak (AT) is a strong candidate for an FNSF as a consequence of its mature physics base, capability to address the key issues with a more compact device, and the direct relevance to an attractive target power plant. Key features of AT are fully noninductive current drive, strong plasma cross section shaping, internal profiles consistent with high bootstrap fraction, and operation at high beta, typically above the free boundary limit, βN > 3 . Work supported by GA IR&D funding, DE-FC02-04ER54698, and DE-FG02-95ER43309.

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".

Adaptive Management: From More Talk to Real Action

NASA Astrophysics Data System (ADS)

Williams, Byron K.; Brown, Eleanor D.

2014-02-01

The challenges currently facing resource managers are large-scale and complex, and demand new approaches to balance development and conservation goals. One approach that shows considerable promise for addressing these challenges is adaptive management, which by now is broadly seen as a natural, intuitive, and potentially effective way to address decision-making in the face of uncertainties. Yet the concept of adaptive management continues to evolve, and its record of success remains limited. In this article, we present an operational framework for adaptive decision-making, and describe the challenges and opportunities in applying it to real-world problems. We discuss the key elements required for adaptive decision-making, and their integration into an iterative process that highlights and distinguishes technical and social learning. We illustrate the elements and processes of the framework with some successful on-the-ground examples of natural resource management. Finally, we address some of the difficulties in applying learning-based management, and finish with a discussion of future directions and strategic challenges.

Restructuring brain drain: strengthening governance and financing for health worker migration.

PubMed

Mackey, Tim K; Liang, Bryan A

2013-01-15

Health worker migration from resource-poor countries to developed countries, also known as ''brain drain'', represents a serious global health crisis and a significant barrier to achieving global health equity. Resource-poor countries are unable to recruit and retain health workers for domestic health systems, resulting in inadequate health infrastructure and millions of dollars in healthcare investment losses. Using acceptable methods of policy analysis, we first assess current strategies aimed at alleviating brain drain and then propose our own global health policy based solution to address current policy limitations. Although governments and private organizations have tried to address this policy challenge, brain drain continues to destabilise public health systems and their populations globally. Most importantly, lack of adequate financing and binding governance solutions continue to fail to prevent health worker brain drain. In response to these challenges, the establishment of a Global Health Resource Fund in conjunction with an international framework for health worker migration could create global governance for stable funding mechanisms encourage equitable migration pathways, and provide data collection that is desperately needed.

Technical Excellence and Communication: The Cornerstones for Successful Safety and Mission Assurance Programs

NASA Technical Reports Server (NTRS)

Malone, Roy W.; Livingston, John M.

2010-01-01

The paper describes the role of technical excellence and communication in the development and maintenance of safety and mission assurance programs. The Marshall Space Flight Center (MSFC) Safety and Mission Assurance (S&MA) organization is used to illustrate philosophies and techniques that strengthen safety and mission assurance efforts and that contribute to healthy and effective organizational cultures. The events and conditions leading to the development of the MSFC S&MA organization are reviewed. Historic issues and concerns are identified. The adverse effects of resource limitations and risk assessment roles are discussed. The structure and functions of the core safety, reliability, and quality assurance functions are presented. The current organization s mission and vision commitments serve as the starting points for the description of the current organization. The goals and objectives are presented that address the criticisms of the predecessor organizations. Additional improvements are presented that address the development of technical excellence and the steps taken to improve communication within the Center, with program customers, and with other Agency S&MA organizations.

Leveraging human decision making through the optimal management of centralized resources

NASA Astrophysics Data System (ADS)

Hyden, Paul; McGrath, Richard G.

2016-05-01

Combining results from mixed integer optimization, stochastic modeling and queuing theory, we will advance the interdisciplinary problem of efficiently and effectively allocating centrally managed resources. Academia currently fails to address this, as the esoteric demands of each of these large research areas limits work across traditional boundaries. The commercial space does not currently address these challenges due to the absence of a profit metric. By constructing algorithms that explicitly use inputs across boundaries, we are able to incorporate the advantages of using human decision makers. Key improvements in the underlying algorithms are made possible by aligning decision maker goals with the feedback loops introduced between the core optimization step and the modeling of the overall stochastic process of supply and demand. A key observation is that human decision-makers must be explicitly included in the analysis for these approaches to be ultimately successful. Transformative access gives warfighters and mission owners greater understanding of global needs and allows for relationships to guide optimal resource allocation decisions. Mastery of demand processes and optimization bottlenecks reveals long term maximum marginal utility gaps in capabilities.

The Prevalence of Micronutrient Deficiencies and Inadequacies in the Middle East and Approaches to Interventions

PubMed Central

Hwalla, Nahla; Al Dhaheri, Ayesha Salem; Radwan, Hadia; Alfawaz, Hanan Abdullah; Fouda, Mona A.; Al-Daghri, Nasser Mohammed; Zaghloul, Sahar; Blumberg, Jeffrey B.

2017-01-01

Micronutrient deficiencies and inadequacies constitute a global health issue, particularly among countries in the Middle East. The objective of this review is to identify micronutrient deficits in the Middle East and to consider current and new approaches to address this problem. Based on the availability of more recent data, this review is primarily focused on countries that are in advanced nutrition transition. Prominent deficits in folate, iron, and vitamin D are noted among children/adolescents, women of childbearing age, pregnant women, and the elderly. Reports indicate that food fortification in the region is sporadic and ineffective, and the use of dietary supplements is low. Nutrition monitoring in the region is limited, and gaps in relevant information present challenges for implementing new policies and approaches to address the problem. Government-sponsored initiatives are necessary to assess current dietary intakes/patterns, support nutrition education, and to reduce food insecurity, especially among vulnerable population groups. Public–private partnerships should be considered in targeting micronutrient fortification programs and supplementation recommendations as approaches to help alleviate the burden of micronutrient deficiencies and inadequacies in the Middle East. PMID:28273802

Total Pancreatectomy With Islet Auto-Transplantation (TPIAT): Summary of an NIDDK Workshop

PubMed Central

Bellin, Melena D.; Gelrud, Andres; Arreaza-Rubin, Guillermo; Dunn, Ty B.; Humar, Abhinav; Morgan, Katherine A.; Naziruddin, Bashoo; Rastellini, Cristiana; Rickels, Michael R.; Schwarzenberg, Sarah J.; Andersen, Dana K.

2014-01-01

A workshop sponsored by the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) focused on research gaps and opportunities in total pancreatectomy with islet autotransplantation (TPIAT) for the management of chronic pancreatitis (CP). The session was held on July 23, 2014 and structured into five sessions: (1) patient selection, indications, and timing; (2) technical aspects of TPIAT; (3) improving success of islet autotransplantation; (4) improving outcomes after total pancreatectomy; and (5) registry considerations for TPIAT. The current state of knowledge was reviewed; knowledge gaps and research needs were specifically highlighted. Common themes included the need to identify which patients best benefit from and when to intervene with TPIAT, current limitations of the surgical procedure, diabetes remission and the potential for improvement, opportunities to better address pain remission, GI complications in this population, and unique features of children with CP considered for TPIAT. The need for a multicenter patient registry that specifically addresses the complexities of CP and total pancreatectomy outcomes as well as post-surgical diabetes outcomes was repeatedly emphasized. PMID:25333399

Restructuring brain drain: strengthening governance and financing for health worker migration

PubMed Central

Mackey, Tim K.; Liang, Bryan A.

2013-01-01

Background Health worker migration from resource-poor countries to developed countries, also known as ‘‘brain drain’’, represents a serious global health crisis and a significant barrier to achieving global health equity. Resource-poor countries are unable to recruit and retain health workers for domestic health systems, resulting in inadequate health infrastructure and millions of dollars in healthcare investment losses. Methods Using acceptable methods of policy analysis, we first assess current strategies aimed at alleviating brain drain and then propose our own global health policy based solution to address current policy limitations. Results Although governments and private organizations have tried to address this policy challenge, brain drain continues to destabilise public health systems and their populations globally. Most importantly, lack of adequate financing and binding governance solutions continue to fail to prevent health worker brain drain. Conclusions In response to these challenges, the establishment of a Global Health Resource Fund in conjunction with an international framework for health worker migration could create global governance for stable funding mechanisms encourage equitable migration pathways, and provide data collection that is desperately needed. PMID:23336617

Technical Excellence and Communication, the Cornerstones for Successful Safety and Mission Assurance Programs

NASA Astrophysics Data System (ADS)

Malone, Roy W.; Livingston, John M.

2010-09-01

The paper describes the role of technical excellence and communication in the development and maintenance of safety and mission assurance programs. The Marshall Space Flight Center(MSFC) Safety and Mission Assurance(S&MA) organization is used to illustrate philosophies and techniques that strengthen safety and mission assurance efforts and that contribute to healthy and effective organizational cultures. The events and conditions leading to the development of the MSFC S&MA organization are reviewed. Historic issues and concerns are identified. The adverse effects of resource limitations and risk assessment roles are discussed. The structure and functions of the core safety, reliability, and quality assurance functions are presented. The current organization’s mission and vision commitments serve as the starting points for the description of the current organization. The goals and objectives are presented that address the criticisms of the predecessor organizations. Additional improvements are presented that address the development of technical excellence and the steps taken to improve communication within the Center, with program customers, and with other Agency S&MA organizations.

Electrical efficiency and droop in MQW LEDs

NASA Astrophysics Data System (ADS)

Malyutenko, V. K.

2014-02-01

It is believed that low power conversion efficiency in commercial MQW LEDs occurs as a result of efficiency droop, current-induced dynamic degradation of the internal quantum efficiency, injection efficiency, and extraction efficiency. Broadly speaking, all these "quenching" mechanisms could be referred to as the optical losses. The vast advances of high-power InGaN and AlGaInP MQW LEDs have been achieved by addressing these losses. In contrast to these studies, in this paper we consider an alternative approach to make high-power LEDs more efficient. We identify current-induced electrical efficiency degradation (EED) as a strong limiting factor of power conversion efficiency. We found that EED is caused by current crowding followed by an increase in current-induced series resistance of a device. By decreasing the current spreading length, EED also causes the optical efficiency to degrade and stands for an important aspect of LED performance. This paper gives scientists the opportunity to look for different attributes of EED.

Professionals' views of fetal-monitoring support the development of devices to provide objective longer-term assessment of fetal wellbeing.

PubMed

Brown, Rebecca; Johnstone, Edward D; Heazell, Alexander E P

2016-01-01

Continuous longer-term fetal monitoring has been proposed to address limitations of current technologies in the detection of fetal compromise. We aimed to assess professionals' views regarding current fetal-monitoring techniques and proposed longer-term continuous fetal monitoring. A questionnaire was designed and validated to assess obstetricians' and midwives' use of current fetal-monitoring techniques and their views towards continuous monitoring. 125 of 173 received responses (72% obstetricians, 28% midwives) were analysed. Professionals had the strongest views about supporting evidence for the most commonly employed fetal-monitoring techniques (maternal awareness of fetal movements, ultrasound assessment of fetal growth and umbilical artery Doppler). 45.1% of professionals agreed that a continuous monitoring device would be beneficial (versus 28.7% who disagreed); this perceived benefit was not influenced by professionals' views regarding current techniques or professional background. Professionals have limited experience of continuous fetal monitoring, but most respondents believed that it would increase maternal anxiety (64.3%) and would have concerns with its use in clinical practice (81.7%). Continuous fetal monitoring would be acceptable to the majority of professionals. However, development of these technologies must be accompanied by extended examination of professionals' and women's views to determine barriers to its introduction.

Some inadequacies of the current human factors certification process of advanced aircraft technologies

NASA Technical Reports Server (NTRS)

Paries, Jean

1994-01-01

Automation related accidents or serious incidents are not limited to advanced technology aircraft. There is a full history of such accidents with conventional technology aircraft. However, this type of occurrence is far from sparing the newest 'glass cockpit' generation, and it even seems to be a growing contributor to its accident rate. Nevertheless, all these aircraft have been properly certificated according to the relevant airworthiness regulations. Therefore, there is a growing concern that with the technological advancement of air transport aircraft cockpits, the current airworthiness regulations addressing cockpit design and human factors may have reached some level of inadequacy. This paper reviews some aspects of the current airworthiness regulations and certification process related to human factors of cockpit design and focuses on questioning their ability to guarantee the intended safety objectives.

FHF2 isoforms differentially regulate Nav1.6 mediated resurgent sodium currents in dorsal root ganglion neurons

PubMed Central

Barbosa, Cindy; Xiao, Yucheng; Johnson, Andrew J.; Xie, Wenrui; Strong, Judith A.; Zhang, Jun-Ming; Cummins, Theodore R.

2017-01-01

Nav1.6 and Nav1.6 mediated resurgent currents have been implicated in several pain pathologies. However, our knowledge of how fast resurgent currents are modulated in neurons is limited. Our study explored the potential regulation of Nav1.6 mediated resurgent currents by isoforms of Fibroblast growth Factor Homologous factor 2 (FHF2) in an effort to address the gap in our knowledge. FHF2 isoforms colocalize with Nav1.6 in peripheral sensory neurons. Cell line studies suggest that these proteins differentially regulate inactivation. In particular, FHF2A mediates long-term inactivation, a mechanism proposed to compete with the open-channel blocker mechanism that mediates resurgent currents. On the other hand, FHF2B lacks the ability to mediate long-term inactivation and may delay inactivation favoring open-channel block. Based on these observations, we hypothesized that FHF2A limits resurgent currents, whereas, FHF2B enhances resurgent currents. Overall our results suggest that FHF2A negatively regulates fast resurgent current by enhancing long-term inactivation and delaying recovery. In contrast FHF2B positively regulated resurgent current and did not alter long-term inactivation. Chimeric constructs of FHF2A and Navβ4 (likely the endogenous open channel blocker in sensory neurons) exhibited differential effects on resurgent currents suggesting that specific regions within FHF2A and Navβ4 have important regulatory functions. Our data also indicate FHFAs and FHF2B isoform expression are differentially regulated in a radicular pain model and that associated neuronal hyperexcitability is substantially attenuated by a FHFA peptide. As such, these findings suggest that FHF2A and FHF2B regulate resurgent current in sensory neurons and may contribute to hyperexcitability associated with some pain pathologies. PMID:27999940

Night work and the reproductive health of women: an integrated literature review.

PubMed

Chau, Yu Moon; West, Sandra; Mapedzahama, Virginia

2014-01-01

The aim of this review was to synthesize current evidence on the effects of night work on the major stages of women's reproductive health, specifically the menstrual cycle, fertility, pregnancy, and menopause. Current understanding suggests that night work (work that causes disruption of a worker's circadian [day/night] rhythms) adversely affects workers' health and well-being. A complex relationship exists between circadian rhythms and reproductive hormones, and this may potentially increase the vulnerability of women to the detrimental effect of night work, including during menopause. A systematic search was conducted (March-May 2011) via CINAHL, MEDLINE, Sociological Abstracts, and Business Source Premier for primary research studies written in English using the key words "shift-work" and "female/women." Findings of identified articles were themed to pregnancy, fertility, aspects of menstrual cycles, and menopause. Twenty articles were identified, (13 articles concerning pregnancy, 3 addressing fertility, and 4 addressing aspects of the menstrual cycle) but no studies addressing menopause were located. All identified articles demonstrated problematic approaches to the determination of night-work exposure. Evidence of the impact of night work on female reproductive health as presented in the current literature is inconclusive. Moreover, available evidence needs to be interpreted with caution, given the various limitations and inconsistencies among the studies in the measurement of night-work exposure and shift-work patterns. Studies that focus specifically on night work are needed to facilitate an understanding of the impact of circadian disruption on the reproductive health of women undertaking night work. © 2013 by the American College of Nurse-Midwives.

Policy responses to problematic video game use: A systematic review of current measures and future possibilities.

PubMed

Király, Orsolya; Griffiths, Mark D; King, Daniel L; Lee, Hae-Kook; Lee, Seung-Yup; Bányai, Fanni; Zsila, Ágnes; Takacs, Zsofia K; Demetrovics, Zsolt

2017-09-01

Background and aims Empirical research into problematic video game playing suggests that overuse might cause functional and psychological impairments for a minority of gamers. Therefore, the need for regulation in the case of video games (whether governmental or self-imposed) has arisen but has only been implemented in a few countries around the world, and predominantly in Asia. This paper provides a systematic review of current and potential policies addressing problematic gaming. Methods After conducting a systematic search in the areas of prevention, treatment, and policy measures relating to problematic Internet and video game use, papers were selected that targeted problematic gaming policies (N = 12; six in English and six in Korean). These papers served as the basis of this review. Results Policies were classified into three major groups: (i) policy measures limiting availability of video games (e.g., shutdown policy, fatigue system, and parental controls), (ii) measures aiming to reduce risk and harm (e.g., warning messages), and (iii) measures taken to provide help services for gamers. Beyond the attempt to classify the current and potential policy measures, the authors also tried to evaluate their efficiency theoretically and (if data were available) empirically. Discussion and conclusions Overall, it appears that although several steps have been taken to address problematic video game playing, most of these steps were not as effective as expected, or had not been evaluated empirically for efficacy. The reason for this may lie in the fact that the policies outlined only addressed or influenced specific aspects of the problem instead of using a more integrative approach.

Modeling Ballistic Current Flow in Carbon Nanotube Wires

NASA Technical Reports Server (NTRS)

Anantram, M. P.; Biegel, Bryan (Technical Monitor)

2001-01-01

Experiments have shown carbon nanotubes (CNT) to be almost perfect conductors at small applied biases. The features of the CNT band structure, large velocity of the crossing subbands and the small number of modes that an electron close to the band center / Fermi energy can scatter into, are the reasons for the near perfect small bias conductance. We show that the CNT band structure does not help at large applied biases - electrons injected into the non crossing subbands can either be Bragg reflected or undergo Zener-type tunneling. This limits the current carrying capacity of CNT. We point out that the current carrying capacity of semiconductor quantum wires in the ballistic limit is different, owing to its band structure. The second aspect addressed is the relationship of nanotube chirality in determining the physics of metal-nanotube coupling. We show that a metallic-zigzag nanotube couples better than an armchair nanotube to a metal contact. This arises because in the case of armchair nanotubes, while the pi band couples well, the pi* band does not couple well to the metal. In the case of zigzag nanotube both crossing modes couple reasonably well to the metal. Many factors such as the role of curvature, strain and defects will play a role in determining the suitability of nanotubes as nanowires. From the limited view point of metal-nanotube coupling, we feel that metallic-zigzag nanotubes are preferable to armchair nanotubes.

Detection methods and performance criteria for genetically modified organisms.

PubMed

Bertheau, Yves; Diolez, Annick; Kobilinsky, André; Magin, Kimberly

2002-01-01

Detection methods for genetically modified organisms (GMOs) are necessary for many applications, from seed purity assessment to compliance of food labeling in several countries. Numerous analytical methods are currently used or under development to support these needs. The currently used methods are bioassays and protein- and DNA-based detection protocols. To avoid discrepancy of results between such largely different methods and, for instance, the potential resulting legal actions, compatibility of the methods is urgently needed. Performance criteria of methods allow evaluation against a common standard. The more-common performance criteria for detection methods are precision, accuracy, sensitivity, and specificity, which together specifically address other terms used to describe the performance of a method, such as applicability, selectivity, calibration, trueness, precision, recovery, operating range, limit of quantitation, limit of detection, and ruggedness. Performance criteria should provide objective tools to accept or reject specific methods, to validate them, to ensure compatibility between validated methods, and be used on a routine basis to reject data outside an acceptable range of variability. When selecting a method of detection, it is also important to consider its applicability, its field of applications, and its limitations, by including factors such as its ability to detect the target analyte in a given matrix, the duration of the analyses, its cost effectiveness, and the necessary sample sizes for testing. Thus, the current GMO detection methods should be evaluated against a common set of performance criteria.

Individualised care for women with assisted conception pregnancies and midwifery practice implications: An analysis of the existing research and current practice.

PubMed

Younger, Mimi; Hollins-Martin, Caroline; Choucri, Lesley

2015-02-01

the aim is to explore the psychosocial needs of women who are pregnant after assisted conception, specifically in vitro Fertilisation and whether their needs are being addressed within the current maternity care service. critical review of the literature using a narrative approach. 15 papers were identified. These included both qualitative and quantitative studies, literature reviews and surveys. The findings of this limited narrative review imply that women who undergo assistive reproductive techniques to achieve pregnancy have higher levels of anxiety in pregnancy and may have some difficulties in the transition to parenthood leading to perinatal morbidity. It appears that for this group of women it is important that their history in achieving pregnancy is known to the care providers, to enable the alleviation of some of the anxieties they face. Various aspects of antenatal care have been identified as possible areas which if addressed may reduce these levels of anxiety leading to a reduction in perinatal morbidity. currently, there is insufficient evidence to suggest that providing specialist midwifery care reduces morbidity in these women. However, maternity service providers should consider offering additional antenatal and postnatal services to meet the needs of this group in advance of further research in this area. Copyright © 2014 Elsevier Ltd. All rights reserved.

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

Huesemann, Michael H.

It is currently believed that science and technology can provide effective solutions to most, if not all, environmental problems facing western industrial societies. The validity of this optimistic assumption is highly questionable for at least three reasons: First, current mechanistic, reductionist science is inherently incapable of providing the complete and accurate information which is required to successfully address environmental problems. Second, both the conservation of mass principle and the second law of thermodynamics dictate that most remediation technologies - while successful in solving specific pollution problems - cause unavoidable negative environmental impacts elsewhere or in the future. Third, it ismore » intrinsically impossible to design industrial processes that have no negative environmental impacts. This follows not only from the entropy law but also from the fact that any generation of energy is impossible without negative environmental consequences. It can therefore be concluded that science and technology have only very limited potential in solving current and future environmental problems. Consequently, it will be necessary to address the root cause of environmental deterioration, namely the prevailing materialistic values that are the main driving force for both overpopulation and overconsumption. The long-term protection of the environment is therefore not primarily a technical problem but rather a social and moral problem that can only be solved by drastically reducing the strong influence of materialistic values.« less

Current Concepts and Ongoing Research in the Prevention and Treatment of Open Fracture Infections

PubMed Central

Hannigan, Geoffrey D.; Pulos, Nicholas; Grice, Elizabeth A.; Mehta, Samir

2015-01-01

Significance: Open fractures are fractures in which the bone has violated the skin and soft tissue. Because of their severity, open fractures are associated with complications that can result in increased lengths of hospital stays, multiple operative interventions, and even amputation. One of the factors thought to influence the extent of these complications is exposure and contamination of the open fracture with environmental microorganisms, potentially those that are pathogenic in nature. Recent Advances: Current open fracture care aims to prevent infection by wound classification, prophylactic antibiotic administration, debridement and irrigation, and stable fracture fixation. Critical Issues: Despite these established treatment paradigms, infections and infection-related complications remain a significant clinical burden. To address this, improvements need to be made in our ability to detect bacterial infections, effectively remove wound contamination, eradicate infections, and treat and prevent biofilm formation associated with fracture fixation hardware. Future Directions: Current research is addressing these critical issues. While culture methods are of limited value, culture-independent molecular techniques are being developed to provide informative detection of bacterial contamination and infection. Other advanced contamination- and infection-detecting techniques are also being investigated. New hardware-coating methods are being developed to minimize the risk of biofilm formation in wounds, and immune stimulation techniques are being developed to prevent open fracture infections. PMID:25566415

Simple, Sensitive and Accurate Multiplex Detection of Clinically Important Melanoma DNA Mutations in Circulating Tumour DNA with SERS Nanotags

PubMed Central

Wee, Eugene J.H.; Wang, Yuling; Tsao, Simon Chang-Hao; Trau, Matt

2016-01-01

Sensitive and accurate identification of specific DNA mutations can influence clinical decisions. However accurate diagnosis from limiting samples such as circulating tumour DNA (ctDNA) is challenging. Current approaches based on fluorescence such as quantitative PCR (qPCR) and more recently, droplet digital PCR (ddPCR) have limitations in multiplex detection, sensitivity and the need for expensive specialized equipment. Herein we describe an assay capitalizing on the multiplexing and sensitivity benefits of surface-enhanced Raman spectroscopy (SERS) with the simplicity of standard PCR to address the limitations of current approaches. This proof-of-concept method could reproducibly detect as few as 0.1% (10 copies, CV < 9%) of target sequences thus demonstrating the high sensitivity of the method. The method was then applied to specifically detect three important melanoma mutations in multiplex. Finally, the PCR/SERS assay was used to genotype cell lines and ctDNA from serum samples where results subsequently validated with ddPCR. With ddPCR-like sensitivity and accuracy yet at the convenience of standard PCR, we believe this multiplex PCR/SERS method could find wide applications in both diagnostics and research. PMID:27446486

Simple, Sensitive and Accurate Multiplex Detection of Clinically Important Melanoma DNA Mutations in Circulating Tumour DNA with SERS Nanotags.

PubMed

Wee, Eugene J H; Wang, Yuling; Tsao, Simon Chang-Hao; Trau, Matt

2016-01-01

Sensitive and accurate identification of specific DNA mutations can influence clinical decisions. However accurate diagnosis from limiting samples such as circulating tumour DNA (ctDNA) is challenging. Current approaches based on fluorescence such as quantitative PCR (qPCR) and more recently, droplet digital PCR (ddPCR) have limitations in multiplex detection, sensitivity and the need for expensive specialized equipment. Herein we describe an assay capitalizing on the multiplexing and sensitivity benefits of surface-enhanced Raman spectroscopy (SERS) with the simplicity of standard PCR to address the limitations of current approaches. This proof-of-concept method could reproducibly detect as few as 0.1% (10 copies, CV < 9%) of target sequences thus demonstrating the high sensitivity of the method. The method was then applied to specifically detect three important melanoma mutations in multiplex. Finally, the PCR/SERS assay was used to genotype cell lines and ctDNA from serum samples where results subsequently validated with ddPCR. With ddPCR-like sensitivity and accuracy yet at the convenience of standard PCR, we believe this multiplex PCR/SERS method could find wide applications in both diagnostics and research.

Challenges and unmet needs in basal insulin therapy: lessons from the Asian experience

PubMed Central

Chan, Wing Bun; Chen, Jung Fu; Goh, Su-Yen; Vu, Thi Thanh Huyen; Isip-Tan, Iris Thiele; Mudjanarko, Sony Wibisono; Bajpai, Shailendra; Mabunay, Maria Aileen; Bunnag, Pongamorn

2017-01-01

Basal insulin therapy can improve glycemic control in people with type 2 diabetes. However, timely initiation, optimal titration, and proper adherence to prescribed basal insulin regimens are necessary to achieve optimal glycemic control. Even so, glycemic control may remain suboptimal in a significant proportion of patients. Unique circumstances in Asia (eg, limited resources, management of diabetes primarily in nonspecialist settings, and patient populations that are predominantly less educated) coupled with the limitations of current basal insulin options (eg, risk of hypoglycemia and dosing time inflexibility) amplify the challenge of optimal basal insulin therapy in Asia. Significant progress has been made with long-acting insulin analogs (insulin glargine 100 units/mL and insulin detemir), which provide longer coverage and less risk of hypoglycemia over intermediate-acting insulin (Neutral Protamine Hagedorn insulin). Furthermore, recent clinical evidence suggests that newer long-acting insulin analogs, new insulin glargine 300 units/mL and insulin degludec, may address some of the unmet needs of current basal insulin options in terms of risk of hypoglycemia and dosing time inflexibility. Nevertheless, more can be done to overcome barriers to basal insulin therapy in Asia, through educating both patients and physicians, developing better patient support models, and improving accessibility to long-acting insulin analogs. In this study, we highlight the unique challenges associated with basal insulin therapy in Asia and, where possible, propose strategies to address the unmet needs by drawing on clinical experiences and perspectives in Asia. PMID:29276400

Human systems integration in remotely piloted aircraft operations.

PubMed

Tvaryanas, Anthony P

2006-12-01

The role of humans in remotely piloted aircraft (RPAs) is qualitatively different from manned aviation, lessening the applicability of aerospace medicine human factors knowledge derived from traditional cockpits. Aerospace medicine practitioners should expect to be challenged in addressing RPA crewmember performance. Human systems integration (HSI) provides a model for explaining human performance as a function of the domains of: human factors engineering; personnel; training; manpower; environment, safety, and occupational health (ESOH); habitability; and survivability. RPA crewmember performance is being particularly impacted by issues involving the domains of human factors engineering, personnel, training, manpower, ESOH, and habitability. Specific HSI challenges include: 1) changes in large RPA operator selection and training; 2) human factors engineering deficiencies in current RPA ground control station design and their impact on human error including considerations pertaining to multi-aircraft control; and 3) the combined impact of manpower shortfalls, shiftwork-related fatigue, and degraded crewmember effectiveness. Limited experience and available research makes it difficult to qualitatively or quantitatively predict the collective impact of these issues on RPA crewmember performance. Attending to HSI will be critical for the success of current and future RPA crewmembers. Aerospace medicine practitioners working with RPA crewmembers should gain first-hand knowledge of their task environment while the larger aerospace medicine community needs to address the limited information available on RPA-related aerospace medicine human factors. In the meantime, aeromedical decisions will need to be made based on what is known about other aerospace occupations, realizing this knowledge may have only partial applicability.

Challenges and unmet needs in basal insulin therapy: lessons from the Asian experience.

PubMed

Chan, Wing Bun; Chen, Jung Fu; Goh, Su-Yen; Vu, Thi Thanh Huyen; Isip-Tan, Iris Thiele; Mudjanarko, Sony Wibisono; Bajpai, Shailendra; Mabunay, Maria Aileen; Bunnag, Pongamorn

2017-01-01

Basal insulin therapy can improve glycemic control in people with type 2 diabetes. However, timely initiation, optimal titration, and proper adherence to prescribed basal insulin regimens are necessary to achieve optimal glycemic control. Even so, glycemic control may remain suboptimal in a significant proportion of patients. Unique circumstances in Asia (eg, limited resources, management of diabetes primarily in nonspecialist settings, and patient populations that are predominantly less educated) coupled with the limitations of current basal insulin options (eg, risk of hypoglycemia and dosing time inflexibility) amplify the challenge of optimal basal insulin therapy in Asia. Significant progress has been made with long-acting insulin analogs (insulin glargine 100 units/mL and insulin detemir), which provide longer coverage and less risk of hypoglycemia over intermediate-acting insulin (Neutral Protamine Hagedorn insulin). Furthermore, recent clinical evidence suggests that newer long-acting insulin analogs, new insulin glargine 300 units/mL and insulin degludec, may address some of the unmet needs of current basal insulin options in terms of risk of hypoglycemia and dosing time inflexibility. Nevertheless, more can be done to overcome barriers to basal insulin therapy in Asia, through educating both patients and physicians, developing better patient support models, and improving accessibility to long-acting insulin analogs. In this study, we highlight the unique challenges associated with basal insulin therapy in Asia and, where possible, propose strategies to address the unmet needs by drawing on clinical experiences and perspectives in Asia.

Addressing Patients' Veteran Status: Primary Care Providers' Knowledge, Comfort, and Educational Needs.

PubMed

Vest, Bonnie M; Kulak, Jessica; Hall, Victoria M; Homish, Gregory G

2018-06-01

The military population is frequently overlooked in civilian primary care due to an assumption that they are treated at the Veterans Health Administration (VA). However, less than 50% of eligible veterans receive VA treatment. Primary care providers (PCPs) may need support in addressing veterans' needs. This regional pilot study explored the current state of practice among primary care providers as it pertains to assessing patients' veteran status and their knowledge of and comfort with treating common conditions in this population. An electronic survey was administered to PCPs (N=102) in Western New York. Survey questions asked about assessing military status, understanding of military-related health problems, and thoughts on the priority of addressing these issues in practice. Data were analyzed using descriptive summary statistics. The majority (56%; n=54) of respondents indicated they never or rarely ask their patients about military service, and only 19% (n=18) said they often or always ask. Seventy-one percent (n=68) of providers agreed or strongly agreed it was important to know if their patient was a veteran. Participants indicated limited knowledge about military stressors, resources available for military populations, and common medical conditions impacting veterans. Our pilot results demonstrate that in a regional sample of primary care providers, providers rarely ask patients about their military history; however, they feel it is important information for patient care. While further study is needed, it may be necessary to provide education, specifically pertaining to military culture and health-related sequelae, to address barriers that may be limiting PCPs' provision of care for this population.

A Novel Approach to Prevention for At-Risk HIV-Negative Men Who Have Sex With Men: Creating a Teachable Moment to Promote Informed Sexual Decision-Making

PubMed Central

Cherry, Chauncey; Cain, Demetria; Pope, Howard

2011-01-01

Objectives. As a result of the impact of HIV among men who have sex with men (MSM), multiple strategies for reducing HIV risks have emerged from within the gay community. One common HIV risk reduction strategy limits unprotected sex partners to those who are of the same HIV status (serosorting). We tested a novel, brief, one-on-one intervention, based on informed decision-making and delivered by peer counselors, designed to address the limitations of serosorting (e.g., risk for HIV transmission). Methods. In 2009, we recruited a group of 149 at-risk men living in Atlanta, Georgia, and randomly assigned them to an intervention condition addressing serosorting or a standard-of-care control condition. Results. Men in the serosorting intervention reported fewer sexual partners (Wald χ2 = 8.79, P < .01) at the study follow-ups. Behavioral results were also consistent with changes in psychosocial variables, including condom use self-efficacy and perceptions of risk for HIV transmission. Conclusions. With the current intervention, service providers can offer risk reduction for men arguably at the highest risk for HIV infection in the United States. Addressing risks associated with serosorting in a feasible, low-cost intervention has the potential to significantly affect the HIV epidemic. PMID:21233441

Interdisciplinary Postdoctoral Training in Global Health through a Novel Joint Project for Trainees from Diverse Disciplines: Benefits, Risks, and Observations

PubMed Central

Oberhelman, Richard A.; Huaynate, Cynthia Anticona; Correa, Malena; Malpartida, Holger Mayta; Pajuelo, Monica; Paz-Soldan, Valerie A.; Gilman, Robert H.; Zimic, Mirko; Murphy, Laura; Belizan, Jose

2017-01-01

Postdoctoral training programs are usually highly individualized arrangements between trainees and a limited number of senior mentors in their field, an approach that contrasts with current trends in public health education that promote interdisciplinary training to spur innovation. Herein, we describe an alternative model for postdoctoral training for a group of fellows from distinct disciplines. Fellows work with mentors from diverse fields to create a joint research project or a group of complementary projects, with the goal of developing a new device, intervention, or innovation to address a global health problem. The perceived benefits, challenges, and limitations of this team approach to interdisciplinary postdoctoral training are presented. PMID:27821694

Helicopter noise regulations: An industry perspective

NASA Technical Reports Server (NTRS)

Wagner, R. A.

1978-01-01

A review of helicopter noise measurement programs and noise reduction/economic studies of FAA is given along with a critique of a study which addresses the economic impact of noise reduction on helicopter noise. Modification of several helicopters to reduce noise and demonstrate the economic impact of the application of the current state-of-the-art technology is discussed. Specific helicopters described include Boeing Vertol 347 Helicopter, Hughes OH-6 Helicopter, and Hughes 269C Helicopter. Other topics covered include: (1) noise trends and possible noise limits; (2) accuracy of helicopter noise prediction techniques; (3) limited change possibilities of derivatives; and (4) rotor impulsive noise. The unique operational capabilities of helicopters and the implications relative to noise regulations and certification are discussed.

Dose planning management of patients undergoing salvage whole brain radiation therapy after radiosurgery

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

Saw, Cheng B., E-mail: cheng.saw@aol.com; Battin, Frank; McKeague, Janice

2016-01-01

Dose or treatment planning management is necessary for the re-irradiation of intracranial relapses after focal irradiation, radiosurgery, or stereotactic radiotherapy. The current clinical guidelines for metastatic brain tumors are the use of focal irradiation if the patient presents with 4 lesions or less. Salvage treatments with the use of whole brain radiation therapy (WBRT) can then be used to limit disease progression if there is an intracranial relapse. However, salvage WBRT poses a number of challenges in dose planning to limit disease progression and preserve neurocognitive function. This work presents the dose planning management that addresses a method of delineatingmore » previously treated volumes, dose level matching, and the dose delivery techniques for WBRT.« less

Addressing the Educational Needs of Children with Williams Syndrome: A Rather Neglected Area of Research?

PubMed

Palikara, Olympia; Ashworth, Maria; Van Herwegen, Jo

2018-04-13

Williams syndrome (WS) is a rare neurodevelopmental disorder associated with physical health problems, limitations in cognitive abilities and increased risk of mental health difficulties. This profile of complex needs may make it challenging to support children with WS in schools. Surprisingly, in the current international move for inclusion, limited research exists on the educational provision and academic achievements of children with WS, including the non-existing literature on their voices and the perspectives of key stakeholders. This letter calls for additional research on the risk and protective factors associated with the educational outcomes of these children, the perspectives of the children themselves and the development of the evidence-base about the effectiveness of education intervention programs.

Opportunities for Launch Site Integrated System Health Engineering and Management

NASA Technical Reports Server (NTRS)

Waterman, Robert D.; Langwost, Patricia E.; Waterman, Susan J.

2005-01-01

The launch site processing flow involves operations such as functional verification, preflight servicing and launch. These operations often include hazards that must be controlled to protect human life and critical space hardware assets. Existing command and control capabilities are limited to simple limit checking durig automated monitoring. Contingency actions are highly dependent on human recognition, decision making, and execution. Many opportunities for Integrated System Health Engineering and Management (ISHEM) exist throughout the processing flow. This paper will present the current human-centered approach to health management as performed today for the shuttle and space station programs. In addition, it will address some of the more critical ISHEM needs, and provide recommendations for future implementation of ISHEM at the launch site.

Mechanistic insights for the development of Li-O2 battery materials: addressing Li2O2 conductivity limitations and electrolyte and cathode instabilities.

PubMed

McCloskey, Bryan D; Burke, Colin M; Nichols, Jessica E; Renfrew, Sara E

2015-08-18

The Li-air battery has received significant attention over the past decade given its high theoretical specific energy compared to competing energy storage technologies. Yet, numerous scientific challenges remain unsolved in the pursuit of attaining a battery with modest Coulombic efficiency and high capacity. In this Feature Article, we provide our current perspective on challenges facing the development of nonaqueous Li-O2 battery cathodes. We initially present a review on our understanding of electrochemical processes occurring at the nonaqueous Li-O2 cathode. Electrolyte and cathode instabilities and Li2O2 conductivity limitations are then discussed, and suggestions for future materials research development to alleviate these issues are provided.

Novel biomarkers for prediabetes, diabetes, and associated complications

PubMed Central

Dorcely, Brenda; Katz, Karin; Jagannathan, Ram; Chiang, Stephanie S; Oluwadare, Babajide; Goldberg, Ira J; Bergman, Michael

2017-01-01

The number of individuals with prediabetes is expected to grow substantially and estimated to globally affect 482 million people by 2040. Therefore, effective methods for diagnosing prediabetes will be required to reduce the risk of progressing to diabetes and its complications. The current biomarkers, glycated hemoglobin (HbA1c), fructosamine, and glycated albumin have limitations including moderate sensitivity and specificity and are inaccurate in certain clinical conditions. Therefore, identification of additional biomarkers is being explored recognizing that any single biomarker will also likely have inherent limitations. Therefore, combining several biomarkers may more precisely identify those at high risk for developing prediabetes and subsequent progression to diabetes. This review describes recently identified biomarkers and their potential utility for addressing the burgeoning epidemic of dysglycemic disorders. PMID:28860833

Dynamic Scattering Mode LCDs

NASA Astrophysics Data System (ADS)

Bahadur, Birendra

The following sections are included: * INTRODUCTION * CELL DESIGNING * EXPERIMENTAL OBSERVATIONS IN NEMATICS RELATED WITH DYNAMIC SCATTERING * Experimental Observations at D.C. Field and Electrode Effects * Experimental Observation at Low Frequency A.C. Fields * Homogeneously Aligned Nematic Regime * Williams Domains * Dynamic Scattering * Experimental Observation at High Frequency A.C. Field * Other Experimental Observations * THEORETICAL INTERPRETATIONS * Felici Model * Carr-Helfrich Model * D.C. Excitation * Dubois-Violette, de Gennes and Parodi Model * Low Freqency or Conductive Regime * High Frequency or Dielectric Regime * DYNAMIC SCATTERING IN SMECRIC A PHASE * ELECTRO-OPTICAL CHARACTERISTICS AND LIMITATIONS * Contrast Ratio vs. Voltage, Viewing Angle, Cell Gap, Wavelength and Temperature * Display Current vs. Voltage, Cell Gap and Temperature * Switching Time * Effect of Alignment * Effect of Conductivity, Temperature and Frequency * Addressing of DSM LCDs * Limitations of DSM LCDs * ACKNOWLEDGEMENTS * REFERENCES

A Clinical Approach to Addressing Diet with Migraine Patients.

PubMed

Slavin, Margaret; Ailani, Jessica

2017-02-01

Migraine is a common disorder causing attacks of neurological dysfunction and pain. Treatment ranges from pharmacological to lifestyle changes to improve both frequency and severity of attacks. Focus on lifestyle changes, especially diet, is often discussed during clinical visits in the care of migraine patients. Diet may play a role in triggering migraine, but available evidence on migraine and diet is limited. When advising patients on dietary changes to improve migraine, it is important to acknowledge the limits in evidence and the larger role that diet may play in lifestyle changes. This review will focus on current evidence on the effect of diet and migraine and use a case to illustrate how to approach diet changes in a patient with migraine.

Threshold-voltage modulated phase change heterojunction for application of high density memory

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

Yan, Baihan; Tong, Hao, E-mail: tonghao@hust.edu.cn; Qian, Hang

2015-09-28

Phase change random access memory is one of the most important candidates for the next generation non-volatile memory technology. However, the ability to reduce its memory size is compromised by the fundamental limitations inherent in the CMOS technology. While 0T1R configuration without any additional access transistor shows great advantages in improving the storage density, the leakage current and small operation window limit its application in large-scale arrays. In this work, phase change heterojunction based on GeTe and n-Si is fabricated to address those problems. The relationship between threshold voltage and doping concentration is investigated, and energy band diagrams and X-raymore » photoelectron spectroscopy measurements are provided to explain the results. The threshold voltage is modulated to provide a large operational window based on this relationship. The switching performance of the heterojunction is also tested, showing a good reverse characteristic, which could effectively decrease the leakage current. Furthermore, a reliable read-write-erase function is achieved during the tests. Phase change heterojunction is proposed for high-density memory, showing some notable advantages, such as modulated threshold voltage, large operational window, and low leakage current.« less

Robotic applications in abdominal surgery: their limitations and future developments.

PubMed

Taylor, G W; Jayne, D G

2007-03-01

In the past 20 years, the technical aspects of abdominal surgery have changed dramatically. Operations are now routinely performed by laparoscopic techniques utilizing small abdominal incisions, with less patient discomfort, earlier recovery, improved cosmesis, and in many cases reduced economic burden on the healthcare provider. These benefits have largely been seen in the application of laparoscopic techniques to relatively straightforward procedures. It is not clear whether the same benefits carry through to more complex abdominal operations, which are more technically demanding and for which current laparoscopic instrumentation is less well adapted. The aim of surgical robotics is to address these problems and allow the advantages of minimal access surgery to be seen in a greater range of operations. A literature search was performed to ascertain the current state of the art in surgical robotics for the abdomen, and the technologies emerging within this field. The reference lists of the sourced articles were also searched for further relevant papers. Currently available robotic devices for abdominal surgery are limited to large, costly 'slave-master' or telemanipulator systems, such as the da Vinci (Intuitive Surgical, Sunny Vale, CA). In addition to their size and expense, these systems share the same limitation, by virtue of the fulcrum effect on instrument manipulation inherent in the use of ports by which external instruments gain access to the abdominal cavity. In order to overcome these limitations several smaller telemanipulator systems are being developed, and progress towards freely mobile intracorporeal devices is being made. While current robotic systems have considerable advantages over conventional laparoscopic techniques, they are not without limitations. Miniaturisation of robotic components and systems is feasible and necessary to allow minimally invasive techniques to reach full potential. The ultimate extrapolation of this progress is the development of intracorporeal robotics, the feasibility of which has been demonstrated. Copyright 2006 John Wiley & Sons, Ltd.

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.

Moral Hard‐Wiring and Moral Enhancement

PubMed Central

Persson, Ingmar

2017-01-01

Abstract We have argued for an urgent need for moral bioenhancement; that human moral psychology is limited in its ability to address current existential threats due to the evolutionary function of morality to maximize cooperation in small groups. We address here Powell and Buchanan's novel objection that there is an ‘inclusivist anomaly’: humans have the capacity to care beyond in‐groups. They propose that ‘exclusivist’ (group‐based) morality is sensitive to environmental cues that historically indicated out‐group threat. When this is not present, we are inclusivist. They conclude that moral bioenhancement is unnecessary or less effective than socio‐cultural interventions. We argue that Powell and Buchanan underestimate the hard‐wiring features of moral psychology; their appeal to adaptively plastic, conditionally expressed responses accounts for only a fragment of our moral psychology. In addition to restrictions on our altruistic concern that their account addresses – such as racism and sexism – there are ones it is ill‐suited to address: that our concern is stronger for kin and friends and for concrete individuals rather than for statistical lives; also our bias towards the near future. Hard‐wired features of our moral psychology that are not clearly restrictions in altruistic concern also include reciprocity, tit‐for‐tat, and others. Biomedical means are not the only, and maybe not the most important, means of moral enhancement. Socio‐cultural means are of great importance and there are currently no biomedical interventions for many hard‐wired features. Nevertheless research is desirable because the influence of these features is greater than our critics think. PMID:28300281

Moral Hard-Wiring and Moral Enhancement.

PubMed

Persson, Ingmar; Savulescu, Julian

2017-05-01

We have argued for an urgent need for moral bioenhancement; that human moral psychology is limited in its ability to address current existential threats due to the evolutionary function of morality to maximize cooperation in small groups. We address here Powell and Buchanan's novel objection that there is an 'inclusivist anomaly': humans have the capacity to care beyond in-groups. They propose that 'exclusivist' (group-based) morality is sensitive to environmental cues that historically indicated out-group threat. When this is not present, we are inclusivist. They conclude that moral bioenhancement is unnecessary or less effective than socio-cultural interventions. We argue that Powell and Buchanan underestimate the hard-wiring features of moral psychology; their appeal to adaptively plastic, conditionally expressed responses accounts for only a fragment of our moral psychology. In addition to restrictions on our altruistic concern that their account addresses - such as racism and sexism - there are ones it is ill-suited to address: that our concern is stronger for kin and friends and for concrete individuals rather than for statistical lives; also our bias towards the near future. Hard-wired features of our moral psychology that are not clearly restrictions in altruistic concern also include reciprocity, tit-for-tat, and others. Biomedical means are not the only, and maybe not the most important, means of moral enhancement. Socio-cultural means are of great importance and there are currently no biomedical interventions for many hard-wired features. Nevertheless research is desirable because the influence of these features is greater than our critics think. © 2017 The Authors Bioethics Published by John Wiley & Sons Ltd.

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.

Toward Treatment Integrity: Developing an Approach to Measure the Treatment Integrity of a Dialectical Behavior Therapy Intervention With Homeless Youth in the Community.

PubMed

McCay, Elizabeth; Carter, Celina; Aiello, Andria; Quesnel, Susan; Howes, Carol; Johansson, Bjorn

2016-10-01

The current paper discusses an approach to measuring treatment integrity of dialectical behavioral therapy (DBT) when implemented within two programs providing services to street-involved youth in the community. Measuring treatment integrity is a critical component of effective implementation of evidence-based interventions in clinical practice, since sound treatment integrity increases confidence in client outcomes and intervention replicability. Despite being an essential part of implementation science, few studies report on treatment integrity, with limited research addressing either measurement tools or maintenance of treatment integrity. To address the lack of available treatment integrity measures, researchers in the current study developed and piloted a treatment integrity measure which pertain to the individual and group components of DBT. A total of 20 recordings were assessed using the treatment integrity measure. Results indicate that the community agency staff (e.g. youth workers, social workers & nurses) implemented the intervention as intended; increasing confidence in the outcome variables, the staffs' training and the replicability of the intervention. This article offers one approach to addressing treatment integrity when implementing evidence-based interventions, such as DBT in a community setting, and discusses the need for effective and feasible integrity measures that can be adopted in order to strengthen mental health practice in community settings. Copyright © 2016 Elsevier Inc. All rights reserved.

Physicians’ duty to recontact and update genetic advice

PubMed Central

Stevens, Yvonne A; Senner, Grant D; Marchant, Gary E

2017-01-01

This perspective addresses whether physicians have a duty to recontact former or current patients to update clinical advice based on newly discovered genomic information. Genetic information is unique compared with other medical data in that the underlying data do not appreciably change during the patients’ lifetime, but the clinical significance of that information will continue to evolve. Based on relevant case law and guidelines, there is no general, established legal duty for physicians to affirmatively recontact former or current patients to update clinical advice based on newly discovered genetic information. However, integration of genomics into clinical practice is advancing quickly, and there may be limited, specific situations where a physician may have a duty to provide updated genetic information. PMID:29158769

[AIDS and pauperization: principal concepts and empirical evidence].

PubMed

Bastos, F I; Szwarcwald, C L

2000-01-01

This paper discusses methodologies for analyzing relations between social inequalities, marginalization, prejudice, and vulnerability to HIV/AIDS, highlighting current difficulties and alternative research strategies. It also reviews the international and Brazilian literature, emphasizing: economic and macropolitical dimensions in the spread of HIV/AIDS; the role of drug policies and consumption; gender inequalities and prejudice; racial/ethnic inequalities and prejudice; and interaction with other STIs and their relationship to poverty; HIV/AIDS and health care standards, especially access to antiretroviral therapy; and human rights violations. Despite current methodological dilemmas in analyzing relations between psychosocial, cultural, and sociopolitical variables and vulnerability to HIV/AIDS and the limited Brazil literature, such themes merit further investigation, addressing Brazilian social and cultural specificities and profiting from recently developed research strategies.

Simulation study of short-channel effects of tunnel field-effect transistors

NASA Astrophysics Data System (ADS)

Fukuda, Koichi; Asai, Hidehiro; Hattori, Junichi; Mori, Takahiro; Morita, Yukinori; Mizubayashi, Wataru; Masahara, Meishoku; Migita, Shinji; Ota, Hiroyuki; Endo, Kazuhiro; Matsukawa, Takashi

2018-04-01

Short-channel effects of tunnel field-effect transistors (FETs) are investigated in detail using simulations of a nonlocal band-to-band tunneling model. Discussion is limited to silicon. Several simulation scenarios were considered to address different effects, such as source overlap and drain offset effects. Adopting the drain offset to suppress the drain leakage current suppressed the short channel effects. The physical mechanism underlying the short-channel behavior of the tunnel FETs (TFETs) was very different from that of metal-oxide-semiconductor FETs (MOSFETs). The minimal gate lengths that do not lose on-state current by one order are shown to be 3 nm for single-gate structures and 2 nm for double gate structures, as determined from the drain offset structure.

Vaccines: From Empirical Development to Rational Design

PubMed Central

Rueckert, Christine; Guzmán, Carlos A.

2012-01-01

Infectious diseases are responsible for an overwhelming number of deaths worldwide and their clinical management is often hampered by the emergence of multi-drug-resistant strains. Therefore, prevention through vaccination currently represents the best course of action to combat them. However, immune escape and evasion by pathogens often render vaccine development difficult. Furthermore, most currently available vaccines were empirically designed. In this review, we discuss why rational design of vaccines is not only desirable but also necessary. We introduce recent developments towards specifically tailored antigens, adjuvants, and delivery systems, and discuss the methodological gaps and lack of knowledge still hampering true rational vaccine design. Finally, we address the potential and limitations of different strategies and technologies for advancing vaccine development. PMID:23144616

Poliovirus Studies during the Endgame of the Polio Eradication Program.

PubMed

Arita, Minetaro

2017-01-24

Since the beginning of Global Polio Eradication Initiative in 1988, poliomyelitis cases caused by wild poliovirus (PV) have been drastically reduced, with only 74 cases reported in 2 endemic countries in 2015. The current limited PV transmission suggests that we are in the endgame of the polio eradication program. However, specific challenges have emerged in the endgame, including tight budget, switching of the vaccines, and changes in biorisk management of PV. To overcome these challenges, several PV studies have been implemented in the eradication program. Some of the responses to the emerging challenges in the polio endgame might be valuable in other infectious diseases eradication programs. Here, I will review challenges that confront the polio eradication program and current research to address these challenges.

Protecting posted genes: social networking and the limits of GINA.

PubMed

Soo-Jin Lee, Sandra; Borgelt, Emily

2014-01-01

The combination of decreased genotyping costs and prolific social media use is fueling a personal genetic testing industry in which consumers purchase and interact with genetic risk information online. Consumers and their genetic risk profiles are protected in some respects by the 2008 federal Genetic Information Nondiscrimination Act (GINA), which forbids the discriminatory use of genetic information by employers and health insurers; however, practical and technical limitations undermine its enforceability, given the everyday practices of online social networking and its impact on the workplace. In the Web 2.0 era, employers in most states can legally search about job candidates and employees online, probing social networking sites for personal information that might bear on hiring and employment decisions. We examine GINA's protections for online sharing of genetic information as well as its limitations, and propose policy recommendations to address current gaps that leave employees' genetic information vulnerable in a Web-based world.

77 FR 4385 - Self-Regulatory Organizations; NASDAQ OMX PHLX LLC; Notice of Filing and Immediate Effectiveness...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-01-27

... ``Exchanges''), to pause trading during periods of extraordinary market volatility in S&P 500 stocks.\\3\\ The... the date on which a limit up/limit down mechanism to address extraordinary market volatility, if... adoption of a limit up/limit down mechanism to address extraordinary market volatility, and further...

Gender career divide and women's disadvantage in depressive symptoms and physical limitations in France.

PubMed

Cambois, Emmanuelle; Garrouste, Clémentine; Pailhé, Ariane

2017-12-01

This study investigated the relationship between women's disadvantage in mental health and physical functioning and gender differences in career backgrounds. Sexual division of labor persists and key career characteristics are overrepresented in women: low-skilled first job, downward occupational trajectory, interruptions. These interrelated characteristics are usually linked to poor health. Their overrepresentation in women may be related to the female-male health gap; however, it may not if overrepresentation transposed into substantially weaker associations with poor health outcomes. To address this question, we used the French population survey "Health and Occupational Trajectories" (2006) and focused on 45-74 year-old individuals who ever worked (n=7537). Past career characteristics were qualified by retrospective information. Logistic regressions identified past characteristics related to current depressive symptoms and physical limitations. Non-linear decomposition showed whether these characteristics contributed to the gender health gap, through their different distribution and/or association with health. The overrepresentation of unskilled first jobs, current and past inactivity and unemployment in women contributed to their excess depressive symptoms. These contributions were only slightly reduced by the weaker mental health-relatedness of current inactivity in women and increased by the stronger relatedness of low-skilled and self-employed first jobs. Overrepresentation of current inactivity, past interruptions and downward trajectories also contributed positively to women's excess physical limitations. Gender-specific career backgrounds were significantly linked to women's disadvantage in mental health and physical functioning. We need to further explore whether equalization of opportunities, especially at the early stages and in terms of career continuity, could help to reduce women's mental and physical health disadvantage.

Health Technology Assessment and Private Payers' Coverage of Personalized Medicine

PubMed Central

Trosman, Julia R.; Van Bebber, Stephanie L.; Phillips, Kathryn A.

2011-01-01

Purpose: Health technology assessment (HTA) plays an increasing role in translating emerging technologies into clinical practice and policy. Private payers are important users of HTA whose decisions impact adoption and use of new technologies. We examine the current use of HTA by private payers in coverage decisions for personalized medicine, a field that is increasingly impacting oncology practice. Study Design: Literature review and semistructured interviews. Methods: We reviewed seven HTA organizations used by private payers in decision making and explored how HTA is used by major US private payers (n = 11) for coverage of personalized medicine. Results: All payers used HTA in coverage decisions, but the number of HTA organizations used by an individual payer ranged from one (n = 1) to all seven (n = 1), with the majority of payers (n = 8) using three or more. Payers relied more extensively on HTAs for reviews of personalized medicine (64%) than for other technologies. Most payers (82%) equally valued expertise of reviewers and rigor of evaluation as HTA strengths, whereas genomic-specific methodology was less important. Key reported shortcomings were limited availability of reviews (73%) and limited inclusion of nonclinical factors (91%), such as cost-effectiveness or adoption of technology in clinical practice. Conclusion: Payers use a range of HTAs in their coverage decisions related to personalized medicine, but the current state of HTA to comprehensively guide those decisions is limited. HTA organizations should address current gaps to improve their relevance to payers and clinicians. Current HTA shortcomings may also inform the national HTA agenda. PMID:21886515

Affect and Health Behavior Co-Occurrence: The Emerging Roles of Transdiagnostic Factors and Sociocultural Factors.

PubMed

Zvolensky, Michael J; Leventhal, Adam M

2016-01-01

The majority of scientific work addressing relations among affective states and health correlates has focused primarily on their co-occurrence and a limited range of health conditions. We have developed a Special Issue to highlight recent advances in this emerging field of work that addresses the nature and interplay between affective states and disorders, in terms of their impact and consequences from health status and behavior. This Special Issue is organized into three parts classified as (a) co-occurrence and interplay between (b) transdiagnostic factors and (c) sociocultural factors. It is hoped that this issue will (a) alert readers to the significance of this work at different levels of analysis, (b) illustrate the many domains currently being explored via innovative approaches, and (c) identify fecund areas for future systematic study. © The Author(s) 2016.

Ten steps to developing a national agenda to address financial conflicts of interest in industry sponsored clinical research.

PubMed

Tereskerz, Patricia M; Moreno, Jonathan

2005-01-01

Financial liaisons between clinical researchers, research institutions, and industrial sponsors have gained momentum in recent years. In the process, it has been argued by many that trust in the research infrastructure is being eroded by the financial conflicts of interest that emerge from these arrangements. Yet, the financial resources of industry are needed to continue technology transfer from the bench to the bedside. Policy makers and government regulators are currently struggling to determine how to best manage financial conflicts of interest that emerge from these liaisons. Various organizations and government entities have proposed different strategies. This paper explores the limitations of existing measures and recommends that a unified national agenda is needed. We propose 10 steps to develop an agenda to address financial conflicts of interest in industry-sponsored clinical research.

Semantic interoperability challenges to process large amount of data perspectives in forensic and legal medicine.

PubMed

Jaulent, Marie-Christine; Leprovost, Damien; Charlet, Jean; Choquet, Remy

2018-07-01

This article is a position paper dealing with semantic interoperability challenges. It addresses the Variety and Veracity dimensions when integrating, sharing and reusing large amount of heterogeneous data for data analysis and decision making applications in the healthcare domain. Many issues are raised by the necessity to conform Big Data to interoperability standards. We discuss how semantics can contribute to the improvement of information sharing and address the problem of data mediation with domain ontologies. We then introduce the main steps for building domain ontologies as they could be implemented in the context of Forensic and Legal medicine. We conclude with a particular emphasis on the current limitations in standardisation and the importance of knowledge formalization. Copyright © 2016 Elsevier Ltd and Faculty of Forensic and Legal Medicine. All rights reserved.

Improving Pathologists' Communication Skills.

PubMed

Dintzis, Suzanne

2016-08-01

The 2015 Institute of Medicine report on diagnostic error has placed a national spotlight on the importance of improving communication among clinicians and between clinicians and patients [1]. The report emphasizes the critical role that communication plays in patient safety and outlines ways that pathologists can support this process. Despite recognition of communication as an essential element in patient care, pathologists currently undergo limited (if any) formal training in communication skills. To address this gap, we at the University of Washington Medical Center developed communication training with the goal of establishing best practice procedures for effective pathology communication. The course includes lectures, role playing, and simulated clinician-pathologist interactions for training and evaluation of pathology communication performance. Providing communication training can help create reliable communication pathways that anticipate and address potential barriers and errors before they happen. © 2016 American Medical Association. All Rights Reserved.

75 FR 61704 - Fisheries of the South Atlantic; South Atlantic Fishery Management Council; Public Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2010-10-06

... of black sea bass and golden tilefish; Amendment 24 addressing management of red grouper and Amendment 22 addressing long- term management of red snapper, and the Comprehensive Annual Catch Limit (ACL... & 10 to the Snapper Grouper Fishery Management Plan (FMP) addressing trip limits and changes to red...

Computing patient data in the cloud: practical and legal considerations for genetics and genomics research in Europe and internationally.

PubMed

Molnár-Gábor, Fruzsina; Lueck, Rupert; Yakneen, Sergei; Korbel, Jan O

2017-06-20

Biomedical research is becoming increasingly large-scale and international. Cloud computing enables the comprehensive integration of genomic and clinical data, and the global sharing and collaborative processing of these data within a flexibly scalable infrastructure. Clouds offer novel research opportunities in genomics, as they facilitate cohort studies to be carried out at unprecedented scale, and they enable computer processing with superior pace and throughput, allowing researchers to address questions that could not be addressed by studies using limited cohorts. A well-developed example of such research is the Pan-Cancer Analysis of Whole Genomes project, which involves the analysis of petabyte-scale genomic datasets from research centers in different locations or countries and different jurisdictions. Aside from the tremendous opportunities, there are also concerns regarding the utilization of clouds; these concerns pertain to perceived limitations in data security and protection, and the need for due consideration of the rights of patient donors and research participants. Furthermore, the increased outsourcing of information technology impedes the ability of researchers to act within the realm of existing local regulations owing to fundamental differences in the understanding of the right to data protection in various legal systems. In this Opinion article, we address the current opportunities and limitations of cloud computing and highlight the responsible use of federated and hybrid clouds that are set up between public and private partners as an adequate solution for genetics and genomics research in Europe, and under certain conditions between Europe and international partners. This approach could represent a sensible middle ground between fragmented individual solutions and a "one-size-fits-all" approach.

Researcher's guide to the NASA Ames Flight Simulator for Advanced Aircraft (FSAA)

NASA Technical Reports Server (NTRS)

Sinacori, J. B.; Stapleford, R. L.; Jewell, W. F.; Lehman, J. M.

1977-01-01

Performance, limitations, supporting software, and current checkout and operating procedures are presented for the flight simulator, in terms useful to the researcher who intends to use it. Suggestions to help the researcher prepare the experimental plan are also given. The FSAA's central computer, cockpit, and visual and motion systems are addressed individually but their interaction is considered as well. Data required, available options, user responsibilities, and occupancy procedures are given in a form that facilitates the initial communication required with the NASA operations' group.

Molecular Genetic Studies of Bone Mechanical Strain and of Pedigrees with Very High Bone Density

DTIC Science & Technology

2010-11-01

shear, such as 129J and AKR (reported previously), would also exhibit this same A G SNP at nucleotide 1075 of the Lepr. Our future work will address...no person shall be subject to any penalty for failing to comply with a collection of information if it does not display a currently valid OMB control...CLASSIFICATION OF: “U” 17. LIMITATION OF ABSTRACT 18. NUMBER OF PAGES 362 19a. NAME OF RESPONSIBLE PERSON USAMRMC a . REPORT U b. ABSTRACT U c. THIS

Human Effectiveness and Risk Characterization of the Electromuscular Incapacitation Device - A Limited Analysis of the TASER. Part 1. Technical Report

DTIC Science & Technology

2005-03-01

factors such as wind, temperature, and precipitation do not affect the dose of electricity delivered since the electricity flows through insulated wires...additional (and perhaps lethal) force. It is unknown if these mechanisms for success will also occur in DoD use. If they do not, and if the complete or...information if it does not display s currently valid OMB control number. PLEASE DO NOT RETURN YOUR FORM TO THE ABOVE ADDRESS. 1. REPORT DATE (DD-MM-YYYY

Addressing Production System Failures Using Multi-agent Control

NASA Astrophysics Data System (ADS)

Gautam, Rajesh; Miyashita, Kazuo

Output in high-volume production facilities is limited by bottleneck machines. We propose a control mechanism by modeling workstations as agents that pull jobs from other agents based on their current WIP level and requirements. During failures, when flows of some jobs are disrupted, the agents pull alternative jobs to maintain utilization of their capacity at a high level. In this paper, we empirically demonstrate that the proposed mechanism can react to failures more appropriately than other control mechanisms using a benchmark problem of a semiconductor manufacturing process.

Fabrication and Characterization of a Long Wavelength InP HBT-Based Optical Receiver

NASA Technical Reports Server (NTRS)

Roenker, Kenneth P.

1997-01-01

Development of a high speed photodetector - the InP-based phototransistor (HPT) for use in optical receivers for microwave signal distribution for satellite phased array antennas is addressed. Currently, p-i-n photodetectors are used because of their compatibility with the heterojunction bipolar transistor (HBT), but their performance limits the bandwidth of these optical receivers. The HPT photodetector was investigated here as an alternative photodetector for monolithic integration with heterojunction bipolar transistor amplifiers in long wavelength (1.3 micron), gigahertz (GHz) frequency optical receivers.

Environmental management practices and engineering science: a review and typology for future research.

PubMed

Evangelinos, Konstantinos I; Allan, Stuart; Jones, Keith; Nikolaou, Ioannis E

2014-04-01

Current literature describes a number of environmental management practices and cleaner production methods that facilitate different industrial sectors to address their various environmental impacts. The high number of present practices makes their use especially difficult and complicated. This paper aims to shed light on this field by providing a typology of those environmental management practices (such as environmental management systems, environmental indicators assessment methodologies, and cleaner productions methods) and their limitations. It also describes the strengths and weaknesses of using such tools and thoughts for future research. © 2013 SETAC.

Analytical aspects of plant metabolite profiling platforms: current standings and future aims.

PubMed

Seger, Christoph; Sturm, Sonja

2007-02-01

Over the past years, metabolic profiling has been established as a comprehensive systems biology tool. Mass spectrometry or NMR spectroscopy-based technology platforms combined with unsupervised or supervised multivariate statistical methodologies allow a deep insight into the complex metabolite patterns of plant-derived samples. Within this review, we provide a thorough introduction to the analytical hard- and software requirements of metabolic profiling platforms. Methodological limitations are addressed, and the metabolic profiling workflow is exemplified by summarizing recent applications ranging from model systems to more applied topics.

Increasing the linguistic competence of the nurse with limited English proficiency.

PubMed

Guttman, Minerva S

2004-01-01

Teaching linguistic competence to nursing students educated in the United States but whose families are recent immigrants is a difficult task for nurse educators. Although students may easily learn the mechanics of a new language, the cultural differences must also be addressed. In the face of the current nursing shortage, it is critically important that strategies to improve linguistic competence be incorporated into curricular efforts. This article describes integrated skills reinforcement as one academic strategy to improve reading, speaking, listening, and writing skills. Suggestions are made for incorporating and evaluating these techniques.

Managed care, consumerism, preventive medicine: does a causal connection exist?

PubMed

Rizzo, John A; Xie, Yang

2006-07-01

Managed care plans, and HMOs in particular, have long touted that their emphasis is on preventive care, to avoid expensive illness later in life. However, few articles in the contemporary literature adequately address this claim. The available evidence seems to support that HMOs do, in fact, provide greater access to preventive services, but the limitations of this research are substantial. This article discusses the scientific evidence on the relationships between managed care arrangements and the implications for preventive care in the current era, emphasizing consumer choices and less-restrictive plan structures.

The science and questions surrounding chronic traumatic encephalopathy.

PubMed

Ban, Vin Shen; Madden, Christopher J; Bailes, Julian E; Hunt Batjer, H; Lonser, Russell R

2016-04-01

Recently, the pathobiology, causes, associated factors, incidence and prevalence, and natural history of chronic traumatic encephalopathy (CTE) have been debated. Data from retrospective case series and high-profile media reports have fueled public fear and affected the medical community's understanding of the role of sports-related traumatic brain injury (TBI) in the development of CTE. There are a number of limitations posed by the current evidence that can lead to confusion within the public and scientific community. In this paper, the authors address common questions surrounding the science of CTE and propose future research directions.

A Profession Without Limits: The Changing Role of Reference Librarians.

PubMed

Sullo, Elaine; Gomes, Alexandra W

2016-01-01

Reference librarians, specifically those working in academic health sciences environments, have expanded their roles and taken on new and unique responsibilities. While librarians at The George Washington University's Himmelfarb Health Sciences Library continue to provide traditional reference services, they have gone beyond their comfort zone in many cases to become involved in activities that are outside of the librarian's established role. This article describes the current roles of Himmelfarb's reference librarians, as well as the way these librarians prepared for these roles and addressed the associated challenges.

Eight questions about physician-rating websites: a systematic review.

PubMed

Emmert, Martin; Sander, Uwe; Pisch, Frank

2013-02-01

Physician-rating websites (PRWs) are currently gaining in popularity because they increase transparency in the health care system. However, research on the characteristics and content of these portals remains limited. To identify and synthesize published evidence in peer-reviewed journals regarding frequently discussed issues about PRWs. Peer-reviewed English and German language literature was searched in seven databases (Medline (via PubMed), the Cochrane Library, Business Source Complete, ABI/Inform Complete, PsycInfo, Scopus, and ISI web of knowledge) without any time constraints. Additionally, reference lists of included studies were screened to assure completeness. The following eight previously defined questions were addressed: 1) What percentage of physicians has been rated? 2) What is the average number of ratings on PRWs? 3) Are there any differences among rated physicians related to socioeconomic status? 4) Are ratings more likely to be positive or negative? 5) What significance do patient narratives have? 6) How should physicians deal with PRWs? 7) What major shortcomings do PRWs have? 8) What recommendations can be made for further improvement of PRWs? Twenty-four articles published in peer-reviewed journals met our inclusion criteria. Most studies were published by US (n=13) and German (n=8) researchers; however, the focus differed considerably. The current usage of PRWs is still low but is increasing. International data show that 1 out of 6 physicians has been rated, and approximately 90% of all ratings on PRWs were positive. Although often a concern, we could not find any evidence of "doctor-bashing". Physicians should not ignore these websites, but rather, monitor the information available and use it for internal and ex-ternal purpose. Several shortcomings limit the significance of the results published on PRWs; some recommendations to address these limitations are presented. Although the number of publications is still low, PRWs are gaining more attention in research. But the current condition of PRWs is lacking. This is the case both in the United States and in Germany. Further research is necessary to increase the quality of the websites, especially from the patients' perspective.

76 FR 19823 - Self-Regulatory Organizations; NASDAQ OMX PHLX LLC; Notice of Filing and Immediate Effectiveness...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-04-08

..., 2011 or the date on which a limit up/limit down mechanism to address extraordinary market volatility..., 2011 or the date on which a limit up/limit down mechanism to address extraordinary market volatility... volatility in S&P 500 stocks.\\3\\ The rules require the Listing Markets \\4\\ to issue five-minute trading...

Engineering the next generation of clinical deep brain stimulation technology.

PubMed

McIntyre, Cameron C; Chaturvedi, Ashutosh; Shamir, Reuben R; Lempka, Scott F

2015-01-01

Deep brain stimulation (DBS) has evolved into a powerful clinical therapy for a range of neurological disorders, but even with impressive clinical growth, DBS technology has been relatively stagnant over its history. However, enhanced collaborations between neural engineers, neuroscientists, physicists, neurologists, and neurosurgeons are beginning to address some of the limitations of current DBS technology. These interactions have helped to develop novel ideas for the next generation of clinical DBS systems. This review attempts collate some of that progress with two goals in mind. First, provide a general description of current clinical DBS practices, geared toward educating biomedical engineers and computer scientists on a field that needs their expertise and attention. Second, describe some of the technological developments that are currently underway in surgical targeting, stimulation parameter selection, stimulation protocols, and stimulation hardware that are being directly evaluated for near term clinical application. Copyright © 2015 Elsevier Inc. All rights reserved.

River runoff estimates based on remotely sensed surface velocities

NASA Astrophysics Data System (ADS)

Grünler, Steffen; Stammer, Detlef; Romeiser, Roland

2010-05-01

One promising technique for river runoff estimates from space is the retrieval of surface currents on the basis of synthetic aperture radar along-track interferometry (ATI). The German satellite TerraSAR-X, which was launched in June 2007, will permit ATI measurements in an experimental mode. Based on numerical simulations, we present findings of a research project in which the potential of satellite measurements of various parameters with different temporal and spatial sampling characteristics is evaluated. A sampling strategy for river runoff estimates is developed. We address the achievable accuracy and limitations of such estimates for different local flow conditions at selected test site. High-resolution three-dimensional current fields in the Elbe river (Germany) from a numerical model are used as reference data set and input for simulations of a variety of possible measuring and data interpretation strategies to be evaluated. Addressing the problem of aliasing we removed tidal signals from the sampling data. Discharge estimates on the basis of measured surface current fields and river widths from TerraSAR-X are successfully simulated. The differences of the resulted net discharge estimate are between 30-55% for a required continuously observation period of one year. We discuss the applicability of the measuring strategies to a number of major rivers. Further we show results of runoff estimates by the retrieval of surface current fields by real TerraSAR-X ATI data (AS mode) for the Elbe river study area.

Medical Data Architecture (MDA) Project Status

NASA Technical Reports Server (NTRS)

Krihak, M.; Middour, C.; Gurram, M.; Wolfe, S.; Marker, N.; Winther, S.; Ronzano, K.; Bolles, D.; Toscano, W.; Shaw, T.

2018-01-01

The Medical Data Architecture (MDA) project supports the Exploration Medical Capability (ExMC) risk to minimize or reduce the risk of adverse health outcomes and decrements in performance due to in-flight medical capabilities on human exploration missions. To mitigate this risk, the ExMC MDA project addresses the technical limitations identified in ExMC Gap Med 07: We do not have the capability to comprehensively process medically-relevant information to support medical operations during exploration missions. This gap identifies that the current in-flight medical data management includes a combination of data collection and distribution methods that are minimally integrated with on-board medical devices and systems. Furthermore, there are a variety of data sources and methods of data collection. For an exploration mission, the seamless management of such data will enable a more medically autonomous crew than the current paradigm. The medical system requirements are being developed in parallel with the exploration mission architecture and vehicle design. ExMC has recognized that in order to make informed decisions about a medical data architecture framework, current methods for medical data management must not only be understood, but an architecture must also be identified that provides the crew with actionable insight to medical conditions. This medical data architecture will provide the necessary functionality to address the challenges of executing a self-contained medical system that approaches crew health care delivery without assistance from ground support. Hence, the products supported by current prototype development will directly inform exploration medical system requirements.

Postpartum depression among visible and invisible sexual minority women: a pilot study.

PubMed

Flanders, Corey E; Gibson, Margaret F; Goldberg, Abbie E; Ross, Lori E

2016-04-01

Significant numbers of sexual minority women are choosing to parent. Despite this, there is limited research on postpartum depression (PPD) with sexual minority mothers and less research considering differences within sexual minority women in the experience of PPD. This research examines two questions to address this gap in research: (1) Do experiences of PPD symptoms vary between different subgroups of sexual minority women, and (2) Which recruitment strategies effectively address the challenge of recruiting sexual minority women who are pregnant? Two Canadian studies recruited participants via consecutive or convenience sampling from midwifery clinics and hospital sites. Participants completed prenatal and postnatal measures of PPD symptoms, social support, and perceived discrimination. Considering our first question, we found an interaction effect between past sexual behavior and current partner gender. Women currently partnered with men reported higher scores on the Edinburgh Postpartum Depression Scale when their sexual history included partners of more than one gender, whereas this effect was not found among women who were currently partnered with women or not partnered. Regarding our second question, most sexual minority participants recruited through convenience sampling were partnered with women and identified as lesbian or queer, while most participants recruited through consecutive sampling were partnered with men and identified as bisexual. Women whose sexual histories include more than one gender and are currently partnered with men may be at a higher risk for PPD symptoms. Recruitment method may influence the type of sample recruited for perinatal mental health research among sexual minority women.

Medical Data Architecture Project Status

NASA Technical Reports Server (NTRS)

Krihak, M.; Middour, C.; Gurram, M.; Wolfe, S.; Marker, N.; Winther, S.; Ronzano, K.; Bolles, D.; Toscano, W.; Shaw, T.

2018-01-01

The Medical Data Architecture (MDA) project supports the Exploration Medical Capability (ExMC) risk to minimize or reduce the risk of adverse health outcomes and decrements in performance due to in-flight medical capabilities on human exploration missions. To mitigate this risk, the ExMC MDA project addresses the technical limitations identified in ExMC Gap Med 07: We do not have the capability to comprehensively process medically-relevant information to support medical operations during exploration missions. This gap identifies that the current in-flight medical data management includes a combination of data collection and distribution methods that are minimally integrated with on-board medical devices and systems. Furthermore, there are a variety of data sources and methods of data collection. For an exploration mission, the seamless management of such data will enable a more medically autonomous crew than the current paradigm. The medical system requirements are being developed in parallel with the exploration mission architecture and vehicle design. ExMC has recognized that in order to make informed decisions about a medical data architecture framework, current methods for medical data management must not only be understood, but an architecture must also be identified that provides the crew with actionable insight to medical conditions. This medical data architecture will provide the necessary functionality to address the challenges of executing a self-contained medical system that approaches crew health care delivery without assistance from ground support. Hence, the products supported by current prototype development will directly inform exploration medical system requirements.

Lithium-Metal Infused Trenches: Progress toward a Divertor Solution

NASA Astrophysics Data System (ADS)

Ruzic, D. N.; Fiflis, P.; Christenson, M.; Szott, M.; Xu, W.; Jung, S.; Morgan, T. W.; Kalathiparambil, K.

2014-10-01

The application of liquid metal, especially liquid lithium, as a plasma facing component (PFC) has the capacity to offer a strong alternative to solid PFCs by reducing damage concerns and enhancing plasma performance. The Liquid-Metal Infused Trenches (LiMIT) concept is a liquid metal divertor alternative which employs thermoelectric current from either plasma or external heating in tandem with the toroidal field to self-propel liquid lithium through a series of trenches. LiMIT has been tested in several devices, namely HT-7, the UIUC SLiDE and TELS facilities and Magnum PSI at heat fluxes of up to 3 MW/m-2. Results of these experiments, including velocity and temperature measurements, power handling considerations, and preliminary vapor shielding results will be discussed, focusing on the 117 shots performed at Magnum scanning magnetic fields and heat fluxes up to ~ 0.3 T and 3 MW/m-2. Concerns over tritium retention and MHD droplet ejection will additionally be addressed. LiMIT has also been proposed to function as a limiter on the EAST moveable limiter arm and tests have been performed with a prototype module inclined at various angles.

Competition and facilitation may lead to asymmetric range shift dynamics with climate change.

PubMed

Ettinger, Ailene; HilleRisLambers, Janneke

2017-09-01

Forecasts of widespread range shifts with climate change stem from assumptions that climate drives species' distributions. However, local adaptation and biotic interactions also influence range limits and thus may impact range shifts. Despite the potential importance of these factors, few studies have directly tested their effects on performance at range limits. We address how population-level variation and biotic interactions may affect range shifts by transplanting seeds and seedlings of western North American conifers of different origin populations into different competitive neighborhoods within and beyond their elevational ranges and monitoring their performance. We find evidence that competition with neighboring trees limits performance within current ranges, but that interactions between adults and juveniles switch from competitive to facilitative at upper range limits. Local adaptation had weaker effects on performance that did not predictably vary with range position or seed origin. Our findings suggest that competitive interactions may slow species turnover within forests at lower range limits, whereas facilitative interactions may accelerate the pace of tree expansions upward near timberline. © 2017 John Wiley & Sons Ltd.

Acceleration and focusing of plasma flows

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

Griswold, Martin Elias

The acceleration of flowing plasmas is a fundamental problem that is useful in a wide variety of technological applications. We consider the problem from the perspective of plasma propulsion. Gridded ion thrusters and Hall thrusters are the most commonly used devices to create flowing plasma for space propulsion, but both suffer from fundamental limitations. Gridded ion sources create good quality beams in terms of energy spread and spatial divergence, but the Child-Langmuir law in the non-neutral acceleration region limits the maximum achievable current density. Hall thrusters avoid this limitation by accelerating ions in quasi-neutral plasma but, as a result, producemore » plumes with high spatial divergence and large energy spread. In addition the more complicated magnetized plasma in the Hall Thruster produces oscillations that can reduce the efficiency of the thruster by increasing electron transport to the anode. We present investigations of three techniques to address the fundamental limitations on the performance of each thruster. First, we propose a method to increase the time-averaged current density (and thus thrust density) produced by a gridded ion source above the Child-Langmuir limit by introducing time-varying boundary conditions. Next, we use an electrostatic plasma lens to focus the Hall thruster plume, and finally we develop a technique to suppress a prominent oscillation that degrades the performance of Hall thrusters. The technique to loosen the constraints on current density from gridded ion thrusters actually applies much more broadly to any space charge limited flow. We investigate the technique with a numerical simulation and by proving a theoretical upper bound. While we ultimately conclude that the approach is not suitable for space propulsion, our results proved useful in another area, providing a benchmark for research into the spontaneously time-dependent current that arises in microdiodes. Next, we experimentally demonstrate a novel approach to reducing plume divergence by using a PL located in the plume of the thruster to focus ions after they were ionized and accelerated. Finally we further improve thruster operation by suppressing a prominent low frequency oscillation in the thruster known as the rotating spoke. The suppression leads to decreased electron transport and more control over the operating conditions in the thruster.« less

The Mars Orbital Catalog of Hydrated Alteration Signatures (MOCHAS) - Initial release

NASA Astrophysics Data System (ADS)

Carter, John; OMEGA and CRISM Teams

2016-10-01

Aqueous minerals have been identified from orbit at a number of localities, and their analysis allowed refining the water story of Early Mars. They are also a main science driver when selecting current and upcoming landing sites for roving missions.Available catalogs of mineral detections exhibit a number of drawbacks such as a limited sample size (a thousand sites at most), inhomogeneous sampling of the surface and of the investigation methods, and the lack of contextual information (e.g. spatial extent, morphological context). The MOCHAS project strives to address such limitations by providing a global, detailed survey of aqueous minerals on Mars based on 10 years of data from the OMEGA and CRISM imaging spectrometers. Contextual data is provided, including deposit sizes, morphology and detailed composition when available. Sampling biases are also addressed.It will be openly distributed in GIS-ready format and will be participative. For example, it will be possible for researchers to submit requests for specific mapping of regions of interest, or add/refine mineral detections.An initial release is scheduled in Fall 2016 and will feature a two orders of magnitude increase in sample size compared to previous studies.

Predictors of employment for young adults with developmental motor disabilities.

PubMed

Magill-Evans, Joyce; Galambos, Nancy; Darrah, Johanna; Nickerson, Christy

2008-01-01

To identify the personal, family, and community factors that facilitate or hinder employment for young adults with developmental motor disabilities. Quantitative methods with an embedded qualitative component were used. Seventy-six persons between the ages of 20 and 30 years of age (Mean = 25, SD = 3.1) with a diagnosis of either cerebral palsy or spina bifida completed questionnaires addressing factors such as depression, and participated in a semi-structured interview that allowed participants to describe their experiences with education, employment, transportation, and other services. Almost half of the participants (n = 35) were not currently employed. Hierarchical regression analyses indicated that gender (females were less likely to be employed), IQ (lower IQ associated with unemployment), and transportation dependence accounted for 42% of the variance in employment. Themes emerging from content analysis of the interviews supported the findings related to transportation barriers. Social reactions to disability limited employment opportunities, and participants often felt stuck in terms of employment options with limited opportunities for advancement. Transportation is a significant barrier to employment and innovative solutions are needed. Issues related to gender need to be considered when addressing employment inequities for persons with primarily motor disabilities.

Open source modular ptosis crutch for the treatment of myasthenia gravis.

PubMed

Saidi, Trust; Sivarasu, Sudesh; Douglas, Tania S

2018-02-01

Pharmacologic treatment of Myasthenia Gravis presents challenges due to poor tolerability in some patients. Conventional ptosis crutches have limitations such as interference with blinking which causes ocular surface drying, and frequent irritation of the eyes. To address this problem, a modular and adjustable ptosis crutch for elevating the upper eyelid in Myasthenia Gravis patients has been proposed as a non-surgical and low-cost solution. Areas covered: This paper reviews the literature on the challenges in the treatment of Myasthenia Gravis globally and focuses on a modular and adjustable ptosis crutch that has been developed by the Medical Device Laboratory at the University of Cape Town. Expert commentary: The new medical device has potential as a simple, effective and unobtrusive solution to elevate the drooping upper eyelid(s) above the visual axis without the need for medication and surgery. Access to the technology is provided through an open source platform which makes it available globally. Open access provides opportunities for further open innovation to address the current limitations of the device, ultimately for the benefit not only of people suffering from Myasthenia Gravis but also of those with ptosis from other aetiologies.

A CD45-based barcoding approach to multiplex mass-cytometry (CyTOF).

PubMed

Lai, Liyun; Ong, Raymond; Li, Juntao; Albani, Salvatore

2015-04-01

CyTOF enables the study of the immune system with a complexity, depth, and multidimensionality never achieved before. However, the full potential of using CyTOF can be limited by scarce cell samples. Barcoding strategies developed based on direct labeling of cells using maleimido-monoamide-DOTA (m-DOTA) provide a very useful tool. However, using m-DOTA has some inherent problems, mainly associated with signal intensity. This may be a source of uncertainty when samples are multiplexed. As an alternative or complementary approach to m-DOTA, conjugating an antibody, specific for a membrane protein present on most immune cells, with different isotopes could address the issues of stability and signal intensity needed for effective barcoding. We chose for this purpose CD45, and designed experiments to address different types of cultures and the ability to detect extra- and intra-cellular targets. We show here that our approach provides an useful alternative to m-DOTA in terms of sensitivity, specificity, flexibility, and user-friendliness. Our manuscript provides details to effectively barcode immune cells, overcoming limitations in current technology and enabling the use of CyTOF with scarce samples (for instance precious clinical samples). © 2015 The Authors. Published by Wiley Periodicals, Inc.

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.

Active books: the design of an implantable stimulator that minimizes cable count using integrated circuits very close to electrodes.

PubMed

Liu, Xiao; Demosthenous, Andreas; Vanhoestenberghe, Anne; Jiang, Dai; Donaldson, Nick

2012-06-01

This paper presents an integrated stimulator that can be embedded in implantable electrode books for interfacing with nerve roots at the cauda equina. The Active Book overcomes the limitation of conventional nerve root stimulators which can only support a small number of stimulating electrodes due to cable count restriction through the dura. Instead, a distributed stimulation system with many tripole electrodes can be configured using several Active Books which are addressed sequentially. The stimulator was fabricated in a 0.6-μm high-voltage CMOS process and occupies a silicon area of 4.2 × 6.5 mm(2). The circuit was designed to deliver up to 8 mA stimulus current to tripole electrodes from an 18 V power supply. Input pad count is limited to five (two power and three control lines) hence requiring a specific procedure for downloading stimulation commands to the chip and extracting information from it. Supported commands include adjusting the amplitude of stimulus current, varying the current ratio at the two anodes in each channel, and measuring relative humidity inside the chip package. In addition to stimulation mode, the chip supports quiescent mode, dissipating less than 100 nA current from the power supply. The performance of the stimulator chip was verified with bench tests including measurements using tripoles in saline.

Experimental evaluation of a flexible I/O architecture for accelerating workflow engines in ultrascale environments

DOE PAGES

Duro, Francisco Rodrigo; Blas, Javier Garcia; Isaila, Florin; ...

2016-10-06

The increasing volume of scientific data and the limited scalability and performance of storage systems are currently presenting a significant limitation for the productivity of the scientific workflows running on both high-performance computing (HPC) and cloud platforms. Clearly needed is better integration of storage systems and workflow engines to address this problem. This paper presents and evaluates a novel solution that leverages codesign principles for integrating Hercules—an in-memory data store—with a workflow management system. We consider four main aspects: workflow representation, task scheduling, task placement, and task termination. As a result, the experimental evaluation on both cloud and HPC systemsmore » demonstrates significant performance and scalability improvements over existing state-of-the-art approaches.« less

Setting radon-specific release criteria and demonstrating compliance for land affected by NORM.

PubMed

García-Talavera, M; Martínez, M; Matarranz, J L M; Ramos, L

2008-11-01

Residues from industrial activities involving naturally occurring radioactive materials (NORMs) may cause radiation exposures to members of the public, particularly when NORM-affected land is brought into residential use. To provide an adequate protection against radiation in such situations, the following limiting criteria are currently required in Spain for releasing NORM-affected land: (i) no more than a 300 microSv yr(-1) increase (excluding radon doses) over the natural background; (ii) (222)Rn concentrations in hypothetical future dwellings lower than 200 Bq m(-3); and (iii) reduction of all radiation exposures to as low as reasonable achievable. This paper addresses some of the problems encountered in translating the (222)Rn criterion into site-specific release limits and in demonstrating compliance with them.

Military service, deployments, and exposures in relation to amyotrophic lateral sclerosis etiology and survival.

PubMed

Beard, John D; Kamel, Freya

2015-01-01

Rates of amyotrophic lateral sclerosis (ALS) have been reported to be higher among US military veterans, who currently number more than 21 million, but the causal factor(s) has not been identified. We conducted a review to examine the weight of evidence for associations between military service, deployments, and exposures and ALS etiology and survival. Thirty articles or abstracts published through 2013 were reviewed. Although the current evidence suggests a positive association with ALS etiology, it is too limited to draw firm conclusions regarding associations between military service and ALS etiology or survival. Some evidence suggests that deployment to the 1990-1991 Persian Gulf War may be associated with ALS etiology, but there is currently no strong evidence that any particular military exposure is associated with ALS etiology. Future studies should address the limitations of previous ones, such as reliance on mortality as a surrogate for incidence, a dearth of survival analyses, lack of clinical data, low statistical power, and limited exposure assessment. The Genes and Environmental Exposures in Veterans with Amyotrophic Lateral Sclerosis (GENEVA) Study is one such study, but additional research is needed to determine whether military-related factors are associated with ALS and to assess potential prevention strategies. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health 2014. This work is written by (a) US Government employee(s) and is in the public domain in the US.

Accuracy of SLR Observations and Stability of its Analysis Products

NASA Astrophysics Data System (ADS)

Pavlis, E. C.; Kuzmicz-Cieslak, M.; Wolford, N.

2010-12-01

Satellite Laser Ranging (SLR) is currently the only space technique that determines the origin of the International Terrestrial Reference Frame (ITRF) and contributing in equal parts with VLBI, to the definition of its scale. The ITRS requires the origin of its realization, the ITRF, to coincide with the center of mass of the Earth system --the geocenter. Earth orbiting satellites describe orbits centered at the geocenter, so all satellite techniques would in principle sense its location and provide access to it. What singles out SLR is the fact that it is an absolute and very accurate technique compared to those using RF technologies (at present). Despite these theoretical attributes, SLR in practice is far from perfect. There are modeling issues that affect its precision and accuracy, and practical issues (primarily the current tracking network) that are the main cause of its long-term stability. Until we have deployed the next generation tracking networks that will support the goals set forth by the Global Geodetic Observing System (GGOS), we will have to cope with these facts and understand the limitations that they impose and how they affect the various ITRS realizations. We will discuss the current system limitations and the ways that the SLR community is addressing these at present. This will include improved modeling of the measurements, the dynamics of the target satellites, the geophysical models describing the station position at measurement times and the role of the limited SLR ground and space segments deployed today.

Perceptions and Practices of Mass Bat Exposure Events in the Setting of Rabies Among U.S. Public Health Agencies.

PubMed

Hsu, C H; Brown, C M; Murphy, J M; Haskell, M G; Williams, C; Feldman, K; Mitchell, K; Blanton, J D; Petersen, B W; Wallace, R M

2017-03-01

Current guidelines in the setting of exposures to potentially rabid bats established by the Advisory Committee on Immunization Practices (ACIP) address post-exposure prophylaxis (PEP) administration in situations where a person may not be aware that a bite or direct contact has occurred and the bat is not available for diagnostic testing. These include instances when a bat is discovered in a room where a person awakens from sleep, is a child without an adult witness, has a mental disability or is intoxicated. The current ACIP guidelines, however, do not address PEP in the setting of multiple persons exposed to a bat or a bat colony, otherwise known as mass bat exposure (MBE) events. Due to a dearth of recommendations for response to these events, the reported reactions by public health agencies have varied widely. To address this perceived limitation, a survey of 45 state public health agencies was conducted to characterize prior experiences with MBE and practices to mitigate the public health risks. In general, most states (69% of the respondents) felt current ACIP guidelines were unclear in MBE scenarios. Thirty-three of the 45 states reported prior experience with MBE, receiving an average of 16.9 MBE calls per year and an investment of 106.7 person-hours annually on MBE investigations. PEP criteria, investigation methods and the experts recruited in MBE investigations varied between states. These dissimilarities could reflect differences in experience, scenario and resources. The lack of consistency in state responses to potential mass exposures to a highly fatal disease along with the large contingent of states dissatisfied with current ACIP guidance warrants the development of national guidelines in MBE settings. Published 2016. This article is a U.S. Government work and is in the public domain in the USA. Zoonoses and Public Health published by Blackwell Verlag GmbH.

Comparison of the new Japanese legislation for expedited approval of regenerative medicine products with the existing systems in the USA and European Union

PubMed Central

Jokura, Yoji; Yano, Kazuo

2017-01-01

Abstract Legislation for expedited‐approval pathways and programmes for drugs, biologics or medical devices has been enacted for rapid commercialization of innovative products in the United States of America (USA) and the European Union (EU). However, less innovative products are increasingly benefitting from these expedited‐approval pathways, and obligations to collect and report post‐marketing data on approved products are being bypassed frequently. The Japanese government recently enacted legislation for a new conditional and time‐limited approval pathway dedicated to regenerative medicine products. The current study examines this new legislation and compares it with existing US and EU regulatory frameworks, with a particular focus on how it addresses the limitations of existing systems. Regulations, guidance documents and approval information were gathered from the websites of the respective authorities in the USA, the EU and Japan, and the systems were categorized through qualitative analysis. The pathways and programmes from each region were categorized into four groups, based on the requirement of pre‐ or post‐marketing clinical data. Expedited‐approval pathways in the USA and the EU provide similar qualification criteria, such as severity of target disease; however, such criteria are not specified for the new pathway in Japan. Only the Japanese pathway stipulates a time limitation on exceptional approval, requiring post‐marketing study for conditional and time‐limited products. Continuous improvement is necessary to solve previously addressed issues within the expedited‐approval pathways and programmes and to ensure that innovative medical products are rigourously screened, but also readily available to patients in need. The time limitation of conditional approval could be a potential solution to some of these problems. Copyright © 2017 The Authors. Tissue Engineering Regenerative Medicine published by John Wiley & Sons, Ltd. PMID:28211195

Harmonization of ethics in health technology assessment: a revision of the Socratic approach.

PubMed

Hofmann, Bjørn; Droste, Sigrid; Oortwijn, Wija; Cleemput, Irina; Sacchini, Dario

2014-01-01

Ethics has been part of health technology assessment (HTA) from its beginning in the 1970s, and is currently part of HTA definitions. Several methods in ethics have been used in HTA. Some approaches have been developed especially for HTA, such as the Socratic approach, which has been used for a wide range of health technologies. The Socratic approach is used in several ways, and there is a need for harmonization to promote its usability and the transferability of its results. Accordingly, the objective of this study was to stimulate experts in ethics and HTA to revise the Socratic approach. Based on the current literature and experiences in applying methods in ethics, a panel of ethics experts involved in HTA critically analyzed the limitations of the Socratic approach during a face-to-face workshop. On the basis of this analysis a revision of the Socratic approach was agreed on after deliberation in several rounds through e-mail correspondence. Several limitations with the Socratic approach are identified and addressed in the revised version which consists of a procedure of six steps, 7 main questions and thirty-three explanatory and guiding questions. The revised approach has a broader scope and provides more guidance than its predecessor. Methods for information retrieval have been elaborated. The presented revision of the Socratic approach is the result of a joint effort of experts in the field of ethics and HTA. Consensus is reached in the expert panel on an approach that is considered to be more clear, comprehensive, and applicable for addressing ethical issues in HTA.

Observed versus predicted carboxyhemoglobin levels in cellulose triacetate workers exposed to methylene chloride.

PubMed

Amsel, J; Soden, K J; Sielken, R L; Valdez-Flora, C

2001-08-01

Occupational exposure to methylene chloride, together with carboxyhemoglobin concentrations, has not been studied previously. Carboxyhemoglobin levels were measured in non-smoking employees exposed to varying concentrations of methylene chloride during the manufacture of cellulose triacetate fibers. The observed carboxyhemoglobin levels were compared to predicted concentrations using a pharmacokinetic model. The presence of carboxyhemoglobin in non-smokers exposed to methylene chloride results primarily from the metabolism of methylene chloride in the liver and exhibits a linear dose-response relationship. The observed levels of carboxyhemoglobin in non-smokers at the end of an 8-hour shift depend upon exposures to methylene chloride that day but are independent of occupational exposures on previous days. The observed daily concentrations of carboxyhemoglobin are consistent with predicted concentrations using a pharmacokinetic model. While varying exposure patterns were shown to change the rate of metabolite formation at the end of shift, these same exposure patterns had almost no effect on the total amount of carbon monoxide in the blood. While the present study addresses the relationship between methylene chloride, carbon monoxide, carboxyhemoglobin and ischemic heart disease, it does not address the issue of tumorigenicity, which is also the basis for the current U.S. Occupational Health and Safety workplace exposure limit of 25 ppm. This study provides support for the conclusion that the current American Conference of Governmental Industrial Hygienists 8-hour Threshold Limit Value of 50 ppm adequately protects human health with regard to ischemic heart disease and carboxyhemoglobin formation among non-smokers. Copyright 2001 Wiley-Liss, Inc.

Pilot study of Creating Change, a new past-focused model for PTSD and substance abuse.

PubMed

Najavits, Lisa M; Johnson, Kay M

2014-01-01

Creating Change (CC) is a new past-focused behavioral therapy model developed for comorbid posttraumatic stress disorder (PTSD) and substance use disorder (SUD). It was designed to address current gaps in the field, including the need for a past-focused PTSD/SUD model that has flexibility, can work with complex clients, responds to the staffing and resource limitations of SUD and other community-based treatment programs, can be conducted in group or individual format, and engages clients and clinicians. It was designed to follow the style, tone, and format of Seeking Safety, a successful present-focused PTSD/SUD model. CC can be used in conjunction with SS and/or other models if desired. We conducted a pilot outcome trial of the model with seven men and women outpatients diagnosed with current PTSD and SUD, who were predominantly minority and low-income, with chronic PTSD and SUD. Assessments were conducted pre- and post-treatment. Significant improvements were found in multiple domains including some PTSD and trauma-related symptoms (eg, dissociation, anxiety, depression, and sexual problems); broader psychopathology (eg, paranoia, psychotic symptoms, obsessive symptoms, and interpersonal sensitivity); daily life functioning; cognitions related to PTSD; coping strategies; and suicidal ideation (altogether 19 variables, far exceeding the rate expected by chance). Effect sizes were consistently large, including for both alcohol and drug problems. No adverse events were reported. Despite study methodology limitations, CC is promising. Clients can benefit from past-focused therapy that addresses PTSD and SUD in integrated fashion. © American Academy of Addiction Psychiatry.

Humidified high flow nasal cannulae: current practice in Australasian nurseries, a survey.

PubMed

Hough, Judith L; Shearman, Andrew D; Jardine, Luke A; Davies, Mark W

2012-02-01

Humidified High Flow Nasal Cannula (HHFNC) has been increasingly adopted as a new means of respiratory support throughout the world. However, evidence to support its safety and efficacy is limited. The aim of the present survey was to determine current practices regarding the usage of HHFNC by neonatologists in Australia and New Zealand. Surveys were sent to all 167 neonatologists identified by the list of centres in the Australia and New Zealand Neonatal Network. A total of 157 surveys were sent to valid email addresses: 111 (71%) responded of which 105 (67%) had completed the questionnaire. HHFNC is used in 17 (63%) of neonatal intensive care units in Australia and New Zealand. It is most commonly used to reduce nasal trauma (91%) and provide continuous positive airways pressure (62%). The main perceived benefits of HHFNC were the easier application and care of the infant (86%), and improved tolerance by the baby (84%). Rain out leading to fluid instillation into the upper airway (59%) was the most common problem. This survey has provided a snapshot of the practice of HHFNC usage in Australia and New Zealand in 2010 and has revealed that HHFNC use is widespread and that clinical practices are diverse. The majority of neonatologists acknowledge that there is limited evidence to support its efficacy and safety, and would be happy to participate in clinical trials to address how best to deliver HHFNC. © 2011 The Authors. Journal of Paediatrics and Child Health © 2011 Paediatrics and Child Health Division (Royal Australasian College of Physicians).

Economic concepts to address future water supply-demand imbalances in Iran, Morocco and Saudi Arabia

NASA Astrophysics Data System (ADS)

Hellegers, Petra; Immerzeel, Walter; Droogers, Peter

2013-10-01

In Middle East and North Africa (MENA) countries, renewable groundwater and surface water supply are limited while demand for water is growing rapidly. Climate change is expected to increase water demand even further. The main aim of this paper is to evaluate the water supply-demand imbalances in Iran, Morocco and Saudi Arabia in 2040-2050 under dry, average and wet climate change projections and to show on the basis of the marginal cost and marginal value of water the optimum mix of supply-side and demand-side adjustments to address the imbalance. A hydrological model has been used to estimate the water supply-demand imbalance. Water supply and demand curves have been used to explore for which (marginal value of) water usage the marginal cost of supply-enhancement becomes too expensive. The results indicate that in the future in all cases, except in Iran under the wet climate projection, the quantity of water demanded has to be reduced considerably to address the imbalance, which is indeed what is currently happening already.

Measuring transplant center performance: The goals are not controversial but the methods and consequences can be.

PubMed

Jay, Colleen; Schold, Jesse D

2017-03-01

Risks of regulatory scrutiny has generated widespread concern about increasingly risk averse transplant center behaviors regarding both donor and candidate acceptance patterns. To address potential unintended consequences threatening access to care, we discuss recent changes in regulatory metrics and potential improvements in quality oversight of transplant centers. Despite many recent changes to one-year patient and graft survival regulatory criteria, the capacity to accurately identify true underperforming centers and avoiding false positive flagging remains an area of great concern. Numerous studies have demonstrated restrictions in transplant volume and access following transplant center flagging. Current regulatory criteria are limited in their capacity to accurately identify poorly performing centers and potentially encourage risk-averse behavior by transplant centers. Efforts to address these concerns should focus on (1) improving risk-adjustment models with better data which captures the acuity of candidate and donor risk, (2) reconsidering primary outcomes measured to assess comprehensive transplant center performance, (3) improving education to address rational or perceived disincentives, and (4) using data more effectively to share best practices.

Dendritic cells for active immunotherapy: optimizing design and manufacture in order to develop commercially and clinically viable products.

PubMed

Nicolette, C A; Healey, D; Tcherepanova, I; Whelton, P; Monesmith, T; Coombs, L; Finke, L H; Whiteside, T; Miesowicz, F

2007-09-27

Dendritic cell (DC) active immunotherapy is potentially efficacious in a broad array of malignant disease settings. However, challenges remain in optimizing DC-based therapy for maximum clinical efficacy within manufacturing processes that permit quality control and scale-up of consistent products. In this review we discuss the critical issues that must be addressed in order to optimize DC-based product design and manufacture, and highlight the DC based platforms currently addressing these issues. Variables in DC-based product design include the type of antigenic payload used, DC maturation steps and activation processes, and functional assays. Issues to consider in development include: (a) minimizing the invasiveness of patient biological material collection; (b) minimizing handling and manipulations of tissue at the clinical site; (c) centralized product manufacturing and standardized processing and capacity for commercial-scale production; (d) rapid product release turnaround time; (e) the ability to manufacture sufficient product from limited starting material; and (f) standardized release criteria for DC phenotype and function. Improvements in the design and manufacture of DC products have resulted in a handful of promising leads currently in clinical development.

Promoting innovation: Enhancing transdisciplinary opportunities for medical and engineering students.

PubMed

Brazile, Tiffany; Hostetter Shoop, Glenda; McDonough, Christine M; Van Citters, Douglas W

2018-01-30

Addressing current healthcare challenges requires innovation and collaboration. Current literature provides limited guidance in promoting these skills in medical school. One approach involves transdisciplinary training in which students from different disciplines work together toward a shared goal. We assessed the need for such a curriculum at Dartmouth College. We surveyed medical and engineering students' educational values; learning experiences; professional goals; and interest in transdisciplinary education and innovation. Data were analyzed using descriptive statistics. Shared values among student groups included leadership development, innovation, collaboration, and resource sharing. Medical students felt their curriculum inadequately addressed creativity and innovation relative to their engineering counterparts (p < 0.05). Medical students felt less prepared for entrepreneurial activities (p < 0.05), while engineering students indicated a need for basic medical knowledge and patient-oriented design factors. Despite strong interest, collaboration was less than 50% of indicated interest. Medical and engineering students share an interest in the innovation process and need a shared curriculum to facilitate collaboration. A transdisciplinary course that familiarizes students with this process has the potential to promote physicians and engineers as leaders and innovators who can effectively work across industry lines. A transdisciplinary course was piloted in Spring 2017.

Malaria medicines to address drug resistance and support malaria elimination efforts.

PubMed

Achan, Jane; Mwesigwa, Julia; Edwin, Chinagozi Precious; D'alessandro, Umberto

2018-01-01

Antimalarial drugs are essential weapons to fight malaria and have been used effectively since the 17 th century. However, P.falciparum resistance has been reported to almost all available antimalarial drugs, including artemisinin derivatives, raising concerns that this could jeopardize malaria elimination. Areas covered: In this article, we present a historical perspective of antimalarial drug resistance, review current evidence of resistance to available antimalarial drugs and discuss possible mitigating strategies to address this challenge. Expert commentary: The historical approach to drug resistance has been to change the national treatment policy to an alternative treatment. However, alternatives to artemisinin-based combination treatment are currently extremely limited. Innovative approaches utilizing available schizonticidal drugs such as triple combination therapies or multiple first line treatments could delay the emergence and spread of drug resistance. Transmission blocking drugs like primaquine may play a key role if given to a substantial proportion of malaria infected persons. Deploying antimalarial medicines in mass drug administration or mass screening and treatment campaigns could also contribute to containment efforts by eliminating resistant parasites in some settings. Ultimately, response to drug resistance should also include further investment in the development of new antimalarial drugs.

COPD patient education and support - Achieving patient-centredness.

PubMed

Stoilkova-Hartmann, Ana; Franssen, Frits M E; Augustin, Ingrid M L; Wouters, Emiel F M; Barnard, Katharine D

2018-06-01

The art of medicine is undergoing a dramatic shift in focus, evolving to focus on patient involvement as partners in care, transforming the traditional, prescriptive, reactive practice of healthcare into a proactive discipline. The personal and societal burden of chronic diseases is burgeoning and unsustainable in current systems, novel approaches are required to address this. Although considerable progress has been made in the development of diagnostics, therapeutics and care guidelines for patients with chronic obstructive pulmonary disease (COPD), questions remain surrounding the implementation of best practice education and support. Current educational programmes, personal limitations and preferences and patient-clinician communication in modification of coping styles and behaviour are discussed. A novel holistic model, the Kaleidoscope Model of Care is proposed to address the barriers to optimal self-care behaviours. Holistic approaches are essential for optimal self-management and improved outcomes. Guidance on personalised goals for patients to help meeting their therapy priorities is needed to aid healthcare professionals (HCPs) and funders to minimise healthcare burden and costs. The novel KALMOD approach may optimise patient empowerment, exploring whole-life factors that impact COPD care and improve interactions between patients and HCPs for optimised outcomes. Copyright © 2018. Published by Elsevier B.V.

Cognitive and Family Correlates of Current Suicidal Ideation in Children with Bipolar Disorder

PubMed Central

Weinstein, Sally M.; Van Meter, Anna; Katz, Andrea C.; Peters, Amy T.; West, Amy E.

2014-01-01

Background Suicidality among youth with bipolar disorder is an extreme, but largely unaddressed, public health problem. The current study examined the psychosocial characteristics differentiating youth with varying severities of suicidal ideation that may dictate targets for suicide prevention interventions. Methods Participants included 72 youth aged 7–13 (M = 9.19, SD = 1.61) with DSM-IV-TR bipolar I, II, or NOS and a parent/caregiver. Current suicidal ideation and correlates were assessed at intake, including: demographics and clinical factors (diagnosis, symptom severity, psychiatric comorbidity); child factors (cognitive risk and quality of life); and family factors (parenting stress, family cohesion, and family rigidity). Results Current ideation was prevalent in this young sample: 41% endorsed any ideation, and 31% endorsed active forms. Depression symptoms, quality of life, hopelessness, self-esteem, and family rigidity differentiated youth with increasing ideation severity. Separate logistic regressions examined all significant child- and family-level factors, controlling for demographic and clinical variables. Greater family rigidity and lower self-esteem remained significant predictors of current planful ideation. Diagnosis, index episode, comorbidity, and mania severity did not differentiate non-ideators from those with current ideation. Limitations Limitations include the small sample to examine low base-rate severe ideation, cross-sectional analyses and generalizability of findings beyond the outpatient clinical sample. Conclusions Findings underscore the importance of assessing and addressing suicidality in preadolescent youth with bipolar disorder, before youth progress to more severe suicidal behaviors. Results also highlight child self-esteem and family rigidity as key treatment targets to reduce suicide risk in pediatric bipolar disorder. PMID:25462390

An Imposed Dynamo Current Drive Experiment: Demonstration of Confinement

NASA Astrophysics Data System (ADS)

Jarboe, Thomas; Hansen, Chris; Hossack, Aaron; Marklin, George; Morgan, Kyle; Nelson, Brian; Sutherland, Derek; Victor, Brian

2014-10-01

An experiment for studying and developing the efficient sustainment of a spheromak with sufficient confinement (current-drive power heats the plasma to its stability β-limit) and in the keV temperature range is discussed. A high- β spheromak sustained by imposed dynamo current drive (IDCD) is justified because: previous transient experiments showed sufficient confinement in the keV range with no external toroidal field coil; recent results on HIT-SI show sustainment with sufficient confinement at low temperature; the potential of IDCD of solving other fusion issues; a very attractive reactor concept; and the general need for efficient current drive in magnetic fusion. The design of a 0.55 m minor radius machine with the required density control, wall loading, and neutral shielding for a 2 s pulse is presented. Peak temperatures of 1 keV and toroidal currents of 1.35 MA and 16% wall-normalized plasma beta are envisioned. The experiment is large enough to address the key issues yet small enough for rapid modification and for extended MHD modeling of startup and code validation.

Novel methods to optimize the effects of transcranial direct current stimulation: a systematic review of transcranial direct current stimulation patents.

PubMed

Malavera, Alejandra; Vasquez, Alejandra; Fregni, Felipe

2015-01-01

Transcranial direct current stimulation (tDCS) is a neuromodulatory technique that has been extensively studied. While there have been initial positive results in some clinical trials, there is still variability in tDCS results. The aim of this article is to review and discuss patents assessing novel methods to optimize the use of tDCS. A systematic review was performed using Google patents database with tDCS as the main technique, with patents filling date between 2010 and 2015. Twenty-two patents met our inclusion criteria. These patents attempt to address current tDCS limitations. Only a few of them have been investigated in clinical trials (i.e., high-definition tDCS), and indeed most of them have not been tested before in human trials. Further clinical testing is required to assess which patents are more likely to optimize the effects of tDCS. We discuss the potential optimization of tDCS based on these patents and the current experience with standard tDCS.

Irradiation-Accelerated Corrosion of Reactor Core Materials. Final Report

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

Jiao, Zhujie; Was, Gary; Bartels, David

2015-04-02

This project aims to understand how radiation accelerates corrosion of reactor core materials. The combination of high temperature, chemically aggressive coolants, a high radiation flux and mechanical stress poses a major challenge for the life extension of current light water reactors, as well as the success of most all GenIV concepts. Of these four drivers, the combination of radiation and corrosion places the most severe demands on materials, for which an understanding of the fundamental science is simply absent. Only a few experiments have been conducted to understand how corrosion occurs under irradiation, yet the limited data indicates that themore » effect is large; irradiation causes order of magnitude increases in corrosion rates. Without a firm understanding of the mechanisms by which radiation and corrosion interact in film formation, growth, breakdown and repair, the extension of the current LWR fleet beyond 60 years and the success of advanced nuclear energy systems are questionable. The proposed work will address the process of irradiation-accelerated corrosion that is important to all current and advanced reactor designs, but remains very poorly understood. An improved understanding of the role of irradiation in the corrosion process will provide the community with the tools to develop predictive models for in-reactor corrosion, and to address specific, important forms of corrosion such as irradiation assisted stress corrosion cracking.« less

Discovery and preclinical development of dasabuvir for the treatment of hepatitis C infection.

PubMed

El Kassas, Mohamed; Elbaz, Tamer; Hafez, Enas; Wifi, Mohamed Naguib; Esmat, Gamal

2017-06-01

Hepatitis C virus (HCV) is a leading cause of liver-related morbidity and mortality. Positively, the introduction of new directly-acting antivirals (DAAs) have led to dramatic improvements in response rates to antiviral therapy. Furthermore, newer generations of DAAs have demonstrated better safety profiles as well as efficacy than older generations. Current treatment recommendations are based on different combinations of DAAs. Current combination therapies rely on agents that target the different steps of viral replication by using different molecules from various DAAs families. Areas covered: In this review, the authors summarize data from of one of the recently developed NS5B polymerase inhibitors, dasabuvir, formerly known as ABT-333. Herein, the authors discuss the drug discovery data for dasabuvir including data from preclinical, toxicological resistance studies. The authors also review dasabuvir's clinical efficacy across various clinical challenges, in addition to its limitations in clinical practice. Expert opinion: Dasabuvir represents an important medical advance when used as a combination therapy for HCV. Unfortunately, it does present limitations like low genotypic coverage and further research is still required to address some of the lingering issues.

Negative Transference Numbers in Polymer Electrolytes

NASA Astrophysics Data System (ADS)

Pesko, Danielle; Timachova, Ksenia; Balsara, Nitash

Energy density and safety of conventional lithium-ion batteries is limited by the use of flammable organic liquids as a solvent for lithium salts. Polymer electrolytes have the potential to address both limitations. The poor performance of batteries with polymer electrolytes is generally attributed to low ionic conductivity. The purpose of our work is to show that another transport property, the cation transference number, t +, of polymer electrolytes is fundamentally different from that of conventional electrolytes. Our experimental approach, based on concentrated solution theory, indicates that t + of mixtures of poly(ethylene oxide) and LiTFSI salt are negative over most of the accessible concentration window. In contrast, approaches based on dilute solution theory suggest that t + in the same system is positive. In addition to presenting a new approach for determining t +, we also present data obtained from the steady-state current method, pulsed-field-gradient NMR, and the current-interrupt method. Discrepancies between different approaches are resolved. Our work implies that in the absence of concentration gradients, the net fluxes of both cations and anions are directed toward the positive electrode. Conventional liquid electrolytes do not suffer from this constraint.

Quantum-assisted biomolecular modelling.

PubMed

Harris, Sarah A; Kendon, Vivien M

2010-08-13

Our understanding of the physics of biological molecules, such as proteins and DNA, is limited because the approximations we usually apply to model inert materials are not, in general, applicable to soft, chemically inhomogeneous systems. The configurational complexity of biomolecules means the entropic contribution to the free energy is a significant factor in their behaviour, requiring detailed dynamical calculations to fully evaluate. Computer simulations capable of taking all interatomic interactions into account are therefore vital. However, even with the best current supercomputing facilities, we are unable to capture enough of the most interesting aspects of their behaviour to properly understand how they work. This limits our ability to design new molecules, to treat diseases, for example. Progress in biomolecular simulation depends crucially on increasing the computing power available. Faster classical computers are in the pipeline, but these provide only incremental improvements. Quantum computing offers the possibility of performing huge numbers of calculations in parallel, when it becomes available. We discuss the current open questions in biomolecular simulation, how these might be addressed using quantum computation and speculate on the future importance of quantum-assisted biomolecular modelling.

An improved correlation to predict molecular weight between crosslinks based on equilibrium degree of swelling of hydrogel networks.

PubMed

Jimenez-Vergara, Andrea C; Lewis, John; Hahn, Mariah S; Munoz-Pinto, Dany J

2018-04-01

Accurate characterization of hydrogel diffusional properties is of substantial importance for a range of biotechnological applications. The diffusional capacity of hydrogels has commonly been estimated using the average molecular weight between crosslinks (M c ), which is calculated based on the equilibrium degree of swelling. However, the existing correlation linking M c and equilibrium swelling fails to accurately reflect the diffusional properties of highly crosslinked hydrogel networks. Also, as demonstrated herein, the current model fails to accurately predict the diffusional properties of hydrogels when polymer concentration and molecular weight are varied simultaneously. To address these limitations, we evaluated the diffusional properties of 48 distinct hydrogel formulations using two different photoinitiator systems, employing molecular size exclusion as an alternative methodology to calculate average hydrogel mesh size. The resulting data were then utilized to develop a revised correlation between M c and hydrogel equilibrium swelling that substantially reduces the limitations associated with the current correlation. © 2017 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater, 106B: 1339-1348, 2018. © 2017 Wiley Periodicals, Inc.

Operation of large RF sources for H-: Lessons learned at ELISE

NASA Astrophysics Data System (ADS)

Fantz, U.; Wünderlich, D.; Heinemann, B.; Kraus, W.; Riedl, R.

2017-08-01

The goal of the ELISE test facility is to demonstrate that large RF-driven negative ion sources (1 × 1 m2 source area with 360 kW installed RF power) can achieve the parameters required for the ITER beam sources in terms of current densities and beam homogeneity at a filling pressure of 0.3 Pa for pulse lengths of up to one hour. With the experience in operation of the test facility, the beam source inspection and maintenance as well as with the results of the achieved source performance so far, conclusions are drawn for commissioning and operation of the ITER beam sources. Addressed are critical technical RF issues, extrapolations to the required RF power, Cs consumption and Cs ovens, the need of adjusting the magnetic filter field strength as well as the temporal dynamic and spatial asymmetry of the co-extracted electron current. It is proposed to relax the low pressure limit to 0.4 Pa and to replace the fixed electron-to-ion ratio by a power density limit for the extraction grid. This would be highly beneficial for controlling the co-extracted electrons.

Weight and the Future of Space Flight Hardware Cost Modeling

NASA Technical Reports Server (NTRS)

Prince, Frank A.

2003-01-01

Weight has been used as the primary input variable for cost estimating almost as long as there have been parametric cost models. While there are good reasons for using weight, serious limitations exist. These limitations have been addressed by multi-variable equations and trend analysis in models such as NAFCOM, PRICE, and SEER; however, these models have not be able to address the significant time lags that can occur between the development of similar space flight hardware systems. These time lags make the cost analyst's job difficult because insufficient data exists to perform trend analysis, and the current set of parametric models are not well suited to accommodating process improvements in space flight hardware design, development, build and test. As a result, people of good faith can have serious disagreement over the cost for new systems. To address these shortcomings, new cost modeling approaches are needed. The most promising approach is process based (sometimes called activity) costing. Developing process based models will require a detailed understanding of the functions required to produce space flight hardware combined with innovative approaches to estimating the necessary resources. Particularly challenging will be the lack of data at the process level. One method for developing a model is to combine notional algorithms with a discrete event simulation and model changes to the total cost as perturbations to the program are introduced. Despite these challenges, the potential benefits are such that efforts should be focused on developing process based cost models.

The potential of multi-compound nanoparticles to bypass drug resistance in cancer.

PubMed

Da Silva, C G; Peters, Godefridus J; Ossendorp, Ferry; Cruz, Luis J

2017-11-01

The therapeutic efficacy of conventional chemotherapy against several solid tumors is generally limited and this is often due to the development of resistance or poor delivery of the drugs to the tumor. Mechanisms of resistance may vary between cancer types. However, with current development of genetic analyses, imaging, and novel delivery systems, we may be able to characterize and bypass resistance, e.g., by inhibition of the right target at the tumor site. Therefore, combined drug treatments, where one drug will revert or obstruct the development of resistance and the other will concurrently kill the cancer cell, are rational solutions. However, drug exposure of one drug will defer greatly from the other due to their physicochemical properties. In this sense, multi-compound nanoparticles are an excellent modality to equalize drug exposure, i.e., one common physicochemical profile. In this review, we will discuss novel approaches that employ nanoparticle technology that addresses specific mechanisms of resistance in cancer. The PubMed literature was consulted and reviewed. Nanoparticle technology is emerging as a dexterous solution that may address several forms of resistance in cancer. For instance, we discuss advances that address mechanisms of resistance with multi-compound nanoparticles which co-deliver chemotherapeutics with an anti-resistance agent. Promising anti-resistance agents are (1) targeted in vivo gene silencing methods aimed to disrupt key resistance gene expression or (2) protein kinase inhibitors to disrupt key resistance pathways or (3) efflux pumps inhibitors to limit drug cellular efflux.

Noninvasive clinical assessment of port-wine stain birthmarks using current and future optical imaging technology: A review

PubMed Central

Sharif, S.A.; Taydas, E.; Mazhar, A.; Rahimian, R.; Kelly, K.M.; Choi, B.; Durkin, A.J.

2012-01-01

Port wine stain (PWS) birthmarks are one class of benign congenital vascular malformation. Laser therapy is the most successful treatment modality of PWS. Unfortunately, this approach has limited efficacy, with only 10% of patients experiencing complete blanching of the PWS. To address this problem, several research groups have developed technologies and methods designed to study treatment outcome and improve treatment efficacy. This paper reviews seven optical imaging techniques currently in use or under development to assess treatment efficacy, focusing on: Reflectance spectrophotometers/tristimulus colorimeters, Laser Doppler flowmetry (LDF) and Laser Doppler imaging (LDI), Cross-polarized diffuse reflectance color imaging system (CDR), Reflectance Confocal Microscopy (RCM), Optical Coherence Tomography (OCT), Spatial Frequency Domain Imaging (SFDI), and Laser Speckle Imaging (LSI). PMID:22804872

Beyond Depression: Towards a Process-Based Approach to Research, Diagnosis, and Treatment.

PubMed

Forgeard, Marie J C; Haigh, Emily A P; Beck, Aaron T; Davidson, Richard J; Henn, Fritz A; Maier, Steven F; Mayberg, Helen S; Seligman, Martin E P

2011-12-01

Despite decades of research on the etiology and treatment of depression, a significant proportion of the population is affected by the disorder, fails to respond to treatment and is plagued by relapse. Six prominent scientists, Aaron Beck, Richard Davidson, Fritz Henn, Steven Maier, Helen Mayberg, and Martin Seligman, gathered to discuss the current state of scientific knowledge on depression, and in particular on the basic neurobiological and psychopathological processes at play in the disorder. These general themes were addressed: 1) the relevance of learned helplessness as a basic process involved in the development of depression; 2) the limitations of our current taxonomy of psychological disorders; 3) the need to work towards a psychobiological process-based taxonomy; and 4) the clinical implications of implementing such a process-based taxonomy.

The Scalable Checkpoint/Restart Library

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

Moody, A.

The Scalable Checkpoint/Restart (SCR) library provides an interface that codes may use to worite our and read in application-level checkpoints in a scalable fashion. In the current implementation, checkpoint files are cached in local storage (hard disk or RAM disk) on the compute nodes. This technique provides scalable aggregate bandwidth and uses storage resources that are fully dedicated to the job. This approach addresses the two common drawbacks of checkpointing a large-scale application to a shared parallel file system, namely, limited bandwidth and file system contention. In fact, on current platforms, SCR scales linearly with the number of compute nodes.more » It has been benchmarked as high as 720GB/s on 1094 nodes of Atlas, which is nearly two orders of magnitude faster thanthe parallel file system.« less

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.

From truck to optical fibre: the coming-of-age of eVLBI

NASA Astrophysics Data System (ADS)

Szomoru, A.; Biggs, A.; Garrett, M.; van Langevelde, H. J.; Olnon, F.; Paragi, Z.; Parsley, S.; Pogrebenko, S.; Reynolds, C.

Spurred by the advent of disk-based recording systems and the nearly explosive increase of internet bandwidth, eVLBI (Parsley et al. te{parsley}) has undergone a remarkable development over the past two years. From ftp-based transfers of small amounts of astronomical data, through near real-time correlation (disk-buffered at the correlator), it has culminated this spring in the first three telescope real-time correlation at JIVE (Onsala, Westerbork and Jodrell Bank). In this paper we will give a review of this development and the current state of affairs. We will also address the current limitations and the way we may improve both bandwidth and reliability and finally we will discuss the opportunities a true high-bandwidth real-time VLBI correlator will provide. (astro-ph/0412686)

Beyond Depression: Towards a Process-Based Approach to Research, Diagnosis, and Treatment

PubMed Central

Forgeard, Marie J. C.; Haigh, Emily A. P.; Beck, Aaron T.; Davidson, Richard J.; Henn, Fritz A.; Maier, Steven F.; Mayberg, Helen S.; Seligman, Martin E. P.

2012-01-01

Despite decades of research on the etiology and treatment of depression, a significant proportion of the population is affected by the disorder, fails to respond to treatment and is plagued by relapse. Six prominent scientists, Aaron Beck, Richard Davidson, Fritz Henn, Steven Maier, Helen Mayberg, and Martin Seligman, gathered to discuss the current state of scientific knowledge on depression, and in particular on the basic neurobiological and psychopathological processes at play in the disorder. These general themes were addressed: 1) the relevance of learned helplessness as a basic process involved in the development of depression; 2) the limitations of our current taxonomy of psychological disorders; 3) the need to work towards a psychobiological process-based taxonomy; and 4) the clinical implications of implementing such a process-based taxonomy. PMID:22509072

The VLTI: An Ever Improving Imaging Machine

NASA Astrophysics Data System (ADS)

Merand, Antoine

2018-04-01

The last decade has seen VLTI transitioning from 2 to 3 to 4 Telescopes recombination. This led to an increase in the morphological complexity observations are able to address, and ultimately the possibility to reconstruct images. Reconstructing images using 4T data only is not a simple feat and requires coordinated observations with multiple re-configurations of VLTI moving telescopes, the Auxiliary Telescopes (AT). Whereas the current second generation instruments (GRAVITY and MATISSE) combine the 4 currently available telescopes, the VLTI platform can accommodate many more telescopes, and the tunnel has space for 2 more delay lines, allowing to combine simultaneously up to 8 telescopes. I will have a look at how VLTI could evolve to include and operate additional telescopes, as well as the improvements (and limitations) related to imaging stellar surfaces.

The value of value of information: best informing research design and prioritization using current methods.

PubMed

Eckermann, Simon; Karnon, Jon; Willan, Andrew R

2010-01-01

Value of information (VOI) methods have been proposed as a systematic approach to inform optimal research design and prioritization. Four related questions arise that VOI methods could address. (i) Is further research for a health technology assessment (HTA) potentially worthwhile? (ii) Is the cost of a given research design less than its expected value? (iii) What is the optimal research design for an HTA? (iv) How can research funding be best prioritized across alternative HTAs? Following Occam's razor, we consider the usefulness of VOI methods in informing questions 1-4 relative to their simplicity of use. Expected value of perfect information (EVPI) with current information, while simple to calculate, is shown to provide neither a necessary nor a sufficient condition to address question 1, given that what EVPI needs to exceed varies with the cost of research design, which can vary from very large down to negligible. Hence, for any given HTA, EVPI does not discriminate, as it can be large and further research not worthwhile or small and further research worthwhile. In contrast, each of questions 1-4 are shown to be fully addressed (necessary and sufficient) where VOI methods are applied to maximize expected value of sample information (EVSI) minus expected costs across designs. In comparing complexity in use of VOI methods, applying the central limit theorem (CLT) simplifies analysis to enable easy estimation of EVSI and optimal overall research design, and has been shown to outperform bootstrapping, particularly with small samples. Consequently, VOI methods applying the CLT to inform optimal overall research design satisfy Occam's razor in both improving decision making and reducing complexity. Furthermore, they enable consideration of relevant decision contexts, including option value and opportunity cost of delay, time, imperfect implementation and optimal design across jurisdictions. More complex VOI methods such as bootstrapping of the expected value of partial EVPI may have potential value in refining overall research design. However, Occam's razor must be seriously considered in application of these VOI methods, given their increased complexity and current limitations in informing decision making, with restriction to EVPI rather than EVSI and not allowing for important decision-making contexts. Initial use of CLT methods to focus these more complex partial VOI methods towards where they may be useful in refining optimal overall trial design is suggested. Integrating CLT methods with such partial VOI methods to allow estimation of partial EVSI is suggested in future research to add value to the current VOI toolkit.

Toward a Concept of Operations for Aviation Weather Information Implementation in the Evolving National Airspace System

NASA Technical Reports Server (NTRS)

McAdaragh, Raymon M.

2002-01-01

The capacity of the National Airspace System is being stressed due to the limits of current technologies. Because of this, the FAA and NASA are working to develop new technologies to increase the system's capacity which enhancing safety. Adverse weather has been determined to be a major factor in aircraft accidents and fatalities and the FAA and NASA have developed programs to improve aviation weather information technologies and communications for system users The Aviation Weather Information Element of the Weather Accident Prevention Project of NASA's Aviation Safety Program is currently working to develop these technologies in coordination with the FAA and industry. This paper sets forth a theoretical approach to implement these new technologies while addressing the National Airspace System (NAS) as an evolving system with Weather Information as one of its subSystems. With this approach in place, system users will be able to acquire the type of weather information that is needed based upon the type of decision-making situation and condition that is encountered. The theoretical approach addressed in this paper takes the form of a model for weather information implementation. This model addresses the use of weather information in three decision-making situations, based upon the system user's operational perspective. The model also addresses two decision-making conditions, which are based upon the need for collaboration due to the level of support offered by the weather information provided by each new product or technology. The model is proposed for use in weather information implementation in order to provide a systems approach to the NAS. Enhancements to the NAS collaborative decision-making capabilities are also suggested.

Statin myopathy: the fly in the ointment for the prevention of cardiovascular disease in the 21st century?

PubMed

Keen, Helen I; Krishnarajah, Janakan; Bates, Timothy R; Watts, Gerald F

2014-09-01

Cardiovascular disease (CVD) remains the leading cause of death in industrialized nations. Despite clear evidence of CVD risk reduction with HMG-CoA reductase inhibitors (statins), the side effects of these medications, particularly myopathy, limit their effectiveness. Studies into the mechanisms, aetiology and management of statin myopathy are limited by lack of an internationally agreed clinical definition and tools for assessing outcomes. Currently there is a paucity of evidence to guide the management of patients affected by statin myopathy; with the exception of dose reduction, there is little evidence that other strategies can improve statin tolerance, and even less evidence to suggest these alternate dosing strategies reduce cardiovascular risk. This review will cover current definitions, clinical presentations, risk factors, pathogenesis and management. PubMed was searched (English language, to 2014) for key articles pertaining to statin myopathy. This review then briefly describes our experience of managing this condition in a tertiary lipid disorders clinic, in the setting of limited guiding evidence. Knowledge gaps in the field of statin myopathy are identified and future research directions are suggested. We urge the need for international attention to address this important, but largely neglected clinical problem, that if unresolved will remain an impediment to the effective prevention and treatment of CVD.

Is ginger beneficial for nausea and vomiting? An update of the literature.

PubMed

Marx, Wolfgang; Kiss, Nicole; Isenring, Liz

2015-06-01

Nausea and vomiting can pose a significant burden to patients in a variety of clinical settings. Previous evidence suggests that ginger may be an effective treatment for these symptoms; however, current evidence has been mixed. This article discusses recent clinical trials that have investigated ginger as a treatment for multiple types of nausea and vomiting. In addition, the potential mechanisms of action of ginger will be discussed. This article identified nine studies and seven reviews that investigated ginger for morning sickness, postoperative nausea and vomiting, chemotherapy-induced, and antiretroviral-induced nausea and vomiting. All studies reported that ginger provided a significant reduction in nausea and vomiting; however, the clinical relevance of some studies is less certain. Common limitations within the literature include the lack of standardized extracts, poorly controlled or blinded studies, and limited sample size. In addition, recent evidence has provided further support for 5-HT3 receptor antagonism as a mechanism by which ginger may exert its potentially beneficial effect on nausea and vomiting. The results of studies in this article suggest that ginger is a promising treatment for nausea and vomiting in a variety of clinical settings and possesses a clinically relevant mechanism. However, further studies are required to address the limitations in the current clinical literature before firm recommendations for its use can be made.

NIOSH comments to DOL on the occupational safety and health advance notice of proposed rulemaking: Occupational exposure to methylene chloride by R. A. Lemen, February 25, 1987

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

Not Available

1987-02-25

The testimony addressed the concerns of NIOSH regarding the advance notice of proposed rulemaking (ANPR) dealing with occupational exposure to methylene-chloride (75092) (MC). Specifically the testimony addressed the studies that OSHA should consider in its assessment of the potential health risks, especially the carcinogenic, chronic neurological, encephalopathic, teratogenic, and mutagenic effects of MC; the dermal absorption studies available and the extent of the potential adverse health effects resulting from dermal exposure; studies or evidence indicating the combined effects of inhalation and dermal exposures; how OSHA should estimate the significance of risk at the current exposure limits; what the permissible exposuremore » levels should be; production and control systems; substitution availability; protective equipment and clothing; worker exposure and monitoring; worker training; and medical surveillance.« less

Challenges in translating vascular tissue engineering to the pediatric clinic.

PubMed

Duncan, Daniel R; Breuer, Christopher K

2011-10-14

The development of tissue-engineered vascular grafts for use in cardiovascular surgery holds great promise for improving outcomes in pediatric patients with complex congenital cardiac anomalies. Currently used synthetic grafts have a number of shortcomings in this setting but a tissue engineering approach has emerged in the past decade as a way to address these limitations. The first clinical trial of this technology showed that it is safe and effective but the primary mode of graft failure is stenosis. A variety of murine and large animal models have been developed to study and improve tissue engineering approaches with the hope of translating this technology into routine clinical use, but challenges remain. The purpose of this report is to address the clinical problem and review recent advances in vascular tissue engineering for pediatric applications. A deeper understanding of the mechanisms of neovessel formation and stenosis will enable rational design of improved tissue-engineered vascular grafts.

Circulating tumor DNA as a liquid biopsy target for detection of pancreatic cancer

PubMed Central

Takai, Erina; Yachida, Shinichi

2016-01-01

Most pancreatic cancer patients present with advanced metastatic disease, resulting in extremely poor 5-year survival, mainly because of the lack of a reliable modality for early detection and limited therapeutic options for advanced disease. Therefore, there is a need for minimally-invasive diagnostic tools for detecting pancreatic cancer at an early stage, when curative surgery and also novel therapeutic approaches including precision medicine may be feasible. The “liquid biopsy” addresses these unmet clinical needs based on the concept that simple peripheral blood sampling and detection of circulating tumor DNA (ctDNA) could provide diagnostic information. In this review, we provide an overview of the current status of blood-based tests for diagnosis of pancreatic cancer and the potential utility of ctDNA for precision medicine. We also discuss challenges that remain to be addressed in developing practical ctDNA-based liquid biopsy approaches for early diagnosis of pancreatic cancer. PMID:27784960

Circulating tumor DNA as a liquid biopsy target for detection of pancreatic cancer.

PubMed

Takai, Erina; Yachida, Shinichi

2016-10-14

Most pancreatic cancer patients present with advanced metastatic disease, resulting in extremely poor 5-year survival, mainly because of the lack of a reliable modality for early detection and limited therapeutic options for advanced disease. Therefore, there is a need for minimally-invasive diagnostic tools for detecting pancreatic cancer at an early stage, when curative surgery and also novel therapeutic approaches including precision medicine may be feasible. The "liquid biopsy" addresses these unmet clinical needs based on the concept that simple peripheral blood sampling and detection of circulating tumor DNA (ctDNA) could provide diagnostic information. In this review, we provide an overview of the current status of blood-based tests for diagnosis of pancreatic cancer and the potential utility of ctDNA for precision medicine. We also discuss challenges that remain to be addressed in developing practical ctDNA-based liquid biopsy approaches for early diagnosis of pancreatic cancer.

Information Security Analysis Using Game Theory and Simulation

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

Schlicher, Bob G; Abercrombie, Robert K

Information security analysis can be performed using game theory implemented in dynamic simulations of Agent Based Models (ABMs). Such simulations can be verified with the results from game theory analysis and further used to explore larger scale, real world scenarios involving multiple attackers, defenders, and information assets. Our approach addresses imperfect information and scalability that allows us to also address previous limitations of current stochastic game models. Such models only consider perfect information assuming that the defender is always able to detect attacks; assuming that the state transition probabilities are fixed before the game assuming that the players actions aremore » always synchronous; and that most models are not scalable with the size and complexity of systems under consideration. Our use of ABMs yields results of selected experiments that demonstrate our proposed approach and provides a quantitative measure for realistic information systems and their related security scenarios.« less

ID201202961, DOE S-124,539, Information Security Analysis Using Game Theory and Simulation

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

Abercrombie, Robert K; Schlicher, Bob G

Information security analysis can be performed using game theory implemented in dynamic simulations of Agent Based Models (ABMs). Such simulations can be verified with the results from game theory analysis and further used to explore larger scale, real world scenarios involving multiple attackers, defenders, and information assets. Our approach addresses imperfect information and scalability that allows us to also address previous limitations of current stochastic game models. Such models only consider perfect information assuming that the defender is always able to detect attacks; assuming that the state transition probabilities are fixed before the game assuming that the players actions aremore » always synchronous; and that most models are not scalable with the size and complexity of systems under consideration. Our use of ABMs yields results of selected experiments that demonstrate our proposed approach and provides a quantitative measure for realistic information systems and their related security scenarios.« less

Neuroscience in Nigeria: the past, the present and the future.

PubMed

Balogun, Wasiu Gbolahan; Cobham, Ansa Emmanuel; Amin, Abdulbasit

2018-04-01

The science of the brain and nervous system cuts across almost all aspects of human life and is one of the fastest growing scientific fields worldwide. This necessitates the demand for pragmatic investment by all nations to ensure improved education and quality of research in Neurosciences. Although obvious efforts are being made in advancing the field in developed societies, there is limited data addressing the state of neuroscience in sub-Saharan Africa. Here, we review the state of neuroscience development in Nigeria, Africa's most populous country and its largest economy, critically evaluating the history, the current situation and future projections. This review specifically addresses trends in clinical and basic neuroscience research and education. We conclude by highlighting potentially helpful strategies that will catalyse development in neuroscience education and research in Nigeria, among which are an increase in research funding, provision of tools and equipment for training and research, and upgrading of the infrastructure at hand.

Lessons Learned from Crime Caught on Camera

PubMed Central

Bernasco, Wim

2018-01-01

Objectives: The widespread use of camera surveillance in public places offers criminologists the opportunity to systematically and unobtrusively observe crime, their main subject matter. The purpose of this essay is to inform the reader of current developments in research on crimes caught on camera. Methods: We address the importance of direct observation of behavior and review criminological studies that used observational methods, with and without cameras, including the ones published in this issue. We also discuss the uses of camera recordings in other social sciences and in biology. Results: We formulate six key insights that emerge from the literature and make recommendations for future research. Conclusions: Camera recordings of real-life crime are likely to become part of the criminological tool kit that will help us better understand the situational and interactional elements of crime. Like any source, it has limitations that are best addressed by triangulation with other sources. PMID:29472728

Behind the scenes: A medical natural language processing project.

PubMed

Wu, Joy T; Dernoncourt, Franck; Gehrmann, Sebastian; Tyler, Patrick D; Moseley, Edward T; Carlson, Eric T; Grant, David W; Li, Yeran; Welt, Jonathan; Celi, Leo Anthony

2018-04-01

Advancement of Artificial Intelligence (AI) capabilities in medicine can help address many pressing problems in healthcare. However, AI research endeavors in healthcare may not be clinically relevant, may have unrealistic expectations, or may not be explicit enough about their limitations. A diverse and well-functioning multidisciplinary team (MDT) can help identify appropriate and achievable AI research agendas in healthcare, and advance medical AI technologies by developing AI algorithms as well as addressing the shortage of appropriately labeled datasets for machine learning. In this paper, our team of engineers, clinicians and machine learning experts share their experience and lessons learned from their two-year-long collaboration on a natural language processing (NLP) research project. We highlight specific challenges encountered in cross-disciplinary teamwork, dataset creation for NLP research, and expectation setting for current medical AI technologies. Copyright © 2017. Published by Elsevier B.V.

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

Winn, Barry L.; Broholm, C.; Bird, M.

X-ray and neutron scattering techniques are capable of acquiring information about the structure and dynamics of quantum matter. However, the high-field magnet systems currently available at x-ray and neutron scattering facilities in the United States are limited to fields of 16 tesla (T) at maximum, which precludes applications that require and/or study ultra-high field states of matter. This gap in capability—and the need to address it—is a central conclusion of the 2005 National Academy of Sciences report by the Committee on Opportunities in High Magnetic Field Science. To address this gap, we propose a magnet development program that would moremore » than double the field range accessible to scattering experiments. With the development and use of new ultra-high field–magnets, the program would bring into view new worlds of quantum matter with profound impacts on our understanding of advanced electronic materials.« less

Teaching undergraduate nursing students about environmental health: addressing public health issues through simulation.

PubMed

Stanley, Mary Jo; Rojas, Deb

2014-01-01

Schools of nursing are challenged to find clinical placements in public health settings. Use of simulation can address situations unique to public health, with attention to specific concerns, such as environmental health. Environmental health is an integral part of public health nursing and is a standard of professional practice. Current simulations focus on acute care situations, offering limited scenarios with a public health perspective and excluding environmental health. This study's simulation scenario was created to enhance nursing students' understanding of public health concepts within an environmental health context. Outcomes from the simulation include the need for integration of environmental issues in public health teaching. Students stated that this scenario provided a broader understanding of the environmental influences that can affect the client's and family's health. This scenario fills a void in simulation content, while providing an interactive teaching and learning strategy to help students to apply knowledge to practice. Copyright 2014, SLACK Incorporated.

Electrically Injected UV-Visible Nanowire Lasers

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

Wang, George T.; Li, Changyi; Li, Qiming

2015-09-01

There is strong interest in minimizing the volume of lasers to enable ultracompact, low-power, coherent light sources. Nanowires represent an ideal candidate for such nanolasers as stand-alone optical cavities and gain media, and optically pumped nanowire lasing has been demonstrated in several semiconductor systems. Electrically injected nanowire lasers are needed to realize actual working devices but have been elusive due to limitations of current methods to address the requirement for nanowire device heterostructures with high material quality, controlled doping and geometry, low optical loss, and efficient carrier injection. In this project we proposed to demonstrate electrically injected single nanowire lasersmore » emitting in the important UV to visible wavelengths. Our approach to simultaneously address these challenges is based on high quality III-nitride nanowire device heterostructures with precisely controlled geometries and strong gain and mode confinement to minimize lasing thresholds, enabled by a unique top-down nanowire fabrication technique.« less

Improving Process Evaluations of Health Behavior Interventions: Learning From the Social Sciences.

PubMed

Morgan-Trimmer, Sarah

2015-09-01

This article reflects on the current state of process evaluations of health behavior interventions and argues that evaluation practice in this area could be improved by drawing on the social science literature to a greater degree. While process evaluations of health behavior interventions have increasingly engaged with the social world and sociological aspects of interventions, there has been a lag in applying relevant and potentially useful approaches from the social sciences. This has limited the scope for health behavior process evaluations to address pertinent contextual issues and methodological challenges. Three aspects of process evaluations are discussed: the incorporation of contexts of interventions; engagement with the concept of "process" in process evaluation; and working with theory to understand interventions. Following on from this, the article also comments on the need for new methodologies and on the implications for addressing health inequalities. © The Author(s) 2013.

A model of integrated health care in a poverty-impacted community in New York City: Importance of early detection and addressing potential barriers to intervention implementation.

PubMed

Acri, Mary C; Bornheimer, Lindsay A; O'Brien, Kyle; Sezer, Sara; Little, Virna; Cleek, Andrew F; McKay, Mary M

2016-04-01

Disruptive behavior disorders (DBDs) are chronic, impairing, and costly behavioral health conditions that are four times more prevalent among children of color living in impoverished communities as compared to the general population. This disparity is largely due to the increased exposure to stressors related to low socioeconomic status including community violence, unstable housing, under supported schools, substance abuse, and limited support systems. However, despite high rates and greater need, there is a considerably lower rate of mental health service utilization among these youth. Accordingly, the current study aims to describe a unique model of integrated health care for ethnically diverse youth living in a New York City borough. With an emphasis on addressing possible barriers to implementation, integrated models for children have the potential to prevent ongoing mental health problems through early detection and intervention.

Food taxation and pricing strategies to "thin out" the obesity epidemic.

PubMed

Kim, Daniel; Kawachi, Ichiro

2006-05-01

This article highlights characteristics of two related yet distinct economic approaches to addressing the current obesity epidemic in the United States: the general taxation of soft drinks, snack foods, and/or fast foods, and the application of pricing incentives/disincentives on foods sold in schools and worksites. The article specifically focuses on the: (1) rationale for, (2) potential barriers and limitations to, and (3) possible unintended consequences of implementing these policy interventions at the state level. Novel empirical evidence showing strong positive associations between the presence of state-level taxation on soft drinks or snack foods between 1991 and 1998 and relative changes in obesity prevalence over the same time period is further presented. The article concludes by summarizing the similarities and dissimilarities of the two approaches, and by emphasizing some of the gaps and priorities regarding these strategies that should be addressed in future research and policies to best effect obesity prevention.

A description of the new 3D electron gun and collector modeling tool: MICHELLE

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

Petillo, J.; Mondelli, A.; Krueger, W.

1999-07-01

A new 3D finite element gun and collector modeling code is under development at SAIC in collaboration with industrial partners and national laboratories. This development program has been designed specifically to address the shortcomings of current simulation and modeling tools. In particular, although there are 3D gun codes that exist today, their ability to address fine scale features is somewhat limited in 3D due to disparate length scales of certain classes of devices. Additionally, features like advanced emission rules, including thermionic Child's law and comprehensive secondary emission models also need attention. The program specifically targets problems classes including gridded-guns, sheet-beammore » guns, multi-beam devices, and anisotropic collectors. The presentation will provide an overview of the program objectives, the approach to be taken by the development team, and a status of the project.« less

48 CFR 6101.2 - Filing cases; time limits for filing; notice of docketing; consolidation [Rule 2].

Code of Federal Regulations, 2012 CFR

2012-10-01

... 48 Federal Acquisition Regulations System 7 2012-10-01 2012-10-01 false Filing cases; time limits... 6101.2 Filing cases; time limits for filing; notice of docketing; consolidation [Rule 2]. (a) Filing... name, address, telephone number, facsimile machine number, and e-mail address, if available, of the...

Dielectrophoretic label-free immunoassay for rare-analyte quantification in biological samples

NASA Astrophysics Data System (ADS)

Velmanickam, Logeeshan; Laudenbach, Darrin; Nawarathna, Dharmakeerthi

2016-10-01

The current gold standard for detecting or quantifying target analytes from blood samples is the ELISA (enzyme-linked immunosorbent assay). The detection limit of ELISA is about 250 pg/ml. However, to quantify analytes that are related to various stages of tumors including early detection requires detecting well below the current limit of the ELISA test. For example, Interleukin 6 (IL-6) levels of early oral cancer patients are <100 pg/ml and the prostate specific antigen level of the early stage of prostate cancer is about 1 ng/ml. Further, it has been reported that there are significantly less than 1 pg /mL of analytes in the early stage of tumors. Therefore, depending on the tumor type and the stage of the tumors, it is required to quantify various levels of analytes ranging from ng/ml to pg/ml. To accommodate these critical needs in the current diagnosis, there is a need for a technique that has a large dynamic range with an ability to detect extremely low levels of target analytes (

In vivo miniature robots for natural orifice surgery: State of the art and future perspectives.

PubMed

Tiwari, Manish M; Reynoso, Jason F; Lehman, Amy C; Tsang, Albert W; Farritor, Shane M; Oleynikov, Dmitry

2010-06-27

Natural orifice translumenal endoscopic surgery (NOTES) is the integration of laparoscopic minimally invasive surgery techniques with endoscopic technology. Despite the advances in NOTES technology, the approach presents several unique instrumentation and technique-specific challenges. Current flexible endoscopy platforms for NOTES have several drawbacks including limited stability, triangulation and dexterity, and lack of adequate visualization, suggesting the need for new and improved instrumentation for this approach. Much of the current focus is on the development of flexible endoscopy platforms that incorporate robotic technology. An alternative approach to access the abdominal viscera for either a laparoscopic or NOTES procedure is the use of small robotic devices that can be implanted in an intracorporeal manner. Multiple, independent, miniature robots can be simultaneously inserted into the abdominal cavity to provide a robotic platform for NOTES surgery. The capabilities of the robots include imaging, retraction, tissue and organ manipulation, and precise maneuverability in the abdominal cavity. Such a platform affords several advantages including enhanced visualization, better surgical dexterity and improved triangulation for NOTES. This review discusses the current status and future perspectives of this novel miniature robotics platform for the NOTES approach. Although these technologies are still in pre-clinical development, a miniature robotics platform provides a unique method for addressing the limitations of minimally invasive surgery, and NOTES in particular.

Context matters: A community-based study of urban minority parents’ views on child health

PubMed Central

Bolar, Cassandra L.; Hernandez, Natalie; Akintobi, Tabia Henry; McAllister, Calvin; Ferguson, Aneeqah S.; Rollins, Latrice; Wrenn, Glenda; Okafor, Martha; Collins, David; Clem, Thomas

2016-01-01

Background Among children, there are substantial ethno-racial minority disparities across a broad range of health-related behaviors, experiences, and outcomes. Addressing these disparities is important, as childhood and adolescence establish health trajectories that extend throughout life. Methods The current study employed a community-based participatory research approach to gain community insight on child health priorities and to frame an intervention aimed at improving the health of minority children. Eight focus groups were conducted among seventy-five African American parents in a Southeastern city. The current study was guided by an ecological theoretical framework. Results Although the focus of this investigation was on community identification of child health priorities, participants cited, as root determinants, contextual factors, which included lack of healthy food options, lack of spaces for physical activity, and community violence. These co-occurring factors were related to limited engagement in outdoor activities and physical activity, increased obesity, and poor mental health and coping. Poor parenting was cited as the most substantial barrier to improving child health outcomes, and quality parenting was identified as the most important issue to address for community programs focused on promoting the health and success of children. For improving health outcomes for children in their neighborhoods, establishment of positive social capital and constructive activities were also cited. Conclusions These results reinforce social determinants of health as influences on child health outcomes and describe how community engagement can address potential solutions through interventions that resonate with program participants. PMID:27275021

Lunar and Mars Exploration: The Autonomy Factor

NASA Technical Reports Server (NTRS)

Rando, Cynthia M.; Schuh, Susan V.

2008-01-01

Long duration space flight crews have relied heavily on almost constant communication with ground control mission support. Ground control teams provide vehicle status and system monitoring, while offering near real time support for specific tasks, emergencies, and ensuring crew health and well being. With extended exploration goals to lunar and Mars outposts, real time communication with ground control teams and the ground s ability to conduct mission monitoring will be very limited compared to the resources provided to current International Space Station (ISS) crews. An operational shift toward more autonomy and a heavier reliance on the crew to monitor their vehicle and operations will be required for these future missions. NASA s future exploration endeavors and the subsequent increased autonomy will require a shift in crew skill composition, i.e. engineer, doctor, mission specialist etc. and lead to new training challenges and mission scenarios. Specifically, operational and design changes will be necessary in many areas including: Habitat Infrastructure and Support Systems, Crew Composition, Training, Procedures and Mission Planning. This paper will specifically address how to apply ISS lessons learned to further use ISS as a test bed to address decreased amounts of ground support to achieve full autonomous operations for lunar and Mars missions. Understanding these lessons learned and applying them to current operations will help to address the future impacts of increased crew autonomy for the lunar and Mars outposts and pave the way for success in increasingly longer mission durations.

Improving the informed consent process in international collaborative rare disease research: effective consent for effective research

PubMed Central

Gainotti, Sabina; Turner, Cathy; Woods, Simon; Kole, Anna; McCormack, Pauline; Lochmüller, Hanns; Riess, Olaf; Straub, Volker; Posada, Manuel; Taruscio, Domenica; Mascalzoni, Deborah

2016-01-01

The increased international sharing of data in research consortia and the introduction of new technologies for sequencing challenge the informed consent (IC) process, adding complexities that require coordination between research centres worldwide. Rare disease consortia present special challenges since available data and samples may be very limited. Thus, it is especially relevant to ensure the best use of available resources but at the same time protect patients' right to integrity. To achieve this aim, there is an ethical duty to plan in advance the best possible consent procedure in order to address possible ethical and legal hurdles that could hamper research in the future. Therefore, it is especially important to identify key core elements (CEs) to be addressed in the IC documents for international collaborative research in two different situations: (1) new research collections (biobanks and registries) for which information documents can be created according to current guidelines and (2) established collections obtained without IC or with a previous consent that does not cover all CEs. We propose here a strategy to deal with consent in these situations. The principles have been applied and are in current practice within the RD-Connect consortia – a global research infrastructure funded by the European Commission Seventh Framework program but forward looking in terms of issues addressed. However, the principles established, the lessons learned and the implications for future research are of direct relevance to all internationally collaborative rare-disease projects. PMID:26860059

Addressing bystander exposure to agricultural pesticides in life cycle impact assessment.

PubMed

Ryberg, Morten Walbech; Rosenbaum, Ralph K; Mosqueron, Luc; Fantke, Peter

2018-04-01

Residents living near agricultural fields may be exposed to pesticides drifting from the fields after application to different field crops. To address this currently missing exposure pathway in life cycle assessment (LCA), we developed a modeling framework for quantifying exposure of bystanders to pesticide spray drift from agricultural fields. Our framework consists of three parts addressing: (1) loss of pesticides from an agricultural field via spray drift; (2) environmental fate of pesticide in air outside of the treated field; and (3) exposure of bystanders to pesticides via inhalation. A comparison with measured data in a case study on pesticides applied to potato fields shows that our model gives good predictions of pesticide air concentrations. We compared our bystander exposure estimates with pathways currently included in LCA, namely aggregated inhalation and ingestion exposure mediated via the environment for the general population, and general population exposure via ingestion of pesticide residues in consumed food crops. The results show that exposure of bystanders is limited relative to total population exposure from ingestion of pesticide residues in crops, but that the exposure magnitude of individual bystanders can be substantially larger than the exposure of populations not living in the proximity to agricultural fields. Our framework for assessing bystander exposure to pesticide applications closes a relevant gap in the exposure assessment included in LCA for agricultural pesticides. This inclusion aids decision-making based on LCA as previously restricted knowledge about exposure of bystanders can now be taken into account. Copyright © 2018 Elsevier Ltd. All rights reserved.

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.

ASSESSMENT OF DYNAMIC PRA TECHNIQUES WITH INDUSTRY AVERAGE COMPONENT PERFORMANCE DATA

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

Yadav, Vaibhav; Agarwal, Vivek; Gribok, Andrei V.

In the nuclear industry, risk monitors are intended to provide a point-in-time estimate of the system risk given the current plant configuration. Current risk monitors are limited in that they do not properly take into account the deteriorating states of plant equipment, which are unit-specific. Current approaches to computing risk monitors use probabilistic risk assessment (PRA) techniques, but the assessment is typically a snapshot in time. Living PRA models attempt to address limitations of traditional PRA models in a limited sense by including temporary changes in plant and system configurations. However, information on plant component health are not considered. Thismore » often leaves risk monitors using living PRA models incapable of conducting evaluations with dynamic degradation scenarios evolving over time. There is a need to develop enabling approaches to solidify risk monitors to provide time and condition-dependent risk by integrating traditional PRA models with condition monitoring and prognostic techniques. This paper presents estimation of system risk evolution over time by integrating plant risk monitoring data with dynamic PRA methods incorporating aging and degradation. Several online, non-destructive approaches have been developed for diagnosing plant component conditions in nuclear industry, i.e., condition indication index, using vibration analysis, current signatures, and operational history [1]. In this work the component performance measures at U.S. commercial nuclear power plants (NPP) [2] are incorporated within the various dynamic PRA methodologies [3] to provide better estimates of probability of failures. Aging and degradation is modeled within the Level-1 PRA framework and is applied to several failure modes of pumps and can be extended to a range of components, viz. valves, generators, batteries, and pipes.« less

100 Years of the Physics of Diodes

NASA Astrophysics Data System (ADS)

Luginsland, John

2013-10-01

The Child-Langmuir Law (CL), discovered 100 years ago, gives the maximum current that can be transported across a planar diode in the steady state. As a quintessential example of the impact of space-charge shielding near a charged surface, it is central to the studies of high current diodes, such as high power microwave sources, vacuum microelectronics, electron and ion sources, and high current drivers used in high-energy density physics experiments. CL remains a touchstone of fundamental sheath physics, including contemporary studies of nano-scale quantum diodes and plasmonic devices. Its solid state analog is the Mott-Gurney law, governing the maximum charge injection in solids, such as organic materials and other dielectrics, which is important to energy devices, such as solar cells and light-emitting diodes. This paper reviews the important advances in the physics of diodes since the discovery of CL, including virtual cathode formation and extension of CL to multiple dimensions, to the quantum regime, and to ultrafast processes. We will review the influence of magnetic fields, multiple species in bipolar flow, electromagnetic and time dependent effects in both short pulse and high frequency THz limits, and single electron regimes. Transitions from various emission mechanisms (thermionic, field, and photo-emission) to the space charge limited state (CL) will be addressed, especially highlighting important simulation and experimental developments in selected contemporary areas of study. This talk will stress the fundamental physical links between the physics of beams to limiting currents in other areas, such as low temperature plasmas, laser plasmas, and space propulsion. Also emphasized is the role of non-equilibrium phenomena associated with materials and plasmas in close contact. Work supported by the Air Force Office of Scientific Research.

28 CFR Appendix A to Part 74 - Declarations of Eligibility by Persons Identified by the Office of Redress Administration and...

Code of Federal Regulations, 2010 CFR

2010-07-01

... representative. Complete the following information: (1) Current Legal Name: (2) Current Address: Street: City.... app. 1989b. Complete the following information: (1) Current Legal Name: (2) Current Address: Street... to ORA such as the signed statements of two or more people with personal knowledge of the death...

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…

22 CFR 96.32 - Internal structure and oversight.

Code of Federal Regulations, 2011 CFR

2011-04-01

... known, under either its current or any former form of organization, and the addresses and phone numbers used when such names were used; (2) The name, address, and phone number of each current director... number of such other provider; and (3) The name, address, and phone number of any entity it uses or...

22 CFR 96.32 - Internal structure and oversight.

Code of Federal Regulations, 2012 CFR

2012-04-01

... known, under either its current or any former form of organization, and the addresses and phone numbers used when such names were used; (2) The name, address, and phone number of each current director... number of such other provider; and (3) The name, address, and phone number of any entity it uses or...

22 CFR 96.32 - Internal structure and oversight.

Code of Federal Regulations, 2014 CFR

2014-04-01

... known, under either its current or any former form of organization, and the addresses and phone numbers used when such names were used; (2) The name, address, and phone number of each current director... number of such other provider; and (3) The name, address, and phone number of any entity it uses or...

22 CFR 96.32 - Internal structure and oversight.

Code of Federal Regulations, 2013 CFR

2013-04-01

... known, under either its current or any former form of organization, and the addresses and phone numbers used when such names were used; (2) The name, address, and phone number of each current director... number of such other provider; and (3) The name, address, and phone number of any entity it uses or...

Assessing the need for a new nationally representative household panel survey in the United States

PubMed Central

Moffitt, Robert; Schoeni, Robert F.; Brown, Charles; Chase-Lansdale, P. Lindsay; Couper, Mick P.; Diez-Roux, Ana V.; Hurst, Erik; Seltzer, Judith A.

2015-01-01

We introduce this special issue on the critical matter of whether the existing household panel surveys in the U.S. are adequate to address the important emerging social science and policy questions of the next few decades. We summarize the conference papers which address this issue in different domains. The papers detail many new and important emerging research questions but also identify key limitations in existing panels in addressing those questions. To address these limitations, we consider the advantages and disadvantages of initiating a new, general-purpose omnibus household panel in the U.S. We also discuss the particular benefits of starting new panels that have specific targeted domains such as child development, population health and health care. We also develop a list of valuable enhancements to existing panels which could address many of their limitations. PMID:26688609

How Many Wolves (Canis lupus) Fit into Germany? The Role of Assumptions in Predictive Rule-Based Habitat Models for Habitat Generalists

PubMed Central

Fechter, Dominik; Storch, Ilse

2014-01-01

Due to legislative protection, many species, including large carnivores, are currently recolonizing Europe. To address the impending human-wildlife conflicts in advance, predictive habitat models can be used to determine potentially suitable habitat and areas likely to be recolonized. As field data are often limited, quantitative rule based models or the extrapolation of results from other studies are often the techniques of choice. Using the wolf (Canis lupus) in Germany as a model for habitat generalists, we developed a habitat model based on the location and extent of twelve existing wolf home ranges in Eastern Germany, current knowledge on wolf biology, different habitat modeling techniques and various input data to analyze ten different input parameter sets and address the following questions: (1) How do a priori assumptions and different input data or habitat modeling techniques affect the abundance and distribution of potentially suitable wolf habitat and the number of wolf packs in Germany? (2) In a synthesis across input parameter sets, what areas are predicted to be most suitable? (3) Are existing wolf pack home ranges in Eastern Germany consistent with current knowledge on wolf biology and habitat relationships? Our results indicate that depending on which assumptions on habitat relationships are applied in the model and which modeling techniques are chosen, the amount of potentially suitable habitat estimated varies greatly. Depending on a priori assumptions, Germany could accommodate between 154 and 1769 wolf packs. The locations of the existing wolf pack home ranges in Eastern Germany indicate that wolves are able to adapt to areas densely populated by humans, but are limited to areas with low road densities. Our analysis suggests that predictive habitat maps in general, should be interpreted with caution and illustrates the risk for habitat modelers to concentrate on only one selection of habitat factors or modeling technique. PMID:25029506

Strategies to Build Readiness in Community Mobilization Efforts for Implementation in a Multi-Year Teen Pregnancy Prevention Initiative.

PubMed

Bhuiya, Nazmim; House, L Duane; Desmarais, Jeffrey; Fletcher, Erica; Conlin, Maeve; Perez-McAdoo, Sarah; Waggett, Jessica; Tendulkar, Shalini A

2017-03-01

This paper describes an assessment of community readiness to implement a community-wide teen pregnancy prevention initiative, Youth First, and presents strategies used to enhance this readiness as informed by the assessment. Twenty-five community stakeholder interviews were conducted to assess four domains of readiness: (1) attitudes, perception, and knowledge of teen pregnancy; (2) perceived level of readiness; (3) resources, existing and current efforts; and (4) leadership. Interview transcripts were coded and analyzed to identify key themes. Stakeholders acknowledged teen pregnancy as an issue but lacked contextual information. They also perceived the community as ready to address the issue and recognized some organizations already championing efforts. However, many key players were not involved, and ongoing data collection to assess teen pregnancy and prevention efforts was limited. Though many stakeholders were ready to engage in teen pregnancy prevention efforts, they required additional information and training to appropriately address the issue. In response to the assessment findings, several strategies were applied to address readiness and build Youth First partners' capacity to implement the community-wide initiative. Thus, to successfully implement community-wide prevention efforts, it is valuable to assess the level of community readiness to address health issues. Copyright © 2016 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

Delivering an action agenda for nutrition interventions addressing adolescent girls and young women: priorities for implementation and research.

PubMed

Bhutta, Zulfiqar A; Lassi, Zohra S; Bergeron, Gilles; Koletzko, Berthold; Salam, Rehana; Diaz, Angela; McLean, Mireille; Black, Robert E; De-Regil, Luz Maria; Christian, Parul; Prentice, Andrew M; Klein, Jonathan D; Keenan, William; Hanson, Mark

2017-04-01

Adolescent nutritional behaviors are assuming considerable importance in nutrition interventions given their important relationships with medium- and long-term outcomes. This is the period when young people undergo major anatomical and physiological maturational changes in preparation for adulthood. Nutritional requirements during puberty are higher during adolescence than during the prepubertal stage and during adulthood. A significant proportion of adolescents also become parents, and hence the importance of their health and nutritional status before as well as during pregnancy has its impact on their own health, fetal well-being, and newborn health. In this paper, we describe the evidence-based nutrition recommendations and the current global guidance for nutrition actions for adolescents. Despite the limitations of available information, we believe that a range of interventions are feasible to address outcomes in this age group, although some would need to start earlier in childhood. We propose packages of preventive care and management comprising nutrition-specific and nutrition-sensitive interventions to address adolescent undernutrition, overnutrition, and micronutrient deficiencies. We discuss potential delivery platforms and strategies relevant to low- and middle-income countries. Beyond the evidence synthesis, there is a clear need to translate evidence into policy and for implementation of key recommendations and addressing knowledge gaps through prioritized research. © 2017 New York Academy of Sciences.

Research on the effects of integrated resorts in Korea on gambling addiction

PubMed Central

Jin, Chan-Ho

2015-01-01

This research discusses the effects of the integrated resorts centered around casinos being implemented in Korea. It particularly focuses on the symptoms and most recent definitions of gambling addiction such as physiological or psychological dependence from excessive gambling. This paper suggests that there is a high prevalence rate of pathological gambling in Korea. It provides an argument for prevention, early detection, and lastly, active and voluntary treatment. Furthermore, the study addresses the physiological pathway of gambling addiction and the physiological factors of gambling addicts to suggest exercise rehabilitation that are currently limited to psychological treatments. PMID:26331132

Research on the effects of integrated resorts in Korea on gambling addiction.

PubMed

Jin, Chan-Ho

2015-08-01

This research discusses the effects of the integrated resorts centered around casinos being implemented in Korea. It particularly focuses on the symptoms and most recent definitions of gambling addiction such as physiological or psychological dependence from excessive gambling. This paper suggests that there is a high prevalence rate of pathological gambling in Korea. It provides an argument for prevention, early detection, and lastly, active and voluntary treatment. Furthermore, the study addresses the physiological pathway of gambling addiction and the physiological factors of gambling addicts to suggest exercise rehabilitation that are currently limited to psychological treatments.

Complementary and alternative medical therapies for attention-deficit/hyperactivity disorder and autism.

PubMed

Weber, Wendy; Newmark, Sanford

2007-12-01

Complementary and alternative medical (CAM) therapies are commonly used by parents for their children who have attention deficit hyperactivity disorder (ADHD) or autism spectrum disorders. The use of these therapies is well documented, yet the evidence of the safety and efficacy of these treatments in children is limited. This article describes the current evidence-based CAM therapies for ADHD and autism, focusing on nutritional interventions; natural health products, including essential fatty acids, vitamins, minerals, and other health supplements; biofeedback; and reducing environmental toxins. The CAM evidence in ADHD is addressed, as is the CAM literature in autism.

Post-traumatic hypopituitarism and fatigue.

PubMed

Masel, Brent E; Zgaljardic, Dennis J; Forman, Jack

2017-10-01

Post-traumatic hypopituitarism (PTH) associated with chronic cognitive, psychiatric, and/or behavioural sequelae is common following moderate to severe traumatic brain injury (TBI). More specifically, due to a cascade of hormonal deficiencies secondary to PTH, individuals with TBI may experience debilitating fatigue that can negatively impact functional recovery, as it can limit participation in brain injury rehabilitation services and lead to an increase in maladaptive lifestyle practices. While the mechanisms underlying fatigue and TBI are not entirely understood, the current review will address the specific anatomy and physiology of the pituitary gland, as well as the association between pituitary dysfunction and fatigue in individuals with TBI.

Computational Fluid Dynamics Technology for Hypersonic Applications

NASA Technical Reports Server (NTRS)

Gnoffo, Peter A.

2003-01-01

Several current challenges in computational fluid dynamics and aerothermodynamics for hypersonic vehicle applications are discussed. Example simulations are presented from code validation and code benchmarking efforts to illustrate capabilities and limitations. Opportunities to advance the state-of-art in algorithms, grid generation and adaptation, and code validation are identified. Highlights of diverse efforts to address these challenges are then discussed. One such effort to re-engineer and synthesize the existing analysis capability in LAURA, VULCAN, and FUN3D will provide context for these discussions. The critical (and evolving) role of agile software engineering practice in the capability enhancement process is also noted.

Ultrahigh field MRI in clinical neuroimmunology: a potential contribution to improved diagnostics and personalised disease management.

PubMed

Sinnecker, Tim; Kuchling, Joseph; Dusek, Petr; Dörr, Jan; Niendorf, Thoralf; Paul, Friedemann; Wuerfel, Jens

2015-01-01

Conventional magnetic resonance imaging (MRI) at 1.5 Tesla (T) is limited by modest spatial resolution and signal-to-noise ratio (SNR), impeding the identification and classification of inflammatory central nervous system changes in current clinical practice. Gaining from enhanced susceptibility effects and improved SNR, ultrahigh field MRI at 7 T depicts inflammatory brain lesions in great detail. This review summarises recent reports on 7 T MRI in neuroinflammatory diseases and addresses the question as to whether ultrahigh field MRI may eventually improve clinical decision-making and personalised disease management.

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.

Multidimensional materials and device architectures for future hybrid energy storage

DOE PAGES

Lukatskaya, Maria R.; Dunn, Bruce; Gogotsi, Yury

2016-09-07

Electrical energy storage plays a vital role in daily life due to our dependence on numerous portable electronic devices. Moreover, with the continued miniaturization of electronics, integration of wireless devices into our homes and clothes and the widely anticipated ‘Internet of Things’, there are intensive efforts to develop miniature yet powerful electrical energy storage devices. Here, this review addresses the cutting edge of electrical energy storage technology, outlining approaches to overcome current limitations and providing future research directions towards the next generation of electrical energy storage devices whose characteristics represent a true hybridization of batteries and electrochemical capacitors.

Enhanced resolution and accuracy of freeform metrology through Subaperture Stitching Interferometry

NASA Astrophysics Data System (ADS)

Supranowitz, Chris; Maloney, Chris; Murphy, Paul; Dumas, Paul

2017-10-01

Recent advances in polishing and metrology have addressed many of the challenges in the fabrication and metrology of freeform surfaces, and the manufacture of these surfaces is possible today. However, achieving the form and mid-spatial frequency (MSF) specifications that are typical of visible imaging systems remains a challenge. Interferometric metrology for freeform surfaces is thus highly desirable for such applications, but the capability is currently quite limited for freeforms. In this paper, we provide preliminary results that demonstrate accurate, high-resolution measurements of freeform surfaces using prototype software on QED's ASI™ (Aspheric Stitching Interferometer).

System data communication structures for active-control transport aircraft, volume 1

NASA Technical Reports Server (NTRS)

Hopkins, A. L.; Martin, J. H.; Brock, L. D.; Jansson, D. G.; Serben, S.; Smith, T. B.; Hanley, L. D.

1981-01-01

Candidate data communication techniques are identified, including dedicated links, local buses, broadcast buses, multiplex buses, and mesh networks. The design methodology for mesh networks is then discussed, including network topology and node architecture. Several concepts of power distribution are reviewed, including current limiting and mesh networks for power. The technology issues of packaging, transmission media, and lightning are addressed, and, finally, the analysis tools developed to aid in the communication design process are described. There are special tools to analyze the reliability and connectivity of networks and more general reliability analysis tools for all types of systems.

Multidimensional materials and device architectures for future hybrid energy storage

NASA Astrophysics Data System (ADS)

Lukatskaya, Maria R.; Dunn, Bruce; Gogotsi, Yury

2016-09-01

Electrical energy storage plays a vital role in daily life due to our dependence on numerous portable electronic devices. Moreover, with the continued miniaturization of electronics, integration of wireless devices into our homes and clothes and the widely anticipated `Internet of Things', there are intensive efforts to develop miniature yet powerful electrical energy storage devices. This review addresses the cutting edge of electrical energy storage technology, outlining approaches to overcome current limitations and providing future research directions towards the next generation of electrical energy storage devices whose characteristics represent a true hybridization of batteries and electrochemical capacitors.

Chemotherapy-Induced Peripheral Neuropathy: A Current Review

PubMed Central

Staff, Nathan P.; Grisold, Anna; Grisold, Wolfgang; Windebank, Anthony J.

2017-01-01

Chemotherapy-induced peripheral neuropathy (CIPN) is a common dose-limiting side effect experienced by patients receiving treatment for cancer. Approximately 30–40% of patients treated with neurotoxic chemotherapy will develop CIPN and there is considerable variability in its severity between patients. It is often sensory-predominant with pain and can lead to long-term morbidity in survivors. The prevalence and burden of CIPN late effects will likely increase as cancer survival rates continue to improve. In this review, we discuss the approach to peripheral neuropathy in patients with cancer and address the clinical phenotypes and pathomechanisms of specific neurotoxic chemotherapeutic agents. PMID:28486769

Multidimensional materials and device architectures for future hybrid energy storage

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

Lukatskaya, Maria R.; Dunn, Bruce; Gogotsi, Yury

Electrical energy storage plays a vital role in daily life due to our dependence on numerous portable electronic devices. Moreover, with the continued miniaturization of electronics, integration of wireless devices into our homes and clothes and the widely anticipated ‘Internet of Things’, there are intensive efforts to develop miniature yet powerful electrical energy storage devices. Here, this review addresses the cutting edge of electrical energy storage technology, outlining approaches to overcome current limitations and providing future research directions towards the next generation of electrical energy storage devices whose characteristics represent a true hybridization of batteries and electrochemical capacitors.

Perpendicular Magnetic Anisotropy in Ultrathin Co/Ni Multilayer Films Studies with Ferromagnetic Resonance and Magnetic X-Ray Microspectroscopy

DTIC Science & Technology

2012-06-28

a collection of information if it does not display a currently valid OMB control number . PLEASE DO NOT RETURN YOUR FORM TO THE ABOVE ADDRESS. a...REPORT TYPE New Reprint 17. LIMITATION OF ABSTRACT UU 15. NUMBER OF PAGES 5d. PROJECT NUMBER 5e. TASK NUMBER 5f. WORK UNIT NUMBER 5c. PROGRAM...ELEMENT NUMBER 5b. GRANT NUMBER 5a. CONTRACT NUMBER W911NF-08-1-0317 611103 Form Approved OMB NO. 0704-0188 54223-MS-MUR.32 11. SPONSOR/MONITOR’S

Development of a Microprocessor-Based Asynchronous Data Communications Line Tester.

DTIC Science & Technology

1981-12-01

either RS232 or 20 mA current loop 13. Current loop optically isolated 14. Current loop selectable for either active or pasive mode 15. Address...Executin Invoking the execution of the software is therefore a matter of power-up and reset. The software will wait for a response from the console (any key...SIO has two channels as previously mentioned. Addressing the SIO then is a matter of addressing these two channels. The port addrecses are user defined

Comparative investigation of the energetic ion spectra comprising the magnetospheric ring currents of the solar system

PubMed Central

Mauk, B H

2014-01-01

Investigated here are factors that control the intensities and shapes of energetic ion spectra that make up the ring current populations of the strongly magnetized planets of the solar system, specifically those of Earth, Jupiter, Saturn, Uranus, and Neptune. Following a previous and similar comparative investigation of radiation belt electrons, we here turn our attention to ions. Specifically, we examine the possible role of the differential ion Kennel-Petschek limit, as moderated by Electromagnetic Ion Cyclotron (EMIC) waves, as a standard for comparing the most intense ion spectra within the strongly magnetized planetary magnetospheres. In carrying out this investigation, the substantial complexities engendered by the very different ion composition distributions of these diverse magnetospheres must be addressed, given that the dispersion properties of the EMIC waves are strongly determined by the ion composition of the plasmas within which the waves propagate. Chosen for comparison are the ion spectra within these systems that are the most intense observed, specifically at 100 keV and 1 MeV. We find that Earth and Jupiter are unique in having their most intense ion spectra likely limited and sculpted by the Kennel-Petschek process. The ion spectra of Saturn, Uranus, and Neptune reside far below their respective limits and are likely limited by interactions with gas and dust (Saturn) and by the absence of robust ion acceleration processes (Uranus and Neptune). Suggestions are provided for further testing the efficacy of the differential Kennel-Petschek limit for ions using the Van Allen Probes. PMID:26167438

The limits of palaeontological knowledge: finding the gold among the dross

NASA Technical Reports Server (NTRS)

Knoll, A. H.; Walter, M. R.

1996-01-01

Palaeontological interpretation rests on two interwoven sets of comparisons with the modern world. Palaeobiological interpretation relies on the placement of fossils within a phylogenetic and functional framework based primarily on the comparative biology of living organisms. Analogy to currently observable chemical, physical and taphonomic processes enables palaeoenvironmental inferences to be drawn from geological data. In older rocks, comparisons with the modern Earth can become tenuous, limiting palaeontological interpretation. The problem reaches its apogee in Archaean successions, yet pursuit of multiple lines of evidence establishes that complex microbial communities, fuelled by autotrophy and, likely, photoautotrophy, existed 3500 million years ago. Although Archaean palaeontology has to date focused on silicified coastal sediments, improved understanding of Earth's earliest biosphere may depend on the development of alternative environmental and taphonomic analogies. Spring precipitates and hydrothermal metal deposits are promising candidates. Terrestrial organisms may be of limited value in interpreting such fossils as may be found on Mars, although some points of comparison could prove general. Given limited opportunities for exploration, proper choice of environmental analogy is critical. Spring precipitates constitute excellent deposits for addressing questions of biology on another planet.

Revising the personality disorder diagnostic criteria for the Diagnostic and Statistical Manual of Mental Disorders-Fifth Edition (DSM-V): consider the later life context.

PubMed

Balsis, Steve; Segal, Daniel L; Donahue, Cailin

2009-10-01

The categorical measurement approach implemented by the Diagnostic and Statistical Manual of Mental Disorders-Fourth Edition (DSM-IV) personality disorder (PD) diagnostic system is theoretically and pragmatically limited. As a result, many prominent psychologists now advocate for a shift away from this approach in favor of more conceptually sound dimensional measurement. This shift is expected to improve the psychometric properties of the personality disorder (PD) diagnostic system and make it more useful for clinicians and researchers. The current article suggests that despite the probable benefits of such a change, several limitations will remain if the new diagnostic system does not closely consider the context of later life. A failure to address the unique challenges associated with the assessment of personality in older adults likely will result in the continued limited validity, reliability, and utility of the Diagnostic and Statistical Manual of Mental Disorders (DSM) system for this growing population. This article discusses these limitations and their possible implications. (c) 2009 APA, all rights reserved.

Overcoming Language and Literacy Barriers in Safety and Health Training of Agricultural Workers

PubMed Central

Arcury, Thomas A.; Estrada, Jorge M.; Quandt, Sara A.

2010-01-01

The workforce in all areas of United States agriculture and forestry is becoming increasingly diverse in language, culture, and education. Many agricultural workers are immigrants who have limited English language skills and limited educational attainment. Providing safety and health training to this large, diverse, dispersed, and often transient population of workers is challenging. This review, prepared for the 2010 Agricultural Safety and Health Council of America/National Institute for Occupational Safety and Health conference, “Be Safe, Be Profitable: Protecting Workers in Agriculture,” is divided into five sections. First, we describe the occupational and demographic characteristics of agricultural workers in the US to highlight their safety and health training needs. Second, we summarize current research on the social and cultural attributes of agricultural workers and agricultural employers that affect the provision of safety and health training. Worker and employer attributes include language, literacy, financial limitations, work beliefs, and health beliefs. Third, we review current initiatives addressing safety and health training for agricultural workers that consider worker language and literacy. These initiatives are limited to a few specific topics (e.g., pesticides, heat stress); they do not provide general programs of safety training that would help establish a culture of workplace safety. However, several innovative approaches to health and safety training are being implemented, including the use of community-based participatory approaches and lay health promoter programs. Fourth, the limited industry response for safety training with this linguistically diverse and educationally limited workforce is summarized. Finally, gaps in knowledge and practice are summarized and recommendations to develop educationally, culturally, and linguistically appropriate safety and health training are presented. PMID:20665309

Evaluating a scalable model for implementing electronic health records in resource-limited settings.

PubMed

Were, Martin C; Emenyonu, Nneka; Achieng, Marion; Shen, Changyu; Ssali, John; Masaba, John P M; Tierney, William M

2010-01-01

Current models for implementing electronic health records (EHRs) in resource-limited settings may not be scalable because they fail to address human-resource and cost constraints. This paper describes an implementation model which relies on shared responsibility between local sites and an external three-pronged support infrastructure consisting of: (1) a national technical expertise center, (2) an implementer's community, and (3) a developer's community. This model was used to implement an open-source EHR in three Ugandan HIV-clinics. Pre-post time-motion study at one site revealed that Primary Care Providers spent a third less time in direct and indirect care of patients (p<0.001) and 40% more time on personal activities (p=0.09) after EHRs implementation. Time spent by previously enrolled patients with non-clinician staff fell by half (p=0.004) and with pharmacy by 63% (p<0.001). Surveyed providers were highly satisfied with the EHRs and its support infrastructure. This model offers a viable approach for broadly implementing EHRs in resource-limited settings.

The South Carolina bridge-scour envelope curves

USGS Publications Warehouse

Benedict, Stephen T.; Feaster, Toby D.; Caldwell, Andral W.

2016-09-30

The U.S. Geological Survey, in cooperation with the South Carolina Department of Transportation, conducted a series of three field investigations to evaluate historical, riverine bridge scour in the Piedmont and Coastal Plain regions of South Carolina. These investigations included data collected at 231 riverine bridges, which lead to the development of bridge-scour envelope curves for clear-water and live-bed components of scour. The application and limitations of the South Carolina bridge-scour envelope curves were documented in four reports, each report addressing selected components of bridge scour. The current investigation (2016) synthesizes the findings of these previous reports into a guidance manual providing an integrated procedure for applying the envelope curves. Additionally, the investigation provides limited verification for selected bridge-scour envelope curves by comparing them to field data collected outside of South Carolina from previously published sources. Although the bridge-scour envelope curves have limitations, they are useful supplementary tools for assessing the potential for scour at riverine bridges in South Carolina.

[Stress at the emergency service: possibilities and limits of new managerial strategies].

PubMed

Boller, Erika

2003-12-01

The current study with health professionals from an emergency service intended to identify stress-precipitating factors and to evidence possible managerial and political alternatives in order to minimize the intensity of stress symptoms. The data were collected through a semi-structured interview and, later on, complemented by observation. As found out, the working environment is an agent that causes stress, resulting from daily circumstances faced through factors from the working environment as well as from subjective ones. Neither factors from the context and from the working environment nor anti-stress care performed by the workers were observed. Considering the local reality, possibilities and limits are presented for the implementation and direction of political strategies addressed to the higher administration and for the development of institutional and personal strategies that allow coping stress.

Need for "conflict version" of primary surgery: war surgery in the era of low-intensity conflicts.

PubMed

Morikawa, Masahiro J

2006-01-01

The conventional wars between nations have widely been replaced by low-intensity conflicts within nations today, resulting in different patterns of injuries and practice of surgical care. A blurred front line, protracted durations of violence, indiscriminant fighting, and the emergence of specific surgical problems characterize low-intensity conflicts. In protracted conflicts with limited resources, surgical outcomes depend on many factors other than surgical skills, such as social/cultural values and economical feasibility. This paper examines how the characteristics of current conflicts affect surgical practice and will address key issues to evolve care to adapt to these changes. Key issues are (1) need for comprehensive surgical skills, (2) importance of improving local capacities, (3) long-term impact of trauma, and (4) limited access to information required to improve surgical skills.

The Parity Paradigm: Can Legislation Help Reduce the Cost Burden of Oral Anticancer Medications?

PubMed

Kircher, Sheetal M; Meeker, Caitlin R; Nimeiri, Halla; Geynisman, Daniel M; Zafar, S Yousuf; Shankaran, Veena; de Souza, Jonas; Wong, Yu-Ning

2016-01-01

Over the last decade, there has been increased development and use of oral anticancer medications, which sometimes leads to high cost sharing for patients. Drug parity laws require insurance plans to cover oral anticancer medications with the same cost sharing as intravenous/injected chemotherapy or have a capped limit on out-of-pocket costs. There are currently 36 enacted state laws (plus the District of Columbia) addressing drug parity, but no federal laws. In this policy perspective piece, we discuss the history, opportunities, and limitations of drug parity laws in oncology. We also discuss the implications of provisions of the Affordable Care Act and other proposed policy reforms on financing oral chemotherapy. Copyright © 2016 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

Thinking about a limited future enhances the positivity of younger and older adults' recall: Support for socioemotional selectivity theory.

PubMed

Barber, Sarah J; Opitz, Philipp C; Martins, Bruna; Sakaki, Michiko; Mather, Mara

2016-08-01

Compared with younger adults, older adults have a relative preference to attend to and remember positive over negative information. This is known as the "positivity effect," and researchers have typically evoked socioemotional selectivity theory to explain it. According to socioemotional selectivity theory, as people get older they begin to perceive their time left in life as more limited. These reduced time horizons prompt older adults to prioritize achieving emotional gratification and thus exhibit increased positivity in attention and recall. Although this is the most commonly cited explanation of the positivity effect, there is currently a lack of clear experimental evidence demonstrating a link between time horizons and positivity. The goal of the current research was to address this issue. In two separate experiments, we asked participants to complete a writing activity, which directed them to think of time as being either limited or expansive (Experiments 1 and 2) or did not orient them to think about time in a particular manner (Experiment 2). Participants were then shown a series of emotional pictures, which they subsequently tried to recall. Results from both studies showed that regardless of chronological age, thinking about a limited future enhanced the relative positivity of participants' recall. Furthermore, the results of Experiment 2 showed that this effect was not driven by changes in mood. Thus, the fact that older adults' recall is typically more positive than younger adults' recall may index naturally shifting time horizons and goals with age.

Education and technology used to improve the quality of life for people with diabetes mellitus type II.

PubMed

Dudley, Brooke; Heiland, Brianne; Kohler-Rausch, Elizabeth; Kovic, Mark

2014-01-01

The incidence of type II diabetes mellitus (DMT2) is expected to continue to rise. Current research has analyzed various tools, strategies, programs, barriers, and support in regards to the self-management of this condition. However, past researchers have yet to analyze the education process; including the adaptation of specific strategies in activities of daily living and roles, as well as the influence of health care providers in the integration of these strategies. The purpose of this qualitative case study was to identify the strengths and limitations of the current model of diabetes education in the United States and hypothesize how technology can impact quality of life. Key informants on diabetes education were recruited from diabetes education centers through the American Association of Diabetes Educators. Semi-structured interviews were conducted with participants. Health care practitioners convey limited knowledge of DMT2. Individuals with DMT2 often have limited understanding of the implications of poor self-management. There appears to be no consistent standard of care for how to effectively incorporate self-management strategies. There is limited education for the use of technology in self-management. Diabetes educators describe that technology could be beneficial. Findings suggest the importance of the role of care providers in emphasizing the implications of poor self-management strategies; that a multidisciplinary approach may enhance the education process; and a need for further developments in technology to address DMT2 self-management strategies.

New views on global child health: global solutions for care of vulnerable children in the United States.

PubMed

Uwemedimo, Omolara T; Arora, Gitanjli; Russ, Christiana M

2016-10-01

This paper provides a brief overview of the current landscape of global child health and the impact of social determinants on the world's children. In the United States (US), global child health (GCH) has increasingly been highlighted as a priority area by national organizations, such as the National Academy of Medicine and American Academy of Pediatrics, as well as individual pediatricians committed to ensuring the health of all children regardless of geographic location. Although GCH is commonly used to refer to the health of children outside of the US, here, we highlight the recent call for GCH to also include care of US vulnerable children. Many of the lessons learned from abroad can be applied to pediatrics domestically by addressing social determinants that contribute to health disparities. Using the 'three-delay' framework, effective global health interventions target delays in seeking, accessing, and/or receiving adequate care. In resource-limited, international settings, novel health system strengthening approaches, such as peer groups, community health workers, health vouchers, cultural humility training, and provision of family-centered care, can mitigate barriers to healthcare and improve access to medical services. The creative use of limited resources for pediatric care internationally may offer insight into effective strategies to address health challenges that children face here in the US. The growing number of child health providers with clinical experience in resource-limited, low-income countries can serve as an unforeseen yet formidable resource for improving pediatric care in underserved US communities.

Patterns in workplace accommodations for people with multiple sclerosis to overcome cognitive and other disease-related limitations.

PubMed

Leslie, Mykal; Kinyanjui, Benson; Bishop, Malachy; Rumrill, Phillip D; Roessler, Richard T

2015-01-01

Cognitive symptoms and other functional limitations associated with multiple sclerosis (MS) have a significant negative impact on employment status. Work accommodations positively impact the ability of a person with MS to obtain and retain employment, however, current understanding of the role of accommodations in the careers of adults with MS is limited. To analyze the percentage of American workers with MS who utilize workplace accommodations as per Title I of the ADA, the types of accommodations most frequently required, and differences in disease variables, job-related factors, and quality of life between workers using and not using work accommodations. Data from 746 employed adult members of the National MS Society surveyed about career concerns were analyzed. Descriptive and inferential statistics were used as appropriate to address the research questions. Approximately 25% reported having requested accommodations, and 87.7% reported receiving the requested accommodation. Participants with progressive MS, cognitive impairment, higher number of MS symptoms and greater symptom severity were more likely to use work accommodations. Participants with accommodations reported poorer job match and career optimism than those using no accommodations. This large-scale analysis addresses several outstanding questions concerning work accommodations among workers with MS. Cognitive symptoms and disease severity are strongly associated with need for accommodations, however accommodations do not appear to promote job satisfaction or longevity. The accommodation request process and the impact of accommodations on employment retention remain important research foci.

A survey of synthetic cannabinoid consumption by current cannabis users.

PubMed

Gunderson, Erik W; Haughey, Heather M; Ait-Daoud, Nassima; Joshi, Amruta S; Hart, Carl L

2014-01-01

Despite growing concern about the increased rates of synthetic cannabinoid (SC) use and their effects, only limited data are available that addresses these issues. This study assessed the extent of SC product use and reported effects among a cohort of adult marijuana and tobacco users. A brief telephone interview was conducted with individuals who had given permission to be contacted for future research while screening for a cannabis/nicotine dependence medication development study (NCT01204723). Respondents (N = 42; 88% participation rate) were primarily young adults, male, racially diverse, and high school graduates. Nearly all currently smoked tobacco and cannabis, with 86% smoking cannabis on 5 or more days per week. Nearly all (91%) were familiar with SC products, half (50%) reported smoking SC products previously, and a substantial minority (24%) reported current use (i.e., past month). Despite a federal ban on 5 common SCs, which went into effect on March 1, 2011, a number of respondents reported continued SC product use. Common reasons reported for use included, but were not limited to, seeking a new "high" similar to that produced by marijuana and avoiding drug use detection via a positive urine screen. The primary side effects were trouble thinking clearly, headache, dry mouth, and anxiety. No significant differences were found between synthetic cannabinoid product users (ever or current) and nonusers by demographics or other characteristics. Among current marijuana and tobacco users, SC product consumption was common and persisted despite a federal ban. The primary reasons for the use of SC-containing products seem to be to evade drug detection and to experience a marijuana-like high.

Evidence-based recommendations for the prescription of exercise for major depressive disorder.

PubMed

Rethorst, Chad D; Trivedi, Madhukar H

2013-05-01

Major depressive disorder (MDD) is a source of great disease burden, due in part to the limited accessibility and effectiveness of current treatments. Although current treatments are efficacious in a segment of the population with MDD, there is a clear need for alternative and augmentation treatment strategies. Exercise is one such alternative treatment option. Research has shown exercise to be efficacious as both a stand-alone and an augmentation therapy. As a result, exercise is now included in the American Psychiatric Association's treatment recommendations. The purpose of this article is to provide clinicians with a knowledge base to prescribe exercise to their patients. The authors describe the evidence supporting the use of exercise in the treatment of MDD, provide evidence-based recommendations for prescribing exercise, and address practical considerations related to prescribing exercise in real-world treatment settings.

The Strengths and Limitations of South Africa's Search for Apartheid-Era Missing Persons.

PubMed

Aronson, Jay D

2011-07-01

This article examines efforts to account for missing persons from the apartheid era in South Africa by family members, civil society organizations and the current government's Missing Persons Task Team, which emerged out of the Truth and Reconciliation Commission process. It focuses on how missing persons have been officially defined in the South African context and the extent to which the South African government is able to address the current needs and desires of relatives of the missing. I make two main arguments: that family members ought to have an active role in shaping the initiatives and institutions that seek to resolve the fate of missing people, and that the South African government ought to take a more holistic 'grave-to-grave' approach to the process of identifying, returning and reburying the remains of the missing.

Non-invasive prenatal testing for fetal chromosome abnormalities: review of clinical and ethical issues

PubMed Central

Gekas, Jean; Langlois, Sylvie; Ravitsky, Vardit; Audibert, François; van den Berg, David Gradus; Haidar, Hazar; Rousseau, François

2016-01-01

Genomics-based non-invasive prenatal screening using cell-free DNA (cfDNA screening) was proposed to reduce the number of invasive procedures in current prenatal diagnosis for fetal aneuploidies. We review here the clinical and ethical issues of cfDNA screening. To date, it is not clear how cfDNA screening is going to impact the performances of clinical prenatal diagnosis and how it could be incorporated in real life. The direct marketing to users may have facilitated the early introduction of cfDNA screening into clinical practice despite limited evidence-based independent research data supporting this rapid shift. There is a need to address the most important ethical, legal, and social issues before its implementation in a mass setting. Its introduction might worsen current tendencies to neglect the reproductive autonomy of pregnant women. PMID:26893576

Work Package 5: Contingency Management. Mission Planning Requirements Document: Preliminary Version. Revision A

NASA Technical Reports Server (NTRS)

2005-01-01

The purpose of this document is to identify the general flight/mission planning requirements for same-day file-and-fly access to the NAS for both civil and military High-Altitude Long Endurance (HALE) Unmanned Aircraft System (UAS). Currently the scope of this document is limited to Step 1, operations above flight level 43,000 feet (FL430). This document describes the current applicable mission planning requirements and procedures for both manned and unmanned aircraft and addresses HALE UAS flight planning considerations in the future National Airspace System (NAS). It also discusses the unique performance and operational capabilities of HALE UAS associated with the Access 5 Project, presents some of the projected performance characteristics and conceptual missions for future systems, and provides detailed analysis of the recommended mission planning elements for operating HALE UAS in the NAS.

Deaf Education in a Planetarium

NASA Astrophysics Data System (ADS)

Liu, Muxue; Hintz, E. G.; Jones, M.; Lawler, J.; Fisler, A.; Mumford, H.

2013-01-01

Over the years we have struggled with the difficulty of giving a planetarium show to a deaf audience. This is especially true for a younger audience with limited reading abilities. You must illuminate the ASL signer which causes light splash onto the dome. You must slow the presentation down to allow for time to interpret and then point. A slower presentation can have an adverse impact on the learning of the hearing students if the presentation is made to a mixed audience. To address these issues, we are currently working on methods to improve deaf education in a planetarium environment. We will present an overview of the current project along with efforts to establish baselines comprehension levels for both deaf and hearing children. This work is partially funded by an NSF IIS-1124548 grant and funding from the Sorenson Foundation.